bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Cashew Nutshell Oil Supplementation as Phenol Source for Protein Protection on In Vitro Nutrient Digestibility
Authors: Fitriastuti Rahma , Yusiati Lies Mira , Widyobroto Budi Prasetyo , Bachruddin Zaenal , Hanim Chusnul
Published: December 2019

The current study was aimed to evaluate the ability of phenol content in cashew nutshell liquid (CNSL) in binding protein and its effect on in vitro nutrient digestibility. This research divided into three steps, there were determination of total phenol and tannins content in CNSL, optimalization binding of CNSL tannin to bovine serum albumin with the determination of protein-percipitable phenolics compound and protein content using Lowry method, after that amount of optimalization supplementation of CNSL was used for measuring on in vitro nutrient digestibility by Tilley and Terry method. The results showed that phenol and tannin content of CNSL were 148.69 g/100 ml and 28.3 g/100 ml. One gram tannin in CNSL could be bound by 65.83 g protein. Optimum tannin were used in this study was 5.85 g tannin or equivalent to 163.91 mg of CNSL. Amount of CNSL were used in various levels, there are 0, 50, 100, 150 dan 200 mg. CNSL supplementation reduced dry matter, organic matter crude protein digestibility in rumen, and didn’t reduce dry matter dan crude protein in vitro post rumen digestibility. Supplementation of CNSL increased feed efficiency on in vitro.
Arts, mental distress, mental health functioning & life satisfaction: fixed effects analyses of a nationally-representative panel study
Authors: Wang Senhu , Mak Hei Wan , Fancourt Daisy
Published: December 2019

Background. Arts engagement within communities is ubiquitous across cultures globally and previous research has suggested its benefits for mental health and wellbeing. However, it remains unclear whether these benefits are driven by arts engagement itself or by important confounders such as socio-economic status (SES), childhood arts engagement, previous mental health, personality, or self-selection bias. The aim of this study is to use fixed effects models that account for unidentified time-constant confounding measures to examine the longitudinal association between arts (frequency of both arts participation and cultural attendance), mental distress, mental health functioning and life satisfaction.
Methods. Data from 23,660 individuals (with a mean age of 47 years) included in the UK Understanding Society wave 2 (2010-2012) and wave 5 (2013-2015) were analyzed. Aside from controlling for all time-constant variables using the fixed-effects models, we additionally adjusted for time-varying demographic factors (e.g. age and marital status), health behaviors and social support variables.
Results. After controlling for all time-constant variables and identified time-varying confounders, frequent arts participation and cultural attendance were associated with lower levels of mental distress and higher levels of life satisfaction, with arts participation additionally associated with better mental health functioning. Health-related and social time-varying factors were shown to partly but not wholly explain the observed associations.
Conclusion. Arts engagement amongst the population as a whole may help enhance positive mental health and life satisfaction, and protect against mental distress. These results are not explained by any time-constant confounding factors.
Analysis of Affecting Factors on Patient Safety Culture in Public and Private Hospitals in Iran
Authors: khoshakhlagh amir hossein , Khatooni Elham , Akbarzadeh Isa , Yazdanirad Saeid , Sheidaei Ali
Published: December 2019

Background : Patient safety culture is one of the main components of the quality of health services and is one of the main priorities of health studies. Accordingly, this study aimed to determine and compare the views of healthcare staff on the patients’ safety culture and the impact of effective factors on patient safety culture in public and private hospitals in Tehran, Iran. Methods : This cross-sectional study was carried out on a sample of 1203 health care workers employed in three public and three private hospitals in Tehran, Iran. Stratified random sampling was used in this study. Data were collected using the Maslach burnout inventory and patient safety culture questionnaire (HSOPSC). IBM SPSS v22 and Amos v23 were used to perform path analysis. Results : 867 (72.57%) females and 747 (27.43%) males with a mean age of 33.88 ± 7.66 were included. The average percentage of positive responses to the safety culture questionnaire in public and private hospitals was 65.5% and 58.3%, respectively. The strengths of patient safety culture in public hospitals were in three dimensions including non-punitive response to errors (80%), organizational learning—continuous improvement (79.77%), and overall perceptions of patient safety (75.16%), and in private hospitals, were three dimensions including non-punitive responses to errors (71.41%), organizational learning & continuous improvement (69.24%), and teamwork within units (62.35%). The type of hospital and work-shift hours influenced the burnout and patient safety questionnaire scores (P-value <0.05). The path analysis results indicate the fitness of the proposed model (RMSEA= 0.024). The results showed a negative impact of a work shift (β= -0.791), occupational burnout (β= -0.554) and hospital type (β= -0.147) on the observance of patient safety culture. Conclusion: providing feedback on errors and requirements for the frequent incident reporting, and patient information exchange seem necessary to promote the patient's safety culture. Also, considering the negative impact of the shift work and burnout on patient safety culture, by planning and managing these factors appropriately, correct actions could be designed to improve the safety culture.
Diazepam and ethanol differently modulate neuronal activity in organotypic cortical cultures
Authors: Kreuzer Matthias , García Paul S , Brucklacher-Waldert Verena , Claasen Rebecca , Schneider Gerhard , Antkowiak Bernd , Drexler Berthold
Published: December 2019

