bluuebunny/crossref_metadata_2025 huggingface dataset:
Prediction and management of strangulated bowel obstruction: a multi-dimensional model analysis
Authors: Xu Wei-xuan , Zhong Qi-hong , Cai Yong , Zhan Can-hong , Chen Shuai , Wang Hui , Lin Lin , Geng Ying-qian , Hou Ping , Chen Xian-qiang , Zhang Jun-rong
Published: June 2022

Background

Distinguishing strangulated bowel obstruction (StBO) from simple bowel obstruction (SiBO) still poses a challenge for emergency surgeons. We aimed to construct a predictive model that could distinctly discriminate StBO from SiBO based on the degree of bowel ischemia.

Methods

The patients diagnosed with intestinal obstruction were enrolled and divided into SiBO group and StBO group. Binary logistic regression was applied to identify independent risk factors, and then predictive models based on radiological and multi-dimensional models were constructed. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) were calculated to assess the accuracy of the predicted models. Via stratification analysis, we validated the multi-dimensional model in the prediction of transmural necrosis both in the training set and validation set.

Results

Of the 281 patients with SBO, 45 (16.0%) were found to have StBO, while 236(84.0%) with SiBO. The AUC of the radiological model was 0.706 (95%CI, 0.617–0.795). In the multivariate analysis, seven risk factors including pain duration ≤ 3 days (OR = 3.775), rebound tenderness (OR = 5.201), low-to-absent bowel sounds (OR = 5.006), low levels of potassium (OR = 3.696) and sodium (OR = 3.753), high levels of BUN (OR = 4.349), high radiological score (OR = 11.264) were identified. The AUC of the multi-dimensional model was 0.857(95%CI, 0.793–0.920). In the stratification analysis, the proportion of patients with transmural necrosis was significantly greater in the high-risk group (24%) than in the medium-risk group (3%). No transmural necrosis was found in the low-risk group. The AUC of the validation set was 0.910 (95%CI, 0.843–0.976). None of patients in the low-risk and medium-risk score group suffered with StBO. However, all patients with bowel ischemia (12%) and necrosis (24%) were resorted into high-risk score group.

Conclusion

The novel multi-dimensional model offers a useful tool for predicting StBO. Clinical management could be performed according to the multivariate score.
Association between the LRP5 rs556442 gene polymorphism and the risks of NAFLD and CHD in a Chinese Han population
Authors: Han Dongli , Zhang Haiying , Liu Shousheng , Zhuang Likun , Zhao Zhenzhen , Ding Hongguang , Xin Yongning
Published: June 2022

Background

Multiple studies have demonstrated the involvement of low-density lipoprotein receptor-related protein 5 (LRP5) in metabolism-related diseases. This study explored the relationship between the LRP5 rs556442 gene polymorphism and the risks of non-alcoholic fatty liver disease (NAFLD) and coronary heart disease (CHD) in a Chinese Han population.

Methods

This retrospective case–control study included 247 patients with NAFLD, 200 patients with CHD, 118 patients with both NAFLD and CHD, and 339 healthy controls from June 2018 to June 2019 at Qingdao Municipal Hospital. Basic information and clinical characteristics were collected for all subjects. The genotype and allele frequency of LRP5 rs556442 were determined.

Results

The genotype distributions of LRP5 rs556442 differed significantly between the CHD and NAFLD + CHD groups (P < 0.05). The LRP5 rs556442 GG genotype markedly promoted the risk of NAFLD in CHD patients [odds ratio (OR) = 2.857, 95% confidence interval (CI): 1.196–6.824, P = 0.018). After adjustment for sex, age, and body mass index (BMI), this association remained significant (OR = 3.252, 95% CI: 1.306–8.102, P = 0.011). In addition, the LRP5 rs556442 AA + AG genotype was associated with an increased BMI in obese NAFLD patients (OR = 1.526, 95% CI: 1.004–2.319, P = 0.048). However, after adjustment for sex and age, this association was no longer significant (OR = 1.504, 95% CI: 0.991–2.282, P = 0.055).

Conclusions

This study found that the LRP5 rs556442 GG genotype increased the risk of NAFLD in CHD patients and AA + AG genotype may be associated with an increased BMI in obese NAFLD patients among a Chinese Han population.

Trial registration ChiCTR, ChiCTR1800015426. Registered 28 March 2018—Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=26239.
Multimorbidity patterns in adult day health center clients with dementia: a latent class analysis
Authors: Sadarangani Tina , Perissinotto Carla , Boafo Jonelle , Zhong Jie , Yu Gary
Published: June 2022

Background

Persons living with dementia (PLWD) in adult day centers (ADCs) represent a complex and vulnerable population whose well-being is at risk based on numerous factors. Greater knowledge of the interaction between dementia, chronic conditions, and social determinants of health would enable ADCs to identify and target the use of their resources to better support clients in need of in-depth intervention. The purpose of this paper is to (a) classify PLWD in ADCs according to their level of medical complexity and (b) identify the demographic, functional, and clinical characteristics of those with the highest degree of medical complexity.

Methods

This was a secondary data analysis of 3052 clients with a dementia diagnosis from 53 ADCs across the state of California between 2012 and 2019. The most common diagnosis codes were organized into 28 disease categories to enable a latent class analysis (LCA). Chi-square test, analysis of variance (ANOVA), and Kruskal-Wallis tests were conducted to examine differences among latent classes with respect to clinical and functional characteristics.

