bluuebunny/crossref_metadata_2025 huggingface dataset:
The clinical value of passive leg raising plus ultrasound to predict fluid responsiveness in children after cardiac surgery
Authors: Luo Deqiang , Dai Wei , Lei Lei , cai xueying
Published: August 2020

Background: There are few non-invasive monitoring methods that can reliably predict fluid responsiveness (FR) in children. Here, we interrogate the value of doppler ultrasound evaluation of passive leg raising (PLR)-induced changes in stroke volume (SV) and cardiac output (CO) as a predictor of FR in children with mechanical ventilation after congenital cardiac surgery. Methods: A total of 40 children with mechanical ventilation following congenital cardiac surgery, who required volume expansion (VE) were included in this study. Hemodynamic parameters such as heart rate (HR), mean arterial pressure (MAP), SV, and central venous pressure (CVP) were monitored before and after PLR and VE. Besides, we assessed changes in SV and CO by bedside ultrasound. Patients showing >10% increase in SV in response to VE were considered to be responders (26 patients), while the rest (14 patients) were defined as non-responders. Results: Our data demonstrated that ΔSV-PLR and ΔCO- PLR were positively correlated with ΔSV-VE (r = 0.683, p <0.001 and r = 0.374, p = 0.017, respectively), and the area under the ROC curve (AUC) of ΔSV-PLR was 0.879 (95% CI [0.745 1.000], p < 0.001). The best cut-off value for ΔSV-PLR in predicting FR was 13%, with its sensitivity and specificity were 81.8% and 86.3%, respectively. ΔCVP, ΔHR, and ΔMAP were weak predictors of FR in the children. Conclusion: Our study demonstrated that SV changes, as evaluated by noninvasive ultrasound combined with PLR, could effectively evaluate FR in children under mechanical ventilation following congenital cardiac surgery.
Development and validation of a cancer stem cell-related signature for prognostic prediction in pancreatic ductal adenocarcinoma
Authors: Feng Zengyu , Shi Minmin , Li Kexian , Ma Yang , Jiang Lingxi , Chen Hao , Peng Chenghong
Published: August 2020

Background

Cancer stem cells (CSCs) are crucial to malignant behavior and poor prognosis of pancreatic ductal adenocarcinoma (PDAC). In recent years, CSC biology has been widely studied, but practical prognostic signatures based on CSC-related genes have not been established and reported in PDAC.

Methods

This signature was developed and validated in seven independent PDAC datasets. MTAB-6134 cohort was used as training set, while one Chinese local cohort and five other public cohorts were used for external validation. CSC-related genes with credible prognostic roles were selected to form the signature, and its predictive performance was evaluated by Kaplan-Meier survival, receiver operating characteristic (ROC), and calibration curves. Correlation analysis was employed to clarify the potential biological characteristics.

Results

A robust signature comprising DCBLD2, GSDMD, PMAIP1, and PLOD2 was developed. It could classify patients into high-risk and low-risk groups, and high risk patients had significantly shorter overall survival (OS) and disease-free survival (DFS) compared with low risk patients. Calibration curves and Cox regression analysis demonstrated the powerful predictive performance. ROC curves showed an improved survival prediction provided by this model. Functional analysis revealed positive association between risk score and CSC marker. These results had cross-dataset compatibility.

Conclusions

We established a novel four-gene signature based on CSC-related genes which could serve as a powerful prognostic tool in PDAC.

Impact

This signature can offer potential help for further improving current TNM staging system, and providing data for the development of novel personalized therapeutic strategies in the future.
Acting between guidelines and reality. Managers’ balancing between standardisation and adaptive behaviour in patient safety work- an interview study
Authors: Hedsköld Mats , Sachs Magna Andreen , Rosander Thorleif , von Knorring Mia , Harenstam Karin Pukk
Published: August 2020

Background: Safety culture can be described and understood through its manifestations in the organisation as artefacts, espoused values and basic underlying assumptions and is strongly related to leadership-yet it remains elusive as a concept. Even if the literature points to leadership as an important factor for creating and sustaining a mature safety culture, little is known about how the safety work of first line managers’ actually is done and how they balance the different and often conflicting organizational goals in everyday practice. The purpose of this study was to explore how health care first line managers perceive their role and how they promote patient safety and patient safety culture in their units. Methods: Interview study with first line managers in intensive care units in in eight different hospitals located in the middle of Sweden. An inductive qualitative content analysis approach was used. Results: We present how first line managers view their role in patient safety and exemplify concrete strategies by which managers promote safety culture by acting as role models, designing everyday work and promoting psychological safety and a learning environment. Conclusions: Our study shows the central role of front-line managers in designing the everyday work in the ICU. Although promoted widely in Swedish healthcare at the time for the interviews, the HSOPSC was not mentioned by the managers as a central source of information on the unit’s safety culture.
Barriers and Facilitators of Kangaroo Mother Care Adoption in Five Chinese Hospitals: a Qualitative Study
Authors: Yue Jieya , Liu Jun , Williams Sarah , Zhang Bo , Zhao Yingxi , Zhang Qiannan , Zhang Lin , Liu Xin , Wall Stephen , Wetzel Greta , Zhao Gengli , Bouey Jennifer
Published: August 2020

