bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploratory factor analysis of PROMIS-29 V1.0, PROMIS Global Health and the RAND SF-36 from chiropractic responders attending care in a practice-based research network
Authors: Alcantara Joel , Whetten Andrew , Zabriskie Cameron , Jones Sharad 
Published: March 2021

Abstract
Background
The SF-36 questionnaire is perhaps the most widely used quality of life instrument in the world today, while the PROMIS instruments continue to gain popularity. Given their continued use in chiropractic research and practice, we examined their latent domain structure using exploratory factor analysis (EFA).

Methods
To uncover latent structures of a large series of measured variables from the PROMIS-29, PROMIS Global Health and RAND SF-36 domains, we defined a factor analysis model represented by the equation $$X = \mu + \Lambda F +\epsilon$$

X
=
μ
+
Λ
F
+
ϵ

, where $$X = (X_{1} , \ldots ,X_{p} )^{T}$$

X
=

(

X
1

,
…
,

X
p

)

T

is the matrix of random vectors corresponding to the domains with a mean of $$\mu$$
μ
and the covariance matrix $$\Sigma ,$$

Σ
,

$$\Lambda = \{ l_{jk} \}_{pxm}$$

Λ
=

{

l

jk

}

pxm

denotes the matrix of factor loadings, $$F = (F_{1} , \ldots ,F_{m} )^{T}$$

F
=

(

F
1

,
…
,

F
m

)

T

denotes the matrix of unobserved latent variables that influence the collection of domains and $$\epsilon = (_{1} , \ldots ,_{p} )^{T}$$

ϵ
=

(
1

,
…

,
p

)

T

is the vector of latent error terms. The matrix of item responses X was the only observed quantity with restrictions such that variable scores were uncorrelated and of unit variance with the latent errors being independent with the variance vector $$\psi$$
ψ
. The inherited structure of X was expressed simply by $$\Sigma = \Lambda \Lambda^{T} + \psi$$

Σ
=
Λ

Λ
T

+
ψ

. Orthogonal and oblique rotations were performed on the $$\Lambda$$
Λ
matrix with this equation to improve clarity of the latent structure. Model parameters $$\left( {\mu ,\Lambda ,\psi } \right)$$

μ
,
Λ
,
ψ

were optimized using the method of minimum residuals. Each EFA model was constructed with Pearson and Polychoric correlation.

Results
For the PROMIS-29, domains were confirmed to be strongly correlated with Factor 1 (i.e., mental health) or Factor 2 (i.e., physical health). Satisfaction with participation in social roles was highly correlated with a 3rd factor (i.e., social health). For the PROMIS Global Health Scale, a 2-factor EFA confirmed the GPH and GMH domains. For the RAND SF-36, an apparent lack of definable structure was observed except for physical function which had a high correlational relationship with Factor 2. The remaining domains lacked correlation with any factors.

Conclusion
Distinct separation in the latent factors between presumed physical, mental and social health domains were found with the PROMIS instruments but relatively indistinguishable domains in the RAND SF-36. We encourage continued efforts in this area of research to improving patient reported outcomes.
Quality of life in young and middle age adult temporomandibular disorders patients and asymptomatic subjects: a systematic review and meta-analysis
Authors: Pigozzi Lucas Bozzetti , Pereira Duziene Denardini , Pattussi Marcos Pascoal , Moret-Tatay Carmen , Irigaray Tatiana Quarti , Weber João Batista Blessmann , Grossi Patrícia Krieger , Grossi Márcio Lima 
Published: March 2021

Abstract
Aims
To compare the difference in the quality of life between temporomandibular disorders (TMD) patients and non-TMD subjects diagnosed with the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) or the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD).

Methods
Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica database (EMBASE) and Latin American and Caribbean Health Sciences Literature (LILACS) databases were searched in studies published in English and Portuguese. The search was performed by two independent reviewers in duplicate. A manual search and the gray literature were also included. The inclusion criteria were clinical studies that used the RDC/TMD axis I and quality of life with standard questionnaires in young and middle-aged adult population (18–55 years). The data were analyzed quantitatively by combining the results in a meta-analysis using forest plots. The measure of effect used was the standardized mean difference (SMD) in depression levels. The Newcastle–Ottawa Scale (NOS) was used to evaluate the quality of the studies. The publication bias was assessed by funnel plots. The initial search included 806 articles without duplications.

