bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combining Cell Therapy with Autologous Schwann Cell and Bone Marrow-derived Mesenchymal Stem Cell in Patients with Subacute Complete Spinal Cord Injury: Safety Considerations and Possible Outcomes
Authors: Yazdani Saeed Oraee , Akhlaghpasand Mohammadhosein , Golmohammadi Maryam , Hafizi Maryam , Zomorrod Mina Soufi , Kabir Nima Mohseni , Oraee-Yazdani Maryam , Zali Alireza , Soleimani Masoud 
Published: December 2020

Abstract
Background Cellular transplantations have promising effects on treating spinal cord injury (SCI) patients. Safety alongside the complementary characteristics of Mesenchymal stem cells (MSC) and Schwann cells (SC) are suggested to be the two of the best candidates in SCI treatment. In this study, we assessed the safety and efficacy of intrathecal co-transplantation of autologous bone marrow MSC and SC in the patients with subacute traumatic complete SCI.Methods Eleven patients with complete SCI (American Spinal Injury Association Impairment Scale (AIS); grade A) were enrolled in this study during the subacute period of injury. The patients received intrathecal autologous combination of MSC and SC and were followed-up for 12 months. We assessed neurological changes by American Spinal Injury Association’s (ASIA) sensory-motor scale, functional recovery by spinal cord independence measure (SCIM-III), and subjective changes along with adverse events (AE) with our checklist. Furthermore, electromyography (EMG), nerve conduction velocity (NCV), magnetic resonance imaging (MRI), and urodynamic study (UDS) were conducted for all the patients at the baseline, 6 months, and one year after the intervention.Results Light touch ASIA score alterations were approximately the same as the pinprick changes (11.6 ± 13.1 and 12 ± 13, respectively) in 50% of the cervical and 63% of the lumbar-thoracic patients and both were more than the motor score alterations (9.5 ± 3.3 in 75% of the cervical and 14% of the lumbar-thoracic patients). SCIM III total scores (21.2 ± 13.3) and all its sub-scores (“respiration and sphincter management” (15 ± 9.9), “mobility” (9.5 ± 13.3), and “self-care” (6 ± 1.4)) had significant changes after cell injection. Our findings support that the most remarkable positive, subjective improvements were in trunk movement, equilibrium in standing/sitting position, sensation of the bladder and rectal filling, and ability of voluntary voiding. Our safety evaluation revealed no systemic complications and radiological images showed no neoplastic overgrowth, syringomyelia, or pseudo-meningocele.Conclusion The present study showed that autologous SC and bone marrow-derived MSC transplantation at the subacute stage of SCI could reveal significant improvement in sensory and neurological functions among the patients. It appears that using this combination of cells is safe and effective for clinical application to the spinal cord regeneration during the subacute period.
Identification of Differentially Expressed Genes Triggered by Aberrant Methylation in Idiopathic Pulmonary Fibrosis Using Integrated Bioinformatic Analysis
Authors: Chen Shuaijun , Zhang Jun , Ma Wanli , Ye Hong 
Published: December 2020

Abstract
BackgroundIdiopathic pulmonary fibrosis (IPF) is a relentlessly progressive and fatal fibrotic lung disease all over the world, and specific pathogenesis is still not well understood. DNA methylation is an essential epigenetic mechanism, which likely contributes to the progress of IPF. The purpose of this study is to identify aberrantly methylated differentially expressed genes (DEGs) in IPF and to explore the underlying mechanisms of IPF by using integrated bioinformatics analysis.MethodGene expression profiles and gene methylation profile were downloaded and analyzed to identify the aberrantly methylated‐differentially expressed genes. Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), Search Tool for the Retrieval of Interacting Genes Database (STRING) and Gene set enrichment analysis (GSEA) were used to evaluate function of DEGs. RT-PCR was used to verify the mRNA levels of DEGs in mice with pulmonary fibrosis.ResultsBy analyzing the differentially expressed genes of the three IPF expression profiles, and taking the intersection, we got 143 co-upregulated genes and 104 co-downregulated genes; GO and KEGG pathway analysis of the DEGs suggested these genes involved in the extracellular matrix organization, multicellular organismal homeostasis. Combining the sequencing data of two IPF methylation chips, we have identified genes that may be regulated by methylation in IPF. Finally, we obtained the mRNA expression of DEGs using a mouse model of pulmonary fibrosis.ConclusionThrough integrated analysis and experimental verification, we found a series of biomarkers which were regulated by methylation should be potential therapeutic targets for IPF.
Conceptual Framework for Task Shifting and Task Sharing: An International Delphi Study
Authors: Orkin Aaron , Rao Sampreeth , Venugopal Jeyasakthi , Kithulegoda Natasha , Wegier Pete , Ritchie Stephen D. , VanderBurgh David , Martiniuk Alexandra , Salamanca-Buentello Fabio , Upshur Ross 
Published: December 2020

