bluuebunny/crossref_metadata_2025 huggingface dataset:
Active Enhancer Assessment by H3K27ac ChIP-seq Reveals Claudin-1 as a Biomarker for Radiation Resistance in Colorectal Cancer
Authors: Chen Zu-Xuan , Huang He-Qing , Wen Jia-Ying , Qin Li-Sha , Song Yao-Dong , Fang Ye-Ying , Zeng Da-Tong , Huang Wei-Jian , Qin Xin-Gan , Gan Ting-Qing , Luo Jie , Li Jian-Jun
Published: December 2021

Background

Colorectal cancer (CRC) represents the third most common malignant tumor in the worldwide. Radiotherapy is the common therapeutic treatment for CRC, but radiation resistance is often encountered. ChIP-seq of Histone H3K27 acetylation (H3K27ac) has revealed enhancers that play an important role in CRC. This study examined the relationship between an active CRC enhancer and claudin-1 (CLDN1), and its effect on CRC radiation resistance.

Methods

The target CRC genes of active enhancers were obtained from public H3K27ac ChIP-seq, and the genes highly expressed in radio-resistant CRC were screened and intersected with enhancer-driven genes. The clinical roles of CLDN1 in radiation resistance were examined using the t-test, standard mean deviation (SMD), summary receiver operating characteristic curve and Kaplan-Meier curves. The co-expressed genes of CLDN1 were calculated using Pearson Correlation analysis, and Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes and Gene Set Variation Analysis (GSVA) analyses were used to examine the molecular mechanisms of CLDN1.

Results

Total 13 703 CRC genes were regulated by enhancers using 58 H3K27ac ChIP-seq. Claudin-1 (CLDN1) was enhancer-driven and notably up-regulated in CRC tissues compared to non-CRC controls, with a SMD of 3.45 (95 CI % = .56-4.35). CLDN1 expression was increased in radiation-resistant CRC with a SMD of .42 (95% CI = .16-.68) and an area under the curve of .74 (95% CI = .70-.77). The cell cycle and immune macrophage levels were the most significant pathways associated with CLDN1.

Conclusion

CLDN1 as an enhancer-regulated gene that can boost radiation resistance in patients with CRC.
Study on flow and heat transfer characteristics for propane in twisted oval and the two-start twisted helically wound tube
Authors: Yu Jiawen , Chen Jie , Mi Xiaoguang , Jiang Yiqiang , Fan Xiaozhou , Zhu Zuchao
Published: December 2021

In this paper, the numerical simulation was used to study the flow and heat transfer characteristics for twisted oval and two-start twisted helically wound tubes with Reynolds numbers 4000–16,000. The significant factors that affect the flow and heat transfer characteristics were analyzed. The range of twist pitch p is 0.02–0.10 m, and ellipse ratio r is 1.2–2 for twisted oval tube, the groove depth e is 0.4–2 mm for two-start twisted tube. The result showed that the relative friction coefficient and Nusselt number increased with the increase of ellipse ratio r and decreased with the increase of twist pitch p for twisted oval helically wound tube. With the growth of Reynolds number, the effects of twist pitch p and ellipse ratio r on the flow characteristics decreased. In addition, the average level of the thermal enhancement factor TEF of the two-start twisted was higher than that of the twisted oval helically wound tube. The maximum enhancements factor TEF of 1.1312 is obtained with groove depth of 2.0, twisted pitch of 0.02, and Reynolds number of 4000 for the two-start twisted tube. Finally, new empirical formulas for flow and heat transfer in helically wound tubes were proposed for two kinds of enhanced tubes.
The 2019–2020 Chilean anti-neoliberal uprising: A catalyst for decolonial de-monumentalization
Authors: Badilla Manuela , Aguilera Carolina
Published: December 2021

This article analyzes the interventions of monuments that occurred in conjunction with the mass 2019–2020 anti-neoliberal protests in Chile where almost 400 monuments representing Spanish conquerors and colonial and nineteenth-century national heroes were pulled down, contested, or transformed. The article illustrates how a social movement against social injustices and inequalities enacted and engaged with decolonial repertoires of action. It analyzes two performative cases of toppled monuments to Pedro de Valdivia, the leading Spanish conqueror, in the southern cities of Concepción and Valdivia. It then examines recent debate about the anti-racist and decolonial de-monumentalization trend seen around the world and discusses some particularities of the Latin American case. It concludes by arguing that, although the monument interventions involved spontaneous and effervescent ritualistic affects, they are expressive of decolonial challenges to intertwined and long-standing national memories, calling for reconsideration of our national identities.
Moving Toward Person-Centered Care: Valuing Emotions in Hospital Design and Architecture
Authors: Bogaert Brenda
Published: December 2021

The intangible value of emotions is often neglected in healthcare evaluations; however, it forms an important part of the hospital experience that needs to be taken into consideration to move toward person-centered care. This article conceptualizes how space and architecture may influence patient, family, and healthcare provider emotions. Building upon Gaston Bachelard’s Poetics of Space, theories on emotional design and architecture, as well as research in environmental design, we suggest several ways to value emotions in hospital design and architecture. The first theme explores several hospital spaces (the waiting room, the hospital room, the treatment room) using Bachelard’s phenomenology in order to show how to facilitate emotional security by catering to the individual needs of the user. The second discusses the overall hospital room environment, notably the influence of light, color, and sound on the patient’s emotional experience. The third explores architectural theorist Giuliana Bruno’s theory of e(motion) to explore the hospital space as vissuto, a space of lived experiences, that invites us to rethink the design and architecture of hospital spaces to allow for patient participation. The article also gives suggestions of qualitative, person-centered methodologies that can be used to move forward this debate.
Principal Candidates’ Reflective Learning During a Full-Time Internship
Authors: Drake Timothy A. , Ivey Laura , Seaton Lacey
Published: December 2021

