bluuebunny/crossref_metadata_2025_split huggingface dataset:
White lie during patient care: A qualitative study of nurses’ perspectives
Authors: nasrabadi Alireza Nikbakht , joolaee soodabeh , Navab Elham , esmaeilie Maryam , shali mahboobe 
Published: September 2020

Abstract
Background: Keeping the patients well and fully informed about diagnosis, prognosis, and treatments is one of the patient’s rights in any healthcare system. Although all healthcare providers have the same viewpoint about rendering the truth in treatment process, sometimes the truth is not told to the patients; that is why the healthcare staff tell “white lie” instead. This study aimed to explore the nurses’ experience of white lies during patient care.
Methods: This qualitative study was conducted from June to December 2018. Eighteen hospital nurses were recruited with maximum variation from ten state-run educational hospitals affiliated to Tehran University of Medical Sciences. Purposeful sampling was used and data were collected by semi-structured interviews that were continued until data saturation. Data were classified and analyzed by content analysis approach.
Results: The data analysis in this study resulted in four main categories and eleven subcategories. The main categories included hope crisis, bad news, cultural diversity, and nurses’ limited professional competences.

Conclusion: Results of the present study showed that, white lie told by nurses during patient care may be due to a wide range of patient, nurse and/or organizational related factors. Communication was the main factor that influenced information rendering. Nurses’ communication with patients should be based on mutual respect, trust and adequate cultural knowledge, and also nurses should provide precise information to patients, so that they can make accurate decisions regarding their health care.
Blood Loss from Transverse Versus Longitudinal Uterine Incision in Abdominal Myomectomy: A Randomized Controlled Trial
Authors: Elguindy Alaa , Hemeda Hosam , Shawky Mohamed Esmat , Elsenity Mohamed , Elsayed Medhat Adel , Fahim Ahmed , Afifi Khaled , Nawara Maii 
Published: September 2020

Abstract
Background: It is unclear whether transverse uterine incision is non-inferior to longitudinal incision during myomectomy with regard to bleeding. Our aim was to compare between transverse and longitudinal uterine incisions in myomectomy.Methods: A parallel randomized controlled single-blinded study in a university affiliated hospital, in the period between January 2017 and April 2018, in which 52 women candidates for abdominal myomectomy were randomized into transverse uterine incision or longitudinal uterine incision groups (26 in each group). Intraoperative blood loss (estimated directly by blood volume in suction bottle and linen towels and indirectly by difference between preoperative and postoperative hematocrit), operative time and postoperative fever were analyzed.Results: No statistically significant difference was found between transverse and longitudinal incisions regarding intraoperative blood loss (389.7 ± 98.56 ml vs 485.04 ± 230.6 ml respectively, p value=0.07), operative time (59.96 ± 16.78 min vs 66.58 ± 17.33 min respectively, p value=0.18), and postoperative fever (4% vs 8.33%, p value=0.6).Conclusion: Transverse uterine incision does not cause more blood loss than longitudinal incision and is a reasonable option during abdominal myomectomy.Trial registration: NCT03009812 at clinicaltrials.gov, registered January 2017
Using practical wisdom to facilitate ethical decision-making: a major empirical study of phronesis in the decision narratives of doctors
Authors: Conroy Mervyn , Malik Aisha Y , Hale Catherine , Weir Catherine , Brockie Alan , Turner Chris 
Published: September 2020

