bluuebunny/crossref_metadata_2025 huggingface dataset:
Soil bacterial communities associated with stony soils influence the tuber size of Tetrastigma hemsleyanum
Authors: Guo Haipeng , Hong Chuntao , Zhang Jianhong , Qin Wensheng , Wei Bin
Published: June 2020

Background

Plants grown in stony soils have better-developed root systems and higher crop yields than those grown in non-stony soils. The roles of various physical and chemical effects of stony soils on plant growth have been published, but the roles of soil microbiota and rhizosphere microbiota have not been investigated.
Methods

Tetrastigma hemsleyanum plants were cultivated for two years in stony soils and in the same soil from which rock-fragments had been removed. The microbiome and the tuber transcriptome were analyzed, using multiple bioinformatics methods.
Results

The soil microbiota of these two soils were markedly different, and the stony soils contained high abundances of bacterial taxa belonging to the Actinobacteria, Rokubacteria, Rhizobiales, Desulfarculaceae, and Chthoniobacteraceae. These discriminatory taxa in soils may promote the tuber growth of T. hemsleyanum, through releasing nutrients from rocks and colonizing the rhizosphere and tuber surface of T. hemsleyanum. In addition, stony soils induced a dramatic change in the tuber’s transcriptome, particularly with respect to the pathways of phytohormone biosynthesis, photosynthesis, and biotic stress resistance, expression levels of which showed strong correlations with the aforementioned bacterial taxa.
Conclusions

These results indicated that beneficial effects of stony soils on plant growth may be closely correlated with their specific microbiota, which can, in turn, influence multiple biological processes of host. This is the first study to reveal the role of stony soils-driven microbiota in tuber growth, and stony soils can represent a microbial repository for the screening of microbial isolates to increase plant yield.
Low Dose Hyperbaric Bupivacaine and Dexmedetomidine as an Adjuvant in Spinal Anaesthesia, Caesarean Section: A Randomized Controlled Trial
Authors: Nasr Ahmed Ashraf , Helal Safaa Mohamed , Soltan Wesam Eldin Abdelrahman
Published: June 2020

Background

Alpha-2 agonist, e.g. dexmedetomidine, is a non-opioid adjuvant with a substantial role in extending the analgesic duration of the subarachnoid block. Here, we aim to test the efficacy of adding dexmedetomidine to hyperbaric bupivacaine in the caesarean delivery, targeting enhanced postoperative analgesia and more stable hemodynamics.
Methods

40 parturient women scheduled for elective caesarean section were enrolled and randomly allocated to two groups. Low Dose – Dexmedetomidine (LD- DEX) group (n = 20) received 7 mg hyperbaric bupivacaine plus 10 µg dexmedetomidine, control group (n = 20) received 12 mg hyperbaric bupivacaine. Continuous normally distributed data were expressed as mean and standard deviation. Ordinal data and continuous data not fitting to the normal distribution curve were presented as medians (range) meanwhile categorical data were reported as percentage of the total number. Regarding the autonomic variables, we did a stratified analysis to compare the mean change of these variables every 3 minutes till 60 minutes through a two-sample t-test (Welch t-test). All statistical analyses were performed using R software version 3.4.4
Results

LD- DEX groups showed significant faster and prolonged sensory block (P-value < 0.05), stable maternal hemodynamic maintained by less amount of IV fluids (P-value < 0.01), lower doses of ephedrine (P-value = 0.02), no signs of foetal distress, and low incidence of postoperative maternal shivering. As well, 3 hours cut off pain was more significant in LD- DEX group (P-value < 0.01).
Conclusion

LD- DEX group provided an optimum intraoperative condition and postoperative analgesia with less maternal side effects and no neonatal risks, encouraging enhanced recovery and less hospital in-stay.
Based on Exosome-Derived Genes for Constructing Diagnostic, Prognostic and Recurrence Models and Predicting Therapeutic Response for Hepatocellular Carcinoma
Authors: Ji Jiansong , Tang Bufu , Zhu Jinyu , Gao Yang , Tu Jianfei , Yang Weibin , Fang Shiji , Weng Qiaoyou , Zhao Zhongwei , Xu Min , Yang Yang , Chen Minjiang , Lu Chenying
Published: June 2020

Background: In this study, we performed a comprehensive analysis to identify the optimal gene set derived from exosomes in hepatocellular carcinoma (HCC) with great prognostic value to construct prognostic, recurrence and diagnostic models and predicted therapeutic response for hepatocellular carcinoma.Methods: Differential expression analysis and Weighted Gene Co-Expression Network Analysis (WGCNA) of RNA-sequencing were used to identify differentially expressed exosome-derived genes related to HCC. Univariate and multivariate Cox regression analyses were performed to determine exosome-derived genes associated with prognosis of HCC to construct a prognostic model, and recurrence and diagnostic models were built based on the same genes. Results: MYL6B and THOC2 were determined to be closely related to prognosis in HCC. The prognostic and recurrence models built based on these two genes were confirmed to be independent predictive factors with superior predictive performance. Patients with high prognostic risk had poorer prognosis than patients with low prognostic risk in all HCC sets, namely, the TCGA cohort (HR=2.5, P<0.001), ICGC cohort (HR=3.15, P<0.001) and GSE14520 cohort (HR=1.85, P=0.004). A higher recurrence probability was found in patients with high recurrence risk than in patients with low recurrence risk in the HCC sets of the TCGA cohort (HR=2.44, P<0.001) and GSE14520 cohort (HR=1.54, P=0.025). High prognostic risk patients had higher expression of immune checkpoints, such as PD1, B7H3, B7H5, CTLA4 and TIM3 (P<0.05). Patients with higher prognostic risk showed higher resistance to some chemotherapy and targeted drugs, such as methotrexate, erlotinib and vinorelbine (P<0.05). The diagnostic models based on the same two genes were determined to accurately distinguish HCC from normal subjects and dysplastic nodules.Conclusions: Prognostic, recurrence, and diagnostic models based on the two exosome-derived genes (MYL6B and THOC2) were proven superior predictive performance. Our findings lay the foundation for identifying molecular markers to increase the early detection rate of HCC, improve disease outcomes, and determine more effective individualized treatment options for patients.
Patients With Chronic Migraine Without History of Medication Overuse Are Characterized by a Peculiar White Matter Fiber Bundle Profile
Authors: Coppola Gianluca , Renzo Antonio Di , Tinelli Emanuele , Petolicchio Barbara , Lorenzo Cherubino Di , Parisi Vincenzo , Serrao Mariano , Calistri Valentina , Tardioli Stefano , Cartocci Gaia , Caramia Francesca , Piero Vittorio Di , Pierelli Francesco
Published: June 2020

