bluuebunny/crossref_metadata_2025 huggingface dataset:
Symptomatic Nonunion After a Tibial-Sided Posterior Cruciate Ligament Avulsion Fracture Treated with Open Repair
Authors: Johnson Jordan , Gupton Marco , Schneider Jonathan , Deivaraju Chenthuran
Published: July 2021

Case:

A 30-year-old man was in a motorcycle accident resulting in an avulsion fracture of the tibial insertion of the posterior cruciate ligament (PCL). After 19 months of nonoperative treatment, the patient presented with a nonunion and symptoms of pain and instability. He was treated with an open repair with screw fixation through a posterior approach. Six months postoperatively, the patient returned to his work as a heavy laborer with full range of motion and no instability.

Conclusion:

PCL avulsion fracture nonunion results in symptoms of swelling, pain, and instability. These symptoms can be treated with screw fixation through a posterior approach.
Dissection of an Ulnar Nerve Previously Transposed and Wrapped with Human Amniotic Membrane
Authors: Mirzayan Raffy , Syed Sajjad P. , Shean Christopher J.
Published: July 2021

Cases:

We present 3 patients who underwent ulnar nerve transposition and wrapping of the nerve with human amniotic membrane (HAM). All 3 patients subsequently required a reoperation for the original pathologic condition (not for ulnar nerve symptoms), necessitating the exploration and dissection of the transposed ulnar nerve. We demonstrate the lack of scar formation and ease of separation between nerve and surrounding tissue, as well as histology in one case taken from the perineural tissues (previous amniotic membrane), demonstrating no inflammatory cells or absence of scar tissue formation.

Conclusion:

Exploration and dissection of a previously transposed ulnar nerve can be facilitated by wrapping the nerve with HAM to prevent scarring and perineural fibrosis.
Internal Rotation Stress Test Reduces Cross-Pinning and Improves Outcomes in Displaced Pediatric Supracondylar Humeral Fractures
Authors: Rees Andrew B. , Schultz Jacob D. , Wollenman Lucas C. , Moore-Lotridge Stephanie N. , Martus Jeffrey E. , Mencio Gregory A. , Schoenecker Jonathan G.
Published: July 2021

Background:

Stabilization of the medial column is vital in preventing the loss of fixation and malunion in displaced pediatric supracondylar humeral fractures (SCHFs). The preferred percutaneous pin configuration for medial column fixation remains controversial between medial pinning (cross-pinning) and additional lateral-based pinning. The intraoperative internal rotation stress test (IRST) has been proposed to reliably determine the optimal fixation strategy for each unique fracture. This study evaluated the impact of implementing the IRST on both the choice of pin configuration and institution-wide complications in pediatric patients treated operatively for SCHFs.

Methods:

Pediatric patients undergoing percutaneous pinning for SCHFs between 2007 and 2017 at a single center were retrospectively reviewed. The IRST was made a universal institutional practice in 2013. Patients were divided into 2 groups for analysis: (1) patients who underwent treatment before the IRST was implemented in 2013 (the pre-IRST group), and (2) patients who were treated after the IRST was implemented in 2013 (the IRST group). Subgroup analysis was completed for patients in the IRST group who were treated with cross-pinning or 3 lateral-based pins.

Results:

In this study, 820 patients in the pre-IRST group and 636 patients in the IRST group were included. After the IRST implementation, the rate of loss of fixation fell from 1.2% to 0% (p = 0.003), and the reoperation rate fell from 3.3% to 0.2% (p < 0.001). No cases resulted in a loss of fixation after the adoption of the IRST. The number of patients treated with cross-pinning decreased significantly from 53.2% to 31.6% (p < 0.001) after the IRST implementation, yet cross-pinning continued to be used for more severe fractures. Complication rates within the IRST group were not significantly different (p > 0.05) between cross-pinning and 3 lateral-based pins.

Conclusions:

In the largest cohort reported on to date, to our knowledge, institutional implementation of the IRST resulted in a significant reduction in the use of cross-pinning. Although the usage of cross-pinning decreased, cross-pinning was still used frequently in the most severe fractures. The IRST use also resulted in significantly fewer complications such as loss of fixation after institution-wide implementation of the IRST for treating pediatric SCHFs.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Milk Tumor Necrosis Factor Alpha and Interleukin-1Beta Among Toxoplasma gondii-Free and Infected Women
Authors: Al-Hassnawi Alaa Tareq Shakir , Al-Morshidy Kassim Abdulla Hamza , Al-Harbi Nuha Yaarub
Published: July 2021

Pro-inflammatory cytokines play an important role in intercellular communications. In the last two decades, many cytokines have been identified in human milk. These cytokines are variable according to different conditions such as pathogenic infections which strongly stimulated the immune response. The present study aims to determine of IL1β and TNF-α in Toxoplasma gondii-free and infected women in an attempt to clarify the impacts of the infections on cytokines especially in mother's milk. The serum and milk sample were collected from 96 samples (48 for seropositive and 48 for seronegative). To confirm the Toxoplasma gondii infection; enzyme linked immunofluorescence assay (ELIFA) was used to detect anti-Toxoplasma IgG antibodies. TNF-α and IL1β levels were measured by ELISA technique. Regarding milk TNF-alpha, there were statistical differences in Toxoplasma-infected from Toxoplasma-free subjects, whereas no statistical variations in TNF-α were found between other studied groups. IL1β showed significant variation just between milk and serum in infected and non-infected subjects, whereas no variations were recorded in other groups. In conclusion, based on statistical analysis, present study showed good evidence that toxoplasmosis is one of the risk factors for increasing milk cytokine. Also, a significant increase in TNF-α and IL1β in mother's breast milk may indicate a key role for inducing or developing of inflammations in suckling. Thus, further investigations are needed to cover this area of study.
Ghrelin and Leptin and Their Relations with Insulin Resistance in Diabetes Mellitus Type 2 Patients
Authors: Sadiq Chinar Hameed , Hussein Ridha Hassan , Maulood Ismail Mustafa
Published: July 2021

