bluuebunny/crossref_metadata_2025 huggingface dataset:
Glucagon-like peptide-1 (GLP-1) receptor agonists and cardiovascular events in patients with type 2 diabetes mellitus: A meta-analysis of double-blind, randomized, placebo-controlled clinical trials
Authors: Qin Jing , Song Li
Published: February 2020

Background: The cardiovascular effects of glucagon-like peptide-1 (GLP-1) receptor agonists are still controversial in the treatment of type 2 diabetes mellitus (T2DM) patients. The purpose of this study was to evaluate the risk of cardiovascular events of GLP-1 (albiglutide, exenatide, liraglutide, semaglutide, lixisenatide and dulaglutide) receptor agonists in T2DM patients.Methods: PubMed and Embase were searched to find relevant randomized controlled trials (RCTs) from inception to June 2019 that evaluated the effect of GLP-1 receptor agonists on cardiovascular events in patients with T2DM. The T2DM patients of all the eligible trials received either GLP-1 therapy or placebo, and the cardiovascular outcomes included death from cardiovascular causes, fatal or non-fatal myocardial infarction and fatal or non-fatal stroke.Results: We included 6 multinational double-blind randomized placebo-control trials that included a total of 52821 T2DM patients. The results indicated that GLP-1 receptor agonists reduced the risk of death from cardiovascular causes (RR: 0.90; 95% CI: 0.83–0.97; P = 0.004) and fatal or non-fatal stroke (RR: 0.85; 95% CI: 0.77–0.94; P = 0.001) compared with the placebo controls. But GLP-1 receptor agonists did not significantly alter the fatal or non-fatal myocardial infarction compared with the placebo (RR: 0.91; 95% CI: 0.82 – 1.01; P = 0.06).Conclusion: We concluded that GLP-1 receptor agonist therapy could reduce the risk of death from cardiovascular causes and fatal or non-fatal stroke compared with the placebo in the treatment of T2DM patients in trials with cardiovascular outcomes.
Enhanced antitumor efficacy on colon cancer using EGF functionalized PLGA nanoparticles loaded with 5-Fluorouracil and perﬂuorocarbon
Authors: Author) Pingping Wu(Former Corresponding , Zhou Qing , Zhu Huayun , Zhuang Yan , Author) Jun Bao(New Corresponding
Published: February 2020

Background: Recurrence and metastasis are the shortcomings of the clinical treatment of colon cancer. Finding an efficacy strategy for the treatment of colon cancer is important. In recent years, poly lactic-co-glycolic acid (PLGA) has been shown to have potential as a broad therapeutic drug delivery system. This study aimed to design a dual-loaded nanoparticles drug delivery system to overcome the limitations of chemotherapeutic drugs in colon cancer therapy. Methods: We developed epidermal growth factor (EGF) functionalized poly PLGA nanoparticles (NPs) co-loaded with 5-fluorouracil (5Fu) and perﬂuorocarbon (PFC) (EGF-PLGA@5Fu/PFC NPs) for target therapy of colon cancer. EGF-PLGA@5Fu /PFC NPs were estimated by morphology, size distribution, in vitro stability and release profile. CCK-8, Hoechst33342 staining and flow cytometry assays were performed to investigate the functions of EGF-PLGA@5Fu/PFC NPs in SW620 cells. Results: We found that EGF-PLGA@5Fu/PFC NPs had an average size of 200 nm with a 5Fu-loading efficiency of 7.29%. Targeted EGF-PLGA@5Fu/PFC NPs exhibited higher cellular uptake than non-targeted NPs in colon cancer cells. EGF-PLGA@5Fu/PFC NPs were found to have the best efficiency on cell viability suppression and apoptosis induction in SW620 colon cancer cells. In xenograft mice, EGF-PLGA@5Fu/PFC NPs had the best suppressive effects on tumor growth compared with 5Fu, PLGA@5Fu and PLGA@5Fu/PFC NPs. The results of histopathological analysis further indicated that EGF-targeted NPs were the most efficient on tumor growth inhibition. Mechanically, the data demonstrated the improved therapeutic outcomes were owing to the fact that PFC relieved tumor hypoxia via transporting oxygen to the tumor. Conclusions: We creatively constructed a biocompatible nanodrug delivery system and functionalized nanoparticles might provide new potential for selective delivery of chemotherapy drugs to cancers.
Identification of the Eutrema Salsugineum EsMYB90 gene important for anthocyanin biosynthesis
Authors: Qi Yuting , Gu Caihong , Wang Xingjun , Gao Shiqing , Li Changsheng , Zhao Chuanzhi , Li Chuanshun , Ma Changle , Zhao Dazhong , Zhang Quan
Published: February 2020