Background: We investigated intracerebral fiber bundles using a tract-based spatial statistics (TBSS) analysis of diffusion tensor imaging (DTI) datato investigate microstructural integrity in patients with episodic (MO) and chronic migraine (CM).Methods: We performed DTI in 19 patients with MO within interictal periods, 18 patients with CM without any history of drug abuse, and 18 healthy controls (HCs) using a 3T magnetic resonance imaging scanner. We calculated diffusion metrics, including fractional anisotropy (FA), axial diffusion (AD), radial diffusion (RD), and mean diffusion (MD).Results: TBSS revealed no significant differences in the FA, MD, RD, and AD maps between the MO and HC groups. In comparison to the HC group, theCM group exhibited widespread increased RD (bilateral superior [SCR] and posterior corona radiata [PCR], bilateral genu of the corpus callosum [CC], bilateral posterior limb of internal capsule [IC], bilateral superior longitudinal fasciculus [LF]) and MD values (tracts of the right SCR and PCR, right superior LF, and right splenium of the CC). In comparison to theMO group, theCM group showed decreased FA (bilateral SCR and PCR, bilateral body of CC, right superior LF, right forceps minor) and increased MD values (bilateral SCR and right PCR, right body of CC, right superior LF, right splenium of CC, and right posterior limb of IC). Conclusion: Our results suggest that chronic migraine can be associated withthe widespread disruption of normal white matter integrity in the brain.
Inflammation and Endothelial Injury Profiling in COVID-19 Pediatric Multi-system Inflammatory Syndrome
Authors: Fraser Douglas , Patterson Eric , Daley Mark , Cepinskas Gedaminas
Published: June 2020

Background

COVID-19 is associated with a novel multi-system inflammatory syndrome that shares some characteristics with Kawasaki’s Disease. The syndrome manifestation is delayed relative to COVID-19 onset, with a spectrum of clinical severity. Clinical signs may include persistent fever, gastrointestinal symptoms, cardiac inflammation and/or shock.
Case Presentation:

We measured 59 inflammatory and endothelial injury plasma analytes in an adolescent girl that presented with malaise, fever, cough, strawberry tongue and jaundice. Her COVID-19 status was positive with detection of 2 SARS-CoV-2 viral genes using polymerase chain reaction. She was treated with intravenous immunoglobulin prior to blood draw, but our plasma measurements suggested a unique analyte expression pattern associated with inflammation, endothelial injury and microvascular glycocalyx degradation.
Conclusions

COVID-19 is associated with a multi-system inflammatory syndrome and a unique inflammatory and endothelial injury signature. Analyte markers of inflammation and endothelium injury might serve as putative biomarkers and/or be investigated further as potential therapeutic targets.
Effect of the extent of short-duration exercise stress combined with adenosine triphosphate on the artifacts of two different regions on myocardial perfusion single-photon emission computed tomography
Authors: Shinoda Yukinori , Tachibana Koichi , Minamisaka Tomoko , Fukuoka Hidetada , Inui Hirooki , Ueno Keisuke , Inoue Soki , Mine Kentaro , Ueda Kumpei , Hoshida Shiro
Published: June 2020

Background: We aimed to evaluate the differences in the reduction of undesired artifacts among different low-grade exercise stress levels combined with drug stress and their related factors by using myocardial perfusion single-photon emission computed tomography (SPECT) in patients with suspicious coronary artery disease.Methods: We divided patients into 4 groups as follows: group A, adenosine triphosphate (ATP) for 6 min; group A+25 W, ATP+25 W exercise for 6 min; group A+35 W, ATP+35 W exercise for 6 min; group A+45 W, ATP+45 W exercise for 6 min) and enrolled only those whose summed stress scores were <3. Undesired artifacts were evaluated on the basis of heart-to-liver activity (H/L) ratio and heart-to-10 pixels below the heart (H/below the H) ratio. Results: The logarithmic values of H/L and H/below the H ratios were significantly higher in groups A+35 W and A+45 W than in group A. In all the patients, the logarithmic values of H/L and H/below the H ratios positively correlated with heart rate (p=0.004 and p=0.008, respectively), rate pressure product (RPP; p=0.005 and p=0.008, respectively), and the increment of RPP (p=0.002 and p=0.005, respectively) after stress in the univariate analysis. The left ventricular end-diastolic volume (LVEDV) after stress (p=0.002) negatively correlated with the logarithmic value of H/below the H ratio, but not H/L ratio. Although male sex was independently associated with the logarithmic values of both H/L (p=0.014) and H/below the H ratios (p=0.001) in multivariate regression analysis, LVEDV was also independently associated with the logarithmic value of H/below the H ratio (p<0.001).Conclusion: ATP plus ≥35 W exercise stress for 6 min was useful for reducing undesired artifacts after stress in myocardial perfusion SPECT. LVEDV after stress was independently associated with the H/below the H ratio, but not the H/L ratio.
Evaluating the Implementation of the SWITCH® School Wellness Intervention Through Mixed Methods
Authors: McLoughlin Gabriella M , Candal Priscila , Vazou Spyridoula , Lee Joey A , Dzewaltowski David A , Rosenkranz Ric R , Lanningham-Foster Lorraine , Gentile Douglas A , Liechty Laura , Chen Senlin , Welk Gregory J
Published: June 2020

