bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inhaled granulocyte-macrophage colony stimulating factor for mild-to-moderate autoimmune pulmonary alveolar proteinosis - a six month phase II randomized study with 24 months of follow-up
Authors: Tian Xinlun , Yang Yanli , Chen Lulu , Sui Xin , Xu Wenshuai , Li Xue , Guo Xiaobei , Liu Lingshan , Situ Yusen , Wang Jun , Zhao Yang , Meng Shuzhen , Song Wei , Xiao Yonglong , Xu Kai-Feng 
Published: June 2020

Abstract
Background: Treatment of autoimmune pulmonary alveolar proteinosis (aPAP) by inhaled granulocyte-macrophage colony stimulating factor (GM-CSF) is considered safe and effective. Evidence of benefit from GM-CSG inhalation for mild to moderate aPAP patients is limited.Methods: In this multicenter, randomized, open-labeled clinical trial, 36 aPAP patients with mild to moderate disease severity were randomized into either the GM-CSF treatment group or control group. Inhaled GM-CSF was prescribed for 6 months, and patients received follow-up for another 18 months without treatment. Physiological features of the patients were analyzed.Results: There were 36 patients (19 in the treatment group, 17 in the control group) included. There were no significant differences in the primary endpoints as measured by the change of alveolar arterial oxygen gradient (A-aDO2) from the baseline values to the values obtained during treatment or during the following 18-month non-treatment observation period [control group vs. treatment group: 0.51±12.09 mmHg vs. -0.35±13.76 mmHg, p=0.848 (3 month); 1.85±11.21 mmHg vs. 7.31±8.81 mmHg, p=0.146 (6 months); 6.05±11.14 mmHg vs. 6.61±10.64mmHg, p=0.899 (24 months)]). Percentage of diffusion capacity predicted (DLCO%) and percentage of total lung capacity predicted (TLC%), however, were significantly improved in the treatment group by the end of the study (P=0.010 and 0.027). St. George Respiratory questionnaire (SGRQ) scores were better after 6 months treatment with GM-CSF compared to the control group, and the benefits of treatment were maintained throughout the observation period. No severe side effects were observed during the study.Conclusion: Six months of inhaled GM-CSF treatment had no effect on the alveolar–arterial oxygen gradient in patients with mild to moderate pulmonary alveolar proteinosis. There were changes in some clinical or laboratory measures, but no clinically important changes were noted at the end of study. (Clinical Trial Registry: NCT02243228, Registered on September 17, 2014, https://www.clinicaltrials.gov/ct2/show/NCT02243228?term=NCT02243228&draw=2&rank=1)
Kinesin superfamily protein 21B acts as an oncogene in non-small cell lung cancer
Authors: Sun Zhi-Gang , Pan Feng , Shao Jing-Bo , Yan Qian-Qian , Lu Lu , Zhang Nan 
Published: June 2020

Abstract
Background: Kinesin superfamily proteins (KIFs) serve as microtubule-dependent molecular motors, and are involved in the progression of many malignant tumors. In this study, we aimed to investigate the expression pattern and precise role of kinesin family member 21B (KIF21B) in non-small cell lung cancer (NSCLC). Methods: KIF21B expression in 72 cases of NSCLC tissues was measured by immunohistochemical staining (IHC). We used shRNA-KIF21B interference to silence KIF21B in NSCLC H1299 and A549 cells and normal lung epithelial bronchus BEAS-2B cells. The biological roles of KIF21B in the growth and metastasis abilities of NSCLC cells were measured by Cell Counting Kit-8 (CCK8), colony formation and Hoechst 33342/PI, wound-healing, and Transwell assays, respectively. Expression of apoptosis-related proteins was determined using western blot. The effect of KIF21B on tumor growth in vivo was examined using nude mice model. Results: KIF21B was up-regulated in NSCLC tissues, and correlated with pathological lymph node and pTNM stage, its high expression was predicted a poor prognosis of patients with NSCLC. Silencing of KIF21B mediated by lentivirus-delivered shRNA significantly inhibited the proliferation ability of H1299 and A549 cells. KIF21B knockdown increased apoptosis in H1299 and A549 cells, down-regulated the expression of Bcl-2 and up-regulated the expression of Bax and active Caspase 3. Moreover, KIF21B knockdown decreased the level of phosphorylated form of Akt (p-Akt) and Cyclin D1 expression in H1299 and A549 cells. In addition, silencing of KIF21B impeded the migration and invasion of H1299 and A549 cells. Further, silencing of KIF 21B dramatically inhibited xenograft growth in BALB/c nude mice. However, silencing of KIF21B did not affect the proliferation, migration and invasion of BEAS-2B cells.Conclusions: These results reveal that KIF21B is up-regulated in NSCLC and acts as an oncogene in the growth and metastasis of NSCLC, which may function as a potential therapeutic target and a prognostic biomarker for NSCLC.
Non-active implantable device treating acid reflux with a new dynamic treatment approach: 1-year results
Authors: Bjelović Miloš , Harsányi László , Altorjay Áron , Kincses Zsolt , Forsell Peter 
Published: June 2020

