bluuebunny/crossref_metadata_2025_split huggingface dataset:
Moral Structuring Of Children During The Process Of Obtaining Informed Consent In Clinical And Research Settings
Authors: Díaz-Pérez Anderson , Quiroz Elkin Navarro , MARENCO DILIA APARICIO 
Published: June 2020

Abstract
Background. Informed consent is an important factor in a child’s moral structure from which different types of doctor–patient relationships arise. Children’s autonomy is currently under discussion in terms of their decent treatment, beyond which it is perceived by clinicians and/or researchers. Methods. This is a transversal, qualitative study via a subjectivist approach and a interpretivist approach. The study was performed by conducting semi-structured interviews of 21 people by clinicians and researchers. Data analysis was performed with the SPSS 21® and Atlas Ti 7.0® programmes. Results. Influential practices in the doctor–patient relationship were approach and paternalistic. In the deliberative model, the child is expected to have a moral awareness of their care. The paternalistic model determined that submission was a way of structuring the child, since he or she is considered to be a subject of extreme care. Conclusions. The differentiated objectification [educational] process recognises the internal and external elements of the child. Informed consent proved to be the appropriate means for strengthening moral and structuring the child.
Molecular epidemiology and clinical characteristics of hepatitis delta virus (HDV) infected patients with elevated transaminases in Shanghai, China
Authors: Wu Shanshan , Zhang Yi , Tang Yuyan , Yao Ting , Lv Mengjiao , Tang Zhenghao , Zang Guoqing , Yu Yongsheng , Chen Xiaohua 
Published: June 2020

Abstract
Background: Patients coinfected with HBV and hepatitis D virus (HDV) have a greater risk of HCC and cirrhosis. The current study was undertaken to assess HDV genotype distribution and determine clinical characteristics of hepatitis delta virus (HDV) among HBsAg positive individuals in Shanghai.Method: This retrospective study involved 225 serum samples from HBsAg positive hospitalized patients from October 2010 to April 2013. HDV-specific RT-nested PCR was used to amplify HDV RNA. HDV genotypes were characterized by Next-generation sequencing (NGS), followed by phylogenetic analyses. HDV/HBV co-infected patients and HBV mono-infected patients were compared clinically and virologically.Results: Out of the 225 HBsAg-positive serum samples with elevated transaminases, HDV-RNA was identified in 11 (4.9%) patients. The HBV loads in the HDV positive group were significantly lower than the HDV negative HBV-infected patients. The aminotransferase enzymes were significantly higher in HDV/HBV co-infected compared to HDV negative patients (P<0.05). Phylogenetic analyses indicated that HDV-2 genotype being the predominant genotype, other HDV genotypes were not observed. HDV/HBV patients were significantly associated with a rather unfavourable clinical outcome.Conclusion： In summary, our study showed that the prevalence of HDV infection in patients with elevated transaminases is not low and the predominance of HDV genotype 2 infection in Shanghai. This finding helps us to better understand the correlation of HDV/HBV co-infection. Moreover, Next-generation sequencing (NGS) technologies provide a rapid, precise method for generating HDV genomes to define infecting genotypes.
Analysis of lifetime death probability for major causes of death among residents in China
Authors: yuan ping , Xiang Jianjun , Borg Matthew , CHEN Tiehui , Lin Xiuquan , Peng Xiane , ZHENG Kuicheng 
Published: June 2020

Abstract
Background: Cumulative mortality rate and cumulative mortality risk are two commonly used indicators to measure the impact and severity of diseases. However, they are calculated during a defined life span and assume the subject does not die from other causes. This study aims to use a new indicator, lifetime death probability (LDP), to estimate the lifetime death probabilities for the top five leading causes of death in China and explore the regional differences and trends over time. Methods: LDPs were calculated using a probability additive formula and abridged life tables. Results: In 2014, LDPs for heart disease, cerebrovascular disease, malignancy, respiratory disease, and injury and poisoning were 24.4%, 23.7%, 19.2%, 15.5%, and 5.3%, respectively. The LDPs for heart disease and malignancy increased by 7.3% and 0.5%, respectively, compared to those from 2004 to 2005. In contrast, the LDPs for cerebrovascular and respiratory disease decreased by 1.0% and 3.9%, respectively, compared to those in 2004-2005. Across the eastern, central and western regions, malignancy had the highest LDP in the eastern region, cerebrovascular and heart diseases in the central region, and respiratory diseases, and injury and poisoning in the western region. Conclusions: LDP is an effective indicator for comparing health outcomes and can be applied for future disease surveillance. Heart disease and malignancy were the two most common causes of death in China, but with regional differences. There is a need to implement targeted measures to prevent chronic diseases in different regions.
Changes in Oral Health Indicators due to Implementation of the National Health Insurance Services Coverage for First Molar Dental Sealant for Children and Adolescents in South Korea
Authors: Choi Jin-Sun , Ma Deuk-Sang 
Published: June 2020

