bluuebunny/crossref_metadata_2025_split huggingface dataset:
De novo transcriptome sequencing of Rhododendron molle and identification of genes involved in the biosynthesis of secondary metabolites
Authors: Zhou Guolin , Zhu Ping 
Published: August 2020

Abstract
Background: Rhododendron molle (Ericaceae) is a traditional Chinese medicinal plant, its flower and root have been widely used to treat rheumatism and relieve pain for thousands of years in China. Chemical studies have revealed that R. molle contains abundant secondary metabolites such as terpenoinds, flavonoids and lignans, some of which have exhibited various bioactivities including antioxidant, hypotension and analgesic activity. In spite of immense pharmaceutical importance, the mechanism underlying the biosynthesis of secondary metabolites remains unknown and the genomic information is unavailable. Results: To gain molecular insight into this plant, especially on the information of pharmaceutically important secondary metabolites including grayanane diterpenoids, we conducted deep transcriptome sequencing for R. molle flower and root using the Illumina Hiseq platform. In total, 100,603 unigenes were generated through de novo assembly with mean length of 778 bp, 57.1% of these unigenes were annotated in public databases and 17,906 of those unigenes showed significant match in the KEGG database. Unigenes involved in the biosynthesis of secondary metabolites were annotated, including the TPSs and CYPs that were potentially responsible for the biosynthesis of grayanoids. Moreover, 3,376 transcription factors and 10,828 simple sequence repeats (SSRs) were also identified. Additionally, we further performed differential gene expression (DEG) analysis of the flower and root transcriptome libraries and identified numerous genes that were specifically expressed or up-regulated in flower.Conclusions: To the best of our knowledge, this is the first time to generate and thoroughly analyze the transcriptome data of both R. molle flower and root. This study provided an important genetic resource which will shed light on elucidating various secondary metabolite biosynthetic pathways in R. molle, especially for those with medicinal value and allow for drug development in this plant.
A Randomised Dose-Response Study of Prophylactic Methoxamine Infusion for Preventing Spinal-induced Hypotension during Cesarean Delivery
Authors: Fu Feng , Tang Yu-wen , Chen Hong , Jiao Cui-cui , Ma Na , Chen Xinzhong 
Published: August 2020

Abstract
Background: α-receptor agonists have been reported to be safe and effective for treating or preventing spinal-induced hypotension during cesarean delivery. As a pure α1 adrenergic agonist, methoxamine has potential advantages of reducing myocardial oxygen consumption and protecting the heart in obstetric patients compared to phenylephrine. The aim of this study was to determine the optimal prophylactic methoxamine infusion dose that would be effective for preventing spinal-induced hypotension in 50% (ED50) and 95% (ED95) of parturients. Methods: Eighty parturients with a singleton pregnancy scheduled for elective cesarean delivery were randomly allocated to receive prophylactic methoxamine infusion at one of four different fixed-rates: 1μg/kg/min (group M1), 2μg/kg/min (group M2), 3μg/kg/min (group M3), or 4μg/kg/min (group M4). An adequate response was defined as absence of hypotension (maternal SBP <80% of baseline or SBP < 90 mmHg). The values for ED50 and ED95 of prophylactic methoxamine infusion were determined by probit regression model. The outcomes of maternal hemodynamics and fetal status were compared among the groups. Results: The calculated ED50 and ED95 (95% confidence interval) of prophylactic methoxamine infusion dose were 2.178 (95% CI 1.564 to 2.680) μg/kg/min and 4.821 (95% CI 3.951 to 7.017) μg/kg/min, respectively. The incidence of hypotension decreased with increasing methoxamine infusion dose (15/20, 11/20, 7/20 and 2/20 in group M1, M2, M3 and M4 respectively, P < 0.001). 1-minute Apgar scores and umbilical arterial PaO2 were lower but umbilical arterial PaCO2 was higher in Group M1. No difference was found in the other incidence of adverse effects and neonatal outcomes among groups. Conclusions: Under the conditions of this study, when prophylactic methoxamine infusion was given at a fixed-rate based on body weight for preventing spinal-induced hypotension in obstetric patients, the values for ED50 and ED95 were 2.178μg/kg/min and 4.821μg/kg/min respectively.
Association of MC4R (rs17782313) with diabetes and cardiovascular disease in Korean men and women
Authors: Sull Jae Woong , Kim Gitae , Jee Sun Ha 
Published: August 2020

