bluuebunny/crossref_metadata_2025_split huggingface dataset:
Molecular cloning, characterization, and expression analysis of lipopolysaccharide-induced TNF-α factor (LITAF) in the mud crab, Scylla paramamosain
Authors: Wu Yue , Sun Yuxiao , Zhang Wanrong , Yang Jingjing , Zhou Xiefei , Xu Liaoyi , Wang Peichen , Xu Haisheng 
Published: July 2020

Abstract
Lipopolysaccharide-induced TNF-α factor (LITAF) is an important transcription factor mediating the expression of inflammatory cytokines, including TNF-α, which is involved in the innate immune defence against infectious agents. In this study, the Scylla paramamosain LITAF (LITAF) gene was cloned and identified from S. paramamosain using RT-PCR and RACE. The full length cDNA of LITAF was 1116 bp, contained an ORF of 495 bp encoding a polypeptide of 164 amino acids with predicted molecular mass of 17.86 kDa and a theoretical isoelectric point of 8.51. Sequence alignment showed that LITAF possessed a typical LITAF domain with two CXXC motifs and eight conserved cysteine residues. Phylogenetic analysis indicated that LITAF clustered closely with known LITAFs from Eriocheir sinensis and Litopenaeus vannamei. qRT-PCR analysis showed LITAF mRNA transcript expressed ubiquitously in all examined tissues with the highest expression in haemocytes, while lower expression in hepatopancreas. Its expression levels displayed a trend of up-regulation and then returned to its initial value in haemocytes and gill, post challenge with LPS, Poly (I : C), and Vibrio alginolyticus, respectively. Furthermore, the LITAF protein was verified to be located in hyalinocytes, semi-granulocytes and granulocytes, and was distributed throughout the cytoplasm and nucleus, especially in cytoplasm. These results provide a basis for further investigating the roles of LITAF in the immune signaling pathways as a transcription factor in S. paramamosain.
Is It Important Which Suturing Technique Used for Pharyngeal Mucosal Closure in Total Laryngectomy? Modified Continuous Connell Suture May Decrease Pharyngocutaneous Fistula
Authors: Avci Hakan , Karabulut Burak 
Published: July 2020

Objective: The aim of this study is to research the correlation between pharyngeal mucosal suture techniques and pharyngocutaneous fistula (PCF) development after total laryngectomy. We also aimed to investigate other risk factor for fistula development. Methods: Medical charts of 85 patients who had total laryngectomy during August 2016 and February 2020 were reviewed. Sixteen patients were excluded due to exclusion criteria. Patients were grouped according to pharyngeal mucosal suture technique. Group 1 had modified continuous Connell suture and group 2 had interrupted submucosal suture for mucosal closure of pharynx. Demographic, medical, and surgical records reviewed for comparison. Results: Overall PCF rate was 28%;PCF rates were 16% (5/31) in group 1 and 39% (15/38) in group 2. This difference was significant (Pearson χ2 P = .033). There was no difference between groups due to age, gender, smoking history, tumor stage preoperative albumin levels, preoperative hemoglobin levels, radiotherapy status, chronic obstructive pulmonary disorder and diabetes mellitus history of patients, previous tracheostomy, neck dissection. But correlation analysis revealed that PCF formation significantly related with suture technique ( P = .032), preoperative albumin level <3.5 g/dL ( P = .028), preoperative hemoglobin level <12.5 g/dL ( P = .041), and previous radiotherapy status ( P = .012) of the patients. We also showed that suture technique is an independent predictive factor for PCF formation when other factors were controlled by univariate analysis. Conclusion: The suture technique used for pharyngeal mucosal closure, preoperative albumin level <3.5 g/dL, preoperative hemoglobin levels<12.5 g/dL, and previous radiotherapy to the head and neck are risk factors for PCF development. Modified continuous Connell suture is a good option for pharyngeal closure.
Ten-year retrospective study on mandibular fractures in central Taiwan
Authors: Chen Yi-Tzu , Chiu Yu-Wei , Chang Yu-Chao , Lin Chiao-Wen 
Published: July 2020

