bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identification of novel circulating angiogenic factors in small bowel angiodysplasia: a further step towards delineating the pathophysiology and defining treatment targets
Authors: Holleran Grainne , Smith Sinead , McNamara Deirdre 
Published: July 2019

Abstract
Background:
Small bowel angiodysplasia (SBA) accounts for 50% of small bowel bleeding, with a poor prognosis due to inadequate response to limited treatments. A poor understanding of the pathophysiology of the condition impedes improvements in diagnosis and treatments. We previously identified the Angiopoietin pathway to be associated with SBA, however this may be only one of many angiogenic drivers.
Methods:
We initially measured relative levels of 55 angiogenic factors in serum of Small Bowel Angiodysplasia (SBA) patients and non-bleeding controls. Quantitative Enzyme-linked Immunosorbent Assay (ELISA) measurements of any significant factors detected were then performed in a larger group of patients and controls.
Results:
Serum measurements of relative levels of 55 angiogenic factors were performed in seven SBA patients and controls and identified significant differences in five factors between groups– Angiopoietin-1 (Ang1), Angiopoietin-2 (Ang2), Tissue-Inhibitor of Metalloproteinases 1 (TIMP1), Endostatin and Platelet-derived Growth Factor-AA (PDGF-AA). We found no differences in levels of Vascular Endothelial Growth Factor (VEGF). Quantitative serum ELISA measurements of TIMP1, Endostatin and PDGF-AA were performed in 20 SBA patients and controls and showed significantly lower mean levels of TIMP1 and higher levels of Endostatin in SBA patients compared to controls, with no differences in PDGF-AA levels.
Conclusions:
This study confirms our previous findings, that Ang1 and Ang2 are key factors associated with SBA formation, and that VEGF is unlikely to have a key role in SBA pathophysiology. We have identified two new anti-angiogenic factors likely to be involved in SBA development, TIMP1 and Endostatin. Further assessments of circulating and tissue levels of these factors may advance the discovery of the pathophysiology of SBA and identify therapeutic targets.
HBsAg quantification predicts off-treatment response to interferon in chronic hepatitis B patients：A retrospective study of 250 cases
Authors: Wu Shuai , Luo Wenfan , Wu Yin , Chen Hongjie , Peng Jie 
Published: July 2019

Abstract
Background: For chronic hepatitis B (CHB) patients without willingness to extend the routine duration of interferon (IFN) therapy, it is important to identify patients who will benefit from treatment cessation. Hepatitis B surface antigen (HBsAg) quantification is recommended for management of IFN therapy. At present, the understanding on end-of-treatment (EOT) HBsAg level predicting post-treatment response to IFN is still finite.
Methods: Patients with CHB infection and treated with IFN-based therapy during the period from December 2010 to December 2017 at Nanfang Hospital were enrolled in this study. Serum HBsAg levels at EOT were measured to evaluate the associations between EOT HBsAg levels (Group 1, HBsAg >0.05 and ≤10 IU/mL; Group 2, HBsAg >10 and ≤200 IU/mL; Group 3, HBsAg >200 IU/mL) with post-treatment HBsAg loss. Chi-squared, t-test, ,Kaplan-Meier analysis, Cox regression analysis, and Multivariate Logistic regression analysis were used to analyse and evaluate differences between the there groups.
Results: The cumulative HBsAg loss rates 5 years after treatment in Group 1-3 were 30.4% (17/56), 9.8%(4/41) and 0%(0/153) (p<0.001). An EOT HBsAg level of >10 IU/mL showed relatively high negative predictive value (NPV) of up to 97.9% for HBsAg loss. Low baseline HBsAg level <25000 IU/mL, on-treatment HBsAg decline >1 log10IU/mL at week 24 and EOT HBsAg level ≤10 IU/mL were found significantly associated with HBsAg loss. A total of 6 patients have achieved HBsAg loss at EOT and 17 patients with EOT HBsAg level ≤10 IU/mL have achieved post-treatment HBsAg loss. Baseline characteristics, dynamic changes of on-treatment HBsAg and duration of IFN therapy were balanced across patients with EOT or post-treatment HBsAg loss.
Conclusion: EOT HBsAg level can serve as a monitoring indicator for IFN therapy. EOT HBsAg level ≤10 IU/mL was found to lead to high rate of post-treatment HBsAg loss. For patients without willingness to extend IFN treatment, off-treatment follow-up could be considered when HBsAg level decreased to ≤10 IU/mL.
Nursing staff´s evaluation of facilitators and barriers during implementation of wireless nurse call systems in residential care facilities. A cross-sectional study.
Authors: Dugstad Janne , Sundling Vibeke , Nilsen Etty R. , Eide Hilde 
Published: July 2019

