bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of service changes affecting distance/time to access urgent and emergency care facilities on patient outcomes: a systematic review
Authors: Chambers Duncan , Cantrell Anna , Baxter Susan , Turner Janette , Booth Andrew 
Published: May 2020

Abstract
Background
Reconfiguration of urgent and emergency care services often increases travel time/distance for patients to reach an appropriate facility. Evidence of the effects of reconfiguration is important for local communities and commissioners and providers of health services.

Methods
We performed a systematic review of the evidence regarding effects of service reconfigurations that increase the time/distance for some patients to reach an urgent and emergency care (UEC) facility. We searched seven bibliographic databases from 2000 to February 2019 and used citation tracking and reference lists to identify additional studies. We included studies of any design that compared outcomes for people with conditions requiring emergency treatment before and after service reconfiguration with an associated change in travel time/distance to access UEC. Studies had to be conducted in the UK or other developed countries. Data extraction and quality assessment (using the Joanna Briggs Institute checklist for quasi-experimental studies) were undertaken by a single reviewer with a sample checked for accuracy and consistency. We performed a narrative synthesis of the included studies. Overall strength of evidence was assessed using a previously published method that considers volume, quality and consistency.

Results
We included 12 studies, of which six were conducted in the USA, two in the UK and four in other European countries. The studies used a variety of observational designs, with before–after and cohort designs being most common. Only two studies included an independent control site/sites where no reconfiguration had taken place. The reconfigurations evaluated in these studies reported relatively small effects on average travel times/distance.

Discussion
For studies of general UEC populations, there was no convincing evidence as to whether reconfiguration affected mortality risk. However, evidence of increased risk was identified from studies of patients with acute myocardial infarction, particularly 1 to 4 years after reconfiguration. Evidence for other conditions was inconsistent or very limited.

Conclusions
We found insufficient evidence to determine whether increased distance to UEC increases mortality risk for the general population of people requiring UEC, although this conclusion may not extend to people with specific conditions.
A glycolysis-based 4-mRNA signature correlates with the prognosis and cell cycle process in patients with bladder cancer
Authors: Zhang Chen , Gou Xin , He Weiyang , Yang Huaan , Yin Hubin 
Published: May 2020

Abstract
Background
Bladder cancer is one of the most prevalent malignancies worldwide. However, traditional indicators have limited predictive effects on the clinical outcomes of bladder cancer. The aim of this study was to develop and validate a glycolysis-related gene signature for predicting the prognosis of patients with bladder cancer that have limited therapeutic options.

Methods
mRNA expression profiling was obtained from patients with bladder cancer from The Cancer Genome Atlas (TCGA) database. Gene set enrichment analysis (GSEA) was conducted to identify glycolytic gene sets that were significantly different between bladder cancer tissues and paired normal tissues. A prognosis-related gene signature was constructed by univariate and multivariate Cox analysis. Kaplan–Meier curves and time-dependent receiver operating characteristic (ROC) curves were utilized to evaluate the signature. A nomogram combined with the gene signature and clinical parameters was constructed. Correlations between glycolysis-related gene signature and molecular characterization as well as cancer subtypes were analyzed. RT-qPCR was applied to analyze gene expression. Functional experiments were performed to determine the role of PKM2 in the proliferation of bladder cancer cells.

Results
Using a Cox proportional regression model, we established that a 4-mRNA signature (NUP205, NUPL2, PFKFB1 and PKM) was significantly associated with prognosis in bladder cancer patients. Based on the signature, patients were split into high and low risk groups, with different prognostic outcomes. The gene signature was an independent prognostic indicator for overall survival. The ability of the 4-mRNA signature to make an accurate prognosis was tested in two other validation datasets. GSEA was performed to explore the 4-mRNA related canonical pathways and biological processes, such as the cell cycle, hypoxia, p53 pathway, and PI3K/AKT/mTOR pathway. A heatmap showing the correlation between risk score and cell cycle signature was generated. RT-qPCR revealed the genes that were differentially expressed between normal and cancer tissues. Experiments showed that PKM2 plays essential roles in cell proliferation and the cell cycle.

