bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-Term Outcomes After Toe-To-Thumb Transfers for Burn Reconstruction in Children
Authors: Yoon Alfred P , Jones Neil F
Published: June 2021

Children are one of the most vulnerable populations to burns, and hands are frequently burned anatomical structures. Restoring function in a severely burned pediatric hand is challenging. We present our experience with pediatric toe-to-thumb transfers for burn reconstruction. A retrospective review was conducted of all pediatric toe-to-thumb transfer patients between 2009 and 2014. Children younger than the age of 18 who underwent secondary reconstruction after electrical or thermal burn injuries with at least a 5-year follow-up were included. Functional outcomes were measured with the modified Kapandji score. Complications of the reconstructed hand as well as the donor foot were recorded. Four children with 10 toe-to-hand transfers (four great toes, two second toes, and two combined second–third toes) met the inclusion criteria. The average follow-up length was 104 months (range 60–144 months). Two children sustained thermal burn injuries and two sustained electrical burn injuries. Three children achieved opposition of the reconstructed toe-to-thumb transfer to the small finger (Kapandji score 5), and one child achieved opposition of the reconstructed toe-to-thumb transfer to the proximal phalanx of the middle finger, the only remaining finger (Kapandji score 3). No donor foot morbidities were noted postoperatively. Toe-to-thumb transfers should be considered the standard of care for thumb reconstruction in children with severe burn injuries of their hands to provide restoration of sensation, pinch, grasp, and opposition with minimal morbidity of the donor foot.
Evaluating and Comparing the Natural Cell Structure and Dimensions of Honey Bee Comb Cells of Chinese Bee, Apis cerana cerana (Hymenoptera: Apidae) and Italian Bee, Apis mellifera ligustica (Hymenoptera: Apidae)
Authors: Yang Shunhua , Deng Shangkao , Kuang Haiou , Zhou Danyin , Gong Xueyang , Dong Kun
Published: June 2021

The hexagonal structure of the honey bee comb cell has been the source of many studies attempting to understand its structure and function. In the storage area of the comb, only honey is stored and no brood is reared. We predicted that honey bees may construct different hexagonal cells for brood rearing and honey storage. We used quantitative analyses to evaluate the structure and function of the natural comb cell in the Chinese bee, Apis cerana cerana and the Italian bee, A. mellifera ligustica. We made cell molds using a crystal glue solution and measured the structure and inclination of cells. We found that the comb cells of A. c. cerana had both upward-sloping and downward-sloping cells; while the A. m. ligustica cells all tilted upwards. Interestingly, the cells did not conform to the regular hexagonal prism structure and showed irregular diameter sizes. In both species, comb cells also were differentiated into worker, drone and honey cells, differing in their diameter and depth. This study revealed unique differences in the structure and function of comb cells and showed that honey bees design their cells with precise engineering to increase storage capacity, and to create adequate growing room for their brood.
Root stem cell niche networks: it’s complexed! Insights from Arabidopsis
Authors: Pardal Renan , Heidstra Renze
Published: June 2021

The presence of two meristematic cell populations in the root and shoot apex allows plants to grow indefinitely. Due to its simple and predictable tissue organization, the Arabidopsis root apical meristem remains an ideal model to study mechanisms such as stem cell specification, asymmetric cell division, and differentiation in plants. The root stem cell niche consists of a quiescent organizing centre surrounded by mitotically active stem cells, which originate all root tissues. The transcription factors PLETHORA, SCARECROW, and WOX5 form signalling hubs that integrate multiple inputs from an increasing number of proteins implicated in the regulation of stem cell niche function. Recently, locally produced auxin was added to the list of important mobile factors in the stem cell niche. In addition, protein–protein interaction data elegantly demonstrate how parallel pathways can meet in a common objective. Here we discuss how multiple networks converge to specify and maintain the root stem cell niche.
A precise photometric ratio via laser excitation of the sodium layer – II. Two-photon excitation using lasers detuned from 589.16 and 819.71 nm resonances
Authors: Albert Justin E , Budker Dmitry , Chance Kelly , Gordon Iouli E , Bustos Felipe Pedreros , Pospelov Maxim , Rochester Simon M , Sadeghpour H R
Published: June 2021

This paper is the second in a pair of papers on the topic of the generation of a two-colour artificial star [which we term a laser photometric ratio star (LPRS)] of de-excitation light from neutral sodium atoms in the mesosphere, for use in precision telescopic measurements in astronomy and atmospheric physics, and more specifically for the calibration of measurements of dark energy using type Ia supernovae. The two techniques, respectively, described in both this and the previous paper would each generate an LPRS with a precisely 1:1 ratio of yellow (589/590 nm) photons to near-infrared (819/820 nm) photons produced in the mesosphere. Both techniques would provide novel mechanisms for establishing a spectrophotometric calibration ratio of unprecedented precision, from above most of Earth’s atmosphere, for upcoming telescopic observations across astronomy and atmospheric physics; thus greatly improving the performance of upcoming measurements of dark energy parameters using type Ia supernovae. The technique described in this paper has the advantage of producing a much brighter (specifically, brighter by approximately a factor of 103) LPRS, using lower power (≤30 W average power) lasers, than the technique using a single 500 W average power laser described in the first paper of this pair. However, the technique described here would require polarization filters to be installed into the telescope camera in order to sufficiently remove laser atmospheric Rayleigh backscatter from telescope images, whereas the technique described in the first paper would only require more typical wavelength filters in order to sufficiently remove laser Rayleigh backscatter.
Patterns and Causes of Signed Linkage Disequilibria in Flies and Plants
Authors: Sandler George , Wright Stephen I , Agrawal Aneil F
Published: June 2021

