bluuebunny/crossref_metadata_2025 huggingface dataset:
Transcriptomic and proteomic analysis reveals mechanisms of low pollen-pistil compatibility during water lily cross breeding
Authors: Sun Chun-Qing , Chen Fa-Di , Teng Nian-Jun , Yao Yue-Mei , Shan Xi , Dai Zhong-Liang
Published: December 2019

Background

In water lily (Nymphaea) hybrid breeding, breeders often encounter non-viable seeds, which make it difficult to transfer desired or targeted genes of differentNymphaeagermplasm. We found that pre-fertilization barriers were the main factor in the failure of the hybridization ofNymphaea. The mechanism of low compatibility between the pollen and stigma remains unclear; therefore, we studied the differences of stigma transcripts and proteomes at 0, 2, and 6 h after pollination (HAP). Moreover, some regulatory genes and functional proteins that may cause low pollen-pistil compatibility inNymphaeawere identified.

Results

RNA-seq was performed for three comparisons (2 vs 0 HAP, 6 vs 2 HAP, 6 vs 0 HAP), and the number of differentially expressed genes (DEGs) was 8789 (4680 were up-regulated), 6401 (3020 were up-regulated), and 11,284 (6148 were up-regulated), respectively. Using label-free analysis, 75 (2 vs 0 HAP) proteins (43 increased and 32 decreased), nine (6 vs 2 HAP) proteins (three increased and six decreased), and 90 (6 vs 0 HAP) proteins (52 increased and 38 decreased) were defined as differentially expressed proteins (DEPs). Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses revealed that the DEGs and DEPs were mainly involved in cell wall organization or biogenesis, S-adenosylmethionine (SAM) metabolism, hydrogen peroxide decomposition and metabolism, reactive oxygen species (ROS) metabolism, secondary metabolism, secondary metabolite biosynthesis, and phenylpropanoid biosynthesis.

Conclusions

Our transcriptomic and proteomic analysis highlighted specific genes, incuding those in ROS metabolism, biosynthesis of flavonoids, SAM metabolism, cell wall organization or biogenesis and phenylpropanoid biosynthesis that warrant further study in investigations of the pollen-stigma interaction of water lily. This study strengthens our understanding of the mechanism of low pollen-pistil compatibility inNymphaeaat the molecular level, and provides a theoretical basis for overcoming the pre-fertilization barriers inNymphaeain the future.
The Sydney triage to admission risk tool (START) to improve patient flow in an emergency department: a model of care implementation pilot study
Authors: Ebker-White Anja , Bein Kendall J. , Berendsen Russell Saartje , Dinh Michael M.
Published: December 2019

Background

The Sydney Triage to Admission Risk Tool (START) is a validated clinical analytics tool designed to estimate the probability of in-patient admission based on Emergency Department triage characteristics.

Methods

This was a single centre pilot implementation study using a matched case control sample of patients assessed at ED triage. Patients in the intervention group were identified at triage by the START tool as likely requiring in-patient admission and briefly assessed by an ED Consultant. Bed management were notified of these patients and their likely admitting team based on senior early assessment. Matched controls were identified on the same day of presentation if they were admitted to the same in-patient teams as patients in the intervention group and same START score category. Outcomes were ED length of stay and proportion of patients correctly classified as an in-patient admission by the START tool.

Results

One hundred and thirteen patients were assessed using the START-based model of care. When compared with matched control patients, this intervention model of care was associated with a significant reduction in ED length of stay [301 min (IQR 225–397) versus 423 min (IQR 297–587) p < 0.001] and proportion of patients meeting 4 h length of stay thresholds increased from 24 to 45% (p < 0.001).

Conclusion

In this small pilot implementation study, the START tool, when used in conjunction with senior early assessment was associated with a reduction in ED length of stay. Further controlled studies are now underway to further examine its utility across other ED settings.
Value-based healthcare in ischemic stroke care: case-mix adjustment models for clinical and patient-reported outcomes
Authors: Oemrawsingh Arvind , van Leeuwen Nikki , Venema Esmee , Limburg Martien , de Leeuw Frank-Erik , Wijffels Markus P. , de Groot Aafke J. , Hilkens Pieter H. E. , Hazelzet Jan A. , Dippel Diederik W. J. , Bakker Carla H. , Voogdt-Pruis Helene R. , Lingsma Hester F.
Published: December 2019

Background

Patient-Reported Outcome Measures (PROMs) have been proposed for benchmarking health care quality across hospitals, which requires extensive case-mix adjustment. The current study’s aim was to develop and compare case-mix models for mortality, a functional outcome, and a patient-reported outcome measure (PROM) in ischemic stroke care.

Methods

Data from ischemic stroke patients, admitted to four stroke centers in the Netherlands between 2014 and 2016 with available outcome information (N = 1022), was analyzed. Case-mix adjustment models were developed for mortality, modified Rankin Scale (mRS) scores and EQ-5D index scores with respectively binary logistic, proportional odds and linear regression models with stepwise backward selection. Predictive ability of these models was determined with R-squared (R2) and area-under-the-receiver-operating-characteristic-curve (AUC) statistics.

