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1. Quality-of-life outcomes and risk prediction for patients randomized to nivolumab plus ipilimumab vs nivolumab on LungMAP-S1400I.

Author

Unger, Joseph, Qian, Lu, Redman, Mary, Tavernier, Susan, Minasian, Lori, Sigal, Ellen, Papadimitrakopoulou, Vassiliki, Leblanc, Michael, Cleeland, Charles, Dzingle, Samuel, Summers, Thomas, Chao, Herta, Madhusudhana, Sheshadri, Villaruz, Liza, Crawford, Jeffrey, Gray, Jhanelle, Kelly, Karen, Gandara, David, Bazhenova, Lyudmila, Herbst, Roy, Gettinger, Scott, and Moinpour, Carol

Subjects
Humans, Male, Aged, Female, Nivolumab, Ipilimumab, Quality of Life, Antineoplastic Combined Chemotherapy Protocols, Carcinoma, Non-Small-Cell Lung, Lung Neoplasms
Abstract

BACKGROUND: An important issue for patients with cancer treated with novel therapeutics is how they weigh the effects of treatment on survival and quality of life (QOL). We compared QOL in patients enrolled to SWOG S1400I, a substudy of the LungMAP biomarker-driven master protocol. METHODS: SWOG S1400I was a randomized phase III trial comparing nivolumab plus ipilimumab vs nivolumab for treatment of immunotherapy-naïve disease in advanced squamous cell lung cancer. The primary endpoint was the MD Anderson Symptom Inventory-Lung Cancer severity score at week 7 and week 13 with a target difference of 1.0 points, assessed using multivariable linear regression. A composite risk model for progression-free and overall survival was derived using best-subset selection. RESULTS: Among 158 evaluable patients, median age was 67.6 years and most were male (66.5%). The adjusted MD Anderson Symptom Inventory-Lung Cancer severity score was 0.04 points (95% confidence interval [CI] = -0.44 to 0.51 points; P = .89) at week 7 and 0.12 points (95% CI = -0.41 to 0.65; P = .66) at week 13. A composite risk model showed that patients with high levels of appetite loss and shortness of breath had a threefold increased risk of progression or death (hazard ratio [HR] = 3.06, 95% CI = 1.88 to 4.98; P

Published
2023

2. Diagnostic yield of a multi-strategy genetic testing procedure in a nationwide cohort of 728 patients with infantile spasms in China

Author

Li-Ying Liu, Qian Lu, Qiu-Hong Wang, Yang-Yang Wang, Bo Zhang, and Li-Ping Zou

Subjects
Male, DNA Copy Number Variations, Neurology, Tuberous Sclerosis, Exome Sequencing, Humans, Female, Genetic Testing, Neurology (clinical), General Medicine, Spasms, Infantile
Abstract

Infantile spasms (IS) is a common epilepsy syndrome in infancy. Genetically based birth defects are among the many causes of infantile spasms. Genetic diagnosis can reveal the etiology of IS and guide treatment strategies and genetic counseling, but significant challenges surround the choice of appropriate genetic diagnostic strategies to improve the diagnostic yield in IS.For a cohort of Chinese patients with IS, appropriate genetic testing methods were selected according to etiological classification. Methods included karyotyping, copy number variation detection, single-gene sequencing, targeted sequencing panel, and whole-exome sequencing.A total of 728 children with IS from fifteen provinces and municipalities in China from June 2015 to October 2020 were recruited in the study. Among them, 436 were males (59.9%). The median age was 9.46 months. The diagnostic yield of our study was 31.5% (185/587). The top five causative genes were TSC2 (n = 91), STXBP1 (n = 21), TSC1 (n = 15), SCN2A (n = 6), and CDKL5 (n = 6). The genetic diagnostic yield was 100% in Down syndrome (n = 1), neurofibromatosis (n = 2), and methylmalonic acidemia (n = 2), 83.5% in tuberous sclerosis complex (n = 127), and 16.7% in unsolved infantile spasms (n = 442). Different genetic testing methods for different etiologies show large differences in diagnostic yields.This study demonstrates that appropriate genetic testing procedures for different phenotypes can ensure a high diagnostic yield.

Published
2022

3. Risk factors of unilateral breast cancer-related lymphedema: an updated systematic review and meta-analysis of 84 cohort studies

Author

Aomei, Shen, Qian, Lu, Xin, Fu, Xiaoxia, Wei, Liyuan, Zhang, Jingru, Bian, Wanmin, Qiang, and Dong, Pang

Subjects
Cohort Studies, Oncology, Risk Factors, Breast Cancer Lymphedema, Axilla, Unilateral Breast Neoplasms, Humans, Lymph Node Excision, Female, Breast Neoplasms, Lymphedema, Mastectomy
Abstract

To review and update the incidence and risk factors for breast cancer-related lymphedema based on cohort studies.The study was guided by the Joanna Briggs Institute methodology and the Cochrane handbook for systematic reviews. PubMed, EMBASE, CINAHL, Scopus, Web of Science, The Cochrane Library, CNKI, SinoMed, and Wan Fang Database were searched from inception to November 15, 2021. Cohort studies reported adjusted risk factors were selected. PRISMA guideline was followed. Study quality were evaluated using the Newcastle-Ottawa scale. Random-effects models were adopted. The robustness of pooled estimates was validated by meta-regression and subgroup analysis. Lymphedema incidence and adjusted risk factors in the multivariable analyses with hazard / odds ratios and 95% CIs were recorded.Eighty-four cohort studies involving 58,358 breast cancer patients were included. The pooled incidence of lymphedema was 21.9% (95% CI, 19.8-24.0%). Fourteen factors were identified including ethnicity (black vs. white), higher body mass index, higher weight increase, hypertension, higher cancer stage (III vs. I-II), larger tumor size, mastectomy (vs. breast conservation surgery), axillary lymph nodes dissection, more lymph nodes dissected, higher level of lymph nodes dissection, chemotherapy, radiotherapy, surgery complications, and higher relative volume increase postoperatively. Additionally, breast reconstruction surgery, and adequate finance were found to play a protective role. However, other variables such as age, number of positive lymph nodes, and exercise were not correlated with risk of lymphedema.Treatment-related factors still leading the development of breast cancer-related lymphedema. Other factors such as postoperative weight increase and finance status also play a part. Our findings suggest the need to shift the focus from treatment-related factors to modifiable psycho-social-behavioral factors.

Published
2022

4. Development and psychometric evaluation of a lymphoedema self‐management behaviour questionnaire for breast cancer patients

Author

Xiaoxia Wei, Qian Lu, Aomei Shen, Xin Fu, Lichuan Zhang, Yujie Wang, and Yingxin Wang

Subjects
Cross-Sectional Studies, Psychometrics, Oncology, Self-Management, Surveys and Questionnaires, Humans, Reproducibility of Results, Female, Breast Neoplasms, Lymphedema
Abstract

The study was aimed to develop and evaluate a lymphoedema self-management behaviour questionnaire (LSMBQ) for breast cancer patients.The initial version of the behaviour questionnaire was developed based on the framework of self-management and the evidence summary of lymphoedema self-management. Two rounds of expert consultation were conducted to validate the questionnaire's content validity. A cross-sectional survey was then conducted in breast wards of two hospitals in China to evaluate the reliability and validity of this scale. Exploratory structural equation model was used to test the construct validity. T-test was used to analyse the known group validity. Structural equation model was applied to verify the relationship between self-efficacy, social support, and lymphoedema self-management behaviour to test the convergent validity. Also, the internal consistency reliability and test-retest reliability were evaluated.The questionnaire's content validity was satisfactory. There were 22 items included in the LSMBQ for validation and 260 completed the survey. A six-factor structure with good construct validity was identified. The result of t-test verified that patients who knew the risk of lymphoedema and those who received lymphoedema health education had higher scores of lymphoedema self-management behaviours (P 0.05), indicating that the questionnaire has good known group validity. The fitting results of the structural equation model indicated that the 22-item questionnaire had good convergent validity. Cronbach's alpha coefficients and test-retest reliability for the total questionnaire were 0.910 and 0.875, respectively.The 22-item LSMBQ appears to have adequate reliability and validity to assess the lymphoedema self-management behaviours for breast cancer patients.

Published
2022

5. Relationship Between Anticipatory Grief and Communication Avoidance in Chinese Caregivers of Patients With Advanced Cancer

Author

Renxiu Guo, Xiaoting Hou, Wenhua Yu, Hong Yang, Yuhan Lu, and Qian Lu

Subjects
Male, China, media_common.quotation_subject, Anger, Irritability, Anticipatory grief, Neoplasms, Intervention (counseling), medicine, Humans, Child, media_common, Oncology (nursing), business.industry, Communication, Middle Aged, Sadness, Cross-Sectional Studies, Caregivers, Oncology, Feeling, Spouse, Anxiety, Female, Grief, medicine.symptom, business, Clinical psychology
Abstract

Background Anticipatory grief (AG) and its relationship with communication avoidance in Chinese caregivers of patients with advanced cancer have not been previously examined. An association between AG and communication avoidance could provide important insights to Chinese caregivers worthwhile to be investigated. Objectives The aims of this study were to evaluate AG and communication avoidance with patients among Chinese caregivers of patients with advanced cancer and to identify their relationship. Methods A cross-sectional study was conducted with a convenience sample of caregivers of patients with advanced cancer practicing at an academic cancer hospital. The participants completed the Anticipatory Grief Scale (AGS) and the Caregivers' Communication With Patients About Illness and Death scale. Results Of the 256 participants, the mean age was 49.10 (SD, 12.87) years, and 63.28% of participants were female. The mean AGS score was 88.05 (SD, 18.42). The AGS subscales in descending order of scores were feeling of loss, sadness, decreased ability to function at usual tasks, anxiety, anger, guilt, and irritability. The mean Caregivers' Communication With Patients About Illness and Death score was 3.60 (SD, 1.13). In the multiple linear regression, AG severity was significantly, positively correlated with communication avoidance. Old age, low education level, religious belief, low income, and living with the patient, spouse, parents, and child implied severe AG. Conclusions Chinese caregivers of patients with advanced cancer reported a high AG and poor communication with patients about illness and death. Less communication was related to more severe AG. Implications for practice Healthcare professionals should pay attention to AG severity and communication of caregivers of patients with advanced cancer to explore the suitable clinical intervention.

Published
2021

6. Social constraints and fear of recurrence among Chinese American breast cancer survivors: An exploration of psychosocial mediators

Author

Qian Lu and Nelson C. Y. Yeung

Subjects
Mediation (statistics), media_common.quotation_subject, Psychological intervention, Psycho-oncology, Shame, Breast Neoplasms, Experimental and Cognitive Psychology, Breast cancer, Cancer Survivors, Surveys and Questionnaires, medicine, Humans, Emotional expression, media_common, Chinese americans, Asian, business.industry, Fear, medicine.disease, Psychiatry and Mental health, Cross-Sectional Studies, Oncology, Female, business, Psychosocial, Clinical psychology
Abstract

OBJECTIVE Fear of cancer recurrence (FCR) is commonly experienced among Caucasian and Chinese American breast cancer survivors (BCS). Emerging studies have suggested that Caucasian BCS' communication with family members contributes to their FCR. However, whether such findings apply to Chinese American BCS has yet to be explored. This study examined the association between social constraints (i.e., perceived barriers from significant others inhibiting cancer-related disclosure) and FCR among 136 Chinese American BCS, plus proposed that self-stigma (i.e., internalized feelings of shame about having cancer), bodily pain, and ambivalence over emotional expression (AEE; conflict between the desire to express emotions and the fear of its consequences) would mediate the association. METHODS Participants recruited through cancer associations in the USA were invited to complete a cross-sectional survey measuring their socio-demographic/cancer-related variables and the above-mentioned psychological variables. RESULTS Higher levels of social constraints, AEE, self-stigma, and bodily pain were associated with higher FCR (rs ranged from 0.27 to 0.40, ps

Published
2021

7. Overcoming constraints of the model minority stereotype to advance Asian American health

Author

Annette L. Stanton, Qian Lu, and Jacqueline H J Kim

Subjects
Male, Health Status, media_common.quotation_subject, Immigration, Population, MEDLINE, Stereotype, PsycINFO, Criminology, Article, Humans, education, Minority Groups, General Psychology, media_common, Health Services Needs and Demand, Stereotyping, education.field_of_study, Asian, General Medicine, United States, Mental Health, National Institutes of Health (U.S.), Behavioral medicine, Pacific islanders, Female, Model minority
Abstract

Asian Americans are the fastest growing U.S. immigrant group, projected to become the largest immigrant group by 2065, but the quantity of research on Asian Americans' health has not mirrored changing demographics. Asian Americans have been understudied for more than 25 years, with only 0.17% of National Institutes of Health (NIH) expenditures allocated to projects including Asian American, Native Hawaiian, and Pacific Islander populations (Ðoàn et al., 2019). This disproportionality may result in part from the model minority stereotype (MMS) being extended to health, perpetuating the ideas that Asian Americans are well-positioned with regard to health status and that associated research is not essential. Accordingly, the aims for this article are threefold: (a) bring attention to the inadequate representation of the Asian American population in health-related science, (b) question the MMS in health, and (c) outline potential pathways through which the MMS limits what is knowable on Asian American health issues and needs. We discuss the limited meaningfulness of nonrepresentative aggregated statistics purporting the model minority image and provide counterexamples. We also present a stereotype-constraints model with the MMS contributing to a bottleneck for Asian American health-related knowledge, accompanied by present-day circumstances (e.g., sparse data, few psychologists/behavioral medicine scientists focused on Asian American health). We conclude with initial recommendations for addressing MMS-associated constraints in psychology and more broadly. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Published
2021

8. Fatostatin inhibits SREBP2-mediated cholesterol uptake via LDLR against selective estrogen receptor α modulator-induced hepatic lipid accumulation

Author

Miao Li, Qian Lu, Yangping Zhu, Xue Fan, Wen Zhao, Luyong Zhang, Zhenzhou Jiang, and Qinwei Yu

Subjects
Selective Estrogen Receptor Modulators, Pyridines, Estrogen Receptor alpha, Breast Neoplasms, General Medicine, Toxicology, Tamoxifen, Thiazoles, Cholesterol, Liver, Receptors, LDL, Non-alcoholic Fatty Liver Disease, Humans, Female, Sterol Regulatory Element Binding Protein 2
Abstract

Estrogen receptor α (ERα) plays a key role in the adaptive response of liver metabolism to energy demands, especially in controlling lipid metabolism. Tamoxifen (TMX), a main drug for the treatment of ER-positive breast cancer in clinical, is a selective ER modulator (SERM). However, accordingly, the long-term use of TMX would lead to nonalcoholic fatty liver (NAFLD) in clinical, which had no definite treatment up to now. Fatostatin (Fato), an inhibitor of sterol-regulatory element binding protein 2 (SREBP2), was reported as a synergistic inhibitor of ER-positive breast cancer with TMX, but the hepatic lipid regulation of this combination is still unknown. Herein, we aimed to explore the effect and mechanism of Fato against TMX-induced NAFLD. The results identified that hepatic cholesterol content increase was the main reason for TMX-induced NAFLD. It was caused by the upregulation of circulating cholesterol uptake mediated by low density lipoprotein receptor (LDLR) in liver, which resulted from the activation of SREBP2. Meanwhile, Fato could inhibit activation of SREBP2-LDLR pathway, alleviating TMX-induced hepatic cholesterol accumulation. In summary, these results provided a new insight into the mechanism of TMX-induced NAFLD. Moreover, it supported the combination of Fato and TMX for the treatment of ER-positive breast cancer to reduce the adverse effect of TMX in clinical.

Published
2022

9. HBx acts as an oncogene and promotes the invasion and metastasis of hepatocellular carcinoma both in vivo and vitro

Author

Wu Meilong, Qian lu, Jiahong Dong, Xiaojuan Wang, Lei Gong, Xiaobin Feng, Bin Shu, Shizhong Yang, and Yanfeng Liu

Subjects
Adult, Male, Carcinoma, Hepatocellular, viruses, Mice, Nude, medicine.disease_cause, Viral vector, Metastasis, Mice, 03 medical and health sciences, 0302 clinical medicine, In vivo, Animals, Humans, Medicine, Neoplasm Invasiveness, Viral Regulatory and Accessory Proteins, Aged, Hepatitis B virus, Hepatology, Oncogene, business.industry, Liver Neoplasms, Gastroenterology, Oncogenes, Transfection, Middle Aged, Hepatitis B, medicine.disease, digestive system diseases, Gene Expression Regulation, Neoplastic, HBx, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Trans-Activators, Cancer research, Female, 030211 gastroenterology & hepatology, business
Abstract

Background and Aims Hepatitis B virus X (HBx) has been reported to be closely related to hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). This study aimed to detect the expression pattern of HBx and explore whether HBx protein can promote HCC invasion and metastasis both in vivo and vitro. Methods HBx expression was detected in HCC tissues via immunochemistry. A recombinant adenovirus vector containing the HBx gene was constructed and transfected into the HCC cell line SMMC-7721. Wound healing, transwell migration, and invasion assays were performed to evaluate migration and invasion potentials. A splenic implant tumor nude mice model was established to confirm its invasion and metastatic abilities in vivo. Results The positive rate of HBx in HCC tissues was 67.89%. HBx overexpression significantly promoted the migration and invasion abilities of SMMC-7721 cells in vitro. The tumor model showed that splenic implant tumor volume and number of liver metastatic tumor nodes were significantly larger and higher in the HBx overexpression group than in the control group. Conclusions HBx is highly expressed in HCC tissues and promotes HCC invasion and metastasis both in vivo and vitro with oncogene activity, thereby suggesting that HBx can serve as a novel therapeutic target in HCC.

