bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of the surgical strategy and postoperative clinical effect of thoracic ossification of ligament flavum with dural ossification
Authors: Liu Tao , Tian Shuo , Wang Zheng , Liu Zhen , Ding Wen-Yuan , Yang Da-Long
Published: May 2022

PURPOSE Our research was designed to analyse the postoperative clinical results of patients suffering from single-segment thoracic ossification of the ligamentum flavum (TOLF) combined with dural ossification (DO) who underwent posterior laminar decompression and internal fixation.METHODS This retrospective research included thirty-two patients who underwent surgery for ossifying the ligamentum flavum in the thoracic spine between January 2016 and January 2020. Patients were fallen into one group included patients with evidence of DO during surgery, and the other group included patients without evidence of DO. We assessed and compared general clinical characteristics and health-related outcomes before surgery and during follow-up.RESULTS The DO group had a longer operation duration, more blood loss, and longer hospital stay (operation time: 94.75±6.78 min vs. 80.00±10.13 min, p<0.001; blood loss: 331.67±50.06 ml vs. 253.00±48.24 ml, p<0.001; length of hospital stay: 13.83±2.76 days vs. 10.05±2.33 days, p<0.001). Complications: There were 12 cases of cerebrospinal fluid leakage and 1 case of superficial wound infection in the DO group. However, the neurological recovery and health-associated quality of life (HRQOL) scores showed no statistically significant changes between the DO and non-DO groups (p>0.05).CONCLUSIONS Thoracic myelopathy because of ossifying a single thoracic ligamentum flavum is uncommon. Posterior laminectomy and internal fixation combined with intraoperative resection of the ossified ligamentum flavum and dura is an efficient and relatively safe method for treating TOLF with DO, which can provide satisfactory results. Moreover, DO had no significant effect on postoperative neurological recovery and health-related quality of life scores.
Morphology of the normal right coronary artery in the heart of chinchilla (Chinchilla laniger Molina)
Authors: Kuchinka Jacek , Radzimirska Małgorzata , Banaś Dariusz , Nowak Elżbieta , Szczurkowski Aleksander
Published: May 2022

Previously it has been reported that the right coronary artery is absent in the coronary vascularization of the heart in the chinchilla. Our research was carried out on thirty chinchillas (Chinchilla laniger Molina). The coronary vessels were filled with colored latex to render them visible. The examinations were supplemented additionally with the use of microcomputed tomography with arterial contrast. Our study demonstrates its undoubtedly presence of the right coronary artery. In all subjects the right coronary artery was present, as was the left coronary artery. Two types of right coronary artery were found. Our results indicate that the normal pattern of coronary vascularization of heart in chinchilla includes both the right and left coronary arteries.
Development of transfer device with customized sling lifts
Authors: Jeong SeYeon , Cho Ki-hun , Hong SoungKyun , Choi Wonjae , Lee Kwangkook , Lee GyuChang
Published: May 2022

Background: Bedridden patients and disabled persons need help from a guardian or caregiver even in the activities of daily living. In particular, for transfer of them, the use of a transfer lift has been recommended. However, the existing devices have limitations in terms of support according to the individual’s characteristics. This study aimed to develop a transfer lift device utilizing the user’s body fitting sling equipped with an air tube inside the sling. Results: Customized sling lifts are generally floor-based lifts that consist of a sling that holds the user’s body and a lift that moves the sling to the desired position. One characteristic feature of the device is an air tube, which is used on the sling to allow the sling to be adjusted to the user’s body. Conclusion: The device will be useful in the advancement and commercialization of customized sling lifts, to ensure the safe and efficient transfer of persons with disabilities.
Brain Glutathione Increase and Seizure Burden Decrease in Patients with Intractable Epilepsy on Ketogenic Diet
Authors: Hazany Saman , DeClouette Brittany , Lowe Jessica , Kim Paul E , Bluml Stefan , Partikian Arthur
Published: May 2022

Background and Purpose: Ketogenic diet (KD) improves seizure control in patients with drug-resistant forms of epilepsy; however, the mechanism of action remains poorly understood. Increased mitochondrial levels of glutathione (GSH) might contribute to a change in seizure susceptibility suggestive of possible anticonvulsant role for GSH. Our goals were to quantify changes of absolute GSH levels in the brain by in vivo MR spectroscopy and correlate that with degree of seizure control in patients on KD. Methods: Five cognitively normal adult patients with drug-resistant epilepsy were initially included and 2 completed the study. Each patient was evaluated by a neurologist and registered dietitian at baseline, 1, 3, and 6 months for seizure status and diet adherence. Each patient received a baseline short TE single-voxel water-suppressed point-resolved spectroscopy (PRESS) 1 H MRS in parieto/occipital grey matter and parietal white matter on a 3 Tesla General Electric magnet prior to starting the ketogenic diet and a follow-up stury at 6 months. Multiple metabolites, including GSH, were quantified using LCModel.Results: After being on ketogenic diet for 6 months, both patients (42-years-old male and 35-years-old female) demonstrated marked increases in absolute GSH level in both gray matter (0.1 to 1.4 and 0.1 to 0.7 IU) and white matter (0.65 to 1.5 and 0.8 to 2 IU), as well as 50% improvements in seizure duration and frequency. Other metabolites including ketone bodies, Acetone (Acn), Beta hydroxybutyrate (βHB), and acetoacetate (AcAC), did not demonstrate consistent changes. Conclusion: Markedly increased levels of GSH (7-fold and 14-fold) were observed in longitudinal prospective study of two adult patients with intractable epilepsy with 50% seizure improvement after initiation of ketogenic diets. This pilot study supports the possible anticonvulsant role of GSH in the brain.
m6A regulator-based methylation modification patterns and characterization of tumor microenvironment in acute myeloid leukemia
Authors: Xu Zi-jun , Wen Xiang-mei , Zhang Yuan-cui , Jin Ye , Ma Ji-chun , Gu Yu , Chen Xin-yi , Xia Pei-hui , Qian Wei , Lin Jiang , Qian Jun
Published: May 2022

