bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Freeze-Thaw Cycles on the Weathering and Disintegration Rates of Coal Gangue
Authors: Gong Chuangang , Yang Liya
Published: April 2024

Coal extraction in China is increasingly moving towards colder regions such as Xinjiang and Inner Mongolia. However, these mines face land restoration challenges due to a scarcity of fertile topsoil. This study explores the potential of coal gangue, a mining byproduct, as a viable substitute for topsoil. The study examines the effects of humidity fluctuations and freeze-thaw cycles, both individually and in combination, on the weathering disintegration of coal gangue. Fourteen interventions were analysed, and the findings indicate that the combined application of humidity and freeze-thaw cycles significantly accelerates the disintegration process, outperforming the individual interventions. In addition, it was found that significant temperature variations cause moisture and salts within the gangue to expand, which affects the rate of disintegration. The study showed that the rate of weathering disintegration was significantly higher in conditions of saturated humidity-freeze-thaw cycles compared to unsaturated humidity conditions. This highlights the essential role of ice crystals in accelerating the weathering process during temperature fluctuations. The study highlights the importance of humidity over temperature in the weathering and disintegration of coal gangue. It also suggests that freeze-thaw cycles can enhance this process.
Mortality in Surgical Site Infections Post-cardiac Surgery - a Prospective, International Id-iri Study
Authors: Erdem Hakan , Ankarali Handan , Al-Tawfiq Jaffar A. , Angamuthu Kumar , Piljic Dragan , Umihanic Ajdin , Dayyab Farouq , Karamanlioğlu Dilek , Pekok Abdullah Umut , Sonmezer Meliha Cagla , El-Kholy Amani , Gad Maha Ali , Velicki Lazar , Akyildiz Ozay , Altindis Mustafa , Başkol-Elik Dilşah , Erturk-Sengel Buket , Kara İbrahim , Kahraman Umit , Özdemir Mehmet , Caskurlu Hulya , Cag Yasemin , Al-Khalifa Abdulwahab , Hakamifard Atousa , Batinjan Marina Kljaković-Gašpić , Tahir Muhammad , Tukenmez-Tigen Elif , Zajkowska Joanna , ElKholy Jehan , Gašparović Hrvoje , Gul Ozlem , Tehrani Hamed Azhdari , Doyuk-Kartal Elif , Aybar-Bilir Yesim , Kahraman Hasip , Mikulić Hrvoje , Dayan Saim , Cascio Antonio , Yurdakul Eray Serdar , Colkesen Fatma , Karahangil Kadriye , Espinosa Angel , Rahimi Bilal Ahmad , Vangel Zdraveski
Published: April 2024

OBJECTIVES
Surgical site infections (SSIs) after cardiac surgery increase morbidity and mortality. This multi-center study aimed to identify mortality risk factors associated with SSIs following heart surgery.
METHODS
Conducted from January to March 2023, this prospective study included 167 patients aged > 16 with post-heart surgery SSIs. The primary focus was on 30-day mortality. Univariate analysis and a multivariate logistic regression model, utilizing the Backward elimination method, were employed to establish the final model.
RESULTS
A number of factors had substantial correlations to death. These included urinary catheterization [OR 14.197 (90% CI 12.198–91.721)], emergent surgery [OR 8.470 (90% CI 2.028–35.379)], valvular replacement [OR 4.487 (90% CI 1.001–20.627)], higher qSOFA scores [OR 3.147 (90% CI 1.450–6.827)], advancing age [OR 1.075 (90% CI 1.020–1.132)] and postoperative re-interventions within 30 days following SSI [OR 14.832 (90% CI 2.684–81.972)]. No pathogen was isolated from wound cultures in 53 (31.7%) patients. 43.1% of SSIs (n = 72) were due to Gram-positive microorganisms, while 27.5% of cases (n = 46) involved Gram-negatives. Among Gram-positives, Staphylococci (n = 30, 17.9%) were the predominant microorganisms, while Klebsiellae (n = 16, 9.6%), Escherichia coli (n = 9, 5.4%), Pseudomonas aeruginosa (n = 7, 4.2%), and were the most prevalent among Gram-negatives. Colonization with VRE, MRSA, carbapenem resistant enteric bacteria on admission was detected in 9 (6.1%) cases.
CONCLUSION
To mitigate mortality following heart surgery, stringent infection control measures, preoperative screening, and effective surgical antisepsis are crucial. Timely detection of bloodstream infections and the clinical progression of the disease reflected by qSOFA score, and effective treatment are other essential components of SSI management.
Comparative analysis of myoelectric activity and mandibular movement in healthy and temporomandibular disorder subjects
Authors: Xiaojie Xing , Yiling Cheng , Honglei Lin , Jiamei Peng , Xiaoyong Wu , Hao Yu , Hui Cheng
Published: April 2024

