bluuebunny/crossref_metadata_2025 huggingface dataset:
Non-pharmacological Interventions of Pain Management Used During Labour; an Exploratory Descriptive Qualitative Study of Puerperal Women in Adidome Government Hospital of the Volta Region, Ghana
Authors: Konlan Kennedy Diema , Afaya Agani , Mensah Eugenia , Suuk Amos Nawunimali , Kombat Dahamata Issahaku
Published: December 2020

Background: Women have experienced labour pain over the years as various attempts have been made to effectively manage this pain. There is paucity of literature on the experiences and perceptions about labour pain management with the contemporary Ghanaian health system. This study explored the perspective of puerperal women on the use of non-pharmacological labour pain management at Adidome Government Hospital. Methods: The study adopted an exploratory descriptive qualitative approach as data was collected through individual interviews. Informed consent was obtained from all participants who were purposively sampled. Interviews were audio recorded and transcribed immediately. Thematic analysis was engaged in three interrelated stages, namely data reduction, data display, and data conclusion to analyse the transcript and field notes. Results were presented with supporting quotes from the transcripts. Results: The majority (41.2%) of the women described labour pain as very severe, severe (35.3%) and moderate (23.5%) as the pain lasted more than 12 hours (58.8%). The various strategies adopted in managing labour pains included shouting and walking around (47.1%), crying and screaming (35.3%) and staying calm and snapping the fingers (17.6%). Women indicated they were satisfied (52.9%) and very satisfied (23.5%) of the midwives' attitude towards pain management. The pain management strategies adopted during labour included women engaged in deep breathing exercises, chatting with other people and relatives, diversion therapy, reassurance, taking a shower, assuming side lying positions, and receiving intravenous therapy. The presence of the husband of a labouring woman during improved pain bearing ability.Conclusion: It is important that midwives institute pragmatic protocols in the labour ward that ensure a relaxing atmosphere for women in labour, respond to the sensitivity and specificity of labouring women needs and when possible significant others of the labouring women could be allowed to visit. Expectant mothers should be educated more on non – pharmacological pain management to reduce anxieties and improve decision making.
Modeling the Risk of Radiation Pneumonitis in Esophageal Squamous Cell Carcinoma Treated with Definitive Chemoradiotherapy
Authors: Lan Kaiqi , Xu Cheng , Liu Shiliang , Zhu Jinhan , Yang Yadi , Zhang Li , Xi Mian
Published: December 2020

Purpose: To develop and validate a nomogram for the prediction of symptomatic radiation pneumonitis (RP) in patients with esophageal squamous cell carcinoma (ESCC) who received definitive concurrent chemoradiotherapy.Methods: Clinical factors, dose-volume histogram parameters, and pulmonary function parameters were collected from 402 ESCC patients between 2010 and 2017, including 321 patients in the primary cohort and 81 in the validation cohort. The end-point was the occurrence of symptomatic RP (grade ≥2) within the first 12 months after radiotherapy. Univariate and multivariate logistic regression analyses were applied to evaluate the predictive value of each factor for RP. A prediction model was generated in the primary cohort, which was internally validated to assess its performance.Results: In the primary cohort, 31 patients (9.7%) experienced symptomatic RP. Based on logistic regression model, patients with larger planning target volumes (PTVs) or higher lung V20 had a higher predictive risk of RP, whereas the overall risk was substantially higher for three-dimensional conformal radiotherapy (3DCRT) than intensity-modulated radiotherapy. On multivariate analysis, independent predictive factors for RP were smoking history (P=0.018), radiotherapy modality (P<0.001), PTV (P=0.014), and lung V20 (P=0.002), which were incorporated into the nomogram. The areas under the receiver operating characteristic curve of the nomogram in the primary and validation cohorts were 0.772 and 0.900, respectively, which were superior to each predictor alone.Conclusions: Non-smoking status, 3DCRT, lung V20 (>27.5%), and PTV (≥713.0 cc) were significantly associated with a higher risk of RP. A nomogram was built with satisfactory prediction ability.
The Association Between Homocysteine Levels and Cardiovascular Disease Risk Among Middle-Aged and Elderly Adults in Taiwan
Authors: Shih Chin-Chuan , Shih Yu-Lin , Chen Jau-Yuan
Published: December 2020

Background Our study aimed to determine the association between homocysteine levels and cardiovascular disease (CVD) risk in middle-aged and elderly adults in a community in northern Taiwan.MethodsParticipants in our study included adults aged 50 to 85 years old during community health examinations on 2019. A total of 396 people were enrolled. We divided participants according to tertiles of homocysteine level (low, middle and high groups). The CVD risk was calculated by the Framingham cardiovascular risk score (FRS). An FRS ≥ 20% indicated high CVD risk. Pearson correlation coefficients were calculated between homocysteine level and other cardio-metabolic risk factors while adjusting for age. High CVD risk in the middle and high homocysteine groups was compared with that in the low homocysteine group by multivariate logistic regression with adjustments for age, sex, smoking, hypertension (HTN), diabetes mellitus (DM), body mass index (BMI) and hyperlipidemia. The Youden index and receiver operating characteristic (ROC) curves were performed to determine the optimized cut-off value.ResultsThere were 396 people enrolled for analysis; 41.4% of participants were male, and the average age was 63.72 (±8.76). In our study, we showed a positive correlation of homocysteine with FRS. In the logistic regression models, the prevalence of high CVD risk was increased as homocysteine increased. The odds ratio (OR) and 95% confidence interval for high CVD risk was 2.851 (1.402 to 5.801) in the high homocysteine level group compared with the low homocysteine group after adjusting for traditional CVD risk factors (P=0.004). The area under the ROC curve was 0.67, and a homocysteine cut-off value of 12.15 µmol/L was determined.ConclusionsMiddle-aged and elderly people with increased homocysteine levels were associated with higher FRSs in this Taiwan community. Furthermore, homocysteine was an independent risk factor for high CVD risk in this study.
Chromobox4/5 Serve as Potential Prognostic Biomarkers and Targets for Breast Invasive Carcinoma
Authors: Dai Libing , Yao Yicun , Ye Dongping
Published: December 2020