Abstract
Background: In South Korea, dental sealant was included in the National Health Insurance Services (NHIS) coverage for the first molar for ages 6–14 in December 2009. The second molar was included in 2012, and the age of insurance coverage was extended to under 18 in 2013. This study aimed to verify the effectiveness of an NHIS dental sealant coverage policy for children and adolescents by comparing the changes in first molar oral health indicators before and after policy implementation.Methods: The Korea National Health and Nutrition Examination Survey data were analyzed; the fourth period (2007–2009) provided data for before and the sixth period (2013–2015) provided data for after policy implementation. The proportion of individuals with first-molar sealant, decay-missing-filled first molar permanent teeth, and single crowns in the group aged 11-20 years were calculated. Data were analyzed using chi-square for complex samples and the complex samples general linear model. In addition, complex-sample logistic regression analysis was performed to confirm the association between factors. Results: Compared with non-beneficiaries, among policy beneficiaries, sealant ownership increased by 7.7% (from 27.8 to 35.5, P<0.001), and the number of permanent teeth with sealant per capita increased by approximately 0.4 to 0.8 (P<0.001). The proportion of individuals with decay-missing-filled permanent teeth decreased by 9.1% (from 68.4 to 59.3, P<0.001), and the average decay-missing-filled permanent teeth index per person decreased by approximately 2.0 to 1.5 (P<0.001). The rate of single-crown holders decreased by 2.7% (from 8.7 to 6.0, P>0.05), and the average single-crown index decreased by approximately 0.11 to 0.08 per person(P>0.05). The number of sealants increased with age and household income (P<0.001). The mother’s education level affected sealant experience (P<0.05). The caries rate was higher in females and older respondents (P <0.001).Conclusions: The sealant covered by NHIS contributed to decreasing dental caries in Korea. However, policies that can reduce oral health inequality should also be considered, and a follow-up study is required for long-term sealant maintenance in Korea.
Cancer risk after total hip replacements. A prospective study of 41,402 patients in the Norwegian Arthroplasty Register linked to the Cancer Registry of Norway
Authors: Dybvik Eva , Furnes Ove , Havelin Leif I. , Fosså Sophie D. , Trovik Clement , Lie Stein Atle 
Published: June 2020

Abstract
Background Concerns have been raised that implants used in total hip replacements (THR) could lead to increased cancer risk. Several different materials, metals and fixation techniques are used in joint prostheses and different types of articulation can cause an increased invasion of particles or ions into the human body. Methods Patients with THR registered in the Norwegian Arthroplasty Register during 1987-2009 were linked to the Cancer registry of Norway. Patients with THR due to osteoarthritis, under the age of 75 at time of surgery, were included. Standardized incidence ratios (SIR) were applied to compare cancer risk for THR patients to the general population. Types of THR were divided into cemented (both components), uncemented (both components), and hybrid (cemented femoral and uncemented acetabular components). To account for selection mechanisms, time dependent covariates were applied in Cox-regression, adjusting for cancer risk the first 10 years after surgery. The analyses were adjusted for age, gender and if the patient had additional THR-surgery in the same or the opposite hip. The study follows the STROBE guidelines.Results Comparing patients with THR to the general population in Norway we found no differences in cancer risk. The overall SIR for the THR-patients after 10 years follow-up was 1.02 (95% CI: 0.97-1.07). For cemented THR, the SIR after 10 years follow-up was 0.99 (95% CI: 0.94-1.05), for uncemented, 1.16 (95% CI: 1.02-1.30), and for hybrid 1.12 (95% CI: 0.91-1.33). Adjusted Cox analyses showed that patients with uncemented THRs had an elevated risk for cancer (hazard ratio: HR=1.24, 95% CI: 1.05-1.46, p=0.009) when compared to patients with cemented THRs after 10 years follow-up. Stratified by gender the increased risk was only present for men. The risk for patients with hybrid THRs was not significantly increased (HR=1.07, 95% CI: 0.85-1.35, p=0.55) compared to patients with cemented THRs.Conclusions THR patients had no increased risk for cancer compared to the general population. We found, however, that receiving an uncemented THR was associated with a small increased risk for cancer compared to cemented THR in males, but that this may be prone to unmeasured confounding.
Effects of Virtual Reality Associated With Serious Games for Upper Limb Rehabilitation in Patients With Multiple Sclerosis. a Randomized Controlled Trial
Authors: Cuesta-Gómez Alicia , Baeza Patricia Sanchez-Herrera , Oña-Simbaña Edwin Daniel , Martínez-Medina Alicia , Ortiz-Comino Carmen , de Quirós Carlos Balaguer-Bernaldo , Jardón-Huete Alberto , Cuerda Roberto Cano-de la 
Published: June 2020