Background: Anthocyanins contribute to coloration and antioxidation effects in different plant tissues. MYB transcription factors have been demonstrated to be a key regulator for anthocyanin synthesis in many plants. However, little information was available about the MYB genes in the halophyte species Eutrema salsugineum . Result: Here we report the identification of an important anthocyanin biosynthesis regulator Es MYB90 from Eutrema salsugineum , which is a halophyte tolerant to multiple abiotic stresses. Our phylogenetic and localization analyses supported that Es MYB90 is an R2R3 type of MYB transcription factor. Ectopic expression of EsMYB90 in tobacco and Arabidopsis enhanced pigmentation and anthocyanin accumulation in various organs. The transcriptome analysis revealed that 42 genes upregulated by Es MYB90 in 35S : EsMYB90 tobacco transgenic plants are required for anthocyanin biosynthesis. Moreover, our qRT-PCR results showed that Es MYB90 promoted expression of early ( PAL , CHS , and CHI ) and late ( DFR , ANS , and UFGT ) anthocyanin biosynthesis genes in stems, leaves, and flowers of 35S : EsMYB90 tobacco transgenic plants. Conclusions: Our results indicated that Es MYB90 is a MYB transcription factor, which regulates anthocyanin biosynthesis genes to control anthocyanin biosynthesis. Our work provides a new tool to enhance anthocyanin production in various plants. Keywords : Anthocyanin, flavonoid, Eutrema salsugineum , R2R3 MYB transcription factor, Es MYB90, transcriptional regulation, anthocyanin biosynthesis genes.
Understanding implementation barriers in the national scale-up of Differentiated ART delivery in Uganda
Authors: ZAKUMUMPA HENRY , Rujumba Joseph , Kwiringira Japheth , Katureebe Cordelia , Spicer Neil
Published: February 2020

Background
Although Differentiated Service Delivery (DSD) for anti-retroviral therapy (ART) has been rolled-out nationally in several countries since World Health Organization (WHO)’s landmark 2016 guidelines, there is little research evaluating post-implementation outcomes. The objective of this study was to explore patients’ and HIV service managers’ perspectives on barriers to implementation of Differentiated ART delivery in Uganda.
Methods
We employed a qualitative descriptive design involving 124 participants. Between April and June 2019 we conducted 76 qualitative interviews with national-level HIV program managers (n=18), District Health Team leaders (n=24), representatives of PEPFAR implementing organizations (11), ART clinic in-charges (23) in six purposively selected Uganda districts with a high HIV burden (Kampala, Luwero, Wakiso, Mbale, Budadiri, Bulambuli). Six focus group discussions (48 participants) were held with patients enrolled in DSD models in case-study districts. Data were analyzed by thematic approach as guided by a multi-level analytical framework: Individual-level factors; Health-system factors; Community factors; and Context.
Results
Our data shows that multiple barriers have been encountered in DSD implementation. Individual-level: Individualized stigma and a fear of detachment from health facilities by stable patients enrolled in community-based models were reported as bottlenecks. Socio-economic status was reported to have an influence on patient selection of DSD models. Health-system: Insufficient training of health workers in DSD delivery and supply chain barriers to multi-month ART dispensing were identified as constraints. Patients perceived current selection of DSD models to be provider-intensive and not sufficiently patient-centred. Community: Community-level stigma and insufficient funding to providers to fully operationalize community drug pick-up points were identified as limitations. Context: Frequent changes in physical addresses among urban clients were reported to impede the running of patient groups of rotating ART refill pick-ups.
Conclusion
This is one of the first multi-stakeholder evaluations of national DSD implementation in Uganda since initial roll-out in 2017. Multi-level interventions are needed to accelerate further DSD implementation in Uganda from demand-side (addressing HIV-related stigma, community engagement) and supply-side dimensions (strengthening ART supply chain capacities, increasing funding for community models and further DSD program design to improve patient-centeredness).
MiR-21-5p regulates extracellular matrix degradation and angiogenesis in TMJOA by targeting Spry1.
Authors: Ma Shixing , Zhang Aobo , Li Xiaole , Zhang Shizhou , Liu Shaopeng , Zhao Haoming , Wu Shichao , Chen Lei , Ma Chuan , Zhao Huaqiang
Published: February 2020

Background Due to the lack of research on the pathological mechanism of temporomandibular joint osteoarthritis (TMJOA), there are few effective treatment measures in the clinic. In recent years, microRNAs (miRs) have been demonstrated to play an important role in the pathogenesis of osteoarthritis (OA) by regulating a variety of target genes, and the latest evidence shows that miR-21-5p is specifically overexpressed in OA. The purpose of this project was to clarify whether miR-21-5p can regulate the TMJOA process by targeting Spry1. Methods TMJOA was induced by a unilateral anterior crossbite (UAC) model, and the effect of miR-21-5p knockout on TMJOA was evaluated by toluidine blue and immunohistochemical staining. Primary mouse condylar chondrocytes (MCCs) were isolated, cultured and transfected with a series of mimics, inhibitors, siRNA-Spry1 or cDNA Spry1. Western blotting, RT-qPCR, immunofluorescence staining, and toluidine blue staining were used to detect the effect of miR-21-5p and its target gene Spry1 on the expression of MMP-13, VEGF and p-ERK1/2 in TMJOA. The effect of miR-21-5p on angiogenesis was evaluated by chick embryo CAM assay and Western blotting. Results In the UAC model, the cartilage thickness and extracellular matrix of miR-21-5p knockout mice were less damaged. Luciferase experiments confirmed that Spry1 was the direct target of miR-21-5p. The expression levels of Spry1, MMP-13, VEGF and p-ERK1/2 in MCCs transfected with miR-21-5p mimic were higher than those in the inhibitor group. Under the simulated inflammatory environment of IL-1β, the expression levels of MMP-13, VEGF and p-ERK1/2 were positively correlated with miR-21-5p, while Spry1 was negatively correlated with miR-21-5p. Inhibition of miR-21-5p expression and overexpression of Spry1 enhanced the inhibition of MMP-13, VEGF and p-ERK1/2 expression. MiR-21-5p had a significant role in promoting angiogenesis in the chick embryo CAM assay, and this role was clearly mediated by the ERK-MAPK signalling pathway. Conclusion This study verified that miR-21-5p can promote the process of TMJOA by targeting Spry1, which provides a new direction for future research on the treatment of this disease.
Comparative transcriptome analysis between inbred and hybrids reveals molecular insights into yield heterosis of upland cotton
Authors: Shahzad Kashif , Zhang Xuexian , Guo Liping , Qi Tingxiang , Bao Lisheng , Zhang Meng , Zhang Bingbing , Wang Hailin , Tang Huini , Qiao Xiuqin , Feng Juanjuan , Wu Jianyong , Xing Chaozhu
Published: February 2020

