bluuebunny/crossref_metadata_2025 huggingface dataset:
Accuracy of soft tissue balancing in total knee arthroplasty using surgeon-defined assessment versus a gap-balancer or electronic sensor
Authors: Zhao Ran , Liu Yanqing , Tian Hua
Published: May 2021

Background

Soft tissue balancing is essential for the success of total knee arthroplasty (TKA) and is mainly dependent on surgeon-defined assessment (SDA) or a gap-balancer (GB). However, an electronic sensor has been developed to objectively measure the gap pressure. This study aimed to evaluate the accuracy of soft tissue balancing using SDA and GB compared with a sensor.

Methods

Forty-eight patients undergoing TKA (60 knees) were prospectively enrolled. Soft tissue balancing was sequentially performed using SDA, a GB, and an electronic sensor. We compared the SDA, GB, and sensor data to calculate the sensitivity, specificity, and accuracy at 0°, 45°, 90°, and 120° flexion. Cumulative summation (CUSUM) analysis was performed to assess the surgeon’s performance during the sensor introductory phase.

Results

The sensitivity of SDA was 63.3%, 68.3%, 80.0%, and 80.0% at 0°, 45°, 90°, and 120°, respectively. The accuracy of the GB compared with sensor data was 76.7% and 71.7% at 0° and 90°, respectively.

Cohen’s kappa coefficient for the accuracy of the GB was 0.406 at 0° (moderate agreement) and 0.227 at 90° (fair agreement). The CUSUM 0° line achieved good prior performance at case 45, CUSUM 90° and 120° showed a trend toward good prior performance, while CUSUM 45° reached poor prior performance at case 8.

Conclusion

SDA was a poor predictor of knee balance. GB improved the accuracy of soft tissue balancing, but was still less accurate than the sensor, particularly for unbalanced knees. SDA improved with ongoing use of the sensor, except at 45° flexion.
Muscle pedicle bone flap transplantation for treating femoral neck fracture in adults: a systematic review
Authors: Wu Yipeng , Song Muguo , Peng Guangliang , Xu Yongqing , Li Yang , Wei Mingjie , Tang Hui , Lv Qian , Wang Teng , Cai Xingbo
Published: May 2021

Background

This systematic review was conducted to gather available evidence on the effectiveness of muscle pedicle bone flap transplantation in adult patients with femoral neck fractures.

Methods

Databases such as PubMed, EMBASE, IEEE, Web of Science, and Cochrane library were searched from their dates of inception until March 2021. Two reviewers independently selected the interventional studies on the assessment of the effectiveness of muscle pedicle bone flap transplantation for femoral neck fractures; data extraction and assessment of the methodological quality as per the Institute of Health Economics quality appraisal checklist were also performed by the reviewers. The effectiveness and complication outcomes were assessed by calculating the average rates.

Results

Overall, 20 studies with 1022 patients were included in this review. Notably, the methodologic quality of the included studies was typically poor. The average effective rates were as follows: good, 73.4%; fair, 15.4%; and poor, 10.9%. Moreover, the average nonunion rate, average avascular necrosis rate, average collapse rate, and the overall reoperation rate were 9.0%, 6.7%, 4.7%, and 7.3%, respectively.

Conclusions

This systematic review of heterogeneous studies with varying number of patients and varying surgical techniques indicated that muscle pedicle bone flap transplantation provides promising results with low rates of avascular necrosis and nonunion. Nevertheless, further controlled studies are required to ascertain the effectiveness of muscle pedicle bone flap transplantation in treating femoral neck fracture.
A somatic mutation in PIK3CD unravels a novel candidate gene for lymphatic malformation
Authors: Wang Shengcai , Wang Wei , Zhang Xuexi , Gui Jingang , Zhang Jie , Guo Yongli , Liu Yuanhu , Han Lin , Liu Qiaoyin , Li Yanzhen , Sun Nian , Liu Zhiyong , Du Jiangnan , Tai Jun , Ni Xin
Published: May 2021

Background

Lymphatic malformations (LMs) are benign congenital malformations that stem from the abnormal development of the lymphatic vessels during early embryogenesis. Somatic PIK3CA gene mutations are conventional cause leading to LMs. Both macrocystic and microcystic LMs arise due to lymphatic endothelial cell-autonomous defects, depending on the time in development at which PIK3CA gene mutation occurs. Recent study finds a PIK3CA mutation in 79% of LMs. However, discovering new genetic events in this disease is crucial to identify the molecular mechanism of the pathogenesis and further develop new targeted therapies.

Results

Here, we initially performed whole-exome sequencing in six children with LMs to find a new causal gene. Somatic mutations in PIK3CA (c.1633G > A [p. E545K] and PIK3CD (c.1997T > C [p.L666P]) were discovered in two different individuals. In vitro functional studies were conducted to demonstrate the pathogenicity of the novel mutation c.1997T > C in PIK3CD. We found that L666P promoted the cell proliferation and migration of human umbilical vein endothelial cells (HUVECs) and induced hyperactivation of the mTOR pathway. These findings indicate that the PIK3CD mutation affects downstream signalling in endothelial cells, which may impair normal lymphangiogenesis.

Conclusions

This study reveals a novel candidate gene associated with the development of LMs, which is consistent with previous researches. These findings in our study may offer a novel gene target for developing therapies, which acts in tight interaction with the previously known PIK3CA.
Engineering oleaginous yeast Rhodotorula toruloides for overproduction of fatty acid ethyl esters
Authors: Zhang Yang , Peng Jie , Zhao Huimin , Shi Shuobo
Published: May 2021

Background

Production of biofuels and green chemicals by microbes is currently of great interest due to the increasingly limited reserves of fossil fuels. Biodiesel, especially fatty acid ethyl esters (FAEEs), is considered as an attractive alternative because of its similarity with petrodiesel and compatibility with existing infrastructures. Cost-efficient bio-production of FAEEs requires a highly lipogenic production host that is suitable for large-scale fermentation. As a non-model oleaginous yeast that can be cultured to an extremely high cell density and accumulate over 70% cell mass as lipids, Rhodotorula toruloides represents an attractive host for FAEEs production.

