bluuebunny/crossref_metadata_2025_split huggingface dataset:
Detrimental role of sphingosine kinase 1 in kidney damage in DOCA-salt hypertensive model: evidence from knockout mice
Authors: Lyu Bingqing , Wang Weili , Ji Xin-Ying , Ritter Joseph K. , Li Ningjun 
Published: May 2020

Abstract
Background
Sphingosine-1-phosphate (S1P) is a bioactive metabolite of sphingolipids and produced by sphingosine kinases (SphK1 and SphK2). SphK1/S1P pathway is implicated in the progression of chronic kidney disease. However, the role of SphK1/S1P pathway in renal injury in hypertension has not been reported. This study tested the hypothesis that SphK1/S1P pathway mediates the kidney damage in DOCA-salt hypertensive mice.

Methods
Male wild type (WT) C57BL6 and SphK1 knockout (KO) mice were subjected to unilateral nephrectomy, subcutaneous implant containing 50 mg of deoxycorticosterone acetate (DOCA) and 1% NaCl drinking water for 7 weeks. At the end of experiments, blood pressure data, 24 h urine and kidney samples were collected. Renal mRNA levels of SphK1 were measured by real-time RT-PCR. Markers for fibrogenesis and immune cell infiltration in kidneys were detected using Western blot and immunohistochemistray analysis, respectively. The glomerular morphological changes were examined in kidney tissue slides stained with Periodic-Acid Schiff. Four groups were studied: wild type control (WT-C), WT-DOCA, KO-C and KO-DOCA.

Results
The renal SphK1 mRNA expression was significantly upregulated in WT-DOCA mice, whereas this upregulation of renal SphK1 mRNA was blocked in KO-DOCA mice. There was no difference in DOCA-salt-induced hypertension between WT and KO mice. The urinary albumin was increased in both DOCA-salt groups. However, the albuminuria was significantly lower in KO-DOCA than in WT-DOCA group. There were increases in glomerulosclerosis indices in both DOCA-salt groups, whereas the increases were also significantly lower in KO-DOCA than in WT-DOCA mice. Renal protein levels of α-smooth muscle actin were upregulated in both DOCA-salt groups, but the increase was significant lower in KO-DOCA than in WT-DOCA group. The increased staining areas of collagen detected by Sirius Red-staining in kidney tissue sections were also attenuated in KO-DOCA compared with WT-DOCA mice. In contrast, the increased infiltration of CD43+ (a T cell marker) or CD68+ (a macrophage marker) cells in DOCA-salt kidneys showed no significant difference between WT-DOCA and KO-DOCA mice.

Conclusions
SphK1/S1P signaling pathway mediates kidney damage in DOCA-salt hypertensive mice independent of blood pressure and immune modulation.
Protocols of a diagnostic study and a randomized controlled non-inferiority trial comparing televisits vs standard in-person outpatient visits for narcolepsy diagnosis and care: TElemedicine for NARcolepsy (TENAR)
Authors: Ingravallo Francesca , Vignatelli Luca , Pagotto Uberto , Vandi Stefano , Moresco Monica , Mangiaruga Anastasia , Oriolo Claudia , Zenesini Corrado , Pizza Fabio , Plazzi Giuseppe 
Published: May 2020

