bluuebunny/crossref_metadata_2025 huggingface dataset:
Balanced callose and cellulose biosynthesis in Arabidopsis quorum-sensing signaling and pattern-triggered immunity
Authors: Liu Xiaolin , Ma Zhiming , Tran Tuan Minh , Rautengarten Carsten , Cheng Yingying , Yang Liang , Ebert Berit , Persson Staffan , Miao Yansong
Published: August 2023

The plant cell wall (CW) is one of the most important physical barriers that phytopathogens must conquer to invade their hosts. This barrier is a dynamic structure that responds to pathogen infection through a complex network of immune receptors, together with CW-synthesizing and CW-degrading enzymes. Callose deposition in the primary CW is a well-known physical response to pathogen infection. Notably, callose and cellulose biosynthesis share an initial substrate, UDP-glucose, which is the main load-bearing component of the CW. However, how these 2 critical biosynthetic processes are balanced during plant–pathogen interactions remains unclear. Here, using 2 different pathogen-derived molecules, bacterial flagellin (flg22) and the diffusible signal factor (DSF) produced by Xanthomonas campestris pv. campestris, we show a negative correlation between cellulose and callose biosynthesis in Arabidopsis (Arabidopsis thaliana). By quantifying the abundance of callose and cellulose under DSF or flg22 elicitation and characterizing the dynamics of the enzymes involved in the biosynthesis and degradation of these 2 polymers, we show that the balance of these 2 CW components is mediated by the activity of a β-1,3-glucanase (BG2). Our data demonstrate balanced cellulose and callose biosynthesis during plant immune responses.
Expert legitimacy and competing legitimation in Italian school reforms
Authors: Galanti Maria Tullia
Published: August 2023

In the face of the complexities of problem-solving , experts are gaining centrality in policymaking (Weiss, 1979). At the same time, they are increasingly challenged in their legitimacy, which is not only technical but also political. Challenges to the legitimacy of experts suggest that other types of legitimacy are important for policymaking. Issues of legitimacy are particularly important for sound policymaking when the authority of experts and the value of evidence are contested and when the debate over policy solutions is particularly conflictual and ideological. In this paper, I use three exploratory cases of the use of expertise in education policy in Italy to show how policymakers design different advisory committees to enhance different types of legitimacy (epistemic, bureaucratic, and political). The findings suggest that while policymakers design advisory committees primarily to meet their legitimacy needs, the legitimacy of a decision requires different types of sources to generate consent and to allow for the impact of expertise.
NIR-responsive carrier-free nanoparticles based on berberine hydrochloride and indocyanine green for synergistic antibacterial therapy and promoting infected wound healing
Authors: Duan Youyu , Xu Peiyao , Ge Panyuan , Chen Linfei , Chen Ying , Kankala Ranjith Kumar , Wang Shibin , Chen Aizheng
Published: August 2023

Bacterial infections cause severe health conditions, resulting in a significant economic burden for the public health system. Although natural phytochemicals are considered promising anti-bacterial agents, they suffer from several limitations, such as poor water solubility and low bioavailability in vivo, severely restricting their wide application. Herein, we constructed a near-infrared (NIR)-responsive carrier-free berberine hydrochloride (BH, phytochemicals)/indocyanine green (ICG, photosensitizer) nanoparticles (BI NPs) for synergistic antibacterial of an infected wound. Through electrostatic interaction and π–π stacking, the hydrophobic BH and amphiphilic ICG are initially self-assembled to generate carrier-free nanoparticles. The obtained BI NPs demonstrated NIR-responsive drug release behavior and better photothermal conversion efficiency of up to 36%. In addition, BI NPs stimulated by NIR laser exhibited remarkable antibacterial activity, which realized the synergistic antibacterial treatment and promoted infected wound healing. In summary, the current research results provided a candidate strategy for self-assembling new BI NPs to treat bacterial infections synergistically.
Early anakinra treatment improves cardiac outcome of multisystem inflammatory syndrome in children, regardless of disease severity
Authors: Taddio Andrea , Della Paolera Sara , Abbagnato Luisa , Agrusti Anna , Badolato Raffaele , Biscaro Francesca , Caorsi Roberta , Consolaro Alessandro , Dellepiane Rosa Maria , Fabi Marianna , Floretta Ilenia , Gattorno Marco , Giangreco Manuela , La Torre Francesco , Maggio Maria Cristina , Mambelli Lorenzo , Mauro Angela , Mastrolia Maria Vincenza , Meneghel Alessandra , Montin Davide , Ricci Francesca , Simonini Gabriele , Smarrazzo Andrea , Sottile Rita , Stucchi Sara , Tardi Maria , Verdoni Lucio , Zuccotti Gianvincenzo , Zunica Fiammetta , Ravelli Angelo , Cattalini Marco ,   the Italian Society of Pediatric Rheumatology (ReumaPed), Adamoli P , Alberelli M C , Alessio M , Alizzi C , Barone P , Baselli L A , Bennato V , Biscaro F , Boscarol G , Bossi G , Campana A , Campus S , Carone M , Civino A , Conti G , Dei Rossi E , Del Giudice E , Dell'Anna A , De Luca M , Felici E , Filocamo G , Foschini M L , Gallizzi R , Giordano S , Lanciotti S , Lattanzi B , Lazzerotti A , Licciardi F , Manerba A , Mannarino S , Marino A , Marolda A , Martelli L , Martini G , Mazza A , Minasi D , Miniaci A , Minoia F , Olivieri A , Pennoni G , Pignataro R , Ricci F , Rigante D , Rossi M , Santagati C , Soliani M , Sonego S , Sperlì D , Teruzzi B L , Tierno E , Utytatnikova T , Valentini P , Vergine G
Published: August 2023

Objective

The main aim of this study was to define the best treatment option for multisystem inflammatory syndrome in children (MIS-C) and to analyse the role of anakinra.

