bluuebunny/crossref_metadata_2025 huggingface dataset:
Brusatol From Brucea javanica Suppresses Arsenic Trioxide-Induced PD-L1 Upregulation Through Inhibition of NRF2 in Leukemia Cells
Authors: Zhang Shunji , Sui Meijuan , Zhang Zhuo , Su Yanhua
Published: October 2022

Overexpression of programed death-ligand 1 (PD-L1) is associated with poor prognosis in leukemia. Moreover, antitumor pharmaceuticals have been shown to induce immunoresistance, leading to reduced efficacy. Previous studies have indicated that arsenic trioxide (ATO) promotes immune evasion by inducing PD-L1 expression in solid tumors; however, little is known about its role in leukemia. A proportion of patients with acute promyelocytic leukemia were resistant to ATO therapy. Thus, this study aimed to investigate the effect of ATO on the expression of PD-L1 in leukemia cells and the underlying mechanism mediated through the nuclear factor erythroid 2 related factor (NRF2) protein. Brusatol, extracted from Brucea javanica, was selected as a unique NRF2 inhibitor, and we evaluated the possibility of using a regimen combining ATO/Brusatol in leukemia therapy. Promyelocytic NB4 and lymphocytic Jurkat cells were treated with ATO and brusatol either alone or in combination. We found that ATO significantly upregulated the expression of PD-L1 in NB4 and Jurkat cells at both the protein and mRNA levels compared with its expression in the untreated cell group. Mechanistically, ATO increased nuclear NRF2 expression and the extent of NRF2 binding to the PD-L1 promoter. Pharmacological inhibition of NRF2 by brusatol significantly blocked this effect, thereby reducing ATO-induced PD-L1 expression. In addition, the combination of brusatol and ATO showed stronger cytotoxicity than ATO alone indicated by cell counting kit-8 assay. Therefore, brusatol may further enhance the antileukemia effect of ATO not only by inhibiting ATO-induced PD-L1 expression but also by enhancing ATO-induced cytotoxicity. Our study provides a rationale for the clinical application of ATO/brusatol combination therapy.
Compromise-Building in the Spotlight of the Media? Individual and Situational Influences on the Self-Mediatization of Parliamentary Negotiations
Authors: Philipps Gerrit
Published: October 2022

Political actors in negotiations often face the challenge of contradictory logics of discreet compromise-building on the one hand and generating media publicity to enhance transparency and gain public support on the other. This paper examines how members of parliament (MPs) handle this dilemma within intra-coalition parliamentary negotiations that are essential for legislative decision-making. By referring to the mediatization approach, the concept of self-mediatization of political negotiation systems is introduced to theoretically capture politicians’ self-initiated media publications regarding negotiations and associated changes in their negotiation behavior. It is hypothesized that the self-mediatization of negotiations is influenced by negotiators’ general tendency to seek media attention as well as situational pressures and incentives. The hypotheses were tested with a factorial survey among German state-level MPs ( n = 258) using experimental vignettes. Results show that both individual and situational factors affect parliamentarians’ tendency to publicly communicate about negotiations and consequently negotiate in a more news-media-logic-compatible, that is, more conflictual, manner. However, since the surveyed MPs on average show a high willingness to agree with their coalition partner on the explicit secrecy of negotiations, independent of the influencing parameters examined, self-mediatization does not seem to be an existential threat to the intra-coalition compromise-building capacity of parliamentary negotiation systems.
You Can Change a Girl’s Life Today: The Truth About Periods and Endometriosis
Authors: Mackenzie Malcolm , Cohn Shannon
Published: October 2022

While endometriosis, a condition where tissue growing outside the uterus causes pain and infertility, is generally widespread among teenage girls and women, it is often misdiagnosed leading to a delay in treatment while the symptoms and damage from the disease increase. This article uses a case study to illustrate the signs and symptoms of endometriosis in a teenage girl, while also discussing many factors surrounding the issue such as the incidence, disease burden, medical research and women, reasons for diagnostic delay, and the current recommended treatments. School nurses are in the unique position to identify young girls and adolescents who are presenting with painful periods or other symptoms possibly associated with endometriosis and can become advocates for the next generation of patients.
Along for the ride through liminal space: A role transition and recovery perspective on the work-to-home commute
Authors: McAlpine Kristie L. , Piszczek Matthew M.
Published: October 2022

The increase in remote work during COVID-19 has drawn attention to the function of commutes as work-home transitions. While prior work-home research has referenced commutes as an example of role transitions, little is known about how the characteristics of a commute or the behaviors and processes undertaken in a commute affect their nature. We integrate research on commute characteristics, role transitions, and psychological recovery to develop a transitional perspective of commuting. We provide a conceptualization of liminal space that differentiates its physical and temporal dimensions and its psychological dimension as characteristics of the space through which one transitions during the commute and the experience of rolelessness one may perceive while doing so. We argue that perceived liminality during the commute frees cognitive resources for psychological role transition and recovery. Based on our conceptual model, we discuss implications for role transitions, commuting, and telecommuting research.
Compassion focused therapy for pain management: ‘3 systems approach’ to understanding why striving and self-criticism are key psychological barriers to regulating activity and improving self-care for people living with persistent pain
Authors: Malpus Zoey , Nazar Zaynab , Smith Chloe , Armitage Lesley
Published: October 2022

Background

This paper describes the development of an eight-week Compassion Focused Therapy for Pain Management (CFT-PM) group. This group was specifically designed for ‘strivers’ a sub-group of people with persistent pain who tend to engage in over-activity and resist making reasonable adjustments to their activity levels to accommodate their persistent pain. ‘Strivers’ tend to cope by ignoring their pain and pushing on through, in the shorter term leading to ‘boom and bust’ activity-related exacerbations of their pain. They also risk the development of additional persistent fatigue and burnout in the longer term.

