bluuebunny/crossref_metadata_2025_split huggingface dataset:
Performance of composite measures used in a trial of etanercept and methotrexate as monotherapy or in combination in psoriatic arthritis
Authors: Coates Laura C , Merola Joseph F , Mease Philip J , Ogdie Alexis , Gladman Dafna D , Strand Vibeke , van Mens Leonieke J J , Liu Lyrica , Yen Priscilla K , Collier David H , Kricorian Gregory , Chung James B , Helliwell Philip S 
Published: April 2020

Abstract

Objectives
To examine which composite measures are most sensitive to change when measuring psoriatic arthritis (PsA) disease activity, analyses compared the responsiveness of composite measures used in a 48-week randomized, controlled trial of MTX and etanercept in patients with PsA.

Methods
The trial randomised 851 patients to receive weekly: MTX (20 mg/week), etanercept (50 mg/week) or MTX plus etanercept. Dichotomous composite measures examined included ACR 20/50/70 responses, minimal disease activity (MDA) and very low disease activity (VLDA). Continuous composite measures examined included Disease Activity Score (28 joints) using CRP (DAS28-CRP), Clinical Disease Activity Index (CDAI), Simplified Disease Activity Index (SDAI), Disease Activity for Psoriatic Arthritis (DAPSA) and Psoriatic Arthritis Disease Activity Score (PASDAS).

Results
At week 24, etanercept-treated groups were significantly more effective than MTX monotherapy to achieve ACR 20 (primary end point) and MDA (key secondary end point). When examining score changes from baseline at week 24 across the five continuous composite measures, PASDAS demonstrated relatively greater changes in the etanercept-treated groups compared with MTX monotherapy and had the largest effect size and standardized response. Joint count changes drove overall score changes at week 24 from baseline in all the continuous composite measures except for PASDAS, which was driven by the Physician and Patient Global Assessments.

Conclusion
PASDAS was the most sensitive continuous composite measure examined with results that mirrored the protocol-defined primary and key secondary outcomes. Composite measures with multiple domains, such as PASDAS, may better quantify change in PsA disease burden.

Trail registration
https://ClinicalTrials.gov, number NCT02376790.
High- density lipoprotein function is abnormal in idiopathic inflammatory myopathies
Authors: Bae Sangmae Sharon , Lee Yuen Yin , Shahbazian Ani , Wang Jennifer , Meriwether David , Golub Ilana , Oganesian Buzand , Dowd Tyler , Reddy Srinivasa T , Charles-Schoeman Christina 
Published: April 2020

AbstractObjectiveDamage to the vascular endothelium is strongly implicated in the pathogenesis of idiopathic inflammatory myopathies (IIM). Normally, high-density lipoprotein (HDL) protects the vascular endothelium from damage from oxidized phospholipids, which accumulate under conditions of oxidative stress. The current work evaluated the antioxidant function of HDL in IIM patients.MethodsHDL’s antioxidant function was measured in IIM patients using a cell-free assay, which assesses the ability of isolated patient HDL to inhibit oxidation of low-density lipoproteins and is reported as the HDL inflammatory index (HII). Cholesterol profiles were measured for all patients, and subgroup analysis included assessment of oxidized fatty acids in HDL and plasma MPO activity. A subgroup of IIM patients was compared with healthy controls.ResultsThe antioxidant function of HDL was significantly worse in patients with IIM (n = 95) compared with healthy controls (n = 41) [mean (S.d.) HII 1.12 (0.61) vs 0.82 (0.13), P &lt; 0.0001]. Higher HII associated with higher plasma MPO activity [mean (S.d.) 13.2 (9.1) vs 9.1 (4.6), P = 0.0006] and higher oxidized fatty acids in HDL. Higher 5-hydroxyeicosatetraenoic acid in HDL correlated with worse diffusion capacity in patients with interstitial lung disease (r = −0.58, P = 0.02), and HDL’s antioxidant function was most impaired in patients with autoantibodies against melanoma differentiation-associated protein 5 (MDA5) or anti-synthetase antibodies. In multivariate analysis including 182 IIM patients, higher HII was associated with higher disease activity and DM diagnosis.ConclusionThe antioxidant function of HDL is abnormal in IIM patients and may warrant further investigation for its role in propagating microvascular inflammation and damage in this patient population.
Neurostructural correlates of hope: dispositional hope mediates the impact of the SMA gray matter volume on subjective well-being in late adolescence
Authors: Wang Song , Zhao Yajun , Li Jingguang , Lai Han , Qiu Chen , Pan Nanfang , Gong Qiyong 
Published: April 2020

