bluuebunny/crossref_metadata_2025 huggingface dataset:
The accuracy of ultrasound to predict endotracheal tube size for pediatric patients with congenital scoliosis
Authors: Hao Jianhong , Zhang Jie , Dong Buhuai , Luo Zhenguo
Published: May 2020

Background: Ultrasonography has been used for prediction the endotracheal tube(ETT) size through measuring the cricoid cartilage diameter. The aim of this study was to determine the accuracy of ultrasound to predict ETT size for pediatric patients with congenital scoliosis.Methods:Fifty pediatric patients underwent scoliosis surgery were included in the study. According to the position of scoliosis, patients were divided into three groups: Group C (cervical lateral bending); Group T ( thoracic scoliosis); and Group L (lumbar scoliosis). For all participants, the transverse diameter of the cricoid cartilage was measured with ultrasonography and the initial ETT size was chosen according to the measurements, then the leak test was used to determine the best‑fit ETT size. In each group, the ETT size measured by ultrasound and the best‑fit ETT size were compared using Bland-Altman analysis and linear regression analysis.Results: There was a strong correlation between the best‑fit ETT size and the ETT size predicted by ultrasound in Group T (r=0.93, p<0.001) and Group L(r=0.95, p<0.001) and a moderate correlation in Group C(r=0.83, p<0.001). Bland-Altman analysis show that the ETT size was over estimated by ultrasound in pediatric patients with cervical lateral bending.Conclusion: Ultrasound is a reliable tool to predict ETT size for pediatric patients with thoracic scoliosis and lumbar scoliosis. However, compared to what was predicted by ultrasonography, pediatric patients with cervical lateral bending need a smaller sized ETT.
Short- and long-term mortality prediction in critically ill subjects: a cohort study
Authors: Czajka Szymon , Ziębińska Katarzyna , Marczenko Konstanty , Posmyk Barbara , Szczepańska Anna , Krzych Łukasz
Published: May 2020

Background. There are several scoring systems used for in-hospital mortality prediction in critical illness. Their application in a local scenario requires validation to ensure appropriate diagnostic accuracy. Also, their use in assessing post-discharge mortality in the ICU survivors has not been extensively studied.Aim. To evaluate the ability of APACHE II, III and SAPS II to predict in-hospital and post-discharge mortality in adult ICU patients.Material and methods. APACHE II, APACHE III and SAPS II, with corresponding predicted mortality ratios, were calculated for 303 consecutive patients admitted to the 10-bed ICU in 2016. Long-term mortality was calculated based on information taken from PESEL database.Results. Median APACHE II, APACHE III and SAPS II scores were 19, 67 and 44 points, with corresponding in-hospital mortality ratios of 28.1, 18.5 and 34.8%. Observed in-hospital mortality was 35.6%. 12-month post-discharge mortality reached 17.4%. All systems predicted in-hospital mortality (p<0.05): APACHE II (AUC=0.783; 95%CI 0.732-0.828), APACHE III (AUC=0.793; 95%CI 0.743-0.838) and SAPS II (AUC=0.792; 95%CI 0.742-0.836), as well as mortality after ICU discharge (p<0.05): APACHE II (AUC=0.712; 95%CI 0.643-0.775), APACHE III (AUC=0.721; 95%CI 0.653-0.783) and SAPS II (AUC=0.695; 95%CI 0.625-0.759), with no statistically significant difference between them (p>0.05).Conclusions. Although the predictive values were the highest for APACHE III and SAPS II, no differences were noticed between the scores. In case of post-discharge mortality, diagnostic accuracy was much lower. Further studies are needed to create scores estimating the long-term prognosis of subjects successfully discharged from the ICU.
Therapeutic Pulmonary Telerehabilitation Protocol in patients affected by COVID-19, confined in their homes: Study Protocol for a Randomized Control Trial
Authors: Gonzalez-Gerez Juan Jose , Utrera Carlos Bernal , Anarte-Lazo Ernesto , García-Vidal Jose Antonio , Botella-Rico José Martin , Rodriguez-Blanco Cleofas
Published: May 2020

Background: In December 2019, 27 cases of pneumonia, of unknown cause, were identified in the province of Hubei (China). The WHO declared the situation as a Public Health emergency of International Concern and it was finally declared a global pandemic on March 11, 2020. Spanish Government obliges the entire population to remain confined to their homes, with exception of essential basic services, to stop the spread of COVID-19. Home isolation implies a notable physical deconditioning. Telerehabilitation methods have reported positive experiences and we propose to study in affected patients of COVID-19, due to the general house confinement of the entire Spanish population. Methods: Patients will be recruited in the regions of Andalusia, Murcia and Valencia (Spain). Patients will remain confined to their homes, and there they will carry out their assigned exercise program, which will be controlled telematically. Evaluators will attend to carry out all measurements at the beginning, during, and end of the study, telematically controlled. The patients will be randomly divided into three groups, two of them will perform a home exercise program (breathing exercises or non-specific exercises for muscle toning) and the third group will perform sedentary activities, using mental activation techniques, and will act as a sham group. We will evaluate respiratory variables and other variables of physical state through physical tests, effort and perceived fatigue. The data will be statistically analyzed, and the hypotheses will be tested between the groups, using the SPSS software, v.20, considering a 95% confidence interval. Discussion: We will analyze the results, in terms of level of fatigue and perceived exertion, physical health, and maintenance of respiratory activity of two types of exercise programs, toning and respiratory, applied in patients affected by COVID19 during the period of home confinement. We intend to investigate a field not previously studied, such as the repercussion of carrying out a toning and respiratory exercise program in these patients, in historical circumstances that no one had previously observed in Spain, since the general population has never been forced to remain confined in their homes, due to a pandemic infection, by coronavirus (COVID19). Observing the effects that these two home exercise programs could produce in patients infected with COVID19, we will try to better analyze and understand the mechanisms that are associated with worsening of breathing in this type of patient.
Marks, and their proportioning between examinations, tutorials and assignment, as determinants of the performance of nursing students in a pharmacology course
Authors: Doggrell Sheila
Published: May 2020

