bluuebunny/crossref_metadata_2025 huggingface dataset:
Durvalumab in frail and elder patients with stage four NSCLC: Study protocol of the randomized phase II DURATION trial
Authors: Kuon Jonas , Hommertgen Adriane , Krisam Johannes , Lasitschka Felix , Stenzinger Albrecht , Blasi Miriam , Bozorgmehr Farastuk , Maenz Martin , Kieser Meinhard , Schneider Marc , Thomas Michael
Published: March 2020

Background: Elderly patients represent a major fraction of non-small cell lung cancer (NSCLC) patients in routine clinical practice, but they are still underrepresented in clinical trials. In particular, data regarding efficacy and safety in frail or elderly patients with respect to immunotherapy are lacking. Importantly, immunosenescence in elderly patients might interfere with activities of immune-modulating drugs such as PD-1/PD-L1 inhibitors. Thus, there is an urgent need to assess safety and efficacy of such inhibitors in this group. Methods/design: In this prospective, open label, treatment stratified, and randomized phase II study, 200 patients with stage IV NSCLC amenable at least to single-agent chemotherapy (CT). Eligible patients must be 70 years or older and/or “frail” (Charlson Comorbidity Index >1) or have a restricted performance status (Eastern Cooperative Oncology Group, ECOG >1). Patients are stratified according to modified Cancer and Age Research Group (CARG) score:”fit” patients are allocated to combination CT (carboplatin/ nab -paclitaxel), “less fit” patients receive single-agent CT (gemcitabine or vinorelbine). After allocation to strata, patients are randomized 1:1 to receive either 4 cycles of CT or 2 cycles of CT followed by 2 cycles of durvalumab and subsequent maintenance treatment with durvalumab every 4 weeks. The primary endpoint is the rate of treatment related grade III/IV adverse events (Common Terminology Criteria for Adverse Events, CTCAE V4.03). As secondary endpoints, progression-free survival (PFS) according to Response Evaluation Criteria in Solid Tumours (RECIST) version 1.1, response rate (RR), overall survival (OS), descriptive subgroup analyses according to PD-L1 expression, and quality of life are addressed. Geriatric screening assessments and functional tests will be performed to complete the phenotyping of a potential “frail” and “elderly” patient cohort. The trial is accompanied by a biomaterial repository to explore potential biomarkers. Discussion: The DURATION trial will prospectively investigate the safety and tolerability of anti-PD-L1 treatment with durvalumab after chemotherapy in elderly and frail patients and thereby provide new insights into the effect of PD-L1 blockade and the impact of immunosenescence in this cohort of patients.
Low adherence to exercise may have influenced the proportion of OMERACT-OARSI responders in an integrated OA care model: Secondary analyses from a cluster-randomised stepped wedge trial
Authors: Moseng Tuva , Dagfinrud Hanne , Bodegom-Vos Leti van , Dziedzic Krysia , Hagen Kåre Birger , Natvig Bård , Røtterud Jan Harald , Vlieland Thea Vliet , Østerås Nina
Published: March 2020

Background: To address the well-documented gap between hip and knee osteoarthritis (OA) treatment recommendations and current clinical practice, a structured model for integrated OA care was developed and evaluated in a stepped-wedge cluster-randomised controlled trial. The current study used secondary outcomes to evaluate clinically important response to treatment through the Outcome Measures in Rheumatology Clinical Trials clinical responder criteria (OMERACT-OARSI responder criteria) after 3 and 6 months between patients receiving the structured OA care model vs. usual care. Secondly, the study aimed to investigate if the proportion of responders in the intervention group was influenced by adherence to the exercise program inherent in the model. Methods: The study was conducted in primary healthcare in six Norwegian municipalities. General practitioners and physiotherapists received training in OA treatment recommendations and use of the structured model. The intervention group attended a physiotherapist-led OA education program and performed individually tailored exercises for 8-12 weeks. The control group received usual care. Patient-reported pain, function and global assessment of disease activity during the last week were evaluated using 11-point numeric rating scales (NRS 0-10). These scores were used to calculate the proportion of OMERACT-OARSI responders. Two-level mixed logistic regression models were fitted to investigate differences in responders between the intervention and control group. Results: 284 intervention and 109 control group participants with hip and knee OA recruited from primary care in six Norwegian municipalities. In total 47% of the intervention and 35% of the control group participants were responders at 3 or 6 months combined; showing an uncertain between-group difference (OR adjusted 1.38 (95% CI 0.41, 4.67). In the intervention group, 184 participants completed the exercise programme (exercised ≥2 times/week for ≥8 weeks) and 55% of these were classified as responders. In contrast, 28% of the 86 non-completers were classified as responders. Conclusions: The difference in proportion of OMERACT-OARSI responders at 3 and 6 months between the intervention and control group was uncertain. In the intervention group, a larger proportion of responders were seen among the exercise completers compared to the non-completers.
High post-anthesis temperature effects on bread wheat (Triticum aestivum L.) grain transcriptome during early grain-filling
Authors: Kino Richard Ian , Pellny Till , Mitchell Rowan Andrew Craig , Gonzalez-Uriarte Asier , Tosi Paola
Published: March 2020

