bluuebunny/crossref_metadata_2025 huggingface dataset:
Anaesthetic concerns of a child with symptomatic vitamin D deficiency rickets with secondary hyperparathyroidism: A case report
Authors: Bandyopadhyay Soumily , Jain Nisha , Bandyopadhyay Anjishnujit
Published: April 2024

Rickets is a paediatric bone disorder characterised by defective mineralisation of bony matrix due to abnormalities in calcium and phosphate metabolism. Despite being a common disease globally, literature on the anaesthetic concerns in rickets are scant. Herein, we describe the management of a 12-year-old child with symptomatic vitamin D deficiency rickets with secondary hyperparathyroidism, undergoing general anaesthesia for an urgent orthopaedic procedure. There are numerous risks involved in such a case, such as hypocalcemia, hypophosphatemia, chest and vertebral deformities, restrictive lung disease, difficult intubation and weaning, difficult regional anaesthesia, chronic bone pain, infectious complications and postoperative decreased renal function, all of which require careful preoperative assessment and risk stratification. In elective surgeries, it is important to optimise the metabolic parameters before taking up the case. However, in urgent and emergent procedures like ours, it is imperative to take up the case after informing the parents of the risks involved.
How Can Vietnamese Companies Benefit from Management Accounting Systems and Supply Chain Integration Under Business Environment Uncertainty?
Authors: Hieu Le Thi Thu , Nguyen Nguyen Phong , Hoai Tu Thanh
Published: April 2024

We develop and test a moderated mediation model to explain how management accounting systems impact supply chain integration and firm performance, and how perceived environmental uncertainty influences these relationships. Partial least squares structural equation modeling was used to analyze the survey data from 158 supply chain firms in Vietnam. Results indicate that the use of management accounting systems increases the extent of supply chain integration, which in turn enhances firm performance. Furthermore, perceived environmental uncertainty moderates the positive associations between the use of management accounting systems, supply chain integration, and firm performance. This study makes several contributions to existing literature. First, it elucidates the role of supply chain integration in promoting partner integration in the Vietnamese context. Second, it reveals the performance implications of the interaction between management accounting systems and supply chain integration. Our findings have important implications for supply chain management because they emphasize the need to develop effective management accounting systems and supply chain integration strategies in the context of environmental uncertainty.
A Comparison of Post-Operative Patient Reported Outcome Measurements Following Bunion Surgery: Modified Lapidus vs Minimally Invasive Techniques
Authors: Bhend Madeline , Gauthier Chase , Gonzalez Tyler , Jackson J. Benjamin
Published: April 2024

Introduction/Purpose:

The modified Lapidus procedure (MLP) or a minimally invasive surgery distal transverse osteotomy (MISDTO) are acceptable surgical treatment options for hallux valgus. The current literature is evolving when comparing the effects of each procedure on patient reported outcomes and post-operative complications. The purpose of this study is to compare postoperative outcomes, time to weight bear, and patient reported outcomes using the Patient Reported Outcome Instrumentation System (PROMIS) for the MLP and MISDTO.

Methods:

This study retrospectively reviewed patients who underwent a MLP or MISDTO for hallux valgus correction at Prisma Health Midlands between February 2020 – February 2022. Data collected included: demographic data, postoperative outcomes, time to weight bear, and PROMIS scores, including Pain Interference (PI), Physical Function (PF), and Mobility scores. Paired Student’s T-Test and Wilcoxon Rank Sum test were used to compare continuous variables and Chi-Squared test for categorical variables.

Results:

A total of 81 patients undergoing MLP and 78 undergoing MISDTO were included in the study. Average follow-up for MLP and MISDTO patients was 53.7 and 43.4 weeks, respectively. MLP demonstrated significant improvement in PI (52.5 vs 56.8, P< 0.001) and Mobility (46.3 vs 43.4, P=0.044) scores, while MISDTO demonstrated a significant improvement in PI (48.8 vs 57.1, P< 0.001), PF (50.2 vs 44.9, P< 0.001), and Mobility (49 vs 42.8, P< 0.001) scores. MISDTO patients had significantly larger improvements in PI (7.6 vs 4.5, P=0.008), PF (5.3 vs 2.2, P=0.026), and Mobility (5.5 vs 2.9, P=0.02) compared to MLP patients. MISDTO patients had a significantly lower non-union rate (13.6% vs 2.6%, P=0.025), hardware failure rate (0% vs 9.9%, P=0.007), and time to weight-bear (2.2 vs 7.8 weeks, P< 0.001).

Conclusion:

Both MLP and MISDTO procedures are effective treatments for improving the pain and mobility issues associated with hallux valgus while maintaining patients’ function. MISDTO was found to improve patient reported outcomes significantly more than MLP, with a lower non-union rate, lower hardware failure rate, and shorter time to weight-bear. These findings suggest MISDTO is superior to MLP in improving patient reported outcomes and postoperative outcomes in the treatment of hallux valgus. Further study multicenter and long term outcome studies could be useful further evaluate these short term findings.
A Prospective Evaluation of a 3D-Printed 4th-Generation Total Ankle Prosthesis with 1-Year Follow- Up
Authors: Gross Christopher E. , Scott Daniel , Friscia David A. , Ellis Scott J. , Owens Richard F.
Published: April 2024

Introduction/Purpose:

Fixation of fourth-generation ankle replacements is evolving. Given the concern for tibial tray loosening or radiolucencies, three-dimensional (3-D) printing has been suggested as a solution. Additive manufacturing allows for the creation of an optimal implant surface for improved initial stability and bony on growth. To date, there are no reported data concerning survivorship and clinical improvement following a 3-D printed ankle replacement. Documentation of implant survivability and comparison studies of the latest generation implants are limited. The purpose of this study is report on prospectively-collected patient reported outcome measures (PROMs) in a multi-institutional study of a 3-D printed fourth-generation total ankle.

