bluuebunny/crossref_metadata_2025_split huggingface dataset:
The prevalence and increasing trends of overweight, general obesity, and abdominal obesity among Chinese adults: a repeated cross-sectional study
Authors: Chen Yongjie , Peng Qin , Yang Yu , Zheng Senshuang , Wang Yuan , Lu Wenli 
Published: October 2019

AbstractBackgroundThe prevalence of general and abdominal obesity has increased rapidly in China. The aims of this study were to estimate the dynamic prevalence of overweight, general obesity, and abdominal obesity and the distribution of body mass index (BMI) and waist circumference (WC) among Chinese adults.MethodsData were obtained from the China Health and Nutrition Survey (CHNS). According to the suggestions of the WHO for Chinese populations, overweight was defined as a 23 kg/m2 ≤ BMI < 27.5 kg/m2and general obesity as a BMI ≥ 27.5 kg/m2. Abdominal obesity was defined as a WC ≥ 90 cm for males and ≥ 80 cm for females. Grade 1, grade 2, and grade 3 obesity were defined as 27.5 kg/m2 ≤ BMI < 32.5 kg/m2, 32.5 kg/m2 ≤ BMI < 37.5 kg/m2, and BMI ≥ 37.5 kg/m2, respectively. Generalized estimation equations were used to estimate the prevalence and trends of overweight, general and abdominal obesity.ResultsThis study included 12,543 participant. From 1989 to 2011, the median BMI of males and females increased by 2.65 kg/m2and 1.90 kg/m2, respectively; and WC increased by 8.50 cm and 7.00 cm, respectively. In 2011, the age-adjusted prevalence of overweight, general obesity, and abdominal obesity were 38.80% (95%CI: 37.95–39.65%), 13.99% (95%CI: 13.38–14.59%), and 43.15% (95%CI: 42.28–44.01%), respectively, and significantly increased across all cycles of the survey among all subgroups (allP < 0.0001). The age-adjusted prevalence of grade 1–3 obesity significantly increased in total sample and sex subgroups (allP < 0.0001). For all indicators, there were significant increases in annualORsamong all subgroups (allP < 0.0001), with the exception of grade 2 obesity. Significant differences were observed inORsacross the three age groups in males. AndORssignificantly decreased with age.ConclusionsThe age-adjusted prevalence of overweight, general obesity, and abdominal obesity significantly increased among Chinese adults from 1989 to 2011. The obesity population is trending toward an increased proportion of males and younger individuals in China.
Video-assisted thoracoscopic surgery versus muscle-sparing thoracotomy for non-small cell lung cancer: a systematic review and meta-analysis
Authors: Wang Zihuai , Pang Long , Tang Jiexi , Cheng Jiahan , Chen Nan , Zhou Jian , Liu Lunxu 
Published: October 2019

Abstract

Background
It has been widely accepted that video-assisted thoracoscopic surgery (VATS) lobectomy is superior to conventional open thoracotomy lobectomy in many aspects. However, the direct comparison between VATS and Muscle-sparing thoracotomy (MST) has not been widely conducted. We aimed to compare the perioperative outcomes in non-small cell lung cancer (NSCLC) patients following VATS and MST.

Methods
PubMed, EMBASE, the Cochrane Library and Web of Science were searched for relevant studies. The retrieval time was up to April 24, 2019. Studies investigating the comparison of video-assisted thoracoscopy and muscle-sparing thoracotomy were included in our meta-analysis. Odds ratio and mean differences with 95% confidential interval were applied to determine the effectiveness of dichotomous or continuous variables respectively.

Results
A total of 10 studies were included with 1514 patients. Compared with MST, the incidence of postoperative complications in VATS [OR = 0.54; 95%CI(0.4, 0.73); P < 0.001] and the hospital stay [MD = -1.5; 95%CI(− 2.28, − 0.73); P = 0.0001] decreased significantly, chest tube drainage time [MD = -0.71; 95%CI(− 1.18, − 0.24); P = 0.003] were shorter and the intraoperative blood loss [MD = − 43.87; 95%CI(− 73.66, − 14.08); P = 0.004] were less in VATS group. VATS also showed a relatively longer operative time [MD = 17.11; 95%CI(2.38, 31.85); P = 0.02]. However, no significant differences were observed in numbers of resected lymph nodes, postoperative mortality, postoperative pneumonia and postoperative bleeding.

