bluuebunny/crossref_metadata_2025 huggingface dataset:
Perinatal outcomes of monochorionic diamniotic triplet pregnancies: a case series
Authors: Xu Tingting , Wang Xiaodong , Yu Haiyan , Liu Xinghui
Published: December 2019

Background

Triplet pregnancies are associated with higher fetal morbidity and mortality rates as well as life-threatening maternal complications. Monochorionic diamniotic (MCDA) triplet pregnancies are very rare compared to other types of triplet pregnancies.

Case presentation

We report three cases of MCDA triplet pregnancies between January 2012 and December 2017. Two of these MCDA triplet pregnancies received regular and intensive prenatal care, were diagnosed by ultrasonography during the first trimester or early second trimester, and had good perinatal outcomes. The case with irregular perinatal care had poor outcomes, and the MCDA triplet pregnancy was diagnosed intrapartum.

Conclusions

The possibility of continuing an MCDA triplet pregnancy should be recognized. Early diagnosis, regular antenatal care, close prenatal monitoring, and sufficient communication are recommended to obtain better perinatal outcomes in MCDA triplet pregnancies.
Comparison of anterior segment changes after femtosecond laser LASIK and SMILE using a dual rotating Scheimpflug analyzer
Authors: Kim Bu Ki , Mun Su Joung , Yang Young Hoon , Kim Ji Sun , Moon Jun Hyung , Chung Young Taek
Published: December 2019

Background

To compare the changes in the anterior segment after femtosecond laser in situ keratomileusis (FS-LASIK) and small incision lenticule extraction (SMILE) using a dual rotating Scheimpflug (DRS) analyzer (Galilei®; Ziemer Ophthalmology, Port, Switzerland).

Methods

A total of 218 eyes of 109 patients who underwent FS-LASIK or SMILE for myopic correction were retrospectively studied. Ninety-eight eyes of 49 patients who underwent FS-LASIK were compared to 120 eyes of 60 patients treated with SMILE. A DRS analyzer was used for preoperative and 6-month postoperative anterior segment analyses. Measured variables included the central corneal thickness (CCT), anterior chamber depth (ACD), anterior and posterior keratometry (K), anterior and posterior best-fit sphere radius, and maximum posterior elevation (MPE).

Results

After the procedure, the amount of CCT decrease was higher in the SMILE group than in the FS-LASIK group, but it was not statistically significant. The MPE was significantly increased after both procedures (p < 0.001 and p = 0.001 in the FS-LASIK and SMILE groups, respectively), with the amount of elevation being higher after FS-LASIK than after SMILE even though it was not statistically significant. And there was a significant change in the steep and average posterior K in the FS-LASIK group (p = 0.006 and 0.001, respectively), but not in the SMILE group.

Conclusions

Regarding changes in the MPE and posterior K, changes in the posterior corneal surface were greater after FS-LASIK than after SMILE.

Trial registration

The trial registration number: KCT0003628. Date of registration: 15 March 2019.
Mapping the prevalence and nature of drug related problems among hospitalised children in the United Kingdom: a systematic review
Authors: Sutherland Adam , Phipps Denham L. , Tomlin Stephen , Ashcroft Darren M.
Published: December 2019

Background

Problems arising from medicines usage are recognised as a key patient safety issue. Children are a particular concern, given that they are more likely than adults to experience medication-related harm. While previous reviews have provided an estimate of prevalence in this population, these predate recent developments in the delivery of paediatric care. Hence, there is a need for an updated, focussed and critical review of the prevalence and nature of drug-related problems in hospitalised children in the UK, in order to support the development and targeting of interventions to improve medication safety.

Methods

Nine electronic databases (Medline, Embase, CINAHL, PsychInfo, IPA, Scopus, HMIC, BNI, The Cochrane library and clinical trial databases) were searched from January 1999 to April 2019. Studies were included if they were based in the UK, reported on the frequency of adverse drug reactions (ADRs), adverse drug events (ADEs) or medication errors (MEs) affecting hospitalised children. Quality appraisal of the studies was also conducted.

Results

In all, 26 studies were included. There were no studies which specifically reported prevalence of adverse drug events. Two adverse drug reaction studies reported a median prevalence of 25.6% of patients (IQR 21.8–29.9); 79.2% of reactions warranted withdrawal of medication. Sixteen studies reported on prescribing errors (median prevalence 6.5%; IQR 4.7–13.3); of which, the median rate of dose prescribing errors was 11.1% (IQR 2.9–13). Ten studies reported on administration errors with a median prevalence of 16.3% (IQR 6.4–23). Administration technique errors represented 53% (IQR 52.7–67.4) of these errors. Errors detected during medicines reconciliation at hospital admission affected 43% of patients, 23% (Range 20.1–46) of prescribed medication; 70.3% (Range 50–78) were classified as potentially harmful. Medication errors detected during reconciliation on discharge from hospital affected 33% of patients and 19.7% of medicines, with 22% considered potentially harmful. No studies examined the prevalence of monitoring or dispensing errors.

