bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and Predictors of Anxiety and Depressive Symptoms among Patients Diagnosed with Oral Cancer in China: A cross-sectional study
Authors: Yuan Lulu , Pan Bochen , Wang Weiren , Wang Lie , Zhang Xujie , Gao Yuqin
Published: May 2020

Background Anxiety and depression are common mental health problems among patients with cancer. While many psychological variables have been proven to influence anxiety and depressive symptoms, the variables are not mutually exclusive and their integrated effects on patients with oral cancer are yet unknown. The present study aims to explore the prevalence of anxiety and depressive symptoms among patients with oral cancer, to find out key potentially predictive factors associated with anxiety and depressive symptoms. Method A cross-sectional study was carried out for Chinese patients with oral cancer between May 2016 and October 2017 in two Grade-A Tertiary Hospitals in Shenyang, China. 230 patients with oral cancer were interviewed with questionnaires on demographic variables, Zung Self-Rating Anxiety Scale (SAS), Center for Epidemiologic Studies Depression Scale (CES-D), Herth Hope Index (HHI), Social Impact Scale, Multidimensional Scale of Perceived Social Support (MSPSS), Revised Life Orientation Test (LOT-R), Perceived Stress Scale-10 (PSS-10), and General Perceived Self-efficacy Scale(GSE). Chi-square test, nonparametric test, t-test and logistic regression analyses were conducted where appropriate to explore predictive factors of anxiety symptoms and depressive symptoms.Results The prevalence of anxiety symptoms and depressive symptoms in the sample population was 36.96% (85/230) and 65.21% (150/230), respectively. Social isolation dimension of stigma (β=0.409, OR=1.505, CI:1.193~1.900), optimism (β=-0.253, OR=0.777, CI:0.644~0.937), and perceived stress (β=0.209, OR=1.232, CI:1.084~1.400) were predictors of anxiety symptoms. Marriage (β=1.653, OR=5.224, CI:1.483~18.399), positive readiness and expectancy dimension of hope (β=-0.455, OR=0.634, CI:0.424~0.948), social isolation dimension of stigma (β=0.302, OR=1.352, CI:1.046~1.748) and perceived stress (β=0.252, OR=1.286, CI:1.118~1.479) were predictors of depressive symptoms among oral cancer patients. Conclusion The prevalence of anxiety symptoms and depressive symptoms was high among oral cancer patients in China. The communal predictors of anxiety and depressive symptoms in patients with oral cancer were levels of perceived stress and social isolation of stigma. In addition, optimism was a predictor of anxiety symptoms and hope was a predictor of depressive symptoms.
Expression of tripartite motif‑containing 44 and its prognostic and clinicopathological value in human malignancies：a meta-analysis
Authors: Xiao Guoliang , Yang Qiuxi , Bao Ziwei , Mao Haixia , Zhang Yi , Lin Shibu
Published: May 2020

Background: Previous researches have reported that tripartite motif-containing 44 (TRIM44) is related to the prognosis of multiple human tumors. This study was designed to systematically assess the prognostic value of TRIM44 in human malignancies and summarize its possible tumor-related mechanisms.Methods: The available databases were searched for eligible studies that evaluated the clinicopathological and prognostic roles of TRIM44 in patients with malignancies. The hazard ratios (HR) and odds ratios (OR) were combined to assess the predictive role of TRIM44 using Stata/SE 14.1 software.Results: A total of 1,740 patients from thirteen original studies were finally included in this study. The results of the combined analysis showed that over-expression of TRIM44 protein was significantly correlated with shorter overall survival (OS) (HR = 1.94, 95% CI: 1.60-2.35) and worse disease-free survival (DFS) (HR= 2.13, 95% CI: 1.24-3.65) in cancer patients. Additionally, the combined ORs indicated that elevated expression level of TRIM44 protein was significantly associated with lymph node metastasis (OR=2.69, 95% CI: 1.71-4.24), distant metastasis (OR=10.35, 95% CI: 1.01-106.24), poor tumor differentiation (OR=1.78, 95% CI: 1.03-3.09), increased depth of tumor invasion (OR=2.72, 95% CI: 1.73-4.30), advanced clinical stage (OR=2.75, 95% CI: 2.04-3.71), and recurrence (OR=2.30, 95% CI: 1.34-3.95). Furthermore, analysis results using Gene Expression Profiling Interactive Analysis (GEPIA) showed that the expression level of TRIM44 mRNA was higher in most tumor tissues than in the corresponding normal tissues, and the relationship between TRIM44 mRNA level and prognosis in various malignant tumors also explored in GEPIA and OS analysis webservers.Conclusions: TRIM44 may serve as a valuable prognostic biomarker and a potential therapeutic target for patients with malignancies.
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: May 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 (PbI2/PbBr2)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 MAPbI3 and MAPbIxBr3-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.
Knowledge, attitude, motivation and planning of breastfeeding; A cross sectional study among Jordanian women.
Authors: khasawneh wasim , Kheirallah Khalid , Mazin Mai , Abdulnabi Sanaa
Published: May 2020

