bluuebunny/crossref_metadata_2025_split huggingface dataset:
Real GDP growth rates and health care spending – Comparison between the G7 and the EM7 countries
Authors: Jakovljevic Mihajlo , Timofeyev Yuriy , Ranabhat Chhabi , Fernandes Paula Odete , Teixeira João , Rancic Nemanja , Reshetnikov Vladimir 
Published: January 2020

Abstract
Background: Accelerated globalization has substantially contributed to the rise of emerging markets worldwide. The G7 and Emerging Markets Seven (EM7) behaved in significantly different macroeconomic ways before, during, and after the 2008 Global Financial Crisis. Average real GDP growth rates remained substantially higher among the EM7, while unemployment rates changed their patterns after the crisis. Worldwide economic growth began to accelerate again, starting from year 2017. However, approximately one half of this growth is attributable to the EM7, while only a quarter to the G7 nations. This paper aims to analyse the association between the health spending and real GDP growth in the G7 and the EM7 countries.Results: In terms of GDP growth, the EM7 exhibited higher degree of resilience during the 2008 Global Crisis, compared to the G7. Unemployment in the G7 nations was rising significantly, compared to pre-recession levels, but, in the EM7, it remained traditionally high. In the G7, the austerity (measured as a percentage of GPD and in PPP basis) significantly decreased the public health expenditure, even so in than in the EM7. Out-of-pocket health expenditure grew at far more concerning pace in the EM7 compared to the G7 during the Crisis, exposing vulnerability of citizens and households living close to poverty line. Regression analysis demonstrated that, in the G7, real GDP growth had positive impact on out-of-pocket expenditure measured as a percentage of current health expenditure expressed as a percentage of GDP (CHE). In the EM7, it affected negatively CHE, CHE per capita in PPP in constant 2011 international USD, and out-of-pocket expenditure per capita in PPP international USD. Conclusion: The EM7 countries showed stronger endurance withstanding the consequences of the global economic crisis as compared to the G7 economies. Evidence of that were most visible in real growth rates and unemployment rates, before, during, and after the crisis. It influenced health spending patterns in both groups, although they tended to diverge instead of converging in several important areas.
Gut microbiota and butyrate contribute to nonalcoholic fatty liver disease in premenopause due to estrogen deficiency
Authors: Liu Limin , Qingsong Fu , Tiantian Li , Kai Shao , Xing Zhu , Yingzi Cong , Xiaoyun Zhao 
Published: January 2020

Abstract
Background：The incidence of nonalcoholic fatty liver disease (NAFLD) in postmenopausal women has increased significantly. NAFLD can be effectively inhibited by estrogen, but the severe side effects, especially the increased risk of malignant tumors, limit its application. Thus, it is of great clinical significance to explore the mechanism by which estrogen inhibits NAFLD. Gut microbiota and its metabolites short chain fatty acids (SCFA) have been shown to play important roles in the development of NAFLD.Objective：In this study, we investigated the impact of estrogen deficiency on the gut microbiome and SCFA in both NAFLD patients and an experimental NAFLD model in premenopause.Methods：The levels of estrogen，insulin and leptin was measured using ELISA. Gut microbiota was analyzed by 16S rRNA gene sequence analysis. Tissue sections were stained with hematoxylin and eosin. SCFAs were determined with Agilent 6890 N gas chromatography (GC). We quantified mRNA levels of genes in our study by quantitative real time-PCR. Additionally, Western Blotting was used to validate protein expression.Results：We showed that female NAFLD patients had much lower estrogen levels. Estrogen deficient mice, due to ovariectomy (OVX), suffered more severe liver steatosis with an elevated body weight, abdominal fat weight, and serum triglycerides with deterioration in histological hepatic steatosis. Altered gut microbiota composition and decreased butyrate content were found in patients with NAFLD and in OVX mice. Furthermore, fecal microbiota transplantation (FMT) or supplementing with butyrate markedly alleviated NAFLD in OVX mice. The production of antimicrobial peptides (AMP) RegIIIg, β-defensins 1, 3 and the expression of intestinal epithelial tight junction, including ZO-1 and occludin5, were decreased in the OVX mice compared to control mice. Upregulation of PPAR-ɣ and VLDLR and downregulation of PPAR-ɑ indicated that OVX mice suffered from abnormal lipid metabolism.Conclusions：These data indicate that changes in the gut microbiota and SCFA caused by estrogen reduction, together with a disorder in AMP production and lipid metabolism, promote NAFLD, thus provide microbiota derived SCFAs as new therapeutic targets for the clinical prevention and treatment of NAFLD.
Determinants of Glycemic Control among Urban Patients with Type 2 Diabetes: A mediation analysis from real-world evidence
Authors: Silva-Tinoco Rubén , Cuatecontzi-Xochitiotzi Teresa , Torre-Saldaña Viridiana De la , León-García Enrique , Serna-Alvarado Javier , Orea-Tejeda Arturo , Castillo-Martínez Lilia , Gay Juan G. , de-León David Cantú , Prada Diddier 
Published: January 2020

