bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of hyperuricemia in adolescents from 2000 to 2019 in Asia: A meta-analysis
Authors: Chen Lihui , Han Shuguang , Liu Fengjing , Chen Si , Chen Xiaoting , Chen Haibing
Published: May 2020

Background: Studies of the prevalence of hyperuricemia in adolescents have been limited to specific areas and the prevalence in Asia is unknown. Objectives: This study was to determine the prevalence of hyperuricemia in adolescents in Asia from 2000 to 2019.Data sources: A comprehensive search was conducted to identify all relevant cross-sectional studies in Pubmed, Embase, and Cochrane library databases.Study eligibility criteria: “hyperuricemia” and “adolescent” were the two critical inclusion criteria. Participants, and interventions: Adolescents;Study appraisal and synthesis methods: Two reviewers independently extracted data and assessed study quality using STROBE check list. Extracted information included the first author, study year, country, publication year, sample size, number of cases, and age of onset. Heterogeneity among studies was evaluated using the Q test and quantified using the I2 statistic. Subgroup analyses were performed to identify the source of the heterogeneity. The possibility of publication bias was assessed using Egger’s test. Results: The meta-analysis included 11 articles. The pooled prevalence of hyperuricemia in adolescents in Asia was 15.4% (95% CI 9.5-21.2%) and the prevalence of adolescents in Taiwan was higher than that in mainland China. The prevalence in coastal areas was higher than that in inland areas. The prevalence of men was higher than that of women. After excluding the high prevalence study in Taiwan, the prevalence of adolescents has been increasing year by year. Publication bias was observed but the results did not change after a trim and fill test, indicating that the impact of this bias was likely insignificant.Limitations: The diagnostic criteria for hyperuricemia for adolescents varied among the studies; some studies used their own cut-off values for hyperuricemia in adolescents.Conclusions and implications of key findings: Hyperuricemia prevalence in adolescents is high and continues to increase. The prevalence varies with geography, gender, and time. Effective measures should be taken to prevent any further increase in the incidence of adolescent hyperuricemia.Systematic review registration number: Not applicable.
Healthy aging through the lens of community-based practitioners: a focus group study
Authors: Dev Rubee , Zaslavsky Oleg , Cochrane Barbara , Eagen Thomas , Woods Nancy F
Published: May 2020

Background: Nearly one in every seven Americans is 65 years and older, facing day-to-day challenge of aging. Although interest in healthy aging is growing, most of the efforts are directed towards understanding the perceptions of older adults. Little is known about the perspectives of community-based practitioners who work with older adults and deliver programs to promote healthy aging. The purpose of this project was to expand knowledge on healthy aging by exploring the perspectives of community-based practitioners working directly with older adults. Methods: We purposively sampled community-based practitioners (n=12, including nurses, physician, social workers, and other community services professionals) working with older adults, who then participated in one of three in-depth focus group discussions conducted between March and June 2016. Each focus group discussion lasted for about two hours. Verbatim transcript data were analyzed in Atlas.ti 7 using a conventional content analysis with an inductive approach, and consensual validation of coding was achieved.Results: Three core categories of healthy aging were identified: (1) characteristics of healthy aging; (2) healthy aging attainment; and (3) programs and activities for healthy aging. Practitioners identified a number of characteristics of healthy aging under person-specific (physiological, basic, psych-emotional, and cognitive needs), social aspects (creating community and contributing to the community), and spiritual dimensions (cultural views and beliefs) of healthy aging. Healthy aging attainment was represented as facilitators and barriers both with respect to care recipients and care providers, and programs and activities through promoting fitness and wellness. Conclusions: The rapidly changing demographics and aging population in the United States and their various needs suggest the implications for recognizing opportunities and developing and implementing programs to promote healthy aging. Although practitioners’ perspectives had some overlap with traditional research and medical views on healthy aging, the unique and holistic conceptual framework derived in the study might provide a more refined foundation for delivering appropriate health care services to the American aging population.
Article Functional MYB transcription factor gene HtMYB2 is associated with anthocyanin biosynthesis in Helianthus tuberosus L.
Authors: Gao Jieming , Sun Xuemei , Zong Yuan , Yang Shipeng , Wang Lihui , Liu Baolong
Published: May 2020

Background: Tuber color is an important trait for Helianthus tuberosus L. (Jerusalem artichoke). Usually, purple tubers with high anthocyanin content are more nutritious than white tuber. But, the molecular mechanism underlying it is unknown. Results: In the current study, high-throughput RNA-sequencing was used to compare the transcriptomes between plants with tubers with red or white epidermis. Anthocyanin biosynthesis structural genes had greater expression in the red-skinned tubers of cultivar QY1, indicating that the anthocyanin biosynthesis pathway was activated in ‘QY1’; quantitative PCR confirmed this difference in expression. HtMYB2 (Unigene44371_All) was the only MYB transcription factor, homologous to the MYB transcription factor regulating anthocyanin biosynthesis, expressed in the red tuber epidermis of ‘QY1’. The anthocyanin concentration in the root, stem, leaf, flower, and tuber epidermis of ‘QY1’ was higher than in ‘QY3’, especially tuber epidermis. Correspondingly, HtMYB2 had greater expression in these tissues of ‘QY1’ than in ‘QY3’. The expression of HtMYB2 was associated with anthocyanin accumulation in the different tissues. Overexpression of HtMYB2 activated the anthocyanin biosynthesis pathway, accumulating the pigment in leaves of transgenic tobacco, supporting the model that HtMYB2 regulated anthocyanin biosynthesis. Further experiments found that HtMYB2 had the same coding sequence and genomic sequence in ‘QY1’ and ‘QY3’, but that there were several single nucleotide polymorphisms and one insertion–deletion (indel) mutation of 21 nucleotides in the promoter region between the two alleles. The deletion of three nucleotides “AAA” made the promoter of ‘QY1’ predicted to contain one more possible promoter region. A specific primer, based on the indel, could differentiate between cultivars with red or white tuber epidermis. The genetic variation in HtMYB2 was associated with the tuber skin color in a natural population. Conclusions: RNA-seq can successfully isolate the candidate gene ( HTMYB2 ) controlling anthocyanin biosynthesis in purple epidermis of Jerusalem artichoke tuber. HTMYB2 can regulate anthocyanin biosynthesis in plants and is closely related to the formation of purple phenotype in tubers. This study should be useful in understanding the genetic mechanism underlying different tuber skin colors and in breeding new H. tuberosus cultivars with different tuber skin colors.
MAGE-A4, NY-ESO-1 and SAGE mRNA expression rates and co-expression relationships in solid tumours
Authors: Ishihara Mikiya , Kageyama Shinichi , Miyahara Yoshihiro , Ishikawa Takeshi , Ueda Shugo , Soga Norihito , Naota Hiroaki , Mukai Katsumi , Harada Naozumi , Ikeda Hiroaki , Shiku Hiroshi
Published: May 2020

