bluuebunny/crossref_metadata_2025 huggingface dataset:
How Students Use Learning Analytics Dashboards in Higher Education: A Learning Performance Perspective
Authors: Chen Li , Geng Xuewang , Lu Min , Shimada Atsushi , Yamada Masanori
Published: August 2023

Developed to maximize learning performance, learning analytics dashboards (LAD) are becoming increasingly commonplace in education. An LAD’s effectiveness depends on how it is used and varies according to users’ academic levels. In this study, two LADs and a learning support system were used in a higher education course to support students’ cognitive and self-regulated learning (SRL) strategies. A total of 54 students’ learning logs on three systems and their learning performance scores were collected; descriptive statistics of learning behaviors, Mann-Whitney U test, and lag sequential analysis were used to explore how students with different learning performances used LADs to support their learning. Compared to low-performers, high-performers used the LADs more frequently during preview and review phases and conducted more monitoring and reflection strategies to support their learning. Finally, some practical implications for improving the design and use of LADs were provided.
The lower Osteotomy Level is Associated With Decreased Revision Surgery Due to Mechanical Complications After Three-Column Osteotomy in Patients With Adult Spinal Deformity: A Multi-Institutional Retrospective Study
Authors: Kawabata Atsuyuki , Sakai Kenichiro , Yamada Kentaro , Utagawa Kurando , Hashimoto Jun , Morishita Shingo , Matsukura Yu , Oyaizu Takuya , Hirai Takashi , Inose Hiroyuki , Tomori Masaki , Torigoe Ichiro , Onuma Hiroaki , Kusano Kazuo , Otani Kazuyuki , Arai Yoshiyasu , Shindo Shigeo , Okawa Atsushi , Yoshii Toshitaka
Published: August 2023

Study design

A multi-institutional retrospective study.

Objectives

To investigate risk factors of mechanical failure in three-column osteotomy (3COs) in patients with adult spinal deformity (ASD), focusing on the osteotomy level.

Methods

We retrospectively reviewed 111 patients with ASD who underwent 3COs with at least 2 years of follow-up. Radiographic parameters, clinical data on early and late postoperative complications were collected. Surgical outcomes were compared between the low-level osteotomy group and the high-level osteotomy group: osteotomy level of L3 or lower group (LO group, n = 60) and osteotomy of L2 or higher group (HO group, n = 51).

Results

Of the 111 patients, 25 needed revision surgery for mechanical complication (mechanical failure). A lower t-score (odds ratio [OR] .39 P = .002) and being in the HO group (OR 4.54, P = .03) were independently associated with mechanical failure. In the analysis divided by the osteotomy level (LO and HO), no difference in early complications or neurological complications was found between the two groups. The rates of overall mechanical complications, rod failure, and mechanical failure were significantly higher in the HO group than in the LO group. After propensity score matching, mechanical complications and failures were still significantly more observed in the HO group than in the LO group ( P = .01 and .029, respectively).

Conclusions

A lower t-score and osteotomy of L2 or higher were associated with increased risks of mechanical failure. Lower osteotomy was associated with better correction of sagittal balance and a lower rate of mechanical complications.
Accurate Placement and Revisions for Cervical Pedicle Screws Placed With or Without Navigation: A Systematic Review and Meta-Analysis
Authors: Bindels B. J. J. , Dronkers B. E. G. , Smits M. L. J. , Verlaan J. J.
Published: August 2023

Study Design

Systematic review and meta-analysis.

Objectives

To evaluate the accuracy of placement for cervical pedicle screws with and without the use of spinal navigation.

Methods

A structured search was conducted in electronic databases without any language or date restrictions. Eligible studies reported the proportion of accurately placed cervical pedicle screws measured on intraoperative or postoperative 3D imaging, and reported whether intraoperative navigation was used during screw placement. Randomized Studies (MINORS) criteria were used to evaluate the methodological quality of how accuracy was assessed for cervical pedicle screws.

Results

After screening and critical appraisal, 4697 cervical pedicle screws from 18 studies were included in the meta-analysis. The pooled proportion for cervical pedicle screws with a breach up to 2 mm was 94% for navigated screws and did not differ from the pooled proportion for non-navigated screws (96%). The pooled proportion for cervical pedicle screws placed completely in the pedicle was 76% for navigated screws and did not differ from the pooled proportion for non-navigated screws (82%). Intraoperative screw reposition rates and screw revision rates as a result of postoperative imaging also did not differ between navigated and non-navigated screw placement.

Conclusions

This systematic review and meta-analysis found that the use of spinal navigation systems does not significantly improve the accuracy of placement of cervical pedicle screws compared to screws placed without navigation. Future studies evaluating intraoperative navigation for cervical pedicle screw placement should focus on the learning curve, postoperative complications, and the complexity of surgical cases.
The Equipoise Between the Treatment of Glioblastoma and the Risk of Secondary Acute Myelogenous Leukemia: An Illustrative Case Report
Authors: Harari-Turquie Moises , Moturi Krishna Rekha , Horton Darrell D. , Rabinowitz Ian
Published: August 2023

We present a case report of a 56-year-old woman who was diagnosed with biopsy-proven left thalamic glioblastoma multiforme (GBM). She was treated with standard concurrent chemotherapy and radiation, as well as a 2-year period of adjuvant temozolomide. She relapsed 2 ½ years after starting her initial therapy and was treated with bevacizumab and lomustine, but she relapsed. She was then placed on a phase 1/2 clinical trial that included KHK2455 and mogamulizumab-kpkc individually and in combination for almost 4 years. She had a rapid demise due to the development of a neutropenic pneumonia and treatment-induced acute myeloid leukemia (AML) and elected for hospice care.
Republication of “Peroneus Brevis Tenodesis: Side-to-Side or Weave?”
Authors: Janney Cory F. , Iloanya Michael , Morris Randal , Panchbhavi Vinod K.
Published: August 2023

Background:

Inversion ankle injuries are extremely common, sometimes causing injury to the peroneus brevis tendon. If more than 50% of the tendon is injured, it oftentimes requires tenodesis to the adjacent peroneus longus tendon. Both Pulvertaft (PT) and side-to-side (SS) techniques have been used for joining the 2 tendons. The purpose of this study was to compare the strength and stiffness of these 2 techniques.