Background In Jordan, the rate of exclusive breastfeeding is declining. The trend variation in breastfeeding practice is determined by different factors including antenatal women’s attitude and planning which are affected by their awareness and the support they receive. This study aims to assess knowledge, attitude, support, and planning of breastfeeding among Jordanian women.Methods A face-to-face cross sectional semi-structured questionnaire survey was conducted among healthy women in the antenatal clinic and postpartum ward at three hospitals in Northern Jordan during the period August 2019 to December 2019. Data were collected about demographic characteristics, women’s knowledge and attitude towards breastfeeding, antenatal and postnatal support and counseling, and feeding planning. Customized scales were utilized to assess knowledge and attitude. Factors associated with planning to breastfeed were reported.Results 660 women completed the survey questionnaire. The majority were 20 to 35 years of age. 10% were primiparous and 30% were employed. 78% were knowledgeable about breastfeeding benefits and aware of WHO recommendations. 72% had a positive attitude towards breastfeeding. More than half received support from their husbands to breastfeed their infants, while less than 20% received any counseling from their obstetric providers. 97% reported their intention to breastfeed, and more than half indicated their willing to exclusively breastfeed. With multilogistic regression model, predictors of EBF planning include primiparty (AOR 1.79 95% C.I 1.1, 3.25), positive attitude (AOR 1.80 95% C.I 1.05, 3.1) and positive husband’s support (AOR 1.92 95% C.I. 1.18, 3.15). Barriers include women’s employment (AOR 0.43 95% C.I. 0.26, 0.70) and low birth weight (AOR 0.46 95% C.I. 0.25, 0.84)Conclusion Jordanian women are highly knowledgeable about breastfeeding benefits, and they exhibit a positive attitude towards breastfeeding resulting in a very high percentage intending to breastfeed their infants. Limited counseling about breastfeeding is a major gap in antenatal care. As intentions might not reflect the actual practice after delivery, gaps and barriers affecting the determinants of successful breastfeeding should be identified, and corrective tools should be accordingly implemented. Assigning a specific time allotment for antenatal or postnatal counseling and support is expected to promote breastfeeding practice in our population.
Comparison of survival outcomes of locally advanced cervical cancer by histopathological types in the Surveillance, Epidemiology, and End Results (SEER) database: A propensity score matching study
Authors: Tian Tian , Gong Xing , Gao Dong Xu , Li Qing Yan , Ju Wen , Ai Qin Yi
Published: May 2020

Background: There has been limited research on the comparison of squamous cell carcinoma (SCC) and adenocarcinoma (AC) of cervical cancer and that lack of information may have significant bearing on the treatment of patients. We compared survival outcomes between squamous cell carcinoma and adenocarcinoma in locally advanced cervical cancer patients and examined factors related to the prognosis of cervical cancer.Methods: We identified 4,131 patients with stage IB2-ⅣA cervical cancer patients diagnosed between 2010 and 2015 by using the Surveillance, Epidemiology, and End Results (SEER) database. Variables related to the prognosis of cervical cancer were compared using both univariate and multivariate Cox models and log-rank method before and after propensity score matching. We compared the efficacy of radiotherapy alone to radiotherapy combined with chemotherapy or/and surgery in overall survival of SCC and AC. Results: Our sample included 3,385 patients with SCC (81.9%) and 746 patients with AC (18.1%). The 5-year overall survival on comparing the squamous cell carcinoma group and adenocarcinoma group was not significant (P>0.05). Using propensity score matching, 676 pairs of patients were selected. The 5-year overall survival of matched patients did not differ significantly (P>0.05). Histology was not independently associated with overall survival in multivariate Cox model (P>0.05). Factors affecting overall survival included FIGO stage IVA (P<0.05), chemotherapy (P<0.05), and external radiation combined with brachytherapy (P<0.05). Patients with SCC that were treated with radiation alone had significantly worse OS than AC patients receiving radiation only (P<0.05). Conclusions: The OS in AC of the cervix is similar to that SCC in when treated with radiotherapy combined with chemotherapy and/or surgery but better when treated with radiation alone.
MicroRNA-219c-5p regulates bladder smooth muscle cell fibrosis by targeting FN1
Authors: Liu Bowen , Ding Yafei , Li Peng , Wang Tao , Jia Zhankui , Gu Chaohui , Yang Jinjian
Published: May 2020

Background

We found that the bladders of multiple sclerosis mice were significantly fibrotic. This study aimed to investigate the relationship between fibronectin 1 (FN1) and bladder fibrosis, as well as the microRNAs involved in FN1 regulation.
Methods

The degree of bladder smooth muscle fibrosis was observed by immunohistochemistry. In addition, we used quantitative real-time polymerase chain reaction (RT-qPCR) and Western blotting to determine FN1 expression in bladders with different grades of fibrosis. Bioinformatics analysis revealed that miR-199a-3p, miR-219c-5p and miR-3572-3p could inhibit FN1 synthesis. Therefore, miR-199a-3p, miR-219c-5p and miR-3572-3p were overexpressed or knocked down in bladder smooth muscle cells (BSMCs), and the respective transfection and FN1 knockdown efficiencies were detected by RT-qPCR. Only miR-219c-5p overexpression and knockdown produced the expected results. A dual luciferase reporter assay was used to determine the targeting relationship between miR-219c-5p and FN1. Flow cytometry and Cell Counting Kit 8 (CCK8) experiments confirmed that miR-219c-5p reduced FN1 expression and affected the biological activity of smooth muscle cells.
Results

