bluuebunny/crossref_metadata_2025_split huggingface dataset:
MicroRNA-183-5p acts as a potential diagnostic biomarker for atherosclerosis and regulates the growth of vascular smooth muscle cell
Authors: Sun Bin , Shan Zhengkun , Sun Guoyu , Wang Xiaolong 
Published: November 2019

Abstract
Background Atherosclerosis (AS) is a multifactorial chronic disease, and vascular smooth muscle cells (VSMCs) plays an important role in the pathology of AS. MicroRNAs regulate multiple cellular biological processes. This study aimed to investigate the clinical value of miR-183-5p in AS patients, and further explored the effects of miR-183-5p on the proliferation and migration of VSMCs. Methods qRT-PCR was used to test the level of miR-183-5p. The diagnostic value of miR-183-5p for AS patients was assessed by a receiver operating characteristic (ROC) analysis. Cell proliferation and migration were determined via CCK-8 and Transwell assay. Results MiR-183-5p was highly expressed in AS patients compared with the healthy group. Serum miR-183-5p expression was positively associated with CIMT and CRP in AS patients. The ROC analysis suggested that miR-183-5p had quality to be used as a biomarker with high specificity and sensitivity for AS detection. Overexpression of miR-183-5p promoted the proliferation and migration of VSMCs. Downregulation of miR-183-5p attenuated ox-LDL stimulated VSMCs proliferation and migration. Conclusion MiR-183-5p is highly expressed in AS patients, and downregulation of miR-183-5p attenuated ox-LDL stimulated VSMCs proliferation and migration. MiR-183-5p may be a key molecular for the diagnosis and treatment of AS in the future.
Cost-effectiveness of insulin degludec versus insulin glargine U100 in adults with type 1 and type 2 diabetes mellitus in Bulgaria
Authors: Russel-Szymczyk Monika , Valov Vasil , Savova Alexandra , Manova Manoela 
Published: November 2019

Abstract
Background This study investigates the cost-effectiveness of insulin degludec (degludec) versus biosimilar insulin glargine U100 (glargine U100) in patients with type 1 (T1DM) and type 2 diabetes mellitus (T2DM) in Bulgaria.Methods A simple, short-term model was used to compare the treatment costs and outcomes associated with hypoglycaemic events with degludec versus glargine U100 in patients with T1DM and T2DM from the perspective of the Bulgarian National Health Insurance Fund. Cost-effectiveness was analysed over a 1-year time horizon using data from clinical trials. The outcome measure was the incremental cost-effectiveness ratio (ICER).Results Degludec was highly cost-effective versus glargine U100 in people with T1DM and T2DM in Bulgaria. The ICERs were estimated to be 4,493.68 BGN/quality-adjusted life year (QALY) in T1DM, 399.11 BGN/QALY in T2DM on basal oral therapy (T2DM BOT ) and 7,365.22 BGN/QALY in T2DM on basal bolus therapy (T2DM B/B ), which all fall below the cost-effectiveness threshold of 39,619 BGN in Bulgaria. Insulin costs were higher with degludec in all three patient groups, however these were partially offset by savings from a reduction in hypoglycaemic events with degludec versus glargine U100. Sensitivity analysis demonstrated that the results were robust and largely insensitive to variations in input parameters. At a willingness-to-pay threshold of 39,619 BGN/QALY, the probability of degludec being cost-effective versus glargine U100 was 60.0% in T1DM, 99.4% in T2DM BOT and 91.3% in T2DM B/B .Conclusion Degludec is a cost-effective alternative to biosimilar glargine U100 for patients with T1DM and T2DM in Bulgaria. Degludec could be of particular benefit to those patients suffering recurrent hypoglycaemia and those who require additional flexibility in the dosing of insulin.
Elevated levels of serum urokinase plasminogen activator predict poor prognosis in hepatocellular carcinoma after resection
Authors: Tsai Ming-Chao , Yen Yi-Hao , Chang Kuo-Chin , Hung Chao-Hung , Chen Chien-Hung , Lin Ming-Tsung , Hu Tsung-Hui 
Published: November 2019

