bluuebunny/crossref_metadata_2025 huggingface dataset:
Nutrition knowledge and Attitude in Medical Students of Tabriz University of Medical Sciences in 2017-2018
Authors: Dolatkhah Neda , Aghamohammadi Dawood , Khalili Azizeh Farshbaf , Hajifaraji Majid , Hashemian Maryam , Esmaeili Sepideh
Published: October 2019

Objectives : In this cross-sectional study among 220 medical students we aimed to determine the nutritional knowledge and attitude of medical students through clinical training courses (externship and internship) of Tabriz University of Medical Sciences, Iran. A nutritional knowledge questionnaire included 51 questions was used to determine the correct, perceived and accuracy of knowledge of the participant in different aspects of nutrition sciences. Nutritional knowledge was calculated as percentage of correct responses. The nutrition attitude questionnaire included 30 questions. Both questionnaires were confirmed in terms of the validity and reliability for assessing nutritional knowledge and attitude in this sample of Iranian medical students.
Results: The mean score of correct knowledge was not significantly different among externs and interns (68.20±7.50% and 67.87±6.04% respectively, p=0.729). Results showed that most of the participants (49.61% of externs and 57.14% of inters) had a poor nutritional knowledge, significantly varied by age (p=0.035). The mean attitude index of the subjects was not significantly different among externs and interns (106.37±13.66 and 108.16±13.35 out of 145 respectively, p=0.337). Most students (92.7%) had a very appropriate attitude toward nutrition, significantly varied by sex (p=0.010). These findings indicate that there are multiple deficiencies in nutrition knowledge of medical students.
Graft failure of IgA nephropathy in renal allografts following living donor transplantation: predictive factor analysis of 102 biopsies
Authors: Zhang Jin , Chen Guo-dong , Qiu Jiang , Liu Guo-chang , Chen Li-zhong , Fu Kai , Wu Zi-xuan
Published: October 2019

Background To investigate predictive factors related to graft failure of IgA nephropathy(IgAN) in renal allografts following living donor transplantation. Methods We identified a series of 102 biopsies diagnosed as IgAN in renal allografts following living donor transplantation from July 2004 to January 2017 at our center, and assess the predict value of the Lee's classification and the 2009 Oxford classification in IgAN in renal allografts, clinical, ultrasonic and pathological characteristics at biopsy and the outcomes were retrospectively analyzed. Results The 5-year graft cumulative survival rate after transplantation was 91.4%. The 4-year graft cumulative survival rate after biopsy diagnosis of IgAN in renal allografts was 59.6%. The mean time ± SD to disease was 4.7 ± 3.5 years. The color doppler ultrasound and blood flow imagine showed the echo enhancement, the reduced blood flow distribution, the reduced peak systolic velocity of main renal artery, and the increased resistance index of arcuate renal artery were valuable in evaluating the graft dysfunction. The Cox multivariate analysis revealed that the 24-h urinary protein level (HR 1.6 for 1-g increase, 95%CI 1.2-2.0), estimated glomerular filtration rate (eGFR) (HR 1.0 for 1-mL/min/1.73m^2 decline, 95%CI 1.0-1.1), and mesangial C1q deposition (HR 3.0, 95%CI 1.2-7.4) at biopsy were independent predictive factors of graft failure of IgAN in renal allografts. Conclusions IgAN in renal allografts occurred frequently within 5 years after transplantation. The risk of graft failure should be taken seriously in patients who exhibit heavy proteinuria and/or a declined eGFR as the initial symptoms; a high lesion grade (grade IV-V of Lee’s classification) and/or mesangial C1q deposition may also indicated a poor outcome.
First referral to an Integrated Onco-Palliative Care program: a retrospective analysis of its timing
Authors: Barth Claire , Colombet Isabelle , Montheil Vincent , Huillard Olivier , Boudou-Rouquette Pascaline , Tlemsani Camille , Alexandre Jérôme , Goldwasser François , Vinant Pascale
Published: October 2019

Background : Palliative care (PC) referral is recommended early in the course of advanced cancer. This study aims to describe, in an integrated onco-palliative care program (IOPC), patient’s profile when first referred to this program, timing of this referral and its impact on the trajectory of care at end-of-life.
Patients and Methods : The IOPC combined the weekly onco-palliative meeting (OPM) dedicated to patients with incurable cancer, and/or the clinical evaluation by the PC team. Oncologists can refer to the multidisciplinary board of the OPM the patients for whom goals and organization of care need to be discussed. We analyzed all patients first referred at OPM in 2011-2013. We defined the index of precocity (IP), as the ratio of the time from first referral to death by the time from diagnosis of incurability to death, ranging from 0 (late referral) to 1 (early referral).
Results: Of the 416 patients included, 57% presented with lung, urothelial cancers, or sarcoma. At first referral to IOPC, 76% were receiving antitumoral treatment, 63% were outpatients, 56% had a performance status ≤2 and 46% had a serum albumin level >35g/l. The median [1 st -3 rd quartile] IP was 0.39 [0.16-0.72], ranging between 0.53 [0.20-0.79] (earliest, for lung cancer) to 0.16 [0.07-0.56] (latest, for prostate cancer). Among 367 decedents, 42 (13%) received antitumoral treatment within 14 days before death, and 157 (43%) died in PC units.
Conclusions : The IOPC is an effective organization to enable early integration of PC and decrease aggressiveness of care near the end-of life. The IP is a useful tool to model the trajectory of care while taking into account each cancer types and therapeutic advances.
Challenges and opportunities in the continuity of care for hypertension: a mixed-methods study embedded in the Tajikistan Health Services Improvement Project
Authors: Chukwuma Adanna , Gong Estelle , Latypova Mutriba , Fraser-Hurt Nicole
Published: October 2019