AbstractBackgroundNarcolepsy is a rare chronic sleep disorder that typically begins in youth. Excessive daytime sleepiness is the main disabling symptom, but the disease is often associated with severe endocrine-metabolic and psychosocial issues, worsened by a long diagnostic delay, requiring a multidisciplinary approach. The scarcity of reference Sleep Centres forces the patient and family to travel for seeking medical consultations, increasing the economic and psychosocial burden of the disease. Growing evidence suggests that Telemedicine may facilitate patient access to sleep consultations and its non-inferiority in terms of patient satisfaction, adherence to treatment, and symptom improvement for sleep disorders. However, Telemedicine clinical and economic benefits for patients with narcolepsy are still unknown.MethodsTENAR is a two-part project, including: 1. a cross-sectional study (involving 250 children and adults with suspected narcolepsy) evaluating the accuracy of Teletriage (i.e., a synchronous live interactive sleep assessment through a Televisit) for narcolepsy diagnosis compared to the reference standard; and 2. a two-arm, parallel, open randomized controlled trial (RCT) to demonstrate the non-inferiority of the multidisciplinary care of narcolepsy through Televisits versus standard care. In this RCT, 202 adolescents (> 14 y.o.) and adults with narcolepsy will be randomly allocated (1:1 ratio) either to Televisits via videoconference or to standard in-person outpatient follow-up visits (control arm). The primary outcome is sleepiness control (according to the Epworth Sleepiness Scale). Secondary outcomes are other symptoms control, compliance with treatment, metabolic control, quality of life, feasibility, patient and family satisfaction with care, safety, and disease-related costs. At baseline and at 12 months, patients will undergo neurologic, metabolic, and psychosocial assessments and we will measure primary and secondary outcomes. Primary outcomes will be also measured at 6 months (remotely or in person, according to the arm).DiscussionTENAR project will assess, for the first time, the feasibility, accuracy, efficacy and safety of Telemedicine procedures applied to the diagnosis and the multidisciplinary care of children and adults with narcolepsy. The study may be a model for the remote management of other rare disorders, offering care access for patients living in areas lacking medical centres with specific expertise.Trial registrationNumber of the Tele-multidisciplinary care studyNCT04316286. Registered 20 March 2020.
Spinal metastasis of glioblastoma multiforme before gliosarcomatous transformation: a case report
Authors: Hsu Bing-Hung , Lee Wei-Hwa , Yang Shun-Tai , Han Cheng-Ta , Tseng Yuan-Yun 
Published: May 2020

Abstract
Background
Glioblastoma multiforme (GBM) is one of the most aggressive malignant brain tumors. Intracranial GBM metastases to the spine are rarely detected clinically. Secondary gliosarcomas after treatment of primary GBM are rarely described.

Case presentation
Herein, we report the case of a 53-year-old woman who presented to our emergency room with progressive headache and weakness on the left side. Plain computed tomography and contrast magnetic resonance imaging of the brain revealed an approximately 6.8 cm × 4.5 cm right temporoparietooccipital intraaxial cystic tumor with surrounding diffuse perifocal edema that caused midline shift toward the left. Emergency craniotomy was performed to remove the tumor, and pathological examination revealed GBM. The patient received proton beam therapy, Gliadel implantation, and oral temozolomide chemotherapy as well as targeted therapy with bevacizumab. Approximately 15 months after diagnosis, she underwent surgical resection of the right temporal recurrent tumor and was newly diagnosed as having a metastatic spinal tumor. Pathologically, the right temporal and metastatic spinal tumors were gliosarcoma and GBM, respectively.

Conclusions
Concurrent spinal metastasis and gliosarcomatous transformation, which are two types of GBM complications, are rare. To our knowledge, this is the first report of a case of recurrent GBM with gliosarcoma after proton bean therapy.
Gut microbiota in early pregnancy among women with Hyperglycaemia vs. Normal blood glucose
Authors: Gao Beibei , Zhong Mengdan , Shen Qiong , Wu Ying , Cao Mengdie , Ju Songwen , Chen Lei 
Published: May 2020

AbstractBackgroundRecent studies suggest that there is a link between the gut microbiota and glucose metabolism. This study aimed to compare the gut microbiota during early pregnancy of women with hyperglycymia to those with normal blood glucose.MethodsGut microbial composition was analysed in 22 women with hyperglycaemia and 28 age-matched healthy controls during their first prenatal visits (< 20 weeks) using high throughput sequencing of the V3-V4 region of the 16S ribosomal RNA gene. Hyperglycemia was diagnosed based on the criteria recommended by the International Association of Diabetes and Pregnancy Study Groups in 2010.ResultsWomen with hyperglycemia in pregnancy (HIP) had significantly lower microbial richness and diversity compared with healthy pregnant women. The proportions of theFirmicutesandBacteroidetesphyla and the ratio ofFirmicutes:Bacteroideteswere not different between the two groups. We observed that individuals with HIP had an increased abundance ofNocardiaceae,Fusobacteriaceae, etc., whereas healthy controls had significantly higher levels ofChristensenellaceae,Clostridiales_vadinBB60_group,Coriobacteriaceae, etc. Similarly, levels of the members of theRuminococcaceaefamily,includingRuminococcaceae_UCG-014,Ruminococcaceae_UCG-003, andRuminococcaceae_UCG-002,were significantly reduced in the HIP group and were negatively correlated with HbA1c. HbA1c levels were positively correlated withBacteroidaceaeandEnterobacteriaceaeand negatively correlated withChristensenellaceae, etc. CRP was positively correlated with theBacteroidaceaeandFusobacteriaceaefamilies and theFusobacteriumgenus.ConclusionsOur study revealed that individuals with HIP have gut microbial dysbiosis and that certain bacterial groups are associated with glucose metabolism during pregnancy. Further study is needed to provide new ideas to control glucose by modifying the gut microbiota.
Prevalence and factors associated with early initiation of breastfeeding among women in Moshi municipal, northern Tanzania
Authors: Lyellu Hadija Y. , Hussein Tamara H. , Wandel Margareta , Stray-Pedersen Babill , Mgongo Melina , Msuya Sia E. 
Published: May 2020