Objectives: Temporomandibular disorders (TMD) are one of the leading causes of craniofacial pain, and a high incidence of TMD in young adults has been reported. Previous studies have used surface electromyography (sEMG) and mandibular kinematic analysis to diagnose TMD. This study aimed to provide normal reference values of sEMG and mandibular kinematics in Chinese young adults, compare the sex differences and assess the diagnosis value of these indices.
Materials and methods: This was an observational study that 90 healthy young adults (49 women and 41 men) with individual normal occlusion were strictly selected by diagnosis standard, and 26 TMD patients with disc displacement (13 with reduction and 13 without reduction) were recruited. The sEMG signals of the anterior temporalis (TA), masseter (MM), and sternocleidomastoid and digastric were recorded in the mandibular postural positions (MPP) and during maximal voluntary clenching (MVC) with K7 electromyograph. Mandibular kinematics, including maximum opening and opening/closing velocities, were assessed by K7 kinesiograph.
Results: In healthy subjects, the sEMG reference values ranged from 3.0 to 4.3 μV in the MPP. The sEMG values during MVC, maximum opening, and opening velocity were significantly higher in males than in females, and also these indices showed good diagnostic efficiency for articular TMD.
Conclusions: Reference values and sex differences in sEMG and mandibular kinematics in healthy subjects were determined. Compared with them, TMD patientsshowed significantly lower myoelectric activity during maximal biting and restricted mouth opening range and velocity, which may assist in TMD diagnosis.
Clinical relevance: By analyzing sEMG of masticatory muscle and mandibular kinematics data from healthy Chinese young adults and TMD patients with disc displacement, this study evaluated the sex difference and diagnosis value of these indices for TMD.
Clinical Trial Registration ID: NCT06372769
ALK5/Smad signaling mediates rapamycin therapeutic response and TET2-dependent chromatin remodeling in vascular smooth muscle cell differentiation
Authors: Martin Kathleen , Chakraborty Raja , Chatterjee Payel , Dave Jui , Lezon-Geyda Kimberly , Joshi Divyesh , O'Brien Brendan , Greif Daniel , Hwa John , Schulz Vincent , Gallagher Patrick
Published: April 2024

Background: Vascular smooth muscle cell (VSMC) phenotypic switching contributes to vascular repair and remodeling but also to pathologies including intimal hyperplasia. The mTORC1 inhibitor rapamycin is an effective drug-eluting stent agent that promotes VSMC differentiation. TGFβ also promotes VSMC differentiation through SMAD transcription factors. We investigated unexpected convergence between these pathways in VSMC plasticity.
Methods: We assessed the interactions between rapamycin and the Transforming Growth Factor-β Receptor 1 (ALK5) signaling in human coronary artery SMCs (hCASMCs) and in vascular remodeling using inducible SMC–specific knockout mice (ALK5iKO).
Results: Genome-wide histone H3K27 acetylation analysis unexpectedly identified SMAD binding elements (SBE) as the motif most enriched after rapamycin treatment of hCASMCs. We found that rapamycin treatment promotes rapid phosphorylation of SMAD2/3 (pSMAD2/3). Signaling studies revealed this phosphorylation required ALK5 activity but not TGF-β ligand, and ALK5 and SMAD2/3 were both required for rapamycin-induced differentiation. We determined that rapamycin relieves FKBP12 inhibition of ALK5 to promote ligand-independent Smad signaling, and FKBP12 knockdown was sufficient to induce contractile genes. Notably, rapamycin treatment induced an interaction between TET2 and SMAD2/3, and these SMADs were required for differentiation-associated chromatin remodeling, including DNA hydroxymethylation and histone acetylation at contractile genes, suggesting that SMADs and TET2 function in concert at SBE- and CArG-containing promoter regions. We also found that mTORC1 inhibition with Raptor knockdown induces TET2 expression but fails to induce chromatin remodeling and SMC differentiation in the absence of SMAD2/3. In vivo, ALK5iKO mice exhibited severe intimal hyperplasia after carotid artery injury compared to controls and were entirely resistant to the therapeutic effect of rapamycin, despite persistent inhibition of mTORC1. Consistent with the in vitro findings, rapamycin treatment elevated pSMAD3 staining post-injury in the medial layer of control but not ALK5iKO mice.
Conclusions: We report the unexpected observation that rapamycin requires FKBP12/ALK5/SMAD2/3 signaling to promote TET2-dependent chromatin remodeling and VSMC differentiation. Understanding these mechanisms may provide new avenues to modulate VSMC phenotype and may hold therapeutic promise for cardiovascular diseases.
Health-related quality of life and associated factors among patients with liver cancer
Authors: Du Xiangyu , Liao Anque , Li Jia , Ye Ziping , Li Jiang
Published: April 2024

Objective
This study aims to comprehensively evaluate the Health-Related Quality of Life (HRQoL) in Chinese liver cancer patients. The research considers socio-demographic and clinical determinants and incorporates generic (EQ-5D-5L) and disease-specific (EORTC QLQ-C30) instruments for a more nuanced analysis.
Methods
A cross-sectional study involved 229 liver cancer patients treated at two prominent Chinese hospitals from February to July 2023. The study utilized generic instruments EQ-5D-5L and the disease-specific HCC18 tool for QoL assessment. Statistical analyses included descriptive statistics, Mann-Whitney U test, Kruskal-Wallis H test, and multivariate linear regression.
Results
Factors such as ECOG PS, Child-Pugh class, BCLC, and CNLC stages significantly impacted HRQoL scores. Age, education, alcohol consumption, ALB levels, and hypertension influenced EQ-5D-5L VAS scores. Living status, TBil levels, ALB levels, PVTT, and treatment type affected EQ-5D-5L utility and QLQ-C30 summary scores. Notably, living alone correlated with higher utility values. Multivariate analysis revealed consistent influences of ECOG PS and CNLC stage on EQ-5D-5L VAS, utility, EORTC QLQ-C30 GHS/QoL, and summary score.
Conclusion
This study provides a comprehensive evaluation of HRQoL in Chinese liver cancer patients, integrating generic and disease-specific instruments. ECOG PS and CNLC stage emerged as crucial determinants of HRQoL. The findings underscore the importance of tailored interventions to enhance HRQoL in this population. Future research can explore variations in utility values under different sets and optimize health economic assessments.
Warthin-Like Mucoepidermoid Carcinoma: A Case Series Addressing the Need for Diagnostic Criteria Manuscript type: Case series
Authors: Agrawal Tushar , Patil Asawari , Mittal Neha , Rane Swapnil , Rabade Katha , Bal Munita
Published: April 2024

