bluuebunny/crossref_metadata_2025 huggingface dataset:
Tuberculosis of the Spine
Authors: Jain Anil Kumar , Rajasekaran S. , Jaggi Karan Raj , Myneedu Vithal Prasad
Published: February 2020

➢ Diagnosis of spinal tuberculosis (TB) in the early (inflammatory) stage is essential to prevent the development of spinal deformity and neurological deficit.

➢ As spinal TB is a paucibacillary disease, diagnosis is established through a combination of clinical evaluation, imaging features, acid-fast bacilli smear, mycobacterial culture, histologic and/or cytologic evaluation, and molecular methods of diagnosis. No single modality can ascertain a diagnosis in all cases.

➢ Spinal TB is a medical disease to be treated by antitubercular therapy (ATT) until healing is attained. The consensus for the definition of a healed status in bone and joint TB, and consequent length of ATT intake, remains unresolved. Children with spinal TB need to be followed until skeletal maturity as kyphotic deformity may increase with growth.

➢ The indications for surgery and type of surgery performed (decompression, instrumented stabilization, or deformity correction) are case-specific decisions. Surgical correction of spinal deformity is easier to perform in active disease than in healed disease.

➢ Drug-resistant strains present an emerging challenge. Demonstration of drug resistance is often difficult in patients with spinal TB because of the lack of bacterial growth on culture. Molecular methods of diagnosis are often useful in such patients. Establishment of treatment protocols requires further long-term and large-scale clinical trials.
Intramedullary Nailing Versus External Fixation in the Treatment of Open Tibial Fractures in Tanzania
Authors: Haonga Billy T. , Liu Max , Albright Patrick , Challa Sravya T. , Ali Syed H. , Lazar Ann A. , Eliezer Edmund N. , Shearer David W. , Morshed Saam
Published: February 2020

Background:

Open tibial fractures are common injuries in low and middle-income countries, but there is no consensus regarding treatment with intramedullary nailing versus external fixation. The purpose of the present study was to compare the outcomes of initial treatment with intramedullary nailing or external fixation in adults with open tibial fractures.

Methods:

We conducted a randomized clinical trial (RCT) at a tertiary orthopaedic center in Tanzania. Adults with acute diaphyseal open tibial fractures were randomly assigned to statically locked, hand-reamed intramedullary nailing or uniplanar external fixation. The primary outcome was death or reoperation for the treatment of deep infection, nonunion, or malalignment. Secondary outcomes included quality of life as measured with the EuroQol-5 Dimensions (EQ-5D) questionnaire, radiographic alignment, and healing as measured with the modified Radiographic Union Scale for Tibial fractures (mRUST).

Results:

Of the 240 patients who were enrolled, 221 (92.1%) (including 111 managed with intramedullary nailing and 110 managed with external fixation) completed 1-year follow-up. There were 44 primary outcome events (with rates of 18.0% and 21.9% in the intramedullary nailing and external fixation groups, respectively) (relative risk [RR] = 0.83 [95% confidence interval (CI), 0.49 to 1.41]; p = 0.505). There was no significant difference between the groups in terms of the rate of deep infection. Intramedullary nailing was associated with a lower risk of coronal malalignment (RR = 0.11 [95% CI, 0.01 to 0.85]; p = 0.01) and sagittal malalignment (RR = 0.17 [95% CI, 0.02 to 1.35]; p = 0.065) at 1 year. The EQ-5D index favored intramedullary nailing at 6 weeks (mean difference [MD] = 0.07 [95% CI = 0.03 to 0.11]; p < 0.001), but this difference dissipated by 1 year. Radiographic healing (mRUST) favored intramedullary nailing at 6 weeks (MD = 1.2 [95% CI = 0.4 to 2.0]; p = 0.005), 12 weeks (MD = 1.0 [95% CI = 0.3 to 1.7]; p = 0.005), and 1 year (MD = 0.8 [95% CI = 0.2 to 1.5]; p = 0.013).

Conclusions:

To our knowledge, the present study is the first RCT assessing intramedullary nailing versus external fixation for the treatment of open tibial fractures in sub-Saharan Africa. Differences in primary events were not detected, and only coronal alignment significantly favored the use of intramedullary nailing.

Level of Evidence:

Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Implementasi Metode Altman Z-Score untuk Memprediksi Kebangkrutan Perusahaan
Authors: Mudzakar Mochamad Kohar
Published: February 2020

Studi menyangkut kebangkrutan pada perusahaan yang terdaftar dalam indeks LQ-45 ditujukan untuk mengukur dan memprediksi ketidakmampuan finansial dengan metode Altman Z-Score. Studi dilakukan pada 19 perusahaan sebagai sampel yang diambil berdasarkan teknik purposive sampling, didasarkan pada kriteria perusahaan secara konstan melaporkan laporan keuangan dari 2010-2013. Metode investigasi yang digunakan adalah eksplanatori deskriptif verifikatif untuk menggambarkan dan mengukur kebangkrutan perusahaan. Hasil penelitian menunjukan perusahaan yang memenuhi kategori sehat pada tahun 2010 sebanyak 15 perusahaan, dan tahun 2011-2013 sebanyak 14 perusahaan. Kategori rawan tahun 2010 sebanyak tiga perusahaan, tahun 2011-2012 sebanyak empat perusahaan, dan tahun 2013 sebanyak dua perusahaan. Untuk kategori bangkrut tahun 2010-2012 sebanyak satu perusahaan, dan tahun 2013 sebanyak tiga perusahaan.
Pengaruh Etika Bisnis Terhadap Kepuasan Pelanggan Andayani Waroeng Steak N Djawa (Studi Pada Andayani Waroeng Steak N Djawa Di Pamekasan)
Authors: Al Amir Berry Irsyad
Published: February 2020

