bluuebunny/crossref_metadata_2025 huggingface dataset:
Research capacity of Australian and New Zealand emergency medicine departments
Authors:   on behalf of the ACEM Clinical Trials Network, Walker Katie , Tan Shijie Ian , Fatovich Daniel , Watkins Gina , Stephenson Melanie , Ting Joseph , Whittome Richard , Wang Wei , Knott Jonathan
Published: April 2020

Background

Large, multicentre studies are required in emergency medicine to advance clinical care and improve patient outcomes. The Australasian College for Emergency Medicine clinical trials network is available to researchers to assist with facilitating large, multicentre research. However, there is no current information about the research capacity of emergency departments (EDs) in Australia and New Zealand.

Methods

All EDs accredited for emergency medicine training in Australia and New Zealand were eligible to participate. Research leads or ED directors were invited via email and telephone to complete a survey. Data were collected regarding the presence of a research lead; their research experience; available research resources including colleagues, funding, departmental paid research time; publications; and research culture.

Results

One hundred and twelve responses were received on behalf of 122 (84%) sites (10 satellite plus main) from a possible 143 sites with all types of hospitals and regions represented. Research leads were identified at 66 (59%) sites; 32 (29%) had a director of emergency medicine research. A wide range of research was underway. Ninety-six sites (66%) contributed data to multicentre projects. Twenty-one centres (17%) were highly productive with multiple resources (skilled colleagues, funding, staffing), a positive research culture and high-volume output. Sixty to seventy centres (50–58%) had limited resources, experienced an unsupportive research culture and authored manuscripts infrequently. Paid time for research directors was associated with increased research outputs.

Discussion

ACEM sites have the capacity to undertake large multicentre studies with a varied network of sites and researchers. While some sites are well equipped for research, the majority of EDs had minimal research output.
Enabling a green just-in-time navigation through stakeholder collaboration
Authors: Arjona Aroca Jordi , Giménez Maldonado José Andrés , Ferrús Clari Gabriel , Alonso i García Nuria , Calabria Lucía , Lara Jorge
Published: April 2020

Background

The shipping industry has grown spectacularly during the last 50 years transporting nowadays, approximately, the 80–90% of goods worldwide. However, maritime transport remains a highly inefficient industry. Only in the last 10–15 years has the industry started studying how to optimize navigation speeds and digitization is just entering ports. Consequently, institutions like the International Maritime Organization (IMO) are pressing towards the adoption of measures that increase the industry efficiency, like Just-In-Time (JIT) operations.

Methods and Results

This paper shows why the Sea Traffic Management (STM) concept, based on stakeholder collaboration, is a JIT enabler. To do so, we analyze 1 year of navigation data of 33 ships, estimating the impact of JIT barriers on shipping and showing the benefits that the adoption of STM, with different maturity levels, could provide to the industry. Our evaluation shows that, only for containerships, STM can help reducing by 15–23% of fuel consumption and GHG emissions.
Origin-dependence of variation in seed morphology, mineral composition and germination percentage in Gynandropsis gynandra (L.) Briq. accessions from Africa and Asia
Authors: Blalogoe Jelila S. , Odindo Alfred O. , Sogbohossou E. O. Dêêdi , Sibiya Julia , Achigan-Dako Enoch G.
Published: April 2020

Background

Spider plant [Gynandropsis gynandra(L.) Briq.], an economically promising African leafy vegetable, characterized for leaf yield components and nutritive quality, exhibits poor seed germination that hinders a wider expansion of the crop in urban and periurban horticultural systems. So far, there is little information pertaining to seed morphological traits and mineral elements content that may be associated with higher seed germination. This research investigated the hypothesis that spider plants from different geographical areas exhibited differences in seed mineral composition, morphological traits, and germination capacity. To this end, twenty-nine accessions ofGynandropsis gynandrafrom West and East-Southern Africa, and Asia were screened for variation in seed size (area, perimeter, length, width), 10-seed weight, mean germination time, germination percentage and mineral content variations. The scanning electron microscopy (SEM), light microscopy and energy dispersive spectroscopy (EDS) solution were used to study seed morphology and mineral composition.

Results

We show for the first time the external and internal structure of the seeds ofGynandropsis gynandraand measured eight mineral elements, including carbon (C), oxygen (O), magnesium (Mg), aluminium (Al), phosphorus (P), sulphur (S), potassium (K) and calcium (Ca). The accessions differed significantly (p < 0.001) with respect to seed size (area, perimeter, length, width), 10-seed weight, mean germination time and germination percentage. The hierarchical cluster analysis based on fourteen variables grouped the accessions into three distinct clusters, partially dependent on their geographical origin. Asian accessions exhibited smaller seeds and recorded higher values in terms of germination percentage. West African accessions had bigger seeds but with lower germination percentage. Variation in minerals such as potassium, carbon, and calcium content showed different patterns according to geographical origins.

Conclusion

Smaller seeds inG. gynandraexhibited better germination capacity. The Asian germplasm is a potential source of cultivars with a higher germination percentage for improving seed quality in the species.
Congenital chloride diarrhea and Pendred syndrome: case report of siblings with two rare recessive disorders of SLC26 family genes
Authors: Lindberg Eva , Moller Claes , Kere Juha , Wedenoja Satu , Anderzén-Carlsson Agneta
Published: April 2020

Background

Congenital chloride diarrhea (CLD; OMIM 214700) is a rare autosomal recessive disorder caused by pathogenic variations in the solute carrier family 26 member A3 (SLC26A3) gene. Without salt substitution, this chronic diarrheal disorder causes severe dehydration and electrolyte disturbances. Homozygous variants in the nearby gene SLC26A4 disrupt anion exchange in the inner ear and the thyroid, causing Pendred syndrome (PDS; OMIM 274600), which is the most frequent form of syndromic deafness.

