bluuebunny/crossref_metadata_2025_split huggingface dataset:
Findings from a pilot randomised trial of a social network self-management intervention in COPD
Authors: Welch Lindsay , Orlando Rosanna , Lin Sharon X. , Vassilev Ivaylo , Rogers Anne 
Published: June 2020

Abstract
Background
Self-Management Support (SMS), refers to the actions taken by individuals to recognise and manage their own health. It is increasingly recognised that individuals with chronic obstructive pulmonary disease (COPD) require additional support with their Self-management. Emerging evidence suggests that the use of a social network intervention can improve health outcomes and increase quality of life. In order to understand the potential benefits of SMS in COPD, the GENIE (Generating Engagement in Network Support) SMS tool was implemented and evaluated in a COPD primary care context. The GENIE intervention is a social networking tool that consists of 3 parts; a concentric circle modelling to map existing social networks; a questions sections to elicit preferences for activities; a map of selected resources is then produced, aligned with the user’s interests and suggestions for connections to existing network members and to new resources.

Methods
A pilot, parallel, single blind, block randomised controlled trial. Patients with COPD ranging from mild-very severe were recruited. Participants provided written consent and were then randomised to either the intervention or usual care. The primary aim was to understand the clinical benefit through the analysis of health status, symptom burden and quality of life. The secondary outcome measure was health utilisation. NHS cost differences were reported between groups using the GENIE intervention over usual care.

Results
The GENIE pilot results demonstrate maintenance in health status and clinical symptoms with a decrease in anxiety. An overall increase in quality of life was observed, these findings did not reach significance. A cost reduction was demonstrated in inpatient stay with no difference in primary care costs. Overall a cost reduction in NHS service utilisation was indicated in the intervention group.

Conclusion
This pilot study indicated that using a social network intervention can encourage the development of new social connections and extend existing support networks for COPD patients. Increasing network support in this population is of benefit to both patients and NHS providers in terms of cost reductions and enhancing wellbeing. This broadens the understanding of possible new approaches to SMS in community COPD patients, which could now be investigated in a larger population over a longer period.

Trial registration
Clinical Trials.gov PRS National Library of Medicine. Protocol ID number: 19175, Clinical Trial ID: NCT02935452.
MIR205HG acts as a ceRNA to expedite cell proliferation and progression in lung squamous cell carcinoma via targeting miR-299-3p/MAP3K2 axis
Authors: Liu Limin , Li Yulei , Zhang Ruifang , Li Chun , Xiong Jing , Wei Yuan 
Published: June 2020

Abstract
Introduction
Long noncoding RNAs (lncRNAs) have been associated with many types of cancers, but their molecular mechanisms in lung squamous cell carcinoma (LUSC) have not been fully studied. Therefore, the current study investigated the regulation role of microRNA-205 host gene (MIR205HG) in LUSC and recognized the target genes managed by this lncRNA.

Methods
MIR205HG expression was assessed by the quantitative real-time polymerase chain reaction (qRT-PCR) analysis. The effects of silenced MIR205HG on cell biological behaviors were detected by colony formation assay, transwell assay, flow cytometry analysis and western blot analysis. Luciferase reporter assay and RNA immunoprecipitation (RIP) assay were utilized to proof the binding relationship between miR-299-3p and MIR205HG/mitogen-activated protein kinase kinase kinase 2 (MAP 3 K2).

Results
The expression levels of MIR205HG in LUSC tissues and cell lines were obviously up-regulated. Down-regulation of MIR205HG expression remarkably reduced cell proliferation, migration and epithelial-to-mesenchymal transition (EMT) progression, whereas promoted cell apoptosis. MIR205HG could bind with miR-299-3p and down-regulation of MIR205HG elevated miR-299-3p expression. MAP 3 K2 acted as the target gene of miR-299-3p and was up-regulated by MIR205HG overexpression. Overexpressing MAP 3 K2 could counteract the effects of down-regulating MIR205HG on LUSC progression to some degree.

