bluuebunny/crossref_metadata_2025_split huggingface dataset:
Population-based case-finding to identify subjects with undiagnosed asthma or COPD
Authors: Preteroti Matthew , Whitmore G. Alex , Vandemheen Katherine L. , FitzGerald J. Mark , Lemière Catherine , Boulet Louis-Philippe , Penz Erika , Field Stephen K. , Gupta Samir , McIvor R. Andrew , Mayers Irvin , Hernandez Paul , Lougheed Diane , Ainslie Martha , Licskai Christopher , Azher Tanweer , Fraser Ian , Mahdavian Masoud , Aaron Shawn D. 
Published: April 2020

Background∼5–10% of adults may have undiagnosed airflow obstruction. The objective of this study was to develop a population-based case-finding strategy to assess the prevalence of undiagnosed airflow obstruction (asthma or COPD) amongst adults with respiratory symptoms in Canada.MethodsAdults without a previous history of asthma, COPD or lung disease were recruited using random digit-dialling and asked if they had symptoms of dyspnoea, cough, sputum or wheeze within the past 6 months. Those who answered affirmatively completed the Asthma Screening Questionnaire (ASQ), COPD-Diagnostic Questionnaire (COPD-DQ) and COPD Assessment Test (CAT). Those with an ASQ score of ≥6 or a COPD-DQ score of ≥20 underwent pre- and post-bronchodilator spirometry to diagnose asthma or COPD.Results12 117 individuals were contacted at home and assessed for study eligibility. Of the 1260 eligible individuals, 910 (72%) enrolled and underwent spirometry. Ultimately, 184 subjects (20% of those enrolled) had obstructive lung disease (73 asthma and 111 COPD). Individuals found to have undiagnosed asthma or COPD had more severe respiratory symptoms and impaired quality of life compared with those without airflow obstruction. The ASQ, COPD-DQ, and CAT had ROC areas for predicting undiagnosed asthma or COPD of 0.49, 0.64 and 0.56, respectively. Four descriptive variables (age, BMI, sex and pack-years smoked) produced better receiver operating characteristic (ROC) values than the questionnaires (ROC area=0.68).Conclusion20% of randomly selected individuals who report respiratory symptoms in Canada have undiagnosed airflow obstruction due to asthma or COPD. Questionnaires could exclude subjects at low risk but lack the ability to accurately find subjects with undiagnosed disease.
Novel airway smooth muscle–mast cell interactions and a role for the TRPV4-ATP axis in non-atopic asthma
Authors: Bonvini Sara J. , Birrell Mark A. , Dubuis Eric , Adcock John J. , Wortley Michael A. , Flajolet Pauline , Bradding Peter , Belvisi Maria G. 
Published: April 2020

Mast cell–airway smooth muscle (ASM) interactions play a major role in the immunoglobulin (Ig)E- dependent bronchoconstriction seen in asthma but less is known about IgE-independent mechanisms of mast cell activation. Transient receptor potential cation channel, subfamily V, member 4 (TRPV4) activation causes contraction of human ASMviathe release of cysteinyl leukotrienes (cysLTs) but the mechanism is unknown. The objective of the present study was to investigate a role for IgE-independent, mast cell–ASM interaction in TRPV4-induced bronchospasm.Bronchoconstriction was measured in anaesthetised guinea pigs and contraction of human and guinea-pig airway tissue assessed using isometric tension measurements. Increases in intracellular [Ca2+] were imaged using the Ca2+-sensitive dye FURA2, and time-lapse ptychography was utilised as a surrogate for contraction of ASM cells.The TRPV4 agonist GSK1016790A caused contractionin vivoin the guinea pig, and in human and guinea-pig tracheal tissue, which was inhibited by the TRPV4 antagonist GSK2193874. GSK1016790A increased [Ca2+]iand released ATP in human ASM cells without causing contraction. TRPV4 and ATP evoked contraction in isolated tracheal tissue but co-culture experiments indicated a requirement for human lung mast cells. Expression profiling and pharmacological studies demonstrated that mast cell activation was dependent upon ATP activating the P2X4 receptor. Trypsin was shown to evoke contraction of tracheal tissueviaactivation of PAR-2-TRPV4-ATP-cysLT axis indicating the potential disease relevance of this signalling pathway.TRPV4 activation increases [Ca2+]iand releases ATP from ASM cells triggering P2X4-dependent release of cysLTs from mast cells resulting in ASM contraction. This study delineates a novel mast cell–ASM interaction and TRPV4 as a driver of IgE-independent mast cell-dependent bronchospasm.
Short-term and long-term effect of a high-intensity pulmonary rehabilitation programme in obese patients with asthma: a randomised controlled trial
Authors: Türk Yasemin , Theel Willy , van Huisstede Astrid , van de Geijn Gert-Jan M. , Birnie Erwin , Hiemstra Pieter S. , Sont Jacob K. , Taube Christian , Braunstahl Gert-Jan 
Published: April 2020