Case presentation

We report an unusual co-occurrence of two rare homozygous mutations in both the SLC26A3 and SLC26A4 genes, causing a rare combination of both CLD and PDS in two siblings. Although the clinical pictures were typical, the combined loss of these anion transporters might modulate the risk of renal injury associated with CLD.

Conclusions

Familial presentation of two rare autosomal recessive disorders with loss of function of different SLC26 anion transporters is described. Independent homozygous variants in the SLC26A3 and SLC26A4 genes cause CLD and PDS in siblings, shedding light on co-occurrence of rare recessive traits in the progeny of consanguineous couples.
INHBA is a prognostic predictor for patients with colon adenocarcinoma
Authors: Li Xueying , Yu Weiming , Liang Chao , Xu Yuan , Zhang Miaozun , Ding Xiaoyun , Cai Xianlei
Published: April 2020

Background

Colon adenocarcinoma (COAD) is one of the most lethal cancers. It is particularly important to accurately predict prognosis and to provide individualized treatment. Several lines of evidence suggest that genetic factors and clinicopathological characteristics are related to cancer onset and progression. The aim of this study was to identify potential prognostic genes and to develop a nomogram to predict survival and recurrence of COAD.

Methods

To identify potential prognostic genes in COAD, microarray datasets were downloaded from the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) were obtained from GEO2R. Venn diagram was drawn to select those genes that were overexpressed in all datasets, and survival analyses were performed to determine the prognostic values of the selected genes. New nomograms were developed based on the genes that were significantly associated with prognosis. Clinicopathological data were obtained from The Cancer Genome Atlas (TCGA). Finally, the new nomograms were compared head-to-head comparison with the TNM nomogram.

Results

From GSE21510, GSE110223, GSE113513 and GSE110224, a total of 834, 218, 236 and 613 overexpressed DEGs were screened out, respectively. The Venn diagram revealed that 12 genes appeared in all four profiles. After survival analyses, only INHBA expression was associated with both overall survival (OS) and disease-free survival (DFS). Multivariate analyses revealed that age, pathological N and pathological M were significant independent risk factors for OS. Age, pathological N, pathological M and INHBA were significant independent risk factors for DFS. Two prediction models predicted the probability of 3-year survival and 5-year survival for OS and DFS, respectively. The concordance indexes were 0.785 for 3-year overall survival, 0.759 for 5-year overall survival, 0.789 for 3-year disease-free survival and 0.757 for 5-year disease-free survival. The head-to-head comparison according to time-dependent ROC curves indicated that the new models had higher predictive accuracy. Decision curve analyses (DCA) indicated that the clinical value of the new models were higher than TNM models for predicting disease-free survival.

Conclusion

The combination of INHBA expression with a clinical nomogram improves prognostic power in colon adenocarcinoma, especially for predicting recurrence.
Deconvolution of diffuse gastric cancer and the suppression of CD34 on the BALB/c nude mice model
Authors: Yoon Seon-Jin , Park Jungmin , Shin Youngmin , Choi Yuna , Park Sahng Wook , Kang Seok-Gu , Son Hye Young , Huh Yong-Min
Published: April 2020

Background

Gastric cancer is a considerable burden for worldwide patients. And diffuse gastric cancer is the most insidious subgroup with poor survival. The phenotypic characterization of the diffuse gastric cancer cell line can be useful for gastric cancer researchers. In this article, we aimed to characterize the diffuse gastric cancer cells with MRI and transcriptomic data. We hypothesized that gene expression pattern is associated with the phenotype of the cells and that the heterogeneous enhancement pattern and the high tumorigenicity of SNU484 can be modulated by the perturbation of the highly expressed gene.

Methods

We evaluated the 9.4 T magnetic resonance imaging and transcriptomic data of the orthotopic mice models from diffuse gastric cancer cells such as SNU484, Hs746T, SNU668, and KATO III. We included MKN74 as an intestinal cancer control cell. After comprehensive analysis integrating MRI and transcriptomic data, we selected CD34 and validated the effect by shRNA in the BALB/c nude mice models.

Results

SNU484, SNU668, Hs746T, and MKN74 formed orthotopic tumors by the 5 weeks after cell injection. The diffuse phenotype was found in the SNU484 and Hs746T. SNU484 was the only tumor showing the heterogeneous enhancement pattern on T2 images with a high level of CD34 expression. Knockdown of CD34 decreased the round-void shape in the H&E staining (P = 0.028), the heterogeneous T2 enhancement, and orthotopic tumorigenicity (100% vs 66.7%). The RNAseq showed that the suppressed CD34 is associated with the downregulated gene-sets of the extracellular matrix remodeling.

Conclusion

Suppression of CD34 in the human-originated gastric cancer cell suggests that it is important for the round-void histologic shape, heterogeneous enhancement pattern on MRI, and the growth of gastric cancer cell line.
Axial length change and its relationship with baseline choroidal thickness – a five-year longitudinal study in Danish adolescents: the CCC2000 eye study
Authors: Hansen Mathias Hvidtfelt , Kessel Line , Li Xiao Qiang , Skovgaard Anne Mette , Larsen Michael , Munch Inger Christine
Published: April 2020

Background

Myopic eyes are longer than nonmyopic eyes and have thinner choroids. The purpose of present study was to investigate whether a thinner subfoveal choroid at 11 years of age predicted axial eye elongation and myopia during adolescence.

