bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of the COVID-19 pandemic on complications and mortality of patients with cardiac surgery
Authors: Wang Xue , Gao Heng , Zhang Zhanqin , Deng Chao , Yan Yang , Shi Tao
Published: December 2021

Objectives

The purpose of this study was to assess changes in cardiovascular disease severity, types, postoperative complications and prognosis during the COVID-19 pandemic and to explore possible influencing factors.

Methods

A total of 422 patients were enrolled in this study, and hospitalization and short-term follow-up data were retained. The patient population included 273 men and 149 women. Patients had a median (IQR) age of 54 (45–62) years and were divided into an observation group (130) and a control group (292), primarily according to severity of disease, disease types, baseline indexes, biochemical indexes, cardiac function indexes, complications and prognosis.

Results

During the COVID-19 pandemic, compared with the same period last year, there was a significant increase in patients with aortic dissection (27.69% vs 5.82%), a significant decrease in patients with valvular heart disease (43.08% vs 66.78%), and significantly increased emergency admission (50.00% vs 21.23%) and severity (54.62% vs 27.40%). Family company (76.37% vs 64.62%) was decreased, EuroSCORE [6.5 (2–9) vs 2 (0–5)] score, Pro-BNP [857.50 (241.00–2222.50) vs 542.40 (113.45–1776.75)] ng/L, six months mortality rate (18.46% vs 8.90%), and postoperative complications, including infected patients, atelectasis, pulmonary edema, and so on were increased, with longer length of stay in the ICU and hospital in COVID-19 pandemic. Survival analysis curve further demonstrated that it had an impact on the deaths of patients during the COVID-19 pandemic period. Through ROC analysis of the death factors of patients, it was concluded that Family company affected the death of patients, and the area under the curve was 0.654 (P < 0.05).

Conclusions

In this study, we found that the admission rate of critically ill patients with cardiovascular disease, complications of cardiac surgery, and short-term mortality of patients all exhibited a short-term increase, family company may be a risk factors for short-term mortality, that may be related to public pressure caused by the COVID-19 pandemic.
Infectious diseases as a cause of death among cancer patients: a trend analysis and population-based study of outcome in the United States based on the Surveillance, Epidemiology, and End Results database
Authors: Elhadi Muhammed , Khaled Ala , Msherghi Ahmed
Published: December 2021

Background

Infectious diseases are a major cause of morbidity and mortality among cancer patients. We aimed to determine the incidence of infectious diseases as a cause of death among cancer patients and analyze the trends and risk factors associated with mortality.

Methods

In total, 151,440 cancer patients who died from infectious diseases in the US diagnosed between 1973 and 2014 from the Surveillance, Epidemiology, and End Results program were enrolled. A trend analysis of annual cancer deaths caused by infectious diseases was conducted. Cox proportional hazards model and survival decision tree model were performed.

Result

The most common infectious diseases were pneumonia and influenza (n = 72,133), parasitic and other infectious (n = 47,310) diseases, and septicemia (n = 31,119). The patients’ mean age was 66.33 years; majority of them were male (62%). The overall incidence from 1973 to 2014 showed an insignificant decrease (annual percentage change =  − 0.3, 95% confidence interval [CI] =  − 2.2–1.7, P = 0.8). Parasitic and other infectious diseases, including HIV (standardized incidence ratio [SIR] = 1.77, 95% CI = 1.69–1.84), had the highest incidence, followed by septicemia (SIR = 0.84, 95% CI = 0.81–0.88), tuberculosis (SIR = 0.72, 95% CI = 0.51–0.99), and pneumonia (SIR = 0.63, 95% CI = 0.61–0.64). Based on the Cox regression analysis, old black male patients with intrahepatic tumor or acute leukemia of different grades, except the well-differentiated grade, had the highest risk of dying from infectious diseases.

Conclusion

Infectious diseases remain the major cause of morbidity and mortality among cancer patients. Early recognition of risk factors and timely intervention may help mitigate the negative consequences on patients’ quality of life and prognosis, improving the prognosis and preventing early death from infection, which is preventable in most cases.
An emerging simple and effective approach to increase the productivity of thraustochytrids microbial lipids by regulating glycolysis process and triacylglycerols’ decomposition
Authors: Ma Wang , Wang Yu-Zhou , Nong Fang-Tong , Du Fei , Xu Ying-Shuang , Huang Peng-Wei , Sun Xiao-Man
Published: December 2021

Background

The oleaginous microorganism Schizochytrium sp. is widely used in scientific research and commercial lipid production processes. However, low glucose-to-lipid conversion rate (GLCR) and low lipid productivity of Schizochytrium sp. restrict the feasibility of its use.

Results

Orlistat is a lipase inhibitor, which avoids triacylglycerols (TAGs) from hydrolysis by lipase. TAGs are the main storage forms of fatty acids in Schizochytrium sp. In this study, the usage of orlistat increased the GLCR by 21.88% in the middle stage of fermentation. Whereas the productivity of lipid increased 1.34 times reaching 0.73 g/L/h, the saturated fatty acid and polyunsaturated fatty acid yield increased from 21.2 and 39.1 to 34.9 and 48.5 g/L, respectively, indicating the advantages of using a lipase inhibitor in microbial lipids fermentation. Similarly, the system was also successful in Thraustochytrid Aurantiochytrium. The metabolic regulatory mechanisms stimulated by orlistat in Schizochytrium sp. were further investigated using transcriptomics and metabolomics. The results showed that orlistat redistributed carbon allocation and enhanced the energy supply when inhibiting the TAGs’ degradation pathway. Therefore, lipase in Schizochytrium sp. prefers to hydrolyze saturated fatty acid TAGs into the β-oxidation pathway.