Conclusions

Children are commonly affected by drug-related problems throughout their hospital journey. Given the high prevalence and risk of patient harm,, there is a need for a deeper theoretical understanding of paediatric medication systems to enable more effective interventions to be developed to improve patient safety.
How involuntary subordination and social support influence the association between self-esteem and depression: a moderated mediation model
Authors: Shen Qiuming , Shi Yue , Zhang Shuxian , Tsamlag Lhakpa , Wang Huwen , Chang Ruijie , Peng Zihe , Wang Ying , Shang Meili , Cai Yong
Published: December 2019

Background

In China, young migrants are at elevated risk of mental health problems, such as depression. The influence of self-esteem on depression is well acknowledged. We examined correlates of depression and their mediating and moderating role in the association between self-esteem and depression to promote a better understanding of depression prevention among young migrants.

Methods

We conducted a cross-sectional study among young Chinese migrants. A moderated mediation model was used to test the combined effect of involuntary subordination and social support on the association between self-esteem and depression. The Johnson–Neyman method was used to identify the range of scores for which social support acted as a moderator.

Results

A total of 572 participants completed questionnaires. The median depression score was 19 (interquartile range: 14). Self-esteem had a negative effect on involuntary subordination (β = − 2.1440,p < 0.001). Involuntary subordination (β = 0.2406, p < 0.001), self-esteem (β = − 0.3870,p < 0.01), and social support (β = − 0.1221, p < 0.01) all had significant effects on depression. The effect of involuntary subordination on depression was moderated by social support (β = − 0.0041,p < 0.05), and the effect decreased as social support scores increased.

Conclusions

Our results indicated a mediating role of involuntary subordination and a moderating role of social support in the association between self-esteem and depression among young Chinese migrants. Future intervention strategies should focus on these factors to reduce depressive symptoms.
Prevalence and associated factors of zinc deficiency among pregnant women and children in Ethiopia: a systematic review and meta-analysis
Authors: Berhe Kidanemaryam , Gebrearegay Freweini , Gebremariam Hadush
Published: December 2019

Background

Pregnant women and children are the most vulnerable groups to zinc deficiency. Despite the presence of few primary studies, studies that could provide strong evidence that would help policymakers to develop appropriate interventional strategies in addressing zinc deficiency among pregnant women and children are limited in Ethiopia. Therefore, the aim of this systematic review and meta-analysis was to estimate the national pooled prevalence and associated factors of zinc deficiency among pregnant women and children.

Methods

We searched Pub Med, Scopus, CINAHL, Google Scholar, and Google for studies reported on zinc deficiency and associated factors among pregnant women and children. Search terms were ‘zinc deficiency’, ‘zinc status’, ‘associated factors’, ‘children’, ‘pregnant women’, and ‘Ethiopia’ using the boolean operators ‘OR’ or ‘AND’. Searches were using English language. A preferred reporting item for systematic reviews and meta-analysis (PRISMA) checklist was used. Two authors independently reviewed the studies. The effect sizes of the meta-analysis were the prevalence of zinc deficiency and adjusted odds ratio (AOR) of the associated factors. Finally, the Comprehensive Meta-Analysis (CMA) version 3.3.07 was used for statistical analysis by applying the random-effects model and publication bias was assessed using funnel plots and Egger’s test.

Results

Thirteen studies (7 among pregnant women having total participants of 2371 pregnant women and 6 among children with total participants of 5154 children) were included in this systematic review and meta-analysis. Using the random-effects model, the pooled prevalence of zinc deficiency was 59.9% (95%CI: 51.9, 67.7%) and 38.4% (95%CI: 28.6, 49.4) among pregnant women and children, respectively. The associated factors for zinc deficiency among pregnant women were coffee intake (adjusted odds ratio (AOR) =1.76), low intake of animal source foods (AOR = 2.57), and inadequate diet diversity (AOR = 2.12).

Conclusion

Overall, zinc deficiency among pregnant women and children is a significant public health concern in Ethiopia. Promoting dietary modification to enhance the bioavailability of zinc, improving diet diversity, and consuming animal source foods would help in alleviating and/or minimizing the problem among the target groups. Zinc supplementation could also be considered for pregnant women and children.
Prevalence of selected intestinal protozoan infections in marginalized rural communities in Palestine
Authors: Al-Jawabreh Amer , Ereqat Suheir , Dumaidi Kamal , Al-Jawabreh Hanan , Abdeen Ziad , Nasereddin Abdelmajeed
Published: December 2019

Background

Intestinal parasitic infections are common in rural areas with poor infrastructure and low socioeconomic status. The aim of this study was to estimate the prevalence of selected parasitic infections in marginalized rural areas in the northern part of the Palestinian West Bank Region, using conventional and PCR-based methods, and also to assess risk predictors of infection.

Methods

A cross-sectional study was conducted on 104 individuals from three rural villages in the Jordan Valley. Stool samples were collected and examined by a battery of tests that included microscopy of wet fecal samples in normal saline with iodine, concentration by ethyl acetate sedimentation and also by zinc sulfate floatation, a conventional PCR and a real-time PCR (qPCR). Risk factors were assessed that included demographic, socioeconomic, and behavioral characteristics. Data on method performance was analyzed by kappa-statistic, Cochrane’s Q, and McNemar post hoc test. Mid-P exact test and odds ratio were used to discern association between outcome and risk predictors.