Methods

Longitudinal, population-based observational study. Axial length was measured using an interferometric device and choroidal thickness was measured by spectral-domain optical coherence tomography. Myopia was defined as non-cycloplegic subjective spherical equivalent refraction ≤ − 0.50 diopters.

Results

Right eyes of 714 children (317 boys) were examined at age (median (IQR)) 11.5 (0.6) years and 16.6 (0.3) years during which axial length (median (IQR)) increased by 243 (202) μm in eyes without myopia (n = 630) at baseline compared with 454 (549) μm in eyes with myopia (n = 84) at baseline, p < 0.0001. A thicker baseline subfoveal choroid was associated with increased five-year axial elongation after adjustment for baseline axial length in nonmyopic eyes (β = 27 μm/100 μm, 95%CI 6 to 48, p = 0.011) but not in myopic eyes (p = 0.34). Subfoveal choroidal thickness at 11 years of age did not predict incident myopia at 16 years of age (p = 0.11). Longer baseline axial length was associated with greater five-year axial elongation in both myopic (β = 196 μm/mm, 95%CI 127 to 265, p < 0.0001) and nonmyopic eyes (β = 28 μm/mm, 95%CI 7 to 49, p = 0.0085) and the odds for incident myopia increased with 1.57 (95%CI 1.18 to 2.09, p = 0.0020) per mm longer axial length at baseline.

Conclusion

A thin subfoveal choroid at age 11 years did not predict axial eye elongation and incident myopia from age 11 to 16 years. A longer eye at age 11 years was associated with greater subsequent axial eye elongation and with increased risk of incident myopia at age 16 years.
Comparison of facilitated tucking and oral dextrose in reducing the pain of heel stick in preterm infants: a randomized clinical trial
Authors: Ranjbar Athareh , Bernstein Colleen , Shariat Mamak , Ranjbar Hadi
Published: April 2020

Background

With the increase in hospitalization of premature infants in emergency departments and the painful procedure in these sectors, appropriate methods of pain relief are required. This study aimed to compare the effect of oral dextrose and facilitated tucking in the reduction of pain during heel sticks in premature infants and assess their effectiveness and feasibility for use in emergency settings.

Methods

This study was a randomized controlled clinical trial with cross-over design. Sixty infants were recruited from a Neonatal Intensive Care Unit (NICU) at Valiasr hospital in Tehran, Iran from March 2015 to September 2016. They were randomly allocated into three groups (no pain relief method, oral dextrose and facilitated tucking). Six blood samples were collected by heel stick for each infant. Oral dextrose and facilitated tucking were compared with the routine method of blood sampling and pain was measured two times for each method. The pain scores was measured by the Premature Infant Pain Profile (PIPP). Repeated Measure ANOVA, ANOVA and Scheffe post-hoc test were used with SPSS 16.

Results

The pain score’s increase during heel stick was significantly lower after using oral dextrose (3.58 ± 0.34) and facilitated tucking (5.58 ± 0.53) in comparison to the routine method (8.91 ± 0.18) of blood sampling (P < 0.001, η2 = 0.971). Oral dextrose was more effective than facilitated tucking (P < 0.001, Cohen’s d = 4.49). The emergency nurses rated oral dextrose as easier (t = 2.20, df = 118, p = 0.02, Cohen’s d = 0.39) and more applicable method (t = 2.99, df = 118, p = 0.003, Cohen’s d = 0.54) for the emergency department.

Conclusions

Facilitated tucking is an effective method of pain reduction which can be used in the absence of oral dextrose, in a situation in which it is contraindicated or in combination with oral dextrose. Based on the increase of infant’s admission in emergency department future studies are needed to identify the best method of pain reduction for procedures in this setting.

Trial registration

Current Controlled Trials IRCT201408029568N9, 2014-09-08.
Non-contact monitoring of agitation and use of a sheltering device in patients with dementia in emergency departments: a feasibility study
Authors: Kroll Lisa , Böhning Nikolaus , Müßigbrodt Heidi , Stahl Maria , Halkin Pavel , Liehr Birgit , Grunow Christine , Kujumdshieva-Böhning Borjana , Freise Christian , Hopfenmüller Werner , Friesdorf Wolfgang , Jockers-Scherübl Maria , Somasundaram Rajan
Published: April 2020

Background

Agitation is common in geriatric patients with cognitive impairment, e.g. in persons with dementia (PWD), who are admitted to an emergency department (ED). It might be a first sign of upcoming delirium and is associated with a higher risk of an unfavorable clinical course. Hence, monitoring of vital signs and enhanced movement as indicators of upcoming agitation is essential in these patients during their stay in the ED. Since PWD rarely tolerate fixed monitoring devices, a novel developed non-contact monitoring system (NCMSys) might represent an appropriate alternative.

Aim of this feasibility study was to test the validity of a NCMSys and of the tent-like “Charité Dome” (ChD), aimed to shelter PWD from the busy ED environment. Furthermore, effects of the ChD on wellbeing and agitation of PWD were investigated.