Methods

This is a multicentre retrospective cohort study. Patients were treated according to the attending physician’s decision. The patients were divided into four groups on the basis of the first treatment at time of admittance: (i) IVIG, (ii) IVIG and methylprednisolone (≤2 mg/kg/day), (iii) IVIG with high-dose methylprednisolone (>2 mg/kg/day) and (iv) anakinra with or without IVIG and/or methylprednisolone. Primary outcomes were defined as the presence of at least one of the following features: death, the failure of initial treatment, meaning the need for additional treatment for clinical worsening and cardiac involvement at the end of follow-up.

Results

Two hundred thirty-nine patients were recruited. At univariate analysis, persistent heart involvement at discharge was more frequent in those not receiving anakinra as initial treatment (3/21 vs 66/189; P = 0.047). After comparisons between the four treatment regimens, adjusting for the propensity score, we observed that early treatment with anakinra was associated with a lower probability of developing persistent heart disease at the end of follow-up (odds ratio: 0.6; 95% CI: 0.4–1.0).

Conclusion

We report that early treatment with anakinra is safe and very effective in patients with severe MIS-C. In addition, our study suggests that early treatment with anakinra is the most favourable option for patients with a higher risk of developing a severe disease outcome.
Disparities in multimorbidity and comorbidities in rheumatoid arthritis by sex across the lifespan
Authors: Stevens Maria A , Dykhoff Hayley J , Kronzer Vanessa L , Myasoedova Elena , Davis John M , Duarte-García Alí , Crowson Cynthia S
Published: August 2023

Objectives

Multimorbidity is burdensome for people with RA. We investigated differences in multimorbidity and comorbidities by sex and age in the RA population.

Methods

This cross-sectional analysis used national administrative claims (OptumLabs® Data Warehouse) from people with RA and non-RA comparators (matched on age, sex, race, census region, index year and length of baseline insurance coverage) from 2010–2019. RA was determined using a validated algorithm. Multimorbidity was defined as ≥2 (MM2+) or ≥5 (MM5+) comorbidities from a validated set of 44 chronic conditions. We used logistic regression to assess associations between characteristics and multimorbidity.

Results

The sample included 154 391 RA patients and 154 391 non-RA comparators. For people aged 18–50 years, RA women (vs RA men) had 7.5 and 4.4 (vs 3.2 and 0.9 in non-RA women vs non-RA men) percentage point increases for MM2+ and MM5+, respectively. For people aged 51+ years, RA women (vs RA men) had 2.1 and 2.5 (vs 1.2 and 0.3 in non-RA women vs non-RA men) percentage point increases for MM2+ and MM5+, respectively. Interactions revealed that differences in multimorbidity between women and men were exacerbated by RA (vs non-RA) (P < 0.05), with more pronounced effects in people aged 18–50. Men had more cardiovascular-related conditions, whereas RA women had more psychological, neurological and general musculoskeletal conditions. Other comorbidities varied by sex and age.

Conclusion

Multimorbidity disproportionately impacts women with RA. Research, clinical and policy agendas for rheumatic diseases should acknowledge and support the variation in care needs by sex and gender across the lifespan.
Differential outcomes of high‐fat diet on age‐related rescaling of cochlear frequency place coding
Authors: Zhang Yu , Lin Guotong , Xue Na , Wang Yi , Du Tingting , Liu Huihui , Xiong Wei , Shang Wei , Wu Hao , Song Lei
Published: August 2023

Auditory frequency coding is place‐specific, which depends on the mechanical coupling of the basilar membrane‐outer hair cell (OHC)‐tectorial membrane network. Prestin‐based OHC electromotility improves cochlear frequency selectivity and sensitivity. Cochlear amplification determines the frequency coding wherein discrete sound frequencies find a ‘best’ place along the cochlear length. Loss of OHC is the leading cause of age‐related hearing loss (ARHL) and is the most common cause of sensorineural hearing loss and compromised speech perception. Lipid interaction with Prestin impacts OHC function. It has been established that high‐fat diet (HFD) is associated with ARHL. To determine whether genetic background and metabolism preserve cochlear frequency place coding, we examined the effect of HFD in C57BL/6J (B6) and CBA/CaJ (CBA) on ARHL.We found a significant rescuing effect on ARHL in aged B6 HFD cohort. Prestin levels and cell sizes were better maintained in the experimental B6‐HFD group. We also found that distortion product otoacoustic emission (DPOAE) group delay measurement was preserved, which suggested stable frequency place coding. In contrast, the response to HFD in the CBA cohort was modest with no appreciable benefit to hearing threshold. Notably, group delay was shortened with age along with the control. In addition, the frequency dependent OHC nonlinear capacitance gradient was most pronounced at young age but decreased with age. Cochlear RNA‐seq analysis revealed differential TRPV1 expression and lipid homeostasis. Activation of TRPV1 and downregulation of arachidonic acid led to downregulation of inflammatory response in B6 HFD, which protects the cochlea from ARHL. The genetic background and metabolic state‐derived changes in OHC morphology and function collectively contribute to a redefined cochlear frequency place coding and improved age‐related pitch perception.
Quantitative Romberg on a Force Plate
Authors: Kesler Kyle , Glassman Steven D. , Gum Jeffrey L. , Djurasovic Mladen , Campbell Mitchell J. , Schmidt Grant O. , Carreon Leah Y.
Published: August 2023

Study Design.

