bluuebunny/crossref_metadata_2025 huggingface dataset:
Individualized Embryo Selection Strategy Developed by Stacking Machine Learning Model for Better In Vitro Fertilization Outcomes: An Application Study.
Authors: XI Qingsong , YANG Qiyu , WANG Meng , HUANG Bo , ZHANG Bo , LI Zhou , LIU Shuai , YANG Liu , ZHU Lixia , Jin Lei
Published: January 2021

Background: To minimize the rate of in vitro fertilization (IVF)- associated multiple-embryo gestation, significant efforts have been made. Previous studies related to machine learning in IVF mainly focused on selecting the top-quality embryos to improve outcomes, however, in patients with sub-optimal prognosis or with medium- or inferior-quality embryos, the selection between SET and DET could be perplexing. Methods: This was an application study including 7887 patients with 8585 embryos treated during 2016 to 2018, in Tongji Hospital, Wuhan, China. A hierarchical model was established using the machine learning system XGBoost, to learn embryo implantation potential and the impact of double embryos transfer (DET) simultaneously. The performance of the model was evaluated with the AUC of the ROC curve. Multiple regression analyses were also conducted on the 19 selected features to demonstrate the differences between feature importance for prediction and statistical relationship with outcomes.Results: For a single embryo transfer (SET) pregnancy, the following variables remained significant: age, attempts at IVF, estradiol level on hCG day, and endometrial thickness. For DET pregnancy, age, attempts at IVF, endometrial thickness, and the newly added P1+P2 remained significant. For DET twin risk, age, attempts at IVF, 2PN/ MII, and P1×P2 remained significant. The algorithm was repeated 30 times, and averaged AUC of 0.7945, 0.8385, and 0.7229 were achieved for SET pregnancy, DET pregnancy, and DET twin risk, respectively. The trend of predictive and observed rates both in pregnancy and twin risk was basically identical. XGBoost outperformed the other two algorithms: logistic regression and classification and regression tree. Conclusion: Artificial intelligence based on determinant-weighting analysis could offer an individualized embryo selection strategy for any given patient, and predict clinical pregnancy rate and twin risk, therefore optimizing clinical outcomes.
Biomechanical Characteristics of Tibio-Femoral Joint After Partial Medial Meniscectomy Under Different Flexion Angles：A Finite Element Analysis
Authors: Zhang Xiaohui , Wang Jun , Yuan Shuo , Liao Bagen , Liang De
Published: January 2021

Background : Arthroscopy is a commonly-used surgical procedure for meniscal tears. However, recent studies have pointed out that arthroscopy may lead to an elevated risk of knee osteoarthritis(KOA). The biomechanical analysis after arthroscopic partial meniscectomy(APM) is helpful to clarify the biomechanical factors of KOA. Therefore, this study aims to elucidate cartilage stress and meniscus displacement of the tibiofemoral joint under flexion and rotation loads after APM.Methods：A detailed finite element model of the knee bone, cartilage, meniscus, and major ligaments was established by combining computed tomography and magnetic resonance images. Vertical load and front load were applied to simulate different knee buckling angles. At the same time, by simulating flexion of different degrees and internal and external rotations, the stresses on tibiofemoral articular cartilage and meniscus displacement were evaluated.Results：Generally, the contact stress on both the femoral tibial articular cartilage and the meniscus increased with the increased flexion degree. Moreover, the maximum stress on the tibial plateau gradually moved backward. The maximum position shift value of the lateral meniscus was larger than that of the medial meniscus.Conclusion：Our finite element model provides a realistic three-dimensional model to evaluate the influence of different joint range of motion and rotating tibiofemoral joint stress distribution. The decreased displacement of the medial meniscus may explain the higher pressure on the knee components. These characteristics of the medial tibiofemoral joint indicate the potential biomechanical risk of knee degeneration.
The Riccati Equation and the Hidden Parameter &Variable
Authors: Zhao Ji-Xiang
Published: January 2021

Using suitable function transformation in combination with a specific Riccati-type equation solvable, general solution of the Riccati equation in the form of elementary quadrature is given. In the process of solving the Riccati equation, the hidden parameter and variable are discovered. This indicates that hidden parameter & variable exist in all differential equations associated with the Riccati equation, such as the second-order linear ODEs, the Schrödinger equation and the Navier–Stokes equation.
Estimating the burden of Paediatric HIV in an ‘A’ category district in India: An epidemiological study
Authors: Sinha Anju , Washington Reynold , Sethumadhvan Rajeev , Potty Rajaram , Isac Shajy , Thavraj Vasantha , Pandey Ravindra
Published: January 2021

