bluuebunny/crossref_metadata_2025 huggingface dataset:
Validating a transnational fracture treatment registry using a standardized method
Authors: Frese Jasper , Gode Annalice , Heinrichs Gerhard , Will Armin , Schulz Arndt-Peter
Published: November 2019

Aim

Subsequent to a three-month pilot phase, recruiting patients for the newly established BFCC (Baltic Fracture Competence Centre) transnational fracture registry, a validation of the data quality needed to be carried out, applying a standardized method.Method

During the literature research, the method of “adaptive monitoring” fulfilled the requirements of the registry and was applied. It consisted of a three-step audit process; firstly, scoring of the overall data quality, followed by source data verification of a sample size, relative to the scoring result, and finally, feedback to the registry on measures to improve data quality. Statistical methods for scoring of data quality and visualisation of discrepancies between registry data and source data were developed and applied.Results

Initially, the data quality of the registry scored as medium. During source data verification, missing items in the registry, causing medium data quality, turned out to be absent in the source as well. A subsequent adaptation of the score evaluated the registry’s data quality as good. It was suggested to add variables to some items in order to improve the accuracy of the registry.Discussion

The application of the method of adaptive monitoring has only been published by Jacke et al., with a similar improvement of the scoring result following the audit process. Displaying data from the registry in graphs helped to find missing items and discover issues with data formats. Graphically comparing the degree of agreement between the registry and source data allowed to discover systematic faults.Conclusions

The method of adaptive monitoring gives a substantiated guideline for systematically evaluating and monitoring a registry’s data quality and is currently second to none. The resulting transparency of the registry’s data quality could be helpful in annual reports, as published by most major registries. As the method has been rarely applied, further successive applications in established registries would be desirable.
Validating a transnational fracture treatment registry using a standardized method
Authors: Frese Jasper , Gode Annalice , Heinrichs Gerhard , Will Armin , Schulz Arndt-Peter
Published: November 2019

Aim Subsequent to a three-month pilot phase, recruiting patients for the newly established BFCC (Baltic Fracture Competence Centre) transnational fracture registry, a validation of the data quality needed to be carried out, applying a standardized method.Method During the literature research, the method of “adaptive monitoring” fulfilled the requirements of the registry and was applied. It consisted of a three-step audit process; firstly, scoring of the overall data quality, followed by source data verification of a sample size, relative to the scoring result, and finally, feedback to the registry on measures to improve data quality. Statistical methods for scoring of data quality and visualisation of discrepancies between registry data and source data were developed and applied.Results Initially, the data quality of the registry scored as medium. During source data verification, missing items in the registry, causing medium data quality, turned out to be absent in the source as well. A subsequent adaptation of the score evaluated the registry’s data quality as good. It was suggested to add variables to some items in order to improve the accuracy of the registry.Discussion The application of the method of adaptive monitoring has only been published by Jacke et al., with a similar improvement of the scoring result following the audit process. Displaying data from the registry in graphs helped to find missing items and discover issues with data formats. Graphically comparing the degree of agreement between the registry and source data allowed to discover systematic faults.Conclusions The method of adaptive monitoring gives a substantiated guideline for systematically evaluating and monitoring a registry’s data quality and is currently second to none. The resulting transparency of the registry’s data quality could be helpful in annual reports, as published by most major registries. As the method has been rarely applied, further successive applications in established registries would be desirable.
The predictors and patterns of the early recurrence of pancreatic ductal adenocarcinoma after pancreatectomy: the influence of pre- and post- operative adjuvant therapy
Authors: Suto Hironobu , Okano Keiichi , Oshima Minoru , Ando Yasuhisa , Takahashi Shigeo , Shibata Toru , Kamada Hideki , Kobara Hideki , Masaki Tsutomu , Suzuki Yasuyuki
Published: November 2019

Background The perioperative factors predicting or influencing early pancreatic ductal adenocarcinoma recurrence are unclear. This study attempted to identify the predictive factors for early pancreatic ductal adenocarcinoma recurrence post-pancreatectomy and the influence of pre- and post- operative adjuvant therapy.
Methods One hundred and fifteen patients undergoing curative resection for pancreatic ductal adenocarcinoma between 2000 and 2016 at our institution were retrospectively analyzed. Patients were divided into two groups: those who did (n=34) and did not (n=81) experience a recurrence within 6 months postoperatively.
Results Multivariate analyses demonstrated postoperative CA19-9 de-normalization, no postoperative adjuvant chemotherapy, and serosal invasion were independent risk factors for early recurrence (P<0.001, P=0.001, and P=0.010, respectively). A subgroup analysis showed patients with (n=51) and without (n=64) preoperative chemoradiotherapy had different predictors. Although postoperative adjuvant chemotherapy was not a significant indicator in patients with preoperative chemoradiotherapy, CA19-9 de-normalization and no postoperative adjuvant chemotherapy were significant indicators in patients without preoperative chemotherapy. Preoperative chemotherapy strongly prevented early local recurrence while postoperative adjuvant chemotherapy prevented early distant recurrence.
Conclusions CA19-9 de-normalization was an important predictor of early recurrence of pancreatic ductal adenocarcinoma. Although postoperative adjuvant chemotherapy was an important preventive measure against early recurrence, particularly for distant recurrence, preoperative chemoradiotherapy could strongly prevent the early local recurrence of pancreatic ductal adenocarcinoma. These perioperative adjuvant therapies could have a complementary relationship.
Tailoring cryo-electron microscopy grids by photo-micropatterning for in-cell structural studies
Authors: Toro-Nahuelpan Mauricio , Zagoriy Ievgeniia , Senger Fabrice , Blanchoin Laurent , Théry Manuel , Mahamid Julia
Published: November 2019