Results

An optimal 4-class solution was chosen to reflect chronic conditions among PLWD: high medical complexity, moderate medical complexity, low medical complexity, and no medical complexity. Those in the high medical complexity were taking an average of 12.72 (+/− 6.52) medications and attending the ADC an average of 3.98 days (+/− 1.31) per week—values that exceeded any other class. They also experienced hospitalizations more than any other group (19.0%) and met requirements for the nursing facility level of care (77.4%). In addition, the group experienced the greatest frequency of bladder (57.5%) and bowel (15.7%) incontinence.

Conclusions

Our results illustrate a high degree of medical complexity among PLWD in ADCs. A majority of PLWD not only have multimorbidity but are socially disadvantaged. Our results demonstrate that a comprehensive multidisciplinary approach that involves community partners such as ADCs is critically needed that addresses functional decline, loneliness, social isolation, and multimorbidity which can negatively impact PLWD.
Should preoperative computed tomography be routine examination for cervicofacial space infections?
Authors: Liang Jiayu , Jiang Linli , Li Maoye , Liu Lei , Li Hui
Published: June 2022

Background

Cervicofacial space infections are potentially life-threatening, which require accurate diagnosis, early incision, and adequate drainage. The utilization of computed tomography (CT) in cervicofacial space infections has significantly increased for its advantages in the evaluation of abscesses, its availability, and low cost. However, the clinical value of preoperative CT imaging in cervicofacial space infections remains controversial for its poor specificity, radiation exposure, potential complications, and extra cost. We, therefore, investigated whether CT examination should be used as a routine examination in the treatment of patients with cervicofacial space infections.

Methods

A retrospective study of all patients affected by cervicofacial space infections that received incision and drainage surgery from Jan 2016 to Dec 2020 was performed at West China Hospital of Stomatology at Sichuan University. Patients were divided into two groups: the group with preoperative CT and without preoperative CT. Outcomes, including reoperation rate, missed diagnosis rate, days of symptom relief, length of stay, duration of surgery, and total cost of hospitalization, were analyzed.

Results

Out of n = 153 patients, 108 patients underwent surgery with preoperative CT and 45 patients without preoperative CT. The reoperation rate in the preoperative CT group (6/108, 5.6%) was significantly lower (P = 0.00) than that in the group without preoperative CT (10/45, 22.2%). Significant reduction of missed diagnosis rate (P = 0.00), days of symptom relief (P = 0.01), length of stay(P = 0.03), and duration of surgery (P = 0.01) were detected in the preoperative CT group. The results demonstrated that the utilization of preoperative CT can reduce the missed diagnosis rate and repeated surgery complications.

Conclusions

We recommend preoperative CT as a routine examination in cervicofacial space infections.
miR-2682-3p antagonizes its host lncRNA-MIR137HG by interacting with the same target FUS to regulate the progression of gastric cancer
Authors: Du Yantao , Chen Yichen , Wu Tao , Fan Xiaodan , Lin Wei , Jiang Zhouhua
Published: June 2022

Background

The mechanism of long non-coding RNA MIR137HG in human gastric cancer (GC) is currently unknown. In the present study, we aimed to explore the function and mechanism of MIR137HG in gastric cancer.

Methods

The expression of lncRNA-MIR137HG in 69 gastric cancer samples and their paired surgical margin (SM) tissue samples were tested by QRT-PCR. UCSC was used to find the gene location relationship among MIR137HG and its embedded miRNAs. TargetScan was used to predict the targets of miR-2682-3p. Starbase was used to predict the candidate proteins that interacted with MIR137HG. Western blot, co-focus, and RIP assay were used to verify the direct interaction between MIR137HG and FUS (fused in sarcoma/translocated in liposarcoma, FUS/TLS), while dual-luciferase reporter assay was used to confirm the interaction between miR-2682-3p and FUS. Cell migration assays, colony formation, and xenografts assay were used to investigate the function of MIR137HG and miR-2682-3p to tumor growth and metastasis. Western blot assay was used to explore the downstream candidate protein of FUS.

Results

Data showed that MIR137HG expressed significantly higher in GC than in SM. MIR137HG promoted colony formation and migration in vitro and promoted tumor formation and metastasis in vivo. MIR137HG is distributed in both the nucleus and cytoplasm. It was co-located with FUS and could directly interact with FUS, which might interact with other proteins, such as MET(MET-proto-oncogene, receptor tyrosine kinase), RHOC(ras homolog family member), and CTNNB1(catenin beta1). These proteins may involve different signaling pathways to regulate gastric cancer progression. By contrast, the embedded miR-2682-3p could antagonize the series functions of its host lncRNA-MIR137HG by targeting FUS.

Conclusions

lncRNA-MIR137HG promoted growth and metastasis in gastric cancer by interacting with FUS, while miR-2682-3p could inhibit the function of MIR137HG via the same target FUS.
Effect of musculature on mortality, a retrospective cohort study
Authors: Shaver Amy L. , Platek Mary E. , Singh Anurag K. , Ma Sung Jun , Farrugia Mark , Wilding Gregory , Ray Andrew D. , Ochs-Balcom Heather M. , Noyes Katia
Published: June 2022

Background

While often life-saving, treatment for head and neck cancer (HNC) can be debilitating resulting in unplanned hospitalization. Hospitalizations in cancer patients may disrupt treatment and result in poor outcomes. Pre-treatment muscle quality and quantity ascertained through diagnostic imaging may help identify patients at high risk of poor outcomes early. The primary objective of this study was to determine if pre-treatment musculature was associated with all-cause mortality.

