bluuebunny/crossref_metadata_2025_split huggingface dataset:
How parents cope with the care of a child with epilepsy: Based upon grounded theory
Authors: nematollahi Monirsadat , Rabori Roghayeh Mehdi pour , Keshavarz Fatemeh , Bagherian Behnaz 
Published: May 2020

Abstract
Background: parents of children with seizure face the complicated health issues of their children. Coping strategies of parents as major care providers impact not only their handling of stresses on themselves but also the children's quality of life. This study investigated the coping processes of parents of children with a seizure at two educational hospitals affiliated with the Kerman University of Medical Sciences in Iran. Method: Twenty parents (15 mothers and 5fathers), and three nurses were selected using the purposive sampling method. Data was collected using qualitative semi-structured interviews and analyzed using the method suggested by Corbin and Strauss version 2008. The Interviews were conducted until thematic saturation was achieved. Results: The adaptation process had five phases: “Disbelief, Patience on what happened, change to preserve, acceptance of the current situation, and self- empowerment."In summary, the parents of children with seizure had 5-phase coping strategy. The Core category achieved was "continued efforts of parents to restore calm."Conclusion: Properly assessing the stresses on parents of children with seizure and their coping strategies may help medical staff and social services provide more targeted support and promote the balance of the family function.
Distinctions between sex and time in patterns of DNA methylation across puberty
Authors: Moore Sarah Rose , Humphreys Kathryn Leigh , Colich Natalie Lisanne , Davis Elena Goetz , Lin David Tse Shen , MacIsaac Julia Lynn , Kobor Michael Steffen , Gotlib Ian Henry 
Published: May 2020

Abstract
Background: There are significant sex differences in human physiology and disease; the genomic sources of these differences, however, are not well understood. During puberty, a drastic neuroendocrine shift signals physical changes resulting in robust sex differences in human physiology. Here, we explore how shifting patterns of DNA methylation may inform these pathways of biological plasticity during the pubertal transition. In this study we analyzed DNA methylation (DNAm) in saliva at two time points across the pubertal transition within the same individuals. Our purpose was to compare two domains of DNAm patterns that may inform processes of sexual differentiation 1) sex related sites, which demonstrated differences between males from females and 2) time related sites in which DNAm shifted significantly between timepoints. We further explored the correlated network structure sex and time related DNAm networks and linked these patterns to pubertal stage, assays of salivary testosterone, a reliable diagnostic of free, unbound hormone that is available to act on target tissues, and overlap with androgen response elements.Results: Sites that differed by biological sex were largely independent of sites that underwent change across puberty. Time-related DNAm sites, but not sex-related sites, formed correlated networks that were associated with pubertal stage. Both time and sex DNAm networks reflected salivary testosterone levels that were enriched for androgen response elements, with sex-related DNAm networks being informative of testosterone levels above and beyond biological sex later in the pubertal transition. Conclusions: These results inform our understanding of the distinction between sex- and time-related differences in DNAm during the critical period of puberty and highlight a novel linkage between correlated patterns of sex-related DNAm and levels of salivary testosterone.
Integrative expression network analysis of microRNA and gene isoforms in sacred lotus
Authors: Zhang Yue , Rahmani Razgar Seyed , Yang Xingyu , Chen Jinming , Shi Tao 
Published: May 2020

Abstract
Background: Gene expression is complex and regulated by multiple molecular mechanisms, such as miRNA-mediated gene inhibition and alternative-splicing of pre-mRNAs. However, the coordination of interaction between miRNAs with different splicing isoforms, and the change of splicing isoform in response to different cellular environments are largely unexplored in plants. In this study, we analyzed the miRNA and mRNA transcriptome from lotus (Nelumbo nucifera), an economically important flowering plant.Results: Through RNA-seq analyses on miRNAs and their target genes (isoforms) among six lotus tissues, expression of most miRNAs seem to be negatively correlated with their targets and tend to be tissue-specific. Further, our results showed that preferential interactions between miRNAs and hub gene isoforms in one coexpression module which is highly correlated with leaf. Intriguingly, for many genes, their corresponding isoforms were assigned to different co-expressed modules, and they exhibited more divergent mRNA structures including presence and absence of miRNA binding sites, suggesting functional divergence for many isoforms is escalated by both structural and expression divergence. Further detailed functional enrichment analysis of miRNA targets revealed that miRNAs are involved in the regulation of lotus growth and development by regulating plant hormone-related pathway genes.Conclusions: Taken together, our comprehensive analyses of miRNA and mRNA transcriptome elucidate the coordination of interaction between miRNAs and different splicing isoforms, and highlight the functional divergence of many transcript isoforms from the same locus in lotus.
Symptoms in the general Norwegian adult population - prevalence and associated factors
Authors: Krogstad Hilde , Loge Jon Håvard , Grotmol Kjersti , Kaasa Stein , Kiserud Cecilie Essholt , Salvesen Øyvind , Hjermstad Marianne Jensen 
Published: May 2020