Background: Cancer testis (CT) antigens are promising targets for cancer immunotherapies such as cancer vaccines and genetically modified adoptive T cell therapy. In this study, we evaluated the expression of three CT antigens, melanoma-associated antigen A4 (MAGE-A4), New York oesophageal squamous cell carcinoma 1 (NY-ESO-1) and sarcoma antigen gene (SAGE). Methods: MAGE-A4, NY-ESO-1 and/or SAGE antigen expression in tumour samples was evaluated by quantitative real-time polymerase chain reaction (qRT-PCR). Informed consent was obtained from individuals prior to study enrolment. Results: In total, 585 samples in 21 tumour types were evaluated between June 2009 and March 2018. The positive expression rates of these CT antigens were as follows: MAGE-A4, 34.6% (range, 30.7-38.7); NY-ESO-1, 21.0% (range, 17.2-25.1); and SAGE, 21.8% (range, 18.5-25.4). The MAGE-A4 antigen was expressed in 54.9% of oesophageal cancers, 37.5% of head and neck cancers, 35.0% of gastric cancers and 34.2% of ovarian cancers; the NY-ESO-1 antigen was expressed in 28.6% of lung cancers, 25.3% of oesophageal cancers and 22.6% of ovarian cancers; and the SAGE antigen was expressed in 35.3% of prostate cancers, 32.9% of oesophageal cancers and 26.3% of ovarian cancers. The most common tumour type in this study was oesophageal cancer. MAGE-A4, NY-ESO-1 and SAGE antigen expression were assessed in 214 oesophageal cancer samples, among which 24 (11.2%) were triple-positive, 58 (27.1%) were positive for any two, 59 (27.6%) were positive for any one, and 73 (34.1%) were triple negative. Conclusions: Oesophageal cancer exhibited a relatively high rate of CT antigen mRNA expression positivity.
Elevated levels of miR-483-5p in oocytes aggravates premature ovarian insufficiency induced by CDDP by targeting the FKBP4
Authors: zhao huihui , Gu Wenqing , Ouyang Huogui , Pan Wenbin , Zhang Hanbin , Shuai Ling , Diao Ruiying , Wang Liping
Published: May 2020

Background: Premature ovarian insufficiency (POI) is characterized by a loss of ovarian function before 40 years-of-age and represents an existing challenge cause of female infertility. POI is one of the dominant causes of cis-diaminedichloroplatinum (cisplatin, CDDP)-induced reproductive impairment. However, the detailed mechanisms underlying POI induced by CDDP remain unclear.Methods: The POI C57B6/J mouse model was created by administering CDDP. The effects of FKBP4 were investigated using isobaric tags for relative and absolute quantification analysis (iTRAQ), real-time quantitative PCR (qRT-PCR) and western blotting. Target prediction was predicted using TargetScan software. Levels of sex hormones were tested using Enzyme-linked immunosorbent assays (ELISA).Results: We found that the FKBP4 protein was down-regulated in the ovaries of CDDP model. Target prediction identified FKBP4 as a potential target for miR-483-5p, which was expressed at high levels in both the ovaries and serum of CDDP-POI mice, and in the serum from POI patients. In vitro experiments further confirmed that FKBP4 was the target for miR-483-5p in human cervical cancer cells (HeLa). The overexpression of FKBP4 in human granulosa cells (KGN) alleviated the apoptosis caused by CDDP and the overexpression of miR-483-5p. Furthermore, the overexpression of miR-483-5p in oocytes caused injury to the ovaries, and disrupted the levels of sex hormones in CDDP-POI mice (AMH: P < 0.01; E2: P < 0.01; FSH: P < 0.01).Conclusions: Analyses showed that miR-483-5p targets the FKBP4 protein in a mouse model of POI induced by CDDP. Elevated levels of miR-483-5p in oocytes could aggravate POI induced by CDDP by targeting FKBP4. Overall, our data demonstrate that miR-483-5p was responsible for the underlying pathophysiology of POI induced by chemotherapeutic treatments, such as CDDP.
Activated CAMKKβ-AMPK Signaling Promotes Autophagy in a Spheroid Model of Ovarian Tumour Metastasis
Authors: Laski Jeremi , Singha Bipradeb , Wang Xu , Valdés Yudith Ramos , Collins Olga , Shepherd Trevor
Published: May 2020