Methods

Patient demographic and clinical characteristics were abstracted from the cancer center electronic database (n = 403). Musculature was ascertained from pre-treatment CT scans. Propensity score matching was utilized to adjust for confounding bias when comparing patients with and without myosteatosis and with and without low muscle mass (LMM). Overall survival (OS) was evaluated using the Kaplan–Meier method and Cox multivariable analysis.

Results

A majority of patients were male (81.6%), white (89.6%), with stage IV (41.2%) oropharyngeal cancer (51.1%) treated with definitive radiation and chemotherapy (93.3%). Patients with myosteatosis and those with LMM were more likely to die compared to those with normal musculature (5-yr OS HR 1.55; 95% CI 1.03–2.34; HR 1.58; 95% CI 1.04–2.38).

Conclusions

Musculature at the time of diagnosis was associated with overall mortality. Diagnostic imaging could be utilized to aid in assessing candidates for interventions targeted at maintaining and increasing muscle reserves.
Otitis media with effusion in children aged 2–12 years attending the paediatric clinic at Mulago National Referral Hospital, a Ugandan tertiary hospital: a cross-sectional study
Authors: Bamaraki Kabagambe , Namwagala Justine , Hidour Rym , Bambi Emma Nsalazi
Published: June 2022

Background

Otitis media with effusion (OME) is common in children aged between 6 months to 4 years, and it is one of the causes of hearing loss (HL) in children worldwide. OME is a type of inflammation of the middle ear in which there is a collection of fluid. The latter causes HL which interferes with speech and language development, communication skills, school performance, psychosocial skills, and quality of life of children.

Methods

This was a prospective cross-sectional study on 246 children aged 2 -12 years, attending the Mulago National Referral Hospital (MNRH). A consecutive sampling procedure was used to reach each participant under ethical considerations until the sample size was reached. All children aged 2–12 years who meet inclusion criteria were examined first by the Pediatrician and then by the Principal Investigator. Patients with tympanogram type B (flat curve) were diagnosed to have OME. The prevalence of OME was summarized as a proportion and multivariate analysis was used to determine the factors associated with OME. Data were analyzed using the STATA version 13.0.

Results

A total of 246 children were recruited for the study. Of the 246 children, 60% were male. The median age of the participants was 4.8 ± 2.8 years. The prevalence of OME was found to be 11%. Upper respiratory tract infections (URTI), recurrent AOM (p = 0.005, OR:5.14, 95% CI: 1.66–15.96), and snoring (p = 0.000, OR: 6.32, 95% CI: 2.32–17.26) were found to be strongly associated with OME in children aged 2–12 years attending the Mulago National Referral Hospital.

Conclusions

The prevalence of OME among children aged 2–12 years attending MNRH was found to be 11%. There is an association between OME and URTI, recurrent AOM, and snoring in children aged 2–12 years attending MNRH.
Alterations of monoamine neurotransmitters, HPA-axis hormones, and inflammation cytokines in reserpine-induced hyperalgesia and depression comorbidity rat model
Authors: Zhao Jingjie , Shi Wei , Lu Yujia , Gao Xuesong , Wang Anna , Zhang Shan , Du Yi , Wang Yongzhi , Li Li
Published: June 2022

Background

Pain and depression often occur simultaneously, but the mechanism of this condition is still unclear.

Methods

The aim of this study was to examine the alterations of monoamine neurotransmitters, hypothalamic–pituitary–adrenal (HPA) axis hormones, and inflammation cytokines in hyperalgesia and depression comorbidities. The reserpine-induced “Sprague Dawley” (SD) rat models were used, and the concentrations of monoamine neurotransmitters serotonin (5-HT), norepinephrine (NE), dopamine (DA), and their metabolic products 5-hydroxyindoleacetic acid (5-HIAA), Homovanillic acid (HVA), 3,4-Dihydroxyphenylacetic acid (DOPAC) in raphe nucleus region were tested by High Performance Liquid Chromatography (HPLC). Serum levels of Adrenocorticotropic Hormone (ACTH), Cortisol (CORT), and inflammatory cytokines interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, interferon (IFN)-γ, IL-4, IL-10 were assessed by enzyme linked immunosorbent assay.

Results

Repeated reserpine injection induced hyperalgesia and depressive behaviors with decreased sucrose preference and horizontal movement distance, and increased immobility time in forced swimming test. The concentrations of 5-HT and NE in raphe nucleus, and ACTH and CORT in serum were elevated in the model group. And the model group showed increases in serum IL-1β and IL-6, and decrease in serum IL-10.

Conclusion

More research in these areas is needed to understand the pathogenesis of the disease, so as to find more and better therapeutic targets.
Perceptions of community members on contextual factors driving cardiovascular disease behavioural risk in Ghana: a qualitative study
Authors: Mensah Naa Adjeley , Sanuade Olutobi Adekunle , Baatiema Leonard
Published: June 2022

Background

There is clear evidence that lifestyle interventions are effective towards reducing cardiovascular risk. However, implementing these interventions in real-world setting has been suboptimal, especially in sub-Saharan Africa, thus creating ‘evidence to practice gap.’ We explore perceptions of community members on contextual factors driving cardiovascular disease (CVD) behavioural risk (alcohol consumption, smoking, physical (in)activity and fruits and vegetables consumption) in Ghana.

Methods

This was a cross-sectional study. Thirty (30) focus group discussions (FGDs) were carried out in five communities in Ghana (Ga Mashie, Tafo, Gyegyeano, Chanshegu and Agorve) between October and November 2017, and these were analysed using a thematic approach.