Background: Epidemiological information on the disease burden of paediatric HIV is lacking in India. The National AIDS Control Program (NACP) provides estimates of paediatric HIV based on its projections of adult infections. The window of opportunity for diagnosis and treatment is very narrow a third of HIV infected children do not see their first birthday and half of them do not reach their second birthday. Early detection of pediatric HIV is crucial for prevention of morbidities, growth delays and death. Methods: The study aimed to estimate the disease burden of pediatric HIV among children in ‘A’ category district of a high HIV prevalence state. The study used an innovative multipronged methodology to estimate the disease burden in a high burden district in India. Details of methodology have been published and include early case detection in infants (0-18 months) born to HIV positive women, among children in families with HIV positive parents, and among sick children (0 to 14 years) presenting in a health facility and screened using a modified IMCI-HIV algorithm, were methods used. The overall burden of paediatric HIV was calculated as a product of cases detected in each strategy multiplied by a net inflation factor for each strategy.Results: The existing pool of HIV infection in the district works out to be 3266 HIV positive children <15 years of age, among a mid-year (2013) projected child population of 1401688, thus giving us an overall HIV prevalence among children of 0.23%. The proportion of children among all people living with HIV in the district works out to 10.4% (3266/ (3266+28119)Conclusions: The study reported a higher prevalence than reported earlier from projections of the NACP. An overall 0.23% HIV prevalence among children was estimated which is 2.5 times that of the earlier reported prevalence for Karnataka state. The proportion of children among all persons living with HIV in Belgaum district in this study is 10.4% against 6.54% reported earlier for India. The study methodology is replicable for other settings and other diseases.
Nox4 mediates RANKL-induced ER-phagy and Osteoclastogenesis via activating ROS/PERK/eIF-2α/ATF4 Pathway
Authors: Sun Jing , Cheng Wugui , Li Songtao , Yang Sizhen , Zhang Ying , Hu Xu , Qiu Hao , Xu Shangcheng , Chu Tongwei
Published: January 2021

Background: Receptor activator of nuclear factor-κB ligand (RANKL) has been found to induce osteoclastogenesis and bone resorption. However, the underlying molecular mechanisms remain unclear. Results: Inhibitor chloroquine (CQ) was used to verified the role of autophagy in RANKL-induced osteoclastogenesis; Via downregulating Nox4 with inhibitor (DPI) and retrovirus-conveyed shRNA, we further explored the importance of Nox4 in RANKL-induced autophagy and osteoclastogenesis, as well as the regulatory effects of Nox4 on nonmitochondrial reactive oxygen species (ROS) and PERK/eIF-2α/ATF4 pathway.Intracellular ROS scavenger (NAC), mitochondrial-targeted antioxidant (Mito-TEMPO) and inhibitor of PERK (GSK2606414) were also employed to investigate the role of ROS and PERK/eIF-2α/ATF4 pathway in RANKL-induced autophagy and osteoclastogenesis. RANKL markedly increased autophagy, while CQ treatment caused reduction of RANKL-induced autophagy and osteoclastogenesis. Consistent with the increased autophagy, the protein levels of Nox4 were significantly increased, and Nox4 was selectively localized within the endoplasmic reticulum (ER) after RANKL stimulation. DPI and shRNA efficiently decreased the protein level and (or) activity of Nox4 in the ER and inhibited RANKL-induced autophagy and osteoclastogenesis. Mechanistically, we found that Nox4 regulates RANKL-induced autophagy activation by stimulating the production of nonmitochondrial ROS. Additionally, Nox4-derived nonmitochondrial ROS dramatically activate PERK/eIF-2α/ATF4, which is a critical unfolded protein response (UPR)-related signaling pathway. Blocking the activation of the PERK/eIF-2α/ATF4 signaling pathway either by Nox4 shRNA, ROS antioxidant or PERK inhibitor (GSK2606414) treatment significantly inhibited endoplasmic reticulum autophagy (ER-phagy) during RANKL-induced osteoclastogenesis. Conclusions: Our findings provide new insights into the processes of RANKL-induced osteoclastogenesis and will help the development of new therapeutic strategies for osteoclastogenesis-related diseases.
PSMC2/E2F1 Axis Promotes the Development and Progression of Glioma
Authors: Qi Xuchen , Lu Qin , Xie Dajiang , Lv Junhui , Liu Yiwei , Yang Shuxu , Wang Yirong , Zheng Xueyong
Published: January 2021

Background

Glioma is the most common type of malignant brain tumor with limited treatment strategy and poor prognosis. Proteasome 26S subunit ATPase 2 (PSMC2) is a key member of the 26S proteasome 19S regulatory subunit, whose role in glioma is still not clear. In this context, we aim to explore the role of PSMC2 in glioma in vitro and in vivo.
Methods

Expression of PSMC2 in in glioma tissues and normal tissues are detected by immunohistochemical (IHC) analysis. The proliferation assays (MTT assay and Celigo cell counting assay), flow cytometry and migration assays (wound-healing assay and Transwell) are used to detect the effects of PSMC2 knockdown on glioma cells. The influence of PSMC2 knockdown on tumor growth in vivo was evaluated by mice xenograft models. In addition, the downstream target of PSMC2 is determined by human GeneChip and Ingenuity Pathway Analysis (IPA).
Results

PSMC2 is overexpressed in glioma tissues than normal tissues. Moreover, knockdown of PSMC2 can inhibit the proliferation, migration and arrest cell cycle in G2 phase of glioma cells. Additionally, PSMC2 knockdown promotes glioma cell apoptosis by increasing expression of caspase3, caspase8, IGFBP-1, while reducing expression of IGF-I, Survivin, TRAILR-4. In vivo findings reveal that PSMC2 knockdown inhibit the tumorigenicity of glioma cells. Furthermore, downstream of PSMC2 is explored, identifying E2F transcription factor 1 (E2F1) as a potential target. Notably, E2F1 knockdown exhibits similar effects on the development of glioma with PSMC2, which could strengthen the inhibition effects of PSMC2 knockdown on glioma synergistically.
Conclusions

