bluuebunny/crossref_metadata_2025 huggingface dataset:
A detailed in silico analysis of secondary metabolite biosynthesis clusters in the genome of the broad host range plant pathogenic fungus Sclerotinia sclerotiorum
Authors: Graham-Taylor Carolyn , Kamphuis Lars G , Derbyshire Mark
Published: October 2019

Background

The broad host range pathogen Sclerotinia sclerotiorum infects over 400 plant species and causes substantial yield losses in crops worldwide. Secondary metabolites are known to play important roles in the virulence of plant pathogens, but little is known about the secondary metabolite repertoire of S. sclerotiorum. In this study, we predicted secondary metabolite biosynthetic gene clusters in the genome of S. sclerotiorum and analysed their expression during infection of Brassica napus using an existing transcriptome data set. We also investigated their sequence diversity among a panel of 25 previously published S. sclerotiorum isolate genomes.Results

We identified 80 putative secondary metabolite clusters. Over half of the clusters contained at least three transcriptionally coregulated genes. Comparative genomics revealed clusters homologous to clusters in the closely related plant pathogen Botrytis cinerea for production of carotenoids, hydroxamate siderophores, DHN melanin and botcinic acid. We also identified putative phytotoxin clusters that can potentially produce the polyketide sclerin and an epipolythiodioxopiperazine. Secondary metabolite clusters were enriched in subtelomeric genomic regions, and those containing paralogues showed a particularly strong association with repeats. The positional bias we identified was borne out by intraspecific comparisons that revealed putative secondary metabolite genes suffered more presence / absence polymorphisms and exhibited a significantly higher sequence diversity than other genes.Conclusions

These data suggest that S. sclerotiorum produces numerous secondary metabolites during plant infection and that their gene clusters undergo enhanced rates of mutation, duplication and recombination in subtelomeric regions. The microevolutionary regimes leading to S. sclerotiorum secondary metabolite diversity have yet to be elucidated. Several potential phytotoxins documented in this study provide the basis for future functional analyses.
Motor Intervention With And Without Nintendo® Wii For Children With Developmental Coordination Disorder: Protocol For A Randomized Clinical Trial
Authors: NETO JORGE Lopes CAVALCANTE , Steenbergen Bert , Tudella Eloisa
Published: October 2019

Abstract
Background:
Despite the benefits highlighted by motor interventions based on virtual reality for children with Developmental Coordination Disorder (DCD), there are still doubts whether these are greater than those obtained with conventional interventions due to the absence of systematized protocols and lack of evidence. Here we present a protocol to systematically compare the effects of two motor training programs (one Nintendo® Wii based and the other no-Wii motor activities) on the motor learning in children with DCD.
Methods/Design:
Two intervention protocols (one based on Nintendo® Wii and the other no-Wii motor activities) will be carried out, with interventions occurring twice a week in 60-minute sessions, with a minimum of 12 and a maximum of 16 sessions per child.
The protocols were developed based on the domains of the Movement Assessment Battery for Children – Second Edition (MABC-2) (Manual dexterity, aiming & catching, balance), with two activities for each of the MABC -2 domains. The study will include children aged 7 to 10 with total MABC-2 score ≤16, and Developmental Coordination Disorder Questionnaire (DCDQ) score <46 (age of 7 years), score <55 (age group of 8 to 9 years and 11 months), or score <57 (age of 10 years) as scored by the parents. Children will be randomly allocated by draw in one of the two intervention protocols. MABC-2 and DCDQ will be applied before and after intervention to evaluate the effects of the interventions on motor performance and parents’ perception respectively. Motor learning will be assessed by means of the scores obtained in the games. Evaluators and therapists will be trained and evaluators will be blind about the data of the children in the study.
Discussion: Owing to its motivating aspects, training with Nintendo® Wii may be particularly beneficial for children with DCD. The results of this study protocol will help researchers and therapists to better understand the benefits of Nintendo® Wii based motor intervention over those obtained with no-Wii interventions in children with DCD. It will also create references about more systematized protocols for replication in clinical practice, seeking the improvement of the motor components of these children.
Trial registration: http://www.ensaiosclinicos.gov.br/rg/RBR-89ydgj/
Atmiyata, a community led intervention to address common mental disorders: Study protocol for a stepped wedge cluster randomized controlled trial in rural Gujarat, India
Authors: Joag Kaustubh , Kalha Jasmine , Pandit Deepa , Chatterjee Susmita , Krishnamoorthy Sadhvi , Shields-Zeeman Laura , Pathare Soumitra
Published: October 2019

