bluuebunny/crossref_metadata_2025 huggingface dataset:
Favorable prognosis of breast cancer brain metastases patients with limited intracranial and extracranial metastatic lesions
Authors: Shi Wei , Li Yang , Sun Hua , Zhang Li , Meng Jin , Wang Xiaofang , Chen Xingxing , Zhang Xiaomeng , Mei Xin , Ma Jinli , Mo Miao , Zhou Changming , Liang Fei , Shao Zhimin , Zhang Zhen , Guo Xiaomao , Yu Xiaoli , Yang Zhaozhi
Published: July 2023

Background

Breast cancer brain metastases (BCBM) are highly heterogenous with widely differing survival. The prognosis of the oligometastatic breast cancer (BC) patients with brain metastases (BM) has not been well studied. We aimed to investigate the prognosis of BCBM patients with limited intracranial and extracranial metastatic lesions.

Methods

Four hundred and forty-five BCBM patients treated between 1st January 2008 and 31st December 2018 at our institute were included. Clinical characteristics and treatment information were obtained from patient’s medical records. The updated breast Graded Prognostic Assessment (Breast GPA) was calculated.

Results

The median OS after diagnosis of BM were 15.9 months. Median OS for patients with GPA 0–1.0, 1.5–2, 2.5–3 and 3.5–4 were 6.9, 14.2, 21.8, 42.6 months respectively. The total number of intracranial and extracranial metastatic lesions, in addition to the Breast GPA, salvage local therapy and systemic therapy (anti-HER2 therapy, chemotherapy and endocrine therapy) were demonstrated to be associated with prognosis. One hundred and thirteen patients (25.4%) had 1–5 total metastatic lesions at BM diagnosis. Patients with 1–5 total metastatic lesions had a significantly longer median OS of 24.3 months compared to those with greater than 5 total metastatic lesions with a median OS of 12.2 months (P < 0.001; multivariate HR 0.55, 95% CI, 0.43–0.72). Among the patients with 1–5 metastatic lesions, median OS for GPA 0–1.0 was 9.8 months, compared to 22.8, 28.8 and 71.0 for GPA 1.5–2.0, 2.5–3.0 and 3.5–4.0 respectively, which is much longer than the corresponding patients with greater than 5 total metastatic lesions, with medium OS of 6.8, 11.6, 18.6 and 42.6 months respectively for GPA 0–1.0, 1.5–2.0, 2.5–3.0 and 3.5–4.0.

Conclusions

The patients with 1–5 total metastatic lesions demonstrated better OS. The prognostic value of the Breast GPA and the survival benefit of salvage local therapy and continuation of systemic therapy after BM were confirmed.
Synergistic effect of LCI with ESWT on treating patients with mild to moderate CTS: a randomized controlled trial
Authors: Gholipour Morteza , Bonakdar Sona , Gorji Mona , Minaei Reza
Published: July 2023

Background

Applying radial extracorporeal shock wave therapy (R-ESWT) with LCI(local corticosteroid injection) in carpal tunnel syndrome (CTS) management is gaining momentum. The objective is to actualize the topic of this study.

Methods

In this prospective randomized controlled trial, forty patients with mild to moderate CTS are divided into two sham- R-ESWT and R-ESWT groups subject to LCI(local corticosteroid injection). The first group received four sessions of sham-ESWT weekly, which involved sound but no energy; the second group received R-ESWT at equal intervals and were assessed for pain score (VAS score) and symptoms (GSS) baseline, 1st month, 3rd month, and 6th month.

Results

A considerable improvement is observed in both groups for pain at (P < 0.05) and symptoms at (P < 0.05) in the 3rd month. The second group revealed more significant symptom improvement at (P < 0.05) in the 6th month.

Conclusion

The R-ESWT + LCI combined therapy course is the first line of treatment in patients with mild to moderate symptoms and leads to control and reduction of symptoms and the need for surgery, thus a primary concern in CTS treatment with an orthopedist.
CircTBX5 knockdown modulates the miR-558/MyD88 axis to alleviate IL-1β-induced inflammation, apoptosis and extracellular matrix degradation in chondrocytes via inactivating the NF-κB signaling
Authors: Wei Wei , Mu Hongjie , Cui Qiaoyi , Yu Peng , Liu Tong , Wang Tao , Sheng Lin
Published: July 2023

Background

It has been widely shared that the dysregulation of circular RNA (circRNA) may contribute to the progression of osteoarthritis (OA). OA is characterized by persistent chondrocyte injury. We aimed to clarify the role of circTBX5 in IL-1β-induced chondrocyte injury.

Methods

The expression of circTBX5, miR-558 and MyD88 mRNA was measured using quantitative real-time PCR (qPCR). Cell viability, proliferation and apoptosis were assessed by CCK-8, EdU or flow cytometry assay. The protein levels of extracellular matrix (ECM)-associated markers, MyD88, IkBα, p65 and phosphorylated IkBα were measured by western blot. The release of inflammatory factors was assessed by ELISA. The targets of circTBX5 were screened by RIP and pull-down assay. The putative binding between miR-558 and circTBX5 or MyD88 was validated by dual-luciferase reporter assay.

