bluuebunny/crossref_metadata_2025_split huggingface dataset:
Loss of PR55α promotes proliferation and metastasis by activating MAPK/AKT signaling in hepatocellular carcinoma
Authors: JiangSheng Zhao , GuoFeng Chen , JingQi Li , ShiQi Liu , Quan Jin , ZhengWei Zhang , FUZhen Qi , JianHuai Zhang , JianBo Xu 
Published: January 2021

Abstract
Background: PR55α plays important roles in oncogenesis and progression of numerous malignancies. However, its role in hepatocellular carcinoma (HCC) is unclear. Methods: PR55α expressions in HCC tissues and paired healthy liver samples were detected using Western blot and tissue microarray immunohistochemistry. We knocked down the expression of PR55α in SMMC-7721 and LM3 cell lines via small interfering and lentivirus. In vitro cell counting, colony formation, migration and invasion assays were performed along with in vivo xenograft implantation and lung metastases experiments. The potential mechanisms involving target signal pathways were investigated by RNA-sequencing.Results: PR55α expression level was suppressed in HCC tissues in comparison to healthy liver samples and was indicative of poorer prognosis. Knockdown of PR55α significantly promoted cell proliferation and migration, induced repression of the cell cycle progression and apoptosis in vitro while accelerating in vivo HCC growth and metastasis. Mechanistic analysis indicated that PR55α silencing was involved with MAPK/AKT signal pathway activation and resulted in increased phosphorylation of both AKT and ERK1/2.Conclusion: This study identifies PR55α to be a candidate novel therapeutic target in the treatment of HCC.
Artesunate Ameliorates Cigarette Smoke-Induced Airway Remodeling via PPAR-γ/TGF-β1/Smad2/3 Signaling Pathway
Authors: Pan Kunming , Lu Juanjuan , Song Yun 
Published: January 2021

Abstract
Background: Airway remodeling, the major pathological feature of chronic obstructive pulmonary disease (COPD), leads to poorly reversible airway obstructions. Current pharmacological interventions are ineffective in controlling airway remodeling. Herein, in this study, we investigated the potential role of artesunate in preventing and treating airway remodeling and the underlying molecular mechanisms in vitro and in vivo.Methods: The COPD rat model was established by cigarette smoke (CS) exposure. After 12 weeks’ treatment of artesunate for COPD rats, the pathological changes of lung tissues were observed by ELISA test, histochemical and immunohistochemical staining. Lung functional experiment was also carried out to elucidate artesunates’ effects. The human bronchial smooth muscle (HBSM) cells were used to clarify the underlying molecular mechanisms. Results: Artesunate treatment inhibited CS-induced airway inflammation and oxidative stress in a dose-dependent manner, simultaneously significantly reduced airway remodeling through inhibiting α-SMA and cyclin D1 expressions. Mechanistically, upregulation of PPAR-γ expression and inactivation of TGF-β1/Smad2/3 signaling by artesunate treatment were found in vivo and in vitro. Furthermore, PPAR-γ knockdown by siRNA transfection abolished the ability of artesunate to inhibiting HBSM cell proliferation, via triggering the activation of TGF-β1/Smad2/3 signaling pathway and downregulating the expression of α-SMA and cyclin D1 in HBSM cells.Conclusions: These findings suggest that artesunate could be valuable for treating airway remodeling by targeting PPAR-γ/TGF-β1/Smad signaling in COPD.
Rapid-Flow Expulsion Maneuver in Subglottic Secretion Clearance to Prevent Ventilator-Associated Pneumonia: A Randomized Controlled Study
Authors: Li Ying , Yuan Xue , Sun Bing , Li Hai-chao , Chu Hui-wen , Wang Li , Zhao Yu , Tang Xiao , Wang Rui , Li Xu-yan , Tong Zhao-hui , Wang Chen 
Published: January 2021

