bluuebunny/crossref_metadata_2025 huggingface dataset:
17-Year Follow-Up of Comparing Mastoscopic and Conventional Axillary Dissection in Breast Cancer: A Multicentres, Randomized Controlled Trial
Authors: Luo， Chengyu , Cao Guang , Guo Wenbin , Yang Jie , Sun Qiuru , Wei Wei , Wu Shuhua , Fang Shubin , Zeng Qingliang , Zhao Zhensheng , Meng Fanjie , Huang Xuandong , Zhang Xianlan , Li Ruihua , Ma Xiufeng , Luo Chaoying , Yang Yun
Published: September 2021

Background: Longer follow-up was necessary to testify the exact value of mastoscopic axillary lymph node dissection (MALND).Methods：From January 1, 2003 to December 31, 2005, 1027 patients with breast cancer were randomly assigned to two groups: MALND and CALND (conventional axillary lymph node dissection). 996 eligible patients were enrolled.Results：The final cohort of 996 patients was followed for an average of 198 months. The events other than death differed significantly between the two cohorts（p=0.0311） (46.3% in MALND and 53.2% in CALND, respectively). The sum of the events other than death and deaths from other causes was much more in CALND （59.6%）than in MALND (53.4%）（p=0.0494）. The 17-year DFS rates were 36.7 percent for MALND group and 33.6 percent for CALND group，respectively. There was a signiﬁcant difference between the groups (p=.0306). The OS rates were 53.2 percent after MALND and 46.0 percent after CALND ( p= .0119). The MALND patients had much less axillary pain (p =. 0000), numbness or paresthesia (p = .0000) ，arm mobility (p =. 0000), and arm swelling on operated side (p = .0000). The aesthetic appearance of axilla in MALND group was much better than that in CALND group (p =. 0000) at an average follow-up of 17-year.Conclusions：The use of MALND in breast cancer surgery not only decreases the relapse and arm complications but also improves long-term survival of patients. Therefore, MALND should be one of the preferred approaches for breast cancer surgery when ALND is needed.
Relationship between fibrinogen/albumin ratio and early renal damage markers in patients with hypertension
Authors: dong jiankai jian , Zhang Yaping
Published: September 2021

Aim:To investigate the relationship between fibrinogen/albumin ratio (FAR) and early renal damage in hypertensive patients.Patients & methods:A retrospective study included 626 patients with hypertension, grouped according to the FAR tertiles and the presence or absence of early renal impairment. Early renal damage indicators[Serum cystatin c and β2 microglobulin] were detected in each group, and the differences between groups were compared, and the factors affecting early renal damage indicators were analyzed.Results:Serum cystatin c(CysC) and β2 microglobulin(β2-MG) levels in patients increased with FAR. In the renal impairment group, the fibrinogen and FAR were significantly increased, and serum albumin was decreased. FAR was positively correlated with β2-MG and CysC. Regression analysis showed that FAR level was a factor affecting blood β2-MG(β=6.632, p＜0.001)and CysC(β=1.991, p＜0.001).Conclusion:Elevated FAR is an independent risk factor for early renal damage in hypertensive patients
Role of NRF2 cascade in determining the differential response of cervical cancer cells to anticancer drugs- an in vitro study
Authors: Ramesh Pushkal Sinduvadi , Raja Sharanya , Udayakumar Shwethambari Harave , Chandrashekar Shruthi , Nataraj Suma M , Devegowda Devananda
Published: September 2021

Background
Cervical cancers are usually treatable if detected in early stages by a combination of therapies. However, the prognosis of cervical cancer patients with metastasis remains unfavorable due to the fact that most of the cervical carcinomas are either resistant to anticancer drugs or show signs of relapse after initial treatment. Therefore, it is important to control the chemoresistance as it is the key to develop effective treatment options for cervical cancer.
Objective
The current study aimed at evaluating the differential responses of cervical cancer cells to anti-cancer drugs and assessed whether the differences in the expression profiles of antioxidant genes regulated by NRF2 (nuclear factor erythroid-2-related factor 2), led to the variations in the sensitivities of the cancer cells to treatment. Methodology: Three cervical cancer cell lines were investigated for their differences in NRF2 pathway by measuring the gene expression and enzyme activity. The differences in the sensitivity to anti-cancer drugs and variation in ROS profile was also evaluated. The addition of exogenous drugs to manipulate the intracellular ROS and its effect on NRF2 pathway genes was also investigated.
Results
HeLa and SiHa cells were more sensitive to cisplatin and oxaliplatin treatment than C33A cells. HeLa and SiHa cells had significantly lower NRF2 gene levels, NQO1 enzyme activity and basal GSH levels than C33A cells. Levels of ROS induced were higher in HeLa than C33A cells.
Conclusion
Overall, the differences in the cellular levels of antioxidant regulatory genes led to the differential response of cervical cancer cells to anti-cancer drugs.
Pregnancy and Obstetric Outcomes of Dichorionic and Trichorionic Triamniotic Triplet Pregnancy with Multifetal Pregnancy Reduction: A Retrospective Analysis Study
Authors: Liu Shuhua , Li Guanjian , Wang Chao , Chen Xianxia , Zhou Ping , Song Bing , Wei Zhaolian
Published: September 2021

