bluuebunny/crossref_metadata_2025 huggingface dataset:
The Influence of KDR Genetic Variation on the Efficacy and Safety of Patients With Advanced NSCLC Receiving First-Line Bevacizumab Plus Chemotherapy Regimen
Authors: Geng Nan , Su Jingwei , Liu Zhikun , Ding Cuimin , Xie Shaonan , Hu Wenxia
Published: June 2021

Objective:

Angiogenesis plays an important role in the growth and metastasis of non-small cell lung cancer (NSCLC). Bevacizumab is a humanized monoclonal antibody that mainly acts on vascular endothelial growth factor A (VEGFA). Kinase insert domain receptor (KDR) is the most important target of VEGFA. The aim of present study was to investigate the influence of KDR genetic variation on the efficacy and safety of patients with advanced NSCLC receiving first-line bevacizumab plus chemotherapy regimen.

Methods:

A total of 169 patients with advanced NSCLC who received bevacizumab combined with chemotherapy were recruited in this study. Clinical outcome of the regimens was evaluated in the hospital. Peripheral blood and biopsy tissue specimens of patients were collected for the genotyping of KDR genetic variation and KDR mRNA expression, respectively. The association between KDR genotype status and other variables were analyzed. Univariate analysis of genotype status and prognosis was implemented using the Kaplan-Meier survival analysis method. Multivariate Cox regression analysis was performed to adjust the confounding factors.

Results:

Of the polymorphisms analyzed, only V297 L was of clinical significance. The prevalence of V297 L among the study population were as follows: CC genotype 123 cases (72.8%), CT genotype 41 cases (24.3%), TT genotype 5 cases (2.9%). The minimum allele frequency is 0.15. The distribution frequencies of the 3 genotypes corresponded with Hardy-Weinberg equilibrium ( P = 0.489). Patients with TT and CT genotypes were merged in the subsequent comparison of clinical outcomes. The analysis of efficacy exhibited that the objective response rates (ORR) of patients with CC genotype and CT/TT genotypes were 52.8% and 47.8% ( P = 0.561), respectively. Prognosis indicated that the median progression free survival (PFS) of patients with CC genotype and CT/TT genotype were 8.9 and 5.5 months, respectively ( P = 0.006). The median OS of the 2 genotypes were 20.0 and 14.9 months, respectively ( P = 0.021). Adjusted in multivariate Cox regression analysis of PFS, CT/TT genotypes were an independent factor for PFS [hazard ratio (HR) = 1.59, P = 0.011). Safety profile according to genotype status of V297 L failed to find significant difference. Interestingly, the expression of KDR mRNA of patients with CT/TT genotype was significantly higher than that of patients with CC genotype in the 58 cancer tissue specimens ( P < 0.001).

Conclusion:

The clinical comes of patients with advanced NSCLC receiving first-line bevacizumab plus chemotherapy regimens might be impacted by polymorphism V297 L through mediating the mRNA expression of KDR.
Comparative Effectiveness of Lifestyle Intervention on Fasting Plasma Glucose in Normal Weight Versus Overweight and Obese Adults With Prediabetes
Authors: Salmon Mandy K. , Gordon Neil F. , Constantinou Demitri , Reid Kevin S. , Wright Brenda S. , Kridl Terri L. , Faircloth George C.
Published: June 2021

Background. It is hypothesized that normal weight individuals develop diabetes through different pathophysiological mechanisms and that methods of prevention may differ in the absence of overweight/obesity. In this study, we compared the effect of lifestyle health coaching (LHC) on fasting plasma glucose (FPG) in normal weight, overweight, and obese US adults with prediabetes. Methods. Subjects were 1358 individuals who completed baseline and follow-up evaluations as part of an LHC program (follow-up = ~6 months). Participants were stratified, based on baseline body mass index (BMI), into normal weight (n = 129), overweight (n = 345), and obese (n = 884) cohorts. LHC included counseling, predominantly via telehealth, on exercise and nutrition. Results. BMI decreased ( P < .001) in the overweight and obese participants but was unchanged in the normal weight participants. FPG decreased ( P < .001) in all 3 cohorts, and the magnitude of decrease did not differ significantly among cohorts. FPG decreased to <5.6 mmol/L in 58.1%, 49.3%, and 41.4% of the normal weight, overweight, and obese participants, respectively. Conclusions. To our knowledge, this study is the first outside of Asia to show that LHC is as effective in managing FPG in normal weight adults with prediabetes versus those who are overweight/obese.
Spontaneous pneumomediastinum: A report of two cases at a district general hospital
Authors: Yong Nathanael , Olowu Oladimeji
Published: June 2021

Spontaneous pneumomediastinum is a rare condition thought to be caused by excessive Valsalva manoeuvre during the second stage of labour. Women with pneumomediastinum typically presents with chest pain or tightness, dyspnoea, and a tearing sensation around the neck. It is commonly diagnosed with a chest radiograph but further imaging may be necessary to exclude more sinister conditions with similar clinical features. We describe two cases of pneumomediastinum and the different management approaches with different multi-disciplinary input. It is often a self-limiting condition. We propose a management algorithm for women suspected to have pneumomediastinum during the intrapartum and postpartum period.
China’s Pledge to Civilise “All Under Heaven”
Authors: Dykmann Klaas , Bruun Ole
Published: June 2021

