bluuebunny/crossref_metadata_2025 huggingface dataset:
Urban-Rural Disparities in Treatment Outcomes Among Recurrent TB Cases in Zambia
Authors: Mutembo Simon , Mutanga Jane Namangolwa , Musokotwane Kebby , Kanene Cuthbert , Dobbin Kevin , Li Changwe , Yao Xiaobai , Marconi Vincent , Whalen Christopher
Published: November 2019

Setting
Southern province, Zambia.
Background
At least 13 – 20% of all Tuberculosis (TB) cases are recurrent TB. Recurrent TB patients have high risk of Multi-Drug Resistant TB (MDR-TB).
Objective
To estimate the prevalence of recurrent TB among TB cases and compare risk of unfavorable treatment outcomes between rural and urban settings.
Methods
In a retrospective cohort study, we used mixed effects logistic regression to asses associations between explanatory and outcome variables. Primary outcome was all-cause mortality and exposure was setting (rural/urban).
Results
Overall 3,566 recurrent TB cases were diagnosed among 25,533 TB patients. The prevalence of recurrent TB was 15.3% (95% CI: 14.8 15.9) in urban and 11.3% (95% CI: 10.7 12.0) in rural areas. Death occurred in 197 (5.5%), 103 (2.9%) were lost to follow-up, and 113 (3.2%) failed treatment. Rural settings had 70% higher risk of death (adjusted OR: 1.7; 95% CI: 1.2 2.7). Risk of lost to follow-up was twice higher in rural than urban (adjusted OR: 2.0 95% CI: 1.3 3.0). Compared to HIV-uninfected, HIV-infected individuals on Antiretroviral Treatment (ART) were 70% more likely to die (adjusted OR: 1.7; 95% CI: 1.2 3.1).
Conclusion
Recurrent TB prevalence was generally high in both urban and rural settings. The risk of mortality and lost to follow-up was higher among rural patients. We recommend a well-organized Directly Observed Therapy strategy adapted to setting.
ROS as a Novel Indicator to Predict Anticancer Drug Efficacy
Authors: Zaidieh Tarek , Smith James , Ball Karen , An Qian
Published: November 2019

Background
Mitochondria are considered a primary intracellular site of reactive oxygen species (ROS) generation. Generally, cancer cells with mitochondrial genetic abnormalities (copy number change and mutations) have escalated ROS levels compared to normal cells. Since high levels of ROS can trigger apoptosis, treating cancer cells with low doses of mitochondria-targeting / ROS-stimulating agents may offer cancer-specific therapy. This study aimed to investigate how baseline ROS levels might influence cancer cells’ response to ROS-stimulating therapy.
Methods
Four cancer and one normal cell lines were treated with a conventional drug (cisplatin) and a mitochondria-targeting agent (dequalinium chloride hydrate) separately and jointly. Cell viability was assessed and drug combination synergisms were indicated by the combination index (CI). Mitochondrial DNA copy number (MtDNAcn), ROS and mitochondrial membrane potential (MMP) were measured, and the relative expression levels of the genes and proteins involved in ROS-mediated apoptosis pathways were also investigated.
Results
Our data showed a correlation between the baseline ROS level, mtDNAcn and drug sensitivity in the tested cells. Synergistic effect of both drugs was also observed with ROS being the key contributor in cell death.
Conclusions
Our findings suggest that mitochondria-targeting therapy could be more effective compared to conventional treatments. In addition, cancer cells with low levels of ROS may be more sensitive to the treatment, while cells with high levels of ROS may be more resistant. Doubtlessly, further studies employing a wider range of cell lines and in vivo experiments are needed to validate our results. However, this study provides an insight into understanding the influence of intracellular ROS on drug sensitivity, and may lead to the development of new therapeutic strategies to improve efficacy of anticancer therapy.
Comparative transcriptome analysis revealed the conversions of stamens into pistil-like structures in Aegilops crassa cytoplasmic male sterile wheat (Triticum aestivum)
Authors: Liu Qi , Liu Zi han , Li Wei , Song Xi Yue
Published: November 2019

Background: Aegilops crassa cytoplasm is an essential material for investigating the cytoplasm of cytoplasmic male sterility (CMS). Moreover, the stamens of C303A exhibit a high degree of pistillody, turning almost white. However, the underlying molecular mechanism of C303A pistillody remains unclear. Therefore, to gain a better understanding of C303A, the phenotypic and cytological features of C303A were observed to identify the key stage that the homeotic transformation of stamens into pistil-like structures, transcriptome profiles were determined by Illumina RNA sequencing technology (RNA-Seq) of stamen. Results: Through morphological observation, for CMS wheat with Aegilops crassa cytoplasm (CMS-C) line C303A, the pistil of which developed normally, but stamens were ultimately aborted and the stamens released no pollen when mature. According to the results of the paraffin section, stamens began to transform into pistils or pistil-like structures at binucleate stage (BNS). Therefore, the stamens of line C303A and its maintainer 303B at BNS were collected for transcriptome sequencing. A total of 20,444 wheat genes were detected as being differentially expressed between C303A and 303B stamens, included 10,283 up-regulated and 10,161 down-regulated genes. Gene Ontology Enrichment Analyses showed that most differentially expressed genes (DEGs) distributed on the metabolic process, cell, cellular process, catalytic activity and cell part. From KEGG, we knew that DEGs were mainly enriched to energy metabolism. We also found several essential genes that may contribute to pistillody in C303A. Based on the above analysis, we believe that due to the confusion of energy metabolism and reactive oxygen metabolism, thereby inducing the pistillody and eventually lead to the abortion of C303A. Conclusion:This study unravels the complex transcriptome profiles in C303A stamen, highlighting the energy metabolism and class B MADS-box genes related to pistillody. This work should lay the foundations of future studies in the mechanical response to wheat stamen and pollen development in CMS.
Hierarchical transcriptional control regulates Plasmodium falciparum sexual differentiation
Authors: Biljon Riëtte van , Wyk Roelof van , Painter Heather J. , Orchard Lindsey , Reader Janette , Niemand Jandeli , Llinás Manuel , Birkholtz Lyn-Marie
Published: November 2019