RNA N6-methyladenosine (m6A) is the most common and intensively studied RNA modification that critically regulates RNA metabolism, cell signaling, cell survival, and differentiation. However, the overall role of multiple m6A regulators in the tumor microenvironment (TME) has not yet been fully elucidated in acute myeloid leukemia (AML). In our study, we explored the genetic and transcriptional alterations of 23 m6A regulators in AML patients. Three distinct molecular subtypes were identified and associated with prognosis, patient clinicopathological features, as well as TME characteristics. The TME characterization revealed that m6A patterns were highly connected with metabolic pathways such as biosynthesis of unsaturated fatty acids, cysteine and methionine metabolism, and citrate cycle TCA cycle. Then, based on the differentially expressed genes (DEGs) related to m6A molecular subtypes, our study categorized the entire cohort into three m6A gene clusters. Furthermore, we constructed the m6A score for quantification of the m6A modification pattern of individual AML patients. It was found that the tumor-infiltrating lymphocyte cells (TILs) closely correlated with the three m6A clusters, three m6A gene clusters, and m6Ascore. And many signaling pathways were involved, including glycogen degradation, drug metabolism by cytochrome P450, pyruvate metabolism, and so on. Our comprehensive analysis of m6A regulators in AML demonstrated their potential roles in the clinicopathological features, prognosis, tumor microenvironment, and particularly metabolic pathways. These findings may improve our understanding of m6A regulators in AML and offers new perspectives on the assessment of prognosis and the development of anticancer strategy.
Blocking the Expression of the Nitrate Reductase Gene OsNia3 Confers Early Maturation in Rice
Authors: Han RuiCai , Wang YuPeng , Li ChenYan , Wu ZiMing , Huang RenLiang
Published: May 2022

Early flowering is a major contributing factor to early crop maturation and is a prerequisite for the expansion of crop production to high latitudes with short growing seasons as well as for annual double/triple cropping systems. Nitrogen is the mineral element most limiting to plant growth and, consequently, also to crop yield. Nitrogen also plays a role in the regulation of flowering time. Here, we show that OsNia3 is a member of the rice nitrate reductase (NR) gene family. OsNia3 was found to be expressed in stem nodes of rice, while the loss of its function led to a reduction in plant height mainly due to disrupted nitrate metabolism at the site of OsNia3 expression. The expression levels of genes related to nitrate transport, nitrate assimilation, and ammonium assimilation, such as OsNia1, OsNRT2.3A, and OsNGS1, increased in the leaves of osnia3 mutant plants, concomitant with an increase in the activity of the nitrogen metabolism pathway. The ammonium and amino acid contents in the leaves also increased in the osnia3 mutant, as did the chlorophyll content. Phenotypic analysis showed that the osnia3 mutant exhibited a shorter growth period compared with wild-type plants; nevertheless, yield was not significantly affected in mutant plants. The deletion of the OsNia3 gene led to the upregulation of genes related to the photoperiod regulation network (OsGI, OsHd1, and OsHd3a), which likely promoted early flowering. These results indicated that OsNia3 is involved in the floral inhibition pathway (OsGI-OsHd1-OsHd3a) in rice under long-day conditions. Our findings provide a theoretical and material basis for the coordination and improvement of early maturity and high-yield traits in rice breeding.
Development and validation of a multiple factor-based prognostic score system of thrombosis in polycythemia vera (MFPS-PV)
Authors: Gu Wenjing , Zhang Yuhui , Sun Ting , Mankai Ju , Xiaofan Liu , Xue Feng , Chen Yunfei , Wei Liu , Zhang Donglei , Huiyuan Li , Wang Wentian , Chi Ying , Yang Renchi , Bai Jie , Fu Rongfeng , Zhang Lei
Published: May 2022

Thrombosis is an important cause of death in patients with polycythemia vera (PV). This study aimed to develop and validate a multiple factor-based prediction model of thrombosis and to propose risk-adapted treatment strategies for the 2016 World Health Organization-defined PV. The study involved 301 patients in the training cohort and another 194 patients in the external validation cohort. Multivariate analysis indicated that age ≥ 57 years (hazard ratio [HR] 2.586, p = 0.006), cardiovascular risk factors (HR 4.599, p = 0.005), previous thrombosis (HR 4.780, p < 0.001), and at least one high-risk mutation for thrombosis (mutations in DNMT3A, ASXL1, and BCOR/BCORL1) (HR 3.732, p < 0.001) were independent risk factors for thrombosis. After assigning HR-weighted scores to each risk factor, a multiple factor-based prognostic score system of thrombosis (MFPS-PV) was developed, classifying patients into low-risk (0–1 points), intermediate-risk (2–3 points), and high-risk (≥ 4 points) groups. Patients in the three groups had significantly different thrombosis-free survival rates (p < 0.001). The MFPS-PV outperformed the conventional two-tiered stratification (C-index 0.746 vs 0.643) and remained consistent during external validation. Finally, a risk-adapted therapeutic strategy was established based on the MFPS-PV. In conclusion, the MFPS-PV, integrating genetic and clinical characteristics for the first time, can significantly predict thrombosis and has great therapeutic implications.
Influence of physical activity on the progression of osteoarthritis of the nonoperative hip after unilateral total hip arthroplasty: A prospective cohort study
Authors: Sekita Junya , Takahira Naonobu , Watanabe Hiroyuki , kudo Sho , Kusaba Atsushi , Kondo Saiji
Published: May 2022

