bluuebunny/crossref_metadata_2025_split huggingface dataset:
Worsening pulmonary outcomes during sex reassignment therapy in a transgender female with cystic fibrosis (CF) and asthma/allergic bronchopulmonary aspergillosis: a case report
Authors: Lam G. Y. , Goodwin J. , Wilcox P. , Quon B. S. 
Published: August 2020

Abstract
Background
Cystic Fibrosis (CF) is a hereditary pulmonary and extra-pulmonary disease that occurs equally in men and women. However, a difference in morbidity and mortality rates between the sexes has been long documented. Similarly, a sex-disparity in disease severity has been reported in asthma as well. Studies done to date point to estrogen as a possible cause of this sex disparity in pulmonary outcomes in both conditions.

Case presentation
Here, we describe a case of a patient with CF and asthma/allergic bronchopulmonary aspergillosis (ABPA) undergoing sex reassignment therapy (male-to-female) and the negative impact it had on her lung function and frequency of pulmonary exacerbations in the context of increasing doses of exogenous estrogen.

Conclusions
This case raises the possibility of a link between estrogen and worsening pulmonary outcomes and the need for further studies into transgender individuals with CF and/or asthma/ABPA as well as those undergoing high dose estrogen therapy for other indications.
The ceramide [NP]/[NS] ratio in the stratum corneum is a potential marker for skin properties and epidermal differentiation
Authors: Yokose Urara , Ishikawa Junko , Morokuma Yuki , Naoe Ayano , Inoue Yosuke , Yasuda Yuka , Tsujimura Hisashi , Fujimura Tsutomu , Murase Takatoshi , Hatamochi Atsushi 
Published: August 2020

Abstract
Background
Specific species of ceramides (Cer), major constituents of lipids in the stratum corneum (SC), are decreased and are correlated with SC barrier and water-holding functions in the skin of patients with atopic dermatitis (AD) or psoriasis (Pso). However, possible correlations between Cer subclass ratios and skin properties in barrier-disrupted skin and in healthy skin remain unclear. The objective of this study was to identify a new marker to evaluate skin properties and epidermal differentiation in SC not only in barrier-disrupted skin but also in healthy skin.

Methods
The Cer subclass ratios in the SC of healthy control subjects and in patients with AD or Pso were evaluated. Correlations with candidate markers and facial skin features of healthy Japanese females (20–74 years old, n = 210) were investigated. Variations of markers during epidermal differentiation were studied in human epidermis and in cultured keratinocytes.

Results
The ratios of Cer [NP]/[NS], Cer [NH]/[NS], Cer [NP]/[AS], Cer [NH]/[NS], Cer [NDS]/[AS], Cer [AH]/[AS] and Cer [EOP]/[AS] showed significant differences between non-lesional skin of AD patients and normal skin of healthy control subjects, as well as Pso patients and their healthy control subjects. The Cer [NP]/[NS] ratio was correlated with SC functional parameters (transepidermal water loss and capacitance) and with skin appearance (texture, scaling and color) even in the cheek skin of healthy female subjects. The Cer [NP]/[NS] ratio in the SC was approximately 18-times higher than in living keratinocytes, and it increased as they differentiated.

Conclusions
The Cer [NP]/[NS] ratio in the SC is a potential marker for skin properties and epidermal differentiation in barrier-disrupted skin as well as in healthy skin.
Disruption of microbial cell morphology by Buxus macowanii
Authors: Ngobeni B. , Mashele S. S. , Malebo N. J. , van der Watt E. , Manduna I. T. 
Published: August 2020