In this case study, we explore how principal candidates made sense of their internship by analyzing their weekly reflections during a school year. We found that candidates’ views of leadership developed from viewing leadership solely through the lens of making decisions and providing direction, to recognizing that much of the work of a school leader came from building relationships and delegating leadership responsibilities. Candidates’ experiences managing student discipline, conducting classroom walkthroughs and teacher evaluations, and leading professional development and professional learning communities (PLCs) were especially developmental. We conclude with implications for preservice training programs and future research.
Trends in Academic Achievement Within Otolaryngology: Does Fellowship Training Impact Research Productivity?
Authors: Moffatt David C. , Ferry Andrew M. , Stuart Jared M. , Supernaw Jesse D. , Wright Alex E. , Davis Erik D. , Chaaban Mohamad R.
Published: December 2021

Background

Scholarly productivity and research output vary among different subspecialties. The h-index was developed as a more wholesome metric that measures an author's contribution to literature.

Objective

Through a web-based cross-sectional analysis, we investigated the differences in scholarly impact and influence of both fellowship and nonfellowship-trained academic otolaryngologists in the United States. A secondary objective was to further understand the output among the larger fellowship fields.

Methods

A cross-sectional analysis was performed for active faculty otolaryngologists. A total of 1704 otolaryngologists were identified as faculty in residency training programs across the United States. Their h-index and publication data were gathered using the Scopus database. The data were obtained in August 2019 and analysis occurred in January 2020.

Results

Head and neck surgical faculty (25.5%) had the highest representation with fellowship experience. Among all faculty, there was no statistical difference in the overall average h-index scores when comparing faculty that had fellowship training with those who did not (12.6 and 12.1, respectively, P = .498). Rhinologists had the highest publication output per year at 3.90. Among fellowship-trained faculty, the highest average h-index and total publications were seen in head & neck surgery, while facial plastics had the lowest averages ( P < .001).

Conclusions

In this study, fellowship-trained faculty had a greater but not significant scholarly impact than nonfellowship faculty. Furthermore, there were significant variations in output among the various subspecialties of otolaryngology. Growing fields, as academic rhinology, are continuing to flourish in robust research productivity and output. This study further demonstrates the potential, growing influence of fellowship training on research involvement and academic advancement within the otolaryngology subspecialties.
Opiate Use After Endoscopic Endonasal Transsphenoidal Surgery
Authors: Wu Tara J. , Kianian Reza , Villalpando Emmanuel G. , Nakhla Morcos N. , Wells Christine , Heaney Anthony P. , Bergsneider Marvin , Wang Marilene B.
Published: December 2021

Background

The literature on opiate use after endoscopic endonasal transsphenoidal surgery (EETS) is limited.

Objective

To determine the risk factors for higher opiate use following EETS and the quantity of opiates used after discharge.

Methods

A retrospective review of 144 patients undergoing EETS from July 2018 to July 2020 was conducted. Patient, tumor, and surgical factors were documented. Pain scores and medications used on postoperative days (POD) 0 and 1, and discharge prescriptions, were recorded. Opiate use was quantified using morphine milligram equivalents (MME) dose. Multiple linear regression determined risk factors independently associated with POD0 to 1 opiate use.

Results

On POD 0 to 1, mean pain score was 4.9/10 (standard deviation [SD] ± 2.0). Mean acetaminophen use was 3.4 tablets (SD ± 1.6; 650 mg per tablet). Mean opiate use was 35.6 MME (SD ± 36.3), equivalent to 4.7 tablets (SD ± 4.8) of oxycodone 5 mg. Multiple linear regression showed that current smokers required an additional 37.1 MME ( P = .011), and patients with grade 3 intraoperative cerebrospinal fluid leaks required an additional 36.7 MME ( P = .046) on POD0 to 1. On discharge, mean opiate prescription was 117.7 MME (SD ± 102.1), equivalent to 15.7 tablets (SD ± 13.6) of oxycodone 5 mg. Thirty-nine patients (27.1%) did not require prescriptions. Only 10 patients (6.9%) required opiate refill(s) within 30 days after surgery.

Conclusion

Patients undergoing EETS have higher opiate needs compared to those undergoing endoscopic sinus surgery, although the overall requirements are still considered low. Independent risk factors associated with higher opiate use in the immediate postoperative period included current smokers and grade 3 intraoperative cerebrospinal fluid leaks.
Sharing Money With Humans Versus Computers: On the Role of Honesty-Humility and (Non-)Social Preferences
Authors: Nielsen Yngwie Asbjørn , Thielmann Isabel , Zettler Ingo , Pfattheicher Stefan
Published: December 2021