Background: Hypertension, a significant risk factor for ischemic heart disease and other chronic conditions, is the third-highest cause of death and disability in Tajikistan. Thus, ensuring the early detection and appropriate management of hypertension is a core element of strategies to improve population health in Tajikistan. For a strategy to be successful, it should be informed by the causes of gaps in service delivery and feasible solutions to these challenges. The objective of this study was to undertake a systematic assessment of hypertension case detection and retention in care within Tajikistan’s primary health care system, and to identify challenges and appropriate solutions.

Methods: Our mixed-methods study drew on the cascade of care framework to examine patient progression through the recommended stages of hypertension care. We triangulated data from household surveys and facility registries within Tajikistan’s Health Services Improvement Project (HSIP) to describe the cascade. Focus group discussions with local HSIP stakeholders identified the barriers to and facilitators for care. Drawing on global empirical evidence on effective interventions and stakeholder judgments on the feasibility of implementation, we developed recommendations to improve hypertension service delivery that were informed by our quantitative and qualitative findings.

Results: We review the results for the case detection stage of the cascade of care, which had the most significant gaps. Of the half a million people with hypertension in Khatlon and Sogd Oblasts (administrative regions), about 10 percent have been diagnosed in Khatlon and only 5 percent in Sogd. Barriers to case detection include misinformation about hypertension, ambiguous protocols, and limited delivery capacity. Solutions identified to these challenges were mobilizing faith-based organizations, scaling up screening through health caravans, task-shifting to increase provider supply, and introducing job aids for providers.

Conclusions: Translating findings on discontinuities in care for hypertension and other chronic diseases to actionable policy insights can be facilitated by collaboration with local stakeholders, triangulation of data sources, and identifying the intersection between the feasible and the effective in defining solutions to service delivery challenges.
Prevalence and Risk Factors for Microalbuminuria in Children with Sickle Cell Disease at King Abdulaziz University Hospital: A Retrospective Cross-sectional Study
Authors: Alzahrani Yahya A , Algarni Malak Ali , Alnashri Maryam Mohammed , AlSayyad Hanan Mohammad , Aljahdali Khadijah Mohammed , Alead Joud Emad , Alhjrsy Yara Ali , Alzahrani Fatma Salih , Safder Osama
Published: October 2019

Objectives

Previous studies have not addressed microalbuminuria in pediatric patients with sickle cell disease (SCD) in Jeddah, Saudi Arabia. This study aimed to determine the prevalence of microalbuminuria and identify associated risk factors in children with SCD at King Abdulaziz University Hospital.Results

Overall, 42.5% of the patients enrolled were Saudi Arabian and 51% were male. The patients’ mean age was 12.4 years, and the highest percentage (40%) was in the age group of 15–18 years. The prevalence of microalbuminuria was 9.6%, and hematuria was present in 8% of cases. The percentage of patients with hematuria was significantly higher in the microalbuminuria group (22.6%) than in the non-microalbuminuria group (6.5%; P=.007). The percentage of patients with acute chest syndrome was also higher in the microalbuminuria group (26%) than in the non-microalbuminuria group (8%; P=0.005). The percentage of patients with gallbladder stones was higher in the microalbuminuria group (13%) than in the non-microalbuminuria group (2.4%; P=.014). However, the mean number of blood transfusions was higher in the non-microalbuminuria group than in the microalbuminuria group (P=.002). Sickle cell nephropathy manifests as microalbuminuria, begins at an early age, occurs in all types of SCD, and is associated with disease severity.
Diversity and bioactivities of fungal endophytes from Distylium chinense, a rare waterlogging tolerant plant endemic to the Three Gorges Reservoir
Authors: Duan Xiaoxiang , Xu Fangfang , Qin Dan , Gao Tiancong , Shen Weiyun , Zuo Shihao , Yu Baohong , Xu Jieru , Peng Yajun , Dong Jinyan
Published: October 2019

Background

The present study involves diversity and biological activities of the endophytic fungal community from Distylium chinense , a rare waterlogging tolerant plant endemic to the Three Gorges Reservoir. This study has been conducted hypothesizing that the microbial communities in the TGR area would contribute to the host plant tolerating a range of abiotic stress such as summer flooding, infertility, drought, salinity and soil erosion etc., and they may produce new metabolites, which may possess plentiful bioactive property, especially antioxidant activity. Therefore in the current study, the antioxidant, antimicrobial and anticancer activities of 154 endophytes recovered from D. chinense have been investigated. Furthermore, the active metabolites of the most broad-spectrum bioactive strain have also been studied.Results

