bluuebunny/crossref_metadata_2025 huggingface dataset:
Genome-wide analysis of RopGEF gene family to identify genes contributing to pollen tube growth in rice (Oryza sativa)
Authors: Kim Eui-Jung , Park Sung-Wook , Hong Woo-Jong , Silva Jeniffer , Liang Wanqi , Zhang Dabing , Jung Ki-Hong , Kim Yu-jin
Published: February 2020

Background: In plants, the key roles played by RopGEF-mediated ROP signaling in diverse processes, including polar tip growth, have been identified. Despite their important roles in reproduction, a comprehensive analysis of RopGEF members has not yet been performed in rice (Oryza sativa). To determine whether RopGEF regulators are involved in rice pollen tube growth, we performed genome-wide analysis of this family in rice.Results: Phylogenomic and meta-expression analysis of eleven RopGEFs in rice showed that four genes were preferentially expressed in mature pollen. These four genes contain the plant-specific Rop nucleotide exchanger (PRONE) domain and possible phosphorylated residues, suggesting a conserved role in polar tip growth with Arabidopsis thaliana. In subcellular localization analysis of the four RopGEFs through tobacco (Nicotiana benthamiana) infiltration, four proteins were predominantly identified in plasma membrane. Moreover, double mutants of RopGEF2/8 exhibited reduced pollen germination, causing partial male sterility. These genes possess unique cis-acting elements in their promoters compared with the other RopGEF genes. Conclusions: In this study, four RopGEF genes were identified as pollen-specific gene in eleven members of rice, and the expression pattern, promoter analysis, and evolutionary relationship of the RopGEF family were studied compared with Arabidopsis. Our study indicated that four RopGEF genes might function during pollen germination in distinct subcellular localization. Our study could provide valuable information on the functional study of RopGEF in rice.
Serum levels of soluble programmed death-ligand 1 (sPD-L1) in patients with primary central nervous system diffuse large B-cell lymphoma
Authors: Cho Inju , Lee Hansang , Yoon Sang Eun , Ryu Kyung Ju , Ko Young Hyeh , Kim Won Seog , Kim Seok Jin
Published: February 2020

Background The interaction of programmed death-1 protein (PD-1) and programmed death-1 ligand (PD-L1) produces immunosuppressive activity, protecting tumor cells from anti-tumor immunity and possibly releasing soluble PD-L1 (sPD-L1) from PD-L1 expressing tumor cells. Therefore, we measured serum levels of sPD-L1 in patients with primary central nervous system lymphoma (PCNSL) and explored its clinical implications. Methods Sixty-eight patients with newly diagnosed PCNSL had diffuse large B-cell lymphoma and were treated with high-dose methotrexate-containing chemotherapy. The measurement of sPD-L1 and cytokines was performed using serum samples archived at diagnosis, and the tissue expression of PD-L1 was also analyzed from archived paraffin-embedded tissue blocks. Disease relapse, progression-free survival (PFS), and overall survival (OS) were analyzed according to the extent of sPD-L1 in serum and PD-L1 in tissue. Results The median level of serum sPD-L1 (0.429 ng/mL) was higher than in healthy control patients (0.364 ng/mL). The occurrence of relapse was more frequent in the high sPD-L1 (78%) than the low sPD-L1 group (50%), though the groups did not have different clinical or pathological characteristics at diagnosis. As a result, the OS and PFS for the high sPD-L1 group were significantly lower than those in the low group. PD-L1-positive tumor cells were found in 35 patients (67%), and the extent of PD-L1-postive tumor cells was positively associated with serum sPD-L1 levels ( r = 0.299, P = 0.031). Among the 34 cytokines analyzed, only the serum level of IL-7 correlated with the serum level of sPD-L1 (r = 0.521, P < 0.001). Conclusions Serum levels of sPD-L1 could reflect the expression of PD-L1 in PCNSL tumor cells and predict patient survival outcomes. Therefore, sPD-L1 in serum could be a feasible biomarker for determining a risk-adapted treatment strategy for PCNSL patients.
Plasma HER2ECD a promising test for patient prognosis and prediction of response in HER2 positive breast cancer: Results of a randomized study - SAKK 22/99
Authors: Eppenberger-Castori Serenella , Klingbiel Dirk , Ruhstaller Thomas , Dietrich Daniel , Rufle Daniel Alexander , Rothgiesser Karin , Pagani Olivia , Thürlimann Beat
Published: February 2020

