bluuebunny/crossref_metadata_2025 huggingface dataset:
A randomised controlled trial of clinical and cost-effectiveness of the PASS Plus intervention for young children with autism spectrum disorder in New Delhi, India: Study protocol for the COMPASS trial.
Authors: Roy Reetabrata , Leadbitter Kathy , Shields Gemma , Taylor Carol , Aldred Catherine , Juneja Monica , Gulati Sheffali , Vajaratkar Vivek , Davies Linda , Emsley Richard , Patel Vikram , Divan Gauri , Green Jonathan , Team COMPASS
Published: January 2023

Background: Autism Spectrum Disorders (ASD) is a neurodevelopmental disability affecting at least 5 million children in South Asia. Majority of these children are without access to evidence-based care. The UK Pre-school Autism Communication Therapy (PACT) is the only intervention to have shown sustained impact on autism symptoms. It was systematically adapted for non-specialist community delivery in South Asia; as the 'Parent-mediated Autism Social Communication Intervention for non-Specialists (PASS) and extended ‘PASS Plus’ interventions. RCTs of both showed feasibility, acceptability and positive effect on parent and child dyadic outcomes.
Methods: The Communication-centred Parent-mediated treatment for Autism Spectrum Disorder in South Asia (COMPASS) trial is now a scale-up two centre, two arm single (rater) blinded random allocation parallel group study of the PASS Plus intervention in addition to treatment as usual (TAU) compared to TAU alone, plus health economic evaluation – embedded in the India health system. 240 children (approximately 120 intervention/120 TAU) with ASD aged 2-9 years will be recruited from two tertiary care government hospitals in New Delhi, India. Accredited Social Health Activists will be one of the intervention delivery agents. Families will undertake up to 12 communication sessions over 8 months and will be offered the Plus modules which address coexisting problems. The trial’s primary endpoint is at 9 months from randomization, with follow-up at 15 months. The primary outcome is autism symptom severity; secondary outcomes include parent-child communication, child adaptation, quality of life and parental wellbeing. Primary analysis will follow intention-to-treat principles using linear mixed model regressions with group allocation and repeated measures as random effects. The primary cost-effectiveness analysis will use a societal perspective over the 15-month period of intervention and follow-up.
Discussion: If clinically and cost effective, this programme will fill an important gap of scalable interventions delivered by non specialist health workers within the current care pathways for autistic children and their families in low resource contexts. The programme has been implemented through the COVID-19 pandemic when restrictions were in place; intervention delivery and evaluation processes have been adapted to address these conditions.
Trial Registration: ISRCTN; ISRCTN21454676; Registered 22 June 2018; https://www.isrctn.com/ISRCTN21454676?q=21454676;
Nanosilicate-functionalized nanofibrous membrane facilitated periodontal regeneration potential by harnessing periodontal ligament cell-mediated osteogenesis and immunomodulation
Authors: Xu Xiongcheng , Xiao Long , Xu Yanmei , Xiao Nianqi , Jin Weiqiu , Chen Yuling , Li Yanfen , Luo Kai
Published: January 2023

Background: Although various new biomaterials have enriched the methods for periodontal regeneration, their efficacy is still controversial, and the regeneration of damaged support tissue in the periodontium remains challenging. Laponite (LAP) nanosilicate is a layered two-dimensionalnanoscale, ultrathin nanomaterial with a unique structure and brilliant biocompatibility and bioactivity. Incorporation of LAP nanosilicate into polycaprolactone (PCL/LAP) provided cumulative effects on osteogenesis, angiogenesis and osteoclastogenesis during bone regeneration.
Methods:This study aimed to investigate the effects of nanosilicate-incorporated PCL (PCL/LAP) nanofibrous membranes on periodontal ligament cells (PDLCs) in vitro and periodontal regeneration in vivo. A PCL/LAP nanofibrous membrane was fabricated by an electrospinning method. The morphology and mechanical property of PCL/LAP nanofibrous membrane were characterized by scanning electron microscopy (SEM), energy dispersive spectrum of X-ray (EDS) and tensile test. The proliferationand osteogenic differentiation of PDLCs on the PCL/LAP nanofibrous membrane were determined. A PDLCs and macrophage coculturesystem was used to explore the immunomodulatory effects of the PCL/LAP nanofibrous membrane. PCL/LAP nanofibrous membrane was implanted into rat calvarial and periodontal defects, and the regenerative potential was evaluated by microcomputed topography (micro-CT) and histological analysis.
Results: The PCL/LAP nanofibrous membrane showed good biocompatibility and bioactivity. It enhanced the proliferation and osteogenic differentiation of PDLCs. The PCL/LAP nanofibrous membrane also stimulated anti-inflammatory and pro-remodeling N2 neutrophil formation, regulated inflammatory responses and induced M2 macrophage polarization by orchestrating the immunomodulatory effects of PDLCs. The PCL/LAP nanofibrous membrane promoted rat calvarial defect repair and periodontal regeneration in vivo.
Conclusions: LAP nanosilicate-incorporated PCL membrane is capable of mediating osteogenesis and immunomodulation of PDLCs in vitro and acceleratingperiodontal regeneration in vivo. It could be a promising biomaterial for periodontal regeneration therapy.
PEGylated Nanoparticles Loaded with 2-Methoxyestradiol for the Treatment of Uterine Leiomyoma in a Patient-Derived Xenograft Mouse Model
Authors: Al-Enazy Sanaalarab , Kirschen Gregory W. , Vincent Kathleen , Yang Jinping , Saada Jamal , Shah Mansi , Motamedi Massoud , Salama Salama A. , Kilic Gokhan , Rytting Erik , Borahay Mostafa
Published: January 2023

