bluuebunny/crossref_metadata_2025 huggingface dataset:
Automated Classification of Osteoarthritis in the Knee Using Deep Learning
Authors: Olsson Simon , Akbarian Ehsan , Lind Anna , Razavian Ali Sharif , Gordon Max
Published: January 2021

BACKGROUNDPrevalence for knee osteoarthritis is rising in Sweden and globally due to an ageing and more obese population. This has subsequently led to an increasing demand for knee arthroplasties. Correctly diagnosing, classifying, follow-up and planning for either conservative or operative management of knee OA is therefore of a great interest. Most orthopedic surgeons rely on standard weight bearing radiographs, improving the reliability and reproducibility of these interpretations could thus be hugely beneficial. Recently deep learning, a form of artificial intelligence (AI), has shown promising results for interpreting radiographs. In this study, we aim to evaluate how well an AI can classify knee OA severity using entire image series and not excluding common visual disturbances such as implants, casts and other pathologies.MethodsWe selected 6103 radiograph exams taken at Danderyd University Hospital between the years 2002-2016 and manually categorized them according to the Kellgren & Lawrence grading scale (KL). We then trained a convolutional neural network that we evaluated against a test set of 300 exams. These exams had been reviewed independently by two senior orthopedic surgeons who settled exams with disagreement through a consensus session. ResultsOur network yielded an overall high AUC of >0.87 for all KL grades except KL grade 2 and a mean AUC of 0.92. When merging adjacent KL grades together, all but one group showed near perfect results with AUC > 0.95 indicating excellent performance. ConclusionWe found that we could teach a neural network classify knee OA severity and laterality using the KL grading scale without cleaning the input data from major visual disturbances such as implants and other pathologies.
Clinical, Radiological, Pedobarographic, and Quality of Life Outcomes of the Ponseti Treatment for Clubfoot: A Prospective Study from Iran
Authors: Vahidi Kamyar , Shamabadi Ahmad , Nabian Mohammad Hossein , Vosoughi Fardis , Zargarbashi Ramin , Panjavi Behnam
Published: January 2021

Background: Talipes equinovarus, also known as clubfoot, is a congenital anomaly that affects one newborn per 1000 live births. Its standard treatment strategy is the Ponseti casting management. This study aims to report the long-term outcomes of the Ponseti treatment in Iran.Methods: A prospective cohort study was enrolled to evaluate clinical outcomes, radiological results, pedobarographic measurements, and quality of life after the Ponseti treatment in patients with clubfoot who were followed for at least five years.Results: In this study, 25 clubfeet of 18 patients were included. Significant reductions in Pirani, Dimeglio, and CAP scores, improved ankle dorsiflexion, and acceptable pedobarographic indices were observed in this study. From the radiological evaluation indices, the calcaneal pitch and lateral talus-first metatarsal angles were significantly reduced. The quality of life of patients after five years of treatment was favorable, which was better in females. This study showed that the results of the Ponseti treatment remained acceptable after five years.Conclusions: The Ponseti management for clubfoot in the long term appears to maintain significant improvements. However, the rate of recurrence – albeit without disruption to daily activities - cannot be ignored.
The Two-dimensional and Three-dimensional T2 Weighted Imaging-based Radiomic Signatures Selected for the Preoperative Discrimination of Ovarian Borderline Tumors and Epithelial Cancer.
Authors: Liu Xuefen , Wang Tianping , Zhang Guofu , Hua Keqin , Jiang Hua , Duan Shaofeng , Jin Jun , Zhang He
Published: January 2021

Background: Accurate discrimination between ovarian borderline tumors (BOTs) and malignancies with imaging play an important role in management.Purpose: To evaluate the ability of T2-weighted imaging (T2WI)-based radiomics to discriminate ovarian borderline tumors (BOTs) from malignancies based on two-dimensional (2D) and three-dimensional (3D) lesion segmentation methods.Methods: A total of 95 patients with pathologically proven ovarian BOTs and 101 patients with malignancies were retrospectively included in this study. We evaluated the diagnostic performance of the signatures derived from T2WI-based radiomics in their ability to differentiate between BOTs and malignancies and compared the performance differences in the 2D and 3D segmentation models. The least absolute shrinkage and selection operator method (LASSO) was used for radiomics feature selection and machine learning processing.Results: The radiomics score between BOTs and malignancies in four types of selected T2WI-based radiomics models differed significantly at the statistical level (p < 0.0001). For the classification between BOTs and malignant masses, the 2D and 3D coronal T2WI-based radiomics models yielded accuracy values of 0.79 and 0.83 in the testing group, respectively; the 2D and 3D sagittal fat-suppressed (fs) T2WI-based radiomics models yielded an accuracy of 0.78 and 0.99, respectively.Conclusion: Our results suggest that T2WI-based radiomic features were highly correlated with ovarian tumor subtype classification. 3D-sagittal MRI radiomics features may help clinicians differentiate ovarian BOTs from malignancies with high accuracy (ACC).
Availability of Medical Oxygen and its Clinical Practice in Thirty Two Public Hospitals of Ethiopia: A Cross-Sectional Time-Series Design
Authors: Tolla Habtamu Seyoum , Asemere Yigeremu Abebe , Desale Alebel Yaregal , Woyessa Dinkineh Bikila , Fekadu Zinabie Feleke , Belete Alemayehu Berhanu , Battu Audrey , Lam Felix
Published: January 2021

