bluuebunny/crossref_metadata_2025 huggingface dataset:
Detection of gene expression in sentinel lymph node of primary breast cancer patients
Authors: Soleimani Shahrzad , Alizadeh Shargh Shohreh , Keramatinia Aliasghar , Mehrvar Narjes , Mansouri Neda , Doosti Abbas , Mortazavi-Tabatabaei Seyed Abdolreza , Hashemi Mehrdad , Movafagh Abolfazl
Published: May 2018

Sentinel lymph node (SLN) micrometstasis detection improves outcome for breast cancer follow up procedure. The aim of the present study was to identify gene profiles that accurately predicted the outcome of breast cancer patients. Fifty tumor sample from breast cancer patients were analyzed for the expression of 3 genes using quantitative-PCR. Also clinical verification for recurrence to distant organs was performed. Three gene signature were confirmed based on tumor's stage, grade, ER status, using conditional logistic regression. Based on this findings, the negative reported lymph nodes for metastasis, had micro metastasis in significant values. There was a significant difference between normal and cancer samples in 3 gene expression marker and also there was meaningful relationship between three gene expression with tumor's grade, stage according to progression of tumor. A novel gene expression signature predictive of micro metastatic patients was evaluated. In this assessment, relationship between this gene with tumor's features   that finding clear role for these genes with tumor's outcome, needs to be established.
Multidrug resistance, prevalence and phylogenetic analysis of genes encoding class II and III integrons in clinically isolated Escherichia coli
Authors: Taha Manal Mohamed Elhassan , Homeida Hisham Elraih , Dafalla Omer Mohammed Elhassan , Abdelwahab Siddig Ibrahim
Published: May 2018

The present study was conducted to evaluate the susceptibility, multidrug resistance and genetic characteristics of Escherichia coli (E. coli) strains, isolated from clinical samples from Jazan Hospital, Jazan, Saudi Arabia. A total of 95 samples were recruited from wound, urine, stool and blood. The isolates were assessed for their antibiotic susceptibilities and the presence of class II and III integrons was studied using PCR technique. Integron II-positive PCR products were further confirmed using partial sequencing. Ampicillin (84.2%) was found to be the most resistant antibiotic followed by ciprofloxacin (57.9%), gentamicin (56.8%), nalidixic acid (50.5%), cefotaxim (49.5%), ofloxacin (45.3%), amikacin (26.3%) and imipenem (16.8%), respectively. Seventy-six isolated strains were designated as multidrug resistant (MDR), while non-MDR was found in 19 strains (20.0%). Out of 76 MDR E. coli isolates, 41 (53.9%) were identified as positive for class II and 5 (6.5%) were positive for class III integron. Bioinformatics' analysis have shown that the sequences of our samples aligned along with many published sequences of integron II. Our findings further strengthen the significance of hospital-based and community E. coli strains on rising the burden of antimicrobial resistance.
TGFÎ²1-mediated PI3K/Akt and p38 MAP kinase dependent alternative splicing of fibronectin extra domain A in human podocyte culture
Authors: Madne Tarunkumar Hemraj , Dockrell Mark Edward Carl
Published: May 2018

Alternative splicing is an important gene regulation process to distribute proteins in health and diseases. Extra Domain A+ Fibronectin (EDA+Fn) is an alternatively spliced form of fibronectin (Fn) protein, present in the extra cellular matrix (ECM) and a recognised marker of various pathologies. TGFÎ²1 has been shown to induce alternative splicing of EDA+Fn in many cell types. Podocytes are spectacular cell type and play a key role in filtration and synthesise ECM proteins in renal physiology and pathology. In our previous study we have demonstrated expression and alternative splicing of EDA+Fn in basal condition in human podocytes culture. TGFÎ²1 further induced the basal expression and alternative splicing of EDA+Fn through Alk5 receptor and SR proteins. In this study, we have investigated TGFÎ²1 mediated signalling involved in alternative splicing of EDA+Fn in human podocytes. We have performed western blotting to characterise the expression of the EDA+Fn protein and other signalling proteins and RT-PCR to look for signalling pathways involved in regulation of alternative splicing of EDA+Fn in conditionally immortalised human podocytes culture.We have used TGFÎ²1 as a stimulator and SB431542, SB202190 and LY294002 for inhibitory studies. In this work, we have demonstrated in human podocytes culture TGFÎ²1 2.5ng/ml induced phosphorylation of Smad1/5/8, Smad2 and Smad3 via the ALK5 receptor. TGFÎ²1 significantly induced the PI3K/Akt pathway and the PI3K/Akt pathway inhibitor LY294002 significantly downregulated basal as well as TGFÎ²1 induced alternative splicing of EDA+Fn in human podocytes. In addition to this, TGFÎ²1 significantly induced the p38 MAP kinase signalling pathway and p38 MAP kinase signalling pathway inhibitor SB202190 downregulated the TGFÎ²1-mediated alternative splicing of EDA+Fn in human podocytes. The results with PI3K and p38 MAP kinase signalling pathway suggest that inhibiting PI3K signalling pathway downregulated the basal alternative splicing of EDA+Fn in human podocytes and its the inhibition of p38 Map Kinase signalling pathway which had specifically downregulated the TGFÎ²1 mediated alternative splicing of EDA+Fn in human podocytes culture. Activation of TGFÎ²1-mediated Smad1/5/8 via Alk5 receptor suggests that TGFÎ²1 signalling pathway involved Alk5/Alk1 receptor axis signalling in human podocytes.
Swainsonine induces apoptosis of rat cardiomyocytes via mitochondria"‘mediated pathway
Authors: Zheng Xiang , Wang Shushu , Chen Dakai , Yang Xiaoming
Published: May 2018

