bluuebunny/crossref_metadata_2025 huggingface dataset:
Formation Mechanism of Precursor Films at High Temperatures: A Review
Authors: Lin Qiaoli , Liu Lu , Zhu Wenqi
Published: March 2022

The formation of a precursor film (PF) is always coupled with better wettability; thus, clarifying the formation mechanism is required to optimize the interfacial structures. However, recent research focuses on inert wetting systems at room temperature, which cannot guide practical material processing at high temperatures. In this review, PF formation mechanisms at high temperatures were reviewed. The mechanisms are surface diffusion, evaporation–condensation, subcutaneous infiltration, and rapid absorption and film overflow. In experimental metal/metal systems, the most probable mechanism is subcutaneous infiltration, related to the apparent contact angle, radius, and height of the gap between the substrate metal and the oxide film. The rapid absorption and film overflow mechanism usually occurs in metal/ceramic systems. The PF appearance for the adsorption mechanism must satisfy the paradox, that is, the relative inertial and high-affinity liquid/solid interface. Finally, another possible mechanism of PF appearance for the reactive wetting system at high temperatures was proposed, that is, the thin-surface transport mechanism. The PF formation is sensitive to external conditions. Therefore, it is necessary to develop thermodynamic and dynamic models for predicting and simulating PFs.
Defect Analysis and Innovation Design of Synchronizer for Clutchless Automatic Mechanical Transmission
Authors: Zhang Lipeng , Peng Yunao , Yang Haojie , Li Shaohua
Published: March 2022

The synchronizer is a key component of automatic mechanical transmission (AMT) equipped in electric vehicles, but the inertial lock-ring synchronizer (ILRS) commonly used there is not suitable especially for pure electric vehicles without a clutch because of big shift impact. To make the shifting process rapid and smooth, a new synchronizer named pressure-controllable friction ring synchronizer (PCFRS) was designed. Initially, the inevitable shortcoming of ILRS was verified by simulation and test. Furthermore, the mechanical characteristics and advantages of the new synchronizer over ILRS were analyzed. Then, the formulations describing the dynamic transmission based on the working mechanism of the PCFRS were established. Finally, the shifting simulation results with PCFRS and ILRS based on the same operating conditions were compared and analyzed. The research shows that the PCFRS can meet the main shifting evaluation index of an AMT without complex control methods, as well as it takes only 0.2406 s to finish the comfortable and zero-speed-difference shifting. The shifting quality of PCFRS is better than that of the ILRS. It lays a foundation for using the new synchronizer as a part of clutchless AMTs equipped in pure electric vehicles.
A comparison of clinicopathologic features of prostate cancer between Nigerian and South African black men
Authors: Ahmed Ridwan Oladotun , Sewram Vikash , Oyesegun Adisa Rasaaq , Ayele Birhanu , van Wyk Abrie , Fernandez Pedro
Published: March 2022

Background

Globally, prostate cancer (PCa) is the commonest non-cutaneous male malignancy. It is more aggressive among black men with little known reasons as to the cause and continued trend among black men. This disproportionate pattern of PCa especially among black men of African ancestry resident in Africa calls for a closer look. Nigeria and South Africa, combined, have the highest cumulative risk incidence of PCa in Africa. The present study investigated the clinicopathologic behaviour of PCa among Nigerian and South African black men and the relationship between the disease and socio-demographic characteristics alongside medical co-morbidities.

Methods

A retrospective cross-sectional study was undertaken in which de-identified records of 234 black men with pathologically confirmed PCa between 2007 and 2017 from two tertiary hospitals, in Nigeria (National Hospital, Abuja) and South Africa (Tygerberg Hospital, Cape Town), were reviewed.

Results

Median age at presentation from both countries was 66 years (interquartile range, IQR 61–73 years) while the median PSA at presentation was 46 ng/ml (IQR 16–336.5 ng/ml). Half of the men (117/234) presented with locally advanced disease while metastatic disease was observed in 65.9% (27/41) of Nigerian men and 34.1% (14/41) of South African men. Thirty-three per cent of the men presented with organ-confined disease. Overall, Nigerian men presented with less organ-confined disease and significantly higher stage of disease (p < 0.001). Risk stratification using PSA, Gleason scores and T-staging showed that 84.2% (n = 197) of all the men presented with high-risk PCa disease. There was a statistically significant difference between Nigerian and South African black men (p = 0.003) in terms of disease risk at presentation. Logistic regression analysis showed that age (Adjusted OR 1.053 (95% CI 1.003–1.106),p = 0.003) and country of residence (Adjusted OR 4.281 (95% CI 1.690–10.844),p = 0.002) had a statistically significant relationship with high risk of PCa while disease co-morbidities (like diabetes and hypertension) and rural/urban location in both countries did not.

Conclusions

Disparities exist between PCa presentation and clinicopathologic behaviour among Nigerian and South African black men. Nigerian men showed higher disease risk at presentation. Environmental-genetic interactions need further exploration in the aetio-pathogenesis of PCa in black men of African ancestry.
Nocardia keratitis: amikacin nonsusceptibility, risk factors, and treatment outcomes
Authors: Adre Ethan , Maestre-Mesa Jorge , Durkee Heather , Arboleda Alejandro , Flynn Harry , Amescua Guillermo , Parel Jean-Marie , Miller Darlene
Published: March 2022

Purpose

To report the increasing trends in Nocardia keratitis species diversity and in vitro antibiotic susceptibility, to demonstrate contact lens wear as a risk factor, and to report visual acuity outcomes after treatment.

