bluuebunny/crossref_metadata_2025 huggingface dataset:
GR, Sgk1, and NDRG1 in esophageal squamous cell carcinoma: their correlation with therapeutic outcome of neoadjuvant chemotherapy
Authors: Ueki Shunsuke , Fujishima Fumiyoshi , Konno Takuro , Ishida Hirotaka , Okamoto Hiroshi , Takaya Kai , Sato Chiaki , Taniyama Yusuke , Kamei Takashi , Sasano Hironobu
Published: February 2020

Background
Esophageal squamous cell carcinoma (ESCC) is a highly malignant neoplasm. Glucocorticoid(GC)-Glucocorticoid receptor (GR) pathway plays pivotal roles in cellular response to various stresses of tumor cells including chemotherapy. However, the status of GC-GR pathway in ESCC, including its correlation with chemotherapeutic responses has remained largely unknown.
Method
GR, serum-and glucocorticoid-regulated kinase 1(Sgk1), and N-myc down regulation gene 1(NDRG1) were immunolocalized in 98 ESCC patients who had undergone esophagectomy following neoadjuvant chemotherapy(NAC) with 2 courses of 5-Fluorouracil(5-FU) + Cisplatin (CDDP). We also examined biopsy specimens before NAC in 42 cases and compared the results between those before and after NAC.
Results
Overall survival (OS) of the patients treated with surgery following NAC was significantly shorter in the group with high GR than that with low GR ( P = 0.0473). Both OS and disease-free survival (DFS) were significantly shorter in both Sgk1- and NDRG1-high groups than low groups (OS: Sgk1, P = 0.0055; NDRG1, P = 0.0021; DFS: Sgk1, P = 0.0240; NDRG1, P = 0.0086). When evaluating the findings in biopsy specimens before NAC, DFS was significantly shorter in the high Sgk1 group ( P = 0.0095), and both OS and DFS was shorter in high NDRG1 group (OS, P = 0.0233; DFS, P = 0.0006) than respective low groups. Among high NDRG1 group of biopsy specimens before NAC, the tumor reduction rate by NAC was significantly attenuated ( P = 0.021).
Conclusions
High status of GR, Sgk1, and NDRG1 in ESCC after NAC was significantly associated with over all worse prognosis and there were no significant changes in the status of those above before and after NAC. Therefore , increased activity of GC-GR pathway with enhanced induction of Sgk1 and NDRG1 in carcinoma cells plays pivotal roles in tumor progression and development of chemoresistance in ESCC patients undergoing NAC.
Clinical pictures, treatments, resource use, and costs of norovirus gastroenteritis in long-term care facilities: A survey with a chart review in Japan
Authors: Fujiki Saori , Ishizaki Tatsuro , Nakayama Takeo
Published: February 2020

Background

Outbreaks of norovirus infection can have detrimental impacts on long-term care facilities. This study investigated the incidence, clinical picture, treatment, resource use, and costs of norovirus gastroenteritis in long-term care facilities.

Methods

Nineteen facilities in Osaka and Kyoto, Japan participated in questionnaire surveys conducted between 2009 and 2011 regarding the incidence of norovirus gastroenteritis. From clinical charts, the characteristics, symptoms, and treatment of infected residents were analyzed. Total drug cost per infected resident was calculated by multiplying the unit price for each drug by the daily dose and the number of days administered and summing the costs for each drug (USD 1 = JPY 100).

Results

Over the 3-year period, 8 outbreaks of norovirus gastroenteritis occurred in 6 facilities. The mean clinical course of 107 infected residents in five facilities that granted permission to examine patients’ medical records was 4 days, with all but one resident presenting with vomiting and/or diarrhea, and 84 (79%) also presenting with associated symptoms. Of 107 infected residents, 72 (67%) were isolated. The proportion of infected residents isolated varied from 50% to 100% depending on the facility. Of the infected residents, 81 (76%) received some type of medication, the most common being infusion (67 patients, 63%) and antibiotics (30 patients, 28%). The median total cost of all drugs administered was USD 4.4, and the median drug cost per infected resident per day was USD 2.0. Total drug cost over the entire treatment period was the highest for antibiotics, at USD 8.6.

Conclusion

Clinical course was similar to those of norovirus cases examined at other facilities. The majority of infected residents received some type of medication. Although the economic burden was not large, not a few infected residents were given antibiotics, which are ineffective for norovirus.
Facilitators and Barriers of Managing Patients with Multiple Chronic Conditions in the Community: A Qualitative Study
Authors: Foo Kah Mun , Sundram Meena , Legido-Quigley Helena
Published: February 2020