Background: Malaria pathogenesis relies on sexual gametocyte forms of the malaria parasite to be transmitted between the infected human and the mosquito host but the molecular mechanisms controlling gametocytogenesis remains poorly understood. Here we provide a high-resolution transcriptome of Plasmodium falciparum as it commits to and develops through gametocytogenesis.
Results : The gametocyte-associated transcriptome is significantly different from that of the asexual parasites, with dynamic gene expression shifts characterizing early, intermediate and late-stage gametocyte development and results in differential timing for sex-specific transcripts. The transcriptional dynamics suggest strict transcriptional control during gametocytogenesis in P. falciparum, which we propose is mediated by putative regulators including epigenetic mechanisms (driving active repression of proliferation-associated processes) and a cascade-like expression of ApiAP2 transcription factors.
Conclusions : The gametocyte transcriptome serves as the blueprint for sexual differentiation and will be a rich resource for future functional studies on this critical stage of Plasmodium development, as the intraerythrocytic transcriptome has been for our understanding of the asexual cycle.
Liver stiffness measurement predicts the difficulty of Kasai procedure in Biliary Atresia: a single center retrospective analysis of 199 patients
Authors: Shen Qiulong , Chen Yajun , Peng Chunhui , Pang Wenbo , Wang Zengmeng , Wu Dongyang , Wang Kai , Huang Xinjie
Published: November 2019

Background: Kasai procedure is the standard initial treatment of infants with biliary atresia. The key to perform a successful surgery is to accurately remove the fibrous portal plate near the liver hilum. Yet how to estimate surgical difficulty pre-operatively remains unclear. This study aims to design an algorithm that predicts the difficulty of Kasai procedure using liver stiffness measurement (LSM). Methods: 199 patients were included from April 2012 to December 2016. The patients were all surgically diagnosed with biliary atresia. Group A comprised of patients with porta hepatis retraction (the angle between the plane of the fibrous porta plate and the plane of the medial liver closest to the plate was equal to or smaller than 90°), group B comprised of patients without porta hepatis retraction (the angle between the plane of the fibrous porta plate and the plane of the medial liver closest to the plate was greater than 90°). Liver function measurements and LSM were measured for all patients within three days before surgery. Results: Our study included 19 cases in group A (9 males, 10 females) and 180 cases in group B (87 males, 93 females). LSM had statistical differences between the two groups, 28.10(14.90) kPa VS 10.89(7.10) kPa, P =0.000. There was a significant relationship between LSM and operative age, TBA, AST, GGT (P=0.000, 0.003, 0.003, 0.012, correlation coefficient =0.323, 0.213, 0.207, 0.179). The AUROC of LSM was 0.919. When the cutoff value was 15.15 kPa(OR=3.989; P = 0.000), the sensitivity, specificity, PPV, NPV and diagnostic accuracy were 0.947, 0.750, 0.285, 0.992 and 0.768, respectively. When the value was 23.75kPa(OR=3.483; P = 0.000), the sensitivity, specificity, PPV, NPV and diagnostic accuracy were 0.631, 0.950, 0.571, 0.960 and 0.919, respectively. Conclusions: LSM can be used to predict the difficulty in dissecting fibrous portal plate, and in turn, the difficulty of Kasai procedure. LSM>23.75 kPa suggests a more complicated surgery.
Meibomian Gland Dysfunction (MGD), as Diagnosed by Non-Contact Infrared Meibography, in Dogs with Ocular Surface Disorders (OSD): A Retrospective Study.
Authors: Vinas Marta , Maggio Federica , D’Anna Nunzio , Rabozzi Roberto , Peruccio Claudio
Published: November 2019