Conclusions

This study provides a simple and effective approach to improve lipid production, and makes us understand the mechanism of lipid accumulation and decomposition in Schizochytrium sp., offering new guidance for the exploitation of oleaginous microorganisms.
Rhegmatogenous retinal detachment in Coats’ disease: a case report
Authors: Khadka Simanta , Byanju Raghunandan , Parajuli Sabina
Published: December 2021

Background

Coats’ disease was originally defined as a unilateral idiopathic exudative retinopathy in young males, characterized by abnormal retinal vascular telangiectasia with intraretinal and subretinal lipid exudation. The retinal detachment is usually exudative. Herein, we describe a case of rhegmatogenous retinal detachment with detectable retinal break in a patient with Coats’ disease.

Case presentation

A 15-year-old Indo-Aryan male patient presented with sudden painless diminution of vision in his right eye of 4 days duration. Upon examination, the anterior segment in both eyes and left fundus was within normal limits. Dilated fundus evaluation of the right eye revealed telangiectasia of the retinal vessels, with subretinal exudation in superotemporal and superonasal quadrants and presence of subretinal fluid in the superotemporal area extending into fovea. There was also presence of single flap horseshoe tear in the superotemporal quadrant at around the 10 o’clock position in the equatorial region, with no secondary changes. The retina was reattached with encircling band buckle combined with vitrectomy and silicon oil tamponade. Seven months post vitrectomy, lenticular opacification developed, for which he underwent silicon oil removal, along with lens aspiration and implantation of foldable intraocular lens. Over the period of 1 year, his best corrected visual acuity improved from 6/60 to 6/18 in the affected eye at the last follow-up visit. The recovery was uneventful following the subsequent surgery.

Conclusion

Coats’ disease has a remarkable diversity in clinical presentation and morphology. The disease can also present with an underlying break, which may not be attributed to any iatrogenic modality. The treatment modalities in coats’ disease should be tailored individually due to the low incidence of the disease and the great variation in severity upon presentation. Prompt management restores the best possible anatomical outcome and maintains good vision.
Development of a molecular marker based on chloroplast gene for specific identification of Korean Hibiscus (Hibiscus syriacus ‘Simbaek’)
Authors: Wang Rongbo , Park Sang Yong , Park Sul Woong , Puja Aditi Mitra , Kim Yeon-Ju
Published: December 2021

Due to the rise in substitution and adulteration of herbal products, as well as the lack of genetic information on Hibiscus plants, more molecular markers are needed to understand the genetic diversity and avoid their misidentification. There are many allelic variants of the functional genes in Hibiscus and other plants, which control their respective phenotypes and other characteristics. Identifying alleles of the desired trait by determining diversification through gene-typing allele-specific markers for authentication is, therefore, a potent strategy. The purpose of this study was to use insertion/deletion (InDel) markers to identify Hibiscus syriacus cultivars. We developed a novel InDel marker for Korean Hibiscus ‘Simbaek’, based on the trnL-F region of the chloroplast gene. Through this InDel site, a modified specific primer pair and a novel multiplex polymerase chain reaction (PCR) system were developed for specific identification of the Korean Hibiscus Simbaek cultivar. The molecular markers developed in this study were highly specific and accurately authenticated as Simbaek from the five main cultivars of H. syriacus. Taken together, the described method is a potential tool for the identification and selection of germplasm resource of Simbaek cultivar.

Graphical Abstract
Obesity Modifies the Performance of Fibrosis Biomarkers in Nonalcoholic Fatty Liver Disease
Authors: Qadri Sami , Ahlholm Noora , Lønsmann Ida , Pellegrini Paola , Poikola Anni , Luukkonen Panu K , Porthan Kimmo , Juuti Anne , Sammalkorpi Henna , Penttilä Anne K , D’Ambrosio Roberta , Soardo Giorgio , Leeming Diana J , Karsdal Morten , Arola Johanna , Kechagias Stergios , Pelusi Serena , Ekstedt Mattias , Valenti Luca , Hagström Hannes , Yki-Järvinen Hannele
Published: December 2021

Context

Guidelines recommend blood-based fibrosis biomarkers to identify advanced nonalcoholic fatty liver disease (NAFLD), which is particularly prevalent in patients with obesity.

Objective

To study whether the degree of obesity affects the performance of liver fibrosis biomarkers in NAFLD.

Design

Cross-sectional cohort study comparing simple fibrosis scores [Fibrosis-4 Index (FIB-4); NAFLD Fibrosis Score (NFS); aspartate aminotransferase to platelet ratio index; BARD (body mass index, aspartate-to-alanine aminotransferase ratio, diabetes); Hepamet Fibrosis Score (HFS)] and newer scores incorporating neo-epitope biomarkers PRO-C3 (ADAPT, FIBC3) or cytokeratin 18 (MACK-3).

Setting

Tertiary referral center.

Patients

We recruited overweight/obese patients from endocrinology (n = 307) and hepatology (n = 71) clinics undergoing a liver biopsy [median body mass index (BMI) 40.3 (interquartile range 36.0-44.7) kg/m2]. Additionally, we studied 859 less obese patients with biopsy-proven NAFLD to derive BMI-adjusted cutoffs for NFS.