Background
Approximately one-third of all adults worldwide are diagnosed with multiple chronic conditions (MCCs). The literature has identified several challenges facing providers and patients coping with managing MCCs in the community, yet few studies have considered their viewpoints in combination. A qualitative study involving healthcare providers and users was thus conducted to examine facilitators and barriers of managing patients with MCCs in the community in Singapore.
Methods
This study involves 26 semi-structured interviews with 10 physicians, 2 caregivers and 14 patients seeking treatment in the polyclinics that provide subsidised primary care services. Topic guides were developed with reference to the literature review, Chronic Care Model (CCM) and framework for patient-centred access to healthcare.
Results
Despite the perceived affordability and availability of the support system, some patients still encountered financial difficulties in managing care. These include inadequacy of the nation-wide medical savings scheme to cover outpatient treatment and medications. Half of healthcare users did not know where to seek help. While patients could access comprehensive services in polyclinics, those who did not visit the clinics might not receive timely care. Furthermore, patients reported long consultation waiting time.
Physicians were able to propose and drive quality improvement projects to improve care quality. However, there were challenges to delivering safe and quality care with limited consultation duration due to the need to manage high patient load and waiting time, inadequate communication with specialists to coordinate care, and resource constraints in managing complex patients.
Although providers could equip patients with self-management and lifestyle-related guidelines, patients’ actions are influenced by multiple factors, including work requirements, beliefs and environment.
Conclusions
There were barriers on care access, delivery and self-management. It is crucial to adopt a whole-of-society approach involving individuals, community, institutions and policymakers to improve and support MCC management. This study has also highlighted the importance of considering the different viewpoints of healthcare providers and users in policy formulation and community care planning.
Linking crop traits to transcriptome differences in a progeny population of tetraploid potato
Authors: Alexandersson Erik , Kushwaha Sandeep , Subedi Aastha , Weighill Deborah , Climer Sharlee , Jacobson Daniel , Andreasson Erik
Published: February 2020

Background
Potato is the third most consumed crop in the world. Breeding for traits such as yield, product quality and pathogen resistance are main priorities. Identifying molecular signatures of these and other important traits is important in future breeding efforts. In this study, a progeny population from a cross between a breeding line, SW93-1015, and a cultivar, Désirée, was studied by trait analysis and RNA-seq in order to develop understanding of segregating traits at the molecular level and identify transcripts with expressional correlation to these traits. Transcript markers with predictive value for field performance applicable under controlled environments would be of great value for plant breeding.

Results
A total of 34 progeny lines from SW93-1015 and Désirée were phenotyped for 17 different traits in a field in Nordic climate conditions and controlled climate settings. A master transcriptome was constructed with all 34 progeny lines and the parents through a de novo assembly of RNA-seq reads. Gene expression data obtained in a controlled environment from the 34 lines was correlated to traits by different similarity indices, including Pearson and Spearman, as well as DUO, which calculates the co-occurrence between high and low values for gene expression and trait. Our study linked transcripts to traits such as yield, growth rate, high laying tubers, late and tuber blight, tuber greening and early flowering. We found several transcripts associated to late blight resistance and transcripts encoding receptors were associated to Dickeya solani susceptibility. Transcript levels of a UBX-domain protein was negatively associated to yield and a GLABRA2 expression modulator was negatively associated to growth rate.

Conclusion
In our study, we identify 100’s of transcripts, putatively linked based on expression with 17 traits of potato, representing both well-known and novel associations. This approach can be used to link the transcriptome to traits. We explore the possibility of associating the level of transcript expression from controlled, optimal environments to traits in a progeny population with different methods introducing the application of DUO for the first time on transcriptome data. We verify the expression pattern for five of the putative transcript markers in another progeny population.
Lipase immobilized on functionalized superparamagnetic few-layer graphene oxide as an efficient nanobiocatalyst for biodiesel production from Chlorella vulgaris bio-oil
Authors: Nematian Tahereh , Shakeri Alireza , Salehi Zeinab , Saboury Ali Aakbar
Published: February 2020

Background Microalgae, due to its well-recognized advantages have been gained renewed interest as potentially good feedstock for biodiesel. Production of fatty acid methyl esters (FAMEs) as a type of biodiesel was carried out from Chlorella vulgaris bio oil. Biodiesel was produced in the presence of nano-biocatalysts composed of immobilized lipase on functionalized superparamagnetic few-layer graphene oxide via a transesterification reaction. A hybrid of few-layer graphene oxide and Fe 3 O 4 (MGO) was prepared and characterized. The MGO was functionalized with 3-aminopropyl triethoxysilane (MGO-AP) as well as with a couple of AP and glutaraldehyde (MGO-AP-GA). The Rhizopus oryzae lipase (ROL) was immobilized on MGO and MGO-AP using electrostatic interactions as well as on MGO-AP-GA using covalent bonding. The supports, MGO, MGO-AP, and MGO-AP-GA, as well as Nano-biocatalyst, ROL/MGO, ROL/MGO-AP, and ROL/MGO-AP-GA, were characterized using FESEM, VSM, FTIR, and XRD. The few-layer graphene oxide was characterized using AFM and the surface charge of supports was evaluated with the zeta potential technique. The nano-biocatalysts assay was performed with an evaluation of kinetic parameters, loading capacity, relative activity, time-course thermal stability, and storage stability. Biodiesel production was carried out in the presence of nano-biocatalysts and their reusability was evaluated in 5 cycles of transesterification reaction. Results: The AFM analysis confirmed the few-layer structure of graphene oxide and VSM also confirmed that all supports were superparamagnetic. The maximum loading of ROL (70.2%) was related to MGO-AP-GA. The highest biodiesel conversion of 71.19% achieved in the presence of ROL/MGO-AP-GA. Furthermore, this nano-biocatalyst could maintain 58.77% of its catalytic performance after 5 cycles of the transesterification reaction and was the best catalyst in the case of reusability. Conclusions: In this study, the synthesized nano-biocatalyst based on bare and functionalized magnetic graphene oxide was applied and optimized in the process of converting microalgae bio-oil to biodiesel for the first time and compared with bare lipase immobilized on magnetic nanoparticles. Results showed that the loading capacity, kinetic parameters, thermal stability, and storage stability improved by the functionalization of MGO. The biocatalysts, which were prepared via covalent bonding immobilization of enzyme generally, showed better characteristics. Keywords Few-layer graphene oxide; Biodiesel; Chlorella vulgaris ; Bio-oil; Superparamagnetic; Nano-biocatalyst.
Jordanian women’s experiences and constructions of labour and birth in different settings, over time and across generations: A qualitative study
Authors: Hussein Suha Abed Almajeed Abdallah , Dahlen Hannah G , Ogunsiji Olayide , Schmied Virginia
Published: February 2020