Abstract
BACKGROUND RefluxStop™ is an implantable, non-active, single use device to be used in the laparoscopic treatment of GERD. RefluxStop™ aims to block the movement of the LES up into the thorax and keep the angle of His in its original anatomically correct position. This new device restores normal anatomy, leaving the food passageway unaffected. METHODS In prospective, single arm, multicentric clinical investigation analyzing safety and effectiveness of the RefluxStop™ device to treat GERD, 50 subjects with chronic GERD had been included. They were operated using standardized surgical technique between December 2016 and September 2017 and followed up for one year (CE-mark investigation 6-months). Primary safety outcome was the prevalence of serious adverse events related to the device and primary effectiveness outcome reduction of GERD symptoms based on the GERD HRQL score. Secondary outcomes were the prevalence of the adverse events apart from serious, reduction of the total acid exposure time on 24-hour pH monitoring, reduction in average daily PPI dosage and subject satisfaction. RESULTS There were no serious adverse events related to the device. Average GERD-HRQL total score at 1 year improved 86% from baseline (p<0.001). 24-h pH monitoring compared to baseline showed a mean reduction percentage of overall time with pH<4 from 16.35% to 0.80% at the 6-month visit (p<0.001). At 1-year: No new cases of dysphagia were recorded, occurred in 2 subjects, both significantly reduced compared to baseline. Regular daily PPI use before surgery occurred in all 50 subjects. At the 1-year follow-up only 1 subject took regular daily PPIs due to too low placement of the device thereby prohibiting its function. None or minimal occasional episodes of regurgitation occurred in 97.8% of evaluable subjects. Gas bloating disappeared in 30 subjects and improved in 7 subjects. CONCLUSION The new principle of RefluxStop™ is safe and effective to treat GERD according to investigation results. At 1-year follow up visit, both the GERD-HRQL score and 24-h pH monitoring results indicate success for the new treatment principle. In addition, with the dynamic treatment for acid reflux, which avoids compressing the food passageway, prevalence of dysphagia and gas bloating are significantly reduced.
Biodegradable hollow mesoporous organosilica nanotheranostics (HMON) for multi-mode imaging and mild photo-therapeutic-induced mitochondrial damage on gastric cancer
Authors: Guo Weihong , Chen Zhian , Chen Jiajia , Feng Xiaoli , Yang Yang , Huang Huilin , Liang Yanrui , Shen Guodong , Liang Yu , Peng Chao , Li Yanbing , Li Guoxin , Huang Wenhua , Zhao Bingxia , Hu Yanfeng 
Published: June 2020

Abstract
Background: CuS-modified hollow mesoporous organosilica nanoparticles (HMON@CuS) have been preferred as non-invasive treatment for cancer, as near infrared (NIR)-induced photo-thermal effect (PTT) and/or photo-dynamic effect (PDT) could increase cancer cells’ apoptosis. However, the certain role of HMON@CuS-produced-PTT&PDT inducing gastric cancer (GC) cells’ mitochondrial damage, remained unclear. Moreover, theranostic eﬃciency of HMON@CuS might be well improved by applying multi-modal imaging, which could offer an optimal therapeutic region and time window. Herein, new nanotheranostics agents were reported by Gd doped HMON decorated by CuS nanocrystals (called HMON@CuS/Gd).Results: HMON@CuS/Gd exhibited appropriate size distribution, good biocompatibility, L-Glutathione (GSH) responsive degradable properties, high photo-thermal conversion eﬃciency (82.4%) and a simultaneous reactive oxygen species (ROS) generation effect. Meanwhile, HMON@CuS/Gd could efficiently enter GC cells, induce combined mild PTT (43-45 °C) and PDT under mild NIR power density (0.8W/cm2). Surprisingly, it was found that PTT might not be the only factor of cell apoptosis, as ROS induced by PDT also seemed playing an essential role. The NIR-induced ROS could attack mitochondrial transmembrane potentials (MTPs), then promote mitochondrial reactive oxygen species (mitoROS) production. Meanwhile, mitochondrial damage dramatically changed the expression of anti-apoptotic protein (Bcl-2) and pro-apoptotic protein (Bax). Since that, mitochondrial permeability transition pore (mPTP) was opened, followed by inducing more cytochrome c (Cyto C) releasing from mitochondria into cytosol, and finally activated caspase-9/caspase-3-depended cell apoptosis pathway. Our in vivo data also showed that HMON@CuS/Gd exhibited good fluorescence (FL) imaging (wrapping fluorescent agent), enhanced T1 imaging under magnetic resonance imaging (MRI) and infrared thermal (IRT) imaging capacities. Guided by FL/MRI/ IRT trimodal imaging, HMON@CuS/Gd could selectively cause mild photo-therapy at cancer region, efficiently inhibit the growth of GC cells without evident systemic toxicity in vivo. Conclusion: HMON@CuS/Gd could serve as a promising multifunctional nanotheranostic platform and as a cancer photo-therapy agent through inducing mitochondrial dysfunction on GC.
The Associated Risk Factors and Psychosocial Adjustments among the Peer Victimized Adolescents in Malaysia: A Population-based Nationwide Study
Authors: heng pei pei , Lim Kuang Hock , Teh Chien Huey , PS Balvinder Singh Gill 
Published: June 2020