AbstractBackgroundMicrobial infections are one of the major causes of death globally. This is attributed to the rising costs of primary healthcare and its inaccessibility especially in developing countries. Moreover, there has been an increase in microbial strains that have reduced susceptibility to antimicrobial drugs. Research on the antimicrobial properties of medicinal plants, which could address these problems, has become more important as they present fewer side effects when compared to the antibiotics currently in use. This study evaluated the antimicrobial properties of a methanolic extract fromBuxus macowaniiin order to assess its potential in the development of novel antimicrobial drugs.MethodsAntimicrobial activity of the extract was evaluated using the broth microdilution method. The effects ofB. macowaniion the morphology ofB. cereuswere observed using Scanning and Transmission electron microscopy. Chemical profiling of the plant extract was performed using the GCMS.ResultsThe extract showed antimicrobial activity against all the microbial species used. Microscopic examination of the cells ofB. cereuscells treated withBuxus macowaniishowed some changes in morphology such as damage of the cell wall, swelling of the cells and incomplete cell division that eventually resulted in cell death. Neophytadiene, an antimicrobial compound was detected in the extract using GCMS.ConclusionThe morphological disruptions of the cell wall ofBacillus cereusexplain the antimicrobial properties ofB. macowaniiand indicate its possible application in the development of natural antimicrobial drugs.
Efficacy of smartphone-based Mobile learning versus lecture-based learning for instruction of Cephalometric landmark identification
Authors: Golshah Amin , Dehdar Fatemeh , Imani Mohammad Moslem , Nikkerdar Nafiseh 
Published: August 2020

Abstract
Background
Considering the increasing popularity of electronic learning, particularly smartphone-based mobile learning, and its reportedly optimal efficacy for instruction of complicated topics, this study aimed to compare the efficacy of smartphone-based mobile learning versus lecture-based learning for instruction of cephalometric landmark identification.

Methods
This quasi-experimental interventional study evaluated 53 dental students (4th year) in two groups of intervention (n = 27; smartphone instruction using an application) and control (n = 26, traditional lecture-based instruction). Two weeks after the instructions, dental students were asked to identify four landmarks namely the posterior nasal spine (PNS), orbitale (Or), articulare (Ar) and gonion (Go) on lateral cephalograms. The mean coordinates of each landmark identified by orthodontists served as the reference point, and the mean distance from each identified point to the reference point was reported as the mean consistency while the standard deviation of this mean was reported as the precision of measurement. Data were analyzed using SPSS version 18 via independent sample t-test.

Results
No significant difference was noted between the two groups in identification of PNS, Ar or Go (P > 0.05). However, the mean error rate in identification of Or was significantly lower in smartphone group compared with the traditional learning group (P = 0.020).

Conclusions
Smartphone-based mobile learning had a comparable, and even slightly superior, efficacy to lecture-based learning for instruction of cephalometric landmark identification, and may be considered, at least as an adjunct, to enhance the instruction of complicated topics.

Trial registration number
This is not a human subject research. https://ethics.research.ac.ir/ProposalCertificateEn.php?id=33714&Print=true&NoPrintHeader=true&NoPrintFooter=true&NoPrintPageBorder=true&LetterPrint=true.
A retrospective analysis of usefulness of impulse oscillometry system in the treatment of asthma
Authors: Sugawara Hiroyuki , Saito Atsushi , Yokoyama Saori , Tsunematsu Kazunori , Chiba Hirofumi , Takahashi Hiroki 
Published: August 2020

Abstract
Background
Bronchial asthma (BA) has different phenotypes, and it requires a clinically effective subtype classification system. The impulse oscillometry system (IOS) is an emerging technique device used in respiratory functional tests. However, its efficacy has not been validated. Therefore, this study aimed to assess the relationship between BA and the IOS parameters, and the difference in the therapeutic effects of inhaled corticosteroids (ICSs) among the subtype classifications was evaluated using the IOS.

Methods
Of the 245 patients with bronchial asthma who were screened, 108 were enrolled in this study. These patients were divided based on three subtypes according to the IOS result as follows: central predominant type (n = 34), peripheral predominant type (n = 58), and resistless type (n = 16). Then, the following ICSs were randomly prescribed in daily medical care: coarse-particle ICS (fluticasone propionate [FP]), fine-particle ICS (mometasone furoate [MF]), and moderate-particle ICS (budesonide [BUD]). The treatment effects were assessed using the Asthma Health Questionnaire (AHQ) and the Asthma Control Test (ACT) and were compared among the three subtypes.