Background: The pharmacodynamic results of diazepam and ethanol administration are similar, in that each can mediate amnestic, sedative-hypnotic effects. Although each of these molecules effectively reduce the activity of central neurons, diazepam does so through modulation of a more specific set of receptor targets (GABAA receptors containing a g-subunit), while alcohol is less selective in its receptor bioactivity. Our investigation focuses on divergent actions of diazepam and ethanol on the firing patterns of cultured cortical neurons.
Method: We used electrophysiological recordings from organotypic slice cultures derived from Sprague-Dawley rat neocortex. We exposed these cultures to either diazepam (15 and 30 µM, n = 7) or ethanol (30 and 60 mM, n = 11) and recorded the electrical activity at baseline and experimental conditions. For analysis, we extracted the episodes of spontaneous activity, i.e., cortical up-states. After separation of action potential and local field potential (LFP) activity, we looked at differences in the number of action potentials, in the spectral power of the LFP, as well as in the coupling between action potential and LFP phase.
Results: While both substances seem to decrease neocortical action potential firing in a not significantly different (p=0.659, Mann-Whitney U) fashion, diazepam increases the spectral power of the up-state without significantly impacting the spectral composition, whereas ethanol does not significantly change the spectral power but the oscillatory architecture of the up-state as revealed by the Friedman test with Bonferroni correction (p<0.05). Further, the action potential to LFP-phase coupling reveals a synchronizing effect of diazepam for a wide frequency range and a narrow-band de-synchronizing effect for ethanol (p<0.05, Kolmogorov-Smirnov test).
Conclusion: Diazepam and ethanol, induce specific patterns of network depressant actions. Diazepam induces cortical network inhibition and increased synchronicity via gamma subunit containing GABAA receptors. Ethanol also induces cortical network inhibition, but without an increase in synchronicity via a wider span of molecular targets.
Patient Centred Medical Home (PCMH) transitions in western Sydney, Australia: A qualitative study
Authors: Metusela Christine , Usherwood Tim , Lawson Kenny , Angus Lisa , Kmet Walter , Ferdousi Shahana , Reath Jennifer
Published: December 2019

Objectives Patient Centred Medical Homes (PCMHs), increasingly evidenced to provide high quality primary care, are new to Australia. To learn how this promising new healthcare model works in an Australian setting we explored experiences of healthcare providers in outer urban Sydney, where a number of practices are transitioning from traditional Australian general practice models to incorporate elements of PCMH approaches. Design We collected qualitative data from semi-structured interviews with healthcare providers working in a range of transitioning practices and thematically analysed the data. Setting and participants We interviewed 35 participants including general practitioners, practice managers and practice nurses from 25 purposively sampled general practices in western Sydney, Australia, seeking maximal variation in practice size, patient demographics and type of engagement in practice transformation. Results Interviewees described PCMH transformation highlighting the importance of whole of practice engagement with a shared vision; key strategies for transformation to PCMH models of care including leadership, training and supportive information technology; structures and processes required to provide team-based, data-driven care; and constraints such as lack of space and the current Australian fee-for-service general practice funding model. They also reported their perceptions of early outcomes of the PCMH model of care, describing enhanced patient and staff satisfaction and also noting fewer hospital admissions, as likely to reduce costs of care. Conclusions Our study exploring the experience of early adopters of PCMH models of care in Australia, informs the international movement towards PCMH models of care. Our findings provide guidance for practices considering similar transitions and describe the challenges of such transitions within a fee-for-service payment system.
Light Enhanced Cognitive Behavioural Therapy (CBT+) for Sleep and Fatigue: Study Protocol for a Randomized Controlled Trial during Chemotherapy for Breast Cancer
Authors: Bean Helena Rose , Stafford Lesley , Little Ruth , Diggens Justine , Ftanou Maria , Alexander Marliese , Francis Prudence A , Bei Bei , Wiley Joshua F
Published: December 2019

Background: Women with breast cancer experience a significantly higher prevalence of sleep disturbances and insomnia compared with the general population. The experience of persistent sleep disturbance places these women at a higher risk of psychological and physical morbidity and a reduced quality of life. Treatment of sleep in this population is not part of routine care, and often is managed inadequately. This randomised controlled trial will examine the combined effects of Cognitive Behavioural Therapy (CBT) and bright light therapy (BLT) on the symptoms of insomnia, fatigue, and mental health. Method/design: Women diagnosed with breast cancer who receive intravenous chemotherapy treatment at a quaternary referral metropolitan cancer centre in Melbourne Australia will be recruited. Recruitment will occur after diagnosis and prior to completion of chemotherapy. Eligible women will be randomised to the combined CBT and BLT intervention (CBT+) or relaxation audio enhanced treatment as usual (TAU+). The CBT+ group will receive one face-to-face session on sleep strategies, one subsequent telephone call, and seven email packages containing CBT-based information and strategies. CBT+ participants will also wear Luminette® light glasses for 20 minutes each morning for the six-week duration of the intervention. Women in TAU+ will receive two relaxation audio tracks via email. Outcomes will be measured at multiple points throughout the six weeks. Primary outcomes will be symptoms of insomnia and sleep efficiency, measured using the Insomnia Severity Index and a self-reported sleep diary. Secondary outcomes include objective measures of sleep assessed using the ActiGraph wGT3X-BT; and sleep-related complaints, fatigue and mental health, all assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) measure. Data will also be collected on potential treatment moderators and mechanisms, and adherence to treatment. There will be three-month follow-up measurements of fatigue, sleep-related impairment, sleep disturbance, depression, and anxiety. Discussion: This is the first randomised controlled trial to combine CBT and BLT for the treatment of sleep disturbances in women with breast cancer. This novel design addresses the multiple causal factors for sleep complaints in this population. Results from this trial will advance knowledge in this field and may have important clinical implications for how best to treat sleep disturbance and insomnia in this population. If effective, the largely email-based format of the intervention would allow for relatively easy translation. Trial Registration: Australian New Zealand Clinical Trials Registry (ANZCTR), Registration number: ACTRN12618001255279. Retrospectively registered on: 25/07/2018, recruitment began: 24/07/2018.
The side effects of service changes: exploring the longitudinal impact of participation in a randomised controlled trial (DOORWAYS) on staff perceptions of barriers to change.
Authors: Laker Caroline , Cella Matteo , Callard Felicity , Wykes Til
Published: December 2019