A total of 154 fungal endophytes were isolated from roots and stems. They were categorized into 30 morphotypes based on cultural characteristics and were affiliated with 27 different taxa. Among these, the most abundant fungal orders included Diaporthales (34.4%) and Botryosphaeriales (30.5%), which were predominantly represented by the species Phomopsis sp. (24.7%) and Neofusicoccum parvum (23.4%). Fermentation extracts were evaluated, screening for antioxidant, antimicrobial and anticancer activities. Among the 154 isolates tested, 99 (64.3%) displayed significant antioxidant activity, 153 (99.4%) exhibited inclusive antimicrobial activity against at least one tested microorganism and 27 (17.5%) showed exclusive anticancer activity against one or more cancer cell lines. Specifically, the crude extract of Irpex lacteus DR10-1 exhibited note-worthy bioactivities. Further chemical investigation on DR10-1 strain resulted in the isolation and identification of two known bioactive metabolites, indole-3-carboxylic acid ( 1 ) and indole-3-carboxaldehyde ( 2 ), indicating their potential roles in plant growth promotion and human medicinal value.Conclusion

These results indicated that diverse endophytic fungal population inhabits D. chinense . One of the fungal isolate DR10-1 ( Irpex lacteus ) exhibited significant antioxidant, antimicrobial and anticancer potential. Further, its active secondary metabolites 1 and 2 also showed antioxidant, antimicrobial and anticancer potential.
Microbiological and cytological characterization of coelomic fluid from three captive endangered amphibian Gastrotheca species with edema syndrome: Preliminary analysis.
Authors: Oleas-Paz Anahí , Santamaría-Naranjo Ana Cecilia , Rojas-Carrillo Maira , Merino-Viteri Andrés , Genoy-Puerto Alexander
Published: October 2019

Objective: Edema syndrome is highly prevalent but under researched in captive frogs around the world. The objective of the present study was to characterize at a basic microbiological and cytological level the edema fluid of 20 individuals of the genus Gastrotheca to determine the presence of possible anaerobic and aerobic bacteria.
Results: Fourteen types of bacteria were identified in the edema fluid, twelve of them at the species level ( Pasteurella haemolytica , Hafnia alvei , Enterobacter agglomerans , Aeromonas hydrophila , Pseudomonas fluorescens , Burkholderia pseudomallei , Salmonella arizonae , Enterobacter gergoviae , Enterobacter sakazakii , Yersinia enterocolitica , Klebsiella oxytoca, and Klebsiella ozaenae ) and two at the genus level ( Enterococcus spp. and Streptococcus spp.). The most frequently identified cells were lymphocytes (37.7% in females and 46.4% in males), erythrocytes (23.5% in females and 17.5% in males) and neutrophils (4.2% in females and 2.8% in males). Finally, no relationship was found between the data obtained and the sex of the individuals studied.
Screening And Quantification Of Anti-Quorum Sensing And Antibiofilm Activities Of Phyllosphere Bacteria Against Biofilm Forming Bacteria
Authors: THEODORA NADINE AMABEL , DOMINIKA VANIA , Waturangi Diana Elizabeth
Published: October 2019

Objective

The objectives of this research were to screen anti-quorum sensing activity of phyllosphere bacteria and quantify their antibiofilm activity against biofilm forming bacteria ( Bacillus cereus, Staphylococcus aureus, Enterococcus faecalis, Salmonella typhimurium, Vibrio cholerae, Pseudomonas aeruginosa). Results

We found 11 phyllosphere bacteria isolates with potential anti-quorum sensing activity. Most of the crude extracts from phyllosphere bacteria isolates had anti-quorum sensing activity against Chromobacterium violaceum at certain concentration (20 and 10 mg/mL), but not crude extract from isolate JB 7F. Crude extracts showed various antibiofilm activities against all tested pathogenic bacteria.
Robot-Assisted Bronchoscopy for Pulmonary Lesion Diagnosis: Results from the Initial Multicenter Experience
Authors: Chaddha Udit , Kovacs Stephen P. , Hogarth Douglas Kyle , Manley Christopher , Cumbo-Nacheli Gustavo , Bhavani Sivasubramanium V. , Kumar Rohit , Shende Manisha , III John P. Egan , Murgu Septimiu
Published: October 2019

Background The Robotic Endoscopic System (Auris Health, Inc., Redwood City, CA) has the potential to overcome several limitations of contemporary guided-bronchoscopic technologies for the diagnosis of lung lesions. Our objective is to report on the initial post-marketing feasibility, safety and diagnostic yield of this technology.Methods We retrospectively reviewed data on consecutive cases in which robot-assisted bronchoscopy was used to sample lung lesions at four centers in the US (academic and community) from June 15th, 2018 to December 15th, 2018.Results One hundred and sixty-seven lesions in 165 patients were included in the analysis, with an average follow-up of 185 ± 55 days. The average size of target lesions was 25.0 ± 15.0 mm. Seventy-one percent were located in the peripheral third of the lung. Pneumothorax and airway bleeding occurred in 3.6% and 2.4% cases, respectively. Navigation was successful in 88.6% of cases. Tissue samples were successfully obtained in 98.8%. The diagnostic yield estimates ranged from 69.1% to 77% assuming the cases of biopsy-proven inflammation without any follow-up information (N=13) were false-negatives and true-negatives, respectively. The yield was 81.5%, 71.7% and 26.9% for concentric, eccentric and absent r-EBUS views, respectively. Diagnostic yield was not affected by lesion size, density, lobar location or centrality.Conclusions RAB implementation in community and academic centers is safe and feasible, with an initial diagnostic yield of 69.1-77% in patients with lung lesions that require diagnostic bronchoscopy. Comparative trials with the existing bronchoscopic technologies are needed to determine cost-effectiveness of this technology.
Spiral artery blood flow during pregnancy: a systematic review and meta-analysis.
Authors: Schiffer Veronique , Evers Laura , de Haas Sander , Ghossein Chahinda , Al-Nasiry Salwan , Spaanderman Marc
Published: October 2019