Methods:

Patients presenting for a total ankle replacement at 12 institutions were prospectively enrolled and implanted in both academic and private settings. Patients had demographics and PROMs recorded pre-operatively and at 6 month and 12-month intervals. The following PROMs were collected: Ankle Osteoarthritis Score (AOS), PROMIS Global Physical Health, Foot and Ankle Outcome Score (FAOS), and satisfaction scores. The preoperative and latest follow-up scores for patients with two years of follow-up were analyzed.

Results:

91 of 177 subjects enrolled have reached one-year in follow-up currently. From the 177 enrolled (52.5% male) with an average age of 64.0±10.3 years old with an average BMI of 30.8±6.2. The pre-operative diagnosis for arthritis type was degenerative arthritis (27.7%), rheumatoid arthritis (1.7), post-traumatic arthritis (70.1%), and other (0.50%). There were 3 (1.69%) clinical failures:1 early infection: at 2 months, 1 tibial subsidence at 7 months, and 1 deep infection associated with trauma at 8 months post-operatively. The patients improved in all PROMs domains at one year including: Mean Total AOS (19.0. ± 17.5) p<.0001); PROMIS Global Physical Health (49.6 ± 17.1 p<.0001); Total FAOS Symptom Scores at 1 year (75.0 ± 19.5, p<.0001). The Total FAOS QOL at 1 year is 65.3 ± 25.2.

Conclusion:

At one-year post-implantation follow-up, the fourth generation 3D printed total ankle replacement had a low revision rate and proved to be safe and effective compared to historical ankle replacement outcomes. Patients were overwhelmingly satisfied and had statistically significant clinical improvements in each domain of their PROMs.
"I Can’t Exercise Because My Foot Hurts Me Too Much." Does BMI Change after Common Foot and Ankle Surgeries? A Retrospective Review
Authors: Weiss Samantha N. , Higgins Margaret , McKeeman Jonathan , Lachman James R.
Published: April 2024

Introduction/Purpose:

The World Health Organization reports that 1.9 billion people worldwide have a body mass index (BMI) that classifies them as being either overweight (BMI > 25) or obese (BMI > 30). Patients often claim, prior to orthopaedic surgery, that their physical activity and exercise is negatively impacted by their orthopaedic condition. Hip and Knee arthroplasty literature has established that patients with high preoperative BMI continue to have high BMI post-operatively, despite also reporting improvements in their joint pain. No such studies exist in foot and ankle surgery. The purpose of this study was to analyze changes in BMI after many common foot and ankle surgeries.

Methods:

A retrospective review of all patients undergoing bunion correction, flatfoot correction, 1st MTP arthrodesis, and midfoot arthrodesis procedures between November 2018 and December 2022 was conducted in this IRB approved, single center study. BMI data was collected from the electronic medical record for preoperative and 12 months postoperative time points. Descriptive statistics were reported for age, gender, diabetes, A1c for diabetic patients, smoking status, and overall follow up time. Repeated measures of analysis of variation were conducted with one between-groups factor being type of surgery.

Results:

196 patients were included in the study. The average age was 62.1 years, 151(76.6%) patients were female. Average BMI amongst all patients preoperatively was 29.58 +/- 5.21, and postoperatively 29.79 +/- 5.33, with an overall average increase in BMI of 0.2182 +/- 2.21. Upon subgroup analysis, all surgical cohorts yielded an increase in postoperative BMI (bunion +0.2489 +/- 2.06, double arthrodesis +0.4767 +/- 1.37, 1st MTP fusion +0.2293 +/- 2.07, midfoot arthrodesis +0.0251 +/- 3.10) although these changes did not reach significance (p value 0.425). There was no significant difference observed in changes in BMI between surgical groups (p value 0.958). BMI outcomes were normally distributed with acceptable equality of error variances (Levene’s test p- values > 0.270).

Conclusion:

The current statistics surrounding the prevalence of overweight and obesity are staggering. The results of this study demonstrate that elective orthopaedic surgery of common foot and ankle procedures do not facilitate a change in BMI one year postoperatively, despite the goal of reducing chronic pain and increasing physical function, which is often cited as the primary restriction to exercise amongst patient populations. Additional studies are warranted to further elucidate changes in BMI to adequately council patients regarding postoperative expectations. Study Data Summary
Spatial Distribution and Characteristics of Protein Content and Composition in Japonica Rice Grains: Implications for Sake Quality
Authors: Takahashi Kei , Kohno Hiromi , Okuda Masaki
Published: April 2024

