bluuebunny/crossref_metadata_2025 huggingface dataset:
A Phase 2 Randomised Controlled Trial of Serelaxin to Lower Portal Pressure in Cirrhosis (STOPP)
Authors: Fallowfield Jonathan , Gifford Fiona J , Dunne Philip DJ , Weir Graeme , Ireland Hamish , Graham Catriona , Tuck Sharon , Hayes Peter C
Published: January 2020

Background: In preclinical models recombinant human relaxin-2 (serelaxin) had anti-fibrotic effects and ameliorated portal hypertension (PH). A small exploratory study in patients with cirrhosis also suggested that serelaxin could reduce portal pressure. Methods: In a phase 2 double-blind randomised controlled study conducted in a single centre (Royal Infirmary of Edinburgh, UK), male and female adult participants with cirrhosis and clinically-significant PH (CSPH; hepatic venous pressure gradient (HVPG) >10 mmHg) were enrolled. Participants were allocated to serelaxin or placebo in a 3:1 ratio. The placebo control group was used to maintain the blind. The primary endpoint was the change from baseline in fasting HVPG after 2 h peripheral i.v. serelaxin infusion (80 μg/kg/day for 60 min followed by 30 μg/kg/day for at least 60 min). Secondary endpoints included the change from baseline in hepatic blood flow and systemic haemodynamics (cardiac index, systemic vascular resistance index and aortic pulse wave velocity). Short-term safety and tolerability of serelaxin was also assessed. Results: A total of 17 participants were screened, 15 were randomised and 11 completed the study (n=9 serelaxin, n=2 placebo). Reasons for withdrawal were baseline HVPG <10 mmHg (n=2) and technical failure (n=2). Median age was 56 (range 43-69) and 73% of participants were male. Cirrhosis aetiologies were alcohol (n=10), non-alcoholic fatty liver disease (n=2), hepatitis C (n=2) and hepatitis B (n=1). Participants were Child-Pugh class A (60%) and B (40%) with a median Model for End-Stage Liver Disease score of 10 (range 6-14). Mean baseline HVPG was 16.3 mmHg (range 10.3-21.7). Individual responses were variable, but overall there was no statistically significant change in HVPG after 2 h i.v. serelaxin (arithmetic mean of difference ±SD was 0.4 ±3.5 mmHg (95% CI -2.3, 3.1; p=0.76)). There were also no substantial changes from baseline in hepatic blood flow or systemic haemodynamic measures following serelaxin. We recorded 12 adverse events in 7 participants treated with serelaxin; none were significant, and most were unrelated to the investigational medicinal product. There were no serious adverse events. Conclusion: In a small randomised phase 2 proof-of-concept study in patients with cirrhosis and CSPH, serelaxin infusion was safe and well-tolerated but had a neutral effect on HVPG.
Epidemiology of patients with musculoskeletal soft tissue sarcomas in a cancer hospital in Central China: A study of 1624 cases.
Authors: Zhang Peng , Liu Jinyan , Feng Feifei , Zhang Qiao , Duan Guangcai , Yao Weitao
Published: January 2020

Background : To analyze the incidence characteristics of 1624 inpatients with soft tissue sarcoma (STS) during 2006 to 2016 in Henan Province Cancer Hospital in Central China. Methods : The information of electronic medical record from the first hospitalized patients with STS in Henan Province Cancer Hospital during January 1, 2006 to December 31, 2016 was collected, and descriptive statistics was analyzed on age, gender, pathological type and tumor location by using SPSS21.0 software. Results : There were 1624 inpatients with STS in Henan Province Cancer Hospital in 2006~2016.The top nine pathological subtypes of STS with high constituent ratio were undifferentiated pleomorphic sarcoma (UPS,23.83%),synovial sarcoma(16.69%), liposarcoma(13.67%), fibrosarcoma(10.22%), sarcoma without definite type (8.99%), leiomyosarcoma(7.02%), dermatofibrosarcoma protuberant (5.79%),rhabdomyosarcoma (4.68%) and malignant neurilemmoma(4.25%). The average age of inpatients was 44.71±17.91, and the inpatients aged 35-64 accounted for 56.34%.The number of UPS inpatients reached the peak at the age of 45 to 59; The median age of inpatients with rhabdomyosarcoma was 17 year.In total 1624 inpatients of STS, the number of male and female inpatients were 923 and 701, respectively. The gender ratio was 1.32:1. The proportion of UPS in either male or female inpatients was the highest, accounting for 23.07% and 24.82%, respectively. The number of male inpatients was more than that of female in the top nine pathological subtypes of STS except leiomyosarcoma (the gender ratio was 0.84:1). The most common initiation location of UPS, synovial sarcoma, liposarcoma was lower extremity, accounting for 51.16%, 53.13% and 52.25% in corresponding pathological type group, respectively. Dermatofibrosarcoma protuberant, rhabdomyosarcoma and fibrosarcoma were all mainly initiated in trunk, accounting for 72.34%, 47.83% and 45.57% , respectively. Leiomyosarcoma tend to occur in retroperitoneum. Conclusion : The top three pathological subtypes of STS with high constituent ratio were UPS, synovial sarcoma and liposarcoma.UPS should be paid more attention on the prevention, treatment and research in Henan province in future for its highest proportion of STS.
Evaluation of the "License, Master, Doctorate" reform in medical school of University of Lomé (Togo): strengths and weaknesses
Authors: TECLESSOU Julienne , KPELAO Essossinam , SAKA Bayaki
Published: January 2020

