bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Influence Of The Infusion Of Ephedrine And Phenylephrine On The Hemodynamic Stability After Subarachnoid Anesthesia In Senior Adults - A Controlled Randomized Study
Authors: Žunić Miodrag Vojislav , Škvarč Nevenka Krčevski , Kamenik Mirt 
Published: July 2019

Abstract
ABSTRACT
Study objective: We studied the influence of ephedrine or phenylephrine infusion given immediately after spinal anesthesia (SA) on hemodynamics in elderly orthopedic patients.
Design: A prospective, randomized, double-blind, placebo-controlled study.
Intervention: After subarachnoid injection of 15 mg of levobupivacaine the participants received either an infusion of ephedrine 20 mg (E group), phenylephrine 250 mcg (P group) or saline (C group) within 30 minutes. For 15 minutes before and and 30 minutes after SA we measured blood pressure, cardiac index (CI) and heart rate (HR).
Results
70 patients were included in the final analysis. At the end of measurements mean arterial pressure decreased significantly after SA in comparison to baseline in the C group but was maintained in the P and the E group, with no significant differences between the groups. CI decreased after SA in the C group was maintained in the P group and increased significantly in the E group, with significant differences between the C and the E group (p=0.049) and between the P and the E (p=0.01) group at the end of measurements. HR decreased significantly after SA in the C and the P group and was maintained in the E group, with significant differences between the P and the E group (p=0.033) at the end of measurements.
Conclusions
Hemodynamic changes after SA in elderly orthopedic patients can be prevented by an immediate infusion of phenylephrine or ephedrine. In addition to maintaining blood pressure the ephedrine infusion also maintains HR and increases CI after spinal anaesthesia.

Key words: spinal anesthesia, hemodynamic stability, phenylephrine, ephedrine

Trial registration: ISRCTN registry ISRCTN44377602. Registered on 15 June 2017.
Retroclavicular vs Infraclavicular block For Upper Limb Anesthesia: A Multi-Centric Randomized Trial
Authors: Blanco Andres Felipe Gil , Laferriere-Langlois Pascal , Jessop David , D’Aragon Frederick , Sansoucy Yanick , Albert Natalie , Tétreault Pascal , Echave Pablo 
Published: July 2019

Abstract
Background: The coracoid approach is a simple method to perform ultrasound-guided brachial plexus regional anesthesia (RA) but its simplicity is counterbalanced by a difficult needle visualization. We hypothesized that the retroclavicular (RCB) approach is not longer to perform when compared to the coracoid (ICB) approach, and improves needle visualization.
Methods: This randomized, controlled, non-inferiority trail conducted in two hospitals, included patients undergoing distal upper limb surgery. Patients were randomly assigned to a brachial plexus block (ICB or RCB). The primary outcome was performance time (sum of visualization and needling time), and was analyzed with a non-inferiority test of averages. Depth of sensory and motor blockade, surgical success, total anesthesia time, needle visualization, number of needle passes and complications were also evaluated. Subgroup analysis restricted to patients with higher body mass index was completed.
Results: We included 109 patients between September 2016 and May 2017. Mean RCB performance time was 7.1% shorter than ICB (retro: 4.8 ± 2.0 min; infra: 5.2 ± 2.3 min, p=0.06) with a 95% CI reaching up to 5.8% longer. RCB conferred an ultrasound-needle angle closer to 0° and significantly improved needle visibility after the clavicle was cleared and before local anesthetic administration. No differences were found in the secondary outcomes. Similar results were found in the subgroup analysis.
Conclusion: In patients undergoing distal upper limb surgery with an infraclavicular anesthesia, performance time with RCB approach was deemed clinically similar to ICB approach while improving needle visibility.
Clinical Trial Registration: ClinicalTrials.gov (NCT02913625), registered 26 September 2016
Completion rate of Physician Orders for Life-Sustaining Treatment for patients with metastatic or recurrent cancer: A cross-sectional study
Authors: Kim Ju Won , Choi Jung Yoon , Jang Won Jin , Choi Yoon Ji , Choi Youn Seon , Shin Sang Won , Kim Yeul Hong , Park Kyong Hwa 
Published: July 2019