Background A hallmark of epithelial ovarian cancer (EOC) metastasis is the process of spheroid formation, whereby tumour cells aggregate into 3D structures while in suspension in the peritoneal cavity. EOC spheroids are subjected to bioenergetic stress, thereby activating AMP-activated protein kinase (AMPK) signaling to enter a metabolically quiescent state, which can facilitate cell survival under nutrient-limiting conditions. Independently, we have also demonstrated that EOC spheroids induce autophagy, a process that degrades and recycles intracellular components to restore energy and metabolites. Herein, we sought to examine whether AMPK controls autophagy induction as a cell survival mechanism in EOC spheroids. Results We observed a co-ordinate increase in phosphorylated AMPK and the autophagy marker LC3-II during EOC spheroid formation. Reduced AMPK expression by siRNA-mediated knockdown of PRKAA1 and PRKAA2 blocked autophagic flux in EOC spheroids as visualized by fluorescence microscopy using the mCherry-eGFP-LC3B reporter. A complementary approach using pharmacologic agents Compound C and CAMKKβ inhibitor STO-609 to inhibit AMPK activity both yielded a potent blockade of autophagic flux as well. However, direct activation of AMPK in EOC cells using oligomycin and metformin was insufficient to induce autophagy. STO-609 treatment of EOC spheroids resulted in reduced viability in 7 out of 9 cell lines, but with no observed effect in non-malignant FT190 cell spheroids. Conclusions Our results support the premise that CAMKKβ-mediated AMPK activity is required, at least in part, to regulate autophagy induction in EOC spheroids and support cell viability in this in vitro model of EOC metastasis.
Initial experience of complete laparoscopic radical nephroureterectomy combined with transvesical laparoscopic excision of distal ureter in patients with upper urinary tract cancer
Authors: Miyake Makito , Nishimura Nobutaka , Aoki Katsuya , Ohmori Chihiro , Shimizu Takuto , Owari Takuya , Hori Shunta , Morizawa Yosuke , Gotoh Daisuke , Nakai Yasushi , Anai Satoshi , Torimoto Kazumasa , Tanaka Nobumich , Fujimoto Kiyohide
Published: May 2020

Background: Selecting the treatment procedure for cancer patients is a challenging task. We report our initial experience of complete laparoscopic radical nephroureterectomy (RNU) for patients with upper urinary tract urothelial cancer (UTUC).Methods: A total of four patients with UTUC underwent complete laparoscopic RNU combined with transvesical laparoscopic excision of the distal ureter using three 5-mm ports. Transvaginal specimen extraction was applied in female patients to reduce incisional pain and improve cosmesis. Peri-operative complications were evaluated using the Clavien–Dindo classification system. Postoperative pain was evaluated during hospitalization using a numeric pain rating scale (scales of 1 to 10). Patients who underwent retroperitoneal laparoscopic surgery combined with open excision of the distal ureter during the same period were included as a control group (conventional RNU, consisting of laparoscopic nephrectomy with open bladder cuff excision) for pain scale evaluation.Results: The novel surgery was successfully completed for all four patients (two males and two females). The mean pneumoperitoneum time for retroperitoneoscopic nephroureterectomy and specimen extraction was 174 min, while the mean pneumovesicum time for the ureteral orifice excision was 88 min. One male patient had bladder leakage at the suture site of the bladder wall, which lasted for two weeks. No patient experienced recurrent disease during the follow-up period (median, 10 months). Mild to moderate pain lasted for 5 or 6 days after RNU. A couple of days after surgery, the numeric pain rating scale of complete laparoscopic RNU and conventional RNU group reached its peak level at 3.0 ± 1.8 and 5.3 ± 2.8, respectively. There was no statistical difference in the degree of postoperative pain (P=0.31).Conclusions: We described our initial experience and outcome of complete laparoscopic RNU for UTUC. Further experience and research are required to determine whether this advanced laparoscopic technique yields better outcomes and has true clinical value.
The use of information and communication technologies in Latin American dentists: A Cross-Sectional Study from Ecuador
Authors: Cherrez-Ojeda Ivan , Vera-Paz Carlos A. , Vanegas Emanuel , Gallardo Juan Carlos , Felix Miguel , Espinoza-Fuentes Fernando , Chedraui Peter , Gavilanes Danilo , Mata Valeria
Published: May 2020

Background: The use of information and communication technologies (ICTs) provide the tools for enabling fast and reliable real-time communications, as well as the transfer of information between dental professionals and their patients. However, little is known about the frequency and preference of ICTs among Latin-American dentists. Our study aims to fill this gap by assessing different aspects related to ICTs, mainly the frequency of use, perceptions, and barriers among Ecuadorian dentists. Methods: An anonymous, cross-sectional survey-based study was conducted among 342 Ecuadorian dentists. The final questionnaire included 13 items related to the frequency of use, perceptions, and barriers of ICTs. Bivariate analysis was performed by using chi-squared testing to explore the association between the independent variables and the intended use of ICTs, as well as to characterize the perceptions and barriers related to ICTs. Results: In general, most participants reported the use of ICTs to communicate with colleagues (99.7%), and patients (96.2%), while only 63.5% reported using ICTs to obtain academic information in their daily practice. WhatsApp was rated as the most used ICT for communicating with colleagues and patients. A majority of participants considered that ICTs can be useful for facilitating continuing dental education (92.1%), searching new work opportunities (91.5%), promoting health (90.1%), working with colleagues and other health professionals (91.2%), promoting their professional services (90.6%), and for resolving clinical cases (87.7%). On the subject of barriers, privacy and security concerns about personal and/or patient information was the biggest concern among dentists (65%), followed by lack of time to learn how to use and/or use ICTs (48%), lack of mobile internet access (28.1%), and lack of internet access at work (24.9%). Conclusion: In our study, we found that Ecuadorian dentists had a high usage rate of ICTs, mainly for communicating with other colleagues and patients, while the academic use of technology remains a comparatively underused application. Most participants had a positive perception towards ICTs, while privacy and security concerns were identified as the main barrier. Older age was associated with a less favourable perception as well as an increased likelihood of reporting barriers related to the use of technology.
Factors affecting tracheostomy in critically ill paediatric patients in Japan: a data-based analysis
Authors: Ishihara Tadashi , Tanaka Hiroshi
Published: May 2020