Background
In programs with higher proportions of marks allocated to ongoing assessment, the students have higher overall marks than those with a lower proportion allocated to assessment. Little or no attention has been made to how the allocation affects the academic success of students in individual courses. The purpose of this study was to determine how the allocation of marks to examinations, tutorials and an assignment affects the performance of nursing students in a pharmacology course.
Methods
For students who passed a pharmacology course (i) the marks for examinations and ongoing assessment (tutorials and/or an assignment) were compared, and (ii) regression line and correlation analysis was undertaken to determine any association between these marks. In addition, for completing students, modelling was undertaken to determine the effects of changing the allocation of marks on passing and failing rates.
Results
Nursing students who passed a pharmacology course obtained significantly lower marks in examinations than ongoing assessment, and for the ongoing assessment, lower marks in the assignment than tutorials. Regression line analysis showed that the marks in ongoing assessment (tutorials and/or the assignment) versus examination marks were a poor line-fit. The correlation coefficients between ongoing assessment and examinations were weak to moderate. A high percentage of students passed the course (> 90%) and, modelling for completing students, showed that decreasing the marks for examination would have led to slightly more students passing the pharmacology course with higher grades. In contrast, increasing the marks for examination would have dramatically decreased the number of students passing the course, and their grades.
Conclusions
The allocation of marks can have a major effect on student performance. As ongoing assessment is not a good predictor of performance in examination this has implications for students who rely on passing examinations for their advancement. For instance, nursing students in some countries (e.g. USA) are required to pass examinations prior to registration, whereas in others (e.g. Australia) they are not. Consideration needs to be given as to whether it is appropriate for nursing students who fail examinations to pass courses/programs.
Potential benefits of adaptive intensity modulated proton therapy in nasopharyngeal carcinomas: a planning comparison study
Authors: minatogawa hideki , Yasuda Koichi , Dekura Yasuhiro , Takao Seishin , Matsuura Taeko , Yoshimura Takaaki , Suzuki Ryusuke , Yokota Isao , Fujima Noriyuki , Onimaru Rikiya , Shimizu Shinichi , Aoyama Hidefumi , Shirato Hiroki
Published: May 2020

Background
To investigate potential advantages of adaptive intensity modulated proton beam therapy (A-IMPT) by comparing it to adaptive intensity modulated X-ray therapy (A-IMXT) for nasopharyngeal carcinomas (NPC).
Methods
Six patients with NPC treated with A-IMXT (step and shoot approach) and concomitant chemotherapy between 2015 and 2016 were selected. In the actual treatment, 46 Gy in 23fr fractions was prescribed using the initial plan and 24 Gy/12fr was prescribed using an adapted plan thereafter. New treatment planning of A-IMPT was made for the same patients using equivalent dose fractionation schedule and dose constraints. The dose volume statistics based on deformable images and dose accumulation was used in the comparison of A-IMXT with A-IMPT.
Results
The mean doses to the right parotid gland (p = 0.004), left parotid gland (p = 0.012), the oral cavity (p < 0.001), the thyroid gland (p = 0.047), the supraglottic larynx (p < 0.001), the glottic larynx (p = 0.001), the superior pharyngeal constrictor muscle (PCM) (p < 0.001), the middle PCM (p = 0.002), the inferior PCM (p < 0.001), and the cricopharyngeal muscle (p = 0.031) in A-IMPT are statistically significantly lower than those of A-IMRT with the statistical significance. The mean dose to the oral cavity, supraglottic larynx, and glottic larynx were all reduced by more than 20 GyE.
Conclusion
The adaptive approach is suggested to enhance the potential benefit of IMPT compared to IMXT to reduce adverse effects for patients with NPC.
Discovery and validation of mucosal TNF expression combined with histological score - a biomarker for personalized treatment in ulcerative colitis
Authors: Florholmen Jon R. , Johnsen Kay-Martin , Renate Meyer , Olsen Trine , Moe Øystein Kittel , Tandberg Petter , Gundersen Mona D. , Kvamme Jan-Magnus , Johnsen Knut , Løitegård Terje , Raschpichler Gabriele , Vold Cecilia , Sørbye Sveinung W. , Goll Rasmus
Published: May 2020