Methods

A retrospective clinical case series was performed at a single academic referral center which identified 26 patients with culture-confirmed Nocardia keratitis between 2014 and 2021. A combination of conventional microbiology and molecular techniques were used to identify isolates. Antibiotic susceptibilities were determined using both commercial and in-house laboratory methods. Microbiology and electronic medical records were used to characterize patients’ clinical profiles.

Results

Patients’ median age was 32.5 years with a 2:1 male to female ratio. Eighty-four percent (n = 21/25) of patients were diagnosed within two weeks of symptom onset. Nocardia amikacinitolerans (n = 11/26) was the most recovered Nocardia isolate among study patients. Sixty-four percent (n = 16/25) of all isolates, including all 11 N. amikacinitolerans isolates, were resistant to amikacin. All isolates were susceptible to trimethoprim sulfamethoxazole. Contact lens wear was the leading identified risk factor (n = 23/26) in this population. Median time to resolution was 44 days (n = 23, range: 3–190 days). Seventy-one percent of patients (n = 15/21) had a final visual acuity of 20/40 or better.

Conclusion

Amikacin resistant Nocardia isolates were the majority in the current study. Trimethoprim sulfamethoxazole may be the preferred alternative antibiotic treatment based on in vitro susceptibilities. Contact lens wear was the major risk factor for Nocardia keratitis in South Florida. Overall visual acuity treatment outcomes of patients were favorable.
Early stage evaluation of colon cancer using tungsten disulfide quantum dots and bacteriophage nano-biocomposite as an efficient electrochemical platform
Authors: Pourakbari Ramin , Yousefi Mehdi , Khalilzadeh Balal , Irani-nezhad Mahsa Haddad , Khataee Alireza , Aghebati-Maleki Leili , Soleimanian Alireza , Kamrani Amin , Chakari-Khiavi Forough , Abolhasan Rozita , Motallebnezhad Morteza , Jadidi-Niaragh Farhad , Yousefi Bahman , Kafil Hossein Samadi , Hojjat-Farsangi Mohammad , Rashidi Mohammad-Reza
Published: March 2022

Background

Recently, biosensors have become popular analytical tools for small analytes due to their high sensitivity and wide analytical range. In the present work, development of a novel biosensing method based on tungsten disulfide quantum dots (WS2QDs)-Au for rapidly and selectively detecting c-Met protein is introduced. As a proof of concept, M13 bacteriophage-based biosensors were used for the electrochemical detection of c-Met protein as a colon cancer biomarker.

Method

The M13 bacteriophage (virus), as the biorecognition element, was immobilized on glassy carbon electrodes which were modified by WS2QDs-functionalized gold nanoparticles. The stepwise presence of the WS2QDs, gold nanoparticles, and immobilized phage on glassy carbon electrodes were confirmed by scanning electron microscope (SEM) and square wave voltammetry (SWV) technique.

Results

The designed biosensor was applied to measure the amount of c-Met protein in standard solutions, and consequently the desirable detection limit of 1 pg was obtained. Finally, as a proof of concept, the developed platform was used for the evaluation of c-Met protein in serum samples of colon cancer-suffering patients and the results were compared with the results of the common Elisa kit.

Conclusions

As an interesting part of this study, some concentrations of the c-Met protein in colon cancer serum samples which could not be determined by Elisa, were easily analyzed by the developed bioassay system. The developed bioassay system has great potential to application in biomedical laboratories.

Graphical Abstract
Cyclical regression covariates remove the major confounding effect of cyclical developmental gene expression with strain-specific drug response in the malaria parasite Plasmodium falciparum
Authors: Foster Gabriel J. , Sievert Mackenzie A. C. , Button-Simons Katrina , Vendrely Katelyn M. , Romero-Severson Jeanne , Ferdig Michael T.
Published: March 2022

Background

The cyclical nature of gene expression in the intraerythrocytic development cycle (IDC) of the malaria parasite, Plasmodium falciparum, confounds the accurate detection of specific transcriptional differences, e.g. as provoked by the development of drug resistance. In lab-based studies, P. falciparum cultures are synchronized to remove this confounding factor, but the rapid detection of emerging resistance to artemisinin therapies requires rapid analysis of transcriptomes extracted directly from clinical samples. Here we propose the use of cyclical regression covariates (CRC) to eliminate the major confounding effect of developmentally driven transcriptional changes in clinical samples. We show that elimination of this confounding factor reduces both Type I and Type II errors and demonstrate the effectiveness of this approach using a published dataset of 1043 transcriptomes extracted directly from patient blood samples with different patient clearance times after treatment with artemisinin.

Results

We apply this method to two publicly available datasets and demonstrate its ability to reduce the confounding of differences in transcript levels due to misaligned intraerythrocytic development time. Adjusting the clinical 1043 transcriptomes dataset with CRC results in detection of fewer functional categories than previously reported from the same data set adjusted using other methods. We also detect mostly the same functional categories, but observe fewer genes within these categories. Finally, the CRC method identifies genes in a functional category that was absent from the results when the dataset was adjusted using other methods. Analysis of differential gene expression in the clinical data samples that vary broadly for developmental stage resulted in the detection of far fewer transcripts in fewer functional categories while, at the same time, identifying genes in two functional categories not present in the unadjusted data analysis. These differences are consistent with the expectation that CRC reduces both false positives and false negatives with the largest effect on datasets from samples with greater variance in developmental stage.

