bluuebunny/crossref_metadata_2025_split huggingface dataset:
Education as a Moderator in the Effect of Successful Aging on Mortality Risk in Elderly Chinese: A National Longitudinal Study (2011-2016)
Authors: Cao Peiya , Luo Huiqiang , Li Jijie , Ren Xiaohui 
Published: July 2020

Abstract
BackgroundSome studies have found that successful aging and its components were significantly associated with older adults’ health, their achievement has a positive effect on reducing mortality rates. However, there is little evidence to discuss whether education could modify the effect of successful aging on morality risk. Numerous literatures from worldwide were cross-sectional and previous studies on the association between successful aging and mortality in China were quite few. We aim to evaluate the effect of successful aging and each of its components on mortality risk of older in China, further discussed whether education was a moderator in this effect and investigated differences in results among males and females.MethodsData was derived from CHARLS (China Health and Retirement Longitudinal Study), which is a nationally representative follow-up survey. Cox proportional hazards models were used to estimate the education's moderate effect on the relationship between successful aging and mortality.ResultsIn total, 4824 residents aged 60 years and above were recorded. 15.18% (n=367) for males and 15.74% (n=379) for females were defined as successful aging and the mortality were 2.61% (n=63) for males and 3.45% (n=83) for females during the survey. It is the first longitudinal study using national cohort data to research the educational effects on the association between mortality and successful aging, our study showed that the effect only existed in females aged 65-74 years old group with lower education.ConclusionsEducation has the significant effect on the relationship between successful aging and mortality. Physical health is significantly associated with the achieving of successful aging among young older. More measures should be paid on improving mental health among the young female older with lower education to achieve successful aging and to against mortality and live longevity.
Promoting Respectful Maternity Care for Adolescents In Ghana: a Quasi-Experimental Research Study Protocol
Authors: Habib Helen H , Torpey Kwasi , Maya Ernest Tei , Ankomah Augustine 
Published: July 2020

Abstract
BackgroundIntra-partum mistreatment by healthcare providers remains a global public health and human rights challenge. Adolescents, who are typically younger, poorer and less educated have been found to be disproportionately exposed to intra-partum mistreatment. In Ghana, maternal mortality remains a leading cause of death among adolescent females, despite increasing patronage of skilled birth attendance in health facilities. In response to the the World Health Organisation Human Reproduction Programme (WHO-HRP) recommendations to address mistreatment with Respectful Maternity Care (RMC), this study aims to generate evidence on promoting respectful treatment of adolescents using an intervention that trains health providers on the concept of mistreatment, their professional roles in RMC and the rights of adolescents to RMC.MethodsThis study will employ a pre-test post-test quasi-experimental design. At pre-test and post-test, quantitative surveys will be conducted among adolescents who deliver at health facilities about their labour experience with mistreatment and RMC. A total target of 392 participants will be recruited across intervention and control facilities. Qualitative interviews will also be conducted with selected adolescents and health professionals for an in-depth understanding of the phenomenon. Following the pre-test, a facility-based training module will be implemented at intervention facilities for the facility midwives. The modules will be co-facilitated by the principal investigator and key resource persons from the district health directorate Quality of Care teams. Training will cover the rights of adolescents to quality healthcare, classifications of mistreatment, RMC as a concept and the role of professionals in providing RMC. No intervention will occur in the control facilities. Descriptive statistics, logistic regressions and difference in differences analyses will be computed. Qualitative data will be transcribed and thematically analysed.DiscussionThis study is designed to test the success of an intervention in promoting RMC and reducing intra-partum mistreatment towards adolescents. It is expected that the findings of this study will be beneficial in adding to the body of knowledge in improving maternal healthcare and reducing maternal mortality, especially for adolescents.Trial Registry DetailsName of the registry: Pan African Clinical Trials RegistryDate of registration: 9th March, 2020URL of trial registry record: https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=9837
T cell phenotypes associated with metabolically healthy obesity: Results from the Berlin Aging Study II
Authors: Sbierski-Kind Julia , Goldeck David , Buchmann Nikolaus , Spranger Joachim , Volk Hans-Dieter , Steinhagen-Thiessen Elisabeth , Pawelec Graham , Demuth Ilja , Spira Dominik 
Published: July 2020

