bluuebunny/crossref_metadata_2025 huggingface dataset:
Usefulness of the Intrarenal Resistivity Index As A Cardiovascular Risk Marker in Afro-Descendants: An Observational, Cross-Sectional Study
Authors: Souza Francival , Lages Joyce , Magalhaes Eliane , Brito Dyego , Mendes Vinicius , Filho Natalino
Published: December 2020

Background: Cardiovascular diseases are a major cause of morbidity and mortality in Brazil and worldwide. Stratification of the risk of these diseases in asymptomatic patients using biomarkers can lead to early detection of patients at high risk of cardiovascular disease and promote the prevention of relevant events. The intrarenal resistivity index (IRI) is an imaging test that assesses renal perfusion, systemic hemodynamics, and atherosclerosis. It has been reported that changes in IRI are associated with morbidity and mortality in a population of patients with hypertension, diabetes, and chronic kidney disease. The present study tested a hypothesis that IRI is associated with imaging biomarkers of cardiovascular risk in a population of Afro-descendants. Methods: A total of 313 Afro-descendants with high cardiovascular risk were assessed using kidney ultrasound, Doppler echocardiography, carotid Doppler, and computed tomography to assess the calcium score. The individuals were divided into Group 1 with normal IRI and Group 2 with high IRI. Results: The mean intrarenal resistivity index was 0.61 in group 1 and 0.71 in group 2, and the mean age was 56.9 years, with 53% being female. Group 2 had significantly greater left ventricular mass, larger left atrium, and a higher prevalence of diastolic dysfunction (34.5% vs. 66.7%, p<0.0001). Group 2 also had a significantly higher frequency of carotid plaque (31% vs. 64%, p<0.001) as well as total coronary artery calcium score and higher frequency of high coronary artery calcium score (56.37 vs. 212.03, p<0.0001 and 24% vs. 50%, p<0.001, respectively). The presence of diastolic dysfunction with high left atrial pressure, coronary artery calcium score >0, and carotid plaque was independently associated with the intrarenal resistivity index. Conclusions: The intrarenal resistivity index is associated with imaging biomarkers of cardiovascular risk, mainly with the coronary artery calcium score, diastolic dysfunction, and atherosclerotic carotid plaque in people of African descent, with high cardiovascular risk.
Evaluating ecological risks and tracking potential factors influencing heavy metals in sediments in an urban river
Authors: Liu Dongping , Yu Huibin , Gao Hongjie , Xu Weining
Published: December 2020

Background
Heavy metal pollution of aquatic systems is a global issue that has received considerable attention. Canonical correlation analysis (CCA), principal component analysis (PCA), and potential ecological risk index (PERI) have been applied to heavy metal data to trace potential factors, identify regional differences, and evaluate ecological risks. Sediment cores of 200 cm in length were taken using a drilling platform at 10 sampling sites along the Xihe River, an urban river located in western Shenyang City, China, divided into 10 layers (20 cm each). The concentrations of the As, Cd, Cr, Cu, Hg, Ni, Pb and Zn were measured for each layer. Eight heavy metals, namely Pb, Zn, Ag, Cd, Cr, Cu, Ni, and Hg, were measured for each layer in this study.
Results
The average concentrations of the As, Cd, Cu, Hg, and Zn were significantly higher than their background values in soils in the region, and mainly gathered at 0–120 cm in depth in the upstream, 0–60 cm in the midstream, and 0–20 cm downstream. This indicated that these heavy metals were derived from the upstream areas where a large quantity of effluents from the wastewater treatment plants enter the river. Ni, Pb, and Cr were close or slightly higher than their background values. The decreasing order of the average concentration of the Cd was upstream > midstream > downstream, so were the Cr, Cu, Ni and Zn. The trend of the average concentration of the As was different to the Cd; being highest midstream, followed by upstream and then downstream. The potential factors of heavy metal pollution were Cd, Cu, Hg, Zn, and As concentrations, especially Cd and Hg, whose ecological risks were much higher than those of Ni, Cr, and Pb. The ecological risk levels of all heavy metals were much higher upstream than midstream and downstream.
Conclusions
Industrial discharge was the dominate source for eight heavy metals in the surveyed area, and rural domestic sewage has a stronger influence on the Hg pollution than industrial pollutants. These findings indicate that effective management strategies should be developed to protect the environmental quality of urban rivers.
First report on the occurrence of a single species cyanobacterial bloom in a lake in Cyprus: Monitoring and treatment with hydrogen peroxide releasing granules
Authors: Keliri Eleni , Paraskeva Christia , Sofokleous Angelos , Sukenik Assaf , Dziga Dariusz , Chernova Ekaterina , Brient Luc , Antoniou Maria G
Published: December 2020