Methods

Both devices were attached to patient’s bed. Tests on technical validity and safety issues of NCMSys and ChD were performed at the iDoc institute with six healthy volunteers. A feasibility study evaluating the reliability of the NCMSys with and without the ChD was performed in the real-life setting of an ED and on a geriatric-gerontopsychiatric ward. 19 patients were included, ten males and nine females; mean age: 77.4 (55–93) years of which 14 were PWD. PWD inclusion criteria were age ≥ 55 years, a dementia diagnosis and a written consent (by patients or by a custodian). Exclusion criteria were acute life-threatening situations and a missing consent.

Results

Measurements of heart rate, changes in movement and sound emissions by the NCMSys were valid, whereas patient movements affected respiratory rate measurements. The ChD did not impact patients’ vital signs or movements in our study setting. However, 53% of the PWD (7/13) and most of the patients without dementia (4/5) benefited from its use regarding their agitation and overall wellbeing.

Conclusions

The results of this feasibility study encourage a future controlled clinical trial in geriatric ED patients, including PWD, to further evaluate if our concept of non-contact measurement of vital signs and movement combined with the “Charité Dome” helps to prevent upcoming agitation in this vulnerable patient group in the ED.

Trial registration

ICTRP: “Charité-Dome-Study - DRKS00014737” (retrospectively registered).
Subjective social status is an important determinant of perceived stress among adolescents: a cross-sectional study
Authors: Steen Pernille Bach , Poulsen Per Høgh , Andersen Johan Hviid , Biering Karin
Published: April 2020

Background

Stress is an increasing public health problem, and the association between stress and subjective social status (SSS) among adolescents has received little attention. SSS in society have shown to be associated with perceived stress, but the association between SSS in school and stress has never been examined. The aim of this study was to explore the association between SSS and perceived stress in Danish adolescent boys and girls.

Methods

Data was collected in 2017 in frame of The Danish Occupation of Children and Adolescents Cohort (FOCA cohort), where Danish 9th graders (age 15/16) from 1746 schools participated in a survey (4527 girls, 3654 boys, aged 15 to 16 years). SSS in society and SSS in school were the exposure variables, and the level of perceived stress was the outcome variable. Associations between SSS in school and in society separately with perceived stress was analysed using linear regression models stratified by gender and adjusted to social and health-related factors (e.g. neighbourhood safety, home characteristics, grade meaning, homework load, self-rated health, smoking, alcohol consumption).

Results

The mean overall PSS score was 14.7; for girls the score was 16.3, and for boys it was 12.6. The analyses revealed a strong linear association between SSS, in both society and school, and perceived stress. The lower the SSS, the higher perceived stress. The associations were the same for both genders, but girls reported a higher level of stress than did boys.

Conclusion

We found that girls reported a higher level of perceived stress than boys. Furthermore, we found a strong association between low SSS in society and especially SSS in school and a high level of perceived stress among Danish adolescents.
Knowledge of and attitudes towards erosive tooth wear among students of two Chinese universities
Authors: Hong Deng-wei , Lin Xiu-jiao , Wiegand Annette , Yu Hao
Published: April 2020

Background

To assess the knowledge of and attitudes towards erosive tooth wear among dental, medical, and non-medical university students of two Chinese universities.

Methods

A questionnaire containing 15 questions on knowledge of erosive tooth wear and 10 questions on attitudes towards erosive tooth wear was designed, and its psychometric properties (reliability and validity) were analysed in a pilot study (n = 120 students). The following 3 groups of university students (n = 635) were recruited based on a convenience sampling technique and were distributed the questionnaire via an online survey system: dental students (DSs), medical students (MSs), and non-medical students (NSs). Differences in the scores between groups and genders were analysed by one-way analysis of variance (ANOVA). The Pearson correlation coefficient was used to determine the association between the knowledge and attitude scores (P < 0.05).

Results

The questionnaire was found to be reliable, valid and reproducible. A total of 435 students participated in this study (response rate: 69.6%). The knowledge score of the DSs (11.5 ± 3.4) was significantly higher than those of the NSs (5.5 ± 4.0) and MSs (6.1 ± 4.0) (P < 0.001). The attitude score of the DSs (45.2 ± 6.5) was significantly higher than those of the NSs (41.1 ± 6.9) and MSs (41.8 ± 6.4) (P < 0.001). The majority of DSs expressed attitudes that were more accurate and positive than those expressed by the other 2 groups. The attitude score was positively correlated with the knowledge score (r = 0.237, P < 0.001).

Conclusions

Dental students had more accurate knowledge of and more positive attitudes towards erosive tooth wear than medical and non-medical students. In this population, a positive correlation was established between knowledge of and attitudes towards erosive tooth wear.
Changes in individual and contextual socio-economic level influence on reproductive behavior in Spanish women in the MCC-Spain study
Authors: Gómez-Acebo Inés , Dierssen-Sotos Trinidad , Palazuelos Camilo , Castaño-Vinyals Gemma , Pérez-Gómez Beatriz , Amiano Pilar , Fernández-Villa Tania , Ardanaz Eva , Suarez-Calleja Claudia , Alguacil Juan , Molina-Barceló Ana , Jiménez-Moleón José J. , Molero Jessica Alonso , Roca-Barceló Aina , Chirlaque María-Dolores , Vázquez José Pedro Fernández , Molinuevo Amaia , Aragonés Nuria , Serra Maria Sala , Binefa Gemma , Moreno Victor , Pollán Marina , Kogevinas Manolis , Llorca Javier
Published: April 2020

Background

The association between socioeconomic level and reproductive factors has been widely studied. For example, it is well known that women with lower socioeconomic status (SES) tend to have more children, the age at first-born being earlier. However, less is known about to what extent the great socioeconomic changes occurred in a country (Spain) could modify women reproductive factors. The main purpose of this article is to analyze the influence of individual and contextual socioeconomic levels on reproductive factors in Spanish women, and to explore whether this influence has changed over the last decades.

