bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pitchers of Nepenthes khasiana express several digestive-enzyme encoding genes, harbor mostly fungi and probably evolved through changes in the expression of leaf polarity genes
Authors: Dkhar Jeremy , Bhaskar Yogendra Kumar , Lynn Andrew , Pareek Ashwani 
Published: November 2020

Abstract
Background
A structural phenomenon seen in certain lineages of angiosperms that has captivated many scholars including Charles Darwin is the evolution of plant carnivory. Evidently, these structural features collectively termed carnivorous syndrome, evolved to aid nutritional acquisition from attracted, captured and digested prey. We now understand why plant carnivory evolved but how carnivorous plants acquired these attributes remains a mystery. In an attempt to understand the evolution of Nepenthes pitcher and to shed more light on its role in prey digestion, we analyzed the transcriptome data of the highly specialized Nepenthes khasiana leaf comprising the leaf base lamina, tendril and the different parts/zones of the pitcher tube viz. digestive zone, waxy zone and lid.

Results
In total, we generated around 262 million high-quality Illumina reads. Reads were pooled, normalized and de novo assembled to generate a reference transcriptome of about 412,224 transcripts. We then estimated transcript abundance along the N. khasiana leaf by mapping individual reads from each part/zone to the reference transcriptome. Correlation-based hierarchical clustering analysis of 27,208 commonly expressed genes indicated functional relationship and similar cellular processes underlying the development of the leaf base and the pitcher, thereby implying that the Nepenthes pitcher is indeed a modified leaf. From a list of 2386 differentially expressed genes (DEGs), we identified transcripts encoding key enzymes involved in prey digestion and protection against pathogen attack, some of which are expressed at high levels in the digestive zone. Interestingly, many of these enzyme-encoding genes are also expressed in the unopened N. khasiana pitcher. Transcripts showing homology to both bacteria and fungi were also detected; and in the digestive zone, fungi are more predominant as compared to bacteria. Taking cues from histology and scanning electron microscopy (SEM) photomicrographs, we found altered expressions of key regulatory genes involved in leaf development. Of particular interest, the expression of class III HOMEODOMAIN-LEUCINE ZIPPER (HD-ZIPIII) and ARGONAUTE (AGO) genes were upregulated in the tendril.

Conclusions
Our findings suggest that N. khasiana pitchers employ a wide range of enzymes for prey digestion and plant defense, harbor microbes and probably evolved through altered expression of leaf polarity genes.
Demographic history and genetic differentiation of an endemic and endangered Ulmus lamellosa (Ulmus)
Authors: Hou Huimin , Ye Hang , Wang Zhi , Wu Jiahui , Gao Yue , Han Wei , Na Dongchen , Sun Genlou , Wang Yiling 
Published: November 2020

AbstractBackgroundUlmus lamellosa(one of the ancient species ofUlmus) is an endemic and endangered plant that has undergone climatic oscillations and geographical changes. The elucidation of its demographic history and genetic differentiation is critical for understanding the evolutionary process and ecological adaption to forests in Northern China.ResultsPolymorphic haplotypes were detected in most populations ofU. lamellosavia DNA sequencing. All haplotypes were divided into three phylogeographic clades fundamentally corresponding to their geographical distribution, namely THM (Taihang Mountains), YM (Yinshan Mountains), and YSM (Yanshan Mountains) groups. The YSM group, which is regarded as ancestral, possessed higher genetic diversity and significant genetic variability in contrast to the YSM and YM groups. Meanwhile, the divergence time of intraspecies haplotypes occurred during the Miocene-Pliocene, which was associated with major Tertiary geological and/or climatic events. Different degrees of gene exchanges were identified between the three groups. During glaciation, the YSM and THM regions might have served as refugia forU. lamellosa. Based on ITS data, range expansion was not expected through evolutionary processes, except for the THM group. A series of mountain uplifts (e.g., Yanshan Mountains and Taihang Mountains) following the Miocene-Pliocene, and subsequently quaternary climatic oscillations in Northern China, further promoted divergence betweenU. lamellosapopulations.ConclusionsGeographical topology and climate change in Northern China played a critical role in establishing the current phylogeographic structural patterns ofU. lamellosa. These results provide important data and clues that facilitate the demographic study of tree species in Northern China.
Protocol of the EFFORT study: a prospective study of FOLFIRI plus aflibercept as second-line treatment after progression on FOLFOXIRI plus bevacizumab or during maintenance treatment in patients with unresectable/metastatic colorectal cancer
Authors: Satake Hironaga , Ando Koji , Oki Eiji , Shimokawa Mototsugu , Makiyama Akitaka , Saeki Hiroshi , Tsuji Akihito , Mori Masaki 
Published: November 2020