Background: Cyanobacteria are phytoplankton microorganisms, also known as blue-green algae, and an essential component of the food web in all aquatic ecosystems. Excess loads of nutrients into waterbodies can cause their rapid and excessive growth which leads to the formation of cyanobacterial harmful algal blooms (cyano-HABs). Toxic species of cyanobacteria genera excrete into the water a broad range of bioactive metabolites, some of which are known as cyanotoxins. These metabolites can negatively affect the ecosystem, and human and animal health in various ways, thus their presence needs to be closely monitored. This study aimed to monitor a lake at the Athalassa National Forest Park in Cyprus, in order to correlate its trophic condition with its water quality characteristics and identify the key environmental variables driving cyanobacteria blooming and their toxicity. In addition, surface water during the blooming period was collected and used in bench-scale experiments in order to test novel hydrogen peroxide releasing granules as mitigation processes for cyano-HABs.Results: The monitoring lasted throughout 2019 with ten sampling events taking place during this period. Samples were mainly analyzed for phytoplankton community, and various physicochemical parameters: pH, conductivity, salinity, total and dissolved nutrients. Obtained data indicated that cyanobacteria blooming lasted for four months (June – September), while microscopic observation of preserved samples showed that 99% of the phytoplankton biovolume was attributed to a single picocyanobacterial species, the Merismopedia sp. Select samples were analysed for the presence of toxins genes with positive results mainly for mcyB and mcyE genes. Further analysis with HPLC MS/MS, revealed that cyanotoxins’ concentration was lower than the method detection limit - MDL (<2-6 ng/L). Conclusion: The present study highlights the importance of monitoring several water characteristics to conclude on the main drivers of a bloom and its toxicity. The findings demonstrated that it is not enough to test cyanotoxin genes as indicator of their presence since, in case of mono-domination, cyanobacteria may not be active on producing the toxins. Treatment experiments of contaminated water indicated that slow realizing peroxide granules may be an alternative to hydrogen peroxide. Treatment with CaO2 granules outperformed MgO2 granules due to higher H2O2 releasing capacity.
A New Method to Detect Gastro-esophageal Reflux in Critically Ill Mechanically Ventilated Patients: A Clinical Proof of Concept Study
Authors: Bar-Lavie YARON Phillip , Steinlauf Shirly
Published: December 2020

BackgroundTracheal aspiration of gastric content among mechanically ventilated and tube-fed critically ill patients is of great concern. The mechanism leading to bacterial colonization of the lower respiratory tract in mechanically ventilated patients is tracheal aspiration of oral or gastric contents leading to Ventilator Associated Pneumonia (VAP). VAP is the most common nosocomial infection in the Intensive Care Unit (ICU). ICU-VAP generates about half of the cases of hospital-acquired pneumonia. There are various nursing practices available to reduce the rate of aspiration, but their efficacy is limited and they are not strong enough to prevent aspiration and VAP in practice. In this clinical study we used the smARTrack System, by ART MEDICAL, to assess the frequency of gastro-esophageal reflux in 20 ventilated ICU patients and its' correlation to procedures during routine patient care. MethodsThe smARTrack System is comprised of a novel gastric tube and an electronic monitoring console, which contains the system's software. The tube contains a series of bio-impedance sensors that can detect the presence of fluid around them. We conducted a study on 20 ICU ventilated patients at the Rambam Health Care Campus in Haifa, Israel. Reflux events and their duration were recorded when the tube detected gastric content rising above the sensors located at the lower esophageal sphincterResultsOur main findings shows that gastro-esophageal reflux occurs on average three times per hour of mechanical ventilation. We have also recorded three common clinical scenarios that were associated with a high risk of reflux; patient position-change, enteral fluid bolus, tracheal suction and migration of the feeding tube tip during ongoing use. ConclusionsGasto-esophageal reflux is a common event in the ICU as shown by the smARTrack System and may be related to routine patient care procedures. This study provides an important insight into the consequences of these procedures and might suggest ways to further improve them in reducing the rate of gasto-esophageal reflux and the risk of VAP among mechanicaly ventilated ICU patients.https://clinicaltrials.gov/ct2/show/NCT02705781?term=smARTrack&draw=2&rank=1 registered 11.3.2016
Systematic Analysis of the Lysine Malonylome in Sanghuangporus Sanghuang
Authors: Wang Tong , Wang Guangyuan , Zhang Guoli , Hou Ranran , Zhou Liwei , Tian Xuemei
Published: December 2020

Background: Sanghuangporus sanghuang is a well-known traditional medicinal mushroom associated with mulberry, which has enormous economic and medical value. Despite being known for many years, proteomics studies of S. sanghuang have not been reported. In this paper, a series of technologies, such as high-performance liquid chromatography (HPLC) classification technology, malonyl peptide segment enrichment technology and proteomics technology, are combined to study the qualitative analysis of malonylation in S. sanghuang.Results: Strategies for qualitative proteomics included malonyl enrichment and high-resolution liquid chromatography-tandem mass spectrometry (LC-MS/MS). In total, 714 malonyl modification sites were matched to 255 different proteins. The analysis indicated that malonyl modifications are involved in a wide range of acellular functions and displayed a distinct subcellular localization.Bioinformatics analysis indicates that malonylated proteins are engaged in different metabolic pathways, including glyoxylate and dicarboxylate metabolism, glycolysis/gluconeogenesis, and the tricarboxylic acid (TCA) cycle; consequently, a total of 26 enzymes related to triterpene and polysaccharide biosynthesis were found to be malonylated.Conclusions: These findings suggest that malonylation is associated with many metabolic pathways, particularly the metabolism of bioactive compounds. This paper provides the first comprehensive survey of malonylation in S. sanghuang.
Accelerometer informed time-energy budgets reveal the importance of temperature to the activity of a wild, arid zone canid
Authors: Tatler Jack , Currie Shannon E. , Cassey Phillip , Scharf Anne K. , Roshier David A. , Prowse Thomas A. A.
Published: December 2020