Published
2021

10. Abdominal drainage systems in modified piggyback orthotopic liver transplantation

Author

Rui Tang, Jin-Jie An, Lihan Yu, Qian Lu, Jun-Wei Han, and Jing-Yi Lin

Subjects
Adult, Male, medicine.medical_specialty, Hepatology, Orthotopic liver transplantation, business.industry, Gastroenterology, Abdominal Cavity, Equipment Design, Middle Aged, Liver Transplantation, Surgery, Abdominal drainage, Postoperative Complications, Liver, medicine, Drainage, Humans, Female, business, Aged
Published
2021

11. Platelet-rich plasma regulating the repair of ultraviolet B–induced acute tissue inflammation: adjusting macrophage polarization through the activin receptor–follistatin system

Author

Bingrong Zhou, Xu-Feng Yin, Yueyue Li, Yihe Chen, Wen Qian, Gajin Park, Dan Luo, Ni Zeng, Weiwei Ma, Qian Lu, Meijie Zhang, and Li-wen Ma

Subjects
Follistatin, Ultraviolet Rays, macrophage polarization, Activin Receptors, Photoaging, Macrophage polarization, Bioengineering, Inflammation, Applied Microbiology and Biotechnology, Skin Aging, Rats, Sprague-Dawley, medicine, Animals, Skin, integumentary system, biology, Platelet-Rich Plasma, Chemistry, Macrophages, Regeneration (biology), activin, General Medicine, Activin receptor, medicine.disease, Rats, Disease Models, Animal, UVB-induced acute photodamage, Platelet-rich plasma, biology.protein, Cancer research, Female, medicine.symptom, TP248.13-248.65, Research Article, Research Paper, Biotechnology
Abstract

Ultraviolet B (UVB) is one of the most common exogenous factors in skin aging, especially photoaging. Once a large amount of UVB accumulates within a short period of time, skin tissue can become inflamed. It has also been found in clinics that platelet-rich plasma (PRP) can promote wound repair; therefore, the aim of this study was to identify the mechanism by which PRP repairs UVB-induced skin photodamage. We used PRP of Sprague-Dawley rats with the two-spin technique in the established acute UVB radiation photodamage model and harvested the corresponding skin after 1, 7, and 28 d. Hematoxylin and eosin staining was used to observe tissue inflammation. We found that PRP reduces inflammation in the early stages of UVB-induced acute skin damage, and then promotes the proliferation of collagen in the middle and late stages. Moreover, PRP can stimulate Act A and M1 polarization in the early stage, while inhibiting activin A (Act A) and inducing M2 polarization in the middle and late stages. In conclusion, this study demonstrates that PRP plays an important regulatory role in helping reduce UVB-induced acute skin tissue inflammation by adjusting macrophage polarization, which alleviates skin inflammation and stimulates collagen regeneration.

Published
2021

12. HPVs Vaccination among Racial/Ethnic Minority College Students: Current Status and Future Direction

Author

Lois M. Ramondetta, Qian Lu, Dalnim Cho, and Luz M. Garcini

Subjects
Male, viruses, Psychological intervention, Ethnic group, CINAHL, Article, 03 medical and health sciences, 0302 clinical medicine, Health care, Ethnicity, Humans, Medicine, 030212 general & internal medicine, Students, Minority Groups, 030505 public health, business.industry, Papillomavirus Infections, Vaccination, virus diseases, General Medicine, Pacific islanders, Female, 0305 other medical science, business, Psychosocial, Inclusion (education), Demography
Abstract

Objectives College is an important period for catch-up vaccination for Human Papillomaviruses (HPVs), but HPVs vaccination rates are low among college students. Given that racial/ethnic minorities are disproportionately affected by HPVs-related cancers, the aim of the present study is to conduct a scoping review about HPVs and HPVs vaccination conducted among racial/ethnic minority college students. Specifically, we examined: 1) the prevalence of HPVs vaccination among racial/ethnic minority college students in the US and 2) the correlates of HPVs vaccination or vaccination intention/interest. Methods We searched three database (PubMed, PsycINFO, and CINAHL) for relevant articles. Of 58 articles initially identified, 23 articles met all inclusion/exclusion criteria. Results Racial/ethnic minority college women (especially Black and Asian/Pacific Islander) were less likely to be vaccinated compared to their non-Hispanic white counterparts. Racial/ethnic minority college men reported lower knowledge of HPVs and HPVs vaccination compared with their women counterparts. However, overall, a majority of racial/ethnic minority college students appeared to have high knowledge about HPVs and intention to vaccinate. Age, doctor recommendation, and psychosocial and cultural factors (e.g., HPVs/HPVs vaccine knowledge, perceived benefits of vaccination, social norms and values, mistrust of health care providers, and cultural norms) were associated with vaccination and individuals’ intention to be vaccinated. Discussion Significant racial/ethnic disparities in HPVs vaccination exist among both college men and women. Interventions to increase vaccine awareness, access, and uptake among racial/ethnic minority college students are lacking and warranted. Interventions targeting only knowledge and/or intention might not be sufficient. Theory-based studies that examine unique factors involved in vaccine uptake during college across multiple levels of influence including psychosocial, provider, health care, and culture are needed.

Published
2020

13. Self‐stigma and quality of life among Chinese American breast cancer survivors: A serial multiple mediation model

Author

Lingjun Chen, Lilian J. Shin, Celia C Y Wong, Qiao Chu, Qian Lu, and Leqi Chen

Subjects
Adult, Coping (psychology), Social Stigma, Population, Breast Neoplasms, Experimental and Cognitive Psychology, Article, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Cancer Survivors, Negatively associated, Surveys and Questionnaires, Adaptation, Psychological, Health care, Humans, Medicine, 030212 general & internal medicine, education, Path analysis (statistics), Chinese americans, education.field_of_study, Asian, Depression, business.industry, Middle Aged, medicine.disease, Self Efficacy, Psychiatry and Mental health, Oncology, 030220 oncology & carcinogenesis, Quality of Life, Female, Self stigma, business, Clinical psychology
Abstract

Objective Despite the increasing scholarly attention toward self-stigma among Asian breast cancer survivors, research is limited about the underlying psychological mechanisms by which self-stigma may influence quality of life for this population. The present study investigated how self-stigma is associated with quality of life among Chinese American breast cancer survivors by examining the serial mediating effects of concerns about breast cancer, self-efficacy for coping with cancer, and depressive symptoms. Methods Chinese American breast cancer survivors (n = 112) completed a questionnaire packet assessing self-stigma related to breast cancer, concerns about breast cancer, self-efficacy for coping with cancer, depressive symptoms, and quality of life. Path analysis was conducted to test the hypothesized serial multiple mediation model. Results The hypothesized model was supported: self-stigma was negatively associated with quality of life through concerns about breast cancer, self-efficacy, and depressive symptoms. After the mediators were controlled for, the direct effect of self-stigma on quality of life was no longer significant. Conclusions Our findings suggest that concerns about breast cancer, self-efficacy for coping, and depressive symptoms are important pathways through which self-stigma may influence quality of life among Chinese American breast cancer survivors. Healthcare practitioners should be aware of survivors' self-stigma and make efforts to alleviate survivors' excessive cancer concerns, facilitate their self-efficacy, and offer emotional support to improve quality of life for this population.

Published
2020

14. Evaluating a Pilot Culturally Sensitive Psychosocial Intervention on Posttraumatic Growth for Chinese American Breast Cancer Survivors

Author

Carol Chunfeng Wang, Lingjun Chen, Alice Loh, Moni Tang, Qian Lu, Qiao Chu, and Lucy Young

Subjects
China, Social Determinants of Health, Ethnic group, Breast Neoplasms, Psychosocial Intervention, Article, law.invention, 03 medical and health sciences, Interpersonal relationship, 0302 clinical medicine, Breast cancer, Cancer Survivors, Randomized controlled trial, law, Intervention (counseling), Ethnicity, medicine, Humans, 030212 general & internal medicine, Minority Groups, Applied Psychology, Chinese americans, 030505 public health, Asian, Posttraumatic growth, business.industry, medicine.disease, Culturally Competent Care, Psychiatry and Mental health, Quality of Life, Female, 0305 other medical science, business, Posttraumatic Growth, Psychological, Psychosocial, Clinical psychology
Abstract

This study investigated the potential benefit of a pilot culturally sensitive group support intervention, named Joy Luck Academy (JLA), in fostering posttraumatic growth among Chinese American breast cancer survivors. Eighty-six Chinese American breast cancer survivors participated in an eight-week single-arm pre-/post-test trial of an intervention program, which included educational lectures and peer mentor support. The JLA participants were compared with an independent sample of 109 Chinese American breast cancer survivors who went through routine care. Both groups completed baseline and eight-week follow-up assessments of the five facets of posttraumatic growth (meaningful interpersonal relationships, finding new possibilities in life, personal strength, appreciation of life, and spirituality). From baseline to follow-up, the JLA participants displayed significant improvements in the total score of posttraumatic growth (d = 0.44, 95% CI: 3.64 to 11.17), meaningful interpersonal relationships (d = 0.44, 95% CI: 1.18 to 3.81), appreciation of life (d = 0.33, 95% CI: 0.17 to 1.60), finding new possibilities in life (d = 0.40, 95% CI: 0.92 to 3.06), and personal strength (d = 0.36, 95% CI: 0.54 to 2.23). In contrast, the routine care participants showed no significant change in any of these outcome variables (all p > .05, d < 0.2). The findings suggest the potential benefit of a culturally sensitive group support intervention in facilitating posttraumatic growth for Chinese American breast cancer survivors, indicating the need for a randomized controlled trial. The educational lectures and peer mentor support may be adapted to tailor the needs of other ethnic minority cancer patients.

Published
2020

15. Establishment of a Liquid Chromatography-Tandem Mass Spectrometry Method for the Determination of Immunosuppressant Levels in the Peripheral Blood Mononuclear Cells of Chinese Renal Transplant Recipients

Author

Bing Chen, Hao-Qiang Shi, Pei-Jun Zhou, Hui-Min An, Jia-Qian Lu, Xiao-Hui Zhai, and Kun Shao

Subjects
Male, Adolescent, Pharmacology, Kidney, 030226 pharmacology & pharmacy, Peripheral blood mononuclear cell, Tacrolimus, Mycophenolic acid, 03 medical and health sciences, 0302 clinical medicine, Asian People, Pharmacokinetics, Tandem Mass Spectrometry, Liquid chromatography–mass spectrometry, Cyclosporin a, medicine, Humans, Protein precipitation, Pharmacology (medical), Whole blood, Chemistry, Mycophenolic Acid, Kidney Transplantation, Transplant Recipients, Cyclosporine, Leukocytes, Mononuclear, Female, Drug Monitoring, Immunosuppressive Agents, Chromatography, Liquid, medicine.drug
Abstract

BACKGROUND Monitoring immunosuppressant levels, such as mycophenolic acid (MPA), cyclosporin A (CsA), and tacrolimus (TAC), in peripheral blood mononuclear cells (PBMCs) could be useful in organ transplant patients administered individualized therapy. The authors developed a liquid chromatography-tandem mass spectrometry assay technique to simultaneously determine immunosuppressant levels in PBMCs and assess their pharmacokinetics in Chinese renal allograft recipients. METHODS PBMCs were isolated from the whole blood of 27 Chinese renal transplant patients using Ficoll-Paque Plus solution, and cell number was determined; acetonitrile treatment for protein precipitation, and gradient elution was performed on an Agilent Eclipse XDB-C18 column (3.5 μm, 2.1 × 100 mm) with mobile phase: water and methanol (containing 2 mM ammonium formate); flow rate: 0.3 mL·min. RESULTS The calibration curves of MPA, CsA, and TAC had a linear range (ng·mL): 0.098-39.2 (r = 0.9987), 0.255-102 (r = 0.9969), and 0.028-11.2 (r = 0.9993), respectively. The extraction effects, matrix effects, and mean relative recovery of these immunosuppressants were 70.4%-93.2%, 72.7%-96.5%, and 90.1%-112.4%, respectively. The within-day and between-day coefficients of variation were

Published
2020

16. Hesperetin Inhibits TGF-β1-Induced Migration and Invasion of Triple Negative Breast Cancer MDA-MB-231 Cells via Suppressing Fyn/Paxillin/RhoA Pathway

Author

Qian Lu, Yongwei Lai, Hong Zhang, Kuang Ren, Wei Liu, Ying An, Jiahong Yao, and Hongyan Fan

Subjects
Transforming Growth Factor beta1, Complementary and alternative medicine, Oncology, Cell Movement, Cell Line, Tumor, Hesperidin, Humans, Female, Triple Negative Breast Neoplasms, Paxillin, Proto-Oncogene Proteins c-fyn, rhoA GTP-Binding Protein
Abstract

Triple-negative breast cancer is an aggressive subtype of breast cancer with poor clinical outcomes and poor prognosis. Hesperetin is an active component extracted from Citrus fruits and Traditional Chinese Medicine has a wide range of pharmacological effects. Here, we assessed the anti-migration and anti-invasive effects and explored inhibitory mechanisms of hesperetin on metastasis of human triple negative breast cancer MDA-MB-231 cells. Cell viability experiments revealed that 200 μM hesperetin has a clear inhibitory effect on MDA-MB-231 cells. TGF-β1 treatment induces apparent tumor progression in MDA-MB-231 cells including aberrant wound-healing and invasion ability, which is effectively suppressed by hesperetin co-treatment. Additionally, hesperetin inhibited the TGF-β1-mediated actin stress fiber formation. Western blot results showed that hesperetin suppressed the TGF-β1-mediated (i) activation of Fyn, (ii) phosphorylation of paxillin at Y31, Y88, and Y118 sites, (iii) the increased expression of RhoA, and (iv) activation of Rho-kinase. We demonstrated the increased interaction of Fyn with paxillin and RhoA protein in the TGF-β1-induced metastasis of MDA-MB-231 cells. Small interfering RNA Fyn inhibited phosphorylation of paxillin (Y31) and activation of Rho-kinase induced by TGF-β1. In conclusion, hesperetin has a significant inhibitory effect on migration and invasion of MDA-MB-231 cells induced by TGF-β1, which might be attributed to inhibiting the Fyn/paxillin/RhoA pathway.

Published
2022

17. Risk and Main Contributing Factors for Constipation in Patients with Gastrointestinal Cancer: A Multicenter Cross-Sectional Study in China

Author

Xiaoxiao Ma, Qian Lu, Yuhan Lu, and Xin Li

Subjects
Analgesics, Opioid, Cross-Sectional Studies, Oncology, Quality of Life, Antiemetics, Humans, Female, Middle Aged, Calcium Channel Blockers, Constipation, Gastrointestinal Neoplasms
Abstract

Background and objectives: The purpose of this study is to determine the risk of constipation and to identify the significant risk factors for constipation in patients with gastrointestinal cancer using the Chinese version of the Constipation Risk Assessment Scale (CRAS-C), as well as to explore the complementary constipation risk factors in patients with gastrointestinal cancer, to improve the specificity of the CRAS-C in this population, and finally to provide a theoretical basis for constipation prevention. Research design and methods: A cross-sectional study involving multiple centers was conducted. A total of 190 patients with gastrointestinal cancer completed surveys that included demographic information, defecation habits, and the CRAS-C. The mean, SD, median, maximum, minimum, frequency, and percentage were used as indicators for the constipation risk and significant risk factors. The t-test and Chi-square tests were used to analyze constipation indicators in patients with gastrointestinal cancer. Results: 190 patients were 58.92±12.07 years of age.The total CRAS-C mean (SD) score was 13.22 (4.69). 51 patients (26.8%) scored lower than 11, who were at the low risk level of constipation. 139 patients (73.2%) scored 11 or above, who were at the high risk level of constipation. The top 10 factors were insufficient liquid intake(81.1%), failure to consume bran products daily(78.9%), insufficient fiber intake(77.9%), antiemetics (74.7%), cytotoxic chemotherapy (52.6%), colorectal/abdominal diseases (42.6%), opioid analgesics (35.3%), opioid analgesics(26.8%), calcium channel blockers (16.3%), endocrine disorders (14.2%). Chi square test showed that constipating for most of the past 3 months, ascites and ECOG score were complementary constipation risk factors in gastrointestinal cancer patients. Conclusion: The findings indicate that most gastrointestinal cancer patients were at a high risk of constipation. There are also several complementary constipation risk factors and CRAS-C can be further revised in future studies to make it more specific in gastrointestinal cancer patients. Integrating CRAS into the pathway of constipation management, carrying out constipation risk screening for hospitalized cancer patients, building systematic constipation prevention plan based on risk assessment are important to reduce the incidence of constipation in patients with gastrointestinal cancer, and improve the quality of life.

