bluuebunny/crossref_metadata_2025 huggingface dataset:
The Association between Care Left Undone and Temporary Nursing Staff ratios in Acute Settings: A cross- sectional survey of registered nurses
Authors: Senek Michaela , ROBERTSON STEVE , RYAN TONY , RN RACHEL KING , WOOD EMILY , TOD ANGELA
Published: July 2020

Background: The shortage of health workers is a global phenomenon. To meet increasing patient demands on UK health services, providers are increasingly relying on temporary staff to fill permanent posts. This study examines the occurrence of ‘care left undone’, understaffing and temporary staffing across acute sector settings. Methods: “Secondary data analysis from an RCN administered online survey covering nurses from hospitals and trusts across all four UK countries. Staffing and ‘care left undone’ measures were derived from the responses of 8,841 registered nurses across the UK. A locally smoothed scatterplot smoothing regression analysis (Loess) was used to model the relationship between any ‘care left undone’ events and full complement, modest and severely understaffed shifts, and proportions of temporary staff. Results: Occurrence of ‘care left undone’ was highest in Emergency Departments (48.4%) and lowest in Theatre settings (21%). The odds of ‘care left undone’ increase with increasing proportion of temporary staff. This trend is the same in all understaffing categories. On shifts with a full quota of nursing staff, an increase in the proportion of temporary staff from 0 to 10 per cent increases the odds of care left undone by 6 per cent (OR= 1.06, 95 % CI, 1.04-1.09). Within the full quota staffing category, the difference becomes statistically significant (p<0.05) on shifts with a proportion of temporary nursing staff of 40 per cent or more. On shifts with a full quota of nursing staff the odds of a ‘care left undone’ event is 10 per cent more with the proportion of temporary nursing staff at 50 per cent, compared to shifts with modest understaffing of 25 per cent or less with no temporary nursing staff (OR=1.1, 95%CI, 0.96-1.25). Conclusion: The odds of a ‘care left undone’ event are similar for fully staffed shifts with a high temporary nursing staff ratio compared to severely understaffed shifts with no temporary nursing staff. Increasing the proportion of temporary nurse staff is associated with higher rates of self-reported care left undone by nursing staff. This has significant implications for nurse managers and policy makers.
The genome-wide supported CACNA1C gene polymorphisms and the risk of schizophrenia: an updated meta-analysis
Authors: Liu Yongping , Wu Xue , Xia Xi , Yao Jun , Wang Bao-jie
Published: July 2020

Background: The CACNA1C gene was defined as a risk gene for schizophrenia in a large genome-wide association study of European ancestry performed by the Psychiatric Genomics Consortium. Previous meta-analyses focused on the association between the CACNA1C gene rs1006737 and schizophrenia. The present study focused on whether there was an ancestral difference in the effect of the CACNA1C gene rs1006737 on schizophrenia. rs2007044 and rs4765905 were analyzed for their effect on the risk of schizophrenia. Methods: Pooled, subgroup, sensitivity, and publication bias analysis were conducted.Results: A total of 18 studies met the inclusion criteria, including fourteen rs1006737 studies (15,213 cases, 19,412 controls), three rs2007044 studies (6,007 cases, 6,518 controls), and two rs4765905 studies (2,435 cases, 2,639 controls). An allele model study also related rs2007044 and rs4765905 to schizophrenia. The overall meta-analysis for rs1006737, which included the allele contrast, dominant, recessive, codominance, and complete overdominance models, showed significant differences between rs1006737 and schizophrenia. However, the ancestral-based subgroup analysis for rs1006737 found that the genotypes GG and GG + GA were only protective factors for schizophrenia in Europeans. In contrast, the rs1006737 GA genotype only reduced the risk of schizophrenia in Asians. Conclusions: Rs1006737, rs2007044, and rs4765905 of the CACNA1C gene were associated with susceptibility to schizophrenia. However, the influence model for rs1006737 on schizophrenia in Asians and Europeans demonstrated both similarities and differences between the two ancestors.
A Protocol for Revealing Oral Neutrophil Heterogeneity by Single-Cell Immune Profiling in Human Saliva
Authors: Choudhury Saibyasachi N. , Novotny Mark , Aevermann Brian D , Lee Steven , Mandava Aishwarya , Qian Yu , Scheuermann Richard , Freire Marcelo
Published: July 2020

Neutrophils are the most abundant white blood cells in the human body responsible for fighting viral, bacterial and fungi infections. Out of the 100 billion neutrophils produced daily, it is estimated that 10 % of these cells end up in oral biofluids. Because saliva is a fluid accessible through non-invasive techniques, it is an optimal source of cells and molecule surveillance in health and disease. While neutrophils are abundant in saliva, scientific advancements in neutrophil biology have been hampered likely due to their short life span, inability to divide once terminally differentiated, sensitivity to physical stress, and low RNA content. Here, we devise a protocol aiming to understand neutrophil heterogeneity by improving isolation methods, single-cell RNA extraction, sequencing and bioinformatic pipelines. Advanced flow cytometry 3D analysis, and machine learning validated our gating system model, by including positive neutrophil markers and excluding other immune cells and uncovered neutrophil heterogeneity. Considering specific cell markers, unique mitochondrial content, stringent and less stringent filtering strategies, our transcriptome single cell findings unraveled novel neutrophil subpopulations. Collectively, this methodology accelerates the discovery of salivary immune landscapes, with the promise of improving the understanding of diversification mechanisms, clinical diagnostics in health and disease, and guide targeted therapies.
Factors associated with cyber-victimization among immigrants and non-immigrants in Canada: A cross-sectional nationally-representative study.
Authors: Kenny Kathleen , Merry Lisa , Douglas Brownbridge A. , Urquia ML
Published: July 2020