Abstract
Background: Patients´ own perceptions and evaluations of symptoms, functioning and other health-related factors, i.e. Patient Reported Outcomes (PROs), are important elements for providing good patient care. Symptoms are subjective and best elicited by the patient orally or by using PRO measures (PROMs),be it on paper, or as electronic assessment tools. Reference values on frequently used PROMs facilitate the interpretation of scores for use in clinics and research settings, by comparing patient data with relevant samples from the general population. Study objectives were to (1) present reference values for the M.D. Anderson Symptom Inventory (MDASI) (2) examine the occurrence and intensity of symptoms assessed by the MDASI in a general Norwegian adult population sample, and (3) examine factors associated with higher symptom burden defined as the sum score of all symptoms, and factors associated with symptoms` interference on functions.Methods: In 2015, MDASI was sent by mail as part of a larger survey, to a representative sample of the general Norwegian adult population (N = 6165). Medical comorbidities were assessed by the Self-Administered Comorbidity Questionnaire. Depression was self-reported on the Patient Health Questionnaire 9 (PHQ-9). Linear multivariable regression analysis was used to examine for factors associated with MDASI sum score and factors associated with symptoms’ interference on functions. Results: The response rate was 36%. More women (54%) than men (46%) responded. Mean age was 55 years (SD 14). The most frequent symptoms were fatigue (59.7%), drowsiness (56.2%) and pain (56.1%). Fatigue, pain and disturbed sleep had the highest mean scores. The presence of one or more comorbidities, increasing PHQ-9 score and lower level of education were associated with higher MDASI sum score (p<0.001). The MDASI sum score and the PHQ-9 score were positively associated with all interference items (p<0.001) except for walking (p=0.22). Conclusion: This study provides the first Norwegian reference values for MDASI. The presence of one or more comorbidities, higher level of depressive symptoms and lower level of education were significantly associated with higher MDASI sum score. These covariates must be controlled for when using the reference values.
CO2 or air cholangiography reduces the risk of post-ERCP cholangitis in patients with Bismuth type IV hilar biliary obstruction
Authors: zhang wenhui , Ding Peng peng , liu lei , wang yanling , lai wenhui , han jingjing , han jun , li hanwei 
Published: May 2020

Abstract
Background: Endoscopic biliary stenting by endoscopic retrograde cholangiopancreatography (ERCP) is the most common form of palliation for malignant hilar obstruction. However, ERCP in such cases is associated with a risk of cholangitis. The incidence of post-ERCP cholangitis is particularly high in Bismuth type IV hilar obstruction, and this risk is further increased when the contrast injected for cholangiography is not drained. This study aims to compare the incidence of cholangitis associated with the use of contrast agent, air and CO2 for cholangiography in type IV hilar biliary lesions. Methods: The clinical data of consecutive 70 patients with type IV hilar obstruction, who underwent ERCP from October 2013 to November 2017, was retrospectively analyzed. These patients were divided into three groups based on the agent used for cholangiography: group A, contrast (n=22); group B, air (n=18); group C, CO2 (n=30). These three methods of cholangiography were chronologically separated. Prior to the ERCP, MRCP was obtained from all patients to guide the endoscopic intervention. Results: At baseline, there was no significant difference in the patient’s age, gender, symptoms and liver function tests among the three groups (P>0.05). The complication rates was significantly higher in group A than in groups B and C (63.6% vs. 26.7% and 27.8%, P<0.05). The incidence of post-ERCP cholangitis was significantly higher in group A (P<0.05), while the incidence of post-ERCP pancreatitis and bleeding were similar in the three groups. After ERCP, the mean hospital stay was shorter in groups B and C, when compared to group A (P<0.05). There was no significant difference in the 30-day mortality rate among the three groups (P>0.05). Furthermore, there was no significant difference between group B and C in terms of primary end points. Conclusion: CO2 or air cholangiography during ERCP for type IV hilar obstruction is associated with reduced risk of post-ERCP cholangitis, when compared to conventional contrast agents.
Non-steroidal anti-inflammatory drug-induced enteropathy as a major risk factor for small bowel bleeding: A retrospective study
Authors: Lim Doo-Ho , Jung Kyoungwon , Lee Seung Bum , Park In Kyu , Cha Hee Jeong , Park Jae Ho , Kim Byung Gyu , Jung Seok Won , Du Jeong In , Kim Jae Hyun , Kim Sung Eun , Moon Won , Park Moo In , Park Seun Ja 
Published: May 2020