Background Kangaroo mother care (KMC) has been proved to be a safe and cost-effective standard of care for preterm babies. China hasn’t adopted the KMC practice widely until recently. We aim to assess barriers and facilitators of KMC adoption in neonatal intensive care units (NICUs) and postnatal wards in China. Methods We conducted clinical observations and semi-structured interviews with nurses, physicians, and parents who performed KMC in seven NICUs and postnatal wards housed in five hospitals in different provinces of China between August and September 2018. The interviews provided first-hand stakeholder perspectives on barriers and facilitators of KMC implementation and sustainability. We further explored health system’s readiness and families’ willingness to sustain KMC practice following its pilot introduction. We coded data for emerging themes related to financial barriers, parent- and hospital-level perceived barriers, and facilitators of KMC adoption, specifically those unique in the Chinese context. Results Five hospitals with KMC pilot programs were selected for clinical observations and 38 semi-structured interviews were conducted. Common cultural barriers included concerns with the conflict with traditional postpartum confinement (Zuo-yue-zi) practice and grandparents’ resistance, while a strong family support is a facilitator for KMC adoption. Some parents reported anxiety and guilt associated with having a preterm baby, which can be a parental-level barrier to KMC. Hospital-level factors such as fear of nosocomial infection and shortage of staff and spaces impeded the KMC implementation, and supportive community and peer group organized by the hospital contributed to KMC uptake. Financial barriers included lodging costs for caregivers and supply costs for hospitals. Conclusions We provided a comprehensive in-depth report on the multi-level KMC barriers and facilitators in China. We recommend policy interventions specifically addressing these barriers and facilitators and increase family and peer support to improve KMC adoption in China. We also recommend that well-designed local cultural and economic feasibility and acceptability studies should be conducted before the KMC uptake.
The role of TNFAIP8-mediated mTOR-Akt-ULK1 signaling pathway in gastric cancer
Authors: Chen Zheng , Zhang Jianguo , Dong Chenyang , Li Dongsheng , Yin Yuehan , Yu Wenhai , Chen Yuezhi
Published: August 2020

Background: The purpose of this article was to study the role of TNFAIP8 in gastric cancer. Methods: RT-PCR was used to detect the expression of TNFAIP8 mRNA and protein level in normal gastric mucosa cells and four gastric cancer cell lines. TNFAIP8 was silenced or overexpressed in two cell lines, CCK-8 cell viability was used, transwell experiment was used to detect cell invasion capability, and flow cytometry was used to detect cell apoptosis. TNFAIP was silenced or overexpressed in a cell line, and nude mice were inoculated to form transplanted tumors. HE staining and immunohistochemistry staining were used to detect the histopathological changes of tumors. Results: The mRNA and protein expression of TNFAIP8 was significantly up-regulated in GC patients and cells. After silencing and overexpressing TNFAIP8, gastric cancer cells with high expression increased, apoptosis decreased, and cell invasion increased. Expression of mTOR-Akt-ULK1 signal pathway was inhibited and autophagy signal was activated. Conclusions: Our findings indicate that TNFAIP8 inhibited gastric cancer cells by inhibiting mTOR-Akt-ULK1 signal pathway and activating autophagy signal.
Association between SNPs within MicroRNA Binding Sites and the Prognosis of Breast Cancer
Authors: Zhang Liwen , Han Lu , Huang Yubei , Feng Ziwei , Wang Xin , Li Haixin , Song Fangfang , Liu Luyang , Li Junxian , Zheng Hong , Wang Peishan , Song Fengju , Chen Kexin
Published: August 2020

Background: Single nucleotide polymorphisms (SNPs) within microRNA binding sites can affect the binding of microRNA to mRNA and regulate gene expression, thereby contributing to the prognosis of cancer. We performed this study to explore the association between SNPs within microRNA binding sites and the prognosis of breast cancer.Methods: We carried out a two-stage study including 2647 breast cancer patients, with a median follow-up of 68 months (range 0-159). In stage I, we genotyped 192 SNPs within microRNA binding sites using the Illumina Goldengate platform. In stage II, we validated SNPs significantly associated with breast cancer prognosis in another dataset using the TaqMan platform. Survival times was calculated, and Kaplan-Meier curves and Cox regression model were used to analyze survival of breast cancer patients with different genotypes.Results: We identified 8 SNPs significantly associated with breast cancer prognosis in stage I (P<0.05), and only rs10878441 was statistically significant in stage II (AA vs CC: adjusted HR=2.21, 95% CI: 1.11-4.42, P=0.024). We combined the data from stage I and stage II, and found that, compared with rs10878441 AA genotype, CC genotype was significantly associated with poor survival of breast cancer (HR=1.69, 95% CI: 1.18-2.42, P=0.004; adjusted HR=2.19, 95% CI: 1.30-3.70, P=0.003). Stratified analyses demonstrated that rs10878441 was related to breast cancer prognosis in grade II patients and lymph node-negative patients (P<0.05).Conclusions: The LRKK2 rs10878441 CC genotype is associated with poor prognosis of breast cancer in a Chinese population, and it could be used as a potential prognostic biomarker for breast cancer. Further studies are warranted.
Analysis of Bioavailable Toluene by Using Recombinant Luminescent Bacterial Biosensors with Different Promoters
Authors: Wang Guey-Horng , Tsai Teh-Hua , Kui Chun-Chi , Cheng Chiu-Yu , Huang Tzu-Ling , Chung Ying-Chien
Published: August 2020