Background
There are no accurate markers that can predict clinical outcome in ulcerative colitis at time of diagnosis. The aim of this study was to explore a comprehensive data set to identify and validate predictors of clinical outcome in the first year following diagnosis.
Methods
Treatment naive-patients with ulcerative colitis were included at time of initial diagnosis from 2004–2014, followed by a validation study from 2014–2018. Patients were treated according to clinical guidelines following a standard step-up regime. Patients were categorized according to the treatment level necessary to achieve clinical remission: mild, moderate and severe. The biopsies were assessed by Robarts histopathology index (RHI) and TNF gene transcripts.
Results
We included 66 patients in the calibration cohort and 89 patients in the validation. Mucosal TNF transcripts showed high test reliability for predicting severe outcome in UC. When combined with histological activity (RHI) scores the test improved its diagnostic reliability. Based on the cut-off values of mucosal TNF and RHI scores from the calibration cohort, the combined test had still high reliability in the validation cohort (specificity 0.99, sensitivity 0.44, PPV 0.89, NPV 0.87) and a diagnostic odds-ratio (DOR) of 54.
Conclusions
The combined test using TNF transcript and histological score at debut of UC can predict severe outcome and the need for anti-TNF therapy with a high level of precision. These validated data may be of great clinical utility and contribute to a personalized medical approach with the possibility of top-down treatment for selected patients.
OSCE 3D: a virtual clinical skills assessment tool for coronavirus pandemic times
Authors: Faria Alexandre Loureiro , Perdigão Anne Carolinne Bezerra , Marçal Edgar , Kubrusly Marcos , Peixoto Raquel Autran Coelho , Junior Arnaldo Aires Peixoto
Published: May 2020

Background : In pandemic times where the “lockdown strategy” has been adopted, the use of innovations using technological resources such as the creation of instruments that can replace traditional teaching-learning methods in the training of health professionals is essential. The aim of this study was to develop and evaluate the usability of a realistic interactive simulation computer system using three-dimensional imaging technology and virtual reality with free-access computational tools available on the web. Methods : the development of a prototype (OSCE 3D) was based on the steps used for the construction of simulation software of a "Serious Game". An experimental phase was carried out to assess usability, through a questionnaire based on the System Usability Scale. The study was approved by the Research Ethics Committee of the institution and all patients signed the Informed Consent Form. Results : a total of 39 undergraduate medical students from the 6th semester of a private university center of northeast do Brazil voluntarily participated in the evaluation of the OSCE 3D. The usability evaluation presented a mean score of 75.4 with a margin of error of 3.2, considered a good usability according to the literature. Conclusions : this work allowed the development of a low-cost prototype, using a three-dimension realistic simulation system for OSCE assessment stations. This product, even in the prototype phase, showed good usability.
Quality of Nursing Education in Philippines: Difference in Quality of Nursing Programme in relation to Profile of Faculty Members
Authors: Appiah Stella
Published: May 2020

Background
The subject of continuous quality of nursing education programme is an extremely sensitive issue worldwide, particularly in Philippines where high number of their trained registered nurses are exported to both developed and developing countries. The assessment of quality of nursing education programmes are usually measured using passing rates in licensure examinations by several government organizations. However, few studies have associated quality of nursing education to the quality of nursing instructors, this study probed further and determined whether the quality of nursing education programmes differs according to profile of faculty members in Philippines colleges of higher education in higher educational institutions.
Methods
A cross-sectional survey study design was employed in this study. One hundred and eight-five (185) faculty members in fifteen (15) higher educational institutions were selected for the research using purposive sampling. The study was carried out with the period of January 1 – June 30, 2017. Close-ended structured questionnaires based on study objectives were used to collect data. Frequency and Percentages were used to analyse the profile of faculty members whereas weighted means from a four liker’s scale was used to interpret the extent of perceived quality of nursing education programme.
Results
Majority, 39% and 46% of faculty members had 1–5 years’ clinical experience and 6–10 years of teaching experience respectively. Study participants with a grand weighted mean of 3.84 out of 4.00 strongly agreed that quality of nursing education programme is synonyms with other universities in the world. Significant differences existed in the quality of mission/vision/goals/objectives (p-value = 0.008), curriculum and instruction (p-value = 0.038), administration of nursing programme (p-value = 0.025), faculty development programme (p-value = 0.003), physical structure and equipment (p-value = 0.016), student services (p-value = 0.017), admission of students (p-value = 0.010) and quality assurance system (p-value = 0.009) in relation to teaching experience of faculty members.
Conclusion
Faculty members strongly perceived nursing education programmes to be of good quality in this study. Teaching experience of instructors predicted significant differences in the quality of nursing education programme in all the quality matrix indicators. However, clinical experience and job category of faculty members rather showed that quality of nursing education is the same throughout all the higher educational institutions.
Triaged treatment-based conventional weapon combat wound classification code design and injury spectrum statistical analysis
Authors: PENG BO , Liu Shuo , Pan Fei , He Zhen , Li Tan-shi
Published: May 2020