BACKGROUND: There has been an increasing number of children surviving with high medical needs, for whom tracheostomy and/or home ventilation is part of their chronic disease management. The purpose of this study was to describe the indications, epidemiology, frequency, and associated factors for tracheostomy in critically ill paediatric patients using the data available in the Japanese Registry of Paediatric Acute Care (JaRPAC).METHODS: This multicentre epidemiologic study collected data concerning paediatric tracheostomy from the JaRPAC database. Patients were divided into two groups: those with or without tracheostomies when they were discharged from the ICU or PICU. Consecutive patients aged ≤ 16 years who did not undergo tracheostomy when admitted to ICU or PICU between April 2014 and March 2017 were included.RESULTS: A total of 23 hospitals participated, involving 6,199 paediatric patients registered in the JaRPAC database during the study period. Of the registered paediatric patients, 5,769 (95%) patients were admitted to the ICUs or PICUs without tracheostomies. Among the patients, 181 patients (3.1%) had undergone tracheostomies. There were significant differences in chronic conditions (134, 74.0% versus 3096, 55.4%, p < 0.01), chromosomal anomalies (19, 10.5% versus 326, 5.8%, p < 0.01), urgent admission (151, 83.4% versus 3093, 55.4%, p < 0.01). More tracheostomies were performed on patients who were admitted for respiratory failure (61, 33.7% versus 926, 16.1%, p < 0.01) and for post-cardiac pulmonary arrest (CPA) resuscitation (40, 22.1% versus 71, 1.1%, p < 0.01).CONCLUSIONS: This is the first report to use a large-scale registry of critically ill paediatric patients in Japan to describe the interrelated factors of tracheostomies. Chronic conditions (especially for neuromuscular disease), chromosomal anomaly, urgent admission, admission due to respiratory failure, or treatment for post-CPA resuscitation all had the possibility to be risk factors for tracheostomy.
Ice accommodation in plant tissues pinpointed by cryo-microscopy in reflected-polarised-light
Authors: Stegner Matthias , Wagner Johanna , Neuner Gilbert
Published: May 2020

Background Freezing resistant plant organs are capable to manage ice formation, ice propagation, and ice accommodation down to variable temperature limits without damage. Insights in ice management strategies are essential for the fundamental understanding of plant freezing and frost survival. However, knowledge about ice management is scarce. Ice crystal localization inside plant tissues is challenging and is mainly based on optical appearance of ice in terms of colour and shape, investigated by microscopic methods. Notwithstanding, there are major uncertainties regarding the reliability and accuracy of ice identification and localisation. Surface light reflections, which can originate from water or resin, even at non-freezing temperatures, can have a similar appearance as ice. We applied the principle of birefringence, which is a property of ice but not of liquid water, in reflected-light microscopy to localise ice crystals in frozen plant tissues in an unambiguous manner. Results In reflected-light microscopy, water was clearly visible, while ice was more difficult to identify. With the presented polarised cryo-microscopic system, water, including surface light reflections, became invisible, whereas ice crystals showed a bright and shiny appearance. Based on this, we were able to detect loci where ice crystals are accommodated in frozen and viable plant tissues. In Buxus sempervirens leaves, large ice needles occupied and expanded the space between the adaxial and abaxial leaf tissues. In Galanthus nivalis leaves, air-filled cavities became filled up with ice. Buds of Picea abies managed ice in a cavity at the bud basis and between bud scales. By observing the shape and attachment point of the ice crystals, it was possible to identify tissue fractions that segregate intracellular water towards the aggregating ice crystals. Conclusion Cryo-microscopy in reflected-polarised-light allowed a robust identification of ice crystals in frozen plant tissue. It distinguishes itself, compared with other methods, by its ease of ice identification, time and cost efficiency and the possibility for high throughput. Profound knowledge about ice management strategies, within the whole range of freezing resistance capacities in the plant kingdom, might be the link to applied science for creating arrangements to avoid future frost damage to crops.
Promotion of ubiquitination-dependent survivin destruction contributes to xanthohumol-mediated tumor suppression and overcomes radioresistance in human oral squamous cell carcinoma
Authors: li ming , gao feng , yu xinfang , zhao qiung , zhou li , liu wenbin , li wei
Published: May 2020