Methods:

Five matched pairs of cadaver ankle specimens were randomized to receive either an SS or PT tenodesis of the peroneus brevis to longus tendons. Following the tenodesis, the specimens were tested for failure load, displacement, energy absorbed at failure, and peak load. Stiffness was also calculated. Paired t tests were performed to detect differences between the 2 conditions.

Results:

There were no statistically significant differences between the SS and PT tenodesis for any of the metrics measured. For stiffness, the techniques were very similar (SS = 10.14 [4.35], PT = 12.85 [1.72]).

Conclusion:

There is no difference in failure load, displacement, energy absorbed at failure, peak load or stiffness between the PT and SS techniques for peroneal tenodesis.

Level of Evidence:

Level V, cadaver study.
Pharmacokinetic and pharmacodynamic assessments of atogepant in healthy male adults: Results from phase 1 studies
Authors: Boinpally Ramesh , Depré Marleen , Van Lancker Griet , Dockendorf Marissa F , Bondiskey Phung , Denef Jean-Francois , Reynders Tom , Matthews Catherine Zhou , Min K Chris , Xu Jialin , Trugman Joel M , de Hoon Jan
Published: August 2023

Background/Hypothesis:

Atogepant, an oral calcitonin gene-related peptide receptor antagonist, is approved for the preventive treatment of migraine in adults. This manuscript characterizes the safety, tolerability, pharmacokinetics and pharmacokinetic/pharmacodynamic relationship of atogepant in healthy males.

Methods:

Data from two single-ascending dose phase 1 studies of atogepant were utilized to characterize pharmacokinetics and demonstrate proof of activity of atogepant in a capsaicin-induced dermal vasodilatation model and to determine the dosage(s) that results in 90% inhibition of capsaicin-induced dermal vasodilatation (effective concentration, EC90) over 24 hours.

Results:

Single (0.4−200 mg) doses of atogepant were generally well tolerated by healthy participants with no treatment-related study discontinuations. Atogepant was rapidly absorbed with peak plasma concentrations occurring 1–2 hours post dose and a mean elimination half-life of ∼11 hours. Based on the capsaicin-induced dermal vasodilatation and pharmacokinetic/pharmacodynamic models, atogepant has an estimated EC90 of 13.6 nM which was reached within 30 minutes at therapeutic doses and maintained for 24 hours at dosages of 60 mg once daily and 30 and 60 mg twice daily.

Conclusion/Interpretation:

Atogepant reached effective concentrations within 0.5 hours which were maintained for 24 hours at dosages of 60 mg once daily and 30 and 60 mg twice daily for the prevention of migraine.

Trial Registration:

Clinical Trial EudraCT Numbers: 2011-005020-18 (Study 1) and 2012-001192-36 (Study 2).
Paternal high-fat diet altered SETD2 gene methylation in sperm of F0 and F1 mice
Authors: Wei Suhua , Luo Shiwei , Zhang Haifeng , Li Yandong , Zhao Juan
Published: August 2023

Paternal high-fat diet (HFD) can alter the epigenetics of sperm DNA, resulting in the transmission of obesity-related traits to the offspring. Previous studies have mainly focused on the HFD-induced changes in DNA methylation of imprinted genes, overlooking the potential involvement of non-imprinted genes in this process. SETD2, an important epigenetically-regulated gene known for its response to environmental stress, remains poorly understood in the context of high-fat diet-induced epigenetic changes. Here we examined the effect of obesity from a HFD on paternal SETD2 expression and methylation in sperm, and embryos at the blastocyst stage and during subsequent development, to determine the alteration of SETD2 in paternal intergenerational and transgenerational inheritance. The result showed that mice fed with HFD for two months had significantly increased SETD2 expression in testis and sperm. The paternal HFD significantly altered the DNA methylation level with 20 of the 26 CpG sites being changed in sperm from F0 mice. Paternal high-fat diet increased apoptotic index and decreased total cell number of blastocysts, which were closely correlated with DNA methylation level of sperm. Out of the 26 CpG sites, we also found three CpG sites that were significantly changed in the sperm from F1 mice, which meant that the methylation changes at these three CpG sites were maintained.