Background: School wellness programming is important for promoting academic achievement and healthy lifestyles in youth; however, research is needed on methods that can help schools implement and sustain programs on their own. The purpose of this study was to investigate factors within and outside the school environment that impacted school capacity for implementation and potential sustainability of wellness programming. Methods: As part of the School Wellness Integration Targeting Child Health (SWITCH®) intervention, elementary school wellness teams (N=30) were guided through a capacity-building process focused on promoting the adoption of healthy lifestyle behaviors in students. Data on implementation were collected through three standardized surveys and interviews (pre-mid-post) and a post-implementation interview. Indicators of organizational capacity were assessed using the School Wellness Readiness Assessment (SWRA). Paired t-tests were run to assess changes in implementation (classroom, physical education, lunchroom settings), capacity, and stakeholder engagement over time. One-way analysis of variance (ANOVA) tests were run to examine how implementation of best practices (low, moderate, high) explained differences in capacity gains. Qualitative data were analyzed through inductive and deductive analysis, following the Consolidated Framework for Implementation Research (CFIR). Results: Paired t-tests showed non-significant increases in school and setting-specific capacity and implementation of SWITCH best practices over time, in addition to a consistent level of engagement from key stakeholders. ANOVA analyses revealed positive, non-significant variances between implementation group and gains in school capacity (F[2,24]=1.63; p=.21), class capacity (F[2,24]=0.20 p=.82), lunchroom capacity (F[2,24]=0.29; p=.78), and physical education (F[2,24]=1.45; p=.25). Qualitative data demonstrated factors within the outer setting (i.e., engaging community partners) that facilitated programming. Inner-setting factors (i.e., relationships with administration and staff) significantly affected implementation. Implementation process construct themes (e.g., planning, adaptation of resources to meet school capacity/needs, and engaging students as leaders) were cited as key facilitators. Schools discussed factors impacting sustainability, such school culture and knowledge of school wellness policy. Conclusions: Findings suggest a modest but important impact of implementation on capacity change which is the primary goal of SWITCH. The results document the importance of allowing schools to adapt programming to meet their local needs.Trial Registration: NCT04045288
Morphology and Morphogenesis of A New Soil Ciliate, Holostichides Songi Nov. Spec. with Notes on the Phylogeny of Holostichides (Ciliophora, Hypotrichia)
Authors: Wang Jingyi , Li Jingbao , Wang Yurui , Shao Chen
Published: June 2020

Background: Hypotrichia are a group with the most complex morphology and morphogenesis within the ciliated protists. The classification of the genus Holostichides is poorly understood particularly due to the lack of molecular data. Hence, the systematic relationship between this genus and other taxa in the subclass Hypotrichia remains unresolved. In this paper, the morphology and morphogenesis of Holostichides songi nov. spec. were studied, in addition, genomic DNA was extracted in order to sequence the small subunit rDNA. The main aims of this study were to document morphogenesis in H. songi nov. spec. and investigate the systematics of Holostichides based on morphology, morphogenetic, and molecular data.Results: A new bakuellid ciliate, Holostichides songi nov. spec. isolated from China, is investigated in terms of its morphology, ontogenesis, and molecular phylogenesis. It is characterized by size in vivo 150–180 µm × 45–60 µm; 27–46 macronuclear nodules; cortical granules dark, spherical, about 0.5 µm across, clustered in groups and then arranged longitudinally; three frontal cirri with one to four smaller cirri below the middle one, one buccal cirrus, 9–15 frontoterminal cirri, and midventral complex composed of five to eight cirral pairs and two long midventral rows. The main events during binary fission are as follows: (1) in the proter, the undulating membrane anlage is formed from both the dedifferentiation of old undulating membranes and the basal bodies developing de novo, and the posterior part of the parental adoral zone of membranelles is renewed by new structure formed from the oral primordium; (2) in the opisthe, the oral primordium is formed intrakinetally; (3) Besides the second frontal cirrus and buccal cirrus, the frontoventral-transverse cirral anlage II produces the extra one to four cirri. Phylogenetic analyses based on SSU rDNA sequence data suggest a close relationship between Holostichides songi nov. spec. and its congeners, indicating that the genus Holostichides is monophyletic.Conclusions: The new bakuellid ciliate, Holostichides songi nov. spec. was studied using standard methods. In addition, the monophyly of the genus Holostichides is well supported in the phylogenetic tree.
Folic acid-containing nanofibers by simultaneous process for transdermal drug delivery: preparation, characterization, and in vitro biocompatibility
Authors: Parın Fatma Nur , Aydemir Çiğdem İnci , Taner Gökçe , Yıldırım Kenan
Published: June 2020