Background: It is generally beneficial for triplet gestation or high-order multiple pregnancies to operate multifetal pregnancy reduction (MFPR) after assisted reproductive techniques. However, data on pregnancy outcomes is lacking regarding dichorionic triamniotic (DCTA) and trichorionic triplets (TCTA) pregnancy.Method: This research analyzes the difference between 128 DCTA and 179 TCTA pregnancies with or without MFPR after in vitro fertilization/intracytoplasmic sperm injection cycles between January 2015 and June 2020. The subdivided subgroups of the two groups are reduction to singleton, reduction to dichorionic twins, and anticipation management groups. We also compare the pregnancy and obstetric outcomes between 2104 dichorionic twins and 122 monochorionic twins.Result: The research subgroups were DCTA to monochorionic singleton pregnancies (n=76), DCTA to dichorionic twin pregnancies (n=18), DCTA-anticipation management (n=34), TCTA to monochorionic singleton pregnancies (n=31), TCTA to dichorionic twin pregnancies (n=130), and TCTA-anticipation management (n=18). In DCTA-anticipation management group, the complete miscarriage rate is dramatically higher, and the survival rate and the rate of take-home babies are lower. However, there was no difference between the rates of complete miscarriages, survival rates, and take-home babies in TCTA-anticipation management group. But the complete miscarriage rate of DCTA-anticipation management was obviously higher than that of TCTA-anticipation management group (29.41 vs. 5.56%, p=0.044). For obstetric outcomes, MFPR to singleton group had higher gestational week and average birth weight, but lower premature delivery, gestational hypertension rates and low birth weight in both DCTA and TCTA pregnancy groups (all p<0.05). Monochorionic twins have higher rates of complete, early, and late miscarriage, premature delivery, and late premature delivery, and lower survival rate and twin survival rate rates (p<0.05).Conclusion: MFPR could improve gestational week and average birth weight, reducing premature delivery, LBW, and gestational hypertension rates in DCTA and TCTA pregnancies. Monochorionic twins have worse pregnancy and obstetric outcomes. MFPR to singleton is preferable recommended in the pregnancy and obstetric management of complex triplets with monochorionic pair.
The Impact of Delays During the Pandemic Months on Survival of Lung Cancer Patients in Canada in 2020.
Authors: Khandelwal Luv , Begum Housne , Nippak Pria
Published: September 2021

Objective

Most cancer deaths in the world are due to lung cancer and delays in diagnosis and treatment sharply reduce survival in lung cancer patients. This study examined the impact of delays during the early months of the pandemic on the survival of newly identified lung cancer patients in Canada in 2020.
Methods

The incidence of lung cancer, using population statistics from Statistics Canada and incidence rates from the Canadian Cancer Statistics in 2020, was estimated. Stage-wise incidences for each sex were calculated for each age group for each month of 2020. Using delay impact on each stage the final results were calculated.
Results

A total of 5,004 life years would have been lost due to 448 deaths in the long term (40 months) attributed to the delays caused during March, April, May and June in Canada. The estimated incidence for all stages of lung cancer for these months was 9,801 although the observed incidence was expected to be 6,571 due to reduced screenings. Hence, it was within the missing 3,231 cases that delays would occur. Over the short term (10 months) there are expected to be 151 early deaths and 273 deaths in the intermediate-term (20 months).
Conclusion

The COVID pandemic is estimated to result in increased mortality and fewer diagnosis’ of lung cancer patients in Canada in 2020.
Identification of MicroRNA-mRNA Regulatory Networks in Periodontitis by Bioinformatics Analysis
Authors: Gao Xiaoli , Zhao Dong , Wang Zuomin , Zhang Zheng , Han Jing
Published: September 2021

Background: Periodontitis is a complex infectious disease with various causes and contributing factors. In recent years, microRNAs (miRNAs) have been commonly accepted as having key regulatory functions in periodontal disease. The aim of this study was to identify miRNAs and hub genes involved in periodontal disease pathogenesis using a miRNA-mRNA interaction network.Methods: The GSE54710 miRNA microarray dataset and the gene expression microarray dataset GSE16134 were downloaded from the Gene Expression Omnibus database. The differentially expressed miRNAs (DEMis) and mRNAs (DEMs) were screened using P <0.05 and |log FC| ≥1. Potential upstream transcription factors and downstream target genes of candidate DEMis were predicted using the FunRich and miRNet programs, respectively. Subsequently, DEMs were uploaded to the STRING database, a protein-protein interaction (PPI) network was established, and the cytoHubba plugin was used to screen out key hub mRNAs. The key genes in the miRNA-mRNA regulatory network were extracted by intersecting the target genes of candidate DEMis and DEMs. Cytoscape software was used to visualise the interaction between miRNAs and mRNAs and to predict the hub genes. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were used to analyse the key genes in the regulatory network.Results: Ten DEMis and 161 DEMs were filtered out, from which we constructed a miRNA-mRNA network consisting of six miRNAs and 32 mRNAs. KEGG pathway analysis showed that mRNAs in the regulatory network were mainly involved in the IL-17 signalling pathway. Hsa-miR-203/CXCL8, hsa-miR-203/BTG2, and hsa-miR-203/DNAJB9 were identified as four potential regulatory pathways for periodontitis. Conclusion: In this study, a potential miRNA–mRNA regulatory network was first constructed and four regulatory pathways were identified for periodontitis to help clarify the aetiology of the disease and provide potential therapeutic targets.
Effects of Micronized Bamboo Powder on Growth Performance, Serum Biochemical Indexes, Cecal Chyme Microflora and Metabolism of Broilers Aged 1-22 Days
Authors: Dai Fawen , Lin Tao , Cheng Lumin , Wang Jian , Zuo Jianjun , Feng Dingyuan
Published: September 2021