In conclusion, we found that paternal exposure to an HFD disrupted the methylation pattern of SETD2 in the sperm of F0 mice and resulted in perturbed SETD2 expression. Furthermore, the paternal high-fat diet influenced embryo apoptosis and development, possibly through the SETD2 pathway. The altered methylation of SETD2 in sperm induced by paternal HFD partially persisted in the sperm of the F1 generation, highlighting the role of SETD2 as an epigenetic carrier for paternal intergenerational and transgenerational inheritance.
Biochemical effects of polypropylene microplastics on red tilapia (Oreochromis niloticus) after individual and combined exposure with boron
Authors: Yang Jian , Karbalaei Samaneh , Hussein Shallal M. , Ahmad Ahmad Fahad , Walker Tony R. , Salimi Kobra
Published: August 2023

Toxicity of single pollutants or microplastics (MPs) on organisms have been widely reported. However, their combined toxicity with boron has not been investigated. This study examined effects of individual polypropylene microplastics (PP-MPs) or mixed PP-MPs and boron on biochemical biomarkers in red tilapia (Oreochromis niloticus). O. niloticus were exposed for 21 days to pristine PP-MPs concentrations (10 or 100 mg/L), concentrations of boron alone (30 or 70 mg/L), and identical concentrations of boron in the presence of PP-MPs in laboratory aquaria. Results showed that higher concentrations of individual PP-MPs lead to significantly decreased acetylcholinesterase (AChE) in the brain and malondialdehyde (MDA) in fish liver. In contrast, superoxide dismutase (SOD), glutathione peroxidase (GPx), and glutathione (GSH) were significantly increased in fish liver exposed to higher concentrations of individual PP-MPs. Mixed concentrations of boron and PP-MPs significantly decreased AChE, GSH, and MDA activity in fish. In contrast, mixed concentrations of boron and PP-MPs significantly increased CAT, SOD, and GPx activity in fish. Findings highlight that PP-MPs may increase adverse effects of boron in O. niloticus. We present evidence that individual MPs in long-term exposure have a significant impact on biomarker responses in O. niloticus.
Alkaline and acidic soil constraints on iron accumulation by Rice cultivars in relation to several physio-biochemical parameters
Authors: Saleem Ammara , Zulfiqar Asma , Saleem Muhammad Zafar , Ali Baber , Saleem Muhammad Hamzah , Ali Shafaqat , Tufekci Ebru Derelli , Tufekci Ali Rıza , Rahimi Mehdi , Mostafa Reham M.
Published: August 2023

Agricultural production is severely limited by an iron deficiency. Alkaline soils increase iron deficiency in rice crops, consequently leading to nutrient deficiencies in humans. Adding iron to rice enhances both its elemental composition and the nutritional value it offers humans through the food chain. The purpose of the current pot experiment was to investigate the impact of Fe treatment in alkaline (pH 7.5) and acidic (pH 5.5) soils to introduce iron-rich rice. Iron was applied to the plants in the soil in the form of an aqueous solution of FeSO4 with five different concentrations (100, 200, 300, 400, and 500 mM). The results obtained from the current study demonstrated a significant increase in Fe content in Oryza sativa with the application of iron in both alkaline and acidic pH soils. Specifically, Basmati-515, one of the rice cultivars tested, exhibited a notable 13% increase in iron total accumulation per plant and an 11% increase in root-to-shoot ratio in acidic soil. In contrast to Basmati-198, which demonstrated maximum response in alkaline soil, Basmati-515 exhibited notable increases in all parameters, including a 31% increase in dry weight, 16% increase in total chlorophyll content, an 11% increase in CAT (catalase) activity, 7% increase in APX (ascorbate peroxidase) activity, 26% increase in POD (peroxidase) activity, and a remarkable 92% increase in SOD (superoxide dismutase) in acidic soil. In alkaline soil, Basmati-198 exhibited respective decreases of 40% and 39% in MDA and H2O2 content, whereas Basmati-515 demonstrated a more significant decrease of 50% and 67% in MDA and H2O2 in acidic soil. These results emphasize the potential for targeted soil management strategies to improve iron nutrition and address iron deficiency in agricultural systems. By considering soil conditions, it is possible to enhance iron content and promote its availability in alkaline and acidic soils, ultimately contributing to improved crop nutrition and human health.
Analgesia quality index improves the quality of postoperative pain management: a retrospective observational study of 14,747 patients between 2014 and 2021
Authors: Wang Di , Guo Yihui , Yin Qian , Cao Hanzhong , Chen Xiaohong , Qian Hua , Ji Muhuo , Zhang Jianfeng
Published: August 2023

Background

The application of artificial intelligence patient-controlled analgesia (AI-PCA) facilitates the remote monitoring of analgesia management, the implementation of mobile ward rounds, and the automatic recording of all types of key data in the clinical setting. However, it cannot quantify the quality of postoperative analgesia management. This study aimed to establish an index (analgesia quality index (AQI)) to re-monitor and re-evaluate the system, equipment, medical staff and degree of patient matching to quantify the quality of postoperative pain management through machine learning.

Methods

Utilizing the wireless analgesic pump system database of the Cancer Hospital Affiliated with Nantong University, this retrospective observational study recruited consecutive patients who underwent postoperative analgesia using AI-PCA from June 1, 2014, to August 31, 2021. All patients were grouped according to whether or not the AQI was used to guide the management of postoperative analgesia: The control group did not receive the AQI guidance for postoperative analgesia and the experimental group received the AQI guidance for postoperative analgesia. The primary outcome was the incidence of moderate-to-severe pain (numeric rating scale (NRS) score ≥ 4) and the second outcome was the incidence of total adverse reactions. Furthermore, indicators of AQI were recorded.

Results

A total of 14,747 patients were included in this current study. The incidence of moderate-to-severe pain was 26.3% in the control group and 21.7% in the experimental group. The estimated ratio difference was 4.6% between the two groups (95% confidence interval [CI], 3.2% to 6.0%; P < 0.001). There were significant differences between groups. Otherwise, the differences in the incidence of total adverse reactions between the two groups were nonsignificant.

