bluuebunny/crossref_metadata_2025_split huggingface dataset:
Case report: New clinical clue of hyper-endogenous heparinization provides an imperative guideline for Treatment of Postpartum Hemorrhage with DIC via TEG guides and protamine intervention
Authors: Yan Tian , Fei He , Dong Lai , Changfu Ji 
Published: June 2020

Abstract
BackgroundPostpartum hemorrhage (PPH) is a leading cause of maternal mortality and severe maternal morbidity worldwide and involves disseminated intravascular coagulation (DIC) secondary to cause massive blood loss. The coagulation abnormality in response to severe trauma or infection is a latent cause that may aggravate PPH.Case presentationA 26-year-old puerpera with 39 weeks of menolipsis case lacks amniotic fluid and uterus infection was examined. During the cesarean section, the patient presented fever and massive hemorrhage that she became the DIC and shock. The low coagulation of this PPH patient was diagnosed by Thromboelastography (TEG) guiding with heparinase (type I). The patient appeared a critical condition admitted in emergency room. According the continuous detection via TEG guides assay, she was observed in coagulopathy and hyper-heparinization. And subsequently the protamine correction for the patient's coagulation abnormality, the patient who became a stable condition after 4 hours of urgent treatment.ConclusionTEG-guided determination of endogenous heparin and subsequent infusion of protamine effectively reversed the syndrome of PPH with DIC. This is the first case report that infection and bleeding might be major causes of hyper-endogenous heparinization without exogenous heparin intervention. The hyper-endogenous heparinization is clinically taken into consideration for the syndrome of PPH with low coagulation.
EML4-ALK induces cellular senescence in mortal normal human cells and promotes anchorage-independent growth in immortalized normal human cells
Authors: Miyanaga Akihiko , Matsumoto Masaru , Beck Jessica A. , Horikawa Izumi , Oike Takahiro , Okayama Hirokazu , Tanaka Hiromi , Burkett Sandra S. , Robles Ana I. , Khan Mohammed , Lissa Delphine , Seike Masahiro , Gemma Akihiko , Mano Hiroyuki , Harris Curtis C. 
Published: June 2020

Abstract
Background: Chromosomal inversions involving anaplastic lymphoma kinase (ALK) and echinoderm microtubule associated protein like 4 (EML4) generate a fusion protein EML4-ALK in non-small cell lung cancer (NSCLC). The understanding of EML4-ALK function can be improved by a functional study using normal human cells.Methods: Here we for the first time conduct such study to examine the effects of EML4-ALK on cell proliferation, cellular senescence, DNA damage, gene expression profiles and transformed phenotypes.Results: The lentiviral expression of EML4-ALK in mortal, normal human fibroblasts caused, through its constitutive ALK kinase activity, an early induction of cellular senescence with senescence-associated b-galactosidase activity, upregulation of p16INK4A and p21WAF1, and accumulated DNA damage. In contrast, when EML4-ALK was expressed in normal human fibroblasts immortalized by telomerase reverse transcriptase (hTERT), which is activated in the vast majority of NSCLC, the cells showed accelerated proliferation and acquired anchorage-independent growth ability in soft-agar medium, without accumulated DNA damage, chromosome aberration, nor p53 mutation. EML4-ALK induced the phosphorylation of STAT3 in both mortal and immortalized cells, but RNA sequencing analysis suggested that the different STAT3-regulated signaling pathways contributed to the different phenotypic outcomes in these cells. While EML4-ALK also induced anchorage-independent growth in hTERT-immortalized human bronchial epithelial cells in vitro, the expression of EML4-ALK alone did not cause detectable in vivo tumorigenicity in immunodeficient mice.Conclusions: Our data indicate that the immortalized state is critical for EML4-ALK to manifest its in vitro transforming activity in human cells. This study provides the isogenic pairs of human cells with and without EML4-ALK expression.
Talking the talk in junior interprofessional education: Is healthcare terminology a barrier or facilitator?
Authors: Nadarajah Shamara , Azim Arden , Yılmaz Derya Uzelli , Sibbald Matthew 
Published: June 2020