Background: High post-anthesis (p.a) temperatures reduce mature grain weight in wheat. However, the causes of this reduction are not entirely known. Control of grain expansion by the maternally derived pericarp of the grain has previously been suggested, although this interaction has not been investigated under high p.a. temperatures. Down-regulation of pericarp localised genes that regulate cell wall expansion under high p.a. temperatures may limit expansion of the encapsulated endosperm due to a loss of plasticity in the pericarp, reducing mature grain weight. Here the effect of high p.a. temperatures on the transcriptome of the pericarp and endosperm of the wheat grain during early grain-filling was investigated via RNA-Seq and is discussed alongside grain moisture dynamics during early grain development and mature grain weight. Results: High p.a. temperatures applied from 6-days after anthesis (daa) and until 18daa reduced the grain’s ability to accumulate water, with total grain moisture and percentage grain moisture content being significantly reduced from 14daa onwards. Mature grain weight was also significantly reduced by the same high p.a. temperatures applied from 6daa for 4-days or more, in a separate experiment. Comparison of our RNA-Seq data from whole grains, with existing data sets from isolated pericarp and endosperm tissues enabled the identification of subsets of genes whose expression was significantly affected by high p.a. temperature and predominantly expressed in either tissue. Hierarchical clustering and gene ontology analysis resulted in the identification of a number of genes implicated in the regulation of cell wall expansion, predominantly expressed in the pericarp and significantly down-regulated under high p.a. temperatures, including endoglucanase, xyloglucan endotransglycosylases and a β-expansin. An over-representation of genes involved in the ‘cuticle development’ functional pathway that were expressed in the pericarp and affected by high p.a. temperatures was also observed. Conclusions: High p.a. temperature induced down-regulation of genes involved in regulating pericarp cell wall expansion. This concomitant down-regulation with a reduction in total grain moisture content and grain weight following the same treatment period, adds support to the theory that high p.a. temperatures may cause a reduction in mature grain weight as result of decreased pericarp cell wall expansion.
Results of Caring and Reaching for Health (CARE): A Cluster-Randomized Controlled Trial Assessing a Worksite Wellness Intervention for Child Care Staff
Authors: Linnan Laura A , Vaughn Amber E , Smith Falon , Westgate Philip , Hales Derek , Arandia Gabriela , Neshteruk Cody , Willis Erik , Ward Dianne S.
Published: March 2020

Background: Child care workers are among the lowest paid US workers and experience a wide array of health concerns. The physical and mental demands of their job and the lack of employer-provided health-insurance increase health risks. The Caring and Reaching for Health (CARE) study evaluated a 6-month Healthy Lifestyles intervention targeting child care workers’ physical activity (primary outcome), other health behaviors, and their workplace health environment. Methods: Eligible child care centers, defined as being in operation for at least two years and employing at least four staff, were enrolled into CARE’s cluster-randomized trial. Centers and their child care staff were randomly assigned to either the Healthy Lifestyles (HL) intervention arm or the Healthy Finances (HF) attention control arm using a block randomization approach. Intervention components were delivered through in-person workshops, center-level displays, informational magazines, director coaching, electronic messaging, and an interactive website. Outcome measures were collected during center visits at baseline and immediately post-intervention by trained data collectors blinded to center arm assignment. Workers’ physical activity was assessed with accelerometers, worn for seven days. Secondary outcome measures included biometric assessments of health and fitness, web-based surveys about health behaviors, and an environmental audit of workplace supports for health. Multi-level linear mixed models assessed worker- and center-level changes in these outcomes. Results: Participants included 553 child care workers representing 56 centers (HL=250 staff/28 centers, HF=303 staff/28 centers). At six months, moderate-to-vigorous physical activity declined slightly in both arms (-1.3 minutes/day, 95% CI: -3.0, 0.3 in HL; -1.9 minutes/day, 95% CI: -3.3, -0.5 in HF), but there was no significant group by time interaction. Several secondary outcomes for other health behaviors and workplace health environment showed improvements in favor of the intervention arm, yet differences did not remain statistically significant after adjustment for multiple comparisons. Conclusions: While the Healthy Lifestyles intervention did not improve health behaviors or the workplace health environment, results confirmed the pressing need to focus on the health of child care workers. Future interventions should focus on prevalent health issues (e.g., weight, stress), include both high-tech and high-touch intervention strategies, and address work conditions or other social determinants of health (e.g. wages) as a means of improving the health of these important workers.
Drug resistance occurred in a newly characterized preclinical model of lung cancer brain metastasis.
Authors: Shah Neal , Liu Zhongwei , Tallman Rachel M. , Mohammad Afroz , Sprowls Samuel A , Saralkar Pushkar A. , Vickers Schuyler D. , Pinti Mark V. , Gao Weimin , Lockman Paul R
Published: March 2020

Background
Cancer metastasis and drug resistance have traditionally been studied separately, though these two lethal pathological phenomena almost always occur concurrently. Brain metastasis occurs in a large proportion of lung cancer patients (~30%). Once diagnosed, patients have a poor prognosis surviving typically less than 1 year due to lack of treatment efficacy.

Methods
Human metastatic lung cancer cells (PC-9-Br) were injected into the left cardiac ventricle of female athymic nude mice. Brain lesions were allowed to grow for 21 days, animals were then randomized into treatment groups and treated until presentation of neurological symptoms or when moribund. Prior to tissue collection mice were injected with Oregon Green and 14C-Aminoisobutyric acid followed by an indocyanine green vascular washout. Tracer accumulation was determined by quantitative fluorescent microscopy and quantitative autoradiography. Survival was tracked and tumor burden was monitored via bioluminescent imaging. Extent of mutation differences and acquired resistance was measured in-vitro through half-maximal inhibitory assays and qRT-PCR analysis.

