bluuebunny/crossref_metadata_2025_split huggingface dataset:
Post traumatic stress symptom variation associated with sleep characteristics
Authors: Biggs Quinn M. , Ursano Robert J. , Wang Jing , Wynn Gary H. , Carr Russell B. , Fullerton Carol S. 
Published: April 2020

Abstract
Background
Post traumatic stress disorder (PTSD) and sleep problems are highly related. The relationship between nighttime sleep characteristics and next day post traumatic stress symptoms (PTSS) is not well known. This study examined the relationship between the previous night’s sleep duration, number of awakenings, sleep quality, trouble falling asleep, and difficulty staying asleep and PTSS the following day.

Methods
Using an ecological momentary assessment methodology, individuals with probable PTSD (N = 61) reported their nighttime sleep characteristics daily and PTSS four times per day for 15 days. Univariate and multivariate linear mixed models were used to examine the previous night’s (within-subjects) and person’s mean (between-subjects) associations between sleep characteristics and PTSS.

Results
The previous night’s sleep duration (p < .001), sleep quality (p < .001), trouble falling asleep (p < .001), and difficulty staying asleep (p < .001) significantly predicted the next day’s PTSS. When examined in a multivariate model including all characteristics simultaneously, previous night’s sleep duration (p = .024), trouble falling asleep (p = .019), and difficulty staying asleep (p < .001) continued to predict PTSS, but sleep quality (p = .667) did not. When considering a person’s mean, trouble falling asleep (p = .006) and difficulty staying asleep (p = .001) predicted PTSS, but only difficulty staying asleep (p = .018) predicted PTSS in a multivariate model.

Conclusions
Among individuals with PTSD, the previous night’s sleep duration, trouble falling asleep, and difficulty staying asleep predict next day PTSD symptoms. Interventions that facilitate falling and staying asleep and increase time slept may be important for treating PTSD.
Attenuation of intermittent hypoxia-induced apoptosis and fibrosis in pulmonary tissues via suppression of ER stress activation
Authors: Shi Zhihui , Xu Linhao , Xie Hui , Ouyang Ruoyun , Ke Ya , Zhou Rui , Yung Wing-Ho 
Published: April 2020

AbstractBackgroundObstructive sleep apnea (OSA) is associated with pulmonary fibrosis and endothelial apoptosis in pulmonary tissues. Chronic intermittent hypoxia (IH) is considered to be the primary player in OSA, but the mechanisms underlying its effect on pulmonary tissues are unknown. Endoplasmic reticulum (ER) stress induced by IH treatment plays an important role in accelerating the process of fibrosis and induction of apoptosis.MethodsMice were placed in IH chambers for 4 weeks with an oscillating oxygen (O2) concentration between 5 and 21%, cycling every 90s for 8 h daily. Mice were randomly divided into four groups: control group (normal oxygen), tauroursodeoxycholic acid (TUDCA) group (normal oxygen intraperitoneally injected with TUDCA), IH group and IH + TUDCA group. After 4 weeks, the proteins in three branch signaling pathways of ER stress, including protein kinase RNA (PKR)-like/Pancreatic ER kinase (PERK), activating transcription factor 6 (ATF-6) and inositol-requiring enzyme 1 (IRE-1), were evaluated. The cleaved caspase-3, caspase-12 and TUNNEL staining was assessed. Furthermore, the expression of transforming growth factor-β1 (TGF-β1) and thrombospondin-1(TSP-1), two extracellular matrix proteins that play critical role in fibrosis, were examined. Finally, Masson’s trichrome staining was performed to detect the expression of collagen.ResultsAfter 4 weeks of IH treatment, the expressions of two ER stress markers, glucose regulated protein-78 (Grp78) and transcription factor C/EBP homologous protein (CHOP) were increased which was prevented by administration of the ER stress attenuator, TUDCA. The expressions of PERK, but not those of ATF-6 and IRE-1, were increased. The effects of IH were accompanied by an increased number of apoptotic cells and increased expressions of cleaved caspase-3 and caspase-12 in pulmonary tissues. In addition, histological examination suggested the presence of fibrosis after chronic IH treatment, indicated by increased expression of collagen, which was associated with the up-regulation of TGF-β1 and TSP-1 that are known to promote fibrosis. Similarly, TUDCA could reduce the extent of fibrotic area and the expression levels of these proteins.ConclusionsIt reveals the roles of ER stress, especially the PERK pathway, in IH induced apoptosis and fibrosis in pulmonary tissues that might underlie the pulmonary complications observed in OSA.
Melanoma of unknown primary in the pancreas: should it be considered primary?
Authors: Jin Yanwen , Ran Congdun , Li Fuyu , Cheng Nansheng 
Published: April 2020

