bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regional differences in reasons for consultation and general practitioners’ spectrum of services in Northern Germany – Results of a cross-sectional observational study
Authors: Schäfer Ingmar , Hansen Heike , Ruppel Thomas , Lühmann Dagmar , Wagner Hans-Otto , Kazek Agata , Scherer Martin 
Published: December 2019

Abstract
Background
Among other factors, the patients’ consultation reasons and GPs’ spectrum of services determine the process and outcome of the medical treatment. So far, however, there has been little information on differences in reasons for consultation and GPs’ services between urban and rural areas. Our study’s goal was thus to investigate these factors in relation to the regional location of GPs’ practices.

Methods
We conducted a cross-sectional observational study based on standardised GP interviews in a quota sampling design. All counties and independent cities within a radius of 120 km around Hamburg were divided into three regional categories (urban area, environs, rural area) and stratified proportionally to the population size. Differences in the number of reasons for consultation and services were analysed by multivariate linear regressions in mixed models adjusted for random effects on the levels of the German federal states and administrative districts. Differences in individual consultation reasons and services were identified by logistic regression via stepwise forward and backward selection.

Results
Primary care practices in 34 of the 37 selected administrative districts (91.9%) were represented in the dataset. In total, 211 GPs were personally interviewed. On average, GPs saw 344 patients per month with a slightly higher number of patients in rural areas. They reported 59.1 ± 15.4 different reasons for consultation and 30.3 + 3.9 different services. There was no statistically significant regional variation in the number of different consultation reasons, but there was a broader service spectrum by rural GPs (ß=-1.42; 95% confidence interval -2.75/-0.08; p=0.038) which was statistically explained by a higher level of medical training. Additionally, there were differences in the frequency of individual consultation reasons and services between rural and urban areas.

Conclusion
GPs in rural areas performed more frequently services usually provided by medical specialists in urban areas. This might be caused by a low availability of specialists in rural areas. The association between medical training and service spectrum might imply that GPs compensate the specific needs of their patients by completing advanced medical training before or after setting up a medical practice.

Trial registration
The study was registered in ClinicalTrials.gov (NCT02558322).
Ubiquitin-specific protease 44 inhibits cell proliferation and migration via inhibition of JNK pathway in clear cell renal cell cancer
Authors: Zhou Jiangqiao , Wang Tianyu , Qiu Tao , Chen Zhongbao , Ma Xiaoxiong , Zhang Long , Zou Jilin 
Published: December 2019

Abstract
Background: Clear cell renal cell carcinoma (ccRCC) is the most common form of adult kidney cancer. USP44 has been reported to be involved in various cancers. This study aimed to investigate the function role and molecular mechanism of USP44 in ccRCC. Methods: Data obtained from TCGA data portal and GSO database were analyzed to uncover the clinical relevance of USP44 expression and tumor development. The function of USP44 in cell proliferation and migration was assessed by cellular and molecular analysis. Results: USP44 was lowly expressed in the ccRCC cancer tissues compared to the normal tissue. Further, USP44 expression was negatively correlated with tumor stage, tumor grade, and patient survival . USP44 overexpression significantly inhibited tumor cell proliferation and migration of 786-O cell as well as Caki-1 cell. In addition, USP44 overexpression also prohibited cell proliferation by up-regulating P21, down-regulating Cyclin D1 expression, and inhibited cell migration by up-regulating MMP2 and MMP9 expression. In contrast, USP44 knockdown enhances ccRCC cell proliferation and migration. Furthermore, the USP44 function in inhibiting ccRCC cell proliferation and migration is associated with the phosphorylation level of JNK. Conclusion: In summary, this study showed that USP44 may be a marker in predicting the ccRCC progression and USP44 inhibits ccRCC cell proliferation and migration dependent on the JNK pathway.
The association between individual perceptions of PM2.5 pollution and pulmonary function in Chinese middle-aged and elderly residents
Authors: Chen Qi , Zhang Jiayao , Xu Yan , Sun Hong , Ding Zhen 
Published: December 2019