Micromachining by cryo-focused ion beam (FIB) milling coupled to cryo-electron tomography (ET) enables visualization of macromolecules directly inside cells. Yet, spatial control of cell adhesion on electron microscopy (EM) grids remains a bottleneck in the specimen preparation pipeline. This protocol describes a contactless and mask-free photo-micropatterning of EM grids for site-specific deposition of extracellular matrix-related proteins. We achieved accurate and reproducible cell positioning, leading to optimized preparations for cryo-FIB milling. We tested HeLa and RPE1 cell lines on various grid types (gold or titanium mesh coated with SiO2, gold or carbon films). Briefly, grids were passivated with an anti-fouling agent, followed by controlled ablation of the passivation layer, and further functionalization with fibronectin. The micropatterning procedure takes ~3 h. Employing micropatterning to produce complex shapes generated a predictable intracellular organization, allowing direct correlation between cellular architecture and in-cell 3D-structural characterization of the underlying machinery at molecular resolution.
Perioperative poor grip strength recovery is associated with 30-day complication rate after cardiac surgery discharge in middle-aged and older adults- a prospective observational study
Authors: Fu Liyuan , Zhang Yuanyuan , Shao Bohan , Liu Xiangjing , Yuan Bo , Wang Zhengqing , Chen Tienan , Liu Zhigang , Liu Xiaocheng , Guo Qi
Published: November 2019

Background: Although perioperative care during heart surgery has improved considerably, the rate of postoperative complications has remained stable. It has not been concluded how to better apply grip strength to clinical, postoperative complications. So our study aimed at researching the best way for using grip value for predicting early postoperative complications. Methods: A total of 212 patients with mean age 63.8±6.3 who underwent cardiac surgery participated in our study. We analyzed the ROC curve of grip strength, grip/weight and grip recovery with complications, found the best cutoff point. Logistic regression confirmed the association between grip strength grouping and complications. Results: We found that 36 patients had 30-day complications. EuroSCORE were 2.15±1.52 and 2.42±1.58 between normal and complication groups, respectively. The area under the receiver-operating characteristic curve (AUC) of grip recovery take the most area (0.837, p<0.001), and the cutoff point was 83.92%. In logistic regression, lower grip recovery has higher risk impact on 30-day complications for 25.68 times than normal group, after adjusted surgery-related factors. After regrouped characteristic information by grip recovery cutoff point , we found that percentage of the estimated 6 minute walk distance (41.5 vs 48.3, p=0.028) and hospitalization time (7.2 vs 6.1, p=0.042) had worse trends in lower recovery group. Conclusions: Poor grip recovery may be related to higher risk of postoperative complications within 30 days after discharge in middle-aged and older people independent of surgical risk. The results of this study provide a reference for the development of rehabilitation programs in the early postoperative recovery, and may also be a prognostic indicator for postoperative high-risk groups.
Identification and characterization of differentially expressed exosomal microRNAs in bovine milk infected with Staphylococcus aureus
Authors: Ma Shaoyang , Tong Chao , Ibeagha-Awemu Eveline M. , Zhao Xin
Published: November 2019

Background: MicroRNAs (miRNA) in milk-derived exosomes may reflect pathophysiological changes caused by mastitis. This study profiled miRNAs in exosomes from both normal milk and mastitic milk infected by Staphylococcus aureus (S. aureus). The potential targets for differentially expressed (DE) miRNAs were predicted and the target genes for bta-miR-378 and bta-miR-185 were also validated.
Results: Total RNA from milk exosomes was collected from healthy cows (n=3, the control group) and S. aureus infected cows (n=6, the SA group). Two hundred ninety miRNAs (221 known and 69 novel ones) were identified. Among them, 22 known and 15 novel miRNAs were differentially expressed. Target genes of DE miRNAs were significantly enriched in intracellular protein transport, endoplasmic reticulum and identical protein binding. Two miRNAs (bta-miR-378 and bta-miR-185) with high read counts and log 2 fold changes (>3.5) were significantly higher in mastitic milk infected with S. aureus. One target gene (V AT1L) of bta-miR-378 and five target genes (DYRK1B , MLLT3 , HP1BP3 , NPR2 and PGM1) of bta-miR-185 were validated.
Conclusion: DE miRNAs in exosomes from normal and S. aureus infected milk were identified. The predicted targets for two DE miRNAs (bta-miR-378 and bta-miR-185) were further validated. The linkage between the validated target genes and diseases suggested that we should pay particular attention to exosome miRNAs from mastitic milk in terms of milk safety.
Investigating Associated Factors with Glomerular Filtration Rate : Structural Equation Modeling
Authors: Jamshidi Parastoo , Najafi Farid , Mostafaee Shayan , Shakiba Ebrahem , pasdar yahya , Hamzeh Behrooz , Moradinazar Mahdi
Published: November 2019

