bluuebunny/crossref_metadata_2025 huggingface dataset:
CsLAZY1 mediates shoot gravitropism and branch angle in tea plants (Camellia sinensis)
Authors: Xia Xiaobo , Mi Xiaozeng , Jin Ling , Guo Rui , Zhu Junyan , Xie Hui , Liu Lu , An Yanlin , Zhang Cao , Wei Chaoling , Liu Shengrui
Published: May 2021

Background

Branch angle is a pivotal component of tea plant architecture. Tea plant architecture not only affects tea quality and yield but also influences the efficiency of automatic tea plant pruning. However, the molecular mechanism controlling the branch angle, which is an important aspect of plant architecture, is poorly understood in tea plants.

Results

In the present study, three CsLAZY genes were identified from tea plant genome data through sequence homology analysis. Phylogenetic tree displayed that the CsLAZY genes had high sequence similarity with LAZY genes from other plant species, especially those in woody plants. The expression patterns of the three CsLAZYs were surveyed in eight tissues. We further verified the expression levels of the key CsLAZY1 transcript in different tissues among eight tea cultivars and found that CsLAZY1 was highly expressed in stem. Subcellular localization analysis showed that the CsLAZY1 protein was localized in the plasma membrane. CsLAZY1 was transferred into Arabidopsis thaliana to investigate its potential role in regulating shoot development. Remarkably, the CsLAZY1 overexpressed plants responded more effectively than the wild-type plants to a gravity inversion treatment under light and dark conditions. The results indicate that CsLAZY1 plays an important role in regulating shoot gravitropism in tea plants.

Conclusions

The results provide important evidence for understanding the functions of CsLAZY1 in regulating shoot gravitropism and influencing the stem branch angle in tea plants. This report identifies CsLAZY1 as a promising gene resource for the improvement of tea plant architecture.
Association of epicardial fat thickness with left ventricular diastolic function parameters in a community population
Authors: Ma Wei , Zhang Baowei , Yang Ying , Qi Litong , Zhou Jin , Li Min , Jia Jia , Zhang Yan , Yong Huo
Published: May 2021

Background

We examined the relationship between epicardial fat thickness (EFT) measured by echocardiography and left ventricular diastolic function parameters in a Beijing community population.

Methods

We included 1004 participants in this study. Echocardiographic parameters including E and A peak velocity, the early diastolic velocities (e′) of the septal and lateral mitral annulus using tissue doppler imaging, E/e′, and EFT were measured. EFT1 was measured perpendicularly on the right ventricular free wall at end diastole in the extension line of the aortic root. EFT2 was the maximum thickness measured perpendicularly on the right ventricular free wall at end diastole. Multivariable linear regression was used to analyze the relationship between EFT and the mean e′ and E/e′.

Results

The mean age of the participants was 63.91 ± 9.02 years, and 51.4% were men. EFT1 and EFT2 were negatively correlated with lateral e′, septal e′, and mean e′ (p < 0.05), and the correlation coefficient for EFT1 and EFT2 and mean e′ was − 0.138 and − 0.180, respectively. EFT1 and EFT2 were positively correlated with lateral E/e′, septal E/e′, and mean E/e′ (p < 0.05), and the correlation coefficient for EFT1 and EFT2 and mean e′ was 0.100 and 0.090, respectively. Multivariable egression analysis showed that EFT2 was independently and negatively associated with e′ mean (β = − 0.078 [95% confidence interval = − 0.143, − 0.012, p = 0.020]). There were no interactions between EFT2 and any covariates, including age or heart groups, sex, BMI, or presence of hypertension, diabetes, or coronary heart disease, in relation to left ventricular diastolic dysfunction.

Conclusions

EFT2 was negatively and independently associated with e′ mean, which suggests that more attention to this type of adipose fat is required for cardiovascular disease therapy.
Application value of tissue tuberculosis antigen combined with Xpert MTB/RIF detection in differential diagnoses of intestinal tuberculosis and Crohn’s disease
Authors: Fei Baoying , Zhou Lin , Zhang Yu , Luo Linhe , Chen Yuanyuan
Published: May 2021

Background

The purpose of this study was to examine the value of Xpert MTB/RIF assay and detection of additional Mycobacterium tuberculosis complex (MTBC) species antigens from intestinal tissue samples in differentiating intestinal tuberculosis (ITB) from Crohn’s disease (CD).

Methods

Several clinical specimens of intestinal tissue obtained by either endoscopic biopsy or surgical excision were used for mycobacteriologic solid cultures,Xpert MTB/RIF assays, immunohistochemistry, and histological examinations. Four antigens (38KDa, ESAT-6, MPT64, and Ag85 complex) of MTBC in the intestinal tissue were detected by immunohistochemical analysis.

Results

The study included 42 patients with ITB and 46 with CD. Perianal lesions and longitudinal ulcers were more common in patients with CD, while caseating granuloma and annular ulcers were more common in patients with ITB. The positive rate of MTBC detected by Xpert MTB/RIF in intestinal tissues of patients with ITB was 33.33%, which was significantly higher than that in patients with CD and that detected using acid-fast staining smears. It was also higher than that detected by tissue MTBC culture, but the difference was not statistically significant. The positive MPT64 expression rate in patients with ITB was 40.48%, which was significantly higher than that observed in patients with CD. The sensitivity of parallelly combined detection of tuberculosis protein MPT64 and Xpert MTB/RIF in diagnosing ITB was 50.0%.

