bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of a vocational rehabilitation programme on return to work among sick-listed primary health care patients A population-based matched, case-control study
Authors: von Celsing Anna-Sophia , Kristiansson Per , Svärdsudd Kurt , Wallman Thorne
Published: February 2020

Background: To evaluate the efficacy of a multidisciplinary vocational programme in sick-listed, primary health care patients as compared to matched non-programme patients. Methods: The design was a 3-year prospective population-based, matched case-control study. It was set in a large primary healthcare centre in the city of Eskilstuna, Sweden. The subjects were 943 sickness-certified patients (482 women and 461 men). Intervention: 170 high-risk patients and a matched control group (n = 340) with similar risk for not returning to work within expected time, based on propensity score was created. The intervention group passed a multidisciplinary medical assessment and a coordinated vocational programme, while the control group received usual care by their general practitioner. Main outcome measures: Sick leave conclusion and the day when it occurred. Results: The follow-up time was subdivided into four periods. During the first two periods, days 1–14 and days 15–112 after baseline, the intervention group had a significantly lower sick leave conclusion rate than the control group (hazard ratios, (HR) 0.32, 95% CI 0.20–0.51, p < 0.0001 and 0.47, 95% CI 0.35–0.64). During the third period, days 113–365, the intervention group had an insignificantly lower conclusion rate (HR 0.70, 95% CI 0.46–1.08, p = 0.10), and during the fourth follow-up period, days 366–1096, the intervention group had an insignificantly higher conclusion rate than the control group (HR 1.16, 95% CI 0.69–1.96, p = 0.58). Across the total follow-up period, the intervention group had a lower conclusion rate than the control group (HR 0.55, 95% CI 0.45–0.66, p < 0.0001). Conclusions: No positive significant effects of the rehabilitation programme on time to sick leave conclusion were found.
Community perceptions about dementia in southwestern Uganda
Authors: Owokuhaisa Judith , Rukundo Godfrey Zari , Wakida Edith , Obua Celestino , Buss Stephanie S.
Published: February 2020

Background

With the increasing number of people surviving into older age in Africa, dementia is becoming a public health concern. Understanding the social dynamics of dementia in resource-limited settings is critical for developing effective interventions. We explored community perceptions about people with dementia in southwestern Uganda.

Methods

Fifty-nine individuals (aged 19-85 years, 56% female) participated in seven focus group discussions. In addition, 22 individual in-depth interviews were conducted among individuals (aged 22-84 years, 36% female). Both interviews and focus group discussions were audio recorded, transcribed verbatim, and evaluated using a quantitative content analysis approach.

Results

Five themes were generated during content analysis: i) Labeling of the illness, ii) Presentation of the person with dementia, iii) Causation, iv) Impact of the disease on people with dementia and their caregivers and v) Views on how to address unmet needs in dementia care. Dementia was commonly referred to as “ okuhuga ” or “okwebwayebwa” (also, oruhuzyo/ empugye / akahuriko) which translates as “mental disorientation”. The participants reported that most people with dementia presented with forgetfulness, defecating and urinating on themselves, wandering away from home, going out naked, and picking up garbage. Some participants perceived memory problems as a normal part of the aging process, while others attributed the cause of dementia to syphilis, cancer, allergy, old age, satanic powers, witchcraft, poor nutrition, or life stress. Participants reported multiple sources of stress for caregivers of people with dementia, including financial, social, and emotional burdens. Finally, participants suggested that community and governmental organizations should be involved in meeting the needs of people with dementia and their caregivers.

Conclusions

Community members in southwestern Uganda largely identified dementia as a problem that comes with older age, and can identify key features of dementia presentation. Participants identified significant stressors affecting people with dementia and their caregivers, and reported that families and caregivers would benefit from education on the management of symptoms of dementia, and assistance in overcoming associated financial, social, and emotional burdens related to caretaking.
Social networks and quality of life among female breast cancer patients at Tikur Anbessa Specialzed Hospital, Addis Ababa, Ethiopia 2019
Authors: Aberaraw Rahle , Boka Abdisa , Teshome Roza , Yeshambel Addisu
Published: February 2020

Background: Breast cancer is a major life-threatening global public health problem. It is the most common form of cancer in females in many developing countries including Ethiopia. Social networks could change the course of cancer and can influence the quality of life among breast cancer patients. Therefore, the purpose of this study was to assess social networks and quality of life among female breast cancer patients attending in Tikur Anbassa Specialized Hospital, Addis Ababa, Ethiopia 2019. Methods: An institutional-based cross-sectional study was conducted in Tikur Anbessa Specialized Hospital Addis Ababa, Ethiopia from March 1 to April 30/2019. A total of 214 female breast cancer patients were included Binary and multiple logistic regression was used to show the association of social networks and quality of life. Result: A total of 214 females with breast cancer were recruited with a mean age of 41.85. Participants who had children (AOR=5, 95%CL: 1.3,21 COR=6), and other relatives (AOR=6, 95%CI: 1.2,30, COR=7), were more likely to have good social networks. Participants who were not married (AOR=0.02, 95%CI: 0.03, 0.28), had no parents living (AOR=0.1, 95%CI: 0.02, 0.4), no close friends (AOR=0.06, 95%CI: 0.01, 0.4), and no neighbors (AOR=0.09, 95%CI: 0.03, 0.5) had poor social networks. Conclusion: The quality of life was relatively low and social networks were found to be poor in women with breast cancer. Health-care providers in oncology departments need to focus on addressing the side effects of therapy and social networks which may help to improve the quality of life of females with breast cancer.
Differentiation of suprasellar meningiomas from non-functioning pituitary macroadenomas by 18F-FDG and 13N-Ammonia PET/CT
Authors: Ding Lei , Zhang Fangling , He Qiao , Li Zhoulei , Shi Xinchong , Li Ruocheng , Zhang Xiangsong
Published: February 2020

