bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Biomechanical Role of the Fibula in Lower Limbs: A Fracture Mechanics Analysis
Authors: Shao Bin , Xing Jianqiang , Liu Dong , Wang Dawei , Zhao Bei , Wang Tingguang , Mu Weidong 
Published: May 2021

Abstract
BackgroundFibular grafting is widely used in the treatment of various bone nonunions and defects because of its good therapeutic effects. Furthermore, partial fibular resection has been used as a treatment for fibular tumors, injuries, and other conditions. The fibula plays important roles in the biomechanics of the lower limbs. Some experts have used cadaver specimens to study these aspects. In this study, the biomechanical effects of the fibula in lower limbs were researched through mechanics analysis.MethodsWe randomly collected knee joint computed tomography (CT) scans from eight adults, including three left knees and five right knees. The DICOM formatted CT scan images were imported into Mimics software. The tibia and fibula were extracted with the CT-bone function in Mimics software, and 3D models of the tibia and fibula were obtained. Each model was imported into 3-MATIC and LS-DYNA software to smooth the surface, perform meshing, define material properties, and set the failure parameters, interface properties, vertical loads and boundary conditions. The tibial fractures in both models were calculated to evaluate the biomechanical role of the fibula in the lower leg.ResultsThe validity of the model was verified, and the fibular load condition was similar to those previously reported. In the model with fibular support, the fracture load of the tibia was 78.27±3.36 KN, the initial fracture time was 0.69±0.01 s, and the complete fracture time was 0.75±0.01 s. The fibula carried approximately 7% of the load on the lower leg. In the fibular defect model, the fracture load of the tibia was 72.71±3.25 KN, the initial fracture time was 0.54±0.02 s, and the complete fracture time was 0.62±0.01 s.Conclusions﻿The fibula play an essential biomechanical role in lower limb load-bearing and therefore is worthy of clinical attention. We believe that LS-DYNA can be used as an effective tool for the study of fracture mechanics.
Association Between IL-18 Gene Polymorphism and Hashimoto Thyroiditis
Authors: Karakaya Dilek , Genc Gunes Cakmak , Celik Sevim Karakas , Aktas Tugba , Bayraktaroglu Taner , Dursun Ahmet 
Published: May 2021

Abstract
BackgroundHashimoto’s thyroiditis (HT) is the most frequent organ-specific autoimmune disease (AIT), which is called lymphocytic thyroiditis in which T helper-1 lymphocytes mediate the disease. IL-18 is expressed in thyroid follicular cells (TFCs) during HT. The findings of studies aimed at investigating the relationship between IL-18 and HT are highly contradictory. In this study, we aimed to investigate the association between IL-18 gene polymorphism and HT.Methods and ResultsThe study was included 97 patients diagnosed with HT and 86 volunteers in the healthy control group. The IL18-607C/A (rs1946518) ve -137G/C (rs187238) genotypes were determined using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. No significant difference in the mean ages and gender was observed between the groups (p = 0.763 and p = 0.658, respectively). -137 IL18 CG genotype is higher in HT than controls. The risk of the IL-18 CG genotype for HT patients was more than 2.237 times higher (OR; 2.237 %95 Cl: 1.195–4.187, p = 0.039) compared to that of the G/G genotype. Also, -607 AC genotype is higher in the control group than in the HT group (in individuals with the IL18 CG genotype).Conclusions﻿According to our results, the CG genotype might be a risk factor for HT. Conversely, there is a possibility that the AC genotype also plays a protective role against the condition. However, further studies will contribute to the emergence of new solutions by revealing the molecular and cellular mechanisms of HT.
Bmal1- and Per2-Mediated Regulation of the Osteogenic Differentiation and Proliferation of Mouse BMSCs by Modulating the Wnt/β-catenin Pathway
Authors: Zheng Jiawen , Zhang Lanxin , Tan Zhen , Wang Yuhong , Zhao Qing , Zhang Chenxiaoxue , Wei Xiaoyu , Yang Yuqing 
Published: May 2021

