bluuebunny/crossref_metadata_2025 huggingface dataset:
Knowledge, Attitude and Practices toward Chronic Kidney Disease among care providers in Jimma Town: Cross-sectional study
Authors: Wolide Amare Desalegn , Goro Kabaye Kumele , Dibaba Fantu Kerga , Debalke Serkadis , Seboka Meskerem , Tufa Birtukan Edilu , Fufa Fanta Gashe , Bobasa Eshetu Mulisa
Published: May 2020

Background: Chronic kidney disease (CKD) is a common and growing health problem that requires adequate Knowledge by health care providers to reduce the progress of the disease. Thus, this study aimed to assess the care provider's Knowledge, attitude, and practices toward CKD. Method: A cross-sectional study conducted among 326 care providers at Jimma University Specialized hospital and three medium to higher clinics found in Jimma Town. Collected data entered into Epi-Data version 3.1 and exported to SPSS version 21 for windows for data analysis. Descriptive statistics and generalized linear modal used to analyze the data.Result: The mean age and service year of the participants were 29.68(±4.877) and 4.28(±4.561), respectively. The overall weighted Knowledge, attitude, and practice score of the study participant were 9.0971(8.77, 9.42), 2.53(2.4, 2.65), 10.14(9.94, 10.33) respectively. Over half of the care providers had the awareness to use eGFR to assess kidney function and patient referral to Nephrologists. Also, many care providers knew the five-stage of CKD and the risk factors of CKD, such as diabetes, long-term alcohol consumption, anemia, and cardiovascular disorders, respectively. Care providers had an understanding of late detection, and referral of CKD would increase kidney disease complications. Besides, 275(84.4%) of them are worried about treatment costs related to CKD. Over half of the care providers, 238(73.0%), believed that the Ethiopian ministry of health gave less attention to the problem. Furthermore, 234(71.8%) are interested in studying more on CKD management. Majority 256(78.5%), very likely or likely refer the patient to senior physician and NephrologistConclusion: Care providers showed enough Knowledge, a favorable attitude, and practice toward CKD.
Characterization of Gut Microbiota Associated with Clinical Parameters in Intrahepatic Cholestasis of Pregnancy
Authors: Li Rong , chen xuehai , Liu Zhongzhen , Chen Yan , Liu Chuan , Ye Lingfei , Xiao Liang , Yang Zhenjun , He Jian , Wang Wen-Jing , Qi Hongbo
Published: May 2020

Background: Intrahepatic cholestasis of pregnancy (ICP) is a liver disorder that specifically occurs in pregnancy. Elevated levels of liver transaminases aspartate aminotransferase, alanine aminotransferase and serum bilirubin levels are common biochemical characteristics in ICP. The disorder is associated with an increased risk of premature delivery and stillbirth. The characterization of the potential microbiota in ICP could go a long way in the prevention and treatment of this pregnancy disease.Methods: A total of 58 patients were recruited for our study: 27 ICP patients and 31 healthy pregnant subjects with no ICP. The V3 and V4 regions of the 16S rDNA collected from fecal samples of both diseased and control groups were amplified. 16S rRNA gene amplicon sequencing was then performed on gut microbiota. Sequencing data were analyzed and the correlation between components of microbiota and patient ICP status was found. Related metabolic pathways, relative abundance and significantly different OTUs (Operational Taxonomic Units) between ICP and controls were also identified.Results: Elevated levels of total bile acid, ALT, AST, Dbil and Tbil were recorded or observed in ICP subjects as compared to the control. Gut microbiota in pregnant women was dominated by four major phyla and 27 core genera. PCoA analysis results indicated that there was no significant clustering in Bray-Curtis distance matrices. Our results showed that there was a correlation between specific OTUs and measured clinical parameters of pregnant women. Comparison at the different taxonomy levels revealed high levels of abundance of Blautia and Citrobacter in ICP patients. At the family level, Enterobacteriaceae and Leuconostocaceae were higher in ICP patients. 638 KEGG Orthologs and 138 pathways significantly differed in the two groups; ICP patients and control group and PLS-DA model with VIP plots indicated a total of eight genera and seven species were key taxa in ICP and control groups.Conclusions: Our research indicated that although there was no significant clustering by PCoA analysis, patients with ICP have increased rare bacteria at different phylogenetic levels. Our results also illustrated that all 638 KEGG Orthologs and 136 in 138 KEGG pathways were less abundant in ICP patients compared to the controls.
Genome compartmentalization predates species divergence in the plant pathogen genus Zymoseptoria
Authors: Feurtey Alice , Lorrain Cecile , Croll Daniel , Eschenbrenner Christoph , Freitag Michael , Habig Michael , Haueisen Janine , Möller Mareike , Schotanus Klaas , Stukenbrock Eva H.
Published: May 2020