Abstract
Background
Early initiation of breastfeeding (EIBF) is a predetermining factor for exclusive breastfeeding, and thus a foundation for optimal breastfeeding practices. Rates of EIBF are low globally (42%) and in Tanzania (51%), yet few studies have been done on this issue in Tanzania. This study aimed to determine the prevalence and factors associated with early initiation of breastfeeding among women in northern Tanzania.

Methodology
This study extracted information from a cohort of 536 women who were followed from 3rd trimester period October 2013 to December 2015 in Moshi municipal, northern Tanzania. The data for this paper was collected by the use of questionnaires at enrolment, delivery and 7 days after delivery. The analysis is based on data from 413 women for whom complete information was obtained. Log binomial regression analysis was used to determine factors associated with early initiation of breastfeeding.

Results
The prevalence of EIBF was 83%. Overall, women had high knowledge on colostrum (94%), knowledge on exclusive breastfeeding (81%) and time of breastfeeding initiation (71%), but only 54% were counseled on breastfeeding during antenatal care. Knowledge on timely initiation of breastfeeding during pregnancy and vaginal delivery were associated with EIBF.

Conclusion
Early initiation of breastfeeding is high (83%) in Moshi Municipal but still below the universal coverage recommended by WHO and UNICEF. There is missed opportunity by health facilities to counsel and support early initiation of breastfeeding given high antenatal and facility delivery in this setting. There is a need to evaluate health facility bottle necks to optimal support of early initiation of breastfeeding in Tanzania.
Intentions to use maternity waiting homes and associated factors in Northwest Ethiopia
Authors: Endayehu Mekonen , Yitayal Mezgebu , Debie Ayal 
Published: May 2020

Abstract
Background
Maternity Waiting Homes (MWHs) are residential facilities located within hospitals or health centers to accommodate women in their final weeks of pregnancy to bridge the geographical gap in obstetric care. Little is known, however, about women’s intentions to use MWHs. Thus, this study aimed to assess pregnant women’s intentions to use MWHs and associated factors in East Bellesa district, northwest Ethiopia.

Methods
A community-based cross-sectional study was conducted among 525 pregnant women in East Bellesa district from March to May 2018. Study participants were selected using systematic random sampling. Binary logistic regression was used for analysis. Adjusted Odds Ratio (aOR) with 95% Confidence Interval (CI), and p-value < 0.05 were used to identify factors associated with intentions to use MWHs.

Results
In the study area, 326/499 (65.3%) pregnant women had the intention to use MWHs. Pregnant women who had good knowledge about maternal healthcare and obstetric complications (aOR 6.40; 95% CI 3.6–11.5), positive subjective norms related to women’s perceptions of social pressure (aOR 5.14; 95% CI 2.9–9.2), positive perceived behavioral control of women on the extent to which women feel confident (aOR 4.74; 95% CI 2.7–8.4), rich wealth status (aOR 4.21; 95% CI 2.1–8.4), women who decided by themselves to use maternal services (aOR 2.74; 95% CI 1.2–6.2), attended antenatal care (aOR 2.24; 95% CI 1.2–4.1) and favorable attitudes towards women’s overall evaluation of MWHs (aOR 1.86; 95% CI 1.0–3.4) had higher odds of intentions to use MWHs.