Abstract
Background: Small bowel (SB) bleeding accounts for 5% of all gastrointestinal (GI) bleeding cases and 80% of obscure GI bleeding cases. Although angioectasia is the common etiology of SB bleeding, nonsteroidal anti-inflammatory drug (NSAID)-induced SB lesions are also reported as a major cause in studies from Eastern countries. Herein, we assessed the frequency of occurrence of NSAID-induced SB lesions in Korean patients with obscure GI bleeding. Methods: We retrospectively analyzed medical records of all consecutive patients aged ≥18 years who underwent capsule endoscopy from March 2018 to February 2019 at Ulsan University Hospital and Kosin University Gospel Hospital. Results: Of the 83 subjects (all Korean; mean age ± standard deviation: 59 ± 18 years; age range: 18–84 years; men: n=52; women: n=31), 55 (66.2%) had stool with clear blood and 28 (33.8%) had normal stool with iron deficiency anemia. The detection rate of SB bleeding and lesions using capsule endoscopy was 72.3% (60 of 83 patients). A significantly higher frequency (40 of 51) of ulcerative/erosive lesions than other causes was observed in patients with inactive bleeding but visible SB lesions. As a result, NSAID-induced enteropathy accounted for 30.1% of 83 patients with obscure GI bleeding (25 of the all 60 SB bleeding cases).Conclusions: Contrary to what is reported for patients in Western countries, this study in Korean patients showed an improved diagnostic yield of capsule endoscopy for obscure GI bleeding and that NSAID-induced enteropathy was the most common etiology of SB bleeding. Aggressive small intestine examination is required for patients with unexplained GI bleeding.
“Universal test and treat” program reduced TB incidence by 75% among a cohort of adults taking antiretroviral therapy (ART) in Gurage zone, South Ethiopia
Authors: Girum Tadele , Yasin Fedila , Dessu Samuel , Zeleke Bereket , Geremew Mulugeta 
Published: May 2020

Abstract
Background: Tuberculosis (TB) remains the leading cause of morbidity and mortality in peoples living with HIV. At least 25% of deaths are attributed to TB. It is believed that, Universal test and treat (UTT) program for HIV reduces incidence of TB and most countries implement the program. However, there is limited study conducted to evaluate the impact of UTT on TB incidence. Therefore, by recruiting a cohort of ART users in the “UTT” and “differed treatment” programs we aimed to measure the effect of the UTT program on incidence of TB.Objective: To measure the effect of “UTT” program on TB incidence among a cohort of adults taking antiretroviral therapy (ART) in Gurage zone, South Ethiopia.Methods: Health facility based retrospective cohort study through record review of 5 year (2014-2019) cohort was conducted in public facilities of Gurage Zone. Randomly selected 384 records were reviewed by using standardized structured checklist. Data was entered by Epi info version 7 and analyzed by STATA. Generalized Linear Model with binomial link function was fitted to measure adjusted incidence density/Incidence rate ratio and identify predictors of incidence difference between the two programs.Results: During the follow up period, 39 incident TB cases were occurred, and making the overall incidence rate of 4.79/100 person-year (PY). It is significantly lower in the UTT (IR=2.10/100 PY) than the differed program (IR=6.23/100 PY). The adjusted Incidence Rate Ratio (AIRR) of TB among patients enrolled in the UTT program was; 0.25 (95% CI=0.08-0.70) compared to patients enrolled in the differed program. Thus, UTT program reduce TB incidence by 75% compared to differed program. In addition to the program, IPT (isoniazid preventive therapy) use (AIRR= 0.35 (95% CI=0.22-0.48)), WHO Stage I and II (AIRR=0.70 (95% CI=0.61-0.94)) and higher Base line CD4 count (AIRR=0.96 (95% CI=.94-0.99)) significantly reduce incidence of TB. Whereas, treatment failure increase the incidence (AIRR=5.8 (95% CI=1.93-8.46)). Conclusion: TB incidence was significantly reduced by 75% after UTT. Therefore, intervention to further reduce the incidence has to focus on strengthening UTT program and IPT.
Rivastigmine improves dual-task gait velocity in patients with Alzheimer’s disease
Authors: Shimura Hideki , Aiba Saiko , Hayashi Akito , Hattori Nobutaka , Urabe Takao 
Published: May 2020