Background: Antagonistic co-evolution can drive rapid adaptation in pathogens and shape genome architecture. Comparative genome analyses of several fungal pathogens revealed highly variable genomes, for many species characterized by specific repeat-rich genome compartments with exceptionally high sequence variability. Dynamic genome structure may enable fast adaptation to host genetics. The wheat pathogen Zymoseptoria tritici with its highly variable genome, has emerged as a model organism to study genome evolution of plant pathogens. Here, we compared genomes of Z. tritici isolates and of sister species infecting wild grasses to address the evolution of genome composition and structure. Results: Using long-read technology, we sequenced and assembled genomes of Z. ardabiliae, Z. brevis, Z. pseudotritici and Z. passerinii, together with two isolates of Z. tritici. We report a high extent of genome collinearity among Zymoseptoria species and high conservation of genomic, transcriptomic and epigenomic signatures of compartmentalization. We identify high gene content variability both within and between species. In addition, such variability is mainly limited to the accessory chromosomes and accessory compartments. Despite strong host specificity and non-overlapping host-range between species, predicted effectors are mainly shared among Zymoseptoria species, yet exhibiting a high level of presence-absence polymorphism within Z. tritici. Using in planta transcriptomic data from Z. tritici, we suggest different roles for the shared orthologs and for the accessory genes during infection of their hosts. Conclusion: Despite previous reports of high genomic plasticity in Z. tritici, we describe here a high level of conservation in genomic, epigenomic and transcriptomic composition and structure across the genus Zymoseptoria. The compartmentalized genome allows the maintenance of a functional core genome co-occurring with a highly variable accessory genome.
Decoding the differentiation of mesenchymal stem cells into mesangial cells at the transcriptomic level
Authors: Wong Chee-Yin , Chang Yao-Ming , Tsai Yu-Shuen , Ng Wailap Victor , Cheong Soon-Keng , Chang Ting-Yu , Chung I-Fang , Lim Yang-Mooi
Published: May 2020

Background: Mesangial cells play an important role in the glomerulus, providing mechanical support to it, and maintaining efficient ultrafiltration of renal plasma. Loss of mesangial cells due to pathologic conditions may lead to impaired renal function. Mesenchymal stem cells (MSC) can differentiate into many cell types, including mesangial cells. However transcriptomic profiling during MSC differentiation into mesangial cells had not been studied yet. The aim of this study is to examine the pattern of transcriptomic changes during MSC differentiation into mesangial cells as well as to understand the involvement of transcription factor (TF) along the differentiation process, and finally to elucidate the relationship among TF-TF and TF-key gene or biomarkers during the differentiation of MSC into mesangial cells.Methods: Differentiation of MSC into mesangial cells was induced by co-culturing with injured mesangial cells. Total RNA from co-cultured MSC was extracted before running RNA sequencing. Generated RNA-seq data was analysed by two methods simultaneously: 1) Monotonic Feature Selector (MFSelector) to identify the key genes with ascending and descending monotonic patterns, and 2) Time-Ordered Gene Co-expression Network (TO-GCN) to construct a TF co-expression network. Results : MFSelector has identified several monotonic key genes (either ascending or descending). These identified descending monotonic key genes are related to stemness or regulation of cell cycle while ascending monotonic key genes are associated with the functions of mesangial cells. The TFs were arranged in a co-expression network in order of time by TO-GCN analysis. Additionally, not only can TO-GCN analysis classify the differentiation process into three stages: differentiation preparation, differentiation initiation and maturation, but it can also explore TF-TF-key genes regulatory relationships in the muscle contraction process.Conclusions: A systematic analysis for transcriptomic profiling of MSC differentiation into mesangial cells has been established. Key genes or biomarkers, TFs and pathways involved in differentiation of MSC-mesangial cells have been identified and the related biological implications have been discussed. Finally, we further elucidated for the first time the three main stages of mesangial cell differentiation, and the regulatory relationships between TF-TF-key genes existing in the muscle contraction process.
Fingerfoods: a feasibility study to enhance fruit and vegetable consumption in Dutch patients with dementia in a nursing home
Authors: Visscher Annemijn , Battjes-Fries Marieke CE , de Rest Ondine van , Patijn Olga N , Lee Mascha van der , Wijma-Idsinga Nienke , Pot Gerda K , Voshol Peter
Published: May 2020

Background Eating problems are highly prevalent in older patients with dementia and as a consequence, these patients are at greater risk of becoming malnourished. Fingerfoods, snacks that can be picked with thumb and forefinger, could be used to counteract malnutrition in patients with dementia. The aim of this feasibility study was to evaluate whether providing fruit and vegetable rich fingerfoods in the form of recognizable and familiar snacks on top of the normal intake was feasible for both patients with dementia and caregivers as a means to increase patients’ nutritional status.Methods Institutionalised patients with dementia (N = 15, 93% female, mean age = 85 years) were included in this feasibility study in the Netherlands. The residents received their regular diet supplemented with fingerfoods, comprising quiches and cakes rich in fruit or vegetables, for 6 weeks. Daily fingerfood consumption together with compensation behaviour at dinner of residents was administered with a checklist and food diaries at the start and end of the intervention as dose delivered. Furthermore, caregivers were asked to fill out a feedback form at the end of the intervention to measure fidelity and appreciation of the intervention. Results Patients consumed on average 1.4 pieces (70 grams) of fingerfoods daily, containing 41 grams of fruit and/or vegetables. Fruit and vegetable consumption increased during the provision of the fingerfoods and the residents seemed not to compensate this intake during the rest of the day. The intervention was generally positively received by the majority of caregivers, depending on the type of fingerfood and state of the resident. Conclusion This feasibility study showed that providing recognizable fruit and vegetable rich fingerfoods to patients with dementia seems feasible for both patients and caregivers and could provide a pragmatic approach to enhance fruit and vegetable consumption in institutionalized elderly. In an up-scaled study, effects of fingerfoods on nutritional status and quality of life should be investigated. Trial Registration: Requested.
Identification of immune-related biomarkers associated with tumorigenesis and prognosis in cutaneous melanoma patients
Authors: Huang Biao , Han Wei , Sheng Zu-Feng , Shen Guo-Liang
Published: May 2020