Abstract
Background: Following endotracheal intubation, clearing secretions above the endotracheal tube cuff decreases the incidence of ventilator-associated pneumonia (VAP); therefore, subglottic secretion drainage (SSD) is widely advocated. Our group developed a novel technique to remove the subglottic secretions, the rapid-flow expulsion maneuver (RFEM). The objective of this study is to explore the effectiveness and safety of RFEM compared with SSD.Methods: This study was a single center, prospective, randomized and controlled trial, conducted at Respiratory Intensive Care Unit (ICU) of Beijing Chao-Yang Hospital, a university-affiliated tertiary hospital. The primary outcome was the incidence of VAP, assessed for non-inferiority.Results: Patients with an endotracheal tube allowing drainage of subglottic secretions (n=241) were randomly assigned to either the RFEM group (n=120) or SSD group (n=121). Eleven patients (9.17%) in the RFEM group and 13 (10.74%) in the SSD group developed VAP (difference, -1.59; 95% confidence interval [CI], [-9.20 6.03]), as the upper limit of 95% CI was not greater than pre-defined non-inferiority limit(10%), RFEM was declared non-inferior to SSD. There were no statistically significant differences in the duration of mechanical ventilation, ICU mortality, or ICU length of stay and costs between groups. In terms of safety, no accidental extubation or maneuver-related barotrauma occurred in the RFEM group. The incidence of post-extubation laryngeal edema and reintubation was similar in both groups.Conclusions: RFEM is effective and safe, with non-inferiority compared to SSD in terms of the incidence of VAP. RFEM could be an alternative method in first-line treatment of respiratory ICU patients. Trial registration: This study has been registered on ClinicalTrials.gov (registration number: NCT02032849, https://clinicaltrials.gov/ct2/show/NCT02032849); registered on January 2014.
Adaptation and preliminary psychometric properties of three self-stigma outcome measures for people living with dementia
Authors: Bhatt Jemini , Stoner Charlotte R , Scior Katrina , Charlesworth Georgina 
Published: January 2021

Abstract
Background: A diagnosis of dementia presents individuals with both social and psychological challenges but research on self-stigma in dementia has been largely confined to qualitative approaches due to a lack of robust outcome measures that assess change. The Stigma Impact Scale (SIS) is the most commonly used measure of self-stigma in dementia but its suitability as a tool to assess change in a diverse UK population is unclear. Thus, the aim of this study was to identify, adapt and evaluate the acceptability and preliminary psychometric properties of self-stigma measures for people with dementia for use as measures of change. Method: A 4-step sequential design of identifying, selecting, adapting and testing psychometric measures as follows: 1) identification of stigma outcome measures through reviewing anti-stigma intervention literature, 2) selection of candidate measures through quality assessment (Terwee criteria) and expert consultation, 3) adaptation for UK dementia population (Stewart and colleagues Modification Framework) 4) testing of adapted measures in people living with dementia (N=40) to establish acceptability and preliminary reproducibility (test retest), criterion (concurrent with SIS) and construct (negative convergence with Rosenberg self-esteem scale) validity. Results: Seven measures were identified from the review, but most were poor quality (Terwee range: 0-4). Three measures were selected for modification: Stigma Stress Scale; Secrecy subscale of the Stigma Coping Orientation Scale; Disclosure Related Distress Scale. Internal consistency and test-retest reliability were acceptable (.866≤α≤ .938; ICC .721-.774), except for the Stigma Stress Scale (α= .643) for which the component subscales (perceived harm, ability to cope) had stronger psychometric properties. Concurrent validity with the SIS was not established (r<.7) although there were significant correlations between total SIS and perceived harm (r=.587) and between internalized shame and secrecy (r=.488). Relationships with self-esteem were in the hypothesized direction for all scales and subscales indicating convergent validity.Conclusion: Stigma scales from mental health are not readily adapted for use with people with dementia. However there is preliminary evidence for the acceptability, reliability and validity of measures of perceived harm, secrecy and stigma impact. Further conceptual and psychometric development is required.
The prevalence of type 2 diabetes and prediabetes among armed forces personnel: a systematic review and meta-analysis
Authors: Fathalipour Mohammad , Taghdir Maryam , Hassanipour Soheil , Sepandi Mojtaba , Abbaszadeh Sepideh 
Published: January 2021

