bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality of life of children with spinal muscular atrophy and their caregivers from the perspective of caregivers : a Chinese cross-sectional study
Authors: Yao Mei , Ma Ying , Qian Ruiying , Xia Yu , Yuan Changzheng , Bai Guannan , Mao Shanshan 
Published: October 2020

Abstract
Background: Spinal muscular atrophy (SMA) is an autosomal-recessive motor neuron disease leading to dysfunction of multiple organs. SMA can impair the quality of life (QoL) of patients and family. We aimed to evaluate the QoL of children with SMA and their caregivers and to identify the factors associated with QoL in a cross-sectional study conducted in China.Methods: We recruited 101 children aged 0-17 years with SMA and their caregivers from a children’s hospital in China. Twenty-six children had type I SMA, 56 type II and 19 type III. Each child’s QoL was measured by the Pediatric Quality of Life Inventory 3.0 Neuromuscular Module (PedsQL NMM), which was completed by the child’s caregivers. The caregiver’s QoL was measured by the Pediatric Quality of Life Inventory Family Impact Module (PedsQL FIM). Information on sociodemographic characteristics, disease-specific characteristics, and treatments were collected using the proxy-reported questionnaire. Two-sample t-tests and one-way ANOVA were used to compare differences in average scores of QoL across subgroups.Results: Children with type III SMA had a higher average Total score of PedsQL NMM and higher average scores in domains Neuromuscular disease and Family resources than children with type I or type II SMA (p < 0.001). Caregivers of children with type III SMA reported higher average scores in the domains of Physical, Emotional, Social, and Cognitive functioning of the PedsQL FIM than those of children with types I or II SMA (p < 0.05). In addition, disease-related characteristics (e.g. limited mobility, motor degeneration, skeleton deformity, and digestive system dysfunction) and respiratory support were associated with lower average scores of PedsQL NMM and PedsQL FIM (p < 0.05). Exercise training, multidisciplinary team management and use of the medication Nusinersen were each associated with higher average scores in both PedsQL NMM and FIM (p < 0.05).Conclusion: Our study has demonstrated factors that may impair or improve QoL of children patients with SMA and their parents. Particularly, QoL was relatively poor in children with type I and type II SMA as well as in their caregivers compared to those with type III SMA. We strongly recommend that standard of care in a multidisciplinary team (MDT) be strengthened to improve the QoL of SMA patients. Our study called for increased attention from clinical physicians on measuring QoL in their clinical practices in order to enhance the understanding of impacts of SMA and to make better decisions regarding treatment.
Scar quality examination comparing titanium coated suture material and non-coated suture material on flap donor sites in reconstructive surgery
Authors: Berninghausen Laura Katharina , Osterhoff Georg , Langer Stefan , Kohler Lukas Herbert 
Published: October 2020

Abstract
Background Wound healing and scar quality after trauma are subject to impairment through excessive wound healing, chronic wound or even surgical site infections. Optimizing the process of scar formation and skin healing is crucial in virtually all fields of medicine. In this regard, we tested the possible usage and advantages of titanium coated suture material.METHODS We performed a prospective observational cohort study including 30 patients who underwent soft tissue reconstruction. One half of the donor flap site was sutured with titanium coated suture material, while the other half was closed with non-coated sutures. Scar quality of the donor flap site was assessed by photographs and POSAS scores on days 2-5, 14, 42, 72 and 180 postoperatively. RESULTS No difference between the titanium coated sutures and non-coated sutures was seen in the POSAS assessment, neither for the patient scale at 14, 42, 72 and 180 days, nor for the observer scale on the same dates. Comorbidities like diabetes, chronic renal failure and smoking as well as the BMI of each patient affected the wound healing process to an equal degree on both sides of the suture. CONCLUSIONSNo difference between the titanium coated and non-titanium-coated suture material was seen in the POSAS assessment in regard to scar quality and wound healing. The titanium-coated suture material can be considered to be equally as effective and safe in all qualities as the non-titanium-coated suture material, even in patients with comorbidities. Clinical Trial RegisterThis study is registered at the German Clinical Trials Register (DRKS) under the registration number DRKS00021767. (https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00021767)
Relationship between blood Lead status and anemia in Ugandan children with malaria infection
Authors: Mukisa Ambrose K , Kasozi Denis M , Aguttu Claire , Vuzi Peter C. , Kyambadde Joseph 
Published: October 2020