Background: Oxygen is an essential medicine that saves many children dying of hypoxemia from pneumonia. Nearly more than 95% of deaths occur in developing countries. Similarly, the prevalence of pneumonia is high in Ethiopia. Oxygen therapy is a lifesaving treatment, however, the appropriate use and administration of oxygen in clinical practice is often challenging without knowledge of its potential risks and benefits. Therefore, the study aims to assess the functional availability of oxygen devices and its clinical practice in public hospitals of Ethiopia.Methods: A facility-based cross-sectional time-series design was conducted from December 2015 to December 2019. Primary data was collected from 32 public hospitals bi-annually. Similarly, medical record charts were reviewed retrospectively biannually using interviewer-administered structured questionnaires. A chi-square test that claimed P<0.05 used to assess the statistical significance differences.Results: The study was conducted in thirty-two public hospitals of Ethiopia, where capacity building and technical support interventions implemented. Of which, 15 (46.9%) were General hospitals, and the remaining 10 (31.2%) and 7 (21.9%) were Referral and Primary hospitals respectively. Multifaceted approaches such as on-site and off-site capacity building of healthcare workers, regular mentorship, technical assistance, development of guideline/manuals, oxygen device procurement and maintenance were provided to healthcare workers and health facilities. Functional availability of oxygen has shown a statistically significant increase from 62% to 100% in Pediatric In-patient Department of general and referral hospitals (p-value < 0.001). Similarly, functional availability of Pulse Oximetry has shown statistically significant increased from 45% to 96%. With regard to the clinical practice, SpO2 measurement at diagnosis and admission has increased from 10.2% to 75% and 20.5% to 83% respectively.Conclusions: Based on the intervention results, we can conclude that multifaceted approaches targeting healthcare workers capacity, increased device procurement and on-site device maintenance with on-site mentorship can improve the availability of medical oxygen and pulse oximetry and clinical practice of oxygen therapy in health facilities. Therefore, ensuring device availability along with regular technical support and close follow-up of healthcare workers and facilities are key and the initiative needs to be scaled-up.
Modified MCL Indentation Technique in Total Knee Arthroplasty With Severe Type II Valgus Deformity
Authors: Li Feng , Wang Cheng , Zhao Minwei , Geng Xiao , Li Junyang , Zhou Ge , Sun Dong , Tian Hua
Published: January 2021

Purpose A modified technique, medial indentation of the medial collateral ligament(MCL),was usedin total kneearthroplastywith severe type II valgus deformity. The study compared the clinical outcomes of the technique relative to conventional release group. Methods Consecutive patients with a Krackow type II valgus deformity of >20° who underwent a primary unilateral TKA between May 2008 and June 2017 were retrospectively studied. Modified MCL indentation technique was performed in 20 patients (group A), while the remaining 23 patients (group B) received routine release technique. Radiological parameters, such as the valgus angle (VA), and functional outcomes including the use of constraint implants, Knee Society Score(KSS), Knee Society function score(KSF), and height of the polyethylene insert, were compared between the two groups.Results 43 consecutive patients had a minimum 2-year follow-up. The preoperative VA was comparable between group A (23.5° ± 5.8°) and group B (21.3° ± 3.2°, P =0.134), so was the postoperative VA (1.1° ± 2.1° and 2.5° ± 3.0°, P =0.084 in groups A and B, respectively).The postoperative KSS and KSF showed marked improvement. While no statistically significant difference in preoperative or postoperative functional scores was found between two groups, group A had thinner PE insert (9.5 ± 1.1 mm vs. 12.9 ± 1.5 mm) and less use of constrained condylar inserts(15% vs. 69.6%). Conclusion Modified MCL indentation technique can achieve good outcomes in TKA with type II valgus deformity of >20°.
Serum Lactate:Creatinine Ratio as a Potential Therapeutic Markers of Liver Failure Patients Treated by Artificial Liver Support Systems
Authors: Sun Shuilin , Chen Ling , Zhou Guanlin , Guo Lili , geng Ruijin , Yang Wenlong , Xie Baogang , Wang Wenxin
Published: January 2021

Artificial liver support systems (ALSSs) have been recommended as important approaches for treating liver fuilure (LF) patients. However, very few studies have focused on the screening of potential serum therapeutic markers of LF patients treated by ALSSs. Here, serum samples were obtained from 57 LF patients before and after ALSSs treatment and analyzed by metabonomics. The results showed that ratios of creatine:creatinine, taurine:creatinine, and lactate:creatinine were significantly altered and restored to normal levels after ALSSs treatment. The ratio of lactate:creatinine showed the highest area under a receiver-operating characteristic curve (AUROC) value (0.650), which was higher than that of the prothrombin time activity (PTA, 0.562). A retrospective analysis showed that serum lactate:creatinine ratios among the LF patient groups were 0.038 ± 0.002 (survival group, n=48), 0.048 ± 0.005 (three-month death group, n=24), and 0.052 ± 0.005 (one-month death group, n=33), which was significantly negatively correlated with survival (r= - 0.26). Another retrospective cohort analysis (n=81) of LF patients showed that the lactate-creatinine ratio in the death group remained unchanged, but fell markedly in the survival group (0.052 ± 0.005 vs. 0.025 ± 0.002) after ALSSs treatment. In comparison, the serum PTA levels were no statistical differences of in both the death group and survival group after ALSSs treatment. The AUROC of serum lactate-creatinine ratio and PTA after ALSSs treatment for diagnosis of survival group from death group was 0.682 and 0.591 respectively. These results indicate that the serum lactate-creatinine ratio may be more reliable than measures of PTA to evaluate the therapeutic effect of ALSSs treatment in LF patients.
COVID-19 Associated Pancreatitis: A Review of 66 Cases
Authors: Rahimian Zahra , Ardekani Ali , Feili Afrooz , Lankarani Kamran Bagheri
Published: January 2021

