bluuebunny/crossref_metadata_2025 huggingface dataset:
Platelets Loaded with Recombinant ADAMTS13 Are Efficacious in Inhibiting Arterial Thrombosis Under Flow: A Potential Novel Therapeutic for Acquired TTP
Authors: Abdelgawwad Mohammad , Zheng Liang , Zheng X. Long
Published: April 2021

Background: Thrombotic thrombocytopenic purpura (TTP), a potentially life-threatening blood clotting disorder, is resulted from severe deficiency of ADAMTS13 activity. Plasma exchange is the only effective initial therapy for acquired TTP, which replenishes ADAMTS13 while removing autoantibodies. However, the in-hospital mortality rate is still high, suggesting that another more effective therapy is urgently needed.

Objectives: The present study aims to develop a novel therapy using platelets as carriers to deliver recombinant ADAMTS13 (rADAMTS13) to the sites of vascular injury, where platelets are activated and de-granulated to release rADAMTS13 from the storage granules. Our specific aims are: 1) determine the in vitro uptake of rADAMTS13 by platelets; 2) determine the efficacy of platelet-delivered rADAMTS13 in anti-arterial thrombosis under flow and in vivo.

Methods: Freshly isolated human platelets from whole blood were incubated with an increasing concentration of rADAMTS13 (0, 5, 20, 50, and 100 µg/ml) at 25°C and 37°C for hours. Platelets were then washed and lysed with 1% Triton X-100 to assess the rADAMTS13 activity via a FRETS-VWF73 assay. Western blotting and confocal microscopy determined the amounts of rADAMTS13 protein and localization in platelets, respectively. The anti-thrombotic activity of the released rADAMTS13 from activated platelets was determined by a microfluidic system (BioFlux) and by a ferric chloride induced thrombus formation in mesenteric arterioles/venules in Adamts13-/- mice.

Results: Human washed platelets were able to uptake rADAMTS13 in a temperature- and concentration-dependent manner. The rADAMTS13 protein packed inside human platelets remained intact and active towards the FRET-VWF73 substrate. Confocal microscopic analysis demonstrated its localization of uptaken rADAMTS13 in the alpha granules, partially overlapped with VWF. The rADAMTS13 released from activated human platelets under shear (100 dyne/cm2) was capable of cleaving VWF and inhibiting platelet agglutination and aggregation on a collagen-coated surface in a concentration-dependent manner. Transfusion of platelets expressing rADAMTS13 into Adamts13-/- mice dramatically reduced the rate of thrombus formation in the mesenteric arterioles/venules after ferric chloride injury.

Conclusions: Our results demonstrate that human platelets can be reengineered in vitro to contain sufficient amounts of rADAMTS13 in the alpha granules. The rADAMTS13 inside platelets is releasable and proteolytically functional under shear stress or in vivo under flow. Our findings suggest that the transfusion of platelets loaded with rADAMTS13 may represent a novel therapeutic strategy for acquired TTP with inhibitors.

Disclosures

Zheng: Alexion: Speakers Bureau; Ablynx: Consultancy.
Targeted Education after an Emergency Department Visit Increases Hydroxyurea Initiation in Children with Sickle Cell Anemia
Authors: Kappa Sarah , Pecker Lydia , Darbari Deepika S. , Nickel Robert
Published: April 2021

Introduction: Hydroxyurea decreases many complications of sickle cell anemia (SCA) but is underused in treatment-eligible patients. Barriers to hydroxyurea initiation occur on the health care system, provider, and patient level. Novel strategies to increase hydroxyurea use in patients with SCA are needed. To address this challenge at our center, we implemented the Quick Start Hydroxyurea Initiation Project (Q-SHIP).

Methods: Patients with SCA were eligible to participate in Q-SHIP if they presented to the Children's National Health System (CNHS) emergency department (ED) for pain or acute chest syndrome and were not taking hydroxyurea. Patients <9 months old, on chronic transfusions, pregnant, or not followed by CNHS hematology were excluded. Eligible patients were referred to a weekly Q-SHIP clinic visit focused on hydroxyurea education and were offered initiating treatment at the visit's conclusion. Participants completed a pre-session questionnaire, discussed hydroxyurea with a hematologist using a handbook developed by CNHS, and watched videos featuring patients and parents of children with SCA sharing their experience with hydroxyurea. Subjects were classified as starting hydroxyurea if they had a clinic visit for hydroxyurea monitoring within 3 months of participation in a Q-SHIP session.

Results: Over 13 months (2/1/2016 - 3/31/2017) 65 eligible patients participated in Q-SHIP a median of 5 days (IQR 2, 20 days) after ED or hospital discharge. Although 44% (28/64) of participants reported no previous hydroxyurea offer, provider clinic documentation indicated that 61% (17/28) of these families had declined a previous hydroxyurea offer. After Q-SHIP, 55% (36/65) of participants started hydroxyurea. Subjects who started hydroxyurea after Q-SHIP were similar to those who did not, except subjects who started were more likely have a history of an intensive care unit admission (Table 1). After a median follow-up of 11 months, 81% (29/36) of participants who started hydroxyurea after Q-SHIP continued on therapy. Among Q-SHIP participants continuing treatment, mean corpuscular volume increased by a median of 8.6 fL (IQR +5.4, +17.7, p<0.0001) and hemoglobin F increased by a median of 5.8% (IQR +3.0, +11.3, p<0.001). One year after implementation of Q-SHIP, the proportion of treatment-eligible patients with SCA who presented to the ED with pain or ACS who were receiving hydroxyurea increased; February 2016: 56% (32/57) vs. February 2017: 73% (43/59), p=0.059.

