bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Angle of Trunk Rotation in Children With Growth Hormone Deficiency
Authors: Kobylińska Magdalena , Malak Roksana Ewa , Majewska Katarzyna , Samborski Włodzimierz , Kędzia Andrzej 
Published: September 2020

Abstract
Background. Growth hormone plays a vital role in the human body. Its deficiency can lead to numerous disorders, including musculoskeletal system defects. Treatment with recombinant human growth hormone (rhGH) in children suffering from growth hormone deficiency (GHD) increases muscle mass and improves bone structure.Aim. The purpose of this study was to evaluate the angle of trunk rotation (ATR) in patients diagnosed with GHD treated with rhGH and to observe the incidence of scoliosis.Material and Methods. The study was conducted among 50 children diagnosed with GHD. The group consisted of 11 girls and 39 boys aged 6-16. The study group included 50 children: 10 children just qualified for rhGH treatment and 40 patients undergoing this treatment, with different therapy duration. ATR was measured using a Bunnell scoliometer on five levels of the spine: cervical 7 / thoracic 1, thoracic 6, thoracic 12 / lumbar 1, lumbar 3, lumbar 5 / sacral 1.Results. The most numerous asymmetries among the examined group were in the thoracolumbar segment and at the thoracic 6 level. Girls had greater asymmetries compared to boys especially at thoraco – lumbar and lumbar 3 level. There were no statistically significant differences in ATR at any level comparing patients before hormonal treatment and patients undergoing rhGH treatment. The age of the beginning of the therapy, the duration of rhGH therapy, and body mass index (BMI) also had no effect on ATR. Sport activities had a positive impact on the results obtained by scoliometer assessment.Conclusions. The angle of trunk rotation is higher in growth hormone-deficient females than in males. Weight, height, BMI, the time of growth hormone therapy beginning and the duration of this therapy do not influence ATR. The more sport activities, the lower value of the angle of trunk rotation, especially in male patients. Obtained results support the thesis, that treatment with recombinant human growth hormone does not increase the incidence of scoliosis.
Novel Strategy for Isolation of Mice Bone Marrow –Derived Endothelial Cells (BMECs)
Authors: Smith Alhaji Osman , Adzraku Seyram Yao , Ju Wen , Qiao Jianlin , Xu Kailin , Zeng Lingyu 
Published: September 2020

Abstract
Background: In the bone marrow microenvironment, endothelial cells (ECs) are individual cells that form part of the sinusoidal blood vessels called "bone marrow endothelial niche." They account for less than two percent of the bone marrow cells. They may play critical functions in generating growth and inhibitory factors that promote the recovery of the hematopoietic stem cells. Methods: Two steps approach for isolation of bone marrow endothelial cells from mice. In brief, the bone marrow extracted from the mice long bones and culture overnight with DMEM supplemented with 20% FBS and antibiotics. The floating cells discarded, and the adhered section detaches with accutase and bone marrow endothelial cells selected using CD31 microbeads. The isolated bone marrow endothelial cells were cultured in dish pre-coated with rat-tail collagen type 1 with endothelial growth factor media. The cells were verified by confocal microscopy for morphology and tube formation by matrigel assay. We validate the purity of the cells by flow cytometry, RT-qPCR, immunofluorescence staining, and immunoblotting. Finally, we induced the bone marrow endothelial cells with recombinant tumor necrosis factor-alpha.Results: Our findings prove that the cell isolated are characteristic of bone marrow endothelial cells and response to tumor necrosis factor-alpha by an increase in proliferation and enhance the expression of adhesion molecules.Conclusions: This method simplifies the extraction of primary bone marrow endothelial cells for in vitro studies. The significance of this method will provide an excellent opportunity for stem cell research of endothelial cells function and dysregulation in vitro studies of mice model.
Prevalence and Risk Factors of Metabolic-Associated Fatty Liver Disease in School-Age Children and Adolescents in Shenyang, China
Authors: Lin Guan , Xinhe Zhang , Haoyu Tian , Xing Jin , Dan Li , Ningning Wang , Jing Sun , Wang Xue , Zilu Zeng , Li Yiling 
Published: September 2020