Does giving behavior in economic games reflect true prosocial preferences or is it due to confusion? Research showing that trait Honesty-Humility accounts for giving behavior suggests the former, whereas research showing that participants give money to a computer might suggest the latter. In three preregistered, well-powered studies, we examined the relation of Honesty-Humility with behavior in the Dictator Game (Study 1, N = 468) and Public Goods Game (Studies 2 and 3, each N = 313), while participants interacted either with humans (“social game”) or with a computer (“non-social game”). We found that (a) decisions in the non-social game predicted decisions in the social game, supporting the confusion hypothesis; (b) the effect of Honesty-Humility differed within and between games; and (b) participants who gave money to the computer reported acting as if they were playing with humans. Overall, the studies suggest that both prosocial preferences and confusion underlie giving behavior.
Media Framing of Women’s Football During the COVID-19 Pandemic
Authors: Parry Keith D. , Clarkson Beth G. , Bowes Ali , Grubb Laura , Rowe David
Published: December 2021

This article examines British media coverage of women’s association football during the coronavirus (COVID-19) pandemic, to identify how the media framed the women’s game and how these frames could shape the public perceptions of it. Through a database search of British-based news coverage of women’s football, 100 news articles were identified in the first 6 months after the start of the pandemic. A thematic analysis was conducted, and five dominant frames were detected in the context of COVID-19: 1) financial precariousness of women’s football; 2) the commercial prioritisation of men’s football; 3) practical consideration of the sport (e.g., alterations to national and international competitions); 4) debating the future of women’s football and 5) concern for players (e.g., welfare, uncertain working conditions). These frames depart from the past trivialisation and sexualisation of women’s sport, demonstrate the increased visibility of women’s football, and shift the narrative towards the elite stratum of the game. Most of this reporting was by women journalists, while men were shown to write less than women about women’s football. This research advocates continued diversification of the sports journalism workforce to dissolve the hegemonic masculine culture that still largely dominates the industry.
Minimally Invasive Posterior Cervical Foraminotomy Versus Anterior Cervical Fusion and Arthroplasty: Systematic Review and Meta-Analysis
Authors: Platt Andrew , Fessler Richard G. , Traynelis Vincent C. , O’Toole John E.
Published: December 2021

Study Design

Systematic review and meta-analysis.

Objectives

Patients with lateral cervical disc and foraminal pathology can be treated with anterior and posterior approaches including anterior cervical discectomy and fusion(ACDF), cervical total disc arthroplasty(TDA), and minimally invasive posterior cervical foraminotomy(MIS-PCF). Although MIS-PCF may have some advantages over the anterior approaches, few comparative studies and meta-analyses have been done to assess superiority.

Methods

This study includes a systematic review of the literature and meta-analysis of studies directly comparing minimally invasive posterior cervical foraminotomy to either anterior cervical discectomy and fusion or cervical total disc arthroplasty.

Results

In comparing patients undergoing ACDF and MIS-PCF, operative time ranged from 68 to 97.8 minutes in the ACDF group compared to 28 to 93.9 minutes in the MIS-PCF group. Mean postoperative length of stay ranged from 33.84 to 112.8 hours in the ACDF group compared to 13.68 to 83.6 hours in the MIS-PCF group. The total complication rates were 3.72% in the ACDF group and 3.73% in the MIS-PCF group. A random-effects model meta-analysis was carried out which failed to show a statistically significant difference in the complication rate between the two procedures(OR .91; 95% CI 0.13, 6.43; P = .92, I2 = 59%). The total reoperation rate was 3.5% in the ACDF group and 5.4% in the MIS-PCF group. A random-effects model meta-analysis was carried out which failed to show a statistically significant difference in the reoperation rate between the two procedures(OR .66; 95% CI 0.33, 1.33; P = .25, I2 = 0). In comparing patients undergoing TDA and MIS-PCF, operative time ranged from 90.3 to 106.7 minutes in the TDA group compared to 77.4 to 93.9 minutes in the MIS-PCF group. Mean postoperative length of stay ranged from 103.2 to 165.6 hours in the TDA group and 93.6 to 98.4 hours in the MIS-PCF group. The complication rate ranged from 23.5 to 28.6% in the TDA group and 0 to 14.3% in the MIS-PCF group. The overall reoperation rates were 2.6% in the TDA group and 10.2% in the MIS-PCF group.

Conclusions

There is no clear superiority between MIS-PCF and ACDF/TDA in terms of operative time, postoperative length of stay, or rate of complications/reoperations. Further studies with increased follow-up intervals >48 months, and higher sample sizes are necessary to determine the true superiority of MIS-PCF and anterior neck approaches in treatment of lateral disc and foraminal pathology.
Influence of Single-Digit Exclusions on Grip Strength in Healthy Male Adults
Authors: Sankar Krishnakumar , Christ Jobin
Published: December 2021