Background : Downstream remodeling of the SpA decreases utero-placental resistance drastically, allowing sustained and increased blood flow to the placenta at all circumstances. We systematically evaluated available reports to visualize adaptation of spiral arteries throughout pregnancy by ultra-sonographic measurements and evaluated when this process is completed. Methods : A systematic review and meta-analysis of spiral artery flow (pulsatility index (PI), resistance index (RI) and peak systolic velocity (PSV)) was performed. English articles were obtained from Pubmed, EMBASE and Cochrane Library and included articles were assessed on quality and risk of bias. Weighted means of Doppler indices were calculated using a random-effects model. Results : In healthy pregnancies, PI and RI decreased from 0.75 (95% CI: 0.67-0.83) and 0.49 (95% CI: 0.46-0.53) in the first trimester to 0.52 (95% CI: 0.48-0.56, p=0.003) and 0.40 (95% CI: 0.38-0.42, p=0.080) in the second trimester and to 0.49 (95% CI: 0.44-0.53, p=0.510) and 0.36 (95% CI: 0.35-0.37, p=0.307) in the third trimester, respectively. In parallel, PSV altered from 0.24 m/s (95% CI: 0.17-0.31 m/s) to 0.28 m/s (95% CI: 0.22-0.34 m/s, p=0.377) and to 0.25 m/s (95% CI: 0.21-0.28 m/s, p=0.919) in the three trimesters. In absence of second and third trimester Doppler data in complicated gestation, only a difference in PI was observed between complicated and healthy pregnancies during the first trimester (1.49 vs 0.76, p<0.001). Although individual studies have identified differences in PI between SpA located in the central part of the placental bed versus those located at its periphery, this meta-analysis could not confirm this (p=0.349) . Conclusions : This review and meta-analysis concludes that an observed decrease of SpA PI and RI from the first towards the second trimester parallels the physiological trophoblast invasion converting SpA during early gestation, a process completed in the midst of the second trimester. Higher PI and RI were found in SpA of complicated pregnancies compared to healthy pregnancies, possibly reflecting suboptimal utero-placental circulation. Longitudinal studies examining comprehensively the predictive value of spiral artery Doppler for complicated pregnancies are yet to be carried out.
Metastatic breast cancer patient perception of somatic tumor genomic testing
Authors: Adams Elizabeth J. , Asad Sarah , Reinbolt Raquel E. , Collier Katharine A. , Abdel-Rasoul Mahmoud , Gillespie Susan , Chen James L. , Cherian Mathew A. , Noonan Anne M. , Sardesai Sagar , VanDeusen Jeffrey , Wesolowski Robert , Williams Nicole , Shapiro Charles L. , Macrae Erin R. , Toland Amanda E. , Senter Leigha , Ramaswamy Bhuvaneswari , Lee Clara N. , Lustberg Maryam B. , Stover Daniel
Published: October 2019

Purpose: To assess metastatic breast cancer (MBC) patient perceptions and comprehension of tumor genomic testing and to evaluate associations with psychological wellbeing. Methods: In a prospective, single institution, single-arm trial, patients with MBC underwent next-generation sequencing at study entry, with sequencing results released at progression. Patients who completed surveys before undergoing sequencing were included in the study (n=58). We administered four validated psychosocial measures: Center for Epidemiologic Studies Depression Scale, Beck Anxiety Inventory, Trust in Physician Scale, and Communication and Attitudinal Self-Efficacy scale for Cancer. Genetic comprehension was assessed using 7-question objective and 6-question subjective measures. Longitudinal data were assessed using paired Wilcoxon signed rank and McNemar’s test of agreement. Results: There were no significant differences between the beginning and end of study in depression, anxiety, physician trust, or self-efficacy (median time on study: 7.6 months). Depression and anxiety were positively associated with each other and both negatively associated with self-efficacy. Self-efficacy decreased from pre- to post-genomic testing (p=0.05). There was a wide range of objective genetics comprehension and comprehension was significantly lower in non-white patients (p=0.02) and patients with lower income (p=0.04). Patients expressed increased confidence in their ability to teach others about genetics at end of study. Conclusions: This is the only study, to our knowledge, to longitudinally evaluate multiple psychological metrics in MBC as patients undergo tumor genomic testing. Among patients with MBC, depression and anxiety metrics were negatively correlated with patient self-efficacy. Patients undergoing somatic genomic testing had limited genomic knowledge, which varied by demographic groups.
Transcriptomic profiling revealed key signaling pathways for cold tolerance and acclimation of two carp species
Authors: Ge Guodong , Long Yong , Shi Lianyu , Ren Jing , Yan Junjun , Li Chitao , Li Qing , Cui Zongbin
Published: October 2019

