bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcomes and Complications of Oblique Lateral Interbody Fusion as a Surgical Option in Elderly Patients (Over 70 Years Old) with Degenerative Spinal Disease
Authors: Lee Yong Min , Son Dong Wuk , Oh Bu Kwang , Lee Su Hung , Lee Jun Seok , Kim Young Ha , Sung Soon Ki , Lee Sang Weon , Song Geun Sung
Published: October 2023

Objective: As Korea has become a super-aging society, the number of elderly patients with degenerative spinal disease has steadily increased. This study aimed to evaluate the usefulness of oblique lumbar interbody fusion (OLIF) by comparing the results and complications between OLIF and open spinal fusion in elderly patients with degenerative spinal disease.Methods: Thirty-one patients underwent one-level posterior lumbar interbody fusion (PLIF), and 35 patients underwent one-level indirect decompression OLIF. The clinical outcomes of the two patient groups were analyzed using the visual analog scale (VAS) and Oswestry Disability Index (ODI). Through a comparative analysis of pre- and post-operative images, we measured changes in disc height (DH) and foraminal height (FH), and investigated the occurrence of subsidence in each patient group. The cross-sectional area was measured using magnetic resonance imaging pre- and post-operatively in OLIF.Results: The pre-operative VAS and ODI scores were similar between the two groups and tended to improve post-operatively. In the OLIF group, the estimated blood loss (EBL) was significantly lower, DH and FH gains were more frequent, DH and FH maintenance was better, and cage subsidence occurred less frequently. In OLIF, psoas paresis and approach-site hematoma occurred; however, all patients with psoas paresis recovered without further treatment before discharge. In the PLIF group, dural tears occurred in four patients who recovered without revision surgery. Conclusion: OLIF enables indirect decompression, reduced EBL, shorter hospitalization, and lesser subsidence. OLIF is considered a beneficial, minimally invasive surgical method for elderly patients.
Schwann cells-derived exosomes facilitate revascularization via regulating endothelial metabolic reprogramming after peripheral nerve injury.
Authors: Sun Jun , Sun Jun , Wu Zhimin , Liao Zhi , Gao Qun , Li Zhangyu , Li Hao , Ling Cong , Chen Chuan , Wang Hui
Published: October 2023

Vascular reconstruction is indispensable for the regenerative microenvironment after peripheral nerve injury (PNI), while the intrinsic mechanisms remain unclear. Our study found a novel function of Schwann cell facilitating intraneural revascularization and a novel mechanism of miR-21-5p regulating energy metabolism of endothelia cells (ECs) in favor of glycolysis, and determines an important link among exosome, metabolism, angiogenesis, and nerve repair after peripheral nerve injury. Hypoxia-upregulated miR-21-5p in Schwann cells-derived exosomes targets von Hippel-Lindau/Hypoxia-inducible factor-1α (VHL/HIF-1α) pathway and pyruvate dehydrogenase-E1α subunit (PDH-E1α) at once to further skew ECs’ energy metabolism to glycolysis. Interestingly, HIF-1α inactivated PDH-E1α by activating PDK1 to restrain ECs’ oxidative phosphorylation (OXPHOS) finally enhancing glycolysis. Thus, the modulation of ECs’energic metabolism by SCs-Exos-derived miR-21-5p is crucial for intraneural revascularization and nerve regeneration in response to injury.
Evaluation of Developmental Toxicity and Oxidative Stress Caused by Zinc Oxide Nanoparticles in Zebra fish Embryos/ Larvae
Authors: Uvarajan Deenathayalan , Ravichandran Nandita , Krishnamoorthy Kavithaa , Subramaniyan Kavithaa Vengamuthu , Chandramohan Govindasamy , S. Al-Numair Khalid , A. Alsaif Mohammed , Pil Cheon Yong , Narayanasamy Arul , Durairaj Brindha
Published: October 2023

Zinc oxide nanoparticles (ZnO NPs) are used in various fields, including biological ones. ZnO NPs are eventually disposed of in the environment where they may affect natural systems, and there is no international law to regulate their manufacture, usage, and disposal. Hence, this present study is carried out to synthesize a more non-toxic and bioactive ZnO NPs from the marine algae Sargassum polycystum. The ZnO NPs were biologically produced using the marine algae Sargassum polycystum. The Dynamic light scattering result describes that synthesized particles average size about 100nm in diameter Transmission electron microscopy (TEM) analysis demonstrated the rod like morphology of ZnO NPs. Fourier transmission infrared spectroscopy (FT-IR) results revealed the presence of functional groups in ZnO NPs. The selected area electron diffraction (SAED) results strongly suggested the ZnO NPs crystallinity. ZnO NPs surface morphology and compositions were identified by scanning electron microscopy (SEM- EDX) values. To analyse the toxicity of synthesized nanoparticles zebra fish larvae were used, which involved subjecting embryos to various ZnO NPs concentrations at 1 hpf and analysing the results at 96 hpf. The 60 and 80 ppm sub-lethal doses were chosen for further studies based on the LC50 (82.23 ppm). In the ZnO NPs treated groups, a significant slowdown in pulse rate and a delay in hatching were seen, both of which impacted the embryonic processes. A teratogenic study revealed a dose-dependent increase in the incidence of developmental deformities in the treated groups. Along with increased oxidants and a corresponding reduction in antioxidant enzymes, Na+ K+-ATPase and AChE activity changes were seen in ZnO NPs treated zebra fish larvae groups. The apoptosis process was increased in ZnO NPs treated groups revealed by acridine orange staining. These results indicate that the green synthesis process cannot mitigate the oxidative stress induced by ZnO NPs on oxidative signalling.
Acute Kidney Injury in Critically Ill Older Adults: Baseline Estimated Glomerular Filtration Rate and Its Association With In-Hospital Mortality
Authors: Nascimento Ginivaldo Victor Ribeiro do , Teixeira Maria Clara Lopes , de Jesus Kezia França , Soares Isabella Melo , de Araújo Ludmila Carvalho
Published: October 2023