Main Outcome Measures

Biomarker area under the receiver operating characteristic (AUROC), sensitivity, specificity, and predictive values to identify histological stage ≥F3 fibrosis or nonalcoholic steatohepatitis with ≥F2 fibrosis [fibrotic nonalcoholic steatohepatitis (NASH)].

Results

The scores with an AUROC ≥0.85 to identify ≥F3 fibrosis were ADAPT, FIB-4, FIBC3, and HFS. For fibrotic NASH, the best predictors were MACK-3 and ADAPT. The specificities of NFS, BARD, and FIBC3 deteriorated as a function of BMI. We derived and validated new cutoffs for NFS to rule in/out ≥F3 fibrosis in groups with BMIs <30.0, 30.0 to 39.9, and ≥40.0 kg/m2. This optimized its performance at all levels of BMI. Sequentially combining FIB-4 with ADAPT or FIBC3 increased specificity to diagnose ≥F3 fibrosis.

Conclusions

In obese patients, the best-performing fibrosis biomarkers are ADAPT and the inexpensive FIB-4, which are unaffected by BMI. The widely used NFS loses specificity in obese individuals, which may be corrected with BMI-adjusted cutoffs.
Lumbar Fixation Using the Cortical Bone Trajectory Fixation: A Single Surgeon's Experience With 3-Year Follow-up
Authors: Arzoglou Vasileios , Vial Izziddine , Hussain Masood , Deepak Srihari , Andalib Amin , Storey Matthew , Graham Christopher , Tsitlakidis Abraham
Published: December 2021

BACKGROUND:

Pedicle screw fixation with a cortical bone trajectory (CBT) has emerged as an effective alternative to traditional techniques of lumbar fusion, especially in osteoporotic patients. The proposed benefits of CBT screws include a stronger grip in the elderly and osteoporotic population and low surgical morbidity. We present a prospective study with a 3-yr follow-up of 80 patients operated on by the same surgeon.

OBJECTIVE:

To assess the outcomes of the CBT technique in patients with at least 3-yr follow-up.

METHODS:

Eighty patients who underwent lumbar fusion using the CBT fixation by the same surgeon were included in the study. The outcomes, Oswestry Disability Index (ODI), back pain visual analog scale (VAS), leg pain VAS, walking distance, opioid use, nonopioid analgesia use, and EuroQol 5D-5L index were measured preoperatively and during the 1- and 3-yr postoperative follow-up visits. Time from surgery, indication for surgery, intervertebral cage insertion, body mass index (BMI), and their interactions were analyzed as predictors in a separate mixed-effects model for each outcome. We assessed all outcomes as 1 group of patients, but we also elaborated on a classification scheme based on a combination of radiological and dynamical assessment of microinstability, macroinstability, and spondylolisthesis.

RESULTS:

The relationship between the outcomes and time showed considerable interpatient heterogeneity because all intercepts (all P < .001) and the linear trend temporal slopes for walking distance (P = .019) and nonopioid analgesics use (P < .001) varied across patients. The intercepts and the linear trend slopes for nonopioid use were significantly correlated (P = .039). Time from surgery significantly predicted all outcomes (P < .001). Intervertebral cage insertion was associated with significantly less opioid use (P = .017). The indication for surgery significantly modified the effect of time on the ODI (P = .042) and the VAS for leg pain (P = .025). Moreover, higher BMI was also associated with a significantly steeper linear trend in the VAS for leg pain (P = .028). Among patients with microinstability, the linear trend for the EuroQol 5D-5L index was significantly steeper with, rather than without, spondylolisthesis (P = .024).

CONCLUSION:

In all patients who underwent CBT-based lumbar fusion, there was a steep trend toward improvement in ODI, VAS score for leg pain, and opioid use at 1 yr after surgery. Patients with normal BMI and microinstability alone had a decline in the rate of improvement at 3 yr, whereas the rest continued to show improvement at 3 yr postprocedure. Spinal fixation and fusion using CBT shows satisfactory outcomes. Larger series and a double-blind randomized trial would be helpful for further identifying the pros and cons of this technique.
From Postoperative to Preoperative: A Case Series of Hypofractionated and Single-Fraction Neoadjuvant Stereotactic Radiosurgery for Brain Metastases
Authors: Udovicich Cristian , Ng Sweet Ping , Tange Damien , Bailey Nola , Haghighi Neda
Published: December 2021

BACKGROUND:

Postoperative stereotactic radiosurgery after resection of brain metastases is currently the standard of care. However, rates of leptomeningeal disease (LMD) after postoperative stereotactic radiosurgery have been reported to be >30%. Neoadjuvant stereotactic radiosurgery (NaSRS) has been proposed as an alternative treatment approach to decrease this risk.

OBJECTIVE:

To report the local control (LC) and LMD rates in patients undergoing NaSRS.

METHODS:

Our retrospective multicenter case series included consecutive patients planned for SRS followed by resection of intracranial lesions with a confirmed primary malignancy. Concurrent SRS alone to other intracranial lesions was permitted. Exclusion criteria included previous local treatment to that particular lesion and Eastern Cooperative Oncology Group performance status ≥3. Outcomes reported included LC, distant intracranial control (DC), overall survival, LMD, and radionecrosis (RN) rates.