Abstract
There has been increasing interest in identifying factors to predict subjective well-being in the emerging field of positive psychology over the past two decades. Dispositional hope, which reflects one’s goal-directed tendencies, including both pathway thinking (planning to meet goals) and agency thinking (goal-directed determination), has emerged as a stable predictor for subjective well-being. However, the neurobiological substrates of dispositional hope and the brain-hope mechanism for predicting subjective well-being remain unclear. Here, we examined these issues in 231 high school graduates within the same grade by estimating cortical gray matter volume (GMV) utilizing a voxel-based morphometry method based on structural magnetic resonance imaging. Whole-brain regression analyses and prediction analyses showed that higher dispositional hope was stably associated with greater GMV in the left supplementary motor area (SMA). Furthermore, mediation analyses revealed that dispositional hope mediated the relation between left SMA volume and subjective well-being. Critically, our results were obtained after adjusting for age, sex, family socioeconomic status and total GMV. Altogether, our study presents novel evidence for the neuroanatomical basis of dispositional hope and suggests an underlying indirect effect of dispositional hope on the link between brain gray matter structure and subjective well-being.
Democracy as Disorder: Institutionalized Sources of Democratic Ambivalence Among the Upper and Middle Class in Manila
Authors: Garrido Marco 
Published: April 2020

AbstractScholars contend that weak institutions as manifest in corruption and bad governance are driving people towards illiberal forms of democracy. This explanation is underspecified. It does not make clear why people are turning towards authoritarian rule instead of working to strengthen democratic institutions. It cannot explain why we are seeing, specifically, a turn to the politics of discipline in countries like the Philippines. We need a better grasp of how weak institutions are experienced and how this experience shapes people’s attitudes towards democracy. Drawing upon several years of ethnographic research, I depict the experience of democracy of the upper and middle class in Metro Manila. For informants, the problem of democracy is not that institutions are weak but that valued institutions are actively contradicted by disvalued ones. They describe an experience of disorder, identifying four major sources: corruption, rule-bending, clientelism, and informal settlement. A view of democracy as disorder prompts calls for “disciplining” it. These findings lead us to reframe the issue. Whereas a weak institutions’ framework emphasizes the gap between valued rules and regressive norms, I emphasize their contradiction as shaping perceptions of disorder. Contradiction is experienced as a moral dilemma, a conflict between how things are done and how they should be done. This experience is informed by a normative sensibility rooted in upper- and middle-class position. The framework provides a better account of democratic backsliding: socially embedded, broader in scope, and closer to experience.
Men’s Social Integration after Incarceration: The Role of Organizationally Embedded Prison-Forged Networks
Authors: Riggs Robert 
Published: April 2020

AbstractResearch shows that social ties and social support are central to former prisoners’ social integration; however, most scholarship focuses on family ties. Beyond family ties, we know little about the composition of former prisoners’ personal networks or how non-family ties may form and influence social integration. This article investigates in detail the personal networks of a group of male former prisoners and documents how they use their social ties during the transition into the community. In addition to family, many men were networked with others with whom they had formed relationships in prison. In contrast to criminological research on criminal peers, this study finds that networks formed through participation in prison programs operated by community-based organizations were prosocial and endured into the men’s release into the community. These organizationally embedded prison-forged networks gave transitioning men access to and impelled activation of forms of social capital in free society. These findings suggest scholars and policymakers should use care in defining what a criminal peer is and that parole policies forbidding parolees from associating with others who have criminal records may in some cases do more harm than good.
Prolonged Length of Stay and Risk of Unplanned 30-Day Readmission After Elective Spine Surgery
Authors: Kim Robert B. , Wilkerson Christopher , Karsy Michael , Joyce Evan , Rolston John D. , Couldwell William T. , Mahan Mark A. 
Published: April 2020

