bluuebunny/crossref_metadata_2025 huggingface dataset:
Myxoid stroma is associated with postoperative relapse in patients with stage II colon cancer
Authors: Okuyama Takashi , Sameshima Shinichi , Takeshita Emiko , Mitsui Takashi , Noro Takuji , Ono Yuko , Noie Tamaki , Ban Shinichi , Oya Masatoshi
Published: August 2020

Background: Fibrosis surrounding cancer cells has been shown to affect cancer cell metastatic behavior. The present study aimed to explore the utility of myxoid stroma as a predictive factor for postoperative relapse in patients with stage II colon cancer.Methods: The present study retrospectively investigated 169 patients who underwent curative surgical resection of stage II colon cancer. The fibrotic stroma was classified according to Ueno’s criteria, and the patients were divided into the myxoid (MY) group and the non-MY (NMY) group. We also recorded tumor budding (TB) and investigated the combination of MY and TB for postoperative relapse. Postoperative survival was also explored.Results: Thirty-two (18.9%) patients had MY. MY was significantly associated with tumor budding (TB) and postoperative relapse (p<0.001 and p<0.001, respectively). The 5-year RFS rates in MY group and NMY group were 52.1% and 94.6% (p<0.0001), and the 5-year OS rates in MY group and NMY group were 74.6% and 93.3% (p=0.001). Multivariate analysis showed that both MY and TB were significant risk factors for postoperative relapse (p<0.001 and p=0.02, respectively), and that only TB was a significant risk factor for OS (p=0.043). Furthermore, compared with patients with either one of MY or TB, patients with both MY and TB had postoperative relapse more frequently (11.4% vs. 53.8%).Conclusions: The present study suggests that MY is a predictive marker for postoperative relapse in patients with stage II colon cancer.
Association of Lean Body Mass to Menopausal Symptoms: The Study of Women’s Health Across the Nation
Authors: Woods Rosanne , Hess Rebecca , Biddington Carol , Federico Marc
Published: August 2020

Background: The purpose of this study was to examine the association of lean body mass (LBM) to the development of vasomotor symptoms (VMS) as women transition through menopause.Methods: This study is a secondary use of data available for public use from follow up visits six through 10 for participants in the Study of Women’s Health Across the Nation. The study examined 2,533 women, between the ages 42 – 52 years, each year over a10-year period. Data was modeled for associations of lean body mass and VMS. Changes in LBM since prior visit and since baseline were also modeled along with differences in means using binary logistic regression, adjusting for covariates.Results: LBM was significantly associated to concurrent VMS (p = .036), percent change in LBM since prior visit (p = .003), percent change since baseline (p <.001), and overall means associations (p = .023). LBM was not significant for VMS at individual visit measures. In mixed regression modeling, time was significant (p <.0001) at all visits. The estimated probability of developing VMS decreases significantly as LBM increases. Conclusions: Lean body mass is negatively associated with incident VMS. Our data suggests that maintaining higher levels of LBM during the menopausal transition may be protective against the development of VMS. Every woman will experience menopause in her life and the ability to potentially prevent the onset of specific symptoms through basic interventions, such as resistance training to increase lean body mass, may positively impact this large population.
Oral Status of Elderly Patients in Long-Term Care Facilities: A Systematic Review
Authors: Ruiz-Roca Juan Antonio , Martin-Fuentes Dora , Martinez-Beneyto Yolanda , Oñate-Sanchez Ricardo Elias
Published: August 2020

Background: elderly patients who spend long periods hospitalised or those who are in a situation of institutionalisation represent a risk group in this regard, since many of them suffer a degree of dependence and need help to perform the basic personal care tasks. It is therefore important to learn more about the oral health status of this group of patients in order to make a proper assessment of the situation as well as to develop protocols for its management. The purpose of this study was to conduct a systematic review to ascertain the oral health status of elderly patients institutionalised or hospitalised for a long period of time.Methods: a systematic review of the literature published in three different databases (PubMed, Embase and Cochrane Library) was conducted, with 12 different combinations of keywords based on the following selection criteria: studies published in the last 5 years, in English and/or Spanish and/or Portuguese, with samples of ≥30 patients, performed in patients older than 65 years, admitted to any type of institution and/or care centre for at least 7 days and in which the state of hard and/or soft tissues of the oral cavity were assessed in some way. The selected articles were subjected to a thorough analysis.Results: The search strategy covered 1,014 articles: 689 from Pubmed and 325 from Cochrane Library. After applying the eligibility criteria, five articles were selected for our review. The level of evidence of the articles was3, with a sample consisting of 773 patients in which most of them were women with an average age older than 70 years old.Conclusions: the oral health of patients aged more than 65 is worse than that of the rest of the population. Long-term in hospitals or being institutionalised in a retirement home makes this group susceptible to a worsening of their oral health status. It is necessary to develop protocols for the oral health care of these patients, accompanied by training programmes for the personnel.
Examining fidelity in the INFORM trial, a complex team-based behavioural intervention
Authors: Ginsburg Liane , Hoben Matthias , Easterbrook Adam , Andersen Elizabeth , Anderson Ruth , Cranley Lisa , Lanham Holly , Norton Peter , Weeks Lori , Estabrooks Carole
Published: August 2020