With increasing bladder fibrosis, FN1 expression increased, while miR-199a-3p, miR-219c-5p, and miR-3572-3p expression levels decreased. The RT-qPCR results after transfection showed that only miR-219c-5p could regulate FN1. Indeed, the dual luciferase reporter assay results indicated that miR-219c-5p targeted FN1 directly. CCK8 and cell cycle assays showed that miR-219c-5p overexpression inhibited BSMC proliferation, while miR-219c-5p knockdown promoted BSMC proliferation. An apoptosis assay showed that miR-219c-5p overexpression promoted apoptosis, while miR-219c-5p knockdown inhibited BSMC apoptosis.
Conclusions

Our findings indicate that FN1 upregulation and miR-219c-5p downregulation play an important role in the development of bladder fibrosis, and miR-219c-5p participates in the fibrosis of BSMCs by regulating FN1 expression. Thus, a novel antifibrotic function of miR-219c-5p is proposed, which may represent a potential target for the diagnosis and treatment of bladder fibrosis.
Identification of Loci Controlling Mineral Element Concentration In Soybean Seeds
Authors: MALLE SIDIKI , Morrison Malcolm , Belzile Francois
Published: May 2020

Background Mineral nutrients play a crucial role in the biochemical and physiological functions of biological systems. The enhancement of seed mineral nutrient content via genetic improvement is considered as the most promising and cost-effective approach compared alternative means for meeting the dietary needs. The overall objective of this study was to perform a GWAS approach analysis of mineral nutrient (Ca, K, P and S) content in seeds on a core set of 137 soybean lines that are representative of the diversity of soybeans cultivated in Canada (maturity group 000-II).Results This panel of 137 soybean lines was grown in five environments (in total) and the seed mineral nutrient was measured using a portable x-ray fluorescence (P-XRF) spectrometer. The association analyses were carried out using three statistical models and a set of 2.2 million SNP obtained from a combined dataset of genotyping-by-sequencing and whole-genome sequencing. Eight QTLs significantly associated with the Ca, K, P and S content were identified by at least two of the three statistical models used (in two environments) contributing each from 17 to 31% of the phenotypic variation. A strong reproducibility of the effect of seven out these eight QTLs was observed in three different environments. In total, three candidate genes were identified involved in transport and assimilation of these mineral elements.Conclusions There have been very few GWAS studies to identify QTLs associated with the mineral element content of soybean seeds. In addition to being new, the QTLs identified in this study and candidate genes will be useful for the genetic improvement of soybeans nutritional quality through marker-assisted selection. Moreover, this study also provides details on the range of phenotypic variation encountered within the Canadian soybean germplasm.
Inhibiting MAPK14 showed anti-prolactinomas effect
Authors: Ding Qiaoyan , Zhang Yu , Ma Li , Chen Yong-gang , Wu Jin-hu , Zhang Hong-feng , Wang Xiong
Published: May 2020

Background The pathogenesis of prolactinomas has not been clarified yet. p38 MAPK signaling including p38α MAPK (MAPK14), p38β (MAPK11), p38γ (MAPK12) and p38δ (MAPK13) is related to the development and progression of many cancers. We sought to investigate the role of MAPK14 in prolactinomas.Methods Immunofluorescence assay was performed on the prolactin (PRL) and MAPK14 protein expressions of pituitary gland in C57BL/6 mice and human prolactinomas specimens. We analyzed the role of MAPK14 in prolactinomas using estradiol-induced model and DRD2-/- model in C57BL/6 wild-type (WT), MAPK14-/- , DRD2-/-MAPK14+/- mice. GH3 cells were transfected with different sets of MAPK14 siRNA, which to study MAPK14 and PRL protein expression in GH3.Results Immunofluorescenc assaye found that PRL and MAPK14 were co-locatied and increased significantly in the pituitary gland of estradiol-injected prolactinomas mice than in control mice. And the deficiency of MAPK14 significantly inhibited the tumor overgrowth, along with the PRL decrease in estradiol-induced mice. Furthermore, MAPK14 deficiency in DRD2-/-MAPK14+/- mice significantly inhibited the overgrowth of pituitary gland and PRL production and secretion than in DRD2-/- mice. And MAPK14 knockdown by siRNA inhibited PRL production in GH3 cells.Conclusion The results establish that MAPK14 plays a promoting role in the formation of prolactinomas, and validate MAPK14 as potential therapeutic target.
Effect of different types of cerebral perfusion for acute type A aortic dissection, unilateral versus bilateral
Authors: liu zhengqin , Wang Chen , Zhang Xiquan , Wu Shuming , fang changcun , pang xinyan
Published: May 2020