Results

CircTBX5 and MyD88 were enhanced, while miR-558 was downregulated in OA cartilage tissues and IL-1β-treated C28/I2 cells. IL-1β induced C28/I2 cell injury by impairing cell viability and proliferation and promoting cell apoptosis, ECM degradation and inflammatory response, while circTBX5 knockdown alleviated IL-1β induced injury. CircTBX5 bound to miR-558 to regulate IL-1β induced cell injury. In addition, MyD88 was a target of miR-558, and circTBX5 targeted miR-558 to positively regulate MyD88 expression. MiR-558 enrichment attenuated IL-1β induced injury by sequestering MyD88 expression. Moreover, circTBX5 knockdown weakened the activity of NF-κB signaling, while miR-558 inhibition or MyD88 overexpression recovered the activity of NF-κB signaling.

Conclusion

CircTBX5 knockdown modulated the miR-558/MyD88 axis to alleviate IL-1β induced chondrocyte apoptosis, ECM degradation and inflammation via inactivating the NF-кB signaling pathway.
Pseudoaneurysm after aortopulmonary window repair and bilateral lung transplantation for eisenmenger syndrome: a case report
Authors: Nagashima Toshiaki , Taira Masaki , Hasegawa Moyu , Kugo Yosuke , Watanabe Takuji , Yoshioka Daisuke , Shimamura Kazuo , Ueno Takayoshi , Miyagawa Shigeru
Published: July 2023

Background

Aortopulmonary window (APW) is a rare congenital cardiac anomaly characterized by communication between the main pulmonary artery and ascending aorta. There are various surgical techniques, and the short- and long-term results are excellent if the surgical repair is performed early in life. To our knowledge, there have been no reports of pseudoaneurysm after APW repair. Herein, we present a case of a 30-year-old woman with an ascending aortic pseudoaneurysm found at the site of APW repair nine months after the APW repair and bilateral lung transplantation.

Case presentations

A 30-year-old woman presented with APW and Eisenmenger syndrome. The patient underwent APW repair and bilateral lung transplantation. We transected the communication between the aorta and pulmonary artery and closed the aortic side directly with strips of felts. Nine months after the surgery, the patient complained of chest pain. Cardiac computed tomography revealed an ascending aortic pseudoaneurysm at the anastomotic site. Emergent graft replacement of the ascending aorta was performed and the postoperative course was uneventful.

Conclusions

We have presented a case of a pseudoaneurysm at the anastomotic site after APW repair and bilateral lung transplantation. The choice of surgical technique should be based on the patient’s background requiring lung transplantation, and in these cases close postoperative follow-up is required.
Landscape of PCOS co-expression gene and its role in predicting prognosis and assisting immunotherapy in endometrial cancer
Authors: Zhang Yun , Hu Yifang , Yu Jian , Xie Xiaoyan , Jiang Feng , Wu Chuyan
Published: July 2023

Background

Endometrial carcinoma (EC) is the sixth most frequent malignancy in women and is often linked to high estrogen exposure. Polycystic ovarian syndrome (PCOS) is a known risk factor for EC, but the underlying mechanisms remain unclear.

Methods

We investigated shared gene signals and potential biological pathways to identify effective therapy options for PCOS- and EC-related malignancies. Weighted gene expression network analysis (WGCNA) was used to identify genes associated with PCOS and EC using gene expression data from the Gene Expression Omnibus (GEO) and Cancer Genome Atlas (TCGA) datasets. Enrichment analysis using Cluego software revealed that the steroid hormone biosynthetic process was a critical feature in both PCOS and EC. A predictive signature encompassing genes involved in steroid hormone production was developed using multivariate and least absolute shrinkage and selection operator (LASSO) regression analysis to predict the prognosis of EC. Then, we conducted further experimental verification.

Results

Patients in the TCGA cohort with high predictive scores had poorer outcomes than those with low scores. We also investigated the relationship between tumor microenvironment (TME) features and predictive risk rating and found that patients with low-risk scores had higher levels of inflammatory and inhibitory immune cells. Also, we found that immunotherapy against anti-CTLA4 and anti-PD-1/PD-L1 was successful in treating individuals with low risk. Low-risk individuals were more responsive to crizotinib therapy, according to further research performed using the “pRRophetic” R package. We further confirmed that IGF2 expression was associated with tumor cell migration, proliferation, and invasion in EC cells.

Conclutions

By uncovering the pathways and genes linking PCOS and EC, our findings may provide new therapeutic strategies for patients with PCOS-related EC.
Renal interferon-inducible protein 16 expression is associated with disease activity and prognosis in lupus nephritis
Authors: Wang Xueyao , Fu Shaojie , Yu Jinyu , Ma Fuzhe , Zhang Lihong , Wang Jiahui , Wang Luyu , Tan Yue , Yi Huanfa , Wu Hao , Xu Zhonggao
Published: July 2023

Background

Lupus nephritis (LN) is one of the most severe complications of systemic lupus erythematosus (SLE). However, the current management of LN remains unsatisfactory due to sneaky symptoms during early stages and lack of reliable predictors of disease progression.

Methods

Bioinformatics and machine learning algorithms were initially used to explore the potential biomarkers for LN development. Identified biomarker expression was evaluated by immunohistochemistry (IHC) and multiplex immunofluorescence (IF) in 104 LN patients, 12 diabetic kidney disease (DKD) patients, 12 minimal change disease (MCD) patients, 12 IgA nephropathy (IgAN) patients and 14 normal controls (NC). The association of biomarker expression with clinicopathologic indices and prognosis was analyzed. Gene Set Enrichment Analysis (GSEA) and Gene Set Variation Analysis (GSVA) were utilized to explore potential mechanisms.