Background: Overexpression of survivin plays a crucial role in tumorigenesis and correlates with poor prognosis in human malignancies. Thus, survivin has been proposed as an attractive target for new anti-tumor interventions. Methods: A natural product library was used for natural compound screening through MTS assay. The expression of survivin in oral squamous cell carcinoma (OSCC) and the inhibitory effect of xanthohumol (XN) on OSCC were examined by anchorage-dependent and -independent growth assays, immunoblot, immunofluorescence, immunohistochemical staining, ubiquitination analysis, co-immunoprecipitation assay, CRISPR-Cas9-based gene knockout, and xenograft experiment. Results: Survivin is highly expressed in OSCC patient-derived tissues and cell lines. Knockout of survivin reduced the tumorigenic properties of OSCC cells in vitro and in vivo . With a natural compound screening, we identified that xanthohumol inhibited OSCC cells by reducing survivin protein level and activating mitochondrial apoptotic signaling. Xanthohumol inhibited the Akt-Wee1-CDK1 signaling, which in turn decreased survivin phosphorylation on Thr34, and facilitated E3 ligase Fbxl7-mediated survivin ubiquitination and degradation. Xanthohumol alone or in combination with radiation overcame radioresistance in OSCC xenograft tumors. Conclusion: Our findings indicate that targeting survivin for degradation might a promising strategy for OSCC treatment.
Effects of reflection and immediate feedback to improve clinical reasoning of medical students in the assessment of dermatologic conditions: A randomised controlled trial
Authors: Choi Sungjun , Oh Sohee , Lee Dong-Hun , Yoon Hyun-Sun
Published: May 2020

BACKGROUND: There are few studies that directly compared different interventions to improve medical students’ clinical reasoning for dermatologic conditions. OBJECTIVE: To investigate the effectiveness of adding practice with reflection and immediate feedback on traditional dermatology electives in improving medical students' ability in evaluating skin lesions. METHODS: The participants were fourth-year medical students of Seoul National University College of Medicine, Korea, who were enrolled to take a 2-week dermatology elective course (n=87). Students were assigned to one of the three educational interventions: 2-hour training involving 10 written clinical cases (experimental); 1-hour lecture and 1-hour outpatient clinic (lecture); and 2-hour outpatient clinic (no intervention). Before and at the end of rotation, diagnostic accuracy was estimated using 20 written clinical cases with photographs (10 novel cases presented in diagnostic training [training set], 10 cases with diagnoses not included in training [control set]). RESULTS: There was a significant interaction effect of intervention×set×time. A post hoc analysis indicated that the students in the experimental group outperformed students in the other two groups only in the training set of the final tests; after completing the 2-week rotation, for the training set, the mean score was higher in the experimental group (7.5±1.3) than in the lecture (5.7±1.6) and no intervention (5.6±1.3) groups, producing an effect size of 1.2 standard deviation (SD) and 1.5 SD, respectively. CONCLUSION: Practicing written clinical cases with reflection and feedback is superior to a lecture-based approach and yields additional benefits to a dermatology elective, thereby enhancing medical students’ ability to accurately diagnose skin lesions. Trial registration: ClinicalTrials.gov, NCT03472001. Registered 21 March 2018, https://clinicaltrials.gov/ct2/show/NCT03472001
Left Atrial Strain and Diastolic Function Abnormalities in Obese and Type 2 Diabetic Adolescents and Young Adults.
Authors: Steele Jeremy Mark , Urbina Elaine M , Mazur Wojciech M , Khoury Philip R , Nagueh Sherif F , Tretter Justin T , Alsaied Tarek
Published: May 2020

Background
Adults with obesity and type 2 diabetes mellitus (T2DM) related to obesity are at increased risk of heart failure with preserved ejection fraction (HFpEF). Whether left ventricular (LV) diastolic function abnormalities related to obesity and T2DM start in adolescence and early adulthood is unknown. We non-invasively evaluated the differences seen in LV diastolic and left atrial (LA) function in adolescents and young adults with obesity and T2DM.
Methods
We analyzed echocardiographic measures of LV diastolic function in patients with structurally normal hearts which were divided into 3 groups (normal weight, obese, and T2DM). Spectral and tissue Doppler and 2-D speckle tracking measurements of diastolic function were obtained. Logistic regression was performed to compare the prevalence of abnormalities in diastolic function based on the worst 25th percentile for each measure to determine the prevalence of diastolic and LA function abnormalities in obese and T2DM patients.
Results
331 teenagers and young adults (median age 22.1 years) were analyzed (101 normal weight, 114 obese, 116 T2DM). Obese and T2DM group had lower E/A and higher E/e’. Obese and T2DM patients had significantly lower atrial reservoir, conduit, and booster strain and worse reservoir and conduit strain rate compared to normal patients (p < 0.001 for all measures). All patients had normal LA volumes. On multivariable analysis, conduit strain and reservoir and conduit strain rate were independently associated with having below the 25th percentile e’. Conduit strain rate was independently associated with having below the 25th percentile for mitral E/A ratio on multivariable analysis.
Conclusions
Abnormal indices of LV diastolic function are detected in adolescents and young adults with obesity and T2DM. LA function and strain analysis were able to detect evidence of decreased reservoir, conduit, and booster strain in these patients although LA volume was normal. The use of LA function strain may increase our ability to detect early diastolic function abnormalities in this population.
Occurrence and predictive risk factors associated with in-stent restenosis after drug-eluting stent implantation in diabetic patients: a prospective, clinical cohort study
Authors: Zhao ShengGang , Xu Jian-Jiang , Jiang Li-Qin , Chu Zhen-Liang , Tao An-Qian , Jin Lei , Han Ji-Bo , Zhang Bin , Zheng Zhan-Xiong , Shi Feng-Jie , Zhang Ran , Zhang Xiang-Yu , Jiang Fen-Fen , Han Bing-Jiang
Published: May 2020

Background

The incidence of in-stent restenosis (ISR) in patients with diabetes mellitus (DM) after percutaneous coronary intervention (PCI) is significantly higher than that in patients without DM, but the mechanism is not clear. We hypothesised that patients with and risk factors including dyslipidaemia, elevated inflammatory factors would be prone to induction of ISR, and that dynamic observation of the comprehensive risk factor changes before and after PCI would be helpful to identify ISR .
Methods