With China’s global rise, both its state leadership and key academics have engaged in developing a civilisational discourse for the twenty-first century partly based on ancient cosmological concepts. This article explores the meanings of and intentions behind this discourse, including its promise of a Chinese-led world order, and discusses its intended audience and international appeal. In the backdrop of theoretical debates on empires and their missions, the article claims that without a corresponding cultural appeal, China’s rising economic power and geostrategic clout are insufficient conditions to realise an empire in the classical sense. Growing inconsistencies mar the country’s imperial ambitions, such as those between a global civilising outreach and a toughening domestic embrace. Instead, imperial rhetoric is cautiously integrated in the party-state’s restoration of a Chinese “empire within,” indicating self-centredness and a lurking re-traditionalising of Chinese state power.
Hip and Core Muscle Activation During High-Load Core Stabilization Exercises
Authors: Khosrokiani Zohre , Letafatkar Amir , Sheikhi Bahram , Thomas Abbey C. , Aghaie-ataabadi Peyman , Hedayati Mohamad-Taghi
Published: June 2021

Background:

There is some evidence that high-load lumbar stabilization exercises, such as back bridge, can recruit both local and global muscles.

Hypothesis:

Therapeutic exercises would optimize gluteus maximus (GMax), gluteus medius (GMed), multifidus (MF), and transversus abdominis (TrA) activation, while minimizing the activation of the tensor fascia latae (TFL) and erector spinae (ES) muscles in healthy individuals.

Design:

Cross-sectional study.

Setting:

Research laboratory.

Level of Evidence:

Level 4.

Methods:

In this cross-sectional study, surface electromyography (EMG) of GMax, GMed, TFL, TrA, MF, and ES was used to quantify the gluteal-to-TFL muscle activation (GTA) index and a ratio of local to global (L/G) lumbar muscles during (1) the elbow-toe exercise in the prone position, (2) the elbow-toe with right left lifted, (3) the hand-knee with left arm and right leg lifted, (4) the back bridge, (5) the back bridge with right leg lifted, (6) the back bridge with left leg lifted, (7) the side bridge with left leg lifted, (8) the side bridge with right leg lifted, and (9) the elbow-toe with right leg horizontally lifted exercises in healthy individuals (20 men, 20 women; age, 25 ± 4 years).

Results:

The back bridge exercise with left leg lift generated the highest L/G muscles activity ratio (L/G = 3.35) while the hand-knee exercise yielded the lowest L/G muscles activity ratio (L/G = 1.21). The side bridge exercise with left elbow and foot and lifting the right leg (GTA = 63.78), hand-knee exercise (GTA = 49.62), back bridge (GTA = 28.05), and elbow-toe exercise with left leg horizontally lifted (GTA = 23.02) generated the highest GTA indices, respectively. Meanwhile, the normalized EMG amplitude for GMax was significantly less than the TFL, for elbow-toe exercise ( P < 0.001), back bridge with left leg lift ( P = 0.001), side bridge exercise with the right elbow and foot and lifting the left leg ( P = 0.002), and elbow-toe exercise with right leg horizontally lifted ( P < 0.001).

Conclusion:

The highest GTA indexes were observed during (1) the side bridge lifting the dominant leg and (2) the hand-knee horizontally lifting dominant leg, respectively. The L/G ratio was highest during (1) the back bridge lifting nondominant leg, (2) back bridge, and (3) back bridge lifting dominant leg, respectively. This study supports the use of back bridge exercises to strengthen the MF and side bridges to improve gluteal muscle activation.

Clinical Relevance:

The highest GTA index was observed in the side bridge lifting the right leg. Highest L/G ratio was in the back bridge with nondominant leg lifted. This study supports the use of back bridge exercises to strengthen the MF. This study supports the use of side bridges to improve gluteal muscle activation.
Chatting about ‘Birthing Across Borders’
Authors: Katz Cindi , Pratt Geraldine
Published: June 2021

In this dialogue, we chat about the metaphors circulating in Bagelman and Gitome’s article ‘Birthing Across Borders’ (contraction, casting light) and think through the potential of other ones (pregnancy, midwives). We also ask questions about the use of the term Indigeneity, appreciate and draw out the rich geographies of place in the article, and puzzle over the meaning and potential of the concept of non-participatory research
The poetics of labour, birth, and bodies
Authors: Fannin Maria
Published: June 2021

This commentary responds to Bagelman and Gitome’s article, ‘Birthing Across Borders: “Contracting” Reproductive Geographies’, in the context of the growing attention paid to an increasingly diverse set of work on ‘reproductive geographies’. Their call for more South-South stories of birth, and of birth in liminal places, resonates with the growing body of literature exploring dimensions of abortion, fertility, reproductive technology, childbirth, and miscarriage by geographers. Their development of the concept of ‘contraction’ from the collection of accounts of birth in the Dadaab camp illustrates the generative potential of theorising with and from the bodily sensations of labour. The commentary concludes with a discussion of the concept of ‘dilation’ by political theorist Jane Bennett, who in seeking a new conceptual language for affective encounter also draws on the affirmative potential of poetic expression.
Structural Racism and Criminal Violence: An Analysis of State-Level Variation in Homicide
Authors: Unnever James D. , Stults Brian J. , Messner Steven F.
Published: June 2021