Results

Age, NIHSS score on admission, and heart failure were the only common predictors across all three case-mix adjustment models. Specific predictors for the EQ-5D index score were sex (β = 0.041), socio-economic status (β = − 0.019) and nationality (β = − 0.074). R2-values for the regression models for mortality (5 predictors), mRS score (9 predictors) and EQ-5D utility score (12 predictors), were respectively R2 = 0.44, R2 = 0.42 and R2 = 0.37.

Conclusions

The set of case-mix adjustment variables for the EQ-5D at three months differed considerably from the set for clinical outcomes in stroke care. The case-mix adjustment variables that were specific to this PROM were sex, socio-economic status and nationality. These variables should be considered in future attempts to risk-adjust for PROMs during benchmarking of hospitals.
Effectiveness of incentives and follow-up on increasing survey response rates and participation in field studies
Authors: Smith Michael G. , Witte Maryam , Rocha Sarah , Basner Mathias
Published: December 2019

Background

Questionnaires are valuable data collection instruments in public health research, and can serve to pre-screen respondents for suitability in future studies. Survey non-response leads to reduced effective sample sizes and can decrease representativeness of the study population, so high response rates are needed to minimize the risk of bias. Here we present results on the success of different postal questionnaire strategies at effecting response, and the effectiveness of these strategies at recruiting participants for a field study on the effects of aircraft noise on sleep.

Methods

In total, we mailed 17 rounds of 240 questionnaires (totaln = 4080) to randomly selected households around Atlanta International Airport. Different mailing rounds were varied in the length of the questionnaire (11, 26 or 55 questions), survey incentive (gift card or $2 cash), number of follow-up waves (0, 2 or 3), incentive for participating in a 5-night in-home sleep study ($100, $150 or $200), and address personalization.

Results

We received completed questionnaires from 407 respondents (response rate 11.4%). Personalizing the address, enclosing a $2 cash incentive with the initial questionnaire mailing and repeated follow-up mailings were effective at increasing response rate. Despite the increased expense of these approaches in terms of each household mailed, the higher response rates meant that they were more cost-effective overall for obtaining an equivalent number of responses. Interest in participating in the field study decreased with age, but was unaffected by the mailing strategies or cash incentives for field study participation. The likelihood that a respondent would participate in the field study was unaffected by survey incentive, survey length, number of follow-up waves, field study incentive, age or sex.

Conclusions

Pre-issued cash incentives and sending follow-up waves could maximize the representativeness and numbers of people from which to recruit, and may be an effective strategy for improving recruitment into field studies.
Protocol, rationale and design of PEOPLE (Post ExpOsure Prophylaxis for LEprosy in the Comoros and Madagascar): a cluster randomized trial on effectiveness of different modalities of implementation of post-exposure prophylaxis of leprosy contacts
Authors: Ortuno-Gutierrez Nimer , Younoussa Assoumani , Randrianantoandro Andriamira , Braet Sofie , Cauchoix Bertrand , Ramboarina Stéphanie , Baco Abdallah , Mzembaba Aboubacar , Salim Zahara , Amidy Mohamed , Grillone Saverio , Richardus Jan Hendrik , de Jong Bouke C. , Hasker Epco
Published: December 2019

Background

Leprosy is an ancient infectious disease with a global annual incidence that has plateaued above 200,000 new cases since over a decade. New strategies are required to overcome this stalemate. Post-exposure prophylaxis (PEP) with a single dose of Rifampicin (SDR) has conditionally been recommended by the World Health Organization (WHO), based on a randomized-controlled-trial in Bangladesh. More evidence is required. The Post ExpOsure Prophylaxis for Leprosy (PEOPLE) trial will assess effectiveness of different modalities of PEP on the Comoros and Madagascar.

Methods

PEOPLE is a cluster-randomized trial with villages selected on previous leprosy-incidence and randomly allocated to four arms. Four annual door-to-door surveys will be performed in all arms. All consenting permanent residents will be screened for leprosy. Leprosy patients will be treated according to international guidelines and eligible contacts will be provided with SDR-PEP.

Arm-1 is the comparator in which no PEP will be provided. In arms 2, 3 and 4, SDR-PEP will be provided at double the regular dose (20 mg/kg) to eligible contacts aged two years and above. In arm 2 all household-members of incident leprosy patients are eligible. In arm 3 not only household-members but also neighbourhood contacts living within 100-m of an incident case are eligible. In arm 4 such neighbourhood contacts are only eligible if they test positive to anti-PGL-I, a serological marker. Incidence rate ratios calculated between the comparator arm 1 and each of the intervention arms will constitute the primary outcome.

Discussion

Different trials on PEP have yielded varying results. The pivotal COLEP trial in Bangladesh showed a 57% reduction in incidence over a two-year period post-intervention without any rebound in the following years. A study in a high-incidence setting in Indonesia showed no effect of PEP provided to close contacts but a major effect of PEP provided as a blanket measure to an entire island population. High background incidence could be the reason of the lack of effect of PEP provided to individual contacts. The PEOPLE trial will assess effectiveness of PEP in a high incidence setting and will compare three different approaches, to identify who benefits most from PEP.