Methods

We performed a cross-sectional design using data from 2038 women recruited as population-based controls in an MCC-Spain case-control study.

Results

Higher parent’s economic level, education level, occupational level and lower urban vulnerability were associated with higher age at first delivery and lower number of pregnancies. These associations were stronger for women born after 1950: women with unfinished primary education had their first delivery 6 years before women with high education if they were born after 1950 (23.4 vs. 29.8 years) but only 3 years before if they were born before 1950 (25.7 vs. 28.0 years). For women born after 1950, the number of pregnancies dropped from 2.1 (unfinished primary school) to 1.7 (high education), whereas it remained almost unchanged in women born before 1950.

Conclusions

Reproductive behavior was associated with both individual and area-level socio-economic indicators. Such association was stronger for women born after 1950 regarding age at first delivery and number of pregnancies and for women born before 1950 regarding consumption of hormonal contraceptives or postmenopausal therapy.
Who should decide for local health services? A mixed methods study of preferences for decision-making in the decentralized Philippine health system
Authors: Liwanag Harvy Joy , Wyss Kaspar
Published: April 2020

Background

The Philippines decentralized government health services through devolution to local governments in 1992. Over the years, opinions varied on the impact of devolved governance to decision-making for local health services. The objective of this study was to analyze decision-makers’ perspectives on who should be making decisions for local health services and on their preferred structure of health service governance should they be able to change the situation.

Methods

We employed a mixed methods approach that included an online survey in one region and in-depth interviews with purposively-selected decision-makers in the Philippine health system. Study participants were asked about their perspectives on decision-making in the functions of planning, health financing, resource management, human resources for health, health service delivery, and data management and monitoring. Analysis of survey results through visualization of data on charts was complemented by the themes that emerged from the qualitative analysis of in-depth interviews based on the Framework Method.

Results

We received 24 online survey responses and interviewed 27 other decision-makers. Survey respondents expressed a preference to shift decision-making away from the local politician in favor of the local health officer in five functions. Most survey participants also preferred re-centralization. Analysis of the interviews suggested that the preferences expressed were likely driven by an expectation that re-centralization would provide a solution to the perceived politicization in decision-making and the reliance of local governments on central support.

Conclusions

Rather than re-centralize the health system, one policy option for consideration for the Philippines would be to maintain devolution but with a revitalized role for the central level to maintain oversight over local governments and regulate their decision-making for the functions. Decentralization, whether in the Philippines or elsewhere, must not only transfer decision-making responsibility to local levels but also ensure that those granted with the decision space could perform decision-making with adequate capacities and could grasp the importance of health services.
Managerial competences in public organisations: the healthcare professionals’ perspective
Authors: Fanelli Simone , Lanza Gianluca , Enna Cristiana , Zangrandi Antonello
Published: April 2020

Background

Human resources play a critical role in encouraging efficient performance within organisations, especially for public healthcare organisations, where competences of staff are key aspects of the quality of services provided. In this context, the enhancement of competences are strategic objectives for Human Resources Management (HRM) in order to achieve excellent and lasting results. However, competences of healthcare professionals are both clinical and managerial. This study identifies specific managerial competences perceived as crucial by healthcare professionals in order to improve their performance and develop suitable HRM practices.

Methods

The research methodology was divided into three main phases using mixed methods, commencing with literature review to identify the initial framework about managerial competences. Focus groups were then used to discuss evidence from the literature. Feedback from focus groups was used to draft the final questionnaire. Finally, the answers to the questionnaire were analysed through statistical software.

Results

The results show that managers and professionals share a view of what specific managerial competences for healthcare organisations should be. Main competences are: quality evaluation based on outcomes; enhancement of professional competences; programming based on process management; project cost assessment; informal communication style; and participatory leadership.

Conclusions

Although the issue of managerial skills in healthcare is widely discussed in literature, findings are often fragmentary. Our work includes a systematic literature review useful for more empirical studies. Furthermore, our results can support public managers who want to set up positive HRM practices for healthcare professionals.
Multiple links between 5-methylcytosine content of mRNA and translation
Authors: Schumann Ulrike , Zhang He-Na , Sibbritt Tennille , Pan Anyu , Horvath Attila , Gross Simon , Clark Susan J. , Yang Li , Preiss Thomas
Published: April 2020

Background

5-Methylcytosine (m5C) is a prevalent base modification in tRNA and rRNA but it also occurs more broadly in the transcriptome, including in mRNA, where it serves incompletely understood molecular functions. In pursuit of potential links of m5C with mRNA translation, we performed polysome profiling of human HeLa cell lysates and subjected RNA from resultant fractions to efficient bisulfite conversion followed by RNA sequencing (bsRNA-seq). Bioinformatic filters for rigorous site calling were devised to reduce technical noise.

