bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postoperative collateral formation after indirect bypass for hemorrhagic moyamoya disease
Authors: Ge Peicong , Zhang Qian , Ye Xun , Liu Xingju , Deng Xiaofeng , Wang Jia , Wang Rong , Zhang Yan , Zhang Dong , Zhao Jizong 
Published: January 2020

Abstract
Background: The research on postoperative collateral formation for hemorrhagic moyamoya disease (MMD) evaluated by using digital subtraction angiography (DSA) is limited. Our study objective was to investigate the postoperative collateral formation after indirect bypass for hemorrhagic MMD.

Methods: All consecutive inpatients with hemorrhagic MMD who received indirect bypass at Beijing Tiantan Hospital, Capital Medical University from January 2010 through December 2018 were screened. The site of the hemorrhage was classified as either anterior or posterior. Postoperative collateral formation was evaluated on lateral views using the Matsushima scale. Univariate and multivariate logistic regression analyses were carried out to determine the factors influencing postoperative collateral formation.

Results: Six-four patients (64 hemispheres) were included in this study. After a median 8.5 months DSA follow-up, 14 (21.9%) hemispheres had grade A collateral circulation, 13 (20.3%) had grade B, and 37 (57.8%) had grade C. Twenty-seven (43.2%) hemispheres had good postoperative collateral formation and 37 (57.8%) had poor postoperative collateral formation. The univariate logistic regression analyses showed that age at operation (OR, 0.954; 95% CI, 0.908–1.003; p=0.066), hemorrhagic site (OR, 4.694; 95% CI, 1.582–13.923; p=0.005), and PCA involvement (OR, 3.474; 95% CI, 0.922–13.086; p=0.066) may effect postoperative collateral formation. The multivariate logistic regression analyses showed that only anterior hemorrhage (OR, 5.222; 95% CI, 1.605–16.987; p=0.006) was significantly related to good postoperative collateral formation.

Conclusion: Anterior hemorrhage was significantly related to good postoperative collateral formation after indirect bypass.
Heterogeneous components of lung adenocarcinomas confer distinct EGFR mutation and PD-L1 expression
Authors: Cai Yi-Ran , Wu Hongbo , Shi Xiaoqin , Dong Yujie , Chang Xiujun , Zhang Li , Zhou Lijuan , Su Dan , Yang Ming 
Published: January 2020

Abstract
Background
Lung adenocarcinoma (LAC) is composed of lepidic, papillary, mucinous, micropapillary and solid components in its parenchyma. Complex responses to therapeutics result from intratumoral heterogeneity. However, it remains confused that what components in a mixed LAC tumor are responsible to the heterogeneous EGFR mutation and PD-L1 expression.
Methods
We investigated EGFR status via laser microdissection to capture spatially separated cancer cell subpopulations and digital droplet PCR to determine the abundance of EGFR sensitizing mutation and naïve T790M. Whilst, PD-L1 expression level via tumor proportion score (TPS) was evaluated by Ventana immunohistochemistry using SP263 antibody. PD-L1 expression levels were tiered in <1%, 1%-49% and >=50% groups.
Results
EGFR mutation harbored in 154 (59%) of 261 LAC patients and more frequently occurred in papillary, lepidic and micropapillary constituents. Higher levels of PD-L1 were found in LACs at stage III and IV (68.3%) versus those at stage I and II (31.7%) ( P =0.04). Solid predominant LACs (41.3%) expressed PD-L1 with TPS >=50%, versus mucinous and lepidic LACs ( P <0.01). LACs with solid constituents also had more positive proportion of PD-L1 protein. Cut-offs <1%, 1%–49% or >=50% were associated with patients’ progression-free survival and longer in the <1% group (22.9 month, 95% CI 17.6-28.2) (P<0.05). LACs consisting of two constituents with PD-L1 TPS <1% had a better prognosis than the groups with single component and more than two components ( P <0.05). Eighteen LACs (6.9%) had concomitantly deletion in exon 19 or L858R and naïve T790M mutation. The abundance of T790M varied diversely with sensitizing mutation. PD-L1 expression was not concordant in same components and usually negative in the EGFR -mutated constituents. Heterogeneous PD-L1 expression occurred in the vicinity of stromal tissues.
Conclusion
Intratumoral genetic heterogeneity of LACs was demonstrated associated with histological patterns. Heterogeneous PD-L1 expression in higher level usually occurred in solid component both in EGFR mutated and EGFR wild-typed LACs. EGFR mutated LACs heterogeneously had sensitizing and resistant mutation and was accompanied with PD-L1 expression, but discordant among histological constituents. Immune checkpoint inhibitor combined with third generation EGFR tyrosine kinase inhibitor should be more effective to these LACs.
Associations with rates of falls among home care clients in Ontario, Canada: a population-based, cross-sectional study
Authors: Manis Derek R. , McArthur Caitlin , Costa Andrew P. 
Published: January 2020