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has shown itself with different clinical manifestations. Besides respiratory distress, cough, and fever, which were the most common symptoms, pancreatitis has been reported as a rare presentation of this disease, but the knowledge on this association and its pathogenesis is sparse. Methods: Four databases, including Pub Med, Scopus, Web of Science, and Google Scholar, were searched for the association of pancreatitis and SARS-CoV- 2 infection, and 29 relevant articles were extracted and reviewed. Results: We reviewed 29 studies provided 66 cases developed acute pancreatitis while they were infected with SARS-CoV-2. The mean age of patients was 49.94 ± 16.96. The female to male ratio was 1.06 (33 to 31). In 44% of cases, acute pancreatitis developed as the primary presentation of Coronavirus Disease 2019 (COVID-19) and 9% of reported cases, expired.Conclusions: During this pandemic, SARS-CoV-2 should be considered in the differential diagnosis of the patients presenting with acute pancreatitis. Although pancreatitis will respond to standard care, these patients need isolation and observation for later development of respiratory symptoms.
Functional and Clinical Results of Patients Who Underwent an Ileal Pouch Anal AnastomosisFunctional and Clinical Results of Patients Who Underwent an Ileal Pouch Anal Anastomosis
Authors: Yavuz Aydin , Gobut Huseyin , Kubat Omer , Altiner Saygin , Dikmen Kursat , Bostanci Hasan , Yuksel Osman
Published: January 2021

Background: Our aim is to evaluate the patients who underwent IPAA in our clinic, in terms of their characteristics, early and late complications, the results, and the problems that may emerge after the IPAA such as the quality of life. Methods: Twenty-two of the 26 patients, who underwent IPAA were included in the study. Evaluations were made on the demographic characteristics of the patients, surgical indications, the type of operation, pathological diagnosis, early and late postoperative complications, and functional outcomes. Cleveland Global Quality of Life scoring was administered in order to evaluate the quality of life.Results: Ten of the patients had UC and 12 had FAP. Nineteen of the patients underwent a two-stage surgical procedure. In postoperative period, ileus occurred in 4 patients (18.2%), 5 had wound infections (22.7%), 3 had a pelvic abscess (13.6%), and other complications developed in 5 patients (22.7%). Two patients had pouchitis (9.1%), 2 had anastomotic stenosis (9.1%), and 2 had pouch dysfunction (9.1%). There was incontinence with fluid in 6 (27.3%) patients. Four patients (18.2%) used pads during the day, requiring defecation with an average of (4.31±2.37) times during the day and (1.04±0.89) times at night. Half of them (50%) had complaints of sexual dysfunction. The life quality score was observed to be significantly better in patients with FAP (0.85±0.13) compared to patients with UC patients (0.71±0.11).Conclusion: This procedure could be applied safely with low comorbidity and good functional outcomes in experienced health centers with high caseloads.
A New Biomarker Tool for Risk Stratification in “De Novo” Acute Heart Failure (OROME)
Authors: Bermejo Rosa Agra , Cacho-Antonio Carla , Gonzalez-Babarro Eva , Rozados-Luis Adriana , Couselo-Seijas Marinela , Gómez-Otero Inés , Varela-Román Alfonso , López-Canoa José N , Gómez-Rodríguez Isabel , Pata María , Eiras Sonia , González-Juanatey Jose R
Published: January 2021

Background: Inflammation is one of the mechanisms involved on heart failure (HF) pathophysiology. Thus, the acute phase reactant protein, orosomucoid, was associated with a worse post-discharge prognosis in de novo acute HF (AHF). However, the presence of anti-inflammatory adipokine, omentin, might protect and reduce the severity of the disease. We wanted to evaluate the value of omentin and orosomucoid combination for stratifying risk of these patients.Methods and Results: Two independent cohorts of patients admitted for de novo AHF in two centers were included in the study (n=218). Orosomucoid and omentin circulating levels were determined by ELISA at discharge. Patients were follow-up for 317 (3-575) days. A predictive model was determined for primary endpoint, death and/or HF readmission. Differences in survival were evaluated using a Log-rank test. According cut-off values of orosomucoid and omentin, patients were classified on UpDown (high orosomucoid and low omentin levels), equal (both proteins high or low) and DownUp (low orosomucoid and high omentin levels). The Kaplan Meier determined worse prognosis for the UpDown group (Long-rank test p=0.02). The predictive model that includes the combination of orosomucoid and omentin groups (OROME) + NT-proBNP values achieved a higher C-index=0.84 than the predictive model with NT-proBNP (C-index=0.80) or OROME (C-index=0.79) or orosomucoid alone (C-index=0.80). Conclusions: The orosomucoid and omentin determination stratifies de novo AHF patients in high, mild and low risk of rehospitalization and/or death for HF. Its combination with NT-proBNP improves its predictive value in this group of patients.
A cooperative DDoS attack detection scheme based on entropy and ensemble learning in SDN
Authors: Yu Shanshan , Zhang Jicheng , Liu Ju , Zhang Xiaoqing , Li Yafeng , Xu Tianfeng
Published: January 2021

In order to solve the problem of Distributed Denial of Service (DDoS) attack detection in software defined network (SDN), we proposed a cooperative DDoS attack detection scheme based on entropy and ensemble learning. This method sets up a coarse grained initial detection module based on entropy in the edge switch to monitor the network status in real time and report to the controller if any abnormality is found. Simultaneously, a fine grained precise attack detection module is designed in the controller, and a ensemble learning-based algorithm is utilized to further identify abnormal traffic accurately. In this framework, the idle computing capability of edge switches is fully utilized with the design idea of edge computing to offload part of the detection task from the control plane to the data plane innovatively. Simulation results of two common DDoS attack methods, ICMP and SYN, show that the system can effectively detect DDoS attacks and greatly reduce the southbound communication overhead and the burden of the controller as well as the detection delay of the attacks.
Presepsin values and Prognostic Nutritional Index predict mortality in intensive care unit patients with sepsis: a pilot study
Authors: Shimoyama Yuichiro , Umegaki Osamu , Kadono Noriko , Minami Toshiaki
Published: January 2021