Conclusion
MIR205HG acts as a competing endogenous RNA (ceRNA) to expedite cell proliferation and progression via targeting miR-299-3p in LUSC.
Treatment of acute Achilles tendon rupture – a multicentre, non-inferiority analysis
Authors: Westin Olof , Sjögren Tony , Svedman Simon , Horvath Alexandra , Hamrin Senorski Eric , Samuelsson Kristian , Ackermann Paul 
Published: June 2020

Abstract
Background
While numerous clinical studies have compared the surgical and non-surgical treatment of acute Achilles tendon rupture (ATR), there are no studies that have performed a non-inferiority analysis between treatments.

Methods
Data from patients who were included in five randomised controlled trials from two different centres in Sweden were used. Outcomes at 1 year after ATR consisted of the patient-reported Achilles tendon Total Rupture Score (ATRS) and the functional heel-rise tests reported as the limb symmetry index (LSI). The non-inferiority statistical 10% margin was calculated as a reflection of a clinically acceptable disadvantage in ATRS and heel-rise outcome when comparing treatments.

Results
A total of 422 patients (350 males and 72 females) aged between 18 and 71 years, with a mean age of 40.6 (standard deviation 8.6), were included. A total of 363 (86%) patients were treated surgically. The ATRS (difference (Δ) = − 0.253 [95% confidence interval (CI); − 5.673;5.785] p = 0.36) and LSI of heel-rise height (difference = 1.43 [95% CI; − 2.43;5.59] p = 0.81), total work (difference = 0.686 [95% CI; − 4.520;6.253] p = 0.67), concentric power (difference = 2.93 [95% CI; − 6.38;11.90] p = 0.063) and repetitions (difference = − 1.30 [95% CI; − 6.32;4.13] p = 0.24) resulted in non-inferiority within a Δ − 10% margin for patients treated non-surgically.

Conclusion
The non-surgical treatment of Achilles tendon ruptures is not inferior compared with that of surgery in terms of 1-year patient-reported and functional outcomes.
Barriers to advance care planning: a qualitative study of seriously ill Chinese patients and their families
Authors: Cheung Johnny T. K. , Au Doreen , Ip Anthony H. F. , Chan Jenny , Ng Kenway , Cheung Lok , Yuen Jacqueline , Hui Elsie , Lee Jenny , Lo Raymond , Woo Jean 
Published: June 2020

Abstract
Background
Advance care planning (ACP) facilitates identification and documentation of patients’ treatment preferences. Its goal aligns with that of palliative care – optimizing quality of life of seriously ill patients. However, concepts of ACP and palliative care remain poorly recognized in Chinese population. This study aims at exploring barriers to ACP from perspective of seriously ill patients and their family caregivers.

Methods
This is a qualitative study conducted in a Palliative Day Care Centre of Hong Kong between October 2016 and July 2017. We carried out focus groups and individual interviews for the seriously ill patients and their family caregivers. A semi-structured interview guide was used to explore participants’ experiences and attitudes about ACP. Qualitative content analysis was adopted to analyze both manifest content and latent content.

Results
A total of 17 patients and 13 family caregivers participated in our study. The qualitative analysis identified four barriers to ACP: 1) limited patients’ participation in autonomous decision making, 2) cognitive and emotional barriers to discussion, 3) lack of readiness and awareness of early discussion, and 4) unprepared healthcare professionals and healthcare system.

Conclusions
Participations of seriously ill patients, family caregivers and healthcare workers in ACP initiation are lacking respectively. A series of interventions are necessary to resolve the barriers.
Impacts of the zero mark-up drug policy on hospitalization expenses of COPD inpatients in Sichuan province, western China: an interrupted time series analysis
Authors: Wang Junman , Li Peiyi , Wen Jin 
Published: June 2020

Abstract
Background
Since 1950, the hospitals had been permitted to take a 15% mark-up of drug purchase price to remedy the loss of public hospitals and doctors’ salaries in China due to tight government budget. This policy resulted in an increasing over-prescriptions which increased burden for patients eventually. The soaring medical expenditures prompted Chinese government to launch the zero mark-up drug policy (ZMDP) in 2009, which aims to eliminate physicians’ financial incentives and lighten patients’ economic burden through cancelling the 15% mark-up. The purpose of this study is to assess the impacts of the ZMDP on hospitalization expenses for inpatients with chronic obstructive pulmonary disease (COPD) in western China.