Results

The overall prevalence of intestinal parasitic infections was 48% (49/102). The predominant parasites wereGiardia lambliaat 37% (37/102) andHymenolepis nanaat 9% (9/102). To concentrate cysts and eggs, sedimentation can be used as an alternative to floatation with a loss of 1% of positive cases. The methods employing PCRs proved crucial as it increased the detected infection rate ofG. lambliaapproximately three-fold from 13% by the conventional methods to 37% by the qPCR. Multiple infections were present in 13% (13/102) of the study group, which included double (10%) and triple (3%) infections. Regarding the genusEntamoeba,E. disparandE. coliwere detected at rates of 2 and 8%, respectively. While none of the individuals were infected with the pathogenicE. histolytica,E. nana(4%) was detected for the first time in the area. Age was a risk predictor for infection (OR = 2.61, CI 95% 1.05–6.45,P = 0.038).

Conclusions

The increased prevalence of intestinal parasitic infections in children in marginalized rural areas in Palestine is worrying. The addition of PCR-based methods is important for the diagnosis of such infections as, with cautious interpretation, it increases proficiency and overcomes underestimation and misdiagnosis of cases. Control measures including education on personal hygiene and environmental sanitation, should be introduced to reduce the prevalence of the intestinal parasites and, thus, the infections they cause in this and other areas.
Robot-assisted bronchoscopy for pulmonary lesion diagnosis: results from the initial multicenter experience
Authors: Chaddha Udit , Kovacs Stephen P. , Manley Christopher , Hogarth D. Kyle , Cumbo-Nacheli Gustavo , Bhavani Sivasubramanium V. , Kumar Rohit , Shende Manisha , Egan John P. , Murgu Septimiu
Published: December 2019

Background

The Robotic Endoscopic System (Auris Health, Inc., Redwood City, CA) has the potential to overcome several limitations of contemporary guided-bronchoscopic technologies for the diagnosis of lung lesions. Our objective is to report on the initial post-marketing feasibility, safety and diagnostic yield of this technology.

Methods

We retrospectively reviewed data on consecutive cases in which robot-assisted bronchoscopy was used to sample lung lesions at four centers in the US (academic and community) from June 15th, 2018 to December 15th, 2018.

Results

One hundred and sixty-seven lesions in 165 patients were included in the analysis, with an average follow-up of 185 ± 55 days. The average size of target lesions was 25.0 ± 15.0 mm. Seventy-one percent were located in the peripheral third of the lung. Pneumothorax and airway bleeding occurred in 3.6 and 2.4% cases, respectively. Navigation was successful in 88.6% of cases. Tissue samples were successfully obtained in 98.8%. The diagnostic yield estimates ranged from 69.1 to 77% assuming the cases of biopsy-proven inflammation without any follow-up information (N = 13) were non-diagnostic and diagnostic, respectively. The yield was 81.5, 71.7 and 26.9% for concentric, eccentric and absent r-EBUS views, respectively. Diagnostic yield was not affected by lesion size, density, lobar location or centrality.

Conclusions

RAB implementation in community and academic centers is safe and feasible, with an initial diagnostic yield of 69.1–77% in patients with lung lesions that require diagnostic bronchoscopy. Comparative trials with the existing bronchoscopic technologies are needed to determine cost-effectiveness of this technology.
Comparison between ultrasound-guided TIVAD via the right innominate vein and the right internal jugular vein approach
Authors: Sun Xingwei , Bai Xuming , Shen Jiaofeng , Yu Ziyang , Zhuang Zhixiang , Jin Yong
Published: December 2019

Background

To compare the efficacy and safety of right internal jugular vein (IJV) approach and right innominate vein (INV) approach for US-guided totally implantable venous access devices (TIVADs), and to explore the advantages and disadvantages of the two approaches.

Methods

Six hundred and nineteen adult patients had long-term infusion and chemotherapy needs and inconvenience of peripheral venous infusion. Right INV approach was used to implant 339 cases of TIVADs, and right IJV approach was used to implant 280 cases of TIVADs. The success rate of one-time catheterization and the incidence of complications in the two groups were retrospectively analyzed.

Results

All patients were successfully implanted in TIVAD. The success rates of one-time puncture in INV group and IJV approach group were 98.53% (334/339) and 95.36% (267/280), respectively. There was significant difference between the two groups (P = 0.020). The incidence of perioperative complications and long-term complications in the right INV group were 1.18% (4/339) and 3.54% (12/339), respectively, while those in the right IJV group were 1.43% (4280) and 3.93% (11280). There was no significant difference in the incidence of perioperative or long-term complications between the two groups (P = 0.785,P = 0.799, respectively).

Conclusions

US-guided TIVADs via the right INV approach and the right IJV approach are both safe and reliable. The right INV approach improves the one-time puncture success rate, as long as the technique is properly operated, serious complications rarely occur.
Comparison of parathyroid hormone kinetics in endoscopic thyroidectomy via bilateral areola with open thyroidectomy
Authors: Zhang Daqi , Wang Tie , Dionigi Gianlorenzo , Zhang Jiao , Zhao Yishen , Xue Gaofeng , Liang Nan , Sun Hui
Published: December 2019

Background

In this study, we aimed to compare the kinetics of intact parathyroid hormone (iPTH) during the perioperative period of endoscopic thyroidectomy via bilateral areola approach (ETBAA) in the same period, following a traditional open thyroidectomy approach (OTA).

