bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of Severe Hand, Foot and Mouth Disease in Xiangyang, China from 2008-2013.
Authors: Liu Jian , Qi Jing 
Published: January 2020

Abstract
Therapeutic strategies for severe hand, foot and mouth disease (HFMD) are currently either inconsequent or deficient in evidence. We retrospectively surveyed HFMD outbreaks in Xiangyang from June 2008 to December 2013. FHMD is staged form I to V according to clinical severity and the case with central nervous system involvement is defined as a severe one. Most severe cases were investigated to analyse risk factors for fatality and to compare the efficiency and outcome of some therapies by binary logistic regression. The overall HFMD cases included 637 (1.26%) severe cases, 38 fatal cases (0.75‰). Analysis indicates that age (<3 y), enterovirus 71 (+), autonomic nervous system dysregulation, pulmonary edema/hemorrhage, CRP (>40 mg/L) and cardiac troponin I (>0.04 ng/mL) are risk factors for fatality (all P < 0.05). Intravenous immunoglobulin (IVIG) and mechanical ventilation applied in early stage IV significantly improved HFMD progression (both P < 0.05) with odds ratios of 0.24 (95% CI: 0.10-0.57) and 0.01 (95% CI: 0.00-0.10), respectively. Methylprednisolone and milrinone administered in any stage, and all therapies applied in stage III made no significant difference on mortality (all P > 0.05). Precise recognition of the severe HFMD cases in early stage IV and timely IVIG and mechanical ventilation application may decrease mortality. Mechanical ventilation training programs and dispatching specialists to county-level or district hospitals when there is no chance for severe HFMD cases to be transferred to superior hospitals are two key successful administrative initiatives.
Relationships of Accelerometer-based Measured Objective Physical Activity and Sedentary Behaviour with Cognitive Function: A Comparative Cross-sectional Study of China’s Elderly Population
Authors: Wu Zhi jian , Wang Zhu ying , Hu Bing qian , Zhang Xu hui , Zhang Fan , Wang Hou lei , Li Fang hui 
Published: January 2020

Abstract
This study aims to explore the effects of physical activity and sedentary behaviour on the decline of cognitive ability among the elderly. It uses objective measures to compensate for the limitations of self-reported physical activity. A cross-sectional survey of 308 people aged over 60 in Nanjing, China, was conducted. Physical activity was measured using the ActiGraph GT3X+, and cognitive function was measured using the Montreal Cognitive Assessment (MoCA). The overall participant model, adjusted for age, BMI, education, and monthly average income found that light physical activity (LPA; β=0.006, p<0.01), moderate-vigorous physical activity (MVPA; β=0.068, p<0.001), and total physical activity (β=0.006, p<0.01) had a significant linear relationship with cognitive ability, while sedentary time (SED) did not (β=-0.020, p＞0.05). Further, LPA only affects the cognitive ability of elderly females (β=0.006, p<0.05). In addition, there was an inverted ‘U’ dose-response relationship between MVPA and cognitive ability. Dose-effect relationship models found that MVPA in the 22.13 min·day–1～38.79 min·day–1 range affected cognitive ability most beneficially. The beta coefficient was higher than the other three groups (β=0.091, p<0.05). In conclusion, while physical activity can significantly improve cognitive ability among the elderly, sedentary behaviour has no significant effect on it.
Hearing loss and cognitive function among Chinese older adults: The role of participation in leisure activities
Authors: Gao Jiamin , Armstrong Nicole M. , Deal Jennifer A. , Lin Frank R. , He Ping 
Published: January 2020