Abstract
Background: “End of life” is a difficult topic of conversation in East Asian cultures, even among patients and doctors who share a good rapport. In 2016, the Hospice, Palliative Care, and Life-Sustaining Treatment Decision-Making Act, which took the form of “Physician Orders for Life-Sustaining Treatment,” was introduced in South Korea. This study was conducted to investigate the completion rate of Physician Orders for Life-Sustaining Treatment in patients with advanced cancer on the active recommendation of physicians, as well as patients’ general attitudes toward end-of-life care.
Methods: We conducted a cross-sectional descriptive survey on patients with advanced cancer. A total of 101 patients with advanced solid cancer agreed to participate in the study. The primary endpoint was the rate of completion of Physician Orders for Life-Sustaining Treatment based on a doctor’s suggestion. Written interviews were conducted to understand the perceptions and factors influencing patients’ decisions.
Results: Of the 101 patients, 72 (71.3%) agreed to prepare Physician Orders for Life-Sustaining Treatment. Patients who had an educational level of high school or higher were more likely to agree to complete Physician Orders for Life-Sustaining Treatment documentation as compared to the lower educational status group. More than half of the respondents who completed Physician Orders for Life-Sustaining Treatment documentation reported that they had more than a fair understanding of “life-sustaining care” or “Physician Orders for Life-Sustaining Treatment.” Participants’ reasons for Physician Orders for Life-Sustaining Treatment completion were diverse.
Conclusions: We found that highly educated patients, who understood the concept behind the policy well, tended to accept Physician Orders for Life-Sustaining Treatment without hesitation. Better education, information shared through the media, and conversations with health care providers might improve understanding of Physician Orders for Life-Sustaining Treatment in patients with cancer.
Loss-of-function mutation of soybean R2R3 MYB transcription factor reduces flavone content and dilutes tawny pubescence color
Authors: Yan Fan , Githiri Stephen M. , Sang Yu , Wang Qingyu , Takahashi Ryoji 
Published: July 2019

Abstract
Background

Pubescence color of soybean is controlled by two genes, T and Td. In the presence of a dominant T allele, dominant and recessive alleles of the Td locus generate tawny and light tawny (or near-gray) pubescence, respectively. Flavones, responsible for pubescence color, are catalyzed by two copies of flavone synthase II genes (FNS II-1 and FNS II-2). This study was conducted to map and clone the Td gene.

Results

Genetic and linkage analysis using an F2 population and F3 families derived from a cross between a Clark near-isogenic line with light tawny pubescence (genotype: TT tdtd) and a Harosoy near-isogenic line with tawny pubescence (TT TdTd) revealed a single gene for pubescence color around the end of chromosome 3. Genome sequence alignment of plant introductions revealed an association between premature stop codons in Glyma.03G258700 (R2R3 MYB transcription factor) and recessive td allele. Cultivars and lines having near-gray or light tawny pubescence and a gray pubescence cultivar with td allele had premature stop codons in the gene. These results suggest that Glyma.03G258700 corresponds to the Td gene. It was predominantly expressed in pubescence. Compared to a tawny pubescence line, a near-isogenic line with td allele produced extremely small amounts of transcripts of Glyma.03G258700, FNS II-1, and FNS II-2 in pubescence. The promoter of FNS II-1 and FNS II-2 shared cis-acting regulatory elements for binding of MYB proteins. These results suggest that the wild-type of Glyma.03G258700 protein binds to the promoter of FNS II genes and upregulates their expression, resulting in increased flavone content and deeper pubescence color. In contrast, mutated Glyma.03G258700 protein fails to upregulate the expression of FNS II genes, resulting in decreased flavone content and dilute pubescence color.