Conclusion: Addressing indications for hydroxyurea therapy in a clinic encounter exclusively for this purpose soon after a SCA complication is a meaningful time to meet with families of children with SCA to initiate treatment.

Disclosures

No relevant conflicts of interest to declare.
Magnetically Powered Microbots: A Novel Approach to Thrombolysis?
Authors: Neeves Keith B. , Tasci Tonguc , Disharoon Dante , Rana Kuldeepsinh , Schoeman Rogier , Herson Paco , Marr David
Published: April 2021

Fibrinolytic drugs such as recombinant tissue plasminogen activator (tPA) have been successfully used to reestablish blood flow in thrombotic strokes. However, they can also lead to intracranial hemorrhaging, must be used within hours of the onset of symptoms, and have limited efficacy in small vessel occlusions distal to major cerebral arteries. Alternatively, catheter-based thrombectomy devices can restore blood flow quickly but are invasive, limited to larger arteries, and can leave residual prothrombotic material on vessel walls. An approach that overcomes these limitations is the injection of individual superparamagnetic particles coated with fibrinolytic drugs that, upon application of a rotating magnetic field, self-assemble into microbots we call microwheels capable of translating to and directly attacking thrombi. We describe an approach that uses the vessel wall to propel in situ assembled microwheels via rolling.1 Driven by low-strength external magnetic fields (~10 mT), microwheel movement occurs with greatly improved speeds (>100 µm/sec) and directional control compared to approaches that use magnetic field gradients to direct similar types of microdevices. Using this approach, tPA-functionalized particles are introduced at a subtherapeutic concentration, which accumulate to therapeutic levels at the periphery of a thrombus. Fibrinolytic microwheels bore into fibrin-rich and platelet-rich thrombi by mechanical action and accomplish reperfusion faster than soluble tPA at comparable concentrations.2 For example, fibrinolysis of plasma-derived fibrin gels is five-fold faster using tPA-microwheels compared to 1 µg/mL tPA. Using a microfluidic model of vascular injury, ~100 µm sized platelet-rich thrombi were formed on collagen-tissue factor surfaces and then ablated with tPA-microwheels in less than five minutes. Combining mechanical and biochemical methods, this approach could reduce the risk of bleeding associated with fibrinolytics and broaden their indications.

1. Tasci TO, Herson PS, Neeves KB, Marr DWM. Surface-enabled propulsion and control of colloidal microwheels. Nature Communication, 2016;7:10225.

2. Tasci TO, Disharoon D, Schoeman RM, Rana K, Herson PS, Marr DWM, Neeves KB. Enhanced fibrinolysis with magnetically powered colloidal microwheels. Small;in press

Disclosures

Neeves: Colorado School of Mines: Patents & Royalties.
Impact of the Coagulation System on the Pathogenesis of Alzheimer's Disease
Authors: Strickland Sidney
Published: April 2021

Alzheimer's disease (AD) leads to cognitive impairment and is eventually fatal. The cognitive decline is associated with extensive neuronal degeneration. The most well-known pathological features of AD are extracellular Aβ plaques, intracellular tau tangles, neuroinflammation, and neuronal loss. Less discussed is that AD is often associated with cerebrovascular abnormalities. The symptoms of AD and cerebrovascular pathology could be independent co-morbidities, with both being increased in aging populations. However, it is also possible that there is a mechanistic link between AD and vascular pathology. The interaction of Aβ with fibrin(ogen) can lead to increased fibrin deposition in cerebral blood vessels, and these accumulated fibrin deposits may disrupt cerebral blood flow and induce microinfarcts, inflammation, and BBB damage, all of which are aspects of cerebrovascular dysfunction observed in AD. At the same time, Ab's ability to activate FXII may contribute to increased fibrin generation through the intrinsic coagulation pathway as well as to increased inflammation and vascular permeability through bradykinin release from HK. These possible roles of Aβ in thrombosis, fibrinolysis, and inflammation via its interaction with fibrinogen and FXII, summarized in Figure 1, will be discussed.

Disclosures

No relevant conflicts of interest to declare.
In Vitro Hematopoietic Reprogramming and Generation of Hematopoietic Stem Cells
Authors: Moore Kateri A.
Published: April 2021

Hematopoietic stem cell (HSC) transplantation is widely used to treat a variety of disorders. Despite advances in the use of umbilical cord blood and mobilized stem cells, donor material remains limited. This is due to insufficient numbers of stem cells in cord blood, poor mobilization, and the lack of ethnic diversity to provide sufficient genetically matched material. Despite intensive efforts there has been limited success in generating transplantable HSCs from pluripotent stem cells (PSCs). Clearly, alternative approaches are necessary. Directly programmed hematopoietic stem/progenitor cells would provide an unlimited patient-specific source for cell replacement and genetic correction therapies as well as a platform for the future generation of patient specific therapeutics and blood products. In 2013 we demonstrated direct reprogramming of mouse fibroblasts into clonogenic hematopoietic progenitors with just four transcription factors (TFs), Gata2, Gfi1b, cFos and Etv6 (Pereira et al 2013). These four TFs induce a dynamic, multi-stage hemogenic process that progresses through an endothelial-like intermediate. As such, it appears to recapitulate definitive developmental hematopoiesis in vitro. We now have strong evidence that a similar hemogenic process can be optimally induced in human fibroblasts with Gata2, Gfi1b, and cFos. These reprogrammed cells are able to multi-lineage repopulate NSG mice. Therefore we maintain that in vitro reprogramming provides a tractable system to address the underlying molecular mechanisms of hemogenesis not possible in primary cells. We have now studied how the TFs bind DNA and initiate a molecular program that changes the epigenetic landscape to allow a change in cell fate. The studies to date have revealed cooperative binding of two of the factors to the binding motif of the other causing simultaneous silencing of fibroblast genes and activation of endothelial and hematopoietic genes.