Abstract
Background
Malignant melanoma is characterized as highly malignant due to its rapid growth and early metastasis. Metastatic melanoma from occult primary is rare. Melanoma of unknown primary in pancreas are even rear. But it is a biologically ill-defined and clinically understudied concept.

Case presentation
In this report, a 43-year-old man was diagnosed with pancreatic carcinoma. Extended total pancreatectomy together with portal vein reconstruction and extensive lymphadenectomy were performed in our hospital. The patient was diagnosed with pancreatic malignant melanoma after pathological examination. He was still alive 20 months after the operation without any evidence of recurrence.

Conclusion
The described case highlights the possibility of primary pancreatic malignant melanoma and the treatment strategies of this rare carcinoma.
Myxofibrosarcoma of the mandible: a case report and review of the literature
Authors: Li Zhengqiang , Liu Xianwen , Zhang Quanyin , Zhang Jie , Huang Mingyi , Liu Shuguang 
Published: April 2020

Abstract
Background
Myxofibrosarcoma (MFS) is a soft tissue sarcoma that commonly occurs in late adult life. It is mainly located in the subcutaneous soft tissues of extremities characterized by a high recurrence rate at the original site. MFS of the head and neck is rare, while it occurs in the maxilla and mandible is extremely rare.

Case presentation
We report a case of MFS of the mandible in a 51-year-old female who presented with a painless gingival swelling and mobile, super-erupted right mandibular second and third molars. Panoramic x-ray and maxillofacial CT revealed an ill-defined radiolucent lesion surrounding the mandibular molars giving a teeth-floating-in-air appearance. Histopathological examination showed scattered spindle and stellate cells with mild atypia distributed in the myxoid stroma. Only a few mitotic figures were identified and no area of tissue necrosis was found. The characteristic thin-walled and curvilinear vasculature were prominent. Immunohistochemistry analysis revealed the tumor cells being positive for vimentin and vascular CD31. CK, S-100, P63, HHF-35 stains were negative. The labeling index of Ki-67 was about 30%. Based on the histopathological and immunohistochemical examinations, the diagnosis of a low-grade MFS was established. This patient underwent a radical segmental excision with a 2-cm margin, supraomohyoid neck dissection and immediate reconstruction of the mandibular continuity defect with a fibular osteocutaneous free flap. This patient has been followed for 20 months to date and has remained disease free.

Conclusions
This report describes a rare case of MFS of the mandible. Recognizing the histopathological features of MFS and applying the appropriate immunohistochemical examinations are crucial in establishing the correct diagnosis. Our case may provide diagnosis and treatment experiences of MFS occurs in the mandible.
The desire to die in palliative care: a sequential mixed methods study to develop a semi-structured clinical approach
Authors: Kremeike Kerstin , Frerich Gerrit , Romotzky Vanessa , Boström Kathleen , Dojan Thomas , Galushko Maren , Shah-Hosseini Kija , Jünger Saskia , Rodin Gary , Pfaff Holger , Perrar Klaus Maria , Voltz Raymond 
Published: April 2020

Abstract
Background
Although desire to die of varying intensity and permanence is frequent in patients receiving palliative care, uncertainty exists concerning appropriate therapeutic responses to it. To support health professionals in dealing with patients´ potential desire to die, a training program and a semi-structured clinical approach was developed. This study aimed for a revision of and consensus building on the clinical approach to support proactively addressing desire to die and routine exploration of death and dying distress.