Results

Five main factors were raised by participants as contextual factors driving alcohol consumption and smoking and these include economic (poverty, unemployment, loss of jobs), psycho-social (worries, hardships, anxieties), medical (pain suppression, illness management), sexual (sexual performance boost), and socio-cultural (curse invocation, quest for supernatural powers) factors. Personal/social factors (time constraints, personal dislike, lack of knowledge of the benefits of exercise), economic factors (poverty, economic hardship), and negative health effects (getting tired easily, medical conditions) were cited as reasons why community members did not engage in physical activity. Consumption of fruits and vegetables in the five communities were determined by availability, cost, personal (dis)like, lack of knowledge about benefits, and cultural taboo. Participants’ narratives revealed that the symbolic functions of some of these behavioural risk factors and the built environment were important determining factors that have sustained these behaviours in these communities over the years.

Conclusions

This study showed that successful implementation of CVD interventions in Ghana needs to address the perceptions of community members on factors driving CVD behavioural risk factors. Future policies and interventions should be developed based on these contextual factors taking into consideration the age, sex and ethnic variations especially with interventions seeking to address CVD risk factors at the primary health care level. These findings should urge local policy makers and health managers to incorporate the roles of these contextual factors in new programs targeting cardiovascular health. Closing the ‘evidence to practice’ gap as far as CVD interventions are concerned may be impossible without this.
Distal biceps tendon ruptures occur with the almost extended elbow and supinated forearm – an online video analytic study
Authors: Lappen Sebastian , Siebenlist Sebastian , Kadantsev Pavel , Hinz Maximilian , Seilern und Aspang Jesse , Lutz Patricia M. , Imhoff Andreas B. , Geyer Stephanie
Published: June 2022

Background

Distal biceps tendon ruptures can lead to significant restrictions in affected patients. The mechanisms of injury described in scientific literature are based exclusively on case reports and theoretical models. This study aimed to determine the position of the upper extremities and forces involved in tendon rupture through analyzing video recordings.

Methods

The public YouTube.com database was queried for videos capturing a clear view of a distal biceps tendon rupture. Two orthopedic surgeons independently assessed the videos for the activity that led to the rupture, the arm position at the time of injury and the forces imposed on the elbow joint.

Results

Fifty-six video segments of a distal biceps rupture were included (55 male). In 96.4%, the distal biceps tendon ruptured with the forearm supinated and the elbow isometrically extended (non-dynamic muscle engagement) (71.4%) or slightly flexed (24%). The most common shoulder positions were adduction (85.7%) and neutral position with respect to rotation (92.9%). Most frequently a tensile force was enacted on the elbow (92.9%) and the most common activity observed was deadlifting (71.4%).

Conclusion

Distal biceps tendon ruptures were most commonly observed in weightlifting with a slightly flexed or isometrically extended elbow and forearm supination. These observations may provide useful information for sports specific evidence-based injury prevention, particularly in high performing athletes and individuals engaged in resistance training.

Level of evidence

Observational study.
Higher risk of knee arthroplasty during ten-year follow-up if baseline radiographic osteoarthritis involves the patellofemoral joint: a CHECK Cohort Study
Authors: Macri Erin M. , van Middelkoop Marienke , Damen Jurgen , Bos P Koen , Bierma-Zeinstra Sita MA
Published: June 2022

Background

Patellofemoral OA is a strong risk factor for progression to generalized whole knee OA, but it is unknown whether involvement of the patellofemoral joint in early radiographic OA (ROA) is associated with risk of undergoing future knee arthroplasty. This is clinically relevant because patellofemoral OA likely requires a different treatment approach than tibiofemoral OA, and identifying prognostic factors for future arthroplasty might assist clinicians with prioritizing and guiding early interventions that could improve long-term outcomes. Therefore, we evaluated association of baseline patellofemoral or tibiofemoral ROA with undergoing knee arthroplasty over 10 years.

Methods

Using the multicenter Cohort Hip and Cohort Knee (CHECK) study, we acquired three views of radiographs in both knees of individuals aged 45–65 years with complaints of knee symptoms in at least one knee. From baseline radiographs, we categorized each knee as having one of four patterns of ROA: no ROA, isolated patellofemoral ROA, isolated tibiofemoral ROA, or combined ROA. We evaluated the 10-year relative hazard for undergoing going arthroplasty, based on baseline ROA pattern, using Cox proportional hazard models, adjusting for age, sex body mass index, and pain severity.

Result

Our sample (n = 842) included 671 (80%) women and had mean (SD) age 56 (5) years, and BMI 26.3 (4.0) kg/m2. Arthroplasties were undertaken in 44/1678 knees. In comparison to having no ROA at baseline, adjusted hazard ratios (aHR) for arthroplasty were highest for combined ROA (aHR 14.2 [95% CI 5.8, 34.6]) and isolated patellofemoral ROA (aHR 12.7 [5.6, 29.0]). Isolated tibiofemoral ROA was not significantly associated with arthroplasty (aHR 2.9 [0.6, 13.6]).

Conclusions

In a sample of middle-aged individuals with complaints in one or both knees, the 10-year relative hazard for undergoing arthroplasty, compared to no ROA, was increased when OA involved the patellofemoral joint, regardless of whether it was isolated to the patellofemoral joint or occurred in combination with tibiofemoral OA. Further research is needed to confirm this association and to clarify the causal mechanism of this relationship. However, our results provide preliminary evidence that identifying patellofemoral ROA may be a clinically useful prognostic indicator in early knee OA.
High levels of TDO2 in relation to pro-inflammatory cytokines in synovium and synovial fluid of patients with osteoarthritis
Authors: Rong Genxiang , Zhang Tao , Xu Yayun , Zhang Zhenyu , Gui Binjie , Hu Kongzu , Zhang Jinling , Tang Zhi , Shen Cailiang
Published: June 2022

Background

Tryptophan 2,3-dioxygenase (TDO2) is the primary enzyme that catabolizes tryptophan to kynurenine. Numerous studies have suggested that TDO2 is involved in inflammation-related diseases. However, its role in osteoarthritis (OA) has not yet been investigated. The aim of the present study was to explore the levels of TDO2 in the synovium and synovial fluid (SF) of patients with OA and its correlation with clinical manifestations and levels of pro-inflammatory cytokines. 