Background
Total hip arthroplasty (THA) is one of the most effective treatments for hip pain and hip dysfunction. There are, however, problems associated with postoperative changes in the nonoperative hip joint and in particular, it is not uncommon for patients with osteoarthritis (OA) to experience increased pain and progression of OA. Appropriate physical activity (PA) and exercise can help maintain and improve physical function in OA patients, but excessive activity may increase the risk of progression of OA. This study aimed to clarify the influence of PA on the progression of OA of the nonoperative hip after unilateral THA.
Design:
This prospective cohort study was conducted from six to 24 months post-THA. Subjects were female patients with hip OA who had undergone unilateral THA. The primary outcome was change in minimal joint space (MJS) (ΔMJS, MJS at 24 months - MJS at six months). Daily step count and moderate to vigorous physical activity (MVPA) were also measured. Patients were divided into two groups by Kellgren-Lawrence (KL) grade (0 or ≥ 1). To identify factors that influence ΔMJS, a generalized linear model approach was used, with adjustment factors (age, body weight, and MJS at six months), KL grade, PA (daily step count/MVPA), and interaction terms between PA and KL grade as explanatory variables.
Results
Eighty-five patients were analyzed. ΔMJS was 0.18 mm at 24 months post-THA. The interaction term between daily step count and KL grade significantly influenced the progression of OA. The regression coefficient of daily step count for ΔMJS was significant in the KL ≥ 1 group, but not in the KL = 0 group. A model with adjustment factors, an interaction term, and both PA measures showed that daily step count and decreasing MVPA increased ΔMJS.
Conclusions
PA influenced the progression of OA in patients with KL grade ≥ 1, but did not influence onset in patients without OA post-THA. Excessive daily step count and/or low MVPA may be a risk factor for the progression of OA.
Acceptability to donate human breast milk among post-natal mothers at St Francis hospital Nsambya Uganda: A mixed method study
Authors: Ahmed Mohammed A.M. , Namisi Charles Patrick , Kirabira Nakibuuka Viktoria , Lwetabe Micheal Webba , Rujumba Joseph
Published: May 2022

Background
Whereas the World Health Organisationrecommends use of donated Human Breast Milk (HBM) as the second best option for preterm babies, whose mothers lack breast milk, HBM donation is not a practice in Uganda. We assessed the level of and factors associated with acceptance to donate HBM among postnatal mothers at St. Francis Hospital Nsambya (SFHN).
Methods
A cross-sectional sequential explanatory mixed method study was used. A questionnaire on socio-demography, awareness and likely acceptability to donate HBM was administered to 410 postnatal mothers at SFHN. Data was entered in Epi Info 7 and analysed using STATA version 13 for multivariate logistic regression to predict factors for acceptance to donate HBM. Focus Group Discussions (4) and Key Informants Interviews (4) were used to explore factors influencing behaviours to donate HBM. Qualitative data was analysed using content thematic approach.
Results
Overall the acceptance to donate HBM was 77.6% and the significant factors were; willingness to express HBM (aOR 7.5,95%CI: 3.01 -18.); wet-nursing knowledge (aOR 2.3,95%CI: 1.1–5.0) and under-5 years clinic visit (aOR 21.3, 95% CI: 2.3–196.9). Emerging themes for accepting to donate HBM were; wet-nursing experience, confidence to donate HBM and its perceived effectiveness. There were concerns about safety and adequacy of HBM, fear to transmit criminality and mental illness through HBM.
Conclusion
Acceptance to donate HBM among postnatal mothers at St. Francis Hospital Nsambya was very high. Willingness to express and store breast milk, prior knowledge about wet nursing and visit to an under five OPD were associated with acceptance. Thus establishing a HBM bank is feasible.
Assessing Clinical Trial Failure Risk Factors And Reasons In Gastric Cancer
Authors: zhang zikai Billy , Yin Junyi , Su Yang , Jiang Hong
Published: May 2022

Gastric cancer is one of the leading cancer-related death causes. Enormous efforts have been focused on this field in these years. However, clinical trial failure is becoming a massive obstacle for researchers to apply their research results for clinical use. This study aimed to analyse the reasons behind clinical failures and identify potential risk factors of clinical trial failures. On December,1,2021, we queried ClinicalTrials.gov for gastric cancer listed in phase II/III. A total of 567 trials are included. 10.2% of these trials are failed. 19 (3.4%) were terminated for good reasons, and 39 (6.9%) were terminated for bad reasons. For trials that terminated due to good reasons, 13 (68.4%) trials were terminated for efficacy reasons. 3 (15.8%) trials were terminated for safety reasons. For trials that terminated due to bad reasons, 18 (46.2%) trials were terminated due to recruitment failure. Multicentre (P-value = 0.026) and countries (P-value = 0.055) are potential risk factors for clinical failures in the simple logistic regression model. In multiple logistic model, we find the odds ratio of the anticipated accrual number is 0.993 (P-value = 0.029) and the anticipated accrual number combined multicentre is 0.999 (P-value = 0.045).The major reasons for gastric cancer trial terminations are recruitment failure, efficacy, and safety reasons. We identified potential risk factors associated with trial failure. By better understanding these reasons, we can prevent potential clinical failures in the future.
Community pharmacists’ counseling practices and patient experiences about topical corticosteroids – an online survey in the Klang Valley, Malaysia
Authors: Nathan Abigail Dayang , Shankar Pathiyil Ravi , Sreerramare Chandrashekhar T
Published: May 2022

