bluuebunny/crossref_metadata_2025 huggingface dataset:
Transcriptome profiling analysis of sex-based differentially expressed mRNAs and lncRNAs in the brains of mature zebrafish (Danio rerio)
Authors: Yuan Wenliang , Jiang Shouwen , Sun Dan , Wu Zhichao , Wei Cai , Dai Chaoxu , Jiang Linhua , Peng Sihua
Published: November 2019

Background

Similar to humans, the zebrafish brain plays a central role in regulating sexual reproduction, maturation and sexual behavior. However, systematic studies of the dimorphic patterns of gene expression in the brain of male and female zebrafish are lacking.

Results

In this study, the mRNA and lncRNA expression profiles were obtained from the brain tissue samples of the three male and three female zebrafish by high-throughput transcriptome sequencing. We identified a total of 108 mRNAs and 50 lncRNAs with sex-based differential expression. We randomly selected four differentially expressed genes for RT-qPCR verification and the results certified that the expression pattern showed a similar trend between RNA-seq and RT-qPCR results. Protein-protein interaction network analysis, Gene Ontology (GO) analysis, and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were performed to obtain the biological significance of differentially expressed mRNA in the brain dimorphism of zebrafish. Finally, a Pearson correlation analysis was performed to construct the co-expression network of the mRNAs and lncRNAs.

Conclusions

We found that 12 new lncRNAs not only have significant gender specificity in the brain of zebrafish, and this finding may provide a clue to further study of the functional difference between male and female zebrafish brain.
Effects of parental genetic divergence on gene expression patterns in interspecific hybrids of Camellia
Authors: Zhang Min , Tang Yi-Wei , Qi Ji , Liu Xin-Kai , Yan Dan-Feng , Zhong Nai-Sheng , Tao Nai-Qi , Gao Ji-Yin , Wang Yu-Guo , Song Zhi-Ping , Yang Ji , Zhang Wen-Ju
Published: November 2019

Background

The merging of two divergent genomes during hybridization can result in the remodeling of parental gene expression in hybrids. A molecular basis underling expression change in hybrid is regulatory divergence, which may change with the parental genetic divergence. However, there still no unanimous conclusion for this hypothesis.

Results

Three species of Camellia with a range of genetic divergence and their F1 hybrids were used to study the effect of parental genetic divergence on gene expression and regulatory patterns in hybrids by RNA-sequencing and allelic expression analysis. We found that though the proportion of differentially expressed genes (DEGs) between the hybrids and their parents did not increase, a greater proportion of DEGs would be non-additively (especially transgressively) expressed in the hybrids as genomes between the parents become more divergent. In addition, the proportion of genes with significant evidence of cis-regulatory divergence increased, whereas with trans-regulatory divergence decreased with parental genetic divergence.

Conclusions

The discordance within hybrid would intensify as the parents become more divergent, manifesting as more DEGs would be non-additively expressed. Trans-regulatory divergence contributed more to the additively inherited genes than cis, however, its contribution to expression difference would be weakened as cis mutations accumulated over time; and this might be an important reason for that the more divergent the parents are, the greater proportion of DEGs would be non-additively expressed in hybrid.
Newly isolated lactic acid bacteria from silage targeting biofilms of foodborne pathogens during milk fermentation
Authors: Gavrilova Elizaveta , Anisimova Elizaveta , Gabdelkhadieva Alsu , Nikitina Elena , Vafina Adel , Yarullina Dina , Bogachev Mikhail , Kayumov Airat
Published: November 2019

Background

Raw milk, meat and plant materials are subjected to high risks of contamination by various pathogenic bacteria and thus their growth prevention is a great challenge in the food industry. Food fermentation by lactic acid bacteria (LAB) besides changing its organoleptic characteristics also helps to eliminate unfavorable microflora and represses growth of pathogens. To the date only few LABs has been reported to exhibit activity against bacteria embedded in the biofilms characterized by extreme resistance to antimicrobials, high exchange rate with resistance genes and represent high risk factor for foodborne disease development.

Results

Six novel LAB strains isolated from the clover silage exhibited pronounced antibacterial activity against biofilm embedded pathogens. We show explicitly that these strains demonstrate high acidification rate, completely repress the growth of E. coli, S. aureus and to a lesser extent P. aeruginosa as well as exhibit appropriate probiotic and milk-fermenting properties. Moreover, in contrast to the approved probiotic strain Lactobacillus plantarum 8PA3, the new isolates were able to efficiently eradicate preformed biofilms of these pathogens and prevent bacterial spreading originating from the biofilm. We suggest these strains as potential additives to the pre-cultures of conventional LAB strains as efficient tools targeting foodborne pathogens in order to prevent food contamination from either seeded raw material or biofilm-fouled equipment.

Conclusions

The AG10 strain identified as L. plantarum demonstrate attractive probiotic and milk fermentation properties as well as high resistance to simulated gastric conditions thus appearing perspective as a starter culture for the prevention of bacterial contamination originating from fouled equipment during milk fermentation.
Isocitrate lyase plays important roles in plant salt tolerance
Authors: Yuenyong Worawat , Sirikantaramas Supaart , Qu Li-Jia , Buaboocha Teerapong
Published: November 2019

Background

Isocitrate lyase (ICL) is a key enzyme in the glyoxylate cycle. In a previous study in rice, the expression of the ICL-encoding gene (OsICL) was highly induced by salt stress and its expression was enhanced in transgenic rice lines overexpressingOsCam1–1, a calmodulin (CaM)-encoding gene. CaM has been implicated in salt tolerance mechanisms in plants; however, the cellular mechanisms mediated by CaM are not clearly understood. In this study, the role ofOsICLin plant salt tolerance mechanisms and the possible involvement of CaM were investigated using transgenic plants expressingOsICLorOsCam1–1.