ObjectiveTo determine the short-term and long-term effects of a high intensity pulmonary rehabilitation programme on asthma control, body composition, lung function and exercise capacity in obese asthma patients.MethodsPatients with obesity (body mass index (BMI)≥30 kg·m−2) and suboptimal controlled asthma (Asthma Control Questionnaire (ACQ)≥0.75) were randomly assigned to a 3-month pulmonary rehabilitation programme (PR only), pulmonary rehabilitation programme with the use of an internet based self-management support programme (PR+SMS) or usual care. The pulmonary rehabilitation programme included high-intensity interval training, nutritional intervention and psychological group sessions. Patients in the usual care group were advised to lose weight and to exercise. The primary outcome was the difference of change of ACQ between PR only and PR+SMS after 3 months. Total follow-up was 12 months.Results34 patients were included in the study (14 PR only, nine PR+SMS, 11 control). Compared with patients in usual care, patients in the PR only group had a significant reduction in BMI and significant improvements in asthma control, exercise capacity and aerobic capacity after 3 months. These improvements persisted during 12 months of follow-up. No difference in ACQ between PR+SMS and PR only groups was observed. However, users of the SMS programme had a significantly lower BMI after 12 months compared with subjects in the PR only group.ConclusionA high-intensity pulmonary rehabilitation programme provides sustained improvements in asthma control, body composition and exercise capacity in obese asthmatics that are not optimally controlled and, therefore, should be considered in the treatment of these patients.
Pleuroparenchymal fibroelastosis in systemic sclerosis: prevalence and prognostic impact
Authors: Bonifazi Martina , Sverzellati Nicola , Negri Eva , Jacob Joseph , Egashira Ryoko , Moser Joanna , Piciucchi Sara , Mei Federico , De Lauretis Angelo , Visca Dina , Goh Nicole , Bonini Matteo , Cirilli Laura , La Vecchia Carlo , Chua Felix , Kouranos Vasileios , Margaritopoulos George , Kokosi Maria , Maher Toby M. , Gasparini Stefano , Gabrielli Armando , Wells Athol U. , Renzoni Elisabetta A. 
Published: April 2020

Interstitial lung disease (ILD) in systemic sclerosis (SSc) is a major cause of morbidity and mortality, mostly presenting as non-specific interstitial pneumonia. Little is known about the prevalence of pleuroparenchymal fibroelastosis (PPFE), a specific entity affecting the visceral pleura and subpleural parenchyma. We set out to estimate PPFE prevalence in two large cohorts of SSc patients and to assess its impact on survival and functional decline.A total of 359 SSc patients, derived from two referral centres in two different countries (UK and Italy), were included. The first available high-resolution computed tomography scan was independently evaluated by two radiologists blind to clinical information, to quantify ILD extent, freestanding bronchial abnormalities, and lobar percentage involvement of PPFE on a four-point categorical scale. Discordant scores were adjudicated by a third scorer. PPFE extent was further classified as limited (≤2/18) or extensive (>2/18). Results were evaluated against functional decline and mortality.The overall prevalence of PPFE in the combined SSc population was 18% (11% with extensive PPFE), with no substantial difference between the two cohorts. PPFE was significantly linked to free-standing bronchial abnormalities (61%versus25% in PPFEversusno PPFE; p<0.0001) and to worse survival, independently of ILD severity or short-term lung function changes (HR 1.89, 95% CI 1.10–3.25; p=0.005).In the current study, we provide an exhaustive description of PPFE prevalence and clinical impact in the largest cohort of SSc subjects published so far. PPFE presence should be carefully considered, due to its significant prognostic implications.
Epigenetic pacemaker: closed form algebraic solutions
Authors: Snir Sagi 
Published: April 2020