Objective

Sepsis is a major cause of mortality for critically ill patients. This study aimed to determine whether presepsin values can predict mortality in patients with sepsis.
Results

Receiver operating characteristic (ROC) curve analysis, Log-rank test, and multivariate analysis identified presepsin values and Prognostic Nutritional Index as predictors of mortality in sepsis patients. Presepsin value on Day 1 was a predictor of early mortality, i.e., death within 7 days of ICU admission; ROC curve analysis revealed an AUC of 0.84, sensitivity of 89%, and specificity of 77%; and multivariate analysis showed an OR of 1.0007, with a 95%CI of 1.0001–1.0013 (p = 0.0320).
Correlation between neurological features, nutritional status and metabolic changes in patients with Ataxia-telangiectasia
Authors: Barreto Talita Lemos Neves , Raslan Ivana , Trajano Karina , Maggi Fernanda , Pedroso José Luiz , Barsottini Orlando , Fonseca Fernando Luiz , Ferreira Ariel , Aranda Carolina , Sarni Roseli
Published: January 2021

Background

Ataxia-telangiectasia (AT) is an autosomal recessive neurodegenerative disorder caused by variants of ATM (ataxia telangiectasia mutated) gene. There is no specific treatment, but clinical management has advanced resulting in longer patient survival. However, these patients develop metabolic changes over time. We aimed to assess the correlation between neurological features, nutritional status and metabolic changes in AT patients.
Results

Significant correlations were found between the scores on the International Cooperative Ataxia Rating Scale (ICARS) and age (r = 0.748; p < 0.001), gamma glutamyl transferase (GGT) (r = 0.743; p < 0.001), insulin levels (r = 0.520; p = 0.016) and the Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) index (r = 0.585; p = 0.005) as well as the scores on the Assessment and Rating of Ataxia (SARA) and age (r = 0.704; p < 0.001), GGT (r = 0.701; p < 0.001), insulin levels (r = 0.706; p < 0.001) and HOMA-IR index (r = 0.764; p < 0.001).
Conclusions

The relevant correlation between severity of ataxia and disease progression with metabolic changes such as liver function impairment and insulin resistance reinforce the importance to monitoring metabolic changes and evaluate nutritional status in these patients.
The ameliorative effect of terpinen-4-ol on ER stress-induced vascular calcification depends on sirt1-mediated regulation of PERK acetylation
Authors: Zhang Yan-Yan , He Li , Tu Meng-Xin , Huang Mei , Chen Yan , Pan Di , Peng Jian-Qing , Shen Xiangchun
Published: January 2021

Background

Endoplasmic reticulum (ER) stress-mediated phenotypic switching of vascular smooth muscle cells (VSMCs) is key to vascular calcification (VC) in patients with chronic kidney disease (CKD). Terpinen-4-ol exerts protective effect against cardiovascular disease, but its role and specific mechanism in VC remain unclear. We explored whether terpinen-4-ol alleviates ER stress-mediated VC through sirtuin 1 (sirt1) and elucidated its mechanism to provide evidence for its application in the clinical prevention and treatment of VC.
Methods

In this study, CKD-related VC animal model and β-glycerophosphate (β-GP)-induced VSMCs calcification model were established. We investigated the part of terpinen-4-ol in ER stress-induced VC in vitro and in vivo. However, in order to clarify whether terpinen-4-ol inhibits the molecular mechanism of ERs-induced VC through sirt1, we further verified the above signal transduction by knocking down sirt1 in vitro and in vivo.
Results

Terpinen-4-ol inhibited calcium deposition, phenotypic switching, and ER stress of VSMCs in vitro and in vivo. Furthermore, pre-incubation with terpinen-4-ol or a sirt1 agonist and transfection with lentivirus overexpressing sirt1 decreased β-GP-induced calcium salt deposition, increased sirt1 protein level, and inhibited PERK-eIF2α-ATF4 pathway activation in VSMCs, thus, alleviating VC. The opposite results were obtained in sirt1-knockdown models. Moreover, sirt1 physically interacted with and deacetylated PERK. Mass spectrometry analysis identified lysine K889 as the acetylation site of sirt1, which regulates PERK. Finally, inhibition of sirt1 reduced the effect of terpinen-4-ol on the deacetylation of PERK in vitro and in vivo and weakened the inhibitory effect of terpinen-4-ol against ER stress-mediated VC.
Conclusions

Terpinen-4-ol inhibits the post-transcriptional modification of PERK at the lysine K889 acetylation site by upregulating sirt1 expression level, thereby ameliorating VC by regulating ER stress. This provides evidence of the molecular mechanism of terpinen-4-ol, which supports its development as a promising therapeutic agent for CKD-VC.
Mental Health and Wellbeing Implications of the COVID-19 Quarantine for Disabled and Disadvantaged Children and Young People: Evidence from a Cross-cultural Study in Zambia and Sierra Leone
Authors: Sharpe Darren , Rajabi Mohsen , Chileshe Clement , Sitali Mayamba , Sesay Ibrahim , Williams James , Sait Siraj
Published: January 2021