Objectives: There is a paucity of research on patterns of cyber-victimization in minority groups, including immigrants. This study aimed at identifying individual, interpersonal and contextual characteristics associated with cyber-victimization among immigrants and non-immigrants.Methods: We drew on nationally representative data from adolescents and adults in the Canadian General Social Survey on victimization (2014). Multivariable logistic regression was employed to identify potential factors associated with cyber-victimization in the last 12 months, stratified by immigrant status and sex. Results: Among 27,425 survey respondents, the weighted prevalence of cyber-victimization in the last 12 months was 2.1% among immigrants and 2.3% among non-immigrants. Cyber-victimization rates differed significantly by sex among immigrants (2.8% for males vs. 1.4% for females), but not among non-immigrants (2.1% for males vs. 2.4% for females). While most other factors associated with cyber-victimization were similar for immigrants and non-immigrants, we found pronounced associations of past child maltreatment (adjusted prevalence odds ratio [aPOR] 4.85, 95% confidence interval [CI] 2.76, 8.52) and residence in an unwelcoming neighbourhood (aPOR 5.08, 95% CI 2.44, 10.55) with cyber-victimization among immigrants that were diminished or absent among non-immigrants. Additionally, sex-stratified analyses among immigrants showed cyber-victimization to be strongly associated with having a mental health condition (aPOR 3.50, 95% CI 1.36, 8.97) among immigrant males only, and with perceived discrimination (aPOR 4.08, 95% CI 1.65, 10.08), as well as being under 24 years old (aPOR 3.24, 95% CI 1.09, 9.60) among immigrant females.Conclusions: Immigration status and sex were differentially associated with cyber-victimization. Findings support the salience of a social-ecological perspective and gender-stratified analyses to better elucidate complex pathways linking cyber-victimization to potential gender-based health inequities among immigrants.
Age, source of and future risk of infection in two settings of Hong Kong and Singapore by March 5, 2020
Authors: Zhu Shuying , Tao Jun , Gao Huizhi , He Daihai
Published: July 2020

Objective To compare the age, source of and future risk of infection in Hong Kong SAR China and Singapore by March 5, 2020.

Results We find significant difference in age patterns of confirmed cases in these two localities and highlight the potential importance of population age structure in confirmed cases, which should be considered in evaluation of the effectiveness of control effort in different localities.
CPEB3 inhibits epithelial-mesenchymal transition by disrupting the crosstalk between colorectal cancer cells and tumor-associated macrophages via IL-6R/STAT3 signaling
Authors: Zhong Qian , Fang Yuxin , Lai Qiuhua , Wang Shanci , He Chengcheng , Li Aimin , Liu Side , Yan Qun
Published: July 2020

Background: Crosstalk between cancer cells and tumor-associated macrophages (TAMs) mediates tumor progression in colorectal cancer (CRC). Cytoplasmic polyadenylation element binding protein 3 (CPEB3) has been shown to exhibit tumor-suppressive role in CRC.Methods: The expression of CPEB3, CD68, CD86 and CD163 was determined in CRC tissues. SW480 or HCT116 cells overexpressing CPEB3 and LoVo or RKO cells with CPEB3 knockdown were constructed. Stably transfected CRC cells were co-cultured with THP-1 macrophages to determine the malignant phenotype of CRC cells, macrophage polarization, and secretory signals. The inhibition of CPEB3 on tumor progression and M2-like TAM polarization was confirmed in nude mice.Results: Decreased CPEB3 expression in CRC was associated with fewer CD86+ TAMs and more CD163+ TAMs. CPEB3 knockdown in CRC cells increased the number of CD163+ TAMs and the expression of IL1RA, IL-6, IL-4 and IL-10 in TAM supernatants. TAMs enhanced CRC cell proliferation and invasion via IL-6, and then activated the IL-6R/STAT3 pathway in CRC cells. However, CPEB3 reduced the IL-6R protein levels by directly binding to IL-6R mRNA, leading to decreased phosphorylated-STAT3 expression in CRC cells. CCL2 was significantly increased in CPEB3 knockdown cells, while CCL2 antibody treatment rescued the effect of CPEB3 knockdown in promoting CD163+ TAM polarization. Eventually, we confirmed that CPEB3 inhibits tumor progression and M2-like TAM polarization in vivo. Conclusions: CPEB3 is involved in the crosstalk between CRC cells and TAMs by targeting IL-6R/STAT3 signaling.
Bidirect effects from cisplatin combine with rosmarinic acid (RA) or hot water extracts of Glechoma hederacea (HWG) on renal cancer cells
Authors: Chou Su-Tze , Ho Bing Ying , Tai Yu Ting , Huang Chun Jen , Chao Wen Wan
Published: July 2020