Abstract
Background Accidental falls among older adults are a leading cause of injury-related hospitalizations. Reducing falls is an ongoing quality improvement priority for home care, given that many home care clients experience falls. In this study, we identify factors associated with the rate of falls among home care clients.Methods We conducted a population-based, cross-sectional study using secondary data from the Hamilton, Niagara, Haldimand, and Brant health region of Ontario, Canada from January 1 – March 31, 2018. We captured person-level characteristics with falls from the Resident Assessment Instrument – Home Care (RAI-HC). Negative binomial regression was used to model the rate of falls.Results Functional characteristics of home care clients had strong, statistically significant associations with the rate of falls. Declines in activities of daily living, assistive device use for locomotion indoors, polypharmacy, and health conditions, such as dizziness or lightheadedness, and parkinsonism, were associated with a higher rate of falls. Males who used assistive devices had a higher rate of falls compared to females; however, males with neurological and cardiovascular health conditions had a decrease in the rate of falls compared to females. Home care clients with parkinsonism who used a cane and took eight or more drugs had stronger associations with an increased rate of falls compared to those who do not have parkinsonism.Conclusions Functional characteristics, polypharmacy, and health conditions are associated with increased rates of falls among home care clients. Home care clients who are at a greater risk of falls may require environmental adjustments in their home to reduce or eliminate the possibility of falling.
G-Protein-Coupled Estrogen Receptor Activation Upregulates Interleukin-1 Receptor Antagonist in the Hippocampus after Global Cerebral Ischemia: Implications for Neuronal Self Defense
Authors: BAI NING , ZHANG QUANGUANG , ZHANG WENLI , LIU BIN , YANG FANG , Brann Darrell , Wang Ruimin 
Published: January 2020

Abstract
Background: G-protein-Coupled Estrogen Receptor (GPER/GPR30) is a novel membrane-associated estrogen receptor that can induce rapid kinase signaling in various cells. Activation of GPER can prevent hippocampal neuronal cell death following transient global cerebral ischemia (GCI), although the mechanisms remain unclear. In the current study, we sought to address whether GPER activation exerts potent anti-inflammatory effects in the rat hippocampus after GCI as a potential mechanism to limit neuronal cell death.
Methods: GCI was induced by four-vessel occlusion in ovariectomized-female SD rats. Specific agonist G1 or antagonist G36 of GPER was administrated using minipump and antisense oligonucleotide (AS) of interleukin-1β receptor antagonist (IL1RA) was administrated using brain infusion kit. Protein expression of IL1RA, NFkB-P65, phosphorylation of CREB (p-CREB), Bcl2, Cleaved-caspase 3 and microglial markers Iba1, CD11b, as well as inflammasome components NLRP3, ASC, Cleaved-caspase 1, and Cle-IL1β in the hippocampal CA1 region were investigated by Immunofluorescent staining and Western blot analysis. The Duo-Link II in situ proximity ligation assay (PLA) was performed to detect the interaction between NLRP3 and ASC. Immunofluorescent staining for NeuN and TUNEL analysis were used to analyze neuronal survival and apoptosis, respectively. We performed Barnes maze and Novel object tests to compare the cognitive function of the rats.
Results: The results showed that G1 attenuated GCI-induced elevation of Iba1 and CD11b in the hippocampal CA1 region at 14d reperfusion, and this effect was blocked by G36. G1 treatment also markedly decreased expression of the NLRP3-ASC-Caspase 1 inflammasome and IL1β activation, as well as downstream NFkB signaling, the effects reversed by G36 administration. Intriguingly, G1 caused a robust elevation in neurons of a well-known endogenous anti-inflammatory factor IL1RA, which was reversed by G36 treatment. G1 also enhanced p-CREB level in the hippocampus, a transcription factor known to enhance expression of IL1RA. Finally, in vivo IL1RA-AS abolished the anti-inflammatory, neuroprotective and anti-apoptotic effects of G1 after GCI, and reversed the cognitive-enhancing effects of G1 at 14d after GCI.
Conclusions: Taken together, the current results suggest that GPER preserves cognitive function following GCI in part by exerting anti-inflammatory effects and enhancing the defense mechanism of neurons by upregulating IL1RA.
Premedication of nalbuphine benefits children gastrointestinal endoscopy screening under sedation: a randomized, controlled, double-blinded clinical trial
Authors: li yong , Zheng jungang , Teen Mark , Huang Changshun 
Published: January 2020

