bluuebunny/crossref_metadata_2025_split huggingface dataset:
Elevated serum matrix metalloprotease (MMP-2) as a candidate biomarker for stable COPD.
Authors: Mahor Durga , Kumari Vandana , Vashisht Kapil , Galgalekar Ruma , Samartha Ravindra M , Mishra Pradyumna K , Banerjee Nalok , Dixit Rajnikant , Saluja Rohit , De Sajal , Pandey Kailash C 
Published: August 2020

Abstract
Background: The increasing trend of Chronic Obstructive Pulmonary Disease (COPD) in becoming the third leading cause of deaths by 2020 is of great concern, globally as well as in India. Dysregulation of protease/anti-protease balance in COPD has been reported to cause tissue destruction, inflammation and airway remodelling; which are peculiar characteristics of COPD. Therefore, it is imperative to explore various serum proteases involved in COPD pathogenesis, as candidate biomarkers. COPD and Asthma often have overlapping symptoms and therefore involvement of certain proteases in their pathogenesis would render accurate diagnosis of COPD to be difficult.Methods: Serum samples from controls, COPD and Asthma patients were collected after requisite institutional ethics committee approvals. The preliminary analysis qualitatively and quantitatively analyzed various serum proteases by ELISA and mass spectrometry techniques. In order to identify a distinct biomarker of COPD, serum neutrophil elastase (NE) and matrix metalloprotease-2 (MMP-2) from COPD and Asthma patients were compared; as these proteases tend to have overlapping activities in both the diseases. A quantitative analysis of the reactive oxygen species (ROS) in the serum of controls and COPD patients was also performed. Statistical analysis for estimation of p-values was performed using unpaired t-test with 95% confidence interval.Results: Amongst the significantly elevated proteases in COPD patients vs the controls- neutrophil elastase (NE) [P <0.0241], caspase-7 [P <0.0001] and matrix metalloprotease-2 (MMP-2) [P <0.0001] were observed, along with increased levels of reactive oxygen species (ROS) [P <0.0001]. The serum dipeptidyl peptidase-IV (DPP-IV) [P <0.0010) concentration was found to be decreased in COPD patients as compared to controls. Interestingly, a distinct elevation of MMP-2 was observed only in COPD patients, but not in Asthma, as compared to controls. Mass spectrometry analysis further identified significant alterations (fold-change) in various proteases (carboxy peptidase, MMP-2 and human leukocyte elastase), anti-proteases (Preg. zone protein, α-2 macroglobulin, peptidase inhibitor) and signalling mediators (cytokine suppressor- SOCS-3).Conclusion: The preliminary study of various serum proteases in stable COPD patients distinctly identified elevated MMP-2 as a candidate biomarker for COPD, subject to its validation in large cohort studies.
Design, Synthesis And Invitro Biological Evaluation Of Benzothiazole, Indole And Imidazole Derivatives As Anti Tubercular Agents Targeting Glutamine Synthetase-1&nbsp;
Authors: Suresh Ayyadurai Jerad , Meenakumari Venkatesan , kalairasi Ponmozhi , Kanimozhi Thangamariyappan , Ramakrishnan Surya Parakkot 
Published: August 2020

Abstract
Due to the emergence of multidrug-resistant TB (MDR-TB) and extensively drug resistant (XDR) TB, the disease becomes a major health security threat globally2. In order to eliminate DRTB there is an urgent need of novel molecules which are very effective with lesser side effects. Hence this research work focused to work on synthesis and biological evaluation of benzothiazole, indole and imidazole derivatives as anti tubercular agents. Benzothiazole, indole and imidazole moieties were designed and docked against glutamine synthetase (PDB ID-3ZXR) using Autodock®tools software. Compounds with minimum binding energy were selected and screened for in silico toxicity prediction using osiris® software and in silico drug likeness prediction by using molinspiration® software. The compounds were synthesized and characterized by IR, 1H NMR and LC-MS. Anti-tubercular activity was evaluated by Microplate Alamar Blue Assay (MABA) method. Among the synthesized compounds, indole derivatives and imidazole derivatives was found to be active at micro gram level.
MRI Patterns of Non-Enhancing T2-FLAIR Hyperintensity Lesions in Primary CNS Lymphoma
Authors: Liu Hao , Hou Haiman , Liu Xiaoge , Bai Jie , Zhang Yong , Cheng Jingliang 
Published: August 2020