Background
Community Pharmacists (CPs) play an important role in patient counselling regarding the use of topical corticosteroids. We assessed the CP’s self-reported counselling practices regarding topical corticosteroids and patients’ reported counselling experiences.
Methods
A previously developed questionnaire was adapted to the Malaysian context. A random sample of 364 registered CPs practicing in three states Selangor, Kuala Lumpur, and Putrajaya were invited for an online survey. CPS questionnaire covered CPS’s perceived patient knowledge about topical corticosteroid (TCS) use, CPs counseling practices, and their perceived barriers to counselling. Thirty patients were also selected from five pharmacies i.e., six consecutive patients who consulted each CP were invited to participate in the patient survey by completing a checklist about their experiences regarding the counselling received.
Results
A majority (> 90%) of the CPs most of the time explained to the patients that medication was TCS and frequency and duration of application but only 10% correctly identified scenarios needing medical referrals. Only about half of the CPs always explained about side effects, strength, efficacy, and storage of TCS. The two main barriers were patients’ negative perception of TCS (65.4%) and pharmacists’ lack of time for counselling (49.7%). Counselling practice score was associated with CPs age (aOR 0.86, 95%CI 0.78–0.94), pharmacists’ recommendation on TCS use (aOR 0.11, 95%CI 0.02–0.61), and time spent on counselling (aOR 1.42, 95%CI 1.13–1.64).
Conclusion
CPs counselling practices to their patient about the use of TCS requires improvement. Continuing education and hands-on training are needed for CPs regarding counselling about TCS use.
Rapid intraoperative immunohistochemistry (RD-IHC) is a useful tool in intraoperative pathologic diagnosis
Authors: Zhang Yu , Cheng Xian-kui , Yao Zhi-gang , Qin Ye-jun
Published: May 2022

Intraoperative pathologic diagnosis for lesions plays an important role in determining the surgery procedure. Accurate pathological diagnosis could lead to earlier, more effective treatments. But the accuracy of frozen sections pathology diagnosis in controversial cases maybe discount. Most of the time, the surgeon had to wait for the post-operative immunohistochemistry results to decide whether to have a second operation. In our study, rapid intraoperative immunohistochemistry was used for the diagnosis of controversial cases, which greatly improved the diagnostic accuracy and reduced rates of deferred diagnoses. Also, the total procedures of rapid intraoperative immunohistochemistry can be finished within 10 min that allows its general application for intraoperative frozen section diagnosis. In conclusion, rapid intraoperative immunohistochemistry could be a useful tool in intraoperative pathologic diagnosis.
Correlation between TACS and FAP with Prognosis of Clear Cell Renal Cell Carcinoma Patient
Authors: Warli Syah Mirsya , Putrantyo Ivan , Laksmi Lidya Imelda
Published: May 2022

Background: Despite recent promising findings from immunotherapy and other targeted medicines, individuals with metastatic Clear Cell Renal Cell Carcinoma (mCCRCC) still have a poor prognosis. Biomarkers associated with metastatic status in CCRCC are important for early detection and for the identification of new therapeutic targets. Fibroblast activation protein (FAP) expression is associated with development of early metastases and worse cancer-specific survival. Tumor-associated collagen signature (TACS) is type of collagen that develop during tumor growth and associated with tumor invasion.Methods: 26 metastatic clear cell renal cell carcinoma patients that underwent nephrectomy were admitted to this study. Data regarding age, sex, Fuhrman’s grade, tumor diameter, staging, FAP expression, and TACS grading were collected. Spearman rho test was used to correlate FAP expression and TACS grading in both primary tumors and metastases, and with patients age and sex.Results: FAP expression correlated positively with TACS degree (Spearman rho test r = 0.51; p = 0.0001). FAP was positive in 25 (96%) of all intratumor samples and positive in 22(84%) of all stromal sample.Conclusion: FAP can be used as prognostic factor in metastatic CCRCC, its presence can predict aggressiveness of mCRCC and poorer outcome in patient. Furthermore TACS can be also used for prediction of aggressiveness and metastasis due to the changes are necessary for tumor to invade other organs.
Study on fermentation mechanisms of Arisaema cum Bile based on microbial diversity-odor characteristic components
Authors: Wu Xu , Wang Jing , Zou Ting , He Su-Rong , Wu Ya-Nan , Wen Si-Hua , Li Ya-Juan , Liu Qian , Chen Xi , Qi Chun-Yan , Zhang Qiao , Song Yi-Jun , Zhao Chong-Bo , Wang Chang-Li
Published: May 2022

