bluuebunny/crossref_metadata_2025 huggingface dataset:
More that unites us than divides us? A qualitative study of integration of community health and social care services
Authors: Mitchell Claire , Tazzyman Abigail , Howard Susan J. , Hodgson Damian
Published: May 2020

Background: The integration of community health and social care services has been widely promoted nationally as a vital step to improve patient centred care, reduce costs, reduce admissions to hospital and facilitate timely and effective discharge from hospital. The complexities of integration raise questions about the practical challenges of integrating health and care given embedded professional and organisational boundaries in both sectors. We describe how an English city created a single, integrated care partnership, to integrate community health and social care services. This led to the development of twelve integrated neighbourhood teams, combining and co-locating professionals across three separate localities. The aim of this research is to identify the context and the factors enabling and hindering integration from a qualitative process evaluation.Methods: Twenty-four semi-structured interviews were conducted with equal numbers of health and social care staff at strategic and operational level. The data was subjected to thematic analysis. Results: We describe three key themes: 1) shared vision and leadership; 2) organisational factors; 3) professional workforce factors. We found a clarity of vision and purpose of integration throughout the partnership, but there were challenges related to the introduction of devolved leadership. There were widespread concerns that the specified outcome measures did not capture the complexities of integration. Organisational challenges included a lack of detail around clinical and service delivery planning, tensions around variable human resource practices and barriers to data sharing. A lack of understanding and trust meant professional workforce integration remained a key challenge, although integration was also seen as a potential solution to engender relationship building. Conclusions: Given the long-term national policy focus on integration this ambitious approach to integrate community health and social care has highlighted implications for leadership, organisational design and inter-professional working. Given the ethos of valuing the local assets of individuals and networks within the new partnership we found the integrated neighbourhood teams could all learn from each other. Many of the challenges of integration could benefit from embracing the inherent capabilities across the integrated neighbourhood teams and localities of this city.
A comparison of the Indian Diet with the EAT-Lancet Reference Diet
Authors: Sharma Manika , Kishore Avinash , Roy Devesh , Joshi Kuhu
Published: May 2020

Background The 2019 EAT-Lancet Commission report recommends healthy diets that can feed 10 billion people by 2050 from environmentally sustainable food systems. This study compares food consumption patterns in India, from different income groups, regions and sectors (rural/urban), with the EAT-Lancet reference diet and highlights the deviations. Methods The analysis was done using data from the Consumption Expenditure Survey (CES) of a nationally representative sample of 0.102 million households from 7469 villages and 5268 urban blocks of India conducted by the National Sample Survey Organization (NSSO) in 2011-12. This is the most recent nationally representative data on household consumption in India. Calorie consumption (kcal/capita/day) of each food group was calculated using the quantity of consumption from the data and nutritional values of food items provided by NSSO. Diets for rural and urban, poor and rich households across different regions were compared with EAT-Lancet reference diet. Results The average daily calorie consumption in India is below the recommended 2503 kcal/capita/day across all groups compared, except for the richest 5% of the population. Calorie share of whole grains is significantly higher than the EAT-Lancet recommendations while those of fruits, vegetables, legumes, meat, fish and eggs are significantly lower. The share of calories from protein sources is only 6-8% in India compared to 29% in the reference diet. The imbalance is highest for the households in the lowest decile of consumption expenditure, but even the richest households in India do not consume adequate amounts of fruits, vegetables and non-cereal proteins in their diets. An average Indian household consumes more calories from processed foods than fruits. Conclusions Indian diets, across states and income groups, are unhealthy. Indians also consume excess amounts of cereals and not enough proteins, fruits, and vegetables. Importantly, unlike many countries, excess consumption of animal protein is not a problem in India. Indian policymakers need to accelerate food-system-wide efforts to make healthier and sustainable diets more affordable, accessible and acceptable.
ApoE and apoC-III-defined HDL subtypes: A descriptive study of their lecithin cholesterol acyl transferase and cholesteryl ester transfer protein content and activity
Authors: Amaya-Montoya Mateo , Pinzón-Cortés Jairo A , Silva-Bermúdez Lina S , Ruiz-Manco Daniel , Perez-Matos Maria C , Jimenez-Mora Mario A , Mendivil Carlos O
Published: May 2020