Leiomyomas, the most common benign neoplasms of the female reproductive tract, currently have limited medical treatment options. Drugs targeting estrogen/progesterone signaling are used, but side effects and limited efficacy in many cases are major limitation of their clinical use. Previous studies from our laboratory and others demonstrated that 2-methoxyestradiol (2-ME) is promising treatment for uterine fibroids. However, its poor bioavailability and rapid degradation hinder its development for clinical use. The objective of this study is to evaluate the in vivo effect of biodegradable and biocompatible 2-ME-loaded PEGylated nanoparticles in a patient-derived leiomyoma xenograft mouse model. Diblock copolymer nanoparticles loaded with 2-ME were prepared by nanoprecipitation. Female 6-week age immunodeficient NOG (NOD/Shi-scid/IL-2Rγnull) mice were used. Estrogen-progesterone pellets were implanted subcutaneously. Five days later, patient-derived human fibroid tumors were xenografted bilaterally subcutaneously. Engrafted mice were treated with 2-ME-loaded or blank (control) PEGylated nanoparticles. Nanoparticles were injected intraperitoneally and after 28 days of treatment, tumor volume was measured by caliper following hair removal, and tumor were removed and weighed. Up to 99.1% encapsulation efficiency was achieved, and the in vitro release profile showed minimal burst release, thus confirming the high encapsulation efficiency. In vivo administration of the 2-ME-loaded nanoparticles led to 51% growth inhibition of xenografted tumors compared to controls (P < 0.01). Thus, 2-ME-loaded nanoparticles may represent a novel approach for the treatment of uterine fibroids.
Work-Related Musculoskeletal Symptoms Among Saudi Radiologists: A Cross-Sectional Multi-Centre Study
Authors: Alelyani Magbool , Gameraddin Moawia , Alkhushayl Abdullah M. , Altowaijri Aljoharah M. , Qashqari Maryam Ibrahim , Alzahrani Fahad Ali Ahmed , Gareeballah Awadia
Published: January 2023

Background
Musculoskeletal disorders are common health problems worldwide. Several factors cause these symptoms, including ergonomics and other individual considerations. Computer users are prone to repetitive strain injuries that increase the risk of developing musculoskeletal symptoms (MSS). Radiologists are susceptible to developing MSS because they work long hours analysing medical images on computers in an increasingly digitalised field. This study aimed to identify the prevalence of MSS among Saudi radiologists and the associated risk factors.
Methods
This cross-sectional study was conducted on November 12, 2021, on 814 Saudi radiologists from various regions in Saudi Arabia. It comprised a Nordic Musculoskeletal Questionnaire examination of MSS. The study's primary outcome was the presence of musculoskeletal complaints in any body region that limited participation in routine activities over the previous 12 months. The results were descriptively examined using binary logistic regression analysis to estimate the odds ratio of participants who had disabling musculoskeletal complaints in the previous 12 months. All university, public, and private radiologists received an online survey containing questions about work surroundings, workload (e.g., spent at a computer workstation), and demographic characteristics.
Results
The prevalence of musculoskeletal complaints among the radiologists was 87.7%. Most of the participants (82%) were younger than 40 years of age. Radiography and computed tomography were the most common imaging modalities that caused MSS (53.4% and 26.8%, respectively). The most common symptoms were neck pain (59.3%) and lower back pain (57.1%). After adjustment, age, years of experience, and part-time employment were significantly associated with increased MSS (OR = .219, 95% CI = .057–.836; OR = .235, 95% CI = 087–.634; and OR = 2.673, 95% CI = 1.434–4.981, respectively). Females were more likely to report MSS than males (OR = 2.12, 95% CI = 1.327–3.377).
Conclusions
MSS are common among Saudi radiologists, with neck pain and lower back pain being the most frequently reported symptoms. Gender, age, years of experience, type of imaging modality, and employment status were the most common associated risk factors for developing MSS. These findings are vital for the development of interventional plans to reduce the prevalence of musculoskeletal complaints in clinical radiologists.
EDB-FN targeted probes for the surgical navigation, radionuclide imaging and therapy of thyroid cancer
Authors: Li Ruping , He Huihui , Li Xinling , Zheng Xiaobin , Li Zhijian , Zhang Hu , Ye Jiacong , Zhang Weiguang , Yu Chunjing , Feng Guokai , Fan Wei
Published: January 2023

Purpose
Extradomain B of fibronectin (EDB-FN) is a promising diagnostic and therapeutic biomarker for thyroid cancer (TC). Here, we identified a high-affinity EDB-FN targeted peptide named EDBp, and developed three EDBp-based probes, Cy5-EDBp, [18F]-EDBp and [177Lu]-EDBp the surgical navigation, radionuclide imaging and therapy of TC.
Methods
Based on the previously identified EDB-FN targeted peptide ZD2, the optimized EDB-FN targeted peptide EDBp was identified by using the alanine scan strategy. Three EDBp-based probes, Cy5-EDBp, [18F]-EDBp and [177Lu]-EDBp, were developed for fluorescence imaging, positron emission tomography (PET) imaging and radiotherapy in TC tumor-bearing mice, respectively. Additionally, [18F]-EDBp was evaluated in two TC patients.
Results
The binding affinity of EDBp to the EDB fragment protein (Kd = 14.4 ± 1.4 nM, n = 3) was approximately 336-fold greater than that of the ZD2 (Kd = 4839.7 ± 361.7 nM, n = 3). Fluorescence imaging with Cy5-EDBp facilitated the complete removal of TC tumors. [18F]-EDBp PET imaging clearly delineated TC tumors, with high tumor uptake (16.43 ± 1.008%ID/g, n = 6, at 1 h postinjection). Radiotherapy with [177Lu]-EDBp inhibited tumor growth and prolonged survival in TC tumor-bearing mice (survival time of different treatment groups: Saline vs. EDBp vs. ABRAXANE vs. [177Lu]-EDBp = 8 d vs. 8 d vs. 11.67 d vs. 22.33 d, ***p < 0.001). Importantly, the first-in-human evaluation of [18F]-EDBp demonstrated that it had specific targeting properties (SUVmax value of 3.6) and safety.
Conclusion
Cy5-EDBp, [18F]-EDBp and [177Lu]-EDBp are promising candidates for the surgical navigation, radionuclide imaging and radionuclide therapy of TC, respectively.
Temporal relationships between BMI and obesity-related predictors of cardiometabolic and breast cancer risk in a longitudinal cohort
Authors: Xu Bin , LV Liang , Chen Xin , Li Xingyue , Zhao Xunying , Yang Huifang , Feng Wanting , Jiang Xia , Li Jiayuan
Published: January 2023

