bluuebunny/crossref_metadata_2025 huggingface dataset:
Poster 263: MRI Evaluation of Pediatric Knee Morphology
Authors: Sun Yuhang , Campbell Abigail , Haselman William , Uquillas Carlos
Published: August 2023

Objectives:

Abnormal patellar femoral morphology is a central risk factor for patellar instability. While this relationship has been well studied in the adult population, less is known about the relationship during skeletal development. Prior studies have demonstrated that the morphology of the knee changes as a child develops. We predict that a significant difference in the morphological development of children with instability compared to children without instability. Our objective is to compare the progression of morphological parameters in patients with patellar instability to patients without patellar instability.

Methods:

An IRB approved retrospective chart review was performed measuring TT-TG, trochlear depth, and patellar height (Caton Deschamps Index) in skeletally immature patients between the ages of 5 and 16 who underwent an MRI of their knee. Patients with patellar instability were MRI age matched in a 1 to 2 ratio to patients without patellar instability. Exclusion criteria included osteoarthritis, prior knee surgery, and unreadable MRIs. Morphological measurements were then compared between the two group. Statistical analysis was performed using paired sample t-tests with p≤ 0.05 considered significant. Morphological measurements were then plotted overtime at each age group to determine changes in morphology as a patient develops.

Results:

A total of 180 patients were included in our analysis. Sixty patients with patellar instability were compared to 120 patients without patellar instability. There was a significant difference in all measurements between the patients with patellar instability and patients without (TT-TG 10.50mm versus 15.72mm, p<0.01; trochlear depth 5.55 mm versus 3.77mm, p<0.01; Caton Deschamps Index 1.07 versus 1.19, p<0.01). TT-TG for patients with prior instability was greater at all ages when compared patients without patellar instability. As patients aged, trochlear depth increased in patients without patellar instability, while it remained relatively stable in patients with patellar instability. Caton Deschamps Index was greater in patients with patellar instability compared to patients without patellar instability at most ages, however they were mostly within normal limit (0.6-1.3).

Conclusions:

Our data demonstrates that trochlear depth continues to increase in skeletally immature patients without patellar instability as they aged, while patients with patellar instability remained relatively stable. Future studies can be aimed at determining if intervening at a younger age and reducing the patella in these unstable patients can result in increased trochlear depth as they develop.
Poster 278: Spin in the Abstracts of Meta-analyses and Systematic Reviews: Quadriceps Tendon Graft for Anterior Cruciate Ligament Reconstruction
Authors: Taka Taka , Peterson Joshua , Chung Jun Ho , Syed Hasan , Liu Joseph , Gulbrandsen Matthew
Published: August 2023

Objectives:

Spin is a reporting bias that misrepresents research. Ultimately it can impact surgeon decision making and patient care. Anterior Cruciate Ligament (ACL) reconstruction is common; however debate continues over the optimal graft choice. The quadriceps tendon has become an increasingly popular graft. The purpose of this study was to identify the prevalence of spin in meta-analysis and systematic review abstracts regarding the treatment of ACL injuries with quadriceps tendon graft.

Methods:

Electronic libraries (MEDLINE, Embase, Web of Science, Google Scholar) were searched for meta-analyses and systematic reviews regarding the treatment of ACL tears with quadriceps tendon graft. The key words used for searches included (ACL or Anterior Cruciate Ligament) and (Quad or Quadricep or Quadriceps). All meta-analyses and systematic reviews that contained analysis for quadriceps tendon graft for ACL reconstruction were included. The nine most severe types of spin commonly found in abstracts were used as an evaluation tool to assess the articles. Further evaluation included year of publication, number of citations, journal impact factor, and AMSTAR-2 score.

Results:

The electronic database search resulted in 986 articles, of which 13 met our inclusion criteria. After review of these papers, it was found that 53.8% (7/13) of the included articles contained one of the nine most severe forms of spin. Of the types of spin evaluated, type 3 spin (selective reporting of or overemphasis on efficacy outcomes or analysis favoring the beneficial effect of the experimental intervention) was found to be the most prevalent (4/13, 30.8%). The other common types of spin found included type 5: conclusion claims the beneficial effect of the experimental treatment despite high risk of bias in primary studies (2/13, 15.4%); and type 9: conclusion claims the beneficial effect of the experimental treatment despite reporting bias (2/13, 15.4%). A detailed accounting of the prevalence of each type of spin can be found in Table 1. There was no relationship between the presence or total types of spin when comparing the publication year, journal impact factor, number of citations per year for the article, or the A MeaSurement Tool to Assess systematic Reviews-2 (AMSTAR-2) rating.

Conclusions:

This study demonstrated the presence of spin in a significant portion (53.8%) of meta- analysis and systematic review abstracts pertaining to quadriceps tendon graft for ACL reconstruction. Orthopedic surgeons should learn to recognize spin as they review articles when deciding the treatment course for ACL injuries. Additionally, strict criteria should be considered to reduce the prevalence of spin in orthopedic literature. [Table: see text]
Poster 307: A Standardized Method that Improves Readability of Patient Education Materials in Sports Medicine Knee Injuries
Authors: Cherian Nathan , Baumann John , Gieg Samuel , DeFroda Steven , Hanish Stefan
Published: August 2023

Objectives:

Sports-related knee injuries such as anterior cruciate ligament (ACL) or meniscus tears are very common, and there are ample resources for knee injury-related patient education materials (PEMs). However, the anatomy, pathology, and treatment plans of knee injuries are often described in terms that are obscure to patients. While the internet has become a vast resource for medical information, online PEMs in orthopaedics have consistently been shown to be written above the NIH- recommended sixth-grade reading level to the detriment of patient health literacy. The purpose of this study is to develop a standardized method to improve readability of orthopaedic PEMs without diluting their critical content by reducing the use of complex words (>3 syllables) and shortening sentence length to <15 words.