The quantity and composition of rice proteins play a crucial role in determining taste quality ofsake, Japanese rice wine. However, the spatial distribution of proteins within rice grains, especially in endosperm tissue, and the differences between rice varieties remain unclear. Here, we analyzed the crude protein contents and composition ratios of table (NipponbareandKoshihikari) and genuine sake rice varieties (Yamadanishiki,Gohyakumangoku,Dewasansan,Dewanosato, andYumenokaori) to elucidate their spatial distribution within the Japonica rice grain endosperm. Seven sake rice varieties were polished over five harvest years using a brewer’s rice-polishing machine. We obtained fractions at 90–70% (the outermost endosperm fraction), 70–50%, 50–30%, and 30–0% (the central region of the endosperm fraction).YamadanishikiandDewanosatoexhibited considerably lower crude protein contents than the other cultivars. After applying SDS-PAGE, the protein composition, comprising glutelin/total protein (G/TP), prolamin/TP (P/TP), and G/P ratios of these fractions was determined. In white rice (at a 90% rice-polishing ratio), the average ratio of the major protein composition was G/TP 41%, P/TP 21%, and G/P ratios of 1.97.GohyakumangokuandYamadanishikihad higher G/TP ratio, whileDewanosatohad a lower value. Despite having lower crude protein contents,YamadanishikiandDewanosatoexhibited significantly varying G/TP ratios. The G/TP ratio markedly varied among rice varieties, particularly in the rice grains’ central region. The 50–30% fraction had the highest P/TP ratio among all tested rice varieties, suggesting spatial differences in P/TP within rice grains.Koshihikarihad the lowest P/TP ratio. In addition, the 50–30% fraction had the lowest G/P ratio among all tested rice varieties, withGohyakumangokuhaving the highest G/P ratio.Dewanosatohad the lowest G/P value, and this value significantly differed from that ofYamadanishikiin the 30–0% fraction. We found substantial differences in protein composition within distinct spatial regions of rice grains, and larger differences among rice varieties were observed in the rice grain’s central region.
MultiToxPred 1.0: a novel comprehensive tool for predicting 27 classes of protein toxins using an ensemble machine learning approach
Authors: Beltrán Jorge F. , Herrera-Belén Lisandra , Parraguez-Contreras Fernanda , Farías Jorge G. , Machuca-Sepúlveda Jorge , Short Stefania
Published: April 2024

Protein toxins are defense mechanisms and adaptations found in various organisms and microorganisms, and their use in scientific research as therapeutic candidates is gaining relevance due to their effectiveness and specificity against cellular targets. However, discovering these toxins is time-consuming and expensive. In silico tools, particularly those based on machine learning and deep learning, have emerged as valuable resources to address this challenge. Existing tools primarily focus on binary classification, determining whether a protein is a toxin or not, and occasionally identifying specific types of toxins. For the first time, we propose a novel approach capable of classifying protein toxins into 27 distinct categories based on their mode of action within cells. To accomplish this, we assessed multiple machine learning techniques and found that an ensemble model incorporating the Light Gradient Boosting Machine and Quadratic Discriminant Analysis algorithms exhibited the best performance. During the tenfold cross-validation on the training dataset, our model exhibited notable metrics: 0.840 accuracy, 0.827 F1 score, 0.836 precision, 0.840 sensitivity, and 0.989 AUC. In the testing stage, using an independent dataset, the model achieved 0.846 accuracy, 0.838 F1 score, 0.847 precision, 0.849 sensitivity, and 0.991 AUC. These results present a powerful next-generation tool called MultiToxPred 1.0, accessible through a web application. We believe that MultiToxPred 1.0 has the potential to become an indispensable resource for researchers, facilitating the efficient identification of protein toxins. By leveraging this tool, scientists can accelerate their search for these toxins and advance their understanding of their therapeutic potential.
Split Pool Ligation-based Single-cell Transcriptome sequencing (SPLiT-seq) data processing pipeline comparison
Authors: Kuijpers Lucas , Hornung Bastian , van den Hout - van Vroonhoven Mirjam C. G. N. , van IJcken Wilfred F. J. , Grosveld Frank , Mulugeta Eskeatnaf
Published: April 2024

Background

Single-cell sequencing techniques are revolutionizing every field of biology by providing the ability to measure the abundance of biological molecules at a single-cell resolution. Although single-cell sequencing approaches have been developed for several molecular modalities, single-cell transcriptome sequencing is the most prevalent and widely applied technique. SPLiT-seq (split-pool ligation-based transcriptome sequencing) is one of these single-cell transcriptome techniques that applies a unique combinatorial-barcoding approach by splitting and pooling cells into multi-well plates containing barcodes. This unique approach required the development of dedicated computational tools to preprocess the data and extract the count matrices. Here we compare eight bioinformatic pipelines (alevin-fry splitp, LR-splitpipe, SCSit, splitpipe, splitpipeline, SPLiTseq-demultiplex, STARsolo and zUMI) that have been developed to process SPLiT-seq data. We provide an overview of the tools, their computational performance, functionality and impact on downstream processing of the single-cell data, which vary greatly depending on the tool used.

Results

We show that STARsolo, splitpipe and alevin-fry splitp can all handle large amount of data within reasonable time. In contrast, the other five pipelines are slow when handling large datasets. When using smaller dataset, cell barcode results are similar with the exception of SPLiTseq-demultiplex and splitpipeline. LR-splitpipe that is originally designed for processing long-read sequencing data is the slowest of all pipelines. Alevin-fry produced different down-stream results that are difficult to interpret. STARsolo functions nearly identical to splitpipe and produce results that are highly similar to each other. However, STARsolo lacks the function to collapse random hexamer reads for which some additional coding is required.