Abstract
BackgroundObesity is associated with chronic low-grade inflammation leading to metabolic and cardiovascular diseases, but a subset of obese individuals is considered metabolically healthy. The underlying pathophysiologic mechanisms remain elusive and clinical studies on the relationship between inflammatory markers and metabolically healthy obesity (MHO) are scarce.MethodsIn this cross-sectional analysis, we included a sample of 437 older participants (60–84 years) from the Berlin Aging Study II (BASE-II). Peripheral blood mononuclear cells were isolated, immune cell subsets were analyzed with multiparameter flow cytometry and systemic cytokine levels were measured. Immune cell parameters were correlated with metabolic measures and multiple linear regression analysis was conducted and adjusted for various demographic and clinical factors.ResultsWe found that frequencies of naïve and memory CD4+ and CD8+ T cells inversely correlated with measures for insulin sensitivity in the older population. Moreover, the percentages of naïve CD4+ and CD8+ T cells were significantly higher, whereas activated T cells and IL-6 levels were lower in metabolically healthy compared to metabolically unhealthy obese individuals. The percentages of naïve CD4+ and CD8+ T cells were predictive for impaired insulin sensitivity (ß=0.16, p = 0.01 and ß=0.11, p = 0.04), and the association of naïve CD4+ T cells with insulin sensitivity persisted after multivariate adjustment (ß=0.14, p = 0.02).ConclusionsThese findings support the hypothesis that parameters of systemic inflammation can differentiate metabolically healthy from metabolically unhealthy obese individuals that are at higher risk for cardiometabolic diseases and may have clinical implications with regard to obesity treatment stratification.Trial registrationDRKS00009277. Registered 31 August 2015 - Retrospectively registered, https://www.base2.mpg.de/de
Hypertension Care Cascade at a Large Urban HIV Clinic in Uganda: A Mixed Methods Study Using the Capability, Opportunity, Motivation for Behavior change (COM-B) model
Authors: Muddu Martin , Ssinabulya Isaac , Kigozi Simon P. , Ssennyonjo Rebecca , Ayebare Florence , Katwesigye Rodgers , Mbuliro Mary , Kimera Isaac , Longenecker Chris T. , Kamya Moses R. , Schwartz Jeremy I. , Katahoire Anne R. , Semitala Fred C. 
Published: July 2020

Abstract
Background: Persons Living with HIV (PLHIV) receiving antiretroviral therapy (ART) have a high prevalence of hypertension (HTN) and increased risk of mortality from cardiovascular diseases. HTN and HIV care integration is recommended in Uganda, though its implementation has lagged. In this study, we sought to analyze the HTN and HIV care cascades and explore barriers and facilitators of HTN/HIV integration within a large HIV clinic in urban Uganda.Methods: We conducted an explanatory sequential mixed methods study at Mulago ISS clinic in Kampala, Uganda. We determined proportions of patients in HTN and HIV care cascade steps of: Screened, Diagnosed, Initiated on treatment, Retained, and Controlled. Guided by the Capability, Opportunity, Motivation and Behavior (COM-B) model, we then conducted semi-structured interviews and focus group discussions with healthcare providers and hypertensive PLHIV (n=45). We coded the qualitative data deductively and analyzed the data thematically categorizing them as themes that influenced HTN care positively or negatively. These denoted barriers and facilitators, respectively.Results: Of 15,953 adult PLHIV, 99.1% were initiated on ART, 89.5% were retained in care and 98.0% achieved control (viral suppression) at one year. All 15,953 (100%) participants were screened for HTN, of whom 24.3% had HTN. HTN treatment initiation, one-year retention, and control were low at 1.0%, 15.4% and 5.0%, respectively. Barriers and facilitators of HTN/HIV integration appeared in all three COM-B domains. Barriers included low patient knowledge of HTN complications, less priority by patients for HTN treatment compared to ART, sub-optimal provider knowledge of HTN treatment, lack of HTN treatment protocols, inadequate supply of anti-hypertensive medicines and lack of HTN care performance targets. Facilitators included patients’ and providers’ interest in HTN/HIV integration, patients’ interest in PLHIV peers support, providers’ knowledge and skills for HTN screening, optimal ART adherence counseling, and availability of automated BP machines. Conclusion: The prevalence of HTN among PLHIV is high, but the HTN care cascade is sub-optimal in this successful HIV clinic. To close these gaps, models of integrated HTN/HIV care are urgently needed. These findings provide a basis for designing contextually appropriate interventions for HTN/HIV integration in Uganda and other low and middle-income countries.
Identification Of Gene Signature For Renal Cell Carcinoma-Associated Fibroblasts Mediating Cancer Progression And Affecting Prognosis
Authors: Liu Bitian , Chen Xiaonan , Zhan Yunhong , Wu Bin , Pan Shen 
Published: July 2020