Conclusion
Compared with MST, VATS was associated with lower incidence of postoperative complications, shorter length of hospital stay, less intraoperative blood loss and less chest tube drainage, which showed that VATS was a comparable method to MST. Meanwhile, these results should be further conformed by more randomized control trials.
Puerarin inhibits the osteoclastogenesis by inhibiting RANKL-dependent and –independent autophagic responses
Authors: Zhang Guoyou , Wang Yu , Tang Guoke , Ma Yuanzheng 
Published: October 2019

Abstract

Background
Puerarin exerts therapeutic effect on osteoporosis due to its inhibitory effect on the formation of osteoclasts. Puerarin is also widely established as an autophagy inhibitor. The study aimed to investigate the significance of autophagy in Puerarin-treated osteoclast formation.

Methods
Osteoclast precursors (OCPs) derived from bone marrow-derived macrophages (BMMs) were treated with Puerarin along with RANKL or without RANKL, and then the autophagic parameters of OCPs (including autophagic proteins, LC3 transformation, autophagosome or LC3-puncta) were observed through Western Blotting, Transmission Electron Microscopy and Immunofluorescence assays. Next, after using overexpression vectors of autophagic genes (Atg7, Atg5 and BECN1) to alter autophagy activity, OCP proliferation was measured by Ethynyl deoxyuridine (EdU) assays and Cell Counting Kit-8 (CCK-8) kit, and osteoclast differentiation was assessed by Tartrate-resistant acid phosphatase (TRAP) staining.

Results
The results showed that Puerarin could directly inhibit the autophagy and proliferation of OCPs. Importantly, overexpression of autophagic genes Atg5, Atg7 and BECN1 reversed Puerarin-inhibited OCP autophagy and proliferation. What’s more, RANKL could promote the autography of OCPs, which was recovered by Puerarin treatment. Interestingly, different from single-Puerarin treatment, we found that in the presence of RANKL, only BECN1 overexpression significantly reversed Puerarin-inhibited osteoclast differentiation and OCP autophagy.

Conclusion
In conclusion, Puerarin could inhibit the OCP autophagy in the presence or absence of RANKL, which blocked the OCP proliferation and osteoclast differentiation respectively. Moreover, BECN1 plays an essential role in Puerarin-inhibited osteoclastogenesis. Our study provides potential clue to further complete the intrinsic mechanism of Puerarin in treating osteoporosis.
Team-based learning (TBL): a community of practice
Authors: Burgess Annette , Haq Inam , Bleasel Jane , Roberts Chris , Garsia Roger , Randal Nicholas , Mellis Craig 
Published: October 2019

Abstract

Background
Rapid changes in medical practice have a large impact on the demands faced by educators in preparing students for future participation in a multifaceted healthcare workforce. Competencies required by today’s medical graduates encompass the ability to effectively collaborate, communicate and problem solve. The learning needs of medical students have also changed over time. Today’s medical students are highly interconnected, enjoying teamwork and collaborative practice, and desire continuous, explicit feedback. They want structured learning activities, with clear expectations, and enjoy a sense of accomplishment on their achievements. The conflation of these issues has seen many medical schools adopt the model of Team-based learning (TBL). Using the conceptual framework of communities of practice, we sought to qualitatively explore students’ and teachers’ experience of TBL in Year 1 of a graduate entry medical program.

Methods
Convenience sampling was used to select 169/350 (48%) Year 1 students who completed three TBL sessions. Each TBL session was facilitated by three senior clinicians. Following participation in the TBLs, students were invited to attend focus groups, and all facilitators (n = 9) were invited to attend interviews. A coding framework was developed to code the entire dataset, using the theoretical lens of communities of practice.

Results
34/169 (20%) of students attended focus groups. Three facilitators (3/9, 33%) were interviewed. Students and facilitators felt the structure and organisation of TBL made students accountable for their learning and team contributions. The combined expertise and clinical experience of facilitators, with immediate feedback helped groups to work both independently and collaboratively. Facilitators found working with their peers in the TBLs to be a rewarding experience.