Background. Fidelity in complex behavioural interventions is underexplored. This study examines fidelity of the INFORM trial and explores the relationship between fidelity, study arm and the trial’s primary outcome – care aide involvement in formal team communications about resident care. Methods. A concurrent process evaluation of implementation fidelity was conducted in 33 nursing homes in Western Canada (Alberta and British Columbia). Study participants were from 106 clinical care units clustered in 33 nursing homes randomized to the Basic and Enhanced Assisted Feedback arms of the INFORM trial.Results. Fidelity of the INFORM intervention was moderate to high, with fidelity delivery and receipt higher than fidelity enactment for both study arms. Higher enactment teams experienced a significantly larger improvement in formal team communications between baseline and follow-up than lower enactment teams (F(1, 70) = 4.27, p = .042).Conclusions. Overall fidelity enactment was associated with improvements in formal team communications, but study arm was not. This suggests that the intensity with which an intervention is offered and delivered may be less important than the intensity with which intervention participants enact the core components of an intervention. Greater attention to fidelity assessment and publication of fidelity results through studies such as this one is critical to improving the utility of published trials.
Effect of different types of cerebral perfusion for acute type A aortic dissection, unilateral versus bilateral
Authors: liu zhengqin , Wang Chen , Zhang Xiquan , Wu Shuming , fang changcun , pang xinyan
Published: August 2020

Background: Antegrade cerebral perfusion (ACP), including unilateral and bilateral, is most commonly used way for cerebral protection in aortic surgery. There is still no consensus on the superiority of the two methods. Our research was aimed to investigate the clinical effects between u-ACP and b-ACP. Methods: 321 of 356 patients with type A aortic dissection were studied retrospectively. 124 patients (38.6%) received u-ACP and 197 patients(61.4%) received b-ACP. We compared the incidence of postoperative neurological complications and other collected data between two groups. We also analyzed perioperative variables in order to find the potential associated factors for neurolocial dysfunction (ND). Results: For u-ACP group, 54 patients (43.5%) had postoperative neurological complications including 22 patients (17.7%) with permanent neurologic dysfunction (PND) and 32 patients (25.8%) with temporary neurologic dysfunction (TND). For b-ACP group, 47 patients (23.8%) experienced postoperative neurological complications including 16 patients (8.1%) of PND and 31 patients (15.7%) of TND. The incidence of PND and TND were significantly different between two groups along with shorter CPB time (p=0.016), higher nasopharyngeal temperature (p≦0.000), shorter ventilation time (p=0.018) and lower incidence of hypoxia (p=0.022). Furthermore, multivariate stepwise logistic regression analysis confirmed that preoperative neurological dysfunction (OR=1.20, P= 0.028), CPB duration (OR=3.21, P=0.002 ) and type of cerebral perfusion (OR=1.48, P=0.017) were strongly associated with postoperative ND. Conclusions: In our study, we found that b-ACP procedure had shorter CPB time, milder hypothermia, shorter ventilation time, lower incidence of postoperative hypoxia and neurological dysfunction compared to u-ACP. Meanwhile, we discovered the incidence of ND was independently associated with there factors, including preoperative neurological dysfunction, CPB time and type of cerebral perfusion.
Evaluation of adhesion barrier types in a rat hepatectomy-induced adhesion model
Authors: Shimizu Atsushi , Kai Miho , Tasaki Masako , Chino Naotaka , Hasegawa Kiyoshi , Kokudo Norihiro
Published: August 2020

Background: Adhesion formation after hepatectomy creates problems for repeat hepatectomy. This study aimed to compare the effectiveness of a spray (AdSpray) and sheet adhesion barrier (Seprafilm) in a rat hepatectomy-induced adhesion model.Methods: Thirty male Sprague-Dawley rats underwent partial resection of the left lateral liver lobe. They were randomly assigned to control (n=10), AdSpray (n=10), and Seprafilm groups. Seven days after surgery, the animals were sacrificed, and adhesions at the hepatic resection surface were blindly evaluated.Results: In the control group, adhesions were formed in all 10 animals (100%), with a 69% adhesion extent (mean). In the AdSpray group, the incidence of adhesions (40%) and the adhesion extent (mean, 10%) were significantly lower than in the control group (incidence; p = 0.0147, adhesion extent; p = 0.0007). In the Seprafilm group, the incidence of adhesions was 70%. The adhesion extent of Seprafilm (mean, 30%) was significantly lower than in the control group (p = 0.0492). No significant differences were observed between the AdSpray and Seprafilm groups. As for histopathological examination, animals in the AdSpray group showed a similar healing profile to that of the control group without delayed healing and regeneration of mesothelial cells. In contrast, the Seprafilm group showed ongoing foreign body reaction to Seprafilm, and regeneration of mesothelial cells was immature at 7 days.Conclusions: Both the spray-type gel and sheet adhesion barriers significantly reduced adhesion formation after hepatectomy. The spray-type adhesion barrier caused no adverse events and induced favorable healing. These adhesion barriers may be effective in hepatectomy. Further animal studies and clinical trials are required to determine their benefits in clinical use.
Influence of multiple apolipoprotein A-I and B genetic variations on insulin resistance and metabolic syndrome in obstructive sleep apnea
Authors: Xinyi Li , Zhihui Fu , Huajun Xu , Jianyin Zou , Huaming Zhu , Zhiqiang Li , Kaiming Su , De Huai , Hongliang Yi , Jian Guan , Shankai Yin
Published: August 2020

