bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics of lupus and lupus nephritis at a tertiary care center in Lebanon
Authors: Koubar S H , Kort J , Kawtharani S , Chaaya M , Makki M , Uthman I 
Published: September 2019

Introduction Systemic lupus erythematosus affects 4.8–78.5 people per 100,000 worldwide, 90% of whom are females. Geography and ethnicity have been shown to significantly affect the prevalence and natural history of the disease. Lupus nephritis affects around half of patients with systemic lupus erythematosus. Data about systemic lupus erythematosus and lupus nephritis in the Middle East are still scarce. In this study, we aimed to describe the characteristics of systemic lupus erythematosus and lupus nephritis at a tertiary care center in Lebanon. Methods This is a retrospective chart review of all biopsy-proven lupus nephritis patients admitted to the American University of Beirut medical center between January 2000 and December 2018. Patients above 12 years of age who had any International Society of Nephrology/Renal Pathology Society (ISN/RPS) class of lupus nephritis on their renal biopsy were included in the study. Results The study included 55 patients with lupus nephritis. Upon presentation of systemic lupus erythematosus, the most common clinical feature was arthritis, seen in 83% of patients, followed by anemia (82%) and malar rash (48%). In total 93% had positive ANA, 89% had positive anti-dsDNA and 98% of patients had proteinuria. The most common ISN/RPS class of lupus nephritis in our series was IV (49%). At the time of the biopsy 15% of patients underwent dialysis. At 6 months, 11/27 had complete remission, 6/27 had partial remission and 10/27 had no remission. At 1 year, 8/23 had complete remission, 4/23 had partial remission and 11/23 had no remission. During the study period, 15 out of 35 patients available for analysis had chronic kidney disease (CKD) and six out of 34 patients developed end-stage kidney disease requiring renal replacement therapy. In comparison to other series in the region, our series had more males affected, higher creatinine at the time of biopsy and greater degree of proteinuria. Conclusion Our study provided insight on the demographics, characteristics, and outcomes of lupus nephritis in Lebanon. Interestingly, male gender was present in a quarter of patients. This warrants further investigation and confirmation. We are hoping to expand this experience into a national prospective registry to further characterize this entity in our region.
Simulation-Based Training Models for Cleft Palate Repair: A Systematic Review
Authors: Raveendran Maria 
Published: September 2019

Objective: Simulation-based training is a relatively new inclusion to surgical training curricula, with promises of achieving increased competency while maximizing patient safety. Cleft palate, which contributes significantly to the global burden of surgically treatable diseases, is a challenging repair to learn due to the high level of skill and dexterity required, delicate oral tissues, and limited space of an infant oral cavity. Simulation training can allow cleft palate education to move from an observational to a competency-based learning. Hence, this systematic review presents the models described in the literature that simulate cleft palate repair. Design: The systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. An electronic search of the MEDLINE and Cochrane databases was performed. Qualitative data were extracted, and the models were stratified based on their anatomical fidelity and realism, forming the basis of the curriculum. Results: The database search returned 3261 articles. Twelve articles were considered eligible for inclusion. The anatomical fidelity, human tissue likeness, evidence of improved outcomes, and cost are discussed. Conclusions: Cleft palate is a globally significant birth defect and its repair is a difficult procedure to learn. This review presents the 12 models of cleft palate described in the literature, highlighting the advances and gaps in current cleft palate simulation.
Radiation oncology outpatient medication management needs and service gaps – A cross-sectional study of patients and clinicians
Authors: Maleki Sam , Alexander Marliese , Liu Chen , Rischin Danny , Lingaratnam Senthil , Fua Tsien 
Published: September 2019