Conclusions
The community of practice found in the TBL classes, provided an enriching and rewarding learning environment that motivated students to build on their basic knowledge and apply what had been learnt. The interactions of experienced, senior clinicians as facilitators, sharing their expertise within a clinical context, prompted effective student engagement in learning and understanding. Our change in curriculum design and pedagogy will assist in preparing medical students for demands of the increasingly complex healthcare systems in which they will work.
The relationship between perfectionism and symptoms of depression in medical school applicants
Authors: Bußenius Lisa , Harendza Sigrid 
Published: October 2019

Abstract

Background
The association between perfectionism and depression in the medical profession can ultimately influence physicians’ performance negatively. In medical students, especially maladaptive perfectionism is connected with distress and lower academic performance. The expression of perfectionism and symptoms of depression at the time of medical school application is not known. Therefore, we explored perfectionism and symptoms of depression in participants of multiple mini-interviews for medical school admission and investigated possible differences between applicants who were eventually admitted or rejected.

Methods
After the multiple mini-interviews admission procedure at Hamburg Medical School in August 2018, 146 applicants filled out a questionnaire including sociodemographic data and the following validated instruments: Multidimensional Perfectionism Scale by Hewitt and Flett (MPS-H), Multidimensional Perfectionism Scale by Frost (MPS-F), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), and a 10-item version of the Big Five Inventory (BFI-10). The two groups of admitted and rejected applicants were compared and the correlation between symptoms of depression and perfectionism further explored.

Results
The admitted applicants were significantly more extrovert and had lower depression scores compared to the rejected applicants. In both groups, the composite scales of Adaptive Perfectionism (r = .21, p = .011) and Maladaptive Perfectionism (r = .43, p < .001) as well as their components correlated significantly with the PHQ-9 results. Maladaptive Perfectionism accounted for about 18% of variance in the PHQ-9 score.

Conclusions
Rejected medical school applicants who participated in a multiple mini-interviews admission procedure showed higher levels of depression symptoms than admitted applicants. The degree of depressive symptoms can be partly explained by Maladaptive Perfectionism scores. Since coping in medical school and in postgraduate medical education require robust mental health, perfectionism questionnaires could be an additional tool in medical school selection processes.
Are perceived bad working conditions and perceived workplace bullying associated with doctor visits? Results of the nationally representative German General Social Survey
Authors: Hajek André , König Hans-Helmut 
Published: October 2019

Abstract

Background
The reason for doctor visits associated with bad working conditions (and workplace bullying) remains unknown. Therefore, the aim of this study was to examine the association between perceived working conditions as well as workplace bullying and the number of doctor visits as well as the reason for seeing a doctor.

Methods
Data were derived from the German General Social Survey, a representative cross-section of the population in the year 2014. Self-reported doctor visits in the last 3 months were used as outcome measure. Self-rated working conditions (noise, bad air; time/performance pressure; bad working atmosphere; overtime; shifts/night work; hard physical labour) and workplace bullying were assessed. The reason for seeing a doctor was also recorded (acute illness; chronic illness; feeling unwell; requesting advice; visit to the doctor’s office without consulting the doctor (e.g., need to get a prescription); preventive medical check-up/vaccination). Regression analysis stratified by sex was conducted.

Results
Adjusting for various potential confounders, Poisson regressions showed that workplace bullying was associated with increased doctor visits in men, but not in women. Contrarily, time/performance pressure at work was only associated with increased doctor visits in women, but not in men. Furthermore, the probability of visiting the doctor for reasons of acute illness or feeling unwell increased with workplace bullying in men. The probability of visiting the doctor because of feeling unwell increased with time/performance pressure in women.

Conclusions
Our findings stress the association between adverse working conditions (workplace bullying as well as time/performance pressure at work) and doctor visits, with remarkable gender differences. Longitudinal studies are required to confirm the present findings and to obtain further insights into this relationship.
Plasma metabolomics and clinical predictors of survival differences in COPD patients
Authors: Pinto-Plata Victor , Casanova Ciro , Divo Miguel , Tesfaigzi Yohannes , Calhoun Vince , Sui Jing , Polverino Francesca , Priolo Carmen , Petersen Hans , de Torres Juan Pablo , Marin Jose Maria , Owen Caroline A. , Baz Rebeca , Cordova Elizabeth , Celli Bartolome 
Published: October 2019

Abstract

Background
Plasma metabolomics profile (PMP) in COPD has been associated with clinical characteristics, but PMP’s relationship to survival has not been reported. We determined PMP differences between patients with COPD who died an average of 2 years after enrollment (Non-survivors, NS) compared to those who survived (S) and also with age matched controls (C).

