bluuebunny/crossref_metadata_2025 huggingface dataset:
Deciphering the transcriptional regulatory networks that control size, color, and oil content in Brassica rapa seeds
Authors: Niu Yue , Wu Limin , Li Yanhua , Huang Hualei , Qian Mingchao , Sun Wei , Zhu Hong , Xu Yuanfang , Fan Yonghai , Mahmood Umer , Xu Benbo , Zhang Kai , Qu Cunmin , Li Jiana , Lu Kun
Published: May 2020

Background: Brassica rapa is an important oilseed and vegetable crop species and is the A subgenome donor of two important oilseed Brassica crops, Brassica napus and Brassica juncea. Although seed size (SZ), seed color (SC), and oil content (OC) substantially affect seed yield and quality, the mechanisms regulating these traits in Brassica crops remain unclear.Results: We collected seeds from a pair of B. rapa accessions with significantly different SZ, SC, and OC at seven seed developmental stages (every 7 days from 7 to 49 days after pollination), and identified 28,954 differentially expressed genes (DEGs) from seven pairwise comparisons between accessions at each developmental stage. K-means clustering identified a group of cell cycle-related genes closely connected to variation in SZ of B. rapa. A weighted correlation analysis using the WGCNA package in R revealed two important co-expression modules comprising genes whose expression was positively correlated with SZ increase and negatively correlated with seed yellowness, respectively. Upregulated expression of cell cycle-related genes in one module was important for the G2/M cell cycle transition, and the transcription factor Bra.A05TSO1 seemed to positively stimulate the expression of two CYCB1;2 genes to promote seed development. In the second module, a conserved complex regulated by the transcription factor TT8 appear to determine SC through downregulation of TT8 and its target genes TT3, TT18, and ANR. In the third module, WRI1 and FUS3 were conserved to increase the seed OC, and Bra.A03GRF5 was revealed as a key transcription factor on lipid biosynthesis. Further, upregulation of genes involved in triacylglycerol biosynthesis and storage in the seed oil body may increase OC. We further validated the accuracy of the transcriptome data by quantitative real-time PCR of 15 DEGs. Finally, we used our results to construct detailed models to clarify the regulatory mechanisms underlying variations in SZ, SC, and OC in B. rapa.Conclusions: This study provides insight into the regulatory mechanisms underlying the variations of SZ, SC, and OC in plants based on transcriptome comparison. The findings hold great promise for improving seed yield, quality and OC through genetic engineering of critical genes in future molecular breeding.
Evaluation of the association between presenteeism and perceived availability of social support among hospital doctors in Zhejiang, China
Authors: Xi Xiaoyu , Lu Qianni , Lu Mengqing , Xu Ailin , Hu Hao , Ung Carolina Oi Lam
Published: May 2020

Background: This study investigated the association between presenteeism and the perceived availability of social support among hospital doctors in China. Methods: A questionnaire was administered by doctors randomly selected from 13 hospital in Hangzhou China using stratified sampling. Logit model was used for data analysis. Results: The overall response rate was 88.16%. Among hospital doctors, for each unit increase of the perceived availability of social support, the prevalence of presenteeism was decreased by 8.3% (OR=0.91, P=0.000). In particular, if the doctors perceived availability of appraisal support, belonging support and tangible support as sufficient, the act of presenteeism was reduced by 20.2% (OR=0.806, P=0.000) 20.4% (OR=0.803, P=0.000) and 21.0% (OR=0.799, P=0.000) respectively with statistical differences. Conclusion: In China, appraisal support, belonging support and tangible support, compared to other social support, had a stronger negative correlation with presenteeism among hospital doctors. The benefits of social support in alleviating doctors’ presenteeism warrant further investigation.
Is early integration of palliative home care in oncology treatment feasible and acceptable for advanced cancer patients and their health care providers? A phase 2 mixed-methods study.
Authors: Dhollander Naomi , Smets Tinne , De Vleminck Aline , Lapeire Lore , Pardon Koen , Deliens Luc
Published: May 2020

Background
To support the early integration of palliative home care (PHC) in cancer treatment, we developed the EPHECT intervention and pilot tested it with 32 advanced cancer patients in Belgium using a pre post design. We aim to determine the feasibility, acceptability and perceived effectiveness of the EPHECT intervention.
Methods
Interviews with patients (n = 16 of which 11 dyadic with family caregivers), oncologists and GPs (n = 11) and a focus group with the PHC team. We further analyzed the study materials and logbooks of the PHC team. Preliminary effectiveness was assessed with questionnaires EORTC QLQ C-30, HADS and FAMCARE and were filled in at baseline and 12, 18 and 24 weeks.
Results
Patient reported feelings of safety and control and an optimized quality of life. Being introduced earlier opened space for the PHC team to focus on more than symptom management. Telephone-based contact appeared to be insufficient to support interprofessional collaboration. Furthermore, some family caregivers reported that the nurse of the PHC team was focused little on them.
Conclusion
Nurses of PHC teams are able to deliver early palliative care to advanced cancer patients. However, more attention needs to be given to family caregivers as caregiver and client. Furthermore, the home visits by the PHC team have to be further evaluated and adapted. Lastly, professionals have to find a more efficient way to discuss future care.
The primary total knee arthroplasty: a global analysis
Authors: Gao Jiaxiang , Xing Dan , Dong Shengjie , Lin Jianhao
Published: May 2020