Background: Utilization of heterosis has greatly enhanced the productivity of many crops worldwide. Understanding the potential molecular mechanism about how hybridization in cotton produces superior yield is critical for efficient plant breeding. Results: With the whole-genome RNA sequencing, here, high, medium, and low hybrids varying in level of yield heterosis were screened based on different years and locations field experimentation. Phenotypically, high Department showed a mean of 14% more seed cotton yield than its better parent. A total of 63 samples comprised of different squaring stage tissues of three hybrids and four their inbred parents were used to perform transcriptomic analysis. A comparison of transcriptomic differences in each hybrid parent triad revealed a higher percentage of differentially expressed genes (DEGs) in each tissue. Expression level dominance analysis exposed the majority of hybrids DEGs followed parent like expressions. Functional annotations identified an array of DEGs involved in ATP and protein binding, membrane, cell wall, mitochondrion, and protein phosphorylation. Starch and sucrose metabolism and plant hormone signal transduction pathways were most enriched in each hybrid. Further, these two pathways had most mapped DEGs on known seed cotton yield QTLs. Integration of transcriptome, QTLs, and gene co-expression network analysis raveled genes GhBZR1, GhASK8, At3g43860, GhGBSS1, GhAPL2, GhMPK4, GhPHO1, GhJAZ10, and GhCRR21 displayed a complex regulatory network of many interconnected genes. qRT-PCR of these DEGs was performed to ensure the accuracy of RNA-Seq data. Conclusions: Through genome-wide comparative transcriptome analysis, the current study provides novel insights about phenomics and genomics of heterosis in upland cotton. Our results and data resources will be useful for dissecting the molecular mechanism of yield heterosis in cotton.
Cultural adaptation and psychometric evaluation of the Swedish version of the Reproductive Concerns After Cancer (RCAC) scale
Authors: Anandavadivelan Poorna , Wiklander Maria , Eriksson Lars E. , Wettergren Lena , Lampic Claudia
Published: February 2020

Background Reproductive concerns are common among young cancer survivors and include worries related to different aspects of fertility and parenthood. The Reproductive Concerns After Cancer (RCAC) scale is an 18-item scale with six dimensions, developed to capture a variety of such concerns. The aim of the present study was to culturally adapt the RCAC scale into Swedish and evaluate its psychometric properties among young women with cancer experience. Methods The RCAC was forward-translated from English into Swedish and assessed for cultural adaptation based on a two-panel approach followed by cognitive interviews with representatives of the target group. For the psychometric evaluation, a Swedish cohort of 181 young adult breast cancer survivors completed a survey including the RCAC scale approximately 1.5 years post-diagnosis. Investigation of the psychometric properties included analyses of construct validity (confirmatory factor analysis and convergent validity), data quality (score distribution, floor and ceiling effects), reliability (Cronbach’s α) and known-groups validity based on current child wish. Results The breast cancer survivors had a mean age of 36.5 (SD 4.1) years and a third of them expressed a current wish for (additional) children. The confirmatory factor analysis yielded a satisfactory fit (RMSEA 0.08, SRMR 0.09, CFI 0.92). Convergent validity was demonstrated by a negative correlation with moderate effect size (-0.361) between the RCAC total score and the emotional functional scale of EORTC QLQ-C30. Reliability was in the acceptable range (α= 0.78-0.92) for four of the dimensions, nearly acceptable for Personal health (α, 0.68) and poor for Becoming pregnant (α= 0.54). Known-groups validity was indicated by significantly higher RCAC mean score differences (MD), reflecting more concerns, among women with a certain (MD 4.56 [95% CI 3.13 to 5.99]) or uncertain (MD 3.41 [95% CI 1.68 to 5.14]) child wish, compared to those with no wish for (additional) children. Conclusion The Swedish RCAC scale demonstrated satisfactory reproducibility of the original RCAC scale with acceptable convergent and known-groups validity, but satisfactory reliability was not achieved for all dimensions. The Swedish RCAC scale exhibits adequate psychometric properties and could be useful for assessment of reproductive concerns in young adult female cancer survivors in Sweden.
Dual-Fano resonances and sensing properties in the crossed ring-shaped metasurface
Authors: He Zhihui , Li Chunjiang , Cui Wei , Xue Weiwei , Li Zhenxiong , Pu Lihui , Feng Jiaojiao , Xiao Xintao , Wang Xuyang , Liu Yajie , Zou Qirui , Yao Yufei , Niu Yixuan , Wang Mengyuan
Published: February 2020

