bluuebunny/crossref_metadata_2025 huggingface dataset:
Contemporary public image of the nursing profession in Saudi Arabia
Authors: Elmorshedy Hala , AlAmrani Abrar , Hassan Mona Hassan Ahmed , Fayed Amel Ahmed , Albrecht Susan Ann
Published: May 2020

Background: In the Kingdom of Saudi Arabia, the nursing profession faces significant challenges including failure to recruit high school students into nursing education; poor nursing identity, and lack of awareness about the nursing profession. The level of community awareness and public image of the nursing profession are critical to recruit and retain students into nursing education, and to improve nurses' sense of identity. Aim: to explore the level of community awareness and public image of the nursing profession in Saudi Arabia Methods: We conducted a cross-sectional study with a convenient sample of 502 adults including 106 males and 396 females, their mean age was 22.93 ± 6.76 years. Data collected included; socio-cultural data, gender preference in getting nursing care, awareness, and perceived socio-cultural barriers to pursue a nursing career. Data were analyzed using SPSS version 21.0. Results: Only 32.5 % preferred to get nursing care by Saudis. The nursing profession was not viewed as a respected job as 71.5% of participants would be ashamed of having a nurse in their families. The study revealed a low median knowledge score (50.0, IQR: 50.0-66.7)). The study highlighted a number of socio-cultural barriers to pursue a nursing career including; the gender-mixed working environment (35.9%), delayed marriage of female nurses (20.3%), and the negative effect of nursing profession on social life (64.5%). Conclusions : Half of the sample had a knowledge score below 50.0 out of 100. This level of Poor awareness, in addition to socio-cultural perceived barriers are the main factors contributing to the negative public image of the nursing profession in Saudi Arabia. Understanding these factors could contribute to implementing focused intervention to improve the negative stereotype of the nursing profession among Saudis.
Differences in gait analysis and clinical outcome after TightRope® or screw fixation in acute syndesmosis rupture: Study protocol for a prospective randomized pilot study
Authors: Doll Julian , Waizenegger Stefan , Bruckner Thomas , Schmidmaier Gerhard , Wolf Sebastian I. , Fischer Christian
Published: May 2020

Background: Ankle sprains and fractures are most common injuries in orthopedic and trauma surgery. The concurrent occurrence of syndesmosis ruptures in these injuries represents a more complex problem, as they often remain undetected. A proper and accurate treatment of injuries of the syndesmosis, both isolated and combined with fractures, is necessary to avoid long-term consequences (chronic instability, cartilage damage and post-traumatic osteoarthritis). The most popular treatment option is a static screw fixation and the newly developed dynamic TightRope ® (Arthrex, Naples, FL, USA). The aim of this pilot study is to compare monitor ankle range of motion and maximum ankle power in gait as functional outcome parameters of instrumented gait analysis, as well as clinical and radiographic outcome for assessing the stabilization of acute syndesmosis rupture with either a static implant (a 3.5mm metallic screw) or a dynamic device (TightRope ® ). Methods: This prospective, randomized, controlled, clinical trial will be carried out at the Center for Orthopedics, Trauma Surgery and Spinal Cord Injury of the University Hospital Heidelberg. Adult patients, who suffer from an acute syndesmosis rupture, both isolated and in combination with fractures of the lateral malleolus (Weber C and Maisonneuve fractures) and who are undergoing surgery at our trauma center will be included in our study. The patients will be randomized to the different treatment options (screw fixation or “TightRope ® ”). Subsequent to the surgical treatment, all patients will receive the same standardized follow-up procedures including a gait analysis and MRI of the ankle at 6 months follow-up. The primary endpoint of the study is the successful healing of the syndesmosis and biomechanical investigation with gait analysis. Discussion: The results of the gait analysis from the current study will help to impartially and reliably evaluate the clinical and biomechanical outcome of both treatment options of acute syndesmosis ruptures. We hypothesize that the dynamic fixation provides an equivalent or better biomechanical, clinical and radiographic outcome in comparison to the screw fixation.
Utilization of Denture Adhesives and the Factors Associated with its Use: A Cross-Sectional Survey
Authors: BO TUN MIN , Hama Yohei , AKIBA NORIHISA , MINAKUCHI SHUNSUKE
Published: May 2020

Background: An increase in the number of elderly edentulous patients likely leads to a greater demand for dentures and denture adhesives. As denture adhesives have positive and negative features, dentists need to know the types of denture adhesive users to be able to provide instruction to denture wearers on how to use denture adhesives effectively. This study aims to examine the utilization of denture adhesives and associated factors.Methods: Seven closed-ended questionnaires were developed for a web-based survey. After that, Fisher’s exact tests were performed to determine the difference in the denture adhesive usage rate by gender, type of denture, last dental visit, and smoking status. A multivariate-adjusted logistic regression analysis was performed with denture adhesive use or non-use as the dependent variable and the other items as independent variables. Next, Fisher’s exact tests and a multivariate-adjusted logistic regression analysis were performed with the type of denture adhesives as the dependent variable in the same way. Statistical analyses were performed for all denture wearers, complete denture wearers, and partial denture wearers. The level of statistical significance was set at p=0.05. Results: A total of 1470 denture wearers in Japan participated in this study. Of these, 318 used denture adhesives, while 212 (66.7%) used cream; 74 (23.3%) used home liner; 25 (7.9%) used powder; four (1.3%) used sheets; and three (0.9%) used several types. The Fisher’s exact tests revealed that the ratios of using denture adhesives were significantly higher for complete denture wearers (p<0.001), last dental visit over one year (p=0.005), and smokers (p=0.005). For partial denture wearers, the ratio was significantly higher in smokers (p=0.262). The multivariate adjusted logistic regression revealed that denture adhesive use or non-use were significantly associated with the type of denture and smoking status in all denture wearers, and just smoking status in partial denture wearers. There were no significant results about the type of denture adhesive selection.Conclusions: From all denture wearers, complete denture wearers and smokers are more likely to use denture adhesives. In addition, smokers significantly use denture adhesives if they are partial denture wearers.
Factors Influencing the Use of Reproductive Health Services among Young Women in Nepal: Analysis of the 2016 Nepal Demographic and Health Survey
Authors: Thapa Naba Raj
Published: May 2020

