bluuebunny/crossref_metadata_2025 huggingface dataset:
suPAR Cut-Offs for Risk Stratification in Patients With Symptoms of COVID-19
Authors: Altintas Izzet , Eugen-Olsen Jesper , Seppälä Santeri , Tingleff Jens , Stauning Marius Ahm , El Caidi Nora Olsen , Elmajdoubi Sanaá , Gamst-Jensen Hejdi , Lindstrøm Mette B , Rasmussen Line Jee Hartmann , Kristiansen Klaus Tjelle , Rasmussen Christian , Nehlin Jan O , Kallemose Thomas , Hyppölä Harri , Andersen Ove
Published: August 2021

Objectives:

Elevated soluble urokinase Plasminogen Activator Receptor (suPAR) is a biomarker associated with adverse outcomes. We aimed to investigate the associations between plasma suPAR levels (testing the cut-offs ⩽4, 4-6, and ⩾6 ng/mL) with risk of 14-day mortality, and with the risk of mechanical ventilation in patients that tested positive for SARS-CoV-2.

Methods:

Observational cohort study of patients presenting with symptoms of COVID-19 at Department of Emergency Medicine, Amager and Hvidovre Hospital, Denmark from March 19th, 2020 to April 3rd, 2020. Plasma suPAR was measured using suPARnostic technologies. Patients were followed for development of mechanical ventilation and mortality for 14 days. Validation of our findings were carried out in a similar sized COVID-19 patient cohort from Mikkeli Central Hospital, Finland.

Results:

Among 386 patients with symptoms of COVID-19, the median (interquartile range) age was 64 years (46-77), 57% were women, median suPAR was 4.0 ng/mL (2.7-5.9). In total, 35 patients (9.1%) died during the 14 days follow-up. Patients with suPAR ⩽4 ng/mL (N = 196; 50.8%) had a low risk of mortality (N = 2; 1.0%; negative predictive value of 99.0%, specificity 55.3%, sensitivity 95.2%, positive predictive value 17.4%). Among patients with suPAR ⩾6 ng/mL (N = 92; 23.8%), 16 died (17.4%). About 99 patients (25.6%) tested positive for SARS CoV-2 and of those 12 (12.1%) developed need for mechanical ventilation. None of the SARS-CoV-2 positive patients with suPAR ⩽4 ng/mL (N = 28; 38.8%) needed mechanical ventilation or died. The Mikkeli Central Hospital validation cohort confirmed our findings concerning suPAR cut-offs for risk of development of mechanical ventilation and mortality.

Conclusions:

Patients with symptoms of COVID-19 and suPAR ⩽4 or ⩾6 ng/mL had low or high risk, respectively, concerning the need for mechanical ventilation or mortality. We suggest cut-offs for identification of risk groups in patients presenting to the ED with symptoms of or confirmed COVID-19.
Promotion of physical activity-related health competence in physical education: A person-oriented approach for evaluating the GEKOS intervention within a cluster randomized controlled trial
Authors: Rosenstiel Stephanie , Volk Carmen , Schmid Julia , Wagner Wolfgang , Demetriou Yolanda , Höner Oliver , Thiel Ansgar , Trautwein Ulrich , Sudeck Gorden
Published: August 2021

A central goal of physical education (PE) is to empower students to be physically active in a health-enhancing way. Therefore, using a competence-based approach, the objective of the health- and fitness-related PE intervention ‘Promotion of physical activity-related health competence in PE’ (GEKOS) was to address practical and theoretical content regarding training, fitness, and health. The aim of this person-oriented study was to examine differential effects of the GEKOS intervention on control competence and related knowledge, skills, abilities, and motivation. A total of 860 ninth graders were randomly assigned to an intervention or control group. Intervention group students received six PE lessons that combined practical and theoretical content regarding training, fitness, and health. Measurements were taken before, directly after, and with a follow-up after 8–12 weeks. Students completed a knowledge test and a fitness test, and filled out scales considering motivation and perceived control competence. Latent profile analysis and multinomial logistic regression were estimated. Five patterns of outcome measures were found. Intervention group students transitioned significantly more often to patterns with improved outcome values. The intervention was especially effective for a subgroup of students who initially had rather low outcome values. For a small proportion of students, the intervention entailed a loss of health-related motivation. The study indicated that students with low control competence and related knowledge, skills, abilities, and motivation can benefit from the GEKOS intervention. Future studies should investigate modes of actions and interventions that explicitly address motivation and vary the content and methods used in PE.
Who are the young users of tobacco products? Prevalence and characteristics of Danish adolescents who have either smoked cigarettes, used alternative tobacco products, or used both
Authors: Kjeld Simone Gad , Andersen Susan , Andersen Anette , Glenstrup Stine , Lund Lisbeth , Danielsen Dina , Bast Lotus Sofie
Published: August 2021

Aims:

We examined characteristics (smoking in social relations, binge drinking, and well-being measures) of Danish 13-year-olds in relation to their tobacco use patterns. Ever use of cigarettes exclusively, ever use of alternative tobacco products (ATPs; e-cigarettes, snus, or waterpipe) exclusively, and use of both cigarettes and ATPs were studied.