Background: The use of total knee arthroplasty (TKA) in treatment of chronic degenerative pathologies of the knee has boasted of an experience of 50 years. Study objective: The aim of this bibliometric and visualized study is to comprehensively examine the current status and global trends of TKA research.Methods: Publications related to TKA research from 2010 to 2019 were retrieved from Web of Science (WoS) and Science Citation Index-Expanded (SCIE) database, and then analyzed through bibliometric methodology. As for the visualized study, the software VOS viewer was utilized for bibliographic coupling, coauthorship, cociation, and co-occurrence analysis, along with further simulation of publication trends in this field.Results: A total of 8631 publications were eventually included. The number of publications tend to increased annually over worldwide. The United States was the pioneer which has made tremendous contributions, with the most publications and citations, as well as the highest H-index. The JOURNAL OF ARTHROPLASTY has published most papers, while CLINICAL ORTHOPAEDICS AND RELATED RESEARCH has the highest citation frequency. Hospital for Special Surgery have made the greatest contribution when total publication number and coauthorship were taken together. Studies could be divided into five clusters: “alignment study”, “revision TKA study”, “complication study”, “rehabilitation study”, and “perioperative management study”, which have a trend of balanced development in this field.Conclusions: There will be an increasing number of publications on TKA research according to the current global trends, and the United States maintained the leadership in this area. Additionally, a trend of balanced development may exist in the field of TKA research, accompanied with inherent changes of hotspots in each cluster.
The awareness, visibility and support for young carers across Europe: a Delphi study
Authors: Nap Henk Herman , Hoefman Renske , de Jong Nynke , Lovink Lieke , Glimmerveen Ludo , Lewis Feylyn , Santini Sara , D’Amen Barbara , Socci Marco , Boccaletti Licia , Casu Giulia , Manattini Alessandra , Brolin Rosita , Sirk Karina , Hlebec Valentina , Rakar Tatjana , Hudobivnik Tjasa , Leu Agnes , Berger Fabian , Magnusson Lennart , Hanson Elizabeth
Published: May 2020

BackgroundAcross Europe there is limited attention paid in media, policy and empirical research to the situation of young carers (YCs) and their needs for support, while similarly to adult carers, they provide care to ill family members. The Delphi study, which provides the focus for this article, had the overall aim of exploring existing successful strategies to support AYCs (Adolescent Young Carers) aged 15-17 years. Compared to YCs, even less is known about AYCs, a group that is in a critical life transition phase. The study forms part of an EU Horizon 2020 funded research project on AYCs.MethodsA two-round Delphi study was conducted with 66 experts on YCs from 10 European countries. Topics included: (1) visibility and awareness raising of AYCs at local, regional, and national levels, (2) current interventions to support AYCs, and (3) future strategies to support AYCs.ResultsExperts reported that there is a lack of visibility and awareness about YCs in general and AYCs in particular. Although awareness is slowly increasing in most countries, with the UK ranked highest, experts acknowledged that it remains challenging to identify YCs in many countries. Furthermore, the level and type of support available for AYCs differs, with most countries mainly offering support on a local level. Diverse views were expressed regarding future strategies to support AYCs. Experts highlighted the importance of specific legislation to formalize the rights of YCs, and the issue of whether young people should be safeguarded from caregiving or if this is part of regular family life. They also emphasised the relevance of available integrated support services for AYCs, including schools, family, health and social care.Conclusion(s) with key messageIn most European countries, there is a lack of awareness and visibility on young people providing care. Identification of YCs is a crucial first step and a common definition of YCs is called for, together with greater opportunities for young adults to identify themselves as YCs.StatementIdentification alone is not sufficient, rather recognition of YCs by society is needed combined with the necessary resources to ensure integrated AYC friendly support services.
Hypoxia Promotes Differentiation of Pure Cartilage from Human iPS Cells
Authors: Shimomura Seiji , Inoue Hiroaki , Arai Yuji , Nakagawa Shuji , Fujii Yuta , Kishida Tsunao , Shin-Ya Masaharu , Ichimaru Shohei , Tsuchida Shinji , Mazda Osam , Kubo Toshikazu
Published: May 2020

BackgroundWhile cartilage can be formed from induced pluripotent stem cells (iPSCs), challenges such as long culture periods and compromised tissue purity remain. We aimed to determine whether cartilaginous tissue can be produced from iPSCs under hypoxia and to evaluate the effects on the cellular metabolism and purity of the tissue.MethodsHuman iPSCs (hiPSCs) were cultured for cartilage differentiation in monolayers under normoxia or hypoxia (5% O2). We evaluated chondrocyte differentiation by real-time reverse transcription-polymerase chain reaction and fluorescence-activated cell sorting. Then, hiPSCs were cultured for cartilage differentiation in 3D culture under normoxia or hypoxia (5% O2). We evaluated cartilage-like tissues on days 28 and 56 through histological analyses.ResultsHypoxia suppressed the expression of immature mesodermal markers T (Brachyury) and Forkhead box protein F1 (FOXF1) and promoted the expression of the chondrogenic markers aggrecan and CD44. Sex determining region Y- box (SOX) 9-positive cells were increased by culture under hypoxia. Percentages of safranin O-positive and type 2 collagen-positive tissues were increased under hypoxia. Moreover, upon hypoxia-inducible factor (HIF)-1α staining, the nuclear dyeability in tissues cultured under hypoxia was greater than that under normoxia.ConclusionsHypoxia not only led to enhanced cartilage matrix production but also improved cell purity by promoting the expression of HIF-1α. By applying this method, highly pure cartilaginous-like tissues may be produced more rapidly and conveniently.
Motion-preserving treatment of unstable atlas fracture: transoral anterior C1-ring osteosynthesis using a laminoplasty plate
Authors: Zou Xiaobao , Ouyang Beiping , Wang Binbin , Yang Haozhi , Ge Su , Chen Yuyue , Ni Ling , Zhang Shuang , Xia Hong , Wu Zenghui , Ma Xiangyang
Published: May 2020