In this study, we constructed recombinant luminescent Escherichia coli with T7, T3, and SP6 promoters inserted between tol and lux genes as toluene biosensors and evaluated their sensitivity, selectivity, and specificity for measuring bioavailable toluene in in groundwater and river water. The luminescence intensity of each biosensor depended on temperature, incubation time, ionic strength, and concentrations of toluene and coexisting organic compounds. Toluene induced the highest luminescence intensity in recombinant lux-expressing E. coli with the T7 promoter [T7-lux-E. coli, limit of detection (LOD) = 0.05 μM], followed by that in E. coli with the T3 promoter (T3-lux-E. coli, LOD = 0.2 μM) and SP6 promoter (SP6-lux-E. coli, LOD = 0.5 μM). Luminescence activities may have been synergistically or antagonistically affected by coexisting organic compounds other than toluene; nevertheless, low concentrations of benzoate and toluene analogs had no such effect. In reproducibility experiments, the biosensors had low relative standard deviation (4.3%–5.8%). SP6-lux-E. coli demonstrated high adaptability to environmental interference. T7-lux-E. coli biosensor—with low LOD, wide measurement range (0.05–500 μM), and acceptable deviation (−14.3% to 9.1%)—is an efficient toluene biosensor. This is the first study evaluating recombinant lux E. coli with different promoters for their potential application in toluene measurement in actual water bodies.
Molecular characteristics of the VP1 region of enterovirus 71 strains in China
Authors: Sun Haiyan , Gao Min , Cui Dawei
Published: August 2020

Background: Enterovirus 71 (EV71) is the most commonly implicated causative agent of severe outbreaks of paediatric hand, foot, and mouth disease (HFMD).VP1 protein, a capsid protein of EV71, is responsible for the genotype of the virus and is essential for vaccine development and effectiveness. However, the genotypes of EV71 isolates in China are still not completely clear.Methods: The VP1 gene sequences of 3712 EV71 virus strains from China,excluding repetitive sequences and 30 known EV71 genotypes as reference strains, between 1986 and 2019 were obtained from GenBank. Phylogenetic tree, amino acid homology, genetic variation and genotype analyses of the EV71VP1 protein were performed with MEGA 6.0 software.Results: The amino acid identity was found to be 88.33%~100% among the 3712 EV71 strains, 93.47%~100% compared with vaccine strain H07, and 93.04%~100% compared with vaccine strains FY7VP5 or FY-23K-B. Since 2000, the prevalent strains of EV71 were mainly of the C4 genotype. Among these, the C4a subgenotype was predominant, followed by the C4b subgenotype; other subgenotypes appeared sporadically between 2005 and 2018 in mainland China. The B4 genotype was the main genotype in Taiwan, and the epidemic strains were constantly changing. Some amino acid variations in VP1 of EV71 occurred with high frequencies, including A289T (20.99%), H22Q (16.49%), A293S (15.95%), S283T (15.11%), V249I (7.76%), N31D (7.25%), and E98K (6.65%).Conclusion: The C4 genotype of EV71 in China matches the vaccine and should effectively control EV71. However, the efficacy of the vaccine is partially affected by the continuous change in epidemic strains in Taiwan. These results suggest that the genetic characteristics of the EV71-VP1 region should be continuously monitored, which is critical for epidemic control and vaccine design to prevent EV71 infection in children.
Methods of analysis of Chloroplast Genomes of C3, Kranz type C4 and Single Cell C4 photosynthetic members of Chenopodiaceae
Authors: Sharpe Richard , Williamson-Benavides Bruce Andreas , Edwards Gerry , Dhingra Amit
Published: August 2020

Background Chloroplast genome information is critical to understanding forms of photosynthesis in the plant kingdom. During the evolutionary process, plants have developed different photosynthetic strategies that are accompanied by complementary biochemical and anatomical features. Members of family Chenopodiaceae have species with C 3 photosynthesis, and variations of C 4 photosynthesis in which photorespiration is reduced by concentrating CO 2 around Rubisco through dual coordinated functioning of dimorphic chloroplasts. Among dicots, the family has the largest number of C 4 species, and greatest structural and biochemical diversity in forms of C 4 including the canonical dual-cell Kranz anatomy, and the recently identified single cell C 4 with the presence of dimorphic chloroplasts separated by a vacuole. This is the first comparative analysis of chloroplast genomes in species representative of photosynthetic types in the family. Results Methodology with high throughput sequencing complemented with Sanger sequencing of selected loci provided high quality and complete chloroplast genomes of seven species in the family and one species in the closely related Amaranthaceae family, representing C 3 , Kranz type C 4 and single cell C 4 (SSC 4 ) photosynthesis Six of the eight chloroplast genomes are new, while two are improved versions of previously published genomes. The depth of coverage obtained using high-throughput sequencing complemented with targeted resequencing of certain loci enabled superior resolution of the border junctions, directionality and repeat region sequences. Comparison of the chloroplast genomes with previously sequenced plastid genomes revealed similar genome organization, gene order and content with a few revisions. High-quality complete chloroplast genome sequences resulted in correcting the orientation the LSC region of the published Bienertia sinuspersici chloroplast genome, identification of stop codons in the rpl23 gene in B. sinuspersici and B. cycloptera , and identifying an instance of IR expansion in the Haloxylon ammodendron inverted repeat sequence. The rare observation of a mitochondria-to-chloroplast inter-organellar gene transfer event was identified in family Chenopodiaceae. Conclusions This study reports complete chloroplast genomes from seven Chenopodiaceae and one Amaranthaceae species. The depth of coverage obtained using high-throughput sequencing complemented with targeted resequencing of certain loci enabled superior resolution of the border junctions, directionality, and repeat region sequences. Therefore, the use of high throughput and Sanger sequencing, in a hybrid method, reaffirms to be rapid, efficient, and reliable for chloroplast genome sequencing.
Serious non-fatal unintentional injuries among in-school adolescents in Sri Lanka: results from the 2016 Sri Lankan Global School-Based Health Survey
Authors: Wickramasinghe Sashimali , Gunawardena Nalika , Punyadasa Dhanusha , Gunawardena Shanthi , Wickramasinghe Champika , Lokubalasooriya Ayesha , Peiris Renuka , Senanayake Sameera
Published: August 2020

