bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Acute Mountain Sickness: How to integrate the advantages of the Lake Louise Score and the Chinese AMS Score
Authors: Wu Yu , Li Peng , Zhong Zhifeng , Xie Jiaxin , Zhou Simin , Gao Yuqi , Chen Jian 
Published: August 2020

Abstract
Aims: To compare the differences in acute mountain sickness (AMS) incidence between two AMS diagnostic scoring criteria, including the Lake Louise Score and the Chinese AMS Score. Methods: A total of 2486 young men completed questionnaires after flying from Chendu (500 m) to Lasha (3658 m). The AMS incidence was investigated using a questionnaire that contained the scoring criteria for the LLS and CAS. To determine the grouping of all the symptoms on the AMS questionnaire, a systematic cluster analysis and two-step cluster analysis were used to analyse various symptoms and cases separately.Results: The AMS incidence was 37.5% (n = 932) according to the LLS, in which the cut-off point depended on headache and a total score ≥ 3, and 59.3% (n = 1473) according to the CAS, in which the cut-off point depended on headache, vomiting or a total score ≥ 5. The LLS and CAS outcomes had a significant positive correlation (Spearman’s rho = 0.918, P < 0.05) and were moderately consistent (kappa value = 0.488, P < 0.001). The positive AMS incidence determined by the CAS was significantly higher than that by the LLS (P < 0.001). Compared with the LLS, the sensitivity was 100%, the specificity was 65.23%, the positive predictive value was 63.34%, and the negative predictive value was 100% for the CAS in the diagnosis of AMS. The CAS identified all AMS subjects diagnosed by the LLS, and an additional 541 subjects. Of all the symptoms investigated, the dominant symptoms were fatigue (59.3%), dizziness (55.0%), headache (50.6%), chest tightness (40.4%), and shortness of breath (37.2%), and the last two symptoms were not included in the LLS. The cluster analysis show that chest distress, shortness of breath and palpitations were relatively independent of the major symptoms assessed by the LLS. Conclusion: The CAS had testing characteristics for diagnosing AMS similar to those of the Lake Louise Questionnaire Score, and the CAS diagnosed a higher prevalence of AMS than the LLS. It is suggested that chest distress and shortness of breath should be paid adequate attention and taken into account in AMS diagnostic criteria in the next revision to better diagnosis and study AMS.
Thawed Cryopreserved Synovial Mesenchymal Stem Cells Show Comparable Effects to Cultured Cells in the Inhibition of Osteoarthritis Progression in Rats
Authors: Horiuchi Kiyotaka , Ozeki Nobutake , Endo Kentaro , Mizuno Mitsuru , Katano Hisako , Akiyama Masako , Tsuji Kunikazu , Koga Hideyuki , Sekiya Ichiro 
Published: August 2020

Abstract
Background Intra-articular injections of mesenchymal stem cells (MSCs) can inhibit the progression of osteoarthritis (OA) in animal studies. Previous reports have used cultured MSCs, but the ability to use thawed cryopreserved MSC stocks would be highly advantageous. Our purpose was to elucidate whether thawed cryopreserved MSCs show comparable inhibitory effects on OA progression in rats to those obtained with cultured MSCs. Methods Cultured rat synovial MSCs or thawed MSCs were compared for in vitro viability and properties. The activity of synovial MSCs derived from rats expressing luciferase was compared by the luminescence intensity both in vitro and in vivo. The inhibitory effect of cultured MSCs on OA progression was evaluated by injecting PBS and cultured MSCs into the right and left knees, respectively, of the same individual meniscectomized rats. A similar test evaluated cryopreservation fluid (95% FBS with 5% DMSO; termed the 95% FBS group) versus thawed MSCs. Cartilage degeneration was assessed at 4 and 8 weeks using gross finding and histological scores. The results were used to set the primary outcome and sample size. Cultured MSCs were then injected into one knee and thawed MSCs into the contralateral knee of the same individual to compare their effects.Results Cultured MSCs and MSCs thawed after cryopreservation in 95% FBS with 5% DMSO had comparable in vitro viability, colony formation, and chondrogenic potential. The luminescence intensity was comparable between the two MSC preparations. In the rat OA model, the gross findings and histological scores for tibial cartilage did not differ at four weeks but were significantly lower in the cultured MSC group than in the PBS group and significantly lower in the thawed MSC group than in the 95% FBS group at eight weeks. These results established the tibial cartilage histological score at eight weeks as the primary outcome and a sample size of nine for comparing cultured versus thawed MSCs. The tibial cartilage histological scores did not differ significantly at eight weeks after injection of cultured and thawed MSCs into the opposite knees of the same individuals.ConclusionsThawed MSCs showed comparable inhibitory effects on OA progression to cultured MSCs.
Proanthocyanidins Induce miR-133b Expression to Promote Ischemic Skeletal Muscle Regeneration by Targeting MKP1
Authors: Chen Shi , Du Chao , Pan Lilong , Yang Qian , Yu Peihe , Wu Fei , Zhou Yang , Hai Rui , Zhang Chunxiang , Zhou Xiangyu 
Published: August 2020