Conclusions

Compared to the traditional management of postoperative analgesia, application of the AQI decreased the incidence of moderate-to-severe pain. Clinical application of the AQI contributes to improving the quality of postoperative analgesia management and may provide guidance for optimum pain management in the postoperative setting.
Skeletal muscle index is associated with long term outcomes after lobectomy for non-small cell lung cancer
Authors: Vedire Yeshwanth , Nitsche Lindsay , Tiadjeri Madeline , McCutcheon Victor , Hall Jack , Barbi Joseph , Yendamuri Sai , Ray Andrew D.
Published: August 2023

Background

Skeletal muscle indices have been associated with improved peri-operative outcomes after surgical resection of non-small-cell lung cancer (NSCLC). However, it is unclear if these indices can predict long term cancer specific outcomes.

Methods

NSCLC patients undergoing lobectomy at our institute between 2009–2015 were included in this analysis (N = 492). Preoperative CT scans were used to quantify skeletal muscle index (SMI) at L4 using sliceOmatic software. Cox proportional modelling was performed for overall (OS) and recurrence free survival (RFS).

Results

For all patients, median SMI was 45.7 cm2/m2 (IQR, 40–53.8). SMI was negatively associated with age (R = -0.2; p < 0.05) and positively associated with BMI (R = 0.46; P < 0.05). No association with either OS or RFS was seen with univariate cox modelling. However, multivariable modelling for SMI with patient age, gender, race, smoking status, DLCO and FEV1 (% predicted), American Society of Anesthesiology (ASA) score, tumor histology and stage, and postoperative neoadjuvant therapy showed improved OS (HR = 0.97; P = 0.0005) and RFS (HR = 0.97; P = 0.01) with SMI. Using sex specific median SMI as cutoff, a lower SMI was associated with poor OS (HR = 1.65, P = 0.001) and RFS (HR = 1.47, P = 0.03).

Conclusions

SMI is associated with improved outcomes after resection of NSCLC. Further studies are needed to understand the biological basis of this observation. This study provides additional rationale for designing and implementation of rehabilitation trials after surgical resection, to gain durable oncologic benefit.
Neo-train: study protocol and feasibility results for a two-arm randomized controlled trial investigating the effect of supervised exercise during neoadjuvant chemotherapy on tumour response in patients with breast cancer
Authors: Kjeldsted Eva , Ammitzbøll Gunn , Jørgensen Lars Bo , Lodin Alexey , Bojesen Rasmus Dahlin , Ceballos Silvia Gonzalez , Rosthøj Susanne , Lænkholm Anne-Vibeke , Skou Søren T. , Jack Sandy , Gehl Julie , Dalton Susanne Oksbjerg
Published: August 2023

Background

Prehabilitation with exercise interventions during neoadjuvant chemotherapy (NACT) is effective in reducing physical and psychosocial chemotherapy-related adverse events in patients with cancer. In preclinical studies, data also support a growth inhibitory effect of aerobic exercise on the tumour microenvironment with possible improved chemotherapy delivery but evidence in human patients is limited. The aim of the study here described is to investigate if supervised exercise with high-intensity aerobic and resistance training during NACT can improve tumour reduction in patients with breast cancer.

Methods

This parallel two-armed randomized controlled trial is planned to include 120 women aged ≥ 18 years with newly diagnosed breast cancer starting standard NACT at a university hospital in Denmark (a total of 90 participants needed according to the power calculation and allowing 25% (n = 30) dropout). The participants will be randomized to usual care or supervised exercise consisting of high-intensity interval training on a stationary exercise bike and machine-based progressive resistance training offered three times a week for 24 weeks during NACT, and screening-based advice to seek counselling in case of moderate-severe psychological distress (Neo-Train program). The primary outcome is tumour size change (maximum diameter of the largest lesion in millimetre) measured by magnetic resonance imaging prior to surgery. Secondary outcomes include clinical/pathological, physical and patient-reported measures such as relative dose intensity of NACT, hospital admissions, body composition, physical fitness, muscle strength, health-related quality of life, general anxiety, depression, and biological measures such as intratumoural vascularity, tumour infiltrating lymphocytes, circulating tumour DNA and blood chemistry. Outcomes will be measured at baseline (one week before to 1–2 weeks after starting NACT), during NACT (approximately week 7, 13 and 19), pre-surgery (approximately week 21–29), at surgery (approximately week 21–30) and 3 months post-surgery (approximately 33–42 weeks from baseline).

Discussion

This study will provide novel and important data on the potential benefits of supervised aerobic and resistance exercise concomitant to NACT on tumour response and the tumour microenvironment in patients with breast cancer, with potential importance for survival and risk of recurrence. If effective, our study may help increase focus of exercise as an active part of the neoadjuvant treatment strategy.

Trial registration

The trial was registered at ClinicalTrials.gov (NCT04623554) on November 10, 2020.
Body surface area is a predictor of maturity status in school children and adolescents
Authors: Alvear-Vasquez Fernando , Vidal-Espinoza Rubén , Gomez-Campos Rossana , de Campos Luis Felipe Castelli Correia , Lazari Evandro , Guzmán-Luján Jose Francisco , Pablos-Monzó Ana , Cossio-Bolaños Marco
Published: August 2023

Background

Generally, Body surface area (BSA) changes significantly during growth and maturation. These increases portend a possible relationship between body size as determined by BSA with maturational status in children and adolescents.