Methods
Within a sequential mixed methods design, we invited 16 palliative patients to participate in semi-structured interviews and 377 (inter-)national experts to attend a two-round Delphi process. Interviews were analyzed using qualitative content analysis and an agreement consensus for the Delphi was determined according to predefined criteria.

Results
11 (69%) patients from different settings participated in face-to-face interviews. As key issues for conversations on desire to die they pointed out the relationship between professionals and patients, the setting and support from external experts, if required. A set of 149 (40%) experts (132/89% from Germany, 17/11% from 9 other countries) evaluated ten domains of the semi-structured clinical approach. There was immediate consensus on nine domains concerning conversation design, suggestions for (self-)reflection, and further recommended action. The one domain in which consensus was not achieved until the second round was “proactively addressing desire to die”.

Conclusions
We have provided the first semi-structured clinical approach to identify and address desire to die and to respond therapeutically – based on evidence, patients’ views and consensus among professional experts.

Trial registration
The study is registered in the German Clinical Trials Register (DRKS00012988; registration date: 27.9.2017) and in the Health Services Research Database (VfD_DEDIPOM_17_003889; registration date: 14.9.2017).
What matters when asking, “what matters to you?” — perceptions and experiences of health care providers on involving older people in transitional care
Authors: Olsen Cecilie Fromholt , Debesay Jonas , Bergland Astrid , Bye Asta , Langaas Anne G. 
Published: April 2020

AbstractBackgroundTransitional care for older chronically ill people is an important area for healthcare quality improvement. A central goal is to involve older people more in transitional care and make care more patient-centered. Recently, asking, “What matters to you?” (WMTY) has become a popular way of approaching the implementation of patient-centered care. The aim of this study was to explore health care providers’ perceptions and experiences regarding the question of WMTY in the context of improving transitional care for older, chronically ill persons.MethodsThe data comprise semi-structured individual interviews with 20 health care providers (HCPs) who took part in a Norwegian quality improvement collaborative, three key informant interviews, and observations of meetings in the quality improvement collaborative. We used a thematic analysis approach.ResultsThree interrelated themes emerged from the analysis: WMTY is a complex process that needs to be framed competently; framing WMTY as a functional approach; and framing WMTY as a relational approach. There was a tension between the functional and the relational approach. This tension seemed to be based in different understandings of the purpose of asking the WMTY question and the responsibility that comes with asking it.ConclusionsWMTY may appear as a simple question, but using it in everyday practice is a complex process, which requires professional competence. When seen in terms of a patient-centered goal process, the challenge of competently eliciting older people’s personal goals and transferring these goals into professional action becomes evident. An important factor seems to be how HCPs regard the limits of their responsibility in relation to giving care within the larger frame of the patient’s life project. Factors in the organizational and political context also seem to influence substantially how HCPs approach older patients with the WMTY question.
Microscopic and submicroscopic Plasmodium infections in indigenous and non-indigenous communities in Colombia
Authors: Montiel Jehidys , Zuluaga Lina M. , Aguirre Daniel C. , Segura Cesar , Tobon-Castaño Alberto , Vásquez Ana M. 
Published: April 2020