Trial registration

Clinicaltrials.Gov. NCT03662022. Initial Protocol Version 1.2, 27-Aug-2018.
A case report of Talaromyces marneffei Oro-pharyngo-laryngitis: a rare manifestation of Talaromycosis
Authors: Wongkamhla Thanyarak , Chongtrakool Piriyaporn , Jitmuang Anupop
Published: December 2019

Background

The incidence of Taralomyces marneffei infection in HIV-infected individuals has been decreasing, whereas its rate is rising among non-HIV immunodeficient persons, particularly patients with anti-interferon-gamma autoantibodies. T. marneffei usually causes invasive and disseminated infections, including fungemia. T. marneffei oro-pharyngo-laryngitis is an unusual manifestation of talaromycosis.

Case presentation

A 52-year-old Thai woman had been diagnosed anti-IFNɣ autoantibodies for 4 years. She had a sore throat, odynophagia, and hoarseness for 3 weeks. She also had febrile symptoms and lost 5 kg in weight. Physical examination revealed marked swelling and hyperemia of both sides of the tonsils, the uvula and palatal arches including a swelling of the epiglottis, and arytenoid. The right tonsillar biopsy exhibited a few intracellular oval and elongated yeast-like organisms with some central transverse septum seen, which subsequently grew a few colonies of T. marneffei on fungal cultures. The patient received amphotericin B deoxycholate 45 mg/dayfor 1 weeks, followed by oral itraconazole 400 mg/day for several months. Her symptoms completely resolved without complication.

Conclusion

In patients with anti-IFN-ɣ autoantibodies, T. marneffei can rarely cause a local infection involving oropharynx and larynx. Fungal culture and pathological examination are warranted for diagnosis T. marneffei oro-pharyngo-laryngitis. This condition requires a long term antifungal therapy.
The effect of antenatal depression and antidepressant treatment on placental tissue: a protein-validated gene expression study
Authors: Edvinsson Åsa , Hellgren Charlotte , Kunovac Kallak Theodora , Åkerud Helena , Skalkidou Alkistis , Stener-Victorin Elisabet , Fornes Romina , Spigset Olav , Lager Susanne , Olivier Jocelien , Sundström-Poromaa Inger
Published: December 2019

Background

Antenatal depression affects 10–20% of pregnant women. Around 2–4% of European pregnant women use antidepressant treatment, most commonly selective serotonin reuptake inhibitors (SSRIs). Poor pregnancy outcomes, such as preterm birth and low birth weight, have been described in women with antenatal depression and in pregnant women on SSRI treatment. However, the effects of antenatal depression and antidepressant treatment on the placenta are largely unknown. The aim of this work was to compare placental gene and protein expression in healthy women, women with untreated antenatal depression and women on antidepressant treatment during pregnancy.

Methods

Placental samples from 47 controls, 25 depressed and 45 SSRI-treated women were analysed by means of qPCR using custom-designed TaqMan low-density arrays (TLDAs) for 44 genes previously known to be involved in the pathophysiology of depression, and expressed in the placenta. Moreover, placental protein expression was determined by means of immunohistochemistry in 37 healthy controls, 13 women with untreated depression and 21 women on antidepressant treatment. Statistical comparisons between groups were performed by one-way ANOVA or the Kruskal–Wallis test.

Results

Nominally significant findings were noted for HTR1A and NPY2R, where women with untreated depression displayed higher gene expression than healthy controls (p < 0.05), whereas women on antidepressant treatment had similar expression as healthy controls. The protein expression analyses revealed higher expression of HTR1A in placentas from women on antidepressant treatment, than in placentas from healthy controls (p < 0.05).

Conclusion

The differentially expressed HTR1A, both at the gene and the protein level that was revealed in this study, suggests the involvement of HTR1A in the effect of antenatal depression on biological mechanisms in the placenta. More research is needed to elucidate the role of depression and antidepressant treatment on the placenta, and, further, the effect on the fetus.
Quality appraisal of gestational diabetes mellitus guidelines with AGREE II: a systematic review
Authors: Zhang Mengxing , Zhou Yingfeng , Zhong Jie , Wang Kairong , Ding Yan , Li Li , Pan Xiuhong
Published: December 2019

Background

Several societies and associations have produced and disseminated clinical practice guidelines (CPGs) for gestational diabetes mellitus (GDM). However, the quality of such guidelines has not been appraised so far. This study aims to evaluate the quality of CPGs for GDM published in the last decade using the AGREE II instrument.

Methods

A systematic search of the National Institute for Health and Care Excellence, New Zealand Guidelines Group, Scottish Intercollegiate Guidelines Network, Medlive, American Diabetes Association, Canadian Diabetes Association, International Diabetes Federation, as well as PubMed, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang Chinese Periodical Database, and VIP Chinese Periodical Database was conducted from inception to June 2018. The quality was assessed by four trained researchers independently, using the AGREE IIinstrument.

Results

A total of 13 guidelines, published from 2009 to 2018, were finally included. Among them, 11 guidelines were evidence-based guidelines, and 2 were expert consensus. Scores for each of the six AGREE II domains(Median ± IQR) were 94 ± 11, 89 ± 53, 58 ± 37, 100 ± 6, 79 ± 48, 100 ± 71 and 67% ± 42%, and guidelines based on expert consensus generally scored lower than evidence-based guidelines (Z = -2.201, p = 0.028). Overall score of 10 guidelines were 5 points and above, and four guidelines were 7 points. Among six domains, two domains: Scope and Purpose, and Clarity of Presentation, had high scores; however, the domains of Rigor of Development, Stakeholder Involvement and Editorial Independence received lower scores.