Methods:

OrthoInfo, a patient education website developed by the Academy of American Orthopedic Surgeons, was queried for PEMs relevant to the care of athletic injuries of the knee. Inclusion criteria were PEMs that were unique, pertained to topics of knee pathology in sports medicine, and written in a prose-format. Exclusion criteria were information presented in video or slideshow format, or topics not pertaining to knee pathology in sports medicine. Readability of PEMs was evaluated using seven unique readability formulas before and after applying a standardized method to improve readability while preserving critical content (reducing the use of >3 syllable words and ensuring sentence length is <15 words). Paired samples t-tests were conducted to assess the relationship between reading levels of the original PEMs and reading level of edited PEMs.

Results:

Reading levels differed significantly between the 23 original PEMs and edited PEMs across all seven readability formulas (p<0.01). Mean Flesch Kincaid Grade Level of original PEMs (9.8±1.4) was significantly increased compared to that of edited PEMs (6.4±1.1) (p=1.9x10-13). 4.0% of original PEMs met NIH recommendations of a sixth-grade reading level compared to 48.0% of modified PEMs.

Conclusions:

A standardized method that reduces the use of >3 syllable words and ensures sentence length is <15 words significantly reduces the reading-grade level of PEMs for sports-related knee injuries. Orthopaedic organizations and institutions should apply this simple standardized method when creating PEMs to enhance health literacy. [Table: see text][Table: see text]
Poster 318: CHANGE IN POSTERIOR TIBIAL SLOPE FOLLOWING DISPLACED PEDIATRIC TIBIAL TUBERCLE FRACTURES: A POTENTIAL MODEL FOR GROWTH MODULATION IN THE ACL DEFICIENT KNEE
Authors: Zogby Andrew , Wilps Tyler , Paras Tyler , Pennock Andrew , Vasudevan Rajiv
Published: August 2023

Objectives:

Increased posterior tibial slope angle (PTSA) increases the risk for anterior cruciate ligament (ACL) tear and ACL graft failure. Proximal tibial slope changing osteotomies are employed in the adult population; growth modulation procedures may present a treatment opportunity in the skeletally immature. This procedure has not been described in the context of ACL injuries, and the rate at which posterior tibial slope could be corrected is unknown. Our purpose was to quantify the rate of change in PTSA following operatively treated displaced tibial tubercle fractures in skeletally immature patients, and to determine how this rate is affected by skeletal age. We hypothesized that there would be a progressive loss of posterior tibial slope after injury, and that rate of change in PTSA would be highest during peak growth velocity

Methods:

We retrospectively reviewed skeletally immature patients with tibial tubercle fractures treated with ORIF. We measured posterior tibial slope angle (PTSA) at ˜3-, 6-, 12-months, and further postoperative time points if available. All subjects had a minimum of 6-months follow up. Bone age at the time of injury was determined. Negative PTSA was indicative of posteriorly directed slope, positive PTSA indicated anterior slope. Linear regression analysis was used to evaluate rate of change in PTSA (ΔPTSA) for individual patients and total cohort trend. Patient regression coefficients were averaged into bone age cohorts. The unit of analysis was the knee.

Results:

Twenty-two patients with 23 knees were included. 86% of patients were male. Average chronologic and bone age was 14 years at time of injury. Average follow-up was 17 months (range 6 to 52 months). Patients had a mean PTSA of -12˚ ± 2.4˚ at the time of injury. The overall mean ΔPTSA for the cohort was 0.30˚ ± 0.31˚ per month (range -0.27˚ to 0.97˚ per month). Linear regression revealed a significant relationship between months post-fixation and PTSA, demonstrating a ΔPTSA of +0.31˚ per month (CI 95% (0.24, 0.38); p<.001) (Figure 1). The highest average ΔPTSA was seen at 14-years (0.58˚ ± 0.44˚ per month). The average overall absolute change in PTSA from injury to final follow-up was +4.1˚ (range -3.4˚ to 21˚) (Figure 2).

Conclusions:

Our data suggest progressively more anterior slope following ORIF. The greatest rate of change in PTSA corresponded with peak growth velocity. These findings may serve as a model for predicting the effect of anterior proximal tibia epiphysiodesis on tibial slope in ACL surgery.
Poster 328: Pre-Operative Low-Intensity Blood Flow Restriction Training Does Not Improve Quadriceps Strength or Hypertrophy After Anterior Cruciate Ligament Reconstruction
Authors: McGurren Daniel , Lee Jedediah , De Luigi Arthur , Klanderman Molly , Chhabra Anikar , Glattke Kaycee
Published: August 2023

Objectives:

The purpose of this study is to evaluate the effect of low-intensity blood flow restriction (LI- BFR) training utilized in a pre-rehabilitative setting for patients undergoing anterior cruciate ligament reconstruction (ACLR) on postoperative outcomes by minimizing postoperative atrophy and impairment of the quadriceps. We hypothesize that postoperative strength and hypertrophy of the quadriceps will be greater in a population that undergoes preoperative LI-BFR training than that of a population that undergoes low-intensity sham control (LI-SHAM) training.