Background: Chromebox (CBX) is a family of epigenetic regulation complexes. Many shreds of evidence suggest that CBXs play a vital role in the tumorigenesis and progression of breast invasive carcinoma (BRCA). However, little is known about the alteration and exact roles of each CBX in BRCA. Methods: In this study, we explored the exact roles of CBXs in the prognosis of BRCA by analyzing ONCOMINE, UALCAN, Kaplan-Meier Plotter, cBioProtal, STRING, and Metascape databases. Results: The mRNA expression of CBX1/2/3/4/6/7/8 was significantly altered and associated with the tumor stage. The protein expression level of 8 CBXs was significantly changed and associated with the tumor stage.Moreover, aberrant expression of CBX3/5/7/8 was significantly associated with clinical outcome for BRCA. Multivariate analysis indicated that genetic alteration of CBX4/5 was an independent prognostic factor for the OS in BRCA patients. Conclusions: These results imply that CBX4/5 might serve as prognostic biomarkers for survival in BRCA patients.
Inulin and Galacto-oligosaccharides Increase the Genotoxic Effect of Colibactin Produced by pks+ Escherichia Coli Strains
Authors: Oliero Manon , Calvé Annie , Fragoso Gabriela , Cuisiniere Thibault , Hajjar Roy , Dobrindt Ulrich , Santos Manuela M.
Published: December 2020

Background: Colibactin is a genotoxin that induces double-strand DNA breaks and is produced by Escherichia coli strains harboring the pks island. Human and animal studies have shown that colibactin-producing gut bacteria promote carcinogenesis and enhance the progression of colorectal cancer through cellular senescence and chromosomal abnormalities. In this study, we investigated the impact of prebiotics on the genotoxicity of colibactin-producing E. coli strains Nissle 1917 and NC101. Methods: Bacteria were grown in medium supplemented with 20, 30 and 40 mg/mL of prebiotics inulin or galacto-oligosaccharide, and with or without 5 µM, 25 µM and 125 µM of iron sulfate. Colibactin expression was assessed by luciferase reporter assay for the clbA gene, essential for colibactin production, in E. coli Nissle 1917 and by RT-PCR in E. coli NC101. The human epithelial colorectal adenocarcinoma cell line, Caco-2, was used to assess colibactin-induced megalocytosis by methylene blue binding assay and genotoxicity by γ-H2AX immunofluorescence analysis. Results: Inulin and galacto-oligosaccharide enhanced the expression of clbA in pks+ E. coli. However, the addition of 125 µM of iron sulfate inhibited the expression of clbA triggered by oligosaccharides. In the presence of either oligosaccharide, E. coli NC101 increased dysplasia and double-strand DNA breaks in Caco-2 cells compared to untreated cells. Conclusion: Our results suggest that, in vitro, prebiotic oligosaccharides exacerbate DNA damage induced by colibactin-producing bacteria. Further studies are necessary to establish whether these results are reproducible in vivo.
Does Fingolimod have anticancer effects? A meta-analysis and systematic review based on experimental animal models of various cancers
Authors: Ge Yuze , Zhou Ping , Kong Lu
Published: December 2020

Background: Numerous studies have explored the anticancer effect of FTY720 (Fingolimod) in animal models, a sphingosine-1-phosphate (S1P) receptor antagonist and an immunosuppressant, but little clinical evidence guides the use of FTY720 in cancer patients.Methods: Strictly, only related published articles about the treatment with FTY720 for various cancers in vivo from January 1998 to January 2020 were selected from PubMed, Web of Science, Ovid, Embase, CNKI and Cochrane databases, and which were qualified. We acquired agreement through discussion. Then, we conducted meta-analysis, subgroups analysis, publication bias analysis and sensitivity analysis based on selected studies. In the last two sections, we summaried and compared side effects, drug combination effects and molecular pathways from selected studies.Results: In the 31 articles included from 2002 to 2019, FTY720 was found to reduce tumor volume (SMD =-2.58, 95% CI: -3.42, -1.75, Z = 6.09, P = 0.000), tumor weight (SMD = -3.69, 95% CI: -5.17, -2.21, Z = 4.88, P = 0.000) and body weight (SMD = -0.86, 95% CI: -1.61, -0.11, Z = 2.23, P = 0.025) in 14 types of cancer. Relevant frequent signal pathways include the Akt pathway, S1PRs-Caspase pathway and the STAT3-PP2A pathway. FTY720 has significant independent or in combination anticancer effects and a lower toxicity in renal cell carcinoma and neuroblastoma mice models. However, it should be noted that FTY720 achieved a significant therapeutic effect in immunodeficient mice, not in immunecompetent mice. Also, the dosage-safety of FTY720 alone in clinical use is a noteworthy issue. In mouse models, the mechanism of the FTY720 treatment of tumors lies in inducing the tumor cells apoptosis through important signaling moleculars.Conclusions: FTY720 alone or in combination exerted significant anti-tumor effects for neuroblastoma and renal cell carcinoma, however not for melanoma. Due to insufficient evidence, more specific studies of FTY720 only and in combination included in immunity, inflammation and melanoma should be carried out in the future preclinical and clinical studies.
A Plug-and-Train Robot (PLUTO) for Hand Rehabilitation: Design and Preliminary Evaluation
Authors: Nehrujee Aravind , Andrew Hallel , Patricia Ann , ReethaJannetSurekha  , Selvaraj SamuelKamaleshKumar , Prakash Henry , Sujatha S. , Balasubramanian Sivakumar
Published: December 2020