Abstract
BackgroundMedical ethics has recently seen a drive away from multiple prescriptive approaches, where physicians are inundated with guidelines and principles, towards alternative, less deontological perspectives. This represents a clear call for theory building that does not produce more guidelines. Phronesis (practical wisdom) offers an alternative approach for ethical decision-making based on an application of accumulated wisdom gained through previous practice dilemmas and decisions experienced by practitioners. Phronesis, sometimes referred to as the ‘executive virtue’, offers a way to navigate the practice virtues for any given case to reach a final decision on the way forward. However, very limited empirical data exist to support the theory of phronesis -based medical decision-making, and what does exist tends to focus on individual practitioners rather than practice-based communities of physicians.MethodsThe primary research question was: What does it mean to medical practitioners to make ethically wise decisions for patients and their communities? A three-year ethnographic study explored the practical wisdom of doctors (n=131) and used their narratives to develop theoretical understanding of the concepts of ethical decision-making. Data collection included narrative interviews and observations with hospital doctors and General Practitioners at all stages in career progression. The analysis draws on neo-Aristotelian and MacIntyrean concepts of practice- based virtue ethics and was supported by an arts-based film production process.FindingsWe found that individually doctors conveyed many different practice virtues and those were consolidated into fifteen virtue continua that convey the participants’ collective practical wisdom, including the phronesis virtue. This study advances the existing theory on phronesis as a decision-making approach because only now a theoretical ‘collective practical wisdom’ exists. ConclusionGiven the arguments that doctors feel professionally and personally vulnerable in the context of ethical decision-making, our contribution in the form of a moral debating resource can support before, during and after decision-making reflection. The potential implications are that these theoretical findings can be used by educators and practitioners as a non-prescriptive alternative to improve ethical decision-making, thereby addressing the call in the literature, and benefit patients and their communities, as well.
Gene Expression Profiling of Inflammatory Cytokines in Esophageal Biopsies of Different Phenotypes of Gastroesophageal Reflux Disease: a cross-sectional study.
Authors: Zavala-Solares Monica , Fonseca-Camarillo Gabriela , Valdovinos Miguel , Granados Julio , Grajales-Figueroa Guido , Zamora-Nava Luis , Aguilar-Olivos Nancy , Valdovinos-García Luis , Yamamoto-Furusho Jesus K. 
Published: September 2020

Abstract
Background: Patients clinical endoscopic phenotypes in gastroesophageal reflux disease (GERD) are classified as: Barrett's esophagus (BE), erosive esophagitis (EE) and non-erosive gastroesophageal reflux disease (NERD). NERD are subclassified in Abnormal acid exposure (AAE) and Normal acid exposure (NAE) according to pH monitoring study. The aim of this study was to characterize genes involved in the pathophysiology and immune response of GERD.Methods: This is an observational and cross-sectional study. All patients with BE, EE, AAE, NAE and control group were subjected to a superior endoscopy (with biopsies of esophageal mucosa). The cytokine mRNA relative quantification of target genes was conducted by RT-PCR. Changes in gene expression were assessed of the genes associated with inflammation in each disease phenotype. Statistical analysis of differential gene expression was performed by using Dunn's Multiple Comparison non-parametric test. A p value < 0.05 was considered as significant. Results: A total of 82 patients were included and they were divided into the following groups: Group BE 16 (19.51%), Group EE 23 (28.04%), Group AAE 13 (15.86%), NAE (15.86%) and Control Group 17 (20.73%). When comparing with control group we found: patients with BE showed an increased expression of IL-8 (P<0.005) and higher levels of: IL-10 and MMP-3, MMP-9 as well; patients with EE had higher levels of IL-1B, IL-6 and IL-10 (P<0.005), patients with AAE showed an increased expression of Il-1B, Il-6, IFN-γ and TNF-α (P<0.005). AAE had a higher expression of Il-1B and TNF-α than NAE (P<0.005). Conclusions: This study demonstrates the differential expression of mediators of inflammation in the esophageal mucosa of patients in GERD endoscopic phenotypes. MMP3 could be implicated in damage to esophageal mucosa. IL-1B and TNF-α could be a differential diagnosis between AAE and NAE in the non-erosive phenotype from endoscopic biopsies.
Integrins Alpha-2 and Beta-1 expression increases through Multiple Generations of the EDW01 Patient-Derived Xenograft Model of Breast Cancer - insight into their role in Epithelial Mesenchymal Transition in vivo gained from an in vitro model system
Authors: Wafai Razan , Williams Elizabeth D. , de Souza Emma , Simpson Peter T. , Reed Amy E. McCart , Kutasovic Jamie R. , Waltham Mark , Snell Cameron E. , Blick Tony , Thompson Erik W. , Hugo Honor 
Published: September 2020

