bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of cortisol in steatotic and non‐steatotic liver surgery
Authors: Cornide‐Petronio María Eugenia , Bujaldon Esther , Mendes‐Braz Mariana , Avalos de León Cindy G. , Jiménez‐Castro Mónica B. , Álvarez‐Mercado Ana I. , Gracia‐Sancho Jordi , Rodés Juan , Peralta Carmen 
Published: April 2017

AbstractThe intent of this study was to examine the effects of regulating cortisol levels on damage and regeneration in livers with and without steatosis subjected to partial hepatectomy under ischaemia–reperfusion. Ultimately, we found that lean animals undergoing liver resection displayed no changes in cortisol, whereas cortisol levels in plasma, liver and adipose tissue were elevated in obese animals undergoing such surgery. Such elevations were attributed to enzymatic upregulation, ensuring cortisol production, and downregulation of enzymes controlling cortisol clearance. In the absence of steatosis, exogenous cortisol administration boosted circulating cortisol, while inducing clearance of hepatic cortisol, thus maintaining low cortisol levels and preventing related hepatocellular harm. In the presence of steatosis, cortisol administration was marked by a substantial rise in intrahepatic availability, thereby exacerbating tissue damage and regenerative failure. The injurious effects of cortisol were linked to high hepatic acethylcholine levels. Upon administering an α7 nicotinic acethylcholine receptor antagonist, no changes in terms of tissue damage or regenerative lapse were apparent in steatotic livers. However, exposure to an M3 muscarinic acetylcholine receptor antagonist protected livers against damage, enhancing parenchymal regeneration and survival rate. These outcomes for the first time provide new mechanistic insight into surgically altered steatotic livers, underscoring the compelling therapeutic potential of cortisol–acetylcholine–M3 muscarinic receptors.
Role of endothelial‐to‐mesenchymal transition induced by TGF‐β1 in transplant kidney interstitial fibrosis
Authors: Wang Zijie , Han Zhijian , Tao Jun , Wang Jun , Liu Xuzhong , Zhou Wanli , Xu Zhen , Zhao Chunchun , Wang Zengjun , Tan Ruoyun , Gu Min 
Published: April 2017

AbstractChronic allograft dysfunction (CAD) induced by kidney interstitial fibrosis is the main cause of allograft failure in kidney transplantation. Endothelial‐to‐mesenchymal transition (EndMT) may play an important role in kidney fibrosis. We, therefore, undertook this study to characterize the functions and potential mechanism of EndMT in transplant kidney interstitial fibrosis. Proteins and mRNAs associated with EndMT were examined in human umbilical vein endothelial cells (HUVECs) treated with transforming growth factor‐beta1 (TGF‐β1) at different doses or at different intervals with western blotting, qRT‐PCR and ELISA assays. Cell motility and migration were evaluated with motility and migration assays. The mechanism of EndMT induced by TGF‐β1 was determined by western blotting analysis of factors involved in various canonical and non‐canonical pathways. In addition, human kidney tissues from control and CAD group were also examined for these proteins by HE, Masson's trichrome, immunohistochemical, indirect immunofluorescence double staining and western blotting assays. TGF‐β1 significantly promoted the development of EndMT in a time‐dependent and dose‐dependent manner and promoted the motility and migration ability of HUVECs. The TGF‐β/Smad and Akt/mTOR/p70S6K signalling pathways were found to be associated with the pathogenesis of EndMT induced by TGF‐β1, which was also proven in vivo by the analysis of specimens from the control and CAD groups. EndMT may promote transplant kidney interstitial fibrosis by targetting the TGF‐β/Smad and Akt/mTOR/p70S6K signalling pathways, and hence, result in the development of CAD in kidney transplant recipients.
Placental growth factor silencing ameliorates liver fibrosis and angiogenesis and inhibits activation of hepatic stellate cells in a murine model of chronic liver disease
Authors: Li Xi , Yao Qun‐Yan , Liu Hong‐Chun , Jin Qian‐Wen , Xu Bei‐Li , Zhang Shun‐Cai , Tu Chuan‐Tao 
Published: April 2017