Results
In the central predominant type, the AHQ score of the MF group was significantly higher than that of the FP group (15.4 vs. 3.6, p < 0.01) and the BUD group (15.4 vs. 8.8, p < 0.05); the ACT score of the FP group was significantly higher than that of the MF and BUD groups (24.3 vs. 21.7, 22.3, respectively, p < 0.05) at 4 weeks after treatment. In the peripheral predominant type, the AHQ score of the FP group was significantly higher than that of the MF group (14.1 vs. 3.4, p < 0.05); the ACT score of the FP group was lower than that of the MF and BUD groups (22.8 vs. 24.6, 24.4, respectively, p < 0.01) at 4 weeks after treatment.

Conclusions
An association was observed between IOS subtype classification and ICS particle size in terms of therapeutic efficacy in BA. This result indicates that the IOS could be an effective tool in the selection of ICS and the evaluation of the BA phenotype.
Using three statistical methods to analyze the association between exposure to 9 compounds and obesity in children and adolescents: NHANES 2005-2010
Authors: Wu Bangsheng , Jiang Yi , Jin Xiaoqing , He Li 
Published: August 2020

Abstract
Background
Various risk factors influence obesity differently, and environmental endocrine disruption may increase the occurrence of obesity. However, most of the previous studies have considered only a unitary exposure or a set of similar exposures instead of mixed exposures, which entail complicated interactions. We utilized three statistical models to evaluate the correlations between mixed chemicals to analyze the association between 9 different chemical exposures and obesity in children and adolescents.

Methods
We fitted the generalized linear regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) to analyze the association between the mixed exposures and obesity in the participants aged 6–19 in the National Health and Nutrition Examination Survey (NHANES) 2005–2010.

Results
In the multivariable logistic regression model, 2,5-dichlorophenol (2,5-DCP) (OR (95% CI): 1.25 (1.11, 1.40)), monoethyl phthalate (MEP) (OR (95% CI): 1.28 (1.04, 1.58)), and mono-isobutyl phthalate (MiBP) (OR (95% CI): 1.42 (1.07, 1.89)) were found to be positively associated with obesity, while methylparaben (MeP) (OR (95% CI): 0.80 (0.68, 0.94)) was negatively associated with obesity. In the multivariable linear regression, MEP was found to be positively associated with the body mass index (BMI) z-score (β (95% CI): 0.12 (0.02, 0.21)). In the WQS regression model, the WQS index had a significant association (OR (95% CI): 1.48 (1.16, 1.89)) with the outcome in the obesity model, in which 2,5-DCP (weighted 0.41), bisphenol A (BPA) (weighted 0.17) and MEP (weighted 0.14) all had relatively high weights. In the BKMR model, despite no statistically significant difference in the overall association between the chemical mixtures and the outcome (obesity or BMI z-score), there was nonetheless an increasing trend. 2,5-DCP and MEP were found to be positively associated with the outcome (obesity or BMI z-score), while fixing other chemicals at their median concentrations.

Conclusion
Comparing the three statistical models, we found that 2,5-DCP and MEP may play an important role in obesity. Considering the advantages and disadvantages of the three statistical models, our study confirms the necessity to combine different statistical models on obesity when dealing with mixed exposures.
Differences in responses to English and Korean versions of the Caregiver Priorities & Child Health Index of Life with Disabilities (CPCHILD)
Authors: Sung Ki Hyuk , Kwon Soon-Sun , Cho Gyeong Hee , Chung Chin Youb , Encisa Clarissa , Menal Huroy , Narayanan Unni G. , Park Moon Seok 
Published: August 2020

Abstract
Background
The purpose of this study was to identify differences in caregiver responses to Korean-language and English-language versions of the Caregiver Priorities & Child Health Index of Life with Disabilities (CPCHILD) questionnaire.

Methods
Patient data were acquired from the Cerebral Palsy Hip Outcomes Project database, which was established to run a large international multicenter prospective cohort study of the outcomes of hip interventions in cerebral palsy. Thirty-three children whose caregivers had completed the Korean version of CPCHILD were matched by propensity scoring with 33 children whose parents completed the English version. Matching was performed on the basis of 12 covariates: age, gender, gross motor function classification system level, migration percentage of right and hip, seizure status, feeding method, tracheostomy status, pelvic obliquity, spinal deformity, parental report of hip pain and contracture interfering with care.

