bluuebunny/crossref_metadata_2025 huggingface dataset:
Reconstruction of an iatrogenic anterior conchal defect with a revolving-door flap
Authors: Liu Xiaofeng , Zhou Tongkui , Zhao Tianlan , Xu Zhicheng
Published: January 2021

Background

Auricular concha has been widely used as a supporting material in rhinoplasty or repairing of auricular defects. However, complications, trauma or iatrogenic excision often result in concha defects which destroy the normal structure of the external ear and further influence daily life. Local flaps are often applied to repair the defects because of their safety and satisfactory functional and aesthetic results.

Case presentation

We report a 24-year-old female who presented with a concha defect that resulted from a complication of concha cartilage graft for rhinoplasty. The anterior concha defect was covered by a revolving-door (RD) flap as a single-stage procedure. The aesthetic and functional outcomes were satisfactory at 6 months post operation.

Conclusion

We recommend the RD flap as an excellent choice for conchal defect reconstruction. Satisfactory aesthetic and functional results can be achieved by this easy-to-learn technique in relatively short surgical time.
Implementation of a beating heart system for training in off-pump and minimally invasive coronary artery bypass
Authors: Yasuda Shota , Van den Eynde Jef , Vandendriessche Katrien , Masuda Munetaka , Meyns Bart , Oosterlinck Wouter
Published: January 2021

Background

Several training devices have been developed to train anastomotic skills in off-pump coronary artery bypass grafting (OPCAB). However, assessment of trainees’ improvement remains challenging. The goal of this study was to develop a new practical scoring chart and investigate its reliability and utility for anastomotic skills in OPCAB and minimally invasive direct coronary artery bypass (MIDCAB).

Methods

A training device was used, which included a beating heart model installed in a dedicated box. A soft plastic tube was used as the left anterior descending artery, and a porcine ureter was used as the left internal mammary artery. Five cardiac surgery fellows (Fellows, > 5 year of surgical experience) and five residents or medical students (Residents, ≤ 5 year of surgical experience) were enrolled for this study. Before and after training, skills were evaluated using a scoring chart that took into account anastomotic time, leakage, shape, flow measurement, and self-estimation.

Results

Mean total score of all trainees was 15.4 ± 4.0 at pre-training and 18.5 ± 2.4 at post-training (P = 0.05). Before training, there was a significant difference in the total score between Fellows and Residents (18.6 ± 2.2 vs 12.2 ± 2.4 points, P = 0.002), which disappeared after training (19.4 ± 2.5 vs 17.6 ± 2.2 points, P = 0.262). Residents benefitted from training with improvements in their time, total score, score for time, score for flow and subtraction score; however, these effects were not seen in Fellows. The most evident training effect was improvement of self-estimation, which was also seen in Fellows.

Conclusions

Residents were most likely to derive benefit from these training models with regard to both efficiency and quality. Training models seem to have an important role in making surgeons feel more comfortable with the procedure.
Prognostic factors in patients who underwent surgery for common peroneal nerve injury: a nest case–control study
Authors: Liu Zhenhui , Yushan Maimaiaili , Liu Yanshi , Yusufu Aihemaitijiang
Published: January 2021

Background

Common peroneal nerve (CPN) injury is one of the most common nerve injuries in the lower extremities and the motor functional recovery of injured common peroneal nerve (CPN) was often unsatisfactory, the mechanism of which is still controversial. The purpose of this retrospective study was to determine the prognostic factors in patients who underwent surgery for CPN injury and provide a tool for clinicians to assess the patients’ prognosis.

Methods

This is a retrospective cohort study of all patients who underwent neural exploration for injured CPN from 2009 to 2019. A total of 387 patients with postoperative follow-up more than 12 months were included in the final analysis. We used univariate logistics regression analyses to explore explanatory variables which were associated with recovery of neurological function. By applying multivariable logistic regression analysis, we determined variables incorporated into clinical prediction model, developed a nomogram by the selected variables, and then assessed discrimination of the model by the area under the curve (AUC) of the receiver operating characteristic (ROC) curve.

Results

The case group included 67 patients and the control group 320 patients. Multivariate logistic regression analysis showed that area (urban vs rural, OR = 3.35), occupation(“blue trouser” worker vs “white-trouser” worker, OR = 4.39), diabetes (OR = 11.68), cardiovascular disease (OR = 51.35), knee joint dislocation (OR = 14.91), proximal fibula fracture (OR = 3.32), tibial plateau fracture (OR = 9.21), vascular injury (OR = 5.37) and hip arthroplasty (OR = 75.96) injury increased the risk of poor motor functional recovery of injured CPN, while high preoperative muscle strength (OR = 0.18) and postoperative knee joint immobilization (OR = 0.11) decreased this risk of injured CPN. AUC of the nomogram was 0.904 and 95% CI was 0.863–0.946.