Results

OsICLwas highly expressed in senesced leaf and significantly induced by salt stress in threeOsCam1–1overexpressing transgenic rice lines as well as in wild type (WT). In WT young leaf, althoughOsICLexpression was not affected by salt stress, all three transgenic lines exhibited highly induced expression levels. In Arabidopsis, salt stress had negative effects on germination and seedling growth of theAtICLknockout mutant (Aticlmutant). To examine the roles ofOsICLwe generated the following transgenic Arabidopsis lines: theAticlmutant expressingOsICLdriven by the nativeAtICLpromoter, theAticlmutant overexpressingOsICLdriven by the 35SCaMV promoter, and WT overexpressingOsICLdriven by the 35SCaMV promoter. Under salt stress, the germination rate and seedling fresh and dry weights of theOsICL-expressing lines were higher than those of theAticlmutant, and the two lines with theiclmutant background were similar to the WT. TheFv/Fmand temperature of rosette leaves in theOsICL-expressing lines were less affected by salt stress than they were in theAticlmutant. Finally, glucose and fructose contents of theAticlmutant under salt stress were highest, whereas those ofOsICL-expressing lines were similar to or lower than those of the WT.

Conclusions

OsICL, a salt-responsive gene, was characterized in the transgenic Arabidopsis lines, revealing thatOsICLexpression could revert the salt sensitivity phenotypes of theAticlknockout mutant. This work provides novel evidence that supports the role of ICL in plant salt tolerance through the glyoxylate cycle and the possible involvement ofOsCam1–1in regulating its transcription.
Human cytomegalovirus seroprevalence and titres in solid organ transplant recipients and transplant donors in Seoul, South Korea
Authors: La Yeonju , Kwon Da Eun , Yoo Seul Gi , Lee Kyoung Hwa , Han Sang Hoon , Song Yong Goo
Published: November 2019

Background

Human cytomegalovirus (HCMV) can cause poor outcomes in solid organ transplant (SOT) recipients; moreover, it is associated with cardiovascular diseases (CVD) in the general population. Accordingly, anti-HCMV immunoglobulin G (IgG) seroepidemiology may be useful in identifying the risk of post-SOT HCMV infection or disease as well as immunosenescence or CVD. However, HCMV seroprevalence and titre have not been fully evaluated with regard to age distribution or compared between SOT recipients and healthy individuals in South Korea.

Methods

We retrospectively retrieved all unduplicated anti-HCMV IgG results of individuals aged > 1 year evaluated between July 2006 and November 2017 at Severance Hospital in Seoul. The cohort, excluding haematopoietic stem cell transplant recipients and subjects with equivocal values, included 2184 SOT recipients and 3015 healthy transplant donors. All IgG results in the SOT recipients were measured during the pre-transplant period.

Results

The overall IgG seroprevalence and titres were significantly higher among SOT recipients than among healthy donors (98.7% vs. 88.6%, p < 0.001, and 64.7 ± 44.3 vs. 49.8 ± 20.6 arbitrary units/mL, p < 0.001, respectively). The lowest seropositive rate in the SOT group was observed in recipients aged between 11 and 15 years (70.6%). The frequency of seropositivity among adults aged ≥41 years increased to ≥90% in SOT recipients and healthy donors. Age was independently associated with higher HCMV seroprevalence (41–60 years, OR, 76.4, 95% CI, 24.5–238.9, p < 0.001; ≥ 61 years, OR, 4.4, 95% CI, 1.3–14.9, p < 0.001, compared to ≤40 years). The healthy donor group had an independently low HCMV seropositive rate (OR, 0.1, 95% CI, 0.1–0.2, p < 0.001).

Conclusions

HCMV seropositivity was the lowest among school-aged children and adolescents. IgG testing revealed an intermediate serostatus risk of post-transplant HCMV infection and disease for most adult SOT recipients in South Korea.
A changing profile of infective endocarditis at a tertiary hospital in China: a retrospective study from 2001 to 2018
Authors: Ren Zuning , Mo Xichao , Chen Hongjie , Peng Jie
Published: November 2019

Background

Infective endocarditis (IE) is a lethal disease which has been changing significantly over the past decades; however, information about IE in China remains scarce. This study surveyed the changes in clinical characteristics of IE at a tertiary hospital in south China over a period of nearly 18 years.

Methods

Medical records with IE patients consecutively hospitalized between June 2001 and June 2018 were selected from the electronic medical records system in Nanfang Hospital of Southern Medical University. Data were divided by admission time into two groups equally: early-period group, June 2001 to December 2009 and later-period group, January 2010 to July 2018.