Study Design.Retrospective database study.Objective.To assess the association between prolonged length of hospital stay (pLOS) (≥4 d) and unplanned readmission in patients undergoing elective spine surgery by controlling the clinical and statistical confounders.Summary of Background Data.pLOS has previously been cited as a risk factor for unplanned hospital readmission. This potentially modifiable risk factor has not been distinguished as an independent risk factor in a large-scale, multi-institutional, risk-adjusted study.Methods.Data were collected from the American College of Surgeons National Surgical Quality Improvement Program database. A retrospective propensity score-matched analysis was used to reduce baseline differences between the cohorts. Univariate and multivariate analyses were performed to assess the degree of association between pLOS and unplanned readmission.Results.From the 99,575 patients that fit the inclusion criteria, propensity score matching yielded 16,920 well-matched pairs (mean standard propensity score difference = 0.017). The overall 30-day unplanned readmission rate of these 33,840 patients was 5.5%. The mean length of stay was 2.0 ± 0.9 days and 6.0 ± 4.5 days (P ≤ 0.001) for the control and pLOS groups, respectively. In our univariate analysis, pLOS was associated with postoperative complications, especially medical complications (22.7%vs.8.3%,P < 0.001). Multivariate analysis of the propensity score-matched population, which adjusted identified confounders (P < 0.02 and ≥10 occurrences), showed pLOS was associated with an increased risk of 30-day unplanned readmission (odds ratio [OR] 1.423, 95% confidence interval [CI] 1.290–1.570,P < 0.001).Conclusion.Patients who undergo elective spine procedures who have any-cause pLOS (≥4 d) are at greater risk of having unplanned 30-day readmission compared with patients with shorter hospital stays.Level of Evidence:4
Effects of Rehabilitation Interventions on Clinical Outcomes in Critically Ill Patients: Systematic Review and Meta-Analysis of Randomized Controlled Trials*
Authors: Waldauf Petr , Jiroutková Kateřina , Krajčová Adéla , Puthucheary Zudin , Duška František 
Published: April 2020

Objectives:
To assess the impact of rehabilitation in ICU on clinical outcomes.

Data Sources:
Secondary data analysis of randomized controlled trials published between 1998 and October 2019 was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Study Selection:
We have selected trials investigating neuromuscular electrical stimulation or cycling exercises or protocolized physical rehabilitation as compared to standard of care in critically ill adults.

Data Extraction:
Mortality, length of stay in ICU and at hospital, days on mechanical ventilator, and adverse events.

Data Synthesis:
We found 43 randomized controlled trials (nine on cycling, 14 on neuromuscular electrical stimulation alone and 20 on protocolized physical rehabilitation) into which 3,548 patients were randomized and none of whom experienced an intervention-related serious adverse event. The exercise interventions had no influence on mortality (odds ratio 0.94 [0.79–1.12], n = 38 randomized controlled trials) but reduced duration of mechanical ventilation (mean difference, –1.7 d [–2.5 to –0.8 d], n = 32, length of stay in ICU (–1.2 d [–2.5 to 0.0 d], n = 32) but not at hospital (–1.6 [–4.3 to 1.2 d], n = 23). The effects on the length of mechanical ventilation and ICU stay were only significant for the protocolized physical rehabilitation subgroup and enhanced in patients with longer ICU stay and lower Acute Physiology and Chronic Health Evaluation II scores. There was no benefit of early start of the intervention. It is likely that the dose of rehabilitation delivered was much lower than dictated by the protocol in many randomized controlled trials and negative results may reflect the failure to implement the intervention.

Conclusions:
Rehabilitation interventions in critically ill patients do not influence mortality and are safe. Protocolized physical rehabilitation significantly shortens time spent on mechanical ventilation and in ICU, but this does not consistently translate into long-term functional benefit. Stable patients with lower Acute Physiology and Chronic Health Evaluation II at admission (<20) and prone to protracted ICU stay may benefit most from rehabilitation interventions.
Small molecule proteomics quantifies differences between normal and fibrotic pulmonary extracellular matrices
Authors: Wan Xin-Long , Zhou Zhi-Liang , Wang Peng , Zhou Xiao-Ming , Xie Meng-Ying , Mei Jin , Weng Jie , Xi Hai-Tao , Chen Chan , Wang Zhi-Yi , Wang Zhi-Bin 
Published: April 2020

Abstract

Background:
Pulmonary fibrosis is a respiratory disease caused by the proliferation of fibroblasts and accumulation of the extracellular matrix (ECM). It is known that the lung ECM is mainly composed of a three-dimensional fiber mesh filled with various high-molecular-weight proteins. However, the small-molecular-weight proteins in the lung ECM and their differences between normal and fibrotic lung ECM are largely unknown.