Methods:

We used self-reported data from students at 46 Danish schools in 2017 comprising 2,307 students (response rate = 86%). Multi-level logistic regression analyses were used to examine the associations between student characteristics and the odds for having ever used any tobacco products, smoked cigarettes exclusively, used ATPs exclusively, or used both cigarettes and ATPs compared with never use of any tobacco products. Unadjusted estimates and estimates adjusted for gender were reported.

Results:

A significant minority of youth (13.2%) had used one or more tobacco products. Of these, 2.0% had exclusively smoked cigarettes, 7.2% had exclusively used ATPs, and 4.0% had used both. Findings showed that all included characteristics (families’ and friends’ smoking, binge drinking, and well-being characteristics) were associated with using any tobacco product; however, students with friends who smoked, had been binge drinking, and had low well-being at home had notably higher odds for having both smoked cigarettes and used ATPs compared to the other tobacco use patterns.

Conclusion:

ATPs were popular among Danish adolescents compared with conventional cigarettes. Thus, prevention efforts among adolescents should not merely focus on the health risks of conventional cigarette smoking but also on ATPs. Students with diverse tobacco use patterns were similar on various characteristics. However, findings indicate that adolescents who had used both conventional cigarettes and ATPs constitute a more risk-averse group in special need of prevention efforts. Gender did not markedly influence the results. These findings may help future strategies aiming at the youngest adolescents at risk of using tobacco products.
Hope for Change: Is Diversifying Production Portfolios an Ideal Strategy to Boost Farming Efficiency in Afghanistan?
Authors: Ahmadzai Hayatullah
Published: August 2021

In this article, I present empirical evidence on the extent of crop diversification and assess its merits as a strategy for improving production efficiency in Afghanistan. The transformed Herfindahl–Harshman index is used to measure the scale and magnitude of crop diversification. I find a compelling evidence that diversifying production portfolios significantly improves production efficiencies. This finding is critical, given that the data show that nearly a third of the farm households do not diversify, achieving, on average, about 52% of potential revenues. The estimated efficiency scores reveal that, on average, the farm households in our analytical sample of over 7,000 households achieve 74% of potential revenue, with nearly 15% of households realizing less than 50% and about 23% between 50% and 70% of potential revenue. These results infer that there exist substantial inefficacies in agricultural production that can be eliminated by employing improved management practices without having to use additional inputs and production resources and rising cost of production. Our results are robust to potential endogeneity bias in crop diversification; I account for the endogeneity problem in the stochastic frontier analysis, by employing a recent estimation approach, using instrumental variable techniques. Mapping the spatial distribution of crop diversification index and estimated efficiency scores across the country revealed that districts with higher diversification levels correspond to higher efficiency indices. Aside from crop diversification, other socio-economic factors also have critical implications for efficiency; households with access to farm assets (such as land, cattle, oxen and tractor) and extension services appear to realize substantially higher production efficiencies. A direct policy recommendation that can be generated from the findings of this study is that crop diversification should be given more recognition by policymakers to enhance productivity and resilience in agriculture.
Gender, networks and academic leadership: A systematic review
Authors: van Helden Daphne L , den Dulk Laura , Steijn Bram , Vernooij Meike W
Published: August 2021

This article systematically reviews 35 empirical articles on the topic of networks and career advancement into academic leadership positions. Our objectives in this systematic review are to clarify (a) the functions that networks fulfil, (b) the outcomes of these functions in terms of career advancement and (c) whether networks are likely to result in more or less career advancement for women compared to men. Four databases were searched using the PRISMA (preferred reporting items for systematic reviews and meta-analyses) approach to select eligible studies published between 1990 and 2019. We distinguish three different functions that networks may fulfil: operational, developmental and strategic. Mixed results are found for the operational and developmental network functions, while the results suggest that the strategic function contributes to career advancement, particularly for men. The reason for this can be found in the masculine academic context. Our findings implicate that a solution involving equal network opportunities needs to be taken up by the academic community as a whole. To further develop the research field, we call for (a) more consistent conceptualisation, (b) more attention to the multiple functions of networks and networking behaviour and (c) more advanced study designs.
Implicit Ambivalence: A Driving Force to Improve Relationship Problems
Authors: Faure Ruddy , McNulty James K. , Meltzer Andrea L. , Righetti Francesca
Published: August 2021

Implicit ambivalence involves holding strong positive and negative implicit evaluations toward the same object. This state is common in close relationships because even the most satisfying partnerships involve in conflicts and other frustrating experiences that can be explained away through effortful motivated reasoning yet remain in memory as mental representations involving the partner. In fact, it appears normative for implicit measures of partner attitudes to reveal implicit ambivalence. Despite being common, however, little is known about the consequences of implicit ambivalence. The present longitudinal investigation provides initial evidence that implicit ambivalence can motivate relationship improvements. Across two studies of newlywed couples ( N = 448 individuals), multilevel dyadic modeling revealed that higher implicit ambivalence was associated with higher motivation to make efforts to improve current marital problems, which predicted reduced marital-problems severity reported by the partner and increased marital satisfaction reported by both spouses 4 months later.
Disclosure Style and Response Engagement During Disclosures of Concealable Stigmatized Identities
Authors: Cipollina Rebecca , Sanchez Diana T. , Egert Ashley , Dominick Janna K. , Albuja Analia F. , Maimon Melanie R.
Published: August 2021

