bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rapid Cycle Implementation and Retrospective Evaluation of a SARS-CoV-2 Checklist in Labor and Delivery
Authors: Zucco Liana , Levy Nadav , Li Yunping , Golen Toni , Shainker Scott A , Hess Philip E , Ramachandran Satya Krishna 
Published: August 2020

Abstract
Background: Preparedness efforts for a COVID-19 outbreak required redesign and implementation of a perioperative workflow for the management of obstetric patients. In this report we describe the rapid cycle implementation of a comprehensive perioperative checklist for care of the COVID-19 parturient and a retrospective analysis of the factors which influenced implementation success.Methods: A newly designed workflow for COVID-19 parturients requiring perioperative care was produced as a checklist, intended for use as a cognitive aid. Implementation and refinement of the workflow was accomplished through rapid-cycling, debriefing and on-site walkthroughs. Retrospective evaluation of the implementation experience was performed using a group deliberation approach, mapped against the Consolidated Framework for Implementation Research (CFIR). Results: Post-implementation, consistent use of the workflow was reported for all obstetric COVID-19 perioperative cases (100% compliance). Evaluation of our implementation using CFIR revealed domains of process implementation and innovation characteristics as overwhelming facilitators for success. Constructs within the outer setting, inner setting and characteristic of individuals (external pressures, baseline culture, and personal attributes) were felt to act as barriers. Constructs such as communication, shifted in influence over time.Conclusion: We describe the implementation of a comprehensive obstetric workflow checklist for care of the COVID-19 perioperative patient. A retrospective evaluation of our implementation experience was possible using CFIR, which enabled identification of barriers and facilitators for change within our unit. Furthermore, we observed that implementation success was possible, despite facilitation being perceived within only two domains at baseline. Emerging themes from this study highlight the importance of thoughtful innovation design, careful implementation planning and the establishment of a long-standing culture of improvement, in order to facilitate implementation of change during a time of crisis.
WITHDRAWN: Aging-related tumor microenvironment changes could worsen the prognosis of GBM patients
Authors: Song Hongwang , Fu Xiaojun , Wu Chenxing , Li Shouwei 
Published: August 2020

Abstract

Background: Glioblastoma multiforme (GBM) is the most malignant tumor in human brain, with highly heterogeneity among different patients. Age could function as an incidence and prognosis risk factor for many tumors.Method: A series of bioinformatic experiments were conducted to evaluate the differences of incidence, differential expressed genes, enriched pathways with the data from Surveillance, Epidemiology, and End Results (SEER) program, the cancer genome atlas (TCGA) and Chinese glioma genome atlas (CGGA) project.Results: We discovered in our present study that distinct difference of incidence and prognosis of different aged GBM patients. By a series of bioinformatic method, we found that the tumor associated fibroblasts (TAFs) was the most crucial tumor microenvironment (TME) component that led to this phenomenon. Epithelial-mesenchymal transition (EMT) could be the mechanism by which TAFs regulate the progression of GBM. Conclusion: We have proposed a close correlation between age and GBM incidence and prognosis, and propose the underlying mechanism behind this correlation by mining different databases, which laid the foundation for future research.
Large Autologous Ilium with Periosteum for Tibiotalar Joint Reconstruction in Rüedi-Allgöwer III Pilon Fractures
Authors: Li Dong , Li Jiao Jiao , Zhu Yuanyuan , Hou Fushan , Li Yuan , Zhao Bin , Wang Bin 
Published: August 2020