Background Staff and service users have expressed concerns that service improvements in U.K. mental health wards have been slow or transient. It is possible that certain changes are positive for some (e.g. service users), but negative for others (e.g. staff), which may affect implementation success. In this study, we explore whether a programme of change to improve the therapeutic milieu on mental health wards influenced staff perceptions of barriers to change, 12 months after implementation. Method A cluster randomised controlled trial called DOORWAYS was conducted on eight inner-city U.K. acute mental health wards. Randomisation was achieved using a list randomly generated by a computer. A psychologist trained ward staff (mainly nurses) to deliver evidence-based groups and supported their initial implementation. The impact of these changes was measured over 12 months (when 4 wards were randomised), according to nurses’ perceptions of barriers to change (VOCALISE), using unstructured multivariate linear regression models. This innovative analysis method allows maximum use of data in randomised controlled trials with reduced sample sizes due to substantial drop out rates. The contextual influences of occupational status (staff) and of workplace setting (ward) were also considered. Results Staff who participated in the intervention had significantly worse perceptions of barriers to change at follow up. The perceptions of staff in the control group did not change over time. In both groups (N=120), direct care staff had more negative perceptions of barriers to change, and perceptions varied according to ward. Across time, direct care staff in the intervention group became more negative than those in the control group. Conclusion Participation in this program of change, worsened staff perceptions of barriers to change. In addition, occupational status (being from the direct care group) had a negative effect on perceptions of barriers to change, an effect that continued across time and was worse in the intervention group. Those providing direct care should be offered extra support when changes are introduced and through the implementation process. More effort should be placed around reducing the perceived burden of innovation for staff in mental health wards.
Plastome phylogenomics, biogeography, and clade diversification of Paris (Melanthiaceae)
Authors: Ji Yunheng , Yang Lifang , Chase Mark W. , Liu Changkun , Yang Zhenyan , Yang Jin , Yang Jun-Bo , Yi Ting-Shuang
Published: December 2019

Background: Paris (Melanthiaceae) is an economically important but taxonomically difficult genus, which is unique in angiosperms because some species have extremely large nuclear genomes. Phylogenetic relationships within Paris have long been controversial. Based on complete plastomes and nuclear ribosomal DNA (nrDNA) sequences, this study aims to reconstruct a robust phylogenetic tree and explore historical biogeography and clade diversification in the genus. Results: All 29 species currently recognized in Paris were sampled. Whole plastomes and nrDNA sequences were generated by the genome skimming approach. Phylogenetic relationships were reconstructed using the maximum likelihood and Bayesian inference methods. Based on the phylogenetic framework and molecular dating, biogeographic scenarios and historical diversification of Paris were explored. Significant conflicts between plastid and nuclear datasets were identified, and the plastome tree is highly congruent with past interpretations of the morphology. Ancestral area reconstruction indicated that Paris may have originated in northeastern Asia and northern China, and has experienced multiple dispersal and vicariance events during its diversification. The rate of clade diversification has sharply accelerated since the Miocene/Pliocene boundary. Conclusions: Our results provide important insights for clarifying some of the long-standing taxonomic debates in Paris . Cytonuclear discordance may have been caused by ancient and recent hybridizations in the genus. The climatic and geological changes since the late Miocene, such as the intensification of Asian monsoon and the rapid uplift of Qinghai-Tibet Plateau, as well as the climatic fluctuations during the Pleistocene, played essential roles in driving range expansion and radiative diversification in Paris . Our findings challenge the theoretical prediction that large genome sizes may limit speciation.
Base-pair Ambiguity and the Kinetics of RNA Folding
Authors: Zhou Guangyao , Loper Jackson , Geman Stuart
Published: December 2019