Abstract
Background
FOLFOXIRI plus bevacizumab is used as a first-line therapy for patients with unresectable or metastatic colorectal cancer. However, there are no clear recommendations for second-line therapy after FOLFOXIRI plus bevacizumab combination. Here, we describe our planning for the EFFORT study to investigate whether FOLFIRI plus aflibercept has efficacy following FOLFOXIRI plus bevacizumab for mCRC.

Methods
EFFORT is an open-label, multicenter, single arm phase II study to evaluate whether a FOLFIRI plus aflibercept has efficacy following FOLFOXIRI plus bevacizumab for mCRC. Patients with unresectable or metastatic colorectal cancer who received FOLFOXIRI plus bevacizumab as a first-line therapy will receive aflibercept and FOLFIRI (aflibercept 4 mg/kg, irinotecan 150 mg/m2 IV over 90 min, with levofolinate 200 mg/m2 IV over 2 h, followed by fluorouracil 400 mg/m2 bolus and fluorouracil 2400 mg/m2 continuous infusion over 46 h) every 2 weeks on day 1 of each cycle. The primary endpoint is progression-free survival (PFS). To achieve 80% power to show a significant response benefit with a one-sided alpha level of 0.10, assuming a threshold progression-free survival of 3 months and an expected value of at least 5.4 months, we estimated that 32 patients are necessary. Secondary endpoints include overall survival, overall response rate, safety, and exploratory biomarker analysis for differentiating anti-VEGF drug in 2nd-line chemotherapy for unresectable or metastatic colorectal cancer.

Discussion
This is the first study to investigate whether FOLFIRI plus aflibercept has efficacy following FOLFOXIRI plus bevacizumab for unresectable or metastatic colorectal cancer. Switching to a different type of anti-VEGF drug in second-line therapy after FOLFOXIRI plus bevacizumab appears to be an attractive treatment strategy when considering survival benefit. It is expected that this phase II study will prove the efficacy of this strategy and that a biomarker for drug selection will be discovered.

Trial registration
Japan Registry of Clinical Trials jRCTs071190003. Registered April 18, 2019.
A randomized phase II trial evaluating the addition of low dose, short course sunitinib to docetaxel in advanced solid tumours
Authors: Ang Yvonne L. E. , Ho Gwo Fuang , Soo Ross A. , Sundar Raghav , Tan Sing Huang , Yong Wei Peng , Ow Samuel G. W. , Lim Joline S. J. , Chong Wan Qin , Soe Phyu Pyar , Tai Bee Choo , Wang Lingzhi , Goh Boon Cher , Lee Soo-Chin 
Published: November 2020