Methods

We conducted a prospective observational study of patients who were undergoing thyroidectomy and level VI clearance. Patients who had been affected by papillary thyroid cancer (PTC) were stratified into three groups: those eligible for endoscopic treatment (ETBAA); patients who were eligible for ETBAA but had opted for OTA (OTA-L); and patients who were not suitable for endoscopic intervention (OTA-H). A process for locating parathyroid glands was utilized to stratify gland dissection laboriousness. In Type A, the gland is firmly fixed to thyroid gland. This type can be sub-classified into three subtypes. A1: the parathyroid gland is attached to the inherent thyroid capsule. A2: the gland is partially embedded in the thyroid gland. A3: the gland is located in the thyroid tissue. Type B is defined as a gland which is separated from the thyroid gland. The iPTH was sampled at wound closure.

Results

There were 100 patients in each group. We found a significant difference between the ETBAA and OTA-H groups for type A2, as well as a loss of parathyroid glands and a number of parathyroid transplantation procedures. The endoscopic group was treated during an earlier stage of thyroid cancer. The iPTH profile of each group decreased, although this was the most consistent in the OTA-H group. A comparison of ETBAA with OTA-L demonstrates that the iPTH level change is similar.

Conclusion

There is no advantage of endoscopic treatment for preserving parathyroid function.
Implementing a clinical-educator curriculum to enrich internal medicine residents’ teaching capacity
Authors: Habboush Yacob , Stoner Alexis , Torres Claribel , Beidas Sary
Published: December 2019

Introduction

Physicians-in-training (residents) are typically the primary educators for medical students during clinical clerkships. However, residents are not formally trained to teach or to assess their teaching. The aim of this study was to assess the implementation of a clinical educator rotation aimed at developing residents’ competencies related to clinical teaching.

Methods

A mixed-methods approach was used to develop and assess the clinical educator rotation at a teaching community hospital. Internal medicine residents who participated in the rotation and consented to the research were assigned to the clinical educator trainee (CET) group, the remaining residents were assigned to the control group. Osteopathic medical students rotating in the medicine service line were invited to participate. The study used descriptive and qualitative analyses to measure primary and secondary outcomes.

Results

The primary outcome measure showed a positive change in resident knowledge, skills and behaviors in communication, reflection, feedback, precepting, and facilitation. Medical student perceptions of resident teaching skills confirmed the observed changes in CETs. Some CETs continued to practice and build their capacity for teaching after completing the rotation. Qualitatively, we derived four common themes among the data; communication, professional engagement, practice-based learning, and systems-based learning.

Conclusion

Resident teaching capacity was enriched after completing the clinical educator rotation. Other benefits included: enhanced patient communication and education, increased resident confidence, personal satisfaction with training, work life-balance and enhanced career satisfaction. Future research should focus on curricular content, faculty development, and delivery assessment. In addition, research efforts should identify appropriate emerging technologies to include in the curriculum for enhancing teaching capacity.
Medical education trends for future physicians in the era of advanced technology and artificial intelligence: an integrative review
Authors: Han Eui-Ryoung , Yeo Sanghee , Kim Min-Jeong , Lee Young-Hee , Park Kwi-Hwa , Roh Hyerin
Published: December 2019

Background

Medical education must adapt to different health care contexts, including digitalized health care systems and a digital generation of students in a hyper-connected world. The aims of this study are to identify and synthesize the values that medical educators need to implement in the curricula and to introduce representative educational programs.

Methods

An integrative review was conducted to combine data from various research designs. We searched for articles on PubMed, Scopus, Web of Science, and EBSCO ERIC between 2011 and 2017. Key search terms were “undergraduate medical education,” “future,” “twenty-first century,” “millennium,” “curriculum,” “teaching,” “learning,” and “assessment.” We screened and extracted them according to inclusion and exclusion criteria from titles and abstracts. All authors read the full texts and discussed them to reach a consensus about the themes and subthemes. Data appraisal was performed using a modified Hawker ‘s evaluation form.

Results

Among the 7616 abstracts initially identified, 28 full-text articles were selected to reflect medical education trends and suggest suitable educational programs. The integrative themes and subthemes of future medical education are as follows: 1) a humanistic approach to patient safety that involves encouraging humanistic doctors and facilitating collaboration; 2) early experience and longitudinal integration by early exposure to patient-oriented integration and longitudinal integrated clerkships; 3) going beyond hospitals toward society by responding to changing community needs and showing respect for diversity; and 4) student-driven learning with advanced technology through active learning with individualization, social interaction, and resource accessibility.

Conclusions

This review integrated the trends in undergraduate medical education in readiness for the anticipated changes in medical environments. The detailed programs introduced in this study could be useful for medical educators in the development of curricula. Further research is required to integrate the educational trends into graduate and continuing medical education, and to investigate the status or effects of innovative educational programs in each medical school or environment.
Analyzing the distribution of rabies clinics and achievements of standardized rabies clinics implementation in mainland China
Authors: Du Zhe , Chen Qingjun , Lyu Xinjun , Wang Tianbing , Wang Chuanlin
Published: December 2019

Background

For rabies prevention and treatment, the Chinese government has been establishing standardized rabies clinics since 2016. This study aimed to investigate the distribution of rabies clinics and the achievements of newly-implemented standardized rabies clinics in mainland China, for the purpose of providing further rabies control strategies.

Methods

The number of rabies clinics, including per million inhabitants in each region, was determined. We sampled 1200 clinics from 8 provinces by multi-stage stratified sampling, and a questionnaire survey was carried out to record each clinic’s achievements. Data collected from 1185 questionnaires were analyzed.

