bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determinants of Hypnotic Discontinuation One Month After Discharge from an Acute Geriatric Ward: A Prospective, Observational Study
Authors: Brantegem Pieter Van , Liesenborghs Astrid , Hias Julie , Milisen Koen , Flamaing Johan , Tournoy Jos , Linden Lorenz Van der 
Published: September 2020

Abstract
BackgroundDeprescribing long-term hypnotic drug use is recommended in older adults to reduce medication-related harm such as falls. It is currently unknown whether this might be feasible in geriatric inpatients. The aim of this study was hence to determine predisposing factors for discontinuation of benzodiazepines and Z-drugs one month after discharge in geriatric inpatients receiving usual care.MethodsA prospective observational study was performed at the University Hospitals Leuven (UZ Leuven, Belgium). Patient characteristics, hypnotic drug use and sleep quality were gathered up to one month after discharge. A multivariable logistic regression model was used to identify independent determinants.ResultsChronic hypnotic drug use was highly prevalent (26.6%) in the geriatric population of UZ Leuven. Ninety-six patients with a mean age of 85.7 (SD 4.7) years admitted to the acute geriatric ward over a period of 10 months were included for analysis. Upon admission, 74% used a benzodiazepine and 26% a Z-drug. One month after discharge, 35 patients (36.5%) discontinued the hypnotic drug and in 23 cases (24.0%) the equivalent daily dose was reduced. Cessation of the hypnotic drug during hospitalization was found to be the only determinant influencing discontinuation one month after discharge with an odds ratio of 9.43 (95% confidence interval: 3.23 – 32.13). This was not associated with any deterioration of sleep quality.ConclusionsThis study confirms the overuse of long-term BZD and Z-drug use in geriatric patients. Cessation of hypnotic drugs during hospitalization was strongly associated with persistent discontinuation one month after discharge.Trial registrationThe study was approved by the Ethics Committee of UZ Leuven (registration number B322201629331).
A Nomogram Based on Clinical Characteristics for Predicting Multiple Organ Dysfunction Syndrome(MODS) Following Multiple Trauma Patients
Authors: Miao ZhenJun , Wei Faxing , Zhou Feng 
Published: September 2020

Abstract
BackgroundMultiple organ dysfunction syndrome (MODS) is the one of common complications,and the leading cause of late mortality in multiple trauma patients.The present study aims to develop and validate a nomogram based on clinical characteristics in order to identify the patients with multiple trauma who were at risk of developing MODS.MethodsAn retrospective cohort study was performed with data from January 2011 to December 2019,totally 770 patients with multiple trauma were enrolled in our study.They were randomly categorized into training set (n=514) and validation set (n=256).The univariate and multivariate logistic regression analyses were used to screen the predictors for multiple trauma patients who were at risk of developing MODS from training set data.Then we established a nomogram based on these above predictors.The discriminative capacity was assessed by receiver operating characteristic (ROC) curve area under the curve (AUC), and the predictive precision was depicted by calibration plot.The Hosmer-Lemeshow test was used to evaluate the the model’s goodness of fit.ResultsOur study showed that age,ISS,hemorrhagic shock,heart rate,blood glucose,D-dimer and APTT were independent risk factors for MODS in patients with multiple trauma by multivariate logistic regression analysis.A nomogram was established on basis of these above risk factors.The area under the curve (AUC) was 0.868 (95% confidence interval [CI]:0.829-0.908) in the training set and 0.884 (95% confidence interval [CI]:0.833-0.935) in the validation set.The Hosmer-Lemeshow test has a p value of 0.227 in training set and 0.554 in validation set respectively,which confirm the model’s goodness of fit.Calibration plot showed that the predicted and actual incidence of MODS probability were fitted well on both internal and external validations.ConclusionsThe present nomogram had a well predictive precision and discrimination capacity,which can facilitate improved screening and early identification of multiple trauma patients who were at high risk of developing MODS.
A Theoretical Investigation of Hybrid Foil-Magnetic Bearings on Operation Mode and Load Sharing Strategy
Authors: Feng Kai , Zhang Hang , Yin Qianwei , Guan Hanqing , Cao Yuanlong 
Published: September 2020