AbstractPlacental growth factor (PlGF) is a member of the vascular endothelial growth factor (VEGF) family and is involved in pathological angiogenesis associated with chronic liver diseases. However, the precise mechanisms underlying PlGF signalling contributing to liver fibrosis and angiogenesis remain largely unexplored. This study aimed to assess the effect of reducing PlGF expression using small interfering RNA (siRNA) on experimental liver fibrosis and angiogenesis, and to elucidate the underlying molecular mechanisms. Fibrosis was induced in mice by carbon tetrachloride (CCl4) for 8 weeks, and mice were treated with PlGF siRNA or non‐targeting control siRNA starting two weeks after initiating CCl4 injections. The results showed that PlGF was highly expressed in cirrhotic human and mice livers; which mainly distributed in activated hepatic stellate cells (HSCs). PlGF silencing robustly reduced liver inflammation, fibrosis, intrahepatic macrophage recruitment, and inhibited the activation of HSCs in vivo. Moreover, PlGF siRNA‐treated fibrotic mice showed diminished hepatic microvessel density and angiogenic factors, such as hypoxia‐inducible factor‐1α (HIF‐1α), VEGF and VEGF receptor‐1. Moreover, down‐regulation of PlGF with siRNA in HSCs inhibited the activation and proliferation of HSCs. Mechanistically, overexpression of PlGF in activated HSCs was induced by hypoxia dependent on HIF‐1α, and PlGF induces HSC activation and proliferation via activation the phosphatidylinositol 3‐kinase (PI3K)/Akt signalling pathways. These findings indicate that PlGF plays an important role in liver fibrosis‐associated angiogenesis and that blockage of PlGF could be an effective strategy for chronic liver disease.
The impact of the Affordable Care Act on hospital‐led community health evaluation in the U.S. Appalachian Ohio region
Authors: Franz Berkeley , Skinner Daniel , Kelleher Kelly 
Published: April 2017

AbstractIn recent years, policy developments in the United States have dramatically changed how nonprofit hospitals interact with surrounding communities. However, despite the importance of these changes encoded in Internal Revenue Service regulations, little is known about how these requirements have affected how nonprofit hospitals are approaching community health evaluation. We present qualitative findings from interviews with hospital employees and consultants overseeing preliminary rounds of community health needs assessments, as required by the Affordable Care Act. The sample comes from the Appalachian region of Ohio, an area targeted because of significant health challenges. Our findings suggest that the Affordable Care Act has led hospitals to formalize their processes, focus on developing an evidence base, cultivate local partnerships, and reflect on the role of the hospital in public health.
Difficulty Managing Medications and Finances in Older Adults: A 10‐year Cohort Study
Authors: Bleijenberg Nienke , Smith Alexander K. , Lee Sei J. , Cenzer Irena Stijacic , Boscardin John W. , Covinsky Kenneth E. 
Published: April 2017

BackgroundDifficulty managing medicines and finances becomes increasingly common with advanced age, and compromises the ability to live safely and independently. Remarkably little is known how often this occurs.ObjectivesTo provide population‐based estimates of the risk of developing incident difficulty managing medications and finances in older adults.DesignA prospective cohort study.SettingThe Health and Retirement Study (HRS), a nationally representative study of older adults.Participants9,434 participants aged 65 and older who did not need help in managing medications or managing finances in 2002. Follow‐up assessments occurred every 2 years until 2012.MeasurementsThe primary outcomes were time to difficulty managing medications and time to difficulty managing finances. Risk factors such as demographics, comorbidities, functional status, and cognitive status were assessed at baseline. Hazard models that considered the competing risk of death were used to estimate both the cumulative incidence of developing difficulty managing medications and finances and to identify potential risk factors. Analyses were adjusted for age, gender, race, marital status, wealth and education.ResultsThe 10 years incidence of difficulty increased markedly with age, ranging from 10.3% (95% CI 9.3–11.6) for managing medications and 23.1% (95% CI 21.6–24.7) for managing finances in those aged 65–69, to 38.2% (95% CI 33.4–43.5) for medicines and 69% (95% CI 63.7–74.3) for finances in those over age 85. Women had a higher probability of developing difficulty managing medications and managing finances than men.ConclusionThis study highlights the importance of preparing older adults for the likelihood they will need assistance with managing their medicines and finances as the risk for having difficulty with these activities over time is substantial.
Caregiver Integration During Discharge Planning for Older Adults to Reduce Resource Use: A Metaanalysis
Authors: Rodakowski Juleen , Rocco Philip B. , Ortiz Maqui , Folb Barbara , Schulz Richard , Morton Sally C. , Leathers Sally Caine , Hu Lu , James A. Everette 
Published: April 2017