Abstract
Aims To explore the determinants of glycemic control (GC) among patients with type 2 diabetes (PwD) to provide insight into the pathways of the effect of diabetes knowledge on GC.Methods A multicenter cross-sectional study was conducted in PwD from 28 primary outpatient centers located in Mexico City. Using the multivariable-adjusted models, we determined the associations between diabetes knowledge, self-care behaviors, and glycemic control. The mediation analyses used linear regression models, where the significance of indirect effects was calculated with bootstrapping.Results The population (N=513) had a mean age of 53.8 years (standard deviation: 11.3 yrs.), and 65.9% were women. Using multivariable-adjusted linear models, we found that diabetes knowledge was associated with glycemic control (β: -0.102, 95% Confidence Interval [95% CI] -0.189, -0.014). Diabetes knowledge was also independently associated with self-care behavior (for physical activity: β: 0.181, 95% CI 0.088, 0.273), and self-care behavior was associated with glycemic control (for physical activity: β: -0.112, 95% CI -0.194, -0.029).The association between diabetes knowledge and glycemic control was lost after adjustment for self-care behaviors, especially physical activity (β: -0.084, 95% CI -0.182, 0.014, p -value: 0.062). Finally, the mediation models showed that the effect of diabetes knowledge on glycemic control was 17% independently mediated by physical activity ( p -value: 0.049).Conclusions Self-care activities, particularly physical activity, mediated the effect of diabetes knowledge on glycemic control. Our results indicate that diabetes knowledge should be reinforced in low-income PwD, with an emphasis on the benefits physical activity has on improving GC.
Chronic Exposure to Diesel Exhaust Particulate Matter Impairs Meiotic Progression during Spermatogenesis in a Mouse Model
Authors: Yang Wei , Xu Yanyi , Pan Hongjie , Tian Fang , Wang Yuzhu , Xia Minjie , Hu Jingying , Yang Mingjun , Tao Shimin , Sun Shenfei , Kan Haidong , Li Runsheng , Ying Zhekang , Li Weihua 
Published: January 2020

Abstract
Background: Exposure to air pollutants represented by diesel exhaust PM2.5 (DEP) correlates with the decline of semen quality, but the underlying biological mechanism has not been fully understood. In the present study, mice were intratracheally instilled with DEP for around 7 months, and the effects of PM2.5 exposure on the spermatogenic process as well as the alterations of testicular gene expression profile were assessed. Results: Our results show that chronic exposure to DEP significantly impairs the fertility of male mice without influencing their libido. Compared with Vehicle-exposed group, the sperm count and motility from DEP-exposed mice were significantly decreased. In addition, immunohistological staining of γH2AX and DMC1, biomarkers for meiotic double strand breaks (DSBs), demonstrated that chronic exposure to DEP comprised the repair of meiotic DSBs, thus disrupts the spermatogenesis. Deep RNA sequencing test shows massive altered expressions of testicular genes including the GnRH signaling pathway. Conclusion: In summary, our research demonstrates that chronic exposure to PM2.5 disrupts spermatogenesis through targeting the meiotic recombination, providing a new perspective for the research on the male reproductive system damage caused by air pollution.
Quantitative assessment of neural elements in rat model using nerve growth factor after remnant-preserving anterior cruciate ligament reconstruction: a hematoxylin and eosin stain and immunohistochemical study
Authors: Lee Sung Hyun , Cho Hyung Gyu , Song Jin Soo , Chun Keun Churl , Chun Churl Hong 
Published: January 2020