Longitudinal observational cohort.

Objectives.

The purpose of this study was to evaluate the utility of Quantitative Romberg measurements as pre-op and post-op balance outcome measures.

Summary of Background Data.

Cervical spondylotic myelopathy (CSM) is characterized by balance deficiencies produced by impaired proprioception. Evaluation is subjective, and binary physical exam findings lack the precision to assess postoperative outcome improvement.

Methods.

CSM patients were prospectively enrolled to undergo preoperative and postoperative Quantitative Romberg tests on a force plate to record center of pressure (COP) motion for 30 seconds with eyes open followed by eyes closed. Revision cases were excluded. Kinematics of COP movement parameters were compared between preoperative and postoperative state for each patient.

Results.

Twenty-seven CSM patients were enrolled and completed both pre/post-testing. The mean age was 60.0 years, with 13 (48%) males and 9 (33%) smokers. Mean number of surgical levels was 2.48. The minimum mean follow-up was six months. There was a statistically significant improvement in eyes closed after surgery compared with preoperative for total COP motion (523.44 vs. 387.00 cm, P<0.001), average sway speed (17.41 vs. 13.00 cm/s, P<0.001), and total lateral COP motion (253.44 vs. 186.70 cm, P<0.001). There was no statistically significant improvement in the modified Japanese Orthopaedic Association (13.29 vs. 14.29, P=0.28).

Conclusions.

CSM balance findings on Quantitative Romberg testing significantly improve postoperatively in patients with CSM. These findings support this testing as representative of proprioceptive balance deficiencies seen in CSM. Quantitative Romberg may be used as an objective measure of clinical outcome and assist in stratification of surgical interventions, surgery timing, and technique.
Radiographic Predictors of Subaxial Subluxation After Atlantoaxial Fusion
Authors: Takasawa Eiji , Iizuka Yoichi , Takakura Kenta , Inomata Kazuhiro , Tomomatsu Yusuke , Ito Shunsuke , Honda Akira , Ishiwata Sho , Mieda Tokue , Chikuda Hirotaka
Published: August 2023

Study Design:

A retrospective study.

Objective:

The aim of this study was to clarify preoperative radiographic predictors associated with the development of subaxial subluxation (SAS) after surgery.

Background:

The incidence of atlantoaxial fusion for atlantoaxial instability has been increasing. SAS can develop after surgery despite atlantoaxial fusion with the optimal C1–C2 angle. We hypothesized that preoperative discordant angular contribution in the upper and subaxial cervical spine is associated with the occurrence of postoperative SAS.

Materials and Methods:

Patients who underwent surgery for atlantoaxial instability with a minimum 5-year follow-up and control participants were included. The O–C2 angle, C2 slope (C2S), C2–C7 cervical lordosis (CL), and T1 slope (T1S) were measured. We focused on the angular contribution ratio in the upper cervical spine to the whole CL, and the preoperative C2/T1S ratio was defined as the ratio of C2S to T1S.

Results:

Twenty-seven patients (SAS=11, no-SAS=16; mean age, 60.7 y old; 77.8% female; mean follow-up duration, 6.8 y) and 23 demographically matched control participants were enrolled. The SAS onset was at 4.7 postoperative years. Preoperatively, the O–C2 angle, C2–C7 CL, and T1S were comparable between the SAS, no-SAS, and control groups. The preoperative C2S and C2/T1S ratio were smaller in the SAS group than in the no-SAS or control group (C2S, 11.0 vs. 18.4 vs. 18.7 degrees; C2/T1S ratio, 0.49 vs. 0.77 vs. 0.78, P<0.05). The receiver operating characteristic curve analysis demonstrated that the C2/T1S ratio had higher specificity and similar sensitivity as a predictor of postoperative SAS than C2S (specificity: 0.90 vs. 0.87; sensitivity: 0.73 vs. 0.73). The estimated cutoff values of the C2S and C2/T1S ratio were 14 degrees and 0.58, respectively.

Conclusions:

The preoperative C2/T1S ratio was closely associated with postoperative SAS. Patients with a C2/T1S ratio <0.58 were at a high risk of SAS after atlantoaxial fusion.