ObjectivesTo determine the effect of integrating informal caregivers into discharge planning on postdischarge cost and resource use in older adults.DesignA systematic review and metaanalysis of randomized controlled trials that examine the effect of discharge planning with caregiver integration begun before discharge on healthcare cost and resource use outcomes. MEDLINE, EMBASE, and the Cochrane Library databases were searched for all English‐language articles published between 1990 and April 2016.SettingHospital or skilled nursing facility.ParticipantsOlder adults with informal caregivers discharged to a community setting.MeasurementsReadmission rates, length of and time to post‐discharge rehospitalizations, costs of postdischarge care.ResultsOf 10,715 abstracts identified, 15 studies met the inclusion criteria. Eleven studies provided sufficient detail to calculate readmission rates for treatment and control participants. Discharge planning interventions with caregiver integration were associated with a 25% fewer readmissions at 90 days (relative risk (RR) = 0.75, 95% confidence interval (CI) = 0.62–0.91) and 24% fewer readmissions at 180 days (RR = 0.76, 95% CI = 0.64–0.90). The majority of studies reported statistically significant shorter time to readmission, shorter rehospitalization, and lower costs of postdischarge care among discharge planning interventions with caregiver integration.ConclusionFor older adults discharged to a community setting, the integration of caregivers into the discharge planning process reduces the risk of hospital readmission.
Oral fish oil positively influences nutritional‐inflammatory risk in patients with haematological malignancies during chemotherapy with an impact on long‐term survival: a randomised clinical trial
Authors: Chagas T. R. , Borges D. S. , de Oliveira P. F. , Mocellin M. C. , Barbosa A. M. , Camargo C. Q. , Del Moral J. Â. G. , Poli A. , Calder P. C. , Trindade E. B. S. M. , Nunes E. A. 
Published: April 2017

AbstractBackgroundStudies suggest that the ingestion of fish oil (FO), a source of the omega‐3 polyunsaturated fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), can reduce the deleterious side‐effects of chemotherapy. The aim of this randomised clinical trial was to evaluate the effect of supplementation with oral FO for 9 weeks on nutritional parameters and inflammatory nutritional risk in patients with haematological malignancies during the beginning of chemotherapy.MethodsTwenty‐two patients with leukaemia or lymphoma were randomised to the unsupplemented group (UG) (n = 13) or supplemented group (SG) (n = 9). SG received 2 g/day of fish oil for 9 weeks. Nutritional status, serum acute‐phase proteins and plasma fatty acids were evaluated before (T0) and after (T1) the intervention period. Data were analysed using two models; model 1, comprising data from all patients included in the study, and model 2, comprising data from UG patients with no increase in the proportions of EPA and DHA in plasma and data from SG patients showing an at least 100% increase in plasma EPA and DHA.ResultsSG showed an increased plasma proportion of EPA and DHA in both models. In model 2, C‐reactive protein (CRP) and CRP/albumin ratio showed larger reductions in the SG. Overall long‐term survival in both models (465 days after the start of the chemotherapy) was higher in the group ingesting fish oil (P < 0.05).ConclusionsThese findings indicate an improved nutritional‐inflammatory risk and potential effects on long‐term survival in patients with haematological malignancies supplemented with FO during the beginning of chemotherapy.
Implementation of a Hydrotherapy Protocol to Improve Postpartum Pain Management
Authors: Batten Meghann , Stevenson Eleanor , Zimmermann Deb , Isaacs Christine 
Published: April 2017