RESULTS:

Overall, 28 patients with 29 lesions were eligible for analysis. The median follow-up was 12.8 months. The mean age was 62.5 (range 43-80) years, and 55% were Eastern Cooperative Oncology Group performance status 0 to 1. The most common primary malignancies included non-small cell lung cancer (43%) and melanoma (32%). Hypofractionated SRS was used in 62.1%. The 12-month LC and LMD rates were 91.3% and 4.0%, respectively. The 12-month RN, DC, and overall survival rates were 5.0%, 51.5%, and 60.1%, respectively.

CONCLUSION:

Compared with postoperative SRS, our study suggests that NaSRS leads to comparable local control with a decreased risk of LMD and RN. This is the first NaSRS series with a majority of patients treated with fractionated SRS. NaSRS is a promising approach for appropriate patients where surgical resection is a component of local therapy.
Nowe stanowisko Carex buekii (Cyperaceae) na Pogórzu Rzeszowskim
Authors: Hałucha Piotr
Published: December 2021

Carex buekii is a rare species in Poland. In 2020, the new locality of this species was found in the Rzeszów Foothills (SE Poland, ATPOL grid square FF78).
Thoughts on the Symbolism and Origin of Apollo’s Fight Against the Pythian Snake
Authors: Jagiełło Mieszek
Published: December 2021

The following paper deals with the mythological story about Apollo’s fight against a she-snake at Pytho, where he eventually builds a sanctuary – the Delphic Oracle. First, it is attempted to decipher the terms Pytho, Delphi and Omphalos. A symbolism revolving around an underlying theme of birth is considered. Then, the stories about Apollo and about Kadmos, as well as a motif in Pherecydes’ theogony, and the Anatolian Illuyanka Myth are being presented as subjects of a comparative analysis. This leads to the proposal that all four narratives have a common origin in Western Anatolia or Pre-Greek Hellas.
Beer in Antiquity, Antiquity in Beer?
Authors: Duszyński Wojciech
Published: December 2021

Modern breweries taking inspiration from ancient cultures appear as a quite interesting phenomenon, because beer is absent from the current imaginarium about the ancient Greeks and Romans. Yet it was not unknown to them, as demonstrated by the survey of sources in the first part of the text. Actually, some brewers today are aware of the beverage’s presence in ancient literature and use this knowledge in the naming of their products. Others decide on less direct references, to some historical or mythical characters. Some producers do not limit themselves to names of their brews, but also attempt to reconstruct the ancient drinks. In the second (main) part of the article several cases of each type are presented, together with an analysis of methods of the references’ presentation and explanation to the consumer. Also, some observations are made about the reasons why breweries decide to use ancient themes at all.
Utilization of Puskesmas in Efforts to Prevent COVID-19 in Bengkulu City
Authors: Oktarianita Oktarianita , Sartika Andry , Wati Nopia , Pratiwi Bintang Agustina
Published: December 2021

Background: Puskesmas as First Level Health Facilities (FKTP) plays a vital role during the Covid-19 pandemic in preventing and controlling the number of Covid-19 cases by anticipating, detecting, responding to events. However, at this time, the puskesmas are still underutilized by the community. The highest confirmed positive cases in Bengkulu City were in the Gading Cempaka District, with 990 cases. This study aimed to determine the variables related to the utilization of puskesmas in Bengkulu City. Methods: This research was quantitative research with a cross-sectional study design. Data collection was carried out by distributing questionnaires to respondents using an accidental sampling technique executed in March-August 2021. The research population was the entire community of Bengkulu City, with a sample of 110 respondents from the Gading Cempaka District, Bengkulu City. Data were analyzed by univariate to multivariate logistic regression. Results: The results show that 88 respondents (78.2%) have utilized the puskesmas, as many as 86 (78.2%) were female, 86 respondents (60.9%) belonged to the young age group, respondents with higher education were 73 respondents ( 66.4%), 73 respondents (66.4%) worked and as many as 79 respondents (71.8%) have income <UMP. The bivariate analysis results showed that the factors related to the utilization of the puskesmas (p<0.05) were variables of age, education, occupation, and income despite no relationship between gender, distance, knowledge, and family support (p>Î±). The results of the multivariate analysis showed that education was the dominant factor influencing the utilization of the puskesmas with (p-value = 0.010; B = 2.707; 95% CI = 1.892-118.569). Conclusion: The community has taken advantage of the puskesmas in terms of preventing Covid-19. The utilization of puskesmas is affected by age and education level.
Job Safety Analysis and Hazard Identification of Welding Process in Semarang - JSA Method AS/NZS 4360:2004
Authors: Pramitasari Ratih , Haikal Haikal , Yuantari MG Catur , Dwi Kristin Ishak Kurnia , Treesak Chalobon
Published: December 2021

Background: The welding workshop in Semarang City is spread over several areas in Semarang City. There are several types of work in welding workshops, namely, cutting raw materials, assembling, welding, grinding, sanding, and painting. This study aimed to analyze occupational safety and health risks in the informal welding workshop using the JSA (Job Safety Analysis) AS/NZS 4360:2004 Risk Management method. Method: This research was conducted using semi-quantitative method with descriptive analysis. A cross-sectional research design was used because data (observations, interviews, filling in risk analysis tables, work accidents, occupational diseases, and controls) were collected at a particular time. The study was conducted in Semarang, Central Java, and the population was all informal welding workshops. Result: This study showed that there are 8 types of welding tasks, 21 potential hazards, and 24 health consequences in a welding process. The total score calculated by multiplying "chance" by "severity" shows that 11 health consequences were acceptable risk while 13 others were high risk. Conclusion: The highest score of occupational health hazards was electric shock due to chipped cable, electric shock due to a chipped short circuit, and wet/rain/cloudy work area. Welders are recommended to follow the proper instruction in the welding process, and each workshop must provide a first aid box for its workers.
Physical and Psychological Violence in Dating with Sleep Duration of Adolescents in Bantul Regency
Authors: Ayu Suci Musvita , Sofiana Liena , Martantika Dina Ayu , Gustina Erni
Published: December 2021