Objective To analyse the epidemiology of mandibular fractures and the correlation between combined fractures during a 10-year period in central Taiwan. Methods This retrospective study analysed data collected from the medical records of patients that had mandibular fractures between January 2007 and October 2017. Data on age, sex, cause of injury, anatomical site of fracture, treatment and complications were obtained and analysed. Results A total of 265 patients who received treatment were included in the study. The mean ± SD age was 30.08 ± 13.47 years (range, 6–70 years) and the 21–30 years age group showed the highest incidence of mandibular fractures. The male-to-female ratio was 1.25:1. Road traffic accidents were the most common cause of fracture (206 of 265; 77.74%). The symphysis and parasymphysis area was the most common fracture site (169 of 420; 39.29%). Single-site fracture represented slightly more than 50% of the total 420 fractures. The most frequent combination of two fractures was an angle fracture combined with a symphysis and parasymphysis fracture (29 of 106 double fracture patients [27.36%]). There was a weak positive association between several combinations of fractures. Conclusions A better understanding of the influence of age and sex on the mechanism of injury is of great clinical importance in the assessment and diagnosis of fractures.
Multiple functions of policosanol in elderly patients with dyslipidemia
Authors: Li Chunlin , Ding Yu , Si Quanjin , Li Kailiang , Xu Kun 
Published: July 2020

Objective To determine the multiple functions of policosanol in elderly dyslipidemia patients. Methodology: There were 294 elderly dyslipidemia patients enrolled into this clinical study. They were randomly divided into four groups, as follows: 20 mg policosanol (group A, n = 64); 10 mg policosanol (group B, n = 72); 20 mg atorvastatin (group C, n = 91); and 10 mg policosanol + 20 mg atorvastatin (group D, n = 62). Plasma platelet count, platelet aggregation rate, circulating endothelial cell (CEC) count, high sensitivity C-reactive protein (hs-CRP), and carotid intima–media thickness (IMT) were measured before the study (week 0) and at weeks 12, 24, and 52. Results In group A, the platelet aggregation rate caused by adenosine diphosphate (ADP) after treatment was significantly decreased compared with before treatment (48.79% ± 20.29% vs. 40.37% ± 23.56%), but the arachidonic acid (AA)-induced platelet aggregation rates were similar. The platelet aggregation rates induced by AA and ADP in groups B, C, and D did not change significantly. CEC counts and hs-CRP and homocysteine levels in all groups after treatment were significantly lower compared with before treatment, but carotid IMTs were similar. Conclusion Policosanol regulates blood lipid levels and improves endothelial cell function, and it could delay the progress of atherosclerosis. Trial registration number: ChiCTR-RRC-17013396 (retrospectively registered).
Histopathology of inferior vena cava obstruction in Budd–Chiari syndrome by clamp biopsy
Authors: Bi Yonghua , Zhu Xiaoyan , Yi Mengfei , Han Xinwei , Ren Jianzhuang 
Published: July 2020

Objective We aimed to analyze the pathological changes of the occlusive area of the inferior vena cava (IVC) in patients with Budd–Chiari syndrome (BCS) and to explore its possible etiology and pathogenesis. Methods Color Doppler ultrasound and IVC angiography were used to evaluate causes of occlusion. Clamp biopsies were performed in the occlusive area of the IVC in 31 patients with BCS, and the specimens were examined pathologically. Clinical data were collected retrospectively. Results The success rate of clamp biopsy was 100% (31/31) and the sensitivity of pathology was 96.8% (30/31). By microscopic analysis, we found 27 cases of fibrous connective tissue, including 8 cases of thrombosis and 19 cases of inflammatory cell infiltration, vitreous degeneration, or mucinous degeneration of fibrous connective tissue; 3 cases showed thrombus organized with fibrosis. Conclusion The occluding lesion in the IVC of BCS may be caused by local thrombosis, followed gradually by organization and fibrosis.
Palliative Care During COVID-19: Data and Visits From Loved Ones
Authors: Heath Laura , Yates Sharon , Carey Matthew , Miller Mary 
Published: July 2020