Background: The relationships between apolipoprotein A-I (APOA-I), apolipoprotein B (APOB) with insulin resistance, metabolic syndrome (MetS) are unclear in OSA. We aimed to evaluate whether the multiple single nucleotide polymorphism (SNP) variants of APOA-I and APOB exert a collaborative effect on insulin resistance and MetS in OSA. Methods: Initially, 12 APOA-I SNPs and 30 APOB SNPs in 5,259 subjects were examined. After strict screening, four APOA-I SNPs and five APOB SNPs in 4,007 participants were included. For each participant, the genetic risk score (GRS) was calculated based on the cumulative effect of multiple genetic variants of APOA-I and APOB. Logistic regression analyses were used to evaluate the relationships between APOA-I/APOB genetic polymorphisms, insulin resistance, and MetS in OSA. Results: Serum APOB levels increased the risk of insulin resistance and MetS adjusting for age, gender and BMI [odds ratio (OR=3.168, P < 0.001; OR=6.098, P < 0.001, respectively]. APOA-I GRS decreased the risk of insulin resistance and MetS after adjustments (OR = 0.917, P = 0.001; OR = 0.870, P < 0.001, respectively). APOB GRS had no association with insulin resistance (OR = 1.364, P =0.610), and had weak association with MetS after adjustments (OR =1.072, P = 0.042). In addition, individuals in the top quintile of the APOA-I genetic score distribution had a lower risk of insulin resistance and MetS after adjustments (OR = 0.761, P = 0.007; OR = 0.637, P < 0.001, respectively). Conclusions: In patients with OSA, cumulative effects of APOA-I genetic variations decreased the risk of insulin resistance and MetS, whereas multiple APOB genetic variations had no associations with insulin resistance and weak association with MetS.
GWAS unveils features between early- and late-flowering pearl millets
Authors: Diack Oumar , Kanfany Ghislain , Gueye Mame Codou , Sy Ousmane , Fofana Amadou , Tall Hamidou , Serba Desalegn D. , Zekraoui Leila , Berthouly-Salazar Cécile , Vigouroux Yves , Diouf Diaga , KANE NDJIDO ARDO
Published: August 2020

Background: Pearl millet, a dietary food for around 100 million people in Africa and in India, has a large diversity due to an extensive genetic diversity combined with a high degree of admixture with wild relatives. In Senegal, two major morphotypes are distinguished: early-flowering and late-flowering millets. The phenotypic variabilities according to the flowering time plays an important role in pearl millet adaptation to climate variability. A better understanding of the genetic makeup of these variabilities would allow breeding of pearl millet fitting different climatic areas. In this study, we aimed to characterize the genetic basis of these phenotypic differences. Results: We defined a core collection capturing most of the diversity of cultivated pearl millet of Senegal, which includes 60 early-flowering Souna and 31 late-flowering Sanio. This panel was evaluated during the 2016 and 2017 rainy seasons at Nioro for 16 agro-morphological traits. Phenological and phenotypic traits linked with yield, flowering time, and biomass helped differentiated early- and late-flowering millets. Further, using genotyping-by-sequencing (GBS), 21,663 single nucleotide polymorphisms (SNPs) with minor allele frequencies of more than 5% were identified. Sparse Non-Negative Matrix Factorization (sNMF) analysis confirms the genetic structure in two gene pools associated with flowering time differences. Moreover, two chromosomal regions on linkage groups (LG 3) (~89.7Mb) and (LG 6) (~68.1Mb) differentiated the early-flowering into two clusters. Genome-wide association study (GWAS) was used to associate phenotypic variation to the SNPs and 18 genes were linked to flowering time, plant height, nodal tiller number, and biomass (P-value ˂ 2.3E-06). Conclusions: The diversity of early- and late-flowering pearl millet landraces of Senegal was captured using a heuristic approach. Key phenology and phenotypic traits, SNPs, and candidate genes underlying flowering time, tillering, biomass and plant height of pearl millet were identified. Chromosome rearrangements in LG3 and LG6 were implicated as a source of variation in early-flowering morphotypes. Using candidate genes underlying these features between pearl millet morphotypes would have paramount importance in breeding strategies under climate change scenarios.
Using Routine Health Information Data for Research in Low- and Middle-Income Countries: A Systematic Review
Authors: Hung Yuen Wai , Hoxha Klesta , Irwin Bridget R. , Law Michael R. , Grépin Karen Ann
Published: August 2020