Results
Twenty-four articles were included in the final systematic review. Of these, 9 were included in the meta-analysis, where it was shown a statistically significant in all axis I groups: (a) global TMD—groups I, II and III combined, N = 3829, SMD (95% CI) = 1.06 (0.65–1.51), p = 0.000; (b) group I—muscle disorders, N = 3,056, SMD (95% CI) = 0.82 (0.45–1.18), p = 0.000; (c) group II—disc displacements, N = 3,184, SMD (95% CI) = 0.59 (0.26–0.91), p = 0.000; and (d) group III—arthralgia/arthritis/arthrosis, N = 2781, SMD (95% CI) = 0.98 (0.59–1.36), p = 0.000. When compared to controls.

Conclusions
Quality of life is affected in all axis I TMD patients, especially in groups I and III with higher pain intensity and disability as compared to group II.
Evaluating antenatal breastmilk expression outcomes: a scoping review
Authors: Foudil-Bey Imane , Murphy Malia S. Q. , Dunn Sandra , Keely Erin J. , El-Chaâr Darine 
Published: March 2021

Abstract
Background
Antenatal breastmilk expression (aBME) is recommended by some healthcare providers to improve lactation, breastfeeding, and newborn outcomes, particularly for women with diabetes as they face unique challenges with breastfeeding. However, there is limited evidence of the potential harms and benefits of this practice. Our objective was to conduct a scoping review to map the literature describing maternal and newborn outcomes of aBME.

Methods
We searched Medline, Embase, CINAHL, Cochrane Database of Systematic Reviews, British Library E-Theses Online Services (EThOS) database, OpenGrey, and Clinical trials.gov from inception to January 2020. Studies in English that reported on the effect of aBME on maternal and newborn outcomes, and the experiences of women who have engaged in the practice were included for screening. Titles, abstracts, and full-text articles were screened by two independent reviewers. A critical appraisal and clinical consultation were conducted. Key findings were extracted and summarized.

Results
We screened 659 studies and 20 met the inclusion criteria. The majority of included studies (n = 11, 55.0%) were published after 2015, and seven (35.0%) originated from Australia. Ten (50.0%) studies provided data on high-risk obstetrical populations, including those with diabetes (n = 8), overweight or obesity (n = 1), and preeclampsia (n = 1). Commonly reported outcomes included breastfeeding status at discharge or follow-up, mode of delivery, newborn blood glucose, and time to establishing full lactation. Maternal experiences were related to challenges with aBME, confidence and mastery, perceived impact, security and altruism, learning and resources, and physical symptoms as a result of aBME. The critical appraisal demonstrated limited high-quality evidence surrounding aBME.

Conclusions
Our findings demonstrate increasing interest in the safety, efficacy, and acceptability of aBME. Existing studies are heterogenous with variable research questions, outcomes, study designs, and methodology. The recommendations made in this review can be used to help inform future studies evaluating aBME.
Feasibility and efficacy of a decision aid for emergency department patients with suspected ureterolithiasis: protocol for an adaptive randomized controlled trial
Authors: Schoenfeld Elizabeth M. , Poronsky Kye E. , Westafer Lauren M. , DiFronzo Brianna M. , Visintainer Paul , Scales Charles D. , Hess Erik P. , Lindenauer Peter K. 
Published: March 2021

Abstract
Background
Approximately 2 million patients present to emergency departments in the USA annually with signs and symptoms of ureterolithiasis (or renal colic, the pain from an obstructing kidney stone). Both ultrasound and CT scan can be used for diagnosis, but the vast majority of patients receive a CT scan. Diagnostic pathways utilizing ultrasound have been shown to decrease radiation exposure to patients but are potentially less accurate. Because of these and other trade-offs, this decision has been proposed as appropriate for Shared Decision-Making (SDM), where clinicians and patients discuss clinical options and their consequences and arrive at a decision together. We developed a decision aid to facilitate SDM in this scenario. The objective of this study is to determine the effects of this decision aid, as compared to usual care, on patient knowledge, radiation exposure, engagement, safety, and healthcare utilization.