Ghrelin and leptin are hunger hormones related to type 2 diabetes mellitus (T2DM), and the pathogenesis of T2DM is the abnormality in insulin secretion and insulin resistance (IR). The aim of this study is to evaluate ghrelin and leptin concentrations in blood and to specify the relationship of these hormones as dependent variables with some biochemical and clinical measurements in T2DM patients. In this study, forty one T2DM and forty three non-diabetes mellitus (non-DM) subjects, aged between 40-60 years and with normal weight, were enrolled. Fasting serum ghrelin and leptin were estimated by enzyme-linked immunosorbent assay (ELISA). In our results ghrelin was significantly increased, and leptin was significantly decreased, in T2DM patients compared with non-DM subjects. Ghrelin was positively correlated with the fasting blood glucose (FBG) and IR, but inversely related to the insulin sensitivity (IS). Leptin was negatively correlated with mean arterial pressure (MAP), FBG, glycated hemoglobin (HbA1c), IR, low-density lipoprotein cholesterol, nitric oxide (NO), and alanine aminotransferase (ALT), as well as showed a linear correlation with IS and a strong dependence on sex. The area under the curve (AUC) value shows ghrelin and leptin as biomarkers for T2DM. In conclusion ghrelin and leptin hormones have predictive ability to predict T2DM, as they are significantly associated with IR, IS, free radicals, and lipid profile.
The Factors Affecting the Physical Activity of the Health Care Workers of Iran University of Medical Sciences: A Qualitative Study
Authors: Hoveidamanesh Soodabeh , Tayefi Batool , Rampisheh Zahra , Khalili Narjes , Ramezani Mozhdeh
Published: July 2021

Background: The low physical activity is a challenge in adults. A majority of adults spend many hours each week at work, so the workplace is a suitable site for health promotion and implementation of physical activity programs. This qualitative study was implemented to identify worksite physical activity barriers and facilitators from the perspective of the employees of the Iran University of Medical Science. Methods: In the present qualitative content analysis, five focus group discussions were held with the participation of 68 personnel of Iran University of Medical Sciences. Purposive sampling with maximum diversity was carried out for the study. Results: The analysis of the data led to the identification of three general themes, including challenges and barriers, strategies, and incentives (facilitators). The four main categories of challenges and barriers included policy-making and legislation, organizational factors, structural factors, and personal factors. Most barriers identified by the participants were placed in the personal factors and organizational factors categories. The strategies for increasing physical activity were identified in the following three categories: Policy-making and legislation, organizational factors, and environmental factors. The majority of the strategies proposed were placed in the organizational factors and policy-making and legislation categories.Conclusions: Increasing physical activity in the workplace as a strategy for the general promotion of physical activity in people requires interventions in different areas, especially with regard to organizational factors and policy-making and legislation.
SOX2 knockdown with siRNA reverses cisplatin resistance in NSCLC by regulating APE1 signaling
Authors: Chen Taiyu , Zhou Ji , Li Peng-cheng , Tang Chun-han , Yang Fang , Xu Ke , Li Tao , Ren Tao
Published: July 2021

Objective
SOX2 is related to drug resistance in many types of cancer, including lung cancer. Herein, we investigated the role of SOX2 and its regulatory signaling in cisplatin-treated non-small-cell lung cancer (NSCLC).
Methods
The effects of SOX2 on cell viability, proliferation, and apoptosis were evaluated in vitro. Western blotting, real-time quantitative PCR (qPCR), immunohistochemistry (IHC), and luciferase reporter assays were used to investigate the underlying mechanism. Kaplan-Meier survival analysis and the log-rank test were used to assess the relationship between SOX2 expression and patient survival.
Results
A549/CDDP cells had marked resistance to cisplatin and stronger colony formation ability than A549 cells. The expression of SOX2 protein or mRNA in A549/CDDP was higher than that in A549. Knockdown of SOX2 in A549/CDDP induced apoptosis by inhibiting colony formation and decreasing viability, but overexpression of SOX2 reversed these effects. Interestingly, Genomatix software predicted that the APE1 promoter has some SOX2 binding sites, while the SOX2 promoter has no APE1 binding sites. Furthermore, luciferase reporter assays proved that SOX2 could bind the promoter of APE1 in 293T cells. We further verified that SOX2 expression was not affected by shAPE1 in A549/CDDP. As expected, colony formation was obviously inhibited and apoptosis was strongly enhanced in A549/CDDP treated with SOX2 siSOX2 alone or combined with CDDP compared with control cells. Meaningfully, patients with high expression of SOX2 survived longer than those with low expression of SOX2.
Conclusion
siSOX2 overcomes cisplatin resistance by regulating APE1 signaling, providing a new target for overcoming cisplatin resistance in NSCLC.
Effects of the Covid-19 Pandemic on Maternity Staff in 2020 – A Scoping Review
Authors: Schmitt Nadine , Mattern Elke , Cignacco Eva , Seliger Gregor , König-Bachmann Martina , Striebich Sabine , Ayerle Gertrud M.
Published: July 2021