Abstract
Background
Use of jargon and complex healthcare terminology is a potential barrier to interprofessional education (IPE). Healthcare terminology can be separated into two categories: inclusive terminology shared amongst professions, and exclusive terminology unique to one profession. We sought to understand how complex terminology is perceived by junior learners in an IPE setting.
Methods
We conducted a mixed methods study involving medical, nursing, and physician assistant students attending IPE simulation workshops. Students reviewed scenarios used in the workshops and identified terminology they considered “inclusive” or “exclusive”. Then, students participated in focus group discussions surrounding attitudes/perceptions towards healthcare terminology.
Results
23 students analyzed 14 cases, identifying on average 21 terms per case as healthcare terminology (29% of overall word count). Of the 290 terms identified, 113 terms were classified as healthcare terminology, 46 as inclusive and 17 as exclusive by > 50% of participants. Analysis of focus group transcripts revealed 4 themes: abbreviations were commonly perceived as complex terminology, unfamiliarity with terminology was often attributed to being early in training even if exclusive, simulation was considered a safe space for learning, and learning terminology was a valued objective in early IPE.
Conclusions
Students perceive a lot of healthcare terminology in learning materials, which is recognized as a valuable learning objective in their early IPE experiences, but also a challenge. Categorization of healthcare language is inconsistent among students and may reflect individual differences in prior experiences. Overall, healthcare terminology is a valued desirable difficulty among junior learners, and should not be avoided in IPE.
Specialty Career Preferences among Final Year Medical Students at the School of Medicine, Makerere University College of Health Sciences, Uganda
Authors: Kuteesa Job , Musiime Victor , Munabi Ian G. , Mubuuke Aloysius G. , Opoka Robert , Mukunya David , Kiguli Sarah 
Published: June 2020

Abstract
Background : Uganda has an imbalanced distribution of the health workforce, which may be influenced by the specialty career preferences of medical students. In spite of this, there is inadequate literature concerning the factors influencing specialty career preferences in our setting. We aimed to determine the specialty career preferences and the factors influencing the preferences among final year medical students in the School of Medicine, Makerere University College of Health Sciences (MakCHS). Methods: A sequential explanatory mixed methods study design with a descriptive cross-sectional study followed by a qualitative study was used. A total of 135 final year medical students in MakCHS were recruited using consecutive sampling. Self-administered questionnaires and three focus group discussions were conducted. Quantitative data was analysed in STATA version 13 (StataCorp, College Station, Tx, USA) using descriptive statistics, chi-square tests and logistic regression. Qualitative data was analysed in NVIVO version 12 (QRS International, Cambridge, MA) using content analysis. Results: Of 135 students 91 (67.4%) were male and their median age was 24 years (IQR: 24, 26). As a first choice, the most preferred specialty career was obstetrics and gynecology (34/135, 25.2%), followed by surgery (27/135, 20.0%), pediatrics (18/135, 13.3%) and internal medicine (17/135, 12.6%). Non-established specialties such as anesthesia and Ear Nose and Throat (ENT) were not selected as a first choice by any student. Female students had 63% less odds of selecting surgical related specialties compared to males (aOR=0.37, 95%CI: 0.17-0.84) . The focus group discussions highlighted controlled lifestyle, assurance of a good life through better financial remuneration and inspirational specialists as facilitators for specialty preference. Bad experience during the clinical rotations, lack of career guidance plus perceived poor and miserable specialists were highlighted as barriers to specialty preference. Conclusion. Obstetrics and Gynecology, Surgery, Pediatrics and Internal Medicine are well-established disciplines, which were dominantly preferred. Females were less likely to select surgical disciplines given the perceived effects on lifestyle by these disciplines for example interruption of family life. Therefore, a need to formulate career guidance and mentorship programs is required, to attract students to the neglected disciplines.
A WISH questionnaire to measure the faculty perceptions of the medical simulation environment as their workplace
Authors: Torres Kamil , Mamcarz Izabela , Radczuk Natalia , Mamcarz Piotr , Torres Anna 
Published: June 2020

Abstract
Background

The medical simulation environment is a specific type of work environment. It would seem essential for educators to have a tool with which they could identify its features to maximize the effectiveness of medical simulation – teachers’ workplace - and optimize their work efforts. The purpose of this research study was to construct a proprietary tool, which would help to characterize the medical simulation environment as a type of work environment and also to identify particular factors that are important in organizing the educational environment in simulation.
Methods