BackgroundMovement is the major contributor to active energy expenditure in most vertebrates and it is regularly characterised by body acceleration that can be captured by animal-attached accelerometers (ACC). Overall dynamic body acceleration (ODBA) is a metric derived from ACC data, which can be used as a proxy for energy expenditure over fine time scales. MethodsHere, we used ACC and GPS data collected from free-ranging dingoes in central Australia to investigate their activity-specific energetics, and activity patterns through time and space. We classified dingo activity into stationary, walking, and running behaviours, and estimated daily energy expenditure via activity-specific time-energy budgets. We tested whether dingoes behaviourally thermoregulate by modelling ODBA as a function of ambient temperature (Ta) during the day and night. We used traditional distance measurements (GPS) as well as fine-scale activity (ODBA) data to assess their daily movement patterns.ResultsWe retrieved ACC and GPS data from seven dingoes. Their mass-specific daily energy expenditure was significantly lower in summer (288 kJ kg-1 day-1) than winter (495 kJ kg-1 day-1; p = 0.03). Overall, dingoes were much less active during summer where 91% of their day was spent stationary in contrast to just 46% during winter. There was a sharp decrease in ODBA with increasing ambient temperature during the day (R2 = 0.59), whereas ODBA increased with increasing Ta at night (R2 = 0.39). Distance and ODBA were positively correlated (R = 0.65) and produced similar crepuscular patterns of activity.ConclusionOur results indicated solar radiation and ambient temperature drove the behaviour of dingoes. Seasonal differences of daily energy expenditure (DEE) in free-ranging eutherian mammals have been found in several species, though this was the first time it has been observed in a wild canid. The negative relationship between dingo activity (ODBA) and Ta during the day implies that high heat gain from solar radiation is a factor limiting diurnal dingo activity in an arid environment.
Synergistic Effect of Autophagy Inhibitor Si-beclin1 Combined With the Doxorubicin Nano-delivery System Against Advanced Prostate Cancer
Authors: Hu Chuling , Gu Fenfen , Gao Yuan , Gong Chunai , Xia Qingming , Gao Shen
Published: December 2020

Apoptosis tolerance is an important mechanism of tumor resistance in tumor therapy. Autophagy can prevent apoptosis induced by antitumor drugs and promote tumor resistance. The purpose of the presentn study was to improve the sensitivity of chemotherapeutic drugs and enhance the efficacy by inhibiting autophagy. In the present study, hydrophobic doxorubicin-hydrazone-caproyl-maleimide (DOX-EMCH) and autophagy-inhibitory si-Beclin1 were simultaneously delivered via the amphiphilic peptide micelle system(Co-MPs) using ploy(L-arginine)-poly(L-histidine)-DOX-EMCH as the copolymer building unit. It was found that the constructed micelle system promoted the escape of si-Beclin1 from endosomes and the release of DOX into the nucleus and the Co-MPs exhibited 2.7–fold higher cytotoxicity and apoptosis, in PC3 cells than DOX treatment alone did, which demonstrates the si-Beclin1 inhibited the autophagy activity of prostate cancer (PCa) cells by targeting the type III PI3K pathway and improve the sensitivity to the chemotherapy drug DOX. In addition, the peptide micelles successfully targeted DOX and si-Beclin1 passively to the tumor tissue. Compared with DOX or si-Beclin1 treatment alone, the Co-MPs showed a 3.4-fold greater tumor inhibition in vivo, which demonstrated a synergistic anti-proliferative effect in vivo. Our results suggest that the Co-MPs developed in this study may prove to be a promising combination method to provide autophagy inhibition and chemotherapy in cancer treatment, especially for PCa.
Treatment of Old Vertebral Compression Fracture With Kyphosis by Different Reconstruction Methods: a Finite Element Analysis
Authors: Ye Han , Xiaodong Wang , Jincheng Wu , Hanpeng Xu , Zepei Zhang , Kepeng Li , Yang Song , Jun Miao
Published: December 2020

Background: In repair of vertebral compression fractures, there is a lack of effective biomechanical verification as to whether only half of the vertebral body and the upper and lower intervertebral discs has any effect on spinal biomechanics; there also remains debate as to the appropriate length of fixation.Methods: A model of old vertebral compression fractures with kyphosis was established based on CT data. Vertebral column resection (VCR) and posterior unilateral vertebral resection and reconstruction (PUVCR) were performed at T12; long- and short-segment fixation methods were applied, and we analyzed biomechanical changes after surgery.Results: Range of motion (ROM) decreased in all fixed models, with lumbar VCR decreasing the most and short posterior unilateral vertebral resection and reconstruction (SPUVCR) decreasing the least; in the long posterior unilateral vertebral resection and reconstruction (LPUVCR) model, the internal fixation system produced the maximum VMS stress of 213.25 MPa in a lateral bending motion, and a minimum stress of 40.22 MPa in a lateral bending motion in the SVCR.Conclusion: There was little difference in thoracolumbar ROM between PUVCR and VCR models, while thoracolumbar ROM was smaller in long-segment fixation than in short-segment fixation. In all models, the VMS was greatest at the screw-rod junction and greatest at the ribcage–vertebral body interface, which partly explains the high probability of internal fixation failure and prosthesis migration in these two positions.
Mismatch Between Proximal Rod Contour Angle and Proximal Junctional Angle: A Risk Factor Associated with Proximal Junctional Kyphosis After Growing Rods Treatment for Early-Onset Scoliosis
Authors: Yang Bo , Xu Liang , Qiu Yong , Wang Muyi , Du Changzhi , Wang Bin , Zhu Zezhang , Sun Xu
Published: December 2020