Abstract
BackgroundBmal1 and Per2 are the core components of the circadian clock genes(CCGs). Bmal1-/- mice exhibit premature aging, as indicated by hypotrichosis and osteoporosis, with a loss of proliferation ability. The same occurs in Per2-/- mice, albeit to a less severe degree. However, whether the effects of Bmal1 and Per2 on proliferation and osteogenic differentiation are synergistic or antagonistic remains unclear. Thus, our study aimed to explore the effects and specific mechanism.Materials and methodsLentiviral and adenoviral vectors were constructed to silence or overexpress Bmal1 or Per2 and MTT, flow cytometry, RT-qPCR, WB, immunohistochemistry, alizarin red staining and ChIP-Seq analyses were applied to identify the possible mechanism. ResultsThe successful knockdown and overexpression of Bmal1/Per2 were detected by fluorescence microcopy. Flow cytometry found out that Bmal1 or Per2 knockdown resulted in G1-phase cell cycle arrest. RT-qPCR showed the different expression levels of Wnt-3a, c-myc1 and axin2 in the Wnt/β-catenin signaling pathway as well as the gene expression change of Rorα and Rev-erbα. Meanwhile, Related proteins such as β-catenin, TCF-1, and P-GSK-3β were detected. ALP activity and the amount of mineral nodules were compared. ChIP-Seq results showed the possible mechanism.Conclusions﻿Bmal1 and Per2, as primary canonical clock genes, showed synergistic effects on the proliferation and differentiation of BMSCs. They would inhibit the Wnt/β-catenin signaling pathway by downregulating Rorα expression or upregulating Rev-erbα expression, both of which were also key elements of CCGs. And this may be the mechanism by which they negatively regulate the osteogenic differentiation of BMSCs.
A Questionnaire Based on A Sub-Regional Hierarchical Level Showed the Following: Application of Medical Accident Insurance is Suitable in Shanghai, China
Authors: Wan Li-Tao , Chen Gang 
Published: May 2021

Abstract
Background: The application of medical accident insurance could not only cover parts of patients’ property loss caused by non-medical negligence, but also reduce the risks of medical staff during medical services. However, the compensation mechanism for medical accidents is unsound in china. Methods: In order to figure out the awareness and acceptance of the medical accident insurance in Shanghai medical institutions, medical staff and patients, a questionnaire survey was conducted. The feedback, which in total came from 22 medical institutions, 1,689 medical staff and 1,342 patients, was statistically analyzed by chi-square test.Results：Only 22.72% of the 22 hospitals in this questionnaire survey purchased medical accident insurance. As a result, medical accident insurance only accounts for 3.13% of medical compensation, which was far lower than the negotiated compensation ratio (61.25%) and the medical liability insurance compensation ratio (14.38%). This may be due to the low awareness of medical accident insurance, and our survey also proves this phenomenon. In this survey, we find that only a small proportion (22.73%) of medical institutions purchase medical accident insurance. What is more unexpected is that the vast majorities of patients (50.00%) and medical workers (64.00%) have only heard of it and are not aware of it. Although nearly half of the patients (45.16%) and medical workers (58.26%) are willing to buy medical accident insurance, there were still some patients and medical workers who were uncertain (32.80% and 38.82%, respectively) or unwilling to buy it (8.94% and 16.02%, respectively). The reason is nothing more than that no benefits will occur while the cost is high. Among those willing to buy, the majority of the patients (58.19%) and medical workers (54.39%) only accept the amount of insurance less than RMB 200 yuan. Conclusions: The acceptability and cognition of medical accident insurance in medical workers and patients are still at a low level in Shanghai. In addition, preliminary data from medical institutions purchasing medical accident insurance shows that the insurance can effectively reduce medical disputes and ease economic burden. To sum up, medical accident insurance has good application prospect and space in Shanghai, China.
Exploring Socioeconomic Inequities in Access to Palliative and End-of-life Care in the Uk: A Mixed Methods Narrative Synthesis
Authors: French Maddy , Keegan Thomas , Anestis Eleftherios , Preston Nancy 
Published: May 2021

Abstract
Background: Efforts to understand and tackle socioeconomic inequities in access to palliative and end-of-life care require comprehensive understanding about the extent of and reasons for inequities. Most research on this topic examines differences in receipt of care. There is a need for theoretically driven research that considers both receipt of care and the wider factors influencing the relationship between socioeconomic position and access to palliative and end-of-life care. Methods: A mixed-methods narrative synthesis on socioeconomic position and access to palliative and end-of-life care in the UK. Study searches were conducted in databases AMED, Medline, Embase, CINAHL, SocIndex, and Academic Literature Search along with grey literature sources in July 2020. The candidacy model of access, which describes access as a seven-stage negotiation between patients and providers, guided study searches and provided a theoretical lens through which data were synthesised.Results: Searches retrieved 5303 studies (after de-duplication), 29 of which were included. The synthesis generated four overarching themes, within which concepts of candidacy were evident: identifying needs; taking action; local conditions; and receiving care.Conclusion: Socioeconomic position does not have a consistent association with receipt of palliative and end-of-life care in the UK. The use of the candidacy model of access helped to identify key gaps in the UK evidence, including those concerning the relationship between socioeconomic position, organisational context, and assessing need for palliative care.
Breastfeeding and Humanitarian Emergencies: the Experiences of Pregnant and Lactating Women During the Earthquake in Abruzzo, Italy
Authors: Giusti Angela , Marchetti Francesca , Zambri Francesca , Pro Elide , Brillo Eleonora , Colaceci Sofia 
Published: May 2021