Methods 

Synovium and SF samples were collected from patients with OA and patients with joint trauma (controls) during surgery. An enzyme-linked immunosorbent assay (ELISA) was used to measure TDO2, interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) levels in the synovium and SF. Diagnostic performance of TDO2 in the synovium to discriminate between controls and OA patients was assessed using receiver operating characteristic (ROC) curve analysis. Correlations between TDO2 levels, OA clinical features, and pro-inflammatory cytokines were evaluated using Pearson correlation analysis. Effects of IL-1β or TNF-α stimulation on TDO2 expression in OA-fibroblast-like synoviocytes (OA-FLS) were also examined.

Results

The levels of TDO2, IL-1β, and TNF-α in the synovium of patients with OA were found to be significantly higher than those in controls. ROC curve analysis revealed an area under the curve (AUC) of 0.800 with 64.3% sensitivity and 85.0% specificity of TOD2 in the synovium, which enabled discriminating patients with OA from controls. Moreover, protein expression of TDO2 was upregulated to a greater extent in OA-FLS than in normal synovial fibroblasts (NSF). Furthermore, the levels of TDO2 showed significantly positive correlation with IL-1β and TNF-α levels in the synovium and SF. TDO2 levels in the synovium were also positively correlated with the Kellgren-Lawrence score. Additionally, TDO2 protein expression was significantly increased in IL-1β‒ or TNF-α‒stimulated OA-FLS than in control FLS.

Conclusion

These data indicate that highTDO2 levels in the synovium can be correlated with pro-inflammatory cytokines and severity of OA.
Long-term outcomes after extra-levator versus conventional abdominoperineal excision for low rectal cancer
Authors: Zhang Haoyu , Li Ganbin , Cao Ke , Zhai Zhiwei , Wei Guanghui , Ye Chunxiang , Zhao Baocheng , Wang Zhenjun , Han Jiagang
Published: June 2022

Purpose

Extralevator (ELAPE) and abdominoperineal excision (APE) are two major surgical approaches for low rectal cancer patients. Although excellent short-term efficacy is achieved in patients undergoing ELAPE, the long-term benefits have not been established. In this study we evaluated the safety, pathological and survival outcomes in rectal cancer patients who underwent ELAPE and APE.

Methods

One hundred fourteen patients were enrolled, including 68 in the ELAPE group and 46 in the APE group at the Beijing Chaoyang Hospital, Capital Medical University from January 2011 to November 2020. The baseline characteristics, overall survival (OS), progression-free survival (PFS), and local recurrence-free survival (LRFS) were calculated and compared between the two groups.

Results

Demographics and tumor stage were comparable between the two groups. The 5-year PFS (67.2% versus 38.6%, log-rank P = 0.008) were significantly improved in the ELAPE group compared to the APE group, and the survival advantage was especially reflected in patients with pT3 tumors, positive lymph nodes or even those who have not received neoadjuvant chemoradiotherapy. Multivariate analysis showed that APE was an independent risk factor for OS (hazard ratio 3.000, 95% confidence interval 1.171 to 4.970, P = 0.004) and PFS (hazard ratio 2.730, 95% confidence interval 1.506 to 4.984, P = 0.001).

Conclusion

 Compared with APE, ELAPE improved long-term outcomes for low rectal cancer patients, especially among patients with pT3 tumors, positive lymph nodes or those without neoadjuvant chemoradiotherapy.
Disparate access to breast cancer screening and treatment
Authors: Castaldi Maria , Smiley Abbas , Kechejian Katharine , Butler Jonathan , Latifi Rifat
Published: June 2022

Background

Barriers to breast cancer screening remain despite Medicaid expansion for preventive screening tests and implementation of patient navigation programs under the Affordable Care Act. Women from underserved communities experience disproportionately low rates of screening mammography. This study compares barriers to breast cancer screening among women at an inner-city safety-net center (City) and those at a suburban county medical center (County). Inner city and suburban county medical centers’ initiatives were studied to compare outcomes of breast cancer screening and factors that influence access to care.

Methods

Women 40 years of age or older delinquent in breast cancer screening were offered patient navigation services between October 2014 and September 2019. Four different screening time-to-event intervals were investigated: time from patient navigation acceptance to screening mammography, to diagnostic mammography, to biopsy, and overall screening completion time. Barriers to complete breast cancer screening between the two centers were compared.

Results

Women from lowest income quartiles took significantly longer to complete breast cancer screening when compared to women from higher income quartiles when a barrier was present, regardless of barrier type and center. Transportation was a major barrier to screening mammography completion, while fear was the major barrier to abnormal screening work up.

