bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regulation of autophagy by microRNAs in human breast cancer
Authors: Chong Zhi Xiong , Yeap Swee Keong , Ho Wan Yong 
Published: March 2021

AbstractBreast cancer is the most common solid cancer that affects female population globally. MicroRNAs (miRNAs) are short non-coding RNAs that can regulate post-transcriptional modification of multiple downstream genes. Autophagy is a conserved cellular catabolic activity that aims to provide nutrients and degrade un-usable macromolecules in mammalian cells. A number of in vitro, in vivo and clinical studies have reported that some miRNAs could modulate autophagy activity in human breast cancer cells, and these would influence human breast cancer progression and treatment response. Therefore, this review was aimed to discuss the roles of autophagy-regulating miRNAs in influencing breast cancer development and treatment response. The review would first introduce autophagy types and process, followed by the discussion of the roles of different miRNAs in modulating autophagy in human breast cancer, and to explore how would this miRNA-autophagy regulatory process affect the disease progression or treatment response. Lastly, the potential applications and challenges of utilizing autophagy-regulating miRNAs as breast cancer biomarkers and novel therapeutic agents would be discussed.
Policy disparities in response to the first wave of COVID-19 between China and Germany
Authors: Zhang Yuyao , Shi Leiyu , Chen Haiqian , Wang Xiaohan , Sun Gang 
Published: March 2021

Abstract
Objective
Our research summarized policy disparities in response to the first wave of COVID-19 between China and Germany. We look forward to providing policy experience for other countries still in severe epidemics.

Methods
We analyzed data provided by National Health Commission of the People’s Republic of China and Johns Hopkins University Coronavirus Resource Center for the period 10 January 2020 to 25 May 252,020. We used generalized linear model to evaluate the associations between the main control policies and the number of confirmed cases and the policy disparities in response to the first wave of COVID-19 between China and Germany.

Results
The generalized linear models show that the following factors influence the cumulative number of confirmed cases in China: the Joint Prevention and Control Mechanism; locking down the worst-hit areas; the highest level response to public health emergencies; the expansion of medical insurance coverage to suspected patients; makeshift hospitals; residential closed management; counterpart assistance. The following factors influence the cumulative number of confirmed cases in Germany: the Novel Coronavirus Crisis Command; large gathering cancelled; real-time COVID-19 risk assessment; the medical emergency plan; schools closure; restrictions on the import of overseas epidemics; the no-contact protocol.

Conclusions
There are two differences between China and Germany in non-pharmaceutical interventions: China adopted the blocking strategy, and Germany adopted the first mitigation and then blocking strategy; China’s goal is to eliminate the virus, and Germany’s goal is to protect high-risk groups to reduce losses. At the same time, the policies implemented by the two countries have similarities: strict blockade is a key measure to control the source of infection, and improving medical response capabilities is an important way to reduce mortality.
Graphene oxide exacerbates dextran sodium sulfate-induced colitis via ROS/AMPK/p53 signaling to mediate apoptosis
Authors: Liu Siliang , Xu Angao , Gao Yanfei , Xie Yue , Liu Zhipeng , Sun Meiling , Mao Hua , Wang Xinying 
Published: March 2021

Abstract
Background
Graphene oxide (GO), a novel carbon-based nanomaterial, has promising applications in biomedicine. However, it induces potential cytotoxic effects on the gastrointestinal (GI) tract cells, and these effects have been largely uncharacterized. The present study aimed to explore the toxic effects of GO on the intestinal tract especially under pre-existing inflammatory conditions, such as inflammatory bowel disease (IBD), and elucidate underlying mechanisms.