Objectives: A vital component of the coronavirus response is care of the dying COVID-19 patient. We document the demographics, symptoms experienced, medications required, effectiveness observed, and challenges to high-quality holistic palliative care in 31 patients. This will aid colleagues in primary and secondary care settings anticipate common symptoms and formulate management plans. Methods: A retrospective survey was conducted of patients referred to the hospital palliative care service in a tertiary hospital, south east of England between March 21 and April 26, 2020. Patients included had a confirmed laboratory diagnosis of COVID-19 via reverse transcription polymerase chain reaction nasopharyngeal swab for SARS-Cov-2 or radiological evidence of COVID-19. Results: The thirty-one patients included were predominantly male (77%), elderly (median [interquartile range]: 84 [76-89]), and had multiple (4 [3-5]) comorbidities. Referral was made in the last 2 [1-3] days of life. Common symptoms were breathlessness (84%) and delirium (77%). Fifty-eight percent of patients received at least 1 “as required” dose of an opioid or midazolam in the 24 hours before death. Sixty percent of patients needed a continuous subcutaneous infusion and the median morphine dose was 10 mg S/C per 24 hours and midazolam 10 mg S/C per 24 hours. Nineteen percent of our cohort had a loved one or relative present when dying. Conclusion: We provide additional data to the internationally reported pool examining death arising from infection with SARS-CoV-19. The majority of patients had symptoms controlled with low doses of morphine and midazolam, and death was rapid. The impact of low visitation during dying needs exploring.
Impact of clinical pharmacists in an inpatient medical oncology service: A prospective study at a comprehensive cancer center in Jordan
Authors: Faqeer Nour , Mustafa Nour , Abd Al-jalil Noor , Qur’an Tasnim 
Published: July 2020

Introduction Clinical pharmacy is considered an integral discipline in the health care system for optimizing therapy and reducing drug-related problems. The objective of this study was to evaluate the impact of clinical pharmacists in optimizing management in a medical oncology service. Methods A prospective study was conducted at King Hussein Cancer Center between July 2019 and September 2019 of patients admitted to the medical oncology service. The impact of clinical pharmacists was measured by evaluating their interventions, defined as actions that were expected to result in a change in patient management. Data were collected daily by routine review of patients' profiles and by recording clinical pharmacists’ interventions. The data collected were baseline characteristics of patients, numbers and types of clinical pharmacists’ interventions, their significance, medications involved, and rate of acceptance of clinical pharmacists’ interventions by physicians. The significance of each intervention was assessed by two clinical pharmacists on a Hatoum scale. Physicians’ acceptance was assessed by whether the recommendations were implemented. Results During the study period, 748 patients were included, of whom 605 required a total of 1683 clinical interventions. The mean age was 56.3 years (±15.5 SD). Of the interventions, 39% resulted in initiation of a drug and 25% in drug discontinuations. The drug group most commonly associated with clinical pharmacists’ interventions was antibiotics (26.5%). Physicians accepted 98% of the clinical pharmacists’ interventions, and 92.4% of the interventions brought care to a more appropriate level and were considered significant. Conclusion Most patients in the medical oncology service required clinical pharmacists’ interventions, as demonstrated by the high number of significant clinical pharmacists’ interventions. Studies should be conducted to follow up these findings with respect to patient outcomes and cost savings.
Delayed metastasis in patients with intraocular retinoblastoma: A review of three cases
Authors: Vempuluru Vijitha S , Jakati Saumya , Kaliki Swathi 
Published: July 2020

Purpose: To discuss the clinical presentation, management, and outcome of delayed metastasis in retinoblastoma (RB). Methods: Retrospective case series of three patients. Results: Mean age at diagnosis of RB was 29 months (median, 28 months; range, 11–48 months). All were males with non-familial bilateral intraocular RB. Primary treatment for RB included intravenous chemotherapy in all three cases. Secondary treatment included transpupillary thermotherapy/cryotherapy ( n = 6 eyes), periocular chemotherapy ( n = 2 eyes), intravitreal chemotherapy ( n = 1 eye), intra-arterial chemotherapy ( n = 1 eye), external beam radiotherapy (EBRT; n = 2 eyes), and enucleation ( n = 2 eyes). Primary tumor regression was achieved in all cases and remained status quo at the time of diagnosis of distant metastasis. Two patients developed bone metastasis (ulna; tibia) and one developed soft tissue metastasis (temporal fossa) over a mean follow-up period of 6 years (median, 7 years; range, 5–8 years) from diagnosis of RB. Mean age of detection of metastatic disease was 8 years (median, 8 years; range, 7–9 years). All the lesions were solitary and the diagnosis of metastatic retinoblastoma was confirmed by tissue biopsy. Metastatic disease was treated with surgical excision ( n = 1), chemotherapy ( n = 2), and EBRT ( n = 2). All patients are alive, with two patients free of disease over a mean follow-up period of 23 months (median, 23 months; range, 12–33 months); and 1 in remission 7 months after completion of EBRT. Conclusion: Long-term follow-up of RB cases is mandatory. In spite of intraocular tumor regression, metastasis can still occur many years after treatment of RB.
University Lecturers and Students Could Help in Community Education About SARS-CoV-2 Infection in Uganda
Authors: Echoru Isaac , Kasozi Keneth Iceland , Usman Ibe Michael , Mutuku Irene Mukenya , Ssebuufu Robinson , Ajambo Patricia Decanar , Ssempijja Fred , Mujinya Regan , Matama Kevin , Musoke Grace Henry , Ayikobua Emmanuel Tiyo , Ninsiima Herbert Izo , Dare Samuel Sunday , Eze Ejike Daniel , Bukenya Edmund Eriya , Keyune Nambatya Grace , MacLeod Ewan , Welburn Susan Christina 
Published: July 2020