Conclusion

Disparity in breast cancer screening and management persists despite implementation of a patient navigation program. In the presence of a barrier, women from the lowest income quartiles have prolonged breast cancer screening completion time regardless of center or barrier type. Women who experience fear have longest screening time completion. Future directions aim to increase resource allocation to ameliorate wait times in overburdened safety-net hospitals as well as advanced training for patient navigators to alleviate women’s fears.
Ginsenoside Rg-1 prevents elevated cytosolic Ca2+ via store-operated Ca2+ entry in high-glucose–stimulated vascular endothelial and smooth muscle cells
Authors: Han A Young , Ha Su Min , Shin You Kyoung , Seol Geun Hee
Published: June 2022

Background

Ginsenoside Rg-1 (Rg-1), a triterpenoid saponin abundantly present in Panax ginseng, is a type of naturally occurring steroid with known anti-diabetic and anti-inflammatory effects. In this study, we sought to confirm the effects and mechanisms of action of Rg-1 on store-operated Ca2+ entry (SOCE) in human vascular endothelial cell line (EA) and murine aortic vascular smooth muscle cell line (MOVAS) cells exposed to high glucose.

Methods

Cytosolic Ca2+ concentrations in EA and MOVAS cells were measured by monitoring fluorescence of the ratiometric Ca2+-indicator, Fura-2 AM.

Results

High glucose significantly increased Ca2+ influx by abnormally activating SOCE in EA and MOVAS cells. Notably, this high glucose-induced increase in SOCE was restored to normal levels in EA and MOVAS cells by Rg-1. Moreover, Rg-1 induced reductions in SOCE in cells exposed to high glucose were significantly inhibited by the plasma membrane Ca2+ ATPase (PMCA) blocker lanthanum, the Na+/K+-ATPase blocker ouabain, or the Na+/Ca2+ exchanger (NCX) blockers Ni2+ and KB-R7943. These observations suggest that the mechanism of action of Rg-1 inhibition of SOCE involves PMCA and Na+/K+-ATPase, and an increase in Ca2+ efflux via NCXs in both EA and MOVAS cells exposed to high glucose.

Conclusions

These findings indicate that Rg-1 may protect vascular endothelial and smooth muscle cells from Ca2+ increases following exposure to hyperglycemic conditions.
Wenyang Huazhuo Tongluo formula alleviates pulmonary vascular injury and downregulates HIF-1α in bleomycin-induced systemic sclerosis mouse model
Authors: Li Kai , Wang Qian , Lv Qin , Guo Kelei , Han Li , Duan Peipei , Deng Yongzheng , Bian Hua
Published: June 2022

Background

Vascular damage, autoimmune abnormalities, and fibrosis are the three pathological features of systemic sclerosis (SSc).However, pulmonary vascular damage is the main factor affecting the progression and prognosis of SSc. The main purpose of this study was to explore the molecular mechanism of Wenyang Huazhuo Tongluo Formula in alleviating pulmonary vascular injury in bleomycin-induced SSc mouse model.

Methods

Masson staining and H&E staining were used to analyze the degree of pulmonary vascular fibrosis and the infiltration of leukocyte cells in lung tissue ofbleomycin-induced SSc mouse models treated with saline (BLM group), Wenyang Huazhuo Tongluo Formula (WYHZTL group) and HIF-1α inhibitor KC7F2 (KC7F2 group). Blood vessel exudation was determined by analyzing the cell number and albumin concentration in bronchoalveolar lavage fluid using a cell counter and ELISA assay, respectively. The degree of vascular injury was assessed by measuring the expression levels of vWF, E-selectin, ICAM-1, VCAM-1, VE-cadherin and claudin-5 in serum and pulmonary vascular endothelial cells using ELISA and immunofluorescence staining. Finally, the effect of Wenyang Huazhuo Tongluo Formula on the expression of HIF-1α was detected using immunofluorescence staining.

Results

Wenyang Huazhuo Tongluo Formula and KC7F2 significantly inhibited bleomycin-induced pulmonary vascular fibrosis and the level of perivascular inflammatory cell infiltration. The number of cells and the concentration of albumin were significantly reduced in the bronchoalveolar lavage fluid of the WYHZTL group and KC7F2 group compared with the BLM group. In addition, treatment with Wenyang Huazhuo Tongluo Formula and KC7F2 significantly downregulated the expression levels of vWF, E-selectin, ICAM-1, VCAM-1 and HIF-1α, but upregulated the expression of VE-cadherin and claudin-5 in serum and pulmonary vascular endothelial cells, compared with treatment with saline.

Conclusions

This study reveals that Wenyang Huazhuo Tongluo Formula plays a new role in the treatment of SSc by alleviating pulmonary vascular damage. Furthermore, we found that Wenyang Huazhuo Tongluo Formula alleviates pulmonary vascular injury and inhibits HIF-1α expression.
Training of radiotherapy professionals: status, content, satisfaction and improvement suggestions in the Greater Region
Authors: Dubois Nadège , Nguyet Diep Anh , Ghuysen Alexandre , Declaye Joséfine , Donneau Anne-Françoise , Vogin Guillaume , Fleckenstein Jochen , Coucke Philippe , Ben Mustapha Selma
Published: June 2022

Background

The initial training of Radiation Oncology professionals can vary widely across Europe. The aim of this study was to assess the status and content of the initial training programs currently implemented in the Greater Region: Lorraine (Nancy, France), Saarland (Homburg, Germany), Luxembourg, and Liège (Wallonia, Belgium).

Methods

A survey was developed to investigate (1) the overall satisfaction, learning objectives, and teaching methods used during initial training programs and (2) the perceptions of the importance of key professional competencies as described by the CanMEDS (a framework that identifies and describes the abilities physicians require to effectively meet the health care needs of the people they serve). In addition, open-ended questions were used to elicit opinions on room for improvement. Participants (N = 38) were physicians (radiation oncologists (RO) seniors and residents) and radiation therapists (RTTs).

