bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Ethical Leadership on Subjective Wellbeing, Given the Moderator Job Satisfaction (A Case Study of Private Hospitals in Mashhad)
Authors: Kaffashpoor Azar , sadeghian samaneh
Published: June 2020

Background: The emerging ethical leadership, a novel approach in leadership perspective, has provided the ground for building and promoting individual and organizational effectiveness through prioritizing ethics in organization. The purpose of the study is survey of effect of Ethical Leadership on Subjective Wellbeing, Given the Moderator Job Satisfaction in Private Hospitals in MashhadMethods: This research, employing a descriptive-correlational survey design, was conducted in 2015-2016 to examine the probable effect of ethical leadership on subjective wellbeing and job satisfaction (both as the outcome variable and the mediator) among the nurses of private hospitals in Mashhad, Iran. The statistical population included all nurses of private hospitals in Mashhad city (730 nurses, in total) from among whom following a simple randomized method, 166 nurses were selected as a sample of respondents. The data were collected with the adapted version of the questionnaire designed by Yang (2014) the validity and reliability of which were tested and confirmed. For data analysis, structural equation modeling (SEM) was used. Results: The results indicated a positive significant relationship between ethical leadership and job satisfaction. Ethical leadership only indirectly and through job satisfaction positively and significantly affected the subjective wellbeing of nurses.Conclusions: This suggests that an emphasis on ethics and ethically-oriented leaders in hospitals, aided by job satisfaction, can provide a positive climate which can lead to the subjective wellbeing of nurses.
Establishment of Reference Range of CD4 T-Lymphocyte in Healthy Nepalese Adults
Authors: Mishra Shravan Kumar , Shrestha Lilee , Pandit Roshan , Khadka Sundar , Shrestha Bimal , Dhital Subhash , Sharma Saroj , Sharma Mukunda , Mahato Raj Kumar , Shakya Geeta , Manandhar Krishna Das
Published: June 2020

Objective: CD4 T lymphocytes are the most widely used cellular markers to assess the course of HIV infection, clinical staging and, monitoring the effect of antiretroviral therapy. The regional reference range for Eastern, Central and Western development region of Nepal had already been established whereas the same was still lacking in Mid-western and Far-western development region. The objective of this study was to establish reference range of CD4 T lymphocyte in the remaining two development regions and finally the national reference range using data from previous study. Results: The average values (mean ± SD) of CD4 and CD3 T cell in present study was (819 ± 294) cells/μl and (1546 ± 532) cells/μl, respectively. The absolute CD4 T cell (914 ± 303) and CD3 T cell (1671 ± 560) count in female were significantly higher than those from male, CD4 (757 ± 270) and CD3 (1465 ± 499) (p value - 0.000). National reference value of CD4 was determined to be (798 ± 335) cells/μl for healthy Nepalese adults.
A scoping review of admission criteria and selection methods in nursing education
Authors: Zamanzadeh Vahid , Ghahramanian Akram , Valizadeh Leila , Bagheriyeh Farzaneh , Lynagh Marita
Published: June 2020

Background: Nursing education institutions are required to select and train applicants who have appropriate characteristics for delivering effective healthcare. Unlike other healthcare professions and despite the need to attract and select a competent workforce, there has been no comprehensive analysis of the selection criteria and methods used to recruit nursing students. As there is relatively limited prior research available, we conducted a scoping review to explore and synthesise the existing evidence regarding admission criteria and selection methods of nursing students and for the purpose of identifying an agenda for future research in this field.Methods: Our scoping review follows the Arksey and O’Malley five-step proposition including identifying the research question and relevant studies, study selection, tabulation of data, and summarizing and reporting the results. Seven databases (PubMed, CINAHL, Scopus, ERIC, SID, Irandoc and PsycINFO) were searched systematically using relevant keywords. Articles on admission of undergraduate nursing students published in both English and/or Persian from 2006 to 2019 were retrieved.Results: Existing research evidence suggests that nursing students are largely selected on the basis of two criteria - “cognitive-academic abilities” and “non-cognitive abilities.” Cognitive-academic abilities were assessed in four main dimensions of mathematics, language and communication, natural sciences and reasoning skills mainly through standardized tests and academic records. Our review shows a wide range of non-cognitive characteristics are evaluated in nursing applicants including: morality, interpersonal communication skills and psychological strength. The selection method most commonly used to assess characteristics was through interviews (panel interviews or multiple mini interviews). Other methods included references, personal statements and personality assessment tools. Conclusions: This is the first scoping review of literature regarding nursing education selection and recruitment. Results can be used to inform nursing education policymakers and institutions in the design of their selection practices. Future research should concentrate on the evaluation and improvement methods of student selection including content and predictive validity analysis of multiple mini interview and standardized tests, development of cost-effective selection methods and job analysis studies to identify specific non-cognitive characteristics for nursing.
Characterization of bacterial community of rumen from bovine during laminitis challenge by high-throughput sequencing
Authors: Guo Jian , Sun Haowen , Maimai T. , Zhao Caijun , Cao Yongguo , Zhang Naisheng , Hu Xiaoyu , Fu Yunhe
Published: June 2020