Hand neurorehabilitation involves the training of movements at various joints of the forearm, wrist, fingers, and thumb. Assisted training of all these joints either requires either one complex multiple degree-of-freedom (DOF) robot or a set of simple robots with one or two DOF. Both of these are not economically or clinically viable solutions. The paper presents work that addresses this problem with a single DOF robot that can train multiple joints one at a time – the plug and train robot (PLUTO). PLUTO has a single actuator with a set of passive attachments/mechanisms that can be easily attached/detached to train for wrist flexion-extension, wrist ulnar-radial deviation, forearm pronation-supination, and gross hand opening-closings. The robot can provide training in active and assisted regimes. PLUTO is linked to performance adaptive computer games to provide feedback to the patients and motivate them during training. As the first step toward clinical validation, the device's usability was evaluated in 45 potential stakeholders/end-users of the device, including 15 patients, 15 caregivers, and 15 clinicians with standardized questionnaires: System Usability Scale (SUS) and User Experience Questionnaire (UEQ). Patients and caregivers were administered the questionnaire after a two-session training. Clinicians, on the other hand, had a single session demo after which feedback was obtained. The total SUS score obtained from the patients, clinicians, and healthy subjects was 73.3 ± 14.6 (n = 45), indicating good usability. The UEQ score was rated positively in all subscales by both the patients and clinicians, indicating that the features of PLUTO match their expectations. The positive response from the preliminary testing and the feedback from the stakeholders indicates that with additional passive mechanisms, assessment features, and optimized ergonomics, PLUTO will be a versatile, affordable, and useful system for routine use in clinics and also patients’ homes for delivering minimally supervised hand therapy.
Views of University Students in Jordan towards Biobanking
Authors: Khatib Faisal , Jibrin Dayana , Al-Majali Joud , Elhussieni Mira , Almasaid Sharifeh , Ahram Mamoun
Published: December 2020

BackgroundBiobanks are considered a primary mean of supporting contemporary research, in order to deliver personalized and precise diagnostics with public acceptance and participation as a corner stone for their success.AimsThis study aims to assess knowledge, perception, and attitudes towards biomedical research and biobanking among students at the University of Jordan.MethodologyAn online questionnaire was designed, developed, and piloted. It was divided into 5 sections that included questions related to issues of biomedical research and biobanking as well as factors influencing decision to participate.ResultsResponses from 435 students revealed that 52.9% previously heard of biobanks. There was overwhelming acceptance for participation in biomedical, genetic, and biobanking research. A blood sample was the most preferred for donation. Protection of privacy, a consent prior to donation, approval of an ethics committee, and trust towards researchers were the most important factors associated with willingness to participate. On the other hand, vagueness of the type of research performed on samples and not receiving research results had a negative connotation. There was no clear agreement on the type of consent preferred by students, but to be contacted and informed of research results was preferred by the majority. Students also preferred disposal of samples and information when deciding to withdraw from participation.ConclusionThere is strong enthusiasm among students to participate in biomedical research and biobanking with all rights reserved thus providing hope for a very promising future in Jordan.
Trust and Professionalism in Science: Medical Codes as a Model for Scientific Negligence?
Authors: Desmond Hugh , Dierickx Kris
Published: December 2020

Background: Professional communities such as the medical community are acutely concerned with negligence: the category of misconduct where a professional does not live up to the standards expected of a professional of similar qualifications. Since science is currently strengthening its structures of self-regulation in parallel to the professions, this raises the question to what extent the scientific community is concerned with negligence, and if not, whether it should be. By means of comparative analysis of medical and scientific codes of conduct, we aim to highlight the role (or lack thereof) of negligence provisions in codes of conduct for scientists, and to discuss the normative consequences for future codes of conduct.Methods: We collected scientific and medical codes of conduct in a selection of OECD countries, and submitted each code of conduct to comparative textual analysis.Results: Negligence is invariably listed as an infraction of the norms of integrity in medical codes of conduct, but only rarely so in the scientific codes. When the latter list negligence, they typically do not provide any detail on the meaning of ‘negligence’.Discussion: Unlike codes of conduct for professionals, current codes of conduct for scientists are largely silent on the issue of negligence, or explicitly exclude negligence as a type of misconduct. In the few cases where negligence is stipulated to constitute misconduct, no responsibilities are identified that would help prevent negligence. While we caution against unreasonable negligence provisions as well as disproportional sanctioning systems, we do argue that negligence provisions are crucial for justified trust in the scientific community, and hence that there is a very strong rationale for including negligence provisions in codes of conduct.
The Artificial Intelligence (AI)-Based Chatbot for Promoting Physical Activity and Healthy Diet: Protocol for a Systematic Review
Authors: Oh Yoo Jung , Zhang Jingwen , Fang Min-Lin , Fukuoka Yoshimi
Published: December 2020