Abstract
Background: Cancer-associated fibroblasts (CAFs) are most abundant in stroma and are critically involved in cancer progression. However, the specific signature of CAFs and related clinicopathological parameters in renal cell carcinoma (RCC) remain unclear. Methods: In this work, methods using recognized gene signatures were employed to roughly assess the infiltration level of the stroma and CAFs in RCC based on the data in The Cancer Genome Atlas. Weighted gene co-expression network analysis (WGCNA) was used to cluster transcriptomes and correlate with CAFs to identify specific markers. A comparison of fibroblast versus urothelial carcinoma cell lines and correlation with previously reported CAF markers were performed to demonstrate the specific expressed of the gene signature. The gene signature was used to compare fibroblast infiltration of each sample through single sample gene set enrichment analysis, and the clinical significance of fibroblasts was analyzed via Cox risk assessment and the chi-square test. Finally, we used validation data to verify the clinical significance of the fibroblast gene signature in RCC. Results: Roughly calculated tumor matrix and CAF levels were significantly higher in kidney cancer than in normal tissues. More than 85% of fibroblast-specific markers identified by WGCNA were consistent with markers obtained via single-cell sequencing. These markers were more highly expressed in fibroblast cell lines and were significantly correlated with canonical CAFs makers. Data validation also showed that CAFs were significant correlation with survival and pathological grade. Conclusions: In summary, our findings indicate that the gene signature potentially serves as a biomarker of CAFs in RCC and that infiltration of fibroblasts in RCC is an independent prognostic factor associated with pathological grade and stage of tumor. The ability to recognize specific CAF markers using WGCNA is comparable to single-cell sequencing.
LY3214996 Relieves Acquired Resistance To Sorafenib in Hepatocellular Carcinoma Cells
Authors: Ma Yongfang , Xu Ruyue , Liu Xueke , Zhang Yinci , Song Li , Qiu XinYing , Cai Shuyu , Zhou Shuping , Xie Yinghai , Li Amin , Cao Weiya , Tang Xiaolong 
Published: July 2020

Abstract
Background: Due to the reactivation of ERK signaling in sorafenib-resisitant hepatocellular carcinoma (HCC) cells, in this study, the anti-cancer effect of LY3214996 (selective ERK1/2 inhibitor) combined with sorafenib on HCC cells was evaluated. Methods: Phosphorylation of the key kinases in the Ras/Raf/MAPK and PI3K/Akt pathways were detected using Western blot. Cells proliferation, migration, cell cycle and apoptosis were evaluated in Huh7 and Huh7R cells. Results: LY3214996 significantly reduced phosphorylation levels of the tested kinases of Ras/Raf/MAPK and PI3K/Akt pathways including p-c-Raf, p-P90RSK, p-S6K and p-eIF4EBP1 activated by sorafenib, despite increased p-ERK1/2 levels. It was found that LY3214996 enhanced the anti-proliferation, anti-migration, blocking cell cycle progression and pro-apoptotic effects of sorafenib on Huh7R cells.Conclusions: The reactivation of ERK1/2 might be highly related to molecular mechanism of acquired drug resistance. LY3214996 combined with sorafenib enhanced anti-tumor effects in HCC. Consequently, combined treatment of LY3214996 and sorafenib provides a second-line therapy for acquired resistant in advanced HCC.
Comparison of Dietary Acid Load Score Between Celiac Patients and healthy Population
Authors: Nikniaz Zeinab , Mahdavi Reza , Nikniaz Leila , Shirmohammadi Masood , Sabbagh Mojgan Akhavan 
Published: July 2020