Conclusion
The established 4‑mRNA signature may act as a promising model for generating accurate prognoses for patients with bladder cancer, but the specific biological mechanism needs further verification.
Effect of green tea consumption on blood lipids: a systematic review and meta-analysis of randomized controlled trials
Authors: Xu Renfan , Yang Ke , Li Sui , Dai Meiyan , Chen Guangzhi 
Published: May 2020

Abstract
Background
Strong epidemiologic evidence indicates that green tea intake is protective against hyperlipidemia; however, randomized controlled studies have presented varying results. In the present study, we aimed to conduct a literature review and meta-analysis to assess the effect of green tea on blood lipids.

Methods
PubMed, Embase, and the Cochrane Library were electronically explored from inception to September 2019 for all relevant studies. Random effect models were used to estimate blood lipid changes between green tea supplementation and control groups by evaluating the weighted mean differences (WMD) with 95% confidence intervals (CIs). The risk of bias for study was assessed using the Cochrane tool. Publication bias was evaluated using funnel plots and Egger’s tests.

Results
Thirty-one trials with a total of 3321 subjects were included in the meta-analysis. In general, green tea intake significantly lowered the total cholesterol (TC); WMD: − 4.66 mg/dL; 95% CI: − 6.36, − 2.96 mg/dL; P < 0.0001) and low-density lipoprotein (LDL) cholesterol (WMD:− 4.55 mg/dL; 95% CI: − 6.31, − 2.80 mg/dL; P < 0.0001) levels compared with those in the control. Green tea consumption did not affect high-density lipoprotein (HDL) cholesterol; however, it reduced the triglycerides compared with that in the control (WMD: − 3.77 mg/dL; 95% CI: − 8.90, 1.37 mg/dL; P = 0.15). In addition, significant publication bias from funnel plots or Egger’s tests was not evident.

Conclusions
Collectively, consumption of green tea lowers LDL cholesterol and TC, but not HDL cholesterol or triglycerides in both normal weight subjects and those who were overweight/obese; however, additional well-designed studies that include more diverse populations and longer duration are warranted.
Plasma concentration of brominated flame retardants and postmenopausal breast cancer risk: a nested case-control study in the French E3N cohort
Authors: Mancini Francesca Romana , Cano-Sancho German , Mohamed Oceane , Cervenka Iris , Omichessan Hanane , Marchand Philippe , Boutron-Ruault Marie-Christine , Arveux Patrick , Severi Gianluca , Antignac Jean-Philippe , Kvaskoff Marina 
Published: May 2020

Abstract
Background
Brominated flame retardants (BFRs) are lipophilic substances with endocrine-disrupting properties. To date, only few investigations, mainly retrospective case-control studies, have explored the link between internal levels of BFRs and the risk of breast cancer, leading to conflicting results. We investigated the associations between plasma concentrations of two main groups of BFRs, PBDEs (pentabromodiphenyl ethers) and PBBs (polybrominated biphenyls), and the risk of breast cancer in a nested case-control study.

Methods
A total of 197 incident breast cancer cases and 197 controls with a blood sample collected in 1994–1999 were included. Plasma levels of PBDE congeners (BDE-28, BDE-47, BDE-99, BDE-100, BDE153, BDE-154) and of PBB-153 were measured by gas chromatography coupled to high-resolution mass spectrometry. Conditional logistic regression models, adjusted for potential confounders, were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).

Results
Women were aged 56 years on average at blood draw. All cases, except for one, were diagnosed after menopause, with an average age at diagnosis of 68 years. Overall, we found no evidence of an association between plasma levels of PBDEs and PBB-153 and postmenopausal breast cancer risk (log-concentrations of BFRs yielding non-statistically significant ORs of 0.87 to 1.07). The analysis showed a non-linear inverse association for BDE-100 and BDE-153 and postmenopausal breast cancer risk; nevertheless, these findings were statistically significant only when the exposure was modeled as ng/L plasma (third vs. first quintile: OR = 0.42, 95%CI = 0.19–0.93 and OR = 0.42, 95%CI = 0.18–0.98, respectively) and not when modeled as ng/gr of lipids (OR = 0.58, 95%CI = 0.27–1.25 and OR = 0.53, 95%CI = 0.25–1.17). These results were unchanged in stratified analyses by tumor hormone receptor expression or body mass index.