Background: glomerular filtration rate (GFR) is a valid indicator for kidney function. Different factors can affect GFR. The purpose of this study is to assess direct and indirect effects of GFR-related factors using structural equation modeling.Patients and methods:We analyzed data from baseline phase of Ravansar Non-Communicable Disease cohort study. Data on socio-behavioral, nutritional, cardiovascular, and metabolic risk factors were entered in a conceptual model in order to test direct and indirect effects of factors related to GFR,separately in male and female, using the structural equation modeling.Results: Of 8927 individuals participated in this study, 4212 subjects were male (47.20%) and 4715 subjects were female (52.80%). The obtained mean and standard deviation of GFR was 76.05 (±14.31) per 1.73 . GFR for 0.2%, 11.3%, 73.0% and 15.50% of people were <30, , and , respectively. Hypertension and aging in both gender and atherogenic factor in male directly, and in female directly and indirectly had a lower effect on GFR. Blood urea nitrogen and smoking in male and female, directly or indirectly through other variables, were associated with a lower GFR. In female, diabetes had a lower direct and indirect effect on GFR. Obesity in female was directly associated with uper and indirectly associated with lower GFR.Conclusion: According to our results, aging, hypertension, diabetes, obesity and high lipid profile, and BUN had a decreasing direct and indirect effects on GFR. Although low GFR might have different reasons and it is not a consistent sign of CKD, our findings, are in line with other reports, provide more detailed informations about important risk factors of low GFR. Public awareness about such factors can improve public practice of positive health behaviours.
Early intervention and follow-up programs among children with cerebral palsy in Moldova: potential impact on impairments?
Authors: Bufteac Ecaterina Gincota , Andersen Guro L. , Spinei Larisa , Jahnsen Reidun
Published: November 2019

Aim: To study whether early intervention services (EI) and a follow-up program (FU) influence outcomes of children with cerebral palsy (CP) in Moldova.
Methods: Records from 351 children with CP in Moldova born during 2009 and 2010 were retrieved from hospital and orphanage archives between 1 July 2016 and 30 September 2017. We investigated the proportion enrolled in EI and FU at the Early Intervention Centre Voinicel and at the Institute of Mother and Child in 2009-2012. Logistic regression analyses were applied to calculate crude and adjusted odds ratios (OR) with 95% confidence intervals (CI) for outcomes in children enrolled and not enrolled.
Results: Among all children with CP, 166 (47%) were enrolled in EI and FU. Of the 51 children born extremely preterm (gestational age ≤31 weeks), 46 (90%) were enrolled, compared to 97 (39%) of the 250 children born at term. Among 110 non-walking children with CP, 82 (74%) were enrolled into EI and FU, compared to 84 (35%) of 241 able to walk.
There was no difference in outcomes of cognition, communication, vision and hearing impairments between those enrolled or not enrolled in EI and FU. However, the subgroup analyses showed that the risk of contractures was five times higher among those not enrolled, regardless of GMFCS level (OR = 5.474, 95% CI 3.306–9.063, p <0.000).
Conclusion: In Moldova, EI and FU seem to be offered mostly to extremely preterm and non-walking children with CP. The results indicate a decreased risk for contractures in these children.
Level of medication self-management capacity among patients on ambulatory care exiting hospital pharmacy at Muhimbili National hospital, Tanzania: a descriptive cross-sectional study
Authors: Mlyuka Hamu Joseph , Salehe Hija , Mikomangwa Wigilya P , Kilonzi Manase E , Marealle Alphonce I , Mutagonda Ritah F , Bwire George M.
Published: November 2019

Objectives: Medication management capacity of a patient on ambulatory care is direct related to adherence. To our knowledge data on medication management capacity for ambulatory care patients exiting outpatient pharmacy outlets in Tanzania are scarce. This study aimed to determine the level of medication management capacity among patients on ambulatory care exiting Muhimbili National Hospital outpatient pharmacy outlet. Results: A total of 424 patients on ambulatory care participated in the study. Three hundred eighty seven (91.3%) out of 424 interview questionnaires had complete data and qualified for data analysis. Majority (62.3%) out of 387 study participants had poor medication management capacity; 65.3% out of 387 patients were unable to correctly read the prescription and match the drugs they are carrying. More than half (57.4%) out of 387 participants were unable to correctly take the dose, 73.9% out of 387 were unable to correctly tell the dosing frequency and duration. Only 10.6% out 155 patients with prescription containing drugs with warning or precaution or contraindication or potential side effects were aware.
Pilot study of expanded newborn screening for 573 genes related to severe diseases in China: results from 1173 newborns
Authors: Luo Xiaomei , Sun Yu , Xu Feng , Guo Jun , Li Lin , Lin Zhiwei , Ye Jun , Gu Xuefan , Yu Yongguo
Published: November 2019

