bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Diabetes Mellitus on Left Ventricular Longitudinal Function of Patients with Non-Ischemic Dilated Cardiomyopathy
Authors: Tanaka Hidekazu , Tatsumi Kazuhiro , Matsuzoe Hiroki , Matsumoto Kensuke , Hirata Ken-ichi 
Published: May 2020

Abstract
Background
Left ventricular (LV) longitudinal dysfunction has been identified in type 2 diabetes mellitus (T2DM) patients with preserved LV ejection fraction (LVEF). However, the impact of T2DM on LV longitudinal function or the association of LV longitudinal function with outcome for dilated cardiomyopathy (DCM) remains unclear.
Methods
We retrospectively studied 206 patients with non-ischemic DCM, mean age of 59 ± 17 years and LVEF of 31 ± 8% (all < 45%). All patients underwent a standard echocardiographic examination, and LV longitudinal function was assessed in terms of global longitudinal strain (GLS). Long-term outcomes were assessed, with a median follow-up period of 6.2 years, as primary endpoints of death from or hospitalization for deteriorating heart failure.
Results
GLS of DCM patients with T2DM (n = 55) was significantly lower than that in DCM patients without T2DM (n = 151) in spite of similar conventional LV function (7.0 ± 2.0% vs. 7.8 ± 2.2%, p = 0.03). Kaplan-Meier curves indicated that long-term outcomes for DCM patients without T2DM were better than for those with T2DM (log-rank p = 0.001). Subdividing the two groups into four with by using the median value of GLS (7.9%) showed long-term outcome was worst for DCM patients with T2DM and low GLS. Cox proportional hazards analyses demonstrated an independent association of T2DM, GLS and left atrial volume index with long-term outcome. Moreover, multiple regression analysis for the association of GLS showed that T2DM was the independent determinant parameter for GLS as well as for LVEF and left atrial volume index.
Conclusion
Management of DCM patients with T2DM may be improved by using GLS guidance.
Physiotherapists’ Awareness of Risk of Bone Demineralisation and Falls in People Living with HIV and their Perceptions about Fall Risk Management: A Qualitative Study
Authors: Charumbira Maria Yvonne , Berner Karina , Louw Quinette 
Published: May 2020

Abstract
Background: Recent research has indicated a seemingly increased propensity for both falls and accelerated bone loss in people living with HIV (PLWH). Physiotherapists play a crucial role in optimising function and quality of life of PLWH through prevention of falls and reducing the harm that results. Aim: This study aimed to explore physiotherapists’ awareness of falls risk and accelerated bone demineralisation in PLWH and their perceptions about current falls prevention in the care of PLWH in selected regions of sub-Saharan Africa. Method: An interpretative exploratory qualitative research method with a phenomenological approach was employed to explore physiotherapists’ perceptions and experiences regarding bone health and falls in PLWH. In-depth semi-structured telephonic interviews were used to collect data from 21 physiotherapists working in primary HIV care. Transcribed interview data were coded in Atlas.ti.8 ® and analysed using inductive thematic analysis. Results: The primary study revealed a lack of awareness by physiotherapists of falls risk and bone demineralisation in PLWH. As such, physiotherapists did not link falls or fractures to HIV or antiretroviral therapy (ART) when they did observe such events during their general patient assessments. However, in retrospect, some physiotherapists were able to recognise risk factors linked to falls in those with HIV. Current services for falls prevention, as perceived by the physiotherapists, were sub-optimal. Conclusion: Physiotherapists may need to be more aware of the potential risk of falls and bone demineralisation in PLWH and routinely assess for these phenomena in both older and younger PLWH. Key words: Accidental falls, Bone mineral density, HIV, physiotherapists, sub-Saharan Africa
CD4- and CD8-Expressing Cells in the Chambers of Normal, Cataract and Uveitic Eyes: A Comparative Study in Dogs
Authors: Maślanka Tomasz , Ziółkowski Hubert , Garncarz Jacek , Ziółkowska Natalia 
Published: May 2020