Background: Cisplatin (CDDP) is a chemotherapeutic drug which also causes adverse side effects. Glechoma hederacea is a traditional Chinese herb belonging to the Labiatae family and has many biological activities. Our previous study indicated that rosmarinic acid (RA) was the most abundant phytochemical in G. hederacea. However, the antioxidant or anti-inflammatory effects of the combined treatment of G. hederacea, RA and CDDP on human renal cell carcinoma (RCC) 786-O cells have not been clearly demonstrated. We aimed to investigate the bioefficacy of hot water extracts of G. hederacea (HWG) and RA in inhibiting RCC 786-O cell activity and its synergism with CDDP against metastatic renal cancer cell. Methods: Bioactivities of the combination treatment of HWG, RA, HWG/CDDP and RA/CDDP were assessed using the MTT assay and transwell migration, and the crude extract/compound efficacy was evaluated using wound healing migration assays, flow cytometry and western blotting. Results: Our study indicates that CDDP inhibits 786-O cell proliferation and migration and HWG and RA protect against these effects. On the other hand, HWG and RA demonstrate a low cytotoxic effect in human renal proximal tubular epithelial cell line -2 (HK-2 cells). Cell cycle analysis found that HWG/CDDP and RA/CDDP combined treatment exerted cytotoxicity by inducing G2/M arrest and apoptosis. RA in combined with CDDP significantly inhibiting the expression of p-FAK (Tyr 925) in RCC 786-O cells in vitro.Conclusion: We propose that the inhibition of RA on RCC 786-O cell invasion and migration may partly occur through the downregulation of FAK phosphorylation. The HWG/CDDP and RA/CDDP combined treatments may be effective strategies for intervention of RCC 786-O cell activity.
How we teach children with asthma to use their inhaler: A scoping review protocol
Authors: McCrossan Patrick , Mallon Orla , Shields Michael , O'Donoghue Dara
Published: July 2020

Background One reason that asthma remains poorly controlled in children is poor inhaler technique. Current guidelines recommend checking inhaler technique at each clinical visit. However, they do not specify how best to train children to mastery of correct inhaler technique. Currently many children are simply shown how to use inhalers (brief intervention) which results in less than 50% with correct inhaler technique. The aim of this scoping review is to explore published literature on teaching methods used to train children to master correct inhaler technique.Methods This scoping review will follow the Arksey and O'Malley framework and the Joanna Briggs Institute guidelines. We will search (from inception onwards): MEDLINE, Embase, Scopus, Web of Science, CINAHL and the Cochrane library. We will include quantitative studies, (e.g. randomised controlled trials, cohort studies and case-control studies), published from the year 1956 to present, on teaching the skill of inhaler technique to children with asthma. Two reviewers will complete all screening and data abstraction independently. Data will be extracted onto a data charting table to create a descriptive summary of the results. Data will then be synthesised with descriptive statistics and visual mapping.Discussion This scoping review will provide a broad overview of currently used educational methods to improve inhaler technique in children with asthma. The analysis will allow us to refine future research in this area by focusing on the most effective methods and optimising them.
Development and application of perfect SSR markers in cotton
Authors: wu yuzhen , Huang Longyu , Zhou Dayun , Fu Xiaoqiong , Li Chao , Wei Shoujun , Peng Jun , Kuang Meng
Published: July 2020

Background: This study aimed to develop a set of perfect simple sequence repeat (SSR) markers with a single copy in the cotton genome, with the objective of constructing a DNA fingerprint database that is suitable for authenticating cotton cultivars. We optimized the polymerase chain reaction (PCR) system for multi-platform compatibility and improving detection efficiency. Based on the reference genome of upland cotton and 10× resequencing data of 48 basic cotton germplasm lines, single-copy polymorphic SSR sites were identified and developed as diploidization SSR markers. The SSR markers were detected by denaturing polyacrylamide gel electrophoresis (PAGE) for initial screening, then fluorescence capillary electrophoresis for secondary screening. The final perfect SSR markers were evaluated and verified using 210 lines from different sources among Chinese cotton regional trials. Results: Using bioinformatics techniques, 1 246 SSR markers were designed from 26 626 single-copy SSR loci. Adopting a stepwise (primary and secondary) screening strategy, a set of 60 perfect SSR markers was selected that showed high amplification efficiency and stability, easy interpretation of peak type, multiple allelic variations, high polymorphism information content (PIC) value, uniform chromosome distribution, and single-copy characteristics. A multiplex PCR system was established with ten SSR markers using capillary electrophoresis detection. Conclusions: A set of perfect SSR markers of cotton was developed and a high-throughput SSR marker detection system was established. This study lays a foundation for large-scale and standardized construction of a cotton DNA fingerprint database for authenticating cotton varieties.
Whole exome sequencing identifies a novel mutation in spermine synthase gene (SMS) associated with Snyder-Robinson Syndrome
Authors: Qazi Talal J. , Wu Qiao , Aierken Ailikemu , Lu Daru , Bukhari Ihtisham , Hussain Hafiz M. J. , Yang Jingming , Mir Asif , Qing Hong
Published: July 2020

Background: Loss of function mutations in the spermine synthase gene (SMS) have been reported to cause a rare X-linked intellectual disability known as Snyder-Robinson Syndrome (SRS). Besides intellectual disability, SRS is also characterized by reduced bone density, osteoporosis and facial dysmorphism. SRS phenotypes evolve with age from childhood to adulthood. Methods: Whole exome sequencing was performed to know the causative gene/pathogenic variant. Later we confirmed the pathogenic variant through Sanger sequencing. Furthermore, we also performed the mutational analysis through HOPE SERVER and SWISS-MODEL. Also, radiographs were also obtained for affected individual to confirm the disease features. Results: In this article, we report the first Pakistani family consisting of three patients with SRS and a novel missense pathogenic variant in the SMS gene (c.905 C>T p.(Ser302Leu)). In addition to the typical phenotypes, one patient presented with early-onset seizures. Clinical features, genetic and in-silico analysis linked the affected patients of the family with Snyder-Robinson and suggest that this novel mutation affects the spermine synthase activityConclusion: A novel missense variant in the SMS, c.905C >T p. (Ser302Leu), causing Snyder- Robinson Syndrome (SRS) is reported in three members of Pakistani Family.
Implementing oncology clinical trials in Nigeria: A model for Capacity building.
Authors: Ntekim Atara , Ibraheem Abiola , Sofoluwe Adenike , Adepoju Toyosi , Oluwasanu Mojisola , Aniagwu Toyin , Awolude Olutosin , Balogun Williams , Kotila Olayinka , Adejumo Prisca , Babalola Chinedum Peace , Arinola Ganiyu , Ojengbede Oladosu , Olopade Christopher O , Olopade Olufunmilayo I
Published: July 2020

