bluuebunny/crossref_metadata_2025 huggingface dataset:
Ground Water Induced Changes in Velocities of P and S Waves (Vp and Vs) Measured Using Accurately Controlled Seismic Source
Authors: Suzuki Rina , Yamaoka Koshun , Tsuji Shuhei , Watanabe Toshiki
Published: December 2020

We analyzed the temporal variation in the travel times of both the P and S waves (Vp and Vs) for 14 months at Toyohashi (central Japan) with a continuously operating vibration source that could produce both P and S waves efficiently. The seismic waves produced by the source, which is named ACROSS (accurately-controlled routinely-operated signal system), were recorded by three nearby seismic stations, and the travel time variation at each station was calculated using the transfer function calculated from the recorded data. We observed the seasonal variations in the Vp and Vs for all the stations—which can be interpreted using the change in the fluid saturation and crack density of subsurface rocks—are consistent with the variation in the ground water level. The short-term responses to rainfall are observed at the nearest station; the interpretation of the changes in crack density and saturation is inconsistent with the ground water observation partly due the initial response to rainfall. This can be interpreted as an air-water mixture within pores or cracks on a fine scale.
Curcumin and Its Analog Alleviate Diabetes-induced Damages by Regulating Inflammation and Oxidative Stress in Brain of Diabetic Rats​
Authors: Miao Chengfeng , Chen Hanbin , Li Yulian , Guo Ying , Xu Feifei , Chen Qi , Zhang Yanyan , Hu Mengjun , Chen Guorong
Published: December 2020

Background: Diabetic encephalopathy is a severe diabetes complication with cognitive dysfunction and neuropsychiatric disability. The mechanisms underlying diabetic encephalopathy is believed to be relevant with oxidative stress, vascular amylin deposition, immune receptors, inflammation, etc. This study wanted to evaluate the ability of curcumin and its analog A13 to alleviate oxidative stress and inflammation in diabetes-induced damages in brain.Methods: Sixty adult male Sprague-Dawley rats were divided into 5 groups: normal control (NC) group, diabetes mellitus (DM) group, curcumin-treated diabetes mellitus (CUR) group, high dose of A13-treated diabetes mellitus (HA) group, low dose of A13-treated diabetes mellitus (LA) group. Activation of the nuclear factor kappa-B (NF-κB p65) pathway was detected by RT-qPCR, immunohistochemical (IHC) staining and Western blot; oxidative stress was detected by biochemical detection kit; brain tissue sections were stained with hematoxylin–eosin (HE) staining and Myelin staining. Results: RT-qPCR, IHC staining and Western blot showed that curcumin and A13 treatment could inhibit the NF-κB p65 pathway. Curcumin and A13 increased the activity of superoxide dismutase and decreased the malondialdehyde level in the brain of diabetic rats. Furthermore, HE staining and Myelin staining demonstrated that the histological lesions of the brain in diabetic rats could be significantly ameliorated by curcumin and A13.Conclusion: Curcumin analog A13 could alleviate the damages in the brain of diabetes rats by regulating the pathways of inflammation and oxidative stress. A13 may be a new potential therapeutic agent for diabetic encephalopathy.
The Expression of miR-513c and miR-3163 was Downregulated in Tumor Tissues Compared with Margin Tissues of Patients with Breast Cancer
Authors: Delgir Soheila , Ilkhani Khandan , Safi Asma , Montazari Vahid , Seif Farhad , Bastami Milad , Alivand Mohammad-Reza
Published: December 2020

Background: Breast cancer (BC) is the most common invasive cancer with different subtypes that its metabolism is unique compared with normal cells. Glutamine is considered critical nutrition, that many cancer cells, particularly BC cells are dependent on it for growth and proliferation. Therefore, targeting glutamine metabolism, especially enzymes related to this pathway, can be beneficial to design anti-cancer agents. Recently, evidence has shown that miRNAs with a short length and single-strand properties play a significant role in regulating the genes related to glutamine metabolism and may control the development of cancer. Methods: In-silico analysis confirmed that miR-513c and miR-3163 might be involved in glutamine metabolism, the expression level of these two miRNAs was examined in eighty BC tissues and margin tissues. Furthermore, in-silico analysis was applied to predict the potential biological processes and molecular pathways of miR-513c and miR-3163 based on their gene targets. Results: In-silico studies revealed the top categories of biological processes and cellular pathways that play a critical role in metabolism reprogramming and cancer development were target genes for miR-513c and miR-3163. The current study showed that miR-513c (p-value= 0.02062 and fold change= -2.3801) and miR-3163 (p-value= 0.02034 and fold change= -2.3792) were downregulated in tumor tissues compared to margin tissues. Furthermore, the subgroup analysis did not show any substantial relationship between expression levels of these two miRNAs and factors such as age, family history cancer, and abortion. Conclusion: miR-513c and miR-3163 are downregulated in BC tissues, which may act as tumor suppressors and may also be considered as potential therapeutic target for patients with BC.
The Impact of Preoperative Biliary Drainage on Postoperative Outcomes after Pancreaticoduodenectomy: A Single Center Retrospective Study
Authors: Mo Daihai , Ma Hongyun , Wang Zhen , Hu Jiayang , Li Gang
Published: December 2020