This prospective cohort study consecutively enrolled 360 patients who received coronary drug-eluting stent implantation. Patients who underwent coronary angiography (CAG) and received clinical follow-up were prospectively reviewed. The patients were assigned to a DM (262) or a non-DM (98) group. The patients were further assigned according to whether ISR was present to the non-DM + non-ISR, non-DM + ISR, DM + non-ISR, and DM + ISR groups. The patients were further assigned according to whether low-density lipoprotein (LDL-c) was decreased more than 50% compared with baseline, or was less than 1.80 mmol/L in the follow-up, to the LDL-c achieved or the LDL-c failure groups.
Results

DM patients were prone to develop ISR after PCI and the degree of coronary stenosis was more severe than in non-DM patients. This result was more striking in DM and LDL-c failure patients. The levels of total cholesterol (TC), triglyceride, high-density lipoprotein (HDL-c), LDL-c, apolipoprotein B100, apolipoprotein E, remnant lipoprotein, TC/HDL-c ratio and triglyceride/HDL-c ratio in the DM + non-ISR were similar to those in the DM + ISR group before PCI and CAG. .The DM + ISR group had the highest levels of haemoglobin A1c and the highest Gensini scores. The inflammatory index changes including leukocytes and neutrophils were the most striking in the DM + ISR group. In multivariate regression analysis, neutrophil changes and glycosylated haemoglobin were independent risk factors for ISR [△neutrophil, OR 1.929,95% CI 1.216–3.058; HbA1-c OR 1.559,95% CI 1.001–1.707].
Conclusion

Coronary artery disease patients with DM had a high risk for ISR if they had preoperative risk factors including dyslipidaemia, elevated inflammatory factors, and a high Gensini score. Dynamic observation of the changes of the preoperative and postoperative comprehensive risk factors was helpful to identify ISR in patients with DM.
Antimicrobial Activity Screening of Rhizosphere Soil Bacteria from Tomato and Genome-Based Analysis of their Antimicrobial Biosynthetic Potential
Authors: Zhou Lu , Song Chunxu , Li Zhibo , Kuipers Oscar P.
Published: May 2020

Background: Tomato plant growth is frequently hampered by a high susceptibility to pests and diseases. Traditional chemical control causes a serious impact on both the environment and human health. Therefore, seeking environment-friendly and cost-effective green methods in agricultural production becomes crucial nowadays. Plant Growth Promoting Rhizobacteria (PGPR) can promote plant growth through biological activity. Their use is considered to be a promising sustainable approach for crop growth. Moreover, a vast number of biosynthetic gene clusters (BGCs) for secondary metabolite production are being revealed in PGPR, which helps to find potential anti-microbial activities for tomato disease control.Results: We isolated 351 bacterial strains (181 of which are Bacillus sp.) from healthy tomato, rhizosphere soil, and tomato tissues. In vitro antagonistic assays revealed that 34 Bacillus strains have antimicrobial activity against Erwinia carotovora, Pseudomonas syringae; Rhizoctonia solani; Botrytis cinerea; Verticillium dahliae and Phytophthora infestans. The genomes of 10 Bacillus and Paenibacillus strains with good antagonistic activity were sequenced. Via genome mining approaches, we identified 120 BGCs encoding NRPs, PKs-NRPs, PKs, terpenes and bacteriocins, including known compounds such as fengycin, surfactin, bacillibactin, subtilin, etc. In addition, several novel BGCs were identified. We discovered that the NRPs and PKs-NRPs BGCs in Bacillus species are encoding highly conserved known compounds as well as various novel variants.Conclusions: This study highlights the great number of varieties of BGCs in Bacillus strains. These findings pave the road for future usage of Bacillus strains as biocontrol agents for tomato disease control and are a resource arsenal for novel antimicrobial discovery.
BMP4 Signaling Activates the Wnt-Lin28A-Blimp1-Wnt Positive Feedback Pathway to Promote Primordial Germ Cell Formation via Altering H3K4me2
Authors: Zuo Qisheng , Zhang Yani , Chen Guohong , Li Bichun
Published: May 2020

(Background) The unique developmental characteristics of bird primordial germ cells (PGC) have enabled genetic engineering–based breeding and restoration of endangered birds via transplantation in vitro. However, the limited number of PGC has limited their application. Thus, there is an urgent need to elucidate the mechanism of PGC formation in vitro to enhance its efficiency. (Results) Here, we confirmed that activation of BMP4 and Wnt signaling (Wnt5A/β-catenin/TCF7L2) is critical for PGC formation via RNA-seq (ESCs, PGC and SSCs) and in vitro induction models. Wnt signaling activated via BMP4 in turn activates transcription of Lin28A by inducing β-catenin to compete with LSD1 for binding to the transcription factor TCF7L2, causing LSD1 to dissociate from the Lin28A promoter and enhanced H3K4me2 methylation in this region. Lin28A promotes PGC formation by inhibiting gga-let7a-3p maturation to initiate Blimp1 expression. Interestingly, expression of Blimp1 helped sustain Wnt5A expression by preventing LSD1 binding to the Wnt5A promoter. We thus elucidated a positive feedback pathway involving Wnt-Lin28-Blimp1-Wnt, with BMP4 functioning as an activator that ensures PGC formation. (Conclusion) In summary, our study clarified the molecular mechanism by which BMP4 and Wnt signaling regulate PGC formation via a positive feedback system. Our data provide both a theoretical and technical basis for studies aimed at enhancing the generation of PGC in vitro.
A Survey of U.S. Medical School Full-Time Faculty Members Age 55+ One-fifth are caregivers and most report caregiving strain
Authors: Skarupski Kimberly Ann , Roth David L , Durso Samuel C
Published: May 2020