Background : Routine health information systems (RHISs) support resource allocation and management decisions at all levels of the health system, as well as strategy development and policy-making in many low- and middle-income countries (LMICs). Although RHIS data represent a rich source of information, such data are currently underused for research purposes, largely due to concerns over data quality. Given that substantial investments have been made in strengthening RHISs in LMICs in recent years and that there is a growing demand for more real-time data from researchers, this systematic review builds upon the existing literature to summarize the extent to which RHIS data have been used in peer-reviewed research publications. Methods : Using terms ‘routine health information system’, ‘health information system’, or ‘health management information system’ and a list of LMICs, four electronic peer-review literature databases were searched from inception to February 20 2019: PubMed, Scopus, EMBASE, and EconLit. Articles were assessed for inclusion based on pre-determined eligibility criteria and study characteristics were extracted from included articles using a piloted data extraction form. Results : We identified 132 studies that met our inclusion criteria, originating in 37 different countries. Overall, the majority of the studies identified were from Sub-Saharan Africa and were published within the last five years. Malaria and maternal health were the most commonly studied health conditions, although a number of other health conditions and health services were also explored. Conclusions : Our study identified an increasing use of RHIS data for research purposes, with many studies applying rigorous study designs and analytic methods to advance program evaluation, monitoring and assessing services, and epidemiological studies in LMICs. RHIS data represent an underused source of data and should be made more available and further embraced by the research community in LMIC health systems.
Perceptions of patients with end-stage kidney disease (ESKD) and their informal caregivers on palliative care as a treatment option: a qualitative study
Authors: Sarfo-Walters Catherine , Boateng Edward Appiah
Published: August 2020

Background: Palliative care is increasingly becoming an accepted treatment choice for many individuals diagnosed with end-stage kidney disease (ESKD). Yet, its utilisation is non-existent in many lower- and middle-income countries (LMICs). This study explored the perceptions of individuals with ESKD and their informal caregivers on palliative care as a treatment option for the disease in Ghana.Methods: This was a phenomenological study, with an in-depth analysis of data collected from nine individuals with ESKD and six informal caregivers through individual, face-to-face semi-structured interviews. The study was conducted in two renal centres within the Kumasi metropolis, Ghana among individuals with ESKD seeking care from both renal centres and their informal caregivers.Results: Three main themes were derived from this study – motivation for initiating haemodialysis, facing realities of haemodialysis, and considering palliative care. Participants felt that haemodialysis (HD) was not meeting their health expectations and demonstrated a general willingness to utilise palliative care if it would reduce suffering. Conclusions: This study has shown that individuals with ESKD or their informal caregivers would consider palliative care services, if available. It paves the way for discussions about palliative care for ESKD to begin across renal centres within Ghana and other similar settings. Exploring perspectives of clinicians in such settings could inform strategies on how to implement palliative care for ESKD management in such settings.
The Professional Contribution of Chiropractors to Danish elite football clubs: A qualitative exploration of role and perceived value in an interprofessional service provision context.
Authors: Hostrup Joachim , Koza Anders , Myburgh Corrie
Published: August 2020

Background: Interprofessional team-based care has been widely adopted in elite level athletic health and performance practice. Although chiropractors can claim some penetration as health care service providers in high level sport, their position as valued members of interprofessional health care teams, especially those built around traditional medical organisational structures, is unclear. As a first step to map the professional practice landscape of Danish sports chiropractors, this investigation sought to explore the perceived role and value of chiropractors as service providers in elite Danish football clubs. Methods: A comparative qualitative case study using semi-structured individual interviews was conducted. Six Danish Superliga clubs were purposively sampled to compare and contrast instances where chiropractors were absent from the health care team, contracted as in-house health care team members or engaged as external service providers. Triangulated responses were solicited from healthcare co-ordinators, chiropractors and athletes within each club’s organisation through short semi-structured individual interviews. The audio-recorded responses were transcribed verbatim and thematically analysed using a framework approach. Results: Inductive and deductive coding revealed 14 unique codes, which were further organised into 4 code families relating to the role of chiropractors, benefits of utilizing chiropractic care and facilitators and barriers to interprofessional practice. From this framework 3 themes were abstracted, these being: “Broadening horizons”, “In-house preferred to take-away” and “Already covered, or even necessary?”. Conclusion: In this practice context, chiropractors fill the role of musculoskeletal health care service providers. Their perceived value stems from additional expert disciplinary knowledge, improved diagnostic triage and increased treatment flexibility. However, where not utilized, the role of the spinal health expert is questioned and when acknowledged, limited to that of a technician/therapist. It is unclear whether chiropractors can claim core team member status. Further exploration of this interesting context of interprofessional practice is warranted.
High conservation combined with high plasticity: genomics and evolution of Borrelia bavariensis
Authors: Becker Noémie S , Rollins Robert Ethan , Nosenko Kateryna , Paulus Alexander , Martin Samantha , Krebs Stefan , Takano Ai , Sato Kozue , Kovalev Sergey Y , Kawabata Hiroki , Fingerle Volker , Margos Gabriele
Published: August 2020

Background

Borrelia bavariensis is one of the agents of Lyme Borreliosis (or Lyme disease) in Eurasia. The genome of the Borrelia burgdorferi sensu lato species complex, that includes B. bavariensis , is known to be very complex and fragmented making the assembly of whole genomes with next-generation sequencing data a challenge.