We advance a structural racism approach to understanding the variation in homicide across the U.S. states. We conceptualize structural racism by juxtaposing the conditions for Blacks with those for Whites across multiple domains. We also include two ideological beliefs, racial resentments and Whites perceptions that their racialized social status is threatened by minority gains. The results show that higher Black homicide rates are associated with greater exposure to structural racism and that states with more Whites who harbor racial resentments have higher rates of Black homicides. We also found that states with more Whites who feel that their status is threatened exhibit higher rates of White homicides. However, the results reveal that structural racism exhibits a non-significant association with White homicide rates. We conclude that the challenge going forward is to develop strategies that can undo the oppression of Blacks without enhancing attitudes of Whites that promote criminality.
Cognitive linguistic Treatment in Landau Kleffner Syndrome: Improvement in Daily Life Communication
Authors: Meulen Ineke van der , Pangalila Robert F. , de Sandt-Koenderman W. Mieke E. van
Published: June 2021

We report a case study of cognitive linguistic treatment in a teenager with chronic severe Landau Kleffner Syndrome. The effect of speech and language therapy in LKS is rarely examined and our case is unique in that we use an effective approach in adult aphasia to treat language deficits in aphasia in LKS. The results show successful acquisition of a considerable amount of new words as well as improved communication in daily life. However, auditory verbal agnosia, the most prominent feature in LKS, persisted. Cognitive linguistic treatment seems a promising treatment to improve spoken language production in LKS, but more research is needed to optimize speech and language therapy of auditory verbal agnosia and auditory language comprehension in children with LKS
A Quasi-Randomized Controlled Trial of the I-PLAN Intervention to Promote Hearing Aid Use Among First-Time Adult Hearing Aid Users
Authors: Ismail Afzarini H. , Munro Kevin J. , Armitage Christopher J. , Marsden Antonia , Dawes Piers D.
Published: June 2021

Suboptimal hearing aid use negatively impacts health and well-being. The aim of this study was to conduct a controlled trial of a behavior change intervention to promote hearing aid use. This study was a quasi-randomized controlled trial with two arms. A total of 160 first-time hearing aid users were recruited at their hearing aid fitting appointments. The control arm received standard care. In addition to standard care, the intervention arm received I-PLAN, which comprised (a) information about the consequences of hearing aid use/nonuse, (b) reminder prompt to use the hearing aids, and (c) an action plan. The primary outcome, measured at 6 weeks, was self-reported proportion of time the hearing aid was used in situations that caused hearing difficulty. Secondary outcomes were data-logged hearing aid use, self-reported hearing aid benefit, self-regulation, and habit formation. The results showed that the proportion of time the hearing aids were used in situations that caused hearing difficulty was similar in both groups. There were no statistically significant differences between groups in any outcome measure including data-logged hearing aid use. The relatively high levels of hearing aid use across research participants may have limited the potential for the intervention to impact on hearing aid use. Although the intervention materials proved acceptable and deliverable, future intervention trials should target suboptimal hearing aid users.
Aversive racism and community-instigated policing: The spatial politics of Nextdoor
Authors: Bloch Stefano
Published: June 2021

I bring an understanding of the concept and practice of “aversive racism” to scholarly thinking about community formation. I argue that the exclusionary contours of community are in part a product of racialized in- and outgrouping from which people’s capacities for place-making are judged and localized policing is instigated. In bringing these concepts, formations, and practices together, this paper contributes to how urbanists might continue to think about the role of race in displacement, particularly as it plays out in the context of neighborhood change and gentrification more broadly. In the penultimate section I provide a discussion of the popular Nextdoor app as a means of illustrating a contemporary example of community-instigated policing and platform for what Dána-Ain Davis calls “muted racism.”
Perceptions of African American Adults With Type 2 Diabetes on Family Support: Type, Quality, and Recommendations
Authors: Hu Jie , Mion Lorraine C. , Tan Alai , Du Yang , Chang Mei-Wei , Miller Carla , Joseph Joshua J.
Published: June 2021

Purpose

The overall purpose of the study was to explore perceptions of family support in diabetes self-management among African American adults with type 2 diabetes.

Methods

A qualitative study using focus group methodology and individual interviews was conducted. Thirty-seven African American adults with type 2 diabetes were recruited in the Midwest, United States. Data were analyzed using qualitative content analysis.

Results

Themes emerged from the perspectives of the social interdependence theory. Positive family support included emotional support, instrumental support, and specific information or advice on diabetes management strategies. Positivity, family communication, and healthy eating/meal planning were perceived as helpful family behaviors. Negative support was perceived as intentional or unintentional behaviors. Family members’ help in decision-making included goal setting with family member(s) and help in making decisions on diet and exercise. Recommendations included exercise and nutritional programs, support groups, family involvement, and materials and resources. Motivations for attending diabetes programs included involving family members, sharing success stories, seeing positive results, encouraging and caring, and providing incentives.