Methods:

Twenty-eight subjects undergoing primary ACLR underwent 2 weeks of either a BFR intervention or a SHAM intervention at a rate of 2 sessions per week before surgery. Quadriceps strength and cross-sectional area were measured as well as other exploratory outcomes were measured before and after the intervention before surgery and at 5 different time points after surgery, through 6 months postoperative. Quadriceps strength was assessed through handheld dynamometry and a leg press test and quadriceps cross-sectional area was assessed using musculoskeletal ultrasound imaging.

Results:

Adjusting for sex, time, and strength/hypertrophy at baseline, there were no significant differences found between treatment groups for the primary endpoints. Compared to 24-48 hours pre- op, this suggests that the post-op average hypertrophy remains significantly lower through 24 weeks post-op, while leg strength is similar at 24 weeks post-op as measured by handheld dynamometer and even significantly larger at 24 weeks as measured by the leg press test.

Conclusions:

A 2-week preoperative program of LI-BFR training may not be effective to improve postoperative quadriceps strength and hypertrophy after ACLR.
Poster 394: The COVID Rebound Effect: Incidence of Tendon Rupture Surgeries in the Peri-Pandemic COVID Era
Authors: Fisher Nina , Lin Charles , buldo-licciardi michael , Gonzalez-Lomas Guillem , Strauss Eric , Alaia Michael , Jazrawi Laith , Bi Andrew
Published: August 2023

Objectives:

The COVID-19 pandemic led to increased sedentary behavior and BMIs during 2020, which may decondition musculotendinous units and lead to increased risk for injury. Our hypothesis is as patients return to pre-COVID levels of activity, we hypothesize that there will be a resultant rebound increase in tendon ruptures.

Methods:

The electronic medical record was queried for current procedural terminology codes for tendon ruptures (Achilles, patella, quadriceps, hamstring, distal biceps, triceps, and pectoralis major) from January 2017 to December 2021 at a single academic urban center. Data was reviewed to ensure only acute tendon rupture repairs were included. The years 2017 – 2019 was used as a proxy for pre- COVID rates, 2020 as a proxy for the COVID quarantine, and 2021 as a proxy for “Post-COVID” activity. Univariate analysis was performed for comparative data.

Results:

A total of 1879 patients (82.8% male, mean age 47.8 years) who sustained tendon injuries and underwent surgical repair were identified. There were 589 (31.3%) Achilles tendon repairs, 181 (9.6%) patella tendon repairs, 414 (22.0%) quadriceps tendon repairs, 100 (5.3%) hamstring tendon repairs, 397 (21.1%) distal biceps repairs, 105 (5.6%) triceps repairs, and 93 (4.9%) pectoralis tendon repairs. The total number of tendon injuries per year was: 2017 – 357 (19.0%), 2018 – 380 (20.2%), 2019 – 380 (20.2%), 2020 – 308 (16.4%), 2021 – 454 (24.2%). The rates in 2017, 2018, and 2019 were within 1% of each other, but there was a 3.8% decrease in rate of tendon injuries from 2019 to 2020, and a 7.8% increase in rate of tendon injuries from 2020 to 2021 (Figure 1). When analyzed by quarter, linear regression model demonstrated a statistically significant increase in case counts over the period from Q2 2020 to Q2 2021 (β = 21.20; 95% CI = 13.62 - 28.78, p-value < 0.01).

Conclusions:

A “COVID rebound” of tendon rupture repairs in 2021 from a prolonged period of inactivity during 2020 occurred at a single academic center. As patients return to pre-COVID levels of activity that may be unsuitable to their deconditioned state, health care providers, should counsel patients appropriately on return to activity or sport following long periods of induced inactivity. : This study presents important epidemiologic information on musculotendinous injury rates during the COVID-19 pandemic, that can help providers counsel patients when returning to their former baseline levels of physical activity.
Individual Listener Preference for Strength of Single-Microphone Noise-Reduction; Trade-off Between Noise Tolerance and Signal Distortion Tolerance
Authors: Reinten Ilja , de Ronde-Brons Inge , Houben Rolph , Dreschler Wouter
Published: August 2023

There are large interindividual variations in preference for strength of noise-reduction (NR). It is hypothesized that each individual's tolerance for background noise on one hand and signal distortions on the other hand form this preference. We aim to visualize and analyze this so-called trade-off between noise attenuation and signal quality. Dutch sentences in stationary background noise were processed with different NR strengths. We used an NR algorithm that allows us to separate the positive effects of NR (noise attenuation) from the negative effects (signal distortion). Stimuli consisted of speech in noise with different degrees of (1) background noise, (2) signal distortions, or (3) both (i.e., realistic NR at different NR strengths). With pairwise comparisons, participants chose which stimulus they preferred for prolonged listening. Twelve listeners with mild to moderate hearing loss participated in the study. For all participants, a trade-off between noise attenuation and signal quality was found and visualized. The strength of preference was estimated with the Bradley–Terry–Luce choice model and was different for all individuals but in the same order of magnitude for distortion effects and noise effects. Strength of preference of realistic NR was smaller by a factor of ten. This study used a unique setup to capture the individual trade-off between noise attenuation and signal quality in NR. Disturbance from signal distortions is as important as disturbance from background noise for determining preference for NR strength. Individual listeners differ in their sensitivity to both factors and as a consequence in their preferred NR strength.
Social Determinants of Health in Community-Dwelling Dementia Patients Aged 65 and Over: Analysis of the 2019 National Health Interview Survey
Authors: Li Joanne M. , Boustani Malaz A. , French Dustin D.
Published: August 2023