Results

Interferon-inducible protein 16 (IFI16) was identified as a potential biomarker for LN. IFI16 was highly expressed in the kidneys of LN patients compared to those with MCD, DKD, IgAN or NC. IFI16 co-localized with certain renal and inflammatory cells. Glomerular IFI16 expression was correlated with pathological activity indices of LN, while tubulointerstitial IFI16 expression was correlated with pathological chronicity indices. Renal IFI16 expression was positively associated with systemic lupus erythematosus disease activity index (SLEDAI) and serum creatinine while negatively related to baseline eGFR and serum complement C3. Additionally, higher IFI16 expression was closely related to poorer prognosis of LN patients. GSEA and GSVA suggested that IFI16 expression was involved in adaptive immune-related processes of LN.

Conclusion

Renal IFI16 expression is a potential biomarker for disease activity and clinical prognosis in LN patients. Renal IFI16 levels may be used to shed light on predicting the renal response and develop precise therapy for LN.
The role of Huidouba in regulating skeletal muscle metabolic disorders in prediabetic mice through AMPK/PGC-1α/PPARα pathway
Authors: Tian Yu , Shi Dongxu , Liao Haiying , Lu Binan , Pang Zongran
Published: July 2023

Prediabetes is a transitional state between normal blood glucose levels and diabetes, but it is also a reversible process. At the same time, as one of the most important tissues in the human body, the metabolic disorder of skeletal muscle is closely related to prediabetes. Huidouba (HDB) is a clinically proven traditional Chinese medicine with significant effects in regulating disorders of glucose and lipid metabolism. Our study aimed to investigate the efficacy and mechanism of HDB in prediabetic model mice from the perspective of skeletal muscle. C57BL/6J mice (6 weeks old) were fed a high-fat diet (HFD) for 12 weeks to replicate the prediabetic model. Three concentrations of HDB were treated with metformin as a positive control. After administration, fasting blood glucose was measured as an indicator of glucose metabolism, as well as lipid metabolism indicators such as total triglyceride (TG), low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C), free fatty acid (FFA), and lactate dehydrogenase (LDH). Muscle fat accumulation and glycogen accumulation were observed. The protein expression levels of p-AMPK, AMPK, PGC-1α, PPAR-α, and GLUT-4 were detected. After HDB treatment, fasting blood glucose was significantly improved, and TG, LDL-C, FFA, and LDH in serum and lipid accumulation in muscle tissue were significantly reduced. In addition, HDB significantly upregulated the expression levels of p-AMPK/AMPK, PGC-1α, PPAR-α, and GLUT-4 in muscle tissue. In conclusion, HDB can alleviate the symptoms of prediabetic model mice by promoting the AMPK/PGC-1α/PPARα pathway and upregulating the expression of GLUT-4 protein.
Multi-task deep cross-attention networks for far-field speaker verification and keyword spotting
Authors: Liang Xingwei , Zhang Zehua , Xu Ruifeng
Published: July 2023

Personalized voice triggering is a key technology in voice assistants and serves as the first step for users to activate the voice assistant. Personalized voice triggering involves keyword spotting (KWS) and speaker verification (SV). Conventional approaches to this task include developing KWS and SV systems separately. This paper proposes a single system called the multi-task deep cross-attention network (MTCANet) that simultaneously performs KWS and SV, while effectively utilizing information relevant to both tasks. The proposed framework integrates a KWS sub-network and an SV sub-network to enhance performance in challenging conditions such as noisy environments, short-duration speech, and model generalization. At the core of MTCANet are three modules: a novel deep cross-attention (DCA) module to integrate KWS and SV tasks, a multi-layer stacked shared encoder (SE) to reduce the impact of noise on the recognition rate, and soft attention (SA) modules to allow the model to focus on pertinent information in the middle layer while preventing gradient vanishing. Our proposed model demonstrates outstanding performance in the well-off test set, improving by 0.2%, 0.023, and 2.28% over the well-known SV model emphasized channel attention, propagation, and aggregation in time delay neural network (ECAPA-TDNN) and the advanced KWS model Convmixer in terms of equal error rate (EER), minimum detection cost function (minDCF), and accuracy (Acc), respectively.
Interventions targeting the mental health and wellbeing of care-experienced children and young people in higher-income countries: Evidence map and systematic review
Authors: Evans Rhiannon , MacDonald Sarah , Trubey Rob , Noyes Jane , Robling Michael , Willis Simone , Boffey Maria , Wooders Charlotte , Vinnicombe Soo , Melendez-Torres G. J.
Published: July 2023

Background

The mental health and wellbeing of care-experienced children and young people (i.e. foster care, kinship care, residential care) is poorer than non-care-experienced populations. The Care-experienced cHildren and young people’s Interventions to improve Mental health and wEll-being outcomes Systematic review (CHIMES) aimed to synthesise the international evidence base for interventions targeting subjective wellbeing, mental health and suicide amongst care-experienced young people aged ≤ 25 years.

Methods

For the first phase of the review, we constructed an evidence map identifying key clusters and gaps in interventions and evaluations. Studies were identified through 16 electronic databases and 22 health and social care websites, in addition to expert recommendations, citation tracking and screening of relevant systematic reviews. We charted interventions and evaluations with a summary narrative, tables and infographics.