Conclusions

In general, the methodological quality of GDM guidelines is high, and evidence-based guidelines are superior to expert consensus. However, the domains of Rigor of Development, Stakeholder Involvement and Editorial Independence still need improvement. A systematic approach in the development of these guidelines and updating timely is needed. In some regions, more attention for guideline adaptation is recommended.
Social determinants of delivery mode in Jiangsu, China
Authors: Fan Hong , Gu Hai , You Hua , Xu Xinpeng , Kou Yun , Yang Nichao
Published: December 2019

Background

Less evidence exists regarding the association of social determinants and delivery mode in Jiangsu, and if the trend is influenced by the type of residence. This study aims to identify the significant social determinants of delivery mode, and also to compare the main differences in delivery mode between urban and rural areas.

Methods

We used data from the cross-sectional National Health Service Surveys conducted in Jiangsu Province in 2013. For the purposes of this study, information from women (15–64 years old) who had experienced childbirth the last 5 years were examined, and a total of 1365 participants were selected as research subjects.

Results

Participants using vaginal delivery mode and cesarean delivery mode were found in 616 (45.1%) and 751(54.9%) participants, respectively. The proportion of women using cesarean delivery was 53.5% in rural area and 58.2% in urban area. Meanwhile, our results showed that women in middle Jiangsu were more likely to use cesarean delivery, and cesarean delivery is more prevalent among richer women. We also find that the more use of prenatal care visit, the more use of cesarean delivery.

Conclusions

This study validated the relationship between social determinants and the mode of delivery in Jiangsu province. Social determinants are contextual factors, which may vary by region and additional work is needed to fully understand these relationships globally. Further studies are needed to elucidate mechanisms and pathways across various populations, and these social determinants should be incorporated into future multi-level interventions designed to decrease the cesarean delivery rate.
Predicting peripartum blood transfusion: focusing on pre-pregnancy characteristics
Authors: Ouh Yung-Taek , Lee Kyu-Min , Ahn Ki Hoon , Hong Soon-Cheol , Oh Min-Jeong , Kim Hai-Joong , Han Sung Won , Cho Geum Joon
Published: December 2019

Background

Obstetric hemorrhage is one of the most common causes of obstetrical morbidity and mortality, and transfusion is the most important management for hemorrhage. The aim of our study was to investigate the pre-pregnancy and pregnancy risk factors for peripartum transfusion.

Methods

Women who delivered a baby from 2010 to 2014 in Korea and participated in the Korean National Health Screening Program for Infants and Children were included. To analyze pre-pregnant risk factors for peripartum transfusion, an additional analysis was done for women who underwent a National Health Screening Examination within 1 year before pregnancy, including maternal waist circumference, body mass index, blood pressure, laboratory tests and history of smoking. Multivariable logistic regression analysis was used to estimate the risk factors for peripartum transfusion.

Results

Of the total 1,980,126 women who met the inclusion criteria, 36,868 (1.86%) were transfused at peripartum. In a multivariable regression model, the pregnancy risk factors for peripartum transfusion included maternal age above 35 years [odds ratio (OR): 1.41; 95% confidence interval (CI): 1.32–1.50], preterm birth (OR: 2.39; 95% CI: 2.15–2.65), and maternal hypertension (OR: 2.49; 95% CI: 2.24–2.77). Pre-pregnancy risk factors including fasting glucose level of more than 126 mg/dL (OR: 1.11; 95% CI: 1.02–1.20), current-smoker status (OR: 1.20; 95% CI: 1.06–1.37), and waist-circumference less than 80 cm (OR: 1.18; 95% CI: 1.06–1.30) were independently associated with peripartum blood transfusion.

Conclusions

Several pre-pregnancy and pregnancy risk factors were associated with peripartum blood transfusion. Some identified factors are modifiable before conception, and our study validated peripartum blood transfusion as a form of triage.
Remodeling of hepatic stellate cells orchestrated the stroma-derived oxaliplatin-resistance through CCN3 paracrine in hepatocellular carcinoma
Authors: Liao Xia , Bu Yang , Chang Fan , Jia Fengan , Song Ge , Xiao Xuelian , Zhang Mei , Ning Pengbo , Jia Qingan
Published: December 2019

Background

Hepatic stellate cells (HSCs) have a key role in fibrogenesis and in the filtrates of the hepatocellular carcinoma (HCC) stroma, in which they are remodeled and play a critical role in HCC progression. However, the precise role of HSCs trending, infiltration and paracrine in orchestrating the stroma-derived oxaliplatin-resistance in HCC is still vague.

Methods

The chemo-resistant models were established to explore the correlation between HSC cells and the condition of chemoresistance. The HCC clinical samples were collected to confirm this phenomenon. Then, the relationship between secretory CCN3 from oxaliplatin-resistant HCC and the infiltration of HSCs in associated HCC microenvironment was evaluated. Finally, the role and mechanism of HSCs remodeling in the orchestration of oxaliplatin-resistant HCC were explored.

Results

The increased infiltration of HSCs and collagen accumulation were found in the microenvironment of oxaliplatin-resistant HCC. The cDNA profiles of the oxaliplatin-resistant HCC was reanalyzed, and CCN3 was one of the significantly increased genes. In HCC clinical samples, the levels of CCN3 and α-SMA are positively correlated, and high expression of CCN3 and α-SMA are positively associated with malignant phenotype and poor prognosis. Then the enhanced abilities of migration and proliferation of HSCs, and elevation of the cytokines paracrine from HSCs relating to HCC malignancy were proved in vitro and in vivo, and which were related to CCN3-ERK signaling pathway activation.