Background The functionality of high-density lipoproteins (HDL) is a better cardiovascular risk predictor than HDL concentrations. One of the key elements of HDL functionality is its apolipoprotein composition. Lecithin-cholesterol acyl transferase (LCAT) and cholesterol-ester transfer protein (CETP) are enzymes involved in HDL-mediated reverse cholesterol transport. This study assessed the concentration and activity of LCAT and CETP in HDL subspecies defined by their content of apolipoproteins E (apoE) and C-III (apoC-III) in humans. Methods Eighteen adults (ten women and eight men, mean age 55.6, BMI 26.9 Kg/m 2 , HbA1c 5.4%) were studied. HDL from each participant were isolated and divided into four subspecies containing respectively: No apoE and no apoC-III (E-C-), apoE but not apoC-III (E+C-), apoC-III but no apoE (E-C+) and both apoE and apoC-III (E+C+). The concentration and enzymatic activity of LCAT and CETP were measured within each HDL subspecies using immunoenzymatic and fluorometric methods. Additionally, the size distribution of HDL in each apolipoprotein-defined fraction was determined using non-denaturing electrophoresis and anti-apoA-I western blotting. Results HDL without apoE or apoC-III was the predominant HDL subtype. The size distribution of HDL was very similar in all the four apolipoprotein-defined subtypes. LCAT was most abundant in E-C- HDL (3.58 mg/mL, 59.6 % of plasma LCAT mass), while HDL with apoE or apoC-III had much less LCAT (19.8%, 12.2% and 8.37% of plasma LCAT respectively for E+C-, E-C+ and E+C+). LCAT mass was lower in E+C- HDL relative to E-C- HDL, but LCAT activity was similar in both fractions, signaling a greater activity-to-mass ratio associated with the presence of apoE. Both CETP mass and CETP activity showed only slight variations across HDL subspecies. There was an inverse correlation between plasma LCAT activity and concentrations of both E-C+ pre-beta HDL (r=-0.55, P =0.017) and E-C- alpha 1 HDL (r=-0.49, P =0.041). Conversely, there was a direct correlation between plasma CETP activity and concentrations of E-C+ alpha 1 HDL (r=0.52, P =0.025). Conclusions The presence of apoE in small HDL is correlated with increased LCAT activity and esterification of plasma cholesterol. These results favor an interpretation that LCAT and apoE interact to enhance anti-atherogenic pathways of HDL.
Outcomes following administration of tranexamic acid in combat-related intracranial hemorrhage: a cohort study
Authors: Walker Patrick F , Bozzay Joseph D. , Johnston Luke R. , Elster Eric A. , Rodriguez Carlos J. , Bradley Matthew J.
Published: May 2020

BACKGROUND Tranexamic acid (TXA) may be a useful adjunct for military patients with severe traumatic brain injury (TBI). These patients are often treated in austere settings without immediate access to neurosurgical intervention. The purpose of this study was to evaluate any association between TXA use and progression of intracranial hemorrhage (ICH), neurologic outcomes, and venous thromboembolism (VTE) in TBI.METHODS This was a retrospective cohort study of combat casualties from October 2010 to December 2015 who were transferred to a military treatment facility (MTF) in the United States. Data collected included: demographics, types of injuries, initial and interval head computerized tomography (CT) scans, Glasgow Coma Scores (GCS), and six-month Glasgow Outcome Scores (GOS). Results were stratified based on TXA administration, progression of ICH, and VTE.RESULTS Of the 687 active duty service members reviewed, 71 patients had ICH (10.3%). Most casualties were injured in a blast (80.3%), with 36 patients (50.7%) sustaining a penetrating TBI. Mean ISS was 28.2 ± 12.3. Nine patients (12.7%) received a massive transfusion within 24 hours of injury, and TXA was administered to 14 (19.7%) casualties. Patients that received TXA had lower initial reported GCS (9.2 ± 4.4 vs. 12.5 ± 3.4, p=0.003), similar discharge GCS (13.3 ±4.0 vs. 13.8±3.2, p=0.58), and a larger improvement between initial and discharge GCS (3.7±3.9 vs. 1.3±3.1, p=0.02). However, there was no difference in mortality (7.1% vs. 7.0%, p=1.00), progression of ICH (45.5% vs. 14.7%, p=0.09), frequency of cranial decompression (50.0% vs. 42.1%, p=0.76), or mean GOS (3.5±0.9 vs. 3.8±1.0, p=0.13). Patients administered TXA had a higher rate of VTE (35.7% vs. 7.0%, p=0.01). On multivariate analysis, however, TXA was not independently associated with VTE.CONCLUSIONS Patients that received TXA were associated with an improvement in GCS but not in progression of ICH or GOS. TXA was not independently associated with VTE, although this may be related to a paucity of patients receiving TXA. Decisions about TXA administration in combat casualties with ICH should be considered in the context of the availability of neurosurgical intervention as well as severity of extracranial injuries and need for massive transfusion.
Analysis of primary oral and oropharyngeal squamous cell carcinoma in inhabitants of Beijing, China—A 10-year continuous single-center study
Authors: Bai Xuexiao , Zhang Jie , Wei Li
Published: May 2020

Background This study aimed to describe some of the characteristics of the inhabitants of Beijing with oral and oropharyngeal squamous cell carcinoma(OSCC) who had received treatment at Stomatology Hospital of Peking University and to analyze the survival rate and the prognostic factors of patients following surgical treatment..Methods Data of 603 consecutive cases with primary OSCC between 2004 and 2013 were obtained from the Stomatology Hospital of Peking University. Clinical data including age, sex, living district, primary site，TNM stage, history of drinking and smoking, pathological differentiation, treatment, survival were retrospectively analyzed.Results The male: female ratio was 1.1:1. The frequency of site involvement in descending order were tongue(34.3%), gingiva(25.0%), buccal mucosa(13.8%), oral floor(9.0%), oropharynx(8.5%), lip(6.3%) and palate(3.2%). Female OSCC patients tended to be significantly older than men with OSCC (P < 0.05). The percentage of patients with TNM stage III-IV OSCC was 52.4%. The results revealed that 65.3% of male patients and only 6.3% of female patients smoked or drank. The overall 5-year survival rate was 64%. Female patients had a worse prognosis than male patients. Among the patients who received surgery, tumor size and lymph node involvement were independent prognostic factors. Smoking and drinking were not prognostic factors. Conclusion Among the Beijing inhabitants who were diagnosed with OSCC and treated in our hospital in the past 10 years, more than half of them were in the advanced stage, and the cancer stage was the main prognostic factor of oral cancer. Therefore, the recognition of oral cancer should be strengthened, and early detection and treatment of OSCC should be achieved to improve the survival rate.
The Relationship and Trends of Socio-Demographic Index, Healthy Life Expectancy and Life Expectancy in China
Authors: Miao Xinlei , Guo Xiuhua , Cai Yue , Zhang Xiang , Meng Qun
Published: May 2020