Background
C1-ring osteosynthesis is a valid alternative to posterior C1–C2 or C0–C2 fusion to preserve important C1–C2 motion in the treatment of unstable atlas fractures. Nevertheless, the fixation instruments used in current studies for transoral anterior C1-ring osteosynthesis were not suitable for anterior anatomy of the atlas or did not have reduction mechanism. We therefore present this report to investigate preliminary clinical effects of transoral anterior C1-ring osteosynthesis using a laminoplasty plate in unstable atlas fractures.
Methods
From January 2014 to December 2017, 13 patients with unstable atlas fractures were retrospectively reviewed. All patients were treated with transoral anterior C1-ring osteosynthesis using a laminoplasty plate. Pre- and postoperative images were obtained to assess reduction of the fracture, internal fixation placement, and bone union. Neurological function, range of motion, and pain levels were evaluated clinically on follow-up.
Results
The surgeries were successfully performed in all cases. The average follow-up duration was 16.6 ± 4.4 months (range 12–24 months). One patient suffered screw loosening after operation and underwent replacement operation subsequently. Satisfactory clinical outcomes were achieved in all patients with ideal fracture reduction, reliable plate placement, well-preserved range of motion, and neck pain alleviation. All patients achieved bone union of fractures without loss of reduction or implant failure or C1–C2 instability during the follow-up. No vascular or neurological complication was noted during the operation and follow-up.
Conclusions
Transoral anterior C1-ring osteosynthesis using a laminoplasty plate is a effective surgical treatment for unstable atlas fractures. This technique has a ingenious reduction mechanism, and can provide satisfactory bone union and preservation of C1–C2 motion.
Outcomes of Tissue Reconstruction in Distal Lower Leg Fractures: a Retrospective Cohort Study
Authors: Aydogan Emrah , Langer Stefan , Josten Christoph , Fakler Johannes Maria Karl , Henkelmann Ralf
Published: May 2020

Background:Open and closed fractures can be associated with posttraumatic or postoperative soft tissue defects caused by initial trauma, operative procedures or infections. This study evaluated the outcomes of postoperative qualities ofpatients with open or closed lower leg fractures,related softtissue defects, and subsequent flap coverage.Methods:We performed a retrospective single-center cohort study in a level 1 trauma center. We analyzed thepatients treated fromJanuary 2012 through December 2017 and recorded demographics, treatment, and outcome data.The outcome data were measured via patient-reported Foot and Ankle Outcomes Scores (FAOS) and EQ-5D-5L scores.Results: We included 22 patients with complicated fractures (11 open and 11 closed) and subsequent softtissue defects and flap coverages. The mean follow-up time was 41.2 months. Twenty-onepatients developed infections, and necrosis at the site of surgery manifested in all closed fractures. Therefore, all patients needed soft tissue reconstructions. Preoperatively, 16patients underwent arterial examinations via angiography and sixunderwent ultrasound examinations of the venous system. Ten patients had complications involving the flaps due to ischemia and consequent necrosis. The mean EQ-5D index was 0.62 ± 0.27, EQ-5DVAS score was 57.7 ± 20.2. The mean FAOS was 60.7 ± 22.2; in particular,quality of life was 32.3± 28.8. The rate of returning to work in our patient groupwas 37.5% after one year.Conclusions:Distal tibial fracturesoften require revisions and soft tissue reconstruction. The evaluated patient population had poor outcomes in terms of function, quality of life and return to work. Our results imply that the severity of associated soft tissue damage with many revision operations and flap complications lead to a poorer outcome with respect to patients without flap ischemia.
Norwegian Nurses’ Reflections Upon Experiences of Ethical Challenges in Older People Care - A Qualitative Thematic Analysis
Authors: Rykkje Linda , Holm Anne Lise , Hem Marit Helene
Published: May 2020

Background: Many countries face an increasingly older population in need of health care services. There are reports of lack of qualified staff and resources, resulting in poor quality and undignified care. Care quality is depended upon factors like organization and staffing, but it is also recommended to focus on what staff members experience in clinical practice. In addition, ethical competence is a precondition for high quality care. The aim of this study is to provide knowledge about ethically challenging situations in caring for older people in institutions such as nursing homes and hospitals, and to gain insight into nurses’ written reflections about their experiences and management of ethical challenges in clinical practice.Methods: The data material consist of reflection notes by continuous education students in advanced gerontology in Norway. Data was collected in 2017–2018. We included 42 of 83 notes and utilized qualitative thematic analysis.Findings: “Doing what is in the patients’ best interest” is the guiding principle for the participants, portrayed through three themes as follows: a) Meeting vulnerability, discomfort and emotional pain, b) Collaboration with relatives, and c) Struggling to perform professional care. Within each theme, we provide a variety of ethically challenging situations in older people care. The findings represent the participants’ written experiences and reflections upon how they manage the situation and their effort to provide the best possible care.Conclusions: Health care professionals’ ethical competences may develop when reflecting upon their care performance. Therefore, building ethical competence should be a priority in education of healthcare professionals and in clinical practice. We acknowledge that ethical reflection does not automatically improve care quality, although we find that it fosters increased awareness of one’s action, and as such, it can act as a potential for change.Implications for practice: How nurses reflect upon and manage challenging situations indicates that quality in care is possible despite scarce resources, and this may contribute to reduce ageism and encourage health care personnel to be willing to work in older people care.
Factors associated with the Uptake of Immediate Postpartum Intrauterine Contraceptive Devices(PPIUCD) in Rwanda: A Mixed Methods Study
Authors: Kanakuze Chris Adrien , Dan Kaye K , Musabirema Priscilla , Pascal Nkubito , Mbalinda Scovia Nalugo
Published: May 2020

