BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: :Comparative analyses of Diaphorobacter polyhydroxybutyrativorans SL-205T and Diaphorobacter nitroreducens NA10BT were conducted for clarifying their taxonomic relationship. The sequences of the 16S rRNA gene and nine housekeeping genes of SL-205T and NA10BT shared high similarities, above 98.8 %. Whole-genomic comparison between the two strains revealed a digital DNA-DNA hybridization estimate of 85.1 % and an average nucleotide identity of 98.3 % that were well above respective recognized thresholds for bacterial species delineation, strongly indicating that they represent the same genomospecies. The metabolic, physiological and chemotaxonomic features of SL-205T were also shown to be congruent with those of NA10BT. Therefore, we conclude that Diaphorobacter polyhydroxybutyrativoransQiu et al. 2015 is a later heterotypic synonym of Diaphorobacter nitroreducens Khan and Hiraishi 2003.

背景与目标： : 对聚羟基丁酸酯SL-205T和硝基酸酯NA10BT进行了比较分析，以阐明它们的分类学关系。16S rRNA基因与SL-205T和NA10BT的9个管家基因的序列具有很高的相似性，在98.8   % 以上。两种菌株之间的全基因组比较揭示了85.1   % 的数字dna-dna杂交估计值和98.3   % 的平均核苷酸同一性，其远高于细菌物种描绘的各自公认的阈值，强烈表明它们代表相同的基因组物种。SL-205T的代谢，生理和化学分类学特征也与NA10BT一致。因此，我们得出结论，多羟基丁酸黄杆菌 (Diaphorobacter polyhydroxybutyrativoranscuqiu) 等人。2015是后来的异型亚硝基酸亚可汗和平石2003的异型同义词。

BACKGROUND & AIMS: OBJECTIVE:To compare open and laparoscopic appendectomies and to evaluate the level of efficacy of both types of appendectomy performed at Aga Khan University Hospital (AKUH). METHODS:Based on this strong study rationale, a clinical audit of patient's records was performed to evaluate the significance of this technique as a treatment modality. The study population comprised of patients with appendicitis admitted in the Department of Surgery from January 2004 to December 2004. The patients' charts were reviewed to ascertain whether the procedure was done as an acute case or as an elective procedure. The predictor variables explored in this study were: age, gender, ultrasound and CT focused procedure, operative time, post-operative stay, number of hours required for the return of bowel function, use of narcotic analgesia and the total hospital bill of the respective patients. RESULTS:A total of 49 patients' clinical charts were reviewed. Of these, 29 patients had had laparoscopic appendectomies and the remaining 20 had open appendectomies. The mean post-operative stay in days was relatively shorter for laparoscopic appendectomy (1.97 +/- 2.3) compared to open appendectomy (3.1 +/- 1.8). The average time for the return of bowel movement was remarkably lesser for laparoscopic appendectomy (10.6 +/- 8.2) hours than open appendectomy (21 +/- 13) hours. Two of the independent variables: CT focused (P-value: 0.01) and operative times in minutes (P-value: 0.06) were found to be significantly associated with the types of appendectomy. Hence our study found that laparoscopic appendectomy, although relatively expensive, is a safe and effective procedure for the removal of appendix over open appendectomy.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:To estimate normal values of peak expiratory flow rate (PEFR), forced expiratory volume in first second (FEV1), forced vital capacity (FVC) and ratio between FEV1/FVC among non-smoking staff and students at The Aga Khan University (AKU) Hospital, Karachi, and to study the effect of age, gender and body mass index (BMI) on these variables. DESIGN:A cross-sectional study. PLACE AND DURATION OF STUDY:This study was conducted at the Multidisciplinary Laboratory (MDL) of AKUH, Karachi from May to November 2005. PATIENTS AND METHODS:Two hundred forty-one healthy never smokers were approached through non-probability convenient sampling among the staff and students of AKU and were screened through a questionnaire. Data from 200 subjects was used for analysis. Subjects were excluded if pregnant, body mass index (BMI) not ranging from 17-25, FEV1/FVC% less than 70 or with non-reproducible results. The mean values of FVC, FEV1, FEV1/FVC% and PEFR among males and females in different ages were compared by 't' test. Linear regression was applied to study the effect of age and BMI on the outcome variables. RESULTS:Mean FVC, FEV1 and PEFR were found to be higher in males than the females in all the age groups, the difference in FVC was significantly higher in the age groups of less than 20 years and 20-29 years (2.09L, CI: 1.27-2.92) and (1.51L, CI: 1.29-1.73) respectively. The above spirometric values declined with age and increased with height. Increase in age by one year resulted in 0.051 L decline in FVC (CI: -0.056, -0.034) whereas increase in height by a centimeter improved the FVC by 0.044L (CI: 0.03, 0.056). CONCLUSION:The mean FVC, FEV1 and PEFR were higher in males in each age group. Females had higher FEV1/FVC%. Height had positive linear relationship and age was inversely related whereas BMI was not significantly associated with these variables. In order to generalize these reference values, a larger study following the ATS criteria is needed.