Swainsonine is an Astragalus membranaceus extract. It is indole, alkaloid, and soluble in water. Its effect on rat cardiomyocytes apoptosis, and the mechanisms underlying that effect, were investigated by inducing apoptosis in H9c2 cells. This was detected by MTT assay, Annexin V-FITC/propidium iodide double staining and western blotting. Flow cytometry and fluorescence microscopy were used to confirm swainsonine's effect on mitochondrial membrane potential and levels of reactive oxygen species, while an ATP-dependent bioluminescence assay kit served to find the ATP contents. Assessment was also carried out for peroxisome proliferator activated receptor Î³ co-activator 1Î± (PGC-1Î±) expression levels as well as those of such apoptosis-associated proteins as Cytochrome c, Caspase-3, B-cell lymphoma 2 (Bcl-2) and Bcl-2-associated X protein (Bax). Overall, indications were that swainsonine may have the potential to inhibit viability of cells, decrease expression of PGC-1Î±, induce mitochondrial dysfunction, upregulate Cytochrome c, Bax and Caspase-3, and downregulate Bcl-2. The suggestion would be that apoptosis may be induced through signalling pathways in H9c2 cells mediated by mitochondria.
Expression of extracellular matrix and adhesion proteins in pelvic organ prolapse
Authors: Cecati Monica , Corradetti Alessandra , Sartini Davide , Pozzi Valentina , Giannubilo Stefano R , Saccucci Franca , Ciavattini Andrea , Emanuelli Monica
Published: May 2018

Pelvic organ prolapse (POP) is a common disorder in women. It is characterized by the descent of the vaginal wall with consequent drop of pelvic organs. Pregnancy, labour and childbirth seem to be important events leading to the development of POP, since they are associated with prolonged stretch and mechanical stress of muscles, ligaments and connective tissue supporting pelvic organs. In pubocervical fascia, we explored the expression level of extracellular matrix and adhesion molecules. Tissue samples were obtained from twenty patients with POP who underwent cystocele repair, and from twenty control subjects during hysterectomy surgery. The PCR array analysis was performed and data were confirmed by Real-Time PCR and Western Blot.  Real-Time PCR results showed a significant upregulation for extracellular matrix protein 1 (ECM1) and integrin beta 3 (ITGB3) and a significant downregulation for FBLN5 in POP group. The decreased mRNA expression of FBLN5 in pathological samples was paralleled by a quantitative decrease in the corresponding protein, as Western Blot test highlighted. Our data provide an understanding of molecular mechanisms involved in POP-related pathophysiological processes and might represent an important tool to develop novel therapeutic agents for the treatment of this condition.
Molecular analysis of integron gene cassette arrays associated multi-drug resistant Enterobacteriaceae isolates from poultry
Authors: El-Demerdash Azza S , Aggour Mohamed G , El-Azzouny Mona M , Abou-Khadra Sally H
Published: May 2018

The study investigated 110 Enterobacteriaceae isolates from broiler chickens isolated from Sharkia poultry farms and analyzed the isolates antimicrobial resistance and the presence of integrons as a potential basis for this resistance. Antibiotic susceptibilities against 12 different antibiotics were determined by the disk diffusion method. Prevalences and classes of integrons were then detected in multi-drug resistant (MDR) strains using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) followed by sequencing of the variable parts. Fifty-three isolates were MDR (resistant to three or more antimicrobial agents). High resistance was detected for rifamycin (82.7%), erythromycin (67.2%), and amoxicillin-clavulanic acid (63%). Classes 1 and 2 integrons were detected in 38 of 53 MDR Enterobacteriaceae isolates of which the most common were Salmonella species (n=19), followed by Escherichia coli (12), Klebsiella pneumoniae (3), Proteus species (3), and Citrobacter freundii (1). Three isolates only harbored class 1 integrons while the remaining 35 isolates carried class 2.  All class 1 integron positive isolates exhibited the same gene cassettes arrangements: 1.) dfrA12-orfF–aadA27 (1.6 kbp); 2.) aadA23 (1.0 kbp); and 3.) dfrA15 (0.8 kbp). Moreover, four different gene cassettes were identified within class 2 integrons: 1.) dfrA1-sat2-aadA30 (2 kbp) in all isolates; 2.) sat2-aadA1 (1.7 kbp) in only one isolate; 3.) catB2 (0.9 kbp) in four isolates; and 4.) a new variant of sat2 (0.65 kbp) in three isolates. Efforts should be made to introduce surveillance programs for monitoring antimicrobial resistance that could potentially be transmitted from broiler chickens to human via integrons.
Relating pancreatic ductal adenocarcinoma tumor samples and cell lines using gene expression data in translational research
Authors: Shuaichen Liu , Guangyi Wang
Published: May 2018

Cancer cell lines are useful tools to study cancer biology. Choosing proper cell lines based on experimental design for different experiments is vital. Relating tumors and cell lines, and recognizing their similarities and differences are thus very important for translational research. Abundant online databases with genomic and expression profile are suitable resources for conducting the assessment. Pancreatic ductal adenocarcinoma (PDAC) is a severe cancer with grim prognosis. Current effective treatments of PDAC remain limited. In this study, we compared the gene expression profile of 178 PDAC tumor samples from The Cancer Genome Atlas and 44 pancreatic cancer cell lines from Cancer Cell Line Encyclopedia. We showed that all pancreatic cancer cell lines resemble PDAC tumors but the correlation is different. Our study will be used to guide the selection of PDAC cell lines.
Association between polymorphisms of glucocorticoid receptor genes and asthma: A meta-analysis
Authors: Fu Guanglei , Fu Lijun , Cai Youli , Zhao Hui , Fu Wenjun
Published: May 2018