Background: Differentiation of suprasellar meningiomas (SSMs) from non-functioning pituitary macroadenomas (NFPMAs) is useful for clinical management. We investigated the utility of 13 N-ammonia combined with 18 F-FDG positron emission tomography (PET)/computed tomography (CT) in distinguishing SSMs from NFPMAs retrospectively. Methods: Fourteen NFPMAs patients and eleven SSMs patients with histopathologic diagnosis were included in this study. Every patient underwent both 18 F-FDG and 13 N-ammonia PET/CT scans. The tumor to gray matter (T/G) ratios were calculated for the evaluation of tumor uptake. Results: The uptake of 18 F-FDG was higher in NFPMAs than SSMs, whereas the uptake of 1 3 N- ammonia was obviously lower in NFPMAs than SSMs. The differences of 18 F-FDG and 13 N-ammonia uptake between the two groups were significant respectively (0.92[0.46] vs 0.59[0.29], P <0.05, 18 F-FDG; 1.58±0.56 vs 2.80±1.45, P <0.05, 13 N-ammonia). Tumor classification demonstrated a high overall accuracy of 96.0% for differential diagnosis. When the two traces were combined, only 1 SSM was misclassified into the NFPMA group. Conclusion : SSMs and NFPMAs have different metabolic characteristics on 18 F-FDG and 13 N-ammonia PET images. The combination of these two tracers can effectively distinguish SSMs from NFPMAs.
Communication mediums used by patients and health professionals during access and provision of healthcare in low resource settings: A cross-sectional study
Authors: Dongyele Mathias , Ansong Daniel , Adjei Francis Osei , Xamuzu Evans , Mensah Nicholas Karikari , Owusu Alfred Kwame , Dankwa Bright Atta , Newton Sam Kofi , Odoom Samuel Frimpong , Bonney Joseph , Adjei Duncan , Amusu Anne , Akowuah Emmanuel Kofi , Lartey Kelvin , Appiah Christopher Seth Yaw
Published: February 2020

Background: The issue with communication mediums during service provision and for making enquiries to a hospital on the type of services available, availability of physicians and beds at the receiving hospitals, and a reminder system remains a challenge for patients and providers of the health service in sub-Sharan Africa. This present study sought to review the existing healthcare communication mediums from the perspectives of patients and health professionals at the Komfo Anokye Teaching Hospital, Kumasi Ghana. Method: A descriptive cross-sectional design was employed with a multilevel sampling method to select a total of 651 participants consisting of 304 patients, 303 health workers and 44 hospital directorate managers for the study. A well-structured survey questionnaire was used to collect data from respondents. Results: Most hospital staff (66.4%) used a blend of social media and direct means (face-to-face medium) to communicate among themselves whereas 89.8% only communicates with management through meetings sections. Predominantly, 97.4% of the staff communicated by direct means (face-to-face medium) with patients. Almost all management members of the hospital communicated with the general public using letters and official memos. Conclusions: There is evidence of combination of both traditional mediums (face-to-face) and the technological mediums (social media) for communications by health providers and health consumers. However, there is a dissatisfaction with delayed information flow and poor feedbacks with the use of the traditional mediums. Therefore, a digital mobile application communication system is recommended to offer efficient communication within and outside the Ghanaian health facilities.
Establishment of a type 1 diabetes structured education programme suitable for Chinese patients: Type 1 Diabetes Education in Lifestyle and Self Adjustment (TELSA)
Authors: Xie Yuting , Liu Fang , Huang Fansu , Lan Chunna , Guo Jia , He Jing , Li Lezhi , Li Xia , Zhou Zhiguang
Published: February 2020

Background: Various guidelines recommend that all adults diagnosed with type 1 diabetes (T1D) should be offered an evidence based, structured education programme (SEP) to optimize self-management care. China has a 13,000 annual increase in newly diagnosed T1D cases and is now the fourth largest country in the number of new T1D cases per year. However, there is yet no validated SEP targeted to T1D patients in China. The purpose of this study is to establish a structured T1D self-management education programme—‘Type 1 Diabetes Education in Lifestyle and Self Adjustment’ (TELSA) that is adapted to medical and cultural practices in China.
Methods: TELSA programme was developed based on the ADDIE model, following three steps: i) Semi-structured interviews were administered to 10 healthcare professionals (HCPs) and 13 T1D patients. Different topic guides, focusing on 4 dimensions including goals, contents, format of delivery, and quality assurance, were designed for either HCPs or patients. The interviews were recorded and analysed with thematic analysis. ii) Extracted themes were modified according to Delphi consultation. iii) Preliminary courses were conducted as pilot study to evaluate the effects of TELSA and optimization of the curriculum was finalized accordingly.
Results: A total of 18 themes in 4 dimensions of the programme design were identified in the final version: i) goals: ‘behaviour modification’ and ‘outcome improvement’; ii) contents: ‘living with T1D’, ‘self-monitoring of blood glucose’, ‘knowing insulin’, ‘insulin dose adjustment’, ‘carbohydrates and carbohydrate counting’, ‘hypoglycaemia’, ‘complications’, ‘managing psychological issues’, ‘physical activities’, and ‘question-and-answer’; iii) format: ‘multidisciplinary team combined with peer support’, ‘face-to-face education followed with distal learning’, and ‘2-day programme held on weekends’; and iv) quality assurance: ‘after-class quiz’, ‘patients’ feedback’, and ‘long-term evaluation on effectiveness’.
Conclusions: A type 1 diabetes structured education programme in China was set up and shown to be applicable under local medical, social, and cultural environment.
Lifetime risk assessment in cholesterol management among hypertensive patients: Observational cross-sectional study based on electronic health record data.
Authors: Tahkola Aapo , Korhonen Päivi , Kautiainen Hannu , Niiranen Teemu , Mäntyselkä Pekka
Published: February 2020