Background: Utilization of reproductive health services is a key component for preventing young women from different sexual and reproductive health problems. Thus, the objective of this study is to determine the factors influencing the use of reproductive health services among young women in Nepal. Methods: Data have been extracted from the 2016 Nepal Demographic and Health Survey (NDHS) datasets wherein the weighted sample population size was restricted for modern contraceptive use to 1593 whereas for the antenatal care and skilled birth attendants to1606. This study has selected three reproductive health indicators as outcome variables of reproductive health service utilization for the analysis viz, modern contraceptive use, at least four antenatal care visits, and use of skilled birth attendants. Likewise, all calculations are based on standard sample weight of NDHS. Results: The study has found that 21% of young women used modern contraception, 71% attended at least four ANC visits, and 67% utilized a skilled birth attendant at delivery. Young Janajati women, women having 1-2, and 3 or more living children, women participating household decision-making, and the ones having exposure to media were more likely to use modern contraceptives, whereas the women who want more children were less likely to use them. Higher education attainments, higher wealth quintile, and lower birth order were associated with higher level of receiving at least four ANC visits and SBAs. However, the young women willing to have more children and having access to media have higher odds of receiving at least four ANC visits; and the women attending four and more ANC visits have higher odds of using SBAs. Conclusions: In order to improve the use of reproductive health services among young women, efforts should be made to enrich the young women of lower educational level, lower economic status, higher birth order, and lower exposure to media. Further research is required to detect the causes that affect the use of reproductive health services.
Protein delivery in intermittent and continuous enteral nutrition with a protein-rich formula in critically ill patients - A protocol for the prospective randomised controlled proof-of-concept Protein Bolus Nutrition (Pro BoNo) study
Authors: Reinhold Simona , Yeginsoy Désirée , Hollinger Alexa , Todorov Atanas , Tintignac Lionel , Sinnreich Michael , Kiss Caroline , Gebhard Caroline Eva , Kovács Balázs , Gysi Bianca , Imwinkelried Lara , Siegemund Martin
Published: May 2020

Background Critically ill patients rapidly develop muscle wasting resulting in sarcopenia, long-term disability and higher mortality. Bolus nutrition (30-60 min period), while having a similar incidence of aspiration as continuous feeding, seems to provide metabolic benefits through increased muscle protein synthesis due to higher leucine peaks. To date, clinical evidence on achievement of nutritional goals and influence of bolus nutrition on skeletal muscle metabolism in ICU patients is lacking. The aim of the Pro BoNo study (Protein Bolus Nutrition) is to compare intermittent and continuous enteral feeding with a specific high-protein formula. We hypothesise that target quantity of protein is reached earlier (within 36 hours) by an intermittent feeding protocol with a favourable influence on muscle protein synthesis. Methods Pro BoNo is a prospective randomised controlled study aiming to compare the impact of intermittent and continuous enteral feeding on preventing muscle wasting in 60 critically ill patients recruited during the first 48 hours after ICU admission. The primary outcome measure is the time until the daily protein target (≥1.5 g protein/kg bodyweight/24h) is achieved. Secondary outcome measures include tolerance of enteral feeding and evolution of glucose, urea and IGF-1. Ultrasound and muscle biopsy of the quadriceps will be performed. Discussion The Basel Pro BoNo study aims to collect innovative data on the effect of intermittent enteral feeding of critically ill patients on muscle wasting. Trial registration ClinicalTrials.gov Identifier: NCT03587870, registered July 16, 2018. Swiss National Clinical Trial Portal identifier: SNCTP000003234, last updated July 24, 2019.
Adjunctive therapies for the nonsurgical treatment of peri-implant diseases: systemic review and meta-analysis
Authors: xiao yuhan , Qin Yichun , Yu Haiyang
Published: May 2020

Background Peri-implant diseases are mainly caused by biofilms around the implant and may lead to implant failure. Non-surgical mechanical debridement with different adjunctive therapies has being applied in the treatment of peri-implant diseases. This systematic review aims to figure out whether one adjunctive therapy is superior to any other. Methods Two independent authors screened the literature via the MEDLINE, Cochrane Library and Science Direct. Only clinical randomized controlled trials (RCTs) that compared the efficacy of adjunctive therapies in the treatment of peri-implant diseases with non-surgical mechanical debridement (MD) were included in this review. The studies selected were published before June 2020. Comparisons of clinical outcomes were estimated using meta-analysis Results: A total of eighteen RCTs met the inclusion criteria, of which 13 articles were included in the meta-analysis. The following adjunctive interventions were compared in the included studies: modifying the prosthesis; air abrasive; photodynamic therapy; local antibiotics; systemic antibiotics; probiotics. Statistically significant difference was observed between MD with photodynamic therapy and MD alone at 3 months follow-up ( P < 0.01). There is no statistical difference between MD with chlorhexidine and MD alone in the treatment of peri-implant diseases at 3 months follow-up ( P = 0.84), so is MD with probiotics and MD alone ( P = 0.96), and so is systemic antibiotics and MD alone ( P = 0.47). Conclusion. MD adjunct with PDT is an effective treatment for peri-implant mucositis. However, there is still no effective non-surgical treatment for peri-implantitis.
Identification of potential biomarkers and candidate small molecule drugs in glioblastoma
Authors: Lu Wei-cheng , Xie Hui , Yuan Ce , Li Jin-jiang , Li Zhao-yang , Wu An-hua
Published: May 2020