Abstract
Background: Emergencies have a great impact on infant and young child feeding. Although the evidence, the recommended feeding practices are often not implemented in the emergency response, undermining infant and maternal health. The aim of this study was to explore the experiences of pregnant and lactating women during the earthquake emergency that occurred in L’Aquila on April 6, 2009.Methods: The study design was qualitative descriptive. Data were collected by individual semi-structured interviews, investigating the mother’s experiences of pregnancy, childbirth, breastfeeding, infant formula or complementary feeding during the emergency and the post emergency phase. Data analysis was categorical and was performed by using N-Vivo software.Results: Six women who were pregnant at the time of the earthquake were interviewed in January 2010. In addition to the essential needs of pregnant and lactating women, such as those related to the emergency shelters conditions, the main findings emerged from this study were: the reconfiguration of relationships and the central role of partners and family support; the need of spaces for sharing experiences and practices with other mothers; the lack of breastfeeding support after the hospital discharge; the inappropriate donations and distribution of Breast Milk Substitutes.Conclusions: During and after L’Aquila earthquake, several aspects of infant and young child feeding did not comply with standard practices and recommendations. The response system appeared not always able to address the specific needs of pregnant and lactating women. It is urgent to develop management plans, policies and procedures and provide communication, sensitization, and training on infant and young child feeding at all levels and sectors of the emergency response.
Chronic Co-morbidity and Self-management Skills Among Adult HIV Patients in Ethopia
Authors: Woldie Yadessa Tegene , Bilal Selamawit Mengesha , Tanis Rianne , Spaargaren Babette , Toma Alemayehu , Spigt Mark 
Published: May 2021

Abstract
Background: HIV requires life-long adherence to treatment and diet, also to avoid chronic co-morbidity. Self-management is widely recognized as an essential part of care for people with chronic disease. We aimed to quantify the prevalence of co-morbidity among adult HIV patients and their self-management skills.Methods: An institutional based cross sectional study was conducted from May to June 2019. We selected a total of 520 adult HIV patients, attending antiretroviral therapy clinics in three Hospitals in Southern Ethiopia. Data were collected at routine care consultations by nine trained nurses using a pre-tested structured questionnaire. Result: The mean age of the study participants was 38.7±9 years. Prevalence of diabetes and Hypertension was 1.5% and 9.4%, respectively. Being older, overweight, and obese was significantly associated with chronic comorbidity. The total score of HIV Self-management was 42±3.92 out of 60. The least mean score (1.69±0.9) was seen in the social support domain of HIV self-management.Conclusion: The prevalence of diabetes and hypertension was relatively low in our population. Self-management skills seem to be low, but many aspects of self-management are poorly understood in Ethiopia (low-income) setting.
The Gut Microbiota Mediates the Inhibition of Seizure-induced Respiratory Arrest in DBA/1 Mice fed a High Tryptophan Diet
Authors: Yue Qiang , Cai Mingfei , Xiao Bo , Zhan Qiong , Zeng Chang 
Published: May 2021