Conclusions

HSCs remodeling are positively related to CCN3 paracrine in hepatocellular carcinoma, which orchestrated the stroma-derived resistance to chemotherapy in HCC.
The impact of RNA extraction method on accurate RNA sequencing from formalin-fixed paraffin-embedded tissues
Authors: Marczyk Michal , Fu Chunxiao , Lau Rosanna , Du Lili , Trevarton Alexander J. , Sinn Bruno V. , Gould Rebekah E. , Pusztai Lajos , Hatzis Christos , Symmans W. Fraser
Published: December 2019

Background

Utilization of RNA sequencing methods to measure gene expression from archival formalin-fixed paraffin-embedded (FFPE) tumor samples in translational research and clinical trials requires reliable interpretation of the impact of pre-analytical variables on the data obtained, particularly the methods used to preserve samples and to purify RNA.

Methods

Matched tissue samples from 12 breast cancers were fresh frozen (FF) and preserved in RNAlater or fixed in formalin and processed as FFPE tissue. Total RNA was extracted and purified from FF samples using the Qiagen RNeasy kit, and in duplicate from FFPE tissue sections using three different kits (Norgen, Qiagen and Roche). All RNA samples underwent whole transcriptome RNA sequencing (wtRNAseq) and targeted RNA sequencing for 31 transcripts included in a signature of sensitivity to endocrine therapy. We assessed the effect of RNA extraction kit on the reliability of gene expression levels using linear mixed-effects model analysis, concordance correlation coefficient (CCC) and differential analysis. All protein-coding genes in the wtRNAseq and three gene expression signatures for breast cancer were assessed for concordance.

Results

Despite variable quality of the RNA extracted from FFPE samples by different kits, all had similar concordance of overall gene expression from wtRNAseq between matched FF and FFPE samples (median CCC 0.63–0.66) and between technical replicates (median expression difference 0.13–0.22). More than half of genes were differentially expressed between FF and FFPE, but with low fold change (median |LFC| 0.31–0.34). Two out of three breast cancer signatures studied were highly robust in all samples using any kit, whereas the third signature was similarly discordant irrespective of the kit used. The targeted RNAseq assay was concordant between FFPE and FF samples using any of the kits (CCC 0.91–0.96).

Conclusions

The selection of kit to purify RNA from FFPE did not influence the overall quality of results from wtRNAseq, thus variable reproducibility of gene signatures probably relates to the reliability of individual gene selected and possibly to the algorithm. Targeted RNAseq showed promising performance for clinical deployment of quantitative assays in breast cancer from FFPE samples, although numerical scores were not identical to those from wtRNAseq and would require calibration.
Ages of hepatocellular carcinoma occurrence and life expectancy are associated with a UGT2B28 genomic variation
Authors: Le Puo-Hsien , Kuo Chia-Jung , Hsieh Yi-Chung , Chen Tsung-Hsing , Lin Chih-Lang , Yeh Chau-Ting , Liang Kung-Hao
Published: December 2019

Background

Hepatocellular carcinoma (HCC) is an aggressive solid tumor. HCC occurred at younger and elder ages were considered driven by different oncogenic mechanisms, and they demonstrated distinct clinical courses.

Methods

A total of 382 HCC patients treated by surgical resections was analyzed.

Results

A univariate-multivariate analysis showed that viral etiology (chronic hepatitis B, C) and the UDP glucuronosyltransferase family 2 member B28 (UGT2B28) genomic variant rs2132039 were independently associated with the age at presentation of HCC (all adjusted P < 0.05). An extensive evaluations of clinicalpathological factors showed that the age (Odds ratio [OR], 1.016; 95% confidence interval [CI], 1.001–1.032; adjusted P = 0.037) and ascites (OR, 3.505; CI, 1.358–9.048; adjusted P = 0.010) were two independent factors associated with this genomic variant. The age was 54.1 ± 14.6 years for patients with the “TT” variant type, and 58.2 ± 13.7 years for those with the “Non-TT” variant type. The age disparity was most prominent in alcoholic patients (OR, 1.079; CI, 1.035–1.125; P < 0.001, age of “TT”, 49.6 ± 12.2; age of “non-TT”, 59.3 ± 10.7). This genomic variant was also associated with age of recurrence (P = 0.025), distant metastasis (P = 0.024) and HCC-related death (P = 0.008) in non-censored patients.

Conclusions

An UGT2B28 genomic variant was indicative of the age of HCC presentation, recurrence, distant metastasis and death.
Could aspirin be a lifesaver for prostate cancer patients in prostate cancer-specific mortality?: an update systematic review and meta-analysis
Authors: Zhou Jiatong , Xia Shuai , Li Tao , Liu Ranlu
Published: December 2019

Background

Currently, clinical studies on the prognosis of prostate cancer (PC) taking aspirin were developing, but the precise mechanism of aspirin on tumor cells was still unclear. In addition, the conclusion that aspirin can improve the prognosis of PC patients continues to be controversial. Therefore, we collected comprehensive literatures and performed our study to explore the prognostic effect of aspirin on PC.