Conclusions

Cyclical regression covariates have immediate application to parasite transcriptome sequencing directly from clinical blood samples and to cost-constrained in vitro experiments.
Genomic insights into lineage-specific evolution of the oleosin family in Euphorbiaceae
Authors: Zou Zhi , Zhao Yongguo , Zhang Li
Published: March 2022

Background

Lipid droplets (LDs) present in land plants serve as an essential energy and carbon reserve for seed germination and seedling development. Oleosins, the most abundant structural proteins of LDs, comprise a small family involved in LD formation, stabilization and degradation. Despite their importance, our knowledge on oleosins is still poor in Euphorbiaceae, a large plant family that contains several important oil-bearing species.

Results

To uncover lineage-specific evolution of oleosin genes in Euphorbiaceae, in this study, we performed a genome-wide identification and comprehensive comparison of the oleosin family in Euphorbiaceae species with available genome sequences, i.e. castor bean (Ricinus communis), physic nut (Jatropha curcas), tung tree (Vernicia fordii), Mercurialis annua, cassava (Manihot esculenta) and rubber tree (Hevea brasiliensis), and a number of five, five, five, five, eight and eight members were found, respectively. Synteny analysis revealed one-to-one collinear relationship of oleosin genes between the former four (i.e. castor bean, physic nut, tung tree and M. annua) as well as latter two species (i.e. cassava and rubber tree), whereas one-to-one and one-to-two collinear relationships were observed between physic nut and cassava, reflecting the occurrence of one recent whole-genome duplication (WGD) in the last common ancestor of cassava and rubber tree. The presence of five ortholog groups representing three previously defined clades (i.e. U, SL and SH) dates back at least to the Malpighiales ancestor, because they are also conserved in poplar (Populus trichocarpa), a tree having experienced one Salicaceae-specific recent WGD. As observed in poplar, WGD was shown to be the main driver for the family expansion in both cassava and rubber tree. Nevertheless, same retention patterns of WGD-derived duplicates observed in cassava and rubber tree are somewhat different from that of poplar, though certain homologous fragments are still present in rubber tree. Further transcriptional profiling revealed an apparent seed-predominant expression pattern of oleosin genes in physic nut, castor bean and rubber tree. Moreover, structure and expression divergence of paralogous pairs were also observed in both cassava and rubber tree.

Conclusion

Comparative genomics analysis of oleosin genes reported in this study improved our knowledge on lineage-specific family evolution in Euphorbiaceae, which also provides valuable information for further functional analysis and utilization of key members and their promoters.
Hydrogen sulfide attenuates intracellular oxidative stress via repressing glycolate oxidase activities in Arabidopsis thaliana
Authors: Wang Lijuan , Mu Xiujie , Chen Xi , Han Yi
Published: March 2022

Background

Hydrogen sulfide (H2S) has been proposed to exert anti-oxidative effect under many environmental stresses; however, how it influences oxidative stress remains largely unclear.

Results

Here, we assessed the effects of H2S on oxidative stress responses such as salicylic acid (SA)-dependent cell death, which triggered by increased H2O2 availability in Arabidopsis thaliana catalase-deficient mutants cat2 displaying around 20% wild-type catalase activity. H2S generation and its producing enzyme L-cysteine desulfhydrase (LCD/DES) were found to transient increase in response to intracellular oxidative stress. Although introducing the mutation of des1, an important LCD, into the cat2 background produced little effect, H2S fumigation not only rescued the cell death phenotype of cat2 plant, but also attenuated SA accumulation and oxidation of the glutathione pool. Unexpectedly, the activities of major components of ascorbate–glutathione pathway were less affected by the presence of H2S treatment, but decreased glycolate oxidase (GOX) in combination with accumulation of glycolate implied H2S treatment impacts the cellular redox homeostasis by repressing the GOX-catalyzed reaction likely via altering the major GOX transcript levels.

Conclusions

Our findings reveal a link between H2S and peroxisomal H2O2 production that has implications for the understanding of the multifaceted roles of H2S in the regulation of oxidative stress responses.
Mortality and survival of tuberculosis coinfected patients living with AIDS in São Paulo, Brazil: a 12-year cohort study
Authors: Tancredi Mariza Vono , Sakabe Sumire , Waldman Eliseu Alves
Published: March 2022

Background

TB is still one of the leading causes of death among HIV patients. This study evaluates the effect of TB on the mortality rate, survival time, and predictors of survival in patients with AIDS living in different areas in São Paulo State (SPS).

Methods

Retrospective cohort of adolescents and adults with AIDS, diagnosed between 2003 and 2007 and followed-up until 2014. Data were obtained from the Brazilian Ministry of Health. Mortality rates were estimated by person-years. Survival analysis used the date of diagnosis as the reference for the construction of Kaplan–Meier curves. The Cox model was used for the investigation of survival-associated factors.

Results

A total of 35,515 patients were included, of whom 63.0% were male; 64.7% at the age group of 30 to 49 years, 64.4% were white, 12.9% co-infected with TB, and 37.6% had CD4 count above 200 cells/mm3 at diagnosis of AIDS. The 12-year survival probabilities were 74.1% and 55.7% among patients without and with TB co-infection, respectively. After adjustment for sex, age and year of diagnosis, the following exposures were independently associated with lower survival: residing in municipalities of the Interior (Hazard ratio (HR) = 1.43) and Coastal Area (HR = 1.9); illiteracy (HR = 2.61); being co-infected with TB (HR = 1.70); CD4 count below 200 cells/mm3 at AIDS diagnosis (HR = 2.31); viral load above 500 copies/ml at AIDS diagnosis (HR = 1.99); HAART1 regimen (one non-nucleoside reverse transcriptase inhibitor or boosted old protease inhibitors) (HR = 1.94).