BackgroundUnintentional injuries among adolescents is a major public health problem world over. A great majority of the annual deaths among adolescents is due to unintentional injuries; being the leading cause of death among them throughout the world. The aim of this study was to estimate the incidence of injuries and their associated factors among school going adolescents aged 13-17 years using the data of the most recent Global School-Based Health Survey (GSHS) conducted in Sri Lanka.MethodsA cross-sectional survey was conducted, using a self-administered questionnaire, among 3,262 adolescents attending government schools. The sample was selected through a two-staged cluster sampling technique. In the first stage, 40 schools were selected, using probability proportional to school enrollment size, out of all schools that have 8-12 grades in the country. Then, from the selected schools, classes were selected using systematic equal probability sampling with a random start. Weighted prevalence was calculated, and logistic regression analysis was conducted in order to determine the correlates.ResultsDuring the 12 months before the survey, 35.8% (95% CI-30.7 - 41.1) of the students reported being seriously injured once or more times. The injuries were more common among males, but were equally common among different age groups (13-15 age group vs 16-17 age group). The most common type of injury was cut or stab wound (5.5%), followed by broken bone/dislocated joint (5.3%). Multivariable analysis revealed that only a few factors were associated with injury, such as male sex, being bullied, being physically attacked, and/or being in a physical fight.ConclusionThis study demonstrated that the prevalence of serious unintentional injuries among school going adolescents is a major public health problem in Sri Lanka. This timely and comprehensive survey would help the policy makers and researchers identify the unmet needs related to adolescent injuries. Furthermore, evidence generated form the study should be given due consideration while designing school-based interventions in order to prevent adolescent injuries.
Antimicrobial Resistance and Molecular Detection of Extended Spectrum β-Lactamase Producing Escherichia coli Isolates from Raw Meat in Greater Accra Region, Ghana
Authors: Dsani Esther , Afari Edwin Andrews , Danso-Appiah Anthony , Kenu Ernest , Kaburi Basil Benduri , Egyir Beverly
Published: August 2020

BackgroundTypically, raw meat can be contaminated with antibiotic resistant pathogens at unhygienic slaughter and sale points. Consumption of meat contaminated with antibiotic resistant E. coli is associated with grave health care consequences. The aim of this study was to determine the microbial quality of raw meat, the antimicrobial susceptibility and Extended Spectrum Beta Lactamase (ESBL) production in E. coli isolates from raw meat. ResultsTotal Plate Counts exceeded the acceptable limit of 5.0 log CFU/ cm2 in 60.5% (124/205) of raw meat samples. Total Coliform Counts in 70.7% (145/205) of samples were in excess of the acceptable limit of 2.5 log CFU/cm2. E. coli was detected in about half of raw meat samples (48%), ranging from 9.5% -79.0% among the slaughter sites. Isolates were susceptible to meropenem (100%), ceftriaxone (99%), cefotaxime (98%), chloramphenicol (97%), gentamycin (97%), ciprofloxacin (92%) and amikacin (92%), but resistant to ampicillin (57%), tetracycline (45%), sulfamethoxazole-trimethoprim (21%) and cefuroxime (17%). Multi-drug resistance (MDR) was identified in 22% of the isolates. The blaTEM gene was detected in 4% (4/98) of E. coli isolates in this study. ConclusionThe levels of microbial contamination of raw meat in this study were unacceptable. Meat handlers and consumers are at risk of foodborne infections from E. coli including ESBL producing E. coli that are resistant to most antibiotics in use. We recommend an enhanced surveillance for antibiotic resistance in food products for the early detection of emerging resistant bacteria species in the food chain.
Value and Feasibility of South-South Medical Elective Exchanges in Africa
Authors: Daniels Katy , Thomson Emma , Nawagi Faith , Flinkenflogel Maaike
Published: August 2020

Background An elective is part of the curriculum where students have the flexibility to choose both the study topic and location. International medical electives are a well-established part of curricula at most medical schools in high-income countries. They are highly valued by students and have proven educational benefits, though do come with challenges, such as lack of reciprocity. Low and middle-income countries frequently host students from high-income countries providing learning opportunities, yet also carry the burden of supervision and resource consumption, whilst their students get few elective opportunities. This study explores the value and feasibility of South-South Medical Elective Exchanges (SSMEE), which creates elective opportunities for African medical students in other African countries to create reciprocity within the elective system.MethodA qualitative evaluation of the South-South Medical Elective Exchanges was conducted using a case study approach. Four African medical schools, College of Medicine, Malawi; University of Rwanda, Rwanda; University of Witwatersrand, South Africa and Makerere University, Uganda participated in the pilot study in 2017/18. Each institution selected two students to participate in a four-week elective to another participating institute. Participating students completed a pre-elective questionnaire and a post-elective interview exploring expectations, learning outcomes, challenges and how they are applying this learning. Data was analysed thematically.ResultsData presented is from six of the eight participating students. All students found the elective a valuable experience and learning was demonstrated in four key areas: clinical knowledge and skills; attitudes; personal and professional development and global perspectives. For some, it challenged their assumptions of what an elective is because valuable learning can be achieved whilst remaining in Africa. The main challenge found related to funding the elective. ConclusionsThe SSMEE model is feasible and provides valuable learning for participating students and their peers/colleagues. Financing electives remains the biggest challenge. Since this pilot study, SSMEE has become part of a regional elective exchange network in Africa with an additional four institutions in three other countries. As such SSMEE has resulted in increased opportunities for African medical students and better educational outcomes that are likely to have a positive effect on healthcare systems in Africa.
Electroacupuncture reduces scopolamine-induced amnesia via mediating the miR-210/SIN3A and miR-183/SIN3A signaling pathway
Authors: Ye Fan , Tian Shiming , Hu Huimin , Yu Zhengwen
Published: August 2020