Recent studies have evaluated the associations between polymorphisms of glucocorticoid receptor genes and asthma. However, the conclusions of these studies are conflicting. The objective of this meta-analysis was to clarify the association between all known polymorphisms of glucocorticoid receptor genetic loci and susceptibility to asthma, based on existing reports. We conducted a meta-analysis of the association between glucocorticoid receptor polymorphisms (NR3C1) and asthma risk. A systematical literature search was performed in PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), and Cochrane Library until January 15, 2018. The odds ratio (OR), 95% confidence interval (CI), and P value were calculated using Mantel-Haenszel statistics under the allele, homozygote, heterozygote, dominant, or recessive models. P values of less than 0.05 were considered to represent statistically significant associations between glucocorticoid receptor gene polymorphisms and asthma. All statistical analyses were done using the "meta” package (version 4.9–0) of R version 3.4.3 and RStudio version 1.0.44. A total of fourteen studies, reported via ten articles from online databases were included in our meta-analysis. For BclI (from eight studies), a significant association was detected in the allele model, homozygote model, and recessive model (C versus G: OR (95% CI) = 0.63 (0.40–0.97), CC versus GG: OR (95% CI) = 0.41(0.17–0.97), CC versus GC + GG: OR (95% CI) = 0.54(0.34–0.88)), but not in the heterozygote model or the dominant model. For ER22/23EK (from four studies), TthIII1 (from two studies), no significant association was found for any genetic model. After subgroup analyses by age, significant associations were observed for the allele model, homozygote model, dominant model and recessive model for BclI in adults. The ER22/23EK and TthIII1 polymorphisms were not found to be associated with susceptibility to ASTHMA; however, the BclI polymorphisms were significantly associated with ASTHMA in adults.
Prevalence of alpha actinin-3 gene (ACTN3) R577X and angiotensin converting enzyme (ACE) insertion / deletion gene polymorphisms in national and amateur Turkish athletes
Authors: Eroğlu Onur , Zileli Rayif , Nalbant M. Ali , Ulucan Korkut
Published: May 2018

Studies to date showed the importance of alpha- actinin-3 (ACTN3) R577X and angiotensin converting enzyme (ACE) ID polymorphisms on determining athletic performance. Therefore, in this study, we aimed to examine polymorphisms given to Turkish athletes and compare them with sedentary individuals. Genomic DNAs were extracted from peripheral blood by using commercially available DNA isolation kit (Macherey-Nagel, NucleoSpin®, Germany). For this study, a total of 84 volunteers (23 national athletes, 27 amateur athletes and 34 sedentary controls) was recruited.  ACE ID genotypes were determined by conventional polymerase chain reaction, and ACTN3 R577X polymorphisms by polymerase chain reaction- restriction fragment length polymorphism methodology.   In ACTN3 R577X polymorphism, RX was the dominating genotype, and we detected no RR genotype in national athletes. (no RR genotype was detected in national athletes) X allele is more frequent in national athletes and R allele was more frequent in both amateur athletes and control group. II genotype was more frequent in national athletes and in control group, whereas DD genotype was more frequent in amateur athletes for ACE ID polymorphism. When we consider alleles, D allele was found more frequently in amateur athletes and control group whereas I allele was more frequent in national athletes in ACE ID polymorphism. For ACTN3, X allele was superior to R allele. ACTN3 R577X and ACE ID polymorphisms were important biomarkers in determining athletic performance. However, our results in Turkish athletes suggest that ACE D allele and ACTN3 X alleles may be beneficial to athletes potentially, regardless of the distance they perform.
In silico estrogen-like activity and in vivo osteoclastogenesis inhibitory effect of Cicer arietinum extract
Authors: Sayed Amany A. , Elfiky Abdo A.
Published: May 2018

Postmenopausal osteoporosis is a common disorder accompanied with estrogen deficiency in women. Plants containing phytoestrogens and amino acids have been used in the osteoporosis treatment. The present study aims to evaluate the estrogen-like activity of the Cicer arietinum extract (CAE) and its ability to inhibit osteoclastogenesis process. These achieved by investigating the binding of its active phytoestrogens (genistein, daidzein, formononetin and biochanin A) to the estrogen receptors (ER) Î± and Î² of rats and human in silico. In addition, in vivo study on ovariectomized (OVX) rats is performed. For in vivo study, twenty four rats were divided into four groups (n= 6). Group I is the sham control rats which administered distilled water. Groups II, III, and IV are OVX groups which administered distilled water, CAE (500 mg/kg), and alendronate; respectively. The docking study revealed that the phytoestrogens docked into the protein active site with binding energies comparable with that of estrogens (estriol and Î²-estradiol) which means the similarity between the estrogenic contents of CAE and the ensogenous ones. Additionally, in vivo study revealed that CAE reverse TRAP5b and RANKL levels that drastically increased in the untreated OVX group. But, it trigger upregulation of OPG, enhance the OPG/RANKL ratio and modulate the bone and uterus alterations of OVX group. Phytoestrogens and the bone-protective amino acids contents of CAE could be responsible for their estrogen-like effect and antiosteoporotic activity. These results concluded that CAE is an attractive candidate for developing a potential therapeutic cheap agent used as an alternative to the synthetic estrogen replacement therapy. Further, in vivo validation is required for its clinical application.
CREBRF promotes the proliferation of human gastric cancer cells via the AKT signaling pathway
Authors: Han Jiming , Zhang Lu , Zhang Jing , Jiang Qiuyu , Tong Dongdong , Wang Xiaofei , Gao Xing , Zhao Lingyu , Huang Chen
Published: May 2018

