bluuebunny/crossref_metadata_2025 huggingface dataset:
Brain perfusion imaging using 99mTc-Ethyl cysteinate dimer with acetazolamide challenge reveals “steal phenomenon” in suspected stroke: A case report
Authors: Khairuman Khairul Aliff , Shahrir Ahmad Danial , Suppiah Subapriya , Vashu Ravindran , Shamim Syed Ejaz
Published: July 2023

Chronic cerebral ischaemia (CCI) is a potentially life-threatening condition caused by carotid artery occlusion, hypotension and other causes. Moyamoya Syndrome (MMS) is an example of CCI, in which there is progressive narrowing of the branches of the internal carotid artery. Conventionally, magnetic resonance angiography (MRA) or digital subtraction angiogram (DSA) are utilised to visualise the vascular abnormalities. However, nuclear medicine imaging can help to give more functional information that can improve the management and surgical outcome of patients. There is a need to highlight the role of single-photon emission computed tomography/computed tomography (SPECT/CT) imaging using 99mTc-Ethyl Cysteinate Dimer (99mTc-ECD) with Acetazolamide (ACZ) challenge to diagnose MMS and decide on further surgical or medical intervention. We illustrate a case of a young woman who benefited from this imaging for the management of her condition.
Unexpected rapid symptom response after praziquantel to intestinal Schistosoma mansoni symptoms: A case report from Rwanda
Authors: Sibomana Jean Pierre , Getaneh Ferehiwot B , Graham Brian , Giraneza Robert
Published: July 2023

The clinical effect of praziquantel on chronic intestinal schistosomiasis in the literature is lacking. We report a patient who presented with 3 years of non-specific abdominal pain and underwent colonoscopy, which revealed colon polyps that, on biopsy, were confirmed to be due to Schistosoma mansoni. The patient was given a single dose of praziquantel, and his abdominal symptoms disappeared within 24 h. Patients with abdominal pain in the setting of chronic Schistosoma infection should be given praziquantel and assess response clinically.
Unilateral proptosis in a patient with thyroid eye disease: A case report
Authors: Bhattarai Himal Bikram , Thapaliya Ishwor , Dhungana Shrawan , Singh Prabesh Bikram , Bhattarai Madhur , Pokhrel Bidushi , Khanal Santosh , Lamichhane Saral , Gautam Swotantra , Basnet Bibhusan
Published: July 2023

Unilateral proptosis is an abnormality in which one eye sticks out forward more than the other. Bulging of the eye is commonly seen in Graves’ ophthalmopathy, but it’s mostly bilateral. Thyroid eye disease presents as the most common extrathyroidal manifestation of Graves’ disease, and rarely leads to unilateral proptosis. A 25-year-old female with a history of weight loss, menstrual irregularities, and palpitations presented with progressive right eye bulging, which was further confirmed by magnetic resonance imaging and biochemical investigations. Magnetic resonance imaging of the orbit revealed unilateral extraocular muscle enlargement and enhancement with sparing of the tendons. Timely therapy is crucial for reversing the ocular manifestations of thyroid eye disease.
Setting priorities in health: The managers' perspectives versus general public
Authors: Araújo Nuno , Reis Ana Maria , Borges Ana , Neves José Maia , Rosa Alvaro
Published: July 2023

Introduction

Decision-makers are constantly confronted with the need of balancing limited resources while establishing rationing criteria in health care system. However, there is an emerging trend in involving citizens in rationing debates as mechanism to assuring legitimacy in the decision-making process. This paper aims to explore citizens’ opinions on priority setting in health care access in comparison with the perspectives of managers.

Methods

An online questionnaire was used to collect the data. A logistic regression was applied to evaluate factors that shape the prioritisation of groups in access to health care services. The collected data comprehends 400 individuals, aged 18 years old and over living in continental Portugal.

Results

The study results reveal that managers and the general public, in the context of limited resources, both agree with the need to prioritise some groups over others in access to health care services. The priority groups would include the elderly, children, and people with chronic conditions. The most outstanding finding is that managers prefer children as their first priority group against the general public who has considered as top priority the elder ones.

Discussion

This study identified which stakeholders are prone to be included in decision-making processes for effective priority-setting models in the health care systems and evaluated their preferences.
Improving clinical trial recruitment with warm transfers
Authors: Peer Kyle , Cotliar Jonathan , Goulian Andrew
Published: July 2023

During recruitment for a large, decentralized clinical trial for high-risk individuals with COVID-19, respondents were either transferred in real-time to a clinical research coordinator (i.e. warm transfer), or a callback time was arranged. A retrospective analysis was conducted on 2341 respondents comparing the rate of enrollment among those who were warm-transferred and those for whom a callback was arranged. A respondent who warm-transferred was significantly more likely to enroll in the clinical trial.
Factors and Clusters of Musical Self-Concept Discovered in a Cross-Cultural Sample of Swiss, Chinese, and Taiwanese Students
Authors: Petersen Suse , Camp Marc-Antoine , Kull Annatina
Published: July 2023