Abstract
Background: Management of Rüedi-Allgöwer III or AO type C3 pilon fracture present numerous challenges to the orthopaedic surgeon. A joint preservation technique using a large autologous ilium with periosteum in combination with internal implant fixation was reported to improve the outcome of reconstruction. Methods: Twenty-five patients with soft tissue injury of Tscherne-Gotzen I-II after Rüedi-Allgöwer III pilon fracture received a large autologous ilium with periosteum for tibiotalar joint reconstruction and open reduction and internal fixation (ORIF), between March 2015 and September 2018. The visual analog scale (VAS), American Orthopaedic Foot & Ankle Society (AOFAS) score, and Burwell and Charnley criteria were used for outcome analysis.Results: Twenty patients with an average age of 45.2 years were followed for an average of 18.3 months. The VAS and AOFAS scores, and Burwell and Charnley ratings were recorded at the last follow-up after reconstructive surgery. Two patients developed redness and swelling at the wound site, but recovered after local care and dressing changes. No patient displayed deep surgical site infection, donor site complication, non-union or local complication during the final follow-up. The average bone union time was 18.3 months (range 3-36).Conclusions: Large autologous ilium with periosteum in combination with ORIF can be safely performed for tibiotalar joint reconstruction. This method greatly reduces the risk of post-operative complications following articular reconstruction for Rüedi-Allgöwer III pilon fractures.Level of Evidence: Level III, retrospective cohort study
Implementation of a Complex Health Services Intervention in Long-term Care Homes: A Process Evaluation Using Focus Groups
Authors: Warth Rieka von der , Kaiser Vanessa , Reese Christina , Brühmann Boris A. , Farin-Glattacker Erik 
Published: August 2020

Abstract
BackgroundWith increasing numbers of the elderly living in nursing homes in Germany, the need for on-site primary care increases. A lack of primary care in nursing homes can lead to unnecessary hospitalization, higher mortality, and morbidity in the elderly. Therefore, project CoCare (“coordinated medical care”) implements a complex health intervention in nursing homes, using among others regular medical rounds, a shared patient medical record and medication checks, aiming to improve the coordination of medical care. This study reports the results of a process evaluation assessing the perceived acceptance and barriers of the project by stakeholders.MethodsFocus group interviews were held between the fall of 2018 and the fall of 2019 with nursing staff, general practitioners and medical assistants working in or consulting a participating nursing home. A half-structured modular guideline was used to ask participants about their opinion on different aspects of CoCare. Focus groups were analyzed using qualitative content analysis. ResultsIn total, N=11 focus group interviews with N= 74 participants were conducted. Ten main themes with seven subthemes were identified, encompassing all aspects of CoCare. The overall acceptance of the project was good. Participants elected to talk most often about the project modules “communication and collaboration” and “medical rounds”, with participants concluding CoCare had prevented unnecessary hospitalizations. Main barriers were understaffing and complexity of the program.ConclusionImplementation of CoCare in nursing homes is complex and holds some barriers. However, the overall acceptance was good and first positive results were reported by participants. Furthermore, the project provides a good structure to overcome potential barriers.Trial Registration: German Clinical Trial Register (DRKS00012703)
Identification of regulatory networks and hub genes controlling mammary gland development and lactation in dairy goats during the late lactation, dry period, and late gestation stages
Authors: Xuan Rong , Chao Tianle , Zhao Xiaodong , Wang Aili , Chu Yunpeng , Li Qing , Zhao Yilin , Ji Zhibin , Wang Jianmin 
Published: August 2020

Abstract
Background

From the late lactation to late gestation stages, the mammary gland tissue of goats undergoes a process from involution to remodeling and then to high differentiation of mammary gland tissue. From the perspective of lactation, this is a continuous development process of the goat mammary gland from the termination of lactation to the restoration of lactation. We performed transcriptome sequencing on goat mammary gland tissues at three mammary gland developmental stages to screen for differentially expressed genes that affect mammary gland development and the physiological process of lactation and mapped their expression profiles in three stages. The objective of this study is to reveal the expression characteristics of these genes and their potential function during mammary gland development and lactation.
Results

We identified 1,381 differentially expressed genes in the mammary gland during three stages and found that the expression level of genes encoding casein, such as alpha-s1-casein (CSN1S1), alpha-s2-casein (CSN1S2), beta-casein (CSN2), and kappa-casein (CSN3), and alpha-lactalbumin (LALBA) were higher in mammary gland tissues during the late lactation stage and late gestation stage than those during the dry period. In addition, we constructed six functional networks related to differentially expressed genes and found that these genes are closely related to mammary gland growth and development, apoptosis, immunity, substance transport, biosynthesis, and metabolism. Finally, we identified 35 differentially expressed transcription factors, which were classified into 16 families, and predicted that transcription factors of the basic leucine zipper domain (bZIP) family and basic helix-loop-helix (bHLH) family regulated the expression levels of genes related to mammary gland development and lactation.
Conclusions