Results
A PC-9 brain seeking line (PC-9-Br) was established. Mice inoculated with PC-9-Br resulted in a significantly decreased survival time compared with mice inoculated with parental PC-9. Non-targeted chemotherapy with cisplatin and etoposide (51.5 days) significantly prolonged survival of PC-9-Br brain metastases in mice compared to vehicle control (42 days) or cisplatin and pemetrexed (45 days). Further in-vivo imaging showed greater tumor vasculature in mice treated with cisplatin and etoposide compared to non-tumor regions, which was not observed in mice treated with vehicle or cisplatin and pemetrexed. More importantly, PC-9-Br showed significant resistance to gefitinib by in-vitro MTT assays (IC50>2.5 µM at 48hrs and 0.1 µM at 72hrs) compared with parental PC-9 (IC50: 0.75 µM at 48hrs and 0.027 µM at 72hrs). Further studies on the molecular mechanisms of gefitinib resistance revealed that EGFR and phospho-EGFR were significantly decreased in PC-9-Br compared with PC-9. Expression of E-cadherin and vimentin did not show EMT in PC-9-Br compared with parental PC-9, and PC-9-Br had neither T790 mutation nor amplifications of MET and HER2 compared with parental PC-9.

Conclusion
Our study demonstrated that brain metastases of lung cancer cells may independently prompt drug resistance without drug treatment.
Insect Repellents Mediate Species-Specific Olfactory Behaviors in Mosquitoes
Authors: Afify Ali , Potter Christopher John
Published: March 2020

Background: The species-specific mode of action for DEET and many other mosquito repellents is often unclear. Confusion may arise for many reasons. First, the response of a single mosquito species is often used to represent all mosquito species. Second, behavioral studies usually test the effect of repellents on mosquito attraction towards human odorants, rather than their direct repulsive effect on mosquitoes. Third, the mosquito sensory neuron responses towards repellents are often not directly examined. Methods: Here, we used a close proximity response assay to test the direct repulsive effect of six mosquito repellents on Anopheles coluzzii , Aedes aegypti , and Culex quinquefasciatus mosquitoes. Additionally, we used this behavioral assay and calcium imaging recordings of antennae to test the response of An. coluzzii mosquitoes towards two human odorants (1-octen-3-ol and benzaldehyde) at different concentrations, and mixtures of the repellents lemongrass oil and p-menthane-3,8-diol (PMD) with DEET. Results: We found that An. coluzzii mosquitoes were repelled by lemongrass oil and PMD, while Ae. aegypti and Cx. Quinquefasciatus mosquitoes were repelled by lemongrass oil, PMD, eugenol, and DEET. In addition, we found that high concentrations of 1-octen-3-ol and benzaldehyde were repellent, and activated more olfactory receptor neurons on the An. coluzzii antenna than lower concentrations. Finally, we found that changes in olfactory responses to repellent mixtures reflected changes in repulsive behaviors. Conclusions: Our findings suggest that different species of mosquitoes have different behavioral responses to repellents. We further suggest that high-odor concentrations may recruit repellent-sensing neurons, or generally excite many olfactory neurons, yielding repellent behavioral responses. Finally, we show that DEET can decrease the neuronal and behavioral response of An. coluzzii mosquitoes towards PMD but not towards lemongrass oil. Overall, these studies can help inform mosquito repellent choice by species, guide decisions on effective repellent blends, and could ultimately identify the olfactory neurons and receptors in mosquitoes that mediate repellency.
Lufenuron can be transferred by gravid Aedes aegypti females to breeding sites and can affect its fertility, fecundity and blood intake capacity
Authors: Gonzalez Paula V , Harburguer Laura
Published: March 2020

Background: Aedes aegypti (L.) is the main vector of dengue, yellow fever, Zika and chikungunya viruses. A new method for controlling this mosquito has been developed based on the possibility that wild adult mosquitoes exposed to artificial resting sites contaminated with a larvicide, can disseminate it to larval breeding sites, is named ‘‘auto-dissemination’’. The present study was undertaken to evaluate if a chitin synthesis inhibitor like lufenuron can by disseminated to larval breeding sites and prevent adult emergence and also if forced contact of Ae. aegypti females with treated surfaces can affect its fertility, fecundity and blood intake capacity.
Methods: Larval susceptibility to lufenuron was measured through EI 50 and EI 90 . On the other hand gravid females were exposed by tarsal contact to lufenuron-treated papers, we used the WHO susceptibility test kit tube to line the papers, and 1, 3 or 5 females for the transference. We also evaluated if the exposure of mosquito females to lufenuron-treated papers (0.4 and 1 mg a.i./cm 2 ) has an effect on their fertility, fecundity or in the ability to feed on blood. In each assay 12-15 mosquito females were exposed to lufenuron for 1 hour; 24 h before (before blood meal - BBM) or 24 h after a blood meal (ABM).
Results: Lufenuron proved to be very active against Ae. aegypti larvae with an EI 50 of 0.164 ppb and EI 90 of 0.81 ppb. We also found that lufenuron can be transferred by females from treated surfaces to clean containers causing the inhibition of emergence of the larvae (between 30 and 50%). This effect was dependent on the concentration applied on the paper and also the number of females added to each cage.
Conclusions: This paper introduces an innovation by first exploring the possibility that an IGR belonging to the group of benzoylphenyl ureas, such as lufenuron, can be transferred by gravid females to breeding sites and that at the same time can have an effect on fertility, fecundity and blood intake capacity of adult mosquitoes.
Keywords: Aedes aegypti , lufenuron, auto-disemination, fertility, fecundity.
Hybrid Simulation of pediatric gynecologic examination: a mix-methods study of learners’ attitudes and factors affecting learning.
Authors: Torres Anna , Horodeńska Magdalena , Witkowski Grzegorz , Torres Kamil
Published: March 2020