Abstract
Background The eye chambers constitute an immunologically privileged compartment. The presence of CD4+ and CD8+ cells in the chambers of normal and cataract eyes is a research problem that so far has been explored only fragmentarily. The first aim of our research was to determine whether CD4+ and CD8+ cells are present in the normal chambers of the eye in dogs, and if so, what the relative and absolute counts of these cells are. Another objective was to verify the hypothesis that uncomplicated cataract may be associated with the local recruitment of CD4+ and CD8+ cells.Results The presence of CD4+ and CD8+ cells was detected in aqueous humor (AH) samples of normal and cataract eyes. However, on average only 55 and 236 events for combined subsets of CD4+ and CD8+ cells were collected for the entire volume of AH from normal and cataract eyes, respectively. The statistical analysis did not reveal significant differences in the percentage and absolute number of CD4+ cells between normal and cataract eyes. However, the values of these parameters in AH samples from cataract eyes were approximately 2- and 3-fold higher than in normal eyes, respectively. The mean percentage and absolute count of CD8+ cells increased approximately by 2.7- and 6-fold, respectively, in AH samples from cataract eyes compared to normal ones. The absolute count, but not the percentage, of CD4+ and CD8+ cells in AH of uveitic eyes was approximately 5- and 3-fold higher than in cataract eyes.Conclusions The results indicate that CD4+ and CD8+ cells occur constitutively in the normal chambers of the eye in dogs. However, considering the extremely low abundance of these cells, it needs to be concluded that both of these cell populations appeared in trace amounts. The development of uncomplicated cataract in dogs may not be immunologically neutral in terms of the local immune response, but it may be associated with the recruitment of CD8+ cells into the eye chambers. This event does not seem to be of an inflammatory nature because it appears on a scale a few times smaller than in the course of uveitis.
Objective Measures of Functional Outcome in Recovery from Open Lower Limb Fractures – A Report from an Ortho-Plastic Research Clinic
Authors: I Pallister , Handley Gregory Jack , Maggs Sharon , Davies Ann-Marie , Kyle Amanda , Bodger Owen , Dafydd Hywel 
Published: May 2020

Abstract
BACKGROUNDOpen lower limb fractures are serious, potentially life-changing injuriesrequiring combined ortho-plastic surgery and have significantly worse outcomes than similar closed fractures. There is little objective published data to determine which functional outcome measures best reflect progress or completeness of physical recovery.Our hypothesis was that objective measures combining strength, agility and balance would better reflect recovery than isolated parameters (e.g. range of motion) and would compare well to patients’ perceived recovery.METHODSAdultopen lower limb fracture patients were followed-up at 6 and 12 weeks, 6, 9 and 12 months post-injury. The mechanism,injurypattern, age, gender and treatment were recorded. Isolated parameter objective functional outcome measures (OFOMs)(range of movement and MRC strength grade) were compared to combined OFOMs(timed up and go (TUAG), comfortable and fast gait speed (CGS and FGS), Edgren Side Step Test(ESST) and Single Leg balance. Patient reported outcomes were recorded (Global Perceived Effect (GPE) scoreand Disability Rating Index (DRI)). RESULTS68 patients (54 male) with a medianage of 45 years (range 20-75). Neither range of movement,strength nor Single Leg balance consistently improved with time. TUAG, ESST, CGS, FGS and GPE scoresshowed consistent improvement, with TUAG and FGS showing highest proportion of improving results at each time-point. Patients’ estimation of recovery paralleled these measures with all but 2 patients achieving the minimum clinical important difference in DRI by 12 months compared to baseline. However, the GPE score compared favourably withthe DRI having a higher proportion of improving responses at each time-point. DISCUSSIONFunctional recovery is a key determinant in patients returning to work, providing for themselves and their family or resuming independent living for older patients. This study has demonstrated time-related improvements in combined OFOMs measuringmobility, strength, agility and balance paralleling patients’ perception of recovery in the 12 months after open lower limb fractures. Over the same time-frame, the simple GPE score compared favourably with the DRI. Such parameters could become part of a defined core outcomes set. Focussing rehabilitation towards these combined OFOMs may help hasten recovery.Trial registrationSouth West Wales REC 06/WMW02/10)
Association Between Morphologic Grading and Implantation Rate of Euploid Blastocyst
Authors: Lou Hua , Li Na , Guan Yichun , Zhang Yuchao , Hao Dayong , Cui Shihong 
Published: May 2020