Background:Meibomian gland dysfunction (MGD) is one of the possible conditions underlying ocular surface disorders (OSD). Prevalence of MGD in dogs affected by OSD has not yet been reported. We aimed to evaluate the prevalence of MGD among OSD canine patients, which had been assessed by non-contact infrared meibography and interferometry, and to identify MGD associated factors that might guide its diagnosis. Medical records of canine patients examined for OSD between 2016 and 2019 were reviewed. The frequency of MGD was evaluated within different categories (skull conformation, gender, eye and STT-1). The putative MGD risk factors and frequency of MGD within grades of interferometry were evaluated in a regression analysis model and reported as odd ratios (ORs).
Results:One hundred fifty eyes from 81 dogs with OSD were included with median age 75 months (range 3-192) and female representation with 52%. MGD was present in 70% of the examined eyes. MGD risk was higher in males ORadj= 3.015 (95% CI: 1.395 - 6.514) (P= 0.005) and older patients ORadj= 1.207 (95% CI: 1.081 - 1.348) (P= 0.001). No significant differences were found between left and right eyes (P= 0.66) or between the two types of skull conformation (P= 0.477) and MGD presence. MGD was associated to the lowest lipid layer (LL) thickness, as assessed by interferometry (grade 0) OR= 16.00 (95% CI: 2.104 - 121.68) (P< 0.001). STT values were not significantly associated with the presence of MGD (P > 0.05).
Conclusions:MGD is a common underlying pathology in OSD. Being male and higher age are risk factors for MGD. An interferometry grade 0 may guide OSD diagnosis towards MGD.
Patterns of physical activity and health-related quality of life amongst patients with multimorbidity in a multi-ethnic Asian population
Authors: Subramaniam Mythily , Zhang Yunjue , Lau Jue Hua , Vaingankar Janhavi Ajit , Abdin Edimansyah , Chong Siow Ann , Lee Eng Sing
Published: November 2019

Background: The co-occurrence of two or more chronic medical conditions in an individual is defined as multimorbidity. Lifestyle factors, including poor dietary patterns, physical inactivity, tobacco use, and excessive alcohol consumption are key modifiable risk factors that play a role in the development of chronic medical conditions and potentially multimorbidity. The current study aimed to examine the levels of physical activity among those with multimorbidity and its association with socio-demographic factors, clinical parameters, and health-related quality of life (HRQoL) among community-dwelling adults attending a primary care clinic in Singapore. Methods: This cross-sectional study was conducted among patients with multimorbidity between August 2014 and June 2016. Physical activity was measured using the International Physical Activity Questionnaire (IPAQ) Short Form. Health related quality of life (HRQoL) was measured using the EuroQol-5 Dimension (EQ-5D-3L). Data on clinical parameters like hemoglobin A1c (HbA1C), low-density lipoprotein cholesterol (LDL-C), and blood pressure were collected from patient records. Multivariable logistic regression analysis and linear regression were performed to determine the association between IPAQ and clinical health outcomes, as well as HRQoL measures, respectively. Results: In all, 932 respondents with multimorbidity were recruited for the study. Of them, 500 (53.8%) had low physical activity, 325 (35.0%) had moderate physical activity, while 104 (11.2%) had high physical activity. Respondents who were insufficiently active had significantly higher odds of being overweight/ obese (OR: 1.5, 95% confidence interval [CI]: 1.1- 1.9, p = 0.01) as compared to those were sufficient physical active. The multiple linear regression model revealed that insufficient activity level was negatively associated with EQ-5D index scores (β = -0.05, p < 0.001) and the visual acuity scale (β = -4.4, p < 0.001) measuring HRQoL as compared to sufficient activity levels in respondents with multimorbidity. Conclusions: The low levels of physical activity among patients with multimorbidity, and its association with overweight status and poorer HRQoL emphasizes the importance of increasing physical activity in this population. Family physicians treating patients with chronic diseases need to continue encouraging and helping individuals to initiate and maintain appropriate physical activity levels.
Comparison of sciatic nerve block quality achieved using the anterior and posterior approaches: A randomised trial
Authors: Yektaş Abdulkadir , Balkan Bedih
Published: November 2019

Background: The co-administration of sciatic and femoral nerve blocks can provide anaesthesia and analgesia in patients undergoing lower extremity surgeries. Several approaches to achieve sciatic nerve block have been described, including anterior and posterior approaches.
Methods: In total, 58 study patients were randomly assigned to receive either anterior (group A, n=29) or posterior (group P, n=29) sciatic nerve block. Thereafter, the following parameters were determined: sensory and motor block start and end times, time to first fentanyl requirement after blockade but before the start of the operation, time to first fentanyl requirement after the start of the operation, mean fentanyl dose administered after blockade but before the start of the operation, mean fentanyl dose after the start of the operation, time to first diclofenac sodium dose, and total dose of diclofenac sodium required. The trial was retrospectively registered on 11 July 2018.
Results: The time to initiation of sensory block was significantly shorter in group P than in group A (7.70±2.05 min and 12.88±4.87 min, respectively; p=0.01). Group P also had a significantly shorter time to first fentanyl requirement after block but before the start of the operation (00.00±00.00 min for group P and 4.05±7.47 min for group A; p<0.01), significantly higher mean fentanyl dose per patient after block but before the start of the operation (44.03±23.78 µg for group P and 31.20±27.79 µg for group A), significantly longer time to first fentanyl requirement after the start of the operation (16.24±7.13 min for group P and 00.00±00.00 min for group A; p=0.01), and significantly lower mean fentanyl dose per patient after the start of the operation (11.51±2.87 µg for group P and 147.75±22.30 µg for group A). Patient satisfaction (p<0.01), anaesthesia quality (p=0.006), and surgical quality (p=0.047) were significantly higher in group P.
Conclusions: Anterior and posterior approaches can be used to achieve sciatic nerve block in patients undergoing surgery for malleolar fractures. However, better anaesthesia and pain control results can be obtained if analgesia is administered preoperatively in patients with a posterior approach block and after the start of the operation in patients with an anterior approach block.
Prevalence of objectively measured movement asymmetry in yearling Standardbred trotters
Authors: Kallerud Anne Selven , Fjordbakk Cathrine T. , Hendrickson Eli H. S. , Persson-Sjodin Emma , Hammarberg Marie , Rhodin Marie , Hernlund Elin
Published: November 2019