Background Socio-Demographic Index (SDI) is an index to evaluate social development. Healthy life expectancy (HLE/HALE) can comprehensively measure the population health. This paper analyzes the relationship and trend of Socio-Demographic Index, life expectancy (LE) and healthy life expectancy, which provides a reference for improving population health. Methods We used R Studio (version 1.2.5033) for correlation matrix analysis of SDI, HALE and LE. Meanwhile, we divided provinces into 3 regions according to the 2019 Chinese Health Statistics Yearbook and analyzed the distribution by ArcGIS 10.5 of healthy life expectancy and SDI of 31 provinces and cities in China.Results From 1990 to 2016, socio-demographic, life expectancy and healthy life expectancy showed a gradual increasing trend, and the level in eastern provinces were higher than western provinces in China. There is a correlation between socio-demographic (included its composition that education for aged 15 and older, Gross Domestic Product and total fertility rates under the age of 25), healthy life expectancy and life expectancy. Total fertility rates under the age of 25 has a negative correlation with other variables.Conclusions There is a strong positive correlation between healthy life expectancy, life expectancy and socio-demographic index. The government should consider take the implementation of personalized policies to steadily improve the development of SDI, at the same time to improve healthy life expectancy from improving maternal health and reducing infant mortality, paying attention to adult health, reducing the early death rate of chronic diseases.
Cigarette smoking is associated with high level of ferroptosis in seminal plasma and affects semen quality
Authors: Ou Zhanhui , Wen Qirong , Deng Yu , Yu Yang , Chen Zhiheng , Sun Ling
Published: May 2020

Purpose The effects of cigarette smoking on male semen quality are controversial, and the molecular mechanisms underlying how cigarette smoking affects semen quality are not clear yet. Methods In this study, semen samples from 70 heavy smokers and 75 non-smokers receiving infertility treatment were included. Basic semen parameters in non-smokers and heavy smokers were evaluated. Levels of glutathione (GSH), lipid reactive oxygen species (ROS), iron and GSH-dependent peroxidase 4 (GPX4) protein level were observed in human seminal plasma and in GC-2Spd cells exposed to cigarette smoke condensate (CSC). Results Heavy smokers had significantly higher abnormalities (sperm viability and sperm progressive motility) than non-smoking counterparts. Comparing non-smokers group, GSH level was reduced in the group of heavy smokers (P<0.05). However, the level of lipid ROS and iron were significantly increased (P<0.05). Besides, GSH level was reduced following treatment with CSC for 24 hours, while lipid ROS and iron levels were increased (P<0.05). However, the levels were reduced after being co-cultured with Ferrostatin-1 (Fer-1) (P<0.05). The level of GPX4 protein was reduced after being treated with CSC in 24 hours, and increased after being co-cultured with Fer-1(P<0.05). Conclusion Cigarette smoking is associated with high level of ferroptosis in seminal plasma and affect semen quality.
EBV-positive intravascular large B-cell lymphoma of the liver: a case report and literature review
Authors: Li Qingjiao , Li Jinghe , Yang Keda , Peng Ying , Xiang Yao , Sun Shuyuan , Zeng Jian , Zhang Xin , Wang Junpu
Published: May 2020

Background Intravascular large B-cell lymphoma (IVLBCL) is an extremely rare subtype of diffuse large B-cell lymphoma that most commonly involves the central nervous system, skin, and bone marrow. To our knowledge, Epstein-Barr virus (EBV)-positive IVLBCL in the liver has never been reported in the literature. Case presentation We report a case of a 65-year-old Chinese man with complaint of fever for 18 days. No obvious abnormality was found by physical examination. Laboratory findings were notable for anemia, thrombocytopenia, and elevated level of serum lactate dehydrogenase. Bone marrow on smear, biopsy, and flow cytometry revealed no lymphoma. Imaging studies showed a slightly lower density lesion in the liver with high fluorodeoxyglucose uptake and hepatosplenomegaly. Percutaneous liver biopsy revealed clustering of large atypical lymphocytes within the hepatic sinusoids. Immunohistochemically, these lymphoma cells were positive for CD20, PAX-5, MUM-1, BCL-6 and CD5, but negative for CD3 and CD10. Besides, Epstein-Barr virus-encoded RNA was detected in tumor cells by in situ hybridization. BCL-2 , BCL-6 and MYC genes were intact tested by fluorescence in situ hybridization analysis. The patient was diagnosed as IVLBCL and died after 1 month of hospitalization without receiving immunochemotherapy. Conclusions IVLBCL of the liver is a highly rare lymphoma with nonspecific manifestations and dismal prognosis. Full recognition of its clinicopathological features will help to better diagnose this disease.
Very High Baseline HIV viremia impairs efficacy of NNRTI-based ART: A long-term observation in treatment-naïve patients
Authors: Chen Shuai , Han Yang , Song Xiaojing , Li Yanling , Zhu Ting , Lu Hongzhou , Tang Xiaoping , Zhang Tong , Zhao Min , He Yun , He Shenghua , Wang Min , Li Yongzhen , Huang Shaobiao , Li Yong , Liu Jing , Cao Wei , Li Taisheng
Published: May 2020