Background: There is both higher mortality and morbidity from cancer in low and medium income countries (LMICs) compared with high income countries (HICs). Clinical trial activities and development of more effective and less toxic therapies have led to significant improvements in morbidity and mortality from cancer in HICs. Unfortunately, clinical trials remain low in LMICs due to poor infrastructure and paucity of experienced personnel to execute clinical trials. There is an urgent need to build local capacity for evidence based treatment for cancer patients in LMICs. Methods: We conducted a survey at facilities in four Teaching Hospitals in South West Nigeria using a checklist of information on various aspects of clinical trial activities. The gaps identified were addressed using resources sourced in partnership with investigators at HIC institutions. Results: Deficits in infrastructure were in areas of patient care such as availability of oncology pharmacists, standard laboratories and diagnostic facilities, clinical equipment maintenance and regular calibrations, trained personnel for clinical trial activities, investigational products handling and disposals and lack of standard operating procedures for clinical activities. There were two GCP trained personnel, two study coordinators and one research pharmacist across the four sites. Interventions were instituted to address the observed deficits in all four sites which are now well positioned to undertake clinical trials in oncology. Training on all aspects of clinical trial was also provided.Conclusions: Partnerships with institutions in HICs can successfully identify, address, and improve deficits in infrastructure for clinical trial in LMICs. The HICs should lead in providing funds, mentorship and training for LMIC institutions to improve and expand clinical trials in LMIC countries.
Targeted alpha immunotherapy of CD20-positive B-cell lymphoma model: Dosimetry estimate of 225Ac-DOTA-rituximab using 64Cu-DOTA-rituximab
Authors: Lee Chul-Hee , Lim Ilhan , Woo Sang-Keun , Kim Wook , Kim Kwang Il , Lee Kyo Chul , Song Kanghyon , Lim Sang Moo
Published: July 2020

Background: To evaluate the radiation dosimetry of 225Ac-DOTA-rituximab using Monte Carlo simulation of 64Cu-DOTA-rituximab. Methods: CD20 expression was evaluated in lymphoma cell lines (Jurkat and Raji). DOTA-rituximab was conjugated and then chelated by 64Cu. Tumor xenograft models were established in BALB/c-nu mice. Animal PET/CT imaging was obtained after tail vein injection with and without a pre-dose of 2 mg of cold rituximab. Specific binding of tumors was evaluated by an organ distribution assay and autoradiography. CD20 expression in tumor tissues was evaluated by immunohistochemistry. The residence time was calculated using 64Cu-DOTA-rituximab PET/CT acquisition data using OLINDA/EXM software. 225Ac-DOTA-rituximab tumor dosimetry was performed using Monte Carlo simulation with 64Cu-DOTA-rituximab PET/CT images.Results: CD20 protein was highly expressed in Raji cells. Specific binding of Raji cells was 90 times that of Jurkat cells (p<0.0001). Immunoreactivity was more than 75%. PET/CT imaging with 64Cu-DOTA-rituximab was specifically observed in tumors. The radioactivity of the tumor was much higher than that of other organs, and tumor uptake was related to CD20 expression. The predicted human dose for the administration of 64Cu-DOTA-rituximab was measured as the effective dose (1.07E-02 mSv/MBq). In the tumor region, equivalent doses of 225Ac-DOTA-rituximab (14 SvRBE5/MBq) were much higher (74-fold) than those of 64Cu-DOTA-rituximab (0.19 SvRBE5/MBq) (p<0.01).Conclusion: Tumor dosimetry of 225Ac-DOTA-rituximab can be estimated via the Monte Carlo simulation of 64Cu-DOTA-rituximab. 225Ac-DOTA-rituximab can be employed for lymphoma as targeted alpha therapy.
Atorvastatin Promotes Bone Formation in Aged apoE–/– Mice through the Sirt1–Runx2 Axis
Authors: Hong Wei , Wei Zhanying , Qiu Zhaohui , Li Zheng , Fu Chensheng , Ye Zhibin , Xu Xiaoya
Published: July 2020