Abstract
Background: Dexterity and activities of daily living limitations on the upper limb (UL) represent one of the most common problems in patients with multiple sclerosis (MS). The aim of this study was to evaluate the effectiveness of the specially developed Serious Games that make use of the Leap Motion Controller (LMC) as main user interface for improving UL grip muscle strength, dexterity, fatigue, quality of life, satisfaction and compliance. Methods: A single-blinded randomized controlled trial was conducted. The sample was randomized into two groups: an experimental group who received treatment based on serious games designed by the research team using the developed LMC based Serious Games for the UL plus conventional rehabilitation, and a control group who received the same conventional rehabilitation for the UL. Both groups received two 60 min sessions per week over a ten-week period. Grip muscle strength, coordination, speed of movements, fine and gross UL dexterity, fatigue, quality of life, satisfaction and compliance were assessed in both groups pre-treatment, post-treatment and in a follow-up period of one month without receiving any treatment. Results : In the experimental group compared to the control group, significant improvements were observed in the post-treatment assessment for coordination, speed of movements, fine and gross UL dexterity. Also, significant results were found in the follow-up in coordination, speed of movements, fine and gross for the more affected side. Conclusions: An experimental protocol using an LMC based Serious Games designed for UL rehabilitation showed improvements for unilateral gross manual dexterity, fine manual dexterity, and coordination in MS patients with high satisfaction and excellent compliance.
Relationship of chest CT score with clinical characteristics of 108 patients hospitalized with COVID-19 in Wuhan, China
Authors: Zhang Jie , Meng Guangping , Li Wei , Shi Bingqing , Dong Hongna , Su Zhenzhong , Huang Qian , gao peng 
Published: June 2020

Abstract
Background: In December 2019, the outbreak of a disease subsequently termed COVID-19 occurred in Wuhan, China. The number of cases increased rapidly and spread to six continents. However, there is limited information on the chest computed tomography (CT) results of affected patients. Chest CT can assess the severity of COVID-19 and has sufficient sensitivity to assess changes in response to glucocorticoid therapy.Objective: Analyze COVID-19 patients to determine the relationships of clinical characteristics, chest CT score, and levels of inflammatory mediators. Methods: This retrospective, single-center case series of 108 consecutive hospitalized patients with confirmed COVID-19 at Tongji Hospital, Tongji Medical College of HUST (Wuhan, China) examined patients admitted from January 1 to January 28, 2020. Patient demographics, comorbidities, clinical findings, chest CT results, and CT scores of affected lung parenchyma were recorded. The relationships between chest CT score with levels of systemic inflammatory mediators were determined.Results: All patients exhibited signs of significant systemic inflammation, including increased levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin, chest CT score, and a decreased lymphocyte (LY) count. Chest CT score had positive associations with white blood cell (WBC) count, CRP, ESR, procalcitonin, and abnormal coagulation function, and a negative association with LY count. Treatment with a glucocorticoid increased the LY count, reduced the CT score and CRP level, and improved coagulation function.Conclusions: COVID-19 infection is characterized by a systemic inflammatory response that affects the lungs, blood, digestive system, and circulatory systems. The chest CT score is a good indicator of the extent of systemic inflammation. Glucocorticoid treatment appears to reduce systemic inflammation in these patients.
Global targetome analysis reveals critical role of miR-29a in pancreatic stellate cell mediated regulation of PDAC tumor microenvironment
Authors: Dey Shatovisha , Liu Sheng , Factora Tricia D , Taleb Solaema , Riverahernandez Primavera , Udari Lata , Zhong Xiaoling , Wan Jun , Kota Janaiah 
Published: June 2020