Background
In hypertensive patients, reducing plasma low-density lipoprotein cholesterol level (LDL-C) is one of the main interventions for preventing chronic cardiovascular diseases (CVD). However, LDL-C control remains generally insufficient, also in patients with hypertension. We analyzed Electronic Health Record (EHR) data of 7117 hypertensive patients to find the most potential age and sex subgroups in greatest need for improvement in real life dyslipidemia treatment. Taking into account the current discussion on lifetime CVD risk, we focused on the age dependence in LDL-C control.
Methods
In this observational cross-sectional study, based on routine electronic health record (EHR) data, we investigated LDL-C control of hypertensive, non-diabetic patients without renal dysfunction or CVD, aged 30 years or more in Finnish primary care setting.
Results
More than half (54% of women and 53 % of men) of untreated patients did not meet the LDL-C target of <3 mmol/l and one third (35% of women and 33 % of men) of patients did not reach the target even with the lipid-lowering medication (LLM). Furthermore, higher age was strongly associated with better LDL-C control (p<0.001) and lower LDL-C level (p<0.001) in individuals with and without LLM. Higher age was also strongly associated with LLM prescription (p<0.001). In total, about half of the patients were on LLM (53% of women and 51 % of men).
Conclusions
Our findings indicate that dyslipidemia treatment among Finnish primary care hypertensive patients is generally insufficient, particularly in younger age groups who might benefit the most from CVD risk reduction over time. Clinicians should probably rely more on the lifetime risk of CVD, especially when treating working age hypertensive patients.
Genome-wide analysis of long non-coding RNAs (lncRNAs) in two contrasting rapeseed (Brassica napus L.) genotypes subjected to drought stress and re-watering
Authors: Tan Xiaoyu , Li Su , Hu Liyong , Zhang Chunlei
Published: February 2020

Background: Drought stress is a major abiotic factor that affects rapeseed ( Brassica napus L.) productivity. Though previous studies indicated that long non-coding RNAs (lncRNAs) play a key role in response to drought stress, a scheme for genome-wide identification and characterization of lncRNAs’ response to drought stress is still lacking, especially in the case of B . napus . In order to further understand the molecular mechanism of the response of B . napus to drought stress, we compared changes in the transcriptome between Q2 (a drought-tolerant genotype) and Qinyou8 (a drought-sensitive genotype) in response to drought stress and rehydration treatment at the seedling stage.
Results: A total of 5,546 down-regulated and 6,997 up-regulated mRNAs were detected in Q2 compared with 7,824 and 10,251 in Qinyou8, respectively; 369 down-regulated and 108 up-regulated lncRNAs were detected in Q2 compared with 449 and 257 in Qinyou8, respectively. LncRNA- mRNA interaction network analysis indicated that the co-expression network of Q2 was composed of 145 network nodes and 5,175 connections, while the co-expression network of Qinyou8 was composed of 305 network nodes and 22,327 connections. We further identified 34 TFs corresponding to 126 differentially expressed lncRNAs in Q2, and 45 TFs corresponding to 359 differentially expressed lncRNAs in Qinyou8. Differential expression analysis of lncRNAs indicated that up- and down-regulated mRNAs co-expressed with lncRNAs participated in different metabolic pathways and were involved in different regulatory mechanisms in the two genotypes . Notably, some lncRNAs were co-expressed with BnaC07g44670D, which are associated with plant hormone signal transduction. Additionally, some mRNAs which were co-located with XLOC_052298, XLOC_094954 and XLOC_012868 were mainly categorized as signal transport and defense/stress response.
Conclusions: The results of this study increased our understanding of expression characterization of rapeseed lncRNAs in response to drought stress and re-watering, which would be useful to provide a reference for the further study of the function and action mechanisms of lncRNAs under drought stress and re-watering.
Comparative transcriptome analysis reveals evolutionary divergence and shared network of cold and salt stress response in diploid D-genome cotton
Authors: Xu Yanchao , Magwanga Richard , Jin Dingsha , Cai Xiaoyan , Hou Yuqing , Zheng Juyun , Agong Stephen Gaya , Zhou Baoliang , Wang Kunbo , Liu Fang , Zhou Zhongli
Published: February 2020

