bluuebunny/crossref_metadata_2025_split huggingface dataset:
E-cigarette-Induced Pulmonary Inflammation and Dysregulated Repair are Mediated by nAChR α7 Receptor
Authors: Wang Qixin , Sundar Isaac , Li Dongmei , Lucas Joseph , Muthumalage Thivanka , McDonough Samantha , Rahman Irfan 
Published: February 2020

Abstract
Electronic cigarette (e-cig) vaping is increasing rapidly in the United States, as e-cigs are considered less harmful than combustible cigarettes. However, limited research has conducted to understand the mechanism of toxicological and pulmonary effects of e-cigs. We hypothesized that sub-chronic exposure of e-cigs induced inflammatory response and dysregulated repair/extracellular matrix (ECM) remodeling, which occur through the α7 nicotinic acetylcholine receptor (nAChR α7). Adult wild-type (WT), nAChRα7 knockout (KO), and lung epithelial-cell-specific KO (nAChRα7 CreCC10) mice were exposed to e-cig aerosol containing propylene glycol (PG) with or without nicotine. Bronchoalveolar lavage fluids (BALF) and lungs were collected for determination of inflammatory responses and ECM remodeling, respectively. Sub-chronic e-cig exposure with nicotine increased the lung influx of macrophages and T-lymphocytes, and the levels of pro-inflammatory cytokines, while nAChR α7 knockdown blocked the inflammatory responses. Interestingly, matrix metalloproteinases (MMPs), such as MMP2, MMP8, and MMP9, in both sex mice were altered at both protein and gene levels when WT mice were exposed to PG alone in a sex-dependent manner. Moreover, MMP12 increased significantly in male mice exposed to PG with or without nicotine in a nAChR α7 dependent manner. Additionally, the abundance of ECM proteins, such as collagen and fibronectin, was significantly altered after sub-chronic e-cig exposure with or without nicotine in a sex-dependent manner, but nAChR α7 independent manner. Overall, sub-chronic e-cig exposure with or without nicotine affected lung inflammation and repair responses/ECM remodeling, which were mediated by nAChR α7 in a sex-dependent manner.
Construction of miRNA-mRNA regulatory network and prognostic signature in endometrial cancer
Authors: Liu Jinhui , Sun Rui , Nie Sipei , Yang Jing , Li Siyue , Jiang Yi , Cheng wenjun 
Published: February 2020

Abstract
Background: Many studies have well supported the close relationship between miRNA and endometrial cancer (EC). This bioinformatic study, compared with other similar studies, confirmed a new miRNA-mRNA regulatory network to investigate the miRNA-mRNA regulatory network and the prognostic biomarkers in EC. Methods: We downloaded RNA-seq and miRNA-seq data of endometrial cancer from the TCGA database, and then we used EdegR package to screen differentially expressed miRNAs and mRNAs (DE-miRNAs and DE-mRNAs). The differentially expressed genes (DEGs) were identified and their functions were predicted using the functional and pathway enrichment analysis. Protein–protein interaction (PPI) network was established using STRING database, and the hub genes were verified by Gene Expression Proﬁling Interactive Analysis (GEPIA). Then, we constructed a regulatory network of EC-associated miRNAs and hub genes by Cytoscape, and determined the expression of unexplored miRNAs in EC tissues and normal adjacent tissues by quantitative Real-Time PCR (qRT-PCR). A prognostic signature model and a predictive nomogram were constructed. Finally, we explored the association between the prognostic model and the immune cell infiltration. Results: 11531 DE-mRNAs and 236 DE-miRNAs, as well as 275 and 118 candidate DEGs for upregulated and downregulated DE-miRNAs were screened out. These DEGs were significantly concentrated in FOXO signaling pathway, cell cycle and Focal adhesion. Among the 20 hub genes identified, 17 exhibited significantly different expression compared with normal tissues. The miRNA-mRNA network included 5 downregulated and 13 upregulated DE-miRNAs . qRT-PCR proved that the expression levels of miRNA-18a-5p, miRNA-18b-5p, miRNA-449c-5p and miRNA-1224-5p and their target genes, NR3C1, CTGF, MYC, and TNS1 were consistent with our predictions. Univariate and multivariate Cox proportional hazards regression analyses of the hub genes revealed that NR3C1, EZH2, and GATA4 showed a significant prognostic value. We identified the three-gene signature as an independent prognostic indicator for EC ( p =0.022，HR=1.321, 95% CI: 1.041-1.675) and these genes were closely related to eight types of immune infiltration cells. Conclusion: Our study revealed the mechanisms of the carcinogenesis and progression of EC.
Sarcopenic Obesity in Facioscapulohumeral Muscular Dystrophy
Authors: Vera Kathryn , McConville Mary , Kyba Michael , Keller-Ross Manda 
Published: February 2020