Nanofibers with bioactive agents are good candidates for skin-care applications due to high spesific surface area, low density and highly porous structure. In this study, hydrophilic based bioactive nanofibers were produced via an electrospinning and electrospraying simultaneous process. Polyvinyl alcohol (PVA), polyvinyl alcohol-gelatin (PVA-Gel) and polyvinyl alcohol-alginate (PVA-Alg) polymers were used as the matrix material and folic acid (FA) particles were dispersed simultaneously on the surface of these hydrophilic nanofibers. The morphology of the nanofibers (NFs) was uniform and dispersed folic acid particles incorporated into the structure of nanofibers as confirmed by scanning electron microscopy (SEM). Thermal behavior, chemical structure of the composite nanofibers were analyzed/investigated by thermogravimetric analysis (TGA) and Attenuated Total Reflectance-Fourier Transform Infrared Spectroscopy (ATR-FTIR) which showed that no chemical bonding between vitamin and polymers. A controlled release of FA-loaded electrospun fibers were carried out by UV-Vis in vitro study within the 8 hour-period in artificial sweat solutions (acidic media, pH 5,44). The obtained PVA/FA, PVA-Gel/FA and PVA-Alg/FA fibers released 49.6 %, 69.55 % and 50.88 % of the sprayed FA in 8 h, indicating the influence of polymer matrix and polymer-drug interactions, on its release from the polymer matrix. Moreover, biocompatibility of all developed novel NFs was assessed by two different cytotoxicity tests,3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and neutral red uptake (NRU) assay in L929 cell lines. In all cases, it is clearly concluded that these new electrospun fibers had fast-release of the vitamin and the hybrid process is suitable for transdermal patch applications, especially for skin-care products. Moreover, it has been proposed nanofiber with folic acid as a patch may prevent the COVID-19. The results of cytotoxicity assays on L929 cell reveal that all prepared NFs have no or slight cell toxicity. PVA and PVA-Gel with/without FA nanofibers seems more biocompatible than PVA-Alg nanofibers.
Risk factors for anastomotic leakage and its impact on long-term survival in left-sided colorectal cancer surgery
Authors: Kryzauskas Marius , Bausys Augustinas , Degutyte Austeja Elzbieta , Abeciunas Vilius , Poskus Eligijus , Dulskas Audrius , Strupas Kestutis , Poskus Tomas
Published: June 2020

Background
Anastomotic leakage (AL) significantly impairs short-term outcomes. The impact on the long-term outcomes remains unclear. This study aimed to identify the risk factors for AL and the impact on long-term survival in patients with left-sided colorectal cancer.
Methods
Nine-hundred patients with left-sided colorectal carcinoma who underwent sigmoid or rectal resection were enrolled in the study. Risk factors for AL after sigmoid or rectal resection were identified and long-term outcomes of patients with and without AL were compared.
Results
AL rates following sigmoid and rectal resection were 5.1% and 10.7%, respectively. Higher ASA score (III-IV; OR = 10.54, p = 0.007) was associated with AL in patients undergoing sigmoid surgery on multivariate analysis. Male sex (OR = 2.40, p = 0.004), CCI score > 5 (OR = 1.72, p = 0.025) and T3/T4 stage tumors (OR = 2.25, p = 0.017) were risk factors for AL after rectal resection on multivariate analysis. AL impaired disease-free and overall survival in patients undergoing sigmoid (p = 0.009 and p = 0.001) and rectal (p = 0.003 and p = 0.014) surgery.
Conclusion
ASA score of III-IV is an independent risk factor for AL after sigmoid surgery and male sex, higher CCI score, and advanced T stage are risk factors for AL after rectal surgery. AL impairs the long-term survival in patients undergoing left-sided colorectal surgery.
Rapid Detection of Anti-SARS-CoV-2 IgM and IgG Using a Selenium Nanoparticle-based Lateral Flow Immunoassay
Authors: Wang Zhi-Zeng , Zheng Zhi , Wang Xuan-Ce , Zheng Pei-Ming , Cui Fa-Cai , Zhou Qian-Wen , Hu Hang-Zhan , Li Xiao-Quan , Zhang Hai-Long , Wei Yin-Xiang , Li Gang , Li Xia , Zhang Jun , Wang Yao-Hui , Ma Yuan-Fang
Published: June 2020

Background: Coronavirus disease 2019 is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 is highly transmissible. Early and rapid testing is necessary to effectively prevent and control the outbreak. Detection of SARS-CoV-2 antibodies with lateral flow immunoassay can achieve this goal. Antibody detection is especially effective for the detection of asymptomatic infection.Methods: In this study, SARS-CoV-2 nucleoprotein was expressed by E. coli and purified by affinity chromatography. We used the highly stable and sensitive selenium nanoparticle as the labeling probe coupled with the SARS-CoV-2 nucleoprotein to prepare a new SARS-CoV-2 antibody (IgM and IgG) detection kit. The sensitivity and specificity of the kit were verified by plasma of COVID-19 patients and health persons. Separate detection of IgM and IgG, such as in this assay, was performed in order to reduce mutual interference and improve the accuracy of the test results.Results: The SARS-CoV-2 nucleoprotein was purified on a nickel column, and the final purity was greater than 90%. The sensitivity of the kit was 94.74% and the specificity was 95.12% by 41 negative plasma samples and 19 positive plasma samples detection.Conclusions: The assay kit does not require any special device for reading the results and the readout is a simple color change that can be evaluated with the naked eye. This kit is suitable for rapid and real-time detection of the SARS-CoV-2 antibody.
HGF Treatment Promotes Cardiac Function and Cardiac Repair: Meta-analysis of Pig Models With Myocardial Infarction
Authors: Du Chong , Chen Xiao-Wen , Wang Ze-Mu , Meng Hao-Yu , Li Ya-Fei , Wei Tian-Wen , Wang Lian-Sheng
Published: June 2020