Background: Laminitis is a classic problem in the dairy industry, which can cause a great economic loss. However, the etiology and pathogenesis of laminitis have yet to be understood. In recent years, the microbiota has been the focus of much investigation in the search for various diseases. The present study aimed to explore the relationship between ruminal bacterial microbiota and laminitis. Results: The serum of healthy and laminitis bovines (n=8, respectively) collected from farms was used to detect concentrations of LPS, lactic acid, and histamine by the detection kits. This study used 16S rRNA sequencing to identify the differences in the bacterial community. The results showed that there was a significant increase in LPS and lactic acid in the laminitis group. Furthermore, microbial data analysis revealed that the laminitis group increased the abundance of bacteria with acid metabolites, such as Candidatus Saccharimonas, Saccharofermentans, Erysipelotrichaceae UCG-009, and Erysipelotrichaceae UCG-008, and [Clostridium] papyrosolvens and Ruminococcaceae bacterium AE2021.Conclusions: In summary, the changes in ruminal bacteria may potentially serve as the risk of laminitis.
Prevalence of Helicobacter pylori among Sudanese patients diagnosed with colon polyps and colon cancer using immunohistochemistry technique.
Authors: Mohamed Aziza K. , Elhassan Nazik M. , Awhag Zahra A. , Ali Fadwa S. , Ali Eman T. , Mhmoud Najwa A. , Siddig Emmanuel E. , Hassan Rowa , Ahmed Eiman S. , Fattahi Azam , Ahmed Ayman , Muneer Mohamed S. , Osman Hussam A. , Mohamed Nouh Saad , Edris Ali MM.
Published: June 2020

Objectives: Infection with the bacteria Helicobacter pylori has been classified as class one carcinogen associated with increasing susceptibility of gastritis and gastric carcinoma. This study is aiming at investigating the prevalence of H. pylori among colon polyps and colon cancer patients. A descriptive cross-sectional hospital-based study was conducted between February and June 2017. Sixty-nine formalin-fixed paraffin blocks collected from colon polyps and colon cancer patients to detect H. pylori using immunohistochemistry technique. Results: Of the Sixty-nine patients included in the study, 39 (56.5%) males and 30 (43.5%) were females, their age ranged from 21 to 80 years with a mean age of 47.1±19.7. Of the 69 colon polyps and colon cancer patients, 44 (63.8%) were diagnosed as adenocarcinoma, 10 (14.5%) colitis, 15 (21.7%) juvenile polyposis syndrome. The results of immunohistochemistry technique showed the presence of 16 (23.2%) positive patients for H. pylori infection. Of these 16, 13 (81.3%) patients were diagnosed with adenocarcinoma and 3 (18.7%) patients were diagnosed with juvenile polyps. The results of H. pylori detection among the different colon polyps and colon cancer patients were showing a statistically significant association for H. pylori infection and adenocarcinoma, P value 0.028.
More fuel to the fire: Some patients with non-celiac gluten sensitivity exhibit adaptive immunological responses in duodenal mucosa
Authors: Castillo-Rodal Antonia Isabel , Furuzawa-Carballeda Janette , Pelaez-Luna Mario , Castro-Gomez Jose , Lopez-Vidal Yolanda , Uscanga Luis Federico
Published: June 2020

Background
In contrast to the well characterized Celiac Disease (CD), the clinical scenarios encompassed in non-celiac gluten sensitivity (NCGS) might be related to different antigens that trigger distinct immune-inflammatory reactions. Although an increased number of intestinal intraepithelial lymphocytes is observed at the inception of both diseases, subsequent immunopathogenic pathways seems to be different.
Aims
To compare the immunological profile in the duodenal mucosa of patients with CD, self-reported gluten intolerant subjects and gluten tolerant patients with functional dyspepsia (GT-FD).
Methods
In a blind, cross-sectional study, duodenal biopsies from 15 consecutive untreated patients with active CD, 9 NCGS individuals and 10 GT-FD subjects were studied by flow-cytometry and immunohistochemistry. We determined the presence of pro-inflammatory cytokine expressing monocytes and monocyte-derived dendritic cells involved in innate immune activation, cytokine-driven polarization and maintenance of Th1 and Th17/Th22, and anti-inflammatory/profibrogenic cytokines.
Results
CD patients presented a higher percentage of cells expressing all tested cytokines in lamina propria and epithelium than GT-FD group. Cytokines that induce and maintain Th1 and Th17 polarization were higher in CD compared to NCGS and GT-FD cases; and higher in NCGS compared to GT-FD. Similar differences in the expression of IL-4 and TGF- β1 were detected, while IL-10-expressing cells were lower in NCGS patients compared to CD and GT-FD subjects.
Conclusions
NCGS patients exhibit components of both, innate and adaptive immune mechanisms but to a lesser extent compared to CD. The clinical characteristics and HLA status of our NCGS group resemble that described in subjects with irritable bowel syndrome sensible to gluten and probably represents a distinct phenotype of this syndrome.
Smart Ubiquitous Chatbot for COVID-19 Assistance with Deep learning Sentiment Analysis Model during and after quarantine
Authors: Ouerhani Nourchène , Maalel Ahmed , Ghézala Henda Ben , Chouri Soulaymen
Published: June 2020