背景与目标：

BACKGROUND & AIMS: INTRODUCTION:Performance in an admission test and carefully conducted, structured interview provides a uniform basis for the assessment of applicants prepared in different systems of education for admission to an institute of higher professional learning. We studied the predictability of the system of education followed by the students prior to entrance into the Medical College, the admission test scores, and interview ratings on performance after five trimesters at the Aga Khan University Medical College. METHOD:A cohort of 374 medical students who were admitted during 1989--1994, were considered. The associations between the admission test score, interview ratings, system of education, and the scores obtained for anatomy, physiology, biochemistry and community health sciences examinations held after five trimesters were analysed using appropriate statistical procedures. RESULTS:Interview ratings were associated with the scores in Physiology but not other subjects. The chief finding of this study was the association between the system of education and performance in both the admission test and the examination after five trimesters. Students who followed the British school curricula for 13 years scored significantly higher than those who followed the 12 years of the Pakistani system. When controlled for the admission test score, the difference in mean scores of the two groups was still evident for two subjects; community health sciences and physiology. CONCLUSION:We believe that the evidence indicates differences in learning methods inculcated by the system of education prior to entry into the Medical College, notwithstanding the 1-year difference in duration of education.

背景与目标：

BACKGROUND & AIMS: :Familial adenomatous polyposis (FAP) is characterized by the presence of numerous adenomatous polyps in the colorectum, as well as an autosomal dominant mode of inheritance. This syndrome will inevitably lead to colorectal cancer when left untreated, and it is estimated that 1% of all colorectal cancer cases are due to it. Over the past 20 years molecular genetic studies on FAP patients have laid down the basis for the elucidation of the genetic phenomena that ultimately result in the development of colorectal cancer. Professor P. Meera Khan was one of the leading authorities in the world of molecular genetics of colorectal cancer in general and of FAP in particular. His scientific contributions from the pre-DNA era up to the recent implementation of molecular genetic research in daily clinical practice have helped revolutionize our approach and management of FAP patients and their relatives.

背景与目标： 家族性腺瘤性息肉病 (FAP) 的特征是结直肠中存在大量腺瘤性息肉，以及常染色体显性遗传模式。如果不治疗，这种综合征不可避免地会导致大肠癌，据估计，所有大肠癌病例中有1% 是由它引起的。在过去的20年中，对FAP患者的分子遗传学研究为阐明最终导致结直肠癌发展的遗传现象奠定了基础。P. Meera Khan教授是大肠癌分子遗传学领域的主要权威之一，尤其是FAP。从DNA前时代到分子遗传学研究在日常临床实践中的最新实施，他的科学贡献帮助彻底改变了我们对FAP患者及其亲属的方法和管理。

BACKGROUND & AIMS: :Science, technology, engineering, and mathematics education reform efforts have called for widespread adoption of evidence-based teaching in which faculty members attend to student outcomes through assessment practice. Awareness about the importance of assessment has illuminated the need to understand what faculty members know and how they engage with assessment knowledge and practice. The Faculty Self-Reported Assessment Survey (FRAS) is a new instrument for evaluating science faculty assessment knowledge and experience. Instrument validation was composed of two distinct studies: an empirical evaluation of the psychometric properties of the FRAS and a comparative known-groups validation to explore the ability of the FRAS to differentiate levels of faculty assessment experience. The FRAS was found to be highly reliable (α = 0.96). The dimensionality of the instrument enabled distinction of assessment knowledge into categories of program design, instrumentation, and validation. In the known-groups validation, the FRAS distinguished between faculty groups with differing levels of assessment experience. Faculty members with formal assessment experience self-reported higher levels of familiarity with assessment terms, higher frequencies of assessment activity, increased confidence in conducting assessment, and more positive attitudes toward assessment than faculty members who were novices in assessment. These results suggest that the FRAS can reliably and validly differentiate levels of expertise in faculty knowledge of assessment.