Results

A Total of 313 IE patients were included in our study. Compared with the early-period group, patients in the later-period group included fewer intravenous drug users (IVDUs), older age at onset, reduced development of pulmonary embolism, less renal dysfunction, decreased proportion of Staphylococcus aureus infection and fewer vegetations observed in the right heart by echocardiography. The later-period group also showed a higher proportion of ischemic strokes and higher proportion of positive microbiological findings compared with the early-period group. The in-hospital mortality remained about the same between the two periods and the multivariate analysis identified intravenous drug addicted, prosthetic valve endocarditis, hemorrhagic stroke, acute congestive heart failure, renal insufficiency, left-sided endocarditis, early surgical as independent predictors of in-hospital mortality.

Conclusions

Our study demonstrated a dramatic change in the profile of IE over a period of 18 years at a tertiary hospital in south China and presented several independent predictors of in-hospital mortality. The geographic variations observed in our study will be of important value to profile the clinical feature of China and offer the reference for clinical decisions in our region.
Isolated hypoglossal nerve palsy from internal carotid artery dissection related to PKD-1 gene mutation
Authors: Chen Zhaoyao , Yuan Jun , Li Hui , Yuan Cuiping , Yin Kailin , Liang Sen , Li Pengfei , Wu Minghua
Published: November 2019

Background

Internal carotid artery dissection has been well recognized as a major cause of ischaemic stroke in young and middle-aged adults. However, internal carotid artery dissection induced hypoglossal nerve palsy has been seldom reported and may be difficult to diagnose in time for treatment; even angiography sometimes misses potential dissection, especially when obvious lumen geometry changing is absent.

Case presentation

We report a 42-year-old man who presented with isolated hypoglossal nerve palsy. High-resolution MRI showed the aetiological dissected internal carotid artery. In addition, a potential genetic structural defect of the arterial wall was suggested due to an exon region mutation in the polycystic-kidney-disease type 1 gene.

Conclusions

Hypoglossal nerve palsy is a rare manifestations of carotid dissection. High-resolution MRI may provide useful information about the vascular wall to assist in the diagnosis of dissection. High-throughput sequencing might be useful to identify potential cerebrovascular-related gene mutation, especially in young individuals with an undetermined aetiology.
Cooperation of Dnmt3a R878H with Nras G12D promotes leukemogenesis in knock-in mice: a pilot study
Authors: Shi Xiaodong , Yang Ying , Shang Siqi , Wu Songfang , Zhang Weina , Peng Lijun , Huang Ting , Zhang Ruihong , Ren Ruibao , Mi Jianqing , Wang Yueying
Published: November 2019

Background

DNMT3A R882H, a frequent mutation in acute myeloid leukemia (AML), plays a critical role in malignant hematopoiesis. Recent findings suggest that DNMT3A mutant acts as a founder mutation and requires additional genetic events to induce full-blown AML. Here, we investigated the cooperation of mutant DNMT3A and NRAS in leukemogenesis by generating a double knock-in (DKI) mouse model harboring both Dnmt3a R878H and Nras G12D mutations.

Methods

DKI mice with both Dnmt3a R878H and Nras G12D mutations were generated by crossing Dnmt3a R878H knock-in (KI) mice and Nras G12D KI mice. Routine blood test, flow cytometry analysis and morphological analysis were performed to determine disease phenotype. RNA-sequencing (RNA-seq), RT-PCR and Western blot were carried out to reveal the molecular mechanism.

Results

The DKI mice developed a more aggressive AML with a significantly shortened lifespan and higher percentage of blast cells compared with KI mice expressing Dnmt3a or Nras mutation alone. RNA-seq analysis showed that Dnmt3a and Nras mutations collaboratively caused abnormal expression of a series of genes related to differentiation arrest and growth advantage. Myc transcription factor and its target genes related to proliferation and apoptosis were up-regulated, thus contributing to promote the process of leukemogenesis.

Conclusion

This study showed that cooperation of DNMT3A mutation and NRAS mutation could promote the onset of AML by synergistically disturbing the transcriptional profiling with Myc pathway involvement in DKI mice.
A single exercise session improves side-effects of chemotherapy in women with breast cancer: an observational study
Authors: Johnsson Anna , Demmelmaier Ingrid , Sjövall Katarina , Wagner Philippe , Olsson Håkan , Tornberg Åsa B.
Published: November 2019

Background

To measure changes in four common chemotherapy related side-effects (low energy, stress, nausea and pain) immediately after a single exercise session within the first week after treatment.

Methods

Thirty-eight patients with chemotherapy-treated breast cancer, participating in a multi-centre randomised controlled study, thePhysical Training and Cancer study (Phys-Can)were included in this sub-study. The Phys-Can intervention included endurance and resistance training. Before and after a single training session (endurance or resistance) within the first week of chemotherapy, energy and stress were measured with the Stress-Energy Questionnaire during Leisure Time, and nausea and pain were assessed using a Visual Analog Scale 0–10. Paired t-tests were performed to analyse the changes, and linear regression was used to analyse associations with potential predictors.

Results

Thirty-eight participants performed 26 endurance training sessions and 31 resistance training sessions in the first week after chemotherapy. Energy and nausea improved significantly after endurance training, and energy, stress and nausea improved significantly after resistance training. Energy increased (p = 0.03 and 0.001) and nausea decreased (p = 0.006 and 0.034) immediately after a single session of endurance or resistance training, and stress decreased (p = 0.014) after resistance exercise.