Abstract
Background: Previous studies of diabetes among armed forces personnel did not assess a comprehensive disease prevalence. We conducted a systematic review and meta-analysis to estimate the prevalence of type 2 diabetes and prediabetes among military personnel and police officers.Methods: We carried out a systematic search on electronic databases from January 2000 to July 2020. All studies with a report of the prevalence of diabetes and/or prediabetes among armed forces personnel were selected. The Cochran test and I2 statistics were used to determine the heterogeneity of the studies. Random- or fixed-effects model, along with subgroup analysis on diabetes or prediabetes as well as the component of armed forces, was carried out to determine the overall prevalence. All analyses were conducted using STATA software.Results: Among 858 citations, 30 studies were entered into the meta-analysis, involving 1879170 individuals. The meta-analysis estimated the prevalence of type 2 diabetes among the military personnel (9.15%; 95% confidence intervals [CI]: 5.35-12.96) and police officers (9.58%; CI: 5.98-13.18). The overall prevalence of prediabetes among the military personnel and the police officers were 7.32% (CI: 4.22-10.42) and 6.35% (CI: 5.26-7.44), respectively. Conclusion: The prevalence of diabetes and prediabetes among armed forces was consistent with global reports among the general population. These results will inform policy-makers and healthcare providers to find solutions and help to take action to reduce diabetes risk factors on a wider scale, particularly among armed forces personnel.
The effectiveness of a training programme in everyday cognition in healthy older adults: A randomised controlled trial
Authors: Gómez Celia Sánchez , Rodríguez Eduardo José Fernández 
Published: January 2021

Abstract
Background: Everyday cognition is the application of basic cognitive skills and knowledge of the specific cognitive domain for the resolution of problems that are integrated within the instrumental domains of functioning. The main objective is to evaluate the effectiveness of a Training Programme in Everyday Cognition in order to improve the levels of everyday cognition and global cognitive performance in older adults.Methods: A randomised controlled trial of two groups. The sample was composed of healthy older adults. The intervention of the experimental group consisted of an Everyday Cognition Training Programme, and the intervention of the control group consisted of a Conventional Cognitive Training Programme. The Rapid Assessment of Cognitive Functions test (ERFC) and the Everyday Cognition Battery test (ECB) were used to assess the intervention.Results: Total sample (n=237) composed of 44 men and 223 women, with a mean age of 73.45 years. Statistically significant differences (p <0.001) were evidenced between the control group and the experimental group in both the ECB and ERFC; in the final evaluation of the study and in the follow-up.Conclusion: The use of a Daily Cognition Training Programme presents greater benefits in terms of both global cognitive performance and everyday cognition than the use of a Conventional Cognitive Training Programme in elderly adults.Trial registration: ClinicalTrials.gov: NCT04041999 (https://clinicaltrials.gov/ct2/show/NCT04041999)Retrospectively registered. Date of trial registration: 8th July 2019.
Determinants of successful guideline implementation: A national cross-sectional survey
Authors: Jin Yinghui , Tan Li-Ming , Khan Khalid S. , Deng Tong , Huang Chao , Han Fei , Zhang Jing , Huang Qiao , Huang Di , Wang Dan-qi , Wang Yu , Zeng Xiantao , Wang Qiang , Wang Xing-huan 
Published: January 2021

Abstract
Background: CPGs are not uniformly successful in improving care and several instances of implementation failure have been reported. Performing a comprehensive assessment of the barriers and enablers is key to developing an informed implementation strategy. Our objective was to investigate determinants of guideline implementation and explore associations of self-reported adherence to guidelines with characteristics of participants in China.Methods: This is a cross-sectional survey, using multi-stage stratified typical sampling based on China's economic regional divisions (the East, the Middle, the West and the Northeast). 2-5 provinces were selected from each region. 2-3 cities were selected in each province, and secondary and tertiary hospitals from each city were included. We developed a questionnaire underpinned by recommended methods for the design and conduct of self-administered surveys and based on conceptual framework of guideline use, in-depth related literature analysis, guideline development manuals, related behavior change theory. Finally, multivariate analyses were performed using logistic regression to produce adjusted odds ratios (OR) and 95% confidence intervals (95%CI).Results: The questionnaire consisted of four sections: knowledge of methodology for developing guidelines; barriers to accessing guideline; barriers to guideline implementation; and methods for improving guideline implementation. There were 1732 participants (87.3% response rate) from 51 hospitals. Of these, 77.2% reported to have used guidelines frequently or very frequently. The key barriers to guideline use were lack of education or training (46.2%), and overly simplistic wording or overly broad scope of recommendations (43.8%). Level of adherence to guidelines was associated with geographical regions (the northeast P＜0.001; the west P=0.02; the middle P＜0.001 compared with the east), hospital grades(P=0.028), length of practitioners’ practice (P =0.006), education background (PhD, P=0.027; Master, P=0.002), evidence-based medicine skills acquired in work unit (P=0.012), and medical specialty of practitioner (General Practice, P=0.006; Surgery, P=0.043). Conclusion: Despite general acknowledgement of the importance of guidelines, the use of guidelines was not as frequent as might have been expected. To optimize the likelihood of adherence to guidelines, guideline implementation should follow an actively developed dissemination plan incorporating features associated with adherence in our study.
Evaluation of automated molecular tests for detection of SARS-CoV-2 in pooled nasopharyngeal and saliva specimens
Authors: Al-Hail Hamad , Mirza Faheem , Hashemi Alaa Al , Ahmad Muneera Naseer , Tang Patrick , Hasan Mohammad Rubayet 
Published: January 2021