Conclusion

Our comprehensive comparative analysis aids users in selecting the most suitable analysis tool for efficient SPLiT-seq data processing, while also detailing the specific prerequisites for each of these pipelines. From the available pipelines, we recommend splitpipe or STARSolo for SPLiT-seq data analysis.
Changes in temperature in preheated crystalloids at ambient temperatures relevant to a prehospital setting: an experimental simulation study with the application of prehospital treatment of trauma patients suffering from accidental hypothermia
Authors: Jensen Emil , Rentzhog Helena , Herlitz Johan , Axelsson Christer , Lundgren Peter
Published: April 2024

Background

Accidental hypothermia is common in all trauma patients and contributes to the lethal diamond, increasing both morbidity and mortality. In hypotensive shock, fluid resuscitation is recommended using fluids with a temperature of 37–42°, as fluid temperature can decrease the patient’s body temperature. In Sweden, virtually all prehospital services use preheated fluids. The aim of the present study was to investigate how the temperature of preheated infusion fluids is affected by the ambient temperatures and flow rates relevant for prehospital emergency care.

Methods

In this experimental simulation study, temperature changes in crystalloids preheated to 39 °C were evaluated. The fluid temperature changes were measured both in the infusion bag and at the patient end of the infusion system. Measurements were conducted in conditions relevant to prehospital emergency care, with ambient temperatures varying between − 4 and 28 °C and flow rates of 1000 ml/h and 6000 ml/h, through an uninsulated infusion set at a length of 175 cm.

Results

The flow rate and ambient temperature affected the temperature in the infusion fluid both in the infusion bag and at the patient end of the system. A lower ambient temperature and lower flow rate were both associated with a greater temperature loss in the infusion fluid.

Conclusion

This study shows that both a high infusion rate and a high ambient temperature are needed if an infusion fluid preheated to 39 °C is to remain above 37 °C when it reaches the patient using a 175-cm-long uninsulated infusion set. It is apparent that the lower the ambient temperature, the higher the flow rate needs to be to limit temperature loss of the fluid.
Successful therapy with tenofovir disoproxil fumarate (TDF) in patients with chronic hepatitis B (CHB) does not guarantee amelioration of liver damage assessing by transient elastography. A retrospective - prospective multicenter study
Authors: Kranidioti Hariklia , Zisimopoulos Konstantinos , Oikonomou Theodora , Voulgaris Theodoros , Siakavellas Spyros , Agorastou Polixeni , Deutsch Melanie , Triantos Christos , Goulis Ioannis , Papatheodoridis George , Manolakopoulos Spilios
Published: April 2024

Background

Preventing disease progression and viral suppression are the main goals of antiviral therapy in chronic hepatitis B (CHB). Liver stiffness measurement (LSM) by transient elastography is a reliable non-invasive method to assess liver fibrosis in patients with CHB. Our aim was to explore factors that may affect changes in LSMs during long term tenofovir (TDF) monotherapy in a well characterized cohort of patients with compensated CHB.

Methods

We analyzed serial LSMs in 103 adult patients with CHB who were on TDF monotherapy and had at least three LSMs over a period of 90 months.

Results

Twenty-five (24%) patients had advanced fibrosis at baseline. A significant decline in mean LSM between baseline and last visit (8.7 ± 6.2 kPa vs. 6.7 ± 3.3, p = 10− 3) was observed. Twenty-four (23%) patients had progression of liver fibrosis with mean increase in liver stiffness of 2.8 kPa (range: 0.2–10.2 kPa). Multivariate analysis showed that BMI ≥ 25 (OR, 0.014; 95% CI, 0.001–0.157; p = 0.001) and advanced fibrosis (OR, 5.169; 95% CI, 1.240–21.540; p = 0.024) were independently associated with a fibrosis regression of > 30% of liver stiffness compared to baseline value.

Conclusions

In CHB patients TDF monotherapy resulted in liver fibrosis regression, especially in patients with advanced fibrosis. Despite the successful antiviral effect of TDF, 1 out of 4 patients had liver fibrosis progression. Obesity and advanced fibrosis at baseline were independently associated with significant liver fibrosis regression.
Determinants of hospital readmissions in older people with dementia: a narrative review
Authors: Browne Bria , Ali Khalid , Ford Elizabeth , Tabet Naji
Published: April 2024

Introduction

Over 50% of hospitalised older people with dementia have multimorbidity, and are at an increased risk of hospital readmissions within 30 days of their discharge. Between 20-40% of these readmissions may be preventable. Current research focuses on the physical causes of hospital readmissions. However, older people with dementia have additional psychosocial factors that are likely to increase their risk of readmissions. This narrative review aimed to identify psychosocial determinants of hospital readmissions, within the context of known physical factors.

Methods

Electronic databases MEDLINE, EMBASE, CINAHL and PsychInfo were searched from inception until July 2022 and followed up in February 2024. Quantitative and qualitative studies in English including adults aged 65 years and over with dementia, their care workers and informal carers were considered if they investigated hospital readmissions. An inductive approach was adopted to map the determinants of readmissions. Identified themes were described as narrative categories.

Results

Seventeen studies including 7,194,878 participants met our inclusion criteria from a total of 6369 articles. Sixteen quantitative studies included observational cohort and randomised controlled trial designs, and one study was qualitative. Ten studies were based in the USA, and one study each from Taiwan, Australia, Canada, Sweden, Japan, Denmark, and The Netherlands. Large hospital and insurance records provided data on over 2 million patients in one American study. Physical determinants included reduced mobility and accumulation of long-term conditions. Psychosocial determinants included inadequate hospital discharge planning, limited interdisciplinary collaboration, socioeconomic inequalities among ethnic minorities, and behavioural and psychological symptoms. Other important psychosocial factors such as loneliness, poverty and mental well-being, were not included in the studies.