Abstract
Background: Immunohistochemical analyses of anterior cruciate ligament (ACL) allografts following remnant-preserving ACL reconstructions using Achilles tendon allografts have provided evidence for the presence of neural elements. In this study, we aimed to examine the expression of neural elements and quantify the presence of neural cells in ACL remnants and Achilles allografts using nerve growth factor (NGF) therapy after remnant-preserving ACL reconstruction. Methods: Experiments were conducted on 5 pairs of rats (approximately 8 weeks old and weighting 320 g at the time of surgery). Longitudinally-split Achilles tendons from the paired rats were freshly frozen and later defrosted with warm saline and allografted onto the right ACL of the other, which was partially detached at the femoral attachment site. A sham operation was conducted on the left knee to be used as Control. NGF was injected in both the knee joints 1 week after surgery. The presence of neural cells in the ACL of the sham-operated knee, allografted Achilles tendon, and ACL remnant was examined 6 weeks post surgery using H and E and immunohistochemical staining. Results: H and E staining did not reveal neural cells in any of the three groups. However, immunohistochemical analysis showed the presence of nestin-positive neural elements in normal ACL as well as ACL remnants. Additionally, neural elements were examined in 7 of the 8 (87.5%) allograft tissues. Quantitative analysis showed no difference in the number and area of nuclei among the three groups. However, the number and area of neural cells in Achilles allograft were significantly lower than in the other two groups (p=0.000 and p=0.001, respectively). Conclusion: Our observations indicate that ACL remnants promote new ingrowth and persistence of neural cells. We suggest that the ingrowth of neural elements could support the persistence and new ingrowth of mechanoreceptors, thereby enhancing the functional stability of knee joints. Moreover, the expression of neural cells in Achilles allograft was lower than that of normal ACL or ACL remnants in the quantitative evaluation, thereby confirming the essential role of ACL remnants in knee joint functionalization. Key terms: anterior cruciate ligament, remnant preservation, immunohistochemistry, nerve growth factor
The frequency of reduction loss after arthroscopic fixation of acute acromioclavicular dislocations using a double-button device, and its effect on clinical and radiological results
Authors: Çarkçı Engin , Polat Ayşe E , Gürpınar Tahsin 
Published: January 2020

Abstract
Background The aim of this study was to investigate the effect of reduction loss of more than 3 mm on clinical and radiological results after at least 2 years of follow-up after arthroscopic fixation of acute acromioclavicular joint dislocations using a double-button device.Methods Thirty-six patients who had acute (<3 weeks old), type III or V Acromioclavicular (AC) joint dislocations underwent arthroscopic fixation of the AC joint using a double-button device. Clinical and radiological evaluations were performed at preoperative, postoperative first day, 3 months and last follow-up. When the coracoclavicular (CC) distances of patients at the last follow-up were compared to the early postop CC distances, those with a difference of 3 mm or less were grouped as group A and those with a difference of more than 3 mm were grouped as group B.Results There was no statistically significant difference between the groups in terms of age, gender, follow-up time, time from injury to surgery, return to work, and distribution of Rockwood classification. Pre-operative CC distance was reduced from 18.7 ± 3.5 to 8.5 ± 0.6 in the early postoperative period. Anatomic reduction was achieved in all patients compared with the unaffected side (CC distance 8.6 ± 0.7). However, the CC distance increased to 9.9 ± 1.5 at the third month follow-up and increased to 11 ± 2.7 at the last follow-up. There were no significant Constant score differences between the groups in the preoperative and last follow-up periods (p>0.05). At the last follow-up, the mean Acromioclavicular Joint Instability (ACJI) score of group A was 84.4 ± 8, whereas it was 68.3 ± 8.3 for group B, and the difference was statistically significant (p<0.01). Furthermore, the subjective evaluation and aesthetic subjective satisfaction values of group B were lower than group A (p <0.01).Conclusions Reduction loss of more than 3 mm was observed in 25% of patients after arthroscopic fixation of acute acromioclavicular dislocations using a double-button device. Although this loss did not create a statistically significant difference in Constant scores, AC joint-specific tests such as ACJI, subjective evaluation, and aesthetic subjective satisfaction values were significantly impaired.
A Danish version of the Oral Health Impact Profile-14 (OHIP-14): Translation and cross-cultural adaptation.
Authors: Gera Arwa , Cattaneo Paolo M. , Cornelis Marie A. 
Published: January 2020