Necrotic enteritis is common in broilers, which makes negative effects on growth performance. Adding insoluble fiber to diet of broilers has been reported to improve intestinal health and promote growth performance. Bamboo powder is a cheap raw material with rich insoluble fiber. This study aims to explore the effects of feeding micronized bamboo powder (MBP) on growth performance, serum biochemical indexes, intestinal microflora, and metabolism of broilers. A total of 1440 1-day-old ephedra chickens were randomly divided into three groups considering gender and body weight: (1) Group D: feeding with basal diet without antibiotics; (2) Group E: feeding with basal diet supplemented with 5% rice bran (RB); (3) Group F: feeding with basal diet supplemented with 1% MBP. Each group involved 8 replicates, with 60 chickens per replicate. After feeding for 22 days, various indexes were detected. For the growth performance, the weight gain and feed consumption ratio (G: F) of Group F supplemented with MBP is 0.57 ± 0.04, which is significantly higher than that of E group supplemented with RB (0.52 ± 0.01, P < 0.05). For the serum biochemical indexes, the glutathione peroxidase activity in Group F is significantly higher than that of in Group D, while the malondialdehyde content is significantly lower than that of in Group D and Group E (P < 0.05 for all). The fresh cecal chyme is taken for determination. In Group F, the α diversity index Faith_pd is significantly lower in Group F than that of in Group D. The microorganism species in cecal chyme of Group F and Group E are also different. The metabolic pathways of Group F differ from those of Group D and Group E, mainly manifested in fatty acid metabolism, amino acid metabolism and intestinal immune IgA production. Adding 1% MBP to broiler diet can enhance the anti-oxidant capacity, improve chyme microflora, regulate the metabolism pathways responsible for intestinal fatty acids, amino acids, and immunity.
The Relationship Between Brain Natriuretic Peptide (NT-proBNP) Levels and Diastolic Heart Failure in Patients With COVID-19
Authors: Ziaie Naghmeh , Ezoji Khadijeh , Ziaei Seyedeh Golnaz , Chehrazi Mohammad , Maleh Parviz Amri , Pourkia Roghayeh , Seyfi Shahram
Published: September 2021

Background: Diastolic dysfunction has been reported in patients with COVID-19. Due to the role of N-terminal pro-brain natriuretic peptide (NT-proBNP) in the diagnosis of heart failure, this study investigated the relationship between serum NT-proBNP levels and diastolic heart failure in COVID-19 patients.Methods: This descriptive-analytical study was performed at Ayatollah Rouhani Hospital in Babol. Fifty-four patients with confirmed COVID-19 diagnosis who were admitted to the ICU were included in the study. The primary outcome was the relationship and predictive role of NT-proBNP and diastolic heart failure in patients with severe SARS-COV-2 infection. Patients with pro BNP >125 pg/mL underwent echocardiography and the relationship between echocardiographic indices and NT-proBNP was assessed as a secondary outcome.Results: Our study showed that plasma NT-proBNP levels in patients with increased diastolic dysfunction were associated with disease severity. It was also found that the cut-off point of NT-proBNP = 799 pg/mL could be a predictor of diastolic dysfunction grades two and three. In this study, patients with a serum NT-proBNP level equal or above 799 had 37 times higher chance of having diastolic dysfunction than those with a serum NT-proBNP level below 799. Patients with NT-proBNP above 556 had RV_EA> 2 in echocardiography, indicating increased right-sided filling pressures.Conclusion: Despite the confounding factors in the interpretation of the pro BNP level in COVID-19, its level can be used to estimate the presence of high-grade diastolic heart failure on the left and right sides of the heart and the presence of high filling pressures. Lower levels of NT-proBNP are associated with right-sided diastolic failure.
What do Biphasic Flow Experiments Reveal On the Variability of Exposure on Alluvial Fans and Which Implications for Risk Assessment Result From This?
Authors: Diaz Hector , Mazzorana Bruno , Gems Bernhard , Rojas Ivan , Santibañez Nicole , Iribarren Pablo , Pino Mario , Iroumé Andres
Published: September 2021

Autogenic processes, such as sudden avulsions, unexpected channel migrations and backfilling phenomena, can considerably alter the propagation of sediment-laden flows on alluvial fans. Once the initial and boundary conditions of the hazard scenario with a given return period are determined, the delineation of the associated exposed areas is based on one numerical, essentially deterministic, process simulation, which may not adequately reflect the underlying process variability. By following a ‘similarity-of-process concept’ we generated sediment-laden flows on an experimental alluvial fan. Thereby, we considered an alluvial fan model layout with a curved guiding channel and featuring a convex shape. As loading conditions, we defined a reference, an increased and a reduced level for the released water volume and the predisposed solid fraction. Further, we imposed two different stream power regimes and executed, for each factor combination, eight experimental runs. The associated exposure areas were recorded by video and were mapped in a GIS. We then analyzed exposure data and derived exposure probability maps superposing the footprints of the eight repetitions generated by each experimental loading condition. The patterns of exposure associated with specific loading conditions showed a noticeable variability due to the main effect of the total event volume, the solid fraction and the interactions between them and with the imposed stream power in the feeding channel. Our research highlights that a probabilistic notion of exposure in risk assessment and mitigation needs to be considered. Further, a major challenge consists in adapting numerical codes to better mirror the stochastics of process propagation for more reliable flood hazard and risk assessments.
Development and Evaluation of Video-Based Educational Materials for Nutritional Management of Cancer in Children Among Healthcare Professionals and Caregivers
Authors: Razalli Nurul Huda , Alias Hamidah , Mohammad Mohd Hafizuddin , Rahim Nur Ruzaireena , Zulkipli Nur Qharena Alwani
Published: September 2021