Results

We found that rabies clinics were mostly located in the southwest, central, and eastern regions of China; these accounted for 67.1% of all clinics. The eastern and south regions showed the lowest number of rabies clinics per million inhabitants (0.15 and 0.12, respectively). The total standard-reaching rate of rabies clinics in mainland China was only 11.0%, with significant differences in the rate among regions (X2 = 33.004, p <  0.001). Specifically, the qualified rates of supporting facilities and functional areas were 13.9% (X2 = 34.003, p <  0.001) and 56.1% (X2 = 9.943, p = 0.019), respectively. Vaccines with 2 different substrates and professional flushing equipment were provided by 40.5% (X2 = 27.935, p = 0.001) and 37.7% (X2 = 54.922, p = 0.001) of clinics, respectively.

Conclusion

Regional differences do exist in the distribution of rabies clinics in mainland China, with relative low number per million population in south and eastern China. There are few standardized rabies clinics in mainland China. Efforts are needed to establish supporting facilities, especially for wound treatment and vaccination. Future research should focus on the improvement of rabies clinics standardization.
Introduction of primary screening using high-risk HPV DNA detection in the Dutch cervical cancer screening programme: a population-based cohort study
Authors: Aitken Clare A. , van Agt Heleen M. E. , Siebers Albert G. , van Kemenade Folkert J. , Niesters Hubert G. M. , Melchers Willem J. G. , Vedder Judith E. M. , Schuurman Rob , van den Brule Adriaan J. C. , van der Linden Hans C. , Hinrichs John W. J. , Molijn Anco , Hoogduin Klaas J. , van Hemel Bettien M. , de Kok Inge M. C. M.
Published: December 2019

Background

In January 2017, the Dutch cervical cancer screening programme transitioned from cytomorphological to primary high-risk HPV (hrHPV) DNA screening, including the introduction of self-sampling, for women aged between 30 and 60 years. The Netherlands was the first country to switch to hrHPV screening at the national level. We investigated the health impact of this transition by comparing performance indicators from the new hrHPV-based programme with the previous cytology-based programme.

Methods

We obtained data from the Dutch nationwide network and registry of histo- and cytopathology (PALGA) for 454,573 women eligible for screening in 2017 who participated in the hrHPV-based programme between 1 January 2017 and 30 June 2018 (maximum follow-up of almost 21 months) and for 483,146 women eligible for screening in 2015 who participated in the cytology-based programme between 1 January 2015 and 31 March 2016 (maximum follow-up of 40 months). We compared indicators of participation (participation rate), referral (screen positivity; referral rate) and detection (cervical intraepithelial neoplasia (CIN) detection; number of referrals per detected CIN lesion).

Results

Participation in the hrHPV-based programme was significantly lower than that in the cytology-based programme (61% vs 64%). Screen positivity and direct referral rates were significantly higher in the hrHPV-based programme (positivity rate: 5% vs 9%; referral rate: 1% vs 3%). CIN2+ detection increased from 11 to 14 per 1000 women screened. Overall, approximately 2.2 times more clinical irrelevant findings (i.e. ≤CIN1) were found in the hrHPV-based programme, compared with approximately 1·3 times more clinically relevant findings (i.e. CIN2+); this difference was mostly due to a national policy change recommending colposcopy, rather than observation, of hrHPV-positive, ASC-US/LSIL results in the hrHPV-based programme.

Conclusions

This is the first time that comprehensive results of nationwide implementation of hrHPV-based screening have been reported using high-quality data with a long follow-up. We have shown that both benefits and potential harms are higher in one screening round of a well-implemented hrHPV-based screening programme than in an established cytology-based programme. Lower participation in the new hrHPV programme may be due to factors such as invitation policy changes and the phased roll-out of the new programme. Our findings add further to evidence from trials and modelling studies on the effectiveness of hrHPV-based screening.
MiR-566 mediates cell migration and invasion in colon cancer cells by direct targeting of PSKH1
Authors: Zhang Ying , Zhang Siqi , Yin Jian , Xu Ruisi
Published: December 2019

Background

Colorectal cancer (CRC), a common malignancy worldwide, and microRNAs (miRs) have been suggested to play roles in the disease. MiR-566 expression has been shown to be reduced in CRC, but its functions and mechanisms are still unclear.

Methods

Cell viability was assessed by using the CellTiter 96 AQueous One Solution Cell Proliferation kit. Cell proliferation was measured with MTT assay. Cell metastasis were measured by transwell assay. Luciferase reporter assays was used to confirm the target of MiR-566. PSKH1 expression was measured by RT-PCR and western blot.

Results

In the present study, we first observed that miR-566 was expressed in several CRC cell lines (SW480, SW620, LoVo, HT29 and Caco-2) at low levels compared to control colon epithelial cell lines (FHC). Further study showed that miR-566 overexpression suppressed cell survival and impeded cell proliferation, whereas inhibition of its expression enhanced cell survival and proliferation. Transwell assays showed that cell invasion and migration were reduced in cells overexpressing miR-566 and increased in those with inhibition of miR-566. Further analysis confirmed that PSKH1 is a target of miR-566. MiR-566 overexpression significantly inhibited PSKH1 expression and reintroduction of PSKH1 partially reversed the effects of miR-566 on CRC cell growth and metastasis in SW480 and Caco-2 cells.