Introduction: The License, Master, and Doctorate (LMD) reform which structured high studies in three cycles has been instituted since the Bologna declaration in 1999. To be conformed to international standards, the LMD system has been instituted in university of Lomé in 2009 to foster pathways between medical and paramedical training. The purpose of this study was to evaluate the strengths and weaknesses of the LMD reform since its introduction in medical school of Lomé.
Method: It was an opinion survey conducted in 4 months in University of Lomé among the medical school’s teachers about strengths and weaknesses of LMD reform since its application. The strengths were defined as all facilities brought by LMD reform in organization of courses and practices, evaluations, new Information and Communication Technologies (ICTs) (internet, video projector, courses on line). The LMD weaknesses were defined as any problem generated by the LMD system.
Results: Of 113 resident teachers of the medical school of Lomé, seventy-six have completed the questionnaire (67.2%). The majority of teachers (74) thought that the introduction of LMD reform will make Lomé medical school fit into international standards. The availability of the video projectors was noted by 90.8% of the teachers and 82.9% of them used it for teaching. There was no online course. The main strengths of LMD were: a better evaluation system (33.3%), the organization of training in units with credit (28.6%), the usage of new ICTs (23.8%).
Many weaknesses of LMD reform were noted by teachers: the plethoric number of students (36.2%), the absence of an intermediate diploma and pathways between studies (29.3%). The Insufficiency of human resources and material was also mentioned.
Conclusion: This study highlights that LMD reform needs adaptation to local realities and improvement to ensure that students will get good training in conformity with international standards.
Objective evaluation of postoperative changes in real-life activity levels in the postoperative course of lumbar spinal surgery using wearable trackers
Authors: Inoue Masahiro , Orita Sumihis , Inage Kazuhide , Suzuki Miyako , Fujimoto Kazuki , Shiga Yasuhiro , Kanamoto Hirohito , Abe Koki , Kinoshita Hideyuki , Norimoto Masaki , Umimura Tomotaka , Sato Takashi , Sato Masashi , Suzuki Masahiro , Enomoto Keigo , Eguchi Yawara , Akazawa Tsutomu , Aoki Yasuchika , Kawasaki Yohei , Ohtori Seiji
Published: January 2020

Background: Lumbar spinal disease causes disabilities in performing daily activities. Operative treatments are aimed at pain relief and rapid return to routine activity. Patient-based outcome measures are used to evaluate pathologies and therapeutic effects associated with lumbar spinal disease. Nevertheless, it remains unknown as to how much such treatment improves activity levels.The purpose of the current study was to measure changes in activity levels before and after lumbar spinal surgery using a wearable activity tracker and to analyze the differences between results and patient-based outcomes.Methods: Sixty patients who underwent lumbar surgery were studied. The physical activity of participants was objectively evaluated using a wearable Micro-Motion logger system (Actigraph). We measured the amount of activity before and at 1, 3, 6, and 12 months after the surgery to evaluate postoperative changes. The Japanese Orthopaedic Association Back Pain Evaluation Questionnaire, Oswestry Disability Index, Roland-Morris Disability Questionnaire and visual analog scale were used to assess patient-based outcomes of pain and activities of daily living-related scores; we analyzed the relationships between scores and actual activity levels. Results: The amount of actual activity decreased significantly 1 month after the surgery compared to that during the preoperative period, which then improved after 3 months postoperatively (p <0.01). Furthermore, there was a significant improvement 6 months after the surgery compared to that during the preoperative period (p < 0.05). The changes in activity for each period were strongly correlated, regardless of the period. In contrast, a significant improvement was observed at 1 month after the surgery in almost all items of the patient-based questionnaires (p < 0.05).Conclusions: The objective activity tracker demonstrated that lumbar surgery results in the amount of activity decreasing 1 month just after surgery followed by gradual postoperative recovery within 3 months. By contrast, patient-based outcomes showed improvement in 1 month that was significantly different from the change in actual activity, indicating a gap between patient-oriented clinical scores and their actual activities.
Prevalence of dental caries in decidous teeth and oral health related quality of life among preschool children aged 4-6 years in Kisarawe, Tanzania.
Authors: Masumo Ray Mrisho , Ndekero Tumaini S. , Carneiro Lorna C.
Published: January 2020