We study dual-Fano resonances and its sensing properties in a crossed ring-shaped metasurface by use of the finite-different time-domain (FDTD) simulation. The results show that the dual-Fano resonances in the proposed crossed ring-shaped metasurface are caused by the interaction among three local surface plasmon resonances (LSPRs), and the spectra of dual-Fano resonances can be tuned by the radius of the circular ring (CR) nanostructure, the distance between the center of the two CRs in x direction, and the polarization of the incident light. Interestingly, single Fano resonance splits into dual-Fano resonances in the case of asymmetric ring structure arrangement or non-y-axis polarized incident or the distance d<120 nm. Moreover, we can also find that the refractive sensitivity in the proposed crossed ring-shaped metasurface can reach up to 1010 nm/RIU and 1300 nm/RIU at Fano resonance peak 1 and Fano resonance peak 2, respectively. These results may play an important role for designing high sensitive plasmonic sensors.
Cognitive, language and behavioral outcomes in children in middle childhood with autism spectrum disorders exposed to early comprehensive treatment models: A meta-analysis and meta-regression
Authors: Shi Bijun , Wu Weijia , Dai Meixia , Zeng Jingjing , Luo Jingyin , Cai Li , Wan Bin , Jing Jin
Published: February 2020

Background Early comprehensive treatment models (CTMs) have developed as effective treatments for children with autism spectrum disorder (ASD). Numerous studies have suggested that they can improve short-term outcomes, but little is known about middle childhood outcomes. The current meta-analysis reviewed studies reporting broader outcomes in middle childhood in children with ASD who ever participated in a CTM and examined the predictors of primary outcomes. Methods We searched eight databases up to June 13, 2019, for relevant trials and natural experiments. Longitudinal studies were selected if they investigated the outcomes of CTMs in middle childhood in children with ASD. Two meta-analyses were undertaken to determine a summary estimate of change in treatment outcomes and evaluate the effect of CTMs; one used the standardized mean change between the pretest and posttest, and the other a classical meta-analysis. Stratified and random effects meta-regression analyses were performed to search for outcome differences among studies. Results Eighteen intervention studies (involving 495 children with ASD) met all the inclusion criteria: 12 used early intensive behavioral intervention (EIBI) and two the Early Start Denver Model (ESDM). Outcomes were categorized into three parts: cognitive, language and behavioral (e.g., adaptive functioning and symptomatology). Overall, most children with ASD in middle childhood who participated in an early CTM make gains in many areas of functioning, especially with regard to symptom and language-related outcomes. Stratified analyses indicated that the ESDM displayed the largest effect on IQ improvement (ES=1.37, 95% CI: 0.95-1.80), while EIBI was more effective for symptom reduction (ES=-1.27, 95% CI: -1.96 to -0.58). Further meta-regression suggested that interventions with parent involvement and longer treatment hours yielded greater improvements in IQ and social adaptive functioning, respectively. Conclusion The results demonstrate a positive association between CTMs and better prognosis in middle childhood, especially regarding symptoms and language. However, most of the extant research involves small, non-randomized studies, preventing definitive conclusions from being drawn. What is certain is that the outcomes in middle childhood of children with ASD are still far from normal, especially for adaptive functioning, and the three mediating variables were treatment elements: approach, implementer and total treatment hours.
Evaluation of a cell-based osteogenic formulation compliant with good manufacturing practice for use in tissue engineering
Authors: Vivas Daniel , Grau-Vorster Marta , Oliver-Vila Irene , García-López Joan , Vives Joaquim
Published: February 2020

Background Proper bony tissue regeneration requires mechanical stabilization, an osteogenic biological activity and appropriate scaffolds. The latter two elements can be combined in a hydrogel format for effective delivery, so it can readily adapt to the architecture of the defect. Results We evaluated a Good Manufacturing Practice-compliant formulation composed of bone marrow-derived mesenchymal stromal cells in combination with bone particles (Ø = 0.25 to 1 µm) and fibrin, which can be readily translated into the clinical setting for the treatment of bone defects, as an alternative to bone tissue autografts. Remarkably, cells survived with unaltered phenotype (CD73 + , CD90 + , CD105 + , CD31 - , CD45 - ) and retained their osteogenic capacity up to 48 h after being combined with hydrogel and bone particles, thus demonstrating the stability of their identity and potency. Moreover, in a subchronic toxicity in vivo study, no toxicity was observed upon subcutaneous administration in athymic mice and signs of osteogenesis and vascularization were detected two months after administration. Conclusions The preclinical data gathered in the present work, in compliance with current quality and regulatory requirements, demonstrated the feasibility of formulating an osteogenic cell-based tissue engineering product with a defined profile including identity, purity and potency ( in vitro and in vivo ), which is required prior to move towards its use of prior to its clinical use.
Growth, yield and grain nutrients response of wheat (Triticum aestivum L.) to biochar,lime and farmyard manure amendment of the croplands in southern Ethiopia.
Authors: Lulu Mekdes , Lemma Bekele , Hidoto Legesse
Published: February 2020