In the spring of 2020, the SARS-CoV-2 virus caused the Covid-19 pandemic, bringing with it drastic changes and challenges for health systems and medical staff. Among the affected were obstetricians and midwives, whose close physical contact with pregnant women, women who recently gave birth, and their children was indispensable. In the obstetric setting, births cannot be postponed, and maternity staff had to adapt to assure obstetric safety while balancing evidence-based standards with the new challenges posed by the pandemic. This scoping review gives a comprehensive overview of the effecs the Covid-19 pandemic had on maternity staff. We followed the evidence-based approach described by Arksey & O’Malley: we searched several databases for English and German articles published between January 2020 and January 2021 that discussed or touched upon the effects the pandemic had on maternity staff in OECD countries and China.We found that structural challenges caused by the crisis and its subjective effects on maternity staff fell into two main topic areas. Structural challenges (the first main topic) were divided into five subtopics: staff shortages and restructuring; personal protective equipment and tests; switching to virtual communication; handling women with a positive SARS-CoV-2 infection; and excluding accompanying persons. The pandemic also strongly affected the staff’s mental health (the second main topic.) Attempting to meet challenges posed by the pandemic while afraid of contamination, suffering overwork and exhaustion, and struggling to resolve ethical-moral dilemmas had severe negative subjective effects. Several studies indicated increased depression, anxiety, stress levels, and risk of post-traumatic stress symptoms, although the crisis also generated strong occupational solidarity.Care for pregnant, birthing, and breast-feeding women cannot be interrupted, even during a pandemic crisis that requires social distancing. Maternity staff sometimes had to abandon normal standards of obstetric care and were confronted with enormous challenges and structural adjustments that did not leave them unscathed: their mental health suffered considerably. Researchers should study maternity staff’s experiences during the pandemic to prepare recommendations that will protect staff during future epidemics.
MMTV Prevalence in Breast Cancer Samples in Romania - Do Major Geographical Differences Exist in The World Population?
Authors: Fekete Zsolt , Terțan Bristena Octavia , Ráduly Lajos , Eniu Dan Tudor , Buiga Rares , Galatâr Mihaela , Berindan-Neagoe Ioana
Published: July 2021

Background Breast cancer, although the most frequently diagnosed malignant tumor in humans, has a less clear etiology compared to other frequent cancer types. Mouse-mammary tumor virus (MMTV) is involved in breast cancer in mice and dogs and might play a role in the etiology of some breast cancers in humans, since it has been identified in 20-40% of breast cancer samples in Western Europe, USA, Australia and some other parts of the world’s population. The purpose of our study was to identify MMTV DNA sequences in breast tissue samples from breast cancer patients who underwent curative surgery in our regional center in Romania, EU. MethodsWe selected 75 patients with non-metastatic breast cancer treated surgically with curative intent, which did not undergo any neoadjuvant treatment. Out of these patients, 50 underwent radical lumpectomy and 25 modified radical mastectomy. We searched using PCR the MMTV-like DNA env sequence in the breast cancer tissue and normal breast tissue obtained from the same patients. ResultsNone of the examined samples was positive for MMTV-like target sequences on PCR.ConclusionsWe could not prove that MMTV plays a role in the etiology of breast cancer in our patient group. This finding is similar to publications of other geographically related research groups and might be due to the fact that only the Mus musculus domesticus mouse species was proven to carry infectious MMTV, but not the Mus musculus musculus species, which is specific to South-Eastern Europe (including Romania) and some parts of Asia.
Neurological manifestations of COVID-19 associated multisystem inflammatory syndrome in adults (MIS-A)
Authors: Maramattom Boby Varkey
Published: July 2021

Introduction Multi-system inflammatory syndrome (MIS) is a para infectious or post infectious extra-pulmonary complication of COVID-19. Neurological complications are better described in children with Multi-system inflammatory syndrome (MIS) in children (MIS-C). There is a paucity of literature about the neurological manifestations of Multi-system inflammatory syndrome (MIS) in adults (MIS-A).Materials and methods Over a 12-month period, from June 2020 to June 2021, over 350 patients were admitted to our medical and COVID ICUs. Of these, eight patients (2.2%) admitted to our ICU were detected to have a neurologic MIS-A.Results Most patients had a stroke (72.5%). Other manifestations included transverse myelitis, COVID encephalitis, acute encephalopathy, rhabdomyolysis and critical illness myo-neuropathy.Conclusions Most patients with MIS-A and severe neurological involvement had a poor outcome.
Nonalcoholic Fatty Liver Disease and Risk of Myocardial Infarction and Stroke in Young Adults: A Nationwide Population-Based Study
Authors: Chung Goh Eun , Cho Eun Ju , Yoo Jeong-Ju , Chang Young , Cho Yuri , Park Sang-Hyun , Han Kyungdo , Jeong Su-Min , Yoon Kyoung Wan , Shin Dong Wook , Yu Su Jong , Kim Yoon Jun , Yoon Jung-Hwan
Published: July 2021