Conclusions

Intervention programs for African Americans should specifically target challenges in family support, healthy eating, and physical activity at an interpersonal level. Health care providers should assess family roles and family support to facilitate diabetes self-management for African Americans.
The Paradoxical Profession: Project Management and the Contradictory Nature of Sustainable Project Objectives
Authors: Sabini Luca , Alderman Neil
Published: June 2021

Professions are undergoing a significant change in how they integrate environmental and social objectives into their core values. This article examines the situation in which those working in the project management profession are expected to work under contradictory sustainability constraints. In this article, we investigate the tensions project managers experience when addressing sustainable objectives. Results show that when tensions arise over sustainable objectives (temporality of objectives, organizational barriers, and lack of control), they are addressed only when anchored to an economic one in the form of a business case for sustainability. We also find that when matching traditional project objectives with sustainable ones is not possible, practitioners enact a set of reactions characterized as greenwashing, it can’t be one person, no space for sustainability in my job, other actors involved, or pushing back, depending on the specific project context. Adopting the paradox theory lens, we provide an alternative approach to the business case for sustainability. The practical contribution of this article lies in suggesting the need to find strategies to embrace paradoxical situations and we provide some suggestions to illustrate this.
How I use allogeneic HSCT for adults with inborn errors of immunity
Authors: Burns Siobhan O. , Morris Emma C.
Published: June 2021

Inborn errors of immunity (IEIs) are rare inherited disorders arising from monogenic germline mutations in genes that regulate the immune system. The majority of IEI are primary immunodeficiencies characterized by severe infection often associated with autoimmunity, autoinflammation, and/or malignancy. Allogeneic hematopoietic stem cell transplant (HSCT) has been the corrective treatment of choice for many IEIs presenting with severe disease in early childhood, and experience has made this a successful and comparatively safe treatment in affected children. Early HSCT outcomes in adults were poor, resulting in extremely limited use worldwide. This is changing because of a combination of improved IEI diagnosis to inform patient selection, better understanding of the natural history of specific IEI, and improvements in transplant practice. Recently published HSCT outcomes for adults with IEIs have been comparable with pediatric data, making HSCT an important option for correction of clinically severe IEIs in adulthood. Here we discuss our practice for patient selection, timing of HSCT, donor selection and conditioning, peri- and post-HSCT management, and our approach to long-term follow-up. We stress the importance of multidisciplinary involvement in the complex decision-making process that we believe is required for successful outcomes in this rapidly emerging area.
Antifibrotic drugs in lung transplantation and chronic lung allograft dysfunction: a review
Authors: Bos Saskia , De Sadeleer Laurens J. , Vanstapel Arno , Beeckmans Hanne , Sacreas Annelore , Yserbyt Jonas , Wuyts Wim A. , Vos Robin
Published: June 2021

This review aims to provide an overview of pre-transplant antifibrotic therapy on peri-transplant outcomes and to address the possible role of antifibrotics in lung transplant recipients with chronic lung allograft dysfunction.

Lung transplantation is an established treatment modality for patients with various end-stage lung diseases, of which idiopathic pulmonary fibrosis and other progressive fibrosing interstitial lung diseases are growing indications. Theoretically, widespread use of antifibrotics prior to lung transplantation may increase the risk of bronchial anastomotic complications and impaired wound healing.

Long-term graft and patient survival are still hampered by development of chronic lung allograft dysfunction, on which antifibrotics may have a beneficial impact.

Antifibrotics until the moment of lung transplantation proved to be safe, without increasing peri-transplant complications. Currently, best practice is to continue antifibrotics until time of transplantation. In a large multicentre randomised trial, pirfenidone did not appear to have a beneficial effect on lung function decline in established bronchiolitis obliterans syndrome. The results of antifibrotic therapy in restrictive allograft syndrome are eagerly awaited, but nonrandomised data from small case reports/series are promising.
Methods to study organogenesis in decapod crustacean larvae. I. larval rearing, preparation, and fixation
Authors: Torres G. , Melzer R. R. , Spitzner F. , Šargač Z. , Harzsch S. , Gimenez L.
Published: June 2021

Crustacean larvae have served as distinguished models in the field of Ecological Developmental Biology (“EcoDevo”) for many decades, a discipline that examines how developmental mechanisms and their resulting phenotype depend on the environmental context. A contemporary line of research in EcoDevo aims at gaining insights into the immediate tolerance of organisms and their evolutionary potential to adapt to the changing abiotic and biotic environmental conditions created by anthropogenic climate change. Thus, an EcoDevo perspective may be critical to understand and predict the future of organisms in a changing world. Many decapod crustaceans display a complex life cycle that includes pelagic larvae and, in many subgroups, benthic juvenile–adult stages so that a niche shift occurs during the transition from the larval to the juvenile phase. Already at hatching, the larvae possess a wealth of organ systems, many of which also characterise the adult animals, necessary for autonomously surviving and developing in the plankton and suited to respond adaptively to fluctuations of environmental drivers. They also display a rich behavioural repertoire that allows for responses to environmental key factors such as light, hydrostatic pressure, tidal currents, and temperature. Cells, tissues, and organs are at the basis of larval survival, and as the larvae develop, their organs continue to grow in size and complexity. To study organ development, researchers need a suite of state-of-the-art methods adapted to the usually very small size of the larvae. This review and the companion paper set out to provide an overview of methods to study organogenesis in decapod larvae. This first section focuses on larval rearing, preparation, and fixation, whereas the second describes methods to study cells, tissues, and organs.
Real-life use of onabotulinumtoxinA reduces healthcare resource utilization in individuals with chronic migraine: the REPOSE study
Authors: Kollewe Katja , Gaul Charly , Gendolla Astrid , Sommer Katherine
Published: June 2021

Background

Chronic migraine (CM) is associated with substantial economic burden. Real-world data suggests that onabotulinumtoxinA treatment for CM reduces healthcare resource utilisation (HRU) and related costs.