Background：Skin cutaneous melanoma (SKCM) is one of the most malignant and aggressive cancers, causing about 72% of deaths in skin carcinoma. Although extensive study has explored the mechanism of recurrence and metastasis, the tumorigenesis of cutaneous melanoma remains unclear. Exploring the tumorigenesis mechanism may help identify prognostic biomarkers that could serve to guide cancer therapy. Methods：Integrative bioinformatics analyses, including GEO database, TCGA database, DAVID, STRING, Metascape, GEPIA, cBioPortal, TRRUST, TIMER, TISIDB and DGIdb, were performed to unveil the hub genes participating in tumor progression and cancer-associated immunology of SKCM. Furthermore, immunohistochemistry (IHC) staining was performed to validate differential expression levels of hub genes between SKCM tissue and normal tissues from the First Affiliated Hospital of Soochow University cohort. Results: A total of 308 differentially expressed genes (DEGs) and 12 hub genes were found significantly differentially expressed between SKCM and normal skin tissues. Functional annotation indicated that inflammatory response, immune response was closely associated with SKCM tumorigenesis. KEGG pathways in hub genes include IL-10 signaling and chemokine receptors bind chemokine signaling. Five chemokines members (CXCL9, CXCL10, CXCL13, CCL4, CCL5) were associated with better overall survival and pathological stages. IHC results suggested that significantly elevated CXCL9, CXCL10, CXCL13, CCL4 and CCL5 proteins expressed in the SKCM than in the normal tissues. Moreover, our findings suggested that IRF7, RELA, NFKB1, IRF3 and IRF1 are key transcription factors for CCL4, CCL5, CXCL10. In addition, the expressions of CXCL9, CXCL10, CXCL13, CCL4 and CCL5 were positively correlated with infiltration of six immune cells (B-cell, CD8+T cells, CD4+T cells, macrophages, neutrophils, dendritic cells) and 28 types of TILs. Among them, high levels of B cells, CD8+T cells, neutrophils and dendritic cells were significantly related to longer SKCM survival time. Conclusion: In summary, this study mainly identified five chemokine members (CXCL9, CXCL10, CXCL13, CCL4, CCL5) associated with SKCM tumorigenesis, progression, prognosis and immune infiltrations, which might help us evaluate several immune-related targets for cutaneous melanoma therapy.
The lack of selection criteria for surgery in patients with non-colorectal non-neuroendocrine liver metastases
Authors: Bohlok Ali , Lucidi Valerio , Bouazza Fikri , Daher Ali , Germanova Desislava , Laethem Jean luc Van , Hendlisz Alain , donckier Vincent
Published: May 2020

Background: The benefit of surgery in patients with non-colorectal non-neuroendocrine liver metastases (NCRNNELM) remains controversial. At the population level, several statistical prognostic factors and scores have been proposed but inconsistently verified. At the patient level, no selection criteria have been demonstrated to guide individual therapeutic decision making. We aimed to evaluate potential individual selection criteria to predict the benefit of surgery in patients undergoing treatment for NCRNNELM.Methods: Data for 114 patients undergoing surgery for NCRNNELM were reviewed. In this population, we identified an early relapse group (ER), defined as patients with unresectable recurrence <1 year postoperatively who did not benefit from surgery (N=28), and a long-term survival group (LTS), defined as patients who were recurrence-free ≥5-years postoperatively and benefited from surgery (N=20). Clinicopathologic parameters, the Association Française de Chirurgie (AFC) score, and a modified 4-point Clinical Risk Score (mCRS) (excluding CEA level) were analyzed and compared between LTS and ER groups.Results: The majority of patients were female and a majority had an ASA score ≤2 at the time of liver surgery. Median age was 55 years. Almost half of the patients (46%) presented with a single liver metastasis. Intermediate- and low-risk AFC scores represented 40% and 60% of the population, respectively. Five- and ten-year overall survival (OS) and disease-free survival (DFS) rates were 56% and 27%, and 30% and 12%, respectively. Negative prognostic factors were size of liver metastases >50 mm and delay between primary and NCRNNELM <24 months for OS and DFS, respectively. AFC score was not prognostic while high-risk mCRS (score 3-4) was predictive for poorer OS. The clinicopathologic parameters were similar in the ER and LTS groups, except the presence of N+ primary tumor and the size of liver metastases were significantly higher in the ER group. Conclusion: In patients with resectable NCRNNELM, no predictive factors or scores were found to accurately preoperatively differentiate individual cases in whom surgery would be futile from those in whom surgery could be associated with a significant oncological benefit.
Study of Influential Factors of Provincial Health Expenditure -Analysis of Panel Data After the 2009 Healthcare Reform in China
Authors: Hou Ji-Fei , Tian Li-Qi , Zhang Yun , Liu Yan-Zheng , Li Jing , Wang Yue
Published: May 2020