Most empirical studies of linkage disequilibrium (LD) study its magnitude, ignoring its sign. Here, we examine patterns of signed LD in two population genomic data sets, one from Capsella grandiflora and one from Drosophila melanogaster. We consider how processes such as drift, admixture, Hill–Robertson interference, and epistasis may contribute to these patterns. We report that most types of mutations exhibit positive LD, particularly, if they are predicted to be less deleterious. We show with simulations that this pattern arises easily in a model of admixture or distance-biased mating, and that genome-wide differences across site types are generally expected due to differences in the strength of purifying selection even in the absence of epistasis. We further explore how signed LD decays on a finer scale, showing that loss of function mutations exhibit particularly positive LD across short distances, a pattern consistent with intragenic antagonistic epistasis. Controlling for genomic distance, signed LD in C. grandiflora decays faster within genes, compared with between genes, likely a by-product of frequent recombination in gene promoters known to occur in plant genomes. Finally, we use information from published biological networks to explore whether there is evidence for negative synergistic epistasis between interacting radical missense mutations. In D. melanogaster networks, we find a modest but significant enrichment of negative LD, consistent with the possibility of intranetwork negative synergistic epistasis.
Determining subpopulation methylation profiles from bisulfite sequencing data of heterogeneous samples using DXM
Authors: Fong Jerry , Gardner Jacob R , Andrews Jared M , Cashen Amanda F , Payton Jacqueline E , Weinberger Kilian Q , Edwards John R
Published: June 2021

Epigenetic changes, such as aberrant DNA methylation, contribute to cancer clonal expansion and disease progression. However, identifying subpopulation-level changes in a heterogeneous sample remains challenging. Thus, we have developed a computational approach, DXM, to deconvolve the methylation profiles of major allelic subpopulations from the bisulfite sequencing data of a heterogeneous sample. DXM does not require prior knowledge of the number of subpopulations or types of cells to expect. We benchmark DXM’s performance and demonstrate improvement over existing methods. We further experimentally validate DXM predicted allelic subpopulation-methylation profiles in four Diffuse Large B-Cell Lymphomas (DLBCLs). Lastly, as proof-of-concept, we apply DXM to a cohort of 31 DLBCLs and relate allelic subpopulation methylation profiles to relapse. We thus demonstrate that DXM can robustly find allelic subpopulation methylation profiles that may contribute to disease progression using bisulfite sequencing data of any heterogeneous sample.
A transferrable and integrative type I-F Cascade for heterologous genome editing and transcription modulation
Authors: Xu Zeling , Li Yanran , Cao Huiluo , Si Meiru , Zhang Guangming , Woo Patrick C Y , Yan Aixin
Published: June 2021

The Class 1 type I CRISPR–Cas systems represent the most abundant and diverse CRISPR systems in nature. However, their applications for generic genome editing have been hindered due to difficulties of introducing the class-specific, multi-component effectors (Cascade) in heterologous hosts for functioning. Here we established a transferrable Cascade system that enables stable integration and expression of a highly active type I-F Cascade in heterologous bacterial hosts for various genetic exploitations. Using the genetically recalcitrant Pseudomonas species as a paradigm, we show that the transferred Cascade displayed substantially higher DNA interference activity and greater editing capacity than both the integrative and plasmid-borne Cas9 systems, and enabled deletion of large fragments such as the 21-kb integrated cassette with efficiency and simplicity. An advanced I-F-λred system was further developed to enable editing in genotypes with poor homologous recombination capacity, clinical isolates lacking sequence information, and cells containing anti-CRISPR elements Acrs. Lastly, an ‘all-in-one’ I-F Cascade-mediated CRISPRi platform was developed for transcription modulation by simultaneous introduction of the Cascade and the programmed mini-CRISPR array in one-step. This study provides a framework for expanding the diverse type I Cascades for widespread, heterologous genome editing and establishment of editing techniques in ‘non-model’ bacterial species.
Food insecurity and nutritional status among older adults: a systematic review
Authors: Pereira Marlus H Q , Pereira Maria L A S , Campos Glaucia C , Molina Maria C B
Published: June 2021

Context

Food insecurity (FI), characterized by difficulty or inability to access adequate food, has become a public health problem.

Objective

To analyze studies relating FI with nutritional status (NS) among older adults and the associated factors.

Data search

Articles published up to June 2020 were investigated in 5 databases: PubMed, Embase, Scopus, LILACS, and Web of Science. The search, selection, extraction, and quality evaluation were carried out by 2 reviewers.

Data extraction

The authors identified characteristics of the studies and the main data regarding the relationship of interest.

Results

Twenty-two studies were included in the review and their characteristics are summarized and presented using narrative synthesis. In 10 studies (45.4%), a relationship was observed between FI and malnutrition; in another 6 (27.3%), a relationship was observed between FI and being overweight.

Conclusion

A relationship was identified between FI, especially severe forms, and malnutrition, as well as between FI, especially mild forms, and people being overweight. Thus, FI among older adults relates to a 2-fold burden of nutritional outcomes, depending on the level.