Background: Current newborn screening (NBS) in China is mainly aimed at detecting biochemical levels of metabolites in the blood, which may generate false positive/negative results. To explore whether next-generation sequencing (NGS) for dried blood spots can increase the detecting rate of genetic disorders, we carried out a pilot study using NGS in 1,173 newborns who had been tested by traditional NBS. With a focus on inherited metabolic diseases (IMDs), our team investigated the current frequencies of genes related to common inherited metabolic diseases in this cohort.
Methods: We designed an NGS panel of 573 genes related to severe diseases and performed NBS in 1,173 individuals who had been screened by tandem mass spectrometry (MS/MS) as well as for phenylalanine (Phe), thyroid-stimulating hormone (TSH), 17-α-hydroxyprogesterone (17-OHP), and glucose-6-phosphate dehydrogenase (G6PD) abnormalities in a traditional biochemical NBS conducted in September 2016. We compared the biochemical results to the genetic variants and investigated the carrier frequencies of 77 genes related to disorders by MS/MS in these newborns.Results: The biochemical results showed that four newborns (all male) were positive for G6PD by enzymatic assay, while the other biochemical findings including MS/MS, Phe, TSH and 17-OHP were negative. Genetic analysis results revealed that all the four newborns with positive G6PD values harbored hemizygous G6PD mutations. The NGS results also revealed an individual (ID 84123) carrying two SLC22A5 mutations (c.760C>T/p.R254* and c.1400C>G/p.S467C) common in Chinese patients with carnitine deficiency, which were later verified to be in trans, who was biochemically negative in 2016. The MS/MS results in 2019 showed free carnitine deficiency, consistent with the genetic analysis findings. The top five genes with the highest carrier frequencies in these newborns were PAH (1.77%), ETFDH (1.24%), MMACHC (1.15%), SLC25A13 (0.98%), and GCDH (0.80%).
Conclusions: Our study provided data combing biochemical results with genetic variants in 1,173 newborns and confirmed a primary carnitine deficiency patient with false-negative biochemical results. This is also the first study to report the carrier frequencies of 77 IMD-causing genes in China.
Intestinal parasitic infections and determinant factors among school age children in Ethiopia: a cross-sectional study
Authors: Dessie Awrajaw , Gebregzabher Tesfay , Kiros Berihu , Wami Sintayehu Daba , Chercos Daniel Haile
Published: November 2019

Objective The aim of this study was to determine the prevalence of intestinal parasitic infections and associated factors among school children in Sebeya primary school, Northern Ethiopia, 2017.Results The prevalence of intestinal parasites in school age children was (29.9%). E.histolytica/dispar 62 (49.21%), G.lamblia 28 (22.22%), and A. lumbricoides 23 (18.25%) were the most prevalent parasitic organisms identified. Unclean finger nail (AOR= 1.72), defecating in the open field (AOR=2.82), and being barefooted (AOR=1.72) were the determinant factors for intestinal parasitic infections. Frequently washing hands reduced the chance of infections by 68%. Furthermore, children in grade 1-4 and 5-6 had higher odds developing the infections than those in grade 7-8 (AOR=8.21 and AOR=2.50, respectively).
Hernia reduction following laparotomy using small stitch abdominal wall closure with and without mesh augmentation (the HULC trial, DRKS00017517): Study protocol for a randomized controlled trial
Authors: Heger Patrick , Feißt Manuel , Krisam Johannes , Klose Christina , Dörr-Harim Colette , Tenckhoff Solveig , Büchler Markus W. , Diener Markus K. , Mihaljevic Andre
Published: November 2019

Background:

Incisional hernias are among the most frequent complications following abdominal surgery and cause substantial morbidity, impaired health-related quality of life and costs. Despite improvements in abdominal wall closure techniques the risk for developing an incisional hernia is reported to be between 10-30% following midline laparotomies. There have been two recent innovations with promising results to reduce hernia risks, namely the small stitches technique and the placement of a prophylactic mesh. So far, these two techniques have not been evaluated in combination.

Methods:

The HULC trial is a multicentre randomized controlled, observer and patient blinded surgical effectiveness trial with two parallel study groups. A total of 812 patients scheduled for elective abdominal surgery via a midline laparotomy will be randomized in 12 centres after informed consent. Patients will be randomly assigned to the control group receiving closure of the midline incision with a slowly absorbable monofilament suture in small stitches technique or to the intervention group that will receive a small stitches closure followed by augmentation with a light-weight polypropylen mesh in onlay technique. The primary endpoint will be the occurrence of incisional hernias as defined by the European Hernia Society within 24 months after surgery. Further perioperative parameters, as well as patient-reported outcomes, will be analysed as secondary outcomes.

Discussion:

The HULC trial will address the yet unanswered question whether a combination of small stitched fascial closure and onlay mesh augmentation after elective midline laparotomies reduces the risk of incisional hernias. The HULC trial marks the logical and innovative next step in the development of a safe abdominal closure technique.
The efficacy of Bifidobacterium quadruple viable tablet in the treatment of diarrhea predominant irritable bowel syndrome: a randomized, double-blind, placebo-controlled, multicenter trial.
Authors: Zeng Haoyu , Bai Tao , Long Yanqin , Li Xiaoqing , Sun Xiaohong , Lan Yu , Gao Lingling , Zhang Lu , Feng Zenghui , Hou Xiaohua
Published: November 2019