Background: The diagnosis and treatment of Acute Kidney Injury (AKI) rely on recognizing elevated serum creatinine levels as the indicator for suspicion. However, in older adults, lower baseline creatinine levels can hinder the diagnosis, as it may falsely appear normal even in the presence of established AKI. To mitigate this issue, the use of age-validated estimated glomerular filtration rate (eGFR) can enhance the timeliness of interventions.
Methods: This study aimed to analyze the baseline eGFR, before the confirmation of AKI, using the Berlin Initiative Study (BIS)-creatinine and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations in older adults who developed AKI after admission to the ICU and its association with mortality.
Results: A total of 36 patients, who developed AKI after ICU admission were included. Women were 66.7% and average age of 71.67 years. All patients required mechanical ventilation support, and 91.7% required vasopressors. Initial serum creatinine levels appeared normal (0.87 ± 0.22 mg/dL), but eGFR values indicated reduced renal function, particularly using BIS-creatinine (33% vs 18.2%, CKD-EPI). Mortality was 88.9%, and in the multivariate analysis, the associated factors were age (odds ratio [OR] 1.2, 95% confidence interval [CI]: 1.07-1.5, p = 0.049), persistent AKI (OR 16.20, 95% CI: 2.38-48.88, p = 0.026) and baseline BIS-creatinine value < 60 mL/min/1.73 m² (OR 1.19, 95% CI: 1.07-4.79, p = 0.048).
Conclusion: monitoring renal function through eGFR calculation, particularly BIS-creatinine, is important for detecting patients at risk of AKI and contributes to the timely management of AKI in older adult ICU patients.
Sublingual immunotherapy for allergy to crustaceans: the nine-year clinical experience of a Midwest Allergy-Immunology practice.
Authors: Theodoropoulou Lydia Maria , Cullen Niamh A.
Published: October 2023

Background

Diet restrictions and fear of adverse reactions put a significant burden on the nutrition, growth and life styles of children and adults with food allergies. Desensitization to crustaceans by means of sublingual immunotherapy was assessed for efficacy and safety with a view of validating it as a disease-modifying modality. Allergy to crustaceans was chosen as a working model because of its well-defined immunological and clinical features.

Methods

Charts of a Midwest Allergy-Immunology practice from the period January 2014 – June 2023 were reviewed to identify patients with allergy to crustaceans treated with sublingual immunotherapy and to retrospectively evaluate their responses to oral challenge.

Results

Sixty-six patients were identified who had been treated by sublingual immunotherapy for either systemic or localized reactions to crustaceans. Demographics and relevant comorbidities were consistent with those of the atopic population. Sublingual immunotherapy with serially diluted mixtures was initiated at 6.4 - 160 ng/dose and was gradually escalated over a period of 5 – 48 months to 0.5 mg/dose three times a day. The sublingual immunotherapy course ranged from 5 to 72 months (average: 51 months), following which, eighteen patients underwent shrimp oral challenge.
No systemic reactions occurred upon challenge; no patient required epinephrine. Tolerance of target dose equal to or exceeding 42 g shrimp was achieved in 11 patients (61%), seven of whom had originally presented with systemic reactions to crustaceans.
Seven patients (38%) developed one or more of the following localized reactions: oral itching, nasal symptoms, localized perioral hives, localized hives at pressure points, nausea, vomiting, abdominal pain upon exposure to a cumulative dose of 39.2-148.2 g of shrimp during the 4 hours of the challenge. Five of these patients had originally presented with systemic reactions to crustaceans.
Five of the 7 patients who developed localized symptoms during the challenge were subsequently placed on routine exposure to 12-20 g shrimp every other day. Two patients continued sublingual immunotherapy but declined routine exposure to shrimp every other day because they had no intention to incorporate crustaceans to their routine diet. On repeat challenge 6-9 months after original challenge, all five patients who had routine exposure to 12-20 g shrimp every other day tolerated the procedure to target dose without any symptoms.

Conclusions

Desensitization to crustaceans by sublingual immunotherapy appears to be safe and effective. Whether the immune modification induced by sublingual immunotherapy is permanent resulting in sustained tolerance, or the achieved degree of desensitization depends on regular exposure is not known; therefore, following challenge, regular consumption three-four times per week was recommended.
The CCL2/CCR2 axis is related to primary non-response to infliximab therapy in patients with Crohn’s disease
Authors: Yongheng Wang , Weigang Shu , Mengfan Chen , Wang Xiaolei
Published: October 2023

