bluuebunny/crossref_metadata_2025_split huggingface dataset:
GC-PROM: Validation of a patient-reported outcomes measure for Chinese patients with gastric cancer
Authors: Hu Xiaojuan , Zhao Fen , Yu Hongmei , Luo Yanhong , Liu Jinchun , Zhang Yanbo 
Published: October 2019

Abstract
Background: There is increasing recognition that PROs are important in the estimation of the burden of long-term survival among patients with gastric cancer. The study aimed to develop a disease-specific instrument to assess patient-reported outcomes for Chinese patients with gastric cancer.
Method: Following the FDA's draft guidance for patient-reported outcome, conceptual framework and item pool were defined based on relevant existing work. A draft scale was formed after revising some items based on feedback from experts and Chinese patients with gastric cancer. The pre-survey and formal survey were conducted in eight different hospitals in Shanxi Province, and two item-selection process based on classical test theory and item response theory. Finally, the patient-reported outcomes measure for Chinese patients with gastric cancer (GC-PROM) was validated in terms of reliability, validity, and feasibility. The minimal clinically important difference was determined by distribution-based method.
Results: The final GC-PROM consisted of 38 items, 13 subdomains, and 4 domains. Reliability was verified by Cronbach’s alpha coefficient for four domains and 13 subdomains respectively. The validity results showed that the multidimensional scale fulfilled expectations. In the formal survey, the completion rate was 96.16%, and the average filling time was less than half an hour. The values of the minimal clinically important difference were 4.14, 3.41, 3.37, and 3.28 in the four domains.
Conclusions: The GC-PROM had good reliability, validity, and feasibility and thus can be considered an effective clinical evaluation instrument for Chinese patients with gastric cancer.
Low red/far-red ratio as a signal promotes carbon assimilation of soybean seedlings by increasing the photosynthetic capacity
Authors: Yang Feng , Liu Qinlin , Cheng Yajiao , Feng Lingyang , Wu Xiaoling , Fan Yuanfang , Raza Muhammad Ali , Wang Xiaochun , Yong Taiwen , Liu Weiguo , Liu Jiang , Du Junbo , Shu Kai , Yang Wenyu 
Published: October 2019

Abstract
Background: Shading includes low light intensity and varying quality. However, a low red/far-red (R/Fr) ratio of light is a signal that affects plant growth in intercropping and close- planting systems. Thus, the low R/Fr ratio uncoupling from shading conditions was assessed to identify the effect of light quality on photosynthesis and CO 2 assimilation. Soybean plants were grown in a growth chamber with natural solar radiation under four treatments, that is, normal (N, sunlight), N+Fr, Low (L) +Fr, and L light.
Results: Results showed that low R/Fr ratio significantly increased the total biomass, leaf area, starch and sucrose contents, chlorophyll content, net photosynthetic rate, and quantum efficiency of the photosystem II compared with normal R/Fr ratio under the same light intensity condition (P < 0.05). Proteomic analysis of soybean leaves under different treatments was performed to quantify the changes in photosynthesis and CO 2 assimilation in the chloroplast. Among the 7834 proteins quantified, 12 showed a > 1.3-fold change in abundance, of which 1 was related to porphyrin and chlorophyll metabolism, 2 were involved in photosystem I (PS I), 4 were associated with PS II, 3 proteins participated in photosynthetic electron transport, and 2 were involved in starch and sucrose metabolism. The dynamic change in these proteins indicates that photosynthesis and CO 2 assimilation were maintained in the L treatment by up-regulating the component protein levels compared with those in N treatment. Although low R/Fr ratio increased the photosynthetic CO 2 assimilation parameters, the differences in most protein expression levels in N+Fr and L+Fr treatments compared with those in N treatment were insignificant. Similar trends were found in gene expression through quantitative reverse transcription polymerase chain reaction excluding the gene expression of sucrose synthase possible because light environment is one of the factors affecting carbon assimilation.
Conclusions: These results implied that low R/Fr ratio (high Fr light) increased the photosynthetic CO 2 assimilation in the same light intensity by improving the photosynthetic efficiency of the photosystems.
The mmu_circ_0000335 inhibits M1 microglial-induced hippocampal neuronal apoptosis via the miR-19b-3p/SOCS1 axis in a mouse epilepsy model
Authors: Zhu Yong , Li Qiong , Kuang Weiping , Lu Jun , Wang Qin , Xia Shuaishuai , Peng Wei , Li Liang , Yang Ping 
Published: October 2019

