bluuebunny/crossref_metadata_2025_split huggingface dataset:
miR-382-5p promotes cell invasion in hepatocellular carcinoma by targeting PTEN to activate PI3K/Akt signaling pathway
Authors: Lv Bo , Liu Xianzhuo , Zhu Xinfeng , Huang Min 
Published: June 2022

Abstract
Purpose
This study aimed at investigating miR-382-5p expression in tissues and cell lines with hepatocellular carcinoma (HCC), its effects on the invasion of HCC cells, and related mechanisms.

Methods
miR-382-5p expression in HCC tissues, adjacent tissues, cell lines of normal hepatic cells, and HCC cells were detected by qRT-PCR, indicating its upregulation or downregulation in HCC cell lines (Hep3B and HCCLM3). The effect of miR-382-5p on cell invasion was observed by the Transwell experiment. The targeting relationship of miR-382-5p and the phosphatase and tensin homolog (PTEN) was analyzed using bioinformatics tools and the luciferase reporter gene assay. The correlation between miR-382-5p and PTEN was analyzed with Spearman correlation analysis. PTEN expression was observed after upregulation and downregulation of miR-382-5p expression. The effect of miR-382-5p on the expression of key proteins in PI3K/Akt signaling pathway was determined by Western blot.

Results
miR-382-5p expression was upregulated in both HCC tissues and cell lines (both P<0.05). Upregulation or downregulation of miR-382-5p significantly promoted or inhibited the invasion of cell lines, Hep3B, and HCCLM3. The luciferase reporter gene assay confirmed that PTEN is a target of miR-382-5p. The expressions of miR-382-5p and PTEN were negatively correlated (r=−0.742, P<0.001). Upregulation of PTEN expression by plasmid transfection can reverse the invasive effect of miR-382-5p on HCC cells. Upregulation of miR-382-5p can activate PI3K/Akt signaling pathway, and downregulation of miR-382-5p can inhibit PI3K/Akt signaling pathway.

Conclusions
miR-382-5p can activate the PI3K/Akt signaling pathway by targeting PTEN and promote HCC cell invasion.
Integrated breast massage versus traditional breast massage for treatment of plugged milk duct in lactating women: a randomized controlled trial
Authors: Munsittikul Nutchanat , Tantaobharse Supannee , Siripattanapipong Pitiporn , Wutthigate Punnanee , Ngerncham Sopapan , Yangthara Buranee 
Published: June 2022

Abstract
Background
Plugged milk duct during lactation is a common problem in breastfeeding. Traditional breast massage (TBM) has been performed in Thailand with reasonable outcomes, but several follow-up sessions are often required. A new massage technique, the integrated breast massage (IBM), was subsequently developed. This study aimed to compare resolution time, reduction in mass size, and pain score after breast massage between the IBM and TBM techniques.

Methods
This randomized controlled trial was conducted at the Lactation Clinic of the Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand during February 2019-July 2020. Women presenting with acute plugged milk duct were enrolled and randomly allocated to the IBM or TBM/control groups. Mass size in square centimeters (cm2) was calculated by multiplying the perpendicular axes of the mass. Pain score was self-scored by participants using a numerical rating scale. Median time (95% confidence interval [CI]) to resolution of plugged milk duct was derived using Kaplan–Meier survival analysis. Intention-to-treat analysis was performed.

Results
Eighty-four women (42 per group) were included. All enrolled study participants completed the study and were included in the final analysis. Twenty-six (61.9%) and 25 (59.5%) participants from IBM and TBM, respectively, had mass diameter > 5 cm. The median (interquartile range [IQR]) mass size was 30 (20–48) and 20 (12–14) cm2 in IBM and TBM (p = 0.05), respectively. The median (95% CI) time to resolution of plugged duct was 0 (not available) and 1 (0.47–1.53) day in IBM and TBM, respectively (p < 0.01). After the first breast massage, the median (IQR) size of mass reduction was 30 (20–48) and 10 (10–26) cm2 in IBM and TBM, respectively (p = 0.01). The median (IQR) reduction in pain score was 8 (7–8) and 6 (4–7) in IBM and TBM, respectively (p = 0.01). No participants developed skin bruising or hematoma after breast massage.

Conclusions
The IBM technique resolved plugged milk duct significantly faster, with significantly less pain, and with significantly greater reduction in mass size after the first massage compared to TBM.