At first, six faculty members took part in semi-structured interviews, whose findings were used to develop a standardized questionnaire consisting of 30 items. The authors then validated the questionnaire in a survey among the other 32 academic teachers involved in teaching with the use of medical simulation.
Results

The Work In Simulation Healthcare questionnaire addresses the aspects of teaching in a simulation environment referring to technical-administrative conditions, teacher development, and the overall score. The Cronbach's alpha reliability index for the overall result of the questionnaire is α = 8.22 based on standardized items; the reliability index for the scale of ‘the technical and administrative conditions’ and ‘the professional development of teachers’ is α = 0,57 and α = 0,76, respectively. The questionnaire allowed the authors to know the ratings of academic teachers for the two scales.
Conclusions

The Work In Simulation Healthcare questionnaire allows educators to identify the traits of the simulation-teaching environment. It provides the potential to optimize the conditions of medical simulation, improve the quality of teaching and the overall educational process, as well as design effective faculty development programs. The authors of this study consider the WISH questionnaire the first method of this type.
LncRNA SBF2-AS1 Promotes Malignant Phenotypes and Radioresistance of Glioblastoma Cells by Impairing miR-338-3p-targeted MAP4K3 Inhibition
Authors: Pan Hong , XU Jiajun , Wang Guodong , Wang Zheng , Yao Zhigang , Zheng Zhiming 
Published: June 2020

Abstract
Background: Glioblastoma multiforme (GBM) is the most common and aggressive primary brain tumors in adults. LncRNA SBF2-AS1 has been reported to promote malignant progression in multiple human cancers. However, the roles and underlying mechanisms of SBF2-AS1 in GBM are still unknown.Methods: The levels of SBF-AS1 were identified in GBM tissues and normal brain tissues, and in GBM cell lines and normal human astrocytes. The effect of SBF2-AS1 on proliferation, invasion and radiosensitivity was evaluated by CCK-8 assay, transwell assay, γ-H2AX foci assay and clonogenic survival assay in vitro and in vivo. The interactions among SBF2-AS1, miR-338-3p and MAP4K3 were validated through luciferase report, RNA immunoprecipitation and western blot assays. Results: In the present study, we comfirmed that SBF2-AS1 was highly upregulated in GBM tissues and cell lines, and its levels were markedly higher in WHO stage III-IV gliomas compared with WHO stage I-II gliomas. Kaplan-Meier survival analysis revealed that glioma patients with high SBF2-AS1 expression had shorter overall survival than those with low SBF2-AS1 expression. SBF2-AS1 inhibition suppressed the proliferation of GBM cells by down-reguating of Ki-67 and CyclinD1. Moreover, silencing SBF2-AS1 increased the proportion of cells in G1 phase and decreased the proportion of cells in S phase. In addition, SBF2-AS1 inhibition suppressed the invasion of GBM cells by down-reguating of MMP2 and MMP9. Xenograft tumor models revealed that the silencing of SBF2-AS1 inhibited tumor growth in vivo. Moreover, the silencing of SBF2-AS1 significantly sensitized GBM cells to radiation in vitro and in vivo. Indeed, we observed a persistence of γ-H2AX staining after ionizing radiation, leading to enhanced DNA repair and radioresistance. Mechanistically, SBF2-AS1 inhibition reduced the expression of MAP4K3 by directly binding with miR-338-3p in GBM cells. Conclusions: Our study demonstrated that SBF2-AS1 enhanced cell proliferation, invaison and radioresistance via modulating miR-338-3p/MAP4K3 axis, and it is an attractive therapeutic target to overcome radioresistance of GBM.
Screening of Klebsiella Pneumoniae for Carbapenem Resistance and MIC of Imipenem
Authors: Saud Sarada , Agrawal Ashwani , Pokhrel Soniya , Subedi Sushma , Shrestha Sanjit , Amatya Niroj Man 
Published: June 2020