Background: The World Health Organization has placed a lot of attention on vulnerable communities of Africa due to their chronically weak health care systems. Recent findings from Uganda show that medical staff members have sufficient knowledge but poor attitudes toward coronavirus disease 2019 (COVID-19) pandemic. Aim: The aim of this study was to determine the knowledge, attitudes, and preparedness/practices of lecturers and students in the fight against COVID-19. Method: This was a descriptive cross-sectional study of 103 lecturers and students both men and women of age group 18 to 69 years in western Uganda. Data were obtained through a pretested questionnaire availed online. Results: Knowledge on COVID-19 symptoms was highest in this order: fever > dry cough > difficulty breathing > fatigue > headache with no significant differences between lecturers and students. Knowledge of participants on transmission of COVID-19 was highest in the order of cough drops > contaminated surfaces > person-to-person contact > asymptomatic persons > airborne > zoonotic with no significant differences among lecturers and students. Lecturers and students were all willing to continue using personal protective equipment like masks, and personal practices such as covering the mouth while sneezing and coughing, no handshaking, and washing of hands with no significant differences in the responses. The positive attitudes that COVID-19 could kill, anyone can get COVID-19, and willing to abide by the set regulations against the pandemic showed personal concerns and desired efforts against COVID-19. Conclusion: The study identifies lecturers and students as potential stakeholders in the fight against community transmission of COVID-19.
Professional Identity of Male Nursing Students in 3-Year Colleges and Junior Male Nurses in China
Authors: Chen Yan , Zhang Yichun , Jin Renmin 
Published: July 2020

Purpose: To investigate the changing tendency and influencing factors of the professional identity of male nursing students in 3-year colleges and junior male nurses in China. Background: In China, the majority of nurses are 3-year nursing college graduates, among which male nurses are underrepresented. Many male nurses leave the profession 3 or 4 years after graduation. Little is known about the professional identity of Chinese male nursing students in 3-year colleges and junior male nurses. Methods: This study included 237 male nursing students from a 3-year college and 33 junior male nurses with less than 3 years of experience in China. By using the data collected with the Professional Identity Questionnaire of Nursing Students and through in-depth semistructured interviews from November 2019 to April 2020, t-test, and ANOVA analysis in SPSS22.0 were conducted and thematic analysis was applied to interviews. Results: Compared with undergraduate nursing students, Chinese male nursing students in 3-year colleges had a better professional identity, displaying a declining tendency with grades. Junior male nurses reported the lowest professional identity. Demographic factors such as family residence and presence of relatives in medical service were positively related to professional identity. Low professional identity was related to heavy workload as well as gender stereotypes. Two unique contextual factors influenced the professional identity: (a) curriculum setting and (b) nurse exams. Conclusion: College education and initial working experience were critical to professional identity formation for male nurses. Appropriate measures need to be taken to improve professional identity and promote gender diversity.
Predictive and prognostic value of EPIC1 in patients with breast cancer receiving neoadjuvant chemotherapy
Authors: Xu Yaqian , Wang Yan , Yuan Chenwei , Sheng Xiaonan , Sha Rui , Dai Huijuan , Zhang Shan , Wang Yaohui , Lin Yanping , Zhou Liheng , Xu Shuguang , Zhang Jie , Yin Wenjin , Lu Jinsong 
Published: July 2020