Results

We present a genome reconstruction for 33 B. bavariensis isolates from Eurasia based on long-read (Pacific Bioscience, for three isolates) and short-read (Illumina) data. We show that the combination of both sequencing techniques allows proper genome reconstruction of all plasmids in most cases but use of a very close reference is necessary when only short-read sequencing data is available. B. bavariensis genomes combine a high degree of genetic conservation with high plasticity: all isolates share the main chromosome and five plasmids, but the repertoire of other plasmids is highly variable. In addition to plasmid losses and gains through horizontal transfer, we also observe several fusions between plasmids. Although European isolates of B. bavariensis have little diversity in genome content, there is some geographic structure to this variation. In contrast, each Asian isolate has a unique plasmid repertoire and we observe no geographically based differences between Japanese and Russian isolates. Comparing the genomes of Asian and European populations of B. bavariensis suggests that some genes which are markedly different between the two populations may be good candidates for adaptation to the tick vector, ( Ixodes ricinus in Europe and I. persulcatus in Asia).

Conclusions

We present the characterization of genomes of a large sample of B. bavariensis isolates and show that their plasmid content is highly variable. This study opens the way for genomic studies seeking to understand host and vector adaptation as well as human pathogenicity in Eurasian Lyme Borreliosis agents.
Operative invasiveness does not affect the prognosis of patients with non-small cell lung cancer
Authors: Motono Nozomu , Iwai Shun , Iijima Yoshihito , Usuda katsuo , Uramoto Hidetaka
Published: August 2020

Background: The relationship between operative invasiveness and the prognosis in non-small cell lung cancer (NSCLC) patients who have undergone surgery has been controversial.Methods: Clinical data were analyzed for 463 NSCLC patients. Operative invasiveness was defined by wound length, operation time, and the postoperative C-reactive protein (postCRP) level. The operative approach was divided into video-assisted thoracic surgery (VATS) and thoracotomy.Results: The wound length and operation time were significantly correlated with the postCRP level (correlation coefficient (CC) = 0.39, p<0.01; CC = 0.54, p<0.01, respectively). The postCRP level in the VATS group was significantly lower than that in the thoracotomy group (12.2 mg/dl vs 20.58 mg/dl, p<0.01). The relapse-free survival differed significantly based on wound length (p<0.01), operation time (p=0.01), CRP level (p<0.01), and operative approach (p<0.01). The carcinoembryonic antigen level (hazard ratio [HR], 1.58; p = 0.02), pathological stage (pStage) (HR, 2.57; p < 0.01), vascular invasion (HR, 1.95; p = 0.01), and preoperative CRP level (preCRP) (HR, 1.91; p < 0.01) were identified as significant prognostic factors for relapse-free survival in a multivariate analysis. Furthermore, the multivariate analysis showed that smoking history (HR, 2.36; p = 0.03), pStage (HR, 3.26; p < 0.01), and preCRP level were significant prognostic factors for overall survival.Conclusion: Preoperative CRP level was associated with poor prognosis. Although the VATS approach might be less invasive procedure for NSCLC patients, operative invasiveness does not affect the prognosis.
Presence of Fermentable Oligo-, Di-, Monosaccharides, and Polyols (FODMAPs) in commonly eaten foods: Extension of a database to indicate dietary FODMAP content and calculation of intake in the general population from food diary data
Authors: Liljebo Therese , Störsrud Stine , Andreasson Anna
Published: August 2020

Background: FODMAPs (Fermentable Oligo-, Di-, Monosaccharides And Polyols) are known for their health benefits but their fermentation may trigger gastrointestinal symptoms and a low-FODMAP diet is a commonly used intervention for functional gastrointestinal disorders. The use of direct measures of FODMAP is labor intensive and expensive and to facilitate the assessment of FODMAP intake in research and clinical work, a nutritional content database with good quality estimates on FODMAP values is needed. Further, the average intake of FODMAP in a general population would be a useful reference and knowledge the most commonly eaten foods containing FODMAPs would facilitate clinical work utilizing FODMAP diet interventions. Methods: A nutritional content database was extended with published FODMAP content data. The database was used to calculate FODMAP intake from four-day food diaries from 117 individuals from the general population in Sweden and the most common food items containing FODMAPs were identified. Results: FODMAP content for 1060 food items were added to the database resulting in 1805 listed FODMAP values. Mean intake of total FODMAP in the diaries was 19g (fructose: 15.2g; fructan: 3.5g; lactose: 14.1g; galacto-oligosaccharides (GOS) 0.43g and polyols 1.3g per day. Overall the most common eaten food items containing FODMAPs were rye and wheat based foods. Conclusion: Intake of FODMAPs as calculated using the extended database were in line with previous studies supporting its use of the database both research and in clinical interventions. The lists of the most commonly eaten FODMAP food items are provided and may be used to facilitate FODMAP diet interventions.
Quantifying the advantages of conducting a prospective meta-analysis (PMA): a case study of early childhood obesity prevention
Authors: Seidler Anna Lene , Hunter Kylie E , Espinoza David , Mihrshahi Seema , Askie Lisa M
Published: August 2020