Conclusions

The detection of Xpert MTB/RIF in intestinal tissue is a rapid and useful method for establishing an early diagnosis of ITB. The detection of MTBC using Xpert MTB/RIF and MPT64 antigen in intestinal tissues has a definitive value in the differential diagnosis ofITB and CD. The combination of these two methods can improve the detection sensitivity.
Physical activity and sleep duration during pregnancy have interactive effects on caesarean delivery: a population-based cohort study in Tianjin, China
Authors: Yang Yingzi , Li Weiqin , Yang Wen , Wang Leishen , Liu Jinnan , Leng Junhong , Li Wei , Wang Shuo , Li Jing , Hu Gang , Yu Zhijie , Yang Xilin
Published: May 2021

Background

There were inconsistent findings in the literature regarding the associations of physical activity and sleep duration during pregnancy with caesarean delivery for different reasons. It was also unknown whether physical activity and sleep duration during pregnancy had interactive effects on the risks of different types of caesarean delivery. The study aimed to investigate the effects of physical activity, sleep duration and their interactions on the risk of caesarean delivery for medical reasons and non-medical reasons.

Methods

From October 2010 to August 2012, a prospective population-based cohort of 13,015 pregnant women was established in six central urban districts of Tianjin, China. Pregnancy outcomes were retrieved from an electronic database and caesarean delivery was divided into caesarean delivery for medical reasons and caesarean delivery for non-medical reasons. Physical activity and sleep status were collected at 24–28 weeks of gestation using self-reported questionnaires. Logistic regression and additive interaction were used to examine physical activity, sleep duration and their interactive effects on risk of caesarean delivery.

Results

In the cohort, 5692 (43.7%) and 2641 (20.3%) of women had caesarean delivery for medical reasons and non-medical reasons, respectively. Low physical activity increased the risk of caesarean delivery for medical reasons (adjusted OR: 1.13, 95%CI 1.04–1.23) but not caesarean delivery for non-medical reasons. Sleep duration < 7 h/day and poor sleep quality were not associated with caesarean delivery. Sleep duration ≥9 h/day increased the risk of caesarean delivery for medical reasons (1.12, 1.02–1.22) and caesarean delivery for non-medical reasons (1.16, 1.05–1.29). Co-presence of low physical activity and sleep duration ≥9 h/day increased risk of caesarean delivery (1.25, 1.12–1.41), and their additive interaction was statistically significant for caesarean delivery for medical reasons but not for caesarean delivery for non-medical reasons.

Conclusions

Low physical activity and excessive sleep duration during pregnancy each increased the risk of caesarean delivery, and they had an interactive effect on the risk of caesarean delivery for medical reasons but not on the risk of caesarean delivery for non-medical reasons. Increasing physical activity and maintaining recommended sleep duration during pregnancy may have benefits for perinatal health.
Does patient positioning influence blood loss and transfusion rate in hip replacement for femoral neck fractures? A single-centre, retrospective chart review
Authors: Haider Thomas , Seilern und Aspang Jesse , Gahleitner Claudia , Plesser Stefan , Hajdu Stefan
Published: May 2021

Background

We compared blood loss and transfusion frequency between the lateral decubitus and the supine position in patients undergoing hip replacement surgery due to femoral neck fractures.

Methods

We retrospectively included femoral neck fracture patients treated with either hemi (HA) or total hip arthroplasty (THA). We included a total of 626 patients, of which 313 patients underwent surgery in the lateral decubitus position and 313 patients in the supine position. Preoperative and day 1 postoperative blood measures including hemoglobin (Hb), hematocrit (Hct), and red blood cell count (RBC) were evaluated, as well as transfusion records analyzed.

Results

The following decrease of laboratory parameters between pre- and 1st day postoperative measures was noted: RBC: -0.77 G/L (± 0.5 G/L, median = -0.80 G/L; range: -0.50 – -1.10 G/L); Hct: -7.08 % (± 4.7 %, range: -4.70 – -9.90 G/L); Hb: -2.36 g/dL (± 1.6 g/dL, range: -1.50. – -3.40 g/dL). We did not observe significant differences in transfusion frequency between the two study cohorts (p = 0.735 for THA, p = 0.273 for HA). No influence of patient positioning on Hb-decrease, Hct-decrease, or RBC-decrease was noted in our two-way ANOVA models with consideration of implant type and fixation technique (F(3,618) = 1.838, p = 0.139; F(3,618) = 2.606, p = 0.051; F(3,618) = 1.407, p = 0.240).

Conclusions

We did not observe  significant differences in perioperative blood values and transfusion rates in association with patient positioning in patients undergoing hip replacement surgery for femoral neck fractures.

Level of evidence

Level III, retrospective cohort study.
Testing the proportional hazards assumption in cox regression and dealing with possible non-proportionality in total joint arthroplasty research: methodological perspectives and review
Authors: Kuitunen Ilari , Ponkilainen Ville T. , Uimonen Mikko M. , Eskelinen Antti , Reito Aleksi
Published: May 2021

Background

Survival analysis and effect of covariates on survival time is a central research interest. Cox proportional hazards regression remains as a gold standard in the survival analysis. The Cox model relies on the assumption of proportional hazards (PH) across different covariates. PH assumptions should be assessed and handled if violated. Our aim was to investigate the reporting of the Cox regression model details and testing of the PH assumption in survival analysis in total joint arthroplasty (TJA) studies.