Abstract
Background In Uganda, childhood anemia remains a health challenge and is associated with malaria infection as well as iron deficiency. Iron deficiency is intertwined with nutritional status, age and other comorbidities including helminths and Lead toxicity. Environmental Lead levels accounts for one’s blood Lead (BL) levels. Blood Lead competitively blocks iron absorption, inhibits hemoglobin (Hb) biosynthesis and elevates free erythrocyte protoporphyrin (FEP) levels. Lead toxicity’s contribution towards anemia pathogenesis, especially during malaria infection has not been studied. Concomitant exposure to both malaria infection and Lead pollution, exacerbates the anemia status. This study therefore aimed at expounding the anemia status of these Ugandan children aged under 5years who are exposed to both malaria infection and environmental Lead pollution. Methods Briefly, venous blood samples from 198 children were microscopically assayed for malaria parasite density (PD), and hemoglobin (Hb) concentrations using the cyanmethemoglobin method, while BL and FEP levels were determined by the standard atomic absorption spectrophotometric and fluorometric methods respectively. Results One hundred and fifty-one (76.3%) of the children analyzed had moderate anemia (Hb <10>5 g/dL) with Means of BLL=8.6 µg/dL, Hb =7.5 g/dL, FEP/Hb =8.3 µg/g and PD =3.21×103 parasites / µL, while eight (4%) were severely anemic (<5 g/dL). Regression analysis and statistical correlation between PD and Hb (r = -0.231, R2= 0.15 P-value < 0.001) was negative and weak as compared to that between FEP/Hb and Hb (r = -0.6, R2=0.572 P-value=0.001). Conclusion Based on the study’s findings, we conclude that BL significantly contributes to the pathogenesis of anemia and therefore its co-existence with malaria infection in the host exacerbates the anemia status.Trial registration Not applicable
Gut Microbiota: Effect of Pubertal Status
Authors: Yuan Xin , Chen Ruimin , Zhang Ying , Lin Xiangquan , Yang Xiaohong 
Published: October 2020

Abstract
Background: The make-up of gut microbiota at different puberty stages has not been reported. This cross-sectional study analyzed the bio-diversity of gut microbiota at different puberty stages. Result: The subjects (aged 5-15 years) were divided into non-pubertal (n=42, male%: 66.7%) or pubertal groups (n=47, male%:44.68); in both groups, Firmicutes, Bacteroidetes and Proteobacteria were the dominant phylum. There was no difference of alpha- and beta-diversity among disparate puberty stages. Non-pubertal subjects had members of the order Clostridiales, family Clostridiaceae, genus Coprobacillus which were significantly more prevalent than puberty subjects. Also, the pubertal subjects had members of class Betaproteobacteria, order Burkholderiales which were significantly more prevalent than the non-pubertal subjects. Their relative abundance was independent of BMI-Z. In the pubertal subjects, the abundance of genus Adlercreutzia, Ruminococcus, Dorea, Clostridium and Parabacteroides was associated with the level of testosterone.Conclusions: This is the first report of the diversity of gut microbiota at different puberty stages. The various species of gut microbiota changed gradually associated with puberty stages. Differences in gut microflora at different pubertal status may be related to androgen levels.
MiRNA-340-5p mediates the functional and infiltrative promotion of tumor-infiltrating CD8+ T lymphocytes in human diffuse large B cell lymphoma
Authors: Xu Yangyang , Liu Zhenchuan , Lv Lixin , Li Ping , Xiu Bing , Qian Wenbin , Liang Aibin 
Published: October 2020