Background : Preschool years are a critical period in the development of a healthy child. The consequences of poor oral health in preschool children reach beyond dental problems, with oral health-related quality of life (OHRQoL) being associated with overall systematic health as well as one’s quality of life. The purpose of this study was to assess the prevalence of dental caries and its impacts on the OHRQoL in a sample of preschool children in Kisarawe.
Methods: A cross-sectional based study was conducted in 2017. A total of 1,106 preschool children completed a face-to-face interview, using a translated Kiswahili version of the Michigan Oral Health-related Quality of Life Scale (MOHRQoL) –Child Version (2003), and underwent clinical oral examination using WHO (1997) criteria.
Results: The decayed component was the most prevalent (dft = 2.08) and the Significant Caries Index (SiC) was 5.54 double of the (dft), showing polarization of dental caries in the studied population. After adjusting for appropriate covariates, preschool children of age 5 and 6 years old were more likely to have decayed tooth [Adjusted OR = 3.02, (95% CI =2.01-4.54)] and [Adjusted OR=2.23, (95% CI= 1.55-3.20)] respectively. Preschool children without visible plaque on the buccal surface of upper anterior teeth were less likely to have decayed teeth [Adjusted OR=0.21, (95% CI=0.09-0.45)]. Regarding measurements of oral health-related quality of life using the MOHRQoL, only preschool children who reported on ‘do your teeth hurt you now?’ and ‘do kids make fun of your teeth?’ were more likely to have a decayed tooth [Adjusted OR=1.74, (95% CI=1.12-2.71)] and [Adjusted OR=1.87, (95% CI=1.11-3.15)], respectively.
Conclusion: Findings from this study suggest that dental caries affects a significant portion of preschool children and, was associated with poor oral hygiene. The overall impacts of dental caries prevalence to OHRQoL were low in this sample of preschool children . Children having caries (independent variable) were shown to report more frequently that ‘do your teeth hurt you now?’ and ‘do kids make fun of your teeth?’ were more likely to have a decayed tooth among preschool children in Kisarawe, Tanzania.
Individualized procedures for splenic artery dissection during laparoscopic distal pancreatectomy.
Authors: Wada Yusuke , Aoki Takeshi , Murakami Masahiko , Fujimori Akira , Koizumi Tomotake , Kusano Tomokazu , Matsuda Kazuhiro , Nogaki Koji , Hakozaki Tomoki , Shibata Hideki , Tomioka Kodai
Published: January 2020

[Background] There are no established standard criteria for choosing the most appropriate procedure of splenic artery dissection during laparoscopic distal pancreatectomy (LDP). The aim of this study was to evaluate the clinical benefits of individualized procedures for splenic artery dissection during LDP based on the variations in arterial structure visualized on preoperative three-dimensional computed tomography (3D-CT). [Methods] Patients who underwent LDP following 3D-CT at a single center were retrospectively evaluated. 3D-CT images were used to construct virtual 3D laparoscopic images for surgical planning. The splenic artery was classified into two major anatomic types: type S that curves and runs suprapancreatic and type D that runs straight and dorsal to the pancreas. Splenic artery dissection was planned according to these two variations, with type S dissected using an suprapancreatic approach and type D using a dorsal approach. [Results] Type-specific dissection was applied for 30 patients: 25 (83%) with type S and 5 (17%) with type D splenic artery anatomies. In 25 (83%) patients, the splenic artery was successfully dissected using the planned surgical procedure, whereas the surgical plan had to be altered in 5 cases (17%) due to difficulty in dissecting the splenic artery. [Conclusion] The individualized procedures for splenic artery dissection according to anatomic variations visualized on 3D-CT images can help improve the success and safety of LDP.
A novel approach to conducting clinical trials in the community setting: Utilizing patient-driven platforms and social media to drive web-based patient recruitment
Authors: Applequist Janelle , Burroughs Cristina , Ramirez Artemio , Merkel Peter A. , Rothenberg Marc E. , Trapnell Bruce , Desnick Robert J. , Sahin Mustafa , Krischer Jeffrey P.
Published: January 2020

Background: Participant recruitment for clinical research studies remains a significant challenge for researchers. Novel approaches to recruitment are necessary to ensure that populations are easier to reach. In the context of rare diseases, social media provides a unique opportunity for connecting with patient groups that have representatively lower diagnosis rates when compared with more common diseases or illness. We describe the implementation of designing a patient-centered approach to message design for the purposes of recruiting patients for clinical research studies for rare disease populations. Methods: Using an iterative research approach, we analyzed our previous experience of using web-based direct-to-patient recruitment methods to compare these online strategies with traditional center of excellence recruitment strategies. After choosing six research studies for inclusion in the previous study, in-depth, online interviews (n=37) were conducted with patients represented in each disease category to develop and test recruitment message strategies for social media and a Web-based platform for patients to access study information and pre-screen. Finally, relationships were established with Patient Advocacy Groups representing each rare disease category to ensure further dissemination of recruitment materials via their own social media networks. Results: Guided by social marketing theory, we created and tested various recruitment message designs. Three key message concepts preferred by patients emerged: (1) infographic; (2) positive emotional messages; and (3) educational information for sharing. A base study website was designed and created based on the data from patient interviews. This website includes the option for potential participants to pre-screen and determine their eligibility for the study. Conclusions: Study participants report wanting to be involved in the design and implementation of recruitment approaches for clinical research studies. The application of the aforementioned methods could aide in the evolution of clinical research practices for the recruitment of both rare and common diseases, where patient-centric approaches can help to create targeted messages designs that participants pre-test and support.
Cloacal swabs and alcohol bird specimens are good proxies for compositional analyses of gut microbial communities of Great tits (Parus major)
Authors: Bodawatta Kasun H , Puzejova Katerina , Sam Katerina , Poulsen Michael , Jønsson Knud A.
Published: January 2020