Background: Total Healthcare Expenditure (THE) has increased substantially in all countries. Since the health system reform and health policy environment differ from each country, it is necessary to analyze the motivations of THE in a specific country. Methods: The objective of this study was to analyze the influential factors of Provincial THE (PTHE) per capita in China by using spatiotemporal panel data across 31 provinces (including provinces, autonomous regions, and municipalities, all called provinces in here) from 2009-2016 at the provincial and annual level. Generalized Estimating Equation (GEE) was used to identify the influential factors of PTHE per capita. Results: The number of beds per 10,000 population explained most of the variation of PTHE per capita. The results also showed that health expenditure in China reacts more to mortality compared with the Gross Domestic Product (GDP) per capita. But mortality and Out-Of-Pocket Payments (OOP) as a percentage of THE were associated with PTHE per capita negatively. The rate of infectious diseases and THE as a percentage of GDP had no statistical significance. And the Proportion of the Population Aged 65 and Over (POP65) impact PTHE per capita positively. But the coefficient was small. Conclusions: In response to these ﬁndings, we conclude that the impact of the increasing percentage of OOP in THE diminishes the PTHE. Furthermore, we find that both health outcomes and health provision are positively correlated with PTHE, which outweighs the effect of GDP.
NPF：Network propagation for protein function prediction
Authors: Zhao Bihai , Zhang Zhihong , Jiang Meiping , Hu Sai , Luo Yingchun , Wang Lei
Published: May 2020

Background: The accurate annotation of protein functions is of great significance in elucidating the phenomena of life, disease treatment and new drug development. Various methods have been developed to facilitate the prediction of functions by combining protein interaction networks (PINs) with multi-omics data. However, how to make full use of multiple biological data to improve the performance of functions annotation is still a dilemma. Results We presented NPF (Network Propagation for Functions prediction), an integrative protein function predicting framework assisted by network propagation and functional module detection, for discovering interacting partners with similar functions to target proteins. NPF leverages knowledge of the protein interaction network architecture and multi-omics data, such as domain annotation and protein complex information, to augment protein-protein functional similarity in a propagation manner. We have verified the great potential of NPF for accurately inferring protein functions. Comprehensive evaluation of NPF indicates that NPF archived higher performance than competing methods in terms of leave-one-out cross-validation and ten-fold cross validation. Conclusions: We demonstrated that network propagation combined with multi-omics data can not only discover more partners with similar function, but also effectively free from the constraints of the "small-world" feature of protein interaction networks. We conclude that the performance of function prediction depends greatly on whether we can extract and exploit proper functional similarity information from protein correlations.
Person-Centred, Occupation Based Intervention Program Supported with Problem-Solving Therapy for Type 2 Diabetes: a randomized controlled trial
Authors: Ağce Zeynep Bahadır , Ekici Gamze
Published: May 2020

Background: Individuals with diabetes mellitus both have difficulty in solving problems in meaningful occupations and have similar difficulties with self-care regimens. We examined the effects of occupation-based intervention supported with problem-solving therapy of individuals with type 2 diabetes mellitus on participation and satisfaction of meaningful occupations, diabetes-related psychosocial self-efficacy, preferred coping strategies and individual well-being. Methods: This study was planned as a single-blind, randomized controlled study with a 3-months follow-up involving sixty-seven adults with type 2 diabetes. The Canadian Occupational Performance Measure, the Diabetes Empowerment Scale, the Brief COPE and the Five-item World Health Organization Well-Being Index were used. The intervention was conducted in six modules for six weeks, and each implemented about 60 minutes and for one session per week. The six modules included evaluations, diabetes education, and problem-solving therapy. The most important feature of the program is its focus on meaningful occupations for the person via a holistic perspective and provided an opportunity for the participants to apply problem-solving therapy through valued occupation. Differences between groups were analysed using the Mann-Whitney U test, and the Friedman test was used to calculate group-time interaction differences (i.e., baseline, after six weeks and after three months). Results: Individuals with type 2 diabetes mellitus in both groups identified the most significant occupational performance problems in self-care as personal care. Significant improvement was reported in the intervention group when compared to the control group regarding the participation in meaningful occupation, the satisfaction of performance, psychological self-efficacy and well-being results (p<0.001) after the six modules and three months follow-up. The participants' use of effective coping strategies, active coping and acceptance strategies, self-efficacy as revealed results suggest improvement in favor of the intervention group (p<0.05). The intervention group showed significantly improving between measurements at baseline and after three months of modules except for ineffective coping style (p<0.001). Conclusions: The occupation-based problem-solving therapy encourages participation in meaningful occupations, positive effects on psychological self-efficacy, and improves effective coping styles and well-being of type 2 diabetes mellitus. Problem-solving therapies that incorporate individuals’ priorities via meaningful occupation can be used to lead a meaningful and quality life of individuals with type 2 diabetes mellitus
STUDY PROTOCOL The prevalence and risk factors of work-related musculoskeletal disorders among adults in Ethiopia: a study protocol for extending a systematic review with meta-analysis of observational studies
Authors: Gebreyesus Tsiwaye , Nigussie Kalkidan , Getnet Moges Gashaw , Janakiraman Balamurugan
Published: May 2020