Arisaema cum Bile (Dan Nan Xing, DNX) had a history of nearly one thousand years in clinical application of traditional Chinese medicine. It was mainly used to treat pediatric diseases such as convulsion and hyperthermia. However, the current fermentation technology of DNX was lack of scientific explanation, and there was no unified standard. Therefore, this paper study on the relationship between microorganisms and odor by 16SrRNA and GC-IMS technology in the fermentation technology of DNX, and expounds the scientificity of DNX "fermenting in bovine gallbladder for 100 days" and "increasing bile fermentation DNX ". This study prepared DNX with different fermentation time and different fermentation times of numbers, according to the records of 《Xiao Er Yao Zheng Zhi Jue》(小儿药证直决) and 《Yi Sheng Wei Lun》(颐生微论). 16SrRNA sequencing showed that Firmicutes, Proteobacteria, streptophyta, Bacteroidetes and actinobacteria were active in DNX samples. GC-IMS technology detected 41 volatile substances in DNX, mainly including alcohols, esters, aldehydes etc. According to the results of KEGG analysis between flora and odor metabolism pathway, the above flora may affect the content of esters, alcools, acids and aldehyde compounds of DNX by alanine, aspartate and glutamate metabolism, propanoate metabolism, pyruvate metabolism ways, etc. Spearman correlation analysis showed that Nocardiopsis and Acidovorax were significantly negatively correlated with ammonia. Ammonia was one of the main volatile components of the stink smell of DNX, and the stink smell of DNX was weakened, which was convenient for clinical patients to take. There was no significant difference in the relative abundance of Acidovorax between FJ3M and FJ33M, but the abundance was lower in FJ6M. Nocardiopsis began to increase in FJ3M DNX sample, and the abundance was higher in FJ6M. In addition, compared with MJ, it was found that both Acidovorax in nature and in bovine bile played a role in DNX fermentation, but Acidovorax in bovine bile contributed more. Nocardiopsis was carried by bovine bile itself. This result was helpful to expound the scientificity of "DNX fermentation for 100 days" in the《Xiao Er Yao Zheng Zhi Jue》, and can provide a scientific basis for the fermentation and processing technology of DNX.
Impact of obstructive ventilatory impairment on intraoperative bleeding during laparoscopic hepatectomy
Authors: Nakamura Masanori , Okamura Yukiyasu , Sugiura Teiichi , Ashida Ryo , Ohgi Katsuhisa , Yamada Mihoko , Otsuka Shimpei , Nakayama Goro , Kodera Yasuhiro , Uesaka Katsuhiko
Published: May 2022

Purpose: An animal model of laparoscopic hepatectomy showed that bleeding from the hepatic vein is influenced by airway pressure. However, there are little research reports on how airway pressure leads to risks in clinical practice. The main objective of this study was to investigate the impact of preoperative forced expiratory volume % in 1 second (FEV1.0%) on intraoperative blood loss in laparoscopic hepatectomy.Methods:All patients who underwent pure laparoscopic or open hepatectomy from April 2011 to July 2020 were classified into two groups by preoperative spirometry: those with obstructive ventilatory impairment (Obstructive group; FEV1.0%< 70%) and those with normal respiratory function (Normal group; FEV1.0%≥ 70%). Massive blood loss was defined as 400 mL for laparoscopic hepatectomy.Results:In total, 247 and 445 patients underwent pure laparoscopic and open hepatectomy, respectively. Regarding laparoscopic hepatectomy group, blood loss was significantly greater in the Obstructive group (122 vs. 100 mL, P = 0.042). Multivariate analysis revealed that high IWATE criteria scores (≥ 7, odds ratio [OR]: 4.50, P = 0.004) and low preoperative FEV1.0% (< 70%, OR: 2.28, P = 0.043) were independent risk factors for blood loss during laparoscopic hepatectomy. In contrast, FEV1.0% did not affect the blood loss (522 vs. 605 mL, P = 0.113) during open hepatectomy. Conclusion: Obstructive ventilatory impairment (low FEV1.0%) may affect the amount of bleeding during laparoscopic hepatectomy.
Electroacupuncture protects against cerebral ischemia-reperfusion injury via regulating P2X7R expression
Authors: Lin Feihong , Zhu Ye , Liu Haipeng , Li Shan , Huang Xuliang , Mo Yunchang , Wang Junlu , Dai Qinxue
Published: May 2022

Clinically, ischemic stroke is a serious disease hard to cure, therefore it is of great importance to slow down the depletion of ATP to enhance the tolerance of ischemic tissue through aggressive preconditioning. Electroacupuncture (EA) preconditioning has been reported to produce a tolerance for cerebral ischemia, with the underlying mechanism remaining unclear. Given that the P2X7 receptor (P2X7R) mediates the stimulation of microglial cells and is involved in the developmental process of cerebrum ischemia-reperfusion (I/R) damage, we hypothesized that the protective effect of Electroacupuncture preconditioning might be associated with the downregulated P2X7R. In this study, 2 '(3')-O-(4-benzoyl) adenosine triphosphate (BzATP) was utilized as a P2X7R agonist in rats with cerebral ischemia-reperfusion injury (MCAO), from which we found that EA preconditioning ameliorated neurologic scoring, decreased infarction volume, and necrotic neurons, and decreased the release of cytokines, while BzATP exacerbated cerebrum I/R damage and inflammation events compared with the favorable efficacy of EA. In addition, BzATP reversed the positive effects mediated by EA, which was consistent with increased expression of P2X7R. These findings suggest that EA induces cerebral ischemic tolerance to ischemia-reperfusion(I/R) damage by suppressing the expression of P2X7R and the release of inflammatory factors.
Urinary Metabolic Profiling of Liver Fluke-induced Cholangiocarcinoma – a Validation Study
Authors: Alsaleh Munirah , Sithithaworn Paiboon , Khuntikeo Narong , Loilome Watcharin , Yongvanit Puangrat , Hughes Thomas , O’Connor Thomas , Andrews Ross H. , Wadsworth Christopher A. , Williams Roger , Koomson Larry , Cox I. Jane , Holmes Elaine , Taylor-Robinson Simon D.
Published: May 2022