Background: For prospective meta-analyses (PMA), eligible studies are identified and the PMA hypotheses, selection criteria and analysis methods are pre-specified before results of any of the studies are known. This reduces publication bias and selective outcome reporting and provides a unique opportunity for outcome standardisation/harmonisation. We conducted a world-first PMA of four trials investigating interventions to prevent early childhood obesity. The aims of this study were to quantitatively analyse the effects of prospective planning on variations across trials, outcome harmonisation, and the power to detect intervention effects, and to derive recommendations for future PMA.Methods: We examined intervention design, participant characteristics and outcomes collected across the four trials included in the EPOCH PMA using their registration records, protocol publications and variable lists. The outcomes trials that planned to collect prior to inclusion in the PMA were compared to the outcomes trials collected after PMA inclusion. We analysed the proportion of matching outcome definitions across trials, the number of outcomes per trial, and how collaboration increased the statistical power to detect intervention effects.Results: The included trials varied in intervention design and participants, which improved external validity and the ability to perform subgroup analyses for the meta-analysis. While individual trials had limited power to detect the main intervention effect (BMI z-score), synthesising data substantially increased statistical power. Prospective planning led to an increase in number of collected outcome categories (e.g. weight, child’s diet, sleep), and greater outcome harmonisation. Prior to PMA inclusion, only 18% of outcome categories were included in all trials. After PMA inclusion this increased to 91% of outcome categories. However, whilst trials mostly collected the same outcome categories after PMA inclusion, some inconsistencies in how the outcomes were measured remained (such as measuring physical activity by hours of outside play versus using an activity monitor).Conclusion: Prospective planning led to greater outcome harmonisation and greater power to detect intervention effects, while maintaining acceptable variation in trial designs and populations, which improved external validity. Recommendations for future PMA include more detailed harmonisation of outcome measures, and careful pre-specification of analyses to avoid research waste by unnecessary over-collection of data.
Deciphering the transcriptional changes in Escherichia coli strains C41(DE3) and C43(DE3) that makes them a superior choice for membrane protein production.
Authors: Webb Chaille Teresa , Lithgow Trevor
Published: August 2020

Background: The production of membrane proteins for functional and structural protein analysis remains a bottleneck in the continuing quest for understanding biological systems. For recombinant membrane proteins, the Walker strains C41(DE3) and C43(DE3) are a valuable tool because they are capable of producing levels of functional protein that would otherwise be toxic to the cell. At the genome level, amongst only a handful of genetic changes, mutations in the lacUV5 promoter region upstream from the bacteriophage T7 RNA polymerase gene distinguish these strains from BL21(DE3) but do not inform on how the strains have adapted for superior production of recombinant membrane proteins. Results: Comparative transcriptomic analyses revealed a moderate change in gene expression in C41(DE3) and C43(DE3) compared to their parent strain BL21(DE3) under standard growth conditions. However, under the conditions used for membrane protein production (with plasmid carriage and addition of IPTG), the differential response of C41(DE3) and C43(DE3) compared to their parent strain BL21(DE3) was striking. Over 2000 genes were differentially expressed in C41(DE3) with a two-fold change and false discover rate < 0.01 and 1700 genes differentially expressed in C43(DE3) compared to their parent strain BL21(DE3). Conclusion: These results illuminate the cellular adaptations occurring in the Walker strains to alleviate the toxic effects that can occur during membrane protein production, whilst providing changes in metabolism pathways required for membrane protein biogenesis. The BL21(DE3) derivatives strains C41(DE3) and C43(DE3), are adept to the process of membrane biogenesis in E. coli, making them superior to their parent strain for the production of membrane proteins and potentially other toxic proteins.
Effects of various nitrogen regimes on the ability of rapeseed (Brassica napus L.) to suppress littleseed canarygrass (Phalaris minor Retz.)
Authors: Xu Gaofeng , Shen Shicai , Zhang Yun , Clements David Roy , Yang Shaosong , Dong Liyao , Zhang Fudou
Published: August 2020