Conclusions

This study revealed that soybean Glyma.03G258700 encoding the R2R3 MYB transcription factor corresponds to the Td gene. The wild type of MYB protein binds to the promoter of FNS II genes and upregulates their expression, resulting in higher flavone content and deeper pubescence color. Loss-of-function mutation of the gene fails to promote expression of FNS II genes, resulting in lower flavone content and dilute pubescence color.
Genome-wide analysis of RopGEF gene family to identify genes contributing to pollen tube growth in rice (Oryza sativa)
Authors: Kim Eui-Jung , Park Sung-Wook , Hong Woo-Jong , Silva Jeniffer , Jung Ki-Hong , Kim Yu-jin 
Published: July 2019

Abstract
Background: In plants, the key roles played by RopGEF-mediated ROP signaling in diverse processes, including polar tip growth, have been identified. Despite their important roles in reproduction, a comprehensive analysis of RopGEF members has not yet been performed in rice (Oryza sativa). To determine whether RopGEF regulators are involved in rice pollen tube growth, we performed genome-wide analysis of this family in rice.
Results: Phylogenomic and meta-expression analysis of eleven RopGEFs in rice showed that four genes were preferentially expressed in mature pollen. These four genes contain the plant-specific Rop nucleotide exchanger (PRONE) domain and possible phosphorylated residues, suggesting a conserved role in polar tip growth with Arabidopsis. In subcellular localization analysis of the four RopGEFs through tobacco (Nicotiana benthamiana) infiltration was identified in various cellular organelles, indicating their diverse roles during pollen germination in rice. Moreover, these candidate genes possessing unique cis-acting elements in their promoters compared with the other genes.
Conclusions: In this study, four RopGEF genes were identified as pollen-specific gene in eleven members of rice, and the expression pattern, promoter analysis, and evolutionary relationship of the RopGEF family were studied compared with Arabidopsis. Our study indicated that four RopGEF genes might function during pollen germination in distinct subcellular localization. Our study could provide valuable information on the functional study of RopGEF in rice.
A MYB-related Transcription Factor from Sheepgrass, LcMYB2, Promotes Seed Germination and Root Growth under Drought Stress
Authors: guo xiufang , Zhao Pincang , Hou Shenglin , Jia Junting , Yang Weiguang , Liu Zhujiang , Chen Shuangyan , Li Xiaoxia , Qi Dongmei , Liu Gongshe , Cheng Liqin 
Published: July 2019

Abstract
Background

Drought is one of the most serious factors limiting plant growth and production. Sheepgrass can adapt well to various adverse conditions, including drought. However, during germination, sheepgrass young seedlings are sensitive to these adverse conditions. Therefore, the adaptability of seedlings is very important for plant survival, especially in plants that inhabit grasslands or the construction of artificial grassland.

Results

In this study, we found a sheepgrass MYB-related transcription factor, LcMYB2 that is up-regulated by drought stress and returns to a basal level after rewatering. The expression of LcMYB2 was mainly induced by osmotic stress and was localized to the nucleus. Furthermore, we demonstrate that LcMYB2 promoted seed germination and root growth under drought and ABA treatments. Additionally, we confirmed that LcMYB2 can regulate LcDREB2 expression in sheepgrass by binding to its promoter, and it activates the expression of the osmotic stress marker genes AtDREB2A, AtLEA14 and AtP5CS1 by directly binding to their promoters in transgenic Arabidopsis.

Conclusions

Based on these results, we propose that LcMYB2 improves plant drought stress tolerance by increasing the accumulation of osmoprotectants and promoting root growth. Therefore, LcMYB2 plays pivotal roles in plant responses to drought stress and is an important candidate for genetic manipulation to create drought-resistant crops, especially during seed germination.
Ocular biomarkers for cognitive impairment in nonagenarians; a prospective cross-sectional study
Authors: de Kreeke Jacoba Alida van , Legdeur Nienke , Badissi Maryam , Nguyen H. Ton , Konijnenberg Elles , Tomassen Jori , Kate Mara ten , Braber Anouk den , Maier Andrea B. , Tan H. Stevie , Verbraak Frank D. , Visser Pieter Jelle 
Published: July 2019