Abstract
Background: Diabetes is mostly assessed by the fasting glucose level. Several studies reported that serum fasting glucose levels and cardiovascular disease are associated with MC4R. Methods: A total of 4,294 subjects participated in this study. There were 1810 subjects with cardiovascular disease among the 4294 subjects. We used multivariate linear regression models and multiple logistic regression analysis. Results: Individuals with the TC/CC genotype had a 1.29-fold higher risk of diabetes than did those with the TT genotype when adjusting for age, sex, and BMI (OR, 1.29; 95% CI, 1.04-1.60). For healthy subjects, the association was significant in women (OR, 1.99; 95% CI, 1.01-3.93). Men with the TC/CC genotype had a 1.21-fold higher risk of cardiovascular disease than did those with the TT genotype when adjusting for age, sex, and BMI (OR, 1.21; 95% CI, 1.04-1.41). The relationship between MC4R and cardiovascular disease was stronger in lean men (OR, 1.40; 95% CI, 1.12–1.74, p = 0.0028) than in overweight men.Conclusions: This study suggests that the rs17782313 SNP in MC4R is related to diabetes and the SNP is also associated with cardiovascular disease in lean men.
Measuring Clinical Uncertainty and Equipoise by Applying the Agreement Study Methodology to Patient Management Decisions
Authors: FAHED Robert , DARSAUT Tim E. , FARZIN Behzad , CHAGNON Miguel , Raymond Jean 
Published: August 2020

Abstract
Background : Clinical uncertainty and equipoise are vague notions that play important roles in contemporary problems of medical care and research, including the design and conduct of pragmatic trials. Our goal was to show how the reliability study methods normally used to assess diagnostic tests can be applied to particular management decisions to measure the degree of uncertainty and equipoise regarding the use of rival management options.

Methods: We first use thrombectomy in acute stroke as an illustrative example of the method we propose. We then review, item by item, how the various design elements of diagnostic reliability studies can be modified in order to measure clinical uncertainty.

Results: The thrombectomy example shows sufficient disagreement and uncertainty to warrant the conduct of additional randomized trials. The general method we propose is that a sufficient number of diverse individual cases sharing a similar clinical problem and covering a wide spectrum of clinical presentations be assembled into a portfolio that is submitted to a variety of clinicians who routinely manage patients with the clinical problem.

Discussion: Clinicians are asked to independently choose one of the predefined management options, which are selected from those that would be compared within a randomized trial that would address the clinical dilemma. Intra-rater agreement can be assessed at a later time with a second evaluation. Various professional judgments concerning individual patients can then be compared and analyzed using kappa statistics or similar methods. Interpretation of results can be facilitated by providing examples or by translating the results into clinically meaningful summary sentences.

Conclusions: Measuring the uncertainty regarding management options for clinical problems may reveal substantial disagreement, provide an empirical foundation for the notion of equipoise, and inform or facilitate the design/conduct of clinical trials to address the clinical dilemma.
External validation of the Simplified PADUA REnal (SPARE) nephrometry system in predicting surgical outcomes after partial nephrectomy
Authors: Huang Chi-Ping , Chang Chao-Hsiang , Wu Hsi-Chin , Yang Che-Rei , Hsieh Po-Fan , Chen Guang-Heng , Hsiao Po-Jen , Chang Yi-Huei , Wang Yu-Ping , Wang Yu-De 
Published: August 2020

Abstract
Background

Pentafecta is a major goal in the era of partial nephrectomy (PN). Simplified PADUA REnal (SPARE) nephrometry system was developed to evaluate the complexity of tumor. However, the predictive ability in pentafecta of SPARE system is yet to be determined. The aim of this study was to externally validate the applicability of SPARE nephrometry system in predicting pentafecta achievement after partial nephrectomy, and to examine inter-observer concordance.

Methods

We retrospectively reviewed data of 207 consecutive patients who underwent PN between January 2012 and August 2018 at a tertiary referral center. We obtained SPARE, R.E.N.A.L., and PADUA scores and evaluated correlations among the nephrometries and surgical outcomes including pentafecta by Spearman test. Logistic regression analysis was used to identify independent predictors of pentafecta outcomes. We compared the nephrometries to determine the predictive ability of achieving pentafecta using receiver operating characteristic curve analysis. Fleiss’ generalized kappa was used to assessed interobserver variation in the SPARE system.