Background: Overwhelmingly, women in Middle Eastern countries experience birth as dehumanising and disrespectful.Aim: To examine Jordanian women’s experiences and constructions of labour and birth in different settings (home, public and private hospitals in Jordan, and Australian public hospitals), over time and across generations. Method: A qualitative interpretive design was used. Data were collected by face-to-face semi-structured interviews with 27 Jordanian women. Of these women, 20 were living in Jordan (12 had given birth in the last five years and eight had birthed over 15 years ago) while seven were living in Australia (with birthing experience in both Jordan and Australia). Interview data were transcribed verbatim and analysed thematically.Results: Women’s birth experiences differed across settings and generations and were represented in the four themes: ‘Home birth: a place of comfort’; ‘Public Hospital: it’s what you do’; ‘Private Hospital: buying control’ and ‘Australian maternity care: a mixed experience’. In each theme, the concepts: Pain, Privacy, the Personal and to a lesser extent, Purity (cleanliness), were present but experienced in different ways depending on the setting (home, public or private hospital) and the country.Conclusions: The findings demonstrate how meanings attributed to labour and birth, particularly the experience of pain, are produced and reproduced in different settings, providing insights not only into the medical and institutional management of birth, but also the social context influencing decision-making around birth in Jordan and other Middle Eastern countries. In the public hospital environment in Jordan, women were treated in a dehumanised way with no privacy, no support for people and no access to the pain relief they wanted. This was in stark contrast to women birthing at home only one generation before. Change is urgently needed to offer humanised birth in the Jordanian maternity system,
Allo-HSCT compared with immunosuppressive therapy for acquired aplastic anemia: Is superiority a one-sided understanding?
Authors: Zhu Yangmin , Gao Qingyan , Hu Jing , Guan Dongrui , Liu Xu , Zhang Fengkui
Published: February 2020

Acquired aplastic anemia (AA) is a rare hematologic disease characterized by a profound pancytopenia and hypocellular bone marrow. To comprehensively compare the efﬁcacy and safety of allogeneic hematopoietic stem cell transplantation (allo-HSCT) with immunosuppressive therapy (IST) as a front-line treatment for patients with AA. We searched the Medline, Embase, and Cochrane Registry of Controlled Trials databases from January 2000 to March 2019. Studies comparing allo-HSCT with IST as a first-line therapy for patients with AA were included. Fifteen studies including a total of 5336 patients were included in the meta-analysis. The pooled hazard ratio (HR) for overall survival (OS) was 0.4 (95% CI 0.074–0.733, P = 0.016, I2 = 58.8%) and the pooled HR for failure-free survival (FFS) was 1.962 (95% CI 1.43–2.493, P = 0.000, I2 = 0%). The pooled relative risk (RR) for overall response rate (ORR) was 1.691 (95% CI 1.433–1.996, P = 0.000, I2 = 11.6%). Although survival was significantly longer among AA patients undergoing first-line allo-HSCT compared to those undergoing first-line IST, the selection of initial treatment for patients with newly diagnosed AA still requires comprehensive evaluation of donor availability, patient age, expected quality of life, risk of disease relapse or clonal evolution after IST, and potential use of adjunctive eltrombopag.
Full-term low birth weight infants have differentially hypermethylated DNA related to immune system and organ growth: A comparison with full-term normal birth weight infant
Authors: Hayashi Ikuyo , Yamaguchi Ken , Sumitomo Masahiro , Takakura Kenji , Nagai Narumi , Sakane Naoki
Published: February 2020

Objective: Low birth weight (LBW) is a major public health issue as it increases the risk of noncommunicable diseases throughout life. However, the genome-wide DNA methylation patterns of full-term LBW infants (FT-LBWs) are still unclear. This exploratory study aimed to analyze the DNA methylation differences in FT-LBWs compared with those in full-term normal birth weight infants (FT-NBWs) whose mothers were nonsmokers and had no complications. Initially, 702 Japanese women with singleton pregnancies were recruited. Of these, four FT-LBWs and five FT-NBWs were selected as references for DNA methylation analysis, and 862,260 CpGs were assessed using Illumina Infinium MethylationEPIC BeadChip. Gene ontology enrichment analysis was performed using DAVID v6.8 software to identify the biological functions of hyper- and hypomethylated DNA in FT-LBWs.
Results: 483 hyper-differentially methylated genes (DMGs) and 35 hypo-DMGs were identified in FT-LBW promoter regions. Hyper-DMGs were annotated to 11 biological processes; “macrophage differentiation” (e.g., CASP8), “apoptotic mitochondrial changes” (e.g., BH3), “nucleotide-excision repair” (e.g., HUS1), and “negative regulation of inflammatory response” (e.g., NLRP12 and SHARPIN). EREG was classified into “ovarian cumulus expansion” within the “organism growth and organization” category. Our data imply that LBW might be associated with epigenetic modifications, which regulate the immune system and cell maturation.
Clinical efficacy of submucosal injection of triamcinolone acetonide in the treatment of type II/III interstitial cystitis/bladder pain syndrome
Authors: Jiang Tao , Zhou Xiaozhou , Chen Zhipeng , Xiong Tailing , Fu Jian , Liu Zhengchao , Yan Dishi , Zhou Zhansong , Shen Wenhao
Published: February 2020