Background The effect of preoperative biliary drainage (PBD) on the short-term outcomes after pancreaticoduodenectomy (PD) remains controversial. Methods 164 consecutive patients with obstructive jaundice who underwent PD in our center from 2016 to 2017 were retrospectively analyzed. The 120 patients who underwent PBD prior to PD (PBD group) were compared with 44 patients who did not (DS group). The short-term outcomes include overall morbidity, severe complications, postoperative pancreatic fistula(POPF), postpancreatectomy hemorrhage(PPH), intra-abdominal abscess (IAA), sepsis, delayed gastric emptying (DGE), postoperative hospital stay and 90-day death were assesed. Results There were no significant statistical differences in overall morbidity, severe complications, POPF, PPH, IAA, LOS and ninety-day mortality between two groups. The incidence of DGE in PBD group was significantly lower than that in DS group (4.5% vs. 19.2%, P = 0.021). Multivariate regression analysis showed that age over 66 years (OR: 3.094,95% CI: 1.268-7.55) and direct surgery (OR: 5.298, 95% CI: 1.176-23.865) were independent risk factors for DGE. Conclusion For patients with obstructive jaundice, preoperative biliary drainage is independently associated with delayed gastric emptying, but does not affect the overall morbidity and mortality of patients undergoing PD.
Effect of Huangqin Decoction on Regulating Intestinal Flora in Colitis Mice Characterized as The Inhibition of NOD2-Dependent Pathway
Authors: Huang Shaowei , He Jinrong , Chen Yanping , Wang Xiaojing , Li Yanyang , Su Yulin , Wen Ruyan , Li Xiuling , Yang Guanghua , Luo Shuang , Zhou Lian , Luo Xia
Published: December 2020

Background: Dysfunction of the intestinal flora is an important factor in the occurrence and development of ulcerative colitis (UC). Chinese herb Huangqin decoction (HQD) can regulate intestinal flora in UC mice, yet its specific mechanism remains unclear. Our study aimed to clarify the mechanism of HQD in regulating intestinal flora of UC mice.Methods: 3%DSS - induced colitis mice were used to explore the pharmacodynamics of HQD. Colonic bacterial infiltration and the changes of intestinal flora were detected by FISH and 16SrDNA. Expression of RegⅢγ and PRRs (NOD2, TLR5, TLR4) were detected by FCM and WB, respectively. In addition, WB, SqPCR, or IHC were used for the expression of Nod2, MyD88, Rip2, and NF-κB p65 in colon. Cytokines were determined by ELISA.Results: HQD significantly restored the weight, the colonic length, and peripheral blood cell counts of colitis mice; reduced the DAI score and the histological score. 16SrDNA identification showed HQD regulated the balance of intestinal flora. Moreover, the expression of RegⅢγ was suppressed and colonic bacterial infiltration was prevented by HQD. Furthermore, the results of WB showed expression of NOD2 and TLR4 was inhibited by HQD, especially NOD2. And the data of WB, SqPCR and IHC explained that the NOD2-dependent pathway was inhibited by HQD.Conclusions: Our results reveal the mechanism of HQD(1g/kg) in regulating the intestinal flora of colitis mice, which may be closely characterized as the inhibition of the activation of Pattern Recognition Receptors (PRRs), especially NOD2.
The Cognitive Walkthough for Implementation Strategies (CWIS): A Pragmatic Method for Assessing Implementation Strategy Usability
Authors: Lyon Aaron R , Coifman Jessica , Cook Heather , McRee Erin , Liu Freda F. , Ludwig Kristy , Dorsey Shannon , Koerner Kelly , Munson Sean A. , McCauley Elizabeth
Published: December 2020

Background. Implementation strategies have flourished over the last decade in an effort to increase integration of research evidence into clinical practice. Most strategies are complex, socially-mediated processes. Many are complicated, expensive, and ultimately impractical to deliver in real-world settings. The field lacks methods to assess the extent to which implementation strategies are usable and aligned with the needs and constraints of the individuals and contexts who will deliver or receive them. Drawn from the field of human-centered design, cognitive walkthroughs are an efficient assessment method with potential to surface aspects of strategies that may inhibit their usability and, ultimately, their effectiveness. This article presents a novel cognitive walkthrough methodology for evaluating strategy usability as well as an example application to a post-training consultation strategy to support mental health clinicians in the education sector to adopt measurement-based care.Method. The Cognitive Walkthrough for Implementation Strategies (CWIS) is a pragmatic, mixed-methods approach for evaluating complex, socially-mediated implementation strategies in health. CWIS includes six steps: (1) determine preconditions; (2) hierarchical task analysis; (3) task prioritization; (4) convert tasks to scenarios; (5) pragmatic group testing; and (6) usability issue identification, classification, and prioritization. A facilitator conducted two group testing sessions with clinician users (N = 10), guiding participants through 6 scenarios and 11 associated subtasks. Clinicians reported their anticipated likelihood of completing each subtask and provided qualitative justifications during group discussion. Following the walkthrough sessions, users completed a quantitative assessment of strategy usability.Results. Average subtask success ratings indicated substantial variability across participants and subtasks. Usability ratings (scale: 0-100) of the consultation protocol averaged 71.3 (SD = 10.6). Twenty-one usability problems were identified via qualitative coding and classified by severity and problem type to explain the ratings. High-severity problems included potential misalignment between consultation and clinical service timelines as well as digressions during consultation processes.Conclusions. Ratings indicated that usability of the consultation protocol was at the low end of the “acceptable” range. Collectively, the 21 usability issues explained the ISUS quantitative usability data and provided specific direction for usability enhancements. The current study provides preliminary evidence for the utility of CWIS to assess strategy usability and generate a blueprint for redesign.
Improving Implementation of Smoking Cessation Guidelines in Pregnancy Care: Development of an Intervention to Address System, Maternity Service Leader and Clinician Factors
Authors: Passey Megan , Adams Catherine , Paul Christine , Atkins Lou , Longman Jo M.
Published: December 2020

