bluuebunny/crossref_metadata_2025_split huggingface dataset:
U-Shaped Association Between the Triglycerides-Glucose index and the Risk of Incident Diabetes in Apparently Healthy Population: A Population-based Cohort Study
Authors: Xuan Xiuping , Hamaguchi Masahide , Cao Qiuli , Takuro Okamura , Hashimoto Yoshitaka , Obora Akihiro , Kojima Takao , Fukui Michiaki , Yuan Guandou , Guo Zhenya , Luo Zuojie , Qin Yingfen , Luo Xiaoping , Xie Xuemei 
Published: July 2020

Abstract
Background

Although the triglycerides-glucose (TyG) index was thought to be a practical predictor of incident diabetes, the association between them has not been well characterized. The study aimed to further examine the association between the TyG index and incident diabetes in Japanese adults.
Methods

The cases were extracted of the individual participating in the NAGALA (NAfld in the Gifu Area, Longitudinal Analysis) study at Murakami Memorial Hospital from 2004 to 2015, and 14297individuals apparently healthy at baseline were included in the study. Cox proportional hazards models were used to evaluate the associations between baseline TyG levels and incident of T2DM, and a two-piecewise linear regression model was use to examine the threshold effect of the baseline TyG on incident diabetes using a smoothing function. The threshold level (i.e., turning point) was determined using trial and error. A log likelihood ratio test was also conducted to compare the one-line linear regression model with a two-piecewise linear model.
Results

During a median follow-up period of 5.26 (women) and 5.88 (men) years, 47 women and 182 men developed Type 2 diabetes. The risk of diabetes was strongly associated with the baseline TyG index in the fully adjusted model in men but not in women, and no dose-dependent positive relationship between incident diabetes and TyG was observed across TyG tertiles. Intriguingly, two-piecewise linear regression analysis showed a U-shaped association between the TyG index and incident T2DM. The risk of incident diabetes decreased by around 90% in women with TyG < 7.27 (HR: 0.09; P = 0.0435) and 80% in men with TyG < 7.97 (HR 0.21, P = 0.002) with each increment of the TyG index after adjusting for confounders. In contrast, the risk of incident T2DM significantly elevated with the increase in TyG index in men with TyG > 7.97 (HR: 2.42, P < 0.001) and women with TyG > 7.29 (HR 2.76, P = 0.0166).
Conclusions

A U-shaped association was observed between the TyG index and incident T2DM among healthy individuals, with the TyG threshold of 7.97 in men and 7.27 in women. This information may be useful for reducing incident diabetes by maintaining the TyG index near these thresholds.
Pros and Cons of Aspirin for the Primary Prevention of Cardiovascular Events: A Secondary Study of Trial Sequential Analysis
Authors: Zhao Binghao , Wu Qian , Wang Li , Liao Chen , Dong Yifei , Xu Jingsong , Wei Yiping , Zhang Wenxiong 
Published: July 2020

Abstract
Background and aims

Aspirin leads to substantial benefits for the secondary prevention of cardiovascular disease (CVD). We aimed to cast more light on aspirin’s role for the primary prevention of CVD.
Methods

Databases were searched for clinical trials comparing aspirin vs. no aspirin use in this meta-analysis. Efficacy and safety profiles were rigorously investigated. Trial sequential analysis (TSA) was used to determine the robustness of the results.
Results

Fourteen studies with 163 840 participants were eligible (mean follow-up 6.2 y). Aspirin intake was found to be associated with 9%, 13%, and 12% reductions in the risk of cardiovascular events (CV events) (relative risk [RR]: 0.91, 95% confidence intervals [CI]: 0.87–0.96), myocardial infarction (RR: 0.87, 95% CI: 0.77–0.97) and ischaemic stroke (RR: 0.88, 95% CI: 0.80–0.96), respectively; aspirin intake was also associated with 40%, 30%, and 57% increases in the risk of major bleeding (RR: 1.40, 95% CI: 1.29–1.53), intracranial bleeding (RR: 1.30, 95% CI: 1.11–1.52) and major gastrointestinal bleeding (RR: 1.57, 95% CI: 1.38–1.78), respectively. Further, populations with low doses of aspirin intake (≤ 100 mg), populations < 65 y old or populations with body mass index (BMI) ≧ 25 experienced more advantages; high-risk (10-y cardiovascular risk ≧ 10%) and full diabetic individuals reported hardly clinical benefits.
Conclusions