Background: Children and adolescents with reproductive health issues may require immediate or emergency care, however in many countries availability of the pediatric and adolescent gynecology (PAG) service is low . That being said, teaching PAG examination to OBGYN, pediatrics and emergency medicine residents seems reasonable, and cannot be underestimated. In order to provide residents with opportunity to learn PAG examination, a high-fidelity hybrid simulation workshop was implemented in our institution. Methods: The study aimed to investigate learners’ attitudes towards the high-fidelity simulation (HFS) hybrid model as compared with task trainer-SP-voice model in the HFS environment and the factors connected to learners’ attitudes towards the hybrid model that could influence learning in high-fidelity simulation (HFS). The concept of attitude was used as the theoretical framework and the mixed method approach to study design was utilized with simultaneous collection of quantitative (original questionnaires) and qualitative data (semi-structured interviews). Results: Residents valued the HFS hybrid model higher over task trainer-SP-voice model in regards to all three attitude components: cognitive (95%), affective (87.5%) and behavioral (83.7%). Analysis of qualitative data revealed six themes important to learners and informing learning of PAG examination in HFS. Further analysis of the themes allowed to develop a conceptual model, in which six factors connected to attitude components influenced learning. These factors were: task difficulty, attention, emotional realism of the simulation, patient’s emotions, physical realism of the simulation, and technical issues. Conclusions: Participants of our study appreciated learning experience with the HFS hybrid model more, based on attitude questionnaire. Moreover, findings revealed that multiple, various factors connected to attitude may influence learning of PAG examination in HFS with hybrid model, and we propose a conceptual model illustrating relationships between those factors.
Comparison of power-free-chop and phaco-chop techniques for moderate nuclei
Authors: Yao Lin , Bai Haiqing
Published: March 2020

Background: To compare the intraoperative and postoperative effects of power-free-chop and phaco-chop techniques for moderate nuclei in phacoemulsification surgery. Methods: Sixty patients were evaluated in 2 groups prospectively. The power-free-chop technique was performed in Group 1 (30 eyes), and the phaco-chop technique was performed in Group 2 (30 eyes). There were no significant differences between these 2 groups. The cumulative dissipated energy (CDE), time to achieve maximum vision, corneal thickness variation, and time to return to the preoperative values were collected. All parameters were statistically compared in these 2 groups by using the chi-square test and the independent-sample t -test. Results: The CDE was 5.53±1.92 J in Group 1 and 7.02±1.77 J in Group 2. After the operation, the mean time to recover to the maximum vision was 2.80±1.42 days in Group 1 and 3.80±1.92 days in Group 2. The mean postoperative corneal thickness increased 36.9±14.74 μm in Group 1 and 46.20±20.67 μm in Group 2. The mean time to return to preoperative pachymetry values was 3.73±1.70 days and 4.83±2.11 days in Group 1 and Group 2, respectively. There were significant differences in these parameters between the groups. Conclusions: The power-free-chop technique had fewer negative effects on the corneal endothelium, as less ultrasound power was used for moderate nucleus cases. This can accelerate the functional healing process and the return to preoperative physiologic values.
The cerebellum is associated with 2-year prognosis in patients with high-frequency migraine
Authors: Liu Hung Yu , Lee Pei Lin , Chou Kun Hsien , Lai Kuan Lin , Wang Yen Feng , Chen Shih Pin , Chen Wei Ta , Wang Shuu Jiun
Published: March 2020

Background: The increase of headache frequency is associated with higher headache related disability and lower quality of life in patients with migraine. However, the pathophysiology of migraine progression, persistence, or remission is elusive. The purpose of this study is to identify the brain signatures that are predictive of the long-term outcomes among patients with high-frequency migraine (HFM: 10–30 headache days/month).
Methods: We prospectively enrolled patients with HFM and healthy controls and collected their baseline clinical profiles and brain-MRI data at first visit. We longitudinally followed the patients and determined their outcomes at 2-year follow-up. Good outcome was defined as ≥ 50% reduction of baseline headache days and poor outcome was defined as reduction < 50% or frequency increase. Voxel-based morphometry was used to study gray matter volume (GMV), and structural covariance was used to investigate structural connectivity.
Results: Among 56 patients with HFM, 37 had good outcome and 19 poor outcome. Compared to the healthy controls (n = 37), patients with poor outcome had decreased GMV over the left posterior cingulate gyrus, and increased GMV over the bilateral cerebellum and the right precentral gyrus. Further, patients with poor outcome had greater GMV over the right and the left cerebella compared to patients with good outcome, and the GMVs of the cerebella were correlated to 2-year headache frequencies (right: r = 0.38, P = 0.005; left: r = 0.35, P = 0.009). Structural connectivity were increased between the cerebellum and the cuneus, the calcarine cortex, and the temporal lobe, respectively, in patients with poor outcome, and was decreased between the cerebellum and the prefrontal cortex in patients with poor outcome. The structural covariance integrities between the right cerebellum and the right cuneus were correlated to 2-year headache frequencies (r = 0.36, P = 0.008).
Conclusions: Structural volume and connectivity changes of the cerebellum may underlie headache persistence in patients with HFM.
Application of Real-Time Simultaneous Amplification and Testing Method to Accurately and Rapidly Detect Extra-pulmonary Tuberculosis
Authors: Li Tongxin , Shi Tao , Sun Ying , Zhou Kan , Huang Zhenggu , Wang Pengsen , Luo Ming , Nie Xiaoping , Yang Guoqing , Chen Yu , Chen Yaokai
Published: March 2020

