bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers and Facilitators to Colorectal Cancer Diagnosis in New Zealand: A Qualitative Study
Authors: Blackmore Tania , Norman Kimberley , Kidd Jacquie , Cassim Shemana , Chepulis Lynne , Keenan Rawiri , Firth Melissa , Jackson Christopher , Stokes Tim , Weller David , Emery Jon , Lawrenson Ross 
Published: September 2020

Abstract
Background: New Zealand (NZ) has high rates of colorectal cancer but low rates of early diagnosis. Due to a lack of understanding of the pre-diagnostic experience from the patient’s perspective, it is necessary to investigate potential patient and health system factors that contribute to longer diagnostic intervals. Previous qualitative studies have discussed delays using The Model of Pathways to Treatment, but this has not been explored in the NZ context. This study aimed to understand the patient experience and perception of their general practitioner (GP) through the diagnostic process in the Waikato region of NZ. In particular, we sought to investigate potential barriers and facilitators that contribute to longer diagnostic intervals.Methods: Ethical approval for this study was granted by the New Zealand Health and Disability Ethics Committee. Twenty-eight participants, diagnosed with colorectal cancer, were interviewed about their experience. Semi-structured interviews were audio recorded, transcribed verbatim and analysed thematically using The Model of Pathways to Treatment framework (intervals: appraisal, help-seeking, diagnostic).Results: Participant appraisal of symptoms was a barrier to prompt diagnosis, particularly if symptoms were normalised, intermittent, or isolated in occurrence. Successful self-management techniques also resulted in delayed help-seeking. However if symptoms worsened, disruption to work and daily routines were important facilitators to seeking a GP consultation. Participants positively appraised GPs if they showed good technical competence and were proactive in investigating symptoms. Negative GP appraisals were associated with a lack of physical examinations and misdiagnosis, and left participants feeling dehumanised during the diagnostic process. However high levels of GP interpersonal competence could override poor technical competence, resulting in an overall positive experience, even if the cancer was diagnosed at an advanced stage. Māori participants often appraised symptoms inclusive of their sociocultural environment and considered the impact of their symptoms in relation to family.Conclusions: The findings of this study highlight the importance of tailored colorectal cancer symptom communication in health campaigns, and indicate the significance of the interpersonal competence aspect of GP-patient interactions. These findings suggest that interpersonal competence be overtly displayed in all GP interactions to ensure a higher likelihood of a positive experience for the patient.
Mir-20a-5p induced WTX deficiency promotes gastric cancer progressions through regulating PI3K/AKT signaling pathway
Authors: Li Jian , Ye Danli , Shen Peng , Liu Xiaorong , Zhou Peirong , Zhu Guifang , Xu Yangwei , Fu Yun , Li Xuanqi , Sun Jingbo , Xu Jia , Zhang Qingling 
Published: September 2020

Abstract
Background: The X-linked gene WTX (also called AMER1) has been reported to function as a tumour suppressor gene in Wilms’ tumour. In our previous study, WTX expression was shown to be significantly reduced in gastric cancer (GC), but the function and mechanism associated with WTX loss had yet to be fully elucidated. Methods: WTX expression and clinical significance were father analyzed in GC and control normal gastric tissues, and validated in public databases. The candidate pathway which was regulated by WTX during GC progression was searched by KEGG pathway analysis. The miRNA which monitored WTX expression was screened by miRNA microarray. After verified the pathway and miRNA both in vitro and in vivo, the relationship of miRNA, WTX and the downstream pathway were analyzed by Western blot, immunohistochemistry, RT-PCR, Co-immunoprecipitation (Co-IP), and luciferase analyses.Results: The results showed that WTX serves as a tumour suppressor gene in GC. The loss of WTX which is associated with the aggressiveness of GC by promoting GC cell proliferation in vitro and high metastasis in vivo. Furthermore, WTX expression was positively correlated with the overall survival of GC patients. Microarray assays, bioinformatics analysis, and verification experiments showed that WTX loss activates the PI3K/AKT/mTOR pathway and promotes GC cell proliferation and invasion. And the aberrant miR-20a-5p upregulation contributes to WTX loss in GC, which stimulates PI3K phosphorylation to activate PI3K/AKT/mTOR signaling pathway and promoted GC progression.Conclusions: The results of the present study elucidated the mechanism of GC progression, which is at least partially caused by aberrant miR-20a-5p upregulation leading to the inhibition of WTX expression and PI3K/AKT/mTOR signaling pathway activation. These findings provide a comprehensive understanding of the action of the miR-20a-5p/WTX/PI3K/AKT/mTOR signaling pathway in the progression and metastasis of GC.
The impact of diabetes mellitus on acute kidney injury after coronary artery bypass grafting
Authors: Wang Rui , Zhang Hang , Zhu Yifan , Chen Wen , Chen Xin 
Published: September 2020