Background: Nonalcoholic fatty liver disease (NAFLD) is associated with increased risk of cardiovascular diseases (CVDs). Because studies of young adults are limited, we investigated the relationship between NAFLD and cardiovascular events among a nationally representative sample of young adults in Korea. Methods: This population-based cohort study from the Korean National Health Insurance Service included adults who were 20–39 years old when they underwent a health examination from 2009–2012. NAFLD was defined as fatty liver index (FLI) ≥60, and participants were divided into three groups according to FLI (<30, 30−59, and ≥60) to investigate the effect of steatosis by grade. Results: Among 5,324,410 participants, 9.8% had an FLI ≥60. There were 13,051 myocardial infarctions (MI, 0.39%) and 8,573 strokes (0.26%) during a median follow-up of 8.4 years. In multivariable analysis, NAFLD was associated with a higher risk of MI and stroke (hazard ratio [HR]=1.69; 95% confidence interval [CI]: 1.61−1.77 and HR=1.73; 95% CI: 1.63−1.84, respectively). MI and stroke had dose-depended relationships with FLI (HR=1.28 in FLI 30−59 and 1.73 in FLI ≥60 for MI and HR=1.18 in FLI 30−59 and 1.41 in FLI ≥60 for stroke, respectively).Conclusions: NAFLD was an independent predictor of MI and stroke in young adults. These results suggest that primary prevention of CVD should be emphasized in young adults with NAFLD.
An Overview of the Current Situation of Degloving Skin and Soft-Tissue Injuries in China: A Retrospective Study of the Inpatients with DSTI from 2013 to 2018
Authors: Yu Shaoshuo , Fang He , Jiang Yao-nan , Tang Chen-qi , Shi Ying , Gan Lan-xia , Tang Hong-tai , Wang Hai-bo , Sun Yu , Xia Zhaofan
Published: July 2021

Background: Degloving skin and soft-tissue injury (DSTI) is a kind of serious lesion in the field of surgery, with potential risk of morbidity and mortality. This study is aimed to summarize and analyze the current situation of DSTI in China, so as to provide enlightenments for better prevention and treatment. Methods: By searching inpatients’ information on the first page recorded by the Hospital Quality Monitoring System from January 1, 2013 to December 31, 2018, patients diagnosed with DSTI were identified and screened based on the International Classification of Diseases coding System. Demographic characteristics, injury and cost information were collected for analysis. Results: There were 62709 patients who were diagnosed with DSTI, of whom 67.41% were males with a mean age of 43.01±19.70. Peasants and workers, traffic-related accidents and falls, summer and autumn accounted for high percentage of the study indicators. The operation rate of DSTI roughly showed a growing trend, and the average length of stay was 22.02±29.73 days, during which time 0.93% of the patients ended up in death. Medicine took up the first place of the hospitalization expense, but was decreasing year by year, while the proportion of other expenses gradually increased. More than half of the patients paid at their own charge, but the ratio of urban medical insurance was rising. The most and least frequent anatomic site of DSTI were lower extremity (43.40%) and torso (1.59%). Each injury site showed its own characteristics. Conclusions: This is the first retrospective study that targeted a nationwide data bank to make a relatively detailed epidemiological analysis of DSTIs from 2013 to 2018 in China. From this work, not only a preliminary understanding but also enlightenments for better prevention and treatment of DSTI has been gained.
A behavioral intervention to reduce range anxiety and increase electric vehicle uptake
Authors: Herberz Mario , Hahnel Ulf , Brosch Tobias
Published: July 2021

Electric vehicles are on the rise, but are still far from reaching the global market share required to achieve climate objectives. While financial and technological adoption barriers are increasingly removed, psychological barriers remain insufficiently addressed on a large scale. Here, we show that car owners substantially underestimate the compatibility of available battery capacities with their individual mobility needs, increasing the demand of long battery ranges and reducing willingness to adopt. We test a simple behavioral intervention in two randomized online experiments in Germany and the U.S.: providing tailored compatibility information reduced range anxiety and increased willingness to pay for electric vehicles. Compatibility information more strongly increased preferences than information about privileged access to charging infrastructure, and selectively increased preferences of car owners for whom an electric vehicle would yield higher financial benefits. This scalable intervention may complement classical policy approaches in achieving a resource-conscious and global electrification of mobility.
Healthcare Institutions’ Recommendation Regarding the Use of FFP-2 Masks and SARS-Cov-2 Seropositivity Among Healthcare Workers – A Multicenter Longitudinal Cohort Study
Authors: Szajek Katarzyna , Fleisch Felix , Hutter Sandra , Risch Martin , Bechmann Theresa , Luyckx Valerie Ann , Güsewell Sabine , Hirzel Cédric , Cusini Alexia
Published: July 2021