Background: To evaluate the efficacy of submucosal injection of triamcinolone acetonide for the treatment of type II/III interstitial cystitis/bladder pain syndrome.
Methods: A retrospective analysis of the clinical data of type II/III interstitial cystitis/bladder pain syndrome patients treated in our department from April 2016 to August 2018 was conducted, and changes in International Prostate Symptom Scores and the Pelvic Pain and Urgency/Frequency symptom scale after surgery were evaluated to explore factors that may affect patient outcomes.
Results: A total of 27 female patients and 8 male patients were enrolled, with type II patients accounting for 62.9% of the sample, and the median follow-up duration was 31 months (range: 12-40 months). Twenty-two patients (74.3%) had significantly improved questionnaire scores at 4 weeks postoperatively. Treatment efficacy was sustained for at least 1 year in 15 patients, and persistent effectiveness was noted in 10 (28.6%) patients. Patients with an advanced age (p=0.015), high pain scores (p=0.040), and higher International Prostate Symptom Scores (p=0.037) and Pelvic Pain and Urgency/Frequency symptom scale scores (p=0.020) were more likely to benefit from submucosal injection of triamcinolone acetonide. Gender, disease duration, and the presence of Hunner’s lesions had no predictive value for treatment outcomes.
Conclusion: Submucosal injection of triamcinolone acetonide can improve the clinical symptoms and quality of life in both men and women with type II/III interstitial cystitis/bladder pain syndrome. Patients with an advanced age and more severe interstitial cystitis/bladder pain syndrome related symptoms may benefit more from triamcinolone acetonide injection.
Knockdown of hsa_circ_0074298 suppressed the progression of pancreatic cancer by targeting the miR-519/SMOC2 axis
Authors: Chen Hong , Xu Dafang , Wang Lishan , Zhou Jiahua
Published: February 2020

BACKGROUND: Pancreatic cancer (PC) is among the most malignant tumors in digestive system because of its fast progression, metastasis as well as resistance to chemotherapy. Former studies found that circRNAs that differentially expressed were correlated to progression and gemcitabine (GEM)-resistance in PC, and hsa_circ_0074298 aberrant expression played a role in PC progression, but the regulatory mechanism was unclear.
METHODS: Rt-qPCR was used to detect hsa_circ_0074298 expression in PC cell lines. The CCK8, colony formation, and Transwell assays were used to evaluate the effect of hsa_circ_0074298 on PC cell migration and proliferation. Bioinformatics and luciferase reporter experiments were used to study the regulatory mechanism. Nude mouse xenografts were generated to examine the effect of hsa_circ_0074298 on tumor growth.
RESULTS: The present study showed that hsa_circ_0074298 expression increased significantly in both PC cell lines and PC tissues. Downregulation of hsa_circ_0074298 caused a significant decrease in PC cell proliferation and in nude mouse xenograft growth. Hsa_circ_0074298 silencing also increased chemotherapy sensitivity to GEM. Bioinformatics analysis indicated that hsa_circ_0074298 was a miR-519 sponge and that the SMOC2 gene was a miR-519 target. MiR-519 downregulation or SMOC2 overexpression restored cell proliferation, migration, and chemoresistance after hsa_circ_0074298 silencing. The dual luciferase reporter assay showed that hsa_circ_0074298 interacted with miR-519, and miR-519 binding to the SMOC2 3′-UTR, then suppressed posttranscriptional SMOC2 expression.
CONCLUSIONS: Taken together, hsa_circ_0074298 functioned as a tumor promoter through novel miR-519/SMOC2 axis, highlighting its possibility as a potential therapy for PC.
Occurrence of anterior uveitis in patients with spondyloarthritis treated with tumor necrosis factor inhibitors: comparing the soluble receptor to monoclonal antibodies in a large observational cohort
Authors: khoury Gisèle , Morel Jacques , Combe Bernard , Lukas Cédric
Published: February 2020

Background: The objective of this study was to compare in real life the occurrence of anterior uveitis in patients with spondyloarthritis (SpA), including psoriatic arthritis (PsA), treated with the soluble-receptor etanercept (ETA) or monoclonal antibodies (mAb). Methods: This was an observational, retrolective study. Patients with SpA who were prescribed anti-TNF agents between 2000 and 2014 were included. The risk of uveitis was interpreted qualitatively (number of subjects with at least one uveitis) and quantitatively (number of uveitis flares for each individual). Models were adjusted for propensity score of receiving preferentially mAbs or ETA. Results: 429 patients were included (302 with SpA and 127 with PsA); 203 received a Mab and 226 ETA as a first TNF-a inhibitor. Probability of uveitis occurring during the first year of treatment was lower with ETA than mAbs but not significantly (odds ratio 0.94 [95% confidence interval 0.35; 2.54], p=0.90, on qualitative analysis and relative risk 0.62 [0.26; 1.46], p=0.27, on quantitative analysis) after adjustment for the propensity score. The over-time risk of uveitis was numerically higher with ETA than mAbs, but the differences were not statistically significant. Conclusion: In this observational study, the risk of uveitis in patients with SpA does not appear to be greater with ETA than mAbs treatment. The occurrence of uveitis in patients receiving an anti-TNF-a agent seems linked more to history of uveitis than the prescribed molecule.
Nummular Headache - A case report of a rare entity
Authors: Thomas Davis , Heir Gary M. , Patil Amey G. , Soni Prutha K.
Published: February 2020