Method
An interrupted time series was used to assess the impact of the ZMDP in 25 tertiary hospitals of Sichuan province, in which the policy was implemented in 2017. Monthly average total hospitalization expenses including drug expenses, medical service expenses and diagnosis expenses of COPD inpatients were analyzed with segmented regression model developed from January 2015 to June 2018.

Results
After the intervention of the ZMDP, the total hospitalization expenses of COPD patients significantly decreased immediately by 1022.06 CNY (P = .011). The post-policy long-term trend was decreasing by 125.32 CNY (P < .001) per month compared to the pre-policy period. The drug expenses kept downward trend both before and after the policy implementation. It had decreased by 46.42 CNY (P < .001) per month on average before the policy implementation and then dropped 1073.58 CNY (P < .001) immediately after the policy was implemented. Meanwhile, the medical service expenses had an increasing baseline trend of 14.93 CNY (P < .001) per month before the policy intervention, but it increased 197.75 CNY immediately after the policy was implemented (P = .011). The pre-policy period long-term trend of diagnosis expenses had increased by 25.78 CNY (P < .001) per month and decreased immediately by 310.78 CNY (P = .010). The post-policy trend was decreasing by 35.60 CNY (P = .001) per month compared to the pre-policy period.

Conclusion
Our study suggested that the ZMDP have been an effective intervention to curb the increase of hospitalization expenses for inpatients with COPD, especially the drug expenses in western region of China.
Clinical perspectives on hospitals’ role in the opioid epidemic
Authors: Mazurenko Olena , Andraka-Christou Barbara T. , Bair Matthew J. , Kara Areeba Y. , Harle Christopher A. 
Published: June 2020

Abstract
Background
Policymakers, legislators, and clinicians have raised concerns that hospital-based clinicians may be incentivized to inappropriately prescribe and administer opioids when addressing pain care needs of their patients, thus potentially contributing to the ongoing opioid epidemic in the United States. Given the need to involve all healthcare settings, including hospitals, in joint efforts to curb the opioid epidemic, it is essential to understand if clinicians perceive hospitals as contributors to the problem. Therefore, we examined clinical perspectives on the role of hospitals in the opioid epidemic.

Methods
We conducted individual semi-structured interviews with 23 clinicians from 6 different acute care hospitals that are part of a single healthcare system in the Midwestern United States. Our participants were hospitalists (N = 12), inpatient registered nurses (N = 9), and inpatient adult nurse practitioners (N = 2). In the interviews, we asked clinicians whether hospitals play a role in the opioid epidemic, and if so, how hospitals may contribute to the epidemic. We used a qualitative thematic analysis approach to analyze coded text for patterns and themes and examined potential differences in themes by respondent type using Dedoose software.

Results
The majority of clinicians believed hospitals contribute to the opioid epidemic. Multiple clinicians cited Center for Medicare and Medicaid Services’ (CMS) reimbursement policy and the Joint Commission’s report as drivers of inappropriate opioid prescribing in hospitals. Furthermore, numerous clinicians stated that opioids are inappropriately administered in the emergency department (ED), potentially as a mechanism to facilitate discharge and prevent re-admission. Many clinicians also described how overreliance on pre-populated pain care orders for surgical (orthopedic) patients, may be contributing to inappropriate opioid use in the hospital. Finally, clinicians suggested the following initiatives for hospitals to help address the crisis: 1) educating patients about negative consequences of using opioids long-term and setting realistic pain expectations; 2) educating medical staff about appropriate opioid prescribing practices, particularly for patients with complex chronic conditions (chronic pain; opioid use disorder (OUD)); and 3) strengthening the hospital leadership efforts to decrease inappropriate opioid use.

Conclusions
Our findings can inform efforts at decreasing inappropriate opioid use in hospitals.
Responding to COVID-19: how an academic infectious diseases division mobilized in Singapore
Authors: Archuleta Sophia , Cross Gail , Somani Jyoti , Lum Lionel , Santosa Amelia , Alagha Rawan A. , Allen David M. , Ang Alicia , Beh Darius , Chai Louis , Chan Si Min , Lim See Ming , Olszyna Dariusz P. , Ong Catherine , Oon Jolene , Salada Brenda M. A. , Smitasin Nares , Sun Louisa , Tambyah Paul A. , Tham Sai Meng , Yan Gabriel , Yee Chen Hui , Dan Yock Young , Jureen Roland , Tee Nancy , Mahadevan Malcolm , Yau Ying Wei , Quek Swee Chye , Liu Eugene H. , Sin Clara , Bagdasarian Natasha , Fisher Dale A. 
Published: June 2020

Abstract
Background
On January 30, COVID-19 was declared a Public Health Emergency of International Concern—a week after Singapore’s first imported case and 5 days before local transmission. The National University Hospital (NUH) is Singapore’s third largest hospital with 1200 beds, heavy clinical workloads, and major roles in research and teaching.

