bluuebunny/crossref_metadata_2025_split huggingface dataset:
Involvement of ABC-transporters and acyltransferase 1 in intracellular cholesterol-mediated autophagy in bovine alveolar macrophages in response to the Bacillus Calmette-Guerin (BCG) infection
Authors: Xu Jinrui , Zhou Yanbing , Yang Yi , Lv Cuiping , Liu Xiaoming , Wang Yujiong 
Published: May 2020

Abstract
Background: Understanding pathogenic mechanisms is imperative for developing novel treatment to the tuberculosis, an important public health burden worldwide. Recent studies demonstrated that host cholesterol levels have implications in the establishment of Mycobacterium tuberculosis ( M. tuberculosis , Mtb ) i nfection in host cells, in which the intracellular cholesterol-mediated ATP-binding cassette transporters (ABC-transporters) and cholesterol acyltransferase1 (ACAT1) exhibited abilities to regulate macrophage autophagy induced by Mycobacterium bovis Bacillus Calmette–Guérin (BCG). Methods: In the present report, the involvements of ABC-transporters and ACAT1-mediated intracellular cholesterol in autophagy of bovine alveolar macrophages induced by Mycobacterium bovis BCG were interrogated by enzymatic and biochemistry assays in vitro, including quantitative RT-PCR and immunoblotting assays. Results: The results showed that a down-regulated expression of the ABC-transporters and ACAT1 in primary bovine alveolar macrophages (AMs) and murine RAW264.7 cells in response to BCG infection. The inhibited expression of ABC-transporters and ACAT1 was associated with the reduction of intracellular free cholesterol, which in turn induced autophagy in macrophages upon to the Mycobacterial infection. These results strongly suggest an involvement of ABC-transporters and ACAT1 in intracellular cholesterol-mediated autophagy in AMs in response to BCG infection. Conclusion: This study thus provides an insight into into a mechanism by which the cholesterol metabolism regulated the autophagy in macrophages in response to mycobacterial infections .
Why women chose unassisted home birth in Malaysia: A qualitative study
Authors: Tajuddin Nur Amani @ Natasha Ahmad , Suhaimi Julia , Ramdzan Siti Nurkamilla , Malek Khasnur Abd , Ismail Ilham Ameera , Shamsuddin Nurainul Hana , Bakar Ahmad Ihsan Abu , Othman Sajaratulnisah 
Published: May 2020

Abstract
Background: Incidences of unassisted home birthing practices have been increasing in Malaysia despite the accessibility to safe and affordable child birthing facilities. We aimed to explore the reasons for women to make such decisions. Methods: Twelve women participated in in-depth interviews. They were recruited using a snowballing approach. The interviews were supported by a topic guide which was developed based on the Theory of Planned Behaviour and previous literature. The interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis.Results: Women in this study described a range of birthing experiences and personal beliefs as to why they chose unassisted home birth. Four themes emerged from the interviews; i) preferred birthing experience, ii) birth is a natural process, iii) expressing autonomy and iv) faith. Such decision to birth at home unassisted was firm and steadfast despite the possible risks and complications that can occur. Giving birth is perceived to occur naturally regardless of assistance, and unassisted home birth provides the preferred environment which health facilities in Malaysia may lack. They believed that they were in control of the birth processes apart from fulfilling the spiritual beliefs.Conclusions: Women may choose unassisted home birth to express their personal views and values, at the expense of the health risks. Apart from increasing mothers' awareness of the possible complications arising from unassisted home births, urgent efforts are needed to provide better birth experiences in healthcare facilities that resonate with the mothers’ beliefs and values.
Baseline Low ALT Activity, a Marker of Sarcopenia and Frailty, is Associated with Increased Long-Term Mortality after COPD Exacerbations. Historic Prospective Cohort Study.
Authors: Lasman Nir , Shalom Matan , Turpashvili Natia , Goldhaber Gal , Lifshitz Yulia , Leibowitz Eyal , Berger Gideon , Zalzman-Shenhav Gilat , Brom Adi , Cohen Dor , Avaki Chen , Segal Gad 
Published: May 2020