AbstractBackgroundThe indigenous population is considered a highly susceptible group to malaria because individuals usually live in areas with high exposure toAnophelesand poverty, and have limited access to health services. There is a great diversity of indigenous communities in Colombia living in malaria-endemic areas; however, the burden of infection in these populations has not been studied extensively. This study aimed to determine the prevalence ofPlasmodiuminfections in indigenous and non-indigenous communities in two malaria-endemic areas in Colombia.MethodsA community-based cross-sectional survey was conducted in seven villages of Turbo and El Bagre municipalities; three of these villages were indigenous communities. Inhabitants of all ages willing to participate were included. Sociodemographic and clinical data were recorded as well as household information. The parasitological diagnosis was performed by microscopy and nested PCR. The prevalence of microscopy and submicroscopic infection was estimated. An adjusted GEE model was used to explore risk factors associated with the infection.ResultsAmong 713 participants, 60.7% were from indigenous communities.Plasmodiumspp. was detected in 30 subjects (4.2%, CI 95% 2.9–5.9); from those, 29 were in the indigenous population, 47% of infections were afebrile, and most of them submicroscopic (10/14). Microscopic and submicroscopic prevalence was 2.5% (CI 95% 1.6–3.9) and 1.7% (CI 95% 0.9–2.9), respectively. In El Bagre, all infections occurred in indigenous participants (3.9%, CI 95% 2.2–7.1), and 81% were submicroscopic. By contrast, in Turbo, the highest prevalence occurred in indigenous people (11.5%; CI 95%: 7.3-17.5), but 88.8% were microscopic. Living in an indigenous population increased the prevalence of infection compared with a non-indigenous population (PR 19.4; CI 95% 2.3–166.7).ConclusionThere is a high proportion ofPlasmodiuminfection in indigenous communities. A substantial proportion of asymptomatic and submicroscopic carriers were detected. The identification of these infections, not only in indigenous but also in the non-indigenous population, as well as their associated factors, could help to implement specific malaria strategies for each context.
A probabilistic approach for calibration time reduction in hybrid EEG–fTCD brain–computer interfaces
Authors: Khalaf Aya , Akcakaya Murat 
Published: April 2020

Abstract
Background
Generally, brain–computer interfaces (BCIs) require calibration before usage to ensure efficient performance. Therefore, each BCI user has to attend a certain number of calibration sessions to be able to use the system. However, such calibration requirements may be difficult to fulfill especially for patients with disabilities. In this paper, we introduce a probabilistic transfer learning approach to reduce the calibration requirements of our EEG–fTCD hybrid BCI designed using motor imagery (MI) and flickering mental rotation (MR)/word generation (WG) paradigms. The proposed approach identifies the top similar datasets from previous BCI users to a small training dataset collected from a current BCI user and uses these datasets to augment the training data of the current BCI user. To achieve such an aim, EEG and fTCD feature vectors of each trial were projected into scalar scores using support vector machines. EEG and fTCD class conditional distributions were learnt separately using the scores of each class. Bhattacharyya distance was used to identify similarities between class conditional distributions obtained using training trials of the current BCI user and those obtained using trials of previous users.

Results
Experimental results showed that the performance obtained using the proposed transfer learning approach outperforms the performance obtained without transfer learning for both MI and flickering MR/WG paradigms. In particular, it was found that the calibration requirements can be reduced by at least 60.43% for the MI paradigm, while at most a reduction of 17.31% can be achieved for the MR/WG paradigm.

Conclusions
Data collected using the MI paradigm show better generalization across subjects.
Microbiota composition and distribution along the female reproductive tract of women with endometriosis
Authors: Wei Weixia , Zhang Xiaowei , Tang Huiru , Zeng Liping , Wu Ruifang 
Published: April 2020

AbstractEndometriosis (EMS) is a multifactorial disease that affects 10%–15% women of reproductive age and is associated with chronic pelvic pain and infertility. The pathogenesis of EMS has not been consistently explained until now. In this study, we involved 36 endometriosis patients and 14 control subjects who performed laparoscopic surgery due to gynecological benign tumor. The samples from lower third of vagina (CL), posterior vaginal fornix (CU), cervical mucus (CV), endometrium (ET) and peritoneal fluid (PF), were collected and sequenced by 16S rRNA amplicon. The continuous change of the microbiota distribution was identified along the reproductive tract. The flora in lower reproductive tract (CL, CU) were dominated by Lactobacillus. Significant difference of the community diversity began showing in the CV of EMS patients and gradually increased upward the reproductive tract. It indicates the microbiota in cervical samples is expected to be an indicator for the risk of EMS. This study also highlights the decreasing of Lactobacillus in vaginal flora and the increasing of signature Operational Taxonomic Units (OTUs) in transaction zone (CV) and upper reproductive tract (ET, PF) of EMS patients, which reflect the alteration of microbial community associated with EMS, participation of specific colonized bacteria in the EMS pathogenesis and relationship between microbiota and development of disease.
Disruption of androgen signaling during puberty affects Notch pathway in rat seminiferous epithelium
Authors: Kamińska Alicja , Marek Sylwia , Pardyak Laura , Brzoskwinia Małgorzata , Pawlicki Piotr , Bilińska Barbara , Hejmej Anna 
Published: April 2020

Abstract
Background
Onset of spermatogenesis at puberty is critically dependent on the activity of hypothalamic-pituitary-gonadal axis and testosterone production by Leydig cells. The aim of this study was to examine whether activation of Notch receptors and expression of Notch ligands and effector genes in rat seminiferous epithelium are controlled by androgen signaling during puberty.