Methods

REPOSE was a 2-year prospective, multicentre, non-interventional, observational study to describe the real-world use of onabotulinumtoxinA in adult patients with CM. This analysis examined the impact of onabotulinumtoxinA on HRU. Patients received onabotulinumtoxinA treatment approximately every 12 weeks according to their physicians’ discretion, guided by the summary of product characteristics (SPC) and PREEMPT injection paradigm. HRU outcome measures were collected at baseline and all administration visits and included headache-related hospitalizations and healthcare professional (HCP) visits. Health economic data, including family doctor and specialist visits, inpatient treatment for headache, acupuncture, technical diagnostics, use of nonpharmacologic remedies, and work productivity were also collected for patients enrolled at German study centres.

Results

Overall, 641 patients were enrolled at 78 study centres across 7 countries (Germany, UK, Italy, Spain, Norway, Sweden, and Russia), 633 received ≥1 onabotulinumtoxinA dose, and 128 completed the 2-year study. Patients were, on average, aged 45 years, 85% were female, and 60% (n = 377) were from Germany. At the end of the 2-year observation period, significantly fewer patients reported headache-related hospitalizations (p < 0.02) and HCP visits (p < 0.001) within the past 3 months than in the 3 months before baseline. In the German population, reductions were observed across all health services at all follow-up visits compared with baseline. The percentage of patients who saw a family doctor decreased from 41.7% at baseline to 13.5% at administration visit 8 and visits to a medical specialist decreased from 61.7% to 5.2% of patients. Inpatient acute treatment and technical diagnostics declined from 6.4% and 19.7% of patients at baseline to 0.0% and 1.0% at administration 8, respectively. The use of nonpharmacologic remedies and medication for the acute treatment of migraine also decreased with continued onabotulinumtoxinA treatment. Work incapacity, disability, absenteeism, and impaired performance at school/work improved with onabotulinumtoxinA treatment for CM over the 2-year observation period.

Conclusions

Real-world evidence from REPOSE demonstrates that onabotulinumtoxinA treatment is associated with decreased HRU and supports the long-term benefits associated with the use of onabotulinumtoxinA for CM in clinical practice.

Trial registration

NCT01686581. Name of registry: ClinicalTrials.gov. URL of registry: Date of retrospective registration: September 18, 2012. Date of enrolment of first patient: July 23, 2012.
SPECTRA: a tool for enhanced brain wave signal recognition
Authors: Kumar Shiu , Tsunoda Tatsuhiko , Sharma Alok
Published: June 2021

Background

Brain wave signal recognition has gained increased attention in neuro-rehabilitation applications. This has driven the development of brain–computer interface (BCI) systems. Brain wave signals are acquired using electroencephalography (EEG) sensors, processed and decoded to identify the category to which the signal belongs. Once the signal category is determined, it can be used to control external devices. However, the success of such a system essentially relies on significant feature extraction and classification algorithms. One of the commonly used feature extraction technique for BCI systems is common spatial pattern (CSP).

Results

The performance of the proposed spatial-frequency-temporal feature extraction (SPECTRA) predictor is analysed using three public benchmark datasets. Our proposed predictor outperformed other competing methods achieving lowest average error rates of 8.55%, 17.90% and 20.26%, and highest average kappa coefficient values of 0.829, 0.643 and 0.595 for BCI Competition III dataset IVa, BCI Competition IV dataset I and BCI Competition IV dataset IIb, respectively.

Conclusions

Our proposed SPECTRA predictor effectively finds features that are more separable and shows improvement in brain wave signal recognition that can be instrumental in developing improved real-time BCI systems that are computationally efficient.
Gene count from target sequence capture places three whole genome duplication events in Hibiscus L. (Malvaceae)
Authors: Eriksson J. S. , Bacon C. D. , Bennett D. J. , Pfeil B. E. , Oxelman B. , Antonelli A.
Published: June 2021

Background

The great diversity in plant genome size and chromosome number is partly due to polyploidization (i.e. genome doubling events). The differences in genome size and chromosome number among diploid plant species can be a window into the intriguing phenomenon of past genome doubling that may be obscured through time by the process of diploidization. The genus Hibiscus L. (Malvaceae) has a wide diversity of chromosome numbers and a complex genomic history. Hibiscus is ideal for exploring past genomic events because although two ancient genome duplication events have been identified, more are likely to be found due to its diversity of chromosome numbers. To reappraise the history of whole-genome duplication events in Hibiscus, we tested three alternative scenarios describing different polyploidization events.

Results

Using target sequence capture, we designed a new probe set for Hibiscus and generated 87 orthologous genes from four diploid species. We detected paralogues in > 54% putative single-copy genes. 34 of these genes were selected for testing three different genome duplication scenarios using gene counting. All species of Hibiscus sampled shared one genome duplication with H. syriacus, and one whole genome duplication occurred along the branch leading to H. syriacus.