Background: A folding RNA molecule encounters multiple opportunities to form non-native yet energetically favorable pairings of nucleotide sequences. Given this forbidding free-energy landscape, mechanisms have evolved that contribute to a directed and efficient folding process, including catalytic proteins and error-detecting chaperones. Among structural RNA molecules we make a distinction between "bound" molecules, which are active as part of ribonucleoprotein (RNP) complexes, and "unbound," with physiological functions performed without necessarily being bound in RNP complexes. We hypothesized that unbound molecules, lacking the partnering structure of a protein, would be more vulnerable than bound molecules to kinetic traps that compete with native stem structures. We defined an "ambiguity index"---a normalized function of the primary and secondary structure of an individual molecule that measures the number of kinetic traps available to nucleotide sequences that are paired in the native structure, presuming that unbound molecules would have lower indexes. The ambiguity index depends on the purported secondary structure, and was computed under both the comparative ("gold standard") and an equilibrium-based prediction which approximates the minimum free energy (MFE) structure. Arguing that kinetically accessible metastable structures might be more biologically relevant than thermodynamic equilibrium structures, we also hypothesized that MFE-derived ambiguities would be less effective in separating bound and unbound molecules.
Results: We have introduced an intuitive and easily computed function of primary and secondary structures that measures the availability of complementary sequences that could disrupt the formation of native stems on a given molecule---an ambiguity index. Using comparative secondary structures, the ambiguity index is systematically smaller among unbound than bound molecules, as expected. Furthermore, the effect is lost when the presumably more accurate comparative structure is replaced instead by the MFE structure.
Conclusions: A statistical analysis of the relationship between the primary and secondary structures of non-coding RNA molecules suggests that stem-disrupting kinetic traps are substantially less prevalent in molecules not participating in RNP complexes. In that this distinction is apparent under the comparative but not the MFE secondary structure, the results highlight a possible deficiency in structure predictions when based upon assumptions of thermodynamic equilibrium.
Reporting guideline for priority setting of health research (REPRISE)
Authors: Tong Allison , Synnot Anneliese , Crowe Sally , Hill Sophie , Matus Andrea , Scholes-Robertson Nicole , Oliver Sandy , Cowan Katherine , Nasser Mona , Bhaumik Soumyadeep , Gutman Talia , Baumgart Amanda , Craig Jonathan C
Published: December 2019

Background
Research priority setting with stakeholders can help direct the limited resources for health research toward priority areas of need. Ensuring transparency of the priority setting process can strengthen legitimacy and credibility for influencing the research agenda. This study aims to develop a reporting guideline for priority setting of health research.
Methods
We searched electronic databases and relevant websites for sources (frameworks, guidelines, or models for conducting, appraising, reporting or evaluating health research priority setting, and reviews (including systematic reviews)), and primary studies of research priority setting to July 2019. We inductively developed a list of reporting items and piloted the preliminary guideline with a diverse range of 30 priority setting studies from the records retrieved.
Results
From 21556 records, we included 26 sources for the candidate REPRISE framework and 455 primary research studies. The REporting guideline for PRIority SEtting of health research (REPRISE) has 31 reporting items that cover 10 domains: context and scope, governance and team, framework for priority setting, stakeholders/participants, identification and collection of priorities, prioritization of research topics, output, evaluation and feedback, translation and implementation, and funding and conflict of interest. Each reporting item includes a descriptor and examples.
Conclusions
The REPRISE guideline can facilitate comprehensive reporting of studies of research priority setting. Improved transparency in research priority setting may strengthen the acceptability and implementation of the research priorities identified, so that efforts and funding are invested in generating evidence that is of importance to all stakeholders.
GC-PROM: Validation of a patient-reported outcomes measure for Chinese patients with gastric cancer
Authors: Hu Xiaojuan , Zhao Fen , Yu Hongmei , Luo Yanhong , Liu Jinchun , Zhang Yanbo
Published: December 2019

Background: There is increasing recognition that PROs are important in the estimation of the burden of long-term survival among patients with gastric cancer. The study aimed to develop a disease-specific instrument to assess patient-reported outcomes for Chinese patients with gastric cancer.
Method: Following the FDA's draft guidance for patient-reported outcome, conceptual framework and item pool were defined based on relevant existing work. A draft scale was formed after revising some items based on feedback from experts and Chinese patients with gastric cancer. The pre-survey and formal survey were conducted in eight different hospitals in Shanxi Province, and two item-selection process based on classical test theory and item response theory. Finally, the patient-reported outcomes measure for Chinese patients with gastric cancer (GC-PROM) was validated in terms of reliability, validity, and feasibility. The minimal clinically important difference was determined by distribution-based method.
Results: The final GC-PROM consisted of 38 items, 13 subdomains, and 4 domains. Reliability was verified by Cronbach’s alpha coefficient for four domains and 13 subdomains respectively. The validity results showed that the multidimensional scale fulfilled expectations. In the formal survey, the completion rate was 96.16%, and the average filling time was less than half an hour. The values of the minimal clinically important difference were 4.14, 3.41, 3.37, and 3.28 in the four domains.
Conclusions: The GC-PROM had good reliability, validity, and feasibility and thus can be considered an effective clinical evaluation instrument for Chinese patients with gastric cancer.
Elevated expression of AGGF1 predicts poor prognosis and promotes the metastasis of colorectal cancer
Authors: Zhang Xin , Sun Huimin , Chen Wanyuan , He Xianglei
Published: December 2019