Background: Nearly 30% of patients with Crohn's disease (CD) are primary non-response (PNR) to anti-tumor necrosis factor-α (TNF-α) therapy, however, the mechanisms still remain unclear. TNF-α is mainly secreted by macrophages which recruited by the CCL2/CCR2 axis. We inferred that PNR to infliximab may be correlated with the CCL2/CCR2 axis.
Methods: The dataset "GSE52746" including 19 responders and 17 PNR to infliximab was downloaded from Gene Expression Omnibus. The gene expressions were identified by differential gene analysis (DGA) between the two groups. Immune infiltration analysis and functional enrichment were used to determine the differential pathways. The CCL2 and CCR2 mRNA expressions were detected by quantitative PCR in the intestinal biopsy specimens from 11 responders and 13 PNR patients. The numbers of CD68+ macrophages in intestinal mucosa were determined by immunohistochemistry (IHC) staining.
Results: DGA identified 1395 up-regulated and 308 down-regulated genes in the primary non-responders. Compared with the responders, CCL2 and CCR2 expression were significantly upregulated, accompanied by the larger amount of immune cells accumulated in the intestinal mucosa (P<0.05). The signaling pathways related to immune cell migration were markedly enriched in the patients of PNR to infliximab (P<0.05). The significantly higher expressions of CCL2 mRNA (P<0.0001) and CCR2 mRNA (P=0.0072) were validated in the intestinal mucosa from 11 non-responders compared with that from 13 responders. Correspondingly, the numbers of CD68+ macrophages were significantly accumulated in the mucosal tissue of non-responders (P=0.006).
Conclusion: The enhanced CCL2/CCR2 axis recruited by accumulated macrophages in inflammatory intestinal mucosa is closely related with PNR to infliximab in CD patients. Our results provide a potential mechanism on anti-TNF treatment failure.
Effects of transcutaneous electrical acupoint stimulation on postoperative pulmonary complications in video‑assisted thoracic surgical lobectomy: a randomized controlled study
Authors: Jiang MengWei , Zhu JingWen , Wang HongFa , Wang JunLu
Published: October 2023

Background
Recent studies report that transcutaneous electrical acupoint stimulation (TEAS), a non-invasive and non-pharmacological adjunctive for perioperative rehabilitation, may improve respiratory function and reduce the incidence of postoperative pulmonary complications in patients undergoing video-assisted thoracic surgery (VATS).We studied the hypothesis that TEAS may improve inflammatory reaction,Oxygenation and post operative pulmonary complications(PPCs) in patients undergoing VATS lobectomy.
Methods
Data from 130 patients undergoing VATS lobectomy were analysed.All patients were randomized to two groups (TEAS group and Control group),and were managed using the same anaesthetic protocol.TEAS were performed from 30min before induction and during the operation at 2/100 Hz over acupoints Lieque and Hegu on the both side.Veinal blood was drawn for blood routine examination to count quantity of Neutrophil, Platelet and Lymphocyte and then to calculate two inflammatory indicators PLR and NLR at 5 time points.Mixed venous and arterial blood was drawn for measurement of shunt-fraction and dead-space at 3 time points.PPCs(following the ARISCAT study) during postoperative hospitalization were recorded.
Results
Among 130 patients,respiratory infection and pleural effusion were the most common complications.PPCs were less detected in TEAS group than Control group (12.5% vs. 27.3%, OR 2.44 [95% CI, 0.285–0.010]. At T2(Two Lung Ventilation after intubation 5 min),dead-space,and shunt-fraction were no difference between two groups,with the prolonged operation,TEAS group showed obvious advantages after acupoint stimulation,lower dead-space and shunt-fraction were detected in TEAS group(P < 0.001).NLR was lower in TEAS group,the difference was significant at T4(end of One Lung Ventilation,P＜0.001) and T5(first day after operation,P＜0.001),while PLR in there was difference at T5(P = 0.015).Furthermore,binary logistic regression model was built to analyses the correlation between PLR,NLR with PPCs respectively.Result shows PLR and NLR were meaningful in predicting postoperative lung complications as a risk factor.
Conclusions
The effect of TEAS during VATS lobectomy reduces the incidence of the PPCs recorded,attenuates the systemic inflammatory response and improve intraoperative oxygenation.PLR and NLR could be used as a risk factor to predict PPCs.
Evidence-Based Egyptian Clinical Practice Guidelines for the Prevention and Management of Iron Deficiency and Iron Deficiency Anemia in Infants, Children and Adolescents
Authors: Mokhtar Galila , Youssef Ahmed , Baky Ashraf Abdel , khashab Ehab Khairy El , Raafat Enas , Youssry Ilham , Ragab Iman , Sherief Laila , Fathy Manar Mohamed , Hesham Mervat Abdallah , Salah Nouran Yousef , Afifi Rasha AbdelRaouf AbdelAziz , Shalaby Sherein Abdelhamid , Habib Sonia Adolf , Omar Tarek , Gendy Yasmin Gamal El
Published: October 2023

Background: Iron deficiency (ID) is the most common nutritional disorder affecting all age groups. Infants and young children are vulnerable to anemia especially iron deficiency anemia (IDA), which represents a public health problem with defined impacts on the health of communities. IDA, however, is a preventable and treatable condition; therefore, early diagnosis represents the cornerstone in protection from its adverse consequences and combating its contributing factors. Several international guidelines for the management of ID/IDA are available, however national guidelines that can be implemented and suits our local needs are lacking.
Objective: To adapt the pre-existing high-quality practice guidelines for the screening, prevention and management of ID/IDA in different pediatric age groups, to be available for the national use by general practitioners, pediatricians, and other health care professionals.
Results:
The adaptation group for this guideline included key leaders from different Egyptian institutions. The panel used the ADAPTE methodology for adaptation of guidelines. The panel prioritized the health questions and recommendations according to their importance for clinicians and patients. The procedure included searching for existing guidelines, quality appraisal, and adaptation of the recommendations to the target context of use. The guideline covered all important aspects of detection, identification of infants, children, and adolescents at high risk of developing ID/IDA, proper management, and prevention. The final version of the adapted clinical practice guideline (CPG) has been made after thorough review of an external review panel and was guided by their official recommendations and modifications. Implementation tools included algorithms, tables, and flow charts to aid decision making in practice, as well as patient-directed information in the Arabic language.
Conclusions: This adapted guideline serves as a tool for the screening, prevention and management of ID/IDA in different pediatric age groups.
Standardized Nomenclature for Legal Prompting in Generative Language Models
Authors: Sivakumar Aditya , Gelman Ben , Simmons Robert , Yu Edward , Sharp Mackenzie
Published: October 2023