Abstract
Background: Central 5-hydroxytryptamine (5-HT) defects are responsible for the occurrence of audiogenic seizure-induced respiratory arrest (S-IRA) in DBA/1 mice, an animal model of sudden unexpected death in epilepsy (SUDEP). We aimed to explore the effect of a high tryptophan diet (HTD) on SUDEP and its possible mechanism involving 5-HT metabolism via gut microbiota.Methods: Primed animals were randomly assigned to the normal diet (ND) group or HTD group. Before and after diet interventions, 1) S-IRA rates were evaluated, 2) the concentrations of upstream-to-downstream 5-HT metabolites in the plasma and brain were detected by ultra-high-pressure liquid chromatography, and 3) the fecal flora biodiversity and species composition were analysed by 16S rDNA microbiota profiling. Second, antibiotics or probiotics combined with the HTD and S-IRA rates were reassessed.Results: The S-IRA rate in DBA/1 mice was significantly reduced in the HTD group compared with that in control. The HTD obviously increased the levels of tryptophan in the telencephalon and 5-HT and 5-hydroxyindoleacetic acid levels in both the telencephalon and midbrain. The HTD significantly increased the species richness and diversity of gut microbiota. Moreover, there was a significant difference in the gut microbiota composition between the HTD and ND groups. However, antibiotics or probiotics had no synergistic or antagonistic effects on S-IRA reduction mediated by the HTD.Conclusions: An HTD is efficient in lowering S-IRA rates in DBA/1 mice, possibly via modulation of 5-HT metabolism and gut microbiota. Our findings shed light on dietary prevention of SUDEP.
How Do Soil Resources Affect Herbivory in Tropical Plants Along Environmental Gradients? A Test Using Contrasting Congeneric Species
Authors: Pinto Victor Diniz , Badia Clara Cruz Vidart , Soares Glória Ramos , Sousa Hildeberto Caldas , Cornelissen Tatiana , Ribeiro Sérvio Pontes 
Published: May 2021

Abstract
Plants adapted to different habitats exhibit differences in functional traits and these characteristics are influenced by soil properties. We tested the hypothesis that soil resource availability influences the functional traits of plants, affecting therefore herbivory levels. We examined three Byrsonima plant species with different life forms that occurred across a distinct edaphic habitat along the Doce River Basin, South-eastern Brazil. We characterize habitats according to soil nutrient concentration and measured functional characteristics of crown architecture, leaf nutrients, sclerophylly, leaf area and leaf density. In addition, we evaluated how these variables influenced herbivory levels of congeneric plants. Our data have shown that species along a gradient of soil nutrients have functional characteristics influenced by habitat, which in turn affected herbivory levels. By comparing species from different life forms but within the same genus along a stress-gradient of continuous habitats, we described a corresponding gradient of plant functional traits and tissue consumption by herbivorous insects.
Comparative Genomic Characterization of Multidrug-resistant Citrobacter Spp. Strains in Fennec Fox Imported to China
Authors: Qin Jie , Xu Hao , Zhao Yishu , Wang Aifang , Chi Xiaohui , Wen Peipei , Li Shuang , Wu Lingjiao , Bi Sheng 
Published: May 2021

Abstract
Background: To investigate the antimicrobial profiles and genomic characteristics of MDR-Citrobacter spp. strains isolated from Fennec fox imported from Sudan to China.Methods: Citrobacter spp. strains were isolated from stool samples. Matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF-MS) was used for identification. Antimicrobial susceptibility testing was performed using the broth microdilution method. Whole-genome sequencing was performed on an Illumina Novaseq-6000 platform. Acquired antimicrobial resistance genes and plasmid replicons were detected using ResFinder 4.1 and PlasmidFinder 1.3, respectively. Comparative genomic analysis of 277 Citrobacter genomes was also investigated.Results: Isolate FF141 was identified as Citrobacter cronae, isolate FF371, isolate FF414, and isolate FF423 were identified as Citrobacter braakii. Of these, three C. braakii isolates were further confirmed to be ESBL-producer. All isolates are all MDR with resistance to multiple antimicrobials. Plasmids of incompatibility (Inc) group pKPC-CAV1321. Comparative genomics analysis of Citrobacter isolates generated a large core-genome. Genetic diversity was observed in our bacterial collection, which clustered into five main clades. Human, environmental and animal Citrobacter isolates were distributed into five clusters.Conclusions: To our knowledge, this is the first investigation of MDR-Citrobacter from Fennec Fox. Our phenotypic and genomic data further underscore the threat of increased ESBL prevalence in wildlife and emphasize that increased effort should be committed to monitoring the potentially rapid dissemination of ESBL-producers with one health perspective.
Association Between Tfeb Gene Polymorphism, Gene–environment Interaction, and Fatty Liver Disease: a Case–control Study in China
Authors: Mo Chunbao , Mai Tingyu , Cai Jiansheng , He Haoyu , Lu Huaxiang , Tang Xu , Chen Quanhui , Xu Xia , Nong Chuntao , Liu Shuzhen , Tan Dechan , Liu Qiumei , Xu Min , Li You , Zhang Zhiyong , Qin Jian 
Published: May 2021