Background: The expression of SIN3A is closely correlated with electroacupuncture (EA) treatment efficacy of scopolamine-induced amnesia (SIA), but its underlying mechanisms remain to be further explored.Methods: Quantitative real-time PCR was performed to analyze the expression of candidate microRNAs (miRNAs) and SIN3A mRNA in a rat model of SIA. Western blot was carried out to evaluate the differential expression of SIN3A proteins under distinct circumstances. Luciferase assay was used to explore the inhibitory role of certain miRNAs in SIN3A expression. Novel object recognition (NOR) test was performed to assess the memorial ability of SIA rats undergoing EA treatment. Immunohistochemistry was carried out to evaluate the expression of SIN3A in the hippocampus of SIA rats.Results: Rno-miR-183-5p, rno-miR-34c-3p and rno-miR-210-3p were significantly up-regulated in SIA rats treated with EA. In addition, rno-miR-183-5p and rno-miR-210-3p exerted an inhibitory effect on SIN3A expression. EA treatment of SIA rats effectively restored the dysregulated expression of rno-miR-183-5p, rno-miR-210-3p and SIN3A. And EA treatment also promoted the inhibited expression of neuronal IEGs including Arc, Egr1, Homer1 and Narp in the hippocampus of SIA rats. Accordingly, the NOR test also confirmed the effect of EA treatment on the improvement of memory in SIA rats.Conclusion: In this study, an animal model of SIA was treated with EA to investigate its therapeutic effect. Moreover, our work presented solid evidence on the regulatory pathway of miR-183/SIN3A and miR-210/SIN3A in the pathogenesis of SIA.
Increased pretreatment C-reactive protein-to-albumin ratio predicts severe coronavirus disease 2019
Authors: Wang Xiaoyue , Xu Yan , Huang Huang , Jiang Desheng , Zhou Chunlei , Liao Hui , Chen Xiaofeng
Published: August 2020

Objective The aim of this study was to identify early warning signs for severe coronavirus disease 2019 (COVID-19). Methods We retrospectively analysed the clinical data of 90 patients with COVID-19 from Guanggu District of Hubei Women and Children Medical and Healthcare Center, comprising 60 mild cases and 30 severe cases. The demographic data, underlying diseases, clinical manifestations and laboratory blood test results were compared between the two groups. The cutoff values were determined by receiver operating characteristic curve analysis. Logistic regression analysis was performed to identify the independent risk factors for severe COVID-19. Results The patients with mild and severe COVID-19 had significant differences in terms of cancer incidence, age, pretreatment neutrophil-to-lymphocyte ratio (NLR), and pretreatment C-reactive protein-to-albumin ratio (CAR) ( P =0.000; P =0.008; P=0.000; P =0.000). The severity of COVID-19 was positively correlated with comorbid cancer, age, NLR, and CAR ( P <0.005). Multivariate logistic regression analysis showed that age, the NLR and the CAR were independent risk factors for severe COVID-19 (OR=1.086, P =0.008; OR=1.512, P =0.007; OR=17.652, P =0.001). Conclusion An increased CAR can serve as an early warning sign of severe COVID-19 in conjunction with the NLR and age.
Genome-Wide Association Studies and Whole-Genome Prediction Reveal the Genetic Architecture of KRN in Maize
Authors: An Yixin , Chen Lin , Li Yongxiang , Li Chunhui , Shi Yunsu , Zhang Dengfeng , Li Yu , Wang Tianyu
Published: August 2020

Background: Kernel row number (KRN) is an important trait for the domestication and improvement of maize. To explore the genetic basis of KRN has great research significance and can provide the valuable information for molecular assisted selection.Results: In this study, one single-locus method (MLM) and six multi-locus methods (mrMLM, FASTmrMLM, FASTmrEMMA, pLARmEB, pKWmEB and ISIS EM-BLASSO) of genome-wide association studies (GWASs) were used to identify significant quantitative trait nucleotides (QTNs) for KRN in an association panel including 639 maize inbred lines that were genotyped by the MaizeSNP50 BeadChip. In three phenotyping environments and with best linear unbiased prediction (BLUP) values, seven GWAS methods revealed different numbers of KRN-associated QTNs, ranging from 11 to 177. Based on these results, seven important regions for KRN located on chromosomes 1, 2, 3, 5, 9, and 10 were identified by at least three methods and in at least two environments. Moreover, 49 genes from the seven regions were expressed in different maize tissues. Among the 49 genes, ARF29 (Zm00001d026540, encoding auxin response factor 29) and CKO4 (Zm00001d043293, encoding cytokinin oxidase protein) were significantly related to KRN based on expression analysis and candidate gene association mapping. Whole-genome prediction (WGP) for KRN was also performed, and we found that the KRN-associated tagSNPs achieved a high prediction accuracy. The best strategy was to integrate the total KRN-associated tagSNPs identified by all GWAS models. Conclusions: These results aid in our understanding of the genetic architecture of KRN and provide useful information for genomic selection for KRN in maize breeding.
HYPOfractionated Radiation Therapy comparing a standard radiotherapy schedule (over three weeks) with a novel one week schedule in Adjuvant breast cancer: An open-label randomised controlled study (HYPORT- Adjuvant): study protocol for a multicenter, randomized phase III trial.
Authors: Chatterjee Sanjoy , Chakraborty Santam , Group HYPORT Adjuvant Author
Published: August 2020