Background A good audio-visual educational material for caregivers on nutrition management of pediatric oncology patients can improve treatment effectiveness, recovery rate, and nutritional status of patients. This study aimed to develop and evaluate a series of video-based educational materials for nutritional management of pediatric oncology patients among healthcare professionals and caregivers.Methods The development of the video series began with subtopic selection and content refinement based on a printed booklet project previously published by the groups of five experts in dietetics and oncology medicine and five caregivers of pediatric cancer patients. 10 healthcare professionals (medical doctors and dietitians with over 5 years of working experience) and 15 caregivers then evaluated the video series for acceptability and relevance using the Malay version of the Patient Education Materials Assessment Tools for Audio-Visual materials (PEMAT-AV). Sets of understandability and actionability statements were given a score of 0 (disagree) or 1 (agree), and the overall percentage was calculated.ResultFour main topics were selected from the booklet and adopted into 5 video series ranging from 3 to 8 minutes in length developed in the Malay language entitled (i) Introduction to Cancer and the Treatment, (ii) The Side Effects of Cancer Treatment and Management (Part 1), (iii) The Side Effects of Cancer Treatment and Management (Part 2), (iv) Nutrition Management in Children with Cancer, and (v) You Ask, We Answer. The average understandability and actionability scores rated by the healthcare professionals were 98.6%% and 98.7%respectively. Whereas the caregivers’ average score for understandability was 99.5% and 99.6% for actionability.ConclusionsThe findings revealed that a high-quality video series was successfully developed and rated as highly understandable and actionable by both healthcare professionals and caregivers. This reflects positive acceptance and relevance of the nutritional management educational videos by both groups who manage and care for pediatric cancer patients. Trial RegistrationCentre for Research and Instrumentation Management, Research Ethics Committee of The National University of Malaysia; Ref. No. UKM/PPI/111/8/JEP-2021-266
Post-Pharmacy Exam - Are We Ready? - The Results of the Exam conducted in Poland on the Model of the UK
Authors: Merks Piotr , Religioni Urszula , Rutkowska Aleksandra , Munzu Marvin , Panford-Quainoo Edwin , Barańska Agnieszka , Waszyk-Nowaczyk Magdalena , Krysiński Jezrzy
Published: September 2021

Background.

This article aims to present the results of the final exam in pharmacy among Polish pharmacy students. This exam was modeled on the British national exam supervised by the General Pharmaceutical Council.
Methods.

The exam was conducted in 3 cities in Poland, among a total of 175 final-year students. Taking the exam was voluntary and anonymous.
Results.

The results indicate that none of the Polish students achieved the 70% mark required to pass the Great Britain exam. Significant differences in test results were noticed between cities. Students achieved the best average exam result in Bydgoszcz (46.35%), then in Warsaw (38.81%) and Łódź (38.35%)
Conclusions.

The pharmaceutical education system in Poland requires complete changes that will prepare future pharmacists for clinical work. Increasing the role of a pharmacist in health care requires raising the level of education and emphasizing the practical content of education.
Edible Red Seaweed Campylaephora Hypnaeoides J. Agardh Alleviates Obesity and Related Metabolic Disorders in Mice by Suppressing Oxidative Stress and Inflammatory Response
Authors: Murakami Shigeru , Hirazawa Chihiro , Yoshikawa Rina , Mizutani Toshiki , Ohya Takuma , Ma Ning , Ikemori Takahiko , Ito Takashi , Matsuzaki Chiaki
Published: September 2021

Background: The obesity epidemic has become a serious public health problem in many countries worldwide. Seaweed has few calories and is rich in active nutritional components necessary for health promotion and disease prevention. The aim of this study was to investigate the effects of the Campylaephora hypnaeoides J. Agardh (C. hypnaeoides), an edible seaweed traditionally eaten in Japan, on high-fat (HF) diet-induced obesity and related metabolic diseases in mice.Methods: Male C57BL/6J mice were randomly divided into the following groups: normal diet group, HF diet group, HF diet supplemented with 2% C. hypnaeoides, and HF diet supplemented with 6% C. hypnaeoides. After 13 weeks of treatment, the weight of the white adipose tissue and liver, and the serum levels of glucose, insulin, adipokines, and lipids were measured. Hepatic levels of adipokines, oxidant markers, and antioxidant markers were also determined. Insulin resistance was assessed by a glucose tolerance test. Polysaccharides of C. hypnaeoides were purified and their molecular weight was determined by high-performance seize exclusion chromatography. The anti-inflammatory effects of purified polysaccharides were evaluated in RAW264.7 cells. Results: Treatment of HF diet-induced obese mice with C. hypnaeoides for 13 weeks suppressed the increase in body weight and white adipose tissue weight. It also ameliorated insulin resistance, diabetes, hepatic steatosis, and hypercholesterolemia. The ingestion of an HF diet increased serum levels of malondialdehyde (MDA), tumor necrosis factor a (TNF-a), and monocyte chemoattractant protein-1 (MCP-1), while it decreased serum adiponectin levels. In the liver, an HF diet markedly increased the MDA, TNF-a, and interleukin-6 (IL-6) levels, while it decreased glutathione (GSH) and superoxide dismutase (SOD). These metabolic changes induced by HF diet feeding were ameliorated by dietary C. hypnaeoides. Purified polysaccharides and ethanol extract from C. hypnaeoides inhibited the lipopolysaccharide-induced overproduction of nitric oxide and TNF-a in macrophage RAW264.7 cells. Conclusions: The present results indicated that C. hypnaeoides was able to alleviate HF diet-induced metabolic disorders, including obesity, diabetes, hepatic steatosis, and hypercholesterolemia by attenuating inflammation and improving the antioxidant capacity in mice. Polysaccharides and polyphenols may be involved in these beneficial effects of C. hypnaeoides.
DICER1-Associated Central Nervous System Sarcoma with Neural Lineage Differentiation: A Case Report
Authors: Kun Yao , Zejun Duan , Jing Feng , Xueling Qi
Published: September 2021