Abstract
Background

Nurse call systems (NCS) encompass all patients and nursing staff in healthcare facilities. Wireless NCSs offer increased mobility for all users and new affordances to patients unable to actively interact with such systems. Integrated technology potentially decrease response times and prevent alarm-fatigue, and thus increase patient safety and enhance nursing workflow. This study aimed to explore facilitators and barriers for implementation of wireless NCSs in residential care facilities.

Methods

The study had a cross-sectional descriptive design. Using a questionnaire, we collected data from care providers (n=98) based on the Measurement Instrument for Determinants of Innovations (MIDI) in five Norwegian residential care facilities during the first year of implementation of wireless NCSs. Descriptive statistics were used to explore participant characteristics and MIDI scores. MIDI items to which ≥20% of participants disagreed/totally disagreed were regarded as barriers and items to which ≥80% of participants agreed/totally agreed were regarded as facilitators for implementation.

Results

More facilitators (n=23) than barriers (n=6) were identified. No features of the technology itself were found to impede the implementation. The most salient barriers, reported by 37% of the care providers, were their lack of prior knowledge and that they found the wireless NCS difficult to learn. However, 87% became familiar with the systems during implementation. Respectively, 86% and 90% regarded themselves and their colleagues as competent users after the implementation. The greatest facilitators, reported by 98%, were firstly the normative belief of unit managers and secondly the expected outcomes of the NCSs: the importance and probability of achieving prompt call responses and increased safety.

Conclusions

The wireless NCSs were well received and the implementations were satisfactory executed. The barriers to implementation were addressed by training and practicing technological skills, facilitated by the influence and support by the manager and the colleagues within the residential care unit. Wireless NCSs offer a range of advanced applications and services, and further research is needed as more wireless NCS functionalities are implemented into residential care services.
Nutritional care for patients with Ebola Virus Disease in Ebola treatment units – past and current experiences from practitioners
Authors: Ververs Mija , Anantharam Puneet 
Published: July 2019

Abstract
Background
In November 2014, the World health Organization (WHO), in collaboration with UNICEF, and the World Food Programme, produced interim guidelines (iGL) on providing nutritional support to patients in Ebola treatment units (ETUs). They have been translated into French and issued by the Ministry of Health, UNICEF and WHO in adapted versions to be used in the current outbreak in the Democratic Republic of the Congo (DRC). This paper evaluates the use and usefulness of the 2014 iGL in the West Africa and current DRC Ebola virus disease (EVD) outbreaks and identifies experiences and lessons learned from practitioners on the operational aspects of nutritional care and support in ETUs.
Methods
Key-informants (n=26), from 12 organizations (Non Governmental Organizations, United Nations, Red Cross Red Crescent Movement) were interviewed who were actively engaged in the nutritional and/or clinical care of EVD patients.
Results
There was a consensus among key informants that the 2014 iGL initially served a guiding purpose. However, the vast amount of learning from the 2014-2016 and current EVD outbreaks indicates that the interim guidelines need to be revised. Practitioners struggled to find operational solutions for nutritional care, and the challenges were plentiful, especially regarding 1) the different perceptions of the importance of nutritional care among ETU staff; 2) the difficulties around food preparation and distribution for EVD patients; 3) how to take into account the patients’ dietary preferences; 4) the nutritional care needed in relation to specific EVD symptoms; 5) who assumed roles in nutritional care in ETUs; 6) if and how feeding support was organized; 7) whether malnutrition needed to be addressed and how; and 8) whether the intake of specific nutrients could contribute to improved treatment outcomes. Information from the key-informants interviews resulted in numerous lessons learned and recommendations for nutritional support during current and future outbreaks.
Conclusions
This investigation underscored the importance of documenting experiences of practitioners on nutritional care in emerging infectious diseases for which limited scientific evidence exists and for which interim guidelines are produced to fill in knowledge gaps. It also emphasized the importance of nutritional care in ETUs during treatment.
Orthopaedic Surgeons Perceptions of Frailty and Frailty Screening
Authors: Archibald Mandy , Lawless Michael , Gill Tiffany , Chehade Mellick 
Published: July 2019