Cultural and societal settings in which an individual is raised, and the role of music and musical training during an individual’s upbringing, shape the relation to music and the conception of the self with regard to music in the present and in the future. Accordingly, differing cultural and musical biographical backgrounds are reflected in differences of musical self-concepts. The aim was to assess distinct musical self-concept types of Chinese, Taiwanese, and Swiss university music students with an adapted version of the Musical Self-Concept Inquiry (MUSCI), and to analyze these types in terms of the manifestation of different dimensions of the musical self-concept as well as sociodemographic and further personal characteristics. 805 university music students took part in the study. The sample included 293 Swiss, 356 Chinese, and 156 Taiwanese students. An adapted version of the Musical Self-Concept Inquiry was administered, and the data subjected to a principal component and a confirmatory factor analysis to determine the factors of the musical self-concept. A cluster analysis was carried out to identify self-concept clusters. H-, U-, Chi2, and two-sample Kolmogorov–Smirnov Z-tests were carried out to assess cluster differences in the factor manifestations, as well as sociodemographic and further personal aspects. The Musical Self-Concept Inquiry-SwisSino could be confirmed with regard to three factors (ability, mood management, dance), while other factors could not be retained. Three significantly distinct clusters were identified, which differed regarding the factor manifestation and the students’ origin, gender, course of study, main instrument, practice hours, and parental educational background and musical activity. However, due to only a few dimensions of the musical self-concept being verified, the broadness of the concept was restricted. Advances in quantitative comparative music studies will thus require further work on conceptional issues as well as the clarification of cultural notions and adequate translations.
Feasibility of Internet-Based Physical-Cognitive Exercise for Health Benefits of Middle-Aged Obese Women
Authors: Keawtep Puntarik , Kamnardsiri Teerawat , Boripuntakul Sirinun , Wichayanrat Wanachaporn , Worakul Puangsoi , Sungkarat Somporn
Published: July 2023

Introduction:

Obesity in middle-aged women markedly increases the risk for non-communicable diseases, neurodegenerative diseases, and physical and cognitive problems. Exercise, particularly combined physical-cognitive exercise, has been demonstrated to have beneficial effects on both physical and cognitive health. However, middle-aged women often face barriers to engaging in exercise, which include time constraints, lack of motivation, and enjoyment. Incorporating an exercise program into a technology-based intervention in the home environment may help overcome these barriers and promote health benefits. Therefore, this study aimed to assess the feasibility of home-based, physical-cognitive internet-based exercise for middle-aged obese women.

Methods:

A total of 33 middle-aged obese women were enrolled in the study. Participants performed an intervention for 60 min/day, 3 days/week for 3 months. Feasibility outcomes (adherence, adverse events, physical performances, obesity parameters, and enjoyment of the program) were measured.

Results:

Average exercise adherence was 91.67%, and no adverse events were reported in this feasibility study. At the end of the training period, body weight and BMI were significantly decreased compared to baseline. As for physical performances, both cardiorespiratory fitness and lower limb muscle power were significantly improved at post-training when compared to baseline. Furthermore, the participants experienced a high level of exercise enjoyment, and it was maintained over the 3-month training period.

Conclusion:

These findings suggest that home-based, internet-based physical-cognitive exercise was safe and feasible for reducing obesity parameters, improving physical function, maintaining enjoyment over the course of training, and facilitating adherence to exercise in middle-aged obese women.
Construct Validation and Prediction of the School Psychological Capital in Two Chinese Cultural Contexts
Authors: Wu Yajun , Kang Xia
Published: July 2023

Psychological Capital (PsyCap) has received much attention in industrial-organizational research because it is linked to a broad spectrum of adaptive work-related outcomes. However, few studies have been conducted on PsyCap in non-Western school contexts, especially in the ethnic minority areas of Mainland China. The present study aims to validate the school PsyCap scale, examine the latent mean differences of school PsyCap across Dai and Han groups, and verify the correlation between school PsyCap and academic engagement, achievement emotions, and academic achievement in a sample of 769 Chinese school children (Han students = 249, Dai students = 520) in the seventh and eighth grades. Results demonstrated that the Chinese version of the school PsyCap scale had excellent psychometric properties. Besides, there were no significant differences in the mean level of school PsyCap between the two cultural groups of Chinese Dai and Han. However, the multi-group second-order CFA model showed that the mean level of Dai students’ resilience was lower than that of Chinese Han. The findings also showed that school PsyCap has positive predictive effects on optimal academic outcomes (i.e., academic engagement, enjoyment, and academic achievement) but negatively affect boredom. This study enriches the understanding of school PsyCap from a cross-cultural perspective. Both theoretical and practical implications are discussed.
Millennial Customer Engagement with Fintech Services: The Mediating Role of Trust
Authors: Al Karim Rashed , Rabiul Md Karim , Taskia Ayesha , Jarumaneerat Tatiyaporn
Published: July 2023

The study investigates the impacts of Fintech services (such as e-payment service (EPS), Robo-advisory, Regtech service (RTS), and financing service (FS)) on millennial customer engagement (CE) in the context of the private banking sector of Bangladesh. It also examines the mediating role of trust between Fintech services and CE relationships. Data for this study were collected through a structured survey questionnaire from 294 customers (only Fintech users) of different private banks in Bangladesh. The convenience sampling technique was used to select millennial customers. SPSS and SmartPLS software were used for data analysis. The results exhibited that EPS, Robo-advisory, and FS positively impact CE, while RTS was found insignificant with CE. Besides, customer trust (CT) mediates the relationships among EPSs, Robo-advisory, and FSs with CE. Conversely, CT does not mediate the RTS and CE relationship. The study findings contribute to the substantial pool of knowledge in Fintech services, CE, and consumer trust. Remarkably, the mediating role of CT between the Fintech services and CE relationship is the unique novelty of this study and will enrich the existing Fintech literature from Bangladesh’s perspective.
Outcomes After Open Latarjet in Patients With or Without SLAP Lesions
Authors: Billaud Anselme , Garcia-Maya Beatriz , Pesquer Lionel , Pillot Sabine
Published: July 2023

Background:

Up to 20% of shoulders with anterior instability are associated with superior labrum anterior-posterior (SLAP) lesions, and they remain untreated after an open Latarjet procedure. SLAP lesions can be responsible for pain and feelings of instability in high-demand patients.