With the increasing availability of commercial Artificial Intelligence, General Language Models (GLMs) have been widely explored in various domains, including law. However, to ensure accurate and standardized legal results, it is crucial to establish a consistent framework for prompting GLMs. This paper presents one of the first instances of such nomenclature, providing a robust framework of “variables” and “clauses” that enhances legal-focused results. The proposed framework was applied in diverse legal scenarios, demonstrating its potential from both client and attorney perspectives. By introducing standardized variables and clauses, legal professionals can effectively communicate with GLMs. This not only improves the accuracy of the generated outcomes but also facilitates collaboration between AI systems and legal experts. With a common framework in place, legal practitioners can leverage AI technology confidently, knowing that the results produced align with established legal principles. Furthermore, the framework serves as a foundation for future research in the field of legal prompting with GLMs, and several avenues for future research are recommended in this paper. This standardization of nomenclature is expected to contribute to the wider adoption and benefit of GLMs in the legal field, leading to more accurate and reliable outcomes.
Social Isolation and the Risk of Parkinson Disease: the UK Biobank Study
Authors: Geng Tingting , Li Yaqi , Peng Yinshun , Chen Xiao , Xu Xinming , Wang Jian , Sun Liang , Gao Xiang
Published: October 2023

Background
Parkinson disease (PD) has become one of the most rapidly growing causes of disability among the older population and social isolation is a major concern in the PD community. However, the relationship between social isolation and future risk of PD remains unclear.
Methods
This study included 192,340 participants aged 60 or older who were free of dementia and PD at baseline from the UK Biobank study. Social isolation was measured using a composite score derived from three questions on number in household, frequency of friend/family visits, and leisure/social activities. Incident PD cases were identified through electronic health records. Multivariable-adjusted Cox regression models were used to compute the hazard ratio (HR) and 95% confidence interval (CI).
Results
Among the 192,340 participants (mean [standard deviation] age, 64.2 [2.9] years; 103,253 [53.7%] women), 89,075 (46.3%) participants were in the least isolated group and 26,161 (13.6%) were in the most isolated group. Over a median follow-up of 12.5 years, 2048 incident PD cases were documented. Compared to the least isolated group, the multivariable-adjusted HRs (95% CIs) for PD were 1.00 (0.91–1.10) for the moderately isolated group and 1.19 (1.05–1.36) for the most isolated group (P-trend=0.04). The observed association was independent of the genetic susceptibility to PD and consistent in subgroup analyses.
Conclusions
Social isolation was associated with a higher risk of PD regardless of genetic risk. Our findings highlighted the importance of developing screening and intervention strategies for social isolation among older adults to reduce the risk of PD.
Baricitinib improves the efficacy of nintedanib for the treatment of idiopathic pulmonary fibrosis
Authors: Wan Qin , Li Dongdong , Shang Shu , Wu Haifeng , Chen Faxiu , Li Qiugen
Published: October 2023

Background:Nintedanib has been approved to treat idiopathic pulmonary fibrosis (IPF) but with limited efficacy, while targeting Janus Kinases (JAK)/ Transducer and signal activator of transcription (STAT) has emerged as a feasible strategy in this disease recently. However, the therapeutic potential of intervening in both pathways is rarely defined, prompting us to investigate combinatory effects in preclinical studies.Methods:We evaluated both thein vitroandin vivoefficacy of a drug combination, nintedanib with baricitinb, a JAK1/JAK2 inhibitor. We first examined the cell viability of single agents or combinations by the MTT assay. Then we determined the migration of the fibroblasts by a wound healing assay. Meanwhile, we quantified the protein level of related growth factor or cytokines in the cell supernatant by ELISA. We finally investigated the therapeutic potential in a bleomycin-induced mouse model.Results:Our results showed that nintedanib reduced cell viability with a mild effect in both the fibroblast cell line and the fibroblast of a patient with IPF stimulated by TGF-β or IL-6, while increasing its ability to reduce cell viability when combined with baricitinib. Nintedanib was also found to slightly reduce fibroblast migration but dramatically increase efficacy when baricitinib was added. This combinatory effect was also observed by downregulating IL-6 and TGF-β and upregulating IL-10 and IL-13 in MLE12 cells pretreated with bleomycin. In the bleomycin-induced IPF mouse model, the combination therapy increased survival rate and body weight, and reduced lung/body weight ratio compared with single agents, which moderately improved these features, respectively. In addition, both drugs improved lung functions in mice but achieved higher performance when administered together. Furthermore, histopathological improvements were also found among drug treatments, in which the combination attenuated more pulmonary inflammation and fibrosis than the single compounds. Mechanically, baricitinib orchestrated nintedanib in IPF by regulating gene expressions such asil-6,tgf-β,col1α1andfibronectin.Conclusions:Baricitinib improves the efficacy of nintedanib by co-targeting the JAK / STAT pathway, suggesting that the drug combination can be used to therapeutically treat IPF patients.
Effects of Ripening Conditions on the Functional properties, Nutritive values and Oxalate compositions of plantain (Musa paradisiaca) flour
Authors: Oladeji Babatunde Stephen , Effa Emmanuel Bassey , Odama Love Ebenyin
Published: October 2023