Abstract
Background: PM2.5 pollution has become a major public health concern in urban China. Understanding the residents’ individual perceptions toward haze pollution is critical for policymaking and risk communication. However, the perceptions of middle-aged and elderly residents, who particularly vulnerable to haze pollution, are poorly understood. In this study, we aimed to explore their risk perception of haze pollution, and investigating the relationship between health status and pulmonary function parameters and risk perception. Methods: A cross-sectional study of 400 randomly sampled individuals (aged 40 to 90 years) was conducted in Wuxi, a typical PM2.5-polluted city (daily average PM2.5 concentration was 52.73 μg/m3 between 2015-2017). Each participant’s demographic and health information, individual perception and pulmonary function outcomes were collected, and linear models were employed to explore the relationship between personal characteristics and pulmonary function parameters and perception factors. Results: We found that the mean values for controllability (4.99 ± 2.78) and dread of self-risk (6.90 ± 2.45) were the lowest and the highest values, respectively, in our study. Education and average family income were positively related with all individual perception factors, while age was negatively associated. A history of respiratory disease was positively associated with all individual perception factors except controllability. Significant positive associations were observed between PEF (coefficients ranged from 0.18 to 0.22) and FEF75% (coefficients ranged from 0.18 to 0.29) with a variety of individual perception factors. Conclusions: There was a lack of concern and knowledge, weak self-protection consciousness and a strong dread of PM2.5 pollution among the middle-aged and elderly residents in Wuxi. Their individual perceptions were associated with age, education levels, average family income, history of respiratory disease and pulmonary function indexes PEF and FEF75%. Our findings may help policymakers develop effective policies and communication strategies to mitigate the hazards of haze among older residents.
Yellow nutsedge WRI3/4-like gene improves drought tolerance in Arabidopsis thaliana by promoting cuticular wax biosynthesis
Authors: Cheng Chao , Hu Shutong , Han Yun , Xia Di , Huang Bang-Lian , Wu Wenhua , Hussain Jamshaid , Zhang Xuekun , Huang Bangquan 
Published: December 2019

Abstract
Using RACE PCR, full length WRI1-like gene was amplified from yellow nutsedge. Conserved domain and phylogenetic analyses suggested it as WRI3/4-like gene. Tissue-specific expression data showed the highest expression in leaves, followed by roots while the lowest expression was detected in tuber. Transgenic Arabidopsis plants expressing nutsedge WRI3/4-like gene showed significantly improved tolerance to both PEG-simulated drought stress and real dehydration, compared with the wild type (WT). Under normal growth conditions, the expressions of key fatty acid biosynthesis genes was not significantly different between WT and transgenic lines, while the expressions of genes involved in cuticular wax biosynthesis was significantly higher in transgenic lines compared with the WT. The PEG-simulated drought stress did not induce any significant change in the expression of fatty acid and wax biosynthesis genes in WT plants, while the expression of fatty acid and wax biosynthesis genes was significantly increased in transgenic lines compared with WT as well as unstressed transgenic control. The expression of TAG1, the gene involved in triacylglycerol (TAG) accumulation, was significantly lower in the transgenic lines than that in the WT in normal growth conditions. Drought stress slightly decreased the expression of TAG1 in the WT, but significantly lowered it in transgenic lines compared with its unstressed transgenic control and WT. Consistent with gene expression data, the cuticular wax content in Arabidopsis leaves was significantly higher in the transgenic lines than in the WT, while the oil content was not significantly different. Our results indicated that WRI3/4-like gene from Cyperus esculentus improves drought tolerance in Arabidopsis probably by promoting cuticular wax biosynthesis and, hence, could be a valuable target for improving drought tolerance in crops through recombinant DNA technology.
Inhibition of PAR1 attenuates meningeal macrophage activation and vascular inflammation in a rat model of thrombin-induced hydrocephalus
Authors: Hao Xiaodi , Ye Xianghua , Shen Dan , Li Jiawen , Le Chensheng , Tong Lu-sha , Gao Feng 
Published: December 2019

Abstract
BackgroundOur previous studies demonstrated that intraventricular injection of thrombin could induce hydrocephalus. The inflammation of subarachnoid space plays a key role in hydrocephalus. As thrombin, inducing coagulation, could contribute to inflammation, its effects on subarachnoid space have not been well studied. Macrophagic dysfunction may contribute to this course. However, the mechanisms that how thrombin affects macrophage in subarachnoid space have not been illustrated. Our aim was to explore the possible role that macrophage played in thrombin-induced meningeal inflammation, and to furtherly understand its contribution during thrombin-induced hydrocephalus.MethodsThere were two parts in this study. Firstly, rats had an intraventricular injection of saline or thrombin. Secondly, rats received thrombin injection with vehicle or PAR1 antagonist treatment. Immunofluorescence staining was applied to observe the activation of meningeal macrophage and the expression of NeuN in the cortex. Meanwhile, the expression of intercellular adhesion molecule 1 (ICAM1) in meningeal vessels were tested to detect the vascular inflammation. Western blot was applied to measure the secretion of pro-inflammatory cytokines (IL-1β and IFNγ).ResultsOur results demonstrated that intraventricular injection of thrombin caused significant activation of meningeal macrophages, vascular inflammation, and neuron loss. Inhibition of PAR1 pathway attenuated the M1 polarization of meningeal macrophage, reduced the inflammatory infiltrations and prevented the neuron loss, as well as hydrocephalus after thrombin injection.ConclusionsClinically available PAR1 antagonists may offer a novel therapeutic approach candidate for the prevention or the management of inflammation in hemorrhage-induced hydrocephalus.
Food consumption frequency and perceived stress and depressive symptoms among female university students in the UAE: A cross-sectional study
Authors: Ahmad Ohoud , Sabbah Haleama Al , Smail Linda , Hermena Ehab , Ghali Rola Al 
Published: December 2019