Background Hypofractionated radiotherapy is the current standard for adjuvant radiotherapy across many centres. Further hypofractionation may be possible but remains to be investigated in non-caucasian populations with more advanced disease, with a higher proportion of patients requiring mastectomy as well as tumour bed boost. We are reporting the design of randomized controlled trial testing the hypothesis that a one week (5 fractions) regimen of radiotherapy will be non-inferior to a standard three week (15 fractions) schedule. Methods We describe a multicenter, randomized controlled trial recruiting patients at large academic centres across India. Patients without distant metastases who merit adjuvant radiotherapy will be eligible for inclusion in the study. Patients in the control arm will receive adjuvant radiotherapy to the breast or chest wall (with/without regional nodes) to a dose of 40 Gy / 15 fractions / 3 weeks, while those in the experimental arm will receive a dose of 26 Gy / 5 fractions / 1 week (to the same volume). Use of a simultaneous integrated boost (dose of 8 Gy and 6 Gy respectively) is allowed in patients who have undergone breast conservation. A sample size of 2100 patients provides an 80% power to detect a non-inferiority of 3% in the 5-year locoregional recurrence rate with a one-sided type I error of 2.5%, assuming that the locoregional recurrence rate in the control arm is 5% at 5 years (corresponding to a hazard ratio of 1.63). Patients will be recruited over a period of 5 years, and followed up for a further 5 years thereafter. Discussion If a five-fraction regimen of breast cancer is proven to be non-inferior, this will result in a significant improvement in the access to radiotherapy, as well as reduced costs of treatment. The trial gives an opportunity to standardize and quality assure radiotherapy practices across the nation at the same time. Along with the results of the FAST Forward trial, the safety of this intervention in advanced node-positive disease requiring regional nodal radiation will be established. Trial Registration The trial has been registered at the Clinical Trial Registry of India (CTRI) vide registration number: CTRI/2018/12/016816 (31/12/2018) as well as the clinical trial.gov website at NCT03788213 (28/12/2018).
Micronized sacchachitin promotes satellite cell proliferation through TAK1-JNK-AP-1 signaling pathway predominantly by TLR2 activation
Authors: Wu Meng-Huang , Lin Chuang-Yu , Hou Chun-Yin , Sheu Ming-Thau , Chang Hsi
Published: August 2020

​ Background: Ganoderma sp., such as Ganoderma tsugae (GT), play an important role in traditional Chinese medicine. Ganoderma sp. contains several constituents, including Sacacchin, which has recently drawn attention because it can not only enhance the repair of muscle damagebut also strengthen themuscle enforcement. Although Ganoderma sp. have a therapeutic effect for neuromuscular disorders, the underlying mechanism remains unclear. This study investigated the effect and underlying molecular mechanism of micronized sacchachitin(mSC) on satellite cells (SCs), which are known as the muscle stem cells. Methods: The myogenic cells, included SCs (Pax7 + ) were isolated from tibialis anterior muscles of a healthy rat and were cultured in growth media with different mSC concentrations. For the evaluation of SC proliferation, these cultivated cells were immunostained with Pax7 and bromodeoxyuridineassessed simultaneously. The molecular signal pathway was further investigated by using Western blotting and signal pathway inhibitors. Results: Our results revealed that 200 µg/mL mSC had an optimal capability to significantly enhance the SC proliferation. Furthermore, this enhancement of SC proliferation was verified to be involved with activation of TAK1-JNK-AP-1 signaling pathway through TLR2, whose expression on SC surface was confirmed for the first time here. Conclusion: Micronized sacchachitinextracted fromGT was capable of promoting the proliferation of SC under a correct concentration.
The effect of sevoflurane anesthesia for dental procedure on neurodevelopment in children: a prospective, equivalence, controlled trial
Authors: Zhou Pinping , Zhang Chao , Huang Guijin , Hu Yuan , Ma Wenzhu , Yu Cong
Published: August 2020

Background

Dental procedures under general anesthesia (DGA) was found to improve the oral health-related quality of children's life. However, some parents and pediatricians expressed concern about the neurotoxicity of general anesthesia. The purpose of this trial was to investigate whether DGA in children has an adverse effect on neurodevelopment.

Methods

In this prospective, assessor-masked, controlled, equivalence trial, we recruited 340 children younger than 7 years who were undergoing caries treatment between Feb 1, 2019, and Aug 31, 2019, without factors affecting neurodevelopment. They received either sevoflurane-based general anesthesia or awake-local anesthesia. The Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition Chinese version was used to evaluate the neurodevelopment of children at six months after surgery, and the Full-Scale IQ (FSIQ) was selected as the primary outcome. Predefine the 95% CI of a difference in means within five (1/3 SD) as the equivalence margin.

Results

The outcome data were obtained from 129 children in the general anesthesia group and 144 in the local anesthesia group. The median length of general anesthesia was 130 min (IQR 110 – 160). There was equivalence in means of FSIQ score between the general anesthesia group and the local anesthesia group (local minus general anesthesia 0.46, 95% CI -2.35 to 1.61). There was no significant difference in FSIQ scores between different age groups and different anesthesia durations. Just the mother's education could affect the primary outcome.