Results

Based on the SPARE system, 120, 74, and 13 patients were stratified into low-risk, intermediate-risk, and high-risk groups, respectively. Regarding the individual components of pentafecta, there were significant differences in the complication rate (p=0.03), ischemia time (p<0.001), and percent change of eGFR (p<0.001) among the three risk groups. In addition, higher tumor complexity was significantly associated with a lower achievement rate of pentafecta (p=0.01). In Spearman correlation tests, SPARE nephrometry was correlated with ischemia time (ρ:0.37, p<0.001), operative time (ρ:0.28, p<0.001), complication rate (ρ:0.34, p<0.001), percent change of eGFR (ρ:0.34, p<0.001), and progression of chronic kidney disease stage (ρ:0.17, p=0.02). Multivariate analysis revealed that SPARE significantly affected pentafecta (OR: 0.67, p<0.001). In ROC curve analysis, SPARE showed fair predictive ability in the achievement pentafecta (AUC: 0.71). The predictive ability of pentafecta was similar between nephrometries (SPARE vs. R.E.N.A.L., p=0.78; SPARE vs. PADUA, p=0.66). The interobserver concordance of SPARE was excellent (Kappa: 0.82, p=0.03).

Conclusions

SPARE system was a predictive factor of surgical outcomes after PN. This refined nephrometry had similar predictive abilities for pentafecta achievement compared with R.E.N.A.L. and PADUA.
Prevalence and factors associated with intestinal parasites among food handlers in Medebay Zana District, North West Tigray, Northern Ethiopia.
Authors: Regassa Kebrom , Tedla Kiros , Bugssa Gessessew , Gebrekirstos Gebretsadkan , Gebreyesus Hailay , Shfare Mebrahtu Teweldemedhin 
Published: August 2020

Abstract
Introduction: Several epidemiological studies suggest that the prevalence of intestinal parasites is high, especially in developing countries, and are amongst the major public healthchallenges facing Sub-Saharan Africa.The aim of the study was to determine the prevalence of intestinal parasites and its associated factors among food handlers in Medebay Zana District, Tigray, Ethiopia.Methods: A cross-sectional study was conducted among 401 food handler individuals selected by systematic random sampling.Binary and multivariable logistic regression was used to determine the possible association between the independent variable and outcome variables. Statistical significance was declared at p-value <0.05 with a 95% confidence interval. Result: The prevalence of intestinal parasites was 33.2% within this sample. The dominant parasite was Entamoeba coli 50(37.4%), followed by Entamoebahistolytica/dispar 24(18%), Entamoeba hartmanni 18(13.5), Giardia lamblia 17(12.8%), Schistosoma mansoni 8(6%), Hymenolepis nana 7(5.3%), Entervious vermicularies 6(4.5%) and Taenia species 3(2.5%).Conclusion: This study revealed a high prevalence of intestinal parasites among food handlers for a range of intestinal parasites. The significant predictors werethe source of water, washing hands before food preparation, washing hands with soap and water after visiting the toilet, shower installation at workplace, washing the body regularly, and eating raw vegetables and raw meat. Hence, local health planners should implement appropriate interventional measures for the novel risk factors to mitigate the problem.
Withdrawal of Treatment in a Pediatric Intensive Care Unit at a Children’s Hospital in China: A 10-year Retrospective Study
Authors: Liu Huaqing , Su Dongni , Guo Xubei , Dai Yunhong , Dong Xingqiang , Zhu Qiujiao , Bai Zhengjiang , Li Ying , Wu Shuiyan 
Published: August 2020