BackgroundHealth care workers (HCW) are heavily exposed to SARS-CoV-2 from the beginning of the pandemic. We aimed to analyze risk factors for SARS-CoV-2 seroconversion among HCW with a special emphasis on the respective healthcare institutions’ recommendation regarding the use of FFP-2 masks. MethodsWe recruited HCW from 13 health care institutions (HCI) with different mask policies (type IIR surgical face masks vs. FFP-2 masks) in Southeastern Switzerland (canton of Grisons). Sera of participants were analyzed for the presence of SARS-CoV-2 antibodies six months apart, after the first and during the second pandemic wave using an electro-chemiluminescence immunoassay (ECLIA, Roche Diagnostics). We captured risk factors for SARS-CoV-2 infection by using an online questionnaire at both time points. The effects of individual COVID-19 exposure, regional incidence and FFP-2 mask policy on the probability of seroconversion were evaluated with univariable and multivariable logistic regression.ResultsSARS-CoV-2 antibodies were detected in 99 of 2794 (3.5%) HCW at baseline and in 376 of 2315 (16.2%) participants six months later. In multivariable analyses the strongest association for seroconversion was exposure to a household member with known COVID-19 (aOR: 19.82, 95% CI: 8.11-48.43, p<0.001 at baseline and aOR: 8.68, 95% CI: 6.13-12.29, p<0.001 at follow-up). Significant occupational risk factors at baseline included exposure to COVID-19 patients (aOR: 2.79, 95% CI: 1.28-6.09, p=0.010) and to SARS-CoV-2 infected co-workers (aOR: 2.50, 95% CI: 1.52-4.12, p<0.001). At follow up six months later, non-occupational exposure to SARS-CoV-2 infected individuals (aOR: 2.54, 95% CI: 1.66-3.89 p<0.001) and the local COVID-19 incidence of the corresponding HCI (aOR: 1.98, 95% CI: 1.30-3.02, p=0.001) were associated with seroconversion. The healthcare institutions’ mask policy (surgical masks vs. FFP-2 masks) did not affect seroconversion rates of HCW during the first and the second pandemic wave. ConclusionContact with SARS-CoV-2 infected household members was the most important risk factor for seroconversion among HCW. The strongest occupational risk factor was exposure to COVID-19 patients. During this pandemic, with heavy non-occupational exposure to SARS-CoV-2, the mask policy of HCIs did not affect the seroconversion rate of HCWs.
Prevalence and Risk Factors of Untreated Thyroid Dysfunctions in the Older Caucasian Adults: Results of Polsenior 2 Survey
Authors: Kocelak Piotr , Mossakowska Malgorzata , Puzianowska-Kuznicka Monika , Sworczak Krzysztof , Wyszomirski Adam , Handzlik Gabriela , Stefanski Adrian , Zdrojewski Tomasz , Chudek Jerzy
Published: July 2021

Background: To determine the prevalence of treated and untreated thyroid dysfunction and to identify factors associated with increased risk of undiagnosed thyroid dysfunction in older adults.Methods The population of 5987 community-dwelling Polish Caucasian seniors aged 60 years and above who participated in the PolSenior 2 study (2018 – 2019). Population-based cross-sectional multidisciplinary study in design. Data from structured questionnaires, geriatric tests and scales were obtained from all study participants who underwent anthropometric and blood pressure measurements during three home visits. Assessment of thyroid function was based on TSH serum measurements.ResultsThe prevalence of thyroid dysfunction in the Polish population aged 60 years or above was estimated at 15.5% (21.5% in women and 7.2% in men), with 3.2% of undiagnosed individuals among them. The prevalence of hypothyroidism and hyperthyroidism in the studied group was 13.9% (19.4% in women and 6.3% in men) and 1.6% (2.1% in women and 0.9% in men) respectively. In multiple regression analysis independent risk factors for thyroid disorders being untreated were older age (> 75 years), male sex, a low education level (primary or lower) and low utilization of medical services.Conclusions One-fifth of Polish Caucasian seniors with hypothyroidism and one-third with hyperthyroidism is untreated. Older, poorly educated and rarely utilizing medical services seniors, especially men, are more frequently untreated for thyroid dysfunction and some of them do not benefit from contemporary achievements of medicine.
Identifying Methylation-Driven Immune-related Molecular Subtypes Predicts the Prognosis of Hepatocellular Carcinoma
Authors: Yan Qian , Ye Baoqian , Wang Boqing , Zheng Wenjiang , Wang Xiongwen
Published: July 2021

The purpose of this study is to analyze the DNA methylation and gene expression profiles of immune-related CpG sites to identify the molecular subtypes and CpG sites related to the prognosis of HCC. In this study, the DNA methylation and gene expression datasets were downloaded from The Cancer Genome Atlas database, together with immune-related genes downloaded from the immunology database and analysis portal database to explore the prognostic molecular subtypes of HCC. By performing consistent clustering analysis on 830 immune-related CpG sites, we identified seven subgroups with significant differences in overall survival. Finally, 16 classifiers of immune-related CpG sites were constructed and used in the testing set to verify the prognosis of DNA methylation subgroups, and the results were consistent with the training set. Using the TIMER database, we analyzed 16 immune-related CpG sites expression with the abundance of six types of immune infiltrating cells and found that most are positively correlated with the level of infiltration of multiple immune cells in HCC. This study screened potential immune-related prognostic methylation sites and established a new prognosis model of HCC based on DNA methylation molecular subtype, which may help in the early diagnosis of HCC and developing more effective personalized treatments.
Responses of Functional Genes Involved In Nitrogen Cycling To Green Manuring In Different Paddy Soils In South China
Authors: Li Shun , Liang Hai , Wang Yun , Zhang Zihan , Zhang Lei , Zhou Guopeng , Gao Songjuan , Cao Weidong
Published: July 2021