Abstract
Background : Increasing evidence has demonstrated that circular RNAs (circRNAs) participate in epileptogenesis, but the expression profile and role of circRNAs in epilepsy remain unknown. A circRNA microarray was performed to examine epilepsy-related circRNAs. Bioinformatics analyses, luciferin reporter experiments and real-time quantitative PCR (Rt-qPCR) in vitro experiments were performed to demonstrate the mechanism of circRNA-mediated gene regulation of the microglial phenotype under epileptic conditions. Then, to further confirm the effect of circRNAs on nerve damage in the hippocampus, a mouse model of epilepsy was established by intraperitoneal injection of lithium chloride and pilocarpine. Results: The data indicated that 364 circRNAs were differentially expressed comparing epilepsy and control tissues. In particular, mmu_circ_0000335 expression was significantly downregulated in epileptic mice which was confirmed by Rt-qPCR. Overexpression of mmu_circ_0000335 promoted BV2 cell transformation into the M2 macrophage phenotype by increasing expression of CD206, Arg1, Ym1 and IL-10 while decreasing M1 macrophage markers IL-1β, IL-6, TNF-α and IFN-γ expressions under epileptic conditions. mmu_circ_0000335 expression triggered upregulation of Suppressor of Cytokine Signaling 1 (SOCS1) by decreasing miR-19b-3p levels, as determined by luciferase reporter assay. In vivo studies found that mmu_circ_0000335 overexpression decreased epilepsy-induced neural cell apoptosis in the hippocampus by reducing inflammatory cytokine expression. Immunofluorescence detection showed that mmu_circ_0000335 overexpression promoted microglial transformation into the M2 phenotype which had an anti-inflammatory effect. Conclusions: These results collectively indicated that mmu_circ_0000335 was involved in epilepsy progression by functioning as a miR-19b-3p sponge to enhance SOCS1 expression. Thus, mmu_circ_0000335 may be a candidate therapeutic target for epilepsy patients.
Trans-lateral Decubitus Radiograph of the Hip: A New View to Measure the Version of the Femoral Stem
Authors: Ha Yong-Chan , Yoo Jun-Il , Ahn Joong-Mo , Lee Young-Kyun , Kang Yusuhn , Koo Kyung-Hoi 
Published: October 2019

Abstract
Background We developed a radiological method, trans-lateral decubitus view, to measure stem version and assessed its reliability as well as the validity.Methods Trans-lateral decubitus view of the hip was a lateral radiograph, which was taken with the patient in lateral decubitus position, hip extension, 90° knee flexion and patella facing forward. In 40 patients, who underwent total hip replacement (THR), a trans-lateral decubitus view and CT scan of the hip were taken. Three observers measured stem neck-shaft angle (α) on hip AP view, and the stem anteversion (β), which was the angle between the axis of stem neck and axis of the femur, on the trans-lateral decubitus view. The stem version (θ) was calculated using the formula; θ = arc ((tan (180°-β) /tan (180°-α)). The intra and inter-observer reliabilities of each measurement were examined. The radiological measurements were compared with those on the CT scan to evaluate their validity.Results The mean stem anteversion on radiological measurement was 23.72° (SD 8.17) and the mean CT measurement was 23.91° (SD 10.25) (p = 0.929). The intra- and interobserver reliabilities of the radiological measurements were 0.934 and 0.931, respectively. Those of CT measurements were 0.941 and 0.942, respectively. When the radiological anteversion was between -30° and 30°, the correlation coefficient between radiological measurements and CT measurements was 0.729 (p = 0.001).Conclusion The trans-lateral decubitus method appears reliable and valid for the measurement of femoral stem version. Trial Registration: NCT02554149 (29 March 2016).
Identification of cholesterol-assimilating actinomycetes strain and application of statistical modeling approaches for improvement of cholesterol oxidase production by Streptomyces anulatus strain NEAE-94
Authors: El-Naggar Noura El-Ahmady , El-Shweihy Nancy M. 
Published: October 2019