Conclusions

Area, occupation, diabetes, cardiovascular disease, knee joint dislocation, proximal fibula fracture, tibial plateau fracture, vascular injury and hip arthroplasty injury are independent risk factors of motor functional recovery of injured CPN, while high preoperative muscle strength and postoperative knee joint immobilization are protective factors of motor functional recovery of injured CPN. The prediction nomogram can provide a tool for clinicians to assess the prognosis of injured CPN.
Personality traits, psychosocial effects and quality of life of patients submitted to dental bleaching
Authors: Bonafé Elize , Rezende Márcia , Machado Marina Molinari , Lima Suellen Nogueira Linares , Fernandez Eduardo , Baldani Marcia M. P. , Reis Alessandra , Loguercio Alessandro Dourado , Bandeca Matheus Coelho
Published: January 2021

Background

Perception is defined as the ability to distinguish through the senses. All perception is dependent on factors such as personality, previously lived experiences and cultural elements. When planning an aesthetic treatment, consider the way the patients perceive the changes and outcomes is essential for reaching their expectations. The objective of this study was to assess if there was predominance of a personality trait of patient undergoing dental bleaching and if this treatment could promote changes in this traits, in the psychosocial impact and quality of life of these individuals.

Methods

The assessment of personality characteristics, quality of life, psychosocial and self-perception was a cross-sectional observational study and it was carried out by applying questionnaires to 55 patients that were submitted to a clinical phase. The psychometric instruments used were NEO FFI-R (personality), PIDAQ (psychosocial effect) and WHOQOL-BREF (quality of life). Each test domain was prior and after bleaching by Wilcoxon Signed Rank test (α = 0.05). The internal consistencies of each scale were evaluated by Cronbach's alpha.

Results

No statistical significant differences among personality traits means were observed among participants but there was predominance of two predominant personality traits in this study: conscientiousness (45.5%) and extraversion (34.5%). In four test domains of the PIDAQ, significant differences were observed before and after dental bleaching. The overall perception of the PIDAQ was also statistically significant demonstrating an improvement. There were no differences on overall or specific domains scores of the WHOQOL before and after treatment.

Conclusions

Subjects who underwent dental treatment improved their self-confidence and reduced concerns about dental aesthetics, social and personality impact of dental alterations.

Trial registration

This study was conducted in parallel to a clinical investigation that aimed to evaluate tooth sensitivity related to dental bleaching technique and registered in REBEC clinical registry under protocol RBR-6pt2n3 in 13 November 2013.
The role of research in improving responsiveness of palliative care to migrants and other underserved populations in the Netherlands: a qualitative interview study
Authors: Torensma M. , Onwuteaka-Philipsen B. D. , de Voogd X. , Willems D. L. , Suurmond J. L.
Published: January 2021

Background

The aging of migrant populations across Europe challenges researchers in palliative care to produce knowledge that can be used to respond to the needs of the growing group of patients with a migration background and address ethnic disparities in palliative care. The aim of this study was to identify what factors influence researchers’ efforts to address responsiveness of palliative care to patients with a migration background and other underserved populations in their projects.

Methods

We conducted semi-structured interviews with 11 researchers involved in seven projects under the Dutch national program for palliative care innovation.

Results

Researchers’ efforts to address responsiveness of palliative care in their projects were influenced by individual factors, i.e. awareness of the need for responsiveness to patients with a migration background; experience with responsiveness; and, differences in perceptions on responsiveness in palliative care. Researchers’ efforts were furthermore influenced by institutional factors, i.e. the interaction with healthcare institutions and healthcare professionals as they rely on their ability to identify the palliative patient with a migration background, address the topic of palliative care, and enrol these patients in research; scientific standards that limit the flexibility needed for responsive research; and, the responsiveness requirements set by funding agencies.

Conclusion

Researchers play a key role in ensuring research addresses responsiveness to patients with a migration background. Such responsiveness may also benefit other underserved populations. However, at times researchers lack the knowledge and experience needed for responsive research. To address this we recommend training in responsiveness for researchers in the field of palliative care. We also recommend training for healthcare professionals involved in research projects to increase enrolment of patients with a migration background and other underrepresented populations. Lastly, we encourage researchers as well as research institutions and funding agencies to allow flexibility in research practices and set a standard for responsive research practice.
Arabic translation, cultural adaptation, and validation of Australian Pelvic Floor Questionnaire in a Saudi population
Authors: Malaekah Haifaa , Al Medbel Haifaa Saud , Al Mowallad Sameerah , Al Asiri Zahra , Albadrani Alhanouf , Abdullah Hussam
Published: January 2021

Introduction and hypothesis

The aims of the study were the translation, cultural adaptation, and validation of self-administered Australian Pelvic Floor Questionnaire (APFQ) on a Saudi population.

Methods

The translation and cultural adaptation was performed in 854 women over 18 and not pregnant who agreed to answer the Arabic version of the questionnaire. The content/face validity, internal consistency (reliability), and construct validity (factor analysis) were assessed. Statistical analysis was carried out using SPSS 24.0 statistical software.

Results

The Cronbach’s alpha results were above 0.8 for the questionnaire’s overall reliability (bladder function: 0.877, bowel function: 0.834, prolapse symptoms: 0.784, sexual function: 0.762) showing adequate internal consistency reliability and high statistical significance. A statistically significant correlation was observed among the 40 items of the questionnaire. The issue of multicollinearity was not found, and the determinant of the correlation matrix was 0.001. A value of > 0.5 was achieved when the Kaiser–Meyer–Olkin and Bartlett’s tests measured 0.806 and the Bartlett’s test of sphericity was statistically significant χ2 (780) = 4150.46 (p < 0.001). The values of loading indicate that all 4 factors (bladder function, bowel function, prolapse symptoms, sexual function) contributed to each of their items.