Supportive disclosure experiences benefit the well-being of those with concealable stigmatized identities (CSIs). The present research examines relationships between discloser’s disclosure directness, recipient’s response engagement, feelings of identity support, and disclosure response satisfaction. Across several correlational and experimental studies, direct disclosures (i.e., those referencing the CSI more explicitly) were met with more engaged recipient responses (e.g., verbal discussion of CSIs). Moreover, more engaged recipient responses were evaluated by disclosers as more supportive/validating and satisfying. To isolate the effects of disclosure directness, we explored and controlled for other disclosure factors including closeness to recipient and discloser outness. This work fills a current literature gap regarding how disclosure and response styles may promote positive disclosure experiences for those with varied CSIs.
Racial Sentiment and Public Support for Arming Teachers with Guns in the United States
Authors: Baranauskas Andrew J.
Published: August 2021

In the effort to prevent school shootings in the United States, policies that aim to arm teachers with guns have received considerable attention. Recent research on public support for these policies finds that African Americans are substantially less likely to support them, indicating that support for arming teachers is a racial issue. Given the racialized nature of support for punitive crime policies in the United States, it is possible that racial sentiment shapes support for arming teachers as well. This study aims to determine the association between two types of racial sentiment—explicit negative feelings toward racial/ethnic minority groups and racial resentment—and support for arming teachers using a nationally representative data set. While explicit negative feelings toward African Americans and Hispanics are not associated with support for arming teachers, those with racial resentments are significantly more likely to support arming teachers. Racial resentment also weakens the effect of other variables found to be associated with support for arming teachers, including conservative ideology and economic pessimism. Implications for policy and research are discussed.
Frequency-dependent site factors for the Icelandic strong-motion array from a Bayesian hierarchical model of the spatial distribution of spectral accelerations
Authors: Rahpeyma Sahar , Halldorsson Benedikt , Hrafnkelsson Birgir , Jónsson Sigurjón
Published: August 2021

The earthquake ground motions of over 1700 earthquakes recorded on a small-aperture strong-motion array in south Iceland (ICEARRAY I) that is situated on a relatively uniform site condition characterized as rock, exhibit a statistically significant spatial variation of ground-motion amplitudes across the array. Both earthquake and microseismic horizontal-to-vertical spectral ratios (HVSR) have been shown to exhibit distinct and in some cases, bimodal peaks in amplification, indicating site resonance at periods of 0.1–0.3 s, a phenomenon that has been attributed to a surface layer of lava rock lying above a sedimentary layer, a structure that is then repeated with depth under the array. In this study, we implement a Bayesian hierarchical model (BHM) of the seismic ground motions that partitions the model residuals into earthquake event term, station term, and event–station term. We analyzed and compared peak ground acceleration (PGA) with the 5% damped pseudo-acceleration response spectrum (PSA) at oscillator periods of T = 0.05–1.0 s. The results show that the event terms, dominate the total variability of the ground-motion amplitudes over the array. However, the station terms are shown to increase in the period range of 0.1–0.3 s on most stations and to different extents, leading to an increase in the overall variability of ground motions at those periods, captured by a larger inter-station standard deviation. As the station terms are a measure of how much the ground motions at those stations deviate from the array average, they act as proxies for localized site effects and amplification factors. These results, improve our understanding of the key factors that affect the variation of seismic ground motions across the relatively small area of ICEARRAY I. This approach can help to improve the accuracy of earthquake hazard assessments on local scales, which in turn could contribute to more refined seismic risk assessments and engineering decision-making.
How I treat bleeding disorder of unknown cause
Authors: Baker Ross I. , O’Donnell James S.
Published: August 2021

Recent studies have demonstrated that only 30% of patients referred for assessment of a possible bleeding tendency will eventually be diagnosed with a mild bleeding disorder (MBD) such as von Willebrand disease (VWD) or platelet function defect (PFD). Rather, most of these patients will be diagnosed with bleeding disorder of unknown cause (BDUC). There remains an important unmet need to define consensus regarding the clinical and laboratory criteria necessary for a formal BDUC diagnosis. Accumulating recent data suggest that BDUC is being diagnosed with increasing frequency. Objective assessment of bleeding phenotype using a standardized bleeding assessment tool (BAT) therefore represents a fundamental first step in the diagnosis of BDUC. Because BDUC is a diagnosis by exclusion, accurate quantification of bleeding phenotype is critical because this will be the primary determinant on which a diagnosis of BDUC is reached. Importantly, BAT scores suggest that patients with BDUC display bleeding phenotypes comparable to those seen in patients with VWD or PFD. Despite the prevalence of BDUC, diagnosis and management of these patients commonly pose significant clinical dilemmas. We consider these challenges in the context of a number of typical case studies, discuss the available evidence, and outline our approach to the management of these patients.
Sexual activities during the COVID-19 pandemic in Indonesia
Authors: Kusuma A. H. Wisda , Brodjonegoro Sakti R. , Soerohardjo Indrawarman , Hendri Ahmad Z. , Yuri Prahara
Published: August 2021

Background

Corona Virus Disease 2019 (COVID-19) has spread globally starting from late 2019. The WHO declared it a global pandemic in March 2020, causing nations around the world to introduce various control measures to halt the rapid spread of the disease, such as quarantines, lockdowns, and work from home (WFH) policies. These policies often force people to spend more time at home with their cohabitants, or possibly sexual partners. Various negative feelings experienced during those policies are considered to affect the general mood and sexual life of the population. This study aimed to investigate the difference in mood and sexual activity before and during the COVID-19 pandemic.