Background: Previous studies reported that hepatocyte growth factor (HGF) could promote angiogenesis and cardiac function after myocardial infarction (MI) in pigs. However, the results of these studies were controversial. To clarify the therapeutic efficacy of local HGF administration after MI, we performed a systematic review and meta-analysis of data from the pig models, which could provide evidence for the feasibility of clinical HGF application.Methods: PubMed, EMBASE, and China National Knowledge Infrastructure were searched for randomized studies that correspond to our subject. The search terms included (hepatocyte growth factor OR HGF) AND (heart failure OR HF OR myocardial infarction OR MI OR AMI OR coronary heart disease OR CHD). The primary endpoint indicators were identified as the left ventricular ejection fraction (LVEF) and capillaries density. Other parameters reflecting cardiac function and ventricular remodeling were analyzed as secondary indicators, including ventricular volume, infarct size, apoptotic index and others.Results: In total, 9 studies were finally included in the meta-analysis. On comparing the cardiac function indexes, the HGF group was found to be better than the control group in regard to LVEF, stroke volume, left ventricular end-systolic volume (LVESV) and left ventricular end-diastolic volume (LVEDV). However, no statistically significant differences were found in heart rate. Furthermore, HGF treatment promotes angiogenesis in ischemic areas, which is manifested by increased capillary density. In addition, the HGF group was found to be better than the control group when it comes to infarct size, arteriole densities, and other indicators of cardiac remodeling.Conclusions: HGF treatment can effectively promote cardiac function and cardiac repair including angiogenesis, and this strategy is a promising cardio-protective approach that merits further clinical studies.
Effects of Wearable Ankle Robotics for Stair and Over-ground Training on Sub-acute Stroke: A Randomized Controlled Trial
Authors: Yeung Ling Fung , Lau Cathy CY , Lai Charles WK , Soo Yannie OY , Chan Man Lok , Tong Raymond KY
Published: June 2020

Background: Wearable ankle robotics could potentially facilitate intensive repetitive task-specific gait training on stair environment for stroke rehabilitation. A lightweight (0.5kg) and portable exoskeleton ankle robot was designed to facilitate over-ground and stair training either providing active assistance to move paretic ankle augmenting residual motor function (power-assisted ankle robot, PAAR), or passively support dropped foot by lock/release ankle joint for foot clearance in swing phase (swing-controlled ankle robot, SCAR).In this two-center randomized controlled trial, we hypothesized that robot-assisted gait training using either PAAR or SCAR in stair environment are more effective to enhance gait recovery and promote independency in early stroke, than conventional training.Methods: Sub-acute stroke survivors (within two months after stroke onset) received hospital usual care plus 20-session robot-assisted training (at least twice weekly, 30-minute per session) on over-ground and stair environments, wearing PAAR (n=14) or SCAR (n=16), as compared to control group receiving conventional training only (CT, n=17). PAAR provided 2.5Nm-4.2Nm torque which was calibratedin each training session to adjust for any progression of functional changes throughout the intervention. Clinical assessments were performed before and after the 20-session intervention, including functional ambulatory categoryas primary outcome measure, along with Berg balance scale and timed 10-metre walk test.Results: After the 20-session interventions, all three groups showed statistically significant and clinically meaningful within-group functional improvement in all outcome measures (p<0.005). Between-group comparison showed SCAR had greater improvement in functional ambulatory category(mean difference +0.6, medium effect size 0.610) with more than 56% independent walkers after training, as compared to only 29% for CT. Analysis of covariance results showed PAAR had greater improvement in walking speed than SCAR (mean difference +0.15m/s, large effect size 0.752), which was in line with the higher cadence and speed when wearing the robot during the 20-session robot-assisted training over-ground and on stairs.Conclusions: Robot-assisted stair training would lead to greater functional improvement in gait independency and walking speed than conventional training in usual care. The active powered ankle assistance might facilitate users to walk more and faster with their paretic leg during stair and over-ground walking.Trial Registration:ClinicalTrials.gov NCT03184259. Registered on 12 June 2017.
The Value of Local Consolidative Therapy in Osimertinib-treated Non-small Cell Lung Cancer With Oligo-residual Disease
Authors: Zeng Ya , Ni JianJiao , Yu Fan , Zhou Yue , Zhao Yang , Li Shuyan , Guo Tiantian , Chu Li , Yang Xi , Chu Xiao , Cai XuWei , ZHU Zhengfei
Published: June 2020

Background: There was no study investigating real-world utilization and outcome of LCT in Osimertinib-treated NSCLC with oligo-residual disease. This study was to analyze the clinical value of local consolidative therapy (LCT) in Osimertinib-treated non-small cell lung cancer (NSCLC) patients with oligo-residual disease.Methods: Patients receiving standard Osimertinib treatment and developing oligo-residual disease (ﬁve or fewer residual metastatic lesions) were retrospectively reviewed. Local therapies performed to the oligo-residual tumor lesions or primary lung site before Osimertinib treatment failure were considered as LCT.Results: Of 108 patients recruited, first-line and second-line Osimertinib were administered in 25 and 83 patients, respectively, while LCT was performed in 14 patients. With a median follow-up of 43.6 months, 69 patients developed progressive disease. LCT significantly improved progression-free survival (PFS) (NR vs 12.8 months, p=0.01) and was independently associated with prolonged PFS (HR=0.29, 95%CI 0.12 to 0.68, p=0.004). Patients receiving LCT had a numerically longer overall survival (OS) (85.8 vs 77.1 months, p=0.58) and after adjusting for potentially confounding factors, LCT tended to increase OS (HR=0.37, 95%CI 0.12-1.16, p=0.089). Pattern of failure analyses indicated that progressive disease developed at the originally existed oligo-residual lesions in 76.2% of the 63 patients who didn’t receive LCT and had Osimertinib treatment failure. Of note, 7 (70%) of the 10 patients who had oligo-residual cranial disease but didn’t receive LCT, developed more than five progressive lesions in the brain, which were no longer suitable for stereotactic radiosurgery. Conclusion: Among Osimertinib-treated NSCLC patients having oligo-residual lesions, LCT could significantly improve PFS and has a tendency to prolong OS, which need to be verified by further investigations.
Efficacy and safety of low-dose everolimus treatment for renal angiomyolipoma associated with tuberous sclerosis complex
Authors: Hatano Takashi , Endo Katsuhisa , Tamari Mayumi
Published: June 2020