The huge number of deaths caused by the novel pandemic COVID-19, which can affect anyone of any sex, age and socio-demographic status in the world, presents a serious threat for humanity and society. At this point, there are two types of citizens, those oblivious of this contagious disaster's danger that could be one of the causes of its spread, and those who show erratic or even turbulent behavior since fear and anxiety invades our surroundings because of confinement and panic of being affected.In this paper we aim at developing a smart ubiquitous chatbot, called COVID-Chatbot, for COVID-19 assistance during and after quarantine that communicates with a citizen to increase his/her consciousness towards the real danger of this outbreak. Furthermore, COVID-Chatbot is able to recognize and manage stress, during and after lockdown and quarantine period, using natural language processing (NLP).The robust messages delivered from COVID-Chatbot and its way of communication could possibly help to slow the COVID-19 spread.The proposed method is a ubiquitous healthcare service that is presented by its four interdependent modules: Information Understanding Module (IUM) in which the NLP is done, Data Collector Module (DCM) that collect user's non-confidential information to be used later by the Action Generator Module (AGM) that generates the chatbots answers which are managed through its three sub-modules. And finally the Depression Detector Model (DDM) that detects anxiety in the text input through a deep leaning sentiment analysis model to help AGM make the decision to deliver a reassurance message if a bad behavior is distinguished.
Effects of Empagliflozin Versus Placebo on Cardiac Sympathetic Activity in Acute Myocardial Infarction Patients with Type 2 Diabetes Mellitus: The EMBODY Trial
Authors: Shimizu Wataru , Kubota Yoshiaki , Hoshika Yu , Mozawa Kosuke , Tara Shuhei , Tokita Yukichi , Yodogawa Kenji , Iwasaki Yu-ki , Yamamoto Takeshi , Takano Hitoshi , Tsukada Yayoi , Asai Kuniya , Miyamoto Masaaki , Miyauchi Yasushi , Kodani Eitaro , Ishikawa Masahiro , Maruyama Mitsunori , Ogano Michio , Tanabe Jun
Published: June 2020

Background: Protection from lethal ventricular arrhythmias leading to sudden cardiac death (SCD) is a crucial challenge after acute myocardial infarction (AMI). Cardiac sympathetic and parasympathetic activity can be noninvasively assessed using heart rate variability (HRV) and heart rate turbulence (HRT). The EMBODY trial was designed to determine whether the Sodium–glucose cotransporter 2 (SGLT2) inhibitor improves cardiac nerve activity.Methods: This prospective, multicenter, randomized, double-blind, placebo-controlled trial included patients with AMI and T2DM in Japan; 105 patients were randomized (1:1) to receive once-daily 10-mg empagliflozin or placebo. The primary endpoints were changes in HRV, e.g., the standard deviation of all 5-min mean normal RR intervals (SDANN) and the low-frequency–to–high-frequency (LF/HF) ratio from baseline to 24 weeks. Secondary endpoints were changes in other sudden cardiac death (SCD) surrogate markers such as HRT.Results: Overall, 96 patients were included (46, empagliflozin group; 50, placebo group). The changes in SDANN were +11.6 and +9.1 msec in the empagliflozin (P=0.02) and placebo groups (P=0.06), respectively. Change in LF/HF ratio was –0.57 and –0.17 in the empagliflozin (P=0.01) and placebo groups (P=0.43), respectively. Significant improvement was noted in HRT only in the empagliflozin group (P=0.01). Whereas intergroup comparison on HRV and HRT showed no significant difference between the empagliflozin and placebo groups. Compared with the placebo group, the empagliflozin group showed significant decreases in body weight, systolic blood pressure, and uric acid. In the empagliflozin group, no adverse events were observed.Conclusions: This is the first randomized clinical data to evaluate the effect of empagliflozin on cardiac sympathetic and parasympathetic activity in patients with T2D and AMI. Early SGLT2 inhibitor administration in AMI patients with diabetes mellitus might be effective in improving cardiac nerve activity without any adverse events.Trial Registration: The EMBODY trial was registered by the UMIN in November 2017 (ID: 000030158). UMIN000030158; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000034442
What is the Role of Chest CT Scan for Pediatric Patient Diagnosis of COVID-19?
Authors: Zhang Yaqin , Li Guangming , Liu Hongsheng , Chen Binghui , Cai Zeyu , Li Yingqin , Chughtai Aamer , Shan Hong
Published: June 2020

Objectives To retrospectively analyze the CT imaging features and patterns at baseline and as they evolve with time as the disease progresses or resolves in a cohort of pediatric patients affected with 2019 corona virus disease (COVID-19) pneumonia from three different cities in China.Methods We evaluated 29 pediatric patients with COVID-19 in the authors’ institution from Jan 1 to Feb 20, 2020. Cases were confirmed by laboratory test and were analyzed for epidemiological, demographic, clinical, radiological features and patterns.Results 29 initial scans and 23 follow-up scans were obtained from 29 patients. 15(52%) patients had been to Hubei Province and 26 (90%) of them had close contact with the COVID-19 positive patients in 14 days prior to the illness onset. The peak severity time was 5-8 days after symptom onset. A significant difference between the number of involved segments at different time points was indicated (p=0.019). Half (52%) of the laboratory confirmed patients had no CT positive findings. Nine (31%) of the laboratory confirmed patients had no symptoms. Six (21%) had no CT positive findings nor symptoms. All the patients of one center(n=6) whose fecal samples remained positive after the respiratory samples became negative.Conclusion The common positive CT findings included ground-glass opacities (50%), ground-glass opacities mixed with consolidation (36%), peribronchial thickening (21%), and consolidations (14%). We recommend for pediatric patients CT should not be used as a first-line test to diagnose COVID-19.
Large Chest keloids treatment with expanded parasternal intercostal perforator flap
Authors: Liu Hao , Sui Fuqiang , Liu Shu , Song Kexin , Hao Yan , wang youbin
Published: June 2020