Grip strength (GS) of the human hand is vital to deal with objects of various sizes and shapes in daily life. The strength deteriorates if one or more digits of the hand are amputated. The main aim of this study was to determine the influence of single-digit exclusions on the GS. Healthy adults ( n = 102, male) with an age range of 20 to 70 years (mean ± SD, 31.92 ± 13.14 years) participated in the study. The movements of unused digits were restrained using splints to avoid digit enslaving effects. T (Thumb), (I) Index, M (Middle), R (Ring), L (Little) digits were chosen for exclusion based on the digit configurations. The digit configurations were IMRL, MRLT, IMRT IRLT and, IMLT with exclusions T, I, L, M, and, R respectively. The results of two-way ANOVA with repeated measures showed no significant interaction ( p = 0.923) between hand dominance and digit configurations. But statistical significance ( p = 0.000) was observed in digit configurations and hand dominance individually. The results of posthoc analysis using Bonferroni corrected pairwise comparisons showed no statistical significance ( p = 0.004) between IRLT and IMLT of both hands since the corrected p-value was 0.003. The outcomes of the F-test showed no statistical significance ( p > 0.05) between the digit configurations IMRLT, IMRL; IMRL, MRLT; MRLT, IMRT; IRLT, IMLT individually within dominant (D) and non-dominant (ND) hands. When the F-test was performed using the same digit configurations between both hands, statistical significance was not observed in all the configurations except IMLT ( p < 0.05). The results of the Pearson correlation of GS were observed to be very strong between the same digit configurations of D and ND hands.
Beta Blockers as Salvage Treatment in Refractory Septic Shock Complicated With Dynamic Left Ventricular Outflow Tract Obstruction: A Rare Case Presentation
Authors: Pablo Catalá-Ruiz , David Andaluz-Ojeda , Carlos Veras , Álvaro Aparisi , Williams Hinojosa , Carolina Iglesias , Marta Marcos , Leonor Nogales-Martin , Ignacio Amat , San Román Alberto
Published: December 2021

Hypotension is the main finding in patients admitted to an intensive care unit (ICU) with the diagnosis of septic shock and it is related to worse outcomes. In these patients, several underlying causes of hypotension may co-exist, including vasoplegia, hypovolemia, drug-mediated venodilation, or myocardial dysfunction. Nowadays, echocardiography has been positioned as an essential tool in any ICU set to assess fluid status, ventricular ejection fraction, or any other myocardial complications. The high sympathetic tone in severely ill patients, in addition to high doses of adrenergic drugs often needed, may provoke a hypercontractile cardiac state. In the basis of our experience, we present a case of a patient with refractory septic shock and severe hemodynamic collapse, refractory to vasopressors with concomitant respiratory deterioration due to dynamic left ventricular outflow tract obstruction (LVOTO). Transesophageal echocardiography (TOE) was used to assess hemodynamic status and to guide treatment. A critical response to intravenous β-blockers was seen, with a dramatic decrease in vasopressor dosage and respiratory support.
Vertical Drop Jump Biomechanics of Patients With a 3- to 10-Year History of Youth Sport–Related Anterior Cruciate Ligament Reconstruction
Authors: Kuntze Gregor , Nettel-Aguirre Alberto , Lorenzen Kristin N. , Küpper Jessica , Ronsky Janet L. , Whittaker Jackie L. , Emery Carolyn A.
Published: December 2021

Background:

A better understanding of movement biomechanics after anterior cruciate ligament reconstruction (ACLR) could inform injury prevention, knee injury rehabilitation, and osteoarthritis prevention strategies.

Purpose:

To investigate differences in vertical drop jump (VDJ) biomechanics between patients with a 3- to 10-year history of youth sport–related ACLR and uninjured peers of a similar age, sex, and sport.

Study Design:

Cross-sectional study. Level of evidence III.

Methods:

Lower limb kinematics and bilateral ground-reaction forces (GRFs) were recorded for participants performing 10 VDJs. Joint angles and GRF data were analyzed, and statistical analysis was performed using 2 multivariate models. Dependent variables included sagittal (ankle, knee, and hip) and coronal (knee and hip) angles at initial contact and maximum knee flexion, the rate of change of coronal knee angles (35%-90% of the support phase; ie, slopes of linear regression lines), and vertical and mediolateral GRFs (normalized to body weight [BW]). Fixed effects included group, sex, and time since injury. Participant clusters, defined by sex and sport, were considered as random effects.

Results:

Participants included 48 patients with a history of ACLR and 48 uninjured age-, sex-, and sport-matched controls (median age, 22 years [range, 18-26 years]; 67% female). Patients with ACLR demonstrated steeper negative coronal knee angle slopes (β = –0.04 deg/% [95% CI, –0.07 to –0.00 deg/%]; P = .025). A longer time since injury was associated with reduced knee flexion (β = –0.2° [95% CI, –0.3° to –0.0°]; P = .014) and hip flexion (β = –0.1° [95% CI, –0.2° to –0.0°]; P = .018). Regardless of ACLR history, women displayed greater knee valgus at initial contact (β = 2.1° [95% CI, 0.4° to 3.8°]; P = .017), greater coronal knee angle slopes (β = 0.05 deg/% [95% CI, 0.02 to 0.09 deg/%]; P = .004), and larger vertical GRFs (landing: β = –0.34 BW [95% CI, –0.61 to –0.07 BW]; P = .014) (pushoff: β = –0.20 BW [95% CI, –0.32 to –0.08 BW]; P = .001).

Conclusion:

Women and patients with a 3- to 10-year history of ACLR demonstrated VDJ biomechanics that may be associated with knee motion control challenges.

Clinical Relevance:

It is important to consider knee motion control during activities such as VDJs when developing injury prevention and rehabilitation interventions aimed at improving joint health after youth sport–related ACLR.
Cervical Spine Pathology Increases the Risk of Rotator Cuff Tear: A Population-Based Cohort Study
Authors: Wang Jr-Yi , Lin Yu-Ru , Liaw Chen-Kun , Chen Chih-Hwa , Lin Hui-Wen , Huang Shih-Wei
Published: December 2021

Background:

Patients with cervical radiculopathy typically present with shoulder pain and weakness; these symptoms are similar to those of rotator cuff disease. Studies investigating cervical spine pathology (CSP) as an independent risk factor for rotator cuff tear (RCT) are lacking in the literature.