Results

In total, 64 interventions with 124 associated study reports were eligible. The majority of study reports were from the USA (n = 77). Interventions primarily targeted children and young people’s skills and competencies (n = 9 interventions), the parental functioning and practices of carers (n = 26), or a combination of the two (n = 15). While theoretically under-specified, interventions were largely informed by theories of Attachment, Positive Youth Development, and Social Learning Theory. Current evaluations prioritised outcomes (n = 86) and processes (n = 50), with a paucity of study reports including theoretical descriptions (n = 24) or economic evaluations (n = 1). Interventions most frequently targeted outcomes related to mental, behavioural or neurodevelopmental disorders, notably total social, emotional and behavioural problems (n = 48 interventions) and externalising problem behaviours (n = 26). There were a limited number of interventions targeting subjective wellbeing or suicide-related outcomes.

Conclusions

Future intervention development might focus on structural-level intervention theories and components, and target outcomes related to subjective wellbeing and suicide. In accordance with current methodological guidance for intervention development and evaluation, research needs to integrate theoretical, outcome, process and economic evaluation in order to strengthen the evidence base.

Systematic review registration

PROSPERO CRD42020177478.
Effective inclusion practices for neurodiverse children and adolescents in informal STEM learning: a systematic review protocol
Authors: Jenson Ronda J. , Lee Michele S , Day Arden D. , Hughes Amy E. , Maroushek Emma E. , Roberts Kelly D.
Published: July 2023

Background

Informal learning experiences in science, technology, engineering, and math (STEM) can enhance STEM learning that occurs in formal educational settings and curricula as well as generate enthusiasm for considering STEM careers. The aim of this systematic review is to focus on the experiences of neurodiverse students in informal STEM learning. Neurodiversity is a subgroup of neurodevelopmental conditions, such as autism, attention deficit disorder, dyslexia, dyspraxia, and other neurological conditions. The neurodiversity movement regards these conditions as natural forms of human variation, as opposed to dysfunction, and recognizes that neurodiverse individuals possess many strengths relevant to STEM fields.

Methods

The authors will systematically search electronic databases for relevant research and evaluation articles addressing informal STEM learning for K-12 children and youth with neurodiverse conditions. Seven databases and content-relevant websites (e.g., informalscience.org) will be searched using a predetermined search strategy and retrieved articles will be screened by two members of the research team. Data synthesis will include meta-synthesis techniques, depending on the designs of the studies.

Discussion

The synthesis of the findings resulting from various research and evaluation designs, across the K-12 age span, and across various informal STEM learning contexts, will lead to depth and breadth of understanding of ways to improve informal STEM learning programs for neurodiverse children and youth. The identification of informal STEM learning program components and contexts shown to yield positive results will provide specific recommendations for improving inclusiveness, accessibility, and STEM learning for neurodiverse children and youth.

Trial registration

The current study has been registered in PROSPERO. Registration number: CRD42021278618.
Physiotherapy management of children with cerebral palsy in low- and middle-income countries: a scoping review protocol
Authors: Duma Noxolo E. , Hlongwa Mbuzeleni , Benjamin-Damons Natalie , Hlongwana Khumbulani W.
Published: July 2023

Introduction

Cerebral Palsy (CP) is the most common childhood physical disability worldwide. Approximately 1.5 to 4 children per live births live with CP, globally. There have been no specific treatments that can reverse the brain damage responsible for the complex clinical dysfunctions of CP. There are, however, several interventions that are currently being used by physiotherapists, most of which are deemed to be ineffective and unnecessary. We will conduct a scoping review aimed at mapping evidence on the physiotherapy management of children living with CP in low- and middle-income countries (LMICs).

Methods

The scoping review will be guided by the Arksey and O’Malley and Levac et al. frameworks. The databases that will be used to search for literature include PubMed, MEDLINE, CINAHL, EBSCOhost, Web of Science, and ProQuest One Academic and Scopus. Gray literature articles will also be included in this review, provided they meet our inclusion criteria. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis: Extension for Scoping Reviews (PRIMSA-ScR) guideline will be used to report the results of the scoping review. The screened results will be reported using the PRISMA flow diagram guidelines, and the results will be charted using an electronic data charting form and analyzed using thematic analysis.

Discussion

Understanding how physiotherapists manage children with CP in LMICs is essential for the development of internationally sound, yet locally relevant, intervention strategy for physiotherapists. It is anticipated that the results of the scoping review will inform the thinking geared towards the development of a contextualised evidence-based framework for physiotherapists to effectively manage CP in children.

Systematic review registration

Open Science Framework. https://doi.org/10.17605/OSF.IO/VTJ84
Association of statin use and increase in lipoprotein(a): a real-world database research
Authors: Feng Tienan , Li Yao , Xue Xiongfeng , Yang Wei , Li Qiang , Huang Yushi , Zhu Tengteng , Wang Jue , Xu Limin , Li Xianchen , Gao Jing , Sun Shiming , Zhu Bin , Zhang ShuYu , Cao Beibei , Xuan Jianwei , Zhao Zhigang , Qian Biyun
Published: July 2023

Background

There is an increased concern that statins may have an unintended effect of elevated lipoprotein(a) [Lp(a)]. We conducted a large sample real-world study to test the association.