PSMC2 is closely associated with glioma development by targeting E2F1, and might be considered as a novel therapeutic target in patients with glioma.
Arts Engagement Facilitated by Artists With Individuals With Life-limiting Illness: An Integrative Review of the Literature
Authors: Lee Jennifer Baxley , McIlfatrick Sonja , Fitzpatrick Lisa
Published: January 2021

BackgroundLiving with life-limiting illness significantly impacts quality of life. A growing body of evidence suggests that arts engagement, facilitated by artists, promotes a sense of well-being and connection with others. However, much of the evidence is drawn from the use of the arts in broad health contexts or from creative arts therapies’ literature. This review aimed to systematically identify and synthesize existing evidence in order to reveal key knowledge gaps and to inform future research and practice. MethodsAn integrative review of the literature was conducted using a pre-defined, comprehensive search strategy. Databases searched included: PubMed inclusive of MEDLINE, CINAHL, PsycINFO, Scopus, Web of Science, and Embase. Search terms included variations on visual arts, literary arts, and performing arts; service users or patients; and palliative care or end-of-life care. The quality and rigor of articles were scored using Hawker and colleagues’ tool designed to systematically appraise disparate studies. Synthesis was conducted using a constant comparison method as outlined in the integrative review framework.ResultsEight reviewed studies explored literary, performing, and visual arts engagement in residential hospice, day hospice, and hospitals in England, the United States, France, and Canada. Seven of eight studies used qualitative methods and one study engaged in mixed methods. Patient perspectives were most commonly represented followed by health care professionals and family members. Creative writing, music, and visual art were predominant modalities whilst dance and theatre were underrepresented. Themes identified across studies associated arts engagement with 1) a sense of well-being, 2) a newly discovered, or re-framed, sense of self, 3) connection with others, 4) challenges associated with practice. ConclusionThis review synthesized current evidence and key knowledge gaps regarding artists' facilitation of arts engagement in palliative and end-of-life (EOL) care. It serves as a starting point in the consideration of next steps in standardizing professional practice and preparation for artists working in palliative and EOL care settings specifically. Recommendations for future research include exploring the value of collaboration between artists and palliative care teams when engaging with individuals living with life-limiting illness.
Before The 2020 Pandemic: An Observational Study Exploring Public Knowledge, Attitudes, Plans, and Preferences Towards Death and End of Life Care in Wales
Authors: Islam Ishrat , Nelson Annmarie , Longo Mirella , Byrne Anthony
Published: January 2021

Background: Understanding public attitudes towards death and dying is important to inform public policies around End of Life Care (EoLC). We studied the public attitudes towards death and dying in Wales.Methods: An online survey was conducted in 2018. Social media and the HealthWiseWales platform were used to recruit participants. Data were analysed using descriptive statistics and thematic analysis.Results: 2,210 people participated. Loss of independence (84%), manner of death, and leaving their beloved behind were the biggest fears around death and dying. In terms of EoLC, participants sought timely access to care (84%) and being surrounded by loved ones (62%). Being at home was less of a priority (24%). Only 50% were familiar with Advance Care Planning (ACP). A lack of standard procedures as well as of support for the execution of plans and the ability to revisit those plans hindered uptake. The taboo around death conversations, the lack of opportunities and skills to initiate discussion, and personal fear and discomfort inhibited talking bout death and dying. 72% felt that we do not talk enough about death and dying and advocated normalising talking by demystifying death with a positive approach. Health professionals can initiate and support this conversation, but this depended on communication skills and manageable workload pressure. Participants encouraged a public health approach and endorsed the use of: a) social media and other public platforms, b) formal education, c) formal and legal actions, and d) signposting and access to information. Conclusions: People are ready to talk about death and dying and COVID-19 has increased awareness. A combination of top-down and bottom-up initiatives across levels and settings can increase awareness, knowledge, and service-utilisation - drivers to support health professionals and people towards shared decisions which align with people’s end of life wishes and preferences.
Sociodemographic Factors Associated With Knowledge of Type 2 Diabetes in Rural Tamil Nadu, India: a Cross-sectional Study
Authors: MacDonald Hana , Papadopoulos Andrew , Dewey Cate , Humphries Sally , Dodd Warren , Patel Kirit , Little Matthew
Published: January 2021

Background: This study aimed to investigate the overall awareness of type 2 diabetes as well as how sociodemographic factors influence diabetes knowledge. With India having the second highest prevalence of diabetes globally, it is increasingly important to assess how diabetes can be addressed in rural Indian populations. Methods: Systematic random sampling was used to gather study participants in 17 villages within the Krishnagiri district of Tamil Nadu, India. Associations between sociodemographic factors and composite diabetes knowledge score were assessed using a multinomial logistic gllamm model.Results: A total of 753 individuals participated in the study. Overall knowledge on diabetes was low, with 66% of individuals having no knowledge regarding diabetes. Achieving a moderate knowledge score was significantly positively associated with education, wealth, participation in MGNREGA (Mahatma Gandhi National Rural Employment Guarantee Act), and business ownership as a source of income. Achieving a good knowledge score was significantly positively associated with education, wealth, rurality, participation in MGNREGA, business ownership as a source of income, as well as frequency of healthcare typically received. Rurality was significantly negatively associated [Relative Risk Ratio (95% CI)] with both moderate knowledge score [0.34 (0.19, 0.59)], and good knowledge score [0.43 (0.24, 0.74)]. The strongest predictor of having a good knowledge score was having a high school graduate or post-secondary education [11.07 (4.44, 27.61)]. Enrolment in MGNREGA employment was the strongest predictor for having a moderate knowledge score [3.27 (1.93, 5.54)], as well as strongly associated with having a good knowledge score [2.39 (1.31, 4.36)].Conclusion: The low awareness of diabetes seen in this study raises serious concerns for public health in India. Public health efforts must prioritize health equity to lessen the impacts of diabetes in rural populations, where individuals face systemic barriers to receiving prevention and treatment for conditions such as diabetes.
Transient Atypical Lymphoplasmacytic Proliferation in Endometrium Associated With Pyometra: a Case Report
Authors: Otani Tomoyuki , Murakami Kosuke , Kimura Masatomo , Matsuki Mitsuru , Satou Takao , Matsumura Noriomi , Ito Akihiko
Published: January 2021