Abstract
Background. COPD exacerbations have negative impact on patients' survival. Several risk factors for grave outcomes of such exacerbations have been descried. Muscle dysfunction and mass loss were shown to impact negatively on prognosis and survival. Low activity of the enzyme ALT (Alanine amino-transferase) in the blood is a known indicator for sarcopenia and frailty, however, no previous studies addressed the association of low ALT amongst patients hospitalized due to COPD exacerbation and long-term survival. Methods. This is a historic prospective cohort study of patients hospitalized due to acute COPD exacerbation. Results. Included were 232 consecutive COPD exacerbation patients. The median time of follow-up was 34.9 months (IQR 23.13 – 41.73 months). During this period 104 (44.8%) patients died. All patients were grouped to quartiles according to blood ALT levels (after exclusion of cases considered to have hepatic tissue damage (ALT > 40 IU)). The risk of long-term mortality increased, in a statistically significant manner, amongst patients with low ALT values: the median survival of patients with ALT < 11 IU was 18.5 months only while the median survival for the rest of the study group was not reached. For ALT < 11IU; 12-16IU; 17-20IU and >21IU the mortality rates were 69%; 40.9%; 36.3% and 25% respectively (p < 0.001 for comparison of lower quartile with upper three quartiles). The crude hazard ratio for mortality amongst patients with ALT levels lower than 11IU was 2.37 (95% CI; 1.6 – 3.5). This increased risk of mortality remained significant after adjustment for age, weight, creatinine, albumin concentration and cardiovascular diseases (HR = 1.83; 95% CI 1.08 – 3.1, p < 0.05). Conclusions. Low ALT values, a biomarker of sarcopenia and frailty, are associated with poor long-term survival amongst patients hospitalized due to COPD exacerbation.
Pertussis outbreak in Southern Ethiopia: challenges of detection, management and response
Authors: Mitiku Aychiluhim Damtew , Argaw Mesele Damte , Desta Binyam Fekadu , Tsegaye Zergu Taffesse , Atsa Afework Ayele , Tefera Bekele Belayihun , Teferi Ephreme , Rogers Deirdre , Ali Ismael , Gebeyehu Asrat , Anjulo Desta , Abate Derebe Tadesse , Sendeku Agegnehu Gebru , Mulowa Rudzani 
Published: May 2020

Abstract
Background: Despite the availability of effective vaccines, pertussis remains endemic with high fatality rates in low and middle-income countries (LMIC).This study aims to describe an outbreak of pertussis in a health district of Ethiopia. The study highlights the challenges faced by the health system in identifying pertussis cases and appropriately responding to the outbreak at district level. Method: a descriptive cross-sectional study was conducted using data sourced from the district Public Health Emergency and Management (PHEM) surveillance service and outbreak management field reports. Stratified attack rates and fatality rates for pertussis are described. Systemic problems leading to the outbreak are explored and narrated. A modified CDC pertussis case definition was employed with polymerase chain reaction used to confirm cases. Results: From September 2018 to January 2019, 1840 suspected, probable and confirmed pertussis cases and six deaths were identified. Pertussis cases ranged from 1 month to 51 years in age and outbreak occurred in 14 out of the 24 villages of Dara Malo district. The overall attack rate was 1708 per 100,000 population with a fatality rate of 3.3 per 1,000 pertussis cases. The highest attack rate of 12,689/100,000 was seen in infants. Only 41.1% had completed the three-dose pertussis vaccine primary schedule. Investigations suggested the existence of poor cold chain management system in the study area. Conclusion: There is an urgent need to build capacity to strengthen routine vaccination services and improving the maintenance of vaccine cold chain. Other Low-and Middle -Income Countries (LMICs), are urged to take lessons learnt from this outbreak and strengthen their own vaccination programs and capacitate health workers to manage local outbreaks.
Intracranial-to-Central Venous Pressure Gap Predicts the Responsiveness of Intracranial Pressure to PEEP in Patients with Traumatic Brain Injury: a Prospective Cohort Study
Authors: Peng Li Hong , Ning Lin Ying , Hui Cheng Zhi , Wei Qu , Liu Zhang , Yun Li Qing 
Published: May 2020