Abstract
Background: Limb ischemic necrosis is mainly attributed to peripheral arterial disease (PAD). Reducing oxidative stress and promoting damaged skeletal muscle regeneration may be benefit for ischemic limb treatment. Proanthocyanidins (PC) is a powerful antioxidant and free radical scavenger, but little is known about its role and related molecular mechanism in limb ischemic injury. The current study was undertaken to explore its role in the damaged skeletal muscle regeneration both in vitro and vivo, and whether MicroRNAs (miRNAs) involved in this process. Methods: The potential effects of PC on the damaged muscle regeneration were explored in human skeletal muscle satellite cells (HSKMSCs) under hypoxic-ischemic condition and in mice limb ischemia model, then, aberrant expression of miRNAs in ischemic skeletal muscles were determined by microarray analysis, and regulatory mechanism of the specific miRNA on HSKMSCs myogenic differentiation was further investigated by gain and loss of functional experiments. Additionally, the direct target gene was examined by luciferase reporter assay.Results: In mice limb ischemia model, our results revealed that PC reduced oxidative stress level, significantly promoted ischemic limb damaged muscle regeneration and motor function recovery, then, aberrant expression of miRNAs in ischemic skeletal muscles were determined by microarray analysis, combine with the results of the RT-qPCR, the miR-133b-3p was proved to be the specific miRNA. In vitro, our results revealed that PC induced the overexpression of miR-133b to activate the p38-MAPK signal pathway and increased the myogenic differentiation-related molecules expression, which eventually promoted myotubes formation. Furthermore, MKP1 was confirmed a direct target gene of miR-133b.Conclusion: Our results suggest that PC display skeletal muscle protective properties that are mediated by miR-133b /MKP1/ p38-MAPK signal axis, offering a novel therapeutic opportunity for limb ischemic injury.
Prevalence and Characteristics of Cutaneous Allodynia in Migraine and Probable Migraine: A Population-Based Study
Authors: Han Seung Min , Kim Kyung Min , Cho Soo-Jin , Yang Kwang Ik , Kim Daeyoung , Yun Chang-Ho , Chu Min Kyung 
Published: August 2020

Abstract
Background: Cutaneous allodynia (CA) is a common feature of migraine and a clinical marker of central sensitization. Probable migraine (PM) is a subtype of migraine that fulfils all but one criterion of migraine. The present study aimed to evaluate the prevalence and characteristics of CA and those of migraine in PM. Methods: We used the data of the Korean Sleep-Headache study, which was a nation-wide population-based study on headache and sleep. CA was evaluated using the Allodynia Symptom Checklist-12 (ASC-12) questionnaire with ASC-12 score ≥ 3 classified as CA. Results: Of 2501 participants, the prevalence of migraine and PM were 5.0% and 11.6%, respectively. The prevalence of CA did not significantly differ between migraine and PM (16.0% vs. 14.5%, respectively, p = 0.701). Individuals with PM with CA reported a higher monthly frequency of headache (3.3 ± 4.3 vs. 1.8 ± 3.6, respectively, p = 0.044), more severe intensity of headache (Visuals Analogue Scale, median and interquartile range, 6.0 [4.0–7.0] vs. 5.0 [3.0–6.0], respectively, p = 0.002), and higher impact of headache (Headache Impact Test-6, 56.3 ± 7.2 vs. 48.3 ± 8.0, respectively, p < 0.001) and disability (Migraine Disability Assessment, 1.00 [0.00–10.00] vs. 0.00 [0.00–1.00], respectively, p < 0.001) than individuals with PM without CA. Multiple regression analyses revealed that the frequency and intensity of headache, anxiety, and depression were significant factors of CA in individuals with PM. Conclusions: Approximately one-sixth of individuals with migraine and PM experienced CA in a representative sample of Korea. Anxiety, depression, and high frequency of headaches were significant factors of CA in individuals with PM.
Knockdown of nrf2 exacerbates TNF-α-induced proliferation and invasion of rheumatoid arthritis fibroblast-like synoviocytes through activating JNK pathway
Authors: Du Yu , Wang Qian , Tian Na , Lu Meng , Zhang Xian-Long , Dai Sheng-Ming 
Published: August 2020