Methods

We conducted a review in the PubMed database on 28th August 2019. A total of 1154 studies were identified. The abstracts of these studies were screened for words “cox and “hazard*” and if either was found the abstract was read. The abstract had to fulfill the following criteria to be included in the full-text phase: topic was knee or hip TJA surgery; survival analysis was used, and hazard ratio reported. If all the presented criteria were met, the full-text version of the article was then read. The full-text was included if Cox method was used to analyze TJA survival. After accessing the full-texts 318 articles were included in final analysis.

Results

The PH assumption was mentioned in 114 of the included studies (36%). KM analysis was used in 281 (88%) studies and the KM curves were presented graphically in 243 of these (87%). In 110 (45%) studies, the KM survival curves crossed in at least one of the presented figures. The most common way to test the PH assumption was to inspect the log-minus-log plots (n = 59). The time-axis division method was the most used corrected model (n = 30) in cox analysis. Of the 318 included studies only 63 (20%) met the following criteria: PH assumption mentioned, PH assumption tested, testing method of the PH assumption named, the result of the testing mentioned, and the Cox regression model corrected, if required.

Conclusions

Reporting and testing of the PH assumption and dealing with non-proportionality in hip and knee TJA studies was limited. More awareness and education regarding the assumptions behind the used statistical models among researchers, reviewers and editors are needed to improve the quality of TJA research. This could be achieved by better collaboration with methodologists and statisticians and introducing more specific reporting guidelines for TJA studies. Neglecting obvious non-proportionality undermines the overall research efforts since causes of non-proportionality, such as possible underlying pathomechanisms, are not considered and discussed.
Clinical outcomes of doubled-suture Nice knot augmented plate fixation in the treatment of comminuted midshaft clavicle fracture
Authors: Wu Gui , Chen Yao-qing , Chen Chun-yong , Lin Zhang-xiong , Xie Qi-yang , Ye Jun-jian , Xie Yun
Published: May 2021

Background

Free bone fragments were difficult to be fixed in many comminuted midshaft clavicle fractures, and the absence of cortical alignment in comminuted fractures had direct influence on the stability of fixation. This survey was performed to assess the efficacy of doubled-suture Nice knot augmented plate fixation in the treatment of comminuted midshaft clavicle fractures.

Methods

Between 2013 and 2018, all patients with comminuted midshaft clavicle fractures treated with doubled-suture Nice knot augmented plate fixation were retrospectively reviewed and included in this research. Demographic data of the patients, characteristics of the fractures, intraoperative parameters and follow-up data of the patients were evaluated and summarized.

Results

A total of 56 patients were included in this study. The mean follow-up time was 25.6 months (range, 12–60 months). The number of male patients was 38 (67.9 %) and of the female patients was 18 (32.1 %). The average age of all patients was 47.89 ± 16.5 years. The mean time of surgery was 85.6 ± 24.0 min. The average length of incision was 9.2 ± 1.9 cm. The number of doubled-suture Nice knot applied ranged from 1 to 5 knots. All the patients reached bone union after the treatment. There was no implant failure or neurovascular injury observed. And most of the patients showed good functional outcome.

Conclusions

The doubled-suture Nice knot could provide reliable fixation for small bone fragments in comminuted clavicle fractures. Combination of the doubled-suture Nice knot and plate screws fixation was a safe and effective method in comminuted midshaft clavicle fractures treatment.
Lifestyle is associated with thyroid function in subclinical hypothyroidism: a cross-sectional study
Authors: Wu Kejun , Zhou Yu , Ke Sujie , Huang Jingze , Gao Xuelin , Li Beibei , Lin Xiaoying , Liu Xiaohong , Liu Xiaoying , Ma Li , Wang Linxi , Wu Li , Wu Lijuan , Xie Chengwen , Xu Junjun , Wang Yanping , Liu Libin
Published: May 2021

Background

Few studies have focused on the association between lifestyle and subclinical hypothyroidism (SCH). The purpose of this study was to investigate the association between lifestyle and thyroid function in SCH.

Methods

This study was a part of a community-based and cross-sectional study, the Epidemiological Survey of Thyroid Diseases in Fujian Province, China. A total of 159 participants with SCH (81 males and 78 females) and 159 euthyroid (87 males and 72 females) participants without any missing data were included in the analysis. General information and lifestyle information including sleep, exercise, diet and smoking habits of the participants was collected by questionnaire and Pittsburgh sleep quality index scale (PSQI) was collected. Thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroid peroxidase antibody (TPOAb), thyroid globulin antibody (TgAb) and urine iodine concentration (UIC) were tested. Thyroid homeostasis parameter thyroid’ s secretory capacity (SPINA-GT), Jostel’s TSH index (TSHI), thyrotroph T4 sensitivity index (TTSI) were calculated. Logistic regression and multiple linear regression were performed to assess associations.