Method

117 people completed the CFT-PM group; The group was delivered in person ( n = 84) but in online format from July 2020 ( n = 33). 162 people started the CFT-PM group but 45 dropped-out (27.43%).

Results

There was a significant effect for time across all measures: significant improvement was found for depression, self-compassion, pain-related disability, pain-related anxiety and pain self-efficacy. Pain numeric rating scores were approaching significance. There was a significant main effect of diagnosis; post-hoc t-test analysis found significant improvement for all diagnoses on all measures with the exception of spinal. There was also a significant interaction between time and format: post-hoc t-test analysis found greater improvement for virtual format on self-compassion and pain-related anxiety.

Discussion

Findings suggests that CFT-PM may be a clinically effective group intervention with virtual format showing superior improvement. This approach might be less suitable for certain diagnoses; the spinal group may benefit more from traditional CBT-based PMPs. Limitations include the lack of random selection or allocation to treatment group. Future studies should adopt an experimental design to be able to draw firm conclusions regarding causation and efficacy. Despite these limitations, present findings suggest that CFT-PM may be an effective group intervention worthy of further investigation and clinical application.
It Is Time to Flip the Script and Leverage the Point of Care to Discover Ways of Improving Treatment Outcomes for Posttraumatic Stress Disorder: Commentary on “A Sobering Look at Treatment Effectiveness of Military-Related Posttraumatic Stress Disorder” (Levi et al., 2021)
Authors: Litz Brett T.
Published: October 2022

Levi et al. (2021) reported posttreatment outcomes of 709 Israeli veterans seeking treatment for service-related distress and concluded that their results reveal the “limited overall effectiveness” of treatments for posttraumatic stress disorder (PTSD). In this commentary, I critically appraise the categorical/diagnostic, model-based methods Levi et al. employed to examine effectiveness and use their observational study as a point of departure to describe an approach that uses benchmarked, repeated assessments of individual and aggregated outcomes (measurement-based care) to leverage these types of observational results to improve outcomes at the point of care as a way of advancing knowledge about how to best treat PTSD.
Posteromedial Tibial Bone Bruise After Anterior Cruciate Ligament Injury: An MRI Study of Bone Bruise Patterns in 208 Patients
Authors: Byrd Jennifer M. , Colak Ceylan , Yalcin Sercan ,   Clevel and Clinic Sports Medicine*, Winalski Carl ,   Cleveland Clinic Sports Medicine group, Briskin Isaac , Farrow Lutul D. , Jones Morgan H. , Miniaci Anthony A. , Parker Richard D. , Rosneck James T. , Saluan Paul M. , Strnad Gregory J. , Spindler Kurt P.
Published: October 2022

Background:

Bone bruise patterns after anterior cruciate ligament (ACL) rupture may predict the presence of intra-articular pathology and help explain the mechanism of injury. Lateral femoral condyle (LFC) and lateral tibial plateau (LTP) bone bruises are pathognomic to ACL rupture. There is a lack of information regarding medial tibial plateau (MTP) and medial femoral condyle (MFC) bone bruises.

Purpose:

To summarize the prevalence and location of MTP bone bruises with acute ACL rupture and to determine the predictors of MTP bone bruises.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Inclusion criteria were patients who underwent ACL reconstruction between February 2015 and November 2017, magnetic resonance imaging (MRI) within 90 days of injury, and participation in the database. Exclusion criteria included previous ipsilateral surgery, multiligamentous injuries, and incomplete imaging. Due to the large number of cases remaining (n = 600), 150 patients were selected randomly from each year included in the study, for a total of 300 patients. Two readers independently reviewed injury MRI scans using the Costa-Paz bone bruise grading system. Logistic regression was used to identify factors associated with MTP bone bruises.

Results:

Included were 208 patients (mean age, 23.8 years; mean body mass index, 25.6). The mechanism of injury was noncontact in 59% of injuries, with over half from soccer, basketball, and football. The median time from injury to MRI scan was 12 days. Of the 208 patients, 98% (203/208) had a bone bruise, 79% (164/208) had an MTP bone bruise, and 83% (172/208) had bruises in both medial and lateral compartments. The most common pattern, representing 46.6% of patients (97/208), was a bruise in all 4 locations (MFC, LFC, MTP, and LTP). Of the 164 MTP bruises, 160 (98%) involved the posterior third of the plateau, and 161 were grade 1. The presence of an MFC bruise was the only independent risk factor for an MTP bruise (odds ratio, 3.71). The resulting nomogram demonstrated MFC bruise, sport, and mechanism of injury were the most important predictors of an MTP bruise.

