The perceived and objectively measured effects of clinical pathways' implementation on medical care in China

<div><p>Introduction</p><p>Substantial resources have been expended on clinical pathways (CPs), but the reported effects of CPs on medical care vary considerably. This study sought to determine the effects of CPs on medical care in Chinese hospitals, including the perceived effects of CPs on medical care and the objectively measured patient outcomes.</p><p>Methods</p><p>Study data were obtained from 54 public hospitals in three provinces of China in 2015. Hospital questionnaires, employee surveys, and chart reviews were used to collect data related to hospital characteristics, the implementation of CPs and compliance status, perceived effects of CPs, and objectively measured patient outcomes. Logistic regression models and linear regression models were adopted in this study.</p><p>Results</p><p>The effects of CPs were not highly perceived by the hospitals or by the managers and physicians in China. The relatively low involvement in the implementation of and adherence to CPs resulted in CPs having no significant effects on hospital medical care as a whole. However, a chart review of 5 conditions in Chinese hospitals demonstrated that compliance with national CPs reduced the length of stay (LOS) and inpatient medical costs.</p><p>Conclusions</p><p>CPs should be implemented widely and followed closely to improve hospital medical care as a whole, and further studies should be conducted to identify the key elements of the effects of CPs on patient clinical outcomes.</p></div

Logistic models for physician-perceived effects of CPs on medical care^†.

<p>Logistic models for physician-perceived effects of CPs on medical care<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0196776#t002fn001" target="_blank">^†</a>.</p

Perceived effects of CPs on medical care (at the hospital and individual levels) ^†.

<p>Perceived effects of CPs on medical care (at the hospital and individual levels) <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0196776#t001fn001" target="_blank">^†</a>.</p

Logistic models for the objectively measured effects of CPs at the hospital level^†.

<p>Logistic models for the objectively measured effects of CPs at the hospital level<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0196776#t003fn001" target="_blank">^†</a>.</p

N-doped fiber anchoring PdNi nanoparticles and catalyzing Suzuki reaction

In this work, polydopamine-modified carbon fiber-supported PdNi nanoparticles were facially prepared and used in the Suzuki cross-coupling reaction with a high catalytic activity. The introduction of nickel increases the electron density around palladium and the catalytic activity. At the same time, comparing the effect of high-temperature carbonization, it is found that high temperature can enhance the electron transfer between the metal and the carrier and make the metal and the carrier bond more firmly. Provide new ideas for fixing nanoparticles in the future.</p

sj-docx-1-wmr-10.1177_0734242X221139057 – Supplemental material for Removal of refractory organics from landfill leachate by in situ electrogenerated H2O2 combined with an Fe0 Fenton-like process

Supplemental material, sj-docx-1-wmr-10.1177_0734242X221139057 for Removal of refractory organics from landfill leachate by in situ electrogenerated H2O2 combined with an Fe0 Fenton-like process by Zhiheng Li, Jie Bai, Yihui Li and Fan Wang in Waste Management & Research</p

MicroRNA-532 and microRNA-3064 inhibit cell proliferation and invasion by acting as direct regulators of human telomerase reverse transcriptase in ovarian cancer

<div><p>Human telomerase reverse transcriptase (hTERT) plays a crucial role in ovarian cancer (OC) progression. However, the mechanisms underlying hTERT upregulation in OC, and the specific microRNAs (miRNAs) involved in the regulation of hTERT in OC cells, remains unclear. We performed a bioinformatics search to identify potential miRNAs that bind to the 3'-untranslated region (3'-UTR) region of the hTERT mRNA. We examined the expression levels of miR-532/miR-3064 in OC tissues and normal ovarian tissues, and analyzed the correlation between miRNA expression and OC patient outcomes. The impacts of miR-532/miR-3064 on hTERT expression were evaluated by western blot analysis and hTERT 3'-UTR reporter assays. We investigated the effects of miR-532/miR-3064 on proliferation and invasion in OC cells. We found that miR-532 and miR-3064 are down-regulated in OC specimens. We observed a significant association between reduced miR-532/miR-3064 expression and poorer survival of patients with OC. We confirmed that in OC cells, these two miRNAs downregulate hTERT levels by directly targeting its 3'-UTR region, and inhibited proliferation, EMT and invasion of OC cells. In addition, the overexpression of the hTERT cDNA lacking the 3'-UTR partially restored miR-532/miR-3064-inhibited OC cell proliferation and invasion. The silencing of hTERT by siRNA oligonucleotides abolished these malignant features, and phenocopied the effects of miR-532/miR-3064 overexpression. Furthermore, overexpression of miR-532/miR-3064 inhibits the growth of OC cells <i>in vivo</i>. Our findings demonstrate a miR-532/miR-3064-mediated mechanism responsible for hTERT upregulation in OC cells, and reveal a possibility of targeting miR-532/miR-3064 for future treatment of OC.</p></div

miR-532 and miR-3064 inhibit OC growth <i>in vivo</i>.

<p>(<b>A</b>) Nude mice were subcutaneously injected with 1.0 × 106 ES-2 cells stably overexpressing miR-532, miR-3064 or the corresponding negative control (Neg). After implantation for 6 days, tumor volume measurement began and was performed every 4 days (n = 8); (<b>B</b>) The xenograft tumors removed from nude mice were analyzed by immunohistochemistry for expression of Ki-67. **<i>P</i> < 0.01.</p

miR-532/miR-3064 overexpression inhibits, whereas miR-532/miR-3064 silencing promotes proliferation and invasion in OC cells.

<p>(<b>A, B</b>) Cell morphology of OC cells transfected with either miR-532/miR-3064 mimics (<b>A</b>) or miR-532/miR-3064 inhibitors (<b>B</b>); (<b>C, D</b>) Representative images of invaded ES-2 (<b>C</b>) and SKOV-3 (<b>D</b>) cells transfected as indicated; (<b>E, F</b>) Cell counting kit-8 assay (<b>E</b>) and transwell invasion assay (<b>F</b>) with OC cells transfected with miR-532/miR-3064 mimics or miR-532/miR-3064 inhibitors. **: <i>P</i> < 0.01.</p

Identification of hTERT as a target for miR-532 and miR-3064 in OC cells.

<p>(<b>A, B</b>) Luciferase assay was performed in OC cells that were co-transfected with reporter vectors carrying either the wild-type (WT) version or the mutated (MUT) version of hTERT 3'-UTR, along with either miR-532/miR-3064 mimics (<b>A</b>) or miR-532/miR-3064 inhibitors (<b>B</b>). Neg mimic: negative control miRNA mimic; Neg inhibitor: negative control miRNA inhibitor; (<b>C, D</b>) Expression of hTERT, Slug, E-cadherin, Bax and GAPDH was determined using western blotting in ES-2 (<b>C</b>) or SKOV-3 (<b>D</b>) cells transfected with miR-532/miR-3064 mimics or miR-532/miR-3064 inhibitors, respectively; (<b>E</b>) The qPCR analysis of hTERT levels in OC patient samples and normal ovarian tissue samples; (<b>F</b>) Kaplan-Meier survival curves showing lower overall survival in patients with high (above median value) versus low (below median value) hTERT levels. **: <i>P</i> < 0.01.</p