Methods

This retrospective cohort study was conducted using data from an integrated SuValue database, which includes 221 hospitals across China covering more than 200,000 of population with longitudinal follow-up to 10 years. Propensity score matching was applied to identify two comparable cohorts with statin users and non-statin users. Detailed follow-up information such as Lp(a) levels were extracted. The hazard ratio was calculated on Lp(a) changes based on the statin usage cohorts. Detailed subgroup and different characteristic cohorts’ analyses were also conducted.

Results

After baseline propensity score matching, a total of 42,166 patients were included in a 1:1 matched ratio between statin users and non-statin users. In the case of no difference in low density lipoprotein (LDL-C), Lp(a) was increased significantly with the use of statins (adjusted HR 1.47; 95% confidence interval [CI] 1.43–1.50). Lp(a) increase was observed in various subgroup analyses and different cohorts. The dose intensity of statin was positively associated with the evaluated Lp(a) level.

Conclusion

The use of statins was associated with an increased risk of Lp(a) elevation compared with non-statin use counterparts. The clinical relevance of these increases needs to be addressed in surrogate marker trials and/or large, cardiovascular outcomes trials.
BUN level is associated with cancer prevalence
Authors: Wang Cai , Sun Hao , Liu Jin
Published: July 2023

Blood urea nitrogen (BUN) was an important biomarker for the development and prognosis of many diseases. Numerous studies had demonstrated that BUN had a strong relationship with long-term mortality, survival and the prevalence of some diseases. The diagnosis and treatment, prognosis and long-term survival rate of cancer were the focus of clinical research at present. However, the relationship between BUN level and cancer prevalence was not clear. To investigate the relationship between BUN level and cancer prevalence, we performed a statistical analysis of population data from the National Health and Nutrition Examination Survey (NHANES) database. The results of the study showed that BUN level were positively correlated with cancer prevalence, and the correlation was more pronounced in breast cancer.
Does loop length change after anterior cruciate ligament reconstruction with adjustable loop cortical suspension device?: Observation of the hamstring graft completely filling the femoral tunnel
Authors: Hyodo Kojiro , Kanamori Akihiro , Watanabe Ryunosuke , Ainoya Takeshi , Kikuchi Naoya , Arai Norihito , Yamazaki Masashi
Published: July 2023

Purpose

The adjustable loop cortical suspension device (ALD) is a useful femoral fixation device in anterior cruciate ligament (ACL) reconstructions, but the possibility of loosening has been suggested. The purpose of this study was to evaluate the elongation of an adjustable loop and the position of the hamstring graft inside the femoral socket.

Methods

The subjects were 33 patients who underwent ACL reconstruction with a hamstring tendon. The graft was fixed using ALD and completely filled the femoral socket. Magnetic resonance images were taken one week and one year after the operation. The loop length, femoral socket length, and graft length inside the socket were measured and statistically compared with the clinical outcomes.

Results

The loop length one week after surgery was 18.9 ± 4.4 mm, and 1 year after surgery was 19.9 ± 4.5 mm (P < 0.001). The gap between the top of the graft and femoral socket was 0.9 ± 1.8 mm one week after surgery and 1.3 ± 1.7 mm one year after surgery (P = 0.259). At one week post‐operation, a gap was found in nine patients (27.3%). The loop length and gap did not strongly correlate with clinical findings.

Conclusion

ACL reconstruction using ALD showed a gap between the graft and femoral socket at the one week post‐operation mark in 27.3% of participants. One year after the surgery, there were cases where the gap increased and/or decreased, but the elongation of the loop was 1 mm on average. Our findings suggest that ALD is clinically safe to use; however, has the possibility of initial loop elongation and non‐uniform changes.

Level of evidence

IV.
Teaching and learning the four English skills before and during the COVID-19 era: perceptions of EFL faculty and students in Saudi higher education
Authors: Alhaider Siham Mousa
Published: July 2023

At the peak of the COVID-19 pandemic in 2020, synchronous online learning replaced physical classes worldwide. However, sustaining the quality of education during this transition was a challenge. Specifically, teaching and learning the four English skills (listening, speaking, reading and writing) among English-as-a-foreign-language (EFL) learners in contexts such as Saudi Arabia required greater adjustments to meet learners’ demands during the pandemic. Within this context, this study explored how online teaching and learning helped develop the four English skills among Saudi EFL students. A survey was conducted among EFL faculty and learners in a Saudi Arabian higher-learning institution regarding the diverse aspects of language skills development before and during the pandemic. Data were analyzed using descriptive and inferential statistics. The results showed that e-learning was most beneficial for writing and least beneficial for speaking and that writing was most nurtured and adopted in almost all schoolwork, while speaking was neglected during online courses. Indeed, instructors must be prepared for an effective online learning experience in the future. This study aims to strengthen the field of EFL teaching and learning in Saudi Arabia and related contexts by describing learners’ perceptions of their experiences before and during the pandemic.
Dynamic changes of DNA methylation induced by benzo(a)pyrene in cancer
Authors: Wang Huizeng , Liu Bingchun , Chen Hong , Xu Peixin , Xue Huiting , Yuan Jianlong
Published: July 2023

Benzo(a)pyrene (BaP), the earliest and most significant carcinogen among polycyclic aromatic hydrocarbons (PAHs), has been found in foods, tobacco smoke, and automobiles exhaust, etc. Exposure to BaP induced DNA damage directly, or oxidative stress-related damage, resulting in cell apoptosis and carcinogenesis in human respiratory system, digestive system, reproductive system, etc. Moreover, BaP triggered genome-wide epigenetic alterations by methylation, which might cause disturbances in regulation of gene expression, and thereby induced cancer. It has been proved that BaP reduced genome-wide DNA methylation, and activated proto-oncogene by hypomethylation in the promoter region, but silenced tumor suppressor genes by promoter hypermethylation, resulting in cancer initiation and progression. Here we summarized the changes in DNA methylation in BaP exposure, and revealed the methylation of DNA plays a role in cancer development.