Purpose:

To investigate the risk of RCT among patients with CSP who have undergone cervical diskectomy (CD) and to determine whether CD reduces this risk.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

The authors queried the Taiwan National Health Insurance Research Database for patients diagnosed with CSP between 2004 and 2008 and followed up until the end of 2010. A control cohort comprised patients without CSP who were age- and sex-matched in a 4-to-1 ratio with patients with CSP through propensity score matching. A Cox multivariate proportional hazards model was applied to analyze the risk factors for RCT. After adjustment for confounders, the authors calculated the hazard ratio (HR) and adjusted HR (aHR) between the study and control cohorts. The effects of CD on the risk of RCT were also analyzed.

Results:

The study included 3245 patients and 12,980 matched controls. A higher RCT incidence rate was found in the CSP cohort, with an aHR of 1.52 (95% CI, 1.22-1.89; P < .001). Patients with CSP who underwent CD had a risk of RCT similar to that of the controls, with an aHR of 1.65 (95% CI, 0.90-3.03; P > .05).

Conclusion:

Patients with CSP had a 1.52-fold higher risk of RCT than healthy controls. Patients with CSP with CD did not have a high risk of RCT, possibly indicating a protective effect of diskectomy against RCT.
Educating Nursing Students Through the Pandemic: The Essentials of Collaboration
Authors: Beauvais Audrey , Kazer Meredith , Rebeschi Lisa M. , Baker Rosemarie , Lupinacci Jeanette H.
Published: December 2021

Introduction

Throughout the COVID-19 pandemic, meeting regulatory educational requirements and graduating students competent for nursing practice was essential. Competent graduates were needed to support a strong nursing workforce in Connecticut during this chaotic time in health care. This paper describes the powerful impact of statewide collaboration toward meeting this goal.

Methods

The Connecticut League for Nursing Council of Deans and Directors (Council) organized six work groups to address the practice issues brought about by COVID-19 to continue educating nursing students and ensure a robust nursing workforce for the state. Volunteers from the Council offered to lead the groups and members joined based on interest. The six work groups were: (1) enhance communication with the Connecticut Board of Examiners for Nursing (BOEN), (2) examine academic progression policies across programs to ensure academic rigor, (3) examine integration of nursing students into professional practice and the provision of support for new graduates, (4) Strategize on transition to practice issues, (5) ensure APRN students meet the required 500 precepted direct client care hours, and (6) examine summer clinical experience options for RN and LPN students.

Conclusion

The Council's top priority was to graduate competent nursing students ready for practice. This necessitated the establishment of a framework for ongoing deep, timely discussions among Council members and with the BOEN regarding the new education imperative for creative patient care learning experiences. Through collaborative efforts, the Council was able to enhance robust and timely sharing of strategies, policies, and other guidelines. The Council has partnered with the Connecticut Nurses Association, Connecticut Hospital Association, and the Connecticut Center for Nursing Workforce to provide a strong united nursing voice for executive decision-making and within the political arena in support of the role of nursing students and faculty, and their continuous involvement within direct caregiving environments.
Personalized Nursing Care in Precision-Medicine Era
Authors: Lopes-Júnior Luís Carlos
Published: December 2021

The extensive investment and development of research in molecular biology in the last decades, mainly after the completion of the Human Genome Project, has raised many expectations regarding its impact on Precision-Medicine Era. To meet the new demands for care, it is necessary that the omics sciences be integrated into nursing practice, especially in nursing care. Based on knowledge of structural genomics, it has been improved techniques that enabled the advancement of research related to functional genomics, which together comprising the “omics” sciences including the transcriptomics, proteomics, the epigenomics and metabolomics. The current challenge is to transform this expanded set of information into clinical benefits for patients, through more accurate diagnoses, treatments, and personalized care to the particularities of individuals and communities. For Nursing, the main challenge is the incorporation of the omics sciences in training and professional practice, so that nurses can safely, scientifically, and autonomously empower themselves to provide personalized care to individuals and families based on Precision-Medicine Era. In this paper, a debate on the impacts and challenges for Nursing to incorporate the Precision-Medicine into clinical practice is described.
从《字学纂要》书写现象看金龙壮族文化心理特征
Authors: 史 维坤
Published: December 2021

文字使用作为一种社会现象，是使用者心理状态和精神面貌的一面镜子。《字学纂要》作为金龙壮族地区的工具书与识字课本，不仅是金龙壮族文字使用情况实录，更是该群体文化心理的真实写照。我们透过《字学纂要》书写现象观察金龙壮族心理特征，发现地处中越边境的金龙壮族一直以来秉持着强烈的国家认同和民族认同，同时也体现出了开放包容的心态与求真务实的作风。
Technical Considerations for an Anteromedializing Tibial Tubercle Osteotomy
Authors: Moran Thomas E. , Ignozzi Anthony J. , Dart Scott , Diduch David R.
Published: December 2021

Background:

Tibial tubercle osteotomy and distal realignment allows for adjustment to the patellofemoral articulation in order to improve patellar tracking and redistribute patellar contract pressures.

Indications:

A healthy, active 39-year-old woman status post right knee tibial tubercle osteotomy presented with >2 years of patellar instability symptoms in the left knee. Imaging revealed a tibial tubercle to trochlear groove (TT-TG) distance of 21 mm and patellar tendon lateral trochlear ridge (PT-LTR) distance of 14 mm.