BackgroundWith the rise of artificial intelligence (AI) technologies in recent years, the rapidly expanding fields of AI-supported chatbot lifestyle interventions have offered new solutions to the global epidemic of physical inactivity and obesity. However, to the best of our knowledge no systematic review of chatbot-based lifestyle change intervention exists. The goals of this systematic review are to summarize the characteristics of chatbot interventions and to synthesize and evaluate uses of chatbots to improve physical activity, dietary, and weight management behaviors and to identify knowledge gaps and directions for future studies.MethodsIn collaboration with a medical librarian, six electronic bibliographic databases (PubMed, EMBASE, ACM Digital Library, Web of Science, PsycINFO, and IEEE) will be searched to identify all relevant studies. Main outcomes include changes in self-report and/or objectively measured physical activity, sedentary behavior, diet, and body weight. Additional outcomes include feasibility, acceptability, safety, and user satisfactions of chatbots. Two reviewers will independently screen the title and abstract, conduct a full-text screening to select the qualified studies, extract data from the included studies, and assess the risk of bias using Covidence software. Lastly, we will conduct a qualitative synthesis of the findings. However, if several randomized controlled trials that report similar outcome measurements are identified., quantitative synthesis will be provided.DiscussionTo the best of our knowledge, this is the first systematic review to synthesize and evaluate the existing research that assess the impact of AI chatbots on changing physical activity, dietary, and weight management behaviors. We anticipate our findings to advance knowledge by identifying the key characteristics of effective AI chatbot interventions and by highlighting knowledge gaps and limitations in the literature.Systematic review registrationInternational Prospective Register of Systematic Reviews (PROSPERO): CRD42020216761.
Risk factors leading to glaucoma surgery of glaucoma patient using Japanese nationwide administrative claims data: A retrospective non-interventional cohort study
Authors: Shirai Chikako , Tsuda Satoru , Tarasawa Kunio , Fushimi Kiyohide , Fujimori Kenji , Nakazawa Toru
Published: December 2020

Background
Early recognition and management of baseline risk factors may play an important role in reducing glaucoma surgery burdens. However, no studies have investigated them using real-world data in Japan or other countries. This study aimed to clarify the risk factors leading to glaucoma surgery of glaucoma patient using the Japanese nationwide administrative claims data associated with the diagnosis procedure combination (DPC) system.
Methods
It was a retrospective, non-interventional cohort study. Data were collected from patients who were admitted to DPC participating hospitals, nationwide acute care hospitals and diagnosed with glaucoma between 2012 to 2018. The primary outcome was the risk factors associated with glaucoma surgery. The association between baseline characteristics and glaucoma surgery was identified using multivariable logistic regression analysis by comparing patients with and without glaucoma surgery. Meanwhile, the secondary outcomes included the rate of comorbidities, the rate of concomitant drug use and the treatment patterns of glaucoma eye drops at the index admission. Among patients with glaucoma surgery, the risk factors leading to cataract surgery were also evaluated as subgroup analysis.
Results
A total of 29,599 patients included in the analysis, 12,038 and 17,561 patients were in the glaucoma surgery and non-glaucoma surgery cohorts, respectively. The factors associated with the increase in glaucoma surgery were having allergies, taking concomitant drugs including cancer, depression, ischemic heart disease and peptic ulcer, being diagnosed with primary open-angle glaucoma and longer length of stay in hospital. In contrast, the factors associated with the decrease in glaucoma surgery were having hypertension, taking hypertension drug, age ≥ 80 and female.
Conclusions
Special focus on Japanese patients with glaucoma who have allergy-related comorbidities or take immune, nervous, circulatory or gastrointestinal system-related concomitant drugs seems to be desirable.
Genome-wide Characterization and Expression Analysis of YABBY Gene Family in Three Cultivars of Cucurbita Linn. And Their Response of Salt Stress in Cucurbita Moschata
Authors: Yuan Jingping , Shen Changwei , Xin Jingjing , Li Zhenxia , Li Xinzheng , Zhou Junguo
Published: December 2020

BackgroundPlant specific YABBY transcription factors have important biological roles in plant growth and abiotic stress. However, the identification of Cucurbita Linn. YABBY and their response to salt stress have not yet been reported. The gene number, gene distribution on chromosome, gene structure, protein conserved structure, protein motif and the cis-acting element of YABBY in three cultivars of Cucurbita Linn. were analyzed by bioinformatics tools, and their tissue expression patterns and expression profile under salt stress were analyzed.ResultsIn this study, 34 YABBY genes (11 CmoYABBYs in Cucurbita moschata, 12 CmaYABBYs in Cucurbita maxima, and 11 CpeYABBYs in Cucurbita pepo) were identified and they were divided into five subfamilies (YAB1/YAB3, YAB2, INO, CRC and YAB5). YABBYs in the same subfamily usually have similar gene structures (intron-exon distribution) and conserved domains. Chromosomal localization analysis showed that these CmoYABBYs, CmaYABBYs, and CpeYABBYs were unevenly distributed in 8, 9, and 9 chromosomes of 21 chromosomes, respectively. Total of 6 duplicated gene pairs, and they all experienced segmental duplication events. Cis-acting element analysis showed that some Cucurbita Linn. YABBYs were associated with at least one of plant hormone response, plant growth, and abiotic stress response. Transcriptional profiles of CmoYABBYs and CmaYABBYs in roots, stems, leaves, and fruits, and CpeYABBYs in seed and fruit mesocarp showed that YABBYs of Cucurbita Linn. had tissue specificity. Finally, the transcriptional profile of 11 CmoYABBYs in leaf and qRT-PCR analysis of CmoYABBYs in root under salt stress indicated that some genes may play an important role in salt stress.ConclusionsGenome-wide identification and expression analysis of YABBYs revealed the characteristics of YABBY gene family in three cultivars of Cucurbita Linn.. Transcriptome and qRT-PCR analysis revealed the response of the CmoYABBYs to salt stress.This provides a theoretical basis for the functional research and utilization of YABBY genes in Cucurbita Linn..
Combıned-Complex Decongestıve Therapy Reduces Volume And Improves Quality Of Lıfe And Functıonal Status In Patıents Wıth Breast Cancer-Related Lymphedema
Authors: Borman Pinar , Yaman Aysegul , Yasrebi Sina , Inanli Adeviye Pinar
Published: December 2020