Conclusion:

MTP bruise after acute ACL rupture was as prevalent as lateral bruises. The presence of a posterior MTP bruise suggested anterior tibial translation at the time of injury and could portend more medial compartment pathology at the time of injury than previously recognized.
Using Quizizz™ in the Management Classroom
Authors: Smith Sockbeson Caitlin E.
Published: October 2022

Throughout the Covid-19 pandemic, faculty have had to restructure classes to new formats, and expectations of flexibility may remain if and when the pandemic subsides. Quizizz™ is an online platform for quizzing and interactive lessons suitable for in-person, online, and hybrid/hyflex classes. Quizizz, which is available for free or with an inexpensive subscription, allows for increased student engagement. Quizzes or lessons may be launched “live” (synchronously) or assigned as asynchronous work, making the platform valuable for classrooms of various modalities. This article documents how to use Quizizz to set up quizzes or interactive lessons and what the student experience is like, and provides a table documenting the differences between Quizizz and other educational applications.
Assessment of sleep and circadian rhythms of endocrine and immune function among women With advanced breast cancer
Authors: Nouriani Bita , Zeitzer Jamie M , Palesh Oxana G , Koopman Cheryl , Aldridge-Gerry Arianna , Neri Eric , Medina Johnna L , Spiegel David
Published: October 2022

Background

Previous findings indicate important effects of stress, disrupted sleep, and dysregulated circadian rhythms on the progression of cancer. Our understanding of these relationships, however, has been limited by the absence of data from 24-h continuous physiologic monitoring of hormonal and immune activity with simultaneous collection of objective sleep data. The present study successfully employed such an intensive protocol among women with advanced breast cancer.

Purpose

In this paper we describe our protocol in detail. We provide methodological and practical suggestions for assessing sleep and circadian rhythms in the medically ill. Finally, we offer psychological and physical safety guidelines for future studies that aim to utilize similar protocols.

Results

We enrolled 123 women with advanced breast cancer; 18 dropped out, 105 participated (6 provided incomplete data, and 99 completed the protocol). The protocol included: (1) psychological/medical screenings and assessments; (2) a 2-week at-home sleep study, including wrist actigraphy and two nights of polysomnography (PSG); and (3) 28 h in-hospital collection of measures of hormones and immune function, in conjunction with one night of PSG for assessing sleep stages, respiration, and leg movement. Based on the implementation challenges we faced, protocol adjustments were made to address feasibility limitations and to accommodate participant preferences and medical/physiological needs.

Conclusions

By combining and modifying the gold standard protocols for sleep and circadian assessments, researchers can compassionately optimize participant enrollment and protocol compliance, and minimize attrition.
Bringing Together a Transdisciplinary Team to Create and Advance a Shared Vision for Research and Support for Siblings of Youth With Cancer
Authors: Amaro Christina M. , Alderfer Melissa A. , Gerhardt Cynthia A. , Wawrzynski Sarah E. , Goldish Melanie , Long Kristin A.
Published: October 2022

Background: Siblings of youth with cancer are at risk for psychosocial difficulties and report unmet needs. Supporting siblings is a psychosocial standard of care; however, many barriers prevent this standard from being fully achieved. Transdisciplinary team science has potential to generate novel, real-world solutions to complex research problems and can be beneficial to addressing sibling needs within pediatric hematology/oncology nursing. This process paper aims to present a guiding framework for transdisciplinary team science using the experiences of the Sibling Partnership for Advocacy, Research, and Care in Childhood Cancer (SPARCCC) as an exemplar. Methods: SPARCCC employed an established model of transdisciplinary team-based research, which consisted of four phases: development, consultation, implementation, and translation. This transdisciplinary team was comprised of international experts from a variety of disciplines, as well as siblings and families impacted by cancer. Results: SPARCCC held two summits, and team members developed ongoing collaborative efforts to advance advocacy, research, and support for siblings of youth with cancer. The team implemented the four phases of the transdisciplinary team-based framework and used an iterative process to build a shared perspective of the needs of siblings and take action. For instance, we completed a grant application, several manuscripts, and conference presentations to disseminate our findings and begin to advance a focused research agenda for sibling supportive care. Discussion: Transdisciplinary team science holds promise for tackling complex issues within pediatric hematology/oncology nursing research, particularly areas that are not well aligned with more traditional models and can be used to generate novel solutions.
Deep learning approach for cancer subtype classification using high-dimensional gene expression data
Authors: Shen Jiquan , Shi Jiawei , Luo Junwei , Zhai Haixia , Liu Xiaoyan , Wu Zhengjiang , Yan Chaokun , Luo Huimin
Published: October 2022

Motivation

Studies have shown that classifying cancer subtypes can provide valuable information for a range of cancer research, from aetiology and tumour biology to prognosis and personalized treatment. Current methods usually adopt gene expression data to perform cancer subtype classification. However, cancer samples are scarce, and the high-dimensional features of their gene expression data are too sparse to allow most methods to achieve desirable classification results.