Level of Evidence:

Level 4.
Research progress in the mechanism and treatment of osteosarcoma
Authors: Bian Jichao , Liu Yang , Zhao Xiaowei , Meng Chunyang , Zhang Yuanmin , Duan Yangmiao , Wang Guodong
Published: August 2023

Osteosarcoma (OS) is the most common primary malignant bone tumor that more commonly occurs in children and adolescents. The most commonly used treatment for OS is surgery combined with chemotherapy, but the treatment outcomes are typically unsatisfactory. High rates of metastasis and post-treatment recurrence rates are major challenges in the treatment of OS. This underlines the need for studying the in-depth characterization of the pathogenetic mechanisms of OS and development of more effective therapeutic modalities. Previous studies have demonstrated the important role of the bone microenvironment and the regulation of signaling pathways in the occurrence and development of OS. In this review, we discussed the available evidence pertaining to the mechanisms of OS development and identified therapeutic targets for OS. We also summarized the available treatment modalities for OS and identified future priorities for therapeutics research.
Are Physician Assistants Able to Correctly Identify Prescribing Errors? A Cross-Sectional Study
Authors: Gillette Chris , Perry Courtney J. , Ferreri Stefanie P. , Sisson Caroline Grey Bell , Bodner Gayle B. , Jones Caitlin E. , Rogers Samantha D. , Rose Tiffany H. , Ip Edward Hak-Sing , Crandall Sonia J.
Published: August 2023

Purpose

(1) To describe how often physician assistant (PA) students correctly identify prescribing errors and (2) examine between-cohort differences on ability to correctly identify prescribing errors.

Methods

This was a cross-sectional study of 2 cohorts of PA students at one institution. Students were presented with 3 hypothetical prescriptions, 2 of which contained a prescribing error. For each prescription, students were asked to (1) identify whether an error occurred and (2) indicate the type of error. A simple Poisson regression model analyzed the data.

Results

We received responses from 130 students (72.6% response rate). Approximately 12% (12.3%, n = 16) correctly identified whether all 3 prescriptions were correct. The median number of correctly identified prescriptions was 1 (interquartile range = 1). There was not a statistically significant between-cohort difference identifying the correct number of prescriptions (β = 0.27, P = .10).

Conclusion

Physician assistant students' prescribing error identification was similar to previous research in medical and nursing students. Efforts to improve prescribing training are critical to ensure patient safety.
Teaching to Lead: One Program's Experience With Integrating Personal Leadership Into a Doctor of Physical Therapy Curriculum
Authors: Christy Jennifer B. , Morris David , Lein Donald , Clark Diane , Green-Wilson Jennifer
Published: August 2023

Background and Purpose.

Doctor of Physical Therapy (DPT) programs accept responsibility for the development of clinical skills and professional behaviors in students. Academic and clinical faculty endeavor to teach and mentor at the highest levels. Doctor of Physical Therapy programs that develop leadership intentionally, specifically personal, or self-leadership may be successful in leading positive change within their graduates' relationships, environments, and patient outcomes. Personal leadership means leading from within as an individual and does not require the individual to have a leadership title or role. It includes characteristics such as authenticity, passion, emotional intelligence, trustworthiness, and credibility.

Case Description.

This case report will unveil how 1 established residential DPT program integrated personal leadership explicitly as a curricular thread. The 3 pillars are leading self, leading others, and leading systems: organizations and communities. The program used evidence-based processes used to build materials, learning activities, and assessments. The program achieved purposeful integration, including academic/clinical faculty development and progressive student learning experiences.

Outcomes.

Program assessment through focus groups and curricular surveys shows that students value the curricular content in personal leadership and are meeting the curricular thread behavioral objectives.

Discussion and Conclusion.

The personal leadership curricular thread shows promise to promote leadership behaviors in students and graduates.
The Relationship Between the Endoscopic Healing Index, Fecal Calprotectin, and Magnetic Resonance Enterography in Crohn’s Disease
Authors: Smith Emily S. , Chen Johnson , Pan Yushan , Mahtani Prerna , Lukin Dana , Ahmed Waseem , Longman Randy , Burakoff Robert , Scherl Ellen , Battat Robert
Published: August 2023

Introduction:

The serum-based endoscopic healing index (EHI) test identifies endoscopic Crohn’s disease (CD) activity. Data are lacking on the relationship between EHI with other endpoints. We assessed the relationship between EHI and the simplified Magnetic Resonance Index of Activity.

Materials and Methods:

Data were prospectively collected on patients with CD with either an EHI or fecal calprotectin (FCAL) within 90 days of magnetic resonance enterography (MRE). Diagnostic accuracy was assessed using area under the receiver operator characteristics. Proportions with any, severe, and terminal ileum MR inflammation were compared above/below identified thresholds for both EHI and FCAL.

Results:

A total of 241 MREs paired to either EHI or FCAL from 155 patients were included. Both EHI and FCAL had similar accuracy to diagnose inflammation (area under the receiver operator characteristics: EHI: 0.635 to 0.651, FCAL: 0.680 to 0.708). Optimal EHI values were 42 and 26 for inflammation on MRE and endoscopy, respectively. Patients with EHI ≥42 (100% vs. 63%, P=0.002), FCAL >50 µg/g (87% vs. 64%, P<0.001) and FCAL >250 µg/g (90% vs. 75%, P=0.02) had higher rates of simplified Magnetic Resonance Index of Activity ≥1 compared with lower values. EHI differentiated ileitis numerically more than FCAL (delta: 24% to 25% vs. 11% to 21%). Patients with FCAL ≥50 µg/g had higher rates of severe inflammation compared with FCAL <50 µg/g (75% vs. 47%, P<0.001), whereas smaller differentiation existed for EHI threshold of 42 (63% vs. 49%, P=0.35).