Background: This study aimed to establish and evaluate a simultaneous amplification and testing method for detection of extra-pulmonary tuberculosis. Methods: From January 2016 and December 2017 the pus or surgical excision from the lesions of inpatients admitted from Chongqing Public Health Treatment Center were collected. According to the clinical diagnosis, the samples were divided into two groups including extra-pulmonary tuberculosis (Group A) and other diseases excluded from tuberculosis diseases (Group B). Simultaneous detection of Mycobacterium tuberculosis (MTB) used Roche culture method, liquid culture method and simultaneous amplification and testing method (SAT). The sensitivity and specificity of the SAT method were compared with culture methods and clinical diagnosis of extra-pulmonary tuberculosis. Results: For 433 extra-pulmonary tuberculosis (EPTB) specimens and 49 non-TB specimens, the SAT-TB results correlated with 80.5% (388/482 specimens) of the culture assay results. The sensitivity, specificity, and positive and negative predictive values of the SAT-TB test for the diagnosis of EPTB were 83.6%, 79.4%, 59.4%, and 93.0%, respectively, compared to culture methods. Compared with the clinical diagnosis of patients, the sensitivity and specificity of the SAT-TB test were 41.6% and 100%, respectively, the cultures test were 29.3% and 98.0%. Conclusions: SAT test is a simple and rapid test with high specificity which may enhance the detection of EPTB. SAT-TB is a higher clinical diagnosis value for EPTB in clinical microbiology laboratories.
Needs, Aggravation, And Degree Of Burnout In Informal Care Providers Of Patients With Chronic Cvd
Authors: Szlenk-Czyczerska Elżbieta , Guzik Marika , Bielska Dorota Emilia , Ławnik Anna , Polański Piotr , Kurpas Donata
Published: March 2020

Abstract
Background. A growing number of patients with chronic cardiovascular disease (CVD) creates a growing demand for homecare. Personal and professional limitations, health issues, and lack of systemic support of informal care providers are major causes of insufficient care models for chronically ill patients in home environments. This study aimed to identify the sociodemographic variables that are associated with the needs and increasing occupational burnout observed among home care providers.
Methods. This study reports on 161 informal home care providers of patients with CVDs. The research was conducted in the homes of patients, using the Camberwell Assessment of Need Short Appraisal Schedule (CANSAS), the Maslach Burnout Inventory (MBI), and a structured interview questionnaire developed by the authors. Spearman’s rank correlation coefficient test and logistic regression were used for analyses.
Results. The majority of the participants were female (70.2%; n=113). We found that younger care providers were less likely to report unmet needs ( p = 0.011), and less likely to report burnout as measured by the MBI Emotional Exhaustion ( p = 0.010) and Depersonalization ( p = 0.009) subscales. Care providers with primary education were more likely to report burnout on the MBI Depersonalization subscale ( p = 0.028). In addition, care providers who worked more often reported higher levels of met needs ( p = 0.022), and burnout as measured on the MBI Depersonalization ( p = 0.005) and Emotional Exhaustion ( p = 0.018) subscales. Subjects residing in urban areas were more likely to report unmet needs ( p = 0.007), and were also more likely to report burnout as measured on the MBI Emotional Exhaustion ( p = 0.006) subscale.
Conclusion. Older care providers who are unemployed and reside in cities and unemployed should be targeted with directed programmes to determine the category of unmet needs, and for personalized support. Care providers with these demographic characteristics should be targeted for occupational burnout prevention programmes.
Keywords: informal caretaker, met and unmet needs, growing burnout.
lncRNA CRNDE promotes the proliferation and metastasis by acting as sponge miR-539-p to regulate POU2F1 expression in HCC
Authors: Li Zhixi , Wu Gang , Li Jie , Wang Youyu , Ju Xueming , Jiang Wenjun
Published: March 2020

Background This article focuses on the roles and mechanism of lncRNA CRNDE on the progression of HCC. Methods We used qRT-PCR to detect the expression of lncRNA CRNDE in HCC cells, normal cells and clinical tissues. MTT assay, FCM analysis, Transwell migration and invasion assay were used to detect the effects of lncRNA CRNDE on cell viability, apoptosis, migration and invasion of HCC cells. The expression of apoptosis-related proteins Bcl-2, Bax, Cleaved Caspase 3, Cleaved Caspase 9, EMT epithelial marker E-cadherin and mesothelial marker Vimentin were analyzed by Western blot. Online prediction software was used to predict the binding sites between lncRNA CRNDE and miR-539-5p, or miR-539-5p and POU2F1 3’UTR. Dual luciferase reporter assay, qRT-PCR and RNA pulldown were used to detect target-relationship between lncRNA CRNDE and miR-539-5p. Dual luciferase reporter assay, qRT-PCR, Western blot and Immunofluorescence were used to detect target-relationship between miR-539-5p and POU2F1. qRT-PCR was used to detect the expression of miR-539-5p and POU2F1 in clinical tissues. Rescue experiments was used to evaluate the association among lncRNA CRNDE, miR-539-5p and POU2F1. Finally, we used Western blot to detect the effects of lncRNA CRNDE, miR-539-5p and POU2F1 on NF-κB and AKT pathway. Results lncRNA CRNDE was highly expressed in HCC cells and HCC tissues compared with normal cells and the corresponding adjacent normal tissues. lncRNA CRNDE promoted the cell viability, migration and invasion of HCC cells, while inhibited the apoptosis and promoted the EMT process of HCC cells. lncRNA CRNDE adsorbed miR-539-5p acts as a competitive endogenous RNA to regulate POU2F1 expression indirectly. In HCC clinical tissues, miR-539-5p expression decreased and POU2F1 increased compared with the corresponding adjacent normal tissues. lncRNA CRNDE/miR-539-5p/POU2-
F1 participated the NF-κB and AKT pathway in HCC. Conclusion lncRNA CRNDE promotes the expression of POU2F1 by adsorbing miR-539-5p, thus promoting the progression of HCC.
Keywords: HCC, lncRNA CRNDE, miR-539-5p, POU2F1, ceRNA
Comparison of the effectiveness of Aloe Vera Gel with 2% Nitrofurazone ointment on the healing of superficial second-degree burns. Randomised clinical trial
Authors: Varaei Shokoh , Ranjbar Hadi , Sabaghzadeh Parichehr , Bostani Sanaz , Amirsalari Soodabhe
Published: March 2020