AbstractBackgroundDNA methylation is widely used as a biomarker in crucial medical applications as well as for human age prediction of very high accuracy. This biomarker is based on the methylation status of several hundred CpG sites. In a recent line of publications we have adapted a versatile concept from evolutionary biology - the Universal Pacemaker (UPM) - to the setting of epigenetic aging and denoted itthe Epigenetic PaceMaker(EPM). The EPM, as opposed to other epigenetic clocks, is not confined to specific pattern of aging, and the epigenetic age of the individual is inferred independently of other individuals. This allows an explicit modeling of aging trends, in particular non linear relationship between chronological and epigenetic age. In one of these recent works, we have presented an algorithmic improvement based on a two-step conditional expectation maximization (CEM) algorithm to arrive at a critical point on the likelihood surface. The algorithm alternates between a time step and a site step while advancing on the likelihood surface.ResultsHere we introduce non trivial improvements to these steps that are essential for analyzing data sets of realistic magnitude in a manageable time and space. These structural improvements are based on insights from linear algebra and symbolic algebra tools, providing us greater understanding of the degeneracy of the complex problem space. This understanding in turn, leads to the complete elimination of the bottleneck of cumbersome matrix multiplication and inversion, yielding a fast closed form solution in both steps of the CEM.In the experimental results part, we compare the CEM algorithm over several data sets and demonstrate the speedup obtained by the closed form solutions. Our results support the theoretical analysis of this improvement.ConclusionsThese improvements enable us to increase substantially the scale of inputs analyzed by the method, allowing us to apply the new approach to data sets that could not be analyzed before.
Effects of a maternal role adjustment program for first time mothers who use postpartum care centers (Sanhujoriwon) in South Korea: a quasi-experimental study
Authors: Song Ju-Eun , Chae Hyun-Ju , Ko Jung Mi , In Yang Jeong , Kim Tiffany 
Published: April 2020

AbstractBackgroundMany South Korean women stay in specialized postpartum care centers calledSanhujoriwonfor 2 weeks after childbirth, a time which is widely recognized as a critical period for maternal role adjustment. Mothers’ time within the postpartum care center offers a unique opportunity for nursing intervention to promote a successful transition to motherhood, especially for first time mothers. This study aimed to develop a maternal role adjustment program within theSanhujoriwonbased on the ecological model, and to evaluate its effects on maternal role confidence and breastfeeding success.MethodsA non-equivalent control group pretest-posttest design was used. Data were collected from 30 participants in the experimental group and 37 in the control group at four measurement times, i.e., admission day toSanhujoriwon, discharge day fromSanhujoriwon, 4–6 weeks postpartum, and 12 weeks postpartum. The experimental group received the maternal role adjustment program, which included family education and counseling regarding breastfeeding and infant care, and encouraged rooming-in practices during their stay in theSanhujoriwon. The data were analyzed using the IBM SPSS statistics 25.0 program using descriptive statistics, t-test, chi-square test, ANCOVA, and GEE.ResultsThere were significant interaction effects showing different patterns in maternal role confidence and breastfeeding success scores over the four time points. Maternal role confidence in the experimental group gradually increased over time. Maternal role confidence in the control group also increased from baseline to 4 to 6 week postpartum, but abruptly decreased at 12 week postpartum. At 12 weeks postpartum, maternal role confidence in the experimental group was significantly higher than that of the control group. In addition, breastfeeding success scores in the experimental group also gradually increased over the four time points, while those of the control group showed a gradual decline. Breastfeeding success scores were significantly higher than those of control group at both 4–6 weeks and 12 weeks postpartum.ConclusionsThese results indicate that the maternal role adjustment program was effective in improving maternal role confidence and breastfeeding success among first time mothers in the postpartum care center.
Microarray data analysis on gene and miRNA expression to identify biomarkers in non-small cell lung cancer
Authors: Jin Xiang , Guan Yinghui , Zhang Zhen , Wang Hongyue 
Published: April 2020

