Validation of a Novel Traditional Chinese Medicine Pulse Diagnostic Model Using an Artificial Neural Network

In view of lacking a quantifiable traditional Chinese medicine (TCM) pulse diagnostic model, a novel TCM pulse diagnostic model was introduced to quantify the pulse diagnosis. Content validation was performed with a panel of TCM doctors. Criterion validation was tested with essential hypertension. The gold standard was brachial blood pressure measured by a sphygmomanometer. Two hundred and sixty subjects were recruited (139 in the normotensive group and 121 in the hypertensive group). A TCM doctor palpated pulses at left and right cun, guan, and chi points, and quantified pulse qualities according to eight elements (depth, rate, regularity, width, length, smoothness, stiffness, and strength) on a visual analog scale. An artificial neural network was used to develop a pulse diagnostic model differentiating essential hypertension from normotension. Accuracy, specificity, and sensitivity were compared among various diagnostic models. About 80% accuracy was attained among all models. Their specificity and sensitivity varied, ranging from 70% to nearly 90%. It suggested that the novel TCM pulse diagnostic model was valid in terms of its content and diagnostic ability

Methods to disinfect and decontaminate SARS-CoV-2: a systematic review of in vitro studies

Background: Cleaning is a major control component for outbreaks of infection. However, for the SARS-CoV-2 pandemic, there is limited specific guidance regarding the proper disinfection methods that should be used. Methods: We conducted a systematic review of the literature on cleaning, disinfection or decontamination methods in the prevention of SARS-CoV-2. Results: A total of 27 studies were included, reporting a variety of methods with which the effectiveness of interventions were assessed. Virus was inoculated onto different types of material including masks, nasopharyngeal swabs, serum, laboratory plates and simulated saliva, tears or nasal fluid and then interventions were applied in an attempt to eliminate the virus including chemical, ultraviolet (UV) light irradiation, and heat and humidity. At body temperature (37°C) there is evidence that the virus will not be detectable after 2 days but this can be reduced to non-detection at 30 min at 56°C, 15 min at 65°C and 2 min at 98°C. Different experimental methods testing UV light have shown that it can inactivate the virus. Light of 254–365 nm has been used, including simulated sunlight. Many chemical agents including bleach, hand sanitiser, hand wash, soap, ethanol, isopropanol, guandinium thiocynate/t-octylphenoxypolyethoxyethanol, formaldehyde, povidone-iodine, 0.05% chlorhexidine, 0.1% benzalkonium chloride, acidic electrolysed water, Clyraguard copper iodine complex and hydrogen peroxide vapour have been shown to disinfect SARS-CoV-2. Conclusions: Heating, UV light irradiation and chemicals can be used to inactivate SARS-CoV-2 but there is insufficient evidence to support one measure over others in clinical practice

Nurses' knowledge of universal health coverage for inclusive and sustainable elderly care services