Background: DICER1-associated central nervous system sarcoma (DCS) without evidence of other cancer-related syndromes is rare. Though the morphology of DCS was highly variable, the immunophenotype was predominant myogenic phenotype. Other lineage markers were consistently negative. Herein, our objective was to identify the clinical, pathogenesis, treatment and driver mutation of DCS with neurogenic differentiation through whole-exome sequencing (WES) and RNA sequencing (RNA-seq) of both leukocytes and tumor tissues.Case presentation: We describe here the case of a 8-year-old female patient presented with a 8-day history of headache, nausea and vomiting. Magnetic resonance imaging (MRI) revealed a heterogeneous mass in left parietal lobe. The patient underwent the craniotomy via left parietal approach. Histologically, the tumor predominately showed fibrosarcoma-like spindle cells with obvious cytoplasmic eosinophilic globules. Immunohistochemically, the tumor stained positively for NF, Syn, MAP-2, Desmin and DICER1. WES of tumor tissues detected the DICER1 somatic mutation. This case harbored tumor-driving mutations mainly including AR, AXL and ETV5 mutations, proved sarcoma-associated genes in other kind of sarcomas growth, in addition to TP53 and RAF1 mutations which were common found in DCS. All theses findings indicated the diagnosis of DCS with neurogenic differentiation. This neural lineage differentiation was further confirmed by the result of Gene Ontology (GO) analysis. The patient subsequently received high dose radiotherapy (60Gy) and chemotherapy. The MRI showed no evidence of tumor recurrence at the 12 months’ follow-up.Conclusions: This unusual case of DCS with neuronal differentiation is an important addition to the immuno-phenotypic spectrum of DCS. The prognosis is poor for DCS, and total tumor resection and high dose radiotherapy may assist in prolonging survival. Further research is needed to better understand the behavior and treatment of this rare DCS with neuronal differentiation.
Poster as Tool to Improve Hand Hygiene Among Health Science Students: Case-control Study
Authors: Gázquez-López María , Martínez-García Encarnación , Martín-Salvador Adelina , Álvarez-Serrano María Adelaida , García-García Inmaculada , Caparrós-González Rafael A. , Pérez-Morente María Ángeles
Published: September 2021

Background/Purpose:
Hand hygiene is the most effective method for preventing nosocomial infections. Numerous educational interventions have been implemented to improve adherence to hand hygiene and its effectiveness among nursing students, with mixed results. To assess the effectiveness of posters as a tool for teaching hand hygiene and factors associated with the quality of hand hygiene among nursing students.
Methods
An experimental pre-post intervention study was carried out with second-, third-, and fourth-year nursing students randomly assigned to two groups (experimental and control). The two groups performed the handrubbing technique using alcohol-based hand rub. The experimental group was simultaneously shown the poster on hand hygiene produced by the WHO. Before and after the hand rubbing, students took cell samples from their non-dominant hands, which were cultured in Petri dishes for 48 hours. The number of bacterial colony-forming units per cm2 determined the degree of cleanliness of their hands (< 10 = pass; ≥10 = fail).
Summary/Results:
A total of 293 students participated. In the experimental group (n = 161), significant differences were observed by age, with a higher percentage of fails (15.7% vs. 3.6%) among students aged > 22 years. Viewing the poster was associated with passing, all other variables being equal, albeit without statistical significance (ORa = 2.07). Hand contamination prior to the practices was weakly associated with lower hand hygiene quality (ORa = .99).
Conclusions
The use of posters as a teaching method for improving hand hygiene shows indications of effectiveness. Prior contamination of the hands slightly affects the quality of hand hygiene after the practice. Evaluation of new hand hygiene teaching methods at College setting ensures that future nurses are educated and sensitised to the spread of infectious diseases during the COVID-19 pandemic.
Apigenin Alleviates Non-Alcoholic Fatty Liver Disease by Downregulating the NLRP3/NF-κB Signaling Pathway in Mice
Authors: Lu Zheng , Liu Lu , Zhao Shunxin , Zhao Jiangtao , Li Sujun
Published: September 2021

Background: Apigenin, a flavone found in several plant foods with various biological properties including anti-inflammatory and other abilities, alleviated non-alcohol fatty liver disease (NAFLD) induced by a high fat diet (HFD) in mice. However, the mechanisms underlying this protection of inflammation and NAFLD has not been known clearly. Methods: Low density lipoprotein receptor-deficient (Ldlr-/-) mice were fed with HFD diet to induce NAFLD model and were treated with apigenin (50 mg/kg/day) for eight weeks. Hepatic lipid accumulation and inflammation in the livers were analyzed and quantified. In vitro experiments, HepG2 cells were stimulated by LPS plus oleic acid (OA) in the absence of presence of apigenin (50μM). Lipid accumulation and the effect of apigenin on NLRP3/NF-κB signaling pathway was investigated.Results: Apigenin administration reduce the weight, plasma lipid levels in Ldlr-/- mice when fed an HFD. Apigenin (50 mg/kg/day) treated mice displayed reduced hepatic lipid accumulation and inflammation in the livers of mice given the HFD diet. Treating the HepG2 cells with apigenin reduced lipid accumulation. And, apigenin also inhibited activation of NLRP3/NF-κB signaling pathway stimulated by OA together with LPS. Conclusions: Our results indicated that apigenin supplementation prevented NAFLD via down-regulating the NLRP3/NF-κB signaling pathway in mice, and suggested apigenin might be a potential therapeutic agent for the prevention of NAFLD.
Hypoglycemia Induced Mitochondrial Connexin-43 Accumulation Aggravates Diabetic Cardiomyopathy
Authors: Wei Xing , Chang Andrew Chia Hao , Chang Haishuang , Xu Shan , Xue Yilin , Zhang Yuanxin , Lei Ming , Chang Alex Chia Yu , Zhang Qingyong
Published: September 2021