Warthin-like Mucoepidermoid carcinoma(WLMEC) is a newly described rare variant of Mucoepidermoid carcinoma(MEC). Rarity, coupled with potential misdiagnoses as the benign Warthin tumor necessitates careful examination and understanding of clinical and histological features. Lack of defining criteria in the current classification adds to the conundrum.
Cases of WLMEC were retrieved from the archives of Department of Pathology from 2017-2022. Clinical and imaging data were obtained from the Electronic medical record system.
A total of three cases, in two males and one female, aged 25, 49, and 64 years were diagnosed based on the proposed diagnostic criteria. A longstanding painless swelling in all cases, and lymphadenopathy in one case was seen at presentation. Imaging, in all cases, showed a hypodense mass with a mean diameter of 2 cm (range 1.1-2.9cm), involving the superficial lobe of parotid. Histomorphology, only superficially reminiscent of Warthin’s tumor at low power, was of a circumscribed tumour with disorganised cuboidal epithelium instead of oncocytic lining, with epithelial to lymphoid ratio varying from 0.4 to 0.9. Admixed areas with classic MEC morphology were seen (100% cases) comprising 5%, 15% and 25% of the tumour respectively. Atypical mitoses, lymphovascular invasion and perineurial invasion was not seen in any case. Immunohistochemistry for CK7 and P40 was diffusely positive in all. Mucicarmine stain highlighted interspersed mucous cells. As per MSKCC, AFIP and Brandwein systems, all these tumours were low grade, which corroborated with the prognosis as no recurrence or distant metastases was seen in a mean follow-up period of 12 months.
Low power resemblance of WLMEC to Warthin tumor can lead to an erroneous diagnosis with prognostic implications, which may be obviated by using the proposed diagnostic criteria. Awareness of occurrence in younger age, presence of goblet cells, and areas with classic MEC morphology in a thoroughly sampled tumor might help avoid this pitfall.
Mid-term outcomes of robotic-assisted versus video-assisted invasive minimally esophagectomy for esophageal cancer: A retrospective propensity-matched analysis of 842 patients
Authors: Huang Jiang-shan , Zhu Jia-fu , Zhong Qi-hong , Guo Fei-long , Lin Yu-kang , Zhang Zhen-yang , Lin Jiang-Bo
Published: April 2024

Aim: The purpose of this study is to compare the safety, effectiveness, and mid-term survival rates of robot-assisted minimally invasive esophagectomy (RAMIE) and video-assisted minimally invasive esophagectomy(VAMIE) using propensity score matching (PSM) analysis.
Methods: A total of 842 patients undergoing minimally invasive esophagectomy at our department from January 2019 and October 2023 were analyzed, including 694 patients in VAMIE group and 148 in RAMIE group. PSM analysis was applied to generate matched pairs for further comparison. Operative outcomes and postoperative complications were compared between all patients in matched groups. Mid-term outcomes consisting of overall survival (OS) and disease-free survival (DFS) were compared.
Results: After 1:4 PSM, 148 patients in the RAMIE and 592 patients in the VAMIE. Compared to VAMIE, RAMIE exhibited earlier removal of chest (P < 0.001) and neck (P < 0.001) drainage tubes, shorter postoperative hospital stays (P = 0.003), and a higher number of lymph node dissections. However, the surgical duration of RAMIE was longer than that of VAMIE. There were no significant differences between RAMIE group and VAMIE group in postoperative complications. There was no statistically significant difference in the 3-year OS (VAMIE:70.9% and RAMIE:75%) and DFS (VAMIE:56.1% and RAMIE:54.9%) between the two groups.
Conclusion: Compared to VAMIE, RAMIE emerges as a viable and safe surgical approach. The mid-term survival outcomes between the two procedures are comparable, suggesting RAMIE as a potential alternative to minimally invasive esophagectomy.
Bile-derived cfDNA of syncytin-1 and SLC7A11 as a potential molecular marker for early diagnosis of cholangiocarcinoma
Authors: He Jing , Qian Jingrong , Li Xin , Zhao Xiaoyue , Meng Weiwei , Zhuang Xuewei
Published: April 2024

Background: Bile circulating free DNA (cfDNA) as a novel liquid biopsy method for the early clinical diagnosis of cholangiocarcinoma (CCA) has been less reported.
Methods: We collected bile samples from 51 patients with CCA and 48 patients with gallstones at Shandong Provincial third Hospital from September 2022 to December 2023. We quantified bile cfDNA of syncytin-1 and SLC7A11,calculated the correlation bySpearman rank correlation, plotted Receiver Operating Characteristic (ROC) curves, and compared the Area Under Curve (AUC) values to explored early diagnostic utility in patients.
Results: We first found the bile cfDNA of syncytin-1 and SLC7A11 levels in CCA were higher than in gallstones (p < 0.001; p < 0.001). And there was significant correlation between syncytin-1 and SLC7A11 expression (Spearman ’r = 0.458, p < 0.001). The AUC of bile cfDNA of syncytin-1 was 0.891(specificity of 90.2% and sensitivity of 75.0%), the AUC of bile cfDNA of SLC7A11 was 0.793 (specificity of 80.4% and sensitivity of 72.9%), and combination of bile cfDNA of syncytin-1/SLC7A11/CA19-9 markers improved diagnostic efficiency in CCA patients (AUC:0.901, p < 0.001).
Conclusion: The bile cfDNA of syncytin-1 and SLC7A11 was high expression in cholangiocarcinoma, which may be used as a novel biomarker for early diagnosis.
Human papillomavirus type-specific distribution in cervical intraepithelial neoplasia and cancer in The Gambia prior to HPV immunization programme: A baseline for monitoring the quadrivalent vaccine
Authors: Bah Haddy , Ceesay Foday , Leigh Ousman , Bah Haddy Tunkara , Savage Ahmad Tejan , Kimmitt Patrick.T.
Published: April 2024