Pereira CF, Chang B, Qiu J, Niu X, Papatsenko D, Hendry CE, Clark NR, Nomura-Kitabayashi A, Kovacic JC, Ma'ayan A, Schaniel C, Lemischka IR, Moore K. Induction of a Hemogenic Program in Mouse Fibroblasts. Cell Stem Cell. 2013;13:205-218.

Disclosures

No relevant conflicts of interest to declare.
Integrative microRNAome analysis of skeletal muscle of Colossoma macropomum (tambaqui), Piaractus mesopotamicus (pacu), and the hybrid tambacu, based on next-generation sequencing data
Authors: Fantinatti Bruno E. A. , Perez Erika S. , Zanella Bruna T. T. , Valente Jéssica S. , de Paula Tassiana G. , Mareco Edson A. , Carvalho Robson F. , Piazza Silvano , Denti Michela A. , Dal-Pai-Silva Maeli
Published: April 2021

Background

Colossoma macropomum (tambaqui) and Piaractus mesopotamicus (pacu) are good fish species for aquaculture. The tambacu, individuals originating from the induced hybridization of the female tambaqui with the male pacu, present rapid growth and robustness, characteristics which have made the tambacu a good choice for Brazilian fish farms. Here, we used small RNA sequencing to examine global miRNA expression in the genotypes pacu (PC), tambaqui (TQ), and hybrid tambacu (TC), (Juveniles, n = 5 per genotype), to better understand the relationship between tambacu and its parental species, and also to clarify the mechanisms involved in tambacu muscle growth and maintenance based on miRNAs expression.

Results

Regarding differentially expressed (DE) miRNAs between the three genotypes, we observed 8 upregulated and 7 downregulated miRNAs considering TC vs. PC; 14 miRNAs were upregulated and 10 were downregulated considering TC vs. TQ, and 15 miRNAs upregulated and 9 were downregulated considering PC vs. TQ. The majority of the miRNAs showed specific regulation for each genotype pair, and no miRNA were shared between the 3 genotype pairs, in both up- and down-regulated miRNAs. Considering only the miRNAs with validated target genes, we observed the miRNAs miR-144-3p, miR-138-5p, miR-206-3p, and miR-499-5p. GO enrichment analysis showed that the main target genes for these miRNAs were grouped in pathways related to oxygen homeostasis, blood vessel modulation, and oxidative metabolism.

Conclusions

Our global miRNA analysis provided interesting DE miRNAs in the skeletal muscle of pacu, tambaqui, and the hybrid tambacu. In addition, in the hybrid tambacu, we identified some miRNAs controlling important molecular muscle markers that could be relevant for the farming maximization.
The transcriptional landscape of a hepatoma cell line grown on scaffolds of extracellular matrix proteins
Authors: Ghosh Souvik , Börsch Anastasiya , Ghosh Shreemoyee , Zavolan Mihaela
Published: April 2021

Background

The behavior of cells in vivo is complex and highly dynamic, as it results from an interplay between intercellular matrix proteins with surface receptors and other microenvironmental cues. Although the effects of the cellular niche have been investigated for a number of cell types using different molecular approaches, comprehensive assessments of how the global transcriptome responds to 3D scaffolds composed of various extracellular matrix (ECM) constituents at different concentrations are still lacking.

Results

In this study, we explored the effects of two diverse extracellular matrix (ECM) components, Collagen I and Matrigel, on the transcriptional profile of cells in a cell culture system. Culturing Huh-7 cells on traditional cell culture plates (Control) or on the ECM components at different concentrations to modulate microenvironment properties, we have generated transcriptomics data that may be further explored to understand the differentiation and growth potential of this cell type for the development of 3D cultures. Our analysis infers transcription factors that are most responsible for the transcriptome response to the extracellular cues.

Conclusion

Our data indicates that the Collagen I substrate induces a robust transcriptional response in the Huh-7 cells, distinct from that induced by Matrigel. Enhanced hepatocyte markers (ALB and miR-122) reveal a potentially robust remodelling towards primary hepatocytes. Our results aid in defining the appropriate culture and transcription pathways while using hepatoma cell lines. As systems mimicking the in vivo structure and function of liver cells are still being developed, our study could potentially circumvent bottlenecks of limited availability of primary hepatocytes for preclinical studies of drug targets.
Auxin regulated metabolic changes underlying sepal retention and development after pollination in spinach
Authors: Fatima Mahpara , Ma Xiaokai , Zhou Ping , Zaynab Madiha , Ming Ray
Published: April 2021

Background

Pollination accelerate sepal development that enhances plant fitness by protecting seeds in female spinach. This response requires pollination signals that result in the remodeling within the sepal cells for retention and development, but the regulatory mechanism for this response is still unclear. To investigate the early pollination-induced metabolic changes in sepal, we utilize the high-throughput RNA-seq approach.

