bluuebunny/crossref_metadata_2025 huggingface dataset:
Mathematical modelling of electrical potential difference in a non-uniform electric field
Authors: Erol Mustafa , Çolak İldahan Özdeyiş
Published: June 2020

This work offers an unproblematic teaching tool for the instruction of challeng-ing concept of electric potential difference in a non-uniform electric field. Specifically, mathematical modelling process is employed and managed to comprehend and teach exceedingly difficult concepts of uniform and non-uniform electric fields, electrical potential difference, scalar products of vectors and also concept of path integral. In order to accomplish those tasks, initially a basic conducting panel/sheet, that is simply a wet cardboard, is designed as a part of the apparatus, together with a dc power supply, a multi meter and connecting cables. The established method is interesting in the sense that the 3D wet cardboard is novel, very practical and minimal costing, hence the approach offers physics educators fresh teaching routes and opportunities to clarify the puzzling concept of electrical potential difference and further.
A Yoga Intervention for Music Performance Anxiety in Conservatory Students
Authors: Stern Judith RS , Khalsa Sat Bir S , Hofmann Stephan G
Published: June 2020

Music performance anxiety can adversely affect musicians. There is a need for additional treatment strategies, especially those that might be more acceptable to musicians than existing therapies. This pilot study examined the effectiveness of a 9-week yoga practice on reducing music
performance anxiety in undergraduate and graduate music conservatory students, including both vocalists and instrumentalists. The intervention consisted of fourteen 60-minute yoga classes approximately twice a week and a brief daily home practice. Of the 24 students enrolled in the study,
17 attended the post-intervention assessment. Participants who completed the measures at both pre- and post-intervention assessments showed large decreases in music performance anxiety as well as in trait anxiety. Improvements were sustained at 7- to 14-month follow-up. Participants generally
provided positive comments about the program and its benefits. This study suggests that yoga is a promising intervention for music performance anxiety in conservatory students and therefore warrants further research.
DEVELOPMENT OF BIOLOGICAL ASSESSMENT BASED ON STUDENT CRITICAL THINKING SKILLS: a case study in eleventh grade at MAN 2 Palembang
Authors: Aseptianova Aseptianova , Nawawi Sulton , Astia Resti Maya
Published: June 2020

This study aims to determine the characteristics and feasibility of biology assessment based on critical thinking skills. This research is a research and development that adapts to the McIntire Miller development model. The sample used in the first trial was 80 students, and in the second trial were 76 students. Data collection techniques using questionnaire sheets, questionnaire sheets, interview sheets, test instruments in the form of essay questions of biology grade XI based on critical thinking from Facione with indicators: interpretation, analysis, evaluation, explanation, conclusions, and self-regulation. Techniques of data analysis using qualitative analysis and quantitative analysis. The results of this study were in the form of a biology assessment based on critical thinking skills in the form of essays in odd semester XI material and from the results of the 1st and 2nd trials totaling 24 items. The content validity of biology assessment based on critical thinking skills is qualified to very high. The construct validity the items are 28  questions valid (1st trial) with reliability value is 0.875. Furthermore, 24 questions are valid (2nd trial) with reliability value is 0.764. The results of the level of difficulty test are 0.332 (1st trial) and 0.537 (2nd Trial). The value of discriminating power is 1,541 (1st trial) and 2,021 (2nd trial). The data shows that the items can be used to measure students' critical thinking skills. We can involve the mental processes of pupils by the test based on critical thinking skills.
THE EFFECT OF PRACTICUM METHOD ON REPRESENTATION ABILITY AND COGNITIVE LEARNING OUTCOMES
Authors: Sikumbang Darlen , Lengkana Dewi , Foorantika Rita
Published: June 2020

The existence of laboratory activities in or outside the room can facilitate students in visualizing the imagination to be real. This study aims to determine the effect of using practicum methods on the students' representation ability and cognitive learning outcomes on the subject matter Classification of Living Things. This research was conducted at Junior High School 26 Bandar Lampung. The method uses a quasi-experimental method with Pretest-Posttest Non-Equivalent Control Group Design. A random sampling technique took the sample in this study, and the research subject uses class VII A as experiment class and VII B as a control class. The data in this study are quantitative data that were analyzed using the Independent sample t-test. Based on the results of this study, the effect of practicum methods on the students' representation ability is level 1, and 2 before the treatment then increases to levels 3, 4, and 5 after the practicum with the student answers that have made elements representation such as tables, graphs, icons, and images. Therefore, practicum methods can be used by science educators to facilitate students in conceptual understanding by using elements of representation.
FACTORS AFFECTING STUDENT ACCEPTANCE OF EVOLUTION THEORY BASED ON GENDER AND EDUCATIONAL BACKGROUND: a case study in Universitas Islam Madura, Indonesia
Authors: Ramadani Shefa Dwijayanti , Ibama Lukluk
Published: June 2020

Evolution is one area on Biology learning that has the most contravention and misconception for many students in various educational regions globally, including Indonesia. This study aimed to identify student's acceptance of the evolutionary theory. The study was conducted using a mixed-method, in which the results of descriptive research were followed by correlational research on the variables studied. Data were collected by using questionnaire and rubric of Measure of Acceptance of The Theory of Evolution (MATE). The results showed that the average MATE score was 65.05, in which the students tended to have a moderate level of the acceptance of the evolutionary theory. The result showed that sex and religious background correlated with students' acceptance of the evolutionary theory, with a contribution of 49.9%. Thus, these results suggest that evolution is a crucial aspect to be considered in teaching evolution, and there must be an effort to overcome the differences in the acceptance of evolutionary theory in students with different gender and educational backgrounds. Three other factors influence student acceptance of the theory of evolution, namely students' misconceptions, beliefs, and understanding of the nature of science. Therefore, identification of students' prior knowledge is needed to determine the factors that influence students' acceptance in a context.
Ensuring the Epidemiological Safety of Bladder Catheterization
Authors: Kas'yanova I. A. , Kvashnina D. V. , Kovalishena O. V. , Sutyrina O. M.
Published: June 2020