Abstract
To guide the conceptual design of hybrid foil-magnetic bearings (HFMBs), this paper presents a theoretical investigation on operation mode and load sharing strategy. According to the inherent characteristics of GFBs and AMBs, seven possible work scopes are discussed to understand the operation mode of HFMBs. A numerical model coupling the calculations of the film pressure in GFBs and the magnetic forces in AMBs is conducted to predict the performance of HFMBs. The deflection of top foil and bumps is also included in the prediction model. The analysis, which is conducted for static and dynamic performance of HFMBs within three representative work scopes by varying the load sharing, uncovers the effects of the operation mode and load sharing strategy on bearing behavior. Results show that HFMBs performance including the supporting stiffness and stability can be obviously enhanced by adjusting the operating mode and load sharing strategy.
Effect of Additive Ti3SiC2 Content on Mechanical Properties of B4C–TiB2 Composites Ceramics Sintered by Spark Plasma Sintering
Authors: Yan Xingheng , Zhou Xingui , Wang Honglei 
Published: September 2020

Abstract
B4C-TiB2 composite ceramics with ultra-high fracture toughness were successfully prepared via spark plasma sintering at 1900℃ using B4C and Ti3SiC2 as raw materials. The results show that compared with pure B4C ceramics sintered by SPS, the hardness of B4C-TiB2 composite ceramics is decreased, but the flexural strength and fracture toughness are significantly improved, especially the fracture toughness has been improved by leaps and bounds. When the content of Ti3SiC2 is 30vol.%, the B4C-TiB2 composite ceramic has the best comprehensive mechanical properties: hardness, bending strength and fracture toughness are 27.28 GPa, 405.11 MPa and 18.94 MPa·m1/2, respectively. The fracture mode of the B4C-TiB2 composite ceramics is a mixture of transgranular fracture and intergranular fracture. Two main two reasons for the ultra-high fracture toughness are the existence of lamellar graphite at the grain boundary, and the formation of a three-dimensional interpenetrating network covering the whole composite.
Co-creation of an Acceptable Indigenous Food Diet for Children Under Five in Early Childhood Development Centres
Authors: Nepfumbada Gundo , Dzinamarira Tafadzwa , Mashamba-Thompson Tivani Phosa 
Published: September 2020

Abstract
Background: The use of indigenous food (IF) such as green leafy vegetables and fruits in rural communities has been the main source of food despite being replaced by food high in sugar and fats. Early Childhood Development (ECD) centres are uniquely positioned for positive influence to healthy eating of children. The aim of this study was for ECD stakeholders to co-create an IF diet for children under five in ECD centres.Method: A sequential explanatory mixed method design was employed. We conducted focus group discussion with stakeholders employing the community-based participatory research (CBPR) approach and the nominal group technique ranking method to co-create to an acceptable indigenous food diet for children. Data was analyzed using both qualitative and quantitative methods. A thematic approach to qualitative data analysis with a coding framework guided by Consolidated Framework for Implementation Research (intervention characteristics, inner setting, outer setting, characteristics of individuals involved in implementation and the implementation process) was employed to analyse focus group discussion data. Statistical analysis was employed to analyze quantitative data collected through surveys.Results: Study participants included ECD stakeholders (ECD managers, social workers and dieticians) aged 34-52. Participants identified Ditokomane, Oranges, Mabele soft porridge, Dithotse and Dinawa as components of an IF that are suitable and acceptable for children under five years in ECD centres. Conclusion: ECD stakeholders co-created an IF diet to be implemented in ECD centres for children under five. Stakeholders are of the view that IF diet will have more health benefits on children than the current menu that is being used.
A Case of Easily Misdiagnosed Intramuscular Hemangioma
Authors: Li Yujia , Chou Ke , Zhu Wei , Xiong Jiepeng , Gu Yun , Yu Min 
Published: September 2020