Methods:
Healthy adult male Sprague-Dawley rats (Rattus norvegicus) weighing about 150 to 200 g were randomly divided into three groups using random number table: A, B, and C and each group contained five rats. The rats in Group A were administered a single intragastric (i.g.) dose of 500 μL of saline as control, and those in Groups B and C were administered a single i.g. dose of paraquat (PQ) dissolved in 500 μL of saline (20 mg/kg). After 2 weeks, the lungs of rats in Group B were harvested for histological observation, preparation of de-cellularized lung scaffolds, and proteomic analysis for small-molecular-weight proteins, and similar procedures were performed on Group C and A after 4 weeks. The differentially expressed small-molecular-weight proteins (DESMPs) between different groups and the subcellular locations were analyzed.

Results:
Of the 1626 small-molecular-weight proteins identified, 1047 were quantifiable. There were 97 up-regulated and 45 down-regulated proteins in B vs. A, 274 up-regulated and 31 down-regulated proteins in C vs. A, and 237 up-regulated and 28 down-regulated proteins identified in C vs. B. Both the up-regulated and down-regulated proteins in the three comparisons were mainly distributed in single-organism processes and cellular processes within biological process, cell and organelle within cellular component, and binding within molecular function. Further, more up-regulated than down-regulated proteins were identified in most sub-cellular locations. The interactions of DESMPs identified in extracellular location in all comparisons showed that serum albumin (Alb) harbored the highest degree of node (25), followed by prolyl 4-hydroxylase beta polypeptide (12), integrin β1 (10), apolipoprotein A1 (9), and fibrinogen gamma chain (9).

Conclusions:
Numerous PQ-induced DESMPs were identified in de-cellularized lungs of rats by high throughput proteomics analysis. The DESMPs between the control and treatment groups showed diversity in molecular functions, biological processes, and pathways. In addition, the interactions of extracellular DESMPs suggested that the extracellular proteins Alb, Itgb1, Apoa1, P4hb, and Fgg in ECM could be potentially used as biomarker candidates for pulmonary fibrosis. These results provided useful information and new insights regarding pulmonary fibrosis.
The sphingosine-1-phosphate/RhoA/Rho associated kinases/myosin light chain pathway in detrusor of female rats is down-regulated in response to ovariectomy
Authors: Zhang Wei , Liu Xiao-Dong , Wang Jia-Wen , Meng Ling-Feng , Zhang Yao-Guang , Wang Jian-Ye 
Published: April 2020

Abstract

Background
Dysuria is one of the main symptoms of genitourinary syndrome of menopause, which causes serious disruption to the normal life of peri-menopausal women. Studies have shown that it is related to decrease of detrusor contractile function, but the exact mechanism is still poorly understood. Previous results have suggested that the sphingosine-1-phosphate (S1P) pathway can regulate detrusor contraction, and this pathway is affected by estrogen in various tissues. However, how estrogen affects this pathway in the detrusor has not been investigated. In this study, we detected changes of the S1P/RhoA/Rho associated kinases (ROCK)/myosin light chain (MLC) pathway in the detrusor of ovariectomized rats in order to explore the underlying mechanism of dysuria during peri-menopause.

Methods
Thirty-six female Sprague-Dawley rats were randomly divided into SHAM (sham operation), OVX (ovariectomy), and E groups (ovariectomy + estrogen), with 12 rats in each group. We obtained bladder detrusor tissues from each group and examined the mRNA and protein levels of the major components of the S1P/RhoA/ROCK/MLC pathway using quantitative real-time polymerase chain reaction and Western blotting, respectively. We also quantified the content of S1P in the detrusor using an enzyme linked immunosorbent assay. Finally, we compared results between the groups with one-way analysis of variance.