Purpose
To provide evidence for the rapid and efficient classification of combat casualties while simultaneously determining the types of high-incidence fatal injuries that require emergency treatment to support the triage of combat wounds in mass casualty situations.
Methods
The three-tiered treatment echelon consisting of battlefield on-site first aid, emergency treatment, and early treatment was used to design an expanded combat wound classification code system according to the differential needs of combat wound treatment. Three dimensions of evaluation indicators consisting of likelihood, importance, and suitability were established and an optimized quasi-HHI index was used for the normalization and ranking of expert survey results.
Results
We obtained exhaustive combinations from the massive number of combat wound factors in combat wound classification codes, constructed injury spectrum frameworks within the different treatment echelons, and identified high-incidence fatal injuries in different treatment echelons.
Conclusions
Our combat wound classification codes achieved good results in terms of having higher classification speed and accuracy than traditional methods. The high incidence fatal injuries identified by the constructed combat wound spectrum can provide guidance and support when used for the improvement of treatment techniques and upgrading equipment in the Chinese People’s Liberation Army.
The association between family cohesion and disability following blunt trauma: Findings from a level-I trauma center in Saudi Arabia
Authors: Almarwani Sarah , Hijazi Leen , Alamer Modhi , Alnwaiser Jury , Aldakheel Reem , Alsheikh Khalid , Albabtin Ibrahim , Alghnam Suliman
Published: May 2020

Background
Injuries pose a significant burden on population health of Saudi Arabia. Even in nonfatal injuries, the burden varies from temporary to permanent disabilities. Health outcomes following injuries can vary, and predictors of recovery from disability are not well understood. In the Kingdom, family values and cohesion can differ from other countries due to several factors, including religious beliefs and cultural traditions. Learning about predictors of injury recovery can improve prevention as well as planning for rehabilitation programs. Therefore, the study aims to evaluate the association between family cohesion and recovery following blunt injuries.
Methods
This prospective study included 249 patients who were hospitalized for at least one day following blunt trauma in King Abdulaziz Medical City, Riyadh. Adult patients were interviewed twice: initially during admission, and a second interview via the phone three months after discharge. Baseline information included: demographics, injury characteristics, the five dimensions EQ-5D and family support scale. The follow-up interview captured only EQ-5D. Suboptimal family cohesion was defined as any issue with the relationship with parents, friends, spouse, or siblings. Any disability was defined as a reported limitation in one or more domains of the EQ-5D scale. Logistic regression was used to assess the association between family cohesion and recovery at three months.
Results
Of the overall sample, 169 (67.8%) responded to the second interview, and three patients passed away. About 95.2% of patients reported disabilities at baseline, while 88.1% continued to report disabilities after three months. Forty patients (16.1%) reported suboptimal family cohesion. Of these patients, 37(94.87%) were in pain, 33(82.5%) reported problems with usual activities, 32(80%) faced problems with self-care, 32 (80%) patients had difficulty in mobility, and 23(57.5%) were depressed. Multivariable regression suggested that patients with suboptimal family cohesion were less likely to recover from disabilities.
Conclusion
The prevalence of any disability three months after discharge is striking. This study suggests that health outcomes after blunt trauma are affected by the strength of the patient’s family cohesion. More research is needed to identify effective ways through which the provision of social support can reduce long term disability after trauma.
Effectiveness of switching between TNF inhibitors in patients with axial spondyloarthritis: is the reason to switch relevant?
Authors: Manica Santiago Rodrigues , Sepriano Alexandre , Pimentel-Santos Fernando M , Gouveia Nélia , Barcelos Anabela , Branco Jaime , Bernardes Miguel , Ferreira Raquel Miriam , Vieira-Sousa Elsa , Barreira Sofia , Vinagre Filipe , Roque Raquel , Santos Helena , Madeira Nathalie , Rovisco João , Daniel Alexandra , Ramiro Sofia
Published: May 2020

Background: To investigate whether the reason to discontinue the first TNF inhibitor (TNFi) affects the response to a second TNFi in axial spondyloartrhtis (axSpA).Methods: Patients with axSpA from the Rheumatic Diseases Portuguese Register (ReumaPt), who discontinued their first TNFi and started a second TNFi between June 2008 and May 2018 were included. Response was assessed by the Ankylosing Spondylitis Disease Activity Score (ASDAS) clinically important improvement (ASDAS-CII), major important improvement (ASDAS-MI), low disease activity (ASDAS-LDA) and inactive disease (ASDAS-ID). The reason for discontinuation of the first TNFi was defined, according to ASDAS-CII as: primary failure (no response ≤6 months); secondary failure (response ≤6 months but lost thereafter); adverse events; other. The association between the reason of discontinuation of the first TNFi and response to the second TNFi over time was assessed in multivariable generalized equation (GEE) models.Results: In total, 193 patients were included. The reason of discontinuation of the first TNFi did not influence the response to a second TNFi, according to the ASDAS-CII. However, a difference was found with more stringent outcomes, e.g. there was a higher likelihood to achieve ASDAS-ID with the second TNFi for patients discontinuing the first TNFi due to secondary failure (OR: 7.3 [(95%CI: 1.9; 27.7]), adverse events (OR: 9.1 [2.5; 33.3]), or other reasons (OR: 7.7 [1.6; 37.9]) compared to primary failure.Conclusion: Patients with axSpA with secondary failure to their first TNFi, compared to those with primary failure, have better response to the second TNFi according to stringent outcomes.
Cardiac rupture complicating acute myocardial infarction: the clinical features from an observational study and animal experiment
Authors: Lu Qun , Liu Ping , Huo Jian-Hua , Wang Yan-Ni , Ma Ai-Qun , Yuan Zu-Yi , Du Xiao-Jun , Bai Ling
Published: May 2020