Conclusion:

Both EHI and FCAL were specific in their confirmation of inflammation and disease activity on MRE in patients with CD. However, MRE-detected inflammation was frequently present in the presence of low EHI and FCAL in similar proportions.
Investigation of the causal relationship between breast cancer and autoimmune diseases: A bidirectional mendelian randomization study
Authors: Lu Yuyang , Ma Li
Published: August 2023

A clear bidirectional relationship exists between malignant cancers including breast cancer and different autoimmune diseases. However, none of the studies have assessed whether this association is causal and none have used Mendelian randomization for determining this relationship. This study therefore investigated the causal relationship between autoimmune diseases and breast cancer using the Mendelian randomization approach. Summary statistical data were obtained from genome-wide association studies to investigate the causal relationship between different autoimmune diseases including Graves’ disease, Sjögren’s syndrome, Crohn disease, systemic sclerosis, and psoriasis and breast cancer risk. The results revealed no strong evidence to support the causal relationship between Graves disease (odds ratio [OR] = 0.9958; 95% confidence interval [CI]: 0.9982–1.0035), Sjögren’s syndrome (OR = 1.0018; 95% CI: 0.9950–1.0087), Crohn disease (OR = 2.1195, 95% CI: 0.1872–23.9978), systemic sclerosis (OR = 1.0024; 95% CI: 0.997–1.0079), and psoriasis (OR = 1.0016; 95% CI: 0.9913–1.0121) to breast cancer risk. A similar result was obtained in the reverse Mendelian randomization analysis. Our study provides evidence that autoimmune diseases might not have a causal relationship with breast cancer risk in the European population and concludes that shared genetic effects or environmental confounders.
Research progress and hotspots on macrophages in osteoarthritis: A bibliometric analysis from 2009 to 2022
Authors: Liu Yang , Liu Pei-Dong , Zhang Cheng-Ming , Liu Meng-Rou , Wang Gui-Shan , Li Peng-Cui , Yang Zi-Quan
Published: August 2023

Background:

Macrophages in the synovium, as immune cells, can be polarized into different phenotypes to play an anti-inflammatory role in the treatment of osteoarthritis. In this study, bibliometric methods were used to search the relevant literature to find valuable research directions for researchers and provide new targets for osteoarthritis prevention and early treatment.

Methods:

Studies about the application of macrophages in the treatment of osteoarthritis were searched through the Web of Science core database from 2009 to 2022. Microsoft Excel 2019, VOSviewer, CiteSpace, R software, and 2 online websites were used to analyze the research status and predict the future development of the trend in research on macrophages in osteoarthritis.

Results:

The number of publications identified with the search strategy was 1304. China and the United States ranked first in the number of publications. Shanghai Jiao Tong University ranked first in the world with 37 papers. Osteoarthritis and Cartilage was the journal with the most publications, and “exosomes,” “stem cells,” “macrophage polarization,” “regeneration,” and “innate immunity” may remain the research hotspots and frontiers in the future.

Conclusion:

The findings from the global trend analysis indicate that research on macrophages in the treatment of osteoarthritis is gradually deepening, and the number of studies is increasing. Exosomes may become a research trend and hotspot in the future.
Pre- and post-operative comprehensive nursing care versus conventional nursing care: An evaluation of quality of life, postoperative pain, adverse effects, and treatment satisfaction of patients who underwent surgeries and interventional therapies for liver cancer
Authors: Chen PeiPei , Zhang LiQun , Sun JinFeng , Xing QiaoYing , Shi Dan
Published: August 2023

Interventional therapies including chemotherapies and radiotherapies are the most preferred treatment for liver cancer. However, these therapies have adverse effects. Therefore, careful care is required to relieve these adverse effects. The objectives of this study were to evaluate the quality of life, pain, anxiety, depression, adverse effects, and satisfaction of patients with liver cancer who received pre- and post-operative comprehensive nursing care against those of patients who received conventional nursing care. Patients with liver cancer who underwent surgeries and interventional therapies for liver cancer received pre- and post-operative comprehensive nursing care (CMN cohort, n = 105) or conventional nursing care (CNN cohort, n = 135), or did not receive any kind of nursing care (NNC cohort, n = 175). Before the non-treatment intervention(s) (BL), none of the patients had absent post-operative pain, all patients had mild or moderate anxiety and depression, and patients had ≤70 overall quality of life score. In the NNC cohort, a few of the patients reported being completely dissatisfied with overall personal satisfaction, and anxiety, depression, and overall the quality of life of patients were clinically worse during the follow-up period generally after completion of all doses of chemo radiotherapies (EL) as compared to BL. Hospital stays due to surgery, visual analog scale (VAS) score, Zung Self-rating Anxiety Scale score, the Self-rating Depression Scale score, and rehospitalization due to any reason(s) in follow-up were fewer and overall quality of life score and overall personal satisfaction score were higher for patients of the CMN cohort than those of patients at BL and those of patients of the CNN and the NNC cohorts at EL (P < .05 for all). Fever, bleeding, urinary retention, gastrointestinal disturbance, and hepatic and renal impairments reported in patients of the NNC cohort. Fever, bleeding, and urinary retention reported in patients of the CNN cohort (P < .05 for all). Nursing non-treatment intervention(s) is necessary for liver cancer patients after surgery, in the follow-up, and between 2 doses of chemoradiotherapies. Pre- and post-operative comprehensive nursing care relieves postoperative pain, psychological burden and improves quality of life in the follow-up period in patients who underwent surgeries and interventional therapies for liver cancer (Level of Evidence: IV; Technical Efficacy: Stage 5).
Evidence of motor imagery for lower limb motor function recovery after stroke: A systematic review and meta-analysis of randomized controlled trials
Authors: Liu Yibo , Han Qing , Li Zekun , Liu Hao , Sun Xu , Ji Yuanyuan
Published: August 2023

Objective:

To systematically evaluate the efficacy of motor imagery (MI) on lower limb function in patients with stroke based on the existing clinical studies.