Abstract
Background: Intramuscular hemangioma is a kind of benign vascular tumors often occurs in the lower extremity, which occurs in the gluteus medius muscle, and was misdiagnosed as lumbar disc herniation is rarely reported.Case presentation: A 36-year-old female who complaint of accidental pain of the left buttock. She was diagnosed as lumbar disc herniation, and accept the treatment. The symptom slightly relieved, but will relapse soon. Until she takes the X-ray and MRI, a mass was found in the gluteus medius muscle, which was suspected of malignant tumor. Then the tumor was resected and the final diagnosis is intramuscular hemangioma. The symptoms disappear completely and not recurrent.Conclusion: There are usually no special symptoms in patients with intramuscular hemangioma, so it is often misdiagnosed, when the treatment effect is not satisfied, the cause should be timely and correctly analyzed.
Dietary and Lifestyle Behavior in Adults With Epilepsy Needs Improvement: A Case-control Study From North-eastern Poland
Authors: Kulesza Kamila , Cyuńczyk Monika , Kochanowicz Jan , Witkowska Anna 
Published: September 2020

Abstract
Background: Several factors predispose people with epilepsy to cardiovascular diseases. Among them nutrition and lifestyle have not been sufficiently studied. Methods. The study involved 60 epileptic male and female volunteers and 70 healthy controls, corresponding to age and gender. Medical information was collected during the study and a detailed questionnaire survey concerning eating and lifestyle habits was conducted. Physical activity was evaluated using International Physical Activity Questionnaire (IPAQ). Nutritional status was assessed by bioelectric impedance. Venous blood samples were taken for lipid and 25-hydroxyvitamin D3 (25(OH)D3) analyses. Results. A tendency to an increase in LDL cholesterol was found in epileptics. Significantly higher body fat and insignificantly higher visceral fat was found in epileptic men compared to healthy men. In epileptic women a tendency to lower lean body mass was found. Patients with epilepsy were more sedentary, had lower consumption of cottage cheese, fruit, pulses, nuts and seeds, vitamin C and potassium, and higher intake of sugar-sweetened soda, energy from fat and sodium compared to healthy people. As a positive point, epileptics consumed less coffee and alcoholic beverages. More than 80% of diets of epilepsy people were low in folic acid, vitamin D and calcium, but similar tendency was observed in the healthy people. The diets of patients with epilepsy were in a higher percentage poor in niacin, vitamin C and potassium compared to the control group, 25% to 7%, 50% to 31% and 73 to 56% respectively. A significantly lower serum concentration of 25(OH)D3 was observed in epileptic individuals, which in this group was found to be positively modulated by physical activity.Conclusions. The study indicates that several behavior-related habits, which may predispose epileptic people to cardiovascular disease, need to be improved. For this reason, patients with epilepsy should be provided with more comprehensive medical care, including advice on nutrition and physical activity.
Rural urban differential in Transactional sex among unmarried (Not in Union) Young Women (15-24 years) in Uganda
Authors: Okotel Vincent , Wamala Robert , Mbonye Martin Kayitale 
Published: September 2020

Abstract
Background: Transactional sex, a causal exchange of gifts, money and services for sex is practiced globally. Transactional sex is associated with risky sexual behaviors, unintended pregnancy, gender based violence and HIV infection. Proportionally in 2016, TS among young women not in union in Uganda was almost twice in rural areas (16.4%) compared to urban (8.9%) areas. Despite the negative consequences associated with transactional sex, no study in Sub-Saharan Africa Uganda inclusive has provided a detailed account of the contribution of the variations in characteristics and variations in effects of characteristics to the rural-urban gap in transactional sex among young women not in union. This study therefore provides a detailed account of the rural-urban gap in TS by variations in characteristics and variations in effects of characteristics of young women in Uganda. Methods: The study utilized data from UDHS 2016 comprising of 1,595 records of young women (15-24 years) not in union (not currently married or living with a man). Statistical analysis was done using a Non-linear Oaxaca’ Blinder Multivariate Decomposition of the logistic regression. Results: In the results, the overall gap in rural-urban transactional sex is significantly attributed to both variations in characteristics (30.7%) and variations in effects of characteristics (69.3%) of young women (p<0.05). Specifically, the rural-urban gap in transactional sex among young women in Uganda is attributed to variation in total children ever born (-15.2%), age at first sex (10.3%) and variation in effect of highest education (-1, 1014.1%) and HIV stigma (-84.3%). Conclusion: In order to reduce transactional sex especially among young women in rural residence, government and other development partners need to strengthen comprehensive sex-education programs aimed at creating positive attitudes towards HIV, train young women on viable economic activities together with providing them with educational opportunities aimed at delaying sex.
Identification of Significant Genes with poor prognosis in Liver Metastasis of Colorectal Cancer via Bioinformatical Analysis
Authors: Chen Junsheng , Liu Hongzhou 
Published: September 2020