Published
2022

18. Cancer disparities in the context of rurality: risk factors and screening across various U.S. rural classification codes

Author

Kelly A. Hirko, Huiwen Xu, Laura Q. Rogers, Michelle Y. Martin, Siddhartha Roy, Kimberly M. Kelly, Shannon M. Christy, Kimlin Tam Ashing, Jean C. Yi, Marquita W. Lewis-Thames, Cathy D. Meade, Qian Lu, Clement K. Gwede, Julianna Nemeth, Rachel M. Ceballos, Usha Menon, Katie Cueva, Karen Yeary, Lisa M. Klesges, Monica L. Baskin, Kassandra I. Alcaraz, and Sabrina Ford

Subjects
Rural Population, Cancer Research, Cross-Sectional Studies, Oncology, Urban Population, Risk Factors, Humans, Uterine Cervical Neoplasms, Female, Obesity, Early Detection of Cancer, United States
Abstract

Prior cancer research is limited by inconsistencies in defining rurality. The purpose of this study was to describe the prevalence of cancer risk factors and cancer screening behaviors across various county-based rural classification codes, including measures reflecting a continuum, to inform our understanding of cancer disparities according to the extent of rurality.Using an ecological cross-sectional design, we examined differences in cancer risk factors and cancer screening behaviors from the Behavioral Risk Factor Surveillance System and National Health Interview Survey (2008-2013) across rural counties and between rural and urban counties using four rural-urban classification codes for counties and county-equivalents in 2013: U.S. Office of Management and Budget, National Center for Health Statistics, USDA Economic Research Service's rural-urban continuum codes, and Urban Influence Codes.Although a rural-to-urban gradient was not consistently evident across all classification codes, the prevalence of smoking, obesity, physical inactivity, and binge alcohol use increased (all pRural cancer disparities persist across multiple rural-urban classification codes, with marked variation in cancer risk factors and screening evident within rural regions. Focusing only on a rural-urban dichotomy may not sufficiently capture subpopulations of rural residents at greater risk for cancer and cancer-related mortality.

Published
2022

19. [Clinical Value of Ultrasound in Evaluating Stent Placement for Managing Graft Stenosis after Meso-rex Bypass]

Author

Xia, Xie, Qi, Meng, Qian, Lu, Yue-Wei, Zhang, Liang, Wang, and Hua-Bin, Zhang

Subjects
Adult, Male, Young Adult, Treatment Outcome, Adolescent, Portal Vein, Hypertension, Portal, Humans, Portasystemic Shunt, Surgical, Female, Stents, Constriction, Pathologic, Middle Aged
Abstract

Objective To explore the feasibility of using ultrasound to evaluate stent placement for managing graft stenosis after Meso-rex bypass for cavernous transformation of the portal vein in adults. Methods This study enrolled the patients who underwent Meso-rex bypass due to cavernous transformation of the portal vein,were diagnosed graft stenosis by postoperative ultrasound,and then underwent percutaneous portal vein puncture portography and stent placement.We then compared the ultrasonic measurement indicators and sonographic manifestations before and after stent placement,and evaluated the alleviation of portal hypertension symptoms after stent placement and related clinical indexes. Results Finally,8 patients were enrolled in this study,including 5 males and 3 females,with an average age of(32.4±14.7)years.The median duration of follow-up was 26 months after stent placement.The mean diameter of graft stenosis was(2.74±0.23)mm after Meso-rex bypass and became wider[(7.23±0.68)mm]after stent placement(

Published
2022

20. Population Pharmacokinetics and Bayesian Estimation of the Area Under the Concentration‐Time Curve for Ganciclovir in Adult Chinese Renal Allograft Recipients After Valganciclovir Administration

Author

Wen-Bin Rui, Xi-Han Wang, Kun Shao, Jia-Qian Lu, Pei-jun Zhou, Shan-Shan Hu, Bing Chen, Hui-Min An, and Xiao-Hui Zhai

Subjects
Adult, Male, Ganciclovir, medicine.medical_specialty, Adolescent, viruses, Population, Urology, Antiviral Agents, Models, Biological, 030226 pharmacology & pharmacy, Young Adult, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Asian People, Pharmacokinetics, medicine, Humans, Valganciclovir, Pharmacology (medical), education, Pharmacology, education.field_of_study, Creatinine, Dose-Response Relationship, Drug, business.industry, Bayes Theorem, Middle Aged, Prodrug, Kidney Transplantation, Nonlinear Dynamics, chemistry, Area Under Curve, 030220 oncology & carcinogenesis, Renal allograft, Female, Time curve, business, medicine.drug
Abstract

Valganciclovir (VGCV) is the prodrug of ganciclovir (GCV). The objective of this study was to establish a population pharmacokinetic model (PPK) of GCV to investigate the PK characteristics of GCV after administration of VGCV in adult Chinese renal allograft recipients. Seventy Chinese renal allograft recipients were given 450 mg (n = 41) or 900 mg (n = 29) VGCV daily. Blood samples were drawn 0-24 hours after 5 days' therapy, and GCV plasma levels were determined. The PPK model was constructed using nonlinear mixed-effects modeling, and the Bayesian estimation of AUC0-24h was constructed for an individual patient based on limited plasma samples. The PK of GCV was best described by a 2-compartment model with a first-order absorption process. The CL/F, V2 /F, Q/F, V3 /F, Ka , and lag time of GCV were 15.8 ± 0.71 L/h, 10.9 ± 2.38 L, 3.98 ± 0.40 L/h, 167 ± 44.0 L, 0.23 ± 0.0078 1/h, and 0.93 ± 0.017 hours, respectively. Clearance of creatinine was found to have a significant impact on the CL/F of GCV (P < .01). Sampling strategies consisted of plasma concentrations 0 and 2 and 0, 2, and 4 hours after VGCV administration were shown to be suitable for the estimation of the GCV AUC0-24h . The PPK model was acceptable and can describe the PK of GCV in Chinese renal transplant patients administered VGCV. The AUC0-24h of GCV in Chinese renal transplant patients can be calculated by a limited sampling strategy method.

Published
2020

21. Finding the silver linings: Psychosocial correlates of posttraumatic growth among husbands of Chinese breast cancer survivors

Author

Nelson C. Y. Yeung, Lili Ji, Guohua Lu, Qian Lu, and Yiwei Zhang

Subjects
Adult, Male, China, Coping (psychology), Breast Neoplasms, Experimental and Cognitive Psychology, Life Change Events, Stress Disorders, Post-Traumatic, 03 medical and health sciences, Social support, 0302 clinical medicine, Breast cancer, Asian People, Cancer Survivors, Surveys and Questionnaires, Adaptation, Psychological, medicine, Humans, Interpersonal Relations, 030212 general & internal medicine, Marriage, Spouses, Posttraumatic growth, Multilevel model, Social Support, Cognition, Middle Aged, medicine.disease, Psychiatry and Mental health, Cross-Sectional Studies, Caregivers, Oncology, 030220 oncology & carcinogenesis, Female, Psychology, Posttraumatic Growth, Psychological, Psychosocial, Cognitive appraisal, Clinical psychology
Abstract

Caregiving does not have to be a totally negative experience for the husband caregivers of breast cancer survivors (BCS). There are growing interests in exploring the positive psychological changes (aka posttraumatic growth; PTG) among husbands of BCS. Western studies have shown that coping resources, cognitive appraisal, and coping strategies are associated with PTG among caregivers of BCS. Studies in the Chinese context are limited. This study examined the psychosocial correlates of PTG among husbands of Chinese BCS.Husbands of Chinese BCS (N = 176) were recruited from two hospitals in Weifang, China to complete a cross-sectional survey. Their levels of caregiving burden, marital satisfaction, cognitive appraisals, coping strategies, and PTG were measured.After controlling for covariates, hierarchical regression results indicated that higher caregiving burden (β = .29), marital satisfaction (β = .27), challenge appraisal (β = 016), and social support seeking (β = .23) were associated with higher PTG (Ps .05). Additionally, a significant interaction between caregiving burden and positive reframing emerged in explaining PTG (β = .17, P .05). Positive reframing was only associated with higher PTG among those with higher caregiving burden (β = .25, P = .03), but not those with lower caregiving burden (β = -.09, P .05).Stress and coping variables significantly contributed to PTG among husbands of Chinese BCS. Our findings implied that addressing those husband caregivers' marital satisfaction, challenge appraisal toward the impact of breast cancer, and social support seeking could be intervention strategies to facilitate their PTG. Among husbands having higher caregiving burden, positive reframing may also facilitate their PTG.

Published
2020

22. Swallowing functional outcomes and nutritional status in head and neck cancer radiotherapy: longitudinal study

Author

Yujie Wang, Yian Shih, Yiwei Cao, Shuai Jin, Sanli Jin, Qian Lu, Hongmei Li, Liqing Gong, Lichuan Zhang, and Yanli Wang

Subjects
Adult, Male, Mucositis, medicine.medical_specialty, Longitudinal study, Adolescent, Population, Nutritional Status, Medicine (miscellaneous), Radiation Dosage, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Swallowing, medicine, Humans, Longitudinal Studies, Prospective Studies, 030212 general & internal medicine, education, MD Anderson Dysphagia Inventory, Aged, Aged, 80 and over, education.field_of_study, Radiotherapy, Oncology (nursing), business.industry, Head and neck cancer, Pharyngeal Neoplasms, Common Terminology Criteria for Adverse Events, Chemoradiotherapy, General Medicine, Middle Aged, medicine.disease, Dysphagia, Deglutition, Medical–Surgical Nursing, Treatment Outcome, Head and Neck Neoplasms, 030220 oncology & carcinogenesis, Physical therapy, Female, medicine.symptom, Deglutition Disorders, business
Abstract

ObjectiveTo explore the relationships between swallowing functional outcomes and nutritional status in patients with head and neck cancer undergoing radiotherapy (RT).MethodsThis longitudinal study included 122 patients. Data were collected at three time points: baseline (T1), the third week of RT (T2) and the completion of RT (T3). The Common Terminology Criteria for Adverse Events was used to assess the symptom of dysphagia and other toxicities; the MD Anderson Dysphagia Inventory (MDADI) was used to assess the patient-perceived swallowing functional outcomes; the nutritional status was evaluated by the weight ratio and the Patient-Generated Subjective Global Assessment (PG-SGA). The generalised estimating equation (GEE) was used to measure the correlation of MDADI with the weight ratio or PG-SGA and also to analyse the influential factors of swallowing functional outcomes.ResultsThe participants’ acute dysphagia rates were 5.7% at T1, 69.7% at T2 and 77.9% at T3. The swallowing functional outcomes worsen over RT (pConclusionThe swallowing functional outcomes were negatively correlated with nutritional status. Healthcare professionals should identify early on the population at higher risk and focus on multiple toxicities, especially the management of pharynx mucositis, to improve nutritional status.

Published
2020

23. Foot Care Education Among Patients With Diabetes Mellitus in China

Author

Jin Liu, Xiaohui Guo, Yanming Ding, Geheng Yuan, Qian Lu, Ping Yang, Sanli Jin, Xin Qi, Bing Wen, and Dong Pang

Subjects
Male, China, Health Knowledge, Attitudes, Practice, medicine.medical_specialty, Cross-sectional study, MEDLINE, 030209 endocrinology & metabolism, Foot problems, Diabetes Complications, 03 medical and health sciences, 0302 clinical medicine, Surveys and Questionnaires, Diabetes mellitus, Diabetes Mellitus, Humans, Medicine, 030212 general & internal medicine, Foot ulcers, Podiatry, Health Education, Aged, Advanced and Specialized Nursing, Foot, business.industry, Middle Aged, medicine.disease, Diabetic foot, Self Care, Medical–Surgical Nursing, Cross-Sectional Studies, Physical therapy, Female, business, Foot (unit), Foot care
Abstract

To investigate the foot care knowledge and behavior of patients with diabetes to determine effect and current challenges of foot care education, as a basis to improve education and reduce diabetic foot complications.Quantitative, cross-sectional study.A convenience sampling method was used to recruit 200 patients with diabetes from the endocrinology clinic of a tertiary general hospital in Beijing between September 2014 and January 2015. Demographic and disease-related data, foot care education, foot risk stratification status, and knowledge and behavior (KB) scores were collected using investigator-designed questionnaires.Of the 200 patients, 128 (64.0%) patients received routine diabetes education, and 73 (36.5%) received foot care education. The mean ± standard deviation (SD) for KB scores were 63.76 ± 14.85, and 59.78 ± 11.17, respectively. The KB scores of patients who received foot care education (69.54 ± 14.32 and 65.27 ± 11.90) were significantly higher than those who received diabetic education only (60.75 ± 15.27 and 57.54 ± 10.25) and those with no diabetic education (60.21 ± 13.37 and 55.94 ± 8.74) (P.01). The KB scores did not differ for patients based on diabetic foot risk strata (P.05).The foot care KB scores of patients with diabetes were low to moderate levels, particularly on items that pertained to self-foot examination, prompt treatment of foot problems, and regular foot inspection by professionals. Individuals with high risk of developing foot complications did not score higher on the KB questionnaire. These data suggest there is need for improvement in instruction and patient uptake and application of knowledge. We recommend further study on the effectiveness of the delivery of foot care education based on foot risk stratification, and the implications of foot ulcer prevention in community settings.

Published
2020

24. Transgenerational reproductive and developmental toxicity of tebuconazole in <scp> Caenorhabditis elegans </scp>

Author

Lingyi Ma, Qian Lu, Ran Liu, and Yuanqing Bu

Subjects
Male, Offspring, media_common.quotation_subject, Developmental toxicity, 010501 environmental sciences, Toxicology, Risk Assessment, 01 natural sciences, Animals, Genetically Modified, Andrology, 03 medical and health sciences, chemistry.chemical_compound, Toxicity Tests, Animals, Caenorhabditis elegans, 030304 developmental biology, 0105 earth and related environmental sciences, Tebuconazole, media_common, 0303 health sciences, Dose-Response Relationship, Drug, biology, Reproduction, Embryo, Cell Cycle Checkpoints, Triazoles, biology.organism_classification, Brood, Fungicides, Industrial, Germ Cells, chemistry, Female, Development of the gonads
Abstract

The transgenerational reproductive and developmental toxicity of tebuconazole (TEB) in Caenorhabditis elegans was investigated over five generations (P0 - F4). Only parental C.elegans (P0) were exposed to TEB (0, 0.01, 0.1, 1, and 10 μg/L) for 24 h and the subsequent offspring (F1-F4) were grown under TEB-free conditions. TEB exposure caused dose-dependent reproductive defects and developmental impairments in C.elegans. In the P0 generation reproductive defects were observed such as: reduced brood size and embryo hatchability, prolonged generation time, retarded gonadal development, and slower germline proliferation, even at 0.01 μg/L, together with developmental toxicity with significant reduced body length and narrowed body width at 10 μg/L. Additionally, the brood size significantly reduced in F2, which began to recover from F3, but was still lower than the control in F4. The proportion of abnormalities increased significantly in F2 and reduced from F3, but was still higher than the control, suggesting that TEB could have cumulative potential and be passed to offspring through parental exposure. Furthermore, exposure to TEB (10 μg/L) in P0 significantly reduced the body length in F1, which began to recover from F2, and was the same level as the control in F4. There was a concentration-dependent increase in body width in F1-F4, with a significant increase only observed in F1 at 10 μg/L. Thus, parental exposure to TEB induced transgenerational defects in both reproduction and development, emphasizing the significance of considering bio-toxicity over multiple generations to conduct accurate assessment of environmental risks of toxicants.

Published
2020

25. The associations of self-stigma, social constraints, and sleep among Chinese American breast cancer survivors

Author

Ivan H.C. Wu, Lorna H. McNeill, William Tsai, and Qian Lu

Subjects
Emotions, Social Stigma, Breast Neoplasms, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Cancer Survivors, Acquired immunodeficiency syndrome (AIDS), Surveys and Questionnaires, Humans, Medicine, Emotional expression, 030212 general & internal medicine, Social Behavior, Chinese americans, Asian, business.industry, Nursing research, Incidence (epidemiology), Cancer, Middle Aged, medicine.disease, Sleep in non-human animals, Dyssomnias, Self Concept, Affect, Oncology, 030220 oncology & carcinogenesis, Quality of Life, Female, Sleep, business, Clinical psychology
Abstract

The aim of the current study was to examine the incidence of poor sleep quality, medication use, and dysfunction and the association of self-stigma and perceived social constraints (i.e., ambivalence over emotional expression; AEE) on sleep among a sample of Chinese American breast cancer survivors. The data were based on self-report baseline data (n = 136) from an expressive writing intervention study for Chinese American breast cancer survivors (MTime since diagnosis = 27.17 months; SD = 19.31). Participants completed self-report questionnaires related to psychological and physical health and health behaviors. Using linear regression and path modeling, our hypotheses were tested using models where (1) self-stigma predicted sleep characteristics (i.e., quality, medication use, and dysfunction) with (2) AEE mediating the relationship between self-stigma and sleep. Participants frequently reported poor sleep quality (44.9%), use of sleep aids (37.5%), and difficulty staying awake during the day (37.5%). Greater self-stigma was related to greater AEE (b = .48, SE = .09, p

Published
2019

26. Psychometric properties of the Chinese version of the chemotherapy-induced taste alteration scale

Author

Margaret M. Heitkemper, Qian Lu, Ping Yang, Sanli Jin, Lijing Qian, Dong Pang, and Zhuo Job Chen

Subjects
Adult, Male, China, Adolescent, Psychometrics, Antineoplastic Agents, Dysgeusia, Structural equation modeling, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Cronbach's alpha, Neoplasms, Surveys and Questionnaires, Humans, Medicine, Translations, Reliability (statistics), Aged, 030504 nursing, Oncology (nursing), business.industry, Discriminant validity, Reproducibility of Results, Construct validity, General Medicine, Middle Aged, Test (assessment), Convergent validity, Taste, 030220 oncology & carcinogenesis, Scale (social sciences), Female, Factor Analysis, Statistical, 0305 other medical science, business, Clinical psychology
Abstract

Purpose The chemotherapy-induced taste alteration scale (CiTAS) is a reliable and valid instrument to comprehensively assess patients’ taste alterations in an easy way. We aimed to translate it and test its psychometric properties among Chinese cancer patients undergoing chemotherapy. Method A convenience sample of 227 cancer patients were recruited in a tertiary cancer hospital in Beijing. The Chinese version of the CiTAS (C-CiTAS) was developed via rigorous translation methods. An exploratory structural equation model (ESEM) was used to test its construct validity. Correlations between the C-CiTAS scores and the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 scores were calculated for convergent validity. The overall taste alterations scale (OTAS) score was used to test its discriminant validity. Reliabilities were also examined. Results The majority of patients undergoing chemotherapy experienced minor to mild taste alterations. The current factor analysis results using the ESEM supported the original factor solution of the CiTAS, and no item of the CiTAS was dropped. The C-CiTAS demonstrated good construct validity, convergent validity and discriminant validity. The Cronbach's alphas of the C-CiTAS were 0.900 for the overall scale and from 0.570 to 0.857 for the four subscales. Its test-retest reliability was 0.815 (p Conclusions The Chinese version of the CiTAS is a reliable and valid instrument to evaluate cancer patients’ Chemotherapy-induced taste alterations in China.