Conclusions

Here, we corroborated the independent genome doubling previously found in the lineage leading to H. syriacus and a shared genome doubling of this lineage and the remainder of Hibiscus. Additionally, we found a previously undiscovered genome duplication shared by the /Pavonia and /Malvaviscus clades (both nested within Hibiscus) with the occurrences of two copies in what were otherwise single-copy genes. Our results highlight the complexity of genomic diversity in some plant groups, which makes orthology assessment and accurate phylogenomic inference difficult.
Effect of chilling acclimation on germination and seedlings response to cold in different seed coat colored wheat (Triticum aestivum L.)
Authors: Calderon Flores Paulina , Yoon Jin Seok , Kim Dae Yeon , Seo Yong Weon
Published: June 2021

Background

Flavonoids can protect plants against extreme temperatures and ROS due to their antioxidant activities. We found that deep-purple seed coat color was controlled by two gene interaction (12:3:1) from the cross between yellow and deep-purple seed coat colored inbreds. F2:3 seeds were grouped in 3 by seed coat color and germinated under chilling (4 °C) and non-acclimated conditions (18 °C) for a week, followed by normal conditions (18 °C) for three weeks and a subsequent chilling stress (4 °C) induction. We analyzed mean daily germination in each group. Additionally, to study the acclimation in relationship to the different seed coat colors on the germination ability and seedling performances under the cold temperatures, we measured the chlorophyll content, ROS scavenging activity, and expression levels of genes involved in ROS scavenging, flavonoid biosynthetic pathway, and cold response in seedlings.

Results

The results of seed color segregation between yellow and deep purple suggested a two-gene model. In the germination study, normal environmental conditions induced the germination of yellow-seed, while under chilling conditions, the germination ratio of deep purple-seed was higher than that of yellow-colored seeds. We also found that the darker seed coat colors were highly responsive to cold acclimation based on the ROS scavenging enzymes activity and gene expression of ROS scavenging enzymes, flavonoid biosynthetic pathway and cold responsive genes.

Conclusions

We suggest that deep purple colored seed might be in a state of innate pre-acquired stress response state under normal conditions to counteract stresses in a more effective way. Whereas, after the acclimation, another stress should enhance the cold genes expression response, which might result in a more efficient chilling stress response in deep purple seed seedlings.

Low temperature has a large impact on the yield of crops. Thus, understanding the benefit of seed coat color response to chilling stress and the identification of limiting factors are useful for developing breeding strategies in order to improve the yield of wheat under chilling stress.
Epidemiological characteristics and mortality risk factors among COVID-19 patients in Ardabil, Northwest of Iran
Authors: Adham Davoud , Habibzadeh Shahram , Ghobadi Hassan , Jajin Shabnam Asghari , Abbasi-Ghahramanloo Abbas , Moradi-Asl Eslam
Published: June 2021

Background

Coronavirus disease highly contagious, is prevalent in all age and sex groups infecting the respiratory system. The present study seeks to investigate the epidemiology and effective factors in mortality of patients with COVID-19 in Ardabil province, northwestern Iran.

Methods

In a retrospective study, the hospitalized patients with laboratory-diagnosed COVID-19 between February to August 2020 were enrolled. The data registration portal was designated according to Iranian Ministry of Health and Medical Education guidelines. In this portal, demographic information, clinical presentation, laboratory and imaging data were registered for patients in all hospitals in the same format. The Hosmer-Lemeshow strategy was used for variable selection in a multiple model.

Results

Of the patients involved 2812(50.3%) were male and 150 (2.7%) had contact with a confirmed case of COVID-19 in the last 14 days. Pre-existing comorbidity was reported in 1310 (23.4%) patients. Of all patients, 477(8.5%) died due to COVID-19. the result of the multiple logistic regression model indicated that after adjusting for other factors, higher age (OR = 3.11), fever or chills (OR = 1.61), shortness of breath (OR = 1.82), fatigue (OR = 0.71), headache (OR = 0.64), runny nose (OR = 1.54), Skeletal muscle pain (OR = 1.53), hospitalization (OR = 5.66), and hospitalization in ICU (OR = 5.12) were associated with death.

Conclusions

Hospitalization had the strongest effect on mortality followed by hospitalization in ICU, and higher age. This study showed that having some extra-pulmonary symptoms in contrast with pulmonary symptoms can predict as good prognostic factors.
Rationale and design of the OPTIMIZE trial: OPen label multicenter randomized trial comparing standard IMmunosuppression with tacrolimus and mycophenolate mofetil with a low exposure tacrolimus regimen In combination with everolimus in de novo renal transplantation in Elderly patients
Authors: de Boer S. E. , Sanders J. S.F. , Bemelman F. J. , Betjes M. G.H. , Burgerhof J. G.M. , Hilbrands L. , Kuypers D. , van Munster B. C. , Nurmohamed S. A. , de Vries A. P.J. , van Zuilen A. D. , Hesselink D. A. , Berger S. P.
Published: June 2021

Background

In 2019, more than 30 % of all newly transplanted kidney transplant recipients in The Netherlands were above 65 years of age. Elderly patients are less prone to rejection, and death censored graft loss is less frequent compared to younger recipients. Elderly recipients do have increased rates of malignancy and infection-related mortality. Poor kidney transplant function in elderly recipients may be related to both pre-existing (i.e. donor-derived) kidney damage and increased susceptibility to nephrotoxicity of calcineurin inhibitors (CNIs) in kidneys from older donors. Hence, it is pivotal to shift the focus from prevention of rejection to preservation of graft function and prevention of over-immunosuppression in the elderly. The OPTIMIZE study will test the hypothesis that reduced CNI exposure in combination with everolimus will lead to better kidney transplant function, a reduced incidence of complications and improved health-related quality of life for kidney transplant recipients aged 65 years and older, compared to standard immunosuppression.