Background: While lay-health worker models for mental health care have proven to be effective in controlled trials, there is limited evidence on the effectiveness and scalability of these models in rural communities in low- and middle-income countries (LMICs). Atmiyata is a rural community-led intervention using local community volunteers, called Champions, to identify and provide evidence-based counselling for persons with common mental disorders (CMD) as part of a package of community-based interventions for mental health. Methods: The impact of the Atmiyata intervention is evaluated through a stepped wedge cluster randomized controlled trial (SW-CRCT) with a nested economic evaluation. The trial spans across 10 sub-blocks (645 villages) in Mehsana district with 1.52 million rural adult population. There are 56Primary Health Centers (PHCs) in Mehsana district and villages covered under these PHCs are equally divided into four groups of clusters of 14 PHCs each, and the intervention is rolled out in a staggered manner in these groups of villages at an interval of 5 months. The primary outcome is symptomatic improvement measured through the GHQ-12 at 3-month follow-up. Secondary outcomes include: quality of life using the EURO-QoL (EQ- 5D), symptom improvement measured by the Self-Reporting Questionnaire-20 (SRQ-20), functioning using the WHO Disability Assessment Scale (WHO-DAS-12), depression symptoms using the Patient Health Questionnaire, (PHQ-9), anxiety symptoms using Generalized Anxiety Disorder Questionnaire, (GAD-7) and social participation using the Social Participation Scale (SPS). Generalized linear mixed effects model are employed for binary outcomes and linear mixed effects models for continuous outcomes. A Return on investment (ROI) analysis of the intervention will be conducted to understand whether the intervention generates any return on financial investments made into the project. Discussion: Stepped wedge designs are progressively being used to evaluate real-life effectiveness of interventions. To the best of our knowledge, this is the first SW-CRCT in a LMIC evaluating the impact of implementation of a psychosocial mental health intervention. The results of this study will contribute to the evidence on scaling-up lay health worker models for mental health interventions and contribute to the SW-CRCT literature in LMICs.
Do USMLE Steps and ITE Results Predict Performance in the American Board of Internal Medicine Certifying Exam?
Authors: Rayamajhi Supratik , Dhakal Prajwal , Wang Ling , Rai Manoj P , Shrotriya Shiva
Published: October 2019

Objective: To evaluate if United States Medical Licensing Examination (USMLE) Step 1, USMLE Step 2, USMLE Step 3, and residency third-year in-service training exam (ITE) results predict performance of Internal Medicine (IM) residents in American Board of Internal Medicine Certifying Exam (ABIM-CE).

Methods: A retrospective review of USMLE Step 1, USMLE Step 2, USMLE Step 3 scores, residency third year ITE and ABIM-CE of IM residents at our residency program from 2004 through 2017 was conducted. Pearson correlation coefficient and two-sample t-tests were used to assess the relationship between various scores. Multivariate logistic regression was used to predict pass or fail results in ABIM-CE using USMLE and third-year ITE test scores controlling for other covariates.

Results: Among 114 MD residents included in the study; 92% (n=105) passed the ABIM-CE. USMLE score was a significant predictor of passing ABIM-CE. The OR of passing ABIM-CE was 2.70 (95 % CI=1.38-5.29), 2.31 (95% CI=1.33-4.01), and 1.63 (95% CI=0.81-3.29) with a ten-point increase in USMLE Step 1, USMLE Step 2 and USMLE step 3 scores respectively. OR of ABIM-CE passing chance was 2.96 (95% CI=0.95-9.20) with a ten-point increase in the average score of the above three exams. A five percent increase in ITE percentage raised the likelihood of passing ABIM-CE (OR 2.92, 95% CI 1.15-7.38). All residents who failed ABIM-CE had Step 1 scores <220. Among 31 residents with Step 2 score <220, 20% (n=6) failed ABIM. Similarly, 9% of residents with USMLE Step 3 score < 220 failed ABIM-CE; all residents who failed had scored < 220. The probability curve predicted that the chance of passing ABIM- CE was around 80% with USMLE scores greater than 200 and increased to almost 100% with USMLE scores of 250 or more.

Conclusion: USMLE Step 1, USMLE Step 2, and third-year ITE scores strongly predict the chances of passing ABIM-CE. Thus, programs can identify internal medicine residents at risk of failing ABIM-CE and need intervention at an early stage. Various measures such as enrolling them in question banks or board review courses can then be implemented by programs to improve their chances to pass.
The side effects of service changes: exploring the longitudinal impact of participation in a randomised controlled trial (DOORWAYS) on staff perceptions of barriers to change.
Authors: Laker Caroline , Cella Matteo , Callard Felicity , Wykes Til
Published: October 2019

Background Staff and service users have expressed concerns that service improvements in U.K. mental health wards have been slow or transient. It is possible that certain changes are positive for some (e.g. service users), but negative for others (e.g. staff), which may affect implementation success. In this study, we explore whether a programme of change to improve the therapeutic milieu on mental health wards influenced staff perceptions of barriers to change, 12 months after implementation. Method A cluster randomised controlled trial called DOORWAYS was conducted on eight inner-city U.K. acute mental health wards. Randomisation was achieved using a list randomly generated by a computer. A psychologist trained ward staff (mainly nurses) to deliver evidence-based groups and supported their initial implementation. The impact of these changes was measured over 12 months (when 4 wards were randomised), according to nurses’ perceptions of barriers to change (VOCALISE), using unstructured multivariate linear regression models. This innovative analysis method allows maximum use of data in randomised controlled trials with reduced sample sizes due to substantial drop out rates. The contextual influences of occupational status (staff) and of workplace setting (ward) were also considered. Results Staff who participated in the intervention had significantly worse perceptions of barriers to change at follow up. The perceptions of staff in the control group did not change over time. In both groups (N=120), direct care staff had more negative perceptions of barriers to change, and perceptions varied according to ward. Across time, direct care staff in the intervention group became more negative than those in the control group. Conclusion Participation in this program of change, worsened staff perceptions of barriers to change. In addition, occupational status (being from the direct care group) had a negative effect on perceptions of barriers to change, an effect that continued across time and was worse in the intervention group. Those providing direct care should be offered extra support when changes are introduced and through the implementation process. More effort should be placed around reducing the perceived burden of innovation for staff in mental health wards.
Association of sleep quality during pregnancy with stress and depression: a prospective birth cohort study in China
Authors: Gao Ming , Hu Jiajin , Yang Liu , Ding Ning , Wei Xiaotong , Li Lin , Liu Lei , Ma Yanan , Wen Deliang
Published: October 2019

