bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of suprahyoid muscle strengthening exercise using kinesiology taping on muscle activation and thickness in community-dwelling elderly: A randomized controlled trial
Authors: Cho Young-Seok , Yoon Tae-Hyung , Park Ji-Su
Published: September 2023

Background:

Recently, swallowing resistive exercise using kinesiology taping (KT) has been reported as a novel method for dysphagia rehabilitation However, clinical evidence is still unclear, and effects in the elderly have not been confirmed.

Objective:

This study aimed to investigate the effects of suprahyoid muscle strengthening exercise using KT on muscle activation and thickness in community-dwelling elderly.

Methods:

A total of 24 healthy older people were enrolled in this study and randomly assigned to an experimental group and a placebo group. In the experimental group, KT was attached to the front of the neck with a tension of about 70% to 80%, and a resistive swallowing exercise was performed. In the placebo group, the tape was applied similarly but without tension. Both groups performed resistive swallowing exercises 10 times a day (50 swallows per day) for 6 weeks. The activation and thickness of the suprahyoid muscles were measured using portable ultrasound equipment and an surface electromyelograph device.

Results:

The experimental group showed a significant increase in suprahyoid muscle activation (mean and peak) and muscle thickness (digastric and mylohyoid) than the placebo group (all, P < .05).

Conclusion:

This study confirmed that suprahyoid muscle strengthening exercise using KT had a positive effect on the suprahyoid muscles in healthy older adults, thus suggesting the possibility of a therapeutic exercise method for dysphagia rehabilitation.
Loneliness and depression among community-dwelling older adults in China during the COVID-19 epidemic: The mediating role of social support
Authors: Li Pan , Zhong Jiaming , He Yongmei , Yan Hairong , Xie Mi , Meng Lingyao
Published: September 2023

The psychological condition of community-dwelling older adults is a global concern under coronavirus disease 2019. Loneliness is the key risk factor for depression among community-dwelling older adults. This study aims to explore the role of social support as a mediating factor in the relationship between depression and loneliness among community-dwelling older adults. We conducted a cross-sectional study in Chenzhou, Hunan Province, China, from June to December 2021. The sample consisted of 570 community-dwelling adults aged over 60 years. Data were collected through a general information questionnaire, the Social Support Rating Scale, the University of California at Los Angeles Loneliness Scale, and the Center for Epidemiological Survey, Depression Scale. Statistical Package for the Social Sciences PROCESS macro was used to examine the mediating effect of social support between loneliness and depression. This study found that depression was negatively associated with social support (r = −0.381, P < .001), but it was positively correlated with loneliness (r = 0.403, P < .001); loneliness was a predictor of depression (B = 0.333, P < .001). In addition, social support significantly mediated the relationship between loneliness and depression, with an indirect effect of 0.239 (95% Bootstrap CI −0.264 to −0.510), the overall effect value for depression was 0.572, accounting for 56.3% of the total variance in depression within this model. In conclusion, the findings suggest that social support plays a mediating role between depression and loneliness in older adults. This implies that interventions aimed at reducing loneliness and enhancing social support have the potential to alleviate depressive symptoms among this population. By addressing these factors, healthcare professionals and caregivers can promote the mental well-being of older adults and contribute to improved overall quality of life.
Optimal cutoff point of vertebral body cross-sectional area as a morphological parameter for predicting lumbar spondylolysis
Authors: Park SoYoon , Song Yumin , Oh Seonmin , Kim Young Uk
Published: September 2023

The relationship between vertebral body cross-sectional area (VBCSA) and spinal conditions associated with increased lumbar lordosis, such as lumbar spondylolysis (LSL), is not known. We investigated the morphological parameter, VBCSA, to predict LSL. The VBCSA on MRI has not been studied for its association with LSL. We hypothesized that VBCSA is an important morphological parameter for LSL prediction. We collected VBCSA data from 90 patients (43 males and 47 females) with LSL and 91 control subjects (44 males and 47 females) who underwent lumbar spine magnetic resonance imaging (LS-MRI). Axial T2-weighted LS-MRI images were obtained from all participants. Using our picture archiving and communications system, we analyzed the VBCSA at the level of the L5 vertebral body by utilizing MRI. The average VBCSA was 2263.51 ± 306.02 mm2 in the male control group and 1820.92 ± 224.89 mm2 in the male LSL group. LSL patients had significantly lower VBCSAs (P < .001) than did the male controls. The average VBCSA was 1985.21 ± 258.05 mm2 in the female control group and 1553.73 ± 250.02 mm2 in the female LSL group, and the LSL patients also had significantly lower VBCSAs (P < .001) than did the female controls. The optimal VBCSA cutoff value in the male group was 2014.69 mm2 with 76.7% sensitivity, 75.0% specificity, and an area under the receiver operating curve (AUC) of 0.89 (95% CI: 0.82–0.95). In the female group, the optimal cutoff score was 1814.11 mm2 with 76.6% sensitivity, 76.6% specificity, and an AUC of 0.88 (95% CI: 0.82–0.95). VBCSA is a sensitive objective morphological parameter for assessing LSL, and a lower VBCSA is associated with a higher possibility of LSL. We believe that these results will be useful in diagnostic radiology for evaluating patients with LSL.
Effectiveness of unilateral percutaneous vertebroplasty for acute traumatic non-osteoporotic compression vertebral fractures
Authors: Hammed Ali , Mahfoud Moufid , Mohamad Okbah
Published: September 2023