Methods

A comprehensive literature search was performed in April 2019 based on PUBMED. EMBASE. Hazard Ratio (HR) as well as its 95% confidence interval (CIs) for prostate cancer specific mortality (PCSM) was extracted from eligible studies.

Result

A total of 10 eligible articles were used in our study. The pooled results showed that PC patients who used aspirin or taking aspirin did not have lower PCSM than those who had not used (HR =0.89, 95% CI: 0.73–1.08, P>0.05). In subgroup analysis, we found that taking aspirin before diagnosis of prostate cancer and taking aspirin after diagnosis of prostate cancer did not have significant association with PCSM. (pre-diagnostic use, HR = 0.88, 95% CI: 0.72–1.06; post-diagnosis use, HR = 0.88, 95% CI: 0.67–1.17). In addition, we found no significant association between aspirin use or its duration and the risk of PCSM. Another important result demonstrated that aspirin use was not associated with risk of PSCM in either high risk (T ≥ 3 and/or Gleason score ≥ 8) or low risk PC patients(low-risk PC, HR = 1.05, 95% CI: 0.81–1.35; high-risk PC, HR = 0.97, 95% CI: 0.75–1.24).

Conclusion

Our results demonstrated that there was no significant association between aspirin use and the risk of PCSM. At the same time, the dosage and duration of aspirin use had no statistical influence on the risk of PCSM in high/low risk PC. Further studies are needed to confirm the findings.
Identification of food insecurity factors in French-speaking Belgium: a qualitative study
Authors: Huberland Vincent , Semaille Pascal , Kacenelenbogen Nadine
Published: December 2019

Background

Diet is an essential determinant of health. Among the health determinants, we find access problems that are summarized as food insecurity. While such food insecurity has been studied in other countries and correlated to several health problems, it has been scarcely assessed in Belgium. The purpose of this work was to determine the factors of food insecurity existing within the Belgian population.

Method

From November 2016 to February 2017, a qualitative study using semi-structured interviews with 19 adults present attending the waiting rooms of six Public Social Action Centers in French-speaking Belgium, analyzed by grounded theory.

Results

In Belgium, for given food preferences and needs, food insecurity could be summarized as inadequacy between necessary and available resources within two dimensions: at the access level, for financial, temporal, informational, and freedom of action, and at the food use level, for temporal factors, material, knowledge, and skills. In these situations of inadequacy, participants reported finding either strategies to restore balance, or being forced to alter the quality or quantity of their diet.

Conclusion

While several factors of food insecurity may exist in Belgium, it appears essential that the first line of care these factors into consideration, since they could interfere with care and health, and because the first line of care is ideally placed to inform and refer the patients in question. Several courses of action are proposed in this work, which must still be confirmed by other studies.
The relationship between social capital and self-rated health: a multilevel analysis based on a poverty alleviation program in the Philippines
Authors: Hung Natalee , Lau Lincoln Leehang
Published: December 2019

Background

Poor health is both a cause and consequence of poverty, and there is a growing body of evidence suggesting that social capital is an important factor for improving health in resource-poor settings. International Care Ministries (ICM) is a non-governmental organization in the Philippines that provides a poverty alleviation program calledTransform. A core aim of the program is to foster social connectedness and to create a network of support within each community, primarily through consistent community-led small group discussions. The purpose of this research was to investigate the relationship between social capital and self-rated health and how ICM’sTransformprogram may have facilitated changes in those relationships.

Methods

Three types of social capital were explored: bonding-structural, bridging-structural and cognitive. Using cross-sectional data collected before and afterTransform, multilevel modelling was used to examine their effects on self-rated health between the two time points.

Results

The analyses showed that while social capital had minimal effects on self-rated health beforeTransform, a series of associations were identified after the program. Evidence of interdependence between the different types of social capital was also observed: bonding social capital only had a beneficial effect on self-rated healthin the presenceof bridging social capital, but we found that there was a 17 percentage point increase in self-rated health when individuals possessed all possible bridging and bonding relationships. At the same time, our estimates showed that maximising all forms of social capital is not necessarily constructive, as the positive effect of cognitive social capital on self-rated health was weaker at higher levels of bridging social capital.

Conclusions

The results from this study has shown that building social capitalcaninfluence the way people perceive their own health, which can be facilitated by intervention programs which seek to create bonding and bridging relationships.Transform’sintentional design to learn in community could be relevant to program planners as they develop and evaluate community-based programs, making adaptations as necessary to achieve organisation-specific goals while acknowledging the potential for varied effects when applied in different contexts or circumstances.
Accuracy of planar anteversion measurements using anteroposterior radiographs
Authors: Lee Gwang Chul , Lee Sang Hong , Kang Sin Wook , Park Hyung Seok , Jo Suenghwan
Published: December 2019

Background

Several methods using simple anteroposterior (AP) radiographs have been suggested for the measurement of anteversion of the cup component after total hip arthroplasty. Herein, we compared six widely used anteversion measurement methods using two different types of AP radiograph, the conventional pelvis AP and hip-centered AP radiographs, to identify the measurement method and the type of radiograph that would provide the highest accuracy and reliability.