Background: Rwanda has a high unmet need for family planning which could be reduced by improving access to postpartum intrauterine contraceptives device (PPIUCD) insertion. The objective of the study was to assess the prevalence and factors associated with the uptake of PPIUCD among postpartum women in Muhima Hospital.Methods: A concurrent mixed method study was used. Three hundred eight three (383) immediate postpartum mothers, and 10 health services providers were interviewed using structured questionnaire and in-depth interview respectively. Logistics regression was done to assess for factors associated with PPIUCD uptake and thematic analysis was used for qualitative data.Results: The prevalence for PPIUCD use was 28.1% , women who had normal delivery were more likely to take up PPIUCD (Adjusted Odds Ratio (AOR) 2.623, 95%CI=2.017-6.507 compared to those who had cesarean section; women who received PPIUCD counselling during antenatal period were more likely to use PPIUCD ((AOR 2.072, 95%CI=1.018-4.218) as compared to those who didn’t receive any form of counselling ; mothers who received spouse approval were more likely to use PPIUCD (AOR 2.591,95%CI= 1.485-4.492);as compared to those who didn’t receive any spousal approval; women who had more than one child were more likely to use PPIUCD (AOR =2.265, 95%CI=1.472-3.163) as compared to prime gravida; Mothers with birth to pregnancy interval less than two years were more likely to use PPIUCD (AOR =2.123, CI =1.477-2.706) as compared to those who had birth to pregnancy interval more than 2 years. From the qualitative, health education of mothers and partners on PPIUCD, training of health care providers and availability of supplies to provide PPIUCD influenced use of PPIUCD. Conclusion: The acceptability to use for PPIUCD was high in this population. PPIUCD uptake was associated with normal birth, PPIUCD counselling, spousal approval, parity, birth interval, level of education. Health education of mothers and partners on PPIUCD, training of health providers and availability of supplies to provide PPIUCD influenced use PPIUCD.
The prevalence of the Neglected Sexual Side Effects (NSSEs) after early prostate cancer treatment and the role of a questionnaire in its diagnosis: A Scoping Review Protocol
Authors: Roscher Pierre , Wyk Jacqueline M Van
Published: May 2020

Background: Early prostate cancer (PCa) treatment interventions may leave men with debilitating sexual side effects. These side effects may remain permanent, often undiagnosed and undermanaged. The objective of this study is to map the evidence pertaining to the prevalence, and use of questionnaires, related to the neglected sexual side effects (NSSE) after Pca treatment.Methods:This systematic scoping review’s search strategy will involve the following electronic databases: PubMed, Science Direct and Google Scholar. Following title searching, two-independent reviewers will conduct screening of abstracts and full articles. Thescreenings will be guided by the eligibility criteria. Data will be extracted from the included studies and the emerging themes will be analysed. The review team will analyse the implications of the findings in relation to the research question and aim of the study. The Mixed Method Appraisal Tool (MMAT) will be employed for quality appraisal of included studies.Discussion: We anticipate finding a small amount of studies pertaining to the prevalence and questionnaire use for NSSE after early PCa treatment. The study findings will be disseminated through publication in a peer-reviewed journal, peer presentations as well as presentations at relevant conferences
Prognostic Impact of Cancer Activity on Clinically Relevant Bleeding Events After Percutaneous Coronary Intervention: A Retrospective Study
Authors: Nishikawa Tatsuya , Morishima Toshitaka , Fujii Yuki , Okawa Sumiyo , Otsuka Tomoyuki , Kamada Risa , Yasui Taku , Shioyama Wataru , Oka Toru , Tabuchi Takahiro , Fujita Masashi
Published: May 2020

Background: Prevalence of cancer is a high risk factor for bleeding events related with antiplatelet therapy after percutaneous coronary intervention (PCI) in cancer patients. However, the long-term bleeding event rates have not been elucidated previously. Further risk stratification was not sufficiently assessed among cancer patients. This study aimed to evaluate the risk factors for clinically relevant bleeding events in cancer patients after PCI with stent implantation.Methods: Among 236 patients who received PCI between 2013 and 2018, 89 cancer patients with first PCI with stent implantation, without prior dual-antiplatelet therapy (DAPT), were analyzed. They were divided into the active cancer (n=44) and non-active cancer (n=45) groups. The active cancer group included non-operable patients currently on treatment or those with metastasis. The non-active cancer group included patients who had already undergone radical surgery or had planned radical surgery within 3 months after the index PCI. The primary endpoint was bleeding events, characterized as Bleeding Academic Research Consortium (BARC) types 2, 3, and 5. The secondary endpoint was 3-point major adverse cardiovascular events (3P-MACE) determined as the composite of cardiac death, nonfatal myocardial infarction, and nonfatal stroke.Results: During the median follow-up period of 2.2 years, there were 11 patients with bleeding events, with only 1 patient in the non-active cancer group. Of the other 10 patients, 5 experienced bleeding during the dual-antiplatelet therapy (DAPT) period, while the remaining 5 experienced bleeding during the single-antiplatelet therapy (SAPT) period. The Kaplan-Meier analysis showed that the active cancer group had a significantly greater number of bleeding events of BARC types 2, 3, and 5 (log-rank, P=0.010). Multivariate Cox regression hazards model analysis revealed that cancer activity was an independent significant risk factor (HR, 9.03; 95% CI, 1.33–176.69; P=0.023). During the 2.5-years [IQR: 0.7–3.0] follow-up period, there was no significant difference in the 3P-MACE between the active and non-active cancer patients.Conclusions: The non-active cancer group presented with significantly lower clinically relevant bleeding after PCI than the active cancer patients. However, the bleeding risk was high in the active cancer groups during both the DAPT and SAPT periods.
Evaluation of an organisational performance measurement implementation framework for health charities
Authors: Colbran Richard , Ramsden Robyn , Stagnitti Karen , Toumbourou John , Pepin Genevieve
Published: May 2020