Abstract
Background

Over the past decade, there has been significant growth in the awareness and understanding of fragility among orthopaedic surgeons in the context of osteoporotic fractures and with it, improvements in the recognition and management of fragility fractures. Emerging as a major clinical and research focus in aged care is the concept of frailty and its associations with fragility, sarcopenia, falls and rehabilitation. Currently, research is lacking on how orthopaedic surgeons perceive frailty and the role of frailty screening. A baseline understanding of these perceptions is needed to inform integration of frailty identification and management for patient optimization in orthopaedic practices, as well as research and education efforts of patients and healthcare professionals in orthopaedic contexts.

Methods

We used an exploratory design guided by qualitative description to conduct 15 semi-structured telephone and in-person interviews across three orthopaedic surgeon subgroups (Registrars, Junior and Senior Consultants). Data collection and analysis occurred iteratively and was guided by thematic saturation.

Results

Orthopaedic surgeons have a disparate understanding of frailty. Between colleagues, frailty is often referred to non-specifically to suggest a general state of risk to the patient. Frailty screening is regarded positively but its specific utility in orthopaedic environments is questioned. Easy-to-administer frailty screening tools that are not exclusive assessments of functional status are viewed most satisfactorily. However these tools are rarely used.

Conclusions

There is little understanding among orthopaedic surgeons of frailty as a phenotype. Beliefs around modifiability of frailty were dissimilar as were the impact of related risk factors, such a cognitive status, chronic disease, social isolation, and environmental influences. This in turn may significantly impact on the occurrence and treatment outcomes of fragility fracture, a common orthopaedic problem in older populations. This study highlights need for knowledge translation efforts (e.g. education) to achieve cohesive understanding of frailty among health professionals.
miR-450a-5p eliminats MGO-induced insulin resistance via targeting CREB
Authors: Wei Cuifeng , Meng Li , Zhang Yuting 
Published: July 2019

Abstract
Background

miR-450a-5p was involved in fat formation, but its role in insulin resistance remains unclear. This study further investigated the effects of miR-450a-5p in endothelial cells, with the aim of finding a potential target for diabetes mellitus.

Methods

Human umbilical vein endothelial cells (HUVECs) were severally treated with low-glucose, high-glucose, methylglyoxal (MGO), and insulin only or plus MGO. miR-450a-5p was up-regulated or down-regulated in treated HUVECs. miR-450a-5p expression in cells was measured by quantitative real-time polymerase chain reaction (qRT-PCR) assays. The cell activity was determined through MTT experiments. Transwell assay and oil red O staining were used for the detection of cell invasion and fat formation. The expressions of eNOS/AKT pathway-related proteins in cells were assessed by Western blot (WB) analysis. Furthermore, the target gene of miR-450a-5p was analyzed by double-luciferase reporter analysis, and its influence in eNOS/AKT pathway was estimated.

Results

miR-450a-5p decreased obviously in endothelial cells with high-glucose and MGO. Through in vitro cell experiments, we knew that MGO could not only intensify the activity of endothelial cells, but also accelerate cell invasion and fat accumulation, which could be reversed by up-regulated miR-450a-5p. Moreover, MGO inhibited eNOS/AKT pathway activation and NO release mediated by insulin, which were eliminated by up-regulated miR-450a-5p. Furthermore, CREB was the target gene of miR-450a-5p that had an activation effect on the eNOS/AKT pathway.