Abstract
Pooling of samples for SARS-CoV-2 testing in low prevalence settings has been used as an effective strategy to expand testing capacity and mitigate challenges associated with the shortage of supplies. We evaluated two automated molecular test systems for detection of SARS-CoV-2 RNA in pooled specimens. Pooled nasopharyngeal and saliva specimens were tested by Qiagen QIAstat-Dx Respiratory SARS-CoV-2 Panel (QIAstat) or Cepheid Xpert Xpress SARS-CoV-2 (Xpert), and the results were compared to that of standard RT-qPCR tests without pooling. In nasopharyngeal specimens, the sensitivity/specificity of the pool-testing approach, with 5 and 10 specimens per pool, were 77%/100% (n=105) and 74.1%/100% (n=260) by QIAstat, and 97.1%/100% (n=250) and 100%/99.5% (n=200) by Xpert, respectively. Pool-testing of saliva (10 specimens per pool; n=150) by Xpert resulted in 87.5% sensitivity and 99.3% specificity compared to individual tests. Pool size of 5 or 10 specimens did not significantly affect the difference of RT-qPCR cycle threshold (CT) values from standard testing. RT-qPCR CT values obtained with pool testing by both QIAstat or Xpert were positively correlated with that of individual testing (Pearson correlation coefficient r=0.85 to 0.99, p<0.05). However, the CT values from Xpert were significantly stronger (p<0.01, paired T-test) than that of QIAstat in a subset of SARS-CoV-2 positive specimens, with mean differences of -4.3±2.43 and -4.6±2 for individual and pooled tests, respectively. Our results suggest that Xpert SARS-CoV-2 can be utilized for pooled sample testing for COVID-19 screening in low prevalence settings providing significant cost savings and improving throughput without affecting test quality.
Ketamine treatment safety in treatment-resistant depression with somatic comorbidities: focus on dissociation and psychotic symptomatology.
Authors: Włodarczyk Adam , Cubała Wiesław J. , Węgielnik-Gałuszko Maria , Wiglusz Mariusz S. 
Published: January 2021

Abstract
Background and objectives: There is evidence for ketamine use in treatment-resistant depression (TRD). Several safety concerns arise regarding adverse drug reactions and specific subpopulations. The aim of this paper is to investigate the safety of intravenous ketamine treatment concerning dissociative and psychotic measures in TRD inpatients with Major Depressive Disorder (MDD) and Bipolar depression (BP) with somatic comorbidities.Methods: The study population of forty-nine inpatients comprises of MDD and BP subjects treated with ketamine registered in the naturalistic observational protocol of the tertiary reference unit for mood disorders (NCT04226963). This dataset represents an intermittent analysis of an observational study performed for interim modelling of observational learning. The study may be underpowered due to the small sample size. The observations apply to the inhomogeneous TRD population in a single-site with no blinding and are limited to the acute administration. Results: The epilepsy was significantly associated with changes in BPRS over time (p=0.008). Psychotic symptomatology with BPRS scores for comorbid somatic conditions excluding epilepsy turned out to be insignificant (p = 0.198) regardless of the diagnosis. However, for a subgroup of patients with epilepsy substantial fluctuation was seen across all administrations in the time course of the study. Conclusions: In ketamine use, careful consideration of comorbidities and concomitant medication is needed. In ketamine administration, close-clinical supervision is necessary at every visit. Psychotic symptoms must be taken into consideration in planning treatment with TRD patients with epilepsy. Somatic comorbidity may impact dissociative symptomatology. Trial Registration: Study registered: 04DEC2019, clinicaltrials.com no. NCT04226963 https://clinicaltrials.gov/ct2/show/NCT04226963
Characterization of neoplastic cells outlining the cystic space of invasive micropapillary carcinoma of the canine mammary gland.
Authors: Rodrigues Michele Angela , Caldeira-Brant Andre L. , Gomes Dawidson Assis , Silveira Tatiany L. , Chiarini-Garcia Hélio , Cassali Geovanni Dantas 
Published: January 2021