Alzheimer’s Disease and related dementias affect 3.4 million community-dwelling adults in the United States. Given the burden of disease, a greater understanding of modifiable risk factors is crucial for targeted public health strategies. Social determinants of health (SDOH) are modifiable risk factors categorized in five domains: economic status, education, healthcare access, environment, and community context. Although individual SDOH have been linked to dementia, limited research exists on the interaction of SDOH with dementia across multiple domains. The aim of this study was to evaluate the association between SDOH across all five domains and dementia among community-dwelling adults in the United States. A cross-sectional study was performed on community-dwelling adults aged ≥65 years from the 2019 National Health Interview Survey (NHIS). Respondents ( N = 9,277), of whom 303 (4%) self-reported positive dementia diagnosis, were predominantly female (55%), white (76%), and non-Hispanic (91%). Residing in a non-metropolitan area, having a usual place for healthcare, and receiving annual eye or dental exams were negatively associated with dementia. Minority compared to white status was not significantly associated with dementia, suggesting underdiagnosis of dementia within minority groups in the NHIS. We present the first comprehensive national view of SDOH among community-dwelling dementia patients in the United States.
A Primer on the Role of iPhone Apps in Medical and Radiology Education and How to Develop Them
Authors: Weisberg Edmund M , Raminpour Sara , Lugo-Fagundo Elias , Kauffman Lilly , Fishman Elliot K
Published: August 2023

Among the numerous innovations implemented in medical education since the beginning of the 21st century, small-group learning experiences have worked well for modern students and the application of computer technology provided access to thousands of lectures, images, and slides via the internet. This has helped to build an electronic foundation on which further educational adaptations have arisen in the current era, coupled with the altered communications landscape represented by Apple's introduction of the iPhone and Google's subsequent entrance onto the playing field. With the advent of smartphone applications (apps), education has taken on an even more personalized approach. Data show that the use of educational apps has been embraced by today's nursing and medical students, notably including radiology students. We survey recent research on the use and desirability of medical apps and offer practical tips for those ready to embark on developing medical, particularly radiology, educational apps including how to assess and hone them for optimal use.
Decolonizing prisons: Indigenized programming and a critique of critical prison studies
Authors: Tetrault Justin Everett Cobain
Published: August 2023

Critical prison studies (CPS) is increasingly influential in scholarly discussions about decolonizing prisons. Proponents of CPS largely oppose the idea that cultural prison programs are decolonial, which include courses teaching Indigenous cultures and colonial history, prisons facilitating spirituality, involving Elders and communities in rehabilitation, and specialized prisons called “healing lodges.” Most CPS scholars writing on the topic disparage these initiatives as assimilationist and thus a weapon of cultural genocide. For these scholars, decolonizing prisons is impossible. CPS arguments against Indigenized programming are premised on abolitionist theory rather than a discernible decolonial method centring the perspectives of Indigenous peoples affected by prisons. I explore the accuracy and utility of CPS scholars’ arguments against Indigenized programming, drawing from 587 interviews with incarcerated men and women detained inside six prisons across Western Canada. Almost 40% of these participants identified as Indigenous. Indigenous interviewees nearly universally praised Indigenized programs for how they can help heal and empower those affected by colonial violence. Participants desired more cultural programming and easier access to such resources. More research is needed on how prisons develop and implement cultural programming, but existing empirical works suggest that these initiatives, while flawed, support the dignity of incarcerated Indigenous peoples. My critique is a call for criminologists writing on Indigenous issues to consider the ambiguity and tensions of decolonial processes and to premise their arguments foremost on methods centring Indigenous peoples affected by incarceration.
Esophageal Dilation: Pearls and Pitfalls
Authors: DeVault Kenneth R.
Published: August 2023

Esophageal dilation is an important part of endoscopic practice. Proper preparation and technique can optimize outcomes. Techniques include wire guided per oral dilation, blind bougienage and balloon dilation. Fluoroscopy and steroid injections may also be part of endoscopic practice. Diseases that are often and addressed with esophageal dilation include peptic strictures, lower esophageal rings, eosinophilic esophagitis, achalasia and other motility disorders, postoperative dysphagia, radiation induced strictures and malignant strictures. The techniques and approach to all of these disorders will be discussed in this review.
Patterns of Esophageal Motility and Bolus Transit in Children With Repaired Esophageal Atresia
Authors: Bingham Carly , White Emily , Papadopoulos Michalis , Mutalib Mohamed
Published: August 2023

Background:

Esophageal dysmotility is common after esophageal atresia (EA) repair. Esophageal manometry (HRM) is the gold standard to investigate motility. We aim to characterize esophageal dysmotility and bolus transit for liquid and solids in children with repaired EA.

Method:

Retrospective analysis of HRM from children with repaired EA. Five liquid and 5 solid swallows per child were assessed for the standard manometric measurement and peristalsis pattern. Impedance tracings were used to assess bolus transit.