Study Design: A retrospective studyObjectives: To investigate the impact of radiological and surgical factors as well as proximal rod contouring angle (PRCA) on the development of proximal junctional kyphosis (PJK) in early-onset scoliosis(EOS) patients after growing rod (GR) treatment.Methods: We reviewed a consecutive series of EOS patients who had undergone growing rod (GR) treatment between 2009 and 2018 (minimum follow-up of 2 years) at a single institution. Patients were divided into PJK and non-PJK groups according to the occurrence of PJK or not during the follow-up periods. The demographic data, surgical strategies, and radiographic parameters were recorded and compared between the PJK and non-PJK groups. PJK was defined as a PJA＞10° at the last follow-up. PRCA was defined as the angle between the cephalad endplate of the UIV and the lower endplate of the second vertebra caudal to UIV and the PJA-PRCA was defined as the difference between the values of PJA and PRCA. Logistic regression was also performed to identify the risk factors for the occurrence of PJK.Results: This study finally included 95 patients. The mean age at the index surgery was 6.5±2.2 years. Mean follow-up lasted 4.4±1.9 years. Lengthening procedures averaged 4.0 ± 1.8 times. There were 20 patients who were observed with PJK (the incidence, 21.1%). In comparison with the non-PJK group, the PJK group showed a larger preoperative coronal cobb angle (81.8±20.6° vs 70.4±12.4°, P=0.041) and global kyphosis (GK) (56.0±15.3° vs. 45.9±12.9°, P=0.044), as well as a larger GK correction (40.4%±10.0% vs. 30.0%±14.2%, P=0.035). In addition, the PJK group had significantly larger postoperative PJA (10.8±3.1 vs. 5.3±3.1, P＜0.001) and greater postoperative PJA-PRCA (5.3±3.0 vs. 3.66±2.9, P=0.031). The proportion of patients with a value of PJA-PRCA greater than 5° in PJK group was significantly higher than that in the non-PJK group. Multiple logistic regression showed that preoperative GK＞50°, postoperative PJA＞10 and postoperative PJA-PRCA＞5° were the risk factors in predicting PJK after GR treatment.Conclusions: More than one-fifth EOS patients experienced PJK after GR treatment. Besides greater preoperative GK and larger postoperative PJA, PJA-PRCA mismatch may be an independent risk factor of PJK occurrence.
Unilateral Versus Bilateral Pedicle Screw Fixation With Oblique Lateral Interbody Fusion in the Treatment of Multi-level Degenerative Lumbar Disease: a Prospective Study
Authors: Cai Zecheng , Zhang Jianqun , Yang Shulong , Liu Xiaoyin , Chen Zhen , Ma Rong , Liang Simin , Ding Xiaoli , Ma Zongjun , Wu Peng , Ge Zhaohui
Published: December 2020

Background: The purpose of this study was to compare the clinical and radiological outcomes of oblique lateral interbody fusion (OLIF) combined with unilateral (UPSF) and bilateral pedicle screw fixation (BPSF) in the treatment of multi-level degenerative lumbar disease (LDD).Methods: We conducted a prospective study from May 2016 to June 2018. A total of 81 LDD patients were randomized into groups. The first group involving 39 patients received OLIF combined with USPF (UPS group), and the second group of 41 patients received OLIF combined with BPSF (BPS group). The perioperative conditions included intraoperative bleeding, operating time, average hospital stay, and hospitalization expenses. The clinical outcomes included Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), and complications. Moreover, the radiological outcomes included disc height, fusion rate, and cage subsidence rate. These perioperative conditions, clinical outcomes, and radiological conditions of the two study groups were evaluated and compared. All the patients were followed up for 24 to 28 months, with an average follow-up time of 26 months.Results: The intraoperative bleeding, operating time, and hospitalization expenses of the UPS group were significantly less compared with those of the BPS group. Compared with preoperatively, the VAS and ODI scores of the two groups were improved significantly after the operation. At 6 months after operation, the VAS score for back pain and ODI of the UPS group were better than in the BPS group (P < 0.05). Both groups were able to maintain the intervertebral space height of the fusion segment, and there was no significant difference in the fusion rate at the 24 months. There were no significant differences in complications. At the 24 months, there was no significant difference in the cage subsidence of the fusion segment between the two groups. Finally, there was no loose screw and screw fracture in both groups.Conclusions: OLIF combined with UPSF is an effective and reliable surgical method for the treatment of multilevel LDD.
Is Homogeneous Spinal Cord Shortening and Axial Decompression (HSAD) Superior to Adults in The Treatment of Tethered Syndrome in Children
Authors: Shunmin Wang , Luo Xi , Sun Kai Qiang , Zhu Jian , Zhao Feng , Shi Jian Gang
Published: December 2020

Objective: Childhood spinal cord syndrome is a refractory and intractable disease, which gradually worsens with developmental symptoms. The purpose of this study was to evaluate the long-term surgical effects of HSAD in the treatment of tethered cord syndrome in children and adults. Methods: 50 Patients receiving HSAD tethered from January 2011 to September 2014 included in this study. At least 5 years after follow-up, imaging and clinical data collection. JOA score, VAS score, waist and leg dysfunction index (ODI) score were used to evaluate the patient's neurological function and pain improvement. ICI-Q-SF score, urodynamics, and residual urine volume (B-ultrasound) are used to assess urinary function. The Rintala score is used to assess stool function.Results: A total of 50 patients were enrolled and the patients were divided into children group (n=26) and adult group(n=24). JOA improvement rate in children group (54.95%±14.14%vs34.95%±11.82%), maximum urine flow rate improvement value (4.87±5.49vs1.40±1.88) and residual urine volume improvement value (118.46±39.11vs62 .83±59.28) was greater than the adult group, and the postoperative ICIQ-SF score (6.21 ± 4.85vs7.75 ±4.23) was lower than that of the adult group (P <0.05).Conclusion: HSAD can achieve good clinical effects in treating children and adults with tether syndrome. In the long run, it may benefit urinary function, especially in children.
Potential Effects of Angiogenesis-related Factors on the Severity of APAC and Surgical Outcomes of Trabeculectomy
Authors: Wang Jing , Fu Ming-shui , Zhou Min-wen , Ke Bilian , Zhang Zhihua , Xu Xun
Published: December 2020