Conclusions
Our results suggest no clear association between internal levels of PBDEs and PBB-153 and the risk of breast cancer in postmenopausal women. However, these findings need to be carefully interpreted, taking into account limitations due to the limited number of women included in the study, the lack of information concerning genetic susceptibility of cases, and the unavailability of exposure assessment during critical windows of susceptibility for breast cancer. More studies are warranted to further investigate the relationships between PBDE and PBB exposure and breast cancer risk.
Downregulation of hsa_circ_0005243 induces trophoblast cell dysfunction and inflammation via the β-catenin and NF-κB pathways
Authors: Wang Huiyan , Zhou Wenbo , She Guangtong , Yu Bin , Sun Lizhou 
Published: May 2020

Abstract
Background
Gestational diabetes mellitus (GDM) is a common complication in pregnancy that poses a serious threat to the health of both mother and child. While the specific etiology and pathogenesis of this disease are not fully understood, it is thought to arise due to a combination of insulin resistance, inflammation, and genetic factors. Circular RNAs (circRNAs) are a special kind of non-coding RNA that have attracted significant attention in recent years due to their diverse activities, including a potential regulatory role in pregnancy-related diseases, such as GDM.

Methods
We previously reported the existence of a novel circRNA, hsa_circ_0005243, which was identified by RNA sequencing. In this study, we examined its expression in 20 pregnant women with GDM and 20 normal pregnant controls using quantitative reverse transcription PCR analysis. Subsequent in vitro experiments were conducted following hsa_circ_0005243 knockdown in HTR-8/SVneo cells to examine the role of hsa_circ_0005243 in cell proliferation and migration, as well as the secretion of inflammatory factors such as tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6). Finally, we examined the expression of β-catenin and nuclear factor kappa-B (NF-κB) signaling pathways to assess their role in GDM pathogenesis.

Results
Expression of hsa_circ_0005243 was significantly reduced in both the placenta and plasma of GDM patients. Knockdown of hsa_circ_0005243 in trophoblast cells significantly suppressed cell proliferation and migration ability. In addition, increased secretion of inflammatory factors (TNF-α and IL-6) was observed after hsa_circ_0005243 depletion. Further analyses showed that knockdown of hsa_circ_0005243 reduced the expression of β-catenin and increased nuclear NF-κB p65 nuclear translocation.

Conclusions
Downregulation of hsa_circ_0005243 may be associated with the pathogenesis of GDM via the regulation of β-catenin and NF-κB signal pathways, suggesting a new potential therapeutic target for GDM.
Are the doctors of the future ready to support breastfeeding? A cross-sectional study in the UK
Authors: Biggs Kirsty V. , Fidler Katy J. , Shenker Natalie S. , Brown Heather 
Published: May 2020

Abstract
Background
Currently there is no published data on the inclusion of breastfeeding education within the UK medical school curriculum. This study aims to address this knowledge gap and explore students’ perceptions of their readiness to support breastfeeding.

Methods
An online survey was used to collect data from 32 UK undergraduate medical schools and their students. All students in their final two years of study at the 30 universities offering a 5- or 6-year medicine course, were eligible.

Results
Curriculum data was obtained from 26 (81%) institutions. Compulsory breastfeeding education was provided by 85% (N = 22) institutions with 81% (n = 21) providing lecture-based teaching and 19% (n = 5) offering formal clinical education. Overall, 411 students from 22 institutions participated. A moderate ability to identify the benefits of breastfeeding was observed; however, self-rated confidence in practical skills was poor. Assisting with latching was the least confident skill, with confidence in only 3% (14/411) students. Most students (93%) viewed doctors as playing an important role in breastfeeding, with those interested in either women’s health, paediatrics or general practice perceiving the role of doctors as more important. Overall, 93% (381/411) students requested further breastfeeding education.

Conclusions
This study suggests UK medical schools are not adequately preparing students to support breastfeeding patients. Further studies should explore the competency of doctors to meet the needs of lactating women, and design optimal training for UK medical students.
The effectiveness of cognitive- behavioral therapy on quality of life in women with hypothyroidism in the reproductive age: a randomized controlled trial
Authors: Rezaei Sohaila , Abedi Parvin , Maraghi Elham , Hamid Najmeh , Rashidi Homaira 
Published: May 2020

Abstract
Background
Worldwide, hypothyroidism affects 3.7% of the population, and is associated with impaired quality of life. This study aimed to evaluate the effect of cognitive- behavioral therapy (CBT) on the quality of life in women with hypothyroidism.