Results

We obtained ~ 1000 candidate m5C sites in the wider transcriptome, most of which were found in mRNA. Multiple novel sites were validated by amplicon-specific bsRNA-seq in independent samples of either human HeLa, LNCaP and PrEC cells. Furthermore, RNAi-mediated depletion of either the NSUN2 or TRDMT1 m5C:RNA methyltransferases showed a clear dependence on NSUN2 for the majority of tested sites in both mRNAs and noncoding RNAs. Candidate m5C sites in mRNAs are enriched in 5′UTRs and near start codons and are embedded in a local context reminiscent of the NSUN2-dependent m5C sites found in the variable loop of tRNA. Analysing mRNA sites across the polysome profile revealed that modification levels, at bulk and for many individual sites, were inversely correlated with ribosome association.

Conclusions

Our findings emphasise the major role of NSUN2 in placing the m5C mark transcriptome-wide. We further present evidence that substantiates a functional interdependence of cytosine methylation level with mRNA translation. Additionally, we identify several compelling candidate sites for future mechanistic analysis.
Clinical evaluation of modified invaginated pancreaticojejunostomy for pancreaticoduodenectomy
Authors: Wang Dong , Liu Xiao , Wu Hongwei , Liu Kun , Zhou Xiaona , Liu Jun , Guo Wei , Zhang Zhongtao
Published: April 2020

Background

Pancreaticoduodenectomy (PD) remains the major curative operation for malignant neoplasm of pancreas or cancerous tumors near the pancreas. Despite advancements in recent years, the postoperative recurrence rate of these neoplasms and tumors remains high. Moreover, overall morbidity remains high due to clinically relevant postoperative pancreatic fistula (POPF).

Methods

To compare the clinical outcomes of modified invaginated anastomosis and mucosa-to-mucosa anastomosis, this retrospective study included 343 patients who underwent PD from January 2008 to January 2019 at Beijing Friendship Hospital, Capital Medical University. The patients’ general conditions and disease status were preoperatively evaluated. The surgical procedure was recorded, and operative management was appropriately performed.

Results

Compared with mucosa-to-mucosa anastomosis, modified invaginated anastomosis resulted in a higher intraoperative blood transfusion rate (P < 0.001) and lower hospitalization expenses (P = 0.049). However, no significant differences were found in operation time (P = 0.790), intraoperative bleeding (P = 0.428), postoperative recovery exhaust time (P = 0.442), time to normal flow of food (P = 0.163), and hospitalization time (P = 0.567). Operation time was a risk factor for POPF (odds ratio 1.010; 95% confidence interval 1.003–1.016; P = 0.003). The incidence of pancreatic fistula (grades B and C) was lower in the patients who underwent modified invaginated anastomosis (14.1%) than in those who underwent mucosa-to-mucosa anastomosis (15.3%). The operation time was greater in the POPF group than in the non POPF group among the patients who received modified invaginated anastomosis (P = 0.003) and mucosa-to-mucosa anastomosis (P = 0.002).

Conclusion

Modified invaginated pancreaticojejunostomy for PD resulted in a decreased incidence of POPF; it may serve as a new approach for PD while managing patients who have undergone PD.
Performing ICSI within 4 hours after denudation optimizes clinical outcomes in ICSI cycles
Authors: Zhang Yini , Ma Yongzhuang , Fang Zishui , Hu Shiqiao , Li Zhou , Zhu Lixia , Jin Lei
Published: April 2020

Background

The study aimed to investigate whether and how general and partial time intervals between processes, from human chorionic gonadotrophin (HCG) trigger to intracytoplasmic sperm injection (ICSI), affected the laboratory and reproductive outcomes in ICSI cycles.

Methods

This was a retrospective data analysis of 3602 women who underwent ICSI treatment cycles using partner or donor sperms, performed at Reproduction Medicine Center of Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology (Wuhan, China) between October 2016 and September 2018. The clinical pregnancy rate was the major outcome in the study. The fertilization and available embryo rates were secondary outcomes.

Results

Data from 3602 consecutive fresh ICSI cycles was analysed. Multivariate linear regression and logistic regression analysis of factors related to fertilization and clinical pregnancy rates showed that fertilization rate (P = 0.001) and clinical pregnancy rate (P = 0.037) were significantly associated with denudation (DN)-ICSI interval. Long DN-ICSI interval was associated with higher rate of fertilization than short DN-ICSI interval but significantly decreased clinical pregnancy rate when the interval is over 4 h (P < 0.05).

Conclusions

DN-ICSI time interval can act as an independent predictor for clinical outcomes in ICSI cycles. The optimal time for ICSI is within 4 h after oocyte denudation for excellent laboratory and reproductive outcomes in ICSI cycles.
Discerning undifferentiated anxiety from syndromal anxiety in acute-phase schizophrenia
Authors: Naidu Kalai , van Staden Werdie , Fletcher Lizelle
Published: April 2020

Background

Literature on anxiety in schizophrenia is confined to well-established diagnostic syndromes and the diagnostic category of unspecified anxiety disorder has not been quantitatively verified in this population. This study examined whether anxiety that is not differentiated into the well-established syndromes is empirically discernible from syndromal anxiety and no anxiety in acute-phase schizophrenia.

Methods

After sampling 111 acute-phase schizophrenia patients, they were stratified into three groups: syndromal anxiety; undifferentiated anxiety; and without anxiety disorder. The groups were compared statistically in two data sets on measures for anxiety, psychotic severity, depressive features, akathisia and medication use.

