bluuebunny/crossref_metadata_2025_split huggingface dataset:
L-Carnitine Ameliorates the Muscle Wasting of Cancer Cachexia through the AKT/FOXO3a/MaFbx Axis
Authors: Wu Changpeng , Zhu Mingxing , Lu Zongliang , Zhang Yaowen , Li Long , Li Na , Yin Liangyu , Wang He , Song Wei , Xu Hongxia 
Published: June 2021

Abstract
Recent studies suggest potential benefits of applying L-carnitine in the treatment of cancer cachexia, but the precise mechanisms remain unknown. This study was conducted to determine the mechanism by which L-carnitine reduces cancer cachexia. We found that L-carnitine increased the gastrocnemius muscle (GM) weight in the CT-26-bearing cachexia mouse model and the cross-sectional fiber area (CFA) of the GM and myotube diameters of C2C12 cells treated with TNF-α. Additionally, L-carnitine reduced the protein expression of muscle RING-type E3 ubiquitin ligase 1 (MuRF1), muscle atrophy F-box protein (MaFbx) and FOXO3a, and increased the p-FOXO3a level in vivo and in vitro, indicating that L-carnitine inhibits muscle protein ubiquitination in models of cachexia. Inhibition of Akt, upstream of FOXO3a, reversed the effects of L-carnitine on the FOXO3a/MaFbx pathway and myotube diameters, without affecting FOXO3a/MuRF-1. In addition to regulating the ubiquitination of muscle proteins, L-carnitine also increased the levels of p-p70S6K and p70S6K, which are involved in protein synthesis. Akt inhibition did not reverse the effects of L-carnitine on p70S6K. Hence, L-carnitine ameliorated cancer cachexia via the Akt/FOXO3/MaFbx and p70S6K pathways. Moreover, L-carnitine reduced the serum levels of interleukin-1 (IL-1) and interleukin-6 (IL-6), factors known to induce cancer cachexia. However, there were minimal effects on TNF-α, another inducer of cachexia. Taken together, these results revealed a novel mechanism of action by which L-carnitine protects muscle cells and reduces inflammation related to cancer cachexia.
Assessment of Iron Overload in a Cohort of Sri Lankan Patients with Transfusion Dependent Beta Thalassaemia and its Correlation with Pathogenic Variants in HBB, HFE, SLC40A1, and TFR2 Genes
Authors: Dissanayake Ruwangi , Samarasinghe Nayana , Waidyanatha Samantha , Pathirana Sajeewani , Dissanayake Vajira HW , Wettasinghe Kalum , Gooneratne Lallindra , Wickramasinghe Pujitha 
Published: June 2021

Abstract
Background. Iron overload (IO) is a complication in transfusion dependent beta thalassaemmia (TDT). Pathogenic variants in genes involving iron metabolism may confer increased risk of IO. The objective of this study was to determine the magnitude of the cardiac and hepatic IO and determine whether pathogenic variants in HFE, SLC40A1 and TFR2 genes increase the risk of IO in a cohort of TDT patients in Sri Lanka.Materials and Methods. Fifty-seven (57) patients with TDT were recruited for this study. Serum ferritin was done once in 3 months for one year in all. Those who were ≥ 8 years of age underwent T2* MRI of the liver and heart. Fifty-two (52) patients underwent next generation sequencing (NGS) to identify pathogenic variants in HBB, HFE, SLC40A1 and TFR2 genes.Results. The mean age (SD) of this cohort was 9.5 (±4.6) years. It comprised of 30 (52.6%) boys and 27 (47.4%) girls. The mean serum ferritin was 3405 (±2670.5) ng/dl. Hepatic IO was seen in 38 (95%) patients and cardiac IO was seen in 17 (42.5%) patients. All patients with cardiac IO were asymptomatic and had normal echocardiogrammes. There was no statistically significant correlation between serum ferritin and hepatic or cardiac IO.32 (61.5%), 18 (34.6%), 2 (3.8%) of patients were homozygotes, compound heterozygotes and heterozygotes for pathogenic variants in the HBB gene. 9 (17.3%) and 3 (5.8%) patients were heterozygotes for pathogenic variants of HFE and SLC40A1 genes respectively. There were no pathogenic variants for the TfR2 gene. The heterozygotes of the pathogenic variants of the HFE and SLC40A1 genes were not at increased risk of IO.Conclusions. Cardiac T2* MRI helps to detect cardiac IO prior to the onset of symptoms when the echocardiogramme is normal. It is important to perform hepatic and cardiac MRI T2* to detect IO in patients with TDT.
Landslide Hazard Zonation and Evaluation Around Debre Markos Town, NW Ethiopia—A GIS-Based Statistical Approach
Authors: Manderso Dawit Asmare 
Published: June 2021