Background Comprehensive studies of wild bird microbiomes are often limited by difficulties of sample acquisition. However, widely used non-invasive cloacal swab methods and under-explored museum specimens preserved in alcohol provide promising avenues to increase our understanding of wild bird microbiomes, provided that they accurately portray natural microbial community compositions. To investigate this assertion, we used 16S rRNA amplicon sequencing of Great tit (Parus major) gut microbiomes to compare 1) microbial communities obtained from dissected digestive tract regions and cloacal swabs, and 2) microbial communities obtained from freshly dissected gut regions and from samples preserved in alcohol for two weeks or two months, respectively. Results We found no significant differences in alpha diversities in communities of different gut regions and cloacal swabs (except in OTU richness between the dissected cloacal region and the cloacal swabs), or between fresh and alcohol preserved samples. However, we did find significant differences in beta diversity and community composition of cloacal swab samples compared to different gut regions. Despite these community-level differences, swab samples qualitatively captured the majority of the bacterial diversity throughout the gut better than any single compartment. Bacterial community compositions of alcohol-preserved specimens did not differ significantly from freshly dissected samples, although some low-abundant taxa were lost in the alcohol preserved specimens. Conclusions Our findings suggest that cloacal swabs, similar to non-invasive fecal sampling, qualitatively depict the gut microbiota composition without having to collect birds to extract the full digestive tract. Secondly, the satisfactory depiction of gut microbial communities in alcohol preserved samples opens up for the possibility of using an enormous resource readily available through museum collections to characterize bird gut microbiomes. The use of extensive museum specimen collections of birds for microbial gut analyses would allow for investigations of temporal patterns of wild bird gut microbiomes, including the potential effects of climate change and anthropogenic impacts. Overall, the utilization of cloacal swabs and museum alcohol specimens can positively impact bird gut microbiome research to help increase our understanding of the role and evolution of wild bird hosts and gut microbial communities.
Staging Procedures Fail to Benefit to the Fertility-preserved Women with Borderline Ovarian Tumors: A Retrospective Analysis of 448 cases
Authors: Li Na , Gou Jinhai , Li Lin , Ming Xiu , Hu Ting Wenyi , Li Zhengyu
Published: January 2020

Purpose The study is aimed to evaluate the potential effect of clinicopathologic and surgical factors on the prognosis and fertile outcomes in the patients with borderline ovarian tumors. Patients and Methods We performed a retrospective analysis involving BOT patients who had underwent surgical procedures in West China Second University Hospital from January 2008 to January 2015 . The disease-free survival (DFS) outcomes and potential prognostic factors were evaluated using Kaplan-Meier method and Cox regression analysis, respectively. Furthermore, the fertile outcomes were analyzed using Pearson Χ2 and Fish correlation test. Results A total of 448 patients were included with a median age of 37.1 years and a median follow-up time of 113 months. Forty-two (11.6%) recurrences with the mean recurrence interval 80.2 months and four (0.9%) deaths were observed. One hundred and eighteen (26.3%) patients were underwent staging surgery and the remaining 330 (73.7%) patents underwent unstaged surgery. A total of 233 patients undergoing fertility sparing surgery (FSS) attempted to conceive and 92 (39.48%) of them achieved pregnancy. No statistically significant difference of fertile outcomes were found between staging surgery group or not (P=0.691). In univariate analyse, staging surgery was obviously associated with DFS (HR=2.191 P=0.005), but was not an independent prognostic factor (p=0.600) for DFS on multivariate analysis. The multivariate Cox analysis revealed that advanced FIGO stage (≥stage II), positive ascites\pelvic washings and laparotomy approach were independent prognostic factors for DFS in overall patients, whereas advanced stage (≥stage II), laparotomy approach, cystectomy-included procedure, invasive implants and bilateral tumors were independent prognostic factors for DFS in patients undergoing FSS. In addition, laparoscopy approach had better prognosis than laparotomy in patients of early stage (stage I) with fertility desire. Conclusion Patients with BOT fail to benefit from surgical staging in prognosis and fertile outcomes. Laparoscopy will be recommended to patients of stage I with fertility desire. Patients with fertility desire at advanced stage (≥stage II), invasive implants and bilateral tumors should pay more attention to the risk of recurrence and choose FSS carefully.
Risk Factors Associated With Outcomes of Non-cardioembolic Ischemic Stroke In Patients Stratified By Essen Stroke Risk Score
Authors: Ping Yanting Ping , Yang Qianqian Yang , Huang Yuwen Huang , Xu Huimin Xu , Dai Haibin
Published: January 2020

Background: Identifying risk factors of cardiovascular events is crucial for stroke prevention and they can be used as predictive factors of stroke outcomes.In this study, it is to evaluate the risk factors that predict outcomes of acute non-cardioembolic ischemic stroke in patients stratified by Essen Stroke Risk Score (ESRS). Methods: A retrospective study was carried out in acute non-cardioembolic ischemic stroke patients in a Chinese tertiary-care teaching hospital. ESRS stratification and factors that might influence the outcomes of stroke, as indicated by fatal or non-fatal combined vascular events of recurrent stroke, myocardial infarction, or primary intracranial hemorrhage, were documented. Univariate analysis and multivariable regression analysis was used to identify independent predictors of stroke outcomes. Results: A total of 878 patients with acute non-cardioembolic ischemic stroke who completed a mean follow-up of 5.2 years were enrolled, and 163 patients experienced at least one component of the combined vascular event. In patients with an ESRS ≤ 3, age ≥ 65 years (OR , 2.935; 95% CI 1.625-5.301, P < 0.001) and clopidogrel treatment (OR , 1.685 ; 95% CI , 1.026-2.768; P = 0.041) were significantly associated with stroke outcomes. In patients with an ESRS > 3, age ≥ 65 years (OR , 2.107, 95% CI , 1.208-3.673 ; P = 0.008) and history of diabetes (OR , 1.465 ; 95% CI , 1.041–2.062 ; P = 0.027) were risk factors for stroke outcomes , whereas clopidogrel treatment (OR , 0.542; 95% CI , 0.356–0.824; P = 0.003) was a protective factor for stroke outcomes. Conclusions: According to this study, clopidogrel treatment, blood pressure control, and glycemic control are protective factors for stroke outcomes in high-risk patients (ESRS>3).
Effects of Remote Ischemic Conditioning on Hand Engagement in individuals with Spinal cord Injury (RICHES): A Preliminary Crossover Study
Authors: Wu Yu-Kuang , Harel Noam Y , Wecht Jill M , Bloom Ona
Published: January 2020