Abstract
Background: Diabetes mellitus(DM) is an indicator affects postoperative mortality and morbidity after coronary artery bypass grafting (CABG). Acute kidney injury (AKI) is one of the frequent postoperative complications after CABG. This multi-centre register study designed to investigate the impact of DM on postoperative AKI in primary isolated CABG patients. Methods: We included all patients (n =4325) from Jiangsu Province CABG register who underwent primary isolated CABG from September 2017 to August 2019. The patients were divided into 3 groups: No-DM group(n=3067), DM-oral group (DM with oral hypoglycemic agents, n=706) and DM-insulin group (DM with insulin treatment, n=552). The development and severity of AKI were based on Acute Kidney Injury Network (AKIN) criteria. Results: There were totally 338, 108 and 145 patients developed AKI in No-DM, DM-oral and DM-insulin group respectively. Comparing with No-DM group , DM-oral group had a higher rate of AKI(χ2=10.071, p=0.002), DM-insulin group had a higher rate(χ2=94.042, p＜0.001) and severity of AKI(χ2=10.649, p=0.005). The adjusted odds ratio for AKI was 1.26 (95% CI 1.03-1.57) in DM-oral group and 3.92 (95% CI 3.27-5.16) in DM-insulin group, in comparison with No-DM group. Conclusions: Independent of baseline renal function or cardiac function, DM was associated with an increased risk of AKI after CABG, especially in patients with insulin treatment, who also had a higher severity of AKI.
Effects of dapagliflozin on serum and urinary uric acid levels in patients with type 2 diabetes: a prospective pilot trial
Authors: Yuan Tao , Liu Shixuan , Dong Yingyue , Fu Yong , Tang Yan , Zhao Wei-Gang 
Published: September 2020

Abstract
Background: We aimed to evaluate the effects of short-term therapy with dapagliflozin on serum uric acid (SUA) and urinary uric acid (UUA) levels in patients with type 2 diabetes.Methods: In this prospective pilot trial, 8 patients with type 2 diabetes mellitus were assigned to the treatment group with dapagliflozin 10 mg once daily for one week, and 7 subjects with normal glucose tolerance were recruited into the control group. Data of anthropometric measurements, SUA, 24-hour UUA, fractional excretion of UA (FEUA), serum lipid parameters and 3-hour oral glucose tolerance test (OGTT) were collected in both treatment and control groups; all examinations were repeated after treatment. The area under the curve of glucose (AUCGlu) was calculated to reflect the general glucose levels, while insulin resistance and islet β-cell function were reflected by indexes calculated according to the data obtained from the OGTT.Results: The weight and serum lipid parameters showed no differences before and after treatment with dapagliflozin for one week. We found SUA levels decreased from 347.75 ± 7.75 μmol/L before treatment to 273.25 ± 43.18 μmol/L after treatment, with a statistically significant difference (P=0.001) and was accompanied by a significant increase in FEUA from 0.009 to 0.029 (P=0.035); there was a linear correlation between SUA and FEUA levels. Glucose control, insulin sensitivity and islet β-cell function were improved to a certain extent. We also found a positive correlation between the decrease in glucose levels and the improvement in islet β-cell function.Conclusions: The SUA-lowering effect of dapagliflozin could be driven by increasing UA excretion within one week of treatment, and a certain degree of improvement in glucose levels and islet β-cell function were observed.
Steroid metabolites for diagnosing and predicting clinicopathological features in cortisol-producing adrenocortical carcinoma.
Authors: Suzuki Sawako , Minamidate Tomoki , Shiga Akina , Ruike Yutarou , Ishiwata Kazuki , Naito Kumiko , Ishida Akiko , Deguchi Hanna , Fujimoto Masanori , Koide Hisashi , Tatsuno Ichiro , Ikeda Jun-ichiro , Yamazaki Yuto , Sasano Hironobu , Yokote Koutaro 
Published: September 2020

