bluuebunny/crossref_metadata_2025_split huggingface dataset:
How does ageism influence frailty? A preliminary study using a structural equation model
Authors: Ye Bo , Gao Junling , Fu Hua , Chen Hao , Dong Wenjing , Gu Ming 
Published: April 2020

Abstract
Objectives: Based on the Stereotype Embodiment Theory (SET), this study aims to examine the mechanism of ageism on frailty through the proposed framework of "Experiences of Ageism (EA) → Age Stereotypes (AS) → Attitudes to ageing (AA) → Frailty" using a structural equation model (SEM). Methods: A community-based study involving 630 participants aged 60 years and older was conducted in Shanghai. EA, AS, AA and frailty status were assessed by validated scales. In particular, EA included three parts in this study, as the first part was the experiences of explicit prejudice or discrimination because of age, another two parts were the experiences of witnessed and encountered implicit negative age-based stereotypes. A SEM was performed to examine whether the proposed paths from EA to frailty were supported. Results: EA had a significant indirect effect (β'=.344×-.365×-.333=.023, p<.001) on frailty through the path of "EA → AS → AA → Frailty" after controlling for covariates. AA had a direct effect (β=-.337, p<.001) on frailty; AS fully mediated the association between EA and AA (indirect effect=.344×-.365=-.126, p<.001), and AA fully mediated the association between AS and frailty (indirect effect=-.365×-.333=.122, p<.001). Conclusions: These findings demonstrated a mechanism from ageism to frailty, and highlighted the potential threat of negative AS on health. Ageism and frailty are both great challenges for the process of healthy ageing.
Effect of Two Major Health Reforms on Health Care Cost and Utilization in Fars Province of Iran: Family Physician Program and Health Transformation Plan
Authors: Bayati Mohsen , Keshavarz Khosro , Lotfi Farhad , KebriaeeZadeh Abbas , Barati Omid , Zareian Shahram , Amiri Akbar , Delavari Sajad 
Published: April 2020

Abstract
Background: Family physician program (FPP) and health transformation plan (HTP) are two major reforms that have been implemented in Iran's health system in recent. The present study was aimed at evaluating the impact of these two reforms on the level of service utilization and cost of health care services.
Methods: This longitudinal study was conducted on people insured by social security organization in Fars province during 2009-2016. The data on the utilization of services and costs of general practitioner visits, specialist visits, medications, imaging, laboratory tests, and hospitalization were collected. Interrupted time series analysis was used to analyze the effect of the two mentioned reforms.
Results: FPP resulted in a significant reduction in the number of specialist visits, imaging, and laboratory tests in the short term, and in the number of radiology services, laboratory tests, and hospitalization in the long term. In contrast, HTP significantly increased the utilization of radiology services and laboratory tests both in the short term and long term. Concerning the costs, FPP resulted in a reduction in costs in short and long term except general practitioners' and specialist visit, and medication in long term. However, HTP resulted in an increase in health care costs in both of the studied time periods.
Conclusions: FPP has been successful in rationalizing the utilization of services. On the other hand, HTP has improved people’s access to services by increasing the utilization; but it has increased health care costs. Therefore, policymakers must adopt an agenda to revise and re-design the plan.
Screening for triazole resistance in clinically significant Aspergillus species; report from Pakistan
Authors: Moin Safia , Farooqi Joveria , Jabeen Kauser , Laiq Sidra , Zafar Afia 
Published: April 2020