Urinary tract infections (UTI) represent actual form of healthcare-associated infections. The main risk factor of UTI is bladder catheterization. Currently, there are not valid and systematic data on the frequency of atheter-associated urinary tract infections (CAUTI) in Russia, because standard case determination for the official registration is not being used and, consequently, no full-scale records and registration of this nosological form is being maintained. Research objective: to estimate incident rate and potential risk factors of UTI in patients when making bladder catheterization in the urology department at the multidisciplinary clinic for adults. In the course of diagnostic and treatment process it has been determined that bladder catheterizations ratio among all indoor patients amounted to 49,6%; in 2,3% of cases intrusive procedure was carried out urgently in the form of a single urine drainage; the overwhelming majority of catheterized patients were men – 61,5%; catheterization of 9,7% of patients has been lasted for more than 7 days; 48,5% of catheterized patients were individuals of 60 years old and over. According to retrospective analysis data with the use of standard case determination it was found out that CAUTI case rate amounted to 10,68 (95% CI 7,08–14,28) per 100 patients; stratified index of CAUTI incidence amounted to 32,86 per 1000 patient-days of catheterization (95% CI: 21,66–44,06). Epidemical process of CAUTI is characterized by high intensity, predominance of S. epidermidis. The result of the work was the development of a standard operating procedure for setting up a urethral catheter, which includes 8 stages of epidemiologically safe catheterization of the bladder. The proposed SOP on catheterization focuses on individual actions that require mandatory implementation and control.
Characterization of the Epidemic Process of HIV Infection in a Region With a High Level of HIV Prevalence Over a Long Period of Time (Example of the Tyumen Region)
Authors: Kondratova S. Е. , Marchenko A. N. , Kashuba E. A.
Published: June 2020

The purpose of the study is to analyze the dynamics of the development of the HIV epidemic process in the Tyumen region in 1993–2018 (without autonomous okrugs).

Materials and methods. The work used epidemiological, descriptive-evaluative, analytical and statistical research methods, with the calculation of intensive (incidence, incidence) and extensive indicators (structure of incidence, incidence), determining the trend of the epidemic process.

Results and conclusions. As of the end of 2018, more than 1,2% of the population is infected with HIV in the Tyumen region. The average long-term growth rate is +259,9% (expressed). Over the 26 years of HIV registration, men have been predominantly infected, the route of infection is parenteral (narcotic). Since 2002, the proportion of sexual transmission of HIV has doubled, sexual heterosexual transmission has become the leading one at the present stage of the development of the epidemic process (59,8%). A «portrait» of a modern HIV-infected person in the region can be considered a predominantly unemployed man or woman (taking into account the trend) aged 40–49 years and older, with a secondary specialized education, subject to deviant behavior (including when using drugs). At the present stage, there is an obvious redistribution of the structure of the identified HIV-infected people towards the predominance of older age groups and pensioners with an increase in HIV +52,8%. The decrease in the growth rate and the incidence rate of HIV over the past 3 years is a positive trend amid the generalized nature of the spread of HIV.
Comparison of refractive outcomes after photorefractive keratectomy with different optical zones using Mel 90 excimer laser
Authors: Shin Dae Hwan , Lee Yong Woo , Song Ji Eun , Choi Chul Young
Published: June 2020

Background: A larger optical zone for photorefractive keratectomy may improve optical quality and stability. However, there is need for limiting ablation diameter in that a larger ablation diameter requires greater ablation depth, and minimizing ablation depth may reduce adverse effects on postoperative wound healing, haze and keratoectasia. In this study, we compared the changes in clinical outcomes and the degree of regression between a 6.0 mm optical zone and 6.5 mm optical zone following PRK.Methods: The records of 95 eyes that had undergone PRK with a 6.0 OZ (n = 40) and a 6.5 OZ (n = 55) were retrospectively reviewed. We compared data including the spherical equivalent of manifest refraction (SE of MR), simulated K (Sim K), thinnest corneal thickness, change in thinnest corneal thickness (the initial value divided by corrected diopter [ΔTCT/CD]), Q value, corneal higher order aberrations (HOAs) and spherical aberration (SA) pre-operation, at 3 and 6 months postoperative and at the last follow-up visit (Mean; 20.71 ± 10.52, 17.47 ± 6.57 months in the 6.0 and 6.5 OZ group, respectively).Results: There were no significant differences in the SE of MR, Sim K and UDVA between the 6.0 OZ group and the 6.5 OZ group over 1 year of follow-up after PRK, and the 6.0 OZ group required less ΔTCT/CD than the 6.5 OZ group. The 6.5 OZ group showed better results in terms of post-operative HOAs of RMS, SA and Q value. When comparing that pattern of change in Sim K, there was no significant difference between the 6.0 OZ group and the 6.5 OZ group.Conclusions: The clinical refractive outcomes and regression after PRK using Mel 90 excimer laser with a 6.0 OZ were comparable to those with a 6.5 OZ.
The Relationship Between Retroperitoneal Lymphadenectomy and Survival in Advanced Ovarian Cancer Patients
Authors: Fang Chenyan , Zhang Yingli , Zhao Lingqin , Chen Xi , Xia Liang , Zhang Ping
Published: June 2020