Abstract
Background: CD8+ tumor-infiltrating T lymphocytes (T-TILs) in the tumor microenvironment (TME) play an important role in tumor development, and miRNAs regulate tumor cell interactions with the microenvironment. T-TIL-based tumor immunotherapy provides a promising treatment strategy in diffuse large B-cell lymphoma (DLBCL). MiRNAs tend to be attractive targets for novel antitumor interventions. Methods: Weighted gene coexpression network analysis (WGCNA), CIBERSORT analysis and Cox regression analysis were used to identify CD8+ T-TIL-related miRNAs. RT-PCR, western blotting, immunohistochemistry (IHC), in situ hybridization (ISH), luciferase reporter assay, coimmunoprecipitation and ubiquitination analyses were used to detect miRNA, mRNA and protein expression and their combination. The viability and function of CD8+ T cells after stimulation were evaluated by enzyme-linked immunosorbent assay (ELISA), cytotoxicity assay, functional avidity assessment, flow cytometry and Cell Counting Kit-8 (CCK-8) assay. DLBCL cell lines, primary cells and a murine xenograft model established with A20 cell injection were used as in vitro and in vivo experimental models. Results: MiR-340-5p was positively correlated with CD8+ T-TILs in DLBCL patients, and KMT5A was a direct target gene of miR-340-5p. CD8+ T-cell function was significantly enhanced by miR-340-5p mimics both in vitro and in vivo, which was reversed by KMT5A overexpression. We demonstrated that COP1/CD73 was involved in the downstream mechanism of the miR-340-5p/KMT5A axis involving ubiquitination. In vivo, we validated an improved CD8+ T-TIL infiltration rate and tumor suppression with miR-340-5p treatment. Furthermore, miR-340-5p directly regulated the biological activity of DLBCL cells without CD8+ T-cell participation. Conclusions: MiR-340-5p promoted CD8+ T-TIL infiltration and antitumor function by regulating KMT5A and COP1 and further activating CD73 ubiquitination. MiR-340-5p is potentially a novel target for DLBCL immunotherapy.
Baseline assessment of antibiotics prescribing for acute, non-complicated infections in primary care in Germany in the cluster randomized trial ARena
Authors: Poss-Doering Regina , Weber Dorothea , Kamradt Martina , Andres Edith , Kaufmann-Kolle Petra , Szecsenyi Joachim 
Published: October 2020

Abstract
Background Antimicrobial resistance is fueled by inappropriate prescribing and use of antibiotics. Global and national strategies support rational and adequate use of antibiotics to retain treatment options and fight resistances. In Germany, the ARena project (Sustainable reduction of antibiotic-induced antimicrobial resistance) was intended to promote the rational and appropriate use of antibiotics for acute non-complicated infections by addressing physicians, care teams and patients through multiple interacting interventions. This paper presents patterns of antibiotics prescribing for patients with acute non-complicated infections in participating primary care networks prior to the start of the ARena project, explores variation across subgroups of patients and draws comparisons to reference groups which represent standard care. Methods In mixed logistic regression models, we explored factors associated with the primary outcome defined as the proportion of patients with acute non-complicated infections consulting primary care practices who received an antibiotic prescription. Secondary outcomes concerned the prescription of different types of antibiotics. Descriptive methods were used to summarize the data referring to primary care networks, reference groups, and subgroups. Results Across all observed cases, antibiotic prescription rates were 31.7% in reference groups and 32.0% in primary care networks. Being the largest group of physicians observed, General practitioners prescribed antibiotics more frequently than other medical specialist groups (otolaryngologists vs. General practitioners OR=0.465 CI=[0.302; 0.719], p<0.001, pediatricians vs. General practitioners: OR=0.369 CI=[0.135; 1.011], p=0.053). Quinolone prescription rates were moderate (8.1% in reference groups and 9.9% in primary care networks). Patients with comorbidities had a higher likelihood of receiving an antibiotic and quinolone prescription and were less likely to receive a recommended substance. Younger patients were less likely to receive antibiotics (OR=0.771 CI=[0.636; 0.933], p=0.008). Female gender was associated with higher rates of antibiotic prescriptions compared to males (OR=1.293 CI=[1.201, 1.392], p<0.001).Conclusion Prior to the ARena project, observed antibiotic prescription rates for acute non-complicated infections were moderate, but there was still room for improvement. The use of recommended substances was low which indicates a need for creating stronger awareness of guideline-conform use of antibiotics.
The Patient, Investigator, Nurse, Carer Questionnaire (PINC-Q): A cross-sectional, retrospective, non-interventional study exploring the impact of less frequent medication administration with paliperidone palmitate 3-monthly as maintenance treatment for schizophrenia
Authors: Pungor Katalin , Sanchez Pedro , Pappa Sofia , Attal Jerome , Leopold Karolina , Steegen Geertie , Vita Antonio , Marsella Carol , Verrijcken Caroline , Lahaye Marjolein , Wooller Annette 
Published: October 2020