Background Statins are the most widely used drugs in elderly patients, the most common clinical application of statins is in aged hyperlipemia patients. There are few studies on the effects and mechanisms of statins on bone in elderly mice with hyperlipemia. The study is to examine the effects of atorvastatin on bone phenotypes and metabolism in aged apolipoprotein E-deficient (apoE –/– ) mice, and the possible mechanisms involved in these changes. Methods Twenty-four 60-week-old apoE –/– mice were randomly allocated to two groups. Twelve mice were orally gavaged with atorvastatin (10 mg/kg body weight/day) for 12 weeks; the others served as the control group. Bone mass and skeletal microarchitecture were determined using micro-CT. Bone metabolism was assessed by serum analyses, qRT-PCR, and Western blot. Bone marrow-derived mesenchymal stem cells (BMSCs) from apoE –/– mice were differentiated into osteoblasts and treated with atorvastatin and Sirt1 inhibitor EX-527. Results The results showed that long-term administration of atorvastatin increases bone mass and improves bone microarchitecture in trabecular bone but not in cortical bone. Furthermore, the serum bone formation marker osteocalcin (OCN) was ameliorated by atorvastatin, whereas the bone resorption marker tartrate-resistant acid phosphatase 5b (Trap5b) did not appear to be impacted by atorvastatin treatment. The mRNA expression of Sirt1, runt-related transcription factor 2 (Runx2), alkaline phosphatase (ALP) and OCN in bone tissue were increased after atorvastatin administration. Western blot showed same trend in Sirt1 and Runx2. The in vitro study showed that when BMSCs from apoE –/– mice were pretreated with EX527, the higher expression of Runx2, ALP and OCN activated by atorvastatin decreased significantly or showed no difference compared with the control. The protein expression of Runx2 showed same trend. Conclusions Accordingly, the current study validates the hypothesis that atorvastatin can increase bone mass and promote osteogenesis in aged apoE −/− mice by regulating the Sirt1–Runx2 axis.
High expression of Fibroblast activation protein (FAP) predicts poor outcome in high-grade serous ovarian cancer
Authors: Li Min , Cheng Xue , Rong Rong , Tang Xiuwu , Chen Youguo
Published: July 2020

Background: High-grade serous ovarian cancer (HSOC) is a fatal form of ovarian cancer. Previous studies indicated some potential biomarkers for clinical evaluation of HSOC prognosis. However, there is a lack of systematic analysis of different expression genes (DEGs) to screen and detect significant biomarkers of HSOC. Method and materials: TCGA database was conducted to analyze relevant genes expression in HSOC. Outcomes of candidate genes expression, including overall survival (OS) and progression-free survival (PFS), were calculated by Cox regression analysis for hazard rates (HR). Histopathological investigation of the identified genes was carried out in 151 Chinese HSOC patients to validate gene expression in different stages of HSOC. Results: Of all 57,331 genes that were analyzed, FAP was identified as the only novel gene that significantly contributed to both OS and PFS of HSOC. In addition, FAP had a consistent expression profile between carcinoma-paracarcinoma and early-advanced stages of HSOC. Immunological tests in paraffin section also confirmed that up-regulation of FAP was present in advanced stage HSOC patients. Prediction of FAP network association suggested that FN1 could be a potential downstream gene which further influenced HSOC survival. Conclusions: High-level expression of FAP was associated with poor prognosis of HSOC via FN1 pathway.
Association of organizational and patient behaviors with nurse well-being in China: a cross-sectional study
Authors: Wang Xiaoyu , Ye Beizhu , Gao Xiao , Liang Yuan
Published: July 2020

Background: Nurse play a primary care role, although existing research about improving nurse well-being mainly focus on the workplace environment, there is controversy regarding the underlying factors. The purpose of this study was to investigate the relationship between organizational and patient behaviors with nurse well-being.Methods: A cross-sectional quantitative study was carried out in 77 hospitals in China between July 2014 and April 2015.Results: Of the 4885 respondents, 58.78% nurses reported being satisfied with their life; however, only 36.14% nurses were satisfied with their work, and 79.85% nurses reported they would not choose nursing again if given the opportunity. Within the organizational behaviors, nurses reporting very poor pay justice tended to report a higher turnover intention (OR = 2.03, 95% CI:1.29-3.21) and lower life happiness (OR = 0.67, 95% CI:0.45-0.98). Similarly, very poor attention to staff interests (OR = 1.79, 95% CI:1.15–2.77) and opinions (OR = 2.41, 95% CI: 1.55–3.73) were strongly associated with higher turnover intention. Within the patient behaviors, a low level of patient trust was more strongly and negatively associated with job satisfaction (OR = 0.44, 95% CI: 0.32–0.61) and life happiness (OR = 0.53, 95% CI: 0.37–0.75) compared with unreasonable demands by patients, and more positively associated with turnover intention (OR = 5.61, 95% CI: 3.66–8.60).Conclusion: Given the widespread distress among nurses, these findings suggest that interventions targeting improved nurse well-being should be expanded from individual nurses to hospital organization and patients, reflected the internal and external hospital environment, respectively.
Decreased Cerebrovascular Reserve is the Initial Cause of White Matter Hyperintensity Related Cognitive Decline
Authors: Yang Dan , Chu Lan , Xu Hengheng , Ni Ling , Qin Ruomeng , Ma Junyi , Shao Pengfei , Huang Lili , Luo Caimei , Li Mengchun , Yao Zhelv , Sheng Xiaoning , Zhang Bing , Zhang Meijuan , Xu Yun
Published: July 2020

Background: Increasing evidences have demonstrated the progressions of white matter hyperintensity (WMH) are associated with cerebrovascular reserve(CVR) and cognitive decline.The present study hypothesized that impaired CVR is associated with WMH progression and may lead to cognitive decline through WMH.Methods:A total of 244 WMH subjects were recruited and were categorized into WMH-I (n=112), WMH-II (n=76)and WMH-III(n=56) groups according to Fazekas rating scale.The individual CVR was measured using blood-oxygenation level-dependent (BOLD) signal fluctuations obtained from resting-state functional MRI(rs-fMRI). We compared maps of the CVR and clinical features among the three groups. Multiple linear regression analysis was performed to investigate the correlations of WMH volume with impaired CVR and cognitive functions indifferent domains controlling for age, sex, years of education, vascular risk factors, numbers of lacunas and cerebral microbleeds in all WMH individuals.Results: Compared with the WMH-I group, both WMH-II and WMH-III groups showed CVR decline in the left frontal and occipital areas. Multiple linear regression analysis showed WMH volumewas negatively associated with CVR impairments in left frontal/occipital areas and cognitive functions including global cognitive function (GCF), executive function (EF), information processing speed (IPS), memory and visuospatial processing function (VPF)(all P<0.05). Additionally, mediation analysis revealed CVR impairments in left frontal and occipital areas didn’t directly lead to cognitive decline, but indirectly caused cognitive decline in multiple domains through increasing WMH burdens (all 95% confidence intervals didn’t contain zero). Conclusion:The CVR decline initially resulted in WMH progression, which is responsible for the following development of cognitive decline. This study shed lights on exploring the pathogenesis of WMH progression and underlying mechanisms of WMH-related cognitive decline.
Effectiveness of Intravitreal Chemotherapy-Assisted Endoresection in Monocular Patients with Group D Retinoblastoma
Authors: Yu Xiling , Li Xueke , Xing Yue , Lu Siduo , Tanumiharjo Silvia , Ma Jin
Published: July 2020