Abstract
Abstract
Background:
Burden of aspergillosis is reported to be significant from developing countries including those in South Asia. The estimated burden in Pakistan is also high on the background of tuberculosis and chronic lung diseases. There is concern for management of aspergillosis with the emergence of azole resistant Aspergillus species in neighbouring countries in Central and South Asia.
Hence the aim of this study was to screen significant Aspergillus species isolates at the Microbiology Section of Aga Khan Clinical Laboratories, Pakistan, for triazole resistance.
Methods:
A descriptive cross-sectional study, conducted at the Aga Khan University Laboratories, Karachi, from September 2016-May 2019. One hundred and fourteen, clinically significant Aspergillus isolates [ A. fumigatus (38; 33.3%), A. flavus (64; 56.1%), A. niger (9; 7.9%) A. terreus (3; 2.6%)] were included. The clinical spectrum ranged from invasive aspergillosis (IA) (n=25; 21.9%), chronic pulmonary aspergillosis (CPA) (n=58; 50.9%), allergic bronchopulmonary aspergillosis (ABPA) (n=4; 3.5%), severe asthma with fungal sensitization (SAFS) (n=4; 3.5%), saprophytic tracheobronchial aspergillosis (n=23; 20.2%). Screening for triazole resistance was performed by antifungal agar screening method. The minimum inhibitory concentration (MIC) of itraconazole, voriconazole and posaconazole against 41 isolates, a subset of the collection, were tested and interpreted according to the Clinical and Laboratory Standards Institute broth microdilution method.
Results:
All the isolates were triazole-susceptible on agar screening. MICs of all three azole antifungals for 41 tested isolates were found to be ≤1 ml/L; all isolates tested were categorized as triazole-susceptible, including 4 isolates from patients previously on triazole therapy for more than two weeks.
Conclusion:
Triazole resistance could not be detected amongst clinical Aspergillus isolates from Karachi. However, environmental strains remain to be tested for a holistic assessment of the situation. This study will set precedence for future periodic antifungal resistance surveillance in our region on Aspergillus isolates.
Keywords: Aspergillosis, Aspergillus flavus, Aspergillus fumigatus, Aspergillus niger, Aspergillus terreus, itraconazole, voriconazole and posaconazole.
Clinical audit in the Pediatric primary care office and overweight prevention in toddlers.
Authors: Limauro Raffaele , Gallo Patrizia , Cioffi Luigi , Antignani Angelo , Cioffi Valentina , Calella Patrizia , Valerio Giuliana 
Published: April 2020

Abstract
Background: Clinical audit is a process by which physicians or other health care professionals perform a regular and systematic review of their clinical practice and amend it, when necessary. An internal audit allows to review the activities carried out by professionals, in order to assess the appropriateness, effectiveness, efficiency and safety of the services provided. Aim of this study was to apply the process of clinical audit to the obesity/overweight care in toddlers. After the correction of the nutritional errors that were considered potentially responsible for the excess weight gain, the effect of the changes of dietary advice s on the frequency of overweight/obesity was assessed in a cohort of children aged 24-36 months. Methods: Three Italian primary care pediatricians set up the audit strategy by recognizing the high prevalence of overweight and obesity in the entire cohort of toddlers born in 2005, 2006 and 2007 (Pre-Audit group, age 24-36 months old) under their care. By reviewing their clinical practice, they changed the protocol of weaning and feeding up to 36 months, mainly reducing protein and sugar excess. The change involved the cohorts of toddlers born in the years 2010, 2011 and 2012 (Post-Audit group). Results: Change in the approach of pediatricians to children’s diet yielded a reduction of the frequency of overweight/obesity in children between 24 and 36 months of life from 26.3% in the Pre-Audit group to 13.9% in the Post-Audit group (p<0.0001). Conclusion: Clinical audit revealed high rates of obesity/overweight among toddlers. The practice developed a new strategy for nutritional counseling, which was effective in reducing the frequency of overweight/obesity in young children. Keywords: Children; Clinical audit; Feeding; Overweight, Weaning.
Circulating betatrophin/ANGPTL8 levels correlate with body fat distribution in individuals with normal glucose tolerance but not those with glucose disorders
Authors: Zheng Jing , Liu Juan , Hong Beverly S , New Weijian Ke , New Minmin Huang , Li Yanbing 
Published: April 2020