Aspirin intake was associated with a reduced risk of CV events and an increased incidence of bleeding profiles in primary prevention. It is necessary to identify individual’s CVD risk using clear examinations or assessments before aspirin intake, and truly realize individualized prescription.
The Additive Effects of Type 2 Diabetes Mellitus on Left Ventricular Deformation and Myocardial Perfusion in Essential Hypertension: a 3.0T Cardiac Magnetic Resonance Study
Authors: Li Xue-Ming , Jiang Li , Guo Ying-Kun , Ren Yan , Han Pei-Lun , Peng Li-Qing , Shi Rui , Yan Wei-Feng , Yang Zhigang 
Published: July 2020

Abstract
Background
Type 2 diabetes mellitus (T2DM) increases the risks of heart failure and mortality in patients with hypertension, however the underlying mechanism is unclear. This study aims to investigate the impact of coexisting T2DM on left ventricular (LV) deformation and myocardial perfusion in hypertensive individuals.
Materials and Methods
Seventy hypertensive patients without T2DM [HTN(T2DM-)], forty patients with T2DM [HTN(T2DM+)] and 37 age- and sex-matched controls underwent cardiac magnetic resonance examination. Left ventricular (LV) myocardial strains, including global radial (GRPS), circumferential (GCPS) and longitudinal peak strain (GLPS), and resting myocardial perfusion indices, including upslope, time to maximum signal intensity (TTM), and max signal intensity (MaxSI), were measured and compared among groups by analysis of covariance after adjusting for age, sex, body mass index (BMI) and heart rate followed by Bonferroni’s post hoc test. Backwards stepwise multivariable linear regression analyses were performed to determine the effects of T2DM on LV strains and myocardial perfusion indices in patients with hypertension.
Results
Both GRPS and GLPS deteriorated significantly from controls, through HTN(T2DM-), to HTN(T2DM+) group; GCPS in HTN(T2DM+) group was lower than those in both HTN(T2DM-) and control groups. Compared with controls, HTN(T2DM-) group showed higher myocardial perfusion, and HTN(T2DM+) group exhibited lower perfusion than HTN(T2DM-) group and controls. Multiple regression analyses considering covariates of systolic blood pressure, age, sex, BMI, heart rate, smoking, indexed LV mass and eGFR demonstrated that T2DM was independently associated with LV strains (GRPS: p = 0.002, model R2 = 0.383; GCPS: p < 0.001, model R2 = 0.472; and GLPS: p = 0.002, model R2 = 0.424, respectively) and perfusion indices (upslope: p < 0.001, model R2 = 0.293; TTM: p < 0.001, model R2 = 0.299; and MaxSI: p < 0.001, model R2 = 0.268, respectively) in hypertension. When both T2DM and perfusion indices were included in the regression analyses, both T2DM and TTM were independently associated with GRPS (p = 0.044 and 0.017, model R2 = 0.390) and GCPS (p = 0.002 and 0.001, model R2 = 0.424), and TTM but not perfusion indices was independently associated with GLPS (p = 0.002, model R2 = 0.424).
Conclusion
In patients with hypertension, T2DM had an additive deleterious effect on subclinical LV systolic dysfunction and myocardial perfusion, and impaired myocardial perfusion by coexisting T2DM was associated with deteriorated LV systolic dysfunction.
Gender Differentials on Productivity of Rice Farmers in South-western Nigeria: An Oaxaca-blinder Decomposition Approach
Authors: Ojo Temitope Oluwaseun , Baiyegunhi Lloyd J. S. , Danso-Abbeam Gideon , Ogundeji Abiodun A 
Published: July 2020

Abstract
One of the critical constraints hindering the transformation of African agriculture in general, and Nigerian agriculture in particular, is gender disparities in productivity. This study, therefore, examines gender inequality in farm productivity and sources of the productivity differentials among rice farmers in Nigeria, using the Oaxaca-Blinder (OB) gender decomposition model. The results revealed an uneven situation between men and women, leading to a gender productivity gap of about 29% in favour of men. Thus, female-managed plots are 29% less productive than male-managed plots. The decomposition of the sources of gender productivity differences shows that marital status, education, farm size and access to market information are the significant determinants of the endowment factor that contribute to about 15% of the productivity gap. The study, therefore, concludes that gender productivity inequalities exist in the Nigerian agricultural sector, hence, paying attention to these productivity gaps and factors contributing to these gaps is crucial in formulating policy interventions oriented towards women empowerment.
Evaluation of Herpes Simplex Virus Type 1 Antibody in Dental Students of Birjand University of Medical Sciences
Authors: Parvaie Parvin , EbrahimianBaghan Saideh , Zardats Mahmood , Shrifzadeh Gholamreza , Osmani Freshteh 
Published: July 2020