Aims We studied the effects of green manuring on the nitrogen (N) cycling process in different paddy soils.Methods Field experiments conducted in Hunan, Jiangxi, Henan and Fujian provinces in south China to investigate the responses of rice yield, soil properties, and functional genes involved in N cycling to green manuring. The field experiments had four treatments, i.e., no fertilizer application (NF), using milk vetch (Astragalus sinicus L.) as green manure without chemical fertilizer (GM), winter fallow and chemical fertilizer (CF), and a combination of green manure and chemical fertilizer (GMCF). Results The results showed that rice yield significantly increased in GMCF treatment. The copies of nifH gene significantly increased in GMCF in Jiangxi and Henan provinces. Ammonia oxidizing archaeal (AOA) amoA gene was predominant in all provinces compared with ammonia oxidizing bacterial (AOB). Compared with CF treatment, The copies of AOB-amoA gene were reduced in GMCF, indicating the inhibition of soil nitrification. The nirK gene was negatively correlated with SOM, TN, NH4+-N, NO3--N and AP, indicating that the positive effects of green manure on soil nutrients caused the inhibition of denitrification process. The nirK gene was the most critical factor influencing rice yield among the tested functional genes, with a relative influence of 63.5%. In comparison SOM was the most important factor (with a relative influence of 41.0%) among soil chemical properties. Conclusions In conclusion, the application of green manures changed the abundance of functional genes involved in the N cycling, and combined application with chemical fertilizer inhibited soil nitrification and denitrification.
Hyaluronan based gel promotes human Dental Pulp Stem Cells bone differentiation by activating YAP/TAZ pathway
Authors: Noce Marcella La , Stellavato Antonietta , Vassallo Valentina , Cammarota Marcella , Laino Luigi , Desiderio Vincenzo , Nicoletti Giovanni Francesco , Tirino Virginia , Papaccio Gianpaolo , Schiraldi Chiara , Ferraro Giuseppe Andrea
Published: July 2021

Background. Hyaluronic acid (HA) is the major component of the extracellular matrix of human tissue, where it regulates processes such as osmotic pressure, water retention, cell migration, and differentiation. For these reasons, hyaluronans are currently used in regenerative medicine in different areas. Nevertheless, hyaluronans exist in different forms accordingly with molecular weight and degree of crosslinking, which can have a different and context-depended effects on cellular processes. Thus, picking the most appropriate form of hyaluronan turn out to be fundamental as it can make a huge difference in tissue regeneration. MSCs have attracted attention in tissue regeneration for their proliferation potential and ability to differentiate in several cytotypes. Among MSCs, human Dental Pulp Stem Cells (hDPSCs) were shown to be remarkably suitable for bone differentiation.In this study, we tested the capability to induce osteogenic differentiation in hDPSCs of three hyaluronans forms: linear pharmaceutical-grade hyaluronans at high (HHA), low molecular weight (LHA), and the recently stabilized hybrid cooperative complexes (HCC), containing both sizes.Methods. hDPSCs were treated with HHA, LHA, HCC for 7, 14 and 21 days. The effects of hyaluronans on osteogenic differentiation were evaluated by qRT-PCR and WB of osteogenic markers and by Alizarin Red S staining. CD44, the main receptor of the HA on cell surface and an upstream regulator of YAP/TAZ signaling, was analyzed by immunofluorescence. YAP/TAZ expression was measured by qRT-PCR. To confirm the involvement of YAP/TAZ pathway, YAP/TAZ inhibitor-1 was used and the loss of function of YAP/TAZ was evaluated by qRT-PCR, WB and immunofluorescence.Results. HCC was found to be the most impacting in inducing osteogenesis, with significant effects already at 7-14 days of treatment. HCC induced strong overexpression of osteocalcin, osteopontin, and bone sialoprotein, calcification nodule formation, and CD44 up-regulation.In addition, we showed that this biological process is associated to the activation of YAP/TAZ pathway and its target genes CTGF, ANKDR-1, RUNX-1, and RUNX-2.Conclusions. In conclusion, in this study we show that HA’s molecular weight can have a tremendous impact on HA performance for bone regeneration, and we unveil a new molecular mechanism by which HA acts on stem cells.
Impact of COPD treatment on survival in patients with advanced non-small cell lung cancer
Authors: Jo Hyunji , Park Sojung , Kim Nam Eun , Park So Young , Ryu Yon Ju , Chang Jung Hyun , Lee Jin Hwa
Published: July 2021

Background
Chronic obstructive pulmonary disease (COPD) is associated with a poor prognosis in patients with non-small cell lung cancer (NSCLC). However, the impact of COPD treatment on the survival of patients with advanced NSCLC remains uncertain.
Methods
We retrospectively investigated COPD patients among patients newly diagnosed with advanced NSCLC between September 2005 and August 2019 at a university hospital. The diagnosis of COPD was made by forced expiratory volume in 1 second (FEV1)/forced vital capacity < 0.7 with spirometry performed within one year before and after the diagnosis of NSCLC. The clinical characteristics, lung function, and survival outcomes were analyzed and compared between patients who did and did not receive COPD treatment.
Results
Among 221 patients with advanced NSCLC and COPD, 124 received treatment for COPD and 97 did not receive treatment for COPD. A total of 190 (86.0%) patients were newly diagnosed with COPD at the time of diagnosis of advanced NSCLC. FEV1 and FEV1 % predicted values were greater in the no-treatment group than in the COPD treatment group (P < 0.001). The median overall survival (OS) of the treatment group was 10.7 months while that of the no-treatment group was 8.7 months (P = 0.007). In multivariate Cox regression analysis, COPD treatment was independently associated with improved OS after adjustment for sex, age, body mass index, FEV1, lung cancer stage, and chemotherapy (hazard ratio, 0.71; 95% confidence interval, 0.53–0.95; P = 0.021).
Conclusion
COPD treatment was associated with improved OS in patients with advanced NSCLC and COPD. Therefore, pretreatment spirometry and maximal treatment for COPD may offer a chance of optimal management for patients with advanced NSCLC.
Turkey Ovarian Tissue Transplantation: Effects of Surgical Technique on Graft Attachment and Immunological Status of the Grafts 6 Days Post-surgery
Authors: Hall George B , Long Julie A. , Susta Leonardo , Wood Ben J. , Bédécarrats Grégoy Yves
Published: July 2021