Background: Persistent infection with the high-risk human papillomavirus (HR-HPV) is associated with causing nearly 95% of cervical cancer and remains a worldwide concern. In the Gambia, cervical cancer is the leading cause of cancer deaths in women. Current estimates indicate that 286 women are annually diagnosed with cervical cancer with a fatality rate of 70%. In an attempt to address this, in 2019 the quadrivalent HPV vaccine was incorporated into the Gambia’s expanded programme on Immunisation. The aim of the study was to retrospectively assess the prevalence and distribution of high-risk HPV genotype in archived, formalin fixed paraffin embedded cervical biopsy tissues diagnosed with cervical cancer in the Gambia from year 2013 -2022.
Method: A total of 223 samples with histologically diagnosis of cervical cancer with adequate tissues were sectioned and deparaffinised, followed by HPV DNA extraction and the detection of HR-HPV by real-time multiplex PCR. The internal housekeeping gene was amplified in 119 samples, which were subsequently tested for HPV DNA.
Results: HPV prevalence was found to be 87% (104 /119) in cervical cancer cases, 15 (12.6%) samples tested negative for HPV DNA. In single infections, HPV 16 genotype was the most frequent type in cervical cancer cases accounting for 53% (56/104), followed by other high risk HPV genotypes 17% (18/104), and HPV genotype 18 was found in 15% (16/104) of cervical cancer cases. HPV related cervical cancer was most common in the 32 -42 year (28.8%, 30/104) aged women. A significant association between age and diagnosis with cervical cancer (p = 0.023), and HPV genotype (p = 0.038) was observed.
Conclusion: There was no difference in the distribution of HPV 16 and 18 genotypes in cervical cancer cases in The Gambia in comparison with the global distribution. However, the high prevalence of single infections with other HR-HPV, and multiple infections with HPV 16 and other HR-HPV genotypes seen in this study, clearly shows that the nonavalent HPV vaccine could be more beneficial for The Gambia. This study provides The Gambia with a baseline data to use in policy decisions regarding future evaluation of the quadrivalent HPV vaccine in the country.
Retention of patients in HIV/AIDS care at the healthcare facility level in Ethiopia: Same-day antiretroviral initiation status
Authors: Chachu Kidanu Hurisa , Maboe KEFILOE ADOLPHINA
Published: April 2024

Background
To meet the ambitious goal of eradicating the HIV epidemic by 2030, the Joint United Nations Programme on HIV/AIDS has set 95-95-95 targets. These targets aim for 95% of HIV-infected individuals to know their status, 95% to initiate antiretroviral therapy (ART), and 95% to achieve virologic suppression by 2030. In Ethiopia, progress towards these targets has been made, but challenges persist. This study aims to evaluate same-day ART initiation status regarding retention of patients in HIV/AIDS care at the healthcare facility level in Ethiopia.
Methods
A cross-sectional study design was conducted involving retrospective document analysis of 332 clinical records. The study included clinical records of patients initiated on same-day ART from the 1st of October 2017 until the 30th of October 2019. Data was analyzed quantitatively, descriptive and inferential statistical analyses were performed using Statistical Package for Social Science (SPSS) version 28.0 software. Data analysis involved conducting logistic regression to examine the relationships between factors associated with retention in HIV care.
Results
The results indicated varying retention rates over different time intervals: 35% at 6 months (n = 49), 81% at 12 months (n = 50), 89% from 13 to 18 months (n = 63), and 94% at 24 months (n = 34), with an overall retention in HIV/Care at 59% (n = 196). The study’s logistic regression analysis revealed that gender has a significant effect on retention (β = 2.890, p < 0.01), tertiary education was 0.2 times greater than no formal education, that is, (β = 0.212, p < 0.05), tertiary education was 0.13 times more than a secondary education, which is (β = 0.131, p < 0.01), patients who reside in urban areas were more likely to be retained than those who reside in rural areas, that is, (β = 0.467, p < 0.05), patients with a good level of adherence were 0.1 times more likely to be retained in comparison to those with a fair level of adherence (β = 0.092, p < 0.01).
Conclusion
The study underscores the importance of same-day ART initiation in enhancing retention rates among patients in HIV/AIDS care in Ethiopia. Factors such as gender, education level, urban residence, adherence, functional status, and WHO stage significantly influence retention. Addressing these factors through targeted interventions is crucial for achieving sustained improvements in HIV care and advancing towards epidemic eradication goals by 2030.
The association between the Health Promotion Levy and employment in South Africa: an interrupted time series analysis
Authors: Dare Chengetai , Boachie Micheal Kofi , Goldstein Susan , Thsehla Evelyn
Published: April 2024