Systematic Review Registration

PROSPERO registration no. CRD42020185086.
Downsizing in plants—UV light induces pronounced morphological changes in the absence of stress
Authors: Qian Minjie , Rosenqvist Eva , Prinsen Els , Pescheck Frauke , Flygare Ann-Marie , Kalbina Irina , Jansen Marcel A.K. , Strid Åke
Published: June 2021

Ultraviolet (UV) light induces a stocky phenotype in many plant species. In this study, we investigate this effect with regard to specific UV wavebands (UV-A or UV-B) and the cause for this dwarfing. UV-A- or UV-B-enrichment of growth light both resulted in a smaller cucumber (Cucumis sativus L.) phenotype, exhibiting decreased stem and petiole lengths and leaf area (LA). Effects were larger in plants grown in UV-B- than in UV-A-enriched light. In plants grown in UV-A-enriched light, decreases in stem and petiole lengths were similar independent of tissue age. In the presence of UV-B radiation, stems and petioles were progressively shorter the younger the tissue. Also, plants grown under UV-A-enriched light significantly reallocated photosynthates from shoot to root and also had thicker leaves with decreased specific LA. Our data therefore imply different morphological plant regulatory mechanisms under UV-A and UV-B radiation. There was no evidence of stress in the UV-exposed plants, neither in photosynthetic parameters, total chlorophyll content, or in accumulation of damaged DNA (cyclobutane pyrimidine dimers). The abscisic acid content of the plants also was consistent with non-stress conditions. Parameters such as total leaf antioxidant activity, leaf adaxial epidermal flavonol content and foliar total UV-absorbing pigment levels revealed successful UV acclimation of the plants. Thus, the UV-induced dwarfing, which displayed different phenotypes depending on UV wavelengths, occurred in healthy cucumber plants, implying a regulatory adjustment as part of the UV acclimation processes involving UV-A and/or UV-B photoreceptors.
Genome- and transcriptome-wide off-target analyses of an improved cytosine base editor
Authors: Randall Linnell Bentley , Sretenovic Simon , Wu Yuechao , Yin Desuo , Zhang Tao , Eck Joyce Van , Qi Yiping
Published: June 2021

Cytosine base editors (CBEs) are the promising tools for precise genome editing in plants. It is important to investigate potential off-target effects of an efficient CBE at the genome and transcriptome levels in a major crop. Based on comparison of five cytidine deaminases and two different promoters for expressing single-guide RNAs (sgRNAs), we tested a highly efficient A3A/Y130F-BE3 system for efficient C-to-T base editing in tomato (Solanum lycopersicum). We then conducted whole-genome sequencing of four base-edited tomato plants, three Green fluorescent protein (GFP)-expressing control plants, and two wild-type plants. The sequencing depths ranged from 25× to 49× with read mapping rates >97%. No sgRNA-dependent off-target mutations were detected. Our data show an average of approximately 1,000 single-nucleotide variations (SNVs) and approximately 100 insertions and deletions (indels) per GFP control plant. Base-edited plants had on average elevated levels of SNVs (approximately 1,250) and indels (approximately 300) per plant. On average, about 200 more C-to-T (G-to-A) mutations were found in a base-edited plant than a GFP control plant, suggesting some level of sgRNA-independent off-target effects, though the difference is not statistically significant. We also conducted RNA sequencing of the same four base-edited plants and three GFP control plants. An average of approximately 200 RNA SNVs was discovered per plant for either base-edited or GFP control plants. Furthermore, no specific enrichment of C-to-U mutations can be found in the base-edited plants. Hence, we cannot find any evidence for bona fide off-target mutations by A3A/Y130F-BE3 at the transcriptome level.
Effect of the phosphodiesterase 4 inhibitor apremilast on cardiometabolic outcomes in psoriatic disease—results of the Immune Metabolic Associations in Psoriatic Arthritis study
Authors: Ferguson Lyn D , Cathcart Susanne , Rimmer Dominic , Semple Gary , Brooksbank Katriona , Paterson Caron , Brown Rosemary , Harvie John , Gao Xuan , Radjenovic Aleksandra , Welsh Paul , McInnes Iain B , Sattar Naveed , Siebert Stefan
Published: June 2021

Objectives

Studies have suggested phosphodiesterase 4 (PDE4) inhibition may be associated with weight loss and other cardiometabolic benefits. We evaluated the effect of the PDE4 inhibitor apremilast on body weight and composition, glucose homeostasis, lipid profiles and vascular function in psoriatic disease and whether weight change correlated with therapeutic response.

Methods

We conducted a prospective, open-label study (Immune Metabolic Associations in Psoriatic Arthritis) of adults receiving apremilast 30 mg as part of routine care for PsA and/or psoriasis. Cardiometabolic, anthropometric and disease activity assessments were performed at baseline (pre-apremilast) and at months 1, 3 and 6 of apremilast treatment in 60 patients. A subgroup underwent further assessment of endothelial function, body composition and adipocyte morphology.