Background: Diabetic cardiomyopathy (DCM) is a complex multifaceted disease responsible for elevated hospitalization and mortality in patients with diabetes mellitus (DM). DCM patients exhibit subclinical diastolic dysfunction, progression towards systolic impairment, and abnormal electrophysiology. Hypoglycemia events that occur spontaneously or due to excess insulin administration threaten the lives of DM patients – with the increased risk of sudden death. However, the molecular underpinnings of hypoglycemia-aggravated DCM remain to be elucidated. Methods and Results: Here we used the established streptozotocin-induced type 1 diabetic cardiomyopathy (T1 DCM) murine model to investigate how hypoglycemia aggravates DCM progression. We showed that chronic hyper- or hypoglycemic challenges dampened cardiac diastolic function in vivo as well as myocardial contractility and calcium handling in isolated cardiomyocytes. Similar contractile defects were recapitulated using neonatal mouse ventricular myocytes (NMVMs) under glucose fluctuation challenges. Using immunoprecipitation mass spectrometry, we identified and validated that hypoglycemia challenge activates the MEK/ERK and PI3K/Akt pathways which results in Cx43 phosphorylation by Src protein in cardiomyocytes. Cx43 dissociation and accumulation at mitochondrial inner membrane was confirmed both in human and murine cardiomyocytes. To determine causality, we overexpressed a mitochondrial targeting Cx43 (mtCx43) using AAV2. At normal blood glucose levels, mtCx43 overexpression recapitulated cardiomyocytes contractile deficiencies, cardiac diastolic dysfunction as well as aberrant electrophysiology both in vitro as well as in vivo. Conclusions: Hypoglycemia challenges results in the accumulation of mtCx43 through the MEK/ERK/Src and PI3K/Akt/Src pathways. We provide evidence that Cx43 mislocalization is present in diabetes mellitus patient hearts, STZ-induced DCM murine model, and glucose fluctuation challenged NMVMs. Mechanistically, we demonstrated that mtCx43 is responsible for inducing aberrant contraction and disrupts electrophysiology in cardiomyocytes and our results support targeting of mtCx43 in treating DCM. Translational perspective: Severe hypoglycemia drives cardiac dysfunction and aggressive ventricular arrhythmias in patients with DCM that leads to sudden cardiac death. Here we demonstrate that Cx43 mislocalization to mitochondria occurs upon hypoglycemic challenge and mtCx43 accumulation is responsible for cardiac diastolic dysfunction, cardiomyocyte contractile dysfunction, and aberrant electrophysiology in vivo. Our findings give support for therapeutic targeting of MEK/ERK/Src and PI3K/Akt/Src pathways to prevent mtCx43-driven DCM.
Nonsteroidal Anti-inflammatory Drugs (NSAID) Do Not Increase Blood Loss or the Incidence of Postoperative Epidural Hematomas When Using Minimally Invasive Fusion Techniques in the Degenerative Lumbar Spine
Authors: Senker Wolfgang , Stefanits Harald , Gmeiner Matthias , Trutschnig Wolfgang , Franke Jörg , Gruber Andreas
Published: September 2021

Objective: Nonsteroidal anti-inflammatory drugs (NSAID) are essential in surgeons’ armamentarium for pain relief and antiphlogistic effects. However, spine surgeons are concerned about the drugs’ impact on coagulation, fearing hemodynamic instability due to blood loss and neurological complications due to postoperative hematoma. Furthermore, there are no clear guidelines for the use of these drugs.Materials and methods: In this retrospective subgroup analysis of a prospective observational study, we investigated 181 patients who underwent minimally invasive spinal fusions in degenerative lumbar spine pathologies. 83 patients were given NSAID perioperatively, 54 of which were female and 29 male. Of these patients who took NSAID, 39 were on NSAID until at least one day before surgery or perioperatively, whilst the others discontinued their NSAID medication at least three days before surgery. Differences in perioperative blood loss, as well as complication rates between patients with and without NSAID treatment, were investigated.Results: A significantly higher amount of blood loss during surgery and the monitoring period was encountered in patients whose spine was fused in more than one level, regardless of whether NSAID medication was taken or not and up until what point. Furthermore, it was found that taking NSAID medication had no effect on the incidence of postoperative epidural hematomas.Conclusion: Perioperatively taking NSAID medication does not increase blood loss or the incidence of postoperative hematoma in patients undergoing minimally invasive lumbar spinal fusion surgery.
Discordance Between Circulating Atherogenic Cholesterol Mass and Lipoprotein Particle Concentration in Relation to Future Cardiovascular Disease in China Population
Authors: Su Xin , Zuo Yingting , Zhai Qi , Zhang Yibo , Xia Zhang , Li Yuhao , He Yan
Published: September 2021