Background Closely related species of the carp family ( Cyprinidae ) have evolved distinctive abilities to survive under cold stress, but molecular mechanisms underlying the generation of cold resistance remain largely unknow. In this study, we compared transcriptomic profiles of two carp species to identify key factors and pathways for cold tolerance and acclimation. Results Larvae of Songpu mirror carp and Barbless carp that were pretreated at 18°C for 24 hours significantly improved their survival rates under lethal cold temperature at 8°C or 10°C, indicating that two carp species possess the ability of cold acclimation. However, Songpu mirror carp exhibited stronger abilities of cold tolerance and acclimation than Barbless carp. Transcriptomic profiles of Songpu mirror carp and Barbless carp larvae at 28°C and 18°C were compared during cold acclimation through RNA-seq. Differentially expressed genes that are closely associated with the differences in cold acclimation between two carp species were identified through bioinformatics and Venn's diagram analysis. GO enrichment analysis of these genes indicated that cellular component assembly involved in morphogenesis, secondary alcohol metabolism and drug transport were the most up-regulated biological processes during cold acclimation of Songpu mirror carp. Conversely, positive regulation of macroautophagy, intracellular protein transport, and organonitrogen compound catabolism were the most down-regulated biological processes during cold acclimation of Barbless carp. KEGG enrichment analysis revealed that factors in the FoxO-related signaling pathways are mainly responsible for the development of differences in cold tolerance and acclimation between two carp species since altering the phosphorylation of key proteins in the FoxO-related signaling pathways with inhibitors or an activator significantly decreased the cold tolerance and acclimation of Songpu mirror carp. These data provided key clues for dissection of molecular mechanisms underlying the development of cold tolerance and acclimation in carps. Conclusions These findings indicate that larvae of two carp species possess different abilities of cold tolerance and can build cold acclimation under mild low temperature. Multiple biological processes and FoxO-related signaling pathways are closely associated with the development of differences in cold tolerance and acclimation between two carp species. Keywords: Carp; cold tolerance; cold acclimation; RNA-Seq; biological process; signaling pathways
Evolution of PHAS Loci in the Young Spike of Allohexaploid Wheat
Authors: Zhang Rongzhi , Huang Siyuan , Li Shiming , Song Guoqi , Li Yulian , Li Wei , Li Jihu , Gao Jie , Gu Tiantian , Li Dandan , Zhang Shujuan , Li Genying
Published: October 2019

Background PhasiRNAs (phased secondary siRNAs) play important regulatory roles in the development processes and biotic and abiotic stresses in plants. A class of phasiRNAs involve in the reproductive development in grasses. Reproductive-associated phasiRNAs include two categories, 21-nt (nucleotide) and 24-nt phasiRNAs, which are triggered by miR2118 and miR2275 in premeiotic and meiotic anthers, respectively, which had been reported in rice, maize and other grass species. However, there were still absence in Triticum The allohexaploid wheat ( Triticum aestivum ) genome consists of three closely related subgenomes (subA, subB and subD), which is a model of allopolyploid in plants. And the evolution of PHAS loci in polyploid plants is still unavailable.Results Here, using 261 small RNA expression datasets from various tissues, a batch of PHAS (phasiRNA precursors) loci were identified in the young spike of wheat, most of which were triggered by miR2118 and miR2275 in their target site regions. Dissection of PHAS and their trigger miRNAs among the diploid (AA and DD), tetraploid (AABB) and hexaploid (AABBDD) genomes of Triticum indicated that distribution of PHAS loci were dominant randomly in local chromosomes, while their trigger miR2118 was dominant only in the subB genome. The diversity of PHAS loci in the three subgenomes of wheat and their progenitor genomes (AA, DD and AABB) suggested that they originated or diverged before the occurrence of AABB. The positive relationship between the PHAS loci or the trigger miRNAs and the ploidy of genome indicated the expansion of genome was the major drive force for the increase of PHAS loci and their trigger miRNAs in Triticum . In addition, the PHAS transcripts responded to abiotic stresses such as cold stress in wheat.Conclusions Altogether, non-coding phasiRNAs are conserved transcriptional regulators that display quick plasticity in genome dominance and sequence diversity and are involved in reproductive development and abiotic stress in wheat. It could be referred to molecular research on male reproductive development in Triticum .
Reconstruction and analysis of genome-scale metabolic model of weak Crabtree positive yeast Lachancea kluyveri
Authors: Nanda Piyush , Patra Pradipta , Das Manali , Ghosh Amit
Published: October 2019

Background Lachancea kluyveri , a weak Crabtree positive yeast, has been extensively studied for the unique URC pyrimidine catabolism it harbours. It produces more biomass than Saccharomyces cerevisiae due to the underlying Crabtree effect and resorts to fermentation only in oxygen limiting conditions that makes it suitable host for industrial scale protein production. Ethyl acetate, an important industrial chemical, has been demonstrated to be a major overflow metabolite during aerobic batch cultivation with a specific rate of 0.12 g per g dry weight per hour. Here, we attempted to reconstruct the metabolism of the yeast from the genome to better explain the observed phenotypes and aid further hypothesis generation. Results We report the first genome-scale metabolic model, iPN730, using Build Fungal Model in KBase workspace. The inconsistencies in the model were manually corrected using literature and published datasets. The model comprises of 1235 reactions, 1179 metabolites and 730 genes distributed in 8 compartments. The in silico viability and the growth rates in various carbon sources show good agreement. The gene essentiality of the metabolic model also performs well in comparison to experimental data confirmed by statistical analysis. Dynamic flux balance analysis describes the growth dynamics, substrate utilization and product formation kinetics in various oxygen limited conditions. The URC pyrimidine degradation pathway incorporated into the model enables it to grow on uracil or urea as the sole nitrogen source. Conclusion The genome-scale metabolic construction of L. kluyveri provides better understanding of metabolism, particularly that of pyrimidine metabolism and ethyl acetate production. Metabolic flux analysis using the model will enable hypotheses generation to gain deeper understanding of metabolism in weakly Crabtree positive yeast.
Relationship between platelet count and hepatic failure and residual liver regeneration after hemihepatectomy in patients with hepatitis B-related primary hepatocellular carcinoma
Authors: Ye Chuhui , Xu Banghao , Lu Kaiyi , Lu Tingting , Zhang Ling , Zeng Jingjing , Guo Ya , Peng Minhao , Wen Zhang
Published: October 2019