Abstract
Background: Colorectal cancer (CRC) is a common malignant tumor in the world wild, and more than 50% patients have liver metastases. Purpose: The purpose of this study is to identify significant genes with poor outcome and the underlying mechanisms of CRC liver metastases. Methods: Gene expression profiles of GSE50760, GSE41568 and GSE14297 are available on website of GEO database. Differentially expressed genes (DEGs) between CRC liver metastases and primary tissues were picked out by GEO2R tool and Venn diagram software. The Database for Annotation, Visualization and Integrated Discovery (DAVID) was used to analyze Kyoto Encyclopedia of Gene and Genome (KEGG) pathway and gene ontology (GO). Then protein-protein interaction (PPI) of these DEGs was visualized by Cytoscape with Search Tool for the Retrieval of Interacting Genes (STRING). Results: There were total of 147 consistently expressed genes in the three datasets, including 123 up-regulated genes and 24 down-regulated genes enriched in complement and coagulation cascades, drug metabolism-cytochrome P450, metabolism of xenobiotics by cytochrome P450, prion diseases, chemical carcinogenesis, staphylococcus aureus infection and linoleic acid metabolism. Of PPI network analyzed by Molecular Complex Detection (MCODE) plug-in, all 39 genes were selected. Moreover, for the analysis of CRC survival among those genes, Kaplan–Meier analysis was implemented and 4 (SERPING1 ITIH2 CDH2 APOE) of 39 genes had a significantly worse prognosis. Conclusion: we have identified four significant DEGs with poor prognosis in CRC liver metastases on the basis of integrated bioinformatical methods, which could be potential therapeutic targets for CRC patients with liver metastases.
Economic Evaluation of Quality Improvement Interventions Targeting Elderly Population in Long-term Care: A Scoping Review&nbsp;
Authors: Khowaja Asif Raza , Krause Christina , Kennedy Colleen , Ridout Ben , Mitton Craig 
Published: September 2020

Abstract
Background: Quality improvement (QI) has received much wider attention in public policy, given the ever-increasing aging population and growing demand of long-term care (LTC). In the policy context, health system planners and administrators need to know the evidence on cost-effectiveness for resource allocation decisions. The objectives of this study were to: identify costs and benefits of the QI strategies in the economic literature; and synthesize the methodological approaches used in the economic studies and reported evidence around the cost-effectiveness of QI strategies in LTC. Methods: A scoping review of three online databases, including PubMed, EconLit, and Google Scholar, was conducted to identify economic studies focusing on elderly population published from September 2010 to August 2020. A combination of search expressions was used to identify the original research articles. Study titles and abstracts were screened, and only full-text articles meeting the inclusion criteria were retained in the review. A standard data extraction template was used capturing patient population, intervention, comparator, the outcome of interest, and study design (PICOS). Results: The search identified 657 records, of which 16 were included in the review. The financial costs were categorized into three groups: (i) developmental, (ii) operational, and (iii) health resource utilization. The terms ‘Quality of life,’ ‘Health-related Quality of Life’, and ‘Quality of Care’ were interchangeably used to express the health outcomes. This study showed mixed results suggesting a substantial variability around cost-effectiveness of QI interventions targeting elderly population in LTC. Almost all studies reported a public payer perspective and a discount rate ranged from 0 to 7%. A poorly defined baseline, the complex nature of the intervention, a lack of appropriate comparator, and varying duration of implementation were key methodological limitations. Conclusions: This review highlights important knowledge gaps regarding societal costs and inconsistencies in reporting of the outcome measures. More research is needed to analyze long-term costs and consequences to better inform decisions on resource allocation in LTC.
Lysophosphatidic Acid-induced EGFR Transactivation Promotes Gastric Cancer DNA Replication Through Up-Regulation of Geminin
Authors: Zhao Haile , Gezi Gezi , Tian Xiaoxia , Jia Peijun , Morigen Morigen , Fan Lifei 
Published: September 2020