Abstract
Background Cholesterol oxidase biosensors have been applied to detect cholesterol level in different in serum and foods samples. Due to a wide range of industrial and clinical applications of microbial cholesterol oxidase, isolation and detection of new microbial source (s) of cholesterol oxidase are very important.Results Among the potential strains, Streptomyces sp. strain NEAE-94 was chosen and identified based on cultural, morphological and physiological characteristics; in addition to the 16S rRNA sequence which had been deposited in the GenBank database under the accession number KC354803. Cholesterol oxidase production in shake flask by Streptomyces anulatus strain NEAE-94 was optimized using response surface methodology. The production parameters were first screened using a Plackett-Burman design and the parameters with significant effects on the production of cholesterol oxidase were identified. Out of the fifteen factors screened, agitation speed, cholesterol and yeast extract concentration were selected due to significant positive effects on the production of cholesterol oxidase. The optimal levels of these variables and the effects of their mutual interactions on cholesterol oxidase production were determined using Box-Behnken design. The maximum cholesterol oxidase activity (27.31 U/mL) was achieved at cholesterol concentration (4 g/L), the agitation speed (150 rpm/min) and yeast extract concentration (5 g/L). In comparison with cholesterol oxidase production by Streptomyces anulatus strain NEAE-94 before the application of Plackett-Burman design, the statistical optimization resulted in an increased production by 4.66 times.Conclusions The maximal cholesterol oxidase activity is obtained at the following fermentation conditions: g/L (cholesterol 4, yeast extract 5, NaCl 0.5, K 2 HPO 4 1, FeSO 4 .7H 2 O 0.01, MgSO 4 .7H 2 O 0.5), pH 7, inoculum size 4% (v/v), temperature 37°C, agitation speed 150 rpm/min, medium volume 100 mL and incubation time 5 days.
Evaluation of tumor immunity after administration of conditionally replicative adenoviral vector in canine osteosarcoma patients
Authors: Agarwal Payal , Gammon Elizabeth A , Sandey Maninder , Lindley Stephanie S , Koehler Jey W , Matz Brad M , Smith Annette N , Kashentseva Elena A , Dmitriev Igor , Curiel David T , Smith Bruce F 
Published: October 2019

Abstract
Background: Osteosarcoma is one among the most common neoplasms in dogs. Current treatments include leg-amputation or limb-sparing techniques along with chemotherapy that show limited efficacy and fail to prevent metastasis. Conditionally replicative adenoviruses (CRAd) are gene therapy tools that replicate exclusively in targeted tumor cells, causing a cytopathic effect and in turn release of new virus particles to infect additional cells. We proposed that OC-CAVE1 (CAV2 with the E1A promoter replaced with the osteocalcin promotor) may also enhance existing immunity against tumors by overcoming immune tolerance via exposure of new epitopes and cytokine signaling. A previous study indicated administration of OC-CAVE1 was safe and showed specific replication in osteosarcoma cells. Results: We enrolled eleven client-owned dogs with spontaneously occurring osteosarcomas in a pilot clinical-trial. All dogs were injected with OC-CAVE1 following amputation of the affected limb or limb-sparing surgery. Dogs were monitored for viremia and viral shedding. There was minimal virus shedding in urine and feces by the 6th day and no virus was present in blood after 4 weeks. CAV-2 antibody-titers increased in all of the patients, post-CRAd injection. OC-CAVE1 injections did not result in a statistically significant increase in life span, although 2 dogs in the study achieved survival times in excess of 1 year. Immunological assays were performed to monitor 1) humoral response against tumors, 2) levels of circulatory CD11c+ cells, 3) levels of regulatory T cells, and 4) cytotoxic activity of tumor specific T cells against autologous tumor cells between pre-CRAd administration and 4 weeks post-CRAd administration samples. Western blots indicated an increased humoral immune response against pre-existing antigens in some dogs, but flow cytometry did not support this apparent increase. Cytotoxic T-cell activity did not increase in a consistent pattern. Levels of circulatory regulatory T-cells did decrease statistically in all patients. Conclusions: Administration of the CRAd OC-CAVE1 resulted in alteration of some immune response parameters but did not appear to result in increased survival duration. Weak replication of OC-CAVE1 in metastatic cells and delay of chemotherapy following CRAd treatment may contribute to the lack of improvement in survival time of the clinical patients.
Medical termination for pregnancy in early first trimester (≤ 63 days): a systematic review
Authors: Abubeker Ferid Abbas , Lavelanet Antonella , Rodriguez Maria I. , Kim Caron 
Published: October 2019