Conclusion

The impact of TB on survival of AIDS was heterogeneous, and affected by age, years of formal education, early AIDS diagnosis, and proper ARV treatment. These factors may not fully explain the different survival outcomes in each of the four regions within the same state. These results may subsidize focused interventions and public health policies conveying specific needs in each of the areas.
Self-management program for patients with chronic kidney disease (SMP-CKD) in Southern China: protocol for an ambispective cohort study
Authors: Ouyang Wen-wei , Chen Hui-fen , Xu Xue-yi , Zhang Xian-long , Fu Li-zhe , Tang Fang , Wen Ze-huai , Marrone Gaetano , Liu Li-chang , Lin Jing-xia , Liu Xu-sheng , Wu Yi-fan
Published: March 2022

Background

Chronic kidney disease (CKD) is a major global health problem. Short-term self-management has been considered to effect some renal and psychological endpoints. However, there are currently very few studies about self-management for CKD that a) have been scientifically designed by a theory-based framework and b) that evaluate the long-term effects and working mechanism. This study presents the rationale and design of a theory-based cohort study to explore how this self-management intervention works and its effectiveness on the Chinese CKD population.

Methods

In this ambispective intervention cohort study,1,200 patients with CKD stages 1–5 will be recruited from July 2015 to July 2024 in 3 branches of Guangdong Provincial Hospital of Chinese Medicine (GPHCM) in Guangdong province, China. The patients in the self-management cohort will choose to receive an intervention that consists of education, nutrition/diet modification, lifestyle change recommendation, medication review, and psychology support based on Social Cognition Theory (SCT). The patients in the control cohort will do regular follow-ups based on the clinic rules. All the patients will be followed up for 5 years, or until the occurrence of a primary outcome. Detailed clinical, laboratory markers, nutritional status, psychological exposures and outcome questionaries will be collected semiannually in CKD stage 1–2 and trimonthly in stage 3–5 patients. The primary outcome is the occurrence of composite clinical endpoints (doubling of serum creatinine level, ESKD, loss of renal function (≥ 40% decline in GFR from baseline), death, major cardiovascular or cerebrovascular events). The main secondary outcomes include the absolute change and slope of eGFR, absolute changes of urinary protein creatinine ratio, 24-h urine proteinuria, intact parathyroid hormone level, and self-management adherence rate and quality of life from baseline to end of the study. The effectiveness of self-management will be analyzed and the association between longitudinal trajectories of self-management and renal outcomes will be evaluated.

Discussion

This study aims to provide further evidence for the effectiveness of theory-based self-management in CKD patients and to improve the lives of patients with CKD by slowing progression, improving psychological well-being and overall quality of life.

Trial registration

Chinese Clinical Trial Register (ChiCTR1900024633). 19 July, 2019. http://www.chictr.org.cn/showproj.aspx?proj=38378
Efficacy and safety of a low-sodium diet and spironolactone in patients with stage 1-3a chronic kidney disease: a pilot study
Authors: Zhang Hongmei , Zhu Bin , Chang Liyang , Ye Xingxing , Tian Rongrong , He Luchen , Yu Dongrong , Chen Hongyu , Wang Yongjun
Published: March 2022

Background

Excessive salt intake is associated with the deterioration of chronic kidney disease (CKD). Aldosterone is also known as an independent risk factor for kidney injury. Dietary sodium intake acts as a main stimulator in aldosterone-mediated kidney injury. Hence, this study aimed to further investigate the renal protective effects and safety of a low-sodium diet in combination with spironolactone (SPL) in stage 1-3a CKD.

Methods

This single-center, SPL-blinded randomized controlled trial recruited patients with stage 1-3a CKD, randomized into three groups, low-sodium (3 g/d salt) + placebo, medium-sodium (5 g/d salt) + SPL, and low-sodium (3 g/d salt) + SPL. Patients received 12 weeks of intervention. The primary and secondary endpoints were 24-h urine protein and estimated glomerular filtration rate (eGFR) at the end of the intervention, respectively.

Results

A total of 74 patients were analyzed eventually. Significantly decreased 24-h urine protein was found in all three groups, from 0.37 to 0.23 g/d (P = 0.004) in the low-sodium+placebo group, from 0.44 to 0.29 g/d (P = 0.020) in the medium-sodium+SPL group, and from 0.35 to 0.31 g/d (P = 0.013) in the low-sodium +SPL group. There were no significant differences among the three groups in 24-h urine protein amount change after intervention from pre-treatment values (P = 0.760, ITT set). The results of the 24-h urine protein by using PP set analysis was similar to the ITT set. No significant differences in eGFR, nutritional, metabolic, inflammatory, and other biomarkers were observed across all three groups (P > 0.05). No safety signal was observed.

Conclusion

No additional benefit was observed when SPL was prescribed to patients already on a low-sodium diet (3.0 g/d). Still, small doses of SPL may benefit patients with poor sodium restriction. A combination of short-term low-dose SPL and ARB is safe for patients with stage 1-3a CKD, but blood potassium must be regularly monitored.

Trial registration

Name of the registry: Chinese clinical trial registry.

Trial registration number: ChiCTR1900026991.