AbstractBackgroundWe previously reported that low-dose, short-course sunitinib prior to neoadjuvant doxorubicin-cyclophosphamide (AC) normalised tumour vasculature and improved perfusion, but resulted in neutropenia and delayed subsequent cycles in breast cancer patients. This study combined sunitinib with docetaxel, which has an earlier neutrophil nadir than AC.MethodsPatients with advanced solid cancers were randomized 1:1 to 3-weekly docetaxel 75 mg/m2, with or without sunitinib 12.5 mg daily for 7 days prior to docetaxel, stratified by primary tumour site. Primary endpoints were objective-response (ORR:CR + PR) and clinical-benefit rate (CBR:CR + PR + SD); secondary endpoints were toxicity and progression-free-survival (PFS).ResultsWe enrolled 68 patients from 2 study sites; 33 received docetaxel-sunitinib and 35 docetaxel alone, with 33 breast, 25 lung and 10 patients with other cancers.There was no difference in ORR (30.3% vs 28.6%,p = 0.432, odds-ratio [OR] 1.10, 95% CI 0.38–3.18); CBR was lower in the docetaxel-sunitinib arm (48.5% vs 71.4%,p = 0.027 OR 0.37, 95% CI 0.14–1.01). Median PFS was shorter in the docetaxel-sunitinib arm (2.9 vs 4.9 months, hazard-ratio [HR] 2.00, 95% CI 1.15–3.48,p = 0.014) overall, as well as in breast (4.2 vs 5.6 months,p = 0.048) and other cancers (2.0 vs 5.3 months,p = 0.009), but not in lung cancers (2.9 vs 4.1 months,p = 0.597). Median OS was similar in both arms overall (9.9 vs 10.5 months, HR 0.92, 95% CI 0.51–1.67,p = 0.789), and in the breast (18.9 vs 25.8 months,p = 0.354), lung (7.0 vs 6.7 months,p = 0.970) and other cancers (4.5 vs 8.8 months,p = 0.449) subgroups.Grade 3/4 haematological toxicities were lower with docetaxel-sunitinib (18.2% vs 34.3%,p = 0.132), attributed to greater discretionary use of prophylactic G-CSF (90.9% vs 63.0%,p = 0.024). Grade 3/4 non-haematological toxicities were similar (12.1% vs 14.3%,p = 0.792).ConclusionsThe addition of sunitinib to docetaxel was well-tolerated but did not improve outcomes. The possible negative impact in metastatic breast cancer patients is contrary to results of adding sunitinib to neoadjuvant AC. These negative results suggest that the intermittent administration of sunitinib in the current dose and schedule with docetaxel in advanced solid tumours, particularly breast cancers, is not beneficial.Trial registrationThe study was registered (NCT01803503) prospectively on clinicaltrials.gov on 4th March 2013.
Systematic review of the incidence of post-operative trichiasis in Africa
Authors: Mwangi Grace , Courtright Paul , Solomon Anthony W 
Published: November 2020

Abstract
Background
Surgery for trichiasis is one of the pillars of the World Health Organization’s strategy for global elimination of trachoma as a public health problem. A high incidence of post-operative trichiasis or other poor surgical outcomes could jeopardize these efforts. In this review, we aimed to summarize the reported incidence of post-operative trichiasis and other poor outcomes of trichiasis surgery in Africa.

Methods
We conducted a systematic literature search using PubMed, Academic Search Premier, Africa-Wide Information, CINAHL and Health Source Nursing through EBSCOhost, Web of Science, and the Cochrane Central Register of Controlled Trials. Reference lists of included studies were also reviewed to identify further potentially relevant publications. All observational and interventional studies that measured post-operative trichiasis in Africa as an outcome of trichiasis surgery were included.

Results
Thirty-five papers reporting on 22 studies (9 interventional,13 observational; total 13,737 participants) met the inclusion criteria. The reported incidence of post-operative trichiasis in the included studies ranged from 2% (at 6 weeks after bilamellar tarsal rotation) to 69% (at 3 weeks after anterior lamellar repositioning). The incidence varied by surgical procedure, study design, and length of follow-up.

Conclusion
Trichiasis surgical outcomes should be improved. National trachoma programmes could benefit from identifying and adopting strategies to improve the performance and quality of their surgical service.
Comparison of Body Mass Index and fat percentage criteria classification of 7–13 year-old rural boys in South Africa
Authors: van Gent Maya , Pienaar Anita , Noorbhai Habib 
Published: November 2020

Abstract
Background
The aim of this paper was to investigate whether BMI and fat percentage classification criteria, would classify a sample of 7–13 year old boys from a rural background in similar nutritional categories.

Methods
A cross-sectional study with a stratified random sampling included 601 rural boys (7–13 years old). Fat percentage criteria classification and BMI were calculated and compared. Maturity status, and age at peak height velocity (PHV) were indirectly determined. Statistical techniques included descriptive statistics, Pearson product correlation coefficients, the Kappa agreement test and the McNemar’s test. The level of statistical significance was set at p ≤ 0.05.