Background
The production and consumption of sugar-sweetened beverages (SSBs) have been increasing over the past years, globally. However, there is overwhelming evidence linking SSBs to the rising prevalence in obesity and its comorbidities. In South Africa, the prevalence of overweight and obesity is high and is among the highest in Sub-Saharan Africa. In response to rising prevalence in obesity and its comorbidities, on 1 April 2018 the South African government introduced an SSB tax, known as the Health Promotion Levy (HPL). However, the levy has been opposed by the sugar industry, claiming that it leads to jobs losses. Against this backdrop, this study seeks to investigate the association between the HPL and employment in the sugar industry.
Methods
We employed single-group interrupted time series analyses using the Quarterly Labour Force Survey data from Statistics South Africa.
Results
Our results show that the HPL has not been associated with job losses (or generation) in the sugar-related industries in South Africa. These findings are consistent with the findings on the effects of SSB taxes on employment in other jurisdictions.
Conclusions
Considering that the HPL does not impede employment, and the overwhelming evidence on the effectiveness of SSB taxes, together with the relatively low tax burden, it is imperative that the government raises the HPL from the current 8% of the retail price to the WHO-recommended 20% threshold. The government should also consider expanding the HPL to fruit juices. Such strategies are important in encouraging people to reduce the intake of SSBs, while enabling the government to raise additional revenue for the fiscus.
Insights into the taxonomy and virulence-related genetic profiles in Cupriavidus by comparative genomic analysis
Authors: Chen Shenglei , Wang Xiaoyu , Zhang Leilei
Published: April 2024

Background: Cupriavidusspecies have significant potential for environmental and industrial applications. Some have been recognized as opportunistic pathogens and are increasingly reported to be related to human infections. However, the taxonomic classification of Cupriavidus at the species level remains challenging. This may partly limit the understanding of pathogenesis in Cupriavidus.Here, we aim to clarify the Cupriavidus taxonomy and elucidate virulence-related genetic profiles using comparative genomic analysis.
Results:This study used eight Cupriavidus species to investigate the taxonomy of Cupriavidus. Of these, C. alkaliphilus, C. basilensis, C. gilardii, C. oxalaticus, C. necator, and C. taiwanensis are species complex, and the first four species are first reported as the species complex. More importantly, C. alkaliphilus and part of C. taiwanensis mixed, suggesting that some strains of these two species were probably mislabeled. The open pan-genome and prevalence of mobile genetic elements indicated high genetic variation in Cupriavidus. A total of 47 genes related to virulence factors were identified in Cupriavidus. Virulence factors in almost all Cupriavidus strains were related to the antimicrobial activity (acrB), biofilm (adeG, algU), stress survival (clpP, katA, sodB, ureA, ureB, and ureG), adherence (htpB,kdsA) and others (icl); the opportunistic pathogens, C. gilardii, and C. metallidurans, contained extra virulence genes (plc-2). Furthermore, six types of secretion systems (T1SS-T6SS) were identified in Cupriavidus. T2SS was conserved across all eight species; the other secretion systems presented diverse distribution. Interestingly, C. gilardii possesses two different T3SS clusters. Finally, emre, responsible for the efflux pump of aminoglycoside antibiotics, is a major antibiotic resistance gene of Cupriavidus strains. Other genes related to aminoglycosides, β-lactam, fosfomycin, and multidrug resistance are species-specific among opportunistic pathogens individually.
Conclusions: This study for the first time investigated the taxonomic classification ofCupriavidus andvirulence-related genetic profiles by comparative genomic analysis. Findings from this study lead us to propose updating the taxonomy of the six identified Cupriavidusspecies containing species complex. The virulence-related information, including virulence factors, secretion systems, and antibiotic resistance genes, provides insights into understanding the pathogenesis of Cupriavidus and may facilitate the diagnosis of infections caused by pathogenic Cupriavidus spp.
Impact on members and retail pharmacies of China's Urban Employee Basic Medical Insurance medicine purchasing reforms: Case studies in Wuhan
Authors: Xu Zhihao , Nicholas Stephen , Maitland Elizabeth , Wang Jian , Li Jie , Lv Shenghao , Tan Jialong
Published: April 2024

Background
In 2023, local health authorities implemented prescription medicine purchases from retail pharmacies by urban employee basic medical insurance (UEBMI) members. Using case studies from Wuhan, we assess the impact of the 2023 medicine purchasing reform on the medicine buying behavior; evaluate the benefits of the changes to UEMBI members; and provide insights into China’s retail pharmacies’ business model.
Methods
Daily UEBMI claim data was collected at two Wuhan pharmacies from March 2022 to December 2023, including data on customer age, sex, employment state and claim type before and after the implementation of the 2023 policy. The impact of the new retail pharmacy purchasing policy on medicines purchasing behavior, such as the number of medicine purchasers, the total expenditure per capita, and the medical savings accounts expenditure per capita, were quantitatively evaluated using descriptive statistics and interrupted time series analysis (ITSA).
Results
The characteristics of medicine purchasers were not significantly affected by the new policy. Retired UEBMI members benefited more from allowing UEBMI funds for prescription purchases from retail pharmacies than currently employed UEBMI members. The number of UEBMI member medicine purchasers from retail pharmacies showed a significant upward trend, increasing the benefits to UEBMI members, without medicine over-use or risk of fraud. The benefit to members was measured by the absence of any significant upward per capita total expenditure trend and a significant decrease in the proportion of medicine expenditures from members personal medical savings accounts.
Conclusions
The 2023 reforms allowed UEBMI members to purchase medicine from retail pharmacies, providing medicine accessibility and affordability for members, especially retired members; did not trigger an increase in members’ medicine consumption; attenuated the over-use of hospital pharmacies; and transformed pharmacies’ business model away from a singular focus on price competition towards a combination of price competition and health services.
B cells infiltration potentially responded better to systemic corticoids in oral lichen planus and oral lichenoid lesions
Authors: Feng Ming-hua , Lai Yi-rao , Deng Yi-wen , Li Xi-ye , Pan Lei , Tian Zhen , Wang Yu-feng , Tang Guo-yao
Published: April 2024