Background: The aim of this study was to evaluate the effects of complex decongestive therapy (CDT) in patients with breast cancer-related lymphedema (BCRL), in regard to volume reduction, functional status and quality of life (QoL).Methods: Fifty patients with unilateral BCRL were included. The demographic variables focusing on lymphedema were recorded. All patients received combined phase 1 CDT including skin-care, manual lymphatic drainage, multilayer bandaging and supervised exercises, five times a week for three weeks, as a total of 15 sessions. Patients were assessed by limb volumes and excess volumes according to geometric approximation derived from serial circumference-measurements of the limb, prior and at the end of third week. The functional disability was evaluated by quick disability of arm, shoulder and hand questionnaire (DASH). Quality of life was assessed by the European Organization for Research and Treatment of Cancer Core Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) and its breast cancer module (EORTC-QLQ-BR23­).Results: Fifty females with mean age of 53.22±11.2 years were included. The median duration of lymphedema was 12 months. There were 22 patients in stage1, 26 in stage2 and 2 patients in stage3. The mean baseline limb and excess volumes were significantly decreased at the end of therapies (3262±753cm³ vs 2943±646.6cm³ and 31.36±16.5% vs 19.12±10.4%, p=0.000,respectively). The DASH and EORTC-QLQ-C30 and BR23 scores were also decreased significantly (p<0.05). The improvements in volumes were related negatively with the duration of lymphedema,and the stage of lymphedema. Conclusion: In conclusion phase 1CDT in a combined manner performed daily for 3 weeks, greatly reduces the volumes as well as improves the disability and QoL, especially when performed earlier.Trial Registration: 'retrospectively registered’
The role of Nrf2 in acute and chronic muscle injury
Authors: Bronisz-Budzyńska Iwona , Kozakowska Magdalena , Podkalicka Paulina , Kachamakova-Trojanowska Neli , Łoboda Agnieszka , Dulak Józef
Published: December 2020

The nuclear factor erythroid 2-related factor 2 (Nrf2) is considered as a master cytoprotective factor regulating the expression of genes encoding anti-oxidant, anti-inflammatory, and detoxifying proteins. The role of Nrf2 in the pathophysiology of skeletal muscles has been evaluated in different experimental models, however, due to inconsistent data, we aimed to investigate how Nrf2 transcriptional deficiency (Nrf2tKO) affects muscle functions both in an acute and chronic injury. The acute muscle damage was induced in mice of two genotypes – WT and Nrf2tKO mice by cardiotoxin (CTX) injection. To investigate the role of Nrf2 in chronic muscle pathology, mdx mice that share genetic, biochemical, and histopathological features with Duchenne muscular dystrophy (DMD) were crossed with mice lacking transcriptionally active Nrf2 and double knockouts (mdx/Nrf2tKO) were generated. To worsen the dystrophic phenotype, the analysis of disease pathology was also performed in aggravated conditions, by applying a long-term treadmill test.We have observed slightly increased muscle damage in Nrf2tKO mice after CTX injection. Nevertheless, transcriptional ablation of Nrf2 in mdx mice did not significantly aggravate the most deleterious, pathological hallmarks of DMD related to degeneration, inflammation, fibrotic scar formation, angiogenesis, and the number and proliferation of satellite cells in non-exercised conditions. On the other hand, upon chronic exercises, the degeneration and inflammatory infiltration of the gastrocnemius muscle, but not diaphragm, turned to be increased in Nrf2tKOmdx in comparison to mdx mice. In conclusion, the lack of transcriptionally active Nrf2 influences moderately muscle pathology in acute CTX-induced muscle injury and chronic DMD mouse model, without affecting muscle functionality. Hence, in general, we demonstrated that the deficiency of Nrf2 transcriptional activity has no profound impact on muscle pathology in various models of muscle injury.
Current Status of Scientific Research Accomplishments of Senior Eight-year-program Medical Students in China: A Multicenter Cross-sectional Questionnaire-based Study
Authors: Wan Mengyao , Liu Shuang , Zhu Jiawei , Xiao Sulong , Yuan Lei , Lei Xiaokang , Lei Hao , Shi Xiaomeng , You Wen , Ruan Gechong , Qian Jiaming , Li Ji
Published: December 2020