Background Systematic retroperitoneal lymphadenectomy has been widely used in the surgical treatment of advanced ovarian cancer patients. Nevertheless, the corresponding therapeutic may not provide a survival benefit. The aim of this study was to assess the effect of systematic retroperitoneal lymphadenectomy in such patients. Methods Patients with advanced ovarian cancer (stage III-IV, according to the classification presented by the International Federation of Gynecology and Obstetrics) who were admitted and treated in Zhejiang Cancer Hospital from January 2004 to December 2013 were enrolled and reviewed retrospectively. All patients were optimally or suboptimally debulked (absent or residual tumor <1 cm) and divided into two groups. Group A (no-lymphadenectomy group, n =170): patients did not undergo lymph node resection; lymph nodes resection or biopsy were selective. Group B (n=240): patients underwent systematic retroperitoneal lymphadenectomy. Results A total of 410 eligible patients were enrolled in the study. The patients’ median age was 51 years old (range, 28–72 years old). The 5-year overall survival (OS) and 2-year progression-free survival (PFS) rates were 78% and 24% in the no-lymphadenectomy group and 76% and 26% in the lymphadenectomy group (P=0.385 and 0.214, respectively). Subsequently, there was no significant difference in 5-year OS and 2-year PFS between the two groups stratified to histological types (serous type or non-serous type), the clinical evaluation of negative lymph nodes or with macroscopic peritoneal metastasis beyond pelvic (IIIB-IV). Multivariate Cox regression analysis indicated that systematic retroperitoneal lymphadenectomy was not a significant factor influencing the patients’ survival. Patients in the lymphadenectomy group had a higher incidence of postoperative complications (incidence of infection treated with antibiotics was 21.7% vs. 12.9% [P=0.027]; incidence of lymph cysts was 20.8% vs. 2.4% [P < 0.001]). Conclusions Our study showed that systematic retroperitoneal lymphadenectomy did not significantly improve survival of advanced ovarian cancer patients with residual tumor <1 cm or absent after cytoreductive surgery, and were associated with a higher incidence of postoperative complications.
Role of high-dose salvage radiotherapy for oligometastases of the localised abdominal/pelvic lymph nodes: A retrospective study
Authors: Ito Makoto , Kodaira Takeshi , Koide Yutaro , Okuda Takahito , Mizumatsu Shinichiro , Oshima Yukihiko , Takeuchi Arisa , Mori Toshie , Abe Souichirou , Asai Ayumi , Suzuki Kojiro
Published: June 2020

Background: Abdominal/pelvic lymph node (LN) oligometastasis, a pattern of treatment failure, is observed occasionally, and radiotherapy may work as salvage therapy. The optimal prescription dose, however, is yet to be determined. This study assessed the efficacy of high-dose radiotherapy.Methods: The medical records of 113 patients at 4 institutes were retrospectively analysed who had 1 to 5 abdominal/pelvic LN oligometastases and were treated with definitive radiotherapy between 2008 and 2018. The exclusion criteria included non-epithelial tumours, uncontrolled primary lesions, palliative intent, and re-irradiation. The prescription dose was evaluated by using the equivalent dose in 2 Gy fractions (EQD2). Patients receiving EQD2 ≥60 Gy were placed into the high-dose group, and the remaining others the low-dose group. Kaplan-Meier analyses were performed to evaluate overall survival (OS), local control (LC), and progression-free survival (PFS). Univariate log-rank and multivariate Cox proportional hazards model analyses were performed to explore predictive factors. Adverse events were compared between the high-dose and low-dose groups.Results: The primary tumour sites included the colorectum (n = 28), uterine cervix (n = 27), endometrium (n = 15), and ovaries (n = 10). The rate of 2-year OS was 63.1%, that of LC 59.7%, and that of PFS 19.4%. On multivariate analyses, OS were significantly associated with solitary oligometastasis (hazard ratio [HR]: 0.48, p = 0.02), LC with high-dose radiotherapy (HR: 0.93, p < 0.001), and PFS with long disease-free interval (HR: 0.59, p = 0.01). Whereas high-dose radiotherapy did not significantly improve 2-year OS in the entire cohort (74.8% in the high-dose vs. 52.7% in the low-dose; p = 0.08), it did in the subgroup of solitary oligometastasis (88.8% in the high-dose vs. 56.3% in the low-dose; p = 0.009). As for Late grade ≥3 adverse event, ileus was observed in 7 patients (6%) and gastrointestinal bleeding in 4 (4%). No significant association between the irradiation dose and adverse event incidence was found.Conclusions: As salvage therapy, high-dose radiotherapy was recommendable for oligometastasis in the abdominal/pelvic LNs. For solitary oligometastasis, LC and OS were significantly better in the high-dose group.
Spiral artery blood flow during pregnancy: a systematic review and meta-analysis.
Authors: Schiffer Veronique , Evers Laura , de Haas Sander , Ghossein Chahinda , Al-Nasiry Salwan , Spaanderman Marc
Published: June 2020