Results

We first constructed the FAEE biosynthetic pathways in R. toruloides by introducing various wax ester synthase genes from different sources, and the bifunctional wax ester synthase/acyl-CoA-diacyglycerol acyltransferase (WS/DGAT) gene from Acinetobacter baylyi was successfully expressed, leading to a production of 826 mg/L FAEEs through shake-flask cultivation. We then mutated this bifunctional enzyme to abolish the DGAT activity, and further improved the titer to 1.02 g/L. Finally, to elevate the performance of Δku70-AbWS* in a bioreactor, both batch and fed-batch cultivation strategies were performed. The FAEEs titer, productivity and yield were 4.03 g/L, 69.5 mg/L/h and 57.9 mg/g (mg FAEEs/g glucose) under batch cultivation, and 9.97 g/L, 90.6 mg/L/h, and 86.1 mg/g under fed-batch cultivation. It is worth mentioning that most of the produced FAEEs were secreted out of the cell, which should greatly reduce the cost of downstream processing.

Conclusion

We achieved the highest FAEEs production in yeast with a final titer of 9.97 g/L and demonstrated that the engineered R. toruloides has the potential to serve as a platform strain for efficient production of fatty acid-derived molecules.
Clinical characteristics and prognosis of patients with isolated thrombotic vs. obstetric antiphospholipid syndrome: a prospective cohort study
Authors: Jiang Hui , Wang Chu-Han , Jiang Nan , Li Jing , Wu Chan-Yuan , Wang Qian , Li Meng-Tao , Tian Xin-Ping , Zhao Jiu-Liang , Zhao Yan , Zeng Xiao-Feng
Published: May 2021

Background

Several studies suggested that thrombotic and obstetric antiphospholipid syndromes could be independent identities, but few have systematically compared their clinical characteristics and prognosis.

Objective

The objective of this study is to identify key differences between thrombotic APS (tAPS) and obstetric APS (oAPS).

Methods

This single-center, prospective study included consecutive patients with primary antiphospholipid syndrome (APS) receiving treatment at the Peking Union Medical College Hospital during a period from 2013 to 2020.

Results

Screening of the database yielded a total of 244 women with positive antiphospholipid antibody (aPL). Among the 105 women with primary APS, 39 (37.14%) had isolated tAPS (ItAPS), 44 (41.90%) had isolated oAPS (IoAPS), and 9 (8.57%) had both tAPS and tAPS+oAPS. In comparison to those with IoAPS, patients with ItAPS had older age (41.92 ± 11.97 vs. 33.16 ± 4.22 years, P < 0.01), higher rate of cardiovascular risk (at least one positive of coronary heart disease, hypertension, obesity, diabetes, and hyperlipidemia) (41.03% vs. 6.82%, P < 0.01), and higher frequency of thrombocytopenia (43.59% vs. 20.45%, P < 0.05). Antibody profiles were generally similar among the groups, but isolated anti-β2GPI positivity was more common in patients with IoAPS (52.27% vs. 17.94% for ItAPS, P = 0.01). Triple aPL positivity was more common in patients with both tAPS and oAPS (66.67% vs. 46.15% for ItAPS vs. 25% for IoAPS, P = 0.022). Blood homocysteine was higher in patients with ItAPS (11.20 vs. 9.90 μmol/L for IoAPS, P < 0.05), but there were no differences in inflammatory markers or complements. Recurrence rate of thrombosis was higher in patients with ItAPS (33.33% vs. 2.27% for IoAPS, P ≤ 0.001) with a mean follow-up of 61 months.

Conclusion

Despite generally similar antibody and biochemical profiles, patients with ItAPS had much higher risk of recurrent thrombosis than IoAPS, supporting distinct mechanisms of pathogenesis.
Fli1 deficiency suppresses RALDH1 activity of dermal dendritic cells and related induction of regulatory T cells: a possible role in scleroderma
Authors: Miura Shunsuke , Watanabe Yusuke , Saigusa Ryosuke , Yamashita Takashi , Nakamura Kouki , Hirabayashi Megumi , Miyagawa Takuya , Yoshizaki Ayumi , Trojanowska Maria , Sato Shinichi , Asano Yoshihide
Published: May 2021

Background

Aldehyde dehydrogenase 1 family member A1 (RALDH1)-producing dermal dendritic cells (DCs), a conventional DC subset regulating skin fibrosis, are decreased in the involved skin of patients with systemic sclerosis (SSc). In this study, we investigated the contribution of Fli1 deficiency, a potential predisposing factor of SSc, to the phenotypical alteration of RALDH1-producing dermal DCs by using SSc model mice and SSc skin samples.

Methods

Bleomycin (BLM)-induced skin fibrosis was generated with Fli1+/− and wild-type mice. The proportions of DC and CD4+ T cell subsets were determined by flow cytometry in the dermis of BLM-treated mice. Fli1 expression in dermal DCs was evaluated by immunofluorescence with skin samples of SSc and healthy control subjects.

Results

RALDH activity of dermal DCs was significantly decreased in BLM-treated Fli1+/− mice compared with BLM-treated wild-type mice, whereas the proportion of CD103−CD11b− dermal DCs, a major DC subset producing RALDH1 in response to BLM injection, was comparable between groups. Relevant to this finding, the proportion of regulatory T cells (Tregs) in the dermis was decreased in BLM-treated Fli1+/− mice relative to BLM-treated wild-type mice, while the proportions of Th1, Th2 and Th17 cells were unaltered. In the involved skin of SSc patients, Fli1 was downregulated in CD11c+ cells, including dermal DCs.