Abstract
Backgrounds: Nalbuphine may be a useful opioid for postoperative use in children, but exact efficacy of premedication of nalbuphine in gastrointestinal endoscopy (e.g. compared to other commonly used opioids) has not been determined yet. This study aims to compare the benefits between premedication with nalbuphine and fentanyl on children undergoing gastrointes­tinal endoscopy screening under sedation with propofol. Methods: A total of 460 children with age 3-10 years old, undergoing elective gas­trointestinal endoscopy screening with ASA I -II were randomly assigned to fentanyl group or nalbuphine group, and then they were all subsequently ad­ministrated propofol through target-controlled infusion (TCI) with an effect-site concentration of 3.5 ug/ml, before and during the procedure. We compared postoperative pain, the total consumption of propofol, the cardiovascular parameters, satisfaction scores of patients’ parents, adverse events in patients, injection pain scores and recovery time.Results: The postoperative pain score at time of entering PACU and 10min later in nalbuphine group were lower than that in fentanyl group(1.75±1.87 vs 2.29±2.22 p＜0.05)(1.67±1.81 vs 2.12±1.99 p＜0.05), but the injection pain of propofol and the recovery time is approximate. Patients in two groups had similarly stable hemodynamics. The consumption of propofol was higher in fentanyl group than nalbuphine group (78.7± 13.6 mg vs 71.2 ± 13.9 mg, P <0.05). The incidence of bucking/hiccupping was lower than in the nalbuphine group than that in the fentanyl group (6% vs 14.3%, P <0.005). The incidence of body movement was also lower in the nalbuphine group than the fentanyl group (7.9% vs 18.7%, P<0.005). The satisfaction scores by patients ’parents were higher in the nalbuphine group than fentanyl group (4.9 ± 0.3 vs 4.7 ± 0.5, P<0.05). The incidence of pruritus is lower in the nalbuphine group compared to fentanyl group. (1.0% vs 4.8% P <0.05)Conclusion: Premedication of nalbuphine in children for endoscopy screening sedation has many benefits. The analgesic effect of nalbuphine is superior to that of fentanyl.
Promoting behavior-related low back health in nursing staff by in-person and interactive social media interventions in the workplace: a randomized trial
Authors: Kazemi Seyedeh Somayeh , Tavafian Sedigheh-Sadat , Hiller Claire E , Hidarnia Alireza , Montazeri Ali 
Published: January 2020

Abstract
Background: Nurses are put at high risk of work-related low back pain (LBP) due to the nature of their work. There is wide scientific evidence that the incidence and prevalence of LBP in nurses is high. Therefore, promoting behaviors for low back health in nurses is essential. The aim of this study was to develop and evaluate a theory-based educational intervention on promoting behaviors of low back health via in-person and social media education among nursing personnel with LBP. Methods: The educational content was developed with six modules: knowledge, attitude, self-efficacy, reinforcing factors, enabling factors and behavior. Evaluation of the content was undertaken in nurses, mean age 36.50 ± 5.79 years, with LBP recruited to a community randomized controlled trial with two modes of delivery: in-person (n=60) and social media (n=60). Data were collected with a self-designed questionnaire at baseline, 3 and 6 months. Baseline comparisons between groups were made with Mann-Whitney U Test for non-normal data and T-Test for normal data. Comparison of change scores between groups and two delivery types across the three time periods used the mixed between-within subject analysis of variance. Results: A total of 120 nurses received the allocated intervention and completed the baseline and follow-up questionnaires. The results indicated there were no significant statistical differences between two delivery types in the variables at the baseline (p > .05). All educational component scores increased at 3-months in both groups. At the 6-month follow-up scores increased for enabling factors and behavior in the in-person group, while in the social media group all scores increased except for attitude. Based on Bonferroni Post hoc analysis there was the difference between the delivery types; social media was more effective in knowledge (p = .01), self-efficacy (p = .03), reinforcing factor (p = .05) and behavior (p = .001) than the in-person intervention. Conclusion: An educational program for low back health was developed based on the PRECEDE-PROCEED model and proved effective at improving knowledge, attitude, self-efficacy, reinforcing factors, enabling factors and behavior. However, delivery via social media was more successful than in-person in the maintenance of behavior over the long-term.
Active Play in ASP –A matched-pair cluster-randomized trial investigating the effectiveness of an intervention in After-school programs for supporting children’s physical activity
Authors: Riiser Kirsti , Richardsen Kåre Rønn , Haugen Anders Lund Hage , Lund Siv , Løndal Knut 
Published: January 2020