Results
There were no significant differences in CPCHILD scores for section 4 (Communication and Social Interaction), and section 5 (Health) between two groups. Korean-language CPCHILD scores were significantly lower than English-language CPCHILD scores for section 1 (Personal Care/Activities of Daily Living), section 2 (Positioning, Transferring and Mobility), section 3 (Comfort and Emotions) and section 6 (Overall Quality of Life) as well as in terms of total score.

Conclusions
Cultural influences, and the community or social environment may impact the caregivers’ perception of the health-related quality of life of their children. Therefore, physicians should consider these differences when interpreting the study outcomes across different countries.
Role of exosomes in malignant glioma: microRNAs and proteins in pathogenesis and diagnosis
Authors: Ghaemmaghami Amir B. , Mahjoubin-Tehran Maryam , Movahedpour Ahmad , Morshedi Korosh , Sheida Amirhossein , Taghavi Seyed Pouya , Mirzaei Hamed , Hamblin Michael R. 
Published: August 2020

AbstractMalignant gliomas are the most common and deadly type of central nervous system tumors. Despite some advances in treatment, the mean survival time remains only about 1.25 years. Even after surgery, radiotherapy and chemotherapy, gliomas still have a poor prognosis. Exosomes are the most common type of extracellular vesicles with a size range of 30 to 100 nm, and can act as carriers of proteins, RNAs, and other bioactive molecules. Exosomes play a key role in tumorigenesis and resistance to chemotherapy or radiation. Recent evidence has shown that exosomal microRNAs (miRNAs) can be detected in the extracellular microenvironment, and can also be transferred from cell to cell via exosome secretion and uptake. Therefore, many recent studies have focused on exosomal miRNAs as important cellular regulators in various physiological and pathological conditions. A variety of exosomal miRNAs have been implicated in the initiation and progression of gliomas, by activating and/or inhibiting different signaling pathways. Exosomal miRNAs could be used as therapeutic agents to modulate different biological processes in gliomas. Exosomal miRNAs derived from mesenchymal stem cells could also be used for glioma treatment. The present review summarizes the exosomal miRNAs that have been implicated in the pathogenesis, diagnosis and treatment of gliomas. Moreover, exosomal proteins could also be involved in glioma pathogenesis. Exosomal miRNAs and proteins could also serve as non-invasive biomarkers for prognosis and disease monitoring.
Reproductive health needs of adolescent and young adult women with pediatric rheumatic diseases
Authors: Carandang Kristine , Mruk Veronica , Ardoin Stacy P. , Huynh Brittany , Clowse Megan E. B. , Berlan Elise D. , Edens Cuoghi 
Published: August 2020

Abstract
Background
The purpose of this study was to identify reproductive health knowledge gaps and topics that concern adolescent and young adult (AYA) women with pediatric rheumatic diseases and their parents.

Methods
Data collection occurred in two cohorts. In the first cohort, young women (15–20 years old) with pediatric-onset rheumatic conditions and their parents were recruited from a single, academic pediatric rheumatology center. In the second cohort, young women (18–25 years old) with pediatric-onset rheumatic conditions were recruited from a national conference for families with pediatric rheumatic diseases. This resulted in 20 adolescents and young adults (18.3 ± 2.4 years old), and 7 parent focus group participants. Focus group leaders facilitated discussions centered on reproductive health topics that participants identified as important, their sources of knowledge, and preferences for patient education and ongoing follow-up. Data were summarized independently by 4 researchers to reduce potential bias and subsequently analyzed using rapid qualitative analysis.

Results
All participants, regardless of diagnosis, medication, current sexual activity, or current intention to have children, expressed concern about the effect of their rheumatic condition and medications on fertility, risks to mother and child during and after pregnancy, and obtaining safe and effective contraception. Additionally, some participants discussed the burden of disease and its potential impact on motherhood. Finally, participants raised concern around the effect of disease and medication on routine reproductive health care, such as menstrual cycles, feminine self-care, and preventive exams. Three themes emerged: 1) participants had been advised to avoid unplanned pregnancy, however reported receiving inadequate explanation to support this instruction, 2) participants conceptualized reproductive health as tied to rheumatic disease management and thus suggested ways to include family members in discussion, and 3) rheumatology practitioners were not considered a resource of reproductive health information.