Abstract
Background: The relationship between betatrophin/ANGPTL8 and obesity has been investigated using body mass index (BMI); however, since BMI reflects overall adiposity rather than body fat distribution, it remains unclear whether fat deposition in different areas of the body affects betatrophin expression. Here, we investigated the correlation between circulating betatrophin levels and body fat distribution in patients with different glucose tolerance. Methods: We performed a cross-sectional study in 128 participants with impaired glucose tolerance (IGT; n = 64) or normal glucose tolerance (NGT; n = 64). Circulating betatrophin levels were detected by enzyme-linked immunosorbent assay. Body fat distribution (subcutaneous, visceral, and limb fat) was measured by magnetic resonance imaging (MRI) and a body fat meter. Results: After controlling for age, sex, and BMI, betatrophin was correlated positively with visceral adipose tissue-to-subcutaneous adipose tissue ratio ( VAT/SAT ratio; r = 0.339, p = 0.009) and negatively with body fat ratio (BFR; r = -0.275, p = 0.035), left lower limb fat ratio (LLR; r = -0.330, p = 0.011), and right lower limb fat ratio (RLR; r = -0.288, p = 0.027) in the NGT group, with these correlations remaining after controlling for triglycerides. VAT/SAT ratio (standardized β = 0.419, p = 0.001) was independently associated with serum betatrophin levels; however, betatrophin was not associated with body fat distribution variables in the IGT group. Conclusions: Circulating betatrophin levels correlated positively with VAT/SAT ratio and negatively with lower limb fat, but not subcutaneous or upper limb fat, in individuals with normal glucose tolerance. Thus, betatrophin may be a poten­tial biomarker for body fat distribution in individuals without glucose disorders.
LncGBP9/miR-34a axis drives macrophages toward a phenotype conducive for spinal cord injury repair via STAT1/STAT6 and SOCS3
Authors: Zhou Jiahui , Li Zhiyue , Wu Tianding , Zhao Qun , Zhao Qiancheng , Cao Yong 
Published: April 2020

Abstract
Background: Acute spinal cord injury (SCI) could cause mainly two types of pathological sequelae, the primary mechanical injury, and the secondary injury. The macrophage in SCI are skewed toward the M1 phenotype that might cause the failure to post-SCI repair.
Methods: SCI model was established in Balb/c mice, and the changes in macrophage phenotypes after SCI were monitored. Bioinformatic analyses were performed to select factors that might regulate macrophage polarization after SCI. Mouse bone marrow-derived macrophages ( BMDMs ) were isolated, identified, and induced for M1 or M2 polarization; the effects of lncRNA guanylate binding protein-9 (lnc GBP9 ) and suppressor of cytokine signaling 3 (SOCS 3) on macrophages polarization were examined in vitro and in vivo . The predicted miR-34a binding to lncGBP9 and SOCS3 was validated; the dynamic effects of lncGBP9 and miR-34a on SOCS3, signal transducer and activator of transcription 1 (STAT 1) /STAT6 signaling, and macrophage polarization were examined. Finally, we investigated whether STAT6 could bind the miR-34a promoter to activate its transcription.
Results: In SCI Balb/c mice, macrophage skewing toward M1 phenotypes was observed after SCI. In M1 macrophages, lncGBP9 silencing significantly decreased p-STAT1 and SOCS3 expression and protein levels, as well as the production of Interleukin (IL)-6 and IL-12; in M2 macrophages, lncGBP9 overexpression increased SOCS3 mRNA expression and protein levels while suppressed p-STAT6 levels and the production of IL-10 and transforming growth factor-beta 1 (TGF-β1 ) , indicating that lncGBP9 overexpression promotes the M1 polarization of macrophages. In lncGBP9-silenced SCI mice, the M2 polarization was promoted on day 28 after the operation, further indicating that lncGBP9 silencing revised the predominance of M1 phenotype at the late stage of secondary injury after SCI, therefore improving the repair after SCI. IncGBP9 competed with SOCS3 for miR-34a binding to counteract miR-34a-mediated suppression on SOCS3 and then modulated STAT1/STAT6 signaling and the polarization of macrophages. STAT6 bound the promoter of miR-34a to activate its transcription.
Conclusions: In macrophages, lncGBP9 sponges miR-34a to rescue SOCS3 expression, therefore modulating macrophage polarization through STAT1/STAT6 signaling. STAT6 bound the promoter of miR-34a to activate its transcription, thus forming two different regulatory loops to modulate the phenotype of macrophages after SCI.
Comparison of Clinical Results of Anteromedial and Transtibial Femoral Tunnel Drilling in ACL Reconstruction
Authors: Metso Leena , Nyrhinen Kirsi-Maaria , Bister Ville , Sandelin Jerker , Harilainen Arsi 
Published: April 2020