Background: Nummular Headache is a rare type of chronic primary headache wherein the pain is usually located in a well-circumscribed, round or elliptical shaped area of the scalp. Case Report: A 26-year-old female presented to the Center for TMD/ OFP with the chief complaint of chronic persistent left parietal headache, for more than 10 years, which has been worsening over the past few days with no specific identifiable trigger. The medical history is non- contributory. The primary diagnosis is Nummular Headache. Conclusion: A comprehensive history is the first step to achieve an accurate diagnosis. The diagnosis of Nummular Headache is challenging and confusing due to the rare occurrence. An examination must include imaging and is detrimental in eliminating other underlying pathologies. The diagnosis is made from distinct clinical features after exclusion of all other entities. Keywords: Nummular headache, Rare primary headaches, Coin-shaped headache, Chronic Primary headache, Epicranial headache.
Benefits of a community based interdisciplinary learning exposure: A qualitative study of the One Health approach in teaching at Makerere University, Uganda
Authors: Buregyeya Esther , Atusingwize Edwinah , Nsamba Peninah , Nalwadda Christine , Osuret Jimmy , Kalibbala Patrick , Nuwamanya Ronald , Ssekamatte Tonny , Wakabi Timothy , Bikaako Winnie , Yawe Agnes , Naigaga Irene , Kagarama Juvenal , Kabasa John David , Bazeyo William
Published: February 2020

Makerere University implemented a One Health Institute (OHI) in 2016 involving undergraduate students selected from different disciplines. The students were first taken through theoretical principles in One Health followed by a field attachment in communities. The field attachment aimed to expose students to experiential educational opportunities in the communities in a One Health approach. In this paper, we present students’ experiences and their contributions to the communities of attachment.MethodsThis was a cross-sectional study, utilizing qualitative data collection methods. The study involved students who participated in the OHI field attachment and community members in Western Uganda. Four focus group discussions (FGDs) and four in-depths (IDIs) were conducted among the students, while four FGDs and eight IDIs were conducted among community members. All interviews were audio-recorded, transcribed and analysed manually.ResultsThe four themes that emerged are: students’ understanding and appreciation of One Health concept, their experiences and gains from the multi-disciplinary field attachment, students’ contributions to the community, and challenges faced by the students. Students had good knowledge of One Health. They appreciated that health cannot be achieved by one discipline or sector and thus the need to collaborate across sectors. Regarding experiences and gains during the multi-disciplinary field attachment, the students appreciated that each discipline had a role to play in achieving health in the community. They appreciated the training sighting skills gained in communication, team work and collaboration. They also reported a feeling of gratitude and accomplishment because they felt they made a positive change to the community by putting in place interventions to address some of the community challenges. Similarly, the communities appreciated the students’ contribution in solving their health challenges, ranging from conducting health education to improving sanitation and hygiene.ConclusionsThrough the OHI, students gained One Health competencies including communication, teamwork, and collaboration. Adopting an interdisciplinary model in university teaching system especially during field placement would strengthen skills of collaboration, team work and communication which are critical for a multi-disciplinary approach which is needed among the future workforce in order to solve the current health challenges.
Descriptive epidemiology of objectively-measured, free-living sleep parameters in a rural African setting.
Authors: Cook Ian , Mohlabe Matlawa , Alberts Marianne
Published: February 2020

Objectives

To investigate the descriptive nature of objectively-measured, free-living sleep quantity and quality, and the relationship to adiposity, in a rural African setting in 145 adults (≥40 years, female: n=104, male: n=41). Wrist-mounted, tri-axial accelerometry data was collected over nine days. Measures of sleep quantity and quality, and physical activity were extracted from valid minute-by-minute data. From stature, body mass and waist circumference, body-mass-index and conicity index were calculated. Self-reported data included behavioural, health and socio-demographic variables. Community consultation followed the quantitative data analyses, for validation and interpretation of findings.

Results

Females had more nocturnal sleep than males (7.2 vs. 6.8 hours/night, p=0.0464) while males recorded more diurnal sleep time (p=0.0290). Wake after sleep onset and number of awakenings were higher in females, and sleep efficiency was higher in males (p≤0.0225). Sleep indices were generally similar between weekdays and weekends, except for sleep fragmentation index (p=0.0458). Sleep quantity, but not sleep quality was independently and inversely associated with adiposity (p=0.0453). Physical activity and morbidity measures were significantly and consistently associated with sleep and adiposity measures (p<0.0458). The qualitative data explained some of the unexpected associational directions of the independent variables correlated with sleep variables.
Percutaneous intra-articular injections of ropivacaine, and tranexamic acid and removal of the drainage tube one day after total knee arthroplasty as a component of enhanced recovery after surgery: a randomized control trial
Authors: Pei Lijia , Li Xiaoyang , Liu Yang , Wang Xuyi , Ding Hai , Wang Zhiyan , zhou xinshe
Published: February 2020