Business ethics is a code of conduct employers based on the value - moral values and norms are used as guidance in making decisions and solving problems Zimmerer (1996:20). Menurut Ronald J. Ebert dan Ricky M. Griffin (200:80) Business ethics is a term often used to indicate a person's ethical behavior of managers or employees of an organization.Satisfaction is of feeling happy or disappointed someone who comes from a comparison between the impression of the performance (or result) of a product and hopes (Ronny A. Rusly  (2002 :  37)This study aims to determine whether there is influence of the application of business ethics to customer satisfaction in Andayani Waroeng Steak N Java in Pamekasan. The sample collection technique using accidental sampling with analysis of data using multiple linear regression.
Pelatihan Dan Pengembangan Sumber Daya Manusia
Authors: Bariqi Muhammad Darari
Published: February 2020

Pengembangan SDM sangat diperlukan karena memiliki aspek yang penting bagi peningkatan produktivitas SDM dan juga memiliki tujuan-tujuan tertentu yang pastinya harus dicapai demi kemajuan suatu perusahaan atau organisasi pelayanan sosial. Pengembangan SDM dapat dilakukan dengan pelatihan. Pelatihan yang dilakukan oleh lembaga organisasi pelayanan sosial ditujukan untuk meningkatkan kinerja para SDM. Pelatihan ini biasa dilakukan sesuai dengan kebutuhan para karyawan. Pelatihan ini terkait dengan pengelolaan SDM. Menurut Kettner ada 5 fungsi manajemen, yakni planning, organizing, HRD, fundraising dan system information. Dan pelatihan ini berada dalam manajemen HRD. Dalam hal ini, pekerja sosial penting guna mengetahui manajemen HRD. Dalam hal ini, metode penelitian yang digunakan adalah metode deskriptif dengan pendekatan penelitian kualitatif yang dimana hasil penelitian akan menjabarkan secara deskriptif mengenai proses dari mulainya ditentukan sasaran pelatihan, kegunaan hingga output dari pelatihan. Hasil dari penelitian ini diharapkan dapat menjadi evaluasi.
Pengaruh Corporate Governance Terhadap Manajemen Laba Di Indonesia
Authors: Monica Laura
Published: February 2020

Tujuan  utama  dari  penelitian  ini  adalah  meneliti  hubungan  antara   corporate governance,   yang   diukur   dengan   kepemilikan   manajerial,   kepemilikan   institusional, kepemilikan   asing,   dan   komisaris   independen,      terhadap   manajemen   laba.   Dengan menggunakan sampel dari perusahaan manufaktur yang terdaftar di Bursa Efek Indonesia selama periode 2013-2015.  Penelitian ini menemukan bukti bahwa kepemilikan manajerial dan kepemilikan asing memiliki pengaruh terhadap manajemen laba, sedangkan kepemilikan institusional dan komisaris independen tidak memiliki pengaruh terhadap manajemen laba.
The Effect Of Work Culture On The Improvement Of Work Performance Of Dispora Employees Lamongan Regency
Authors: Siddiq Siddiq , Iswanto Iswanto
Published: February 2020

Work culture is a philosophy as values into the nature, habits, and the driving force that is shared by every individual in the working environment of an organization. This study aims to determine whether the work culture, discipline, openness, and cooperation has partially and simultaneously influence on work performance of Dispora employees. Based on the background and purpose of the study above it can be drawn a conclusion that is allegedly working culture that consists of a variable discipline, openness and cooperation and simultaneous partial effect on work performance. Allegedly discipline variable most dominant influence on the performance of Dispora employees. Data used in the study consisted of: primary data and secondary data. Further data collection techniques by using observation, documentary and questionnaire. Data analysis methods: Test Validity, Reliability Testing , Regression , Correlation , Coefficient of Determination , t Test , and Test F. From the test results obtained t count variable t discipline ( X1 ) 8.694 1.678 ≥ t table , openness variable ( X2 ) 4,656 ≥ t table 1,678 and variable cooperation ( X3 ) 7.498 1.678 ≥ t table. So it can be concluded that the discipline variable ( X1 ) , openness ( X2 ) and cooperation ( X3 ) partially significant effect on job performance ( Y ) employees Dispora Lamongan . ANOVA table F count equal to 233.739 ≥ f. The table is 2.81 means that the variable discipline, openness, and cooperation simultaneously significant effect on job performance . Y = 1.179 + 1,340X1 + 0,578X2 + 0,783X3. Judging from discipline variable regression coefficient of 1.340 has the greatest value compared with other variable regression coefficient (openness and cooperation). Thus it can be concluded that the most dominant factor influencing performance is variable discipline. Based on the above analysis of the research results it can be deduced that the variable discipline , openness , and cooperation has a significant influence on the performance of partially or simultaneously , and it can be seen that the variable most dominant discipline on job performance. Employee discipline should be put forward by the management office. Based on research conducted by multiple factors evident that discipline is regarded as an influential factor on the performance of the Dispora office.
Efektifitas Metode Pembelajaran Field Trip Pendekatan DFC Mengembangkan Entrepreneurial Leadership Anak Petani Garam
Authors: Fitroh Siti Fadjryana , Mayangsari Dewi , Puspitasari Ratna Nila
Published: February 2020