Background: High baseline HIV-RNA level (≥100,000 copies/ml) has been proved to be related with weaker virological response to antiretroviral therapy (ART). However, it was not completely clear whether a very high pre-therapy viral load (≥500,000 copies/ml) can further impair the virological response, especially in the long run. Methods: A retrospective study based on data from multicenter cohorts in China was performed. We enlisted untreated HIV infected adults recruited between18 and 65 years old, who received China’s first-line non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimen. All patients had baseline HIV-RNA levels over 500 copies/ml, showed good adherence, and were followed for at least 24 weeks. Virological suppression (VS) was defined as the first HIV-RNA <50 copies/ml. Virological failure was defined as any of incomplete viral suppression (HIV-RNA ≥200 copies/mL with no recorded VS within 24 weeks of treatment) and viral rebound (confirmed HIV-RNA level ≥50 copies/mL after VS). Chi-square analysis was used to compare rates of VS between different HIV-RNA strata. Kaplan–Meier analysis and Cox regression model were used to compare time to virological suppression. Logistic regression was used to evaluate odds to virological failure.Results: 758 treatment-naïve HIV patients in China were enlisted. Median follow-up time (IQR) was 144 (108-276) weeks. Most patients (68.2%) were given tenofovir disoproxil fumarate (TDF) + lamivudine (3TC) + efavirenz (EFV) regimen. By week 48, rates of VS in three groups (<100,000, 100,000-500,000 and ≥500,000 copies/ml) were 94.1%, 85.0%, and 63.8%, respectively (p<0.001). Very high baseline HIV viremia over 500,000 copies/ml were found to be independently associated with delayed VS [≥500,000 vs. <100,000, adjusted relative hazard (95% CI), 0.455 (0.32-0.65); p <0.001] as well as incomplete viral suppression [≥500,000 vs. <100,000, adjusted odds ratio (aOR) (95% CI), 6.084 (2.761-13.407); p <0.001] and viral rebound [≥500,000 vs. <100,000, aOR (95% CI), 3.671 (1.009-13.355), p =0.048].Conclusion: Very high levels of pre-treatment HIV-RNA were significantly related with delayed efficacy of NNRTI-based ART and increased risk of treatment failure. More potent initial regimens should be considered for those with very high baseline viremia.
Strengthening the clinical laboratory workforce in Cambodia; a case study of a mixed-method in-service training program to improve laboratory quality management system oversight.
Authors: Ong Siew Kim , Donovan Grant T , Ndefru Nayah , Song Sophanna , Leang Chhayheng , Sek Sophat , Noble Michael , Perrone Lucy A
Published: May 2020

Background: Laboratory diagnostic testing service delivery and compliance with international standards for laboratory quality are directly influenced by laboratory workforce competency. Many hospital laboratories in constrained resource settings such as Cambodia struggle to cope with the training needs of laboratory professionals in an environment of competing healthcare development priorities. Resource limited countries need an adaptable and effective approach to provide laboratory professionals with job-specific quality oversight training to ensure the accuracy, timeliness and reliability of diagnostic services. Case Presentation: Here we describe the results of an in-service training and mentoring program conducted with the Cambodia Ministry of Health at 12 tertiary level hospital laboratories to drive improvements in laboratory quality management systems toward ISO 15189 accreditation, which demonstrated significant progress between baseline and outcome audits in a concurrent study. This case study describes the program, and evaluates how the four primary activities, including actionable gap assessments and planning, centralized and in-situ training curriculum, in-person mentoring, and remote tele-mentoring via video communication technologies, contributed towards quality improvement in the participating laboratories.We evaluated participant responses to Likert scale and free response questions from program and training evaluation surveys, and we used thematic analysis to develop a model of best practices within the program’s four primary activities to inform future training approaches. Of these activities, participants agreed most highly that in-person visits and planning based on gap assessments contributed to their learning and ability to improve laboratory operations. Tele-mentoring was rated lowest by participants, who were critical of excessive group dialogue and distraction during web-conferencing; however, feedback suggests both in-person and remote mentoring contribute to continuing education, accountability to action, and peer collaboration and problem solving to improve workforce efforts toward improved quality management systems.Conclusions: We recommend here a package of in-service training activities for laboratory quality management system improvement initiatives in resource constrained settings that includes needs-based curricula and personalized action plans for participants; interactive and on-site training workshops; and in-person mentoring, complemented with well managed and regular tele-mentoring that focuses on knowledge retention, accountability to goals, and collaborative problem solving. Our model presents an adaptable approach to human resource development for quality improvement in medical laboratories.
Ileal proteomic changes associated with IL-25-mediated resistance against intestinal trematode infections
Authors: Álvarez-Izquierdo María , Esteban J. Guillermo , Muñoz-Antoli Carla , Toledo Rafael
Published: May 2020