Background
Wild species of cotton are excellent resistance to abiotic stress. Diploid D-genome cotton showed abundant phenotypic diversity and was the putative donor species of allotetraploid cotton which produce largest textile natural fiber.
Results
A total of 41,053 genes were expressed in all samples by mapping RNA-seq Illumina reads of G. thurberi (D1), G. klotzschianum (D3-k), G. raimondii (D5) and G. trilobum (D8) to reference genome. The numbers of differently expressed genes (DEGs) were significantly higher under cold stress than salt stress. However, 34.1% DEGs under salt stress were overlapped with cold stress in four species. Notably, a potential shared network (cold and salt response, including 16 genes) was mined out by gene co-expression analysis. Totally, 47,180- 55,548 unique genes were identified in four diploid species by De novo assembly. Furthermore, 163, 344, 330 and 161 positively selected genes (PSGs) were detected in thurberi, G. klotzschianum, G. raimondii and G. trilobum by evolutionary analysis, respectively, and 9.5% - 17% PSGs of four species were DEGs in corresponding species under cold or salt stress. What’s more, most of PSGs were enriched GO term related to response to stimulation. G. klotzschianum showed best tolerance under both cold and salt stress. Interestingly, we found that a RALF-like protein coding gene not only is PSGs of G. klotzschianum, but also belongs to the potential shared network.
Conclusion
Our study provided new evidence that gene expression variations of evolution by natural selection were essential drivers of the morphological variations related to environmental adaptation during evolution. Additionally, there exist shared regulated networks under cold and salt stress, such as Ca2+ signal transduction and oxidation reduction processes. Our work establishes a transcriptomic selection mechanism for altering gene expression of four diploid D-genome cotton, and provides available gene resource underlying multi-abiotic resistant cotton breeding strategy.
Elastography for the Diagnosis of High-Suspicion Thyroid Nodules Based on the 2015 American Thyroid Association Guidelines: A Multicenter Study
Authors: Li Hairu , Peng Yulan , Wang Yan , Ai Hong , Zhou Xiaodong , Yang Lichun , Yan Kun , Xiao Ying , Liu Lisha , Luo Baoming , Yong Qiang , Cong Shuzhen , Jiang Shuangquan , Fu Xin , Ma Buyun , Li Yi , Zhang Xixi , Gong Xue , Chen Haitao , Liu Wenying , Tang Ling , LV Xiaoyu , Zhao Xinbao , Li Liang , Gan Kehong , Tian Jiawei
Published: February 2020

Background: An accurate diagnosis for high-suspicion nodules based on the 2015 American Thyroid Association (ATA) guidelines would reduce unnecessary invasive examinations. Elastography is a useful tool for discriminating benign and malignant thyroid nodules. Aims: To investigate the diagnostic efficiency of elastography for high-suspicion thyroid nodules based on the 2015 ATA guidelines in the Chinese population. Materials and Methods: Thyroid nodules with high-suspicion characteristics based on the 2015 ATA guidelines were subjected to conventional ultrasound (US) and ultrasound strain elastography (USE) examinations at 12 hospitals from 4 geographic regions across China. Cytology/histology of thyroid nodules was used as a reference method. Receiver operating characteristic (ROC) curves were plotted to evaluate the diagnostic performance of the elasticity score (ES) and strain ratio (SR). Logistic regression analysis was used to determine the predictors of malignancy. Results: Overall, a total of 1445 thyroid nodules (834 malignant, 611 benign) from 12 centers were included in the final analysis. The areas under the curve of the ES and SR were 0.828 and 0.732, respectively. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of the ES were 92.4%, 60.7%, 79.0%, 76.3% and 85.5% , respectively, and those of the SR were 81.1%, 50.1%, 68.9%, 65.9% and 67.9%, respectively. The combination of the Thyroid Imaging Reporting and Data System (TI-RADS) and ES led to a significant increase in the sensitivity and NPV (97.1% and 91.9%, respectively) compared with the TI-RADS alone. Logistic regression analysis showed that microcalcifications (OR=5.290), taller than wide (OR=12.710), irregular margins (OR=10.117), extrathyroidal extension (ETE; OR=6.412), the ES (OR=3.741) and the SR (OR=1.083) were independent predictors of malignant thyroid nodules. The sensitivity, specificity, accuracy, PPV and NPV of the ES were all superior in nodules ≥1 cm than in those <1 cm (95.0% vs 90.4%, 68.8% vs 56.8%, 85.9% vs 74.4%, 85.2% vs 69.9%, and 87.8% vs 84.2%, respectively). Conclusions: Elastography combined with the ES is a valuable tool for the assessment of high-suspicion thyroid nodules based on the 2015 ATA guidelines, especially in nodules ≥1 cm.
Midbrain/pons area ratio and clinical features predict the prognosis of Progressive Supranuclear Palsy
Authors: Cui Shishuang , Ling Huawei , Du Juanjuan , Lin Yiqi , Pan Jing , Zhou Haiyan , Wang Gang , Wang Ying , Xiao Qin , Liu Jun , Tan Yuyan , Chen Shengdi
Published: February 2020