Conclusions

Both endurance and resistance training were followed by an immediate improvement of common chemotherapy-related side-effects in patients with breast cancer. Patients should be encouraged to exercise even if they suffer from fatigue or nausea during chemotherapy.

Trial registration

NCT02473003, June 16, 2015.
Study protocol for a parallel-group, double-blinded, randomized, controlled, noninferiority trial: the effect and safety of hybrid electroconvulsive therapy (Hybrid-ECT) compared with routine electroconvulsive therapy in patients with depression
Authors: Rong Han , Xu Shu-xian , Zeng Jing , Yang Ying-jia , Zhao Jie , Lai Wen-tao , Chen Li-chang , Deng Wen-feng , Zhang Xiangyang , Zhang Ying-li , Li Min-zhi , Xiao Li , Xie Xin-hui
Published: November 2019

Background

Electroconvulsive therapy (ECT) is the most rapid and effective treatment for patients with depression, ECT can achieve remarkable antidepressant effects in the initial 3–4 sessions, but significant side effects limit its use. However, recent low-charge electrotherapy (LCE) studies have demonstrated antidepressant or antipsychotic effects with significantly fewer side effects. The aim of this study is to propose a novel two-step charge set strategy for ECT treatment, referred to as Hybrid-ECT, to decrease side effects by using a low charge while preserving treatment efficacy.

Methods/design

A randomized, double-blinded, standard-controlled, parallel-group design will be carried out. We plan to enroll 112 inpatients diagnosed with depression (unipolar or bipolar) and randomly assign them to conventional ECT (control group) or to Hybrid-ECT (treatment group, 3 ECT sessions followed by LCE sessions (approximately 2.8 joules per session)). We will evaluate participants across a wide variety of domains including clinical symptoms, cognitive, psychological and functional metrics. We will also perform magnetic resonance imaging (MRI) and event-related potential (ERPs) assessments during treatment to explore brain function differences between ECT and LCE.

Discussion

This research proposes a simple but completely novel ECT strategy that aims to rapidly relieve depressive symptoms and minimize side effects. The mechanism of ECT and LCE will be further discussed.

Trial registration

Chinese Clinical Trial Registry, Number: ChiCTR1900022905 (Registration date: April 30, 2019).
Social-ecological correlates of accelerometer-measured occupational sitting among Japanese desk-based workers
Authors: Kurita Satoshi , Shibata Ai , Ishii Kaori , Koohsari Mohammad Javad , Oka Koichiro
Published: November 2019

Background

Although the main targets for reducing workplace sedentary behavior have been clarified, only a few studies have examined the association between social-ecological factors and workplace sedentary behavior for effective intervention. The present study aimed to examine the social-ecological factors of workplace sedentary behavior among Japanese sedentary workers.

Methods

Participants were recruited via a cross-sectional mail survey targeting randomly sampled 6000 middle-aged people dwelling in Matsuyama-city and Koto-ku in Japan. Participants answered a questionnaire on social-ecological factors, recorded their work time in a diary, and wore a triaxial accelerometer during waking time for 7 consecutive days. Workplace sedentary behavior was measured using accelerometer and was referred to as the work time in the recorded diary. Full-time workers who had mainly sitting work and valid accelerometer data were included in the analysis. Workplace sedentary variables were sedentary breaks per sedentary hour, sedentary time, and ≥ 30 min bouts of sedentary time. The associations between each sedentary variable and social-ecological factors were explored by conducting three multiple linear regression analyses adjusting for sociodemographic and health-related factors.

Results

A total of 227 participants (133 men, mean age 49.9 ± 6.9 years) were included in the analysis. In the overall sample, “typically seeing work colleagues take sedentary breaks” was significantly associated with more sedentary breaks (B [95% confidence interval {CI}=1.40 [0.07 to 2.73]) and shorter ≥30-min bouts of sedentary time (B [95% CI] = −7.08 [−13.75 to −0.40]). “I am motivated to take sedentary breaks” had an unfavorable association with less sedentary breaks (B [95% CI] = −1.36 [−2.61 to −0.12]) and longer sedentary time (B [95% CI] = 4.15 [0.29 to 8.00]). In male workers, “Too stressed to take sedentary breaks” was significantly associated with less sedentary breaks (B [95% CI] = −5.6 [−9.17 to −2.02]).

Conclusions

Seeing work colleagues take sedentary breaks may be important for reducing workplace sedentary behavior. Those who are more sedentary are motivated to take sedentary breaks. Male workers who feel the need to take sedentary breaks at work are more sedentary.
Implantation of 125I radioactive seeds via c-TBNA combined with chemotherapy in an advanced non-small-cell lung carcinoma patient
Authors: Jiang Ai-Gui , Lu Hui-Yu , Ding Zhong-Qi
Published: November 2019

Background

The critical management of advanced non-small-cell lung carcinoma (NSCLC), especially when complicated by severe airway stenosis, is difficult and often leads to high clinical risks and medical costs.