Ripening in plantain results in various modifications of its chemical compositions. The objective of this project was to determine the effects of various ripening conditions on the functional properties, nutritive and oxalate composition of the plantain samples. Matured plantain was harvested and the fingers were divided into six portions coded as RP1- RP5 and UPc of five fingers in each group. RP1 was left on shelf, RP2 was wrapped in foil, RP3 was immersed in water, RP4 was immersed in 5% salt solution and RP5 was immersed in 6% salt solution to ripe while UPc was analyzed unripe as the control. The samples (RP1-RP5) were monitored as they underwent ripening and were prepared into flour upon ripening. Ripe plantain were dried in hot air oven and milled to flour similar to the unripe sample. The proximate, oxalate and mineral (Ca, Fe, Mg, P, K, and Na) compositions of the samples as well as their functional properties were determined. From the protein content values ranged from 2.19 to 6.65% and increased by ripening. The oxalate content values ranged from 11.34 to 36.06mg/100g with a significant reduction due to ripening (p ≤ 0.05). The water absorption capacity values ranged from 1.47 to 2.33g/ml. The calcium content values ranged from 1.17 to 9.05ppm. In conclusion, RP1 (plantain left on the shelf to ripe) was the best in terms of increased nutrient, reduced oxalate composition and better functional properties.
Comparing Flourishing training with Transactional Analysis training Regarding their Effectiveness on Students’ Career Path Optimism and Readiness for Transition from University to the Labor Market
Authors: Rouhafza Omid
Published: October 2023

Background and purpose: common point of view states that students should be prepared to face the world of work in a continuous plan. The purpose of this research was to compare Flourishing training with Transactional Analysis (TA) training regarding their effectiveness on career path optimism and students' readiness for transition from university to the labor market.
Method: The research is semi-experimental with a pretest, post-test design among a control group. The statistical population consisted of final-year undergraduates at Azad University of Gorgan, Iran, in the academic year 2022-2023. 45 people were selected from among the final-year undergraduates using the available sampling method and randomly assigned to two experimental groups and a control group. Experimental Group 1 was subjected to flourishing training, experimental Group 2 was subjected to transactional analysis training, and the control group did not receive any intervention. The research tool was Rottinghaus et al.'s career path optimism questionnaire (2005) and Sadeghi et al.'s (2017) readiness to transition from university to the labor market questionnaire. The research data was analyzed through multivariate analysis of covariance using statistical software SPSS version 26.
Findings: The results showed that both flourishing training and transactional analysis are effective in increasing career path optimism and preparation for the transition from university to the labor market (p<0.05). There was a significant difference in terms of effectiveness; In such a way, flourishing training was more effective in increasing the optimism of the career path and preparation for the transition from the university to the labor market.
Conclusion: The results indicate that flourishing training by strengthening the sense of competence, self-management, self-awareness, positive perception of qualifications, and creating optimism, constantly improves the path to success in transition from university to work.
Exploring Biotechnological Insights into the Variability of Seed Germination in Platanus orientalis L. within the Kashmir Himalayas
Authors: WAGAY OYAIS , Raj Anup
Published: October 2023

Platanus orientalis, commonly known as the Oriental plane tree, is a widely distributed and ecologically significant species with valuable insights for conservation practitioners, foresters, and plant breeders. Understanding the variability in seed germination within half-sib families is crucial for effective breeding programs, conservation efforts, and propagation techniques. This research paper investigates the patterns of seed germination variability in half-sib families of Platanus orientalis. Seeds from multiple half-sib families of Platanus orientalis were collected from a diverse range of parental trees across a natural population. The germination experiment was conducted under controlled environmental conditions, including temperature, moisture, and light. Germination rates, time to germination, and other related parameters were recorded for each seed within the half-sib families. The results demonstrated significant variability in seed germination within the half-sib families of Platanus orientalis. Germination rates ranged from 27.19–40.48%, indicating substantial differences in the reproductive success of individual parental trees. The time to germination also exhibited a wide range, with some seeds germinating within a few days while others took several weeks. Our findings demonstrate substantial variability in seed germination within half-sib families of Platanus orientalis. The study highlights the importance of considering genetic factors and environmental conditions in understanding and managing seed germination in tree populations. This research contributes to a broader understanding of plant floral biology and provides valuable information for conservation and breeding programs focused on Platanus orientalis and related species.
Risk factors for anastomotic leakage in Low Anterior Resection with a Diverting stoma for rectal cancer: A case control study
Authors: Momose Hirotaka , Takahashi Makoto , Kawai Masaya , Sugimoto Kiichi , Honjo Kumpei , Okazawa Yu , Ishiyama Shun , Tomiki Yuichi , Sakamoto Kazuhiro
Published: October 2023