Published
2019

27. Self-management Strategies for Risk Reduction of Subclinical and Mild Stage of Breast Cancer-Related Lymphedema: A Longitudinal, Quasi-experimental Study

Author

Yingxin Wang, Quanping Zhao, Fei Liu, Fenglian Li, Dong Pang, Sanli Jin, Qian Lu, Ping Yang, and Mei R. Fu

Subjects
medicine.medical_specialty, Self-management, Oncology (nursing), business.industry, Self-Management, Breast Neoplasms, medicine.disease, humanities, body regions, Breast cancer, Lymphedema, Oncology, hemic and lymphatic diseases, Internal medicine, Quasi experimental study, medicine, Humans, Female, Stage (cooking), business, Generalized estimating equation, Risk Reduction Behavior, Breast Cancer Related Lymphedema, Subclinical infection
Abstract

BACKGROUND Early intervention with self-management strategies can potentially reduce the risk of progression of breast cancer-related lymphedema (BCRL). OBJECTIVE To determine if The-Optimal-Lymph-Flow (TOLF) program focused on self-management strategies applied to patients with a subclinical or mild stage of BCRL can improve lymphedema-related behaviors, symptom experience, and limb circumference changes. METHODS A total of 41 women with subclinical or mild lymphedema were enrolled in TOLF program. Lymphedema-related behaviors and lymphedema-related symptom experiences were measured by the Breast Cancer and Lymphedema Symptom Experience Index, and limb circumference changes were measured by sequential circumferential limb measurements at baseline and 1, 3, 6, and 12 months after the intervention. Generalized estimating equations were used to estimate the effects of the intervention on outcomes. RESULTS Generalized estimating equations revealed that lymphedema-related behaviors and the number and severity of lymphedema-related symptoms were significantly improved at 4 postintervention test points compared with baseline (all P < .001). Reduced lymphedema-related symptom distress in functional, social, emotional, and psychological and self-perception (all P < .01) also resulted. The majority (77.5%) of patients maintained their preintervention lymphedema status; 17.5% of them reversed from mild lymphedema to subclinical lymphedema; 5.0% of them had lymphedema status progression. CONCLUSION Positive outcomes in terms of lymphedema-related behaviors, relieving lymphedema-related symptom experience, and halting the progression of lymphedema status were documented following TOLF. IMPLICATIONS FOR PRACTICE Nurses could educate patients to incorporate the self-management strategies of TOLF program into daily life to help patients prevent or reverse subclinical or mild stage of BCRL.

Published
2021

28. The relationship between post-traumatic stress and negative emotions in patients with breast cancer: the mediating role of emotion regulation

Author

Miaomiao Wang, Qian Lu, Liping Jia, Shuai Teng, Bingxue Han, Lili Ji, Yu-Feng Ma, Xiang-Lian Sun, Guohua Lu, Jinxia Liu, and He Du

Subjects
Oncology, medicine.medical_specialty, Emotions, Breast Neoplasms, Affect (psychology), Stress Disorders, Post-Traumatic, Breast cancer, Cognition, Internal medicine, medicine, Humans, In patient, Applied Psychology, business.industry, fungi, Traumatic stress, food and beverages, Cancer, medicine.disease, Emotional Regulation, Psychiatry and Mental health, Cross-Sectional Studies, Female, business, Negative emotion
Abstract

Negative emotions can adversely affect the treatment and recovery of breast cancer patients. Post-traumatic stress caused by cancer can increase the negative emotions of patients. This study assess...

Published
2021

29. Costello syndrome with special cutaneous manifestations and HRAS G12D mutation: A case report and literature review

Author

Yueyue Li, Dan Luo, Gajin Park, Wen Qian, Yihe Chen, Hequn Huang, Qian Lu, Meijie Zhang, and Ni Zeng

Subjects
0301 basic medicine, Adult, medicine.medical_specialty, Heterozygote, Hyperkeratosis, Mutation, Missense, HRAS variant, 030105 genetics & heredity, QH426-470, medicine.disease_cause, Clinical Reports, Proto-Oncogene Proteins p21(ras), 03 medical and health sciences, Costello syndrome, Intellectual disability, heterozygous variants, Genetics, Medicine, Humans, HRAS, Molecular Biology, Genetics (clinical), Loose skin, Skin, Mutation, Clinical Report, business.industry, medicine.disease, Dermatology, 030104 developmental biology, Phenotype, Failure to thrive, Female, medicine.symptom, business, p.G12D, Congenital disorder
Abstract

Background Costello syndrome (CS, OMIM 218040) is a rare congenital disorder caused by mutations in HRAS. Previous studies reported that approximately 80% of patients with CS share the same pathogenic variant in HRAS gene in c.34G> A (p.G12S). Here, we report a CS patient with c.34G> A (p.G12D) variant in HRAS gene and she presented with special manifestation. Methods and Results We describe a 31‐year‐old female patient who presented with distinctive facial appearance, intellectual disability, dental abnormalities, hyperkeratosis of palmer and planter, loose skin at birth, papillomata on the face and nipples. The whole‐exome sequencing (WES) technology provided by Haotian Biotechnology (China) confirmed p.G12D variant in HRAS gene. To elucidate the typical features of CS with p.G12D variant, we further reviewed these previously reported cases and found that patients with G12D variant died within three months after birth due to multiple organ failure. They had the typical facial characteristics, failure to thrive, skin and cardiac abnormalities, and gene testing confirmed the diagnosis of CS. Conclusion To the best of our knowledge, this is the first article to report a patient with a p.G12D variant that had special but mild manifestation. Moreover, this report and literature review casts new light on the clinical features of p.G12D variant., BLURB FOR ETOC: Costello syndrome with p.G12D mutation in HRAS gene. Costello syndrome with irregular hypo‐and hyperpigmentation.

Published
2021

30. Impaired Cognitive Empathy in Outpatients with Chronic Musculoskeletal Pain: A Cross-Sectional Study

Author

Chuan He, Lei Zhang, Xi Lu, Hang-Bin Zhang, Zhifei Yin, Qian Lu, Dianhuai Meng, Hang Ou, and Ying Shen

Subjects
Adult, Male, Article Subject, Cross-sectional study, media_common.quotation_subject, Psychological intervention, Neurosciences. Biological psychiatry. Neuropsychiatry, Empathy, Cognition, Pain assessment, Musculoskeletal Pain, Outpatients, medicine, Humans, Cognitive Dysfunction, media_common, Pain Measurement, business.industry, Chronic pain, Middle Aged, medicine.disease, body regions, Cross-Sectional Studies, Neurology, Female, Neurology (clinical), Psychological resilience, Self Report, Chronic Pain, business, Psychosocial, Photic Stimulation, RC321-571, Clinical psychology, Research Article
Abstract

Background. In recent years, a growing number of researchers showed significant interest in psychological and social interventions to manage chronic musculoskeletal (MSK) pain. Cognitive and emotional empathy is an attractive and valuable sociopsychological factor that may provide protection and resilience against chronic MSK pain. However, its effect on outpatients remains underexplored. Objective. To compare the empathy ability between chronic MSK pain outpatients and healthy controls and explore the relationship between cognitive/emotional empathy and chronic pain. Methods. Patients with chronic MSK pain ( n = 22 ) and healthy controls ( n = 26 ) completed the pain assessment and empathy ability task, utilizing a multidimensional empathy assessment tool with satisfactory reliability and validity (i.e., the Chinese version of the Multifaceted Empathy Test (MET-C)). Results. The data indicated that the chronic MSK pain outpatients had impaired cognitive empathy (i.e., lower squared cognitive empathy accuracy: Student’s t = − 2.119 , P = 0.040 , and longer task completion time: Student’s t = 3.382 , P = 0.002 ) compared to healthy controls, and cognitive empathy was negatively correlated with pain intensity ( r = − 0.614 , P = 0.002 ). Further, the impaired cognitive empathy was present in identifying positive, but not negative emotions. Conclusion. These results indicate that chronic MSK pain is associated with impaired empathy ability. Our studies contribute to offering a potential direction for developing psychosocial interventions to treat chronic MSK pain.

Published
2021

31. Confirming the contribution and genetic spectrum of de novo mutation in infantile spasms: Evidence from a Chinese cohort

Author

Fang Liu, Qian Lu, Yang-Yang Wang, Hua Xie, Qiu-Hong Wang, Xiaoli Chen, Jonathan Picker, Meng-Na Zhang, Yu Zhang, Zhengchang Li, Xiaodai Cui, Li-Ying Liu, and Liping Zou

Subjects
0301 basic medicine, Oncology, Proband, Adult, Male, Candidate gene, medicine.medical_specialty, Levetiracetam, Adolescent, CDKL5, Drug Resistance, Formins, QH426-470, 030105 genetics & heredity, Protein Serine-Threonine Kinases, Germline, 03 medical and health sciences, Germline mutation, Munc18 Proteins, Gene Frequency, Internal medicine, Genetics, medicine, STXBP1, Humans, somatic or mosaicism mutation, Child, Molecular Biology, Genetics (clinical), Germ-Line Mutation, business.industry, Mosaicism, Infant, Original Articles, de novo mutation, 030104 developmental biology, Child, Preschool, Cohort, Medical genetics, Original Article, Anticonvulsants, Female, business, Spasms, Infantile, infantile spasms
Abstract

Objective We determined the yield, genetic spectrum, and actual origin of de novo mutations (DNMs) for infantile spasms (ISs) in a Chinese cohort. The efficacy of levetiracetam (LEV) for STXBP1‐related ISs was explored also. Methods Targeted sequencing of 153 epilepsy‐related candidate genes was applied to 289 Chinese patients with undiagnosed ISs. Trio‐based amplicon deep sequencing was used for all DNMs to distinguish somatic/mosaic mutations from germline ones. Results Total of 26 DNMs were identified from 289 recruited Chinese patients with undiagnosed ISs. Among them, 24 DNMs were interpreted as pathogenic mutations based on American College of Medical Genetics and Genomics guidelines, contributing to 8.3% (24/289) of diagnosis yield in the Chinese IS cohort. CDKL5 and STXBP1 are the top genes with recurrent DNMs, accounting for 3.1% (9/289) of yield. Further deep resequencing for the trio members showed that 22.7% (5/22) of DNMs are actually somatic in the proband or a parent. These somatic carriers presented milder seizure attacks than those with true germline DNMs. After treatment with LEV for half a year, three patients with DNM in STXBP1 showed improved clinical symptoms, including seizure‐free and normal electroencephalogram, except for a patient with a second DNM in DIAPH3. Significance Our study confirmed the contribution and genetic spectrum of DNMs in Chinese IS patients. Somatic mutation account for a quarter of DNMs in IS cases. Treatment with LEV improved the prognosis of STXBP1‐related ISs., The contribution and genetic spectrum of de novo mutations (DNMs) was confirmed in infantile spasms (ISs). Somatic mutation accounted for 22.7% of DNMs in IS patients. Treatment with levetiracetam improved the prognosis of STXBP1‐related ISs.

Published
2021

32. hsa‑miR‑5580‑3p inhibits oral cancer cell viability, proliferation and migration by suppressing LAMC2

Author

Qian Lu, Bo Xu, and Rong Fang

Subjects
Male, Cancer Research, Cell Survival, Cell, Down-Regulation, migration, Biochemistry, Cell Movement, Cell Line, Tumor, Biomarkers, Tumor, Genetics, medicine, Humans, RNA, Messenger, Viability assay, Molecular Biology, Cell Proliferation, Wound Healing, Oncogene, Cell growth, Chemistry, LAMC2, miRNA-5580-3p, Articles, oral cancer, Middle Aged, Cell cycle, invasion, Gene Expression Regulation, Neoplastic, MicroRNAs, medicine.anatomical_structure, Oncology, Apoptosis, Cell culture, Cancer cell, Cancer research, Molecular Medicine, Female, Mouth Neoplasms, Laminin
Abstract

The present study aimed to explore whether and how microRNA‑5580‑3p (miR‑5580‑3p) affected oral cancer (OC) cell phenotypes via regulation of laminin subunit γ2 (LAMC2). Bioinformatics analysis was used to identify miR‑5580‑3p/LAMC2, a novel interactome that, to the best of our knowledge, has not been studied previously in OC. In the present study, the expression levels of miR‑5580‑3p and LAMC2 were detected by reverse transcription‑quantitative PCR, while the protein expression levels of LAMC2 were identified using western blotting. To determine the effects of miR‑5580‑3p and LAMC2 in OC, a number of experiments, including Cell Counting Kit‑8, 5‑bromo‑2'‑deoxyuridine cell proliferation and wound healing migration assays, were performed using OC SCC‑4 and Cal‑27 cell lines. Additionally, luciferase reporter assays were employed to examine the interaction between miR‑5580‑3p and LAMC2 mRNA. The results demonstrated that miR‑5580‑3p expression was downregulated, while LAMC2 expression was upregulated in OC tissues and cell lines. In addition to the observation that miR‑5580‑3p promoted the malignant phenotypes of OC, it was also revealed that miR‑5580‑3p inhibited OC cell viability, proliferation and migration by suppressing LAMC2. Therefore, the present study suggested that miR‑5580‑3p and LAMC2 may be potential biomarkers and therapeutic targets for OC diagnosis and therapies in the future.

Published
2021

33. Injury Patterns and Outcomes of Victims After the 2016 Jiangsu Tornado in China: A Retrospective Analysis of Injuries Treated at a Teaching Hospital

Author

Shan Shan Hou, Xing Li, Zhong Qian Lu, Gen Hua Mu, and Yi Jun Deng

Subjects
Adult, Male, China, medicine.medical_specialty, Adolescent, 010504 meteorology & atmospheric sciences, 0211 other engineering and technologies, 02 engineering and technology, 01 natural sciences, Teaching hospital, Outcome Assessment, Health Care, Epidemiology, medicine, Retrospective analysis, Humans, Child, Hospitals, Teaching, Pelvis, Aged, Retrospective Studies, 0105 earth and related environmental sciences, Aged, 80 and over, 021110 strategic, defence & security studies, business.industry, Public Health, Environmental and Occupational Health, Infant, Middle Aged, medicine.disease, Triage, Tornadoes, Pneumonia, Treatment Outcome, medicine.anatomical_structure, Falling (accident), Child, Preschool, Emergency medicine, Wounds and Injuries, Female, medicine.symptom, Tornado, business
Abstract

Objective:The aim of this study is to characterize the injury profiles and outcomes of victims of a tornado in Jiangsu Province, China.Methods:This study retrospectively investigated the clinical records of 144 patients treated at a teaching hospital due to a tornado. Each patient’s demographic data, diagnosis, injury types, causes of injury, infection status, and outcomes were all reviewed.Results:Of the 144 patients, 64 (44.4%) were male, and 80 (55.6%) were female. The patients’ ages ranged from 2 months to 94 years; 91 (63.19%) were admitted within the first 12 h after the disaster. The most frequently injured sites were the body surfaces (24.48%), followed by the limbs and pelvis (21.79%) and chest (20.3%). Soft-tissue injuries and fractures were the most frequent injuries. Traumatic brain injuries were the main causes of death. Tornado-related injuries were primarily caused by flying/falling bricks, wood, and glass. Twenty-three (15.9%) patients suffered from infections, which consisted mainly of skin/soft tissue infections and pneumonia.Conclusions:Destructive tornadoes often cause heavy casualties with little warning. Medical aid agencies must be prepared to accommodate the massive numbers of injured patients after a catastrophe. Proper triage and prompt treatment of injured victims may decrease mortality. (Disaster Med Public Health Preparedness. 2019;xx:xxx-xxx).

Published
2019

34. Correlates of sexual quality of life among husbands of Chinese breast cancer survivors

Author

Qian Lu, Nelson C. Y. Yeung, Lili Ji, Guohua Lu, and Yiwei Zhang

Subjects
Adult, Male, China, Coping (psychology), Sexual Behavior, Cultural context, Breast Neoplasms, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Cancer Survivors, Surveys and Questionnaires, Adaptation, Psychological, medicine, Humans, Marriage, Spouses, 030504 nursing, Oncology (nursing), business.industry, Coping resources, Multilevel model, Stressor, Cognition, social sciences, General Medicine, Middle Aged, medicine.disease, humanities, Cross-Sectional Studies, Caregivers, 030220 oncology & carcinogenesis, Quality of Life, population characteristics, Female, 0305 other medical science, business, Psychosocial, Stress, Psychological, Clinical psychology
Abstract

Western studies found that sexual quality of life (QoL) among husbands of breast cancer survivors was associated with their stress and coping processes. However, little is known about how breast cancer caregiving might be associated with those husbands' sexual QoL in the Chinese cultural context. Guided by the Stress and Coping model, we examined the psychosocial correlates of sexual QoL among husbands of Chinese breast cancer survivors.Husbands of Chinese breast cancer survivors (N = 176) recruited from two hospitals in Weifang, China completed a cross-sectional survey. Their individual characteristics, caregiving-related stressors, cognitive appraisals, coping resources and strategies, and sexual QoL were measured.After controlling for covariates, hierarchical regression results showed that lower caregiving burden (β = -0.34, p .001), higher marital satisfaction (β = 0.20, p .001), and lower harm/threat appraisals (β from -0.22 to -0.20, p .001) were associated with better sexual QoL. Moreover, ambivalence over emotional expression (AEE; inner conflict concerning the desire to express emotions yet failing to do so) was found to moderate between protective buffering and sexual QoL (β = 0.20, p .01), such that the negative association between protective buffering and sexual QoL was only significant among those with higher AEE (β = -0.38, p .003).Both the stress and coping variables and their interactions with individual characteristics could be important determinants of those husbands' sexual QoL. Our findings implied that reducing husbands' caregiving burden, increasing their marital satisfaction, helping them reevaluate the negative impact of breast cancer, and reducing barriers for expressing emotions and concerns may increase their sexual well-being.