Abstract
Background: Interventions directed at after school programs (ASPs) have the potential to support physical activity (PA) in young children. Research has indicated that interventions that emphasize competence building among the ASP staff can lead to increased PA among the children. The present study evaluates the effectiveness of the Active Play in ASP intervention—a program for ASP staff aimed at supporting physical activity physical activity among first graders in ASP. Methods: We used a matched-pair cluster randomized design and included 456 first graders from 14 schools in Norway. From these, 7 ASPs received the intervention (N = 229), while 7 acted as controls (N = 227). Measurements were taken at baseline, immediately post intervention (7 month follow-up) and after a year (19 month follow-up). The primary outcome was moderate and vigorous physical activity (MVPA), which was estimated with predefined cut points of counts per minute (CPM) and expressed as minutes/hour. Secondary outcomes were vigorous and light intensity physical activity (VPA and LPA) and sedentary behavior. The analyses of intervention effects were based on between-group differences in outcome changes between the 3 measurement points and were conducted using a mixed-effects model for repeated measures using categorical time. In separate models, we investigated gender, baseline body mass, and baseline CPM as potential effect modifiers. Results: The intervention yielded no significant short-term or long-term effects in mean MVPA 0.55 min/hour, (95% CI -0.29: 1.38), VPA, LPA, or sedentary behavior. However, subgroup analyses showed that the intervention group had a significant long-term reduction in sedentary behavior time -1.67 min/hour (95% CI -3.12: -0.21) among the 50% of children who were least active at baseline in comparison to the controls. Conclusions: Although the intervention did not significantly increase the mean MVPA among the children in the intervention ASPs compared to controls, it did seem to have an effect by reducing sedentary behavior time among the least active children. An even stronger emphasis on how to identify less active children and support their activity may be needed in order to increase their PA and further reduce sedentary behavior time.
Downregulated hsa_circ_005243 induced trophoblast cell dysfunction and inflammation via β-catenin and NF-κB pathways in gestational diabetes mellitus
Authors: Wang Huiyan , Zhou Wenbo , She Guangtong , Yu Bin , Sun Lizhou 
Published: January 2020

Abstract
Background: Gestational diabetes mellitus(GDM) is a common obstetric pregnancy complication, which poses a serious threat to the health of pregnant women and newborns. The specific etiology and pathogenesis of this disease have not been fully clarified, it is reported to be related with insulin resistance, inflammatory response and genetic factors etc. Circular RNA(circRNA) is a special kind of non-coding RNA, which have been attracted much attention in recent years. It has been reported that circRNAs may play a regulatory role in pregnancy-related diseases, including GDM. Methods: Previously we reported a circRNA, hsa_circ_005243, which was identified by RNA-sequencing. In this study we detected its expression in 20 GDM pregnant women and 20 normal controls using quantitative reverse transcription polymerase chain reaction analysis. Further in vitro experiments were conducted after hsa_circ_005243 knockdown in HTR8-S/Vneo cells, cell proliferation and migration ability was tested, the secretion of inflammatory factors (TNF-α and IL-6) were detected by ELISA. Then we detected the expression of β-catenin and increased nuclear factor kappa-B (NF-κB) signaling pathways which was related to GDM in the mechanism study. Results: We found the expression of hsa_circ_005243 was significantly reduced both in the placenta and plasma of GDM pregnant women. Knockdown of hsa_circ_005243 in trophoblast cells significantly suppressed cell proliferation and migration ability. In addition, increased secretion of inflammatory factors (TNF-α and IL-6) were observed after hsa_circ_005243 depletion. Further mechanism experiments showed that knockdown of hsa_circ_005243 reduced the expression of β-catenin and increased nuclear NF-κB p65 nuclear translocation. Conclusions: Collectively, our study showed that down-regulation of hsa_circ_005243 might be associated with the pathogenesis of GDM through regulating β-catenin and NF-κB signal pathways and suggest a new potential therapeutic target for GDM.
What is the impact of user preferences on the design of the hospital online registration system: An integrated approach
Authors: Lin Chin-Feng , Fu Yin-Chih , Lin Liang-Shiun , Fu Chen-Su 
Published: January 2020