Background: Soil fertility decline in agricultural land is due to intensive cropping system, shortening of the fallow period, reduced manure application, extensive use of crop residues as fuel or fodder and removal of ground cover. This study investigated the effect of biochar (BC), lime and farmyard manure (FYM) on growth, yield and grain nutrient of wheat on croplands at two sites in the southern Ethiopia.Result: Site significantly (P<0.05) influenced most growth parameters, yield and yield components, and grain nutrient concentration of wheat. The effects of BC, lime, and FYM were significant (p ≤ 0.001) on straw yield, grain yield, and total biomass. However, BC (5 t ha -1 ) produced the highest straw yield, grain yield and total biomass. The effects of BC, FYM and lime were significant (P < 0.001) on spike length and seed per spike. Similarly, BC and lime significantly (P < 0.001) affected plant height, number of total and productive tillers. BC (5 t ha -1 ) gave the highest plant height, total tillers and productive tillers, maximum number of seeds per spike,while FYM (10 t ha -1 ) produced the highest spike length. Biochar, FYM and lime significantly (p ≤0.001) affected thousand seed weight, but only BC had significant(p ≤0.001) effect on harvest index. Biochar (5 t ha -1 )and FYM (10 t ha -1 )produced the highest heaver thousand seed weight and the highest harvest index. Biochar significantly (P < 0.05) increased the concentrations of P and K of wheat grain. On the other hand, the highest effect on grain Ca concentration was from the application of lime while the highest effect on grain N concentration was from the application FYM (10 t ha -1 ).Conclusion: The superior effect from BC was attributed to improvements in soil pH, CEC, nutrient availability and water retention. In general, the use of BC could be better option to soil amendment for wheat production on croplands of smallholder farmers.
LINC01006 influences cell proliferation, apoptosis, migration and invasion by targeting miR-34a-5p/DAAM1 in prostate cancer
Authors: Ma Enhui , Wang Qianqian , Li Jinhua , Zhang Xinqi , Guo Zhenjia , Yang Xiaofeng
Published: February 2020

Background: Large quantities of researches have demonstrated that long noncoding RNAs (lncRNAs) exert crucial function in the development of human cancers by acting as oncogenes or tumor suppressors. LINC01006 was once found to have oncogenic function in pancreatic cancer. However, its role is still unclear in prostate cancer (PCa).Methods: RT-qPCR assay examined LINC01006, miR-34a-5p, DAAM1 expression in PCa cells. RNA pull down and luciferase reporter assay were used to certify the relationship between LINC01006 and its downstream targets.Results: LINC01006 was discovered to be remarkably high in PCa cell lines. Moreover, the functional assay validated that LINC01006 silence hindered proliferation, migration and invasion as well as accelerated apoptosis in PCa cells. The results of nucleus cytoplasm fractionation and FISH assay revealed that LINC01006 had the possibility to modulate downstream targets in ceRNA mechanism. MiR-34a-5p was selected out to be low expressed in PCa cell lines. In addition, miR-34a-5p up-regulation restricted proliferative, migratory and invaded capacities while facilitated apoptosis in PCa cells. DAAM1 was determined to be negatively regulated by miR-34a-5p. More interestingly, DAAM1 knockdown had inhibitory effects on PCa cells. Eventually, data of rescue assays exhibited that overexpression of DAAM1 countervailed the suppressive impacts of LINC01006 down-regulation on PCa progression.Conclusions: LINC01006 was an oncogene in PCa by targeting miR-34a-5p/DAAM1, which offered a novel insight for treating PCa.
Utilization of clinical practice guideline on antimicrobial and its determinants in China: A multilevel analysis
Authors: Deng Qingwen , Liu Wenbin
Published: February 2020

Background: Nowadays, irrational use of antimicrobials has threatened public health. It’s necessary to expanding the use of clinical practice guideline (CPG) on antimicrobial for facilitating the proper use of antimicrobial. However, the utilization status of CPG on antimicrobial and the influencing factors are largely unknown. Methods: A cross-sectional survey was conducted, using a structured questionnaire, on a sample among physicians from 16 public hospitals in eastern, central and western part of China. A multilevel regression model was employed to examine factors associated with physicians’ utilization of CPG on antimicrobial. Results: A total of 815 physicians included in this study. About eighty percent of the surveyed physicians reported their strict adherence to the CPG on antimicrobial. Dimensions of “subjective norm”, “perceived risk” and “behavioral intention” from the domain of physician belief, dimension of “ease of use” from the domain of CPG traits, and dimensions of “top management support” and “organization & implementation” from the domain of hospital practice were significantly associated with physicians’ utilization of CPG on antimicrobial. And most demographics of physician were not found to be significantly related to the CPG use. In addition, results showed region is a significant factor affecting physicians’ CPG use. Conclusions: This study depicted the current status of CPG on antimicrobial and comprehensively identified its potential determinants not only from the three domains, such as physician belief, at the individual level, but also from the location region at the organizational level. The results will provide direct reference on implementation of CPG on antimicrobial and will be generalizable to the setting of health care system.
Does Nursing Care Quality integrated with Clinical Governance relate to Hospital Anxiety and Depression among Elderly Patients with Coronary Heart Diseases?
Authors: Bastani Farideh , Afshar Pouya Farokhnezhad , Valipour Oldouz
Published: February 2020