Among the late lactation, dry period, and late gestation stages, there are differences in the expression levels of genes related to mammary gland growth and development, apoptosis, immunity, basic substance transport, biosynthesis, and metabolism in mammary gland tissues. Some genes in the same family or with similar functions have similar expression patterns. These differentially expressed genes or transcription factors work synergistically to participate in the regulation of mammary gland development and the physiological process of lactation.
Protective Effect of Recombinant Ganoderma Lucidum Immunomodulatory Protein (rLZ-8) Against Scopolamine-Induced Alzheimer's Disease in Rats
Authors: Wang Haotian , Fu Jun , Tang Huan , Li Yan , Song Liping , Xu Dan , Hao Qiang , Li Qianwen , Ren Zhihui , Zhou Xiaowei , Chen Hongyu , Zhao Weitao , Jia Juan , Sun Fei , Pei Jin 
Published: August 2020

Abstract
Backgroud: Alzheimer's disease (AD) is one of the most common neurodegenerative diseases in the elderly, seriously threatening the health of the elderly. In this study, the protective effect of recombinant Ganoderma lucidum immunomodulatory protein (rLZ-8) against the scopolamine-induced Alzheimer's disease (AD) in rats was studied for the first time. Methods: Male Wistar rats in rLZ-8-treated groups were intraperitoneally injected with 56 μg/kg, 112 μg/kg, and 224 μg/kg rLZ-8, respectively, those in donepezil group were intraperitoneally injected with 1.0mg/kg donepezil, and those in the normal saline group were intraperitoneally injected with an equal volume of normal saline, successively for 14 days. On the 7th day after the administration, the learning and memory ability of rats was observed by Morris water maze test, and the biochemical indexes and cytokines in the serum and brain tissues of the rats were detected after the behaviour test for investigating the protective mechanism of rLZ-8 against the scopolamine-induced AD in rats. Results: In the water maze test, compared with that in the model group, the escape latency and the swimming distance of rats on the 5th and 6th day were significantly shortened in the three rLZ-8-treated groups. In the space exploration test, compared with that in the model group, the number of passing through the location of original platform was significantly increased and the time of rats’ staying in the second quadrant was significantly prolonged in the three rLZ-8-treated groups, and furthermore, the detectionresults related to Alzheimer's disease in the serum, hippocampus and cerebral cortex of ratsindicated that rLZ-8 could improve the contents or activities of the related indexes. Conclusion: In rlZ-8 could significantly improve the learning and memory ability of AD rats, and the possible mechanism was to improve the learning and memory ability by protecting the cholinergic system.
Potential Diagnostic Value of Circulating miRNA for Multiple Myeloma: A Meta-Analysis.
Authors: Zhang Wen-Ting , Gao Shuai-Shuai , Wang Yan-Jun , Zhang Guo-Xun 
Published: August 2020

Abstract
Multiple myeloma (MM) is the second incurable hematological malignancy. In recent years, due to the rise of microRNA (miRNA), many scholars have participated in the study of its value in the diagnosis of MM, and have obtained good but inconsistent results. Therefore, in order to determine the role of miRNA in the early diagnosis of MM, we searched for related studies including PubMed, Web of Science, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Wanfang Database as of July 20, 2020 to conduct this meta-analysis. To improve the accuracy, the quality assessment of Diagnostic Accuracy Study 2 (QUADAS-2) was used. We also applied random effects models to summarize sensitivity and specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and area under the curve (AUC) to measure diagnostic values, and subgroup analysis used to discover potential sources of heterogeneity. Finally, we collected 32 studies from 15 articles that included a total of 2053 MM patients and 1118 healthy controls. The overall sensitivity, specificity, PLR, NLR, DOR and AUC were 0.81, 0.85, 5.5, 0.22, 25 and 0.90, respectively. Subgroup analysis shows that the down-regulation of microRNA clusters with larger samples size of plasma type could carry out a better diagnostic accuracy of MM patients. In addition, publication bias was not found. In conclusion, circulating miRNA could be a potential non-invasive biomarker for early diagnosis of MM. However, multi-center, more rigorous, and larger-scale studies are needed to verify our conclusions.
Translation, Adaptation and Validation of the Middle East Lower Limb Score (MELLS) Into Arabic
Authors: Hanna Sager , AlKhalaf Fahad , AlSamhan Awdhah , AlHamdan Hend , AlAdwani Bader , Khaja Aliaa 
Published: August 2020