Background.
Cardiac rupture (CR) is a fatal complication of ST-elevation myocardial infarction (STEMI) with its incidence markedly declined in the recent decades. However, clinical features of CR patients now and the effect of reperfusion therapy to CR remain unclear. We investigated the clinical features of CR in STEMI patients and the effect of reperfusion therapy to CR in mice.
Methods.
Two studies were conducted. In Study 1, Data of 1456 STEMI patients admitted to the First Hospital, Xi'an Jiaotong University during 2015.12.~2018.12. were analyzed. In Study 2, 83 male C57BL/6 mice were operated to MI, 39 mice were allocated for MI (group-1) and 21 mice for 1 h (group-2 ) and 23 mice for 4 h (group-3) ischemia followed by reperfusion. All operated mice were monitored up to day-10. Animals were inspected three times daily for the incidence of death and autopsy was done for all mice found died to determine the cause of death.
Results.
CR was diagnosed in 40 patients: free-wall rupture in 17, ventricular septal rupture in 20, and combined locations in 3 cases, present in 19 patients at admission and diagnosed in another 21 patients during 1 ~ 14 days post-STEMI, giving an in-hospital incidence of 1.4%. The mortality of CR patients was high during hospitalization accounting for 39% of total in-hospital death. By multivariate logistic regression analysis, older age, peak CK-MB and peak hs-CRP were independent predictors of CR post-STEMI. There were 17 deaths in group-1 during day 3–6 post MI. In the two IR groups, one mouse died of acute heart failure at day-5 post surgery and the rest of mice survived to the end of experiment without onset of rupture.
Conclusion.
CR remains as a major cause of in-hospital death in STEMI patients. CR Patients are characterized of being elderly, having larger infarct and more server inflammation. Reperfusion therapy can decrease CR incidence sharply.
Tibiotalocalcaneal arthrodesis in osteoarthritis deformation of ankle and subtalar joint – evaluation of treatment results
Authors: Stołtny Tomasz , Dugiełło Bogdan , Pasek Jarosław , Szyluk Karol , Pyda Michał , Spyrka Daniel , Białek Michał , Czuma Przemysław , Pijet Bartłomiej , Werner Krystian , Cieślar Grzegorz , Littner Roman , Pleva Leopold , Koczy Bogdan
Published: May 2020

Background
Tibiotalocalcaneal arthrodesis (TTCA) is an increasingly used method of stiffening the ankle and subtalar joints in advanced degenerative deformities.
Methods
The study group consisted of 19 men who were subjected to intramedullary and intra-osseous arthrodesis using an intramedullary nail. The average age of patients was 46 years (19–68). The main indication for surgical treatment was post-traumatic arthrosis 11 (58%). In the studied group of patients, clinical condition was assessed using the AOFAS classification, quality of life using the SF-12 scale, and assessment of pain intensity using the VAS scale. The above parameters were evaluated before surgery in the early (under 2 years), intermediate (from 2–5 years) and late (over 5 years) postoperative period.
Results
Analysis of the results showed that the assessed clinical condition on the AOFAS scale improved from an average of 20.6 points before TTCA to 63.5 points after the procedure. The result was statistically significant (p < 0.0001). Analyzing the results obtained using the SF-12 quality of life scale, a statistically significant increase was found. In the physical sphere of quality of life PCS-12 increased from 26.5 points to 44.2 points (p = 0.0004) and in the mental sphere of quality of life MCS-12 from 46.1 points to 52.6 points (p = 0.030). The intensity of pain ailments, assessed in the VAS scale, decreased in all three periods of postoperative observation (in the early period p < 0.05, in the intermediate period p = 0.23, and in the late period p < 0.05), with the strongest analgesic effect (reduction of pain intensity by 4.3 points on the VAS scale) was observed in the early post-operative follow-up period.
Conclusions
Tibiotalocalcaneal arthrodesis using an intramedullary nail causes a significant improvement in the clinical condition according to the AOFAS classification, enabling most patients to move independently, a significant improvement in the physical and mental quality of life assessed in the SF-12 scale and a significant reduction in the intensity of pain ailments assessed in the VAS scale, especially in the early postoperative period.
Human CD133-Positive Hematopoietic Progenitor Cells Enhance the Malignancy of Breast Cancer Cells
Authors: Zhang Zhe , Zheng Qinglian , Liu Yonghui , Sun LianQing , Han Pingping , Wang Rui , Zhao Jiao , Hu Shan , Zhao Xinhan
Published: May 2020

Background: Human CD133 + hematopoietic progenitor cells (HPCs) are a specific subset of cells and can regulate the malignancy of tumors. However, how CD133 + HPCs affect the malignancy of human breast cancer has not been clarified.Methods: The CD133 + HPCs were isolated and purified from human umbilical cord blood (UCB) .We used in vitro culture of the MCF-7 and MDA-MB-231 cell line, and MCF-7 and MDA-MB-231 cells into nude mice in order to tested whether CD133 + HPCs affected the apoptosis, proliferation, invasion and EMT of breast cancer cells.Results: Co-culture with CD133 + HPCs, but not UCB CD133- cells, promoted the proliferation of human breast cancer MCF-7 or MDA-MB-231 cells, accompanied by reducing their spontaneous apoptosis in vitro and co-administration with CD133 + HPCs significantly enhanced the growth of implanted breast cancer in vivo. Furthermore, co-culture with CD133 + HPCs, enhanced the invasion of breast cancer cells, N-cadherin and Vimentin expression, but reduced E-cadherin expression in Breast cancer cells.Conclusions: The data indicated that CD133 + HPCs enhanced the malignancy of breast cancer cells by inhibiting their spontaneous apoptosis and promoting the process of epithelial mesenchymal transition. These findings may provide new insights in the role of human CD133 + HPCs in the pathogenic process of breast cancer. Therefore, CD133 + HPCs may be a new therapeutic target for inhibiting the progression of breast cancer.
Oxidative stress mediates the apoptosis and epigenetic modification of the Bcl-2 promoter via DNMT1 in a cigarette smoke-induced emphysema model
Authors: Zeng Huihui , Li Tiao , He Xue , Cai Shan , Luo Hong , Chen Ping , Chen Yan
Published: May 2020