BackgroundMost spinal cord injuries (SCI) are not full transections, indicating that residual nerve circuits are retained after injury. SCI rehabilitation interventions, including physical training and neural stimulation, have been shown to beneficially reorganize motor pathways in the brain, corticospinal tract (CST), and at the spinal level. However, both physical training and neural stimulation require a large number of repetitions, and the retention of the intervention effects may be transient. Therefore, the need remains for an effective approach to synergistically improve the amount and duration of neuroplasticity in combination with other interventions. Remote ischemic conditioning (RIC) demonstrates several potential advantages as a candidate for such an approach. In this proposed study, we will investigate RIC coupled with physical training to promote neuroplasticity in hand muscles after cervical SCI This will be the first study to introduce RIC in the SCI population, so we will extensively focus on safety, tolerability, and hemodynamic responses during RIC.MethodsThis is a prospective randomized-order crossover trial to be performed over 24 months in 16 participants including 8 healthy controls and 8 participants with chronic cervical SCI. Patients will participate in one screening session (SCI subjects only) and two experimental sessions consisting of either active or sham RIC preceding a bout of pinch movement exercise. Serial evaluations will be carried out at baseline, after RIC, immediately after pinch exercise, and follow up 15-minutes later. The primary outcome is the change in corticospinal excitability (primarily measured by the motor evoked potential of abductor pollicis brevis muscle). Secondary outcomes will include maximal volitional pinch force, and inflammatory biomarkers such as components of the TLR signaling pathway. To ensure safety, we will monitor tolerability and hemodynamic responses during RIC.DiscussionThis study is the first to test RIC in people with cervical spinal cord injury and to investigate whether RIC alters corticospinal excitability. By sharing the details of our research protocol, we hope other interested researchers will seek to investigate similar approaches – depending on overlap with the current study and mutual sharing of participant-level data, this could increase the sample size, power, and generalizability of the analysis and results.
Interactomics: Development of an efficient and improved Agrobacterium tumefaciens-mediated transformation method for transient expression of heterologous protein in recalcitrant plant tissues in planta
Authors: Affandi Nurhafizah Dahniar , Mostaffa Nur Hikmah , Al-Idrus Aisyafaznim
Published: January 2020

Background: Since more researches leaned towards a holistic approach of “omics” to understand PPI, interactomics studies pivoting on AP-MS approach are getting popular amongst plant scientists. However, to date, AP-MS approach has yet to be adopted to study plant-pathogen interaction even in model plants, hence, the needs to design and develop an optimised transformation procedure for successful isolation of pathogen-targeted plant proteins.Methods: Banana plants were grown in soil or hydroponic media for 2-3 months before subjected to transformation procedure. As a bait, m16D10 , a mature parasitism gene isolated from Meloidogyne incognita was transiently expressed in banana root tissues cv. Grand naine (ITC1256) to prey for interacting plant proteins. Subsequently, the plant-pathogen interacting protein complex was “pulled” at the purification step using histidine affinity column, electrophoresed in SDS-PAGE gel and subjected to western blot assay.Results: We first compared Agrobacterium tumefaciens -mediated transformation quality on root tissues grown in soil and hydroponic media and found that the latter yielded higher area of transformed tissues (99% - 100%). We found hydroponic-grown root tissues were amenable to syringe-based agroinfiltration method and required lesser acclimatisation period compared to the soil-grown root tissues. Our result showed that western blot minimum detection limit of heterologous protein amount in the purified root protein product was at 1:1 ratio, with minimum concentration of 9 mg/mL of purified protein. Using these parameters, western blot assay confirmed the expression of m16D10 gene in transformed plant root tissues and SDS-PAGE gel revealed that we had isolated putative plant proteins interacting with the bait protein.Conclusion: An improved, efficient, and cost-effective Agrobacterium tumefaciens -mediated transformation protocol was developed for transient expression of heterologous protein in recalcitrant plant tissues, suitable for AP-MS-based plant-pathogen interaction studies. Confirming our hypothesis, we demonstrated that the improved method had successfully “pulled-out” banana root proteins interacting with m16D10 protein using histidine affinity column.
Influence of malformation of right coronary artery originating from the left sinus on the hemodynamic environment
Authors: Cong Mengyang , Xu Xingming , Qiu Jianfeng , Dai Shun , Chen Chuanzhi , Qian Xiuqing , Zhang Hongbin , Qin Shengxue , Zhao Huihui
Published: January 2020