Background Objective measurement of movement asymmetry is gaining in popularity, especially as an adjunct to traditional lameness evaluation. Earlier research has highlighted the need for more knowledge regarding the clinical significance of measured movement asymmetry, and the influence of biological variation. Evaluating the locomotor system of the Standardbred trotter can be challenging, and studies using objective technology on this breed are few. The aim of this study was to quantify the prevalence and magnitude of objectively measured movement asymmetry in young, presumed sound Standardbred trotters, by performing objective movement analysis during in-hand trot and while driven on a track. Our hypothesis was that asymmetry scores would be higher when evaluating horses in-hand versus while driving on a track.Results Of 103 horses included in the study, 77 were measured both in-hand and on the track, 24 were measured only in-hand, and two were measured only on the track. Previously set symmetry thresholds for the measurement system were used, during both in-hand and track trials. The majority of horses (91, 88.3%) did not have any trials below threshold. Front and/or hind limb parameters were above the symmetry thresholds during in-hand trials for 94 (93.1%) horses, and during track trials for 74 (93.7%) horses. For the total 180 in-hand and track trials, 166 (92.2%) trials were above threshold. Asymmetry magnitude ranged from mild to severe, with the majority of horses showing mild asymmetry. A minority of horses (19.7%) switched side of asymmetry for one or more parameters between in-hand and track trials. Trial standard deviations were overall high, mainly due to horse behavior, and this variability should be considered when interpreting the results. There was no significant effect on asymmetry of measuring horses in-hand versus driven.Conclusions A high proportion of presumed sound Standardbred yearlings showed movement asymmetries above previously determined thresholds. The biological and clinical relevance of the study findings may be aided by examining how this asymmetry evolves over time and with training. This is important in order to ensure the welfare of the Standardbred trotter.
Indicators of missing Electronic Medical Record (EMR) discharge summaries: A retrospective study on data from a large Canadian cohort
Authors: Wiebe Natalie , Xu Yuan , Shaheen Abdel Aziz , Eastwood Catherine , Boussat Bastien , Quan Hude
Published: November 2019

Background:
Healthcare systems worldwide have adopted the electronic medical record (EMR). EMRs are an efficient method of interprofessional communication, and can improve data availability for secondary research purposes. The discharge summary (DS) is a crucial document for both interprofessional communication, and coding of data for research purposes. We aimed to assess the completeness of our EMRs by assessing the presence of a DS in the EMR. Additionally, we evaluated the presence of indicators for a missing DS.
Method:
A retrospective chart review was conducted on 3,011 inpatient charts from 3 hospitals in Calgary, Alberta Canada. 893 charts were missing an electronic DS. A 10% sample was drawn to assess for presence of a paper DS. A list of variables was compiled to assess for association between patient and hospital characteristics, patient comorbidities, and the absence of an electronic DS. A Chi-square test, Fisher’s test and logistic regression were conducted to assess for associations.
Results:
The univariate analyses showed that age, being a surgical patient, a Charlson Comorbidity Index (CCI) of </1, as well as patients with myocardial infarctions, congestive heart failure, cerebrovascular disease, dementia, chronic pulmonary disease, diabetes, and renal disease were associated with a missing DS. The multivariate logistic regression showed that those that were middle aged, surgical patients, or with fewer comorbidities were more likely to have a missing DS. Within the 10% sample, approximately 50% of all patients were from a surgical department, all of which were missing both electronic and paper discharge summaries.
Conclusion:
Our study is the first to describe indicators associated with missing electronic discharge summaries. There is a modern day propensity for adoption of the EMR across healthcare systems worldwide. The EMR, especially the DS, is used for the improvement of interprofessional communication, patient outcomes, and data quality. Therefore, the implications of an incomplete EMR are widespread. Our findings will caution future researchers using EMR data about the potential for incomplete data, particularly for patients who are surgical, middle aged, and have fewer comorbidities. Additionally, our study highlights the need for further investigation into the lack of discharge summaries in surgical units.
Implementation and adoption of a health insurance support tool in the electronic health record: A mixed methods analysis within a randomized trial
Authors: Hatch Brigit , Tillotson Carrie , Huguet Nathalie , Marino Miguel , Baron Andrea , Nelson Joan , Sumic Aleksandra , Cohen Deborah , DeVoe Jennifer
Published: November 2019