Background: Prospective inter-relationships among biomarkers were unexplored, which may provide mechanistic insights into diseases. We investigated the longitudinal associations of BMI change with trajectories of biomarkers related to cardiometabolic or breast cancer risk.
Methods: A longitudinal study was conducted among 400 healthy women between 2019 to 2021. Cross‑lagged path analysis was used to examine the temporal relationships among BMI, cardiometabolic risk score (CRS), and obesity‑related proteins score (OPS) of breast cancer. Linear mixed-effect models were applied to investigate associations of time-varying BMI with biomarker-based risk score trajectories.
Results: Baseline BMI was associated with subsequent change of both cardiometabolic (P=0.06) and breast cancer predictors (P=0.03), and baseline CRS were positively associated with OPS change (P<0.001) but not vice versa. After fully adjustment of confounders, we found a 0.058 (95%CI= 0.009-0.107, P=0.020) units increase of CRS and a 1.021 (95%CI= 0.041-1.995, P=0.040) units increase of OPS as BMI increased 1 kg/m2 per year in postmenopausal women. OPS increased 0.784 (95%CI= 0.053-1.512, P=0.035) units as CRS increased 1 unit per year. However, among premenopausal women, BMI only significantly affected CRS (β=0.057, 95%CI=0.007 to 0.107, P=0.025). No significant change of OPS with time-varying CRS was found.
Conclusions: Higher increase rates of BMI were associated with worse trajectories of biomarker-based risk of cardiometabolic and breast cancer. The longitudinal impact of CRS on OPS is unidirectional.
Impacts: Recommendations such as weight control for the reduction of cardiometabolic risk factors may benefit breast cancer prevention, especially in postmenopausal women.
Lived experiences and perspectives of patients with type 2 diabetes on poor glycaemic control in Kinshasa, Democratic Republic of the Congo: a qualitative study
Authors: Lubaki Jean-Pierre Fina , Francis Joel Msafiri , Omole Olufemi Babatunde
Published: January 2023

Background
Glycaemic control is a significant problem in diabetes care in sub-Saharan Africa. In the Democratic Republic of the Congo, factors associated with glycaemic control are not fully known as previous studies rarely explored patients’ perspectives and lived experiences. This study describes the lived experiences and perspectives of patients with type 2 diabetes regarding glycaemic control in Kinshasa, Democratic Republic of the Congo.
Methods
This study was a qualitative study conducted in 7 health centres in 7 health districts (out of 24) in Kinshasa. Purposively selected patients with type 2 were invited to participate in in-depth interviews to explore their lived experience on diabetes treatment and glycaemic control. All interviews were audio recorded, transcribed verbatim and translated into English by a language expert. Data coding and thematic analysis were performed using the MAXQDA 2022.
Results
Twenty-three participants were included in the study. Six themes emerged as explanations for glycaemic control in Kinshasa. Three of these themes were related to poor glycaemic control: poor self-care, poor clinical care in primary health care facilities, and limited sociodemographic and financial support. Three additional themes emerged for good glycaemic control: motivation and commitment to treatment, individualized and available care, and ability to perform the change for glycaemic control.
Conclusions
Patients’ perspectives and lived experiences of diabetes care and glycaemic control in Kinshasa transcend personal, health system and psychosocial aspects of care. Efforts to strengthen diabetes care in this setting need to focus on promoting self-care, training healthcare providers on an evidence-based clinical approach, and providing psychosocial support that motivates patients to commit to care. The implementation of universal health coverage at the primary care level would ensure accessibility to diabetes care for socioeconomically deprived patients.
Genome-wide identification and expression pattern analysis of R2R3-MYB transcription factor gene family involved in puerarin biosynthesis and response to hormone in Puararia lobata var. thomsonii
Authors: Wu Zhengdan , Zeng Wendan , Li Changfu , Wang Jihua , Shang Xiaohong , Xiao Liang , Cao Sheng , Zhang Yansheng , Xu Shiqiang , Yan Huabing
Published: January 2023