Background. Acute primary angle closure (APAC) caused by an abrupt closure of trabecular meshwork can develop into angle closure glaucoma due to uncontrolled IOP. Under reduced oxygen tension, hypoxia inducible transcription factors will be accumulated. EPO (erythropoietin) and PDGF (platelet derived growth factor) families are thought to be associated with angiogenesis under hypoxic condition.Methods. Concentrations of EPO, PDGF-AA, -BB, -CC and -DD collected in aqueous humor samples were measured. Before operations, correlations between target proteins and IOP were detected between APAC (acute primary angle closure) and cataract patients. Based on the post-operative follow-up, the effects of EPO and PDGF family members on the successful rate of trabeculectomy were tested. Results. The levels of EPO, PDGF-CC and -DD were significantly elevated in the APAC group compared to the cataract group. During the post-operative follow-up, EPO, PDGF-CC and -DD showed significant differences between the success and failure groups. In multivariable linear regression analyses, failed filtration surgery was more likely in APAC eyes with higher EPO level. The Kaplan-Meier survival plot suggested that the success rate in eyes with low EPO level was significantly higher than that in eyes with high EPO level.Conclusion. The levels of EPO, PDGF-CC and -DD were significantly elevated in failure group. EPO level correlated with preoperative IOP and numbers of eyedrops, and higher EPO level in aqueous humor is a risk factor for trabeculectomy failure. It can be a biomarker to estimate the severity of APAC and the success rate of surgery. The investigation of mechanism of EPO in APAC a may have potential clinical applications for the surgical treatment of APAC.
Multi-Carbon Dots and Aptamer Based Signal Amplification Ratiometric Fluorescence Probe for Protein Tyrosine Kinase 7 Detection
Authors: Ma Yunsu , Wang Yuan , Liu Yongjie , Shi Lujia , Yang Dongzhi
Published: December 2020

Background: Protein tyrosine kinase 7 (PTK 7) is a membrane receptor, whichcan be found in various kinds of cancers . In view of this, detection of PTK 7 in theperipheral circulation would be an effective way for the early diagnosis of cancer.Results: In this work, a multi carbon dots and aptamer based signal amplificationratiometric fluorescence probe was developed . The fluorescence of the aptamermodified y CDs and b CDs were respectively chosen as the detection signal and interiorlabel The fluorescence of y CDs was quenched by Fe 3 O 4 and cDNA (complement toaptamer) compound without PTK 7 but recovered by the addition of PTK 7. Then, t hefree aptamer was cut by DNase Ⅰ, which amplified the detection signal. The ratiometricfluorescence sensor for PTK 7 was established with the LOD of 0.016 ng mL-1Conclusions: Summary , a multi carbon dots and aptamer based signal amplificationratiometric fluorescence probe was developed for the detection of protein tyrosinekinase 7. The developed probe was applied to PTK 7 detection in MCF 7 cells andhuman serum with satisf ying results, thus indicat ing that this probe ha s huge potentialin clinical practice.
Service Providers’ Perceptions of Support Needs for Indigenous Cancer Patients in Saskatchewan: a Needs Assessment
Authors: Sedgewick Jennifer R. , Ali Anum , Badea Andreea , Carr Tracey , Groot Gary
Published: December 2020

Background: In Saskatchewan, Canada, Indigenous cancer care services at the municipal, provincial, and federal levels are intended to improve quality care but can result in a complex, fragmented, and multi-jurisdictional health care system. A multi-phase needs assessment project was initiated to document Indigenous cancer care needs. Guided by Indigenous patient partners, clinicians, academics, and policy makers, the present study reflects a needs assessment of Indigenous cancer supports from the perspectives of cancer care service providers.Methods: Qualitative data were collected through three group interviews with 20 service providers for cancer patients and their families at three Saskatchewan cities. Participants included chemotherapy and radiation nurses, social workers, a patient navigator, dieticians, and practicum students. A semi-structured interview guide was used to conduct the sessions to allow for freedom of responses. Data were recorded, transcribed verbatim, and analyzed using thematic analysis. Results: Service providers’ perspectives were categorized into five themes: 1) addressing travel-related issues, 2) logistical challenges, 3) improvements to Indigenous-specific health care supports, 4) cultural sensitivity in health care, and 5) consistency in care. Supports differed for the two Indigenous groups, First Nations and Métis. Service providers made recommendations regarding how needs could be met. They saw language translation providers and Elder supports as important. Travel recommendations included medical taxis accommodating for more breaks to alleviate the uncomfortable side effects of cancer treatment and Indigenous-specific accommodations be provided. These recommendations aligned with supports that are available in four other Canadian provinces.Conclusions: These results identified gaps in supports and outlined recommendations to address barriers to cancer care from the perspectives of service providers. These recommendations may inform evidence-based health system interventions for Indigenous cancer patients and ultimately aim to improve cancer care services, quality of life, and health outcomes of Indigenous patients throughout their cancer journey.
­­STAT3 combines with Rho-ROCK signaling pathway inhibitor, regulate axon growth of ganglion cells derived from retinal Müller cells
Authors: zhou xuezhi , Wang Yujue , Peng Manjuan , He Ye , Peng Jingjie , Zhang Xuan , Wang Chao , Song Weitao
Published: December 2020