Results

In this paper, we propose a deep learning approach by combining a convolutional neural network (CNN) and bidirectional gated recurrent unit (BiGRU): our approach, DCGN, aims to achieve nonlinear dimensionality reduction and learn features to eliminate irrelevant factors in gene expression data. Specifically, DCGN first uses the synthetic minority oversampling technique algorithm to equalize data. The CNN can handle high-dimensional data without stress and extract important local features, and the BiGRU can analyse deep features and retain their important information; the DCGN captures key features by combining both neural networks to overcome the challenges of small sample sizes and sparse, high-dimensional features. In the experiments, we compared the DCGN to seven other cancer subtype classification methods using breast and bladder cancer gene expression datasets. The experimental results show that the DCGN performs better than the other seven methods and can provide more satisfactory classification results.
Female gender, dissatisfaction with weight, and number of IBD related surgeries as independent risk factors for eating disorders among patients with inflammatory bowel diseases
Authors: Stoleru Gianna , Leopold Andrew , Auerbach Amanda , Nehman Shelley , Wong Uni
Published: October 2022

Background

The prevalence and risk factors of eating disorders among patients with IBD are poorly described in existing literature. Early recognition and intervention may influence clinical outcomes in both physical and mental health. The primary aims of this study were to describe the prevalence and identify risk factors for eating disorders among patients with IBD using a validated questionnaire, the EAT-26.

Methods

The EAT-26 was administered via email as an anonymous, unpaid, online survey to 1589 patients with an electronic medical record coded diagnosis of IBD (ulcerative colitis or Crohn’s disease) who had visited our Digestive Health Center in the last 3 years. Demographics and IBD characteristics were also included in our survey. A score of 20 or higher on the EAT-26 portion of the survey was considered a positive screen for eating disorder risk.

Results

Fifteen (4.8%) survey participants screened positively for ED risk. These 15 participants who screened positively had statistically significant differences in self-identified gender (93% female, p = 0.031), happiness with current weight (80% dissatisfied with their current weight and trying to lose weight, p < 0.01), prior eating disorder diagnosis (20%, p < 0.01), and number of IBD related surgeries (27% having 3 or more, p = 0.013).

Conclusions

This study identifies independent risk factors for eating disorder risk in patients with IBD including female gender, dissatisfaction with current weight, number of IBD related surgeries, and history of prior eating disorder diagnosis.
Tumor microenvironment-related gene selenium-binding protein 1 (SELENBP1) is associated with immunotherapy efficacy and survival in colorectal cancer
Authors: Zhu Cheng , Wang Siya , Du Yishan , Dai Ying , Huai Qian , Li Xiaolei , Du Yingying , Dai Hanren , Yuan Wenkang , Yin Shi , Wang Hua
Published: October 2022

Background

Selenium-binding protein 1 (SELENBP1), a member of the selenium-containing protein family, plays an important role in malignant tumorigenesis and progression. However, it is currently lacking research about relationship between SELENBP1 and immunotherapy in colorectal cancer (CRC).

Methods

We first analyzed the expression levels of SELENBP1 based on the Cancer Genome Atlas (TCGA), Oncomine andUALCAN. Chisq.test, Fisher.test, Wilcoxon-Mann-Whitney test and logistic regression were used to analyze the relationship of clinical characteristics with SELENBP1 expression. Then Gene ontology/ Kyoto encyclopedia of genes and genomes (GO/KEGG), Gene set enrichment analysis (GSEA) enrichment analysis to clarify bio-processes and signaling pathways. The cBioPortal was used to perform analysis of mutation sites, types, etc. of SELENBP1. In addition, the correlation of SELENBP1 gene with tumor immune infiltration and prognosis was analyzed using ssGSEA, ESTIMATE, tumor immune dysfunction and rejection (TIDE) algorithm and Kaplan-Meier (KM) Plotter database. Quantitative real-time PCR (qRT-PCR) and western blotting (WB) were used to validate the expression of SELENBP1 in CRC samples and matched normal tissues. Immunohistochemistry (IHC) was further performed to detect the expression of SELENBP1 in CRC samples and matched normal tissues.

Results

We found that SELENBP1 expression was lower in CRC compared to normal colorectal tissue and was associated with poor prognosis. The aggressiveness of CRC increased with decreased SELENBP1 expression. Enrichment analysis showed that the SELENBP1 gene was significantly enriched in several pathways, such as programmed death 1 (PD-1) signaling, signaling by interleukins, TCR signaling, collagen degradation, costimulation by the CD28 family. Decreased expression of SELENBP1 was associated with DNA methylation and mutation. Immune infiltration analysis identified that SELENBP1 expression was closely related to various immune cells and immune chemokines/receptors. With increasing SELENBP1 expression, immune and stromal components in the tumor microenvironment were significantly decreased. SELENBP1 expression in CRC patients affects patient prognosis by influencing tumor immune infiltration. Beside this, SELENBP1 expression is closely related to the sensitivity of chemotherapy and immunotherapy.

Conclusions

Survival analysis as well as enrichment and immunoassay results suggest that SELENBP1 can be considered as a promising prognostic biomarker for CRC. SELENBP1 expression is closely associated with immune infiltration and immunotherapy. Collectively, our study provided useful information on the oncogenic role of SELENBP1, contributing to further exploring the underlying mechanisms.
Using machine learning to identify gene interaction networks associated with breast cancer
Authors: Liu Liyuan , Zhai Wenli , Wang Fei , Yu Lixiang , Zhou Fei , Xiang Yujuan , Huang Shuya , Zheng Chao , Yuan Zhongshang , He Yong , Yu Zhigang , Ji Jiadong
Published: October 2022

Background

Breast cancer (BC) is one of the most prevalent cancers worldwide but its etiology remains unclear. Obesity is recognized as a risk factor for BC, and many obesity-related genes may be involved in its occurrence and development. Research assessing the complex genetic mechanisms of BC should not only consider the effect of a single gene on the disease, but also focus on the interaction between genes. This study sought to construct a gene interaction network to identify potential pathogenic BC genes.