Background: EPIC1 is an oncogenic long non-coding ribonucleic acid (RNA) that promotes cell growth and cell-cycle progression and inhibits apoptosis in several cancer cell lines. However, clinical studies on EPIC1 in breast cancer, specifically in the neoadjuvant setting, are relatively few. Methods: Patients treated with weekly paclitaxel–cisplatin-based neoadjuvant chemotherapy after core-needle biopsy were included in the study. Real-time quantitative polymerase chain reaction assays were performed to detect EPIC1 expression. Results: Among all patients included in this study ( n = 111), higher EPIC1 expression was associated with estrogen receptor negativity, human epidermal growth factor receptor 2 positivity, higher Ki67 index, and higher histologic grade. Multivariate analysis suggested that EPIC1 expression was an independent predictive factor for pathological complete response, with a significant interaction between EPIC1 expression and age. The Kaplan–Meier Plotter dataset suggested that the EPIC1 high-expression group showed a worse 10-year distant metastasis-free survival and post-progression survival when compared with the EPIC1 low-expression group. The Cancer Genome Atlas dataset suggested that the overall survival in the EPIC1 high-expression group was inferior to that in the EPIC1 low-expression group, specifically in hormone receptor (HorR)-positive patients and patients aged <50 years. Pathway analysis revealed the top pathways that indicated the potential mechanisms of EPIC1 in chemoresistance, including the daunorubicin and doxorubicin metabolic processes. Conclusions: Our study suggests that EPIC1 may be a promising biomarker for both neoadjuvant chemosensitivity and long-term clinical outcomes in breast cancer, specifically in the HorR-positive premenopausal subgroup. It may also help identify candidate responders and determine treatment strategies.
Achilles Injury and Access to Care in South Florida
Authors: Boden Allison L. , Geller Joseph S. , Granger Caroline J. , Summers Spencer H. , Kaplan Jonathan , Aiyer Amiethab 
Published: July 2020

Introduction. Despite the amount of orthopaedic research evaluating access to care based on insurance status, no study quantifies the effects of insurance status on the care of acute Achilles tendon ruptures. Methods. Using Current Procedural Terminology codes, we identified all patients who underwent surgical management of Achilles tendon rupture between December 31, 2013, and December 31, 2018, and followed-up at either a county hospital–based orthopaedic surgery clinic and/or private university–based clinic. Inclusion criteria included patients who (1) underwent surgical management of an Achilles tendon rupture during this time period and (2) were at least 18 years of age at the time of surgery. A univariate 2-tailed t test was used to compare various groups. Statistical significance was set at P < 0.05. Results. When compared to adequately insured patients (private and Medicare), underinsured patients (uninsured and Medicaid) experienced a significantly greater time from the date of injury to first clinic visit (14.5 days vs 5.2 days, P < .001), first clinic visit to surgery (34.6 days vs 4.8 days, P < .002), injury to surgery date (48.9 days vs 9.8 days, P < .001), initial presentation to when magnetic resonance imaging was obtained (48.1 days vs 1.9 days, P < .002). Conclusions. Disparities in access to care for Achilles tendon ruptures are intimately related to insurance status. Uninsured and Medicaid patients are subject to institutional delays and decreased access to care when compared to patients with private insurance. Levels of Evidence: Level III: Prognostic, retrospective
Prophylactic total pancreatectomy in individuals at high risk of pancreatic ductal adenocarcinoma (PROPAN): systematic review and shared decision‐making programme using decision tables
Authors: Scholten Lianne , Latenstein Anouk EJ , Aalfs Cora M , Bruno Marco J , Busch Olivier R , Bonsing Bert A. , Koerkamp Bas Groot , Molenaar I Quintus , Ubbink Dirk T , van Hooft Jeanin E , Fockens Paul , Glas Jolanda , DeVries J Hans , Besselink Marc G ,   for the Dutch Pancreatic Cancer Group
Published: July 2020

BackgroundIndividuals with a very high lifetime risk of developing pancreatic ductal adenocarcinoma; for example, hereditary pancreatitis and main‐duct or mixed‐type intraductal papillary mucinous neoplasm, may wish to discuss prophylactic total pancreatectomy but strategies to do so are lacking.ObjectiveTo develop a shared decision‐making programme for prophylactic total pancreatectomy using decision tables.MethodsFocus group meetings with patients were used to identify relevant questions. Systematic reviews were performed to answer these questions.ResultsThe first tables included hereditary pancreatitis and main‐duct or mixed‐type intraductal papillary mucinous neoplasm. No studies focused on prophylactic total pancreatectomy in these groups. In 52 studies (3570 patients), major morbidity after total pancreatectomy was 25% and 30‐day mortality was 6%. After minimally invasive total pancreatectomy (seven studies, 35 patients) this was, respectively, 13% and 0%. Exocrine insufficiency‐related symptoms occurred in 33%. Quality of life after total pancreatectomy was slightly lower compared with the general population.ConclusionThe decision tables can be helpful for discussing prophylactic total pancreatectomy with individuals at high risk of pancreatic ductal adenocarcinoma.