Graphical Abstract
Effects of tannic acid on proteins and fat in cream
Authors: Wicks Cameron J. , Bolling Bradley W. , Hartel Richard W.
Published: July 2023

Abstracts

The addition of polyphenols to ice cream mix has been shown to cause a decrease in melting rate of that ice cream, although the mechanisms of this effect are not well understood. To better understand this phenomenon, the objective of this study was to understand the effects of a polyphenol, tannic acid (TA), on dairy cream. TA was added to cream at 0.75%, 1.5% and 3% (wt/wt) concentrations. An increase in complex viscosity was seen as TA% increased. The effect of pH on protein aggregation was minimal since the pH values of the resulting TA-cream samples were generally above the isoelectric point of milk proteins. Microscope images and particle size distributions confirmed the presence of fat globule clusters in these samples, creating a network at 3% TA. Using sodium dodecyl sulfate (SDS) and ethylenediaminetetraacetic acid (EDTA) to disperse both fat and protein, average particle size and microscope images suggested that milk protein-TA interactions helped create the clusters. No evidence of partial coalescence was observed. These findings can help optimize the complex effect of polyphenols in the dairy matrix to create higher quality products.

Graphical Abstract
Symposium Review: 3rd International Geomechanics Symposium gathers experts from around the world
Authors: Badri Mohammed , Han Gang , AlBinhassan Nasher
Published: July 2023

The 3rd International Geomechanics Symposium (IGS2022) took place 7–10 November 2022 in Abu Dhabi. Focusing on the role of geomechanics in energy efficiency and sustainability, the technical program covered a range of technology applications including rock and in-situ stress characterization, natural fractures, faults, drilling, completion, stimulation, production, and reservoir engineering. It also showcased geomechanics applications in CO2 sequestration, hydrogen storage, and new energies.
Salivary Metabolomic Signatures and Body Mass Index in Italian Adolescents: A Pilot Study
Authors: India Aldana Sandra , Valvi Damaskini , Joshi Anu , Lucchini Roberto G , Placidi Donatella , Petrick Lauren , Horton Megan , Niedzwiecki Megan , Colicino Elena
Published: July 2023

Context

Obesity surveillance is scarce in adolescents, and little is known on whether salivary metabolomics data, emerging minimally invasive biomarkers, can characterize metabolic patterns associated with overweight or obesity in adolescents.

Objective

This pilot study aims to identify the salivary molecular signatures associated with body mass index (BMI) in Italian adolescents.

Methods

Saliva samples and BMI were collected in a subset of n = 74 young adolescents enrolled in the Public Health Impact of Metal Exposure study (2007-2014). A total of 217 untargeted metabolites were identified using liquid chromatography-high resolution mass spectrometry. Robust linear regression was used to cross-sectionally determine associations between metabolomic signatures and sex-specific BMI-for-age z-scores (z-BMI).

Results

Nearly 35% of the adolescents (median age: 12 years; 51% females) were either obese or overweight. A higher z-BMI was observed in males compared to females (P = .02). One nucleoside (deoxyadenosine) and 2 lipids (18:0-18:2 phosphatidylcholine and dipalmitoyl-phosphoethanolamine) were negatively related to z-BMI (P < .05), whereas 2 benzenoids (3-hydroxyanthranilic acid and a phthalate metabolite) were positively associated with z-BMI (P < .05). In males, several metabolites including deoxyadenosine, as well as deoxycarnitine, hyodeoxycholic acid, N-methylglutamic acid, bisphenol P, and trigonelline were downregulated, while 3 metabolites (3-hydroxyanthranilic acid, theobromine/theophylline/paraxanthine, and alanine) were upregulated in relation to z-BMI (P < .05). In females, deoxyadenosine and dipalmitoyl-phosphoethanolamine were negatively associated with z-BMI while deoxycarnitine and a phthalate metabolite were positively associated (P < .05). A single energy-related pathway was enriched in the identified associations in females (carnitine synthesis, P = .04).

Conclusion

Salivary metabolites involved in nucleotide, lipid, and energy metabolism were primarily altered in relation to BMI in adolescents.
Evaluation of conventional methods for species identification of Staphylococcus aureus using MALDI-TOF MS, protein identification and quantification
Authors:   Graduate Program in Medical Technology, Faculty of Allied Health Sciences, Thammasat University, Pathum Thani Province, Thailand, Arsheewa Weewan , Samosornsuk Seksun ,   Department of Medical Technology, Faculty of Allied Health Sciences, Thammasat University, Pathum Thani Province, Thailand, Khattiyawech Chollanant ,   Department of Medical Technology, Faculty of Allied Health Sciences, Thammasat University, Pathum Thani Province, Thailand, Jainhuknan Jaran ,   Bruker Switzerland AG (Bruker Daltonics GmbH & Co. KG), Bangkok, Thailand, Khumdee Pradchama ,   Department of Medical Technology, Faculty of Allied Health Sciences, Thammasat University, Pathum Thani Province, Thailand, Samosornsuk Worada ,   Department of Medical Technology, Faculty of Allied Health Sciences, Thammasat University, Pathum Thani Province, Thailand
Published: July 2023