Results

On two measures of anxiety and for both data sets, the groups were significantly different without evidence of a confounding influence by akathisia, medication, or psychotic severity. The undifferentiated group was different from the syndromal group on the Staden Schizophrenia Anxiety Rating Scale (S-SARS) for both data sets (mean difference = 7.46,p < 0.001; mean difference = 7.69,p < 0.002) and on the Hamilton Anxiety Rating Scale for the one data set (mean difference = 14.68,p < 0.001) but not for the replicative data set (mean difference = 1.49,p = 0.494). The undifferentiated anxiety group was different from the no anxiety group for the respective data sets on both anxiety scales (S-SARS: mean difference = 8.67,p < 0.001; mean difference = 8.64,p < 0.001)(HAM-A: mean difference = 6.05,p < 0.001; mean difference = 8.67,p = 0.002). When depressive features had a confounding effect, it was small relative to the group differences.

Conclusions

The results suggest some patients in acute-phase schizophrenia present with undifferentiated anxiety that is discernible from both syndromal anxiety and those without an anxiety disorder. This finding may serve as empirical grounds for clinicians to recognise undifferentiated anxiety in acute-phase schizophrenia, and for further research into the clinical importance of undifferentiated anxiety in this population.
Connecting healthcare professionals in Central America through management and leadership development: a social network analysis
Authors: Prado Andrea M. , Pearson Andy A. , Bertelsen Nathan S. , Pagán José A.
Published: April 2020

Background

Leadership and management training has become increasingly important in the education of health care professionals. Previous research has shown the benefits that a network provides to its members, such as access to resources and information, but ideas for creating these networks vary. This study used social network analysis to explore the interactions among Central American Healthcare Initiative (CAHI) Fellowship alumni and learn more about information sharing, mentoring, and project development activities among alumni. The CAHI Fellowship provides leadership and management training for multidisciplinary healthcare professionals to reduce health inequities in the region. Access to a network was previously reported as one of the top benefits of the program.

Results

Information shared from the work of 100 CAHI fellows from six countries, especially within the same country, was analyzed. Mentoring relationships clustered around professions and project types, and networks of joint projects clustered by country. Mentorship, which CAHI management promoted, and joint project networks, in which members voluntarily engaged, had similar inclusiveness ratios.

Conclusion

Social networks are strategic tools for health care leadership development programs to increase their impact by promoting interactions among participants. These programs can amplify intergenerational and intercountry ties by organizing events, provide opportunities for alumni to meet, assign mentors, and support collaborative action groups. Collaborative networks have great value to potentiate health professionals’ leadership and management capabilities in a resource-constrained setting, such as the Global South.
Radiotherapeutic management of cervical lymph node metastases from an unknown primary site – experiences from a large cohort treated with modern radiation techniques
Authors: Sprave Tanja , Rühle Alexander , Hees Katharina , Kalckreuth Tobias , Verma Vivek , Stoian Raluca , Zamboglou Constantinos , Pfeiffer Jens , Laszig Roland , Knopf Andreas , Grosu Anca-Ligia , Nicolay Nils H.
Published: April 2020

Purpose

To analyze management and outcomes following (chemo)radiation therapy in patients with cervical lymph node metastases from an unknown primary site (CCUP) in a large single-center cohort.

Methods

Between 2008 and 2019, 58 patients with CCUP were treated with (chemo)radiation therapy at the University of Freiburg Medical Center and were included in this analysis. Overall survival (OS), locoregional progression-free survival (PFS) and distant metastasis-free survival (DMFS) were calculated using the Kaplan-Meier method. The use of diagnostic procedures and their impact on oncological outcomes was analyzed by Cox regression, and treatment-related toxicities were quantified.

Results

Median follow-up was 29.9 months (range 4.6–121.9). Twenty-one patients (36.2%) received definitive RT, 35 (60.3%) underwent adjuvant RT, and 2 (3.4%) were treated for oligometastatic disease. Concurrent chemotherapy was prescribed in 40 patients (69.0%). 89.6% of patients completed the prescribed RT, and 65.0% completed the prescribed simultaneous chemotherapy. Locoregional recurrence was observed in 7 patients (12.1%) and distant metastases in 13 cases (22.4%). OS was 81,1, 64.9% and 56,6% after 1, 3 and 5 years, respectively.

Univariate analysis of age, gender, extracapsular spread, tumor grading, neck dissection, diagnostic utilization of 18F-fluorodeoxyglucose positron-emission tomography and concomitant chemotherapy showed no effect on OS (p > 0.05 for all), while smoking was significantly associated with decreased survival (p < 0.05). There was a trend towards impaired OS for patients with advanced nodal status (pN3) (p = 0.07). Three patients (5.2%) experienced grade 3 radiation dermatitis, and 12 (22.4%) developed grade 3 and 1 (1.7%) grade 4 mucositis.

Conclusions

RT of the panpharynx and cervical lymph nodes with concurrent chemotherapy in case of risk factors demonstrated good locoregional control, but the metachronous occurrence of distant metastases limited survival and must be further addressed.
MicroRNA-505 is involved in the regulation of osteogenic differentiation of MC3T3-E1 cells partially by targeting RUNX2
Authors: Li Weihua , Chen Zongchao , Cai Chuanqi , Li Gunjun , Wang Xiao , Shi Zhenyu
Published: April 2020

Objective

Evidence suggests that microRNAs (miRNAs) regulate the expression of genes involved in bone metabolism. This study aimed to investigate the role of miR-505 in the osteogenic differentiation of MC3T3-E1 cells.