Abstract
Background An efficient registration system for all these types of Taiwan medical institutions will enable outpatients to register online and inform them of the best time to go to the hospital and when their turn for medical treatment is. Hence, understanding the outpatients’/users’ actual needs is important for hospital managers to design a user-friendly registration system. Purpose This study, based on means-end chain (MEC) theory and the Kano model, aims to: 1) understand user preferences toward using a hospital online registration system by constructing the Kano–MEC hierarchical value map, and 2) deduce and formulate effective system planning and promotion strategies. Methodology/approach Mixed methods research was employed to collect data. A total of 16 hospital registration websites were examined and 34 in-depth interviews were conducted. All the interview transcripts were analyzed, and 16 attribute, 13 consequence, and 4 value variables were obtained for a final questionnaire design. A total of 376 valid samples were collected from a questionnaire survey to construct a Kano–MEC hierarchical value map. Results The Kano–MEC hierarchical value map depicts hospital online registration users’ innermost thoughts and cognitive structure with regard to their attribute/consequence/value preferences and their attribute performance, as categorized by Kano’s quality classifications. Conclusions The Kano–MEC map showed that “right-clicking the registration by department tab,” “modifying or canceling one’s appointment,” “downloading doctor’s schedule,” “doctor introduction,” “right-clicking the registration by doctor’s name,” and “instant messaging” are classified as Kano’s one-dimensional attributes that can improve users’ satisfaction and reduce their dissatisfaction by increasing quality fulfillment. Practice Implications Evidently, managers should focus on “right-clicking the registration by department tab,” “modifying or canceling one’s appointment,” “downloading doctor’s schedule,” “doctor introduction,” “right-clicking the registration by doctor’s name,” and “instant messaging” to formulate their system planning for enhancing the functions of their online registration system and increasing user satisfaction.
Different screening frequency of carbapenem-resistant Enterobacteriaceae in patients undergoing hematopoietic stem cell transplantation: which one is better?
Authors: Yang Tingting , Luo Xueping , Yang Qing , Chen Hongchao , Luo Yi , Zhao Yanmin , Ye Yishan , Lai Xiaoyu , Yu Jian , Tan Yamin , Wei Guoqing , Huang He , Shi Jimin 
Published: January 2020

Abstract
BackgroundConsensus has been reached that carbapenem-resistant Enterobacteriaceae (CRE) screening in immunosuppressed individuals can reduce the incidence of severe CRE infection. However, there is no standard for effective screening and relevant studies has been fewer reported, especially for hematopoietic stem cell transplantation (HSCT) population. Methods We retrospectively studied the clinical data of 395 consecutive HSCT patients admitted in our center from September 2017 to April 2019 during two periods, single screening and continuous screening. During period 1 (September 2017 to June 2018), 200 patients received single stool CRE screening within one week before transplantation. During period 2 (July 2018 to April 2019), we implemented continuous weekly stool CRE screening after admission. For patients colonized with CRE, target management were received:(1) contact precaution;(2) preemptive CRE-targeted treatment if necessary. Results During period 1 , three patients with CRE colonization were detected (1.5%). The BSI percent of CRE was 2.0% (4 patients) and related 30-day mortality was 50.0% (2 out of 4 patients). During period 2, twenty-one patients with CRE colonization were detected and the detection rate was significantly higher than that in period 1(P<0.001). The CRE BSIs rate decreased to 0.5% (1/195) and there was no CRE-related mortality. Conclusion The increase of screening frequency contributed to the detection of patients with CRE colonization. Targeted management for these colonized patients may contribute to reduce the incidence and related mortality of CRE bloodstream infection, therefore improving the prognosis of HSCT patients.