Background: The sleep quality of pregnant women in the third trimester is related to mental health. However, there is still a lack of large-scale cohort research exploring this relationship in the second trimester. Thus, we assessed the associations of sleep quality during the second trimester with antenatal stress and antenatal and postnatal depression.
Methods: We examined 1152 pregnant women from a prospective cohort study in China to assess the associations of sleep quality in the second trimester with antenatal stress, antenatal depression, and postnatal depression. We used linear regression models and logistic regression models to examine the associations of sleep quality (Pittsburgh Sleep Quality Index [PSQI]) during pregnancy with perinatal stress (Pregnancy Pressure Scale [PPS]) and depression (Edinburgh Postnatal Depression Scale [EPDS]) status. We further assessed the relationship in groups divided according to age.
Results: PSQI scores were positively associated with antenatal PPS scores (β: 1.52, 95% confidence interval [CI]: 1.28, 1.76), antenatal EPDS scores (β: 0.68, 95% CI: 0.58, 0.78), and postpartum EPDS scores (β: 0.51, 95% CI: 0.38, 0.64). Poor sleep quality was associated with antenatal stress status (odds ratio [OR]: 2.60, 95% CI: 1.79, 3.77), antenatal depression status (OR: 3.42, 95% CI: 2.48, 4.72), and postpartum depression status (OR: 2.40, 95% CI: 1.58, 3.64). The association of sleep quality in the second trimester with postnatal depression status was found in women older than 30 years old (OR: 4.12, 95% CI: 2.18, 7.78) and not in women younger than 30 years old.
Conclusion: Poor sleep quality in the second trimester among Chinese pregnant women is associated with stress and depression symptoms. Strategies to boost sleep quality should be considered during prenatal health care to improve women’s mental health status.
The utility of a shortened palliative care screening tool to predict death within 12 months – a prospective observational study in two South African hospitals with a high HIV burden
Authors: Raubenheimer Peter , Day Cascia , Abdullah Faried , Manning Katherine , Cupido Clint , Peter Jonny
Published: October 2019

Background: Timely identification of people who are at risk of dying is an important first component of end-of-life care. Clinicians often fail to identify such patients, thus trigger tools have been developed to assist in this process.Aim: To evaluate the performance of a screening tool (based on the Gold Standards Framework Prognostic Indicator Guidance) to predict death at 12 months in a population of hospitalised patients in South AfricaDesign: Prospective cohort observational study using linkage analysis of hospitalised patients to death certification records.Setting/participants: Patients admitted to the acute medical services in two public hospitals in Cape Town, South AfricaResults: 822 patients (median age of 52 years), admitted with a variety of medical conditions were assessed during their admission. 22% of the cohort were HIV-infected. 218 patients were identified using the screening tool as being in the last year of their lives. Mortality in this group was 56% at 12 months, compared with 7% for those not meeting any criteria. The specific indicator component of the tool performed best in predicting death in both HIV-infected and HIV-uninfected patients, with a sensitivity of 74% (68-81%), specificity of 85% (83-88%), a positive predictive value of 56% (49-63%) and a negative predictive value of 93% (91-95%). The hazard ratio of 12-month mortality for those identified vs not was 11.52 (7.87 – 16.9; p < 0.001). Conclusions:The identification tool is suitable for use in hospitals in low-middle income country setting that have both a high communicable and non-communicable disease burden amongst young patients, the majority under age 60.
Long Term Surgical Outcomes For Infective Endocarditis In People Who Inject Drugs: A Systematic Review And Meta-Analysis
Authors: Goodman-Meza David , Weiss Robert E , Gamboa Sebastian , Gallegos Abel , Bui Alex AT , Goetz Matthew B , Shoptaw Steve , Landovitz Raphael J
Published: October 2019

Background: In recent years, the number of infective endocarditis (IE) cases associated with injection drug use has increased. Clinical guidelines suggest deferring surgery for IE in people who inject drugs (PWID) due to a concern for worse outcomes in comparison to non-injectors (non-PWID). We performed a systematic review and meta-analysis of long-term outcomes in PWID who underwent cardiac surgery and compared these outcomes to non-PWID.
Methods: We systematically searched for studies reported between 1965 and 2018. We used an algorithm to estimate individual patient data (eIPD) from Kaplan-Meier (KM) curves and combined it with published individual patient data (IPD) to analyze long-term outcomes after cardiac surgery for IE in PWID . Our primary outcome was survival. Secondary outcomes were reoperation and mortality at 30-days, one-, five-, and 10-years. Random effects Cox regression was used for estimating survival.
Results: We included 27 studies in the systematic review and 19 provided data (KM or IPD) for the meta-analysis. PWID were younger and more likely to have S. aureus than non-PWID. Survival at 30-days, one-, five-, and 10-years was 94.3%, 81.0%, 62.1%, and 56.6% in PWID, respectively; and 96.4%, 85.0%, 70.3%, and 63.4% in non-PWID. PWID had 47% greater hazard of death (HR 1.47, 95% CI, 1.05-2.05) and more than twice the hazard of reoperation (HR 2.37, 95% CI, 1.25-4.50) than non-PWID.
Conclusion: PWID had shorter survival that non-PWID. Implementing evidence-based interventions and testing new modalities are urgently needed to improve outcomes in PWID after cardiac surgery.
Quality Of Life Questionnaire for women with Gestational Diabetes Mellitus (GDMQ-36): Development and Psychometric Properties
Authors: mokhlesi samira , simbar masoumeh , tehrani fahimeh ramezani , kariman Nourossadat , majd hamid alavi
Published: October 2019