Background: Echinostoma caproni (Trematoda: Echinostomatidae) is an intestinal trematode, which has been extensively used to investigate the factors that determine the rejection of intestinal helminths. In this sense, several studies have shown that IL-25 is critical for the development of resistance against E. caproni in mice. In fact, treatment of mice with recombinant IL-25 generates resistance against primary E. caproni infection. However, the mechanisms by which IL-25 induces resistance remain unknown.Methods: To study the mechanisms responsible for resistance elicited by IL-25, we analyze the ileal proteomic changes induced by IL-25 in mice and their potential role in resistance. To this purpose, we compare the protein expression profiles in the ileum of four experimental groups of mice: naïve controls; E. caproni -infected mice; rIL-25-treated mice; and rIL-25-treated mice exposed to E. caproni metacercariae.Results: Quantitative comparison by 2D-DIGE showed significant changes in a total of 41 spots. Forty of those spots validated protein spots were identified by mass spectrometry corresponding to 24 proteins.Conclusions: The analysis of our results indicates that resistance to infectiuon is associated with the maintenance of the intestinal epithelial homeostasis and the regulation of proliferation and cell death. These results provide new insights into the proteins involved in the regulation of tissue homeostasis after intestinal infection and its transcendence in resistance.
Effects of bone marrow mononuclear cells on induction of axonal sprouting in cortico-cortical and cortico-striatal pathways in an animal model of cortical ablation.
Authors: Sampaio Maria de Fatima dos Santos , Guimarães Arthur Giraldi , Lourenço Camila da Silva , Pereira Messias Gonzaga , Coimbra Norberto Cysne
Published: May 2020

Objectives Many therapies have been proposed in order to investigate the mechanisms of neural repair associated with neurological diseases, including BMMC (Bone marrow Mononuclear Cells) transplantation. However, studies show that some brain injuries are less responsive to neural repair, such as, for example, cortical ablation. On the other hand, models of cortical ablation have shown functional recovery after BMMC transplantation. Thus, it is relevant to expand knowledge about BMMC, also, in the induction of neuroplasticity, in this model, considering treating a promising event for the rehabilitation of neurological diseases. Using the experimental model of cortical ablation, adult male Wistar rats, which is known to be poorly responsive to neuroplasticity, the aim of this study was to investigate the effects of BMMC on axonal sprouting induction in cortico-cortical and cortico-striatal projections. An anterograde neurotracer was used to evaluate the distribution of axonal fibers.ResultsQuantitative analyses were performed and the results showed that BMMC were not able to significantly induce axonal sprouting in the evaluated areas. Our results reinforced the idea that cortical ablation may be less responsive to neuroplasticity and the beneficial effects of BMMC therapy depend on the particularities of a neural microenvironment intrinsic to a given lesion.
The common concerns regarding the COVID-19 outbreak in Iran: Explored findings from a qualitative study
Authors: Shahabi Saeed , Sadati Ahmad Kalateh , Zarei Leila , Noroozi Masoome , Tabrizi Reza , Heydari Seyyed Taghi , Lankarani Kamran Bagheri
Published: May 2020

Background

The first cases of coronavirus disease 2019 (COVID-19) were reported in Iran on February 20, and then the virus spread rapidly in all parts of the country, so that over 95000 positive cases and approximately 6000 deaths have been confirmed in this region until May 1, 2020. Even if measures taken in this respect have had significant impacts on reducing the incidence rate of COVID-19, a large number of other problems have arisen. Following this situation, people have been also drawn against many concerns, especially Iranian population with their own previous socioeconomic and cultural problems. Therefore, this nation-wide project aimed to investigate common concerns regarding COVID-19 outbreak in Iran.
Methods

This qualitative study was conducted in Iran from February to March 2020 via an online open-ended questionnaire. The participants were also selected using convenience and snowball sampling methods. As well, the data collection process continued until data saturation was achieved. In addition, thematic content analysis was utilized to analysis the transcribed texts.
Results

The statements retrieved also represented the most challenging psychological stress experienced by the participants. Four themes were accordingly recognized based on the content analysis including stressful conditions, health concerns, social and political concerns, and economic concerns. Throughout the study, a major proportion of the participants commented that psychological disorders such as fear, anxiety, stress, and ennui were their main challenges regarding this pandemic. Furthermore, lack of social responsibility, worries about high-risk and susceptible groups, decreased economic power of the public, financial hardships for low-income groups, shortage of healthcare facilities, and adverse effects of disinfectants were expressed as the main concerns.
Conclusions

As a whole, it is evident that people have confronted with several challenges and need help together with effective policies and strategies during and after this pandemic to reduce their current concerns. The study findings provided a favorable ground to develop and adopt the required policies in Iran and other countries. It was concluded that creating local, national, and global solidarity in such epidemics is an inevitable necessity.
Comparative Heavy Metal Removal Efficiencies of Biosurfactants Produced by Odoribacter Splanchnicus DSM 20712, Bacterium Clone JX981747 and Soil Washing Agents
Authors: Ogbulie TOOCHUKWU Ekwutosi , Okore Chioma Chimezie , Ejele Agunna Everest
Published: May 2020