Purpose/Hypothesis:

The aim of this study was to compare the early functional outcomes and return to sport rates in athletes after the Latarjet procedure with versus without associated SLAP lesions. It was hypothesized that untreated SLAP lesions would not influence clinical results.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Inclusion criteria were athletes with anterior shoulder instability treated with Latarjet procedure, a minimum follow-up of 1 year, and an available preoperative computed tomography arthrogram. We recorded patient characteristics; type of sport; bone loss; Rowe, Single Assessment Numeric Evaluation (SANE), and 11-item Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores; 5-point pain and satisfaction scores; reported apprehension; and return to sport. Patients with and without a preoperative type 5 SLAP lesion on imaging were compared.

Results:

Fifty patients were included (mean age, 22 ± 5 years [range, 16-36 years]; mean follow-up, 27 ± 9 months [range, 12-42 months]). Thirty-four patients practiced contact sports, including 20 rugby players. Twelve patients (24%) had a preoperative SLAP lesion. Groups with (+) and without (–) a SLAP lesion were comparable in terms of age, sex, number of instability episodes, type of sport, and glenoid and humeral bone loss. The SLAP+ group had significantly worse outcomes with a lower Rowe score (79 ± 23 vs 91 ± 15; P = .018) and painless rate (50% vs 77%; P = .04). There were no significant differences between the groups in SANE score (SLAP+ vs SLAP–: 80% vs 87%), QuickDASH score (8% vs 8%), return to sport (83% vs 91%), apprehension (79% vs 50%), and reported satisfaction. There was 1 episode of postoperative subluxation in each group.

Conclusion:

Patients who underwent an open Latarjet procedure with an associated SLAP tear more frequently reported postoperative pain than those without a SLAP lesion. Patients with untreated SLAP tears had significantly lower Rowe scores, although SANE score and return to sport were not significantly different between the groups.
Accuracy of a Smartphone Software Application Compared With a Handheld Goniometer for Measuring Shoulder Range of Motion in Asymptomatic Adults
Authors: Soeters Rupali , Damodar Dhanur , Borman Nicole , Jacobson Kendal , Shi Jing , Pillai Raji , Mehran Nima
Published: July 2023

Background:

Typically, shoulder range of motion (ROM) measurements are performed in a clinic setting, where physicians, physical therapists (PTs), and occupational therapists make use of a goniometer.

Purpose:

To determine the accuracy of a smartphone-based ROM software application (app) in assessing active shoulder ROM and compare the measurements with traditional goniometry as measured by a PT.

Study Design:

Cohort study (diagnosis); Level of evidence, 2.

Methods:

This prospective, nonblinded study was conducted at a single institution with adult asymptomatic participants with full active ROM of both shoulders. Participants were enrolled between June 1 and 15, 2021. Each participant self-assessed their active shoulder ROM using the PeerWell smartphone app. A single PT concurrently measured each participant’s active shoulder ROM using a handheld universal goniometer. Bilateral shoulder ROM (forward flexion, abduction [AB], external rotation, internal rotation [IR], and extension) was measured 2 times for each participant. Interrater reliability between the smartphone app and PT measurements as well as intrarater reliability for each method of measurement were assessed using the intraclass correlation coefficient (ICC), and limits of agreement were analyzed for the difference in measurement methods.

Results:

Data were analyzed for 60 shoulders (30 right, 30 left) from 30 participants (mean age, 31.4 ± 11.7 years; 73% female). The interrater reliability between the 2 methods was excellent for all movements (ICCs, 0.90-0.96). For all movements except shoulder AB, the mean difference in the measurements between the 2 methods was <1.3°; the mean difference in AB ROM was 2.08°. For all movements except IR, both PTs and the app showed excellent intrarater reliability (ICCs >0.90); for IR, good intrarater reliability (ICC ≥0.75) was observed.

Conclusion:

The PeerWell smartphone app provided measurements comparable with manual measurements taken by a PT using a goniometer. These data provide evidence that the smartphone app is a reliable and valid tool for measuring shoulder ROM and show promise for measuring and monitoring patient ROM remotely.
The Student Voice: Decolonising the Curriculum
Authors: Takhar Shaminder
Published: July 2023

This case study presents the importance of the student voice to decolonise the curriculum at a British university. The aim is to emphasise the increasing necessity and urgency for student input to the wider decolonisation process as a means to foster equality. It has been argued by some scholars that decolonisation of the curriculum in higher education institutions (HEIs) is closely connected to the racial awarding gap and the student voice plays an integral role regarding future decisions about pedagogy. The Student Voice: Decolonising the curriculum project did not ask Black, Asian, and Minority Ethnic (BAME) students to spend time helping the university to decolonise the curriculum, rather it sought input from students who are experiencing the current curriculum. The process of decolonisation is often underestimated and not acted upon due to a lack of time. However, it is important as often the racial awarding gap reflects pedagogical practices which exclude BAME students. Student input to pedagogical decisions is an important step towards inclusivity. Critical conversations and co-produced resources such as websites can all contribute to an institution better equipped to deliver pedagogical practice contributing to narrowing the racial awarding gap and the wider aim to decolonise the curriculum.
New bone formation accelerates during lower limb lengthening and deformity correction in children with Ollier’s disease
Authors: Wu Chunxing , Huang Yiyong , Huang Peng , Mo Yueqiang , Wang Dahui , Ning Bo
Published: July 2023

Background

Ollier’s disease can cause severe length discrepancy of the lower extremities and deformity in children. Osteotomy and limb lengthening with external fixation can correct the limb deformity. This study evaluated (1) whether the duration of external fixation was reduced in patients with Ollier’s disease, and (2) the incidence of complications such as pin tract infection, external fixation loosening, and joint stiffness.