Abstract
The main goal of this research was to perform a landslide hazard zonation and evaluation around Debre Markos town, North West Ethiopia, found about 300 km from the capital city Addis Ababa. To achieve the aim, a GIS-based probabilistic statistical technique was used to rate the governing factors, followed by geoprocessing in the GIS setting to produce the landslide hazard zonation map. In this research, eight internal causative and external triggering factors were selected: slope material (lithology and soil mass), elevation, aspect, slope, land use land cover, curvature, distance to fault, and distance to drainage. Data were collected from field mapping, secondary maps, and digital elevation models. Systematic and detailed fieldwork had been done for image interpretation and inventory mapping. Accordingly, the past landslides map of the research area was prepared. All influencing factors were statistically analyzed to determine their relationship to previous landslides. The results revealed that 17.15% (40.60 km2), 25.53% (60.45 km2), 28.04% (66.39 km2), 18.93% (44.83 km2), and 10.36% (24.54 km2) of the research area falls under no hazard, low hazard, moderate hazard, high hazard, and very high hazard respectively. The validation of the landslide hazard zonation map reveals that 1%, 2%, 3%, and 94% of past landslides fall in no hazard zone, low hazard, moderate hazard zone, and high hazard or very high hazard zones respectively. The validation of the landslide hazard zonation map thus, it has been adequately demonstrated that the adopted approach has produced acceptable results. The defined hazard zones can practically be utilized for land management and infrastructure construction in the study area.
Decoupled Soil Labile Carbon and Nitrogen Dynamics Triggered by Urban Vegetation
Authors: Dou Xiaolin , Lu Meng , Chen Liding 
Published: June 2021

Abstract
Purpose Studies about soil carbon (C) and nitrogen (N) dynamics with land use change are urgently needed for urban ecosystems. We used fractionation of soils combined with stable isotopic analysis to examine soil C and N cycles after decadal forest and lawn planting in the Pearl River Delta, China. Methods Soil samples from bare soil (CK) and four land use treatments (55 and 20 years of forest plantation, F-55 and F-20; 55 and 20 years of lawn plantation, L-55 and L-20) were split into different chemical fractions. Then we analyzed the C and N contents, C/N ratio, δ13C and δ15N, C and N recalcitrant indices (RIC, RIN), and a C pool management index (CPMI).Results Forest vegetation substantially enhanced soil organic carbon (SOC) caused by the recalcitrant (RC) and labile C (LC) pools, while the larger soil organic nitrogen (SON) was ascribed to the increased recalcitrant N (RN). Enhanced LC but minor changes in labile N (LN) suggested a decoupled C and N in labile fractions of the forest soils. In contrast, the larger LN, and the enhanced decomposition of SOC, indicated that the lawns may have inhibited N mineralization of labile pools, also suggesting a decoupled C and N turnover and leading to low RIN values. Conclusions Urban forest and lawn plantations significantly changed the soil C and N dynamics, and emphasized the inconsistency between C and N processes, especially in labile pools, which would eventually lead to minor changes in N and limit the ecosystem C sequestration.
Extracorporeal CO2 Removal in Acute Exacerbation of COPD Not Responding to Non-Invasive Ventilation: a Single Center Experience
Authors: Azzi Mathilde , Aboab Jerome , Alviset Sophie , Ushmorova Daria , Ferreira Luis , Ioos Vincent , Memain Nathalie , Issoufaly Tazime , Lermuzeaux Mathilde , Laine Laurent , Serbouti Rita , Silva Daniel 
Published: June 2021