Abstract
Background: Approximately 60% of adrenocortical carcinomas (ACC) are functional, and Cushing’s syndrome is the most frequent diagnosis that has been revealed to have a particularly poor prognosis. Since 30% of ACC present steroid hormone-producing disorganization, measurement of steroid metabolites in suspected ACC is recommended. Previous reports demonstrated that steroid hormone precursors or their urine metabolites, which can be assessed using liquid chromatography tandem mass spectrometry (LC-MS/MS) or gas chromatography mass spectrometry (GC-MS) respectively, are useful for distinguishing ACC from cortisol-producing adenomas (CPA); however, despite high precision, LC-MS/MS and GC-MS require a highly trained team, are expensive and have limited capacity. Methods: Here, we examined 12 serum steroid metabolites using an immunoassay, which is a more rapid and less costly method than LC-MS/MS, in cortisol-producing ACC and CPA. Further, the correlation of each steroid metabolite to the classification stage and pathological status in ACC was analyzed. Results: Reflecting disorganized steroidogenesis, the immunoassay revealed that all basal levels of steroid precursors were significantly increased in cortisol-producing ACC compared to CPA; in particular, 17-hydroxypregnenolone (glucocorticoid and androgen precursor ) and 11-deoxycorticosterone (mineralocorticoid precursor) showed a large area under the ROC curve with high sensitivity and specificity when setting the cut-off at 1.78 ng/ml and 0.4 mg/ml, respectively. Additionally, a combination of androstenedione and DHEAS also showed high specificity with high accuracy. In cortisol-producing ACC, 11-deoxycortisol (glucocorticoid precursor) showed significant positive correlations with predictive prognostic factors used in ENSAT classification, while testosterone showed significant positive correlations to the Ki67-index in both men and women.Conclusion: Less expensive and more widely available RIA and ECLIA may also biochemically distinguish ACC from CPA and may predict the clinicopathological features of ACC.
Lateral lymph node dissection reduces local recurrence of locally advanced lower rectal cancer in the absence of preoperative neoadjuvant chemoradiotherapy: A systematic review and meta-analysis
Authors: Gao Xiang , Wang Cun , Yu Yong-Yang , Yang Lie , Zhou Zong-Guang 
Published: September 2020

Abstract
Background: The role of lateral lymph node dissection (LLND) in the treatment of locally advanced lower rectal cancer remains controversial. The present study was conducted to compare total mesorectal excision (TME) with or without LLND among patients with lower rectal cancer in clinical stage II/III.Methods: PubMed, Embase, Ovid, Cochrane Library, Google Scholar, and the ClinicalTrials.gov databases were systematically searched for publications that compared TME with or without LLND among patients with lower rectal cancer in clinical stage II/III. Subgroup analysis was performed based on whether preoperative neoadjuvant chemoradiotherapy (nCRT) was undertaken. The hazard ratios (HR), relative risk (RR), and weighted mean difference (WMD) were pooled.Results: Twelve studies that included 4458 patients were identified in the current meta-analysis. Collected data demonstrated that TME with LLND was associated with significantly longer operation time (WMD 90.73 min, P<0.001), more intraoperative blood loss (WMD 303.20 mL, P<0.001), and postoperative complications (RR=1.35, P=0.02). Urinary dysfunction (RR 1.44, P=0.38), sexual dysfunction (RR 1.41, P=0.17), and postoperative mortality (RR=1.52, P=0.70) were similar between the two groups. No statistically significant differences were observed in OS (HR 0.93, P=0.62), DFS (HR 0.99, P=0.96), total recurrence (RR 0.98, P=0.83), lateral recurrence (RR 0.49, P=0.14) or distant recurrence (RR 0.95, P=0.78) between the two groups regardless the use of nCRT. LLND significantly reduced local recurrence rate of patients who did not receive nCRT (RR 0.71, P=0.004), while the difference was not significant when nCRT was performed (RR 0.70, P=0.36).Conclusions: Our study found out LLND could not significantly improve survival in locally advanced lower rectal cancer but could reduce the local recurrence in the absence of preoperative nCRT. The advantage of controlling local recurrence might be replaced with nCRT.Registration: The protocol for this meta-analysis was registered prospectively with PROSPERO (CRD42020135575) on May 16, 2019.
Birth preparedness and complication readiness among women of reproductive age in Kenya and Tanzania: a community-based cross-sectional survey
Authors: Orwa James , Gatimu Samwel Maina , Mantel Michaela , Luchters Stanley , Mugerwa Micheal A. , Brownie Sharon , Subi Leonard , Mrema Secilia , Nyaga Lucy , Edwards Grace , Mwasha Loveluck , Isangula Kahabi , Selestine Edna , Jadavji Sofia , Pell Rachel , Mbekenga Columba , Temmerman Marleen 
Published: September 2020