Background
The HER2 extracellular domain shed in blood (HER2 ECD ) is reported to rise and fall in parallel with HER2+ breast cancer behavior. In this study, we evaluated the clinical relevance of plasma HER2 ECD values in patients with metastatic breast cancer treated in the SAKK22/99 trial comparing trastuzumab monotherapy followed by trastuzumab-chemotherapy combination at progression versus upfront combination therapy.
Methods
Quantitative assessment of plasma HER2 ECD was performed in 133 patients at baseline; after 2-24 hours; at 3 weeks; at first response evaluation (8-9 weeks); and at tumor progression. Associations with tumor characteristics, disease course and trial treatment were evaluated.
Results
Baseline HER2 ECD levels were stable within 24 hours after the first trastuzumab injection. These plasma values correlated positively with the HER2 gene ratio (r s =0.39, P <0.001) and HER2 protein expression levels (r s =0.36, P <0.001) but not with ER/PR status of the primary tumor. HER2 ECD baseline levels were positively associated with the presence of visceral disease ( P =0.05) and poor patients’ outcome (Cox-regression: P =0.009). Patients with high baseline levels ( > 35ng/ml) had the worst overall survival ( P =0.03) if treated with upfront combination therapy. Conversely, patients with low HER2 ECD baseline values (<15ng/ml) had longer time to progression on combined trastuzumab-chemotherapy when first treated with trastuzumab monotherapy ( P =0.02). Monitoring HER2 ECD levels during the course of the trial revealed significant time ( P =0.001) and time-treatment arm interactions ( P =0.0007). Under upfront trastuzumab alone, the HER2 ECD levels remained stable until just before disease progression. In patients responding to combination treatment HER2 ECD levels decreased to > 20%.
Conclusions
Plasma HER2 ECD levels in patients with metastatic breast cancer reflect HER2 disease status. This robust biomarker might help identifying patients without visceral disease profiting from a sequential treatment’s modality. Monitoring HER2 ECD levels during trastuzumab monotherapy could help defining the optimal time to introduce chemotherapy.
Brucella Melitensis B115-Based Elisa to Unravel False Positive Serologic Reactions in Bovine Brucellosis: A Field Study
Authors: trotta adriana , Marinaro Mariarosaria , Cirilli Margie , Sposato Alessio , Adone Rosanna , Beverelli Matteo , Buonavoglia Domenico , Corrente Marialaura
Published: February 2020

Background: Brucellosis is a zoonosis whose incidence is not declining worldwide despite the global effort to control the disease. Accurate and precise diagnosis is a crucial step in any prophylaxis program but single tests to unequivocally detect animals infected with Brucella spp. are currently unavailable. In Italy, serological diagnosis of bovine brucellosis is performed with two official tests: a rapid agglutination test (i.e., Rose Bengal Plate test, RBPT) and a complement fixation test (CFT) that detect antibodies directed mainly to the smooth lipopolysaccharide (S-LPS). Neither of the two tests is able to avoid the detection of false positive serological reactions (FPSRs) caused by bacteria sharing S-LPS components with Brucella spp. and responsible for the single reactors (SR) phenomenon. A B. melitensis R strain-based ELISA showed a good diagnostic performance in unravelling FP animals; however, since a limited number of animals were analyzed in that study, a large field study was conducted here to discriminate between Brucella-infected from FP animals, with the final aim of reducing the unnecessary slaughter of the latter. An ELISA based on a R strain of Brucella, i.e., Brucella melitensis B115, was employed to measure specific IgG responses in a collection of bovine sera (n=648). Sera were obtained from 180 farms (either officially brucellosis-free or not brucellosis-free) recruited during an extended period of time (2014-2018) and were preliminarily assayed with the official tests by the Italian Reference Centers and then subjected to the ELISA.Results: Negative sera, when subjected to the ELISA, gave O.D. values below the cutoff; SR sera, i.e. RBPT positive and CFT negative, as well as double positive (DP) sera, i.e. RBPT and CFT positive, gave O.D. values that were below the cutoff. All positive sera, i.e. from Brucella-infected animals, were RBPT positive and CFT positive (ICFTU ranging from 20 to 1280) and gave ELISA O.D. values above the cutoff. Conclusions: The B. melitensis B115-based ELISA systematically unravelled all false positive (FP) sera while confirming the diagnosis in Brucella-infected animals. Thus, the test employed in the present study may complement the official assays to avoid the costly slaughter of FP animals.
Loop ileostomy closure: a retrospective comparison of three techniques
Authors: Lord Ian , Reeves Lesley , Gray Andrew , Woodfield John , Clifford Kari , Thompson-Fawcett Mark
Published: February 2020

The authors have withdrawn this preprint from Research Square.
A Probabilistic Approach for Economic Evaluation of Occupational Health and Safety Interventions: A Case Study of Silica Exposure Reduction Interventions in the Construction Sector
Authors: Mofidi Amirabbas , Tompa Emile , Mortazavi SeyedBagher , Esfahanipour Akbar , Demers Paul A.
Published: February 2020

Background: Construction workers are at a high risk of exposure to various types of hazardous substances such as crystalline silica. Though multiple studies indicate the evidence regarding the effectiveness of different silica exposure reduction interventions in the construction sector, the decisions for selecting a specific silica exposure reduction intervention are best informed by an economic evaluation. Economic evaluation of interventions is subjected to uncertainties in practice, mostly due to the lack of precise data on important variables. In this study, we aim to identify the most cost-beneficial silica exposure reduction intervention for the construction sector under uncertain situation. Methods: We apply a probabilistic modeling approach that covers a large number of variables relevant to the cost of lung cancer, as well as the costs of silica exposure reduction interventions. To estimate the societal lifetime cost of lung cancer, we use an incidence cost approach. To estimate the net benefit of each intervention, we compare the expected cost of lung cancer cases averted, with expected cost of implementation of the intervention in one calendar year. Sensitivity analysis is used to quantify how different variables effects interventions net benefit. Results: A positive net benefit is expected for all considered interventions. The highest number of lung cancer cases are averted by combined use of wet method, local exhaust ventilation and personal protective equipment, about 107 cases, with expected net benefit of $45.9 million. Results also suggest that the level of exposure is an important determinant for the selection of the most cost-beneficial intervention. Conclusions: This study provides important insights for decision makers about silica exposure reduction interventions in the construction sector. It also provides an overview of the potential advantages of using probabilistic modeling approach to undertake economic evaluations, particularly when researchers are confronted with a large number of uncertain variables.
Exploring the Roles of Fecundity-related Long Non-coding RNAs and mRNAs in the Adrenal Gland of Small-tailed Han Sheep
Authors: Xia Qing , Li Qiuling , Gan Shangquan , Guo Xiaofei , Zhang Xiaosheng , Zhang Jinlong , Chu Mingxing
Published: February 2020