Abstract
Background A wide range of drugs have been studied for first trimester medical abortion. Studies evaluating different regimens, including combination mifepristone and misoprostol and misoprostol alone regimens, show varying results related to safety, efficacy and other outcomes. Objectives To compare the safety, effectiveness and acceptability of medical abortion and to compare medical methods with surgical methods of abortion ≤ 63 days of gestation. Methods Pubmed and EMBASE were systematically searched from inception through January 2019 using a combination of MeSH, keywords and text words. Randomized controlled trials on induced abortion at ≤ 63 days that compared different regimens of medical abortion using mifepristone and/or misoprostol and trials that compared medical with surgical methods of abortion were included. We extracted data into a pre‐designed form, calculated effect estimates, and performed meta‐analyses where possible. The primary outcomes were ongoing pregnancy and successful abortion. Results Combined regimens using mifepristone and misoprostol had lower rates of ongoing pregnancy and higher rates of successful abortion compared to misoprostol only regimen. Conclusion In this systematic review, we establish medical methods of abortion utilizing combination mifepristone/misoprostol or misoprostol alone are effective, safe and acceptable. In combined regimen, misoprostol 800 μg given vaginally or sublingually had lower rates of ongoing pregnancy and higher rates of successful abortion with moderate certainty of evidence.
AsHSP26.8a, a creeping bentgrass small heat shock protein integrates different signaling pathways to modulate plant abiotic stress response
Authors: Sun Xinbo , Zhu Junfei , Li Xin , Li Zhigang , Han Liebao , Luo Hong 
Published: October 2019

Abstract
Background Small heat shock proteins (sHSPs) are critical for plant response to biotic and abiotic stresses, especially heat stress. They have also been implicated in various aspects of plant development. However, the acting mechanisms of the sHSPs in plants, especially in perennial grass species, remain largely elusive.Results In this study, AsHSP26.8a , a novel chloroplast-localized sHSP gene from creeping bentgrass ( Agrostis stolonifera ) was cloned and its role in plant response to environmental stress was studied. AsHSP26.8a encodes a protein of 26.8kDa. Its expression was strongly induced in both leaf and root tissues by heat stress. Transgenic Arabidopsis plants constitutively expressing AsHSP26.8a exhibited reduced tolerance to heat stress. Furthermore, overexpression of AsHSP26.8a led to hypersensitivity to exogenous ABA and salinity during germination and post-germinative growth. Global gene expression analysis indicated that AsHSP26.8a modulates the expression of heat-shock transcription factors, ABA-dependent and -independent as well as other stress signaling pathways.Conclusion Our results suggest that AsHSP26.8a may play a negative role in plant response to various abiotic stresses through modulating ABA and other stress signaling pathways.
Structure and surgical dissection layers of the bare area of the liver
Authors: Ishii Takamichi , Seo Satoru , Ito Takashi , Ogiso Satoshi , Fukumitsu Ken , Taura Kojiro , Kaido Toshimi , Uemoto Shinji 
Published: October 2019