Abstract
Background: Klebsiella pneumoniae is a common opportunistic pathogen causing a wider range of infections, pneumonia, urinary tract infection, bacteremia, and liver abscesses; primarily in immunocompromised as well as immunocompetent individuals. This bacterium presents itself as an antibiotic resistant one especially in third generation cephalosporins and carbapenem, creating serious global challenges. Therefore, this cross-sectional study was conducted in B & B Hospital, Lalitpur with the aim to screening the distribution of carbapenem resistance Klebsiella pneumoniae through ertapenem and assess the minimum inhibitory concentration of imipenem for screened carbapenem positive K. pneumoniae. Methods: From 3447 different clinical samples collected according to standard guidelines, Klebsiella pneumoniae was identified through conventional microbiological techniques, staining and a panel of biochemical tests. The antibiotic susceptibility test of isolates was performed by the Kirby-Bauer disc diffusion method as per CLSI 2018 guidelines. Screening of carbapenem resistant was assessed by using ertapenem disc and the MIC of imipenem for carbapenem resistant and intermediate was done through epsilometer. Results: A total of 85 nonduplicate Klebsiella pneumoniae were identified and their antibiotic susceptibility test revealed that ceftriaxone was the least effective antibiotic. The number of MDR, carbapenem resistant and intermediate isolates was 51, 46 and 3, respectively. The MIC of imipenem through epsilometer from resistant and intermediate ertapenem isolates revealed that 31, 5 and 13 isolates were resistant, intermediate and sensitive, respectively.Conclusion: These findings showed the inconsistency in detection of carbapenem resistant isolates in routine microbiology laboratories and further support the other tests for detection of carbapenem resistance as suggested by CLSI.
Integrated analysis identifies a pathway-related competing endogenous RNA network in the progression of Pancreatic cancer
Authors: Tan Xiaodong , Zu Fuqiang , Liu Peng , Wang Huaitao , Zhu Ting , Sun Jian , Sheng Weiwei 
Published: June 2020

Abstract
Background
It is well acknowledged that cancer-related pathways play pivotal roles in the progression of pancreatic cancer (PC). Employing multi-omics analysis, we aim to identify the pathway-related ceRNA network associated with PC progression.
Methods
We divided eight GEO datasets into three groups according to their platform, and combined TCGA and GTEx databases as a group. Additionally, we screened out the differentially expressed genes (DEGs) and performed functional enrichment analysis in each group, and recognized the top hub genes in the most enriched pathway. Furthermore, the upstream of miRNAs and lncRNAs were predicted and validated according to their expression and prognostic roles. Finally, the co-expression analysis was applied to identify a pathway-related ceRNA network in the progression of PC.
Results
A total of 51 significant pathways that common enriched in all groups were spotted. Enrichment analysis indicated that pathway in cancer was greatly linked with tumor formation and progression. Next, the top 20 hug genes in this pathway were recognized, and stepwise prediction and validation from mRNA to lncRNA, including 11 hub genes, 4 key miRNAs, and 2 key lncRNAs, were applied to identify a meaningful ceRNA network according to ceRNA rules. Ultimately, we identified the PVT1/miR-20b-/CCND1 axis as a promising pathway-related ceRNA axis in the progression of PC.
Conclusion
Overall, we elucidate the pathway-related ceRNA regulatory network of PVT1/miR-20b-/CCND1 in the progression of PC, which can be considered as therapeutic targets and encouraging prognostic biomarkers for PC.
miR-105-3p acts an oncogene to promote proliferation and metastasis of breast cancer cell by targeting GOLIM4miR-105-3p acts an oncogene to promote proliferation and metastasis of breast cancer cell by targeting GOLIM4
Authors: Lin Bo , Shi Enyi , Jin Qiu , Zhao Wenhui , Wang Juan , Ji Runyuan 
Published: June 2020