Abstract
BackgroundTask shifting and sharing (TS/S) involves the redistribution of health tasks within workforces and communities. Conceptual frameworks lay out the key factors, constructs, and variables involved in a given phenomenon, as well as the relationships between those factors. Though TS/S is a leading strategy to address health worker shortages and improve access to services worldwide, a conceptual framework for this approach is lacking.MethodsWe used an online Delphi process to engage an international panel of scholars with experience in knowledge synthesis concerning TS/S and develop a conceptual framework for TS/S. We invited 55 prospective panellists to participate in a series of questionnaires exploring the purpose of TS/S and the characteristics of contexts amenable to TS/S programmes. Panellist responses were analysed and integrated through an iterative process to achieve consensus on the elements included in the conceptual framework. ResultsThe panel achieved consensus concerning the included concepts after three Delphi rounds among 15 panelists.The COATS Framework (Concepts and Opportunities to Advance Task Shifting and Task Sharing) offers a refined definition of TS/S and a general-purpose statement to guide TS/S programmes. COATS describes that opportunities for health system improvement arising from TS/S programmes depending on the implementation context, and enumerates eight essential conditions and important considerations for launching TS/S interventions.ConclusionThe COATS Framework offers an essential theoretical and conceptual model for TS/S programmes. The COATS Framework is comprehensive and adaptable, and can guide refinements in policy, programme development, evaluation, and research to improve TS/S globally.
Extended Injection Intervals of Gonadotropins With Superficial Skin Administration In Ivf Treatment Is both Cost-Effective and Patient-Friendly
Authors: Hsu Isabel , Hsu Leonard , Hsu Chao Chin 
Published: December 2020

Abstract
BackgroundWomen undergoing IVF treatments have to receive daily injections of rFSH for multiple follicles growth based on the short half-life of rFSH administered subcutaneously. This study was designed to assess if longer intervals of injection, based on rFSH half-life of 102 hours under superficial subcutaneous administration, effective for women receiving IVF.MethodsOne hundred women, aged 25–45, requesting IVF treatments from January to December 2018 were recruited in this observatory study. All women received long protocol employing GnRH-agonist since day 18 of the previous cycle. An initial bolus of 900 IU rFSH was injected into superficial subcutaneous skin at day 2 of the treatment cycle followed by longer intervals with added doses at day 7 and/or day 10. The main outcomes included the dose of gonadotropin and numbers of injection, serum FSH level, and mature oocytes retrieved.ResultsA total of 70 women completed the treatments, in which 10, 30, and 30 women received one, two and three injections of rFSH, respectively. On average, 2.31 ± 0.73 numbers of Gn injection and 1662 ± 397 IU of rFSH were administered. In comparison with baseline FSH level of 5.6 ± 2.2 IU/L, the serum concentrations of FSH were 35.3 ± 7.0 to 10.7 ± 3.7 IU/L at 1 to 5 days after an initial 900 IU rFSH administration. There were 10.5 ± 6.6 mature oocytes retrieved which resulted in 7.3 ± 5.1 two pronuclei embryos, and 1.8 ± 0.6 embryos were transferred back to the uterus and the remaining embryos were cryopreserved. In total, 72%, 91%, and 31% were noted for fertilization, cleavage, and implantation rates, respectively. The cumulative live birth rate was 36%.ConclusionsBased on the serum FSH levels detected, rFSH only needs to be administered every five days instead of daily injection. This administration mode with less injections and much less expenses for gonadotropin might reach the goal of a more patient-friendly and cost-effective treatment for IVF. Regarding higher response and efficacy of the present study, this administration mode could be employed in women with poor ovarian reserve and in women of poor or suboptimal ovarian response.Trial registration: None
Galectin-9 regulates serum amyloid A-induced inflammasome activation in human neutrophils
Authors: Temmoku Jumpei , Fujita Yuya , Matsumoto Haruki , Matsuoka Naoki , Asano Tomoyuki i , Sato Shuzo , Furuya Makiko , Suzuki Eiji , Watanabe Hiroshi , Migita Kiyoshi 
Published: December 2020