Published
2019

35. Inactivation of TSC1 promotes epithelial-mesenchymal transition of renal tubular epithelial cells in mouse diabetic nephropathy

Author

Yibing Chen, Hao Yang, Chengcheng Li, Wen-wen Wang, Qian Lu, Xiaoxing Yin, Jin Wang, Lei Du, and Lei Wang

Subjects
0301 basic medicine, Male, medicine.medical_treatment, mTORC1, epithelial–mesenchymal transition, db/db mice, Tuberous Sclerosis Complex 1 Protein, Kidney Tubules, Proximal, 0302 clinical medicine, Cell Movement, Pharmacology (medical), Diabetic Nephropathies, Mice, Knockout, Chemistry, Cell migration, General Medicine, Transfection, Cadherins, renal fibrosis, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Knockout mouse, Female, Signal Transduction, congenital, hereditary, and neonatal diseases and abnormalities, Epithelial-Mesenchymal Transition, Kidney Cortex, tuberous sclerosis complex 1, Renal cortex, Mice, Transgenic, Mechanistic Target of Rapamycin Complex 1, Article, 03 medical and health sciences, human proximal tubular epithelial cell line HK-2, medicine, Renal fibrosis, Animals, Humans, Vimentin, Epithelial–mesenchymal transition, Pharmacology, rapamycin, Growth factor, diabetic nephropathy, Correction, Epithelial Cells, TSC1−/− mice, Fibrosis, Actins, 030104 developmental biology, Glucose, Cancer research, Zonula Occludens-1 Protein
Abstract

Epithelial–mesenchymal transition (EMT) of renal tubular epithelial cells is one of the potential mechanisms of renal fibrosis, which promotes the development of diabetic nephropathy (DN). However, the molecular mechanisms of EMT remain largely unknown. Tuberous sclerosis proteins TSC1 and TSC2 are key integrators of growth factor signaling, and the loss of TSC1 or TSC2 function leads to a spectrum of diseases that underlie abnormalities in cell growth, proliferation, differentiation, and migration. In this study, we investigated the effects of TSC1 on high glucose (HG)-induced EMT of human proximal tubular epithelial HK-2 cells in vitro and renal fibrosis in TSC1−/− and db/db mice. We found that the exposure of HK-2 cells to HG (30 mM) time-dependently decreased TSC1 expression, increased the phosphorylation of mTORC1, P70S6K, and 4E-BP-1, and promoted cell migration, resulting in EMT. Transfection of the cells with TSC1 mimic significantly ameliorated HG-induced EMT of HK-2 cells. The tubules-specific TSC1 knockout mice (TSC1−/−) displayed a significant decline in renal function. TSC1−/− mice, similar to db/db mice, showed greatly activated mTORC1 signaling and EMT process in the renal cortex and exacerbated renal fibrosis. Overexpression of TSC1 through LV-TSC1 transfection significantly alleviated the progression of EMT and renal fibrosis in the renal cortex of db/db mice. Taken together, our results suggest that TSC1 plays a key role in mediating HG-induced EMT, and inhibition of TSC1-regulated mTORC1 signaling may be a potential approach to prevent renal fibrosis in DN.

Published
2019

36. Validation of a Chinese version critical‐care pain observation tool in nonintubated and intubated critically ill patients: Two cross‐sectional studies

Author

Hai-Yan Zhang, Fen Hu, Qian Lu, You-Zhong An, Jie Chen, Yi Feng, Yan-Chun Zhan, Xiao-Ying Wu, and Jian Yang

Subjects
Adult, Male, China, medicine.medical_specialty, Intraclass correlation, Cross-sectional study, Critical Care Nursing, 03 medical and health sciences, Chinese version, 0302 clinical medicine, Cronbach's alpha, Pain assessment, Numeric Rating Scale, Humans, Medicine, 030212 general & internal medicine, General Nursing, Aged, Pain Measurement, 030504 nursing, Critically ill, business.industry, Reproducibility of Results, General Medicine, Middle Aged, Intensive Care Units, Cross-Sectional Studies, Physical therapy, Female, Observational study, Intubation, 0305 other medical science, business
Abstract

Aims and objectives To validate the Chinese version of the Critical-Care Pain Observation Tool (CPOT) in nonintubated and intubated ICU patients. Background While CPOT was found to have the best psychometric properties among objective pain assessment scales, there is no Chinese version CPOT for nonintubated patients. Design Cross-sectional design was used in these two observational studies. Methods Seventy-six nonintubated patients and 53 intubated patients were assessed to examine internal consistency, criterion-related and discriminative validity of CPOT in the first study. Pain assessment during low pain condition as well as increased pain condition was performed by Numeric Rating Scale (NRS) and the Chinese version COPT. Forty nonintubated patients and 43 intubated patients were assessed to examine inter-rater reliability in the second study. A bedside nurse and a researcher independently executed paired pain assessments with CPOT in the same conditions. The STROBE Statement was followed to guide these studies. Results The Cronbach's α in nonintubated patients and intubated patients was 0.903-0.930 and 0.868-0.870. The intraclass correlation coefficients (ICCs) in nonintubated patients ranged from 0.959-0.982, and the ICC in intubated patients ranged from 0.947-0.959, confirming the inter-rater reliability. The moderately positive Pearson's correlations between CPOT and NRS scores (r = 0.757-0.838 in nonintubated patients, r = 0.574-0.705 in intubated patients) indicated the criterion-related validity. A significant increase in CPOT scores in the increased pain condition compared with those acquired in the low pain condition verified the discriminative validity. Conclusions The Chinese version of CPOT was presented to be valid and reliable for both nonintubated and intubated critically ill adults, which could be applicable for pain assessment in patients in ICU. Relevance to clinical practice This study provides an applicable pain assessment tool for both nonintubated patients and intubated patients in ICU.

Published
2019

37. Benefits of a Psychosocial Intervention on Positive Affect and Posttraumatic Growth for Chinese American Breast Cancer Survivors: A Pilot Study

Author

Krystal Warmoth, Jing Xie, Qian Lu, Nelson C. Y. Yeung, Hannah Feng, Lucy Young, and Alice Loh

Subjects
Adult, Community-Based Participatory Research, Breast Neoplasms, Pilot Projects, Peer support, Affect (psychology), Article, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Quality of life (healthcare), Cancer Survivors, Intervention (counseling), medicine, Humans, Psychology, 030212 general & internal medicine, Applied Psychology, Chinese americans, 030505 public health, Asian, Posttraumatic growth, business.industry, Psychosocial Support Systems, Middle Aged, medicine.disease, Affect, Psychiatry and Mental health, Quality of Life, Female, 0305 other medical science, business, Posttraumatic Growth, Psychological, Psychosocial, Clinical psychology
Abstract

Breast cancer survivors report persistent psychological and physical symptoms, which affect their quality of life and may challenge the recovery process. Due to social, cultural, and linguistic barriers, culturally sensitive care is largely unavailable for Chinese Americans, and their psychological needs are not often addressed. We aimed to investigate whether the Joy Luck Academy (JLA), a psychosocial intervention providing both information and peer support, was associated with positive adjustment among Chinese American breast cancer survivors. Thirty-nine Chinese American breast cancer survivors participated in a pilot psychosocial intervention. The educational materials and lectures were delivered in the participants' native language of Chinese. All of the educators and mentors shared the same linguistic and cultural background with the participants. The program utilized a community-based participatory research (CBPR) approach to further enhance the cultural sensitivity of the intervention. Participants' post-traumatic growth and positive affect were assessed before and after the intervention. The JLA showed an improvement in positive affect, and they had a greater appreciation for life. The intervention was found to be feasible, well-accepted, and beneficial for this population. Chinese American breast cancer survivors reported improved psychological health after attending the intervention. These findings encourage the development and implementation of psychosocial interventions for Chinese breast cancer survivors. Similar programs could be integrated into other ethnic or cultural communities.

Published
2019

38. Limited sampling strategy for the estimation of the area under the concentration-time curve for ganciclovir in Chinese adult renal allograft recipients

Author

Shan-Shan Hu, Kun Shao, Wen-Bin Rui, Xiao-Hui Zhai, Jia-Qian Lu, Hui-Min An, Pei-jun Zhou, and Bing Chen

Subjects
Adult, Male, Ganciclovir, medicine.medical_specialty, Adolescent, Cmax, Urology, Antiviral Agents, 030226 pharmacology & pharmacy, 03 medical and health sciences, 0302 clinical medicine, Asian People, Pharmacokinetics, Linear regression, Humans, Transplantation, Homologous, Valganciclovir, Medicine, Pharmacology (medical), 030212 general & internal medicine, Pharmacology, Blood Specimen Collection, medicine.diagnostic_test, business.industry, General Medicine, Middle Aged, Stepwise regression, Kidney Transplantation, Therapeutic drug monitoring, Area Under Curve, Cytomegalovirus Infections, Renal allograft, Female, Drug Monitoring, business, Immunosuppressive Agents, medicine.drug
Abstract

Valganciclovir (VGCV) treatment is recommended for the prevention of cytomegalovirus (CMV) infection in renal allograft recipients. The aim of the present study is to investigate the pharmacokinetic characteristics of ganciclovir (GCV) after administration of VGCV in Chinese adult renal allograft recipients and estimate the exposure to GCV using limited sampling strategy (LSS). Forty Chinese renal allograft recipients were given 450 mg or 900 mg VGCV daily. Blood samples were drawn before treatment and 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, and 24 h after 5 days of VGCV therapy, and the plasma concentrations of VGCV and GCV were determined using a liquid chromatography-mass spectrometry assay. The major pharmacokinetic parameters for GCV and VGCV were determined using a noncompartmental assay. Multiple stepwise linear regression analysis was conducted to establish a model equation for the estimation of the GCV AUC0–24 h in Chinese patients using LSS. In the 450 and 900 mg groups, the Cmax for VGCV was 0.2 ± 0.10 and 0.4 ± 0.16 mg/L, respectively; the Cmax for GCV was 4.2 ± 1.1 and 8.6 ± 1.6 mg/L, respectively; and the AUC0–24 h for GCV was 28.4 ± 8.4 and 60.7 ± 17.5 mg·h/L, respectively. For the establishment of LSS models, 40 patients were divided into the training group (n = 24) and validation group (n = 16). The model equations used for the calculation of AUC0–24 h for GCV were established in the training group by using multiple linear regression assay. Equations including AUC = 8.1 + 29.7 × C0 + 5.7 × C4 (r2 = 0.91) and AUC = − 0.4 + 11.0 × C0 + 2.1 × C2 + 13.7 × C8 (r2 = 0.98) were acceptable. The %MPE and %MAPE values obtained from the validation group for the two model equations were 5.89 ± 14.5% and 12.1 ± 9.53%, and − 1.30 ± 4.40% and 3.28 ± 3.11%, respectively. The LSS models that included C0 and C4 or C0, C2, and C8 in the estimation of AUC0–24 h for GCV had favorable performance and can be used for therapeutic drug monitoring in the prevention of CMV infection using VGCV in Chinese renal allograft recipients.

Published
2019

39. Relationship between subjective taste alteration and weight loss in head and neck cancer patients treated with radiotherapy: A longitudinal study

Author

Shuai Jin, Hangjing Cui, Sanli Jin, Qian Lu, Hongmei Li, and Lichuan Zhang

Subjects
Adult, Male, Longitudinal study, Taste, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Dysgeusia, digestive system, Gee, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Weight loss, Internal medicine, Weight Loss, medicine, Humans, Longitudinal Studies, 030212 general & internal medicine, Generalized estimating equation, Aged, Aged, 80 and over, Oncology (nursing), business.industry, Head and neck cancer, Repeated measures design, General Medicine, Middle Aged, medicine.disease, Radiation therapy, Head and Neck Neoplasms, 030220 oncology & carcinogenesis, Female, medicine.symptom, business
Abstract

Purpose To conduct a dynamic and comprehensive evaluation of subjective taste alteration (STA)and identify the association between STA and weight loss in patients with head and neck cancer (HNC) who were treated with radiotherapy . Methods STA and weight of 114 patients were recorded at baseline, mid-treatment, post-treatment, and one to two months after radiotherapy (follow-up). Generalized estimating equations (GEE) were used to conduct repeated measures analyses of STA and weight loss at four time-points and assess the relationship between them. Results The prevalence of STA was 13.2% (baseline), 83.3% (mid-treatment), 92.1% (post-treatment), and 77.9% (follow-up), respectively; the prevalence of ≥10% weight loss increased from 1.8% (mid-treatment) to 44.2% (follow-up). The severity of STA was increasingly poor with radiation therapy and did not return to the baseline level at the follow-up. Meanwhile, the weight of patients did not increase at the follow-up. Among the four subscales of STA ( decline in basic taste, general taste alterations, phantogeusia and parageusia , and discomfort), only the discomfort score (β = −2.988; p = 0.005; 95%confidence interval: −5.084–0.891) had a significant effect on weight loss. Conclusions The main finding of this study was that STA, particularly the discomfort symptom associated with dietary intake, as a common and persistent symptom among HNC patients during and after radiotherapy, might promote weight loss in patients, which should be afforded greater attention from medical staff.

Published
2018

40. Ambivalence over emotional expression and intrusive thoughts as moderators of the link between self-stigma and depressive symptoms among Chinese American breast cancer survivors

Author

William Tsai and Qian Lu

Subjects
Adult, medicine.medical_specialty, Social Stigma, Population, Psychological intervention, Breast Neoplasms, Disease, Article, 03 medical and health sciences, Cognition, 0302 clinical medicine, Breast cancer, Cancer Survivors, Surveys and Questionnaires, medicine, Humans, 030212 general & internal medicine, education, General Psychology, Chinese americans, education.field_of_study, 030505 public health, Asian, Depression, business.industry, Public health, Middle Aged, medicine.disease, Mental health, Affect, Psychiatry and Mental health, Health psychology, Socioeconomic Factors, Female, 0305 other medical science, business, Clinical psychology
Abstract

Due to successful public health campaigns, breast cancer has successfully transformed from a highly stigmatized illness to a philanthropically supported disease in the United States. However, Chinese American breast cancer survivors continue to experience high levels of self-stigma and associated negative mental health outcomes. In the present study, we examined the relations between self-stigma and depressive symptoms, and further tested individual difference variables such as ambivalence over emotional expression and intrusive thoughts that may exacerbate the harmful effects of self-stigma among this population. One hundred and twelve foreign-born Chinese breast cancer survivors living in the United States completed questionnaires measuring self-stigma, depressive symptoms, AEE, and intrusive thoughts. We found significant AEE x Self-stigma and Intrusive-Thought x Self-Stigma interaction effects in predicting depressive symptoms. Specifically, the relationships between self-stigma and depressive symptoms were exacerbated among individuals with high levels of AEE and intrusive thoughts. Self-stigma represents a significant predictor of depressive symptoms among Chinese breast cancer survivors, and particularly so for individuals with higher levels of AEE and intrusive thoughts. The findings suggest that for interventions designed to reduce the negative mental health outcomes associated with self-stigma, targeting risk factors such as AEE and intrusive thoughts might be promising.

Published
2018

41. Understanding racial-ethnic differences in patient-centered care (PCC) in oncology through a critical race theory lens: A qualitative comparison of PCC among Black, Hispanic, and White cancer patients

Author

Kelly J. Brassil, Richard F. Brown, Margaret L. Osborne, Kerri-Anne R. Mitchell, and Qian Lu

Subjects
Gerontology, Male, media_common.quotation_subject, Critical race theory, Ethnic group, Black People, General Medicine, Hispanic or Latino, Health equity, Article, Optimism, Feeling, Neoplasms, Patient-Centered Care, Ethnicity, Humans, Female, Racial/ethnic difference, Thematic analysis, Healthcare Disparities, Psychology, Qualitative research, media_common
Abstract

Objectives Patient-centered care (PCC) experiences can vary by race and ethnicity and likely contribute to cancer care disparities. We compared PCC concepts between Non-Hispanic White (White), Hispanic, and Non-Hispanic Black (Black) cancer patients utilizing Critical Race Theory (CRT) to understand the relationships between racial-ethnic identity and PCC. Methods A thematic analysis and in-depth CRT-informed analysis of individual interviews exploring patient values, unmet needs, preferences, and priorities were performed. Results:Participants were aged > 25 yrs old, 53% male, and included 5 Hispanic, 4 Black and 6 White cancer patients. Unmet needs for time to make decisions, and provider interaction between visits and the value for finding meaning in the illness emerged among Blacks and Whites. The unmet need for a long-term treatment plan emerged among Blacks, and the preference of research participation among Whites. A value for optimism was observed among Hispanics and Whites. Racial-ethnic variations in patient descriptions and experiences of their values, unmet needs, preferences, and priorities were identified. Conclusions Underrepresented groups face subtle but significant challenges in feeling cared for and understood, voicing concerns, and obtaining quality care. Practice Implications: Increased mutual understanding and provider knowledge of unique PCC experiences among underrepresented cancer patients are needed.