Background: Work-related musculoskeletal disorders impose a significant and most often underappreciated burden to the individual, nation, healthcare system, and society as a whole. To the best of our knowledge, there is a lack of reliable estimates on the prevalence of work-related musculoskeletal disorders in Ethiopia. The objective of this study will be to assess the existing literature on the prevalence rates and determinant factors of work-related musculoskeletal disorders in Ethiopia.Method: We will search PubMed/MEDLINE, Embase, SCOPUS, PsycINFO, PEDro and Ebsco (from January 2000 onwards). Grey literature will be identified through searching Google Scholar and dissertation databases. Observational studies reporting on the prevalence of work-related musculoskeletal disorders among adult Ethiopians will be included. The primary outcome will be the prevalence of work-related musculoskeletal disorders. Secondary outcomes will be the prevalence of any risk factors in association with work-related musculoskeletal disorders. Two reviewers will independently screen all citations, full-text articles, and abstract data. The study methodological quality (or bias) will be appraised using an appropriate tool. If feasible, we will conduct random effects meta-analysis of observational data. Subgroup analyses will be conducted to explore the potential sources of heterogeneity (e.g. gender, sample size, type of occupation).Publication bias and heterogeneity between the included studies will also be assessed and reported.Discussion: This systematic review will provide a synthesis of the literature on the prevalence of work-related musculoskeletal disorders and their risk factors in Ethiopia. The results of this review could help the policymakers in occupational health and health care sectors in identifying priority areas for interventions in work-related musculoskeletal disorders and will also serve as a baseline for the decision-making processes of musculoskeletal health promotion, work exposure implementations, and prevention programs in workplaces. Systematic review registration: PROSPERO CRD42020164240
Therapeutic abortion in Iran: an epidemiologic study of legal abortion in 2 years
Authors: Mahdavi Seyed Amirhosein , Jafari Asieh , Azimi Khadijeh , Dehghanizadeh Nikoo , Bazegar Abdolrazagh
Published: May 2020

Objectives: Unsafe abortion is one of the most important causes of death and disability among mothers in countries where abortion is illegal. These conditions have changed since then. The present study has investigated the cases who were referred to the legal medicine organization to receive abortion permission. This country level secondary patient data analysis, investigated all the cases who were referred to the legal medicine centers of Iran for abortion permission during 2015 to 2017.Results: From 21477 applicants, 15617 (72.71%) received permission including 14367 (91.99%) for fetal abnormalities and 1250 (8.01%) for maternal diseases. The most common fetal abnormalities/disorders were nervous system malformations (26.4%), chromosomal abnormalities (18.4%) and of maternal diseases were circulatory system diseases (43.9%), neoplasms (13.4%) and genitourinary system diseases (9.9%). The most common reasons for not permission were lack of supplementary documents to prove (38.8%), not competency with the criteria (33.9%), and gestational age of more than 19 weeks (25.8%).
Correlation of Clinicopathological Features and IL6 Expression in Tumor Budding of Colon Adenocarcinoma
Authors: Sato Koichi , Uehara Takeshi , Iwaya Mai , Nakajima Tomoyuki , Tobe Yosuke , Miyagawa Yusuke , Ota Hiroyoshi
Published: May 2020

Background: Interleukin-6 (IL6) is one of the main cytokines produced by cancer-associated fibroblasts (CAFs). IL6 is linked with cancer progression and poor prognosis by activating cancer cells and modifying the cancer microenvironment. However, little is known about the expression of IL6 in tumor budding (TB) and its association with TB in colon adenocarcinoma (CA). Methods: The clinicopathological and prognostic significance of IL6 in TB was examined using a tissue microarray consisting of 36 patient samples of TB in CA. IL6 mRNA was detected by RNAscope kit. Patients were stratified into negative and positive IL6 expression groups.Results: IL6 expression was overwhelmingly observed in CAFs but was negligible in cancer cells. In the IL6-positive group in CAFs, TB grade was higher than in the IL6-negative group (P=0.0161). There was a significant difference in overall survival (OS) between CA cases in the IL6-positive group and the IL6-negative group (log rank test, P=0.0367). Cox proportional hazard regression model revealed that the IL6-negative group (OR = 0.25; 95% CI: 0.05–0.96; P=0.0440) had better OS for CA than the IL6-positive group. Conclusions: TB may be affected by IL6 expression, and IL6 expression in CAFs at TB may make IL6 an important prognostic marker.
Characteristics of Endocrine Metabolism in AL Amyloidosis Patients
Authors: Cao Changchun , Pan Binbin , Cao Feifei , Wan Xin
Published: May 2020