Background Gestational diabetes mellitus carries serious risks to mother and fetus and causes social, mental, and psychological consequences which can affect mothers’ quality of life. Accordingly, this study aims to develop and assess the psychometric properties of quality of life questionnaire for women with gestational diabetes mellitus. Methods A methodological study of sequential exploratory mixed method was developed and implemented. It included qualitative (development of a quality of life questionnaire for mothers with GDM) and quantitative (assessment of psychometric prosperities of quality of life questionnaire for mothers with GDM) phases. Results Based on the findings of the qualitative phase and literature review, the primary questionnaire was prepared with 142 items. The outcome of face validity and content validity assessment was a 67-item questionnaire. S-CVI and S-CVR turned out to be 0.92 and 0.68, respectively. The results of exploratory factor analysis yielded an instrument with 36 items in five domains including concerns about high-risk pregnancy, perceived constraints, disease complications, medication and treatment, and support. Five factors explained 46.68% of the total variance of the questionnaire. The results indicated a moderate and significant correlation between the questionnaire of “Diabetes Clients Quality Of Life” and the researcher-made questionnaire (r=0.63). Cronbach’s alpha coefficient for the entire scale was 0.93 and the intra-class correlation coefficient was 0.95. Conclusion Quality of life questionnaire for mothers with GDM is a valid and reliable tool capable of measuring the quality of life of women with GDM.
Thermoregulation adaptation of Rheum tanguticum stereostructure leaf
Authors: Hu Yanping , Qian Qian , Zhang Huixuan , Lin Gonghua , Wang Jun , Wang Li , Li Yi , Jang Jyan-Chyun , Li Wenjing
Published: October 2019

Background: Leaf is an important plant organ with great variation in shape and size. Leaf size tends to be smaller in plants thrived in the areas of higher elevation and lower annual mean temperature. The Qinghai-Tibetan Plateau is situated at a high altitude of ＞4,000 m with low annual average temperature. Leaves for most plants species in Qinghai-Tibetan Plateau are small, however, Rheum tanguticum with large leaves is an exception. Here we show that large leaf of R. tanguticum with three-dimensional structure is an ideal solution of thermoregulation with little energy consumption.Results: With increase in age, leaves of R. tanguticum transit from a small oval plane to a large palmatipartite stereostructure. Furthermore, temperature variation of different parts is a distinct character in stereostructure leaves of R. tanguticum. The temperature of regular leaves under strong solar radiation could be much higher than the ambient temperature. However, the stereostructure leaf could lower leaf temperature by avoiding the direct solar radiation and promoting local airflow to prevent serious scorch.Conclusions: Our results demonstrate that the robust three-dimensional leaf structure is a formation for R. tanguticum to adapt to the strong solar radiation and low temperature in Qinghai-Tibetan Plateau through modulation of local temperature in different parts of the large leaves.
Immediate implant placement in anterior teeth with grafting material of autogenous tooth bone vs xenogenic bone
Authors: Wu Dong , Zhou Lin , Lin Jichao , Chen Jiang , Huang Wenxiu , Chen Yonghui
Published: October 2019

Objectives: The aim of the study was to compare the efficacy of the autogenous tooth bone and xenogenic bone grafted in immediate implant placement with bone defect. Material and methods: Thirty patients whose compromised anterior teeth need immediate implant placement were enrolled. Autogenous tooth bone made from the extracted teeth by chair-side or the xenogenic bone were used to repaired bone defect. Clinical examination, radiographic assessment about the horizontal bone change in the level of 0mm, 3mm and 6mm below the implant neck and the marginal bone loss were made immediately, 6 and 12 months after implant placement. Questionnaire of feeling was made at the time of removing the sutures.Results: All implants achieved the success criteria without any complications at the follow-up period. The percent of the horizontal bone change and the marginal bone loss at 6 and 12 months were almost the same between two groups (P>.05). The horizontal bone loss at the first or the latter 6 months is almost the same (P>.05). But the horizontal bone loss at the 6 mm level is less than the 0 mm and 3 mm levels at 6 and 12 months (P<.05). Meanwhile patients seem more satisfied with the autogenous tooth bone derived from the questionnaire.Conclusion: The bone volume change in the facial part of the implant after immediate placement is almost the same between two groups.Clinical Relevance: Providing clinical evidence that the autogenous tooth bone made from compromised tooth can be an acceptable bone graft material.
The impact of mental fatigue on brain activity: A comparative study between resting state and task state using EEG
Authors: Li Gang , Luo Youdong , Jiao Weidong , Jiang Yonghua , Gao Zhao , Huang Shan , Zhang Jianhua
Published: October 2019