BackgroundSmoking during pregnancy increases the risk of multiple serious adverse infant, child and maternal outcomes, yet nearly 10% of Australian women still smoke during pregnancy. Despite evidence-based guidelines that recommend routine and repeated smoking cessation support (SCS) for all pregnant women, the provision of recommended SCS remains poor. Guidance on developing complex interventions to improve health care recommends drawing on existing theories, reviewing evidence, undertaking primary data collection, attending to future real-world implementation, and designing and refining interventions using iterative cycles with stakeholder input throughout. Here we describe using the Behaviour Change Wheel (BCW) to apply these principles in developing an intervention to improve provision of SCS in Australian maternity services.MethodsWorking closely with key stakeholders in the New South Wales (NSW) health system, we applied the steps of the BCW method then undertook a small feasibility study in one service to further refine the intervention. Stakeholders were engaged in multiple ways – as a core research team member, through a project Advisory Group, targeted meetings with policy makers, a large workshop to review potential components and the feasibility study. ResultsBarriers to and enablers of providing SCS were identified in five of six components described in the BCW method (psychological capability, physical opportunity, social opportunity, and in reflective and automatic motivation). These were mapped to intervention types and we selected education, training, enablement, environmental restructuring, persuasion, incentivisation and modelling as suitable in our context. Through application of the APEASE criteria (Affordability, Practicability, Effectiveness, Acceptability, Side effects, and Equity) in the stakeholder workshop, behaviour change techniques were selected and applied in developing the intervention which includes systems, clinician and leadership elements. The feasibility study confirmed feasibility and acceptability of the midwifery component and the need to further strengthen the leadership component. ConclusionsUsing the BCW method combined with strong stakeholder engagement from inception resulted in transparent development of the MOHMQuit intervention, which targets identified barriers to and enablers of the provision of SCS and is developed specifically for the context in which it will be implemented. The intervention is being trialed in eight public maternity services in NSW.
Readiness to Implement Symptom Management Care Pathways in Pediatric Cancer
Authors: Dupuis L Lee , Grimes Allison , Vettese Emily , Klesges Lisa M. , Sung Lillian
Published: December 2020

Background: To describe barriers to pediatric cancer symptom management care pathway implementation and the impact of the COVID-19 pandemic on clinical research evaluating their implementation. Methods: We included 25 pediatric oncology hospitals in the United States that supported a grant submission to perform a cluster randomized trial in which the intervention encompassed care pathways for symptom management. A survey was distributed to site principal investigators to measure contextual elements related to care pathway implementation. Questions included the inner setting measures of the Consolidated Framework for Implementation Research (CFIR), study-specific potential barriers and the impact of the COVID-19 pandemic on clinical research. The Wilcoxon rank sum test was used to compare characteristics of institutions that agreed that their department supported the implementation of symptom management care pathways vs. institutions that did not agree.Results: Of the 25 sites, one withdrew because of resource constraints and one did not respond, leaving 23 institutions. Among the seven CFIR constructs, the least supported was implementation climate; 57% agreed there was support, 39% agreed there was recognition and 39% agreed there was prioritization for symptom management care pathway implementation at their institution. Most common barriers were lack of person-time to create care pathways and champion their use (35%), lack of interest from physicians (30%) and lack of information technology resources (26%). Most sites reported no negative impact of the COVID-19 pandemic across research activities. Sites with fewer pediatric cancer patients were more likely to agree that staff are supported to implement symptom management care pathways (P=0.003). Conclusions: The most commonly reported barriers to implementation were lack of support, recognition and prioritization. The COVID-19 pandemic was not a major barrier to clinical research activities in pediatric oncology.Clinical Trial Registration: NCT04614662
Gender Difference in the Association Between Serum Uric Acid Level and Metabolic Syndrome and Components: A Cross-Sectional Analysis among Chinese Young Adults
Authors: Fang Zhengmei , Chen Yan , Zhu Lijun , He Lianping , Jin Yuelong , Yao Yingshui
Published: December 2020

Background: This study aimed to investigate the associations between serum uric acid (SUA) levels and metabolic syndrome (MetS) and MetS components in Chinese young adults. Methods: A cross-sectional survey was conducted among 3044 young adults (1266 men and 1778 women). The anthropometric index, lipid profile, fasting blood glucose and SUA levels were measured. Male and female participants were grouped according to the quartiles of SUA level separately. Multiple logistic regression analyses were performed to evaluate the association of SUA quartiles with MetS and its components. Results: The overall prevalence of hyperuricemia and MetS was 29.7% and 2%, respectively. Multiple logistic regression analysis revealed that compared with the lowest 2 quartiles of SUA together, the highest quartile showed an association with the prevalence of MetS and high triglyceride in males, and OR (95% CI) were 3.438(1.090-10.841) and 4.364(2.133-8.930) respectively after adjustments confounding factors. In terms of abdominal obesity, compared with the lowest 2 quartiles of SUA together, the OR (95% CI) was 1.976(1.128-3.459) for those in the third quartile and 1.766(1.020-3.057) for those in the highest quartile after adjustments confounding factors in females. Conclusions: This study suggested a significant positive relationship between SUA and MetS and its components among young adults. Hence, routine measurement of SUA is recommended to prevent hyperuricemia and its related complications.
Real-world Use of Ceftolozane/tazobactam: a Systematic Literature Review
Authors: Puzniak Laura , Dillon Ryan , Palmer Thomas , Collings Hannah , Enstone Ashley
Published: December 2020