Background: Downstream remodeling of the spiral arteries (SpA) decreases utero-placental resistance drastically, allowing sustained and increased blood flow to the placenta at all circumstances. We systematically evaluated available reports to visualize adaptation of spiral arteries throughout pregnancy by ultra-sonographic measurements and evaluated when this process is completed. Methods: A systematic review and meta-analysis of spiral artery flow (pulsatility index (PI), resistance index (RI) and peak systolic velocity (PSV)) was performed. English articles were obtained from Pubmed, EMBASE and Cochrane Library and included articles were assessed on quality and risk of bias. Weighted means of Doppler indices were calculated using a random-effects model. Results: In healthy pregnancies, PI and RI decreased from 0.80 (95% CI: 0.70-0.89) and 0.50 (95% CI: 0.47-0.54) in the first trimester to 0.50 (95% CI: 0.45-0.55, p<0.001) and 0.39 (95% CI: 0.37-0.42, p<0.001) in the second trimester and to 0.49 (95% CI: 0.44-0.53, p=0.752) and 0.36 (95% CI: 0.35-0.38, p=0.037) in the third trimester, respectively. In parallel, PSV altered from 0.22 m/s (95% CI: 0.13-0.30 m/s) to 0.28 m/s (95% CI: 0.17-0.40 m/s, p=0.377) and to 0.25 m/s (95% CI: 0.20-0.30 m/s, p=0.560) in the three trimesters. In absence of second and third trimester Doppler data in complicated gestation, only a difference in PI was observed between complicated and healthy pregnancies during the first trimester (1.49 vs 0.80, p<0.001). Although individual studies have identified differences in PI between SpA located in the central part of the placental bed versus those located at its periphery, this meta-analysis could not confirm this (p=0.349). Conclusions: This review and meta-analysis concludes that an observed decrease of SpA PI and RI from the first towards the second trimester parallels the physiological trophoblast invasion converting SpA during early gestation, a process completed in the midst of the second trimester. Higher PI was found in SpA of complicated pregnancies compared to healthy pregnancies, possibly reflecting suboptimal utero-placental circulation. Longitudinal studies examining comprehensively the predictive value of spiral artery Doppler for complicated pregnancies are yet to be carried out.
Medical termination for pregnancy in early first trimester (≤ 63 days) using combination of mifepristone and misoprostol or misoprostol alone: : a systematic review
Authors: Abubeker Ferid Abbas , Lavelanet Antonella , Rodriguez Maria I. , Kim Caron
Published: June 2020

Background A wide range of drugs have been studied for first trimester medical abortion. Studies evaluating different regimens, including combination mifepristone and misoprostol and misoprostol alone regimens, show varying results related to safety, efficacy and other outcomes. Objectives To compare the safety, effectiveness and acceptability of medical abortion and to compare medical methods with surgical methods of abortion ≤ 63 days of gestation.Methods Pubmed and EMBASE were systematically searched from inception through January 2019 using a combination of MeSH, keywords and text words. Randomized controlled trials on induced abortion at ≤ 63 days that compared different regimens of medical abortion using mifepristone and/or misoprostol and trials that compared medical with surgical methods of abortion were included. We extracted data into a pre‐designed form, calculated effect estimates, and performed meta‐analyses where possible. The primary outcomes were ongoing pregnancy and successful abortion.Results Combined regimens using mifepristone and misoprostol had lower rates of ongoing pregnancy and higher rates of successful abortion compared to misoprostol only regimens. In combined regimens, misoprostol 800 μg appears to be more effective than 400 μg. There was no significant difference with different dosing intervals between mifepristone and misoprostol and routes of misoprostol administration in combination or misoprostol alone regimens. The rate of serious adverse events was generally low.Conclusion In this systematic review, we establish medical methods of abortion utilizing combination mifepristone and misoprostol or misoprostol alone are effective, safe and acceptable. More robust studies evaluating both the different combination and misoprostol alone regimens are needed to strengthen existing evidence as well as assess patient perspectives towards a particular regimen.
Immunohistochemical Expression of Vitamin D Receptor and Forkhead Box P3 in Classic Hodgkin Lymphoma: Correlation with Clinical and Pathologic Findings
Authors: Gupta Gaurav , Agrawal Tanupriya , Pilichowska Monika
Published: June 2020

Background Expression of forkhead box P3 (FOXP3), a key regulator of T-cell function, in the tumor immune microenvironment is related to survival in classic Hodgkin lymphoma (CHL). Vitamin D receptor (VDR), a transcription factor, agonists have been shown to induce FOXP3 expression in T-cells and enhance recruitment of these cells to the inflammatory sites. VDR expression is CHL has been described. However, there is no data on expression of VDR in context of quantity of FOXP3 positive cells in CHL. Methods We examined and correlated immunohistochemical expression of VDR and FOXP3 along with clinical and pathology findings in 29 cases of CHL. Results VDR was expressed in Hodgkin Reed-Sternberg (HRS) cells and background lymphocytes and FOXP3 was expressed in background lymphocytes. 82% of CHL cases, regardless of the subtype, expressed VDR and in majority of the cases, VDR expression was directly proportional to the quantity of FOXP3 expressing lymphocytes in the tumor microenvironment. In cases with higher clinical stage (III/IV), only 28.5% of cases diffusely expressed VDR and FOXP3 compared to 71.4% showing focal positivity. Whereas in cases with lower clinical stages (I/II), the expression pattern of VDR and FOXP3 was almost similar (41.6% diffuse versus 33.3% focal). Interestingly, focal VDR and FOXP3 expression pattern was significantly higher among males. Mixed cellularity cases showed predilection for focal VDR and FOXP3 expression (80% cases); whereas nodular sclerosis subtype had focal and diffuse VDR and FOXP3 expression patterns in similar proportion. Cases with diffuse VDR and FOXP3 expression were less likely to have bone marrow involvement. Epstein Barr virus- encoded small RNA (EBER) positive cases were predominantly focally positive (80%) for VDR and FOXP3. Conclusions In summary, quantity of FOXP3 positive T-cells in CHL microenvironment seems to correlate with VDR expression. Clinical stage show a trend of inverse correlation with expression of VDR and quantity of FOXP3 positive T-cells. These findings suggest that VDR could be a possible prognostic and therapeutic target in CHL.
Differences in gait analysis and clinical outcome after TightRope® or screw fixation in acute syndesmosis rupture: Study protocol for a prospective randomized pilot study
Authors: Doll Julian , Waizenegger Stefan , Bruckner Thomas , Schmidmaier Gerhard , Wolf Sebastian I. , Fischer Christian
Published: June 2020