Results:

Ninety measurements were assessed from 9 patients, 44% Females. Mean age was 10.5 (±4.6) years. All children had dysphagia and anastomotic strictures were excluded. None of the children had intact peristalsis, 44.4% of the liquid swallows were failed, 33.3% fragmented and 22.2% ineffective. 44.4% of the solid swallows were failed, 44.4% fragmented and 11.1% ineffective. 33.3% had incomplete bolus transit in the whole esophagus, 44.4% in the upper and 11% in the lower esophagus. Mean peristalsis break for liquid was 7 cm (±2.1) and for solid was 5.9 cm (±3.2) P .025.

Conclusion:

Impaired esophageal motility is universal post EA repair. Failed and ineffective peristalsis predominate with incomplete bolus transit and large peristalsis breaks after liquid and solid swallows. HRM can provide clinical guidance, diagnostic and prognostic information post EA repair.
Solidaric solarities: Governance principles for transforming solar power relations
Authors: Sareen Siddharth , Sorman Alevgul H , Stock Ryan , Mahoney Katherine , Girard Bérénice
Published: August 2023

Solar energy has become the world's cheapest and fastest scaling electricity source. Multiple societal sectors are electrifying, and the scale and pace of change give some hope of near-future rapid climate mitigation through solar rollouts despite the bleak record to date. Critiques of utility-scale solar development foreground injustices like displacing marginalised groups and perpetuating resource inequity. Governance scholars argue for stringent regulations towards just transitions, and community energy research shows that smaller-scale solar solutions hold promise in being more equitable. Our contribution argues for the possibility of redistributive and emancipatory solar development, drawing from scholarship on governance (institutional configurations, policy mixes and cross-sectoral regulation) and scale (comparative energy geographies with attention to context-specificity and trans-local connection). We conceptualise and operationalise the term ‘solidaric solarities’ as modalities of harnessing solar energy to advance empowerment, interconnectedness and community wealth for victims of energy injustices. This focuses on political economy issues, where solar development can advance solidarity with historically marginalised groups, to create affordable distributed future renewable energy systems. The analysis underpinning this normative orientation leverages secondary research and scholarly expertise on solar rollouts. We offer pragmatic governance principles informed by values that engender solidarity, illuminating potential pathways to enable solidaric solar transitions.
An Asymptomatic, Iatrogenic Hemobilia Detected by Contrast Enhanced Ultrasound of the Gallbladder
Authors: Menozzi Guido , Ricci Andrea , Farina Francesca Maria , Elisa Garlassi , Maccabruni Valeria , Marani Barbara , Arletti Laura , Grendene Carlo
Published: August 2023

Hemorrhage within the biliary system (hemobilia), is an infrequent complication that can arise during percutaneous procedures involving the liver. The clinical diagnosis of hemobilia is often challenging, as symptoms are quite unspecific and often display a late onset. In such cases, sonography of the gallbladder can play a crucial role in the early detection of hemobilia. A case report is provided of a 72-year-old man who underwent a sonography-guided percutaneous biopsy of a 22-mm focal lesion, within the eighth segment of the liver. In this patient, asymptomatic active hemobilia was promptly identified through contrast-enhanced ultrasound (CEUS) which was performed immediately after the invasive procedure. Crucially, this postprocedural complication may have gone undiagnosed without an early postprocedure grayscale visual analysis and CEUS evaluation, since the patient was completely asymptomatic. In conclusion, a grayscale sonogram of the gallbladder is suggested and should be considered before and immediately after percutaneous invasive procedures of the liver. In the instances where suspicion of hemobilia arises, CEUS can be used to assess the presence of active bleeding. Implementing this type of imaging protocol may possibly reveal a higher frequency of hemobilia than is commonly reported.
HNRNPC promotes collagen fiber alignment and immune evasion in breast cancer via activation of the VIRMA-mediated TFAP2A/DDR1 axis
Authors: Lian Bin , Yan Shuxun , Li Jiayi , Bai Zhengyang , Li Jinping
Published: August 2023

Background

Cancers aggressively reorganize collagen in their microenvironment, leading to the evasion of tumor cells from immune surveillance. However, the biological significance and molecular mechanism of collagen alignment in breast cancer (BC) have not been well established.

Methods

In this study, BC-related RNA-Seq data were obtained from the TCGA database to analyze the correlation between DDR1 and immune cells. Mouse BC cells EO771 were selected for in vitro validation, and dual-luciferase experiments were conducted to examine the effect of TFAP2A on DDR1 promoter transcription activity. ChIP experiments were performed to assess TFAP2A enrichment on the DDR1 promoter, while Me-RIP experiments were conducted to detect TFAP2A mRNA m6A modification levels, and PAR-CLIP experiments were conducted to determine VIRMA’s binding to TFAP2A mRNA and RIP experiments to investigate HNRNPC’s recognition of m6A modification on TFAP2A mRNA. Additionally, an in vivo mouse BC transplant model and the micro-physiological system was constructed for validation, and Masson staining was used to assess collagen fiber arrangement. Immunohistochemistry was conducted to identify the number of CD8-positive cells in mouse BC tumors and Collagen IV content in ECM, while CD8 + T cell migration experiments were performed to measure CD8 + T cell migration.