Abstract
Background: Metabolic-associated fatty liver disease (MAFLD) refers to abnormal accumulation of fat in the liver for metabolic dysfunction. With modern socioeconomic conditions and changes in dietary patterns, the prevalence of MAFLD is increasing, to the detrimental of children’s learning and quality of life. We investigated the prevalence and influencing factors of metabolic-associated fatty liver disease (MAFLD) in school-aged children and adolescents in Shenyang, China. Methods: In 2019, we collected demographic, anthropometric and liver health assessments from a random sample of Shenyang’ s school-aged children (7-12 years old) and adolescents (13-18 years old). Experienced hepatologists used transient elastography to diagnose the presence of fatty liver in the students. A random subsample was selected to complete a questionnaire to explore the impact of lifestyle habits on fatty liver disease.Results: The overall prevalence of MAFLD in these students was 23.83%, with a non-significant difference between children (22.73%) and adolescents (24.43%). The prevalence of MAFLD was significantly higher among boys than among girls. Compared with non-overweight students, a significantly higher proportion of the overweight group had fatty liver. Moreover, questionnaire responses on exercise habits, normal diet, and parental factors were associated with fatty liver.Conclusions: MAFLD is very prevalent in children and adolescents in Shenyang city. Due to the close relationship between MAFLD and obesity, lifestyle plays a major role in the occurrence of MAFLD.Trial registration: the First Affiliated Hospital of China Medical University, [2020]2020-258-2. Registered 6 June 2020 - Retrospectively registered.
Correlations Between&nbsp;Morphine Use and Adverse Outcomes in Acute ST-Segment Elevation Myocardial Infarction with Acute Heart Failure: A Retrospective Study
Authors: lin yaowang , yuan jie , zhu yong , Liu Huadong , pang xinli , Dong Shaohong 
Published: September 2020

Abstract
Background: The available data regarding the safety of morphine use in cases of STEMI with AHF (Killip ≥2) remain insufficient. The aim of the study was to further examine the safety of intravenous morphine in patients with STEMI and AHF over 1 year of follow-up after primary percutaneous coronary intervention (PPCI).Methods: 275 consecutive patients with STEMI and AHF were included and divided into groups that did or did not receive in-hospital intravenous morphine. Endpoints included major adverse cardiovascular events (MACEs) and the need for invasive mechanical ventilation during hospitalization and 1 year of follow-up. Results: The in-hospital occurrences of cardiac death and cardiogenic shock were much higher in patients who received morphine than that those who did not (15.20% vs 6.67%, p=0.035; odds ratio [OR]=2.509, 95% confidence interval [CI] 1.121–5.620, and 14.40% vs 6.00%, p=0.033; OR=2.636, 95% CI 1.139-6.097, respectively). Additionally, more patients in the group treated with morphine experienced the secondary outcome of in-hospital invasive mechanical ventilation compared with the group not treated with morphine (19.20% vs 10.67%, p=0.031; OR=2.308, 95% CI 1.138–4.684). However, no difference between-group differences were observed for the incidence of MACEs, cardiac death, or all-cause death over 1 year of follow-up.Conclusions: Intravenous morphine administration is highly correlated with in-hospital MACEs and the need for additional invasive mechanical ventilation in STEMI patients with AHF after PPCI, but not for long-time adverse outcomes.
Contextual Factors and Mechanisms that Influence Sustainability: A Realist Evaluation of Two Provincially Scaled Evidence-Based Initiatives
Authors: Flynn Rachel , Mrklas Kelly , Campbell Alyson , Wasylak Tracy , Scott Shannon D 
Published: September 2020