BackgroundMüller differentiated RGCs have potential therapeutic value for glaucoma. However, axonal regeneration of differentiated RGCs has been a difficult problem. Studies have confirmed that STAT3 and Y27632 play essential roles in regulating neuronal axon regeneration. Whether STAT3 and Y27632 can induce the Müller differentiated RGCs axon regeneration is still unknown.MethodRetina Müller cells were isolated and purified from Day 21 SD rats’ retina and were differentiated into retinal stem cells. The stem cells were randomly divided into five groups (control group, AAV-STAT3 group, shSTAT3 group, Y27632 group and AAV-STAT3 + Y27632 group). The axon length in each group were measured by ImageJ. Immunofluorescence were used to label the RGCs. The mRNA level of pluripotent associated and differentiation-associated proteins was analysed by qRT-PCR. Stem cells in different groups were injected into mice model of glaucoma. Immunohistochemical, Immunohistochemistry and OCT were performed to access RGC layer thickness in glaucoma model. VEP was used to detect the optic nerve conduction function.ResultsIn this study, we found that overexpression of STAT3 could promote the growth of RGCs axons generated by Müller cell differentiation. Combined with Y27632, axonal regeneration was significantly longer than that of the STAT3 group. However, after STAT3 was knocked out, axonal regeneration significantly decreased or even stopped. The mRNA levels of Esrrb, Prdm14, Sox2, and Rex1 in Müller differentiated RGCs after overexpression STAT3 combined with Y27632 were significantly increased, while the mRNA levels of Nestin, Eomes, Mixl1 and Gata4 were significantly decreased. The mRNA levels of Socs3, Pten, Klf9, and Mdm4 were significantly decreased, while the mRNA levels of Dclk2, Armcx1, C-MYC, and Nrn1 were significantly increased. The mRNA levels of differentiation and pluripotency marker genes showed opposite results after STAT3 deletion. After injecting Müller differentiated RGCs intervened by STAT3 combined with Y27632 into the eyes of the glaucoma model mice, the axon length, OCT displayed RGC layer thickness and the electrophysiology indicated by VEP were superior to those of the glaucoma model group.ConclusionsThese findings suggested that STAT3 combined with Y27632 can significantly improve the axonal growth level of RGCs, and reveal the potential mechanism to induce pluripotency of RGCs.
Trapped in a Vicious Cycle of Violence: A Qualitative Inquiry into the Experiences of HIV Serodiscordant Married Couples
Authors: larki mona , bahri narjes , roudsari robab latifnejad
Published: December 2020

Background: Violence against women is a major, complex, multidimensional and widespread public health concern worldwide. The current qualitative study was conducted to understand the experience of violence among HIV negative women in serodiscordant relationships.Methods: A qualitative description (QD) was conducted from October 2018 to January 2020 (16-month period) in Mashhad, Iran. The researchers recruited 15 HIV negative women who lived with HIV positive men through purposive sampling method. The data were collected using semi-structured interviews. Data analyzed using conventional content analysis adopted by Graneheim and Lundman (2004). Results: The main overarching theme emerged entitled: trapped in a vicious cycle of violence. It consisted of four categories of self-directed violence, intimate partner violence, cultural violence and structural violence. The cycle of violence began soon after awareness of husband's infection with acts such as suicide attempts and a sense of abhorrence for living with an infected person, and continued with confrontation with various types of violence in the family and society.Conclusions: This study provided an insight into different aspects of violence in Iranian women in HIV serodiscordant relationships. Healthcare providers should be able to address topics related to the violence for women who are in HIV serodiscordant relationships.
Community Health Workers: Challenges and Vulnerabilities of Accredited Social Health Activists Working in Conflict-affected Settings in the State of Assam, India
Authors: Rajbangshi Preety R , Nambiar Devaki , Srivast Aradhana
Published: December 2020

Introduction:. It is well acknowledged that India’s Community Health workers known as Accredited Social Health Activists (ASHA) are the bedrock of its health system. Many ASHAs are currently working in fragile and conflict-affected settings. No efforts have yet been made to understand the challenges and vulnerabilities of these female workers. This paper seeks to address this gap by bringing attention to the situation of ASHAs working in the fragile and conflict settings and how conflict impacts them and their work. Methods: Qualitative fieldwork was undertaken in four conflict-affected villages in two conflict-affected districts -Kokrajhar and Karbi Anglong of Assam state situated in the North-East region of India. Detailed account of four ASHAs from the majority (Bodo or Karbi) and minority (Adivasi or Koch) communities serving roughly 4000 people is presented. Data transliterated into English were analysed by authors by developing a codebook using grounded theory and thematic organisation of codes. Results: ASHAs reported facing challenges in ensuring access to health services during and immediately after outbreaks of conflict. They experienced difficulty in arranging transport and breakdown of services at remote health facilities. Their physical safety and security were at risk during episodes of conflict. ASHAs reported hostile attitudes of the communities they served due to the breakdown of social relations, trauma due to displacement, and loss of family members, particularly their husbands. Conclusion: Conflict must be recognised as an important context within which community health workers operate, with greater policy focus and research devoted to understanding and addressing the barriers they face as workers and as persons affected by conflict.
β-Conglycinin regulates distal intestinal immunity through the CIITA-mediated MHC II-PI3K/Akt/mTOR signaling pathway in hybrid grouper (Epinephelus fuscoguttatus ♀ × E. lanceolatus ♂): The ameliorative effects of sodium butyrate (NaB)
Authors: Yin Bin , Liu Hongyu , Tan Beiping , Dong Xiaohui , Chi Shuyan , Yang Qihui , Zhang Shuang
Published: December 2020