Gastric cancer (GC) is one of the most common malignant cancer around the world, however the mechanisms is still unclear. In the present study, we investigated the function of CREB3 regulatory factor (CREBRF) in human GC and explored its relevant molecular mechanism. We found that CREBRF was highly expressed in primary GC tissues and the expression level was associated with the clinicopathologic characteristics of GC. CREBRF silencing inhibited GC cell proliferation and induced G1/G0 to S phase cell cycle arrest through regulating Cyclin A, Cyclin D1 and CDK2 expressions. Furthermore, the results showed that knockdown of CREBRF suppressed the activation of AKT signaling pathway. We further discovered that activating of AKT rescued the effect of CREBRF silencing on cell growth and drove cell re-enter into the S phase of the cell cycle with SC79 (a AKT activator). Taken together, our study demonstrated that CREBRF might promote GC cell proliferation and induce G1-S phase transition through activating AKT signaling pathway. These findings suggest that CREBRF acts as a novel oncogene and may be a potential therapeutic target in therapy of GC.
Association between the functional PTPN22 G788A (R263Q) polymorphism and susceptibility to autoimmune diseases: A meta-analysis
Authors: Bae Sang-Cheol , Lee Young Ho
Published: May 2018

This study explored whether the functional protein tyrosine phosphatase nonreceptor 22 (PTPN22) G788A (R263Q) polymorphism is associated with susceptibility to autoimmune diseases. A meta-analysis was conducted using 23 comparative studies with a total of 16,719 patients and 17,783 controls. The meta-analysis showed an association between the A allele of the PTPN22 G788A polymorphism and decreased risk of autoimmune diseases in all subjects (p < 0.001). Analysis after stratification by ethnicity indicated that the PTPN22 788A allele was significantly associated with autoimmune diseases in Europeans (p < 0.001) but not in Latin Americans. Meta-analysis by autoimmune disease type showed a significant negative association between the PTPN22 788A allele and systemic lupus erythematous (SLE) (p = 001), rheumatoid arthritis (RA) (p = 0.008), ulcerative colitis (UC) (p = 0.016), but not Crohn's disease (CD). A single study for each showed no association between the PTPN22 788A allele and systemic sclerosis, giant cell arteritis, Henoch-schonlein purpura, uveitis, and Grave's disease. This meta-analysis demonstrates that the PTPN22 G788A polymorphism confers protection against SLE, RA, and UC, supporting evidence of association of the PTPN22 gene with a subgroup of autoimmune diseases.
Intradiscal ozone therapy for lumbar disc herniation
Authors: Ozcan Sibel , Muz Arzu , Yildiz Altun Aysun , Onal Selami Ates
Published: May 2018

The rationale behind intradiscal O2-O3 therapy is the pain elicited by the mechanical compression of the nerve root, which is associated with periganglionic and periradicular inflammation. This study aimed to determine the effect of intradiscal ozone injection on pain score and satisfaction of patients with low back pain (LBP) secondary to disc herniation. Patients with LBP diagnosed with disc herniation were enrolled in this clinical trial. After prepping and draping the area, intradiscal injection of ozone/oxygen mixture (10 ml, 25Î¼g/ml) was performed under fluoroscopy guide (c-arm). Pain score and patient satisfaction were assessed prior to the injection (baseline) and 1, 3, 6, 12 and 24 months after the injection. Sixty three patients (24 males, 39 females) with mean age of 53.3 ±2.0 y enrolled in the study. The mean±standard deviation (SD) of pain score before intervention was 6.968 ±0.11. Pain score was reduced to 4.25±0.19 at 1 month, 4.33±0.20 at 3 months, 4.87 ±0.21 at 6 months and 5.22 ±0.20 at 24 months. According to the modified MacNab scale success of pain relief was as follows: excellent: 4 (6.3%), good: 17 (26.98 %), sufficient: 13 (20.63 %), poor: 13 (20.63 %), no result: 11 (17.46%), negative: 4 (6.3 %). Intradiscal ozone therapy was determined to provide improved outcomes in patients with single level of bulging and protrusion.
Influence of medium composition and physical factors on enhanced production of endoglucanase by locally isolated fungal strain in solid state fermentation
Authors: Abdullah Roheena , Javed Peracha Bakhtawar , Nisar Kinza , Iqtedar Mehwish , Kaleem Afshan , Iftikhar Tehreema , Saleem Faiza , Naz Shagufta
Published: May 2018

Endoglucanase is one of the most important enzymes of the cellulase group.  Endoglucanase are involved in the catalytic hydrolysis of cellulose and plays a pivotal role in different sectors like pharmaceutical, textile, detergent, and food processing as well as paper and pulp industry. With consumers getting more and more aware of environmental issues, industries find enzymes as a better option over other chemical catalysts. In the current research different thermophilic fungal strains were isolated from the different sources. Qualitative screening was carried out on the basis of cellulose hydrolysis zone. The quantitative screening was carried out employing solid state fermentation.  The fungal culture, showing highest EG potential was selected identified and assigned the code Aspergillus fumigatus BBT2. Different fermentation media were evaluated and M 2 containing wheat bran gave maximum EG production. The maximal enzyme productivity was recorded in 72 hours, 40°C, pH 5, inoculum size 1.5ml, and moisture content (1:1). Glucose (1%) and peptone (1%) were optimized as best carbon and nitrogen sources, respectively.
Complex yet fauna-deficient seagrass ecosystems at risk in southern Myanmar
Authors: Jones Benjamin L. , Cullen-Unsworth Leanne C. , Howard Robert , Unsworth Richard K.F.
Published: May 2018