Methods

This research was a cross-sectional pilot study. Authors collected data from 131 randomly selected, sexually active volunteer subjects using a self-administered online questionnaire. Subjects’ mood status, behavior, and frequency of sexual intercourse before and during COVID-19 pandemic in Indonesia were analyzed.

Results

Subjects consisted of 67 (51.1%) men and 64 (48.9%) women. Our analysis shows that there was a decline in overall mood scale, and also sexual activity frequency, before and during the pandemic (4.63 vs. 4.03; 80.2% vs. 67.9%, respectively). The COVID-19 pandemic control measures may enable subjects to have more time with their sexual partners at home, but it does not increase the frequency of their sexual activities.

Conclusion

There was a slight decrease in overall mood scale and sexual activity frequency during the COVID-19 pandemic recorded among subjects. The authors suspect that depression symptoms, fear, anxiety, irritability, boredom, confusion, and feeling of being isolated experienced during strict pandemic control measures, caused by stressors such as job loss, decreased monthly income, and the current state of the pandemic are influencing these phenomena.
Dynamic changes in liver function parameters in patients with coronavirus disease 2019: a multicentre, retrospective study
Authors: Zeng Qing-Lei , Yu Zu-Jiang , Ji Fanpu , Li Guang-Ming , Zhang Guo-Fan , Xu Jiang-Hai , Lin Wan-Bao , Zhang Guo-Qiang , Li Guo-Tao , Cui Guang-Lin , Wang Fu-Sheng
Published: August 2021

Background

Liver injuries have been reported in patients with coronavirus disease 2019 (COVID-19). This study aimed to investigate the clinical role played by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Methods

In this multicentre, retrospective study, the parameters of liver function tests in COVID-19 inpatients were compared between various time-points in reference to SARS-CoV-2 shedding, and 3 to 7 days before the first detection of viral shedding was regarded as the reference baseline.

Results

In total, 70 COVID-19 inpatients were enrolled. Twenty-two (31.4%) patients had a self-medication history after illness. At baseline, 10 (14.3%), 7 (10%), 9 (12.9%), 2 (2.9%), 15 (21.4%), and 4 (5.7%) patients already had abnormal alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), albumin, and total bilirubin (TBIL) values, respectively. ALT and AST abnormal rates and levels did not show any significant dynamic changes during the full period of viral shedding (all p > 0.05). The GGT abnormal rate (p = 0.008) and level (p = 0.033) significantly increased on day 10 of viral shedding. Meanwhile, no simultaneous significant increases in abnormal ALP rates and levels were observed. TBIL abnormal rates and levels significantly increased on days 1 and 5 of viral shedding (all p < 0.05). Albumin abnormal decrease rates increased, and levels decreased consistently from baseline to SARS-CoV-2 clearance day (all p < 0.05). Thirteen (18.6%) patients had chronic liver disease, two of whom died. The ALT and AST abnormal rates and levels did not increase in patients with chronic liver disease during SARS-CoV-2 shedding.

Conclusions

SARS-CoV-2 does not directly lead to elevations in ALT and AST but may result in elevations in GGT and TBIL; albumin decreased extraordinarily even when SARS-CoV-2 shedding ended.
A novel treatment strategy for lapatinib resistance in a subset of HER2-amplified gastric cancer
Authors: Ning Gang , Zhu Qihui , Kang Wonyoung , Lee Hamin , Maher Leigh , Suh Yun-Suhk , Michaud Michael , Silva Mayerlin , Kwon Jee Young , Zhang Chengsheng , Lee Charles
Published: August 2021

Background

Gastric cancer (GC) is one of the leading causes of cancer-related deaths worldwide. Human epidermal growth factor receptor 2 (HER2) amplification occurs in approximately 13–23% of all GC cases and patients with HER2 overexpression exhibit a poor prognosis. Lapatinib, a dual EGFR/HER2 tyrosine kinase inhibitor, is an effective agent to treat HER2-amplified breast cancer but it failed in gastric cancer (GC) clinical trials. However, the molecular mechanism of lapatinib resistance in HER2-amplified GC is not well studied.

Methods

We employed an unbiased, genome-scale screening with pooled CRISPR library on HER2-amplified GC cell lines to identify genes that are associated with resistance to lapatinib. To validate the candidate genes, we applied in vitro and in vivo pharmacological tests to confirm the function of the target genes.

Results

We found that loss of function of CSK or PTEN conferred lapatinib resistance in HER2-amplified GC cell lines NCI-N87 and OE19, respectively. Moreover, PI3K and MAPK signaling was significantly increased in CSK or PTEN null cells. Furthermore, in vitro and in vivo pharmacological study has shown that lapatinib resistance by the loss of function of CSK or PTEN, could be overcome by lapatinib combined with the PI3K inhibitor copanlisib and MEK inhibitor trametinib.