Abstract
Background: Published data and practice recommendations on end-of-life care generally reflect Western practice frameworks; there are limited data on withdrawal of treatment for children in China. Methods: Withdrawal of treatment for children in the pediatric intensive care unit (PICU) of a regional children’s hospital in eastern China from 2006 to 2017 was studied retrospectively. Withdrawal of treatment was categorized as medical withdrawal or premature withdrawal. The guardian’s self-reported reasons for abandoning the child’s treatment were recorded from 2011. Results: The incidence of withdrawal of treatment for children in the PICU decreased significantly; for premature withdrawal the 3-year average of 15.1% in 2006–2008 decreased to 1.9% in 2015–2017 (87.4% reduction). The overall incidence of withdrawal of care reduced over the time period, and withdrawal of therapy by guardians was the main contributor to the overall reduction. The median age of children for whom treatment was withdrawn increased from 14.5 months (interquartile range: 4.0–72.0) in 2006 to 40.5 months (interquartile range: 8.0–99.0) in 2017. Among the reasons given by guardians of children whose treatment was withdrawn in 2011–2017, “illness is too severe” ranked first, accounting for 66.3%, followed by “condition has been improved” (20.9%). Only a few guardians ascribed treatment withdrawal to economic reasons. Conclusions: The frequency of withdrawal of medical therapy has changed over time in this children’s hospital PICU, and parental decision-making has been a large part of the change.
Osteopontin promoter polymorphisms and risk of urolithiasis: a candidate gene association and meta-analysis study
Authors: Amar Ali , Afzal Ayesha , Hameed Athar , Ahmad Mumtaz , Khan Abdul Rafay , Najma Humaira , Abid Aiysha , Khaliq Shagufta 
Published: August 2020

Abstract
Background: Urolithiasis is a worldwide urological problem with significant contribution of genetic factors. Pakistan, which resides within the Afro-Asian stone belt, has a high reported prevalence (12%) of urolithiasis. Osteopontin (SPP1) is a urinary macromolecule with a suggested critical role in modulating renal stone formation, genetic polymorphisms of which may determine individual risk of developing urolithiasis. However, results of previous studies regarding SPP1 polymorphisms and susceptibility to urolithiasis have apparent inconsistencies with no data available for local population. Methods: A total of 235 urolithiasis patients and 243 healthy controls, all of Pakistani ancestry, underwent genotyping for six SPP1 genetic polymorphisms in an effort to investigate potential association with urolithiasis using indigenous candidate gene association study design. Further, a comprehensive meta-analysis following a systematic literature search was also done to ascertain an evidence based account of any existent association regarding SPP1 promoter polymorphisms and risk of developing urolithiasis.Results: Three SPP1 promoter polymorphisms, rs2853744:G>T, rs11730582:T>C and rs11439060:delG>G, were found to be significantly associated with risk of urolithiasis in indigenous genetic association study (OR = 3.14; p = 0.006, OR = 1.78; p = 0.006 and OR = 1.60; p = 0.012, respectively). We also observed a 1.68-fold positive association of a tri-allelic haplotype of these SPP1 promoter polymorphisms (G-C-dG) with risk of urolithiasis (OR = 1.68; p = 0.0079). However, no association was evident when data were stratified according to gender, age at first presentation, stone recurrence, stone multiplicity, parental consanguinity and family history of urolithiasis. The overall results from meta-analysis, which included 4 studies, suggested a significant association of SPP1 rs2853744:G>T polymorphism with susceptibility of urolithiasis (OR = 1.37; p = 0.004), but not for other SPP1 polymorphic variants analyzed. Conclusions: In conclusion, we report significant association of 3 SPP1 polymorphisms with urolithiasis for the first time from South Asia, however, this association persisted only for SPP1 rs2853744:G>T polymorphism after meta-analysis of pooled studies. Further studies with a larger sample size will be required to validate this association and assess any potential usefulness in diagnosis and prognosis of renal stone disease.
Clinical significance of skeletal muscle density and sarcopenia in patients with pancreatic cancer undergoing first-line chemotherapy : a retrospective observational study.
Authors: Kim In-Ho , Choi Moon Hyung , Lee In Seok , Hong Tae Ho , Lee Myung Ah 
Published: August 2020