Although vertebroplasty is a well-known treatment for osteoporotic and neoplastic compression fractures, there is limited evidence to support its use in traumatic compression fractures without osteoporotic degeneration. The purpose of this study was to evaluate the correlation of kyphosis and wedge angles with pain relief and functional outcome after percutaneous vertebroplasty. 38 patients who harbored acute traumatic non-osteoporotic compression vertebral fractures without neurological complications refractory to at least 5 days of conservative treatment were included in this study. Follow-up evaluations included pain (assessed with the visual analog scale) and medication use. Functional outcome was measured using Oswestry low back pain disability questionnaire. Cobb angles, Gardner angles and kyphotic angles were measured on the full-spine radiographs preoperatively and postoperatively. The axial pain visual analog scale score (8.05 ± 1.23 pre-op vs 1.18 ± 1.09 post-op, P < .05) and The Oswestry low back pain disability questionnaire score (33.45 ± 6.97 pre-op vs 4.47 ± 2.41 post-op, P < .05). The Cobb’s angle (19.66° ± 8.68° pre-op vs 15.08° ± 7.51° post-op, P < .05), the Gardner’s angle (17.72° ± 6.52° pre-op vs 14.13° ± 7.13° post-op, P < .05) and the kyphotic angle (17.51° ± 5.8° pre-op vs 8.81° ± 4.14°post-op, P < .05) were significantly reduced postoperatively therefore, local kyphosis was markedly restored after vertebroplasty. Our findings show that vertebroplasty for patients with traumatic spinal compression fractures reduces pain, improves mobility, reduces the need for painkillers, and significantly affects kyphotic angles.
An analysis of the usefulness for using skin adhesive without closed-suction drainage in primary total hip arthroplasty: A retrospective propensity score matched study
Authors: Lee Chan Young , Jin Sheng-Yu , Jeong Hwiwoo , Yoon Taek-Rim , Park Kyung-Soon
Published: September 2023

The closed suction surgical drainage system (CSSD) is routinely used after total hip arthroplasty (THA) by orthopedic surgeons in many institutions. However, it has not been shown to decrease the rate of wound infection significantly and may even increase blood loss. This study aimed to evaluate the usefulness of using skin adhesive without CSSD in uncomplicated THA. From July 2015 to September 2017, 200 patients undergoing unilateral THA were enrolled and divided into 2 groups, either receive CSSD (134 patients) or not receive CSSD (66 patients). Then, the propensity matched was performed. Calculated total blood loss, changes in hemoglobin (Hgb) level, transfusions were evaluated. In addition, data on the length of hospital stay, operation time, closure time, time to using crutches following THA were collected. Finally, Harris hip score (HHS), total estimated cost, and complications were assessed. The non-CSSD group had comparatively less blood loss (508.5 ± 280.3 mL compared with 742.1 ± 330.3 mL, P < .001), fewer transfusions (0.03 units compared with 0.3 units, P = .02), less transfusion rate (1.9% compared with 17.3 %, P = .02), lower change of Hgb from immediate postoperative period to 3 days later(1.6 ± 1.0 g/dL compared with 2.0 ± 0.8 g/dL, P = .03), than the CSSD group. There was a longer duration of hospital stay in the CSSD groups (7.2 days compared with 7.8 days, P = .03) The mean total cost in the non-CSSD group was $162.1, which was less than that of the CSSD group, which spent $288.5 on average (P < .001). there was 1 allergic reaction in the non-CSSD group (P = .32). The use of skin adhesive without CSSD could help decrease blood loss, the need for transfusion, and the length of hospital stay, and seems to more cost-effectiveness than using CSSD. It may also provide superior results and allow the patient to recover faster. Using this type of skin adhesive without CSSD is an efficient wound closure method for patients undergoing uncomplicated THA. However, care must be taken for allergic reactions, especially for patients with known or suspected allergies to cyanoacrylate or formaldehyde.
Neonatal seizures: Etiologies, clinical characteristics, and radiological features: A cross-sectional study
Authors: Almuqbil Mohammed , Alrumayyan Yousof , Alattas Shahad , Baarmah Duaa , AlTuwaijri Waleed , AlRumayyan Ahmed , AlRifai Mohammed Tala , Al Madhi Asma , Al-shehri Hassan , Alsaif Saif
Published: September 2023

Seizures are a common clinical indication of central nervous system damage or abnormality in neonates. We aimed to identify the etiologies, clinical characteristics, and radiological features of neonatal seizures. This is a cross-sectional, retrospective, descriptive study using data obtained from the neonatal intensive care unit in King Abdulaziz Medical City (KAMC), a governmental, academic tertiary hospital in Riyadh, Saudi Arabia. The population of interest were neonates diagnosed with a neonatal seizure at KAMC between April 2015 and March 2019. A total of 61 patients with neonatal seizures were included in the study. The most common etiology was hypoxic-ischemic encephalopathy (43%). A total of 32 patients were full-term (52.5%). Around one-fifth of the study sample (21.3%) had a family history of neonatal seizures. Around 43.0% of the patients had epilepsy episodes. More than half of the patients (57.0%) were on one anti-seizure medication. Patients were followed up after 1 year, they had multiple comorbidities, including developmental delay, epilepsy, and cerebral palsy. Developmental delay was identified in 62.3% of the patients. A total of 19 patients have passed away (31%). Neonatal seizures are a common manifestation of neurologic disorders in neonates and are associated with high morbidity and mortality. Therefore, early identification of seizure etiology and proper management may help to improve the outcome.
The comparison of the watertight and non-watertight dural closure in supratentorial craniotomy: A single-institute 10-year experience with 698 patients
Authors: Wang Jianbo , Li Peiliang , Liang Bo , Ding Xinghuan , Gao Haili , Feng Enshan
Published: September 2023