Background
R2R3-MYB transcription factors regulate secondary metabolism, stress responses and development in various plants. Puerarin is a bioactive ingredient and most abundant secondary metabolite isolated from Puararia lobata. The biosynthesis of puerarin proceeds via the phenylpropanoid pathway and isoflavonoids pathway, in which 9 key enzymes are involved. The expression of these structural genes is under control of specific PtR2R3-MYB genes in different plant tissues. However, how PtR2R3-MYB genes regulates structural genes in puerarin biosynthesis remains elusive. This study mined the PtR2R3-MYB genes involved in puerarin biosynthesis and response to hormone in Puararia lobata var. thomsonii.
Results
A total of 209 PtR2R3-MYB proteins were identified, in which classified into 35 subgroups based on the phylogenetic topology and the classification of the R2R3-MYB superfamily in Arabidopsis thaliana. Furtherly physical and chemical characteristics, gene structure, and conserved motif analysis were also used to further analyze PtR2R3-MYBs. Combining puerarin content and RNA-seq data, speculated on the regulated puerarin biosynthesis of PtR2R3-MYB genes and structural genes, thus 21 PtR2R3-MYB genes and 25 structural genes were selected for validation gene expression and further explore its response to MeJA and GSH treatment by using qRT-PCR analysis technique. Correlation analysis and cis-acting element analysis revealed that 6 PtR2R3-MYB genes (PtMYB039, PtMYB057, PtMYB080, PtMYB109, PtMYB115 and PtMYB138) and 7 structural genes (PtHID2, PtHID9, PtIFS3, PtUGT069, PtUGT188, PtUGT286 and PtUGT297) were directly or indirectly regulation of puerarin biosynthesis in FG11. It is worth noting that after MeJA and GSH treatment for 12–24 hours, the expression changes of most candidate genes were consistent with the correlation of puerarin biosynthesis, which also shows that MeJA and GSH have the potential to mediate puerarin biosynthesis by regulating gene expression in FG11.
Conclusions
Overall, this study provides a comprehensive understanding of the PtR2R3-MYB and will paves the way to reveal the transcriptional regulation of puerarin biosynthesis and response to phytohormone of PtR2R3-MYB genes in Puararia lobata var. thomsonii.
Airway collapse as the predominant clinical feature following remimazolam-induced anaphylaxis: a case report
Authors: Hu Xiawei , Tang Yaning , Fang Xiangming
Published: January 2023

Background
remimazolam is an ultra-short-acting intravenous benzodiazepine, which has been used as sedative/anesthetic in procedural sedation and anesthesia. Although peri-operative anaphylaxis due to remimazolam has been reported recently, the spectrum of the allergic reactions is still not fully known.
Case presentation:
we describe a case of anaphylaxis following remimazolam administration in a male patient undergoing colonoscopy under procedural sedation. The patient presented complex clinical signs including airway changes, skin symptoms, gastrointestinal manifestations and hemodynamic fluctuations. Different from other reported cases, respiratory compromise was the initial and main clinical feature of remimiazolam-induced anaphylaxis.
Conclusions
remimazolam-induced anaphylaxis has a rapid onset and complex clinical features. This case reminds anesthesiologists should be particularly alert to the unknown adverse reactions of new anesthetics.
De Garengeot Hernia, an acute appendicitis in the right femoral hernia canal, and successful management with transabdominal closure and appendectomy: A Case Report
Authors: YU POCHUAN , Wang Ling-Ting , Chang Chun-Yu , Tsai Yao-Chou , Chong Kian-Hwee
Published: January 2023

Incarceration of the appendix within a femoral hernia is a rare condition of abdominal wall hernia. We report a case of a 56-year-old female whose appendix was trapped in the right femoral canal. There are few reports in the literature on entrapment of the appendix within a femoral hernia. The management of this condition includes antibiotics, drainage appendectomy, hernioplasty and mesh repair.
Treatment of osteoporosis using a selective androgen receptor modulator ostarine in an orchiectomized rat model
Authors: Böker Kai O. , Komrakova Marina , Fahrendorff Linda , Spelsberg Bastian Ranjith , Hoffmann Daniel Bernd , Schilling Arndt F. , Lehmann Wolfgang , Taudien Stefan , Sehmisch Stephan
Published: January 2023

Purpose:
The selective androgen receptor modulator ostarine has been shown to have advantageous effects on skeletal tissue properties, reducing muscle wasting and improving physical function in males. However, data on effects in male osteoporosis remain limited. In this study, the effects of ostarine on osteoporotic bone were evaluated in a rat model of male osteoporosis and compared with those of testosterone treatments.
Methods: Eight-month-old male Sprague-Dawley rats were orchiectomized (Orx) and grouped (n=15/group):
1) Orx, 2) Ostarine Therapy, 3) Test. Therapy, 4) Ostarine Prophylaxe and 5) Test. Proph. Fifteen rats were left non-orchiectomized (Non Orx). Proph. treatments were begun directly after orchiectomy and continued for 18 weeks, whereas Therapy treatments were initiated 12 weeks after Orx. Ostarine and Test. were applied orally at daily doses of 0.4 and 50 mg/kg body weight, respectively. The lumbar vertebral bodies and femora were analyzed via biomechanical, micro-CT, ashing, and gene expression analyses.
Results: Ostarine Proph. showed positive effects in preventing osteoporotic changes in cortical and trabecular bone; biomechanical parameters were not affected; prostate weight was increased. Ostarine Therapy increased solely the cortical density of the femur; other bone parameters remained unaffected. Test. Proph. positively influenced cortical density in femur; Test. Therapy did not change any bony parameters.
Conclusion: Ostarine Proph. could be further investigated as a preventative treatment for male osteoporosis, but an androgenic effect on the prostate comparable to testosterone should be taken into consideration. Combination therapies with other anti-osteoporosis agents should be considered in future studies to strengthen the selective effects on the bone tissue.
Severe phenotype of a heterozygous with variant on FGFR3 in the second trimester: a case report
Authors: Chen Shujun , Dong Hongmei , Luo Yong , Zhang Yingpin , Li Pan
Published: January 2023

Background

Achondroplasia is a congenital skeletal system malformation caused by missense mutation of FGFR3 gene with an incidence of 1 per 20,000–30,000 newborns, which is an autosomal dominant inheritance disease. Despite similar imaging features, the homozygous achondroplasia is absolutely lethal due to thoracic stenosis, whereas heterozygous achondroplasia does not lead to fetal death.