Abstract
Background: Sarcopenic obesity has been observed in people with neuromuscular impairment, and is linked to adverse health outcomes.It is unclear, however, if sarcopenia obesity develops in adults with facioscapulohumeral muscular dystrophy (FSHD). Methods: This research was designed to determine if adults with FSHD meet criteria for sarcopenic obesity (appendicular lean mass index (ALMI) scores of <7.26 kg/m2 or 5.45 kg/m2; % body fat of >28% or 40% in men/women). Ten people with FSHD (50±11 years, 2 females) and ten age/sex-matched controls (47±13 years, 2 females) completed one visit, which included a full-body dual-energy x-ray absorptiometry (DXA) scan. Regional and whole body total mass (g), fat mass (FM, (g, %)), and lean mass (LM, (g, %)) were collected; body mass index (BMI, kg/m2) and and sarcopenia measures (appendicular lean mass (sum of arm/leg lean mass, ALM (kg)), ALMI (kg/m2)) were computed. Results: Although total body mass was similar between adults with FSHD and controls (84.5±12.9 vs. 81.8±13.5 kg, respectively; p=0.65), the proportion of mass due to fat was much higher in FSHD, with many individuals having >50% mass due to fat (means: 40.8±7.0 vs. 27.9±7.5%; p=0.001). ALM volume was 23% lower and ALMI was 27% lower in FSHD (p<0.01). Whole body LM trended to be lower in FSHD vs. controls (p=0.05) and arm and leg LM were both lower in FSHD compared with controls (p<0.05). Furthermore, the % LM was 18% lower in FSHD vs. controls (p=0.001). FSHD participants exhibited greater total body FM (p<0.01), total leg fat mass (p<0.001), and but similar total arm fat mass (p=0.09). Conclusions: These data demonstrate that people with FSHD, although similar in total body mass to controls, commonly meet the definition of sarcopenic obesity, with significant consequences for quality of life, and implications for disease management.
Uptake and acceptability of human papillomavirus self-sampling in rural and remote Aboriginal communities: Evaluation of a nurse-led community engagement model
Authors: Dutton Tegan , Marjoram Jo , Burgess Shellie , Campbell Laurinne , Vail Anne , Callan Nichole , Jacob Sunil , Hawkes David , Saville Marion , Bailey Jannine 
Published: February 2020

Abstract
Background Aboriginal women experience disproportionately higher rates of cervical cancer mortality yet are less likely to participate in screening for early detection. This study sought to determine whether a community-based HPV self-sampling service model can effectively recruit never-screened and under-screened Aboriginal women to participate in cervical cancer screening; assess the clinical outcomes; and explore the acceptability of the model from the perspective of the participants. Methods Aboriginal women aged 25-69 years of age were recruited from eight rural and remote communities in New South Wales, Australia to participate in HPV self-sampling via a community-based service model. Outcome measures were: number of women screened by HPV self-sampling, their prior cervical screening status (under-screened or never-screened), clinical outcomes and participation in follow-up pathways of care, and satisfaction with the service model. Results In total, 215 women conducted a HPV self-sampling test and 200 evaluation surveys were completed. One-fifth of participants (n=46) were never-screened and one-third (n=69) were under-screened. Many were unsure of their screening status. Nine women were HPV 16/18 positive and eight had completed all follow up by the conclusion of the study. A further 30 women were HPV other positive of which 14 had completed follow up at the conclusion of the study. Satisfaction with the HPV self-sampling kit, the process of self-sampling and the service model was high (>92% satisfied on all items). Many women had difficulty understanding their official HPV results and placed high importance on the nurse explaining it to them. Conclusions A community-based service model that respects Women’s Business can effectively recruit under-screened and never-screened Aboriginal women to complete cervical cancer screening. Furthermore, this service model supports them to complete recommended follow-up care and engage with their local existing health services.
Cost-Effectiveness Analysis Of Text Messaging To Support Health Advice For Smoking Cessation
Authors: Cobos-Campos Raquel , Mar Javier , Apiñaniz Antxon , de Lafuente Arantza Sáez , Parraza Naiara , Aizpuru Felipe , Orive Gorka 
Published: February 2020