The application of two biosurfactants in the removal of copper, zinc, and lead from waste metal dumpsite soil with their efficiencies was compared to soil washing agents as KNO3, Ca(NO3)2 and NaOH. The test soil samples were also spiked separately with different concentrations (50 mg/L, 250 mg/L, 750 mg/L and 1500 mg/L ) of CuSO4, ZnSO4 and Pb(NO3)2. The biosurfactants used were produced by Odoribacter splanchnicus DSM 20712 (WBS1) and an unidentified bacterium clone JX981747 (CMS). Five different treatment set up comprising of different ratios (20:1, 15:1, 10:1, 5:1, and 1:1) with the soil solution constant was respectively used. The heavy metal contents were measured using Atomic Absorption Spectrophotometer and the percentage heavy metal removal efficiency was calculated. The highest concentrations of biosurfactant (20:1) at different spiked concentrations of metallic salts recorded the highest values of copper (95.47%, 95.73%, 91.69%, 78.82%); zinc (97.98%, 98.98%, 97.29%, 96.78%) and lead (97.68%, 93.09%, 88.12%, 84.98%) removal. The percentage metal removed in each treatment increased with increasing concentration of the biosurfactants and washing agents (1:1 to 20:1). The chemical structure of the two biosurfactants analyzed using Gas Chromatography Mass Spectroscopy (GC-MS) depict the major component of biosurfactants produced from Odoribacter splanchnicus DSM 20712 to be Di-n- amyl phthalate while 9, Octadecanoic acid, methyl ester was from unidentified bacterium clone JX981747. The one dimensional paper chromatography showed presence of galactose/glucose, mannose, ribose, rhamnose in the biosurfactants produced from Odoribacter splanchnicus DSM 20712 whereas the unidentified bacterium clone JX981747 produced biosurfactants that contained all sugars except mannose. The test biosurfactants studied showed high levels of copper and lead removal than zinc when compared with the test soil washing agents (KNO3), Ca(NO3)2 and NaOH used in this study. Biosurfactants have thus shown to have the ability to remove metals hence its use requires scaling up for environmental applications.
miR-301b-3p promotes lung adenocarcinoma cell proliferation, migration and invasion by targeting DLC1
Authors: Liu Haitao , Ma Xingjie , Niu Niu , Zhao Junjie , Lu Chao , Yang Fan , Qi Weibo
Published: May 2020

Background

miR-301b-3p has been reported to be abnormally expressed in various human cancers including lung cancer. However, the underlying role and molecular mechanisms in lung adenocarcinoma (LUAD) remain unclear. This study aimed to elucidate the underlying mechanisms of miR-301b-3p in LUAD.
Methods

Based on TCGA database, we found that miR-301b-3p was prominently up-regulated in LUAD tissues. A series of functional experiments including CCK-8 assay, colony formation assay and Transwell assay uncovered that the up-regulation of miR-301b-3p facilitated LUAD cell proliferation, migration and invasion abilities. Bioinformatics analysis and dual-luciferase reporter gene assay demonstrated that Deleted in Liver Cancer 1 (DLC1) was negatively regulated by miR-301b-3p, and it was extremely lowly expressed in LUAD tissues and cells.
Results

Rescue experiments suggested that overexpressing DLC1 restored the promoting effect of miR-301b-3p on LUAD cell proliferation, migration and invasion.
Conclusions

Taken together, our study elucidated that miR-301b-3p promoted LUAD cell proliferation, migration and invasion by targeted suppressing DLC1 expression. The discovery of the mechanism provides a novel therapeutic strategy for LUAD patients, which helps to improve the survival of patients.
A New Botox Therapy Method in Chronic Anal Fissüre
Authors: Boz Alper , Acar Hasan Zafer
Published: May 2020

BackgroundBotox toxin treatment(BT) is an effective method in chronic anal fissures(CAF).However, there are different suggestions regarding the application place and method of BT in the literature. Our aim in this study is to reveal the most appropriate application site and method in BT for CAFs. MethodsFor this purpose, 2 groups were randomly selected from patients who admitted to our hospital with CAF complaints. In our study, we performed the BT application in different places in different amounts in both groups. After the treatment, we evaluated the recurrence and anal incontinence scores of the patients in certain periods and compared them with each other. The follow-up period for our patients were at least 12 months. ResultsThe recurrence rate was found to be 33.3% in patients in Group A (Gp A) and 19.3% in patients in Group B (Gp B). Patients in Gp A had a statistically significant higher recurrence rate (inadequate treatment) compared to patients in Gp B at the first control, which was performed at first week after treatment(p<00.5). Anal incontinence rate 3.3% in Gp A, 6.4% in Gp B. The difference between anal incontinence rates according to Cleveland Clinic Incontinence Score (CCIS) was not statistically significant between patients with GP A and Gp B (p>0.05).Conclusion3-way BT in internal and external anal sphincters in CAFs, is an effective and low-risk treatment method.
The Influence of Electronic Health Record Use on Collaboration Among Medical Specialties
Authors: Vos Janita F.J. , Boonstra Albert , Kooistra Arjen , Seelen Marc , Offenbeek Marjolein van
Published: May 2020