Background and aims: Glioblastoma (GBM) is a common and aggressive primary brain tumor, and the prognosis for GBM patients remains poor. This study aimed to identify the key genes associated with the development of GBM and provide new diagnostic and therapies for GBM. Methods: Three microarray datasets (GSE111260, GSE103227, and GSE104267) were selected from Gene Expression Omnibus (GEO) database for integrated analysis. The differential expressed genes (DEGs) between GBM and normal tissues. Then, prognosis related DEGs were screened by survival analysis, followed by functional enrichment analysis. The protein-protein interaction (PPI) network was constructed to explore the hub genes associated with GBM. The mRNA and protein expression levels of hub genes were respectively validated in silico using The Cancer Genome Atlas (TCGA) and Human Protein Atlas (HPA) databases. Subsequently, the small molecule drugs of GBM were predicted by Connectivity Map (CMAP) database. Results: A total of 78 prognosis related DEGs were identified, of which10 hub genes with higher degree were obtained by PPI analysis. The mRNA expression and protein expression levels of CETN2 , MKI67 , ARL13B , and SETDB1 were overexpressed in GBM tissues, while the expression levels of CALN1 , ELAVL3 , ADCY3 , SYN2 , SLC12A5 , and SOD1 were down-regulated in GBM tissues. Additionally, these genes were significantly associated with the prognosis of GBM. We eventually predicted the 10 most vital small molecule drugs, which potentially imitate or reverse GBM carcinogenic status. Cycloserine and 11-deoxy-16,16-dimethylprostaglandin E2 might be considered as potential therapeutic drugs of GBM. Conclusions: Our study provided 10 key genes for diagnosis, prognosis, and therapeutic target for GBM. These findings might contribute to a better comprehension of molecular mechanisms of GBM development, and provide new perspective for further GBM research. However, specific regulatory mechanism of these genes needed further elaboration.
The correlation between imaging expression of P16 and S100 in hypertrophic ligamentum flavum
Authors: Hu Wei , Liu Yidong , Kan Shunli , Zhang Tengfei , Jiang Zehua , Zhu Rusen
Published: May 2020

Background: Lumbar spinal stenosis (LSS) is a common degenerative disease, which can lead to neurological dysfunction and requires surgical treatment. In the previous study, we used H&E staining and immunohistochemistry to qualitatively analyze the expression of S100 and P16 in the pathological process of ligamentum flavum (LF) hypertrophy in patients with LSS. To further explore the relationship between P16, S100 and LF hypertrophy in patients with LSS, we quantitatively detected S100 and P16 and their expressed products based on molecular biology techniques, and analyzed their imaging correlation.Methods: Before posterior lumbar surgery, LF thickness was measured by Magnetic Resonance Imaging (MRI). Through the operation, we obtained the specimens of LF from 120 patients, all of whom were L4/5 LF. They were designated: simple lumbar disc herniation (LDH), single-segment spinal stenosis (SLSS), and double-segment LSS (DLSS). The detection of each side of LF was assessed. S100 and P16 and their expression products were detected by western blot and quantitative polymerase chain reaction (qPCR).Results: The dorsal mRNA expression of P16 in DLSS group was significantly higher than that in SLSS group. On the dorsal and dural side of LF, the expression of P16 mRNA and proteins in the LDH group was significantly lower than that in SLSS and DLSS groups. We found a correlation between the thickness of LF and the expression of P16. However, there was no significant difference in the expression of S100 mRNA and S100 protein on both sides of the ligament and among the three groups, and no significant correlation between the expression of S100 and the thickness of LF.Conclusions: P16 is involved in the process of LF hypertrophy in patients with LSS, and the imaging thickness of LF is related to the expression of P16. No obvious evidence proves that S100 may be related to the hypertrophy of LF in patients with LSS.
Preterm Intraventricular Hemorrhage in vitro: Modeling the Cytopathology of the Ventricular Zone
Authors: Castaneyra-Ruiz Leandro , McAllister James P. , Morales Diego M. , Brody Steven L. , Isaacs Albert M. , Limbrick David D.
Published: May 2020

Background: Severe intraventricular hemorrhage (IVH) is one of the most devastating neurological complications in preterm infants, with the majority suffering long-term neurological morbidity and up to 50 percent developing post hemorrhagic hydrocephalus (PHH). Despite the importance of this disease, its cytopathological mechanisms are not well known. An in vitro model of IVH is required to investigate the effects of blood and its components on the developing ventricular zone (VZ) and its stem cell niche. To address this need, we developed a new in vitro model to mimic the cytopathological conditions of IVH in the preterm infant. Methods: Maturing neuroepithelial cells from the VZ were harvested from the entire lateral ventricles of wild type C57BL/6 mice at 1-4 days of age and expanded in proliferation media for 3-5 days. At confluence, cells were re-plated onto 24-well plates in differentiation media to generate ependymal cells (EC). At approximately 3-5 days, which corresponded to the onset of ependymal cell differentiation based on the appearance of multiciliated cells , phosphate-buffered saline for controls or syngeneic whole blood for IVH was added to the ependymal cell surface. The cells were examined for the expression of EC markers of differentiation and maturation to qualitatively and quantitatively assess the effect of blood exposure on VZ transition from neuroepithelial cells to EC. Discussion: This model will allow investigators to test cytopathological mechanisms contributing to the pathology of IVH with high temporal resolution and query the impact of injury to the maturation of the VZ. This technique recapitulates features of normal maturation of the VZ in vitro, offering the capacity to investigate the developmental features of VZ biogenesis.
Should syndesmotic screws be removed or retained? A meta-analysis
Authors: Qin Wanjin , Yang Peng , Lv Nanning , Chen Kaiwen , Yang Huilin , Shen Minjie
Published: May 2020