Conclusions

Fli1 deficiency inhibits RALDH1 activity of CD103−CD11b− dermal DCs and related induction of Tregs in BLM-treated mice. Considering Fli1 reduction in SSc dermal DCs, Fli1deficiency may impair the dermal DC-Treg system, contributing to the development of skin fibrosis in SSc.
The effect of omega3 fatty acid supplementation on PPARγ and UCP2 expressions, resting energy expenditure, and appetite in athletes
Authors: Moradi Sara , Alivand Mohamadreza , KhajeBishak Yaser , AsghariJafarabadi Mohamad , Alipour Maedeh , Chilibeck Philip D. , Alipour Beitullah
Published: May 2021

Background

Omega3 fatty acids as a ligand of energy-related genes, have a role in metabolism, and energy expenditure. These effects are due to changes in the expression of peroxisome proliferator-activated receptor-gamma (PPARγ) and uncoupling protein2 (UCP2). This study evaluated the effect of omega3 supplements on PPARγ mRNA expression and UCP2 mRNA expression and protein levels, as regulators of energy metabolism, resting energy expenditure (REE), and appetite in athletes.

Methods

In a 3-week double-blind RCT in Tabriz, Iran, in 2019, 36 male athletes, age 21.86 (±3.15) y with 16.17 (±5.96)% body fat were randomized to either an intervention (2000 mg/day omega3; EPA: 360, DHA: 240) or placebo (2000 mg/day edible paraffin) groups. Appetite and REE were assessed before and after the intervention. PPARγ and UCP2 mRNA expression and UCP2 protein levels in blood were evaluated by standard methods.

Results

Results showed PPARγ mRNA levels, and UCP2 mRNA and protein levels increased in omega3 group (p < 0.05), as did REE (p < 0.05). Also, differences in the sensation of hunger or satiety were significant (p < 0.05).

Conclusions

Our findings showed that omega3 supplementation leads to the up-regulation of PPARγ and UCP2 expressions as the indicators of metabolism in healthy athletes.
Genomic characterization of bacteria from the ultra-oligotrophic Madison aquifer: insight into the archetypical LuxI/LuxR and identification of novel LuxR solos
Authors: Wengert Peter C. , Wong Narayan H. , Barton Hazel A. , Gan Han Ming , Hudson André O. , Savka Michael A.
Published: May 2021

Objectives

To characterize the bacterial community of Wind Cave’s Madison aquifer through whole-genome sequencing, and to better understand the bacterial ecology by identifying genes involved in acyl-homoserine lactone (AHL) based quorum-sensing (QS) systems.

Results

Genome-based taxonomic classification revealed the microbial richness present in the pristine Madison aquifer. The strains were found to span eleven genera and fourteen species, of which eight had uncertain taxonomic classifications. The genomes of strains SD129 and SD340 were found to contain the archetypical AHL QS system composed of two genes, luxI and luxR. Surprisingly, the genomes of strains SD115, SD129, SD274 and SD316 were found to contain one to three luxR orphans (solos). Strain SD129, besides possessing an archetypical AHL QS luxI-luxR pair, also contained two luxR solos, while strain SD316 contained three LuxR solos and no luxI-luxR pairs. The ligand-binding domain of two LuxR solos, one each from strains SD129 and SD316, were found to contain novel substitutions not previously reported, thus may represent two LuxR orphans that detection and response to unknown self-produced signal(s), or to signal(s) produced by other organisms.
Conscious rat PET imaging with soft immobilization for quantitation of brain functions: comprehensive assessment of anesthesia effects on cerebral blood flow and metabolism
Authors: Suzuki Chie , Kosugi Mutsumi , Magata Yasuhiro
Published: May 2021

Background

Animal brain functions evaluated by in vivo imaging under anesthesia can be affected by anesthetic agents, resulting in incorrect assessment of physiological brain function. We therefore performed dynamic positron emission tomography (PET) imaging of conscious rats using recently reported soft immobilization to validate the efficacy of the immobilization for brain function assessments. We also determined the effects of six anesthetic agents—a mixed anesthetic agent (MMB), ketamine + xylazine (KX), chloral hydrate (Chloral), pentobarbital (PTB), propofol (PF), and isoflurane (IFL)—on brain function by comparison with conscious rats.

Results

The immobilization enabled 45-min dynamic [18F]FDG-PET acquisition with arterial blood sampling using conscious rats without the use of special techniques or invasive surgery. The spatial resolution and quantitativity of [18F]FDG-PET were not significantly lower for conscious rats than for anesthetized rats. While MMB, Chloral, PTB, and PF showed ubiquitous reduction in the cerebral metabolic rates of glucose (CMRglu) in brain regions, KX and IFL showed higher reductions in cerebellum and interbrain, and cerebellum, respectively. Cerebral blood flow (CBF) was reduced by MMB, KX, PTB, and PF; increased by IFL; and unaltered by Chloral. The magnitude of decrease in CMRglu and CBF for MMB were not larger than for other five anesthetic agents, although blood glucose levels and body temperature can be easily affected by MMB.