Background: Intraoperative injections of ropivacaine and tranexamic acid have an increasing role as part of analgesia and haemostasis for enhanced recovery after Total Knee Arthroplasty. However, drug efficiency gradually disappears one day after surgery. Drainage tube placed for too long can cause various complications. This study evaluates whether the postoperative injections of ropivacaine, and tranexamic acid and removal of the drainage tube one day would promote recovery after TKA. Methods: A total of 80 participants were randomly assigned to two groups. One group was treated with additional intra-articular injections at 08:30 on postoperative day 1 and the removal of drainage tube simultaneously (Trial Group). Another group was dealt with no injection and removal of the drainage tube responding to the amount of drainage fluid (Control Group). The multi-drug solution included 100 mg ropivacaine, and 1 g tranexamic acid, and 10 mL saline. The primary outcomes assessed included visual analog scale score, length of hospital stay after surgery, the circumference of the knee, total blood loss volume. Results: The group that received an additional intra-articular injection of ropivacaine had a significantly lower area under the curve for visual analog scale score than the no injection group at rest (424 ± 32 compared with 515 ± 39, p = 0.003). The Trial Group can reduce the length of hospital stay after surgery over the Control Group (7.1 ± 3.1 days compared with 8.7 ± 3.2 days, p = 0.003). The group that received an additional intra-articular injection of tranexamic acid have no difference in total blood loss volume & the circumference of knee joint over the no additional intra-articular injection group (910.6 ± 385.3 mL compared with 974.8 ± 408.2 mL, p=0.47 & 38.9 ±5.4cm compared with 38.8±2.4cm，p=0.91). Conclusions: Intra-articular injection of ropivacaine, and tranexamic acid and removal of the drainage tube one day after TKA can further promote recovery after TKA. Keywords: enhanced recovery after surgery, total knee arthroplasty, tranexamic acid, ropivacaine
High-viscosity bone cement for vertebral compression fractures: a prospective study on intravertebral diffusion of bone cement
Authors: wang meiyong , jin qunhua
Published: February 2020

Objective Bone cement leakage causes severe complication following percutaneous vertebroplasty. This study probed the diffusion and leakage status of bone cement injected within diverged time duration, so as to find the optimal injection time for bone cement. Methods A total of 70 patients with osteoporotic vertebral compression fractures with a symptom of low back pain, who underwent treatment at hospital were enrolled in this study. Patients were randomized into three groups: <180 s, 180-300, and >300 s of injection time duration from the beginning to the completion of the injection. The scenarios of vertebral bone cement leakage and diffusion were inspected using postoperative CT. Results The diffusion coefficient was higher in group A than in group B whereas it was higher in group B than in group C, but without statistical significance among the three groups. The leakage rate was without statistical significance among the three groups. The injection time of bone cement was negatively correlated with the diffusion coefficient, at the correlation coefficient of -0.253. Conclusions The diffusion coefficient of high-viscosity bone cement is likely negatively correlated with the injection time, and the leakage rate of high-viscosity bone cement probably does not reduce with the prolongation of injection time.
IL-37 Gene Modification Enhances the Protective Effects of Mesenchymal Stromal Cells on Intestinal Ischemia Reperfusion Injury
Authors: Kong Dejun , Hu Yonghao , Li Xiang , Yu Dingding , Li Hongyue , Zhao Yiming , Qin Yafei , Jin Wang , Zhang Baoren , Wang Bo , Wang Hongda , Li Guangming , Wang Hao
Published: February 2020

Background: Ischemia reperfusion injury (IRI) is the major cause of intestinal damage in clinic. Although either mesenchymal stromal cells (MSCs) or interleukin 37 (IL-37) showed some beneficial roles to ameliorate IRI, their effects are limited. In this study, the protective effects of IL-37 gene-modified MSCs (IL-37-MSCs) for better prevention of intestinal IRI are investigated.Methods: Intestinal IRI model was established by occluding the superior mesenteric artery for 30min and then reperfusing for 72 hours in rats. Forty adult male SD rats were randomly divided into sham control, IL-37-MSC-treated, MSC-treated, recombinant IL-37 (rIL-37)-treated and untreated groups. Intestinal damage was assessed by H&E staining. The levels of gut barrier function factors (diamine oxidase and D-Lactate) and inflammation reactivity cytokine IL-1β were assayed by ELISA. The expressions of tissue damage-related NLRP3 inflammasome and relative proteins including clevead caspase-1, IL-1β and IL-18 were detected by western blot. As downstream of IL-1β and IL-18, the mRNA levels of proinflammatory mediators IL-6 and TNF-α were determined by qPCR. Data were analyzed by one-way analysis of variance among groups.Results: IL-37-MSCs were able to migrate to the damaged tissue and significantly inhibit intestinal IRI. As compared with MSCs or rIL-37 monotherapy group, IL-37-MSC treatment not only improved gut barrier function but also decreased local and systemic inflammation reactivity cytokine IL-1β level in IRI rats. In addition, tissue damage-related NLRP3 and relative proteins (cleaved caspase-1, IL-1β and 4 IL-18) were significantly decreased in IRI rats treated with IL-37-MSCs. Furthermore, IL-1β and IL-18 related proinflammatory mediators IL-6 and TNF-α mRNA expressions were markedly decreased following IL-37-MSC treatment.Conclusion: The results suggest that IL-37 gene modification significantly enhance the protective effects of MSCs against intestinal IRI. In addition, NLRP3-related signaling pathways could be associated with IL-37-MSC mediated protection.
Targeting 14-3-3ζ overcomes resistance to EGFR-TKI in lung adenocarcinoma via BMP2/Smad/ID-1 signaling
Authors: Cui Jinfang , Song Yang , Han Xuejiao , Hu Jing , Chen Yanbo , Chen Xuesong , Xu Xiaomin , Xing Ying , Lu Hailing , Cai Li
Published: February 2020