Methods
We studied prospectively 90 patients with severe COPD and 30 controls. NS were divided in discovery and validation cohorts (30 patients each) and the results compared to the PMP of 30 S and C. All participants completed lung function tests, dyspnea scores, quality of life, exercise capacity, BODE index, and plasma metabolomics by liquid and gas chromatography / mass spectometry (LC/MS, LC/MS2, GC/MS). Statistically, we used Random Forest Analysis (RFA) and Support Vector Machine (SVM) to determine metabolites that differentiated the 3 groups and compared the ability of metabolites vs. clinical characteristics to classify patients into survivors and non-survivors.

Results
There were 79 metabolites statistically different between S and NS [p < 0.05 and false discovery rate (q value) < 0.1]. RFA and SVM classification of COPD survivors and non-survivors had a predicted accuracy of 74 and 85% respectively. Elevation of tricyclic acid cycle intermediates branched amino acids depletion and increase in lactate, fructose and xylonate showed the most relevant differences between S vs. NS suggesting alteration in mitochondrial oxidative energy generation. PMP had similar predictive power for risk of death as information provided by clinical characteristics.

Conclusions
A plasma metabolomic profile characterized by an oxidative energy production difference between survivors and non-survivors was observed in COPD patients 2 years before death.
Identification of differentially expressed circRNAs and a novel hsa_circ_0000144 that promote tumor growth in gastric cancer
Authors: Wei Jianming , Wang Jinmiao , Gao Xibo , Qi Feng 
Published: October 2019

AbstractBackgroundCircular RNAs (circRNAs) are involved in regulating tumor pathogenesis. The mechanism of circRNAs in gastric cancer (GC) is still unknown. Our study aimed to identify differentially expressed circRNAs and assess a novel circRNA (hsa_circ_0000144) in the proliferation, migration, and invasion in GC.MethodsGene ontology (GO) enrichment and analyses of Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways, pathway network, and the ceRNA regulatory network of hsa_circ_0000144 targeting miRNAs and mRNAs were performed with the help of bioinformatics using R language and Perl software. hsa_circ_0000144 expression and circRNA knockdown in GC cell lines were detected using quantitative PCR (qPCR) in vitro. Cell proliferation, migration, and invasion after circRNA knockdown were measured using the cell counting kit-8 assay and Transwell assay.ResultsThe circRNA expression profile GSE78092 downloaded from the Gene Expression Omnibus database included three GC patients and three normal tissues. Thirty-two differentially expressed circRNAs comprised six upregulated circRNAs and 26 downregulated circRNAs. In particular, the ErbB signaling pathway, neurotrophin signaling pathway, cellular senescence, and pathways in bladder cancer and GC played the most important roles in the pathway network. The expression of hsa_circ_0000144 was upregulated in GC cell lines. Hsa_circ_0000144 knockdown suppressed tumor growth in vitro.ConclusionsHsa_circ_0000144 promotes GC cell proliferation, migration, and invasion, and the ceRNA regulatory network of hsa_circ_0000144 targeting miRNAs and mRNAs might be biomarkers for GC diagnosis and targeted therapy.
Potential Role of circPVT1 as a proliferative factor and treatment target in esophageal carcinoma
Authors: Zhong Rongrong , Chen Zhuozhi , Mo Ting , Li Zimo , Zhang Peng 
Published: October 2019

Abstract

Background
Many circRNAs have been reported to play important roles in cancer development and have the potential to serve as a novel class of biomarkers for clinical diagnosis. However, the role of circRNAs in esophageal carcinoma (EC) remains unclear. In the current study, we investigated the potential role of circPVT1 in esophageal carcinoma.

Methods
Quantitative real-time PCR was performed to detect circPVT1 levels. CircPVT1-specific siRNA or plasmids were used to knock down or overexpression the target RNA. Hoechst Staining was implemented to evaluate the ratio of cell apoptosis. Transwell migration assays were carried out to study the effects of circPVT1 on esophageal squamous cell carcinoma cell invasion. RegRNA 2.0 was used for bioinformatics analysis. The expression levels of Pax-4, Pax-6, PPARα and PPAR-γ were assessed using Western blot.