Background: Antibacterial-resistant gram-negative infections are a serious risk to global public health. Resistant Enterobacterales and Pseudomonas aeruginosa are highly prevalent, particularly in healthcare settings, and there are limited effective treatment options. Patients with infections caused by resistant pathogens have considerably worse outcomes, and significantly higher costs, relative to patients with susceptible infections. Ceftolozane/tazobactam (C/T) has established efficacy in clinical trials. This review aimed to collate data on C/T use in clinical practice.Methods: This systematic literature review searched online biomedical databases for real-world studies of C/T for gram-negative infections. Relevant study, patient, and treatment characteristics, microbiology, and efficacy outcomes were captured.Results: There were 83 studies comprising 3,701 patients were identified. The most common infections were respiratory infections (52.9% of reported infections), urinary tract infections (UTIs; 14.9%), and intra-abdominal infections (IAIs; 10.1%). Most patients included were seriously ill and had multiple comorbidities. The majority of patients had infections caused by P. aeruginosa (90.7%), of which 86.0% were antimicrobial-resistant. C/T was used as both a 1.5 g q8h and 3 g q8h dose, for a median duration of 7–56 days (varying between studies). Outcome rates were comparable between studies: clinical success rates ranged from 45.7–100.0%, with 27 studies (69%) reporting clinical success rates of >70%; microbiological success rates ranged from 31–100%, with 14 studies (74%) reporting microbiological success rates of >70%. Mortality rates ranged from 0–50%, with 31 studies (69%) reporting mortality rates of ≤20%. In comparative studies, C/T was as effective as aminoglycoside- or polymyxin-based regimens, and in some instances, significantly more effective.Conclusions: The studies identified in this review demonstrate that C/T is effective in clinical practice, despite the diverse group of seriously ill patients, different levels of resistance of the pathogens treated, and varying dosing regimens used. Furthermore, comparative studies suggest that C/T offers a successful alternative to standard of care (SoC).
Hospital Acquired Blood Stream Infection in an Adult Intensive Care Unit: a Retrospective Case Series
Authors: Harte Jeffrey , Soothill Germander , Samuel Jack , Sharifi Laurence , White Mary
Published: December 2020

Introduction: Hospital acquired blood stream infections are a common and serious complication in critically ill patients. Methods: A retrospective case series was undertaken investigating the incidence and causes of bacteraemia on an intensive care unit with a high proportion of postoperative cardiothoracic surgical and oncology patients. Results: 405 eligible patients were admitted to the intensive care unit over the course of nine months. 12 of these patients developed a unit acquired blood stream infection. The average Acute Physiology And Chronic Health Evaluation II (APACHE II) score of patients, who developed bacteraemia was greater than those who did not (19.8 versus 16.8 respectively). The risk of developing bacteraemia was associated with intubation and higher rates of invasive procedures. The mortality rate amongst the group of patients that developed bacteraemia was 33%. There was a higher proportion of Gram-negative bacteria isolated on blood cultures than in intensive care units reported in other studies.Conclusion: Critical care patients are at risk of secondary bloodstream infection. This study highlights the importance of measures to reduce the risk of infection in the intensive care setting particularly in patients who have undergone invasive procedures.
Identification and Validation of Three Core Genes in p53 Signaling Pathway in Hepatitis B Virus-Related Hepatocellular Carcinoma
Authors: Yu Mingxue , Xu Wenli , Jie Yusheng , Pang Jiahui , Huang Siqi , Cao Jing , Gong Jiao , Li Xinhua , Chong Yutian
Published: December 2020

Background：Hepatocellular carcinoma (HCC) is a common cancer and the leading cause is persistent hepatitis B virus infection. We aimed to identify some core genes and pathways for HBV-related HCC. Methods: Gene expression profiles of GSE62232, GSE121248, and GSE94660 were available from Gene Expression Omnibus. The GEO2R online tool and Venn diagram software were applied to analyze commonly differentially expressed genes. Then functional enrichment analysis using Gene Ontology (GO) and the Kyoto Encyclopedia of Gene and Genome (KEGG) as well as the protein-protein interaction (PPI) network was conducted. The overall survival rates and the expression levels were detected by Kaplan-Meier plotter and Gene Expression Profiling Interactive Analysis (GEPIA). Next, gene set enrichment analysis (GSEA) was performed to verify the KEGG pathway analysis. Furthermore, quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) was performed to validate the levels of gene expression in tumor tissues from HBV related HCC patients, HBV-related liver cell lines, and transfection si-p53 and knock-out p53 liver cancer cell lines. Finally, the prediction of the ceRNA network was constructed with R software. Results: Fifteen highly expressed genes associated with significantly worse prognoses were selected and CCNB1, CDK1, and RRM2 in the p53 signaling pathway were identified as core genes. GSEA results showed highly-expressed samples of three core genes were all enriched in the p53 signaling pathway in a validation dataset(P<0.0001). Expression of these three core genes were consistently higher in tumor tissue samples (P<0.0001) and liver cancer cell lines (P<0.05). However, transfection si-p53 and knock-out p53 liver cancer cell lines had lower expression (P<0.05). LncRNAs, including NEAT1, MALAT1, XIST, AC021078.1, and SNHG16, were identified by close interactions with core genes. Conclusions: CCNB1, CDK1, and RRM2 were enriched in the p53 signaling pathway and could be potential biomarkers and therapeutic targets for HBV-related HCC.
Patient with Multiple Rib Fractures Developed into Phrenic Hernia after Cardiopulmonary Resuscitation
Authors: Cheng Shaowen , Yang Jian , Peng Lei , Chen Yangping , Hu Zhihua
Published: December 2020