Results

In patients (median age 54.5 years, 63% women, median BMI 33.2 kg/m2), apremilast was associated with a mean weight loss of 2.2 kg (95% CI 1.4, 3.0; P < 0.001) and a mean BMI decrease of 0.8 kg/m2 (95% CI 0.5, 1.2; P < 0.001) after 6 months of treatment. Body composition analysis demonstrated a reduction in total abdominal fat [mean decrease 0.52 L (95% CI 0.08, 0.96), P = 0.022], principally subcutaneous adipose tissue [mean decrease 0.37 L (95% CI 0.05, 0.68), P = 0.022]. There was no change in adipocyte diameter, haemoglobin A1c, lipid, glucagon-like peptide-1 or vascular function. Psoriatic disease activity improved with apremilast, although this was not correlated with weight change.

Conclusion

Following apremilast treatment, we observed weight loss, principally abdominal subcutaneous fat, and improvement in psoriatic disease activity. The latter was independent of weight change, suggesting apremilast likely acts through direct immunological mechanisms.
Dynamic Interplay Between Insight and Persistent Negative Symptoms in First Episode of Psychosis: A Longitudinal Study
Authors: Raucher-Chéné Delphine , Bodnar Michael , Lavigne Katie M , Malla Ashok , Joober Ridha , Lepage Martin
Published: June 2021

Persistent negative symptoms (PNS) are an important factor of first episode of psychosis (FEP) that present early on in the course of illness and have a major impact on long-term functional outcome. Lack of clinical insight is consistently associated with negative symptoms during the course of schizophrenia, yet only a few studies have explored its evolution in FEP. We sought to explore clinical insight change over a 24-month time period in relation to PNS in a large sample of FEP patients. Clinical insight was assessed in 515 FEP patients using the Scale to assess Unawareness of Mental Disorder. Data on awareness of illness, belief in response to medication, and belief in need for medication were analyzed. Patients were divided into 3 groups based on the presence of negative symptoms: idiopathic (PNS; n = 135), secondary (sPNS; n = 98), or absence (non-PNS; n = 282). Secondary PNS were those with PNS but also had clinically relevant levels of positive, depressive, or extrapyramidal symptoms. Our results revealed that insight improved during the first 2 months for all groups. Patients with PNS and sPNS displayed poorer insight across the 24-month period compared to the non-PNS group, but these 2 groups did not significantly differ. This large longitudinal study supported the strong relationship known to exist between poor insight and negative symptoms early in the course of the disorder and probes into potential factors that transcend the distinction between idiopathic and secondary negative symptoms.
Patterns of concomitant prescription, over-the-counter and natural sleep aid use over a 12-month period: a population based study
Authors: Cheung Janet M Y , Jarrin Denise C , Beaulieu-Bonneau Simon , Ivers Hans , Morin Geneviève , Morin Charles M
Published: June 2021

Study Objectives

Concomitant patterns of sleep aid use may provide insight for understanding the transition to chronic sleep medication use. Therefore, we sought to characterize the trajectories of concomitant natural product (NP), over-the-counter (OTC), and prescribed (Rx) sleep aid use in a population-based sample over 12-months.

Methods

Self-reported data on the use of NP, OTC, and Rx sleep aids were extracted from a Canadian longitudinal study on the natural history of insomnia (N = 3416, M age = 49.7 ± 14.7 years old; 62% women) at baseline, 6-month, and 12-month. Latent class growth modeling was used to identify latent class trajectories using MPlus Version 7. Participants completed a battery of clinical measures: Ford Insomnia Response to Stress Test, abbreviated Dysfunctional Beliefs and Attitudes about Sleep Scale, Beck Depression Inventory, Insomnia Severity Index and, the Pittsburgh Sleep Quality Index. Associations between class membership and baseline covariates were evaluated.

Results

Concurrent sleep aid use fell into six distinct latent class trajectories over a 12-month period: Minimal Use (74.5%), Rx-Dominant (11.3%), NP-Dominant (6.3%), OTC-Dominant (4.3%), Rx-NP-Dominant (2.4%), and Rx-OTC-Dominant (1.1%). The three latent classes with prominent prescribed agent use predicted greater incidence of healthcare professional consultations for their sleep (p < 0.05), poorer sleep quality (p < 0.001), elevated dysfunctional sleep beliefs (p < 0.001), and sleep reactivity (p < 0.001). Compared to the other four latent classes, clinical profiles of Rx-NP-dominant and Rx-OTC-dominant groups endorsed greater severity across measures.

Conclusions

Patterns of sleep aid use may provide insight for identifying individuals who may be vulnerable to inappropriate self-medicating practices.
Assessment of obstructive sleep apnea-related sleep fragmentation utilizing deep learning-based sleep staging from photoplethysmography
Authors: Huttunen Riku , Leppänen Timo , Duce Brett , Oksenberg Arie , Myllymaa Sami , Töyräs Juha , Korkalainen Henri
Published: June 2021

Study Objectives

To assess the relationship between obstructive sleep apnea (OSA) severity and sleep fragmentation, accurate differentiation between sleep and wakefulness is needed. Sleep staging is usually performed manually using electroencephalography (EEG). This is time-consuming due to complexity of EEG setup and the amount of work in manual scoring. In this study, we aimed to develop an automated deep learning-based solution to assess OSA-related sleep fragmentation based on photoplethysmography (PPG) signal.

Methods

A combination of convolutional and recurrent neural networks was used for PPG-based sleep staging. The models were trained using two large clinical datasets from Israel (n = 2149) and Australia (n = 877) and tested separately on three-class (wake/NREM/REM), four-class (wake/N1 + N2/N3/REM), and five-class (wake/N1/N2/N3/REM) classification. The relationship between OSA severity categories and sleep fragmentation was assessed using survival analysis of mean continuous sleep. Overlapping PPG epochs were applied to artificially obtain denser hypnograms for better identification of fragmented sleep.