Abstract
Background: Breast cancers acquire aggressive capabilities via epithelial to mesenchymal transition (EMT), in which various integrins/integrin linked kinase signalling are upregulated. Methods: We investigated this in two patient-derived xenografts (PDXs) developed from breast-to-bone metastases, and it’s functional significance in a breast cancer cell line system. ED03 and EDW01 PDXs were grown subcutaneously in immunocompromised SCID mice through 11 passages and 7 passages, respectively. Tumour tissue was assessed using immunohistochemistry (IHC) for estrogen receptor (ER)-alpha, E-cadherin, vimentin, Twist1, beta-catenin, P120-RasGAP, CD44, CD24 and Ki67, and RT-qPCR of EMT-related factors (CDH1, VIM, CD44, CD24), integrins beta 1 (ITGB1), alpha 2 (ITGA2) and ILK. Integrin and ILK expression in epidermal growth factor (EGF) induced EMT of the PMC42-ET breast cancer cell line was assessed by RT-qPCR and Western blotting, as were the effects of their transient knockdown via small interfering RNA +/- EGF. Cell migration, changes in cell morphology and adhesion of siRNA-transfected PMC42-ET cells to various extracellular matrix (ECM) substrates was assessed.Results: The ED03 (ER+/PR-/HER2-/lobular) and EDW01 (ER+/PR-/HER2-/ductal) PDXs were both classified as molecular subtype luminal A. ED03 xenografts exhibited mutated E-cadherin with minimal expression, but remained vimentin-negative across all passages. In EDW01, the hypoxic indicator gene CAIX and Twist1 were co-ordinately upregulated at passage 4-5, corresponding with a decrease in E-cadherin. At passages 6-7, VIM was upregulated along with ITGB1 and ITGA2, consistent with an increasing EMT. The ED03 PDX displayed minimal change over passages in mice, for all genes examined. ILK, ITGB1 and ITGA2 mRNAs were also increased in the EGF-induced EMT of PMC42-ET cells (in which CDH1 was downregulated) although siRNA against these targets revealed that this induction was not necessary for the observed EMT. However, their knockdown significantly reduced EMT-associated adhesion and Transwell migration.Conclusion: Our data suggest that despite an increase in ITGA2 and ITGB1 gene expression in the EMT exhibited by EDW01 PDX over multiple generations, this pathway may not necessarily drive the EMT process.
Efficacy evaluation of photodynamic therapy for oral lichen planus: a systematic review and meta-analysis
Authors: He Yuqing , Deng Jiaxin , Zhao Yi , Tao Huiqian , Dan Hongxia , Xu Hao , Chen Qianming 
Published: September 2020

Abstract
Background Photodynamic therapy (PDT) is a new option for oral lichen planus (OLP) management; however, there are different opinions on the efficacy of PDT for OLP. The aim of this study was to comprehensively assess the efficacy of PDT in the treatment of OLP and compare PDT with steroid therapy . Methods A systematic review and meta-analysis were conducted to assess the curative effect of PDT. Five electronic databases were searched, PubMed, Web of Science, the Cochrane Library, Embase, and EBSCO up to 1 December, 2019. Random and fixed effects models for pooled estimates calculation were used and the Meta package of R was applied. Results Pooled estimates revealed that, after PDT, the lesion size decreased by 1.53 cm 2 (95% confidence interval (CI): 0.71–2.35) after PDT and the partial response (PR) was 0.77 (95% CI: 0.65–0.85). The visual analogue scale (VAS) score decreased by 3.82 (95% CI: 2.80–4.85) and the Thongprasom sign score decreased by 1.33 (95% CI: 0.56–2.10) after PDT. Subgroup analyses revealed that the 5-aminolevulinic acid (5-ALA) was more effective than methylene blue (MB), with a PR of 0.87 (95% CI: 0.80–0.91). The topical use of 5-ALA yielded a better response than gargling methylene blue. In terms of VAS, the diode laser showed a better clinical PR in the treatment of OLP. In terms of changes in lesion size, the efficacy of the semiconductor laser was higher than that of the diode laser. PDT had a similar efficacy to topical corticosteroids, as shown by pooled estimates of five randomised controlled trials with 139 lesions. Conclusion PDT could be a valuable optional treatment for the management of OLP. And the results indicated that the curative effect of PDT is similar to that of topical corticosteroids in the treatment of OLP.
Identification of an immune gene signature for predicting the prognosis of patients with uterine corpus endometrial carcinoma
Authors: Zhou Cankun , Li Chaomei , Yan Fangli , Zheng Yuhua 
Published: September 2020