Main body
With memories of SARS still vivid, there was an urgent requirement for the NUH Division of Infectious Diseases to adapt—undergoing major reorganization to face rapidly changing priorities while ensuring usual essential services and standards. Leveraging on individual strengths, our division mobilized to meet the demands of COVID-19 while engaging in high-level coordination, strategy, and advocacy. We present our experience of the 60 days since the nation’s first case. During this time, our hospital has managed 3030 suspect cases, including 1300 inpatients, 37 confirmed cases, and overseen 4384 samples tested for COVID-19.

Conclusion
Complex hospital adaptations were supported by an unprecedented number of workflows and coordination channels essential to safe and effective operations. The actions we describe, aligned with international recommendations and emerging evidence-based best practices, may serve as a framework for other divisions and institutions facing the spread of COVID-19 globally.
Development of a new gene expression vector for Thermus thermophilus using a silica-inducible promoter
Authors: Fujino Yasuhiro , Goda Shuichiro , Suematsu Yuri , Doi Katsumi 
Published: June 2020

Abstract
Background
Thermostable enzymes are commonly produced in mesophilic hosts for research and bioengineering purposes. However, these hosts do not overexpress the active forms of some biologically functional thermoenzymes. Therefore, an efficient thermophilic expression system is needed. Thermus thermophilus contains an easily manipulable genome and is therefore among the best candidate microbes for a “hot” expression system. We previously identified a strong and inducible promoter that was active in T. thermophilus under supersaturated silica conditions. Here, we report a new heterologous gene expression system based on a silica-inducible promoter in T. thermophilus.

Results
A Thermus sp. A4 gene encoding thermostable β-galactosidase was cloned as a reporter gene into the expression vector pSix1, which contains a selection marker that confers thermostable resistance to hygromycin and a 600 bp DNA region containing a putative silica-inducible promoter. β-galactosidase activity was 11-fold higher in the presence than in the absence of 10 mM silicic acid. SDS-PAGE revealed a prominent band corresponding to 73 kDa of β-galactosidase, and this enzyme was expressed as an active and soluble protein (yield: 27 mg/L) in Thermus but as an inclusion body in Escherichia coli. Truncation of the putative silica-inducible promoter region in Thermus expression vector improved the yield of the target protein, possibly by avoiding plasmid instability due to homologous recombination. Finally, we developed an expression vector containing the pSix1 backbone and a 100 bp DNA region corresponding to the silica-inducible promoter. We used this vector to successfully express the active form of glutamate dehydrogenase from Pyrobaculum islandicum (PisGDH) without additional treatment (yield: 9.5 mg/L), whereas the expression of active PisGDH in E. coli required heat treatment.

Conclusion
We successfully expressed the thermostable β-galactosidase and PisGDH in T. thermophilus as active and soluble forms and achieved with our system the highest known protein expression levels in this species. These thermoenzymes were expressed in active and soluble forms. Our results validate the use of our silica-inducible expression system as a novel strategy for the intracellular overexpression of thermostable proteins.
The expression profiles and prognostic values of HSPs family members in Head and neck cancer
Authors: Fan Guorun , Tu Yaqin , Wu Nan , Xiao Hongjun 
Published: June 2020

Abstract
Background
Head and neck squamous cell carcinoma (HNSC) ranks as the sixth most common malignancy. The identification of highly specific and sensitive prognostic markers and potential drug targets can contribute to enhanced patient prognosis and individualized treatments. Heat shock proteins (HSPs) act as molecular chaperones and play a crucial role in maintaining cell homeostasis. Recently, research has indicated that HSPs also act as “evil chaperones” in cancer development.

Methods
In this study, we assessed the expression of HSPs in HNSC patients using the ONCOMINE, GEPIA, and UALCAN databases. Mutations of HSP genes were also analysed using the cBioPortal database. Additionally, the expression levels of HSPs were verified using the Human Protein Altas (THPA) database.