Conclusions

In this trial, prolonged DGA with a sevoflurane-only anesthetic in preschool children, does not adversely affect neurodevelopment at six months after surgery compared with awake-local anesthesia.
Ontogenetic plasticity in cranial morphology is associated with a change in the food processing behavior in Alpine newts
Authors: Schwarz Daniel , Konow Nicolai , Porro Laura Beatriz , Heiss Egon
Published: August 2020

Background: The feeding apparatus of salamanders consists mainly of the cranium, mandible, teeth, hyobranchial apparatus and the muscles of the cranial region. The morphology of the feeding apparatus in turn determines the boundary conditions for possible food processing mechanisms. However, the morphology of the feeding apparatus changes substantially during metamorphosis, prompting the hypothesis that larvae might use a different food processing mechanism than post-metamorphic adults. Salamandrid newts with facultative metamorphosis are suitable for testing this hypothesis as adults with divergent feeding apparatus morphologies often coexist in the same population, share similar body sizes, and feed on overlapping prey spectra.

Methods: We use high-speed videography to quantify the in vivo movements of key anatomical elements during food processing in paedomorphic and metamorphic Alpine newts (Ichthyosaura alpestris). Additionally, we use micro-computed tomography (μCT) to analyze morphological differences in the feeding apparatus of paedomorphic and metamorphic Alpine newts and sort them into late-larval, mid-metamorphic and post-metamorphic morphotypes.

Results: Late-larval, mid-metamorphic and post-metamorphic individuals exhibited clear morphological differences in their feeding apparatus. Regardless of the paedomorphic state being externally evident, paedomorphic specimens can conceal different morphotypes (i.e., late-larval and mid-metamorphic morphotypes). Though feeding on the same prey under the same (aquatic) condition, food processing kinematics differed between late-larval, mid-metamorphic and post-metamorphic morphotypes.

Conclusions: The food processing mechanism in the Alpine newt changes along with morphology of the feeding apparatus during ontogeny, from a mandible-based to a tongue-based processing mechanism as the mandible’s changing morphology prevents chewing and the tongue allows enhanced protraction. These results could indicate that early tetrapods, in analogy to salamanders, may have developed new feeding mechanisms in their aquatic environment and that these functional innovations may have later paved the way for terrestrial feeding mechanisms.
Circ_0004913 sponges miR-1290 and regulates FOXC1 to inhibit the proliferation of hepatocellular carcinoma
Authors: Yu Yabin , Han Suyang , Li Meng , Song Yan , qi fuzhen
Published: August 2020

Circ_0004913, miR-1290, FOXC1, Proliferation,Hepatocellular carcinoma.
DL-3-n-butylphthalide improved physical and learning and memory performance of rodents exposed to acute and chronic hypobaric hypoxia
Authors: Xu Gang , Shi Yikun , Sun Binda , Liu Lu , E Guoji , He Shu , Zhang Jianyang , Liu Bao , Hu Qiu , Chen Jian , Gao Yuqi , Zhang Erlong
Published: August 2020

Background: Studies revealed the protective effect of DL-3-n-butylphthalide (NBP) against ischemic hypoxia diseases. However, the role of NBP in animals with hypobaric hypoxia is elusive. This study investigated the effect of NBP on animals with acute and chronic hypobaric hypoxia. Methods: SD rats and Kunming mice administrated with NBP ( 90, 180 and 360 mg/kg for mice, 60, 120, and 240 mg/kg for rats and 90, 180 and 360 mg/kg for mice 60, 120, and 240 mg/kg for rats ) were placed located in 10,000 m hypobaric hypoxia chamber. And survival analysis of animals implied that NBP could significantly improve and survival percent at 30 min were analyzed . Then, drug treated animals rats (mice) were evaluated for exhaustive exhausted time and exhaustive exhausted distance in forced exercise wheel-track treadmill and treadmill running and motor-driven wheel-track treadmill experiments at 5,800 m (5,000 m) for 3 or 21 days or 21 days , to evaluate changes of physical functions. Rats were also evaluated for times of active escape , and average time of active escape , time of passive escape, and average time of passive escape in a shuttle-box experiment at 5,800 m for 7 days or 28 days 7 or 28 days , to evaluate changes of cognitive learning and memory function s . ATP level was evaluated measured in the gastrocnemius muscle and maloaldehyde (MDA), superoxide dismutase (SOD), hydrogen peroxide (H 2 O 2 ), lactate, and glutathione peroxiase (GSH-Px) measurements and routine blood tests were detected in serum of rats . Results: Survival analysis in 10,000 m indicated NBP could improve hypoxia tolerance ability. Exhaustive Exhausted time for rats (NBP, 120 and 240 mg/kg) and exhaustive exhausted time and distance for mice (NBP, 90 mg/kg) significantly increased under acute hypoxia. And NBP treatment also significantly increased the exhaustive exhausted time for rats under chronic hypoxia. Moreover, NBP of 120 and 240 mg/kg significantly increased the average time s of passive active escape under acute and chronic hypoxia. These results suggested that NBP could improve physical and cognitive learning and memory functions under acute and chronic hypobaric hypoxia. Furthermore, the levels of MDA and H 2 O 2 decreased but those of SOD and GSH-Px in serum of rats increased under acute and chronic hypoxia. Furthermore, Additionally, the content of ATP in gastrocnemius muscle significantly increased, while lactate in serum level significantly decreased. The results presented suggested that NBP could regulate redox homeostasis and improve energy metabolism of hypobaric hypoxic rats. Conclusion: NBP could improve physical and cognitive learning and memory functions under acute and chronic hypobaric hypoxia by increasing anti-oxidative capacity and energy supply.
Tumor marker based survival analysis for patients with pseudomyxoma peritonei of appendiceal origin: A retrospective cohort study
Authors: Bai Mingjian , Wang Shilong , Ma Ruiqing , Cai Ying , Lu Yiyan , Hou Nianzong , Liang Guowei , Xu Hongbin , Zhang Man
Published: August 2020

Background Pseudomyxoma peritonei (PMP) is a rare disease, the prognosis of overall survival (OS) is affected by many factors, present study aim to screen independent prediction indicators and establish a nomogram for PMP.