Experience is part of an important aspect of learning, besides that it needs to be noted that the characteristics of early childhood, the main one is high curiosity supported by imagination. To be able to facilitate it all is needed to provide the right stimulus through the methods and approaches integrated in learning. The form of learning activities is also a determining factor, which is clearly all done in the principle of fun learning and that is in entrepreneurial activities. In every learning that is applied to early childhood it is important to be formed consistently both at home, school and the environment around the residence. In learning also aims at the formation of personal character that is having the soul of leadership. By having these characters, the hope is that the child can later become the successor to the generation that has been tradition in Lembung Village, Galis Subdistrict, Pamekasan Regency, namely Garam entrepreneurs. However, all of that must go through a process, if you want the right end. This study involved 15 group B students at the PKK Lembung Kindergarten, using qualitative methods with sources of data on observation, interviews and documentation. The purpose of this study is to look at the effectiveness of learning using field trip learning methods or tourism works integrated with the DFC approach to salt farmers. The field trip method integrated with the DFC approach in entrepreneurial activities has the aim that the salt farmer's children who already have entrepreneurial leadership provision have more courage, independence, skills so as to minimize failures in themselves, not easily discouraged, continue to struggle and be optimistic.
Diagnostic evaluation of IgM ELISA and IgM Immunofluorescence assay for the diagnosis of Acute Scrub Typhus in central Nepal
Authors: Gautam Rajendra , Parajuli Keshab , Tshokey Tshokey , Stenos John , Sherchand Jeevan Bahadur
Published: February 2020

Introduction Scrub typhus is an acute febrile illness caused by the obligate intracellular bacterium,Orientia tsutsugamushi. Given their affordability and ease of use, antibody based diagnostic assays can be important diagnostic tools for early detection of scrub typhus fever in resource poor countries like Nepal. Immunochromatography (ICT) and IgM ELISA are two of the routinely employed antibody based assays for diagnosis of Scrub typhus fever in Nepal, although the recommended gold standard diagnostic test is IgM Immunofluorescence assay (IFA). This study evaluated the InBios Scrub Typhus Detect™ Immunoglobulin M (IgM) ELISA and IgM Immunofluorescence assays in single serum sample at the time of admission. Methodology Study participants (1585 suspected cases), were enrolled based on acute febrile illness with suspected scrub typhus cases in central Nepal from April 2017 to March 2018. Blood sample was collected from the suspected patients of scrub typhus, presenting with acute febrile illness. IgM antibody to Orientia tsusugamushi was detected by using Scrub Typhus Detect™ Kit (In Bios International, USA) and an in-house IgM IFA (Australian Rickettsial Reference Laboratory, Geelong, Australia. The IFA assay was performed with the Gilliam, Karp, Kato strains and O. chuto antigens following the ARRL protocol. Result Statistical analysis of ELISA IgM results when compared to reference test, IgM IFA results demonstrated the following characteristics, sensitivity 84.0% (95%CI: 79.73%-87.68%), specificity 94.82% (95% CI: 93.43%-95.99%), positive likelihood ratio 16.21% (95% CI: 12.71%-20.67%), negative likelihood ratio 0.17% (95% CI: 0.13-0.21%), disease prevalence 22.08% (95% CI: 20.06%-24.21%), positive predictive value 82.12% (95% CI: 78.28-85.42%) and negative predictive value 95.44% (95% CI: 94.27%-96.38%) respectively. Conclusion The study indicated that the IgM ELISA has the sensitivity 84.0% (95% CI: 79.73%-87.68%) and specificity 94.82% (95% CI: 93.43%-95.99%). Although IgM IFA is considered the gold standard test for the diagnosis of scrub typhus cases, it is relatively expensive, requires trained personal and a microscope with fluorescence filters. Scrub typhus IgM ELISA with appropriate OD cut–off values may be the best alternative test and possible viable option for resource limited endemic countries like Nepal.
A randomized controlled trial study of the acceptability, feasibility, and preliminary impact of SITA (SMS as an Incentive To Adhere): A mobile technology-based intervention informed by behavioral economics to improve ART adherence among youth in Uganda
Authors: MacCarthy Sarah , Wagner Zachary , Mendoza-Graf Alexandra , Gutierrez Carlos Ignacio , Samba Clare , Birungi Josephine , Okoboi Stephen , Linnemayr Sebastian
Published: February 2020

Background: Studies report serious adherence problems among youth (individuals age 15-24 years of age) in Uganda. Recent growth in mobile phone ownership has highlighted the potential of using text-based interventions to improve antiretroviral treatment (ART) adherence among Ugandan youth. We piloted a randomized controlled trial of a text-based intervention providing weekly real-time antiretroviral adherence feedback, based on information from a smart pill box, to HIV-positive Ugandan youth. In this paper, we report the acceptability, feasibility, and preliminary impact of the intervention.
Methods: We randomized participants to a control group, or to receive messages with information on either their own adherence levels (Treatment 1 - T1), or their own adherence and peer adherence levels (Treatment 2 – T2). We conducted six focus groups from December 2016 to March 2017 with providers and youth ages 15-24, double coded 130 excerpts, and achieved a pooled Cohen’s Kappa of 0.79 and 0.80 based on 34 randomly selected excerpts.
Results: The quantitative and qualitative data show that the intervention was deemed acceptable and feasible. After controlling for baseline adherence, the T1 group had 3.8 percentage point lower adherence than the control group (95% CI -9.9, 2.3) and the T2 group had 2.4 percentage points higher adherence than the control group (95% CI -3.0, 7.9). However, there was an increasing treatment effect over time for the T2 group with the largest effect towards the end of the study; a 2.5 percentage point increase in the initial 9-weeks that grows steadily to 9.0 percentage points by the last 9-weeks of the study. We find negative treatment effects for T1 in 3 of the 4 9-week intervals. This pilot study was not designed to detect statistically significant differences.
Conclusions: Improving youth’s adherence by supplementing information about their adherence with information about the adherence of peers is a promising new strategy that should be further evaluated in a fully-powered study. Providing one’s own adherence information alone appears to have less potential.
Serum levels of soluble programmed death-ligand 1 (sPD-L1) in patients with primary central nervous system diffuse large B-cell lymphoma
Authors: Cho Inju , Lee Hansang , Yoon Sang Eun , Ryu Kyung Ju , Ko Young Hyeh , Kim Won Seog , Kim Seok Jin
Published: February 2020