Background: Ankle sprains and fractures are most common injuries in orthopedic and trauma surgery. The concurrent occurrence of syndesmosis ruptures in these injuries represents a more complex problem, as they often remain undetected. A proper and accurate treatment of injuries of the syndesmosis, both isolated and combined with fractures, is necessary to avoid long-term consequences (chronic instability, cartilage damage and post-traumatic osteoarthritis). The most popular treatment option is a static screw fixation and the newly developed dynamic TightRope® (Arthrex, Naples, FL, USA). The aim of this pilot study is to compare monitor ankle range of motion and maximum ankle power in gait as functional outcome parameters of instrumented gait analysis, as well as clinical and radiographic outcome for assessing the stabilization of acute syndesmosis rupture with either a static implant (a 3.5mm metallic screw) or a dynamic device (TightRope®).Methods: This prospective, randomized, controlled, clinical trial will be carried out at the Center for Orthopedics, Trauma Surgery and Spinal Cord Injury of the University Hospital Heidelberg. Adult patients, who suffer from an acute syndesmosis rupture, both isolated and in combination with fractures of the lateral malleolus (Weber C and Maisonneuve fractures) and who are undergoing surgery at our trauma center will be included in our study. The patients will be randomized to the different treatment options (screw fixation or “TightRope®”). Subsequent to the surgical treatment, all patients will receive the same standardized follow-up procedures including a gait analysis and MRI of the ankle at 6 months follow-up.The primary endpoint of the study is the successful healing of the syndesmosis and biomechanical investigation with gait analysis.Discussion: The results of the gait analysis from the current study will help to impartially and reliably evaluate the clinical and biomechanical outcome of both treatment options of acute syndesmosis ruptures. We hypothesize that the dynamic fixation provides an equivalent or better biomechanical, clinical and radiographic outcome in comparison to the screw fixation.Trial registration:German Clinical Trials Register (DRKS), ID: DRKS00013562, registered on 07.12.2017.
Statistical approaches to computing sample size in cluster randomized trials: a simulation study
Authors: Ranjan Ashutosh , Song Guangzi , Coffey Christopher S , McClure Leslie A
Published: June 2020

Background: Cluster randomized trials, which randomize groups of individuals to an intervention, are common in health services research when one wants to evaluate improvement in a subject's outcome by intervening at an organizational level. For many such trials, sample size calculation is performed under the assumption of equal cluster size. For a variety of reasons, many trials that set out to recruit clusters of the same size end up with unequal clusters. This leads to a misalignment between the method used for sample size calculation and the data analysis, which may affect trial power. Various weighted analysis methods for analyzing cluster means have been suggested to overcome the problem introduced by unbalanced clusters; however, the performance of such methods has not been evaluated extensively.
Methods: We examine the use of the general linear model for analysis of clustered randomized trials that assume equal cluster sizes during the planning stage, but for which the realized cluster sizes are unequal. We demonstrate the performance of three approaches using different weights for analyzing the cluster means: (1) the standard analysis of cluster means, (2) weighting by cluster size, and (3) minimum variance weights. Several distributions are used to generate cluster sizes to assess a range of patterns of imbalance. The variability in cluster size is measured by the coefficient of variation (CV). We assess the impact of using each of the three methods of analysis with respect to type I error and power of the study and how each are impacted by the variability in cluster size via simulations.
Results: Analyses that assumes equal clusters provide a reasonable approximation when cluster sizes vary minimally (CV < 0.30). For analyses weighted by cluster size type I errors were inflated, and that worsened as the variation in cluster size increases, despite reasonable power. However, minimum variance weighted analyses best maintain target power and level of significance under scenarios considered.
Conclusion: Unweighted analyses work well as an approximate method when variation in cluster size is minimal. However, using minimum variance weights performs much better across the full range of variation in cluster size and is recommended.
Biofilm formation, antimicrobial susceptibility and virulence genes of Uropathogenic Escherichia coli isolated from clinical isolates in Uganda
Authors: Katongole Paul , Nalubega Fatuma , Florence Najjuka Christine , Asiimwe Benon , Andia Irene
Published: June 2020