Abstract
Background

Bullying and victimization among secondary school – going adolescents is a severe social issue which demands concerted attention from the policy-makers, health-care providers and community. The victimized children, in the long term might develop the deleterious consequences on mental health. This study aimed to determine the prevalence of victimization among Malaysian school-attending adolescents, the associated risk factors and its psychosocial impacts among victims.
Methods

Data was derived from the Global School Health Survey Malaysia (GSHS-M). A total of 25,461 students aged 13–18 years from 234 randomly selected schools were recruited utilizing a two-state cluster sampling design. The study tool employed standardized self-administered questionnaire. Data was analyzed descriptively and multivariable logistic regression using SPSS version 20.0.
Results

About one fifth (17.9%, 95%CI 16.8–19.0) of the respondents reported being victimized at least once in the past 30-days. Made fun of gender and body image was the most prevalent type of bullying (41.0%, 95%CI 38.3–43.8). Multivariable logistic regression analysis further substantiated that likelihood of victimization was higher among the boys (aOR 1.30, 95%CI 1.17–1.44), students of lower secondary form (aOR 1.87, 95%CI 1.64–2.13), those without close friend (aOR 2.09, 95%CI 1.66–2.64) as well as the obese respondents (aOR 1.29, 95%CI 1.13–1.47). Victims without parental support were more likely to missed school (aOR 0.81, 95%CI 0.59–1.13), considered suicide (aOR 1.60, 95%CI 1.18–2.18), made suicide plan (aOR 1.45, 95%CI 2.01–1.08), as well as attempted suicide at least once in the past 12 months (aOR 0.48, 95%CI 0.33–0.69).
Conclusion

School bullying among secondary school-going adolescents warranted specially tailored intervention strategies, particularly to minimize the physical as well as psychosocial impact among the victims.
Intermediate Outcomes of ab Externo Circumferentialtrabeculotomy and Canaloplastyin POAG Patients with Prior Incisional Glaucoma Surgery
Authors: Wang Huaizhou , Xin Chen , Han Ying , Shi Yan , Ziaei Sarah , Wang Ningli 
Published: June 2020

Abstract
Background: To compare the efficacy and safety of ab externo circumferential trabeculotomy (ECT) and canaloplasty on primary open angle glaucoma (POAG) patients with failed filtering surgery and intact schlemm’s canal (SC).Methods: We conducted a retrospective chart review of POAG patients with failed filtering surgery and intact SC, who further received ECT and canaloplasty. The primary outcome measures were intraocular pressure (IOP) and the number of topical medications at each follow-up point.The secondary outcome compared the quantified success rate at1-year follow-up between the groups. Results:Twenty-nine eyes were recruited in the ECT group and 19 eyes in canaloplasty group. The postoperative IOP and the number of topical medications decreased significantly in both groups(p<0.001). The IOP at 3-month and 6-monthwas significantly lower in the ECT group (p=0.039, p=0.001) than in the canaloplasty group. Although the IOP at 12-mon was similar between the two groups, the number of topical medications was less in the ECP group (p=0.040). Hyphema (72.4%) and ciliary body detachment (27.6%), which mainly resolve spontaneously, were two leading complications in the ECT group. The prevalence of hyphema was higher in ECT than in canaloplasty group (p<0.001). Conclusion: For POAG with failed filtering surgery and intact SC, canaloplasty may be safer, whereas ECT presented better IOP control.Translational Relevance:
The association between various biological, behavioural and psychosocial factors and type 2 diabetes mellitus in Africa: a systematic review and meta-analysis
Authors: Issaka Ayuba , Paradies Yin , Cameron Adrian J , Stevenson Christopher 
Published: June 2020