Abstract
Background: To understand the implications of switching from paliperidone palmitate 1-monthly (PP1M) to paliperidone palmitate 3-monthly (PP3M) treatment of schizophrenia from the perspective of four key stakeholders: patients, physicians, nurses and carers. Methods: PINC-Q was a cross-sectional, retrospective, non-interventional study comprising a one-time questionnaire for adult patients (aged ≥18 years) with schizophrenia (International Classification of Diseases; ICD-10) and their physician, nurse and carer. Questionnaires were developed in association with patient and carer advocacy groups (GAMIAN and EUFAMI) and following an advisory board formed of psychiatrists and nurses. The degree of alignment between stakeholders was also examined. Results: Responses were received from a total of 224 evaluable patients. For most patients (88.4%), responses were received from at least two other stakeholders. Patients were moderately ill with mild-to-moderate lack of insight and had received PP1M for a mean (standard deviation [SD]) of 23.9 (21.28) months before switching to PP3M (duration mean [SD] 12.8 [3.72] months). The most frequently reported reasons to switch from PP1M to PP3M were ‘to live life as normally as possible’ and ‘patient convenience’. Over 79% of responses within each stakeholder group stated that PP3M helped the patients, with increased patient activity and social involvement, improved frequency and quality of physician–patient and nurse–patient communication and decreased perceived stigma. Conclusions: The results of the PINC-Q study add to the increasing body of evidence supporting the benefits of PP3M in a population of patients with schizophrenia representative of real-world clinical practice.
Multiple waves of freshwater colonization of the three-spined stickleback in the Japanese Archipelago
Authors: Kakioka Ryo , Mori Seiichi , Kokita Tomoyuki , Hosoki Takuya K , Nagano Atsushi J , Ishikawa Asano , Kume Manabu , Toyoda Atsushi , Kitano Jun 
Published: October 2020

Abstract
Background: The three-spined stickleback (Gasterosteus aculeatus) is a remarkable system to study the genetic mechanisms underlying parallel evolution during the transition from marine to freshwater habitats. Although the majority of previous studies on the parallel evolution of sticklebacks have mainly focused on postglacial freshwater populations in the Pacific Northwest of North America and northern Europe, we recently use Japanese stickleback populations for investigating shared and unique features of adaptation and speciation between geographically distant populations. However, we currently lack a comprehensive phylogeny of the Japanese three-spined sticklebacks, despite the fact that a good phylogeny is essential for any evolutionary and ecological studies. Here, we conducted a phylogenomic analysis of the three-spined stickleback in the Japanese Archipelago.Results: We found that freshwater colonization occurred in multiple waves, each of which may reflect different interglacial isolations. Some of the oldest freshwater populations from the central regions of the mainland of Japan (hariyo populations) were estimated to colonize freshwater approximately 170,000 years ago. The next wave of colonization likely occurred approximately 100,000 years ago. The inferred origins of several human-introduced populations showed that introduction occurred mainly from nearby habitats. We also found a new habitat of the three-spined stickleback sympatric with the Japan Sea stickleback (Gasterosteus nipponicus).Conclusions: These Japanese stickleback systems differ from those in the Pacific Northwest of North America and northern Europe in terms of divergence time and history. Stickleback populations in the Japanese Archipelago offer valuable opportunities to study diverse evolutionary processes in historical and contemporary timescales.
Patients with Pretreatment Leukoencephalopathy and Older Patients have More Cognitive Decline after Whole Brain Radiotherapy
Authors: Chan Matthew , Ferguson David , Mhurchu Elaine Ni , Yuan Ren , Gondara Lovedeep , McKenzie Michael , Olson Robert , Thiessen Brian , Lalani Nafisha , Ma Roy , Nichol Alan 
Published: October 2020