Abstract
Background.

Fibroblast-like synoviocytes (FLS) in the synovial tissue of rheumatoid arthritis (RA) exhibit over-proliferative and aggressive phenotypes, which participate in the pathophysiology of RA. In RA, little is known about the non-antioxidant effect of nuclear factor erythroid 2-related factor 2 (nrf2), master regulator of redox homeostasis. In this study, we explored the expression and upstream regulatory factors of nrf2, and revealed its functions in modulating the proliferation and invasion in RA-FLS.
Methods.

FLS were isolated from RA and osteoarthritis patients. Expression of nrf2 in the synovial tissues and FLS was analyzed by immunohistochemistry, real-time PCR, western blot, and immunofluorescence. Cell proliferation was examined by Cell Counting Kit-8, and cell invasion was tested by transwell assay. Phosphorylation of JNK was determined by Western blot.
Results.

Nrf2 expression in the RA synovial tissues was upregulated. TNF-α promoted expression and nuclear translocation of nrf2 in RA-FLS, and increased the intracellular reactive oxygen species (ROS) level. Nrf2 nuclear translocation was blocked by ROS inhibitor N-acetylcysteine. Both knockdown of nrf2 by siRNA and inhibition of nrf2 by ML385 significantly promoted the TNF-α-induced proliferation and invasion of RA-FLS. Activation of nrf2 by sulforaphane (SFN) profoundly inhibited the TNF-α-induced proliferation and invasion of RA-FLS. Knockdown of nrf2 also enhanced the TNF-α-induced matrix metalloproteinases (MMPs) expression and phosphorylation of JNK in RA-FLS. Proliferation and invasion of RA-FLS incubated with TNF-α and nrf2 siRNA was inhibited by pre-treatment with JNK inhibitor SP600125.
Conclusion.

Taken together, nrf2 is over-expressed in synovial tissues of RA patients, which may be induced by TNF-α and ROS levels. Increased nrf2 may suppress TNF-α-induced proliferation, invasion, and MMPs expression in RA-FLS through inhibiting JNK activation, indicating that nrf2 plays a protective role to relieve the severity of synovitis in RA.
Seeking Safety: A Focus Group Study of Young Adults’ Cannabis-Related Attitudes, and Behavior in A State With Legalized Recreational Cannabis
Authors: Amroussia Nada , Watanabe Mika , Pearson Jennifer L 
Published: August 2020

Abstract
Background Only July 1, 2017, Nevada became the fifth state to allow the legal sale of recreational cannabis products for adults over the age of 21 years. This study investigates young adults’ cannabis-related attitudes, perceptions, and behaviors in a state where recreational and medical cannabis use was recently legalized.Methods We conducted 8 focus groups stratified by cannabis use (regular users, occasional users, and nonusers) with 32 college students aged 18 to 24. Data were analyzed using the inductive qualitative thematic analysis method. Results Four themes emerged during analyses: “sort of legal,” “mitigating harm through legalization,” “cannabis use… less risky and more accepted,” and “seeking safety.” Despite their limited knowledge of cannabis regulation, the majority of the participants supported recreational cannabis legalization from a harm reduction perspective. Most participants did not believe that cannabis legalization had affected their use behavior. However, participants, especially cannabis users, perceived that recreational cannabis legalization created a context where cannabis use was legally, socially, and behaviorally “safer” than in an illegal context, even for those below the legal age of use. Conclusions Most studies focus on the role of perceived health risk on cannabis use. If there are population-level long-term effects of recreational cannabis legalization on use behavior, findings suggest that they will be mediated by the perceived legal, social, and behavioral risk of using cannabis.
Is oxygen therapy beneficial for normoxemic patients with acute heart failure? A propensity score matched study
Authors: Yu Yue , Yao Ren-qi , Zhang Yu-feng , Wang Su-yu , Xi Wang , Wang Jun-nan , Huang Xiao-yi , Yao Yong-ming , Wang Zhinong 
Published: August 2020