Background: Emphysema is a crucial pathological characteristic of chronic obstructive pulmonary disease (COPD). Oxidative stress, apoptosis and epigenetic mechanisms contribute to the pathogenesis of emphysema. However, an attempt to accurately identify whether these mechanisms interact with each other and how they are triggered has never been conducted. Method: The total reactive oxygen species (ROS) level, pulmonary apoptosis and B-cell lymphoma/ leukemia-2 (Bcl-2) expression, an apoptosis regulator, were detected in samples from COPD patients. Bisulfite sequencing PCR (BSP) was conducted to observe the alterations in the methylation of the Bcl-2 promoter in specimens. The dysregulation of DNA methyltransferase enzyme 1 (DNMT1), a vital DNA methyltransferase enzyme, in the lungs of patients was confirmed through western blotting. To find out interactions between oxidative stress and DNA methylation in emphysema, mouse models were built with antioxidant treatment and DNMT1 silencing, and were examined with the pulmonary apoptosis, Bcl-2 and DNMT1 expression, and epigenetic alterations of Bcl-2. Results: Higher reactive oxygen species (ROS) levels and pulmonary apoptosis were observed in COPD patients than in healthy controls. Downregulated Bcl-2 expression with increased promoter methylation and DNMT1 protein expression was found in COPD patients. Antioxidant treatment reduced the level of ROS and dysregulation of DNMT1 expression and emphysematous progression in the smoking models. Following DNMT1 blockage, smoking models showed improved lung function, pulmonary apoptosis, emphysematous progression, and increased Bcl-2 protein expression with less promoter methylation than emphysema mice.Conclusion: Cigarette-induced oxidative stress mediates pulmonary apoptosis and hypermethylation of the Bcl-2 promoter in emphysema models through DNMT1.
Effect of Post-Treatment Fluvastatin for Hemorrhagic Shock in Rats
Authors: Kim Oh Hyun , Kim Soo-Ki , Jung Soon-Hee , Hwang Sung Oh , Kim Hyun , Cha KyoungChul , Cha Yong Sung , An Gyo Jin , Lee Kang Hyun
Published: May 2020

Background

To investigate the biochemical, histologic, and immunologic effects of post-treatment use of fluvastatin in cases of hemorrhagic shock in a rat model.
Methods

Experimental rats were randomly divided into four groups: (1) the control group received no drugs and did not undergo hemorrhagic shock (HS); (2) the control + statin group received fluvastatin 1 mg/kg without HS; (3) the HS group received normal saline after HS; (4) the HS + statin group received fluvastatin 1 mg/kg + normal saline after HS. HS was induced by femoral arterial catheter blood extraction of 30% of the total blood volume. Mean arterial pressure and heart rate were monitored for 2 h after starting blood withdrawal. Arterial blood gas, complete blood count, and serum cytokine levels were measured at baseline, 2 hrs after HS, and 48 hrs after resuscitation. Kidney, lung, and small intestines were removed for pathological examination 48 h after HS.
Results

The HS and HS + statins groups showed reduced bicarbonate, base excess, and platelet counts, all of which differed significantly from values in the control and control + statin groups at the end of the resuscitation period. The HS + statin group exhibited significantly elevated serum IL-10 2 hrs after resuscitation compared with the control group (P < 0.05). Except for IL-10, the group-time interaction was not significant for other cytokine profiles.
Conclusion

This study demonstrated that post-treatment with fluvastatin increased anti-inflammatory cytokines IL-10 production and affected cytokine profiles in rats after HS.
Case report: Heart failure from thyrotoxicosis due to Grave’s disease
Authors: Aujayeb Avinash , Dundas James , Madathil Asgar
Published: May 2020

A 30-year-old female patient with a past medical history of pernicious anaemia presented with pleuritic chest pain, palpitations, fatigue, coryzal symptoms and a high temperature. She was hypoxic and tachycardic and was extensively investigated as well as aggressively treated. A type 1 ‘gut feeling’ assessment by the admitting medical registrar made the diagnosis possible as thyroid function tests were grossly deranged and pointed to Grave’s disease causing heart failure, complicated by pneumonia. The patient was discharged on carbimazole, antibiotics and beta blockers. She has now been swapped onto propylthiouracil and is under active follow up
Brain Dicer1 is down-regulated in a mouse model of Alzheimer’s disease via Aβ42-induced repression of nuclear factor erythroid 2-related factor 2
Authors: Wang Yan , Lian Meiling , Zhou Jing , wu shengzhou
Published: May 2020