Results

Spinach variety ‘Cornel 9’ was used for differentially expressed gene analysis followed by experiments of auxin analog and auxin inhibitor treatments. We first compared the candidate transcripts expressed differentially at different time points (12H, 48H, and 96H) after pollination and detected significant difference in Trp-dependent auxin biosynthesis and auxin modulation and transduction process. Furthermore, several auxin regulatory pathways i.e. cell division, cell wall expansion, and biogenesis were activated from pollination to early developmental symptoms in sepals following pollination. To further confirm the role auxin genes play in the sepal development, auxin analog (2, 4-D; IAA) and auxin transport inhibitor (NPA) with different concentrations gradient were sprayed to the spinach unpollinated and pollinated flowers, respectively. NPA treatment resulted in auxin transport weakening that led to inhibition of sepal development at concentration 0.1 and 1 mM after pollination. 2, 4-D and IAA treatment to unpollinated flowers resulted in sepal development at lower concentration but wilting at higher concentration.

Conclusion

We hypothesized that sepal retention and development might have associated with auxin homeostasis that regulates the sepal size by modulating associated pathways. These findings advanced the understanding of this unusual phenomenon of sepal growth instead of abscission after pollination in spinach.
FISH landmarks reflecting meiotic recombination and structural alterations of chromosomes in wheat (Triticum aestivum L.)
Authors: Zou Yang , Wan Linrong , Luo Jie , Tang Zongxiang , Fu Shulan
Published: April 2021

Background

DNA sequence composition affects meiotic recombination. However, the correlation between tandem repeat composition and meiotic recombination in common wheat (Triticum aestivum L.) is unclear.

Results

Non-denaturing fluorescent in situ hybridization (ND-FISH) with oligonucleotide (oligo) probes derived from tandem repeats and single-copy FISH were used to investigate recombination in three kinds of the long arm of wheat 5A chromosome (5AL). 5AL535–18/275 arm carries the tandem repeats pTa-535, Oligo-18, and pTa-275, 5AL119.2–18/275 arm carries the tandem repeats pSc119.2, Oligo-18 and pTa-275, and 5AL119.2 arm carries the tandem repeats pSc119.2. In the progeny of 5AL535–18/275 × 5AL119.2, double recombination occurred between pSc119.2 and pTa-535 clusters (119–535 interval), and between pTa-535 and Oligo-18/pTa-275 clusters (535–18 interval). The recombination rate in the 119–535 interval in the progeny of 5AL535–18/275 × 5AL119.2–18/275 was higher than that in the progeny of 5AL535–18/275 × 5AL119.2. Recombination in the 119–535 interval produced 5AL119 + 535 segments with pTa-535 and pSc119.2 tandem repeats and 5ALNo segments without these repeats. The 5AL119 + 535 and 5ALNo segments were localized between the signal sites of the single-copy probes SC5A-479 and SC5A-527. The segment between SC5A-479 and SC5A-527 in the metaphase 5ALNo was significantly longer than that in the metaphase 5AL119 + 535.

Conclusion

The structural variations caused by tandem repeats might be one of the factors affecting meiotic recombination in wheat. Meiotic recombination aggregated two kinds of tandemly repeated clusters into the same chromosome, making the metaphase chromosome more condensed. To conclude, our study provides a robust tool to measure meiotic recombination and select parents for wheat breeding programs.
Effect of low-concentration carbohydrate on patient-centered quality of recovery in patients undergoing thyroidectomy: a prospective randomized trial
Authors: Wang Shun , Gao Peng-fei , Guo Xiao , Xu Qi , Zhang Yun-feng , Wang Guo-qiang , Lin Jing-yan
Published: April 2021

Backround

At present, low-concentration carbohydrate is rarely used in minor trauma surgery, and its clinical efficacy is unknown. The aim of the study was to evaluate the effect of preoperative oral low-concentration carbohydrate on patient-centered quality of recovery in patients undergoing thyroidectomy using Quality of Recovery − 15 (QoR-15) questionnaire.

Methods

One hundred twenty patients were randomized to oral intake of 300 ml carbohydrate solution (CH group) or 300 ml pure water (PW group) 2 h before surgery or fasting for 8 h before surgery (F group). The QoR-15 questionnaire was administered to compare the quality of recovery at 1d before surgery (T0), 24 h, 48 h, 72 h after surgery (T1, T2, T3), and perioperative blood glucose was recorded.

Results

Compared to the F group, the QoR-15 scores were statistically higher in the CH and PW group at T1 (P < 0.05), and the enhancement of recovery quality reached the clinical significance at T1 in the CH group compared with the F group. Among the five dimensions of the QoR-15 questionnaire, physical comfort, physiological support and emotional dimension in the CH group were significantly better than the F group (P < 0.05) at T1. Besides, blood glucose of CH group was significantly lower than the PW group and F group at each time point after surgery.

Conclusions

Low-concentration carbohydrate could decrease the incidence of postoperative hyperglycemia and improve the patient-centered quality of recovery on patients undergoing open thyroidectomy at the early stage postoperatively.

Trial registration

ChiCTR1900024731. Date of registration: 25/07/2019.
Dexmedetomidine attenuates myocardial ischemia-reperfusion injury in vitro by inhibiting NLRP3 Inflammasome activation
Authors: Huang Yaru , Sun Xiaotong , Juan Zhaodong , Zhang Rui , Wang Ruoguo , Meng Shuqi , Zhou Jiajia , Li Yan , Xu Keyou , Xie Keliang
Published: April 2021

Background

Myocardial ischemia-reperfusion injury (MIRI) is the most common cause of death worldwide. The NOD-, LRR- and pyrin domain-containing protein 3 (NLRP3) inflammasome plays an important role in the inflammatory response to MIRI. Dexmedetomidine (DEX), a specific agonist of α2-adrenergic receptor, is commonly used for sedation and analgesia in anesthesia and critically ill patients. Several studies have shown that dexmedetomidine has a strong anti-inflammatory effect in many diseases. Here, we investigated whether dexmedetomidine protects against MIRI by inhibiting the activation of the NLRP3 inflammasome in vitro.