Background Patients receiving radiotherapy for the treatment of cancer can have complex medication requirements related to the management of side-effects and impaired swallowing ability. This study surveyed patients and clinicians to identify service gaps and unmet medication management needs. Methods Patient and clinician surveys were developed by a multidisciplinary team based on previously validated questionnaires. The patient survey focused on medication use and adherence. The clinician survey was based around a clinical case study and focused on identifying service gaps and practice variations. This survey was disseminated to radiation oncologists, pharmacists and nurses involved with the care of head and neck or lung cancer patients in Victoria. Results A total of 93 surveys were completed including 53 patient surveys and 40 clinician surveys. Radiotherapy patients reported high medication usage with up to 53% taking five or more medications daily. When asked the same set of questions relating to medication education requirements, patients receiving polypharmacy reported greater needs (72%) than recognised by the surveyed multidisciplinary clinician group (58%). They also reported a non-adherence rate of 46%. In addition, further disparities were identified in clinician practices and their approach to clinical situations which may result in conflicting advice and confusion for patients. Conclusion While recognising deficiencies relating to the provision of medication information, oncologists, nurses and pharmacists underestimated patient needs for medication information, education and follow-up. Findings support the rationale for integration of pharmacy services within the radiotherapy clinics to support patient care and bridge service gaps relating to medication management.
Overexpression of miRNA-21 Promotes the Proliferation and Invasion in Hepatocellular Carcinoma Cells via Suppressing SMAD7
Authors: Wang Yan , Zhang Ping , Yuan Mei , Li Xiaojie 
Published: September 2019

Purpose: This study aimed to explore the molecular mechanism of microRNA-21 and smad family member 7 in hepatocellular carcinoma. Method: A total of 57 participants were divided into control group (healthy participants, n = 10) and hepatocellular carcinoma group (hepatocellular carcinoma patients, n = 37). The expression of microRNA-21 levels were first detected in these two groups. Cell transfection was performed on hepatoma cell lines, followed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide and Transwell assay to reveal proliferation and invasion ability. Furthermore, the relation between microRNA-21 and smad family member 7 was revealed by luciferase reporter gene and RNA immunoprecipitation assay. Finally, a transplantation tumor model of breast cancer in mice was constructed. Results: The serum indicators including α-alanine aminotransferase, aspartate aminotransferase, and albumin were differentially expressed between hepatocellular carcinoma group and control group. Compared to the control group, there was a high expression of microRNA-21 in hepatocellular carcinoma group. Low expression of microRNA-21 inhibited the proliferation and invasion of HepG2.2.15 and Huh7-1.3 cells. Luciferase reporter gene and RNA innumoprecipitation assay showed that smad family member 7 was the target gene of microRNA-21. Moreover, mice model analysis showed that microRNA-21 might regulate the growth of the transplanted tumors in mice by targeting smad family member 7. Conclusion: The upregulated microRNA-21 might participate in the proliferation and migration in cells of hepatocellular carcinoma via suppression of smad family member 7. Furthermore, serum indicators such as alanine aminotransferase, aspartate aminotransferase, and albumin might be used as serum diagnostic markers for hepatocellular carcinoma.
Berberine protects steatotic donor undergoing liver transplantation via inhibiting endoplasmic reticulum stress-mediated reticulophagy
Authors: Zhang Nan , Sheng Mingwei , Wu Man , Zhang Xinyue , Ding Yijie , Lin Yuanbang , Yu Wenli , Wang Shusen , Du Hongyin 
Published: September 2019