Abstract
Background: This study compares long term results of femoral tunnel drilling between anteromedial (AM) and transtibial (TT) techniques in reconstruction of anterior cruciate ligament (ACL).
Methods: 300 patients with ACL reconstructions were chosen to this study from previously collected data of ACL reconstructions.They were divided into two groups: 150 patients with AM and 150 with TT drilling. In the AM group the reconstructions were performed using semitendinosus graft with Tape Locking Screw (TLS™) technique (n=87) or Retrobutton™ femoral and BioScrew™ tibial fixation with a semitendinosus-gracilis graft (n=63). In the TT group the fixation method used was Rigidfix™ femoral and Intrafix tibial fixation with a semitendinosus-gracilis graft. The evaluation methods were clinical examination, knee scores (Lysholm, Tegner, IKDC) and instrumented laxity measurements (KT-2000™). Our aim was to evaluate if there is a better rotational stability and therefore better clinical resultswhen using AM drilling compared to TT drilling.
Results: Revision procedures were excluded from the study. There were 132 patients in the AM group and 133 in the TT group for evaluation. In the two year follow-up there were 60 patients in the AM group (45,5 %) and 58 in the TT group (43,6 %). There were no statistically significant differences found between the groups.
Conclusion: Both drilling techniques resulted in improved patient performance and patient satisfaction. We found no data supporting the hypothesis that AM drilling technique provides better rotational stability to the knee.

Trial registration: ISRCTN registry with study ID ISRCTN16407730.

Keywords: Anterior cruciate ligament reconstruction; clinicaloutcome; anteromedial; transtibial
Low doses of Bisphenol S affect post-translational modifications of sperm proteins in male mice
Authors: Řimnáčová Hedvika , Štiavnická Miriam , Moravec Jiří , Chemek Marouane , Kolinko Yaroslav , García-Álvarez Olga , Mouton Peter R. , Trejo Azalia Mariel Carranza , Fenclová Tereza , Eretová Nikola , Hošek Petr , Klein Pavel , Králíčková Milena , Petr Jaroslav , Nevoral Jan 
Published: April 2020

Abstract
Background Bisphenol S (BPS) is increasingly used as a replacement for bisphenol A in the manufacture of products containing polycarbonates and epoxy resins. However, further studies of BPS exposure are needed for the assessment of health risks to humans. In this study we assessed the potential harmfulness of low-dose BPS on reproduction in male mice. Methods To simulate human exposure under experimental conditions, 8-week-old outbred ICR male mice received 8 weeks of drinking water containing a broad range of BPS doses [0.001, 1.0, or 100 µg/kg body weight (bw)/day, BPS1-3] or vehicle control. Mice were sacrificed and testicular tissue taken for histological analysis and protein identification by nano-liquid chromatography/mass spectrometry (MS) and sperm collected for immunodetection of acetylated lysine and phosphorylated tyrosine followed by protein characterisation using matrix-assisted laser desorption ionisation time-of-flight MS (MALDI-TOF MS). Results The results indicate that compared to vehicle, 100 µg/kg/day exposure (BPS3) leads to 1) significant histopathology in testicular tissue; and, 2) higher levels of the histone protein γH2AX, a reliable marker of DNA damage. There were fewer mature spermatozoa in the germ layer in the experimental group treated with 1 µg/kg bw (BPS2). Finally, Western blot and MALDI-TOF MS studies showed significant alterations in the sperm acetylome and phosphorylome in mice treated with the lowest (BPS1) exposure (0.001 µg/kg/day). Conclusions In summary, this range of qualitative and quantitative findings in young male mice raise the possibility that relatively low doses of BPS may impair mammalian reproduction through epigenetic modifications of sperm proteins.
Identification of Severities of Spinal Cord Injury during Acute Phase in Rats by Diffusion Tensor Imaging
Authors: Chen Beike , Tan Qiang , Zhao Weikang , Yang Qiming , Zhang Hongyan , Gao Fabao , Liu Xin , Feng Hua , Jiang Dianming 
Published: April 2020