Conclusions

This study provides the Arabic version of the self-administered APFQ as a reliable and valid instrument for evaluating symptom severity and impact of pelvic floor dysfunction on the quality of life of Arabic women. It also will enable the researchers from Arab countries to use this instrument to assess pelvic floor dysfunction prevalence in their settings.
Designing health professional education curricula using systems thinking perspectives
Authors: Khanna Priya , Roberts Chris , Lane Andrew Stuart
Published: January 2021

Background

Medical students navigate complex personal learning pathways from entry into medical school, through an educational program, and into life-long practice. However, many stakeholders have called for substantive reforms in contemporary curricula, citing concerns about the lack of key abilities amongst newly graduated doctors to work in complex healthcare environments. Despite the need for educators to focus on curricula design, there is a paucity of overarching perspectives that allow synthesis of the various curricular elements in a way that lends meaningfulness and appreciation to the students in terms of navigating the immediate program requirements and beyond. Without such guidance, educators risk creating fragmented program designs that can lead to both unintended and unactionable outcomes for students as well as curriculum designers. Using systems thinking, we set out to address this gap by providing an overarching perspective for curriculum designers to appreciate the relationships and the interactions of the various curricular elements that inform and impact student’s preparedness for practice.

Methods

By framing a curriculum as a complex adaptive system, we used soft systems thinking to develop an initial prototype of a conceptual curricular toolkit, underpinned by an appraisal of relevant literature within health professional education and the broader educational context. The prototype was further refined iteratively after critical reflection by the authors with a diverse range of national and international colleagues via posters, short communications, and workshops at several conferences, and through social media.

Results

We describe how the 3P-6Cs toolkit captures a learner’s personal journey through an educational program into a field of practice by logically linking the three key elements: the personal, the program, and the practice. We demonstrate its application in three examples related to contemporary health profession education curricula. These are: creating integrated educational designs to capture students’ developmental continua, conceptualising immersive clinical placements in non-traditional settings, and complexity-consistent evaluation of curricular interventions.

Conclusion

Applying the 3P-6Cs curricular toolkit to problems of curricula (re)design can provide overarching perspectives that enable educators to have a better understanding of how integration of elements within education programs can inform and impact student’s preparation for lifelong practice.
Development and launch of the first obstetrics and gynaecology master of medicine residency training programme in Botswana
Authors: Luckett R. , Nassali M. , Melese T. , Moreri-Ntshabele B. , Moloi T. , Hofmeyr G. J. , Chobanga K. , Masunge J. , Makhema J. , Pollard M. , Ricciotti H. A. , Ramogola-Masire D. , Bazzett-Matabele L.
Published: January 2021

Background

Sub-Saharan Africa (SSA) faces a severe shortage of Obstetrician Gynaecologists (OBGYNs). While the Lancet Commission for Global Surgery recommends 20 OBGYNs per 100,000 population, Botswana has only 40 OBGYNs for a population of 2.3 million. We describe the development of the first OBGYN Master of Medicine (MMed) training programme in Botswana to address this human resource shortage.

Methods

We developed a 4-year OBGYN MMed programme at the University of Botswana (UB) using the Kern’s approach. In-line with UB MMed standards, the programme includes clinical apprenticeship training complemented by didactic and research requirements. We benchmarked curriculum content, learning outcomes, competencies, assessment strategies and research requirements with regional and international programmes. We engaged relevant local stakeholders and developed international collaborations to support in-country subspecialty training.

Results

The OBGYN MMed curriculum was completed and approved by all relevant UB bodies within ten months during which time additional staff were recruited and programme financing was assured. The programme was advertised immediately; 26 candidates applied for four positions, and all selected candidates accepted. The programme was launched in January 2020 with government salary support of all residents. The clinical rotations and curricular development have been rolled out successfully. The first round of continuous assessment of residents was performed and internal programme evaluation was conducted. The national accreditation process was initiated.

Conclusion

Training OBGYNs in-country has many benefits to health systems in SSA. Curricula can be adjusted to local resource context yet achieve international standards through thoughtful design and purposeful collaborations.
Women’s viewpoints on egg freezing in Austria: an online Q-methodology study
Authors: Kostenzer Johanna , de Bont Antoinette , van Exel Job
Published: January 2021

Background

Egg freezing has emerged as a technology of assisted reproductive medicine that allows women to plan for the anticipated loss of fertility and hence to preserve the option to conceive with their own eggs. The technology is surrounded by value-conflicts and is subject to ongoing discussions. This study aims at contributing to the empirical-ethical debate by exploring women’s viewpoints on egg freezing in Austria, where egg freezing for social reasons is currently not allowed.

Methods

Q-methodology was used to identify prevailing viewpoints on egg freezing. 46 female participants ranked a set of 40 statements onto a 9-column forced choice ranking grid according to the level of agreement. Participants were asked to explain their ranking in a follow-up survey. By-person factor analysis was used to identify distinct viewpoints which were interpreted using both the quantitative and the qualitative data.