Background: To determine the efficacy and complications of intravitreal chemotherapy-assisted endoresection for refractory group D retinoblastoma in monocular patients.Methods: In this retrospective case series, intravitreal chemotherapy-assisted endoresection by pars plana vitrectomy was performed in 11 eyes with refractory ICRB group D retinoblastoma unresponsive to standard therapies in monocular patients.Results: Across a mean follow-up period of 42.7 months, globe salvage was attained in all 11 eyes (100%). There was no case of extra-ocular tumor seeding or remote metastasis. In 9 eyes (81.8%), tumor control was achieved with one-time pars plana vitrectomy, whereas in 2 cases (18.2%), repeated treatment such as laser, intravitreal chemotherapy or second pars plana vitrectomy were needed. Retinal reattachment was achieved in all 4 eyes (100%) with previous retinal detachment. 4 eyes (36.4%) required subsequent cataract surgery due to secondary cataract. 10 eyes (90.9%) had improvement in best-corrected visual acuity at the last follow-up.Conclusion: Intravitreal chemotherapy-assisted endoresection appears to be a safe and effective globe-salvaging method for refractory group D retinoblastoma. It is a promising alternative to enucleation and a supplementary therapeutic strategy for those unresponsive to standard therapies, especially for the monocular retinoblastoma patients.
Neurexin and Neuroligins Jointly Regulate Synaptic Degeneration at the Drosophila Neuromuscular Junction based on TEM Studies
Authors: Gan Guangming , Chenchen Zhang , Xiang Gao , Keze Lu , Wei Xie , Junhua Geng
Published: July 2020

Background: The Drosophila larval neuromuscular junction (NMJ) is a well-known model system and is often used to study synapse development and signal transmission in neurology. Here, we show the synaptic degeneration at NMJ boutons, primarily based on transmission electron microscopy (TEM) studies.Methods: To this aim, we extensively acquire the ultrastructure of diffuse NMJ boutons using continuous sectioning and transmission electron microscope in the wide type and the dneurexin (dnrx) and dneuroligins (dngs) mutant.Results: When degeneration starts, the subsynaptic reticulum (SSR) swells, retracts and folds inward, and then, the residual SSR degenerates into a disordered, thin or linear membrane with a shrinking postsynaptic area (PSA) and axon terminal. The axon terminal begins to degenerate from the central region, and the T-bar structure detaches from the presynaptic membrane with clustered synaptic vesicles to accelerate large-scale degeneration, accompanied by retraction of synaptic vesicles and mitochondria. There are two degeneration modes for clear synaptic vesicles. In the first mode, synaptic vesicles without actin filaments degenerate on the membrane with ultrafine spots and collapse and disperse to form an irregular profile with dark ultrafine particles. In the second mode, clear synaptic vesicles with actin filaments degenerate into dense synaptic vesicles, form irregular dark clumps without a membrane, and collapse and disperse to form an irregular profile with dark ultrafine particles. Last, all residual membranes in NMJ boutons, including presynaptic and postsynaptic membranes, become very thin, most of the SSR degenerates into a linear shape, and all the residual elements in axon terminals, such as synaptic vesicles, mitochondria, the cytoskeleton, and the T-bar, degenerate in situ and eventually form a cluster of dark ultrafine particles. Axon terminals and elements within axon terminals degenerate with the postsynaptic SSR, and swelling and retraction of the SSR occurs prior to axon terminal degradation, which degenerates faster and with more intensity than the SSR. NMJ bouton degeneration occurs under normal physiological conditions, but degeneration in dnrx and dnlgs mutant is accelerated. Furthermore, there is a synergistic effect in dnrx;dnlgs double mutants and dnlg2;dnlg3 double mutants that promotes degeneration of NMJ boutons.Conclusions: NMJ bouton degeneration occurs under normal physiological conditions but is accelerated in dnrx and dnlgs mutants. Furthermore, there is a synergistic effect in dnrx;dnlgs double mutants and dnlg2;dnlg3 double mutants that promotes degeneration of NMJ boutons, which suggests that both neurexin and neuroligins play a vital role in preventing synaptic degeneration. This study proposes the model of NMJ bouton degeneration patterns, which is very conducive to in-depth study of neurodegeneration.
Influence of Cyst Size on Ovarian Reserve After Unilateral Laparoscopic Ovarian Cystectomy for Endometrioma and Ovarian Mature Teratoma.
Authors: Chae Heesuk
Published: July 2020