BackgroundIt is uncertain whether measurement of circulating total atherogenic lipoprotein particle cholesterol mass (non-high-density lipoprotein cholesterol [non-HDL-C]) or particle concentration (apolipoprotein B [Apo B]) more accurately reflects risk of incident cardiovascular disease (CVD). We evaluated CVD risk among China population in whom these markers where discordant.MethodsIn total, 7,117 initially healthy participants from the China Health and Nutrition Survey were included. Logistic regressions among Apo B, non-HDL-C, and LDL-C, respectively, were used to examined CVD risk by categories of concordant and discordant values defined by residual differences. Mediation analysis was performed to explore the intermediary effect of Apo B between the obesity and the risk of CVD.ResultsAlthough all 3 biomarkers were correlated (r ≥ 0.81), discordance occurred in approximately 16% of China participants. Participants with discordant high Apo B were more likely to have higher proportion of traditional risk factors and dyslipidemia. During a follow-up of 6 years, 207 CVD cases were identified. High LDL-C, non-HDL-C and Apo B were associated with increased risk of CVD. Participants with discordant high Apo B relative to LDL-C or non-HDL-C had increased CVD risk compared with concordant levels, odds ratios were 1.38 (95% CI: 1.01 to 1.87), 1.40 (95% CI: 1.01 to 1.94), respectively. Furthermore, mediation analyses revealed 16.67% of association between obesity with CVD was mediated by Apo B.ConclusionsDiscordance analysis demonstrates that Apo B is a more accurate marker of CVD risk in China healthy participants than LDL-C and non-HDL-C. Direct measurement of lipoprotein particle concentration might help better inform clinical risk assessment and guide clinical decision making.
The Big Five Model in Bipolar Disorder: A Latent Profile Analysis and its Impact on Longterm Illness Severity
Authors: Ortelbach Niklas , Rote Jonas , Dingelstadt Alice Mai Ly , Stolzenburg Anna , Koenig Cornelia , O'Malley Grace , Quinlivan Esther , Fiebig Jana , Pfeiffer Steffi , König Barbara , Simhandl Christian , Bauer Michael , Pfennig Andrea , Stamm Thomas J.
Published: September 2021

Background Using a personality typing approach, we investigated the relationship between personality profiles and the prediction of longterm illness severity in patients with bipolar disorder (BD). While previous research suggests associations between BD and traits from the NEO-FFI profiles, the current study firstly aimed to identify latent classes of NEO-FFI profiles, and, secondly, to examine their impact on the longterm prognosis of BD. Methods Based on the NEO-FFI profiles of 134 euthymic patients diagnosed with BD (64.2% female, mean age = 44.3 years), successive latent profile analyses were conducted. Subsequently, a subsample (n = 80) was examined prospectively by performing multiple regression analysis to evaluate the longitudinal course of the disease (mean: 54.7 weeks) measured using a modified Morbidity Index. Results The latent profile analyses suggested a 3-class model typifying in a resilient (n = 68, 51%), vulnerable (n = 55, 41%) and highly vulnerable (n = 11, 8%) class. In the regression analysis, higher vulnerability predicted a higher longterm Morbidity Index ( R 2 = .28). Conclusions Subgroups of patients with BD share a number of discrete personality features and their illness is characterized by a similar clinical course. This knowledge is valuable in a variety of clinical contexts including early detection, intervention planning and treatment process.
A Multi-Country Cross-Sectional Study of Knowledge and Worry About COVID-19 Among Higher Education Students During the First Wave of the Pandemic
Authors: BERHE NEAMIN M. , DE VELDE SARAH VAN , RABIEE-KHAN FATEMAH , HEIJDE CLAUDIA VAN DER , VONK PETER , WOUTERS EDWIN , HAL GUIDO VAN
Published: September 2021

Background

Public health measures such as physical distancing and distance learning have been implemented during the COVID-19 pandemic. Having inadequate COVID-19 related knowledge can lead to excessive worrying as well as negative COVID-19 outcomes. Our study aimed to assess COVID-19 related knowledge and its association with worries among higher education (HE) students during the first wave of COVID-19.
Methods

A cross sectional survey, COVID-19 International Students Well-being Study (C-19 ISWS) was conducted in 133 Higher Education Institutions (HEIs) in 26 countries between April 27 and July 7, 2020. A stratified convenience sampling technique was used. Descriptive, bivariate, mixed effect logistic regression analysis were conducted using R software.
Results

Out of 127,362 respondents, 72.1 % were female, and 76.5% did not report a previous history of confirmed COVID-19. Majority of those without the previous infection 81,645 (83.7%) were from 21 European countries while the rest 15,850 (16.3%) from 5 non-European countries. The most frequent correct response to COVID-19 related knowledge questions among respondents was having the virus without having symptoms (94.3%). Compared to participants with good knowledge, the odds of being worried of acquiring SARS-COV-2 infection with poor knowledge was 1.05 (95%CI:1.03,1.08) and the odds of being worried of contracting severe COVID-19 was 1.36 (95%CI:1.31,1.40).
Conclusion

COVID-19 related knowledge was independently associated with both worry of acquiring SARS-COV-2 infection as well as contracting severe COVID-19. We recommend scaling up of awareness campaigns through media to increase the comprehensive COVID-19 related knowledge in order to tackle excessive worries about acquiring severe COVID-19.
Mucinous Cystadenocarcinoma in Breast: Complicated with Lymph Node, Thoracic Wall Metastasis, and Contralateral Triple Negative Breast Cancer: A Case Report
Authors: Li Zhenyu , Jiang Qingming , Guo Dongfang , Cao Yong , Peng Yangling , Zhang Jing , Dong Juanhui
Published: September 2021