Abstract
Background Urokinase plasminogen activator (uPA) is an extracellular matrix-degrading protease that is involved in the invasiveness and progression of cancer. There is good evidence that uPA expression is a clinically relevant biomarker in some solid tumors, but its role in hepatocellulcar carcinoma (HCC) is uncertain. We evaluated the prognostic value of serum uPA before surgery in HCC patients receiving curative resection.Methods Serum uPA levels were determined by enzyme-linked immunosorbent assay in 282 HCC patients who received complete liver resections at Kaohsiung Chang Gung Memorial Hospital. Overall survival (OS) curves were constructed using the Kaplan-Meier method and compared using the log-rank test. A Cox proportional -hazards regression model was used to identify independent prognostic factors. The median follow-up time was 52 months.Results Patients with higher pretreatment serum uPA (≥1 ng/ml) had significantly shorter OS ( p = 0.002). Patients with liver cirrhosis, hypoalbuminemia, and thrombocytopenia were significantly more likely to present with elevated uPA levels. Multivariate Cox regression analyses indicated that high pretreatment serum uPA [hazard ratio (HR), 1.848, p = 0.006], vascular invasion (HR, 2.940, p <0.001), and pathology stage III/IV (HR, 3.517, p <0.001) were independent prognostic factors for OS. In further stratified analyses, the combination of serum uPA and AFP had more capacity to predict OS.Conclusions We conclude that uPA is a clinically relevant biomarker in HCC patients receiving curative resection, with higher expression of uPA being associated with higher mortality. This also highlights the potential utility of uPA as a therapeutic target for improved treatment strategies.
IL-1-conferred gene expression pattern in ERα+ BCa and AR+ PCa cells is intrinsic to ERα- BCa and AR- PCa cells and promotes cell survival
Authors: Nawas Afshan F. , Kanchwala Mohammed , Thomas-Jardin Shayna E. , Dahl Haley , Daescu Kelly , Bautista Monica , Anunobi Vanessa , Wong Ally , Meade Rachel Katherine , Mistry Ragini , Ghatwai Nisha , Bayerl Felix , Xing Chao , Delk Nikki 
Published: November 2019

Abstract
Background Breast (BCa) and prostate (PCa) cancers are hormone receptor (HR)-driven cancers. Thus, BCa and PCa patients are given therapies that reduce hormone levels or directly blocks HR activity; but most patients eventually develop treatment resistance. We have previously reported that interleukin-1 (IL-1) inflammatory cytokine downregulates ERα and AR mRNA in HR-positive (HR+) BCa and PCa cell lines, yet the cells can remain viable. Additionally, we identified pro-survival proteins and processes upregulated by IL-1 in HR+ BCa and PCa cells, that are basally high in HR- BCa and PCa cells. Therefore, we hypothesize that IL-1 confers a conserved gene expression pattern in HR+ BCa and PCa cells that mimics conserved basal gene expression patterns in HR- BCa and PCa cells to promote HR-independent survival and tumorigenicity.Methods We performed RNA sequencing (RNA-seq) for HR+ BCa and PCa cell lines exposed to IL-1 and for untreated HR- BCa and PCa cell lines. We confirmed expression patterns of select genes by RT-qPCR and used siRNA and/or drug inhibition to silence select genes in HR- BCa cell lines. Finally, we performed Ingenuity Pathway Analysis (IPA) and used the gene ontology web-based tool, GOrilla, to identify signaling pathways encoded by our RNA-seq data set.Results We identified 350 genes in common between BCa and PCa cells that are induced or repressed by IL-1 in HR+ cells that are, respectively, basally high or low in HR- cells. Among these genes, we identified Sequestome-1 (SQSTM1/p62) and SRY (Sex-Determining Region Y)-Box 9 (SOX9 ) to be essential for survival of HR- BCa and PCa cell lines. Analysis of publicly available data indicates that p62 and SOX9 expression are elevated in HR-independent BCa and PCa sublines generated in vitro, suggesting that p62 and SOX9 have a role in acquired hormone receptor independence and treatment resistance. We also assessed HR- cell line viability in response to the p62-targeting drug, verteporfin, and found that verteporfin is cytotoxic for HR- cell lines. Conclusions Our 350 gene set can be used to identify novel therapeutic targets and/or biomarkers conserved among acquired (e.g. due to inflammation) or intrinsic HR-independent BCa and PCa.
Acute suppurative thyroiditis with thyroid abscess in adults: clinical presentation, treatment and outcomes
Authors: Falhammar Henrik , Wallin Göran , Calissendorff Jan 
Published: November 2019