Backgrounds: Progressive Supranuclear Palsy (PSP) is a rare movement disorder with poor prognosis. This retrospective study aims to characterize the natural history of PSP and to find predictors of shorter survival and faster decline of activity of daily living. Method: All patients recruited fulfilled the movement disorder society (MDS) clinical diagnostic criteria for PSP (MDS-PSP criteria) for probable and possible PSP with median 12 years. Data were obtained including age, sex, date of onset, age at onset (AAO), symptoms reported at first visit and follow-up, date of death and date of institutionalization. Magnetic resonance imaging was collected at the first visit. Endpoints were death and institutionalization. Kaplan-Meier method and Cox proportional hazard model were used to explore factors associated with early death and institutionalization. Results: 59 patients fulfilling MDS-PSP criteria were enrolled in our study. 19 patients (32.2%) had died and 31 patients (52.5%) were institutionalizedl by the end of the follow-up. Predictors associated with poorer survival were late-onset PSP and decreased M/P area ratio. Predictors associated with earlier institutionalization were older AAO and decreased M/P area ratio. Conclusion: older and decreased M/P area ratio were predictors for earlier dearth and institutionalization in PSP. The neuroimaging biomarker M/P area ratio was a predictor for prognosis in PSP.
Assessing capacity of health facilities to provide routine maternal and newborn care in low-income settings: what proportions are ready to provide good-quality care, and what proportions of women receive it?
Authors: Tomlin Keith , Berhanu Della , Gautham Meenakshi , Umar Nasir , Schellenberg Joanna , Wickremasinghe Deepthi , Marchant Tanya
Published: February 2020

Background
Good quality maternal and newborn care at primary health facilities is essential, but in settings with high maternal and newborn mortality the evidence for the protective effect of facility delivery is inconsistent. We surveyed samples of health facilities in three settings with high maternal mortality to assess their readiness to provide routine maternal and newborn care, and proportions of women using facilities that were ready to offer good quality care. Surveys were conducted in 2012 and 2015 to assess changes over time.
Methods
Surveys were conducted in Ethiopia, the Indian state of Uttar Pradesh and Gombe State in North-Eastern Nigeria. At each facility the staffing, infrastructure and commodities were quantified. These formed components of four “signal functions” that describe aspects of routine maternal and newborn care. A facility was considered ready to perform a signal function if all the required components were present. Readiness to perform all four signal functions classed a facility as ready to provide good quality routine care. From facility registers we counted deliveries and calculated the proportions of women delivering in facilities ready to offer good quality routine care.
Results
In Ethiopia the proportion of deliveries in facilities classed as ready to offer good quality routine care rose from 40% (95% confidence interval (CI) 26-57) in 2012 to 43% (95% CI 31-56) in 2015. In Uttar Pradesh these estimates were 4% (95% CI 1-24) in 2012 and 39% (95% CI 25-55) in 2015, while in Nigeria they were 25% (95% CI 6-66) in 2012 and zero in 2015. Improved facility readiness in Ethiopia and Uttar Pradesh arose from increased supplies of commodities, while in Nigeria facility readiness fell due to depleted commodity supplies and fewer Skilled Birth Attendants.
Conclusions
This study quantifies the readiness of health facilities to offer good quality routine maternal and newborn care, and may help explain inconsistent outcomes of facility care in some settings. Signal function methodology can provide a rapid and inexpensive measure of such facility readiness. Incorporating data on facility deliveries and repeating the analyses highlights the adjustments that could have greatest impact upon routine maternal and newborn care.
Enhancing Xanthine Dehydrogenase Activity is an Effective Way to Delay Leaf Senescence and Increase Rice Yield
Authors: Han Ruicai , He Xunfeng , Pan Xiaohua , Shi Qinghua , Wu Ziming
Published: February 2020

Xanthine dehydrogenase (XDH) is an important enzyme in purine metabolism. It is involved in regulation of the normal growth and non-biological stress-induced ageing processes in plants. The present study investigated XDH’s role in regulating rice leaf senescence. We measured physical characteristics, chlorophyll content and fluorescence parameters, active oxygen metabolism, and purine metabolism in wild-type Kitaake rice ( Oryza sativa L.), an OsXDH over-expression transgenic line ( OE9 ), and an OsXDH RNA interference line ( Ri3 ) during different growth stages. The expression patterns of the OsXDH gene confirmed that XDH was involved in the regulation of normal and abiotic stress-induced ageing processes in rice. There was no significant difference between the phenotypes of transgenic lines and wild type at the seedling stage, but differences were observed at the full heading and maturation stages. The OE9 plants were taller, with higher chlorophyll content, and their photosystems had stronger light energy absorption, transmission, dissipation, and distribution capacity, which ultimately improved the seed setting rate and 1000-seed weight. The opposite effect was found in the Ri3 plants. The OE9 line had a strong ability to remove reactive oxygen species, with increased accumulation of allantoin and alantoate. Experimental spraying of allantoin on leaves showed that it could alleviate chlorophyll degradation and decrease the content of H 2 O 2 and malonaldehyde (MDA) in rice leaves after the full heading stage. The urate oxidase gene ( UO ) expression levels in the interference line were significantly lower than those in the over-expression line and wild-type lines. The allantoinase ( ALN ) and allantoate amidinohydrolase ( AAH ) genes had significantly higher expression in the Ri3 plants than the in OE9 or wild-type plants, with OE9 plants showing the lowest levels. The senescence-related genes ACD1 , WRKY23 , WRKY53 , SGR , XERO1 , and GH27 in Ri3 plants had the highest expression levels, followed by those in the wild-type plants, with OE9 plants showing the lowest levels. These results suggest that enhanced activity of XDH can regulate the synthesis of urea-related substances, improve plant antioxidant capacity, effectively delay the ageing process in rice leaves, and increase rice yield.
Improving the diagnosis of common parotid tumors via the combination of CT image biomarkers and clinical parameters
Authors: Zhang Dan , Li Xiaojiao , Lv Liang , Yu Jiayi , Yang Chao , Xiong Hua , Liao Ruikun , Zhou Bi , Huang Xianlong , Liu Xiaoshuang , tang zhuoyue
Published: February 2020