Background: Irritable bowel syndrome (IBS) is one of the most acommon functional gastrointestinal disorders characterized by recurrent abdominal pain associated with defecation or a change in bowel habits. Leading to significant negative effect on patients’ quality of life and huge financial burden to health system, the management of IBS is a great challenge. Probiotics are considered as an effective therapy, however, in a lack of high-quality evidence of efficacy, no specific strain- and dose-probiotics were recommended in clinical guidelines. This study aims to evaluate the efficacy of the bifidobacterium quadruple viable tablet in the treatment of IBS-D.
Methods/design: A multicenter randomized controlled trial will be performed in fourteen hospitals. A total of three hundred patients fulfill the eligible criteria will be stratified divided into an experimental group and a control group randomly in a ratio of 1:1. The experimental group is treated with the bifidobacterium quadruple viable tablet while the control group is treated with placebo. All the patients will receive a 4-week treatment and a 2-week follow-up. The primary outcome is the effectiveness in improving abdominal pain and stool consistency, the secondary outcome include evaluation of overall symptom relief, frequency of defecation, bloating, urgency of defecation, remedial medication, score of IBS-QOL and changes of microbiota and metabonomics. Physical examination, vital signs, laboratory tests, adverse events and concomitant medication will be taken into account for intervention safety assessment during the trial.
Discussion: This multicenter randomized controlled trial may provide high-quality evidence on the efficacy of the bifidobacterium quadruple viable tablet for IBS-D on both physical and mental dimensions in China. To fill the gap of previous probiotics intervention studies, in addition, this study will also present safety assessment which will be a significant emphasis.
Perceptions about preconception care among health care providers in Ibadan, southwest Nigeria - A qualitative study
Authors: Ojifinni Oludoyinmola Omobolade , Ibisomi Latifat
Published: November 2019

Background:
Preconception care (PCC) is a recognised strategy for optimising maternal health and improving maternal and neonatal outcomes. Research has shown that PCC services are minimally available and yet to be fully integrated into maternal health services in Nigeria. This study explored the perceptions about PCC services among health care providers in Ibadan, Nigeria.
Methods:
This was a case study research among 26 health care providers – 16 specialist physicians and nine nurses covering 10 specialties: Obstetrics/Gynaecology, Cardiology, Endocrinology among others at the primary, secondary and tertiary health care levels. In-depth interviews were digitally recorded, transcribed verbatim and analysed on MAXQDA using thematic analysis.
Results:
Six main themes were identified from the data – scope of PCC, people who require PCC, where PCC services can be provided, acceptability of PCC services, relevance of PCC to different specialties including gynaecologists, cardiologists, nephrologists, psychiatrists and possible benefits of PCC. PCC was viewed as care for women, men and couples before pregnancy to optimise health status and ensure positive pregnancy outcomes. Almost all participants stated that PCC services should be offered at all three levels of health care with referral when needed from the lower to higher levels. The prevailing opinion on the circumstances when PCC is required was that although all people of reproductive age would benefit, those who had medical problems such as hypertension, sickle cell disease, diabetes and infertility would benefit more. Participants opined that delayed health care seeking observed in the community may influence acceptability of PCC especially for people without known pre-existing conditions. All specialist physicians identified the relevance of PCC to their practice and identified potential benefits of PCC. The potential benefits outlined included opportunity to plan and prepare for pregnancy to ensure positive pregnancy outcomes.
Conclusion:
Preconception care is perceived as being more important for promoting positive pregnancy outcomes in people with known medical problems and is relevant to different specialities of medical practice. Provision of the service will however require establishment of guidelines and its uptake will depend on acceptability to people with known medical problems who will benefit from the service.
CRISPR/Cas9-mediated targeted mutagenesis of GmLHY genes alters plant height and internode length in soybean
Authors: Cheng Qun , Dong Lidong , Su Tong , Li Tingyu , Gan Zhuoran , Nan Haiyang , Lu Sijia , Fang Chao , Kong Liping , Li Haiyang , Hou Zhihong , Kou Kun , Tang Yang , Lin Xiaoya , Zhao Xiaohui , Chen Liyu , Liu Baohui , Kong Fanjiang
Published: November 2019

Background: Soybean (Glycine max) is an economically important oil and protein crop. Plant height is a key trait that significantly impacts the yield of soybean; however, research on the molecular mechanisms associated with soybean plant height is lacking. The CRISPR (clustered regularly interspaced short palindromic repeat)/Cas9 (CRISPR-associated system 9) system is a recently developed technology for gene editing that has been utilized to edit the genomes of crop plants.
Results: Here, we designed four gRNAs to mutate four LATE ELONGATED HYPOCOTYL (LHY) genes in soybean. In order to test whether the gRNAs could perform properly in transgenic soybean plants, we first tested the CRISPR construct in transgenic soybean hairy roots using Agrobacterium rhizogenes strain K599. Once confirmed, we performed stable soybean transformation and obtained 19 independent transgenic soybean plants. Subsequently, we obtained one T1 transgene-free homozygous quadruple mutant of GmLHY by self-crossing. The phenotypes of the T2-generation transgene-free quadruple mutant plants were observed, and the results showed that the quadruple mutant of GmLHY displayed reduced plant height and shortened internodes. The levels of endogenous gibberellic acid (GA3) in Gmlhy1a1b2a2b was lower than in the wild type (WT), and the shortened internode phenotype could be rescued by treatment with exogenous GA3. In addition, the relative expression levels of GA metabolic pathway genes in the quadruple mutant of GmLHY were significantly decreased in comparison to the WT. These results suggest that GmLHY encodes an MYB transcription factor that affects plant height through mediating the GA pathway in soybean. We also developed genetic markers for identifying mutants for application in breeding studies.
Conclusions: Our results indicate that CRISPR/Cas9-mediated targeted mutagenesis of four GmLHY genes reduces soybean plant height and shortens internodes from 20 to 35 days after emergence (DAE). These findings provide insight into the mechanisms underlying plant height regulatory networks in soybean.
Sociodemographic and Health-Related Characteristics of a Safety-Net Patient Population
Authors: Agovi Afiba Manza-Azele , Anikpo Ifedioranma , Cvitanovich Matthew J. , Yan Lu , Chu Tzu-Chun , MacDonald Brooke , Gehr Aaron W. , Craten Kevin , Ojha Rohit P.
Published: November 2019