Abstract
Background

Type 2 diabetes mellitus (T2DM) is a significant public health concern in many African countries. While the determinants underpinning T2DM are likely to be Africa-specific, knowledge of these risk factors is largely derived from developed countries. This is the first systematic review and meta-analysis to include biological, behavioural and psychosocial risk factors for T2DM in Africa.
Methods

Relevant scientific databases were searched, and data were extracted from 66 studies. Fifty- nine studies reported unadjusted data and were analysed using Comprehensive Meta-Analysis (CMA) software version 2.0. The Odds ratios (OR) and their 95% CIs for the associations between BMI indices (overweight, obesity), central obesity (waist circumference, waist to hip ratio), behavioural (alcohol, fruit and vegetable consumption, smoking), physical inactivity, and psychosocial factors (stress, anxiety, and depression) and T2DM were calculated using a random-effect model. Moderator effects of age, language-spoken, sub-regions and urban/rural location was assessed.
Results

A number of risk factors were associated with T2DM including, BMI-based definitions of obesity [OR = 3.22, 95% CI: 92.73, 3.80)], overweight [OR = 2.22, 95% CI: (1.90, 2.58)], or overweight/obesity [OR = 2.58, 95% CI: (1.76, 3.78)]; Central obesity as measured by waist circumference [OR = 2.51, 95% CI: (1.86, 3.37)], or waist to hip ratio [OR = 2.03, 95% CI: 1.51, 2.72]; psychosocial factors which includes stress [OR = 2.2, 95% CI: (1.46, 3.31)], depression [OR = 2.42, 95% CI: (1.14, 3.31)] and anxiety [OR = 2.05, 95% (CI:1.0, 4.18)] and physical inactivity [OR = 1.88, 95% CI: (1.53, 2.23)]. Current smoker [OR = 1.13, 95% CI: (0.84, 1.49)], alcohol consumption [OR = 1.10, 95% CI: (0.82, 1.47)] and inadequate fruit and vegetable consumption [OR = 0.81, 95% CI: (0.57, 1.16)] were not associated with T2DM. Locality (urban/rural), language spoken, and sub-region (East/West Africa) did not significantly moderate the associations between the risk factors and T2DM.
Conclusion

Obesity (defined by BMI) is most strongly associated with T2DM. Overweight, waist circumference and waist to hip ratio, physical inactivity, psychosocial risk factors defined as stress, depression, anxiety were all significantly associated with T2DM. These findings add novel meta-analyses of associations between diverse individual risk factors and T2DM within the African context.
Perceived facilitators and barriers to chronic disease management in primary care networks: a qualitative study
Authors: Foo Chuan De , Surendran Shilpa , Tam Chen Hee , Ho Elaine Qiao Ying , Matchar David Bruce , Car Josip , Koh Gerald Choon Huat 
Published: June 2020

Abstract
Background

The increasing chronic disease burden in developed countries has placed tremendous strain on tertiary healthcare infrastructure and resources. Therefore, there is an urgent need to shift chronic disease management from tertiary to primary care providers to mitigate the increase in demand for chronic care at hospitals. The organization of private general practitioners (GPs) into Primary Care Networks (PCNs) is a pragmatic move by Singapore, a developed and multi-ethnic urban city, to provide private GPs with team-based care capabilities and a platform to track care indicators for better management of chronic patients. As the PCN initiative is still in its embryonic stages, there is a void in research regarding its ability to empower private GPs to manage chronic patients effectively. This qualitative study aims to explore the facilitators and barriers for the management of chronic patients by private GPs in the PCN.
Method:

We conducted 30 semi-structured in-depth interviews with GPs enrolled in a PCN. Qualitative analysis of audio transcripts was performed to extract themes which highlighted the facilitators and barriers faced by PCN in the early stages of its development.
Results