Results

Bioinformatics analysis showed that DDR1 was highly expressed in BC and negatively correlated with the proportion of anti-tumor immune cell infiltration. In vitro cell experiments indicated that VIRMA, HNRNPC, TFAP2A, and DDR1 were highly expressed in BC cells. In addition, HNRNPC promoted TFAP2A expression and, therefore, DDR1 transcription by recognizing the m6A modification of TFAP2A mRNA by VIRMA. In vivo animal experiments further confirmed that VIRMA and HNRNPC enhanced the TFAP2A/DDR1 axis, promoting collagen fiber alignment, reducing anti-tumor immune cell infiltration, and promoting immune escape in BC.

Conclusion

This study demonstrated that HNRNPC promoted DDR1 transcription by recognizing VIRMA-unveiled m6A modification of TFAP2A mRNA, which enhanced collagen fiber alignment and ultimately resulted in the reduction of anti-tumor immune cell infiltration and promotion of immune escape in BC.
Medicinal plant genomics
Authors: Siadjeu Christian , Pucker Boas
Published: August 2023

Recent developments in plant genomics have enabled a comprehensive analysis of the medicinal potential of plants based on their gene repertoire. Genes of biosynthesis pathways can be discovered through comparative genomics and through integration of transcriptomic data. Data-driven discovery of specialized metabolites could accelerate research.
Genome-wide characterization, evolutionary analysis, and expression pattern analysis of the trihelix transcription factor family and gene expression analysis under MeJA treatment in Panax ginseng
Authors: Hu Jian , Liu Tao , Huo Huimin , Liu Sizhang , Liu Mingming , Liu Chang , Zhao Mingzhu , Wang Kangyu , Wang Yi , Zhang Meiping
Published: August 2023

Panax ginseng is a well-known medicinal plant with several pharmacological uses in China. The trihelix family transcription factors, also known as GT factors, can be involved in the regulation of growth and developmental processes in plants. There have been no in-depth reports or systematic studies about the trihelix transcription factor in ginseng. In this study, the structure, chromosomal localization, gene duplication, phylogeny, functional differentiation, expression patterns and coexpression interactions of trihelix transcripts were analysed using bioinformatics methods based on the ginseng transcriptome database. Thirty-two trihelix transcription factor genes were identified in ginseng, and these genes were alternatively spliced to obtain 218 transcripts. These transcripts were unevenly distributed on different chromosomes of ginseng, and phylogenetic analysis classified the PgGT transcripts into five subgroups. Gene Ontology (GO) analysis classified PgGT transcripts into eight functional subclasses, indicating that they are functionally diverse. The expression pattern analysis of 218 PgGT transcripts revealed that their expression was tissue-specific and spatiotemporally-specific in 14 different tissues of 4-year-old ginseng, 4 different ages of ginseng roots, and 42 farmers’ cultivars of 4-year-old ginseng roots. Despite the differences in the expression patterns of these transcripts, coexpression network analysis revealed that these transcripts could be expressed synergistically in ginseng. In addition, two randomly selected PgGT transcripts in each of the five different subfamilies were subjected to methyl jasmonate treatment at different times, and PgGT was able to respond to the regulation of methy1 jasmonate. These results provide a theoretical basis and gene resources for an in-depth study of the function of trihelix genes in other plants.
Prediction of lymph node status in patients with early-stage cervical cancer based on radiomic features of magnetic resonance imaging (MRI) images
Authors: Liu Shuyu , Zhou Yu , Wang Caizhi , Shen Junjie , Zheng Yi
Published: August 2023

Background

Lymph node metastasis is an important factor affecting the treatment and prognosis of patients with cervical cancer. However, the comparison of different algorithms and features to predict lymph node metastasis is not well understood. This study aimed to construct a non-invasive model for predicting lymph node metastasis in patients with cervical cancer based on clinical features combined with the radiomic features of magnetic resonance imaging (MRI) images.

Methods

A total of 180 cervical cancer patients were divided into the training set (n = 126) and testing set (n = 54). In this cross-sectional study, radiomic features of MRI images and clinical features of patients were collected. The least absolute shrinkage and selection operator (LASSO) regression was used to filter the features. Seven machine learning methods, including eXtreme Gradient Boosting (XGBoost), Logistic Regression, Multinomial Naive Bayes (MNB), Support Vector Machine (SVM), Decision Tree, Random Forest, and Gradient Boosting Decision Tree (GBDT) are used to build the models. Receiver operating characteristics (ROC) curve and area under the curve (AUC), accuracy, sensitivity, and specificity were calculated to assess the performance of the models.

Results

Of these 180 patients, 49 (27.22%) patients had lymph node metastases. Five of the 122 radiomic features and 3 clinical features were used to build predictive models. Compared with other models, the MNB model was the most robust, with its AUC, specificity, and accuracy on the testing set of 0.745 (95%CI: 0.740–0.750), 0.900 (95%CI: 0.807–0.993), and 0.778 (95%CI: 0.667–0.889), respectively. Furthermore, the AUCs of the MNB models with clinical features only, radiomic features only, and combined features were 0.698 (95%CI: 0.692–0.704), 0.632 (95%CI: 0.627–0.637), and 0.745 (95%CI: 0.740–0.750), respectively.