Conclusion

The six anesthetic agents induced various effects on CMRglu and CBF. The immobilization technique presented here is a promising tool for noninvasive brain functional imaging using conscious rats to avoid the effects of anesthetic agents.
Exploring the oxygenase function of Form II Rubisco for production of glycolate from CO2
Authors: Yang Fan , Zhang Junli , Cai Zhen , Zhou Jie , Li Yin
Published: May 2021

The oxygenase activity of Ribulose-1,5-bisphosphate carboxylase/oxygenase (Rubisco) converts ribulose-1,5-bisphosphate (RuBP) into 2-phosphoglycolate, which in turn channels into photorespiration, resulting in carbon and energy loss in higher plants. We observed that glycolate can be accumulated extracellularly when two genes encoding the glycolate dehydrogenase of cyanobacteria Synechocystis sp. PCC 6803 were inactivated. This inspired us to explore the oxygenase function of Rubisco for production of glycolate, an important industrial chemical, from CO2 by engineered cyanobacteria. Since the oxygenase activity of Rubisco is generally low in CO2-rich carboxysome of cyanobacteria, we introduced Form II Rubisco, which cannot be assembled in carboxysome, into the cytoplasm of cyanobacteria. Heterologous expression of a Form II Rubisco from endosymbiont of tubeworm Riftia pachyptila (RPE Rubisco) significantly increased glycolate production. We show that the RPE Rubisco is expressed in the cytoplasm. Glycolate production increased upon addition of NaHCO3 but decreased upon supplying CO2. The titer of glycolate reached 2.8 g/L in 18 days, a 14-fold increase compared with the initial strain with glycolate dehydrogenase inactivated. This is also the highest glycolate titer biotechnologically produced from CO2 ever reported. Photosynthetic production of glycolate demonstrated the oxygenase activity of Form II Rubisco can be explored for production of chemicals from CO2.
Programming adaptive laboratory evolution of 4-hydroxyisoleucine production driven by a lysine biosensor in Corynebacterium glutamicum
Authors: Yu Xinping , Shi Feng , Liu Haiyan , Tan Shuyu , Li Yongfu
Published: May 2021

4-Hydroxyisoleucine (4-HIL) is a promising drug for treating diabetes. In our previous study, 4-HIL was synthesized from self-produced L-isoleucine (Ile) in Corynebacterium glutamicum by expressing an Ile dioxygenase gene. Although the 4-HIL production of recombinant strain SZ06 increased significantly, a by-product, L-lysine (Lys) was accumulated because of the share of the first several enzymes in Ile and Lys biosynthetic pathways. In this study, programming adaptive laboratory evolution (ALE) was designed and conducted in SZ06 to promote 4-HIL biosynthesis. At first, a programming evolutionary system pMK was constructed, which contains a Lys biosensor LysG-PlysE and an evolutionary actuator composed of a mutagenesis gene and a fluorescent protein gene. The evolutionary strain SZ06/pMK was then let to be evolved programmatically and spontaneously by sensing Lys concentration. After successive rounds of evolution, nine mutant strains K1 − K9 with significantly increased 4-HIL production and growth performance were obtained. The maximum 4-HIL titer was 152.19 ± 14.60 mM, 28.4% higher than that in SZ06. This titer was higher than those of all the metabolic engineered C. glutamicum strains ever constructed. The whole genome sequencing of the nine evolved strains revealed approximately 30 genetic mutations in each strain. Only one mutation was directly related to the Lys biosynthetic pathway. Therefore, programming ALE driven by Lys biosensor can be used as an effective strategy to increase 4-HIL production in C. glutamicum.
Role of sleep on respiratory failure after extubation in the ICU
Authors: Thille Arnaud W. , Barrau Stephanie , Beuvon Clément , Marie Damien , Reynaud Faustine , Bardin Justine , Pépin-Lehalleur Adrien , Bironneau Vanessa , Meurice Jean-Claude , Coudroy Rémi , Frat Jean-Pierre , Robert René , Rault Christophe , Drouot Xavier
Published: May 2021

Background

Sleep had never been assessed immediately after extubation in patients still in the ICU. However, sleep deprivation may alter respiratory function and may promote respiratory failure. We hypothesized that sleep alterations after extubation could be associated with an increased risk of post-extubation respiratory failure and reintubation. We conducted a prospective observational cohort study performed at the medical ICU of the university hospital of Poitiers in France. Patients at high-risk of extubation failure (> 65 years, with any underlying cardiac or lung disease, or intubated > 7 days) were included. Patients intubated less than 24 h, with central nervous or psychiatric disorders, continuous sedation, neuroleptic medication, or uncooperative were excluded. Sleep was assessed by complete polysomnography just following extubation including the night. The main objective was to compare sleep between patients who developed post-extubation respiratory failure or required reintubation and the others.

Results

Over a 3-year period, 52 patients had complete polysomnography among whom 12 (23%) developed post-extubation respiratory failure and 8 (15%) required reintubation. Among them, 10 (19%) had atypical sleep, 15 (29%) had no deep sleep, and 33 (63%) had no rapid eye movement (REM) sleep. Total sleep time was 3.2 h in median [interquartile range, 2.0–4.4] in patients who developed post-extubation respiratory failure vs. 2.0 [1.1–3.8] in those who were successfully extubated (p = 0.34). Total sleep time, and durations of deep and REM sleep stages did not differ between patients who required reintubation and the others. Reintubation rates were 21% (7/33) in patients with no REM sleep and 5% (1/19) in patients with REM sleep (difference, − 16% [95% CI − 33% to 6%];p = 0.23).