Results

Three distinct viewpoints were identified:(1) “women should decide for themselves”,(2) “we should accept nature but change policy”, and (3) “we need an informed societal debate”. These viewpoints provide insights into how biomedical innovations such as egg freezing are perceived by women in Austria and illustrate the normative tensions regarding such innovations.

Conclusions

Acknowledging the different prioritizations of values regarding assisted reproductive technologies is important to better understand the underlying normative tensions in a country where egg freezing for social reasons is currently not allowed. The study adds new empirical insights to the ongoing debate by outlining and discussing viewpoints of those directly affected: women. Following up on the lay persons perspective is particularly important in the context of future biomedical innovations that may challenge established norms and create new tensions. It therefore also adds to the societal debate and supports evidence-informed policy making in that regard.
An innovative strategy for standardized, structured, and interoperable results in ophthalmic examinations
Authors: Mun Yongseok , Kim Jooyoung , Noh Kyoung Jin , Lee Soochahn , Kim Seok , Yi Soyoung , Park Kyu Hyung , Yoo Sooyoung , Chang Dong Jin , Park Sang Jun
Published: January 2021

Background

Although ophthalmic devices have made remarkable progress and are widely used, most lack standardization of both image review and results reporting systems, making interoperability unachievable. We developed and validated new software for extracting, transforming, and storing information from report images produced by ophthalmic examination devices to generate standardized, structured, and interoperable information to assist ophthalmologists in eye clinics.

Results

We selected report images derived from optical coherence tomography (OCT). The new software consists of three parts: (1) The Area Explorer, which determines whether the designated area in the configuration file contains numeric values or tomographic images; (2) The Value Reader, which converts images to text according to ophthalmic measurements; and (3) The Finding Classifier, which classifies pathologic findings from tomographic images included in the report. After assessment of Value Reader accuracy by human experts, all report images were converted and stored in a database. We applied the Value Reader, which achieved 99.67% accuracy, to a total of 433,175 OCT report images acquired in a single tertiary hospital from 07/04/2006 to 08/31/2019. The Finding Classifier provided pathologic findings (e.g., macular edema and subretinal fluid) and disease activity. Patient longitudinal data could be easily reviewed to document changes in measurements over time. The final results were loaded into a common data model (CDM), and the cropped tomographic images were loaded into the Picture Archive Communication System.

Conclusions

The newly developed software extracts valuable information from OCT images and may be extended to other types of report image files produced by medical devices. Furthermore, powerful databases such as the CDM may be implemented or augmented by adding the information captured through our program.
Student nurses’ knowledge acquisition on oral medication administration: comparison of lecture demonstration vs. video demonstration
Authors: Sugathapala Ravilal Devananda Udeshika Priyadar , Chandrika Mattaka Gamage Ruwini
Published: January 2021

Background

Oral Medication administration is one of the paramount nursing procedures, where nurses must pay their utmost commitment. The vital aims are to reduce medication errors and ensure patient safety. The objectives of this study were to evaluate whether the nursing students could learn and retain the basic guidelines for oral medication administration when they are taught using a video-assisted teaching method compared with the lecture-demonstration method and to assess the students’ attitudes towards the two types of teaching methods.

Methods

This study was conducted as a quasi-experimental study with a pre and post-test design. Forty-five students in the first year of the bachelor’s degree in nursing programme participated. All the participants completed a self- administered questionnaire, including socio demographic data and questions of oral medication administration. Subsequently, participants were randomly assigned to two groups. Oral medication administration procedure was taught using two different teaching methods. Finally, the post-test knowledge scores of both groups were assessed and analysed using the paired-sample t-test.

Results

The results revealed that there was no significant difference in terms of age, gender and type of residence of students in the two groups. When comparing the pre-test mean score and post-test mean score using paired sample t-test, there was a statistically significant difference in both video demonstration group (t = − 4.533, p < 0.001) and lecture-demonstration group (t = − 4.208, p < 0.001). Almost all the students obtained good knowledge scores regardless of the method used in teaching oral medication administration. However, when comparing post-test scores of both groups using an independent sample t-test, it was identified that there was no significant difference between the two groups. Therefore, it was difficult to identify which method was effective than the other. According to the student feedback obtained at the end of the study, 67% of them preferred to have more video demonstrations in their skills classes.

Conclusion

The results of this study suggested that oral medication administration can be effectively taught using lecture-demonstration and video-demonstration teaching methods.
Nurses’ and midwives’ knowledge, attitudes, and acceptance regarding human papillomavirus vaccination in Ghana: a cross-sectional study
Authors: Ebu Nancy Innocentia , Abotsi-Foli Gifty Esinam , Gakpo Doreen Faakonam
Published: January 2021

Background

Nurses and midwives play important roles in educating the public on cervical cancer prevention strategies.

Aim

This study sought to assess nurses’ and midwives’ knowledge of, attitudes towards, and acceptance of human papillomavirus (HPV) vaccination in relation to their background characteristics.