Background Burn injuries are one of the most common sources of trauma globally that comprise a significant drain on long-term personal and healthcare cost Large surface area burn wounds are difficult to manage and may result in significant physiologic and psychological sequelae . The aim of this study was to compare the effectiveness of Aloe Vera gel with Nitrofurazone ointment in the healing of superficial second-degree burn wounds.Methods The present study was a split body controlled, randomized clinical trial. The sample was recruited from patients with superficial second-degree burn wound who were prescribed to treat with 2% Nitrofurazone ointment. Thirty patients with at least two burn, each burn on an alternate side of the body, entered the study — samples allocated to two groups which received Aloe Vera gel or 2% Nitrofurazone ointment on their burns. Bates-Jensen Wound assessment tool (BWAT) was used to evaluate the healing of burns. The burns were evaluated before, one, two and three weeks after the beginning of treatment.Results The mean ± SD of BWAT scores in Aloe Vera zones were 30.32 ± 3.28, 27.33 ± 3.38, 21.33 ± 3.13, 16.12 ± 2.16 respectively (F(2, 65.07) =440.00, p=0.001). The mean ± SD of BWAT scores in Nitrofurazone ointment zones were 30.51 ± 3.79, 28.45 ± 3.49, 23.36 ± 2.89, 19.23 ± 2.11 (F(1, 52.00) =228.00, p=0.001).Conclusions There is a significant difference in (BWAT) scores between intervention and control groups. Aloe Vera gel was as effective as Nitrofurazone ointment in the treatment of superficial second-degree burns.Trial registration IRCT2014113020151N1. Registered 14 December 2014, https://www.irct.ir/trial/17874
Symptoms of ocular surface disease in construction workers: comparative study with office workers.
Authors: Hernandez-Llamas Sergio , Paz-Ramos Ana Karen , Marcos-González Patricio , Amparo Francisco , Garza Manuel
Published: March 2020

Purpose To investigate and contrast the prevalence of dry eye symptoms in construction workers and office workers using the OSDI questionnaire. Methods A cross-sectional, observational study was conducted using the OSDI questionnaire to evaluate dry eye symptoms and associated risk factors. Sampled size calculation with a power of 80% and a 95% degree of confidence suggested the inclusion of 298 participants. Results We studied 304 subjects (149 construction workers and 155 office workers). More than half (55%) of the participants presented dry eye symptoms (OSDI > 12). The average OSDI score was 21.30 ± 22.20 points, being lower in the group of construction workers (12.45±17.50) than in-office workers (28.51±22.99) (p <0.001). Considering participants who had moderate and severe symptoms (23 to 100 points in OSDI), office workers presented dry eye symptoms 4.15 times more frequent than construction workers (OR 4.15, 95% CI 2.52, 6.85). Women presented statistical evidence of higher OSDI scores than men (32.47 ± 23.72 vs. 14.87 ± 18.48, respectively). Conclusions Construction workers have four times less risk of presenting dry eye symptoms than people working in the average office space highlighting the pernicious effects of some of the conditions in the office environment to the ocular surface. .
Evolution of arthroscopic treatment from intracapsular to extracapsular for patients with refractory tennis elbow: A mixed-method study.
Authors: Yang Yu-ping , Chu Hong-ling , Yuan Shuo , Yan Hui , Xiao Jian , Cheng Xu , Luo Hao , Liu Yu-lei , Tao Li-yuan , Zhao Yi-ming , Cui Guoqing
Published: March 2020