Background: Angiogenic factor with G-patch and FHA domains 1 (AGGF1) can promote angiogenesis and increasing evidence has highlighted the important roles of AGGF1 in tumorigenesis. However, the differential expression as well as the biological functions of AGGF1 in colorectal cancer (CRC) remain to be established. The purpose of the present study is therefore to identify the effect of AGGF1 on prognosis and metastasis in CRC patients.
Methods: The expression level of AGGF1 in CRC was examined by qPCR, western blot and immunohistochemistry in a tissue microarray containing 101 CRC specimens and paired normal mucosae. And the effect of AGGF1 on CRC cell malignance was investigated in our established stable AGGF1 upregulated and knockdown CRC cell lines.
Results: The expression level of AGGF1 in CRC tissue was not significantly different to that in adjacent normal mucosa at the mRNA level. However, at the protein level, AGGF1 expression in CRC tissues was significantly higher than in paired normal mucosa, which showed a clear association with TNM stage, AJCC stage, vascular invasion, and differentiation. Further, we revealed an apparent correlation between AGGF1 expression and poorer disease-free survival and overall survival of CRC patients. In addition, we discovered that AGGF1 significantly promoted CRC cell wound healing, migration, and invasion in vitro and distant metastasis in vivo.
Conclusions: Our study demonstrates the aberrant expression of AGGF1 in CRC and provides a basis on which to explore the application of AGGF1 as a novel prognostic biomarker as well as a therapeutic target for CRC patients, especially for CRC patients with distant metastasis.
Technical Requirements Framework of Hospital Information Systems: Design and Evaluation
Authors: Farzandipour Mehrdad , Meidani Zahra , Nabovati Ehsan , Jabali Monireh Sadeqi , Banadaki Razieh Dehghan
Published: December 2019

Background Hospital Information System (HIS) implementation is complex and costly compared to other information systems. Therefore, the present study was conducted with the aim of designing and evaluating technical HIS requirements.Methods This study was conducted in 2016 in two parts: designing technical requirements and evaluating the HIS. The first part of the study was performed through the Delphi technique. In the second part of the study, evaluation of systems was done using a checklist based on the approved requirements.Results In the first part of the study, the final list of technical HIS requirements was designed with 73 items in four domains including ‘communication service’, ‘system architecture’, ‘security service’, and ‘system response time’. In the second part, the results of the evaluation indicated that the approved requirements had been observed in 63.8%, 65.5%, 72.4%, and 76.3% of the HIS software programs in the dimensions of ‘communication service’, ‘system architecture’, ‘security service’, and ‘system response time’, respectively.Conclusions The technical HIS evaluation tool was designed to be used in the evaluation and selection of the system. The evaluation results also indicated that the studied HISs were weaker in ‘communication service’ and ‘system architecture’ domains compared to the other two domains under study.
Comparison of the effects of empagliflozin and glimepiride on endothelial function in patients with type 2 diabetes: A randomized controlled study
Authors: Tamura Haruka , Kondo Yoshinobu , Ito Kohei , Hasebe Masanori , Satoh Shinobu , Terauchi Yasuo
Published: December 2019

Background: Among patients with type 2 diabetes and established cardiovascular disease, those receiving empagliflozin have a lower rate of primary composite cardiovascular outcomes and death from any cause. Alternatively, treatment with sulfonylurea reduces microvascular complications in diabetes but appears to increase cardiovascular hospitalization or mortality in combination with metformin. Therefore, in the present study, we assessed the effects of empagliflozin and glimepiride, a sulfonylurea, on endothelial function using flow–mediated dilation (FMD) to estimate arteriosclerosis and cardiovascular events in patients with type 2 diabetes.
Methods: In this prospective, open-label, randomized, parallel-group comparison, 58 patients with type 2 diabetes were administered metformin and glargine before bedtime for 12 weeks, followed by the random addition of 10 mg empagliflozin or 0.5 mg glimepiride for 12 weeks. The primary outcome was the change in the FMD measurement (DFMDs), which was measured prior to and following 12 weeks of additional treatment. Secondary outcomes comprised changes in metabolic markers and body composition.
Results: Analysis of the empagliflozin group (n = 30) and glimepiride group (n = 28) showed no significant differences in DFMDs (empagliflozin, −0.19 ± 2.34%; glimepiride, −0.37 ± 2.77%; P ＝ 0.79). Likewise, glycated hemoglobin (HbA1c) changes were similar between the two groups. Body weight changes significantly differed (empagliflozin, –0.59 ± 2.5 kg; glimepiride, 1.2 ± 3.0 kg; P = 0.02). However, analysis of the body composition revealed that body fluid volume significantly decreased only after empagliflozin treatment (baseline, 35.8 ± 6.8 L; after 12 weeks, –0.33 ± 0.72 L; P = 0.03).
Conclusions: Empagliflozin did not improve endothelial function compared with glimepiride in patients with type 2 diabetes, but decreased their body fluid volume. This suggested that the coronary protective effect of empagliflozin is not derived by protecting endothelial function but rather from reducing the risk of heart failure.
Detection of Early Adenocarcinoma of the Esophagogastric Junction by Spraying an Enzyme-Activatable Fluorescent Probe Targeting Dipeptidyl Peptidase-IV
Authors: Yamamoto Keiko , Ohnishi Shunsuke , Mizushima Takeshi , Kodaira Junichi , Ono Masayoshi , Hatanaka Yutaka , Hatanaka Kanako , Kuriki Yugo , Kamiya Mako , Ehira Nobuyuki , Shinada Keisuke , Takahashi Hiroaki , Shimizu Yuichi , Urano Yasuteru , Sakamoto Naoya
Published: December 2019