Background:Long non-coding RNAs (lncRNAs) can play important roles in uterine and ovarian functions. However, little researches have been done on the role of lncRNAs in the adrenal gland of sheep. Herein, RNA sequencing was used to compare and analyze gene expressions in adrenal tissue between follicular phase and luteal phase inFecBBB(MM) andFecB++(WW) sheep, respectively, and differentially expressed lncRNAs and genes associated with reproduction were identified.Results:In MM sheep, 38 lncRNAs and 545 mRNAs were differentially expressed in the adrenal gland between the luteal and follicular phases; In WW sheep, 513 differentially expressed lncRNAs and 2481 mRNAs were identified. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses indicated that differentially expressed lncRNAs and their target genes are mainly involved in the circadian rhythm, the mitogen activated protein kinase, thyroid, ovarian steroidogenesis and transforming growth factor beta signaling pathways. Differentially expressed lncRNAs can regulate reproduction by modulating genes involved in these signaling pathways and biological processes. Specifically,XLOC_254761,XLOC_357966,105614839andXLOC_212877targetingCREB1,PER3,SMAD1andTGFBR2, respectively, appear to play key regulatory roles.Conclusion:These results broaden our understanding of lncRNAs in adrenal gland of sheep and provide new insights into the molecular mechanisms underlying sheep reproduction.
Evaluation of a sitting light volleyball intervention to adults with physical disabilities: Qualitative study using social–ecological approach
Authors: Leung Ka Man , Chung Pak-Kwong , Chu William
Published: February 2020

Background: This study was part of a 15-week sitting light volleyball (SLVB) intervention programme which examined the effectiveness of the intervention on physical and psychological attributes of adults with physical disabilities (PWPD) in Hong Kong. SLVB was a new sport, combing Paralympic volleyball and light volleyball. Gaining an in-depth understanding of the perceptions and experiences of PWPD in the SLVB intervention is critical to further develop SLVB as a PA intervention and sport. Using a social–ecological model (SEM), (a) the participants’ experiences regarding the intervention were assessed and (b) the suitability and feasibility of the SLVB intervention to PWPD were qualitatively examined. Methods: Twenty participants (mean age = 53.52 years standard deviation (SD = 9.02), 60% female participants; 25% had at least a college degree) attended our semi-structured interviews. Results: Using content analysis, their experiences at the individual or intrapersonal level (physical and psychological health, enjoyment, novelty, competence autonomy); interpersonal levels (socialization, teamwork, social support); organizational and community levels (perceived sport venue environment, venue accessibility, safety, dissemination of information, and community facilities); and policy level (resources allocation by the government) were obtained. The participants also commented on the suitability and feasibility of the SLVB intervention for PWPD, contents and coaching, modified rules, duration of session and scheduling, and number of participants and coaches. Conclusion: This qualitative study identified several themes for engaging PWPD in SLVB, and demonstrated that adopting a multilevel approach to intervention in SLVB has positive outcomes to participants. In general, SLVB is suitable and feasible to PWPD. The study contributes to an in-depth understanding of the experiences among PWPD in the SLVB intervention, which is very critical to the further development of SLVB in terms of a PA intervention and sport.
Associations between maternal BMI, breastfeeding practices and infant anthropometric status in Colombia; secondary analysis of ENSIN 2010.
Authors: Aldana-Parra Fanny , Olaya Gilma , Fewtrell Mary
Published: February 2020

Background: Maternal malnutrition and infant feeding mode impact short and long term infant and child morbidity and mortality. The period of lactation may provide an opportunity to modulate the risk of disease later in life. Our aim was to estimate the effect of maternal body mass index (BMI) and infant feeding mode, particularly breastfeeding practices, on the anthropometric status of children under two years in Colombia.
Methods: A secondary analysis was performed using the data from ENSIN 2010. Term infants under 2y, singleton, with a mother older than 18y, were included in the analysis. Outcomes were wasting (WLZ<-2SD), overweight (WLZ>+2SD) and stunting (LAZ<-2SD). Predictors were infant feeding (exclusive and predominant BF constructed from 24-hour recall, age at introduction of liquids, semisolids and solids) and maternal BMI. Socioeconomic variables, maternal education and age, conditions during pregnancy and birth weight were analyzed as covariates.
Results: Mothers of overweight infants had higher BMI (Mean dif=1.47 kg/m2; 95% CI=2.1, 0.8) than those with normal weight infants. Stunting and wasting were not predicted by maternal anthropometry or infant feeding mode. Fewer maternal years of education were associated with wasting (OR=0.90; 95% CI=0.86, 0.97; p=0.003) and stunting (OR=0.92; 95% CI=0.89, 0.94; p<0.0001), while more maternal years of education were associated with overweight (OR=1.06; 95% CI=1.02, 1.01; p=0.001); higher birth weight was associated with overweight (OR=1.001; 95% CI=1.00, 1.001; p<0.0001) and lower birth was associated with stunting (OR=0.99; 95% CI=0.89; p<0.0001) in the final regression model.
Conclusions: Maternal BMI is a modifiable target for public health policy to promote healthy infant growth. Infant nutritional status is affected by direct and indirect factors that need to be addressed in further studies.
Countertransference feelings and personality disorders: A psychometric evaluation of a brief version of the Feeling Word Checklist (FWC-BV)
Authors: Breivik Randi , Wilberg Theresa , Evensen Julie , Røssberg Jan Ivar , Dahl Hanne Sofie , Pedersen Geir A. Feigum
Published: February 2020