BackgroundNon acute health charities form part of the global health services industry yet face concerns regarding performance and accountability. Organisational performance measurement (OPM) is enables performance however is under utilised in the non acute health charity sector. The Non-acute Health Charity Performance Implementation Framework (NCPI Framework) was developed to support OPM implementation in non acute health charities. The study goal was to assess whether NCPI Framework implementation could positively impact on the introduction of OPM to case study organisation. The hypothesis was that NCPI Framework implementation would positively impact on the introduction of OPM in a non acute health charity.MethodsA convergent parallel design mixed methods case study evaluation was conducted of the twelve-month implementation of the NCPI Framework in a non acute health charity. Pre and post survey quantitative and qualitative techniques were used to assess the infrastructure and systems used to support the NCPI Framework’s program design and implementation in addition to participant perception of OPM usefulness. This study analysed quantitative data collected using identical pre and post Likert scales surveys. Response rates were 74% at pre and 64% at post data collection times. The valid percentage was used to exclude incomplete responses. Then, data were analysed using descriptive statistics such as modes, means and standard deviation. Wilcoxon Signed Rank Test was used to examine changes between pre and post data. ResultsResults support the hypothesis that the implementation of the NCPI Framework positively impacted on the introduction of organisational performance measurement in the case study organisation. The results were statistically significant and demonstrated positive change in implementation infrastructure and participant perception of OPM usefulness. Board members (59%) reported a lower level of change in positive perception of usefulness than staff (93%) and salaried clinical advisors (93%).ConclusionThis is the first methodological evaluation of OPM implementation in the non acute health charity sector. Results suggest the NCPI Framework has potential to support the establishment of infrastructure, systems and participant engagement to enable OPM introduction in non acute health charities.
Identification of a Novel Mutation in the KITLG Gene in a Chinese Family with Familial Progressive Hyper- and Hypopigmentation
Authors: Wang Jianbo , Li Weisheng , Zhou Naihui , Zhang Shoumin , Li Xueli , Li Zhenlu , Yang Ziliang , Li Min , Sun Miao
Published: May 2020

Background Familial progressive hyper- and hypopigmentation (FPHH, MIM 145250) is a rare hereditary skin disorder that is predominantly characterized by progressive, diffuse, partly blotchy hyperpigmented lesions intermingled with scattered hypopigmented spots, lentigines and sometimes Cafe-au-lait spots (CALs). Heterozygous mutations of KIT ligand (KITLG, MIM 184745) gene, which encodes KIT ligand protein, is responsible for FPHH.Results A novel mutation c.104A > T (p.Asn35Ile) and a recurrent mutation c.101C > T (p.Thr34Ile) in the KITLG gene with two Chinese FPHH families were identified. So far, various pathogenic gain-of-function mutations in the KITLG gene have been described, which are located in or near the conserved VTNN motif (amino acid 33–37) in exon 2 of the KITLG gene. The reported mutations are only involved in 33V, 34T, 36N, 37V but not 35N. As SIFT and Polyphen-2 softwares showed, these two mutations were both predicted to be detrimental variations. Three-dimensional protein structures modeling indicated the mutant KITLG proteins might affect KITLG affinity to its receptor c-KIT. To date, only eight KITLG mutations were associated with FPHH and no clear genotype-phenotype correlations had been well established.Conclusions We have now identified a novel mutation c.104A > T (p.Asn35Ile) of KITLG gene, which was first reported in FPHH located within the conserved 35N of the motif. These results strengthen our understanding of FPHH and expand the mutational spectrum of the KITLG gene.
A retrospective study of potential influence factors on Helicobacter pylori infection treatment
Authors: Qi Xiaomei , Xia Luoluo , Xie Laiping , Huang Dingde , Yang Ying
Published: May 2020