Background
In rectal cancer surgery, a diverting stoma (DS) is used to reduce anastomotic leakage (AL). However, there is still uncertainty whether use of a DS really avoids AL. In this study, we identified risk factors for AL coexisting with a DS to examine the usefulness of establishment of a DS.
Methods
The subjects were 143 patients with rectal cancer who underwent laparoscopic or robot-assisted low anterior resection with DS creation from January 2010 to May 2021. Patients and operative characteristics were examined using univariate and multivariate analyses to identify risk factors for AL.
Results
Of the 143 subjects, 30 (21%) had AL, including asymptomatic AL in 19 cases (13%) and AL requiring conservative therapy in 11 cases (8%). No case of AL required reoperation. In cases with asymptomatic AL, there was a defect in the anastomosis found by colonoscopy several days after operation before discharge. In univariate analysis, preoperative Glasgow prognostic score (GPS) ≥ 1 (p = 0.046) and number of stapler firings ≥ 3 (p = 0.002) were associated with AL. In multivariate analysis, only GPS ≥ 1 was significantly associated with increased AL (p = 0.033; odds ratio = 4.225; 95% confidence interval 1.122 to 15.905).
Conclusion
DS creation is effective in avoiding the need for reoperation for AL. Preoperative GPS ≥ 1 is a risk factor for AL in low anterior resection with a DS for rectal cancer.
Optical Coherence Tomography Angiography in Ocular Toxoplasmosis: Capillary Flow Density and Faz Analysis
Authors: Farci Roberta , Maurizio Fossarello , Arturo Carta
Published: October 2023

Purpose. To describe the clinical follow-up of an ocular toxoplasmosis (OT) retinitis by means of angio-OCT.
Materials and methods. A 28 years-old male patient underwent OCT-A at the baseline. The patient was treated with oral Bactrim (2 tablets twice daily) three consecutive daily intravenous bolus of 1000 mg solumedrol, followed by oral prednisolone 50 mg daily, topical steroids every 2 h, and mydriaticum. OCT-A was subsequently performed 4 weeks and one month after, respectively.
Results. At the baseline, an absence of decorrelation signal in correspondence of the scar and an increased decorrelation signal along the borders of the lesion were present; choroidal vesselsappeared congested and dilated and FAZ was disrupted. One month and two months later, choroidal vessels around the chorioretinal scar appeared constricted. FAZ area was increased and nonperfusion areas appeared to be reduced.
Conclusions. Angio-OCT could be an useful tool to understand vascular changes in OT clinical course.
The potential role of TP63 regulating ZC3H13-mediated HLA-A m6A methylation modification in HR-HPV persistent infection patients
Authors: Xu Shuiqing , Wang Ming , Xu Jianqing , Wu Yumei
Published: October 2023

Objective
The aim of this study is to investigate the short-term persistent HPV infection and natural prognosis in patients with IA1 cervical cancer after CKC, and to explore the mechanism of persistent HPV infection leading to cervical lesions based on database analysis.
Methods
This is a prospective observation cohort study which enrolled the stage IA1 patients who select to receive CKC as the treatment modality in a single center from January 24, 2018, to June 9, 2022. The primary outcome was the persistent infection status and remession rates within two years after the CKC. In addition, the relevant mechanism was explored based on database analysis. The Cancer Genome Atlas (TCGA) database is the source of RNA sequencing data of cervical cancer patients. The gene Expression omnibus (GEO) database was used as the validation set to verify the expression of TP63 mRNA in the process from normal cervical to precancerous lesions, and the difference of TP63 between cancerous lesions and paracarcinoma was verified by Western blot. The limma package of R software, Kaplan-Meier survival curve and Log-rank test were used to screen the genes related to m6A methylation modification affecting the prognosis of cervical cancer. spearman correlation analysis was used to verify the correlation between genes, and Timer2.0 immune database was used to analyze the correlation between the expression level of key genes and the level of immune infiltration. JASPAR and SRAMP open access databases were used to verify the relevant RNA sequence binding sites and m6A methylation modification sites.
Results
A total of 98 eligible patients were included and the main types of HPV was as following: HPV 16 (76.19%,64/84), HPV 58 (10.71%,9/84), HPV 33 (9.52%,8/84), and unknown type 14.28% (14/98). The HR-HPV negative rates of the whole cohort at 3, 6, 9, 12, 15, 18, 21, and 24 months after CKC were 76% (19/25), 80.95% (34/42), 76.47%(39/51), 76.92%(40/52), 75.93%(41/54), 76.36%(42/55), 75.44%(43/57), and 74.58% (44/59), which was stable within 2 years after surgery. Based on the database analysis, this study proposes the relevant mechanism hypothesis of HPV persistent infection and difficult to clear: TP63 acts on the promoter of ZC3H13 to induce its expression and promote the m6A methylation modification of HLA-A mRNA 3’UTR, which leads to the accelerated degradation of HLA-A mRNA and further inhibits the antigen presentation of HPV viral proteins, leading to HPV escape from CD8 + T cell killing.
Conclusion
The negative rate of HR-HPV remained stable within 2 years after the CKC.Standardized follow-up after conization is very important for patients with stage IA1 cervical cancer.This study elucidates the mechanism of TP63-ZC3H13-HLA-A axis and provides A therapeutic target for HPV clearance and prevention of recurrence in patients with stage IA cervical cancer after conization.
Early enteral nutrition may reduce the incidence of Refeeding Syndrome for severe COVID-19 patients with high nutritional risks
Authors: Xiao Liuniu , Ran Xiao , Li Shusheng
Published: October 2023