Background Plasmablastic lymphoma is a mature B-cell neoplasm with plasmablastic differentiation, often associated with human immunodeficiency virus (HIV) infection and other forms of immunosuppression. Although it is usually an aggressive disease, spontaneous regression has been seen in a few cases. Plasmablastic lymphoma in the uterus is rare. Here we report a case of atypical lymphoplasmacytic proliferation resembling plasmablastic lymphoma associated with pyometra that disappeared completely as the pyometra resolved. Case presentation A 76-year-old HIV-negative woman presented with abnormal vaginal bleeding. Ultrasound and MRI findings were consistent with pyometra diagnosis. Endometrial biopsy revealed large plasmablastoid cells with abundant cytoplasms and prominent nucleoli proliferating in the endometrium. Immunohistochemistry showed that large cells stained positive for CD138, CD79a, and MUM1, and negative for CD20, PAX5, CD3, and CD5. Ki67 labelled at least 80% of the large cells. Epstein–Barr virus was detected in a small number of cells. The histological picture was highly indicative of lymphoma, especially plasmablastic lymphoma, though the clinical context was unusual. As the pyometra was treated and resolved, the intrauterine abnormality disappeared completely. The patient has been well after 16 months with no sign of recurrent disease. Conclusions This case underscores the sometimes blurry distinction between benign inflammation and lymphomas.
Reach, Adoption and Sustainability of a Mobile Clinical Decision Support Tool Paired With a National Quality Improvement Project Targeting Emergency Department Febrile Infant Management
Authors: Kerns Ellen K , McCulloh Russell , Dai Hongying
Published: January 2021

Background: Electronic clinical decision support (ECDS) tools are often developed within quality improvement (QI) projects to increase adherence with the latest clinical practice guidelines (CPGs).However, scalability and sustainability of ECDS beyond the time and location of their associated project are very limited. Deploying ECDS using a mobile app (mECDS) has shown the potential to be a viable method of overcoming these limitations. However, it is unclear what pattern the spread of uptake and use of such a tool might follow.Methods: In 2016, our team released a freely available mECDS as part of a national multi-site project entitled Reducing Variation in Infant Sepsis Evaluation (REVISE). For this study, we evaluated trends in weekly mECDS usage measures defined as 1) REVISE metric related screen views (MetricHits), 2) unique designated market areas (DMA) where the mECDS was used (Unique DMAs), 3) density of use or MetricHits/Unique DMAs (HitsPerDMA). Linear regressions were performed to examine the app usage trends measures across three time periods (during REVISE, 1-year post, 2-year post). Separate regression analyses were performed among DMAs that contained a REVISE site and those that did not. The number of REVISE sites in the DMA, the number of children’s hospitals in the DMA, DMA population, and season were also evaluated as confounding factors.Results: Strong growth in the number of unique DMAs and MetricHits occurred during the period of 1-year post the REVISE project. The overall usage continued to be relatively stable during the period of 2-years post. HitsPerDMA had stronger growth in DMAs with a REVISE site than those without. MetricHits were higher in DMAs with a larger population, more REVISE sites, and more children’s hospitals. There were also more MetricHits in the summer than in the winter months. Conclusions: Both temporal and spatial increases in mECDS app usage were found as evidence of a contagion method of spread. Other confounding factors may also play a role in app reach, adoption, and sustainability. Further research is needed to determine the factors driving passive diffusion and its impact on clinical practice and patient outcomes.
Food Marketing, Eating Behaviors and Gender Among Children and Adolescents: A Scoping Review
Authors: Castronuovo Luciana , Guarnieri Leila , Tiscornia Victoria , Allemandi Lorena
Published: January 2021