Conclusions

Our study suggests that loss-of-function mutations of CSK and PTEN cause lapatinib resistance by re-activating MAPK and PI3K pathways, and further proved these two pathways are druggable targets. Inhibiting the two pathways synergistically are effective to overcome lapatinib resistance in HER2-amplified GC. This study provides insights for understanding the resistant mechanism of HER2 targeted therapy and novel strategies that may ultimately overcome resistance or limited efficacy of lapatinib treatment for subset of HER2 amplified GC.
CpG immunostimulatory oligodeoxynucleotide 1826 as a novel nasal ODN adjuvant enhanced the protective efficacy of the periodontitis gene vaccine in a periodontitis model in SD rats
Authors: Bai Guohui , Yu Hang , Guan Xiaoyan , Zeng Fengjiao , Liu Xia , Chen Bin , Liu Jianguo , Tian Yuan
Published: August 2021

Background

We previously demonstrated that nasal administration of periodontitis gene vaccine (pVAX1-HA2-fimA) or pVAX1-HA2-fimA plus IL-15 as adjuvant provoked protective immunity in the periodontal tissue of SD rats. This study evaluated the immune effect of pVAX1-HA2-fimA plus CpG-ODN 1826 as an adjuvant in the SD rat periodontitis models to improve the efficacy of the previously used vaccine.

Methods

Periodontitis was induced in maxillary second molars in SD rats receiving a ligature and infected with Porphyromonas gingivalis. Forty-two SD rats were randomly assigned to six groups: A, control without P. gingivalis; B, P. gingivalis with saline; C, P. gingivalis with pVAX1; D, P. gingivalis with pVAX1-HA2-fimA; E, P. gingivalis with pVAX1-HA2-fimA/IL-15; F, P. gingivalis with pVAX1-HA2-fimA+CpG ODN 1826 (30 µg). The levels of FimA-specific and HA2-specific secretory IgA antibodies in the saliva of rats were measured by ELISA. The levels of COX-2 and RANKL were detected by immunohistochemical assay. Morphometric analysis was used to evaluate alveolar bone loss. Major organs were observed by HE staining.

Results

30 μg could be the optimal immunization dose for CpG-ODN 1826 and the levels of SIgA antibody were consistently higher in the pVAX1-HA2-fimA+CpG-ODN 1826 (30 µg) group than in the other groups during weeks 1–8 (P < 0.05, except week 1 or 2). Morphometric analysis demonstrated that pVAX1-HA2-fimA+CpG-ODN 1826 (30 µg) significantly reduced alveolar bone loss in ligated maxillary molars in group F compared with groups B–E (P < 0.05). Immunohistochemical assays revealed that the levels of COX-2 and RANKL were significantly lower in group F compared with groups B–E (P < 0.05). HE staining results of the major organs indicated that pVAX1-HA2-fimA with or without CpG-ODN 1826 was not toxic for in vivo use.

Conclusions

These results indicated that CpG-ODN 1826 (30 µg) could be used as an effective and safe mucosal adjuvant for pVAX1-HA2-fimA in SD rats since it could elicit mucosal SIgA responses and modulate COX-2 and RANKL production during weeks 1–8, thereby inhibiting inflammation and decreasing bone loss.
Providing dignity therapy to patients with advanced cancer: a feasibility study within the setting of a hospital palliative care unit
Authors: Nunziante Francesca , Tanzi Silvia , Alquati Sara , Autelitano Cristina , Bedeschi Enrica , Bertocchi Elisabetta , Dragani Matilde , Simonazzi Davide , Turola Elena , Braglia Luca , Masini Luciano , Di Leo Silvia
Published: August 2021

Background

Dignity is a basic principle of palliative care and is intrinsic in the daily practice of professionals assisting individuals with incurable diseases. Dignity Therapy (DT) is a short-term intervention aimed at improving the sense of purpose, meaning and self-worth and at reducing the existential distress of patients facing advanced illness. Few studies have examined how DT works in countries of non-Anglo Saxon culture and in different real-life settings. Moreover, most studies do not provide detailed information on how DT is conducted, limiting a reliable assessment of DT protocol application and of its evaluation procedure.

The aim of this study was to assess the feasibility and acceptability of a nurse-led DT intervention in advanced cancer patients receiving palliative care.

Method

This is a mixed-method study using before and after evaluation and semistructured interviews. Cancer patients referred to a hospital palliative care unit were recruited and provided with DT. The duration of sessions, and timeframes concerning each step of the study, were recorded, and descriptive statistical analyses were performed.

The patients' dignity-related distress and feedback toward the intervention were assessed through the Patient Dignity Inventory and the Dignity Therapy Patient Feedback Questionnaire, respectively. Three nurses were interviewed on their experience in delivering the intervention, and the data were analyzed qualitatively.

Results

A total of 37/50 patients were enrolled (74.0%), of whom 28 (75.7%) completed the assessment. In 76.7% of cases, patients completed the intervention in the time limit scheduled in the study. No statistically significant reduction in the Patient Dignity Inventory scores was observed at the end of the intervention; most patients found DT to be helpful and satisfactory. Building opportunities for personal growth and providing holistic care emerged among the facilitators to DT implementation. Nurses also highlighted too great of a time commitment and a difficult collaboration with ward colleagues among the barriers.