Abstract
Purpose: The non-enhancing T2-FLAIR hyperintensity lesions at a distance from the enhancing tumor site at baseline have been observed of neoplastic nature in primary central nervous system lymphomas (PCNSL). Our aim was to explore the incidence, location, and morphology of the non-enhancing T2-FLAIR hyperintensity lesions in PCNSL.Methods: We retrospectively reviewed patients diagnosed with immunocompetent PCNSL at our institution. We identified and evaluated the T2-FLAIR hyperintensity lesions without enhancement that markedly decrease or disappear in the MRI after treatment. MRI characteristics of PCNSL at initial presentation were analyzed and compared between patients with non-enhancing T2-FLAIR hyperintensity lesions and patients without these lesions.Results: Among 89 patients, 10 patients (11.2%) were found to have non-enhancing T2-FLAIR hyperintensity lesions at a distance from the enhancing tumor site at baseline, that showed a markedly decrease or disappearance after treatment. The locations of these lesions were as follows: the juxtacortical and deep white matter in 7 lesions, periventricular white matter in 2 lesions, basal ganglia in 1 lesion, and infratentorial aera in 1 lesion. Baseline MRI characteristics in patients with non-enhancing T2-FLAIR hyperintensity lesions exhibited a higher rate of multiple enhancing lesions (P = 0.027), and bilateral enhancing lesions (P = 0.001), compared to patients without non-enhancing T2-FLAIR hyperintensity lesions.Conclusion: Non-enhancing T2-FLAIR hyperintensity lesions at a distance from the enhancing tumor lesions in patients with PCNSL, which indicated of neoplastic nature, was not rare. Those non-enhancing lesions should be incorporated in the initial evaluation of tumor burden and response in the follow up.
Regional Variation and Socioeconomic Inequalities in Obesity Prevalence Among Non-pregnant Women in Chad: Evidence From Three Waves of Chad Demographic and Health Surveys
Authors: Shibre Gebretsadik , Zegeye Betregiorgis Hailu , Garedew Gashaw Woldeamanuiel , Negash Wassie , Lemma Gorems , Mamo Mitku Taderegew 
Published: August 2020

Abstract
Background: While the prevalence of obesity is increasing worldwide, the growing rates of overweight and obesity in developing countries are alarming. Obesity is widely recognized as a risk factor for non-communicable diseases (NCDs), including diabetes, cancer and cardiovascular diseases. Available evidence on whether obesity has been more prevalent among higher or lower socioeconomic groups, across regions and urban-rural women’s are inconsistent. This study examined socioeconomic, urban-rural and sub-national regional inequalities in obesity among non-pregnant women in Chad.Method: Using cross-sectional data from Demographic and Health Surveys (DHS) from Chad conducted between 1996 and 2014, we used the World Health Organization Health Equity Assessment Toolkit to analyze the socio-economic and regional inequalities in obesity prevalence among non-pregnant women aged 15-49 years. Inequalities are assessed using socioeconomic and demographic indicators such as wealth index, education level and place of residence. We presented inequalities using both simple and complex summary measures, namely Difference (D), Population Attributable Risk (PAR), Population Attributable Fraction (PAF) and Ratio (R).Results: Though constant pattern overtime, both wealth-driven and place of residence inequality were observed in all three surveys by Difference measure and in the first and last surveys by Ratio measure. Similarly, including the recent survey (D=-2.80%, 95% CI:-4.15, -1.45, R= 0.37%, 95% CI: 0.23, 0.50) absolute (in 1996 & 2014 survey) and relative (in all three surveys) educational status inequality with constant pattern were observed. Substantial absolute (PAR=-2.2%, 95% CI: -3.21, -1.34) and relative (PAF= -91.9%, 95% CI: -129.58, -54.29) regional inequality was observed with increasing and constant pattern by simple (D) and complex (PAR, PAF) measures. Conclusion: Both socioeconomic and area-based obesity inequalities disfavoring women in the higher socioeconomic status and residing in urban areas. Prevention of obesity prevalence should be government and stakeholders’ priority through organizing the evidence, health promotion and prevention interventions for at risk population and general population.
A Congenital Right Sided Diaphragmatic Hernia Presented in Pregnancy: Rare Case Report
Authors: Gharde Pankaj , Dwivedi Sankalp , Gharde Pramita Muntode , Jamdade Piyush , Aalam Azeem 
Published: August 2020