Methods

Two groups were compared with respect to age, angular correction (AC), lengthening gap (LG), distraction index (DI), lengthening length (LL), lengthening length percentage (L%), lengthening index (LI), bone healing index (BHI), and external fixation index (EFI). Group 1 (Ollier’s disease) comprised nine patients undergoing 11 lower limb lengthening procedures using external fixators; group 2 (control, normal lengthened bone) comprised 28 patients undergoing 29 lengthening procedures with external fixators.

Results

In patients with Ollier’s disease, full correction of the deformity and full restoration of length were achieved in all cases. In the femur, the mean AC (15.97° vs. 6.72°) and DI (1.11 mm/day vs. 0.78 mm/day) were significantly larger, while the LI (9.71 days/cm vs. 13.49 days/cm), BHI (27.00 days/cm vs. 42.09 days/cm), and EFI (37.86 days/cm vs. 56.97 days/cm) were all significantly shorter in group 1 than in group 2 (p < 0.05). In the tibia, the mean AC and L% were larger, while the LG, LI, BHI, and EFI were all shorter in group 1 than in group 2. There was no significant difference between the two groups in the incidence of complications.

Conclusion

In children with Ollier’s disease, new bone formation accelerated and the healing speed of the lengthened segments was faster throughout the whole lengthening period with external fixation, and full correction of the deformity and full restoration of length could be achieved.

Level of Evidence III
Peptidase inhibitor (PI16) impairs bladder cancer metastasis by inhibiting NF-κB activation via disrupting multiple-site ubiquitination of NEMO
Authors: Kuang Xiangqin , Zhang Zhuojun , Li Difeng , Bao Wenhao , Pan Jinyuan , Zhou Ping , Chen Han , Gao Zhiqing , Xie Xiaoyi , Yang Chunxiao , Zhu Ge , Zhou Zhongqiu , Tang Ruiming , Feng Zhengfu , Zhou Lihuan , Feng Xiaoli , Wang Lan , Yang Jianan , Jiang Lili
Published: July 2023

Background

Bladder cancer (BLCA) is a malignancy that frequently metastasizes and leads to poor patient prognosis. It is essential to understand the molecular mechanisms underlying the progression and metastasis of BLCA and identify potential biomarkers.

Methods

The expression of peptidase inhibitor 16 (PI16) was analysed using quantitative PCR, immunoblotting and immunohistochemistry assays. The functional roles of PI16 were evaluated using wound healing, transwell, and human umbilical vein endothelial cell tube formation assays, as well as in vivo tumour models. The effects of PI16 on nuclear factor κB (NF-κB) signalling activation were examined using luciferase reporter gene systems, immunoblotting and immunofluorescence assays. Co-immunoprecipitation was used to investigate the interaction of PI16 with annexin-A1 (ANXA1) and NEMO.

Results

PI16 expression was downregulated in bladder cancer tissues, and lower PI16 levels correlated with disease progression and poor survival in patients with BLCA. Overexpressing PI16 inhibited BLCA cell growth, motility, invasion and angiogenesis in vitro and in vivo, while silencing PI16 had the opposite effects. Mechanistically, PI16 inhibited the activation of the NF-κB pathway by interacting with ANXA1, which inhibited K63 and M1 ubiquitination of NEMO.

Conclusions

These results indicate that PI16 functions as a tumour suppressor in BLCA by inhibiting tumour growth and metastasis. Additionally, PI16 may serve as a potential biomarker for metastatic BLCA.
Influence of scat ageing on the gut microbiome: how old is too old?
Authors: Oliveros Alejandro , Terraube Julien , Levengood Alexis L. , Powell Daniel , Frère Céline H.
Published: July 2023

Background

The study of the host-microbiome by the collection of non-invasive samples has the potential to become a powerful tool for conservation monitoring and surveillance of wildlife. However, multiple factors can bias the quality of data recovered from scats, particularly when field-collected samples are used given that the time of defecation is unknown. Previous studies using scats have shown that the impact of aerobic exposure on the microbial composition is species-specific, leading to different rates of change in microbial communities. However, the impact that this aging process has on the relationship between the bacterial and fungal composition has yet to be explored. In this study, we measured the effects of time post-defecation on bacterial and fungal compositions in a controlled experiment using scat samples from the endangered koala (Phascolarctos cinereus).

Results

We found that the bacterial composition remained stable through the scat aging process, while the fungal composition did not. The absence of an increase in facultative anaerobes and the stable population of obligate anaerobic bacteria were likely due to our sampling from the inner portion of the scat. We report a cluster of fungal taxa that colonises scats after defecation which can dilute the genetic material from the autochthonous mycoflora and inhibit recovery.