Abstract
Background: Smoking in one of the most serious public health problems. It is well known that it constitutes a major risk factor for chronic diseases and the leading cause of preventable death worldwide.Due to high prevalence of smokers, new cost-effective strategies seeking to increase smoking cessation rates are needed. Methods:We performed a cost-effectiveness analysis comparing two treatments: health advice provided by general practitioners and nurses in primary care, and health advice reinforced by sending motivational text messages to patients’ mobile phones. A Markov model was used in which patients transitioned between three mutually exclusive health states (smoker, former smoker and dead) after 6-month cycles. We calculated the cost-effectiveness ratio associated with the sending of motivational messages throughout a patient’s life. Health care and society perspectives (separately) was adopted. Costs taken into account were direct health care costs and direct health care cost and costsfor lost productivity, respectively.Additionally, deterministic sensitivity analysis was performed modifying the probability of smoking cessation with each option. Results:Sending of text messages as a tool to support health advice was found to be cost-effective as it was associated with increases in costs of €7.4 and €1,327 per QALY gained for men and women respectively from a healthcare perspective, significantly far from the published cost-effectiveness threshold. From a societal perspective, the combined programmed was dominant. Conclusions: Sending text messages is a cost-effective approach. These findings support the implantation of the combined program across primary care health centres.
Genetic testing for the diagnosis and classification of joint hypermobility: a case report of 15 patients
Authors: Zeng Lanlan , Zhang Li , Linpeng Siyuan , Li Zhuo , Liang Desheng , Wu lingqian 
Published: February 2020

Abstract
Background Joint hypermobility (JH) is used to define the capability of a joint moving passively or actively beyond normal limits along physiological axes, which can be influenced by multiple factors (genetic factors, age, gender, weight and training), and the accurate incidence is unclear. In this study, we aimed to identify the genetic cause of JH in 15 patients from seven unrelated Chinese families. Results We identified seven pathogenic/likely-pathogenic variants: two novel mutations, in the COL6A2 and CHST14 genes, and five reported mutations in the COL11A1 , NALCN , GALNS and COL5A1 respectively. Based on the genetic testing, we were able to diagnose the precise condition for each patient: Stickler syndrome in Proband 1, the Ullrich congenital muscular dystrophy in proband 2, CLIFAHDD syndrome in proband 3, Mucopolysaccharidosis IVA in proband 4, Classical Ehlers-Danlos syndrome (EDS) in proband 5, and Musculocontractural EDS in proband 6. Moreover, this is the first time to describe the Musculocontractural EDS caused by CHST14 in China. Though the expression of the mRNA and protein have not significantly changed, we speculated that the mutation of the CHST14 may affect the sulfotransterase activity of the protein. Conclusions The diagnosis in all probands except proband 6 and 7 were corrected following genetic analysis, indicating the importance of the genetic testing in the diagnosis and classification of JH cases. Our findings also offered insight into the genotype-phenotypes relationship and expanded the mutation spectrum of the disease-causing genes in JH.
Association between physical activity and conversion from mild cognitive impairment to dementia
Authors: Kim Yeo Jin , Han Kyung-Do , Baek Min Seok , Cho Hanna , Lyoo Chul Hyoung 
Published: February 2020

Abstract
Background Physical activity has been suggested to prevent the conversion of mild cognitive impairment (MCI) to dementia in patients. We investigated the association between the continuance and regularity of physical activity and the risk of developing dementia in patients with MCI. Methods We analyzed data for 247,149 individuals in the National Health Insurance Service (NHIS) cohort who were enrolled between January 1, 2009 and December 31, 2015. The patients were divided into four groups: those who did not engage in physical activity consistently (Never-PA group), those who initiated physical activity (Initiation-PA group), those who ceased physical activity (Withdrawal-PA group), and those who performed physical activity consistently (Maintenance-PA group). We also divided the patients into two groups: those who engaged in physical activity irregularly (Irregular-PA) and those who undertook physical activity regularly (Regular-PA). Results When the risk for the Never-PA group was set as the benchmark (ref=1), the Maintenance-PA group had the lowest incidence of Alzheimer’s disease (AD) compared to the other groups (HR= 0.82, 95% CI 0.79-0.86). The AD risk of Initiation-PA group (HR = 0.89, 95% CI 0.85-0.93) and Withdrawal-PA group (HR = 1, 95% CI 0.96-1.04) was still lower than the Never-PA group. In addition, compared to the Irregular-PA group, the Regular-PA group had a 15% reduced risk for developing AD. Conclusions Continued regular physical activity in patients with MCI is associated with a protective effect against developing AD. Moreover, ceasing physical activity could halt this protective effect.
Higher Plasma Cystatin C is associated with Mortality after Acute Respiratory Distress Syndrome: Findings from a Fluid and Catheter Treatment Trial (FACTT) Substudy
Authors: Hendrickson Carolyn M. , Kwong Yuenting Diana , Belzer Annika G , Shlipak Michael G , Matthay Michael A , Liu Kathleen Dori 
Published: February 2020