Results

Compared with euthyroid subjects, patients with SCH were more likely to have poor overall sleep quality (15.1 vs.25.8 %, P = 0.018) and l less likely to stay up late on weekdays (54.7 vs. 23.9 % P < 0.001). In SCH group, exercise was the influencing factor of TSH (β= -0.224, P = 0.004), thyroid secretory capacity (β = 0.244, P = 0.006) and thyrotropin resistance (β = 0.206, P = 0.009). Iodine excess was the influencing factor of thyroid secretory capacity (β = 0.209, P = 0.001) and pituitary thyroid stimulating function (β = 0.167, P = 0.034). Smoking was the influencing factor of pituitary thyroid stimulating function (β = 0.161, P = 0.040). Staying up late on weekends was the influencing factor of thyroid secretory capacity (β = 0.151, P = 0.047). After adjusting for possible confounders, logistic regression showed that those with poor overall sleep quality assessed by PSQI and iodine excess had an increased risk of SCH (OR 2.159, 95 %CI 1.186–3.928, P = 0.012 and OR 2.119, 95 %CI 1.008–4.456, P = 0.048, respectively).

Conclusions

Lifestyle including sleep, smoking, diet and exercise was closely related to thyroid function especially thyroid homeostasis in SCH.
Effect of MTA versus CEM apical plugs on fracture resistance of endodontically treated simulated immature teeth restored with cast metal posts: an in-vitro study
Authors: Grayli Ensieh , Dashtban Abbas , Shadan Leyla , Behnampour Naser , Afshari Elham
Published: May 2021

Background

Endodontically treated immature teeth which are restored with cast metal posts are of the most susceptible teeth to fracture. An apical plug is usually used as root end filling in order to seal the wide apical foramen. The current study was performed to evaluate the effect of different apical plug materials (MTA and Calcium enriched mixture cement) at varied thicknesses on fracture resistance of teeth restored with cast metal posts.

Methods

A total of 40 extracted intact single-rooted human mandibular premolars (removed for orthodontic reasons) were used in the study. The coronal part of each tooth was removed and root canal preparation was performed. A size 4 Gates Glidden drill was used to enlarge the canal and was passed through the apical foramen in order to simulate an immature apex. Samples were randomly divided into 5 groups (n = 8) according to apical plug (control group: No plug, group MTA5: 5 mm MTA plug, group CEM5: 5 mm CEM plug, group MTA3: 3 mm MTA plug, group CEM3: 3 mm CEM plug). Post-space preparations were performed and cast metal post-and-cores were fabricated and cemented. Fracture resistance was assessed using a universal testing machine. Fracture thresholds were recorded and data were analyzed using One-way ANOVA and Dunnett’s T3 tests with significance level at P value < 0.05.

Results

The analysis showed a significant difference of fracture resistance between groups (P value < 0.05). The mean fracture resistance of samples in control group was significantly lower than MTA5 (P value = 0.003). There was no significant difference between other groups (P value > 0.05).

Conclusions

Within the limits of this study, the evidence indicated that placement of a 5 mm MTA apical plug increased the fracture resistance in simulated immature teeth which are restored with cast metal posts, compared to control group (gutta-percha and sealer). While the results were not as promising for a 3 mm MTA apical plug or either 3 or 5 mm CEM apical plug.
Decision making in the end-of-life care of patients who are terminally ill with cancer – a qualitative descriptive study with a phenomenological approach from the experience of healthcare workers
Authors: Luna-Meza Angela , Godoy-Casasbuenas Natalia , Calvache José Andrés , Díaz-Amado Eduardo , Gempeler Rueda Fritz E. , Morales Olga , Leal Fabian , Gómez-Restrepo Carlos , de Vries Esther
Published: May 2021

Background

In Colombia, recent legislation regarding end-of-life decisions includes palliative sedation, advance directives and euthanasia. We analysed which aspects influence health professionals´ decisions regarding end-of-life medical decisions and care for cancer patients.

Methods

Qualitative descriptive–exploratory study based on phenomenology using semi-structured interviews. We interviewed 28 oncologists, palliative care specialists, general practitioners and nurses from three major Colombian institutions, all involved in end-of-life care of cancer patients: Hospital Universitario San Ignacio and Instituto Nacional de Cancerología in Bogotá and Hospital Universitario San José in Popayan.

Results

When making decisions regarding end-of-life care, professionals consider: 1. Patient’s clinical condition, cultural and social context, in particular treating indigenous patients requires special skills. 2. Professional skills and expertise: training in palliative care and experience in discussing end-of-life options and fear of legal consequences. Physicians indicate that many patients deny their imminent death which hampers shared decision-making and conversations. They mention frequent ambiguity regarding who initiates conversations regarding end-of-life decisions with patients and who finally takes decisions. Patients rarely initiate such conversations and the professionals normally do not ask patients directly for their preferences. Fear of confrontation with family members and lawsuits leads healthcare workers to carry out interventions such as initiating artificial feeding techniques and cardiopulmonary resuscitation, even in the absence of expected benefits. The opinions regarding the acceptability of palliative sedation, euthanasia and use of medications to accelerate death without the patients´ explicit request vary greatly. 3. Conditions of the insurance system: limitations exist in the offer of oncology and palliative care services for important proportions of the Colombian population. Colombians have access to opioid medications, barriers to their application are largely in delivery by the health system, the requirement of trained personnel for intravenous administration and ambulatory and home care plans which in Colombia are rare.