Methods

A descriptive cross-sectional study using questionnaires was conducted with a convenience sample of 318 female nurses and midwives, ages 20 to 59, at the Korle-Bu Teaching Hospital in Ghana. The data were summarised using frequencies, percentages, chi-square tests, and Fisher’s exact tests.

Results

The results indicated that 41.5% (n = 132) of the participants had high levels of knowledge about cervical cancer risk factors, and 17.6% (n = 56) of the respondents had received at least one dose of the HPV vaccine. Reasons for receiving the HPV vaccination included advice from a colleague (12.9%, n = 41) and perceived threat of cervical cancer (11.7%, n = 37). Of the 262 respondents who had not been vaccinated, 24.45% (n = 78) strongly agreed and 28.0% (n = 89) agreed with the statement that there was limited information on HPV vaccination. Also, there were statistically significant associations between age (X2 = 23.746, p = 0.001), marital status (X2 = 14.758, p = 0.005), completed level of education (X2 = 21.692, p = 0.001), and duration of working at the hospital (X2 = 8.424, p = 0.038) and acceptance of HPV vaccination.

Conclusions

This study demonstrated gaps in knowledge about cervical cancer risk factors and attitudes towards HPV vaccination, indicating the need for targeted measures to improve knowledge and attitudes. Also, measures to increase acceptance of HPV vaccination among nurses and midwives should consider their sociodemographic characteristics.
Framing global discourses on non-communicable diseases: a scoping review
Authors: Tan Melisa Mei Jin , Han Emeline , Shrestha Pami , Wu Shishi , Shiraz Farah , Koh Gerald Choon-Huat , McKee Martin , Legido-Quigley Helena
Published: January 2021

Background

The choices that policymakers make are shaped by how their problems are framed. At last, non-communicable diseases (NCDs) have risen high on the global policy agenda, but there are many disputed issues. First, what are they? Their name refers not to what they are but what they are not. Second, where do their boundaries lie? What diseases are included? Third, should we view their causes as mainly biomedical, behavioural, or social, or a combination? Our failure to resolve these issues has been invoked as a reason for our limited progress in developing and implementing effective remedies. In this scoping review, we ask “What is known from the existing literature about how NCDs are framed in the global policy discourses?” We answer it by reviewing the frames employed in policy and academic discourses.

Methods

We searched nine electronic databases for articles published since inception to 31 May 2019. We also reviewed websites of eight international organisations to identify global NCDs policies. We extracted data and synthesised findings to identify key thematic frames.

Results

We included 36 articles and nine policy documents on global NCDs policies. We identified five discursive domains that have been used and where there are differing perspectives. These are: “Expanding the NCDs frame to include mental health and air pollution”; “NCDs and their determinants”; “A rights-based approach to NCDs”; “Approaches to achieving policy coherence in NCDs globally”; and “NCDs as part of Sustainable Socio-economic Development”. We further identified 12 frames within the five discursive domains.

Conclusions

This scoping review identifies issues that remain unresolved and points to a need for alignment of perspectives among global health policy actors, as well as synergies with those working on mental health, maternal health, and child health. The current COVID-19 pandemic warrants greater consideration of its impact on global NCDs policies. Future global strategies for NCDs need to consider explicitly how NCDs are framed in a changing global health discourse and ensure adequate alignment with implementation and global health issues. There is a need for global strategies to recognise the pertinent role of actors in shaping policy discourses.
High turnover in clinical dietetics: a qualitative analysis
Authors: Hewko Sarah , Oyesegun Amirah , Clow Samantha , VanLeeuwen Charlene
Published: January 2021

Background

Relationships between dietitians and other healthcare providers can impact the degree to which patient care is collaborative; inefficient communication can lead to suboptimal care. It takes time for multidisciplinary team members to build collaborative, trusting relationships. For this reason, frequent dietitian turnover is of concern. Consequences include fewer referrals to clinical dietetic services and limited provider continuity. The characteristics of clinical dietetic jobs associated with high turnover have not been identified. We predicted that managers would identify disease prestige as having an impact. In this study, we aimed to explore: 1) characteristics of clinical dietetic jobs associated with the highest turnover, and 2) consequences of high turnover on patients and managers of clinical dietitians.

Methods

Research assistants conducted semi-structured interviews with ten managers of clinical dietitians in the Canadian public healthcare system. We employed a constant comparative approach to thematic analysis. We classified themes related to turnover as either avoidable or unavoidable.

Results

Sub-themes under avoidable turnover included lack of manager support, growth opportunities, burnout/workload, tension/conflict and hours of work. Sub-themes under unavoidable turnover included life-stage/life-events and geography. We also identified themes related to consequences of turnover, including: burnout/workload, client/patient impact, tension/conflict, cost and gap-specific. As predicted, prestige was perceived as playing a role in triggering dietitian turnover. Managers observed high turnover resulting in low provider continuity and limiting patient access to dietitians.