Methods
96 women with hypothyroidism randomly allocated into two groups: CBT group (n = 48) and control group (n = 48). Women in the CBT group were classified into four sub-groups of 12, and each sub-group received eight sessions of counseling (each session lasting 90 min). We collected data using a demographic questionnaire and the 36-Item Short Form Health Survey (SF 36) for measuring the quality of life. We used the independent t-test, chi-square test and ANCOVA to analyze the data.

Results
Five women from each group withdrew from the study, leaving 43 women in each group. The scores on physical functioning, physical health problems, social functioning and pain improved in the CBT group after the intervention, but the differences between the two groups were not significant. The scores on emotional health, emotional health problems, energy and emotions, and general health were significantly better in the CBT group than those in the control group (p < 0.05).

Conclusion
Counseling using CBT can improve some aspects of quality of life, including emotional health, emotional health problems, energy and general health in patients with hypothyroidism.

Trial registration number
Iranian Registry for Clinical Trials: 20190323043101 N1. https://www.irct.ir/
Faecal calprotectin and ultrasonography as non-invasive screening tools for detecting colorectal polyps in children with sporadic rectal bleeding: a prospective study
Authors: Di Nardo Giovanni , Esposito Francesco , Ziparo Chiara , Strisciuglio Caterina , Vassallo Francesca , Di Serafino Marco , Villa Maria Pia , Parisi Pasquale , Evangelisti Melania , Pacchiarotti Claudia , Corleto Vito Domenico 
Published: May 2020

Abstract
Background
Colorectal polyps are reported in 6,1% of paediatric colonoscopies and in 12% of those performed for lower gastrointestinal bleeding. Although colonoscopy is widely used in paediatric patients, it requires bowel preparation and general anaesthesia or deep sedation, and in rare cases, it can cause complications. Non-invasive screening techniques able to predict polyps in children with isolated and sporadic rectal bleeding may play a key role in the selection of patients needing colonoscopy.

Methods
We enrolled all children undergoing colonoscopy for isolated and sporadic rectal bleeding to determine the diagnostic accuracy of faecal calprotectin, ultrasonography (US) and digital rectal examination as diagnostic methods for screening colorectal polyps.

Results
A total of 26 of 59 enrolled patients (44.1%) had colonic polyps, one patient had multiple polyps, and 23% of children had polyps proximal to the splenic flexure. The diagnostic accuracy of faecal calprotectin for detecting colorectal polyps was 96.6%, with a sensitivity of 100%. False-positive faecal calprotectin was shown in 2 patients with non-steroidal anti-inflammatory drug-related lesions. The diagnostic accuracy of ultrasound was 77.9%. Polyps not seen with ultrasound tended to be relatively smaller (1.5 vs 2.3, p = 0.001) and located in the rectum. The combined use of FC, US and digital rectal examination obtained a specificity and PPV of 100%.

Conclusions
FC combined with US and digital rectal examination is a good and promising non-invasive screening test for detecting colorectal polyps in children with isolated and sporadic rectal bleeding.
Physical exercise during exposure to 40-Hz light flicker improves cognitive functions in the 3xTg mouse model of Alzheimer’s disease
Authors: Park Sang-Seo , Park Hye-Sang , Kim Chang-Ju , Kang Hyun-Sik , Kim Dong-Hyun , Baek Seung-Soo , Kim Tae-Woon 
Published: May 2020

Abstract
Background
Exercise promotes brain health and improves cognitive functioning in the elderly, while 40-Hz light flickering through the visual cortex reduces amyloid beta (Aβ) by stabilizing gamma oscillation. We examined whether exercise was associated with hippocampus-mediated improvement in cognitive functioning in the 3xTg-Alzheimer’s disease (3xTg-AD) murine model following exposure to 40-Hz light flickering and exercise.

Methods
We subjected 12-month-old 3xTg-AD mice to exercise and 40-Hz light flickering for 3 months to investigate spatial learning, memory, long-term memory, Aβ levels, tau levels, mitochondrial functioning including Ca2+ retention and H2O2 emission, apoptosis, and neurogenesis in the hippocampus.