Conclusions

Sleep assessment by polysomnography after extubation showed a dramatically low total, deep and REM sleep time. Sleep did not differ between patients who were successfully extubated and those who developed post-extubation respiratory failure or required reintubation.
Hilfer fractional differential inclusions with Erdélyi–Kober fractional integral boundary condition
Authors: Lachouri Adel , Abdo Mohammed S. , Ardjouni Abdelouaheb , Abdalla Bahaaeldin , Abdeljawad Thabet
Published: May 2021

In this article, we debate the existence of solutions for a nonlinear Hilfer fractional differential inclusion with nonlocal Erdélyi–Kober fractional integral boundary conditions (FIBC). Both cases of convex- and nonconvex-valued right-hand side are considered. Our obtained results are new in the framework of Hilfer fractional derivative and Erdélyi–Kober fractional integral with FIBC via the fixed point theorems (FPTs) for a set-valued analysis. Some pertinent examples demonstrating the effectiveness of the theoretical results are presented.
On a pair of fuzzy mappings in modular-like metric spaces with applications
Authors: Rasham Tahair , Shoaib Abdullah , Park Choonkill , Agarwal Ravi P. , Aydi Hassen
Published: May 2021

The aim of this work is to establish results in fixed point theory for a pair of fuzzy dominated mappings which forms a rational fuzzy dominated V-contraction in modular-like metric spaces. Some results via a partial order and using the graph concept are also developed. We apply our results to ensure the existence of a solution of nonlinear Volterra-type integral equations.
Nonexistence results of Caputo-type fractional problem
Authors: Kassim Mohammed D. , Ali Saeed M. , Abdo Mohammed S. , Jarad Fahd
Published: May 2021

In this paper, we deal with Caputo-type fractional differential inequality where there is a low-order fractional derivative with the term polynomial source. We investigate the nonexistence of nontrivial global solutions in a suitable space via the test function technique and some properties of fractional integrals. Finally, we demonstrate three examples to illustrate our results. The presented results are more general than those in the literature, which can be obtained as particular cases.
Fixed point problems for generalized contractions with applications
Authors: Nazam Muhammad , Park Choonkil , Arshad Muhammad
Published: May 2021

In this paper, we investigate the conditions on the control mappings $\psi ,\varphi :(0,\infty )\rightarrow \mathbb{R}$
ψ
,
φ
:
(
0
,
∞
)
→
R
that guarantee the existence of the fixed points of the mapping $T:X\rightarrow P(X)$
T
:
X
→
P
(
X
)
satisfying the following inequalities: $$ \psi \bigl(H(Tx,Ty)\bigr)\leq \varphi \bigl(d(x,y)\bigr) \quad \forall x,y\in X, \text{provided that } H(Tx,Ty)>0, $$
ψ

(
H
(
T
x
,
T
y
)
)

≤
φ

(
d
(
x
,
y
)
)

∀
x
,
y
∈
X
,
provided that 
H
(
T
x
,
T
y
)
>
0
,
and $$ \psi \bigl(H(Tx,Ty)\bigr)\leq \varphi \bigl(A(x,y)\bigr) \quad \forall x,y\in X, \text{provided that } H(Tx,Ty)>0, $$
ψ

(
H
(
T
x
,
T
y
)
)

≤
φ

(
A
(
x
,
y
)
)

∀
x
,
y
∈
X
,
provided that 
H
(
T
x
,
T
y
)
>
0
,
where $A(x,y)=\max \{ d(x,y), d(x,Tx), d(y,Ty), (d(x,Ty) +d(Tx,y))/2 \} $
A
(
x
,
y
)
=
max
{
d
(
x
,
y
)
,
d
(
x
,
T
x
)
,
d
(
y
,
T
y
)
,
(
d
(
x
,
T
y
)
+
d
(
T
x
,
y
)
)
/
2
}
, and $(X, d)$
(
X
,
d
)
is a metric space. The obtained fixed point results improve many earlier results on the set-valued contractions. As an application, we consider the existence of the solutions of an FDE.
Epidemiological profile of patients with rifampicin-resistant tuberculosis: an analysis of the Uganda National Tuberculosis Reference Laboratory Surveillance Data, 2014–2018
Authors: Bahizi Gloria , Majwala Robert Kaos , Kisaka Stevens , Nyombi Abdunoor , Musisi Kenneth , Kwesiga Benon , Bulage Lilian , Ario Alex Riolexus , Turyahabwe Stavia
Published: May 2021

Background

Drug-resistant tuberculosis (DR-TB), including rifampicin-resistant tuberculosis (RR-TB) and multidrug-resistant tuberculosis (MDR-TB, or RR-TB with additional isoniazid resistance), presents challenges to TB control. In Uganda, the GeneXpert test provides point-of-care testing for TB and rifampicin resistance. Patients identified with RR-TB receive culture-based drug susceptibility testing (DST) to identify additional resistance, if any. There are few data on the epidemiological profiles of current DR-TB patients in Uganda. We described patients with RR-TB in Uganda and assessed the trends of RR-TB to inform TB control interventions.

Methods

We identified patients with RR-TB whose samples were referred for culture and DST during 2014–2018 from routinely-generated laboratory surveillance data at the Uganda National Tuberculosis Reference Laboratory. Data on patient demographics and drug sensitivity profile of Mycobacterium tuberculosis isolates were abstracted. Population data were obtained from the Uganda Bureau of Statistics to calculate incidence. Descriptive epidemiology was performed, and logistic regression used to assess trends.

Results

We identified 1474 patients whose mean age was 36 ± 17 years. Overall incidence was 3.8/100,000 population. Males were more affected by RR-TB than females (4.9 vs. 2.7/100,000, p ≤ 0.01). Geographically, Northern Uganda was the most affected region (IR = 6.9/100,000) followed by the Central region (IR = 5.01/100,000). The overall population incidence of RR-TB increased by 20% over the evaluation period (OR = 1.2; 95% CI 1.15–1.23); RR-TB in new TB cases increased by 35% (OR = 1.35; 95% CI 1.3–1.4) and by 7% in previously-treated cases (OR = 1.07; 95% CI 1.0–1.1). Of the 1474 patients with RR-TB, 923 (63%) were culture-positive of whom 670 (72%) had full DST available. Based on the DST results, 522/670 (78%) had MDR-TB.