Abstract
Background: In 2012, Alberta Health Services created Strategic Clinical NetworksTM (SCNs) to develop and implement evidence-informed, clinician-led and team-delivered health system improvement in Alberta, Canada. SCNs have had several provincial successes in improving health outcomes. Little research has been done on the sustainability of these efforts. Methods: We conducted a qualitative realist evaluation using a case study approach to identify and explain the contextual factors and mechanisms perceived to influence the sustainability of two provincial SCN initiatives. The context (C) + mechanism (M) = outcome (O) configurations (CMOcs) heuristic guided our research. Results: We conducted thirty realist interviews in two cases and found four important mechanisms facilitating sustainability: the use of a collaborative approach audit & feedback, the informal leadership role, and patient stories. Informal leaders were often hands-on and influential to front-line staff. Learning collaboratives broke down professional and organizational silos and encouraged collective sharing and learning, motivating participants to continue with the initiative. Continual audit-feedback interventions motivated participants to want to perform and improve on a long-term basis, increasing the likelihood of initiative sustainability. Patient stories demonstrated the initiatives’ impact on patient outcomes, motivating staff to want to continue doing the initiative, and increasing the likelihood of its sustainability. Conclusions: There are important contextual factors and mechanisms within sustainment processes that may apply to systems change implementers. Our research revealed the causal relationship between implementation and sustainability and how outcomes from implementation shape sustainability contexts. Future work is needed to evaluate the effectiveness of informal leadership, learning collaboratives, audit-feedback, and patient stories as sustainability interventions, to generate better guidance on planning sustainable improvements with long term impact.
Vitamin D Deficiency is Associated With Higher Level of High Sensitivity C-reactive Protein (Hs-crp) in Patients Undergoing Elective Coronary Stenting
Authors: foroughinia farzaneh , Mottaghi Shaghayegh , Alimardani Mohammad Reza 
Published: September 2020

Abstract
Background: Vitamin D deficiency, a prevalent worldwide concern, has been reported to have a pivotal role in many cardiovascular and inflammatory diseases. Percutaneous coronary intervention (PCI) is a therapeutic approach that may have several short-term and long-term cardiovascular complications, supposing to be mediated with high sensitive C-reactive protein (hs-CRP), an inflammatory marker. This study aimed to investigate the association between vitamin D status and hs-CRP level, as a prognostic marker, in patients undergoing elective PCI. Methods: The study population comprised of 150 patients who underwent elective coronary angioplasty. In order to measure vitamin D and hs-CRP levels, venous blood samples were obtained at baseline and 24 hours after PCI. Results: Our results showed a significant inverse relationship between post-PCI hs-CRP and also pre-post hs-CRP difference levels and vitamin D status. Conclusion: Hs-CRP content is higher in vitamin D deficient patients. Therefore, these patients, especially severely-deficient ones (25(OH)D<10ng/ml), may benefit from supplementation with vitamin D prior to PCI.
Novel Germline Mutation in BCAR1 in Two Siblings With Lung Cancer: a Possible Susceptibility Gene
Authors: Kuikui Zhu , Yangchao Zhao , Lu Wu , Sijia Zhang , Yan Zong , Zhenyu Li , Qianwen Li , Fang Cheng , Meng Rui 
Published: September 2020

Abstract
Background: Lung cancer is the most prevalent malignancy worldwide. Most patients were sporadic and carried somatic mutations in hotspot genes. At present, accumulating researches had identified several germline mutations that predispose patients to lung cancer. In this report, two siblings were diagnosed as lung squamous cell carcinoma and lung adenocarcinoma, respectively. Results: The two siblings shared similar features of a germline insertion of 11 bp (GCCCTGGCATT) in BCAR1 producing a frameshift at codon 314 which is located at the substrate domain. The BCAR1 was previously demonstrated to be associated with lung cancer. The variant detected in this report would impair the regulation and functions of BRCA1 in some extent, thus may promote lung cancer tumorigenesis. Our findings suggest that BCAR1 is a possible susceptibility gene for lung cancer, and its functional analyses in lung cancer need further investigation.Conclusions: In this study, we first reported a novel causative mechanism of Lung cancer: an insertion of 11 bp in BCAR1 gene, which can be helpful in the genetic diagnosis of this disease.
Identification of Hub Genes and Key Pathways of Paraquat Induced Human&nbsp;Embryonic&nbsp;Pulmonary Fibrosis by Bioinformatics Analysis and&nbsp;Vitro Experiments
Authors: Fu Yue , Zeng Xiang Xia , Hu Jin Lun , Yan Mei , Xie CHun Ming , XU Wei Gan , Gu Zi Cong 
Published: September 2020