Trial registration
Retrospectively registered in the Thai Clinical Trials Registry on 25 September 2019 (TCTR20190925001).
How can a joint European health technology assessment provide an ‘additional benefit’ over the current standard of national assessments?
Authors: Julian Elaine , Gianfrate Fabrizio , Sola-Morales Oriol , Mol Peter , Bergmann Jean-François , Salmonson Tomas , Hebborn Ansgar , Grande Mathilde , Ruof Jörg 
Published: June 2022

Abstract
Objectives
We conducted a multi-stakeholder survey to determine key areas where a joint European health technology assessment (HTA) could provide ‘additional benefit’ compared to the status quo of many parallel independent national and subnational assessments.

Methods
Leveraging three iterative Delphi cycles, a semiquantitative questionnaire was developed covering evidence challenges and heterogeneity of value drivers within HTAs across Europe with a focus on hematology/oncology. The questionnaire consisted of five sections: i) background information; ii) value drivers in HTA assessments today; iii) evolving evidence challenges; iv) heterogeneity of value drivers across Europe; v) impact of Europe’s Beating Cancer Plan (EBCP). The questionnaire was circulated across n = 189 stakeholder institutions comprising HTA and regulatory bodies, clinical oncology associations, patient representatives, and industry associations.

Results
N = 30 responses were received (HTA bodies: 9; regulators: 10; patients’ and physicians’ associations: 3 each; industry: 5). Overall, 17 countries and EU level institutions were represented in the responses. Consistency across countries and stakeholder groups was high. Most relevant value drivers in HTAs today (scale 1, low to 5, high) were clinical trial design (mean 4.45), right endpoints (mean 4.40), and size of comparative effect (mean 4.33). Small patient numbers (mean 4.28) and innovative study designs (mean 4.1) were considered the most relevant evolving evidence challenges. Heterogeneity between regulatory and HTA evidence requirements and heterogeneity of the various national treatment standards and national HTA evidence requirements was high. All clinical and patient participants stated to have been with EBCP initiatives.

Conclusions
For a European HTA to provide an ‘additional benefit’ over the multitude of existing national assessments key methodological and process challenges need to be addressed. These include approaches to address uncertainty in clinical development; comparator choice; consistency in approaching patient-relevant endpoints; and a transparent and consistent management of both HTA and regulatory procedures as well as their interface, including all involved stakeholder groups.
Effects of DNA methylation on cardiometabolic risk factors: a systematic review and meta-analysis
Authors: Barouti Zahra , Heidari-Beni Motahar , Shabanian-Boroujeni Anahita , Mohammadzadeh Morteza , Pahlevani Vida , Poursafa Parnian , Mohebpour Fatemeh , Kelishadi Roya 
Published: June 2022

Abstract
Background
Epigenetic changes, especially DNA methylation have a main role in regulating cardiometabolic disorders and their risk factors. This study provides a review of the current evidence on the association between methylation of some genes (LINE1, ABCG1, SREBF1, PHOSPHO1, ADRB3, and LEP) and cardiometabolic risk factors.

Methods
A systematic literature search was conducted in electronic databases including Web of Science, PubMed, EMBASE, Google Scholar and Scopus up to end of 2020. All observational human studies (cross-sectional, case–control, and cohort) were included. Studies that assessed the effect of DNA methylation on cardiometabolic risk factors were selected.

Results
Among 1398 articles, eight studies and twenty-one studies were included in the meta-analysis and the systematic review, respectively. Our study showed ABCG1 and LINE1 methylation were positively associated with blood pressure (Fisher’s zr = 0.07 (0.06, 0.09), 95% CI: 0.05 to 0.08). Methylation in LINE1, ABCG1, SREBF1, PHOSPHO1 and ADRB3 had no significant association with HDL levels (Fisher’s zr = − 0.05 (− 0.13, 0.03), 95% CI:-0.12 to 0.02). Positive association was existed between LINE1, ABCG1 and LEP methylation and LDL levels (Fisher’s zr = 0.13 (0.04, 0.23), 95% CI: 0.03 to 0.23). Moreover, positive association was found between HbA1C and ABCG1 methylation (Fisher’s zr = 0.11 (0.09, 0.13), 95% CI: 0.09 to 0.12). DNA methylation of LINE1, ABCG1 and SREBF1 genes had no significant association with glucose levels (Fisher’s zr = 0.01 (− 0.12, 0.14), 95% CI:-0.12 to 0.14).