Methods:

Eight databases were searched up from the establishment of database to November 2022 to identify eligible studies. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 2 researchers used the Cochrane Systematic Review manual to independently cross-check the quality of the included literature and extract valid data. The RevMan 5.3 statistical software was used to obtain the meta-analysis, through the mean difference (MD) and 95% confidence intervals (CI).

Results:

A total of seventeen studies with 939 patients were included in the systematic review. The overall quality of the included studies was moderate. Meta-analysis showed that Fugl-Meyer Assessment of the lower extremity (FMA-LE) (MD = 4.86, 95%CI: 4.31, 5.42, P < .00001), berg balance scale (MD = 6.18, 95%CI: 4.57, 7.78, P < .00001), functional ambulation category (MD = 0.87, 95%CI: 0.41, 1.32, P = .0002), and the Modified Barthel Index (MD = 6.75, 95%CI: 3.23, 10.28, P = .0002) score improved significantly in the MI group compared with the control group.

Conclusions:

Current evidence shows that MI could effectively improve lower limb motor function and activities of daily living in stroke patients. Due to the limitations of the number and quality of the included studies, the above conclusions need to be verified by more high-quality studies.
Association between Chinese herbal medicine (CHM) treatment and depression among cancer patients in China: An outpatient-based cross-sectional study
Authors: Lin Huiyue , Zhang Xueting , Zhang Yi , Cui Wenjing , Jia Fang , Wang Juyong
Published: August 2023

Depression is a prevalent condition among cancer patients and significantly impacts their quality of life. Traditional Chinese Medicine, particularly Chinese Herbal Medicine (CHM), has shown potential in both anti-tumor and anti-depressive effects. However, there is a dearth of scientific literature exploring the association between CHM treatment and depression in cancer patients. This study aims to investigate the relationship between CHM treatment and depression in cancer patients. A cross-sectional study was conducted among cancer outpatients at Longhua Hosiptal, Shanghai University of Traditional Chinese Medicine, from June 2020 to April 2021 (Ethical approval number: 2020LCSY057). All patients signed informed consent and completed The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (EORTC QLQ-C30). Hamilton depression scale was evaluated depression by psychiatrists. The power of the sample size was determined using Gpower statistical and SPSS were used for statistical analysis. A total of 809 completed the study. Gender, medical insurance, the classification of time since diagnosis, ECOG, cancer stage, metastasis, gene mutation, treatment plan and CHM treatment were an important factor affecting depression (P < .05). Further analysis investigated the impact of CHM treatment on depression. There were 374 enrolled in CHM group and 435 enrolled in Non-CHM group. The assessment results of Hamilton depression scale and EORTC QLQ-C30 in CHM group were superior to those in Non-CHM group. The morbidity of depression is 50.27% in CHM group and 66.44% in Non-CHM group. After adjusting for potential confounders (gender, medical insurance, cancer stage, etc.), CHM treatment indicated negative correlation with depression (Odds ratio (OR) = 0.7, 95% confidence interval (CI): 0.5–0.9, P = .020). The interaction effects within each subgroup were no significantly affect the relationship between CHM treatment and depression (P > .05). CHM treatment was an independent protective factor for depression in cancer patients, and lead to better quality of life for cancer patients.
The study of different dosages of remazolam combined with sufentanil and propofol on painless gastroscopy: A randomized controlled trial
Authors: Wu Xiaohong , Zeng Lin , Zhang Tianyao , Wu Wei , Tian Ying , Dong Shuhua
Published: August 2023

Background:

Gastroscopy is one of the most commonly used diagnostic modalities for upper gastrointestinal disorders. Remazolam besylate, a new type of ultrashort-acting benzodiazepine drug, has been less studied in gastroscopy. In this study, we studied the efficacy and safety of remazolam combined with propofol for painless gastroscopy.

Methods:

This is a single-center, randomized controlled clinical trial. Hundred patients undergoing painless gastroscopy were included in this study and randomly divided into 2 groups (n = 50 per group): the remazolam 3 mg group (R3 group) and the remazolam 6 mg group (R6 group). Sufentanil, remazolam, and propofol are used to anesthetize the patients, and then, the effects of different dosages of remazolam on these patients are compared and analyzed. The patient’s general condition, vital signs at different times, the dosage of propofol (mg) and additional times, complications, duration of gastroscopy (minute), awakening time (minute), residence time in the resuscitation room (minute), and adverse reactions were recorded.

Results:

R3 group systolic blood pressure and diastolic blood pressure are more stable (P < .05); The number of additional propofol in R6 group was less (P < .05). The incidence of hypotension was lower in R3 group, as well as the time of awakening and staying in the resuscitation room were shorter (P < .05).