Background Safety-net health systems are an important source of healthcare for underserved or vulnerable individuals, but definitions of safety-net institutions are largely based on patient characteristics. Some definitions may not accurately identify such institutions. Therefore, we aimed to describe the characteristics of urban safety-net patients in Texas and compare the distribution of morbidities between safety-net and general population patients. Methods We used hospital claims data from the Dallas-Fort Worth Hospital Council Foundation to create a cross-sectional cohort. Eligible patients were aged ≥18 years and Tarrant County residents in 2018. Patients were divided into two groups for comparison. The first group represented patients with hospital claims from JPS Health Network (i.e. safety-net population). The second group represented all patients with hospital claims in Tarrant County (i.e. general population). We estimated frequencies of patient characteristics. In addition, we estimated overall and payor-stratified standardized morbidity ratios (SMRs) adjusted for age, gender, and race/ethnicity to compare the prevalence of common chronic diseases between safety-net patients and patients in the general population. Results Our study population comprised 459,827 patients, of whom 74,323 (16%) were safety-net patients. Patients aged ≥65 years comprised 23% of the general population and 11% of the safety-net population. Non-Hispanic Whites comprised 52% of the general population and 29% of safety-net patients. A larger proportion of safety-net patients were uninsured compared with general population patients (safety-net: 54%; general population: 25%), but Medicaid distribution was less discrepant (safety-net: 9%; general population: 7%). Medicare was the primary payor for 24% of general population patients and 14% of safety-net patients. Safety-net patients had relative excesses of mental health and chronic conditions ranging between 5% and 230% for all selected conditions except dementia/Alzheimer’s. The patterns for payor-stratified SMRs were consistent with the overall results. Conclusions We observed considerable sociodemographic diversity and a high burden of mental health and chronic conditions among safety-net patients, which may support understanding the healthcare needs of safety-net populations. Our findings raise questions about definitions of safety-net institutions based on Medicaid distribution alone and the transportability of findings from studies in which safety-net populations are unrepresented.
Effects of Comprehensive Sexuality Education on the comprehensive knowledge and attitude to condom use among first-year students in Arba Minch University: a quasi-experimental study
Authors: Boti Negussie , Hussen Sultan , Shegaze Mulugeta , Shibru Simon , shibiru Tamiru , Zerihun Eshetu , Godana Wanzahun , Abebe Sintayehu , Gebretsadik Woyinshet , Desalegn Nathan , Temtime Zebene
Published: November 2019

ABSTRACT
Objective: To assess the effect of comprehensive sexuality education on the comprehensive knowledge and attitude to condom use among first-year students at Arba Minch University .
Results: A total of 832 students participated at a baseline, and 820 students participated at the posttest. This study found that there was a significant effect on changing students’ knowledge and attitude towards a condom. In the education group, the students’ average change of comprehensive condom knowledge score was 0.229 higher than the average score of students' in the control group (ATE=0.229, 95% CI, 0.132 to 0.328; p < 0.001). The average change of attitude toward condom score of students’ in the education group was 1.834 higher than the average change score of students’ in the control group (ATE=1.834, 95% CI, 1.195 to 2.772; p < 0.001).This study provides further evidence on the effectiveness of comprehensive sexuality education in terms of knowledge and attitude towards a condom. Therefore, the implementation of this education should be strengthened in order the prevent youths from STI/HIV and unintended pregnancies.
Real-world data of eribulin in advanced and pretreated HER2-negative breast cancer in a Spanish comprehensive cancer center
Authors: Sirvén Milana Bergamino , Fernández-Ortega Adela , Stradella Agostina , Morilla Idoia , Falo Catalina , Vázquez Silvia , Castany Roser , Villanueva Rafael , Recalde Sabela , Pérez Valentí Navarro , Gil-Gil Miguel , Pernas Sonia
Published: November 2019