Background: The Anomalous origin of the Right Coronary Artery (RCA) from the Left Coronary artery sinus(AORL) is one of the abnormal origins of the coronary arteries. Most of these issues seldom have effects on human health, but some individuals may have symptoms such as myocardial ischaemia or even sudden death. Recently, researchers are studying AORL through clinical cases, but study based on computational fluid dynamics (CFD) is rarely seen. In this study, haemodynamic changes between normal origin of the RCA and AORL are compared according to numerical simulation results.Methods: Realistic three-dimensional models of 16 normal right coronary arteries and 26 abnormal origins of the right coronary arteries were reconstructed, respectively. The blood flow was numerically simulated using software ANSYS. This study involves one-way fluid-solid coupling finite element model in which the blood is assumed to be incompressible Newtonian fluid, and the vessel is assumed to be isotropic, linear elastic material.Results: The differences of the cross-sectional area at the inlet between the normal group and the abnormal group was significant ( P <0.0001). There were significant differences in the volumetric flow ( P <0.0001) and the pressure ( P =0.0001). There were positive correlations with the ratio of the cross-sectional area of the RCA to the inlet area of the ascending aorta (AAO) and the ratio of the inlet volumetric flow of the RCA to the volumetric flow of the AAO, in both the normal ( P =0.0001, r=0.8198) and abnormal ( P =0.0199, r=0.4925) group.Conclusion: This study shows that the cross-sectional area of the inlet of AORL may cause ischaemia symptoms, and the results may contribute to the further understanding of the clinical symptoms of AORL based on the haemodynamics.
Factors contributing to diagnostic delay of Caroli syndrome: a single-center, retrospective study
Authors: Shi Wen , Huang Xiao-ming , Feng Yun-lu , Wang Feng-dan , Gao Xiao-xing , Jiao Yang
Published: January 2020

Background Caroli syndrome (CS) is a rare congenital disorder without pathognomonic clinical symptoms or laboratory findings. Imaging modalities are first-line diagnostic methods.Methods A retrospective analysis was conducted on CS patients admitted to a single tertiary medical center in Mainland China. The diagnostic timelines of CS patients were reviewed to demonstrate the initial findings at diagnosis of CS, the risk factors associated with diagnostic delay, and potential clues leading to early diagnosis. Results The median diagnostic delay was 1.75 years (range: 1 month to 29 years, interquartile range: 6.2 years) in sixteen enrolled CS patients. Sex, age, and initial symptoms were not associated with diagnostic delay. 87.5% of CS patients were diagnosed by imaging, and the accuracy of ultrasonography, computed tomography (CT), and magnetic resonance cholangiopancreatography was 25%, 69.2%, and 83.3%, respectively. The median diagnostic delays for patients with or without CT performed at the first hospital visited according to physician and radiologist suspicion of the diagnosis were 7.4 months and 6 years, respectively (p=0.021). Hepatic cysts with splenomegaly were found by ultrasound in over half of CS patients.Conclusions The majority of CS patients were not diagnosed until complications of portal hypertension had already developed due to the non-specific clinical presentations, rarity, and therefore low index of suspicion for CS. Some patients had positive autoantibodies, which can lead to misdiagnosis. Recognition and early suspicion of the disease were important factors influencing diagnostic delay of CS. Hepatic cysts plus splenomegaly detected by US, which is almost always the first imaging test, might provide a clinical clue to include CS in the differential diagnosis.
Socioeconomic Inequalities in Tobacco Smoking in Women Aged 15-54 in Iran: A multilevel model
Authors: oradi Ghobad , Goodarzi Elham , Khosravi Ardeshir
Published: January 2020

Background Significant evidence suggests an inverse relationship between socioeconomic status and tobacco smoking, where inequality is visible among different social and economic strata. The aim of this study was to investigate the prevalence and economic and social inequalities in tobacco smoking in women aged 15-54 in Iran.MethodThis study is a cross-sectional study. Sampling in this study was a randomized clustered multistage sampling with equal clusters. A total of 35,305 women aged 15-55 enrolled in the study. Data analysis was in two stages. In the first stage, the social and economic inequalities were investigated using the concentration index and concentration curve method, and in the second method, and multilevel method was used to identify the determinants.ResultsThe prevalence of tobacco smoking in women was 12.24%. The concentration index for smoking was CI = -0.07 [95% CI (-0.09, -0.05)], which represents smoking in people with low socioeconomic status. The results of the multilevel analysis indicated that the marital status of people over the age of 35 and the economic class was related to smoking in women.ConclusionInequality in tobacco smoking in women is to the interest of the well-off group, and this inequality varies in different provinces. Marital status, place of residence, age and socioeconomic status of women are factors influencing the prevalence of tobacco smoking in women, and these issues should be noticed to reduce inequalities.
Recruitment patterns in a large international randomized controlled trial of perioperative care in cancer patients
Authors: Gazendam Aaron , Bozzo Anthony , Schneider Patricia , Giglio Victoria , Wilson David , Ghert Michelle
Published: January 2020