Conclusions

Our findings strongly support the acceptability, but only partially support the feasibility, of nurse-led DT in advanced cancer patients in a hospital setting. Further research is needed on how to transfer the potential benefits of DT into clinical practice.

Trial registration

Retrospectively registered on ClinicalTrial.govNCT04738305.
Intrauterine devices migrated into the bladder: two case reports and literature review
Authors: Liu Guangtao , Li Feifei , Ao Min , Huang Guimin
Published: August 2021

Background

Intrauterine devices (IUD) are widely used all over the world. One of the most serious complications is uterine perforation, and it is very rare for the IUD to penetrate the bladder after perforation. Here we report two cases of IUD migration into the bladder, and review the literature to analyze the possible causes and solutions of such complications.

Case presentation

Case NO. 1 is a 37-year-old female who presented lower urinary tract symptoms for a year. Cystoscopy showed that a strip of metal penetrated into the bladder, and the surface was covered with stones. The patient underwent cystotomy and foreign body removal under general anesthesia. Case NO. 2 is a 46-year-old woman who previously inserted an IUD in 1998, but she had an unexpected pregnancy in 1999. Her doctor believed that "the IUD had spontaneously expulsed" and a new IUD was inserted after her pregnancy was terminated. Her CT scan showed an IUD on the left side of the bladder and another IUD in the uterus. Her foreign body was removed by cystotomy.

Conclusion

Patients with IUD should be suggested to check the device regularly, and those who with a missed IUD have to rule out the possibility of IUD migration. For patients with IUD combined with lower urinary tract symptoms, it is necessary to be aware of whether IUD perforation affects the bladder.
Effect of an aged wearing suit on nursing student’s knowledge and attitude
Authors: Mandegari Bamakan Zahra , Nasiriani Khadijeh , Madadizadeh Farzan , Keshmiri Fatemeh
Published: August 2021

Background

The knowledge and attitude of health care providers are important and influential factors in providing care services to the elderly and need to be considered during the training course. Simulation in geriatric nursing education can be an opportunity for learners to experience the restrictions of the elderly. The present study was conducted to determine the effect of training through simulation on the attitude and knowledge of nursing students in elderly care.

Methods

This study was quasi-experimental with two experimental and control groups of pre and post-test, which was conducted on 70 nursing students of the 5th semester (two groups of 35 people). For the experimental group, the elderly simulation suit was worn for two hours, which was designed by the researcher and created sensory, physical, and motor restrictions similar to the elderly for students. Before and after the study, Kogan’s attitudes toward older people scale and Palmore’s “facts on aging quiz” were completed by students. The data were analyzed using an independent t-test and paired t-test using SPSS version 16 software.

Results

The mean scores of students’ knowledge in the experimental and control groups had no significant difference at the beginning of the study (p < 0.05). But the mean scores of knowledge in the experimental group before and after the intervention was (9.2 ± 2.6) and (15.3 ± 3.5), respectively, and in the control group before and after the intervention was (10.4 ± 2.9) and (11.3 ± 2.6), respectively, which had a statistically significant difference (p = 0.0001). The mean scores of students’ attitudes in the experimental and control groups had no significant difference at the beginning of the study (p < 0.05). The mean scores of attitude in the experimental group before and after the intervention was (114.69 ± 8.4) and (157.31 ± 10.7), respectively and in the control group before and after the intervention was (113.34 ± 13.6) and (108.5 ± 16.6), respectively, which was significantly different (p = 0.0001).

Conclusions

Based on the findings, the experience of aging restrictions through simulation has improved the knowledge and attitude of nursing students towards the elderly. Nursing education requires the growth of attitudinal skills, individuals’ beliefs, and creating empathy among them, so creating simulation opportunities can assist nursing students in the educational processes.
Low costs and opportunities for efficiency: a cost analysis of the first year of programmatic PrEP delivery in Kenya’s public sector
Authors: Peebles Kathryn , Mugwanya Kenneth K. , Irungu Elizabeth , Odoyo Josephine , Wamoni Elizabeth , Morton Jennifer F. , Ngure Kenneth , Bukusi Elizabeth A. , Mugo Nelly R. , Masyuko Sarah , Mukui Irene , Baeten Jared M. , Barnabas Ruanne V. ,   for the Partners Scale-Up Project Team
Published: August 2021

Background

In 2017, the Kenyan Ministry of Health integrated provision of pre-exposure prophylaxis (PrEP) into public HIV-1 care clinics as a key component of the national HIV-1 prevention strategy. Estimates of the cost of PrEP provision are needed to inform the affordability and cost-effectiveness of PrEP in Kenya.

Methods

We conducted activity-based micro-costing from the payer perspective to estimate both the financial and economic costs of all resources and activities required to provide PrEP in Kenya’s public sector. We estimated total and unit costs in 2019 United States dollars from a combination of project expense reports, Ministry of Health training reports, clinic staff interviews, time-and-motion observations, and routinely collected data from PrEP recipient files from 25 high-volume HIV-1 care clinics.