Results
All age groups presented with statistically significant high correlations between BMI and fat percentage, and low to medium correlations between fat percentage and maturity age (MA). Measurement of agreement between BMI and fat percentage classifications showed poor to fair agreements for all age groups, with the exception of the eight-year old group which presented a moderate agreement.

Conclusions
Classifications based on BMI and fat percentage, results in different classifications for the same population. Until further research has been done to determine the best classification for nutritional status, it is recommended that both classification methods be used for more accurate classification of nutritional status.
Systems leadership in practice: thematic insights from three public health case studies
Authors: Bigland Charlotte , Evans David , Bolden Richard , Rae Maggie 
Published: November 2020

Abstract
Background
‘Systems leadership’ has emerged as a key concept in global public health alongside such related concepts as ‘systems thinking’ and ‘whole systems approaches.’ It is an approach that is well suited to issues that require collective action, where no single organisation can control the outcomes. While there is a growing literature on the theory of systems leadership in a number of fields, there remains a lack of published empirical studies of public health systems leadership for professionals to learn from. The aim of the current project was to conduct cases studies in UK public health to provide empirical evidence on the nature of effective systems leadership practice.

Methods
Three system leadership case studies were identified in the key domains of public health: health protection, healthcare public health and health improvement. A total of 27 semi-structured interviews were conducted. Data were thematically analysed to identify the components of effective systems leadership in each case and its impact.

Results
The thematic analysis identified themes around ‘getting started,’ ‘maintaining momentum’ and ‘indicators of success’ in systems leadership. In terms of getting started, the analysis showed that both a compelling ‘call to action’ and assembling an effective ‘coalition of the willing’ are important. To maintain momentum, the analysis identified themes relating to system structure, culture and the people involved. Regarding culture, the main themes that emerged were the importance of nurturing strong relationships, curiosity and a desire to understand the system, and promoting resilience. The analysis identified three components that could be used as indicators of success; these were a sense of enjoyment from the work, resource gains to the system and shifts in data indicators at the population level.

Conclusions
This study has provided insight into the nature of systems leadership in public health settings in the UK. It has identified factors that contribute to effective public health systems leadership and offers a thematic model in terms of establishing a systems leadership approach, maintaining momentum and identifying key success indicators.
Evaluation of a multimedia youth anti-smoking and girls’ empowerment campaign: SKY Girls Ghana
Authors: Hutchinson Paul , Leyton Alejandra , Meekers Dominique , Stoecker Charles , Wood Francine , Murray Joanna , Dodoo Naa Dodua , Biney Adriana 
Published: November 2020

Abstract
Background
Given the long-term health effects of smoking during adolescence and the substantial role that tobacco-related morbidity and mortality play in the global burden of disease, there is a worldwide need to design and implement effective youth-focused smoking prevention interventions. While smoking prevention interventions that focus on both social competence and social influence have been successful in preventing smoking uptake among adolescents in developed countries, their effectiveness in developing countries has not yet been clearly demonstrated. SKY Girls is a multimedia, empowerment and anti-smoking program aimed at 13–16-year old girls in Accra, Ghana. The program uses school and community-based events, a magazine, movies, a radio program, social media and other promotional activities to stimulate normative and behavioral change.

Methods
This study uses pre/post longitudinal data on 2625 girls collected from an interviewer-administered questionnaire. A quasi-experimental matched design was used, incorporating comparison cities with limited or no exposure to SKY Girls (Teshie, Kumasi and Sunyani). Fixed-effects modeling with inverse probability weighting was used to obtain doubly robust estimators and measure the causal influence of SKY Girls on a set of 15 outcome indicators.

Results
Results indicate that living and studying in the intervention city was associated with an 11.4 percentage point (pp) (95% CI [2.1, 20.7]) increase in the proportion of girls perceiving support outside their families; an 11.7 pp. decrease (95% CI [− 20.8, − 2.6]) in girls’ perception of pressure to smoke cigarettes; a 12.3 pp. increase (95% CI [2.1, 20.7]) in the proportion of girls who had conversations with friends about smoking; an 11.7 pp. increase (95% CI [3.8, 20.8]) in their perceived ability to make choices about what they like and do not like, and 20.3 pp. (95% CI [− 28.4, − 12.2]) and 12.1 pp. (95% CI [− 20.7, − 3.5]) reductions in the proportion agreeing with the idea that peers can justify smoking shisha and cigarettes, respectively. An analysis of the dose-effect associations between exposure to multiple campaign components and desired outcomes was included and discussed.