Background: Tuberous sclerosis complex (TSC) is a rare disease, with an autosomal dominant mode of inheritance, that results in systemic hamartoma. Renal angiomyolipoma (AML) is observed in 50-80% of TSC patients. Everolimus is recommended as an initial treatment for TSC-associated AML; however, few studies have investigated the efficacy and safety of low-dose everolimus therapy. In the present study, we evaluated the safety and efficacy of low-dose everolimus treatment in patients with TSC-associated AML with renal dysfunction or low body weight.Methods: From January 2014 through December 2018, a total of 50 adult patients underwent everolimus treatment for AML associated with TSC. For patients with renal dysfunction (serum creatinine level ≥1.5 mg/dl) or low body weight (body weight <35 kg), 5 mg of everolimus was administered daily (low-dose group). For patients without renal dysfunction or low body weight, 10 mg of everolimus was administered daily (conventional-dose group). The treatment effects and adverse events (graded according to the Common Terminology Criteria for Adverse Events v5.0–JCOG) were compared between the two groups. Results: There were 20 patients in the low-dose group, and 30 in the conventional-dose group. The average reduction rate of the AML volume in the low-dose group was 52%, whereas it was 60% in the conventional-dose group. No significant differences were found in the average reduction rate between the groups (P=0.24). The average blood everolimus trough levels were 7.7±3.1 ng/mL in the low-dose group and 12.2±5.7 ng/mL in the conventional-dose group. The level was significantly higher in the conventional-dose group than in the low-dose group (P=0.004). The incidences of stomatitis and irregular menstruation were significantly lower in the low-dose group than in the conventional-dose group (P=0.009, P=0.045, respectively).Conclusions: The present study demonstrates that low-dose everolimus treatment is safe and effective for TSC-associated AML. This treatment was well tolerated and adverse events were mild in all cases. Based on our results, low-dose everolimus can be considered a treatment option for patients with TSC-associated AML, especially for those who have renal dysfunction or low body weight.
A new regression model for the forecasting of COVID-19 outbreak evolution: an application to Italian data
Authors: Sisti Davide , Rocchi Ettore , Peluso Sara , Amatori Stefano , Carletti Margherita
Published: June 2020

The novel coronavirus SARS-CoV-2 was first identified in China in December 2019. In just over five months, the virus affected over 4 million people and caused about 300,000 deaths. This study aimed to model new COVID-19 cases in Italy using a new curve. A new empirical curve is proposed to model the number of new cases of COVID-19. It resembles a known exponential growth curve which has a straight line as an exponent, but in the growth curve proposed, the exponent is a logistic curve multiplied for a straight line. This curve shows an initial phase, the expected exponential growth; then rises to the maximum value and finally reaches zero. We characterized the epidemic growth patterns for the entire Italian nation and for each of the 20 Italian regions. The estimated growth curve has been used to calculate the expected time of the beginning, the time related to peak, and the end of the epidemics. Our analysis explores the development of the epidemics in Italy and the impact of the containment measures. Data obtained are useful to forecast future scenario and the possible end of the outbreak.
Reference Ranges for Respiratory Ciliary Function for Chinese Children May Not Be Extrapolated From European Data
Authors: LEE So-Lun , O'Callaghan Christopher , Lau Yu-Lung , Lee Chun-Wai Davy
Published: June 2020

Background:To aid in the diagnosis of Primary Ciliary Dyskinesia (PCD) and to evaluate the respiratory epithelium in respiratory disease, normal age related reference ranges are needed for ciliary beat frequency (CBF), beat pattern and ultrastructure. These reference data are not available for Asian or Chinese children. Our aim was to establish reference ranges for healthy Chinese children.Methods:Ciliated epithelial samples were obtained from 135 health Chinese children aged below 18 years by brushing the inferior nasal turbinate. CBF and beat pattern were analysedfrom high speed video recordings. Epithelial integrity and ciliary ultrastructure were assessed using transmission electronic microscopy. Results:The mean CBF from 135 children studied was 10.1 Hz (95% CI 9.8 to 10.4). Approximately 20% (ranged 18.0-24.2 %) of ciliated epithelial edges were found to have areas of dyskinetically beating cilia. Normal beat pattern was observed in ciliated epithelium from all subjects. We did not find any effect of exposure to second hand smoke on CBF in our subjects. Microtubular defects were found in 9.3% of all of the cilia counted in these children while other ciliary ultrastructural defects were found in less than 3%.Conclusions: We established the reference range for CBF, beat pattern and ultrastructure in healthy Chinese children. Using similar methodology, we found a lower overall mean CBF than previously obtained European values. This study highlights the need to establish normative data for ciliary function in different populations.
The Scar Cosmesis Assessment and Rating Scale To Evaluate The Cosmetic Outcomes of The Totally Thoracoscopic Cardiac Surgery
Authors: Huang Ling-chen , Chen Dao-zhong , Chen Liang-wan , Xu Qi-chen , Zheng Zi-he , Dai Xiao-fu
Published: June 2020