Methods
This is the protocol for an adaptive randomized controlled trial to determine the effects of the intervention—a decision aid (“Kidney Stone Choice”)—on patient-centered outcomes, compared with usual care. Patients age 18–55 presenting to the emergency department with signs and symptoms consistent with acute uncomplicated ureterolithiasis will be consecutively enrolled and randomized. Participants will be blinded to group allocation. We will collect outcomes related to patient knowledge, radiation exposure, trust in physician, safety, and downstream healthcare utilization.

Discussion
We hypothesize that this study will demonstrate that “Kidney Stone Choice,” the decision aid created for this scenario, improves patient knowledge and decreases exposure to ionizing radiation. The adaptive design of this study will allow us to identify issues with fidelity and feasibility and subsequently evaluate the intervention for efficacy.

Trial registration
ClinicalTrials.gov NCT04234035. Registered on 21 January 2020 – Retrospectively Registered
Synergistic effects of type I PRMT and PARP inhibitors against non-small cell lung cancer cells
Authors: Dominici Claudia , Sgarioto Nicolas , Yu Zhenbao , Sesma-Sanz Laura , Masson Jean-Yves , Richard Stéphane , Raynal Noël J.-M. 
Published: March 2021

Abstract
Background
Non-small cell lung carcinoma (NSCLC) is a leading cause of cancer-related death and represents a major health burden worldwide. Current therapies for NSCLC include chemotherapy, immunotherapy, and targeted molecular agents such as tyrosine kinase inhibitors and epigenetic drugs such as DNA methyltransferase inhibitors. However, survival rates remain low for patients with NSCLC, especially those with metastatic disease. A major cause for therapeutic failure is drug resistance, highlighting the need for novel therapies and combination strategies. Given that epigenetic modulators such as protein arginine methyltransferases (PRMTs) are frequently overexpressed in cancers, PRMT inhibitors are a promising class of cancer therapeutics. We screened a library of epigenetic and anticancer drugs to identify compounds that would synergize with MS023, a type I PRMT inhibitor, in decreasing the viability of methylthioadenosine phosphorylase (MTAP)-negative NSCLC cells.

Results
Among 181 compounds, we identified PARP inhibitors (PARPi) as having a strong synergistic interaction with type I PRMT inhibition. The combination of MS023 and the PARP inhibitor BMN-673 (Talazoparib) demonstrated strong synergistic interaction at low nanomolar concentrations in MTAP-negative NSCLC cell lines A549, SK-LU-1 and HCC4006. The re-introduction of MTAP decreased the sensitivity of the combination therapy in A549. The combination therapy resulted in elevated γ-H2AX foci indicating increased DNA damage causing decreased cell viability. Lastly, the combination therapy was effective in PARPi resistant ovarian cancer cells, suggesting that type I PRMT inhibitors could mitigate PARPi resistance, thus potentially having an important clinical impact for cancer treatment.

Conclusions
These findings identify a novel cancer drug combination therapy, which is more potent than the separate single-agent therapies. Thus, combining PARP inhibitors and type I PRMT inhibitors represents a new therapeutic opportunity for MTAP-negative NSCLC and certain cancer cells resistant to PARP inhibitors.
Imaging diagnosis of classical and new pneumoconiosis: predominant reticular HRCT pattern
Authors: Masanori Akira 
Published: March 2021

AbstractOur understanding of the manifestations of pneumoconioses is evolving in recent years. Associations between novel exposures and diffuse interstitial lung disease have been newly recognized. In advanced asbestosis, two types of fibrosis are seen, probably related to dose of exposure, existence of pleural fibrosis, and the host factor status of the individual. In pneumoconiosis of predominant reticular type, nodular opacities are often seen in the early phase. The nodular pattern is centrilobular, although some in metal lung show perilymphatic distribution, mimicking sarcoidosis. High-resolution computed tomography enables a more comprehensive correlation between the pathologic findings and clinically relevant imaging findings. The clinician must understand the spectrum of characteristic imaging features related to both known dust exposures and to historically recent new dust exposures.
Transcriptional factor FoxM1-activated microRNA-335-3p maintains the self-renewal of neural stem cells by inhibiting p53 signaling pathway via Fmr1
Authors: Jia Jiaoying , Cui Yan , Tan Zhigang , Liu Min , Jiang Yugang 
Published: March 2021

Abstract
Background
New mechanistic insights into the self-renewal ability and multipotent properties of neural stem cells (NSCs) are currently under active investigation for potential use in the treatment of neurological diseases. In this study, NSCs were isolated from the forebrain of fetal rats and cultured to induce NSC differentiation, which was associated with low expression of the non-coding RNA microRNA-335-3p (miR-335-3p).