Conclusion

Between 2014 and 2018, the incidence of RR-TB increased especially among newly-diagnosed TB patients. We recommend intensified efforts and screening for early diagnosis especially among previously treated patients. Mechanisms should be in put to ensure that all patients with RR-TB obtain DST.
Neglected Tarlov cysts: a case of a Tarlov cyst with spermatorrhea
Authors: Sun Pan , Xu Wangbing , Ye Yongxiang , Zhong Faming , Wan Xuan , Li Yong
Published: May 2021

Background

Tarlov cysts are a commonly misdiagnosed condition, which can present with many rare symptoms. We report a case of a Tarlov cyst with spermatorrhea and review the pertinent literature.

Case presentation

A 42-year-old male patient had a history of spermatorrhea for > 10 years, but was incorrectly diagnosed as the patient and the doctors consistently mistook the symptoms for a genitourinary disease. Magnetic resonance imaging showed that two cysts in the sacral canal. The diagnosis was Tarlov cyst. We performed surgery to remove the cyst and the symptoms of spermatorrhea disappeared after the operation.

Conclusions

This case demonstrates that orthopedics and urologists should improve their understanding of Tarlov cysts to avoid misdiagnosis and mistreatment.
Building science through questions in Content and Language Integrated Learning (CLIL) classrooms
Authors: Tagnin Laura , Ní Ríordáin Máire
Published: May 2021

Background

The growing population of students that are learning science through a Content and Language Integrated Learning approach (CLIL) has led to concerns about these students’ ability to fully participate in a rich classroom discourse to develop content knowledge. A lack of information about science development through classroom discourse in CLIL settings brought us to focus on the questions teachers ask in upper secondary CLIL biology classrooms. Our aim was to understand how these questions effect science content learning opportunities. A multiple-case study design was implemented to examine and understand the complexities of teacher-student interactions. Data were collected in three case studies, each located in a different school (two in Germany and one in Italy), where CLIL senior secondary science classrooms were observed and audio-recorded. Classroom talk transcripts were analyzed using a mixed methods approach to discourse analysis.

Results

Findings suggest that a teacher’s strategic use of questions has the potential to promote both science understanding and science language development. Questioning contingent on students’ answers was observed to both promote content understanding and to lessen the linguistic demand on CLIL students by splitting both reasoning processes and language production into more manageable units. In addition, a higher level of cognitive engagement was present only when students managed to participate in the classroom discourse with answers longer than single utterances. To allow students to actively participate in the classroom discourse, teachers were observed adopting and promoting translanguaging practices, that is, the flexible use of more than one linguistic code. Furthermore, teachers asked language-related questions that promoted both understanding and use of disciplinary language.

Conclusions

The questioning practices observed in this study offer both practitioners and researchers ways of understanding issues of content access in upper secondary CLIL science classrooms. We recommend STEM teachers in CLIL settings not to oversimplify the linguistic demand on students, as this leads to an oversimplification of content. To lessen the linguistic barriers, practical strategies are recommended to support both cognitively and linguistically productive questioning in STEM CLIL classrooms.
Moringa oleifera
gum based silver and zinc oxide nanoparticles: green synthesis, characterization and their antibacterial potential against MRSA
Authors: Irfan Muhammad , Munir Hira , Ismail Hammad
Published: May 2021

Background

Herein, we first time used the gum
Moringa oleifera
as reducing and capping agent for successful synthesis of silver nitrate and zinc oxide nanoparticles(NPs) through green synthesis approach. This study was aimed to check antibacterial activities of synthesized NPs against multidrug resistant bacteria
methicillin-resistant Staphylococcus aureus
(MRSA).

Methods

Aqueous solutions of AgNO
3
and purified gum powder were mixed with 1:1 ratio, autoclaved at 120
o
C for 2 min. NPs pellet collected after centrifugation at 10,000 g for 20 min. ZnO NPs were prepared by mixing purified gum powder and metal salt with1:1 ratio, heated (70
o
C) and stirred at 100 rpm for 4 h followed by centrifugation at 10,000 
g
for 20 min. Pellet was washed and calcinated at 400
o
C for 4 h. Antibacterial potential against
E. coli, S. aureus
and
methicillin-resistant Staphylococcus aureus
(MRSA) was assessed by widely used Kirby-Bauer antibiotic susceptibility test.

Results

Optical observation of colour change from transparent to dark and
UV-Visible
analysis confirmed the synthesis of NPs. Fourier transform infrared spectroscopy (FTIR) of prepared nonmaterial revealed the characteristic AgNPs and ZnO stretch vibrations at wave number of 523 cm
− 1
and 471 cm
− 1
resectively. Crystalline nature of AgNPs and ZnO NPs was confirmed by x-ray diffraction pattern with clear sharp Peaks. Scanning electron microscopy (SEM) revealed good surface morphology of AgNPs and ZnO NPs with 50nm and 60nm size respectively. AgNPs and ZnO NPs exhibited excellent antibacterial activity against
E. coli
(with zone of inhibition of 21 ± 02mm and 22 ± 03mm) and
S.aureus
( with zone of inhibition of 20 ± 03mm and 21 ± 02mm) while good activity was observed against “super bug”
methicillin-resistant Staphylococcus aureus
(MRSA) with 16 ± 03mm ad 17 ± 02mm zone if inhibitions respectively.

Conclusions

This novel addition of Moringa Gum based nanoparticles will open new dimensions in the field of nanomedicine and pharmaceutics especially against MDR bacterial strains.
Both intermuscular fat and LVEF decline promote heart failure symptoms in cancer survivors
Authors: Reding Kerryn W. , O’Connell Nathaniel S. , D’Agostino Ralph B. , Hundley William , Lucas Alexander R. , Ladd Amy C. , Jordan Jennifer H. , Heiston Emily M. , Ge Yaorong , Hundley W. Gregory
Published: May 2021

Background

Approximately 20% of cancer survivors treated with chemotherapy experience worsening heart failure (HF) symptoms post-cancer treatment. While research has predominantly investigated the role of cardiotoxic treatments, much less attention has focused on other risk factors, such as adiposity. However, emerging data in cancer survivors indicates that adiposity may also impact a variety of cardiovascular outcomes. Methods: In a prospective study of 62 patients diagnosed with cancer followed for 24 months from cancer diagnosis through to survivorship (post-cancer treatment), we ascertained baseline fat depots including intermuscular fat (IMF) of the erector spinae muscles; and pre- and post-cancer treatment left ventricular ejection fraction (LVEF) and HF symptoms at baseline and 24-months, respectively. Linear regression was used to model independent variables in relation to HF symptoms at 24-months.