Background: Littleseed canarygrass (Phalaris minor Retz.) is one of the most troublesome invasive weeds infesting winter crops in Yunnan Province, China. Our previous study found that rapeseed (Bassica napus L.) was a logical candidate crop to control littleseed canarygrass in agroecosystems. Nitrogen (N) could impact plant community composition by altering competitive interactions, however, the effects of different N regimes on weed control efficacy of rapeseed were unknown. Here, we report the effects of different N regimes on the control efficacy of littleseed canarygrass by rapeseed and their competitive effects and photosynthetic characteristics. Results: The results showed that the rapeseed yield and its control efficacy on littleseed canarygrass were significantly affected (P<0.05) under different N regimes, and the control efficacy of littleseed canarygrass by rapeseed increased first and then decreased with the increase of basal nitrogen rates, while increasing topdressing N rates increased control efficacy of littleseed canarygrass by rapeseed only. In fact, yield and weed control efficacy of rapeseed was most ideal when both basal and top-dressing N was 90 kg·ha-1. We also found that N significantly impacted the competitive ability of rapeseed to littleseed canarygrass and rapeseed had a highest competitive ability when both basal and top-dressing N was 90 kg·ha-1. With the increase of basal nitrogen rates, competitive balance index (CB) of rapeseed increased first and then decreased, but which gradually increased with increasing of topdressing N rates. Our research also showed level and period of N application had a significant effect (P<0.01) on the photosynthetic rate (Pn) and chlorophyll content (Chl) of both rapeseed and littleseed canarygrass. Under the same N application regime, the Pn and Chl of littleseed canarygrass were higher than that of rapeseed in December, while the Pn and Chl of rapeseed was higher than that of littleseed canarygrass in February. Our study indicated that photosynthetic characteristics of rapeseed and littleseed canarygrass in different growth stages differ in their sensitivity to N regimes, creating a dynamic competitive relationship. Conclusions: Together, our results demonstrated that rational application of fertilizer N could help rapeseed produce higher yields and greater weed control efficacy, suggesting that future modeling or experimental studies on utilizing crops to control invasive weeds should carefully consider both timing and placement of N.
The Receptor Binding Domain of SARS-CoV-2 Spike protein is the result of an ancestral recombination between the bat-CoV RaTG13 and the pangolin-CoV MP789
Authors: Flores-Alanis Alejandro , Sandner-Miranda Luisa , Delgado Gabriela , Cravioto Alejandro , Morales-Espinosa Rosario
Published: August 2020

Objective: In December 2019 a novel coronavirus (SARS-CoV-2) that is causing the current COVID-19 pandemic was identified in Wuhan, China. Many questions have been raised about its origin and adaptation to humans. In the present work we performed a genetic analysis of the Spike glycoprotein (S) of SARS-CoV-2 and other related coronaviruses (CoVs) isolated from different hosts in order to trace the evolutionary history of this protein and the adaptation of SARS-CoV-2 to humans.Results: Based on the sequence analysis of the S gene, we suggest that the origin of SARS-CoV-2 is the result of recombination events between bat and pangolin CoVs. The hybrid SARS-CoV-2 ancestor jumped to humans and has been maintained by natural selection. Although the S protein of RaTG13 bat CoV has a high nucleotide identity with the S protein of SARS-CoV-2, the phylogenetic tree and the haplotype network suggest a non-direct parental relationship between these CoVs. Moreover, it is likely that the basic function of the receptor-binding domain (RBD) of S protein was acquired by the SARS-CoV-2 from the MP789 pangolin CoV by recombination and it has been highly conserved.
Oral Health Promotion Program for Persons With Severe Mental Illness: A Cluster Randomized Controlled Study
Authors: Kuo Mei-Wen , Yeh Shu-Hui , Chang Heng-Ming , Teng Po-Ren
Published: August 2020

ObjectiveTo evaluate the effectiveness of a composite oral health promotion program designed to reduce dental plaque among persons with severe mental illness in a psychiatric institution.MethodsA cluster randomized controlled study was carried out in chronic psychiatric wards of a general hospital in central Taiwan. Sixty-eight eligible male individuals admitted to 2 wards were randomly assigned to an experimental and a control group. Participants in the experimental group underwent an oral health promotion program that consisted of biweekly group education sessions, and a 12-week individual behavioral modification for oral hygiene course. The participants in the control group received usual care only. Dental plaque (measured by the Plaque Control Index) was examined by a single dentist before and after the experiment. Each participant responded to a questionnaire regarding oral health knowledge, attitude and behavior before and after the experiment.ResultsFifty-eight individuals completed the study. Before the experiment, the plaque index was similar between the intervention group (68.9; N=27) and the control group (69.8; N=31). After the experiment, the plaque index was significantly better in the intervention group than in the control group (42.6 vs. 61.8; P<0.001). Participants in the intervention group also demonstrated better oral health knowledge, attitude and behavior than those in the control group after the experiment. ConclusionsA composite oral health promotion program using both group education and individual behavioral methods over a 12-week period was effective in both reducing dental plaque and improving the oral health knowledge of persons with severe mental illness in the institution. Trial registration: This study was retrospectively registered in Clinicaltrials.gov, with number NCT04464941, dated 7/7/2020. http://register.clinicaltrials.gov/RD103035018.
Identification of risk features for complication in Gaucher’s Disease patients: A Machine Learning analysis of the Spanish Registry of Gaucher Disease.
Authors: Andrade-Campos Marcio M , de Frutos Laura López , Cebolla Jorge J , Serrano-Gonzalo Irene , Medrano-Engay Blanca , Roca-Espiau Mercedes , Gomez-Barrera Beatriz , Pérez-Heredia Jorge , Iniguez David , Giraldo Pilar
Published: August 2020

Background : Since enzyme replacement therapy for Gaucher disease (MIM#230800) has become available, both awareness of and the natural history of the disease have changed. However, there remain unmet needs such as the identification of patients at risk of developing bone crisis during therapy and late complications such as cancer or parkinsonism. The Spanish Gaucher Disease Registry has worked since 1993 to compile demographic, clinical, genetic, analytical, imaging and follow-up data from more than 400 patients. The aims of this study were to discover correlations between patients’ characteristics at diagnosis and to identify risk features for the development of late complications; for this a machine learning approach involving correlation networks and decision trees analyses was applied.