Background The aim of this study was to evaluate the different clinical outcomes after removing or retaining syndesmotic screws, and the difference in clinical outcomes after retaining broken or loose syndesmotic screws was also evaluated.Methods A systematic literature search was performed using PubMed, Web of Science, EMBASE and the Cochrane Central Register of Controlled Trials. In this meta-analysis, we conducted online searches using the search terms “syndesmotic diastasis”, “syndesmotic injury”, “syndesmotic screw”, “syndesmotic fixation”, and “tibiofibular syndesmosis”. The analysis was performed on data from all the studies that met the selection criteria. Clinical outcomes were expressed as standard mean differences for continuous outcomes with 95 % confidence intervals. Heterogeneity was assessed using the Chi2 test and the I2 statistic.Results There were 2 randomized controlled trials (RCTs) and 6 observational articles included in this analysis. In the comparison between retained and removed screws and the comparison between broken or loose and removed screws, no significant difference was found in terms of visual analogue scale (VAS), Olerud-Molander Ankle Score (OMAS) and American Orthopaedic Foot and Ankle Society (AOFAS) ankle/hindfoot score. Broken or loose screws were associated with better AOFAS scores compared with removed or intact screws, and no significant difference was found in terms of VAS and OMAS scores.Conclusions According to our analysis, there was no significant difference in clinical outcomes between removed and retained screws. Broken or loose screws were not associated with bad functional outcomes and may even lead to better function compared with removed or retained screws.
Construction of a sensitive and specific lead biosensor using a genetically engineered bacterial system with a luciferase gene reporter controlled by pbr and cadA promoters
Authors: Nourmohammadi Esmail , Hosseinkhani Saman , Nedaeinia Reza , Khoshdel-Sarkarizi Hoda , Nedaeinia Mozhdeh , Ranjbar Maryam , Ebrahimi Neshat , Farjami Zahra , Nourmohammadi Mohammad , Mahmoudi Ali , Goli Mohammad , A.Ferns Gordon , Sadeghizadeh Majid
Published: May 2020

Background: A bacterial biosensor refers to genetically engineered bacteria that produce an assessable signal in the presence of a physical or chemical agent in the environment. Methods: We have designed and evaluated a bacterial biosensor expressing a luciferase-reporter gene controlled by pbr and cadA promoters in Cupriavidus metallidurans (previously termed Ralstonia metallidurans) containing the CH34 and pI258 plasmids of Staphylococcus aureus, respectively, and that can be used for the detection of heavy metals. In the present study, we have produced and evaluated biosensor plasmids designated pGL3-luc/pbr-biosensor and pGL3-luc/cad-biosensor, that were based on the expression of luc+ under the control of the cad promoter and the cadC gene of S. aureus plasmid pI258 and pbr promoter and pbrR gene from plasmid pMOL30 of Cupriavidus metallidurans. Results: We found that the biodegradable pGL3-luc/pbr-biosensor could be used to measure lead concentrations between 1-100 μM in the presence of other metals, including: zinc, cadmium, tin and nickel. The latter metals did not result in any significant gene expression of the reporter. The pGL3-luc/cad-biosensor was able to detect lead concentrations between 10 nM to 10 μM. Conclusions: This biosensor was found to be a specific for measuring lead ions in both environmental and biological samples.
Prospective evaluation of contrast-enhanced ultrasound of breast BI-RADS 3-5 lesions
Authors: Eva Janu , Lucie Krikavova , Jirina Little , Karel Dvorak , Dagmar Brancikova , Eva Jandakova , Tomas Pavlik , Petra Kovalcikova , Kazda Tomas , Vlastimil Valek
Published: May 2020