Watertight dural closure (WTDC) is considered crucial by many neurosurgeons in cranial base surgery, infratentorial craniotomy, and spinal intradural procedure. Whether WTDC also reduce complications remains controversial in supratentorial craniotomy. The objective of this study is to investigate the relationship between WTDC and CSF-related complications in supratentorial craniotomy for the resection of space-occupying lesions. A retrospective analysis of patients who suffered from intracranial space-occupying lesions at Beijing Ditan Hospital between January 2011 and December 2021 was conducted. A total of 698 cases were reviewed with attention to the operative approach, subgaleal fluid collection, wound healing impairment, postoperative infection, and post-craniotomy headaches. The study included a total of 423 patients with WTDC and 275 patients without WTDC. Patients without WTDC had a significantly higher rate of infection (10.9% vs 4.5% with WTDC, P = .001). The rate of subgaleal fluid collection was 9.7% in the WTDC group and 11.3% in the non-WTDC group, but this difference was not statistically significant (P = .502). They suffered from a greater incidence of post-craniotomy headaches in the WTDC group (13.5% vs 9.5% in the non-WTDC group), but without statistical significance (P = .109). We also found no difference in wound healing impairment (P = .719). There is less postoperative infection associated with WTDC during intracranial space-occupying lesion removal than without WTDC in supratentorial craniotomy.
Percutaneous transhepatic biliary drainage (PTBD) in patients with biliary leakage: Technical and clinical outcomes
Authors: Deniz Sinan , Öcal Osman , Wildgruber Moritz , Ümütlü Muzaffer , Puhr-Westerheide Daniel , Fabritius Matthias , Mansour Nabeel , Schulz Christian , Koliogiannis Dionysios , Guba Markus , Ricke Jens , Seidensticker Max
Published: September 2023

The purpose of this study is to evaluate the technical and clinical outcome of percutaneous transhepatic biliary drainage (PTBD) in patients with biliary leakage. All patients who underwent ultrasound-assisted PTBD between January 2017 and December 2021 due to biliary leakage with nondilated biliary systems were retrospectively evaluated for periprocedural characteristics, medical indications, technical success (successful placement of drainage catheter), clinical success (resolved leak without additional procedures), fluoroscopy time, procedure duration, and clinical outcomes. 74 patients with a mean age of 64.1 ± 15.1 years were identified. Surgery was the most common etiology of biliary leak with 93.2% of the cases. PTBD had a 91.8% (68/74) technical success rate and an 80.8% clinical success rate. The mean procedure and fluoroscopy duration were 43.5 and 18.6 minutes. Age > 65 years (P = .027) and left-sided drainage (P = .034) were significant risk factors of clinical failure. Procedure-related major complications were 2 bleedings from the liver and 1 bleeding from an intercostal artery (major complication rate 4%). PTBD is a feasible, safe, and effective treatment option in patients with biliary leakage with low complication rates.
Reproductive health factors in relation to risk of hypertension in postmenopausal women: Results from NHANES 2011–2014
Authors: He Zehao , Wen Xiaoxiao , Zhou Long
Published: September 2023

Few studies have systematically assessed the relationship between multiple reproductive factors and hypertension, and these limited studies paid more attention to age at menarche and menopause, abortion, or the number of live births, and yielded controversial results. This study aimed to explore the relationship between reproductive health factors and hypertension from 5 aspects: history of menstruation, pregnancy, delivery, gynecological surgery, and reproductive-related medication use. We analyzed data from the National Health and Nutrition Examination Survey 2011 to 2014. Data on reproductive factors were collected using a questionnaire survey. The associations between multiple reproductive factors and the risk of hypertension were assessed using multivariable logistic regression models. There were significant inverse associations between age at menopause (odds ratio [OR] = 0.984, 95% confidence interval [CI]: 0.971–0.998, P = .0234 per 1-year increase), age at first live birth (OR = 0.970, 95% CI: 0.944–0.998, P = .0346 per 1-year increase), age at last live birth (OR = 0.982, 95% CI: 0.964–0.999, P = .0488 per 1-year increase), and the risk of hypertension. In contrast, a positive association was found between the risk of hypertension and a history of gestational diabetes (OR = 1.693, 95% CI: 1.042–2.751, P = .0333), hysterectomy (OR = 1.398, 95% CI: 1.139–1.717, P = .0014), ovariectomy (OR = 1.374, 95% CI: 1.074–1.758, P = .0115), and birth control pill use (OR = 1.293, 95% CI: 1.035–1.616, P = .0236). Age at menopause but not menarche, is inversely associated with hypertension. A history of gestational diabetes, hysterectomy, ovariectomy, or birth control pills was associated with a higher risk of hypertension.
Clinical analysis of 908 patients with aortic dissection under different Stanford types: A cross-sectional study
Authors: Zhang Jinhua , Gao Sikang
Published: September 2023