Abstract
Background: Abscess in the thyroid gland is a rare but severe infectious disease. The condition can have anatomic or iatrogenic underlying causes. If untreated it could be fatal. Pathogens vary considerably. Treatment is intravenous antibiotics, drainage, and sometimes surgery. Methods: The electronic medical records of all adult patients with acute thyroiditis 2003–2017 treated at the Karolinska University Hospital (catchment area 2 million) in Sweden were systematically reviewed. Results: Five patients were found in the catchment area. One patient from another region but known to us was also included. Thus, six patients (aged 28-73 years) were included in the study. Median length of hospital stay was 7.5 days (4-79 days). All were treated with antibiotics (intravenous n=5, oral n=1). Total antibiotic treatment duration was 13.5 days (10-41 days). Blood cultures were positive in three (streptococcus pneumonia, streptococci sanguineous, pepto streptococci), deep tissue culture in three (escherichia coli, candida, hemophilic influenza) and no positive culture at all in two. Drainage was used in three patients. All patients recovered without recurrences. Surgery was performed twice in the acute phase in one. There was no recurrence during 7 years (3-12) of follow-up, but one patient died after three years (severe heart failure and pneumonia). Conclusion: Thyroid abscess in adults is extremely rare nowadays in the developed world. With prompt antibiotic therapy, drainage and in some cases thyroidectomy the prognosis seems favourable.
Serum levels of the chemokine CCL2 are elevated in malignant pleural mesothelioma patients
Authors: Kishimoto Takumi , Fujimoto Nobukazu , Ebara Takeshi , Omori Toyonori , Oguri Tetsuya , Niimi Akio , Yokoyama Takako , Kato Munehiro , Usami Ikuji , Nishio Masayuki , Yoshikawa Kosho , Tokuyama Takeshi , Tamura Mouka , Yokoyama Yoshifumi , Tsuboi Ken , Matsuo Yoichi , Xu Jiegou , Takahashi Satoru , Abdelgied Mohamed , Alexander William T. , Alexander David B , Tsuda Hiroyuki 
Published: November 2019

Abstract
Background: Malignant pleural mesothelioma (MPM) is a debilitating disease of the pleural cavity. It is primarily associated with previous inhalation of asbestos fibers. These fibers initiate an oxidant coupled inflammatory response. Repeated exposure to asbestos fibers results in a prolonged inflammatory response and cycles of tissue damage and repair. The inflammation-associated cycles of tissue damage and repair are intimately involved in the development of asbestos-associated cancers. Macrophages are a key component of asbestos-associated inflammation and play essential roles in the etiology of a variety of cancers. Macrophages are also a source of C-C motif chemokine ligand 2 (CCL2), and a variety of tumor-types express CCL2. High levels of CCL2 are present in the pleural effusions of mesothelioma patients, however, CCL2 has not been examined in the serum of mesothelioma patients. Methods: The present study was carried out with 50 MPM patients and 356 subjects who were possibly exposed to asbestos but did not have disease symptoms and 41 healthy volunteers without a history of exposure to asbestos. The levels of CCL2 in the serum of the study participants was determined using ELISA. Results: Levels of CCL2 were significantly elevated in the serum of patients with advanced MPM patients. Conclusions: Our findings are consistent with the premise that the CCL2/CCR2 axis and myeloid-derived cells play an important role in MPM and disease progression. Therapies are being developed that target CCL2/CCR2 and tumor resident myeloid cells, and clinical trials are being pursued that use these therapies as part of the treatment regimen. The results of trials with patients with a similar serum CCL2 pattern as MPM patients will have important implications for the treatment of MPM.
Abnormal Cisatracurium Pharmacodynamics and Pharmacokinetics among Patients with Severe Aortic Regurgitation during Anesthetic Induction
Authors: Huang Xiaocong , Chen Lei , Cai Yujing , Wei Jinfeng , Lin Lina , Sun Jie , Peng Xuemei , Wang Sheng 
Published: November 2019