Abstract
Objective

The Nod-like receptor (NLR) Family Pyrin Domain Containing 3 (NLRP3) inflammasome plays roles in host defense and the development of autoinflammation. Galection-9 (Gal-9), one of the β-galactoside binding lectins, plays important regulatory roles in autoimmune diseases. T cell immunoglobulin and mucin-domain containing molecule 3 (TIM-3)/Gal-9 inhibitory interaction has been proposed in innate immune system. We investigate the role of Galectin-9 (Gal-9) on serum amyloid A (SAA)-induced inflammasome activation and IL-1β processing by human neutrophils.
Results

SAA stimulation induced the release of cleavage of IL-1β (p17) from neutrophils suggesting that SAA induces the inflammasome activation and subsequent processing of pro-IL-1β. ELISA data demonstrated that SAA stimulation also induced cleaved caspase-1 (p20) secretion from human neutrophils, and this release was suppressed by Gal-9 pretreatment. Gal-9 pretreatment diminished the SAA-induced cleaved IL-1β secretion, however, did not affect SAA-induced pro-IL-1β secretion from neutrophils. Furthermore, Gal-9 pretreatment suppressed SAA-induced intracellular accumulation of cleaved IL-1β, suggesting that Gal-9 functions as a negative regulator of SAA-induced inflammasome activation and may be a potential therapeutic target for the treatment of autoinflammatory disorders.
Path analysis reveals the direct effect of PCB28 on cognitive dysfunction in older Chinese females
Authors: Pan Chen-Wei , Zhao Hui-Juan , Xu Yong , Tian Dajun , Xiao Shuo , Wang Haiyin , Wei Xiao , Ruan Yuanyuan , Tao Gonghua , Zheng Weiwei 
Published: December 2020

Abstract
Background

Current findings support the hypothesis that the exposure of dioxin-like polychlorinated biphenyls (dl-PCBs) has adverse cognitive effects even at levels that are generally considered to pose low or no risk. However, the effect of non-dioxin-like PCBs (ndl-PCBs) on neurobehavior of aging people is largely unknown. Therefore, this study aimed toinvestigate the association of ndl-PCBs burden with the cognition functions among elderly adults.
Methods

Using samples and data from Weitang Geriatric Diseases study (2014–2015), 6 indicator-PCBs were detected in plasma by GC-MS and cognitive dysfunction (CoD) were measured by the Abbreviated Mental Test in 266 participants (age: 61–90). Sequential logistic regression was used to analyze the effects of PCBs on cognition functions. Then the female aged less than and equal to 80 years was selected, and path analysis was used to determine the direct or indirect impacts of co-exposure PCBs on COD by Structural Equation Modeling.
Results

After sequential adjusting for potential confounder, no association of PCBs 52, 101, 138, 153, 180, LPCBs, HPCBs, and ∑PCBs with the risk of COD was observed; however, the exposure of PCB28 was significantly associated with COD ((Model 3: OR = 3.12, 95% CI = 1.19–8.11, p = 0.020). The final path model also fits that only exposure to PCB28 had a direct effect on COD (β = 0.696, SE = 1.14; p = 0.036).
Conclusions

After controlling the co-exposures and confounders, the exposure to PCB28 can directly increase the risk of cognitive impairment in older Chinese females.
Obesity Measures, Metabolic Health and Their Association with 15-Year All-Cause and Cardiovascular Mortality in the SAMINOR 1 Survey: A Population-Based Cohort Study
Authors: Michalsen Vilde Lehne , Wild Sarah H. , Kvaløy Kirsti , Svartberg Johan , Melhus Marita , Broderstad Ann Ragnhild 
Published: December 2020