Technique Description:

After knee arthroscopy is performed, an open incision is made along the inferomedial patellar tendon. Two pilot holes are created before a sagittal saw is used to make the tibial tubercle osteotomy, before completing it with an osteotome. Anteromedialization and/or distalization of the osteotomy is performed relative to templated values in order to improve patellar articulation. After correction, 3 bicortical screws are placed to achieve stable fixation.

Results:

There were no immediate complications following surgery. Surgical management led to improvement of the patient’s patellofemoral pain, which allowed return to prior baseline level of function.

Discussion/Conclusion:

The preferred technique for an anteromedialzing tibial tubercle osteotomy is presented. An anteromedializing tibial tubercle osteotomy is an effective surgical option for patients with evidence of patellar maltracking or central or lateral patellar chondromalacia whom have failed conservative management. This case demonstrates the efficacy of an anteromedializing tibial tubercle osteotomy to provide pain relief by improving patellar tracking and offloading patellar contact pressures on areas of prominent chondral wear.
Single-molecule imaging of von Willebrand factor reveals tension-dependent self-association
Authors: Fu Hongxia , Jiang Yan , Wong Wesley P. , Springer Timothy A.
Published: December 2021

von Willebrand factor (VWF) is an ultralong concatemeric protein important in hemostasis and thrombosis. VWF molecules can associate with other VWF molecules, but little is known about the mechanism. Hydrodynamic drag exerts tensile force on surface-tethered VWF that extends it and is maximal at the tether point and declines linearly to 0 at the downstream free end. Using single-molecule fluorescence microscopy, we directly visualized the kinetics of binding of free VWF in flow to surface-tethered single VWF molecules. We showed that self-association requires elongation of tethered VWF and that association increases with tension in tethered VWF, reaches half maximum at a characteristic tension of ∼10 pN, and plateaus above ∼25 pN. Association is reversible and hence noncovalent; a sharp decrease in shear flow results in rapid dissociation of bound VWF. Tethered primary VWF molecules can recruit more than their own mass of secondary VWF molecules from the flow stream. Kinetics show that instead of accelerating, the rate of accumulation decreases with time, revealing an inherently self-limiting self-association mechanism. We propose that this may occur because multiple tether points between secondary and primary VWF result in lower tension on the secondary VWF, which shields more highly tensioned primary VWF from further association. Glycoprotein Ibα (GPIbα) binding and VWF self-association occur in the same region of high tension in tethered VWF concatemers; however, the half-maximal tension required for activation of GPIbα is higher, suggesting differences in molecular mechanisms. These results have important implications for the mechanism of platelet plug formation in hemostasis and thrombosis.
Transcriptomic and metabolomic changes triggered by Macrosiphum rosivorum in rose (Rosa longicuspis)
Authors: Gao Penghua , Zhang Hao , Yan Huijun , Zhou Ningning , Yan Bo , Fan Yuanlan , Tang Kaixue , Qiu Xianqin
Published: December 2021

Background

Rose is one of the most popular flowers in the wold. Its field growth and quality are negatively affected by aphids. However, the defence mechanisms used by rose plants against aphids are unclear. Therefore, to understand the defence mechanism of rose under aphid stress, transcriptome and metabolome techniques were used to investigate the regulation mechanism in R. longicuspis infected with M. rosivorum.

Result

In our study, after inoculation with M. rosivorum, M. rosivorum quickly colonized R. longicuspis. A total of 34,202 genes and 758 metabolites were detected in all samples. Under M. rosivorum stress, R. longicuspis responded by MAPK cascades, plant hormone signal transduction pathway activation, RlMYBs and RlERFs transcription factors expression and ROS production. Interestingly, the ‘brassinosteroid biosynthesis’ pathway was significantly enriched in A3 d-vs.-A5 d. Further analysis showed that M. rosivorum induced the biosynthesis of secondary metabolites such as terpenoids, tannins and phenolic acids, among others. Importantly, the ‘glutathione metabolic’ and ‘glucosinolate biosynthesis’ pathways were significantly enriched, which involved in the rose against aphids.

Conclusion

Our study provides candidate genes and metabolites for Rosa defence against aphids. This study provides a theoretical basis for further exploring the molecular regulation mechanism of rose aphid resistance and aphid resistance breeding in the future.
Transcriptome and proteome profiling revealed molecular mechanism of selenium responses in bread wheat (Triticum aestivum L.)
Authors: Feng Xiaoqing , Ma Qian
Published: December 2021

Background

Although selenium (Se) plays important roles in scavenging free radicals, alleviating oxidative stresses, and strengthening immune system, the knowledge about Se responses in bread wheat is still limited. In order to clarify the molecular mechanism of Se responses in bread wheat, 2-week-old wheat seedlings of cultivar ‘Jimai22’ treated with 10 μM disodium selenate (Na2SeO4) for 0, 3, and 24 h were collected and analyzed by transcriptional sequencing and tandem mass tag-based (TMT) quantitative proteomics.

Results

At least 11,656 proteins and 133,911 genes were identified, and proteins including ATP sulfurylase (APS), cysteine synthase (CS), SeCys lyase, sulfate transporters, glutathione S-transferase (GSTs), glutathione peroxidase (GSH-Px), glutaredoxins (GRXs), superoxide dismutases (SODs), catalases (CATs), heat shock proteins (HSPs), UDP-glycose flavonoid glycosyltransferases (UFGTs), sucrose-6-phosphate hydrolases (Suc-6-PHs), archaeal phosphoglucose isomerases (APGIs), malate synthases (MSs), and endo-1,4-beta-xylanase (Xyn) in Se accumulation, ROS scavenging, secondary metabolism, and carbohydrate metabolism were significantly differently expressed.