Background

The interaction of programmed death-1 protein (PD-1) and programmed death-1 ligand (PD-L1) produces immunosuppressive activity, protecting tumor cells from anti-tumor immunity and possibly releasing soluble PD-L1 (sPD-L1) from PD-L1 expressing tumor cells. Therefore, we measured serum levels of sPD-L1 in patients with primary central nervous system lymphoma (PCNSL) and explored its clinical implications.

Methods

Sixty-eight patients with newly diagnosed PCNSL had diffuse large B-cell lymphoma and were treated with high-dose methotrexate-containing chemotherapy. The measurement of sPD-L1 and cytokines was performed using serum samples archived at diagnosis, and the tissue expression of PD-L1 was also analyzed from archived paraffin-embedded tissue blocks. Disease relapse, progression-free survival (PFS), and overall survival (OS) were analyzed according to the extent of sPD-L1 in serum and PD-L1 in tissue.

Results

The median level of serum sPD-L1 (0.429 ng/mL) was higher than in healthy control patients (0.364 ng/mL). The occurrence of relapse was more frequent in the high sPD-L1 (78%) than the low sPD-L1 group (50%), though the groups did not have different clinical or pathological characteristics at diagnosis. As a result, the OS and PFS for the high sPD-L1 group were significantly lower than those in the low group. PD-L1-positive tumor cells were found in 35 patients (67%), and the extent of PD-L1-postive tumor cells was positively associated with serum sPD-L1 levels ( r = 0.299, P = 0.031). Among the 34 cytokines analyzed, only the serum level of IL-7 correlated with the serum level of sPD-L1 (r = 0.521, P < 0.001).

Conclusions

Serum levels of sPD-L1 could reflect the expression of PD-L1 in PCNSL tumor cells and predict patient survival outcomes. Therefore, sPD-L1 in serum could be a feasible biomarker for determining a risk-adapted treatment strategy for PCNSL patients.
Puccinia triticina pathotypes-THTT and THTS display complex transcript profiles on Thatcher
Authors: Wei jie , Cui Liping , Du dongdong , Zhang na , Meng qingfang , Yan hongfei , Yang wenxiang
Published: February 2020

Background: Wheat leaf rust is an important disease worldwide. Understanding the Puccinia triticina f.sp tritici (Pt) pathogenic molecular mechanism and inconstant toxic region are highly important for managing the disease. The present study aimed to analyze pathogenic divergences between Pt isolates. Results: Total RNA was extracted from Thatcher infected by two Pt isolates, Tc361_1 (THTT) and Tc284_2 (THTS) at 144 hours post inoculation (hpi). The mRNA then was harvested and sequenced. Results indicated that a total of 2,784 differential expressed genes (DEGs) were detected. Forty-five genes were specifically expressed in THTT including transcription initiation factor, transmembrane transporter activity and so on, while 26 genes were specially expressed in THTS including GTPase activity, ABC transporter and so on. Fifty-four differential expressed candidate effectors were screened from the tow isolates. Two candidate effectors were chosen and validated on tabacco, and the result showed that they can inhibit the necrosis induced by Bax. qRT-PCR of 12 significantly different expressed genes were carried out to prove that the results of RNA-seq is similar to that of qRT-PCR at 144 hpi and show their expression level in the early stage and the difference between two Pt pathotypes.Conclusion: The results obtained in this study showed that the transcript profiles between THTT or THTS and Thatcher were very complicated.
Frequency of thrombophilia associated genes. Population – based study.
Authors: Wawrusiewicz-Kurylonek Natalia , Kretowski Adam Jacek , Posmyk Renata
Published: February 2020

Background: Thrombophilia is a hypercoagulable state that may have a genetic basis (inherited) or can be acquired. It is a multifactorial condition and only the mutual interactions between the environment and genes may lead to the development of clinical manifestation. This state is the main factor promoting venous (rarely arterial) thromboembolism (VTE). Inherited thrombophilia is mainly associated with two pathogenic variants in the V coagulation factor ( FV ) and the prothrombin ( FII ) genes. The aim of our study was to evaluate the frequency of two pathogenic variants in FII and FV genes as inherited thrombophilia factors in a group within the Polish population in comparison with other described populations.
Methods: All studied groups consisted of 633 unrelated patients aged between 18 and 70. Individuals in the research group come from the Podlasie region of Poland. Genotyping of FII and FV variants was performed using the 7900HT Fast Real-Time PCR System and were genotyped by TaqMan assay.
Results: The pathogenic allele frequency for A allele was 0.03 (3%) and 0.07 (7%) for FII and FV genes, respectively. The GA/AA genotypes (c.*97G>A variant) were observed in only 33 (5.03%) individuals in the studied group. Additionally, the frequency of GA/AA genotypes was over 17.4% in the coagulation factor V. Co-incidence of heterozygous genotype GA of variants FII and FV genes was observed in only 4 subjects.
Conclusions: The FII gene variant shown in our study is less frequent than in other European countries (about 6%). In contrast, the A allele of the FV gene occurs with a frequency similar to that of Northern, Central and South Central Europe (about 5%).
Genome-wide analysis of wheat DNA-binding with one finger (Dof) transcription factor genes: evolutionary characteristics and diverse abiotic stress responses
Authors: Liu Yue , Liu Nannan , Deng Xiong , Liu Dongmiao , Li Mengfei , Cui Dada , Hu Yingkao , Yan Yueming
Published: February 2020