Conclusions

Managers of publicly-employed dietitians identified many factors as contributing to high turnover. Future prospective research, incorporating the objective measure of turnover and multi-method analysis of work characteristics and work setting, would be of value in the identification of characteristics of clinical dietetic jobs associated with high turnover and the consequences of high turnover on patients and managers of these staff.
Perceived barriers to seeking cancer care in the Gaza Strip: a cross-sectional study
Authors: Elshami Mohamedraed , Bottcher Bettina , Alkhatib Mohammed , Ismail Iyad , Abu-Nemer Khitam , Hana Mustafa , Qandeel Ahmed , Abdelwahed Ahmed , Yazji Hamza , Abuamro Hisham , Matar Ghadeer , Alsahhar Ahmed , Abolamzi Ahmed , Baraka Obay , Elblbessy Mahmood , Samra Tahani , Alshorbassi Nabeela , Elshami Alaa
Published: January 2021

Background

Several factors might contribute to the delay to get cancer care including poor cancer awareness and having barriers to seeking help. This study described these barriers in Gaza and their association with recalling and recognizing cancer symptoms and risk factors.

Methods

A cross-sectional study was conducted in Gaza. Adult visitors (≥18 years) to the largest three governmental hospitals and adolescent students (15–17 years) from ten high schools were recruited. A translated-into-Arabic version of the validated Cancer Awareness Measure (CAM) was used to collect data in face-to-face interviews. It described demographic data, barriers to seek cancer care as well as recall and recognition of cancer symptoms and risk factors. Responses were compared between adults and adolescents as well as males and females.

Results

Of 3033 participants approached, 2886 completed the CAM (response rate= 95.2%). Among them, 1429 (49.5%) were adult (702 females; 49.1%) and 1457 (50.5%) were adolescent (781 females; 53.6%). The mean age± standard deviation (SD) of adult and adolescent participants was 33.7±11.7 years and 16.3±0.8 years, respectively. Emotional barriers were the most common barriers with ‘feeling scared’ as the most reported barrier (n=1512, 52.4%). Females and adolescents were more likely to report ‘feeling scared’ as a barrier than males and adults, respectively. Higher recall scores for cancer symptoms were associated with lower likelihood to report ‘embarrassment’, ‘worry about wasting doctor’s time’ and ‘difficulty arranging transport’. This was also seen for recalling risk factors, where ‘embarrassment’ and all practical barriers showed significant inverse associations with higher scores. In addition, greater recognition scores of cancer risk factors were inversely associated with reporting ‘embarrassment’ and ‘feeling scared’.

Conclusions

The most commonly perceived barriers to seeking cancer care were ‘feeling scared’ and ‘feeling worried about what the doctor might find’, followed by practical and service barriers. Females and adolescents were more likely to report ‘fear’ as a barrier to seek medical advice. Having a higher recall of cancer symptoms and risk factors was inversely associated with reporting most barriers. To improve patient outcome, early presentation can be facilitated by targeting barriers specific to population groups.
The vaginal microflora changes in various stages of the estrous cycle of healthy female dogs and the ones with genital tract infections
Authors: Golińska Edyta , Sowińska Natalia , Tomusiak-Plebanek Anna , Szydło Marlena , Witka Natalia , Lenarczyk Joanna , Strus Magdalena
Published: January 2021

Background

Inflammatory diseases of reproductive tract in bitches are a common problem in veterinary practice. The inflammation can lead to serious health problems. Research to determine the correlation between the health status of females, phase of the cycle, age and bacterial flora of the genital tract has been ongoing for years, but the results obtained by individual authors are often contradictory.

Results

A total of 39 dogs were included in this study. Ten were qualified to the 1st group with genital tract infections (8 in anestrus and 2 in proestrus) and 29 to the 2nd group without such infections (16 in anestrus, 9 in proestrus and 4 in diestrus). The most common bacterial isolates obtained from the vaginal tract of all dogs were Escherichia coli, Staphylococcus pseudintermedius and Streptococcus canis. The prevalence of Gram-negative rods (other than E. coli) was significantly higher in the group with genital tract infections versus healthy dogs. There was no presence of Chlamydiaceae, Chlamydia abortus and lactic acid-producing bacteria in tested swabs.

Conclusions

Our study identified the most common bacteria in the genital tract of bitches. The total number of bacteria was almost the same in the healthy and infected dogs, as well as between the cycle stages. In our opinion, bacterial culturing of vaginal swab specimens from bitches without signs of genital disease is of little value. Furthermore, it should always be preceded by clinical examination and cytological examination of the vaginal epithelium.
Developing a scoring tool to estimate the risk of deterioration for normotensive patients with acute pulmonary embolism on admission
Authors: Gao Yizhuo , Ji Chao , Zhao Hongyu , Han Jun , Shen Haitao , Jia Dong
Published: January 2021

Background

It is important to identify deterioration in normotensive patients with acute pulmonary embolism (PE). This study aimed to develop a tool for predicting deterioration among normotensive patients with acute PE on admission.

Methods

Clinical, laboratory, and computed tomography parameters were retrospectively collected for normotensive patients with acute PE who were treated at a Chinese center from January 2011 to May 2020 on admission into the hospital. The endpoint of the deterioration was any adverse outcome within 30 days. Eligible patients were randomized 2:1 to derivation and validation cohorts, and a nomogram was developed and validated by the aforementioned cohorts, respectively. The areas under the curves (AUCs) with 95% confidence intervals (CIs) were calculated. A risk-scoring tool for predicting deterioration was applied as a web-based calculator.