Abstract
Introduction: Delayed health-seeking continues to contribute to preventable maternal and neonatal deaths in low resource countries. Some of the strategies to avoid the delay include early preparation for the birth and detection of danger signs. We aimed to assess the level of practice and factors associated with birth preparedness and complication readiness (BPCR) in Kenya and Tanzania.Methods: We conducted community-based multi-stage cross-sectional surveys in Kilifi and Kisii counties in Kenya and Mwanza region in Tanzania and included women who delivered two years preceding the survey (2016–2017). A woman who mentioned at least three out of five BPCR components was considered well-prepared. Bivariate and multivariable proportional odds model were used to determine the factors associated with the BPCR. The STROBE guidelines for cross-sectional studies informed the design and reporting of this study.Results: Only 11.4% (59/519) and 7.6% (31/409) of women were well-prepared for birth and its complications in Kenya and Tanzania, respectively, while 39.7% and 30.6% were unprepared, respectively. Level of education (primary: adjusted odds ratio (aOR): 1.59, 95% CI: 1.14–2.20, secondary: aOR: 2.24, 95% CI: 1.39–3.59), delivery within health facility (aOR: 1.63, 95% CI: 1.15–2.29), good knowledge of danger signs during pregnancy (aOR: 1.28, 95% CI: 0.80–2.04), labour and childbirth (aOR: 1.57, 95% CI: 0.93–2.67), postpartum (aOR: 2.69, 95% CI: 1.24–5.79), and antenatal care were associated with BPCR (aOR: 1.42, 95% CI: 1.13–1.78).Conclusion: Overall, most pregnant women were not prepared for birth and its complications in Kilifi, Kisii and Mwanza region. Improving level of education, creating awareness on danger signs during preconception, pregnancy, childbirth, and postpartum period, and encouraging antenatal care and skilled birth care among women and their male partners/families are recommended strategies to promote BPCR practices and contribute to improved pregnancy outcomes in women and newborns.
Distinct role of 5’UTR sequences in dendritic trafficking of BDNF mRNA: additional mechanisms for the BDNF splice variants spatial code.
Authors: Colliva Andrea , Tongiorgi Enrico 
Published: September 2020

Abstract
The neurotrophin Brain-derived neurotrophic factor (BDNF) is encoded by multiple bipartite transcripts. Each BDNF transcript is composed by one out of eleven alternatively spliced exons containing the 5’untranslated region (UTR), and one common exon encompassing the coding sequence (CDS) and the 3’UTR with two variants (short and long). In neurons, BDNF mRNA variants have a distinct subcellular distribution, constituting a “spatial code”, with exon 1, 3, 5, 7 and 8 located in neuronal somata, exon 4 extending into proximal dendrites, and exon 2 and 6 reaching distal dendrites. We previously showed that the CDS encodes constitutive dendritic targeting signals (DTS) and that both the 3’UTR-short and the 3’UTR-long contain activity-dependent DTS. However, the role of individual 5’UTR exons in mRNA sorting remains unclear. Here, we tested the ability of each different BDNF 5'UTRs to affect the subcellular localization of the green fluorescent protein (GFP) reporter mRNA. We found that exon 2 splicing isoforms (2a, 2b, and 2c) induced a constitutive dendritic targeting of the GFP reporter mRNA towards distal dendritic segments. The other isoforms did not affect GFP-mRNA dendritic trafficking. Through a bioinformatic analysis, we identified five unique cis-elements in exon 2a, 2b, and 2c which might contribute to building a DTS. This study provides additional information on the mechanism regulating the cellular sorting of BDNF mRNA variants.
Unraveling the Influence of Non-Fullerene Acceptor Molecular&nbsp;Packing on Phovoltaic Performance of Organic Solar Cells
Authors: Sun Yanming , Ye Linglong , Weng Kangkang , Xu Jinqiu , Du Xiaoyan , Chandrabose Sreelakshmi , Chen Kai , Zhou Jiadong , Han Guangchao , Tan Songting , Xie Zengqi , Yi Yuanping , Li Ning , Liu Feng , Hodgkiss Justin , Brabec Christoph 
Published: September 2020