Conclusion
Two thirds (65.3%) of pregnant women had intentions to use MWHs. Factors such as women’s knowledge, subjective norms related to women’s perceptions of social pressure, perceived behavioral control of women on the extent to which women feel confident to utilize, and wealth status, decision-making power, attending antenatal care and attitude towards women’s overall evaluation of MWHs were significantly associated with the intention to use MWHs. Therefore, improving women’s awareness by providing continuous health education during antenatal care visits, devising strategies to improve women’s wealth status, and strengthening decision-making power may enhance their intention to use MWHs.
Neoadjuvant chemotherapy followed by curative-intent surgery for perihilar cholangiocarcinoma based on its anatomical resectability classification and lymph node status
Authors: Kuriyama Naohisa , Usui Masanobu , Gyoten Kazuaki , Hayasaki Aoi , Fujii Takehiro , Iizawa Yusuke , Kato Hiroyuki , Murata Yasuhiro , Tanemura Akihiro , Kishiwada Masashi , Sakurai Hiroyuki , Mizuno Shugo , Isaji Shuji 
Published: May 2020

Abstract
Background
The prognosis of patients with perihilar cholangiocarcinoma have been unsatisfactory. We established new anatomical resectability classification for patients with localized perihilar cholangiocarcinoma and performed neoadjuvant chemotherapy followed by curative-intent surgery based on its resectability classification and lymph node status to improve prognosis. This study aimed to clarify the long-term outcomes and validation of our strategy.

Methods
Between September 2010 and August 2018, 72 consecutive patients with perihilar cholangiocarcinoma were classified into three groups: Resectable (R = 29), Borderline resectable (BR = 23), and Locally advanced (LA = 20), based on the two factors of tumor vascular and biliary extension. R with clinically lymph node metastasis, BR, and LA patients received neoadjuvant chemotherapy using gemcitabine plus S-1.

Results
Forty-seven patients (65.3%) received neoadjuvant chemotherapy: R in 8, BR in 21, and 18 in LA, respectively. Fifty-nine patients (68.1%) underwent curative-intent surgery: R in 26, BR in 17, and LA in 6. Five-year disease-specific survival was 31.5% (median survival time: 33.0 months): 50.3% (not reached) in R, 30.0% (31.4 months) in BR, and 16.5% (22.5 months) in LA, which were relatively stratified. Among 49 patients with resection, disease-specific survival was 43.8% (57.0 months): 57.6% (not reached) in R, 41.0% (52.4 months) in BR, and 0% (49.4 months) in LA, which were significantly good prognosis compared to 23 patients without resection (17.2 months). Multivariate analysis identified preoperative high carcinoembryonic antigen levels (more than 8.5 ng/ml) and pT4 as independent poor prognostic factor of patients with resection.

Conclusion
Neoadjuvant chemotherapy based on resectability classification and lymph node status was feasible, and was considered efficacious in selected patients.
Prognostic nutrition index as a predictor of coronary artery aneurysm in Kawasaki Disease
Authors: Tai I-Hsin , Wu Pei-Lin , Guo Mindy Ming-Huey , Lee Jessica , Chu Chi-Hsiang , Hsieh Kai-Sheng , Kuo Ho-Chang 
Published: May 2020

Abstract
Background
Kawasaki Disease (KD) is considered a major acquired heart disease in children under the age of 5. Coronary artery aneurysm (CAA) can occur in serious cases despite extreme therapy efforts. Previous studies have reported low serum albumin level was associated with disease outcome, but no further investigation was addressed yet.

Method
This retrospective (case-control) study randomly included children with KD who were admitted and underwent laboratory tests before undergoing IVIG treatment in this institution, the largest tertiary medical center in southern Taiwan from 2012 to 2016. Prognostic nutrition index (PNI), an albumin-based formula product, was evaluated as a predictor of CAA the first time. The progression of CAA was monitored using serial echocardiography for six months. We performed multivariable logistic regression analysis on the laboratory test and PNI with the disease outcome of the KD patients.

Result
Of the 275 children, 149 had CAA, including transient dilatation, while the other 126 did not develop CAA during the 6-month follow-up period. A multivariate logistic regression model revealed that PNI, gender, IVIG non-responder, and platelet count are significant predictors of CAA with a 95% confidence interval estimator of 1.999, 3.058, 3.864 and 1.004, respectively. Using PNI to predict CAA presence gave an area under the receiver-operating-characteristics (ROC) curve of 0.596. For a cutoff of 0.5 in the logistic regression model and the PNI cut-off point is taken as 55 together with IVIG non-responder, boy gender, and platelet count take into account, sensitivity and specificity were 65.7 and 70.4%.