Background: DNA binding with one finger (Dof) transcription factors play important roles in plant growth and abiotic stress responses. Although genome-wide identification and analysis of the DOF transcription factor family has been reported in other species, no relevant studies have emerged in wheat. The aim of this study was to investigate the evolutionary and functional characteristics associated with plant growth and abiotic stress responses by genome-wide analysis of the wheat Dof transcription factor gene family. Using the recently released wheat genome database (Results: Using the recently released wheat genome database (IWGSC RefSeq v1.1), we identified 96 wheat Dof gene family members, which were phylogenetically clustered into five distinct subfamilies. Gene duplication analysis revealed a broad and heterogeneous distribution of TaDofs on the chromosome groups 1 to 7, and obvious tandem duplication genes were present on chromosomes 2 and 3.Members of the same gene subfamily had similar exon-intron structures, while members of different subfamilies had obvious differences. Functional divergence analysis indicated that type-II functional divergence played a major role in the differentiation of the TaDof gene family. Positive selection analysis revealed that the Dof gene family experienced different degrees of positive selection pressure during the process of evolution, and five significant positive selection sites (30A, 31T, 33A, 102G and 104S) were identified. Additionally, nine groups of coevolving amino acid sites, which may play a key role in maintaining the structural and functional stability of Dof proteins, were identified. The results from the RNA-seq data and qRT-PCR analysis revealed that TaDof genes exhibited obvious expression preference or specificity in different organs and developmental stages, as well as in diverse abiotic stress responses. Most TaDof genes were significantly upregulated by heat, PEG and heavy metal stresses. Conclusions: The genome-wide analysis and identification of wheat DOF transcription factor family and the discovery of important amino acid sites are expected to provide new insights into the structure, evolution and function of the plant Dof gene family.
Prevalence and factors associated with frailty in hospitalized older Patients
Authors: HAMMAMI Sonia , Zarrouk Amira , Piron Cecile , Almas Ioana , Sakly Nabil , Latteur Veronique
Published: February 2020

Background: Frailty is a multidimensional syndrome that leads to an increase of an age-related disorder of several physiological systems, and cognitive abilities decline. The aim of this study was to evaluate the prevalence of frailty among older persons in Belgium and we examined the factors associated with frailty with a principal focus en cognitive, dietary status, and inflammatory parameters Methods: A total of 124 participants (90 women, 34 men; age: mean ± SD: 85.9 ± 5.5 years) were studied, recruited from the Geriatrics department, Belgium. Nutritional, cognitive status and physical activity were assessed using Mini Mental State Examination score (MMSE), Mini Nutritional Assessment score (MNA), and Katz score, respectively. Frailty syndrome was evaluated using the modified Short Emergency Geriatric Assessment (SEGA) score. Medication and medical history were recorded. Analyzed biochemical parameters included C-reactive protein (CRP), complete blood count, blood creatinine, vitamin D level, and serum protein electrophoresis. According to SEGA score, participants were divided into non-frail (n=19), frail (n=25) and severely frail patients (n= 80). Results: The SEGA score was inversely correlated with MMSE, MNA and Katz score. SEGA score was negatively correlated to albumin levels (r = -0.30; p<0.001) and positively correlated to CRP, polypharmacy and age(r = 0.28, r = 0.37, r = 0.33 and p<0.01 respectively) . Logistic regression showed a strong association between frailty, Katz score, dementia, polypharmacy and living in nursing home. Conclusion : Our results provide useful information for understanding mechanisms of frailty. This will help to develop preventive strategies for the elderly at the pre-frailty stage.
Efficacy and clinical predictors of response to rTMS treatment in pharmacoresistant obsessive-compulsive disorder (OCD): A retrospective study
Authors: Rostami Reza , Kazemi Reza , Jabbari Arezoo , Madani Azam , Rostami Hosseinreza , Taherpour Mohammad Amin , Molavi Parviz , Jaafari Nematollah , Kuo Min-Fang , Vicario Carmelo M. , Nitsche Michael A. , Salehinejad Mohammad Ali
Published: February 2020