Methods

We developed two custom-made bi-planar anteversion measurement models for the validation test. The models were designed for pelvis AP and hip-centered AP radiographs, respectively. The radiographs were acquired using the inclination angles of both models, changing from 10° to 70° at 10° increments. For each inclination angle, anteversion was changed from 0° to 30° at 5° increments. The measurements were obtained independently by two orthopedic surgeons blinded from each other’s measurements, using the methods of 1) Pradhan et al., 2) Lewinnek et al., 3) Widmer et al., 4) Liaw et al., 5) Hassan et al., and 6) Ackland et al. The measurements were repeated after 2 months. The accuracy, compared with that of the reference angle, and intra-observer and inter-observer reliabilities of each method were calculated.

Results

The highest accuracy was found when the method of Liaw et al. was used with hip-centered AP radiographs, which showed a difference of 1.37° ± 1.73 from the reference angle. Moreover, regardless of the type of radiograph, the methods by Pradhan et al., Lewinnek et al., and Liaw et al. showed excellent correlations with the reference anteversion. However, substantial differences were found when the methods by Widmer et al., Hassan et al., and Ackland et al. were used, regardless of the type of radiograph used. When anteversion was measured in an inclination between 30° and 50°, the method of Pradhan et al., when used with pelvis AP radiographs, showed the highest accuracy (1.23° ± 0.92°). We also found no significant difference in anteversions between the measurements made on pelvic and hip-centered AP radiographs. Both interobserver and intraobserver reliabilities were high for all the measurements tested.

Conclusions

The methods by Pradhan et al., Liaw et al., and Lewinnek et al. may provide relatively accurate anteversion measurements with high reliability, regardless of the type of radiograph.
Paramedic information needs in end-of-life care: a qualitative interview study exploring access to a shared electronic record as a potential solution
Authors: Patterson Rebecca , Standing Holly , Lee Mark , Dalkin Sonia , Lhussier Monique , Exley Catherine , Brittain Katie
Published: December 2019

Background

Limited access to, understanding of, and trust in paper-based patient information is a key factor influencing paramedic decisions to transfer patients nearing end-of-life to hospital. Practical solutions to this problem are rarely examined in research. This paper explores the extent to which access to, and quality of, patient information affects the care paramedics provide to patients nearing end-of-life, and their views on a shared electronic record as a means of accessing up-to-date patient information.

Method

Semi-structured interviews with paramedics (n = 10) based in the north of England, drawn from a group of health and social care professionals (n = 61) participating in a study exploring data recording and sharing practices in end-of-life care. Data were analysed using thematic analysis.

Results

Two key themes were identified regarding paramedic views of patient information: 1) access to information on patients nearing end-of-life, and 2) views on the proposed EPaCCS. Paramedics reported they are typically unable to access up-to-date patient information, particularly advance care planning documents, and consequently often feel they have little option but to actively treat and transport patients to hospital – a decision not always appropriate for, or desired by, the patient. While paramedics acknowledged a shared electronic record (such as EPaCCs) could support them to provide community-based care where desired and appropriate, numerous practical and technical issues must be overcome to ensure the successful implementation of such a record.

Conclusions

Access to up-to-date patient information is a barrier to paramedics delivering appropriate end-of-life care. Current approaches to information recording are often inconsistent, inaccurate, and inaccessible to paramedics. Whilst a shared electronic record may provide paramedics with greater and timelier access to patient information, meaning they are better able to facilitate community-based care, this is only one of a series of improvements required to enable this to become routine practice.
Preferred problem solving and decision-making role in fertility treatment among women following an unsuccessful in vitro fertilization cycle
Authors: Chan Celia Hoi Yan , Lau Bobo Hi Po , Tam Michelle Yi Jun , Ng Ernest Hung Yu
Published: December 2019

Background

While the literature on healthcare decision-making has long focused on doctor-patient interaction, fertility treatment is an exception, characterized by a triangular interplay between the doctor, the woman and her partner. This study examined treatment decision-making preferences of women undergoing in vitro fertilization (IVF) treatment, following an unsuccessful IVF cycle, especially their preferred level of doctor and spousal involvement.

Methods

A cross-sectional survey was conducted with 246 Chinese women undergoing IVF recruited from an assisted reproduction clinic of a university-affiliated hospital in Hong Kong. Data collection was conducted between January 2014 and August 2015.

Results

Most participants preferred sharing the decision-making tasks with their doctors (92%). In the doctor-patient relationship, passive roles were associated with higher marital satisfaction, presence of religious affiliation and secondary infertility, while autonomous roles were related to female-factor infertility. Fifty-two percent of participants anticipated sharing decision-making, while 46% preferred handing over the decision to their husbands. Preference for a passive rather than a shared role in the spousal relationship was related to a higher husband’s age, greater marital satisfaction and higher anxiety.

Conclusions

In brief, women tended to prefer sharing decision-making tasks with their doctor as well as actively engaging their partner in making decisions about fertility treatment. This study adds to our understanding of women’s role preference and level of involvement in infertility treatment decision-making by providing quantitative evidence from women’s experience. It highlights the importance of healthcare professionals in facilitating shared decision-making among couples.
Systems pharmacology based approach to investigate the in-vivo therapeutic efficacy of Albizia lebbeck (L.) in experimental model of Parkinson’s disease
Authors: Saleem Uzma , Raza Zohaib , Anwar Fareeha , Chaudary Zunera , Ahmad Bashir
Published: December 2019

Background

Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by loss of dopaminergic neurons in substantia nigra pars compacta and clinically manifested mainly with motor dysfunctions. Plants are rich source of medicinally important bioactive compounds and inhabitants of underdeveloped countries used plants for treatment of various ailments. Albizia lebbeck has been reported to possess antioxidant and neuroprotective properties that suggest the evaluation of its traditional therapeutic potential in neurodegenerative diseases.