Abstract
Background: Dysregulation of miRNAs is involved in carcinogenesis of breast cancer and may be used to prognostic biomarkers and therapeutic target during cancer process. The purpose of this study was to explore the effects of miR-105-3p on tumourigenicity of breast cancer and its underlying molecular mechanisms.Methods: Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was applied to detect the miR-105-3p in breast cancer tissues. The impacts of miR-105-3p on proliferation, migration, invasion and apoptosis of human breast cancer lines (MCF-7 and ZR-75-30) were evaluated by CCK-8, transwell chamber assay, TUNEL assay and western blot assay, respectively. Besides, bioinformatics and luciferase reporter assay were used find out the targeted gene of miR-105-3p.Results: The expression of miR-105-3p was elevated in breast cancer tissues and increased with tumor severity. Downregulation of miR-105-3p could inhibit cell proliferation, suppress cell migration/invasion, and promote cell apoptosis in MCF-7 and ZR-75-30 cells. Furthermore, Golgi integral membrane protein 4 (GOLIM4) was identified to be the direct target gene of miR-105-3p by bioinformatics and luciferase reporter assay. In addition, silencing of GOLIM4 could restore the anti-breast cancer effects induced by miR-105-3p downregulation.Conclusions: miR-105-3p acts an oncogene to promote proliferation and metastasis of breast cancer cell by targeting GOLIM4, which provides a new target for the prevention and treatment of breast cancer.
Suppression of FoxO3a Increases Responsiveness of Glioma Cells to Radiation Treatment
Authors: Wang Zhihan , Chen Binghong , Liao Keman , Xu Hao , Xing Jin , Wei Zilong , Liu Chaobo , Lin Yingying , Ren Li 
Published: June 2020

Abstract
Background Glioblastoma multiforme (GBM) is the most deadly and common cerebral malignant tumors in adults. Radiotherapy is one of the major treatments for GBM patients. Further work is urgently required to discover the mechanisms conferring GBM radioresistance.Methods Reverse transcription-quantitative PCR was applied to detect the relative expression of FoxO3a in glioma cell lines after radiation. Lentivirus mediated FoxO3a knockdown cells were constructed and were confirmed by RT-qPCR and western blot. Plate clone formation assay and flow cytometry was used to determine the colony formation ability and cell apoptosis following radiotherapy, respectively. DNA damage and levels of apoptotic proteins were determined by comet assay and western blot.Results FoxO3a was significantly up-regulated in GBM cells in response to radiation. Knockdown of FoxO3a enhances the responsiveness of glioma cells to radiotherapy, the cell clonogenic formation and DNA repair process with elevated the percentage of apoptotic cells. Moreover, suppression of FoxO3a increased pro-apoptotic proteins Caspase 3, Caspase 7 and Bax levels after radiotherapy.Conclusions The study indicated that suppression of FoxO3a increased radiosensitivity in glioma cells, which might be a potential diagnostic and therapeutic target. Inhibition of FoxO3a expression enhances the responsiveness of glioma cells to radiotherapy, and its proliferation ability is weaker than that of normal Foxo3 cells
Prevalence and Determinants of Substance Use Among a Sample of Iranian Adolescents with Ease of Access to Drugs: An Application of Social Development Model
Authors: Bami Roya Shahsavari , Khoshab Hadi , Davarani Mohammad Mehdi Fadakar , Jahani Yunes , Nakhaee Nozar , Nadrian Haidar , Iranpour Abedin 
Published: June 2020

Abstract
Background Explaining the risk and protective factors of substance use (SU) is the most important principle while designing preventive interventions. The aim of this study was to investigate the prevalence rate and determinants of SU in adolescents based on the social development model (SDM). Method In 2018, applying a cross-sectional design, cluster multistage random sampling was employed to recruit 600 adolescents in Bam County, Iran, to participate in the study. A valid and reliable SDM-based instrument was used to collect data.Results The prevalence rate of using at least one substance was 42% (in girls 33.6% and in boys 50.3%). Having close friends with SU was found as the riskiest factor. A score increase in involvement in prosocial activities and interactions, attachment and commitment to prosocial others (family and school), and skills for interaction/involvement among adolescents reduced the probability of ever use of SU by 53%, 37% and 49%, respectively. Also, one score increase in perceived rewards for antisocial interaction/involvement, belief in antisocial values and situational perception among the participants increased the probability of ever use SU by 2.22, 2.24 and 1.22 times. Conclusion The SDM was helpful in determining the predictors of SU among Iranian adolescents. In community-based interventions to prevent SU among adolescents, a great focus should be firstly on identifying the probability of SU in close friends. Moreover, the involvement of adolescents in prosocial activities and interactions, attachment and commitment to prosocial others (family and school), and skills for interaction/involvement should be core categories while designing community-based interventional studies.