Background
Conventional median sternotomy is widely used in cardiac surgery, while the totally thoracoscopic cardiac surgery which is considered to have aesthetic advantages now is increasingly used in China because patients' requirements for minimally invasive and aesthetically pleasing are significantly increased. Fewer studies have been conducted on the assessment of surgical scars after cardiac surgery. Compared to a median sternotomy approach, multiple-incision totally thoracoscopic cardiac surgery offers smaller but numerous and scattered incisions. In addition to two working ports on the upper and lower margins of the right breast, we also need an inguinal incision and an axillary incision. So, does totally thoracoscopic cardiac surgery really have aesthetic advantages? This study has the following objectives: (a) to compare the long term cosmetic effect of post-operative scars between median sternotomy cardiac surgery and totally thoracoscopic cardiac surgery; (b) to evaluate the effectiveness of the Scar Cosmesis Assessment and Rating(SCAR) scale, in combination with the Numeric Rating Scale(NRS) in the assessment of surgical scars after cardiac surgery.
Methods
Collection of consecutive patients who came to our institution from January 2019 to May 2019 for cardiac surgery via median sternotomy or totally thoracoscopic approach for at least one year of follow-up. Inter-rater reliability, internal consistency and convergent validity were evaluated for the SCAR scale and the NRS. Clinic characteristics and the scores of the SCAR scale and the NRS were analyzed using the Student's t test or Mann-Whitney U-test between the two groups.
Results
Thirty-one patients underwent cardiac surgery via a totally thoracoscopic approach (TA n = 31), and forty-two patients via a median sternotomy approach (SA n = 42). No significant differences were found in demographic and clinical data between the two groups. Validity and reliability of the SCAR scale and the NRS were satisfactory. The results of the SCAR scale showed that SA group scored significantly higher than TA group on “overall impression” and “patient questions” subscales with statistical significance (P < 0.05). The overall SCAR scale scores and the NRS scores were statistically significant (P < 0.05).
Conclusions
The SCAR scale in combination with the NRS is an effective tool for assessment of scar aesthetics after cardiac surgery. Surgical scars of totally thoracoscopic cardiac surgery can achieve desirable cosmetic effects in Chinese population. Especially in susceptible individuals with high risk of keloid and hypertrophic scars. Patients with appropriate indications can undergo cardiac surgery through the totally thoracoscopic approach and obtain a satisfactory scar appearance.
Effectiveness of a Breastfeeding Program for Mothers Returning to Work in Japan: a quasi-experiment study
Authors: Nakada Kaori
Published: June 2020

Background: Maternal employment has been described as a barrier to breastfeeding in many countries. In Japan, many mothers quit breastfeeding after returning to work because they do not know how to continue breastfeeding. The primary objective of this study was to investigate the effectiveness of a breastfeeding support program for mothers in Japan by comparing the breastfeeding continuation rate with a control group at 3 months after returning to work. The second objective was to explore the effectiveness of a pamphlet containing information to help mothers returning to work continue breastfeeding by comparing breastfeeding continuation rates in women given the pamphlet and a control group.Methods: This was a quasi-experimental design study with a program group (n=48), pamphlet group (n=46) and control group (n=47) that took place from February 2017 to August 2018. Participants in the program and pamphlet groups were women who planned to return to work within 4–12 months after giving birth, while the control group included women who had been back at work for at least 3 months. The program involved a 90-min breastfeeding class, a pamphlet, a newsletter, and email consultation. The pamphlet group was sent only the pamphlet, while the control group received no intervention. The outcome was breastfeeding continuation rate at 3 months after returning to work.Results: The breastfeeding continuation rate 3 months after returning to work was significantly higher in the program group than in the control group (79.2% vs. 51.1%, p=0.004). After adjusting for background factors, the program intervention had an effect on breastfeeding rates (adjusted odds ratio=4.68, 95% confidence interval: 1.57–13.96; p=0.006). However, comparison of the pamphlet and control groups revealed no significant differences in breastfeeding continuation rates at 3 months after returning to work (69.6% vs. 51.1%, p=0.07).Conclusions: Program intervention resulted in a significant increase in breastfeeding continuation rates 3 months after returning to work. Randomized controlled trials are needed to make this program applicable in practice. Pamphlet intervention resulted in no significant difference, but the proportion of breastfeeding continuation was high; therefore, further study is necessary after examining the contents of the pamphlet.
A Predictive Signature for Oxaliplatin and 5-fluorouracil Based Chemotherapy Inlocally Advanced Gastric Cancer
Authors: Wang Qinchuan , Liu Xiyong , Chen Chen , Chen Jida , Xu Beisi , Chen Lini , Zhou Jichun , Huang Yasheng , Chen Wenjun , Teng Rongyue , Zhao Wenhe , Jin Lidan , Shen Jun , Shen Jianguo , Yen Yun , Wang Linbo
Published: June 2020