Conclusions

To improve end-of-life decision making, Colombian healthcare workers and patients need to openly discuss wishes, needs and care options and prepare caregivers. Promotion of palliative care education and development of palliative care centres and home care plans is necessary to facilitate access to end-of-life care. Patients and caregivers’ perspectives are needed to complement physicians’ perceptions and practices.
Medical education reform in Tajikistan: comparison of the conventional one-year family medicine residency program and the new two-year residency program for postgraduate medical education
Authors: Bohle Leah F. , Valencia Edgar , Ross Greta , Dzhabarovna Davlyatova Dilbar , Yarbaeva Shakhlo N. , Kasymova Zukhra A. , Prytherch Helen
Published: May 2021

Introduction

The last two decades have seen a shift in former Soviet countries from highly specialized to more family medicine-focused systems. Medical education has slowly adjusted to these reforms, although the region is still at risk to have a chronic shortage of family doctors. This paper presents the evaluation of a new post-graduate family medicine program in Tajikistan, focused on competency-based training. The findings are relevant for policy makers, international organizations and practitioners participating in similar medical education reform programs.

Methods

We employed a quasi-experimental control group design and compared intervention residents, control group residents with traditional training, and 1st year residents with no training in two outcomes, clinical knowledge and competencies. We employed two objective measures, a written multiple-choice question test (MCQT) and an Objective Structured Clinical Examination (OSCE), respectively. We report reliability and validity of the measures along with ANOVA, planned contrasts and effect size estimates to examine differences across groups.

Results

We found statistically significant differences in both clinical knowledge and competencies between intervention and control groups. We also detected a large intervention effect size. Participants in the intervention outperformed control group participants in the two measures. Our analysis suggests that intervention and control group participants are comparable in terms of initial knowledge and competencies, strengthening the argument that the intervention caused the improvement in the program outcomes.

Discussion

Receiving tailored training and structured opportunities to practice knowledge and competencies in clinical settings have a positive effect on the education of family medicine doctors in Tajikistan. Our results support curriculum reform and investment in medical education in the form of longer and supervised on-the-job preparation designed to be more in line with international standards. We discuss suggestions for future studies and potential requirements to inform replicability in other countries.

Conclusion

Family medicine is well recognized as central to health systems throughout the world, but high quality residency training lags behind in some countries. Our study showed that investing in family medicine residency programs and structured training is effective in increasing critical clinical competencies. We encourage promoting comprehensive post graduate family medicine doctor training so that the goals of a family medicine centered health system are attainable.
Constrains for seeking post-abortion care among adolescents and young women in Guangzhou, China: a cross-sectional study
Authors: Wang Yiding , Liu Jinzhi , Xiong Ribo , Liu Yan
Published: May 2021

Background

In China, post-abortion care (PAC) services mainly focus on married couples, such that adolescents and unmarried young women have limited access to those services for contraception counseling. The provision of youth-friendly PAC services in public hospitals is a new concept in China. This study examined the magnitude of PAC services utilization as well as factors influencing its uptake among adolescents and young women in Guangzhou, China.

Methods

A cross-sectional study was performed from 1st March 2020 to 30th September 2020 using an anonymous self-administered questionnaire among 688 women aged 15–24 years in Tianhe district, Guangzhou. The Multivariate logistic regression was used to determine factors that were significantly associated with the uptake of PAC services.

Results

The magnitude of PAC services utilization was 35.9% among adolescents and young women in Guangzhou, China. Students were 69.0% significantly less likely to use PAC services compared to women who had no job. Immigrants were 59.0% significantly less likely to use PAC services than their native counterparts. Women who had a feeling of stigma were 70.0% significantly less likely to use PAC services compared to those who did not feel stigmatized.

Conclusions

The study highlights the need to strengthen youth-friendly PAC services provision, and emphasizes the importance of education about both family planning and abortion services among disadvantaged subgroups of women in the study setting.
3D printing guide plate for accurate hemicortical bone tumor resection in metaphysis of distal femoral: a technical note
Authors: Wu Hongwei , Yang Shuo , Liu Jianfan , Li Linqin , Luo Yi , Dai Zixun , Wang Xin , Yao Xinyu , Zhou Feng , Li Xian’an
Published: May 2021

Background

Surgical resection and reconstruction for low-grade bone sarcoma in the metaphysis of the distal femur remain challenging. We hypothesized that 3D printing osteotomy guide plate could assist to accurately resect the tumor lesion and save the joint function.

Methods

From January 2017 to August 2019, five patients diagnosed with low-grade bone sarcoma in the metaphysis of the distal femur were treated with hemicortical resection using 3D printing guide plate. Autologous bone graft was inactivated in a high-temperature water bath and re-implanted in situ fixed with plate and screw. Patients were followed up from 17 to 33 months. The Musculoskeletal Tumor Society Score was used to evaluate the joint function. X-ray was used to evaluate the bone union.

Results

One patient was paracorticular osteosarcoma, and four cases had highly differentiated chondrosarcoma. All cases were involved in the metaphysis of the distal femur. Patients were followed up from 13 to 33 months, with an average of 23.6 months. There was neither post-operation infection, internal fixation loosening, nor fracture occurrence in any of the patients. The Musculoskeletal Tumor Society Score averaged at 28.1, while the International Society of Limb Salvage imaging score examination averaged 89.8%.