Abstract
Background: Uterine corpus endometrial carcinoma (UCEC) is a frequent gynecological malignancy with a poor prognosis particularly at an advanced stage. Herein, this study aims to construct prognostic markers of UCEC based on immune-related genes to predict the prognosis of UCEC.Methods: We analyzed expression data of 575 UCEC patients from The Cancer Genome Atlas database and immune genes from the ImmPort database, which were used for generation and validation of the signature. We constructed a transcription factor regulatory network based on Cistrome databases, and also performed functional enrichment and pathway analyses for the differentially expressed immune genes. Moreover, the prognostic value of 410 immune genes was determined using the Cox regression analysis. We then constructed and verified a prognostic signature. Finally, we performed immune infiltration analysis using TIMER-generating immune cell content.Results: The immune cell microenvironment as well as the PI3K-Akt, and MARK signaling pathways were involved in UCEC development. The established prognostic signature revealed a ten-gene prognostic signature, comprising of PDIA3, LTA, PSMC4, TNF, SBDS, HDGF, HTR3E, NR3C1, PGR, and CBLC. This signature showed a strong prognostic ability in both the training and testing sets and thus can be used as an independent tool to predict the prognosis of UCEC. In addition, levels of B cells and neutrophils were significantly correlated with the patient's risk score, while the expression of ten genes was associated with immune cell infiltrates.Conclusions: In summary, the ten-gene prognostic signature may guide the selection of the immunotherapy for UCEC.
Preoperative positive voided urine cytology predicts poor clinical outcomes in patients with upper tract urothelial carcinoma undergoing nephroureterectomy
Authors: Liu Wen , Wang Zhankun , Liu Shuai , Yao Yu , Liu Yong , Zhang Guiming 
Published: September 2020

Abstract
Background: Performance of urinary cytology is recommended as the part of a standard diagnostic workup and base surveillance regimens in upper tract urothelial carcinoma (UTUC). However, the effect of positive voided urine cytology (VUC) on UTUC prognosis, compared with negative VUC, has not been fully demonstrated. This study aimed to evaluate the impact of preoperative VUC on predicting intravesical recurrence, disease recurrence, and mortality in patients with UTUC who underwent nephroureterectomy (RNU).Methods: Clinicopathological information was collected from 315 UTUC patients treated with RNU. The association between VUC and oncological outcomes was analyzed using the Kaplan–Meier method with log-rank test and Cox proportional hazards regression models. Multiple logistic regression analysis was performed to identify the influence of VUC on tumor grade.Results: Preoperative positive VUC, presenting in 101 patients (32%), was significantly associated with tumor multifocality (P=0.017) and higher tumor grade (P=0.010). On multivariate Cox regression analyses, preoperative positive VUC was an independent prognostic factor of intravesical recurrence-free survival (RFS) (hazard ratio [HR]=2.21, 95% confidence interval [CI] 1.06–4.64; P=0.035), RFS (HR=1.80, 95% CI 1.08–2.99; P=0.023), and cancer-specific survival (CSS) (HR=1.87, 95% CI 1.10–3.18; P=0.020), but not overall survival (HR=1.32, 95% CI 0.80–2.18; P=0.28). Logistic regression analysis revealed that VUC was related to high tumor grade in UTUC (odds ratio=2.23, 95%CI 1.15–4.52).Conclusion: Preoperative positive VUC significantly increases the risk of intravesical recurrence in UTUC patients undergoing RNU. In addition, positive VUC is an adverse predictor of RFS and CSS, which might be due to the association between positive VUC and high tumor grade.
Mastery and self-esteem mediate the association between visual acuity and mental health: a population-based longitudinal cohort study
Authors: Maaswinkel Ivar M , Aa Hilde PA van der , Rens Ger HMB van , Beekman Aartjan TF , Twisk Jos WR , Nispen Ruth MA van 
Published: September 2020

Abstract
Background: With deteriorating eyesight, people often become dependent on others for many aspects of their daily lives. As a result, they feel less ‘in control’ and experience lower self-esteem. Lower sense of mastery and self-esteem are known to predict depression, but their roles in people with visual impairment have only marginally been investigated. Therefore, this study aimed to determine the influence of mastery and self-esteem on the relationship between visual acuity and mental health.Methods: A longitudinal cohort study was performed using data from the Longitudinal Aging Study Amsterdam (LASA), collected between 2001 and 2012. A community-based population of 2599 older adults (mean age 72 years) were included, who were randomly selected from population registers. Outcomes of interest were the Pearlin Mastery Scale, Rosenberg Self-Esteem Scale, Center for Epidemiologic Studies – Depression scale and the Hospital Anxiety Depression Scale – Anxiety subscale. Linear mixed models were used to establish the association between visual acuity and mental health over time.Results: Mean age was 72 years, 56% was female and 1.2% qualified as having low vision. Visual impairment was associated with a lower sense of mastery (β = -0.477, p < 0.001), lower self-esteem (β = -0.166, p = 0.008) and more depression (β = 0.235, p < 0.001). No significant association between visual acuity and anxiety was found. The relationship between visual acuity and depression was mediated by self-esteem (25%) and sense of mastery (79%).Conclusions: Vision loss was associated with depression. This association was mediated by self-esteem and sense of mastery. This provides us with new possibilities to identify, support and treat those at risk for developing depression by aiming to increase their self-esteem and sense of mastery.
Bone marrow derived mesenchymal stem cells pretreated with erythropoietin accelerate the repair of acute kidney injury
Authors: zhou song , Qiao Yu-ming , Liu Yong-guang , Liu Ding , Hu Jian-min , Liao Jun , Li Min , Guo Ying , Fan Li-pei , Li Liu-Yang , Zhao Ming 
Published: September 2020