Conclusions

Up-regulated miR-450a-5p eliminated MGO-induced insulin resistance via targeting CREB, which might be a potential target to improve insulin resistance and benefit patients with related diseases.
Association distribution characteristics of natural and artificial Larix gmelinii forests along environmental gradients in northeast China
Authors: Bai Xiaohang , Yu Jinghua , Yuan Shusheng , Tan Yihong 
Published: July 2019

Abstract
Background: Larix gmelinii forest is one of coniferous forests in cold-temperate zone, which is a vital part of national strategic landscape of ecological security of China. Plant association distribution is different in natural and artificial Larix gmelinii forests, meanwhile, determining mechanisms in typical associations of Larix gmelinii forests still need to be explored. The study focused on which environmental factors actuated association distribution of natural and artificial Larix gmelinii forests in northeast China. Two-way indicator species analysis (TWINSPAN) and canonical correspondence analysis (CCA) were used to classify plant associations and explored the relationship between species and environment.
Results: All the plots (n=175, size=30 m×30 m) of Larix gmelinii forests were classified into 6 plant associations by TWINSPAN. Species diversity in natural forests were higher than that in artificial forests. Ass.III and Ass.IV only appeared in natural forests, meanwhile, Ass.VI only appeared in artificial forests. The primary environmental drivers of species diversity patterns in natural forests were annual mean temperature, followed by annual precipitation, elevation, slope aspect, and canopy density. However, elevation and annual precipitation had strong effects in determining association distribution in artificial forests.
Conclusions: Plant association distribution showed habitat preferences, besides, natural forests had higher species diversity and more resistance than artificial forests. The study can be used as a reference for Larix gmelinii forest ecosystem protection in northeast China and a theoretical basis for scientific management in similar areas.
Fibrin-Associated Large B-Cell Lymphoma: First Report Within A Cerebral Artery Aneurysm And Literature Review
Authors: Zanelli Magda , Zizzo Maurizio , Montanaro Marco , Gomes Vito , Martino Giovanni , De Marco Loredana , Orcioni Giulio Fraternali , Martelli Maria Paola , Ascani Stefano 
Published: July 2019

Abstract
Background: Fibrin-associated diffuse large B-cell lymphoma (FA-DLBCL) is a rare Epstein-Barr virus (EBV) positive lymphoproliferative disorder included in the current World Health Organization (WHO) classification. It arises within fibrinous material in the context of hematomas, pseudocysts, cardiac myxoma or in relation with prosthetic devices. In these clinical settings the diagnosis requires an high index of suspicion, because it does not form a mass itself, being composed of small foci of neoplastic cells. Despite overlapping features with diffuse large B-cell lymphoma associated with chronic inflammation, it deserves a separate classification, being not mass-forming and often following an indolent course.
Case presentation: A 64-year-old immunocompetent woman required medical care for cerebral hemorrhage. Computed Tomography (CT) angiography identified an aneurysm in the left middle cerebral artery. A FA-DLBCL was incidentally identified within thrombotic material in the context of the arterial aneurysm. After surgical removal, it followed a benign course with no further treatment.
Conclusions: The current case represents the first report of FA-DLBCL identified in a cerebral artery aneurysm, expanding the clinicopathologic spectrum of this rare entity. A complete literature review is additionally made.
Impact of the comprehensive geriatric assessment on treatment decision in geriatric oncology
Authors: Sourdet Sandrine , Brechemier Delphine , Steinmeyer Zara , Gerard Stephane , Balardy Laurent 
Published: July 2019

Abstract
Background

The comprehensive geriatric assessment (CGA) is the gold standard in geriatric oncology to identify patients at high risk of adverse outcomes and optimize cancer and overall management. Many studies have demonstrated that CGA could modify oncologic treatment decision. However, there is little knowledge on which domains of the CGA are associated with this change. Moreover, the impact of frailty and physical performances on cancer treatment changes have been rarely assessed.

Methods

This is a cross-sectional study of older patients with solid or hematologic cancer referred by oncologists for a geriatric evaluation before cancer treatment. A comprehensive geriatric assessment was performed by a multidisciplinary team to decide if the initial cancer treatment plan was appropriate or not. We performed a multivariate analysis to identify CGA domains associated with the risk to judge the treatment inappropriate.