Abstract
Background College students lack experience and ability to cope and adapt with their new life events which make them more prone to experience stress or depression that could affect their dietary behavior. There may be an increase or a decrease in the consumption of a certain food group under stress or depression, and the amount of food ingested in general may differ as well. These changes in eating behavior could lead to lifestyle behaviors affecting the overall health and well-being of a population. This study assessed whether perceived stress and depressive symptoms predict the frequency of consumption of specific food groups among female university students.Methods A cross-sectional study was conducted among female university students using a simple random sampling method. The response rate was 97% yielded a total number of 385 participants. The associations between stress levels and the most/least consumed food groups, and between depressive symptoms levels and the most/least consumed food groups were assessed. The questionnaire included a 12-item self-administered food frequency questionnaire, Cohen’s Perceived Stress Scale, and Beck Depression Inventory-II. The study was approved by the University Ethical Committee before data collection. One-way Analysis of Variance (ANOVA) or the independent-sample t-test were carried out to test the equality of population means across the categories of each independent variable (predictor) depending on the independent variable number of categories.Results Overall, this group of female university students fell under the mild mood disturbance category (depressive symptoms) (BDI-II) and had moderate perceived stress (PSS). Perceived stress was associated with more frequent consumption of salad/raw vegetables and cooked vegetables, and less frequent consumption of cake/cookies and meat/sausage products (p<.05). Additionally, depressive symptoms were associated with less frequent consumption of fresh fruits and more consumption of fast food/canned food and soft drinks (p<.05).Conclusions The data showed that stress and depression predicted different dietary preferences consistent with distinctions between stress and depression on human behavior. Specifically, the results revealed associations between soft drinks consumption and higher depressive symptoms, and between frequent consumption of salad/raw vegetables and cooked vegetables and higher perceived stress among this group of female university students.
Efficacy and safety of Acupuncture for Gastrointestinal Dysfunction after Laparoscopy: study protocol for a randomized controlled trial
Authors: LIU LISHA , YUAN XIULI , JIANG QUANMIN , YANG LEI , HUANG GUANGQIANG , ZHANG JINGYUAN , JING LUO , LIU XIAOYING , HUO JIAN 
Published: December 2019

Abstract
Background: Postoperative gastrointestinal dysfunction is one of the common complications after surgery. At present, there has no internationally recognized acupuncture program although it has a positive effect on the recovery of postoperative gastrointestinal function. In this report, we have designed a scientific trial protocol to analyze the feasibility of applying acupuncture to gastrointestinal dysfunction after laparoscopic surgery. We intend to conduct a randomized controlled trial based on this protocol to evaluate the efficacy and safety of the acupuncture for postoperative gastrointestinal dysfunction. Method / design: This study is a randomized, evaluator blinded, controlled, multi-center clinical trial, which has been designed according to the Consolidated Standards of Reporting Trials (CONSORT 2010) and the standard for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA). The subjects will be chosen from the inpatients who have undergone laparoscopic surgery of Mianyang Hospital Affiliated to Chengdu University of traditional Chinese medicine, Mianyang Third People's Hospital and Mianyang Anzhou District People's Hospital. According to the random number generated by SPSS 25.0 software, the qualified subjects will be randomly assigned to the experimental group, the control group, and the blank group. Therapies will be performed 30 minutes after operation, the experimental group will be treated with acupuncture, the control group will be treated with intravenous injection of granisetron, and the blank group will be treated with intravenous injection of physiological saline. The main outcome is the first time of flatus after operation, and the secondary outcomes are abdominal pain, abdominal distention, nausea, vomiting times, gastrointestinal hormone level, and mental state. We will also evaluate the efficacy and safety of acupuncture on the basis of the principle of good clinical practice (GCP). Discuss: This is a standardized and scientific clinical trial to evaluate the efficacy and safety of acupuncture for gastrointestinal dysfunction after laparoscopic surgery. Our goal is to provide objective evidence and improve the acupoint prescription in clinical practice, so as to promote the clinical application of this technology. Trial registration China clinical trial registration ID: CHICTR -1800016991. Registered on 6 July 2018.Discussion
A novel method based on Adaptive Periodic Segment Matrix and Singular Value Decomposition for removing EMG artifact in ECG signal
Authors: chen xieqi , Lin Jianhui , Huang Chenguang , Huang Yan , He Liu 
Published: December 2019