Abstract
Background: Mechanical ventilation (MV) with positive end-expiratory pressure (PEEP) is commonly applied in patients with severe traumatic brain injury (sTBI). However, the individual responsiveness of intracranial pressure (ICP) to PEEP varies. Thus, identifying an indicator detecting ICP responsiveness to PEEP is of great significance. As central venous pressure (CVP) could act as an intermediary to transduce pressure from PEEP to ICP, we developed a new indicator, PICGap, representing the gap between baseline ICP and baseline CVP. The aim of the current study was to explore the relationship between PICGap and ICP responsiveness to PEEP. Methods: A total of 112 patients with sTBI undergoing MV were enrolled in this prospective cohort study. ICP, CVP, cerebral perfusion pressure (CPP), static compliance of the respiratory system (Cst), and end-tidal carbon dioxide pressure (PetCO2) were recorded at the initial (3 cmH2O) and adjusted (15 cmH2O) levels of PEEP. PICGap was assessed as baseline ICP - baseline CVP (when PEEP=3 cmH2O). The patients were classified into the ICP responder and non-responder groups based on whether ICP increment with PEEP adjusted from 3 cmH2O to 15 cmH2O was greater than 20% of baseline ICP. The above parameters were compared between the two groups, and prediction of ICP responsiveness to PEEP adjustment was evaluated by receiver operating characteristic (ROC) curve analysis. Results: Compared with the non-responder group, the responder group had lower PICGap (1.63±1.33 versus 6.56±2.46 mmHg; p<0.001), lower baseline ICP, and higher baseline CVP. ROC curve analysis suggested that PICGap was a stronger predictive indicator of ICP responsiveness to PEEP (AUC=0.957, 95%CI 0.918-0.996; p<0.001) compared with baseline ICP and baseline CVP, with favorable sensitivity (95.24%, 95%CI 86.91%-98.70%) and specificity (87.6%, 95%CI 75.76%-94.27%), at a cut off value of 2.5 mmHg. Conclusion: The impact of PEEP on ICP depends on the gap between baseline ICP and baseline CVP, i.e. PICGap. In addition, PICGap is a potential predictor of ICP responsiveness to PEEP adjustment in patients with sTBI.
Adherence to ready-to-use food and acceptability of outpatient nutritional therapy in HIV-infected undernourished Senegalese adolescents: research-based recommendations for routine care.
Authors: Niasse Fatou , Varloteaux Marie , Diop Karim , Ndiaye Sidy Mokhtar , Diouf François Niokhor , Mbodj Pape Birane , Niang Babacar , Diack Aminata , Cames Cecile 
Published: May 2020

Abstract
Background: Ready-to-use food (RUF) is increasingly used for nutritional therapy in HIV-infected individuals. However, practical guidance advising nutrition care to HIV-infected adolescents is lacking, so that little is known about the acceptability of such therapy in this vulnerable population. This study assesses the overall acceptability and perception of a RUF-based therapy and risk factors associated with sub-optimal RUF intake in HIV-infected undernourished adolescents in Senegal.Methods: Participants 5 to 18 years of age with acute malnutrition were enrolled in 12 HIV clinics in Senegal. Participants were provided with imported RUF, according to WHO prescription weight- and age-bands (2009), until recovery or for a maximum of 9-12 months. Malnutrition and recovery were defined according to WHO growth standards. Adherence was assessed fortnightly by self-reported RUF intake over the period. Sub-optimal RUF intake was defined as when consumption of the RUF provision was < 50%. RUF therapy acceptability and perceptions were assessed using a structured questionnaire at week 2 and focus group discussions (FGDs) at the end of the study. Factors associated with sub-optimal RUF intake at week 2 were identified using a stepwise logistic regression model. Results: We enrolled 173 participants, with a median age of 12.5 years (Interquartile range: 9.5 – 14.9), of whom 61% recovered from malnutrition within the study period. Median follow-up duration was 66 days (21 – 224). RUF consumption was stable, varying between 64% and 57% of the RUF provided, throughout the follow-up. At week 2, sub-optimal RUF intake was observed in 31% of participants. Dislike of the taste of RUF (aOR=5.0, 95% CI: 2.0 – 12.3), HIV non-disclosure (5.1, 1.9 – 13.9) and food insecurity (2.8, 1.1 – 7.2) were the major risk factors associated with sub-optimal RUF intake at week 2. FGDs showed that the need to hide from others to avoid sharing and undesirable effects were other constraints on RUF feeding. Conclusions: This study revealed several factors reducing the acceptability and adherence to RUF therapy based on WHO guidelines in HIV-infected adolescents. Tailoring prescription guidance and empowering young patients in their care are crucial levers for improving the acceptability of RUF-based therapy in routine care. ClinicalTrials.gov identifier: NCT03101852, 04/04/2017
The development of a questionnaire to assess leisure time screen-based media use and its proximal correlates in children (SCREENS-Q)
Authors: Klakk Heidi , Wester Christian Tolstrup , Olesen Line Grønholt , Rasmussen Martin Gillies , Kristensen Peter Lund , Pedersen Jesper , Grøntved Anders 
Published: May 2020