Conclusions

Taken together, the data show that CRC cell growth and metastasis can be significantly suppressed by miR-566 through targeting PSKH1.
Clinical outcomes of complete cytoreduction with concurrent liver resection followed by hyperthermic intraperitoneal chemotherapy for synchronous peritoneal and liver metastatic colorectal cancer
Authors: Jeon Youngbae , Park Eun Jung , Lim Jin Hong , Baik Seung Hyuk
Published: December 2019

Background

This study aimed to evaluate the clinical outcomes of concurrent liver resection with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in colorectal cancer patients with synchronous liver and peritoneal metastases.

Methods

Patients with colorectal liver and peritoneal metastasis who underwent complete cytoreduction and hyperthermic intraperitoneal chemotherapy with concurrent liver surgery between September 2014 and July 2018 were included. Perioperative outcomes, overall survival, and progression-free survival were analyzed retrospectively.

Results

In total, 22 patients were included. The median peritoneal cancer index was 13 (range, 0–26), and the median number of liver metastases was 3 (range, 1–13). The mean total operative time was 11.4 ± 2.6 h. Minor postoperative complications (Clavien-Dindo grade I–II) were reported in 10 patients (45.5%), and major postoperative complications (grade III–V) were reported in five patients (22.7%), including one mortality patient. The median overall survival since diagnosis with metastasis was 27.4 months. The median overall survival since surgical intervention and the progression-free survival were 16.7 months and 7.1 months, respectively.

Conclusions

This short-term follow-up study showed that, in an experienced center, combined resection with hyperthermic intraperitoneal chemotherapy for colorectal liver and peritoneal metastases was feasible and safe with acceptable oncologic outcomes.
Modifiable factors which predict children’s gross motor competence: a prospective cohort study
Authors: Barnett Lisa M. , Hnatiuk Jill A. , Salmon Jo , Hesketh Kylie D.
Published: December 2019

Background

Fundamental motor skills (FMS) are important for physical activity and healthy weight status in children, yet it is unclear which early childhood factors facilitate subsequent motor skill. The aim of this prospective study was to investigate which modifiable family and home environment factors in the early years predict children’s FMS at age five.

Methods

Mothers from the Melbourne InFANT program (registered with the International Standard Randomised Controlled Trial Number Register (ISRCTN81847050)) completed questionnaires when child was aged 4, 9, 19 months old, and 3.5 years old on factors hypothesised to predict motor skills. Some factors were grouped in tertiles (high, medium, low) due to the nature of the distribution. At 5 years old children were assessed on 6 locomotor and 6 object control skills (Test of Gross Motor Development-2). Eight regression models examined the association between factors at each time-point and children’s skills (object control and locomotor) at 5 years old.

Results

The sample varied by time-point (178 to 259 children). Maternal physical activity optimism (4 months; β = 2.43), home physical activity equipment (9 months; β = 0.82), time outdoors – middle (9 months; β = 2.50) and highest tertile (9 months; β = 2.86), time free to move about - highest tertile (19 months; β = 2.41), time with older children - middle (19 months; β = 3.15) and highest tertile (3.5 years; β = 3.00) were predictive of better locomotor scores. Mothers’ own physical activity (9 months; β = − 0.01) and time active with mum – highest tertile (3.5 years; β = − 3.73) were negatively associated with locomotor skill. Time with older children - highest (4 months; β = 2.27) and middle tertile (19 months; β = 2.97), time free to move about – middle (19 months; β = 2.55) and highest tertile (19 months; β = 2.47), and more home equipment (9 months; β = 0.83); (3.5 years; β = 0.17) were predictive of better object control skills. Maternal physical activity knowledge (3.5 years; β = − 3.05) was negatively associated with object control skill.

Conclusions

Providing a supportive environment with older children and equipment, and allowing toddlers’ freedom to move, appears important. Opportunities exist to educate parents on their important role in developing children’s motor skills. Clinicians could advise parents that the home environment can make a difference to their child’s FMS starting from infancy.
Plant leaves for wrapping zongzi in China: an ethnobotanical study
Authors: Lin Fengke , Luo Binsheng , Long Bo , Long Chunlin
Published: December 2019

Background

Zongzi, a common Chinese rice-pudding and one of the most symbolic foods in traditional Chinese festivals, is integral to both Chinese traditional culture and daily meals. Traditionally, the leaves of different plant species have been used to wrap zongzi. The variety of zongzi leaves (ZLs) can contribute to the zongzi-based cultural diversity. Given the cultural and dietary significance of zongzi, the ethnobotanical surveys were carried out, aiming to investigate the diversity of plant species and associated traditional botanical knowledge of ZLs, which could attract particular attention for their further studies.

Method

Both literature studies and field surveys were conducted in the study. The field investigations were carried out from May 2006 to June 2018 throughout China. Ethnobotanical information about ZLs was obtained by direct observation, semi-structured interviews, and key informant interviews.