Results
The components of the S1P pathway and the RhoA/ROCK/MLC pathway of the OVX group were significantly decreased, as compared with SHAM group. The percent decreases of the components in the S1P pathway were as follows: sphingosine kinase 1 (mRNA: 39%, protein: 45%) (both P < 0.05), S1P (21.73 ± 1.09 nmol/g vs. 18.86 ± 0.69 nmol/g) (P < 0.05), and S1P receptor 2/3 (S1PR2/3) (mRNA: 25%, 27%, respectively) (P < 0.05). However, the protein expression levels of S1PR2/3 and the protein and mRNA levels of SphK2 and S1PR1 did not show significant differences between groups (P > 0.05). The percent decreases of the components in the RhoA/ROCK/MLC pathway were as follows: ROCK2 (protein: 41%, mRNA: 36%) (both P < 0.05), p-MYPT1 (protein: 54%) (P < 0.05), and p-MLC20 (protein: 47%) (P < 0.05), but there were no significant differences in the mRNA and protein levels of RhoA, ROCK1, MYPT1, and MLC20 (all P > 0.05). In addition, all of the above-mentioned decreases could be reversed after estrogen supplementation (E group vs. SHAM group) (all P > 0.05).

Conclusion
In this study, we confirmed that ovariectomy is closely associated with the down-regulation of the S1P/RhoA/ROCK/MLC pathway in the rat detrusor, which may be one mechanism of dysuria caused by decreased contractile function of the female detrusor during peri-menopause.
Practical use of electronic health records among patients with diabetes in scientific research
Authors: Shen Yun , Zhou Jian , Hu Gang 
Published: April 2020

AbstractElectronic health (medical) records, which are also considered as patients’ information that are routinely collected, provide a great chance for researchers to develop an epidemiological understanding of disease. Electronic health records systems cannot develop without the advance of computer industries. While conducting clinical trials that are always costly, feasible and reasonable analysis of routine patients’ information is more cost-effective and reflective of clinical practice, which is also called real world study. Real world studies can be well supported by big data in healthcare industry. Real world studies become more and more focused and important with the development of evidence-based medicine. These big data will definitely help in making decisions, making policies and guidelines, monitoring of effectiveness and safety on new drugs or technologies. Extracting, cleaning, and analyzing such big data will be a great challenge for clinical researchers. Successful applications and developments of electronic health record in western countries (eg, disease registries, health insurance claims, etc) have provided a clear direction for Chinese researchers. However, it is still at primary stages in China. This review tries to provide a full perspective on how to translate the electronic health records into scientific achievements, for example, among patients with diabetes. As a summary in the end, resource sharing and collaborations are highly recommended among hospitals and healthcare groups.
Early Mobilization of Patients Receiving Vasoactive Drugs in Critical Care Units: A Systematic Review
Authors: Jacob Prasobh , Surendran Praveen Jayaprabha , E M Muhamed Aleef , Papasavvas Theodoros , Praveen Reshma , Swaminathan Narasimman , Milligan Fiona 
Published: April 2020

Purpose:
Mobilization is feasible, safe, and beneficial to patients admitted to critical care units. Vasoactive therapy appears to be one of the most common barriers to early mobilization. Many recent publications have studied the safety and feasibility of mobilizing patients with these vasoactive drugs. The aim of this review was to synthesize the prevailing evidence pertaining to mobilizing patients receiving vasoactive drugs.

Methods:
The protocol was developed and registered on PROSPERO (CRD42019127448). A comprehensive literature search was conducted using PubMed, Physiotherapy Evidence Database (PEDRO), Cochrane Central, and Embase (through Cochrane) for original research, including case studies and consensus guidelines. PRISMA guidelines were used to conduct and report this review. The included articles were appraised using the Newcastle-Ottawa Scale independently and a consensus reached by 3 reviewers.

Results and Conclusion:
Evidence determining specific doses of vasoactive drugs that would allow safe mobilization of patients in critical care is lacking. The criteria that have been used to determine the eligibility to mobilize patients on vasoactive drugs have not been consistent.