Background
The Feeling Word Checklist (FWC) is a self-report questionnaire designed to measure therapists’ countertransference (CT) feelings. The primary aim of the study was to evaluate the psychometric properties of a brief version of the Feeling Word Checklist (FWC-BV) comprising 12 feeling words. The second aim was to validate the factor structure by examining the associations between the FWC-BV factors, patients’ personality pathology and therapeutic alliance (TA).
Methods
Therapists at 13 different outpatient units within the Norwegian Network of Personality Disorders completed the FWC-BV every 6 months during the course of treating a patient with a personality disorder (PD), over a period of 2.5 years. A large sample of patients (N=2425) with personality pathology participated in the study. The data were analysed with exploratory (EFA) and confirmatory (CFA) factor analysis. Internal consistency was estimated using Mc Donald’s coefficient Omega (ωt). The Structured Clinical Interview for DSM-IV – Axis II (SCID II) and Mini International Neuropsychiatric Interview (MINI) were used as diagnostic instruments, and patient-rated TA was assessed using the Working Alliance Inventory (WAI-SR).
Results
Factor analyses revealed three clinically meaningful factors: Inadequate, Idealised and Confident. These factors had acceptable psychometric properties. Most notably, a number of borderline PD criteria correlated positively with the factors Inadequate and Idealised, and negatively with the factor Confident. All the factors correlated significantly with at least one of the WAI-SR subscales
Conclusions
The FWC-BV measures three clinically meaningful aspects of therapists’ CT feelings. This brief version of the FWC seems satisfactory for use in further research and in clinical contexts.
Keywords: Countertransference, Feeling Word Checklist, factor analysis, personality disorder, psychometrics
Genome-wide analysis of the citrus B3 superfamily and their association with somatic embryogenesis
Authors: Liu Zheng , Ge Xiao-Xia , Wu Xiao-Meng , Xu Qiang , Atkinson Ross G. , Guo Wen-Wu
Published: February 2020

Background: In citrus, genetic improvement via biotechnology is hindered by the obstacle of in vitro regeneration via somatic embryogenesis (SE). Although a few B3 transcription factors are reported to regulate embryogenesis, little is known about the B3 superfamily in citrus, and which members might be involved in SE.Results: Genome-wide sequence analysis identified 72 (CsB3) and 69 (CgB3) putative B3 superfamily members in the genomes of sweet orange (Citrus sinensis, polyembryonic) and pummelo (C. grandis, monoembryonic), respectively. Genome duplication analysis indicated that segmental and tandem duplication events contributed to the expansion of the B3 superfamily in citrus, and that the B3 superfamily evolved under the effect of purifying selection. Phylogenetic relationships were well supported by conserved gene structure and motifs outside the B3 domain, which allowed possible functions to be inferred by comparison with homologous genes from Arabidopsis. Expression analysis identified 23 B3 superfamily members that were expressed during SE in citrus and 17 that may play functional roles at late SE stages. Eight B3 genes were identified that were specific to the genome of polyembryonic sweet orange compared to monoembryonic pummelo. Of these eight B3 genes, CsARF19 was found to be specifically expressed at higher levels in embryogenic callus (EC), implying its possible involvement in EC initiation. Conclusions: This study provides a genome-wide analysis of the citrus B3 superfamily, including its genome organization, evolutionary features and expression profiles, and identifies specific family members that may be associated with SE.
The diagonal branches and outcomes inpatients with anterior ST- elevation myocardial infarction
Authors: Zhang Shuning , Deng Xin , Yang Wenlong , Xia Liping , Yao Kang , Lu Hao , Ge Lei , Li Shen , Sun Aijun , Zou Yunzeng , Qian Juying , Ge Junbo
Published: February 2020

Background: The management of diagonal branch (D) occlusion is still controversary. The association between the flow loss of D and the prognosis remains unclear. We aim to detect the impact of D flow on cardiac function and clinical outcomes in patients with anterior ST-segment elevation myocardial infarction (STEMI). Methods: Patients with anterior STEMI undergoing primary percutaneous coronary intervention (PCI)at our clinic between October 2015 and October 2018were reviewed. Anterior STEMI due to left anterior descending artery (LAD) occlusion with or without loss of the main D flow (TIMI grade 0-1 or 2-3) was enrolled in the analysis. The short- and long-term incidence of major adverse cardiac events (MACEs, a composite of all-cause death, target vessel revascularization and reinfarction) and left ventricular ejection fraction (LVEF) were analyzed. Results: A total of 392 patients (mean age of 63.9years) with anterior STEMI treated with primary PCI was enrolled in the study. They were divided into two groups, loss (TIMI grade 0-1, n=69) and no loss (TIMI grade2-3, n=323) of D flow, before primary PCI. Compared with the group without loss of D flow, the group with loss of D flow showed a lower LVEF post PCI (41.0% vs. 48.8%, p=0.003). Meanwhile, loss of D flow resulted in the higher in-hospital, one-month, and 18-month incidence of MACEs, especially in all-cause mortality (all p<0.05). Landmark analysis further indicated that the significant differences in 18-month outcomes between the two groups mainly resulted from the differences during the hospitalization. In addition, multivariate Cox proportional hazards analysis found that D flow loss before primary PCI was independent factor predicting short- and long-term outcomes in patients with anterior STEMI. Conclusion: Loss of the main D flow in anterior STEMI patients was independently associated with the higher in-hospital incidences of MACEs and all-cause death as well as the lower LVEF.
Efficacy and cultural appropriateness of psychosocial interventions for paediatric burn patients and caregivers: A systematic review.
Authors: Williams Hayley , Hunter Kate , Clapham Kathleen , Ryder Courtney , Kimble Roy , Griffin Bronwyn
Published: February 2020