Abstract
Background: Acute exacerbation of chronic obstructive pulmonary disease (ae-COPD) has a gold standard treatment: non-invasive ventilation (NIV). However, this treatment sometime fails, and an invasive mechanical ventilation (IMV) is required. The extracorporeal CO₂ removal (ECCO₂R) device can be an alternative to intubation. The aim of the study is to evaluate ECCO₂R efficiency and safety and enlighten ECCO₂R benefit/risk compared to IMV.Methods: Consecutive ae-COPD patients for whom NIV failed were retrospectively analyzed during two periods: before and after the ECCO₂R device implementation in our ICU in 2015. We considered the before period as standard of care and patients were treated with IMV. The ECCO₂R device was a pump-driven veno-venous system (Xenios AG).Results: The two groups (ECCO₂R n = 26 and Control group n = 25) were comparable at baseline except for the BMI which was significantly higher in the ECCO₂R group (30kg/m² versus 25kg/m²). The pH and PaCO₂ improved significantly in both groups. The mean time on ECCO₂R was 5,4 days whereas IMV lasted 27 days in the control group. Four patients needed IMV in the ECCO₂R group (of which 3 occurred after ECCO₂R weaning). There were 7 major bleeding events with ECCO₂R and 3 led to premature termination of ECCO₂R. In the control group, there were 8 ventilator associated pneumonia, 25 haemodynamic instability and 6 self extubations. The mean time in ICU and hospital stay in the ECCO₂R and control groups were 18 vs 30 days, 29 vs 49 days, respectively and the 90-day mortality rates were 15% vs 28%.Conclusions: ECCO₂R brings significant improvement on pH and PaCO₂ in ae-COPD patients failing NIV therapy and permit to avoid intubation in 85% with low complication rates compared to IMV. These results have yet to be proven in a larger randomized study.Trial registration: ClinicalTrials.gov, NCT04882410. Date of registration May 12th 2021, Retrospectively registered.https://www.clinicaltrials.gov/ct2/show/NCT04882410
Evaluation of the Implementation of a Multidisciplinary Fast Track Program for Geriatric Acute Hip Fracture Patients at a University Hospital in Resource-Limited Settings
Authors: Sura-amonrattana Unchana , Tharmviboonsri Theerawoot , Unnanuntana Aasis , Tantigate Direk , Srinonpras Varalak 
Published: June 2021

Abstract
Background: Hip fractures are common among frail, older people and associated with multiple adverse outcomes, including death. Timely and appropriate care by a multidisciplinary team may improve outcomes. Implementing a team to jointly deliver the service in resource-limited settings is challenging, particularly on the effectiveness of patient outcomes. Methods: A retrospective cohort study to compare outcomes of hip fracture patients aged 65 or older admitted at Siriraj hospital pre- and post-implementation of the Fast-track program. The primary outcome was the incidence of medical complications. The secondary outcomes were time to surgery, factors related to the occurrence of various complications, in-hospital mortality, and mortality at month 3, month 6 and month 12 after the operation. Results: 302 patients were enrolled from the Siriraj hospital’s database between October 2016 and October 2018; 151 patients in each group with a mean age of 80 years were analyzed. Clinical parameters were similar between groups except the Fast-track group comprising more patients with dementia (37.1% VS 23.8%, p<0.012). In the Fast-track group, there was a significantly higher proportion of patients underwent surgery within 72-hours (80.3% VS 44.7%, p<0.001) and the length of stay was significantly shorter (11 days (8-17) VS 13 days (9-18), p=0.017). There was no significant difference in medical complications and mortality. Stratified analysis by dementia status showed a trend in delirium reduction in both demented and non-demented groups, and a pressure injury reduction among patients with dementia after the program was implemented but there was no statistical significance.Conclusions: The implementation of a multidisciplinary team for hip fracture patients is feasible in resource-limited settings. In the Fast-track system, time to surgery was reduced and the length of stay was shortened. Other outcome benefits were not shown, which may be due to incomplete uptake of all involved disciplines.
Cough Hypersensitivity in Patients With Metabolic Syndrome: A Clinical Finding and Its Possible Mechanisms
Authors: Cheng Jiafen , Xie Zhuangli , Wang Shengyuan , Wen Siwan , Niu Shanshan , Shi Cuiqin , Yu Li , Xu Xianghuai 
Published: June 2021