Abstract
Objective To determine the association between the morphologic grading and implantation rate of euploid blastocysts in single frozen-thawed embryo transfer (SET) cycles.Design: Retrospective cohort study.Setting: Single university-based fertility centerPatient(s): Women aged 25–40 years undergoing euploid SET from January 2017 to December 2019 were identified.Main Outcomes Measure(s): Implantation rate (IR)Result(s): A total of 271 euploid SET cycles were included. The cycles were divided into three groups based on their morphologic grading before cryopreservation: good-quality (n = 58), average-quality (n = 88) and poor-quality blastocysts (n = 125). Good-quality blastocysts yielded statistically significantly higher implantation rates than poor-quality embryos (79.31% vs. 48%; adjusted odds ratio [OR] 3.269; 95% confidence interval [CI] 1.518–7.040). The OR remained significant after adjusting for maternal age, body mass index (BMI), type of infertility, basal follicle-stimulating hormone (FSH), AMH (anti-Müllerian hormone), peak endometrial thickness, type of SET cycle and day of blastocyst biopsy. According to post hoc analysis of age and the day of trophectoderm (TE) biopsy, the implantation rates in women aged < 35 years were higher after good-quality blastocyst transfer than poor-quality blastocyst transfer (80.39% vs. 48.62%, P = 0.003). Logistic regression analyses that adjusted for these variables identified higher implantation rates (OR 3.478, 95% CI 1.530–7.908) for good-quality blastocysts than for blastocysts that underwent poor-quality cycles, but not in women aged ≥ 35 years (71.43% vs. 62.50%, P = 0.402) (Table 2). The implantation rates were higher among women with good-quality blastocysts on both day 5 and day 6 of TE biopsy than among those with poor-quality blastocysts (day 5, 80.43% vs. 55.77%, P = 0.017; day 6, 75.00% vs. 42.47%, P = 0.074). Day 5 euploid blastocysts had no significant difference in implantation potential compared with similarly graded day 6 euploid blastocysts.Conclusions: Blastocyst morphologic grading was associated with implantation rate for euploid embryo transfers after adjustment for potential confounders. These findings suggest that evaluating blastocyst morphology is critical when selecting the best euploid blastocyst.
Exosomes from bone marrow mesenchymal stem cells promoted osteogenic differentiation by delivering miR-196a that targeted Dkk1 to activate Wnt/β-catenin pathway
Authors: Peng Zhi , Lou Zhenkai , Li Zhongjie , Li Shaobo , Yang Kaishun , Lu Sheng , Li Chao 
Published: May 2020

Abstract
Background:

Osteoporosis is the most common bone metabolic disease. Emerging evidence suggests that exosomes are secreted by diverse cells such as bone marrow mesenchymal stem cells (BMSCs), and play important role in cell-to-cell communication and tissue homeostasis. Recently, the discovery of exosomes has attracted attention in the field of bone remodeling.
Methods:

The exosomes were extracted from BMSCs and labeled by PKH-67, and then incubated with hFOB1.19 cells to investigate the miR-196a function on the osteoblast differentiation of hFOB1.19. The osteoblast differentiation was detected via alizarin red staining and the expression of osteoblast genes were detected by western blot. The cell apoptosis was detected by flow cytometer. The target relationship of miR-196a and Dickkopf-1 (Dkk1) were verified by luciferase assay and western blot.
Results:

Here we demonstrated that exosomes extracted from BMSCs (BMSC-exo) significantly promoted hFOB1.19 differentiation to osteoblasts. We found that BMSC-exo were enriched with miR-196a and delivered miR-196a to hFOB1.19 cells to inhibit its target Dkk1, which is a negative regulator of Wnt/β-catenin pathway.
Conclusion:

BMSC-exo activated Wnt/β-catenin pathway to promote osteogenic differentiation, while BMSC-exo failed to exert the effects when miR-196a was deprived. In conclusion, miR-196a delivered by exosomes from BMSCs plays an essential role in enhancing osteoblastic differentiation by targeting Dkk1 to activate Wnt/β-catenin pathway.
Metagenomic insights into the diversity of carbohydrate-degrading enzymes in the yak fecal microbial community
Authors: Gong Ga , Zhou Saisai , Luo Runbo , Gesang Zhuoma , Suolang Sizhu 
Published: May 2020

Abstract
Background: As a special herbivorous ruminant, yak is supposed to utilize the gastrointestinal microbiota to digest plant materials. Although the cellulolytic bacteria of yak rumen have been reported, there is still limited information about whether carbohydrate metabolizing enzymes in its intestinal flora are abundant for the degradation of complex lignocellulosic biomass.