Phrenic hernia is a rare condition in patients with multiple rib fractures after cardiopulmonary resuscitation. We report a 28-year-old case of multiple injuries with multiple rib fractures who developed Phrenic hernia after cardiopulmonary resuscitation and underwent emergency surgery after sudden respiratory and cardiac arrest in ICU. This is the first report of Phrenic hernia after cardiopulmonary resuscitation after respiratory and cardiac arrest of multiple rib fractures in China.
‘Drinking and Dropping’: On Interacting with Plastic Pollution and Waste in South-Eastern Nigeria
Authors: Henderson Lesley , Dumbili Emeka W.
Published: December 2020

Nigeria is reported as having released up to 0.34 million tonnes of plastic debris into the ocean in 2010 and ranked ninth country in the world for pollution of the marine environment. It is a postcolonial, oil-rich country where plastic is cheap and widely available. Currently, there is no government policy regulating single-use plastic products. Previous studies have identified university student residential areas as ‘hot spots’ for plastic waste. We used qualitative methods (focus groups and semi-structured interviews) to explore how students made sense of their single use plastics consumption (including ‘pure water’ plastic sachets) and analysed how young Nigerians interact with plastic waste. Students perceived plastic waste as malodorous, causing harm to human health and blighting environmental aesthetics. Students saw themselves as the cause of plastic pollution (as consumers) whereas plastic industries were framed positively as producers bringing progress and prosperity. Participants were open about their indiscriminate littering practices subverting other study findings where responsibility tends to be deflected (to policy makers, producers). While we are relying on self-reported behaviour, we found no obvious link between awareness of environmental harm caused by plastic pollution and students’ actions. Within this peer group of young Nigerians, it was not considered ‘normal’ or ‘cool’ socially to use waste bins or recycle. We suggest that further research is needed into how plastic pollution is made sense of in terms of individual responsibility; lay understandings of miasmas; perceptions of public/private spaces and plastics as a signifier of modernity and enhanced social status.
A novel Chinese Medicine JY5 Formula Alleviates Hepatic Fibrosis Through Inhibiting Notch Signaling Pathway
Authors: Fu Yadong , Xiao Zhun , Tian Xiaoting , Liu Wei , Hu Yonghong , Fang Jing , Gao Siqi , Zhang Dingqi , Mu Yongping , Zhang Hua , Hu Yiyang , Huang Chenggang , Chen Jiamei , Liu Ping
Published: December 2020

Background: Advanced liver fibrosis can lead to cirrhosis, resulting in an accelerated risk of liver failure and hepatocellular carcinoma. It is necessary to develop an effective antifibrotic strategy. It has been reported that Fuzheng Huayu formula (FZHY) had a remarkable anti-hepatic fibrosis effect. Here, We obtain a new anti-fibrotic composition, which consists of the main active ingredients of FZHY formula and investigate its mechanism of pharmacological action.Methods: The main active ingredients of FZHY through the quantitative analysis in FZHY extracts and FZHY-treated plasma and liver in rats were investigated. The best anti-fibrotic composition of the main active ingredients was studied through the uniform design and validation experiments in vivo and its mechanism was evaluated in CCl4- and BDL-induced liver fibrosis models in rats and mice and TGF-β1-indued LX-2 cells activation model in vitro.Results：A novel composition, namely JY5 formula, which consisted of Salvianolic acid B, schisantherin A and amygdalin, the main active components of FZHY, could significantly alleviated hepatic hydroxyproline content and collagen deposition in CCl4- and BDL-induced fibrotic liver in rats and mice. Further studies showed that JY5 could inhibit the activation of hepatic stellate cells (HSCs) through inactivating Notch signaling in vivo and in vitro.Conclusions: We found a novel composition JY5 formula, which had an anti-hepatic fibrotic effect through inhibiting Notch signaling pathway, consequently suppressing HSCs activation. These results may provide some adequate scientific basis for the clinical research and application of JY5 formula, as a potential new therapeutic candidate for liver fibrosis.
Waist-to-Height Ratio, Waist Circumference, Body Mass Index and Risk of Cardiometabolic Multimorbidity: A National Longitudinal Cohort Study
Authors: Lu Yanqiang , Liu Siyuan , Qiao Yanan , Li Guochen , Wu Ying , Ke Chaofu
Published: December 2020