Steatotic livers are more susceptible to ischemia/reperfusion injury, and increase the risk of primary graft non-function after liver transplantation. The protective effects of berberine have been described in various liver pathological models. However, it is unknown if berberine exerts its beneficial action in steatotic donors undergoing liver transplantation. In the present study, male Wistar rats were fed with high-fat diet (HFD) for 12 weeks to induce moderate steatotic liver. Then orthotropic liver transplantation was constructed. Berberine (200 mg/kg/d) was given intragastrically one week before liver transplantation. Thapsigargin (TG) (0.2 mg/kg) was administrated intravenously 24 h before liver transplantation. Liver function, oxidative stress, and inflammatory cytokine were detected by biochemical or histopathological analysis. The morphology of autophagosomes and endoplasmic reticulum (ER) was observed by transmission electron microscopy. The expression of CHOP, BIP, the phosphorylation of PERK, LC3-II/I, Beclin-1, and p62 were determined by Western blot assay. The co-localization of endoplasmic reticulum marker (KDEL) and autophagic protein (LC3B) was analyzed by immunofluorescence microscopy. The level of reticulophagy hallmark (FAM134B) was determined by immunohistochemistry. Compared with HFD + LT group, berberine ameliorated hepatocellular damage, decreased the oxidative stress level and inflammatory cytokine release. Simultaneously, berberine inhibited the expression of both endoplasmic reticulum stress parameters and autophagy-related proteins. Additionally, the co-localization of endoplasmic reticulum marker and LC3B was also reduced in HFD + BBR + LT group. berberine down-regulated the level of FAM134B. TG reversed the beneficial effects of berberine. Our study revealed that berberine exerts protective effects on steatotic livers undergoing transplantation by inhibiting endoplasmic reticulum stress-mediated reticulophagy. Impact statement Berberine is isolated from traditional Chinese medicine plants and has dramatically therapeutic potential against inflammation, diarrhea, and diabetes. But the benefits of BBR on steatotic grafts after liver transplantation remain poorly understood. Our findings might help explain the mechanism of berberine in protecting steatotic livers undergoing transplantation and give advantageous insights that berberine has potential as a suitable candidate for preventing hepatic injury after steatotic liver transplantation by inhibiting ER stress-mediated reticulophagy.
Reduced regional activity and functional connectivity within sensorimotor network in Parkinson’s patients with restless legs syndrome
Authors: Li Zhe , Chen Jun , Lin Yuwan , Zhou Miaomiao , Cai Qiaodi , Li Xinchun , Wu Zhuohua , Chen Xinjie , Yang Xinling , Zhu Xiaoqin , Lu Jianjun , Zhang Li , Liu Bo , Luo Xiaodong , Xu Pingyi 
Published: September 2019

Background Restless legs syndrome is an important sleep disturbance in Parkinson’s disease. Restless legs syndrome causes an urge to move the legs accompanying sensations which can be difficult to describe but include aching, burning, tingling, or crawling. However, the underlying pathophysiology of restless legs syndrome in Parkinson’s disease remains unknown and no imaging investigation has been conducted to explore its mechanism to date. Objective This study is to investigate the brain functional changes in Parkinson’s disease with restless legs syndrome (PD-RLS+) patients using functional magnetic resonance imaging. Methods Data of functional magnetic resonance imaging were collected from 14 PD-RLS+ patients, 20 Parkinson’s disease without restless legs syndrome (PD-RLS−) patients, as well as 19 normal controls during restless legs syndrome-free periods. Intraregional brain activity was evaluated by regional homogeneity method and compared between each pair of the three groups. Area with significantly altered regional homogeneity between two patient groups was further selected as seed in subsequent functional connectivity analysis. Correlations between clinical variables and the altered regional homogeneity and functional connectivity were then assessed in patient groups. Results Compared with PD-RLS−, PD-RLS+ had much reduced brain activity in the right precentral gyrus, which was negatively associated with restless legs scores in Parkinson’s disease patients. Comparison between PD-RLS+ and normal controls revealed that brain activities were increased in the left brainstem and reduced in the left lingual, fusiform and inferior occipital gyri, middle cingulate and paracingulate gyri, and supplement motor area. Further functional connectivity analysis between right precentral gyrus and left postcentral/precentral gyri decreased dramatically within PD-RLS+ patients, which were also negatively correlated with restless legs symptoms in patient groups. Conclusion PD-RLS+ patients showed diminished regional homogeneity and functional connectivity within the precentral and postcentral gyri, which implies that the functional abnormalities in sensorimotor network may disrupt the lateral pain pathway, contributing to restless legs syndrome symptoms in Parkinson’s disease patients. This may provide imaging evidence to explore the pathophysiology of Parkinson’s disease-related restless legs syndrome.
Involving patients in recognising clinical deterioration in hospital using the Patient Wellness Questionnaire: A mixed-methods study
Authors: Albutt Abigail , O'Hara Jane , Conner Mark , Lawton Rebecca 
Published: September 2019