Conclusions
Young women and their parents reported dissatisfaction with the availability, quantity, and quality of reproductive health information they received, particularly when related to their pediatric-onset rheumatic disease. These findings provide an initial step in understanding the patient perspective of reproductive health in rheumatology, and how to address these concerns in the care of young women with rheumatic diseases.
Suicidal behavior in problematic substance uses in South Gondar zone, Northwest Ethiopia: a cross-sectional survey
Authors: Legas Getasew , Belete Habte , Asnakew Sintayehu , Belete Amsalu , Shumet Shegaye 
Published: August 2020

Abstract
Background
Suicidal behavior has a significant contribution to the global burden of disease that affects individuals, families and communities at different age groups. Sadly, up to 75% of suicides in the world occur in low-and- middle income countries which have no adequate resource to prevent it. The aim of this study was to assess suicidal behavior and associated factors among community residents with problematic substance use in South Gondar zone, northwest Ethiopia.

Methods
Community based cross-sectional survey was conducted by using a suicidal behavior revised questionnaire from January 15 to March 15, 2019. A total of 4035 participants were screened for problematic substance use by using multi stage cluster sampling and 846 participants were positive for problematic substance use then asked for suicidal behavior. Multiple logistic regression analyses used to see adjusted odd rations (AOR). Multilevel binary logistic regression was used to account for the hierarchical structure of the two-level data within individual and districts level.

Results
The prevalence of suicidal behavior over the last 12 months in problematic substance uses was found to be 41.4% with 95% of confidence interval (CI) (38.2–44.9). Perceived stigma, [AOR = 1.605, 95% CI (1.16–2.23)], family history of suicide [AOR = 3.22, 95% CI (1.46–7.10)], physical illness [AOR = 2.45 95% CI (1.157–3.84)], rural resident [AOR = 1.74, 95% CI (1.16–2.62)], depression [AOR = 4.44, 95% CI (3.15–6.27)] and living alone (AOR = 1.61, 95% CI (1.16–2.24) were risks factors for suicidal behavior.

Conclusion
Suicidal behavior in problematic substance uses found to be high. Health workers should pay attention to decrease suicidal behavior and to control amendable factors.
Inhibition of the mechanistic target of rapamycin induces cell survival via MAPK in tuberous sclerosis complex
Authors: Lu Yiyang , Zhang Erik Y. , Liu Jie , Yu Jane J. 
Published: August 2020

Abstract
Background
Tuberous sclerosis complex (TSC) is a genetic disorder that cause tumors to form in many organs. These lesions may lead to epilepsy, autism, developmental delay, renal, and pulmonary failure. Loss of function mutations in TSC1 and TSC2 genes by aberrant activation of the mechanistic target of rapamycin (mTORC1) signaling pathway are the known causes of TSC. Therefore, targeting mTORC1 becomes a most available therapeutic strategy for TSC. Although mTORC1 inhibitor rapamycin and Rapalogs have demonstrated exciting results in the recent clinical trials, however, tumors rebound and upon the discontinuation of the mTORC1 inhibition. Thus, understanding the underlying molecular mechanisms responsible for rapamycin-induced cell survival becomes an urgent need. Identification of additional molecular targets and development more effective remission-inducing therapeutic strategies are necessary for TSC patients.

Results
We have discovered an Mitogen-activated protein kinase (MAPK)-evoked positive feedback loop that dampens the efficacy of mTORC1 inhibition. Mechanistically, mTORC1 inhibition increased MEK1-dependent activation of MAPK in TSC-deficient cells. Pharmacological inhibition of MAPK abrogated this feedback loop activation. Importantly, the combinatorial inhibition of mTORC1 and MAPK induces the death of TSC2-deficient cells.

Conclusions
Our results provide a rationale for dual targeting of mTORC1 and MAPK pathways in TSC and other mTORC1 hyperactive neoplasm.