背景与目标： : 科学，技术，工程和数学教育改革的努力要求广泛采用循证教学，在这种教学中，教师通过评估实践来关注学生的成绩。对评估重要性的认识表明，有必要了解教职员工的知识以及他们如何参与评估知识和实践。教师自我报告评估调查 (FRAS) 是评估科学教师评估知识和经验的新工具。仪器验证由两项不同的研究组成: 对fra的心理测量特性进行实证评估，以及对已知群体进行比较的验证，以探索fra区分教师评估经验水平的能力。发现该fra是高度可靠的 (α = 0.96)。仪器的维度可以将评估知识区分为程序设计，仪器和验证类别。在已知小组的验证中，fra区分了具有不同评估经验水平的教师小组。具有正式评估经验的教职员工自我报告了对评估术语的熟悉程度更高，评估活动的频率更高，对进行评估的信心增强以及对评估的态度比评估新手更积极。这些结果表明，fra可以可靠且有效地区分教师评估知识的专业水平。

BACKGROUND & AIMS: :Syntenin is an adaptor-like molecule that binds to the cytoplasmic domains of all four vertebrate syndecans. Syntenin-syndecan binding involves the C-terminal part of syntenin that contains a tandem of PDZ domains. Here we provide evidence that each PDZ domain of syntenin can interact with a syndecan. Isolated or combined mutations of the carboxylate binding lysines in the inter-betaAbetaB loops and of the alphaB1 residues in either one or both the PDZ domains of syntenin all reduce syntenin-syndecan binding in yeast two-hybrid, blot-overlay, and surface plasmon resonance assays. PDZ2 mutations have more pronounced effects on binding than PDZ1 mutations, but complete abrogation of syntenin-syndecan binding requires the combination of both the lysine and the alphaB1 mutations in both the PDZ domains of syntenin. Isothermal calorimetric titration of syntenin with syndecan peptide reveals the presence of two binding sites in syntenin. Yet, unlike a tandem of two PDZ2 domains and a reconstituted PDZ1+PDZ2 tandem, a tandem of two PDZ1 domains and isolated PDZ1 or PDZ2 domains do not interact with syndecan bait. We conclude to a co-operative binding mode whereby neither of these two PDZ domains is sufficient by itself but where PDZ2 functions as a "major" or "high affinity" syndecan binding domain, and PDZ1 functions as an "accessory" or "low affinity" syndecan binding domain. The paired, but not the isolated PDZ domains of syntenin bind also strongly to the immobilized cytoplasmic domains of neurexin and B-class ephrins. By inference, these data suggest a model whereby recruitment of syntenin to membrane surfaces requires two compatible types of bait that are in "synteny" (occurring together in location) and engages both PDZ domains of syntenin. The synteny of compatible bait may result from the assemblies and co-assemblies of syndecans and other similarly suited partners in larger supramolecular complexes. In general, an intramolecular combination of PDZ domains that are weak, taken individually, would appear to be designed to detect rather than drive the formation of specific molecular assemblies.

背景与目标： : Syntenin是一种衔接子样分子，与所有四种脊椎动物syndecans的细胞质结构域结合。Syntenin-syndecanbinding涉及syntenin的C端部分，其中包含串联的PDZ结构域。在这里，我们提供的证据表明，syntenin的每个PDZ结构域都可以与syndecan相互作用。Betaabetaab间环中的羧酸盐结合赖氨酸的分离或组合突变以及syntenin的一个或两个PDZ结构域中的alphaB1残基的分离或组合突变都减少了酵母双杂交，印迹覆盖和表面等离子体共振分析中的syntenin-syndecana结合。PDZ2突变对结合的影响比PDZ1突变更明显，但是syntenin-syndecan结合的完全废除需要在syntenin的两个PDZ结构域中同时结合赖氨酸和 αb1突变。用syndecan肽对syntenin进行等温量热滴定，发现syntenin中存在两个结合位点。然而，与两个PDZ2结构域的串联和重构的PDZ1 PDZ2串联不同，两个PDZ1结构域和分离的PDZ1或PDZ2结构域的串联不与syndeca诱饵相互作用。我们得出结论，这是一种合作结合模式，因此这两个PDZ结构域本身都不足够，但是PDZ2充当 “主要” 或 “高亲和力” syndecan结合域，而PDZ1充当 “附件” 或 “低亲和力” syndecan结合域。合成蛋白的配对但不是分离的PDZ结构域也与固定的neurexin和B类肾上腺素的胞质结构域紧密结合。通过推论，这些数据提出了一个模型，其中将syntenin募集到膜表面需要两种兼容类型的诱饵，它们处于 “synteny” (在位置上同时发生) 并与syntenin的两个PDZ结构域结合。相容诱饵的合并性可能是由较大的超分子复合物中syndecans和其他类似合适的伴侣的组装和共组装引起的。通常，单独使用弱的PDZ结构域的分子内组合似乎旨在检测而不是驱动特定分子组装体的形成。