Background

β-Conglycinin (7S) is a strong immunogenic protein that modulates immune responses in the intestines of aquatic animals, whereas sodium butyrate (NaB) may promote growth by protecting the intestinal tract of fish. However, the mechanisms of action of 7S and NaB in these regards have yet to be determined.
Results

In this study, we investigated the effects of low and high doses of 7S and the ameliorative effects of NaB (based on high-dose 7S) on the growth performance, serum immunity, distal histopathology, and CIITA-mediated MHC II-PI3K/Akt/mTOR pathway in hybrid groupers (Epinephelus fuscoguttatus ♀ × E. lanceolatus ♂). The results revealed that the specific growth rate of groupers significantly increased, decreased, and increased in the low-level 7S (bL), high-level 7S (bH) high-level 7S plus NaB (bH-NaB) groups, respectively. The feed coefficient ratio was significantly increased in the bH and bH-NaB groups, whereas serum levels of IgE, IFN-γ, IL-1β, and TNF-α were upregulated in the bH group, and IgE was upregulated in the bH-NaB group. With respect to distal intestine histopathology, the intestinal diameter/plica height ratio was significantly increased in the bH group. Furthermore, there were increases in nitric oxide, nitric oxide synthase (NOS), and peroxynitrite anion (ONOO) in the bH group, and decreases in NOS and ONOO in the bH-NaB group In the distal intestinal tract, the mRNA levels of TSC1, mTOR C2, CIITA, and CREB1 were significantly upregulated in all three treatment groups, whereas those of IKKα, Rheb, mTOR C1, mLST8, EIF4B, NFY, GILT, and AEP were upregulated and downregulated in the bH and bH-NaB groups, respectively.
Conclusions

Collectively, these results indicate that 7S has a regulatory effect on serum immunity and can also affect distal intestinal tract development in hybrid groupers by modulating hindgut injury-related parameters. Within the distal intestinal tract, 7S can induce intestinal inflammation by activating the CIITA-mediated MHC II-PI3K/Akt/mTOR pathway, which eventually manifests as a reduction in growth performance. Supplementing feed with NaB represents an effective approach for enhancing serum immunity, and also protects the intestines from damage caused by high doses of 7S.
Effects of flaxseed supplementation on omega-6 to omega-3 fatty acid balance, lipid mediator profile, proinflammatory cytokines and stress indices in laying hens
Authors: Lee Sang-Mok , Kim Hee Kyum , Lee Ho-Bin , Kwon Oh-Dae , Lee Eun-Bi , Bok Jin-Duck , Cho Chong-Su , Choi Yun-Jaie , Kang Sang-Kee
Published: December 2020

Background: Although polyunsaturated fatty acids are in the spotlight due to their physiological effects on inflammation and stress of livestock animals, the biological roles of their derivatives, termed lipid mediators, have been little reported in laying hens. Results: In this study, two hundred 33-week-old laying hens were fed 0, 0.9, 1.8, or 3.6% (w/w) dietary flaxseed (Lintex170) with a commercial basal diet for 4 weeks to determine the physiological effects of dietary flaxseed, an omega-3-rich ingredient, on host inflammation or stress states regarding lipid mediator profiles, and also its impact on laying performance. The physiological changes in the omega-6 to omega-3 ratio, lipid mediator profiles, serum proinflammatory cytokine (tumor necrosis factor-alpha, interleukin-1beta, interleukin-6) levels, serum corticosterone levels, and the ratio of heterophils to lymphocytes were monitored. Supplementing dietary flaxseed greatly reduced the omega-6 to omega-3 fatty acid ratio from 25.85 to 4.16 in eggs and from 19.23 to 4.08 in serum samples between groups fed with 0% and 3.6% dietary flaxseed after the experimental period. In addition, the lipid mediator profiles of laying hens were modulated by supplementation with flaxseed, mainly resulting in enrichment of omega-3 fatty acid-derived lipid mediators. Furthermore, the level of proinflammatory cytokines TNF-alpha decreased when fed 3.6% (w/w) dietary flaxseed. Two stress indices, corticosterone in the serum and the heterophil to lymphocyte ratio showed significant reductions in laying hens fed 3.6% (w/w) dietary flaxseed. Additionally, overall laying performance indices were significantly improved by supplementary flaxseed. Conclusion: Taken together, these findings suggest that the decreased omega-6 to omega-3 ratio and enrichment of omega-3-derived lipid mediators induced by dietary flaxseed may contribute to reducing the stress state in laying hens, improving laying performance. These findings broaden the understanding of lipid mediator profiles in laying hens, and the results will be applied to develop antiinflammatory and antistress feed additives for the poultry industry.
Judgment grounds in surrogate decision-making in Japanese clinical practice: A qualitative survey
Authors: Tanaka Masashi , Ohnishi Kayoko , Enzo Aya , Okita Taketoshi , Asai Atsushi
Published: December 2020