Conclusions

Here, we demonstrate that the 3D printing osteotomy guide plate-assisted hemicortical bone resection is a beneficial strategy to effectively resect the primary low-grade malignant bone tumors in the metaphysis of the distal femur and retained satisfied joint function.
Improvement of sleep quality 6 months after total knee arthroplasty: a systematic review and meta-analysis
Authors: Alipourian Ali , Farhadian Negin , Zereshki Ehsan , Khazaie Habibollah
Published: May 2021

Background

Total knee arthroplasty (TKA) is an accepted, effective treatment to restore function, relieve pain, and improve the quality of life in patients with advanced osteoarthritis. One complication of this major surgery is impaired sleep quality. This study examines the quality of sleep in patients undergoing TKA before and after their operation.

Methods

All relevant records were obtained using a systematic search in three online databases: PubMed, Scopus, and Cochrane library. Out of the 177 records retrieved, only eight matched the inclusion criteria. Due to the lack of sufficient data, only four studies entered the meta-analysis. Values reported for sleep quality based on the Pittsburgh Sleep Quality Index (PSQI) were extracted from patient records before and after surgery. A random-effect model was used to analyze the data.

Results

The results of the meta-analysis show a significant difference in the improvement of sleep quality after surgery at two time points of 4–6 weeks after surgery from the preoperative baseline (SMD − 0.16; 95% CI − 1.05 to 0.74; P = 0.0) and 3–6 months after surgery from the preoperative baseline (SMD − 0.92; 95% CI − 1.61 to − 0.24; P = 0.0).

Conclusions

The results show that TKA generally improves the patients’ sleep quality. Although some studies reported disrupted sleep quality in periods close to the surgery (especially in the early days after surgery), all studies have reported improved sleep quality in the late postoperative intervals.
Treatment of Chylothorax complicating pulmonary resection with hypertonic glucose Pleurodesis
Authors: Zhang Kejian , Li Changyuan , Zhang Mingrui , Li Yang
Published: May 2021

Background

To retrospectively assess the efficacy of hypertonic glucose pleurodesis for treatment of chylothorax after pulmonary resection.

Methods

Out of a total of 8252 patients who underwent pulmonary resection (at least lobectomy) at department of thoracic surgery, between June 2008 and December 2015, 58 patients (0.7%) developed postoperative chylothorax. All patients received conservative treatment, including thoracic closed drainage, oral fasting, and total parenteral nutrition.

Results

Conservative treatment was successful in 50 (86.2%) patients, while eight patients [mean age: 58.0 years (range, 45–75)] were treated with hypertonic glucose pleurodesis. All eight patients had undergone operation for lung cancer (four squamous cell carcinomas and four adenocarcinomas). The bronchial stump was covered by pleural flap in three patients. After pleurodesis, three patients developed fever but without empyema; thoracentesis was performed in two patients. The mean time interval between pleurodesis and operation was 4.3 days (range,3–5) days. The average length of stay was 23.1 days (range, 18–31). No recurrent pleural effusion was observed over a mean follow-up duration of 28 months.

Conclusion

Hypertonic glucose pleurodesis performed via the chest drainage tube is a viable treatment option for chylothorax after lung resection, prior to resorting to a thoracoscopic or thoracotomic ductus thoracicus ligation of the thoracic duct leak. It is a simple, safe and efficient modality associated with rapid recovery and less pain.
Post-transplant cyclophosphamide containing regimens after matched sibling, matched unrelated and haploidentical donor transplants in patients with acute lymphoblastic leukemia in first complete remission, a comparative study of the ALWP of the EBMT
Authors: Sanz Jaime , Galimard Jacques-Emmanuel , Labopin Myriam , Afanasyev Boris , Sergeevich Moiseev Ivan , Angelucci Emanuele , Kröger Nicolaus , Koc Yener , Ciceri Fabio , Diez-Martin J. L. , Arat Mutlu , Sica Simona , Rovira Montserrat , Aljurf Mahmoud , Tischer Johanna , Savani Bipin , Ruggeri Annalisa , Nagler Arnon , Mohty Mohamad
Published: May 2021

Background

There is no information on the impact of donor type in allogeneic hematopoietic stem cell transplantation (HCT) using homogeneous graft-versus-host (GVHD) prophylaxis with post-transplant cyclophosphamide (PTCy) in acute lymphoblastic leukemia (ALL).

Methods

We retrospectively analyzed outcomes of adult patients with ALL in CR1 that had received HCT with PTCy as GVHD prophylaxis from HLA-matched sibling (MSD) (n = 78), matched unrelated (MUD) (n = 94) and haploidentical family (Haplo) (n = 297) donors registered in the EBMT database between 2010 and 2018. The median follow-up period of the entire cohort was 2.2 years.

Results

Median age of patients was 38 years (range 18–76). Compared to MSD and MUD, Haplo patients received peripheral blood less frequently. For Haplo, MUD, and MSD, the cumulative incidence of 100-day acute GVHD grade II–IV and III–IV, and 2-year chronic and extensive chronic GVHD were 32%, 41%, and 34% (p = 0.4); 13%, 15%, and 15% (p = 0.8); 35%, 50%, and 42% (p = 0.01); and 11%, 17%, and 21% (p = 0.2), respectively. At 2 years, the cumulative incidence of relapse and non-relapse mortality was 20%, 20%, and 28% (p = 0.8); and 21%, 18%, and 21% (p = 0.8) for Haplo, MUD, and MSD, respectively. The leukemia-free survival, overall survival and GVHD-free, relapse-free survival for Haplo, MUD, and MSD was 59%, 62%, and 51% (p = 0.8); 66%, 69%, and 62% (p = 0.8); and 46%, 44%, and 35% (p = 0.9), respectively. On multivariable analysis, transplant outcomes did not differ significantly between donor types. TBI-based conditioning was associated with better LFS.