Methods 119 PMP patients received cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) in our center for the first time were included between 01/06/2013 and 22/11/2019 . The log-rank test was used to compare the OS rate among groups, subsequently, variables with P<0.10 were subjected to multivariate Cox model for screening independent prediction indicators.

Finally, the nomogram prediction models will be established.

Results Univariate analysis showed that Barthel Index Score, Albumin, D-Dimer, CEA, CA125, CA19-9, CA724, CA242, PCI, degree of radical surgery, histopathological grade were signiﬁcant predictors for OS in PMP. At multivariate analysis, Sex, D-Dimer, CA125, CA19-9, PCI, and degree of radical surgery were independently associated with OS rate in PMP. A nomogram was plotted based on the independent predictive factors for PMP and undergone internal validation, ROC analysis was performed to calculate discrimination ability of prediction model, the area under curves (AUC) was 0.880 (95% CI : 0.806- 0.933).

Conclusions Several factors (Sex, D-Dimer, CA125, CA19-9, PCI, and degree of radical surgery) have independent prognostic value for survival in PMP, the tumor based prediction model has a better prediction value, more researches are need to verify and improve the prediction model.
Relationship between insulin sensitivity and gene expression in human skeletal muscle
Authors: Parikh Hemang , Elgzyri Targ , Alibegovic Amra , Hiscock Natalie , Ekström Ola , Eriksson Karl-Fredrik , Vaag Allan , Groop Leif , Ström Kristoffer , Hansson Ola
Published: August 2020

BackgroundInsulin resistance in skeletal muscle is a key feature of the pre-diabetic state, hypertension, dyslipidemia, cardiovascular diseases, and also predicts type 2 diabetes. However, the underlying molecular mechanisms are still poorly understood. MethodsTo explore these mechanisms, we related global skeletal muscle gene expression profiling of 38 non-diabetic men to physiological measures of insulin sensitivity. Results We identified 70 genes positively and 110 genes inversely correlated with insulin sensitivity in human skeletal muscle, identifying autophagy-related genes as positively correlated with insulin sensitivity. Replication in an independent study of 9 non-diabetic men resulted in 10 overlapping genes that strongly correlated with insulin sensitivity, including CPT1B and SIRT2 , involved in lipid metabolism, and FBXW5 that regulates mammalian target-of-rapamycin (mTOR) and autophagy. The expression of CPT1B , SIRT2 and FBXW5 was also positively correlated with the expression of key genes promoting the phenotype of an insulin sensitive myocyte e.g. PPARGC1A . ConclusionsThese data suggest that activation of genes involved in lipid metabolism, e.g. CPT1B and SIRT2 , and genes regulating autophagy and mTOR signaling, e.g. FBXW5 , are associated with increased insulin sensitivity in human skeletal muscle, reflecting a highly flexible nutrient sensing.
Clinical characteristics and Mortality risk factors among COVID-19 patients in Qom–Iran; The results of a Retrospective Cohort study
Authors: Hormati Ahmad , Ghomi SeyedYaser Foroghi , sohrabi masoudreza , Gholami Ali , Jafari Saeede , Jabbari Amir , AminNejad Reza , Khodadadi Javad , shakeri Mansoureh , ShahHamzeh Alireza , Afifian Mahbobeh , Azad Zohre , Ahmadpour Sajjad , Karbalai MohammadHadi , Babaei MohammadReza , Karimzadeh Parisa , Hosseini SeyedKamal Esshagh
Published: August 2020

Background & AimCoronavirus 2019 (COVID-19) outbreak in the Middle East was initially reported in Qom-Iran. Clinical and epidemiologic and mortality risk factors details have not been already fully explained.MethodIn a retrospective study, the hospitalized adult patients with laboratory diagnosed COVID-19 between February 25 to March 20, 2020 were enrolled. A checklist including demographic, clinical, laboratorial, imaging, and treatment data was completed for each of the participant. The data were extracted from electronic medical records. In case of lack of information, a member of the research team contacted them via phone. All the dead patients and the first one hundred survived patients with these criteria were enrolled in the study. Outcome defined as death or discharge of patients.ResultsOf admitted patients, 200 patients who had been discharged or died were involved in this study. The majority of them were male (56%). The mean age of all patients was 62.63 ± 14.9. Co-morbidity was reported in 124 (62%) patients in which hypertension was the most common. The most frequent clinical presentations were dyspnea in 169 (84.5%), cough in 150 (75%), and fatigue/weakness in 123 (61.5%) patients. The main complications were respiratory failure and acute respiratory distress syndrome with prevalence of 143 (71.5%) and 105 (52.5%), accordingly. Multiple logistic models showed that decline of hemoglobin level (OR = 10.09), neutrophilia (OR = 3.48), high blood urea nitrogen (OR = 4.29,), SpO2 ≤ 90% (OR = 3.38), and presence of patchy consolidation (OR = 6.81) were associated with poor outcome.ConclusionCOVID-19 disease has multiple aspects. CT scan findings, complete blood count with differential, high blood urea nitrogen and SpO2 are related to mortality. Hence needs to pay serious attention during admitting and surveillance, particularly among elderly patients and who with preexisting morbidities.