Results

Only 21.1% of the respondents declared having acquired all the competencies required for their professional practice during their initial training. Heterogeneity in teaching methods was noted within professional programs but there is no difference between those from RO and RTT in the teaching of technical and relational skills. Relational skills were not addressed in a range of 39.5–57.9% of respondent’s curricula. More practical lessons were deemed necessary to improve radiotherapy (RT) training programs.

Conclusions

Radiation oncology professionals expressed the need for more practical teaching, especially in the training of non-technical skills. Regarding the perceived importance of professional aptitudes, radiation oncology professionals highlighted medical and relational skills as the most important competencies.
Patient participation in Dutch ethics support: practice, ideals, challenges and recommendations—a national survey
Authors: Eijkholt Marleen , de Snoo-Trimp Janine , Ligtenberg Wieke , Molewijk Bert
Published: June 2022

Background

Patient participation in clinical ethics support services (CESS) has been marked as an important issue. There seems to be a wide variety of practices globally, but extensive theoretical or empirical studies on the matter are missing. Scarce publications indicate that, in Europe, patient participation in CESS (fused and abbreviated hereafter as: PP) varies from region to region, and per type of support. Practices vary from being non-existent, to patients being a full conversation partner. This contrasts with North America, where PP seems more or less standard. While PP seems to be on the rise in Europe, there is no data to confirm this. This study sought a deep understanding of both habits and the attitudes towards PP in the Netherlands, including respondents’ practical and normative perspectives on the matter.

Methods and Results

We developed a national survey on PP for Dutch CESS staff. Our survey comprised a total of 25 open and close-ended questions, focused on four topics related to PP (1) goals of CESS, (2) status quo of PP, (3) ideas and ideals concerning PP, and (4) obstacles for PP.

Discussion

The four most important findings were that: (1) Patient participation in Dutch CESS is far from standard. (2) Views on patient participation are very much intertwined with the goals of ethics support. (3) Hesitations, fears and perceived obstacles for PP were not on principle and (4) Most respondents see PP as a positive opportunity, yet requiring additional training, practical guidance and experience.

Conclusions

Various normative reasons require PP. However, PP seems far from standard and somewhat rare in Dutch CESS settings. Our respondents did not raise many principled objections to PP. Instead, reasons for the lack of PP are intertwined with viewpoints on the goals of CESS, which seemingly focus on supporting health care professionals (HCPs). Training and practical guidance was thought to be helpful for gaining experience for both CESS staff and HCPs.
Can systematic implementation support improve programme fidelity by improving care providers’ perceptions of implementation factors? A cluster randomized trial
Authors: Hartveit Miriam , Hovlid Einar , Øvretveit John , Assmus Jørg , Bond Gary , Joa Inge , Heiervang Kristin , Stensrud Bjørn , Høifødt Tordis Sørensen , Biringer Eva , Ruud Torleif
Published: June 2022

Background

Investigations of implementation factors (e.g., collegial support and sense of coherence) are recommended to better understand and address inadequate implementation outcomes. Little is known about the relationship between implementation factors and outcomes, especially in later phases of an implementation effort. The aims of this study were to assess the association between implementation success (measured by programme fidelity) and care providers’ perceptions of implementation factors during an implementation process and to investigate whether these perceptions are affected by systematic implementation support.

Methods

Using a cluster-randomized design, mental health clinics were drawn to receive implementation support for one (intervention) and not for another (control) of four evidence-based practices. Programme fidelity and care providers’ perceptions (Implementation Process Assessment Tool questionnaire) were scored for both intervention and control groups at baseline, 6-, 12- and 18-months. Associations and group differences were tested by means of descriptive statistics (mean, standard deviation and confidence interval) and linear mixed effect analysis.

Results

Including 33 mental health centres or wards, we found care providers’ perceptions of a set of implementation factors to be associated with fidelity but not at baseline. After 18 months of implementation effort, fidelity and care providers’ perceptions were strongly correlated (B (95% CI) = .7 (.2, 1.1), p = .004). Care providers perceived implementation factors more positively when implementation support was provided than when it was not (t (140) = 2.22, p = .028).

Conclusions

Implementation support can facilitate positive perceptions among care providers, which is associated with higher programme fidelity. To improve implementation success, we should pay more attention to how care providers constantly perceive implementation factors during all phases of the implementation effort. Further research is needed to investigate the validity of our findings in other settings and to improve our understanding of ongoing decision-making among care providers, i.e., the mechanisms of sustaining the high fidelity of recommended practices.

Trial registration

ClinicalTrials.gov Identifier: NCT03271242 (registration date: 05.09.2017).
Medicinal plants used to treat livestock ailments in Ensaro District, North Shewa Zone, Amhara Regional State, Ethiopia
Authors: Asfaw Asaye , Lulekal Ermias , Bekele Tamrat , Debella Asfaw , Debebe Eyob , Sisay Bihonegn
Published: June 2022

Background

In Ethiopia, the majority of animal owners throughout the country depend on traditional healthcare practices to manage their animals' health problems. This ethnoveterinary study was carried out in Ensaro District, North Showa Zone, and Amhara Region, Ethiopia, to identify medicinal plant species used by the local community to treat various livestock ailments.

Methods

To collect ethnobotanical information, a total of 389 informants (283 men and 106 women) were selected. Among these 95 traditional medicine practitioners were purposely chosen, while the remaining 294 were selected through a systematic random sampling method. Ethnobotanical data were collected through semi-structured interviews, participant observation, guided filed walks and focus group discussions. The Informant Consensus Factor (ICF) and Fidelity Level (FL) values, preference, and direct matrix exercise ranking were determined using quantitative methods. Statistical tests were used to compare indigenous knowledge of medicinal plants among different informant groups.