Conclusion

Poorly defined roles and responsibilities of health and social care professionals and poor communication during care transitions, increase the risk of readmission in older people with dementia. These identified psychosocial determinants are likely to significantly contribute to readmissions. However, future research should focus on the understanding of the interaction between a host of psychosocial and physical determinants, and multidisciplinary interventions across care settings to reduce hospital readmissions.
The mediating role of hope in the relation between uncertainty and social support with self-management among patients with ESKD undergoing hemodialysis
Authors: Parviniannasab Ali Mohammad , Dehghani Fatemeh , Hosseini Seyyed Ali
Published: April 2024

Background

Self-management behaviours are critical for patients requiring regular hemodialysis (HD) therapy. This study aimed to test the relationship between social support, uncertainty and self-management among HD patients and to explore whether hope plays a mediating role.

Methods

In a cross-sectional study, a convenience sample of 212 HD patients from two hospitals completed the Perceived Social Support Scale (PSSS), Herth Hope Index (HHI), Short form Mishel Uncertainty in Illness Scale (SF-MUIS), and hemodialysis Self-Management Instrument (HD-SMI). Data were analysed using structural equation modelling.

Results

The main finding indicated that social support positively affected self-management (β = 0.50, t = 4.97, p < 0.001), and uncertainty negatively affected self-management (β =-0.37, t=-4.12, p = < 0.001). In mediational model analysis, the effect of social support on self-management was fully mediated [(β = 0.12; 95% BC CI (0.047, 0.228)] by hope. Also, the effect of uncertainty on self-management was fully mediated [(β=- 0.014; 95% BC CI (-0.114, -0.003)] by hope.

Conclusions

“Considering factors influencing self-management in HD patients is crucial for improving quality of life. Receiving support and informational resources can not only foster hope but also reduce their uncertainty, thus aiding in enhancing clinical outcomes, quality of life, and reducing complications. “Health care providers, especially nurses were advised to accept the existence of uncertainty, help patients make optimal use of support resources, and give more importance to disambiguation to reassure them. Therefore, well-designed interventions that enhance social support and hope and reduce uncertainty may help improve self-management behaviour in HD patients.
Depression of LncRNA DANCR alleviates tubular injury in diabetic nephropathy by regulating KLF5 through sponge miR-214-5p
Authors: Kuang Yongling , Yang Juan , Sun Meimei , Rui Tingting , Yang Zhenhua , Shi Meihua
Published: April 2024

Objective

Diabetic nephropathy (DN) manifests a critical aspect in the form of renal tubular injury. The current research aimed to determine the function and mechanism of long non-coding ribonucleic acid (LncRNA) differentiation antagonising non-protein coding RNA (DANCR), with a focus on its impact on renal tubular injury.

Methods

Quantitative reverse transcription polymerase chain reaction was employed to analyze the RNA levels of DANCR in the serum of patients with DN or human proximal tubular epithelial cells (human kidney 2 [HK2]). The diagnostic significance of DANCR was assessed using a receiver operating characteristic curve. A DN model was established by inducing HK-2 cells with high glucose (HG). Cell proliferation, apoptosis, and the levels of inflammatory factors, reactive oxygen species (ROS), and malondialdehyde (MDA) were detected using the Cell Counting Kit − 8, flow cytometry, and enzyme-linked immunosorbent assay. The interaction between microRNA (miR)-214-5p and DANCR or Krüppel-like factor 5 (KLF5) was investigated using RNA immunoprecipitation and dual-luciferase reporter assays.

Results

Elevated levels of DANCR were observed in the serum of patients with DN and HG-inducted HK-2 cells (P < 0.05). DANCR levels effectively identified patients with DN from patients with type 2 diabetes mellitus. Silencing of DANCR protected against HG-induced tubular injury by restoring cell proliferation, inhibiting apoptosis, and reducing the secretion of inflammatory factors and oxidative stress production (P < 0.05). DANCR functions as a sponge for miR-214-5p, and the mitigation of DANCR silencing on HG-induced renal tubular injury was partially attenuated with reduced miR-214-5p (P < 0.05). Additionally, KLF5 was identified as the target of miR-214-5p.

Conclusion

DANCR was identified as diagnostic potential for DN and the alleviation of renal tubular injury via the miR-214-5p/KLF5 axis, following DANCR silencing, introduces a novel perspective and approach to mitigating DN.
Lung adenocarcinoma discovered during the follow-up of lung-dominant connective tissue disease: a case report and literature review
Authors: Zhu Zi Heng , Guo Yi , Wang Xiao Yin , Sun Xian Wen
Published: April 2024