Abstract
Background: Cystatin C is a well validated marker of glomerular filtration rate in chronic kidney disease. Higher plasma concentrations of cystatin C are associated with worse clinical outcomes in heterogenous populations of critically-ill patients and may be superior to creatinine in identifying kidney injury in critically-ill patients. We hypothesized that elevated levels of plasma cystatin C in patients with Acute Respiratory Distress Syndrome (ARDS) would be associated with mortality risk. Methods: In a retrospective study, cystatin C was measured by nephelometry on plasma obtained at enrollment from 919 patients in the Fluid and Catheter Treatment Trial. Multivariable logistic regression was performed testing the association between quartiles of cystatin C and 60-day mortality. Analyses were stratified by Acute kidney injury (AKI) status identified in the first 7 days after enrollment by Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Results: Cystatin C was significantly higher among those patients who died compared to those who survived to 60 days [1.2 (0.9 – 1.9) mg/L vs. 0.8 (0.6 – 1.2) mg/L, p <0.001]. Compared to the lower three quartiles, subjects in the highest quartile of cystatin C had a significantly higher odds of death at 60 days [OR 1.8 (1.2-2.6), p=0.003 in adjusted analyses]; the odds of death incrementally rose in higher cystatin C quartiles compared to the lowest quartile (OR 1.1, 1.8, and 2.5). In adjusted analyses stratified by AKI status, compared to subjects in the lower three quartiles, subjects in the highest quartile of cystatin C with AKI had a significantly higher odds of death at 60 days both in participants with AKI [OR 1.6 (1.0-2.4), p=0.048] and those without AKI [OR 2.4 (1.2-5.0), p=0.017]. In adjusted analyses, there was no significant association between sex-stratified baseline creatinine quartiles and mortality. Conclusions: Higher plasma levels of cystatin C on enrollment were strongly associated with mortality at 60-days in patients with ARDS with and without AKI identified by creatinine-based definitions. Compared to creatinine, cystatin C may be a better biomarker of kidney function in patients with ARDS and therefore identify patients with multiple organ failure at higher risk of death.
The Impact of Interval Training on Cardiorespiratory Fitness, Body Composition, Physical Fitness, and Metabolic Parameters in Older Adults: a Systematic Review and Meta-Analysis
Authors: Wu Zhi-Jian , Wang Zhu-Ying , Gao Hao-En , Zhou Xian-Feng , LI Fang Hui 
Published: February 2020

Abstract
Background: This review and meta-analysis aimed to evaluate the effects of high-intensity interval training (HIIT) on cardiorespiratory fitness, body composition, physical fitness, and health-related outcomes in older adults. Methods: Four electronic databases (PubMed, Scopus, Medline, and Web of Science) were searched (until Oct 2019) for randomized trials comparing the effect of HIIT on physical fitness, metabolic parameters, and cardiorespiratory fitness in older adults. The Cochrane risk of bias assessment tool was used to evaluate the methodological quality of the included studies; Stata 14.0 software was used for statistical analysis.Results: HIIT significantly improved the maximum rate of oxygen consumption (VO 2max ) compared with a moderate-intensity continuous training (MICT) protocol (HIIT vs. MICT: weighted mean difference = 2.04, 95% confidence interval: 1.01-3.07, p < 0.001). Additional subgroup analyses determined that training periods > 12 wks, training frequencies of 2 sessions/wk, session lengths of 40 min, 6 sets and repetitions, training times per repetition of > 60 s, and rest times of < 90 s are more effective for VO 2max . Conclusions:This systematic review and meta-analysis showed that HIIT induces favorable adaptions in cardiorespiratory fitness, physical fitness, muscle power, cardiac contractile function, and citrate synthase activities in older individuals which may help to maintain aerobic fitness and slow down the process of sarcopenia.
A Scoping Review of Pre-hospital Technology to Assist Ambulance Personnel with Patient Diagnosis or Stratification during the Emergency Assessment of Suspected Stroke
Authors: Lumley Hannah Amanda , Flynn Darren , Shaw Lisa , McClelland Graham , Ford Gary A. , White Phil , Price Christopher 
Published: February 2020