Abstract
Background: Ocular imaging receives much attention as a source of potential biomarkers for dementia. In the present study, we analyze these ocular biomarkers in cognitively impaired and healthy participants in a population aged over 90 years (= nonagenarian), and elucidate the effects of age on these biomarkers.
Methods: For this prospective cross-sectional study, we included individuals from the EMIF-AD 90+ study, consisting of a cognitively healthy (N=67) and cognitively impaired group (N=33), and the EMIF-AD PreclinAD study, consisting of cognitively healthy controls aged ≥60 (N=198). Participants underwent Optical Coherence Tomography (OCT) and fundus photography of both eyes. OCT was used to asses total and individual inner retinal layer thickness in the macular region (Early Treatment Diabetic Retinopathy Study circles) as well as peripapillary retinal nerve fiber layer thickness, fundus images were analyzed with Singapore I Vessel Assessment to obtain 7 retinal vascular parameters. Values for both eyes were averaged. Differences in ocular biomarkers between the 2 nonagenarian groups were analyzed using linear regression, differences between the individual nonagenarian groups and controls were analyzed using generalized estimating equations.
Results: Ocular biomarkers did not differ between the healthy and cognitively impaired nonagenarian groups. Both nonagenarian groups differed in most ocular biomarkers from the younger controls.
Conclusion: Ocular biomarkers were not associated with cognitive impairment in nonagenarians, making their use as a screening tool for dementing disorders in this group limited. However, ocular biomarkers were significantly associated with chronological age, which were very similar to those ascribed to occur in Alzheimer’s Disease.
Exploring factors associated with self-treatment among different elder subgroups in rural China: a cross-sectional study
Authors: Xu Wanchun , Li Zhong , Pan Zijing , He Ruibo , Zhang Liang 
Published: July 2019

Abstract
Background

Self-treatment is a common and widespread behaviour, of which the risks are multiplied in old age. However, the determinants of self-treatment among elders in the current rural China remain unclear. This study aims to explore the determinants of self-treatment among elders in rural China, focusing on context-specific and multi-dimensional factors.

Methods

Based on a multi-stage stratified random sampling method, a cross-sectional household survey was conducted among 30 villages in Sinan County, Guizhou Province in western China. Data were collected through a self-administered questionnaire on the healthcare needs of residents. The analysis was restricted to elders who reported illness within the last 2 weeks, and the final sample size was 338 (individuals). Pearson’s chi-squared test and binary logistic regression analysis were performed among the whole sample group and four subgroups.

Results

Approximately 25.94% of the 1303 elders reported illness within the last 2 weeks, of whom 34.4% indicated self-treatment. The variables independently associated with a greater probability of self-treatment in the whole sample group were better health status, no recent alcohol consumption and no utilisation of family practice services; the same predictors were found in the subgroup of elders with chronic diseases. No significant predictors were found in the subgroup of elders without chronic diseases. Empty-nest elders with higher affinity to traditional Chinese medicine (TCM) and drinking alcohol recently were less likely to self-treat. Non-empty-nest elders who were no less than 75 years old and at better health status were more likely to self-treat.

Conclusion

Better health status, no recent alcohol consumption and no utilisation of family practice are associated with self-treatment among rural elders. Advanced age and self-care habits in TCM also play roles in some subgroups. Deeper understanding of the self-treatment behaviour among rural elders may provide insights for developing improvement strategies of the family practice system in China.
MEDICATION BURDEN AND INAPPROPRIATE PRESCRIPTION RISK AMONG ELDERLY WITH ADVANCED CHRONIC KIDNEY DISEASE
Authors: Roux-Marson Clarisse , Baranski Jean-Baptiste , Fafin Coraline , Extermann Guillaume , Vigneau Cecile , Couchoud Cecile , Moranne Olivier 
Published: July 2019