Case presentation

A 51-year-old previously healthy male was admitted to the Department of Respiratory and Critical Care Medicine, Taizhou People’s Hospital, in November 2018 for haemoptysis and difficulty breathing during a 15-d period. Following admission, chest computed tomography (CT) showed a large mass in the left hilum with atelectasis in the left upper lobe and obstructive pneumonia in the left lower lobe. Bronchoscopy revealed that the lesions occurred in the distal segment of the left main trachea, with occlusion of the left upper bronchus and significant narrowing of the lower bronchus. A basal mucosal biopsy of the lump tissue was performed after haemostasis treatment with sub-plasma coagulation (APC), and squamous lung carcinoma was confirmed. Following the final diagnosis, the patient was successfully treated with implantation of 125I radioactive seeds via transbronchial needle aspiration (c-TBNA) combined with chemotherapy.

Conclusion

We believe that implantation of 125I radioactive seeds via c-TBNA is an effective treatment for patients with advanced lung cancer and those presenting with severe and mixed main bronchus stenosis.
Rapid generation and selection of Cas9-engineering TRP53 R172P mice that do not have off-target effects
Authors: Zheng Guoxing , Zhu Qingqing , Dong Junchao , Lin Xin , Zhu Chengming
Published: November 2019

Background

Genetic mutations cause severe human diseases, and suitable animal models to study the regulatory mechanisms involved are required. The CRISPR/Cas9 system is a powerful, highly efficient and easily manipulated tool for genetic modifications. However, utilization of CRISPR/Cas9 to introduce point mutations and the exclusion of off-target effects in mice remain challenging. TP53-R175 is one of the most frequently mutated sites in human cancers, and it plays crucial roles in human diseases, including cancers and diabetes.

Results

Here, we generated TRP53-R172P mutant mice (C57BL/6 J, corresponding to TP53-R175P in humans) using a single microinjection of the CRISPR/Cas9 system. The optimal parameters comprised gRNA selection, donor designation (silent mutations within gRNA region), the concentration of CRISPR components and the cellular sites of injection. TRP53-R172P conversion was genetically and functionally confirmed. Combination of TA cloning and Sanger sequencing helped identify the correctly targeted mice as well as the off-target effects in the engineered mice, which provide us a strategy to select the on-target mice without off-target effects quickly and efficiently.

Conclusions

A single injection of the this optimized CRISPR/Cas9 system can be applied to introduce particular mutations in the genome of mice without off-target effects to model various human diseases.
Impact of experience of psychiatrists and psychiatry residents regarding electronic communication and social networking on internet use patterns: a questionnaire survey for developing e-professionalism in South Korea
Authors: Lee Yeon Jung , Hwang Jaeuk , Lee Soyoung Irene , Woo Sung-Il , Hahn Sang Woo , Koh Steve
Published: November 2019

Background

The development of technology, novel communication, and social networking can positively or negatively affect the therapeutic alliance between patients and psychiatrists. We conducted this study to identify Internet use patterns of psychiatrists and psychiatry residents in South Korea and to provide basic data for developing e-professionalism.

Methods

In this questionnaire survey included a total of 250 participants, of which 195 (78%) completed the questionnaire. Questions included demographics, use of email, web searches, personal and professional use of websites and social networking, and negative and positive experiences of electronic communication and social networking. We confirmed the correlation between experience and use patterns of psychiatrists’ electronic communication and social networking.

Results

A total of 129 participants (66.2%) reported that they posted their personal or professional content online, 112 (57.9%) had received patients’ requests through electronic communication or social networking, and 120 (61.4%) had communicated with patients via electronic communication or social networking. In total, 170 participants (87.2%) reported that they were worried about the negative consequences of using electronic communication and social networking, and 180 (92.3%) indicated they were not educated about electronic communication or social networking.

Conclusion

In order to reduce the negative effects of electronic communication and social networking, we need guidelines that are appropriate for the situation in South Korea. Furthermore, future research will need to identify and suggest solutions for negative experiences of electronic communication and social networking that may affect the relationship between patients and physicians.
The relationship between students’ perception of the educational environment and their subjective happiness
Authors: Yoo Dong-Mi , Kim Do-Hwan
Published: November 2019

Background

Happiness, a subjective judgment about one’s quality of life, is influenced by environmental factors and should be considered as an important goal of medical education, which should support each learner’s development as a person as well as a professional. However, although several studies have reported on the correlation between Dundee Ready Educational Environment Measure (DREEM) scores and students’ academic achievement, few have investigated the relationship between DREEM scores and students’ subjective happiness. This study examined different perceptions of the educational environment between phases of the curriculum and determined which DREEM subscales affect the overall level of happiness.

Methods

We used the Korean version of the DREEM questionnaire and a single item measure of happiness on a scale of 0 to 10. First we analyzed student perceptions of the educational environment according to their demographic characteristics using independent sample t-tests and one-way analysis of variance. A multiple regression analysis was performed to reveal which subscales affect the overall level of happiness while controlling for grade point average (GPA) and other demographic characteristics.

Results

The subjects were 239 medical school students across all stages of the curriculum. The students’ overall perception was more positive for the educational environment during Phase 3 (clerkship) than Phase 1 (pre-medical). Among the DREEM subscales, this difference was especially prominent in Students’ Perception of Learning and Students’ Academic Self-Perceptions. In contrast, no difference in the subjective perception of happiness was found between phases. The effect of GPA on happiness became insignificant under the control of other variables, but the influence of the Students’ Social Self-Perceptions (SSSP) subscale remained significant.