Objective: To develop and validate diagnostic models of the common parotid tumors based on whole-volume CT textural image biomarkers (IBMs) in combination with clinical parameters at a single institution.
Methods: The study cohort was composed of 51 pleomorphic adenoma (PA) patients and 42 Warthin tumor (WT) patients. Clinical parameters and conventional image features were scored retrospectively and textural IBMs were extracted from CT images of arterial phase . Independent-samples t test or Chi-square test was used for evaluating the significance of the difference among clinical parameters, conventional CT image features, and textural IBMs. The diagnostic performance of univariate model and multivariate model was evaluated via receiver operating characteristic (ROC) curve and area under ROC curve (AUC).
Results: Significant differences were found in clinical parameters (age, gender, disease duration, smoking), conventional image features (site, maximum diameter, time-density curve, peripheral vessels sign) and textural IBMs (mean, uniformity, energy, entropy) between PA group and WT group (P＜0.05). ROC analysis showed that clinical parameter (age) and quantitative textural IBMs (mean, energy, entropy) were able to categorize the patients into PA group and WT group, with the AUC of 0.784, 0.902, 0.910, 0.805, respectively. When IBMs were added in clinical model, the multivariate models including age-mean and age-energy performed significantly better than the univariate models with the improved AUC of 0.940, 0.944, respectively (P＜0.001).
Conclusions: Both clinical parameter and CT textural IBMs can be used for the preoperative, noninvasive diagnosis of parotid PA and WT. The diagnostic performance of textural IBM model was obviously better than that of clinical model and conventional image model in this study. While the multivariate model consisted of clinical parameter and textural IBM had the optimal diagnostic performance, which would contribute to the better selection of individualized surgery program.
Burden and associated factors of Scabies outbreak in Guna-begemidir district, south Gondar, Amhara, Ethiopia, 2018
Authors: Adamu Temesgen Anteye , Tsegaye Adino Tesfahun
Published: February 2020

Background Scabies is an infestation of the skin by the human itch mite ( Sarcoptes scabiei var. hominis ). The parasite is found worldwide and affects people of all races and social classes. Studies shows that the prevalence of scabies is far different as 0.2% in developed countries up to 24% in developing countries. Ethiopia also reports scabies outbreak frequently since 2017. Recent studies show that the attack rate was 25% in Gondar city in Yekolo-temaries and 11% at Badewacho District, Southern Ethiopia. Methods A community based unmatched case-control (1:2 ratios) study was conducted in guna-begemidir district, using collected scabies line listed data and face to face interview to assess risk factors from January to February 2018 with sample size of 156 cases and 312 control. The data were collected using structured questionnaire, and analyzed using SPSS version 22 statistical software. Odds Ratios (OR), P value and 95% Confidence interval (CI) was computed to determine associated factors. Result A total of 4269 scabies case were reported from the district, attack rate of 7.9%. Of those cases 2254 (52.8%) were males. 10 (52.6%) kebeles were affected by the outbreak. The attack rate varies by kebeles which ranges from 0.88% to 25.5%. The highest attack rate was in mena-medihanealem kebele which is 25.5%. Sleeping with Scabies Patients, washing with scabies patients in the past 6 months, putting of cloths with diseased patient cloths and Household daily water consumption were significantly associated with scabies diseases on multivariable analysis. Conclusion and recommendation Scabies is public health problem in the district. Due to delayed detection and response, the disease was highly disseminated mainly because of drug shortage throughout the region. We recommend enhancing, strong ongoing active case surveillance of scabies; health education & availing drugs to all health facilities and do more on the above significant variables.
Transcriptional reprogramming strategies and miRNA-mediated regulation networks of Taxus media induced into callus cells from tissues
Authors: Chen Ying , Zhang Meng , Jin Xiaofei , Tao Haoran , Wang Yamin , Peng Bo , Fu Chunhua , Yu Longjiang
Published: February 2020