Results: Here, this study aimed to decode the structure and function of yak fecal microbiota using deep metagenome sequencing. A comprehensive gene catalog comprising 4.5 million microbial genes was established and functionally annotated to characterize the primary metabolic potential of the microbiome based on metagenomic assemblies from 92 Gb sequencing data. A full spectrum of genes encoding carbohydrate-active enzymes were identified and about three-quarters of these genes assigned to a wide range of enzyme families were involved in the breakdown of complex dietary carbohydrates, including 120 families of glycoside hydrolases, 25 families of polysaccharide lyases, and 15 families of carbohydrate esterases. Inference of taxonomic assignments to the carbohydrate-degrading enzymes revealed the major microbial contributors were the members of Firmicutes and Bacteroidetes, both of which were also the most dominating bacterial populations in the yak fecal microbiome. Metagenomic binning further reconstructed 86 prokaryotic genomes, and a highly diversified profile of glycoside hydrolases associated with plant-derived polysaccharide degradation was also identified in these uncultured genomes, many of which were novel species with highly fibrolytic capability.

Conclusions: Our findings shed light on a great diversity of carbohydrate-degrading enzymes in the yak gut microbial community and uncultured species, providing a useful genetic resource for future studies on the discovery of novel enzymes with industrial potential.
Zymosan Promotes Proliferation, Candida albicans Adhesion and IL-1β Production of Oral Squamous Cell Carcinoma In Vitro
Authors: CHEN XU , Luo Qingqiong , Ding Jieying , Yang Meng , Zhang Ruiyang , Chen Fuxiang 
Published: May 2020

Abstract
Oral squamous cell carcinoma (OSCC) is the most common type of head and neck squamous cell carcinoma (HNSCC), and the effect of zymosan, a component of yeast cell wall, on oral cancer remains unclear. Cell proliferation assay was performed with CCK-8 to evaluate the effect of zymosan on proliferation of OSCC cell lines including WSU-HN4, WSU-HN6 and CAL-27, and potential mechanism was explored by quantitative real-time PCR, immunofluorescence assay and western blot. Cell adhesion assay was conducted to determine the adhesion of Candida albicans to OSCC cells, and related gene expression and protein was detected. Also, the proinflammatory cytokines including IL-6, IL-8, TNF-α and IL-1β from OSCC cells were determined by ELISA. In current study, zymosan (ZYM) promotes proliferation of OSCC cell lines including WSU-HN4, WSU-HN6 and CAL-27 by CCK-8 assay via TLR2/MyD88 pathway. By cell adhesion assay, the number of Candida albicans per oil field significantly increased in ZYM-treated OSCC cells compared to controls. When treated with zymosan, OSCC cells secreted significantly more pro-inflammatory cytokine IL-1β, which could enhance inflammation in oral cancer microenvironment. Zymosan from fungi cell wall promotes proliferation, Candida albicans adhesion and IL-1β production of oral squamous cell carcinoma by in-vitro experiments.
Distinct eGFR trajectories are associated with risk of myocardial infarction in people with diabetes or pre-diabetes
Authors: Zuo Yingting , Wang Anxin , Chen Shuohua , Tian Xue , Wu Shouling , He Yan 
Published: May 2020

Abstract
Background

The relationship between estimated glomerular filtration rate (eGFR) trajectories and myocardial infarction (MI) remains unclear in people with diabetes or prediabetes. We aimed to identify common eGFR trajectories in people with diabetes or prediabetes and to examine their association with MI risk.
Methods

The data of this analysis was derived from the Kailuan study, which was a prospective community-based cohort study. The eGFR trajectories of 24,723 participants from year 2006 to 2012 were generated by latent mixture modeling. Incident cases of MI occurred during 2012 to 2017, confirmed by review of medical records. Cox proportional hazards models were used to calculate hazard ratios (HR) and their 95% confidence intervals (CIs) for the subsequent risk of MI of different eGFR trajectories.
Results

We identified 5 distinct eGFR trajectories, and named them as low-stable (9.4%), moderate-stable (31.4%), moderate-increasing (29.5%), high-decreasing (13.9%) and high-stable (15.8%) according to their range and pattern. During a mean follow-up of 4.61 years, there were a total of 235 incident MI. Although, the high-decreasing group had similar eGFR levels with the moderate-stable group at last exposure period, the risk was much higher (adjusted HR, 3.43; 95%CI, 1.56–7.54 versus adjusted HR, 2.82; 95%CI, 1.34–5.95). Notably, the moderate-increasing group had reached to the normal range, still had a significantly increased risk (adjusted HR, 2.55; 95%CI, 1.21–5.39).
Conclusions

eGFR trajectories were associated with MI risk in people with diabetes or prediabetes. Emphasis should be placed on early and long-term detection and control of eGFR decreases to further reduce MI risk.
Anti-PD1/PDL1 antibodies plus chemotherapy as first-line treatment for advanced esophageal squamous cell carcinoma
Authors: Qian Jiong , Lin Wu , Wang Haohao , Mao Chenyu , Jiang Haiping , Teng Lisong , Xu Nong 
Published: May 2020