Methods

We established an MIRI model in cardiomyocytes (CMs) alone and in coculture with cardiac fibroblasts (CFs) by hypoxia/reoxygenation (H/R) in vitro. The cells were treated with dexmedetomidine with or without MCC950 (a potent selective NLRP3 inhibitor). The beating rate and cell viability of cardiomyocytes, NLRP3 localization, the expression of inflammatory cytokines and NLRP3 inflammasome-related proteins, and the expression of apoptosis-related proteins, including Bcl2 and BAX, were determined.

Results

Dexmedetomidine treatment increased the beating rates and viability of cardiomyocytes cocultured with cardiac fibroblasts. The expression of the NLRP3 protein was significantly upregulated in cardiac fibroblasts but not in cardiomyocytes after H/R and was significantly attenuated by dexmedetomidine treatment. Expression of the inflammatory cytokines IL-1β, IL-18 and TNF-α was significantly increased in cardiac fibroblasts after H/R and was attenuated by dexmedetomidine treatment. NLRP3 inflammasome activation induced the increased expression of cleaved caspase1, mature IL-1β and IL-18, while dexmedetomidine suppressed H/R-induced NLRP3 inflammasome activation in cardiac fibroblasts. In addition, dexmedetomidine reduced the expression of Bcl2 and BAX in cocultured cardiomyocytes by suppressing H/R-induced NLRP3 inflammasome activation in cardiac fibroblasts.

Conclusion

Dexmedetomidine treatment can suppress H/R-induced NLRP3 inflammasome activation in cardiac fibroblasts, thereby alleviating MIRI by inhibiting the inflammatory response.
The inverse association between unhealthy eating habit and mucosal healing among patients with ulcerative colitis
Authors: Furukawa Shinya , Yagi Sen , Shiraishi Kana , Hashimoto Yu , Kitahata Shogo , Hanayama Masakazu , Tange Kazuhiro , Mori Kenichiro , Ninomiya Tomoyuki , Suzuki Seiyuu , Shibata Naozumi , Murakami Hidehiro , Ohashi Katsuhisa , Hasebe Aki , Tomida Hideomi , Yamamoto Yasunori , Takeshita Eiji , Ikeda Yoshio , Hiasa Yoichi
Published: April 2021

Background

Although the association between eating habits which can be modified and digestive diseases has been reported, to date, no research has evaluated the association between eating habits and ulcerative colitis (UC). Thus, we investigate the association between eating behavior and clinical outcome in Japanese patients with UC.

Methods

Eating quickly, eating until full, and skipping breakfast data was obtained from a self-administered questionnaire. Information on clinical outcome was collected from medical records. Mucosal healing (MH) and partial MH was defined as a Mayo endoscopic subscore of 0 or 0–1, respectively. Age, sex, BMI, current smoking, current drinking, prednisolone use, and anti-TNFα monoclonal antibody use were selected a priori as potential confounding factors.

Results

Study subjects consisted of 294 Japanese patients with UC. Eating at speed moderate and eating quickly were independently inversely associated with MH: the adjusted odds ratios (ORs) were 0.38 (95% confidence interval [CI] 0.16–0.85) and 0.38 (95% CI 0.17–0.81) (pfor trend = 0.033). Eating until full was independently inversely associated with MH: the adjusted OR was 0.38 (95% CI 0.27–0.86). MH in patients who skipped breakfast was marginally lower than that in patients who did not skip breakfast. No association between eating habits and clinical remission or partial MH was found.

Conclusion

Among patients with UC, eating rate and eating until full may be independently inversely associated with MH but not clinical remission.
Fall awareness behaviour and its associated factors among community dwelling older adults
Authors: Goh Jing Wen , Singh Devinder Kaur Ajit , Mesbah Normala , Hanafi Anis Afifa Mohd , Azwan Adlyn Farhana
Published: April 2021

Background

Falls are one of the major causes of mortality and morbidity in older adults. However, despite adoption of prevention strategies, the number of falls in older adults has not declined. The aim of this study was to examine fall awareness behaviour and its associated factors among Malaysian community dwelling older adults.

Methods

A total of 144 community dwelling older adults (mean age of 70.69 ± 4.3 years) participated in this study. Physical performance were assessed using timed up and go (TUG), gait speed (GS), chair stand and hand grip tests. Fall Awareness Behaviour (FaB) and Fall Risk Assessment Questionnaires (FRAQ) were administered to assess behaviour and fall prevention knowledge respectively.

Results

Stepwise linear regression analysis showed that the practice of fall awareness behaviour (R2 = 0.256) was significantly associated with being male [95% C.I: 2.178 to 7.789, p < 0.001], having lower BMI [95% C.I: − 0.692 to − 0.135, p < 0.05], living with family [95% C.I: 0.022 to 5.953, p < 0.05] and those having higher functional mobility [95% C.I: − 2.008 to − 0.164, p < 0.05].