Results
Treatments had a positive effect; however, the combination of exercise and 40-Hz light flickering exposure was most effective in reducing Aβ and tau levels. Reducing Aβ and tau levels by combination of exercise and 40-Hz light flickering improves Ca2+ homeostasis and reactive oxygen species such as H2O2 in mitochondria and apoptosis including bax, bcl-2, cytochrome c, and cleaved caspase-3 and cell death, cell differentiation, and neurogenesis in the 3xTg-AD model of the hippocampus, resulting in improving cognitive impairment such as spatial learning, memory and long term memory.

Conclusion
Our results show that exercising in a 40-Hz light flickering environment may improve cognitive functioning by reducing Aβ and tau levels, thereby enhancing mitochondrial function and neuroplasticity.
Assessment of clinical activity and severity using serum ANCA and ASCA antibodies in patients with ulcerative colitis
Authors: Pang Yanhua , Ruan Huijie , Wu Dongfang , Lang Yanfei , Sun Ke , Xu Cuiping 
Published: May 2020

Abstract
Background
Ulcerative colitis (UC) is a chronic, non-specific inflammatory bowel disease (IBD) with unknown etiology. The lack of specific clinical manifestations, standard diagnostic criteria, objective and accurate indicators to the severity of the disease and the efficacy of the treatment, often results in difficulties in diagnosis and timely treatment of UC. Therefore, there is a need to develop a clinically suitable serum biomarker assay with high specificity and sensitivity.

Objective and methods
To explore the significance of anti-neutrophil cytoplasmic antibodies (ANCA) and anti-saccharomyces cerevisiae antibodies (ASCA) in the diagnosis, differential diagnosis and treatment assessment in patients with ulcerative colitis (UC). Serum levels of ANCA-IgG, ASCA-IgA and ASCA-IgG were measured by an enzyme-linked immunosorbent assay (ELISA) in 105 UC patients, 52 non-UC patients and 100 healthy controls.

Results
(1) Both the ANCA-IgG level and its positive rate in UC patients were significantly higher than those in non-UC controls and healthy controls (p < 0.01). However, the levels of ASCA-IgA, ASCA-IgG and the positive rates in UC patients had no statistical differences when compared with those in non-UC controls or healthy controls (p > 0.05). (2) The sensitivity of ANCA+ and ANCA+/ASCA− in detecting UC patients was 61.90% and 55.24%, respectively, whereas the specificity was 91.45% and 94.08%, respectively. The sensitivity of ASCA+ and ASCA+/ANCA− in non-UC disease controls was 5.33% and 3.85%, respectively, and specificity was 83.9% and 88.78%, respectively. (3) When UC patients were grouped into mild, moderate or severe subtypes, the ANCA-IgG levels were correlated with the severity of UC, and the differences of the ANCA-IgG levels were statistically different among the three subtypes (p < 0.05). There was no correlation between the levels of ANCA-IgG and the disease locations of UC.

Conclusions
(1) Serum levels of ANCA may be useful in the diagnosis of UC. (2) Dynamic quantitation of ANCA-IgG levels may be helpful in determining the severity of UC and therefore, may guide treatment of UC.
Frequency of Y-chromosome STRs using PowerPlex® Y23 System in Iraqi population
Authors: Mahmood Hanan K. , Salman Nadia F. , Salih Khalifa M. , Hasan Dhurgham H. , Al-Zubaidi Mohammed M. 
Published: May 2020

Abstract
Background
Y-chromosome STRs are valuable in the forensic identification of male DNA from sexual assault cases, and they are used to link families through genetic genealogy.

Materials and methods
For Y-STR analysis, 1032 male blood samples were used in this study, direct PCR technique was used for DNA amplification using the PowerPlex® Y23 System, and then PCR product was run with Genetic Analyzer, and the data were analyzed with the Gene Mapper ID Analysis Software. Frequency-based statistical analysis was calculated with GenAlEx 6.5-Genetic Analysis.

Results
One hundred and eighty-five alleles were detected at the 23 Y-STR loci in 1032 samples. Alleles frequency ranged from 0.002 to 0.813 and the highest allele frequency registered (0.813) for allele 11 at locus DYS392, and the mean haplotype diversity was 0.616 ± 0.027. New variants were registered for DYS458 locus.

Conclusion
The present study established the genetic information obtained by using the PowerPlex® Y23 System for the Iraqi population and also created a database of 23 Y STR markers in this population.