Background: The trend of juvenile delinquency, especially Dating Violence (DV) is still very high. According to the Annual Records (Catahu), there were 2,073 cases in 2018. The Special Region of Yogyakarta ranked sixth as region with the highest DV cases in Indonesia, reaching 980 cases in 2018. In Bantul Regency, 80 cases were reported in 2018. Dating violence can have negative impact on the physical and psychological well-being of adolescents. Physical violence can lead to bruises and fractures while psychological violence affects the victims in the form of depression, stress, anxiety and sleep disturbances. This study aims to analyze the relationship between physical and psychological violence in dating with sleep duration of adolescents. Method: This research used quantitative research method with a cross sectional approach. Data were analyzed using chi square. The sample consisted of 314 high school students (15-19 years old) who were recruited using purposive sampling technique. Only subjects who have dated or are currently dating were included in this study. Results: The results showed that there was a relationship between physical violence in dating and sleep duration (PR = 1,165; 95% CI = 1,050-1,293; p<0.05). However, there was no relationship between psychological violence in dating and sleep duration (PR = 1,068; 95% CI = 0,957-1,192; p>0.05). Conclusion: The results suggest that there is a relationship between physical violence in dating and sleep duration. Teenagers are advised to take advantage of the PIK-R program at school or visit counseling teachers that can help them solving their problems.
Synchronization of Codification of Unspecified Schizophrenia Againts Back-Referral System of Mirit Public Health Center
Authors: Munawaroh Nur Hayati , Afriyani Ndari , Wahyuni Sri , Rachmadi Triyo
Published: December 2021

Background: The disease classification system is a grouping of diseases following the International Statistical Classification of Diseases and Related Health Problems Tenth Revisions ICD-10. The coding application must be in accordance with ICD-10 to obtain a valid code in disease indexing, national, international reporting of morbidity and mortality, analysis of health care costs, and epidemiological and clinical research. The diagnosis of schizoaffective disorder is made if schizophrenia and affective disorder are symptoms based on the ICD-10 diagnostic criteria. This study aims to determine the synchronization of the codification of unspecified schizophrenia and determine the factors that influence it against the back-referral system at the Mirit Health Center. Method: This research is qualitative research with a descriptive approach. Respondents were four officers, i.e. one doctor, one medical record officer, one person holding a mental program, one pharmacy officer. The number of observed medical record documents was 96 data with research indicators of accuracy and completeness of the diagnosis code in patients referred from First Level Health Facilities (FKTP) to Advanced Health Facilities (FKTL). Result: The results showed 30 referrals, with nine referrals having the accuracy of the patient referral diagnosis code. The back-referral program (PRB) for mental illness at the Mirit Health Center, in collaboration with Mbah Marsio's mental health rehabilitation center, was carried out well. However, the implementation of the Chronic Disease Management program (Prolanis) for mental health was still not good. Conclusion: There are many unsynchronized codifications. It is recommended to conduct an evaluation where they communicate with each other about the patient's condition to supervise the implementation of Referback Patients, especially to specialists who write the back-referral form.
Photocontrol of GTPase Cycle and Multimerization of the Small G-Protein H-Ras using Photochromic Azobenzene Derivatives
Authors: Nahar Rufiat , Noor A Alam MD , Alrazi Islam MD , Maruta Shinsaku
Published: December 2021

Ras is a small G protein known as a central regulator of cellular signal transduction that induces processes, such as cell division, transcription. The hypervariable region (HVR) is one of the functional parts of this G protein, which induces multimerization and interaction between Ras and the plasma membrane. We introduced two highly different in polarity photochromic SH group-reactive azobenzene derivatives, N-4-phenyl-azophenyl maleimide (PAM) and 4-chloroacetoamido-4-sulfo-azobenzene (CASAB), into three cysteine residues in HVR to control Ras GTPase using light. PAM stoichiometrically reacted with the SH group of cysteine residues and induced multimerization. The mutants modified with PAM exhibited reversible changes in GTPase activity accelerated by the guanine nucleotide exchange factor and GTPase activating protein and multimerization accompanied by cis- and trans-photoisomerization upon ultraviolet and visible light irradiation. CASAB was incorporated into two of the three cysteine residues in HVR but did not induce multimerization. The H-Ras GTPase modified with CASAB was photo controlled more effectively than PAM-H-Ras. In this study, we revealed that the incorporation of azobenzene derivatives into the functional site of HVR enables photo reversible control of Ras function. Our findings may contribute to the development of a method to control functional biomolecules with physiologically important roles.
Quercetin Modulates Behavioural and Biochemical Alterations in Stressed Mice
Authors: Eduviere Anthony Taghogho , Goodies Moke Emuesiri , Omogbiya Adrian Itivere , Otomewo Lily Oghenevovwero , Olayinka Juliet Nnenda , Aboyewa Faith Eninidiere , Peace Ijeje Atare
Published: December 2021