Results

A total of 44 ethnoveterinary medicinal plant species were collected and identified that were distributed across 43 genera and 28 families. The family Solanaceae stood first by contributing 4 species followed by Amaranthaceae, Asteraceae, Euphorbiaceae, Fabaceae and lamiaceae with 3 species each. Thirty- seven (88.09%) medicinal plants were collected from wild habitats, 6 medicinal plant species were collected from home garden. The most frequently used life form was shrubs (23 species, 54.76%) followed by herbs (13 species, 30.95%). The widely used parts of medicinal plants were leaves followed by roots. Prepared remedies were administered through drenching, dropping, smearing, eating, wrapping, fumigating and washing. There was significant difference in the indigenous knowledge of medicinal plants between gender, urban and rural people, general and key informants and among age groups.

Conclusion

Ensaro District is a relatively rich in diversity of ethnoveterinary medicinal plants together with a rich indigenous knowledge in the local communities to collect and effectively utilize for the management different livestock diseases. On the other hand, these days, agricultural expansion, fuel wood collection, cutting plants for fence, furniture and charcoal production are the major threatening factors of these plant resources. Thus, people of the study area must implement in situ and ex-situ conservation strategies to ensure sustainable utilization of these species.
Deficiency of leukocyte-specific protein 1 (LSP1) alleviates asthmatic inflammation in a mouse model
Authors: Le Nguyen Phuong Khanh , do Nascimento Amanda Florentina , Schneberger David , Quach Chi Cuong , Zhang Xiaobei , Aulakh Gurpreet K. , Dawicki Wojciech , Liu Lixin , Gordon John R. , Singh Baljit
Published: June 2022

Background

Asthma is a major cause of morbidity and mortality in humans. The mechanisms of asthma are still not fully understood. Leukocyte-specific protein-1 (LSP-1) regulates neutrophil migration during acute lung inflammation. However, its role in asthma remains unknown.

Methods

An OVA-induced mouse asthma model in LSP1-deficient (Lsp1−/−) and wild-type (WT) 129/SvJ mice were used to test the hypothesis that the absence of LSP1 would inhibit airway hyperresponsiveness and lung inflammation.

Results

Light and electron microscopic immunocytochemistry and Western blotting showed that, compared with normal healthy lungs, the levels of LSP1 were increased in lungs of OVA-asthmatic mice. Compared to Lsp1−/−OVA mice, WT OVA mice had higher levels of leukocytes in broncho-alveolar lavage fluid and in the lung tissues (P < 0.05). The levels of OVA-specific IgE but not IgA and IgG1 in the serum of WT OVA mice was higher than that of Lsp1−/−OVA mice (P < 0.05). Deficiency of LSP1 significantly reduced the levels of IL-4, IL-5, IL-6, IL-13, and CXCL1 (P < 0.05) but not total proteins in broncho-alveolar lavage fluid in asthmatic mice. The airway hyper-responsiveness to methacholine in Lsp1−/−OVA mice was improved compared to WT OVA mice (P < 0.05). Histology revealed more inflammation (inflammatory cells, and airway and blood vessel wall thickening) in the lungs of WT OVA mice than in those of Lsp1−/−OVA mice. Finally, immunohistology showed localization of LSP1 protein in normal and asthmatic human lungs especially associated with the vascular endothelium and neutrophils.

Conclusion

These data show that LSP1 deficiency reduces airway hyper-responsiveness and lung inflammation, including leukocyte recruitment and cytokine expression, in a mouse model of asthma.
Bartha-K61 vaccine protects nursery pigs against challenge with novel european and asian strains of suid herpesvirus 1
Authors: Papageorgiou Konstantinos V. , Michailidou Margarita , Grivas Ioannis , Petridou Evanthia , Stamelou Efthymia , Efraimidis Konstantinos , Chen Lei , Drew Trevor W. , Kritas Spyridon K.
Published: June 2022

The present study investigates the pathogenicity of two recently isolated strains of Suid herpesvirus 1 (SuHV1), the Greek strain Hercules and the Chinese strain HeN1, in unvaccinated pigs and in pigs vaccinated with a Bartha-K61 strain. In an experiment performed in negative pressure kiosks (isolators), 45-day old seronegative pigs previously oronasally /intramuscularly vaccinated with the Bartha-K61 vaccine strain, along with unvaccinated controls, were challenged either with the Hercules strain or the HeN1 strain of SuHV1. All animals were observed daily for clinical signs and body temperature and nasal swabs, faeces, blood and bodyweight were collected up to a maximum period of 20 days post-challenge (dpc). The results showed that, in the unvaccinated pigs, HeN1 strain was more virulent than the Hercules strain, with increased mortality, shorter time to death and higher group clinical score (p < 0.05). However, after vaccination with the Bartha-K61 vaccine, there was a drastic reduction in morbidity, mortality, bodyweight loss and virus excretion to almost a similar extent in both strains (p < 0.05). No significant differences were seen among the pigs of the two vaccinated groups compared to unvaccinated unchallenged controls, except a slight elevation in body temperature and in clinical score in the HeN1 vaccinees at 2 and 3 dpc, while bodyweight gain was similar to that of the negative control pigs. Our study showed that despite differences in virulence, the standard vaccination scheme with the Bartha-K61 strain could equally protect nursery pigs against both the European and Chinese strains.