Background Nearly one-third of medical school faculty members are age 55+. As the global population ages, the prevalence of family caregiving is increasing, yet we know very little about the caregiving experiences of aging faculty members in academic medicine. Faculty caregiving responsibilities coupled with projected physician shortages and burnout will likely impact the workforce. We examined the prevalence of caregiving and concomitant caregiving strain and well-being differences between aging, male and female medical school faculty members.Methods We analyzed data from a survey of 2,126 full-time medical school faculty 55 + years of age conducted in 2017. We used chi-square tests of independence and independent samples t-tests to calculate statistical differences between groups.Results Of the faculty members invited to participate, 40.8% completed the survey (N = 2,126). Most were male (1,425; 67.2%), white (1,841; 88.3%), and married/partnered (1,803; 85.5%). The mean age was 62.3 years. Of this sample, 19.0% reported providing care on an on-going basis to a family member, friend, or neighbor with a chronic illness or disability (17.3% [n = 242] of the 1,425 males and 22.4% [n = 154] of female respondents). Among the 396 caregiving faculty members, 90.2% reported experiencing some or a lot of mental or emotional strain from caregiving. Compared to their female faculty caregiver counterparts, males were older (mean age 62.3 years vs. 60.0) and more likely to be married and not living alone.Conclusion These data highlight caregiving responsibilities and significant concomitant mental or emotional strain of a significant proportion of U.S. medical schools’ rapidly aging workforce. Human resource leaders in academic medicine should increase attention to these expanding needs.
Oncologic results in rectal cancer patients with a subcentimeter distal margin after laparoscopic-assisted sphincter-preserving surgery by stratified analysis
Authors: Zhang Chenghai , Yang Hong , Cui Ming , Xing Jiadi , Yao Zhendan , Tan Fei , Zhang Nan , Chen Lei , Liu Maoxing , Xu Kai , Su Xiangqian
Published: May 2020

Background

Distal resection margin (DRM) is closely associated with sphincter-preserving surgery and oncologic safety for patients with mid-low rectal cancers. However, the optimal DRM has not been determined. The purpose of this study to assess the impact of a DRM of ≤ 1 cm on oncologic safety.
Methods

Data of 378 patients who underwent laparoscopic-assisted sphincter-preserving surgery from 2009 to 2015 were retrospectively analyzed. Patients were divided into two groups based on DRM: ≤ 1 cm (n = 74) and > 1 cm (n = 304). Stratified analysis was performed according to neoadjuvant chemoradiotherapy.
Results

On the whole, no significant differences in 5-year disease-free survival (DFS) (92.8 vs. 81.3%; P = 0.128) and 5-year overall survival (OS) (83.7 vs. 82.2%; p = 0.892) were observed in patients with DRMs of ≤ 1 and > 1 cm, respectively. A total of 44 patients received preoperative chemoradiotherapy. In this cohort, the 5-year local recurrence (LR) rates ( p = 0.118) and the 5-year DFS rates ( p = 0.298) were not significantly different between the two groups. A total of 334 patients received surgery without neoadjuvant chemoradiotherapy. There were also no significant differences in the 5-year LR rates ( p = 0.150) and 5-year DFS rates ( p = 0.172) between the two groups.
Conclusions

No matter whether patients with rectal cancers received neoadjuvant therapy or not, sphincter-preserving surgery with a DRM ≤ 1 cm may be acceptable in low rectal cancer without jeopardizing oncologic safety.
Development and Feasibility of A Tailored Habit-based Dietary Intervention Coupled With Oral Rehabilitation On The Nutritional Status Of Older Patients
Authors: McCrum Leigh-Ann , Watson Sinead , McGowan Laura , Mcguinness Bernadette , Cardwell Chris , Clarke Mike , Woodside Jayne V , McKenna Gerry
Published: May 2020

BackgroundOlder adults suffering partial tooth loss may need additional intervention strategies other than oral rehabilitation alone to improve their nutritional status. This study aimed to design and develop a habit-based tailored dietary intervention and to assess the feasibility and acceptability of the intervention, in conjunction with oral rehabilitation, amongst partially dentate older adults.MethodsThe design and development of the dietary intervention (Phase 1) consisted of analysis of the target population’s dietary intake and qualitative research through focus groups with community-dwelling older adults (aged 65 years and over). Feasibility of the intervention was then tested among older adults receiving oral rehabilitation in a small non-randomised single arm study (Phase 2). The primary feasibility outcome was the usability and acceptability of the intervention which was measured using evaluation questionnaires and by conducting post-intervention semi-structured interviews. Secondary outcomes consisted of feasibility of screening procedures; recruitment strategies; and retention/ attrition rates as well as the participant’s compliance to the intervention assessed through self-monitoring tracking sheets.ResultsTwenty-one older adults (mean [SD] age 72.1 [10.4].) took part in one of four focus group discussions (Phase 1). Twelve themes related to barriers (e.g oral health, appetite) and facilitators (e.g nutritional knowledge, retirement) of healthy eating guided intervention development, as did a further five themes when asked for direct intervention feedback. Nine older adult participants (mean [SD] age 72.5[9.7]) were recruited into the feasibility study (Phase 2) where eight themes were identified from feedback interview discussions. Primary outcome measures identified intervention feasibility as participants considered the intervention acceptable and useable as both the evaluation questionnaire and qualitative interview results were overwhelmingly positive. As a secondary outcome measure, strong intervention compliance was also achieved. Screening procedures were accepted but additional recruitment strategies (e.g incorporation of home study visits or recruitment via posters advertisement) may benefit future study enrolment and retention.ConclusionPhase 1 and Phase 2 findings have allowed for an iterative, user-driven intervention to be developed and refined for a randomised control study to evaluate the intervention’s effectiveness.Trial registration: ISRCTN66118345
Efficacy of Integrative Chinese-Western Medicine Treatments for COVID-19 Patients in ICU in Yichang, Hubei, China
Authors: Yuan Ziwen , Zhang Min , Li Jingcheng , Peng Ting , Liang Chen , Lin Zhengfeng , Ming Quan , Peng Qiuping , Fang Run , Zhao Weijun , Luo Bin , Liu Hongbo , Wei Xiaojie , Huang Wusong , Shao Yanfeng , Xiong Shengnan
Published: May 2020