Background: Oral lichen planus (OLP) and oral lichenoid lesion (OLL) are common chronic inflammation in the oral mucosa. B cells infiltration in OLP and OLL, however, little is known about these cells in OLP and OLL.
Objectives: To analyze the function and infiltrating features of B lymphocytes in OLP and OLL, and to preliminarily evaluate their correlation with clinical outcomes.
Methods: Tissue samples were collected from OLP, OLL, and healthy mucosa. The phenotypes and amounts of B cells in tissues were analyzed by single-cell sequencing. Their proportion and infiltrating features in tissues were examined by immunohistochemistry and immunofluorescence. With the systemic medication of corticoids, the correlation between B cells infiltrating characteristics and the clinical outcomes were evaluated.
Results: A quantified proportion increase of B cells was shown in both OLP and OLL. B cells in OLP demonstrated heightened activation and enhanced regulation in immune response. A cohort of 100 patients with OLP/OLL and 13 healthy controls were examined to investigate the B cells infiltration pattern. B cells were distributed in the superficial layer of lamina propria in 92.9% and 41.9% of OLP and OLL, respectively(P<0.01); focally distributed in 25.0% and 62.9% of OLP and OLL, respectively(P<0.01). With the systemic medication of corticoids, the cases with B cell infiltration (B+) in OLP and OLL groups showed a statistically significant reduction in REU scores before and after treatment (P<0.01)
Conclusions: B cells are widely present in OLP and OLL, and B cell infiltration in OLP and OLL are related to the better therapeutic effect of oral corticoids.
Natural foraging selection and gut microecology of two subterranean rodents from the Eurasian Steppe in China
Authors: Sz Zhenghaoni , Fu Heping , Yuan Shuai , Chen Kai , Han Tingting , Bu Fan , Sun Shanshan , Zhu Na , Man Duhu
Published: April 2024

As the most abundant group of mammals, rodents possess a very rich ecotype, which makes them ideal for studying the relationship between diet and host gut microecology. Zokors are specialized herbivorous rodents adapted to living underground. Unlike more generalized herbivorous rodents, they feed on the underground parts of grassland plants. There are two species of the genus Myospalax in the Eurasian steppes in China: one is Myospalax psilurus, which inhabits meadow grasslands and forest edge areas, and the other is M. aspalax, which inhabits typical grassland areas. How are the dietary choices of the two species adapted to long-term subterranean life, and what is the relationship of this diet with gut microbes? Are there unique indicator genera for their gut microbial communities? Relevant factors such as the ability of both species to degrade cellulose are not yet clear. In this study, we analysed the gut bacterial communities and diet composition of two species of zokors using 16S amplicon technology combined with macro-barcoding technology. We found that the diversity of gut microbial bacterial communities in M. psilurus was significantly higher than that in M. aspalax and that the two species of zokors possessed different gut bacterial indicator genera. Based on the results of Mantel analyses, the gut bacterial community of M. aspalax showed a significant positive correlation with the creeping-rooted type food, and there was a complementary relationship between the axis root type food and the rhizome type food dominated (containing bulb types and tuberous root types) food groups. Functional prediction based on KEGG found that M. psilurus possessed a stronger degradation ability in the same cellulose degradation pathway. Neutral modelling results showed that the gut flora of the M. psilurus has a wider ecological niche compared to that of the M. aspalax. This provides a new perspective for understanding how rodents living underground in grassland areas respond to changes in food conditions.
Upper Gastrointestinal Involvement in Crohn's Disease as an Independent Predictor of New-Onset Strictures: Insights from a Extensive Retrospective Cohort Analysis
Authors: Hsu Wei-Chun , Chen Chien-Ming , Kuo Chia-Jung , Tsou Yung-Kuan , Yeh Pai-Jui , Lai Ming‑Wei , Wu Ren-Chin , Chiu Cheng-Tang , Su Ming‑Yao , Pan Yu-Bin , Le Puo-Hsien
Published: April 2024

Background/Aims:
Crohn's Disease (CD) can affect the entire gastrointestinal tract, including the upper sections (UGI), which is often overlooked, especially in Asian populations. There's a notable gap in research regarding the impact of UGI involvement on the intricate landscape of ensuing complications. This study aims to address this gap.
Methods:
Conducting a retrospective study at Chang Gung Memorial Hospital from January 2001 to September 2023, we compared CD patients with UGI (Montreal L4) involvement against non-L4 counterparts, focusing on baseline characteristics, post-diagnosis complications, and overall outcomes.
Results:
The study included 212 CD patients, 111 in the L4 group and 101 in the non-L4 group, with an average follow-up of 40.8 months. At baseline, individuals in the L4 category demonstrated elevated smoking rates, increased Crohn’s Disease Activity Index scores, a higher prevalence of strictures, and a more prevalent usage of biologics and proton pump inhibitors. Moreover, this group was characterized by reduced albumin levels. Upon concluding the follow-up, those with L4 involvement continued to show escalated CDAI scores and hospitalization frequencies, alongside heightened C-reactive protein levels and diminished albumin concentrations. Additionally, the occurrence of UGI involvement, structuring disease at the time of diagnosis, and a younger age at the onset of CD were pinpointed as independent predictors for the development of new-onset strictures.
Conclusions:
CD patients with UGI involvement exhibit elevated disease activity and serve as independent predictors for the development of intestinal strictures. Thorough UGI evaluations at the time of diagnosis, coupled with assertive treatment strategies, are essential for managing these patients effectively.
Evaluation of Electrical Discharge Machining of Radial Inner Flow Channel Holes Using Soft Shaft Electrodes
Authors: Qiu Mingbo , Yao Zongxiu , Wu Entao , Zhang Yimiao , Li Jingtao
Published: April 2024