IntroductionA growing number of women are seeking alternatives to traditional pharmacologic pain management during birth. While there has been an extensive array of nonpharmacologic options developed for labor, there are limited offerings in the postpartum period. The purpose of this quality improvement project was to implement a hydrotherapy protocol in the early postpartum period to improve pain management for women choosing a nonmedicated birth.ProcessThe postpartum hydrotherapy protocol was initiated in a certified nurse‐midwife (CNM) practice in an urban academic medical center. All women who met criteria were offered a 30‐minute warm water immersion bath at one hour postpartum. Pain scores were assessed prior to the bath, at 15 minutes after onset, and again at the conclusion (30 minutes). Women who completed the bath were also asked to complete a brief survey on their experience with postpartum hydrotherapy.OutcomesIn women who used the bath (N = 45), there was a significant reduction in pain scores (P < .001) between the onset of the bath and scores at both 15 minutes and 30 minutes. There was no significant difference between pain scores at 15 minutes and 30 minutes (P = .97). Of those women who completed a survey (n = 43), 97.7% reported both that the bath reduced their pain and improved their birth experience. One hundred percent reported they would use it again in another birth.DiscussionThis project demonstrated successful implementation of a hydrotherapy protocol as an alternative or adjunct to medication for early postpartum pain management that significantly reduced pain and improved the birth experience for those who used it. It offers a nonpharmacologic alternative where there have traditionally been limited options.
Prolactin receptors in Rip‐cre cells, but not in AgRP neurones, are involved in energy homeostasis
Authors: Ladyman S. R. , MacLeod M. A. , Khant Aung Z. , Knowles P. , Phillipps H. R. , Brown R. S. E. , Grattan D. R. 
Published: April 2017

Among its many functions, prolactin has been implicated in energy homeostasis, particularly during pregnancy and lactation. The arcuate nucleus is a key site in the regulation of energy balance. The present study aimed to examine whether arcuate nucleus neuronal populations involved in energy homeostasis are prolactin responsive and whether they can mediate the effects of prolactin on energy homeostasis. To determine whether Agrp neurones or Rip‐Cre neurones are prolactin responsive, transgenic mice expressing the reporter td‐tomato in Agrp neurones (td‐tomato/Agrp‐Cre) or Rip‐Cre neurones (td‐tomato/Rip‐Cre) were treated with prolactin and perfused 45 minutes later. Brains were processed for double‐labelled immunohistochemistry for pSTAT5, a marker of prolactin‐induced intracellular signalling, and td‐tomato. In addition, Agrp‐Cre mice and Rip‐Cre mice were crossed with mice in which the prolactin receptor gene (Prlr) was flanked with LoxP sites (Prlrlox/lox mice). The Prlrlox/lox construct was designed such that Cre‐mediated recombination resulted in deletion of the Prlr and expression of green fluorescent protein (GFP) in its place. In td‐tomato/Rip‐Cre mice, prolactin‐induced pSTAT5 was co‐localised with td‐tomato, indicating that there is a subpopulation of Rip‐Cre neurones in the arcuate nucleus that respond to prolactin. Furthermore, mice with a specific deletion of Prlr in Rip‐Cre neurones had lower body weights, increased oxygen consumption, increased running wheel activity and numerous cells in the arcuate nucleus had positive GFP staining indicating deletion of Prlr from Rip‐Cre neurones. By contrast, no co‐localisation of td‐tomato and pSTAT5 was observed in td‐tomato/Agrp‐Cre mice after prolactin treatment. Moreover, Prlrlox/lox/Agrp‐Cre mice had no positive GFP staining in the arcuate nucleus and did not differ in body weight compared to littermate controls. Overall, these results indicate that Rip‐Cre neurones in the arcuate nucleus are responsive to prolactin and may play a role in the orexigenic effects of prolactin, whereas prolactin does not directly affect Agrp neurones.
Striae distensae: Immunohistochemical assessment of hormone receptors in multigravida and nulligravida
Authors: Youssef Sahar El Sayed , El‐Khateeb Ekramy Ahmed , Aly Dalia Gamal , Moussa Manal Hassan 
Published: April 2017