Background
Antegrade cerebral perfusion (ACP), including unilateral and bilateral, is most commonly used way for cerebral protection in aortic surgery. There is still no consensus on the superiority of the two methods. Our research was aimed to investigate the clinical effects between u-ACP and b-ACP.
Methods
321 patients with type A aortic dissection were studied retrospectively. 124 patients (38.6%) received u-ACP and 197 patients(61.4%) received b-ACP. We compared the incidence of postoperative neurological complications and other collected data between two groups. We also analyzed perioperative variables in order to find the potential associated factors for neurolocial dysfunction (ND).
Results
For u-ACP group, 54 patients (43.5%) had postoperative neurological complications including 22 patients (17.7%) with permanent neurologic dysfunction (PND) and 32 patients (25.8%) with temporary neurologic dysfunction (TND). For b-ACP group, 47 patients (23.8%) experienced postoperative neurological complications including 16 patients (8.1%) of PND and 31 patients (15.7%) of TND. The incidence of PND and TND were significantly different between two groups along with shorter CPB time (p = 0.016), higher nasopharyngeal temperature (p ≦ 0.000), shorter awakening time (p = 0.030) and lower incidence of hypoxia (p = 0.022). Furthermore, multivariate stepwise logistic regression analysis confirmed that preoperative neurological dysfunction (OR = 1.20, P = 0.028), CPB duration (OR = 3.21, P = 0.002 ) and type of cerebral perfusion (OR = 1.48, P = 0.017) were strongly associated with postoperative ND.
Conclusions
In our study, we found that b-ACP procedure had many advantages compared to u-ACP and we inferred that b-ACP may be more suitable for patients with type A AD undergoing total arch replacement.
Prevalence of diabetes, prediabetes, awareness, treatment and control among people 35 years and up
Authors: Shamshirgaran Seyed Morteza , Ghorbani Zohreh , Najafipour Farzad , Sarbakhsh Parvin , Aminisani Nayyereh
Published: May 2020

Background Despite the current endeavors in the prevention and treatment of diabetes, it is, still, one of the leading causes of mortality, morbidity, and health system costs worldwide. The aim of this study was to determine the prevalence of pre-/diabetes, awareness, treatment, and control of diabetes and its correlates among people participating in the pilot phase of the Azar cohort study in the Northwest of Iran.Methods A total of 1038 adults aged 35 years and older in Khamene city, East Azerbaijan province, Northwest of Iran, were recruited for the pilot phase of Azar cohort; a province-level of a nationwide PERSIAN cohort study. A comprehensive questionnaire including sociodemographic and clinical information was completed, and biological samples were collected. The quantities of HbA1C and FBS were adopted as benchmarks for assessing the status of subjects about having diabetes and pre-diabetes. All analyses were performed using STATA (version 14), the statistical software.Results The overall prevalence of diabetes and pre-diabetes was 18.2% and 34.8%, respectively. The result of the multivariate regression model showed, females had a better awareness (2.00 (CI: 0.94–4.26)), and their reception of diabetes’ medicine was higher: 2.57 (CI: 1.25–5.29). Having at least one comorbid condition was associated with an increased awareness of diabetes (3.13 (CI: 1.47–6.66)); in addition, here, the possibility of receiving medication was,also, higher: 4.54 (CI: 2.21–9.32). Furthermore, people who were smokers had a lower awareness. There was a significant increase in diabetes’ control among people with secondary and high school education (2.4 (CI: 0.92–6.23).Conclusions The current study demonstrated the increased prevalence of pre-/diabetes as well as low awareness, inadequate treatment and control. More effective and corrective factors in reducing the risk of diabetes and its control require more attention.
Patient Safety Culture In Primary And Home Care Services
Authors: Lousada Letícia , Dutra Francisco Clécio , Silva Beatriz , Oliveira Natália , Bastos Ismael , Vasconcelos Patrícia , de Carvalho Rhanna Emanuela Fontenele Lima
Published: May 2020

Background: The safety culture in primary care and home care services is still poorly studied, although this level of care is the gateway to health services. This study aims to evaluate the culture of patient safety in Primary and Home Care Services. Methods: This is an observational cross-sectional study carried out with 147 professionals from nine district linked to the Better Home Program and six basic health units. For the evaluation of culture, the Safety Attitudes Questionnaire (SAQ) was used, which considers a positive patient safety culture with scores ≥ 75. Results: Men who work in home care with length of service of three to four years scored better for the Safety Climate, Job Satisfaction, Team Work Climate and Total SAQ. Perception of management and Working Conditions received lower scores from professionals with longer working time.Conclusions: It is concluded that the evaluation of safety culture in the home care service was positive when compared to basic health units.
Efficacy of a High-Dose Proton Pump Inhibitor in Patients with Extraesophageal Symptoms of Gastroesophageal Reflux Disease: A Single Center, Randomized, Open-Label Trial
Authors: Cho Jae Ho , Shin Cheol Min , Yoon Hyuk , Park Young Soo , Kim Nayoung , Lee Dong Ho
Published: May 2020

Background
The extraesophageal manifestations of gastroesophageal reflux disease (GERD) are more difficult to manage than the typical symptoms. The efficacy of high-dose and standard-dose proton pump inhibitors against these atypical symptoms is not yet established.
Methods
In this single center, randomized, open-label study, patients with GERD received rabeprazole for 8 weeks, either 20 mg once daily (standard-dose group) or 20 mg twice daily (high-dose group). Patients were assessed before treatment and at weeks 4 and 8 with a 5-graded scale questionnaire consisting of 2 typical symptoms (heartburn and acid regurgitation) and 8 atypical symptoms (chest pain, cough, globus, wheezing, laryngopharyngitis, hoarseness, belching, and dysphagia). Sufficient improvement of reflux symptoms was defined as ≥ 50% reduction from the initial questionnaire score.
Results
Final analyses included 35 patients in the standard-dose group and 38 patients in the high-dose group. The rate of sufficient improvement for typical symptoms was significantly higher in the high-dose group than in the standard-dose group (100.0% vs. 84.0%, P = 0.040). For atypical symptoms, the rate of sufficient improvement tended to be higher in the high-dose group than in the standard-dose group (82.4% vs. 63.0%, P = 0.087). Scores of typical and some atypical symptoms (cough and globus) improved after treatment, with significant inter-group differences in time-course changes.
Conclusions
High-dose rabeprazole may be more effective for relieving atypical symptoms as well as typical GERD symptoms than a standard-dose regimen.
Trial registration:
This research was enrolled in a registry of clinical trials run by United States National Library of Medicine at the National Institutes of Health (ClinicalTrials.gov Protocol Registration and Results system ID: NCT04001400). This study was registered on June 26, 2019 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04001400.
Efficacy of combination-chemotherapy with pirarubicin, ifosfamide, and etoposide for soft tissue sarcoma: A single-institution retrospective analysis
Authors: Saito Shiro , Aiba Hisaki , Yamada Satoshi , Okamoto Hideki , Hayashi Katsuhiro , Kimura Hiroaki , Miwa Shinji , Otsuka Takanobu , Murakami Hideki
Published: May 2020