Background To explore characteristics of thyroid gland and glucose metabolism in light chain (AL) amyloidosis patients.Methods A total of 20 amyloidosis patients were recruited. Thyroid function and biochemical indices were tested. Intravenous glucose tolerance test was performed in all patients. Thyroid ultrasound was also determined.Results 1.There was 7 patients with hypothyroidism (35%) and 4 patients with subclinical hypothyroidism (20%). Additionally, a total of 6 patients manifested as euthyroid sick syndrome (30%); 2. A number of 15 patients showed thyroid nodule (75%); 3. The fast blood glucose was 4.85±0.8 mmol/l. The level of blood glucose after intravenous glucose tolerance test showed 8.03±1.88 mmol/l at 30 minutes and 7.1±3.22 mmol/l at 120 minutes. 4. The blood insulin levels in fasting, 30 minutes and 120 minutes were 5.2±2.59 mIU/L, 308.3±199.4 mIU/Land 245.66±176.44 mIU/L. Further, the values of C-peptide showed 2.47±1.43 ng/ml, 6.74±3.16 ng/ml and 8.98±4.83 ng/ml. Homeostasis model assessment of insulin resistance and Homeostasis model assessment of β cells of the patients were 1.2±0.62 and 88.45±46.17, respectively. There were 2 patients diagnosed with diabetes and 1 patient with impaired glucose tolerance.Conclusions AL amyloidosis patients revealed high prevalence of hypothyroidism, subclinical hypothyroidism and euthyroid sick syndrome. However, glucose metabolism showed no influence in amyloidosis patients.
Pistils may be required for anthocyanin synthesis —— the whole-transcriptome analysis of mutant and normal capitula of Chrysanthemum morifolium
Authors: Liu Hua , Luo Chang , Chen Dongliang , Wang Yaqin , Guo Shuang , Chen Xiaoxi , Bai Jingyi , Li Mingyuan , Huang Xinlei , Cheng Xi , Huang Conglin
Published: May 2020

Background Chrysanthemum morifolium is one of the most economically important and popular floricultural crops in Asteraceae. Chrysanthemums have many different flower colors and shapes. However, the molecular mechanism controlling the development of chrysanthemum floral colors and shapes is still an enigma. We obtained a cut chrysanthemum variety with mutant capitula in which the ray florets became green and the inside pistils became vegetative buds, while normal capitula have many rounds of purple ray florets and few disc florets. ﻿Results We conducted whole-transcriptome analysis of differentially expressed genes (DEGs) between the mutant and normal capitula using third-generation and second-generation sequencing techniques. We identified DEGs between the mutant and normal capitula to reveal important regulators underlying their differential development. Regulatory genes involved in the photoperiod pathway and the control of floral organ identification as well as important functional genes in the anthocyanin synthesis pathway were also identified. Therefore, a list of candidate genes for studying flower development and anthocyanin synthesis in chrysanthemums was generated. Qualitative analysis of pigments in the florets of normal and mutant capitula revealed anthocyanins were synthesized and accumulated in the florets of normal capitula, but not in the florets of mutant capitula. It was indicated that pistils may be required for anthocyanin synthesis in chrysanthemums. Conclusions These results will help to elucidate the molecular mechanisms of floral organ development and will contribute to the development of techniques for studying flower shape and color regulation to promote breeding in chrysanthemum.
Incomplete Staging in Ovarian Cancer
Authors: Beltman Jogchum , Laven P , Bense JE , Aa Maaike van der , Vos MC , Boll D , Arts HGJ , Reesink N , Trimbos JB , Kruitwagen RFPM
Published: May 2020

Objective Incomplete surgical staging of patients with early stage epithelial ovarian cancer (EOC) has been reported in up to 85% of cases, when based on the International Federation of Obstetrics and Gynaecology (FIGO) staging procedure. The aim of the present retrospective study was to clarify the reasons for incomplete staging.Methods The PRISMA (Prevention Recovery Information System for Monitoring and Analysis) technique was used to evaluate cases with FIGO I-IIa EOC based on incomplete staging from five gynecologic oncologic center hospitals in the Netherlands in the period 2010-2014.Results Fifty cases with an incomplete surgical staging of EOC according to national guidelines were included. The most common reasons for incomplete staging were insufficient random biopsies of the peritoneum (n=34, 68%), and less than ten lymph nodes being resected and/or found at pathology (n=16, 32%). The most mentioned reasons for not performing biopsies were forgetting to do so, and believing that after careful inspection and palpation, taking biopsies is irrelevant and/or already are being taken while performing a hysterectomy (cul-de-sac, bladder). The value of contralateral pelvic lymph node dissection in case of a unilateral ovarian malignancy was also doubted, influencing the number of lymph nodes resected.Conclusion The most important reasons for incomplete staging in EOC are, besides omitting elements by accident, questioning the importance of obligatory elements of the staging procedure. A structured list of staging steps during surgery and more evidence based consensus concerning these obligatory elements might increase the number of complete staging procedures in EOC.
Mitochondrial DNAs provide insight into trypanosome phylogeny and molecular evolution
Authors: Kay Christopher , Williams Tom A , Gibson Wendy
Published: May 2020

Background: Trypanosomes are single-celled eukaryotic parasites characterised by the unique biology of their mitochondrial DNA (mtDNA). African livestock trypanosomes impose a major burden on agriculture across sub-Saharan Africa, but are poorly understood compared to those that cause sleeping sickness and Chagas disease in humans. Here we explore the potential of trypanosome mtDNA to study the evolutionary history of trypanosomes and the molecular evolution of their mtDNAs.Results: We used long-read sequencing to completely assemble mtDNAs from four previously uncharacterized African trypanosomes, and leveraged these assemblies to scaffold and assemble a further 103 trypanosome mtDNAs from published short-read data. While synteny was largely conserved, there were repeated, independent losses of Complex I genes. Comparison of edited and non-edited genes revealed the impact of RNA editing on nucleotide composition, with non-edited genes approaching the limits of GC loss. African tsetse-transmitted trypanosomes showed high levels of RNA editing compared to other trypanosomes. Whole mtDNA coding regions were used to construct time-resolved phylogenetic trees, revealing deep divergence events among isolates of the pathogens Trypanosoma brucei and T. congolense .Conclusions: Our mtDNA data represents a new resource for experimental and evolutionary analyses of trypanosome phylogeny, molecular evolution and function. Molecular clock analyses yielded a timescale for trypanosome evolution congruent with major biogeographical events in Africa and revealed the recent emergence of Trypanosoma brucei gambiense and T. equiperdum , major human and animal pathogens.
Evaluation of Maternal Death Surveillance and Response System in Dewachefa Woreda, Oromia Zone, Amhara Region, Ethiopia, 2018
Authors: Tariku Mengistie
Published: May 2020