Conclusion
This meta-analysis showed that DNA methylation was associated with some cardiometabolic risk factors including LDL-C, HbA1C, and blood pressure.

Registration
Registration ID of the protocol on PROSPERO is CRD42020207677.
The effect of 100% single-occupancy rooms on acquisition of extended-spectrum beta-lactamase-producing Enterobacterales and intra-hospital patient transfers: a prospective before-and-after study
Authors: van der Schoor Adriënne S. , Severin Juliëtte A. , van der Weg Anna S. , Strepis Nikolaos , Klaassen Corné H. W. , van den Akker Johannes P. C. , Bruno Marco J. , Hendriks Johanna M. , Vos Margreet C. , Voor in ’t holt Anne F. 
Published: June 2022

Abstract
Background
Extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) are a well-known cause of healthcare-associated infections. The implementation of single-occupancy rooms is believed to decrease the spread of ESBL-E. Additionally, implementation of single-occupancy rooms is expected to reduce the need for intra-hospital patient transfers. We studied the impact of a new hospital with 100% single-occupancy rooms on the acquisition of ESBL-E and on intra-hospital patient transfers.

Methods
In 2018, the Erasmus MC University Medical Center moved from an old, 1200-bed hospital with mainly multiple-occupancy rooms, to a newly constructed 522-bed hospital with 100% single-occupancy rooms. Adult patients admitted between January 2018 and September 2019 with an expected hospitalization of ≥ 48 h were asked to participate in this study. Perianal samples were taken at admission and discharge. Patient characteristics and clinical information, including number of intra-hospital patient transfers, were collected from the patients’ electronic health records.

Results
Five hundred and ninety-seven patients were included, 225 in the old and 372 in the new hospital building. Fifty-one (8.5%) ESBL-E carriers were identified. Thirty-four (66.7%) patients were already positive at admission, of which 23 without recent hospitalization. Twenty patients acquired an ESBL-E, seven (3.1%) in the old and 13 (3.5%) in the new hospital building (P = 0.801). Forty-one (80.4%) carriers were only detected by the active screening performed during this study. Only 10 (19.6%) patients, six before and four during hospitalization, showed ESBL-E in a clinical sample taken on medical indication. Fifty-six (24.9%) patients were transferred to other rooms in the old hospital, compared to 53 (14.2%) in the new hospital building (P = 0.001). Intra-hospital patient transfers were associated with ESBL-E acquisition (OR 3.18, 95%CI 1.27–7.98), with increasing odds when transferred twice or more.

Conclusion
Transitioning to 100% single-occupancy rooms did not decrease ESBL-E acquisition, but did significantly decrease the number of intra-hospital patient transfers. The latter was associated with lower odds on ESBL-E acquisition. ESBL-E carriers remained largely unidentified through clinical samples.

Trial registration
This study was retrospectively registered in the Dutch National Trial Register on 24-02-2020, with registration number NL8406.
Always Assess the Raw Electroencephalogram: Why Automated Burst Suppression Detection May Not Detect All Episodes
Authors: Fleischmann Antonia , Georgii Marie-Therese , Schuessler Jule , Schneider Gerhard , Pilge Stefanie , Kreuzer Matthias 
Published: June 2022

BACKGROUND:
Electroencephalogram (EEG)-based monitors of anesthesia are used to assess patients’ level of sedation and hypnosis as well as to detect burst suppression during surgery. One of these monitors, the Entropy module, uses an algorithm to calculate the burst suppression ratio (BSR) that reflects the percentage of suppressed EEG. Automated burst suppression detection monitors may not reliably detect this EEG pattern. Hence, we evaluated the detection accuracy of BSR and investigated the EEG features leading to errors in the identification of burst suppression.

METHODS:
With our study, we were able to compare the performance of the BSR to the visual burst suppression detection in the raw EEG and obtain insights on the architecture of the unrecognized burst suppression phases.

RESULTS:
We showed that the BSR did not detect burst suppression in 13 of 90 (14%) patients. Furthermore, the time comparison between the visually identified burst suppression duration and elevated BSR values strongly depended on the BSR value being used as a cutoff. A possible factor for unrecognized burst suppression by the BSR may be a significantly higher suppression amplitude (P = .002). Six of the 13 patients with undetected burst suppression by BSR showed intraoperative state entropy values >80, indicating a risk of awareness while being in burst suppression.