Background
Global liquid chromatography mass spectrometry (LC-MS) profiling in a Thai population identified a urinary metabolic signature in Opisthorchis viverrini-induced cholangiocarcinoma (CCA), primarily characterised by disturbance in acylcarnitine, bile acid, steroid and purine metabolism. However, the detection of thousands of analytes by LC-MS in a biological sample in a single experiment potentially introduces false discovery errors. To verify these observed metabolic perturbations, a second validation dataset from the same population was profiled in similar fashion.
Methods
Reverse-phase ultra-performance liquid-chomatography mass spectrometry (RP-UPLC-MS) was utilised to acquire the global spectral profile of 98 spot urine samples (from 46 healthy volunteers and 52 CCA patients) recruited from Khon Kaen, northeast Thailand (the highest incidence of CCA globally).
Results
Metabolites were differentially expressed in the urinary profiles from CCA patients. High urinary elimination of bile acids was affected by the presence of obstructive jaundice. The urine metabolome associated with non-jaundiced CCA patients showed a distinctive pattern, similar but not identical to published studies. A panel of 10 metabolites achieved a diagnostic accuracy of 93.4% and AUC value of 98.8% (CI = 96.3%-100%) for the presence of CCA.
Conclusion
Global characterisation of CCA urinary metabolome identified several metabolites of biological interest in this validation study. Analyses of the diagnostic utility of the discriminant metabolites showed excellent diagnostic potential. Further larger scale studies are required to confirm these findings internationally, particularly in comparison to sporadic CCA, not associated with liver fluke infestation.
Validation of the Cough Phenotype TBQ among Elderly Finnish Subjects
Authors: Koskela Heikki O , Kaulamo Johanna T , Selander Tuomas A , Lätti Anne M
Published: May 2022

Background
Phenotypes are defined as the observable properties of disorders that are produced by the interactions of the genotype and the environment. The approaches to phenotype disorders have evolved from subjective expert opinion to data-driven methodologies. A previous cluster analysis among working-age subjects with cough revealed a phenotype TBQ (Triggers, Background disorders, Quality of life impairment), which included 38% of the subjects with cough. The present study was carried out to validate this phenotyping among elderly, retired subjects with cough.
Methods
This was an observational, cross-sectional study conducted via email among the members of the Finnish Pensioners` Federation (N = 26 205, 23.6% responded). The final analysis included 1109 subjects with current cough (mean age 72.9 years (range 64–90 years) with 67.7% females). All filled in a comprehensive 86-item questionnaire including the Leicester Cough Questionnaire. Phenotypes were identified utilizing K-means partitional clustering.
Results
Two clusters were identified. The cluster A included 75.2% and cluster B 24.8% of the subjects. The three most important variables to separate the clusters were the number of the cough triggers (mean 2.47 (SD 2.34) vs. 7.08 (3.16), respectively, p < 0.001), Leicester Cough Questionnaire physical domain (5.38 (0.68) vs. 4.21 (0.81), respectively, p < 0.001), and the number of the cough background disorders (0.82 (0.78) vs. 1.99 (0.89), respectively, p < 0.001).
Conclusion
The phenotype TBQ could be identified also among elderly, retired subjects with cough, thus validating the previous phenotyping among working-age subjects. The main underlying pathophysiological feature separating the phenotype TBQ from the rest of the coughing subjects is probably hypersensitivity of the cough reflex arc.
Breast cancer and obesity: a qualitative analysis of a diverse population of breast cancer patients’ perspectives on weight management
Authors: Fasano Genevieve A. , Bayard Solange , Johnson Josh , Gordon Ashley , Harris Mia , Taiwo Evelyn , Yeung Jennifer , Zenilman Michael , Newman Lisa , Bea Vivian J.
Published: May 2022

Purpose
Obesity and weight gain in breast cancer survivors leads to a greater risk of recurrence and a decreased chance of survival. A paucity of data exists regarding strengths, weaknesses, and barriers for implementing culturally sensitive, patient-centered interventions for weight management among minority communities. The objective of this study was to evaluate breast cancer patients’ experience and perspectives regarding weight management in a racially diverse population.
Methods
Semi-structured qualitative interviews were conducted with breast cancer patients with a body mass index ≥ 25 kg/m2 regarding their experience with weight management. Interviews were transcribed verbatim, and a thematic analysis was conducted.
Results
Participants (n = 17) mostly identified as non-Hispanic Black (70.6%). Nearly all participants felt comfortable being approached about weight management, yet less than half (41.2%) reported that they knew about the link between breast cancer and body weight prior to the interview. Four themes emerged: (1) lack of knowledge regarding the link between body weight and breast cancer risk, (2) barriers to weight management including family stressors, high cost, mental health issues, and chronic medical conditions, (3) previous attempts at weight loss including bariatric surgery, and (4) best practices for approaching weight management including discussion of weight management prior to survivorship.
Conclusion
There is a need for a multidisciplinary, patient-centered weight management program for minority breast cancer patients that improves awareness of the link between weight and breast cancer risk. Weight management should be introduced early on as an element of the treatment plan for breast cancer.
Enabling mental health task-sharing: A collective case study of undergraduate clinical associate training programmes in South Africa
Authors: Moodley Saiendhra Vasudevan , Wolvaardt Jacqueline , Grobler Christoffel
Published: May 2022