Background Chest keloids often converged into a large lesion on the chest in some patients. Such keloids often lead to obstacle to excision and reconstruction. We describe a surgical method for large chest keloids with expanded parasternal intercostal perforator flap (EPIPF).Methods Fifteen patients with chest keloid were treated with EPIPF in our department between August 2017 and Dec 2019. The surgical treatment was divided into two different phases. In the first phase, we implanted skin expanders into the layer under the deep fascia beside the keloids. The expander was expanded every week for about 3-4 months. In the second phase, the expander was removed, the keloid tissue was removed and an expanded perforator flap was then designed to cover the wound. Patients were followed-up after surgery. Complications after surgery were analyzed. Recurrence and the patients, satisfactory rate was recorded. Results Of the 15 patients, one patient complicated with undesirable small area wound healing. 11 were cured without scar hypertrophy or recurrence and four were partially cured with a small portion of scar hypertrophy. Eleven patients thought that the esthetic result was good (73.7%), and 4 patients thought the result was acceptable (26.7%). None patient was dissatisfied.Conclusion EPIPF are effective surgical method for managing large chest keloids. It can offer enough skin flap coverage for keloid wound resurfacing with stable blood supply to assure satisfactory results. Level of Evidence: Level IV, case series.
Predictors of Thyroglobulin in the Lymph Nodes Recurrence of Papillary Thyroid Carcinoma Undergoing Total Thyroidectomy
Authors: Xing Zhichao , Qiu Yuxuan , Li Zhe , Zhang Lingyun , Fei Yuan , Zhu Jingqiang , Su Anping
Published: June 2020

Purpose
To investigate serum thyroglobulin (Tg) levels in papillary thyroid carcinoma (PTC) patients with lymph nodes (LNs) recurrence, thereby evaluating possible risk factors and structural features of LNs recurrence.
Methods
All the patients with primary PTC who underwent total thyroidectomy (TT) with central or lateral neck dissection and then re-operated due to LNs recurrence between January 2013 and June 2018 were included. Patients were subdivided groups by different Tg levels.
Results
This study included 60 patients with LNs recurrence. Of all, 49 patients underwent radioactive iodine (RAI) treatment. Maximum unstimulated Tg (uTg) ≥ 0.2 ng/mL were associated with larger diameter of recurrent LNs (P = 0.027), higher possibility of diameters of recurrent LNs ≥ 25 mm (P = 0.023) and higher ratio of metastatic LNs (P < 0.001). Pre-RAI ablation serum-stimulated Tg (off-Tg) ≥ 1 ng/mL and unstimulated Tg detected at 1 week after RAI ablation (on-Tg) ≥ 0.2 ng/mL were associated with larger diameter of recurrent LNs and higher possibility of diameters of recurrent LNs ≥ 25 mm. Number of metastatic LNs ≥ 8 was an independent predictor for maximum uTg ≥ 0.2 ng/mL (OR = 8.767; 95% CI = 1.392–55.216; P = 0.021). Ratio of metastatic LNs ≥ 25% was an independent predictor for off-Tg ≥ 1 ng/mL (OR = 20.997; 95% CI = 1.649-267.384; P = 0.019).
Conclusion
Tg-positive was associated with larger size of recurrent LNs. Number of metastatic LNs ≥ 8 could independently predict maximum uTg-positive. Ratio of metastatic LNs ≥ 25% was an independent predicator for off-Tg-positive.
Coexistence of Recurrent Chromosomal Abnormalities and the Philadelphia Chromosome in Acute and Chronic Myeloid Leukemias: Report of Five Cases and Review of Literature
Authors: Gong Jinying , Zhang Zhenhao , Zhang Wei , Wang Huijun , Feng Xiaofang , Zhou Ji , Zhu Guoqing
Published: June 2020

Progression of chronic myelogenous leukemia (CML) is frequently accompanied by cytogenetic evolution. Additional genetic abnormalities are seen in 10-20 % of CML cases at the time of diagnosis, and in 60–80 % of cases of advanced disease. Unbalanced chromosomal changes such as an extra copy of the Philadelphia chromosome (Ph), trisomy 8, and i(17)(q10) are common. Balanced chromosomal translocations, such as t(3;3), t(8;21), t(15;17), and inv(16) are typically found in acute myeloid leukemia, but rarely occur in CML. Translocations involving 11q23, t(8;21), and inv(16) are relatively common genetic abnormalities in acute leukemia, but are extremely rare in CML. In the literature to date, there are at least 76 Ph+ cases with t(3;21), 47 Ph+ cases with inv(16), 16 Ph+ cases with t(8;21), and 9 Ph+ cases with t(9;11). But most of what has been published is now over thirty years old, without the benefit of modern immunophenotyping to confirm diagnosis, and before the introduction of treatment regimes such as TKI. In this study, we explored the rare concomitant occurrence of coexistence current chromosomal translocation and t(9;22) in CML or acute myeloid leukemia (AML).
Comparison of BSGI, MRI, Mammography, and Ultrasound for the Diagnosis of Breast Lesions and Their Correlations with Specific Molecular Subtypes in Chinese Women.
Authors: Liu Hongbiao , Zhan Hongwei , Sun Da , Zhang Ying
Published: June 2020