Background: Mucinous cystadenocarcinoma of the breast is a very rare and special type adenocarcinoma of the mammary tract. We report a rare case of mucinous cystadenocarcinoma of the breast with an unfavourable prognosis which was confirmed after surgical resection pathologically. Case summary: At low power appearance, the tumor formed mucus-filled spaces of varying sizes, and with mucus-rich tumor cells lining the walls. The tumor cells were arranged in papillary structures. At high magnification, the tumor cells shown moderate to severe atypia, which were most of simple columnar cells with nuclei in the base and cytoplasm rich in mucin. In some areas, tumor cells proliferated, stratified, and clustered that protruded into the cyst cavity, or formed papillary structures with thin fibrovascular core. Immunohistochemical staining showed cytoplasm CK7 strong positive of tumor cells and cytoplasm negative of CK20, PAX-8 and CDX2, which could exclude metastatic tumors from ovary and intestine. And the tumor cells also demonstrated the basal-like characters such as negative for ER, PR, HER-2 (triple-negative), CK5/6 focal positive, EGFR positive. Besides, a triple negative breast cancer with basal-like features, lymph node, thoracic wall metastasis of mucinous cystadenocarcinoma was found. Conclusion: Mucinous cystadenocarcinoma of the breast usually have a favorable prognosis, but in this case, it happened lymph node, thoracic wall metastasis, therefore, it needs extra attention of clinical workers.
Left Atrial Appendage Occlusion for Patients with Valvular Diseases: A Prospective Study Design
Authors: Yuan Xin , Li Baotong , Ju Fan , Sun Hansong
Published: September 2021

Background:As increasing evidence showed the efficacy of percutaneous left atrial appendage (LAA) occlusion in reducing the stroke risks in patients with non-valvular atrial fibrillation(AF), we design this study to quantify the effect of surgical LAA occlusion (SLAAO) for patients with valvular diseases and with or without AF.Methods:The current study will be implemented in two parts: Part 1 (AF study) is a prospective longitudinal study with a plan to consecutively register 2032 patients diagnosed with valvular diseases and AF and receiving cardiovascular surgeries. SLAAO will be performed at the individual surgeon’s preference. We centrally conducted a one-year follow-up on stroke, systemic arterial embolism, and all-cause mortality. Part 2 (non AF study) is a single-blinded, multicenter, randomized controlled trial with the purpose to evaluate the efficacy of SLAAO to reduce one-year embolism events in patients with valvular diseases, without AF, and receiving cardiovascular surgeries. 2118 patients will be randomized 1:1 to the intervention or control arm using a central randomization system.Results:The primary outcome is a composition of newly occurred ischemic stroke/transient ischemic attack (TIA) with positive neuroimaging or systemic arterial embolism, and cardiovascular mortality during one-year follow-up.Conclusion:The trial is designed to evaluate the efficacy of SLAAO to reduce embolism events one year after mitral or aortic surgeries, and this paper presents the prospective study protocol. It provides details of patient randomization, follow-up, methods of analysis of the material, and publication plan.
Climate-driven Impacts in Ports on a Tectonically Active Coast Under Mid- and End-of-century RCP 8.5 Scenario
Authors: Winckler Patricio , Esparza César , Mora Javiera , Melo Oscar , Bambach Nicolás , Contreras-López Manuel , Sactic María Isabel
Published: September 2021

The authors have requested that this preprint be removed from Research Square.
Genetic influences on brain representations of natural audiovisual experiences
Authors: Nishida Satoshi , Toyoda Shunsuke , Honda Chika , Watanabe Mikio , Ollikainen Miina , Vuoksimaa Eero , Kaprio Jaakko , Nishimoto Shinji
Published: September 2021

Natural sensory inputs in everyday situations induce unique experiences that vary between individuals, even when inputs are identical. This experiential uniqueness stems from the representations of sensory signals in each brain. We investigated whether genetic factors control individual differences in sensory representations in the brain by studying the brain representations of natural audiovisual signals in twin-pairs. We measured the brain response to natural movies in twins using functional magnetic resonance imaging and quantified the genetic influence on the multivoxel-pattern similarity of movie clip representations between each twin. The whole-brain analysis revealed a genetic influence on the multivoxel-pattern similarity in widespread brain regions, which included the occipitotemporal sensory cortices as well as the frontoparietal association cortices and subcortical structures. Our findings suggest that genetic factors exhibit an effect on natural audiovisual signaling by controlling audiovisual representations in the brain.
Lung-protective Ventilation Combined With Pressure-controlled Ventilation Volume-guaranteed in Children Undergoing One-lung Ventilation: A Randomised Controlled Trial
Authors: Zhu Change , Zhang Saiji , Yu Shenghua , Zhang Yuting , Wei Rong
Published: September 2021

The purpose of study was to evaluate the effect of lung-protective ventilation (LPV) combined with PCV-VG in children undergoing OLV. Patients were randomly assigned to the LPV combined with PCV-VG group (PCV-VG) or LPV group (volume-controlled ventilation). Both groups received tidal-volume ventilation of 8 ml kg-1 body weight during two-lung ventilation, 6 ml kg‑1 during OLV, with sustained 5 cmH2O positive end-expiratory pressure.The PCV-VG group exhibited lower PIP than the LPV group at T1 (16.8±2.3 vs. 18.7±2.7, P=0.001), T2 (20.2±2.7 vs. 22.4±3.3, P=0.001), and T3 (23.8±3.2 vs. 26.36±3.7, P=0.01). Dynamic compliance was higher in the PCV-VG group at T1, T2 , and T3 (P=0.01). After anaesthesia induction, lung aeration deteriorated, but with no immediate postoperative difference in both groups. Postoperative lung aeration improved and returned to normal from 2.5 h postextubation in both groups. No differences were observed in postoperative pulmonary complications, intra-operative desaturation, hospital stay. In paediatric patients, who underwent thoracoscopic surgery, PCV-VG combined with LPV was superior to LPV in its ability to provide ventilation with lower PIP and higher dynamic compliance. However, the long-term benefits of different ventilation strategies should be further investigated.