Results
Our findings indicated that oral gavage of GO worsened acute colitis induced by 2.5% dextran sodium sulfate (DSS) in mice. In vitro, GO exacerbated DSS-induced inflammation and apoptosis in the FHC cell line, an ideal model of intestinal epithelial cells (IECs). Further, the potential mechanism underlying GO aggravated mice colitis and cell inflammation was explored. Our results revealed that GO treatment triggered apoptosis in FHC cells through the activation of reactive oxygen species (ROS)/AMP-activated protein kinase (AMPK)/p53 pathway, as evidenced by the upregulation of cytochrome c (Cytc), Bax, and cleaved caspase-3 (c-cas3) and the downregulation of Bcl-2. Interestingly, pretreatment with an antioxidant, N-acetyl-L-cysteine, and a specific inhibitor of AMPK activation, Compound C (Com.C), effectively inhibited GO-induced apoptosis in FHC cells.

Conclusions
Our data demonstrate that GO-induced IECs apoptosis via ROS/AMPK/p53 pathway activation accounts for the exacerbation of colitis in vivo and aggravation of inflammation in vitro. These findings provide a new insight into the pathogenesis of IBD induced by environmental factors. Furthermore, our findings enhance our understanding of GO as a potential environmental toxin, which helps delineate the risk of exposure to patients with disturbed intestinal epithelial barrier/inflammatory disorders such as IBD.
Effect of a physical activity and sleep m-health intervention on a composite activity-sleep behaviour score and mental health: a mediation analysis of two randomised controlled trials
Authors: Duncan Mitch J. , Rayward Anna T. , Holliday Elizabeth G. , Brown Wendy J. , Vandelanotte Corneel , Murawski Beatrice , Plotnikoff Ronald C. 
Published: March 2021

Abstract
Background
To examine if a composite activity-sleep behaviour index (ASI) mediates the effects of a combined physical activity and sleep intervention on symptoms of depression, anxiety, or stress, quality of life (QOL), energy and fatigue in adults.

Methods
This analysis used data pooled from two studies: Synergy and Refresh. Synergy: Physically inactive adults (18–65 years) who reported poor sleep quality were recruited for a two-arm Randomised Controlled Trial (RCT) (Physical Activity and Sleep Health (PAS; n = 80), or Wait-list Control (CON; n = 80) groups). Refresh: Physically inactive adults (40–65 years) who reported poor sleep quality were recruited for a three-arm RCT (PAS (n = 110), Sleep Health-Only (SO; n = 110) or CON (n = 55) groups). The SO group was omitted from this study. The PAS groups received a pedometer, and accessed a smartphone/tablet “app” using behaviour change strategies (e.g., self-monitoring, goal setting, action planning), with additional email/SMS support. The ASI score comprised self-reported moderate-to-vigorous-intensity physical activity, resistance training, sitting time, sleep duration, efficiency, quality and timing. Outcomes were assessed using DASS-21 (depression, anxiety, stress), SF-12 (QOL-physical, QOL-mental) and SF-36 (Energy & Fatigue). Assessments were conducted at baseline, 3 months (primary time-point), and 6 months. Mediation effects were examined using Structural Equation Modelling and the product of coefficients approach (AB), with significance set at 0.05.

Results
At 3 months there were no direct intervention effects on mental health, QOL or energy and fatigue (all p > 0.05), and the intervention significantly improved the ASI (all p < 0.05). A more favourable ASI score was associated with improved symptoms of depression, anxiety, stress, QOL-mental and of energy and fatigue (all p < 0.05). The intervention effects on symptoms of depression ([AB; 95%CI] -0.31; − 0.60,-0.11), anxiety (− 0.11; − 0.27,-0.01), stress (− 0.37; − 0.65,-0.174), QOL-mental (0.53; 0.22, 1.01) and ratings of energy and fatigue (0.85; 0.33, 1.63) were mediated by ASI. At 6 months the magnitude of association was larger although the overall pattern of results remained similar.

Conclusions
Improvements in the overall physical activity and sleep behaviours of adults partially mediated the intervention effects on mental health and quality of life outcomes. This highlights the potential benefit of improving the overall pattern of physical activity and sleep on these outcomes.