Introduction: The Prophylactic Antibiotic Regimens in Tumor Surgery (PARITY) randomized controlled trial (RCT) was the first study to prospectively enroll and randomize orthopaedic oncology patients in multiple centers internationally. The objective of this study was to describe recruitment patterns, examine the differences in enrollment across different PARITY sites, and to identify variables associated with differing levels of recruitment.Methods: Data from this study was obtained from the PARITY trial Methods Center and records of correspondence between the Methods Center and recruiting sites. We performed descriptive statistics to report the recruitment patterns over time. We compared recruitment, time to set up, and time to enroll the first patient between North American and international sites, private and public health care models, and the presence or absence of research personnel. Two-tailed non-paired t-tests were performed to test average monthly recruitment rates between groups. Results: A total of 602 patients from 36 North American and 12 international sites were recruited from 2013 to 2019. Average monthly enrollment increased each year of the study. North American sites were able to start up significantly faster than international sites (19.5 vs. 27.0 months p=0.04). However, international sites had a significantly higher recruitment rate once active (0.2 participants/month vs. 0.59 participants/month, p=0.023). Sites with research personnel were able to reach ‘enrolment ready’ status significantly faster than sites without research personnel (19.3 vs. 30.3 months, p=0.032), but there was no difference in recruitment once active (0.28 participants/month vs. 0.2 participants/month). Publicly funded sites were to recruit significantly more patients compared to private institutions (0.4/month vs. 0.17/month, p=0.03).Conclusions: As a collaborative group, the PARITY investigators increased the pace of recruitment throughout the trial, likely by increasing the number of active sites. The longer time to start-up at international sites may be due to the complex governing regulations of pharmaceutical trials. Nevertheless, international sites should be considered essential as they recruited significantly more patients per month once active. The absence of research support personnel may lead to delays in time to start up. The results of the current study will provide guidance for choosing which sites to recruit for participation in future collaborative clinical trials in orthopaedic oncology and other surgical specialties.
Breast milk Vitamin B12 Concentration and Incidence of Diarrhea and Respiratory Infections among Infants in Urban Tanzania: a prospective cohort study
Authors: Lweno Omar Ndano , Sudfeld Christopher R , Hertzmark Ellen , Manji Karim P , Darling Anne Marie , Fawzi Wafaie W
Published: January 2020

Trials of vitamin B12 supplementation in children 6-30 months have shown an increased risk of diarrhea and respiratory infections among participants. These results are not consistent with studies in adults that showed improvement of the immune response following treatment with vitamin B12. We sought to determine how the adequacy of vitamin B12 concentrations in breast milk could act as immune modulator and protect against the incidence of diarrhea and respiratory infections of children up to 18 months in urban Tanzania. A prospective cohort study was undertaken to determine the association of milk vitamin B12 concentration with the incidence of acute respiratory infection and diarrhea among infants in urban Tanzania. A random sample of 491 women enrolled in a trial of multivitamins provided milk for B12 analysis at or around 6 weeks postpartum. Of 491 women, 345 had vitamin B12 concentrations less than the value used to define adequate intake (<310 pmol/L) in breast milk. Using generalized estimating equations, we found no overall association of milk vitamin B12 concentration with incident diarrhea and ARI in infants. Prospective studies that perform longitudinal evaluations of milk B12 concentration over time are needed to clarify the role of milk vitamin B12 in childhood infections.
Combined ANN/ EVOP Factorial Design Approach for Media Screening for Cost-effective Production of Alkaline Proteases from Rhizopus oryzae (SN5) / NCIM-1447 under SSF
Authors: Negi Sangeeta , Vibha Kumari
Published: January 2020

In order to achieve high yield of fungal protease in a very cost effective way and to meet its increased market demand, current study deals with the screening of various agro-wastes as carbon source for the production of protease from Rhizopus oryzae (SN5) / NCIM-1447 under solid state fermentation. Substrates and culture parameters such as wheat bran, soybean meal, black-gram husk, rice husk, mixture of wheat bran, soybean meal, nitrogen sources, pH, temperature and incubation time were first optimized with one factor at time strategy and then EVOP factorial and yield of alkaline protease was achieved 412.8 U/gds at 28oC and pH=6 after 72 hours of fermentation taking wheat bran and soybean as a substrate in 4:1 ratio. Further Artificial Neural Networks (ANN), was trained with data of EVOP and yield of protease was enhanced up to 422.6 U/gds with wheat bran: soyabean in ratio of 70:30, pH 6.2 at 30°C. The evolved process and Rhizopus oryzae (SN5)/NCIM-1447 strain would be promising for protease production at industrial scale at low cost.
TSGA10 Expression Status in Breast Cancer: The Role of Microenvironmental Changes
Authors: Marzbany Marzieh , Norooznezhad Amir Hossein , Hoseinkhani Zohreh , Mahnam Azadeh , Eslampia Kiumaras , Jahani Mozhgan , Mansouri kamran
Published: January 2020