Background

Maternal death surveillance and response (MDSR) is the “litmus test” of the health system that provides evidence for accomplishment, links activities to results, makes maternal death visible at all levels, informs communities & health workers, increases country ownership of data, provides information in real time and allows improvement towards catching all maternal mortalities. The aim of study was to evaluate maternal death surveillance and response system in Dewachefa.
Methods

A cross sectional study design was conducted in two health centers, five health post, district health office and from these facilities 32 health workers were included. Data were collected through focal person, health worker and health extension worker interview by using checklist. Collected data were entered into Epi data version 3.1. These data were exported to statistical package for social science for analysis. Analyzed data were presented in the form of text, table and figures.
Result

The average completeness of weekly report form of the district was 77.4%. Twenty-eight (87.5%) of the health worker had not got Maternal death surveillance and response (MDSR) training. All visited health facilities and Woredas focal person were trained. The system had under notification of maternal death from the community, poor involvement of health facility staff, and discordance of data between public health emergency management, and maternal and newborn health unit report. Establish rapid response team that includes maternal and child health staff’s maternal death review committees in all health facilities.
Aortic Thrombus in patients with Severe Covid-19. Review of three cases
Authors: Carranza Maria , Salazar Danilo , Troya Jesús , Alcazar Roberto , Peña Cristina , Muñoz Nuria
Published: May 2020

Coronavirus disease 2019 (COVID-19) is suspected to predispose to both venous and arterial thromboembolism, in the context of an exaggerated immune response to the virus, especially in severe patients. Even though aortic thrombi are a rare entity, the new COVID-19 establishes the need to include them in the diagnosis, especially in patients with severe disease and no clinical improvement. Herein, we describe a series of three cases of aortic thrombi diagnosed by computerized tomography (CT) angiography in patients with confirmed SARS CoV-2 infection.
Comparative Transcriptomics of Metabolites in Wild and Cultivated Pinellia ternata
Authors: Wang Jue , Zhu Yufeng , Lv Xiangyu , Xiong Yue , Lu Jiawei , Jin Chao , Zhang Jian , Liu Shijia
Published: May 2020

Background: As a traditional Chinese medicine(TCM) used to treat cough, Pinellia ternata (PT) has been utilized for thousands of years. Studies focused on the genetic makeup underlying the differences between wild and cultivated PT are rare, while wild herb is quite effective and indispensable in the clinical use of TCM. There is still rare researches related to the cause of differences between wild and cultivated PT. With the application of transcriptome technology in the field of traditional Chinese medicine, High-throughput RNA sequencing (RNA-seq) could be employed to find out how environment affect the accumulation of active constituent in medicinal herbs.Result: Overall, 133 503 unigenes were assembled, and 1329 genes were differentially expressed in the cultivated PT compared to the wild PT. Of those, 70 DEGs (differentially expressed genes) were significantl[1]y downregulated and 9 were upregulated in the cultivated PT compared to the wild PT after filtering out genes involved in the biosynthesis and metabolism of amino acids, glutathione, phenylpropane and other constituents. These genes were assumed to be of special interest with respect to the better efficacy of the wild PT. Meanwhile, RT-qPCR was utilized to analysis the expression patterns of 9 selected genes and HPLC were applied to quantify the content of adenine and guanosine in PT which verified the RNA-Seq result.Conclusion: 79 DEGs were found in wild and cultivated PT, which played an important role in the synthesis and metabolism of the active ingredients of PT. And the expression of DEGs is higer in wild PT, indicated the importance of wild medicinal herb resources. The experiment produced robust resources for future investigations on the regulation of active ingredients in PT and Araceae and the promotion of the cultivation and clinical use of PT.
Clinical Analysis of Classification for Tibial Plateau Fractures and Popliteal Artery Injury
Authors: Yao Yilun , Wu Xiaoshu , Wu Lei , Yang Lei , Jiang Chunzhi , Yang Wengbo
Published: May 2020