Conclusion

We emphasize the need to preserve the integrity of scat samples collected in the wild and combat the effects of time and provide strategies for doing so.
Enrichment of human nasopharyngeal bacteriome with bacteria from dust after short-term exposure to indoor environment: a pilot study
Authors: Konecna Eva , Videnska Petra , Buresova Lucie , Urik Milan , Smetanova Sona , Smatana Stanislav , Prokes Roman , Lanickova Barbara , Budinska Eva , Klanova Jana , Borilova Linhartova Petra
Published: July 2023

Background

Indoor dust particles are an everyday source of human exposure to microorganisms and their inhalation may directly affect the microbiota of the respiratory tract. We aimed to characterize the changes in human nasopharyngeal bacteriome after short-term exposure to indoor (workplace) environments.

Methods

In this pilot study, nasopharyngeal swabs were taken from 22 participants in the morning and after 8 h of their presence at the workplace. At the same time points, indoor dust samples were collected from the participants’ households (16 from flats and 6 from houses) and workplaces (8 from a maternity hospital – NEO, 6 from a pediatric hospital – ENT, and 8 from a research center – RCX). 16S rRNA sequencing analysis was performed on these human and environmental matrices.

Results

StaphylococcusandCorynebacteriumwere the most abundant genera in both indoor dust and nasopharyngeal samples.The analysis indicated lower bacterial diversity in indoor dust samples from flats compared to houses, NEO, ENT, and RCX (p < 0.05). Participants working in the NEO had the highest nasopharyngeal bacterial diversity of all groups (p < 0.05). After 8 h of exposure to the workplace environment, enrichment of the nasopharynx with several new bacterial genera present in the indoor dust was observed in 76% of study participants; however, no significant changes were observed at the level of the nasopharyngeal bacterial diversity (p > 0.05, Shannon index). These “enriching” bacterial genera overlapped between the hospital workplaces – NEO and ENT but differed from those in the research center – RCX.

Conclusions

The results suggest that although the composition of nasopharyngeal bacteriome is relatively stable during the day. Short-term exposure to the indoor environment can result in the enrichment of the nasopharynx with bacterial DNA from indoor dust; the bacterial composition, however, varies by the indoor workplace environment.
Morpho-physiological mechanisms of two different quinoa ecotypes to resist salt stress
Authors: Hussin Sayed A. , Ali Safwat Hassan , Lotfy Muhammad E. , El-Samad Emad H. Abd , Eid Mohamed A. , Abd-Elkader Ali M. , Eisa Sayed Said
Published: July 2023

Background

Quinoa (Chenopodium quinoa Willd.) is a facultative halophyte showing various mechanisms of salt resistance among different ecotype cultivars. This study aimed to determine salt resistance limits for a Peruvian sea level ecotype “Hualhuas” and a Bolivian salar ecotype “Real” and elucidate individual mechanisms conferring differences in salt resistance between these cultivars. The plants were grown in sandy soil and irrigated with various saline solutions concentrations (0, 100, 200, 300, 400, and 500 mM NaCl) under controlled conditions.

Results

High salinity treatment (500 mM NaCl) reduced the plant growth by 80% and 87% in Hualhuas and Real cultivars, respectively. EC50 (water salinity which reduces the maximum yield by 50%) was at a salinity of 300 mM NaCl for Hualhuas and between 100 and 200 mM NaCl for Real plants. Both cultivars were able to lower the osmotic potential of all organs due to substantial Na+ accumulation. However, Hualhuas plants exhibited distinctly lower Na+ contents and consequently a higher K+/Na+ ratio compared to Real plants, suggesting a more efficient control mechanism for Na+ loading and better K+ retention in Hualhuas plants. Net CO2 assimilation rates (Anet) were reduced, being only 22.4% and 36.2% of the control values in Hualhuas and Real, respectively, at the highest salt concentration. At this salinity level, Hualhuas plants showed lower stomatal conductance (gs) and transpiration rates (E), but higher photosynthetic water use efficiency (PWUE), indicative of an efficient control mechanism over the whole gas-exchange machinery.

Conclusion

These results reveal that Hualhuas is a promising candidate in terms of salt resistance and biomass production compared to Real.
5-year oncological outcomes in left-sided malignant colonic obstruction: stent as bridge to surgery
Authors: Alhassan Noura S , AlShammari Sulaiman A , AlRabah Razan N , AlZahrani Amirah M , Abdulla Maha-Hamadien , Traiki Thamer A Bin , Zubaidi Ahmad M , Al-Obeed Omar A , Alkhayal Khayal A
Published: July 2023

Background

A considerable number of patients with colon cancer present with a colonic obstruction. The use of self-expanding metallic stents (SEMS) as a bridge to surgery (BTS) in potential curative patients with left-sided colonic cancer obstruction remains debatable. Therefore, this study aimed to investigate the 5-year oncological outcomes of using a SEMS as a BTS.

Methods

All patients with left-sided malignant colon obstruction who underwent curative surgery with no metastasis upon presentation between March 2009 and May 2013 were retrospectively reviewed and analyzed.

Results

A total of 45 patients were included, 28 patients underwent upfront surgery, and 17 patients had a stent as a bridge to surgery. T4 stage was statistically significantly higher in patients who had a SEMS as a BTS (35.3% vs. 10.7%) (p-value 0.043). The mean duration in days of the SEMS to surgery was 13.76 (SD 10.08). TNM stage 3 was a prognostic factor toward distant metastasis (HR 5.05). When comparing patients who had upfront surgery to those who had a SEMS as a BTS, higher 5-year disease-free survival (75% vs. 72%) and 5-year overall survival (89% vs. 82%) were seen in patients who had upfront surgery. However, both were statistically insignificant.