CONCLUSIONS:
Our results complement previous results regarding the underestimation of burst suppression by other automated detection modules and highlight the importance of not relying solely on the processed index, but to assess the native EEG during anesthesia.
Working Paper 39: Behavioural drivers of corruption facilitating illegal wildlife trade
Authors: Baez Camargo Claudia , Burgess Gayle 
Published: June 2022

This Problem Analysis is a review of the efficacy and opportunities for using social norm and behaviour change (SNBC) approaches to combat illegal wildlife trade (IWT) and other natural resource-related corruption.
Behavioural science is a rich and expansive field that has received prominent coverage in recent years for the promise it offers as a foundational yet underutilised approach to achieving biodiversity conservation. Extensive literature shows how SNBC initiatives can help combat diverse corruption problems, although for those related to natural resource management the evidence for doing so is sparse.
This report synthesises the available information and suggests the next steps to redress this current lack of evidence. It seeks to:

Understand what SNBC approaches might or might not work in fighting corruption.
Identify entry points for designing SNBC interventions that can effectively reduce corruption related to IWT.

This Analysis has been produced in association with the Targeting Natural Resource Corruption (TNRC) project. The TNRC project is working to improve biodiversity outcomes by helping practitioners to address the threats posed by corruption to wildlife, fisheries and forests. TNRC harnesses existing knowledge, generates new evidence, and supports innovative policy and practice for more effective anti-corruption programming. Learn more at tnrcproject.org.
This publication is made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of the authors and do not necessarily reflect the views of USAID, the United States Government, or individual TNRC consortium members.
UK clinical approaches to address post-stroke fatigue: findings from The Nottingham Fatigue after Stroke study
Authors: Ablewhite Joanne , Condon Laura , Nair Roshan das , Jones Amanda , Jones Fiona , Nouri Fiona , Sprigg Nikola , Thomas Shirley , Drummond Avril 
Published: June 2022

Background/Aims Although post-stroke is common and debilitating, there is little published research on how it is managed by clinicians. The aim of this study was to document UK management of post-stroke fatigue and ascertain whether there are any differences in its management compared to fatigue arising from other conditions. Methods A cross-sectional survey was used with allied health professionals, psychologists, doctors and nurses working clinically in hospitals, the community or both, who routinely provided information, management or treatment to patients with fatigue. Questionnaires were designed and underwent pilot testing. Recruitment was conducted using healthcare professional networks, professional and condition special interest groups and social media, snowballing and personal emails targeting key professional experts. Results A total of 305 questionnaires were analysed; the majority of responses were from occupational therapists (56%, n=171). Although there were different opinions about whether post-stroke fatigue was the same as fatigue resulting from other conditions, the strategies suggested for both were similar. Post-stroke management included pacing (67%, n=204), which is spreading activities out during the day or week, keeping a fatigue diary (39%, n=119) and education (38%, n=117). There were variations in how support was offered, and marked variations in length of follow up; some services were flexible and could retain patients for up to 18 months, while others offered one session and no follow up. Conclusions People with post-stroke fatigue and fatigue arising from other conditions experience different levels of support to manage their fatigue, but the main strategies used in management are similar.
Morbidity status and changes in difficulty in activities of daily living among older adults in India: A panel data analysis
Authors: Patel Priyanka , Muhammad T. , Sahoo Harihar 
Published: June 2022

IntroductionThe study explored the socioeconomic and demographic factors that determine the onset of difficulty, recovery from difficulty and difficulty remaining in functional activity in later years of life. Additionally, the study examined the effects of several combinations of chronic diseases on the changes in later-life functional difficulty.MethodsWe used data from two rounds of India Human Development Survey (IHDS) conducted during 2004–2005 and 2011–2012. A sample of 13,849 respondents aged 55 years and above with a seven year follow-up was considered for this study. The Katz Index of Independence in activities of daily living (ADL) was used to measure the functional disability as an outcome variable. Multinomial logistic regression has been conducted to fulfil the study objectives.ResultsThe overall functional difficulty among older adults was 27.3% and onset of functional difficulty (23.5%) was higher than the recovery from difficulty (2.1%) and remaining with difficulty (1.7%). Onset of functional difficulty in second round was higher among women (27.3%) than men (19.3%). Bivariate and multivariate analyses showed that single and multi-morbidity had a positive significant association with all categories of functional difficulty. Female sex, increasing age and rural place of residence had positive association with onset of difficulty and difficulty remaining in second round. The combinations of morbidities were also found to have positive significant association with functional difficulty i.e., the relative risk (RR) of onset of difficulty in second round is higher among those who had diabetes with high blood pressure (RR-1.7; CI: 1.4–2.0), cataracts with high blood pressure (RR-2.0; CI: 1.5–2.6) and cataracts with asthma (RR-3.1; CI: 2.1–4.6) compared to those with no diabetes and cataract but with high blood pressure or asthma, respectively.ConclusionThe findings suggest that the risk of onset of functional difficulty is higher among older individuals with single and multiple morbidities compared to their healthy counterparts. It is also found that functional difficulty increased with age and was more prevalent in older women and rural residents, suggesting the need for appropriate policy interventions with special focus on the vulnerable senior adults.
Strategi Pengelolaan Kawasan Pesisir di Pasar Banggi Kabupaten Rembang dengan Pendekatan Analytical Hierarchy Process (AHP)
Authors: Wibowo Bambang Argo , Bambang Azis Nur , Pribadi Rudhi , Setiyanto Indradi , Prihantoko Kukuh Eko , Sutanto Himawan Arif 
Published: June 2022