Background: The standard chemotherapy regimens for soft tissue sarcoma are doxorubicin-based. This phase 2 study aimed to assess the efficacy and safety of pirarubicin, ifosfamide, and etoposide combination therapy for patients with this disease.Methods: Between 2008 and 2017, 25 patients with soft tissue sarcoma were treated with pirarubicin (30 mg/m2, 2 days), ifosfamide (2 g/m2, 5 days), and etoposide (100 mg/m2, 3 days) every 3 weeks. The primary endpoint was overall response, and the secondary endpoint was adverse events of this regimen.Results: Response to this regimen according to RECIST criteria was 36% PR (n = 9), 36% SD (n = 9) and 28% PD (n = 7). During the treatment phase, frequent grade 3 or worse adverse events were haematological toxicities including white blood cell decreases (96%), febrile neutropenia (68%), anemia (68%), and platelet count decreases (48%). No long-term adverse events were reported during the study period.Conclusion: This regimen was comparable to previously published doxorubicin-based combination chemotherapy in terms of response rate. Although there were no long lasting adverse events, based on the results, severe haematological toxicity should be considered.
Impact of an Interprofessional, Longitudinal, Undergraduate Student-Initiated Home Visit Program Towards Interprofessional Education
Authors: Ng Kennedy , Leung Gloria Yao Chi , Yow Ka Shing , Ngiam Nerice Heng Wen , Yeo Dillon Guo Dong , Tey Angeline Jie-Yin , Lim Melanie Si Rui , Tang Aaron Kai Wen , Chew Bi Hui , Tham Celine , Yeo Jia Qi , Lau Tang Ching , Wong Sweet Fun , Wong Chek Hooi , Koh Gerald Choon-Huat
Published: May 2020

Background
Interprofessional (IP) practice is an essential aspect of healthcare to meet the challenges of an aging population. Tri-Generational HomeCare (TriGen) is an undergraduate student-initiated, longitudinal, IP home visit program focused on older patients with frequent hospital readmissions.
Methods
Teams comprising healthcare undergraduates and secondary school (SS) students performed home visits for frequently admitted patients (three or more visits in past six months) on a fortnightly basis over a period of six months. They were supported and trained by healthcare professionals from Khoo Teck Puat Hospital (KTPH), a regional healthcare system, and North West Community Development Council (NWCDC), a social service organisation. A multimethod approach was used, with the administration of Readiness for Interprofessional Learning Scale (RIPLS) pre- and post-intervention, and gathering post-intervention quantitative and qualitative feedback.
Results
80.1% of 226 undergraduate participants from 2015 to 2018 enrolled in the study. There was a significant decrease in RIPLS total score from a mean of 80.3 pre-intervention to 79.0 post-intervention with a mean difference of 1.3 (-2.5 – -0.089, p = 0.035). Subscale analysis revealed a significant increase in the subscale “Roles and Responsibility” with a mean difference of 0.46 (0.14–0.77, p < 0.01). There was no significant change in the subscale “Teamwork” and a significant decrease in the subscale “Professional Identity” with a mean difference of -0.14 (-2.1– -0.77, p < 0.01). This was discordant to the participants’ feedback. 91.6% of respondents agreed they could “better appreciate the importance of IP collaboration (IPC) in the care of patients”. Qualitative analysis revealed takeaways including learning from and teaching one another, understanding one’s own role and the role of other healthcare professionals, appreciating teamwork and developing friendship with undergraduates from other professions.
Conclusion
We demonstrated the feasibility of an IP, longitudinal, undergraduate-initiated home visit program that may improve attitudes towards one’s role and responsibilities in IP care for future IPC.
Perioperative serum albumin a predictor of adverse outcomes in major abdominal surgery: Prospective Cohort hospital based study.
Authors: Issangya Christian Ephata , Msuya David , Chilonga Kondo , Herman Ayesiga , Shao Elichilia Robert , Shirima Febronia , Naman Elifaraja , Mkumbi Henry , Pyuza Jeremia , Mtui Emmanuel , Sanga Leah Anku , Abdul Seif , John Beatrice , Chugulu Samuel
Published: May 2020