Abstract
Background: The Middle East Lower Limb Score (MELLS) is an adaptation of the WOMAC questionnaire, specifically adjusted according to the cultural issues of the middle eastern patients with Knee or hip disabilities. The primary objective of this study was to verify if the translation and adaptation of the MELLS into Arabic could be used with ease and consistency by Arab-speaking patients suffering lower limb disabilities.Methods: 110 participants were involved in this study. We performed the internal consistency tests with Cronbach’s alpha. We also calculated floor effects, ceiling effects, as well as test-retest reliability (intra-correlation coefficient). To estimate the validity of MELLS, we used two validated questionnaires – WOMAC and OHS. We confirmed the validity of MELLS questionnaire using Spearman’s correlation.Results: MELLS had a Cronbach’s alpha of 0.88 in the first assessment and 0.92 in the second assessment, which was very high and reliable. Both subscales of MELLS had an internal consistency higher than 0.85. No relevant ceiling and floor effect were observed among the responses. Furthermore, strong significant correlation with WOMAC subscales and OHS was observed, which suggested a good construct validity. Responsiveness of MELLS, however, proved to be lower (but not considerably) than other two questionnaires.Conclusion: The Arabic Middle East Lower Limb Score (MELLS) is a useful and reliable diagnostic tool for Middle eastern patients with knee and hip problems.
A Method to Pre-Screen Rat Mammary Gland Whole Tissue Mounts followed by RNAscope in situ hybridization
Authors: Duderstadt Emily , Sanders Mary Ann , Samuelson David J. 
Published: August 2020

Abstract
Background: RNA in situ hybridization is an extremely useful gene expression analysis technique that preserves the spatiotemporal nature of tissue and allows for evaluation of specific cell populations and morphologies. This technique is especially useful in evaluating expression changes in disease progression models. Tissue processing procedures used to identify pathological disease morphologies in situ could compromise RNA integrity and the reproducibility and quantitative accuracy of RNA in situ hybridization assays. Methods: A combinatorial approach to pre-screen rat mammary gland tissue whole mounts for hyperplastic and malignant lesions that were not visually discernible without staining was used. This pre-screening process was followed by an RNA in situ hybridization analysis method known as RNAscope. Results: We show that there are no differences in the quantitative nature of RNAscope assays between tissue that was immediately formalin-fixed and paraffin embedded (FFPE), which is recommended by the manufacturer, and tissue that was whole mounted and pre-screened for lesions of interest prior to RNAscope. Conclusions: Preserving the integrity of RNA and quantitative nature of the RNAscope assay is important, as it allows unpalpable lesions to be directly identified, bypassing a need for labor-intensive serial sectioning of FFPE tissues to find lesions. This method is applicable to any epithelial-based disease progression model using whole-tissue mounts.
Effect of Occupational Exposure to Whole-Body Vibration and Noise on Sex Hormone Levels: A Case Study in an Automobile Parts Manufacturing Plant
Authors: Mohammadi Hamzeh , Golbabaei Farideh , Dehghan Somayeh Farhang , Ardakani Soheila Khodakarim , Imani Hossein , Tehrani Fahimeh Ramezani 
Published: August 2020

Abstract
Background: The present study investigated the effects of exposure to noise and whole body vibration (WBV) on the levels of sex hormones in an automobile parts manufacturing plant.Methods: The level of workers' exposure (n=162) to each of the mentioned stressors, was measured through standard methods and for each person the time-weighted average (TWA) of exposure was calculated. In order to determine serum sex hormones (free testosterone, LH and FSH), blood samples were taken from all participants after 8-10 hours of fasting between 7-9 am and then the blood samples were analyzed by ELISA method. Results: In general, regarding testosterone as the main male sex hormone, only 49% of the participants were in the normal range. In total of three sections, the lowest mean testosterone levels was observed in the third exposure group (WBV>1.93 m/s2; noise >92.69 dB) of the studied stressor, however, only the difference in testosterone levels between the three different groups of exposure to noise was statistically significant (P = 0.001). The relationship between demographic variables and levels of noise and WBV exposure with sex hormones was not linear and only the relationship between noise exposure and testosterone levels was statistically significant (R = -0.201, P = 0.013). Conclusion: According to the results of Logistic Regression, the WBV had the greatest effect on testosterone levels as the main male hormone. However, according to the results of the correlation test, only the relationship between noise exposure and testosterone levels is statistically significant.
The Nrf2-NLRP3-Caspase1 axis mediates the neuroprotective effects of Celastrol in Parkinson's disease
Authors: Zhang Chenyu , Zhao Miao , Wang Bingwei , Su Zhijie , Guo Bingbing , Zheng Ruimao 
Published: August 2020