Abstract
BackgroundHearing loss, a highly prevalent sensory impairment affecting older adults, is a risk factor for cognition decline. However, there were very limited studies on this association in low-resource countries. This study aimed to assess whether having hearing loss were associated with cognitive decline and engagement in leisure activities modified this association among Chinese elderly.MethodsUsing data from the nationally representative survey of China Longitudinal Healthy Longevity Survey (CLHLS) between 2011-2014, 9,710 individuals aged 65 years old or above with self-reported measures of hearing status and global cognition, as measured by the Modified Mini Mental Examination (MMSE), were included in this study. Fixed-effects models were used to estimate whether leisure activity engagement moderated the association of self-perceived hearing loss with global cognitive change in the overall sample and by sex.ResultsPeople with self-reported hearing loss was associated with cognitive impairment, with an odds ratio of 2.48 [1.22, 5.06]. Sex difference on the association of hearing loss and cognitive impairment was not found. Self-reported hearing loss was associated with cognitive function decline with 8% [-1.22, -0.39] increase in risk compared with those with normal hearing. Frequent engagement in leisure activities moderated the association between hearing loss and cognition. Actively participating in leisure activities modified the relationship between hearing loss and cognitive decline in males, while leisure activity engagement did not modify any associations among females.ConclusionHearing loss was associated with cognitive decline, and leisure activities engagement moderated the association among males rather than females.
ATP hydrolysis determines cold tolerance in rice by regulating available energy for glutathione synthesis
Authors: Yu Pinghui , Jiang Ning , Fu Weimeng , Zheng Guangjie , Li Guangyan , Feng Baohua , Chen Tingting , Ma Jiaying , Li Hubo , Tao Longxing , Fu Guanfu 
Published: January 2020

AbstractBackground Glutathione (GSH) is important for plants to resist against abiotic stress, and a large amount of energy is required in the process. However, it is not clear how the energy status affects the accumulation of GSH in plants under cold stress. Results Two rice genotypes, Zhongzao39 (ZZ39) and its recombinant inbred line 82 (RIL82) were subjected to cold stress for 48 h. Under cold stress, RIL82 suffered more damages than ZZ39 plants, in which the latter had higher increases in APX activity and GSH content than the former compared with their respective controls. This indicated that GSH was mainly responsible for the different cold tolerance between these two rice plants. Interestingly, under cold stress, greater increases in contents of carbohydrate, NAD(H), NADP(H) and ATP as well as the expression levels of GSH1 and GSH2 were showed in RIL82 than ZZ39 plants. In contrast, ATPase activity in RIL82 plants was adversely inhibited by cold stress while it significantly increased in ZZ39 plants. This indicated that cold stress reduced the accumulation of GSH in RIL82 plants mainly due to the inhibition on ATP hydrolysis rather than energy deficit. Conclusion We inferred that the energy status determined by ATP hydrolysis involved in regulating the cold tolerance of plants by controlling GSH synthesis.
Blocking Pins Instead of Blocking Screws in the Treatment of Distal Tibial Fractures with Intramedullary Nail
Authors: Bai Xiaodong , Song Zhaohui , Yao Shuangquan , Liu Song , Ma Lijie , Ren Pengcheng , Wang Pengcheng , Wu Haotian 
Published: January 2020

Abstract
Background: Distal tibial fractures have a high risk of malalignment when treated with intramedullary nails. The use of blocking screws can aid in achieving satisfactory alignment. The aim of this study was to compare the clinical and radiographic outcomes of temporary blocking pins with those of blocking screws for distal tibial fractures. Methods: From June 2011 through November 2018, a total of 90 patients with distal tibial fractures were enrolled in this prospective randomized controlled study. The patients were randomly received either blocking pins or blocking screws reduction during nailing. After reduction, 5 points at the distal fragment were effectively fixed. Results: The operating time in the BP group was 73.77±6.25 min, which was significantly shorter than 80.05±8.51 min in the BS group (P<0.001). The time to healing in the BP group was shorter than that in the BS group (18.52±4.57 vs. 21.51±3.17 weeks; P=0.001). The coronal and sagittal plane deformities at any time points were comparable (all P＞0.05). During the 12-month follow-up period, patients had an average change in the coronal plane of 1.34 degrees in the BP group and 1.00 degrees in the BS group (P=0.120), as well as an average change in the sagittal plane of 1.09 degrees and 0.81 degrees (P=0.110), respectively. Malunion was seen in two patients (5%) in the BP group and one patient (2%) in the BS group ( P＞0.05). Conclusion: The blocking pins can help achieve satisfactory alignment for distal tibial fractures during nailing. Intramedullary nails without blocking screws can afford adequate stability to maintain the reduction during the healing process when an effective five-point anchoring fixation is achieved.
Clinical effects of dynamic stabilization with far cortical locking system in the treatment of simple distal-third tibia fractures: A cohort study
Authors: Peng Jing , Fan Jun , Li Yang , Long Xiaotao , Chen Shiyang , Ren Huanhuan 
Published: January 2020