Background: Testis-specific gene antigen (TSGA10) mainly involves in spermatogenesis and embryogenesis. In the new defined roles, being a tumor suppressor agent or a cancer/testis antigen (CTA) is still unclear for this protein. The current study aimed to examine exact role of TSGA10 as a tumor suppressor or CTA in breast cancer and evaluate the role of microenvironment on its expression. Methods: This study evaluated the expression of TSGA10 and hypoxia-inducible factor 1α (HIF-1α) in two different breast cancer cell lines (MCF-7 and MDA-MB23) as well as their control (MCF10A) using real-time PCR. Moreover, expression of the mentioned genes evaluated in samples obtained from tumoral tissues with two types of controls: paired (tumor-free margin) and unpaired (healthy individuals). Also, in order to asses TSGA10 levels in the tumoral tissues, western blotting was performed. Furthermore, to evaluate the role epigenetic changes on TSGA10 expression, breast cancer cell lines were treated with a histone deacetylase inhibitor (HDACI) as well as H2O2 for oxidative stress induction. Results: The current study evaluated 36 patients diagnosed with breast cancer as well as 10 healthy controls. According to the results, it was shown that 35 (97.7%) and 1 (2.8%) of patients were diagnosed with ductal and lobular carcinomas respectively. The TSGA10 levels in the tumoral samples showed 1.38±0.014-fold decrease and 1.41±0.127-fold increase compared with their paired (P<0.001) and unpaired (P<0.001) controls respectively. Moreover, results of blotting in tumoral tissues expressed significant decrease in TSGA10 levels in comparison to the paired controls (P<0.01). Among the cell lines, TSGA10 expression in MCF-7 and MDA-MB23 cells had 4.9±0.283 and 4.21±0.163 folds of decrease in normoxic and 4.7±.0.283 and 7.1±0.141 folds of expression reduction in hypoxic condition respectively (all P<0.0001). Furthermore, the results showed that HIF-1α expression was up-regulated in both normoxic (P<0.01) and hypoxic (P<0.01) conditions. Also, TSGA10 expression increased up to 7.39±0.156 folds in MCF-7 cells after HDACI treatment (all P<0.01). However, MDA-MB23 cells firstly experienced a decrease and then a notable increase in TSGA10 expression (all P<0.01). Conclusion: Results of current study showed that TSGA10 seems to be tumor suppressor, however, further studies are necessary.
High UBE2T mRNA expression and its prognostic significance in Ovarian cancer: a study based on data mining
Authors: Cai Fu-Cheng
Published: January 2020

Background Ovarian cancer (OC) affects about 22 000 women annually in the US and ranks 5th in cancer deaths, largely due to diagnosed with advanced stage. Epithelial ovarian cancer (EOC) accounts for approximately 90% of all ovarian cancer cases. Our study was to assess the prognostic meaningful of UBE2T expression in OC dependent on data acquired from TCGA and so as to increase further knowledge into the biological pathways involved in OC pathogenesis related to UBE2T. Methods Information on gene expression and comparing clinical data were recognized and downloaded from TCGA. Gene set enrichment analysis (GSEA) created an arranged list of all genes s indicated by their connection with UBE2T expression. Results The scatter plot showed the difference of UBE2T expression between normal and tumor samples ( P <0.01). So as to decide the biological interaction network of UBE2T in OC, we used to tab Network in cBioPortal and the 50 most as often altered neighbor genes of UBE2T were demonstrated utilizing Network and the most frequent alterations were HES1. The GSEA results showed that cell cycle, DNA replication, RNA degradation, some cancers, spliceosome, Huntington’s disease, oxidative phosphorylation are differentially enriched in UBE2T high expression phenotype. Cumulative survive showed that dendritic cell of immune infiltrates statistically significant ( P <0.05) of UBE2T in OC suggesting that dendritic cell significantly affecting the prognosis, it is worth more research and exploration. Conclusion Our study found that the expression of UBE2T was significantly increased in OC patients and associated with several clinical features. UBE2T may be a potentially useful prognostic molecular biomarker of bad survival in OC, while further experimental ought to be performed to demonstrate the biologic effect of UBE2T.
A comparison of medical student competency, attitudes and knowledge of abortion care after a structured clinical curriculum
Authors: Gardner Hallie , Zimmerman Marguerite , Flanigan Moira , Baldwin Maureen K
Published: January 2020

Background: Abortion care is a core educational objective according to the Association of Professors of Gynecology and Obstetrics (APGO), but clinical exposure is variable in medical education. The authors sought to compare professional competency, attitudes, and knowledge regarding abortion between students who attended a structured clinical experience in abortion care to those who chose a less-structured family planning clinical environment. Methods: All medical students participating in the Obstetrics & Gynecology clerkship from 2014-2015 were invited to complete a pre- and post-clerkship survey and grouped based on their attendance to a structured clinical abortion experience at Planned Parenthood (PPCW) versus an alternative Family Planning Clinic (FPC) experience. Competency and attitudes about abortion were assessed using a 100-mm visual analog scale (VAS). Authors assessed knowledge about abortion with multiple-choice questions. Results: A total of 89 students completed the surveys (PPCW: 74; FPC: 15). Students attending PPCW were more likely to observe counseling about abortion and ultrasound prior to abortion (PPCW: 67/74, 91%; FPC: 4/15, 27%, p=<0.01). More PPWC students observed a surgical abortion (91% versus 7% of FPC students). Competency scores improved with composite mean difference in VAS for PPCW of 42.2 mm and FPC of 27.3 mm (p=0.02). Attitude scores were unchanged in those with initial VAS <80 mm. Knowledge improved overall, with greater changes among the PPCW group. Conclusions: A structured clinical abortion experience met APGO educational objectives more than an alternative experience. Future physicians should universally be exposed to clinical abortion care in order to ensure evidence-based education about abortion.