Abstract
Background: The screen-media landscape has changed drastically during the last decade with wide-scale ownership and use of new portable touchscreen-based devices plausibly causing changes in the volume of screen media use and the way children and young people entertain themselves and communicate with friends and family members. This rapid development is not sufficiently mirrored in available tools for measuring children’s screen media use. The aim of this study was to develop and evaluate a parent-reported standardized questionnaire to assess 6-10-year old children’s multiple screen media use and habits, their screen media environment, and its plausible proximal correlates based on a suggested socio-ecological model. Methods: An iterative process was conducted developing the SCREENS questionnaire. Informed by the literature, media experts and end-users, a conceptual framework was made to guide the development of the questionnaire. Parents and media experts evaluated face and content validity. Pilot and field testing in the target group was conducted to assess test-retest reliability using Kappa statistics and intraclass correlation coefficients (ICC). Construct validity of relevant items was assessed using pairwise non-parametric correlations (Spearman’s). The SCREENS questionnaire is based on a multidimensional and formative model. Results: The SCREENS questionnaire covers six domains validated to be important factors of screen media use in children and comprises 19 questions and 92 items. Test-retest reliability (n=37 parents) for continuous variables was moderate to substantial with ICC’s ranging from 0.67 to 0.90. For relevant nominal and ordinal data, kappa values were all above 0.50 with more than 80 percent of the values above 0.61 indicating good test-retest reliability. Internal consistency between two different time use variables (from n=243) showed good correlations with rho ranging from 0.59 to 0.66. Response-time was within 15 min for all participants. Conclusions: SCREENS-Q is a comprehensive tool to assess children’s screen media habits, the screen media environment and possible related correlates. It is a feasible questionnaire with multiple validated constructs and moderate to substantial test-retest reliability of all evaluated items. The SCREENS-Q is a promising tool to investigate children screen media use.
The influence of dietary supplementation with the leucine metabolite β-hydroxy-β-methylbutyrate (HMB) on chemotaxis, phagocytosis and respiratory burst of peripheral blood granulocytes and monocytes in calves
Authors: Wójcik Roman , Małaczewska Joanna , Zwierzchowski Grzegorz , Miciński Jan , Kaczorek-Łukowska Edyta 
Published: May 2020

Abstract
Background A healthy immune system plays a particularly important role in newborns, including in calves that are far more susceptible to infections (viral, bacterial and other) than adult individuals. Therefore the objective of this study was to evaluate the effect of HMB on the chemotactic activity (MIGRATEST® kit), phagocytic activity (PHAGOTEST® kit) and respiratory burst (BURSTTEST® kit) of peripheral blood granulocytes and monocytes in calves by flow cytometry. Results An analysis of granulocyte and monocyte chemotactic activity and phagocytic activity revealed significantly higher levels of phagocytic activity in calves administered HMB than in the control group, expressed in terms of the percentage of phagocytising cells and mean fluorescence intensity (MFI). HMB also had a positive effect on the oxidative metabolism of both granulocytes and monocytes after stimulation with Escherichia coli bacteria and with PMA (4-phorbol-12-β-myristate-13-acetate), expressed in terms of the percentage of oxidative metabolism and MFI. Conclusion HMB stimulates non-specific cell-mediated immunity, which is a very important consideration in newborn calves that are exposed to adverse environmental factors in the first weeks of their life. The supplementation of animal diets with HMB for both preventive and therapeutic purposes can also reduce the use of antibiotics in animal production.
MiR-9-5p promotes rabbit preadipocyte differentiation by suppressing leptin gene expression
Authors: Luo Gang , Hu Shenqiang , Lai Tianfu , Wang Jie , Wang Li , Lai Songjia 
Published: May 2020