Background : A coronary heart disease (CHD) is one of the causes of frequent elderly hospitalizations that are associated with psychological complications such as "hospital anxiety and depression". Furthermore, there needs to be a paradigm shift beyond routine programs toward innovative approaches such as clinical governance (CG) to improve the quality of care. This study aimed to investigate the association between Nursing Care Quality integrated with CG to Hospital Anxiety and Depression among Elderly Patients. Methods : In this descriptive correlational study, 250 elderly patients with CHD admitted to a large teaching hospital in Tehran, Iran as “Aging Friendly Hospital” selected by consecutive sampling method. The data collection instruments included the Quality Patient Care Scale (QUALPAC) and The Hospital Anxiety and Depression Scale (HADS). Data were collected by face to face interviews. Data were analyzed using descriptive and inferential statistics such as independent t-test, ANOVA and correlation coefficients in SPSS v.16 software . Results : Overall, 91.6 % of the subjects perceived the quality of nursing care integrated with CG desirable. The mean score of HADS in the subscales of anxiety and depression were (1.52 ± 1.14 and 2.18 ± 1.51) respectively which indicates hospital anxiety and depression were less than the average level. There was a negative significant correlation between the subjects’ hospital anxiety and quality nursing care (P< 0.01). Conclusion : The findings showed there is an association between perceived quality of nursing care and hospital anxiety among elderly patients. It is recommended that Managers of healthcare services should take into account CG seriously to paradigm shift beyond routinely care program toward innovative approaches of health policy.
New trend of authentic leadership skills in nursing education: The key role of perfectionism and self-efficacy
Authors: Jaworski Mariusz , Panczyk Mariusz , Leńczuk-Gruba Anna , Nowacka Agnieszka , Gotlib Joanna
Published: February 2020

Background: In the literature the need to shape leadership skills in nursing in the process of education is stressed. In order for it to be effective, actions need to be undertaken including some personality traits which may frequently be observed in students of nursing (e.g. perfectionism and self-efficacy). The role of personality traits in acquiring leadership skills is not recognized well. The aim of the study was determining whether perfectionism may be treated as a mediator between the feeling of one’s own efficacy, and authentic leadership skills in students of nursing.Methods: The group of people studied consisted of 615 students of nursing (Women = 96.3%, n=592; Men = 3.7%, n=23), who made up 67.51 % all students of the discipline. The following research tools were used: Authentic Leadership Questionnaire, Almost Perfect Scale-Revised (APS-R), and General Self-Efficacy Scale (GSES).Results: The level of perfectionism is a significant mediator of relations between self-efficacy (GSES) and the level of authentic leadership (Sobel Test: t = 6.958; p = 0.000). The relation, without a mediating factor, is positive, and standardized beta coefficient for the feeling of own efficacy totals beta = 0.470 (p = 0.000), while in the presence of a mediator the strength of the correlation is smaller and amounts to beta = 0.366 (p = 0.000).Conclusions: Taking into account personal variables (perfectionism and self-efficacy) in the process of shaping skills is of key importance. In order to increase the efficacy, the programs of teaching these skills should include mutual relation between perfectionism and self-efficacy.
Acute kidney injury incidence and acute renal replacement modality in intensive care unit patients in Indonesia: A result from Southeast Asia-Acute Kidney Injury Study
Authors: Jonny Jonny , Hasyim Moch , Angelia Vedora , Jahya Ayu Nursantisuryani , Hilman Lydia Permata , Kusumaningrum Venna Febrian , Srisa Nattachai
Published: February 2020

Background : Currently, there is limited data of large databases of acute kidney injury (AKI) epidemiology from Southeast Asia, especially in Indonesia, the biggest countries in. Therefore, we aimed to provide demographic data of intensive care unit (ICU) patients with AKI and the utilization of renal replacement therapy (RRT) in Indonesia. Methods : We collected demographic and clinical data from 952 ICU patients. Patients were classified into AKI and non-AKI. AKI was classified according to the Kidney Disease Improving Global Outcome (KDIGO) criteria in three stages. We then assess the Acute Physiology and Chronic Health Evaluation (APACHE) II score of AKI and non-AKI patients. RRT modalities were listed down by the number of procedures conducted. Results : Overall incidence of AKI was 43%, distributed among three stages: 18.5 % stage 1, 33% stage 2, 48.5 % stage 3. Patients developing AKI need mechanical ventilation more often in comparison with non-AKI. Patients with AKI have an average APACHE score of 16.5, while non-AKI patients have an average score of 9.9. Among AKI patients, 24.6% requires RRT. The most common RRT modalities were intermittent hemodialysis (69.4%), followed by slow low efficiency dialysis (22.1%), continuous renal replacement therapy (4.2%), and peritoneal dialysis (1.1%). Conclusions: This study showed that AKI is a common problem in Indonesian ICU with containing a high mortality rate. We strongly believe that identification the risk factor of AKI will provide the opportunity to develop the predictability score for AKI prevention and finally improve AKI outcome.
Comprehensive lymphadenectomy and survival prediction in uterine serous cancer patients after surgery: a population-based analysis
Authors: Li Hui , Xie Xiaofei , Liu Yunyun , Huang Xiaoxin , Lin Haoliang , Li Jing , Lin Zhongqiu
Published: February 2020

Objective Evidence on uterine serous cancer (USC) prognosis has been limited and inconclusive. We aim to explore the survival benefits of comprehensive lymphadenectomy in USC patients after surgery and develop a prognostic nomogram to predict survival. Materials and Methods USC patients who had undergone hysterectomy between 2010 and 2015 were identified from Surveillance, Epidemiology and End Results (SEER) database. The relationship between the extent of lymphadenectomy and survival, including overall survival (OS) and cancer-specific survival (CSS), was estimated with Kaplan-Meier (K-M) analysis. Univariate and multivariate Cox regression analyses were utilized to determine the independent prognostic factors. A nomogram was then developed, calibrated and internally validated. Results A total of 2853 patients were identified. K-M survival analysis revealed that patients with ≥12 pelvic lymph nodes (PLNs) removed had significantly better OS and CSS than those without (both P <0.001). However, patients with ≥6 para-aortic lymph nodes removed was not associated with similar survival benefits than patients without ( P >0.1). Multivariate analyses for OS and CSS revealed that age, T stage, N stage, tumor size, adjuvant therapy and ≥12 PLNs removed were independent prognostic factors (all P<0.05) and were subsequently incorporated into the nomogram. The Harrell’s C-index of the nomogram was significantly higher than that of the International Federation of Gynecology and Obstetrics staging system (OS: 0.739 vs 0.671, P <0.001; CSS: 0.752 vs 0.695, P <0.001). Furthermore, the nomogram was well calibrated with satisfactory consistency. Conclusions Comprehensive pelvic lymphadenectomy should be recommended to USC patients for its survival benefits. And a nomogram has been developed to predict the survivals of USC patients after surgery.
COVID-19 Spike-host cell receptor GRP78 binding site prediction
Authors: Ibrahim Ibrahim , Abdelmalek Doaa , Elshahat Mohamed , Elfiky Abdo
Published: February 2020