Results

In total, ZLs from 57 plant species were identified and recorded, belonging to 38 genera and 18 families. Several folk legends have been formed to explain the origin of using plant leaves to pack zongzi. Over time, Chinese people have developed diverse traditional botanical knowledge surrounding ZLs, especially regarding the zongzi flavor, antiseptic functions, and medicinal values. Based on the literature review, some species of ZLs such as the leaves of Corchorus capsularis and Vernicia fordii may even pose a potential threat to human health. Presently, in some regions of China, the traditional ZLs, such as Cocos nucifera, Tilia tuan, and Zizania latifolia, are being substituted by commercialized ZLs such as Phragmites australis and Indocalamus tessellatus.

Conclusion

A variety of traditional ZLs have been discovered in China. Although diverse traditional knowledge exists in China surrounding the usage of ZLs, some species may have the potential of threatening human health. Therefore, further explorations are necessary to comprehensively evaluate traditional ZLs, the results of which could help to conserve the cultural diversity of zongzi, to guarantee food safety, and to encourage the uses of plant leaves in food, medicine, and environmental management, for our human health.
Application of thromboelastography to evaluate the effect of different routes administration of tranexamic acid on coagulation function in total hip arthroplasty
Authors: Xu Xingming , Jiang Jiang , Liu Wei , Li Xiaofeng , Lu Huading
Published: December 2019

Background

Tranexamic acid (TXA) is widely used to reduce blood loss and transfusion rates in total hip arthroplasty(THA). Thromboelastography, which can monitor coagulation changes from clotting to fibrinolysis dynamically. In this study, thromboelastography was used to assess the dynamic changes in the coagulation of patients who underwent THA with the administration of TXA.

Methods

This randomized controlled trial consisted of 207 consecutive patients who underwent primary total hip arthroplasty. Patients were randomized into three groups: topical-TXA group received a topical application of TXA, IV-TXA group received an intravenous injection of TXA, and control group. Thromboelastography was performed 1 day before surgery and first, fourth, seventh days after surgery. The primary outcomes were thromboelastography parameters, the rates of deep vein thrombosis(DVT), and pulmonary embolism(PE). Secondary outcomes included perioperative blood loss, transfusion rates, and other perioperative complications.

Results

The mean calculated total blood loss in the Topical-TXA group were 832.7 ± 279.84 ml and 834.8 ± 322.94 ml in the IV-TXA group, which were significantly reduced (p < 0.05) compared with control groups at 1093.3 ± 379.7 ml. There were no significant differences between topical-TXA and IV-TXA groups in total blood loss or transfusion rates. K and R have reached a nadir from preoperative levels to 4th day postoperatively and then began to increase.α angle and CI peaked from preoperative levels to the fourth day postoperatively and then began to decline.IV-TXA significantly (p < 0.05) promoted coagulation levels compared with topical-TXA and control groups in the early postoperative period. Almost no significant differences were observed between topical-TXA and control groups in thromboelastography parameters.No significant differences were observed in the incidence of thromboembolic complications and other perioperative complications.

Conclusions

The topical administration of TXA had the same hemostatic effect as intravenous injection tranexamic acid. Coagulation function peaked on 4th day postoperatively and then began to decline. IV-TXA was more enhanced coagulation functions compared with topical-TXA.
The change of cervical sagittal parameters plays an important role in clinical outcomes of cervical spondylotic myelopathy after multi-level anterior cervical discectomy and fusion
Authors: Fan Xi-Wen , Wang Zhi-Wei , Gao Xian-Da , Ding Wen-Yuan , Yang Da-Long
Published: December 2019

Background

Cervical sagittal parameters were closely related with clinical outcomes after multi-level ACDF. Our purpose was to evaluate the clinical outcomes and cervical sagittal parameters in patients with MCSM after ACDF and to identify the risk factors of poor clinical outcomes.

Material and methods

ACDF was performed in 89 patients with MCSM. Based on average JOA recovery rate, patients were divided good-outcome group (group GO) and poor-outcome group (group PO). The cervical sagittal parameters including Cobb angle, SVA, T1S, cranial tilt and cervical tilt were measured. Multivariate logistic regression was used to identify risk factors.

Results

Fifty-four patients (60.67%) were divided into group GO, while 35 patients (39.33%) were divided into group PO. Cobb angle, SVA and T1S was corrected from preoperative average 11.80° ± 9.63°, 23.69 mm ± 11.69 mm and 24.43° ± 11.78° to postoperative average 15.08° ± 9.05°, 18.79 mm ± 10.78 mm and 26.92° ± 11.94° respectively (p < 0.001). △Cobb angle (p = 0.008) and △SVA (p = 0.009) showed significantly statistical differences between two groups. Longer symptom duration, lower preoperative JOA score, smaller △Cobb angle and larger △SVA were identified as risk factors of poor clinical outcomes.

Conclusion

Multi-level ACDF is an effective surgical method to treat patients with MCSM. However, long duration of preoperative symptoms, lower preoperative JOA score, smaller △Cobb angle and larger △SVA are risk factors for poor outcomes in patients with MCSM after ACDF. Sagittal parameters should be paid attention to in surgery.
miR-624-5p promoted tumorigenesis and metastasis by suppressing hippo signaling through targeting PTPRB in osteosarcoma cells
Authors: Luo Yongjun , Liu Wei , Tang Pengyu , Jiang Dongdong , Gu Changjiang , Huang Yumin , Gong Fangyi , Rong Yuluo , Qian Dingfei , Chen Jian , Zhou Zheng , Zhao Shujie , Wang Jiaxing , Xu Tao , Wei Yongzhong , Yin Guoyong , Fan Jin , Cai Weihua
Published: December 2019

Background

Accumulating evidence indicates that aberrant microRNA (miRNA) expression contributes to osteosarcoma progression. This study aimed to elucidate the association between miR-624-5p expression and osteosarcoma (OS) development and to investigate its underlying mechanism.