Introduction: Uropathogenic E. coli is the leading cause of Urinary tract infections (UTIs), contributing to 80-90% of all community-acquired and 30-50% of all hospital-acquired UTIs. Biofilm forming Uropathogenic E. coli are associated with persistent and chronic inflammation leading to complicated and or recurrent UTIs. Biofilms provide an environment for poor antibiotic penetration and horizontal transfer of virulence genes which favors the development of Multidrug-resistant organisms (MDRO). Understanding biofilm formation and antimicrobial resistance determinants of Uropathogenic E. coli strains will provide insight into the development of treatment options for biofilm-associated UTIs. The aim of this study was to determine the biofilm forming capability, presence of virulence genes and antimicrobial susceptibility pattern of Uropathogenic E. coli isolates in Uganda. Methods: This was a cross-sectional study carried in the Clinical Microbiology and Molecular biology laboratories at the Department of Medical Microbiology, Makerere University College of Health Sciences. We randomly selected 200 Uropathogenic E. coli clinical isolates among the stored isolates collected between January 2018 and December 2018 that had significant bacteriuria (>105 CFU). All isolates were subjected to biofilm detection using the Congo Red Agar method and Antimicrobial susceptibility testing was performed using the Kirby disk diffusion method. The isolates were later subjected PCR for the detection of Urovirulence genes namely; Pap, Fim, Sfa, Afa, Hly and Cnf, using commercially designed primers.Results: In this study, 62.5% (125/200) were positive biofilm formers and 78% (156/200) of these were multi-drug resistant (MDR). The isolates were most resistant to Trimethoprim sulphamethoxazole and Amoxicillin (93%) followed by gentamycin (87%) and the least was imipenem (0.5%). Fim was the most prevalent Urovirulence gene (53.5%) followed by Pap (21%), Sfa (13%), Afa (8%), Cnf (5.5%) and Hyl (0%).Conclusions: We demonstrate a high prevalence of biofilm-forming Uropathogenic E. coli strains that are highly associated with the MDR phenotype. We recommend routine surveillance of antimicrobial resistance and biofilm formation to understand the antibiotics suitable in the management of biofilm-associated UTIs.
Stable high frequencies of sulfadoxine-pyrimethamine resistance associated mutations and absence of K13 mutations in Plasmodium falciparum 3 and 4 years after the introduction of artesunate plus sulfadoxine-pyrimethamine in Ujjain, Madhya Pradesh, India
Authors: Pathak Ashish , Mårtensson Andreas , Gawariker Sudhir , Sharma Ashish , Diwan Vishal , Purohit Manju , Ursing Johan
Published: June 2020

Background Artesunate plus sulfadoxine-pyrimethamine (ASP) is first-line treatment for uncomplicated Plasmodium falciparum malaria in most of India, except for six North-eastern provinces where treatment failure rates were high. In Ujjain, central India, the frequency of mutations associated with increased drug tolerance, but not overt resistance to sulfadoxine and pyrimethamine were 9% and >80%, respectively, in 2009 and 2010, just prior to the introduction of ASP. The frequency of drug resistance associated mutations in Ujjain in 2015-2016 after 3-4 years of ASP use, are reported.Methods Blood samples from patients with P. falciparum mono-infection verified by microscopy were collected on filter-paper at all nine major pathology laboratories in Ujjain city. Codons pfdhfr 16-185, pfdhps 436-632 and K13 407-689 were identified by sequencing. Pfcrt K76T and pfmdr1 N86Y were identified by restriction fragment length polymorphism. Results Sulfadoxine-pyrimethamine resistance-associated pfdhfr 108N and 59R alleles were found in 100/104 (96%) and 87/91 (96%) samples, respectively. Pfdhps 437G was found in 10/105 (10%) samples. Double mutant pfdhfr 59R+108N were found in 75/81 (93%) samples. Triple mutant pfdhfr 59R + 108N and pfdhps 437G were found in 6/78 (8%) samples. Chloroquine-resistance-associated pfcrt 76T was found in 102/102 (100%). Pfmdr1 N86 and 86Y were identified in 83/115 (72%) and 32/115 (28%) samples, respectively. Conclusion The frequency of P. falciparum with reduced susceptibility to sulfadoxine-pyrimethamine remained high, but did not appear to have increased significantly since the introduction of ASP. No polymorphisms in K13 associated with decreased artemisinin susceptibility were found. ASP probably remained effective, supporting continued ASP use.
Identification of Differentially Expressed microRNAs in Metastatic Ovarian Cancer
Authors: Gu Yang , Zhang Shulan
Published: June 2020

Background: The molecular mechanisms of ovarian cancer (OC) remain unclear. We sought to comprehensively identify microRNAs (miRNAs) that are aberrantly expressed in metastatic OC. Methods: Differentially expressed miRNAs were screened from six pairs of primary and metastatic OC tissues; their possible functions were analyzed and target genes were predicted by bioinformatics. Then gene expression profiling results were established by reverse transcription quantitative polymerase chain reaction and western blot. Targeting relationship between miR-7-5p and TGFβ2 was validated by dual-luciferase reporter assay. CCK-8, Transwell assay, scratch test and flow cytometry were used for cell function detection after miR-7-5p overexpression. Results: Twelve miRNAs and 10 target mRNAs were differentially expressed in primary and metastatic OC tissues. ITGB3, TGFβ2 and TNC correlated to miRNA function in metastatic OC. Among all 7 miRNAs, expression of hsa-miR-141-3p, hsa-miR-7-5p, hsa-miR-187-5p, hsa-miR-200a-3p, and hsa-miR-200b-3p in metastatic OC tissues was obviously lower than that in primary OC tissues ( p < 0.05). Moreover, there was a significant correlation between hsa-miR-7-5p and TGFβ2 in OC tissues. Dual-luciferase reporter assay confirmed that hsa-miR-7-5p negatively targeted TGFβ2. After miR-7-5p overexpression, the OC cell viability and invasion were reduced, the cell cycle was blocked ( p < 0.05). Conclusions: Hsa-miR-141-3p, hsa-miR-187-5p, hsa-miR-7-5p, hsa-miR-200a-3p, and hsa-miR-200b-3p expression was prominently lower in metastatic OC than in primary OC, while TGFβ2 expression was markedly increased in metastatic OC tissues. Hsa-miR-7-5p bound to TGFβ2 3’-UTR to inhibit its expression. Hsa-miR-7-5p targeted TGFβ2 to inhibit cell proliferation, invasion and cell cycle entry.
Adjuvant Transarterial Chemoembolization does not Influence Recurrence-free and Overall survivals for Patients with Combined Hepatocellular Carcinoma and Cholangiocarcinoma after Curative Resection: a Propensity Score Matching Analysis
Authors: Liu Wei-Ren , Tian Meng-Xin , Tao Chen-Yang , Tang Zheng , Zhou Yu-Fu , Song Shu-Shu , Jiang Xi-Fei , Wang Han , Zhou Pei-Yun , Qu Wei-Feng , Fang Yuan , Ding Zhen-Bin , Zhou Jian , Fan Jia , Shi Ying-Hong
Published: June 2020