Results

The 845 eligible patients (420 men, 425 women) had an average age of 60.05 ± 15.43 years. Adverse outcomes were identified for 81 patients (9.6%). The nomogram for adverse outcomes included heart rate, systolic pressure, N-terminal-pro brain natriuretic peptide, and ventricle/atrial diameter ratios at 4-chamber view, which provided AUC values of 0.925 in the derivation cohort (95% CI 0.900–0.946, p < 0.001) and 0.900 in the validation cohort (95% CI 0.883–0.948, p < 0.001). A risk-scoring tool was published as a web-based calculator (https://gaoyzcmu.shinyapps.io/APE9AD/).

Conclusions

We developed a web-based scoring tool that may help predict deterioration in normotensive patients with acute PE.
LncRNA LIFR-AS1 promotes proliferation and invasion of gastric cancer cell via miR-29a-3p/COL1A2 axis
Authors: Pan Haiyan , Ding Yuanlin , Jiang Yugang , Wang Xingjie , Rao Jiawei , Zhang Xingshan , Yu Haibing , Hou Qinghua , Li Tao
Published: January 2021

Background

LncRNA was known to be closely associated with the progression of human tumors. The role of lncRNA LIFR-AS1 in the pathogenesis and progression of gastric tumor is still unclear. The aim of this study was to investigate the function of LIFR-AS1 and the underlying mechanism in the pathogenesis and progression of gastric cancer.

Methods

QRT-PCR was used to evaluate the expression of LIFR-AS1, miR-29a-3p and COL1A2 in gastric tumor tissues and cells. Western blotting was used to evaluate the protein expression of COL1A2 in gastric tumor cells. CCK-8 assay, transwell assay and flow cytometry were used to evaluate the roles of LIFR-AS1, miR-29a-3p and COL1A2 in cell proliferation, invasion, migration and apoptosis. The relationship among LIFR-AS1, miR-29a-3p and COL1A2 was assessed by bioinformatics analyses and luciferase reporter assay.

Results

The expression levels of LIFR-AS1 were significantly increased in gastric tumor tissues and cells, while the expression levels of miR-29a-3p were decreased. The expression of miR-29a-3p was negatively correlated with the expression of LIFR-AS1 in gastric cancer tumor tissues. Knocking down of LIFR-AS1 inhibited proliferation, invasion and migration of gastric tumor cells, and induced apoptosis of gastric tumor cells. Bioinformatics analyses and integrated experiments revealed that LIFR-AS1 elevated the expression of COL1A2 through sponging miR-29a-3p, which further resulted in the progression of gastric tumor.

Conclusion

LIFR-AS1 plays an important role as a competing endogenous RNA in gastric tumor pathogenesis and may be a potential target for the diagnosis and treatment of gastric tumor.
MCCC2 promotes HCC development by supporting leucine oncogenic function
Authors: Chen Yu-Yan , Zhang Xue-Ning , Xu Chen-Zhou , Zhou Dan-Hua , Chen Jing , Liu Zhao-Xiu , sun Ying , Huang Wei , Qu Li-Shuai
Published: January 2021

Background

The role of methylcrotonoyl-CoA carboxylase 2 (MCCC2) in the development of tumors is well-established, and the involvement of leucine in the liver is well-known. However, the role of MCCC2 and the correlation between MCCC2 and leucine in the progression of hepatocellular carcinoma (HCC) have not yet been reported.

Methods

In this study, the Gepia database was used to evaluate the prognostic value of MCCC2 in HCC. The expression and localization of MCCC2 in HCC cells were determined by western blot and immunofluorescence assays. Flow cytometry and CCK-8 and transwell assays were carried out to explore the effect of MCCC2 on cell proliferation, migration, and invasion. In addition, mass spectrometry analysis was used to predict the potential cell function of MCCC2 in HCC.

Results

We found that the expression of MCCC2 increased in HCC tissues and that high expression of MCCC2 could predict poor outcomes in HCC patients. Knockdown expression of MCCC2 in HCC cells could reduce cell proliferation, migration, and invasion ability in vitro and could inhibit HCC cell proliferation in vivo. Interestingly, we found that HCC cells transfected with MCCC2-sgRNA failed to respond to leucine deprivation. Meanwhile, leucine deprivation inhibited cell proliferation, migration, and invasion in HCC cells where MCCC2 was present rather than in cells where MCCC2 was absent. In addition, knockdown of MCCC2 significantly reduced the glycolysis markers, glucose consumption, lactate secretion, and acetyl-CoA level, which is a product of leucine metabolism. Furthermore, we found that MCCC2 promotes the activation of ERK. Profiling the MCCC2 binding proteins revealed that MCCC2-associated proteins are enriched in biological processes, such as protein metabolism, energy pathway, and metabolism in HCC cells.