Background Pervasive marketing of unhealthy foods is one of the main drivers behind the global epidemic of childhood and adolescent overweight and obesity. Sex and gender differences come into play in the design of and responses to these marketing strategies, contributing to the perpetuation of stereotyped behavior and generating disparities in food choices and health among boys and girls. The purpose of this paper is to review the current the literature regarding gender differences in food marketing design and perception among children and adolescents to facilitate evidence-based policy dialogues to address gender-based health disparities in NCD prevention.Methods Scoping review of articles published in scientific journals in English and Spanish from 2003 on that addressed the influence of food marketing on eating behaviors among children and adolescents including a gender perspective. The methodological quality of each article was assessed following criteria specific to each study design.Results A total of 40 articles (42 studies) were included in the review. 19 were experimental and 23 had descriptive, cross-sectional designs. 22 studies were found to have low methodological quality, while 11 and 9 were of medium and high quality, respectively. 24 studies found gender-based differences with regards to the effect of food marketing on food intake, food choice and preferences, responses to specific marketing strategies and techniques, perceptions and attitudes towards food marketing and the need for its regulation, and advertising content and exposure. Conclusions The evidence suggests that food marketing has a similar impact on the consumption of unhealthy foods on both boys and girls, but boys were found to be exposed to food advertising more intensively and their preferences to be more affected by this exposure, in line with a mostly male-dominant advertising content. Limitations of these studies include taking gender as an unproblematic construct equivalent to biological sex and the lack of studies focused on developing countries. As gender is a cross-sectional dimension that interacts with other factors driving health disparities, an integrated gender perspective is needed in order to develop effective, evidence-based policies to control food marketing and tackle the childhood overweight pandemic.
What Factors Are Associated With Elbow Stiffness After Operation of Terrible Triad Injury？
Authors: Zhu Jian , Deng Xiangtian , Cheng Xiaodong , Tan Zhanchao , Hu Hongzhi , Zhang Yingze
Published: January 2021

Background: The elbow stiffness is a common complication after operation of terrible triad injury (TTI) and significantly impair the patients’ activities of daily living, while the risk factors have yet to be clearly identified. The goal of this study was to examine the patient-related, injury-related, and treatment-related factors for elbow stiffness after operation of terrible triad injury.Methods: Between January 2013 and December 2019, 71 patients at two tertiary-care referral centers underwent operation of terrible triad injury were respectively reviewed. Range of motion (ROM), Mayo elbow performance scores (MEPS), Broberg-Morrey scores were used for functional evaluation. According to the ROM, the patients were categorized into stiffness group and non-stiffness group. The former had < 100° of extension-flexion ROM and the latter had > 100°. The patient-related, injury-related, and treatment-related factors were extracted from the medial records. The multivariant logistic regression were performed to identify the independent factors.Result: At a mean follow-up of 35.9 months (12-68 months),13 patients were classified into the stiffness group and 58 patients in the non-stiffness group. The stiffness group had significant worse functional scores compared to the non-stiffness group. Patients in the stiffness group were more likely to be Mason type III fracture, high-energy injuries, to have longer time between injury and surgery, ipsilateral upper limb injuries, and other fractures in body. However, multivariant logistic regression analysis revealed that time between injury and surgery > seven days, concurrent ipsilateral upper limb injuries and high-energy injury were independent factors that increased the risk of elbow stiffness after operation of terrible triad injury.Conclusions: The patients underwent operation for terrible triad injury should be informed the probability of elbow stiffness when concurred ipsilateral upper limb injuries and operations should be conducted without delay. Knowledge of these risk factors will be helpful for guiding prophylaxis and early intervention in patients with high risk of elbow stiffness after operation of terrible triad injury.
Correlation Between Weight Bearing Asymmetry and Bone Mineral Density in Patients With Bilateral Knee Osteoarthritis
Authors: Nishizawa Kohei , Harato Kengo , Morishige Yutaro , Kobayashi Shu , Niki Yasuo , Nagura Takeo
Published: January 2021

Background: Although unloading of the joint is related to reduction of the local bone mineral density (BMD), little attention had been paid to the relationship between loading asymmetry and side-to-side difference of BMD in patients with bilateral knee osteoarthritis (OA). The aim of the present study was to evaluate and clarify the relationship between gait parameters and bone mineral density in those patients.Methods: A total of 36 knees in eighteen patients (mean age = 73.7 ± 6.3 years, mean body mass index = 26.7 ± 3.8 kg/m2) with bilateral medial knee OA were enrolled in the present study. All subjects performed relaxed standing and level walking at our gait laboratory after informed consent was obtained. First, ground reaction force was calculated on bilateral knees during standing. The knees in each patient were divided into Higher and Lower force side for the definition of dominant side limb. Second, gait parameters in each subject were obtained. To analyze the factors that affect the weight bearing distribution in both limbs, clinical data and biomechanical parameters were compared between knees. Clinical data included radiographic OA grade, femorotibial angle and BMD at the bilateral femoral neck.Results: Knees on Higher force side were significantly more extended than on Lower force side in standing (P=0.012) and knee excursion during weight acceptance phase in gait was significantly larger in Higher side than in Lower side (P=0.006), while the other parameters were not significantly different. As to the clinical data, Higher force side had greater BMD, compared to Lower force side. In terms of Kellgren-Lawrence scale and femorotibial angle on plain radiographs, there were no significant differences between Higher and Lower force side.Conclusions: Based on loading asymmetry in the present study, lower BMD was observed on Lower force side in patients with knee OA. Therefore, it is helpful for orthopedic surgeons to examine side-to-side differences of bone mineral density or extension limitation during standing for evaluation of the loading condition in patients with bilateral knee OA.
Three-column Subdivision for Isolated Posterolateral Tibial Plateau Fractures and Perspective Surgical Approachs
Authors: Sim Jae Ang , Park Ji Hyeon , Na Young Gon , Lee Byung Hoon
Published: January 2021