Purpose: To determine the benefit of contrast-enhanced ultrasound (CEUS) in the assessment of breast lesions.Materials and Methods: A standardized contrast-enhanced ultrasound was performed in 230 breast lesions classified as BI-RADS category 3 to 5. All lesions were subjected to qualitative and quantitative analysis. MVI (MicroVascular Imaging) technique was used to derive qualitative analysis parameters; blood perfusion of the lesions was assessed (perfusion homogeneity, type of vascularization, enhancement degree). Quantitative analysis was conducted to estimate perfusion changes in the lesions within drawn regions of interest (ROI); parameters TTP (time to peak), PI (peak intensity), WIS (wash in slope), AUC (area under curve) were obtained from time intensity (TI) curves. Acquired data were statistically analyzed to assess the ability of each parameter to differentiate between malignant and benign lesions. The combination of parameters was also evaluated for the possibility of increasing the overall diagnostic accuracy. Biological nature of the lesions was verified by a pathologist. Benign lesions without histopathological verification (BI-RADS 3) were followed up for at least 24 months.Results: Out of 230 lesions, 146 (64%) were benign, 67 (29%) were malignant, 17 (7%) lesions were eliminated. Malignant tumors showed statistically significantly lower TTP parameters (sensitivity 77.6%, specificity 52.7%) and higher WIS values (sensitivity 74.6%, specificity 66.4%) than benign tumors. Enhancement degree also proved to be statistically well discriminating as 55.2% of malignant lesions had a rich vascularity (sensitivity 89.6% and specificity 48.6%). The combination of quantitative analysis parameters (TTP, WIS) with enhancement degree did not result in higher accuracy in distinguishing between malignant and benign breast lesions.Conclusion: We have demonstrated that contrast-enhanced breast ultrasound has the potential to distinguish between malignant and benign lesions. In particular, this method could help to differentiate lesions BI-RADS category 3 and 4 and thus reduce the number of core-cut biopsies performed in benign lesions. Qualitative analysis, despite its subjective element, appeared to be more beneficial. A combination of quantitative and qualitative analysis did not increase the predictive capability of CEUS.
Bioinformatics analysis reveals key genes and pathways that promote melanoma metastasis
Authors: su wenxing , guan yi , huang biao , wang juanjuan , wei yuqian , zhao ying , Jiao qingqing , ji jiang , yu daojiang , Su Wenxing , Guan Yi , Huang Biao , Su Wenxing , Guan Yi , Huang Biao
Published: May 2020

Melanoma has the highest mortality rate of all skin tumors, and metastases are the major cause of death from it. The molecular mechanism leading to melanoma metastasis is currently unclear. With the goal of revealing the underlying mechanism, three data sets with accession numbers GSE8401, GSE46517 and GSE7956 were downloaded from the Gene Expression Omnibus (GEO) database. After identifying the differentially expressed gene (DEG) of primary melanoma and metastatic melanoma, three kinds of analyses were performed, namely functional annotation, protein-protein interaction (PPI) network and module construction, and co-expression and drug-gene interaction prediction analysis. 41 up-regulated genes and 79 down-regulated genes were selected for subsequent analyses. Results of pathway enrichment analysis showed that extracellular matrix organization and proteoglycans in cancer are closely related to melanoma metastasis. In addition, seven pivotal genes were identified from PPI network, including CXCL8, THBS1, COL3A1, TIMP3, KIT, DCN, and IGFBP5, which have all been verified in the TCGA database, but only CXCL8, THBS1 and KIT had significant differences in expression. To conclude, CXCL8, THBS1 and KIT may be the key genes in the metastasis of melanoma and thus may be regarded as therapeutic targets in the future.
miR-200c /FUT4 axis prevents the migration, invasion and proliferation of colon cancer cells by downregulating Wnt/β-catenin pathway
Authors: Cong Jinchun , Yang Chuanjia , Xia Zhixiu , Gong Jian , Zhang Hong
Published: May 2020

Background
To investigate the effects of miR-200c targeting fucosyltransferase 4 (FUT4) on the proliferation, migration and invasion of colon cancer cells and further to explore its mechanism.
Methods
The expression of miR-200c and FUT4 mRNA in Lovo and SW480 cells were detected by quantitative real-time polymerase chain reaction (qRT-PCR), and their correlation was analyzed by Pearson. LipofectamineTM 2000 transfection reagent was used to transfect miR-200c mimic, FUT4 siRNA, FUT4 mimic and FUT4 mimic negative control into Lovo and SW480 cells, and RT-PCR was used to analyze the effect of transfection. Cell counting kitcck-8 (CCK-8), cloning and transwell assays were used to detect the migration, invasion and proliferation of Lovo and SW480 cells, respectively. Immunofluorescence was used to analyze the expression of Ki-67 protein. Moreover, the expression of Wnt/β-catenin signaling pathway-related proteins were detected by western blot. Double luciferase experiment was performed to verify the targeting relationship between miR-200c and FUT4.
Results
Pearson results showed that miR-200c and FUT4 were negatively correlated in Lovo and SW480 cells (correlation coefficients were − 0.9046 and − 0.9236, respectively). MiR-200c overexpression inhibits the proliferation, migration and invasion of Lovo cells by down-regulating FUT4. The expression of Ki67 positive cells and Wnt/β-catenin signaling pathway-related proteins were reduced in miR-200c overexpression and FUT4 silencing groups. The scientific search and dual luciferase reporting system identified FUT4 was the target of miR-200c.
Conclusion
In conclusion, miR-200c overexpression inhibits FUT4 expression and down-regulates the Wnt/β-catenin signaling pathway, thereby inhibiting the migration, invasion and proliferation of colon cancer cells.
Accuracy of telephone triage in suspected transient ischaemic attack or stroke: A cross-sectional study
Authors: Erkelens Daphne Carmen , Rutten Frans H. , Wouters Loes T. , Dolmans L. Servaas , de Groot Esther , Damoiseaux Roger A. , Zwart Dorien L.
Published: May 2020