Abstract
Background: Diaphragmatic hernias are infrequent and remain undiagnosed till the symptoms arise. One third of these patients are asymptomatic. Its diagnosis is only established on the emergence of gastrointestinal, respiratory or cardiovascular complications. Surgical intervention is needed if complications arise. These Diaphragmatic hernias usually involve the left side of diaphragm either through a congenital defect or from a trauma over abdomen or chest as the right side has a type of protective gear which is the Liver lying below the diaphragm. The occurrence of right sided diaphragmatic hernia is rarest of rare. Patients may present with shortness of breath, obstruction, strangulation, gangrene and perforation of gut. The mortality is very high. Symptomatic diaphragmatic hernia in pregnant females is a matter of greater concern. Case Report: A 21-yr-old female, primigravida, primipara, with 22 weeks gestation, complained of severe abdominal pain and intractable vomiting since the last 7 days and for this acute intestinal obstruction was admitted to the emergency department. At the local Primary Health Center her symptoms were partially relieved by symptomatic management, but due to recurrence of symptoms she was referred to our rural hospital.Her chest radiograph revealed a right sided diaphragmatic hernia with large and small intestine as its content. She had no abdominal or respiratory complaints in past. Initially the patient’s general condition improved by nasogastric aspiration but then she developed tachycardia, tachypnoea, nausea and vomiting despite nasogastric aspiration, so emergency exploration was done. Exploratory laparotomy along with right thoracotomy was performed. As the gut was gangrenous, resection anastomosis was done along with diaphragmatic hernia repair.Conclusion: Diaphragmatic hernia in adults and pregnancy is a very rare entity. The right sided diaphragmatic hernia is rarest of rare that too in pregnancy.What makes this case even extraordinary is, it being the first case in studied literature showing specific right sided presentation during pregnancy, as the rest are left sided. Even though the risk of morbidity and mortality is high, once complications arise, but early intervention improves the outcome.
Patient Involvement to Inform the Design of a Clinical Trial in Postbariatric Hypoglycemia
Authors: Hepprich Matthias , Donath Marc Y , Hemkens Lars G 
Published: August 2020

Abstract
Background: Bariatric surgery may lead to symptomatic postprandial hypoglycemia as a major side effect without established therapy so far. We aimed to develop an evidence-based study design of a clinical trial that tests treatment options and can provide useful patient-relevant evidence.Methods: We searched systematically for guidance of core outcome sets to determine the most relevant types of outcomes and duration of such a trial. Our search comprised literature databases, a database of core outcome sets and self-help organizations. We then developed a simple online questionnaire based on interviews with German-speaking patients with postprandial hypoglycemia after bariatric surgery. We recruited participants by reaching out to all German speaking endocrinologists in Switzerland and large Swiss bariatric centers. We asked for preferences regarding outcome types and acceptable duration of being included in a corresponding clinical trial.Results: The systematic search did not identify evidence-based guidance for informing our study design. Experience of clinical and research routine as well as patient interviews helped in identifying potential outcomes and the design of an online questionnaire. Therein, a total of 29 persons started the questionnaire and 22 answered questions related to the primary outcome. Of these, 17 (77.3%) deemed quality of life more relevant as primary outcome than the rate of hypoglycemic episodes. A trial length of four weeks or longer was regarded as acceptable for 19 of 21 respondents to this question (91.4 %) and of six months or longer for 12 respondents (56 %). Conclusions: In situations with no other guidance, a simple questionnaire may help to inform trial design decisions. This study identifies a patient preference for “quality of life” as a primary outcome and supports the evidence-based conception of a patient-centered clinical trial in postbariatric hypoglycemia.
Chordoid Glioma of the Third Ventricular with Three less Common Patterns and Three Rare Patterns
Authors: ma xiaomei , zhu zhi , wang yin , li weiqing 
Published: August 2020