Background: Biobanked poultry ovaries can be revived via transplantation, into a recipient female, which upon maturity will produce donor-derived progeny. Previously, a large portion of these recipients also produced recipient-derived progeny, making them gonadal chimeras. These were potentially created when portions of the recipient’s ovary were inadvertently left behind. Completely removing the recipient ovary would solve this problem, however, leaving a portion of the recipient’s ovary may have inadvertently increased the transplant attachment rate by providing a damaged area for the transplant to attach too. To test this hypothesis in the turkey, we removed various portions (33% to 100%) of recipient ovarian tissue and determined the transplant attachment rate. Furthermore, the use of the abdominal air sac membrane as an additional anchoring point was tested. Finally, the immunological status of the grafts was evaluated by analyzing the presences of CD3 and MUM-1 (T and B cell markers), 6 days post-surgery.Results: The overall attachment rate of transplants was 91% (32/35), while the average size of the transplants was 4.2 ± 0.6 mm2. There was no difference (P > 0.05) in the attachment rates, or transplant size between groups with varying amounts of recipent tissue removed, or by using the abdominal air sac membrane as an anchor. However, all transplants were infiltrated by large numbers of T and B cells. This was shown by a high (P ≤ 0.001) percentage of CD3-positive immunostained cytoplasmic area (49.78 ± 3.90%) in transplants compared to remnant recipient tissue (0.30 ± 0.10%), as well as a high (P ≤ 0.001) percentage of MUM-1-positive immunostained nuclear area (9.85 ± 1.95%) in transplants over remnant recipient tissues (0.39 ± 0.12%).Conclusions: This study showed that neither the portion of the recipient ovary left behind nor the use of the abdominal air sac membrane affected the rate of attachment or the amount of donor tissue that attached. Thus, we recommend removing the entire recipient ovary to prevent gonadal chimeras. The high levels of lymphocytes within the grafts indicate possible tissue rejection, which could be overcome via immunosuppression with or without histocompatibility matching between donors and recipients.
Alpine meadow degradation depresses soil nitrogen fixation by regulating plant functional groups and diazotrophic community composition
Authors: Zhang Lu , Wang Xiangtao , Wang Jie , Liao Lirong , Lei Shilong , Liu Guobin , Zhang Chao
Published: July 2021

Aims
Biological nitrogen fixation (BNF), a function performed by diazotrophic microbes, plays an essential role in nitrogen (N) bioavailability in terrestrial ecosystems. However, little is known about the effects of degradation on soil BNF and diazotrophic communities in alpine meadow.
Methods
We investigated the changes in soil BNF and their potential drivers in alpine meadows along a degradation gradient on the Tibetan Plateau (non-degraded, lightly degraded, moderately degraded, and severely degraded meadows) using real-time quantitative PCR and amplicon sequencing.
Results
Soil BNF rates decreased significantly along the meadow degradation gradient with a range of 17.34–79.84 nmol C2H4 g− 1 dry soil d− 1 across all sites. The highest BNF was observed in the non-degraded meadow and was 1.5–4.6-fold higher than that in degraded meadows. Meadow degradation significantly reduced the gene abundance of nifH and the Shannon and Chao1 diversity indices of diazotrophs, accompanied by a decrease in plant biomass, soil moisture, and nutrient content (C, N component). Soil BNF potential was closely correlated with plant biomass, soil nutrient content, and diazotrophic abundance (including Nostoc, Scytonema, Rhodopseudomonas, Rhizobiales, and Proteobacteria). The community composition of diazotrophs differed markedly among sites with different levels of degradation, and both autotrophic (Cyanobacteria) and heterotrophic (Proteobacteria) diazotrophs contributed simultaneously to the BNF. The plant functional groups, especially the sedges family, were the primary drivers for soil BNF rates via mediating soil moisture, nutrient level (dissolved organic C and N), nifH gene abundance, and diazotrophic community composition.
Conclusions
Our results reveal the underlying mechanism of changes in soil BNF during alpine meadow degradation, emphasize the importance of plant functional groups in shaping the diazotrophic community and BNF potential, and provide insights for the restoration of degraded meadow ecosystems.
Analysis of Exponent K Based on “Share” Project Data and Its Implications on Importance Factors of En 1998-1
Authors: Dragojevic Dejan , Salic Radmila , Milutinovic Zoran
Published: July 2021