BackgroundManagement of the tibial plateau fracture involving posterolateral compartment is technically challenging. This study aimed to introduce a computed tomography-based classification of the posterolateral compartment of tibial plateaus based on the fibula and to propose the individualized surgical approaches for each zone; and 2) to determine the surgical approach based on the classification, would achieve a safe and effective reduction and can improve postoperative clinical outcomes.MethodsEighteen cases of tibia plateau fracture involved the isolated posterolateral compartment in a single institution were retrospectively analyzed. The posterolateral compartment of tibial plateau was segmented into three zones based on the fibular position and individualized surgical approach was proposed for each zone. In anterior Zone I, surgical treatment was performed using an extended anterolateral approach and patient was placed in the supine position; In middle Zone II, using the transfibular approach in the supine position; In posterior Zone III, using the posteromedial approach in prone. Articular reduction (intra-articular step off in CT images) and mechanical medial proximal tibial angle (mMPTA) in simple radiographs taken in the immediate postoperative period and clinical outcomes of the Lysholm knee scoring scale and range of motion were evaluated at postoperative 1-year follow-up,ResultsIn all cases, anatomical articular reduction (intra-articular step off < 2 mm) was achieved, maintained for the follow-up period. The average mMPTA was increased from 87.6º before surgery to 88.2º in immediate postoperative period (p = 0.060), and maintained for the follow-up period (mean 89.9º at one-year follow-up). At the 1-year follow-up, the knee range of motion averaged 140 degrees and the Lysholm knee function scored 95.0 points.ConclusionAn individualized surgical approach and fixation according to three-zone subdivision for isolated posterolateral tibial plateau fractures provided an effective and safe method to treat posterolateral tibial plateau fractures.Level of evidence: Therapeutic study, IV
High Incidence of Postoperative Silent Venous Thromboembolism in Ulcerative Colitis
Authors: Shimada Norimitsu , Ohge Hiroki , Kitagawa Hiroki , Yoshimura Kosuke , Shigemoto Norifumi , Watadani Yusuke , Uegami Shinnosuke , Uemura Kenichiro , Takahashi Shinya
Published: January 2021

Purpose: The incidence of postoperative venous thromboembolism (VTE) is high in patients with inflammatory bowel diseases. We aimed to analyze the incidence and predictive factors of postoperative VTE.Methods: Patients with ulcerative colitis who underwent colon and rectum surgery during 2010–2018 were included. We retrospectively investigated the incidence of postoperative VTE.Results: A total 140 cases of colorectal surgery were included. Postoperative VTE was detected in 24 (17.1%). All patients with VTE had no specific symptoms related to thrombus, except one pulmonary embolism. Portal–mesenteric venous thrombosis was the most frequent (18, 75%); of these, 15 patients underwent total proctocolectomy (TPC) with ileal pouch–anal anastomosis (IPAA). In univariate analysis, VTE occurred more frequently in patients with neoplasia than refractory to medications (27.2% vs. 12.5%; p<0.031). TPC with IPAA was more associated with developing VTE (28%) than total colectomy (10.5%) or proctectomy (5.9%). On logistic regression analysis of predictive risk factors, TPC with IPAA, total colectomy, longer operative time (>4 hours), and high serum D-dimer levels (>5.3 μg/mL) the day following surgery were identified. Conclusion: Postoperative VTE occurred frequently and asymptomatic, especially after TPC with IPAA. D-dimer the day after surgery may be useful predictor of VTE.
Intrauterine Growth Restriction Weakens Anticontractile Influence of NO in Coronary Arteries of Adult Rats 
Authors: Selivanova Ekaterina , Shvetsova Anastasia , Shilova Lyubov , Tarasova Olga , Gaynullina Dina
Published: January 2021

Intrauterine growth restriction (IUGR) is one of the most common pathologies of pregnancy. The cardiovascular consequences of IUGR do not disappear in adulthood and can manifest themselves in pathological alterations of vasomotor control. The hypothesis was tested that IUGR weakens anticontractile influence of NO and augments procontractile influence of Rho-kinase in arteries of adult offspring. To model IUGR in the rat, dams were 50% food restricted starting from the gestational day 11 till delivery. Mesenteric and coronary arteries of male offspring were studied at the age of 3 months using wire myography, qPCR, and Western Blotting. Contractile responses of mesenteric arteries to α1-adrenoceptor agonist methoxamine as well as influences of NO and Rho-kinase did not differ between control and IUGR rats. However, coronary arteries of IUGR rats demonstrated elevated contraction to thromboxane A2 receptor agonist U46619 due to weakened anticontractile influence of NO and enhanced role of Rho-kinase in the endothelium. This was accompanied by reduced abundance of SODI protein and elevated content of RhoA protein in coronary arteries of IUGR rats. IUGR considerably changes the regulation of coronary vascular tone in adulthood and, therefore, can serve as a risk factor for the development of cardiac disorders.
Cell Penetrating Peptides Mediated DNA-Free Transfection in Arabidopsis and Chinese Cabbage
Authors: Wu Han , Zhang Zhipeng , Zhu Kai , Ke Fulai , Zhang Fei , Zhang Yun , Feng Hui
Published: January 2021