Background & aims: Nutrition therapy is an inevitable supportive intervention for COVID-19 patients with high nutritional risks. However, the suitable initiation time of nutrition still remains to be explored. The aim of this study is to determine the association between the enteral nutrition initiation and the incidence of refeeding syndrome for severe COVID-19 patients with high nutritional risks.
Method: We compared the different initiation times and observed their relationship with the incidence of Refeeding Syndrome (RS). We retrospectively collected data of 124 confirmed severe COVID-19 cases with ≥ 3 scores of Nutrition Risk Screen - 2002 who received Enteral Nutrition (EN) from January 1st to April 30th of 2020 in Tongji Hospital. Based on the initiation time, patients who received EN within two days after admission were classified into the early enteral nutrition (EEN) group, while the others were included in the late enteral nutrition (LEN) group. The serum levels of potassium, phosphorus, and magnesium were measured on the third day after EN to compare the incidence of RS between the two groups.
Results: Fifty-four (43.55%) patients were included in the EEN group, while 70 (56.45%) belonged to the LEN group. The mean time interval of EN was one day in EEN and seven days in LEN. The majority of laboratory markers were comparable between the two groups on admission. Three days after EN support, the levels of serum potassium, sodium, phosphorus, and magnesium were significantly lower, and the incidence, as well as the degree of RS, was significantly higher in the LEN group.
Conclusion: We conclude that early EN could be a reasonable mode to reduce the incidence of RS in severe COVID-19 patients with high nutritional risks.
Knowledge and Attitudes Regarding Family Planning Options in Armenia
Authors: Rostomian Lara , Kliethermes Christopher John , Hemmerling Anke
Published: October 2023

Objective: In many Transcaucasian and Middle Eastern populations, research in women’s sexual and reproductive health remains limited, especially in Armenia despite recent political and cultural changes. This study explores the current state of family planning in Armenia while both highlighting the recent progress and identifying current barriers to reproductive health.
Study Design: We conducted a mixed-methods study using both a quantitative survey and qualitative interviews with women and key informants in the field of women’s sexual and reproductive health.
Results: Armenian women are familiar with many types of contraception. The use of modern methods has increased but remains low. Sexual education for women is uncommon and often sought through independent online searches or books. We found no significant access barriers, however, a prevailing distrust in hormonal contraceptive methods left many women to rely on condoms and withdrawal. Although the majority of surveyed women (72%) believed having access to safe abortions was an important right, only 42% would consider having an abortion in the case of an unintended pregnancy. Interviewees highlighted the lack of sexual education, discrepancies in sexual and reproductive services between rural provinces and the urban capital city of Yerevan, as well as the need for information and the government’s responsibility in this field.
Conclusion: The lack of comprehensive sexual education in Armenia fuels misinformation regarding family planning options. One option we recommend is a government-funded sexual education program which begins as culturally sensitive, sex-positive education in schools and continues with counseling and support for women within the healthcare system.
Recovery of radiation induced defects via nanovoids in bulk pure Fe
Authors: Selim Farida , Granberg Fredric , Agarwal Sahil , Kaoumi Djamel , Cooper Jacob , Butterling Maik , Liedke Maciej , Hirschmann Eric , Baldwin Jon , Li Nan , Wang Yongqiang , Wagner Andreas , Uberuaga Blas
Published: October 2023

Enhancing radiation tolerance in materials is at the forefront of materials science. Grain and/or phase boundaries in nanocomposite, nanophase, and nanofoam materials have been shown to provide a promising route to enhancing radiation tolerance. Here, through a combination of positron annihilation spectroscopy, transmission electron microscopy, and computer simulation, we show that pre-existing voids in bulk single phase Fe without the incorporation of nanograins or nanotwins provide sinks for interstitials and vacancies and enhance self-healing of radiation induced defects. Atomistic simulations revealed that the interaction of collision cascades with preexisting voids transforms them into vacancy loops. At higher doses as they absorb vacancies, they regain their original size, an interesting mechanism that explains the experimental observations of voids shrinking, disappearing, then reappearing in their original form. This could lead to transient behavior delaying radiation damage to higher doses or cyclic behavior mitigating radiation damage.
Incidence of Cockroach Populations and Intestinal Pathogens in Different Food-Related Environments
Authors: Liu Jun , Yuan Yongting , Yu Siyu , Lin Chen , Ye Chuchu , Liu Jingyi , Li Huihui , Hao Lipeng , Liu Hanzhao
Published: October 2023

Cockroaches are considered mechanical transmitters of disease, especially in food-related environments, and may pose a risk to human health. This study assessed the potential of cockroaches in food-related environments to mechanically transmit intestinal pathogens. The captured cockroaches with trap were placed together in a low temperature refrigerator at -80 degrees for 2 hours. Standard taxonomic keys and Fluorescent quantitative PCR techniques was applied for species identification and etiological examination. A total of 360 cockroach traps were placed, and 75 of them caught cockroaches (20.83%). The cockroach capture rate in kitchens of catering places was higher than that in handling rooms and storage rooms (P < 0.01). The captured cockroaches were Blattella germanica and Periplaneta fuliginosa. The results showed that both the cockroach species composition and the number of nymphs and adults were significantly different among different types of places (P < 0.05). A total of 8 intestinal pathogens were detected, mainly intestinal viruses infection, sapovirus was the most detected. Shiga toxin-producing Escherichia coli was the most frequently isolated bacterium. Blastocystis hominis had the highest isolation rate. In contrast, 12 diarrhoeal disease pathogens were isolated, and the viruses and bacteria with the highest frequencies were norovirus and E. coli, respectively; no parasites were detected. B. germanica and P. fuliginosa in food-related environments can act as potential vectors for the transmission of intestinal pathogens and may pose a major threat to public health. Therefore, catering places need to strengthen and standardize environmental hygiene.
In vitro evidence of synergistic efficacy with asciminib combined with reduced dose of ATP-binding pocket tyrosine kinase inhibitors according to the ABL1 kinase domain mutation profile
Authors: Kim Jong-Won , Han Ho-Jae , Kim Jaeyoon , Pyne Danielle , Travas Anthea , Ambalavanan Amirthagowri , Kimura Shinya , Deininger Michael , Kim Dennis Dong Huan
Published: October 2023