Abstract
Background The clinical efficiency of routine oxygen therapy is uncertain in patients with acute heart failure (AHF) who do not have hypoxemia. The aim of this study was to investigate the association between oxygen therapy and clinical outcomes in normoxemic patients hospitalized with AHF using real-world data.Methods Normoxemic patients diagnosed with AHF on ICU admission from the electronic ICU (eICU) Collaborative Research Database were included in the current study, in which the study population was divided into the oxygen therapy group and the ambient-air group. Propensity score matching (PSM) was applied to create a balanced covariate distribution between patients receiving supplemental oxygen and those exposed to ambient air. Linear regression and logistic regression models were performed to assess the associations between oxygen therapy and length of stay (LOS), and all-cause in-hospital as well as ICU mortality rates, respectively. A series of sensitivity and subgroup analyses were conducted to further validate the robustness of our findings.Results A total of 2,922 normoxemic patients with AHF were finally included in the analysis. Overall, 42.1% (1,230/2,922) patients were exposed to oxygen therapy, and 57.9% (1,692/2,922) patients did not receive oxygen therapy (defined as the ambient-air group). After PSM analysis, 1,122 pairs of patients were matched: each patient receiving oxygen therapy was matched with a patient without receiving supplemental oxygen. The multivariable logistic model showed that there was no significant interaction between the ambient air and oxygen group for all-cause in-hospital mortality (odds ratio [OR] 1.30; 95% confidence interval [CI] 0.92–1.82; P=0.138) or ICU mortality (OR 1.39; 95% CI 0.83–2.32; P༝0.206) in the post-PSM cohorts. In addition, linear regression analysis revealed that oxygen therapy was associated with prolonged ICU LOS (OR 1.11; 95% CI 1.06–1.15; P༜0.001) and hospital LOS (OR 1.06; 95% CI 1.01–1.10; P༝0.009) after PSM. Furthermore, the absence of an effect of supplemental oxygen on mortality was consistent in all subgroups.Conclusions Routine use of supplemental oxygen in AHF patients without hypoxemia was not found to reduce all-cause in-hospital mortality or ICU mortality.
Knowledge, Attitude and Practice of Health Care Workers on Measuring Adult Vitamin D Level, Diagnosis of Deficiency, and Management of Consequent Health Conditions in Three Ecologies of Ethiopia: A Cross-Sectional Study
Authors: Mekonnen Wubegzier , Feleke Yeweyenhareg , Desalegn Yakob , Tarekegne Getahun , Lambisso Biruk , Haidar Jemal , Zewede Tewabech 
Published: August 2020

Abstract
Background: Vitamin D is very essential for health and its insufficiency is strongly associated with increased overall mortality. Health care workers (HCWs) need to educate on its uses and possible sources although studies show that their knowledge, attitude and practice is low; few studies are available in Ethiopia. The main aim of this study is therefore to assess the knowledge, attitude and practice of measuring adult vitamin D status, diagnosis of deficiency and managing health consequences among HCWs in Ethiopia. Methods: This study was conducted in three districts covering lowland, midland and highland ecologies. A total of 405 health extension workers, nurses, health officers, general practitioners and specialists were interviewed. Tablets were used for data collection to archive in a cloud server. Data were exported to Stata version 14 software for cleaning and analysis. Rates were computed and Chi-square test was used to compare differences between the two groups. Binary logistic regression was used to measure the strength, direction and significance of association between different covariates and the practice of HCWs.Result: The level of good knowledge, positive attitude and good practice in measuring adult vitamin D status, diagnosis of deficiency and managing health consequences among HCWs was 210(51.8%), 261(63.5%) and 195(47.4%) respectively. The odds of good practice in the provision of adult vitamin D service were AOR=6.87: 95% CI (3.57, 13.21) and AOR= 2.20: 95% CI (1.23, 3.92) times higher among HCWs in Addis Ababa and highlands compared with those working in lowlands. Good practice among clinicians was AOR=4.26: 95% CI (1.48, 12.25) times higher compared with those working in leadership positions. The likelihood was AOR=1.96: 95% CI (1.19, 3.23) times higher among those with good knowledge compared with those with poor knowledge. Besides, good practice in adult vitamin D service provision was AOR=2.30: 95% CI (1.40, 3.78) times higher among those with positive attitude compared with those who had negative attitude.Conclusions: Only a little over half of HCWs have good knowledge and close to two-third of them has positive attitude while less than half of them have good practice of measuring adult vitamin D status, diagnosis and managing its health consequences practice. Besides, HCWs residential ecology, clinical position, good knowledge and positive associated is associated with good practice on adult vitamin D. It is essential to provide rigorous and continues training for HCWs focusing on their deployment ecology.
The Effect of Psychosocial Work Environment on the Health-Related Quality of Life of Health Care Providers
Authors: Alshahrani Bashayer , Alumran Arwa 
Published: August 2020