Background Taxus cells are a potential sustainable and environment-friendly source of taxol, but they have low survival ratios and slow grow rates. Despite these limitations, Taxus callus cells induced through 6 months of culture contain more taxol than their parent tissues. In this work, we utilized 6-month-old Taxus media calli to investigate their regulatory mechanisms of taxol biosynthesis by applying multiomics technologies. Our results provide insights into the adaptation strategies of T. media by transcriptional reprogramming when induced into calli from parent tissues. Results Seven out of 12 known taxol, most of flavonoid and phenylpropanoid biosynthesis genes were significantly upregulated in callus cells relative to that in the parent tissue, thus indicating that secondary metabolism is significantly strengthened. The expression of genes involved in pathways metabolizing biological materials, such as amino acids and sugars, also dramatically increased because all nutrients are supplied from the medium. The expression level of 94.1% genes involved in photosynthesis significantly decreased. These results reveal that callus cells undergo transcriptional reprogramming and transition into heterotrophs. Interestingly, common defense and immune activities, such as “plant–pathogen interaction” and salicylic acid- and jasmonic acid-signaling transduction, were repressed in calli. Thus, it’s an intelligent adaption strategy to use secondary metabolites as a cost-effective defense system. MiRNA- and degradome-sequencing results showed the involvement of a precise regulatory network in the miRNA-mediated transcriptional reprogramming of calli. MiRNAs act as direct regulators to enhance the metabolism of biological substances and repress defense activities. Given that only 17 genes of secondary metabolite biosynthesis were effectively regulated, miRNAs are likely to play intermediate roles in the biosynthesis of secondary metabolites by regulating transcriptional factors (TFs), such as ERF, WRKY, and SPL. Conclusion Our results suggest that increasing the biosynthesis of taxol and other secondary metabolites is an active regulatory measure of calli to adapt to heterotrophic culture, and this alteration mainly involved direct and indirect miRNA-induced transcriptional reprogramming. These results expand our understanding of the relationships among the metabolism of biological substances, the biosynthesis of secondary metabolites, and defense systems. They also provide a series of candidate miRNAs and transcription factors for taxol biosynthesis.
Diel Rhythms of Marine Picoplanktonic Communities Assessed by Comparative Metaproteomics
Authors: Geron Augustin , Werner Johannes , Lebaron Philippe , Wattiez Ruddy , Matallana-Surget Sabine
Published: February 2020

Background Diel cycle is of enormous biological importance in that it imposes temporal structure on ecosystem productivity. In the world oceans, microorganisms form complex communities that carry out about half of photosynthesis and the bulk of life-sustaining nutrient cycling. Within these natural microbial assemblages, photoautotrophs, such as Cyanobacteria , display diel rhythmicity in gene expression. To what extent autotrophs and heterotrophs are impacted by light and dark oscillations and how this collectively influences community structure and functionality remains poorly documented. In this study, we compared eight day/night metaproteome profiles of Cyanobacteria and both free-living and attached bacterial fractions from picoplanktonic communities sampled over two consecutive days from the surface north-west Mediterranean Sea. Results Our results showed similar taxonomic structure in both free-living and particle-attached bacteria, dominated by Alphaproteobacteria and Gammaproteobacteria . Temporal rhythmicity in protein expression was observed in both Synechococcales and Rhodobacterales in light-dependent processes such as photosynthesis or UV-stress response. Other biological processes, such as phosphorus or amino acid metabolisms, were also found to cycle in phototrophs. In contrast, proteins from the ubiquitous Pelagibacterales remained stable independently of the day/night oscillations. Conclusion This work integrated for the first time diel comparative metaproteomics on both free-living and particle attached bacterial fractions in coastal oligotrophic environment. Our findings demonstrated a taxa-specific response to diel cycle with a more controlled protein regulation for phototrophs. This study provided additional evidences that timekeeping mechanisms might be widespread among bacteria, broadening our knowledge on diel microbial assemblage dynamics.
The biomechanics of combined lateral and posterior plates for treating proximal humerus fractures with medial column defects
Authors: Zhang Xuedong , Dou YueChao , Wang Xuefei , Ma Jianxiong , Lu Bin , Ma Xinlong , Zhang Yakui
Published: February 2020

Background. We investigated the therapeutic effects associated with the combined use of lateral and posterior plates for treating complex proximal humerus fractures. Methods. We used in vitro biomechanical experiments and computer three-dimensional finite element analyses to investigate the biomechanical properties of combined lateral and posterior plates when treating proximal humerus fractures. Eighteen left SAWBONE (Pacific Research Labs) humerus bones were randomly divided among three groups. We established a medial column defect model for surgical neck fractures in each bone specimen and achieved fixation using a proximal humerus locking plate. Each of the three groups used a different fixation method. Group A used a Proximal Humerus Internal Locking System (PHILOS) plate support only. Group B used the PHILOS plate with a posterior locking plate (but without medial column support screws). Group C used the PHILOS plate with both the posterior locking plate and medial column support screws. We subjected three sets of specimens to axial compression, torsion, shear compression, model failure, fatigue testing, and micro-strain analyses. Results and conclusions. In vitro biomechanical analysis and three-dimensional finite element analyses showed that the PHILOS plate, in combination with the posterior locking plate and medial column support screws (Group C), had significantly enhanced biomechanical properties when compared with traditional single plate supports.
Is hip fracture surgery safe for patients on antiplatelet drugs and is it necessary to delay surgery? A Systematic Review and Meta-analysis
Authors: Yang Zhanyu , Ni Jiangdong , Long Ze , Kuang Letian , Gao Yongquan , Tao Shibin
Published: February 2020