Disruption of the active phase of sleep alters the physiological homeostasis of the body and results in oxidative breakdown which may trigger a wide array of defects. The central nervous system and the metabolic system are some of the most affected systems as described in several literatures. Some plant based compounds with antioxidant property have been previously described in the abrogation of the deleterious effects of active sleep disruption. One of such compounds is quercetin. This study was premeditated to expatiate on the probable neuroprotective effect of quercetin on mice exposed to 72hr active sleep disruption. Mice were allotted into five treatment groups (n = 6): group 1 served as control, group 2 received 10 mL/kg vehicle, groups 3 and 4 received 25 and 50 mg/kg quercetin respectively, and group 5 received 50 mg/kg astaxanthin. Treatment lasted for 7 days while groups 2-5 were exposed to the sleep deprivation protocol starting from day 4. Behavioural tests followed by biochemical assays and histopathological changes in the prefrontal cortex were evaluated. Data were analysed by ANOVA set at p<0.05 significance. The results revealed that quercetin, in both doses, significantly amplified memory performance, attenuated depression-like behaviour, replenished catalase and superoxide dismutase, attenuated nitric oxide levels in brain and liver of mice when compared to control group and protected against loss of prefrontal cortex neurons. In conclusion, quercetin possesses protective effects against sleep deprivation-induced brain damage.
Screening and Characterization of Soil Microbes Producing Antimicrobial Compounds in Makkah Province, Saudi Arabia
Authors: Alharbi Najwa Menwer , Khalid Alharthi Amjad , Alsamadani Alsamadani , Almihmadi Raneem Ahmed , Alaidaroos Bothaina Ali
Published: December 2021

This study aimed to investigate a method to manage antimicrobial resistance (AMR) issues by exploring soil microorganisms that are capable of producing bioactive compounds. Eight different types of soil were selected from three locations to screen, isolate, and identify microorganisms that are capable of producing antimicrobial compounds. The multi-drug resistant strains are Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Candida albicans were selected for primary and secondary screening using the crowded plate method and the agar well diffusion method. Inhibition zones were measured, and data were assessed using statistical tests to check for normality and differences between parametric variables and nonparametric data. This was followed by biochemical characterization, DNA isolation, and polymerase chain reaction (PCR). Molecular identification was performed using 16S rRNA amplification and sequencing. Here, 86 isolates containing bacteria and fungi were successfully extracted from soil samples. Further, 49 of 86 microbes showed possible antimicrobial activity, but only 12 isolates resulted in distinct inhibition zones with the selected multi-drug resistant strains. The following different taxa were identified: Firmicutes (nine strains), Proteobacteria (one strain), Actinobacteria (one strain), and Azotobacter (one strain). Species are represented in a phylogenetic tree, which was constructed using the unweighted pair-group method with arithmetic mean (UPGMA) method. The evolutionary distances were computed using the Maximum Composite Likelihood method. The identified microorganisms showed antimicrobial activity, confirming that soil microorganisms have great potential to address AMR issues.
Assessment of in vivo bone activity patterns in medial mobile-bearing unicompartmental knee arthroplasty
Authors: Beckers Lucas , Dandois Félix , Ooms Dirk , Berger Pieter , Van Laere Koen , Scheys Lennart , Vandenneucker Hilde
Published: December 2021

Aims

Higher osteoblastic bone activity is expected in aseptic loosening and painful unicompartmental knee arthroplasty (UKA). However, insights into normal bone activity patterns after medial UKAs are lacking. The aim of this study was to identify the evolution in bone activity pattern in well-functioning medial mobile-bearing UKAs.

Methods

In total, 34 patients (13 female, 21 male; mean age 62 years (41 to 79); BMI 29.7 kg/m2 (23.6 to 42.1)) with 38 medial Oxford partial UKAs (20 left, 18 right; 19 cementless, 14 cemented, and five hybrid) were prospectively followed with sequential 99mTc-hydroxymethane diphosphonate single photon emission CT (SPECT)/CT preoperatively, and at one and two years postoperatively. Changes in mean osteoblastic activity were investigated using a tracer localization scheme with volumes of interest (VOIs), reported by normalized mean tracer values. A SPECT/CT registration platform additionally explored cortical tracer evolution in zones of interest identified by previous experimental research.

Results

Significant reduction of tracer activity from the preoperative situation was found in femoral and anteromedial tibial VOIs adjacent to the UKA components. Temporarily increased osteoblastic bone activity was observed in VOIs comprising the UKA keel structure at one year postoperatively compared to the preoperative activity. Persistent higher tracer uptake was found in the posterior tibial cortex at final follow-up. Multivariate analysis showed no statistical difference in osteoblastic bone activity underneath cemented or cementless components.

Conclusion

Well-functioning medial mobile-bearing UKAs showed distinct changes in patterns of normalized bone tracer activity in the different VOIs adjacent to the prosthetic components, regardless of their type of fixation. Compared to the preoperative situation, persistent high bone activity was found underneath the keel and the posterior tibial cortex at final follow-up, with significant reduced activity only being identified in femoral and anteromedial tibial VOIs. Cite this article: Bone Joint J 2022;104-B(1):34–44.
Can the rate of mortality and neurological recovery be predicted from the time of onset of symptoms and MRI grade in patients with cerebral fat embolism?
Authors: Armstrong B. Roy W. , Devendra Agraharam , Pokale Shweta , Subramani Bala , Rajesh Babu Velmurugan , Ramesh Perumal , Dheenadhayalan Jayaramaraju , Rajasekaran Shanmuganathan
Published: December 2021

Aims

The aim of this study was to assess whether it is possible to predict the mortality, and the extent and time of neurological recovery from the time of the onset of symptoms and MRI grade, in patients with the cerebral fat embolism syndrome (CFES). This has not previously been investigated.