Dependence on seafood across Southeast Asia is extensive. Myanmar is no exception, but the country’s provisioning marine ecosystems are threatened. Seagrass is one habitat that is frequently overlooked in management as an important fisheries resource, despite its nursery function. In Myanmar, research on seagrass habitats is particularly sparse, and as a result, our understanding of seagrass exploitation remains limited. In this study, we provide a baseline assessment of the seagrass-associated fish assemblages at four locations in the Myeik Archipelago in southern Myanmar using mono Baited Remote Underwater Video systems. Across the sites surveyed only 12 taxa of motile fauna were recorded. Relative to other regional and global studies, this figure is meagre. Our data adds to a growing literature suggesting that the marine ecosystems of Myanmar are in a worrying state. Despite the lack of recorded seagrass associated fauna, our study revealed minimal impacts to seagrass meadows from eutrophication or sedimentation, and the meadows included appeared to be healthy. The sites with the highest number of motile fauna were within Myanmar’s only National Marine Park offering some optimism for the effectiveness of protection, but further assessments are required to allow targeted management of Myanmar’s seagrass meadows.
Metrological traceability and harmonization of medical tests: a quantum leap forward is needed to keep pace with globalization and stringent IVD-regulations in the 21st century!
Authors: Cobbaert Christa , Smit Nico , Gillery Philippe
Published: May 2018

In our efforts to advance the profession and practice of clinical laboratory medicine, strong coordination and collaboration are needed more than ever before. At the dawn of the 21st century, medical laboratories are facing many unmet clinical needs, a technological revolution promising a plethora of better biomarkers, financial constraints, a growing scarcity of well-trained laboratory technicians and a sharply increasing number of International Organization for Standardization guidelines and new regulations to which medical laboratories should comply in order to guarantee safety and effectiveness of medical test results. Although this is a global trend, medical laboratories across continents and countries are in distinct phases and experience various situations. A universal underlying requirement for safe and global use of medical test results is the standardization and harmonization of test results. Since two decades and after a number of endeavors on standardization/harmonization of medical tests, it is time to reflect on the effectiveness of the approaches used. To keep laboratory medicine sustainable, viable and affordable, clarification of the promises of metrological traceability of test results for improving sick and health care, realization of formal commitment among all stakeholders of the metrological traceability chain and preparation of a joint and global plan for action are essential prerequisites. Policy makers and regulators should not only overwhelm the diagnostic sector with oversight and regulations but should also create the conditions by establishing a global professional forum for anchoring the metrological traceability concept in the medical test domain. Even so, professional societies should have a strong voice in their (inter-) national governments to negotiate long-lasting public policy commitment and funds for global standardization of medical tests.
Diagnostic accuracy in Family Medicine residents using a clinical decision support system (DXplain): a randomized-controlled trial
Authors: Martinez-Franco Adrian Israel , Sanchez-Mendiola Melchor , Mazon-Ramirez Juan Jose , Hernandez-Torres Isaias , Rivero-Lopez Carlos , Spicer Troy , Martinez-Gonzalez Adrian
Published: May 2018

Background:

Clinical reasoning is an essential skill in physicians, required to address the challenges of accurate patient diagnoses. The goal of the study was to compare the diagnostic accuracy in Family Medicine residents, with and without the use of a clinical decision support tool (DXplain http://www.mghlcs.org/projects/dxplain).

Methods:

A total of 87 first-year Family Medicine residents, training at the National Autonomous University of Mexico (UNAM) Postgraduate Studies Division in Mexico City, participated voluntarily in the study. They were randomized to a control group and an intervention group that used DXplain. Both groups solved 30 clinical diagnosis cases (internal medicine, pediatrics, gynecology and emergency medicine) in a multiple-choice question test that had validity evidence.

Results:

The percent-correct score in the Diagnosis Test in the control group (44 residents) was 74.1±9.4 (mean±standard deviation) whereas the DXplain intervention group (43 residents) had a score of 82.4±8.5 (p<0.001). There were significant differences in the four knowledge content areas of the test.

Conclusions:

Family Medicine residents have appropriate diagnostic accuracy that can improve with the use of DXplain. This could help decrease diagnostic errors, improve patient safety and the quality of medical practice. The use of clinical decision support systems could be useful in educational interventions and medical practice.
Spread relation of E-valued meromorphic functions and its application
Authors: Wu Nan , Xuan Zu-Xing
Published: May 2018

In this paper, we establish the spread relation of E-valued
meromorphic functions and give some of its applications.
A novel one-pot approach to oxidative aromatization and bromination of pyrazolidin-3-one with HBr-H2O2system
Authors: Yang Shanguang , Liu Jingjing , Jin Zhudan , Tian Wei , Sun Hao , Wang Mingliang
Published: May 2018

An efficient and green one-pot method for the oxidative aromatization and bromination of pyrazolidin-3-ones under mild conditions with a HBr-H2O2system was developed. A mechanism was proposed.
Silencing of MED27 inhibits adrenal cortical carcinogenesis by targeting the Wnt/β-catenin signaling pathway and the epithelial-mesenchymal transition process
Authors: He Hongchao , Dai Jun , Yang Xiaoqun , Wang Xiaojing , Sun Fukang , Zhu Yu
Published: May 2018