Background Measures exist to improve early recognition of, and response to deteriorating patients in hospital. Despite these, 7% of the deaths reported to the National Reporting and Learning System from acute hospitals in 2015 related to a failure to recognise or respond to deterioration. Interventions have been developed that allow patients and relatives to escalate patient deterioration to a critical care outreach team. However, there is not a strong evidence base for the clinical effectiveness of these interventions, or patients' ability to recognise deterioration. Aims The aims of this study were as follows. (a) To identify methods of involving patients in recognising deterioration in hospital, generated by health professionals. (b) To develop and evaluate an identified method of patient involvement in practice, and explore its feasibility and acceptability from the perspectives of patients. Methods The study used a mixed-methods design. A measure to capture patient-reported wellness during observation was developed (Patient Wellness Questionnaire) through focus group discussion with health professionals and patients, and piloted on inpatient wards. Results There was limited uptake where patients were asked to record ratings of their wellness using the Patient Wellness Questionnaire themselves. However, where the researcher asked patients about their wellness using the Patient Wellness Questionnaire and recorded their responses during observation, this was acceptable to most patients. Conclusions This study has developed a measure that can be used to routinely collect patient-reported wellness during observation in hospital and may potentially improve early detection of deterioration.
A System-Level Investigation into the Mechanisms of Apigenin Against Inflammation
Authors: Xie Ying , Liang Dongdong , Wu Qingke , Chen Xuemei , Buabeid Manal Ali , Wang Yanfei 
Published: September 2019

Apigenin is a natural flavone that possesses excellent biological activities especially against aging and cancer. However, the underlying mode of its action is not yet revealed. The purpose of this study was to examine the pharmacological mechanisms of apigenin using the knowledge of network pharmacology, protein-protein interaction (PPI) databases and biological processes analysis through Cytoscape. Apigenin targets were retrieved through PASS Prediction and STITCH database and the interactive associations between these targets were studied using STITCH, followed by GO (gene ontology) and pathway enrichment analysis. As a result of target search, 125 protein targets were retrieved. Moreover, 216 GO terms related to various biological processes, 16 GO terms for various molecular processes, 5 GO terms for the cellular components, and 52 Kyoto Encyclopedia of Genes and Genomes pathway terms were achieved by analyzing gene functional annotation clusters and abundance values of these targets. Most of these terms are strongly associated with inflammation through various pathways, for example, FOXO, mammalian target of rapamycin, tumor necrosis factor, p53, AMP-activated protein kinase, p13K-AKT, and mitogen-activated protein kinase, which play an important role in inflammation, aging and cancer. Apigenin can be used to treat inflammation, aging, and cancer with an underlying mechanism of inflammation suppression. This study contributed excellent information for a better understanding of the modes of action of apigenin. However, further studies such as docking and MD simulation are required to understand the therapeutic and toxicological roles of these targets of apigenin.
Perioperative anaesthesia and coagulation management of haemophilia patients receiving total hip and knee replacement arthroplasty: Experience from a case series
Authors: Li Sibei , Qu Bo , Ma Wuhua , Li Yuhui 
Published: September 2019