Case presentation

A fetus with progressive rhizomelic short limbs and overt narrow chest was detected by prenatal ultrasound in the second trimester. Gene sequencing results of amniotic fluid sample indicated a rare missense variant NM_000142.4: c.1123G > T(p.Gly375Cys), leading to a glusate-to-cysteine substitution. Re-sequencing confirmed that it was a heterozygous mutation, and thoracic stenosis was then confirmed in the corpse by radiological examination.

Conclusions

We identified a wild heterozygous variant of the FGFR3 gene as the rare pathogenic mutation of severe achondroplasia in a fetus. Heterozygous variants of p.Gly375Cys may have a severe phenotype similar to homozygote. It’s crucial to combine prenatal ultrasound with genetic examination to differentiate heterozygous from homozygous achondroplasia. The p.Gly375Cys mutation of FGFR3 gene may serve as a vital target for the diagnosis of severe achondroplasia.
The soil microbiomes of forest ecosystems in Kenya: their diversity and environmental drivers
Authors: Onyango Lorine Akinyi , Ngonga Florence Atieno , Karanja Edward Nderitu , Ochieng Josiah Kuja , Boga Hamadi Iddi , Cowan Don A , Mwangi Kennedy Wanjau , Maghenda Marianne Wughanga , Lebre Pedro Bixirao Neto Marinho , Kambura Anne Kelly
Published: January 2023

Soil microbiomes in forest ecosystems act as both nutrient sources and sinks through a range of processes including organic matter decomposition, nutrient cycling, and humic compound incorporation into the soil. Most forest soil microbial diversity studies have been performed in the northern hemisphere, and very little has been done in forests within African continent. This study examined the composition, diversity and distribution of prokaryotes in Kenyan forests top soils using amplicon sequencing of V4-V5 hypervariable region of the 16S rRNA gene. Additionally, soil physicochemical characteristics were measured to identify abiotic drivers of prokaryotic distribution. Different forest soils were found to have statistically distinct microbiome compositions, with Proteobacteria and Crenarchaeota taxa being the most differentially abundant across regions within bacterial and archaeal phyla, respectively. Key bacterial community drivers included pH, Ca, K, Fe, and total N while archaeal diversity was shaped by Na, pH, Ca, total P and total N. To contextualize the prokaryote diversity of Kenyan forest soils on a global scale, the sample set was compared to amplicon data obtained from forest biomes across the globe; displaying them to harbor distinct microbiomes with an over-representation of uncultured taxa such as TK-10 and Ellin6067 genera.
Efficacy of superficial inferior epigastric vein superdrainage in TRAM and DIEP flap: An Indocyaning green angiography study of 68 cases
Authors: Zhu Ying , Yoo Hyokyung , Min Sally , Chang Hak
Published: January 2023

This study aimed to evaluate the efficacy of venous augmentation using superficial inferior epigastric vein (SIEV) in transverse rectus abdominis musculocutaneous (TRAM) and deep inferior epigastric artery perforator (DIEP) flap. A retrospective review was performed of 62 free TRAM and 6 DIEP unilateral breast reconstructions from September 2017 to July 2022. Intraoperative indocyanine green angiography was performed with the SIEV contralateral to the pedicle clamped and declamped for 20 min. The ratio of hypoperfused area was calculated and compared quantitatively. The preoperative computed tomography angiography was reviewed to measure the SIEV diameter and number of midline-crossing medial branches. Sixty-two percent (42/68 cases) resulted in perfusion improvement after SIEV superdrainage (Group 1), whereas 29.4 percent (20/68 cases) resulted in sustained (Group 2) and 8.8 percent (6/68 cases) in aggravated perfusion (Group3). The mean number of midline-crossing branches (p = 0.002) and mean difference in the diameter of bilateral SIEVs (p = 0.039) were significantly greater in Group 1 compared to the other groups. Superdrainage using the contralateral SIEV in TRAM/DIEP flap is recommended when there are more than 2 midline-crossing medial branches of SIEV and when the caliber of draining vein is greater than that of the pedicle side.
Comparison of time courses in postoperative functional outcomes between simultaneous bilateral and unilateral total knee arthroplasty with propensity score matching
Authors: Oka Tomohiro , Wada Osamu , Mizuno Kiyonori
Published: January 2023

Background: No consensus has been reached on which is better in terms of functional outcomes between simultaneous bilateral and unilateral total knee arthroplasty (TKA). As patient characteristics, such as age, sex, and body mass index, have significant effects on functional outcomes after TKA, we should match these factors before making comparisons. This study aimed to compare time courses in functional outcomes between simultaneous bilateral TKA and unilateral TKA after matching the patient characteristics.
Methods: In this retrospective study, we reviewed the clinical records of patients admitted to our hospital. After excluding the patients who did not meet the criteria, 43 underwent simultaneous bilateral TKA and 382 underwent unilateral TKA were included in this study. We performed propensity score matching for age, sex, and body mass index between simultaneous bilateral and unilateral TKA patients. We measured pain intensity, knee extensor strength, and knee-specific functional outcomes using the new knee society score, including total score, symptoms, patient satisfaction, patient expectations, and functional activities preoperatively and at 3 and 12 months postoperatively. Two-way repeated analysis of variance was performed to compare the time courses in functional outcomes between simultaneous bilateral and unilateral TKA.
Results: After propensity score matching, 40 patients each for underwent bilateral TKA and unilateral TKA were selected. Knee extensor strength in simultaneous bilateral TKA patients was significantly lower than that in unilateral TKA patients at 3 months postoperatively (p = 0.04). A significant interaction was observed between the effects of time and group on knee extensor strength (F [1, 78] = 3.338; interaction: p = 0.042; η2 = 0.052). No significant interactions were found among the other variables measured.
Conclusions: Patients who underwent simultaneous bilateral TKA showed delayed recovery in knee extensor strength at 3 months postoperatively, but recovered to the same level at 12 months postoperatively. Patients who underwent simultaneous bilateral TKA should undergo postoperative rehabilitation focused on alleviating delayed recovery in knee extensor strength during the acute phase.
Integration of Transcriptome and Metabolome Provides Unique Insights to Pathways Associated with Wheat Immature Embryos Infected by Agrobacterium tumefaciens
Authors: Weiwei Wang , Jinliang Guo , Jiayang Ma , Zhulin Wang , Lining Zhang , Zixu Wang , Chao Zhang , Fengli Sun , Yajun Xi
Published: January 2023