Results
In the present study, we demonstrated a significant up-regulation of circPVT1 levels in EC tissues and cancer cell lines. The levels of circPVT1 decreased significantly when the cells were maintained to over-confluence. These results suggested a potential role for circPVT1 in cell proliferation. In addition, overexpressing circPVT1 in TE-10 cell promoted invasive ability of cancer cell. In contrast, siRNA knockdown of circPVT1 inhibited this phenomenon, leading to increased apoptosis levels of TE-10 cell. What’s more, miR-4663 had the effect of inhibiting tumor growth by downregulated Paxs and upregulated PPARs. Whereas, after the addition of circPVT1, this effect no longer worked, suggesting that circPVT1 may affect the malignancy of the tumor by affecting miRNA and regulating the levels of Paxs and PPARs.

Conclusions
Collectively, our study reveals a critical role for circPVT1 in esophageal carcinoma, which may provide new insights of this circRNA as a biomarker for the diagnosis and treatment target of EC.
Cervical kyphosis in asymptomatic populations: incidence, risk factors, and its relationship with health-related quality of life
Authors: Ao Shuang , Liu Yu , Wang Yu , Zhang Hao , Leng Hui 
Published: October 2019

Abstract

Background
Cervical kyphosis has been pointed out in asymptomatic populations. The purposes of this study were (1) to investigate the incidence of cervical kyphosis in asymptomatic populations, (2) to identify risk factors related to cervical kyphosis, and (3) to assess the relationship between cervical kyphosis and health-related quality of life (HRQOL).

Methods
A cohort of 235 asymptomatic volunteers’ records was retrospectively analyzed. Radiographic parameters of the coronal and sagittal planes were measured in the full-length spine x-ray. All patients were classified into two groups based on the cervical lordosis angle: cervical lordosis (CL) and cervical kyphosis (CK). HRQOL was evaluated by EQ-5D and SF-36 (PCS and MCS) questionnaires.

Results
CK was observed in 90 of 235 (38.3%) participants. There was a significant difference with regard to age between volunteers with CK and CL (32.23 ± 8.12 vs. 42.12 ± 6.14, p < 0.05). Several parameters had a significant relationship with CK, including TK, T1 slope, TIA, SVA, and CT. Logistic regression analysis identified age, TK, T1 slope, and SVA as independent risk factors of CK. In addition, there was a negative correlation between CK and the parameters of HRQOL (EQ-5D, − 0.63; PCS, − 0.68; MCS, − 0.59).

Conclusions
The incidence of CK in normal populations is 38.3%. Some spinal parameters are related to CK. CK is associated with the HRQOL.
Safety and efficacy of surgical fixation of fibula fractures using an intramedullary nail: a retrospective observational cohort study in 30 patients
Authors: Boni Guilherme , Sanchez Gustavo T. , Arliani Gustavo , Zelle Boris A. , Pires Robinson E. , dos Reis Fernando B. 
Published: October 2019

Abstract

Background
Open reduction and internal fixation remains the standard treatment for displaced unstable ankle fractures. Plate fixation represents the most frequently used instrumentation option in fibula fractures and favourable outcomes have been reported. Recently, intramedullary nailing techniques have been suggested as a viable alternative resulting in less soft tissue disruption. The objectives of this study are to describe the surgical technique and to evaluate the safety and efficacy of using an intramedullary nail in patients undergoing surgical fixation of their fibula fracture.

Methods
A total of 30 skeletally mature patients with unstable ankle fracture who underwent intramedullary fixation of their fibula fractures from February 2016 to July 2017 were included in this retrospective study. Patients were evaluated using the Short Form-36 (SF-36) and the American Orthopaedic Foot and Ankle Society (AOFAS) at 18 months after surgery.

Results
All patients went on to fracture union. Two patients required a secondary surgical procedure. No patient included in this series developed any wound complications. The mean Physical Component Summary (PCS) of the SF-36 was 53.90 ± 13.3 and the mean Mental Component Summary Score (MCS) was 52.63 ± 11.12. The AOFAS subscale scores were 34.67 ± 1.03 for pain, 42.40 ± 0.2997 for function and 9.50 ± 0.2785 for alignment.

Conclusions
Our study demonstrates promising outcomes associated with intramedullary nail fixation of unstable fibula fractures. We recommend intramedullary nail fixation of fibula fractures to be a safe procedure with a low complication rate.

Level of evidence
Level 4 retrospective case series.