Background: Cardiometabolic multimorbidity is an increasing public health burden. This study aimed to evaluate the association of waist-to-height ratio (WHtR), waist circumference (WC) and body mass index (BMI) with risk of cardiometabolic multimorbidity.Methods: We used data from the China Health and Retirement Longitudinal Study (CHARLS). 10521 participants aged 45 and over were recruited, including 8807 individuals with 0 cardiometabolic disease at baseline (stage Ⅰ) and 1714 individuals with 1 cardiometabolic disease at baseline (stage Ⅱ). Logistic regression was conducted to estimate the odds ratios (ORs) and confidence intervals (CIs). Net reclassification index (NRI) and integrated discrimination improvement (IDI) were used to evaluate the incremental predictive value beyond conventional factors.Results: In stage Ⅰ, increased risk of cardiometabolic multimorbidity was observed among participants with WHtR ≥ 0.5 (OR: 1.76, 95% CI: 1.05–2.97), WC ≥ 85 (men) + WC ≥ 75 (women) (OR: 1.77, 95% CI: 1.05–2.97) or BMI ≥ 24 (OR: 1.48, 95% CI: 0.98–2.24). Furthermore, both NRI and IDI of WHtR and WC were higher than those of BMI. In stage Ⅱ, the adjusted ORs (95% CIs) of WHtR ≥ 0.5, WC ≥ 85 (men) + WC ≥ 75 (women), and BMI ≥ 24 were 2.04 (1.24–3.35), 2.07 (1.28–3.34), and 1.47 (1.06–2.04), respectively. In addition, WC exhibited the highest NRI and IDI.Conclusions: WHtR, WC and BMI are independent predictors of cardiometabolic multimorbidity in middle-aged and elderly Chinese population. WHtR and WC show better abilities in predicting cardiometabolic multimorbidity than BMI.
A methodological review protocol of the use of Bayesian factor analysis in primary care research
Authors: Zhang Hao , Schuster Tibor
Published: December 2020

Background : The development of questionnaires for primary care practice and research is of increasing interest in the literature. In settings where valuable prior knowledge or preliminary data is available, Bayesian factor analysis can be used to incorporate such information when conducting questionnaire construct validation. This protocol outlines a methodological review that will summarize evidence on the current use of Bayesian factor analysis in the primary care literature.
Methods : A comprehensive search strategy has been developed and will be used to identify relevant literature (research studies in primary care) indexed in Medline, Scopus, EMBASE, CINAHL and Cochrane Library. The search strategy includes terms and synonyms for Bayesian factor analysis and primary care. The reference lists of relevant articles being identified will be screened to find further relevant studies. At least two reviewers will independently extract data and resolve discrepancies through consensus. Descriptive analyses will summarize the use and reporting of Bayesian factor analysis approaches for validating questionnaires applicable to primary care.
Discussion: This methodological review will provide a comprehensive overview of the current use and reporting of Bayesian factor analysis in primary care and will provide recommendations for its proper future use.
Risk Factors For Severity Of Thrombocytopenia In Full Term Infants: A Single Center Study
Authors: Saber Amira M , Aziz Shereen P , Almasry Al Zahraa E , Mahmoud Ramadan A
Published: December 2020

Background: Neonatal thrombocytopenia (NT) (platelet count <150 x 109/L) is a common finding in the neonatal intensive care unit (NICU). The main aim of this study was to assess the prevalence, risk factors, and outcomes of severe NT in full term (FT) infants.Methods: During the study period, all FT infants who met the inclusion criteria for NT on two occasions were included. Maternal data, such as maternal age, weight, gestational age, mode of delivery, and history of systemic diseases, including diabetes mellitus, pre-eclampsia, systemic lupus erythematosus, and immune thrombocytopenic purpura, were recorded. Furthermore, neonatal data, such as gender, neonatal weight, causes/duration of admission, types of respiratory support used, complete blood count measurements, and outcomes for neonates admitted to the NICU, were recorded.Results: In total, 55 FT infants with NT met the inclusion criteria, and 29 (52.73%) cases had severe NT. The most common cause of NT was neonatal sepsis (20 cases, 36.35%), followed by a postoperative state (5 cases, 9.09%). Moreover, in cases of positive blood cultures, the most commonly isolated organism was Escherichia coli (6 cases, 10.90%), followed by Klebsiella (5 cases, 9.09%). Cases of severe NT needed more platelet transfusions (P=0.001) and had higher rates of mortality (P=0.001) when compared to cases of mild/moderate NT associated with signs of bleeding and pulmonary/intraventricular hemorrhage (IVH) (P=0.001).Conclusion: Severe NT compared to mild/moderate NT, associated with signs of bleeding and pulmonary/IVH, needed more platelet transfusions, and had increased mortality. Further research is needed to explain which of these complications related to severity of thrombocytopenia or were associated with original disease of the babies.
Limited effects from professional identity formation-oriented intervention on self-regulated learning in a preclinical setting: a randomized-controlled study in Japan
Authors: Matsuyama Yasushi , Nakaya Motoyuki , Leppink Jimmie , Vleuten Cees van der , Asada Yoshikazu , Lebowitz Adam Jon , Sasahara Teppei , Yamamoto Yu , Matsumura Masami , Gomi Akira , Ishikawa Shizukiyo , Okazaki Hitoaki
Published: December 2020

Background: Developing self-regulated learning in preclinical settings is important for future lifelong learning. Previous studies indicate professional identity formation, i.e., formation of self-identity with internalized values and norms of professionalism, might promote self-regulated learning．We designed a professional identity formation-oriented reflection and learning plan format, then tested effectiveness on raising self-regulated learning in a preclinical year curriculum. Methods: A randomized controlled crossover trial was conducted using 112 students at Jichi Medical University. In six one-day problem-based learning sessions in a 7-month pre-clinical year curriculum, Groups A (n = 56, female 18, mean age 21.5y ± 0.7) and B (n = 56, female 11, mean age 21.7y ± 1.0) experienced professional identity formation-oriented format: Group A had three sessions with the intervention format in the first half, B in the second half. Between-group identity stages and self-regulated learning levels were compared using professional identity essays and the Motivated Strategies for Learning Questionnaire.Results: Two-level regression analyses showed no improvement in questionnaire categories but moderate improvement of professional identity stages over time (R2 = 0.069), regardless of timing of intervention. Conclusions: Professional identity moderately forms during the pre-clinical year curriculum. However, neither identity nor self-regulated learning is raised significantly by limited intervention.
Comparison of percutaneous cross screw fixation versus open reduction and internal fixation for pelvic Day type II crescent fracture-dislocation: Case-control study
Authors: Xiang Guangheng , Dong Xiaoyu , Jiang Xingan , Cai Leyi , Wang Jianshun , Guo Xiaoshan , Xiao Jian , Feng Yongzeng
Published: December 2020