Results

Automatic PPG-based sleep staging achieved an accuracy of 83.3% on three-class, 74.1% on four-class, and 68.7% on five-class models. The hazard ratios for decreased mean continuous sleep compared to the non-OSA group obtained with Cox proportional hazards models with 5-s epoch-to-epoch intervals were 1.70, 3.30, and 8.11 for mild, moderate, and severe OSA, respectively. With EEG-based hypnograms scored manually with conventional 30-s epoch-to-epoch intervals, the corresponding hazard ratios were 1.18, 1.78, and 2.90.

Conclusions

PPG-based automatic sleep staging can be used to differentiate between OSA severity categories based on sleep continuity. The differences between the OSA severity categories become more apparent when a shorter epoch-to-epoch interval is used.
The Japanese Red Cross Society’s Emergency Responses in Hiroshima and Nagasaki, 1945
Authors: SUZUKI Michiko
Published: June 2021

The previously unstudied records of the Japanese Red Cross Society (JRCS) narrate the heroic tale of the Red Cross personnel who carried out the organisation’s emergency response in the immediate aftermath of the nuclear detonations in Hiroshima and Nagasaki in August 1945. Aid workers began relief activities on the day of the bombings, while many themselves were suffering from injuries and radiation sickness. They treated civilians, soldiers, and Allied POWs without discrimination. Why did these aid-givers choose to work for the Red Cross in the face of such extreme risk? Why were they willing to walk into ground zero to render aid to survivors? JRCS records make clear that, as well-trained nurses and doctors, most aid workers understood the mortal dangers they faced from radioactive poisoning. This article argues that their actions in Hiroshima and Nagasaki were attributable to strict quasi-military training, which transcended the ideology of the JRCS as an imperialist institution. Their emergency responses demonstrate the extent to which Red Cross workers had internalised their professional mission as medical aid-givers and eventually emerged as exemplars of the humanitarian relief ideal.
Effects of music therapy on cancer-related fatigue, anxiety, and depression in patients with digestive tumors
Authors: Chen Xiaxia , Wei Qiuya , Jing Ruirui , Fan Yong
Published: June 2021

Background:

Digestive tumor is one of the most common cancers, its symptoms and treatment will bring patients with anxiety, depression and other negative emotions, and cause cancer-related fatigue. As a new complementary replacement therapy, music therapy can greatly reduce cancer-related fatigue, anxiety and depression, and achieve good clinical results, but there is a lack of evidence-based medicine. The purpose of this study is to evaluate the effect of music therapy on cancer-related fatigue, anxiety, and depression in patients with digestive tumors by meta-analysis.

Method:

Computer search of Chinese and English databases: Wanfang, VP Information Chinese Journal Service Platform, China National Knowledge Infrastructure, Chinese BioMedicine Literature Database and pubmed, embase, cochrane, web of science. A comprehensive collection of relevant studies on the effects of music therapy on digestive tract cancer-related fatigue, anxiety and depression, the retrieval time is from the date of establishment to March 2021. According to the inclusion and exclusion criteria, the literature is selected, the quality of the literature is evaluated and the data are extracted. The data are analyzed by meta-analysis.

Result:

The purpose of this study is to evaluate the effect of music therapy on digestive tract cancer-related fatigue, anxiety, and depression by European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire, Hamilton Depression Scale, and Hamilton Anxiety Scale .

Conclusion:

This study will provide reliable evidence-based evidence for the clinical application of music therapy in the treatment of digestive tract cancer-related fatigue and anxiety and depression.

OSF Registration number:

DOI 10.17605/OSF.IO/UR4GV.
Retinal toxicity caused by hydroxychloroquine in patients with systemic lupus erythematosus
Authors: Wang Gang , Zhuo Ning , Liao Zheng , Qi Wei , Tian Feng , Wen Zhenhua , Li Jingyang
Published: June 2021

Rationale:

Hydroxychloroquine has excellent anti-inflammatory and immunomodulatory effects as one of the antimalarial drugs. In particular, hydroxychloroquine was once widely used as a treatment for the new coronavirus pneumonia epidemic in 2020. Retinopathy caused by hydroxychloroquine is normally irreversible, but little attention has been paid to it.

Patient concerns:

A 38-year-old young Chinese woman was taking oral hydroxychloroquine 400 mg daily to control lupus disease activity for six years after the diagnosis of systemic lupus erythematosus (SLE). She did not have any history of eye disease and was admitted to the hospital with a sudden blurring of both eyes.

Diagnoses:

The diagnosis of retinal macular degeneration caused by hydroxychloroquine was made after excluding other interfering diseases based on the patient's long-term use of hydroxychloroquine and the results of the eye examination.

Interventions:

The patient was discontinued from hydroxychloroquine. To control the recurrence of SLE, she was given intravenous methylprednisolone, oral tacrolimus and mycophenolate. Meanwhile, she was asked to take extra care of her eyes and to come to the hospital every three months to have her vision checked.

Outcomes:

The patient's blurred vision improved one week later. Three months later, her vision examination showed no further decline (0.4 in the right eye and 0.6 in the left eye). Meanwhile, the SLE disease activity index (SLEDAI) decreased from six points to five points currently.