Abstract
BackgroundPancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive forms of malignancies with a nearly equal incidence and mortality rates in patients. Pancreatic stellate cells (PSCs) are critical players in PDAC microenvironment to promote the aggressiveness and pathogenesis of the disease. Dysregulation of microRNAs (miRNAs) have been shown to play a significant role in progression of PDAC. Earlier, we observed a PSC-specific downregulation of miR-29a in PDAC pancreas, however, the mechanism of action of the molecule in PSCs is still to be elucidated. The current study aims to clarify the regulation of miR-29a in PSCs and identifies functionally important downstream targets that contribute to tumorigenic activities during PDAC progression. MethodsIn this study, using RNAseq approach, we performed transcriptome analysis of paired miR-29a overexpressing hPSC cells and controls. Enrichment analysis was performed with the identified differentially expressed genes (DEGs). miR-29a targets in the dataset were identified, which were utilized to create network interactions. Western blots were performed with the top candidate miR-29a targets in hPSC cells transfected with miR-29a mimic or scramble control. ResultsRNAseq analysis identified 202 differentially expressed genes, which included 19 downregulated direct miR-29a targets. Translational repression of eight key pro-tumorigenic and -fibrotic targets namely IGF-1, COL5A3, CLDN1, E2F7, MYBL2, ITGA6 and ADAMTS2 by miR-29a was observed in PSCs. Using pathway analysis, we find that miR-29a modulates effectors of IGF-1-p53 signaling in PSCs that may hinder carcinogenesis. We further observe a regulatory role of the molecule in pathways associated with PDAC ECM remodeling and tumor-stromal crosstalk, such as INS/IGF-1, RAS/MAPK, laminin interactions and collagen biosynthesis. ConclusionsTogether, our study presents a comprehensive understanding of miR-29a regulation of PSCs, and identifies essential pathways associated with PSC-mediated PDAC pathogenesis. The findings suggest an anti-tumorigenic role of miR-29a in the context of PSC-tumor cell crosstalk and advocates for the potential of the molecule in PDAC targeted therapies.
Short Wave Enhances Mesenchymal Stem Cell Recruitment through Hypoxia-Inducible Factor-1 Signaling in Fracture Healing
Authors: Ye Dongmei , Chen Chen , Wang Qiwen , Zhang Qi , Li Sha , Liu Hongwei 
Published: June 2020

Abstract
Background

As a type of high-frequency electrotherapy, a short wave can promote the fracture healing process; yet, its underlying therapeutic mechanisms still remain unclear.

Purpose

To observe the effect of short wave on mesenchymal stem cell (MSC) homing and its mechanisms associated with fracture healing.

Materials and Methods

For in vivo study, the effect of Short-Wave therapy in relation to fracture healing was examined in stabilized femur fractures model of 40 SD rats. Radiography was used to analyze the morphology and micro-architecture of the callus. Additionally, fluorescence assays were used to analyze the GFP-labeled MSC homing after treatment in 20 nude mice with a femoral fracture. For in vitro study, osteoblast from newborn rats simulated fracture site was first irradiated by the Short-Wave; siRNA targeting HIF-1 was used to investigate the role of HIF-1. Osteoblast culture medium was then collected as chemotaxis content of MSC, and the migration of MSC from rats was evaluated using wound healing assay and trans-well chamber test. The expression of HIF-1 and its related factors were quantified by q RT-PCR, ELISA, and Western blot.

Results

Our in vivo experiment indicated that Short-Wave therapy could promote MSC migration, increase local and serum HIF-1 and SDF-1 levels, induce changes in callus formation, and improve callus microarchitecture and mechanical properties, thus speeding up the healing process of the fracture site. Moreover, the in vitro results further indicated that Short-Waves therapy upregulated HIF-1 and SDF-1 expression in osteoblast and in the medium, as well as the expression of CXCR-4, β-catenin, F-actin and phosphorylation levels of FAK in MSC. On the other hand, the inhibition of HIF-1α was significantly restrained by the inhibition of HIF-1α in osteoblast, and it partially inhibited the migration of MSC.