Abstract
Background: Psychosocial work environment is a significant factor in the provision of quality health care. Understanding the psychosocial work environment in the Saudi Arabian health care system is critical in opening up new paths for future workplace interventions and the promotion of quality health care practices. We determined the relationship between psychosocial work environment and quality of life of employees in a major Saudi health care setting. Methods: We designed a quantitative cross-sectional study conducted at King Fahad University Hospital using a Web-based, validated survey targeting all hospital employees. Results: The study results showed that males have significantly higher quality of life and psychosocial work environment scores (t = -2.992, p < .001) than females (t = -2.07, p < 0.05). Employees with day shifts only had significantly higher quality of life scores compared to regular rotation shifts (t = 3.228, p < 0.001). Pearson correlation showed a significant association between quality of life and psychosocial work environment (r = .349, p < .001). The multivariable regression model showed a significant effect of psychosocial work environment, gender, and type of shift on quality of life (adjusted r2 = 0.2665, f = 16.26, p < 0.001). Conclusion: We anticipated that with higher quality of life, employees’ productivity increases. Thus, we expected patient care to improve by increasing health care providers’ quality of life scores. This study showed a significant correlation between psychosocial work environment and quality of life.
Computed Tomography Findings as Determinants of Local and Systemic Inflammation Biomarkers in Interstitial Lung Diseases: A Retrospective Cohort Study
Authors: Lang David , Akbari Kaveh , Horner Andreas , Hepp Magdalena , Kaiser Bernhard , Pieringer Herwig , Lamprecht Bernd 
Published: August 2020

Abstract
Background: Additional to high-resolution computed tomography (HRCT), peripheral blood (PBL) and broncho-alveolar lavage (BAL) could provide biomarkers to distinguish predominantly inflammatory from non-inflammatory/fibrotic interstitial lung disease (ILD) phenotypes. Methods:HRCT of 127 subsequent ILD-board patients were semi-quantitatively evaluated in a standardized way: Reticulation/honeycombing (RET), traction bronchiectasis (TBR) and emphysema (EMP) were classified as non-inflammatory/fibrotic; consolidations (CON), ground glass opacities (GGO), noduli (NDL) and mosaic attenuation (MOS) as active inflammatory findings. These HRCT findings were counted as present or absent in 6 distinct lung regions, resulting scores were graded as minimal (0-1 regions involved), medium (2-4) or extensive (5-6). Associations between routinely assessed PBL/BAL biomarkers with these radiological scores were evaluated using Spearman correlation coefficients; significance of the graded HRCT scores by applying Kruskal-Wallis tests.Results: Blood neutrophil, lymphocyte and eosinophil fraction, neutrophil-lymphocyte ratio (NLR) and BAL lymphocyte fraction consistently showed opposite correlations for inflammatory versus non-inflammatory/fibrotic HRCT finding scores. Blood lymphocyte fraction significantly differed by graded GGO (p=0.032) and CON (p=0.027) extent, eosinophil fraction by TBR (p=0.006) and NLR by CON (p=0.009). C-reactive protein was significantly related to GGO (p=0.023) and CON (p=0.004), BAL lymphocyte fraction to GGO (p=0.017). Conclusions:Blood lymphocyte and eosinophil fraction, NLR, CRP and BAL lymphocyte fraction may aid to differentiate inflammatory from non-inflammatory/fibrotic ILD patterns. Trial registration:This evaluation was based on data from the ILD registry of Kepler University Hospital Linz, as approved by the ethics committee of the federal state of Upper-Austria (EK Nr. I-26-17).