Abstract
Purpose This study was designed to examine whether severe aortic regurgitation (AR) will affect the pharmacodynamics (PD) and pharmacokinetics (PK) of cisatracurium during anesthetic induction.Methods A total of 32 patients were divided into two groups: the AR group (n=16) and the control group (n=16). Arterial blood samples were drawn before and at 1, 2, 4, 6, 8, 10, 16 and 20 minutes after intravenous injection of 0.15mg/kg cisatracurium. TOF tests were applied to determine the onset time of maximal muscle relaxation. The concentration of cisatracurium in plasma was determined by high-performance liquid chromatography.Results The time to maximal neuromuscular block was prolonged from 2.07(0.08) minutes to 4.03(0.14) minutes, which indicated that the PD responses to cisatracurium were significantly delayed in the AR group (P<0.01) compared to the control group. A conventional two-compartment PK model showed a higher plasma concentration of cisatracurium among the AR group with markedly reduced intercompartment transfer rate (K 12 = 0.19(0.02) and K 21 = 0.11(0.01) in the AR group vs. K 12= 0.26(0.01) and K 21 = 0.19(0.01) in the control group, P<0.01) compared to the control group.Conclusion Backward blood flow during diastole in severe AR impaired distribution of cisatracurium from the central compartment to the peripheral compartment, which accounted for the lagged PD responses. Findings from this study may provide useful guidance for safe administration of cisatracurium and reasonable prediction of PD responses during anaesthetic induction among patients with severe AR.
Serum Amyloid A Protein as a Potential Biomarker in predicting acute onset and association with in-hospital death in acute aortic dissection
Authors: He Yuchen , Ma Changcheng , Xing Jia , Wang Shiyue , Chao Ji , Han Yanshuo , Zhang Jian 
Published: November 2019

Abstract
Background: Acute aortic dissection (AAD) is a life-threatening disorder in vascular surgery with a high early mortality. Serum amyloid A (SAA) is a kind of acute-phase protein with a rapid diagnostic value in other diseases. However, the researches on the performance of SAA for the diagnosis of AAD is still lacking. This retrospective study aimed to evaluate the SAA levels and further explore its potential diagnostic role in AAD patients.
Methods: SAA levels were measured by enzyme-linked immunosorbent assay (ELISA) in 63 controls and 87 AAD patients. Laboratory examinations were also performed. And relative clinical information was collected from participants included in this study.
Results: SAA levels were significantly higher in AAD patients than those in healthy controls. SAA levels were independently associated with the risk of AAD. There was a positive significant correlation between SAA and C reactive protein (R=0.442, and P=0.001). Based on receiver-operating characteristic (ROC) analysis, the area under the curve (AUC) of SAA for the diagnosis of AAD were 0.942 with optimal cut-off points of 0.427mg/L. For in-hospital mortality, the AUC of SAA were 0.732 with optimal cut-off points of 0.500mg/L. According to logistic regression analysis, higher SAA levels represent a higher risk of in-hospital mortality (OR=1.25; 95%CI: 1.07-1.47; P=0.005).
Conclusion: Our findings demonstrated that SAA levels were significantly enhanced in AAD. SAA was closely correlated with inflammatory parameters and coagulation-related parameters in AAD. Furthermore, SAA could be a potential bio-marker for identifying AAD in the early diagnosis. Finally, SAA >5.0 mg/L are independently related to AAD in-hospital mortality.
Assessment of Educational Needs and Design of a Preceptor Development Program for Health Professional Education Programs in Qatar – ‘The Practice Educators’ Academy’
Authors: Mukhalalati Banan , Awaisu A , Elshami S , Paravattil B , Zolezzi M , Abu-Hijleh M , Moslih-Almoslih A , Carr A , Bawadi H , Romanowski M , Almahasneh R , Bacha R 
Published: November 2019