Objective

To determine the relationship between maturity status (MS) obtained by non-invasive anthropometric methods and body surface area (BSA) in children and adolescents of both sexes in a regional population of Chile. Additionally, we sought to verify the type of linear or nonlinear relationship between MS and BSA in both sexes.

Methods

A descriptive (cross-sectional) study was designed in 950 children and adolescents of both sexes (539 males and 411 females). The age range ranged from 6.0 to 17.9 years. Anthropometric measurements were evaluated: body weight, standing height, sitting height. MS was assessed by means of two non-invasive anthropometric techniques. Both techniques predict peak years of growth velocity (APHV) through a regression equation for each sex. BSA (m2) was estimated by means of the Haycock equation.

Results

The R2 in the linear model is relatively lower (R2 = 0.80 to 0.89 in males and 0.74 to 0.66 in females) in relation to the nonlinear quadratic model (R2 = 0.81 in males and 0.76 to 0.69). The quadratic nonlinear quadratic model reflected an adequate fit (RMSE) for the data set, being in men (RMSE = 1.080 and 1.125), while in women (RMSE = 1.779 and 1.479).

Conclusion

BSA is positively associated with MS determined by two non-invasive methods in Chilean children and adolescents: The nonlinear quadratic model was a better fit to the data distribution. The results suggest the use of BSA as a possible predictor of maturity status in Chilean youth.
Predictors of timeliness of vaccination among children of age 12–23 months in Boricha district, Sidama region Ethiopia, in 2019
Authors: Negash Berhan Tsegaye , Tediso Yoseph , Yoseph Amanuel
Published: August 2023

Background

Traditional measurement of vaccine coverage can mask the magnitude of timely uptake of vaccine. Hence, the optimal measurement of timeliness is unclear due to variations in vaccine schedule among countries in the world. In Ethiopia, Oral Polio Virus (OPV), Pentavalent, Tetanus, H. influenza type B, Hepatitis B, and Pneumonia-Conjugate Vaccine (PCV) are basic vaccines which are taken at birth, six weeks, ten weeks, and fourteen weeks respectively. Despite its importance, information is scarce about on-time vaccination in the study area. Therefore, this study aimed to assess prevalence and factors associated with on-time vaccination among children of age 12–23 months in Boricha district, Sidama Ethiopia, in 2019.

Methods

A community based survey was conducted in Boricha district, Sidama region Ethiopia from January 1–30 in 2019. Study participants were selected using stratified multistage sampling technique. Kebeles were stratified based on residence. First, Kebeles were selected using random sampling. Then, systematic random sampling was employed to reach each household. Data were collected using structured and interviewer administered questionnaire. Logistic regression analysis was employed to identify factors associated with timely vaccination. Then, independent variables with p-value < 0.25 in COR were fitted further into multivariate logistic regression analysis model to control the possible cofounders. AOR with 95% CI and p-value < 0.05 was computed and reported as the level of statistical significance.

Results

From a total of 614 study participants, only 609 study participants have responded to questions completely making a response rate of 99.2%. Prevalence of timeliness of vaccination was 26.8% (95% CI: 25, 28) in this study. Factors like children of women with formal education (AOR = 5.3, 95%CI,2.7, 10.4), absence of antenatal care visit (AOR = 4.2,95%CI, 1.8,9.8), home delivery (AOR = 6.2,95%CI,4.0,9.3), lack of postnatal care (AOR = 3.7,95%CI,1.1,13.3), and lack of information about when vaccines completion date (AOR = 2.0, 95% CI,1.13,3.8) were factors influences timely vaccination among children of age 12–23 months.

Conclusion

Prevalence of on-time vaccination among children of age 12–23 months is lower than national threshold. Therefore, sustained health education on vaccination schedule and reminder strategies should be designed and implemented. Furthermore, maternal and child health care services should be enhanced and coordinated to improve on-time uptake of vaccine.
Joint effects of depressive status and body mass index on the risk of incident hypertension in aging population: evidence from a nationwide population-based cohort study
Authors: Luo Qiuxia , Bao Kai , Gao Wenlong , Xiang Yuanyuan , Li Ming , Zhang Yuqi
Published: August 2023

Background

The impact of depressive status (DS) on hypertension incidence is still controversial and has not been studied in Chinese middle-aged and elderly population. This study aimed to explore the relationship between DS and incident hypertension and analyze the joint effects of DS and body mass index (BMI) on hypertension incidence.

Methods

We conducted a prospective cohort study using data from the China Health and Retirement Longitudinal Study (CHARLS), a nationwide population-based study. In 2013, DS was identified using scores from the 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10) among eligible respondents from CHARLS, and hypertension occurrence was observed until 2018. The multiple Cox models were employed to calculate the associations between DS and hypertension incidence. In addition, we also computed the multiplicative interaction (MI) between DS and BMI of incident hypertension and assessed their additive interaction (AI) through relative excess risk due to interaction (RERI), attributable proportion (AP) or synthetic index (S). Positive AI was indicated by RERI > 0, AP > 0 or S > 1.

Results

Over the 5-year follow-up, depressive symptoms increased the risk of hypertension incidence by 19% (hazard ratio (HR) = 1.19, 95% confidence interval (CI): (1.01, 1.41)), while depression was associated with a 24% increased risk (HR = 1.24; 95% CI: (1.03, 1.50)). Significant MIs between DS and overweight or obesity were observed and almost all of AI indexes showed positive joint effects on incident hypertension, of which the depression-obesity combination had the largest joint effect (RERI = 4.47, 95%CI: (0.28, 8.66); AP = 0.67, 95%CI: (0.50, 0.85); S = 4.86,95%CI: (2.66, 8.86)).