Abstract
Background: MicroRNAs (miRNAs) are a class of small non-coding RNAs, which participate in the regulation of cell differentiation. Previous studies have demonstrated that miR-9-5p plays a key role in cancer cell development, but the mechanisms by which miR-9-5p regulates adipogenesis remain poorly understood. The present study intended to investigate its significance in producing rabbits with high-quality meat by observing the regulatory effect of miR-9-5p in preadipocytes and finding the related targets. Methods: In this study, a dual-luciferase reporter assay was employed to validate the targeting relationship between miR-9-5p and leptin gene. We also utilized quantitative reverse transcription PCR (qRT-PCR), western blot, oil red-O staining assay, and determination of triglyceride content to analyze the regulation of miR-9-5p and leptin gene during adipocyte differentiation. Results: The analysis demonstrated that during preadipocyte differentiation, miR-9-5p was up-regulated and the fat formation related biomarkers, i.e., fatty acid-binding protein 4 (FABP4), CCAAT-enhancer binding protein α (C/EBPα), and peroxisome proliferator activated receptor γ (PPARγ) were also up-regulated. Meanwhile, the oil red-O staining assay revealed that the accumulation of lipid droplets increased. We also explored the expression pattern and role of miR-9-5p in adipogenesis using white pre-adipocytes. The results showed that miR-9-5p was up-regulated during preadipocyte differentiation, and overexpression of miR-9-5p enhanced lipid accumulation. Furthermore, we found that the overexpression of miR-9-5p significantly up- regulated the expression of marker genes, PPARγ, C/EBPα and FABP4, and increased the protein levels of PPARγ and triglyceride content. The results suggest that miR-9-5p might be involved in the regulation of rabbit preadipocyte differentiation. We predicted that leptin is the target gene of miR-9-5p, by using bioinformatics tools and the conclusion was validated by a luciferase reporter assay. Finally, we verified that the knock-down of leptin by si-leptin promoted preadipocyte differentiation in rabbits. Conclusion: The results of the present study indicate that miR-9-5p regulates white preadipocyte differentiation in rabbits by targeting the leptin gene.
A convenient clinical nomogram for predicting the cancer-specific survival of individual patients with small-intestine adenocarcinoma
Authors: Wang Na , Yang Jin , Lyu Jun , Liu Qingqing , He Hairong , Liu Jie , Li Li , Ren Xuequn , li zhendong 
Published: May 2020

Abstract
Background: The objective of this study was to develop a practical nomogram for predicting the cancer-specific survival (CSS) of patients with small-intestine adenocarcinoma. Methods: Patients diagnosed with small-intestine adenocarcinoma between 2010 and 2015 were selected for inclusion in this study from the Surveillance, Epidemiology, and End Results (SEER) database. The selected patients were randomly divided into the training and validation cohorts at a ratio of 7:3. The predictors of CSS were identified by applying both forward and backward stepwise selection methods in a Cox regression model. The performance of the nomogram was measured by the concordance index (C-index), the area under receiver operating characteristic curve (AUC), calibration plots, the net reclassification improvement (NRI), the integrated discrimination improvement (IDI), and decision-curve analysis (DCA).Results: Multivariate Cox regression indicated that factors including age at diagnosis, sex, marital status, insurance status, histology grade, SEER stage, surgery status, T stage, and N stage were independent covariates associated with CSS. These factors were used to construct a predictive model, which was built and virtualized by a nomogram. The C-index of the constructed nomogram was 0.850. The AUC values indicated that the established nomogram displayed better discrimination performance than did the seventh edition of the American Joint Committee on Cancer TNM staging system in predicting CSS. The IDI and NRI also showed that the nomogram exhibited superior performance in both the training and validation cohorts. Furthermore, the calibrated nomogram predicted survival rates that closely corresponded to actual survival rates, while the DCA demonstrated the considerable clinical usefulness of the nomogram.Conclusion: We have constructed a nomogram for predicting the CSS of small-intestine adenocarcinoma patients. This prognostic model may improve the ability of clinicians to predict survival in individual patients and provide them with treatment recommendations.