Abstract
Objective: Herpes viruses are ubiquitous human pathogenswhich canall be found in the oral environment. Dental practitioners have a close relationship with many patients and are at risk of cross-infection. So, HSV-1 infectionas a potential occupational hazard for dental workers is important. The aim of this study was to determine the level of HSV1 antibody in dental students of Birjandin 2018-2019.Methods: This descriptive cross-sectional study was performed on 100 dental students of Birjand University of Medical Sciences during a six-month period, who were selected by random cluster sampling. After taking written consent, demographic information and positive history of genital or oral lesions were recorded based on a researcher-made questionnaire. Then, a peripheral blood sample (5 ml) was taken from participants and an anti-virus antibody was examined using an Anti-Herpes-1 IgG kit with ELISA by a pathologist. Finally, the data were analyzed by SPSS 21.Results: About half of the subjects (41%) had contact with HSV1 virus and were carrier of antibodies. The prevalence of HSV1 antibody in pre-clinical and clinical level was higher than in basic science, but there was no significant relationship between students' level of education and antibody prevalence (p = 0.77). Also, there was no significant difference in prevalence of HSV1 antibody by age, sex and marital status of students (p> 0.05).Conclusion: The prevalence of HSV1 antibodies in this study is lower than that of European countries, which may be due to regional culture, which requires further study on different groups and more individuals
Agitated Behavior of Elderly and Alternative Simple Treatments: Individualized music – A feasibility study (the ABrEAST-iM feasibility study)
Authors: Mallidou Anastasia , Boström Anne-Marie , Kaitelidou Daphne , Brett Jennifer , Fowler Sara John , Leckovic Melanie , Nuttall Richard , Porter Michelle , Slade Allan , Slade Marie , Sudbury Fiona , Thompson Vicki 
Published: July 2020

Abstract
Background Behavioral and psychological symptoms of dementia (BPSD) influence older persons’ quality of life. Non-pharmacological interventions such as individualized music (iM) are promising to reduce BPSD and sustain interpersonal connectedness that contributes to quality of life. The purpose of this study was to assess the practicalities (e.g., process, results) of iM activities application on older adults over 65 years of age diagnosed with dementia living in residential care facilities. Our objectives were to: a) evaluate the recruitment process; b) explore the process of iM activity implementation; c) assess the clinical significance of the outcomes. Methods A concurrent mixed methods feasibility study designed and was conducted in two residential care facilities in British Columbia, Canada to assess the practicalities (i.e., recruitment, acceptability of the intervention, adherence to it, and clinical significance) of iM activities implementation on older adults diagnosed with dementia living in residential care facilities. Data were collected from residents, their families and staff using administrative records, observations, surveys, and interviews. Our primary outcomes were affect and quality of life. Results The observed iM activities were feasible, acceptable and adhered to by residents with clinical significance. Specifically, about 47% of eligible residents, their families and staff agreed to participate in and completed the study (recruitment); approximately 86% of participants enthusiastically received and were satisfied with the iM activity (acceptability); more than 70% of participants completed at least seven of the nine iM sessions (adherence); about 55% of participants experienced an increase in positive affect scores and 29% had a decrease in negative affect scores after the intervention; more than 43% of participants had a reduction in BPSD (clinical significance). Finally, participants reported improvement of quality of life and positive effects of iM intervention and provided insights and suggestions to improve it. Conclusions Individualized music activities can be successfully implemented (i.e., feasible, acceptable, adherent) with significant clinical outcomes. Participants reported positive affect emotions, increase in quality of life and well-being. With this feasibility study, we developed a process to identify challenges and their solutions that may assist us in a following pilot study with similar iM intervention.
Psychosocial determinants of frailty among older adults in Singapore: a community-based survey
Authors: Chong Elliot Yeung , Lim Angela Hui-Shan , Mah Freda Cheng Yee , Yeo Lyn Hui Wen , Aw Su , Ng Shu Tian , Yi Huso 
Published: July 2020

Abstract
Background

With increasing life expectancy, it is important to understand the role of non-physical aspects of health in frailty prevention. The study aimed to examine how multiple dimensions of mental and social health, in addition to physical health, were associated with frailty in the population of older adults.
Methods