Background
Albumin is an important protein that transports hormones, fatty acids, and exogenous drugs; it also maintains plasma oncotic pressure. Albumin is considered a negative active phase protein because it decreases during injuries and sepsis. In spite of other factors predicting surgical outcomes, the effect of pre and postoperative serum albumin to surgical complications could be assessed by calculating percentage decrease in albumin (Delta albumin). This study aimed to explore perioperative serum albumin as a predictor of adverse outcomes in major abdominal surgeries.
Methodology:
All adults’ eligible participants from Kilimanjaro Christian Medical Centre Surgical Department were enrolled conveniently. Data were collected using study questionnaire. Full Blood Count (FBP), serum albumin levels preoperatively and on postoperative day 1 was measured abiding to Laboratory Standard Operating Procedures (SOP). Data was entered and analyzed using STATA version 14. Association and extent of decrease in albumin levels as a predictor of surgical site infection (SSI), delayed wound healing and death within 30days of surgery was determined using ordinal logistic regression model. In determining the diagnostic accuracy, a Non-parametric Receiver Operating Curve (ROC) model was used. We adjusted for ASA classification which had negative confounding effect on the predictive power of percent drop in albumin to adverse outcomes.
Results
61 participants were studied; the mean age was 51.6 (SD16.3), majorities were males 40 (65.6%) and post-operative adverse outcome happened to 28 (45.9%) participants. In preoperative serum albumin values, 40 (67.8%) had lower than 3.4 g/l while 51 (91%) had postoperative albumin values lower than 3.4 g/l. Only 15 (27.3%) had high delta albumin with the median percentage value of 14.77%. Delta albumin was an independent significant factor associated with adverse outcome (OR: 6.68; 95% CI: 1.59, 28.09); with a good predictive power and area under ROC curve (AUC) of 0.72 (95% CI 0.55 0.89). The best cutoff value was 11.61% with the sensitivity of 76.92% and specificity of 51.72%.
Conclusion
Early perioperative decrease in serum albumin level may be a good, simple and cost effective tool to predict adverse outcomes in major abdominal surgeries.
The Ebb and Flow of Identity Formation and Competence Development in Sub-specialty Residents: Study of a Continuity Training Setting
Authors: Huda Noureen , Faden Lisa , Wilson Claire A. , Plouffe Rachel A. , Li Edmond , Saini Manpreet Kaur , Chahine Saad
Published: May 2020

Background

Professional identity and competence development are evolving processes, shaped by clinical experiences and socialization in the workplace. The purpose of this study was to investigate the simultaneous development of professional identify formation and competence in a sub-specialty training program.
Methods

The study was conducted in a General Internal Medicine sub-specialty (PGY-4 and PGY-5) continuity training setting, at an academic health sciences center, in Canada. Participants included: current residents, recent graduates, attending physicians and administrative assistants. Data was collected from 2017–2018. A constructivist grounded theory approach was used to analyze anonymized focus group and individual interviews.
Results

The study identified the following: 1) learning activities that support professional identity formation in advanced residents; 2) the relationship between professional identity formation and competencies; 3) the role of administrative assistants and continuity training supervisors in supporting professional identity formation; and 4) a set of invisible learning experiences that occurred as a result of assumptions made by residents about expectations of training and expectations of patient care. Although, there was limited data available on the latter, findings suggested that invisible learning experiences may adversely impact residents’ functioning as independent physicians.
Conclusions

Residents’ professional identities continue to evolve with increasing competency requirements during training. Training programs, for sub-specialty residents, must balance granting of independence with supporting ongoing professional identity formation. They must also be explicit about what constitutes healthy patient care expectations and how practicing physicians manage these expectations.
Patterns of recurrence in adenocarcinoma of the esophagogastric junction: a retrospective study
Authors: Xu Haitao , Zhang Lianguo , Miao Jing , Liu Shuai , Liu Hongjian , Jia Teng , Zhang Qingguang
Published: May 2020

Background
The prognosis of adenocarcinoma of the esophagogastric junction (AEG) is poor. Understanding the postoperative recurrence pattern of AEG is helpful to verify the effectiveness of treatment and optimize subsequent treatment, so as to improve prognosis.
Methods
This single centre,retrospective study included patients with stage III AEG who underwent surgical treatment between January 2009 and December 2016. According to the different postoperative treatment arm, patients were divided into surgery and surgery plus chemotherapy groups. Recurrence-free survival was used as the outcome to compare the recurrence site and pattern between the groups.
Results
In total, enrolled 306 patients, 123 in the surgery group and 183 in the surgery plus chemotherapy group.During follow-up (median 522 days) of 730 days after surgery, 62.0% of patients had tumor recurrence. The overall recurrence rates in the surgery and surgery plus chemotherapy group were 86.9% and 77.0%, respectively. The recurrence patterns of both groups were mainly distant metastasis. Postoperative chemotherapy reduced the incidence of hematogenous dissemination from 51.2–42.0%. Multivariate Cox analysis showed that pN stage increased the risk of recurrence,while surgery plus chemotherapy reduced the risk.
Conclusions
Patients with AEG have a risk of hematogenous dissemination after surgery. Postoperative treatment arm and pN stage were independent risk factors in patients with AEG.Surgery plus chemotherapy can improve RFS and reduce distant metastasis, but they do not have a beneficial role in controlling local recurrence.
CXCR4-CXCL12 axis and distant metastatic outgrowth in head and neck malignancy
Authors: Li Yin , Bahadori Leila , Fritsche Kristin , Knolle Percy , Krüger Achim , Bier Henning , Knopf Andreas
Published: May 2020