Date of registration: Retrospectively registered 28 October 2019.

URL of trial registry record: http://www.chictr.org.cn/searchproj.aspx?title=&officialname=&subjectid=&secondaryid=&applier=&studyleader=ðicalcommitteesanction=&spo
Post-transplant outcomes in recipients of living donor kidneys and intended recipients of living donor kidneys
Authors: Dharia Atit A. , Huang Michael , Nash Michelle M. , Dacouris Niki , Zaltzman Jeffrey S. , Prasad G. V. Ramesh
Published: March 2022

Background

Long-term kidney transplant survival at the population level is consistently favorable, but this survival varies widely at an individual level due to both recipient and donor factors. The distinct contribution of recipient and donor factors to individual post kidney transplant outcome remains unclear. Comparing outcomes in deceased donor (DD) recipients with potential but non-actualized living donors (DD1) to those recipients with actualized living donors (LD), and to DD recipients without potential living donors (DD0) may provide transplant candidates with more information about their own post-transplant prognosis.

Methods

We conducted an observational retrospective cohort study of kidney transplant candidates presenting to our centre for evaluation between 01/01/06 and 31/12/18, and who also received a transplant during that time. Patients were followed to 31/08/2019. Candidates were classified as DD0, DD1, or LD based on whether they had an identified living donor at the time of initial pre-transplant assessment, and if the donor actualized or not. Primary outcome was 5-year death-censored graft survival, adjusted for common pre- and post-transplant donor and recipient risk factors. Secondary outcomes analyzed included patient survival and graft function.

Results

There were 453 kidney transplant recipients (LD = 136, DD1 = 83, DD0 = 234) who received a transplant during the study period. DD0 and DD1 did not differ in key donor organ characteristics. The 5-year death censored graft survival of DD1 was similar to LD (p = 0.19). DD0 graft survival was inferior to LD (p = 0.005), but also trended inferior to DD1 (p = 0.052). By multivariate Cox regression analysis, LD demonstrated similar 5-year graft survival to DD1 (HR for graft loss 0.8 [95% CI 0.25–2.6], p = 0.72) but LD graft survival was superior to DD0 (HR 0.34 [0.16–0.72], p = 0.005). The 5-year patient survival in DD1 was similar to LD (p = 0.26) but was superior to DD0 (p = 0.01).

Conclusions

DD recipients with potential but non-actualized living donors exhibit similar mid-term graft and patient survival compared to LD recipients. Having an identified living donor at the time of pre-transplant assessment portends a favorable prognosis for the recipient.
Acute kidney injury in patients with primary nephrotic syndrome: influencing factors and coping strategies
Authors: Lu Honghua , Xiao Liping , Song Mengqi , Liu Xiaolan , Wang Fang
Published: March 2022

Background

Acute kidney injury (AKI) is a frequent and serious complication in patients with primary nephrotic syndrome (PNS). We aimed to evaluate the influencing factors of AKI in patients with PNS, to provide implications for the clinical management and nursing care of patients with PNS.

Methods

PNS patients who were treated in the Department of Nephrology in our hospital from January 1, 2020 to July 31, 2021 were included. The clinical characteristics and pathological type of PNS patients were evaluated. Pearson correlation and Logistic regression analysis were performed to analyze the related risk factors of AKI in patients with PNS.

Results

A total of 328 patients with PNS were included, the incidence of AKI in PNS patients was 28.05%. Pearson correlation analysis showed that diabetes(r = 0.688), pulmonary infection (r = 0.614), albumin (r = 0.779), serum creatinine (r = 0.617), uric acid (r = 0.522), blood urea nitrogen (r = 0.616), renal tubular casts (r = 0.707) were correlated with AKI in PNS patients (all P < 0.05). Logistic regression analysis indicated that diabetes (OR2.908, 95%CI1.844 ~ 4.231), pulmonary infection(OR3.755, 95%CI2.831 ~ 4.987), albumin ≤ 24 g/L (OR1.923, 95%CI1.214 ~ 2.355), serum creatinine ≥ 90 μmol/L (OR2.517, 95%CI2.074 ~ 3.182), blood urea nitrogen ≥ 6.5 mmol/L (OR1.686, 95%CI1.208 ~ 2.123), uric acid ≥ 390 μmol/L (OR2.755, 95%CI2.131 ~ 3.371), renal tubular casts(OR1.796, 95%CI1.216 ~ 2.208) were the independently influencing factors of AKI in PNS patients (all P < 0.05).

Conclusions

AKI is common in PNS patients. Actively controlling diabetes and pulmonary infection, strengthening nutrition support and renal function monitoring are essential to reduce the occurrence of AKI in PNS patients.
Prognostic effects of treatment protocols for febrile convulsive status epilepticus in children
Authors: Tokumoto Shoichi , Nishiyama Masahiro , Yamaguchi Hiroshi , Tomioka Kazumi , Ishida Yusuke , Toyoshima Daisaku , Kurosawa Hiroshi , Nozu Kandai , Maruyama Azusa , Tanaka Ryojiro , Iijima Kazumoto , Nagase Hiroaki
Published: March 2022

Background

Febrile status epilepticus is the most common form of status epilepticus in children. No previous reports compare the effectiveness of treatment strategies using fosphenytoin (fPHT) or phenobarbital (PB) and those using anesthetics as second-line anti-seizure medication for benzodiazepine-resistant convulsive status epilepticus (CSE). We aimed to examine the outcomes of various treatment strategies for febrile convulsive status epilepticus (FCSE) in a real-world setting while comparing the effects of different treatment protocols and their presence or absence.