BackgroundThe high prevalence of Helicobacter pylori (H. pylori) infection has been associated with overcrowding, poor housing, poor sanitation and unclean water supplies in developing countries.MethodsWe assessed records of symptomatic patients attending Southwest Hospital in 2017, collected patients’ information such as age, gender, education levels, income level, number of family members, frequency of hand washing after defecation, past history of gastropathy and so on. Chi square analysis, t-test and Odds Ratio (OR) were used to evaluate the effect of potential factors on treatment effect.ResultsAge, gender, number of family members, follow-up time, type of toilet, water source and past history of gastropathy seemed to be irrelevant to H. pylori infection control. Higher education level was benefit for patients (OR 0.315, 95% CI 0.134-0.741, P=0.008). Less frequency of hands washing after defecation was harmful factors for H. pylori-positive patients’ treatment (OR=3.438, 95% CI 1.679-7.039, P=0.001). Better income status was a protective factor only in Univariate analysis (OR=0.396 95% CI 0.197-0.795, P=0.01).ConclusionA better education background and strict habits of hands washing were both helpful for H. pylori-positive patients’ treatment.
A Novel Method for Internal Fixation of Fifth Metatarsal Tuberosity Avulsion Fractures
Authors: Zhan Taicheng , Zhu Kunpeng , Hu Jianping , Cai Tao , Zhang Lei , Zhang Chunlin
Published: May 2020

Background:The purpose of this study is to introduce a novel technique of fixation with a suture anchor combined with a headless cannulated screw.Patients and Methods: Ninepatients with fifth metatarsal tuberosity avulsion fractures were recruited and surgically treated witha suture anchor combined with headless cannulated screw fixation. Those patients were seen for follow-up visits monthly. Clinical and radiological outcomes were evaluated after surgery, at 4, 6 and 8 weeks, and monthly thereafter. The functional outcome was graded using the American Orthopedic Foot and Ankle Society (AOFAS) midfoot scoring system at the final follow-up visit.Results: The mean interval to bone union observed radiologically was 5.6 weeks (range 4–8 weeks). No case of delayed union/nonunion or refracture was detected. No screw migration or implant breakage occurred. The mean interval to daily living activities was 8.2 (range 6 to 12) weeks after surgery.The mean AOFASscore improved from 30.8 (range 10 to 45) points preoperatively to 92.3 (range 87 to 98) points at the final follow-up visit.Conclusions:A suture anchor combined with a headless cannulated screw is a reliable technique with good outcomes and can potentially allow for early bone union.
Evaluation of Right Myocardial Performance Index of In Vitro Fertilization Fetuses and Spontaneous Pregnancy Fetuses: A Cross-Sectional Study
Authors: Chen Shaoqi , Zhuang Zemin , Chen Qingzi , Du Xiya , Tan Xuerui
Published: May 2020

OBJECTIVETo establish normal reference range for the fetal right myocardial performance index (RMPI), and compare the reference range between in vitro fertilization (IVF) fetuses and spontaneous pregnancy (SP) fetuses by automatic measurement of the RMPI.METHODSFrom September 2019 to January 2020, 410 participants, who were at 19-40 weeks' gestation, were enrolled into the current study. Among 410 participants, there were 371 spontaneous pregnancies which were matched as control group, and the experimental group involved 39 singleton pregnancies conceived by IVF. RMPI was calculated as (a-b)/b. The three readings were obtained and averaged per examination, with intra-observer repeatability assessed by intraclass correlation coefficient (ICC) and 95% confidence interval (CI). The ‘a’ and ‘b’ intervals were measured at 3 different caliper positions in each fetus: beginning of the original valve clicks (‘original’), beginning of the reflected tricuspid and pulmonary closure clicks (‘reflected’), and peak of valve clicks (‘peak’).RESULTSThe RMPI of SP fetuses was 0.43±0.05 (mean ± standard deviation (SD)), and the RMPI of IVF fetuses was 0.42 ±0.05 (mean ± SD). There was no significant difference in normal reference range of right MPI between IVF fetuses and SP fetuses. No strong correlation was also noted between RMPI with gestational age and heart rate.CONCLUSIONNormal reference ranges of RMPI of IVF fetuses and SP fetuses were established, and no significant difference between IVF fetuses and SP fetuses was found.
Physiological Change Alters Endophytic Bacteria Community in Clubroot of Tumorous Stem Mustard Infected by Plasmodiophora Brassicae
Authors: Wang Diandong , Sun Tingting , Zhao Songyu , Pan Limei , Liu Hongfang , Tian Xueliang
Published: May 2020

Background: Endophytic bacteria are considered as symbionts living within plants and are influenced by abiotic and biotic environmemts. Here, we reveal how endophytic bacteria in tumorous stem mustard (Brassica juncea var. tumida) are affected by clubroot disease using 16S rRNA high-throughput sequencing.Results: The results showed that Proteobacteria was the dominant group in both healthy roots and clubroots, but their abundance differed. At the genus level, Pseudomonas was dominant in clubroots, whereas Rhodanobacter was the dominant in healthy roots. Hierarchical clustering, UniFrac-weighted principal component analysis (PCA), non-metric multidimensional scaling (NMDS) and analysis of similarities (ANOSIM) indicated significant differences between the endophytic bacteria communities in healthy roots and clubroots. The physiologcial properties including soluble sugar, soluble protein, methanol, POD and SOD significantly differed between healthy roots and clubroots. The distance-based redundancy analysis (db-RDA) and two-factor correlation network showed that soluble sugar, soluble protein and methanol were strongly related to the endophytic bacteria community in clubroots, wheares POD and SOD correlated with the endophytic bacteria community in healthy roots.Conclusions: Our results illustrate that physiologcial change caused by P. brassicae infection may alter the endophytic bacteria community in clubroots of tumorous stem mustard.
Coronavirus Disease 19 in Minority Populations of Newark, New Jersey
Authors: Okoh Alexis K , Sossou Christoph , Dangayach Neha S , Meledathu Sherin , Phillips Oluwakemi , Raczek Corrine , Patti Michael , Kang Nathan , Hirji Sameer , Cathcart Charles , Engell Christian , Cohen Marc , Bishburg Eliahu , Nagarakanti Sandhya , Grewal Harpreet
Published: May 2020