Background:The transformation efficiency (TE) of wheat is slow due to its recalcitrance nature to in vitro regeneration and genetic transformation. Nowadays, the TE of wheat immature embryo from cultivar Fielder in the PureWheat technique was greatly improved by a series of special chemical and physical methods. To explore the mechanisms of wheat high TE in this protocol, we strictly followed the procedures to obtain wheat immature embryos afterAgrobacteriuminfection for 24 and 48 h, observed the surface of immature embryos using scanning electron microscope (SEM), and conducted comprehensive transcriptome and metabolome analysis.Results:SEM showed thatAgrobacterium tumefacienswere deposited under the damaged cortex of wheat immature embryos caused by pretreatment and contacted the receptor cells to improve the TE. Transcriptome analysis showed that the differentially expressed genes were mainly enriched in phenylpropanoid biosynthesis, starch and sucrose metabolism, and plant-pathogen interaction, plant hormone signal transduction, MAPK signaling pathway. By analyzing the correlation between differentially expressed genes and metabolites, the expression of many genes and accumulation of metabolites are changed in glucose metabolism and the TCA cycle, as well as amino acid metabolism, it suggests that the wheat embryo infected withAgrobacteriumis an energy demanding process. The shikimate pathway may act as a hub between glucose metabolism and phenylpropane metabolism duringAgrobacteriuminfection. The down-regulation of F5H gene and up-regulation of CCR gene led to the accumulation of lignin precursor through phenylpropane metabolism. In addition, several metabolic pathways and oxidases were found to be involved in the infection treatment, including melatonin biosynthesis, benzoxazinoid biosynthesis, betaine biosynthesis, superoxide dismutase, peroxidase, which suggest that wheat embryo may be under the stress ofAgrobacteriumand thus undergo oxidative stress response.Conclusion:Our findings contribute to understand the underlying the mysterious mechanism of the high TE of wheat immature embryos stimulated byAgrobacteriumby exploring valuable genes and metabolites.
Analysis of influencing factors of small airway dysfunction in adults
Authors: Zhang Yifan , Zhang Haihua , Su Xuan , Wang Ying , Gao Guizhou , Wang Xiaodong , Zhang Tao
Published: January 2023

Background
Small airway dysfunction (SAD) is a widespread, but less typical clinical manifestation of respiratory dysfunction. In lung diseases, SAD can have a higher-than-expected impact on lung function. The aim of this study was to understand the factors that contribute to SAD.
Methods
We included 1233 patients in the pulmonary function room of TangDu Hospital from June 2021 to December 2021. Functional examination guidelines diagnostic criteria: MMEF, MEF50%, MEF25%, two of the three items are lower than 65% of the predicted value, the patient was diagnosed with SAD. We divided the subjects into a small airway disorder group and non-small airway disorder group, and they were asked to complete a questionnaire, and we performed a multivariate scoring of the relevant factors after univariate comparisons among other factors.
Results
The influencing factors of patients with small airway disorder were advanced age (OR = 7.772,95% CI 2.284–26.443), female (OR = 1.545,95% CI 1.103–2.164), family history of respiratory disease (OR = 1.508,95% CI 1.069–2.126), history of occupational dust exposure (OR = 1.723,95% CI 1.177–2.521), history of smoking (OR = 1.732,95% CI 1.231–2.436), history of pet exposure (OR = 1.499,95% CI 1.065–2.110), exposure to O3(OR = 1.008,95% CI 1.003–1.013), chronic bronchitis (OR = 1.947,95% CI 1.376–2.753), emphysema (OR = 2.190,95% CI 1.355–3.539) and asthma (OR = 7.287,95% CI 3.546–14.973).
Conclusion
Small airway disorders are associated with age, gender, exposure to O3, family history of respiratory disease, occupational dust exposure, smoking history, history of pet exposure, chronic bronchitis, and asthma. People with these risk factors should take appropriate precautions to prevent SAD.
Analysis of the influencing factors related to spasticity in patients with spinal cord injuries: a retrospective study
Authors: Wu Shuang , Song Ning , Deng Luoyi , Wang Jia , Wang Xianbin
Published: January 2023