Conclusions

The students’ overall perception of the educational environment was more positive during the clerkship period than in the pre-medical period. Based on our finding that the SSSP correlates significantly with subjective happiness, we suggest that institutions promote not only students’ academic development but also their happiness by fostering an appropriate educational environment.
The Transmural Trauma Care Model (TTCM) for the rehabilitation of trauma patients is effective in improving patient related outcome measures: a non-randomized controlled trial
Authors: Wiertsema Suzanne H. , van Dongen Johanna M. , Geleijn Edwin , Beckerman Heleen , Bloemers Frank W. , Ostelo Raymond W. J. G. , de Groot Vincent
Published: November 2019

Background

The Transmural Trauma Care Model (TTCM) is a refined post-clinical rehabilitation approach, in which a multidisciplinary hospital-based team guides a network of primary care physical therapists in the treatment of trauma patients. The objective of this study was to assess the effectiveness of the TTCM compared to regular care.

Methods

A controlled-before-and-after study was performed in a level 1 trauma center. The TTCM includes four elements: 1) a multidisciplinary team at the outpatient clinic, 2) coordination and individual goal setting for each patient by this team, 3) a network of primary care physical therapists, 4) E-health support for transmural communication. Intervention group patients were prospectively followed (3, 6 and 9 months). The control group consisted of 4 clusters of patients who either had their first consultation at the outpatient clinic 0, 3, 6 or 9 months ago. Outcomes included generic- and disease-specific health-related quality of life (HR-QOL), pain, functional status, patient satisfaction, and perceived recovery. Between-group comparisons were made using linear regression analyses. The recovery pattern of intervention group patients was identified using longitudinal data analysis methods.

Results

A total of 83 participants were included in the intervention group. In the control group, 202 participants were included (68 in the baseline cluster, 26 in the 3-month cluster, 51 in the 6-month cluster, 57 in the 9-month cluster). Between-group differences were statistically significant in favor of the intervention group for disease-specific HR-QOL at 9 months, pain at 6 and 9 months, functional status at 6 and 9 months, patient satisfaction at 3, 6 and 9 months, and perceived recovery at 6 months. No significant differences were found between groups for generic HR-QOL at any time point. Generic HR-QOL, disease-specific HR-QOL, pain, and functional status significantly improved in a linear fashion among intervention group patients during the nine-month follow-up period.

Conclusions

This study provides preliminary evidence that the TTCM is effective in improving patient related outcome measures, such as disease-specific HR-QOL, pain and functional status. A multicenter, and ideally randomized controlled trial, is required to confirm these results.

Trial registration

The trial is registered at the Dutch Trial Register (NTR5474). Registered 12 October 2015. Retrospectively registered.
Active participation of patients with type 2 diabetes in consultations with their primary care practice nurses – what helps and what hinders: a qualitative study
Authors: du Pon E. , Wildeboer A. T. , van Dooren A. A. , Bilo H. J. G. , Kleefstra N. , van Dulmen S.
Published: November 2019

Background

Patients with type 2 diabetes mellitus (T2DM) receiving primary care regularly visit their practice nurses (PNs). By actively participating during medical consultations, patients can better manage their disease, improving clinical outcomes and their quality of life. However, many patients with T2DM do not actively participate during medical consultations. To understand the factors affecting engagement of patients with T2DM, this study aimed to identify factors that help or hinder them from actively participating in consultations with their primary care PNs.

Methods

Two semi-structured focus groups and 12 semi-structured individual interviews were conducted with patients with T2DM (n = 20) who were undergoing treatment by primary care PNs. All interviews were transcribed verbatim and analyzed using a two-step approach derived from the context-mapping framework.

Results

Four factors were found to help encourage patients to actively participate in their consultation: developing trusting relationships with their PNs, having enough time in the appointment, deliberately preparing for consultations, and allowing for the presence of a spouse. Conversely, four factors were found to hinder patients from participating during consultations: lacking the need or motivation to participate, readjusting to a new PN, forgetting to ask questions, and ineffectively expressing their thoughts.

Conclusion

Patients lacked the skills necessary to adequately prepare for a consultation and achieve an active role. In addition, patients’ keen involvement appeared to benefit from a trusting relationship with their PNs. When active participation is impeded by barriers such as a lack of patient’s skills, facilitators should be introduced at an early stage.

Trial registration

Current Controlled Trials NTR4693 (July 16, 2014).
Prevalence, determinants, and characteristics of extemporaneous compounding in Jordanian pharmacies
Authors: AlKhatib Hatim S. , Jalouqa Sara , Maraqa Nour , Ratka Anna , Elayeh Eman , Al Muhaissen Suha
Published: November 2019

Background

Pharmaceutical compounding is an essential component in pharmacy practice allowing pharmacists to provide dosage forms or strengths that are commercially unavailable. Medications compounded for patient-specific needs contribute to personalized medicine. Extemporaneous compounding provided by pharmacies overcomes the market shortage of these therapeutic products. The aim of this study is to investigate and characterize the prevalence, characteristics, and determinants of extemporaneous compounding in Jordanian pharmacies.

Methods

This study was based on a cross-sectional questionnaire and included 431 randomly selected pharmacies in the twelve governorates of the country. Data were collected via face to face interviews of pharmacists who voluntarily and verbally responded to the questions.