Abstract
BackgroundChordoid gliomas are rare, low-grade neoplasms of the third ventricle. In the updated 4th edition of the 2016 WHO classification of tumours of the CNS, it described some three less common histological patterns and rare tissue patterns. Case presentationHere we reported a case with all the uncommon patterns. It was a 52-year-old woman with dizziness and blurred vision. Imaging showed a solid tumor located in the third ventricle with a well-circumscribed border. Histological, almost tumor cells formed into atypical glands with different sizes and irregular shapes in an abundant of solid or loosely collagen matrix. Some tumor cells formed into papillary patterns, micro-papillary patterns. pseudoglandular patterns. Some focal tumor cells were spindle-shape. Only few epithelioid tumor cells formed into clusters and cords embedded into a myxoid stroma like the chordoma. No anaplastic features were identified in any lesion. Immunohistochemically, all the tumor cells were strong reactivity for TTF-1. Some tumor cells strong but focal reactivity for GFAP, NEU-N, and CD34. It showed a recurrent D463H missense mutation in PRKCA. All these findings confirm that the diagnosis was chordoid glioma of the third ventricular. ConclusionsThere may be lots of histopathological features in one chordoid glioma case. It maybe suggested that PRKCA D463H mutation and TTF-1 positive may help to diagnose it.
Development and verification of immune-related long non-coding RNA prognostic signature in bladder cancer
Authors: Lai Cong , Wu Zhenyu , Li Zhuohang , Yu Hao , Li Kuiqing , Tang Zhuang , Liu Cheng , Xu Kewei 
Published: August 2020

Abstract
Background: Bladder cancer is the second most common malignant tumor in urogenital system. The research aimed to investigate the prognostic role of immune-related long non-coding RNA (lncRNA) in bladder cancer. Methods: We extracted 411 bladder cancer samples from The Cancer Genome Atlas database. Single-sample gene set enrichment analysis was employed to assess the immune cell infiltration of these samples. We recognized differentially expressed lncRNAs between tumors and paracancerous tissues, and differentially expressed lncRNAs between the high and low immune cell infiltration groups. Venn diagram analysis detected differentially expressed lncRNAs that intersected the above groups. LncRNAs with prognostic significance were identified by regression analysis and survival analysis. Multivariate Cox analysis was used to establish the risk score model. The nomogram was established and evaluated by receiver operating characteristic (ROC) curve analysis, concordance index (C-index) analysis, calibration chart, and decision curve analysis (DCA). Additionally, we performed gene set enrichment analysis to explore the potential functions of the screened lncRNAs in tumor pathogenesis.Results: Three hundred and twenty differentially expressed lncRNAs were recognized. We randomly divided patients into the training data set and the testing data set at a 2: 1 ratio. In the training data set, 9 immune-related lncRNAs with prognostic significance were identified. The risk score model was constructed to classify patients as high- and low-risk cohorts. Patients in the low-risk cohort had better survival outcomes than those in the high-risk cohort. The nomogram was established based on the indicators including age, gender, TNM stage, and risk score. The model’s predictive performance was confirmed by ROC curve analysis, C-index analysis, calibration chart, and DCA. The testing data set also achieved similar results. Bioinformatics analysis suggested that the 9-lncRNA signature was involved in modulation of various immune responses, antigen processing and presentation, and T cell receptor signaling pathway.Conclusions: The immune-related lncRNAs have the potential to predict the prognosis of bladder cancer and may play a key role in bladder cancer biology.Trial registration: It was a retrospective study and the gene expression data were obtained from the TCGA database. Trial registration was not needed.
Dysregulated Bile Acid Receptor-mediated Signaling and IL-17A Induction are Implicated in Diet-associated Hepatic Health and Cognitive Function
Authors: JENA PRASANT KUMAR , Sheng Lili , Nguyen Michelle , Lucente Jacopo Di , Hu Ying , Li Yongchun , Maezawa Izumi , Jin Lee-way , Wan Yu-Jui 
Published: August 2020