Background : Breast cancer is a leading cause of cancer in females, and is the second leading cancer-related cause of death in this group. Early diagnosis is essential to breast cancer to be effectively treated, and ultrasound, mammography, and MRI represent three key technologies that are utilized for the diagnosis of breast lesions. BSGI is an approach to molecular breast imaging that allows for high-resolution radio-imaging that is not adversely impacted by breast tissue density. This study was therefore designed to assess the relative diagnostic efficacy of BSGI, MRI, mammography, and ultrasound in different molecular subtypes of breast cancer among Chinese women. Methods : Diagnostic findings from 390 breast cancer patients that had undergone diagnosis and treatment in our breast surgery department were retrospectively reviewed. Patients had been diagnosed via BSGI, mammography, ultrasound, and MRI. The diagnostic efficacy of these different imaging modalities and their associated biological characteristics were compared in the present study. Results: A total of 229 of these 390 patients (58.7%) were diagnosed with malignant breast cancer, with the remaining 161 (41.3%) cases having been found to be benign. BSGI, MRI, mammography, and ultrasound yielded respective sensitivity values of 91.7%, 92.5%, 77.3%, and 82.1%, while the respective specificity values for these imaging modalities were 80.7%, 69.7%, 74.5%, and 70.8%. For lesions > 1 cm, BSGI offered a sensitivity of 92.5%, while for dense C and dense D breast tissue it yielded 91.5% and 89.3% sensitivity values, respectively, with these being similar to those achieved for dense A and dense B breast tissue (93.3% and 94.0%, respectively). BSGI also yielded a significantly higher LNR for malignant lesions relative to benign lesions (2.76±1.32 vs 1.46±0.49). Conclusions : These findings confirm that BSGI is highly sensitive and is superior to mammography in the detection and diagnosis of DCIS. Such diagnostic efficacy can be further improved by using BSGI as an auxiliary modality to mammography and ultrasound, potentially improving the reliability of breast lesion diagnosis, thereby ensuring that patients receive rapid and effective treatment without the risk of misdiagnosis or unnecessary surgical treatment.
Target Screening of Plant Secondary Metabolites in River Watersby Liquid Chromatography Coupled to High Resolution Mass Spectrometry (Lc-hrms)
Authors: Nanusha Mulatu Yohannes , Krauss Martin , Schönsee Carina D. , Günthardt Barbara F. , Bucheli Thomas D. , Brack Werner
Published: June 2020

Background:Substantial efforts have been made to monitor potentially hazardous anthropogenic contaminants in surface waters while for plant secondary metabolites(PSMs) almost no data on occurrence in the water cycle are available.These metabolitesenter river waters through various pathways such as leaching, surface run-off and rain sewers or input of litter from vegetation andmight add to the biological activity of the chemical mixture.To reduce this data gap we conducted aLC-HRMS target screening in river waters from two different catchments for 150plant metabolites which were selected from a larger database considering their expected abundance in the vegetation, their potential mobility, persistence and toxicity in the water cycle and commercial availability of standards. Results: The screening revealed the presence of 12out of 150toxic PSMs including coumarins (bergapten, scopoletin, fraxidin, esculetin and psoralen), a flavonoid (formononetin) and alkaloids (lycorine and narciclasine). The compounds narciclasine and lycorine were detected at concentrations up to 3 µg/L while esculetin and fraxidin occurred at concentrations above 1 µg/L.Nine compounds occurred at concentrations above 0.1 µg/L, the Threshold for Toxicological Concern (TTC) for non-genotoxic and non-endocrine disrupting chemicals in drinking water. Conclusions: Our study provides a first insight into potentially biologically active PSMs in surface waters and recommends their consideration in monitoring and risk assessment of water resources. This is currently hampered by a lack of effect data including toxicity to aquatic organisms, endocrine disruption and genotoxicity and demands for involvement of these compounds in biotesting.
Safety of Endostar in combination with chemotherapy in patients with cancer
Authors: wang dongxiao , zhu man , guo daihong , xia lei , huang xiaowu , wang tianlin , zhao changhong
Published: June 2020

Background: A number of studies indicated the benefits and safety of Endostar in combination with chemotherapy in cancer, but the exact real-life safety of Endostar is poorly known. This study aimed to assess the safety of Endostar in combination with chemotherapy in patients with cancer in a real-life setting in China. Methods: This was a retrospective study of patients treated with Endostarin combination with chemotherapy in the Chinese PLA General Hospital (Beijing, China) from 1 st January 2006to 31 st December 2017. All data were obtained from the Hospital Information System(HIS). Laboratory abnormalities were evaluated according to Common Terminology Criteria for Adverse Events(CTCAE) 4.0.Bleeding events and wound healing complications after surgery associated with Endostar were evaluated based on case records. Results: A total of 825 patients were included. There were no patients used Endostar alone in real-life settings. Overall, anemia occurred in 74.5% of the assessed patients, thrombocytopenia occurred in 29.0%, abnormal white blood cell count occurred in 54.5%, abnormal liver function occurred in 13.8%, and increased creatinine occurred in 1.2%. No definite bleeding events and wound healing complications after surgery associated with Endostar were found based on case records. Most laboratory AEs were of grade 1-2. Lung cancer, osteosarcoma and doxorubicin-based chemotherapy was associated with an increased risk of grade≥3 abnormal white blood cell count ( P <0.05). The total dose of Endostar was not associated with severe AEs(grade≥3)of thrombocytopenia and abnormal white blood cell count. Conclusion: The occurrence of AEs during treatment with Endostar in combination with chemotherapy differed across different tumor types and chemotherapy regimens. No new unexpected AEs relating to Endostar were observed from this study. The total dose of Endostar was not associated with increased risk of severe AEs (grade≥3)of thrombocytopenia and abnormal white blood cell count when used in combination with chemotherapy in the real-life setting.
Prenatal diagnosis of 2193 pregnant women with invasive indications for chromosomal abnormalities in southern China: a retrospective study
Authors: Gu Xiaodong , Liu Sudong , Wang Huaxian , Weng Ruiqiang , Guo Xuemin , Zhong Zhixiong
Published: June 2020

