bluuebunny/crossref_metadata_2025 huggingface dataset:
Uniplanar cannulated pedicle screws in the correction of Lenke type 1 adolescent idiopathic scoliosis (AIS)
Authors: Zhao Yiwei , Liu Wubo , Yuan Suomao , Tian Yonghao , Liu Xinyu
Published: June 2020

Background
In the present study, we reported the clinical use of uniplanar cannulated pedicle screws for the correction of Lenke type 1 adolescent Idiopathic scoliosis (AIS), and its safety and clinical outcomes were also evaluated.
Methods
68 patients with Lenke type 1 AIS were included, among which 38 patients were treated with uniplanar cannulated screws at the concave side of periapical levels and multiaxial screws at the other levels (group A). Moreover, the remaining 30 patients were treated with all multiaxial screws (group B). The preoperative and postoperative radiographic parameters of the Lenke type 1 AIS, axial vertebral rotation, and the safety of the pedicle screws were evaluated by X-rays and computed tomography (CT).
Results
Preoperative data was comparable between two groups. The postoperative proximal thoracic (PT) curve, main thoracic (MT) curve, thoracolumbar/lumbar (TL/L) curve, and apical vertebral rotation were significantly improved compared with the preoperative data. The coronal correction rates in group A and B were 83% and 81.9%, respectively (P > 0.05). The derotation rates in group A and B were 60.8% and 43.2%, respectively (P < 0.05). The rotation classification in the group A was also better compared with the group B. The misplacement rate in group A and B was 7.9% and 11.8%, respectively (P < 0.05), and the total misplacement rate on the concave side (11.4%) was higher than that of convex side (8.4%). The lateral perforation was found at the concave side, while the medial perforation was found at the convex side. On the concave side, the misplacement rate in group A and B was 9.7% and 12.3%, respectively (P < 0.05). The grades 2 and 3 perforations were three (3.5%) in the group A and eight (8.2%) in the group B (P < 0.05). On the convex side, the misplacement rate in group A and B was 5.9% and 11.1%, respectively (P < 0.05). The grades 2 and 3 perforations were one (0.9%) in the group A and four (4.4%) in the group B (P < 0.05).
Conclusion
Collectively, uniplanar cannulated pedicle screws could effectively increase the accuracy of pedicle screws and facilitate the derotation of the apical vertebra compared with the multiaxial pedicle screws.
Trial registration
retrospectively registered
Gastrointestinal perforation in anti-NXP2 antibody-associated juvenile dermatomyositis: Case reports and a review of the literature
Authors: Xu Yingjie , Ma Xiaolin , Zhou Zhixuan , Li Jianguo , Huo jun , Zhu Jia , Kang Min , Lai Jianming , Li Xiaohui
Published: June 2020

Background: To summarize the characteristics of gastrointestinal (GI) perforation in anti-NXP2 antibody-associated juvenile dermatomyositis (JDM). Methods: Five patients with GI perforation from a JDM cohort of 120 cases are described. Relevant literature was reviewed. Results: Five patients, including 4 females and 1 male, were involved in the study. The average age of the 5 patients was 5.74 years (5.74 ±2.82). Myositis-specific antibody (MAS) spectrum analysis indicated that the five patients were anti-NXP2 antibody positive. The initial symptoms of GI perforation were progressive abdominal pain and intermittent fever. Two patients also presented with ureteral calculus with hydronephrosis and ureteral stricture. Surgery was performed in four patients, which was successful in only one patient through fistulization. Four patients died (4/5, 80%), and 1 patient was completely relieved after 2 years of treatment. Combined with 16 patients described in the literature, the onset symptom was progressive abdominal pain, which often occurred within 10 months after JDM was diagnosed. Perforation most often occurred in the duodenum, although perforations at multiple sites or recurrent perforations also occurred. The mortality rate of GI perforation in JDM was 38% (8/21). Conclusions: All perforation cases subjected to MAS analysis were anti-NXP2 antibody positive. The onset symptom was abdominal pain. The most common site of perforation was the duodenum in the retroperitoneum, and the lack of acute abdominal manifestations complicated early diagnosis. GI perforation is a fatal complication in JDM, and early diagnosis is very important. More research is needed to determine the pathogenesis and predictive factors of GI perforation in JDM.
Study on Heavy Metal Pollution Characteristics and its Health Risk Assessment from Sludge of Sewage Treatment Plants in Industrial Parks
Authors: Han Xiuyan , Cao Tianyi , Sun Tao
Published: June 2020

Background

In order to study the characteristics of heavy metal pollution from sludge in industrial parks and the effective methods of health risk assessment, in this paper, the pollution characteristics of eight heavy metals including Zn, Cu, Pb, Hg, Cr, Ni, As, Cd in sludge of sewage treatment plants in Nanjing MV Industrial Park were comprehensively evaluated and compared by using Nemerow Index Method, Muller Index Method and Matter element extension method. On this basis, the health risk assessment models of non-carcinogenic and carcinogenic heavy metals were constructed, and the health risks caused by four kinds of non-carcinogenic heavy metals Pb, Zn, Cu, Hg and four kinds of carcinogenic heavy metals Cr, As,Cd, Nicontained in sludge were evaluated by using the practical data of Nanjing Industrial Park.
Results