Background The mental health impact of the COVID-19 pandemic and quarantining on children and young people (CYP) living in low- and middle-income countries (LMICs) has yet to be fully comprehended. CYP in LMICs are at utmost risk, given the COVID-19-related restrictions and social distancing measures, resulting in reduced access to school-based services for nutritional and mental health needs. This study examined mental health of CYP during the first COVID-19 lockdown in Zambia and Sierra Leone.
Method In this cross-sectional study which conducted from 21st June to 8th August 2020, 468 disabled and disadvantaged CYP aged 12 to 25 completed a planning tool that comprised the short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS), as well as open-ended questions covering social connectedness, physical distancing and outdoor activities during the lockdown. The community coaches screened individuals and families who could be eligible to receive emergency aid, and based on a convenience sample following distribution of aid, recipients were invited to complete the online planning tool. The participants were vulnerable children and adolescents (e.g. disadvantaged or living with a disability) living in different provinces of Zambia and Sierra Leone.
Results Mean (SD) SWEMWBS scores for all participants in Zambia and Sierra Leone, were 19.61 (3.45) and 21.65 (2.84), respectively. Mental wellbeing scores were lower in women, younger children and participants with two or more disabilities. Factors significantly associated with poor mental wellbeing in the sample were: type of disability, nationality, peer relationships, connection to others during the pandemic, knowledge about COVID-19, worry about the long-term impact of COVID-19, and the types of self-isolating.
Conclusion The results show that participants who self-reported low levels of COVID-19 health literacy also scored low on the mental wellbeing self-assessment. Yet, despite undoubted limited resources, these CYP are doing well in identifying their needs and maintaining hope in the face of the problems associated with COVID-19 in countries where stigma persists around mental ill-health.
The relationship between insulin sensitivity and serum AT3 activity in patients with type 2 diabetes
Authors: Wang Hong , Cao Jie , Su Jian-bin , Wang Xue-qin , Zhang Dong-mei , Wang Xiao-hua
Published: January 2021

Background: Serum antithrombin 3 (AT3) is a physiological inhibitor of thrombin, and AT3 activity was found to be decreased at the status of type 2 diabetes (T2D). T2D was presented with an increased risk of thrombotic complications at the background of impaired insulin sensitivity. The aim of this study was to investigate the relationship between insulin sensitivity and serum AT3 activity in patients with T2D. Methods: We recruited 1612 patients with T2D for this cross-sectional study from the Second Affiliated Hospital of Nantong University. All patients performed 75-g oral glucose tolerance test (OGTT), and basal and systemic insulin sensitivity were assessed by homeostasis model assessment of insulin resistance (HOMA-IR) and Matsuda index (ISI Matsuda ), respectively. Serum AT3, one of the hemostatic parameters, and the relevant clinical data were collected, as well as other laboratory indicators. Results: It is showed that HOMA-IR decreased, while ISI Matsuda notably increased, across ascending quartiles of serum AT3. Moreover, serum AT3 were was negatively correlated with (r = –0.189, p < 0.001) and positively correlated with ISI Matsuda (r = 0.221, p < 0.001). After adjusted for metabolic risk factors, hemostatic parameters and glucose-lowering therapies by multivariate liner regression analysis, HOMA-IR (β = −0.179, t = −5.823, p < 0.001) and ISI Matsuda (β = 0.191, t = 6.395, p < 0.001) was remained independently associated with the serum AT3 activity patients with T2D, respectively. Conclusions: Reduced basal and systemic insulin sensitivity are associated with decreased AT3 activity in patients with T2D.
A Meta-Analysis of Association Between the MMP-13 rs2252070 Promoter Polymorphism and Cancer Risk
Authors: Yuan Peng , Chen Yudi , Ma Youzhao , Zhang Chengjuan , Ren Pengfei , Xu Benling
Published: January 2021

Background

Originally detected in breast cancer tissue, MMP-13 has been showed to be closely related to cancer development. Increasing evidence has also suggested that rs2252070, one of its SNP, can profoundly influence cancer risk by regulating the expression while the conclusion still remained controversial. Therefore, this meta-analysis was conducted to assess the carcinogenesis effect of this SNP quantitatively.

Methods

Studies about association between rs2252070 polymorphism and cancer risk by March 15, 2020 had been collected in PubMed, Web of Science, Cochrane Library and CNKI. R scripts and STATA software were applied to calculate estimates. Pooled ORs and corresponding 95% CIs were used to evaluate the strength of association.

Results

Twenty studies meeting pre-defined criteria were retrieved for the final statistical analysis, including 8,215 cancer patients and 8,480 healthy controls. The pooled estimates revealed no statistical significance for the association between this polymorphism and the risk of cancer in all 5 genetic models. Similarly, no significance had been detected in stratified analyses by region, cancer type, sample size and genotyping method.

Conclusion

The association between MMP-13 rs2252070 and carcinogenesis was not statistically significant. To elucidate this conclusion, future studies including gene-gene and gene-environment interaction are needed to verify the study results.
Electro-Mechanical Coupling Properties of Band Gaps in an Elastic/Piezoelectric Phononic Crystal Nonlocal Nanobeam With Periodically Attached “spring-Mass” Resonators
Authors: Qian Denghui , Wang Jianchun , He Feiyang
Published: January 2021