Background: In addition to delivering vital health care to millions of patients in the United States, community health centers (CHCs) provide needed health insurance outreach and enrollment support to their communities. We developed a health insurance enrollment tracking tool integrated within the electronic health record (EHR) and conducted a hybrid implementation-effectiveness trial in a CHC-based research network to assess tool adoption using two implementation strategies.
Methods: CHCs were recruited from the OCHIN practice-based research network. Seven health center systems (23 CHC clinic sites) were recruited and randomized to receive basic educational materials alone (Arm 1), or these materials plus facilitation (Arm 2) during the 18-month study period, September 2016-April 2018. Facilitation consisted of monthly contacts with clinic staff and utilized audit and feedback and guided improvement cycles. We measured total and monthly tool utilization from the EHR. We conducted structured interviews of CHC staff to assess factors associated with tool utilization. Qualitative data were analyzed using an immersion-crystallization approach with barriers and facilitators identified using the Consolidated Framework for Implementation Research.
Results: The majority of CHCs in both study arms adopted the enrollment tool. The rate of tool utilization was, on average, higher in Arm 2 compared to Arm 1 (20.0% versus 4.7%, p <0.01). However, by the end of the study period, the rate of tool utilization was similar in both arms; and observed between-arm differences in tool utilization were largely driven by a single, large health center in Arm 2. Perceived relative advantage of the tool was the key factor identified by clinic staff as driving tool utilization. Implementation climate and leadership engagement were also associated with tool utilization.
Conclusions: Using basic education materials and low-intensity facilitation, CHCs quickly adopted an EHR-based tool to support critical outreach and enrollment activities aimed at improving access to health insurance in their communities. Though facilitation carried some benefit, a CHC’s perceived relative advantage of the tool was the primary driver of decisions to implement the tool.
Trial Registration: ClinicalTrials.gov: NCT02355262, Posted February 4, 2015
Impact of First Metatarsal Shortening on Forefoot Loading Pattern: A Finite Element Model Study
Authors: Geng Xiang , Shi Jiaqi , Chen Wenming , Ma Xin , Wang Xu , Zhang Chao , Chen Li
Published: November 2019

Backgrounds There has long been a consensus that shortening of the first metatarsal during hallux valgus reconstruction could lead to postoperative transfer metatarsalgia. However, appropriate shortening is sometimes beneficial for correcting severe deformities or relieving stiff joints. This study is to investigate, from the biomechanical perspective, whether and how much shortening of the first metatarsal could be allowed.
Methods A finite element model of the human foot simulating the push-off phase of the gait was established. Progressive shortening of the first metatarsal from 2 to 8 mm at an increment of 2 mm were sequentially applied to the model, and the corresponding changes in forefoot loading pattern during push-off phase, especially the loading ratio at the central rays, was calculated. The effect of depressing the first metatarsal head was also investigated.
Results With increasing shortening level of the first metatarsal, the plantar pressure of the first ray decreased, while that of the lateral rays continued to rise. When the shortening reaches 6 mm, the load ratio of the central rays exceeds a critical threshold of 55%, which was considered risky; but it could still be manipulated to normal if the distal end of the first metatarsal displaced to the plantar side by 3 mm.
Conclusions During the first metatarsal osteotomy, a maximum of 6 mm shortening length is considered to be within the safe range. Whenever a higher level of shortening is necessary, pushing down the distal metatarsal segment could be a compensatory procedure to maintain normal plantar force distributions.
Transcriptome sequencing of Saccharina japonica sporophytes during whole developmental periods reveals regulatory networks underlying alginate and mannitol biosynthesis
Authors: Author) Zhanru Shao(Former Corresponding , Zhang Pengyan , Lu Chang , Li Shaoxuan , Chen Zhihang , Wang Xiuliang , Author) Delin Duan(New Corresponding
Published: November 2019

Background: Alginate is an important cell wall component and mannitol is a soluble storage carbon substance in the brown seaweed Saccharina japonica. Their contents vary with kelp developmental periods and harvesting time. Alginate and mannitol regulatory networks and molecular mechanisms are largely unknown. Results: With WGCNA and trend analysis of 20,940 known genes and 4,264 new genes produced from transcriptome sequencing of 30 kelp samples from different stages and tissues, we deduced that ribosomal proteins, light harvesting complex proteins and “imm upregulated 3” gene family are closely associated with the meristematic growth and kelp maturity. Moreover, 134 and 6 genes directly involved in the alginate and mannitol metabolism were identified, respectively. Mannose-6-phosphate isomerase (MPI2), phosphomannomutase (PMM1), GDP-mannose 6-dehydrogenase (GMD3) and mannuronate C5-epimerase (MC5E70 and MC5E122) are closely related with the high content of alginate in the distal blade. Mannitol accumulation in the basal blade might be ascribed to high expression of mannitol-1-phosphate dehydrogenase (M1PDH1) and mannitol-1-phosphatase (M1Pase) (in biosynthesis direction) and low expression of mannitol-2-dehydrogenase (M2DH) and Fructokinase (FK) (in degradation direction). Oxidative phosphorylation and photosynthesis provide ATP and NADH for mannitol metabolism whereas glycosylated cycle and tricarboxylic acid (TCA) cycle produce GTP for alginate biosynthesis. RNA/protein synthesis and transportation might affect alginate complex polymerization and secretion processes. Cryptochrome (CRY-DASH), xanthophyll cycle, photosynthesis and carbon fixation influence the production of intermediate metabolite of fructose-6-phosphate, contributing to high content of mannitol in the basal blade. Conclusions: The network of co-responsive DNA synthesis, repair and proteolysis are presumed to be involved in alginate polymerization and secretion, while upstream light-responsive reactions are important for mannitol accumulation in meristem of kelp. Our transcriptome analysis provides new insights into the transcriptional regulatory networks underlying the biosynthesis of alginate and mannitol during S. japonica developments. Keywords: Alginate, Mannitol, Transcriptome, Regulatory networks, Growth, Development, Saccharina japonica
Transcriptome dynamics underlying flower color in marigold (Tagetes erecta L.)
Authors: Zhang Huali , Zhang Shiya , Zhang Hua , Chen Xi , Liang Fang , Qin Heland , Zhang Yue , Cong Richen , Xin Haibo , Zhang Zhao
Published: November 2019