AbstractBackgroundThe aim of this study was to gain further investigation of non-small cell lung cancer (NSCLC) tumorigenesis and identify biomarkers for clinical management of patients through comprehensive bioinformatics analysis.MethodsmiRNA and mRNA microarray datasets were downloaded from GEO (Gene Expression Omnibus) database under the accession number GSE102286 and GSE101929, respectively. Genes and miRNAs with differential expression were identified in NSCLC samples compared with controls, respectively. The interaction between differentially expressed genes (DEGs) and differentially expressed miRNAs (DEmiRs) was predicted, followed by functional enrichment analysis, and construction of miRNA-gene regulatory network, protein-protein interaction (PPI) network, and competing endogenous RNA (ceRNA) network. Through comprehensive bioinformatics analysis, we anticipate to find novel therapeutic targets and biomarkers for NSCLC.ResultsA total of 123 DEmiRs (5 up- and 118 down-regulated miRNAs) and 924 DEGs (309 up- and 615 down-regulated genes) were identified. These genes and miRNAs were significantly involved in different pathways including adherens junction, relaxin signaling pathway, and axon guidance. Furthermore, hsa-miR-9-5p, has-miR-196a-5p and hsa-miR-31-5p, as well as hsa-miR-1, hsa-miR-218-5p and hsa-miR-135a-5p were shown to have higher degree in the miRNA-gene regulatory network and ceRNA network, respectively. Furthermore,BIRC5andFGF2, as well asRTKN2andSLIT3were hubs in the PPI network and ceRNA network, respectively.ConclusionSeveral pathways (adherens junction, relaxin signaling pathway, and axon guidance) miRNAs (hsa-miR-9-5p, has-miR-196a-5p, hsa-miR-31-5p, hsa-miR-1, hsa-miR-218-5p and hsa-miR-135a-5p) and genes (BIRC5,FGF2,RTKN2andSLIT3) may play important roles in the pathogenesis of NSCLC.
Despite early Medicaid expansion, decreased durable virologic suppression among publicly insured people with HIV in Washington, DC: a retrospective analysis
Authors:   on behalf of the DC Cohort Executive Committee, Goldstein Deborah , Hardy W. David , Monroe Anne , Hou Qingjiang , Hart Rachel , Terzian Arpi 
Published: April 2020

Abstract
Background
Despite widely available access to HIV care in Washington, DC, inequities in HIV outcomes persist. We hypothesized that laboratory monitoring and virologic outcomes would not differ significantly based on insurance type.

Methods
We compared HIV monitoring with outcomes among people with HIV (PWH) with private (commercial payer) versus public (Medicare, Medicaid) insurance receiving care at community and hospital clinics. The DC Cohort follows over 8000 PWH from 14 clinics. We included those ≥18 years old enrolled between 2011 and 2015 with stable insurance. Outcomes included frequency of CD4 count and HIV RNA monitoring (> 2 lab measures/year, > 30 days apart) and durable viral suppression (VS; HIV RNA < 50 copies/mL at last visit and receiving antiretroviral therapy (ART) for ≥12 months). Multivariable logistic regression models examined impact of demographic and clinical factors.

Results
Among 3908 PWH, 67.9% were publicly-insured and 58.9% attended community clinics. Compared with privately insured participants, a higher proportion of publicly insured participants had the following characteristics: female sex, Black race, heterosexual, unemployed, and attending community clinics. Despite less lab monitoring, privately-insured PWH had greater durable VS than publicly-insured PWH (ART-naïve: private 70.0% vs public 53.1%, p = 0.03; ART-experienced: private 80.2% vs public 69.4%, p < 0.0001). Privately-insured PWH had greater durable VS than publicly-insured PWH at hospital clinics (AOR = 1.59, 95% CI: 1.20, 2.12; p = 0.001).