Conclusion:

Remazolam 3mg combined with sufentanil and propofol have less effect on hemodynamics in painless gastroscopy, and the patients have shorter awakening time.
The meta-analysis of sister chromatid exchange as a biomarker in healthcare workers with occupational exposure to antineoplastic drugs
Authors: Hu Jinchen , Zhao Feifei , Liu Lin , Huang Hong , Huang Xiaohong
Published: August 2023

Background:

Sister chromatid exchange (SCE) can be used to identify early occupational health status in health care workers. Our aim is to comprehensively assess the relationship between long-term exposure to antineoplastic drugs (ADs) and SCE in health care workers via meta-analysis.

Methods:

Five databases were systematically searched for relevant articles published from inception to November 30, 2022. Literature data are expressed as mean difference and 95% confidence intervals (CI) or relative risk and 95% CI. For I
2 > 50% trials, random effect model is used for statistical analysis, otherwise fixed effect model is used. This review was registered in the International Prospective Register of Systematic Reviews (identifier CRD42023399914).

Results:

Fourteen studies were included in this study. Results showed the level of SCE in healthcare workers exposed to ADs was significantly higher than in controls. The mean difference of the SCE trial was 0.53 (95% CI: 0.10–0.95, P = .01) under a random-effects model.

Conclusions:

The findings suggested a significant correlation between occupational exposure to ADs in health care workers and SCE, requiring the attention of health care workers in general.
Unintended findings: Therapeutic effects of hormones or gamma globulins on Lentiform Fork sign in 3 diabetic uremic patients: Case report/case series
Authors: Li Hui , Chen Wenbiao
Published: August 2023

Introduction:

The lentiform fork sign (LFS) is a unique magnetic resonance imaging (MRI) finding characterized by a bright hyperintense rim delineating the lentiform nucleus as a fork associated with metabolic acidosis in end-stage renal disease.

Patient concerns:

We report 3 cases of LFS in diabetic uremic patients. In one case of uremia, intensive hemodialysis treatment was not effective. Given our poor understanding of LFS, it was regarded as bilateral basal ganglia pathology, and pulse hormone and gamma globulins therapy was initiated. The patient neurological symptoms improved, and the pathological signs on imaging subsided. Based on our experience with the first LFS case, 2 diabetic uremic cases presenting with LFS were successfully treated with hormone or gamma globulin pulse therapy in addition to intensive hemodialysis.

Diagnosis:

Based on the clinical manifestations, past medical history and MRI imaging changes of the 3 cases reported here, the diagnosis of LFS was established.

Interventions:

Our experience from these 3 cases suggests that hormone supplementation and gamma globulin therapy may be indicated for treating LFS.

Lessons:

Our findings highlight that in diabetic uremic dialysis patients with neurological symptoms, LFS should be suspected. The clinical manifestations, past medical history and MRI imaging findings are essential for diagnosing LFS. Hormone supplementation and gamma globulin therapy may be the effective treatment for LFS.
Free lateral tarsal artery perforator flap for repair of volar skin defect of thumb
Authors: Han Zhongbin , Zhang Kuankuan , Niu Haizhou , Liu Yangyang , Zhang Changchun
Published: August 2023

To investigate the effect of free lateral tarsal artery perforator flap in the repair of the volar skin defect of the thumb. From January 2020 to December 2022, the free lateral tarsal artery perforator flap was used to repair the skin defect of the palmar side of the thumb in 11 cases. There were 9 males and 2 females with an average age of 45 years (range, 35–62 years). The causes of injury were mechanical injury in 8 cases, traffic accident in 3 cases, combined with different degrees of tendon and bone exposure and injury. The time from injury to operation was 1 to 4 hours, with an average of 2.5 hours. The size of the flap ranged from 3.0 cm × 3.0 cm to 5.5 cm × 5.0 cm, and the donor site was repaired with the skin graft. All the flaps and skin grafts survived successfully, and the wounds healed in the first stage. All patients were followed up for 6 to 24 months, with an average of 15 months. The appearance of the flap was good, with normal color, no pigmentation, and a soft texture. The 2-point discrimination of the flap was 6 to 11 mm, with an average of 8.5 mm at 6 months after operation. At the last follow-up, 8 cases were excellent and 3 cases were good according to the trial standard of upper limb function evaluation of the Chinese Society of Hand Surgery of the Chinese Medical Association, and the excellent and good rate was 100%. There was no significant effect on the sensation and function of the feet in the donor site, and the patient satisfaction was high. Free lateral tarsal artery perforator flap is a good choice to repair the skin defect of the palmar side of the thumb because of its simple operation, high survival rate and good sensory recovery of the recipient area.
Integrated network pharmacology analysis and in vitro validation revealed the underlying mechanism of Xiyanping injection in treating coronavirus disease 2019
Authors: Li Jialin , Guo Siyu , Tan Yingying , Zhang Jingyuan , Wu Zhishan , Stalin Antony , Zhang Fanqin , Huang Zhihong , Wu Chao , Liu Xinkui , Huang Jiaqi , Wu Jiarui
Published: August 2023

Background:

Coronavirus disease 2019 (COVID-19) has spread rapidly worldwide, leading to a pandemic. In China, Xiyanping injection (XYP) has been recommended as a drug for COVID-19 treatment in the Guideline on Diagnosis and Treatment of COVID-19 by the National Health Commission of the People Republic of China and National Administration of Traditional Chinese Medicine (Trial eighth Edition). However, the relevant mechanisms at the molecular-level need to be further elucidated.