Abstract
Background: Considering the presence of different complications in celiac patients and also limitations of the gluten-free diet (GFD), we intended to assess the diet quality in patients with celiac disease. In this regard, in the present study, we assessed the dietary acid load in adult celiac patients and compare it with that of the healthy population to provide more specific dietary recommendations for celiac patients. Methods: This study was a cross-sectional study that includes 130 celiac patients and 462 Non-celiac population. The 80-item semi-quantitative food frequency questionnaire was used to obtain dietary data. Based on dietary data, the dietary acid load (DAL), Potential renal net acid load (PRAL), and net endogenous acid production (NEAP) were calculated. Results: The mean PRAL value is negative in the celiac group and it was positive in the general population. There was a significant difference in the PRAL score between celiac patients and the general population (p<0.001). The mean NEAP and DAL score were significantly lower in the celiac group compared with the healthy population (P<0.001). There were no significant differences between gluten-free diet adherents and non-adherents regarding the PRAL, NEAP, and DAL values (P>0.05). Conclusion: We showed that the patients with celiac disease had significantly less acidogenic diet compared with that of the general population. Considering the health benefits of a less acidogenic diet, following a gluten-free diet, could have added value to celiac patients and besides the elimination of symptoms, it could also prevent other complications in these patients.
Morphological and Molecular Characterization of Sarcocystis Wenzeli in Chickens (Gallus gallus) in China
Authors: Pan Jing , Ma Chunli , Huang Zhumei , Ye Yulong , Zeng Hongxia , Deng Shuangsheng , Hu Junjie , Tao Jianping 
Published: July 2020

Abstract
Background: There has been considerable confusion concerning the number and classification of Sarcocystis spp. found in chickens. To date, no nucleotide sequences of Sarcocystis spp. from chickens have been provided in GenBank. The present study aimed to investigate the morphological and molecular characteristics of Sarcocystis spp. in chickens in China.Methods: Tissues from 33 chickens were collected in 2019. Sarcocysts were observed using light (LM) and transmission electron microscopy (TEM). Individual sarcocysts from different chickens were selected for DNA extraction, and five loci, 18S rDNA, 28S rDNA, the ITS-1 region (ITS-1), the mitochondrial cox1 gene (cox1), and the apicoplastic rpoB gene (rpoB), were amplified from each sarcocyst, cloned, sequenced and analyzed.Results: Only S. wenzeli was found in 14 of 33 (42.4%) chickens. Under LM, the sarcocysts were microscopic and exhibited palisade-like villar protrusions measuring 1.5–2.8 μm. The bradyzoites were lancet-shaped, measuring 9.2–12.6 × 1.5–3.5 μm. Ultrastructurally, the sarcocyst wall contained numerous stubby hill-like villar protrusions that were up to 1.2 μm long and 1.0 μm wide. The protrusions included scattered microtubules, which extended from the tips of the protrusions into the ground substance. The intraspecific similarity of the five loci (18S rDNA, 28S rDNA, ITS-1, cox1, and rpoB) among the newly obtained sequences ranged from 99.8–100%, 99.7–100%, 99.0–99.9%, 100% and 98.9–100%, respectively. The five loci showed different levels of interspecific sequence similarity with closely related species of Sarcocystis (e.g., 99.8%, 99.0–99.2%, 89.3-89.7%, 98.5%, and 97.5%, respectively, with S. anasi). Phylogenetic analysis based on three of the loci (18S rDNA, cox1, and rpoB) revealed that S. wenzeli formed an independent clade with Sarcocystis spp. that employ geese or ducks as intermediate hosts and canines as the known or presumed definitive host.Conclusions: The sequences of 18S rDNA, 28S rDNA, ITS-1, cox1 and rpoB from S. wenzeli reported here constitute the first records of genetic markers of Sarcocystis from chickens made available in GenBank. Based on sequence analysis, ITS-1 and rpoB are more suitable for discriminating S. wenzeli from closely related species of Sarcocystis. Phylogenetic analysis revealed that S. wenzeli presents a close relationship with Sarcocystis spp. from geese or ducks.
Tocilizumab for juvenile Takayasu arteritis complicated with acute heart failure at onset
Authors: Kanamori Keita , Ogura Masao , Ishikura Kenji , Ishiguro Akira , Ito Shuichi 
Published: July 2020