Methods
Peripubertal (5-week-old) Wistar rats received injections of flutamide (50 mg/kg bw) daily for 7 days to reduce androgen receptor (AR) signaling or a single injection of ethanedimethane sulphonate (EDS; 75 mg/kg bw) to reduce testosterone production. Gene and protein expressions were analyzed by real-time RT-PCR and western blotting, respectively, protein distribution by immunohistochemistry, and steroid hormone concentrations by enzyme-linked immunosorbent assay. Statistical analyses were performed using one-way ANOVA followed by Tukey’s post hoc test or by Kruskal-Wallis test, followed by Dunn’s test.

Results
In both experimental models changes of a similar nature in the expression of Notch pathway components were found. Androgen deprivation caused the reduction of mRNA and protein expression of DLL4 ligand, activated forms of Notch1 and Notch2 receptors and HES1 and HEY1 effector genes (p < 0.05, p < 0.01, p < 0.001). In contrast, DLL1, JAG1 and HES5 expressions increased in seminiferous epithelium of both flutamide and EDS-treated rats (p < 0.05, p < 0.01, p < 0.001).

Conclusions
Androgens and androgen receptor signaling may be considered as factors regulating Notch pathway activity and the expression of Hes and Hey genes in rat seminiferous epithelium during pubertal development. Further studies should focus on functional significance of androgen-Notch signaling cross-talk in the initiation and maintenance of spermatogenesis.
hsa-miR-100-5p, an overexpressed miRNA in human ovarian endometriotic stromal cells, promotes invasion through attenuation of SMARCD1 expression
Authors: Takebayashi Kanetoshi , Nasu Kaei , Okamoto Mamiko , Aoyagi Yoko , Hirakawa Tomoko , Narahara Hisashi 
Published: April 2020

AbstractBackgroundA number of microRNAs are aberrantly expressed in endometriosis and are involved in its pathogenesis. Our previous study demonstrated that has-miR-100-5p expression is enhanced in human endometriotic cyst stromal cells (ECSCs). The present study aimed to elucidate the roles of has-miR-100-5p in the pathogenesis of endometriosis.MethodsNormal endometrial stromal cells (NESCs) were isolated from normal eutopic endometrium without endometriosis. Using hsa-miR-100-5p-transfected NESCs, we evaluated the effect of hsa-miR-100-5p on the invasiveness of these cells by Transwell invasion assay and in-vitro wound repair assay. We also investigated the downstream signal pathways of hsa-miR-100-5p by microarray analysis and Ingenuity pathways analysis.Resultshsa-miR-100-5p transfection enhanced the invasion and motility of NESCs. After hsa-miR-100-5p transfection, mRNA expression of SWItch/sucrose non-fermentable-related matrix-associated actin-dependent regulator of chromatin subfamily D member 1 (SMARCD1) was significantly attenuated. Whereas, the expression of matrix metallopeptidase 1 (MMP1) mRNA and active MMP1 protein levels was upregulated.ConclusionWe found that SMARCD1/MMP-1 is a downstream pathway of hsa-miR-100-5p. hsa-miR-100-5p transfection enhanced the motility of NESCs by inhibiting SMARCD1 expression and MMP1 activation. These findings suggest that enhanced hsa-miR-100-5p expression in endometriosis is involved in promoting the acquisition of endometriosis-specific characteristics during endometriosis development. Our present findings on the roles of hsa-miR-100-5p may thus contribute to understand the epigenetic mechanisms involved in the pathogenesis of endometriosis.