Methods

The study included 953 BC patients and 963 control individuals. Chi-square analysis was used to assess the correlation between demographic characteristics and BC. The joint density-based non-parametric differential interaction network analysis and classification (JDINAC) was used to build a BC gene interaction network using single nucleotide polymorphisms (SNP). The odds ratio (OR) and 95% confidence interval (95% CI) of hub gene SNPs were evaluated using a logistic regression model. To assess reliability, the hub genes were quantified by edgeR program using BC RNA-seq data from The Cancer Genome Atlas (TCGA) and identical edges were verified by logistic regression using UK Biobank datasets. Go and KEGG enrichment analysis were used to explore the biological functions of interactive genes.

Results

Body mass index (BMI) and menopause are important risk factors for BC. After adjusting for potential confounding factors, the BC gene interaction network was identified using JDINAC. LEP, LEPR, XRCC6, and RETN were identified as hub genes and both hub genes and edges were verified. LEPR genetic polymorphisms (rs1137101 and rs4655555) were also significantly associated with BC. Enrichment analysis showed that the identified genes were mainly involved in energy regulation and fat-related signaling pathways.

Conclusion

We explored the interaction network of genes derived from SNP data in BC progression. Gene interaction networks provide new insight into the underlying mechanisms of BC.
Discrepancies in self-reported and measured anthropometric measurements and indices among older Australians: prevalence and correlates
Authors: Fry Jane M. , Temple Jeromey B.
Published: October 2022

Background

Anthropometric measurements and indices such as weight, height and Body Mass Index (BMI) are often used to assess overall health and nutritional status. Clinicians and epidemiologists often rely on self-reported weight and height to measure BMI. Differences between self-reported and measured weight and height can lead to differences between self-reported and measured BMI, biasing relative risks of diseases associated with differential BMI.

Methods

Applying regression analysis to a large nationally representative survey data with contemporaneous self-reports and measurements on 3412 individuals aged 65 or over, we provided estimates of the difference between self-reports and measurements of weight, height and BMI for older Australians, analysing demographic, socioeconomic and health correlates of estimated differences.

Results

We found both males and females underestimated weight, overestimated height and underestimated BMI and there was some evidence these differences increased with age. There was also evidence that these differences were associated with high levels of education and household composition.

Conclusion

Although average differences were small, for many individuals the differences may be significant, indicating measurements should be taken in clinically focused research and practice. This is important as systematic underestimation of BMI in older adults can have implications for estimating the size of populations at risk of many health conditions, including diabetes, hypertension and functional limitations.
Baseline anemia predicts a poor prognosis in patients with non-small cell lung cancer with epidermal growth factor receptor mutations: a retrospective study
Authors: Wei Jingwen , Xiang Jing , Hao Yue , Si Jinfei , Wang Wenxian , Li Fangyin , Song Zhengbo
Published: October 2022

Background

Anemia is relatively common in cancer patients, and baseline anemia is associated with poor survival in patients with non-small cell lung cancer (NSCLC). However, there is a lack of large-sample studies of patients with NSCLC with epidermal growth factor receptor (EGFR) mutations.

Methods

We retrospectively analyzed anemia‑related data for patients with NSCLC and EGFR mutations who were admitted to Zhejiang Cancer Hospital from January 2013 to June 2019 and treated with targeted therapy. The patients’ clinicopathological features were evaluated by χ2 tests and the relationships between clinical characteristics and prognosis were investigated using Kaplan–Meier and multivariate Cox regression analyses.

Results

A total of 2,029 patients treated with EGFR-tyrosine kinase inhibitors (TKIs) were finally enrolled in this study, of whom 24.6% had baseline anemia. Patients without baseline anemia had longer median overall survival (OS) than patients with baseline anemia (36.10 vs. 29.10 months, P = 0.001), and patients with grade < 2 anemia had longer median OS than those with grade ≥ 2 anemia (35.00 vs. 25.10 months, P < 0.001). Multivariate analyses identified baseline anemia as a factor predicting a poor prognosis in terms of OS in patients with EGFR mutations.

Conclusions

Baseline anemia is a significant factor predicting a poor prognosis in terms of OS in patients with NSCLC and EGFR mutations treated with targeted therapy. A higher grade of baseline anemia may also be related to shorter OS. And a higher risk of EGFR-mutated patients who had received targeted therapy could also be observed.
Dietitians’ perspectives on challenges and prospects for group-based education to adults with type 1 diabetes – a qualitative study
Authors: Cairns Sophie Rodebjer , Sjöström Elisabeth Stoltz
Published: October 2022

Background

Type 1 diabetes (T1DM) is an autoimmune disorder which can have short- and long-term adverse effects on health. Dietitians in diabetes offer specialist evidence-based advice to people with T1DM and provide education in either individual or group settings. The purpose of this study was to explore dietitians’ perception of, and role in, group-based education as well as prospects for development.