Background:The present study is aimed to investigate the influence of ovarian cyst size on serum anti-Müllerian hormone levels after laparoscopic ovarian cystectomy in women with endometrioma and ovarian mature teratomaMethods: From March 2017 to December 2018, we retrospectively studied eighty-one patients who underwent unilateral laparoscopic cystectomy for endometrioma (n = 41, endometrioma group) and ovarian mature cystic teratoma (n = 40, teratoma group). Serum anti-Müllerian hormone (AMH) levels were measured preoperatively and 1 month after surgery.Results: The rate of decrease in serum AMH levels after laparoscopic cystectomy was significantly higher in the endometrioma group than in the teratoma group (0.35 ± 0.04% vs. 0.19 ± 0.04%, p = 0.013). In patients with mature cystic teratoma, a statistically significant correlation between the rate of decrease in serum AMH levels and cyst size was observed (r = 0.391, p = 0.013); the rate of decrease in serum AMH levels after surgery was significantly higher in the > 5.13 cm subgroup than in the ≤ 5.13 cm subgroup (p = 0.006). Conclusions: Laparoscopic cystectomy for endometriomas may result in a more significant damage to the ovarian reserve compared with that for ovarian mature cystic teratomas. Cyst diameter and reduced ovarian reserve after surgery were not correlated in patients with endometriomas, whereas a significant correlation was observed in patients with ovarian mature teratomas. The decrease in AMH levels was more evident in patients with a mature teratoma > 5.13 cm.
Genetic Variation Analysis and Treatment Strategy of 20 Patients with Dystrophin Gene Mutations
Authors: Liu Yedan , Chen Jun , Hou Mei , Zhang Yanhui , Guo Ya , Liu Peipei , Li Fei , Yang Chengqing , Song Jie , Wei Wei , Chen Zongbo
Published: July 2020

Introduction.Dystrophin (DMD) gene mutations can affect muscular dystrophin isoform expression and result in progressive muscular dystrophy including Duchenne and Becker muscular dystrophies (DMD and BMD). To establish the correlation between phenotype and genotype and exemplify the current and future treatment for muscular dystrophy disorders, we investigated 20 patients suffering from a dystrophinopathy and summarized clinical manifestation and gene mutations of them.Methods.The clinical manifestations, physical examination, laboratory work, and gene mutation results were collected in 20 patients with DMD or BMD diagnosed by clinical phenotype and genetic sequencing from July 2015 to December 2019. Multiplex ligation probe amplification (MLPA) and next-generation sequencing (NGS) were used to detect mutations in the DMD gene, and detected mutations were confirmed by Sanger sequencing.Results.The clinical manifestation of patients was characterized by progressive symmetrical muscle degeneration, limb weakness, and pseudohypertrophy along with the elevated concentration of creatine kinase, alanine aminotransferase, and aspartate aminotransferase. We found 11 dystrophin gene deletions (55%) and 4 duplication mutations (20%) among the affected patients. However, we also found point mutations including 1 nonsense (20%), 3 frameshifts (60%), and 1 splice sites (20%) mutations in the rest 5 patients. Among the 15 cases of exon deletion or duplication mutations, 7 were inherited from the mother, 3 were de-novo, while the other 5 were not tested. Besides, all 5 point-mutation cases were inherited from the mother, among which 4 point mutations were identified for the first time and linked to the disease phenotype.Conclusions.We provided clinical portraits, genetic results, and the molecular effects of mutations in patients. Four novel point mutations were identified for the first time and associated with the development of DMD and BMD. Further, we expanded knowledge of the DMD variant spectrum and exemplified the emerging therapies in muscular dystrophy.
Depression among infertile women in Gaza strip: Prevalence and correlates
Authors: Elsous Aymen , El-Kass Sae'd Abu , Salama Akram , Radwan Mahmoud , Eid Soha Abo , Baloushah Suha
Published: July 2020

Background

Psychological disorders are expected for women suffering from infertility. Depression is a predictable consequence and requires more investigations and considerations. This study aimed to determine prevalence and severity of depression and its predictors among infertile women in Gaza strip, Palestine using a cross-sectional design.
Methods

A cross sectional study was carried out among three hundred eighty five infertile males from Jan 2019 to Dec 2019. Participants were selected from three main In-vitro fertilization centers (IVFs) following simple random sampling. The Arabic version of Beck depression inventory was used. Logistic regression was performed to determine independent factors associated with depression. The value 0.05 or less was considered statistically significant
Results

The mean age of participated women was 29 ± 6.58 years, and mean duration of marriage and infertility were 7.76 ± 5.31 and 5.43 ± 3.50 years, respectively. Half of women had some form of depression (22.3%, 8.6% and 10.6% showed to have mild depression, moderate and severe depression, respectively). Predictors of depression were: duration of marriage (Wald test: 10.493; CI95%: 0.248–0.774), at least one abortion (Wald test: 21.233, CI95%: 1.863–4.528), primary infertility (Wald test: 6.666, CI95%: 1.148–2.742) and husband cause of infertility (Wald test: 10.878, CI95%: 0.800–0.982).
Conclusion

Infertility has an effect on the psychological aspect of women' life. Psychological intervention including counselling, support and therapy would be necessary to limit consequences of infertility. Such interventions could be implemented in infertility treatment clinics.
Socio-demographic associations of HIV among antenatal care attendees in selected rural primary care facilities in South Africa's Eastern Cape province
Authors: Mabunda Sikhumbuzo A , Sigovana Khuthala , Chitha Wezile , Apalata Teke , Nomatshila Sibusiso
Published: July 2020