To reduce the difficulty in machining inner holes and break the limitation of cavity size on hole depth, a technique using soft shaft electrodes to machine the radial inner flow channel holes was proposed and developed. This technique was used to directly EDM machine inside the cavity after the electrodes were bent. First, the designed soft shaft electrode structure reduced the bending stiffness of the electrode, making the radius of curvature of the soft shaft electrode was less than 10% that of a cylindrical electrode under the same conditions. Second, the effect of the working fluid on EDM machining with soft shaft electrodes was studied, and Na2CO3 solution was selected as the working fluid to eliminate the taper shape and inlet fillet of the holes. Then, the effects of processing parameters, including voltage, pulse width, and duty cycle, on processing time were studied. Finally, a radial inner flow channel hole over 25 mm deep was machined inside the 20 mm diameter circular cavity. The experiment results showed that the soft shaft electrode could directly machine the radial inner flow channel hole with small diameter and large depth-diameter ratio inside the cavity, and solved the contradiction among the part structure, electrode size and the depth of the inner hole. The use of Na2CO3 solution as the working fluid prevented electrolysis on the machined surface, optimized removal conditions of debris, improved processing speed and processing quality, and reduced electrode loss length.
Comparison of tear MMP9 with Schirmer’s test in ocular surface disorders & formulation of a treatment algorithm based on the results
Authors: Gupta Sandeep , Shankar Sandeep , Bhatta Sunandan , Mishra Avinash , Singh Ankita
Published: April 2024

Purpose: To correlate the tear levels of MMP9 with Schirmer’s test in patients with Ocular surface disorder (OSD) & to evaluate treatment with lubricants, steroids and anti-inflammatory drugs based on MMP-9 results.
Methods: 100 eyes with OSD underwent Schirmer’s test & MMP9 estimation. All cases were evaluated on ocular symptomology score (OSS). Association of MMP-9 results with three groups of dry eyes, improvement in objective and subjective parameter in Group I(MMP-9 positive) and Group II(MMP-9 negative) with lubricants and need for additions steroids & Cyclosporine was evaluated.
Results: Out of 100 eyes, 40 eyes tested positive for MMP9. MMP9 positive patients had a mean Schirmer’s value of 12.85 + 7.07 as against MMP9 negative patients who had a mean value of 19.18 + 8.941. 80% were MMP9 positive in severe, 55.6% in moderate and only 22.5% with normal tear secretion were MMP9+ve. No definite Association was found between MMP9 positivity and OSS (chi square test: p>0.05). All MMP9 positive patients were started on lubricants. At 06 months, 85% eyes were continued on lubricants. In 6 eyes (15%) an addition of steroids/Cyclosporine was needed. All patients who were MMP9 negative were started on lubricants, at of 06 months, 96.7% eyes (58 eyes) were continued on lubricants. In 2 eyes (3.3%), addition of Steroid/Cyclosporine was needed.
Conclusion: Results show a trend to evaluate all cases of OSD with MMP- 9 test and treat them depending on results of this test. There is also a case for starting steroids early in cases which are MMP-9 positive.
Factors Affecting Symptom Severity And Quality Of Life In Patients With Outlet Obstructive Constipation: A Cross-Sectional Study
Authors: Xie Xingjie , Li Qing , Zheng Huichao , Huang Bin , Wang Li , Li Fan , Tong Wd
Published: April 2024

Background
Outlet obstruction constipation is the main type of chronic constipation, and has a serious impact on people's lives. However, the factors affecting symptom severity and quality of life are still unclear. This study aimed to analyze factors affecting symptom severity and quality of life in patients with outlet obstructive constipation.
Methods
General clinical information of patients with outlet obstructive constipation from July 2021 to January 2023 were collected continuously by means of a cross-sectional survey. Symptom severity was assessed by the Obstructive Defecation Syndrome scale, and quality of life was assessed by the Patient Assessment of Constipation -Quality of Life scale.
Results
The multiple linear regression analysis showed that: Delivery times (β = 0.114, p = 0.011), drinking less than 1000 ml of water per day (β = 0.106, p = 0.007), lower intake of vegetables and fruits (β = 0.118, p = 0.004), higher SAS score (β = 0.230, p < 0.001), lean (β = 0.088, p = 0.009), smoking history (β = 0.129, p = 0.002), laxative use (β = 0.273, p < 0.001), disease duration > 10 years (β = 0.237, p < 0.001), and perianal disease (β = 0.072, p = 0.042) were independent risk factors for ODS scores; Delivery times (β = 0.114, p = 0.011), drinking less than 1000 ml of water per day (β = 0.113, p = 0.007), intake of fewer vegetables and fruits (β = 0.123, p = 0.004), higher SAS score (β = 0.389, p < 0.001), lean (β = 0.099, p = 0.006), laxative use (β = 0.198, p < 0.001), squatting stool (β = 0.136, p < 0.001), disease duration > 10 years (β = 0.159, p < 0.001), and perianal disease (β = 0.082, p = 0.028) were independent risk factors for PAC-QOL scores.
Conclusions
There are several independent risk factors that significantly impact symptom severity and quality of life in individuals with outlet obstructive constipation.
Combined influence of oral health behaviors and nutritional and inflammatory status on risk of all-cause mortality among US population, NHANES 2011-2018
Authors: Deng Wanjun , Han Peng , Liu Qi , Zhang Yongjian , Zuo Tao , Xiong Huihua
Published: April 2024