Abstract
Purpose: To investigate predictors of cognitive decline after whole brain radiotherapy (WBRT) for brain metastases. Methods: A secondary analysis of a phase 2 clinical trial was conducted in patients who received stereotactic radiosurgery for 1-10 brain metastases and WBRT (NCT01046123). The Montreal Cognitive Assessment (MoCA) was performed at baseline and every three months after WBRT. Baseline T2-weighted fluid attenuation inversion recovery magnetic resonance imaging was independently assessed by two neuroradiologists for the presence of white matter hyperintensities (WMH) using the Fazekas visual rating scale. WMH were also manually segmented for volumetric analysis. Univariable and multivariable logistic regression were used to test the association between baseline variables and MoCA score decline. Results: Forty-six patients survived ≥3 months after treatment. Age (OR 1.12 (1.04 – 1.21, p < 0.01), baseline WMH volume (OR 1.20, 95% CI 1.06 – 1.52, p = 0.02) and baseline Fazekas score ≥ 3/6 (OR 6.4, 95% CI 1.7 – 24.7, p < 0.01) were predictive of MoCA score decline. In multivariable analysis, age was the only significant predictor of MoCA decline. However, all three patients with pre-treatment leukoencephalopathy (Fazekas score = 6/6) had notable adverse outcomes due to cognitive impairment: one required full-time home nursing support and two were institutionalized.Conclusion: A greater decline in cognition after WBRT was observed in older patients and patients with a higher baseline WMH burden. Although this study is small and hypothesis-generating, we propose that radiation oncologists should exercise caution in prescribing WBRT if leukoencephalopathy is present on pre-treatment imaging.
Hybrid Electrophototroph Enables High-Efficiency Carbon Dioxide Valorization to Fuel Molecules
Authors: Li Zhaodong , Wu Chao , Gao Xiang , Addison Bennett , Chen Xihan , Yu Jianping , Svedruzic Drazenka , Blackburn Jeffrey , Xiong Wei 
Published: October 2020

Abstract
Nature’s biocatalytic processes are driven by photosynthesis, whereby photosystems I and II are connected in series for light-stimulated generation of fuel products or electricity. Externally supplying electricity directly to the photosynthetic electron transfer chain (PETC) has numerous potential benefits, although strategies for achieving this goal have remained elusive. Here we report an integrated photo-electrochemical architecture which shuttles electrons directly to PETC in living cyanobacteria. The cathode of this architecture electrochemically interfaces with cyanobacterial cells lacking photosystem II activity that cannot perform photosynthesis independently. Illumination of the cathode channels electrons from external circuit to intracellular PETC through photosystem I, ultimately fueling CO2 conversion to acetate, a model fuel molecule with 9.32% energy efficiency, exceeding the efficiency of natural photosynthesis in higher plants (<1%) and cyanobacteria (~4-7%). The resulting “Electrophototrophic” bio-electrochemical hybrid has the potential to produce fuel chemicals with numerous advantages over standalone natural and artificial photosynthetic approaches.
A brainstem circuit for coordinated pain-control
Authors: Hoon Mark , Gu Xinglong 
Published: October 2020

Abstract
Supraspinal brain regions are involved in modifying nociceptive signals in response to environmental stimuli and stressors including mechanisms that elevate thresholds to noxious stimuli (pain suppression). However, details such as the cells, the circuits, and the molecular mechanisms, by which nociceptive responses are suppressed are incompletely understood. Therefore, we searched for unrecognized brain nuclei involved in these processes. Examination of neurons activated by noxious stimuli revealed catecholaminergic neurons in the caudal ventrolateral medulla that were stimulated by multiple noxious challenges. We found that, upon activation, these neurons operate in a diffuse feed-forward inhibitory loop to attenuate nociceptive reflexes via a descending locus coeruleus to spinal cord pathway. Importantly, this circuit is sufficient to attenuate injury induced allodynia and inhibit glucoprivation induced analgesia and is required for counter-stimulus induced analgesia. Our findings molecularly define a component of the brain pain modulatory system which can coordinate antinociceptive responses.