Results

In the first year of programmatic PrEP delivery in 25 HIV-1 care clinics, 2,567 persons initiated PrEP and accrued 8,847 total months of PrEP coverage, accounting for 2 % of total outpatient clinic visits. The total financial cost to the Ministry of Health was $91,175, translating to an average of $10.31 per person per month. The majority (69 %) of financial costs were attributable to PrEP medication, followed by administrative supplies (17 %) and training (9 %). Economic costs were higher ($188,584 total; $21.32 per person per month) due to the inclusion of the opportunity cost of staff time re-allocated to provide PrEP and a proportional fraction of facility overhead. The vast majority (88 %) of the annual $80,811 economic cost of personnel time was incurred during activities to recruit new clients (e.g., discussion of PrEP within HIV-1 testing and counselling services), while the remaining 12 % was for activities related to both initiation and maintenance of PrEP provision (e.g., client consultations, technical advising, support groups).

Conclusions

Integration of PrEP provision into existing public health HIV-1 care service delivery platforms resulted in minimal additional staff burden and low incremental costs. Efforts to improve the efficiency of PrEP provision should focus on reductions in the cost of PrEP medication and extra-clinic demand creation and community sensitization to reduce personnel time dedicated to recruitment-related activities.

Trial registration

ClinicalTrials.gov registrationNCT03052010. Retrospectively registered on February 14, 2017.
Determination of myrislignan levels in BALB/c mouse plasma by LC-MS/MS and a comparison of its pharmacokinetics after oral and intraperitoneal administration
Authors: Zhang Jili , Si Hongfei , Sun Jichao , Lv Kun , Yan Biqing , Li Bing , Zhou Xuzheng , Zhang Jiyu
Published: August 2021

Background

Myrislignan is a natural product from Myristica sp. with diverse pharmacological activities. Recently, the anti-Toxoplasma gondii (T. gondii) activity of myrislignan has been proposed, and in vivo studies of its pharmacokinetics in BALB/c mice are necessary to further evaluate the clinical effects of myrislignan.

Results

In this study, a sensitive liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and validated to quantify myrislignan levels in mouse plasma using dehydrodiisoeugenol as an internal standard (IS) in positive ion mode. Chromatographic separation of the analytes was achieved using an ACE Ultracore Super C18 analytical column (2.5 μm, 2.1 × 50 mm) at 30 °C. A gradient mobile phase consisting of water (0.1 % formic acid) and acetonitrile (0.1 % formic acid) was delivered at a flow rate of 0.4 mL/min. Myrislignan and the IS eluted at 1.42 and 1.71 min, respectively. A good excellent linear response across the concentration range of 1-1000 ng/mL was achieved (r2 = 0.9973). The lower limit of quantification (LLOQ) was 1 ng/mL, and the inter- and intra-day accuracy and precision of the method showed relative standard deviations (RSDs) less than 10 %. The method was applied to examine the pharmacokinetics of myrislignan in mouse plasma following a single oral administration of 200 mg/kg or intraperitoneal administration of 50 mg/kg myrislignan, and the bioavailability (F) of orally administered myrislignan was only 1.97 % of the bioavailability of intraperitoneally administered myrislignan.

Conclusions

A rapid and sensitive LC-MS/MS method has been was developed, validated and successfully used to determine myrislignan levels in mice after oral or intraperitoneal administration. This study is the first to report the pharmacokinetic parameters of myrislignan in mice and to compare its pharmacokinetics after oral and intraperitoneal administration, which will be useful for further research on the administration of myrislignan in animals and humans.
Care programs and their components for patients with idiopathic pulmonary fibrosis: a systematic review
Authors: Delameillieure Anouk , Vandekerkhof Sarah , Van Grootven Bastiaan , Wuyts Wim A. , Dobbels Fabienne
Published: August 2021

Background

The multidimensional and complex care needs of patients with idiopathic pulmonary fibrosis (IPF) call for appropriate care models. This systematic review aimed to identify care models or components thereof that have been developed for patients with IPF in the outpatient clinical care, to describe their characteristics from the perspective of chronic integrated care and to describe their outcomes.

Methods

A systematic review was conducted using state-of-the-art methodology with searches in PubMed/Medline, Embase, CINAHL and Web Of Science. Researchers independently selected studies and collected data, which were described according to the Chronic Care Model (CCM).

Results

Eighteen articles were included describing 13 new care models or components. The most commonly described CCM elements were ‘delivery system design’ (77%) and ‘self-management support’ (69%), with emphasis on team-based and multidisciplinary care provision and education. The most frequently described outcome was health-related quality of life.

Conclusions

Given the high need for integrated care and the scarcity and heterogeneity of data, developing, evaluating and implementing new models of care for patients with IPF and the comprehensive reporting of these endeavours should be a priority for research and clinical care.
A transcription factor that promotes proliferation, migration, invasion, and epithelial–mesenchymal transition of ovarian cancer cells and its possible mechanisms
Authors: Qi Yingying , Mo Kexin , Zhang Ting
Published: August 2021

Background

Ovarian cancer is one of the most common gynecological malignancies with the high morbidity and mortality. This study was aimed to explore the role of non-structure maintenance of chromosomes condensin I complex subunit H (NCAPH) in the progression of ovarian cancer (OC) and the transcription regulatory effects of GATA binding protein 3 (GATA3) on this gene.