Objective A retrospective analysis of the influences of platelet (PLT) counts on liver failure and liver regeneration in patients with primary hepatocellular carcinoma (HCC) provides a treatment strategy for clinical prevention and treatment of postoperative liver failure and residual liver regeneration. Method The clinical data of 111 patients with a background of hepatitis B virus infection and who underwent (expanded) half liver resection at the First Affiliated Hospital of Guangxi Medical University from June 2012 to June 2017 were collected and statistically analyzed. Results　On the basis of the International Study Group of Liver Surgery liver failure-grading standards and Dino–Clavien postoperative complication criteria, the incidence of grade B and above liver failure was 55%, and complication II level and above was 47.5% in the PLT decline group after semihepatectomy. The incidence rates in the normal group were 26.8% and 23.9%. A statistically significant difference was determined in the two groups (P1=0.003, P2 = 0.011). The average volumes of liver hyperplasia (residual liver volume (RLV)80.4 days − RLV) in the PLT decline and normal groups were 132.09 ± 61.89 cm3 and 190.89 ± 91.98c cm3, respectively; the average rates of hyperplasia ((RLV80.4days−RLV)/RLV) were 16.59%± 7.36% and 24.78% ± 10.82%. The difference between the two groups was statistically significant (PProliferation = 0.001, PProliferation rate = 0.001). Univariable and multivariable logistic regression analyses of postoperative liver failure grade and proliferation rate in patients who underwent semihepatectomy suggested that the decrease in postoperative PLT count (PLT < 125 × 109/L) might be an independent risk factor of severe posthepatectomy liver failure (PHLF) (PHLF-B or above) and residual liver regeneration rate for patients with primary HCC after half liver resection. No death occurred. Conclusions A correlation existed between PLT count and postoperative PHLF or liver regeneration. Monitoring PLT counts after liver resection may help us predict the suffering from PHLF-B or above and severe postoperative complications.
The Influence of dietary diversity on the nutritional status of children between 6 and 23 months of age in Tanzania
Authors: Khamis Ahmed Gharib , Mwanri Akwilina Wendelin , Ntwenya Julius Edward , Kreppel Katharina
Published: October 2019

Background Undernutrition poses a serious health challenge in developing countries. Tanzania has the highest undernutrition burdens in East and Southern Africa. Poor infant and young child feeding practices including consumption of undiversified diet are the main cause for undernutrition. There is limited information regarding the association between dietary diversity and undernutrition in Tanzania. The objective of this paper was to examine to what extent the dietary diversity is associated with undernutrition of children of 6 to 23 months in Tanzania.Methods This is a secondary data analysis from data collected by the Tanzania Demographic and Health Survey of 2015-2016. Stunting, wasting and underweight were calculated from Z-scores based on 2006 WHO standards. A dietary diversity score was created by summing the number of food groups reported for each child by the mother ranging from 0 to 7. Then, a Minimum Dietary Diversity (MDD) indicator was used to assess the diversity of the diet given to children. Bivariate and multivariate logistic regression techniques were used to assess the odds ratios of becoming undernourished.Results A total of 2,960 children were enrolled in this study. The majority (73.9%) of children did not reach the recommended Minimum Dietary Diversity (MDD). The most commonly consumed types of foods were grains, roots and tubers (91%), and Vitamin A containing fruits and vegetables (65%). Consumption of a diverse diet was significantly associated with a reduction of stunting, wasting and being underweight in children. The likelihood of being stunted, wasted and underweight was found to decrease as the number of food group consumed increased. Children who did not received an MDD diet had a significantly higher likelihood of being stunted (AOR=1.37, 95% CI; 1.13-1.65) and underweight (AOR=1.49, 95% CI; 1.15-1.92), but this was not the case for wasting. Consumption of animal source foods has been found to be associated with reduced stunting among children.Conclusion Consumption of a diverse diet was associated with a reduction in undernutrition among children of 6 to 23 months in Tanzania. Measures to improve the type of complementary foods in order to meet the energy and nutritional demands of children should be considered in Tanzania.
Seniors’ Campus Continuums: Local Solutions for Broad Spectrum Seniors Care
Authors: Morton-Chang Frances Margaret , Majumder Shilpi , Berta Whitney
Published: October 2019