Conclusion

DS could lead to hypertension and this impact was amplified when coexisting with higher BMI. It highlighted a need for precise interventions targeting weight management and depression treatment in the aging population to prevent hypertension.
Robot-assisted laparoscopic pyeloplasty is a valid option for ureteropelvic junction obstruction repair in adults with congenital renal abnormalities: a case series study
Authors: Razavi Sarah , Babbin Joshua , Dahl Douglas
Published: August 2023

Background

Congenital renal anomalies are rare but may be associated with obstruction of the ureteropelvic junction. Given the rarity of simultaneous ureteropelvic junction obstruction [UPJO] and renal anomalies in the adult population, there is limited literature on approaching these patients. We report our experience with robotic assisted laparoscopic pyeloplasty for UPJO repair in this subset of patients.

Methods

Data on adult patients with simultaneous congenital renal abnormalities and UPJO who underwent robotic assisted laparoscopic pyeloplasty between 2008 and 2020 was reviewed. Pre-operative data, intraoperative parameters as well as post-operative data including symptom resolution and radiologic findings were recorded.

Results

Ten patients, 4 female and 6 males, with a mean age of 47 years were identified as having simultaneous congenital renal abnormalities and UPJO. Anomalies identified were horseshoe kidney in four patients, duplex kidney with obstruction of one moiety in two patients, malrotated kidney in two patients, and pelvic kidney in two patients. Eight out of ten were symptomatic at presentation with flank pain being the most common symptom. Eight patients underwent robotic pyeloplasty via the dismembered technique, while two underwent robotic Y-V pyeloplasty. With a mean follow up time of 13 months, 8/9 (88%) symptomatic patients enjoyed symptom resolution. Post-op renogram was available for nine patients and showed resolution of obstruction in all patients (100%). One patient developed a urine leak which was managed successfully with drainage.

Conclusions

Robotic assisted laparoscopic pyeloplasty is a safe, feasible and effective surgical approach in management of adult patients with concomitant UPJO and renal anomalies.
Self-assembling peptide and nano-silver fluoride in remineralizing early enamel carious lesions: randomized controlled clinical trial
Authors: Atteya Sara M. , Amer Hala A. , Saleh Susan M. , Safwat Yara
Published: August 2023

Background

Nanoparticles and regenerative biomineralization are new caries prevention technologies. This study assessed the remineralizing effect of self-assembling peptide (P11-4), Nanosilver Fluoride (NSF) and sodium fluoride (NaF) on white spot lesions (WSLs) in permanent teeth.

Methods

Sixty six young adults with WSLs on buccal surfaces in permanent teeth and ICDAS code 1 or 2, were randomly assigned to one of three groups; P11-4, NSF or NaF. Assessment of ICDAS scores, lesion activity (Nyvad scores) and diagnodent readings of lesions were done at baseline and after 1, 3, 6 and 12 months of agents’ application. Comparisons between groups were made using chi squared test and comparison within groups were made using McNemar test. Multilevel binary logistic regression was used to assess the effect of agents on change of ICDAS scores after 3, 6 and 12 months (reduction versus no reduction).

Results

There were 147 teeth in 66 patients; mean ± SD age = 13.46 ± 4.31 years. There were significant differences in the change of ICDAS scores among the three groups after 3 and 6 months (p = 0.005). The reduction in ICDAS score increased steadily in all groups across time with the greatest increase in the P11-4 group: 54.5% after 12 months. Lesion activity (Nyvad scores) showed significant differences among the three groups with the greatest percentage of inactive cases in the P11-4 group. Multilevel binary logistic regression showed non-significant reduction of ICDAS in P11-4 and NSF varnishes compared to NaF varnish (AOR = 2.56, 95% CI: 0.58, 8.77 and AOR = 2.12, 95% CI: 0.59, 7.64 respectively).

Conclusion

P11-4 and NSF varnish reduced the ICDAS scores, caries activity and diagnodent readings of WSLs in permanent teeth. However, the change in ICDAS scores was not significantly different from NaF.

Trial registration

This trial was prospectively registered on the clinicaltrials.gov registry with ID: NCT04929509 on 18/6/2021.
In Vitro evaluation of the effects of whitening toothpastes on the color and surface roughness of different composite resin materials
Authors: Colak Gulben , Katirci Gunseli
Published: August 2023

Background

The aim of this study was to evaluate the effects of traditional and whitening toothpastes on the color and surface roughness of different composite resin materials.

Methods

Eighty disc-shaped samples were prepared for each of the following composite resins: nano-hybrid (Filtek Ultimate Universal; 3 M/ESPE, Saint Paul, USA), micro-hybrid (Charisma Smart; Kulzer, Hanau, Germany) and supra-nano-filled (Omnichroma; Tokuyama, Tokyo, Japan). Each composite-resin sample was randomly divided into the following four subgroups (n = 20 per group): Group 1, control; Group 2, traditional toothpaste (Colgate Total 12; Colgate Palmolive, New York, USA); Group 3, peroxide-based toothpaste (Colgate Optic White; Colgate-Palmolive, New York, USA); and Group 4, blue covarine-based toothpaste (Meridol Gentle White; CP-GABA, Hamburg, Germany). The samples for the toothpaste subgroups were immersed in a coffee solution for 10 min and washed twice a day before each brushing cycle. The specimens were brushed for 30 days. Color analyses were performed using a spectrophotometer (SpectroShade Micro, MHT, Italy). Surface roughness analyses were conducted using a profilometer (Surftest SJ-210 Mitutoyo, Tokyo, Japon). The color and surface roughness analyses were performed at baseline and 1, 7 and 30 days after each treatment. Furthermore, surface topography analysis was performed using Scanning Electron Microscopy (FEG 250-FeiQuanta, the Netherlands). The data were analysed with a three-way robust ANOVA and Bonferroni post-hoc correction (p < 0.05).