Objectives: to explore nurses' knowledge of universal health coverage (UHC) for inclusive and sustainable development of elderly care services. Method: this was a cross-sectional survey. A convenience sample of 326 currently practicing enrolled nurses (EN) or registered nurses (RN) was recruited. Respondents completed a questionnaire which was based on the implementation strategies advocated by the WHO Global Forum for Governmental Chief Nursing Officers and Midwives (GCNOMs). Questions covered the government initiative, healthcare financing policy, human resources policy, and the respondents' perception of importance and contribution of nurses in achieving UHC in elderly care services. Results: the knowledge of nurses about UHC in elderly care services was fairly satisfactory. Nurses in both clinical practice and management perceived themselves as having more contribution and importance than those in education. They were relatively indifferent to healthcare policy and politics. Conclusion: the survey uncovered a considerable knowledge gap in nurses' knowledge of UHC in elderly care services, and shed light on the need for nurses to be more attuned to healthcare policy. The educational curriculum for nurses should be strengthened to include studies in public policy and advocacy. Nurses can make a difference through their participation in the development and implementation of UHC in healthcare services.Objetivos: explorar o conhecimento dos enfermeiros sobre a cobertura universal de saúde (CUS) para o desenvolvimento inclusivo e sustentável de serviços de saúde a idosos. Método: estudo transversal. Foi recrutada uma amostra de conveniência de 326 enrolled nurses (EN) ou registered nurses (RN). Os entrevistados responderam a um questionário com base nas estratégias de implementação preconizadas pelo Fórum Global da OMS para Governmental Chief Nursing Officers and Midwives (GCNOMs). As perguntas abordavam iniciativas do governo, políticas de financiamento da saúde, políticas de recursos humanos e percepção dos entrevistados sobre a importância e contribuição do enfermeiro no alcance da CUS em serviços de cuidados a idosos. Resultado: o conhecimento de enfermeiros sobre a CUS em serviço de atenção ao idoso foi razoavelmente satisfatório. Enfermeiros tanto da prática clínica como da gestão perceberam-se contribuindo mais e tendo mais importância do que aqueles que trabalham na educação. Eles eram relativamente indiferentes à política de saúde e à política. Conclusão: a pesquisa revelou uma lacuna de conhecimento considerável no conhecimento da CUS pelos enfermeiros nos serviços de cuidados a idosos e evidenciou a necessidade de enfermeiros terem mais sintonia com a política de saúde. O currículo de formação para preparar os enfermeiros deve ser reforçado para incluir estudos em política pública e advocacia. Os enfermeiros podem fazer a diferença por meio de sua participação no desenvolvimento e implementação da CUS nos serviços de saúde.Objetivos: explorar los conocimientos que tienen las enfermeras sobre la cobertura universal de salud (CUS) para el desarrollo inclusivo y sostenible de servicios para el cuidado de adultos mayores. Método: se utilizó una encuesta transversal. Se formó una muestra de conveniencia de 326 enrolled nurses (EN) o registered nurses (RN) que actualmente estuvieran ejerciendo. Los encuestados respondieron a un cuestionario basado en las estrategias de implementación apoyadas por el WHO Global Forum for Government Chief Nursing and Midwifery Officers (WGFGCNO). Las preguntas abarcaban la iniciativa del gobierno, políticas de financiamiento de la salud, las políticas de recursos humanos y la percepción de los encuestados sobre la importancia y la contribución de las enfermeras en el logro de la CUS en los servicios de cuidado para adultos mayores. Resultados: el conocimiento de las enfermeras sobre CUS en el servicio de cuidado para los adultos mayores fue bastante satisfactorio. Tanto las enfermeras de práctica clínica y como las de gestión perciben tener un mayor aporte e importancia que las de que están en educación. Tenían un punto de vista relativamente indiferente a la política sanitaria y la política. Conclusión: la encuesta descubrió una considerable brecha en el conocimiento de las enfermeras sobre CUS en los servicios de cuidado para adultos mayores y puso de manifiesto la necesidad de que las enfermeras estén más en sintonía con la política sanitaria. El plan de estudios para la preparación de las enfermeras debe fortalecerse para incluir estudios en las políticas públicas y promoción. Las enfermeras pueden hacer una diferencia a través de su participación en el desarrollo e implementación de CUS en los servicios de salud

Gene Expression Profiling on the Molecular Action of Danshen-Gegen Formula in a Randomized Placebo-Controlled Trial of Postmenopausal Women with Hypercholesterolemia

The Danshen-Gegen formula (DG) is a traditional Chinese herbal formula which has long been used to treat cardiovascular disease. DG was found to be a cardiovascular tonic in our recent research. However, a comprehensive investigation of the molecular mechanism of DG in cardiovascular disease has not been performed. The aim of this study was to clarify the transcriptional profiling of genes modulated by DG on postmenopausal women by using DNAmicroarray technology. We obtained 29 whole blood samples both from DG-treated and placebo-treated subjects. Blood lipid profile and intima-media thickness (IMT) were measured. Affymetrix GeneChip was used to identify differentially expressed genes (DEGs), followed by validation by the real-time PCR method. The results showed that DG-treated group has a significant improvement in IMT and lipid profile as compared to placebo-treated group. For the genomic study, the DG-treated group has a higher number of DEGs identified as compared to the placebo-treated group. Two important biological processes of “regulation of systemic arterial blood pressure by hormone” and “regulation of smooth muscle proliferation” have been identified by GePS in the DG-treated group. No significant biological process and cellular components were identified in the placebo-treated group. This genomic study on the molecular action of DG in postmenopausal women gathered sufficient molecular targets and pathways to reveal that DG could improve neointima thickening and hypertension