Lessons:

Retinopathy caused by hydroxychloroquine is irreversible and there is no particularly effective treatment. Discontinuation of hydroxychloroquine, better daily eye protection, and regular vision checks are the keys to preventing retinopathy. Although hydroxychloroquine causing retinal toxicity was mentioned several years ago, the rate and severity of retinal toxicity require further research. How to get more patients to take care of their eyes requires continuous and increased education by doctors.
Soy diet for nonalcoholic fatty liver disease
Authors: Xiong Pian , Zhu Yong-Fen
Published: June 2021

Introduction:

The efficacy of soy diet for nonalcoholic fatty liver disease remains controversial. We conduct a systematic review and meta-analysis to explore the influence of soy diet vs placebo on the treatment of non-alcoholic fatty liver disease.

Methods:

We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through October 2020 for randomized controlled trials assessing the efficacy of soy diet vs placebo for nonalcoholic fatty liver disease. This meta-analysis is performed using the random-effect model.

Results:

Five randomized controlled trials are included in the meta-analysis. Overall, compared with control group for nonalcoholic fatty liver disease, soy diet is associated with significantly reduced HOMA-IR (standard mean difference [SMD] = −0.42; 95% confidence interval [CI] = −0.76 to −0.08; P = .01), increased insulin (SMD = −0.64; 95% CI = −0.98 to −0.30; P = .0002) and decreased malondialdehyde (SMD = −0.43; 95% CI = −0.74 to −0.13; P = .005), but demonstrated no substantial impact on body mass index (SMD = 0.17; 95% CI = −0.20 to 0.53; P = .37), alanine aminotransferase (SMD = −0.01; 95% CI = −0.61 to 0.60; P = .98), aspartate-aminotransferase (SMD = 0.01; 95% CI = −0.47 to 0.49; P = .97), total cholesterol (SMD = 0.05; 95% CI = −0.25 to 0.35; P = .73) or low density lipoprotein (SMD = 0; 95% CI = −0.30 to 0.30; P = .99).

Conclusions:

Soy diet may benefit to alleviate insulin resistance for nonalcoholic fatty liver disease.
MicroRNA-182 is a potential biomarker for prognosis of gastric cancer
Authors: Xiao Dachun , Xie Jian , Wu Shuai
Published: June 2021

Background:

Being the second leading cause of cancer death in the world, gastric cancer is a common malignant tumor in digestive system. Most patients were diagnosed in advanced stage and had poor prognosis. In recent years, related studies have displayed that MicroRNA-182 (miRNA-182) can promote the proliferation, infiltration, metastasis and drug resistance of tumor cells, so it can be used as a new molecular marker for the early diagnosis, prognosis, and treatment of tumors. However, the expression and prognosis of miRNA-182 in gastric cancer are not clear. Therefore, this study conducted a meta-analysis to further clarify the relationship between the expression of miRNA-182 in gastric cancer and prognosis. In addition, a bioinformatics analysis was adopted to further analyze the possible molecular mechanism of miRNA-182, so as to provide a theoretical basis for the diagnosis, treatment, and prognosis of patients suffering from gastric cancer.

Methods:

The following electronic databases were searched on computer: Wanfang, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure, the Chongqing VIP Chinese Science and Technology Periodical Database, PubMed, Embase, and Web of Science databases. The retrieval time is set to build the database until April 2021. Combined hazard ratios (HRs) and 95% confidence intervals (95% CIs) were used to evaluate the effects of miRNA-182 on the prognosis of gastric cancer. Stata 16.0 software was applied for the meta-analysis. The expression of miRNA-182 in gastric cancer was analyzed by Gene Expression Omnibus database and The Cancer Genome Atlas database. The survival curve of miRNA-182 differential expression was analyzed by OncomiR. The target genes of miRNA-182 were predicted by TargetScan, miRBase, miRTarBase, starBase V2.0, and miRWalk. The target genes were obtained by the intersection of Wayne diagram. DAVID database was used for gene ontology (GO) and Kyoto encyclopedia of genes and genomes enrichment analysis. STRING database and Cytoscape were applied to construct Protein-protein interaction network to obtain key genes (hub gene). The expression of hub gene in gastric cancer was analyzed by gene expression profiling interactive analysis. The survival curve between hub gene and prognosis of gastric cancer was drawn by Kaplan-Meier Plotter database. TIMER database was used to analyze the relationship between hub gene expression and immune cell infiltration in gastric cancer.

Results:

The results of this meta-analysis will be submitted to a peer-reviewed journal for publication.

Conclusion:

This study provides high-quality evidence support for the expression of miRNA-182 and the prognosis of gastric cancer. Through bioinformatics analysis, we further discussed the mechanism of miRNA-182 in gastric cancer and the understanding of related pathways.

OSF Registration Number:

DOI 10.17605/OSF.IO/EHJ6X.
Identify the triple-negative and non-triple-negative breast cancer by using texture features of medicale ultrasonic image
Authors: Chen Qingyu , Xia Jianguo , Zhang Jun
Published: June 2021

The study aimed to explore the value of ultrasound (US) texture analysis in the differential diagnosis of triple-negative breast cancer (TNBC) and non-TNBC.