Trial registration
Australian New Zealand Clinical Trial Registry: ACTRN12617000680369; ACTRN12617000376347.
Universal Trial number: U1111–1194-2680; U1111–1186-6588. Human Research Ethics Committee Approval: H-2016-0267; H-2016–0181.
Biologic disease modifying antirheumatic drugs and Janus kinase inhibitors in paediatric rheumatology – what we know and what we do not know from randomized controlled trials
Authors: Welzel Tatjana , Winskill Carolyn , Zhang Nancy , Woerner Andreas , Pfister Marc 
Published: March 2021

AbstractBackgroundBiologic disease modifying antirheumatic drugs (bDMARDs) and Janus Kinase (JAK) inhibitors are prescribed in adult and paediatric rheumatology. Due to age-dependent changes, disease course, and pharmacokinetic processes paediatric patients with inflammatory rheumatic diseases (PiRD) differ from adult rheumatology patients.MethodsA systematic literature search for randomized clinical trials (RCTs) in PiRD treated with bDMARDs/JAK inhibitors was conducted on Medline,clinicaltrials.gov, clinicaltrialsregister.eu and conference abstracts as of July 2020. RCTs were included if (i) patients were aged ≤20 years, (ii) patients had a predefined rheumatic diagnosis and (iii) RCT reported predefined outcomes. Selected studies were excluded in case of (i) observational or single arm study or (ii) sample size ≤5 patients. Study characteristics were extracted.ResultsOut of 608 screened references, 65 references were selected, reporting 35 unique RCTs. All 35 RCTs reported efficacy while 34/35 provided safety outcomes and 16/35 provided pharmacokinetic data. The most common investigated treatments were TNF inhibitors (60%), IL-1 inhibitors (17%) and IL-6 inhibitors (9%). No RCTs with published results were identified for baricitinib, brodalumab, certolizumab pegol, guselkumab, risankizumab, rituximab, sarilumab, secukinumab, tildrakizumab, or upadacitinib. In patients with juvenile idiopathic arthritis (JIA) 25/35 RCTs were conducted. The remaining 10 RCTs were performed in non-JIA patients including plaque psoriasis, Kawasaki Disease, systemic lupus erythematosus and non-infectious uveitis. In JIA-RCTs, the control arm was mainly placebo and the concomitant treatments were either methotrexate, non-steroidal anti-inflammatory drugs (NSAID) or corticosteroids. Non-JIA patients mostly received NSAID. There are ongoing trials investigating abatacept, adalimumab, baricitinib, brodalumab, certolizumab pegol, etanercept, guselkumab, infliximab, risankizumab, secukinumab, tofacitinib and tildrakizumab.ConclusionDespite the FDA Modernization Act and support of major paediatric rheumatology networks, such as the Pediatric Rheumatology Collaborative Study Group (PRCSG) and the Paediatric Rheumatology International Trials Organization (PRINTO), which resulted in drug approval for PiRD indications, there are limited RCTs in PiRD patients. As therapy response is influenced by age-dependent changes, pharmacokinetic processes and disease course it is important to consider developmental changes in bDMARDs/JAK inhibitor use in PiRD patients. As such it is critical to collaborate and conduct international RCTs to appropriately investigate and characterize efficacy, safety and pharmacokinetics of bDMARDs/JAK inhibitors in paediatric rheumatology.
How do Pacific Island countries add up on contraception, abortion and reproductive coercion? Guidance from the Guttmacher report on investing in sexual and reproductive health
Authors: Dawson Angela , Ekeroma Alec , Wilson Donald , Noovao-Hill Amanda , Panisi Leeanne , Takala Brooke , Black Kirsten , Bateson Deborah 
Published: March 2021

AbstractThe Guttmacher-Lancet Commission report on Sexual and Reproductive Health and Rights called for the acceleration of progress to achieve SRHR that is essential for sustainable development. To integrate the essential services defined in this report into universal health coverage in the 11 sovereign nations in the Pacific, quality data is required to ensure needs are met efficiently and equitably. However, there are no comprehensive reports for Pacific Island countries that provide insight into all areas of SRHR. We collated the latest literature to identify the most up-to-date relevant data from United Nations and Guttmacher Institute reports to discern gaps in SRHR information and services relating to contraception, abortion and reproductive coercion. Investment is urgently required to strengthen health information systems for SRHR in the Pacific.
Chronic exposure to diesel exhaust may cause small airway wall thickening without lumen narrowing: a quantitative computerized tomography study in Chinese diesel engine testers
Authors: Liu Hong , Li Jianyu , Ma Qianli , Tang Jinglong , Jiang Menghui , Cao Xue , Lin Li , Kong Nan , Yu Shanfa , Sood Akshay , Zheng Yuxin , Leng Shuguang , Han Wei 
Published: March 2021