Backgrounds: Among the distinct medical education systems in China, the eight-year program is an elite program dedicated to cultivating physician scientists. Although the research ability of senior students in eight-year medical programs is a pivotal quality, it remains unclear. This study aimed to clarify the current status and challenges of students’ research experience, abilities and outputs.Methods: A multicenter cross-sectional study was conducted in five medical schools in northern China. Electronic questionnaires were sent to 235 randomly chosen fifth-grade or sixth-grade 8-year-program medical students. A total of 211 responses were collected and analyzed using SPSS 22.0.Results: Only 13.3% of participants chose research as their future career goal. Students generally felt that conducting research was stressful and difficult. The greatest obstacle was a lack of time due to heavy workloads. The two major motivations for research were graduation and future employment (75.8%) and research interest (24.2%). More than half of the students (142, 67.3%) had research experience by the time of the survey, among whom 84 students already had research outputs. A higher proportion of students with outputs was motivated by the requirements for graduation or employment compared to students without outputs (71.4% vs. 55.2%, P = 0.046).Conclusions: Senior 8-year-program medical students in China generally had high pressure to conduct research and devoted their efforts to overcome these challenges. More guidance and novel encouragement to enhance students’ initiative and interest in research could be provided by medical schools and educators in the future.
Triple null mutations in starch synthase SSIIa gene homoeologs lead to high amylose and resistant starch in hexaploid wheat
Authors: Schoen Adam , Joshi Anupama , Tiwari Vijay K , Gill Bikram S. , Rawat Nidhi
Published: December 2020

Background: Lack of nutritionally appropriate foods is one of the leading causes of obesity in the US and worldwide. Wheat (Triticum aestivum) provides 20% of the calories consumed daily across the globe. The nutrients in the wheat grain come primarily from the starch composed of amylose and amylopectin. Resistant starch content, which is known to have significant human health benefits, can be increased by modifying starch synthesis pathways. Starch synthase enzyme SSIIa, also known as starch granule protein isoform-1 (SGP-1), is integral to the biosynthesis of the branched and readily digestible glucose polymer amylopectin. The goal of this work was to develop a triple null mutant genotype for SSIIa locus in the elite hard red winter wheat variety ‘Jagger’ and evaluate the effect of the knock-out mutations on resistant starch content in grains with respect to wild type. Results: Knock-out mutations in SSIIa in the three genomes of wheat variety ‘Jagger’ were identified using TILLING. Subsequently, these loss-of function mutations on A, B, and D genomes were combined by crossing to generate a triple knockout mutant genotype Jag-ssiia-∆ABD. The Jag-ssiia-∆ABD had an amylose content of 35.70% compared to 31.15% in Jagger, leading to ~118% increase in resistant starch in the Jag-ssiia-∆ABD genotype of Jagger wheat. The single individual genome mutations also had various effects on starch composition. Conclusions: Our full null Jag-ssiia-∆ABD mutant showed a significant increase in RS without the shriveled grain phenotype seen in other ssiia knockouts in elite wheat cultivars. Moreover, this study shows the potential for developing nutritionally improved foods in a non-GM approach. Since all the mutants have been developed in an elite wheat cultivar, their adoption in production and supply will be feasible in future.
Persistently higher serum sCD40L levels are associated with outcome in septic patients
Authors: Liang Yingjian , Zhu Chengrui , Sun Yini , Li Zhiliang , Wang Liang , Liu Yina , Li Xin , Ma Xiaochun
Published: December 2020

Background: Soluble CD40 ligand (sCD40L) exhibits proinflammatory and procoagulant effects. Recent data indicated that sCD40L plays a significant role in septic patients. The aim of the present study was to determine sCD40L changes in surgical patients without sepsis (SWS) and in surgical sepsis patients (SS) during the first three days at intensive care unit (ICU) admission and to observe the association between sCD40L and mortality.Methods: Time changes in sCD40L levels were assessed for 3 days after ICU admission in 49 patients with SS and compared with 19 SWS patients. Serum sCD40L concentration was detected by ELISA. Survival at 28 days was used as the endpoint.Results: SS had significantly higher sCD40L levels than SWS and control patients. We observed an association between sCD40L levels ≥1028.75 pg/ml at day 2 and 28-day mortality (odds ratio = 7.888; 95% confidence interval = 1.758 to 35.395; P= 0.007). We could not discover any significant differences in gender, presence of septic shock, site of infection, length of stay in the ICU, PaO2/FiO2 ratio, incidence of AKI, ARDS, or type of surgery between nonsurvivors and survivors.Conclusions: Septic patients show persistently higher circulating sCD40L levels in the first three days at ICU admission, and the serum sCD40L levels are associated with the mortality of patients with sepsis; thus, serum sCD40L may be used as a reliable biomarker and therapeutic target in sepsis.
Abnormal regional homogeneity and its relationship with symptom severity in cervical dystonia: A rest state fMRI study
Authors: Wei Shubao , Lu Chunhui , Chen Xiuqiong , Yang Lu , Wei Jing , Jiang Wenyan , Liu Yang , Li Huihui , Qin Yuhong , Lei Yiwu , Qin Chao , Hu Caiyou , Luo Shuguang
Published: December 2020