Abstract
Background: The mortality of metabolic―obesity phenotypes has been thoroughly studied, but it is not known how the association between continuous measures of body mass index (BMI) or waist circumference differ in strata of cardiometabolic health status. Methods: We linked data on 12,815 men and women aged 36―79 years from the SAMINOR 1 Survey with mortality data from the Norwegian Cause of Death Registry. We defined metabolically healthy and unhealthy as having zero and ≥1, respectively, of the following: MetS, pre-existing diabetes or cardiovascular disease (CVD), or prescribed drugs for high blood pressure, hyperglycaemia or dyslipidaemia. We defined general and abdominal obesity as BMI ≥30 kg/m2 and waist circumference ≥88 cm (women) or 102 cm (men), respectively, and cross-classified these categories with metabolic status to create metabolically healthy non-obese and obese (MHNO and MHO) and metabolically unhealthy non-obese and obese (MUNO and MUO) phenotypes. We used Cox regression to estimate the hazard ratio (HR) for all-cause and CVD mortality for 1) the four phenotypes and 2) continuous measures of BMI and waist circumference fitted with restricted cubic splines. We adjusted for age, leisure-time physical activity, education, smoking and alcohol consumption, and tested for interactions with sex and metabolic status (only continuous measures). Results: The MHO phenotype was present in 7.8% of women and 5.8% of men. During a median follow-up of 15.3/15.2 years, 596/938 women/men had died, respectively. The MUNO and MUO group had higher mortality than the MHNO group. Sex and phenotypes interacted with respect to CVD mortality (p=0.05 for general and p=0.02 for abdominal obesity): relative to the MHNO group, the MHO group had an adjusted HR (95% confidence interval) for CVD mortality of 1.05 (0.38–2.88) in women and 2.92 (1.71–5.01) in men. We found curvilinear associations between BMI/waist circumference and all-cause mortality irrespective of metabolic status. Corresponding relationships with CVD mortality were linear and the slope differed by sex and metabolic status.Conclusion: The relationships between continuous measures of BMI/waist circumference and mortality differed by sex, metabolic status and cause of death. Poor metabolic health substantially increases mortality regardless of obesity status.
Leptin Levels in Lymph Node Aspiration Biopsy is a Predictor of Smoking Tendencies: A Pilot Study
Authors: Qeadan Fares , Ahmadian Rosstin , Alden Emily , Pascetti Erica , Gu Lily Y. , Saeed Ali I. 
Published: December 2020

Abstract
Background: Cytokine profiles have traditionally been explored in serum due to its ease of accessibility and the diagnostic and assessment capabilities in a clinic setting. Utilization of additional cytokine depots, such as hilar lymph nodes, has not thoroughly been explored. In this study, we examined the cytokine profile of mediastinal and hilar lymph node fine needle aspirates to identify markers capable of differentiating high-risk smokers (>30 pack-years) from low-risk smokers (<30 pack-years), independent of current cancer diagnosis. Methods: We used the cytokine profiles of 27 patients from a pro-spective convenience pilot study conducted at the University of New Mexico. Logistic regression analysis was employed.Results: A significant difference in mean cytokine values for Leptin was discovered between patients categorized as low-risk and high-risk pack year smokers (p=0.034). Additionally, mean cytokine values of Leptin did not differ between patients by cancer diagnosis (malignant vs. benign). Our analysis demonstrated Leptin as a fair marker for discriminating between high-risk smokers and low-risk smokers (AUC 0.73). Conclusions: We conclude Leptin is an optimal cytokine to discriminate between high-risk and low-risk smokers. To our knowledge, this is the first study to assess the ability of Leptin to serve as such an indicator via hilar lymph nodes.
Comparison of Cost Effectiveness between Video-Assisted Thoracoscopic Surgery (VATS) and Open Lobectomy: A Retrospective Study
Authors: Chen Wei , Yu Zhanwu , Zhang Yichen , Liu Hongxu 
Published: December 2020

Abstract
Background Lung cancer is highly prevalent in Chinese population. The association of operative approach with economic burden in these patients remains unknown. ObjectivesThis institution-level cohort study aimed to compare the cost-related clinical outcomes and health care costs among patients undergoing video-assisted thoracoscopic surgery (VATS) and open lobectomy, and to investigate the factors associated with the costs. MethodsThis retrospective cohort study included patients who underwent VATS or open lobectomy in a provincial referral cancer center in China in 2018. Clinical effectiveness measures included post-operative blood transfusion, lung infection, and length of stay (LOS). Hospitalization costs were extracted from hospital information system to assess economic burden. ResultsCompared to open lobectomy group, the VATS lobectomy group had a lower blood transfusion rate (1.70% vs. 4.33%, P=0.033), lower lung infection rate (23.77% vs. 40.87%, P<0.001) and shorter post-operative LOS (9.42 ± 3.72 days vs. 10.97 ± 5.81 days, P<0.001). Total hospitalization costs of VATS lobectomy group and open lobectomy were similar: RMB 84,908.72±18,914.87, RMB 81,944.70 ±16,625.20, respectively. VATS approach, lung infection, longer post-operative length of stay, male sex, lung cancer diagnosis, and heart disease were associated with higher total hospitalization costs (P<0.05). ConclusionsVATS lobectomy has a lower post-operative blood transfusion rate, lower lung infection rate, and shorter post-operative LOS than open lobectomy. Future studies are needed to investigate other aspects of clinical effectiveness and the economic burden from a societal perspective.
Lesion Segmentation in Breast Ultrasound Images using Optimized Marked Watershed Method
Authors: Shen Xiaoyan , Ma He , Liu Ruibo , Li Hong , He Jiachuan , Wu Xinran 
Published: December 2020