Background: 14-3-3ζ protein which acts as a putative oncoprotein has been found to promote proliferation, metastasis and chemoresistance of cancer cells in several cancers including lung adenocarcinoma (LUAD), however, its significance in epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) resistance remains unknown. Methods: The Cancer Genome Atlas (TCGA) database was used to determine 14-3-3ζ expression in pan-cancer and LUAD. 14-3-3ζ and ID1 expression was then examined in clinical LUAD samples by immunohistochemistry (IHC). Lentiviral transfection with 14-3-3ζ-specific shRNA was used to establish stable 14-3-3ζ knockdown gefitinib resistant PC9 (PC9/GR) and H1975 cell lines. The effect of 14-3-3ζ knockdown on reversing EGFR-TKI resistance was determined in vitro by CCK-8, wound healing, transwell assays and flow cytometry. A xenograft tumor model was established to evaluate the role of 14-3-3ζ in EGFR-TKI resistance. Microarray analysis results showed the multiple pathways regulated by 14-3-3ζ-shRNA. Results: In the present study, we firstly demonstrated that 14-3-3ζ expression was elevated and predicted unfavourable prognosis in pan-cancer including LUAD based on TCGA. In addition, high 14-3-3ζ expression was significantly associated with advanced T stage, TNM stage, present of lymph node metastasis and, importantly, poor treatment response to EGFR-TKI in LUAD patients with EGFR-activating mutations. 14-3-3ζ shRNA significantly sensitized EGFR-TKI-resistant human LUAD cells to geﬁtinib and, notably, reversed epithelial-to-mesenchymal transition (EMT). BMP signaling activation was decreased in EGFR-TKI resistant cells followed by 14-3-3ζ depletion in microarray analysis, which was further validated by Western blot analysis. Furthermore, the expression of 14-3-3ζ positively correlates with ID1 expression in human EGFR-mutant LUAD patient samples. In vivo , 14-3-3ζ shRNA and gefitinib treatment resulted in a significant reduction in the tumor burden compared to that treated with gefitinib alone. Conclusion: Our work uncovers a hitherto unappreciated role of 14-3-3ζ in EGFR-TKI resistance. This study might provide a potential therapeutic approach for treating LUAD patients harboring EGFR mutations.
The use of Lactobacillus plantarum 299v (DSM 9843) in patients with cancers receiving home enteral nutrition – study protocol for a randomized, double-blind, and placebo-controlled trial
Authors: Karolina Kaźmierczak-Siedlecka , Folwarski Marcin , Skonieczna-Żydecka Karolina , Ruszkowski Jakub , Makarewicz Wojciech
Published: February 2020

Background Nutritional treatment is one of the most important components of multidisciplinary anti-cancer therapy. Home enteral nutrition is considered a safe procedure, however, may be associated with the risk of side effects, such as nausea, vomiting, abdominal pain, and diarrhoea. It is uncertain whether diarrhoea is the result of the enteral formula or gut dysbiosis. One of the methods which may be used to alter the composition of gut microbiota is the administration of a probiotic strain. Lactobacillus plantarum 299v may be used as a supportive therapy in patients suffering from irritable bowel syndrome and Clostridium difficile infection. Therefore, the primary aim of this study is to determine the effect of Lactobacillus plantarum 299v on nutritional status of cancer patients receiving home enteral nutrition. The secondary aims are to evaluate the role of this probiotic strain in the improvement of tolerance of enteral formula and patients’ quality of life. Methods Forty patients with cancer receiving home enteral nutrition will be enrolled in this clinical trial and randomized to receive one capsule of Lactobacillus plantarum 299v (Sanprobi IBS®) twice a day or placebo for 12 weeks in a double-blind manner. Laboratory tests (the level of albumin, total protein, transferrin, and total lymphocyte count), anthropometric parameters (body mass, the content of fat mass, muscle mass, and total body water), Nutritional Risk Screening (NRS 2002), tolerance of enteral nutrition as well as quality of life will be measured. Measurements will be obtained at the baseline and after 4 and 12 weeks of treatment. Discussion It is expected that the Lactobacillus plantarum 299v will provide beneficial effects, such as maintenance or improvement of nutritional status, enteral formula tolerance, and quality of life of cancer patients receiving home enteral nutrition. Trial registration ClinicalTrials.gov Identifier: NCT03940768
Quantitative assessment of German Holstein dairy cattle colostrum and impact of thermal treatment on quality of colostrum viscosity and immunoglobulins
Authors: Hassan Abdulwahed Ahmed , Ganz Sebastian , Schneider Florian , Wehrend Axel , Khan Izhar U.H. , Failing Klaus , Bülte Michael , Abdulmawjood Amir
Published: February 2020