BACKGROUND:The purpose of this study is to report the clinical features and outcomes of Black/African American (AA) and Latino Hispanic patients with Coronavirus disease 2019 (COVID-19) hospitalized in an inter-city hospital in the state of New Jersey. METHODS: This is a retrospective cohort study of AA and Latino Hispanic patients with COVID-19 admitted to a 665-bed quaternary care, teaching hospital located in Newark, New Jersey. The study included patients who had completed hospitalization between March 10, 2020, and April 10, 2020. We reviewed demographics, socioeconomic variables and incidence of in-hospital mortality and morbidity. Logistic regression was used to identify predictor of in-hospital death.RESULTS: Out of 416 patients, 251 (60%) had completed hospitalization as of April 10, 2020. The incidence of In-hospital mortality was 38.6% (n=97). Most common symptoms at initial presentation were dyspnea 39% (n=162) followed by cough 38%(n=156) and fever 38% (n=143). Patients were in the highest quartile for population’s density, number of housing units and disproportionately fell into the lowest median income quartile for the state of New Jersey. The incidence septic shock, acute kidney injury (AKI) requiring hemodialysis and admission to an intensive care unit (ICU) was 24% (n=59), 21% (n=52), 33% (n=82) respectively. Independent predictors of in-hospital mortality were older age, lower serum Hemoglobin <10mg/dl, elevated serum Ferritin and Creatinine phosphokinase levels >1200U/L and >1000 U/L.CONCLUSIONS: Findings from an inter-city hospital’s experience with COVID-19 among underserved minority populations showed that, more than one of every three patients were at risk for in-hospital death or morbidity. Older age and elevated inflammatory markers at presentation were associated with in-hospital death.
LncRNA-MEG3 functions as ferroptotic promoter to mediate OGD combined high glucose-induced death of rat brain microvascular endothelial cells via the p53-GPX4 axis
Authors: Chen Cheng , Huang Yan , Xia Pingping , Zhang Fan , Li Longyan , Wang E , Guo Qulian , Ye Zhi
Published: May 2020

Background

Individuals with diabetes are exposed to a higher risk of perioperative stroke than non-diabetics mainly due to persistent hyperglycemia. lncRNA-MEG3 (long non-coding RNA maternally expressed gene 3) has been considered as an important mediator in regulating ischemic stroke. However, the functional and regulatory roles of lncRNA-MEG3 in diabetic brain ischemic injury remain unclear.

Results

In this study, RBMVECs (the rat brain microvascular endothelial cells) were exposed to 6 h of OGD (oxygen and glucose deprivation), and subsequent reperfusion via incubating cells with glucose of various high concentrations for 24 h to imitate in vitro diabetic brain ischemic injury. It was shown that the marker events of ferroptosis and increased lncRNA-MEG3 expression occurred after the injury induced by OGD combined with hyperglycemic treatment. However, all ferroptotic events were reversed with the treatment of MEG3-siRNA. Moreover, in this in vitro model, p53 was also characterized as a downstream target of lncRNA-MEG3. Furthermore, p53 knockdown protected RBMVECs against OGD + hyperglycemic reperfusion-induced ferroptosis, while the overexpression of p53 exerted opposite effects, implying that p53 served as a positive regulator of ferroptosis. Additionally, the overexpression or knockdown of p53 significantly modulated GPX4 expression in RBMVECs exposed to the injury induced by OGD combined with hyperglycemic treatment. Furthermore, GPX4 expression was suppressed again after the introduction of p53 into cells silenced by lncRNA-MEG3. Finally, ChIP assay uncovered that p53 was bound to GPX4 promoter.

Conclusions

Altogether, these data revealed that, by modulating GPX4 transcription and expression, the lncRNA-MEG3-p53 signaling pathway mediated the ferroptosis of RBMVECs upon injury induced by OGD combined with hyperglycemic treatment.
A novel panel based on Immune infiltration and tumor mutational burden for prognostic prediction in hepatocellular carcinoma
Authors: Wu Hewei , Zheng Xingrong , Pan Tao , Yang Xiaoan , Zhang Genglin , Lian Yunwen , Lin Jiaxin , Peng Liang , Xie Chan
Published: May 2020

Background : Tumor mutation burden (TMB) was associated with prognosis in various malignancies, but it remains to be elucidated in hepatocellular carcinoma (HCC). We aimed to investigate the prognostic effects of TMB and its relationship with immune infiltration so as to establish a panel model capable of predicting prognosis.

Methods : TMB was calculated in all 374 HCC patients from the Cancer Genome Atlas, and high TMB and low TMB groups were determined based on propensity score matching and X-tile analysis. WCGNA was utilized to screen out genes related to immune cells and TMB, followed by multivariate analysis to generated the final TMB-Infiltration (TMB-IF) panel. 453 HCC patients from ICGC-LIRI-JP, GSE76427 and GSE20017 verified the robustness and extensibility of TMB-IF. Additionally, whole-exome sequencing (WES) was performed in 8 follow-up patients to investigate the relationship between HCC recurrence and TMB.