Methods

The study included 34 patients who were diagnosed with CFES following trauma between 2012 and 2018. The clinical diagnosis was confirmed and the severity graded by MRI. We investigated the rate of mortality, the time and extent of neurological recovery, the time between the injury and the onset of symptoms, the clinical severity of the condition, and the MRI grade. All patients were male with a mean age of 29.7 years (18 to 70). The mean follow-up was 4.15 years (2 to 8), with neurological recovery being assessed by the Glasgow Outcome Scale and the Mini-Mental State Examination.

Results

In all, seven who had early-onset CFES (< 24 hours), and a severe Takahashi grade on MRI, died. There was a significant association between the time of onset of neurological signs and mortality (p = 0.035). Mortality was also significantly associated with a severe Takahashi grade (p < 0.001). Among the 27 surviving patients, 26 (96.3%) recovered completely. One (3.7%) had a cognitive deficit. The mean time to recovery was 4.7 weeks (2 to 13), with late recovery aftereight eight weeks being recorded in three patients.

Conclusion

There was a significantly increased rate of mortality in patients with CFES who had an early onset of symptoms and a severe grade on MRI. Complete neurological recovery can be expected in most patients with CFES who survive. Cite this article: Bone Joint J 2022;104-B(1):142–149.
Outcomes associated with secondary implant removal and arthrolysis in patients with a painful stiff shoulder after proximal humeral fracture fixation
Authors: Makaram Navnit S. , Goudie Ewan B. , Robinson C. Michael
Published: December 2021

Aims

Open reduction and plate fixation (ORPF) for displaced proximal humerus fractures can achieve reliably good long-term outcomes. However, a minority of patients have persistent pain and stiffness after surgery and may benefit from open arthrolysis, subacromial decompression, and removal of metalwork (ADROM). The long-term results of ADROM remain unknown; we aimed to assess outcomes of patients undergoing this procedure for stiffness following ORPF, and assess predictors of poor outcome.

Methods

Between 1998 and 2018, 424 consecutive patients were treated with primary ORPF for proximal humerus fracture. ADROM was offered to symptomatic patients with a healed fracture at six months postoperatively. Patients were followed up retrospectively with demographic data, fracture characteristics, and complications recorded. Active range of motion (aROM), Oxford Shoulder Score (OSS), and EuroQol five-dimension three-level questionnaire (EQ-5D-3L) were recorded preoperatively and postoperatively.

Results

A total of 138 patients underwent ADROM; 111 patients were available for long-term follow-up at a mean of 10.9 years (range 1 to 20). Mean age was 50.8 years (18 to 75);79 (57.2%) were female. Mean time from primary ORPF to ADROM was 11.9 months (6 to 19). Five patients developed superficial wound infection; ten developed symptomatic osteonecrosis/post-traumatic arthrosis (ON/PTA); four underwent revision arthrolysis. Median OSS improved from 17 (interquartile range (IQR) 12.0 to 22.0) preoperatively to 40.0 (IQR 31.5 to 48.0) postoperatively, and 39.0 (IQR 31.5 to 46.5) at long-term follow-up (p < 0.001). Median EQ-5D-3L improved from 0.079 (IQR -0.057 to 0.215) to 0.691 (IQR 0.441 to 0.941) postoperatively, and 0.701 (IQR 0.570 to 0.832) at long-term follow-up (p < 0.001). We found that aROM improved in all planes (p < 0.001). Among the variables assessed on multivariable analysis, a manual occupation, worsening Charlson Comorbidity Index and increasing socioeconomic deprivation were most consistently predictive of worse patient-reported outcome scores. Patients who subsequently developed ON/PTA reported significantly worse one-year and late OSS.

Conclusion

ADROM in patients with persistent symptomatic stiffness following ORPF can achieve excellent short- and long-term outcomes. More deprived patients, those in a manual occupation, and those with worsening comorbidities have worse outcomes following ADROM. Cite this article: Bone Joint J 2022;104-B(1):157–167.
Diagnostic yield of image-guided biopsy in patients with suspected infectious spondylodiscitis
Authors: Kafle Gokul , Garg Bhavuk , Mehta Nishank , Sharma Raju , Singh Urvashi , Kandasamy Devasenathipathy , Das Prasenjit , Chowdhury Buddhadev
Published: December 2021

Aims

The aims of this study were to determine the diagnostic yield of image-guided biopsy in providing a final diagnosis in patients with suspected infectious spondylodiscitis, to report the diagnostic accuracy of various microbiological tests and histological examinations in these patients, and to report the epidemiology of infectious spondylodiscitis from a country where tuberculosis (TB) is endemic, including the incidence of drug-resistant TB.

Methods

A total of 284 patients with clinically and radiologically suspected infectious spondylodiscitis were prospectively recruited into the study. Image-guided biopsy of the vertebral lesion was performed and specimens were sent for various microbiological tests and histological examinations. The final diagnosis was determined using a composite reference standard based on clinical, radiological, serological, microbiological, and histological findings. The overall diagnostic yield of the biopsy, and that for each test, was calculated in light of the final diagnosis.