Background: Although a variety of non-invasive techniques are used for prenatal genetic screening and diagnosis, our knowledge remains limited regarding the relationship between high-risk prenatal indications and fetal chromosomal abnormalities.Methods: We retrospectively investigated the prenatal genetic screening and karyotype analysis results of pregnant women who had undergone invasive prenatal testing in Prenatal Diagnosis Department of Meizhou People’s Hospital during Jan. 1, 2015 to Dec. 31, 2019. We analyzed the frequencies of chromosome abnormalities in women with high-risk indications.Results: A total of 2,193 pregnant women who had underwent invasive prenatal testing were included in our analysis. Chromosomal abnormalities occurred in 10.3% of these women, and rate increased with maternal age (P < 0.001). The frequencies of chromosome abnormalities varied for women with different high-risk indications, which was 10.3% (226/2193) for abnormal ultrasound results, 3.3% (31/938) for positive serum screening test results, 61.4% (78/127) for positive NIPT results, 9.3% (13/140) for AMA and 11.1% (10/90) for obstetric/family history. Follow up data showed that 380 pregnant women opted for termination the pregnancy, including 211 (55.5%) due to karyotype abnormalities and 169 (45.5%) due to abnormal ultrasonic outcomes.Conclusion: Our data suggested that the prenatal screening methods have high false positive rates. NIPT is the most accurate non-invasive prenatal screening. Apart from karyotype abnormality, abnormal ultrasound results alone accounted for a big part of pregnancy termination.
Willingness to perform induced abortion and associated factors among graduating Midwifery, Medical, Nursing, and Public health officer students of University of Gondar, Northwest Ethiopia: Institution based Cross sectional study
Authors: Enyew Mihretu Molla
Published: June 2020

Background: In developing countries, abortion is often unsafe and a signiﬁcant cause of maternal morbidity and mortality accounting for about 8% (4.7%–13.2%) of maternal mortality worldwide. Internationally, safe abortion services are recognized as reducing maternal mortality, and liberalized abortion laws are associated with reduced mortality resulting from unsafe abortion procedures. However, health care providers have moral, social and gender-based reservations that affects their willingness towards providing induced abortion services. The purpose of this study was to assess willingness to perform induced abortion and associated factors among graduating Midwifery, Medical, Nursing, and Public health officer students of University of Gondar. Methods: Institution based cross sectional study was conducted from March 29 to May 30, 2019. All graduating students available during data collection period were considered as study population. Stratified simple random sampling technique was used to select 424 study participants. Pre tested, semi- structured, self-administered questionnaire was used to collect data. Data analysis was done using SPSS version 20. Ethical clearance was obtained from School of midwifery under the delegation of institutional review board of university of Gondar.Results: 290 students out of 424 students were willing to perform induced abortion for indications supported by Ethiopian abortion law, making a proportion of 68.4% (95%Cl: 64.2, 72.9). Sex (Being male (AOR = 4.89, 95%CI: 3.02, 7.89)), religion (being orthodox than protestant (AOR = 10.41, 95%CI: 3.02, 21.57)), being Muslim than protestant (AOR = 5.73, 95%CI: 1.37, 15.92)) and having once or less a week religious attendance (AOR=2.00, 95% CI: 1.20, 3.34) were factors associated with willingness towards performing induced abortion.Conclusions: According to this study willingness of students towards providing induced abortion services was good. However female students, protestant followers and those students with more than once a week religious attendance should be encouraged in abortion care provisions.
Soil Environmental Quality in Nan Ling Commodity Grain Base Based on Equal Intercept Transformation Radar Chart
Authors: Dong Hai Biao , Zhang Guang Hui , Yan Ming Jiang , Tian Yan Liang
Published: June 2020

Background: Nan Ling commodity grain base is a national high-standard farmland demonstration area. Scientific evaluation of soil environmental quality is of important significance to plan land resources rationally to improve the quality and efficiency of agricultural production.Methods: This paper try to apply the equal intercept transformation radar chart --an improved radar chart--to the assessment of soil environmental quality. In the assessment, the area of equal intercept transformation radar chart is adopted to represents the soil environmental quality.Different from the other assessment methods in common use, the equal intercept transformation radar chart method, as a visual graphic data analysis method, transforms data into graphics and therefore the data information can be retained and excavated more fully. Moreover, this advanced radar chart overcomes targetedly the main defect of the conventional radar chart that the evaluation result depends heavily on the order of arrangement of indicators.Results: The results indicate that the soil environmental quality at depth of 0-60cm in low mountain area of Nan ling commodity grain base is the second grade while that in the hilly and plain area are both the first grade. The indicators of poor soil environmental quality in low mountain area are exogenous Cd and endogenous As, those in hilly area are exogenous Cd and endogenous As and Hg, and that in plain area is exogenous Cd.Conclusion: It is proved through this special case study that the application of equal intercept transformation radar chart to the assessment of soil environmental quality is feasible and more intuitive, comprehensive and fine.
Genetic Determinants Of Clinical Phenotype In Hypertrophic Cardiomyopathy
Authors: Velicki Lazar , Jakovljevic Djordje G , Preveden Andrej , Golubovic Miodrag , Bjelobrk Marija , Ilic Aleksandra , Stojsic Snezana , Barlocco Fausto , Tafelmeier Maria , Okwose Nduka , Tesic Milorad , Brennan Paul , Popovic Dejana , MacGowan Guy A , Ristic Arsen , Filipovic Nenad , Maier Lars S. , Olivotto Iacopo
Published: June 2020