Abstract
Background

Mesenchymal stem cells (MSCs) represent a promising treatment option for acute kidney injury (AKI). The main drawbacks of MSCs therapy, including the lack of specific homing after systemic infusion and early cell death in the inflammatory microenvironment, directly affect the therapeutic efficacy of MSCs. Erythropoietin (EPO)-preconditioning of MSCs promotes their therapeutic effect; however, the underlying mechanism remains unknown. In this study, we sought to investigate the efficacy and mechanism of EPO in bone marrow derived mesenchymal stem cells (BMSCs) for AKI treatment.

Results

We found that incubation of BMSCs with ischemia/reperfusion(I/R)-induced AKI kidney homogenate supernatant (KHS) caused apoptosis in BMSCs, which was decreased by EPO pretreatment, indicating that EPO protected the cells from apoptosis. Further, we showed that EPO up-regulated SIRT1 and Bcl-2 expression and down-regulated p53 expression. This effect was partially reversed by SIRT1 siRNA intervention. The anti-apoptotic effect of EPO in pretreated BMSCs may be mediated through the SIRT1 pathway. In a rat AKI model, 24 h after intravenous infusion, GFP-BMSCs were predominantly located in the lungs. However, EPO pretreatment reduced the lung entrapment of BMSCs and increased their distribution in the target organs. AKI rats infused with EPO-BMSCs had significantly lower levels of serum IL-1β and TNF-α, and a significantly higher level of IL-10 as compared to rats infused with untreated BMSCs. The administration of EPO-BMSCs after reperfusion reduced serum creatinine, blood urea nitrogen, and pathological scores in I/R-AKI rats more effectively than BMSCs treatment did.

Conclusions

Our data suggest that EPO pretreatment enhances the efficacy of BMSCs to improve the renal function and pathological presentation of I/R-AKI rats.
Gastrointestinal Ultrasonographic Findings in Cats With Feline Panleukopenia Virus: a Case Series
Authors: Isaya Rosaria , Ciccarelli Stefano , Enache Daniela , Specchi Swan , Pesaresi Marco , Ferri Filippo , Porporato Federico , Auriemma Edoardo , Contiero Barbara , Coppola Luigi M , Zini Eric 
Published: September 2020

Abstract
BackgroundFeline panleukopenia virus (FPV) is very resistant and highly contagious and infects domestic cats and other felids. FPV is particularly widespread among sheltered cats, and is associated with high morbidity and mortality, causing severe gastroenteritis characterized by anorexia, lethargy, fever, dehydration, hemorrhagic diarrhea, and vomiting. There is currently no data on the ultrasonographic features of cats affected with FPV. This case series describes abdominal ultrasonographic findings in shelter cats with naturally-occurring FPV, and assesses whether are associated with clinical and laboratory findings. Cats affected by FPV were enrolled in the study if an abdominal ultrasound was performed within 12 hours of diagnosis. Clinical, laboratory and survival data were collected from medical records. Ultrasonographic examinations were reviewed for gastrointestinal abnormalities and their associations with the above data were explored.ResultsTwenty-one cats were included. Nine cats (42.9%) died and 12 (57.1%) recovered. Based on ultrasonography, the duodenum and jejunum showed thinning of the mucosal layer in 70.6% and 66.6% of cats, thickening of the muscular layer in 52.9% and 57.1% of cats, and hyperechogenicity of the mucosa in 41.2% and 33.3%. Jejunal hyperechoic mucosal band paralleling the submucosa and irregular luminal surface were both observed in 33.3% of the cats. Survival was positively associated with increased jejunal mucosal echogenicity ( P =0.003) and hyperechoic mucosal band ( P =0.003). Peritoneal free fluid was positively associated with vomiting ( P =0.002).ConclusionThis study provides ultrasonographic features of naturally-occurring FPV in cats, which, as expected, are compatible with gastroenteropathy. The most frequent findings were diffuse small intestine mucosal layer thinning, muscular layer thickening and mucosal hyperechogenicity, and jejunal hyperechoic mucosal band and irregular luminal surface. At diagnosis, ultrasonographic features may be useful to assess survival.