Results

Results revealed that 223 (51.7%) of the surveyed pharmacies practiced extemporaneous compounding. The main reason for not providing extemporaneous compounding services was lack of prescription orders for compounded preparations (53.8%). The second reason was lack of the equipment and supplies necessary for compounding (24.4%). Extemporaneous compounding prescriptions were mainly issued by dermatologists (98.2%); dermatological indication was the most common of all extemporaneous compounded prescriptions. The main reason for requesting compounded medications was the lack of a commercially available product (87.9%). The vast majority of the compounded dosage forms were creams (99.6) and ointments (91.5), followed by solutions (23.3%). Only 5 (2.2%) of the studied compounding pharmacies prepared sterile products. The major sources for compounding protocols were the physician order (94.2%), and ‘in-house’ protocols (44.8%). However, the main resource for estimating compounded medications expiration date was information based on pharmacist’s experience (57.8%) and the physician’s order (53.4%).

Conclusions

Extemporaneous compounding is a common element of pharmaceutical care. Topical preparations are the most commonly compounded products. Finding from this study suggest that there is a need for standardizing the compounded product formularies, product quality testing, and improving the consistency in estimation of an expiration date of compounded products.
Nutritional counselling interactions between health workers and caregivers of children under two years: observations at selected child welfare clinics in Ghana
Authors: Nsiah-Asamoah Christiana , Pereko Kingsley Kwadwo Asare , Intiful Freda Dzifa
Published: November 2019

Background

This study evaluated the Health Works (HWs) nutritional counselling skills and information shared with caregivers. This was a cross-sectional study in which an observation checklist was used to examine Growth Monitoring and Promotion (GMP) activities and educational/counselling activities undertaken by health workers (HWs) to communicate nutrition information to caregivers, depending on the ages of the children.

Methods

A total number of 528 counselling interactions between health workers and caregivers in 16 Child welfare Clinics (CWCs) in two rural districts in Ghana were observed. Frequencies were presented for the information that was obtained from each caregiver and those that were provided by the HWs during the nutritional counselling sessions.

Results

About 95.1 and 61.8% of the caregiver-HW interactions involved mothers of children who were less than 6 months of age and those above 6 months respectively. HWs counselled the caregivers on appropriate nutrition for the child. Health talk messages that were shared with caregivers focused mainly on the importance of attending CWCs and vaccination of children and rarely included any teaching materials. In most of the interactions, HWs made of child’s feeding practices the past 1 month; and also did not provide advice on specific issues of IYCF. Nutritional counselling information given for non-breastfeeding children was inadequate and in some cases absent. Little attention was given to the feeding of children with animal products during counselling.

Conclusion

Generally nutritional information given to caregivers who had children above 6 months was inadequate.
Aberrant populations of circulating T follicular helper cells and regulatory B cells underlying idiopathic pulmonary fibrosis
Authors: Asai Yuichiro , Chiba Hirofumi , Nishikiori Hirotaka , Kamekura Ryuta , Yabe Hayato , Kondo Shun , Miyajima Satsuki , Shigehara Katsunori , Ichimiya Shingo , Takahashi Hiroki
Published: November 2019

Background

T follicular helper (Tfh) cells have been identified as a new category of helper T cells, which express CXCR5 on their surface and induce the production of antigen-specific antibodies. Many investigations have found morbid proliferation and/or activation of Tfh cells in systemic autoimmune and allergic diseases. It is also known that Tfh cells are regulated by regulatory B (Breg) cells in the deteriorating such diseases. Recently, CXCL13, a ligand of CXCR5, has been reported to increase in the peripheral blood and lungs of patients with idiopathic pulmonary fibrosis (IPF). This study aimed to investigate the involvement of Tfh cells and Breg cells in IPF.

Methods

Peripheral blood samples were obtained from 18 patients with IPF. We isolated heparinized peripheral blood mononuclear cells and investigated the proportions of Breg cells, Tfh cells, PD-1+ICOS+ Tfh cells (activated form of Tfh cells), and the Tfh-cell subsets by flow cytometry. These cell profiles were compared with those of 21 healthy controls. Furthermore, we investigated the correlations between profiles of lymphocytes and lung physiology.

Results

The median proportions of Tfh cells per total CD4+ T cells and of PD-1+ICOS+ proportion of Tfh cells per total Tfh cells was significantly more in the IPF patients (20.4 and 5.2%, respectively) compared with healthy controls (15.4 and 2.1%, respectively; p = 0.042 and p = 0.004, respectively). The proportion of Tfh2 cells per total Tfh cells was significantly higher and the proportion of Tfh17 was smaller in the IPF patients than healthy controls. The percentage of Breg cells to total B cells was significantly decreased in the IPF patients (median, 8.5%) compared with that in the controls (median, 19.7%; p < 0.001). The proportion of Breg cells was positively correlated with the annual relative change in diffusing capacity of the lungs for carbon monoxide in the IPF patients (r = 0.583, p = 0.018).