Abstract
Background: Diffusion tensor imaging (DTI) was an effective method to identify subtle changes to normal‐appearing white matter (WM). Here we analyzed the DTI data with other examinations, including motor evoked potentials (MEPs), histopathological images, and behavioral results, to reflect the lesion development in different degrees of spinal cord injury (SCI) in acute and subacute stage. Method: Except for 2 Sprague -Dawley rats died from anesthesia accident, the rest 42 female rats were randomized into 3 groups: control (n=6), moderate group (n=18), and severe group (n=18). Moderate (a 50-g aneurysm clip with 0.4-mm thickness spacer) or severe (a 50-g aneurysm clip with no spacer) contusion SCI at T8 vertebrae were induced. Then the electrophysiological assessments via MEPs, behavioral deterioration via the Basso, Beattie, and Bresnaha (BBB) scores, DTI data, and histopathology examination were analyzed. Results: In this study, we found that the damage of WM myelin, MEPs amplitude, BBB scores and the decreases in values of fractional anisotropy (FA) and axial diffusivity (AD) were more obvious in the severe injury group than that of the moderate group. Additionally, the FA and AD values could identify the extent of SCI in subacute and early acute SCI respectively, reﬂected in the robust correlations with MEPs and BBB scores. While the values of radial diffusivity (RD) showed no significant changes. Conclusions: Our data confirmed that DTI was a valuable in ex vivo imaging tool to identify damaged white matter tracts after graded SCI in rat, which may provide useful information for the early identification of the severity of SCI.
Development and Implementation of a Telenephrology Dashboard for Active Surveillance of Kidney Disease: A Quality Improvement Project
Authors: Swee Melissa L , Sanders M. Lee , Phisitkul Kantima , Bailey George , Thumann Angie , Neuzil Nikki , Kumar Bharat , O'Shea Amy MJ , Dixon Bradley S 
Published: April 2020

Abstract
Background : Kidney disease accounts for more than 50 billion dollars in healthcare expenditures annually. Early detection and intervention may reduce the burden of disease. We describe a quality improvement project to develop a telenephrology dashboard that proactively monitors kidney disease.
Methods : 184,000 Veterans within the Iowa City Veterans Affairs Health Care System were eligible for telenephrology consultation. The dashboard accessed the charts of 53,085 Veterans at risk for kidney disease. We utilized Lean-Six Sigma tools and principles and the Define-Measure-Analyze-Improve-Control Framework to develop and deploy a telenephrology dashboard in 4 community-based outpatient clinics (CBOCs). The primary measure was the number of days to complete consultation. Secondary measures included number of electronic consultations per month, distance and cost of Veteran travel saved, and number of steps for completion of consult.
Results : The data of 1,384 Veterans at the 4 CBOCs were analyzed by the telenephrology dashboard, of which 459 generated telenephrology consults. The number of days to complete any type of consultation was unchanged (48.9 days in 2019, compared to 41.6 days in 2017). The average Veteran saved between $21.60 to $63.90 per trip to Iowa City. Between March 2019 and August 2019, there were 27.3 telenephrology consults per month. The number of steps needed to complete the consult request was decreased from 13 to 9.
Conclusions : Utilization of the telenephrology dashboard system contributed to an increase in consultations completed through electronic means without decreasing face-to-face consults. Electronic consults now outnumber traditional face-to-face consultations at our institution. Telenephrology consultation improved early detection and identification of kidney disease and saved time and costs for Veterans in travel, but did not decrease the average number of days to complete consultation requests.
The Correlation of Online Health Information Seeking Experience with the Health Related Quality of Life: A Cross-sectional Study among Iranian Female Students
Authors: Kavosi Zahra , Vahedian Sara , tafti Arefeh Dehghani , Bahrami Mohammad Amin 
Published: April 2020

Abstract
Background: Given the increasing availability of internet, it has become a common source of health information for all population including students. However, the actual effect of this increased access to information on the health status and its different aspects needs to be studied more. This study aimed to investigate the correlations between online health information seeking behavior and health related quality of life in a sample of high school students of Iran. Methods: A survey was conducted among secondary school girl students of Yazd province, Iran in 2019. A total of 295 students participated in the study. The required data were gathered using two valid questionnaires including eHIQ (Kelly et al., 2015) to measure the online health information seeking experience and validated Persian version of SF-36 to measure the health related quality of life. The collected data were analyzed through descriptive statistics and Pearson correlation coefficient using SPSS version 23. Results: The mean score of eHIQ was 2.71±0.71. Mean scores for physical component summary and mental component summary of SF-36 were 72.90±16.20 and 63.19±22.26, respectively. eHIQ score showed no statistical correlations with physical component summary (P=.46) and mental component summary (P=.53). Conclusion: The findings suggest that seeking online health information does not improve the health related quality of life. The possible causes are discussed but this finding should be studied more.