Methods

This open label, randomized, multicenter clinical trial will include 374 elderly kidney transplant recipients (≥ 65 years) and consists of two strata. Stratum A includes elderly recipients of a kidney from an elderly deceased donor and stratum B includes elderly recipients of a kidney from a living donororfrom a deceased donor < 65 years. In each stratum, subjects will be randomized to a standard, tacrolimus-based immunosuppressive regimen with mycophenolate mofetil and glucocorticoids or an adapted immunosuppressive regimen with reduced CNI exposure in combination with everolimus and glucocorticoids. The primary endpoint is ‘successful transplantation’, defined as survival with a functioning graft and an eGFR ≥ 30 ml/min per 1.73 m2in stratum A and ≥ 45 ml/min per 1.73 m2in stratum B, after 2 years, respectively.

Conclusions

The OPTIMIZE study will help to determine the optimal immunosuppressive regimen after kidney transplantation for elderly patients and the cost-effectiveness of this regimen. It will also provide deeper insight into immunosenescence and both subjective and objective outcomes after kidney transplantation in elderly recipients.

Trial registration

ClinicalTrials.gov:NCT03797196, registered January 9th, 2019. EudraCT: 2018-003194-10, registered March 19th, 2019.
Investigating patient-specific mechanisms of change in SET vs. EFT for depression: study protocol for a mechanistic randomized controlled trial
Authors: Zilcha-Mano Sigal , Shahar Ben , Fisher Hadar , Dolev-Amit Tohar , Greenberg Leslie S. , Barber Jacques P.
Published: June 2021

Background

Major depressive disorder (MDD) is the leading cause of disability worldwide and one of the most heterogeneous mental health disorders. Although there are effective treatments for MDD, about 50% of patients do not respond to treatment. One of the greatest challenges in improving current treatments is identifying the mechanisms responsible for therapeutic change in MDD. The proposed study aims to identify patient-specific mechanisms of change in two treatments for MDD by investigating whether subpopulations of patients differ in the mechanisms of change that operate when receiving a given treatment. Based on theories of targeting weakness and building on strength, we will examine whether the mechanism of change operating when a treatment is provided depends on whether the treatment targets the patient’s strength or weakness.

Method

To test our hypothesis that two treatments, supportive-expressive treatment (SET) and emotion-focused treatment (EFT), differ in their mechanisms of change and to explore whether focusing on the patient’s strength or weakness will result in better treatment outcome, we conduct a mechanistic randomized controlled trial. One hundred and twenty-four individuals diagnosed with MDD are randomized to 16 sessions of either SET or EFT. The two treatments are theorized to differ in their main mechanism of change: SET places emphasis on insight as its main mechanism of change, and EFT places emphasis on emotional processing. Both can serve as strength- or weakness-focused treatments, based on the patient’s baseline levels of insight and emotional processing. The primary outcome is the Hamilton Rating Scale for Depression. Additional measures include self-report measures and clinical interviews, hormonal, motion, acoustic, physiological, and neuroimaging assessments, performance on cognitive tasks, and narrative material (collected from the sessions and interviews).

Discussion

The RCT will expand our understanding of mechanisms of change in psychotherapy, from one-size-fits-all to patient-specific mechanisms of change. By informing therapists about which of the two approaches is most effective with patients based on their baseline characteristics, the RCT will contribute to progress toward personalized treatment.

Trial registration

clinicaltrials.govIdentifier:NCT04576182submitted on October 1st 2020. Funding: The Israel Science Foundation. Trial status: Recruitment is ongoing.
Effect of Hope-oriented group counseling on mental health of infertile women with failed IVF cycles: a randomized controlled trial
Authors: Rahimi Roya , Hasanpour Shirin , Mirghafourvand Mojgan. , Esmaeilpour Khalil
Published: June 2021

Background

Considering the prevalence of infertility in the community and the consequences of failure of infertility treatments on women’s mental health, interventions that can control stress, anxiety and depression in infertile women with a history of IVF failure will be very helpful. This study aimed to determine the effects of hope-oriented group counseling on mental health (primary outcome) and quality of life (QoL) (secondary outcome) of women with failed IVF cycles.

Method

This randomized controlled trial was conducted on 60 women with failed IVF cycles visiting Infertility Clinic at Al-Zahra Teaching Hospital of Tabriz- Iran. Participants were allocated to the intervention group (n = 30) and control group (n = 30) based on a randomized block design. Hope-oriented group counseling was provided to the intervention group in six 45–60 min sessions (once a week). The control group only received routine care to undergo another IVF cycle. The Depression Anxiety Stress Scale-21 (DASS-21) and the SF-12 Quality of Life Scale were filled out by interviewing the participants before the intervention and one week and one month after the intervention. After intervention 26 participants in each group were included in the analysis.