Results

The final diagnosis was tuberculous spondylodiscitis in 250 patients (88%) and pyogenic spondylodiscitis in 22 (7.8%). Six (2.1%) had a noninfectious condition-mimicking infectious spondylodiscitis, and six (2.1%) had no definite diagnosis and improved without specific treatment. The diagnosis was made by image-guided biopsy in 152 patients (56%) with infectious spondylodiscitis. Biopsy was contributory in identifying 132/250 patients (53%) with tuberculous spondylodiscitis, and 20/22 patients (91%) with pyogenic spondylodiscitis. Histological examination was the most sensitive diagnostic modality, followed by Xpert MTB/RIF assay.

Conclusion

Image-guided biopsy has a reasonably high diagnostic yield in patients with suspected infectious spondylodiscitis. A combination of histological examination, Xpert MTB/RIF assay, bacterial culture, and sensitivity provides high diagnostic accuracy in a country in which TB is endemic. Cite this article: Bone Joint J 2022;104-B(1):120–126.
Evaluating Annotated Dataset of Customer Reviews for Aspect Based Sentiment Analysis
Authors: Chehal Dimple , Gupta Parul , Gulati Payal
Published: December 2021

Sentiment analysis of product reviews on e-commerce platforms aids in determining the preferences of customers. Aspect-based sentiment analysis (ABSA) assists in identifying the contributing aspects and their corresponding polarity, thereby allowing for a more detailed analysis of the customer’s inclination toward product aspects. This analysis helps in the transition from the traditional rating-based recommendation process to an improved aspect-based process. To automate ABSA, a labelled dataset is required to train a supervised machine learning model. As the availability of such dataset is limited due to the involvement of human efforts, an annotated dataset has been provided here for performing ABSA on customer reviews of mobile phones. The dataset comprising of product reviews of Apple-iPhone11 has been manually annotated with predefined aspect categories and aspect sentiments. The dataset’s accuracy has been validated using state-of-the-art machine learning techniques such as Naïve Bayes, Support Vector Machine, Logistic Regression, Random Forest, K-Nearest Neighbor and Multi Layer Perceptron, a sequential model built with Keras API. The MLP model built through Keras Sequential API for classifying review text into aspect categories produced the most accurate result with 67.45 percent accuracy. K- nearest neighbor performed the worst with only 49.92 percent accuracy. The Support Vector Machine had the highest accuracy for classifying review text into aspect sentiments with an accuracy of 79.46 percent. The model built with Keras API had the lowest 76.30 percent accuracy. The contribution is beneficial as a benchmark dataset for ABSA of mobile phone reviews.
Efficient Pre-Processing Techniques for Improving Classifiers Performance
Authors: Nickolas S. , Shobha K.
Published: December 2021

Data pre-processing plays a vital role in the life cycle of data mining for accomplishing quality outcomes. In this paper, it is experimentally shown the importance of data pre-processing to achieve highly accurate classifier outcomes by imputing missing values using a novel imputation method, CLUSTPRO, by selecting highly correlated features using Correlation-based Variable Selection (CVS) and by handling imbalanced data using Synthetic Minority Over-sampling Technique (SMOTE). The proposed CLUSTPRO method makes use of Random Forest (RF) and Expectation Maximization (EM) algorithms to impute missing. The imputed results are evaluated using standard evaluation metrics. The CLUSTPRO imputation method outperforms existing, state-of-the-art imputation methods. The combined approach of imputation, feature selection, and imbalanced data handling techniques has significantly contributed to attaining an improved classification accuracy (AUC curve) of 40%–50% in comparison with results obtained without any pre-processing.
The “Sleep Well, Lincolnshire” Project: Evaluation of an Online Sleep Practitioner Clinic
Authors: Elphick Heather , Earley Claire , Tyas Karen , Thomas Lowri , Artis Lisa , Dawson Vicki
Published: December 2021

Objectives: Poor sleep is associated with adverse outcomes during childhood. Behavioral insomnia is the most common sleep difficulty experienced by children. The coronavirus disease 2019 (COVID-19) global pandemic in 2020 has profoundly affected children’s sleep patterns. This project aimed to evaluate a one-toone sleep service delivered via online clinics by community sleep practitioners in the UK.Methods: This was an observational pre- and post-evaluation study over a 12-month period. The intervention derived from aspects of cognitive-behavioral therapy for insomnia. The evaluation was questionnaire-based and assessed sleep parameters and well-being.Results: 104 parents returned completed questionnaires. The average time of sleep onset was 1 hour and 39 minutes pre-intervention and 20 minutes post-intervention. The average number of nights per week that children woke up was 3.9 pre-intervention and 0.9 post-intervention; the number of night awakenings fell from 1.9 to 0.5 and the time that children were awake after sleep onset fell from 66.8 minutes to 5.8 minutes. The average time that children were asleep was 8.0 hours per night pre-intervention and 10.2 hours post-intervention. The improvement in all sleep parameters was statistically significant (p<0.05). All parameters of parental and children’s well-being improved significantly (p<0.05), except for perceived ability to drive (p=0.07). All parents stated that they would recommend sleep support and 20% already had done so.Conclusions: The COVID-19 pandemic has accelerated the development of remote health care solutions, and in the case of children’s sleep clinics, the online mode of intervention delivery that is as effective, acceptable, and accessible as face-to-face delivery.