Conclusion

The MNB model, which combines the radiomic features of MRI images with the clinical features of the patient, can be used as a non-invasive tool for the preoperative assessment of lymph node metastasis.
Quality of life and associated factors among infertile women attending infertility clinic at Mnazi Mmoja Hospital, Zanzibar
Authors: Suleiman Mubina , August Furaha , Nanyaro Mary Winnie , Wangwe Peter , Kikula Amani , Balandya Belinda , Ngarina Matilda , Muganyizi Projestine
Published: August 2023

Background

Worldwide, it is estimated at least 50 million couples are affected by infertility with the prevalence of infertility being 16% in Tanzania. Psychological impact of infertility in patients negatively affects women’s Quality of Life (QoL) defined as a person`s perception of where they are in life in terms of culture and value in the emotional, mind-body, relational, social, environment and tolerability of treatment aspects. Poor Quality of Life is related to increased treatment discontinuation. The aim of this study was to determine the Quality of Life and associated factors among infertile women attending infertility clinic at Mnazi Mmoja Hospital, Zanzibar.

Methods

A hospital based cross–sectional study was conducted among 340 infertile women attending infertility clinic at Mnazi Mmoja Hospital, Zanzibar. Data was collected using FertiQoL tool. The factors associated with Quality of Life using FertiQoL tool in infertile women were estimated in a multivariable linear regression model at 95% confidence interval and 5% level of significance.

Results

Quality of life of infertile women at Mnazi Mmoja infertility clinic was 70.6 ± 10.0 on a scale of 0 to 100. It increased significantly with increase in educational level (p = 0.009). Women with female individual causes on average had 5.07 (B=- 5.07, 95%CI: -7.78, -2.35) and women with individual and respective male partner causes of infertility had on average 4.95 (B= -4.95, 95% CI: -7.77, -2.12) respective decrease in the FertiQoL scores compared to those who had their male partner with problems as reason for infertility. There was an average 4.50 (B=-4.50, 95% CI: 2.30, 6.70) decrease in quality of life in women with secondary infertility compared to women with primary infertility. Every month increase in duration of infertility led to an average of 0.04 (B=-2.57, 95%CI: -0.07, -0.01) decrease in FertiQoL scores.

Conclusion

The overall quality of life in this population was positively associated with level of education but negatively affected with reason for infertility, type of infertility and duration of infertility.
Application of single-port procedure and ERAS management in the laparoscopic myomectomy
Authors: Wang Jing , Xu Xiaomin , Xu Jingui
Published: August 2023

Objective

Advances in surgical techniques and perioperative management are the two major contributing factors to improved surgical outcomes. The purpose of the current study was to compare the efficacy of single-port surgery and perioperative enhanced recovery after surgery (ERAS) management in laparoscopic myomectomy.

Methods

The present study included 120 patients undergoing laparoscopic myomectomy in the Gynecological Ward of Quzhou Affiliated Hospital of Wenzhou Medical University. According to the traditional perioperative management mode and ERAS management, multi-port and single-port procedures, all patients were assigned to the Conventional-SPLS (Single-Port Laparoscopic Surgery with conventional perioperative care) group (n = 34), Conventional-Multi (multi-port laparoscopic surgery with conventional perioperative care) group (n = 47), and ERAS (multi-port laparoscopic surgery with ERAS perioperative care) group (n = 39). The surgical outcomes of the three groups were compared operation time, intraoperative blood loss, variations in postoperative hemoglobin, postoperative walking time, postoperative flatus expelling time, postoperative hospital stay, and visual analog scale (VAS) scores at 6 and 12 h following surgery.

Results

The ERAS group recovered the quickest in terms of postoperative walking time and flatus expelling duration. The ERAS group also recovered the shortest postoperative hospital stay (3.85 ± 1.14 days), which differed significantly from that in the Conventional-Multi group, but not significantly from that in the Conventional-SPLS group. In terms of VAS scores at 6 and 12 h after surgery, the ERAS group had the lowest pain intensity, which differed significantly from that of the other two groups. The effect of surgical procedures or postoperative care on hospital stay was assessed using multiple regression analysis. The results demonstrated that ERAS was an important independent contributor to reducing postoperative hospital stay (β = 0.270, p = 0.002), while single-port surgery did not affect this index (β = 0.107, p = 0.278).

Conclusion

In laparoscopic myomectomy, perioperative ERAS management could control postoperative pain and shorten hospital stay. Single-port surgery could speed up the recovery of gastrointestinal function and postoperative walking time, but it did not affect postoperative pain management or the length of hospital stay. Thus, the most effective approach to improving postoperative outcomes in laparoscopic myomectomy was the application of perioperative ERAS management.
The three-tube method via precise interventional placement for esophagojejunal anastomotic fistula after gastrectomy: a single-center experience
Authors: Ding Xiaolong , Zhang Chenchen , Li Xiaobing , Liu Tao , Ma Yaozhen , Yin Meipan , Li Chunxia , Zhou Gang , Wu Gang
Published: August 2023

Background

Esophagojejunal anastomotic leakage is a serious complication after total gastrectomy. This study evaluated the safety and efficacy of transnasal placement of drainage catheter, jejunal decompression tube, and jejunal nutrition tube under fluoroscopy for treatment of esophagojejunal anastomotic fistula after gastrectomy in gastric cancer patients.

Methods

This is retrospective review of patients with esophagojejunal anastomotic fistula treated with transnasal placement of abscess drainage catheter, decompression tube, and jejunal nutrition tube under fluoroscopy. Fistula healing time, patient survival, and Eastern Cooperative Oncology Group (ECOG) performance status before and after treatment were evaluated.