The model of a locally resonant (LR) epoxy/PZT-4 phononic crystal (PC) nanobeam with “spring-mass” resonators periodically attached on epoxy is proposed. The corresponding band structures are calculated by coupling Euler beam theory, nonlocal piezoelectricity theory and plane wave expansion (PWE) method. Three complete band gaps with widest total width less than 10GHz can be formed in the proposed nanobeam by comprehensively comparing the band structures of three kinds of LR PC nanobeams with resonators attached or not. Furthermore, influencing rules of the coupling fields between electricity and mechanics, “spring-mass” resonator, nonlocal effect and different geometric parameters on first three band gaps are discussed and summarized. All the investigations are expected to be applied to realize the active control of vibration in the region of ultrahigh frequency.
Differential Expression of TgMIC1 in Isolates of Chinese1 Toxoplasma With Different Virulence
Authors: Wang Yang , Han Chengjian , Zhou Rongsheng , Zhu Jinjin , Zhang Famin , Li Jingyang , Qingli Luo , Du Jian , Chu Deyong , Cai Yihong , Shen Jilong , Yu Li
Published: January 2021

The predominant genotype of T. gondii in China is Chinese 1 (ToxoDB#9) lineage. TgCtwh3 and TgCtwh6 are two representative strains of Chinese 1, exhibiting high virulence and low virulence to mice, respectively. Little is known about the virulence mechanism of this non classical genotype. Our previous RNA sequencing data revealed that differential mRNA level of TgMIC1 in TgCtwh3 and TgCtwh6. To further confirm the differential expression of TgMIC1 and its significance in this atypical genotype, quantitative real-time PCR was used to verify the RNA sequencing data firstly, and then polyclonal antibodies against TgMIC1 were prepared and identified. Moreover, the invasion and proliferation of the parasite in HFF cells were observed after treatment with TgMIC1 polyclonal antibody or not. The data showed the protein level of TgMIC1 was significantly higher in high virulence strain TgCtwh3 than that in low virulence strain TgCtwh6, and the invasion and proliferation of TgCtwh3 were inhibited by TgMIC1 polyclonal antibody. Differential expression of TgMIC1 in TgCtwh3 and TgCtwh6 may explain, at least partly, the virulence mechanism of this atypical genotype
Effects of Single Nucleotide Polymorphisms 869 T/C in the Exon 1 Locus of Transforming Growth Factor-β1 Gene on Susceptibility and Airflow Restriction of Chronic Obstructive Pulmonary Disease
Authors: Liu Jie , Zhu Wenjing
Published: January 2021

Background: Chronic obstructive pulmonary disease (COPD) is the most common chronic respiratory disease which is expected to become the third leading cause of death worldwide in 2030. Series of susceptibility genes and single nucleotide polymorphism (SNPs) play an important role in the occurrence and development of COPD.Methods: In our study, 98 COPD patients and 90 healthy volunteers were enrolled. The +869 SNP (SNP, Single Nucleotide Polymorphisms) of TGF-β1 was detected in 98 COPD patients and 90 healthy volunteers by PCR-DNA sequencing. The effects of different genotypes of +869 locus on the susceptibility of COPD, pulmonary function and airflow limitation of COPD patients were analyzed.Results: Allele C of +869 locus was associated with the susceptibility of COPD (OR:1.913, 95% CI: 1.251-2.926). The predicted value of FEV1% (FEV1, Forced Expiratory Volume in One Second) in patients with CC of +869 locus was significantly lower than that in patients with TT (P < 0.05). The genotype frequencies of CC, CT and TT were 6.5%, 58.7% and 34.8% in Mild-to-Moderate airflow restriction patients. In severe airflow restriction patients, the genotype frequencies were CC 23.1%, CT 57.7% and TT 19.2%. The distribution of CC genotype in severe airflow restriction COPD patients was significantly higher than that in Mild-to-Moderate airflow restriction COPD patients (P = 0.037). Moreover, the frequency of C allele was significantly higher in patients with severe airflow restriction than that patients with Mild-to-Moderate airflow restriction (P = 0.024).Conclusions: The SNP of +869 T/C in TGF-β1 is closely related to the susceptibility of COPD and the airflow restriction of COPD patients.
Clinical study of patients with coronary artery disease combined multivessel disease
Authors: Zhu Yuhan , Wen Yongyao , Liu Yanyan , Shen Xiaoxu , Song Maifen
Published: January 2021

Background: To investigate the clinical prognosis of patients with coronary artery disease combined multivessel disease. Methods: The patients who were diagnosed with multivessel disease by coronary angiography were selected in this study. The clinical datas about the clinical prognosis and the incidence of adverse cardiovascular events within five-year follow-up were analyzed. Results: A total of 230 participants were included in this study, includeing 129 male (56.09%) and 101 female (43.91%), the average age was 69.73 ± 10.93. The outcomes showed that the patients with three-vessel lesions had significantly higher rate of diabetes history (51.32% vs. 34.62%, P=0.018), unstable angina pectoris history ( 73.03% vs. 55.13%, P=0.008), and significantly higher risk of cardiogenic mortality (7.24% vs. 1.28%, P=0.045) when compared with patients who had two-vessel lesions. The patients with CTO had significantly higher rate of diabetes history (58.54% vs. 42.86%, P=0.049), unstable angina pectoris history ( 80.49% vs. 64.02%, P=0.029), MI history ( 48.78% vs. 25.40%, P=0.003), significantly lower LVEF (58.73±11.30 vs. 64.23±9.49, P=0.001) and significantly higher risk of recurrent myocardial infarction (12.20% vs. 3.2%, P=0.043) when compared with those patients without CTO. The patients with left main lesions had significantly older age (73.61±9.95 vs. 69.02±10.98, P=0.018) and significantly higher risk of cardiogenic mortality (13.89% vs. 3.61%, P=0.025) when compared with those patients without left main lesions. Conclusions: Among patients with coronary artery disease combined multivessel disease, patients with CTO had significantly lower LVEF and higher risk of recurrent myocardial infarction than patients without CTO. The patients with left main lesions had significantly higher risk of cardiogenic mortality than patients without left main lesions. The patients with three-vessel lesions had higher risk of cardiogenic mortality than patients with two-vessel lesions.
Geographic Information Systems for Vaccine – Preventable Disease Management in Refugees
Authors: Fein Rebecca Anne , Alexander Jeffrey L.
Published: January 2021

