The effects of Terminalia catappa leaf extracts (TCE) have been widely investigated, including its antioxidative, anti-inflammatory, and antidiabetic activity, as well as its antimetastatic effects on several types of human cancer. However, no study has examined the antimetastatic potential of TCE in cervical cancer cells. This study aimed to elucidate the potential antimetastatic properties of ethanol extracts of Terminalia catappa in 12-O-tetradecanoylphorbol-13-acetate treated human cervical cancer cells and investigate the signaling pathway of this process. We demonstrated that TCE elicited very low cytotoxicity and significantly inhibited cellular migration and invasion in human HeLa and SiHa cervical cancer cells. Moreover, the gelatin zymography, reverse transcription-polymerase chain reaction (RT-PCR), and real-time PCR analysis revealed that the activity and mRNA level of matrix metalloproteinase-9 (MMP-9) were inhibited by TCE in a concentration-dependent manner.The Western blot results demonstrated that the highest concentration of TCE (100 μg/ml) reduced the phosphorylation of extracellular signal-regulated kinases 1/2 (ERK1/2) by 46% in the HeLa cell lines. In conclusion, it was revealed that TCE exerted antimetastatic effects on cervical cancer cells by inhibiting the expression of MMP-9 through the ERK1/2 pathway. K E Y W O R D S cervical cancer, MAPK pathway, migration, MMP-9, Terminalia catappa 1 | INTRODUCTION Cervical cancer is one of the leading causes of cancer death and the 4th most frequently occurring malignancy among women worldwide and more than 260 000 women die of cervical cancer annually. 1 Moreover, International Agency for Research on Cancer (IARC) assessed the incidence rate of cervical cancer as 19.0 women per 100 000. 2 Most patients with cervical cancer present with abnormal vaginal bleeding or a cervical mass. 3 Lesion size and pelvic node metastases are vital prognostic factors in cervical cancer. 4 The Chung-Yuan Lee and Shun-Fa Yang contributed equally to the work.
BackgroundPrescribing inappropriate pill splitting is not rare in clinical practice. To reduce inappropriate pill splitting, we developed an automatic warning system linked to a computerized physician order entry (CPOE) system for special oral formulation drugs in outpatient settings. We examined the impact of the warning system on inappropriate prescribing of pill splitting and assess prescribers' responses to the warnings.MethodsDrugs with extended-release or enteric-coated formulations that were not originally intended to be split were recognized as “special oral formulations”. A hard-stop system which could examine non-integer doses of drugs with special oral formulations, provide warnings to interrupt inappropriate prescriptions was integrated in CPOE in a medical center since June 2010. We designed an intervention study to compare the inappropriate splitting before and after the implementation of the warning system (baseline period 2010 January to May vs. intervention period 2010 June to 2011 August). During the intervention period, prescription changes in response to a warning were logged and analyzed.ResultsA total of 470,611 prescribed drug items with 34 different drugs with special oral formulations were prescribed in the study period. During the 15-month intervention period, 909 warnings for 26 different drugs were triggered among 354,523 prescribed drug items with special oral formulations. The warning rate of inappropriate splitting in the late intervention period was lower than those in baseline period (0.16% vs. 0.61%, incidence rate ratio 0.27, 95% CI 0.23–0.31, P<0.001). In respond to warnings, physicians had to make adjustments, of which the majority was changing to an unsplit pill (72.9%).ConclusionsThe interruptive warning system could avoid the prescriptions with inappropriate pill splitting. Accordingly, physicians changed their behavior of prescribing special oral formulations regarding inappropriate pill splitting. We suggest the establishment of such system to target special oral formulations with warnings to prevent inappropriate pill splitting.
PurposeDealing with online rumors or fake information on social media is growing in importance. Most academic research on online rumors has approached the issue from a quantitative modeling perspective. Less attention has been paid to the psychological mechanisms accounting for online rumor transmission behavior on the individual level. Drawing from the theory of stimulus–organism–response, this study aims to explore the nature of online rumors and investigate how the informational characteristics of online rumors are processed through the mediation of psychological variables to promote online rumor forwarding.Design/methodology/approachAn experimental approach to this issue was taken; the researchers investigated how the informational characteristics of online rumors and the psychological mediators promote online rumor transmission.FindingsFour information characteristics (sense-making, funniness, dreadfulness and personal relevance) and three psychological motivators (fact-finding, relationship enhancement and self-enhancement) promote online rumor-forwarding behavior.Originality/valueBecause any online rumor transmitted on social media can go viral, companies may eventually encounter social media-driven crises. Thus, understanding what drives rumor-forwarding behavior can help marketers mitigate and counter online rumors.
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