Methods

This was a qualitative descriptive study conducted in Sweden using a convenience sampling of dietitians working in adult diabetes care. Semi-structured interviews were conducted with participants and data were analysed using a content analysis approach.

Results

Ten dietitians with a median experience of 14.5 years in diabetes care were interviewed. The informants were all appreciative of facilitating group-based education and perceived that it was beneficial for people with T1DM to be part of group processes, but the informants did also suggest that there were challenges for their professional role. The main challenges reported was to adjust the level of depth and complexity to the information provided and the lack of ability to individualize the education-sessions in a heterogenous group. None of the dietitians reported performing pre-assessment or follow-up audits on the group-based education.

Conclusion

There was a great engagement from the dietitians, but they identified a lack of framework that address challenges regarding group-based education. The dietitians experienced examples of person-centred care while facilitating group-based education, which may benefit people with T1DM. Based on the results, it would be valuable to explore the pedagogic training level of Swedish dietitians and potential barriers in their ability to facilitate group-based education. We suggest that a framework for group-based education should be explored together with patient representatives to optimize the care given to ensure cost-effectiveness, optimize clinical outcomes, quality of life and equally accessible care for people with T1DM.
Network toxicology and molecular docking analyses on strychnine indicate CHRM1 is a potential neurotoxic target
Authors: Dai Jialin , Liu Jiangjin , Zhang Maoxin , Yu Yanni , Wang Jie
Published: October 2022

Background

Improper use of strychnine can cause death. The aim of this study was to identify and evaluate toxic mechanisms of action associated with active compounds in strychnine using a network toxicology approach, and explore potential pathogenic targets.

Methods

In the present study, strychnine target and central nervous system-related gene set were established using the Traditional Chinese Medicine Systems Pharmacology (TCMSP) database and four disease gene databases (Genecards, OMIM, PharmGkb, TTD). An “ingredient-target” interactive active network map was constructed using Cytoscape software (version 3.8.0). Functional enrichment analysis was performed based on the hub genes. A protein-protein interaction network was constructed using STRING database. The pharmacokinetics (ADMET) properties of strychnine were evaluated using SwissADME tool. Molecular docking was performed using Autodock Vina to explore the interactions between the active compounds and the target protein.

Results

Five strychnine toxicity-related components and a gene set of 40 genes were obtained. GO and KEGG analyses showed that Strychnine acts on the central nervous system through G protein-coupled receptor signaling pathway. Analysis of “ADMET” related parameters showed a high gastrointestinal tract absorption of (S)-stylopine and isobrucine and the compounds could cross the blood brain barrier. CHRM1 was selected as a key gene in strychnine toxicity. Molecular docking results showed that the co-crystalized ligands did not form hydrogen bond with CHRM1. (S)-stylopine had the highest binding affinity (binding energy = − 8.5 kcal/mol) compared with the other two compounds.

Conclusion

Network toxicology and molecular docking reveal the toxicity mechanisms of strychnine active compounds. The findings showed that CHRM1 is a potential neurotoxic target. (S)-stylopine showed stronger neurotoxic effect compared with the other ligands.
Factors Associated with patient satisfaction towards a prison detention Clinic Care among male drug-using inmates
Authors: Hsieh Fang-Chun , Lin Lan-Ping , Wu Te-Pin , Hsu Shang-Wei , Lai Chao-Ying , Lin Jin-Ding
Published: October 2022

This study assessed patient satisfaction and its associated factors among male drug-using inmates utilizing a prison detention clinic in Taiwan. A cross-sectional design and structured questionnaire were employed to recruit 580 drug-using inmates into the study. The Patient Satisfaction Questionnaire Short Form (PSQ-18), developed by the RAND Corporation, was used as the basis for the short scale of patient satisfaction, and the research data were analyzed using the SPSS for Windows 20.0 statistical software package. The results showed that the research subjects had low patient satisfaction in all the factors assessed compared with the scale’s general norms. Among the original seven satisfaction subscales in this study, the highest score was for the financial aspects, and the lowest was for the amount of time spent with doctors. This study also investigated satisfaction with medical lab exams and the pharmacy at the prison’s clinic, and the satisfaction scores were higher than the original seven subscales. In multiple logistic regression analyses, the final model indicated that the inmates undergoing observed rehabilitation (OR = 13.837, 95% CI = 2.736–69.983) were more likely satisfied with prison detention clinic c than those serving prison sentences. Those inmates with custodial deposits (high vs. low; OR = 1.813, 95% CI = 1.038–3.168), and meet their physical health needs (met vs. unmet; OR = 4.872, 95% CI = 2.054–11.560) had significant correlated with detention clinic care satisfactory level. Although there is only one study setting cannot give a generalizability for people who are incarcerated in Taiwan, this study highlights that the prison authorities should scrutinize factors associated with detention clinic care satisfaction, such as the type of inmate, economic status in the prison, self-reported health status, and their physical health needs, to increase the level of patient satisfaction.
Health worker perceptions of stigma towards Zambian adolescent girls and young women: a qualitative study
Authors: Meek Caroline , Mulenga Drosin M. , Edwards Patrick , Inambwae Sophie , Chelwa Nachela , Mbizvo Michael T. , Roberts Sarah T. , Subramanian Sujha , Nyblade Laura
Published: October 2022