Conclusions

Our findings revealed that MCCC2 plays a critical role in the development of HCC, and the leucine metabolism pathway might be a novel target in HCC treatment.
Prognostic factors of non-muscle invasive bladder cancer: a study based on next-generation sequencing
Authors: Shao Yanxiang , Hu Xu , Yang Zhen , Lia Thongher , Yang Weixiao , Wu Kan , Ren Shangqing , Xiong Sanchao , Dou Weichao , Feng Shuyang , Wang Yaohui , Liu Yang , Wu Kang , Li Xiang
Published: January 2021

Objective

To investigate the genetic prognostic factors for the recurrence of non-muscle invasive bladder cancer.

Materials and methods

The patients underwent transurethral resection of bladder tumor and received bacillus Calmette–Guérin (BCG) or epirubicin. Next-generation sequencing was performed and alterations of genes, pathways, and tumor mutation burden were recorded. Associations between these clinicopathological and genetic variants were estimated, and prognostic factor identified.

Results

A total of 58 cases were included in our study, and 46 patients underwent treatment with BCG. FGFR3 was the most frequently altered gene (48%), and more commonly detected in intermediate-risk patients. Univariate Cox analysis demonstrated that 10 genes were significantly correlated with BCG failure, while NEB, FGFR1 and SDHC were independent recurrence predictors. Besides, epigenetic-related gene pathway mutations were negatively correlated with recurrence (hazard ratio: 0.198, P = 0.023). DNA damage response and repair gene alterations were positively correlated with tumor burden, while altered TP53 was most frequent among these genes and significant correlated with high tumor burden.

Conclusion

BCG instillation significantly reduced the rate of recurrence compared with epirubicin in this population. Potential biomarkers and therapeutic targets were found with the help of next-generation sequencing; correlations between DDR genes alterations and high tumor mutation burden were also demonstrated.
Circ-CCDC66 upregulates REXO1 expression to aggravate cervical cancer progression via restraining miR-452-5p
Authors: Zhang Yan , Li Xing , Zhang Jun , Mao Lin
Published: January 2021

Background

Cervical cancer is one most common cancer types among females over the world. While its underlying mechanisms remain unclear. Circ-CCDC66 has been revealed to participate in multiple biological functions, and contribute to various diseases’ progression. In the current study, we aimed to demonstrate the role of circ-CCDC66 in cervical cancer progression.

Methods

Real-time quantitative PCR (RT-qPCR) was conducted to measure the expression of circ-CCDC66, miR-452-5p, and REXO1 mRNA. Cell fractionation assay and RNA fluorescence in situ hybridization (FISH) were performed to locate circ-CCDC66 in cells. Cell account kit 8 (CCK-8) was used to detect cell proliferation ability. Transwell assay was applied to evaluate cell migration or invasion ability. Bioinformatics analysis, biotinylated RNA pull-down, RNA immunoprecipitation, and dual-luciferase reporter assays were conducted to assess the association between miR-452 and circ-CCDC66 or REXO1. Western blot was applied to measure the protein expression of REXO1. The animal tumor model was used to assess the effect of circ-CCDC66 in vivo.

Results

The expression of circ-CCDC66 was upregulated in cervical cancer tumor tissues in comparison with normal tissues, and correlated with later tumor stage and larger tumor size. Downregulated circ-CCDC66 inhibited cervical cancer cell proliferation, migration, and invasion. Circ-CCDC66 was an efficient molecular sponge for miR-452-5p, and negatively regulated miR-452-5p expression. MiR-452-5p directly targeted to REXO1. Circ-CCDC66 regulated REXO1 expression to modulate cervical cancer progression via miR-452-5p. Moreover, downregulated circ-CCDC66 was found to suppress tumor growth in vivo.

Conclusion

Our results demonstrated the role of circ-CCDC66/miR-452-5p/REXO1 axis in cervical cancer progression, we might provide novel therapeutic targets for cervical cancer clinical intervention.
Oncogenic UBE3C promotes breast cancer progression by activating Wnt/β-catenin signaling
Authors: Hang Chen , Zhao Shanojie , Wang Tiejun , Zhang Yan
Published: January 2021

Background

Breast cancer (BrCa) is the most common female malignancy worldwide and has the highest morbidity among all cancers in females. Unfortunately, the mechanisms of BrCa growth and metastasis, which lead to a poor prognosis in BrCa patients, have not been well characterized.

Methods

Immunohistochemistry (IHC) was performed on a BrCa tissue microarray (TMA) containing 80 samples to evaluate ubiquitin protein ligase E3C (UBE3C) expression. In addition, a series of cellular experiments were conducted to reveal the role of UBE3C in BrCa.

Results

In this research, we identified UBE3C as an oncogenic factor in BrCa growth and metastasis for the first time. UBE3C expression was upregulated in BrCa tissues compared with adjacent breast tissues. BrCa patients with high nuclear UBE3C expression in tumors showed remarkably worse overall survival (OS) than those with low nuclear expression. Knockdown of UBE3C expression in MCF-7 and MDA-MB-453 BrCa cells inhibited cell proliferation, migration and invasion in vitro, while overexpression of UBE3C in these cells exerted the opposite effects. Moreover, UBE3C promoted β-catenin nuclear accumulation, leading to the activation of the Wnt/β-catenin signaling pathway in BrCa cells.

Conclusion

Collectively, these results imply that UBE3C plays crucial roles in BrCa development and progression and that UBE3C may be a novel target for the prevention and treatment of BrCa.