Background: Paediatric burns are highly painful and traumatising injuries that are overrepresented among Aboriginal and Torres Strait Islander people. Paediatric burn patients’ pain remains poorly managed by pharmacological interventions, leading to increased anxiety, distress and trauma in patients and their caregivers. Non-pharmacological psychosocial interventions have been suggested as effective in reducing pain and psychological morbidities among paediatric burn patients and their caregivers; however, the degree of effectiveness and appropriateness for Aboriginal and Torres Strait Islander people is unclear. Methods: A non-date restricted systematic review was conducted through four databases. Studies published in English assessing psychosocial interventions on paediatric burn patients’ physical pain along with theirs and/or their caregiver’s anxiety, distress, or trauma symptoms were identified and included in this review. Included studies were assessed for their ability to reduce one of the outcomes of interests and for their reflection of Aboriginal and Torres Strait Islander peoples’ perspectives of health. Results: Of the 3,178 identified references, 17 were eligible. These include distraction based techniques (n=8), hypnosis/familiar imagery (n=2), therapeutic approaches (n=4), and patient preparation/procedural control (n=3). Distraction techniques incorporating procedural preparation reduced pain, while discharge preparation and increased ‘patient control’ reduced patient and caregiver anxiety; and internet based Cognitive Behaviour Therapy reduced short-term but not long-term post-traumatic stress symptoms. No interventions reflected Aboriginal and Torres Strait Islander peoples’ perspectives of health; and few targeted caregivers and focused on reducing their symptoms. Conclusions: The development and assessment of psychosocial interventions to appropriately meet the needs of Aboriginal and Torres Strait Islander paediatric burn patients is required.
iTRAQ-based quantitative proteomic of tobacco (Nicotiana tabacum L.) identified major host proteins involved in photosystems throughout the aging process
Authors: He Conglian , Sun Shubin , Tang Yun , He Chenggang , Li Pengfei , Xu Tianyang , Zhao Gaokun , Zou Congming , Lin Zhonglong , Chen Yi
Published: February 2020

Background Leaf senescence is one of the most common manifestations in plant senescence and has an important effect on photosynthesis. However, the molecular regulation of leaf senescence in response to photosynthesis is still poorly understood. To gain insight into the molecular mechanisms underpinning tobacco, we integrated photosynthesis, organelle ultrastructural, and proteomic analyses of tobacco leaves during senescence. Results The photosynthetic rate, intercellular CO 2 concentration, tomatal conductance, transpiration rate showed a downward trend and the stability of organelle decreased with the increasing of tobacco leaves age. iTRAQ and PRM verification were used to analyze the proteins expressed in different periods based on photosynthetic physiology and ultramicroscopic observation. A total of 321, 319, 223 diﬀerentially expressed proteins (DEPs) were identified from over maturity (OM) vs immature (IM), OM vs well maturity (WM) and WM vs IM, respectively, including 122/199, 124/195 and 125/98 up/down proteins, respectively. KEGG analysis of DEPs was significantly enriched in metabolic pathways, biosynthesis of secondary metabolites, microbial metabolism in diverse environments, starch and sucrose metabolism. In addition, down-regulated proteins were also involved in metabolic pathways such as carbon sequestration of photosynthetic organisms and photosynthesis. Furthermore, PRM analysis indicated that iTRAQ is highly reliable. Conclusions Our study provided important technical references for screening photosynthetic host proteins of tobacco leaf senescence and revealing the molecular mechanism during the senescence of tobacco leaves.
Implementation of a Quality Improvement Strategy to Increase Outpatient Kidney Transplant Referrals
Authors: Farouk Samira , Atallah Sarah , Campbell Kirk N , Vassalotti Joseph A , Uribarri Jaime
Published: February 2020