Methods:

In this study, XYP related active ingredients, potential targets and COVID-19 related genes were searched in public databases. Protein-protein interaction network and module analyzes were used to screen for key targets. gene ontology and Kyoto encyclopedia of genes and genomes were performed to investigate the potentially relevant signaling pathways. Molecular docking was performed using Autodock Tools and Vina. For the validation of potential mechanism, PolyI:C was used to induce human lung epithelial cells for an inflammation model. Subsequently, CCK-8 assays, enzyme-linked immunosorbent assay, reverse transcription quantitative polymerase chain reaction and western blot were employed to determine the effect of XYP on the expression of key genes.

Results:

Seven effective active ingredients in XYP were searched for 123 targets in the relevant databases. Furthermore, 6446 COVID-19 disease targets were identified. Sodium 9-dehydro-17-hydro-andrographolide-19-yl sulfate was identified as the vital active compounds, and IL-6, TNF, IL-1β, CXCL8, STAT3, MAPK1, MAPK14, and MAPK8 were considered as the key targets. In addition, molecular docking revealed that the active compound and the targets showed good binding affinities. The enrichment analysis predicted that the XYP could regulate the IL-17, Toll-like receptor, PI3K-Akt and JAK-STAT signaling pathways. Consistently, further in vitro experiments demonstrated that XYP could slow down the cytokine storm in the lung tissue of COVID-19 patients by down-regulating IL-6, TNF-α, IL-1β, CXCL8, and p-STAT3.

Conclusion:

Through effective network pharmacology analysis and molecular docking, this study suggests that XYP contains many effective compounds that may target COVID-19 related signaling pathways. Moreover, the in vitro experiment confirmed that XYP could inhibit the cytokine storm by regulating genes or proteins related to immune and inflammatory responses.
Vesicoureteral reflux is associated with increased risk of chronic kidney disease: A nationwide cohort study
Authors: Lee Suat Yee , Lai Jung-Nien , Haw Yulin , Chiu Lu-Ting , Huang Shao Min , Cheng Kang Lun , Chew Fatt Yang
Published: August 2023

The association between vesicoureteral reflux (VUR) and chronic kidney disease (CKD) risk remains unestablished. We investigated the incidence of CKD in children with VUR in Taiwan and evaluated whether they had a higher risk of CKD than the general population. A nationwide population-based cohort study was conducted among children with VUR identified using Taiwan’s National Health Insurance Research Database from 2000 to 2013. VUR was defined according to the International Classification of Diseases, Ninth Revision, Clinical Modification codes. We identified the children with VUR and randomly selected comparison children according to a 1:1 ratio, matching them by age, gender, index year and comorbidity using data from the National Health Insurance Research Database. In total, 8648 children with VUR and 8648 comparison children were included. All children were followed from the study date until a diagnosis of CKD, termination of insurance, or the end of 2013. Cox proportional hazards regressions were performed to compare the hazard ratios for CKD between the 2 cohorts. Incident cases of CKD were identified. After adjustment for potential confounders, the study cohort was independently associated with a higher risk of CKD (adjusted hazard ratio, 3.78; 95% confidence interval, 2.10–7.18). This population-based cohort study indicated that children with VUR have a higher risk of CKD than those without VUR.
Bibliometric analysis of trends in cardiac aging research over the past 20 years
Authors: Hao Yan , Li Bohan , Huber Sally A. , Liu Wei
Published: August 2023

Background:

In recent years, many studies have addressed cardiac aging and related diseases. This study aims to understand the research trend of cardiac aging and find new hot issues.

Methods:

We searched the web of science core collection database for articles published between 2003 and 2022 on the topic of “cardiac aging.” Complete information including keywords, publication year, journal title, country, organization, and author were extracted for analysis. The VOS viewer software was used to generate network maps of keywords, countries, institutions, and author relationships for visual network analysis.

Results:

A total of 1002 papers were analyzed in the study. Overall, the number of annual publications on cardiac aging has increased since 2009, and new hot topics are emerging. The top 3 countries with the most publications were the United States (471 articles), China (209 articles) and Italy (101 articles). The University of Washington published the most papers (35 articles). The cluster analysis with author as the keyword found that the connections among different scholars are scattered and clustered in a small range. Network analysis based on keyword co-occurrence and year of publication identified relevant features and trends in cardiac aging research. According to the results of cluster analysis, all the articles are divided into 4 topics: “mechanisms of cardiac aging”, “prevention and treatment of cardiac aging”, “characteristics of cardiac aging”, and “others.” In recent years, the mechanism and treatment of cardiac aging have attracted the most attention. In both studies, animal models are used more often than in human populations. Mitochondrial dysfunction, autophagy and mitochondrial autophagy are hotspots in current research.

Conclusion:

In this study, bibliometric analysis was used to analyze the research trend of cardiac aging in the past 20 years. The mechanism and treatment of cardiac aging are the most concerned contents. Mitochondrial dysfunction, autophagy and mitophagy are the focus of future research on cardiac aging.