Background: The prognosis of patients with combined hepatocellular carcinoma and intrahepatic cholangiocarcinoma (CHC) is usually poor, and effective adjuvant therapy is missing making it important to investigate whether these patients may benefit from adjuvant transarterial chemoembolization (TACE). We aimed to evaluate the efficiency of adjuvant TACE for long-term recurrence and survival after curative resection before and after propensity score matching (PSM) analysis.Methods: In this retrospective study, of 230 patients who underwent resection for CHC between January 1994 and December 2014, 46 (18.0%) patients received adjuvant TACE. Univariate and multivariate regression analyses were used to identify the independent predictive factors of survival. Cox regression analyses and log-rank tests were used to compare overall survival (OS) and disease-free survival (DFS) between patients who did or did not receive adjuvant TACE.Results: A total of 230 patients (mean age 52.2±11.9 years; 172 men) were enrolled, and 46 (mean age 52.7±11.1 years; 38 men) patients received TACE. Before PSM, in multivariate regression analysis, γ-glutamyl transpeptidase (γ-GT), tumour nodularity, macrovascular invasion (MVI), lymphoid metastasis, and extrahepatic metastasis were associated with OS. Alanine aminotransferase (ALT), MVI, lymphoid metastasis, and preventive TACE (HR: 2.763, 95% CI: 1.769-4.314, p <0.001) were independent prognostic factors for DFS. PSM created 46 pairs of patients. Before PSM, adjuvant preventive TACE was not associated with an increased risk of OS (HR: 0.911, 95% CI: 0.545-1.520, p =0.720) or DFS (HR: 3.345, 95% CI: 1.686-6.638, p =0.001). After PSM, the 5-year OS and DFS rates were comparable in the TACE group and the non-TACE group (OS: 22.7% vs 14.9%, respectively, p =0.75; DFS: 11.2% vs 14.4%, respectively, p =0.06).Conclusions: The present study identified that adjuvant preventive TACE did not influence DFS or OS after curative resection of CHC.
Anti-proliferative activities of Byrsocarpus coccineus Schum. and Thonn. (Connaraceae) using Ovarian Cancer Cell Lines
Authors: Ukwade Caroline E. , Ebuehi Osaretin Albert Taiwo , Adisa Rahmat A. , Singh Santosh K. , Singh Rajesh
Published: June 2020

Background Ovarian cancer (OvCa) is one of the most lethal tumors of gynecologic malignancies, due to lack of early detection, and a high rate of metastasis. The standard treatment for OvCa is surgery and cytotoxic chemotherapy. However, to overcome the high cost and side effects of these treatments, medicinal plants are widely used in developing countries to treat OvCa. Byrsocarpus coccineus plant preparation has been administered to patients traditionally in the management of tumors in Nigeria. In this study, we investigated the anti-proliferative effects of B. coccineus ethanol leaf extract against OVCAR3 and SW 626 OvCa cell lines. After the treatment of the two cell lines with the extracts, analyses were carried out to determine inhibition of proliferation and expression of cell cycle markers, pro-apoptotic, and anti-apoptotic markers. Results Results showed that B. coccineus ethanol leaf extract, significantly inhibited cell migration and colony formation in OVCAR3 and SW626 treated cells in a dose-dependent manner. Results also show that B. coccineus ethanol leaf extract modulated the expression of p53 gene, cell cycle progression, anti-apoptotic and pro-apoptotic genes. Conclusions These results suggest that B. coccineus have anti-proliferative properties and could induce apoptosis. Further investigation will be carried out to isolate bioactive compounds for the treatment of ovarian cancer.
Evaluating blood-brain barrier permeability in a rat model of type 2 diabetes
Authors: Qiao Ju , Lawson Christopher M , Rentrup Kilian FG , Kulkarni Praveen , Ferris Craig
Published: June 2020

Background: This is an exploratory study using a novel imaging modality, quantitative ultrashort time-to-echo, contrast enhanced (QUTE-CE) magnetic resonance imaging to evaluate the permeability of the blood-brain barrier in a rat model of type 2 diabetes with the presumption that small vessel disease is a contributing factor to neuropathology in diabetes. Methods: The BBZDR/Wor rat, a model of type 2 diabetes, and age-matched controls were studied for changes in blood-brain barrier permeability. QUTE-CE, a quantitative vascular biomarker, generated angiographic images with over 500,000 voxels that were registered to a 3D MRI rat brain atlas providing site-specific information on blood-brain barrier permeability in 173 different brain areas.Results: In this model of diabetes, without the support of insulin treatment, there was global capillary pathology with over 84% of the brain showing a significant increase in blood-brain barrier permeability over wild-type controls. Areas of the cerebellum and midbrain dopaminergic system were not significantly affected. Conclusion: Small vessel disease as assessed by permeability in the blood-brain barrier in type 2 diabetes is pervasive and includes much of the brain. The increase in blood-brain barrier permeability is a likely contributing factor to diabetic encephalopathy and dementia.
Insights into the phylogenetic relationship and drug targets of Babesia isolates infective to small ruminants from the mitochondrial genomes
Authors: Wang Xiaoxing , Wang Jinming , Liu Junlong , Liu Aihong , He Xin , Xiang Quanjia , Li Youquan , Yin Hong , Luo Jianxun , Guan Guiquan
Published: June 2020