Background: Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiovascular disease that affects approximately one in 500 people. HCM is a recognized genetic disorder most often caused by mutations involving myosin-binding protein C (MYBPC3) and β-myosin heavy chain (MYH7) which are responsible for approximately three-quarters of the identified mutations.Methods: As a part of the international multidisciplinary SILICOFCM project (www.silicofcm.eu) the present study evaluated the association between underlying genetic mutations and clinical phenotype in patients with HCM. Only patients with confirmed single pathogenic mutations in either MYBPC3 or MYH7 genes were included in the study and divided into two groups accordingly. The MYBPC3 group was comprised of 48 patients (76%), while the MYH7 group included 15 patients (24%). Each patient underwent clinical examination and echocardiography.Results: The most prevalent symptom in patients with MYBPC3 was dyspnea (44%), whereas in patients with MYH7 it was palpitations (33%). The MYBPC3 group had a significantly higher number of patients with a positive family history of HCM (46% vs. 7%; p=0.014). There was a numerically higher prevalence of atrial fibrillation in the MYH7 group (60% vs. 35%, p=0.085). Laboratory analyses revealed normal levels of creatinine (85.5±18.3 vs. 81.3±16.4 µmol/l; p=0.487) and blood urea nitrogen (10.2±15.6 vs. 6.9±3.9 mmol/l; p=0.472) which were similar in both groups. The systolic anterior motion presence was significantly more frequent in patients caring MYH7 mutation (33% vs. 10%; p=0.025), as well as mitral leaflet abnormalities (40% vs. 19%; p=0.039). Calcifications of mitral annulus were registered only in MYH7 patients (20% vs. 0%; p=0.001). The difference in diastolic function, i.e. E/e’ ratio between the two groups was also noted (MYBPC3 8.8±3.3, MYH7 13.9±6.9, p=0.079).Conclusions: Major findings of the present study corroborate the notion that MYH7 gene mutation patients are presented with more pronounced disease severity than those with MYBPC3.
Bilateral Posterior Quadratus Lumborum Block for Pain Relief after Cesarean Delivery: A Randomized Controlled Trial
Authors: Pangthipampai Pawinee , Dejarkom Sukanya , Poolsuppasit Suppachai , Luansritisakul Choopong Luansritisakul , Tangchittam Suwida
Published: June 2020

Background: Achieving optimal abdominal analgesia with few side effects is the goal of pain management after cesarean delivery. Intrathecal morphine is the current standard but ultrasound guided quadratus lumborum block (US-QLB) may offer superior pain control with fewer side effects. This study compared the pain-free period after cesarean delivery among parturients who received spinal block with IT morphine 0.2 mg, with IT morphine 0.2 mg and bilateral QLB, or only bilateral QLB.Methods: Parturients having elective cesarean delivery with a low transverse incision under spinal block were randomized to three groups. Subjects were allocated into IT morphine 0.2 mg with sham QLB (Group IT morphine), IT morphine 0.2 mg and bilateral QLB with 0.25% bupivacaine 25 ml and adrenaline 1:250,000 in each side (Group IT morphine with QLB), or bilateral QLB with 0.25% bupivacaine 25 ml and adrenaline 1:250,000 in each side (Group QLB). A PCA pump was connected to each parturient after completion of the QLB or sham block. The first time to PCA morphine requirement when parturients experienced pain was recorded and compared.Results: Eighty parturients were included. Analysis of Group QLB was terminated early because Kaplan-Meier survival analysis showed the median pain-free period to be significantly shorter in Group QLB at the second interim analysis; [2.50 hours (95% CI: 1.04-3.96) in Group IT morphine vs. 7.75 (95% CI: 5.67-9.83) in Group IT morphine with QLB vs. 1.75 (95% CI: 0.75-2.75) in Group QLB (overall p<0.001)]. The median (min, max) amount of morphine required during 24 hours was 5.5 (0-25) in Group IT morphine vs. 5.0 (0-36) in Group IT morphine with QLB vs. 17.5 (1-40) mg in Group QLB (p<0.001). In the final analysis the median pain-free period was 2.50 hours (95%CI: 1.23-3.77) in Group IT morphine (n=27) and 8.02 (95%CI: 5.96-10.07) in Group IT morphine with QLB (n=28). (Gehan-Breslow p=0.027).Conclusion: US-QLB used in conjunction with IT morphine yielded a statistically significant longer median pain-free period compared with standard IT morphine alone. However, QLB alone provided inferior pain control compared with standard IT morphine. When combined with IT morphine, QLB may provide additional analgesic benefit as a part of multimodal analgesic regimen, especially during the early postoperative period.Trial registration: ClinicalTrials.gov no. NCT03199170 Date registered on June 22, 2017. Prospectively registered.
An Immune-Related Gene Signature for Predicting Survival and Immunotherapy Efficacy in Hepatocellular Carcinoma
Authors: Dai Yifei , Qiang Weijie , Lin Kequan , Gui Yu , Lan Xun , Wang Dong
Published: June 2020

Background: Hepatocellular carcinoma (HCC) ranks the fourth in terms of cancer-related mortality globally. Herein, in this research, we attempted to develop a novel immune-related gene signature that could predict survival and efficacy of immunotherapy for HCC patients.Methods: The transcriptomic and clinical data of HCC samples were downloaded from The Cancer Genome Atlas (TCGA) and GSE14520 datasets, followed by acquisition of immune-related genes from the ImmPort database. Afterwards, an immune-related gene-based prognostic index (IRGPI) was constructed using the Least Absolute Shrinkage and Selection Operator (LASSO) regression model. Kaplan-Meier survival curves as well as time-dependent receiver operating characteristic (ROC) curve were performed to evaluate its predictive capability. Besides, both univariate and multivariate analysis on overall survival for the IRGPI and multiple clinicopathologic factors were carried out, followed by the construction of nomogram. Finally, we explored the possible correlation of IRGPI with immune cell infiltration or immunotherapy efficacy. Results: Analysis of 365 HCC samples identified 11 differentially expressed genes, which were selected to establish the IRGPI. Notably, it can predict survival of HCC patients more accurately than published biomarkers. Furthermore, IRGPI can predict the infiltration of immune cells in the tumor microenvironment of HCC, as well as the response of immunotherapy.Conclusion: Collectively, the currently established IRGPI can accurately predict survival, reflect the immune microenvironment, and predict the efficacy of immunotherapy among HCC patients.
Therapeutic Evaluation of Palbociclib and Its Compatibility with Other Chemotherapies in Primary and Recurrent Nasopharyngeal Carcinoma
Authors: Xue Zhichao , Lui Vivian Wai Yan , Li Yongshu , Lin Jia , You Chanping , Piao Wenyin , Yuan Hui , Khong Pek Lan , Lo Kwok Wai , Cheung Lydia Wai Ting , Tsao Sai Wah , Tsang Chi Man
Published: June 2020