Results

There was no significant difference between the intervention and control groups in the socio-demographic profile of participants (P > 0.05). The post-intervention mean score of stress (adjusted mean difference = − 1.7, 95% confidence interval: − 3.2 to − 0.3,P = 0.018) and depression (adjusted mean difference = − 1.3, 95% confidence interval: − 4.7 to − 1.5,P < 0.001) was significantly lower in the intervention group compared to the control. Although the mean anxiety score was lower in the intervention group compared to the control, the difference between them was not statistically significant (adjusted mean difference = − 1.1, 95% confidence interval: − 2.6 to 0.4,P = 0.153). The mean score of QoL was significantly higher in the intervention group than that of the control group (adjusted mean difference = 6.9, 95% confidence interval: 5.1 to 8.8,P < 0.001).

Conclusion

Hope-oriented group counseling was effective in reducing stress and depression and improving QoL in women with failed IVF cycles. It is recommended to use this counseling approach, along with other methods, to improve the mental health of women with failed IVF cycles.

Trial registration

TCT Registration Number: TCTR20191017003, registered on October 17, 2019.
Risk of COVID-19 infection among prison staff in the United States
Authors: Nowotny Kathryn M. , Seide Kapriske , Brinkley-Rubinstein Lauren
Published: June 2021

Background

Multiple large outbreaks of COVID-19 have been documented in prisons and jails across regions of the world, with hazardous environmental conditions amplify the risks of exposure for both incarcerated people and correctional staff. The objectives of this study are to estimate the cumulative prevalence of COVID-19 cases among U.S. prison staff over time and compare it to the prison inmate population and the general U.S. population, overall, and to examine risk of COVID-19 infection among prison staff across jurisdictions.

Methods

We use publicly available data (April 22, 2020 to January 15, 2021) to estimate COVID-19 crude case rates per 1000 with 95% confidence intervals over the study period for prison staff, incarcerated population, and general population. We also compare COVID-19 case rates between prison staff and the general population within jurisdictions.

Results

Over the study period, prison staff have reported consistently higher rates of COVID-19 compared to the general population, with prison staff case rates more closely mirroring the incarcerated population case rates. The rolling 7-day average case rates for prison staff, prison population, and general population on January 15, 2021 were 196.04 per 1000 (95%CI 194.81, 197.26), 219.16 (95%CI 218.45, 219.86), and 69.80 (95%CI 69.78, 69.83), respectively. There was substantial heterogeneity across jurisdictions, yet in 87% of study jurisdictions, the risk of COVID-19 was significantly greater among prison staff than the general state population.

Conclusions

Targeting staff for COVID-19 mitigation strategies is essential to protect the health of people who intersect with the correctional system and to flatten the curve in the surrounding communities.
Pre-schoolers’ tooth brushing behaviour and association with their oral health: a cross sectional study
Authors: Khan Iqra Muhammad , Mani Shani Ann , Doss Jennifer Geraldine , Danaee Mahmoud , Kong Lydia Yi Li
Published: June 2021

Background

Toothbrushing is an important yet neglected behaviour that affects the oral health of preschool children. Little is reported on parental supervision, an essential aspect of routine effective toothbrushing in this age group. The aim of this study was to evaluate pre-schoolers’ toothbrushing behaviour including parental involvement and its association with their oral health.

Methods

This was a cross-sectional study. A total of 92 preschool children (4–6 years) were invited to participate with their parents/guardians. Nine parameters of toothbrushing behaviour were assessed from parental responses (questionnaire) and observation of child and parents/guardians (video recording). Oral examination included recording plaque, gingival and dental caries indices. BORIS software was used to assess toothbrushing parameters and Smart PLS was used to perform association with a second-generation multivariate analysis to create models with and without confounding factors.

Results

Girls were slightly more (53%) than boys (47%). Children aged 4 years were slightly more in number (38%), followed by 6-year-olds and 5-year-olds. Nearly, 90% parents had tertiary education and 46% had more than 2 children. Differences were recorded in the reported and observed behaviour. Thirty-five percent parents/guardians reported using pea-size toothpaste amount but only 28% were observed. Forty percent reported to brush for 30 s–1 min, however 51% were observed to brush for 1–2 min. Half the children were observed to use fluoridated toothpaste (F < 1000 ppm) under parental supervision (11%). The mean (SD) plaque score reduction after toothbrushing was 10.80 (2.46), mean pre-brushing plaque score was 90.3 (10.2), mean gingival index was 0.89 (0.65) and mean dental caries status (ICDAS(1–6)) was 18.87 (12.39). Toothbrushing behaviour in terms of toothbrushing technique, duration, pattern and frequency, toothbrush type and grip type, toothpaste type and amount, post-brushing mouth rinsing and parental involvement contributed significantly to plaque score change (86%), dental caries status (73%), gingival index (66%) and pre-brushing plaque score (31%). The significant confounding variables had a small influence on oral health of preschool children.

Conclusions

Preschool children’s toothbrushing behaviour was inadequate while their oral health was poor, with a significant association between the two parameters.