A cross-sectional door-to-door survey was conducted with 497 older adults in Singapore. Frailty was assessed using the FRAIL scale. Physical health was assessed by multimorbidity and physical activity; social health by the Lubbens’ Social Network Scale, Community Integration Measure and UCLA loneliness scale; and mental health by the three-factor of the General Health Questionnaire (GHQ): anxiety/depression, loss of confidence and social dysfunction. Hierarchical ordinal regression was conducted to identify independent predictors of frailty, adjusting for socio-demographic variables.
Results

Compared to robust (59.5%) and pre-frail (32.6%) older adults, frail adults (7.9%) reported higher morbidity, lower physical activity, higher scores on all three subscales of GHQ, and had lower scores on all three social health scales that were assessed. In multiple regression model, frailty was significantly associated with 81–90 years old (adj. OR = 3.04), having 2–3 (adj. OR = 1.63) or > 3 (adj. OR = 2.01) chronic diseases, social dysfunction in GHQ (adj. OR = 4.31), and loneliness (adj. OR = 1.26). Physical activity did not remain significantly associated with frailty when mental and social health-related factors were entered in the regression.
Conclusions

The study findings highlight the importance of community intervention in mental and social health among older adults to prevent frailty in later life. Healthy aging is only possible when older adults’ psychosocial needs are addressed.
The TCGA and GEO databases identify COL5A2 as a poorly prognostic gene in patients with advanced gastric cancer
Authors: Tan Yu-en , Chen Qing-chuan , Xing Yao , Zhang Chao , Pan Si-wei , An Wen , Xu Huimian 
Published: July 2020

Abstract
Background

Gastric cancer (GC) metastasis determines the prognosis of patients, and exploring the molecular mechanism of GC metastasis is expected to provide a theoretical basis for clinical treatment. Recent studies have shown that extracellular matrix protein is closely related to GC metastasis. This study aimed to explore the expression profile and role of COL5A2 (Collagen V-type α2), as an extracellular matrix protein, in GC.
Methods

The expression, overall survival and progression-free survival data of COL5 family members were extracted from The Cancer Genome Atlas(TCGA)database, respectively. Paraffin immunohistochemistry and RT-qPCR in GC and matched normal tissues were used to analyze the expression of the target genes. Weighted gene co-expression network analysis of the GSE62229 database was performed out to identify modules and associated genes, and the functions were predicted by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses.
Results

COL5A2 was selected as our research target in the TCGA database, and was also verified in the GSE62229 and GSE15459 datasets. COL5A2 was upregulated in GC tissues by paraffin immunohistochemistry and RT-qPCR. The analysis of clinicopathological characteristics showed a significant difference in the Borrmann type (P = 0.036), histological type (P = 0.013) and T stage(P = 0.011). The prognosis of patients with low COL5A2 expression was better than that of patients with high COL5A2 expression. GSEA results showed that the TCGA and GSE62229 samples were significantly enriched in several well-known cancer-related pathways, such as the TGF-β, MAPK, and JAK2 signaling pathways.
Conclusion

COL5A2 was most closely related to advanced GC among COL5 family members. High COL5A2 expression is associated with a poor prognosis in GC, and may be a novel therapeutic target for GC.
Large-scale transcriptome data analysis reveals prognostic signature genes for overall survival prediction in diffuse large B cell lymphoma
Authors: Pan Mengmeng , Yang Pingping , Wang Fangce , Luo Xiu , Li Bing , Ding Yi , Lu Huina , Dong Yan , Zhang Wenjun , Xiu Bing , Liang Aibin 
Published: July 2020