Background:One of the main objectives ofElectronic Health Records (EHRs) is to enhancecollaboration among healthcare professionals. However, our knowledge of how EHRs actually affect collaborative practices is limited. This study examines how an EHR facilitates and constrains collaborationin five outpatient clinics.Methods: We conducted an embedded case study at five multidisciplinary outpatient clinics of a hospital that had implemented organization-wide EHR. Data were collected through semi-structured interviews with representatives of medical specialties, administration, nursing, and management. Documents were then analyzed to contextualize these data. We examined the following six collaborative affordances of EHRs: (1) portability, (2) co-located access, (3) shared overviews, (4) mutual awareness, (5) messaging, and (6) orchestrating.Results:Our findings demonstratehow an EHRwill simultaneously bothfacilitate andconstrain collaborationamong specialties and disciplines. Affordances that were inscribed in the system for collaboration purposeswere not fully actualized in the focal hospital because:(a)The EHR helps health professionalscoordinate patient care on an informed basis at any time and in any placebut only allows asynchronouspatient record use.(b)The comprehensive patient file affords joint clinical decision-making based on shared data, but specialty- and discipline-specific user-interfaces constrain mutual understanding of that data. Moreover, not all relevant information can be easily shared across specialties and outside the hospital.(c)The reduced necessity forface-to-face communication saves time but is experienced as hindering collective responsibility for a smooth workflow.(d)The EHR affords registration at the source and full registration of activities through orders, but the heightened administrative burdenfor physicians and the strict authorization rules on inputting dataconstrainthe flexible, multidisciplinary collaboration.(e) While the EHR affords a complete overview, information overload occurs due to the parallel generation of individually owned notes and the high frequency of asynchronous communication through messages of varying clinical priority.Conclusions: For the optimal actualization of EHRs’collaborative affordancesin hospitals, coordinated use of these affordancesby health professionalsis a prerequisite.Suchcoordinated userequires organizational, technical, and behavioral adaptations. Suggestions for hospital-wide policies toenhance trust in both the EHR and in its coordinated usefor effective collaboration are offered.
Representativeness of Personality and Involvement Preferences in a Web-Based Survey on Healthcare Decision-Making
Authors: Birkeland Søren , Linkhorst Thea , Haakonsson Anders , Barry Michael John , Möller Sören
Published: May 2020

Background: Obtaining a sample that is representative of the group of interest is of utmost importance in questionnaire studies. In a survey using a state authorized web-portal for citizen communication with authorities, we wanted to investigate the view of adult men on patient involvement in health care decision-making regarding Prostate-Specific Antigen test for prostatic cancer. In this paper, we report on sample characteristics and representativeness of our sample in terms of personality and baseline involvement preferences.Methods: We compared personality profiles (BFI-10) and baseline healthcare decision-making preferences (CPS) in our sample (n = 6,756) to internationally available datasets. Pooled data from a) US, UK, Canada, Australia, and New Zealand (n = 1,512), b) Germany, Netherlands, Switzerland, and Belgium (n = 1,136), and c) Norway, Sweden, Finland, and Denmark (n = 1,313) were used for BFI-10 comparisons. Regarding CPS, we compared our sample with three previous datasets relating to decision-making in cancer (n = 425, 387, and 199).Results: Although statistically significant differences particularly appeared in large dataset comparisons, sample BFI-10 and CPS profiles mostly were within the range of those previously reported. Similarity was greatest in BFI-10 comparisons with group a) where no statistically significant difference could be established in factors ‘agreeableness’ and ‘neuroticism’ (p = .095 and .578, respectively).Conclusion: Despite some variation, our sample displays personality and baseline preference profiles that are generally similar to those described in previous international studies. For example, this was the case with the BFI-10 ‘agreeableness’ measure (incl. trust and fault-finding items), an important factor in healthcare decision-making.
A novel signature of two long non-coding RNAs in BRCA mutant ovarian cancer to predict prognosis and efficiency of chemotherapy
Authors: Pan Yinglian , Jia LiPing , Liu Yuzhu , Han Yiyu , Li Qian , Zou Qin , Zhang Zhongpei , huang jin , Deng Qingchun
Published: May 2020

Background: Ovarian cancer (OV) is the most common type of primary female reproductive cancer. BRCA1/2 gene is an important biomarker for evaluating the risk of OV, breast cancer and other related tumors and influences patient choice of individualized treatment. A powerful signature to predict OV prognosis and improve treatment personalization is urgently needed. This study aimed to identify a novel OV-related lncRNA prognostic biomarker.Methods: A Univariate Cox proportional-hazards and multivariate Cox regression analyses were used to identifying prognostic factors from The Cancer Genome Atlas (TCGA) database. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was assessed, and the sensitivity and specificity of the prediction model were determined.Results: The signature consisting of two long noncoding RNAs(lncRNAs), Z98885.2 and AC011601.1, was selected as a criterion for classifying patients into high and low-risk groups (median survival: 7.2 years vs. 2.3 years). The 3-year overall survival (OS) rates for the high- and low-risk groups were approximately 38% and 100%, respectively. Chemotherapy treatment survival rates indicated that high-risk groups had significantly shorter OS rates with adjuvant chemotherapy than the low-risk groups. The OS of 1-, 3- and 5- years were 100%, 40%, and 15% in the high-risk groups respectively. The survival rate of the high-risk group declined rapidly after two years of OA chemotherapy treatment. In addition, multivariate Cox regression associated with other traditional clinical factors showed that the 2-lncRNA model could be used as an independent OV prognostic factor. Analyses of the Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) indicated that these signatures are pivotal to cancer development.Conclusion: In conclusion, Z98885.2 and AC011601.1 comprise a novel prognostic signature for OV patients with in BRCA1/2 mutations to predict prognosis and chemotherapy efficiency.
The Quality of Lymph Node Harvests in Extralevator Abdominoperineal Excisions
Authors: Liu Ben , Farquharson Ja’Quay
Published: May 2020