Background Eribulin improves survival in pre-treated HER2-negative advanced breast cancer (ABC). However, limited data exist on co-morbidities and central nervous system (CNS) efficacy. The purpose of this study was to review eribulin’s efficacy and safety in everyday clinical practice with special focus on age, body mass index (BMI) and central nervous system (CNS) activity.Methods An observational study was conducted in a series of HER2-negative ABC patients treated from January’14-December’17 outside a clinical trial. Objective Response Rate (ORR), Progression Free Survival (PFS), Overall Survival (OS), and association of clinical and pathological variables with outcome were evaluated.Results Ninety-five women were treated with at least one cycle of eribulin. Median age was 57 (33-83), and 18% were obese. Median number of prior chemotherapies for ABC was 3 (2-5) and 76% of patients had visceral metastases, including 21% with CNS involvement. Most tumors were estrogen receptor-positive (79%). ORR and stable disease (SD) at 6 months were 26.2% and 37.5%, respectively. Remarkably, relevant CNS efficacy was observed with eribulin: 20% of patients obtained partial response and 25% SD. Treatment was generally well tolerated and manageable, with 29% grade 3 and 10.9% grade 4 toxicities. Median PFS and OS were 4.1 months (CI95% 3.2-4.9) and 11.1 months (CI95% 9.5-14.7), respectively. Triple-negative disease, >2organs involved and being younger than 70 years old were independent prognosis factors for worse OS in multivariate analysis. Most patients (75%) progressed in pre-existing metastases sites.Conclusions In everyday clinical practice, eribulin’s efficacy seems similar to pivotal trials. CNS-efficacy was observed. TNBC, >2 organs involved and being younger than 70 years old were independent prognosis factors for worse OS. Remarkably, less incidence of grade 4-toxicity compared to previous studies was found.
Prevalence and genotyping of Toxoplasma gondii in stray cats in Mashhad area, Iran.
Authors: Khodaverdi Majid , Razmi Gholamreza
Published: November 2019

Background: Cats as a definitive host have an important role in the epidemiology of toxoplasmosis in humans and animals. The aim of the study was to determine the frequency of Toxoplasma gondii infection and isolate and identify the genotypes of T. gondii in stray cats in the Mashhad suburb. Methods: From April 2016 to August 2017, 175 fecal samples from stray cats and 31 brain samples from cats killed in driving accidents were collected. The fecal samples were examined by fecal flotation technique and T. gondii-specific PCR. The brain samples were investigated by T. gondii-specific PCR and consequently examined by mice bioassay. The DNA of T. gondii isolated was genotyped using SAG1, SAG2, SAG3, BTUB and GRA6 as PCR-restriction fragment length polymorphism (PCR-RFLP) markers. Results: In the present study, Toxoplasma-like oocysts were microscopically observed in 2.2% (4/175) fecal samples. The presence of Toxoplasma oocysts was confirmed in one microscopy-positive sample by PCR. In addition, T. gondii DNA was detected in 4% (7/175) microscopy-negative samples using PCR. T. gondii was isolated from one brain PCR-positive sample by mice bioassay. The isolate was avirulent and many T. gondii cysts were observed in mice brain. The isolate was successfully genotyped by PCR-RLFP analysis .The isolated genotyped was type II. Besides, eight Toxoplasma-positive fecal samples contained insufficient DNA and only amplified at SAG-3 locus in PCR. These samples were also showed type II pattern at this locus. Conclusions: Parasitological and molecular results showed low frequency of Toxoplasma infection in the stray cats, and identified the genotype of T. gondii isolate as type II, for the first time in Mashhad area, Khorasan Razavi Province.
Addressing the deprived: Need and access of Sexual reproductive health services to street adolescents in Ethiopia: The case of Nekemte Town: Mixed methods study.
Authors: Ababor Abdo Abazinab , Tesso Desalegn Wirtu , Cheme Melese Chego
Published: November 2019

Objectives Research knowledge gap exists in addressing sexual reproductive health services to street adolescents globally. The intensity of SRH problem is high in the settings like Ethiopia where there is limited access and integration of services in the way it responds to the needs of the street adolescents and this study aimed at exploring risky sexual behaviors; needs and barriers of SRH services utilization among street adolescents in Nekemte town. Community based Cross-sectional study design with mixed approaches was used on sample size of 219 street adolescents. Supplementary qualitative data of 24 in-depth interviews were collected from the street adolescents and SRH service providers. Time-location sampling or venue sampling technique (VDT) was used for quantitative study. Quantitative data was analyzed by SPSS version 24.0.Results About 93% of street adolescents reported difficulty of accessing contraceptives. Behavioral change and sustainable access of SRH services is lacking among street adolescents; but, Knowledge gap is more evident in early adolescents (10-13) period than the other classes. Generally, street adolescents are deprived in terms of access of sexual reproductive health services. Mobile and flexible access of contraceptive should be designed targeting street adolescents.
ANTISEPTICS AS ADJUNCTS TO SCALING AND ROOT PLANING IN THE TREATMENT OF PERIODONTITIS: A SYSTEMATIC LITERATURE REVIEW
Authors: Ramanauskaite Egle , Machiulskiene Vita
Published: November 2019