Background

The high prevalence of HIV among adolescent girls and young women aged 15–24 in Eastern and Southern Africa indicates a substantial need for accessible HIV prevention and treatment services in this population. Amidst this need, Zambia has yet to meet global testing and treatment targets among adolescent girls and young women living with HIV. Increasing access to timely, high-quality HIV services in this population requires addressing the intensified anticipated and experienced stigma that adolescent girls and young women often face when seeking HIV care, particularly stigma in the health facility setting. To better understand the multi-level drivers and manifestations of health facility stigma, we explored health workers’ perceptions of clinic- and community-level stigma against adolescent girls and young women seeking sexual and reproductive health, including HIV, services in Lusaka, Zambia.

Methods

We conducted 18 in-depth interviews in August 2020 with clinical and non-clinical health workers across six health facilities in urban and peri-urban Lusaka. Data were coded in Dedoose and thematically analyzed.

Results

Health workers reported observing manifestations of stigma driven by attitudes, awareness, and institutional environment. Clinic-level stigma often mirrored community-level stigma. Health workers clearly described the negative impacts of stigma for adolescent girls and young women and seemed to generally express a desire to avoid stigmatization. Despite this lack of intent to stigmatize, results suggest that community influence perpetuates a lingering presence of stigma, although often unrecognized and unintended, in health workers and clinics.

Conclusions

These findings demonstrate the overlap in health workers’ clinic and community roles and suggest the need for multi-level stigma-reduction approaches that address the influence of community norms on health facility stigma. Stigma-reduction interventions should aim to move beyond fostering basic knowledge about stigma to encouraging critical thinking about internal beliefs and community influence and how these may manifest, often unconsciously, in service delivery to adolescent girls and young women.
Depression and fatigue in active IBD from a microbiome perspective—a Bayesian approach to faecal metagenomics
Authors: Thomann Anne Kerstin , Wüstenberg Torsten , Wirbel Jakob , Knoedler Laura-Louise , Thomann Philipp Arthur , Zeller Georg , Ebert Matthias Philip , Lis Stefanie , Reindl Wolfgang
Published: October 2022

Background

Extraintestinal symptoms are common in inflammatory bowel diseases (IBD) and include depression and fatigue. These are highly prevalent especially in active disease, potentially due to inflammation-mediated changes in the microbiota-gut-brain axis. The aim of this study was to investigate the associations between structural and functional microbiota characteristics and severity of fatigue and depressive symptoms in patients with active IBD.

Methods

We included clinical data of 62 prospectively enrolled patients with IBD in an active disease state. Patients supplied stool samples and completed the questionnaires regarding depression and fatigue symptoms. Based on taxonomic and functional metagenomic profiles of faecal gut microbiota, we used Bayesian statistics to investigate the associative networks and triangle motifs between bacterial genera, functional modules and symptom severity of self-reported fatigue and depression.

Results

Associations with moderate to strong evidence were found for 3 genera (Odoribacter, Anaerotruncus and Alistipes) and 3 functional modules (pectin, glycosaminoglycan and central carbohydrate metabolism) with regard to depression and for 4 genera (Intestinimonas, Anaerotruncus, Eubacterium and Clostridiales g.i.s) and 2 functional modules implicating amino acid and central carbohydrate metabolism with regard to fatigue.

Conclusions

This study provides the first evidence of association triplets between microbiota composition, function and extraintestinal symptoms in active IBD. Depression and fatigue were associated with lower abundances of short-chain fatty acid producers and distinct pathways implicating glycan, carbohydrate and amino acid metabolism. Our results suggest that microbiota-directed therapeutic approaches may reduce fatigue and depression in IBD and should be investigated in future research.
MiR-493-5p inhibits Th9 cell differentiation in allergic asthma by targeting FOXO1
Authors: Rao Xingyu , Dong Heting , Zhang Weili , Sun Huiming , Gu Wenjing , Zhang Xinxing , Huang Li , Yan Yongdong , Hao Chuangli , Ji Wei , Zhu Canhong , Chen Zhengrong
Published: October 2022

The role of micro RNAs (miRNAs) in asthma remains unclear. In this study, we examined the role of miRNA in targeting FOXO1 in asthma. Results showed that miR-493-5p was one of the differentially expressed miRNAs in the PBMCs of asthmatic children, and was also associated with Th cell differentiation. The miR-493-5p expression decreased significantly in the OVA-induced asthma mice than the control groups. The miR-493-5p mimic inhibited the expression of the IL-9, IRF4 and FOXO1, while the inhibitor restored these effects. Moreover, the Dual-Luciferase analysis results showed FOXO1 as a novel valid target of miR-493-5p. According to the rescue experiment, miR-493-5p inhibited Th9 cell differentiation by targeting FOXO1. Then the exosomes in association with the pathogenesis of asthma was identified. Various inflammatory cells implicated in asthmatic processes including B and T lymphocytes, DCs, mast cells, and epithelial cells can release exosomes. Our results demonstrated that the DC-derived exosomes can inhibit Th9 cell differentiation through miR-493-5p, thus DC-derived exosomal miR-493-5p/FOXO1/Th9 may serve as a potential therapeutic target in the development of asthma.
Quality of life instruments in atrial fibrillation: a systematic review of measurement properties
Authors: Sale Alicia , Yu Jessica
Published: October 2022

Objectives

To identify the most frequently used atrial fibrillation-specific quality of life (QoL) instruments across atrial fibrillation (AF) ablation studies and to perform a systematic review of the most frequently used instrument’s measurement properties. This study uses quality of life instruments as an overarching term for any patient reported outcome measure that assesses a person’s health related well-being, functional status, and disease related symptoms.