The aim of present study was to validate the traditional use of Albizia lebbeck (L.) and delineate its mechanism of action in PD. The systems pharmacology approach was employed to explain the Albizia lebbeck (L.) mechanism of action in PD.

Methods

The haloperidol-induced catalepsy was adopted as experimental model of PD for in-vivo studies in wistar albino rats. The systems pharmacology approach was employed to explain the Albizia lebbeck (L.) mechanism of action in PD.

Results

In-vivo studies revealed that Albizia lebbeck improved the motor functions and endurance as demonstrated in behavioral studies which were further supported by the rescue of endogenous antioxidant defense and reversal of ultrastructural damages in histological studies. System pharmacology approach identified 25 drug like compounds interacting with 132 targets in a bipartite graph that revealed the synergistic mechanism of action at system level. Kaemferol, phytosterol and okanin were found to be the important compounds nodes with prominent target nodes of TDP1 and MAPT.

Conclusion

The therapeutic efficiency of Albizia lebbeck in PD was effectively delineated in our experimental and systems pharmacology approach. Moreover, this approach further facilitates the drug discovery from Albizia lebbeck for PD.
Evaluation of the undergraduate family medicine programme of Faculty of Medicine, University of Kelaniya: quantitative and qualitative student feedback
Authors: Perera D. P. , Withana S. S. , Mendis K. , Kasunjith D. V. T. , Jayathilaka W. T. S. , Wickramasuriya S.
Published: December 2019

Background

Worldwide there is an increasing emphasis on the importance of primary care. The ministry of health Sri Lanka issued a directive in 2016 that training of doctors in primary care should be strengthened.

Medical students of the Faculty of Medicine, University of Kelaniya follow a 1 month long clinical appointment in family medicine in their fourth year of study.

Methods

Feedback is taken from students on completion of the appointment. Half the students from each group complete a pre tested structured feedback questionnaire that consists of answers to questions based on a likert scale with a space for free comments. The other half provide qualitative feedback.

In this evaluation data were gathered from 185 (98%) students from all eight clinical groups throughout the year 2016.

Quantitative data were analysed using SPSS version 22. Inductive thematic analysis was used to analyse the qualitative data from the Round Robin activity and free comments from the questionnaire.

Results

The qualitative feedback provided a richer indepth overview of student ideas on the appointment compared to the quantitative data.

In reflection of a desire for learning to be of relevance students wanted clinically oriented teaching focused on management. They preferred active teaching learning methods such as the opportunity to conduct consultations and receive immediate feedback. Students had a high regard for the teaching sessions by general practitioners at their clinics.

The appointment had created an interest in the discipline of family medicine which could have an impact on future choice of career. There were indications to suggest that student attitudes towards patients may have evolved to be more patient centred.

Students appreciated the inclusive and low stress ambience of the learning environment.

Conclusions and recommendations

Regular evaluation of teaching programmes helps maintain accountability of faculty and paves the way for more student centred teaching through the incorporation of students’ views in devising teaching methods. This evaluation found that qualitative feedback provided more descriptive material to reflect on and therefore improve teaching on the programme. It is recommended that more use should be made of qualitative methodologies in programme evaluations.
An attention-based deep learning model for clinical named entity recognition of Chinese electronic medical records
Authors: Li Luqi , Zhao Jie , Hou Li , Zhai Yunkai , Shi Jinming , Cui Fangfang
Published: December 2019

Background

Clinical named entity recognition (CNER) is important for medical information mining and establishment of high-quality knowledge map. Due to the different text features from natural language and a large number of professional and uncommon clinical terms in Chinese electronic medical records (EMRs), there are still many difficulties in clinical named entity recognition of Chinese EMRs. It is of great importance to eliminate semantic interference and improve the ability of autonomous learning of internal features of the model under the small training corpus.

Methods

From the perspective of deep learning, we integrated the attention mechanism into neural network, and proposed an improved clinical named entity recognition method for Chinese electronic medical records called BiLSTM-Att-CRF, which could capture more useful information of the context and avoid the problem of missing information caused by long-distance factors. In addition, medical dictionaries and part-of-speech (POS) features were also introduced to improve the performance of the model.

Results

Based on China Conference on Knowledge Graph and Semantic Computing (CCKS) 2017 and 2018 Chinese EMRs corpus, our BiLSTM-Att-CRF model finally achieved better performance than other widely-used models without additional features(F1-measure of 85.4% in CCKS 2018, F1-measure of 90.29% in CCKS 2017), and achieved the best performance with POS and dictionary features (F1-measure of 86.11% in CCKS 2018, F1-measure of 90.48% in CCKS 2017). In particular, the BiLSTM-Att-CRF model had significant effect on the improvement of Recall.

Conclusions

Our work preliminarily confirmed the validity of attention mechanism in discovering key information and mining text features, which might provide useful ideas for future research in clinical named entity recognition of Chinese electronic medical records. In the future, we will explore the deeper application of attention mechanism in neural network.