Abstract
Background: Invasive micropapillary carcinoma (IMPC) is a rare malignant breast tumor and a variant form of invasive ductal carcinoma that is an aggressive neoplasm of the human breast and canine mammary gland. The importance of the tumor microenvironment in cancer development has gradually been recognized, but little is known about the cell types outlining the cystic space of canine IMPC. This study aimed to characterize the neoplastic cells outlining the cystic space of IMPC.Methods: Immunohistochemistry (IHC), immunofluorescence (IF), superresolution and transmission electron microscopy (TEM) were used to assess the cell types in the cystic areas of IMPCs.Results: Cells expressing the mesenchymal markers alpha-smooth muscle actin (aSMA), Vimentin, and S100A4 outlined the cystic space of IMPC. Furthermore, loss of epithelial cell polarity in IMPC was shown by the localization of MUC1 at the stroma-facing surface. This protein modulates lumen formation and inhibits the cell-stroma interaction. Immunohistochemical and IF staining for the myoepithelial cell marker p63 were negative in IMPC samples, and TEM revealed morphological aspects of myoepithelial-like cells with thin cytoplasmic extensions outlining the cystic space.Conclusions: The cells outlining the cystic space of IMPC in the canine mammary gland were characterized using IHC, IF and TEM. The presence of cells expressing aSMA, Vimentin, and S100A4 in the IMPC stroma suggested a role for tumor-associated fibroblasts in the IMPC microenvironment. The reversal of cell polarity revealed by the limited basal localization of MUC1 may be an important factor contributing to the invasiveness of IMPC. For the first time, the cystic space of canine mammary gland IMPC was shown to be delimited by myoepithelial-like cells that had lost p63 expression. These findings may enhance our understanding of the cellular microenvironment of invasive tumors to improve cancer diagnosis and treatment.
Impact of a transition education program on health-related quality of life in pediatric patients with congenital heart disease: study design for a randomised controlled trial
Authors: Werner Oscar , Bredy Charlene , Lavastre Kathleen , Guillaumont Sophie , Villeon Gregoire De La , Vincenti Marie , Gerl Cristelle , Dulac Yves , Souletie Nathalie , Acar Philippe , Pages Laurence , Picot Marie-Christine , Bourrel Gerard , Engberink Agnes Oude , Millon Elodie , Abassi Hamouda , Amedro Pascal 
Published: January 2021

Abstract
Background: Recent advances in the field of congenital heart disease (CHD) led to an improved prognosis of the patients and in consequence the growth of a new population: the grown up with congenital heart disease. Until recently, more than 50% of these patients were lost to follow up because of the lack of specialized structures. The critical moment is the transition between paediatric and adult unit. Therapeutic education is crucial to solve this issue by helping patients to become independent and responsible. The TRANSITION randomized trial aims to assess the impact of a transition education program on health-related quality of life (HRQoL) of adolescents and young adults with CHD. Methods: Multicentre, randomised, controlled, parallel arm study in CHD patients aged from 13 to 25 years old. Patients will be randomised into 2 groups (education program vs. no intervention). The primary outcome is the change in self-reported HRQoL between baseline and 12-month follow-up. A total of 100 patients in each group is required to observe a significant increase of the overall HRQoL score of 7±13.5 points (on 100) with a power of 80% and an alpha risk of 5%. The secondary outcomes are: clinical outcomes, cardiopulmonary exercise test parameters (peak VO2, VAT, VE/VCO2 slope), level of knowledge of the disease using the Leuven knowledge questionnaire for CHD, physical and psychological status. Discussion: As the current research is opening on patient related outcomes, and as the level of proof in therapeutic education is still low, we sought to assess the efficacy of a therapeutic education program on HRQoL of CHD patients with a randomized trial. Trial registration: This study was approved by the National Ethics Committee (South-Mediterranean IV 2016-A01681-50) and was registered on Clinicaltrials.gov (NCT03005626) on 29th December 2016 Key word: transition; therapeutic education; congenital heart disease; quality of life; adolescent.