This study aimed to explore the effect of MED27 on the expression of epithelial-mesenchymal transition (EMT)-related proteins and β-catenin in adrenal cortical carcinoma (ACC). The functional mechanism of MED27 on ACC processes was also explored. The expression of MED27 was assessed by quantitative real-time polymerase chain reaction (qRT-PCR). siRNA was utilized to knockdown the expression of MED27. CCK8 assays were performed to evaluate SW-13 cell proliferation. Transwell assays were performed to assess the invasion ability, and wound healing assays were utilized to detect migration. A tumor xenograft mouse model was established to investigate the impact of silencing MED27 on tumor growth and metastasis. MED27 was highly expressed in ACC tissues and cells. Down-regulation of MED27 induced ACC cell apoptosis, and significantly attenuated ACC cell proliferation, invasion and metastasis in vivo and in vitro. MED27 knockdown regulated the expression of EMT-related proteins and Wnt/β-catenin signaling pathway-related proteins. Our study investigated the function and mechanism of MED27 and validated that MED27 plays a negative role in ACC occurrence and progression and could be utilized as a new therapeutic target in ACC prevention and treatment.
First-line molecular therapies in the treatment of metastatic colorectal cancer – a literature-based review of phases II and III trials
Authors: Vogel Arndt , Kirstein Martha M.
Published: May 2018

Introduction:

Metastatic colorectal cancer (mCRC) is one of the most common cancers and the second leading cause of cancer worldwide. With the improvement of systemic and operative therapies, median overall survival (mOS) reached 30 months or longer. Here, we will review the use of the anti-vascular endothelial growth factor (VEGF) and anti-epidermal growth factor receptor (EGFR) antibodies in combination with doublet and triplet chemotherapy in patients with borderline and primary unresectable mCRC.

Methods:

Phases II and III trials were included in investigating chemotherapy in the first-line in combination with an anti-VEGF(R) or anti-EGFR in a cohort of patients with mCRC.

Results:

The VEGF-antibody bevacizumab has improved progression-free survival (PFS) in several phase III trials in combination with a chemotherapy doublet. More recently, a higher efficacy has been demonstrated in combination with an intensified chemotherapy including 5-fluoropyrimidine (5-FU), oxaliplatin, and irinotecan within the phase III TRIBE study. Similarly, high resectability rates have been shown in the phase II Olivia trial for patients with liver-limited disease with an intensified chemotherapeutic regime. However, this increase in efficacy was accompanied by an increase in toxicity as well. The efficacy of the EGFR-antibodies cetuximab and panitumumab has been shown in several phase III trials, but their use is restricted to patients whose tumors are RAS wildtype (WT). The phase II trials, CELIM and PLANET, demonstrated a favorable long-term survival for patients with initially non-resectable colorectal liver metastases who respond to conversion therapy with EGFR-antibodies and undergo secondary resection. The CLGB and FIRE-3 trials delivered an inconsistent finding whether anti-VEGF or -EGFR treatment is the better option in the first-line setting. However, there is increasing evidence from post hoc analyses of prospective clinical trials that patients with left-sided tumors benefit from EGFR-directed combination therapy in terms of prolongation of OS and PFS compared with limited, if any, benefit for those with right-sided tumors.

Conclusion:

Both anti-VEGF- and anti-EGFR-directed therapies represent efficient treatment options for patients with mCRC in the first line. For patients with RAS WT, left-sided tumor anti-EGFR-based treatment is recommended. Intensified regimens can be offered initially to unresectable patients in order to achieve resectability at a price of higher toxicity.
Adverse neonatal outcomes and house prices in London
Authors: Dassios Theodore , Refaey Mazen , Kametas Nick , Bhat Ravindra , Greenough Anne
Published: May 2018

Objective

To explore whether the average price of houses per postcode sector [sector house average prices (SHAP)] is related to perinatal outcomes and whether gestational age would be lower and mortality higher in the least expensive areas compared to the most expensive.

Methods

All neonatal unit admissions at King’s College Hospital from 1/1/2012 to 31/12/2016 were reviewed. The SHAP was retrieved from the Land Registry and the population was divided in equal quintiles with quintiles 1 and 5 representing the most and least expensive areas, respectively. Gestational age and birth weight z-score were collected. Mortality was defined as death before discharge from neonatal care.

Results

Three thousand three hundred and sixty infants were included and divided in quintiles consisting of 672 infants. Gestational age was lower in quintile 5 compared to all other quintiles (adjusted P<0.001). Birthweight z-score was not significantly different between the quintiles. The SHAP was lower in the infants who died before discharge (n=92) compared to the SHAP of the infants who were alive at discharge (n=3268) (P<0.001). Infants of quintile 5 had 6 times higher risk of death before discharge from neonatal care compared to infants of quintile 1.

Conclusion

Low SHAPs were associated with poorer perinatal outcomes suggesting SHAP could potentially be used in perinatal populations to determine socio-economic status and associated outcomes.
The African Union Agenda 2063 and the Imperative of Democratic Governance
Authors: Nwebo Osy Ezechukwunyere
Published: May 2018

After more than five decades of the establishment of the Organization of African Unity (OAU) now the African Union (AU), Africa remains at a cross road in her struggle to grapple with the daunting challenges of achieving its core objectives of promoting sustainable development (SD) and economic integration, despite various earlier development initiatives and treaties in that regard. In analyzing the problem, this paper adopts the concept of law as instrument of social change and argues that at the heart of Africa’s missed development opportunities in the past lies the fundamental problem of democratic governance deficit. Indeed, weak governance and its associated political instability, insecurity and lack of peace hinder development and socio-cultural harmony. The paper further argues that there is an ineluctable linkage between democratic governance and sustainability of development and therefore presents the adoption of democratic governance method as the only sustainable way of successfully addressing Africa’s development challenges. In the final analysis, the paper concludes that the achievement SD and integration of the African continent within the framework of agenda 2063 must be predicated on the prioritization and promotion of democratic governance as its necessary adjunct.
Crystal structure of bis(N-(1-(pyrazin-2-yl)ethylidene)nicotinohydrazonato-κ3
N,N′,O)copper(II) C24H20N10O2Cu
Authors: Li Qingqing , Jiao Kaichuang , Xu Zhouqing
Published: May 2018