Abstract
Background We encountered a 12-year-old girl with Takayasu arteritis (TA) who developed acute heart failure at onset. There have been few reports of specific treatment for acute heart failure (AHF) in TA. We successfully treated her with intravenous methylprednisolone and tocilizumab. Case presentation The patient developed palpitations and shortness of breath 3 weeks before admission. Her symptoms exacerbated rapidly and she finally entered our hospital intensive care unit due to respiratory distress and tachycardia. Blood pressure values measured on the left arm and bilateral legs were paradoxically lower than values taken on the right arm. Chest X-ray revealed a severely enlarged heart. Contrast computed tomography showed an expanded aorta, aortic aneurysm, meandering, and irregular diameter of the aorta. The left ventricular ejection fraction (LVEF) was 20% on cardiac ultrasound. Laboratory examination suggested acute inflammation and positivity of HLA-B52. Her medical condition was finally diagnosed as TA with AHF. Along with inotropes and diuretics, methylprednisolone pulse therapy was administered for 3 days on the 2nd and 12th hospital day followed by oral prednisolone. Cardiac function was slightly improved. As intravenous cyclophosphamide therapy requires hydration and may exacerbate AHF, we started weekly subcutaneous tocilizumab treatment (162 mg/week) from the 20th hospital day. Inotropes were discontinued on the 51st hospital day and her LVEF had improved to 37.5% on the 63rd day when she was discharged. Conclusions Tocilizumab could be a significant treatment option for acute heart failure in juvenile TA.
Subcutaneous ticks: first report in a golden jackal and further proof for the negativity of non-canid carnivores
Authors: Mechouk Noureddine , Deak Georgiana , Ionica Angela Monica , Ionescu Dan Traian , Chisamera Gabriel Bogdan , Gherman Calin Mircea , Mihalca Andrei Daniel 
Published: July 2020

Abstract
Background: Ticks are hematophagous arthropods which normally attach to the surface of the skin of the host for the blood meal. Their aberrant presence in the subcutaneous tissue of few carnivores, predominantly foxes has been reported. However, there are no reports in other carnivores such as mustelids or golden jackals. Our aim was to investigate and broaden the host spectrum for this aberrant localization of ticks.Methods: Between 2015 and 2020, 198 carnivore carcasses from 12 species have been examined by parasitological necropsy. If subcutaneous ticks were found, the nodules were removed, carefully dissected, and stored in ethanol. The identification of the subcutaneous ticks was carried out at the species level.Results: A single subcutaneous tick was found in one sample, a golden jackal and was identified as a female Ixodes ricinus. All other carcasses were negative for subcutaneous ticks.Conclusion: The present paper represents the first report of a subcutaneous tick in a golden jackal (Canis aureus), extends the host spectrum of this unusual phenomenon and demonstrates to date its presence only in canid carnivores.
Distribution and Appearance of Ki-67, IL-1α, IL-10 and PGP 9.5 in Reinke’s Oedema-affected Larynx Tissue Compared With Control Tissue
Authors: Konopecka Vita , Pilmane Mara , Sumerags Dins , Sumeraga Gunta 
Published: July 2020

Abstract
Background: Reinke’s oedema (benign diffuse swelling of the vocal folds) induced various morphological changes occurs in the superficial lamina propria also known as the Reinke’s space. Smoking, laryngopharyngeal reflux and vocal fold abuse can promote the development of this condition as well as lead to vocal fold dysfunction and injury. Patients with Reinke’s oedema complain of vocal problems. 3,47/1000 is estimation of the general population prevalence of Reinke’s oedema. Investigation of the distribution and appearance of Ki-67, IL-1α, IL-10 and PGP 9.5 in Reinke’s oedema-affected larynx tissue compared with control tissue was the aim of the work.Methods: Routine histological and immunohistochemical analysis were applied for specimens with Reinke’s oedema and the control group. Biotin-streptavidin biochemical method was used for detection of Ki-67, PGP 9,5, IL-10 and IL-1α. Immunoreactive cells appearance local distribution were evaluated using semiquantitative grading method. Statistical analysis of the data was performed using nonparametric statistical methods (Mann Whitney U test and Spearman’s rank coefficient).Results: A high positive correlation was found between IL-1α and PGP 9.5 epithelial immunoreactive cells and between epithelial and subepithelial IL-10 cells in the control group. Mann-Whitney U tests revealed significant differences in immunoreactive markers between the patients and the control group. With exception of PGP 9.5 positive subepithelial nerves, all other examined markers revelated higher number of immunoreactive positive structures in the patient tissue.Conclusions: Intensive proliferation of the surface epithelium was observed in Reinke’s oedema affected larynx tissue. Increased expression of IL-1 α structures is linked to tissue remodulation, inflammation and remodulation. Notable increase in IL-10 positive structures is indicating to the dominant anti-inflammatory tissue response. PGP 9.5 expression increase is involved in the morphopathogenesis of Reinke’s oedema.Trial registration: This study was approved by the Ethical Committee of Riga Stradins University, issued on 31-10-2019, No 6-2/2/25.