Methods

This was a single-center historical cohort study that was divided into three periods. Patients who presented with febrile convulsive status epilepticus for ≥60 min even after the administration of at least one anticonvulsant were included. During period I (October 2002–December 2006), treatment was performed at the discretion of the attending physician, without a protocol. During period II (January 2007–February 2013), barbiturate coma therapy (BCT) was indicated for FCSE resistant to benzodiazepines. During period III (March 2013–April 2016), BCT was indicated for FCSE resistant to fPHT or PB.

Results

The rate of electroencephalogram monitoring was lower in period I than period II+III (11.5% vs. 85.7%, p<0.01). Midazolam was administered by continuous infusion more often in period I than period II+III (84.6% vs. 25.0%, p<0.01), whereas fPHT was administered less often in period I than period II+III (0% vs. 27.4%, p<0.01). The rate of poor outcome, which was determined using the Pediatric Cerebral Performance Category scale, was higher in period I than period II+III (23.1% vs. 7.1%, p=0.03). The rate of poor outcome did not differ between periods II and III (4.2% vs. 11.1%, p=0.40).

Conclusions

While the presence of a treatment protocol for FCSE in children may improve outcomes, a treatment protocol using fPHT or PB may not be associated with better outcomes.
Mammary tumors alter the fecal bacteriome and permit enteric bacterial translocation
Authors: Loman Brett R. , Russart Kathryn L. G. , Grant Corena V. , Lynch Alexis J. , Bailey Michael T. , Pyter Leah M.
Published: March 2022

Background

Cancer patients experience gastrointestinal and behavioral symptoms, and are at increased risk of systemic infection and inflammation. These conditions are a major source of morbidity and decreased quality of life prior to cancer treatment, but poorly defined etiologies impede successful treatment. The gastrointestinal microbiota shape inflammation, influence cancer progression and treatment, and colonize tumors. However, research has not directly determined if peripheral tumors influence the microbiome and intestinal physiology, thus influencing gastrointestinal and behavioral symptoms. Therefore, the purpose of this study was to examine consequences of orthotopic, syngeneic mammary tumor implantation, growth, and resection on fecal bacteriome composition and intestinal barrier function in relation to systemic inflammation and enteric bacterial translocation in mice.

Methods

Female mice were randomized to 3 experimental groups: sham surgical control, tumor recipients, and tumor recipients later receiving tumor-resection. Mice were sacrificed three weeks after tumor implantation or resection for collection of stool, colon, spleen, and brain tissue and analysis.

Results

Tumor-bearing mice exhibited several markers of colonic barrier disruption, including dampened expression of tight junction proteins (Cldn1 and Ocln) and elevated circulating lipopolysaccharide binding protein (LBP). Compromised colonic barrier integrity was associated with altered fecal bacterial profiles in tumor-mice, including lower relative abundance of Lactobacillus, but higher Bacteroides. Consistent with colonic barrier disruption and altered microbiomes, tumor-mice displayed markers of systemic inflammation including splenomegaly, higher splenic bacterial load, and elevated splenic and brain pro-inflammatory cytokines. Several  bacteria cultured from spleens had 16S rRNA gene amplicons matching those in fecal samples, suggesting they were of intestinal origin. Fecal Lactobacillus was highly-interrelated to physiological parameters disrupted by tumors via correlation network analysis. Tumor resection ameliorated circulating LBP, splenomegaly, and splenic cytokines, but not other parameters associated with loss of colonic barrier integrity and bacterial translocation.

Conclusions

Orthotopic mammary tumors alter the microbiome, reduce intestinal barrier function, increase translocation of enteric bacteria, and alter systemic inflammation. This provides insight into how tumors commence gastrointestinal and behavioral symptoms prior to treatment, and identify targets for future therapeutics, such as probiotic Lactobacillus supplementation.
Herpetic uveitis caused by herpes simplex virus after cataract surgery in a patient without prior viral keratitis or uveitis: a case report
Authors: Hu Feng , Guan Wenxue , Zhang Yongpeng , Peng Xiaoyan
Published: March 2022

Background

To report a case of herpetic uveitis caused by herpes simplex virus after cataract surgery in a patient without prior viral keratitis or uveitis.

Case presentation

A 70-year-old female was referred to our clinic with a 16-day history of acute blurry vision with painful redness in the right eye. She accepted cataract surgery for the right eye ten days before initial of ocular symptoms. There was significant inflammation in anterior chamber of the right eye. Retina exam showed moderate dense vitreous opacity but not necrotic or focal retinal lesion in the right eye. The aqueous humor collected from the right eye was positive for herpes simplex virus (HSV) DNA by PCR. The diagnosis of herpetic uveitis in the right eye was made due to clinical presentations and aqueous humor examination.

Conclusion

Herpetic virus reactivation might occasionally occur after intraocular surgery in patients without prior ocular viral diseases, inducing atypical postoperative intraocular inflammation.
577 nm subthreshold micropulse laser treatment for acute central serous chorioretinopathy: a comparative study
Authors: Long He , Liu Maoxiong , Hu Qinghua , Li Xin
Published: March 2022

Background

To assess the efficacy of 577 nm subthreshold micropulse laser (SML) treatment for acute central serous chorioretinopathy (CSC).