Objectives: This study aimed to evaluate conventional methods for species identification of Staphylococcus aureus by MALDI-TOF MS. Additionally, the representatives of different species were used to analyze protein expression. Materials and methods: A total of 185 non-duplicated clinical S. aureus identified using the conventional method (colony morphology, Gram’s stain, slide coagulase test, tube coagulase test, catalase test, and mannitol fermentation) was confirmed the identification by MALDI-TOF MS and analyzed by Mass spectral profiling (MSP) and Principal component analysis (PCA). The representatives of different species reported by both methods were confirmed using 16SrRNA sequence and analyzed proteins expression by timsTOF MS. Results: All S. aureus suspected isolates could discriminate among species by MALDI-TOF MS including S. aureus (N=151, 81.6%), S. argenteus (N=32, 17.3%), S. hominis (N=1, 0.5%), and S. haemolyticus (N=1, 0.5%). Using 16S rRNA genebased analysis, S. aureus and S. argenteus could not differentiate from each other. Protein expression of S. aureus was similar to S. argenteus. These genes including rpsT, Huti, pyrF, atpD.1, cpfC, SAUA300_0786, atl.1, and MW2416 showed higher expression in S. aureus (MS076) than S. argenteus (MS060), S. haemolyticus (MS095) and S. hominis (MS060). Conclusion: MALDI-TOF MS provides an excellent tool for accurately species identification of staphylococci. S. aureus expressed protein analyzed higher than the other 3 species. The highest protein expression in S. aureus implies the most virulence of this strain.
The impact of the menstrual cycle on orthopaedic sports injuries in female athletes
Authors: Raj Rhody D. , Fontalis Andreas , Grandhi Tarani S. P. , Kim Woo J. , Gabr Ayman , Haddad Fares S.
Published: July 2023

There is a disparity in sport-related injuries between sexes, with females sustaining non-contact musculoskeletal injuries at a higher rate. Anterior cruciate ligament ruptures are between two and eight times more common than in males, and females also have a higher incidence of ankle sprains, patellofemoral pain, and bone stress injuries. The sequelae of such injuries can be devastating to an athlete, resulting in time out of sport, surgery, and the early onset of osteoarthritis. It is important to identify the causes of this disparity and introduce prevention programmes to reduce the incidence of these injuries. A natural difference reflects the effect of reproductive hormones in females, which have receptors in certain musculoskeletal tissues. Relaxin increases ligamentous laxity. Oestrogen decreases the synthesis of collagen and progesterone does the opposite. Insufficient diet and intensive training can lead to menstrual irregularities, which are common in female athletes and result in injury, whereas oral contraception may have a protective effect against certain injuries. It is important for coaches, physiotherapists, nutritionists, doctors, and athletes to be aware of these issues and to implement preventive measures. This annotation explores the relationship between the menstrual cycle and orthopaedic sports injuries in pre-menopausal females, and proposes recommendations to mitigate the risk of sustaining these injuries.

Cite this article: Bone Joint J 2023;105-B(7):723–728.
Is a radiological score able to predict resection-grade chondrosarcoma in primary intraosseous lesions of the long bones?
Authors: Gundavda Manit K. , Lazarides Alexander L. , Burke Zachary D. C. , Focaccia Marco , Griffin Anthony M. , Tsoi Kim M. , Ferguson Peter C. , Wunder Jay S.
Published: July 2023

Aims

The preoperative grading of chondrosarcomas of bone that accurately predicts surgical management is difficult for surgeons, radiologists, and pathologists. There are often discrepancies in grade between the initial biopsy and the final histology. Recent advances in the use of imaging methods have shown promise in the ability to predict the final grade. The most important clinical distinction is between grade 1 chondrosarcomas, which are amenable to curettage, and resection-grade chondrosarcomas (grade 2 and 3) which require en bloc resection. The aim of this study was to evaluate the use of a Radiological Aggressiveness Score (RAS) to predict the grade of primary chondrosarcomas in long bones and thus to guide management.

Methods

A total of 113 patients with a primary chondrosarcoma of a long bone presenting between January 2001 and December 2021 were identified on retrospective review of a single oncology centre’s prospectively collected database. The nine-parameter RAS included variables from radiographs and MRI scans. The best cut-off of parameters to predict the final grade of chondrosarcoma after resection was determined using a receiver operating characteristic curve (ROC), and this was correlated with the biopsy grade.

Results

A RAS of ≥ four parameters was 97.9% sensitive and 90.5% specific in predicting resection-grade chondrosarcoma based on a ROC cut-off derived using the Youden index. Cronbach’s α of 0.897 was derived as the interclass correlation for scoring the lesions by four blinded reviewers who were surgeons. Concordance between resection-grade lesions predicted from the RAS and ROC cut-off with the final grade after resection was 96.46%. Concordance between the biopsy grade and the final grade was 63.8%. However, when the patients were analyzed based on surgical management, the initial biopsy was able to differentiate low-grade from resection-grade chondrosarcomas in 82.9% of biopsies.

Conclusion

These findings suggest that the RAS is an accurate method for guiding the surgical management of patients with these tumours, particularly when the initial biopsy results are discordant with the clinical presentation.