Results
We found that the expression levels of HSPH1, HSPD1, SERPINH1, HSPA4, and HSP90AA1 were significantly higher in tissues from HNSC patients compared with normal tissues. Moreover, HSPH1, HSPD1, SERPINH1, HSPA4 and HSP90AA1 expressions were linked to disease progression. Survival analysis with the GEPIA and OncoLnc databases indicated that upregulation of HSPH1, HSPD1, SERPINH1, HSPA4 and HSP90AA1 was related to poor overall survival (OS).

Conclusion
This study suggests that the HSPH1, HSPD1, SERPINH1, HSPA4 and HSP90AA1 genes are potential clinical targets and prognostic biomarkers for patients with HNSC.
Comprehensive analysis of prognostic alternative splicing signature in cervical cancer
Authors: Ouyang Dong , Yang Ping , Cai Jing , Sun Si , Wang Zehua 
Published: June 2020

Abstract
Background
Alternative splicing (AS) is a key factor in protein-coding gene diversity, and is associated with the development and progression of malignant tumours. However, the role of AS in cervical cancer is unclear.

Methods
The AS data for cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC) were downloaded from The Cancer Genome Atlas (TCGA) SpliceSeq website. Few prognostic AS events were identified through univariate Cox analysis. We further identified the prognostic prediction models of the seven subtypes of AS events and assessed their predictive power. We constructed a clinical prediction model through global analysis of prognostic AS events and established a nomogram using the risk score calculated from the prognostic model and relevant clinical information. Unsupervised cluster analysis was used to explore the relationship between prognostic AS events in the model and clinical features.

Results
A total of 2860 prognostic AS events in cervical cancer were identified. The best predictive effect was shown by a single alternate acceptor subtype with an area under the curve of 0.96. Our clinical prognostic model included a nine-AS event signature, and the c-index of the predicted nomogram model was 0.764. SNRPA and CCDC12 were hub genes for prognosis-associated splicing factors. Unsupervised cluster analysis through the nine prognostic AS events revealed three clusters with different survival patterns.

Conclusions
AS events affect the prognosis and biological progression of cervical cancer. The identified prognostic AS events and splicing regulatory networks can increase our understanding of the underlying mechanisms of cervical cancer, providing new therapeutic strategies.
Circular RNA circUBAP2 regulates proliferation and invasion of osteosarcoma cells through miR-641/YAP1 axis
Authors: Wu Haojie , Li Weihua , Zhu Shutao , Zhang Dengfeng , Zhang Minghui 
Published: June 2020

Abstract
Background
Osteosarcoma (OS) is a common malignant bone cancer and is still a growing threat to young people. Circular RNAs (CircRNAs) are reported to be involved in the development of diverse human cancers. However, the role of circUBAP2 in OS progression is rarely reported.

Methods
Quantitative real-time polymerase chain reaction (qRT-PCR) was conducted to detect the expression levels of circUBAP2 and miR-641 in OS tissues and cells. Cell Counting Kit-8 (CCK-8) assay was employed to check cell proliferation. The ability of cell invasion was evaluated by transwell assay. The protein levels of E-cadherin, Vimentin and Yes-associated protein 1 (YAP1) were measured by western blot. The starBase was used to predict binding sites between miR-641 and circUBAP2 or YAP1 and the dual-luciferase reporter assay was performed to verify the interaction.

Results
The level of circUBAP2 was significantly upregulated in OS tissues and cells compared with normal tissues and cells, which was contrary to the expression of miR-641. Downregulation of circUBAP2 suppressed proliferation and invasion of OS cells and weakened the process of epithelial-mesenchymal transition (EMT). Moreover, miR-641 was a target of circUBAP2 and could bind to the 3′-untranslated region (3′UTR) of YAP1. In addition, overexpression of circUBAP2 or YAP1 reversed the inhibitory effects of miR-641 on proliferation and invasion of OS cells. Further research indicated that circUBAP2 regulated the expression of YAP1 by interacting with miR-641 in OS cells.

Conclusion
Knockdown of circUBAP2 impeded proliferation and invasion of OS cells by downregulating the expression of YAP1 via sponging miR-641.