Background: Application of repetitive transcranial magnetic stimulation (rTMS) for treating obsessive-compulsive disorder (OCD) has been promising, but effects differ between patients. Knowledge about clinical predictors of rTMS response may help to increase clinical efficacy but is not available so far.
Methods: In a retrospective study, we investigated the efficacy of rTMS over the dorsolateral prefrontal cortex (DLPFC) or supplementary motor area (SMA) in 65 pharmaco-resistant OCD outpatients recruited for rTMS treatment from July 2015 to May 2017. Patients received either SMA rTMS or bilateral DLPFC rTMS in case of reporting higher affective and depressive symptoms in addition to the primary OCD symptoms. OCD symptoms and depression/anxiety states were measured at baseline (before the 1 st session) and after the 20th session of rTMS. Additionally, we performed a binary logistic regression analysis on the demographic and clinical variables based on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) 3-factor and 2-factor models and individual items to investigate potential predictors of rTMS response.
Results: Patients’ scores in Y-BOCS and Beck anxiety/depression inventories were significantly decreased following rTMS treatment. 46.2% of all patients responded to rTMS, based on the criterion of at least a 30% reduction in Y-BOCS scores. Both stimulation protocols had similar effects in patients with similar baseline clinical-demographic characteristics. No significant demographic predictors of rTMS efficacy were identified. The factors “Obsession severity”, “resistance” and “disturbance” and the “Interference due to obsessions” and “resistance against compulsions” items of the Y-BOCS significantly predicted response to rTMS.
Conclusions: In patients with less intrusive/interfering thoughts, and low scores in the “obsession severity”, “disturbance”, and “resistance factors, rTMS might have superior effects. Identification of clinical and non-clinical predictors of response is relevant to personalize and adapt rTMS protocols in pharmaco-resistant OCD patients. Interpretation of rTMS efficacy should be done with caution due to the lack of a sham intervention condition.
A novel nomogram to predict the reliability of estimated glomerular filtration rate formula in oncology patients
Authors: Cheng Yichun , Huang Liu , Han Yunfeng , Vanisha Chummun , Ge Shuwang , Xu Gang
Published: February 2020

Background: Formulae of estimated glomerular filtration rate (eGFR) based on serum creatinine (Scr) are routinely used in oncology patients, however, they are inaccurate in some populations. Our aim was to assess the agreement of eGFR formulae and thereby build a nomogram to predict the reliability of estimates.

Methods: Measured GFR (mGFR) using isotope from 445 oncology patients were compared with eGFR from six formulae (Cockcroft-Gault, Modification of Diet in Renal Disease (MDRD), modified MDRD formulae for Chinese (C-MDRD), Chronic Kidney Disease Epidemiology (CKD-EPI) Collaboration, Wright and full age spectrum (FAS)). Bias, precision and accuracy of eGFR formulae were examined. We also evaluated statistics of agreement: the total deviation index (TDI), the concordance correlation coefficient (CCC) and the coverage probability (CP). Multivariate logistic regression was applied to identify characteristics associated with inaccurate eGFR and construct a predictive nomogram.

Results: All eGFR formulae tended to overestimate the eGFR. The percentage of patients with eGFR within 30% the mGFR ranged from 38.0% to 62.8%. Cockcroft-Gault and MDRD showed low bias and high precision. The MDRD formula exhibited lowest TDI, meaning that 90% of estimations ranged from -36 to 36% of mGFR. Multivariate logistic regression showed that inaccuracy of MDRD was found in elderly patients or in patients with eGFR greater than 120 ml/min. A nomogram was constructed to help oncologists to predict the risk of inaccuracy of eGFR. The calibration curve showed good agreement.

Conclusions: Our results suggest that the error of eGFR by any formulae was common and wide in Chinese oncology patients. Our nomogram may assist oncologists in decision-making when mGFR is needed.
Disentangling the Genetics of Sarcopenia: prioritization of NUDT3 and KLF5 as genes for lean mass and HLA-DQB1-AS1 for hand grip strength based on associated SNPs
Authors: Singh Abhishek N. , Gasman Bili
Published: February 2020

Background: Sarcopenia is a skeletal muscle disease of clinical importance that occurs commonly in old age and in various disease sub-categories. Widening the scope of knowledge of the genetics of muscle mass and strength is important because it may allow to identify patients with an increased risk to develop a specific musculoskeletal disease or condition such as sarcopenia based on genetic markers. We used bioinformatics tools to identify gene loci responsible for regulating muscle strength and lean mass, which can then be a target for downstream lab experimentation validation. Single nuclear polymorphisms (SNPs) associated with various disease traits of muscles and specific genes were chosen according to their muscle phenotype association p-value, as traditionally done in Genome Wide Association Studies, GWAS. We've developed and applied a combination of expression quantitative trait loci (eQTLs) and GWAS summary information, to prioritize causative SNP and point out the unique genes associated in the tissues of interest (muscle).
Results: We found NUDT3 and KLF5 for lean mass and HLA-DQB1-AS1 for hand grip strength as candidate genes to target for these phenotypes. The associated regulatory SNPs are rs464553, rs1028883 and rs3129753 respectively.
Conclusion: Transcriptome Wide Association Studies, TWAS, approaches of combining GWAS and eQTL summary statistics proved helpful in statistically prioritizing genes and their associated SNPs for the disease phenotype of study, in this case, Sarcopenia. Potentially regulatory SNPs associated with these genes can be then wet-lab verified, depending on the phenotype it is hypothesized to affect.
Transcriptome analysis of postharvest blueberries (Vaccinium corymbosum‘Duke’) in response to cold stress
Authors: Zhang Fan , Ji ShuJuan , Wei BaoDong , Cheng Shunchang , Wang YaJuan , Hao Jia , Wang SiYao , Zhou Qian
Published: February 2020