Conclusion

Using self-expanding metallic stents as a bridge to surgery yields comparable 5-year survival and disease-free survival rates to upfront emergency surgery. The decision to use SEMS versus opting for emergency surgery should be made after careful patient selection and with the assistance of experienced endoscopists.

Trial registration

N/A.
Identification of a novel immune-related transcriptional regulatory network in sarcopenia
Authors: Zhang Xianzhong , Zhu Guanglou , Zhang Fengmin , Yu Dingye , Jia Xuyang , Ma Bingwei , Chen Weizhe , Cai Xinyu , Mao Lingzhou , Zhuang Chengle , Yu Zhen
Published: July 2023

Background

Sarcopenia is highly prevalent in elderly individuals and has a significant adverse effect on their physical health and quality of life, but the mechanisms remain unclear. Studies have indicated that transcription factors (TFs) and the immune microenvironment play a vital role in skeletal muscle atrophy.

Methods

RNA-seq data of 40 muscle samples were downloaded from the GEO database. Then, differentially expressed genes (DEGs), TFs(DETFs), pathways(DEPs), and the expression of immune gene sets were identified with limma, edgeR, GO, KEGG, ORA, GSVA, and ssGSEA. Furthermore, the results above were integrated into coexpression analysis by Pearson correlation analysis (PCA). Significant coexpression patterns were used to construct the immune-related transcriptional regulatory network by Cytoscape and potential medicine targeting the network was screened by Connectivity Map. Finally, the regulatory mechanisms and RNA expression of DEGs and DETFs were identified by multiple online databases and RT‒qPCR.

Results

We screened 808 DEGs (log2 fold change (FC) > 1 or <  − 1, p < 0.05), 4 DETFs (log2FC > 0.7 or <  − 0.7, p < 0.05), 304 DEPs (enrichment scores (ES) > 1 or <  − 1, p < 0.05), and 1208 differentially expressed immune genes sets (DEIGSs) (p < 0.01). Based on the results of PCA (correlation coefficient (CC) > 0.4 or <  − 0.4, p < 0.01), we then structured an immune-related network with 4 DETFs, 9 final DEGs, 11 final DEPs, and 6 final DEIGSs. Combining the results of online databases and in vitro experiments, we found that PAX5-SERPINA5-PI3K/Akt (CC ≤ 0.444, p ≤ 0.004) was a potential transcriptional regulation axis, and B cells (R = 0.437, p = 0.005) may play a vital role in this signal transduction. Finally, the compound of trichostatin A (enrichment = -0.365, specificity = 0.4257, p < 0.0001) might be a potential medicine for sarcopenia based on the PubChem database and the result of the literature review.

Conclusions

We first identified immune-related transcriptional regulatory network with high-throughput RNA-seq data in sarcopenia. We hypothesized that PAX5-SERPIAN5-PI3K/Akt axis is a potential mechanism in sarcopenia and that B cells may play a vital role in this signal transduction. In addition, trichostatin A might be a potential medicine for sarcopenia.
Clinical outcome of different embryo transfer strategies after late rescue ICSI procedure: a 10-year total fertilisation failure cohort study
Authors: Zhu Xiaxuan , Tian Tian , Jiesisibieke Dina , Fang Shilin , Zhang Nan , Ma Jinxi , Xia Yuqi , Liu Ping , Li Rong , Qiao Jie , Yang Rui
Published: July 2023

Background

Late rescue intracytoplasmic sperm injection (r-ICSI) has not been widely accepted as an alternative solution for unexpected total fertilisation failure (TFF) after in vitro fertilisation (IVF), due to the time-dependent in vitro deterioration of oocyte quality and endometrial growth not being synchronised with embryo development. This study aimed to evaluate the safety profile and effectiveness of freeze-all blastocyst transfer in combination with late r-ICSI.

Methods

This was a retrospective cohort study carried out at the Reproductive Centre of Peking University Third Hospital, Beijing, China. All participants received treatment between 2009 and 2019. 2,270 patients in the aggregate encountered unexpected TFF during 149,054 cycles of IVF and adopted a late r-ICSI procedure. Among these patients, 263 women did not have cleavage-stage embryos available for evaluation. The remaining patients were grouped according to different embryo transfer (ET) strategies (926 women in Group 1 underwent fresh ET, 365 women in Group 2 underwent freeze-all ET, 716 women in Group 3 experienced blastulation failure). Patients received different ET strategies after r-ICSI, with the main outcome measures included live birth rate (LBR), cumulative live birth rate (cLBR), and conservative cLBR.

Results

TFF occurred in 7.4% of all IVF cycles. Group 1 tended to be older at oocyte retrieval, with more infertile years, higher follicle-stimulating hormone (FSH) levels, higher gonadotropin consumption, and fewer oocytes retrieved. Group 2 exhibited considerably better LBRs following the first ET cycle (37.53% vs. 4.64%) and cLBRs (52.60% vs. 8.21%). After adjustment for covariates using binary logistic regression analyses, Group 2 still showed better obstetric performance in LBRs [OR:11.77, 95% CI (8.42–16.45)], cLBRs (OR:11.29, 95% CI (7.84–16.27)], and conservative cLBRs (OR:2.55, 95% CI (1.83–3.55)]. Additionally, the two groups showed similar miscarriage rates, whilst no new-borns with malformations or congenital diseases were reported.