Methods

We analyzed GSE65071 from the GEO database and found miR-624-5p was the most upregulated miRNA. The expression of miR-624-5p and its specific target gene were determined in human OS specimens and cell lines by RT-PCR and western blot. The effects of miR-624-5p depletion or ectopic expression on OS proliferation, migration and invasion were evaluated in vitro using CCK-8 proliferation assay, colony formation assay, transwell assay, would-healing assay and 3D spheroid BME cell invasion assay respectively. We investigated in vivo effects of miR-624-5p using a mouse tumorigenicity model. Besides, luciferase reporter assays were employed to identify interactions between miR-624-5p and its specific target gene.

Results

miR-624-5p expression was upregulated in OS cells and tissues, and overexpressing miR-624-5p led to a higher malignant level of OS, including cell proliferation, migration and invasion in vitro and in vivo. Protein tyrosine phosphatase receptor type B (PTPRB) was negatively correlated with miR-624-5p expression in OS tissues. Using the luciferase reporter assay and Western blotting, PTPRB was confirmed as a downstream target of miR-624-5p. PTPRB restored the effects of miR-624-5p on OS migration and invasion. The Hippo signaling pathway was identified as being involved in the miR-624-5p/PTPRB axis.

Conclusions

In conclusion, our results suggest that miR-624-5p is a negative regulator of PTPRB and a risk factor for tumor metastasis in OS progression.
The atypical cyclin-like protein Spy1 overrides p53-mediated tumour suppression and promotes susceptibility to breast tumourigenesis
Authors: Fifield Bre-Anne , Qemo Ingrid , Kirou Evie , Cardiff Robert D. , Porter Lisa Ann
Published: December 2019

Background

Breast cancer is the most common cancer to affect women and one of the leading causes of cancer-related deaths. Proper regulation of cell cycle checkpoints plays a critical role in preventing the accumulation of deleterious mutations. Perturbations in the expression or activity of mediators of cell cycle progression or checkpoint activation represent important events that may increase susceptibility to the onset of carcinogenesis. The atypical cyclin-like protein Spy1 was isolated in a screen for novel genes that could bypass the DNA damage response. Clinical data demonstrates that protein levels of Spy1 are significantly elevated in ductal and lobular carcinoma of the breast. We hypothesized that elevated Spy1 would override protective cell cycle checkpoints and support the onset of mammary tumourigenesis.

Methods

We generated a transgenic mouse model driving expression of Spy1 in the mammary epithelium. Mammary development, growth characteristics and susceptibility to tumourigenesis were studied. In vitro studies were conducted to investigate the relationship between Spy1 and p53.

Results

We found that in the presence of wild-type p53, Spy1 protein is held ‘in check’ via protein degradation, representing a novel endogenous mechanism to ensure protected checkpoint control. Regulation of Spy1 by p53 is at the protein level and is mediated in part by Nedd4. Mutation or abrogation of p53 is sufficient to allow for accumulation of Spy1 levels resulting in mammary hyperplasia. Sustained elevation of Spy1 results in elevated proliferation of the mammary gland and susceptibility to tumourigenesis.

Conclusions

This mouse model demonstrates for the first time that degradation of the cyclin-like protein Spy1 is an essential component of p53-mediated tumour suppression. Targeting cyclin-like protein activity may therefore represent a mechanism of re-sensitizing cells to important cell cycle checkpoints in a therapeutic setting.
Improving the relevance of randomised trials to primary care: a qualitative study investigating views towards pragmatic trials and the PRECIS-2 tool
Authors: Forbes Gordon , Loudon Kirsty , Clinch Megan , Taylor Stephanie J. C. , Treweek Shaun , Eldridge Sandra
Published: December 2019

Background

Pragmatic trials have been suggested as a way to improve the relevance of clinical trial results to practice. PRECIS-2 (Pragmatic Explanatory Continuum Indicator Summary-2) is a trial design tool which considers how pragmatic a trial is across a number of domains. It is not known whether a pragmatic approach to all PRECIS-2 domains leads to results being more relevant to primary care. The aim of this study was to investigate the views of people with influence on primary care practice towards the design of randomised trials, pragmatic approaches to trial design, and the PRECIS-2 domains.

Methods

We carried out semi-structured interviews with people who influence practice in primary care in the UK. A thematic analysis was undertaken using the framework approach.

Results

We conducted individual or small group interviews involving an elite sample of 17 individuals. We found that an exclusively pragmatic approach to randomised trials may not always make the results of trials more applicable to primary care. For example, it may be better to have less flexibility in the way interventions are delivered in randomised trials than in practice. In addition, an appropriate balance needs to be struck when thinking about levels of resourcing and the intensity of steps needed to improve adherence in a trial. Across other aspects of a trial’s design, for example the population and trial setting, a pragmatic approach was viewed as more appropriate.

Conclusions

To maximize the relevance of research directed at primary care, trials should be conducted with the same populations and settings that are found in primary care. Across other aspects of trials it is not always necessary to match the conditions found in practice.