This study aims to investigate the difference of clinical characteristics and risk factors in aortic dissection (AD) of patients with 2 Stanford subtypes. A retrospective analysis was conducted on 908 patients admitted to Tongji Hospital from July 2019 to January 2021, and the aortic computed tomography angiography was used to clearly diagnose the artery dissection. Patient basic information as well as blood test indicators containing leukocytes, neutrophils, lymphocytes, hemoglobin, myoglobin, hypersensitive cardiac troponin, γ-glutamyl transferase, total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein, ultrasensitive C-reactive protein, glucose were recorded and analyzed. There was no significant difference in gender, heart rate, smoking history, hypertension history and diabetes history between the 2 groups (P > .05), however, compared with type A patients, type B patients were older, and had a significantly higher frequency of alcohol consumption (P < .05); On laboratory tests, type A patients had significantly higher mean leukocytes and neutrophils (P < .05), and significantly lower frequency of reduced hemoglobin than type B patients (P < .05), although there was no statistical difference in lymphocyte, γ-glutamyl transferase, total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein and glucose counts between the 2 groups. Additionally, type A patients had a significantly higher number of abnormal myoglobin, hypersensitive cardiac troponin and ultrasensitive C-reactive protein test results than type B patients (P < .05). The receiver operating characteristic curve analysis showed that the area under the curve for each parameter was 0.605 (0.538–0.673) for hemoglobin, 0.610 (0.543–0.677) for leukocytes and 0.627 (0.561–0.693) for neutrophils. Understanding the relevant clinical indicators and risk factors of patients with different types of AD can provide a new perspective to assist the classification and diagnosis of AD and a basis for effective and rational treatment.
Gas embolism during surgical hysteroscopy leading to cardiac arrest and refractory hypokalemia: A case report and review of literature
Authors: Xu Rong , Zhou Xuefei , Wang Longfei , Cao Yunfei
Published: September 2023

Rationale:

One of the catastrophic complications of surgical hysteroscopy is venous gas embolism (VGE), and this event could cause morbidity and in serious cases may even lead to death. However, in cases of VGE accompanied by refractory hypokalemia is rare and can significantly increase the difficulty of treatment and resuscitation. Here, we successfully treated a patient with fatal VGE during surgical hysteroscopy, accompanied by difficult resuscitation with refractory hypokalemia.

Patient concerns:

We report a rare case of sudden cardiac arrest due to VGE during surgical hysteroscopy, followed by difficult resuscitation with refractory hypokalemia.

Diagnosis:

VGE was diagnosed by a sudden decrease in EtCO2, a loud mill wheel murmur in the thoracic area, and a small number of air bubbles evacuated from the internal jugular catheter. And refractory hypokalemia was diagnosed by serum potassium levels dropping frequently to as low as 2.0 mmol/L within 36 hours of resuscitation after cardiac arrest.

Interventions:

Our vigilant anesthesiologist noticed the early sign of VGE with a sudden drop in EtCO2, and as the cardiac arrest occurred, interventional maneuvers were implemented quickly including termination of the surgical procedure, adjustment of the patient’s position, cardiac resuscitation, continuous chest compression, and correction of electrolyte disturbances, particularly refractory hypokalemia during the early stage of resuscitation.

Outcomes:

The patient regained consciousness 4 days after the cardiac arrest and was discharged 1 month later without any neurological deficits.

Lessons:

As a relatively simple procedure, surgical hysteroscopy may have catastrophic complications. This case demonstrates the full course of fatal gas embolism and difficult resuscitation during hysteroscopic surgery, and emphasizes the importance of early detection, prompt intervention, and timely correction of electrolyte disturbances, such as refractory hypokalemia.
Bone resorption of vertebral bodies at the operative segment after prevail cervical interbody fusion: A case report
Authors: Shen Shufeng , Hu Yong , Chu Zhentao , Dong Weixin
Published: September 2023

Background:

We report an interesting case of bone resorption of vertebral bodies at the operative segment after Peek Prevail cervical interbody fusion. Instability of cervical vertebrae is likely to occur due to increased stress in Peek Prevail implant body for bone resorption. The finite element analysis was used to clarify the biomechanical effects of bone resorption and stress distribution in Peek Prevail implant body.

Methods:

We reported the case of a 48-year-old male patient who underwent Peek Prevail cervical interbody fusion and exhibited bone resorption 1 month after the surgery in X-ray of cervical vertebra. The degree of bone resorption was aggravated 2 months after surgery. Bone resorption in 3 months was similar to that in 2 months. We established a 3D reconstruction of the surgical segment in this case using Mimics software (vision 20.0) to generate basic boss resorption model. We simulated models of bone resorption using Ansys 17.0. The stress distribution of the contact surface between the screw and bone was analyzed under 6 conditions: flexion, extension, left and right flexion, and left and right rotation.

Results:

The loading conditions affected the stress distribution in the implant body. When bone resorption occurred, the stress distribution of the contact surface between screw and bone focus in the tip of the screw increased sharply.