Abstract
Background : The bare area, which lies between the right liver and diaphragm, should be dissected to mobilize the right liver. The bare area was reportedly formed by direct adhesion between the liver and diaphragm, meaning that the bare area lacked serosal components. This study aimed to analyze the structure of the bare area by an integrated study of surgical and laparoscopic images and pathological studies and describe surgical procedures focusing on the multilayered structure. Methods : Surgical specimens of hepatectomy were analyzed histologically to evaluate the macroscopic structure of the bare area. Laparoscopic images and cadaver anatomy of the bare area were also examined, changing the dissection layers of the bare area. Results : The bare area comprised a multilayered structure that resulted in fusions in the hepatic development among the parietal peritoneum (peritoneum of the diaphragm part) and the visceral peritoneum (liver serosa). The multilayered structure of the bare area comprised the liver, sub-serosal connective tissue, liver serosa, parietal peritoneum, retroperitoneal connective tissue, epimysium of the diaphragm, and diaphragm, in order from the liver to the diaphragm. Laparoscopic images sometimes enabled us to recognize the multilayered structure of the bare area. Conclusions : Histopathological findings showed the bare area to be a multilayered structure. In cases where tumors are located underneath the bare area, it could be important to dissect the bare area, with careful attention to its multilayered structure. Surgical dissection of the bare area in the outer layer of the fused peritoneum could allow a sufficient safety margin.
Applying the Modified Early Warning Score (MEWS) to assess geriatric patients in home care settings: A qualitative study of nurses’ and general practitioners’ experiences
Authors: Jeppestøl Kristin , Bragstad Line Kildal , Kirkevold Marit Kirkevold 
Published: October 2019

Abstract
Background : Acute functional decline is a common clinical syndrome in geriatric health care and is typically characterised by nonspecific symptoms and presentations with a mix of physical, psychological, social and functional manifestations. Early warning score (EWS) systems are widely implemented in nursing homes and home care to detect clinical deterioration. The effects of EWS systems have been thoroughly evaluated in hospital care settings, but few studies have evaluated EWS systems in community healthcare. The purpose of this study was to describe the experiences of registered nurses and general practitioners experiences when using the Modified Early Warning Score (MEWS) to support clinical reasoning and decision-making with geriatric home care patients who suffer from acute functional decline. Method: A qualitative methodology was used with a descriptive exploratory design. Data were collected from seven focus group interviews. General practitioners (GPs), and registered nurses (RNs) were purposively sampled from large, medium and small municipalities in Norway. Data were analysed using an inductive content analysis method. Results: MEWS was used as an additional decision-making tool with elderly home care patients when acute functional decline was detected. RNs and GPs highlighted that MEWS supported the clinical reasoning and decision-making process. Additionally , comprehensive reasoning skills and specific knowledge of the patients were needed. RNs identified the need for contextual adjustments to the use of MEWS in home care settings. Implementing MEWS has improved the collaboration and clinical practice of RNs and GPs. The adherence to MEWS follow-up recommendations was adjusted to the home care setting, accounting for potentially limited medical availability. Conclusion : MEWS supported RNs and GPs in conducting comprehensive clinical assessments and reasoning when acute functional decline was detected. Interdisciplinary communication and collaboration appeared to be strengthened, and the GP's work was streamlined. Several limitations were identified with the use of MEWS reference values with geriatric patients, which could lead to ambiguity and misjudgements . MEWS trigger recommendations were experienced as inappropriate to comply within home care. This study identifies the need for a modified evidence-based EWS adjusted for geriatric patients in home care.
Medical education challenges in mainland China: the attractiveness of Problem-based learning
Authors: Guo Kexin , Li Jingwen , Peng Yixiang , Ghoorah Devina , Ma Jianhui , Xiong Nian , Huang Yaling 
Published: October 2019

Abstract
Background: In the recent years, the increasing health care needs and the stricter learning requirements for medical students have led to a mismatch between what is taught at medical school and the actual skills to provide health care service in China,which also have brought challenges to medical teachers and students.The Chinese medical educators, thus, are pursuing new teaching methods to overcome the mismatch and Problem-based learning(PBL) responds to the situation. The current model of medical education is urgently needed to change. Methods: In this paper, we count the number of published articles according to PBL from mainland China and summary the current adoption situations and the typical challenges of PBL in medical education in mainland China. Results:The number of published articles according to PBL from mainland China increases with time in this decade.There are still unresolved application issues from both tutors and students regarding the adjustment to this highly resource-intensive pedagogy Conclusions: The number of colleges adopting PBL has been gradually increasing. This new learning model places hopes on Chinese medical educators who would optimize the educational outcomes based on a clear understanding of the PBL process, principle and practice. We expect that PBL can resolve the medical educational challenges in mainland China.