Abstract
BACKGROUND With the improvement of clinical treatment outcomes in Diffuse large B cell lymphoma (DLBCL), the high rate of relapse in DLBCL patients is still an established barrier, due to the therapeutic strategy selection based on potential target remains unsatisfactory. Therefore, there is an urgent need in further exploration of prognostic biomarkers so as to improve the prognosis of DLBCL.METHODS The univariable and multivariable Cox regression models were employed to screen out gene signatures for DLBCL overall survival prediction. The differential expression analysis was used to identify representative genes in high-risk and low-risk groups, respectively, by student t test and fold change. The functional difference between the high-risk and low-risk groups were identified by the gene set enrichment analysis.RESULTS We conducted a systematic data analysis to screen the candidate genes significantly associated with overall survival of DLBCL in three NCBI Gene Expression Omnibus (GEO) datasets. To construct a prognostic model, five genes (CEBPA, CYP27A1, LST1, MREG, and TARP) were then screened and tested using the multivariable Cox model and the stepwise regression method. Kaplan-Meier curve confirmed the good predictive performance of the five-gene Cox model. Thereafter, the prognostic model and the expression levels of the five genes were validated by means of an independent dataset. All five genes were significantly favorable for the prognosis in DLBCL, both in training and validation datasets. Additionally, further analysis revealed the independence and superiority of the prognostic model in risk prediction. Functional enrichment analysis revealed some vital pathways resulting in unfavorable outcome and potential therapeutic targets in DLBCL.CONCLUSION We developed a five-gene Cox model for the clinical outcome prediction of DLBCL patients. Meanwhile, potential drug selection using this model can help clinicians to improve the clinical practice for the patients.
Distally based peroneal artery perforator-plus fasciocutaneous flap in the reconstruction of soft tissue defects over the distal forefoot: a retrospectively analyzed clinical trial
Authors: Peng Ping , Luo Zhaobiao , Lv Guohua , Ni Jiangdong , Wei Jianwei , Dong Zhonggen 
Published: July 2020

Abstract
Background: Distally based peroneal artery perforator-plus fasciocutaneous (DPAPF) flaps are widely used for reconstructing soft-tissue defects of the lower extremity. However, large studies on this topic, especially DPAPF flaps use for reconstruction of defects over the distal forefoot, are scarce. Herein, we describe our experience on the reconstruction of defects over the distal forefoot using DPAPF flaps.Methods: Between February 2005 and August 2019, 56 DPAPF flaps were used to reconstruct soft-tissue defects in the forefoot. The ankles were fixed in dorsiflexion using a Kirschner wire. Patient factors and flap factors were compared between the “survival” and “partial necrosis” groups.Results: Overall, 47 flaps had survived completely in one stage. Partial necrosis developed in nine flaps, with only one remnant defect covered using a local flap. The distance between the pivot point and recipient area was reduced by fixing the ankles in dorsiflexion. The partial necrosis rate of the DPAPF flaps with the top edge located in the 8th zone was significantly lower than that in the 9th zone (p < 0.05).Conclusions: In combination with fixing of the ankles in dorsiflexion using a Kirschner wire, DPAPF flap is a good option in reconstructing a defect over the distal forefoot.
Patients' risk factors for periprosthetic joint infection in total hip arthroplasty: A systematic review and meta-analysis of 34 studies
Authors: Tu Chao , Ren Xiaolei , Zhang Chenghao , Qi Lin , Wang Wanchun , Lu Qiong , Li Zhihong 
Published: July 2020

Abstract
BackgroundPeriprosthetic joint infection (PJI) is a catastrophic complication following total hip arthroplasty (THA). This meta-analysis aimed to identify the individual-related risk factors that predispose patients to PJI undergoing THA.MethodsWe performed extensive literature retrieval from related databases from inception to October 20, 2019. Patient-related risk factors were compared and grouped according to modifiable factors (BMI, smoke and alcohol abuse), non- modifiable factors (gender, age), and medical history characteristics, such as diabetes mellitus (DM), avascular necrosis (AVN) of femoral head, femoral neck fracture, rheumatoid arthritis (RA), cardiovascular disease (CVD), and osteoarthritis (OA) etc. Meta-analysis was performed using risk ratios with 95% corresponding intervals. Sensitivity analysis and publication bias were performed to assess the credibility of the results.ResultsOverall, 34 studies with 2,141,960 hips were included. By implementing cumulative meta-analysis, we found that higher BMI significantly increased the rate of PJI after THA. Meanwhile, medical characteristics comprising DM, AVN, femoral neck fracture, RA, CVD, chronic pulmonary disease and neurological disease, were also markedly associated with higher PJI risk. Conversely, dysplasia or dislocation, and OA were protective factors. Notably, female gender was protective for PJI only after longer follow-up. Besides, age, smoking, alcohol abuse, previous joint surgery, renal disease, hypertension, cancer and steroid use were not correlated with risk of PJI.ConclusionOur finding indicates that the main risk factors for PJI are high BMI, DM, AVN, femoral neck fracture, RA, CVD, chronic pulmonary disease, and neurological disease. Protective factors are female gender, dysplasia/ dislocation and OA.