Conclusions

This is the first complementary analyses of the transcriptome and proteome related with selenium responses in bread wheat. Our work enhances the understanding about the molecular mechanism of selenium responses in bread wheat.
Feasibility of using infant testing during immunization to estimate HIV mother-to-child-transmission rates in Zambia
Authors: Simbaya Joseph , Funjika Patricia , Moonga Arthur , Mwale John , Kankasa Chipepo
Published: December 2021

Background

This study piloted the feasibility of infant testing in immunization services as a strategy for estimating MTCT rates among the population of HIV exposed infants at national and subnational levels in Zambia.

Methods

The study recruited a cross-sectional nationally representative sample of 8042 caregiver-baby pairs in 38 high volume immunization sites in 7 towns across 3 provinces of Zambia. All mothers who brought their children below the age of one year for immunization at the study facilities were invited to participate in the study. All consenting mothers were interviewed and blood drawn from their babies for; rapid HIV antibody test to determine exposure and DNA PCR test for samples of all HIV-exposed babies to determine HIV infection.

Results

Of 8042 recruited caregiver–baby pairs, 1409 (17.5%) babies were HIV-exposed. Approximately 90.2% of all mothers of HIV exposed infants reported that they attended ANC visits more than two times and facility based deliveries stood at 91.6%. Exclusive breastfeeding among HIV exposed infants reduced with increase in age of infant; it was highest at 6 weeks (82.2%) followed by 10 weeks (74.0%) and 14 weeks (58.2%). MTCT rates were relatively lower than what was reported before in subnational studies and stood at 4.7% among Penta 1 seekers, 2.8% among Penta 2 seekers, 2.1% among Penta 3 seekers and 5.0% among Measles vaccination seekers. The overall MTCT rate stood at 3.8%. About 48.1% of HIV positive babies were male compared to 51.9% females. Babies of mothers below the age of 25 years accounted for almost half (51.9%) of all HIV infected babies in the study. Reported exclusive breastfeeding among HIV positive babies was 77.8% for Penta 1 seekers, 75.0% for Penta 2 seekers and 100% for Penta 3 seekers.

Conclusions

The study succeeded in estimating the MTCT rates using infant testing in immunization services, thereby demonstrating that it is feasible to use routine infant testing in immunization services as a strategy for estimating MTCT rates among the population of HIV-exposed infants in countries with high HIV burden and immunization coverage.
Propagation of a hospital-associated cluster of COVID-19 in Malaysia
Authors: Chong Diane Woei-Quan , Jayaraj Vivek Jason , Ng Chiu-Wan , Sam I-Ching , Said Mas Ayu , Ahmad Zaki Rafdzah , Hairi Noran Naqiah , Nik Farid Nik Daliana , Hoe Victor Chee-Wai , Isahak Marzuki , Ponnampalavanar Sasheela , Syed Omar Sharifah Faridah , Kamaruzzaman Shahrul Bahyah , Ong Hang-Cheng , Hasmukharay Kejal , Hasnan Nazirah , Kamarulzaman Adeeba , Chan Yoke Fun , Chong Yoong Min , Rampal Sanjay
Published: December 2021

Background

Hospitals are vulnerable to COVID-19 outbreaks. Intrahospital transmission of the disease is a threat to the healthcare systems as it increases morbidity and mortality among patients. It is imperative to deepen our understanding of transmission events in hospital-associated cases of COVID-19 for timely implementation of infection prevention and control measures in the hospital in avoiding future outbreaks. We examined the use of epidemiological case investigation combined with whole genome sequencing of cases to investigate and manage a hospital-associated cluster of COVID-19 cases.

Methods

An epidemiological investigation was conducted in a University Hospital in Malaysia from 23 March to 22 April 2020. Contact tracing, risk assessment, testing, symptom surveillance, and outbreak management were conducted following the diagnosis of a healthcare worker with SARS-CoV-2 by real-time PCR. These findings were complemented by whole genome sequencing analysis of a subset of positive cases.

Results

The index case was symptomatic but did not fulfill the initial epidemiological criteria for routine screening. Contact tracing suggested epidemiological linkages of 38 cases with COVID-19. Phylogenetic analysis excluded four of these cases. This cluster included 34 cases comprising ten healthcare worker-cases, nine patient-cases, and 15 community-cases. The epidemic curve demonstrated initial intrahospital transmission that propagated into the community. The estimated median incubation period was 4.7 days (95% CI: 3.5–6.4), and the serial interval was 5.3 days (95% CI: 4.3–6.5).

Conclusion

The study demonstrated the contribution of integrating epidemiological investigation and whole genome sequencing in understanding disease transmission in the hospital setting. Contact tracing, risk assessment, testing, and symptom surveillance remain imperative in resource-limited settings to identify and isolate cases, thereby controlling COVID-19 outbreaks. The use of whole genome sequencing complements field investigation findings in clarifying transmission networks. The safety of a hospital population during this COVID-19 pandemic may be secured with a multidisciplinary approach, good infection control measures, effective preparedness and response plan, and individual-level compliance among the hospital population.
Clinical factors associated with severe hypophosphataemia after kidney transplant
Authors: Ralston Maximilian R. , Stevenson Karen S. , Mark Patrick B. , Geddes Colin C.
Published: December 2021

Background

The mechanism by which hypophosphataemia develops following kidney transplantation remains debated, and limited research is available regarding risk factors. This study aimed to assess the association between recipient and donor variables, and the severity of post-transplantation hypophosphataemia.