Conclusion
The study demonstrates the effectiveness of a multimedia campaign to increase perceived support, empowerment and improve decision-making among adolescent girls in a developing country.
RETRACTED ARTICLE: Protocatechuic aldehyde from Salvia miltiorrhiza exhibits an anti-inflammatory effect through inhibiting MAPK signalling pathway
Authors: Wu Shuang , Wang Qingyu , Wang Jinquan , Duan Baoyu , Tang Qihe , Sun Zhuojian , Han Jinlong , Shan Chenggang , Wang Zhifen , Hao Zhihui 
Published: November 2020

Abstract
Background
The aerial parts of Salvia miltiorrhiza, which was considered to be the waste part and discarded during the root harvest, is rich in protocatechuic aldehyde (PAI). This study investigated the health-promoting effects of extracts and PAI from the aerial parts of Salvia miltiorrhiza, including its anti-inflammatory effects and the underlying mechanisms of action in vitro and in vivo.

Method
Purification of the sample paste of Salvia miltiorrhiza was accomplished using HPLC analysis. TheMTT (Methylthiazolyldiphenyl-tetrazolium bromide) assay was employed to determine the cell viability. The production of inflammatory factors was detected by ELISA assays. The histopathological analysis was used to analyse the lungs and livers of mice treated with PAI. Western blot was performed to reveal the mechanism of PAI in anti-inflammatory.

Results
The extracts and PAI from the aerial parts of Salvia miltiorrhiza inhibited TNF-α, IL-6 production and promoted the production of IL-10 in vivo in mice and in vitro in the macrophage cell line RAW264.7. NF-κB and MAPKs kinase phosphorylation were also suppressed by PAI in vivo and in vitro, indicating that PAI exhibited an anti-inflammatory effect.

Conclusion
These findings suggest that the aerial parts of Salvia miltiorrhiza extract may serve as potential protective agents for inflammatory.
Findings from a three-round Delphi study: essential topics for interprofessional training on complementary and integrative medicine
Authors: Homberg Angelika , Klafke Nadja , Loukanova Svetla , Glassen Katharina 
Published: November 2020

AbstractBackgroundIntegrating complementary medicine into medical care promotes patient-oriented care. A well-informed and collaborative professional healthcare team is essential for effective and patient-safe implementation of these methods. At present, the skills for patient counseling, therapy and care regarding complementary medicine vary among the professional groups involved. Professionals generally feel that they are not sufficiently qualified in this area. Curricular concepts for Complementary and Integrative Medicine (CIM) are virtually non-existent in undergraduate interprofessional training. The aim of this study is to initiate a consensus-building process between various experts (professionals, students, patient and faculty representatives) in order to identify which topics should be the focus of such a curriculum.MethodsA three-round Delphi study was carried out from March 2018 to March 2019 to compile the experience and knowledge of experts in the field of integrative patient care and interprofessional education. Sixty-five experts from Germany and German-speaking Switzerland with various professional backgrounds and experiences were asked to name general content, therapy methods and treatment reasons which should be addressed in interprofessional seminars. In the subsequent rounds these were rated on a seven-point Likert scale. The ratings were assigned to relevance groups and discussed in a final workshop in July 2019.ResultsThe response rates for the three rounds were 76% (n = 50), 80% (n = 40) 90% (n = 36); and 21% (n = 11) for the final workshop. The experts suggested that topics could be aligned along the most common treatment reasons such as insomnia, generalized pain, fatigue and back pain. However, it is important that students also receive an overview of the evidence base for different therapeutic concepts, especially in the field of classical natural medicine, acupuncture and mind-body medicine, and that they get an overview of the effects and interactions of frequently used procedures.ConclusionConsensus was reached among the various experts on the most important topics for an interprofessional CIM curriculum. The systematic evaluation of the topics in this study can help to create a curriculum that achieves a high level of acceptance among teachers, lecturers and students, and thus facilitates implementation at universities and medical faculties.