Background The prognosis of severe COVID-19 patients is poor. There are currently no definitely effective vaccines or antivirus drugs for COVID-19.Methods This prospective cohort study compared the efficacy and safety of integrative Chinese-Western medicine (ICWM) treatments with Western medicine (WM) treatments in severe or critically ill patients. The outcomes included: mortality, hospital stay in ICU, days with ventilator-assisted ventilation, etc.Results A total of 36 confirmed COVID-19 patients in ICU were included. The median age of patients was 66 years (IQR: 53-77.5), and there were 16 female patients (44.4%). There were no significant differences in laboratory tests and complications after treatments between groups. A total of 18 (50%) patients died during hospitalization, and the mortality in the ICWM group (28.6%) was significantly lower than that of the WM group (63.6%, adjusted P = 0.031). And the time of assisted ventilation was shorter in the ICWM group (adjusted P = 0.67). However, the median hospital stay was significantly longer in the ICWM group (18 vs. 14 days, adjusted P༜0.05).Conclusions ICWM treatments could significantly reduce the mortality and improve the clinical symptoms for severe or critically ill patients with COVID-19, and it was safe and cost-effective to add Chinese medicine.
Bile acids increase intestinal markers via FXR/SNAI2/miR-1 axis in the stomach
Authors: Wang Na , Chen Min , Zeng Jiaoxia , Lu Guofang , Wang Jiaojiao , Zhang Jian , Wu Siran , Shi Yongquan
Published: May 2020

Background

Intestinal metaplasia (IM) is a precancerous lesion that increases risk of subsequent gastric cancer (GC). However, factors governing the transformation from normal gastric epithelial cells to IM remain unclear. Previously, miR-1 turned out to play an essential role in the initiation of bile acids (BA)-induced IM. Here, we investigate the mechanism underlying miR-1 inhibition by BA in gastric cells.
Methods

We conducted IPA analysis to determine the potential molecular interacting BA with miR-1. The changes of FXR and SNAI2 after BA treatment were detected by western blot and qRT-PCR. IHC was performed to assess the expression level of FXR and SNAI2 in normal and IM tissue microarrays. The transcriptional regulation of SNAI2 or miR-1 was verified by bioinfamatics, luciferase reporter assay and chromatin immunoprecipitation PCR.
Results

BA treatment caused aberrant expression of FXR and IM markers in gastric cells. Augmented FXR led to the transcriptional activation of SNAI2 which further stimulates the expression of downstream IM markers. Bioinformatics analysis indicated that SNAI2 had miR-1 promoter binding region and we identified that SNAI2 negatively regulated miR-1 transcription. Both FXR and SNAI2 were increased in patients with IM.
Conclusions

This study demonstrated that FXR might be responsible for a series molecular changes in gastric cells after BA, and FXR/SNAI2/miR-1 axis exert a crucial role in BA-induced IM progression. Blocking the activation of the FXR-oriented axis may provide a promising approach for IM or even GC treatment.
The analysis of Upper tract Urinary Stone Composition in HIV-positive Patients: a single center experience
Authors: Menghua Wu , Xin Zheng , Bohan Fan , Yu Zhang , Jimao Zhao
Published: May 2020

Background

To appraise the most common stone composition, serum and urinary biochemical features in HIV-positive patients with urolithiasis.
Methods

We retrospectively searched the records of HIV-positive patients in our stone registry. A retrospective study was generated from our registry. Collecting statistics about fundamental indexes and analyzing them is our basic procedure. Medications were considered. Groups were compared using the Student t and chi-square/Fisher exact tests with significance considered at p < 0.05.
Results

In total of 101 patients were included age, gender, Body Mass Index(BMI), serum calcium, serum uric acid(UA), stone position, and operative method were statistically described. The serum UA of HIV-positive group was higher than that of the negative group (P = 0.028). Patients with HIV-infected had a higher incidence of calcium oxalate dehydrate (CaODH) (p < 0.001). The evaluation of overall stone composition showed that the number of CaODH was higher in HIV-positive group (21.4% vs 8.5%, p < 0.001). There was no significant difference in single calcium oxalate monohydrate(CaOMH) (p = 0.146), and UA (p = 0.7) between the two groups.
Conclusions

In our study the highest stone proportion in HIV patients is calcium oxalate (CaO). HIV positive patients should pay attention to the diet, especially the food containing more calcium. In HIV-positive patients, the level of serum UA should be controlled accordingly. In the development of highly active antiretroviral therapy (HARRT), for low-risk patients, it may not be necessary to consider too much the factors of protease inhibitors (PIs) and other drugs forming urinary calculus.