Cite this article: Bone Joint J 2023;105-B(7):808–814.
Five-year outcomes for patients with a displaced fracture of the distal tibia
Authors: Parsons Nick , Achten Juul , Costa Matt L.
Published: July 2023

Aims

To report the outcomes of patients with a fracture of the distal tibia who were treated with intramedullary nail versus locking plate in the five years after participating in the Fixation of Distal Tibia fracture (FixDT) trial.

Methods

The FixDT trial reported the results for 321 patients randomized to nail or locking plate fixation in the first 12 months after their injury. In this follow-up study, we report the results of 170 of the original participants who agreed to be followed up until five years. Participants reported their Disability Rating Index (DRI) and health-related quality of life (EuroQol five-dimension three-level questionnaire) annually by self-reported questionnaire. Further surgical interventions related to the fracture were also recorded.

Results

There was no evidence of a difference in patient-reported disability, health-related quality of life, or the need for further surgery between participants treated with either type of fixation at five years. Considering the combined results for all participants, there was no significant change in DRI scores after the first 12 months of follow-up (difference between 12 and 24 months, 3.3 (95% confidence interval -1.8 to 8.5); p = 0.203), with patients reporting around 20% disability at five years.

Conclusion

This study shows that the moderate levels of disability and reduced quality of life reported by participants 12 months after a fracture of the distal tibia persist in the medium term, with little evidence of improvement after the first year.

Cite this article: Bone Joint J 2023;105-B(7):795–800.
Clinical results of periacetabular osteotomy with structural bone allograft for the treatment of severe hip dysplasia
Authors: Fujii Masanori , Kawano Shunsuke , Ueno Masaya , Sonohata Motoki , Kitajima Masaru , Tanaka Shiori , Mawatari Daisuke , Mawatari Masaaki
Published: July 2023

Aims

To clarify the mid-term results of transposition osteotomy of the acetabulum (TOA), a type of spherical periacetabular osteotomy, combined with structural allograft bone grafting for severe hip dysplasia.

Methods

We reviewed patients with severe hip dysplasia, defined as Severin IVb or V (lateral centre-edge angle (LCEA) < 0°), who underwent TOA with a structural bone allograft between 1998 and 2019. A medical chart review was conducted to extract demographic data, complications related to the osteotomy, and modified Harris Hip Score (mHHS). Radiological parameters of hip dysplasia were measured on pre- and postoperative radiographs. The cumulative probability of TOA failure (progression to Tönnis grade 3 or conversion to total hip arthroplasty) was estimated using the Kaplan–Meier product-limited method, and a multivariate Cox proportional hazard model was used to identify predictors for failure.

Results

A total of 64 patients (76 hips) were included in this study. The median follow-up period was ten years (interquartile range (IQR) five to 14). The median mHHS improved from 67 (IQR 56 to 80) preoperatively to 96 (IQR 85 to 97) at the latest follow-up (p < 0.001). The radiological parameters improved postoperatively (p < 0.001), with the resulting parameters falling within the normal range in 42% to 95% of hips. The survival rate was 95% at ten years and 80% at 15 years. Preoperative Tönnis grade 2 was an independent risk factor for TOA failure.

Conclusion

Our findings suggest that TOA with structural bone allografting is a viable surgical option for correcting severely dysplastic acetabulum in adolescents and young adults without advanced osteoarthritis, with favourable mid-term outcomes.

Cite this article: Bone Joint J 2023;105-B(7):743–750.
CT methods for measuring glenoid bone loss are inaccurate, and not reproducible or interchangeable
Authors: Tennent Duncan , Antonios Tony , Arnander Magnus , Ejindu Vivian , Papadakos Nik , Rastogi Anshul , Pearse Yemi
Published: July 2023

Aims

Glenoid bone loss is a significant problem in the management of shoulder instability. The threshold at which the bone loss is considered “critical” requiring bony reconstruction has steadily dropped and is now approximately 15%. This necessitates accurate measurement in order that the correct operation is performed. CT scanning is the most commonly used modality and there are a number of techniques described to measure the bone loss however few have been validated. The aim of this study was to assess the accuracy of the most commonly used techniques for measuring glenoid bone loss on CT.

Methods

Anatomically accurate models with known glenoid diameter and degree of bone loss were used to determine the mathematical and statistical accuracy of six of the most commonly described techniques (relative diameter, linear ipsilateral circle of best fit (COBF), linear contralateral COBF, Pico, Sugaya, and circle line methods). The models were prepared at 13.8%, 17.6%, and 22.9% bone loss. Sequential CT scans were taken and randomized. Blinded reviewers made repeated measurements using the different techniques with a threshold for theoretical bone grafting set at 15%.

Results

At 13.8%, only the Pico technique measured under the threshold. At 17.6% and 22.9% bone loss all techniques measured above the threshold. The Pico technique was 97.1% accurate, but had a high false-negative rate and poor sensitivity underestimating the need for grafting. The Sugaya technique had 100% specificity but 25% of the measurements were incorrectly above the threshold. A contralateral COBF underestimates the area by 16% and the diameter by 5 to 7%.

Conclusion

No one method stands out as being truly accurate and clinicians need to be aware of the limitations of their chosen technique. They are not interchangeable, and caution must be used when reading the literature as comparisons are not reliable.

Cite this article: Bone Jt Open 2023;4(7):478–489.