Abstract
BackgroundLysophosphatidic acid (LPA) is one of the simplest active phospholipid molecules. Binding to its receptors on the cell surface, LPA initiates various intracellular signal cascades, involving in numerous biological processes, such as cell proliferation, migration, and apoptosis. If abnormalities occur in the processes of LPA production, receptor expression or signal transduction, it may induce certain diseases and even contribute to the occurrence, development and metastasis of cancer. However, whether the initiation of DNA replication is regulated by LPA has not yet been investigated.MethodsFirst, diverse public databases were analyzed to explore the genetic abnormalities affecting geminin. Next, an LPA gradient treatment was performed on gastric cancer cells, followed by detecting geminin expression variation using western blot analysis. Finally, RNAi technology or inhibitors were used to block the biological activity of related factors in the GPCR induced EGFR transactivation signaling pathway to verify whether the effect of LPA evoked gastric cancer DNA replication is dependent on geminin upregulation.ResultsWe found that LPA specifically up-regulated expression of an essential replication negative regulator geminin in early S phase in gastric cancer cell lines, and that the deletion of geminin selectively induced DNA re-replication. Neither of these phenomena has been observed in normal gastric epithelial cells, indicating LPA-induced geminin up-regulation is restricted to tumor cells. Using RNAi or specific inhibitors to block the activity of related factors in the signaling pathway, we found that LPA acts through LPAR3 and downstream coupled MMPs signaling to trans-activate EGFR, increasing the expression level of geminin in S phase. On the other hand, LPA stimulation induced the up-regulation of de-ubiquitinating enzyme 3 (DUB3) in a short time and inhibited the ubiquitination degradation of geminin to enhance geminin stability and positively regulate the DNA replication initiation in gastric cancer cells. Taken together, our results suggested that LPA mediated DNA replication and S-phase cell-cycle progression through a LPAR3/MMPs/EGFR/PI3K/mTOR signaling axis in gastric cancer. ConclusionsOur research is for the first time to study the regulatory effect of LPA-induced EGFR transactivation in DNA replication of tumor cells, and to uncover a novel mechanism for regulating the stability of geminin through LPA and related downstream signaling pathways. All of which will provide potential targets for the development of signaling pathways and tumor cell-specific EGFR transactivation inhibitor for the treatment of gastric cancer.
Extracellular Vesicles From Steatotic Hepatocytes Provoke Pro-Fibrotic Responses in Stellate Cells.
Authors: Koenen M. Teresa , Caspers Tim , Heinzmann Alexandra C.A. , Fischer Petra , Heinrichs Daniel , Brandt Elisa F. , Wirtz Theresa , Trautwein Christian , Koenen Rory , Berres Marie Luise 
Published: September 2020

Abstract
Background and aimsHigh caloric dietary intake is associated with hepatic steatosis and chronic hepatocyte damage leading ultimately to liver fibrosis and cirrhosis with organ failure. Although the pathophysiologic process orchestrating liver fibrosis is not completely clarified, pivotal steps are the activation and transdifferentiation of hepatic stellate cells. In this study, we aim to assess the direct interplay between hepatocytes and hepatic stellate cells under normal and steatotic conditions and hypothesize that extracellular vesicles (EV) isolated from hepatocytes can directly manipulate the phenotype of stellate cells.MethodsBy high speed centrifugation, EV were isolated from conditioned media of the hepatocellular carcinoma cell line HepG2, under baseline conditions (C-EV) or after induction of steatosis by linoleic and oleic acid for 24 hours (FA-EV). Migration of the stellate cell line TWNT4 towards respective EV as well as sera of NASH patients was investigated using Boyden chambers. TWNT4 phenotype alterations after incubation with EV was determined by qPCR, western blotting and immunofluorescence staining. ResultsHepG2 cells released more EV after treatment with fatty acids. Chemotactic migration of TWNT4 cells was increased specifically towards FA-EV. Prolonged incubation of TWNT4 cells with FA-EV induce expression of proliferation markers and a myofibroblast-like phenotype. Whereas the expression of the collagen type 1 1 gene did not change after FA-EV-treatment, expression of the myofibroblast markers e.g. -smooth muscle cell actin and TIMP1 were significantly increased. ConclusionWe concluded that EV from steatotic HepG2 cells can influence the behavior and phenotype of TWNT4 cells as well as the expression of remodeling markers and guides directed migration. These findings imply EV as operational, intercellular communicators in the pathophysiology of steatosis associated liver fibrosis.