Background: Blueberry (Vaccinium spp.) is a small berry with high economic value. Although cold storage can extend the storage time of blueberry to more than 60 days, it leads to chilling injury (CI) displaying as pedicle pits; and the samples of 0°C-30 days was the critical point of CI. However, little is known about the mechanism and the molecular basis response to cold stress in blueberry have not been explained definitely. To comprehensively reveal the CI mechanisms in response to cold stress, we performed high-throughput RNA Seq analysis to investigate the gene regulation network in 0d (control) and 30d chilled blueberry. At the same time, the pitting and decay rate, electrolyte leakage (EL), malondialdehyde (MDA) proline content and GSH content were measured. Results: Two cDNA libraries from 0d (control) and 30d chilled samples were constructed and sequenced, generating a total of 35,060 unigenes with an N50 length of 1,348bp. Of these, 1852 were differentially expressed, with 1,167 upregulated and 685 downregulated. Forty-five cold-induced transcription factor (TF) families containing 1,023 TFs were identified. The DEGs indicated biological processes such as stress responses; cell wall metabolism; abscisic acid, gibberellin, membrane lipid, energy metabolism, cellular components, and molecular functions were significantly responsed to cold storage. The transcriptional level of 40 DEGs were verified by qRT-PCR. Conclusions: The postharvest cold storage leads serious CI in blueberry, which substantially decreases the quality, storability and consumer acceptance. The MDA content, proline content, EL increased and the GSH content decreased in this chilled process. The biological processes such as stress responses, hormone metabolic processes were significantly affected by CI. Overall, the results obtained here are valuable for preventing CI under cold storage and could help to perfect the lack of the genetic information of non-model plant species. Keywords: Blueberry; Differentially expressed genes; Low temperature storage; Pathways; Pitting; Transcriptome analysis
Effect of Diabetes Mellitus on short-term prognosis of 227 pyogenic liver abscess patients after hospitalization
Authors: Du Zhaoqing , Zhou Xinchen , Zhao Junzhou , Bi Jianbin , Ren Yifan , Zhang Jia , Lin Yuxin , Wu Zheng , Lv Yi , Zhang XuFeng , Wu Rongqian
Published: February 2020

Background: Pyogenic liver abscess (PLA) is an inflammatory disease with increasing incidence. When it occurs with diabetes mellitus (DM), risk of recurrence and the mortality may increase. However, the effect of DM on short-term prognosis of PLA patients after hospitalization remained unknown.
Methods: 227 PLA patients who received treatment at the First Affiliated Hospital of Xi’an Jiaotong University from January 2011 to January 2018 were retrospectively enrolled. They were divided into two groups as DM group (n=61) and Non-DM group (n=166). In the DM group, HbA1C level <7% was considered to be good-control of glycaemia (n=23). The clinical characteristics and overall short-term survivals were analyzed.
Results: The proportion of PLA patients with DM was 26.87%. In the DM group, there was a higher incidence of hypertension and Candida spp. infection. Conservative administration and percutaneous drainage were mainly used in patients with good- (60.87%) and poor-control (60.53%) of glycaemia, respectively. During follow-up, 24 (10.57%) died due to uncontrolled systemic infections and other serious complications. Compared with PLA patients without DM, patients in the DM group had significantly increased 6-month mortality rate after discharge (Log-Rank test, P =0.021). Poor-control of glycaemia did not reduce the six-month survival, while the recurrence rate of PLA within three months showed an almost 3-fold increase (13.16% vs. 4.35%). Further multivariate analyses found that DM was the only independent risk factor for the PLA six-month survival (odd ratio [OR]: 3.019, 95% confidence interval [CI]: 1.138-8.010, P =0.026). However, the blood glucose level had no significant effect on the short-term survival of PLA patients with DM (Log-Rank test, P =0.218).
Conclusions: In PLA patients, DM aggravated short-term mortality and blood glucose levels should be well controlled.
Minimally invasive comprehensive treatment for granulomatous lobular mastitis
Authors: Wang Yaohuai , Song Junlong , Tu Yi , Chen Chuang , Sun Shengrong
Published: February 2020

Objective: To describe a minimally invasive comprehensive treatment for granulomatous lobular mastitis (GLM) and compare its effect with the existing methods, particularly in terms of its recurrence rate and esthetic outcomes.
Methods: This retrospective study reviewed 69 GLM patients receiving the minimally invasive comprehensive treatment. Patients’ information, including age, clinical features, image characteristics, histopathological findings, mastitis history, treatment process, operative technique, recurrence, and esthetic effect, was evaluated.
Results: All patients were female with a median age of 32 (range 17 - 55) years. Hospital stays ranged from 2 to 34 days, with a median of 6 days. The shortest time for complete rehabilitation was 2 days and the longest time was 365 days, with a median of 30 days. After a median follow-up of 391 days (range 162 - 690), 7 patients (10.14%) relapsed. The average cosmetic score was 2.62 ± 0.57 points and was mainly related to the past treatment, especially the surgical history.
Conclusion: Minimally invasive comprehensive treatment is a new method for the treatment of GLM, ensuring a therapeutic effect while maintaining breast beauty.
Early discontinuation of empirical antibiotic treatment in neutropenic patients with acute myeloid leukaemia and high-risk myelodysplastic syndrome
Authors: Niessen Floor Annabel , Mourik Maaike S. M. van , Bruns Anke H. W. , Raijmakers Reinier A. P. , de Groot Mark C.H. , Bruggen Tjomme van der
Published: February 2020