Results

418 patients, mean age 82.8 ± 5.5, were included between 2011 and 2015. The initial cancer treatment plan was judged inappropriate in 56 patients (14.6%). In multivariate analysis, the treatment was judged inappropriate in patients with cognitive impairment (p=0.006), malnutrition (p=0.011), and low physical performances according to the Short Physical Performance Battery (p=0.001).

Conclusion

Cognition, malnutrition and low physical performances significantly affects cancer treatment decision in older adults with cancer. More studies are needed to evaluate their association with survival, treatment toxicity and quality of life. The role of physical performances should be specifically explored.
Neutrophil-to-lymphocyte ratio has predictive value for lymph node involvement and distant metastasis in nasopharyngeal carcinoma patients
Authors: Xingming Ye , Lu Tianzhu , Bai Wendong , Jia Jing , Wang Lin , Zong Jingfeng , Chen Ying 
Published: July 2019

Abstract
Background

Systemic inflammatory responses play important roles in the development and progression of cancer, including the propensity for metastasis. High neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are associated with poor prognosis in nasopharyngeal carcinoma (NPC), but the underlying reasons are unclear. Here, we investigated the associations between a range of hematological parameters and T, N, and M stage in patients with NPC.

Methods

This was a retrospective study of 834 patients treated at our hospital for NPC between November 2011 and December 2012. A control group consisted of 647 healthy volunteers. Associations between disease stage and pretreatment laboratory data including absolute white blood cell (WBC), neutrophil, lymphocyte, and platelet counts; red cell distribution width (RDW); PLR, and NLR were analyzed using the Kruskal−Wallis test. Associations with patient survival were analyzed using the Kaplan−Meier method and log-rank test. The relationship between tumor expression of vascular-endothelial growth factor (VEGF) and circulating neutrophil counts was also evaluated in a subset of patients.

Results

NLR, PLR, RDW, total WBCs, neutrophils, and platelets were elevated, lymphocyte counts were lower, and hemoglobin was unchanged in NPC patients compared with healthy control subjects. NLR, PLR, and RDW were significantly associated with increasing N stage (P<0.0001, P=0.0024, P<0.0001, respectively), and NLR, WBCs, and neutrophils were significantly associated with increasing M stage (P=0.0034, P=0.0157, P=0.0064, respectively). Absolute neutrophil counts correlated positively with tumor VEGF expression (P=0.0377). An NLR of ≥2.26 was associated with a better 5-year distant metastasis-free survival rate compared with <2.26 (89.4% vs 85.0%, P = 0.034).

Conclusions

NLR is significantly associated with local and distant metastasis in NPC patients, and absolute neutrophil count is significantly related to tumor VEGF expression, suggesting that these parameters may be useful predictive biomarkers for NPC.
Do prostatectomy suitable for localized prostate cancer patient: evidence from meta-analysis
Authors: Luo Xiaojin , Yi Meilian , Hu Qun , Yin Weihua 
Published: July 2019

Abstract
Objective:To evaluate the role of prostatectomy for localized prostate cancer patient. Methods: A systematic search was conducted using PubMed, and Web of Science through March 22, 2019 according to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines to identify studies reporting on prostatectomy for localized prostate cancer patient. Results: Of a total of 1827 studies, 6 were considered for evidence synthesis. A total of 4476 patients in 4 studies were included for survival analysis, 2,779 patients received prostatectomy and 1,697 patients were received no treatment but regularly followed up. Two other studies were included for adverse effects analysis. Prostatectomy displayed a significantly decreased risk of death of 35% compared with observation (OR=0.65, 95%CI 0.53-0.81, P<0.0001). Pooled data indicated prostatectomy reduced 55% risk of disease progression (OR=0.45, 95% CI 0.34-0.60, P<0.00001). Anxiety, depressed mode, wellbeing, and sense of meaningfulness for patients were no difference between prostatectomy and observation group. However, prostatectomy increased 2.77 folds risk of erection dysfunction (OR=2.77, 95% CI, 1.60–4.81, P=0.0003 Conclusion: Prostatectomy prolonged survival and deferred disease progression compared to observation for localized prostate cancer patients. Symptoms between two groups were not significant difference except for erection function. Patients should decide prostatectomy or not after balancing the survival benefit and erection dysfunction.