Background: Mental fatigue is usually caused by long-term cognitive activities, mainly manifested as drowsiness, difficulty in concentrating, decreased alertness, disordered thinking, slow reaction, lethargy, reduced work efficiency, error-prone and so on. Mental fatigue has become a widespread sub-health condition, and has a serious impact on the cognitive function of the brain. However, seldom researches explore the differences of mental fatigue on electrophysiological activity between resting state and task state. In the present study, 20 healthy male individuals were recruited to do a consecutive mental arithmetic task to induce mental fatigue, and scalp electroencephalogram (EEG) data were collected before and after the task. The power and relative power of five EEG rhythms both in resting state and task state were analyzed statistically. Results: The results of brain topographies and statistical analysis indicated that mental arithmetic task can successfully induce mental fatigue in the enrolled subjects. The relative power index was more sensitive than the power index in response to mental fatigue, and the relative power for assessing mental fatigue was better in resting state than in task state. Furthermore, we found that it is of great physiological significance to divide alpha frequency band into alpha1 band and alpha2 band in fatigue related studies, and at the same time improve the statistical differences of sub-bands. Conclusions: Our current results suggested that the brain activity in mental fatigue state has great differences between resting state and task state, and it is imperative to select the appropriate state in EEG data acquisition and divide alpha band into alpha1 and alpha2 bands in mental fatigue related researches.
Ratings of Performance in Multisource Feedback: Comparing Performance Theories of Residents and Nurses
Authors: Tariq Muhammad , Govaerts Marjan , Afzal Azam , Ali Syed Ahsan , Zehra Tabassum
Published: October 2019

Background Multisource feedback (MSF) is increasingly being used in assessing trainee performance and its most crucial element are the raters. However there is very little literature about rater behavior in MSF. Raters use multidimensional conceptualizations to distinguish between various behaviors and sub competencies when assessing trainee performance in work settings, also called performance theories. This may not only explain assessor variability in Multi Source Feedback, but also result in differing acceptance (and use) of assessment data for developmental purposes. The purpose of this study was to explore performance theories of various assessor groups (residents and nurses) when assessing performance of residents.Methods The study was conducted at the Aga Khan University in the Department of Medicine. An explanatory sequential mixed methods design was used. Quantitatively, 103 MSF self-ratings by the residents were included. In the qualitative part of the study, a constructivist, inductive research approach was used and conducted semi-structured interviews with 14 nurses and 15 residents involved in Internal Medicine residency training at Aga Khan University (AKU; Pakistan) to explore performance theories. Results Principle Component Analysis of the quantitative data showed a single construct identified as professional behavior (Cronbach’s α = .91). Seven major themes related to performance theories emerged from the qualitative data, namely; communication skills, patient care, accessibility, teamwork skills, responsibility, medical knowledge and professional attitude. There were considerable overlaps, but also meaningful differences in the performance theories of residents and the nurses, especially with respect to accessibility, teamwork and knowledge. Conclusion Our findings suggest that different assessor groups (i.e. residents and nurses) may hold different performance theories when evaluating resident performance. Our results further our understanding of assessor source effects in MSF. Implications of our findings are related to implementation of MSF, and based on our finding we revised the MSF instrument.
Risk factors for HIV infection among married couples in Rakai, Uganda: A cross-sectional study
Authors: Nabukenya Anne M. , Nambuusi Aminah , Matovu Joseph KB
Published: October 2019

Background: Evidence suggests that married couples are at an elevated risk of HIV infection. We explored the risk factors for HIV infection among married couples in settings with differing HIV prevalence in Rakai, Uganda.Methods: This was a cross-sectional study conducted among 664 heterosexual couples living in three HIV prevalence strata (low: 9-11.2%; medium: 11.4-20% or high HIV prevalence: 21% or higher) in Rakai District, south-western Uganda, between November 2013 and February 2014. Data were collected on socio-demographic and behavioural characteristics from all consenting adults and aggregated to allow for couple-level analyses. We conducted bivariate and multivariable Logistic regression to assess the factors that were independently associated with HIV infection among married couples.Results: Of the 664 couples, 6.4% ( n =42) were in HIV-discordant relationships; 5.8% ( n =39) were in concordant HIV-positive relationships while 87.8% ( n =583) were in concordant HIV-negative relationships. At the bivariate analysis, we found that individuals residing in a high HIV prevalence stratum had 4 times the odds of living as part of an HIV infected couple (odds ratio [OR]=4.29; 95% CI:2.95 6.25) than those in other lower HIV prevalence strata. Individuals who had been in at least three previous couple relationships were six times more likely to be part of an HIV infected couple (OR=6.25, 95% CI:4.11, 9.17) than their counterparts. After adjusting for potential cofounders, living in a high HIV prevalence stratum (Adjusted OR [AOR] =2.31, 95% CI: 1.52, 3.52) and being in a second (AOR=3.32, 95% CI: 2, 33, 4.70), third or higher order relationship (AOR=3.79, 95% CI: 2.29, 6.28) were associated with couple HIV infection. Individuals that had stayed together for six or more years had 28% odds of being part of an HIV infected couple (AOR = 0.28; 95%CI: 0.18, 0.43).Conclusion: The risk factors associated with HIV infection in married couples were living in a high HIV prevalence stratum and having a higher number of previous couple relationships. These findings suggest a need for pre-marital couples’ HIV testing to reduce on the number of relationships that form when one or both partners are already infected with HIV.
Effect of Bowel Preparation Volume in Inpatient Colonoscopy: Results of a Prospective, Randomized, Comparative Pilot Study
Authors: Hernandez Patricia V , Horsley-Silva Jennifer L. , Snyder Diana L. , Baffy Noemi , Atia Mary , Koepke Laura , Buras Matthew R. , Lim Elisabeth S. , Ruff Kevin , Umar Sarah B. , Islam Sameer , Ramirez Francisco C.
Published: October 2019