Abstract
Background
Diesel exhaust (DE) is a major source of ultrafine particulate matters (PM) in ambient air and contaminates many occupational settings. Airway remodeling assessed using computerized tomography (CT) correlates well with spirometry in patients with obstructive lung diseases. Structural changes of small airways caused by chronic DE exposure is unknown. Wall and lumen areas of 6th and 9th generations of four candidate airways were quantified using end-inhalation CT scans in 78 diesel engine testers (DET) and 76 non-DETs. Carbon content in airway macrophage (CCAM) in sputum was quantified to assess the dose-response relationship.

Results
Environmental monitoring and CCAM showed a much higher PM exposure in DETs, which was associated with higher wall area and wall area percent for 6th generation of airways. However, no reduction in lumen area was identified. No study subjects met spirometry diagnosis of airway obstruction. This suggested that small airway wall thickening without lumen narrowing may be an early feature of airway remodeling in DETs. The effect of DE exposure status on wall area percent did not differ by lobes or smoking status. Although the trend test was of borderline significance between categorized CCAM and wall area percent, subjects in the highest CCAM category has a 14% increase in wall area percent for the 6th generation of airways compared to subjects in the lowest category. The impact of DE exposure on FEV1 can be partially explained by the wall area percent with mediation effect size equal to 20%, Pperm = 0.028).

Conclusions
Small airway wall thickening without lumen narrowing may be an early image feature detected by CT and underlie the pathology of lung injury in DETs. The pattern of changes in small airway dimensions, i.e., thicker airway wall without lumen narrowing caused by occupational DE exposure was different to that (i.e., thicker airway wall with lumen narrowing) seen in our previous study of workers exposed to nano-scale carbon black aerosol, suggesting constituents other than carbon cores may contribute to such differences. Our study provides some imaging indications of the understanding of the pulmonary toxicity of combustion derived airborne particulate matters in humans.
Psychological distress during the COVID-19 pandemic in Ethiopia: an online cross-sectional study to identify the need for equal attention of intervention
Authors: Ambelu Argaw , Birhanu Zewdie , Yitayih Yimenu , Kebede Yohannes , Mecha Mohammed , Abafita Jemal , Belay Ashenafi , Fufa Diriba 
Published: March 2021

Abstract
Background
The COVID-19 pandemic led individuals to suffer from different levels of mental health problems such as psychological distress, anxiety, depression, denial, panic, and fear. This study aimed at determining the prevalence of psychological distress and associated factors among the Ethiopian population during the COVID-19 pandemic.

Methods
A cross-sectional study was performed through an online survey using different online platforms. The questionnaire was created through Google Form and the survey link was administered by e-mail, LinkedIn, Telegram, and Facebook. Educated Ethiopian population who have access to the internet were invited to participate through an online survey and addressed to 929 respondents. The study participants completed the survey anonymously without any personal identifier. The psychological distress was assessed using the Kessler 10-item tool to measure psychological distress. Data were analyzed using SPSS and logistic regression to examine mutually adjusted associations, expressed as adjusted odds ratios. A generalized additive model was also employed to identify additional predictors using R.

Results
The prevalence of high psychological distress among the study population was 236 (25.5%). Of all respondents, 421 (45.1%) had low psychological distress, 274 (29.4%) had moderate psychological distress, 164 (17.6%) had high psychological distress, and 72 (7.3%) had very high psychological distress. Psychological distress increased with being at young and middle-aged adults, getting information from social media, and not correctly practicing infection prevention and control measures to prevent COVID-19 infection. Respondents with high perceived severity had increased psychological distress. On the contrary, those with the highest score of perceived response efficacy had low distress.