Background: To analyze whether distant metastatic outgrowth in different head and neck malignancies (HNM) underlies the CXCR4-CXCL12 axis as overriding molecular mechanism. Methods: Clinic-pathological data of 1,250 HNM was included. HNM were collected due to different capability to exhibit distant metastasis comprising basal cell, squamous cell, and adenoid-cystic carcinoma as well as melanoma. MMP2/9, TIMP1/2, CXCR4, and CXCL12 immunohistochemistry was done in 190 randomly selected specimens.Results: Immunohistochemistry visualized a significant increase in MMP2/9, TIMP1/2, CXCR4, and CXCL12 protein expression following the clinical occurrence of distant metastasis. CXCR4, CXCL12, and TIMP2-expression significantly increases with number of affected organs by distant metastasis. Cox regression demonstrated CXCR4-overexpression and advanced T-status being independent risk factors of distant metastasis associated death.Conclusion: The CXCR4-CXCL12 axis is associated with the occurrence of distant metastases in different HNM. The increased risk of distant metastasis associated death was identified at primary tumour site and, therefore, potentially influences further treatment protocols.
Phospholipid signaling pathway in Capsicum chinense suspension cells as a key response to a consortium infection
Authors: Sánchez-Sandoval Eugenia , Di-Palma Graciela E Racagni , González-Mendoza Victor M , Cab-Guillén Yahaira A , Muñoz-Sanchez Armando , Ramos-Diaz Ana Luisa , Hernandez-sotomayor Teresa
Published: May 2020

Mexico is considered to be a diversification center for the chili species, but at the same time, these crops have been susceptible to infection by pathogens, such as Colletotrichum, which causes anthracnose diseases and postharvest decay in general. Different studies have been carried out with isolated strains of Colletotrichum in Capsicum plants, however, under growing conditions, the microorganisms are interacting with others, which can increase or decrease their infective capacity. This study presents the first report between plant-pathogen interactions and their biochemical responses in phospholipid pathways for C. chinense to microbial consortium with mainly Colletotrichum ignotum pathogen. The results showed morphological changes in the first hours (h) in the presence of the microbial consortium, and high levels of diacylglycerol pyrophosphate (DGPP) and phosphatidic acid (PA) were found after 6 h postinoculation (hai). These metabolic changes were correlated with high transcription levels of diacylglycerol-kinase (CchDGKs) expressed for 3, 6 and 12 hai and related to pathogen gene markers, such as CchPR1 and CchPR5. Finally, this study shows how the phospholipase C/DGK (PLC/DGK) pathway offers insight into the microbial infection responses of chili crops with damping-off diseases in the Yucatan.
The Association Between Residual Neuromuscular Blockade (RNMB) and Critical Respiratory Events: A Prospective Cohort Study
Authors: Alenezi Faraj , Alnababtah Khalid , Alqahtani Mohammed , Harbi Mohammed Al
Published: May 2020

Background: Inadequate neuromuscular recovery might impair pulmonary function among adult patients who undergo general anaesthesia and might thus contribute to critical respiratory events in the post-anaesthesia care unit (PACU). The aim of this study to investigate whether critical respiratory events (CREs) that described in a modified Murphy’s criteria are significantly associated with residual neuromuscular blockade (RNMB).Method: A prospective cohort study from January to March 2017 from a tertiary hospital from Saudi Arabia for thirty adult patients over 18 years old scheduled for elective surgery under general anaesthesia with neuromuscular blocking drugs (NMBDs) were enrolled in the study. The Mann-Whitney U tests, Chi-Square tests and Independent-Samples T tests were used. The Train-of-four (TOF) ratios were measured upon arrival in the PACU by using Acceleromyography with TOF-Scan. Subjects’ demographics, perioperative data, and the occurrence of postoperative CREs in the PACU were recorded.Results: 26 (86.7%) patients out of thirty in the study has received Rocuronium as NMBDs while Neostigmine as a reversal drug with only 23 (76.7%). The incidence of RNMB (TOF ratio < 0.9) was in 16 patients (53.3%). The incidence of RNMB was significantly higher in female patients (p= 0.033), in patients who had not undergone quantitative neuromuscular monitoring before extubation (p= 0.046) and in patients with shorter duration of surgery (p= 0.001). Postoperative CREs occurred in twenty patients (66.7%), and there were significantly more of these CREs among patients with RNMB (P= 0.001). In addition, a statistically significant difference was observed in the occurrence of CREs according to body mass index (P= 0.047).Conclusion: This research showed that RNMB is a significant contributing factor to the development of critical respiratory events during PACU stay. Therefore, optimal antagonism of neuromuscular blockade and routine quantitative neuromuscular monitoring are recommended to reduce the incidence of RNMB.
WITHDRAWN: Glioblastoma cell-derived extracellular vesicle miR-27a-3p facilitates M2 macrophage polarization
Authors: Zhao Guifang , Yu Hongquan , Ding Lijuan , Wang Weiyao , Wang Huang , Hu Yao , Qin Lingsha , Deng Guangce , Xie Buqing , Li Guofeng , Qi Lin
Published: May 2020