Abstract
Background: Locked plating constructs provided rigid fixation and may suppress callus formation at the fracture site, while far cortical locking (FCL) constructs have been shown to reduce the stiffness, thereby promoting fracture healing. A few publications have demonstrated that FCL construct increased axial dynamization and improved fracture healing. However, it is unclear whether the FCL construct was superior over locked plating construct for treating simple tibia fractures. Thus, we aimed to compare the clinical effect of FCL construct and locked plating construct for these fracture types.Methods: We retrospectively analyzed 18 patients treated with locked plating (control group) and 22 patients treated with the FCL construct (FCL group) from January 2016 to January 2018; the simple distal-third tibia fractures were included (AO/OTA classification: 42A1-A3 or 43A1). Patients were followed up regularly at 1, 2, 3, 6, and 12 months postoperatively, and data from clinical and radiological examinations were obtained. Patients’ demographics, operative time, time to radiological fracture union, time to full weight bearing, callus index, radiographic union score in tibia (RUST), and surgery-related complications were analyzed between the two groups.Results: The baseline patients’ demographics were similar between the two groups (P>0.05). There were no significant differences in of the operative time, time to radiological fracture union, or time to full weight bearing (P>0.05). However, the median callus index was 1.15 (IQR=1.08–1.25) in the FCL group and 1.09 (IQR=1.00–1.14) in the control group, showing a significant difference between the two groups (Z=-2.35, P<0.05), and the RUST was significantly higher at 2 months postoperatively (6.50±0.92 vs 7.59±1.37, P =0.006). Seven out of 18 patients in the control group and 2 out of 22 patients in the FCL group had no callus formation (callus index=1.0). All patients ultimately healed, and the complication rates were similar between the two groups.Conclusions : The FCL construct could promote fracture healing and was superior to locked bridge plating, as it did not lead to more surgery-related complications. Level of Evidence : Ⅲ, retrospective cohort study
Inhibition of Stat3 Phosphorylation Attenuates Impairments in Learning and Memory in 5XFAD Mice, an Animal Model of Alzheimer’s Disease
Authors: Choi Moonseok , Kim Hyunju , Yang Eun-Jeong , Kim Hye-Sun 
Published: January 2020

Abstract

The novel functions of astrocytes under normal conditions have been extensively investigated in terms of synaptogenesis and memory formation. Meanwhile, the pathophysiological roles of astrocytes in the reactive state are thought to have important significance in the pathogenesis of neurodegenerative diseases, including Alzheimer’s disease (AD). However, the detailed mechanisms underlying the transition of astrocytes from the resting state to the reactive state during neurodegenerative disease largely remain to be defined. Here, we investigated the pathways involved in activating astrocytes from the resting state to the reactive state in primary cultured astrocytes treated with oligomeric Aβ and in the hippocampus of 5XFAD mice, an animal model of AD. Treatment with oligomeric Aβ induced an increase in reactive astrocytes, as assessed by the protein level of glial fibrillary acidic protein (GFAP), a marker of reactive astrocytes and this increase was caused by STAT3 phosphorylation in primary cultured astrocytes. The administration of Stattic, an inhibitor of STAT3, rescued the activation of astrocytes in primary cultured astrocytes and in the hippocampus of 6-month-old 5XFAD mice as well as impairments in learning and memory. Collectively, these results demonstrated that reactive astrocytes in the AD brain are induced via STAT3 phosphorylation and that the increase in reactive astrocytes and the impairments in learning and memory observed in 5XFAD mice are rescued by STAT3 inhibition, suggesting that the inhibition of STAT3 phosphorylation in astrocytes may be a novel therapeutic target for cognitive impairment in AD.
Resistance Training Alleviates Skeletal Muscle Atrophy in Rats Exposed to Hypoxia by inhibiting Autophagy Mediated by Acetyl-FoxO1
Authors: FU Pengyu , Zhaowei KONG , Lijing GONG , Holmberg Hans-Christer , Yanchun LI , Jiabei YU , Rongxin ZHU , Jie JIA , Yang HU 
Published: January 2020