Methods

Firstly, NCAPH and GATA3 expression in OC tissues and several human OC cell lines was, respectively, evaluated by TNMplot database and Western blot analysis. Then, NCAPH was silenced to assess the proliferation, migration, and invasion of OC cells in turn using CCK-8, wound healing, and transwell assays. Western blotting was used to determine the expression of epithelial--mesenchymal transition (EMT)-related proteins and PI3K/PDK1/AKT signaling proteins. The potential binding sites of GATA3 on NCAPH promoter were predicated using JASPAR database, which were verified by luciferase reporter assay and chromosomal immunoprecipitation. Subsequently, GATA3 was overexpressed to examine the biological functions of OC cells with NCAPH silencing.

Results

NCAPH and GATA3 expression was significantly upregulated in OC tissues and cell lines. NCAPH loss-of-function notably inhibited the proliferation, migration, invasion, and EMT of OC cells. Moreover, the expression of p-PI3K, PDK1, and p-AKT was downregulated after NCAPH knockdown. Furthermore, GATA3 was confirmed to bind to NCAPH promoter. GATA3 overexpression alleviated the inhibitory effects of NCAPH silencing on the proliferation, migration, invasion, EMT, and expression of proteins in PI3K/PDK1/AKT pathway of OC cells.

Conclusion

To sum up, NCAPH expression transcriptional activation by GATA3 accelerates the progression of OC via upregulating PI3K/PDK1/AKT pathway.
Effects of EFNA1 on cell phenotype and prognosis of esophageal carcinoma
Authors: Zhang Yongqiang , Zhang Jinning , Pan Guanlong , Guan Tianhao , Zhang Changhao , Hao An , Li Yan , Ren Hai
Published: August 2021

Background

To investigate the expression and clinical significance of EFNA1 in broad-spectrum tumors, and to evaluate its relationship with prognosis and biological functions of esophageal carcinoma (ESCA).

Methods

EFNA1 expression in various cancers was analyzed according to the data in the TCGA database. The clinical data were integrated, to analyze the relationship with ESCA clinical parameters and prognosis, and EFNA1 expression in ESCA tissue samples was detected by immunohistochemistry (IHC). Based on bioinformatics, the functional background of EFNA1 overexpression was analyzed. EFNA1 knockout cell model was established by EFNA1-shRNA transfecting ESCA cells, and the effect of knocking down EFNA1 on the proliferation of ESCA cells was detected by MTT.

Results

Among 7563 samples from TCGA, the EFNA1 gene highly expressed in 15 samples with common cancers and endangered the prognosis of patients with tumors. Its overexpression in ESCA and its influence on the prognosis were most significant. EFNA1 expression in 80 samples with ESCA and their paired samples was tested by IHC to verify its high expression (paired t test,P< 0.001) in ESCA tissues. It was found that EFNA1 expression was related to clinical factors (TNM staging,P= 0.031; lymph node metastasis,P= 0.043; infiltration,P= 0.016). Meanwhile, EFNA1 was found to be an independent risk factor based on the COX multi-factor analysis. And to further explore the importance of EFNA1 in tumors, EC-9706 and ECA109 cells were screened from 8 ESCA-related cell lines to build EFNA1 knockdown cell models. The results showed that EFNA1 knockdown significantly inhibited the proliferation of tumor cells (P< 0.05). In terms of molecular mechanism, EFNA1 related genes were significantly enriched in the proliferative pathway according to the pathway enrichment analysis. It was found that knocking down EFNA1 did inhibit cell proliferation based on cell experiments.

Conclusions

EFNA1 overexpression in ESCA tissue is related to the prognosis of patients. Knocking down EFNA1 can significantly inhibit the proliferation of ESCA cells.
Imaging predictor of ophthalmic involvement in maxillary sinus cancer during super selective intra-arterial cisplatin infusion and concomitant radiotherapy (RADPLAT)
Authors: Ashida Hirokazu , Igarashi Takao , Nozawa Yosuke , Munetomo Yohei , Higuchi Takahiro , Yamauchi Hideomi , Baba Akira , Abe Yukiko , Shimura Eiji , Kessoku Hisashi , Nishiya Yukio , Kojima Hiromi , Ojiri Hiroya
Published: August 2021

Objective

To investigate the predictability of ophthalmic artery involvement in maxillary sinus cancer using preprocedural contrast enhanced CT and MRI.

Methods

We analyzed advanced (T3, T4a, and T4b) primary maxillary sinus squamous cell carcinoma treated with super-selective intra-arterial cisplatin infusion and concomitant radiotherapy (RADPLAT) from Oct 2016 to Mar 2020. Two diagnostic radiologists evaluated the tumor invasion site around the maxillary sinus using preprocedural imaging. These results were compared with the angiographic involvement of the ophthalmic artery using statistical analyses. We also evaluated our RADPLAT quality using complication rate, response to treatment, local progressive free survival (LPFS), and overall survival (OS).

Results

Twenty patients were included in this study. There were ten cases of ophthalmic artery tumor stain and there was a correlation between ophthalmic artery involvement and invasion for ethmoid sinus with statistically significant differences. Other imaging findings were not associated with ophthalmic artery involvement.

Conclusions

Ethmoid sinus invasion on preprocedural imaging could suggest ophthalmic artery involvement in maxillary sinus cancer. It may be useful in predicting prognosis and treatment selection.