Abstract
Background Gait impairments are common in patients with Alzheimer’s disease. Cholinesterase inhibitors are used to treat the symptoms of patients with Alzheimer’s disease, but they have not been shown to reduce Alzheimer’s disease-related gait disorders.Methods The aim of the present study was to determine the effect of the acetylcholinesterase inhibitor rivastigmine on gait in 21 newly diagnosed patients with mild to moderate Alzheimer’s disease. The outcome variables were velocity, stride length, and cadence during single-task and dual-task gait trials. The subjects were also assessed with the Mini-Mental State Examination, Alzheimer’s Disease Cooperative Study Activities of Daily Living, Functional Assessment Staging, and Geriatric Depression Scale.Results After 12 weeks of treatment with rivastigmine, gait velocity was significantly improved in dual-task gait trials; gait velocity was increased from 40.59 ± 13.59 m/min at baseline to 46.88 ± 12.73 m/min when counting backward from 100 in steps of 7 while walking, and gait velocity was increased from 37.06 ± 15.57 m/min at baseline to 42.03 ± 14.02 m/min when naming animals while walking. In the single-task gait trials, which consisted only of walking at their usual pace or at a fast pace, gait velocity was not increased by rivastigmine administration.Conclusion Our findings indicated that rivastigmine improved gait in subjects with mild to moderate Alzheimer’s disease. The observed enhancement of dual-task gait might be caused by an improvement of cognitive function rather than motor function.
Cartilage degeneration is associated with activation of the PI3K/AKT signaling pathway in a growing rat experimental model of developmental trochlear dysplasia
Authors: Lin Wei , Dai Yike , Niu Jinghui , Fan Chongyi , Feng Xunkai , Wang Fei 
Published: May 2020

Abstract
Background: Trochlear dysplasia is a commonly encountered lower extremity deformity in humans. However, the molecular mechanism of cartilage degeneration in trochlear dysplasia is unclear thus far. The PI3K/AKT signaling pathway is known to be important for regulating the pathophysiology of cartilage degeneration. This study investigated the relationship of the PI3K/AKT signaling pathway with trochlear dysplasia cartilage degeneration. Materials and methods: In total, 120 female Sprague-Dawley rats (4 weeks of age) were randomly separated into control and experimental groups. Distal femurs were isolated from the experimental group at 4, 8, and 12 weeks after surgery; they were isolated from the control group at the same time points. Micro-computed tomography and histological examination were performed to investigate trochlear anatomy and changes in trochlear cartilage. Subsequently, expression patterns of PI3K/AKT, TGFβ1, and ADAMTS-4 in cartilage were investigated by immunohistochemistry and quantitative polymerase chain reaction. Results: In the experimental group, the trochlear dysplasia model was successfully established at 8 weeks after surgery. Moreover, cartilage degeneration was observed beginning at 8 weeks after surgery, with higher protein and mRNA expression levels of PI3K/AKT, TGFβ1, and ADAMTS-4, relative to the control group. Conclusions: Patellar instability might lead to trochlear dysplasia in growing rats. Moreover, trochlear dysplasia may cause patellofemoral osteoarthritis; cartilage degeneration in trochlear dysplasia might be associated with activation of the PI3K/AKT signaling pathway. These results provide insights regarding the high incidence of osteoarthritis in patients with trochlear dysplasia. However, more research is needed to clarify the underlying mechanisms.
Neutrophil-to-lymphocyte ratio predicts diagnosis and prognosis of patients with hepatocellular: A systematic review and meta-analysis
Authors: Lin Shan , Hu Shiping , Ran Yun , Wu Fenfang 
Published: May 2020