Abstract
Background: Skeletal muscle atrophy induced by hypoxia could affect the physical fitness and training effect of the athletes in the rapid altitude, and also affect the production and life of the general public. Resistance training in a hypoxic environment could effectively alleviate the occurrence of muscular atrophy. Whether autophagy lysosomal pathway, as an important proteolysis pathway, is involved in this process, and whether FoxO1, the key gene of atrophy, plays a role by regulating autophagy is unclear. Methods: Male Sprague-Dawley (SD) rats were randomly divided into normoxic control group (group C), normoxic resistance-training group (group R), hypoxic control group (group H), and hypoxic resistance-training group (group HR). The H and HR groups were exposed to 12.4% oxygen for four weeks. The R and HR groups underwent incremental loaded training by climbing a ladder every other day for four weeks. Results: Compared to parameters in group H, resistance training increased lean body mass (LBM) and wet weight and decreased the expression of atrogin1 of the extensor digitorum longus (EDL) after four weeks ( P <0.05). Resistance training decreased the levels of FoxO1 and Ac-FoxO1 and the extent of their localization in the nucleus and cytoplasm, respectively ( P <0.05), as well as the LC3II/LC3I ratio, the integrated optical density (IOD) of LC3 and the levels of autophagy-related gene 7 (Atg7), and elevated the levels of sequestosome 1 (SQSTM1/p62) ( P <0.05). Most differentially expressed autophagy-related genes (ATGs) interacted with FoxO1, and the functions of these ATGs were mainly enriched in the early autophagy phase. Conclusions: Our findings demonstrate that resistance training lowers the levels of both nuclear FoxO1 and cytoplasmic Ac-FoxO1, as well as reduced autophagic flux in the EDL of rats exposed to hypoxia.
Long non-coding RNA THOR promotes Ovarian Cancer cells progression via STAT3 pathway
Authors: Ge Jing , Han Tao , Shan Lili , Na Jing , Li Ya , Wang Jun 
Published: January 2020

Abstract
Background Ovarian cancer (OC) is one of the most common malignant tumors in the world. The prognosis of OC remains poor due to the advanced stage and distant metastasis at the time of diagnosis. Recently, a novel lncRNA, THOR (testis-associated highly conserved oncogenic long non-coding RNA), was characterized in human cancers and shown to exhibit an oncogenic role. However, the role of THOR in OC was still unknown.Methods RT-PCR and western blot analysis were used to detect the expression of THOR and p-STAT3. The impact of THOR on OC proliferation, metastasis and self-renew was investigated in vitro and in vivo . The prognostic value of THOR was determined in OC patient cohorts.Results In this study, our results found that THOR was markedly upregulated in human OC tissues and predict the poor prognosis of OC patients. THOR knockdown resulted in significant inhibition of the growth, metastasis and self-renewal of OC cells. Mechanistically, THOR drives OC cell progression via the STAT3 signaling. Moreover, the specific STAT3 inhibitor S3I-201 diminished the discrepancy in the growth, metastatic and self-renewal capacity between THOR-silenced OC cells and control cells, which further confirmed that STAT3 was required in THOR-driven OC cells progression.Conclusion Our findings revealed that THOR could promote OC cells growth, metastasis and self-renew by activating STAT3 signaling and may be a good predictive factor and therapeutic target.
What is the role of the PN in the care of people living with dementia, or cognitive impairment, and their support person(s)? : A systematic review.
Authors: Gibson Caroline , Goeman Dianne , Pond Dimity 
Published: January 2020