Conclusion:

Bone resorption of vertebral bodies in the operative segment may be a potential complication after Peek Prevail cervical interbody fusion. Great attention must be paid when bone resorption was occurred in order to avoid screw loosening before vertebral fusion.
Risk factors for distant metastasis of chondrosarcoma: A population-based study
Authors: Deng Guang-Hua , Wang Hong , Tan Zhe , Chen Rong
Published: September 2023

Chondrosarcoma is the second largest bone malignancy after osteosarcoma and mainly affects middle-aged adults, where patients with distant metastasis (DM) often have a poor prognosis. Although nomograms have been widely used to predict distant tumor metastases, there is a lack of large-scale data studies for the diagnostic evaluation of DM in chondrosarcoma. Data on patients diagnosed with chondrosarcoma from 2004 to 2015 were obtained from the Surveillance, Epidemiology, and End Results database. Independent risk factors for having DM from chondrosarcoma were screened using univariate and multivariate logistics regression analysis. A nomogram was created to predict the probability of DM from the screened independent risk factors. The nomogram was then validated using receiver operating characteristic curves and calibration curves. A total of 1870 chondrosarcoma patients were included in the study after data screening, of which 157 patients (8.40%) had DM at the time of diagnosis. Univariate and multivariate logistic regression analysis screened four independent risk factors, including grade, tumor number, T stage, and N stage. receiver operating characteristic curves and calibration curves showed good accuracy of the nomogram in both training and validation sets. The current study screened for independent risk factors for DM from chondrosarcoma, which will help clinicians evaluate patients.
Partial isolated tear of the popliteus tendon following an in-car traffic accident: A rare cause of knee pain: A CARE-compliant case report
Authors: Choi Gyu-Sik , Chang Min Cheol
Published: September 2023

Rationale:

Lesions caused by traffic accidents are often microscopic and minimal; therefore, their diagnosis can be easily overlooked. Moreover, when it is a rarely reported type of lesion, it can be even more easily undiagnosed. Isolated popliteal injuries are uncommon and have rarely been reported.

Patient concerns:

In this case study, we describe a right partially isolated popliteus tendon rupture that was undiagnosed for 2 years in a patient with posterior knee pain after an in-car traffic accident. A 49-year-old female patient presented with right knee pain that had persisted for 2 years and was initiated after an in-car traffic accident. The patient’s right knee pain aggravated while standing and walking. Six months after the accident, her pain was confined to the posterolateral aspect of the knee and subsequently spread throughout her right knee. The pain score was 4 on a numerical rating scale. Physical examination revealed tenderness in the posterolateral corner of the right knee. Additionally, right knee pain was reported in the terminal range of knee flexion during the passive range of motion test. Radiographs of the right knee showed normal findings.

Diagnoses:

A T2-weighted proton density sagittal and coronal knee magnetic resonance imaging revealed a partial-thickness tear with intrasubstance ganglion cysts at the musculotendinous junction of the popliteus tendon. No other abnormalities were observed in the patient.

Intervention:

Conservative treatment involved strengthening exercises and functional rehabilitation programs.

Outcomes:

Six months later, the knee pain almost completely subsided.

Lessons:

Musculoskeletal injuries caused by traffic accidents are frequently overlooked. Therefore, a detailed examination should be conducted for an accurate diagnosis. Clinicians should consider the possibility of popliteal tendon injuries in patients with posterior knee pain.
Smith c/b ratio and teardrop figure measurements; Can it be used in the follow-up of patients who underwent salter innominate osteotomy?
Authors: Dere Kadir Ismail , Topak Duran , Bilal Ökkeş , Doğar Fatih , Özdemir Mustafa Abdullah , Kuşcu Burak
Published: September 2023

Background:

This study aimed to investigate the effectiveness of radiological parameters used in the follow-up of patients who underwent salter innominate osteotomy (SIO) for the treatment of developmental dysplasia of the hip.

Methods:

Acetabular index, c/b ratio, teardrop width, femoral head teardrop distance (TDD), and acetabular teardrop angle were measured on anteroposterior pelvic radiographs of patients who underwent SIO between 2017 and 2020. The patients were divided into 2 groups according to their preoperative Tönnis stage. Twenty-five (51%) hips of 23 patients with Tönnis stage 2 were classified into group 1, and 24 (49%) of 17 patients with Tönnis stages 3 and 4 were classified into group 2. Changes in radiologic parameters over time and between the groups were statistically evaluated.

Results:

The study included 49 hips of 40 patients (37 female and 3 male). The age at surgery was 26.53 (18–53) months. After a mean follow-up period of 33.7 ± 12.8 months, there was no statistically significant difference between Groups 1 and 2 in terms of clinical, radiological and femoral head avascular necrosis results (P = .591, P = 956, P = .492). The changes in radiological parameters over time and between groups were statistically significant. (P < .001). Only the TDD and c/b ratio were significantly different between groups 1 and 2 (P = .002 and P < .001, respectively).

Conclusion:

In our study, along with acetabular index, the c/b ratio, teardrop width, TDD, and acetabular teardrop angle significantly changed after SIO and could be used as a guide for patient follow-up.
The potential use and experimental validation of genomic instability-related lncRNA in pancreatic carcinoma
Authors: Xia Xiuli , Zhao Shushan , Song Xiaoming , Zhang Mengyue , Zhu Xinying , Li Changjuan , Chen Wenting , Zhao Dongqiang
Published: September 2023