Abstract
Purpose: To investigate the changes of cough sensitivity in patients with metabolic syndrome and its possible mechanisms. Method: A total of 29 metabolic syndrome (MetS) patients with OSAHS (group-1), 22 MetS patients without OSAHS (group-2), and 25 healthy controls (group-3) were included. All participants underwent a routine physical examination and completed the gastroesophageal reflux disease questionnaire (GerdQ), and the inflammatory mediator profile were determined. The cough threshold for capsaicin, induced sputum cell count and cell classification, and inflammatory mediators in induced sputum supernatants were compared. The correlation between capsaicin cough sensitivity and various indicators in the MetS population was analyzed. Results: The minimum concentration of inhaled capsaicin needed to induce ≥2 coughs (C2) was significantly different among three groups (H = 13.856, P < 0.001) and lower for group-1 and group-2 than it for group-3 (P = 0.001, P = 0.003), which was similar with the C5 concentrations (the minimum concentration of inhaled capsaicin needed to induce ≥5 coughs). The percentage of neutrophils in induced sputum and the concentrations of calcitonin gene-related peptide (CGRP), substance P (SP), and interleukin 8 (IL-8) in the sputum supernatant of group-1 and group-2 were significantly higher than those of group-3. Besides, the pepsin concentrations were significantly different among the 3 groups (F = 129.362, P < 0.001), which significantly was highest in group-1(P < 0.001) and lowest in group-3 (P < 0.001). In group-1, lgC2 and lgC5 were both negatively correlated with the apnea-hypopnea index (AHI, r = -0.577, P = 0.001; r = -0.394, P = 0.035). Conclusion: Increased capsaicin cough sensitivity in MetS patients is closely related to sleep apnea and gastroesophageal reflux. For patients in MetS patients without OSAHS, gastroesophageal reflux is an important factor for increased capsaicin cough sensitivity. Airway inflammation, especially airway neurogenic inflammation, may also play a role in the pathogenesis of increased capsaicin cough sensitivityTrial registration: The protocol was registered in the Chinese Clinical Trials Register (http://www. chictr. org. cn/) (ChiCTR1800014768). Written informed consent was obtained from all participants before enrollment.
Are Optimised CBCT Protocols Suitable to Detect Simulated Vertical Root Fracture in the Presence of Metal Outside and/or Inside the Fov?
Authors: Candemil Amanda Pelegrin , Salmon Benjamin , Vasconcelos Karla F , Oenning Anne C , Jacobs Reinhilde , Freitas Deborah Q , Haiter-Neto Francisco , Mangione Francesca , Oliveira Matheus L 
Published: June 2021

Abstract
Dose optimisation has been revisited in the literature due to the high frequency of cone-beam CT (CBCT) scans and, the reduction of the field-of-view (FOV) size has shown to be an effective strategy. However, small FOV scans have negative influences of the truncation effect from the exomass.The aim of this study was to evaluate the diagnostic accuracy of an optimised CBCT protocol for the detection of simulated vertical root fracture (VRF) in the presence of metallic artefacts from the exomass and/or endomass.Twenty teeth were endodontically instrumented and VRF was induced in half of them. All teeth were individually placed in a human mandible, metallic materials were placed in the exomass and/or endomass, and CBCT scans were obtained at two dose protocols: standard and optimised. Three radiologists evaluated the images and indicated the presence of VRF using a 5-point scale. Sensitivity, specificity and area under the ROC curve (AUC) were obtained and compared using ANOVA (α=0.05). Overall, sensitivity, specificity and AUC did not differ significantly (p>0.05) between the dose protocols.In conclusion, optimised protocols should be considered in the detection of simulated VRF irrespective of the occurrence of artefacts from metallic materials in the exomass and/or endomass.
The Impact of a Faculty Development Program, the Leadership in Academic Medicine Program (LAMP), On Self-Efficacy, Academic Promotion and Institutional Retention
Authors: Tung Judy , Nahid Musarrat , Rajan Mangala , Logio Lia 
Published: June 2021