Abstract
Background In Dentistry, Oral Health Related Quality of life instruments provide a measure of gains in oral function as well as psychological well-being. Such subjective measures can be assessed by the Oral Health Impact Profile-14 (OHIP-14). However, a translated and validated Danish version of OHIP-14 is not available yet. Hence, the questionnaire can not be used in Denmark. The purpose of this study was to translate and cross-culturally adapt the original English version of Oral Health Impact Profile-14 (OHIP-14) into a Danish version (OHIP-14-DK). In addition, to investigate its applicability among adolescents and adults undergoing orthodontic treatment in Denmark, as well as to assess its internal consistency, reliability, and test-retest reliability.Methods The English version of OHIP-14 was translated into Danish following a standard protocol of cross-cultural adaptation. Stages I –IV: translation phase to eventually generate an “OHIP-14-DK” pre-final version. Stage V: pre-testing phase. A random sample of 22 orthodontic patients (mean age 24.7 years, SD ±14.8; 14 females, 8 males) were selected at Aarhus University, Section of orthodontics, Denmark. All patients self-completed the OHIP-14-DK and were thereafter interviewed. To measure reliability, all patients completed the same questionnaire again after 1-2 weeks interval. Reliability was assessed by Cronbach’s alpha coefficients, Spearman’s correlation coefficient, and ICC.Results The initial and back translations were very similar: OHIP-14-DK proved to have a good level of equivalence with no errors or deviations in the translation, relevant to orthodontic patients, fitting the Danish culture, and understood by individuals as young as 12 years old. The distribution of responses verified that all questions relate to their domains. Therefore, no final adjustments were required for the tested version. Cronbach’s alpha ranged between 0.75-0.84 indicating an adequate to good reliability. Spearman’s correlation coefficient was 0.77 for the OHIP total score. The obtained ICC value for the mean rating was 0.91 (95% confidence interval: 0.78-0.96).Conclusions OHIP-14-DK fits the Danish culture, applicable among adolescents and adults undergoing orthodontic treatment in Denmark. Proved to be face and content valid with good internal consistency, excellent reliability, and strong stability. Study registration case no. 1-10-72-148-19 Keywords: Orthodontics, OHIP-14, Oral health related quality of life, translation, cross-cultural adaptation, Danish.
Benefit of dosimetry distribution for patients with brain metastases from non-small cell lung cancer by Cyberknife Stereotactic radiosurgery (SRS) system
Authors: YU Xuyao , Wang Yuwen , Yuan Zhiyong , Yu Hui , Song Yongchun , Zhao Lujun , Wang Ping 
Published: January 2020