Abstract
Background: Experiential learning is the backbone of many healthcare professional education programs; however, the quality of learning is profoundly dependent on the skills, experiences, and proficiency of the clinical preceptors who largely contribute to this experience. This study was conducted at the Qatar University Health Cluster, which comprises of the Colleges of Pharmacy, Medicine, and Health Sciences, with a primary objective of identifying the educational and teaching needs of preceptors in order to design and validate an educational professional development program. Methods: This study adopted a mixed methods approach and was conducted in three stages: 1) assessment of preceptor educational needs; 2) design of ‘The Practice Educators’ Academy’ program; 3) validation and refinement of the designed program. The needs’ assessment was conducted at all three colleges through a validated survey and focus groups with preceptors, students, and clinical faculty members. The sample included 209 survey respondents and 11 focus group sessions.Results: Results yielded five key themes and a variety of individual preferences, which were used to design a five-module face-to-face two-day interactive workshop. For validation of the designed program, the syllabus was shared with purposively selected scholars and experts in the area of health professions education, and their feedback was collected and critically examined. Further refinement of the program was performed based on this feedback resulting in a representative and validated program ready for piloting. Conclusion: A preceptor development program on experiential teaching and learning skills was successfully designed and validated, with the needs of the clinical preceptors at its core.
Needs assessment for a curriculum for difficult conversations in a neurology residency training program in China
Authors: Zhou Lixin , Wu Bo , Wu Liyong , Cheng Xin , Hu Bo , Yao Ming , Zhu Yicheng , Peng Bin , Cui Liying , Ni Jun 
Published: November 2019

Abstract
Background Communication skill is a core competency in neurology residency training. Specific training in this area at the residency level is often lacking, especially regarding difficult conversations. The aim of this study is to evaluate the current state in which neurology programs in China teach residents about difficult conversations and determine whether there is a perceived need for a formalized educational curriculum in this field.Method An anonymous, 27-question, cross-sectional online survey addressing difficult conversations for neurological residents were distributed to five grade-A, class-3 hospitals selected from the affiliated teaching hospitals of medical schools qualified to provide neurology residency training in China.Results A total of 182 residents responded to the survey, and the response rate was 67.16% (182/271). Of the participants, 84.6% were female and the average age was 26.8 years. The majority of respondent residents (n=168; 92.31%) reported being exposed to at least one difficult conversation in their medical careers. Only 43 (23.63%) participants reported having previously received formal communication skills training. In comparison with residents without previous training, those with previous training indicated significantly more confidence(P=0.003)and were under lower pressure(P=0.037) in managing difficult conversations. Only 97 (53.3%) residents indicated interest in receiving formal training. Time, lack of enthusiasm, lack of educational materials and faculty expertise were commonly cited barriers to formalized training.Conclusion This survey provides a contemporary assessment of the current status of education on the topic of difficult conversations in neurology residency training. Our results suggest that there is an unmet need to further develop and implement educational activities by teaching residents to lead difficult conversations. Targeted communication curriculum in difficult conversation should be further developed and implemented for the neurological residents in China.
Experience of Nurse Educators on the Implementation of the Competency-Based Curriculum for Nursing and Midwifery Programmes in Tanzania: A mixed method study.
Authors: Mmari Vumilia Bettuel , Lilian Mselle Teddy , Stephen Kibusi Mathew , Osaki Kalafunja Mlang'a 
Published: November 2019

Abstract
Background: In Tanzania, the competency based curriculum was introduced in 2008. Despite the government efforts to ensure its effective implementation, there has been a public concern on graduate nurse's and midwives' competencies in providing quality nursing care in the country. This concern has influenced people to question the process of the implementation of competency based curriculum for nursing and midwifery programmes. This study describes experience of the nurse educators in implementing the competency based curriculum for nursing and midwifery programmes in Tanzania.Methods: Convergent parallel mixed method approach was used to explore the experience of nurse educators implementing competency based curriculum. To enhance the validity of the findings, 240 nurse educators, out of 264, answered a questionnaire while the remaining 24 were interviewed. Further, a retrospective observation was done to triangulate the information obtained from the questionnaire and interviews. Results: The study found out that nurse educators struggle implementing the competency based curriculum and 92% of the participants could not clearly explain the concept of the approach itself. 234 of them used lecture discussion (97%) while simulation was used by 128 (53%). Challenges associated with employing participatory teaching and learning methods reported by most participants included time constraints (61; 25%), some method require special skills to teach(33; 13% and tutors needed training on the competency based curriculum to implement it (13; 5%).Conclusion: The results conclude that an understanding of the competency based curriculum is limited among educators. Furthermore, they revealed challenges in employing the participatory teaching and learning methods, hence, underscoring the need to put in place a sustainable strategy for continuous personal development and mentorship. Keywords: Competency based curriculum, implementation fidelity, nurse educators' experience, nursing and midwifery training programmes.