Background: There is a shortage of the human resources needed to deliver mental health services in South Africa which is likely to be exacerbated by COVID-19. Due to mental health workforce shortages, task-shifting and task-sharing approaches have been implemented in other countries. Clinical associates, a mid-level cadre working under the supervision of medical practitioners, could play a role in delivering mental health services but it is not clear if they are adequately prepared . This study explored the mental health curriculum content of the undergraduate clinical associate training programmes in South Africa. Methods: A qualitative collective case study approach was utilised for this multisite study at the three universities in South Africa offering clinical associate degrees. The study consisted of in-depth interviews utilising videoconferencing of individuals involved in each programme and a document review. Thematic analysis of the data was conducted. Results: Nineteen interviews were conducted. Mental health formed part of the curriculum in all three programmes with the bulk of the training taking place in the final year of the three-year degree. Facility-based training ranged from two weeks to four weeks with one university only using hospitals with mental health units while two universities used hospitals at which the students were based for the year regardless of potential mental health exposure they would receive. The list of curricula inclusions extended to seldom-seen conditions. The quality of training and supervision appeared site-dependant and only one university set minimum experiential targets. Conclusions: There is a basis on which to build the competencies and skills regarding mental health in this cadre. A training model that integrates mental health early in the undergraduate curriculum, focuses on common conditions and those with high disease burden, includes time in a mental health unit, provides facility-based trainers with detailed guidance to improve standardisation, and includes specific experiential targets that are monitored will enhance the potential utility of this cadre.
Favourable outcome of multisystem venous thrombosis associated with novel SERPINC1 mutation after treated with dabigatran: a case report and literature review
Authors: Liu Yu , Huang Teng , Jiang Xiaofeng , Zhang Wei , Zhou Honglian , Hu Qi
Published: May 2022

Background: Thrombophilia is a group of disorders that predispose to thrombosis, involving the interaction between genetic and acquired factors, mainly manifested as recurrent venous thromboembolism (VTE). Mutations in SERPINC1 lead to deficiency in antithrombin (AT) which is an endogenous anticoagulant of normal hemostasis and could result in VTE. Herein, we report a case of hereditary thrombophilia manifested by recurrent thrombosis involving the deep veins of the lower extremities, splanchnic veins, and cerebral vein. Case presentation: A 61-year-old male patient with recurrent thrombosis involving the deep veins of the lower extremities, splanchnic veins, and cerebral vein. Laboratory tests revealed a type I AT deficiency in this patient and further whole exome sequencing (WES) identified a novel heterozygous frameshift duplication (c.233_236dup, p.Val80Alafs*26) in SERPINC1 gene. After diagnosis, the patient was treated with dabigatran and obtained a perfect therapeutic effect.Conclusion: A novel frameshift variation (c.233_236dup, p.Val80Alafs*26) within the SERPINC1 gene was identified in a multisystem VTE patient, which may play a significant role in human hereditary AT deficiencies. Our study enriches the insights of genetic factors for VTE and will facilitate the genetic diagnosis of this disease.
The associations between parity, abortion, and menopause status with the prevalence and incidence of thyroid dysfunctions: 12-year follow-up of Tehran Thyroid Study
Authors: Shariatzadeh Siavash , Abdi Hengameh , Hatami Hossein , Amiri Parisa , Shafiee Sepehr , Takyar Miralireza , Azizi Fereidoun , Amouzegar Atieh
Published: May 2022

Background
The effect of thyroid dysfunctions on the female reproductive system is well recognized. Although many studies pointed out the possible effect of female reproductive status alteration on thyroid function, there are too many contradictions to come up with an exact conclusion. This study aimed to investigate the associations of parity, abortion, and menopause status with the prevalence and incidence of thyroid dysfunctions.
Methods
From the Tehran Thyroid Study (TTS) population, 2191 euthyroid female participants at baseline were selected and followed up in three-year intervals. Multivariable Cox proportional hazard model was used to determine associations between the incidence of thyroid dysfunctions with parity, abortion, and menopause status; age, smoking, body mass index, and thyroid peroxidase antibodies positivity were adjusted.
Results
At the baseline, multiple parities were significantly associated with overt hypothyroidism (OR, 95% CI: 1.12, 1.0-1.26) and subclinical hyperthyroidism (OR, 95% CI: 1.11, 1.03–1.21). Likewise, multiple abortions were associated with overt hyperthyroidism (OR, 95% CI: 2.09, 1.02–4.26). Multiple parities (≥ 4) significantly increased the risk of incident subclinical and clinical hypothyroidism. Moreover, the incidence of overt hypothyroidism significantly decreased in mothers with a history of abortion. No significant associations between menopause status with the prevalence and incidence of hypothyroidism or hyperthyroidism were observed.
Conclusions
There are relationships between parity and abortion with thyroid function. Understanding the exact mechanism requires more information at the cellular and molecular level on signaling cascades alterations during pregnancy.
Genetic testing of sperm donors at a human sperm bank in China
Authors: Huang Chuan , Wu Hui-Lan , Zhou Wen-Jun , Huang Zeng-Hui , Luo Xue-Feng , Tang Yu-Ling , Liu Qian , Fan Li-Qing , Nie Hong-Chuan , Zhu Wen-Bing
Published: May 2022