Background: Marigold (Tagetes erecta L.) is an important ornamental plant with a wide variety of flower colors. Despite its economic value, few biochemical and molecular studies have explored the generation of flower color in this species.
Results: To study the mechanism underlying marigold petal color, we performed a metabolomics analysis and de novo cDNA sequencing on the inbred line ‘V-01’ and its petal color mutant ‘V-01M’ at four flower developmental stages. A total of 49,217 unigenes were identified from 24 cDNA libraries. Based on our transcriptomic and metabolomic analyses, we present an overview of carotenoid biosynthesis, degradation, and accumulation in marigold flowers. The carotenoid content of the yellow mutant ‘V-01M’ was higher than that of the orange inbred line ‘V-01’, and the abundances of the yellow compounds lutein, neoxanthin, violaxanthin, zeaxanthin, and antheraxanthin were significantly higher in the mutant. During flower development, the carotenoid biosynthesis genes were upregulated in both ‘V-01’ and ‘V-01M’, with no significant differences between the two lines. By contrast, the carotenoid degradation genes were dramatically downregulated in the yellow mutant ‘V-01M’.
Conclusions: We therefore speculate that the carotenoid degradation genes are the key factors regulating the carotenoid content of marigold flowers. Our research provides a large amount of transcriptomic data and insights into the marigold color metabolome.
Histopathological assessment of optic nerve invasion guided by radiological findings in enucleated globes with retinoblastoma.
Authors: Abusayf Mohammed , Alkatan Hind Manaa , Maktabi Azza MY , Elkhamary Sahar , Almesfer Saleh
Published: November 2019

Purpose: High-risk histopathological features in primary enucleated retinoblastoma globes affect the indication for neoadjuvant chemotherapy to avoid the increased risk of metastasis and to improve survival in such children. Optic nerve (ON) invasion is an important indicator of prognosis and we aim through this study to correlate the detected-ON invasion by imaging with the corresponding confirmed histopathological level of invasion. Methods: This is an approved retrospective study with collaborative agreement between the 2 centres. All enucleated globes with the diagnosis of retinoblastoma received in the histopathology department(s) from January 2015 to December 2016 (2 years) were collected for review by 2 pathologists and the charts were reviewed for basic demographic data. All patients underwent Magnetic resonance imaging (MRI) under sedation upon diagnosis and MRI reading was done by an experienced single neuroradiologist. Results: A total of 38 patients were included: 21 males and 17 females. 29 (77.3%) had unilateral involvement, 7 (18.4%) had bilateral involvement and 2 cases had trilateral disease. The overall mean age at diagnosis was 22.63 ±15.15 months. 28 cases (74%) had pathologically-proven ON invasion: prelaminar (31.6%), laminar (18.4%), and post-laminar (23.7%). Post-laminar ON invasion was identified in 8 cases (true positive), while another 8 were false positive. Only 1 case was missed on MRI (accuracy: 63.3%; sensitivity: 88.9%; specificity: 72.4%; Positive predictive value (PPV): 50%; Negative predictive value (NPV): 95.5%). Conclusions: MRI was found to be less sensitive in evaluating pre-laminar and laminar ON invasion (0.0 and 42.9%) compared to post-laminar invasion (88.9%) but had better specificity in detecting various levels of invasion (72.4 to 83.9%). Obtaining deeper histologic sections in some cases where there are mismatching ON level of invasion between MRI and histopathological examination is recommended to avoid misleading assessment of the high-risk histopathological features. There are no solid international protocols of how many sections should be obtained to evaluate the optic nerve invasion in these globes and this should be established for universal use especially in less developed countries where experienced pathologists might be lacking. Key words: Retinoblastoma; High-risk, Histopathology; Optic nerve invasion; Lamina cribrosa; Radiology; Magnetic resonance imaging; Chemotherapy.
Delivery of a Mental Health First Aid training package and staff peer support service in secondary schools: A mixed-methods implementation study of the WISE intervention
Authors: Fisher Harriet , Harding Sarah , Bell Sarah , Copeland Lauren , Evans Rhiannon , Powell Jillian , Araya Ricardo , Campbell Rona , Ford Tamsin , Gunnell David , Murphy Simon , Kidger Judi
Published: November 2019