This study explored the potential role of long noncoding RNA (lncRNAs) associated with genomic instability in the diagnosis and treatment of pancreatic adenocarcinoma (PAAD). Transcriptome and single-nucleotide variation data of PAAD samples were downloaded from the cancer genome atlas database to explore genomic instability-associated lncRNAs. We constructed a genomic instability-associated lncRNA prognostic signature. Then gene ontology and Kyoto encyclopedia of genes and genomes enrichment analyses were used to explore the physiological role of lncRNAs involved in genomic instability. Tumor microenvironments, immunotherapy response, immune cell infiltration, immune checkpoint, and drug sensitivity were compared between high-risk and low-risk groups. In vitro experiments were performed for external validation. Six lncRNAs associated with genomic instability were identified, capable of predicting the prognosis of PAAD. Patients were assigned to low-risk or high-risk groups using these biomarkers, with better or worse prognosis, respectively. The tumor immune score, immune cell infiltration, and efficacy of immunotherapy were worse in the high-risk group. A drug sensitivity analysis revealed the high- and low-risk groups had different half-maximal inhibitory concentrations. The expression of cancer susceptibility candidate 8 was significantly higher in tumor tissues than in normal tissues, while the expression of LYPLAL1-AS1 exhibited an opposite pattern. They may be potential diagnostic or prognostic biomarkers for patients with pancreatic cancer. Genomic instability-associated lncRNAs were explored in this study and predicted the prognosis of PAAD and stratified patients risk in PAAD. These lncRNAs also predicted the efficacy of immunotherapy and potential therapeutic targets in PAAD.
Social Determinants modulate NK cell activity via obesity, LDL, and DUSP1 signaling
Authors: Baumer Yvonne , Singh Komudi , Baez Andrew S. , Gutierrez-Huerta Christian A. , Chen Long , Igboko Muna , Turner Briana S. , Yeboah Josette A. , Reger Robert N. , Ortiz-Whittingham Lola R. , Bleck Christopher K.E. , Mitchell Valerie M. , Collins Billy S. , Pirooznia Mehdi , Dagur Pradeep K. , Allan David S.J. , Muallem-Schwartz Daniella , Childs Richard W. , Powell-Wiley Tiffany M.
Published: September 2023

Adverse social determinants of health (aSDoH) are associated with obesity and related comorbidities like diabetes, cardiovascular disease, and cancer. Obesity is also associated with natural killer cell (NK) dysregulation, suggesting a potential mechanistic link. Therefore, we measured NK phenotypes and function in a cohort of African-American (AA) women from resource-limited neighborhoods. Obesity was associated with reduced NK cytotoxicity and a shift towards a regulatory phenotype.In vitro, LDL promoted NK dysfunction, implicating hyperlipidemia as a mediator of obesity-related immune dysregulation. Dual specific phosphatase 1 (DUSP1) was induced by LDL and was upregulated in NK cells from subjects with obesity, implicating DUSP1 in obesity-mediated NK dysfunction.In vitro, DUSP1 repressed LAMP1/CD107a, depleting NK cells of functional lysosomes to prevent degranulation and cytokine secretion. Together, these data provide novel mechanistic links between aSDoH, obesity, and immune dysregulation that could be leveraged to improve outcomes in marginalized populations.
Synergistic effects of combing proton- or X-irradiation with anti-PDL1 immunotherapy in two murine oral cancers
Authors: Rykkelid Anne Marit , Sinha Priyanshu Manojkumar , Folefac Charlemagne Asonganyi , Horsman Michael Robert , Sørensen Brita Singers , Søland Tine Merete , Franciscus Schreurs Olaf Joseph , Malinen Eirik , Edin Nina Frederike J
Published: September 2023

Background and purpose

Combining radiation therapy with immunotherapy may be beneficial in treatment of head and neck cancer (HNC), but the combined effect may depend on tumor characteristics and the type of radiation. The purpose was to compare responses for two syngeneic tumor models in mice following X-ray or proton irradiation with or without immune checkpoint inhibition (ICI).

Materials and methods

MOC1 and MOC2 tumors were inoculated in the right hind leg of each mouse (C57BL/6J, n=159). Single-dose irradiation with X-rays or protons and administration of anti-PDL1 started when the tumors reached 200 mm3. Doses of 5-30 Gy were given. Time-dependent tumor volume data were analyzed with a regression model yielding the growth rate γ without irradiation and the reduction in growth rate per dose η. Relative biological effectiveness (RBE) was calculated as the ratio of η for X-rays to that of protons. Synergy between radiation and ICI was estimated as the ratio of η’s.

Results

MOC2 tumors grew faster and were more radioresistant than MOC1 tumors. ICI reduced the growth rate for MOC1 with 20±2% compared to controls, while no reduction was seen for MOC2. RBE for MOC1 wo/w ICI was 0.89±0.04 and 0.93±0.06, respectively, while it was 1.15±0.12 and 1.60±0.17, respectively, for MOC2. Combination synergy for X-rays was 1.22±0.08 and 0.96±0.11 in MOC1 and MOC2, respectively, while was it 1.27±0.06 and 1.33 ±0.13, respectively, for protons.

Conclusions

RBE for protons was dependent on use of ICI and tumor type. A greater synergy may be achieved when combining protons with ICI compared to X-rays and ICI.
Exploring the metabolic profiling ofA. baumanniifor antimicrobial development using genome-scale modelling
Authors: Leonidou Nantia , Xia Yufan , Friedrich Lea , Schütz Monika S. , Dräger Andreas
Published: September 2023