BackgroundSurrogate decision-making is expected to become more prevalent in Japanese clinical practice. Recent years have seen an increase in activities to promote advance care planning (ACP), potentially affecting the manner in which judgments are made in surrogate decision-making. This study aimed to clarify judgment grounds on which surrogate decisions are made in Japan.MethodsThis qualitative study was based on semi-structured interviews regarding judgment grounds in surrogate decision-making for critical life-sustaining treatment choices in acute hospitals.  ResultsA total of 228 participants met the inclusion criteria, and 15 were selected for interviews. We qualitatively analyzed the content of 14 interview transcripts, excluding one which did not meet the inclusion criteria. Based on this analysis, four core categories, 17 categories, 35 subcategories, and 55 codes regarding judgement grounds in surrogate decision-making were extracted. The four core categories were as follows: Patient preference-oriented factor (Type 1); Patient interest-oriented factor (Type 2); Family preference-oriented factor (Type 3); and Balanced patient/family preference-oriented factor (Type 4). The Type 4 core category represented attempts to balance preferences of the patient with those of the surrogate decision-maker. ConclusionsSurrogate decision-makers based their decisions on important matters related to a patient’s life not only on the preferences and best interests of the patient, but also on their own preferences. As the need for surrogate decisions increase in the future, decision-makers will need to consider judgment grounds from a more diverse perspective.
Effect of adding a psychological intervention to routine care of common mental disorders in a specialized mental healthcare facility in Pakistan: a randomized controlled trial
Authors: Hamdani Syed Usman , Huma Zill-e- , Masood Aqsa , Zhou Kiana , Ahmed Zainab , Nazir Huma , Amin Hania , Akhtar Parveen , Bryant Richard , Dawson Katie , Ommeren Mark van , Wang Duolao , Rahman Atif , Minhas Fareed Aslam
Published: December 2020

Background: In many low resource settings, the provision of government mental health care services is limited to specialized psychiatry units in urban hospital care facilities, where the most common treatment for common mental disorders (CMDs) is pharmacotherapy, occasionally with adjunct nonspecific psychological support. We aimed to evaluate the effectiveness of adding a low intensity, psychological intervention, Problem Management Plus (PM+) for CMDs into routine care in a specialized mental health care facility in Pakistan.Methods: A two arm, single-blind individual randomized controlled trial (RCT) was carried out with adults (N=192), referred for psychological support by psychiatrists. The study participants were randomized (1:1) to PM+ plus Treatment as Usual (TAU) (n = 96) or TAU only (n = 96). The primary outcomes were symptoms of anxiety and depression, measured by the Hospital Anxiety and Depression Scale (HADS) and functional impairment as measured by WHO Disability Assessment Schedule (WHODAS 2.0) at 20 weeks after baseline.Results: The analysis was done on intention-to-treat principle. The linear mixed model analysis showed that at 20 weeks after baseline, there was a significant reduction in symptoms of anxiety and depression (mean [SD], 16.23 [8.81] vs 19.79 [7.77]; AMD, -3.10; 95% CI, −0.26 to −5.76); p=0.03 and improvement in functioning (mean [SD], 22.94 [9.37] vs 27.37 [8.36]; AMD, -4.35; 95% CI, -1.45 to -7.24); p=0.004 in PM+ plus TAU versus TAU arm . The follow-up rate was 67% at primary end-point.Conclusions: Specialized care facilities in LMICs may consider adding brief, evidence-based psychological treatments for CMDs to their routine care.Trial Registration: Australian New Zealand Clinical Trials Registry, ACTRN12616000381482. Registered March 23, 2016- Retrospectively registered, https://www.anzctr.org.au/Default.aspx/ ACTRN12616000381482
Patients and relatives as auditors of safe practices in oncology and hematology day hospitals
Authors: Rodrigo-Rincon Isabel , Aristorena Isabel Irigoyen , Tirapu-Leon Belén , Barcala Nicolas Zaballos , Carricas Maite Sarobe , Lobo-Palanco Joaquin , Caamaño Maria Luisa Antelo , Martin-Vizcaino Marta , Burnett Susan
Published: December 2020

BackgroundWhen there is a gap in professionals’ adherence to safe practices during cancer treatment, the consequences can be serious. Identifying these gaps in order to enable improvements in patient safety can be a challenge. This study aimed to assess if cancer patients and their relatives can be given the skills to audit reliably four safe practices, and to explore whether they are willing to play this new role.MethodsWe recruited 136 participants in 2018, from the oncology and haematology day hospital of a tertiary hospital in Spain. Patient identification, hand hygiene, blood or chemotherapy identification, and side effects related to transfusion and chemotherapy, were the safe practices selected for evaluation.The study comprised two parts: an interventional educational program and a cross-sectional design to collect data and assess to what degree participants are able and willing to be auditors depending on their characteristics using multivariate logistic regression models. A participant’s auditing skill were assessed pre and post the educational intervention.ResultsThe model was seeking predictors of being a good auditor. 63 participants (46.3%) were classified as good auditors after the training. To have younger age, higher educational level and to have had an experience of an adverse event were associated with a higher probability of being a good auditor. Additionally, 106 (77.9%) participants said that they would like to audit anonymously the professionals’ compliance of at least three of four safe practices. The willingness to audit safe practices differed depending on the safe practice but these differences did not reach statistical significance.ConclusionsThe data gathered by patients and relatives acting as auditors can provide healthcare organizations with valuable information about safety and quality of care that is not accessible otherwise. This new role provides an innovative way to engage patients and their families’ in healthcare safety where other methods have not had success. The paper sets out the methods that healthcare organizations need to undertake to enrol and train patients and relatives in an auditor role.