Methods

We performed miRNA sequencing to identify differentially expressed miRNAs between MC3T3-E1 cells treated with osteogenic induction medium (OIM) and control cells. Bioinformatics analysis was performed by using the TargetScan and miRDB databases. The expression of miR-505 in MC3T3-E1 cells was detected during osteogenic differentiation. After transfection with miR-505 mimic or miR-505 inhibitor, MC3T3-E1 cells were induced to differentiate into osteoblasts, and the expression of osteogenic differentiation markers (Runt-related transcription factor 2 (RUNX2), alkaline phosphatase (ALP), osteopontin (OPN), osteocalcin (OCN), and osterix (OSX)) was detected.

Results

miR-505 was the most downregulated miRNA among the differentially expressed miRNAs. The RUNX2 gene was identified as a potential target of miR-505 using the target prediction program. miR-505 expression was downregulated during osteogenic differentiation of MC3T3-E1 cells. The expression of osteogenic marker genes was inhibited in MC3T3-E1 cells after transfection with miR-505. However, the expression of osteogenic marker genes was upregulated after transfection with miR-505 inhibitor.

Conclusion

This study is the first to report miR-505 could bind to the RUNX2 gene and thus regulate partly the dysfunction of osteoblasts differentiation, which is expected to be targets for the treatment of osteoporosis.
Forebrain excitatory neuron-specific SENP2 knockout mouse displays hyperactivity, impaired learning and memory, and anxiolytic-like behavior
Authors: Huang Dehua , Liu Huiqing , Zhu Aoxue , Zhou Yi , Li Yong
Published: April 2020

Sentrin/SUMO-specific protease 2 (SENP2) is a member of SENPs family involved in maturation of SUMO precursors and deSUMOylation of specific target, and is highly expressed in the central nervous system (CNS). Although SENP2 has been shown to modulate embryonic development, fatty acid metabolism, atherosclerosis and epilepsy, the function of SENP2 in the CNS remains poorly understood. To address the role of SENP2 in the CNS and its potential involvement in neuropathology, we generated SENP2 conditional knockout mice by crossing floxed SENP2 mice with CaMKIIα-Cre transgenic mice. Behavioral tests revealed that SENP2 ablation induced hyper-locomotor activity, anxiolytic-like behaviors, spatial working memory impairment and fear-associated learning defect. In line with these observations, our RNA sequencing (RNA-seq) data identified a variety of differential expression genes that are particularly enriched in locomotion, learning and memory related biologic process. Taken together, our results indicated that SENP2 plays a critical role in emotional and cognitive regulation. This SENP2 conditional knockout mice model may help reveal novel mechanisms that underlie a variety of neuropsychiatric disorders associated with anxiety and cognition.
Association of genetic and immuno-characteristics with clinical outcomes in patients with RET-rearranged non-small cell lung cancer: a retrospective multicenter study
Authors: Lu Chang , Dong Xiao-Rong , Zhao Jun , Zhang Xu-Chao , Chen Hua-Jun , Zhou Qing , Tu Hai-Yan , Ai Xing-Hao , Chen Xiao-Feng , An Gai-Li , Bai Jun , Shan Jin-Lu , Wang Yi-Na , Yang Shuan-Ying , Liu Xiang , Zhuang Wu , Wu Hui-Ta , Zhu Bo , Xia Xue-Feng , Chen Rong-Rong , Gu De-Jian , Xu Hua-Min , Wu Yi-Long , Yang Jin-Ji
Published: April 2020

Background

Rearranged during transfection (RET) has been proven to be a tumorigenic target in non-small cell lung cancers (NSCLCs). InRET-rearranged NSCLCs, molecular features and their impact on prognosis were not well illustrated, and the activity of mainstay therapeutics has not currently been well compared.

Methods

Patients diagnosed with NSCLCs withRETrearrangements were analyzed for concomitant mutations, tumor mutation burden (TMB), PD-L1 expression, T cell receptor repertoire and clinical outcomes with chemotherapy, immune checkpoint inhibitors (ICIs), and multikinase inhibitors (MKIs).

Results

Among 129 patients withRET-rearranged NSCLC who were analyzed, 41.1% (53/129) had co-occurring genetic alterations by next-generation sequencing, and concomitantTP53mutation appeared most frequently (20/53, 37.7%). Patients with concurrentTP53mutation (n= 15) had shorter overall survival than those without (n= 30; median, 18.4 months [95% CI, 8.6–39.1] vs 24.8 months [95% CI, 11.7–52.8];P< 0.05). Patients with lower peripheral blood TCR diversity (n= 5) had superior overall survival compared with those with higher diversity (n= 6; median, 18.4 months [95% CI, 16.9–19.9] vs 4.8 months [95% CI, 4.5–5.3];P= 0.035). An association with overall survival was not observed for PD-L1 expression nor for tumor mutation burden level. Median progression-free survival was not significantly different across chemotherapy, ICIs, and MKIs (median, 3.5 vs 2.5 vs 3.8 months). For patients treated with ICIs, the disease control rate was 60% (6/10) and the objective response rate was 20% (2/10).

Conclusions

RET-rearranged lung cancers can be heterogeneous in terms of concomitant genetic alterations. Patients with concurrentTP53mutation or high peripheral blood TCR repertoire diversity have relatively inferior overall survival in this series. Outcomes with traditional systemic therapies in general are suboptimal.