BACKGROUND & AIMS: :The Y-chromosome haplogroup C3*-Star Cluster (revised to C2*-ST in this study) was proposed to be the Y-profile of Genghis Khan. Here, we re-examined the origin of C2*-ST and its associations with Genghis Khan and Mongol populations. We analyzed 34 Y-chromosome sequences of haplogroup C2*-ST and its most closely related lineage. We redefined this paternal lineage as C2b1a3a1-F3796 and generated a highly revised phylogenetic tree of the haplogroup, including 36 sub-lineages and 265 non-private Y-chromosome variants. We performed a comprehensive analysis and age estimation of this lineage in eastern Eurasia, including 18,210 individuals from 292 populations. We discovered that the origin of populations with high frequencies of C2*-ST can be traced to either an ancient Niru'un Mongol clan or ordinary Mongol tribes. Importantly, the age of the most recent common ancestor of C2*-ST (2576 years, 95% CI = 1975-3178) and its sub-lineages, and their expansion patterns, are consistent with the diffusion of all Mongolic-speaking populations, rather than Genghis Khan himself or his close male relatives. We concluded that haplogroup C2*-ST is one of the founder paternal lineages of all Mongolic-speaking populations, and direct evidence of an association between C2*-ST and Genghis Khan has yet to be discovered.

背景与目标： : Y染色体单倍群C3 *-星团 (在本研究中修订为C2 *-ST) 被提议为成吉思汗的Y轮廓。在这里，我们重新研究了C2 *-ST的起源及其与成吉思汗和蒙古人口的联系。我们分析了单倍群C2 *-ST的34个Y染色体序列及其最密切相关的谱系。我们将此父系谱系重新定义为C2b1a3a1-F3796，并生成了单倍群的高度修订的系统发育树，包括36个子谱系和265个非私有Y染色体变体。我们对欧亚大陆东部的这一血统进行了全面分析和年龄估计，其中包括来自292个种群的18,210个人。我们发现，C2 *-ST高频率的人口起源可以追溯到古老的尼鲁恩蒙古氏族或普通蒙古部落。重要的是，C2 *-ST的最近共同祖先的年龄 (2576岁，95% ci   =   1975-3178) 及其子血统及其扩展模式与所有蒙古语人口的扩散一致，而不是成吉思汗本人或他的近亲。我们得出的结论是，单倍群C2 *-ST是所有讲蒙古语的人群的创始人父系之一，并且尚未发现C2 *-ST与成吉思汗之间存在关联的直接证据。

BACKGROUND & AIMS: BACKGROUND:Gallbladder cancer (GBC) is a common malignancy in our country; however, very limited data exist on this malignancy in Pakistan. METHODS:This is a retrospective analysis of all the admitted patients diagnosed with GBC or cholangiocarcinoma in between 1st January 1995 to 31st December 2007. RESULTS:A total of 245 patients were admitted with diagnosis of GBC or cholangiocarcinoma. Sixty seven percent were females. Right hypochondrial pain (70.6%) and jaundice (49.8%) were the commonest symptoms, followed by nausea and vomiting (11.8%), weight loss (13%), fever (18.8%), anorexia (9.8%) and ascites (3.3%). Gallstones were seen in 132 (53.9%) patients. Pathological diagnosis was confirmed in 155 (63.2%) patients, adenocarcinoma (94.8%) being the predominant type. Metastasis was seen in 204 (83.3%) patients, with liver and abdominal lymph nodes being the frequent sites of metastasis. Most of the patients presented to the surgeons (42.9%) and gastroenterologists (35.9%) at their first visit. Only 89 (26.3%) patients were referred to medical oncologists and 42 (16.7%) of the patients actually received chemotherapy. The patients who received chemotherapy cisplatin and gemcitabine demonstrated partial responses (40%). Common bile duct stricture was seen in 78 patients and stenting was successful in 73 patients. Fourteen (5.7%) patients are alive to date, one is receiving chemotherapy, and another is alive with advanced disease while 10 patients had incidental diagnosis after surgery. Of all 53.9% of patients have died and 38% are lost to follow up. CONCLUSION:Most of the patients with biliary cancers present late with advanced disease at our referral tertiary care hospital. Minority of the patients received chemotherapy and most of responses were observed with cisplatin and gemcitabine combination or capecitbine based therapy.