Abstract
BackgroundAcademic medical centers invest considerably in faculty development efforts to support the career success and promotion of their faculty and to minimize faculty attrition. This study evaluated the impact of a faculty development program called the Leadership in Academic Medicine Program (LAMP) on participants’ (1) self-ratings of efficacy, (2) promotion in academic rank, and (3) institutional retention. MethodParticipants from the 2013-2020 LAMP cohorts were surveyed pre and post program to assess their level of agreement with statements that spanned domains of self-awareness, self-efficacy, satisfaction with work and work environment. Pre and post responses were compared using McNemar’s tests. Changes in scores across gender were compared using Wilcoxon Rank Sum/Mann-Whitney tests.LAMP participants were matched to nonparticipant controls by gender, rank, department, and time of hire to compare promotions in academic rank and departures from the organization. Kaplan Meier curves and Cox proportional hazards models were used to examine differences. ResultsThere were significant improvements in almost all self-ratings on program surveys (p < 0.05). Greatest improvements were seen in “understand the promotions process” (36% vs. 94%), “comfortable negotiating” (35% vs. 74%), and “time management” (55% vs. 92%). There were no statistically significant differences in improvements by gender, however women faculty rated themselves lower on all pre-program items than men.There was significant difference found in time-to-next promotion (p = 0.003) between LAMP participants and controls. Kaplan-Meier analysis demonstrated that LAMP faculty achieved next promotion more often and faster than controls. Cox-proportional-hazards analyses found that LAMP faculty were 61% more likely to get promoted than controls (hazard ratio [HR] 1.61, 95% confidence interval [CI] 1.16-2.23, p-value= 0.004).There was significant difference found in time-to-departure (p<0.0001) with LAMP faculty retained more often and for longer periods. LAMP faculty were 77% less likely to leave compared to controls (HR 0.23, 95% CI 0.16-0.34, p<0.0001).ConclusionsLAMP is an effective faculty development program as measured subjectively by participant self-ratings and objectively through comparative improvements in academic promotions and institutional retention.
How Can We Meet the Needs of Young People in Vulnerable 'NEET' Situations? A Realist Research Protocol to Evaluate the Delivery and Implementation of (Re)Engagement Initiatives in Northern Sweden
Authors: Jonsson Frida , Hjelte Jan , Sundberg Linda Richter , Nordström Annika , Goicolea Isabel 
Published: June 2021

Abstract
Background

Situated in the northern Swedish context, the project presented in this protocol aims to explore and establish how multi-component ‘(re)engagement’ initiatives work, while providing directions for strengthening the delivery and implementation to better meet the needs of young people in vulnerable ‘NEET’ situations (‘not in employment, education or training’). In this regard, the research emerges from international and national concerns about the challenges faced by young people who are marginalised from mainstream institutions. It is also a response to the ‘(re)engagement’ initiatives that have been implemented, but never rigorously evaluated, in Sweden, which means a substantial body of relevant knowledge is at risk of being lost, and that we currently lack evidence about what works to reengage young people that are neither studying nor working.
Methods

To address the aim and three subsequent research questions, two methodologies will be combined in three phases. Following an iterative analytical process, where results from a realist evaluation will inform a concept mapping study, the project will involve: 1) a realist review of international academic and grey literature to identify underlying programme theories and explore how ‘(re)engagement’ initiatives are expected to work; 2) a realism-based case study to scrutinise the programme theories and assess whether the ‘(re)engagement’ initiatives work as intended; and 3) a participatory concept mapping study to provide directions for strengthening the delivery and implementation of ‘(re)engagement’ initiatives in northern Sweden.
Discussion

While ‘(re)engagement’ initiatives may not be a solution to the problems that exist in labour markets and educational systems today, they may be a partial and perhaps provisional saviour for young people who have already ended up at the margins of society. By evaluating how these initiatives work while providing directions for action, the current project will contribute knowledge useful to improve the support to young people in vulnerable ‘NEET’ situations who need the courage to dare enter a world that has let them down once before.
Testing the Bounds of Compassion in Young Children
Authors: Kirby James N. , Wilks Matti , Green Mitchell , Tanjitpiyanond Porntida , Chowdhury Nafisa , Kirkland Kelly , Nielsen Mark 
Published: June 2021

Abstract
Extensive research shows that, under the right circumstances, children are highly prosocial. Less in known about their capacity for compassion. Across five experiments (N = 285), we aimed to capture the bounds of 4-5-year-old children’s compassionate behaviour. In the first three experiments we varied cost of compassion by changing the reward (study 1), using explicit instructions (study 2), and ownership (study 3). In the final two experiments we varied the target of the compassionate behaviour, examining adults compared to puppet targets (study 4), and whether the target was an in-group member (study 5). We found strong evidence that cost reduces compassionate responding. By contrast, the recipient of compassion did not appear to influence compassionate responding: children were equally likely to help a human adult and a puppet, and an in-group member and neutral agent. Thus, personal cost appears to be a greater inhibitor to compassionate responding than who compassion is directed toward. These findings demonstrate the environmental factors that may reduce compassionate responding in young children, and call for careful consideration of how to mitigate these to create more positive and socially connected environments for children to flourish.