Objective To explore the association between the classification for tibial plateau fractures (TPF) and the popliteal artery injury (PAI).Methods 22 TPF patients accompanied by PAI who were treated from May 2012 to July 2019 were retrospectively analyzed. There were 19 males and 3 females with an average age of 49.43 years. The Schatzker classification and three-column classification were performed for TPF. The severity of extremity injury was evaluated using the mangled extremity severity score (MESS). Except 3 patients treated with amputation, the remaining patients underwent surgical repair of popliteal artery and fracture external fixation. The efficacy was evaluated using the Rasmussen score for tibial head fractures.Results There were 10 cases of Schatzker type IV fractures, 1 case of type V fractures and 11 cases of type VI fractures. Based on the three-column classification, the posterior column was involved in 22 cases, 2 columns in 15 cases and 3 columns in 6 cases. The MESS was 6-10 points, with an average of 7.59 points. Except 1 case directly receiving amputation, 3 cases of segment P1 injury was observed via preoperative DSA + intraoperative exploration, while segment P2 in 6 cases and segment P3 in 12 cases. Popliteal artery was found completely ruptured in 11 cases, partially ruptured in 1 case, and severely contused with thrombosis in 10 cases. The Rasmussen score was given to 19 patients at the last follow-up,except for the cases undergoing amputation. The efficacy was excellent in 8 cases, good in 7 cases, moderate in 3 cases and poor in 1 case.Conclusion: In patients with complex TPF, the risk of PAI becomes higher with the increase of Schatzker classification level. Knee CT scan is helpful in determining the severity of fractures and evaluating PAI. Based on the three-column classification, PAI should be suspected when the fractures involve the medial and posterior column.PAI is mainly in the segment P3, and artery rupture or severe contusion with extensive thrombosis may occur.The postoperative knee function of patients with complex TPF can be well restored by early active surgical repair of popliteal artery.
A new transpedicular lag-screw fixation for treatment of unstable Hangman’s fracture: a minimum 2-year follow-up study
Authors: Liu Yijie , Zhu Yi , Li Xuefeng , Chen Jie , Yang Sen , Yang Huilin , Jiang Weimin
Published: May 2020

Background
A new C2 transpedicular lag-screw designed by our team has been used in human cadaver spines for biomechanical testing, and the results showed that the biomechanical properties of the new C2 transpedicular lag-screw were better than ordinary screws. The objective of this study is to analyze the clinical efficacy and safety of the new C2 transpedicular lag-screw fixation for treatment of an unstable Hangman’s fracture.
Methods
From March 2013 to June 2017, 25 patients who had unstable Hangman’s fractures were operated on with a new C2 transpedicular lag-screw fixation. The patients included 18 males and 7 females whose ages ranged from 31–62 years (average 45.4 ± 9.3 years). The cause of the injury was a traffic accident in 17 patients and a fall from height in 8 patients. Other associated lesions included rupture of the spleen (1 patient) and rib fractures (2 patients). According to the Levine-Edwards classification, 17 patients were Type II and 8 patients were Type IIA, and according to the Frankel Neurological Performance scale, 8 cases and 17 cases were graded as spinal cord injury D and E, respectively. Of the cases, 23 cases received bilateral screw fixation and 2 cases had unilateral screw fixation because another pedicle was chipped. The whole procedure was accomplished with monitoring by“C”-arm fluoroscopy.
Results
The mean follow-up time was (36 ± 12) months and ranged from 24 to 60 months. No obvious symptomatic or radiologic postoperative complications were found during the follow-up period. 6 cases restored from D to E while 2 cases remained D according to American Spinal Injury Association (ASIA) grade. Osseous union was achieved in all cases, and the range of cervical motion recovered to normal level up to the last follow-up.
Conclusions
The primary clinical and radiographic efficacies of a new C2 transpedicular lag-screw fixation for treatment of an unstable Hangman’s fracture were satisfactory. This approach could be considered a simple, effective, reliable and economic surgical method for managing unstable Hangman’s fractures.
Modeling Risk Factors Associated With Time to Pregnancy Termination in Ethiopia: Application of Frailty Models
Authors: Sebu Aboma Temesgen
Published: May 2020

Background: Pregnancy termination commonly known as abortion is the preventable causes for the maternal mortality worldwide that largely forgotten. About 45 % of these pregnancy terminations are unsafe causing death of more than 22,000 women every year and remains major public health problems in developing countries including Ethiopia. This study was also aimed to model and investigate risk factors associated with time to pregnancy termination in Ethiopia by applying survival model considering the clustering effects.Methods: The study considered 15,683 reproductive age group women from 2016 Ethiopian Demographic and Health Survey data. Kaplan-Meier(KM) was employed to estimate the survival curve and this estimated KM survival curve estimated for different groups were tested based on log rank test. To come up with appropriate model for the time to pregnancy termination and the associated risk factors both semi-parametric and parametric survival model with no frailty effects as wells as with shared frailty effects which handles random effects were employed and compared based AIC and BIC of the fitted models.Results: The result of the study showed generalized gamma and lognormal survival models were appropriate models compared with semi-parametric and other candidate parametric models.Fitting these survival model with frailty showed the improvement of the models which was an indication for the presence of unobservable random effects in clusters. Regarding the frailty models comparison, log normal with gamma frailty model was considered as appropriate model for fitting time to pregnancy termination model in Ethiopia compared with other candidate frailty models. Furthermore, the selected frailty model result showed that age of women, ever trying to avoid pregnancy, contraceptive method use, age at first sex, total number of children ever born and place of residence were the identified risk factors for the time to pregnancy termination at 5% level of significance.Conclusions: Based on the finding of this study, starting sex at early age, residing urban areas, having lower number of children, being in married marital status group, chewing chat and do not using contraceptive methods were the risk factors that results pregnancy termination at early age that needs serious consideration to prevent the problem in Ethiopia.