Results

Sixty-four patients were included in the study. Insertion of the transnasal abscess drainage catheter, decompression tube, and jejunal nutrition tube was successful on the first attempt in all patients, while 35 patients received transnasal abscess drainage, 13 received percutaneous abscess drainage, and 16 received transnasal drainage plus percutaneous abscess drainage. Immediately after placement of the tube, the mean volume of drainage was 180 mL (range, 10–850 mL); the amount steadily decreased from then on. The clinical success rate was 84.3% (54/64). Median time to fistula healing was 58 days (range, 7–357 days).

Conclusions

Transnasal insertion of transnasal abscess drainage catheter, jejunal decompression tube, and jejunal nutrition tube under fluoroscopy appears to be a simple, minimally invasive, effective, and safe method for treating esophagojejunal anastomotic fistula after gastrectomy.
Real world time trends in antithrombotic treatment for newly diagnosed atrial fibrillation in China: reports from the GLORIA-AF Phase III registry
Authors: Liu Xiaoxia , Feng Guoze , Marler Sabrina Vogel , Huisman Menno V , Lip Gregory Y. H. , Ma Changsheng
Published: August 2023

Background

Stroke prevention with oral anticoagulant (OAC) therapy, including non-vitamin K antagonist oral anticoagulants (NOACs), is recommended in patients with atrial fibrillation (AF). This analysis describes the antithrombotic prescription patterns for Chinese patients enrolled post-dabigatran approval during Phase II and III of the Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF) program in China.

Methods

Patients aged ≥ 18 years with newly diagnosed (< 3 months before baseline visit) nonvalvular AF at risk of stroke (CHA2DS2-VASc score ≥ 1) were consecutively enrolled in the GLORIA-AF registry. This cross-sectional analysis provides descriptive comparison of Chinese patients in Phase III (2015–2016) with those enrolled in Phase II (2013–2014).

Results

Overall, 1,018 and 1,911 Chinese patients were eligible for analysis in Phase II and III, respectively. Most patients (69.6% and 69.1%, respectively) had high stroke risk (CHA2DS2-VASc score ≥ 2 for males and ≥ 3 for females). High bleeding risk (HAS-BLED score ≥ 3) rates were similar (17.3% for Phase II, 17.6% for Phase III). In Phase II, 5.8%, 15.2%, 36.7% and 42.2% of patients were prescribed NOACs, vitamin K antagonists (VKAs), antiplatelet therapies or no antithrombotic treatment, respectively. The corresponding figures were 17.2%, 23.5%, 37.4% and 21.8% for patients in Phase III, with an overall increase in OAC prescriptions (NOACs or VKAs). In patients with high stroke risk, the prescription patterns in Phase II were 5.6%, 14.4%, 41.0% and 38.9% for NOACs, VKAs, antiplatelets or no antithrombotic treatment, respectively. The respective proportions in Phase III were 15.1%, 23.5%, 40.9% and 20.5%.

Conclusions

Since the availability of dabigatran in China, the overall trend of OAC, including NOAC, prescriptions in Chinese patients with nonvalvular AF has increased over time, albeit with VKAs as the most common antithrombotic treatment. Most patients, including those at high stroke risk, remain undertreated according to best practice guidelines.

Trial registration

ClinicalTrials.gov NCT01468701.
Three-dimensional branch segmentation and phenotype extraction of maize tassel based on deep learning
Authors: Zhang Wenqi , Wu Sheng , Wen Weiliang , Lu Xianju , Wang Chuanyu , Gou Wenbo , Li Yuankun , Guo Xinyu , Zhao Chunjiang
Published: August 2023

Background

The morphological structure phenotype of maize tassel plays an important role in plant growth, reproduction, and yield formation. It is an important step in the distinctness, uniformity, and stability (DUS) testing to obtain maize tassel phenotype traits. Plant organ segmentation can be achieved with high-precision and automated acquisition of maize tassel phenotype traits because of the advances in the point cloud deep learning method. However, this method requires a large number of data sets and is not robust to automatic segmentation of highly adherent organ components; thus, it should be combined with point cloud processing technology.

Results

An innovative method of incomplete annotation of point cloud data was proposed for easy development of the dataset of maize tassels,and an automatic maize tassel phenotype analysis system: MaizeTasselSeg was developed. The tip feature of point cloud is trained and learned based on PointNet +  + network, and the tip point cloud of tassel branch was automatically segmented. Complete branch segmentation was realized based on the shortest path algorithm. The Intersection over Union (IoU), precision, and recall of the segmentation results were 96.29, 96.36, and 93.01, respectively. Six phenotypic traits related to morphological structure (branch count, branch length, branch angle, branch curvature, tassel volume, and dispersion) were automatically extracted from the segmentation point cloud. The squared correlation coefficients (R2) for branch length, branch angle, and branch count were 0.9897, 0.9317, and 0.9587, respectively. The root mean squared error (RMSE) for branch length, branch angle, and branch count were 0.529 cm, 4.516, and 0.875, respectively.

Conclusion

The proposed method provides an efficient scheme for high-throughput organ segmentation of maize tassels and can be used for the automatic extraction of phenotypic traits of maize tassel. In addition, the incomplete annotation approach provides a new idea for morphology-based plant segmentation.