Background: Inpatient status has been shown to be a predictor of poor bowel preparation for colonoscopy; however, the optimal colon cleansing regimen protocol for hospitalized patients is unknown. Our aim was to compare the efficacy of bowel preparation volume size in hospitalized patients undergoing inpatient colonoscopy.Methods: This prospective, single blinded (endoscopist), randomized controlled trial was conducted as a pilot study at a tertiary referral medical center. Hospitalized patients undergoing inpatient colonoscopy were assigned randomly to receive a high, medium, or low-volume solution. Data collection included colon preparation quality based on the Boston Bowel Preparation Scale and a questionnaire given to all subjects, in which we evaluated the ability to completely finish bowel preparation and adverse effects (unpleasant taste, nausea, and vomiting). Results: Twenty-five colonoscopies were performed in 25 subjects. Patients who received low-volume prep averaged a higher mean total BBPS (7.4, SD 1.62), in comparison to patients who received high-volume (6.6, SD 2.19) and medium-volume prep (6.9, SD 1.55), P = 0.64. The low-volume group scored unpleasant taste as 0.6 (0.74), while the high-volume group gave unpleasant taste a score of 2.2 (0.97) and the medium-volume group gave a score of 2.1 (1.36), P < 0.01.Conclusion: Although not statistically significant, a low-volume colon preparation showed a trend of equivalent quality of bowel preparation measured by BBPS in comparison to traditional volume regimens, with less unpleasant taste, which may contribute to better patient compliance and therefore better bowel preparation in the inpatient setting. Further more robust studies are required to confirm these findings.Trial registration: clinicaltrials.gov NCT01978509
Identifying hub genes associated with clinical characteristicsin IgA nephropathy by Weighted Gene Co-expression Network Analysis
Authors: Yang Chengyu , Li Chenyu , Zhao Long , Zhou Bin , Man Xiaofei , Bu Quandong , Luo Congjuan , Shen Xuefei , Jiang Wei , Luan Hong , Che Lin , Wang Yanfei , Xu Yan
Published: October 2019

Background: Clinically, IgA nephropathy has a variety of symptoms including paroxysmal gross hematuria, nephritic and nephrotic syndrome. This study aimed at investigating hub geneand genes modular related to IgA nephropathy clinical characteristics by using weighted gene co-expression network analysis combining clinical, microarray and network database parameters.
Methods: We collected 32 human samples from the European Renal cDNA Bank and used RMA method to preprocess the data and utilize the limma package to obtain differentially expressed gene in renal interstitium and glomeruli. We used the WGCNA package to construct the gene co-expression of differential expression genes and identify hub genes associated with clinical characteristics in renal interstitium and glomeruli, respectively. Gene ontology enrichment analysis and KEGG analysis for hub genes which associated with clinical characteristics were performed by DAVID. PPI information was acquired from STRING.
Results: For glomeruli, 1470 genes differentially expressed between IgA nephropathy patients and healthy control, containing 10 hub genes associated with age, 8 hub genes associated with sex, 48 hub genes associated with Bp enrichd in ERK1 and ERK2 cascade and Rap1 signaling pathway, 223 hub genes associated with BMI enrich in organic acid catabolic process and fatty acid degradation pathway, 136 hub genes associated GFR enriched in immune response and PI3K-Akt signaling pathway, 82 hub genes associated with proteinuria enriched in extracellular matrix organization and PI3K-Akt signaling pathway. In tubulointerstitium, there were 480 genes differentially expressed between IgA nephropathy patients and healthy control. Among 480 DEGs, 6 hub genes associated with age, 15 hub genes associated with sex, 35 hub genes associated with Bp enrichd in positive regulation of apoptotic process, 87 hub genes associated with GFR enriched in negative regulation of macromolecule metabolic process and RNA transport, 33 hub genes associated with proteinuria enriched in regulation of apoptotic process and FoxO signaling pathway. PPI enrichment analysis shown that all hub genes sets are biologically connected cluster.
Conclusions: We made a preliminary investigation on molecular mechanisms of relationship between IgA nephropathy and clinical characteristics and identified hub genes and pathways closely related with BMI, GFR and Proteinuria in IgA nephropathy by a series of bioinformatics analysis.
Joint Longitudinal Data Analysis in detecting Predictors of Hypertension and Type2 Diabetes among adults receiving treatment at Felege Hiwot Teaching and Specialized Hospital, North-western Ethiopia
Authors: Tegegne Awoke Seyou , Alene Getu Degu
Published: October 2019