Background
In China, numerous human sperm banks only perform three-generation family history analysis to exclude genetic diseases with clinical symptoms; therefore, many inherited risks cannot be detected before donor qualification even when a thorough genetic family history evaluation has been performed. Hence, the risk of recessive disease inheritance persists with the current eligibility guidelines in China regarding the donor selection process.
Materials and Methods
Retrospective study that reviewed the genetic test analyses and clinical outcomes of young adult men who were qualified sperm donors at the Hunan Province Human Sperm Bank of China from January 1, 2018, to May 1, 2021. We included a total of 3231 qualified sperm donors: all donors underwent primary screening for thalassemia and glucose-6-phosphate dehydrogenase (G6PD) deficiency. Whereafter, 278 of donors underwent genetic testing for specific genes, and 43 donors underwent whole exome sequencing.
Results
2.4% of 3231 qualified sperm donors might have thalassemia and 1.4% might have G6PD deficiency. Sperm donors with thalassemia and G6PD deficiency would be eliminated. Specific gene testing identified 7 of the 278 donors (2.5%) as carriers of at least one pathogenic or likely pathogenic variant in a gene, including 1.9% of 154 donors (3/154) as carrier variants in α-Like or β-Like globin genes, 17.6% of 17 donors (3/17) as carrier variants in GJB2, 12.5% of 8 donors (1/8) as carrier variants in SMN1. In addition, among the 43 sperm donors carrying the 111 pathogenic/likely pathogenic variants, eight (18.6%) were carriers of pathogenic variants of the GJB2 gene. The frequency, therefore, was approximately 1 in 5.
Conclusions
The data suggest that used blood routine and RDT can make a preliminary screening of sperm donors, and special gene testing should be performed for sperm donors according to the regional incidence of specific genetic diseases. Meanwhile, whole exome sequencing can be used as a supplementary application in sperm donor genetic testing, and aid a successful and healthy pregnancy. However, industry guidelines must be modified to incorporate its use.
PSAT1 is a promising tumor microenvironment-related prognostic biomarker in non-small cell lung cancer
Authors: Li Hongmu , Miao Huikai , Zeng Mingyue , Chen Youfang , Yang Minglei , Wen Zhesheng
Published: May 2022

Background This study aimed to identify tumor microenvironment-related prognostic genes in non-small cell lung cancer (NSCLC).Methods Transcriptome profiles and clinical data of NSCLC samples were collected from Gene Expression Omnibus (GEO) Datasets. The ESTIMATE algorithm was used to calculate stromal and immune scores. Heatmap plots were applied for screening differentially expressed genes (DEGs). Venn diagrams were used to assess the intersection of gene groups. DEGs associated with poor prognosis were selected for subsequent analysis. TCGA and Kaplan-Meier Plotter database were used to validate the results of the above analyses. These findings were experimentally validated in NSCLC tissues using quantitative reverse transcription PCR, western blotting, and immunohistochemical staining. Gene Expression Profiling Interactive Analysis 2 and STRING database were used to investigate co-expression and functional networks associated with hub genes. TIMER database was used to assess the correlation between hub genes and the six main types of tumor-infiltrating immune cells. Finally, pan-cancer analysis of hub genes was conducted to investigate the clinical prognosis of diverse cancers. Results Overall survival analysis of the GSE37745 dataset identified PSAT1 as a risk gene. Kaplan–Meier Plotter data also showed that high expression of PSAT1 results in shorter survival time. Experimental validation confirmed the above results. In addition, the expression level of PSAT1 was correlated with tumor purity and immune cell infiltration in NSCLC. The pan-cancer analysis of PSAT1 offers a relatively comprehensive understanding of the oncogenic roles in different tumors.Conclusion Our results indicate that PSAT1 is a promising tumor microenvironment-related prognostic biomarker for NSCLC.
Efficacy of an interdental brush in cleaning artificial plaque on a 3D-printed model base
Authors: Kim Seo Eun , Kim Mi Jeong , Nam Shin-Eun , Lee Seung Pyo
Published: May 2022

Background: Among interdental cleaning aids (ICAs), interdental brushes (IDBs) are in the spotlight because they can effectively remove plaque from interdental surfaces. Guidance on the correct use of ICAs, such as IDBs, is required to prevent dental plaque accumulation. Since it is impossible to confirm the interdental proximal surface unless extracted, it is difficult to conduct quantitative experiments. This study presented an efficient way to evaluate IDBs by realizing dental structures and embrasures using a Dental computer-aided design (CAD) software and a 3D printer.Methods: Two different sizes of embrasure (0.7 and 1.2 mm) crown models were prepared with CAD software and a 3D printer. To evaluate the cleaning efficacy of IDBs of each size (0.6, 0.7, 0.8, 1.0, 1.2, and 1.5 mm diameters), the 9th cycle of brush move was performed where artificial plaque was spread and a digital camera was used to record the process. The pixels and percentage of cleaning from the recorded digital images were analyzed.Results: The plateau was formed after the 5th brushing cycle under all conditions—after the 5th cycle, the cleaning efficacy of the two crown models was 69.3%–86.4% and 49.8%–75.4%. In these results, the optimal diameters for the IDB were 1.2 and 1.5 mm for embrasure sizes of 0.7 and 1.2 mm, respectively. Moreover, the cleaning efficacy was the highest at 86.4% and 75.4% after the 9th cycle.Conclusions: The 3D-printed model base for the human oral embrasure structure is an adequate model to test artificial plaque removal using IDB. The use of IDBs for more than five cycles does not support the conventional idea that a greater number of IDB brushing moves is more effective in a statistically substantial manner.
Structural reliability of ultra high-performance fibre reinforced concrete beams in shear
Authors: Simwanda Lenganji , De Koker Nico , Viljoen Celeste , Bababfemi Adewumi John
Published: May 2022

A study on the shear model uncertainty and structural reliability of ultra high-performance fibre reinforced concrete (UHPFRC) beams with stirrups is presented. Model factors for the shear models given in the JSCE, AFGC and ACI 544 standards are characterised by comparison to non-linear finite element analyses (NLFEA). In comparison to other shear basic parameters, a notable negative correlation between model factors and product of the shear reinforcement ratio and strength (ρwfywm) is observed and therefore, care should be taken with respect to this variable when deriving partial resistance factors for UHPFRC beams with stirrups. When combined with stochastic descriptions of the remaining parameters that describe these analytical models, reliability values for beams designed to the JSCE and AFGC specifications are found to fall 9%, and 22%, below the target values of these standards, while reliability values for the ACI 544 agree with the target value specified for this standard, implying that the partial resistance factor specified for the ACI 544 is appropriate and in harmony with its presently characterised model factor