Methods

A literature mapping exercise was undergone to identify the most frequently used AF-specific QoL instruments across AF ablation studies published from 2016 to 2021. A systematic review of the most frequently used AF QoL instruments identified from the mapping exercise was performed using the COSMIN guidelines for systematic reviews of patient-reported outcome measurements. A systematic search was conducted in Ovid MEDLINE, Ovid Embase, Ovid PsycINFO, EBSCO CINAHL, and Cochrane CENTRAL. The search used variations of the keywords “atrial fibrillation”, “quality of life”, and “catheter ablation”.

Results

Forty-five instruments were identified via the literature mapping exercise. After excluding non-patient reported outcome instruments, non-AF specific instruments, and instruments appearing only once, six instruments were identified: AF Effect on QualiTy-of-Life (AFEQT), AF Severity Scale, Minnesota Living with Heart Failure Instrument, AF Quality of Life Instrument, Arrhythmia Specific instrument in Tachycardia and Arrhythmia (ASTA), and SCL (Arrhythmia Symptom Checklist, Frequency and Severity). A systematic review of these six AF-specific health related QoL instruments was performed. We screened 3221 articles and 17 studies were eligible for inclusion. Using the COSMIN guidelines, ASTA and AFEQT had the best ratings across measurement properties with both instruments having good ratings for instrument development and internal consistency. However, none of the 17 included articles assessed measurement error and cross-cultural validity.

Conclusions

AFEQT and ASTA had the strongest measurement properties but not all measurement properties were assessed. Considering the large number of indeterminate and insufficient ratings, future research should focus on cross-cultural validation, measurement error, responsiveness, and interpretability. This review summarizes the current evidence for AF QoL instruments across AF ablation studies and outlines areas for future research.
Short-term postoperative outcomes of gastric adenocarcinoma patients treated with curative intent in low-volume centers
Authors: Lacueva Francisco-Javier , Escrig-Sos Javier , Marti-Obiol Roberto , Zaragoza Carmen , Mingol Fernando , Oviedo Miguel , Peris Nuria , Civera Joaquin , Roig Amparo ,   on behalf of the RECEG-CV group, Sabater Consol , Espert Vicente , Todoli Gonzalo , Cases María-José , Mella Mario , Lopez-Mozos Fernando , Carbonell Silvia , Bruna Marcos , Mulas Claudia , Trullenque Ramon , Barreras José-Antonio , Gomez Luis , Sancho Cristina , Aguilo Javier , Navarro Jose-Manuel , Compañ Antonio , Calero Alicia , Canelles Enrique , Montilla Erick , Rodriguez Rodolfo , Gonzalez Yannko , Moya Alejandro , Barber Xavier , Puche Jose , Asencio Francisco
Published: October 2022

Background

Quality standards in postoperative outcomes have not yet been defined for gastric cancer surgery. Also, the effect of centralization of gastric cancer surgery on the improvement of postoperative outcomes continues to be debated. Short-term postoperative outcomes in gastric carcinoma patients in centers with low-volume of annual gastrectomies were assessed. The effect of age on major postoperative morbidity and mortality was also analyzed.

Methods

Patients with gastric or gastroesophageal junction Siewert III type carcinomas who underwent surgical treatment with curative intent between January 2013 and December 2016 were included. Data were obtained from the population-based surgical registry Esophagogastric Carcinoma Registry of the Comunitat Valenciana (RECEG-CV). The RECEG-CV gathers information on demographic characteristics and comorbidity, preoperative study and neoadjuvant treatment, surgical procedure, pathological study, postoperative outcomes, and follow-up. Seventeen hospitals belonging to the public network participated in this registry.

Results

Data from 591 patients were analyzed. Postoperative major morbidity occurred in 154 (26.1%) patients. Overall 30-day or in-hospital mortality, and 90-day postoperative mortality rates were 8.6% and 10.1% respectively. Failure-to-rescue was 39% and it was significantly higher in patients aged 75 years or older in comparison with younger patients (55.3% vs 23.1% p < 0.001).

In the multivariable analysis, age ≥ 75 years (p = 0.029), laparoscopic approach (p = 0.005), and total gastrectomy (p = 0.005) were associated with major postoperative morbidity. Age ≥ 75 years (p = 0.027), pulmonary complications (p = 0.001), cardiac complications (p = 0.001), leakage (p = 0.003), and hemorrhage (p = 0.013) were associated with postoperative mortality.

Conclusions

Centralization of gastric adenocarcinoma treatment in centers with higher annual caseload should be considered to improve the short-term postoperative outcomes in low-volume centers. Patients aged 75 or older had a significantly increased risk of major postoperative morbidity and mortality, and higher failure-to-rescue.