Results

The smallest color change was observed for the micro-hybrid composite resin, and the greatest color change was observed for the nano-hybrid composite resin. Based on the tested composite resin samples, the greatest color change was obtained after using blue covarine–based toothpaste, while the smallest color change was observed after using peroxide-based toothpaste. Moreover, the supra-nano-filled composite resin samples exhibited the lowest roughness values (robust ANOVA test, p < 0.001). There was no statistically significant difference between the mean values of roughness for the composite, group and time interaction (p = 0.937).

Conclusion

Charisma Smart composite resin exhibited significantly lower staining than all the other composite resins tested after using all toothpastes included in the study. Further laboratory and clinical studies are needed to fully understand the long-term effectiveness of whitening toothpaste on composite resin materials.
Potent anti-cancer activity of Sphaerocoryne affinis fruit against cervical cancer HeLa cells via inhibition of cell proliferation and induction of apoptosis
Authors: Le-Trung Nghia , Duong Tue Minh , Dang Thao Thi Phuong , Kamei Kaeko
Published: August 2023

Background

Cervical cancer remains a significant global health issue, highlighting the need for effective therapeutic strategies. Given that Sphaerocoryne affinis (SA) has shown potential anti-cancer activity in several cancer types, herein, we investigate the effects of SA fruit (SAF) on human cervical cancer HeLa cells and their underlying mechanisms of action.

Methods

SAF extract cytotoxicity was assessed in various cancer cell lines. The effects of the hexane fraction (SAF-Hex) on HeLa cell viability, cell cycle protein expression, apoptosis, and DNA damage were evaluated using cytotoxicity assays, Western blotting, quantitative PCR, 4′,6-diamidino-2-phenylindole (DAPI) staining, and a terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay.

Results

SAF-Hex selectively inhibited HeLa cell viability with an IC50 of 4.20 ± 0.36 µg/mL and a selectivity index of 5.11 ± 0.58. The time-dependent cytotoxicity assay showed decreased cell survival after 48 h of treatment, accompanied by morphological changes and apoptotic bodies in HeLa cells. SAF-Hex also suppressed HeLa cell cycle proteins (Cyclin E, CDK2, and CDK1), reduced PCNA transcription, and diminished AKT and mTOR activation, thus inhibiting cell proliferation. The increased γH2AX expression, DNA fragmentation, and caspases-3 and -9 activation indicated SAF-Hex-induced DNA damage and apoptosis. However, the BAX/BCL-2 ratio remained unchanged, and BAX and BCL2 expression was attenuated.

Conclusion

SAF-Hex effectively inhibits HeLa cell proliferation and induces DNA damage in that cervical cancer cell line activating apoptosis through the intrinsic pathway. Interestingly, the BAX/BCL-2 ratio remained unchanged while BAX and BCL2 transcription was attenuated. Hence, further research is required to explore this unexpected finding and facilitate the development of novel therapies targeting cervical cancer HeLa cells.
Recombinant-attenuated Salmonella enterica serovar Choleraesuis vector expressing the PlpE protein of Pasteurella multocida protects mice from lethal challenge
Authors: Zhou Guodong , Tian Jiashuo , Tian Yichen , Ma Qifeng , Li Quan , Wang Shifeng , Shi Huoying
Published: August 2023

Background

Bacterial surface proteins play key roles in pathogenicity and often contribute to microbial adhesion and invasion. Pasteurella lipoprotein E (PlpE), a Pasteurella multocida (P. multocida) surface protein, has recently been identified as a potential vaccine candidate. Live attenuated Salmonella strains have a number of potential advantages as vaccine vectors, including immunization with live vector can mimic natural infections by organisms, lead to the induction of mucosal, humoral, and cellular immune responses. In this study, a previously constructed recombinant attenuated Salmonella Choleraesuis (S. Choleraesuis) vector rSC0016 was used to synthesize and secrete the surface protein PlpE of P. multocida to form the vaccine candidate rSC0016(pS-PlpE). Subsequently, the immunogenicity of S. Choleraesuis rSC0016(pS-PlpE) as an oral vaccine to induce protective immunity against P. multocida in mice was evaluated.

Results

After immunization, the recombinant attenuated S. Choleraesuis vector can efficiently delivered P. multocida PlpE protein in vivo and induced a specific immune response against this heterologous antigen in mice. In addition, compared with the inactivated vaccine, empty vector (rSC0016(pYA3493)) and PBS immunized groups, the rSC0016(pS-PlpE) vaccine candidate group induced higher antigen-specific mucosal, humoral and mixed Th1/Th2 cellular immune responses. After intraperitoneal challenge, the rSC0016(pS-PlpE) immunized group had a markedly enhanced survival rate (80%), a better protection efficiency than 60% of the inactivated vaccine group, and significantly reduced tissue damage.