Methods

This retrospective comparative case-series included 34 eyes of 34 patients with acute CSC who received either 577 nm SML treatment (SML group, n = 16 eyes) or were only monitored (observation group, n = 18 eyes). Acute CSC was defined as disease course < 3 months. Eyes with any history of treatment in the past were excluded. Data were collected over a period of 6 months. The best corrected visual acuity (BCVA), central macular thickness (CMT), and subfoveal choroidal thickness (SFCT) were observed.

Results

SML group showed significantly greater improvement in the BCVA (logMAR) compared to observation group at 1 month (0.20 ± 0.10 vs 0.30 ± 0.12, P < 0.01), 3 months (0.13 ± 0.06 vs 0.21 ± 0.06, P < 0.01) and 6 months (0.01 ± 0.06 vs 0.09 ± 0.66, P < 0.01). The CMT reduction was significantly greater in the SML group at 1 month (337.19 ± 62.96 µm vs 395.11 ± 91.30 µm, P < 0.05), 3 months (312.94 ± 49.50 µm vs 364.50 ± 70.30 µm, P < 0.05) and 6 months (291.38 ± 26.46 µm vs 348.56 ± 54.65 µm, P < 0.05). In the SML group, the SFCT did not show a significant decrease at 1 month (468.88 ± 42.19 µm, P > 0.05) but showed a significant reduction at 3 months (451.75 ± 39.36 µm, P < 0.05) and 6 months (450.50 ± 34.24 µm, P < 0.05) from baseline (489.94 ± 45.86 µm). In the observation group, there was no significant change in SFCF during follow-up. No adverse events occurred in the SML group.

Conclusions

Although some patients with acute CSC show spontaneous healing, timely intervention with 577 nm SML can shorten the disease course, improve visual acuity, and reduce the risk of chronic transformation without adverse events.
Oral health and dental caries experience among students aged 7–15 years old with autism spectrum disorders in Tehran, Iran
Authors: Piraneh Hedieh , Gholami Mahdia , Sargeran Katayoun , Shamshiri Ahmad Reza
Published: March 2022

Background

Autism spectrum disorders (ASD) are a set of developmental, psychological, and neurological disorders that occur in early childhood. The most important characteristic of individuals with autism is difficulty in social interactions and communication. Researchers in the field of oral health have not paid enough attention to these individuals due to their specific behavioral characteristics. Therefore, due to the limitations of the studies in this field in Iran, increasing prevalence of autism, and importance of oral health in people with ASD, this study was conducted to evaluate the oral health status of primary school students with autism (7–15 years old) in autism schools in Tehran.

Methods

Students from seven governmental special primary schools in Tehran were selected for this study. Data about oral health behavior and the presence of each of the seven barriers of tooth brushing task was collected via questionnaires completed by parents. During the dental examination, the cooperation level according to the Frankle Index, oral hygiene status according to the Simplified Oral Hygiene Index, and caries experience (DMFT) of the students were recorded by a calibrated dentist. A psychologist assessed the level of ASD using the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM5). Data analysis including descriptive and regression analysis was done using the SPSS software version 24.

Results

Two hundred and seventeen students aged 7–15 years participated in this study, of whom 65.4% brushed their teeth once or more every day, 85.7% had sugary snacks twice or less per day, 73.7% used fluoridated tooth paste, and 80% brushed their teeth with parents’ help. The most common barrier to tooth brushing was difficulty in brushing (51.6%). The cooperation level was definitely positive in 46.1%. The mean Simplified Oral Hygiene Index (OHI-S) and caries experience (DMFT) scores were 1.92 ± 0.55 and 2.36 ± 2.38, respectively.

Conclusion

The clinical indices of OHI-S and caries experience (DMFT) were used to evaluate the oral health status in the students with ASD in Tehran, Iran. A better oral hygiene status was related to higher brushing frequency and lower sweet snack consumption. The findings of the present study indicate that educational interventions regarding oral hygiene and healthy diet may improve oral self-care in individuals with ASD.
Bidirectional association between knee osteoarthritis and depressive symptoms: evidence from a nationwide population-based cohort
Authors: Lu Han , Wang Limin , Zhou Weijiao , Jin Shida , Chen Hongbo , Su Yi , Li Nan , Shang Shaomei
Published: March 2022

Background

Both knee osteoarthritis (KOA) and depressive symptoms (DS) are major public health issues affecting the quality of life. This study aimed to examine the association between KOA and DS.

Methods

Data were gathered from the China Health and Retirement Longitudinal Study in 2011–2015 which surveyed middle-aged to elderly individuals and their spouses in 28 provinces in China. An adjusted Cox proportional hazards regression model was used to estimate hazard ratios (HRs).

Results

The analysis for baseline KOA and the subsequent risk of DS was based on 2582 participants without baseline DS. During the follow-up, KOA patients were more likely to have DS than non-KOA participants (adjusted HR = 1.38: 95% CI = 1.23 to 1.83). The analysis for baseline DS and the subsequent risk of KOA was based on 4293 participants without baseline KOA, those with DS were more likely to develop KOA than non-DS participants (adjusted HR = 1.51: 95% CI = 1.26 to 1.81). Subgroup analysis showed sex and age had no significant moderating effect on the KOA-DS association.

Conclusions

Our results provide evidence that the association between KOA and DS is bidirectional. Therefore, primary prevention and management of KOA and DS should consider this relationship.
Reconstruction of the anatomy of the hip in total hip arthroplasty with two different kinds of stems
Authors: Fink Bernd , Morgan Mohamed , Schuster Philipp
Published: March 2022

Background

The reconstruction of the individual anatomy is important in total hip replacement. The aim of the study was to compare two different kinds of stems with respect to the reconstruction of the individual anatomy of the hip.