Objective: To investigate the clinical outcomes of percutaneous cross screws internal fixation for pelvic Day type II crescent fracture-dislocation.Methods: We reviewed 66 consecutive patients undergoing surgical treatment for Day type II crescent fracture-dislocation from June 2005 to December 2017. Percutaneous cross screws internal fixation was performed in 40 patients, and open reduction and internal fixation was performed in 26 patients. The patient characteristics, surgical complications, radiographic and clinical outcomes and were compared.Results: There was no statistically difference on the mean time from injury to surgery between the two groups. The time of operation, the amount of blood loss, the length of incision and the hospital stay were significantly shorter in the percutaneous cross screws internal fixation Group. No significant difference on Matta scores and Majeed scores between the two groups. The open reduction and internal fixation Group resulted in a higher rate of intraoperative hemorrhage, nerve injury, discomfort and pain.Conclusion: Percutaneous cross screws internal fixation for Day Ⅱ type pelvic crescent fracture-dislocation was safe and effective. Minimally invasive fixation had the advantages of short operation and hospitalization time, less intraoperative bleeding and surgical trauma.
Simulation-based mastery improved nursing skills in BSc Nursing Students: a quasi-experimental study
Authors: Mehdipour-Rabori Roghaye , Bagherian Behnaz , Nematollahi Monirsadat
Published: December 2020

Background: Clinical education is an essential part of nursing education. Selected clinical teaching methods influence the quality of education. Simulation-based mastery learning has been used to improve clinical skills among nursing students and may provide a novel way to enhance nursing skills. This study aimed to assess the effect of simulation-based mastery learning on the clinical skills of undergraduate nursing students from 2017 to 2019.Methods: This quasi-experimental study was conducted with two groups (the control and intervention). A hundred and five students were selected by random convenience sampling, and written consent was obtained. The intervention group participated in a simulation-based mastery learning intervention, and the control group received no intervention except for traditional training. The students of both groups completed the demographic information questionnaire and the checklist before and after the intervention. The results were analyzed by SPSS version 21 and descriptive and inferential statistics.Results: The results showed no significant differences between the two groups before the intervention (p> 0.05). In addition, students' performance in the intervention and control groups improved significantly at the post-test compared with the baseline (p<0.05). Furthermore, the Cohen test implied that the simulation-based mastery model used by the intervention group was significantly more effective than the traditional training used by the control.Conclusion: These findings showed that mastery learning was more effective in improving clinical skills in undergraduate nursing students. The results suggest that other nursing and health programs can be developed by implementing a mastery-based learning model.
Outcome of a single XEN microstent implant for glaucoma patients with different types of glaucoma
Authors: Schargus Marc , Teilig Therese , Rehak Matus , Busch Catharina , Bormann Caroline , Unterlauft Jan Darius
Published: December 2020

Background The aim of this retrospective study was to compare the efficacy and safety profile of a single XEN-microstent in different types of primary and secondary open angle glaucoma.Methods A single XEN microstent was implanted in patients with primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG), pseudoexfoliation glaucoma (PEX) and secondary glaucoma (Sec.Gl). The intraocular pressure (IOP), the active substances of the applied IOP-lowering drugs, the best corrected visual acuity (BCVA) and the mean deviation (MD) of the perimetry were measured at baseline and at regular follow-ups, scheduled at 2 days and 1, 3, 6 and 12 months after surgery.Results 153 eyes were included in this analysis. 113 eyes were affected by POAG (74%), 5 eyes by NTG (3%), 22 eyes by PEX (14%) and 13 eyes by Sec.Gl (9%). Mean IOP decreased in all treatment groups during the 12 months of follow-up (complete group: 23.9±7.4 to 15.4±5.1 mmHg (p<0.01); POAG: 22.8±6.5 to 15.1±4.6 mmHg (p<0.01); NTG: 16.6±3.4 to 11.6±2.2 mmHg (p<0.05); PEX: 28.0±7.9 to 17.1±6.6 mmHg (p<0.01); Sec.Gl: 28.9±13.9 to 15.5±6.9 mmHg (p<0.05)). In the 153 eyes the average number of IOP-lowering drugs applied decreased from 2.6±1.2 to 0.8±1.3 12 months after surgery (p<0.01). BCVA and mean deviation of automated standard perimetry remained stable in all groups during follow-up.Conclusion As in eyes suffering from POAG, IOP and number of IOP-lowering drugs applied can be effectively reduced by XEN implantation in eyes suffering from NTG, PEX and secondary glaucoma while leaving BCVA and visual field unchanged. Trial registration Trial was registered at DRKS (registration number: DRKS00020800, Registered 25.February 2020 - Retrospectively registered, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00020800)
Age is not the only risk factor in COVID-19: the role of comorbidities and of long staying in residential care homes.
Authors: D'Ascanio Michela , Innammorato Marta , Pasquariello Lara , Pizzirusso Dario , Guerrieri Giulio , Castelli Silvia , Pezzuto Aldo , De Vitis Claudia , Anibaldi Paolo , Marcolongo Adriano , Mancini Rita , Ricci Alberto , Sciacchitano Salvatore
Published: December 2020