Retrospective analysis was done on 93 patients with breast cancer (35 patients with TNBC and 38 patients with non-TNBC) who were admitted to Taizhou people's hospital from July 2015 to June 2019. All lesions were pathologically proven at surgery. US images of all patients were collected. Texture analysis of US images was performed using MaZda software package. The differences between textural features in TNBC and non-TNBC were assessed. Receiver operating characteristic curve analysis was used to compare the diagnostic performance of textural parameters showing significant difference.

Five optimal texture feature parameters were extracted from gray level run-length matrix, including gray level non-uniformity (GLNU) in horizontal direction, vertical gray level non-uniformity, GLNU in the 45 degree direction, run length non-uniformity in 135 degree direction, GLNU in the 135 degree direction. All these texture parameters were statistically higher in TNBC than in non-TNBC (P <.05). Receiver operating characteristic curve analysis indicated that at a threshold of 268.9068, GLNU in horizontal direction exhibited best diagnostic performance for differentiating TNBC from non-TNBC. Logistic regression model established based on all these parameters showed a sensitivity of 69.3%, specificity of 91.4% and area under the curve of 0.834.

US texture features were significantly different between TNBC and non-TNBC, US texture analysis can be used for preliminary differentiation of TNBC from non-TNBC.
Predictive value of miRNA-126 on in-stent restenosis in patients with coronary heart disease
Authors: Qiu Xianke , Wang Jun , Shi Zhongping , Ji Xiaojun , Huang Yiwei , Dai Haiyue
Published: June 2021

Background:

In-stent restenosis (ISR) is one of the most important complications and impacts the long-term effects after percutaneous coronary intervention (PCI) in patients with coronary heart disease (CHD). Related studies have revealed that microRNA (miRNA) can predict ISR in CHD patients. MiRNA-126 may be a potential biomarker for the diagnosis of ISR. However, the accuracy of miRNA-126 in the diagnosis of ISR is still controversial. Therefore, this study carried out meta-analysis to further evaluate the accuracy of miRNA-126 in the diagnosis of ISR. At the same time, bioinformatics is used to predict the target genes and miRNA-126 may be involved in regulation, so as to provide theoretical support for the precise treatment of CHD.

Methods:

The literatures on the miRNA-126 diagnosis of ISR in CHD patients were collected by searching on computer through China National Knowledge Infrastructure, Wanfang, China Biology Medicine disc, PubMed, EMBASE, Cochrane Library and Web of Science. The retrieval time is set to build the database until April 2021. The meta-analysis of the literatures that meet the quality standards was conducted by Stata 16.0 software. TargetScan database, PicTar database, miRanda database, and miRDB database were used to predict miRNA-126 intersection target genes. Gene Ontology (GO) functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) signal pathway enrichment analysis of miRNA-126 target genes were performed by using DAVID database. STRING database was applied to analyze the protein-protein interaction (PPI) network of miRNA-126 target genes. The “Networkanalyzer” function of Cytoscape3.7.2 software is adopted to analyze the network topology attributes, so as to find out the core genes of PPI network.

Results:

The results of this meta-analysis will be submitted to a peer-reviewed journal for publication.

Conclusion:

In this study, meta-analysis and bioinformatics analysis were adopted to further evaluate the accuracy of miRNA-126 in the diagnosis of ISR in CHD patients, and to explore the mechanism of the action of miRNA-126 and understand related pathways.

Ethics and dissemination:

The private information from individuals will not be published. This systematic review also should not damage participants’ rights. Ethical approval is not available. The results may be published in a peer-reviewed journal or disseminated in relevant conferences.

OSF REGISTRATION NUMBER:

DOI 10.17605/OSF.IO/9FMR5.
Surgical management of complicated gynecomastia (associated with foreign body injection) with single-port 3-dimensional videoscope-assisted endoscopic subcutaneous mastectomy and concurrent liposuction
Authors: Wen Tzu-Cheng , Lai Hung-Wen , Mok Chi Wei , Chen Shou-Tung , Chen Dar-Ren , Kuo Shou-Jen
Published: June 2021

Rationale:

Gynecomastia is a common benign breast disorder in men. Surgical management of gynecomastia includes that of a subcutaneous mastectomy with or without concurrent liposuction. Herein, the authors presented a case of complicated gynecomastia (gynecomastia with concurrent foreign body injection) which was successfully managed with an innovative technique that offered acceptable operative time, minimal complications, good recovery and satisfactory aesthetic outcome.

Patient Concerns:

A 39-year-old Taiwanese man who developed gynecomastia along with self-injection of foreign body (salad oil) over the past 10 years for breast enlargement presented as symptomatic bilateral breast lumps.

Diagnosis:

Bedside sonography revealed multiple large droplets of oil in the subcutaneous tissue bilaterally, resembling cystic lesions.

Intervention:

Bilateral single-port 3-dimensional videoscope-assisted endoscopic subcutaneous mastectomy was performed after bilateral breast liposuction. Operative findings include bilateral gynecomastia and previous bilateral breast foreign body material. The total weight of lipoaspirate was 400 grams and 300 grams for right and left side respectively. Subcutaneous mastectomy specimen weight was 820 grams and 661 grams for right and left breast tissue.

Outcomes:

Operative duration was 315 minutes and intraoperative blood loss at 150 ml. Patient was discharged 2 days after the operation, and subsequent follow up ultrasound showed complete removal of foreign bodies and fibrotic breast tissue. Patient was satisfied with the post-operative aesthetic outcomes.