STUDY DESIGN: a retrospective study
OBJECTIVES: The aim of this study was to investigate the related influencing factors of spasticity in individuals with spinal cord injury (SCI).
SETTING: Individuals diagnosed with SCI between January 2019 and December 2021 in the Department of Rehabilitation Medicine, Affiliated Hospital of Guizhou Medical University.
METHODS:
Individuals diagnosed with SCI between January 2019 and December 2021 in the Department of Rehabilitation Medicine, Affiliated Hospital of Guizhou Medical University, were screened for spasticity by using the modified Ashworth spasm scale. A total of 183 individuals diagnosed with SCI were finally included in the study. We collected the individuals’ basic information, including gender, age, disease course, injury segment, American Spinal Injury Association (ASIA) grade, Cause of injury. Univariate and dichotomous logistic regression analysis analyses were used to examine the influencing factors of spasticity in the individuals with SCI.
RESULTS:
The chi-squared test revealed that the course of the disease (p=0.004), the injured segment (p<0.001) and the pressure ulcers of the individuals (p=0.002) with SCI had statistical significance. A dichotomous logistic regression analysis was performed to analyze the influencing factors of spasticity. the course of the disease, the injured segment and the pressure ulcers of the individuals with SCI were independent influencing factors of spasticity in individuals with SCI, among which the prolongation of the course of the disease (when the course of disease was 3 to 6 months and 6 months or more, the incidence of spasticity was 2.441 times (95% CI, 0.968~6.157) and 5.090 times (95% CI, 1.883~13.76), compared with a disease course of less than 3 months) and the presence of pressure ulcers were independent risk factors (the incidence of spasticity in patients with pressure ulcers was 2.481 times (95% CI, 0.961~6.406) higher than that without pressure ulcers). the low injury segment was a protective factor (the incidence of spasticity in thoracic and lumbar spinal cord injuries was 0.363 times (95% CI, 0.154~0.855) and 0.034 times (95% CI, 0.004~0.268) higher than that in cervical spinal cord injuries).
CONCLUSION:
In this study, we found that there was no significant correlation between spasticity after SCI and gender, ASIA grade, cause of injury and other factors. However, the prolongation of the course of the disease and the presence of Pressure ulcers were independent risk factors, and the low injury segment was a protective factor.
Intravoxel incoherent motion (IVIM) for distinguishing glioma and solitary brain metastasis: A pilot multi-parameter magnetic resonance imaging histogram and texture analysis
Authors: Su Yifei , Cheng Rui , Guo Jinxia , Zhang Miaoqi , Wang Junhao , Wang Chunhong , Ji Hongming , Hao Liangliang , He Yexin , Xu Cheng
Published: January 2023

Background: To investigate the value of diffusion-weighted imaging (DWI), intravoxel incoherent motion (IVIM), and amide proton transfer-weighted (APTW) imaging in differentiating the primary glioma from solitary brain metastases (SBM) with the histogram and texture features.
Methods: A total of 65 patients with newly diagnosed glioma or metastases were enrolled. All patients underwent DWI, IVIM, and APTW imaging, as well as the T1W, T2W, T2FLAIR, and enhanced T1W imaging. The first-order texture and histogram features of apparent diffusion coefficient (ADC) from DWI, diffusion coefficient (D), perfusion fraction (f), pseudo-diffusion coefficient (D*) from IVIM, and MTRasym (3.5 ppm) from APTW were extracted from the tumor parenchyma and compared between glioma and SBM. Parameters with significant differences were analyzed with the logistics regression and receiver operator curves to explore the optimal model and compare the differentiation performance.
Results: Higher ADCkurtosis (p=0.02), f90 (p＜0.01), and fkurtosis (p=0.01) were found for glioma, while higher MTRasym (3.5ppm)10 (p= 0.05), fentropy (p＜0.01), and fmean (p＜0.01) were observed for SBM. fkurtosis (OR =0.66, 95%CI 0.48-0.92, p=0.02), and fmean (OR=1.44, 95%CI 1.16-1.18, p<0.01) were independent factors for SBM differentiation. The model combining age, fkurtosis, and fmean showed an AUC of 0.83, while the model combined with fkurtosis and fmean with improved sensitivity had an AUC of 0.81.
Conclusion: The fmean and fkurtosis in enhanced tumor region could be used to differentiate glioma and SBM.
Cre-dependent ACR2-expressing reporter mouse strain for efficient long-lasting inhibition of neuronal activity
Authors: Mukai Yasutaka , Li Yan , Nakamura Akiyo , Fukatsu Noriaki , Iijima Daisuke , Abe Manabu , Sakimura Kenji , Itoi Keiichi , Yamanaka Akihiro
Published: January 2023

Optogenetics is a powerful tool for manipulating neuronal activity by light illumination with high temporal and spatial resolution. Anion-channelrhodopsins (ACRs) are light-gated anion channels that allow researchers to efficiently inhibit neuronal activity. A blue light-sensitive ACR2 has recently been used in several in vivo studies; however, the reporter mouse strain expressing ACR2 has not yet been reported. Here, we generated a new reporter mouse strain, LSL-ACR2, in which ACR2 is expressed under the control of Cre recombinase. We crossed this strain with a noradrenergic neuron-specific driver mouse (NAT-Cre) to generate NAT-ACR2 mice. We confirmed Cre-dependent expression and function of ACR2 in the targeted neurons by immunohistochemistry and electrophysiological recordings in vitro, and confirmed physiological function using an in vivo behavioral experiment. Our results show that the LSL-ACR2 mouse strain can be applied for optogenetic inhibition of targeted neurons, particularly for long-lasting continuous inhibition, upon crossing with Cre-driver mouse strains. The LSL-ACR2 strain can be used to prepare transgenic mice with homogenous expression of ACR2 in targeted neurons with a high penetration ratio, good reproducibility, and no tissue invasion.
Self-reported musculoskeletal disorders and associated factors among HIV/AIDS patients following ART at University Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia, 2021
Authors: Kibret Alemu Kassaw , Mekie Melisew , Eriku Getachew Azeze , Gashaw Moges , Yalew Ermias Solomon , Weldetsadik Fkrte Kebede
Published: January 2023