Background As demand and desire to “age-in-place” grows within an aging population, challenges exist to realizing this wish. Changing demographics and new areas of need have governments nationally and internationally calling for more focused attention on integrative approaches to health and well-being. Seniors’ Campus Continuums seek bridge the “divide” between health and social care for residents and local community. This paper investigates factors that influence Campus evolution, ongoing functioning, and ability to offer wrap around care for older adults wishing remain in their own home and community. Methods This research uses a comparative case study approach across multiple bounded cases to explore how Seniors’ Campus Continuums operating in various contexts integrate health, housing and social care around older adults living on the campus and in the local community. Six seniors’ campuses from across Ontario offering four physically co-located components – mixed independent housing options, internal community supports to residents, external community supports to the broader community, and a long-term care home – were studied and compared. Results Eight factors that promote or impede Seniors’ Campus Continuum evolution, design and function, and ability to provide wrap-around care to older adults with progressive needs are identified including: i. historical legacies; ii. windows of opportunity; iii. organizational structure and capacity; iv. intentional physical and social design; v. campus services mix, amenities and partnerships; vi. policy rigidities and enablers; vii. human resources shortages and innovation; viii. funding limitations and opportunities. Together these factors describe opportunities to optimize care on many levels. Conclusion Seniors’ Campus Continuums offer creative boundary-spanning approaches to address a variety of needs while taking into account local contexts. At an individual level, campuses increase access to a range of care supports and housing options to benefit seniors’ health and wellbeing. At an organizational level, they offer consistency and coordination of care, improved economies of scale, and rich environments for training/research, education and volunteering. At a system level, they offer potential to help people avoid ending up in the “wrong places.” This study fills a gap in evidence-based research around understanding of this integrative model and offers lessons learned for future development.
Different arrhythmic prognosis in high-risk arrhythmogenic right ventricular cardiomyopathy according to the indication of the defibrillator
Authors: Ruiz-Salas Amalio , Navarro-Arce Isabel , Medina-Palomo Carmen , Barrera-Cordero Alberto , Jiménez-Navarro Manuel , Rueda-Calle Eloy , García-Pinilla José Manuel , Cabrera-Bueno Fernando , Morcillo-Hidalgo Luis , Gómez-Doblas Juan José , Alzueta Javier
Published: October 2019

Background: Arrhythmogenic right ventricular cardiomyopathy (ARVC/D) is an inherited cardiomyopathy characterized by ventricular arrhythmias and heart failure. The aim of our study was to analyze the impact of the ICD indication in the prognosis of patients with high-risk ARVC/D according to the consensus document. Methods The high-risk category includes patients who experienced cardiac arrest due to sustained ventricular tachycardia or ventricular fibrillation and patients with severe right or left ventricular dysfunction. We included 41 patients with high-risk ARVC/D: 33 in secondary prevention and 8 in primary prevention. Results We followed 41 patients during 6.37 ± 4.88 years. Twenty-six patients (63.4%) had at least one appropriate arrhythmic event: 24 p (72.7%) in secondary prevention and 2 p (25%) in primary prevention; p=0.02. Twenty-four patients (72.7%) in secondary prevention and five (62.5%) in primary prevention had a cardiovascular event such as arrhythmias, admission due to heart failure, heart transplantation or cardiovascular death. Conclusions High-risk ARVC/D patients had a high number of cardiovascular events, but their nature and treatment were different. Arrhythmic prognosis was worse in secondary prevention and most of the events found in primary prevention were related to heart failure and, therefore, without benefit of the ICD.
Tumour Content Ratio Matters for Detecting Epidermal Growth Factor Receptor Mutation by Cobas Test in Small Biopsies; a Retrospective Study
Authors: Kogo Mariko , Fujimoto Daichi , Hosoya Kazutaka , Nagata Kazuma , Nakagawa Atsushi , Tachikawa Ryo , Yamashita Daisuke , Kitamura Yuka , Imai Yukihiro , Tomii Keisuke
Published: October 2019

Background
Recent studies indicate the benefit of treatment with osimertinib over that with conventional epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) for untreated EGFR -mutated non-small cell lung cancer (NSCLC). Cobas ver2 is the only companion diagnostic method for detecting EGFR mutations with osimertinib treatment. We clinically experience false negative cases with this test, but its actual sensitivity is unknown. Moreover, no study has suggested the importance of tumour dissection, and most facilities do not routinely perform them on small biopsies. The purpose of this study was to evaluate the sensitivity of cobas in clinical practice and clarify the role of dissection as a component of the cobas testing

Materials and Methods
We examined 132 patients with EGFR -mutated NSCLC diagnosed by bronchoscopy and confirmed with PCR clamp. Patients were tested with cobas and the EGFR -positive rate was calculated. Samples with undetected EGFR mutations were retested after tumour dissection and the rate of samples whose EGFR mutation was corrected to positive was assessed. To evaluate tumour cellularity, the tumour content ratio was assessed by calculating tumour cell count over the total cell count on the slide.

Results
The positive rate of EGFR mutation identification was 76% with cobas, although EGFR mutation-negative patients retained responses to TKI therapy equivalent to positive patients did; however, the tumour content ratio of negative samples was significantly lower than that of positive samples. Twenty-nine negative samples underwent dissection and 24% were corrected to positive. Moreover, 53% of the samples with a tumour content ratio below 10% was negative for cobas, but 33% of these turned positive after dissection.