Background: Oral health and inflammation and nutritional status are interconnected, each bearing significant correlation with long-term prognoses in populations. We investigated the interactions and correlations among nutritional and inflammatory indictors, oral health, and all-cause mortality.
Methods: A nationally representative prospective cohort sample was recruited from the National Health and Nutrition Examination Survey (NHANES) conducted in the United States from 2011 to 2018, selecting individuals aged 40 or above (n=10573; weighted population: 7229522) with comprehensive oral health assessments and related biomarkers. Oral health was quantified using multiple indicators to construct an Oral Health Index (OHI), and the Prognostic Nutritional Index (PNI) was employed to reflect general inflammatory and nutritional status. The independent effects of OHI and PNI on all-cause mortality were examined across the population, alongside their interactive prognostic implications.
Results: The study included 10573 participants with complete oral health and related data. Adjusted models revealed that better self- assessed oral health (HR=0.80; 95%CI: 0.67-0.96) and more frequent use of dental floss (HR=0.94; 95%CI: 0.91-0.98) were associated with lower all-cause mortality rates. Conversely, individuals with dental visits exceeding five years (HR=1.35; 95%CI: 1.13-1.62), occupational oral health hazards (HR=1.33; 95%CI: 1.00-1.76), or no history of periodontal cleaning or treatment (HR=1.37; 95%CI: 1.09-1.73) faced higher mortality rates. A higher PNI indicated a lower all-cause mortality risk (HR=0.9; p<0.001). The correlation between the constructed OHI and all-cause mortality was confirmed (HR=0.99, P<0.001), with interaction analysis showing a significantly increased impact of OHI on prognosis at lower PNI levels.
Conclusion: This cohort study observed the effects of oral health and nutritional/inflammatory statuses on all-cause mortality, identifying the lowest risk of mortality among populations with high OHI and PNI levels.
Epigallocatechin-3-gallate protects bovine ruminal epithelial cells against lipopolysaccharide-induced inflammatory damage by activating autophagy
Authors: Zhao Wanli , Shen Taiyu , Huo Yihui , Li Moli , Aernouts Ben , Loor Juan J. , Xu Chuang
Published: April 2024

Background：In non-ruminants, epigallocatechin-3-gallate (EGCG), a major bioactive ingredient of green tea, is well-known to alleviate inflammation. Whether EGCG confers protection against subacute ruminal acidosis (SARA)-induced inflammation and the underlying mechanisms are unknown.
Results：Eight ruminally cannulated Holstein cows in mid-lactation were randomly assigned to either a low-concentrate (40%) diet (CON) or a high-concentrate (60%) diet (HC) for 3 weeks to induce SARA. Cows with SARAhad greater concentrations of tumor necrosis factor (TNF)-α and interleukin-6, and epithelium showed histological signs of damage. Lipopolysacharide was used in vitro to simulate the inflammatory damage caused by SARA uisng immortalized bovine rumen epithelial cells (BREC). Increased phosphorylation of IκBα and nuclear factor kappa-B (NF-κB) p65 due to 10 µg/mL LPS for 6 h revealed a successful chronic inflammatory response in BREC. Pre-treatment of BREC with 50 µM EGCG for 6 h before LPS challenge promoted the degradation of NLR family pyrin domain containing 3 (NLRP3) inflammasome through activation of autophagy, which further repressed activation of NF-κB pathway targeting Toll-like receptor 4(TLR4). The ECGG also upregulated tight junction (TJ) protein expression upon incubation with LPS.
Conclusions：Subacute ruminal acidosis causes ruminal epithelium injury and systemic inflammation in dairy cows. However, the anti-inflammatory effects of EGCG help preserve the integrity of the epithelial barrier through activating autophagy when BREC are exposed to LPS. Thus, EGCG could potentially serve as an effective therapeutic agent for SARA-associated inflammation.
miR-17~92 cluster inhibited meniscal calcification by targeting HIF-1α
Authors: Zhang Yun , Sun Ruizhu , Lu Laiya , Huang Jiefeng , Zhao Cheng , Lu Wuyan , Wang Qian , Ren Jiaxin , Li Shuaijun , Cui Lei
Published: April 2024

Research background: The meniscus functions as a vital component in maintaining the homeostasis of joint biomechanics, and its pathological calcification leads to cartilage destruction. The cluster of miR-17~92 plays an important role in skeletal development. However, the impact of miR-17~92 on meniscal calcification remains unclear.
Methods: To determine the function of miR-17~92 in meniscus, the expression of miR-17~92 in meniscus was deleted by crossing miR-17~92fl/fl mice with transgenic mice Col2-CreERT. Safranin-O, hematoxylin and eosin (H&E) and immunohistochemistry were used to determine the effects of miR-17~92 loss on meniscal calcification. In vitro, we explored the mechanism by knockdown or overexpression of miR-17~92 or hypoxia-inducible factor 1α (HIF-1α) in meniscal cells.
Results: Our investigation revealed decreased expression of miR-17, miR-19b, and miR-92a in IL-1β-treated meniscal cells, which corresponded to a significant increase in the expression of calcification-related genes such as COL10A1, RUNX2, MMP13, and VEGFA, as well as a reduction in the expression of COL1A1 and COL2A1. Particularly, miR-17 exhibited a more pronounced inhibitory effect on calcification compared to the other two microRNAs. Furthermore, our findings demonstrated that IL-1β stimulation led to heightened expression of HIF-1α in meniscal cells. Subsequent experiments involving the administration of prolyl hydroxylase-2 (PHD2) inhibitor (IOX2) resulted in a significant increase in the expression of calcification genes, whereas the supplementation of miR-17 decreased HIF-1α expression and reversed these changes. Conversely, treatment with a HIF-1α inhibitor (PX-478) effectively suppressed the calcification phenotype and restored collagen expression.
Conclusion: Our data suggests that miR-17 plays an essential role in suppressing meniscal calcification and maintaining the anabolic activities of meniscal cells through its targeting of HIF-1α, thereby underscoring miR-17 as a prospective therapeutic target for addressing meniscal calcification.