Background: Babesiosis, a tick-borne disease caused by protozoa of the genus Babesia, is widespread in subtropical and tropical countries. Mitochondria are essential organelles that are responsible for energy transduction and metabolism, calcium homeostasis and cell signaling. Mitochondrial genomes could provide new insight to help elucidate and investigate the biological features, genetic evolution and classification of the protozoa. Nevertheless, there are limited data on the mitochondrial genomes of ovine Babesia spp. in China.Methods: Herein, we sequenced, assembled and annotated the mitochondrial genomes of six ovine Babesia isolates; analyzed the genome size, gene content, genome structure and cytochrome b (cob) amino acid sequences; and performed comparative mitochondrial genomics and phylogenomic analyses among apicomplexan parasites.Results: The mitochondrial genomes range from 5767 to 5946 bp in length with a linear form and contain three protein-encoding genes, cytochrome c oxidase I (cox1), cytochrome c oxidase III (cox3) and cob, six large subunit rRNA genes (LSU), and two terminal inverted repeats (TIR) on both ends. The cob gene sequence analysis indicated the binding site of anti-Babesia drugs that targeted the cytochrome bc1 complex. Babesia microti and Babesia rodhaini have a dual flip-flop inversion of 184-1082 bp, whereas other Babesia spp. and Theileria spp. have one pair of TIRs, 25-1563 bp. Phylogenetic analysis indicated that the six ovine Babesia isolates were divided into two clades, Babesia sp. and Babesia motasi. B. motasi isolates were further separated into two small clades (B. motasi Hebei/Ningxian and B. motasi Tianzhu/Lintan).Conclusions: The data provided new insights into the taxonomic relationships and drug targets of apicomplexan parasites.
Measuring capital in active addiction and recovery: The development of the Strengths And Barriers Recovery Scale (SABRS)
Authors: Best David , Vanderplasschen Wouter , Nisic Mulka
Published: June 2020

Background: The international Life In Recovery (LiR) surveys have provided an important message to the public and policy makers about the reality of change from addiction to recovery, consistently demonstrating both that there are marked gains across a range of life domains and that the longer the person is in recovery the better their recovery strengths and achievements. However, to date, no attempt has been made to quantify the Life In Recovery scales and to assess what levels of change in removing barriers and building strengths is achieved at which point in the recovery journey. Methods: The current study undertakes a preliminary analysis of strengths and barriers from the Life in Recovery measure, using data from a European survey on drug users in recovery (n=480), and suggests that the instrument can be edited into a Strengths And Barriers Recovery Scale (SABRS). The new scale provides a single score for both current recovery strengths and barriers to recovery.Results: The resulting data analysis shows that there are stepwise incremental changes in recovery strengths at different recovery stages, but these occur with only very limited reductions in barriers to recovery, with even those in stable recovery typically having at least two barriers to their quality of life and wellbeing. Greater strengths in active addiction are associated with greater strengths and resources in recovery. Conclusion: As well as demonstrating population changes in each of the domains assessed, the current study has shown the potential of the Life In Recovery Scale as a measure of recovery capital that can be used to support recovery interventions and pathways.
Drp1 is widely, yet heterogeneously, distributed in the mouse central nervous system
Authors: Luo Ting-Ting , Dai Chun-Qiu , Wang Jia-Qi , Wang Zheng-Mei , Yang Yi , Zhang Kun-Long , Wu Fei-Fei , Yang Yan-Ling , Wang Ya-Yun
Published: June 2020

Objectives: Drp1 is widely expressed in the mouse central nervous system and plays a role in inducing the mitochondrial fission process. Many diseases are associated with Drp1 and mitochondria. However, since the exact distribution of Drp1 has not been specifically observed, it is difficult to determine the impact of anti-Drp1 molecules on the human body. Clarifying the specific Drp1 distribution could be a good approach to targeted treatment or prognosis. Methods: We visualized the distribution of Drp1 in different brain regions and explicated the relationship between Drp1 and mitochondria. GAD67-GFP knock-in mice were utilized to detect the expression patterns of Drp1 in GABAergic neurons. We also further analyzed Drp1 expression in human malignant glioma tissue. Results : Drp1 was widely but heterogeneously distributed in the central nervous system. Further observation indicated that Drp1 was highly and heterogeneously expressed in inhibitory neurons. Under transmission electron microscopy, the distribution of Drp1 was higher in dendrites than other areas in neurons, and only a small amount of Drp1 was localized in mitochondria. In human malignant glioma, the fluorescence intensity of Drp1 increased from grade I-III, while grade IV showed a declining trend. Conclusion: In this study, we observed a wide heterogeneous distribution of Drp1 in the central nervous system, which might be related to the occurrence and development of neurologic disease. We hope that the relationship between Drp1 and mitochondria may will to therapeutic guidance in the clinic.