During conflicts, deaths from disease, often from vaccine-preventable diseases, outnumber deaths from violence. The current study was a quantitative, descriptive, case series investigating the burden of vaccine-preventable diseases in refugee populations using geographic information system (GIS) analysis. We focused on cholera, diphtheria, measles, and tuberculosis in the Dadaab complex (primarily Somali and Sudanese), Rohingya, Syrian, Venezuelan, and Yemeni refugee populations. We used retrospective data available to the public. Data were missing for many diseases. Cases of cholera ranged from 1.3 million (Yemen) to 1777 (Dadaab); fatalities ranged from 2500 (Yemen) to 14 (Dadaab). Cases of diptheria ranged from 7340 (Rohingya) to 1249 (Venezuela); fatalities ranged from 214 (Yemen) to 45 (Rohingya). Cases of measles ranged from 6395 (Venezuela) to 104 (Syria); no fatalities were reported. The only data reported for tuberculosis was for Rohingya (880 cases). Our results suggested GIS analysis may be a beneficial resource to address refugee health.
Pro-inflammatory effects of human apatite crystals extracted from patients suffering from calcific tendinopathy.
Authors: Herman Julien , Goff Benoit Le , Lima Julien De , Brion Régis , Chevalier Catherine , Blanchard Frédéric , Darrieutort-Laffite Christelle
Published: January 2021

Background: Calcific tendonitis of the rotator cuff is due to carbonated apatite deposits in the shoulder tendons. During the evolution of the disease, an acute inflammatory episode may occur leading to the disappearance of the calcification. Although hydroxyapatite crystals-induced inflammation has been previously studied with synthetic crystals, no data are available with calcifications extracted from patients suffering from calcific tendinopathy. The objective of the study was to explore the inflammatory properties of human calcifications and the pathways involved. Methods: Human calcifications and synthetic hydroxyapatite were used in vitro to stimulate human monocytes and macrophages, the human myeloid cell line THP-1 and human tenocytes. The release of IL-1β, IL-6 and IL-8 by cells was quantified by ELISA. Gene expression of pro- and anti-inflammatory cytokines was evaluated by quantitative PCR. NF-kB activation and NLRP3 involvement was assessed in THP-1 cells using a NF-kB inhibitor and a Caspase 1 inhibitor. The inflammatory properties were then assessed in vivo using a mouse air pouch model. Results: Human calcifications were able to induce a significant release of IL-1β when incubated with monocytes, macrophages and THP-1 only if they were first primed with LPS (monocytes and macrophages) or PMA (THP-1). Stimulation of THP-1 by human calcifications led to similar levels of IL- 1β when compared to synthetic hydroxyapatite although these levels were significantly inferior in monocytes and macrophages. Patient’s crystals enhanced mRNA expression of pro-IL-1β, as well as IL-18, NF-kB and TGFβ when IL-6 and TNFα expression were not. IL-1β production was reduced by the inhibition of Caspase 1 indicating the role of NLRP3 inflammasome. In vivo, injection of human calcifications or synthetic hydroxyapatite in air pouch led to significant increase in membrane thickness although significant overexpression of IL-1β was only observed for synthetic hydroxyapatite. Conclusions: As synthetic hydroxyapatite, human calcifications were able to induce an inflammatory response resulting in the production of IL-1β after NF-kB activation and through NLRP3 inflammasome. In some experiments, IL-1β induction was lower with human calcifications compared to synthetic apatite. Differences in size, shape and protein content may explain this observation.
Radial BMD and serum CTX-I can Predict the Progression of Carotid Plaque in Rheumatoid Arthritis: A 3-year Prospective Cohort Study
Authors: Han Seungwoo , Kim Na-Ri , Kang Jong-Wan , Eun Jung-Su , Kang Young Mo
Published: January 2021

Objective. Patients with rheumatoid arthritis (RA) are almost twice as likely to develop cardiovascular disease (CVD) as those without. However, traditional CVD risks have been shown to underperform in RA patients; thus, we aimed to identify new surrogate risk factors to better reflect their atherosclerotic burden.Methods. A total of 380 RA patients with carotid atherosclerosis data were analyzed in this prospective cohort study. The primary outcome was carotid plaque progression over the 3-year follow-up period. Risk parameters assessed for the progression of carotid plaque were categorized as demographics, traditional CVD risks, RA-related risks, and bone parameters. Results. The progression of carotid plaque was associated with the level of rheumatoid factor (p = 0.025), serum C-terminal telopeptide of type-I collagen (CTX-I) (p = 0.014), and femur and distal radius bone mass density (BMD) (p = 0.007 and 0.004, respectively), as well as traditional CVD risk factors. In multivariable analyses, the bone parameters of serum CTX-I and distal radius BMD proved to be independent predictors of the progression of carotid plaque along with hyperlipidemia, smoking, and baseline carotid plaque (all, p < 0.05). Adding both serum CTX-I and distal radius BMD increased the carotid plaque progression prediction model’s percentage of explained variance from 24% to 30%.Conclusion. High serum CTX-I and lower radius BMD, reflecting high bone turnover, were independent risk factors for the progression of carotid plaque in RA patients, implicating the direct or indirect role of bone catabolism on the atherosclerotic burden.
Anti-Arthritic Effect of TLR4 Inhibitor TAK-242 Through the Inhibition of Th1 and Th17 Cell Proliferation in a Curdlan-Induced Spondyloarthritis SKG Mouse Model
Authors: Kim Hee Jin , Kim Jung Yeon , Lee Sang Hoon , Yang Hyung-In , Kim Kyoung-Soo
Published: January 2021