Methods
Loss- and gain-of-function experiments were performed in NSCs after induction of differentiation.

Results
Overexpression of miR-335-3p or FoxM1 and inhibition of the Fmr1 or p53 signaling pathways facilitated neurosphere formation, enhanced proliferation and cell cycle entry of NSCs, but restricted NSC differentiation. Mechanistically, FoxM1 positively regulated miR-335-3p by binding to its promoter region, while miR-335-3p targeted and negatively regulated Fmr1. Additionally, the promotive effect of miR-335-3p on NSC self-renewal occurred via p53 signaling pathway inactivation.

Conclusion
Taken together, miR-335-3p activated by FoxM1 could suppress NSC differentiation and promote NSC self-renewal by inactivating the p53 signaling pathway via Fmr1.
Process evaluation of E-learning in continuing medical education: evidence from the China-Gates Foundation Tuberculosis Control Program
Authors: Wang Zi-Yue , Zhang Li-Jie , Liu Yu-Hong , Jiang Wei-Xi , Tang Sheng-Lan , Liu Xiao-Yun 
Published: March 2021

Abstract
Background
E-learning is a growing phenomenon which provides a unique opportunity to address the challenges in continuing medical education (CME). The China-Gates Foundation Tuberculosis (TB) Control Program implemented online training for TB health workers in three provinces of China. We aim to evaluate the implementation of E-learning CME programs, analyse the barriers and facilitators during the implementation process, and to provide policy recommendations.

Methods
Routine monitoring data were collected through the project office from December 2017 to June 2019. In-depth interviews, focus group discussion with project management personnel, teachers, and trainees (n = 78), and staff survey (baseline n = 555, final n = 757) were conducted in selected pilot areas at the provincial, municipal, and county/district levels in the three project provinces (Zhejiang, Jilin, and Ningxia). Descriptive analysis of quantitative data summarized the participation, registration, and certification rates for training activities. Thematic approach was used for qualitative data analysis.

Results
By the end of June 2019, the national and provincial remote training platforms had organized 98 synchronous learning activities, with an average of 173.2 people [standard deviation (SD) = 49.8] per online training session, 163.3 people (SD = 41.2) per online case discussion. In the pilot area, 64.5% of TB health workforce registered the asynchronous learning platform, and 50.1% obtained their professional certifications. Participants agreed that E-learning CME was more economical, has better content as well as more flexible work schedules. However, the project still faced challenges in terms of unmet learning needs, disorganized governance, insufficient hardware and software, unsupported environment, and lack of incentive mechanisms.

Conclusions
Our results suggested that it’s feasible to conduct large scale E-learning CME activities in the three project provinces of China. Training content and format are key facilitators of the program implementation, while the matching of training supply and demand, organizational coordination, internet technology, motivations, and sustainability are key barriers.
Dog breeds and body conformations with predisposition to osteosarcoma in the UK: a case-control study
Authors: Edmunds Grace L. , Smalley Matthew J. , Beck Sam , Errington Rachel J. , Gould Sara , Winter Helen , Brodbelt Dave C. , O’Neill Dan G. 
Published: March 2021