Abstract
Background: Chronic consumption of high sugar and high fat diet associated with liver inflammation and cognitive decline. This paper tests a hypothesis that the development and resolution of diet-induced nonalcoholic fatty liver disease (NAFLD) has an impact on neuroplasticity and cognition. Methods: C57BL/6 wild-type mice were fed with either a healthy control diet (CD) or a fructose, palmitate, and cholesterol (FPC)-enriched diet since weaning. When mice were 3-months old, FPC diet-fed mice were randomly assigned to receive either FPC-enriched diet with or without 6% inulin supplementation. At 8 months of age, all three groups of mice were euthanized followed by analysis of inflammatory signaling in the liver and brain, gut microbiota, and cecal metabolites. Results: Our data shows that FPC diet intake induced hepatic steatosis and inflammation in the liver and brain along with elevated RORγ and IL-17A signaling. Accompanied by microglia activation and reduced hippocampal long-term potentiation, FPC diet intake also reduced postsynaptic density-95 and brain derived neurotrophic factor, whereas inulin supplementation prevented diet-reduced neuroplasticity and the development of NAFLD. In the gut, FPC diet increased Coriobacteriaceae and Erysipelotrichaceae, which are implicated in cholesterol metabolism, and the genus Allobaculum, and inulin supplementation reduced them. Furthermore, FPC diet reduced FXR and TGR5 signalling, and inulin supplementation reversed these changes. Untargeted cecal metabolomics profiling uncovered 273 metabolites, and 104 had significant changes due to FPC diet intake or inulin supplementation. Among the top 10 most affected metabolites, FPC-fed mice had marked increase of zymosterol, a cholesterol biosynthesis metabolite, and reduced 2,8-dihydroxyquinoline, which has known benefits in reducing glucose intolerance; these changes were reversible by inulin supplementation. Additionally, the abundance of Barnesiella, Coprobacter, Clostridium XIVa, and Butyrivibrio were negatively correlated with FPC diet intake and the concentration of cecal zymosterol but positively associated with inulin supplementation. suggesting their benefits. Conclusion: Taken together, the presented data suggest that diet alters the gut microbiota and their metabolites, including bile acids. This will subsequently affect IL-17A signaling, resulting in systemic impacts on both hepatic metabolism and cognitive function.
A Mixed Methods Evaluation of a 4-week Geriatrics Curriculum in Strengthening Knowledge and Comfort Among Orthopaedic Surgery Residents
Authors: Chan Adrian , Chuen Victoria , Perrella Andrew , Limfat Guillaume , Ng Karen , Chau Vicky 
Published: August 2020

Abstract
Background: In 2016, the University of Toronto Faculty of Medicine implemented a 4-week “Orthogeriatrics” rotation for orthopaedic surgery residents. We sought to assess the rotation’s impact on trainees’ knowledge, attitudes, and behaviours toward caring for older adults, and explore areas for improvement.Methods: We used a mixed methods concurrent triangulation design. The Geriatrics Clinical Decision-Making Assessment (GCDMA) and Geriatric Attitudes Scale (GAS) compared knowledge, attitudes, and behaviours between trainees who were or were not exposed to the curriculum. Rotation evaluations and semi-structured interviews with trainees and key informants explored learning experiences and the curriculum’s impact on resident physician growth and development in geriatric competencies.Results: Among trainees who completed the GCDMA (n=19), those exposed to the rotation scored higher in knowledge compared to the unexposed cohort (14.4±2.1 vs. 11.3±2.0, p<0.01). The following themes emerged from the qualitative analysis of 29 stakeholders: Increased awareness and comfort regarding geriatric medicine competencies, appreciation of the value of orthogeriatric collaboration, and suggestions for curriculum improvement. Conclusion: These results suggest that the Orthogeriatrics curriculum strengthens knowledge, behaviour, and comfort towards caring for older adults. Our study aims to inform further curriculum development and facilitate dissemination of geriatric education in surgical training programs across Canada and the world.
Repeat Pulmonary Resection for Lung Malignancies Does Not Affect the Postoperative Complications: A Retrospective Study
Authors: Motono Nozomu , Iwai Shun , Iijima Yoshihito , Usuda Katsuo , Uramoto Hidetaka 
Published: August 2020

Abstract
Background: Although repeat pulmonary resection (RPR) for multiple lung cancer (MLC) has been performed for non-small cell lung cancer (NSCLC) and metastatic lung tumor, with the prognostic benefit detailed in several reports, the risk of RPR has not been well analyzed.Methods: Patients with lung malignancies who underwent complete resection at Kanazawa Medical University between January 2010 and October 2019 were analyzed. The relationship between postoperative complications and preoperative and perioperative factors was analyzed. Postoperative complications were categorized into five grades according to the Clavien–Dindo classification system.Results: A total of 41 patients who were received RPR were enrolled in this study. Primary lung tumor was found in 31 patients, and metastatic lung tumor was found in 10 patients. The postoperative complication rate of the first operation was 29%, and that of the second operation was 29%. While there were no significant factors for an increased incidence of postoperative complication in a multivariate analysis, an operation time over 2 h at the second operation tended to affect the incidence of postoperative complication (p=0.06). Furthermore, the operation time was significantly longer (p=0.02) and wound length tended to be longer (p=0.07) in the ipsilateral group than in the contralateral group. The rate of postoperative complications and the length of the postoperative hospital stay were not significantly different between the two groups.Conclusion: RPR is safely feasible and is not associated with an increased rate of postoperative complications, even on the ipsilateral side.