Abstract
Background: Patients with advanced esophageal squamous cell carcinoma (ESCC) have a poor prognosis with few treatment options. Immunotherapy was suggested as a promising treatment for ESCC from some clinical trials. Here we collected clinical results from 23 patients who were received anti-PD1/PDL1 antibodies (mAbs) plus chemotherapy as first line therapy with advanced ESCC, to analyze this combined therapy’s efficacy on advanced ESCC. Methods: Results of 23 Patients started treatment from December 15th, 2017 to September 27th, 2019 (12 patients were enrolled in phase II clinical trials, 11 patients were treated by physician’s choice regiment) of anti-PD1/PDL1 antibodies (mAbs) plus chemotherapy on advanced ESCC as first line treatment were collected. Regiments were either anti-PD1 or anti-PDL1 mAbs plus traditional chemotherapy (cisplatin/5-fluorouracil (5-FU), Paclitaxel/ cisplatin, Paclitaxel/carboplatin or Paclitaxel/ 5-FU) every 3 weeks for six cycles, followed by maintenance therapy with anti-PD1/PDL1 mAbs. Objective response and safety profiles were observed as well as progression-free survival(PFS), overall survival(OS) and duration of response. Results: Of the 23 patients, 18 (78.3%) responded to treatment: 15 partial and 3 complete response. 4 patients had stable disease and 1 patient had progressive disease. The median time to response was 1.4 months (range, 1.4 months – 2.8 months). Treatment-related adverse events occurred in all patients but 3-4 grade immune-mediated adverse events occurred in only one patient. As of April 10th, 2020, the Objective response rate was 78.3%, the median PFS was 15.5 months and the median OS was 21.5 months. No treatment-related deaths were observed. Conclusions: Anti-PD1/PDL1 antibodies plus chemotherapy as the first-line treatment for advanced ESCC showed promising results with manageable adverse events and worthy of further study.
“One-stop shop”: Safety and efficacy of combining atrial septal defect occlusion and left atrial appendage closure for patients with atrial septal defect and atrial fibrillation.
Authors: zhihui zhang , qing yao , haiyun Huang , ping zhu , xiang xu , zhiyuan Song , huakang Li 
Published: May 2020

Abstract
Background: One-stop occlusion (combination of atrial septal defect [ASD] or patent foramen ovale [PFO] occlusion and left atrial appendage [LAA] closure) in patients with ASD/PFO and atrial fibrillation (AF) has not yet been investigated systematically. This study aimed to evaluate the safety and efficacy of one-stop occlusion in the treatment of adult patients with ASD/PFO and AF.Methods: We recruited inpatients with AF and ASD/PFO between August 2014 and April 2019. Preoperatively, they underwent transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) to determine the ASD/PFO size and margin, presence of thrombus in the LAA, and LAA orifice width and depth at 0°, 45°, 90°, and 135°. After confirmation of the indications of LAA closure (LAAC) and ASD/PFO occlusion, the procedures were performed simultaneously under general anesthesia. Oral anticoagulants were administered for 6 months, and the TTE and TEE were evaluated regularly.Results: Forty-nine patients (age, 65.6±9.6 years) were recruited in this study, including 24 patients with ASD and 25 patients with PFO. They underwent simultaneous LAAC and ASD/PFO occlusion successfully. The mean ASD size and mean diameter of the plug devices for ASD occlusion were 14.2±7.7 and 25.4±8.5 mm, respectively. The mean PFO size was 3.5±0.4 mm. The mean maximal LAA orifice width and depth were 20.5±3.4 and 28.3±3.6 mm, respectively. All patients were implanted with a Watchman device (diameter, 27.1±2.9 mm). Postoperatively, all patients took oral anticoagulants for 6 months, and their mean postoperative follow-up duration was 29.0±12.1 months. Postoperative TEE showed that all had normal positioning of the LAA and ASD/PFO plug devices. At 45-60 days after operation, TEE showed that the LAA and ASD/PFO occluder were in the normal position; however, two patients developed occluder thrombosis (warfarin and novel oral anticoagulants were used, respectively). The anticoagulant therapy was adjusted, and TEE showed that the thrombus disappeared at 6 months after operation.Conclusion: One-stop occlusion is safe and effective for the treatment of adult patients with ASD/PFO and AF. It is also feasible to administer warfarin or novel oral anticoagulants after operation.