Conclusion
Cobas had a high false negative rate in clinical practice, and tumour content ratio might be associated with this rate. Dissection could improve the sensitivity of cobas, especially in samples with low tumour cellularity.
A prospective study of erectile dysfunction in men after pelvic surgical procedures and its association with non - modifiable risk factors
Authors: Artemi Sofia , Vassiliu Panteleimon , Arkadopoulos Nikolaos , Smyrnioti Maria - Eleni , Sarafis Pavlos , Smyrniotis Vasileios
Published: October 2019

Objective: Erectile dysfunction can be caused iatrogenically, due to pelvic surgery. The purpose of this study was to evaluate sexual function at various times after pelvic surgery in male patients and to investigate the non-modifiable risk factors associated with the presence and intensity of sexuality in these patients.
Results: The mean age of the participants was 66.16 ± 13.07 years old. Regarding comorbidity, 47.2% reported various cardiovascular problems, 20.8% hypertension, 9.4% diabetes mellitus and 5.7% depression. A history of colectomy was present in 36.8%, 18.9% had undergone sigmoidectomy, and 33% inguinal hernia repair. The percentage of severe erectile function increased from 38.7% before surgery to 48.1% (25% increase) after surgery, at the end of the follow-up period (p <0.05). In the multivariate analysis model, age emerged as an independent predictor of erectile function ( p <0.001). Age was the most important determinant of the IIEF score, which was aggravated by 25% from the first to the last assessment of patients.
The Effect of the Mobile ‘Blood Pressure Management Application’ on Hypertension Self-Management Enhancement: A Randomised Controlled Trial
Authors: Bozorgi Ali , Hosseini Hamed , Eftekhar Hassan , Majdzadeh Reza , Yoonessi Ali , Ramezankhani Ali , Mansouri Mehdi , Ashoorkhani Mahnaz
Published: October 2019

Background : Self-management of blood pressure is of great significance given the increasing incidence of hypertension and associated disabilities. With the increased use of mobile health in medicine, the present study evaluated the effect of the self-management application on patient adherence to hypertension treatment.
Methods : This clinical trial was performed on 120 hypertensive patients who were provided with a mobile intervention for 8 weeks and followed-up to 24 th weeks. Data on the primary outcome (adherence to treatment) and secondary outcomes (adherence to the DASH diet, regular monitoring of blood pressure, and physical activity) were collected using a questionnaire and a mobile application, respectively. The inter-group change difference over time was analyzed using repeated measures ANOVA (General Linear Model).
Results : The treatment adherence score increased by an average of 5.9 (95%CI: 5.0-6.7) in the intervention group compared to the control group. Scores of adherence to the low-fat and low-salt diet plans were 1.7 (95%CI: 1.3-2.1) and 1.5 (95%CI: 1.2-1.9), respectively. Moreover, moderate physical activity increased to 100.0 minutes (95%CI: 61.7-138.3) per week in the intervention group.
Conclusion: The treatment and control of blood pressure require a multifaceted approach given its complexity and multifactorial nature. Considering the widespread use of smartphones , mhealth interventions can be effective in self-management and better patient adherence to treatments. Our results showed that this application can be used as a successful tool for hypertension self-management in patients attending public hospitals in developing countries.
Trial registration: This study was registered in the Iran Randomized Clinical Trial Center under the number IRCT2015111712211N2 on 1 January 2016.
Comparison of Soil‐Test Extractants for Potassium, Calcium, Magnesium, Sulfur, and Micronutrients in Idaho Soils
Authors: Rogers C. W. , Dari B. , Schroeder K. L.
Published: October 2019

Core Ideas

Multinutrient extractants were correlated to standard tests on alkaline calcareous soils

For the tested nutrients Mehlich‐3 generally extracted greater and H3A less than the common tests used in the Western United States

Mehlich‐3 extracted large amounts of Ca when inorganic‐C as CaCO3was greater than 3.3 g kg−1resulting in poor correlation with the ammonium acetate test

Soil fertility and nutrient management programs across Idaho and the western United States should consider the effective comparison of various extractants for nutrient analyses. Common extractants for K, Ca, Mg, S, and micronutrients (Zn, Cu, Mn, Fe, B, Na) vary (e.g., ammonium acetate [AA], Olsen, etc.). The desire to develop effective correlation equations among common tests in the region and those of multinutrient extractants used or proposed in other geographical regions (i.e., Mehlich‐3 [M‐3] and Haney, Haney, Hossner, Arnold [H3A]) has increased due to the interest in nutrient management planning and in relation to soil health measurements. To investigate these multinutrient tests, 46 primarily alkaline soils were sampled from the 0‐ to 30‐cm depth in agricultural fields in Idaho. Linear regressions between AA and Olsen K and both M‐3 and H3A resulted in a significant positive fit (R2= 0.69–0.90). Notable issues with increased Ca concentrations occurred in soils with large amounts of inorganic C. Removal of these samples improved the relationship between standard and multinutrient soil tests. Specific micronutrient regressions were problematic when both alkaline and acidic soils were analyzed but improved when separated. Mehlich‐3 and H3A extractants were generally well correlated, with the exceptions noted above, to common extractants used in western soils. Thus, this research provides specific correlation equations that could be used for comparison among tests as well as provides evidence of the potential suitability of multinutrient extractants in the region.