With the emergence of multidrug-resistant bacteria, the World Health Organization published a catalog of microorganisms urgently needing new antibiotics, with the carbapenem-resistantAcinetobacter baumanniidesignated as “critical”. Such isolates, frequently detected in healthcare settings, pose a global pandemic threat. One way to facilitate a systemic view of bacterial metabolism and allow the development of new therapeutics is to apply constraint-based modelling. Here, we developed a versatile workflow to build high-quality and simulation-ready genome-scale metabolic models. We applied our workflow to create a novel metabolic model forA. baumanniiand validated its predictive capabilities using experimental nutrient utilization and gene essentiality data. Our analysis showed that our modeliACB23LX could recapitulate cellular metabolic phenotypes observed duringin vitroexperiments, while positive biomass production rates were observed and experimentally validated in various growth media. We further defined a minimal set of compounds that increaseA. baumannii‘s cellular biomass and identified putative essential genes with no human counterparts, offering novel candidates for future antimicrobial development. Finally, we assembled and curated the first collection of reconstructions for distinctA. baumanniistrains and analysed their growth characteristics. The presented models are in a standardised and well-curated format, enhancing their usability for multi-strain network reconstruction.
Application of genome-scale models of metabolism and expression to the simulation and design of recombinant organisms
Authors: Oftadeh Omid , Hatzimanikatis Vassily
Published: September 2023

The production of recombinant proteins in a host using synthetic constructs such as plasmids comes at the cost of detrimental effects such as reduced growth, energetic inefficiencies, and other stress responses, collectively known as metabolic stress. Increasing the number of copies of the foreign gene increases the metabolic load but increases the expression of the foreign protein. Thus, there is a trade-off between biomass and product yield in response to changes in heterologous gene copy number. This work proposes a computational method, rETFL (recombinant Expression and Thermodynamic Flux), for analyzing and predicting the responses of recombinant organisms to the introduction of synthetic constructs. rETFL is an extension to the ETFL formulations designed to reconstruct models of metabolism and expression (ME-models). We have illustrated the capabilities of the method in four studies to (i) capture the growth reduction in plasmid-containingE. coliand recombinant protein production; (ii) explore the trade-off between biomass and product yield as plasmid copy number is varied; (iii) predict the emergence of overflow metabolism in recombinantE. coliin agreement with experimental data; and (iv) investigate the individual pathways and enzymes affected by the presence of the plasmid. We anticipate that rETFL will serve as a comprehensive platform for integrating available omics data for recombinant organisms and making context-specific predictions that can help optimize recombinant expression systems for biopharmaceutical production and gene therapy.
Behavioral and transcriptomic analyses of mecp2 function in zebrafish
Authors: Santistevan Nicholas J. , Ford Colby T. , Gilsdorf Cole S. , Grinblat Yevgenya
Published: September 2023

Rett Syndrome (RTT), a human neurodevelopmental disorder characterized by severe cognitive and motor impairments, is caused by dysfunction of the conserved transcriptional regulator Methyl-CpG-binding protein 2 (MECP2). Genetic analyses in mouse Mecp2 mutants, which exhibit key features of human RTT, have been essential for deciphering the mechanisms of MeCP2 function; nonetheless, our understanding of these complex mechanisms is incomplete. Zebrafish mecp2 mutants exhibit mild behavioral deficits but have not been analyzed in depth. Here we combine transcriptomic and behavioral assays to assess baseline and stimulus-evoked motor responses and sensory filtering in zebrafish mecp2 mutants from 5-7 days post-fertilization (dpf). We show that zebrafish mecp2 function is dispensable for gross movement, acoustic startle response, and sensory filtering (habituation and sensorimotor gating), and reveal a previously unknown role for mecp2 in behavioral responses to visual stimuli. RNA-seq analysis identified a large gene set that requires mecp2 function for correct transcription at 4 dpf, and pathway analysis revealed several pathways that require MeCP2 function in both zebrafish and mammals. These findings show that MeCP2’s function as a transcriptional regulator is conserved across vertebrates and supports using zebrafish to complement mouse modeling in elucidating these conserved mechanisms.
A cluster-randomized trial of client and provider-directed financial interventions to align incentives with appropriate case management in retail medicine outlets: results of the TESTsmART Trial in western Kenya
Authors: Laktabai J. , Kimachas E. , Kipkoech J. , Menya D. , Arthur D. , Zhou Y. , Chepkwony T. , Abel L. , Robie E. , Amunga M. , Ambani G. , Woldeghebriel M. , Garber E. , Eze Nwamaka , Mudabai Pamela , Gallis J.A. , Fashanu Chizoba , Saran I. , Woolsey A. , Visser T. , Turner E.L. , O’Meara W. Prudhomme
Published: September 2023

ACTs are responsible for a substantial proportion of the global reduction in malaria mortality over the last ten years. These reductions would not have been possible without publicly-funded subsidies making these drugs accessible and affordable in the private sector. However, inexpensive ACTs available in retail outlets have contributed substantially to their overconsumption. We test an innovative, scalable, and sustainable strategy to target ACT subsidies to clients with a confirmatory diagnosis. We supportead point-of-care malaria testing (mRDTs) in 39 retail medicine outlets in western Kenya and randomized them to three study arms; control arm offering subsidized RDT testing for 0.4USD, client-directed intervention where all clients who received a positive RDT at the outlet were eligible for a free (fully subsidized) first-line ACT, and a combined client and provider directed intervention where clients with a positive RDT were eligible for free ACT and outlets received 0.1USD for every RDT performed. Our primary outcome was the proportion of ACT dispensed to individuals with a positive diagnostic test. Secondary outcomes included proportion of clients tested at the outlet and adherence to diagnostic test results. 43% of clients chose to test at the outlet. Test results informed treatment decisions and resulted in targeting of ACTs to confirmed malaria cases – 25.3% of test-negative clients purchased an ACT compared to 75% of untested clients. Client-directed and client+provider-directed interventions did not offer further improvements, compared to the control arm, in testing rates (RD=0.09, 95%CI:-0.08,0.26) or dispensing of ACTs to test-positive clients (RD=0.01,95% CI:-0.14, 0.16). Clients were often unaware of the price they paid for the ACT leading to uncertainty in whether the ACT subsidy was passed on to the client. We conclude that mRDTs could reduce ACT overconsumption in the private retail sector, but incentive structures are difficult to scale and their value to private providers is uncertain.
Biomarkers for Identification of High-Risk Coronary Artery Plaques in Patients with Suspected Coronary Artery Disease
Authors: Pedersen Gitte , Dahl Jonathan Nørtoft , Rasmussen Laust Dupont , Blavnsfeldt Anne-Birgitte Garm , Böttcher Sidsel Hauge , Böttcher Matias Hauge , Nyegaard Mette , Nissen Louise , Winther Simon
Published: September 2023