Conclusions

Donor type did not significantly affect transplant outcome in patient with ALL receiving SCT with PTCy.
Designing a tangible tabletop installation and enacting a socioenactive experience with TangiTime
Authors: Méndez Mendoza Yusseli Lizeth , C. Baranauskas M. Cecília
Published: May 2021

Contemporary computational technology (tangible and ubiquitous) are still challenging the mainstream systems design methods, demanding new ways of considering the interaction design and its evaluation. In this work, we draw on concepts of enactivism and enactive systems to investigate interaction and experience in the context of the ubiquity of computational systems. Our study is illustrated with the design and usage experience of TangiTime: a tangible tabletop system proposed for an educational exhibit. TangiTime was designed to enable a socioenactive experience of interaction with the concept of “deep time.” In this paper, we present the TangiTime design process, the artifacts designed and implemented, in its conceptual, interactional, and architectural aspects. Besides that, we present and discuss results of an exploratory study within an exhibition context, to observe how socioenactive aspects of the experience potentially emerge from the interaction. Overall, the paper contributes with elements of design that should be considered when designing a socioenactive experience in environments constituted by contemporary computational technology.
Krukenberg tumor as an incidental finding in a full-term pregnancy: a case report
Authors: Mendoza-Rosado Felipe , Nunez-Isaac Orlando , Espinosa-Marrón Alan , Lopez-Arjona Katheryn , Davila-Martinez Fernando
Published: May 2021

Background

Krukenberg tumor is a rare metastatic tumor of the ovary with histopathological features known as signet ring cells. It usually develops in women around 45 years of age. However, here we describe an uncommon case in a 38-year-old pregnant woman. We report this case due to our unusual findings, the uncommon presentation in this younger age bracket, its diagnostic challenge, and poor prognosis.

Case presentation

We describe a unique case of a young Mexican woman with a history of painful vaginal bleeding at 13 weeks of pregnancy and treated for abruptio placentae. In her routine prenatal visit at week 20 of pregnancy, she was found to have a uterine fundus exceeding the expected measure for her gestational age and was referred to the hospital to discard polyhydramnios. Upon admission, a pelvic ultrasound was performed displaying normal findings in a 25-week pregnancy, and also showing bilateral enlarged ovaries with heterogeneous echogenicity. Magnetic resonance imaging revealed a left tumoral lesion with dimensions of 22.1 × 13.6 × 16.3 cm presenting regular lobulated contours with displacement of peripheral structures and mild compression of the bladder, the left ureter, and the inferior vena cava. The lesion was heterogeneous with irregular borders. The patient was scheduled for a cesarean section; during the operation, the abdominal cavity showed bilateral tumors compatible with MRI findings. The ovarian tumors were sent to pathology, and the results showed poorly differentiated mucinous adenocarcinoma (World Health Organization grade III) with extensive signet ring cells, indicative of a Krukenberg tumor.

Conclusion

This case report describes an uncommon example of a young pregnant woman without identifiable risk factors for gastric cancer who manifested a Krukenberg tumor. This incidental finding suggests that pregnancy obscured the cancer’s clinical appearance. The rapid deterioration in the patient’s condition corresponds to what is described in the literature. The limited information regarding this neoplasm in Mexico and the torpid evolution of the case highlight the importance of conducting additional studies to generate therapeutic interventions aimed at increasing overall survival.
Editorial Expression of Concern: Brette Pearl Spar Mable (BPSM): a potential recoverable catalyst as a renewable source of biodiesel from Thevetia peruviana seed oil for the benefit of sustainable development in West Africa
Authors: Adepoju T. F. , Olatunbosun B. E. , Olatunji O. M. , Ibeh M. A.
Published: May 2021

An amendment to this paper has been published and can be accessed via the original article.
Manuka honey enhanced sensitivity of HepG2, hepatocellular carcinoma cells, for Doxorubicin and induced apoptosis through inhibition of Wnt/β-catenin and ERK1/2
Authors: Al Refaey Heba R. , Newairy Al-Sayeda A. , Wahby Mayssaa M. , Albanese Chris , Elkewedi Mohamed , Choudhry Muhammad Umer , Sultan Ahmed S.
Published: May 2021

Background

Recently, there is increasing awareness focused on the identification of naturally occurring anticancer agents derived from natural products. Manuka honey (MH) has been recognized for its biological properties as antimicrobial, antioxidant, and anticancer properties. However, its antiproliferative mechanism in hepatocellular carcinoma is not investigated. The current study focused mainly on investigating the molecular mechanism and synergistic effect of anticancer properties of MH on Doxorubicin (DOX)-mediated apoptotic cell death, using two different p53 statuses (HepG2 and Hep3B) and one non-tumorigenic immortalized liver cell line.