Background Arthroscopic surgery is widely used in the treatment of refractory tennis elbow due to its advantages of minimally invasive, safe and direct vision. Intra-capsular arthroscopy(intracapsular method), which is performed via natural cavity, is the mainstream arthroscopic procedure. However, intracapsular method requires the damage of joint capsule and may cause intraoperative neurovascular injury and other complications. In view of the defects of intracapsular method, the surgical scheme of the extracapsular arthroscopy (referred to as "extracapsular method") has emerged. The aim of this study was to investigate the exploration history, key theories, methods, and techniques involved in the evolution from the intracapsular method to the extracapsular method for arthroscopic treatment of tennis elbow, and explore the effectiveness and safety of extracapsular method. Methods Qualitative data were collected via focus group interview. 7 surgeons who were selected through purposive sampling discussed on the theories, methods, and technical specifications of the transition from intracapsular method to extracapsular method. Qualitative data were analysed using NVivo11. Quantitative data of consecutive 43 patients were analysed to evaluate the effectiveness and safety of the extracapsular method. Descriptive analysis was conducted to analyse the demographic characteristics and clinical outcomes after surgery. Results The experts agreed that the extracapsular method maintains the integrity of joint capsule and avoids complications caused by joint capsule damage. Extracapsular method was considered easy for surgeons to master and convenient to operate. Technical specifications for extracapsular method were formed based on group discussion. The median time for pain relief and recovery of daily activities of 43 patients treated with these specifications were 3 months and 6 weeks, respectively. The satisfaction rates of Mayo Elbow Performance Scores were 87.2%, 95.6%, and 100% respectively at 3, 6, and 12 months after operation. Conclusion On the basis of international peer innovation, the extracapsular method has been continuously developed in our clinical practice to avoid the possible complications of the intracapsular method. The resulting technical specifications have been shown to have good clinical efficacy and safety in a small sample cohort.
Establishment and validation of finite element model of ossification of cervical posterior longitudinal ligament with intervertebral fusion
Authors: Hui Li , Huiqing Liu , Yaning Zhang
Published: March 2020

[Background ]: To establish a three-dimensional finite element model of ossification of the posterior longitudinal ligament of the cervical spine with intervertebral fusion and verify its effectiveness, and provide a platform for finite element calculation and biomechanical analysis in the later stage.[Method]: Select the Department of Spinal Surgery, Linfen People's Hospital A volunteer imported 719 DICOM format images of cervical spine CT scans into Mimics modeling software to build a preliminary 3D model in the stl format, and used Geomagic Studio 2013 software to refine and refine the 3D model to smooth out noise and generate NURBS surfaces The model was then imported into the finite element analysis software Ansys workbench 15.0, adding ligaments and intervertebral discs, meshing, assigning material properties, and simulating 6 activities of the human cervical spine, and comparing them with references.[Results]: A total of 7 Cervical vertebral body, 1 thoracic vertebral body, 5 intervertebral discs and ligaments, etc., with a total of 320512 nodes and 180905 units. It has a realistic appearance, high degree of detail reduction, and ossification of the cervical longitudinal longitudinal ligament with good geometric similarity Incorporate a three-dimensional finite element model of intervertebral fusion. In flexion and extension, left and right lateral flexion, and axial rotation activity compared with references, there is not much difference.[Conclusion]: OPLL merger interbody fusion dimensional finite element model has good mechanical and geometric similarity after similarity cervical established in this study, the model can provide a platform for the latter to further biomechanical analysis.
Gradient engineered light absorption layer for enhanced carrier separation efficiency in perovskite solar cells
Authors: Wu Gaozhu , Zhu Qing , Zhang Teng , Zou Ziqi , Wang Weiping , Cao Yiyan , Kong Lijing , Zheng Xuanli , Wu Yaping , Li Xu , Wu Zhiming , Kang Junyong
Published: March 2020

Carrier transport behavior in perovskite light absorption layer significantly impacts the performance of perovskite solar cells (PSCs). In this work, reduced carrier recombination losses were achieved by the design of band structure in perovskite materials. An ultrathin (PbI 2 /PbBr 2 ) n film with a gradient thickness ratio was deposited as the lead halide precursor layer by thermal evaporation method, and PSCs with a gradient band structure in perovskite absorption layer were fabricated by a two-step method in ambient atmosphere. For comparison, PSCs with homogeneous perovskite materials of MAPbI 3 and MAPbI x Br 3-x were fabricated as well. It is found that the gradient type-II band structure greatly reduces the carrier lifetime and enhances the carrier separation efficiency. As a result, the PSCs with a gradient band structure exhibit an average power conversion efficiency of 17.5%, which is 1-2% higher than that of traditional PSCs. This work provides a novel method for developing high-efficient PSCs.
Preterm Intraventricular Hemorrhage in vitro: Modeling the Cytopathology of the Ventricular Zone
Authors: Castaneyra-Ruiz Leandro , McAllister James P. , Morales Diego M. , Brody Steven L. , Isaacs Albert M. , Limbrick David D.
Published: March 2020

Background: Severe intraventricular hemorrhage (IVH) is one of the most devastating neurological complications in preterm infants, with the majority suffering long-term neurological morbidity and up to 50 percent developing post hemorrhagic hydrocephalus (PHH). Despite the importance of this disease, its cytopathological mechanisms are not well known. An in vitro model of IVH is required to investigate the effects of blood and its components on the developing ventricular zone (VZ) and its stem cell niche. To address this need, we developed a new in vitro model to mimic the cytopathological conditions of IVH in the preterm infant. Methods: Maturing neuroepithelial cells from the VZ were harvested from the entire lateral ventricles of wild type C57BL/6 mice at 1-4 days of age and expanded in proliferation media for 3-5 days. At confluence, cells were re-plated onto 24-well plates in differentiation media to generate ependymal cells (EC). At approximately 3-5 days, which corresponded to the onset of ependymal cell differentiation based on the appearance of multiciliated cells , phosphate-buffered saline for controls or syngeneic whole blood for IVH was added to the ependymal cell surface. The cells were examined for the expression of EC markers of differentiation and maturation to qualitatively and quantitatively assess the effect of blood exposure on VZ transition from neuroepithelial cells to EC. Discussion: This model will allow investigators to test cytopathological mechanisms contributing to the pathology of IVH with high temporal resolution and query the impact of injury to the maturation of the VZ. This technique recapitulates features of normal maturation of the VZ in vitro, offering the capacity to investigate the developmental features of VZ biogenesis.
Physical activity intervention for rural middle-aged and older Australian adults: A pilot implementation study of the ecofit program delivered in a real-world setting
Authors: Wilczynska Magdalena , Jansson Anna K , Lubans David R , Smith Jordan J , Robards Sara L , Plotnikoff Ronald Cyril
Published: March 2020