Background: The third-generation genome editing system CRISPR/Cas had shown strong application prospects in crop genetic improvement. However, this technology largely depends on genetic transformation. Public concerns on GMO (genetically modified organisms) safety, as well as related regulations, have restricted the application. Therefore, establishing DNA-free transfection system is important to promote CRISPR/Cas genome editing in agriculture.Results：In this paper, cell penetrating peptides fusion protein (CPP-mCherry) was found to be effective on DNA-free transfection. DNA sequences of nine tandem arginine (R9), one cysteine (cys), reporter mCherry and histidine label were sequentially constructed into pET 45B+ expression vector and transformed into Escherichia coli BL21(DE3) strain. CPP-mCherry fusion protein can be induced by 1mM IPTG for at least 1 hour in 28 °C. CPP-mCherry fusion protein can be obtained by 200W ultrasonication, then purified by Ni column and MWCO dialysis. The Arabidopsis thaliana root tips and leaves, as well as Chinese cabbage microspores and 3-week-old microspore embryo can be used as transfected recipient. Concentration can be selected between 10-100μg/ml and incubated overnight at room temperature. R9-cys-mCherry protein can be translocated into the nucleus of microspore. The transfection efficiency of root tips reached 100% and of microspore and MDE was 8.13% and 94.79%, respectively. Conclusions: Here, a CPP mediated DNA-free transfection system was built in dicots. These results lay a technical foundation of DNA-free genome editing.
Efficacy of Doxycycline in treating COVID-19 Positive Patients: A Case Series
Authors: Meybody Zohreh Akhoundi , Owlia Mohammad Bagher , Owlia Sina , nasab Seyed Rohollah Mousavi
Published: January 2021

Background

Given the high morbidity and mortality caused by Coronavrus Disease 2019 (COVID-19), scientific research is necessary to achieve a proper treatment regimen. Since doxycycline is effective in reducing inflammatory factors, including IL-6 and TNF-alpha that play an important role in initiating cytokine storms and probably causing death in patients with COVID-19, its use is associated with low side effects, can be used orally, and is well tolerated, the present study was attempted to evaluate the efficacy of doxycycline in the treatment of inpatients and outpatients with COVID-19.
Methods

This descriptive and prospective study was performed on inpatients and outpatients with COVID-19 from September 14, 2020, to September 28, 2020. The patients were diagnosed with COVID-19 based on polymerase chain reaction test (PCR) from nasopharyngeal secretions or computerized tomography scan (CT). Patients who met the inclusion criteria received doxycycline at a dose of 100 mg every 12 hours for 7 days and then were evaluated on the baseline day and on days 3, 7, and 14 after admission for cough, Shortness of breath (SOB), temperature and oxygen saturation (O2 sat).
Results

Out of 21 patients, 11 patients were male and 10 patients were female. Three patients had diabetes, hypertension, and lymphoma. Only 2 patients were admitted to intensive care unit (ICU), and no patients died. Cough, SOB, temperature, and O2 sat improved in both of outpatients and inpatients compared to baseline. In general, the results showed that doxycycline was more effective in improving cough, SOB, temperature, and O2 sat in outpatients than inpatients. No side effects were reported by the patients.
Conclusion

It can be concluded that doxycycline with the dose and duration prescribed in our study could play an effective role in the treatment of patients with COVID-19. Its use improved patients’ cough, SOB, temperature, and O2 sat.
Ginsenoside Rb1 Improves Brain, Lung, and Intestinal Barrier Damage in Middle Cerebral Artery Occlusion/Reperfusion (MCAO/R) Mice Through the PPARγ Signaling Pathway
Authors: Chen zhuo , Gong shuaishuai , Ren Yuchuan , wang jieman , Li Fang , Zhang YuanYuan , Kou Junping
Published: January 2021

BackgroundIschemic stroke causes brain inflammation and multi-organ injury, in which the peroxisome proliferator-activated receptor-gamma (PPARγ) signaling pathway plays a key role. Studies have indicated that ginsenoside Rb1 (GRb1) can protect blood–brain barrier integrity after stroke. Here, we aimed to determine whether GRb1 can ameliorate brain/lung/intestinal barrier damage in mice with acute cerebral ischemia through the PPARγ signaling pathway. MethodAdult male ICR (Institute of Cancer Research) mice underwent right middle cerebral artery occlusion for 1 h with subsequent 24 h reperfusion to produce ischemia/reperfusion(I/R) injury, following which the mice were administered GRb1 (20 mg/kg) intraperitoneally. The integrity of the brain, pulmonary, and intestinal barriers was assessed using an Evans blue leakage assay and connexin immunofluorescence staining. The serum levels of tumor necrosis factor-α (TNF-α) and interferon-gamma (IFN-γ) were measured by enzyme-linked immunosorbent assay (ELISA), and the expression of PPARγ and phospho-nuclear factor kappa B (NF-κB) p65 was determined by western blot. ResultGRb1 significantly mitigated multi-organ injury and increased the expression of cerebral microvascular, pulmonary vascular, and intestinal epithelial connexins (claudin-5, occludin, and zona occludens 1 (ZO-1). In brain, lung, and intestinal tissues, GRb1 activated PPARγ, decreased phospho-NF-kB p65 levels, and inhibited the production of proinflammatory cytokines, thereby maintaining barrier permeability. However, cotreatment with GRb1 and the PPARγ antagonist GW9662 reversed the barrier-protective effect of GRb1.ConclusionThe results showed that GRb1 can improve brain/lung/intestinal barrier damage post-stroke through the PPARγ pathway.
Teardrop And Sourcil Line (TSL): A Novel Radiographic Sign That Predicts Residual Acetabular Dysplasia in DDH After Closed Reduction
Authors: Huang Peng , Wang Dahui , Mo Yueqiang , Zheng Yiming , Ning Bo
Published: January 2021