Conclusion
PNI could be a candidate of adjunctive predictor of coronary artery aneurysm in addition to IVIG non-responder. Together with low PNI, IVIG non-responder, male gender and platelet count will give high odds to predict coronary artery aneurysm within 6 months of illness.
Low cyclosporine concentrations in children and time to acute graft versus host disease
Authors: Chung Eun Kyung , Yee Jeong , Kim Jae Youn , Gwak Hye Sun 
Published: May 2020

Abstract
Background
Achievement of target blood concentrations of cyclosporine (CsA) early after transplantation is known to be highly effective for reducing the incidence of acute graft versus host disease (aGVHD). However, no research has been conducted for predicting aGVHD occurrence with low CsA concentrations at different time periods. The objective of this study was to investigate the risk of aGVHD according to low CsA concentrations at lag days in children with allogenic hematopoietic stem cell transplantation (HSCT).

Methods
The records of 61 consecutive children who underwent allogeneic HSCT and received CsA as prophylaxis against aGVHD between May 2012 and March 2015 were retrospectively evaluated. The main outcome was any association between low CsA concentrations at lag days and aGVHD occurrence, which was examined for the first month after transplantation. Mean CsA concentrations at three lag periods were calculated: lag days 0–6, 7–13, and 14–20 before aGVHD occurrence.

Results
Patients whose mean CsA concentrations at lag days 0–6 did not reach the initial target concentration had 11.0-fold (95% confidence interval [CI]: 2.3–51.9) greater incidence of aGVHD. In addition, the AORs of low CsA concentrations at lag days 7–13 and 14–20 for developing aGVHD were 108.2 (95% CI: 7.7–1515.5) and 12.1 (95% CI: 1.1–138.1), respectively.

Conclusions
After low CsA concentrations are detected, careful attention needs to be paid to prevent aGVHD.
How did the use of psychotropic drugs change during the Great Recession in Portugal? A follow-up to the National Mental Health Survey
Authors: Silva Manuela , Antunes Ana , Azeredo-Lopes Sofia , Cardoso Graça , Xavier Miguel , Saraceno Benedetto , Caldas-de-Almeida José Miguel 
Published: May 2020

Abstract
Background
Research suggests that economic recessions might be associated with a higher use of psychotropic drugs, but literature is scarce and contradictory in identifying the most vulnerable groups. This study aims to assess possible changes in the use of psychotropic drugs due to the economic recession in Portugal, by comparing self-reported consumption in 2008/09 and 2015/16.

Methods
Data from the World Mental Health Survey Initiative Portugal (2008/09) and the National Mental Health Survey Follow-Up (2015/16) were used (n = 911). McNemar’s tests were performed to estimate changes in consumption of any psychotropic drug and of antidepressants, anxiolytics, and hypnotics/sedatives. Multiple Generalised Estimating Equations models with interaction effects were used to estimate the population odds of consuming psychotropic drugs according to year, gender and age.

Results
An increase of 6.74% was estimated in the consumption of psychotropic drugs from 2008/09 to 2015/16. Population odds of consuming any psychotropic drugs in 2015/16 were estimated to be 1.5 times higher than in 2008/09 (OR = 1.50;95%CI:1.13–2.01), particularly for hypnotics/sedatives (OR = 1.60;95%CI:1.14–2.25). Women and older individuals presented higher odds of consuming any psychotropic drugs (OR = 2.79;95%CI:2.03–3.84, and OR = 1.80;95%CI:1.28–2.54), after adjusting for year of assessment and education. However, when evaluating the interaction effect of the year with gender and age, men and younger individuals reported higher odds of consuming any psychotropic drugs in 2015/16, when compared to 2008/09 (OR = 1.85;95%CI:1.08–3.17, and OR = 1.95;95%CI:1.32–2.90, respectively).

Conclusions
The findings indicate that the period of economic recession was associated with an increased risk of psychotropic drugs use in Portugal. Consumption of psychotropic drugs remained higher among women and older individuals, but the results suggest that the economic crisis had a disproportionate impact on men and younger individuals. This identification of the most vulnerable population groups is useful to design effective and targeted public health interventions aimed at alleviating the effects of economic recessions.