Methods

We compared the restoration of the anatomical parameters (horizontal and vertical offset, femoral neck-shaft angle (NSA) and leg length) of 100 unilateral CoreHip (CH) implantations with 100 unilateral implantations of a standard anatomical stem (Exception (E)). The CoreHip has three different NSAs and exhibits a constant femoral neck length for the different sizes. The Exception stem has a standard and lateralized version with two different NSAs and, in both versions, the femoral neck length increases proportionately with size. The anatomical parameters of the operated and healthy sides were measured and the differences between the two stems compared.

Results

The horizontal (2.5 ± 2.8 mm (mean ± SD) for CH vs. 5.4 ± 4.1 mm for E, p < 0.001) and vertical offset (4.1 ± 3.5 mm for CH vs. 5.0 ± 3.8 mm, p = 0.024) and femoral neck-shaft-angle (1.7 ± 1.6 degrees for CH vs. 5.6 ± 3.4 degrees for E, p < 0.001) could be reconstructed significantly better with the CoreHip system. There was a tendency for the leg length (4.0 ± 3.9 mm for CH vs. 4.5 ± 3.8 mm; p = 0.11) to be better restored with the CoreHip.

Conclusion

The reconstruction of the individual anatomy of the hip with an endoprosthesis could be realized significantly better with the stem that was designed with three different femoral neck-shaft angles and a constant femoral neck length over different sizes.
Antibiotic artificial bone implantation and external fixation for the treatment of infection after intramedullary nail fixation: a retrospective study of 33 cases
Authors: Hua Haotian , Zhang Lei , Guo Zairan , Zhong Wenlong , Chen Jiangfei , Wang Shilin , Guo Jiangang , Wang Xinwei
Published: March 2022

Objective

To explore the clinical effect of antibiotic artificial bone implantation and external fixation in the treatment of infection after intramedullary nail fixation.

Methods

We retrospectively reviewed the clinical data of patients with infection after intramedullary nail fixation treated from March 2010 to August 2020. There were 27 males and 6 female, aged from 12 to 67 years (average 42.27 years), 18 cases on the left side and 15 cases on the right side. Among them, 20 cases were open fractures with initial injury and 13 cases were closed fractures. All patients were treated with intramedullary nail removal, local debridement, antibiotic artificial bone implantation and external fixation. Because of bone defects, 19 patients underwent secondary autologous cancellous bone grafting after infection control. Postoperative wound healing, related inflammatory indicators, fixation time, and bone healing time were recorded and followed up.

Results

The 33 patients were followed up with period of 10 ~ 98 months (average 62.7 months). One patients failed to control the infection effectively after treatment, so received antibiotics artificial bone implantation again. Two patients also received antibiotic artificial bone implants again due to the recurrence of the infection. After treatment, infection was controlled and the fracture healed well. One patient received vacuum sealing drainage (VSD) due to persistent postoperative exudation, and five patients were also cured successfully after continuous dressing. Two patients had sinus tract after surgery, and the wound was cured by continuous dressing change. Nineteen patients received autogenous iliac bone grafts for healing due to bone defects ranging from 3 to 6.5 cm (average 4.15 cm) after infection control. The external fixation time of 33 patients ranged from 4 to 16 months (average 7.79 months), the bone healing time ranged from 4 to 13 months (average 6.67 months), and the related inflammatory indexes returned to normal within 2–8 weeks (average 4.48 weeks).

Conclusion

Antibiotic artificial bone implantation and external fixation is an effective method for the treatment of infection after intramedullary nail fixation.
A meta-analysis of peer-assisted learning on examination performance in clinical knowledge and skills education
Authors: Zhang Yanrui , Maconochie Mark
Published: March 2022

Background

Peer-assisted learning is a method of active learning that is gaining traction throughout higher education. In the medical curriculum, peer-assisted learning has been the subject of independent studies collecting various types of data. However, an overall analysis of those studies providing objective measurements of the influence of peer-assisted learning could be particularly useful for teachers and students alike in a knowledge-heavy curriculum such as medicine. In this study we set out to analyse the efficacy of peer-assisted learning on medical students’ learning of clinical knowledge and skills that is assessed through some objective examination, and thereby define whether such approaches have a reproducible benefit for inclusion in the medical curriculum.

Methods

Databases including Pubmed, Embase and Science Direct were searched for relevant studies containing randomized controlled trials (RCTs) of peer-assisted learning published before July 29th ,2020. A meta-analysis was performed by using RevMan 5.3 software.

Results

Thirteen studies involving 2,003 medical students were analyzed for clinical knowledge and skills gains that included some objective measurement of learning. The results of this meta-analysis indicated that considering all these studies together, peer-assisted learning leads to improvements in clinical knowledge and skills learning for medical students compared with traditional teacher-led passive learning. One study was found likely to be a source of significant heterogeneity, and when this was removed from the meta-analysis, the pooled effect was no longer statistically significant.

Conclusions

Peer-assisted learning can be an effective method of learning applied to medical student education. Active learning through peer-assisted learning should be seen as complementary to teacher-led approaches. Two of the individual studies on peer-assisted learning show a statistically significant benefit on examination performance compared to the other studies considered, that either show negligible benefits or at worst no detriment in learning. This highlights the need for more high-quality and focused randomized control trials to identify those critical parameters that lead to improved student learning using such approaches.