This paper deals with seismic activity represented by a hazard curve through a single parameter – exponent k as given in EN 1998-1, as well as with its implications on importance factors. We have used the SHARE project dataset for calculation of exponent k for the wider European area and limited number of separate national studies for comparison of results since comparison to the SHARE results on the same dataset resulted with values of exponent k smaller by 1–1.5. The results indicate that recommended value of exponent k of 3 is rather an exception than expected value in seismically active regions, and that with the exclusion of Vrancea zone, for majority of Europe exponent k is well below assumed in EN 1998-1, which consequently indicate that importance factors for these locations should be larger than recommended in EN 1998-1.
Rapidly progressive amnestic syndrome with psychiatric and autonomic features: extending the spectrum of GFAP-astrocytopathies and autoimmune dementias?
Authors: Friedrich Maximilian , Hartig Johannes , Prüß Harald , Ip Chi Wang , Volkmann Jens
Published: July 2021

Objective Autoimmune glial fibrillary acidic protein astrocytopathy (GFAP-A) is a steroid-responsive meningoencephalomyelitis, sometimes presenting with atypical clinical signs such as movement disorders or psychiatric and autonomic features. Diagnosis relies on clinical presentation, detection of GFAP autoantibodies in CSF as well as ancillary MRI biomarkers. We aimed to characterize two patients seropositive for GFAP antibodies in CSF presenting with a highly atypical clinical picture of isolated neurocognitive and autonomic features resembling neurodegenerative dementia in absence of cranial MRI abnormalities.Methods Semiquantitative, clinicoradiological, serologic and immunohistochemical analysis of two cases with longitudinal observation over a time course of 18–24 months.Results Both patients had rapidly progressive amnestic syndromes in absence of other focal neurologic signs. Cranial MRI was grossly unremarkable while functional neuroimaging showed cortical and subcortical metabolic changes. Tissue-based assays (TBA) of CSF confirmed GFAP-specific astrocytic binding patterns in rat corpus callosum and hippocampus in both cases. Incomplete steroid response prompted therapy escalation to B-cell depletion, which improved or stabilized disease courses over the observation time.Conclusions These cases suggest that rapidly progressive amnestic syndromes with psychiatric and autonomic features may be a novel phenotype of GFAP astrocytopathy as well as a potentially underrecognized mimic of neurodegenerative dementia amenable to immunomodulation. We recommend including GFAP-AB screening using TBA in the work-up of rapidly progressive dementias especially when autoimmune etiologies are suspected.
The Effects of Cancer Survivor Support Service on Distress in South Korea: A Nationwide Prospective Pilot Study
Authors: Lee Hyun Jeong , Kim Young Ae , Ryu Seong Yeob , Chun Mison , Yim Chang-Yeol , Kang Hee-Taik , Kang Jung Hun , Huh Jung-Sik , Kim Jong-Heun , Lim Kyu-Hyoung , Jung So Youn , Kwon Hyoung-Cheol , Goh Eurah , Lee Yeon-Seung , Ju Hee Young , Yun E Hwa , Chang Yoon Jung
Published: July 2021

Background: To investigate the characteristics of cancer survivors and the effects of the services of the Korean Cancer Survivorship Center Pilot Project launched by the South Korean government on distress.Methods: A prospective observational cohort study was performed in cancer survivors who completed primary treatment. Cancer survivors’ distress and symptoms such as fatigue, pain, depressive mood, anxiety, and insomnia were evaluated by well-trained nurses. Regarding to their needs, medical and psychosocial support services were provided. Results: This study included 1,921 cancer survivors, with a mean age of 57.3 years (68.7% females). The breast cancer was most common, followed by stomach and colorectal cancer. Psychosocial and medical support decreased the percentage of the high-distress group from 50.9% to 30.5% and decreased the percentage of cancer survivors with high scores in fatigue, pain, anxiety, depressive mood, and insomnia. The independent predictors of a low distress level after the use of the services were older age, the relief of fatigue, pain, and insomnia.Conclusions: This study showed that psychosocial and medical support is associated with the lower distress and physical and mental symptoms of cancer survivors. Psychosocial and medical support could contribute to distress relief in cancer survivors. Further management strategies for fatigue, pain, and insomnia are required.
Challenges in implementation of Competency Based Medical Education – A Cross Sectional survey among medical faculty in India
Authors: kandasamy sangeetha , Catherine A.Precilla , Gopalakrishnan Shivkumar
Published: July 2021

Background. In India, Competency Based Medical Education (CBME) is gaining foothold to transform the medical student into a doctor fulfilling community and societal needs. With that end in view the teaching faculty are getting sensitized and trained by the National Faculty Development Program (FDP). Objectives. To assess the awareness about FDP among teaching faculty in medical colleges. To study the attitude & perceived barriers to implementation of CBME. Methods. This questionnaire based multicentric cross sectional study was conducted among teaching faculties in Indian medical institutes. Electronic media [Google forms] was used to disseminate the questionaire. Attitudinal and perceptional differences were internally compared among the faculties.Results. Among 251 participants 90.2% faculties from private institutes had undergone FDP significantly more than those from Government sector (p=0.008). We observed that 92.4% were aware, 80.2 % had undergone Curriculum Implementation Support Program (CISP) and 95.2% did agree that CBME will improve the medical education system.Major challenges perceived were high student to faculty ratio (67.7%), ill developed infrastructure (41.4%) and difficulties in assessment (41.1%). The popular solutions suggested were to increase faculty strength (73.7%), improve infrastructure (69.3%), extra remuneration (35.9 %) and increase administrative support (30.7%). There were significant difference of opinions between teaching faculty of government and private sector (p=0.017).Conclusion. Most of the medical faculty are aware of the need and have acquired a positive attitude to enforcement of CBME. However significant barriers do exist in the form of manpower and resources which need to be addressed.