SummaryBackgroundStriae distensae (SD), a type of dermal scarring, are psychologically disappointing. To date, information and scientific research behind the role of hormonal factors in the development of SD are still unclear. It is vital to understand striae to offer patients the best therapeutic options.ObjectivesTo investigate early alterations regarding the expression of estrogen, androgen, and glucocorticoid receptors (estrogen receptor (ER), androgen receptor (AR), glucocorticoid receptor (GR) in skin samples of multigravida (MG) and nulligravida (NG) cases and to compare them with normal controls.MethodsThis study included 30 subjects (10 MG and 10 NG cases with early SD and 10 healthy controls). Biopsies from SD lesions, perilesional normal skin of cases and normal skin of controls were examined immunohistochemically for ER, AR, and GR expression using immune peroxidase technique.ResultsComparing MG and NG with controls, ER expression appeared reduced in MG and NG (P‐value<.001), AR was elevated in MG (P‐value<.05) with no considerable difference in NG (P‐value>.05), while GR was elevated in both MG and NG (P‐value<.05). On comparing perilesional skin with SD lesions in each of MG and NG groups, SD lesions revealed reduced ER expression in both groups (P‐value<.05), whereas in MG group: AR expression was elevated with no difference detected regarding GR (P‐value˃.05); meanwhile in NG, elevated expression in both AR and GR expression was noted (P‐Value<.001)ConclusionsStriae distansae lesions demonstrated a significant increase in the expression of AR and GR and a declined expression of ER indicating their involvement in the development of early SD.
PATTERNS OF HEALTHCARE ENCOUNTERS EXPERIENCED BY PATIENTS WITH CHRONIC KIDNEY DISEASE
Authors: Welch Janet L. , Meek Julie , Bartlett Ellis Rebecca J. , Ambuehl Roberta , Decker Brian S. 
Published: April 2017

SUMMARYBackgroundPatterns of healthcare encounters by patients in each stage of chronic kidney disease (CKD) have not been fully described.ObjectiveThis study describes patterns of healthcare resource use by patients with CKD.DesignA retrospective descriptive design was used.ParticipantsPatients with Stages 1–5 CKD were identified in five existing de‐identified healthcare insurance claims databases in the United States using codes from the International Classification of Diseases (ICD‐9‐CM).MeasurementsThe databases contained more than 23,660,000 claims records from over 11 million subscribers who were continuously enrolled in a single 2014 health plan. All CKD patients’ 2014 claims were extracted, yielding 1,987 unique people with 110,594 healthcare encounters.ResultsHealthcare resources are used to manage the causes of CKD and its multiple effects on health, and thus the number of healthcare encounters among people with more advanced disease was, as expected, relatively higher. There were more hospitalisations, emergency department visits and specialist encounters in this group. Surprisingly, however, even people in earlier stages of kidney disease experienced a median of 14–17 healthcare encounters during a single calendar year.ConclusionsUnderstanding patterns of healthcare encounters provides important information about the transition experiences of patients with CKD. Exploring ways to reduce the risks associated with transitions in care may prevent problems with home medication management, frequent emergency department visits and potentially avoidable hospitalisations.
Agglomeration economies and the location of foreign direct investment: A meta‐analysis
Authors: Jones Jonathan 
Published: April 2017

AbstractThis paper undertakes a meta‐analysis of the effect of agglomeration economies on foreign direct investment (FDI) location. It finds strong differences in these economies arising from both measurement and study‐specific characteristics. Economies generated from domestic rather than foreign activity have the strongest effects on FDI, with the latter only significant if related to the home country of the investor. Support is also found for studies that identify different sources of agglomeration economies, although this is largely underexplored in the empirical literature. The average agglomeration economies estimate is not influenced by publication bias and indicates genuine effects for agglomeration economies on FDI location choice.
Sleep quality of German soldiers before, during and after deployment in Afghanistan—a prospective study
Authors: Danker‐Hopfe Heidi , Sauter Cornelia , Kowalski Jens T. , Kropp Stefan , Ströhle Andreas , Wesemann Ulrich , Zimmermann Peter L. 
Published: April 2017

SummaryIn this prospective study, subjective sleep quality and excessive daytime sleepiness prior to, during and after deployment of German soldiers in Afghanistan were examined. Sleep quality (Pittsburgh Sleep Quality Index; PSQI) and daytime sleepiness (Epworth Sleepiness Scale; ESS) were assessed in 118 soldiers of the German army, who were deployed in Afghanistan for 6 months (deployment group: DG) and in 146 soldiers of a non‐deployed control group (CG) at baseline. Results of the longitudinal analysis are reported, based on assessments conducted prior to, during the deployment and afterwards in the DG, and in the CG in parallel. Sleep quality and daytime sleepiness in the DG were already impaired during the predeployment training phase and remained at that level during the deployment phase, which clearly indicates the need for more attention on sleep in young soldiers, already at this early stage. The percentage of impaired sleepers decreased significantly after deployment. Programmes to teach techniques to improve sleep and reduce stress should be implemented prior to deployment to reduce sleep difficulties and excessive daytime sleepiness and subsequent psychiatric disorders.