Background: Although several brain networks play important roles in cervical dystonia (CD) patients, regional homogeneity (ReHo) changes in CD patients have not been clarified. We investigated to explore ReHo in CD patients at rest and analyzed its correlations with symptom severity as measured by Tsui scale.Methods: A total of 19 CD patients and 21 gender-, age-, and education-matched healthy controls underwent fMRI scans at rest state. Data were analyzed by ReHo method.Results: Patients showed increased ReHo in the right cerebellum crus I and decreased ReHo in the right superior medial prefrontal cortex (MPFC). Moreover, the right precentral gyrus, right insula, and bilateral middle cingulate gyrus also showed increased ReHo values. A significantly positive correlation was observed between ReHo value in the right cerebellum crus I and symptom severity (p < 0.05).Conclusions: Our investigation suggested abnormal ReHo existed in brain regions of the "pain matrix" and salience network (the right insula and bilateral middle cingulate gyrus), the motor network (the right precentral gyrus), the cerebellum and MPFC and further highlighted the significance of these networks in the pathology of CD.
Statistical analysis of ionospheric total electron content (TEC): Long-term estimation of extreme TEC in Japan
Authors: Nishioka Michi , Saito Susumu , Tao Chihiro , Shiota Daikou , Tsugawa Takuya , Ishii Mamoru
Published: December 2020

Ionospheric total electron content (TEC) is one of the key parameters for users of radio-based systems, such as the Global Navigation Satellite System, high-frequency communication systems, and space-based remote sensing systems, since total ionospheric delay is proportional to TEC through the propagation path. It is important to know extreme TEC values in readiness for hazardous ionospheric conditions. The purpose of this study is to estimate extreme TEC values with occurrences of once per year, ten years, and hundred years in Japan. In order to estimate the extreme values of TEC, a cumulative distribution function of daily TEC is derived using 22 years of TEC data from 1997 to 2018. The extreme values corresponding to once per year and ten years are 90 and 110 TECU, respectively, in Tokyo, Japan. On the other hand, the 22-year data set is not sufficient to estimate the once-per-hundred-year value. Thus, we use the 62-year data set of manually scaled ionosonde data for the critical frequency of the F-layer (foF2) at Kokubunji in Tokyo. First, we study the relationship between TEC and foF2 for 22 years and investigate the slab thickness. Then the result is applied to the statistical distribution of foF2 data for 62 years. The result shows that the once-per-100-year TEC is about 130-190 TECU at Tokyo. The value is also estimated to be 160-230 TECU in Kagoshima and 100-150 TECU in Hokkaido, in the southern and northern parts of Japan, respectively.
Geomagnetic secular variation forecast using the NASA GEMS ensemble Kalman filter: A candidate SV model for IGRF-13
Authors: Tangborn Andrew , Kuang Weijia , Sabaka Terence , Ye Ce
Published: December 2020

We have produced a 5-year mean secular variation (SV) of the geomagnetic field for the period 2020-2025. We use the NASA Geomagnetic Ensemble Modeling System (GEMS), which consists of the NASA Goddard geodynamo model and ensemble Kalman filter (EnKF) with 400 ensemble members. Geomagnetic field models are used as observations for the assimilation, including gufm1 (1590-1960), CM4 (1961-2000) and CM6 (2001-2019). The forecast involves a bias correction scheme that assumes that the model bias changes on timescales much longer than the forecast period, so that they can be removed by successive forecast series. The algorithm was validated on the time period 2010-2015 by comparing with CM6 before being applied to the 2020-2025 time period. This forecast has been submitted as a candidate predictive model of IGRF-13 for the period 2020-2025.
Increased Frequency of β Cells with Abnormal NKX6.1 Expression in Type 2 Diabetes but not in Subjects with Higher Risk for Type 2 Diabetes
Authors: Liu Tengli , Sun Peng , Zou Jiaqi , Wang Le , Wang Guanqiao , Liu Na , Liu Yaojuan , Ding Xuejie , Zhang Boya , Liang Rui , Wang Shusen , Shen Zhongyang
Published: December 2020

Background: NKX6.1 is a transcription factor for insulin, as well as a marker for β cell maturity. Abnormal NKX6.1 expression in β cells, such as translocation from the nucleus to cytoplasm or lost expression, has been shown as a marker for β cell dedifferentiation. Methods: Here, we obtained pancreata sections from organ donors, and aim to characterize NKX6.1 expression in subjects with or without type 2 diabetes mellitus (T2DM), and NKX6.1 and insulin immunofluorescence staining was performed. Results: Our results showed that cells with insulin expression but no nucleic NKX6.1 expression (NKX6.1Nuc-Ins+), and cells with cytoplasmic NKX6.1 expression but no insulin expression (NKX6.1cytIns-) were significantly increased in T2DM subjects and positively correlated with glycated hemoglobin (HbA1c), indicating the elevated β cell dedifferentiation with NKX6.1 inactivation in T2DM. To investigate whether β cell dedifferentiation has initiated in subjects with higher risks for T2DM, we next analyzed the association between β-cell dedifferentiation level in ND subjects with different ages, body mass index, and HbA1c. The results showed the absolute number and percentage of dedifferentiated β cells with NKX6.1 inactivation did not significantly change in subjects with advanced aging, obesity, or modest hyperglycemia, indicating that the β cell dedifferentiation may mainly occur after T2DM was diagnosed. Conclusion: In sum, our results suggested that NKX6.1 expression in β cells is changed in type 2 diabetic subjects, evidenced by significantly increased NKX6.1Nuc-Ins+ and NKX6.1cytIns- cells. This abnormality does not occur more frequently in subjects with a higher risk for T2DM, suggesting that β cell dedifferentiation might be secondary to the pathological changes in T2DM.
Evaluation of 18F-FDG PET/CT Images Acquired with a Reduced Scan Time Duration in Lymphoma Patients using the Digital Biograph Vision
Authors: Weber Manuel , Jentzen Walter , Hofferber Regina , Herrmann Ken , Fendler Wolfgang Peter , Rischpler Christoph , Umutlu Lale , Conti Maurizio , Costa Pedro Fragoso , Sra Miriam , Kersting David
Published: December 2020

Background

The superior accuracy and sensitivity of 18 F-FDG-PET/CT in comparison to morphological imaging alone leads to an upstaging in up to 30% of lymphoma patients. Novel digital PET/CT scanners might enable to reduce administered tracer activity or scan time duration while maintaining diagnostic performance; this might allow for a higher patient throughput or a reduced radiation exposure, respectively. In particular, the radiation exposure reduction is of interest due to the often young age and high remission rate of lymphoma patients.