Abstract
BackgroundTo pursue high precision in tumor and steeper dose fall-off in healthy tissues of brain metastases stereotactic radiosurgery (SRS), this study investigated an opitimized planning by comparison only one multiple-lesions-plan (MLP) and multiple single-lesion-plans (SLP) in the treatment of brain metastases using Cyberknife (CK) Robotic Radiosurgery System. MethodsFifty non-small cell lung cancer (NSCLC) patients (28 males and 22 females) with 2-4 multiple brain metastases were retrospectively replanned with 12 to 32 Gy prescription dose in 1 to 3 fractions. Two different clinical SRS plans (SLP and MLP) for the same patients were generated, under the same collimator and prescription isodose line (62-68%) by CK Multiplan System. Both the SLP and MLP were able to get ＞95% PTV volume covered prescription isodose and meet the Timmerman 2011 OAR (brainstem, optic nerve and pituitary) constraints.ResultsCompared with the SLP, the maximum dose (Dmax) and mean dose (Dmean) of brainstem in the MLP decreased 0.22-3.13% (2.62%) and 2.71-12.56% (5.57%), over all P＜0.05. While the volumes of whole brain minus the tumors received a single dose equivalence of 8-16Gy (V8Gy-V16Gy) could effectively reduce in the MLP. And the treatment time parameters (the total number of beams and monitor units (MU)) of the MLP declined 3.31% and 1.47% (P＜0.05) respectively. Although there were a few differences of conformity index (CI) and homogeneity index (HI) between two treatment plans, it was no statistical significance (P = 2.94 and 1.08＞ 0.05). ConclusionOne multiple-lesions-plan for brain metastases could achieve higher precision in target and lower dose in healthy tissue, while shorten the treatment time and improve the treatment efficiency.
Autism-associated variants of neuroligin 4X impair synaptogenic activity by various molecular mechanisms
Authors: Yumoto Takafumi , Kimura Misaki , Nagatomo Ryota , Watanabe Hirotaka , Okano Hideyuki , Yoshida Fumiaki , Nao Yosuke , Tomita Taisuke 
Published: January 2020

Abstract
Several genetic alterations, including point mutations and copy number variations in NLGN genes have been associated with psychiatric disorders, such as autism spectrum disorder (ASD) and X-linked mental retardation (XLMR). NLGN genes encode neuroligin (NL) proteins, which are adhesion molecules that are important for proper synaptic formation and maturation. Previously, we and others found that the expression level of murine NL1 is regulated by proteolytic processing in a synaptic activity-dependent manner. In this study, we analyzed the effects of missense variants associated with ASD and XLMR on the metabolism and function of NL4X, a protein which is encoded by the NLGN4X gene and is expressed only in humans. NL4X was found to undergo proteolytic processing in human neuronal cells. Almost all NL4X variants caused a substantial decrease in the levels of mature NL4X and its synaptogenic activity in a heterologous culture system. Intriguingly, the L593F variant of NL4X accelerated the proteolysis of mature NL4X proteins located on the cell surface. In contrast, other variants decreased the cell-surface trafficking of NL4X. Notably, protease inhibitors as well as chemical chaperones rescued the expression of mature NL4X. These data suggest that reduced amounts of the functional NL4X protein on the cell surface is a common mechanism by which point mutants of the NL4X protein cause psychiatric disorders, although different molecular mechanisms are thought to be involved. Furthermore, these results highlight that the precision medicine approach based on genetic and cell biological analyses is important for the development of therapeutics for psychiatric disorders.
A Chart Review of Substance Use Screening and Related Documentation among Adolescents in Outpatient Pediatric Clinics: Implications for Practice
Authors: Kuhns Lisa M. , Rogers Brookley , Greeley Katie , Muldoon Abigail L. , Karnik Niranjan , Thompson Hale , Garofalo Robert , Rahmandar Maria 
Published: January 2020

Abstract
Background: Despite recent reductions, youth substance use continues to be a concern in the United States. Structured primary care screening is recommended, but not widely implemented. The purpose of this study was to describe substance use screening in a large academic medical center, assess related factors, and evaluate screening documentation to inform practice. Methods: We abstracted a random sample of 127 records of patients aged 12-17 and coded clinical notes to identify screening cases and related characteristics. We then analyzed descriptive patterns within the data to calculate screening rates, characteristics of screening, and used multivariable logistic regression to identify related factors. Results: Rates of screening by providers were 72% for common substances (alcohol, marijuana, tobacco). The primary method of screening was use of clinical pneumonic cues rather than standardized screening tools. A total of 6% of patients reported substance use during screening. Older age and racial/ethnic minority status were associated with provider screening in multivariable logistic regression models. Conclusions: Despite recommendations, low rates of screening in primary care persist. Failure to use a standardized screening tool may contribute to low screening rates and biased screening. These findings may be used to inform implementation of standardized and structured screening in the clinical environment.