Background Hypertension is one of the chronic diseases with major health problems over the centuries due to its significant contribution to the global health burden. It is familiar that the hypertensive patients are also exposed to other diseases like diabetes in which the two are highly associated to each other. The objective of current investigation was to identify longitudinal predictors of hypertension and type2 diabetes for adult patients receiving treatments at Felege Hiwot Teaching and Specialized Hospital, North western Ethiopia.Methods In this study, 748 hypertensive and type2 diabetic adult patients were randomly selected using systematic sampling technique. A retrospective longitudinal study was conducted on the selected patients to identify predictors of hypertension and type2 diabetes. Patients were receiving treatments related to both hypertension and type2 diabetes.Results The current investigation revealed that age and weight of patients were positively and significantly associated with existence of hypertension and type2 diabetes whereas; visiting times were negatively associated with development of the two response variables. Rural patients, patients who are smoking, drinking alcohols and patients with family disease history were joint predictors for existence variables of interests. The interaction of visiting times * sex, visiting times *residence area and age *sex of patients were also significant factors for the existence of response variables.Conclusion Hypertensive patients living in rural areas and those who are drinking and smoking were highly affected by the existence of type2 diabetes. Awareness should be created to those hypertensive and type2 diabetic patients to attend properly their treatment as prescribed by the health staff. They should also be advised to checkup their hypertension (systolic/ diastolic) and diabetes of type2 regularly.
Vitamin D Deficiency in Non-Autoimmune Hypothyroidism: A case-control study
Authors: Ahi Salma , Dehdar Mohammad Reza , Hatami Naser
Published: October 2019

Objectives:
Although in many studies, the relationship between autoimmune hypothyroidism (Hashimoto) and Vitamin D deficiency was shown, no research has been performed on the role of vitamin D in non-autoimmune hypothyroidism.
Design:
This was a Retrospective case–control study in Endocrinology clinic of Jahrom (south of Iran). The patients with Hashimoto (n=633) and non-Hashimoto hypothyroidism (n=305), along with a control group (n=200) were evaluated. 25(OH)D level, T3 and T4 levels were studied and Anti TPO and Anti TG tests were performed. The results of vitamin D level were analyzed and interpreted using SPSS in terms of the cause of hypothyroidism (immune and non-immune).
Results:
The results of the study showed a significantly lower level of vitamin D in both immune and non-immune Hashimoto’s thyroiditis (HT) in comparison to healthy controls (P<0.05). We observed a significant inverse correlation between the vitamin D and TGAb level (p=0.001, r=-0.261) and a direct correlation of vitamin D with TSH level (p=0.008, r=0.108) in HT patients.
Conclusion:
Finally, the results indicated that non-autoimmune hypothyroidism, as well as HT, is associated with vitamin D deficiency. The role of vitamin D deficiency in HT was thought to be in the association of higher autoantibody (TGAb) level; while, there should be further studies determining vitamin D deficiency's role in non-immune hypothyroidism.
Investigating the role of opiorphin genes in prostate cancer and the possible genetic mechanisms by which they modulate tumor growth and androgen-sensitivity
Authors: Mukherjee Amarnath , Park Augene , Wang Li , Davies Kelvin Paul
Published: October 2019

Background The opiorphin family of genes (represented in humans by ProL1, hSMR3A and hSMR3B) encode peptides which act as potent neutral endopeptidase (NEP) inhibitors. Because modulated NEP activity is associated with cancer development, several years ago a review postulated that dysregulated opiorphin expression may be involved in oncogenesis. This has recently been supported by reports associating changes in expression of opiorphin-encoding genes with breast and oropharyngeal cancer. Based on these reports, we initiated the studies described here to determine if opiorphin-encoding genes play a role in prostate cancer (PrCa).Methods We screened publicly available data bases for evidence of an association between PrCa and opiorphin gene expression and then confirmed these findings using PrCa tissue arrays. Cell-lines representing early (LNCaP) and late stage (PC3) PrCa were engineered to overexpress ProL1 and the growth of xenografted tumors from these lines compared to parent cell lines in male and female nude mice. The changes in global gene expression caused by overexpression of ProL1 in these cell lines was determined by RNA-Seq to identify possible genetic mechanisms related to growth and progression of PrCa.Results Two datasets available on GEO showed an association between upregulation of opiorphin-encoding genes and PrCa, which was confirmed using tissue arrays. Xenografted tumors derived from PC3 engineered to overexpress ProL1 had an initial growth advantage over parent cell lines whilst tumors derived from LNCaP cells overexpressing ProL1 had impaired growth in female mice. Global gene expression analysis suggested that overexpression of ProL1 causes modulated expression of genes involved in signaling, angiogenesis and steroid response pathways. These pathways might be involved in overcoming the hypoxic barrier of the growing tumor and the development of androgen insensitivity.Conclusions This is the first report to show an association between upregulation of opiorphin-encoding genes and PrCa and that their overexpression in PrCa cell-lines modulates tumor growth in mouse xenograft models. Overexpression of opiorphin-encoding genes modulates genetic pathways that previous reports have associated with PrCa growth, suggesting possible genetic mechanisms for tumor development.
Proportion and Determinants of Repeat Induced Abortion Among Women Seeking Abortion Care Services At Debre Markos Town Health Institutions, Amhara Regional State, Ethiopia, 2017
Authors: Mekonen Dawit Gebeyehu , Waktola Mahlet Imana , Nigussie Tewodros Seyoum , Cherkose Endeshaw Adimasu , Abate Addisu Taye
Published: October 2019