Results : A total of 358 patients, 340 type 1 Gaucher disease and 18 type 3 cases were selected. 18% were splenectomyzed and 39% had advanced bone disease. 81% of cases carried heterozygous genotype. 47% of them were diagnosed before the year 2000. Mean age at diagnosis and therapy were 28 and 31.5 years old (y.o.) respectively. 4% developed monoclonal gammopathy undetermined significance or Parkinson Disease, 6% cancer, and 10% died before this study. Previous splenectomy correlates with the development of skeletal complications and severe bone disease (p=0.005); serum levels of IgA, delayed age at start therapy (>9.5 y.o. since diagnosis) also correlates with severe bone disease at diagnosis and with the incidence of bone crisis during therapy. High IgG (>1750mg/dL) levels and age over 60 y.o. at diagnosis were found to be related with the development of cancer. When modelling the decision tree, patients with a delayed diagnosis and therapy were the most severe and with higher risk of complications.

Conclusions : Our work confirms previous observations, highlights the importance of early diagnosis and therapy and identifies new risk features such as high IgA and IgG levels for long-term complications.
Interpersonal Relationships and Drug Use Over Time Among Homeless People: a Qualitative Study.
Authors: de Espíndola Marília Ignácio , Bedendo André , Silva Eroy Aparecida da , Noto Ana Regina
Published: August 2020

Background: Homelessness is one of the most severe forms of social exclusion. It is characterized by processes of weakening of interpersonal bonds, being considered an important public health issue. The objective of this study is to elucidate how the interpersonal relationships changed over the life cycle of homeless drug and alcohol users. Method: We used the qualitative methodology. The participants were adults who had a history of homelessness and use of alcohol and other drugs at some point. The interviews were semi structured and used the timeline instrument. All of them were fully recorded, transcribed, and submitted to Thematic Analysis.Results: Twenty individuals participated in the study. Reports on social exclusion over time stood out in four large themes and their respective subthemes. Theme 1 – Childhood: participants reported instability in their upbringing, abuse, and violence, and regarded their father figure as not very present or absent. Theme 2 – Adolescence: school dropout and failure; acceptance of gender and sexual orientation; birth of first child, living together or getting married prevailed. Theme 3 – Adulthood: estrangement or conflicting relationship with family; health problems; drug trafficking and prostitution. Theme 4 – Cross-cutting factors: death of relatives and substance use. Conclusion: The results suggest that these interpersonal relationships are permeated by successive breakups, conflicts and other events that pile up over time, may start in childhood and cross the subsequent phases. Substance abuse and dependence are mentioned as cross-cutting factors that intensify social exclusion in all the phases of the life cycle.
A Qualitative Meta-Synthesis of Facilitators and Barriers to Tuberculosis Diagnosis and Treatment in Nigeria
Authors: Oga-Omenka Charity , Wakdet Lawrence , Menzies Dick , Zarowsky Christina
Published: August 2020

Background Despite progress in tuberculosis (TB) control globally, TB continues to be a leading cause of death from infectious diseases, claiming 1.2 million lives in 2018; 214,000 of these deaths were due to drug resistant strains. Of the estimated 10 million cases globally in 2018, 24% were in Africa, with Nigeria and South Africa making up most of these numbers.Nigeria ranks 6th in the world for TB burden, with an estimated 4.3% multi-drug resistance in new cases. However, the country had one of the lowest case detection rates, estimated at 24% of incident cases in 2018 - well below the World Health Organization (WHO) STOP TB target of 84%. This rate highlights the need to understand contextual issues influencing tuberculosis management in Nigeria. Our synthesis was aimed at synthesizing qualitative evidence on factors influencing TB care in Nigeria.Methods A three-stage thematic meta-synthesis of qualitative studies was used to identify barriers and facilitators to tuberculosis case finding and treatment in Nigeria. A purposive search of eleven databases was conducted. The date of publication was limited to 2006 to June 2020. We analyzed articles using a three-stage process, resulting in coding, descriptive subthemes and analytical themes.Results Our final synthesis of 10 articles resulted in several categories including community and family involvement, education and knowledge, attitudes and stigma, alternative care options, health system factors (including coverage and human resource), gender, and direct and indirect cost of care. These were grouped into three major themes: individual factors; interpersonal influences; and health system factors.Conclusion Case finding and treatment for TB in Nigeria currently depends more on individual patients presenting voluntarily to the hospital for care, necessitating an understanding of patient behaviors towards TB diagnosis and treatment. Our synthesis has identified several related factors that shape patients’ behavior towards TB management at individual, community and health system levels that can inform future interventions.