Background: Kidney transplantation remains the optimal therapy for patients with end stage kidney disease (ESKD), though a small fraction of patients on dialysis are on organ waitlists. An important barrier to preemptive kidney transplantation and successful waitlisting is timely referral to a kidney transplant center. We implemented a quality improvement strategy to improve outpatient kidney transplant referrals in a single center academic outpatient nephrology clinic.
Methods: Over a 3 month period (July 1 - September 30, 2016), we assessed the baseline kidney transplantation referral rate at our outpatient nephrology clinic for patients 18 - 75 years old with an estimated glomerular filtration rate (eGFR) of less than 20 mL/min/1.73m 2 (2 values over 90 days apart). Charts were manually reviewed by two reviewers to look for kidney transplant referrals and documentation of discussions about kidney transplantation. We then performed a root cause analysis to explore potential barriers to kidney transplantation. Our intervention began on July 1, 2017 and included the implementation of a column in the electronic medical record (EMR) which displayed the patient's last eGFR as part of the clinic schedule. Physicians were given a document listing their patients to be seen that day with an eGFR of < 20 mL/min/1.73m 2 .
Results: 54 unique patients with eGFR ≤ 20 ml/min/1.73 m 2 were identified who were seen in the Clinic between July 1, 2016 and September 30, 2016. 29.6% (16) eligible patients were referred for kidney transplantation evaluation. 69.5% (37) of these patients were not referred for kidney transplant evaluation. 46.3% (25) did not have documentation regarding kidney transplant in the EMR. Following the intervention, 66 unique patients met criteria for eligibility for kidney transplant evaluation. Kidney transplant referrals increased to 60.6% (p < 0.001).
Conclusions: Our pilot implementation study of a strategy to improve outpatient kidney transplant referrals showed that a free, simple, scalable intervention can significantly improve kidney transplant referrals in the outpatient setting Next steps include further study of the impact of early referral to kidney transplant centers on preemptive and living donor kidney transplantation as well as successful waitlisting.
Innovative use of data sources: A Cross-sectional study of Data Linkage Practices across European Countries
Authors: Haneef Romana , Delnord Marie , Vernay Michel , Bauchet Emmanuelle , Gaidelyte Rita , Oyen Herman Van , Or Zeynep , Pérez-Gómez Beatriz , Palmieri Luigi , Achterberg Peter , Tijhuis Mariken , Zaletel Metka , Mathis-Edenhofer Stefan , Májek Ondřej , Haaheim Håkon , Tolonen Hanna , Gallay Anne
Published: February 2020

Background The availability of data generated from different sources is increasing with the possibility to link these data sources together. However, linked administrative data can be complex to use and may require advanced expertise and skills in statistical analysis. The main objectives of this study were to describe the current use of data linkage at the individual level and the artificial intelligence (AI) in routine public health activities, and to identify the related health outcome and intervention indicators and determinants of health for non-communicable diseases. Method We performed a survey across European countries to explore the current practices applied by national institutes of public health and health information and statistics for innovative use of data sources (i.e., the use of data linkage and/or the AI). Results The use of data linkage and the AI at national institutes of public health and health information and statistics in Europe varies. The majority of European countries use data linkage in routine by applying a deterministic method or a combination of two types of linkages (i.e., deterministic & probabilistic) for public health surveillance and research purposes. The use of AI to estimate health indicators is not frequent at national institutes of public health and health information and statistics. Using linked data, 46 health outcome indicators related to seven health conditions, 34 indicators related to determinants and 23 to health interventions were estimated in routine. Complex data regulation laws, lack of human resources, skills and problems with data governance, were reported by European countries as obstacles to link different data sources in routine for public health surveillance and research. Conclusions Our results highlight that the majority of European countries have integrated data linkage in routine public health activities but a few use the AI. A sustainable national health information system and a robust data governance framework allowing to link different data sources are essential to support evidence-informed health policy development process. Building analytical capacity and awareness of the added value of data linkage in national institutes is necessary for improving the utilization of linked data in order to improve the monitoring of public health activities.
Differences in huperzine A yield when different amino acids were added for in vitro thallus culture of Huperzia serrata (Thunb)Trev and gene expression analysis
Authors: YuXuan Ye , YiSheng Tu , Xiao Yu , Qian Huang , Huihui Yuan
Published: February 2020

Background：the secondary metabolite of H. serrata, huperzine A (HupA) can be used in the treatment of Alzheimer’s disease and can improve the cognitive function of patients. The use of in vitro culture and secondary metabolism engineering to obtain secondary metabolites is the most effective method to solve a lack of HupA sources and protect H. serrata as a natural resource. This study was based on the in vitro thallus culture conditions for H. serrate, and different concentrations of alkaloid precursor amino acids (lysine, aspartic acid, and trytophan) were added. We found that addition of different amino acids to thallus cultures had different effects on HupA accumulation. Transcriptome sequencing was carried out on thalli with significant differences in the HupA content due to treatment with different amino acids for differential analysis, and real-time fluorescence quantitative PCR was used for validation to examine the functional genes involved in exogenous amino acid regulation of HupA accumulation in thalli.Results：We found that addition of 1 mmol·L−1 aspartic acid (D) solution promoted HupA accumulation, at a level of 84.05 μg·g−1 dry weight (DW), which was 1.29-fold that of the control (CK: 65.15 μg·g−1 DW). Addition of 4 mmol·L−1 lysine (K) solution significantly inhibited HupA accumulation, at a level of 48.42 μg·g−1 DW, which was 0.75-fold that of the control.Transcriptome sequencing-bioinformatics alignment analysis of the aforementioned materials showed that in GO alignment analysis, functions were annotated for 16,258 unigenes. From the statistical analysis of the DEGs of the three groups, we found that there were 1046, 782, and 1586 DEGs for CK vs D, CK vs K, and D vs K, respectively, with D vs K having the most DEGs. DEGs that were enriched in KEGG metabolic pathways and validated by fluorescence quantitative PCR included PANK1, GDH2, APX, HA1, ND4L, and COX1. Conclusions：The above results showed that HupA content differences in D and K treatments were directly proportional to DEGs. Gene expression differences are the molecular basis that affects HupA accumulation in in vitro thallus cultures. PANK1 and GDH2 encode enzymes that synthesize an alkaloid intermediate.
A randomized pilot study to evaluate graft-first versus fistula-first vascular access strategy in older patients with advanced kidney disease: results of a feasibility study Pilot and Feasibility Studies
Authors: Murea Mariana , Geary Randolph L , Houston Denise K , Edwards Matthew S , Robinson Todd W , Davis Ross P , Hurie Justin B , Williams Timothy K , Velazquez-Ramirez Gabriela , Bagwell Benjamin , Tuttle Audrey B , Moossavi Shahriar , Rocco Michael V , Freedman Barry I , Williamson Jeff D , Divers Jasmin
Published: February 2020