Background: Improving children and young people’s provision for mental health is a current health priority in England. Secondary school teachers have worse mental health outcomes than the general working population, which the Wellbeing in Secondary Education (WISE) cluster randomised controlled trial aimed to improve. The intervention tested delivery of a Mental Health First Aid (MHFA) training package to at least 16 percent of staff, a short mental health awareness session to all teachers, and development of a staff peer-support service. Twenty-five schools were randomised to intervention or control arms. This paper reports findings from an embedded process evaluation to assess the extent of successful intervention implementation.Methods: Mixed methods data collection comprised researcher observations of training delivery, training participant evaluation forms, trainer and peer supporter interviews, peer supporter feedback meetings, logs of support provided, and teacher questionnaires. Quantitative data were summarised descriptively, while thematic analysis was applied to the qualitative data. Results: In the 12 schools assigned to the intervention arm, 113 (8.6%) staff completed the two-day standard MHFA training course, and a further 146 (11.1%) staff completed the one-day MHFA for Schools and Colleges training. In seven (58.3%) schools the required eight percent of staff completed the MHFA training packages. A one-hour mental health awareness raising session was attended by 666 (54.5%) staff. Delivery of the MHFA training package was achieved with high levels of fidelity and quality across schools. All schools set up the peer-support service following training, with a majority adhering to most of the operational guidelines developed from the pilot study. Teachers reported limited use of the peer support service during follow-up. At the second peer-supporter feedback meeting, only three (25.0%) schools indicated they had re-advertised the service and there was evidence of a reduction in support from senior leadership. Conclusion: The MHFA training package was delivered with reasonably high fidelity, and a staff peer support service was established with general, but not complete, adherence to guidelines. In some schools insufficient staff received MHFA training and levels of delivery of the peer support service compromised intervention dose and reach.
Molecular Evolution, Genome-Wide Characterization and Codon Bias Analysis of the SBP-Box Family in Cucumis sativus
Authors: You Yue , Zheng Yuanting , Wang Jian , Li Sujuan , Shao Jianfeng , Qi Guoan , Xu Fei , Wang Gangjun , Chen Zhonghua , Xu Shengchun
Published: November 2019

Background: SQUAMOSA promoter binding protein (SBP)-box genes encode a group of transcription factors which extensively play essential roles in plant development and stress responses. However, the SBP-box gene family has not been well characterized in cucumber (Cucumis sativas). Results: In present study, 15 putative SBP-box genes were identified distributing on 4 chromosomes of cucumber. Evolutionary analysis showed that the green plant SBP family originated from a common ancestor. Phylogenic analysis divided CuSBPs into 6 groups similar to those of Arabidopsis and rice. Intron-exon and motif structure within each group shared common features according to evolutionary study. Expression pattern analysis of transcriptional data about flowering and resistance to powdery mildew demonstrated conserved SBP-box genes function in vegetative-to-reproductive transition and potential roles in other regulatory pathways. Moreover, codon bias analysis explained the mutation and selection pressure exerted on genes. Conclusions: This study comprehensively characterized cucumber CuSBP gene families, which would provide a foundation to explore the functions of CuSBPs for improving yield, quality and stress tolerance of cucumber in the future.
Determinants and aetiologies of postpartum pyrexia; a retrospective analysis in a tertiary health facility in the Littoral Region of Cameroon.
Authors: Ngunyi Yannick Lechedem , Halle-Ekane Gregory , Tendongfor Nicholas , Mbivnjo Etheldreda Leinyuy , Mbarga Armel Evouna , Nembulefack Derick , Abonge Clifford Lo-oh , Egbe Thomas Obinchemti
Published: November 2019

Background Postpartum febrile morbidity is relatively common, occurring in approximately 5–7% of births. Differentiating between potentially serious and benign causes of postpartum pyrexia is fundamental in curbing the mortality rate from sinister causes such as sepsis. The paucity of data on PP in Cameroon makes it difficult to access its actual burden. This study was aimed at determining the prevalence, risk factors and aetiologies of PP at a tertiary hospital in Douala, Cameroon. Methods This was a 2 – year hospital – based retrospective cohort study carried out at the Douala General Hospital (DGH), during which medical records of all postpartum admissions between January 1st 2017 and December 31st 2018 were reviewed. The review consisted of collecting data on socio-demographic characteristics, clinical profile, investigations and final diagnoses. The collected data was analysed in SPSS 23.0. Chi-squared test was used to test the association between variables and a logistic regression analysis was fitted to identify risk factors associated to PP. Results A total of 1520 postpartum files were reviewed. The prevalence of PP was 8.82%. The most frequent causes of PP were: malaria (46.7%), urinary tract infections (18.7%), puerperal sepsis (17.9%) and pneumonia (8.7%). E. coli was the most (49.3%) cultured germ isolated in positive cultures. Onset of PP was more common (85%) within the first 3 days postpartum and malaria (60%) was the leading aetiology within this period. Five or more vaginal examinations prior to delivery (OR 59.151, 95% CI: 21.463-163.019; p<0.001), perineal tears (OR 45.157, 95% CI: 2.266-899.722; p<0.001), and duration of labour >18hours (OR 26.760, 95% CI: 7.100-100.862; p<0.001) were the most significant risk factors associated with PP.Conclusion Approximately 1 in every 12 postpartum cases in the DGH presents with PP. Malaria was the leading cause of PP at DGH especially for cases registered within 3 days postpartum. The risk factors identified were mostly associated to perinatal events, such as frequent vaginal examinations, perineal tears and prolonged labour. Efforts towards preventing identified risk factors thus becomes paramount in order to curb this high rate of PP in the DGH.
Association of CYP19A1 Polymorphism with Genetic Susceptibility to Lung Cancer in Chinese population:a case-control study
Authors: Li Anqi , Li Meng , He Ruiqing , Dang Wenhui , Li Yang , Jin Tianbo , Zhang Ning , Zhang Shanshan , Chen Mingwei
Published: November 2019