Conclusion
Prevalence of psychological distress was substantial. The need for intervention of psychological distress inline with the prevention of COVID-19 is critically essential. The intervention target groups are those whose information sources are from social media, young and middle-aged adults, and those who do not correctly practice infection prevention and control measures against COVID-19 infection.
Timing of early laparoscopic cholecystectomy for acute calculous cholecystitis: a meta-analysis of randomized clinical trials
Authors: Borzellino Giuseppe , Khuri Safi , Pisano Michele , Mansour Subhi , Allievi Niccolò , Ansaloni Luca , Kluger Yoram 
Published: March 2021

AbstractBackgroundEarly cholecystectomy for acute cholecystitis has proved to reduce hospital length of stay but with no benefit in morbidity when compared to delayed surgery. However, in the literature, early timing refers to cholecystectomy performed up to 96 h of admission or up to 1 week of the onset of symptoms. Considering the natural history of acute cholecystitis, the analysis based on such a range of early timings may have missed a potential advantage that could be hypothesized with an early timing of cholecystectomy limited to the initial phase of the disease. The review aimed to explore the hypothesis that adopting immediate cholecystectomy performed within 24 h of admission as early timing could reduce post-operative complications when compared to delayed cholecystectomy.MethodsThe literature search was conducted based on the Patient Intervention Comparison Outcome Study (PICOS) strategy. Randomized trials comparing post-operative complication rate after early and delayed cholecystectomy for acute cholecystitis were included. Studies were grouped based on the timing of cholecystectomy. The hypothesis that immediate cholecystectomy performed within 24 h of admission could reduce post-operative complications was explored by comparing early timing of cholecystectomy performed within and 24 h of admission and early timing of cholecystectomy performed over 24 h of admission both to delayed timing of cholecystectomy within a sub-group analysis. The literature finding allowed the performance of a second analysis in which early timing of cholecystectomy did not refer to admission but to the onset of symptoms.ResultsImmediate cholecystectomy performed within 24 h of admission did not prove to reduce post-operative complications with relative risk (RR) of 1.89 and its 95% confidence interval (CI) [0.76; 4.71]. When the timing was based on the onset of symptoms, cholecystectomy performed within 72 h of symptoms was found to significantly reduce post-operative complications compared to delayed cholecystectomy with RR = 0.60 [95% CI 0.39;0.92].ConclusionThe present study failed to confirm the hypothesis that immediate cholecystectomy performed within 24 h of admission may reduce post- operative complications unless surgery could be performed within 72 h of the onset of symptoms.
Midterm outcomes of early versus late surgery for infective endocarditis with neurologic complications: a meta-analysis
Authors: Yokoyama Yujiro , Goto Taichiro 
Published: March 2021

Abstract
Background
Cerebral infarction (CI) remains one of the most common and fatal complications of infective endocarditis (IE), and the timing of surgery for IE with neurologic complications is controversial. As outcomes beyond the perioperative period have not been assessed with a meta-analysis previously, we conducted a meta-analysis comparing mid- to long-term outcomes of early and late surgery in patients with IE and neurologic complications.

Methods
All studies that investigated early and late surgery in patients with IE and neurologic complications were identified. The primary and secondary endpoints were all-cause mortality and recurrence, respectively. Hazard ratios (HRs) for all-cause mortality and recurrence were extracted from each study.

Results
Our search identified five eligible studies, which were all observational studies consisting of a total of 624 patients with IE and neurologic complications. Pooled analyses demonstrated that all-cause mortality was similar between the early and late surgery groups (HR [95% confidence interval [CI]] = 0.90 [0.49–1.64]; P = 0.10; I2 = 49%). Similarly, the recurrence rates were similar between both groups (HR [95% CI] = 1.86 [0.76–4.52]; P = 0.43; I2 = 0%).

Conclusions
Our meta-analysis showed similar mortality and recurrent rates between the early and late surgery groups. The optimal timing of surgery should be individualized on a case-to-case basis.