Background. Although older adults encompass 40% of patients with advanced chronic kidney disease (CKD), it remains unclear which long-term hemodialysis (HD) vascular access type, arteriovenous (AV) fistula (AVF) or AV graft (AVG), is optimal with respect to effectiveness and patient satisfaction. Clinical outcomes based on the initial AV access type have not been evaluated in randomized controlled trials. This pilot study tested the feasibility of randomizing older adults with CKD to initial AVF versus AVG vascular access surgery. Methods: Patients 65 years or older with pre-dialysis CKD or incident end-stage kidney disease (ESKD) and no prior AV vascular access intervention were randomized in a 1:1 ratio to undergo surgical placement of either AVF-first or AVG-first after providing informed consent. Trial feasibility was evaluated as (i) recruitment of ≥70% of eligible participants, (ii) ≥50% to 70% of participants undergo placement of index AV access within 90 to 180 days of enrollment, respectively, (iii) ≥80% adherence to study-related assessments, and (iv) ≥70% of participants who underwent index AV access placement will have a follow-up duration of ≥12 months after index surgery date. Results: Between September 2018 and October 2019, 81% (44/54) of eligible participants consented and were enrolled in the study; 11 had pre-dialysis CKD and 33 ESKD. After randomization, 100% (21/21) assigned to AVF-first surgery and 78% (18/23) assigned to AVG-first surgery underwent index AV access placement within a median (1st, 3rd quartile) of 5.0 (1.0, 14.0) days and 13.0 (5.0, 44.3) days, respectively, after referral to vascular surgery. The completion rates for study-specific assessments ranged between 40.0 and 88.6%. At median follow-up of 215.0 days, 5 participants expired, 7 completed 12 months of follow-up, and 29 are actively being followed. Assessments of grip strength, functional independence and vascular access satisfaction were completed by >85% of patients who reached pre-specified post-operative assessment time point. Conclusions: Results from this study reveal it is feasible to enroll and randomize older adults with CKD to one of two different HD vascular access placement surgeries. The study can progress with minimum protocol adjustments to a multisite clinical trial.
Surgical treatment strategies for extra-pelvic intravenous leiomyomatosis
Authors: Li Hua , Xu Jing , Lin Qiaowei , Zhang Yong , Zhao Yun , Tong Hanxing , Tu Ruiqin , Xu Demin , Wang Chunsheng , Lu Weiqi
Published: February 2020

Background: Extra-pelvic intravenous leiomyomatosis (IVL) extending into inferior vena cava (IVC) or heart (i.e. intracardiac leiomyomatosis, ICL) is an extremely rare benign disease. No consensus has been reached on the optimal surgical strategy. The aim of this study is to introduce four types of one-stage surgical strategies including less invasive options and a guideline to select patient-specific strategy for this disease.Methods: Twenty-four patients of extra-pelvic IVLs receiving one-stage resections at the Zhongshan Hospital from July 2011 to November 2019 were reviewed retrospectively. Base on the initial experiences of the indiscriminate choices of tumor thrombectomies through sterno-laparotomy under cardiopulmonary bypass (CPB) in 6 ICLs, an anatomy-based guideline for four types of surgical strategies was developed and applied for the next 18 patients. Results: Under the direction of guideline, tumor thrombectomies through single laparotomy were applied without CPB in 2 ICLs and 4 IVLs confined in IVC, or with CPB in 7 ICLs. Guideline-directed double-incisions with CPB were applied in only 5 ICLs, including 1 receiving mini-thoracotomy and 4 receiving sternotomy because of tumor adherences with right atriums in 2 and with pulmonary arteries in 2. All 24 patients accomplished one-stage panhysterectomy, bilateral adnexectomy and complete resections of intracaval and intracardiac tumors. For residual pelvic intravenous tumors in 19 patients, 17 received macroscopically complete resections while the other 2 failed because of high risk of hemorrhage. Intraoperative blood losses, operation time and hospitalization expense in the single-laparotomy non-CPB group were significantly lesser than the other groups. In CPB groups, inpatient stay and hospitalization expense in the single-incision group were significantly lesser than the double-incisions group. All patients were alive and free of recurrences during a mean follow-up of 35.4±27.2 months (range, 1–100 months). The pelvic tumor residues in 2 patients remained unchanged for 51 and 52 months since operation, respectively. Conclusions: For various extra-pelvic IVLs, the 4 types of surgical strategies including less invasive options are feasible, providing these are selected by a guideline base on the tumor extension and morphology. The proposed guideline is believed to accommodate more patients receiving less invasive surgery without compromising the curative effect.
The effect of a 5-year hand hygiene initiative, consisting of the 5 Components, the 5 Steps, and the Hand Hygiene Self-Assessment Framework, an interrupted time-series study.
Authors: Suzuki Yumi , Morino Motoko , Morita Ichizo , Yamamoto Shigenori
Published: February 2020