Background
To effectively reduce vertical HIV transmission requires a reduction of HIV prevalence and incidence among pregnant women and a full understanding of its epidemiology. There is, however, literature paucity of HIV studies focusing on women attending antenatal care in rural areas in South Africa.
Methods
A Cross-sectional study of women attending antenatal care in four Primary Care facilities was conducted using an interviewer-administered questionnaire which collected information on socio-demographic characteristics and medical history. Binomial logistic regression analyses were used to determine factors associated with HIV and to estimate the prevalence ratio (PR). The 95% confidence interval (95%CI) is used for precision of estimates; p ≤ 0.05 for statistical significance.
Results
A total of 343 participants were recruited. The antenatal HIV prevalence was 38.2% (95%CI: 33.2–43.9). Participants older than 40 years were 4.6 times significantly more likely to be HIV positive compared to teenagers (p-value = 0.019). Furthermore, multiparous, unemployed and employed participants, were significantly associated with 40%, 60% and 70% higher antenatal HIV prevalences respectively when compared to primigravidas or tertiary students (p-value < 0.0001).
Conclusion
Despite a 100% antenatal HIV testing rate, the antenatal HIV prevalence remains high and is increasing in this population, coupled with no spousal attendance in antenatal care and poor condom compliance. It is therefore important to remain vigilant and monitor mother-to-child transmission that could be associated with this increased prevalence.
Biosynthesis of Copper Oxide Nanoparticles by Marine Streptomyces MHM38 and their Preventive Efficacy Against Paracetamol-Inducing Hepatic Damage of Albino Rats
Authors: Hamed Moaz , Gazwi Hanaa S.S. , Youssif Asmaa M.
Published: July 2020

Biosynthesis methods, employing microorganisms, have emerged as an eco-friendly, clean and viable alternative to chemical and physical methods. The present study reports the biosynthesis of copper oxide nanoparticles (CuONPs) using cell-free culture supernatant of marine Streptomyces sp. MHM38. For the optimized production of copper oxide nanoparticles, the influence of some parameters such as concentration of copper sulphate, reaction time, filtrate to substrate ratio and pH were studied. 5mM CuSO4 was optimal for NP production. Well-defined CuONP formation occurred after 60 min incubation when equal volume of filtrate (cell-free supernatant) to substrate (CuSO4 solution) was added. NPs remained stable in aqueous solution with increasing time at pH 8. CuONPs were characterized by UV-vis spectroscopy, X-ray diffraction (XRD) and finally the nature of the nanoparticles was identified by elemental analysis (EDX). Uv-vis spectroscopy of CuONPs exhibited peak at 550 nm which corresponds to the Surface Plasmon Resonance of CuONPs. Most of the particles are spherical in shape and size ranges from 1.06 – 6.5 nm analyzed using Transmission Electron Microscope (TEM). Antimicrobial activity of CuONPs was performed by well diffusion method against Enterococcus faecalis ATCC 29212, Salmonella typhimurium ATCC 14028, Pseudomonas aeruginosa ATCC 9027, Escherichia coli ATCC 8939), fungi (Rhizoctonia solani, Fusarium solani, Aspergillus niger) and yeast (Candida albicans ATCC 10237) .The highest antimicrobial activities recorded were against Candida albicans ATCC 10237, were as Salmonella typhimurium ATCC 14028 and Escherichia coli ATCC 8939 showed the lesser activity. The preventive efficacy of CuONPs was evaluated against the oxidative stress induced by paracetamol (PAC) in albino rats. The biochemical findings of CuONPs groups appeared a significant (p˂0.05) diminish in the levels of ALT, AST, ALP, LDH, total and direct bilirubin, Urea, and Creatinine as compared to paracetamol group. Non-enzymatic and enzymatic antioxidants of CuONPs groups were significantly elevated (p˂0.05) in SOD and GSH levels and significantly low NO and MAD levels compared to the paracetamol group. Also, the histopathological examination of the CuONPs groups assured that the impact of improving CuONPs against paracetamol-induced liver damage.
Blood Bioenergetic Biomarkers in Alzheimer’s Disease APOE ε4-Carriers
Authors: Wilkins Heather , Manley Sharon J. , Wang Xiaowan , Menta Blaise W. , Koppel Scott , Bothwell Rebecca , Becker Annette M. , Anderson Heidi , Schwartz Erin , Burns Jeffrey M. , Swerdlow Russell H.
Published: July 2020

Background:This study examined the impact of APOE ε4 on blood cell bioenergetics. Prior studies have shown systemic alterations in blood cells from APOE ε4 carriers.Methods:Platelet mitochondria cytochrome oxidase (COX) and citrate synthase (CS) Vmax activities were measured in APOE ε4 carrier and non-carrier Alzheimer’s disease (AD) subjects, and lymphocyte mitochondria and bioenergetics-relevant protein and viability endpoints were measured using fresh and expanded cultures. Statistical analysis was completed using Student’s T-Test.Results:The mean platelet COX Vmax activity, normalized to protein content, was lower in APOE ε4 carriers and lymphocyte Annexin V, a marker of apoptosis, was significantly higher. PINK1, a protein involved in mitophagy, was higher in APOE ε4 carrier lymphocytes. mTOR and SIRT1, which play a role in energy sensing, were different between the groups; mTOR phosphorylation decreased while SIRT1 phosphorylation increased in APOE ε4 carrier lymphocytes. The lipid synthesis pathway differed, as AceCSI and ATP CL increased in APOE ε4 carrier lymphocytes, and ACC phosphorylation also increased.Conclusions:These findings overall support a relationship between APOE genotype and bioenergetic pathways and indicate that relative to AD non-APOE ε4 carriers, platelets and lymphocytes from AD APOE ε4 carriers exist in a relative state of bioenergetic stress. As APOE ε4 influences AD risk these data may help define a systemic AD biomarker phenotype.