Background: Residual acetabular dysplasia (RAD) is a major problem of developmental dysplasia of the hip (DDH) after closed reduction (CR). Several parameters have been investigated as ways of predicting RAD; however, early prediction of RAD remains controversial. The purpose of this study was to evaluate the radiographic sign of teardrop and sourcil line (TSL) in pediatric patients with DDH to enable prediction of RAD after CR early.Methods: One hundred and twenty-five hips with DDH treated with CR and followed up for at least 2 years were included in this study. The mean age at CR was 18.3 months (range, 9 to 32 months) and the average follow-up time was 44.2 months (range, 24 to 83 months). The acetabular index (AI) was measured at different time points. RAD was determined according to the modified Severin criteria. The cases were divided into two groups according to whether TSL became continuous or not. The relationships among TSL, AI and RAD were analyzed.Results: The RAD incidence was 73.6% (92/125) at the last follow-up. AI at CR and TSL were the prognostic factors for RAD (p=0.017 and 0.001, respectively). Thirty-four hips showed a continuous TSL. The mean time when TSL became continuous after CR was 20.9 months (range, 8 to 57 months). There was a lower RAD rate in the TSL continuous group (p<0.001). There was no statistical difference in the AI at CR between the TSL continuous and discontinuous groups; however, the level of AI after CR was lower in the TSL continuous group. In the TSL continuous group, there was no significant difference in the time at which TSL became continuous after CR between RAD and non-RAD hips.Conclusions: The TSL continuous group had a lower AI and incidence of RAD than the discontinuous group. The TSL can be a predictive factor of RAD in DDH after CR and can predict RAD at an earlier time than AI measurement.
Three-year trajectories in Functional Limitations and Cognitive Decline among Dutch 75+ year olds, using nine-month intervals
Authors: Gardeniers Maura , Groenou Marjolein Broese van , Meijboom Erik Jan , Huisman Martijn
Published: January 2021

Background
Using longitudinal panel data, the aim of this study was to first identify three-year trajectories in cognitive and physical functioning among Dutch older adults. And second, to identify which main characteristics were associated with these trajectories.
Methods
Group-based Trajectory Modelling with mortality jointly estimated was used to identify trajectories, using a scale composed of 6 Activities of Daily Living (ADL) as a measure of physical functioning, and a short version of the mini mental status examination (sMMSE) or the IQCODE as a measure of cognitive functioning. Data came from 574 Dutch adults aged 75+, collected in five nine-month measurement waves conducted between 2015 and 2018 for the Longitudinal Aging Study Amsterdam.
Results
Five trajectories in physical functioning were identified: ‘high’, ‘moderate’, ‘steeply declining’, ‘gradually declining’, and ‘continuously low’. People that were older, lower educated, living in an institution, or suffered from diabetes or cerebrovascular accidents were more likely to follow a low or declining physical trajectory. For cognitive functioning four trajectories were identified: a ‘high’, ‘moderate’, ‘declining’, and ‘low’ trajectory. Old age, low education, living in an institution, and heart- and lung diseases were associated with continuously low or declining cognitive functioning. Mortality risks were highest among those experiencing the continuously low functioning trajectories.
Conclusions
This study identified trajectories comparable to previous studies that used longer time intervals, showing the consistent presence of heterogeneity in both physical and cognitive trajectories. Co-modelling mortality resulted in bigger group sizes for the more adverse trajectories. The favourable trajectories, containing most of the participants, were mostly characterized by absence of disease, whereas trajectories showing decline did not share a common indicator. Specific chronic diseases were associated with different rates of decline, however there was no factor that was associated with all declining trajectories; future research could focus on finding such an indicator.
Efficient Spectral Regulation in Ce:Lu3(Al,Cr)5O12 and Ce:Lu3(Al,Cr)5O12/Ce:Y3Al5O12 Transparent Ceramics With High Color Rendering Index for High-Power White LEDs/LDs
Authors: Zhou Tianyuan , Hou Chen , Zhang Le , Ma Yuelong , Kang Jian , Li Tao , Wang Rui , Huang Jin , Li Junwei , Wang Zhongying , Selim Farida A , Li Ming , Chen Hao
Published: January 2021

Realizing a high color rendering index (CRI) in Ce:LuAG transparent ceramics (TCs) with desired thermal stability is essential to their applications in white LEDs/LDs as color converters. In this study, based on the scheme of configuring the red component by Cr3+ doping, an efficient spectral regulation was realized in Ce,Cr:LuAG TCs. A unilateral shift could be observed in both PL and PLE spectra. By constructing TC-based white LED/LD devices in a remote excitation mode, luminescence properties of Ce,Cr:LuAG TCs were systematically investigated. The CRI values of Ce:LuAG TC based white LEDs could be increased by a magnitude of 46.2%. Particularly, by combining Ce,Cr:LuAG TCs with a 0.5 at.% Ce:YAG TC, a surprising CRI values of 88 and 85.5 were obtained in TC based white LEDs and LDs, respectively. Therefore, Ce,Cr:LuAG TC is a highly promising color convertor for high-power white LEDs/LDs applied in general lighting and displaying.