C24H20N10O2Cu, orthorhombic, Aba2 (no. 41), a = 12.2281(16) Å, b = 19.176(3) Å, c = 9.8689(13) Å, V = 2314.1(5) Å3, Z = 4, R
gt(F) = 0.0381, wR
ref(F
2) = 0.0752, T = 296(3) K.
Crystal structure of diaqua-dinitrato-k2
O,O′((Z)-N-((E)-1-(pyrazin-2-yl)ethylidene)nicotinohydrazonato-k3
N,N′,O)europium(II), C12H14N7O9Eu
Authors: Yaling He , Shilin Zeng , Peiling Zhang , Zhouqing Xu
Published: May 2018

C12H14N7O9Eu, monoclinic, P21/c (no. 14), a = 16.770(3) Å, b = 7.7185(16) Å, c = 15.165(3) Å, β = 108.409(3)°, V = 1862.5(7) Å3, Z = 4, R
gt(F) = 0.0174, wR
ref(F
2) = 0.0453, T = 296(2) K.
The crystal structure of benzenaminium 5,7-dihydroxy-4-oxo-2-phenyl-4H-chromene-8-sulfonate hydrate, C21H19NO8S
Authors: Li Wu-Wu , Zheng Min-Yan , Zhang Zun-Ting
Published: May 2018

C21H19NO8S, triclinic, P1̄ (no. 2), a = 7.2884(9) Å, b = 11.9469(15) Å, c = 12.2002(16) Å, α = 95.862(2)°, β = 106.659(2)°, γ = 93.189(2)°, V = 1008.4(2) Å3, Z = 2, R
gt(F) = 0.0659, wR
ref(F
2) = 0.1831, T = 296(2) K.
Crystal structure of semiconducting potassium poly[(μ2-tetraselenido-κ2
Se
1:Se
4)(μ2-pentaselenido-κ1
Se
1:Se
1)argentate(I)], K3AgSe9
Authors: Kim Kang-Woo , Kim Hyoungjoong
Published: May 2018

K3AgSe9, monoclinic, P21/c (no. 14), a = 11.094(2) Å, b = 9.7164(15) Å, c = 14.223(3) Å, β = 90.738(9)°, V = 1533.0(5) Å3, Z = 4, R
gt(F) = 0.0377, wR
ref(F
2) = 0.0832, T = 223(2) K.
Risperidone-induced type 2 diabetes presenting with diabetic ketoacidosis
Authors: Hui Fang Clarissa Ern , Rafey Mohammed Faraz , Cunningham Aine , Dinneen Sean F , Finucane Francis M
Published: May 2018

A 28-year-old male presented with 2 days of vomiting and abdominal pain, preceded by 2 weeks of thirst, polyuria and polydipsia. He had recently started risperidone for obsessive-compulsive disorder. He reported a high dietary sugar intake and had a strong family history of type 2 diabetes mellitus (T2DM). On admission, he was tachycardic, tachypnoeic and drowsy with a Glasgow Coma Scale (GCS) of 10/15. We noted axillary acanthosis nigricans and obesity (BMI 33.2 kg/m2). Dipstick urinalysis showed ketonuria and glycosuria. Blood results were consistent with diabetic ketoacidosis (DKA), with hyperosmolar state. We initiated our DKA protocol, with intravenous insulin, fluids and potassium, and we discontinued risperidone. His obesity, family history of T2DM, acanthosis nigricans and hyperosmolar state prompted consideration of T2DM presenting with ‘ketosis-prone diabetes’ (KPD) rather than T1DM. Antibody markers of beta-cell autoimmunity were subsequently negative. Four weeks later, he had modified his diet and lost weight, and his metabolic parameters had normalised. We reduced his total daily insulin dose from 35 to 18 units and introduced metformin. We stopped insulin completely by week 7. At 6 months, his glucometer readings and glycated haemoglobin (HbA1c) level had normalised.

Learning points:

Risperidone-induced diabetic ketoacidosis (DKA) is not synonymous with type 1 diabetes, even in young white patients and may be a manifestation of ‘ketosis-prone’ type 2 diabetes (KPD).

KPD is often only confirmed after the initial presentation, when islet autoimmunity and cautious phasing out of insulin therapy have been assessed, and emergency DKA management remains the same.

As in other cases of KPD, a family history of T2DM and presence of cutaneous markers of insulin resistance were important clinical features suggestive of an alternative aetiology for DKA.
OPTIMAL ORGANOPROTECTION, CONTROL OF bLOOD PRESSURE AND METAbOLIC DISORDER WITH THE FIxED COMbINATION OF LISINOPRIL, AMLODIPINE AND ROSUVASTATIN IN SYSTEMIC HYPERTENSION
Authors: Nedogoda S. V. , Chumachek E. V. , Ledyaeva A. A. , Tsoma V. V. , Salasyuk A. S. , Smirnova V. O. , Hripaeva V. Yu. , Palashkin R. V. , Popova E. A.
Published: May 2018

Aim. Evaluation of the ability of the fixed combination of lisinopril, amlodipine and rosuvastatin (Equamer) in achievement of additional angioprotection in patients with systemic arterial hypertension (AH) and high pulse wave velocity (PWV), regardless of previous antihypertensive therapy (AHT).

Material and methods. To the open multicenter observational study 24 weeks duration, 60 patients included, taking double AHT during 6 months. All participants underwent ambulatory 24 hour blood pressure (BP) monitoring, applanation tonometry (augmentation index and central BP), pulse wave velocity assessment, laboratory tests (lipids, fasting glucose, insulin resistance index (HOMA), leptin, high sensitive C-reactive protein (hsCRP) before and after transition to the fixed combination of lisinopril, amlodipine and rosuvastatin (Equamer).