Abstract
Background: Fatty liver disease (FLD) is a serious public health problem that is rapidly increasing. Evidences indicated that the transcription factor EB (TFEB) gene may be involved in the pathophysiology of FLD; however, whether TEFB polymorphism is association with FLD remains unclear.Objectives: To explore the association among TFEB polymorphism, gene–environment interaction, and FLD and provide epidemiological evidence for clarifying the genetic factors of FLD.Methods: This study is a case–control study. Sequenom MassARRAY was applied in genotyping. Logical regression was used to analyze the association between TFEB polymorphism and FLD, and the gene–environment interaction in FLD was evaluated by multiplication and additive interaction models.Results: (1) The alleles and genotypes of each single nucleotide polymorphism of TFEB in the case and control groups were evenly distributed; no statistically substantial difference was observed. (2) Logistic regression analysis indicated that TFEB polymorphism is not remarkably associated with FLD. (3) In the multiplicative interaction model, rs1015149, rs1062966, and rs11754668 had remarkable interaction with smoking amount. Rs1062966 and rs11754668 also had a considerable interaction with body mass index and alcohol intake, respectively. However, no remarkable additive interaction was observed.Conclusion: TFEB polymorphism is not directly associated with FLD susceptibility, but the risk can be changed through gene–environment interaction.
Spectral Imaging With Dual-layer Spectral Detector Computed Tomography for Acute Coronary Syndrome
Authors: Mochizuki Junji , Nakaura Takeshi , Yoshida Naofumi , Nagayama Yasunori , Kidoh Masafumi , Uetani Hiroyuki , Funama Yoshinori , Hata Yoshiki , Azuma Minako , Hirai Toshinori 
Published: May 2021

Abstract
Purpose: To evaluate the feasibility of spectral imaging with dual-layer spectral detector computed tomography (CT) for the diagnosis of acute coronary syndrome.Methods: We identified 33 consecutive patients who underwent cardiac CT using dual-layer spectral detector CT and were diagnosed with acute ischemic syndrome by an invasive coronary angiography. We reconstructed 120 kVp images and generated virtual monochromatic images (VMIs; 40–200 keV in 10 keV increments), iodine concentration maps, and effective atomic number (Z) maps. We calculated the contrast and contrast-to-noise noise ratio (CNR) between myocardial normal and hypo-perfusion and chose the VMIs with the best CNR for quantitative analysis. We compared the image noise, contrast, and CNR of 120 kVp images and the best VMIs, CT value, iodine concentration, and effective Z between myocardial normal and hypo-perfusion with the paired t-test.Results: As the X-ray energy decreased, venous attenuation, contrast, and CNR gradually increased. The 40 keV image yielded the best CNR. There was no significant difference in image noise between the 120 kVp and 40 keV images. The contrast and CNR between myocardial normal and hypo-perfusion were significantly higher in 40 keV images than those in 120 kVp images. The iodine concentration and the effective Z were significantly higher in normal myocardium than those in hypo-perfused myocardium.Conclusion: Spectral imaging with dual-layer spectral detector CT is a feasible technique to detect the hypo-perfused area of acute ischemic syndrome.
Akt1 is required to maintain lipid droplets for release of HCV infectious virions
Authors: Lee Wei-Ping , Lan Keng-Li , Liao Shi-Xian , Huang Yi-Hsiang , Hou Ming-Chih , Lan Keng-Hsin 
Published: May 2021

Abstract
Hepatitis C virus (HCV) relies on the interplay of viral and host factors to complete its life cycle. It has evolved to benefit from Akt activation at some point in the life cycle through a variety of mechanisms. Our preliminary result showed that Akt-specific inhibitor reduced cell culture-derived HCV (HCVcc) infectivity in a dose-dependent manner. To dissect the mechanism, we adopted a two-part cell culture-derived HCV infection protocol with Akt1 small interfering RNAs (siRNAs) to determine the role of Akt in the HCV life cycle. The result showed that Akt1 was a crucial host factor involved in the late stage of HCV life cycle. Akt1 depletion reduced viral particles released from Huh-7.5.1 cells to culture medium with consequent reduction of viral reinfection in cell culture system, which was restored by ectopic Akt1 expression. To further study the mechanism, we found that Akt1 enhanced lipogenic pathway through transcriptional activation of fatty acid synthase (FAS) by sterol regulatory element binding protein-1 (SREBP1) to maintain sufficient lipid droplet that is an essential organelle for assembly and release of HCV infectious virions.