Abstract
Background: Parkinson’s disease (PD) is characterized by the loss of dopaminergic neurons in the substantia nigra pars compacta (SNc), accompanied by chronic neuroinflammation, oxidative stress, and widespread accumulation of α-synuclein. Celastrol (Cel), a potent anti-inflammatory and anti-oxidative pentacyclic triterpene, has emerged as a neuroprotective agent. However, the mechanisms by which celastrol is neuroprotective in PD has not yet been elucidated. Methods: The MPTP and AAV-mediated human wild-type α-syn overexpression within SNc induced PD mouse models were employed in this study. By using multiple genetically modified mice (Nrf2-KO, NLRP3-KO and Caspase1-KO), we identified that celastrol effectively inhibited the NLRP3 inflammasome activation, mitigated motor deficits and nigrostriatal dopaminergic degeneration through Nrf2-NLRP3-Caspase1 pathway. Results: Here we show that celastrol protected against the loss of dopaminergic neurons, mitigated the neuroinflammation and motor deficits in both MPTP-induced PD mouse model and AAV-mediated human α-syn overexpression PD model. Whole-genome deep sequencing analysis reveals that Nrf2, NLRP3 and Caspase1 in SNc may be associated with the neuroprotective actions of celastrol in PD. Conclusions: These findings suggest that Nrf2-NLRP3-Caspase1 axis may be a key target of celastrol in PD treatment, and highlight the favorable properties linked to neuroprotection of celastrol, making celastrol as a promising disease-modifying agent for PD.
An optimized segmentation and quantification approach in microvascular imaging for OCTA-based fibrovascular regression monitoring
Authors: Wu Sheng , Wu Shaowei , Feng Hui , Hu Zizhong , Xie Yejing , Su Yun , Feng Ting , Li Li 
Published: August 2020

Abstract
Background: Quantification of neovascularization changes in fibrovascular membrane (FVM) acquired from optical coherence tomography angiography (OCTA) imaging is extremely important for diagnosis and treatment monitoring of proliferative diabetic retinopathy (PDR). However, few vessel extraction methods have been reported for quantifying the neovascular changes on fibrovascular membrane (FVM) in proliferative diabetic retinopathy PDR based on OCTA imaging.Methods: We propose an optimized approach to segment blood vessels based on an improved vascular connectivity analysis (VCA) algorithm with a combined effort of morphological characterization as well as noise and artifacts elimination. The length and width of vessels are also obtained in quantitative assessment of the microvascular network. Furthermore, we also study the feasibility of the proposed method by monitoring changes of neovascularization on FVM, which is based on the OCTA images of PDR patients after treatment by intravitreal injection of conbercept (IVC).Results: The proposed method has achieved better performance compared with existing algorithms on accuracy and can be used for PRD treatment monitoring. In the study of PDR treatment monitoring, the data show that from the beginning (0 day) to 5th day of treatment, the total length of neovascularization on FVM in this area has been significantly shortened by an 77.8% reduction, indicating significant effects from the treatment applied. Besides, the average width of the neovascularization on FVM at the 7th day after treatment has been increased by 158%, which indicates that most of the narrow neovascularization has been reduced. Conclusion: The result and analysis have confirmed that the proposed optimization process with improved VCA method is both effective and feasible to segment and quantify the neovascularization on FVM with less noise and artifacts, thus can be readily applied to monitor the fibrovascular regression within the treatment period.Clinical Trial Registration: This trial is registered with the Chinese Clinical Trial Registry (Registered 27 December 2017, http://www.chictr.org.cn, registration number 17014160).