Our results suggest that PCNs facilitated private GPs to more effectively manage chronic patients through 1) provision of ancillary services such as diabetic foot screening, diabetic retinal photography and nurse counselling to permit a “one-stop-shop”, 2) systematic monitoring of process and clinical outcome indicators through a chronic disease registry (CDR) to promote accountability for patients’ health outcomes and 3) funding streams for PCNs to hire additional manpower to oversee operations and to reimburse GPs for extended consultations. Barriers include high administrative load in maintaining the CDR due to the lack of a smart electronic clinic management system and financial gradient faced by patients seeking services from private GPs which incur higher out-of-pocket expenses than public primary healthcare institutions.
Conclusion

PCNs demonstrate great promise in empowering and motivating private GPs to manage chronic patients. However, barriers will need to be addressed to ensure the quality and comprehensiveness of PCNs in managing more chronic patients in the face of an ageing population.
The Impact of Parental Myopia on Myopia in University Students: A Cross-Sectional Study from Shanghai, China
Authors: Li Weiran , Xun Pengcheng , Cui Chang , Zhou Jibo 
Published: June 2020

Abstract
Background: To evaluate the effect of parental myopia on Chinese university students with a high prevalence of myopia in Shanghai.Methods: A cross-sectional study of university students in Shanghai, China. All participants responded to a detailed questionnaire, including questions about age, ethnicity and family history. They underwent a standardized ophthalmological examination, including visual acuity, a slit lamp examination and non-cycloplegic auto-refraction. Generalized linear model was used to identify risk factors for myopia.Results: Of the 11,977 total subjects, 91.55% were myopic (spherical equivalent refraction [SER] ≤ -0.75 D), 20.18% were highly myopic (SER ≤ -6.0 D) and only 6.94% were emmetropic (-0.75 D＜SER ≤ 0.75 D). The mean age of the myopic participants (19.7±2.4) was higher than that of the emmetropic participants (19.3±1.9, p < 0.001). 10391 (91.8%) of Han students were myopic, which exhibited greater myopia than minority students (91.5%, p < 0.001). Among the students from families with two myopic parents, 97.9% had myopia. Only 93.7% of students had myopia where only one parent was myopic, and among the students without myopic parents, 90.7% had myopia (p < 0.001). Female students whose parents were myopic (8.0%) were more likely to have myopia than male students whose parents were myopic (7.5%) (p < 0.001). Students with two myopic parents (mean difference: -2.04, 95% CI: -2.21, -1.86) were at a high risk of myopia compared with students with no myopic parents (p < 0.001).Conclusions: This study showed that the refractive status of children in a population with a high prevalence of myopia was related to the status of parents. Increased severity of parental myopia led to a greater risk of myopia in their children.
Factors Associated with the Type of Cesarean Section and the Risk of Postoperative Complications in Greek Women
Authors: Antoniou Evangelia , Orovou Eirini , Iliadou Maria , Sarella Angeliki , Palaska Ermioni , Sarantaki Antigoni , Iatrakis Georgios , Dagla Maria 
Published: June 2020

Abstract
Background Cesarean Section was historically performed to save the lives of mothers and infants. Ηowever, in the past decades, a significant increase in Cesarean Section rates have been observed in Greece and worldwide. The purpose of this research was to investigate the contributing factors to the increase in the Cesarean Section rate (emergency and elective) and postoperative complications.Methods A total of births in 6 months (August 2019- February 2020) at the University Hospital of Larisa in Greece was collected. The performed analysis included the available socio-demographic and medical information in the medical records and a socio-demographic and medical questionnaire for women with cesarean deliveries. We also analyzed the importance of the variables in cesarean deliveries compared to vaginal deliveries and postoperative complications.Results Out of the total number of the included 633 births, the vaginal delivery rate was 42% (n = 268), and the cesarean delivery rate was 58% (n = 365); Elective Cesarean Section was performed in 36% (n = 230) of the Cesarean Section cases and Emergency Cesarean Section in 22% (n = 135). Women with a previous Cesarean Section and women with in vitro fertilization showed higher percentages for Elective Cesarean Section (46%) compared to women who underwent an Emergency Cesarean Section for the same reasons (42.2%). Besides, a higher percentage of Emergency Cesarean Sections was observed in women living in urban centers (OR = 4.044, p = 0.002) and those diagnosed with stress disorders (OR = 7.048, p = 0.004). Furthermore, Cesarean Section complications were more common among women having undergone Emergency Cesarean Section (OR = 10.357, p < 0.001).Conclusion The overall high rates of Cesarean Section in Greece demonstrate the lack of national strategies and prevention mechanisms from iatrogenic interventions and lack of promoting good midwifery practices. More specifically, a decrease in iatrogenic factors leading to the primary Cesarean Section will decrease Cesarean Section rates in Greece.