Background Lung cancer is a kind of cancer with high morbidity and mortality related to genetic factors. Many studies have shown that CYP19A1 gene polymorphism is associated with a variety of cancers, but there are few studies on lung cancer at present. The aim of the study was to explore the correlation between CYP19A1 polymorphisms and lung cancer risk in Chinese population.Methods We enrolled 510 lung cancer patients as the case group and 504 healthy people as the control group. Five single nucleotide polymorphisms determined in CYP19A1 gene were genotyped by MassARRAY, and correlation analysis was performed by Chi square test and logistic regression model.Results The genotypes of rs4646 (OR=0.77, p=0.010), rs6493487 (OR=0.76, p=0.006) and rs17601876 (OR=0.69, p=1.15E-04) in CYP19A1 gene were linked to decreasing the risk of lung cancer, while the rs1062033 (OR=1.49, p=0.029) was linked to increasing lung cancer risk. In gender-stratified analysis, female patients with the GG genotype of the rs6493487 (OR=0.31, p=0.037) and male patients with the rs17601876 (OR=0.52, p=0.012) had lower lung cancer risk. In age-stratified analysis, for patients ≥58 years, decreased lung cancer risk was correlated with the genotypes of rs4646 (OR=0.66, p=0.021), rs6493487 (OR=0.65, p=0.021) and rs17601876 (OR=0.39, p=0.001), and increased risk was associated with the GG genotype of rs1062033 (OR=2.09, p=0.003). In pathologic type-stratified analysis, the AA genotype of rs17601876 (OR=0.41, p=0.048) was associated with decreased risk of small cell lung cancer, and the AA genotype of rs4646 (OR=0.41, p=0.027), the GA genotype of rs6493487 (OR=0.65, p=0.024) and the AA genotype of rs17601876 (OR=0.34, p=0.005) were linked to decreased risk of squamous cell carcinoma.Conclusion CYP19A1 polymorphisms are associated with lung cancer risk, especially in elderly patients and patients with pathologic types of small cell lung cancer and squamous cell carcinoma.
Metabolomics Study of Browning Mechanism in Eggplant Fruits
Authors: Liu Xiaohui , Zhang Shengmei , Shang Jing , Zhang Aidong , Zhu Zongwen , Wu Xuexia , Zha Dingshi
Published: November 2019

Background: Fresh-cut fruits and vegetables is a emerging type of fruits and vegetables processing products for consumers to eat immediately or for the catering industry. Enzymatic browning is one of the crucial problems compromising the flavor and texture of fresh-cut fruit and vegetables. Eggplant is a common vegetable, which is favored by consumers. Accordingly, we used an untargeted metabolomics approach based on liquid chromatography-mass spectrometry (LC-MS) to explore the browning mechanism in peeled eggplant ( Solanum melongena L . ). Results: Metabolomics revealed several hundred differential metabolites, including lipids, phenols, sugars and fatty acids. The content of these metabolites changed dynamically as the peeled time increased. The content of polyphenols, especially chlorogenic acid, increased significantly, suggesting that the main substrate for enzymatic browning in eggplant is chlorogenic acid. Furthermore, all the differential metabolite were mapped to KEGG pathway, revealing significant differences in linoleic acid metabolism, tyrosine metabolism ，glutathione metabolism, pentose phosphate pathway, tropane, piperidine and pyridine alkaloid biosynthesis, phenylpropanol metabolism and glycosylphosphatidylinositol(GPI)-anchor biosynthesis over time. Therefore, we speculate that some metabolic pathways that are closely connected with respiration, glycolysis, ATP synthesis, and phenolic synthesi are disturbed after peeling, under the action of enzymes, eventually leading to browning. Conclusions: We established an untargeted metabolomics method based on LC-MS technology to explain the mechanism of eggplant browning, which may lay the foundation for better understanding the mechanism of browning during the fruits and vegetables deeply processing, and furnish new ideas and perspectives for understanding fruit and vegetable browning in the future.
An Ontology-Based Medical Information Management System for Electronic Claim Processing Systems
Authors: Kose Ilker
Published: November 2019

Background The electronic claim processing (ECP) systems in healthcare insurance require, naturally, comprehensive, and secure management of medical information. Even though the state of the art ECP systems can read the payment rules written in plain-text, there are hundreds of rules (each including tens of conditions) in a conventional ECP system. The conditions of the rules, in turn, refer to thousands of medical entities and concepts. Although domain experts can manage the plain-text payment rules, the length and complexity of the rules yield a lack of understandability and an increase in-rule and inter-rule inconsistencies. Hence, a more efficient and straightforward system is required. This study aims to make the medical data bank that is used for the claim management system more efficient by using ontology. Method We proposed ontology- based on the medical information management system (ONTMIMS) in healthcare insurance- to simplify the payment rules. 1,312 sets of diagnosis and health services are included in ONTMIMS. The development of the ontology compromises four stages: i) specification and conceptualization; ii) formalization; iii) implementation; and, iv) evaluation. Protégé and Apache Jena library are conducted as tools, and the ONTMIMS is used in a real-life ECP system. Results The experiments indicated that ONTMIMS increased the understandability from 35.1% to 64.9%. Distinguishing in-rule inconsistencies increased from 65% to 82.5%, and distinguishing inter-rule inconsistencies increased from 78.8% to 85%. Conclusions Ontology, as in many other studies, is very useful in representing and processing information. That is the first study using ontology in ECP systems used in health insurance institutions. The results showed that ontology increased the in-rule and inter-rule consistency and made the rule sentences more understandable by the domain experts.