Background: Toll-like receptor 4 (TLR4) is involved in the pathogenesis of arthritic diseases. The TLR4 inhibitor TAK-242 has shown potential as a possible treatment for rheumatoid arthritis in an adjuvant-induced arthritis rat model. However, further investigation of the anti-arthritis effect of TAK-242 in other animal models of arthritis disease is required. Objective: This study was conducted to examine the anti-arthritic effects and mechanisms of TAK-242 on curdlan-induced spondyloarthritis in SKG mice. Methods: Curdlan-injected SKG ZAP-70W163C mice were intraperitoneally administered with TAK-242 (3 mg/kg) every other day or anti-IL-23 antibody (100 μg) weekly for 9 weeks. The therapeutic effect of TAK-242 was evaluated in the SKG mice by measuring the inflammation level of foot, ileum, lung and tail by histology, the levels of proinflammatory cytokines in serum, bone mineral density (BMD) in femur and spine, and CD4+T cell subtypes Th1 and Th17 in spleen.Results: TAK-242 treatment significantly reduced clinical score, paw width, and colon length in SKG mice. Consistent with the therapeutic effect, TAK-242 also reduced peripheral arthritis and IL-17 expression in the foot and ileum tissues. It also inhibited inflammation of the lungs, ileum, paws, and tail and reduced serum levels of pro-inflammatory cytokines such as IL-6 and TNF-α. TAK-242 recovered the reduced bone density in the femur but not in the spine. Treatment with TAK-242 also suppressed the populations of Th1 and Th17 cells in the spleen of SKG mice.Conclusions: TAK-242 may show beneficial anti-arthritis effects by inhibiting the proliferation of pro-inflammatory Th1 and Th17 cells. Further research is needed for TAK-242 to be repositioned as a treatment for arthritis disease.
Reinfection Rate and Its Associated Factors after Two-Stage Revision for Infected Total Knee Arthroplasty
Authors: Nam Chang Hyun , Lee Su Chan , Choi Kyungwon , Baek Ji-Hoon , Ahn Hye Sun
Published: January 2021

Background: Two-stage revision is the gold standard for treatment of infected total knee arthroplasty. The purpose of our study was to evaluate the reinfection rate of two-stage revision and to analyze the factors affecting the prognosis of two-stage revision for infected total knee arthroplasty.Methods: One hundred seven cases of two-stage revision for infected total knee arthroplasty were reviewed retrospectively from March 2006 to November 2019. We evaluated possible risk factors between success and reinfection groups. Statistical analyses included multivariable logistic regression analysis to examine the relative contribution of risk factors to the success of two-stage revision. Results: There were 19 cases of reinfection (17.8%) after two-stage revision in our center. Between the success and reinfection groups, there was a significant difference in history of cancer (p=0.015). Also, multivariable logistic regression analysis of risk factors demonstrated history of cancer (HR 5.928, p=0.015). There were no statistically significant differences in reinfection relative to other risk factors. Conclusions: In subjects undergoing two-stage revision for infected total knee arthroplasty, history of cancer was a risk factor for reinfection, though no other significant differences between risk factors was shown for reinfection.Trial registration: Retrospectively registeredLevel of evidence: IV
Minimally invasive open reduction by a modified suture bridge with anchors for avulsion-type greater tuberosity fracture of the humerus
Authors: Kong Lingpeng , Yang Juanjuan , Liu Fanxiao , Han Yong , Lu Qingsen , Jia Honglei , Lv Xiaolong , Hu Fangning , Wang Bomin , Yang Yongliang , Wang Fu
Published: January 2021

Background: This study aims to describe a new procedure of minimally invasive open reduction by a modified suture bridge with anchors for avulsion-type greater tuberosity fracture of the humerus and to evaluate its clinical effectiveness.Methods: From January 2015 to January 2018, 16 patients who were diagnosed with an avulsion-type greater tuberosity fracture of the proximal humerus and treated with minimally invasive open reduction by modified suture bridges with anchors were retrospectively studied. Endpoints were assessed preoperatively and postoperatively and included the visual analog scale (VAS), the University of California Los Angeles (UCLA) shoulders score, the American Shoulder and Elbow Surgeons score (ASES), and the range of motion (ROM) for shoulders.Results: There were 7 males and 9 females with an average age of 44.94 years. Six fractures involved the left shoulder, and 10 involved the right shoulder. The time between injury and operation ranged from 1 to 5 days, with an average of 2.32 days. The average length of stay was 6.5 ± 0.85 days; the mean operation time was 103.1 ± 7.23 minutes; and the mean amount of operative blood loss was 51.88 ± 6.40 ml. All patients achieved bone union within 3 months after surgery. The VAS score significantly decreased at 3 weeks postoperatively (p = 0.002), as did the average degree of forward elevation (p = 0.047). The mean degree of abduction increased at 6 weeks after the operation (p = 0.035), and the average degree of external rotation and internal rotation improved at 3 months postoperatively (p = 0.012; p = 0.007). The ASES score and the UCLA score improved at the 6-week follow-up (p = 0.092; p = 0.029). No procedure-related death or incision-related superficial or deep tissue infection was identified in any case. No iatrogenic neurovascular injuries or fractures were found in this study.Conclusion: The fracture block was fixed firmly by minimally invasive open reduction with a modified suture bridge with anchors. Patients were allowed to move their shoulder early after surgery and recovered quickly. It is an efficient method for the treatment of avulsion-type greater tuberosity fractures of the humerus.