BackgroundThe Netherlands Triage Standard (NTS) is a widely used decision support tool for telephone triage at Dutch out-of-hours primary care services (OHS-PC), which, however, has never been validated against clinical outcomes. We aimed to determine the accuracy of the NTS urgency allocation for patients with neurological symptoms suggestive of a transient ischaemic attack (TIA) or stroke, with the clinical outcomes TIA, stroke, and other (neurologic) life-threatening events (LTEs) as the reference.MethodA cross-sectional study of telephone triage recordings of patients with neurological symptoms calling the OHS-PC between 2014 and 2016.The allocated NTS urgencies were derived from the electronic medical records of the OHS-PC. The clinical outcomes were retrieved from the electronic medical records of the patients’ own general practitioners. The accuracy of a high NTS urgency allocation (medical help within three hours) was calculated in terms of sensitivity, specificity, positive and negative predictive values (PPV and NPV) with the clinical outcomes TIA/stroke/other LTEs as the reference.ResultsOf 1,269 patients, 635 (50.0%) received the diagnosis TIA/stroke (34.2% TIA/minor stroke, 15.8% major ischaemic or haemorrhagic stroke), and 4.8% other LTEs. For TIA/stroke/other LTEs, the sensitivity and specificity of the NTS urgency allocation were 0.72 (95%CI 0.68–0.75) and 0.48 (95%CI 0.43–0.52), and the PPV and NPV were 0.62 (95%CI 0.60–0.64) and 0.58 (95%CI 0.54–0.62).ConclusionsThe NTS decision support tool used in Dutch OHS-PC performed poor to moderately regarding safety (sensitivity) and efficiency (specificity) in allocating adequate urgencies to patients with and without TIA/stroke/other LTEs.Trial registration: the Netherlands National Trial Register, identification number NTR7331.
Targeting Hedgehog pathway and DNA methyltransferases suppress the phenotype of uterine leiomyosarcoma cells
Authors: Garcia Natalia , Al-Hendy Ayman , Baracat Edmund Chada , Carvalho Katia Candido , Yang Qiwei
Published: May 2020

Background: Uterine leiomyosarcoma (LMS) is an aggressive tumor with poor prognosis, high rates of recurrence and metastasis. Several studies have shown an essential role of Hedgehog (HH) signaling in tumor development. The role of HH pathway in LMS is still unclear. Methods: Uterine smooth muscle (USTM) and LMS cells lines were used to evaluate the mRNA and protein expression of HH components. MTT assay was performed to evaluate the inhibitory effect of SMO, GLI1 and DNMT inhibitors for proliferation. Nuclear and cytoplasm fractions were prepared. Protein and RNA expression levels were determined by Western blot and q-PCR analysis. Migration, invasion and apoptosis assays were performed to determine the LMS phenotype after the treatments. The statistical analysis was performed using GraphPad Prism 5, and the statistical significance was accepted for p<0.05.Results: LMS analyses showed upregulation of SMO and GLIs (1, 2 and 3) in LMS compared to the myometrium and uterine leiomyoma. Increased nuclear translocation of GLIs proteins was found in LMS cells as well. After that, we hypothesized that HH pathway could be activated in uterine LMS and its blocking would lead to LMS malignant phenotype suppression. Inhibition of SMO and GLI after treatment with LDE225 and Gant61 respectively, induced both protein downregulation as well as decreased GLIs nuclear translocation. Also, abnormal increased expression of DNMT (1, 3a, and 3b) was observed in LMS, and treatment with a DNMT inhibitor decreased both DNMTs expression and GL1 nuclear translocation. Conclusion: Our analyses showed that deactivation of SMO, GLI and DNMTs was able to inhibit LMS phenotype. Importantly, the combination of those treatments exhibited a potentiated effect on LMS malignant phenotype suppression, leading to a deactivating HH pathway. In conclusion, our studies may provide novel options for uterine LMS patients´ target therapy.
LGR5 Expression is Associated with Prognosis in Poorly Differentiated Gastric Adenocarcinoma
Authors: Ehara Takehito , Uehara Takeshi , Nakajima Tomoyuki , Kinugawa Yasuhiro , Kobayashi Shota , Iwaya Mai , Ota Hiroyoshi , Soejima Yuji
Published: May 2020

Background Leucine-rich repeat-containing G-protein-coupled receptor 5 (LGR5) is an important cancer stem cell marker in gastric cancer. However, no detailed studies are available on LGR5 expression in poorly differentiated gastric adenocarcinoma (PD-AC). Therefore, we investigated the relationship between LGR5 expression and clinicopathological data in PD-AC.Methods LGR5 expression was identified in 41 PD-AC cases using RNAscope, which is a highly sensitive RNA in situ hybridization method. Epstein–Barr virus (EBV) infection was also detected by EBV in situ hybridization.Results In PD-AC, LGR5 expression was identified in 38 of 41 cases, and 17 cases were identified as LGR5 positive. The frequency of EBV positivity tended to be higher in the LGR5-negative group than in the LGR5-positive group (P = 0.0764). Furthermore, the frequency of vascular invasion tended to be higher in the LGR5-positive group than in the LGR5-negative group (P = 0.0764). A significant difference was found in overall survival (OS) between PD-AC cases in the LGR5-positive group and LGR5-negative group (log-rank test, P = 0.0108). The Cox proportional hazard regression model revealed that the LGR5-negative group (HR = 0.29; 95% CI: 0.11–0.74; P = 0.01) showed independently better OS for PD-AC.Conclusions The correlation between LGR5 positivity and poor prognosis in PD-AC may be applicable to target therapy for LGR5 and prognostic markers. Further study is warranted.
Co-designing an industry-academic postgraduate professional education framework for emergency nursing
Authors: Theobald Karen Ann , Coyer Fiona , Henderson Amanda , Fox Robyn , Thomson Bernadette , McCarthy Alexandra
Published: May 2020

Background

This paper describes an evidence-based co-designed study with clinical-academic stakeholders from hospital and university settings. Hospitals and university providers in Australia invest significant but separate resources for postgraduate curricula, resulting in duplication of curricula and resources in the health and higher education sectors.
Methods