Conclusions

Fall awareness behaviour should be emphasized among older females, those with lower functional mobility, higher BMI and living alone.
Response to a sexual risk reduction intervention provided in combination with hepatitis C treatment by HIV/HCV co-infected men who have sex with men: a reflexive thematic analysis
Authors: Künzler-Heule Patrizia , Fierz Katharina , Schmidt Axel Jeremias , Rasi Manuela , Bogdanovic Jasmina , Kocher Agnes , Engberg Sandra , Battegay Manuel , Nöstlinger Christiana , Lehner Andreas , Kouyos Roger , Schmid Patrick , Braun Dominique Laurent , Fehr Jan , Nicca Dunja
Published: April 2021

Background

Hepatitis C virus reinfections in HIV-positive men-who-have-sex-with-men (MSM) challenge the effectiveness of antiviral treatment. To fight this problem, an adapted sexual risk reduction intervention was implemented within a hepatitis C treatment trial. Following this, the current study had two aims and describes 1) how the program was received by participants; and 2) their responses to the program regarding sexual risk taking. Based on the participants’ input, we hoped to judge the intervention’s potential for scale-up.

Methods

Seventeen participants who received the sexual risk reduction intervention in addition to hepatitis C treatment were recruited for semi-structured interviews six to 12 months post-intervention. We evaluated the responses via reflexive thematic analysis and applied the concept of sense-making.

Results

Giving hepatitis C a place and living without it again illustrates how participants received the program and how their experiences were altered by the impact of sense-making. Based on their responses, we allocated participants to three groups: 1. Avoid risks: get rid of hepatitis C for life. For these men, hepatitis C remained a life-threatening disease: they actively modified their risk behavior and felt supported by the intervention in maintaining their behavioral changes. 2. Minimize risks: live as long as possible without hepatitis C. In contrast to group 1, these men saw hepatitis C as a manageable disease. The intervention facilitated reflection on risks and how to develop behavioral changes that suited them individually. 3. Accept risks; live with the risk of hepatitis C. These men perceived behavioral changes as much more difficult than “easy” medical treatment. They expected to either undergo repeated rounds of treatment or stay HCV re-infected.

Conclusion

These results illustrate the diversity of men’s responses and their decisions regarding sexual risk behavior after participating in a combination of antiviral treatment and a sexual risk reduction intervention. Two major aspects were identified: 1) Teachable moments, particularly at the time of diagnosis/treatment, could offer an opportunity to develop openness for behavioral change; 2) adapting sexual risk reduction interventions to sense-making patterns could help to improve its effectiveness. Support for reducing infection risk and raising awareness of preventative measures are additional benefits.

Trial registration

Clinical Trial Number: NCT02785666, 30.05.2016.
Correction to: An unusual tracheal foreign body in a middle-aged male with a 15-year history of coal use: a case report
Authors: Zhong Li-juan , Yan Min , Wang Yi , Zhou Dai-quan , Tang Jian-ming , Xiang Shou-hong
Published: April 2021

An amendment to this paper has been published and can be accessed via the original article.
LncRNA SNHG16 contributes to osteosarcoma progression by acting as a ceRNA of miR-1285-3p
Authors: Xiao Xiao , Jiang Ge , Zhang Shengtao , Hu Shuo , Fan Yunshan , Li Gang , Yu Haiyang , He Shisheng
Published: April 2021

Background

The long non-coding (lnc) RNA activated by small nucleolar RNA host gene 16 (SNHG16), which has been reported to play a vital role in a number of different types of cancer, is a novel lncRNA. However, following an osteosarcoma (OS) study, the expression pattern, biological roles, clinical values and potential molecular mechanism of SNHG16 remain unclear. In the current study, we aimed to examine its expression and possible function in osteosarcoma (OS).

Method

Cell proliferation was measured by colony formation assay and Cell Counting Kit-8 (CCK-8) in vitro, and xenograft transplantation assay in vivo. Meanwhile, we used transwell chambers to test cell migration and invasion was evaluated. Cell cycle and apoptosis was evaluated by flow cytometry assay. Immunoblotting and qPCR analysis was carried out to detect protein and gene expression, respectively. Luciferase reporter assay was used to predict the potential downstream genes.

Results

The present study demonstrated that SNHG16 is highly expressed in both the tissues of patients with OS, as well as OS cell lines, and its expression level was positively correlated with clinical stage and poor overall survival. Functional assays revealed that the depletion of SNHG16 inhibits OS growth, OS cell progression and promotes apoptosis both in vivo and in vitro. In addition, the present study revealed that microRNA-1285-3p expression levels can be decreased by SNHG16 acting as a ‘sponge’, and that this pathway takes part in OS tumor growth in vivo, and OS cell proliferation, invasion, migration and apoptosis in vitro.

Conclusions

The results from the present study demonstrate the role of lncRNA SNHG16 in OS progression, which is SNHG16 might exert oncogenic role in osteosarcoma (OS) by acting as a ceRNA of miR-1285-3p, and it may become a novel target in OS therapy.
Knowledge, attitude and practices related to COVID-19 among young Lebanese population
Authors: Sakr Samer , Ghaddar Ali , Sheet Imtithal , Eid Ali H. , Hamam Bassam
Published: April 2021

Background

As the world faces the most serious and widespread pandemic in recent history, claiming nearly 1,945,610 lives and infecting over 90 million individuals up to January 13, 2021, controlling the spread of COVID-19 is still limited to efforts done by the general population implementing rules and restrictions passed by world governments and organizations. As we wait for the approved vaccines to become widely distributed, the best approach to fighting the spread of this disease is mostly preventative depending largely on individuals’ compliance. This study aimed to determine the knowledge, attitude and practices (KAP) towards COVID-19 in Lebanon.

Methods

A descriptive analysis was performed to describe the outcome measures of knowledge, attitudes and practices towards COVID-19 on a convenience sample from the Lebanese population in relation to socio-demographic characteristics and level of concern towards COVID-19. One thousand eight hundred sixty-one participants filled in an online survey (response rate: 18.5%) distributed by social media to social networks of the research team members.