Background: Periodontitis is microbially-associated, host-mediated inflammatory condition that results in loss of periodontal attachment. The goals of periodontal therapy include arresting the disease progression, establishing healthy, stable, maintainable periodontal conditions. A fundamental strategy of treating periodontitis is scaling and root planing (SRP), however its efficacy may be restricted in areas inaccessible for mechanical instrumentation. As periodontitis is infectious in nature, it might be helpful to use additional antimicrobial adjuncts, in order to eliminate or inactivate pathogenic microflora. The aim of this study is to evaluate the current evidence regarding the potential clinical benefits of using additional antiseptics for SRP in nonsurgical periodontal therapy. Methods: An electronic literature search was conducted in the MEDLINE (Ovid) and Cohrane Central Register of Controlled Trials (CENTRAL) databases for articles published between January 1, 2000 and September 22, 2019. Randomized controlled clinical trials in English that compare the effectiveness of one or more antiseptic agents as adjuncts to SRP with a follow-up of ≥ 6 months were included. A meta-analysis using the random-effects model was performed on the selected qualifying articles. Results: The search resulted in 12 articles that met the inclusion criteria. Based on the vehicle employed to deliver the antiseptic agent, studies were divided into adjunctive sustained-release antiseptics (gels, chips and varnish) and adjunctive irrigation with antiseptics. The meta-analysis demonstrated significant improvements in probing depth (PD) reduction (p = 0.001), clinical attachment level (CAL) gain (p = 0.001), and bleeding on probing (BOP) values (p = 0.001) following the adjunctive subgingival application of sustained-release antiseptics. Additional subgingival irrigation with antiseptics failed to show significant improvements in PD (p = 0.321), CAL (p = 0.7568), or BOP values (p = 0.3549) over SRP alone. Conclusions: Adjunctive subgingivally delivered antiseptics with a sustained-release delivery have significant clinical benefits compared to SRP alone. Key Words: Periodontitis, Antiseptics, Treatment, Review
The impact of different geometric assumption of mitral annular on the assessment of mitral regurgitation volume by Doppler method
Authors: Wang Wugang , Wang Zhibin , Li Junfang , Gong Kun , Zhao Liang , Tang Guozhang , Fu Xiuxiu
Published: November 2019

Background Mitral regurgitation volume (MRvol) by quantitative pulsed Doppler (QPD) method previously recommended suffers from geometric assumption error because of circular geometric assumption of mitral annulus (MA). Therefore, the aim of this study was to evaluate the impact of different geometric assumption of MA on the assessment of MRvol by two-dimensional transthoracic echocardiographic QPD method.Methods This study included 88 patients with varying degrees of mitral regurgitation (MR). The MRvol was evaluated by QPD method using circular or ellipse geometric assumption of MA. MRvol derived from effective regurgitant orifice area by real time three-dimensional echocardiography (RT3DE) multiplied by MR velocity-time integral was used as reference method.Results Assumption of a circular geometry of MA, QPD-MAA4C and QPD-MAPLAX overestimated the MRvol by a mean difference of 10.4 ml ( P < 0.0001) and 22.5 ml ( P < 0.0001) compared with RT3DE. Assumption of a ellipse geometry of MA, there was no significant difference of MRvol (mean difference = 1.7 ml, P = 0.0844) between the QPD-MAA4C+A2C and the RT3DE.Conclusions Assuming that the MA was circular geometry previously recommended, the MRvol by QPD-MAA4C was overestimated compared with the reference method. However, assuming that the MA was ellipse geometry, the MRvol by the QPD-MAA4C+A2C has no significant difference with the reference method.
There is no Dose-response Relationship between Allogeneic Blood Transfusion and Healthcare-associated Infection: A Retrospective Cohort Study
Authors: Lv Yu , Fang Ying , Xiang Qian , Lin Jia , Wu Yu J , Cai Hong M , Wei Qiong D , Wang Hui , Wang Chen , Chen Jing , Ye Jian , Xie Caixia , Li Ting L
Published: November 2019

Background The association between allogeneic blood transfusion (ABT) and healthcare-associated infection (HAI) is considered dose-dependent. However, this association may be confounded by transfusion duration, as prolonged hospitalization stay increases the risk of HAI. Also, it is not clear whether specific blood products have different dose-response risks. Methods In this retrospective cohort study, a logistic regression was used to identify confounding factors, and the association between specific blood products and HAI were analyzed. Then Cox regression and restricted cubic spline regression was used to visualize the hazard of HAI per transfusion product. Results Of 215338 inpatients observed, 4.16% were transfused with a single component blood product. With regard to these transfused patients, 480 patients (5.36 %) developed a HAI during their hospitalization stay. Logistic regression showed that red blood cells (RBCs) transfusion, platelets transfusion and fresh-frozen plasmas (FFPs) transfusion were risk factors for HAI [odds ratio (OR) 1.893, 95% confidence interval (CI) 1.656–2.163; OR 8.903, 95% CI 6.646–11.926 and OR 1.494, 95% CI 1.146–1.949, respectively]. However, restricted cubic spline regression analysis showed that there was no statistically dose-response relationship between different transfusion products and the onset of HAI. Conclusions RBCs transfusion, platelets transfusion and FFPs transfusion were associated with HAI, but there was no dose-response relationship between them.
Nursing students’ perception of infection control and prevention nurses’ work – results of a survey study
Authors: Jaślan Dorota , Różańska Anna , Wałaszek Marta , Szczypta Anna , Gniadek Agnieszka , Wójkowska-Mach Jadwiga
Published: November 2019

Background
The results of several studies in the area of infection control in Poland are disturbing. The situation may be shaped by many factors. But the key factor is the infection teams and especially infection control and prevention nurses (ICPNS) ability of influencing positive medical personnel attitudes and behavior in this area.
Aim of the study The article presents the results of the study on nursing students’ perception of ICPNs work.
Material and method The study was conducted using the author's anonymous questionnaire conducted among nursing students of three Polish universities.
Results
The results proved to be peculiar. About 80% respondents confirmed the ICPNs key role in ensuring patient and personnel safety, while only 31.6% declared its great authority among the hospital staff.
Conclusions
Obtained results indicate the necessity of thorough studies on the organization and structure of infection control in Polish hospitals, with particular emphasis of building its’ positive perception by wards staff as well as implementing education campaign on infection control in hospital environment.