Methods

We performed a single-centre retrospective observational study. We assessed the association between demographic, clinical and biochemical variables and the development of hypophosphataemia. We used linear regression analysis to assess association between these variables and phosphate nadir.

Results

87.6% of patients developed hypophosphataemia. Patients developing hypophosphataemia were younger, had a shorter time on renal replacement therapy, were less likely to have had a parathyroidectomy or to experience delayed graft function, were more likely to have received a living donor transplant, from a younger donor. They had higher pre-transplantation calcium levels, and lower alkaline phosphatase levels.

Receipt of a living donor transplant, lower donor age, not having had a parathyroidectomy, receiving a transplant during the era of tacrolimus-based immunosuppression, not having delayed graft function, higher pre-transplantation calcium, and higher pre-transplantation phosphate were associated with lower phosphate nadir by multiple linear regression.

Conclusions

This analysis demonstrates an association between variables relating to better graft function and hypophosphataemia. The links with biochemical measures of mineral-bone disease remain less clear.
The role of AKR1 family in tamoxifen resistant invasive lobular breast cancer based on data mining
Authors: Xu Dong , Zhang Yiqi , Jin Feng
Published: December 2021

Background

Tamoxifen (TAM) resistance to invasive lobular cell carcinoma is a challenge for breast cancer treatment. This study explored the role of Aldo-keto reductase family 1 (AKR1) family in tamoxifen-resistant aggressive lobular breast cancer based on data mining.

Methods

TAM-resistant invasive lobular breast cancer gene chip was downloaded from the Gene Expression Omnibus (GEO) database (accession-numbered as GSE96670). The online analytical tool GEO2R was used to screen for differentially expressed genes in TAM-resistant invasive lobular breast cancer cells and TAM-sensitive counterparts. A protein-protein interaction (PPI) networks were constructed using the STRING online platform and the Cytoscape software. GeneMANIA and GSCALite online tools were used to reveal the potential role of these hub genes in breast cancer progression and TAM resistance development. And the used the GSE67916 microarray data set to verify the differentially expression of these hub genes in breast cancer. The protein expression levels of AKR1C1, AKR1C2 and AKR1C3 in TAM-sensitive and resistant breast cancer cells were compared. The TAM sensitivity of breast cancer cells with or without AKR1C1, AKR1C2 or AKR1C3 gene manipulation was evaluated by cell viability assay.

Results

A total of 184 differentially expressed genes were screened. Compared with TAM sensitive breast cancer cells, 162 were up-regulated and 22 were down-regulated. The study identified several hub genes in the PPI network that may be involved in the development of TAM resistance of breast cancer, including signal transducer and activator of transcription 1 (STAT1), estrogen receptor alpha (ESR1), fibronectin1 (FN1), cytochrome P4501B1 (CYP1B1), AKR1C1, AKR1C2, AKR1C3 and uridine diphosphate glucuronosyltransferase (UGT) 1A family genes (UGT1A1, UGT1A3, UGT1A4, UGT1A6, UGT1A7, UGT1A8, UGT1A9, UGT1A10). Compared with TAM-sensitive counterparts, the expression levels of AKR1C1, AKR1C2, and AKR1C3 were up-regulated in TAM-resistant breast cancer cells.

Conclusions

Overexpression of each of these three genes significantly increased the resistance of breast cancer cells to TAM treatment, while their knockdown showed opposite effects, indicating that they are potential therapeutic target for the treatment of TAM-resistant breast cancer.
Prognostic significance of the combination of preoperative red cell distribution width and platelet distribution width in patients with gastric cancer
Authors: Saito Hiroaki , Shimizu Shota , Shishido Yuji , Miyatani Kozo , Matsunaga Tomoyuki , Fujiwara Yoshiyuki
Published: December 2021

Background

Platelet distribution width (PDW) and red cell distribution width (RDW) are readily obtainable data, and are reportedly useful as prognostic indicators in some cancers. However, their prognostic significance is unclear in gastric cancer (GC).

Methods

We enrolled 445 patients with histopathological diagnoses of gastric adenocarcinoma who had undergone curative surgeries.

Results

According to the optimal cut-off value of PDW and RDW by receiver operating characteristic (ROC) analysis, we divided patients into PDWHigh (≥ 16.75%), PDWLow (< 16.75%), RDWHigh (≥ 14.25%), and RDWLow (< 14.25%) subgroups. Overall survival (OS) was significantly worse in patients with PDWHigh than in those with PDWLow (P = 0.0015), as was disease specific survival (P = 0.043). OS was also significantly worse in patients with RDWHigh than in those with RDWLow (P <  0.0001), as was disease specific survival (P = 0.0002). Multivariate analysis for OS revealed that both PDW and RDW were independent prognostic indicators. Patients were then given PDW-RDW score by adding points for their different subgroups (1 point each for PDWHigh and RDWHigh; 0 points for PDWLow and RDWLow). OS significantly differed by PDW-RDW score (P <  0.0001), as did disease specific survival (P = 0.0005). In multivariate analysis for OS, PDW-RDW score was found to be an independent prognostic indicator.

Conclusions

The prognosis of GC patients can be precisely predictable by using both PDW and RDW.