Coronaviruses have been circulating between animals and humans repeatedly. A novel human coronavirus, named COVID-19, has recently emerged in Hubei Province, China. Within the first two months, more than 2200 deaths have been confirmed, and there have been more than 79,000 hospitalized patients, mainly in China. Understanding the virus mode of host cell recognition may help to fight the disease and save lives. The spike protein of coronaviruses is the main driving force for host cell recognition. In this study, the COVID-19 corona viral spike binding site to the cell-surface receptor (Glucose Regulated Protein 78 (GRP78)) is predicted using combined molecular modeling docking and structural bioinformatics. The cyclic peptide Pep42 (CTVALPGGYVRVC) was reported earlier to be the docking platform of GRP78 in cancer cells. The COVID-19 spike protein is modeled using its counterpart, the SARS spike. Sequence and structural alignments show that four regions, in addition to its cyclic nature (the S-S bond), have sequence and physicochemical similarities to the cyclic Pep42. Protein-protein docking was performed to test the four regions of the spike that fit tightly in the GRP78 Substrate Binding Domain β (SBDβ). The docking pose revealed the involvement of the SBDβ of GRP78 and the receptor-binding domain of the coronavirus spike protein in recognition of the host cell receptor. We reveal that the binding is more favorable between regions III (C391-C525) and IV (C480-C488) of the spike protein model and GRP78. Region IV is the main driving force for GRP78 binding with the predicted binding affinity of -9.8 kcal/mol. These nine residues (region IV) of the spike can be used to develop therapeutics specific against COVID-19.
Presence of heat shock protein 47-positive fibroblasts in cancer stroma is associated with increased risk of postoperative recurrence in patients with lung cancer
Authors: Miyamura Takuto , Sakamoto Noriho , Ishida Kaori , Kakugawa Tomoyuki , Taniguchi Hirokazu , Okuno Daisuke , Hara Atsuko , Kido Takashi , Ishimoto Hiroshi , Miyazaki Takuro , Matsumoto Keitaro , Tsuchiya Tomoshi , Yamaguchi Hiroyuki , Obase Yasushi , Ishimatsu Yuji , Nagayasu Takeshi , Mukae Hiroshi
Published: February 2020

Background Heat shock protein 47 (HSP47), a collagen-binding protein, has a specific role in the intracellular processing of procollagen production. HSP47 expression is associated with cancer growth and metastasis in several types of cancers. However, none of the studies have assessed whether HSP47 expression is associated with the risk of postoperative recurrence of lung cancer until now. Therefore, we aimed to assess this association. Methods The study population consisted of a cohort of consecutive patients who underwent surgery for lung cancer at Nagasaki University Hospital, Nagasaki, Japan, from January 2009 to December 2010. Patient characteristics, survival and disease-free survival (DFS), and laboratory findings were compared between patients who tested positive and negative for HSP47 expression in lung cancer cells and between those who showed high and low numbers of HSP47-positive fibroblasts in cancer stroma. ResultsA total of 133 patients underwent surgery for lung cancer. Sixty-seven patients (48.5%) showed HSP47-positive cancer cells, and 83 patients (62.4%) showed a higher number of HSP47-positive fibroblasts. The patients with a high number of HSP47-positive fibroblasts had a shorter DFS than those with a low number of HSP47-positive fibroblasts. Multivariate analysis identified only the presence of a high number of HSP47-positive fibroblasts as an independent risk factor for recurrence of lung cancer after surgery (odds ratio, 4.086; 95% confidence interval, 1.116–19.68; P = 0.033) Conclusion The present study demonstrated that the presence of a high number of HSP47-positive fibroblasts in the cancer stroma was a risk factor for recurrence of lung cancer after surgery.
Small intestinal mucosal injury in patients with gastrointestinal cancer who develop complicated fluoropyrimidine-induced diarrhea
Authors: Sakumura Miho , Ando Takayuki , Hosokawa Ayumu , Motoo Iori , Mihara Hiroshi , Ueda Akira , Kajiura Shinya , Nanjo Sohachi , Fujinami Haruka , Ogawa Kohei , Yasuda Ichiro
Published: February 2020