Results

Participants were mainly young (49.4% between 18 and 24 years) and males (73.7%). Participants showed an overall appropriate knowledge of COVID-19 (67.1%) and positive attitude (around 90% were optimistic about treatment and vaccination) and had good preventive practices towards COVID-19 (around 75% washed hands and avoided public places). Knowledge and practices correlated positively with marriage, age, education, working in a healthcare field and with the level of concern about getting COVID-19.

Conclusions

This study found good overall levels of KAP among the studied Lebanese population. This can help in controlling the spread of COVID-19 if individuals were forced to adhere to social distancing and appropriate preventative practices.
Cultural and clinical challenges in sexual health care provision to men who have sex with men in Tanzania: a qualitative study of health professionals’ experiences and health students’ perspectives
Authors: Mgopa Lucy R. , Rosser B. R. Simon , Ross Michael W. , Lukumay Gift Gadiel , Mohammed Inari , Massae Agnes F. , Leshabari Sebalda , Mkonyi Ever , Mushy Stella Emmanuel , Mwakawanga Dorkasi L. , Trent Maria , Wadley James , Bonilla Zobeida E.
Published: April 2021

Background

Health care providers across sub-Saharan Africa continue to face challenges while delivering sexual health care services. We explored the experiences, views and challenges of health care professionals and health students across different disciplines in Tanzania, towards delivery of sexual health services to men who have sex with men.

Methods

Utilizing a qualitative approach, we recruited 121 health care professionals (providers) and students from the fields of midwifery, nursing and medicine in Dar es Salaam, Tanzania. We conducted 18 focus groups discussions, stratified by profession and experience, to investigate clinical management and challenges while addressing a case of an adult male presenting with rectal gonorrhea.

Results

Findings indicated this case as extremely sensitive, clinical management involved establishing rapport and consent, medical care from history taking to treatment, and referral to other specialties. However, the illegal status of homosexuality in Tanzania was a primary concern to participants, this triggered the clinical care of this case scenario as challenging. There were uncertainties whether or not that such a case should be reported to the authorities.

Conclusion

Findings from this study revealed a need for training health students in Tanzania to address sexual health issues including accurate information on homosexuality, reporting requirements and clinical management in the legal and socio-cultural context of the African continent.
Evaluating interventions with victims of intimate partner violence: a community psychology approach
Authors: Albanesi Cinzia , Tomasetto Carlo , Guardabassi Veronica
Published: April 2021

Purpose

Intimate Partner Violence (IPV) is one of the most common forms of domestic violence, with profound implication for women's physical and psychological health. In this text we adopted the Empowerment Process Model (EPM) by Cattaneo and Goodman (Psychol Violence 5(1):84–94) to analyse interventions provided to victims of IPV by a Support Centre for Women (SCW) in Italy, and understand its contribution to women’s empowerment.

Method

We conducted semi-structured interviews with ten women who had been enrolled in a program for IPV survivors at a SCW in the past three years. The interviews focused on the programs’ aims, actions undertaken to reach them, and the impact on the women’s lives, and were analysed using an interpretative phenomenological approach.

Results

Results showed that the interventions provided by the SWC were adapted according to women's needs. In the early phases, women’s primary aim was ending violence, and the intervention by the SCW was deemed as helpful to the extent it provided psychological support, protection and safe housing. Women’s aims subsequently moved to self-actualisation and economic and personal independence which required professional training, internships, and social support. Although satisfying the majority of the women’s expectations, other important needs (e.g., economic support or legal services) were poorly addressed, and cooperation with other services (e.g., police or social services) was sometimes deemed as critical.

Conclusions

By evaluating a program offered by a SCW to IPV survivors through the lens of the EPM model, we found that women deemed the program as effective when both individual resources and empowerment processes were promoted. Strengths, limitations and implications are discussed.
Factors associated with homecare coordination and quality of care: a research protocol for a national multi-center cross-sectional study
Authors: Möckli Nathalie , Simon Michael , Meyer-Massetti Carla , Pihet Sandrine , Fischer Roland , Wächter Matthias , Serdaly Christine , Zúñiga Franziska
Published: April 2021

Introduction

The persistent fragmentation of home healthcare reflects inadequate coordination between care providers. Still, while factors at the system (e.g., regulations) and organisational (e.g., work environment) levels crucially influence homecare organisation, coordination and ultimately quality, knowledge of these factors and their relationships in homecare settings remains limited.

Objectives

This study has three aims: [1] to explore how system-level regulations lead to disparities between homecare agencies’ structures, processes and work environments; [2] to explore how system- and organisation-level factors affect agency-level homecare coordination; and [3] to explore how agency-level care coordination is related to patient-level quality of care.

Design and methods

This study focuses on a national multi-center cross-sectional survey in Swiss homecare settings. It will target 100 homecare agencies, their employees and clients for recruitment, with data collection period planned from January to June 2021. We will assess regulations and financing mechanisms (via public records), agency characteristics (via agency questionnaire data) and homecare employees’ working environments and coordination activities, as well as staff- and patient-level perceptions of coordination and quality of care (via questionnaires for homecare employees, clients and informal caregivers). All collected data will be subjected to descriptive and multi-level analyses.