Conclusions

Freeze-all blastocyst stage ET serves as an optimal strategy to support late r-ICSI. However, for women with limited oocytes available for r-ICSI use, weighing the benefits against the costs of the procedure might be prudent before implementing in vitro blastulation.
Perceptions and attitudes of pediatricians and families with regard to pediatric medication errors at home
Authors: de Dios Javier González , López-Pineda Adriana , Juan Gema Mira-Perceval , Minagorre Pedro J. Alcalá , Guilabert Mercedes , Pérez-Jover Virtudes , Carrillo Irene , Mira José Joaquín
Published: July 2023

Purpose

This study aimed to identify the perceptions and attitudes of pediatricians and parents/caregivers regarding medication errors at home, and to compare the findings from the two populations.

Methods

This was a cross-sectional survey study. We designed a survey for working pediatricians and another one for parents or caregivers of children aged 14 years and younger. The survey’s questions were designed to assess provider and parental opinions about the difficulty faced by parents providing medical treatment, specific questions on medication errors, and on a possible intervention program aimed at preventing pediatric medication errors. Pediatrician and parent responses to matching questions in both surveys were compared.

Results

The surveys were administered in Spain from 2019 to 2021. In total, 182 pediatricians and 194 families took part. Most pediatricians (62.6%) and families (79.3%) considered that managing medical treatment was not among the main difficulties faced by parents in caring for their children. While 79.1% of pediatricians thought that parents consulted the internet to resolve doubts regarding the health of their children, most families (81.1%) said they consulted healthcare professionals. Lack of knowledge among parents and caregivers was one of the causes of medication errors most frequently mentioned by both pediatricians and parents. Most pediatricians (95.1%) said they would recommend a program designed to prevent errors at home.

Conclusions

Pediatricians and families think that medical treatment is not among the main difficulties faced by parents in caring for their children. Most pediatricians said they would recommend a medication error reporting and learning system designed for families of their patients to prevent medication errors that might occur in the home environment.
Mitigation role of physical exercise participation in the relationship between blood cadmium and sleep disturbance: a cross-sectional study
Authors: You Yanwei , Chen Yuquan , Zhang Yangchang , Zhang Qi , Yu Yaohui , Cao Qiang
Published: July 2023

The neurotoxicity of heavy metals received increasingly attention in recent years. Sleeping is regulated and coordinated by nervous system, however, the health hazard of heavy metal like cadmium (Cd) exposure on sleep health remained unknown. Rescue strategies like physical exercise (PE) has emerged to mitigate such influence. An epidemiological design with cross-sectional data from National Health and Nutrition Examination Survey 2007–2010 was applied. The relationship between three blood heavy metals [cadmium (Cd), lead (Pb), mercury (Hg)] and sleep disturbance was analyzed. A total of 8,751 participants were finally included in and the weighted participants were 330,239,463. Weighted quantile sum (WQS) regression indicated that mixed blood metals were positively related to risk of sleep disturbance and the mixture effect of exposure to heavy metals was mainly attributable to Cd (89.1%). Weighted logistic regression showed a significant positive association between the highest quartile of blood Cd and sleep disturbance [(OR (95% CI)): 1.191 (1.014,1.400), p = 0.036] in the fully adjusted model, while no association was found under Pb and Hg exposure. In the association between Q3 and Q4 level of blood Cd and sleep disturbance, moderate-to-vigorous physical exercise group had lower risks than none and low exercise group. In the restricted cubic spline model, it was also verified that higher PE participation was associated with the lowest incidence of sleep disturbance with the increment in Cd concentration. Our study suggested that both policy makers and the public should minimize heavy metal exposure. Moreover, conducting moderate to vigorous physical exercise is a protecting factor to mitigate Cd’s influence on sleep health.
Impact of spinal sagittal malalignment on locomotive syndrome and physical function in community-dwelling middle aged and older women
Authors: Yahata Mio , Watanabe Kei , Tashi Hideki , Ohashi Masayuki , Yoda Takuya , Nawata Atsushi , Nakamura Kazutoshi , Kawashima Hiroyuki
Published: July 2023

Background

Adult spinal deformity has a substantially debilitating effect on older people’s physical and mental health. However, the impact of sagittal malalignment on locomotive syndrome (LS), sarcopenia, and physical function in community-dwelling older women has not yet been clarified. This study aimed to investigate the association between these factors in community-dwelling middle aged and older women.

Methods

A total of 361 women were recruited from participants performing aquatic exercises in a rural area of Japan. The body mass index, skeletal muscle mass index, trunk muscle mass, spinal inclination angle (SIA), grip strength, timed up-and-go test (TUG), maximum stride of the participants, and one-leg standing time were measured. Low back pain (LBP)- and health-related quality of life (HRQOL) were evaluated using the Oswestry Disability Index (ODI) and the Short-Form 8 questionnaire. Associations between the global sagittal alignment using SIA and investigating parameters were analyzed.

Results

The prevalence of sarcopenia was 3.6%. The prevalence of LS (stages 1, 2, and 3) was 43.8% (158 of 361), and the number of participants in each LS stage was 203 (stage 0), 95 (stage 1), 28 (stage 2), and 35 (stage 3). The SIA was significantly correlated with the 25-question geriatric locomotive function scale (r′ = 0.292, p < 0.001), ODI (r′ = 0.267, p < 0.001), and TUG (r′ = 0.453, p < 0.001) after adjusting for age. In the receiver-operating characteristic curve analysis, the cutoff values of SIA for LS ≥ stage 2 and ODI ≥ 20% were 5°.