Introduction: Current guidelines advocate empirical antibiotic treatment (EAT) in haematological patients with febrile neutropenia. However, the optimal duration of EAT is unknown. In 2011, we have introduced a protocol, promoting discontinuation of carbapenems as EAT after three days in most patients and discouraging the standard use of vancomycin as EAT.[NF1] This study assesses the effect of this protocol on carbapenem and vancomycine use in high risk haematological patients and its safety.Methods: A retrospective before-after study was performed comparing a cohort from 2007 to 2011 (period I, before restrictive EAT use) with a cohort from 2011-2014 (period II, restrictive EAT use). Neutropenic episodes related to chemotherapy or stem cell transplantation (SCT) in patients with acute myeloid leukaemia (AML) or high-risk myelodysplastic syndrome (MDS) were analysed. The primary outcome was the use of carbapenems and vancomycin as EAT during neutropenia, expressed as days of therapy (DOT)/100 neutropenic days and analysed with interrupted time series (ITS). Also the use of other antibiotics was analysed to evaluate the overall antibiotic use[NF2] . Safety measurements included 30-day mortality, ICU admittance within 30 days after start of EAT and blood cultures positive for microorganisms sensitive to a carbapenem.Results: 362 neutropenic episodes with a median duration of 18 days were analysed, involving 201 patients. ITS analysis showed decreased carbapenem use with a step change of 16.1 DOT/100 neutropenic days (CI -26.73 to -1.41) and an overall reduction of 21.6% (8.7 DOT/100 neutropenic days). [NF3] Vancomycin use decreased with a step change of 13.7 DOT/100 neutropenic days (95% CI -23.66 to -2.90) and an overall reduction of 54.7% (14.6 DOT/100 neutropenic days). [NF4] There were no striking differences in other therapeutically used broad-spectrum antibiotics. No deaths were directly related to early discontinuation of EAT, also no notable difference in ICU-admission (n=9 in period I, n=9 in period II) and positive blood cultures (n=4 in period I, n=2 in period II) [NF5] was detected.Conclusion: The introduction of a protocol promoting restrictive use of EAT resulted in reduction of carbapenem and vancomycin use and appears to be safe in AML or high-risk MDS patients with febrile neutropenia during chemotherapy or SCT.
Association of type 2 diabetes mellitus and antidiabetic medication with risk of prostate cancer: a population-based case-control study.
Authors: Lin E , Garmo Hans , Hemelrijck Mieke Van , Adolfsson Jan , Stattin Pär , Zethelius Björn , Crawley Danielle
Published: February 2020

Background: Prostate cancer (PCa) and type 2 diabetes mellitus (T2DM) are prevalent conditions that often occur concomitantly. However, many aspects of the impact of T2DM, particularly the duration of T2DM and antidiabetic medications, on PCa risk are poorly understood.
Methods: To assess the association of duration of T2DM and antidiabetic medication with PCa risk, we designed a matched case-control study, including 31,415 men with PCa and 154,812 PCa-free men in Prostate Cancer data Base Sweden (PCBaSe) 4.1.
Results: Overall, a decreased risk of PCa was observed for men with T2DM (odds ratio (OR): 0.81, 95% confidence interval (CI): 0.78-0.84), as compared to men without T2DM. The decreased risk of PCa was consistently showed across duration of T2DM. With respect to use of antidiabetic drugs, this inverse association with duration was also found for all medications types, as compared to men without T2DM, including insulin, metformin and sulphonylurea (SU) (e.g. 3-<5yr insulin OR:0.69, 95%CI:0.60-0.80; 3-<5yr metformin OR: 0.82, 95%CI: 0.74-0.91; 3-<5yr SU OR: 0.72, 95%CI: 0.62-0.83). When stratifying by PCa risk categories, this decreased risk was most evident for diagnosis of low and intermediate-risk PCa (low-risk OR: 0.65, 95%CI: 0.66-0.70, intermediate-risk OR: 0.80, 95%CI: 0.75-0.85).
Conclusions: The study showed an inverse association between pre-existing T2DM and PCa across different durations of T2DM and all types of T2DM medication received. This inverse association was most evident for low- and intermediate-risk PCa, suggesting that whilst T2DM and its medication may protect some men from developing PCa, the relationship warrants further study.
The incidence of collagen-associated adverse events in pediatric population with the use of Fluoroquinolones: a nationwide cohort study in Taiwan
Authors: Yu Pei-Han , Hu Chih-Fen , Liu Jen-Wei , Chung Chi-Hsiang , Chen Yong-Chen , Sun Chien-An , Chien Wu-Chien
Published: February 2020

Background: To evaluate the safety of using fluoroquinolones in pediatric population in Taiwan. Methods : Patients aged 0~18 years old with fluoroquinolones prescriptions ≥5 consecutive days during year 2000 to 2013 were selected from the National Health Insurance Research Database, 4-time case number were selected as controls. We evaluated the patient’s outcome after the use of fluoroquinolones by reviewing a newly diagnosis of the following collagen-associated adverse events by International Classification of Diseases, Ninth Revision, Clinical Modification codes, covering tendons rupture, retinal detachments, gastrointestinal tract perforation, aortic aneurysm or dissection. Results : Of the enrolled patients (n=167,105), collagen-associated adverse effects developed in 85 cases (0.051%) in 6-month tracking, including 0.051% in the fluoroquinolones study cohort (17 in 33,421) and 0.051% (68 in 133,684) in the fluoroquinolones free comparison cohort. The crude hazard ratio for collagen-associated adverse events in the fluoroquinolones group was 0.997 (0.586-1.696; p=0.990). After adjusting for age, sex, catastrophic illness, low-income household, seasons, levels of urbanization, and healthcare, the corrected hazard ratio in 6-month tracking with FQs was 1.330 (95% CI; 0.778-2.276; p=0.255). Conclusions: There is no significant difference of collagen-associated adverse effects between fluoroquinolones group and fluoroquinolones free group from our data. We propose that fluoroquinolones for pediatric population in clinical practice may be not so harmful as previous references reported.