Background: It is still difficult to detect and diagnose early adenocarcinoma of the esophagogastric junction (EGJ) using conventional endoscopy or image-enhanced endoscopy. A glutamylprolyl hydroxymethyl rhodamine green (EP-HMRG) fluorescent probe that can be enzymatically activated to become fluorescent after the cleavage of a dipeptidyl peptidase (DPP)-IV-specific sequence has been developed and is reported to be useful for the detection of squamous cell carcinoma of the head and neck, and esophagus; however, there is a lack of studies that focuses on detecting EGJ adenocarcinoma by fluorescence molecular imaging. Therefore, we investigated the visualization of early EGJ adenocarcinoma by applying EP-HMRG and using clinical samples resected by endoscopic submucosal dissection (ESD). Methods: Fluorescence imaging with EP-HMRG was performed in 21 clinical samples resected by ESD, and the fluorescence intensity of the tumor and non-tumor regions of interest was prospectively measured. Immunohistochemistry was also performed to determine the expression of DPP-IV. Results: Fluorescence imaging of the clinical samples showed that the tumor lesions were visualized within a few minutes after the application of EP-HMRG, with a sensitivity, specificity, and accuracy of 85.7%, 85.7%, and 85.7%, respectively. However, tumors with a background of intestinal metaplasia did not have a sufficient contrast-to-background ratio since complete intestinal metaplasia also expresses DPP-IV. Immunohistochemistry measurements revealed that all fluorescent tumor lesions expressed DPP-IV. Conclusions: Fluorescence imaging with EP-HMRG could be useful for the detection of early EGJ adenocarcinoma lesions that do not have a background of intestinal metaplasia.
The Effectiveness Of Routine Physiotherapy With And Without Neuromobilization In Patients With Shoulder Impingement Syndrome On Pain And Functional Disability; A Randomized Control Clinical Trial
Authors: Akhtar Muhammad , Kirimi Hossein , Gilani Syed Amir , Ahmad Ashfaq , Raza Asim
Published: December 2019

Background: Neuromobilization (NM) includes neurophysiological parameters that vary between clinicians. This randomized controlled trial aimed to investigate the NM on the outcomes of participants with shoulder impingement syndrome (SIS) following treatment sessions (base line to follow up). Study design: Single blinded randomized control clinical trial. Methods: Patients (80) with shoulder impingement syndrome (SIS) were asked to participate in this trial. At the first session, participants were randomly assigned to either control group (40) or experimental group (40). After the baseline assessment routine physiotherapy was executed for both groups, while NM was provided to experimental group. Pain and functional disability score were evaluated on baseline, post treatment and after follow up. Pain was considered as primary out come and functional disability score as secondary outcome. Improvement was evaluated at post treatment and follow up. Differences in outcome between groups were evaluated with clinical improvement. Results: The experimental group compared with control group at 11th week had lower mean pain score 2.15(1.66-2.64) vs 4.90(4.41-5.40); between group difference, 1.82; 95% (CI), -2.38 to -1.25; P ˂ 0.001 and Partial ƞ2=0.33, similarly functional disability score 28.58(27.32-29.83) vs 20.10(18.84-21.36); between group difference ,5.62; 95%CI,(4.32-6.92); P˂ 0.001 and Partial ƞ2=0.49. Over all pain and functional disability score were improved among experimental group relative to control group at 11th week. Conclusion: In an experimental setting, the delivery of neuromobilization leads to significantly different outcomes in participants than in control group. Studies are still required to explore the mechanisms underlying neuromobilization effects. Trial registration: IRCT20190121042445N1, Registered 19 February 2019. Key words: shoulder impingement, neuromobilization, functional disability.
Intrauterine transplantation of autologous menstrual blood stem cells in the treatment of refractory intrauterine adhesion: a prospective cohort study
Authors: Ma Hailan , Liu Mengting , Wu Dongcheng , Li Yufeng , Wang Wei , Yang Keqin , Lu Lanying , He Mei , Deng Taoran , Li Meiling , Wang Wei
Published: December 2019