背景与目标：

BACKGROUND & AIMS: PURPOSE:The purpose of this study was three fold: (1) increase the understanding of gender sensitivity in nursing education and practice; (2) explore male and female nursing student and faculty perceptions on effective classroom and clinical teaching; and (3) clarify the necessity of both bedside teaching and role modeling in a Pakistani nursing program. DESIGN:Five successive focus groups were held to explore perceptions and views of twenty undergraduate, four graduates, and five Pakistani faculty members through guided interviews. Thematic analysis of transcribed data from observation and shorthand notes reached saturation after two rounds of transcription. Triangulated thematic analysis corroborated faculty and student perceptions. FINDINGS:Data extracted two major categories and four themes. The classroom teaching themes emerged as (1) feeling misplaced and disapproved, and (2) gendered teaching style. The clinical teaching themes were identified as (1) feeling bewildered, and (2) preferences for bedside teaching and role modeling. DISCUSSION AND CONCLUSION:The findings highlighted the need for gender sensitivity and cultural awareness in teaching and practice of nursing. Innovative teaching strategies can effectively resolve the contributing barriers to learning among nursing students. IMPLICATION FOR PRACTICE:Awareness of gender differences among the students in addition to faculty enthusiasm communicates positive professional attitudes. Role modeling at bedside requires balancing essential cultural issues in nursing education and practice.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Cutaneous melanoma (CM) is the most lethal type of skin cancers. Nicotinamide adenine dinucleotide phosphate (NADPH) plays an important role in anabolic reactions and tumorigenesis, but many genes are involved in the NADPH system. METHODS:We used 10,912 single-nucleotide polymorphisms (SNPs) (2018 genotyped and 8894 imputed) in 134 NADPH-related genes from a genome-wide association study (GWAS) of 858 patients from The University of Texas MD Anderson Cancer Center (MDACC) in a single-locus analysis to predict CM survival. We then replicated the results in another GWAS data set of 409 patients from the Nurses' Health Study (NHS) and the Health Professionals Follow-up Study (HPFS). RESULTS:There were 95 of 858 (11.1%) and 48 of 409 (11.7%) patients who died of CM, respectively. In multivariable Cox regression analyses, we identified two independent SNPs (TKT rs9864057 G > A and deoxyribose phosphate aldolase (DERA) rs12297652 A > G) to be significantly associated with CM-specific survival [hazards ratio (HR) of 1.52, 95% confidence interval (CI) = 1.18-1.96, P = 1.06 × 10-3 and 1.51 (1.19-1.91, 5.89 × 10-4)] in the meta-analysis, respectively. Furthermore, an increasing number of risk genotypes of these two SNPs was associated with a higher risk of death in the MDACC, the NHS/HPFS, and their combined data sets (Ptrend<0.001, = 0.004 and <0.001, respectively). In the expression quantitative trait loci analysis, TKT rs9864057 G > A and DERA rs12297652 A > G were also significantly associated with higher mRNA expression levels in sun-exposed lower-leg skin (P = 0.043 and 0.006, respectively). CONCLUSIONS:These results suggest that these two potentially functional SNPs may be valuable prognostic biomarkers for CM survival, but larger studies are needed to validate these findings.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:The aim of the retrospective correlational analysis was to identify the attributes valued most by students for assessing the overall effectiveness of a teacher. METHODS:Responses of the students to the two versions of evaluation questionnaires, each attempting to assess 4 and 8 characteristics respectively on a scale of 1-5 were included in the analysis. The third and fourth year students, at the end of each course/module completed a total of 2110 evaluation forms, which were studied. RESULTS:The over all effectiveness of the teacher showed statistically significant correlation of .914 and .895 with ability to communicate ideas effectively and clarity and organisation of the lectures. Whereas the knowledge of subject and the successful use of teaching aids showed a correlation of .658 and .637 with a statistical significance of P < .01. CONCLUSION:Students need a basic outline of what they have to learn and guidance to plan their studies.

背景与目标：