Interstitial lung disease (ILD) can lead to lung cancer, which brings great challenges to differential diagnosis and comprehensive treatment. However, the clinical features of lung-dominant connective tissue disease (LD-CTD) related ILD combined with lung cancer has not been validated. We report the case of an 80-year-old woman with LD-CTD treated regularly with nintedanib who presented progressive dyspnoea and hypoxemia after recurrent viral infections. Her chest computed tomography (CT) showed aggravated interstitial fibrosis in both lower lungs with moderate right pleural effusion. Clinicians should be alert to lung cancer in patients who are experiencing poor responsiveness to treatment or acute progression of ILD. The available literatures about the differential diagnosis of clinical manifestations, imaging, treatment and prognosis of LD-CTD are reviewed and discussed in this study.
Oral health knowledge, practice and associated factors among Junior High School students of Koforidua, Ghana: a cross-sectional study
Authors: Opoku Precious , Salu Samuel , Azornu Cyril Kwami , Komesuor Joyce
Published: April 2024

Background

Oral disease poses a significant public health burden for many countries and affects individuals throughout their lifetime, causing pain, disfigurement, impairment of function and reduced quality of life. Among children and adolescents globally, there is a recognized trend of poor oral hygiene, attributed to the accumulation of plaque and calculus deposits that increase with age. This study assessed the knowledge, practice and factors associated with the practice of oral hygiene among Junior High School students (JHS) in Koforidua, in the Eastern Region of Ghana.

Methods

A school-based cross-sectional study design was conducted among 233 JHS students in Koforidua township using a multistage sampling technique. Descriptive and inferential statistics, including frequency, percentage, and Pearson’s Chi-square test, were conducted. The results were interpreted using tables and graphs.

Results

Findings from the study revealed that more than half 126 (54.1%) of the respondents had a good level of knowledge of oral hygiene. The majority 130 (55.8%) of them also had good oral hygiene practice. The findings further indicated that a significant relationship was found between the class or education level of students and good oral hygiene practice (χ2 = 17.36, p < 0.001).

Conclusion

Overall, the current study found that over half of the JHS students had good knowledge as well as practice of oral hygiene. This reinforces the significance of oral health education and awareness campaigns, especially in school settings, to improve knowledge, attitudes, and behaviours related to oral hygiene. The study however found only class or education level of students to be statistically associated with the practice of oral hygiene. While other variables did not reach statistical significance, our research serves as a starting point for further investigation and exploration of the various factors that may contribute to oral hygiene practices.
Enamel changes of bleached teeth following application of an experimental combination of chitosan-bioactive glass
Authors: Fallahzadeh Farnoosh , Nouri Fahimeh , Rashvand Ensiyeh , Heidari Soolmaz , Najafi Farhood , Soltanian Negar
Published: April 2024

Background

Considering the extensive use of bleaching agents and the occurrence of side effects such as enamel demineralization, this study aimed to assess the enamel changes of bleached teeth following the experimental application of chitosan-bioactive glass (CH-BG).

Methods

In this in vitro study, CH-BG (containing 66% BG) was synthesized and characterized by Fourier-transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD). Thirty sound human premolars were bleached with 40% hydrogen peroxide, and the weight% of calcium and phosphorus elements of the buccal enamel surface was quantified before and after bleaching by scanning electron microscopy/ energy-dispersive X-ray spectroscopy (SEM, EDX). Depending on the surface treatment of the enamel surface, the specimens were divided into three groups (n = 10): control (no treatment), MI Paste (MI), and CH-BG. Then the specimens were stored in artificial saliva for 14 days. The SEM/EDX analyses were performed again on the enamel surface. Data were analyzed by one-way ANOVA and Tukey’s test and a p-value of < 0.05 was considered statistically significant.

Results

In all groups, the weight% of calcium and phosphorus elements of enamel decreased after bleaching; this reduction was significant for phosphorus (p < 0.05) and insignificant for calcium (p > 0.05). After 14 days of remineralization, the weight% of both calcium and phosphorus elements was significantly higher compared to their bleached counterparts in both MI and CH-BG groups (p < 0.05). Following the remineralization process, the difference between MI and CH-BG groups was not significant (p > 0.05) but both had a significant difference with the control group in this regard (p < 0.05).

Conclusions

The synthesized CH-BG compound showed an efficacy comparable to that of MI Paste for enamel remineralization of bleached teeth.
Comparison of the shear bond strengths of two different polyetheretherketone (PEEK) framework materials and CAD–CAM veneer materials
Authors: Gökay Gonca Deste , Aladağ Seda Üstün
Published: April 2024

Background

This study evaluated the shear bond strength (SBS) of two different polyetheretherketone (PEEK) and CAD-CAM materials after aging.

Methods

A total of 42 frameworks were designed and milled from 2 different PEEK discs (Copra Peek, P and BioHPP, B). P and B frameworks were divided into 3 subgroups (n = 7). 14 slices were prepared each from feldspathic ceramic (Vitablocs Mark II, VM), hybrid nanoceramic (Cerasmart, CS), and polymer-infiltrated ceramic (Vita Enamic, VE) blocks. After surface preparations, the slices were cemented to P and B surfaces. The samples were subjected to thermal aging (5000 cycles). SBS of all the samples was measured. Fractured surfaces were examined by SEM/EDX analysis. The Shapiro–Wilk, Two-way Robust ANOVA and Bonferroni correction tests were used to analyze the data (a = .05).

Results

Frameworks, ceramics, and frameworks x ceramics had significant differences (p < 0.05). The highest SBS value was seen in B-VM (p < 0.05). VM offered the highest SBS with both P and B. The differences between P-VM, P-CS, P-VE and B-CS and B-VE were insignificant (p > 0.05). According to EDX analysis, ytterbium and fluorine was seen in B content, unlike P. While VM and CS contained fluorine, barium, and aluminum; sodium and aluminum were observed in the VE structure.