Abstract
Background: The potential value of expanding the Practice Nurse role to include the recognition and management of dementia has been acknowledged and Practice Nurses are well-positioned to provide comprehensive dementia information and support so that people living with dementia are better equipped to self-manage their health and live well with dementia. The purpose of this review was to systematically examine published Australian and international literature to identify the existing and potential roles of Practice Nurse’s involvement in the delivery of care to people living with dementia or cognitive impairment and their support person(s) and also describe the characteristics and effectiveness of nurse interventions in dementia models of care in general practice. Methods: We systematically reviewed the evidence for roles and characteristics of the Practice Nurse in the delivery of dementia care. A comprehensive literature search identified relevant original research published in English between January 2000 and January 2019 and available in full text. Thirteen articles were included. Results: Characteristics of roles, undertaken by nurses working in the general practice setting, which were potentially beneficial to people living with dementia and their support person were identified. These included increased patient accessibility to the Practice Nurse, early recognition and management of cognitive changes, care management and collaboration with the General Practitioner. Limitations of the provision of dementia care by Practice Nurses included a lack of definition of the role, inadequate dementia specific training, time constraints and poor communication with General Practitioners. Conclusions Further research is required to define and evaluate the scope of practice and characteristics of the Practice Nurse role in dementia care provision. Embedding in usual general practice care an evidence-based model of care describing the role of the Practice Nurse in dementia care provision has the potential to increase early recognition of cognitive impairment and more appropriate primary care management of dementia. Systematic Review registration number PROSPERO 2018 CRD42018088191
Comparison of Patients’ Perceived Quality of Primary Care Between Urban and Rural Community Health Centers in Guangdong, China
Authors: chen aiyun , Feng Shanshan , Zhang liang , Shi leiyu 
Published: January 2020

Abstract
Background: A series of reforms were implemented to improve the quality of primary care services in China. This study aims to assess patients' perceived quality of primary health care between rural and urban community health centers in Guangdong.Methods: A cross-sectional survey was conducted from July to December 2015 in Guangdong. We surveyed 1010 respondents who visited either CHCs/CHSs in urban areas or THCs/RHSs in rural areas via face-to-face interviews. A validated Chinese version of Primary Care Assessment Tool-Adult Short Version (PCAT-AS), representing 10 primary care domains, was used to collect information on patients’ primary care experiences. T-test was used for comparison on domain scores and total scores between patients from CHCs/CHSs and THCs/RHSs. Analysis of covariance was employed to compare the adjusted PCAT domain scores and total scores. Multilevel models were used to explore factors associated with PCAT total scores. Results: Overall, patients reported a lower level of experience of community orientation and family centeredness compared to other primary care domains. Patients from THCs/RHSs settings in the rural area reported better primary care experience in four domains, including first contact, accessibility, ongoing care, and community orientation. Higher education background, and those with a chronic disease were associated with better primary care experience, after controlling for confounding factors. Patients who preferred primary care institutions when getting sick or used health services more frequently reported better primary care experience.Conclusion: Continued efforts are needed to strengthen primary care performance, particularly in community orientation and family centeredness. Primary care delivery in CHCs/CHSs settings should be improved in four domains including first contact, accessibility, ongoing care, and community orientation.
The study on knowledge-attitude-practice of primary care physician toward anticoagulants therapy in Non-valvular atrial fibrillation patients in Shanghai of China
Authors: Ye Shasha , Wang Tianhao , Liu Arthur , Yu Ying , Pan Zhigang , Gu Jie 
Published: January 2020

Abstract
Background As the large number of CHS centers in China face the majority of NVAF patients, primary care physicians (PCPs) play the primary role in the prevention of embolization. Therefore, an awareness of anticoagulant management in NVAF patients must be brought into focus among PCPs in China. This study will help primary care physicians (PCPs) increase their awareness of oral anticoagulant (OAC) therapy for non-valvular atrial fibrillation (NVAF) to prevent embolization.Method This was a cross-sectional observational study of 462 PCPs in community health service (CHS) centers across Shanghai. We used a self-administered questionnaire to collect data from September to December 2017. A stratified random cluster sampling was adopted in the 90 CHS centers with the family medicine residency program.Result Among 462 participants, 69.3% (320/462) of females with a medical bachelor’s degree and more than 10 years of work experience predominated in the 30 to 49 years of age group. The mean score for “knowledge,” “attitude” and “practices” of OAC therapy in NVAF patients among PCPs was 3.68±2.752, 53.62±7.148, and 37.63±10.336, respectively. The level of knowledge of OAC therapy in NVAF patients among PCPs was insufficient in over half (75.8%) of participants. The majority (89.8%) of PCPs had a positive attitude and 68.0% had modest performance in the anticoagulant management of NVAF patients.Conclusion The knowledge and behaviors of PCPs were insufficient in OAC therapy to prevent embolization in NVAF patients. The study also revealed the positive attitudes of participants, and their desire to learn the latest knowledge of OAC therapy.