Published
2021

42. Sirolimus Can Increase the Disappearance Rate of Cardiac Rhabdomyomas Associated with Tuberous Sclerosis: A Prospective Cohort and Self-Controlled Case Series Study

Author

Yu-Fen Li, Ling-Yu Pang, Li-Ping Zou, Qian Lu, Li-Ying Liu, Meng-Na Zhang, Xiao-Qiao Chen, and Yang-Yang Wang

Subjects
Male, medicine.medical_specialty, Population, Rhabdomyoma, Cohort Studies, Heart Neoplasms, 03 medical and health sciences, Tuberous sclerosis, 0302 clinical medicine, Sex Factors, Tuberous Sclerosis, 030225 pediatrics, Internal medicine, medicine, Humans, 030212 general & internal medicine, education, Prospective cohort study, Sirolimus, education.field_of_study, Antibiotics, Antineoplastic, Proportional hazards model, business.industry, Hazard ratio, Age Factors, Infant, medicine.disease, Child, Preschool, Pediatrics, Perinatology and Child Health, Female, business, Case series, Cohort study
Abstract

Objectives To investigate the efficacy and safety of sirolimus in the treatment of cardiac rhabdomyomas associated with tuberous sclerosis complex and the specific benefits in different subgroups. Study design The study was a prospective cohort and self-controlled case series study. Based on the prevalence of cardiac rhabdomyoma at different ages, we estimated the natural tumor disappearance rate. The subgroup analysis was done by Cox regression. Self-controlled case series method was used to assess the magnitude and duration of the drug effect. Adverse events were described. Results A total of 217 patients were included in the cohort study. Tumor disappearance rate was higher in younger age groups (hazard ratio = 0.99, P = .027) and female patients (hazard ratio = 2.08, P = .015). The age-adjusted incidence ratio showed that the disappearance of rhabdomyomas between 3 and 6 months was more related to sirolimus. Adverse events were observed 60 times in 42 of 217 children, mainly stomatitis. Conclusions Sirolimus can increase the disappearance rate of cardiac rhabdomyoma in the tuberous sclerosis complex population. Efficacy varies by sex and age: female and younger patients have higher tumor disappearance rate. Sirolimus is well-tolerated.