Background: The actual SARS-CoV-2 outbreak caused a highly transmissible disease with a tremendous impact on elderly people. So far, few studies focused on very elderly patients (over 80 years old). In this study we examined the clinical presentation and the outcome of the disease in this group of patients, admitted to our Hospital in RomeMethods: This is a single-center, retrospective study performed in the Sant’Andrea University Hospital of Rome. We included patients older than 65 years of age with a diagnosis of COVID-19, from March 2020 to May 2020, divided in two groups according to their age (Elderly: 65-80 years old; Very Elderly >80 years old). Data extracted from the each patient record included age, sex, comorbidities, symptoms at onset, the Pneumonia Severity Index (PSI), the ratio of the partial pressure of oxygen in arterial blood (PaO2) to the inspired oxygen fraction (FiO2) (P/F) on admission, laboratory tests, radiological findings on computer tomography (CT), length of hospital stay (LOS), mortality rate and the viral shedding. The differences between the two groups were analyzed by the Fisher’s exact test or the Wilcoxon signed-rank test for categorical variables and the Mann-Whitney U test for continuous variables. To assess significance among multiple groups of factors, we used the Bonferroni correction. The survival time was estimated by Kaplan-Meier method and Log Rank Test. Univariate and Multivariate logistic regression were performed to estimate associations between age, comorbidities, provenance from long-stay residential care homes (LSRCH)s and clinical outcomes. Results: We found that Very Elderly patients had an increased mortality rate, also due to the frequent occurrence of multiple comorbidities. Moreover, we found that patients coming from LSRCHs appeared to be highly susceptible and vulnerable to develop severe manifestations of the disease. Conclusion: We demonstrate that there were considerable differences between Elderly and Very Elderly patients in terms of inflammatory activity, severity of disease, adverse clinical outcomes. To establish a correct risk stratification, comorbidities and information about provenience from LSRCHs should be considered.
Epidemiologic profile of viral hepatitis B and C in North of Iran: Results from PERSIAN Guilan Cohort Study (PGCS)
Authors: Mansour-Ghanaei Fariborz , Joukar Farahnaz , Naghipour Mohammadreza , Hassanipour Soheil , Yeganeh Sara , Sepehrimanesh Masood , Fathalipour Mohammad
Published: December 2020

Objective: Hepatitis B (HBV) and C (HCV) viruses are two severe infectious diseases with a high global health impact. This study aimed to evaluate the prevalence of HBV and HCV in the Prospective Epidemiological Research Studies of the Iranian Adults (PERSIAN) Guilan Cohort Study through immunological and molecular methods.
Results: The blood samples were obtained from 10520 enrolled participants. Complete biochemical and hematological assessments plus urine analysis were done. The presence of HBsAg, anti-HBs, anti-HBc, and anti-HCV antibodies for all participants and HBeAg and anti-HBe antibody for HBV positive patients were evaluated. HBV genomic DNA and HCV genomic RNA were extracted from positive serum samples. The real-time PCR assay was done to quantify HBV and HCV genomes. HCV genotyping was also performed. The HBV and HCV prevalence was 0.24% (95% CI, 0.16 % to 0.35%) and 0.11% (95% CI, 0.06 % to 0.19%), respectively. Rural participants were significantly more HBV positive than urban peoples (P=0.045) while male individuals were significantly more HCV positive than female participants (P=0.013). Our detected HBV and HCV prevalence were lower than other cities/provinces of Iran, which may be due to lifestyle or other unknown reasons.
Baidu Jieduan granule, traditional Chinese medicine, in the treatment of moderate coronavirus disease-2019 (COVID-19): study protocol for an open-label randomized controlled clinical trial
Authors: Zhang Wen , Xie Qin , Xu Xiaoming , Sun Shuting , Fan Tian , Wu Xinxin , Qu Yao , Che Jinhua , Huang Tingrong , Li Huacheng , Zheng You , Jiang Chao , Fang Bangjiang , Zhou Shuang
Published: December 2020

Background: Currently, coronavirus disease-2019 (COVID-19) is continuously and rapidly circulating, resulting in serious and extensive impact on human health. Due to the absence of antiviral medicine for COVID-19 thus far, it is desperately need to develop the effective medicine. Traditional Chinese medicine (TCM) has been widely applied in the treatment of epidemic diseases in China, hoping to produce clinical efficacy and decrease the use of antibiotics and glucocorticoid. The aim of this study is to evaluate the efficacy and safety of Baidu Jieduan granule in curing COVID-19. Methods/design: This multicenter, open-label randomized controlled trial is conducted 300 cases with COVID-19. The patients will be randomly (1:1) divided into treatment group or control group. All cases will receive standard therapy at the same time. The experiment group will receive Baidu Jieduan granule treatment twice a day for 14 days. The outcomes are assessed at baseline and at 3, 5, 7, 14 days after treatment initiation. The primary outcome is the rate of symptom (fever, fatigue, and coughing) recovery. Adverse events (AEs) will be monitored throughout the trial.Discussion: The study will provide a high-quality clinical evidence to support the efficacy and safety of Baidu Jieduan granule in treatment of moderate COVID-19, and also enrich the theory and practice of TCM in treating COVID-19. Trial registration: Chinese Clinical Trial Registry, ChiCTR2000029869. Registered on 15 February 2020