Methods

Twenty patients with (suspected) lymphoma (6 for initial staging, 12 after systemic treatment, 2 in suspicion of recurrence) sequentially underwent 18 F-FDG-PET/CT examinations on a digital PET/CT (Siemens Biograph Vision) with a total scan time duration of 15 minutes (reference acquisition protocol) and 5 minutes (reduced acquisition protocol) using continuous-bed-motion. Both data sets were reconstructed using either standalone time of flight (TOF) or in combination with point spread function (PSF), each with 2 and 4 iterations. Lesion detectability by blinded assessment (separately for supra- and infradiaphragmal nodal lesions and for extranodal lesions), lesion image quantification, and image noise were used as metrics to assess diagnostic performance. Additionally, Deauville Score was compared for all patients after systemic treatment.

Results

All defined regions were correctly classified in the images acquired with reduced emission time, and therefore, no changes in staging were observed. Lesion quantification was acceptable, that is, mean absolute percentage deviation of maximum and peak standardized uptake values were 6.8% and 6.4% (derived from 30 lesions). A threefold reduction of scan time duration led to an increase in image noise from 7.1% to 11.0% (images reconstructed with 4 iterations) and from 4.7% to 7.2% (images reconstructed with 2 iterations). No deviations in Deauville Score were observed.

Conclusion

These results suggest that scan time duration or administered tracer activity can be reduced threefold without compromising diagnostic performance. Especially a reduction of administered activity might allow for a lower radiation exposure and better health economics. Larger trials are warranted to confirm our results.
Breast Cancer in Togolese Women: Immunohistochemistry Subtypes
Authors: ADANI-IFE Ablavi , AMEGBOR Koffi , DOH Kwamé , DARRE Tchin
Published: December 2020

Background: Molecular classification of breast cancer is an important factor for prognostic and clinical outcomes. There are no data regarding molecular breast cancer subtypes among Togolese women. The objective of this study was to evaluate the expression of ER, PR, HER2, and molecular subtypes of breast cancer receptors in Togolese patients and to establish the correlation between clinical and histological data and molecular types. Methods: Clinicopathologic data of patients were collected from clinical records. Immunohistochemistry biomarkers (ER, PR, and HER2) were assessed in patients who have been diagnosed with invasive breast cancer from March 2016 to March 2020 in the department of oncology. The analysis of variance and the Chi-square Test was used to analyze the data. Results: A total of 117 cases were collected. The mean age of patients was 52.05±12.38 with an age range of 30 to 85 years. Half of the patients were over 50 years old and the majority (70.9%) was postmenopausal. More than half of patients (52.1%) presented with T3-T4tumors.The most common histologic subtype of breast cancer was invasive ductal carcinoma of no special type (95.7%). Tumors grade 2 were predominant (51.3%) followed by grade 3 (42.7%). Advanced carcinomas were found in 69 patients (59%). The percentage of ER+, PR+, and HER2 positive tumors was 54.7%, 41%, and 15.4% respectively. The predominant molecular subtype was Triple negative (37.6%), followed by Luminal A (30.8.7%), Luminal B subtype (23.9%), and HER2 enriched (7.7%). There was a significant association between stage and breast cancer subtypes (p 0.025), histologic grade, and subtype (p<0.0001) but no correlation was found with age, menopausal status, and tumor size. Conclusion: Breast carcinoma in our patients are high grade tumors and are diagnosed at an advanced stage. Triple negative and Luminal A are the two predominant breast cancer subtypes in Togolese women. Consequently, Receptor testing availability should be a priority to offer the best breast cancer treatment.
Subcutaneous ticks: first report in a golden jackal and their absence in non-canid carnivores
Authors: Mechouk Noureddine , Deak Georgiana , Ionica Angela Monica , Ionescu Dan Traian , Chisamera Gabriel Bogdan , Gherman Calin Mircea , Mihalca Andrei Daniel
Published: December 2020

Background: Ticks are hematophagous arthropods which normally attach to the surface of the skin of the host. Their aberrant presence in the subcutaneous tissue of a few carnivores, predominantly foxes has been reported. However, there are no reports in other carnivores such as mustelids or golden jackals. Our aim was to investigate and broaden the host spectrum for this aberrant localization of ticks.Methods: Between 2015 and 2020, 198 carnivore carcasses from 12 species were examined by parasitological necropsy. When subcutaneous ticks were found, the nodules were removed, carefully dissected, and stored in ethanol. The morphological identification of the subcutaneous ticks was carried out to the species level.Results: A single subcutaneous tick was found in one carcass, a golden jackal. The tick was identified as a female Ixodes ricinus. All the other carcasses were negative for the presence of subcutaneous ticks.Conclusion: The present paper represents the first report of a subcutaneous tick in a golden jackal (Canis aureus), extends the host spectrum for this unusual phenomenon and reinforces its presence only in canids among carnivores.