Published
2020

43. Critical care admission following elective surgery was not associated with survival benefit

Author

Kahan, Brennan C., Desponia, Koulenti, Kostoula, Arvaniti, Vanessa, Beavis, Douglas, Campbell, Matthew, Chan, Rui, Moreno, Pearse, Rupert M., Scott, Beattie, Pierre-Alain, Clavien, Nicolas, Demartines, Lee, A Fleisher, Mike, Grocott, James, Haddow, Andreas, Hoeft, Peter, Holt, Naomi, Pritchard, Andrew, Rhodes, Duminda, Wijeysundera, Matt, Wilson, Tahania, Ahmed, Kirsty, Everingham, Russell, Hewson, Marta, Januszewska, Rupert, M Pearse, Mandeep-Kaur, Phull, Richard, Halliwell, Mark, Shulman, Paul, Myles, Werner, Schmid, Michael, Hiesmayr, Patrick, Wouters, Stefan de Hert, Suzana, Lobo, Xiangming, Fang, Lars, Rasmussen, Emmanuel, Futier, Matthieu, Biais, Aurélien, Venara, Karem, Slim, Michael, Sander, Despoina, Koulenti, Mathew, Chan, Atul, Kulkarni, Susilo, Chandra, Aida, Tantri, Emad, Geddoa, Muntadhar, Abbas, Giorgio Della Rocca, Datin, Sivasakthi, Marzida, Mansor, Pastor, Luna, Arthur, Bouwman, Wolfgang, Buhre, Tim, Short, Tunde, Osinaike, Ricardo, Matos, Ioana, Grigoras, Mikhail, Kirov, Denis, Protsenko, Bruce, Biccard, Cesar, Aldecoa, Michelle, Chew, Christoph, Hofer, Martin, Hubner, James, Ditai, Tamas, Szakmany, Lee, Fleisher, Marissa, Ferguson, Michael, Macmahon, Ritchie, Cherian, Helen, Currow, Kathirgamanathan, Kanathiban, David, Gillespie, Edward, Pathmanathan, Katherine, Phillips, Jenifer, Reynolds, Joanne, Rowley, Jeanene, Douglas, Ross, Kerridge, Sameer, Garg, Michael, Bennett, Megha, Jain, David, Alcock, Nico, Terblanche, Rochelle, Cotter, Kate, Leslie, Marcelle, Stewart, Nicolette, Zingerle, Antony, Clyde, Oliver, Hambidge, Adam, Rehak, Sharon, Cotterell, Wilson Binh Quan Huynh, Timothy, Mcculloch, Erez, Ben-Menachem, Thomas, Egan, Jennifer, Cope, Paul, Fellinger, Simone, Haselberger, Caroline, Holaubek, Paul, Lichtenegger, Florian, Scherz, Franz, Hoffer, Veronika, Cakova, Andreas, Eichwalder, Norbert, Fischbach, Reinhold, Klug, Elisabeth, Schneider, Martin, Vesely, Reinhart, Wickenhauser, Karl Gernot Grubmueller, Marion, Leitgeb, Friedrich, Lang, Nancy, Toro, Marlene, Bauer, Friedrich, Laengle, Thomas, Mayrhofer, Christian, Buerkle, Karin, Forstner, Reinhard, Germann, Harald, Rinoesl, Elke, Schindler, Ernst, Trampitsch, Gerhard, Fritsch, Christian, Szabo, Jawad, Bidgoli, Hans, Verdoodt, Patrice, Forget, David, Kahn, Fernande, Lois, Mona, Momeni, Caroline, Prégardien, Audrey, Pospiech, Arnaud, Steyaert, Laurent, Veevaete, Dirk De Kegel, Karen De Jongh, Luc, Foubert, Carine, Smitz, Marcel, Vercauteren, Jan, Poelaert, Veerle Van Mossevelde, Jacques, Abeloos, Stefaan, Bouchez, Marc, Coppens, Luc De Baerdemaeker, Isabel, Deblaere, Ann De Bruyne, Stefan De Hert, Kristine, Fonck, Bjorn, Heyse, Tom, Jacobs, Koen, Lapage, Anneliese, Moerman, Martine, Neckebroek, Aliaksandra, Parashchanka, Nathalie, Roels, Nancy Van Den Eynde, Michael, Vandenheuvel, Jurgen Van Limmen, Ann, Vanluchene, Caroline, Vanpeteghem, Piet, Wyffels, Christel, Huygens, Punitha, Vandenbempt, Marc Van de Velde, Dimitri, Dylst, Bruno, Janssen, Evelien, Schreurs, Fábia Berganton Aleixo, Keulle, Candido, Hugo Dias Batista, Mario, Guimarães, Jaqueline, Guizeline, João, Hoffmann, Suzana, M Lobo, Francisco Ricardo Lobo, Vinícius, Nascimento, Katia, Nishiyama, Lucas, Pazetto, Daniela, Souza, Rodrigo Souza Rodrigues, Ana Maria Vilela Dos Santos, Jaquelline, Jardim, Joao, Silva, Paulo do Nascimento Junior, Thalissa Hermínia Baio, Gabriel Isaac Pereira de Castro, Henri Roger Watanabe Oliveira, Cristina Prata Amendola, Gutemberg, Cardoso, Daniela, Ortega, Ana Flavia Brotto, Mirella Cristine De Oliveira, Álvaro, Réa-Neto, Fernando, Dias, Pedro, Azambuja, Marcos Freitas Knibel, Antonio, Martins, William, Almeida, Calim Neder Neto, Maria Angela Tardelli, Eliana, Caser, Marcio, Machado, Crisitiano, Aguzzoli, Sérgio, Baldisserotto, Fernanda Beck Tabajara, Fernanda, Bettega, La Hore Correa Rodrigues Júnior, Julia de Gasperi, Lais, Faina, Marcos Farias Nolasco, Bruna Ferreira da Costa Fischer, Mariana Fosch de Campos Ferreira, Cristina, Hartmann, Marta, Kliemann, 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Bhavika, Daya, Leanne, Drummond, Ali, Elabib, Ehab Helmy Abdel Goad, Ismail, E Goga, Riaz, Goga, Harrichandparsad, R, Richard, E Hodgson, Jordaan, J, Nicky, Kalafatis, Christian, Kampik, T Landers, A, Emil, Loots, Rajhmum, Madansein, Anil, Madaree, Thandinkosi, E Madiba, Vukani, T Manzini, Mbali, Mbuyisa, Rajan, Moodley, Mduduzi, Msomi, Innocent, Mukama, Desigan, Naidoo, Rubeshan, Naidoo, Tesuven, K Naidu, Sindiswa, Ntloko, Eneshia, Padayachee, Lucelle, Padayachee, Martijn, Phaff, Bala, Pillay, Desigan, Pillay, Lutchmee, Pillay, Anupa, Ramnarain, Suren, R Ramphal, Paul, Ryan, Ahmed, Saloojee, Motshedisi, Sebitloane, Noluyolo, Sigcu, Jenna, L Taylor, Alexandra, Torborg, Linda, Visser, Philip, Anderson, Alae, Conradie, Mathew de Swardt, Martin de Villiers, Johan, Eikman, Riaan, Liebenberg, Johan, Mouton, Abbey, Paton, Louwrence van der Merwe, Candice, Wilscott-Davids, Wendy Joan Barrett, Marlet, Bester, Johan de Beer, Jacques, Geldenhuys, Hanni, Gouws, Jan-Hendrik, Potgieter, Magdel, Strydom, Edwin, Wilberforce-Turton, Rubendraj, R Chetty, Subash, Chirkut, Larissa, Cronje, Kim de Vasconcellos, Nokukhanya, Z Dube, N Sibusiso Gama, Garyth, M Green, Randolph, Green-Thompson, Suman Mewa Kinoo, Prenolin, Kistnasami, Kapil, Maharaj, Manogaran, S Moodley, Sibongile, J Mothae, Ruvashni, Naidoo, Aslam, M, Noorbhai, F, Vivesh, Rughubar, Jenendhiran, Reddy, Avesh, Singh, David, L Skinner, Murray, J Smith, Bhagwan, Singh, Ravi, Misra, Maheshwar, Naidoo, Pireshin, Ramdharee, Yvonne, Selibea, Selina, Sewpersad, Shailendra, Sham, Joseph, D Wessels, Cucu, Africander, Tarek, Bejia, Stephen, P Blakemore, Marisa, Botes, Bimalshakth, Bunwarie, Carlos, B Hernandez, Mohammud, A Jeeraz, Dagmara, A Legutko, Acela, G Lopez, Jenine, N De Meyer, Tanaka, Muzenda, Noel, Naidoo, Maryam, Patel, Rao, Pentela, Marina, Junge, Naj, Mansoor, Lana, Rademan, Pawel, Scislowski, Ismail, Seedat, Bianca van den Berg, Doreen van der Merwe, Steyn van Wyk, Komalan, Govender, Darshan, Naicker, Rajesh, Ramjee, 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Woon, Yuan Liang, Abd Hadi, Husni Zaeem, Ahmad Azam, Ummi Azmira, Alias, Abdul Hafiz, Kesut, Saiful Aizar, Lee, Jun May, Ooi, Dar Vin, Sulaiman, Hetty Ayuni, Tengku Lih, Tengku Alini, Veerakumaran, Jeyaganesh, Rojas, Eder, Resendiz, Gerardo Esteban Alvarez, Zapata, Darcy Danitza Mari, Aguilar López, Julio Cesar Jesú, Flores, Armando Adolfo Alvarez, Amador, Juan Carlosc Bravo, Avila, Erendira Jocelin Dominguez, Aquino, Laura Patricia González, Rodriguez, Ricardo Lopez, Landa, Mariana Torre, Urias, Emma, Hollmann, Marku, Hulst, Abraham, Kirzner, Osne, Preckel, Benedikt, Koopman-van Gemert, Ankie, Buise, Marc, Tolenaar, Noortje, Weber, Eric, de Fretes, Jennifer, Houweling, Peter, Ormskerk, Patricia, Van Bommel, Jasper, Lance, Marcu, Smit-Fun, Valerie, van Zundert, Tom, Baas, Peter, de Boer, Hans Donald, Sprakel, Joost, Elferink-Vonk, Renske, Noordzij, Peter, van Zeggeren, Laura, Brand, Bastiaan, spanjersberg, Rob, ten Bokkel-Andela, Janneke, Numan, Janneke, van Klei, Wilton, van Zaane, 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Kwok, Andy, Mohr, Otto, Oyeniyi, Peter, Patnaik, Lisa, Post, Benjamin, Ali, Sarah, Arshad, Homa, Baker, Gerard, Brenner, Laura, Brincat, Maximilian, Brunswicker, Annemarie, Cox, Hannah, Cozar, Octavian Ionut, Durst, Alexander, Fengas, Lior, Flatt, Jim, Glister, Georgina, Narwani, Vishal, Photi, Evangelo, Rankin, Adeline, Rosbergen, Melissa, Tan, Mark, Beaton, Ceri, Horn, Rachel, Hunt, Jane, Rousseau, Guy, Stancombe, Lucia, Absar, Mohammed, Allsop, Joanne, Drinkwater, Zoe, Hodgkiss, Tracey, Smith, Kirsty, Brown, Jamie, Alexander-Sefre, Farhad, Campey, Lorraine, Dudgeon, Lucy, Hall, Kathryn, Hitchcock, Rachael, James, Lynne, Smith, Kate, Winstone, Ulrika, Ahmad, Norfaizan, Bauchmuller, Kri, Harrison, Jonathan, Jeffery, Holly, Miller, Duncan, Pinder, Angela, Pothuneedi, Sailaja, Rosser, Jonathan, Sanghera, Sumayer, Swift, Diane, Walker, Rachel, Bester, Delia, Cavanagh, Sarah, Cripps, Heather, Daniel, Harvey, Lynch, Julie, Paton, Alison, Pyke, Shirley, Scholefield, John, Whitworth, Helen, Bottrill, Fiona, Ramalingam, Ganesh, Webb, Stephen, Akerman, Nik, Antill, Philip, Bourner, Lynsey, Buckley, Sarah, Castle, Gail, Charles, Rob, Eggleston, Christopher, Foster, Rebecca, Gill, Satwant, Lindley, Kate, Lklouk, Mohamed, Lowery, Tracey, Martin, Oliver, Milne, David, O’Connor, Patrick, Ratcliffe, Andrew, Rose, Alastair, Smith, Annie, Varma, Sandeep, Ward, Jackie, Barcraft-Barnes, Helena, Camsooksai, Julie, Colvin, Carolyn, Reschreiter, Henrik, Tbaily, Lee, Venner, Nicola, Hamilton, Caroline, Kelly, Lewi, Toth-Tarsoly, Piroska, Dodsworth, Kerry, Foord, Denise, Gordon, Paul, Hawes, Elizabeth, Lamb, Nikki, Mouland, Johanna, Nightingale, Jeremy, Rose, Steve, Schrieber, Joe, Al ‘Amri, Khalid, Aladin, Hafiz, Arshad, Mohammed Asif, Barraclough, Jame, Bentley, Conor, Bergin, Colin, Carrera, Ronald, Clarkson, Aisling, Collins, Michelle, Cooper, Lauren, Denham, Samuel, Griffiths, Ewen, Ip, Peter, Jeyanthan, Somasundaram, Joory, Kavita, Kaur, Satwant, Marriott, Paul, Mitchell, Natalie, Nagaiah, Sukumar, Nilsson, Annette, Parekh, Nilesh, Pope, Martin, Seager, Joseph, Serag, Hosam, Tameem, Alifia, Thomas, Anna, Thunder, Joanne, Torrance, Andrew, Vohra, Ravinder, whitehouse, Arlo, Wong, Tony, Blunt, Mark, Wong, Kate, Giles, Julian, Reed, Isabelle, Weller, Debbie, Bell, Gillian, Birch, Julie, Damant, Rose, Maiden, Jane, Mewies, Clare, Prince, Claire, Radford, Jane, Balain, Birender, Banerjee, Robin, Barnett, Andrew, Burston, Ben, Davies, Kirsty, Edwards, Jayne, Evans, Chri, Ford, David, Gallacher, Pete, Hill, Simon, Jaffray, David, Karlakki, Sudheer, Kelly, Cormac, Kennedy, Julia, Kiely, Nigel, Lewthwaite, Simon, Marquis, Chri, Ockendon, Matthew, Phillips, Stephen, Pickard, Simon, Richardson, Jame, Roach, Richard, Smith, Tony, Spencer-Jones, Richard, Steele, Niall, Steen, Julie, Van Liefland, Marck, White, Steve, Faulds, Matthew, Harris, Meredyth, Kelly, Carrie, Nicol, Scott, Pearson, Sally Anne, Chukkambotla, Srikanth, Andrew, Alyson, Attrill, Elizabeth, Campbell, Graham, Datson, Amanda, Fouracres, Anna, Graterol, Juan, Graves, Lynne, Hong, Bosun, Ishimaru, Alexander, Karthikeyan, Arvind, King, Helen, Lawson, Tom, Lee, Gregory, Lyons, Saoirse, Macalister Hall, Andrew, Mathoulin, Sophie, Mcintyre, Eilidh, Mclaughlin, Danny, Mulcahy, Kathleen, Ratcliffe, Anna, Robbins, Jame, Sung, Weilin, Tayo, Adeoluwa, Trembath, Lisa, Venugopal, Suneetha, Walker, Robert, Wigmore, Geoffrey, Boereboom, Catherine, Downes, Charlotte, Humphries, Ryan, Melbourne, Susan, Smith, Coral, Tou, Samson, Ullah, Shafa, Batchelor, Nick, Boxall, Leigh, Broomby, Rupert, Deen, Tariq, Hellewell, Alistair, Helliwell, Laurence, Hutchings, Melanie, Hutchins, David, Keenan, Samantha, Mackie, Donna, Donna, Alison, Smith, France, Stone, Lucy, Thorpe, Kevin, Wassall, Richard, Woodgate, Andrew, Baillie, Shelley, Campbell, Tara, James, Sarah, King, Chri, Marques de Araujo, Daniela, Martin, Daniel, Morkane, Clare, Neely, Julia, Rajendram, Rajkumar, Burton, Megan, James, Kathryn, Keevil, Edward, Minik, Orsolya, Morgan, Jenna, Musgrave, Anna, Rajanna, Harish, Roberts, Tracey, Adamson, Michael, Jumbe, Sandra, Kendall, Jennie, Muthuswamy, Mohan Babu, Anderson, Charlotte, Cruikshanks, Andrew, Wrench, Ian, Zeidan, Lisa, Ardern, Diane, Harris, Benjamin, Hellstrom, Johanna, Martin, Jane, Thomas, Richard, Varsani, Nimu, Wrey Brown, Caroline, Docherty, Philip, Gillies, Michael, McGregor, Euan, Usher, Helen, Craig, Jayne, Smith, Andrew, Ahmad, Tahania, Bodger, Phoebe, Creary, Thai, Fowler, Alexander, Hewson, Ru, Ijuo, Eke, Jones, Timothy, Kantsedikas, Ilya, Lahiri, Sumitra, McLean, Aaron Lawson, Niebrzegowska, Edyta, Phull, Mandeep, Wang, Difei, Wickboldt, Nadine, Baldwin, Jacqueline, Doyle, Donna, Mcmullan, Sean, Oladapo, Michelle, Owen, Thoma, Williams, Alexandra, Daniel, Hull, Gregory, Peter, Husain, Tauqeer, Kirk-Bayley, Justin, Mathers, Edward, Montague, Laura, White, Stuart, Avis, Joanne, Cook, Tim, Dali-Kemmery, Lola, Kerslake, Ian, Lambourne, Victoria, Pearson, Annabel, 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Knaggs, Alison, Markar, Sheraz, Perera, Anisha, Scott, Alasdair, Shida, Asako, Sirha, Ravneet, Wright, Sally, Frost, Victoria, Gray, Catherine, MacGregor, Mark, Andrews, Emma, Arrandale, Lindsay, Barrett, Stephen, Cifra, Elna, Cooper, Mariese, Dragnea, Drago, Elna, Cifra, Maclean, Jennifer, Meier, Sonja, Milliken, Donald, Munns, Christopher, Ratanshi, Nadir, Salvana, Abegail, Watson, Anthony, Ali, Hani, Campbell, Gill, Critchley, Rebecca, Hicks, Catherine, Liddle, Alison, Pass, Marc, Ritchie, Charlotte, Thomas, Charlotte, Too, Lingxi, Welsh, Sarah, Gill, Talvinder, Johnson, Joanne, Reed, Joanne, Davis, Edward, Papadopoullos, Sam, Attwood, Clare, Biffen, Andrew, Boulton, Kerenza, Gray, Sophie, Hay, David, Mills, Sarah, Montgomery, Jane, Riddell, Rory, Simpson, Jame, Bhardwaj, Neeraj, Paul, Elaine, Uwubamwen, Nosakhare, Alexander, Maini, Arrich, Jame, Arumugam, Swarna, Blackwood, Dougla, Boggiano, Victoria, Brown, Robyn, Lam Chan, Yik, Chatterjee, Devnandan, Chhabra, Ashok, Christian, Rachel, Costelloe, Hannah, Coxwell Matthewman, Madeline, Dalton, Emma, Darko, Julia, Davari, Maria, Dave, Tejal, Deacon, Matthew, Deepak, Shantal, Edmond, Holly, Ellis, Jessica, El-Sayed, Ahmed, Eneje, Philip, English, Rose, Ewe, Renee, Foers, William, Franklin, John, Gallego, Laura, Garrett, Emily, Goldberg, Olivia, Goss, Harry, Greaves, Rosanna, Harris, Rudy, Hennings, Charle, Jones, Eleanor, Kamali, Nelson, Kokkinos, Naomi, Lewis, Cary, Lignos, Leda, Malgapo, Evaleen Victoria, Malik, Rizwana, Milne, Andrew, Mulligan, John-Patrick, Nicklin, Philippa, Palipane, Natasha, Parsons, Thoma, Piper, Rebecca, Prakash, Rohan, Ramesh, Byron, Rasip, Sarah, Reading, Jacob, Rela, Mariam, Reyes, Anna, Robert, Stephen, Rooms, Martin, Shah, Karishma, Simons, Henry, Solanki, Shalil, Spowart, Emma, Stevens, Amy, Thomas, Christopher, Waggett, Helena, Yassaee, Arrash, Kennedy, Anthony, Scott, Sara, Somanath, Sameer, Berg, Andrew, Hernandez, Miguel, Nanda, Rajesh, Tank, Ghanshyambhai, Wilson, Natalie, 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K., Hamdan, A., Hugill, K., Kottam, L., Lisseter, E., Mawdsley, M., McGivern, J., Padala, K., Phelps, V., Kumar, V.R., Stewart, K., Towse, K., Tregonning, J., Vahedi, A., Walker, A., Baines, D., Bilolikar, A., Chande, S., Copley, E., Dunk, N., Kulkarni, R., Kumar, P., Metodiev, Y., Ncomanzi, D., Raithatha, B., Raymode, P., Szafranski, J., Twohey, L., Watt, P., Weatherall, L., Whitman, Z., Wighton, E., Abayasinghe, C., Chan, A., Darwish, S., Gill, J., Glasgow, E., Hadfield, D., Harris, C., Kochhar, A., Mellis, C., Pool, A., Riozzi, P., Selman, A., Smith, E.J., Vele, L., Gercek, Y., Guy, K., Holden, D., Watson, N., Whysall, K., Andreou, P., Hales, D., Thompson, J., Bowrey, S., McDonald, S., Gilmore, J., Hills, V., Kelly, C., Kelly, S., Lloyd, G., Abbott, T., Gall, L., Torrance, H., Vivian, M., Berntsen, E., Nolan, T., Turner, A., Vohra, A., Brown, A., Clark, R., Coughlan, E., Daniel, C., Patvardhan, C., Pearson, R., Predeep, S., Saad, H., Shanmugam, M., Varley, S., Wylie, K., Cooper, L., Makowski, A., Misztal, B., Moldovan, E., Pegg, C., Donovan, A., Foot, J., Large, S., Claxton, A., Netke, B., Armstrong, R., Calderwood, C., Kwok, A., Mohr, O., Oyeniyi, P., Patnaik, L., Post, B., Ali, S., Arshad, H., Baker, G., Brenner, L., Brincat, M., Brunswicker, A., Cox, H., Cozar, O.I., Durst, A., Fengas, L., Flatt, J., Glister, G., Narwani, V., Photi, E., Rankin, A., Rosbergen, M., Beaton, C., Horn, R., Hunt, J., Rousseau, G., Stancombe, L., Absar, M., Allsop, J., Drinkwater, Z., Hodgkiss, T., Smith, K., Alexander-Sefre, F., Campey, L., Dudgeon, L., Hall, K., Hitchcock, R., James, L., Winstone, U., Ahmad, N., Bauchmuller, K., Harrison, J., Jeffery, H., Miller, D., Pinder, A., Pothuneedi, S., Rosser, J., Sanghera, S., Swift, D., Walker, R., Bester, D., Cavanagh, S., Cripps, H., Daniel, H., Lynch, J., Pyke, S., Scholefield, J., Whitworth, H., Bottrill, F., Ramalingam, G., Webb, S., Akerman, N., Antill, P., Bourner, L., Buckley, S., Castle, G., Charles, R., Eggleston, C., Foster, R., Gill, S., Lindley, K., Lklouk, M., Lowery, T., Martin, O., Milne, D., O'Connor, P., Ratcliffe, A., Rose, A., Smith, A., Varma, S., Ward, J., Barcraft-Barnes, H., Camsooksai, J., Colvin, C., Reschreiter, H., Tbaily, L., Venner, N., Hamilton, C., Kelly, L., Toth-Tarsoly, P., Dodsworth, K., Foord, D., Gordon, P., Hawes, E., Lamb, N., Mouland, J., Nightingale, J., Rose, S., Schrieber, J., Al 'Amri, K., Aladin, H., Arshad, M.A., Barraclough, J., Bentley, C., Bergin, C., Carrera, R., Clarkson, A., Collins, M., Denham, S., Griffiths, E., Ip, P., Jeyanthan, S., Joory, K., Kaur, S., Marriott, P., Mitchell, N., Nagaiah, S., Nilsson, A., Parekh, N., Pope, M., Seager, J., Serag, H., Tameem, A., Thomas, A., Thunder, J., Torrance, A., Vohra, R., Whitehouse, A., Wong, T., Blunt, M., Wong, K., Giles, J., Reed, I., Weller, D., Bell, G., Birch, J., Damant, R., Maiden, J., Mewies, C., Prince, C., Radford, J., Balain, B., Banerjee, R., Barnett, A., Burston, B., Edwards, J., Evans, C., Ford, D., Gallacher, P., Hill, S., Jaffray, D., Karlakki, S., Kennedy, J., Kiely, N., Lewthwaite, S., Marquis, C., Ockendon, M., Phillips, S., Pickard, S., Richardson, J., Roach, R., Smith, T., Spencer-Jones, R., Steele, N., Steen, J., Van Liefland, M., White, S., Faulds, M., Harris, M., Nicol, S., Pearson, S.A., Chukkambotla, S., Andrew, A., Attrill, E., Campbell, G., Datson, A., Fouracres, A., Graterol, J., Graves, L., Hong, B., Ishimaru, A., Karthikeyan, A., King, H., Lawson, T., Lee, G., Lyons, S., Macalister Hall, A., Mathoulin, S., Mcintyre, E., Mclaughlin, D., Mulcahy, K., Robbins, J., Sung, W., Tayo, A., Trembath, L., Venugopal, S., Wigmore, G., Boereboom, C., Downes, C., Humphries, R., Melbourne, S., Tou, S., Ullah, S., Batchelor, N., Boxall, L., Broomby, R., Deen, T., Hellewell, A., Helliwell, L., Hutchings, M., Hutchins, D., Keenan, S., Mackie, D., Donna, A., Smith, F., Stone, L., Thorpe, K., Wassall, R., Woodgate, A., Baillie, S., Campbell, T., James, S., King, C., Marques de Araujo, D., Martin, D., Morkane, C., Neely, J., Rajendram, R., Burton, M., James, K., Keevil, E., Minik, O., Morgan, J., Musgrave, A., Rajanna, H., Roberts, T., Adamson, M., Jumbe, S., Kendall, J., Muthuswamy, M.B., Cruikshanks, A., Wrench, I., Zeidan, L., Ardern, D., Harris, B., Hellstrom, J., Martin, J., Thomas, R., Varsani, N., Wrey Brown, C., Docherty, P., Gillies, M., McGregor, E., Usher, H., Craig, J., Ahmad, T., Bodger, P., Creary, T., Fowler, A., Ijuo, E., Jones, T., Kantsedikas, I., Lahiri, S., McLean, A.L., Niebrzegowska, E., Phull, M., Wickboldt, N., Baldwin, J., Doyle, D., Mcmullan, S., Oladapo, M., Owen, T., Williams, A., Gregory, P., Husain, T., Kirk-Bayley, J., Mathers, E., Montague, L., Avis, J., Cook, T., Dali-Kemmery, L., Kerslake, I., Lambourne, V., Pearson, A., Boyd, C., Callaghan, M., Lawson, C., McCrossan, R., Nesbitt, V., O'connor, L., Sinclair, R., Farid, N., Morgese, C., Bhatia, K., Karmarkar, S., Ahmed, J., Branagan, G., Hutton, M., Swain, A., Brookes, J., Cornell, J., Dolan, R., Hulme, J., Jansen van Vuuren, A., Jowitt, T., Kalashetty, G., Lloyd, F., Patel, K., Sherwood, N., Brown, L., Chandler, B., Deighton, K., Emma, T., Haunch, K., Cheeseman, M., Dent, K., Gray, C., Hood, M., Jones, D., Juj, J., Rao, R., Walker, T., Al Anizi, M., Cheah, C., Cheing, Y., Coutinho, F., Gondo, P., Hadebe, B., Onie Hove, M., Khader, A., Krishnachetty, B., Rhodes, K., Sokhi, J., Baker, K.A., Bertram, W., Looseley, A., Mouton, R., Arnold, G., Arya, S., Balfoussia, D., Baxter, L., Harris, J., Jones, C., Knaggs, A., Markar, S., Perera, A., Scott, A., Shida, A., Sirha, R., Wright, S., Frost, V., MacGregor, M., Andrews, E., Arrandale, L., Barrett, S., Cifra, E., Cooper, M., Dragnea, D., Elna, C., Maclean, J., Meier, S., Milliken, D., Munns, C., Ratanshi, N., Salvana, A., Watson, A., Ali, H., Critchley, R., Hicks, C., Liddle, A., Pass, M., Ritchie, C., Thomas, C., Too, L., Welsh, S., Gill, T., Johnson, J., Reed, J., Davis, E., Papadopoullos, S., Attwood, C., Biffen, A., Boulton, K., Gray, S., Hay, D., Mills, S., Montgomery, J., Riddell, R., Simpson, J., Bhardwaj, N., Paul, E., Uwubamwen, N., Alexander, M., Arrich, J., Arumugam, S., Blackwood, D., Boggiano, V., Lam Chan, Y., Chatterjee, D., Chhabra, A., Christian, R., Costelloe, H., Coxwell Matthewman, M., Dalton, E., Darko, J., Davari, M., Dave, T., Deacon, M., Deepak, S., Edmond, H., Ellis, J., El-Sayed, A., Eneje, P., English, R., Ewe, R., Foers, W., Franklin, J., Gallego, L., Garrett, E., Goldberg, O., Goss, H., Greaves, R., Harris, R., Hennings, C., Jones, E., Kamali, N., Kokkinos, N., Lewis, C., Lignos, L., Malgapo, E.V., Malik, R., Milne, A., Mulligan, J.P., Nicklin, P., Palipane, N., Parsons, T., Piper, R., Prakash, R., Ramesh, B., Rasip, S., Reading, J., Rela, M., Reyes, A., Robert, S., Rooms, M., Shah, K., Simons, H., Solanki, S., Spowart, E., Stevens, A., Waggett, H., Yassaee, A., Kennedy, A., Scott, S., Somanath, S., Berg, A., Hernandez, M., Nanda, R., Tank, G., Wilson, N., Wilson, D., Al-Soudaine, Y., Baldwin, M., Cornish, J., Davies, Z., Davies, L., Edwards, M., Frewer, N., Gallard, S., Glasbey, J., Harries, R., Hopkins, L., Kim, T., Koompirochana, V., Lawson, S., Lewis, M., Makzal, Z., Scourfield, S., Ahmad, Y., Bates, S., Blackwell, C., Bryant, H., Coulter, S., Cruickshank, R., Daniel, S., Daubeny, T., Golder, K., Hawkins, L., Helen, B., Hinxman, H., Levett, D., Skinner, B., Walsgrove, J., Dickson, J., Constantin, K., Karen, M., O'Brien, P., O'Donohoe, L., Payne, H., Sundayi, S., Walker, E., Brooke, J., Cardy, J., Humphreys, S., Kessack, L., Kubitzek, C., Kumar, S., Cotterill, D., Hodzovic, E., Hosdurga, G., Miles, E., Saunders, G., Campbell, M., Chan, P., Jemmett, K., Raj, A., Naik, A., Ramamoorthy, R., Shah, N., Sylvan, A., Blyth, K., Burtenshaw, A., Freeman, D., Johnson, E., Lo, P., Martin, T., Plunkett, E., Wollaston, J., Allison, J., Carroll, C., Craw, N., Craw, S., Pitt-Kerby, T., Rowland-Axe, R., Spurdle, K., McDonald, A., Simon, D., Sinha, V., Banner-Goodspeed, V., Boone, M., Campbell, K., Lu, F., Scannell, J., Sobol, J., Balajonda, N., Clemmons, K., Conde, C., Funk, B., Hopkins, T., Olaleye, O., Omer, O., Pender, M., Porto, A., Waweru, P., Yeh, E., Bodansky, D., Evans, A., Kleopoulos, S., Maril, R., Mathney, E., Sanchez, A., Tinuoye, E., Bateman, B., Eng, K., Jiang, N., Ladha, K., Needleman, J., Chen, L.L., Lane, R., Robinowitz, D., Ghushe, N., Irshad, M., Patel, S., Takemoto, S., Wallace, A., Mazzeffi, M., Rock, P., Wallace, K., Zhu, X., Chua, P., Mattera, M., Sharar, R., Thilen, S., Treggiari, M., Morgan, A., Sofjan, I., Subramaniam, K., Avidan, M., Maybrier, H., Muench, M., and Wildes, T.