Abstract
Background: The Electrocardiogram (ECG) signals are usually used to detect and monitor human health. However, the Electromyogram (EMG) artifact also can be obtained during measurement, these make difficult for doctors in correct diagnosis. In general, the ECG signal is periodic while EMG artifact is non-stationary and has overlapped with it under the frequency domain. According to these characteristics, it is necessary to extract clean ECG signals from noisy EMG artifact signals by using the periodic separation method. Method: A novel Adaptive Periodic Segment Matrix (APSM) based on Singular Value Decomposition (SVD) is proposed for extracting clean ECG from EMG artifact. Firstly a periodic segment estimation method is proposed by obtaining an average periodic length and RR intervals constraint via envelope spectrum of the measured signal. Secondly, the R wave peaks and its position of the ECG signals are detected by these. After that, APSM with rank one is formed using R wave peaks and the calculated RR intervals constraint, Then SVD is processed on this matrix, the restructured ECG signals will be obtained by the first maximum singular value of the formed matrix. The validation of proposed method is made by applying the algorithm to ECG records from the MIT-BIH Arrhythmia Database. The zero-mean percent root-mean-square difference (PRD 1 ), Cross-correlation coefficient and output signal to noise ratio (SNR output ) have been calculated for presenting the algorithm performance by comparison with other methods. Finally two heart disease cases have been studied for P wave and ST segment detection under noisy ECG with EMG artifact.Results: The proposed methods achieved significant improvement in output signal-to-noise ratio, percentage root-mean-square differences and lead to the higher value of cross-correlation coefficient between the original (clean) ECG and the denoised ECG signal. Also, the reconstructed ECG signal can be better able to follow the trend of original (clean) ECG signal under the EMG noise. Conclusion: The proposed periodic segment estimation method can adaptively find the periodic length in ECG signal by using envelope spectrum. Also, the more strict rank one trajectory matrix has been formed in APSM by using R wave peaks and RR intervals constraint. The results show that the proposed APSM-SVD method is effective for EMG artifact removal and extracting the clean ECG signal. The R peak, P wave, QRS complex and ST segment can be preserved in the reconstructed ECG signal.
Predicting the potential distribution of the parasitic Cuscuta chinensis under global warming
Authors: Ren Zichun , Zagorchev Lyuben , Ma Junxia , Yan Ming , Li Junmin 
Published: December 2019

Abstract
Background: The climate is the dominant factor that affects the distribution of plants. Cusucta chinensis is a stem holoparasitic plant without leaves or roots, which develops a haustorium and sucks nutrients from host plants. The potential distribution of the parasitic plant C . chinensis has not been predicted to date. This study used Maxent modeling to predict the potential distribution of C. chinensis, based on the following six main bioclimatic variables: annual mean temperature, isothermality, temperature seasonality, precipitation seasonality, precipitation of the warmest quarter, and precipitation of the coldest quarter. Results: The optimal annual average temperature and isothermality of C. chinensis ranged from 4 to 37°C and less than 45, respectively, while the optimal temperature seasonality and precipitation seasonality ranged from 4000 to 25000 and from 50 to 130, respectively. The optimal precipitation of the warmest season ranged from 300 to 1000 mm and from 2500 to 3500 mm, while that of the coldest season was less than 20000 mm. In Asia, C. chinensis is mainly distributed at latitudes ranging from 20° to 50°. During three specific historical periods (last glacial maximum, mid-Holocene, and 1960–1990) the habitats suitable for C. chinensis were concentrated in the central, northern, southern, and eastern parts of China. From the last glacial maximum to the mid-Holocene, the total area with suitability of 0.5-1 increased by 0.0875 million km 2 ; however, from the mid-Holocene to 1960–1990, the total area with suitability of 0.5-1 decreased by 0.0759 million km 2 . The simulation results of habitat suitability in the two representative concentration pathways (RCP) 2.6 (i.e., the low greenhouse gas emissions pathway) and 8.5 (i.e., the high greenhouse gas emissions pathway) indicate that the habitat suitability of C. chinensis decreased in response to the warming climate. Compared with RCP2.6, areas with averaged suitability and highsuitability for survival (RCP8.5) decreased by 0.18 million km 2 . Conclusion: Suitable habitats of C. chinensis are situated in central, northern, southern, and eastern China. The habitat suitability of C. chinensis decreased in response to the warming climate. These results provide a reference for the management of C. chinensis.