Background:Lymph node (LN) harvest in colorectal cancer resections is a well-recognised prognostic factor for disease staging and determining survival, particularly for node-negative (N0) diseases. Extralevator abdominoperineal excisions (ELAPE) aim to prevent “waisting” that occurs during conventional abdominoperineal resections (APR) for low rectal cancers, and reducing circumferential resection margin (CRM) infiltration rate. Our study investigates whether ELAPE may also improve the quality of LN harvests, addressing gaps in the literature.Methods:This retrospective observational study reviewed 2 sets of 30 consecutive APRs before and after the adoption of ELAPE in our unit. The primary outcomes are the total LN count and rates of meeting the standard of 12-minimum, particularly for those with node-negative disease. The secondary outcomes are the CRM involvement rates. Baseline characteristic including age, sex, laparoscopic or open surgery and neoadjuvant chemoradiotherapy were accounted for in our analyses.Results:Median LN counts were slightly higher in the ELAPE group (16.5 vs. 15). Specimens failing the minimum 12-LN requirements were almost significantly fewer in the ELAPE group (OR=0.456). Among node-negative rectal cancers, significantly fewer resections failed the 12-LN standard in the ELAPE group than APR group (OR=0.211, p=0.044). ELAPE led to a near-significant decrease in CRM involvement (OR=0.365). These improvements were persistently observed after taking into account baselines and potential confounders in regression analyses. ConclusionELAPE provides higher quality of LN harvests that meet the 12-minimal requirements than conventional APR, particularly in node-negative rectal cancers. The superiority is independent of potential confounding factors and may implicate better clinical outcomes.
Inflammation is Correlated with Abnormal Functional Connectivity in Unmedicated Bipolar Depression: A Resting State FMRI Study
Authors: Tang Guixian , Chen Pan , Chen Guanmao , Zhong Shuming , Gong Jiaying , Zhong Hui , Ye Tao , Chen Feng , Wang Jurong , Luo Zhenye , Qi Zhangzhang , Jia Yanbin , Wang Ying , Huang Li
Published: May 2020

Objectives Inflammation might play a role in bipolar disorder (BD), but it remains unclear the relationship between inflammation and brain structural and functional abnormalities in patients with BD. In this study, we focused on the alterations of functional connectivity (FC), peripheral pro-inflammatory cytokines and their correlations to investigate the role of inflammation in FC in BD depression.Methods In this study, 42 unmedicated patients with BD II depression and 62 healthy controls (HCs) were enrolled. Resting-state-functional magnetic resonance imaging (rs-fMRI) was performed in all participants and independent component analysis (ICA) was used. Serum levels of Interleukin-6 (IL-6) and Interleukin-8 (IL-8) were measured in all participants. Correlation between FC values and IL-6 and IL-8 levels in BD was calculated.Results Compared with the HCs, BD II patients showed decreased FC in the left orbitofrontal cortex (OFC) implicating the limbic network and the right precentral gyrus implicating the somatomotor network (SMN). BD II showed increased IL-6 (P = 0.039), IL-8 (P = 0.002) levels. Moreover, abnormal FC in the right precentral gyrus were inversely correlated with the IL-8 (r=-0.458, P = 0.004) levels in BD II. No significant correlation was found between FC in the left OFC and cytokines levels.Conclusions Our findings that serum IL-8 levels is associated with impaired FC in the right precentral gyrus in BD II patients suggest that inflammation might play a crucial role in brain functional abnormalities in BD.
SKP1 promotes YAP-mediated colorectal cancer stemness via suppressing RASSF1
Authors: Tian Cong , Lang Tingyuan , Qiu Jiangfeng , Han Kun , Zhou Lei , Min Daliu , Zhang Zhiqi , Qi Dachuan
Published: May 2020

Background: Cancer stem cells have been recognized as an important drug target, however, the mechanisms underlying the maintenance of cancer stem cells have not been fully understood. SKP1 is a traditional drug target for cancer therapy, while, whether SKP1 could be a target for eradicating cancer stem cells remains elusive.Methods: Human colorectal cancer cell lines HCT-116 and HT-29 and primary human colorectal cancer cells were used in this study. Gene manipulation was performed by lentivirus system. The mRNA and protein levels were examined by qRT-PCR and western blot, respectively. Sphere formation and transwell assay were employed for examination of sphere-forming and migration capacities. The tumorigenicity was examined by xenograft model. The transcriptional activities of the promoters were examined by luciferase reporter assay. Co-immunoprecipitation assay was used to test protein-protein interaction. The relationship between gene expression and survival was analyzed by Kaplan-meier analysis. The correlation between two genes was analyzed by Spearman analysis. Data are represented as mean ± s.d. and the significance was determined by Student’s t-test.Results: SKP1 is upregulated in colorectal cancer stem cells and predicts poor prognosis of colon cancer patients. Overexpression of SKP1 promotes the sphere-forming and migration capacities of colorectal cancer stem cells, and upregulates the expression of cancer stem cell markers. In contrast, SKP1 depletion produces the opposite effects. SKP1 strengthens YAP activity and knockdown of YAP abolished the effect of SKP1 on the stemness of colorectal cancer cells. SKP1 suppresses RASSF1 at both mRNA and protein levels and overexpression of RASSF1 abolished the effect of SKP1.Conclusion: In summary, our results demonstrated that SKP1 suppresses RASSF1 at both mRNA and protein level, attenuates Hippo signaling, activates YAP, and thereby promoting the stemness of colorectal cancer stem cells. Our works thus revealed a novel underlying mechanism of colorectal cancer stem cell maintenance and suggested a novel drug target for eradicating colorectal cancer stem cells.