Abstract
Background: Paraquat is highly toxic pesticide, which usually led to acute lung injury and subsequently develop pulmonary fibrosis, the exact mechanisms of PQ-induced lung fibrosis remain largely unclear and no specific drugs for this disease have been approved. Methods: Our study aimed to identify its potential mechanism though modeling study in vitro and bioinformatics analysis. Gene expression datasets associated with PQ-induced lung fibrosis were obtained from the Gene Expression Omnibus and differentially expressed genes (DEGs) were identified using GEO2R. Functional enrichment analyses were performed using the Database for Annotation. Results: The DEGs in the two datasets, of which 92 overlapping genes were found in two microarray datasets. Functional analysis demonstrated that the 92 DEGs were enriched in the ‘TNF signaling pathway’, ‘CXCR chemokine receptor binding’, and ‘core promoter binding’. Moreover, nine hub genes were identified from a protein‑protein interaction network. Conclusions: This integrative analysis firstly identified candidate genes and pathways in PQ-induced lung fibrosis, as well as benefit to research novel approaches for treating for control of PQ-induced pulmonary fibrosis.
A Precursor to HPV-Independent VSCC&nbsp;: Differentiated Exophytic Vulvar Intraepithelial Lesion -&nbsp;A Case Report
Authors: Zheng Weiping , Li Minhua 
Published: September 2020

Abstract
Background: Vulvar cancer is a relatively rare gynecologic malignant disease. The majority of these tumors are vulvar squamous cell carcinoma (VSCC). There are two distinct aetiopathogenic pathways leading to VSCC: human papillomavirus (HPV)-dependent and HPV-independent. The precursor lesions of HPV-independent VSCC include differentiated vulvar intraepithelial neoplasia(VIN), vulvar acanthosis with altered differentiation(VAAD) and differentiated exophytic vulvar intraepithelial lesion(DE-VIL) . To date, the report of DE-VIL has not been found after this term was proposed in 2017. So it usually has been under-recognised by pathologists in the past owing to the incidence of DE-VIL is relatively small.Case presentation: Here, we report a typical case of DE-VIL, which exhibits the absence of HPV infection and mutations in TP53. Interesting, a small lesion showed similar morphologic feature to HSIL nearby the lesion of DE-VIL.However, it showed same immunochemical patterns with DE-VIL. To date, no other study has reported this phenomenon. Whether it is a rare subtype of DE-VIL or only a accompanying status is still unclear.Conclusions: As the precursor lesions of HPV-independent VSCC, DE-VIL was too difficult to diagnosis due to the lack of sufficient evidence. Therefore, we should pay more and more attention for DE-VIL.
Pleiotropic Effects of Pure Statin May Provide More Cardiac Benefits than Ezetimibe-Statin in a Comparable Intensity for Type 2 Diabetes Mellitus Patients with Extremely Atherosclerotic Cardiovascular Disease Risks
Authors: Kao Yu-Cheng , Chen Tien-Hsing , Liu Chi-Hung , Hwang Jawl-Shan , Hsiao Ching-Chung , Lin Yu-Sheng , Mao Chun-Tai , Hung Ming-Jui , Li Yan-Rong 
Published: September 2020

Abstract
Background: Atorvastatin 40mg (ATOR 40) and ezetimibe 10mg/simvastatin 20mg (EZ-SIM 20) have comparable reductions of low-density lipoprotein cholesterol (LDL-C) but cardiovascular (CV) outcomes between these two therapies are unclear. Our real-world cohort study is to test the hypothesis of pleiotropic effects of purely higher dose statin on CV outcomes beyond comparable reductions of LDL-C, especially for extremely CV risk patients.Methods: Between January 1, 2007 and December 31, 2013, a total of 3372 patients with type 2 diabetes mellitus (T2DM) admitted due to acute coronary syndrome (ACS) or acute ischemic stroke (AIS) were selected as the study cohort from the Taiwan National Health Insurance Research Database. Clinical outcomes were evaluated by ATOR 40 group (n=1686) matched with EZ-SIM 20 group (n=1686). Primary composite outcome includes CV death, non-fatal myocardial infarction, and non-fatal stroke. Secondary composite outcome includes hospitalization for unstable angina (HUA), percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG).Results: With a mean follow-up of 2.4 years, no significant difference of primary composite outcome was observed between ATOR 40 and EZ-SIM 20 groups (subdistribution hazard ratio [SHR], 1.09; 95% confidence interval [CI], 0.95–1.25). Nevertheless, ATOR 40 group had lower risks of HUA (SHR, 0.50; 95% CI, 0.35–0.72), PCI (SHR, 0.82; 95% CI, 0.69–0.97) and CABG (SHR, 0.62; 95% CI, 0.40–0.97) than EZ-SIM 20 group.Conclusions: For T2DM patients after ACS or AIS, ATOR 40 may have lower risks of HUA, PCI and CABG than EZ-SIM 20.
C-terminal domain small phosphatase 1 (CTDSP1) regulates growth factor expression and axonal regeneration
Authors: Gervasi Noreen M , Dimitchev Alexander , Clark Desraj M. , Dingle Marvin , Pisarchik Alexander V. , Nesti Leon J. 
Published: September 2020