Background Oxidative stress critically underlies the neurodegenerative pathogenesis of Alzheimer's disease (AD). Depletion of Dicer1, an endoribonuclease central to microRNA maturation, also leads to neurodegeneration. We therefore hypothesized that altered Dicer1 expression may play a role in AD. Results Using immunoblotting and quantitative real-time PCR, we found that Dicer1 protein and mRNA levels were reduced in the hippocampi of animals of the AD mouse model APPswe/PSEN1dE9 compared with littermate controls. SiRNA-meditated Dicer1 knockdown induced oxidative stress, reduced mitochondrial intermembrane potential, and increased apoptosis in cultured neurons. Aβ42 exposure decreased Dicer1 and also down-regulated the oxidative stress–induced transcriptional regulator nuclear factor erythroid 2-related factor 2 (Nrf2). Conversely, Nrf2 overexpression increased Dicer1 mRNA and protein levels and reverted the Aβ42-induced Dicer1 reduction. To further investigate Dicer1 regulation, we cloned Dicer1 promoter variants harboring the Nrf2-binding site, the antioxidant response elements (ARE), into a luciferase reporter and found that simultaneous transfection of Nrf2-expressing plasmid increased luciferase expression from these promoter constructs. ChIP assays indicated that Nrf2 directly interacted with the ARE motifs in the Dicer1 promoter. Furthermore, Dicer1 overexpression in cultured neurons reverted Aβ42-induced neurite deficits. Of note, injection of Dicer1-expressing adenovirus into the hippocampus of the AD mice significantly improved spatial learning. Conclusions These findings indicate that Dicer1 expression is reduced in the AD brain and that chronic Aβ exposure decreases Dicer1 levels in neurons via Nrf2–ARE signaling. Our results uncover a significant role for Dicer1 in AD and highlight that Dicer1 expression responds to oxidative stress in the brain.
Neural differentiation footprints of mesenchymal stem cell by fetal brain extract
Authors: Razeghian-Jahromi Iman , Mehrabani Davood , Mohammadi Ali , Seno Mohammad Mehdi Ghahremani , Zare Shahrokh , Zibaeenezhad Mohammad Javad , Mowla Ashkan
Published: May 2020

Background Stem cells has brought promising hope to improve impairment in different organs especially those with limited intrinsic regeneration capacity like nervous system. With the use of mesenchymal stem cells' (MSC) capacity to differentiate toward neural cells, this study aimed to examine the potential of fetal rat brain extract (FBE) as a biological inducer to mimic natural differentiation environment. Methods Bone marrow-MSCs were derived from Rattus norvegicus . After characterization of their mesenchymal nature, three groups were considered including control (culture medium only), differentiation (culture medium supplemented by basic fibroblast growth factor and epidermal growth factor), and treatment (culture medium and FBE). Growth curves as well as expression of glial fibrillary acidic protein (GFAP, marker for astroglial cells), galactocerebridase (GaLc, marker for oligodendrocyte and schwann cells), choline acetyl transferase (ChAT, marker for cholinergic neurons), and tyrosine hydroxylase (TH, marker of dopaminergic neurons) were examined in all the three groups at day 3 and 7 post-exposure. Also, nissl staining was performed in the three groups in order to assess protein synthesis and neurotransmitter production. Results Spindle-shaped cells were seen in the control group. There were neural-like cells in the differentiation group while more developed appearance with axon- and dendrite-like processes were present in the treatment group. To examine cell viability after exposure to FBE, growth curve was delineated. Higher proliferation rate and lower population doubling time were seen in the treatment group compared to other two groups. Regarding expression of neural markers, GaLC and ChAT at day 7 was prominent in the treatment group. Nissl bodies, which are rough endoplasmic reticulum, were seen only in the treatment group. Conclusions FBE might be a safer and more efficient inducer than combination of two well-known growth factors in terms of differentiation of MSCs to functional dopaminergic neurons. Making neural cells in vitro is an attractive approach in improvement of injured nervous system.
Road traffic noise, noise sensitivity, psychological and physical health and mortality
Authors: Stansfeld Stephen , Clark Charlotte , Smuk Melanie , Gallacher John , Babisch Wolfgang
Published: May 2020

Background:

Both physical and psychological health outcomes have been associated with exposure to environmental noise. It is not known whether all individuals are equally susceptible to these effects. Noise sensitivity has chiefly been examined in studies of annoyance where it has been shown to moderate the annoyance responses to transport-related noise. Noise sensitivity could have the same moderating effect on physical and psychological health outcomes related to environmental noise exposure but this has been little tested. Noise sensitivity which is also associated with sensitivity to chemicals, light and odours could be an indicator of a more pervasive susceptibility to ill-health related to environmental sources.
Methods:

A cohort of 2398 men between 45 and 59 years, the longitudinal Caerphilly Collaborative Heart Disease study, was established in 1984/88 and followed into the mid-1990 s. Road traffic noise maps were assessed at baseline. Baseline psychological ill-health measures were measured in phase 2 in 1984/88, at phase 3 follow up 1989/93 and phase 4 follow up in 1993/6.Ischaemic heart disease and risk factors were measured in clinic and by questionnaire at baseline and through hospital records and administrative records of deaths during follow up. This study aimed to test if noise sensitivity has a moderating effect on road traffic noise and psychological ill-health and secondly if noise sensitivity predicted physical and psychological ill- health and mortality, irrespective of exposure to road traffic noise.
Results:

Road traffic noise was associated with Phase 4 psychological ill-health but only among those exposed to 56-60dBA (OR = 1.98 95%CI 1.21, 3.24). High noise sensitivity was associated with lower mortality risk (HR = 0.71, 95%CI 0.54–0.94). High noise sensitivity was associated longitudinally with psychological ill-health at phase 3 (OR = 1.82 95%CI1.30, 2.56). There was also weak evidence that noise sensitivity moderated the association of road traffic noise exposure with psychological ill-health.
Conclusions:

Noise sensitivity is a specific predictor of psychological ill-health and may be an indicator of current psychological ill-health as part of a wider construct of environmental susceptibility. It may increase the risk of psychological ill-health when exposed to road traffic noise.
Effect of lead exposure from electronic waste on haemoglobin synthesis in children
Authors: Wang Hongwu , Huang Peng , Zhang Ruibiao , Feng Xueyong , Tang Qiulin , Liu Sixi , Wen Feiqiu , Zeng Li , Liu Yufeng , Wang Tianyou , Ma Lian
Published: May 2020

Background
Primitive electronic waste (e-waste) recycling is ongoing in Guiyu, so toxic heavy metals may continue to threaten the health of children in the area.
Objective
This study aimed to evaluate the effect of e-waste exposure on haemoglobin (Hb) synthesis in preschool children.
Methods
Medical exams were conducted with the consent of children’s guardians and the approval of the Shantou University Medical College Ethics Committee. This study recruited 224 and 204 children in 3–6 years old from Guiyu (exposed group) and from a town without e-waste pollution (control group), respectively. Blood levels of lead, Hb, ferritin, folate and vitamin B12 were tested in all children. Furthermore, all children were assessed for thalassemia, and their parents were asked to complete questionnaires.
Results
There was no significant differences in ferritin, folate, or vitamin B12 levels between the exposed and control groups (P > 0.05). All children were excluded thalassemia. Blood lead level (BLL) and the rate of children with BLL ≥ 10 µg/dL were higher in the exposed group than control group (both P < 0.01). Both groups were further divided into three sub-groups according to BLL (Group A: <5.0 µg/dL; Group B: 5.0–9.9 µg/dL; Group C: ≥10.0 µg/dL). Hb levels were negatively correlated with BLL in exposed group (F = 3.52, P = 0.03), but not in control group (F = 1.98, P = 0.14). Hb levels in group B and group C were significantly lower in exposed group than in control group (Group B, P = 0.01; Group C, P = 0.03). In addition, the prevalence of anaemia in children with lead poisoning in exposed group were significantly higher than those in control group (4.0% versus 0.5%, P < 0.05). The prevalence of anaemia in children without lead poisoning and without iron deficiency in exposed group were also higher than those in control group (6.5% versus 2.0%, P < 0.05).
Conclusion
Lead exposure significantly inhibits Hb synthesis in children living in e-waste dismantling areas compared to those living in non-e-waste dismantling areas. Other toxins released from e-waste may also contribute to the inhibition of Hb synthesis and may lead to anaemia in local children. Further investigations are needed to provide evidence for the development of relevant protective measures.
Meta-Analysis of Association between CT-baesd Features and Tumor Spread Through Air Spaces in Lung Adenocarcinoma
Authors: Yin Qifan , Wang Huien , Cui Hongshang , Wang Wenhao , Yang Guang , Qie Peng , Xun Xuejiao , Han Shaohui , Liu Huining
Published: May 2020

Objective
Spread through air space (STAS) is a novel invasive pattern of lung adenocarcinoma and is also a risk factor for recurrence and worse prognosis of lung adenocarcinoma after sublobar resection. The aims of this study are to evaluate the association between computed tomography (CT)-based features and STAS for preoperative prediction of STAS in lung adenocarcinoma, eventually, which could help us choose appropriate surgical type.
Methods
Systematic research was conducted to search for studies published before September 1, 2019. The association between CT-baesd features of radiological tumor size༞2cm、pure solid nodule、 part-solid nodule or Percentage of solid component(PSC)༞50% and STAS was evaluated. According to rigorous inclusion and exclusion criteria. Eight studies including 2,385 patients published between 2015 and 2018 were finally enrolled in our meta-analysis.
Results
Our results clearly depicted that there is no significant relationship between radiological tumor size༞2 cm and STAS with the combined OR of 1.47(95% CI:0.86–2.51). Meta-analysis of 3 studies showed that pure solid nodule in CT image were more likely to spread through air spaces with pooled OR of 3.10(95%CI2.17-4.43). Meta-analysis of 5 studies revealed the part-solid nodule in CT image may be more likely to appear STAS in adenocarcinoma (ADC) (combined OR:3.10,95%CI:2.17–4.43). PSC༞50% in CT image was a significant independent predictor in the diagnosis of STAS in ADC from our meta-analysis with combined OR of 2.95(95%CI:1.88–4.63).
Conclusion
In conclusion, The CT-based features of pure solid nodule、part-solid nodule、PSC༞50% are promising imaging biomarker for predicting STAS in ADC and may substantially influence the choice of surgical type. In future, more studies with well-designed and large-scale are needed to confirm the conclusion.