Background: Diarrhea is a common adverse event of fluoropyrimidine-based chemotherapy. However, no treatment with promising evidence has been established for chemotherapy-induced diarrhea (CID); limited data are available on the frequency of complicated CID and small intestinal mucosal damage. In this current study, we aimed to determine the incidence of complicated CID and mucosal injury among patients with complicated CID receiving fluoropyrimidine via small bowel capsule endoscopy (CE). Methods: In total, 536 patients with advanced or recurrent gastrointestinal cancer who received fluoropyrimidine-based chemotherapy were retrospectively analyzed. Diarrhea was evaluated using the Common Terminology Criteria for Adverse Events version 4. Complicated CID was defined according to the American Society of Clinical Oncology guidelines. To evaluate small intestinal mucosal injury in patients with complicated CID, CE was performed. Multivariate analysis was performed to identify risk factors for complicated CID.Results: In total, 32 (6%) patients developed complicated CID. Complicating symptoms were noted in 24 (75%) patients, with cramping, vomiting, and sepsis being observed in 15 (63%), 8 (33%), and 2 (8%) patients, respectively. Among the 12 patients who underwent CE, 10 (83%) exhibited abnormal findings. Multivariate analysis showed that oral fluoropyrimidine administration was a risk factor for complicated CID (odds ratio, 2.95; 95% confidence interval, 1.06–8.19).Conclusions: Despite the relatively low incidence of complicated CID, most patients with complicated CID exhibited small intestinal mucosal injury, with some developing fever or sepsis as complications. Thus, bacterial translocation secondary to small intestinal mucosal injury should be considered in the management of patients with complicated fluoropyrimidine-induced diarrhea.
Percutaneous stent placement for malignant hilar biliary obstruction: side-by-side versus stent-in-stent technique
Authors: Zhou Wei-zhong , Liu Sheng , Yang Zheng-Qiang , Xian Yu-Tao , Xu Hong-Dou , Wu Jun-Zheng , Shi Hai-bin
Published: February 2020

PURPOSE To compare the clinical efficacy and safety between side-by-side (SBS) and stent-in-stent (SIS) deployment for malignant hilar biliary obstruction via percutaneous approach. METHODS From July 2012 to April 2019, 65 patients with malignant hilar biliary obstruction who underwent bilateral stenting using either the SBS or SIS techniques were included in this study. Among them, 27 patients underwent stent insertion with a SIS mode (SIS group), and the remaining 38 patients with a SBS mode (SBS group). Technical success, improvement of jaundice, complications, duration of stent patency, and overall survival were evaluated. RESULTS Technical success was achieved in all patients of the two groups. The serum bilirubin level reduced quicker at 1 week after the procedures in the SBS group compared with the SIS group (P=0.02). Although the total complication rate did not differ between the two groups, cholangitis was found to be more frequent in the SIS group (P=0.04). The median stent patency was significant longer in the SBS group (149 days) than in the SIS group (75 days; P=0.02). The median overall survival did not differ significantly between the two groups (SBS vs. SIS, 155 days vs. 143 days; P>0.05). CONCLUSIONS Percutaneous transhepatic bilateral stenting using either SBS or SIS techniques is safe and effective in the management of malignant hilar biliary obstruction. However, SBS offers quicker improvement of jaundice, a lower incidence of cholangitis after the procedures, and a longer stent patency period than SIS.
Downregulation of Long Noncoding RNA TUG1 Attenuate MTDH /NF-κB/IL-1β mediated inflammatory damage via Targeting miR-29b-1-5p After Spinal cord ischemia reperfusion in rats
Authors: Jia Hui , Li Zhe , Fang Bo , Chang Yi , Zhou Yongjian , Ma Hong
Published: February 2020

Background: Spinal cord ischemia reperfusion (IR) is associated with an inflammatory response. The long non-coding RNA (lncRNA) taurine upregulated gene 1 (TUG1) and microRNA-29b (miR-29b) family are frequently dysregulated in neuro-ischemic diseases. However, their potential roles in spinal cord IR injury (IR) are unknown. Methods: A spinal cord IR model was established in rats by14-minute occlusion of aortic arch. The aberrant miRNAs were identified by microarray analysis, and qRT-PCR was used to validate the lncRNA and microRNA levels. The motor function of the differentially-treated animals was assessed by Tarlov scores, and the leakage of Blood-spinal cord barrier (BSCB) was measured in terms of the extravasation of Evans blue (EB) dye. The expression levels of different proteins were analyzed by Western blotting and immunofluorescence. The interaction between TUG1 and miR-29b-1-5p, TRIL and miR-29b-1-5p, and MTDH and miR-29b-1-5p were determined using bioinformatics programs and the dual-luciferase reporter assay. Results: MiR-29b-1-5p was significantly downregulated and TUG1 was upregulated in the spinal cord of rats after IR. In addition, TRIL and MTDH protein levels were also significantly increased after IR. MTDH was predicted as a target of miR-29b-1-5p and its knockdown downregulated NF-κB and IL-1β levels. In addition, a direct interaction was observed between TUG1 and miR-29b-1-5p, and knocking down TUG1 upregulated the miRNA. Furthermore, overexpression of miR-29b-1-5p or TUG1 knockdown alleviated BSCB leakage and improved hind-limb motor function, and downregulated MTDH and its downstream pro-inflammatory cytokines. Suppression of miR-29b-1-5p reversed the neuroprotective effect of TUG1 knockdown, restored the levels of MTDH/ NF-κB/IL-1β and activated astrocytes. Conclusion: Downregulation of TUG1 alleviated MTDH/NF-κB/IL-1β pathway-mediated inflammatory damage after IR by targeting miR-29b-1-5p. Keywords: Spinal cord ischemia reperfusion injury, Neuroinflammation, Blood-spinal cord barrier, Astrocytes, TUG1, miR-29b-1-5p, MTDH