Abstract
Background: Peripheral Nerve Injury (PNI) represents a major clinical and economic burden. Despite the ability of peripheral neurons to regenerate their axons after an injury, patients are often left with motor and/or sensory disability and may develop chronic pain. Successful regeneration and target organ reinnervation require comprehensive transcriptional changes in both injured neurons and support cells located at the site of injury. The expression of most of the genes required for axon growth and guidance and for synapsis formation is repressed by a single master transcriptional regulator, the Repressor Element 1 Silencing Transcription factor (REST). Sustained increase of REST levels after injury inhibits axon regeneration and leads to chronic pain. REST is stabilized by the Carboxy-terminal domain small phosphatase 1 (CTDSP1), which prevents REST targeting to the proteasome. Here, we explore whether knockdown of CTDSP1 promotes neurotrophic factor expression in mesenchymal progenitor cells (MPCs), a type of support cells that can be harvested from the site of injury during surgical debridement, and in dorsal root ganglion (DRG) neurons. In addition, we explore whether CTDSP1 knockdown supports DRG neurite regeneration. Methods: Cultured human MPCs or rat DRG neurons were transfected with REST or CTDSP1 specific siRNA. Neurotrophic factor expression was analyzed by RT-qPCR and Western Blot. Brain-derived Neurotrophic Factor (BDNF) in cell culture medium was quantified by ELISA. Axon regeneration was quantified measuring the length of the longest neurite of a neuron. Results: Knockdown of REST or CTDSP1 in MPCs results in increased expression of BDNF and nerve growth factor (NGF). In addition, knockdown of CTDSP1 leads to increased release of BDNF in cell culture medium from MPCs and to reduced levels of REST protein. Finally, knockdown of CTDSP1 in DRG neurons results in increased levels of BDNF and increased DRG neurite growth rate.Conclusions: CTDSP1 knockdown promotes neurotrophic factor expression in both DRG neurons and the support cells MPCs. In addition, it promotes DRG neuron regeneration. Therapeutics targeting CTDSP1 activity may represent a novel epigenetic strategy to promote peripheral nerve regeneration after PNI by promoting the regenerative program repressed by injury-induced increased levels of REST in both neurons and support cells.
Emergency Department Management Metrics for Severe Pediatric Traumatic Brain Injury
Authors: Liu Maple Bohan , Holt Tanya , Hansen Gregory 
Published: September 2020

Abstract
Background: As the majority of severe pediatric traumatic brain injuries (TBI) are received and managed in the emergency department (ED), the ED trauma center is vital to optimizing management. This study aimed to evaluate current management guidelines, and to recognize other high-risk components of TBI management. Methods: A retrospective chart review was conducted solely at the Jim Pattison Children’s Hospital in Saskatoon, Canada. Data pertaining to emergency department metrics included transport to trauma center, injury severity, indicators for raised intracranial pressure, airway and breathing, circulation, disability/central nervous system, complications, and outcome scores. Results: A total of 56 charts were included in the study population. Mean age of patient population was 14.3 years of age, with 76% being male. Thirty four percent of patients received a blood gas within 15 minutes of admission, and 20% received intervention to correct PCO2. Of the seven patients who received hyperosmolar therapy, three were based on computed tomography (CT) findings and four were based clinically. For 95% of patients, the position of the bed was not documented, and just 4% of patients had head of bed elevated to 30 degrees. Sixty four percent of patients were accompanied by a physician with airway expertise during CT. Conclusions: Building on current TBI guidelines, timeliness of PCO2 retrieval and improvements for targeted hyperosmolar therapy were noted. Two other potential areas for improving management included deliberate considerations for head of bed positioning and personnel accompanying patients undergoing CT.