Background: The loss of endometrial stem cells has been associated with intrauterine adhesion caused by miscarriage, repeated improper intrauterine operation or infection. Cell-based therapies are promising in regenerative medicine. However, the effects of menstrual blood stem cells (MenSCs) therapy on impaired endometrium need to be explored and validated. This study evaluates the effects of intrauterine transplantation of MenSCs on endometrial thickness and pregnancy outcomes in patients with refractory intrauterine adhesion. Methods: This study included a group of infertile women (n=12, age 22-40 years), with refractory intrauterine adhesion (Grade III – IV). Autologous MenSCs isolated from the women’ menstrual blood were expanded in vitro and transplanted into their uteruses, followed by hormone replacement therapy. Transvaginal ultrasound examination was performed to assess the endometrial thickness. Transabdominal ultrasound was conducted to detect pregnancy outcome. Results: Autologous MenSCs were successfully isolated and expanded from menstrual blood and transplanted into the uterus of each patient. A significant improvement of the endometrial thickness was observed (from 3.9±0.9 mm pre-treatment to 7.5±0.6 mm post-treatment (P<0.001)). No adverse reaction was observed. The duration of menstruation was increased (from 2.4±0.7 days pre-treatment to 5.3±0.6 days post-treatment (P<0.001)). Five out of 12 patients achieved clinical pregnancy. Conclusions: Intrauterine transplantation of autologous MenSCs results in regeneration of endometrium, a prolongation of menstrual duration and an increase rate of pregnancy in patients with refractory intrauterine adhesion.
Swedish Translation and Validation of the Pediatric Insomnia Severity Index
Authors: Angelhoff Charlotte , Johansson Peter , Svensson Erland , Sundell Anna Lena
Published: December 2019

Background: To increase health and well-being in young children, it is important to acknowledge and promote the child’s sleep behaviour. However, there is a lack of brief, validated sleep screening instruments for children. The aim of this study was to present a Swedish version of the Pediatric Insomnia Severity Index (PISI), analyse the structure, test the validity and reliability of the instrument. Methods: The English version of the PISI was translated into Swedish, translated back into English, and agreed upon before use. Parents of healthy 3- to 10-year-old children filled out the Swedish version of the PISI and the generic health-related quality of life instrument KIDSCREEN-27 two times. Exploratory and confirmatory factor analyses for baseline and test-retest, structural equation modelling, and correlations between the PISI and KIDSCREEN-27 were performed Results: In total, 160 parents filled out baseline questionnaires (test), whereof 100 parents (63%) filled out the follow-up questionnaires (retest). Confirmative factor analysis of the PISI found two correlated factors: sleep onset problems (SOP) and sleep maintenance problems (SMP). The PISI had substantial construct and test-retest reliability. The PISI factors influenced all KIDSCREEN-27 dimensions. Conclusions: The Swedish version of the PISI is applicable for screening sleep problems and is a useful aid in dialogues with families about sleep. It is also relevant in research and for evaluation of treatment. Keywords: Child; Child, Preschool; Health Promotion; Sleep; Translations; Pediatrics; Validation Studies; Quality of Life
Maternal Subclinical Hypothyroidism in the first trimester is not Associated with Gestational Diabetes Mellitus
Authors: Li Ping , Chen Xinjuan , Cui Jinhui , Meng Zhaoran , Fan Jianhui , Lin Shuo
Published: December 2019

Background: To explore the association between subclinical hypothyroidism (SCH) during the first trimester and gestational diabetes mellitus (GDM) that was happened later on in our cohort. Methods: A total of 6530 pregnant women who first visited before 13 +6 gestational weeks and accepted routinely prenatal services in the third affiliated hospital of Sun Yat-Sen University from January 2015 to September 2018 were finally met the inclusion criteria and recruited. Thyroid functions (TSH, free T4 (FT4) and TPOAb) were performed at the first visit and a 2h 75-g oral glucose tolerance test was performed between 24-28 weeks. Chi-square test and multivariate logistic regression were used to evaluate the association between SCH and GDM. Results: Though SCH group was divided into subgroups according TPOAb status and TSH levels, the incidence of GDM was no change when compared with the normal group (all P > 0.05). No matter adjusting or not for maternal age, maternal pregestational body max index, parity and educational level, the results showed elevated TSH was not associated GDM (all P > 0.05). TPOAb status also had no effect on the incidence of GDM either before or after adjustment ( P > 0.05). Conclusion: Maternal SCH in the first trimester was not associated with GDM, regardless of the TPOAb status or the TSH levels.
Culture of porcine Vascular Wall - Mesenchymal Stem Cells on 3D biodegradable highly porous mineral doped Poly (α-hydroxy) acids scaffolds
Authors: Forni Monica , Bernardini Chiara , Zamparini Fausto , Zannoni Augusta , Salaroli Roberta , Ventrella Domenico , Esposti Micaela Degli , Fabbri Paola , Fava Fabio , Prati Carlo , Gandolfi Maria Giovanna
Published: December 2019

Background Vascularization is a crucial factor when approaching any engineered tissue. Hybrid biomaterials composed of biodegradable synthetic polymers and inorganic materials showed suitable properties for biomedical application. Being Vascular Wall – Mesenchymal Stem Cells derived from pig thoracic aorta (pVW-MSCs) an excellent in vitro model to study vascular remodelling due to their strong angiogenic attitude, the aim of the present study was to demonstrate the angiogenic potential of experimental highly porous scaffolds based on polylactic acid (PLA) or poly-e-caprolactone (PCL) doped with calcium silicates (CaSi) and dicalcium phosphate dehydrated (DCPD), namely PLA-10CaSi-10DCPD and PCL-10CaSi-10DCPD. Results The results obtained clearly demonstrated that the cells colonized the scaffolds and were metabolically active. Moreover cells, grown in these 3D systems, showed the typical gene expression profile they have in control 2D culture, although with some main quantitative differences. DAPI staining and immunofluorescence assay confirmed cellular presence on both scaffolds, however pVW-MSCs cultured in PLA-10CaSi-10DCPD showed an individual cellular growth, in contrast, in PCL-10CaSi-10DCPD scaffolds pVW-MSCs grew in spherical clusters. Conclusion In conclusion, the property of the experimental scaffolds demonstrated the suitability of the scaffolds to be colonized by vascular stem cells for new vessels formation and a potential application in tissue regeneration for biomedical purpose.
Effects of Lactobacillus plantarum on intestinal integrity and immune responses of chickens infected with Clostridium perfringens under the free-range or the specific pathogen free environment
Authors: Xu Tianyue , Chen Yan , Yu Longfei , Wang Jun , Huang Mingxing , Zhu Nianhua
Published: December 2019