Background: M2 macrophage polarization has been found to be correlated with malignancy of glioblastoma. In this study, we investigated the potential role of microRNA (miRNA) derived from extracellular vesicles of glioblastoma (glioblastoma-EVs) in M2 macrophage polarization.Methods: After isolation of human glioblastoma-EVs, transmission electron microscopy (TEM) and Nano-particle tracking analysis (NTA) were performed to identify the EVs. Besides, the proliferation, migration and invasion of glioma cells were analyzed by CCK8 and Transwell assays, respectively. The target genes of miR-27a-3p were predicted through bioinformatics analysis and verified by dual-luciferase reporter gene assay. ChIP assay was applied to detect the binding of enhancer of zeste homologue 1 (EZH1) to lysine-specific demethylase 3A (KDM3A) promoter region and the interaction between KDM3A and connective tissue growth factor (CTGF). Glioblastoma mouse models were established followed by the implement of hematoxylin-eosin (HE) and ELISA staining on pathological changes of mouse brain tissues.Results: Human glioblastoma-EVs were successfully isolated. The high expression of miR-27a-3p was found in glioblastoma tissues as well as glioblastoma-EVs, which could induce M2 polarization, thus promoting glioblastoma cell proliferation, migration and invasion. It was also shown that miR-27a-3p targeted EZH1 and promoted KDM3A expression to elevate the expression of CTGF. Glioblastoma-EVs delivered miR-27a-3p to promote the KDM3A-upregulated CTGF by downregulating EZH1, thereby promoting M2 macrophage polarization and development of glioblastoma in vivo.Conclusion: These findings highlight that EV miR-27a-3p may promote M2 macrophage polarization, which is associated with the progression of tumors.
Intein-mediated intracellular production of active microbial transglutaminase in Corynebacterium glutamicum
Authors: Zhang Nan , Zhang Shan , He Yongzhi , Chen Xin , Zhang Yanfeng , Dong Zhiyang
Published: May 2020

Background The microbial transglutaminase (mTGase) from Streptomyces mobaraense has been widely used in the food industry. Recombinant production of mTGase is tricky because the mTGase is synthesized as an inactive zymogen, which needs to be activated by proteolytic processing. Self-cleaving inteins have been applied to activate the zymogen in a simple and highly specific manner as compared with proteolytic processing. However, self-cleaving inteins suffer from the inherent problem of premature cleavage. Moreover, self-cleaving inteins normally require an additional step of long time incubation to induce the cleavage. These two inherent problems limit self-cleaving inteins for their potential application in the production of mTGase.Results In this study, the premature cleavage of intein Ssp DnaB was observed in Corynebacterium glutamicum when the Ssp DnaB was used to activate mTGase precursor protein. Rather than suppressing it, the premature cleavage was applied to produce active mTGase in C. glutamicum. The SDS-PAGE analysis and the mTGase activity assay indicated that the premature cleavage of intein Ssp DnaB was successfully applied to activate the mTGase intracellularly in C. glutamicum. The subsequent N-terminal amino acid sequencing and site-directed mutagenesis studies demonstrated that the premature cleavage activated the mTGase intracellularly in a highly specific manner. Finally, in a jar fermentor, the intracellular mTGase activity was up to 49 U/mL, which was the highest intracellular mTGase activity ever reported.Conclusions An efficient and simple approach with great potential for large-scale industrial production of active mTGase was presented in this study. This approach employed premature cleavage of intein Ssp DnaB to activate mTGase in C. glutamicum, resulting in high-level intracellular production of active mTGase. Moreover, this approach did not require any further processing steps such as protease treatment or long time incubation, greatly simplifying the production of active mTGase.
Production of bio-xylitol from D-xylose by an engineered Pichia pastoris expressing a recombinant xylose reductase did not require any auxiliary substrate as electron donor
Authors: Louie Michael , Louie Kailin , DenHartog Samuel , Gopishetty Sridhar , Arnold Mark , Das Shuvendu
Published: May 2020

Background: Xylitol is a five-carbon sugar alcohol that has numerous beneficial health properties. It has almost the same sweetness as sucrose but has lower energy value compared to the sucrose. Metabolism of xylitol is insulin independent and thus it is an ideal sweetener for diabetics. It is widely used in food products, oral and personal care, and animal nutrition as well. Here we present a two-stage strategy to produce bio-xylitol from D-xylose using a recombinant Pichia pastoris expressing a heterologous xylose reductase gene. The recombinant P. pastoris cells were first generated by a low-cost, standard procedure. The cells were then used as a catalyst to make the bio-xylitol from D-xylose.Results: P. pastoris expressing XYL1 from P. stipitis and gdh from B. subtilis demonstrated that the biotransformation was very efficient with as high as 80% (w/w) conversion within two hours. The whole cells could be re-used for multiple rounds of catalysis without loss of activity. Also, the cells could directly transform D-xylose in a non-detoxified hemicelluloses hydrolysate to xylitol at 70% (w/w) yield.Conclusions: We demonstrated here that the recombinant P. pastoris expressing xylose reductase could transform D-xylose, either in pure form or in crude hemicelluloses hydrolysate, to bio-xylitol very efficiently. This biocatalytic reaction happened without the external addition of any NAD(P)H, NAD(P)+, and auxiliary substrate as an electron donor. Our experimental design & findings reported here are not limited to the conversion of D-xylose to xylitol only but can be used with other many oxidoreductase reactions also, such as ketone reductases/alcohol dehydrogenases and amino acid dehydrogenases, which are widely used for the synthesis of high-value chemicals and pharmaceutical intermediates.