Background: Recent genomic analyses revealed that druggable molecule targets could only be detected in around 6% of nasopharyngeal carcinoma (NPC) patients. Yet, an addiction to dysregulated CDK4/6-cyclinD1 signalling pathway is an essential event in the pathogenesis of NPC. Using our newly established xenografts and cell lines derived from primary, recurrent and metastatic NPC, we aimed to evaluate the therapeutic efficacy of a specific CDK4/6 inhibitor, palbociclib, and its compatibility with other chemodrugs in treating NPC.Methods: The efficacy of single treatment of palbociclib on NPC models was first evaluated, followed by concurrent treatment with cisplatin or suberanilohydroxamic acid (SAHA). RNA sequencing was used to profile the related pathways in governing the drug response. Palbociclib-resistant NPC cell lines were also established to demonstrate if cisplatin could be used as a second-line treatment once the cells developed resistance to palbociclib. The efficacy of palbociclib treatment on cisplatin-resistant NPC cells was also examined. Results: Palbociclib single drug treatment was confirmed to have a cell cycle arresting effect of NPC cells in G1 phase in vitro. It also had a significant inhibitory effect in all the 6 NPC tumor models in vivo, with a substantial reduction in total tumor volume and proliferation marker Ki-67. Concurrent use of palbociclib dampened the cytotoxic effect of cisplatin in NPC cells in vitro. Notably, combination of palbociclib with SAHA resulted in synergistic cell death of NPC both in vitro and in vivo. Autophagy-associated cell death was found to be involved in the enhanced tumor growth inhibitory effect in the combined palbociclib+SAHA treatment. NPC cell lines trained to sustain growth in high dose of palbociclib and cisplatin remained sensitive in subsequent treatment of cisplatin or palbociclib respectively.Conclusions: This study provides essential evidences to position palbociclib as an alternative therapeutic option to NPC treatment, and to aware the effective administrative timing of palbociclib with other chemodrugs. The findings give the basis for planning of the first-in-human clinical trials of palbociclib regimens in NPC patients.
The Diagnostic Value of DNA Repair Gene in Breast Cancer Recurrence and Metastasis
Authors: Yang Yongxin , Li Xiabin , Hao Liyue , Jiang Deyong , Wu Bin , He Tao , Tang Yan
Published: June 2020

Background: DNA repair genes play a vital role in the treatment of many cancers, and DNA repair genes can be used in breast cancer recurrence and metastasis research. We found that the expression of DNA repair genes in breast cancer patients after recurrence and metastasis is abnormal, however, the clinical predictive significance of DNA repair genes is still elusive. Methods: The nested case-control method was used in patients with breast cancer recurrence and metastasis after surgery (n=109) and patients without recurrence and metastasis after surgery (n=109). The proteins and mRNA of DNA repair genes were detected by immunohistochemistry and Real-time PCR respectively. Results: PARP1(OR=1.485, 95%CI:1.279~1.725, P<0.05), XRCC4(OR= 1.419, 95%CI:1.217~ 1.656, P<0.05) and ERCC1 (OR=1.181, 95%CI: 1.032~1.353, P<0.05) were risk factors for postoperative recurrence and metastasis of breast cancer. Therefore, we used the ROC curve to study the optimal critical values of PARP1, XRCC4, and ERCC1, combined with the comprehensive judgment of clinical experience, we can conclude that PARP1 (cutoff value = 6, Se = 75.23%, Sp = 79.82%), XRCC4 (cutoff value = 6, Se = 78.9%0, Se = 79.82%), ERCC1 (cutoff value = 3, Se = 89.91%, Sp = 47.71%), suggesting that when the PARP1 score is higher than 6 or the XRCC4 score is higher than 6 or the ERCC1 score is higher than 3, the risk of recurrence and metastasis will increases (ORPARP1 = 14.941, 95% CIPARP1: 4.004~55.758, P <0.05; ORXRCC4 = 16.740, 95% CIXRCC4: 6.433 ~ 43.560, P <0.05; ORERCC1 = 5.285, 95% CIERCC1: 1.843 ~ 15.156, P <0.05). Due to PARP1, ERCC1 and XRCC4 belong to a part of DNA repair gene system, and the three proteins are positively correlated by correlation analysis (rPARP1-ERCC1=0.317; rPAPR1-XRCC4=0.329; rERCC1-XRCC4=0.377). The combined diagnosis of the PARR1,ERCC1 and XRCC4 have greater predictive value for the risk of recurrence and metastasis of breast cancer(Se = 88.99%, Sp = 82.57%；OR = 50.914, 95% CI: 10.918, 237.417, P <0.05).Conclusions: The recurrence and metastasis of breast cancer are predictive after PARP1>6, XRCC4>6, and ERCC1>3. The combined diagnosis of the three indicators have greater predictive value for the risk of recurrence and metastasis of breast cancer.