Results

Baseline IMF and LVEF change over 24-months significantly interacted to predict HF score at 24-months. The highest HF symptom score was observed for participants who experienced high IMF at baseline and a high decline in LVEF over 24-months (HF score = 11.0) versus all other categories of baseline IMF and LVEF change.

Conclusions

Together IMF and LVEF decline may play an important role in the worsening of HF symptoms in cancer survivors. The finding that IMF at cancer diagnosis led to elevated HF scores post-treatment suggests that IMF may be a potential target for intervention studies.
A review of the ethnomedicinal, antimicrobial, and phytochemical properties of Musa paradisiaca (plantain)
Authors: Ajijolakewu Kamoldeen Abiodun , Ayoola Abiodun Saheed , Agbabiaka Tariq Oluwakunmi , Zakariyah Folashade Rahmat , Ahmed Nike Risikat , Oyedele Olusegun Julius , Sani Alhasan
Published: May 2021

Background

More people—in both developing and developed countries—now use, and are favourably disposed to, traditional medicine. Musa paradisiaca (plantain) is used extensively in traditional medicine across continents. In this review, we investigated the scientific justification of this extensive usage.

Main body

Generally, several studies validate usage in infectious diseases, but limited antiviral and in vivo reports exist. The mechanistic elicitation of antimicrobial activity has similarly not been ascertained. Contrarily, data abound from rigorous studies on physiological conditions. Activity across categories is tied to the potent phytosterols duo of stigmasterol and β-sitosterol; and the triterpenes viz. cycloeucalenone, 24-methylene-cycloartanol, and 31-norcyclolaudenone; present in plantain. Toxicity studies, while finite, suggest general safety and tolerance.

Conclusions

Findings in the studies reviewed projects plantain as a veritable source for drug bioprospecting that will be of benefit to scientific research and pharmaceutical industries.
Congenital Adrenal Hyperplasia—Current Insights in Pathophysiology, Diagnostics, and Management
Authors: Claahsen - van der Grinten Hedi L , Speiser Phyllis W , Ahmed S Faisal , Arlt Wiebke , Auchus Richard J , Falhammar Henrik , Flück Christa E , Guasti Leonardo , Huebner Angela , Kortmann Barbara B M , Krone Nils , Merke Deborah P , Miller Walter L , Nordenström Anna , Reisch Nicole , Sandberg David E , Stikkelbroeck Nike M M L , Touraine Philippe , Utari Agustini , Wudy Stefan A , White Perrin C
Published: May 2021

Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders affecting cortisol biosynthesis. Reduced activity of an enzyme required for cortisol production leads to chronic overstimulation of the adrenal cortex and accumulation of precursors proximal to the blocked enzymatic step. The most common form of CAH is caused by steroid 21-hydroxylase deficiency due to mutations in CYP21A2. Since the last publication summarizing CAH in Endocrine Reviews in 2000, there have been numerous new developments. These include more detailed understanding of steroidogenic pathways, refinements in neonatal screening, improved diagnostic measurements utilizing chromatography and mass spectrometry coupled with steroid profiling, and improved genotyping methods. Clinical trials of alternative medications and modes of delivery have been recently completed or are under way. Genetic and cell-based treatments are being explored. A large body of data concerning long-term outcomes in patients affected by CAH, including psychosexual well-being, has been enhanced by the establishment of disease registries. This review provides the reader with current insights in CAH with special attention to these new developments.
Roles of Sodium-Glucose Cotransporter 2 of Mesangial Cells in Diabetic Kidney Disease
Authors: Wakisaka Masanori , Nakamura Kuniyuki , Nakano Toshiaki , Kitazono Takanari
Published: May 2021

We have been studying the presence of sodium-glucose cotransporter 2 (SGLT2) in mesangial cells and pericytes since 1992. Recent large placebo-controlled studies of SGLT2 inhibitors in patients with type 2 diabetes mellitus have reported desirable effects of the inhibitors on the diabetic kidney and the diabetic heart. Most studies have indicated that these effects of SGLT2 inhibitors could be mediated by the tubuloglomerular feedback system. However, a recent study about urine sodium excretion in the presence of an SGLT2 inhibitor did not show any increases in urine sodium excretion. A very small dose of an SGLT2 inhibitor did not inhibit SGLT2 at the S1 segment of proximal tubules. Moreover, SGLT2 inhibition protects against progression in chronic kidney disease with and without type 2 diabetes. In these circumstances, the tubuloglomerular feedback hypothesis involves several theoretical concerns that must be clarified. The presence of SGLT2 in mesangial cells seems to be very important for diabetic nephropathy. We now propose a novel mechanism by which the desirable effects of SGLT2 inhibitors on diabetic nephropathy are derived from the direct effect on SGLT2 expressed in mesangial cells.
Parafibromin Abnormalities in Ossifying Fibroma
Authors: Costa-Guda Jessica , Pandya Chetanya , Strahl Maya , Taik Patricia , Sebra Robert , Chen Rong , Uzilov Andrew V , Arnold Andrew
Published: May 2021