Background Necrotic enteritis, which is caused by Clostridium perfringens, has resulted in more than $2 billion losses in the poultry industry every year. Due to the ban of antibiotics in feed industry, alternatives like environment improvement and probiotics have been found to be effective as well. In our study, we aim to explore the protective effect of Lactobacillus plantarum on CP infected chickens in two environments. Results The results showed that the Clostridium perfringens administration led to visible and histomorphological gut lesions. In the specific pathogen free or free-range system environment, dietary supplementation with LP obvious increased the ratio of intestinal villus height to crypt depth and the expression of MUC2 mRNA in ileum mucosa, then reduced the mRNA expression level of TNF-α gene in the ileum mucosa. LP treatment significantly reduced the contents of total protein, total superoxide dismutase and glutamic oxaloacetic transaminase in serum of the chickens. Conclusions The specific pathogen free environment contributed to the recovery of pre-inflammation of the chickens, and free-range system environment contributed to the repair of damage in the later stages of chicken inflammation. Supplementation of LP in FRS environment was more conducive to the recovery of CP infected in chickens.
Curative effect and Safety in Anteromedial Osteoarthritis Patients over 80 Years Old Undergoing Oxford Unicompartmental Knee Arthroplasty (UKA) in China: A Single-Center Retrospective Study
Authors: Cheng Jingbo , Feng Mingli , Cao Guanglei , Li Zheng , An Shuai , Lu Shibao
Published: December 2019

Background: Oxford Unicompartmental Knee Arthroplasty (UKA) has increased rapidly around the world, and the effectiveness and safety of a minimally invasive surgical approach for it demonstrate excellent outcome. Oxford UKA represents an interesting solution for older patients. The aim of our study is to evaluate the perioperative complications and short-term clinical outcome and analyze the safety for older patients who undergo Oxford UKA.Methods: A retrospective review was performed of all patients who underwent Oxford UKA between June 2015 and January 2018. We divided all patients into two groups (ages 60–80; age over 80). We used the HSS score and WOMAC score to evaluate the general condition of the patients’ knees. We also recorded perioperative complications and long-term complications. Result:130 patients (139 knees) between the ages of 60 and 80 (Group 1) and 65 patients (70 knees) over 80 years old (Group 2) were included in the study. The mean follow-up was 22.04 ± 11.04 and 21.76 ± 10.20 months in Group 1 and 2, respectively. At last follow-up, the patients in Group 2 showed lower function scores, but both the HSS score and the WOMAC score were significantly improved in both groups after surgery. The rate of perioperative complications and other complications in elderly patients is the same as in younger patients. Conclusion: Oxford UKA showed validity and safety for elderly patients in China. The knee joint pain symptoms of the elderly patients are relieved and the function is well restored, but the function is still poor compared with the younger patients.
Do we need to adjust for interim analyses in a Bayesian adaptive trial design?
Authors: Ryan Elizabeth , Brock Kristian , Gates Simon , Slade Daniel
Published: December 2019

Background Bayesian adaptive methods are increasingly being used to design clinical trials and offer a number of advantages over traditional approaches. Decisions at analysis points are usually based on the posterior distribution of the parameter of interest. However, there is some confusion amongst statisticians and trialists as to whether control of type I error is required for Bayesian adaptive designs as this is a frequentist concept. Methods We discuss the arguments for and against adjusting for multiplicities in Bayesian trials with interim analyses. We present two case studies demonstrating the effect on type I/II error rates of including interim analyses in Bayesian clinical trials. We propose alternative approaches to adjusting stopping boundaries to control type I error, and also alternative methods for decision-making in Bayesian clinical trials. Results In both case studies we found that the type I error was inflated in the Bayesian adaptive designs through incorporation of interim analyses that allowed early stopping for efficacy and do not make adjustments to account for multiplicity. Incorporation of early stopping for efficacy also increased the power in some instances. An increase in the number of interim analyses that only allowed early stopping for futility decreased the type I error, but also decreased power. An increase in the number of interim analyses that allowed for either early stopping for efficacy or futility generally increased type I error and decreased power. Conclusions If one wishes to demonstrate control of type I error in Bayesian adaptive designs then adjustments to the stopping boundaries are usually required for designs that allow for early stopping for efficacy as the number of analyses increase. If the designs only allow for early stopping for futility then adjustments to the stopping boundaries are not needed to control type I error, but may be required to ensure adequate power. If one instead uses a strict Bayesian approach then type I errors could be ignored and the designs could instead focus on the posterior probabilities of treatment effects of particular values.