Conclusion

Bonding of P and B with VM offers higher SBS. VM, CS and VE did not make any difference in SBS for P, however VM showed a significant difference for B.
Physiology education in China: the current situation and changes over the past 3 decades
Authors: Wei Xuhong , Xu Ting , Guo Ruixian , Tan Zhi , Xin Wenjun
Published: April 2024

Objective

As an experimental biological science, physiology has been taught as an integral component of medical curricula for a long time in China. The teaching effectiveness of physiology courses will directly affect students' learning of other medical disciplines. The purpose of this study is to investigate the current situation and changes in physiology teaching over 30 years in Chinese medical schools.

Methods

National survey was conducted online on the platform SoJump via WeChat and the web. The head of the physiology department in medical school was asked to indicate the information of physiology education from three periods: 1991–2000, 2001–2010, and 2011–2020. The responses of 80 leaders of the Department of Physiology from mainland Chinese medical schools were included in the study for analysis.

Results

The survey showed that the class hours, both of theory and practice, had been decreased. During the past 20 years, the total number of physiology teachers, the number of physiology teachers who had been educated in medical schools, and the number of technicians had been reduced, whereas teachers with doctor’s degrees had been increased. In addition to traditional didactic teaching, new teaching approaches, including problem-based learning/case-based learning/team-based learning, integrated curriculum and formative evaluation systems, had been employed, mostly for more than 5 years, in some medical schools.

Conclusion

The present study has provided historical data regarding the current status of physiology education in China and that in the past thirty years by showing that physiology education in China has developed quickly,even it faces many challenges.
Allocating municipal services to individuals with complex rehabilitation needs – a discourse analysis of individual administrative decision letters
Authors: Ekenes Maren , Oldeide Olin , Wehling Eike
Published: April 2024

Background

Rehabilitation is considered paramount for enhancing quality of life and reducing healthcare costs. As a result of healthcare reforms, Norwegian municipalities have been given greater responsibility for allocating rehabilitation services following discharge from hospital. Individual decision letters serve as the basis for implementing services and they have been described as information labels on the services provided by the municipality. They play an important role in planning and implementing the services in collaboration with the individual applicants. Research indicates that the implementation of policies may lead to unintended consequences, as individuals receiving municipal services perceive them as fragmented. This perception is characterised by limited user involvement and a high focus on body functions. The aim of this study was to examine how municipal decision letters about service allocation incorporate the recommendations made in the official national guideline and reflect a holistic approach to rehabilitation, coordination and user involvement for individuals with comprehensive needs.

Methods

The decision letters of ten individuals with moderate to severe brain injury allocating rehabilitation services in two municipalities were examined. It was assessed whether the content was in accordance with the authorities’ recommendations, and a discourse analysis was conducted using four tools adapted from an established integrated approach.

Results

The letters primarily contained standard texts concerning legal and administrative regulations. They were predominantly in line with the official guideline to municipal service allocation. From a rehabilitation perspective, the focus was mainly on medically oriented care, scarcely referring to psychosocial needs, activity, and participation. The intended user involvement seemed to vary between active and passive status, while the coordination of services was given limited attention.

Conclusions

The written decision letters did fulfil legal and administrative recommendations for service allocation. However, they did not fulfil their potential to serve as a means of conveying rehabilitation issues, such as specification of the allocated services, a holistic approach to health, coordination, or the involvement of users in decision processes. These elements must be incorporated throughout the allocation process if the policies are to be implemented as intended. Findings can have international relevance for discussions between clinicians and policy makers.
Assessing causal links between age at menarche and adolescent mental health: a Mendelian randomisation study
Authors: Askelund Adrian Dahl , Wootton Robyn E. , Torvik Fartein A. , Lawn Rebecca B. , Ask Helga , Corfield Elizabeth C. , Magnus Maria C. , Reichborn-Kjennerud Ted , Magnus Per M. , Andreassen Ole A. , Stoltenberg Camilla , Davey Smith George , Davies Neil M. , Havdahl Alexandra , Hannigan Laurie J.
Published: April 2024

Background

The timing of puberty may have an important impact on adolescent mental health. In particular, earlier age at menarche has been associated with elevated rates of depression in adolescents. Previous research suggests that this relationship may be causal, but replication and an investigation of whether this effect extends to other mental health domains is warranted.

Methods

In this Registered Report, we triangulated evidence from different causal inference methods using a new wave of data (N = 13,398) from the Norwegian Mother, Father, and Child Cohort Study. We combined multiple regression, one- and two-sample Mendelian randomisation (MR), and negative control analyses (using pre-pubertal symptoms as outcomes) to assess the causal links between age at menarche and different domains of adolescent mental health.

Results

Our results supported the hypothesis that earlier age at menarche is associated with elevated depressive symptoms in early adolescence based on multiple regression (β =  − 0.11, 95% CI [− 0.12, − 0.09], pone-tailed < 0.01). One-sample MR analyses suggested that this relationship may be causal (β =  − 0.07, 95% CI [− 0.13, 0.00], pone-tailed = 0.03), but the effect was small, corresponding to just a 0.06 standard deviation increase in depressive symptoms with each earlier year of menarche. There was also some evidence of a causal relationship with depression diagnoses during adolescence based on one-sample MR (OR = 0.74, 95% CI [0.54, 1.01], pone-tailed = 0.03), corresponding to a 29% increase in the odds of receiving a depression diagnosis with each earlier year of menarche. Negative control and two-sample MR sensitivity analyses were broadly consistent with this pattern of results. Multivariable MR analyses accounting for the genetic overlap between age at menarche and childhood body size provided some evidence of confounding. Meanwhile, we found little consistent evidence of effects on other domains of mental health after accounting for co-occurring depression and other confounding.