Background
Asciminib (ASC), inhibiting ABL1 myristoyl pocket, has a different action mechanism from ATP-binding pocket inhibitors (ABPIs). We hypothesized that tyrosine kinase inhibitor (TKI) resistance mediated by ABL1 kinase domain mutation (KDM) can be reversed by combination of ASC with ABPI.
Methods
The efficacy and synergy of combination of ASC with ABPIs was evaluated in 11 different BaF3 cell lines including wild type (WT), G250E, E255K, T315A, M351T, F317L, F317V, H396P, Y253F, M244V, T315I mutant ones and WT K562 cell line.
Results
Combining fixed dose ASC with the reduced doses of ABPI was feasible to inhibit CML/WT cell lines completely. According to sensitivity to the combination of ABPIs with fixed dose ASC, ABL1 KDM cell lines are stratified into high (G250E, E255K, T315A), intermediate (M351T, F317L) or low sensitivity (F317V, H396P, Y253F, M244V and T315I). Reduced dose ABPI combined with fixed dose ASC showed similar efficacy to full dose ABPIs alone in high and intermediate sensitive cells. Ponatinib dose can be reduced to 25% when combined with ASC, but exerting similar efficacy to full dose ponatinib.
Conclusion
The present study provides in vitro evidence of the synergistic efficacy of the combination of ASC with reduced dose of ABPI including dasatinib/ponatinib.
Transplantation of stem cell spheroid-laden three-dimensional patches with bioadhesives for the treatment of myocardial infarction.
Authors: Jeon Hye Ran , Kang Jeon Il , Bhang Suk Ho , Park Kyung Min , Kim Dong-Ik
Published: October 2023

Background Myocardial infarction (MI) is treated with stem cell transplantation using various methods. However, current methods, such as stem cell/spheroids injection, cell sheets, and cardiac patches have some limitations, such as low stem cell engraftment and poor therapeutic effects. Furthermore, these methods cause secondary damage due to injection and suturing to immobilize them in the heart, inducing side effects. Methods We fabricated human adipose-derived stem cell spheroids-laden three-dimensional (3D)-printed patches. The morphology, viability, and paracrine angiogenic effect of spheroids formed within 3D patches were analyzed inin vitroexperiments. We synthesized thiolated gelatin and maleimide-conjugated gelatin as the polymers and fabricated a tissue adhesive biosealant using the polymers. The biocompatibility and biodegradability of the biosealant were evaluated using human dermal fibroblastsin vitroand the mouse subcutaneous modelsin vivo. In addition, the therapeutic effects of stem cell spheroid-laden 3D patches (S_3DP) with biosealant were evaluated using a rat MI modelin vivo. Results The spheroids showed increased viability and expression of angiogenic factors compared to two-dimensional cultured cells. Our gelatin-based tissue adhesive biosealants were rapidly formedviaa thiol-ene reaction and disulfide bond formation and revealed stronger tissue adhesiveness than commercial fibrin glue. Furthermore, we successfully applied S_3DP using a biosealant in a rat MI model without suturingin vivo, thereby improving cardiac function and reducing fibrosis of the heart. Conclusion We developed S_3DP with gelatin-based tissue adhesive biosealant to treat MI. This 3D patch has dual modules, such as open pockets to directly deliver the spheroids with their paracrine effects and closed pockets to improve the engraft rate by protecting the spheroid from harsh microenvironments. In summary, S_3DP and biosealant have excellent potential as advanced stem cell therapies with a sutureless approach to MI treatment.
Exposure and risk assessment for agricultural workers during chlorothalonil and flubendiamide treatments in pepper fields
Authors: Lee Deuk-Yeong , Song Jong-Wook , An Ji-Young , Kim Yeong-Jin , Seo Jong-Su , Kim Jong-Hwan
Published: October 2023

Pesticides are indispensable tools in modern agriculture for enhancing crop productivity. However, the inherent toxicity of pesticides raises significant concerns regarding human exposure, particularly among agricultural workers. This study investigated the exposure and associated risks of two commonly used pesticides in open-field pepper cultivation, i.e., chlorothalonil and flubendiamide, in the Republic of Korea. We used a comprehensive approach, encompassing dermal and inhalation exposure measurements in agricultural workers during two critical scenarios: mixing/loading and application. Results revealed that during mixing/loading, dermal exposure to chlorothalonil was 3.33 mg (0.0002% of the total active ingredient [a.i.]), while flubendiamide exposure amounted to 0.141 mg (0.0001% of the a.i.). Conversely, dermal exposure increased significantly during application to 648.96 mg (chlorothalonil) and 930.97 mg (flubendiamide), representing 0.037% and 0.066% of the total a.i., respectively. Inhalation exposure was also evident, with chlorothalonil and flubendiamide exposure levels varying across scenarios. Notably, the risk assessment using the Risk Index (RI) indicated safe exposure levels during mixing/loading but raised concerns during application, where all RIs exceeded 1, signifying potential risk. We suggest implementing additional personal protective equipment (PPE) during pesticide application, such as gowns and lower-body PPE, to mitigate these risks.