Subjects
Male, HSJ UCI, Critical Care and Intensive Care Medicine, law.invention, Perioperative Care/methods, 0302 clinical medicine, Surgical procedures, 030202 anesthesiology, law, Critical care/utilisation, Postoperative care/methods, Postoperative care/statistics and numerical data, Surgical procedures, operative/mortality, statistics and numerical data, Prospective Studies, Postoperative Period, Postoperative care/methods, education.field_of_study, Postoperative care/method, Elective Surgical Procedures/mortality, fluid output, Middle Aged, fluid administration, Intensive care unit, Hospitalization, Length of Stay/statistics & numerical data, operative/mortality, Intensive Care Units/statistics & numerical data, outcome, Female, Elective Surgical Procedure, Human, Adult, medicine.medical_specialty, Logistic Model, Postoperative care/statistics and numerical data, Critical care/utilisation, Population, Intensive Care Unit, Elective Surgical Procedures/statistics & numerical data, Hospitalization/statistics & numerical data, Humans, Logistic Models, Surgical procedures, operative/mortality, Postoperative care, methods, Perioperative Care, NO, 03 medical and health sciences, Anesthesiology, Intensive care, medicine, Elective surgery, Intensive care medicine, education, business.industry, 030208 emergency & critical care medicine, Perioperative, Length of Stay, Clinical trial, Prospective Studie, septic shock, business
Abstract

PURPOSE: As global initiatives increase patient access to surgical treatments, there is a need to define optimal levels of perioperative care. Our aim was to describe the relationship between the provision and use of critical care resources and postoperative mortality. METHODS: Planned analysis of data collected during an international 7-day cohort study of adults undergoing elective in-patient surgery. We used risk-adjusted mixed-effects logistic regression models to evaluate the association between admission to critical care immediately after surgery and in-hospital mortality. We evaluated hospital-level associations between mortality and critical care admission immediately after surgery, critical care admission to treat life-threatening complications, and hospital provision of critical care beds. We evaluated the effect of national income using interaction tests. RESULTS: 44,814 patients from 474 hospitals in 27 countries were available for analysis. Death was more frequent amongst patients admitted directly to critical care after surgery (critical care: 103/4317 patients [2%], standard ward: 99/39,566 patients [0.3%]; adjusted OR 3.01 [2.10-5.21]; p < 0.001). This association may differ with national income (high income countries OR 2.50 vs. low and middle income countries OR 4.68; p = 0.07). At hospital level, there was no association between mortality and critical care admission directly after surgery (p = 0.26), critical care admission to treat complications (p = 0.33), or provision of critical care beds (p = 0.70). Findings of the hospital-level analyses were not affected by national income status. A sensitivity analysis including only high-risk patients yielded similar findings. CONCLUSIONS: We did not identify any survival benefit from critical care admission following surgery. info:eu-repo/semantics/publishedVersion

Published
2017

44. Improvement in quality of life and psychological well-being associated with a culturally based psychosocial intervention for Chinese American breast cancer survivors

Author

Lucy Young, Qian Lu, Lingjun Chen, Lenna Dawkins-Moultin, Carol Chunfeng Wang, Qiao Chu, Lilian J. Shin, and Alice Loh

Subjects
Adult, China, Breast Neoplasms, Psychosocial Intervention, Peer Group, Article, law.invention, 03 medical and health sciences, Social support, 0302 clinical medicine, Breast cancer, Quality of life (healthcare), Randomized controlled trial, Cancer Survivors, law, medicine, Humans, 030212 general & internal medicine, Chinese americans, Asian, business.industry, Social Support, Middle Aged, medicine.disease, Culturally Competent Care, Oncology, 030220 oncology & carcinogenesis, Psychological well-being, Quality of Life, Anxiety, Female, medicine.symptom, business, Psychosocial, Clinical psychology
Abstract

PURPOSE. The purpose of this study was to investigate improvements in quality of life and psychological well-being among Chinese American breast cancer survivors who participated in a pilot community education and peer-mentor support program. METHODS. One hundred and twenty-nine Chinese American breast cancer survivors who recently completed treatment participated in eight cohorts of the program, Joy Luck Academy, which included weekly education and peer-mentor support sessions. The education sessions covered topics designed to help participants adjust to new life after breast cancer treatment. The peer-mentor support component was designed to provide social support. Quality of life and psychological well-being (e.g., depressive symptoms, anxiety, and low and high-arousal positive and negative affect) were assessed at baseline and immediately after the intervention. RESULTS. Paired-samples t-tests indicated improvements in quality of life, low and high-arousal positive affect, and reductions in depressive symptoms, anxiety, and low-arousal negative affect. CONCLUSION. Our findings suggest that a psychosocial group intervention may improve quality of life and psychological well-being among Chinese American breast cancer survivors. Our intervention has the potential to be applied to other ethnic-minority cancer survivors. Future randomized controlled trials are warranted.

Published
2020

45. The prevalence of sarcopenia and relationships between dietary intake and muscle mass in head and neck cancer patients undergoing radiotherapy: A longitudinal study

Author

Yujie Wang, Qian Lu, Shaowen Xiao, Lichuan Zhang, Yiwei Cao, Sanli Jin, Bing Zhuang, Shuai Jin, Baomin Zheng, and Yan Sun

Subjects
Male, Longitudinal study, medicine.medical_specialty, Sarcopenia, Gee, law.invention, 03 medical and health sciences, Eating, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, medicine, Prevalence, Humans, Longitudinal Studies, Prospective Studies, Muscle, Skeletal, 030504 nursing, Oncology (nursing), business.industry, Head and neck cancer, Cancer, Skeletal muscle, General Medicine, Middle Aged, medicine.disease, medicine.anatomical_structure, Head and Neck Neoplasms, 030220 oncology & carcinogenesis, Female, 0305 other medical science, business, Bioelectrical impedance analysis
Abstract

Purpose Our study aims to investigate dietary intake characteristics and their association with skeletal muscle mass in head and neck cancer patients treated with radiotherapy . Methods From March 2017 to August 2018, patients with head and neck cancer who received radiotherapy at our affiliated hospital were enrolled. Dietary intake was assessed through 24 - hr dietary recall and skeletal muscle mass was evaluated by bioelectrical impedance analysis at three-time points. Appendicular skeletal muscle mass was adjusted for height squared defined sarcopenia and correlated with dietary intake by generalized estimating equations (GEE). Results This study sample comprised 287 patients [median age: 54 years; 187 (65.2%) men]. Median dietary intake at post-treatment was 14.95 kcal/kg/day energy and 0.63 g/kg/day protein. Skeletal muscle mass decreased significantly in all patients. The prevalence of sarcopenia increased from 24.4% before treatment to 46.7% at the end of treatment. Exploratory univariate GEE analysis revealed that radiotherapy time-point, male-gender, age ≥60 and decreased dietary energy intake significantly impacted on muscle loss represented by the appendicular skeletal muscle index. After controlling covariates, dietary energy intake was only positively associated with muscle loss in women ( P = 0.013, 95% CI = 0.003–0.027) but not in men (P = 0.788, 95% CI = −0.007–0.009). Conclusion While the loss in skeletal muscle is more prevalent in men receiving radiotherapy, the effects of dietary energy intake were only associated with women. A prospective randomized clinical trial is required to identify the appropriate amount of dietary energy supplement by gender in cancer patients treated with radiotherapy.

Published
2020

46. Effects of organizational commitment, job satisfaction and workplace violence on turnover intention of emergency nurses: A cross‐sectional study

Author

Lichuan Zhang, Na Li, Zhuo Job Chen, Qian Lu, and Guangqing Xiao

Subjects
Adult, Male, China, Personnel Turnover, Poison control, Intention, Organizational commitment, Emergency Nursing, Nursing Staff, Hospital, Suicide prevention, Job Satisfaction, Occupational safety and health, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Nursing, Surveys and Questionnaires, Injury prevention, Humans, 030212 general & internal medicine, General Nursing, 030504 nursing, Workplace violence, Human factors and ergonomics, Cross-Sectional Studies, Workplace Violence, Female, Job satisfaction, Emergency Service, Hospital, 0305 other medical science, Psychology
Abstract

Aims To describe turnover intention of emergency nurses and clarify the effects of organizational commitment, job satisfaction and workplace violence on turnover intention. Background Research has showed the predictors of turnover intention differed among nurses of different specialties. However, research on turnover intention has mostly focused on general nurses rather than emergency nurses. Design A descriptive, cross-sectional study was conducted. Methods A self-administered questionnaire was used to collect data from 415 emergency nurses in Beijing, China, using convenience sampling. Path analysis was used to test the relationships between organizational commitment, job satisfaction, workplace violence and turnover intention. Results Most emergency nurses (90.2%) had a high level or very high level of turnover intention. Contrary to previous studies, organizational commitment had a significant direct positive effect on workplace violence. It also had a direct positive effect on job satisfaction and a negative effect on turnover intention. Workplace violence had a negative effect on job satisfaction and a positive effect on turnover intention. Job satisfaction had a direct negative effect on turnover intention. Conclusion To reduce turnover intention in the emergency department, measures should be taken to reduce workplace violence and increase nurses' job satisfaction, especially those with high organizational commitment.

Published
2020

47. Effects of nonlinear frequency compression on Mandarin speech and sound-quality perception in hearing-aid users

Author

Li Xu, Qian Lu, Yanyan You, Jinyu Qian, Xueqing Chen, Jing Yang, Volker Kuehnel, Julia Rehmann, and Bo Liu

Subjects
Hearing aid, Adult, Male, Linguistics and Language, medicine.medical_specialty, China, Speech perception, genetic structures, media_common.quotation_subject, medicine.medical_treatment, Hearing Loss, Sensorineural, Audiology, Mandarin Chinese, Language and Linguistics, Frequency compression, 03 medical and health sciences, Speech and Hearing, 0302 clinical medicine, Hearing Aids, Perception, otorhinolaryngologic diseases, medicine, Humans, Correction of Hearing Impairment, Sound quality, 030223 otorhinolaryngology, Correlation of Data, media_common, Aged, Language, Aged, 80 and over, Speech Reception Threshold Test, Auditory Threshold, Middle Aged, language.human_language, language, Linear Models, Speech Perception, Female, Psychology, Noise, 030217 neurology & neurosurgery
Abstract

Objective: The purpose of the present study was to examine the effects of NLFC fitting in hearing aids and auditory acclimatisation on speech perception and sound-quality rating in hearing-impaired...

Published
2020

48. Validation of the Chinese version of chemotherapy-induced Taste Alteration Scale among patients with head and neck cancer undergoing radiotherapy

Author

Yian Shih, Qian Lu, Sanli Jin, Yujie Wang, Yanli Wang, Hongmei Li, Yiwei Cao, Liqing Gong, Shuai Jin, Lichuan Zhang, and Hangjing Cui

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Psychometrics, Antineoplastic Agents, Dysgeusia, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Cronbach's alpha, Asian People, Internal medicine, Surveys and Questionnaires, medicine, Content validity, Humans, Translations, Aged, Aged, 80 and over, 030504 nursing, Oncology (nursing), business.industry, Discriminant validity, Construct validity, Reproducibility of Results, General Medicine, Middle Aged, Confirmatory factor analysis, Exploratory factor analysis, Quartile, Convergent validity, Head and Neck Neoplasms, 030220 oncology & carcinogenesis, Taste, Female, 0305 other medical science, business, Factor Analysis, Statistical
Abstract

Purpose To validate the Chinese version of the Chemotherapy-induced Taste Alteration Scale (CiTAS) among patients with head and neck cancer (HNC) undergoing radiotherapy (RT). Methods Patients with HNC undergoing RT were enrolled from a cancer hospital. Data were collected by face-to-face interview. Patients' subjective taste alterations (TAs) were assessed by the CiTAS. The content validity was evaluated by five experts. Confirmatory and exploratory factor analysis were used to assess construct validity. Convergent validity was assessed by the correlation between the CiTAS score and the Quality of Life Questionnaire-Core 30 (QLQ-C30) score. A single-item subjective intensity taste alteration question and quartiles of RT duration were used to assess the discriminant validity. The reliability was assessed by the Cronbach's alpha and test-retest reliability. Results 253 patients participated this investigation and 25 patients completed twice. Confirmatory factor analysis showed that the original CiTAS structure with four dimensions was not applicable to patients with HNC undergoing RT. The Chinese version of modified-CiTAS (m-CiTAS) retained 17 items (the item “bothered by the smell of food” was deleted) loading onto three factors: decline in taste, discomfort, and phantogeusia and parageusia. The m-CiTAS showed acceptable correlations with the QLQ-C30. It could effectively discriminate the intensity of subjective TAs according to the single-item question and quartiles of RT duration. The m-CiTAS showed acceptable internal consistency (Cronbach's alpha = 0.573–0.958) and test-retest reliability (r = 0.726–0.831, P Conclusions The Chinese version of m-CiTAS is an acceptable and applicable instrument to evaluate TAs among patients with HNC undergoing RT.

Published
2020

49. Profile of Chest Injuries and Oxygen Therapy in Trauma Patients with Acute Respiratory Failure after the Jiangsu Tornado in China: A Retrospective Study

Author

Lei He, Yi Jun Deng, Ping fa Chen, Zhong Qian Lu, Gen Hua Mu, Xing Li, Yun Hao Sun, and Shan Shan Hou

Subjects
Adult, Male, China, Emergency Medical Services, Thoracic Injuries, Chest injury, Emergency Nursing, law.invention, 03 medical and health sciences, 0302 clinical medicine, Injury Severity Score, law, Fraction of inspired oxygen, medicine, Humans, Aged, Retrospective Studies, Aged, 80 and over, Respiratory Distress Syndrome, Abbreviated Injury Scale, business.industry, Multiple Trauma, Oxygen Inhalation Therapy, 030208 emergency & critical care medicine, Emergency department, Middle Aged, medicine.disease, Polytrauma, Intensive care unit, Pulmonary contusion, Tornadoes, 030228 respiratory system, Respiratory failure, Anesthesia, Child, Preschool, Emergency Medicine, Female, business
Abstract

Background:The aim of this study was to analyze the profile of chest injuries, oxygen therapy for respiratory failure, and the outcomes of victims after the Jiangsu tornado, which occurred on June 23, 2016 in Yancheng City, Jiangsu Province, China.Methods:The clinical records of 144 patients referred to Yancheng City No.1 People’s Hospital from June 23 through June 25 were retrospectively investigated. Of those patients, 68 (47.2%) sustained major chest injuries. The demographic details, trauma history, details of injuries and Abbreviated Injury Scores (AIS), therapy for respiratory failure, surgical procedures, length of intensive care unit (ICU) and hospital stay, and mortality were analyzed.Results:Of the 68 patients, 41 (60.3%) were female and 27 (39.7%) were male. The average age of the injured patients was 57.1 years. Forty-six patients (67.6%) suffered from polytrauma. The mean thoracic AIS of the victims was calculated as 2.85 (SD = 0.76). Rib fracture was the most common chest injury, noted in 56 patients (82.4%). Pulmonary contusion was the next most frequent injury, occurring in 12 patients (17.7%). Ten patients with severe chest trauma were admitted to ICU. The median ICU stay was 11.7 (SD = 8.5) days. Five patients required intubation and ventilation, one patient was treated with noninvasive positive pressure ventilation (NPPV), and four patients were treated with high-flow nasal cannula (HFNC). Three patients died during hospitalization. The hospital mortality was 4.41%.Conclusions:Chest trauma was a common type of injury after tornado. The most frequent thoracic injuries were rib fractures and pulmonary contusion. Severe chest trauma is usually associated with a high incidence of respiratory support requirements and a long length of stay in the ICU. Early initiation of appropriate oxygen therapy was vital to restoring normal respiratory function and saving lives. Going forward, HFNC might be an effective and well-tolerated therapeutic addition to the management of acute respiratory failure in chest trauma.

Published
2020

50. Guilt and expressive writing for reducing alcohol use in college students: Study protocol for a randomized control trial

Author

Clayton Neighbors, Jordanna Lembo Riggs, Joanne Angosta, Lindsey M. Rodriguez, Qian Lu, Chelsie M. Young, and Pelin Cunningham-Erdogdu

Subjects
Male, Alcohol Drinking, Universities, Writing, Control (management), Applied psychology, education, Psychological intervention, Article, law.invention, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Randomized controlled trial, law, Intervention (counseling), Medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, Students, Randomized Controlled Trials as Topic, Protocol (science), 030505 public health, Expressive writing, business.industry, General Medicine, Moderation, Distress, Alcoholism, Guilt, Female, 0305 other medical science, business
Abstract

The current proposed study aims to evaluate expressive writing as a novel intervention for reducing problematic drinking among college students. College students are at increased risk for alcohol misuse compared to other adults, and the development of efficacious intervention approaches is an urgent priority. The vast majority of individually focused brief interventions targeting college drinking have focused on personalized feedback approaches and recent innovations have largely been limited to refinements of this paradigm, which require large-scale assessment and intricate programming for implementation. The present research proposes expressive writing as a novel alternative, which has been used extensively in other domains but not as an alcohol intervention strategy. We propose a theoretically-based approach that incorporates expression of the self-conscious emotion of guilt and the written analogue of change talk as proposed mechanisms of intervention efficacy. We will also examine individual differences in guilt-proneness as a moderator of intervention efficacy. Heavy drinking college students (N = 600) will be randomly assigned to one of six expressive writing conditions based on a 2 (alcohol vs. distress) × 2 (guilt vs. no guilt) + 1 (control writing) + 1 (personalized feedback) design. Participation in the study involves completion of a screening assessment, a baseline assessment, three in-lab intervention sessions, post-intervention assessments, and follow-up assessments one-month, three-months, six months, and twelve-months later. If effective, this novel intervention approach would not require any pre-assessment or programming of personalized feedback, and would serve as a more easily disseminable alternative to existing approaches.

Published
2020

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