Background:A World Health Organization (WHO) guideline-based multimodal hand hygiene (HH) initiative consisting of the 5 Components, the 5 Steps, and the HH Self-Assessment Framework (HHSAF) was introduced hospital-wide to a nonteaching Japanese hospital for 5 years. The objective of this study was to assess the effect of this initiative in terms of changes in alcohol-based hand rub (ABHR) consumption and HHSAF score.Methods:The consumption of monthly hospital-wide ABHR was calculated as ml per patient day (PD). The change in ABHR consumption was analysed by an interrupted time series analysis, with a preintervention period of 36 months and an intervention period of 60 months. The correlation between annual ABHR consumption and the HHSAF score was estimated using Pearson’s correlation coefficients.Results:A statistically significant increase was found in the monthly ABHR consumption (change in slope: + 0.479 ml/PD, p < 0.01). Annual ABHR consumption was strongly correlated with the annual HHSAF score (r = 0.971, p < 0.01).Conclusions:A 5-year, 5-step, WHO-based HH initiative significantly increased ABHR consumption. Our study suggested that the HHSAF score can be a good process measure to improve HH in a single facility, as ABHR consumption increased with the HHSAF score.
Implementing a Combined Infection Prevention and Control with Antimicrobial Stewardship Joint Programme to Prevent Caesarean Section Surgical Site Infections and Antimicrobial Resistance: a Tanzanian Tertiary Hospital Experience
Authors: Gentilotti Elisa , De Nardo Pasquale , Nguhuni Boniface , Piscini Alessandro , Damian Caroline , Vairo Francesco , Chaula Zainab , Mencarini Paola , Torokaa Peter , Zumla Alimuddin , Nicastri Emanuele , Ippolito Giuseppe
Published: February 2020

Background Surgical site infections after caesarean section are a leading cause of morbidity and mortality, especially in Low and Middle Income Countries. We hypothesized that combining infection prevention and control with an antimicrobial stewardship programme would decrease the rate of post- caesarean section surgical site infections at the Obstetrics & Gynaecology Department of a Tanzanian tertiary hospital. Methods A first survey was conducted to assess the burden of post-CS SSI. Thereafter, an intervention was introduced including: 1. formal on-the-job training on infection prevention and control; 2. evidence-based education on antimicrobial resistance and good antimicrobial prescribing practice. A second survey was performed to determine the impact of the intervention. The primary outcome of the study was information on the prevalence of post-caesarean section surgical site infections whereas the secondary outcome was the identification of the determinant factors of surgical site infections before/after the intervention and overall. The microbiological characteristics and patterns of antimicrobial resistance were also established. Results A total of 464 and 573 women were surveyed before and after the intervention, respectively. After the intervention, the antibiotic prophylaxis was administered to a significantly higher number of patients (98% vs 2%, p <0.001), caesarean sections were performed by more qualified operators (40% vs 28%, p =0.001), with higher rates of Pfannenstiel skin incisions (29% vs 18%, p <0.001) and of absorbable continuous intradermic sutures (30% vs 19%, p <0.001). The total number of post-caesarean section surgical site infections was 225 (48%) in the pre-intervention group and 95 (17%) in the post intervention group ( p <0.001). A low prevalence of gram-positive isolates and of methicillin-resistant Staphylococus aureus was detected in the post-intervention survey. Conclusions Further research is needed to better understand the potential of a hospital-based multidisciplinary approach to surgical site infections and antimicrobial resistance prevention in resource-constrained settings.
Up-regulation of sarcoplasmic reticulum function protects skeletal muscle against cytoplasmic calcium overload during hibernation in ground squirrels
Authors: Wang Zhe , Zhang Jie , Ma XiuFeng , Chang Hui , Peng Xin , Xu ShenHui , Wang HuiPing , Gao Yunfang
Published: February 2020

We investigated the potential mechanism of the (sarcoplasmic reticulum) SR in maintenance of calcium (Ca2+) homeostasis of slow-twitch muscle (soleus, SOL), fast-twitch muscle (extensor digitorum longus, EDL) and mixed muscle (gastrocnemius, GAS) in hibernating ground squirrels (Spermophilus dauricus). Results showed that cytosolic and SR Ca2+ concentrations in distinct skeletal muscle fibers increased and decreased during late torpor, respectively, but both returned to summer-active levels during early torpor. Ryanodine receptor1 (RyR1) and sarco/endoplasmic reticulum Ca2+ ATPase isoform 1 (SERCA1) protein expression increased during hibernation. Up-regulation factors of SERCA activity: Phospholamban phosphorylation increased in the SOL and GAS, β-adrenergic receptor-2 protein expression increased in the GAS, and calmodulin kinase-2 phosphorylation increased in the SOL during hibernation. Down-regulation factors of SERCA activity: Sarcolipin and SERCA1 co-localization decreased in the EDL and GAS. These data suggest that SERCA activity in skeletal muscle fibers increases likely during hibernation. FKBP12/calsequestrin1 (negative regulatory factors of RyR1) and RyR1 co-localization decreased in the GAS, indicating that the RyR1 channel opening probability increased during hibernation. Dihydropyridine receptors protein expression and its co-localization with RYR1 decreased during hibernation prompts that the contractility of skeletal muscle was weakened. Protein expression of Ca2+-binding proteins calsequestrin1 and calmodulin increased indicating that the ability of intracellular free calcium binding increased during whole hibernation period. These findings confirm that the release, uptake, and binding of free Ca2+ in the SR were enhanced in different skeletal muscles during hibernation. Up-regulation of muscular sarcoplasmic reticulum function protects skeletal muscle fibers against cytoplasmic calcium overload during hibernation in ground squirrels.