Abstract
Background: Ultrasound is the most popular tool for early detection of breast cancer because of its non radiation and low cost. However, breast ultrasound(BUS) images have low resolution and speckle noise, which make lesion segmentation become a challenge. Most of deep learning(DL) models applied on images segmentation don't have good generalization ability for BUS images. Therefore, it is time to go back to the classical method and consider combining it with DL to achieve more accurate and efficient effect in a semi-automatic way.Methods: This paper mainly proposed an effective and efficient semi-automatic BUS images segmentation method, Adaptive morphological snake and marked watershed( AMSMW). It includes two parts: preprocessing and segmentation. In the first part, we combine contrast limited adaptive histogram equalization(CLAHE) and side window filtering(SWF) methods for the first time. In the second part, We use the proposed adaptive morphological snake algorithm (AMS) to provide a mark for marked watershed(MW) method. Results: we tested on 500 BUS images, whose ratio of benign and malignant is 1:1. After quantitative and qualitative analysis, AMSMW is proven to outperform existing classical methods on the effectiveness and efficiency. Furthermore, we compared with Zhuang’s RDAU-NET on both our dataset and theirs. Experimental result showes AMSMW achieved better performance on most of indicators, including loss, accuracy, sensitivity, dice and F1-score. Conlusions: The new image preprocessing method proposed by us has obvious effect on segmentation of breast ultrasound image. In addition, the proposed adaptive morphology snake method and optimized marked watershed turn out to be more efficient and effective than some relative classical method and the advanced DL method at present. Moreover, by studying on the algorithm’s sensitivity in segmenting benign and malignant tumors, we found that AMSMW is more sensitivity to malignant tumors, and more stable to benign tumors, which is significant for further research of precision medicine.
Trends and determinants of HIV transmission among men who inject drugs in the Pokhara Valley, Nepal: Analysis of cross-sectional studies
Authors: Hogan Sam , Page Andrew , Ogbo Felix , Dixit Sameer , Rajbhandari Rajesh Man , Rawal Bir , Deuba Keshab 
Published: December 2020

Abstract
Background HIV is a major public health issue around the world, especially in developing countries. Although the overall prevalence of HIV in Nepal is relatively low, there are specific sub-populations where the prevalence is far higher than the national average. One of these sub-groups is male people who inject drugs (male PWIDs). In order to understand the reasons for the differences in prevalence, a series of socio-demographic, behavioural and knowledge-based risk factors were assessed. Methods The study used a series of 7 cross-sectional survey datasets from Pokhara (Nepal), collected between 2003 and 2017 (N=2,235) to investigate trends in HIV prevalence among male PWIDs by socio-demographic, behavioural, and knowledge-based risk factors. A series of logistic regression models were conducted to investigate the association between study factors and HIV. Results HIV prevalence decreased from the levels seen in 2003 (22.0%) and 2005 (21.7%), with the lowest prevalence recorded in 2015 (2.6%), however prevalence increased in the most recent period (4.9%). A lower risk of HIV was associated with younger age (<=24 years compared to >24 years, OR = 0.17, 95% CI = 0.10-0.31), being married (OR = 1.91, 95% CI = 1.25-3.02) and shorter duration of drug use (<=4 years compared to >4 years, OR = 0.16, 95% CI = 0.09-0.29). A higher risk of HIV was associated with low (compared to secondary or higher) education level (OR = 2.76, 95% CI = 1.75-4.36), a lack of addiction treatment (OR = 2.59, 95% CI = 1.64-4.08), and recent use of unsterilized injection equipment (OR = 2.22, 95% CI = 1.20-4.11). Conclusion The prevalence of HIV in male PWIDs in Pokhara has been variable, but overall has reduced in recent years to 2.6% before increasing in 2017 to 4.9%. The main determinants which increase the risk of HIV among male PWIDs in Pokhara are low education level, a lack of treatment for drug addiction and the recent use of unsterilised equipment. Each of these indicate the need to improve addiction treatment and education programs for intra-venous drug use to aid this key population in avoiding risk-taking behaviours.