Ossifying fibromas are very rare tumors that are sometimes seen as part of the hyperparathyroidism-jaw tumor syndrome (HPT-JT), which is caused by inactivating mutations of the HRPT2/CDC73 tumor suppressor gene. CDC73 mutations have been identified in a subset of sporadic cases but aberrant expression of the encoded protein, parafibromin, has not been demonstrated in ossifying fibroma. We sought to determine if loss of parafibromin regularly contributes to the development of sporadic, nonsyndromic ossifying fibroma. We examined a series of 9 ossifying fibromas, including ossifying, cemento-ossifying, and juvenile active variants, for parafibromin protein expression by immunohistochemistry and for CDC73 sequence abnormalities by Sanger sequencing and/or targeted AmpliSeq panel sequencing. Four ossifying fibromas showed a complete absence of nuclear parafibromin expression; loss of parafibromin expression was coupled with aberrant cytoplasmic parafibromin expression in 1 case. CDC73 mutations were detected in 2 cases with aberrant parafibromin expression. These results provide novel evidence, at the level of protein expression, that loss of the parathyroid CDC73/parafibromin tumor suppressor may play a role in the pathogenesis of a subset of ossifying fibromas.
Time Harms
Authors: Price Margaret
Published: May 2021

Focusing on the theme of “slowness,” this article demonstrates that an individualized approach to access in university life worsens inequity rather than alleviating it. It introduces the concept of the “accommodations loop,” through which slow systems and processes impede access through a relentless focus on individual accommodation and biocertification. The accommodations loop shows that time, often thought of as a desirable commodity, can also be used to harm disabled people in the name of inclusion. In closing, this article argues that we should work toward equity through systems of collective accountability, rather than individual accommodation.
Reclaiming the Radical Politics of Self-Care
Authors: Kim Jina B. , Schalk Sami
Published: May 2021

Since 2016, searches for and discussions of self-care in the United States have increased significantly. While authors who identify as people of color and/or queer critique the capitalist co-optation of this term by linking it conceptually to the work of Audre Lorde, engagement with disability remains conspicuously absent all around, given that Lorde’s use of this concept comes from her 1988 essay on cancer, “A Burst of Light.” This article proposes a reclamation of the radical crip, feminist, queer, and racialized roots of self-care offered by Lorde. Using crip-of-color critique, this article argues that a radical politics of self-care is inextricably tied to the lived experiences and temporalities of multiply marginalized disabled people. It attempts to hold the complexity of claiming time for ourselves to slow down, to take care, while also understanding the real urgency of our contemporary moment. This piece thus proposes that, while crip time is often about slowing and adapting models of time and productivity, crip time as a concept is also urgently needed to understand self-care outside of capitalist imperatives.
Childcare costs and Universal Credit: awareness, affordability and the challenge of an embedded system
Authors: Wood Marsha
Published: May 2021

Helping parents meet the cost of childcare is an important policy objective in the UK and there are various financial subsidies available. For low-income working parents, this support is increasingly provided through Universal Credit, the main means-tested benefit for working-age people in the UK. This article draws on qualitative interviews with parents on Universal Credit and explores issues of awareness, affordability, administration and the consequences of embedding childcare costs into a monthly-based means-tested system. The conclusions reflect on the implications for the Universal Credit goals of supporting employment, of simplification of the system, and of increasing personal responsibility.
The LUCA device: a multi-modal platform combining diffuse optics and ultrasound imaging for thyroid cancer screening
Authors: Cortese Lorenzo , Lo Presti Giuseppe , Zanoletti Marta , Aranda Gloria , Buttafava Mauro , Contini Davide , Dalla Mora Alberto , Dehghani Hamid , Di Sieno Laura , de Fraguier Sixte , Hanzu Felicia A. , Mora Porta Mireia , Nguyen-Dinh An , Renna Marco , Rosinski Bogdan , Squarcia Mattia , Tosi Alberto , Weigel Udo M. , Wojtkiewicz Stanislaw , Durduran Turgut
Published: May 2021

We present the LUCA device, a multi-modal platform combining eight-wavelength near infrared time resolved spectroscopy, sixteen-channel diffuse correlation spectroscopy and a clinical ultrasound in a single device. By simultaneously measuring the tissue hemodynamics and performing ultrasound imaging, this platform aims to tackle the low specificity and sensitivity of the current thyroid cancer diagnosis techniques, improving the screening of thyroid nodules. Here, we show a detailed description of the device, components and modules. Furthermore, we show the device tests performed through well established protocols for phantom validation, and the performance assessment for in vivo. The characterization tests demonstrate that LUCA device is capable of performing high quality measurements, with a precision in determining in vivo tissue optical and dynamic properties of better than 3%, and a reproducibility of better than 10% after ultrasound-guided probe repositioning, even with low photon count-rates, making it suitable for a wide variety of clinical applications.
High speed pulsed laser cutting of anode material for a Li-ion battery in burst mode
Authors: Huang Jinyu , Shi Wenqing , Huang Jiang , Xie Yuping , Ba Yi , He Kuanfang
Published: May 2021

The bursts of picosecond laser pulses have nanosecond-level short interval delay. These bursts contain a variable number of sub-pulses, which are used for laser cutting of copper current collector and graphite anode material for Li-ion battery anode. The influences of 2–10 sub-pulses on kerf edges were studied and were compared with that of a single pulse. The shapes of anode edge cut under different conditions, obtained using scanning electron microscopy (SEM), revealed that using burst mode would yield a smaller heat-affected zone (HAZ) of the copper current collector and smaller delamination width of graphite anode material. The capability of laser cutting of anode was characterized with maximum single-time cutting speed. Results showed that the cutting efficiency was raised evidently with the increase in the number of pulses in a burst, and the maximum cutting speeds for the copper current collector and graphite anode material could reach 3,800 mm/s and 500 mm/s respectively.