Abstract
Background: To investigate the clinical impact of sarcopenia and skeletal muscle density among patients with metastatic pancreatic adenocarcinoma who underwent palliative first line gemcitabine-based chemotherapy.Methods: A total of 330 patients with metastatic pancreatic adenocarcinoma who were treated with palliative first line gemcitabine-based chemotherapy between January 2010 and March 2017 were included in this study. Sarcopenia and skeletal muscle density status were identified by L3 vertebra level skeletal muscle index in cm2/m2 and muscle attenuation in Hounsfield units using computed tomography.Results: A skeletal muscle index to skeletal muscle density comparison revealed a positive correlation (R2 = 0.058, P<0.001). Kaplan–Meier analysis showed that the low skeletal muscle density was related to poor overall survival. Multivariate analysis using Cox regression showed that low skeletal muscle index and low skeletal muscle density were poor prognostic factors for overall survival, respectively. Co-presence of low skeletal muscle index and low skeletal muscle density had more powerful prognostic implication for overall survival. Grade 3 or higher toxicity of chemotherapy was more frequently observed in patients who have a low skeletal muscle index and low skeletal muscle density. Overall survival was not related to skeletal muscle density status among patients who were chemotherapy responders (complete or partial responses). However, among non-responders (stable or progressive disease), low skeletal muscle density groups had significantly poorer overall survival in comparison with high skeletal muscle density groups.Conclusions: Sarcopenia and skeletal muscle density status can be considered a prognostic factor in patients with metastatic pancreatic adenocarcinoma who received palliative first line gemcitabine-based chemotherapy. Severe chemotherapy toxicity occurred in the sarcopenia and low skeletal muscle density groups. Our data suggest that a comprehensive assessment of skeletal muscle parameters may be more useful prognostic factors.
Efficacy of Smartphone-Based Mobile Learning Versus Lecture-Based Learning for Instruction of Cephalometric Landmark Identification&nbsp;
Authors: Golshah Amin , Dehdar Fatemeh , Imani Mohammad Moslem , Nikkerdar Nafiseh 
Published: August 2020

Abstract
Background: Considering the increasing popularity of electronic learning, particularly smartphone-based mobile learning, and its reportedly optimal efficacy for instruction of complicated topics, this study aimed to compare the efficacy of smartphone-based mobile learning versus lecture-based learning for instruction of cephalometric landmark identification. Methods: This quasi-experimental interventional study evaluated 53 dental students (4th year) in two groups of intervention (n=27; smartphone instruction using an application) and control (n=26, traditional lecture-based instruction). Two weeks after the instructions, dental students were asked to identify four landmarks namely the posterior nasal spine (PNS), orbitale (Or), articulare (Ar) and gonion (Go) on lateral cephalograms. The mean coordinates of each landmark identified by orthodontists served as the reference point, and the mean distance from each identified point to the reference point was reported as the mean consistency while the standard deviation of this mean was reported as the precision of measurement. Data were analyzed using SPSS version 18 via independent sample t-test.Results: No significant difference was noted between the two groups in identification of PNS, Ar or Go (P>0.05). However, the mean error rate in identification of Or was significantly lower in smartphone group compared with the traditional learning group (P=0.020).Conclusions: Smartphone-based mobile learning had a comparable, and even slightly superior, efficacy to lecture-based learning for instruction of cephalometric landmark identification, and may be considered, at least as an adjunct, to enhance the instruction of complicated topics.
Impact of long-term industrial contamination on the bacterial communities in urban river sediments
Authors: Zhang Lei , Tu Demei , Li Xingchen , Lu Wenxuan , Li Jing 
Published: August 2020

Abstract
Background: The contamination of the aquatic environment of urban rivers with industrial wastewater has affected the abiotic conditions and biological activities of the trophic levels of the ecosystem, particularly sediments. However, most current research about microorganism in urban aquatic environments has focused on indicator bacteria related to feces and organic pollution. Meanwhile, they ignored the interactions among microorganisms. To deeply understand the impact of industrial contamination on microbial community, we study the bacterial community structure and diversity in river sediments under the influence of different types of industrial pollution by Illumina MiSeq high-throughput sequencing technology and conduct a more detailed analysis of microbial community structure through co-occurrence networks.Results: The overall community composition and abundance of individual bacterial groups differed between samples. In addition, redundancy analysis indicated that the structure of the bacterial community in river sediments was influenced by a variety of environmental factors. TN, TP, TOC and metals (Cu, Zn and Cd) were the most important driving factors that determined the bacterial community in urban river sediments (P <0.01). According to PICRUSt analysis, the bacterial communities in different locations had similar overall functional profiles. It is worth noting that the 15 functional genes related to xenobiotics biodegradation and metabolism were the most abundant in the same location. The non-random assembly patterns of bacterial composition in different types of industrially polluted sediments were determined by a co-occurrence network. Environmental conditions resulting from different industrial pollutants may play an important role in determining their co-occurrence patterns of these bacterial taxa. Among them, the bacterial taxa involved in carbon and nitrogen cycles in module I were relatively abundant, and the bacterial taxa in module II were involved in the repair of metal pollution.Conclusions: Our data indicate that long-term potential interactions between different types of industrial pollution and taxa collectively affect the structure of the bacterial community in urban river sediments.