AbstractBackgroundOsteosarcoma is an aggressive and painful bone neoplasm in dogs. Previous studies have reported epidemiological associations suggesting that large body mass, long bone length and the genetics of certain breeds including the Rottweiler are associated with elevated osteosarcoma risk. However, these studies were often limited by selection bias and confounding factors, and have rarely offered insights into breed-associated protection for osteosarcoma. The current study includes 1756 appendicular and axial osteosarcoma cases presenting to VPG Histology (Bristol, UK) compared against a control population of 905,211 dogs without osteosarcoma from primary care electronic patient records in the VetCompass™ dataset.Methods and study designRetrospective, case-control study. Multivariable logistic regression analysis explored associations between demographic risk factors (including breed, chondrodystrophy, age, sex/neuter status, skull-shape, and body mass) and osteosarcoma of all anatomical sites.ResultsWe identified several breeds with increased and reduced odds of osteosarcoma. At highest risk were the Rottweiler and Great Dane, with > 10 times the odds of osteosarcoma compared with crossbreds, and the Rhodesian Ridgeback, which has not featured in previous lists of at-risk breeds for osteosarcoma, and had an odds ratio of 11.31 (95% confidence interval 7.37–17.35). Breeds at lowest risk of osteosarcoma (protected breeds) included the Bichon Frise, the French Bulldog and the Cavalier King Charles Spaniel, all with odd ratios of less than 0.30 compared with crossbreds. Body mass was strongly associated with osteosarcoma risk; dogs over 40 kg exhibited osteosarcoma odds of 45.44 (95% confidence interval 33.74–61.20) compared with dogs less than 10 kg. Chondrodystrophic breeds had an osteosarcoma odds ratio of 0.13 (95% confidence interval 0.11–0.16) compared with non-chondrodystrophic breeds.ConclusionsThis study provides evidence of strong breed-associated osteosarcoma risk and protection, suggesting a genetic basis for osteosarcoma pathogenesis. It highlights that breeds selected for long legs/large body mass are generally overrepresented amongst at-risk breeds, whilst those selected for short leg length/small body mass are generally protected. These findings could inform genetic studies to identify osteosarcoma risk alleles in canines and humans; as well as increasing awareness amongst veterinarians and owners, resulting in improved breeding practices and clinical management of osteosarcoma in dogs.
Associations between serum calcium, 25(OH)D level and bone mineral density in adolescents
Authors: Pan Kaiyu , Tu Rongliang , Yao Xiaocong , Zhu Zhongxin 
Published: March 2021

Abstract
Backgrounds
It is important to improve our understanding of the roles of calcium and vitamin D in bone health for preventing osteoporosis. We aimed at exploring the associations between serum calcium, vitamin D level, and bone mineral density (BMD) in adolescents included in the National Health and Nutrition Examination Survey (NHANES) 2001–2006.

Methods
Weighted multivariate linear regression models were used to estimate the associations of serum calcium, 25(OH)D level with total BMD. Smooth curve fitting was used to explore the potential non-linear relationship.

Results
A total of 5990 individuals aged between 12 and 19 years were included in this study. The fully-adjusted model showed serum calcium positively correlated with total BMD. However, an inverted U-shaped relationship was found when we performed the smooth curve fitting method, and the inflection point was calculated at 9.6 mg/dL using the two-piecewise linear regression model. In contrast, there was a positive correlation between serum 25(OH)D and total BMD after adjusting for potential confounders.

Conclusions
The present study revealed a positive correlation between serum 25(OH)D level and total BMD, and an inverted U-shaped relationship between serum calcium and total BMD.
The homotetramerization of a GPCR transmits the 20-hydroxyecdysone signal and increases its entry into cells for insect metamorphosis
Authors: Kang Xin-Le , Li Yan-Xue , Li Yan-Li , Wang Jin-Xing , Zhao Xiao-Fan 
Published: March 2021

ABSTRACT
Animal steroid hormones initiate signaling by passive diffusion into cells and binding to their nuclear receptors to regulate gene expression. Animal steroid hormones can initiate signaling via G protein-coupled receptors (GPCRs); however, the underlying mechanisms are unclear. Here, we show that a newly discovered ecdysone-responsive GPCR, ErGPCR-3, transmits the steroid hormone 20-hydroxyecdysone (20E) signal by binding 20E and promoting its entry into cells in the lepidopteran insect Helicoverpa armigera. Knockdown of ErGPCR-3 in larvae caused delayed and abnormal pupation, inhibited remodeling of the larval midgut and fat body, and repressed 20E-induced gene expression. Also, 20E induced both the interaction of ErGPCR-3 with G proteins and rapid intracellular increase in calcium, cAMP and protein phosphorylation. ErGPCR-3 was endocytosed by GPCR kinase 2-mediated phosphorylation, and interacted with β-arrestin-1 and clathrin, to terminate 20E signaling under 20E induction. We found that 20E bound to ErGPCR-3 and induced the ErGPCR-3 homodimer to form a homotetramer, which increased 20E entry into cells. Our study revealed that homotetrameric ErGPCR-3 functions as a cell membrane receptor and increases 20E diffusion into cells to transmit the 20E signal and promote metamorphosis.