Background

Patients with atherosclerotic plaques containing high-risk features have an increased likelihood of events and a worse prognosis. Whether increased levels of Troponin I (TnI) and C-reactive protein (CRP) are associated with the presence of high-risk coronary atherosclerotic plaques (HRP) is not well described. We assessed the association between 1) TnI and 2) CRP with quantified coronary plaque burden, luminal diameter stenosis, and HRP in patients with low/intermediate pre-test probability of obstructive coronary artery disease (CAD) referred for coronary computed tomography angiography (CCTA).

Methods

The CCTA from 1,615 patients were analyzed using a semiautomatic software for coronary artery plaque characterization. Patients with high TnI (>6 ng/L) and high CRP (>2 mg/L) were identified. Associations of TnI and CRP with plaque burden, stenosis (≥50% luminal diameter stenosis on CCTA), and HRP were investigated.

Results

TnI and CRP were both positively correlated with total plaque burden (TnI rs=0.14, p<0.001; CRP rs=0.08, p<0.001). In multivariate logistic regression analyses, high TnI was associated with stenosis (OR 1.43, 95% confidence interval (CI) 1.03-1.99, p=0.034), the presence of HRP (OR 1.79, 95% CI: 1.17– 2.74, p=0.008), and the subtypes of HRP; low attenuation plaque (OR 1.93, 95% CI: 1.24–3.00, p=0.003), and positive remodeling (OR 1.51, 95% CI: 1.07–2.13, p=0.018). For CRP, only stenosis and napkin ring sign correlated significantly.

Conclusion

In patients with suspected CAD, TnI and CRP are associated with HRP features. These findings may suggest that inflammatory and particularly ischemic biomarkers might improve early risk stratification and affect patient management.ClinicalTrials.govidentifier:NCT02264717

CLINICAL PERSPECTIVE

Using CCTA, our findings direct the focus toward plaque characteristics rather than just overall plaque burden, outlining that the presence of stenosis and specifically HRPs may be more important in CAD risk evaluation than the amount of atherosclerosis alone. Our findings suggest that biomarkers can help identify patients with HRP features, which previously were shown to increase the risk of future events. TnI may have a place in pre-test evaluation of patients with stable chest pain by introducing biomarkers to a pre-test clinical likelihood model, which may pave the way for more accurate risk stratification and, consequently, better-informed clinical decision-making. Still, trials on biomarker-guided diagnostic testing and medical therapy in de novo stable chest pain patients are warranted.
ReMIND: The Brain Resection Multimodal Imaging Database
Authors: Juvekar Parikshit , Dorent Reuben , Kögl Fryderyk , Torio Erickson , Barr Colton , Rigolo Laura , Galvin Colin , Jowkar Nick , Kazi Anees , Haouchine Nazim , Cheema Harneet , Navab Nassir , Pieper Steve , Wells William M. , Bi Wenya Linda , Golby Alexandra , Frisken Sarah , Kapur Tina
Published: September 2023

The standard of care for brain tumors is maximal safe surgical resection. Neuronavigation augments the surgeon’s ability to achieve this but loses validity as surgery progresses due to brain shift. Moreover, gliomas are often indistinguishable from surrounding healthy brain tissue. Intraoperative magnetic resonance imaging (iMRI) and ultrasound (iUS) help visualize the tumor and brain shift. iUS is faster and easier to incorporate into surgical workflows but offers a lower contrast between tumorous and healthy tissues than iMRI. With the success of data-hungry Artificial Intelligence algorithms in medical image analysis, the benefits of sharing well-curated data cannot be overstated. To this end, we provide the largest publicly available MRI and iUS database of surgically treated brain tumors, including gliomas (n=92), metastases (n=11), and others (n=11). This collection contains 369 preoperative MRI series, 320 3D iUS series, 301 iMRI series, and 356 segmentations collected from 114 consecutive patients at a single institution. This database is expected to help brain shift and image analysis research and neurosurgical training in interpreting iUS and iMRI.
Universal preprocessing of single-cell genomics data
Authors: Booeshaghi A. Sina , Sullivan Delaney K. , Pachter Lior
Published: September 2023

We describe a workflow for preprocessing a wide variety of single-cell genomics data types. The approach is based on parsing of machine-readableseqspecassay specifications to customize inputs forkb-python, which useskallistoandbustoolsto catalog reads, error correct barcodes, and count reads. The universal preprocessing method is implemented in the Python packagecellatlasthat is available for download at:https://github.com/cellatlas/cellatlas/.