Discussion

The first results are expected by December 2021. Knowledge of factors linked to quality of care is essential to plan and implement quality improvement strategies. This study will help to identify modifiable factors at multiple health system levels that might serve as access points to improve coordination and quality of care.
Coping with the burden of the COVID-19 pandemic: a cross-sectional study of community pharmacists from Serbia
Authors: Jovičić-Bata Jelena , Pavlović Nebojša , Milošević Nataša , Gavarić Neda , Goločorbin-Kon Svetlana , Todorović Nemanja , Lalić-Popović Mladena
Published: April 2021

Background

Rapid spread of COVID-19 forced the public to turn to community pharmacies as the most accessible points of primary healthcare, overloading pharmacy services. The objectives of this research were to detect and describe the changes in work environment of community pharmacists in Vojvodina during the state of emergency due to COVID-19 pandemic. Moreover, the COVID-19 pandemic effects on job related stress were assessed.

Methods

Community pharmacists from Vojvodina completed an online questionnaire on work environment changes related to COVID-19 (cross-sectional study).

Results

Out of the 1574 licenced pharmacists in Vojvodina, 392 completed the survey. Workload increase, reported by 90.8% of pharmacists, was caused mostly by higher demand for safety equipment, antiseptics and disinfectants, dietary products and medicines. Most pharmacists (93.1%) considered pharmacy workflow to be more complex than before the pandemic. Clients’ behavior was described as less pleasant since the start of the pandemic by 67.6% of the community pharmacists. Many were concerned for their health and the health of their families (68.9%). Community pharmacists rated their stress levels higher if they i) were working in larger chains, ii) experienced clients’ behavior as less pleasant or/and iii) were concerned for their/their family health.

Conclusions

Current research pointed out the need for a more robust healthcare system which would allow rapid introduction of new activities and roles for community pharmacists that could possibly decrease job-related stress. Legal steps to improve the work environment in community pharmacies are necessary and urgent in order to fully utilize their skills and knowledge.
The dysbiosis signature of Fusobacterium nucleatum in colorectal cancer-cause or consequences? A systematic review
Authors: Ranjbar Maryam , Salehi Rasoul , Haghjooy Javanmard Shaghayegh , Rafiee Laleh , Faraji Habibollah , jafarpor Sima , Ferns Gordon A. , Ghayour-Mobarhan Majid , Manian Mostafa , Nedaeinia Reza
Published: April 2021

Colorectal cancer (CRC) is the third most common cause of cancer globally and the fourth attributable cause of mortality and morbidity due to cancer. An emerging factor contributing to CRC is the gut microbiota and the cellular changes associated with it. Further insights on this may help in the prevention, diagnosis and new therapeutic approaches to colorectal cancer. In most cases of CRC, genetic factors appear to contribute less to its aetiology than environmental and epigenetic factors; therefore, it may be important to investigate these environmental factors, their effects, and the mechanisms that may contribute to this cancer. The gut microbiota has recently been highlighted as a potential risk factor that may affect the structural components of the tumor microenvironment, as well as free radical and enzymatic metabolites directly, or indirectly. Many studies have reported changes in the gut microbiota of patients with colorectal cancer. What is controversial is whether the cancer is the cause or consequence of the change in the microbiota. There is strong evidence supporting both possibilities. The presence of Fusobacterium nucleatum in human colorectal specimens has been demonstrated by RNA-sequencing. F. nucleatum has been shown to express high levels of virulence factors such as FadA, Fap2 and MORN2 proteins. Our review of the published data suggest that F. nucleatum may be a prognostic biomarker of CRC risk, and hence raises the potential of antibiotic treatment of F. nucleatum for the prevention of CRC.
Gender-based disparities on health indices during COVID-19 crisis: a nationwide cross-sectional study in Jordan
Authors: Abufaraj Mohammad , Eyadat Zaid , Al-sabbagh Mohammed Qussay , Nimer Abdullah , Moonesar Immanuel Azaad , Yang Lin , Al Khatib Walid , Al-Qutob Ra’eda
Published: April 2021

Background

COVID-19 has an inevitable burden on public health, potentially widening the gender gap in healthcare and the economy. We aimed to assess gender-based desparities during COVID-19 in Jordan in terms of health indices, mental well-being and economic burden.

Methods

A nationally representative sample of 1300 participants ≥18 years living in Jordan were selected using stratified random sampling. Data were collected via telephone interviews in this cross-sectional study. Chi-square was used to test age and gender differences according to demographics, economic burden, and health indices (access to healthcare, health insurance, antenatal and reproductive services). A multivariable logistic regression analysis was used to estimate the beta-coefficient (β) and 95% confidence interval (CI) of factors correlated with mental well-being, assessed by patients’ health questionnaire 4 (PHQ-4).

Results

656 (50.5%) men and 644 (49.5%) women completed the interview. Three-fourths of the participants had health insurance during the COVID-19 crisis. There was no significant difference in healthcare coverage or access between women and men (p > 0.05). Half of pregnant women were unable to access antenatal care. Gender was a significant predictor of higher PHQ-4 scores (women vs. men: β: 0.88, 95% CI: 0.54–1.22). Among women, age ≥ 60 years and being married were associated with significantly lower PHQ-4 scores. Only 0.38% of the overall participants lost their jobs; however, 8.3% reported a reduced payment. More women (13.89%) were not paid during the crisis as compared with men (6.92%) (P = 0.01).

Conclusions

Our results showed no gender differences in healthcare coverage or access during the COVID-19 crisis generally. Women in Jordan are experiencing worse outcomes in terms of mental well-being and economic burden. Policymakers should give priority to women’s mental health and antenatal and reproductive services. Financial security should be addressed in all Jordanian COVID-19 national plans because the crisis appears widening the gender gap in the economy.