Using emergency nursing as an exemplar, we co-designed an industry-academic postgraduate education framework that integrated the needs and resources of the health and higher education sectors to streamline postgraduate students’ professional learning.
Results

Outcomes include matrices synchronising professional and regulatory imperatives of postgraduate nursing coursework; mutually-shaped curriculum content, teaching approaches and assessment strategies relevant for postgraduate education; a University-Industry Academic Integration Framework; five guiding principles of postgraduate curriculum development for university-industry curriculum co-design; and a Graduate Certificate of Emergency Nursing curriculum exemplar.
Conclusion

Industry-academic co-design can increase the relevance of postgraduate specialist courses in nursing, strengthening the nexus between both entities to advance learning and employability.
Automatic strategy to identify the risk of malnutrition in primary care by means of Controlling Nutritional (CONUT) Score: a large population study.
Authors: Salinas María , López-Garrigós Maite , Flores Emilio , Puche Carmen , Leiva-Salinas Pablo , Santo-Quiles Ana , Leiva-Salinas Carlos
Published: May 2020

Background

Risk of malnutrition can be evaluated through Controlling Nutritional (CONUT) Score based on total peripheral lymphocytes, serum albumin, and total cholesterol. Our aim was to automatically calculate CONUT in primary care when involved markers were requested and compare its performance with albumin to identify patients at risk of malnutrition. CONUT was evaluated according to patient age, and calculated the potential expenses to calculate CONUT, when serum markers were no requested, and measured.
Methods

We calculated CONUT when the three laboratory markers were requested, compared CONUT and albumin, considering risk of malnutrition CONUT ≥ 2, and albumin < 35 g/L, and counted the number of albumin and/or cholesterol tests that would have been measured to calculate CONUT in patients with total lymphocytes and serum availability, and calculated hypothetical cost.
Results

of the 74743 requests from primary care, CONUT was calculated in 9353 patients. 2256 (24.1%) showed risk of malnutrition according CONUT; 630 (6.8%) through albumin. Albumin alone identified 17.5% of mild cases based on CONUT, but every severe case. The risk of malnutrition increased with patient age. In one year, through an expense of 5430 € in measuring the serum non requested test, we could have screened for risk of malnutrition the entire primary care population that underwent laboratory testing.
Conclusion

CONUT score calculated at no cost when requested involved laboratory markers, detected more patients at risk of malnutrition than albumin, increased with patient age, and could be calculated in all primary care patients by measuring unrequested tests, at a very affordable cost.
Prevalence and Glasgow Outcome Scale score of severe head injury in Mbarara regional referral hospital: A retrospective study
Authors: Odwar Erick , Okidi Ronald , Kayanga Florence , Kitya David , Ttendo Stephen
Published: May 2020

Background: Traumatic brain injury (TBI) is a common cause of death in the Intensive care units and emergency departments with an estimated annual global mortality of 1.5 million people as a result of severe TBI. The prevalence of TBI varies according to regions. Despite this, there is limited data on the outcomes of patients following severe traumatic brain injury in southwestern Uganda. Herein, we studied the prevalence and outcome of severe traumatic brain injury at Mbarara Regional Referral Hospital (MRRH) at discharge.Methods: A retrospective chart review of all TBI over six months (August 2016 - February 2017). The primary outcome was the Glasgow Outcome Scale (GOS) score at discharge. A favorable outcome was either good recovery or moderate disability while unfavorable outcome was severe disability, persistent vegetative state or death. Bivariate and multivariate logistic regression analyses were used to determine the factors associated with GOS score at discharge. Data were analyzed using STATA v13.0.Results: A total of 196 hospital records of TBI patients were reviewed, 80 (40.8%) patients had severe TBI, with the average length of hospital stay at 4.3 ± 2.9 days. The mean patients' age was 35 ± 14 years with the most affected age group being 18 - 34 years (58.8%). The GOS score at discharge were; death (42.5%), persistent vegetative state (0%), severe disability (1.3%), moderate disability (3.8%) and good recovery (52.5%). Pupil size and response had a dose-response relationship with unfavorable outcome when both pupils were dilated and non-reactive to light and had a higher odd ratio (OR=6.05) and strongly associated with unfavorable outcome (p=0.011). However, surgery and seizure prophylaxis were significantly associated with favorable outcome (p=0.033), (p=0.016) and a lesser odd ratio (OR=0.29),(OR=0.31) of having unfavorable outcome respectively. Conclusion: Mbarara regional referral hospital, the prevalence of STBI is still high. Both surgery and seizure prophylaxis were associated with favorable outcome at discharge. However, unfavorable outcome was mainly seen amongst patients who develop a complication.
Neuroprotectin D1 Protects Against Postoperative Delirium-like Behaviors in Aged Mice by Regulating Neuroinflammation Induced by Surgical Trauma
Authors: Zhou Ying , Wang Jiayu , Li Xiaofeng , Li Ke , Chen Lei , Zhang Zongze , Peng Mian
Published: May 2020

Background

Postoperative delirium (POD) is the most common postoperative complication affected elderly patients, yet the underlying mechanism is elusive and without effective therapy. The neuroinflammation hypothesis has been emerging as the pathogenesis of POD. Recently, accumulative evidence has supported the role of specialized proresolving lipid mediators (SPMs) in regulating inflammation. NPD1, a novel member of SPMs, is identified with potent immune-resolvent and neuroprotective effect. We aimed to investigate the role of NPD1 in neuroinflammation and postoperative cognitive function with a mice model of POD.
Methods