Background: Hip fractures are common and account for a large proportion of orthopaedic surgical admissions in elderly patients. However, determining the timing for surgery has been controversial for patients who develop with hip fractures while on antiplatelet treatment.
Methods: Computerized databases for studies published from the inception date to January 2020, including the Cochrane Library, PubMed (Medline), EMBASE, Web of Science TM , ClinicalTrials, ClinicalKey and Google Scholar, were searched using the keywords “Hip AND Fracture”, “Antiplatelet”, “Antithrombocyte”, “Platelet aggregation inhibitors”, “Aspirin”, “Plavix”, and “Clopidogrel”.
Results: In total, 2328 initial articles were identified. Twenty-four studies with 5423 participants were ultimately included in our analysis. Early surgery was associated with an increased transfusion rate in the antiplatelet group compared to the non-antiplatelet group (OR = 1.21; 95% CI, 1.01 to 1.44; p = 0.03). Early surgery for hip fracture patients on antiplatelet therapy was associated with a greater decrease in haemoglobin compared to delayed surgery (WMD = 0.75; 95% CI, 0.50 to 1.00; p < 0.001). However, early surgery appeared to decrease the length of hospitalization (WMD = -6.05; 95% CI, -7.06 to -5.04; p < 0.001) and mortality (OR = 0.43; 95% CI, 0.23 to 0.79; p = 0.006).
Conclusion: It is unnecessary to delay surgery to restore platelet function when patients with hip fractures receive antiplatelet therapy. Furthermore, early surgery can significantly reduce mortality and hospital stay, which is conducive to patient recovery. Future randomized trials should determine whether the results are sustained over time.
How young female adolescents understand their pubertal body changes and reproductive system
Authors: Nayoan Christina Rony , Hoban Elizabeth , Williams Joanne
Published: February 2020

Background: Female adolescents undergo drastic changes in their bodies during puberty. Therefore, they need to be informed about these pending changes at an early age so they can build a foundation for healthy reproductive behaviour. This study explored young female adolescents’ understanding of pubertal body changes and knowledge of their reproductive system. Method: Female students in grades seven, eight and nine were recruited from eight junior high schools in Kupang, Indonesia. Body mapping was conducted together with a semi-structured interview. Data was analyzed using inductive thematic analysis. Result: The median age of participants was 13 years and more than 85% had experienced menstruation. During interviews participants listed their pubertal body changes and then located the female reproductive system on body maps. Two main themes emerged in regards to participants’ perceived pubertal body changes and understanding of reproductive system. Participants aware the changes in their five body areas and could name one or two organs in the female reproductive system but they were unable to locate them on the body maps. The body mapping exercise revealed that participants have limited knowledge of the anatomy and physiology of the female reproductive system. Conclusion: Young female adolescents demonstrated sound knowledge of pubertal body changes. However, they lacked an accurate understanding of the anatomy and physiology of the female reproductive system. The study identified a gap in young female adolescents' knowledge about the anatomy and physiology of the female reproductive system. This study provides evidence on the value of using the body mapping exercise in conjunction with semi-structured interviews in research with young female adolescents on a sensitive topic.
Factors Influencing the Use of Reproductive Health Services Among Young Women in Nepal: Analysis of the 2016 Nepal Demographic and Health Survey
Authors: Thapa Naba Raj
Published: February 2020

Background About one fifth of the total population are young people aged 15-24 years in Nepal. Utilization of reproductive health services is a key component for preventing young women from different sexual and reproductive health problems. The objective of the study is to determine the factors influencing the use of reproductive health services among young women in Nepal. Methods Data is extracted from the 2016 Nepal Demographic and Health Survey (NDHS) datasets. The weighted sample population for modern contraceptive use is restricted to the 1593 young women, 1606 young women for the antenatal care and skilled birth attendant. Three reproductive health indicators were selected as outcome variables of reproductive health service utilization for the analysis- modern contraceptive use, at least four antenatal care visits and skilled birth attendant in delivery. All calculations were based on standard sample weight of Nepal DHS. Results The study found that 21% of young women used modern contraception, 71% attended at least four ANC visits, and 67% utilized a skilled birth attendant at delivery. Young women of Janajati, women who have 1-2, and 3 and more living children, women who participate household decision-making, and have exposure to media were more likely and women who want more children were less likely to use modern contraceptives. Higher education attainment, higher wealth status, and lower birth order were associated with higher level of receiving at least four ANC visits and skilled birth attendants among young women. Young women who want more children, and who have access to media have higher odds of receiving at least four ANC visits and women who attend four and more ANC visits have higher odds of using skilled birth attendants. Conclusion To improve the use of reproductive health services among young women, efforts should be made targeting young women of low education level, low economic status, higher birth order, and low exposure to media. Further research is required to detect the barriers that effects use of reproductive health services among young women.
Routinely collected patient data in neurology research: A systematic mapping review
Authors: Biggin Frances , Emsley Hedley , Knight Jo
Published: February 2020

Background This review focuses on neurology research which uses routinely collected data. The number of such studies is growing alongside the expansion of data collection. We aim to gain a broad picture of the scope of how routine healthcare data have been utilised. Methods This study follows a systematic mapping review approach which does not make a judgement on the quality of the papers included in the review, thereby enabling a complete overview of the field. Results Of 4481 publications retrieved, 386 met the eligibility criteria for this study. These publications covered a wide range of conditions, but the majority were based on one or only a small number of neurological conditions. In particular, publications concerned with three discrete areas of neurological practice - multiple sclerosis (MS), epilepsy/seizure and Parkinson’s disease - accounted for 60% of the total. MS was the focus of the highest proportion of eligible studies (35%), yet in the recent Global Burden of Neurological Disease study it ranks only 14 th out of 15 neurological disorders for DALY rates. In contrast, migraine is the neurological disorder with the highest ranking of DALYs globally (after stroke) and yet it was represented by only 4% of eligible studies. Conclusion This review shows that there is a disproportionately large body of literature pertaining to relatively rare disorders, and a correspondingly small body of literature describing more common conditions. Therefore, there is potential for future research to redress this balance.