Objective the aim of this study was to assess the proportion and determinants of repeat induced abortion among women seeking abortion care services at Debremarkos town health institutions, Amhara regional state, Ethiopia, 2017.Result from the total 567-sample size, 547 women were participated in the study making a response rate of 96.5%. In this study 191 woman reported that they had at least one previous abortion, making the proportion of repeat induced abortion 34.9%. In multivariable logistic regression analysis; illiteracy (AOR=8.45, 95%CI; 1.85, 36.49), living in an urban area (AOR=5.14, 95%CI; 2.29, 11.53), having multiple sexual partner (AOR=6.16, 95%CI; 3.25, 11.68), consuming alcohol (AOR=2.77, 95%CI; 1.52, 5.05) and having a history of physical violence by a male partner (AOR=2.68, 95%CI; 1.45, 4.94) were significantly associated with repeat induced abortion at p value less than 0.05.
The clinical significance of IL-6s and IL-27s in Bronchoalveolar lavage fluids from children with mycoplasma pneumoniae pneumonia
Authors: Zhao Jie , Li Yuyun , Zhang Wen
Published: October 2019

Backgrounds: IL-6 is associated with the severity of mycoplasma pneumoniae pneumonia (MPP). But the relationship of IL-27 and MPP was unknown. Methods: 98 patients with MPP younger than 14 years old were enrolled in this study and divided into mild cases and severe cases by severity of disease, MP single infection group and MP mixed infection group by MP mixed-infection types, and low MP DNA loads group and high MP DNA loads group by MP DNA loads respectively. 15 children with foreign bronchus bodies were also enrolled as control. The levels of IL-6 and IL-27 in BALFs collected from these children were assayed by ELISA. Results: There were significant differences in the levels of IL-6 in BALFs from patients between 3 patient groups, respectively ( P ﹤0.05). Compared with the levels of IL-6 in BALFs from control, the levels of IL-6 in BALFs from the 5 groups were significantly higher ( P ﹤0.05) except that from low MP DNA loads group. The levels of IL-27 in BALFs from MP mixed infection group were significantly higher than those from MP single infection group and control( P ﹤0.05). Conclusion: IL-6 was firmly associated with MPP and had potential application in clinical practice while IL-27 was not associated with MP infection.
Conserved DNA-binding motif loci reflect functional transcription factor binding sites
Authors: Kuno Akihiro , Takahashi Satoru
Published: October 2019

Background
Transcription factors (TF) regulate gene expression by binding to specific DNA elements called DNA-binding motifs, or motifs. The motifs at a certain genomic locus can offer clues for predicting TFs that control target genes. However, since motifs are short nucleotide sequences and many TFs share similar motifs, they are distributed across the whole genome, making it difficult to investigate candidate functional DNA elements. Because previous studies have reported that TF binding sites are highly conserved among mammals, we focused on the conserved motif loci between humans and mice to identify functional DNA elements.

Results
Our results showed that conserved motif loci overlapping considerably with TF binding sites at both promoter and intergenic regions compared to nonconserved motif loci. In addition, conserved motif loci were significantly enriched in enhancer regions and enabled us to predict GATA4 binding to the heart-specific enhancer. Moreover, the integration of ChIP-seq and RNA-seq glioblastoma data revealed that genes with ASCL1 binding at the conserved ASCL1-related motifs were associated with NOTCH signaling, which is a critical pathway in glioblastoma.

Conclusions
These results suggest that conserved motif loci can reflect gene regulatory elements and can be utilized to predict candidate TFs that regulate genes of interest. The conserved motif data are publicly available at https://osf.io/jhfnb/?view_only=1c82bc9963ee45b799be42512abb08d1.
NaCl-responsive ROS scavenging and energy supply in alkaligrass callus revealed from proteomic analysis
Authors: Zhang Yongxue , Zhang Yue , Yu Juanjuan , Zhang Heng , Wang Liyue , Wang Sining , Guo Siyi , Miao Yuchen , Chen Sixue , Li Ying , Dai Shaojun
Published: October 2019

Background: Salinity has obvious effects on plant growth and crop productivity. The salt-responsive mechanisms have been well studied in differentiated organs (e.g., leaves, roots, and stems), but not in unorganized cells such as callus. High-throughput quantitative proteomics approaches have been used to investigate callus development, somatic embryogenesis, organogenesis, and stress response in numbers of plant species. However, they have not been applied to callus from monocotyledonous halophyte alkaligrass ( Puccinellia tenuifora ).
Results: The alkaligrass callus growth, viability, and membrane integrity were disturbed by 50 mM and 150 mM NaCl treatments. Callus cells accumulated the proline, soluble sugar, and glycine betaine for the maintenance of osmotic homeostasis. Importantly, the activities of diverse ROS scavenging enzymes (e.g., SOD, APX, POD, GPX, MDHAR, and GR) and antioxidants (e.g., ASA, DHA, and GSH) were all induced by salinity. The abundance pattern of 55 salt-responsive proteins indicated that salt signal transduction, cytoskeleton, ROS scavenging, energy supply, gene expression, protein synthesis and processing, as well as other basic metabolism processes were altered in callus to cope with stress.
Conclusions: The undifferentiated callus exhibited unique salinity-responsive mechanisms for ROS scavenging and energy supply. Activation of the POD pathway and AsA-GSH cycle was universal in callus and differentiated organs, but salinity-induced SOD pathway and salinity-reduced CAT pathway in callus were different from those in leaves and roots. To cope with salinity, callus mainly relied on glycolysis, but not the TCA cycle, for energy supply.