Background: People with HIV/AIDS following ART experience immunological improvement and normal life expectancy. However, with this increased life expectancy has emerged a symptom burden such as musculoskeletal pain/disorder. Despite, this health problems in HIV/AIDS patients (PLWHAs) have become a concern, there is a lack of data on the prevalence and associated factors of musculoskeletal disorders among HIV/AIDS following ART in sub-Saharan Africa and also in Ethiopia. Therefore, the aim of this study was to assess the prevalence and associated factors of musculoskeletal disorders among adult HIV/AIDS patients following ART clinic at University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia 2021.
Method: An institutional-based cross-sectional study was conducted from September 1st to October 1st, 2021 at University of Gondar comprehensive specialized hospital, Gondar, Ethiopia. The data was collected through an interview-administered questionnaire and patient medical record review of 324 participants. Binary logistic regression was used to identify associated risk factors of musculoskeletal disorders. The strength of the association was detected by the adjusted odds ratio and P-value.
Result: A total of 324, with nearly half the age range of 25-44 years participants were enrolled in this study. Among participants, 158 (48.5%) of them experienced musculoskeletal disorders of annual prevalence. BMI, opportunistic infection [AOR, 10.43; 95%CI 2.756-42.25], type of ART medication used, CD4-count [AOR, 0.13; 95% CI 0.032-0.852], and change in ART regimen change [AOR, 8.14; 95%CI 2.062-32.09] were significantly associated with a musculoskeletal disorder.
Conclusion: The prevalence of musculoskeletal disorders was moderate (48.5%). BMI, recent CD4 count, opportunistic infection, ART regime at initiation, and ART regime change were significantly associated with a musculoskeletal disorder. A multidisciplinary approach is required, to link the ART clinic and physiotherapy department for preventing and treating musculoskeletal disorders among HIV/AIDS patients following ART.
A Clinical Prediction Model to Predict albumin Treatment Outcomes and Provide Dosage Recommendations: Development and Validation Study
Authors: Su Bo , li hui
Published: January 2023

Objective: Intravenous Albumin is widely used in the intensive care unit in patients with Systemic lupus erythematosus. However, The dose of albumin is still controversial.In this study, we intended to develop and validate a machine learning–based model to predict intravenous albumin treatment outcomes and to provide dosage recommendations to clinicians.
Methods: Using Mimic-III V1.4 and Mimic-IV V0.4, we collected data from of patients with SLE admitted to the ICU. Data were divided into two groups based on death or survival within 30 days.Several machine learning methods were used to build prediction models, evaluating model performance by the model area under the receiver operating characteristic curve(AUC).The best performing prediction model was selected. Applying the model to make predictions. The value of intravenous albumin infusion in the input variable was changed using the actual albumin used by the clinician as the baseline. Find the dose that minimizes the risk of death.
Results: Mimic-iv and Mimic-III was used to establish and validation the model. A total of 427 SLE patients, 109 of whom died. They were divided into two groups according to whether they died within 30 days. Random subspace method(RSM) integrated linear discriminant analysis model(LDA) were established. In the external validation AUC results of the models were 0.79[95% CI 0.78 0.82],the model performance was the best. Predictors were: Age at admission in years, Minimum WBC, Maximum WBC, Mechanical ventilation, Mean heart rate, Minimum systolic BP, Vasopressor, dialysis, Accompanied hypertension, nterstitial pneumonia associated with systemic lupus erythematosus, sofa, sirs, sapsii, apsiii, Intravenous administration of albumin, Immunoglobulin M, Minimum Albumin, Urine volume on the first day after admission to ICU, Infection, Complement C4.The model was used to calculate the recommended dose of albumin for intravenous infusion. In the MIMICIV database:366 patients in the survival group, 73 cases in the death group. The survival group improved 26 cases after applying our recommended dose, In the death group, 30 cases were improved. In the MIMICIII database:61 patients in the survival group,36 cases in the death group. The survival group improved 1 cases after applying our recommended dose, In the death group, 6 cases were improved.
Conclusions: RSM-LDA model could be used in the clinical scenario of albumin was infused intravenously treatment with a dosage pattern. The results provide support for recommending optimal albumin was infused intravenously treatment dosing to clinicians.
Effect of Patient-Centred Communication and Usual Source of Care on Potentially Preventable Hospitalization among Patients with Chronic Diseases and Disabilities
Authors: Choi Hyoungshim , Yoon Hyejung , Jung Young-il
Published: January 2023

Background: This study examined the effect of the degree of patient-centred communication (PCC) and having a usual source of care (USC) on potentially preventable hospitalization (PPH) among chronic disease patients with disability. In particular, we empirically analysed whether PCC and USC could reduce the possibility of PPH among patients with disabilities compared to that among those without disabilities.
Methods: This study used data from the Korean Health Panel Survey 2017-2018 (7,271 patients without disabilities and 774 patients with disabilities). The dependent variable was extracted from the 2018 KHPS data, while all other variables included in the analysis were extracted from the 2017 KHPS data and subjected to multivariate logistic regression analysis; subgroup analysis was performed according to the severity of disability.
Results: The incidence of PPH was higher in the group with disabilities (4.5%) than in the group without disabilities (2.2%). Significantly more patients with disabilities than those without disabilities had a USC (67.7% vs. 56.9%), and more patients with severe disabilities than those with mild disabilities had a USC (75.9% vs. 63.5%). Multivariate logistic regression analysis showed that the risk of PPH increased when PCC was insufficient in patients with disabilities (OR = 2.92, 95%CI [1.41–6.04]), those with mild disabilities (OR = 2.51, 95%CI [1.02–6.20]), and those in the severe disability group who did not have a USC (OR = 5.06, 95%CI [1.03–24.80]). The effects of USCs and PCC on PPH were not observed in patients without disabilities.
Conclusion: Sufficient PCC and having a USC helped reduce the incidence of PPH among patients with disabilities and chronic conditions. It is necessary to find practical ways to enhance PCC and expand the use of USCs among patients with disabilities so that they can receive appropriate primary healthcare services in a timely manner.