Conclusions

LBP-related QOL and physical performance were significantly associated with global sagittal alignment. Global sagittal alignment was correlated with the three-stage category of LS. The spinal inclination of 5° was a cutoff value to predict exacerbation of mobility function and HRQOL status.
Declaration: Novel SLC3A1 mutation in a cystinuria patient with xanthine stones: a case report
Authors: Bai Peide , Zhang WenZhao , Lai Longhui , Huang Haichao , Qin Jiaxuan , Duan Bo , Wang Huiqiang , Chen Yuedong , Jia Yuanyuan , Xing Jinchun , Wang Tao , Chen Bin
Published: July 2023

Background

Cystinuria and xanthinuria are both rare genetic diseases involving urinary calculi. However, cases combining these two disorders have not yet been reported.

Case Presentation

In this study, we report a case of cystinuria with xanthine stones and hyperuricemia. The 23-year-old male patient was diagnosed with kidney and ureteral stones, solitary functioning kidney and hyperuricemia after admission to the hospital. The stones were removed by surgery and found to be composed of xanthine.

Conclusion

Genetic testing by next-generation sequencing technology showed that the patient carried the homozygous nonsense mutation c.1113 C> A (p.Tyr371*) in the SLC3A1 gene, which was judged to be a functionally pathogenic variant. Sanger sequencing revealed that the patient’s parents carried this heterozygous mutation, which is a pathogenic variant that can cause cystinuria. The 24-h urine metabolism analysis showed that the cystine content was 644 mg (<320 mg/24 h), indicating that the patient had cystinuria, consistent with the genetic test results. This case shows that cystinuria and xanthine stones can occur simultaneously, and provides evidence of a possible connection between the two conditions. Furthermore, our findings demonstrate the potential value of genetic testing using next-generation sequencing to effectively assist in the clinical diagnosis and treatment of patients with urinary calculi.
The impact of applying various de novo assembly and correction tools on the identification of genome characterization, drug resistance, and virulence factors of clinical isolates using ONT sequencing
Authors: Safar Hussain A. , Alatar Fatemah , Nasser Kother , Al-Ajmi Rehab , Alfouzan Wadha , Mustafa Abu Salim
Published: July 2023

Oxford Nanopore sequencing technology (ONT) is currently widely used due to its affordability, simplicity, and reliability. Despite the advantage ONT has over next-generation sequencing in detecting resistance genes in mobile genetic elements, its relatively high error rate (10–15%) is still a deterrent. Several bioinformatic tools are freely available for raw data processing and obtaining complete and more accurate genome assemblies. In this study, we evaluated the impact of using mix-and-matched read assembly (Flye, Canu, Wtdbg2, and NECAT) and read correction (Medaka, NextPolish, and Racon) tools in generating complete and accurate genome assemblies, and downstream genomic analysis of nine clinical Escherichia coli isolates. Flye and Canu assemblers were the most robust in genome assembly, and Medaka and Racon correction tools significantly improved assembly parameters. Flye functioned well in pan-genome analysis, while Medaka increased the number of core genes detected. Flye, Canu, and NECAT assembler functioned well in detecting antimicrobial resistance genes (AMR), while Wtdbg2 required correction tools for better detection. Flye was the best assembler for detecting and locating both virulence and AMR genes (i.e., chromosomal vs. plasmid). This study provides insight into the performance of several read assembly and read correction tools for analyzing ONT sequencing reads for clinical isolates.
The need for digital health education among next-generation health workers in China: a cross-sectional survey on digital health education
Authors: Ma Mingxue , Li Yuanheng , Gao Lei , Xie Yuzhuo , Zhang Yuwei , Wang Yazhou , Zhao Lu , Liu Xinyan , Jiang Deyou , Fan Chao , Wang Yushu , Demuyakor Isaac , Jiao Mingli , Li Ye
Published: July 2023

Background

Digital health is important for sustainable health systems and universal health coverage. Since the outbreak of COVID-19, many countries, including China, have promoted the introduction of digital health in their medical services. Developing the next generation of physicians with digital health knowledge and skills is a prerequisite for maximizing the potential of digital health.

Objective

We aimed to understand the perception of digital health among Chinese medical students, the current implementation of digital health education in China, and the urgent need of medical students.

Methods

Our cross-sectional survey was conducted online and anonymously among current medical students in China. We used descriptive statistical analysis to examine participant demographic characteristics and the demand for digital health education. Additional analysis was conducted by grouping responses by current participation in a digital health course.

Results

A total of 2122 valid responses were received from 467 medical schools. Most medical students had positive expectations that digital health will change the future of medicine. Compared with wearable devices (85.53%), telemedicine (84.16%), and medical big data (86.38%), fewer respondents believed in the benefits of clinical decision support systems (CDSS) (63.81%). Most respondents said they urgently needed digital health knowledge and skills, and the teaching method of practical training and internship (78.02%) was more popular than the traditional lecture (10.54%). However, only 41.45% wanted to learn about the ethical and legal issues surrounding digital health.

Conclusions

Our study shows that the current needs of Chinese medical students for digital health education remain unmet. A national initiative on digital health education, is necessary and attention should be paid to digital health equity and education globally, focusing on CDSS and artificial intelligence. Ethics knowledge must also be included in medical curriculum. Students as Partners (SAP) is a promising approach for designing digital health courses.