Conclusion

Proliferation and activation of Tfh cells and a decrease in Breg cells were observed in the peripheral blood of patients with IPF. The profile of the Tfh-cell subset also changed. Specific humoral immunity aberration would likely underlie complicated pathophysiology of IPF.
Correction to: Concurrent psychiatry for patients enrolled in opioid agonist treatment: a propensity score matched cohort study in Ontario Canada
Authors: Morin Kristen A. , Eibl Joseph K. , Caswell Joseph M. , Gauthier Graham , Rush Brian , Mushquash Christopher , Lightfoot Nancy E. , Marsh David C.
Published: November 2019

Following publication of the original article [1], we have been notified that the following changes should occur in the content of the article. The details are below.
The best from East and West? Acupuncture and medical training therapy as monotherapies or in combination for adult patients with episodic and chronic tension-type headache: study protocol for a randomized controlled trial
Authors: Schiller J. , Kellner T. , Briest J. , Hoepner K. , Woyciechowski A. , Ostermann A. , Korallus C. , Sturm C. , Weiberlenn T. , Jiang L. , Egen C. , Beissner F. , Stiesch M. , Karst M. , Gutenbrunner C. , Fink M. G.
Published: November 2019

Background

This study aims to evaluate the feasibility and efficacy of a complex health intervention, based on the combination of conventional Western medicine and traditional Chinese medicine (TCM), in an outpatient department of a university hospital for patients with frequent episodic or chronic tension-type headaches.

Methods/design

This is a prospective randomized controlled pilot study with four balanced treatment arms (usual care, acupuncture, training, and training plus acupuncture). Each arm will have 24 patients. After the initial screening examination and randomization, a 6-week treatment period follows, with treatment frequencies decreasing at 2-week intervals. After completion of the intervention, two follow-up evaluations will be performed 3 and 6 months after the start of treatment. At predefined times, the various outcomes (pain intensity, health-related quality of life, pain duration, autonomic regulation, and heart rate variability) as well as the participants’ acceptance of the complex treatment will be evaluated with valid assessment instruments (Migraine Disability Assessment, PHQ-D, GAD-7, and SF-12) and a headache diary. The acupuncture treatment will be based on the rules of TCM, comprising a standardized combination of acupuncture points and additional points selected according to individual pain localization. The training therapy comprises a combination of strength training, endurance training, and training to improve flexibility and coordination. Besides descriptive analyses of the samples, their comparability will be assessed using an analysis of variance (ANOVA) or chi-squared tests. Analyses will be performed on an intention-to-treat basis. Potential interaction effects will be calculated using a repeated-measures ANOVA to test the primary and secondary hypotheses. In supplementary analyses, the proportion of treatment responders (those with a 50% reduction in the frequency of pain episodes) will be determined for each treatment arm.

Discussion

This trial may provide evidence for the additive effects of acupuncture and medical training therapy as a combination treatment and may scientifically support the implementation of this complex health intervention.

Trial registration

Registered on 11 Feburary 2019. German Clinical Trials Register, DRKS00016723.
Complete genome analysis of clinical Shigella strains reveals plasmid pSS1653 with resistance determinants: a triumph of hybrid approach
Authors: Muthuirulandi Sethuvel Dhiviya Prabaa , Veeraraghavan Balaji , Vasudevan Karthick , Devanga Ragupathi Naveen Kumar , Murugan Dhivya , Walia Kamini , Anandan Shalini
Published: November 2019

Shigella is ranked as the second leading cause of diarrheal disease worldwide. Though infection occurs in people of all ages, most of the disease burden constitutes among the children less than 5 years in low and middle income countries. Recent increasing incidence of drug resistant strains make this as a priority pathogen under the antimicrobial resistance surveillance by WHO. Despite this, only limited genomic studies on drug resistant Shigella exists. Here we report the first complete genome of clinical S. flexneri serotype 2a and S. sonnei strains using a hybrid approach of both long-read MinION (Oxford Nanopore Technologies) and short-read Ion Torrent 400 bp sequencing platforms. The utilization of this novel approach in the present study helped to identify the complete plasmid sequence of pSS1653 with structural genetic information of AMR genes such as sulII, tetA, tetR, aph(6)-Id and aph(3′’)-Ib. Identification of AMR genes in mobile elements in this human-restricted enteric pathogen is a potential threat for dissemination to other gut pathogens. The information on Shigella at genome level could help us to understand the genome dynamics of existing and emerging resistant clones.
Six weeks of balance or power training induce no generalizable improvements in balance performance in healthy young adults
Authors: Giboin Louis-Solal , Gruber Markus , Kramer Andreas
Published: November 2019

Background

Training programs for fall prevention often fail to induce large general effects. To improve the efficacy of fall prevention programs, it is crucial to determine which type of training is most effective in inducing generalizable effects, i.e., improvements in untrained situations. Two likely candidates are balance and resistance training. Here, we assessed whether either varied balance training or a training program aiming to increase leg power would improve performance and acquisition rate of a novel balance task.

Methods

Forty-two healthy recreationally active subjects (16 females, age 24 ± 3y) were assigned to a control group, a varied practice balance group or a loaded squat and plyometrics power group, training for 6 weeks (twice per week, 40 min per session). Before and after the training, we measured peak power in countermovement jumps and balance performance in two different untrained balance tasks (10 trials pre and 50 trials post-training).

Results

After training, the performance and the acquisition rate in the two untrained tasks were similar for all groups (no group x time interaction), i.e., no generalization of learning effect was induced by either form of training. Peak power in the countermovement jump did not change significantly in any of the groups.

Conclusions

Neither a six-week power training nor a varied balance training improved performance or acquisition of an untrained balance task. This underpins the task-specificity principle of training and emphasizes the need for studies that assess the mechanisms of transfer and generalization, thus helping to find more effective intervention programs for fall prevention.