Conclusions

In conclusion, our study found that the rSC0016(pS-PlpE) vaccine candidate provided good protection against challenge with wild-type P. multocida serotype A in a mouse infection model, and may potentially be considered for use as a universal vaccine against multiple serotypes of P. multocida in livestock, including pigs.
Polo-like kinase 1 promotes pulmonary hypertension
Authors: Chen Rongrong , Wang Hongfei , Zheng Cuiting , Zhang Xiyu , Li Li , Wang Shengwei , Chen Hongyu , Duan Jing , Zhou Xian , Peng Haiyong , Guo Jing , Zhang Anchen , Li Feifei , Wang Wang , Zhang Yu , Wang Jun , Wang Chen , Meng Yan , Du Xinling , Zhang Hongbing
Published: August 2023

Background

Pulmonary hypertension (PH) is a lethal vascular disease with limited therapeutic options. The mechanistic connections between alveolar hypoxia and PH are not well understood. The aim of this study was to investigate the role of mitotic regulator Polo-like kinase 1 (PLK1) in PH development.

Methods

Mouse lungs along with human pulmonary arterial smooth muscle cells and endothelial cells were used to investigate the effects of hypoxia on PLK1. Hypoxia- or Sugen5416/hypoxia was applied to induce PH in mice.Plk1heterozygous knockout mice and PLK1 inhibitors (BI 2536 and BI 6727)-treated mice were checked for the significance of PLK1 in the development of PH.

Results

Hypoxia stimulated PLK1 expression through induction of HIF1α and RELA. Mice with heterozygous deletion ofPlk1were partially resistant to hypoxia-induced PH. PLK1 inhibitors ameliorated PH in mice.

Conclusions

Augmented PLK1 is essential for the development of PH and is a druggable target for PH.
Mechanisms of radiotherapy resistance and radiosensitization strategies for esophageal squamous cell carcinoma
Authors: An Lingbo , Li Mingyang , Jia Qingge
Published: August 2023

Esophageal squamous cell carcinoma (ESCC) is the sixth most common cause of cancer-related mortality worldwide, with more than half of them occurred in China. Radiotherapy (RT) has been widely used for treating ESCC. However, radiation-induced DNA damage response (DDR) can promote the release of cytokines and chemokines, and triggers inflammatory reactions and changes in the tumor microenvironment (TME), thereby inhibiting the immune function and causing the invasion and metastasis of ESCC. Radioresistance is the major cause of disease progression and mortality in cancer, and it is associated with heterogeneity. Therefore, a better understanding of the radioresistance mechanisms may generate more reversal strategies to improve the cure rates and survival periods of ESCC patients. We mainly summarized the possible mechanisms of radioresistance in order to reveal new targets for ESCC therapy. Then we summarized and compared the current strategies to reverse radioresistance.
Cell membrane-based nanomaterials for theranostics of central nervous system diseases
Authors: Li Wenyue , Cheng Junwei , He Fangfei , Zhang Peisen , Zhang Ni , Wang Jian , Song Qiliang , Hou Yi , Gan Zhihua
Published: August 2023

Central nervous system (CNS) diseases have been widely acknowledged as one of the major healthy concerns globally, which lead to serious impacts on human health. There will be about 135 million CNS diseases cases worldwide by mid-century, and CNS diseases will become the second leading cause of death after the cardiovascular disease by 2040. Most CNS diseases lack of effective diagnostic and therapeutic strategies with one of the reasons that the biological barrier extremely hampers the delivery of theranostic agents. In recent years, nanotechnology-based drug delivery is a quite promising way for CNS diseases due to excellent properties. Among them, cell membrane-based nanomaterials with natural bio-surface, high biocompatibility and biosafety, are of great significance in both the diagnosis and treatment of different CNS diseases. In this review, the state of art of the fabrication of cell membranes-based nanomaterials is introduced. The characteristics of different CNS diseases, and the application of cell membranes-based nanomaterials in the theranostics are summarized. In addition, the future prospects and limitations of cell membrane nanotechnology are anticipated. Through summarizing the state of art of the fabrication, giving examples of CNS diseases, and highlighting the applications in theranostics, the current review provides designing methods and ideas for subsequent cell membrane nanomaterials.
Mackinawite nanozymes as reactive oxygen species scavengers for acute kidney injury alleviation
Authors: Xu Zhuobin , Zhu Yufei , Xie Mengke , Liu Kankan , Cai Liangliang , Wang Huihui , Li Dandan , Chen Hao , Gao Lizeng
Published: August 2023

Background

Iron sulfide nanomaterials have been successfully employed as therapeutic agents for bacterial infection therapy and catalytic-ferroptosis synergistic tumor therapy due to their unique structures, physiochemical properties, and biocompatibility. However, biomedical research and understanding of the biological functions of iron sulfides are insufficient, and how iron sulfide nanomaterials affect reactive oxygen species (ROS) in diseases remains unknown. Acute kidney injury (AKI) is associated with high levels of ROS, and therefore nanomedicine-mediated antioxidant therapy has emerged as a novel strategy for its alleviation.

Results

Here, mackinawite nanozymes were synthesized from glutathione (GSH) and iron ions (Fe3+) (denoted as GFeSNs) using a hydrothermal method, and then evaluated as ROS scavengers for ROS-related AKI treatment. GFeSNs showed broad-spectrum ROS scavenging ability through synergistic interactions of multiple enzymes-like and hydrogen polysulfide-releasing properties. Furthermore, both in vitro and in vivo experiments demonstrated that GFeSNs exhibited outstanding cytoprotective effects against ROS-induced damage at extremely low doses and significantly improved treatment outcomes in AKI.

Conclusions

Given the synergetic antioxidant properties and high biocompatibility, GFeSNs exhibit great potential for the treatment of AKI and other ROS-associated diseases.

Graphical Abstract