Results

MH treatment showed a proliferative inhibitory effect on tested cells in a dose-dependent manner with IC50 concentration of (6.92 ± 0.005%) and (18.62 ± 0.07%) for HepG2 and Hep3B cells, respectively, and induced dramatic morphological changes of Hep-G2 cells, which considered as characteristics feature of apoptosis induction after 48 h of treatment. Our results showed that MH or combined treatments induced higher cytotoxicity in p53-wild type, HepG2, than in p53-null, Hep3B, cells. Cytotoxicity was not observed in normal liver cells. Furthermore, the synergistic effect of MH and Dox on apoptosis was evidenced by increased annexin-V-positive cells and Sub-G1 cells in both tested cell lines with a significant increase in the percentage of Hep-G2 cells at late apoptosis as confirmed by the flow cytometric analysis. Consistently, the proteolytic activities of caspase-3 and the degradation of poly (ADP-ribose) polymerase were also higher in the combined treatment which in turn accompanied by significant inhibitory effects of pERK1/2, mTOR, S6K, oncogenic β-catenin, and cyclin D1 after 48 h. In contrast, the MH or combined treatment-induced apoptosis was accompanied by significantly upregulated expression of proapoptotic Bax protein and downregulated expression of anti-apoptotic Bcl-2 protein after 48 h.

Conclusions

Our data showed a synergistic inhibitory effect of MH on DOX-mediated apoptotic cell death in HCC cells. To our knowledge, the present study provides the first report on the anticancer activity of MH and its combined treatment with DOX on HCC cell lines, introducing MH as a promising natural and nontoxic anticancer compound.
Nutritional quality of the food choices of Canadian children
Authors: Hack Salma , Jessri Mahsa , L’Abbé Mary R.
Published: May 2021

Background

The release of the Canadian Community Health Survey (CCHS), Nutrition 2015 provides a unique opportunity since CCHS 2004 to investigate food choices of Canadian children and adolescents at a national level.

Objective

This study examined the quality and quantity of food choices of children ages 2–8 years and adolescents 9–18 years, using Health Canada’s Surveillance Tool Tier System 2014. It is hypothesized that Canadian children and adolescents are consuming diets poor in nutritional quality based on evidence from the last national nutrition survey in 2004.

Design

Intakes from CCHS 2015, 24-h dietary recall were categorized into Health Canada’s Tiers 1–4, based on CNF/CFG classification system and thresholds for nutrients to limit i.e., total fat, saturated fats, sugars, and sodium to assess quality of food choices. Additionally, dietary intakes were grouped according to Canada’s 2007 food guide servings as the 2019 food guide was not available.

Results

Majority of foods reported by children 2–18 years were categorized as Tier 2 and Tier 3 foods. Investigation of energy contributions from the Tier 4 and “other foods” represented 21–25% of daily calorie intake and of these foods, high fat and/or high sugar foods contributed majority of daily calories to these categories.

Conclusions

This study showed Canadian children 2–18 years are consuming diets high in nutrients recommended to limit. Evidence from this study provides a unique opportunity to improve the nutritional quality of foods, and the food choices of children.
Nonstationary local signal-and-noise orthogonalization
Authors: Chen Yangkang , Fomel Sergey
Published: May 2021

The local signal-and-noise orthogonalization method has been widely used in the seismic processing and imaging community. This method uses a fixed triangle smoother for regularizing the local orthogonalization weight, which is based on the assumption that the energy is homogeneously distributed across the whole seismic profile. The fixed triangle smoother limits the performance of the local orthogonalization method in processing complicated seismic data sets. We have developed a new local orthogonalization method that uses a variable triangle smoother. The nonstationary smoothing radius is obtained by solving an optimization problem in which the low-pass-filtered seismic data are matched by the smoothed data in terms of the local frequency attribute. The new local orthogonalization method with the nonstationary model smoothness constraint is called the nonstationary local orthogonalization method. We have proven the successful performance of the new method using several synthetic and field data evaluations.
Decoupled approximation and separate extrapolation of P- and SV-waves in transversely isotropic media
Authors: Li Bowen , Stovas Alexey
Published: May 2021

Characterizing the kinematics of seismic waves in elastic vertical transversely isotropic (VTI) media involves four independent parameters. To reduce the complexity, the acoustic approximation for P-waves reduces the number of required parameters to three by setting the vertical S-wave velocity to zero. However, because only the SV-wave phase velocities parallel or perpendicular to the symmetry axis are indirectly set to zero, the acoustic approximation leads to coupled P-wave components and SV-wave artifacts. The new acoustic approximation suggests setting the vertical S-wave velocity as a phase angle-dependent variable so that the SV-wave phase velocity is zero at all phase angles. We find that manipulating this parameter is a valid approach for P-wave approximation but doing so inevitably leads to zero- or nonzero-valued spurious SV-wave components. Thus, we have developed a novel approach to efficiently approximate and thoroughly separate the two wave modes in VTI media. First, the exact P- and SV-wave phase velocity expressions are rewritten by introducing an auxiliary function. After confirming the insensitivity of this function, we construct a new expression for it and obtain simplified P- and SV-wave phase velocity expressions, which are three and four parameters, respectively. This approximation process leads to the same reasonable error for both wave modes. Accuracy analysis indicates that, for the P-wave, the overall accuracy performance of our approach is comparable to that of some existing three-parameter approximations. We then derive the corresponding P- and SV-wave equations in tilted transversely isotropic (TTI) media and provide two available solutions, the hybrid finite-difference/pseudospectral scheme and the low-rank approach. Numerical examples illustrate the separability and high accuracy of the proposed P- and SV-wave simulation methods in TTI media.