Abstract
In non-fullerene organic solar cells (OSCs), the long-range structure ordering induced by end group π–π stacking of fused-ring non-fullerene acceptors is considered as the critical factor in realizing efficient charge transport and high power conversion efficiency. Here, we demonstrate that side-chain engineering of non-fullerene acceptors could drive the fused-ring backbone assembly from a π–π stacking mode to an intermixed packing mode, and to a non-stacking mode to refine its solid-state properties. Different from the above-mentioned understanding, we find that close atom contacts in a non-stacking mode can form efficient charge transport pathway through close side atom interactions. The intermixed solid-state packing motif in active layers could enable OSCs with superior efficiency and reduced non-radiative recombination loss compared with devices based on molecules with the classic end-group π–π stacking mode. Our observations provide new insights into the influence of non-fullerene acceptor molecular packing on exciton dissociation, charge transport, and recombination losses, and open a new avenue in material design that endows better photovoltaic performance.
Blocking of Efflux Transporters in Rats Improves Translational Validation of Brain Radioligands
Authors: Shalgunov Vladimir , Xiong Mengfei , L'Estrade Elina T , Raval Nakul R , Andersen Ida Vang , Edgar Fraser G , Speth Nikolaj Raahauge , Bærentzen Simone Larsen , Hansen Hanne Demant , Donovan Lene Lundgaard , Nasser Arafat , Peitersen Siv Thorlund , Kjær Andreas , Knudsen Gitte Moos , Syvänen Stina , Palner Mikael , Herth Matthias Manfred 
Published: September 2020

Abstract
Background: Positron Emission Tomography (PET) is a molecular imaging technique that can be used to investigate the in vivo pharmacology of drugs. Initial preclinical evaluation of PET tracers is often conducted in rodents due to the accessibility of disease models as well as economic considerations. Compared to larger species, rodents display a higher expression and/or activity of efflux transporters such as the P-glycoprotein (P-gp). Low brain uptake could, therefore, be species-specific and uptake in rodents not be predictive for that in humans. We hypothesized that a better prediction from rodent data could be achieved when a tracer is evaluated under P-gp inhibition. Consequently, we compared the performance of eight neuroreceptor tracers in rats with and without P-gp inhibition including a specific binding blockade. This data set was then used to predict the binding of these eight tracers in pigs.Methods: PET tracers targeting serotonin 5-HT2A receptors ([18F]MH.MZ, [18F]Altanserin, [11C]Cimbi-36, [11C]Pimavanserin), serotonin 5-HT7 receptors ([11C]Cimbi-701, [11C]Cimbi-717 and [11C]BA-10) and dopamine D2/3 receptors ([18F]Fallypride) were used in the study. The brain uptake and target-specific binding of these PET radiotracers were evaluated in rats with and without inhibition of P-gp. Rat data were subsequently compared to the results obtained in pigs.Results: Without P-gp inhibition, the amount of target-specific binding in the rat brain was sufficient to justify further translation for three out of eight evaluated tracers. With P-gp inhibition, five out of eight tracers justifyied further translation. The performance in pigs could correctly be predicted for six out of eight tracers when rat data obtained under P-gp inhibition were used, compared to four out of eight tracers without P-gp inhibition.Conclusions: P-gp strongly affects the uptake of PET tracers in rodents, but false prediction outcomes can be reduced by evaluating a tracer under P-gp inhibition.
Are Healthcare Professionals Sufficiently Aware of Dental Ethics? Fields Research in Southeast Turkey
Authors: Bakir Elif Pinar , Bakir Seyhmus , Sonkaya Ezgi , Ünal Samican Ünal 
Published: September 2020

Abstract
Background: The aim of this study was to evaluate the awareness of healthcare personnel in the Dentistry Faculty of Dicle University about “the legal responsibilities of dental practitioners” and “patient rights”. Methods: The study included 150 volunteers who were healthcare workers in the Faculty of Dentistry , Dicle University between June and July 2019. The subjects were randomly selected from five different Professional groups and data were collecte dusing a single data collection form. All items on the form were grade dusing a 5-point Likert –type response. In the statistical analyses, Pearson’ s Chi-square, Yates Chi-square and the Fisher Exact tests were used. Results:The questionnaire responses showed that 61.3% of the study participants had received training on patient rights and 56.7% had information about the legal responsibilities of dentists. The rate of dentists who had received training was below average and 38.9% of the dentists reported not having any information about their own legal responsibilities. A positive response was given to the items on the questionnaire by 58% and a negative responseby 33%. The responses to some items were seen to have been affected by variables such as age, gender and professional group.Conclusion: Although some confusion was experienced by the healthcare personel about patient rights and the legal responsibilities of dentists, the levels of awareness were evaluated as satisfactory.