This study aim to determine priorities in the management of coastal areas in Pasar Banggi, Rembang Regency. Analytical Hierarchy Process (AHP) used to prioritise coastal area management strategy. A total of 15 people were taken as a sample of respondents using purposive sampling consisting of fishermen, coastal community leaders, the Department of Fisheries and Marine Affairs, the Department of Culture and Tourism, the Department of Environment and Academics. The results show that in managing the coastal area at Pasar Banggi, Rembang Regency, the main factor that must be considered is the environment (Ecology) with the most important aspects including mangrove ecosystems, coral reefs, and fish resources. While overall (overall) shows that the priority scale of criteria and alternative management of coastal areas in Pasar Banggi, Rembang Regency with AHP in order of priority is Silvofishery, Ecotourism and Artisanal Fisheries. Thus, the Silvofishery development strategy becomes a top priority in the management of coastal areas in Pasar Banggi, Rembang Regency. Silvofishery is fish farming in the mangrove ecosystem area without having to convert or damage the mangrove ecosystem so that the sustainability of the mangrove ecosystem is maintained. Penelitian ini bertujuan untuk menentukan prioritas dalam pengelolaan Kawasan pesisir di Pasar Banggi Kabupaten Rembang. Analysis Hierarchy Process (AHP) digunakan untuk menentukan prioritas dalam pengelolaan kawasan. Sebanyak 15 orang diambil sebagai sampel responden dengan menggunakan purposive sampling yang terdiri dari nelayan, tokoh masyarakat pesisir, Dinas Perikanan dan Kelautan, Dinas Kebudayaan dan Pariwisata, Dinas Lingkungan Hidup dan Akademisi. Hasil penelitian menunjukkan bahwa dalam mengelola Kawasan pesisir di Pasar Banggi Kabupaten Rembang faktor utama yang harus diperhatikan adalah lingkungan (Ekologi) dengan aspek yang paling penting diantaranya ekosistem mangrove, terumbu karang, dan sumberdaya ikan. Sedangkan secara secara keseluruhan (overall) menunjukkan bahwa skala prioritas kriteria dan alternatif pengelolaan wilayah pesisir di Pasar Banggi Kabupaten Rembang dengan AHP dengan urutan prioritas adalah Silvofishery, Ecotourism dan Artisanal Fisheries. Dengan demikian strategi pengembangan Silvofishery menjadi prioritas utama di dalam pengelolaan wilayah pesisir di Pasar Banggi Kabupaten Rembang. Silvofishery merupakan budidaya ikan di Kawasan ekosistem mangrove tanpa harus mengkonversi atau merusak ekosistem mangrove sehingga keberlanjutan ekosistem mangrove tetap terjaga.
The Inflationary Potential of the Historic 2021 SDR Allocation
Authors: Beretta Edoardo , Neuberger Doris 
Published: June 2022

Abstract
The paper assesses whether Special Drawing Rights (SDR), namely international reserve assets and claims on freely useable currencies of its members created and allocated by the International Monetary Fund (IMF), are inflationary. This question has been already raised in the economic literature, but the paper does so by specifically analyzing its most recent and highest allocation in August 2021 on the one hand and its use by member countries to combat the COVID-19 crisis on the other. Moreover, the article revamps the logical-conceptual debate on the essence of money as issued by banks and what the IMF (which is not a bank) is monetarily speaking capable of.