Abstract
Background: Neutrophil-to-lymphocyte ratio (NLR) is one of the poor prognostic factors of Hepatocellular carcinoma (HCC) in patients. As contradictory data are seen concerning the predictive ability of NLR, a meta-analysis is performed for the determination of its prognostic value in patients with HCC in this study.Methods: We systematically searched several databases including PubMed, EMBASE, and Cochrane Library with the updated date of January 21, 2020. Pooled estimates of odds ratio (OR) and diagnostic odds ratio (DOR) were used to assess the prognostic performance of NLR in HCC patients.Results: Nine studies containing a total of 3,862 HCC patients were included. High baseline NLR was correlated with poor prognosis or recurrence significantly. The patient-based analysis of pooled estimates was as follows: sensitivity 0.68 [95% confidence interval (CI), 0.58-0.77], specificity 0.73 (95% CI, 0.61-0.82), and DOR 6.347 (95% CI, 5.450-7.391), respectively. The pooled positive likelihood ratio (PLR) and negative likelihood ratio (NLHR) were 2.5 (95% CI, 1.8-3.6) and 0.43 (95% CI, 0.33-0.57). Furthermore, the area under the curve (AUC) of summary receiver operating characteristic (SROC) reflecting the diagnostic accuracy was 0.76 (95% CI, 0.72-0.80). Results obtained from subgroup meta-analyses and overall meta-analyses were accordingly consistent with each other.Conclusions: Our findings suggested that NLR is an efficient prognostic factor for patients with HCC, especially for those from East Asian with high incidence. In the future, trails with larger sample sizes and more high-quality evidence are needed to further enhance the patient outcomes.
Induction of IRG1 following ischemic stroke promotes HO-1 and BDNF expression to alleviate neuroinflammation and restrain ischemic brain injury
Authors: Kuo Ping-Chang , Weng Wen-Tsan , Scofield Barbara A. , Furnas Destin , Paraiso Hallel C. , Yu I-Chen , Yen Jui-Hung 
Published: May 2020

Abstract
Background

Inflammatory stimuli induce immunoresponsive gene 1 (IRG1) expression that in turn catalyzes the production of itaconate through diverting cis-aconitate away from the tricarboxylic acid cycle. The immunoregulatory effect of IRG1/itaconate axis has recently documented in LPS-activated mouse and human macrophages. In addition, dimethyl itaconate, an itaconate derivative, was reported to ameliorate disease severity in the animal models of psoriasis and multiple sclerosis. Currently, whether IRG1/itaconate axis exerts an immunomodulatory effect in ischemic stroke is unknown. Thus, we investigated whether IRG1 plays a role in modulating brain injury in ischemic stroke. In addition, the molecular mechanisms underlying the protective effects of IRG1 in ischemic stroke were elucidated.
Methods

Wild type (WT) C57BL/6 and IRG1−/− mice were subjected to 40 minutes middle cerebral artery occlusion (MCAO). Ischemic brain injury, microglia (MG) activation and peripheral immune cell infiltration of the ischemic brain were assessed. Furthermore, the expression of HO-1 and BDNF in the ischemic brain was measured. Finally, IRG1−/− MCAO mice were administered with D3T, an Nrf2/HO-1 pathway inducer, to determine its effects on cerebral BDNF expression and ischemic brain injury.
Results

We observed IRG1 was highly induced in the ischemic brain of WT but not IRG1−/− MCAO mice. Strikingly, IRG1−/− MCAO mice exhibited exacerbated brain injury with enlarged cerebral infarct, enhanced MG activation, and elevated immune cell infiltrates compared to WT MCAO controls. Further analysis of molecular mechanisms underlying the protective effects of IRG1 in ischemic stroke revealed that IRG1 promoted HO-1 and BDNF expression to restrain ischemic brain injury, as IRG1−/− MCAO mice exhibited reduced HO-1 and BDNF expression in the ischemic brain compared to WT MCAO controls. Notably, D3T, an Nrf2/HO-1 pathway inducer, promoted BDNF expression and lessened ischemic brain injury in IRG1−/− MCAO mice.
Conclusions

We demonstrate that the induction of IRG1 following ischemic stroke may serve as an endogenous protective mechanism to restrain ischemic brain injury, and that may be mediated through the protective effect of IRG1 on the induction of HO-1 and BDNF expression in the ischemic brain. Thus, our study suggests that targeting IRG1 may represent a novel approach for the treatment of ischemic stroke.