Conclusions

These results suggested that short wave could increase HIF-1 in callus, which is one of the crucial mechanisms of chemotaxis MSC homing in fracture healing.
Nucleic Acids In Inclusion Bodies Obtained From E. Coli Cells Expressing Human Interferon-Gamma
Authors: Krachmarova Elena , Ivanov Ivan , Nacheva Genoveva 
Published: June 2020

Abstract
BackgroundInclusion bodies (IBs) are protein aggregates in recombinant bacterial cells containing mainly the target recombinant protein. Although it has been shown that IBs contain functional proteins along with protein aggregates, their direct application as pharmaceuticals is hindered by their heterogeneity and hazardous contaminants with bacterial origin. Therefore, together with the production of soluble species, IBs remain the main source for manufacture of recombinant proteins with medical application. The quality and composition of the IBs affect the refolding yield and further purification of the recombinant protein. The knowledge whether nucleic acids are genuine components or concomitant impurities of the IBs is a prerequisite for the understanding of the IBs formation and for development of optimized protocols for recombinant protein refolding and purification. IBs isolated from Escherichia coli overexpressing human interferon-gamma (hIFNγ), a protein with therapeutic application, were used as a model. ResultsIBs were isolated from Escherichia coli LE392 cells transformed with a hIFNγ expressing plasmid under standard conditions and further purified by centrifugation on a sucrose cushion, followed by several steps of sonication and washings with non-denaturing concentrations of urea. The efficiency of the purification was estimated by SDS-PAGE gel electrophoresis and parallel microbiological testing for the presence of residual intact bacteria. Phenol/chloroform extraction showed that the highly purified IBs contain both DNA and RNA. The latter were studied by UV spectroscopy and agarose gel electrophoresis combined with enzymatic treatment and hybridization. DNA was observed as a diffuse fraction mainly in the range of 250 to 1000 bp. RNA isolated by TRIzol® also demonstrated a substantial molecular heterogeneity. Hybridization with 32P-labelled oligonucleotides showed that the IBs contain rRNA and are enriched of hIFNγ mRNA.ConclusionsThe results presented in this study indicate that the nucleic acids might be intrinsic components rather than co-precipitated impurities in the IBs. We assume that the nucleic acids are active participants in the aggregation of recombinant proteins and formation of the IBs that originate from the transcription and translation machinery of the microbial cell factory. Further studies are needed to ascertain this notion.
Impacts of triglycerides-glucose index on prognosis of patients with type 2 diabetes mellitus and non-ST-segment elevation acute coronary syndrome: results from an observational cohort study in China
Authors: Zhao Qi , Zhang Ting-Yu , Cheng Yu-Jing , Ma Yue , Xu Ying-Kai , Yang Jia-Qi , Zhou Yu-jie 
Published: June 2020

Abstract
Background: The relationship between triglycerides-glucose index (TyG index) and the prevalence and prognosis of cardiovascular disease has been confirmed by former studies. However, it remains uncertain whether TyG index has a prognostic impact in patients with type 2 diabetes mellitus (T2DM) and non-ST-segment elevation acute coronary syndrome (NSTE-ACS) undergoing percutaneous coronary intervention (PCI).Methods: The study retrospectively enrolled 798 patients (mean age: 60.9 ± 8.3 years; 68.3% men) with T2DM and NSTE-ACS who underwent PCI at Beijing Anzhen Hospital from January to December 2015. TyG index was calculated as previously reported: ln [fasting TGs (mg/dL) * FBG (mg/dL) / 2]. The primary endpoint was a composite of adverse events as follows: all-cause death, non-fatal myocardial infarction (MI) and ischemia-driven revascularization.Results: TyG index were significantly higher in patients with a primary endpoint event compared with those without. Multivariate Cox analysis showed that 1-unit increase of TyG index was independently associated with higher risk of primary endpoint, independent of other risk factors [hazard ratio (HR) 3.208 per 1-unit increase, 95% confidence interval (CI) 2.400-4.289, P < 0.001]. The addition of TyG index to a baseline risk model had an incremental effect on the predictive value for adverse prognosis [AUC: baseline risk model, 0.800 vs. baseline risk model + TyG index, 0.856, P for comparison < 0.001; category-free net reclassification improvement (NRI) 0.346, P < 0.001; integrated discrimination improvement (IDI) 0.087, P < 0.001].Conclusions: Increased TyG index is a significant predictor of adverse prognosis in patients with T2DM and NSTE-ACS undergoing PCI. Further studies need to be performed to determine whether interventions for TyG index have a positive impact on improving clinical prognosis.