Conclusions
Paradoxical differences between HIV monitoring and durable VS exist among publicly and privately-insured PWH in Washington, DC. Programs serving PWH must improve efforts to address barriers creating inequity in HIV outcomes.
Utility of CT-based navigation in revision total hip arthroplasty for a patient with severe posterior pelvic tilt-case report-
Authors: Watanabe Shintaro , Choe Hyonmin , Kobayashi Naomi , Ike Hiroyuki , Kobayashi Daigo , Higashihira Syota , Inaba Yutaka 
Published: April 2020

Abstract
Background
Hip dislocation after total hip arthroplasty (THA) or hemi-arthroplasty is a rare but serious complication. Dislocation may be prevented by appropriate positioning of the cup angle of inclination and anteversion.

Case presentation
This report describes a 66-year-old woman who underwent revision THA using a computer tomography (CT)-based navigation system to treat an anterior dislocation after hemi-arthroplasty due to a severe posterior pelvic tilt. At initial presentation, her sagittal pelvic tilt angle, measured as anterior pelvic plane (APP) in the supine position, was 38 degrees posterior to the coronal plane. Owing to the posterior pelvic tilt, revision THA was performed using CT-based navigation, while dual mobility was utilized to reduce the risk of re-dislocation. Postoperatively, her sagittal pelvic tilt angle showed further progression over time, with an APP of 66 degrees posterior to the coronal plane in the standing position 3 years after revision THA. Simulation with the Zed Hip system showed that the risk of implant-to-implant impingement was much higher posteriorly than anteriorly. Gait analysis demonstrated hyperextension of the hip joint while walking, although hip joint function required for daily activity was maintained.

Conclusions
Preoperative planning of implant orientation, based on posterior progression of pelvic tilt and accurate placement of components, is important to prevent dislocation in patients with severe posterior pelvic tilt. A dual mobility cup may also improve hip function in these patients.
The role of residents in medical students’ neurology education: current status and future perspectives
Authors: Keser Zafer , Rodriguez Yvo A. , Tremont Jennifer , Hsieh Peggy H. , McCullough Louise D. , Sandrone Stefano , Stimming Erin F. 
Published: April 2020

AbstractBackgroundNeurophobia, a well-described fear of neurology, affects medical students worldwide and may be one of the factors contributing to a shortage of neurologists in the United States. Residents spend a considerable amount of time with medical students; therefore, we sought to understand better the impact neurology residents have on medical students during their neurology clerkship and their subsequent interest in neurology. We aimed to identify and implement strategies to decrease neurophobia and increase the number of students pursuing neurology as a career.MethodsThird-year medical students (n = 234) of UTHealth’s McGovern Medical School rotating through their neurology core clerkship completed two surveys regarding their rotation experiences. Surveys were completed anonymously before and after the clerkship to measure their interest and confidence in neurology and the impact of their interactions with the neurology residents during the clerkship. In parallel, residents participated in a teaching workshop focused on small group teaching to improve their teaching effectiveness. Non-parametrical comparison and ordinal regression analyses were utilized for data analyses.ResultsMedical students reported a statistically significant increase in their confidence in managing neurological conditions and interest in pursuing a neurology residency after their clerkship. There was a significant association between the medical students’ overall rotation experience and the residents’ teaching effectiveness. The overall clerkship experience correlated with the medical students’ interest and confidence in neurology. There was a trend towards an increase in residents’ teaching effectiveness and students’ rotation experience after a resident teaching workshop. Additionally, of note, students who rotated on both and outpatient and inpatient sites during their clerkship reported an increased interest in neurology.ConclusionOur study supports that resident-led teaching efforts are important in improving medical students’ neurologic education and their interest in neurology.Our data also supports that the interest in neurology increased for medical students after their neurology clerkship. We examined future strategies to implement “near-peer” teaching activities to enhance the medical students’ neurologic educational experience. These strategies could potentially mitigate neurophobia and ultimately lead to a much-needed increase in future neurologists.