Purpose: To report 13 consecutive cases of successful triad of anaesthesia, blood and coagulation management (ABC protocol) in haemophilic total joint arthroplasty (TJA) and its feasibility and safety on haemophilic TJA. Methods: All the clinical data of 13 consecutive cases were descend from electronic medical record. Patients who suffered from haemophilia A, undergoing primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) with ABC protocol at the academic hospital from December 2014 to November 2018 were included, and demographic, perioperative characteristics according to the classified method were further analysed. Results: All 13 haemophilic patients had undergone successful surgery with ABC protocol. No massive blood loss was observed in perioperative period. The mean external blood loss was 876.92 ± 592.86 mL. The mean change in haemoglobin was 5.42 ± 2.43 g dL−1 at 5 days post-operatively. The mean allogeneic transfusion volume was 1.23 ± 1.35 units, and the mean volume of autotransfusion was 237.5 ± 76.93 mL. The average clotting factor consumption for per operated joint was 458.26 ± 226.45 IU kg−1 in all cases. No severe perioperative complications were occurred. Conclusion: ABC-related series of measures were appropriate management mode for patients received THA and/or TKA with mild or moderate haemophilia. However, more robust evidence came from larger samples is needed.
Adverse events associated with medical devices in patients at different clinics and hospitals in Colombia
Authors: Machado-Alba Jorge E , Cardona-Trejos Edwar A , Delgado-Pascuaza Yudy Lorena , Torres-Bahamon Daniel R , Portilla Alfredo 
Published: September 2019

Background The use of medical technology may result in damage to patients. The aim was to determine which adverse events and adverse incidents related to medical–surgical devices were most frequently observed in patients seen at 65 health service providers, clinics and hospitals in Colombia. Methods Retrospective study describing reports of adverse events or incidents related to medical devices between 2014 and 2017. From the database of reports, all cases were identified and classified by the type of device, causes and time of identification of the event. Results The devices that were most frequently reported as having events or adverse incidents were those belonging to the vascular access category, with 45.2% of cases, followed by surgical equipment, with 20.2%. The causes of the events or adverse incidents were most often failures of the mechanical components, at 50.6%, followed by manufacturing defects, at 28.7%. The professionals who reported these issues most frequently were nurses, who did so in 33.1% of the cases. A total of 86.8% of the reports were non-serious adverse events, and the failure was identified at the time of device use in 72.8% of the cases. Conclusions Preventive approaches to events and adverse events related to medical devices can mostly be resolved through stricter quality control measures.
The impact of C-reactive protein levels on headache frequency in the HUNT study 2006–2008
Authors: Hagen Knut , Stovner Lars Jacob , Nilsen Kristian Bernhard , Kristoffersen Espen Saxhaug , Winsvold Bendik Slagsvold 
Published: September 2019

Abstract

Background
Increased high sensitivity C- reactive protein (hs-CRP) levels have been found in many earlier studies on migraine, and recently also in persons with migraine and insomnia. The aim of this study was to see whether these findings could be reproduced in a large-scale population-based study.

Methods
A total of 50,807 (54%) out of 94,194 invited aged ≥20 years or older participated in the third wave of the Nord-Trøndelag Health Study study performed in 2006–2008. Among these, 38,807 (41%) had valid measures of hs-CRP and answered questions on headache and insomnia. Elevated hs-CRP was defined as > 3.0 mg/L. The cross-sectional association with headache was estimated by multivariate analyses using multiple logistic regression. The precision of the odds ratio (OR) was assessed with 95% confidence interval (CI).

Results
In the fully adjusted model, elevated hs-CRP was associated with migraine (OR 1.14, 95% CI 1.04–1.25) and migraine with aura (OR 1.15, 95% CI 1.03–1.29). The association was strongest among individuals with headache ≥15 days/month for any headache (OR 1.26, 95% CI 1.08–1.48), migraine (OR 1.62, 95% CI 1.21–2.17), and migraine with aura (OR 1.84, 95% CI 1.27–2.67). No clear relationship was found between elevated hs-CRP and headache less than 7 days/month or with insomnia.

Conclusions
Cross-sectional data from this large-scale population-based study showed that elevated hs-CRP was associated with headache ≥7 days/month, especially evident for migraine with aura.