Abstract
Background: Pre-hospital identification of key subgroups within the suspected stroke population could reduce delays to emergency treatment. We aimed to identify and describe technology with existing proof of concept for diagnosis or stratification of patients in the pre-hospital setting. Methods: A systematic electronic search of published literature (from 01/01/2000 to 06/06/2019) was conducted in five bibliographic databases. Two reviewers independently assessed eligibility of studies or study protocols describing direct stratification methods (portable imaging/biomarkers) or facilitative technology (telemedicine) used by ambulance personnel during the assessment of suspected stroke. Eligible descriptions involved use of technology during the actual assessment of suspected stroke to provide information directly to ambulance personnel in the prehospital setting. Due to study, intervention and setting heterogeneity there was no attempt at meta-analysis. Results: 2887 articles were screened for eligibility, 19 of which were retained. Blood biomarker studies (n=2) were protocols of prospective diagnostic accuracy studies, one examining purines and the other a panel of known and novel biomarkers for identifying stroke sub-types (versus mimic). No data were available on diagnostic accuracy or patient health outcomes. Portable imaging studies (n=2) reported that an infrared screening device for detecting haemorrhages yielded moderate sensitivity and poor specificity in a small study, whilst a dry-EEG study to detect large vessel occlusion in ischaemic stroke has not yet reported results. Fifteen evaluations of pre-hospital telemedicine were identified (12 observational and 3 controlled comparisons) which all involved transmission of stroke assessment data from the pre-hospital setting to the hospital. Diagnosis was generally comparable with hospital diagnosis and most telemedicine systems reduced time-to-treatment; however, it is unknown whether this time saving translated into more favourable clinical outcomes. Telemedicine systems were deemed acceptable by clinicians. Conclusions: Pre-hospital technologies to stratify suspected stroke into clinically important subgroups may be feasible but insufficient evidence precludes recommendations on their routine use in the pre-hospital setting. Multi-centre diagnostic accuracy studies and clinical utility trials combining promising technologies are warranted. Keywords: Stroke; pre-hospital; stratification; diagnosis; technology; biomarkers; imaging; telemedicine; ambulance; paramedic.
Treatment outcomes and prognostic factors for non- malignancy associated secondary hemophagocytic lymphohistiocytosis in children
Authors: Pan Hua , Wang Gaoyan , Guan Enben , Song Liang , Song Aiqin , Liu Xiaodan , Yi Zhi , Sun Li-rong 
Published: February 2020

Abstract
Background: Secondary hemophagocytic lymphohistiocytosis (HLH) is a rare hyperinflammatory syndrome that requires prompt diagnosis and appropriate treatment. A risk-stratification model that could be used to identify high-risk pediatric patients with HLH who should be considered for second-line therapies, including salvage regimens and allogeneic hematopoietic cell transplantation (HCT), was developed.Methods: The medical records of 88 pediatric patients (median age 1.4 years, range 0.2-15 years) with non-malignancy associated secondary HLH were retrospectively reviewed. Treatment strategies included dexamethasone, etoposide, and cyclosporine. Results:Survival analysis showed patients with Epstein-Barr virus(EBV)-HLH experienced better 5-year overall survival (OS) than patients with HLH due to other infections and unknown causes, autoimmune disease, or immunodeficiency (80% vs. 77%, 65%, 11%, p<0.001). On multivariate analysis, among all patients, non-response at 8 weeks was the most powerful predictor of poor OS. When treatment response was excluded, hemoglobin <60g/L and albumin <25g/L at diagnosis were associated with poor OS. In patients with EBV-HLH, hemoglobin <60g/L at diagnosis was associated with poor OS. A prognostic risk score was established and weighted based on hazard ratios calculated for three parameters measured at diagnosis: hemoglobin <60g/L (2 points), platelets <30x109/L (1 point), albumin < 25g/L (2 points). Five-year OS of low-risk (score 0-1), intermediate-risk (score 2), and poor-risk (score ≥3) patients were 88%, 38%, and 22%, respectively (p<0.001).Conclusions: These findings indicate that clinicians should be aware of predictive factors at diagnosis and consider 8-week treatment response to identify patients with high-risk of disease progression and the need for second-line therapy and allogeneic HCT.