Results. By the data from office BP measurement, after transition of patients from the double combinations to fixed combination of lisinopril, amlodipine and rosuvastatin, there was additional decrease of systolic BP (SBP) by 14,3% and diastolic BP (DBP) by 18,5%. By the data from ABPM, decrease of SBP was 16,1%, and DBP — 21,8%. Combination of lisinopril, amlodipine and rosuvastatin decreased PWV by 14,4%, augmentation index by 14,5%, central SBP by 8,1% (p<0,01 for all comparisons with baseline). Fixed combination of lisinopril, amlodipine and rosuvastatin made it to decrease low density lipoproteides by 44%, triglycerides by 36,1% and increase of high density lipoproteides by 10,3% (p<0,01 for all with baseline). Usage of combination of lisinopril, amlodipine and rosuvastatin showed significant decrease of insulin resistance, hsCRP and leptin levels.

Conclusion. Fixed combination of lisinopril, amlodipine and rosuvastatin makes it to better control BP, improve vascular elasticity parameters (augmentation index, PWV, central BP) and facilitates the improvement of lipid and glucose metabolism, decrease of inflammation, leptin resistance in patients taking at baseline double antihypertensive therapy.
Fundamentação de um Programa de Musicoterapia Pré-Natal
Authors: Carvalho Maria Eduarda Salgado
Published: May 2018

O uso da musicoterapia no acompanhamento da gravidez e da preparação para o nascimento constitui uma estratégia inovadora para o desenvolvimento do autoconhecimento, da expressão emocional e elaboração de sentimentos ambivalentes e da criatividade e descoberta de competências adaptativas para lidar com a mudança e transformação que o processo de gravidez e parentalidade desencadeia no casal grávido. Partindo das bases teóricas da psicologia da gravidez e das dimensões particulares da música enquanto experiência temporal e de expressão emocional da ambivalência psicológica, será descrita uma teorização acerca dos fundamentos da musicoterapia na gravidez. Como ilustração desta teorização, serão, igualmente, descritas as linhas de orientação e de funcionamento de um programa pioneiro de musicoterapia pré-natal dirigido a casais grávidos a partir das 22 semanas de gestação.
Alfabeto visual y caligrafía como herramienta terapéutica con personas con demencia temprana
Authors: López Méndez Lorena
Published: May 2018

El Proyecto “Alfabeto Visual” Arte y Salud Alzhéimer, es un proyecto que pretende acercar la educación artística contemporánea a personas con demencia temprana a través de la caligrafía y los refranes, a sus  familiares- cuidadores y personal sanitario. Permitiéndoles participar en una serie de actividades lúdicas, creativas y culturales. El taller forma parte del programa de educación artística diseñado e implementado durante el 2014 y 2015 en el Centro de Referencia Estatal de atención a personas con enfermedad de Alzhéimer y otras Demencias de Salamanca, dependiente del Instituto de Mayores y Servicios Sociales (IMSERSO). Los objetivos del programa están enfocados no sólo en mejorar la calidad de vida  y preservar las capacidades cognitivas a través de la utilización del Arte como herramienta, sino también en sensibilizar a la sociedad, erradicando estigmas asociados a la enfermedad en fases incipientes, donde todavía el participante puede participar y comunicarse. Los resultados del programa nos permiten considerar que el Arte puede ofrecer una nueva oportunidad de aprendizaje y un soporte de ayuda terapéutica tanto individual como cooperativo, desarrollar habilidades cognitivas y funcionales, ampliar recursos emocionales y  disfrutar de la experiencia, fortaleciéndose la seguridad y autoestima en sí mismos, ante la capacidad de formar parte activa del programa.
Satisfação em enfermagem: perspetiva do enfermeiro versus perspetiva do utent
Authors: Garcia Jorge Anes Eugénia Maria , Salvador Ferreira Carina Alexandra
Published: May 2018

A dupla vertente da satisfação dos utentes e da satisfação profissional dos enfermeiros constitui um indicador de resultado, válido na avaliação da qualidade dos serviços. Temos como objetivo avaliar a satisfação dos enfermeiros e a satisfação dos utentes com os cuidados de enfermagem, em meio hospitalar. Foram utilizadas: a escala EAST-Enf, a escala SUCEH21 e questões de caracterização. Desenvolveu-se um estudo transversal, descritivo e exploratório, quantitativo, numa amostra de 124 enfermeiros e 462 utentes no norte de Portugal. A amostra dos profissionais é predominantemente feminina (82.3%), com média de idade a rondar os 42 anos. Dos 462 utentes, a maioria é do sexo feminino (53.2%), com idade média de 57.47 anos. Os enfermeiros mais satisfeitos profissionalmente são os mais jovens (84,13), com menor grau académico (74,80), com tempo de serviço inferior a 10 anos (78,59), que trabalham na unidade de AVC (77,10), e aqueles que exercem funções em serviços com liderança democrática (76.6%). Relativamente aos utentes, os mais satisfeitos com os cuidados de enfermagem são as mulheres (2,87), os mais idosos (2,87), viúvos (2,59), reformados (2,56), internados na unidade de AVC (3). Na satisfação dos enfermeiros, destacam-se como variáveis determinantes, a idade dos enfermeiros e o tempo de serviço. A satisfação dos utentes com os cuidados de enfermagem destaca-se o sexo, idade, estado civil, situação laboral, profissão e serviço de internamento. De forma global, verificou-se uma relação direta entre a satisfação dos profissionais e a satisfação dos utentes. A identificação dessas relações é muito importante nas organizações de saúde, constituindo uma ferramenta sólida na tomada de decisão e, portanto, na prestação de melhores cuidados de saúde.