Background: ecofit is an evidence-based multi-component physical activity intervention that integrates smartphone technology, the outdoor environment and social support. In a previous efficacy trial, significant improvements were found across several clinical, fitness, and mental health outcomes among adults at risk of (or with) type 2 diabetes. Methods: The aim of the present pilot study was to evaluate a number of health-related and feasibility outcomes of the ecofit intervention in a ‘real-world’ setting, using a scalable implementation model. ecofit was adapted and implemented by a rural municipal council in the Upper Hunter Shire, New South Wales, Australia and evaluated using a single-group pre-post design. Inactive middle-aged and older adults (N=59) were recruited and assessed at 6- (primary time-point) and 20-weeks (follow-up). Results: Improvements were found in this predominantly overweight and obese sample for aerobic fitness, functional mobility, upper and lower body muscular fitness, systolic blood pressure and waist circumference at 6-weeks. At 20-weeks, effects were found for aerobic fitness, functional mobility, upper and lower body muscular fitness, and systolic blood pressure. Overall, participants were satisfied with the ecofit program. Participants attended the 6-week primary time-point (66.1%) and follow-up at 20-weeks (41.6%). Conclusions: Our findings support the preliminary effectiveness and feasibility of the ecofit intervention delivered by municipal council staff following a brief training from the research team. This study provides valuable preliminary evidence to support of a larger implementation trial.
Identification of the molecular mechanism and diagnostic biomarkers in the thoracic ossification of the ligamentum flavum using metabolomics and transcriptomics
Authors: Li Jiahao , Yu Lingjia , Guo Shigong , Zhao Yu
Published: March 2020

Background: To establish a metabolite fingerprint of ossification of the thoracic ligamentum flavum (OTLF) patients using liquid chromatography-mass spectrometry (LC-MS) in combination with transcriptomic data and explore the potential molecular mechanism of pathogenesis. Results: 37 metabolites were identifed out by UPLC-MS including uric acid and hypoxanthine. Variable Importance in Projection (VIP) scores suggest that uric acid might have an impact on the process of OTLF. Pathway enrichment indicated that five metabolism pathways were enriched. Transcriptomic data revealed that the purine metabolism pathway may have significant impact on the process of OTLF and that xanthine dehydrogenase (XDH) is the key regulatory factor. Receiver operating characteristic (ROC) analysis indicated that uric acid might be the potential biomarker for OTLF and play an important role within the detailed pathway. ROC revealed that XDH might suppress the metabolism of hypoxanthine and xanthine, leading to a low expression of uric acid, which could be a focal point in developing new therapeutic methods for OTLF. Conclusion: XDH could affect purine metabolism by suppressing the expression of hypoxanthine and xanthine leading to low serum levels of uric acid in OTLF.
Prevalence, antimicrobial susceptibility and genotypic characteristics of Staphylococcus aureus in Tanzania: a systematic review
Authors: Mzee Tutu , Kazimoto Theckla , Madata Joseph , Masalu Rose , Bischoff Markus , Matee Mecky , Becker Sören
Published: March 2020

Background : Information about prevalence, antibiotic resistance and genotyping data of Staphylococcus aureus (S aureus) isolated from different infections and colonization, both in humans and animals is scarce in Tanzania. Given the wide range of infections S aureus can cause and the raise of methicillin resistant S aureus (MRSA) globally, this review was aimed at collecting local published data on the S aureus bacterium to better understand the epidemiology. Methodology: A systematic review of scientific studies reporting on prevalence, antibiotic resistance and genotyping of S aureus in human and animal infection and colonization was done. Literatures extracted from electronic databases such as PubMed and Google Scholar were screened for eligibility and relevant articles included into the review. The review is limited to literatures published in English, between the years 2010 and 2018. . Results: 39 studies conducted in 5 of the 9 administrative zones in Tanzania were reviewed to establish S aureus prevalence in human and animal infection and colonization. Prevalence in human ranged from 1 - 60%. Antibiotic resistance patterns of S aureus isolated from colonized humans showed higher resistance rates against erythromycin (49%), co-trimoxazole (38%) and tetracycline (28%) compared to report from other studies outside Africa. The review suggests an increased MRSA prevalence of up to 33% compared to 16% reported in previous years. Genotypic data reviewed suggested that MRSA predominantly belonged to ST88. S aureus prevalence in animal studies ranged from 33 - 49% whereas MRSA prevalence ranged from 4 - 35%. Generally low antibiotic resistance levels were reported in these studies with exception to penicillin (85%) and ampicillin (73%). Resistance against tetracycline reported at 30% collaborates the suggested overuse of the drug in livestock keeping in Tanzania. Conclusion : Prevalence of MRSA in Tanzania is rising although clear variations between different geographic areas could be observed. Non-susceptibility to commonly prescribed antibiotics in community associated S aureus is of concern. Research strategies to better understand the S aureus epidemiology by including genotypic characterisations, as well as strengthening antimicrobial resistance surveillance and antimicrobial stewardship are recommended.