Abstract
Background
Elderly patients with chronic kidney disease (CKD) frequently present comorbidities that put them at risk of polypharmacy and medication-related problems. This study aims to describe the overall medication profile of patients aged ≥ 75 years with advanced CKD from a multicenter French study and specifically the renally (RIMs) and potentially inappropriate-for-the-elderly medications (PIMs) that they take.
Methods
This is a cross-sectional analysis of medication profiles of individuals aged ≥ 75 years with eGFR < 20 ml/min/1.73m2 followed by a nephrologist, who collected their active prescriptions at the study inclusion visit. Medication profiles were analyzed according to route of administration, therapeutic classification, and their potential inappropriateness for these patients, according to Beers' criteria.
Results
We collected 5196 individual medication prescriptions for 556 patients, for a median of 9 daily medications [7-11]. Antihypertensive agents, antithrombotics, and antianemics were the classes most frequently prescribed. Moreover, 88% of patients had at least 1 medication classified as a RIM, and 21% of those were contraindicated drugs. At least 1 PIM was taken by 68.9%. The prescriptions most frequently requiring reassessment due to potential adverse effects were for proton pump inhibitors and allopurinol. The PIMs for which deprescription is especially important in this population are rilmenidine, long-term benzodiazepines, and anticholinergic drugs such as hydroxyzine.
Conclusion
We showed potential drug-related problems in elderly patients with advanced CKD. Healthcare providers must reassess each medication prescribed for this population, particularly the specific medications identified here.
Slow gait speed is associated with reduction in health status in older ambulatory Chinese: A study for comprehensive geriatric assessment
Authors: Zeng Ping , Dai Yalun , Han Yiwen , Pang Jing , Gong Huan , Li Jian , Zhang Tiemei 
Published: July 2019

Abstract
Background:
Gait speed (GS) is well recognized as a comprehensive index of health status in older people. Nationwide survey data in China have been used to measure the association between slow GS and health status in order to emphasize the importance of measuring GS to detect a decline in health status in older ambulatory Chinese.

Methods:
A group of 2677 male and 2668 female older (aged ≥60) adults, who could perform the GS test, were selected as study subjects.GS was measured by subjects walking across and back over a 10-m course. Gait speed less than 20% that of a reference population (<0.7 m/s) was used as the threshold of slow GS.

Results:
Slow GS was associated with higher co-morbidity, polypharmacy, more medical expenses, increased needs for care and hospitalization, worse ranking on the Geriatric Depression Scale (GDS), and decreased physical and cognitive functions. In logistic regression model, higher education level (OR=0.93, 0.88-0.98), alcohol drinking (OR=0.82, 0.71-0.95), scores on Mini-mental State Examination (OR=0.95, 0.93-0.96), doing housework (OR=0.51, 0.45-0.57), and having a regular daily routine (OR=0.71, 0.51-0.98) were independently associated with faster GS; while co-morbidity (OR=1.79, 1.59-2.03), expressed disinterest in life (OR=1.22, 1.12-1.32), and dissatisfaction with personal health (OR=1.22, 1.13-1.33) were associated with slow GS. The AUC value on ROC analysis was 0.72 for the selected variables.

Conclusions:
Slow GS is associated with poorer health status in Chinese older people. Measuring GS may be a quick and inexpensive tool to help identify individuals with declines in health status and who might benefit from targeted intervention.
Statin prescription among patients with type 2 diabetes in Botswana: findings and implications
Authors: Mwita Julius Chacha , Godman Brian , Esterhuizen Tonya M 
Published: July 2019

Abstract
Background
There is evidence of statin benefit among patients with diabetes regardless of their cholesterol levels or prior cardiovascular disease history. Despite the evidence, there is under-prescription of statins in clinical practice. This study aimed to assess statin prescriptions and associated factors among patients with type 2 diabetes in Botswana.
Methods
The study was a secondary data analysis of 374 randomly selected type 2 diabetes patients at a specialised diabetes clinic at Gaborone Botswana. We assessed the proportion of statin-eligible patients who are prescribed statins and evaluated the adjusted associations between various factors and statin prescription.
Results
Overall, 356 (95.2%) participants were eligible for a statin prescription. Clinicians prescribed statins in 162 (45.5%%; 95% confidence interval [CI]: 40.4% - 50.7%)) of eligible participants, and only one (5.5%) ineligible participant. The probability of statin prescription was high in participants with high baseline low-density lipoprotein cholesterol (risk ratio [RR]: 1.49; 95%CI: 1.17 - 1.89), increasing duration of diabetes (RR: 1.01; 95%CI 1.00 - 1.03) and the presence of chronic kidney disease (RR: 1.35; 95%CI: 1.06 - 1.74).
Conclusion
Most patients with type 2 diabetes are not receiving statins. Clinicians did not consider most guideline-recommended indications for statin prescription. The findings call for improvement in diabetes quality of care by implementing evidence-based guideline recommendations.

Key words: statin, type 2 diabetes mellitus, prescription and Botswana