Objective: This study aimed to determine the color, fat, viscosity, IgG concentration, %Brix and refractive index of fresh postpartum colostrum of German Holstein dairy cattle and assess the impact of different thermal treatments on the visual and dynamic viscosity, in association to IgG concentration, of colostrum that can be used for pasteurization process.Results: Of the total 40 fresh postpartum colostrum, the color of colostrum (white-pale yellow to yellow and dark-yellowish), fat (1.4 - 8.2 100 g-1), IgG (4 - 116 mg mL-1), %Brix (8.5 - 35.4%), refractive index (1.3454 - 1.3905 nD), visual (ranging from watery to liquid and thick) and dynamic (4.9 - 219 cp) viscosity, were recorded. Statistical analysis between visual and dynamic viscosity of fresh colostrum showed significant correlation coefficients (rs = 634). Moreover, a significant correlation between viscosity and three IgG concentrations was observed. Heat-treated colostrum showed dynamic viscosity ranged from 25 to 3066 cP, where dynamic viscosity of colostrum before- and after heat-treatment showed no significant correlation. Treated colostrum containing IgG concentration ≤80 mg mL-1 at 60°C/60 min and ≤68 mg mL-1 at 63.5°C/30 min showed no significant change in the viscosity and can successfully be applied for pasteurization of first postpartum colostrum.
Lessons learned through piloting a community-based SMS referral system for common mental health disorders used by female community health volunteers in rural Nepal
Authors: Bhardwaj Anvita , Subba Prasansa , Rai Sauharda , Bhat Chaya , Ghimire Renasha , Jordans Mark , Green Eric , Vasudevan Lavanya , Kohrt Brandon
Published: February 2020

Objectives: The Community Informant Detection Tool (CIDT) is a paper-based proactive case detection strategy with evidence for improving help-seeking behavior by patients for mental health disorders. Key implementation barriers for the paper-based CIDT include delayed reporting of cases and lack of active follow up. We used mobile phones and structured short message system to improve timeliness of case reporting, follow up and case record keeping. Thirty-six lay health workers piloted this mobile CIDT (mCIDT) for three months in 2017 in rural Nepal.Results: Eight cases were identified by lay health workers using mCIDT, but only two of these cases engaged with health services post-referral. Accuracy with the mCIDT was considerably lower compared to the paper-based CIDT. Higher education levels of lay health workers was associated with greater mCIDT accuracy. Qualitative findings revealed new implementation challenges among cases not following through on referrals due to perceived lack of staff at health facilities, assumptions among lay health workers that all earthquake-related mental health needs had been met, and lack of financial incentives for use of mCIDT. Based on study findings, we present recommendations for introducing a new technology in low resource health systems.
The Mastery Of Cognitive, Affective, And Psychomotor Domains On The Students’ Decision To Be Entrepreneurs In Facing Towards Asean Economic Community-2015
Authors: Amaliana Lutfatul
Published: February 2020

The purpose of this study was to analyze the depth of student understanding in the cognitive, affective, cognitive, and psychomotor domains of Entrepreneurship subjects by using a contextual learning approach to the decision to become entrepreneurs. This research used a descriptive research method with qualitative and quantitative approaches. Descriptive analysis was conducted because this research only gave an overview of the learning conditions in the classroom during the learning process and analyzes the learning outcomes in Entrepreneurship subject by using Contextual Teaching and Learning. Contextual learning (CTL) can be used to increase student participation in discussions, the results of the depth of students' understanding of cognitive, affective, and psychomotor domains have a positive effect on the decision to become entrepreneurs. No previous research comprehensively investigated the domains of cognitive, affective, and psychomotor in the decisions of students to become entrepreneurs in the face of the ASEAN-2015 economic community. This is not only to reduce the rising unemployment rate, but also to face the inevitable changes in the social and economic conditions of the world.
Health System Strategies and Adolescent Sexual Health: Systematic review using Rodgers Concept Analysis Framework
Authors: Nunu Wilfred Njabulo , Makhado Lufuno , Mabunda Jabu Tsakani , Lebese Rachel Tsakani
Published: February 2020

Background: Health Systems Strategies have been key in determining Adolescent Sexual Health outcomes. This study therefore aims to review literature on relationship between Health Systems Strategies and Adolescent Sexual Health issues guided by Rodgers evolutionary concept analysis framework. The study further develops a Conceptual Framework that would guide a study that seeks to “develop strategies to facilitate safe sexual practices in adolescents through Integrated Health Systems in selected Districts in Zimbabwe”.Methods: The words Adolescents, Health Systems, Sexual Health and Strategies were used to search for published literature (in English) on Google Scholar, PUBMED, EBSCO and Science Direct. 111 Articles and 04 reports were obtained and their content screened for relevance and 32 articles 01 report were found suitable and relevant and thus were reviewed. Thematic analysis to identify attributes, antecedents and consequences of Health Systems Strategies on Adolescent Sexual Health was done. These findings were then used to inform the development of the Conceptual Framework.Results: Identified attributes were: contextual, dynamic, engaging and advocating, and inefficient Health Systems in addressing Adolescent Sexual Health. Identified antecedents of these Health System Strategies on Adolescent Sexual Health included; adolescent sexual rights, lack of understanding of what sexual health is, need for integrated Adolescent Sexual Health systems, available resources and type of society. Consequences of these Health Systems Strategies on Adolescent Sexual Health were identified to be; weak Adolescent Sexual Health programs, parallel and fragmented Health Systems, vulnerability and heightened risks for poor health outcomes and challenges in interacting with different ethnic groups and gender.Conclusions: Adolescents are very vulnerable and need to be protected at all costs. There is need to have comprehensive Health Systems Strategies that would positively influence Adolescent Sexual Health.