Lupus nephritis in Chinese children--a territory-wide cohort study in Hong Kong

We report a multicenter study of Chinese children in Hong Kong with systemic lupus erythematosus (SLE) nephritis. Children were included if: they fulfilled the ACR criteria, had significant proteinuria or casturia, were Chinese and younger than 19 years and had been diagnosed with SLE between January 1990 and December 2003. Investigators in each center retrieved data on clinical features, biopsy reports, treatment and outcome of these patients. There were 128 patients (eight boys, 120 girls; mean age: 11.9+/-2.8 years). About 50% presented with multisystem illness and 40% with nephritic/nephrotic symptoms. Negative anti-dsDNA antibodies were found in 6% of the patients. Renal biopsy revealed WHO Class II, III, IV and V nephritis in 13 (10%), 22 (17%), 69 (54%) and 13 (10%) patients, respectively. The clinical severity of the nephritis did not accurately predict renal biopsy findings. The follow-up period ranged from 1 to 16.5 years (mean+/-SD: 5.76+/-3.61 years). During the study five patients died (two from lupus flare, one from cardiomyopathy, two from infections). Four patients had endstage renal failure (ESRF) (one died during a lupus flare). All deaths and end-stage renal failure occurred in the Class IV nephritis group. Chronic organ damage was infrequent in the survivors. The actuarial patient survival rates at 5, 10 and 15 years of age were 95.3, 91.8, and 91.8%, respectively. For Class IV nephritis patients, the survival rates without ESRF at 5, 10, and 15 years were 91.5, 82.3 and 76%, respectively. The survival and chronic morbidity rates of the Chinese SLE children in the present study are comparable to those of other published studies.postprin

An Integrated TCGA Pan-Cancer Clinical Data Resource to Drive High-Quality Survival Outcome Analytics

For a decade, The Cancer Genome Atlas (TCGA) program collected clinicopathologic annotation data along with multi-platform molecular profiles of more than 11,000 human tumors across 33 different cancer types. TCGA clinical data contain key features representing the democratized nature of the data collection process. To ensure proper use of this large clinical dataset associated with genomic features, we developed a standardized dataset named the TCGA Pan-Cancer Clinical Data Resource (TCGA-CDR), which includes four major clinical outcome endpoints. In addition to detailing major challenges and statistical limitations encountered during the effort of integrating the acquired clinical data, we present a summary that includes endpoint usage recommendations for each cancer type. These TCGA-CDR findings appear to be consistent with cancer genomics studies independent of the TCGA effort and provide opportunities for investigating cancer biology using clinical correlates at an unprecedented scale. Analysis of clinicopathologic annotations for over 11,000 cancer patients in the TCGA program leads to the generation of TCGA Clinical Data Resource, which provides recommendations of clinical outcome endpoint usage for 33 cancer types

Pan-Cancer Analysis of lncRNA Regulation Supports Their Targeting of Cancer Genes in Each Tumor Context

Long noncoding RNAs (lncRNAs) are commonly dys-regulated in tumors, but only a handful are known toplay pathophysiological roles in cancer. We inferredlncRNAs that dysregulate cancer pathways, onco-genes, and tumor suppressors (cancer genes) bymodeling their effects on the activity of transcriptionfactors, RNA-binding proteins, and microRNAs in5,185 TCGA tumors and 1,019 ENCODE assays.Our predictions included hundreds of candidateonco- and tumor-suppressor lncRNAs (cancerlncRNAs) whose somatic alterations account for thedysregulation of dozens of cancer genes and path-ways in each of 14 tumor contexts. To demonstrateproof of concept, we showed that perturbations tar-geting OIP5-AS1 (an inferred tumor suppressor) andTUG1 and WT1-AS (inferred onco-lncRNAs) dysre-gulated cancer genes and altered proliferation ofbreast and gynecologic cancer cells. Our analysis in-dicates that, although most lncRNAs are dysregu-lated in a tumor-specific manner, some, includingOIP5-AS1, TUG1, NEAT1, MEG3, and TSIX, synergis-tically dysregulate cancer pathways in multiple tumorcontexts

Pan-cancer Alterations of the MYC Oncogene and Its Proximal Network across the Cancer Genome Atlas

Although theMYConcogene has been implicated incancer, a systematic assessment of alterations ofMYC, related transcription factors, and co-regulatoryproteins, forming the proximal MYC network (PMN),across human cancers is lacking. Using computa-tional approaches, we define genomic and proteo-mic features associated with MYC and the PMNacross the 33 cancers of The Cancer Genome Atlas.Pan-cancer, 28% of all samples had at least one ofthe MYC paralogs amplified. In contrast, the MYCantagonists MGA and MNT were the most frequentlymutated or deleted members, proposing a roleas tumor suppressors.MYCalterations were mutu-ally exclusive withPIK3CA,PTEN,APC,orBRAFalterations, suggesting that MYC is a distinct onco-genic driver. Expression analysis revealed MYC-associated pathways in tumor subtypes, such asimmune response and growth factor signaling; chro-matin, translation, and DNA replication/repair wereconserved pan-cancer. This analysis reveals insightsinto MYC biology and is a reference for biomarkersand therapeutics for cancers with alterations ofMYC or the PMN

Genomic, Pathway Network, and Immunologic Features Distinguishing Squamous Carcinomas

This integrated, multiplatform PanCancer Atlas study co-mapped and identified distinguishing molecular features of squamous cell carcinomas (SCCs) from five sites associated with smokin