Conclusions

We found evidence that age at menarche affected diagnoses of adolescent depression, but not other domains of mental health. Our findings suggest that earlier age at menarche is linked to problems in specific domains rather than adolescent mental health in general.
Evaluation of heterologous expression in Pichia pastoris of Pine Weevil TRPA1 by GFP and flow cytometry
Authors: Werin Balder , Hansson Wennersten Wilhelm , Olsson Robin , Kołodziejczyk Oliwia , Andersson Martin N. , Carlquist Magnus , Johanson Urban
Published: April 2024

Background

The wasabi receptor, also known as the Transient Receptor Potential Ankyrin 1 (TRPA1) ion channel, is a potential target for development of repellents for insects, like the pine weevil (Hylobius abietis) feeding on conifer seedlings and causing damage in forestry. Heterologous expression of TRPA1 from pine weevil in the yeast Pichia pastoris can potentially provide protein for structural and functional studies. Here we take advantage of the Green Fluorescent Protein (GFP) tag to examine the various steps of heterologous expression, to get more insight in clone selection, expression and isolation of the intact purified protein.

Results

The sequence of HaTRPA1 is reported and GFP-tagged constructs were made of the full-length protein and a truncated version (Δ1-708 HaTRPA1), lacking the N-terminal ankyrin repeat domain. Clones were screened on GFP expression plates, induced in small liquid cultures and in fed-batch cultures, and evaluated by flow cytometry and fluorescence microscopy. The screening on plates successfully identifies low-expression clones, but fails to predict the ranking of the best performing clones in small-scale liquid cultures. The two constructs differ in their cellular localization. Δ1-708 HaTRPA1 is found in a ring at the perimeter of cell, whereas HaTRPA1 is forming highly fluorescent speckles in interior regions of the cell. The pattern is consistent in different clones of the same construct and persists in fed-batch culture. The expression of Δ1-708 HaTRPA1 decreases the viability more than HaTRPA1, and in fed-batch culture it is clear that intact cells first express Δ1-708 HaTRPA1 and then become damaged. Purifications show that both constructs suffer from degradation of the expressed protein, but especially the HaTRPA1 construct.

Conclusions

The GFP tag makes it possible to follow expression by flow cytometry and fluorescence microscopy. Analyses of localization, cell viability and expression show that the former two parameters are specific for each of the two evaluated constructs, whereas the relative expression of the constructs varies with the cultivation method. High expression is not all that matters, so taking damaged cells into account, something that may be linked to protein degradation, is important when picking the most suitable construct, clone, and expression scheme.
ALPL regulates pro-angiogenic capacity of mesenchymal stem cells through ATP-P2X7 axis controlled exosomes secretion
Authors: Dong Jiayi , Zhao Wanmin , Zhao Jiangdong , Chen Ji , Liu Ping , Zheng Xueni , Li Dehua , Xue Yang , Zhou Hongzhi
Published: April 2024

Background

Early-onset bone dysplasia is a common manifestation of hypophosphatasia (HPP), an autosomal inherited disease caused by ALPL mutation. ALPL ablation induces prototypical premature bone ageing characteristics, resulting in impaired osteogenic differentiation capacity of human bone marrow mesenchymal stem cells (hBMMSCs). As angiogenesis is tightly coupled with osteogenesis, it also plays a necessary role in sustaining bone homeostasis. We have previously observed a decrease in expression of angiogenesis marker gene CD31 in the metaphysis of long bone in Alpl+/− mice. However, the role of ALPL in regulation of angiogenesis in bone has remained largely unknown.

Methods

Exosomes derived from Normal and HPP hBMMSCs were isolated and identified by ultracentrifugation, transmission electron microscopy, and nanoparticle size measurement. The effects of ALPL on the angiogenic capacity of hBMMSCs from HPP patients were assessed by immunofluorescence, tube formation, wound healing and migration assay. exo-ELISA and Western Blot were used to evaluate the exosomes secretion of hBMMSCs from HPP, and the protein expression of VEGF, PDGFBB, Angiostatin and Endostatin in exosomes respectively.

Results

We verified that ALPL ablation resulted in impaired pro-angiogenic capacity of hBMMSCs, accounting for reduced migration and tube formation of human umbilical vein endothelial cells, as the quantities and proteins composition of exosomes varied with ALPL expression. Mechanistically, loss of function of ALPL enhanced ATP release. Additional ATP, in turn, led to markedly elevated level of ATP receptor P2X7, which consequently promoted exosomes secretion, resulting in a decreased capacity to promote angiogenesis. Conversely, inhibition of P2X7 increased the angiogenic induction capacity by preventing excessive release of anti-angiogenic exosomes in ALPL deficient-hBMMSCs.

Conclusion

The ALPL–ATP axis regulates the pro-angiogenic ability of hBMMSCs by controlling exosomes secretion through the P2X7 receptor. Thus, P2X7 may be proved as an effective therapeutic target for accelerating neovascularization in ALPL–deficient bone defects.