Background: Adjuvantchemotherapy(AC)plays a substantial role in the treatment of locally advanced gastric cancer (LAGC), but the response remains poor. Weaims to improve its efficacy in LAGC. Methods: We identified the expression of eight genes closely associated with platinum and fluorouracil metabolism (RRM1, RRM2, RRM2B, POLH, DUT, TYMS, TYMP, MKI67) in the discovery cohort (N=291). And we further validated the findings in TCGA (N=279) and GEO. Overall survival (OS) was used as an endpoint. Univariate and multivariate Cox models were applied. A multivariate Cox regression model was simulated to predict theOS. Results: In the discovery cohort,the univariate Coxmodelindicated that AC was beneficial to high-RRM1, high-DUT, low-RRM2, low-RRM2B, low-POLH, low-KI67, low-TYMS or low-TYMP patients, the results were validated in the TCGA cohort. The multivariate Cox model showed consistent results. Cumulative analysis indicated that patients with low C-Score respond poorly to the AC, whereas thehigh and mediumC-Score patients significantly benefit from AC. A risk model based on the above variables successfully predicted the OS in both cohorts (AUC=0.75 and 0.67, respectively). Further validation in a panel of gastric cancer cell (GC) lines (N=37) indicated that C-Score is significantly associated with IC50 value to fluorouracil. Mutation profiling showed that C-Score was associated with the number and types of mutations. Conclusion: In this study, we successfully simulated a predictive signature for the efficacy of AC in LAGC patients and further explored the potential mechanisms. Our findings could promote precision medicine and improve the prognosis of LAGC patients.
Meslek Lisesi Kaynaştırma Ortamlarında Fizik Dersi Nasıl Yürütülüyor?
Authors: AKTÜREL İhsan Evren , GÜRGÜR Hasan
Published: June 2020

Özel gereksinimli olan ve olmayan öğrencilerin bir arada eğitim aldıkları, kaynaştırma şeklinde adlandırılan uygulamaların ortaöğretim kurumlarında yaygınlaşmış olduğu bilinmektedir. Burada önemli bir sayıyı da işitme yetersizliği olan öğrenciler oluşturmaktadır. Ortaöğretimde önemli derslerden birisi de fiziktir. Dolayısıyla genel eğitim ortamlarında fizik dersine işitme yetersizliği olan öğrencilerin dahil oldukları gerçeği göz ardı edilmemelidir. Araştırmanın amacı işitme yetersizliği olan öğrencilerin kaynaştırma uygulamalarına dahil oldukları bir meslek lisesinde fizik dersinin nasıl yürütüldüğünün incelenmesidir. Araştırma durum çalışması olarak desenlenmiştir. Araştırmanın katılımcıları; iki rehber ve üç fizik dersi öğretmeni, okul yöneticisi, üçer işiten ve işitme yetersizliği olan öğrenci ve ebeveynlerdir. Sonuçlara göre fizik dersi planlanırken, uygulanırken ve değerlendirilirken işitme yetersizliği olan öğrencilere yönelik bir süreç yaşanmamaktadır. Okulda doğru bir şekilde BEP geliştirilmediği, destek eğitim uygulaması yapılmadığı ve kaynak oda bulunmadığı gözlenmiştir. Elde edilen bulgulara dayalı olarak fizik öğretmenlerine hem işitme yetersizliği olan öğrencilerin eğitimi alanında hem de kaynaştırma uygulamalarına ilişkin hizmetiçi eğitim verilmesi gerektiği ileri sürülebilir.
PERAN MODEL BRAIN-BASED LEARNING PADA PEMBELAJARAN SISTEM SARAF DALAM MENINGKATAN LITERASI SAINS SISWA
Authors: SAADAH KUNI
Published: June 2020

Literasi sains merupakan suatu kemamuan siswa dalan mengidentifikasi pertanyaan guna memperoleh pengetahuan yang baru. Penelitian ini bertujuan untuk mengetahui efektivitas model Brain-Based Learning dalam peningkatan literasi sains siswa pada pembelajaran sistem saraf. Desain penelitian ini yang digunakan adalah Pre-Exsperimental Designs dengan bentuk One-Group Pretest-Posttest Design. Pengambilan sampel menggunakan teknik Purposive Sampling Data yang diambil adalah kemampuan berpikir kritis siswa, rasa ingin tahu siswa, tanggapan siswa, dan tanggapan guru mengenai keterlaksanaan pembelajaran. Instrumen yang digunakan berupa soal pretest posttest, lembar observasi dan rubrik penilaian kemampuan afektif serta psikomotorik siswa, angket tanggapan siswa, dan lembar wawancara tanggapan guru. Pengumpulan data dilakukan dengan menggunakan metode tes, observasi dan angket. Hasil belajar ranah kognitif dianalisis ketuntasan klasikal hasil belajarnya dan uji N-gain. Hasil belajar afektif dan psikomotorik serta tanggapan siswa dianalisis secara deskriptif kuantitatif, sedangkan tanggapan guru dianalisis secara deskriptif kualitatif. Analisis data ditentukan menggunakan aplikasi Microsoft excel. Kemampuan berpikir kritis siswa pada kelas XI MIA 2 hasil uji N-Gain 83,3% dan pada kelas XI MIA 3 75%. Capaian tersebut termasuk dalam kategori tinggi dengan indikator siswa memperoleh nilai ≥70. Rasa ingin tahu siswa kelas XI MIA 2 75% dan pada kelas XI MIA 3 83,3% siswa capaian tersebut termasuk dalam kategori tinggi. Model Brain-Based Learning dapat mencapai indikator keefektifan karena terdapat keberhasilan dan keterpautan model Brain-Based Learning terhadap kemampuan berpikir kritis dan rasa ingin tahu siswa. sehingga dapat disimpulkan bahwa Simpulan: Model Brain-Based Learning efektif untuk peningkatan literasi sains siswa. Kata kunci: Literasi Sains, Brain-Based Learning, Sistem Saraf