Results : Patients in high TMB group had worse prognosis than those in low TMB group, with a cutoff TMB value of 4.9. Enrichment analysis demonstrated that differentially expressed genes were mainly related to T cell activation, cell membrane localization and matrix composition. Tumor immune infiltration analysis revealed the infiltrations of Th2, Th17, and Tgd were up-regulated in high TMB group, while those of Tr1, MAIT, and DC were up-regulated in low TMB group. And TMB-IF fit well with the actual survival observation, with a C-index 0.785 (0.700-0.870), which verified in ICGC-LIRI-JP was 0.670 (0.573-0.767), and 0.774 (0.670-0.877) in GSE76427. In addition, TMB-IF showed a good performance in predicting tumor vascular invasion with a C-index of 0.847 (0.778-0.916).

Conclusions : Higher TMB means worse prognosis in HCC patients. Patients with higher frequency of immune-related gene mutations and TMB are prone to relapse after radical treatment.
Upregulation of EMID1 accelerates to a favorable prognosis and immune infiltration in lung adenocarcinoma.
Authors: Li Chengrui , Wan Yufeng , Deng Weijun , Fei Fan , Wang Linlin , Qi Fuwei , Zheng Zhong
Published: May 2020

Background Lung cancer is a kind of refractory cancer. Lung adenocarcinoma (LUAD) is the main subtype of lung cancer. Although there are many ways to treat lung cancer, the survival rate of patients has not improved. Therefore, more new molecules need to be found for the diagnosis and treatment of LUAD. Methods The data from The Cancer Genome Atlas (TCGA) database were used to analyze the value of EMID1 in diagnosis and prognosis of LUAD. The relationship between clinic pathological features and EMID1 was analyzed with the Wilcoxon signed-rank test and logistic regression by R (v.3.5.1). Gene Set Enrichment Analysis (GSEA) was performed to investigate the potential mechanism of EMID1 expression on the prognosis of LUAD. The correlation between tumor infiltrating immune cells and genes was assessed by CIBERSORT. In addition, GEPIA and Gene Expression Omnibus (GEO) database were used to verify the results. Results The decreased expression of EMID1 was significantly related to the late stage and metastasis of lung cancer. Kaplan Meier survival analysis showed that patients with low expression of EMID1 had worse prognosis than those with high expression of EMID1. Notch signaling pathway may be an important biological pathway for EMID1 to play a role in LUAD. In addition, CIBERSORT also found that the infiltration level of B cells was positively correlated with the expression of EMID1, which played an important role in the immune environment of LUAD. All results were validated in GEO and GEPIA database. Conclusion The analysis of EMID1 was helpful to understand the immune microenvironment of LUAD and improve the survival status of patients with LUAD. All the results suggested that EMID1 might be a new immune related prognostic marker of LUAD.
A Recursive Frequency Smoothing Method of Cyclic Spectrum Density Estimation
Authors: Dai Jianzhong , Feng Xuzhe , Chen Jianyun , Yan Shuhua , Jia Aiai
Published: May 2020

Cyclic spectrum density estimation plays a significant role in cyclostationary signals analysis. Generally, the methods of cyclic spectrum density estimation are mainly focus in time-domain, such as FFT Accumulation Method (FAM) and Strip Spectral Correlation Algorithm (SSCA). In this paper, based on the principle of frequency smoothing methods, an improved method in frequency-domain was proposed, which could reduce the computational cost greatly by using recursion. The recursive method was based on the fact that the range difference of smoothing window was small when window slid. In other words, we could get a new point of cyclic spectrum density just by computing the complex conjugate products of newly coming into window. In addition, the simulation results were given at last, which showed the good performance of our proposed method.
Cost-effectiveness analysis of malaria rapid diagnostic test in the elimination setting
Authors: Du Yanqiu , Ling Xiaoxiao , Jin Jiajie , Zhou Huayun , Zhu Si , Zhu Guoding , Wang Wei , Cao Jun , Huang Jiayan
Published: May 2020

Background As more and more countries approaching the goal of malaria elimination, malaria rapid diagnostic tests (RDT) was recomendated to be a diagnostic strategy to achieve and maintain the statute of malaria free, as it’s less requirments on equipment and experitise than microscopic examination. But there are very few economic evaluations to confirm whether RDT was cost-effective in the setting of malaria elimination. Methods A cost-effectiveness analysis, based on data from Jiangsu province, China, was conducted to compare RDT with microscopy examination for malaria diagnosis. There were three strategies of malaria diagnostic testing evaluated using a decision tree model, 1) microscopy, 2) RDT, 3) RDT followed by microscopy. The effects were measured by the number of malaria cases treated appropriately. Based on the joint perspective of health sector and patient, costs data were collected from hospital information systems, key informant interviews, and patient surveys. Epidemiological data were obtained from local malaria surveillance reports. A hypothetical cohort of 300,000 febrile patients were simulated to calculate the total cost and effect of each strategy. One-way, two-way, and probabilistic sensitivity analysis were performed to test the robustness of the result. Results The results showed that RDT strategy was the most effective (245 cases) but also the most costly (4.47 million USD) compared to using microscopy alone (238 cases, 3.63 million USD), and RDT followed by microscopy (221 cases, 2.75 million USD). There was no strategy dominated. One-way sensitivity analysis reflected that the result was sensitive to the change in labor cost and two-way sensitivity analysis indicated that the result was not sensitive to the proportion of falciparum malaria. The result of Monte Carlo simulation showed that RDT strategy had higher effects and higher cost than other strategies with a high probability. Conclusions Compared to microscopy and RDT followed by microscopy, RDT strategy had higher effects and higher cost in the setting of malaria elimination. This conclusion still would be held when the change in the proportion of falciparum and the cost fluctuations were accounted.