Aged male C57BL/6 mice were subjected to laparotomy under isoflurane anesthesia with NPD1 prophylaxis. The general and memory behaviors were assessed by buried food test, open field test and Y maze test at 6, 9, and 24 hours after the surgery. Expression level of inflammatory cytokines were analyzed by ELISA. The permeability of blood-brain barrier (BBB) was detected by spectrophotometric quantification of extravascular dextran tracer from brain tissue extracts, and the expression of tight junction (TJ) associated proteins by Western blotting. The reactive states of astrocytes and microglia were examined by immunofluorescence. The protective effects of NPD1 was also evaluated through macrophage polarization by flow cytometry, using the bone marrow-derived macrophages cultures.
Results

NPD1 prophylaxis decreased the expression of pro-inflammatory cytokines and increased the expression of anti-inflammatory cytokines in peripheral blood, hippocampus and prefrontal cortex, and limited the leakage of BBB by increasing the expression of TJ associated proteins. Besides, NPD1 prevented the activation of microglia and astrocytes both in the hippocampus and prefrontal cortex, which resulted in improved general and memory function of mice. Furthermore, NPD1 treatment modulated the inflammatory cytokine profile and promoted the macrophage polarization toward M2 in LPS-stimulated macrophages.
Conclusions

These findings verify the anti-inflammatory and proresolving activities of NPD1 in the inflammatory milieu both in vivo and in vitro, and provide better insight into the pathophysiology and potential therapy for POD.
Comparing Community Measures in Lake Microbial Ecology: Metagenomes and Metatranscriptomes and Amplicons, oh my!
Authors: Nuy Julia Kristina , Bornemann Till , Beisser Daniela , Probst Alexander J. , Boenigk Jens
Published: May 2020

Lake ecosystems are hotspots on Earth for biogeochemical cycling yet linking their microbiome to physicochemical parameters remains a challenge. Here, we assess the quality of 16S rRNA gene-based metatranscriptomics, assembled metagenomics and 16S rRNA gene amplicon sequencing for 21 lake ecosystems across Europe. We identified method-dependent, massive differences between community composition and proportional activity for key taxa like Alphaproteobacteria suggesting different ecological conclusions for the same lake ecosystems. In redundancy analysis (RDA), environmental parameters explained the greatest amount of the variance in metatranscriptomes suggesting that the active community is heavily influenced by environmental parameters. While amplicon data recruited the least amount of environmental variables in RDA (pH and temperature), four additional parameters explained the sequenced metagenomes. These results suggest that metagenomes and metatranscriptomes are currently the best methods for linking lake microbiomes to physicochemical parameters and can be used as proxies for designing future ecological surveys.
Development and Validation of Oral Chemotherapy Self-Management Scale
Authors: Peng Qi , Wu Wanying
Published: May 2020

Background With the widespread used of orally administered anticancer agents, the self-management is important for patients with oral chemotherapy, because it’s occurs in the home environment, not clinic settings.Methods OCSMS items were developed through literature review, semi-structured interviews, research seminar and Delphi survey. Their content validity, internal consistency, split-half, test-retest reliability and construct validity were assessed.Results A 36-item scale was developed with five dimensions identified through factor analysis: daily life management, symptom management, medication management, emotional cognitive managemen and social support. Cronbach’s coefficient Alpha, split-half coefficient, test-retest reliability and average content validity index (CVI) scores were 0.929, 0.773, 0.966 and 0.833, respectively, indicating that OCSMS has good reliability and validity.Conclusions The OCSMS is a valid, reliable measurement method of the self-management ability of patients with oral chemotherapy. The OCSMS shows potential as a tool to ensure the safety of patients with cancer. The OCSMS may help evaluate the effectiveness of interventions to improve the self-management ability of patients.
RasV12 Expression in Microglia Promotes Retinal Inflammatory Circuits and Impairment of Photoreceptor
Authors: Moriuchi Yuta , Iwagawa Toshiro , Tsuhako Asano , Koso Hideto , Fujita Yasuyuki , Watanabe Sumiko
Published: May 2020

Background Microglial activation is commonly observed in neurodegenerative diseases. However, its role in the complex inflammatory network remains unclear. In this study, we generated a microglial activation mouse model by inducing the expression of a constitutively active form of Ras in microglia.Methods The double transgenic lines CAG-LSL-RasV12-IRES-EGFP; Cx3cr1CreER (Cx3cr1-RasV12 mice) and CAG-LSL-EGFP;Cx3cr1CreER (control mice) were generated. The expression of RasV12 was induced in microglia by tamoxifen administration. Effects of the expression of RasV12 in the retina were examined by immunohistochemistry of frozen sections, RT-qPCR, and live imaging.Results RasV12 expression in retinal microglial cells promoted cell proliferation, cytokine expression, and phagocytosis. RasV12-expressing microglia migrated towards the apical and basal regions of the retina. Examination of GFAP expression revealed activation of Müller glia in the retina. We also observed loss of the photoreceptors in the outer nuclear layer (ONL) in close proximity to microglial cells. However, no neurodegeneration was observed in the inner nuclear layer (INL) or ganglion cell layer (GCL). Furthermore, we found that RasV12-expressing microglia in the ONL were smaller in size and engulfed photoreceptors. In contrast, the morphology of RasV12-expressing microglia in the GCL and INL resembled resting microglia. In conclusion, RasV12-induced microglial activation impaired rod photoreceptor survival in the ONL, but not in other regions of the retina.Conclusion The expression of RasV12 is sufficient to activate microglia, and our results suggested that microenvironment cues may modulate the microglial phenotypic features and effects of microglial activation.