Lessons:

Single-port 3-dimensional videoscope-assisted endoscopic subcutaneous mastectomy with concurrent liposuction is a promising and safe surgical option for patient with complicated gynecomastia and severe fibrosis.
The application value of continuous nursing intervention on quality of life in patients with stroke
Authors: Han Cai-Yan , Yu Xia
Published: June 2021

Background:

Individual characteristics, physical function disability, emotional, as well as cognitive symptoms, along with the general health discernment might be associated or impact the quality of life of patients suffering from stroke directly or indirectly. Appropriate continuous nursing intervention is required to enhance the quality of life of patients with stroke. Therefore, the present study will be conducted to systematically investigate the application value of continuous nursing intervention for improving the quality of life of patients experiencing stroke.

Methods:

We will conduct a comprehensive search of electronic databases such as MEDLINE, Cochrane Library, CINAHL, EMBASE, Scopus, Chinese National Knowledge Infrastructure, and WanFang databases to identify relevant publications. We will only include studies published in English or Chinese languages. Accordingly, randomized controlled trials evaluating the application value of continuous nursing intervention for improving the quality of life of patients suffering from stroke will be included. We will use 2 independent authors to conduct study selection, extract data, and evaluate the quality of the included studies. In case of any discrepancies, they will be addressed by consensus. Also, we will use RevMan 5.3 software to carry out the statistical analysis.

Results:

The current study will summarize high-quality evidence to systematically explore application value of continuous nursing intervention for improving the quality of life in patients with stroke.

Conclusion:

The present study will summarize the direct and indirect pieces of evidence to ascertain whether continuous nursing intervention can improve the quality of life in patients with stroke.

Ethics and dissemination:

Ethical approval will not be required.

Registration number:

April 25, 2021.osf.io/xnrzt/ (https://osf.io/xnrzt/).
Worldwide prevalence of early repolarization pattern in general population and physically active individuals
Authors: Ji Hong-Yan , Hu Nan , Liu Rui , Zhou Hai-Rong , Gao Wei-Liang , Quan Xiao-Qing
Published: June 2021

Background:

The early repolarization pattern (ERP) has recently been associated with cardiac events such as ventricular arrhythmias and sudden cardiac death. However, estimates of the prevalence of ERP vary widely, especially between the general population and physically active individuals. We performed this systematic review and meta-analysis to quantitatively evaluate the worldwide prevalence of ERP in the general population and physically active individuals.

Methods:

We thoroughly searched the PubMed, EMBASE, Web of science, the Cochrane Library, and Scopus databases for relevant studies published until December 20, 2020. Studies in which prevalence was presented or could be estimated from eligible data were included. The pooled prevalence was analyzed using a random-effect model.

Results:

Finally, we included 29 studies (182,135 subjects) in the general population and 14 studies (8087 subjects) in the physically active individuals. The worldwide pooled prevalence of ERP in the general population was 11.6% (95% confidence interval [CI]: 10.0%–13.3%). The incidence of ERP was 17.0% and 6.2% in men and women, respectively. The prevalence was 20.9% in blacks, 13.4% in Asians, and 10.1% in Caucasians. Additionally, the prevalence of ERP in physically active individuals was 33.9% (95% CI: 25.3%–42.6%).

Conclusion:

A significant difference in the worldwide prevalence of ERP is revealed in this study. The ERP is highly prevalent in men, blacks, and physically active individuals.
Effect assessment of evidence-based nursing in combination with clinical nursing pathway on nephrotic syndrome care in children
Authors: Yu Xia , Han Cai-Yan
Published: June 2021

Background:

Childhood nephrotic syndrome is widespread in pediatric nephrology. In most cases, it needs hospitalization for patient management. An increasing number of studies report that proper nursing care could promote the rate of treatment and improve post-treatment prognosis. Clinical nursing pathways refer to innovative nursing modes with high-quality, excellent efficacy, and low costing treatment. There are reports on how nursing methods that utilize data combine with clinical nursing pathway to enhance nephrotic syndrome care in kids. However, the results remain controversial. Therefore, it is necessary to conduct this study to systematically explore how evidence-based nursing combined with clinical nursing pathway plays a role in nephrotic syndrome care among children.

Methods:

This study protocol will conduct a comprehensive search on MEDLINE, Cochrane Library, CINAHL, EMBASE, Scopus, Chinese National Knowledge Infrastructure, WanFang, and Web of Science electronic databases to identify relevant research articles from inception to April 25, 2021. Studies in both English and Chinese languages are used for this study. This study protocol will analyze randomized controlled trials that investigated the role of evidence-based nursing combined with clinical nursing pathway to care for nephrotic syndrome in children. Two authors will independently screen the search results, select suitable studies for inclusion, extract the characteristics and outcome data of the selected studies, and evaluate the risk of bias based on standard Cochrane methodology. Any discrepancies will be resolved by consensus.

Results:

The present study will summarize high-quality evidence to systematically explore how a nursing model based on evidence combined with clinical nursing pathway influences the caring of children with nephrotic syndrome.

Conclusion:

The present study will summarize the direct and indirect evidence to judge whether evidence-based nursing combined with clinical nursing pathway can improve the treatment and post-treatment prognosis in children with nephrotic syndrome.

Ethics and dissemination:

This study does not require an ethical approval.

Registration number:

April 25, 2021.osf.io/bcrdk/ (https://osf.io/bcrdk/).