According to the evaluation results of heavy metal pollution characteristics in sludge of sewage treatment plants in Nanjing MV Industrial Park, the order of different pollution levels under different assessment methods is as follows: the level of the Nemerow Index Method assessment was low, the level of the Muller Index Method assessment was high, and the level of Grey Clustering Method assessment was relatively moderate. In the health risk assessment of heavy metals, the results showed that the order of effects of non-carcinogenic heavy metals on health risk ranged from large to small was: Hg, Cu, Pb, and Zn, and the health risk of non-carcinogenic heavy metal in children was much higher than that in adults. Similarly, the order of effects of carcinogenic heavy metal health risk ranged from large to small was Cd, Cr, Ni and As, and the health risk of carcinogenic heavy metal in children was slightly lower than that in adults.
Conclusions

It can be seen that there is a certain degree of heavy metal pollution in the sludge of the sewage treatment plant in Nanjing MV Industrial Park, which affects the environmental quality in the park and the health risks of residents. This study verifies the assessment method of the heavy metal pollution characteristics and health risk is effective, and its research results have a guiding role in the management of heavy metal pollution in the sludge of the sewage treatment plant in Nanjing MV Industrial Park. It also has significant theoretical support for the government to formulate the eco-environmental quality standards and related policies of industrial parks.
Care and disposal of the remains of stillborn babies from the parents’ perspective in Taiwan: A phenomenological study
Authors: Sun Jui-Chiung , Rei Wenmay , Chang Min-Yu , Sheu Shuh-Jen
Published: June 2020

Background

Each year, 2.6 million of pregnancies end as stillbirth. Recent literature began to understand parents’ traumatic experience in stillbirth and its profound impact on parents’ mental health and psychosocial effect. But there is little understanding on the actual care and disposal of the stillborn baby, nor is there an agreement on how hospitals should care for the stillborn baby to mitigate parents’ profound loss. The purpose of this study is to understand parents’ perspective on hospital’s care for their stillborn babies, hoping to make suggestions on how can hospitals improve their care to mitigate parents’ grieves.
Methods

A descriptive phenomenological approach was adopted and twenty couples (40 individuals) who had to decide how to care for the remains of their stillborn babies participated in the study. The data were collected through in-depth interviews, which involved semi-structured and open-ended questions. The phenomenological methods of Giorgi were applied to analyze the data.
Results

Parents felt unprepared and lack of support when they had to handle their stillborn babies’ remains. The research results revealed two major themes: 1) Handling stillborn babies remain ignorantly; 2) Pacifying the disturbed soul on both sides. Given stillbirth’s profound implication for parents’ identity and psychosocial role, hospitals need to be more sensitive and proactive to parents’ cultural and religious needs when they care for stillborn baby and handle its body.
Conclusions

It was found in the study that reflection and identification were the emerging themes, which can enable healthcare professionals to understand parents’ concerns in a meaningful way, as they deal with the remains of stillborn babies. Moreover, it is hoped that hospital administration and health care personnel should consider stillborn parents’ concerns and incorporate their needs into nursing assessment and treatment practices.
Comparative study of pine reference genomes reveals transposable element interconnected gene networks
Authors: Voronova Angelika , Rendón-Anaya Martha , Ingvarsson Pär , Kalendar Ruslan , Ruņģis Dainis
Published: June 2020

Background Sequencing the giga-genomes of several pine species belonging to the ancient gymnosperm clade has enabled comparative genomic analyses of these widely distributed outcrossing tree species. Initial sequence studies have revealed the wide distribution and extraordinary diversity of transposable elements (TEs) that occupy the large intergenic spaces. Our previous investigations revealed significant variations of class I TEs within pine subpopulations, but inoculation with pathogen induced correlated expression of TE families in pine seedlings, suggesting TE co-localisation with stress-responsive genes. In this study, we analyzed the distribution of TEs in gene regions of the assembled genomes of Pinus taeda and Pinus lambertiana using high-performance computing resources.Results The quality of draft genomes and the genome annotation have significant consequences for the investigation of TEs and these aspects are discussed. Several TE families were identified in both species genomes frequently inserted into genes or their flanks. The non-autonomous MITE3321 family found in gene flanking regions and provide TATA boxes, several ARR1, DOF, WRKY and GT-binding sites, which are important signals in plant transcription activation and stress-response regulation. Distribution of MITE3321 across gene non-coding regions suggests action of selective pressure on this sequences and formation of gene sub-networks, depending on the location of MITE insertions. DNA TE DTX184 could potentially form microRNAs or provide its target site, thereby connect about 200 important stress-responsive genes in both pine species. Several retrotransposons propagated in gene regions were also identified, such as Copia-1813 containing important light-responsive regulative sequences, however full-length structures of low-copy-number TEs couldn’t be verified in the current genome assemblies. Only rare gene homologs carried similar insertions, indicating that most transposition events occurred after separation of investigated pine species. Node genes that contain many types of interspersed repeats were identified and observed in multiple potential transposable element associated networks.Conclusions This study demonstrated the increased accumulation of TEs in the introns of stress-responsive genes of pines and the probability of rewiring them in responsive networks and sub-networks interconnected with node genes containing multiple TEs. Many such regulatory influences could lead to the adaptive environmental response clines that are characteristic of naturally spread pine populations.
Validation of the Thai Version of Early Childhood Oral Health Impact Scale (Th-ECOHIS)
Authors: Leelataweewud Pattarawadee , Jirarattanasopha Varangkanar , Ungchusak Chantana , Vejvithee Warangkana
Published: June 2020

Background: Early childhood caries (ECC) has been prevalent in Thailand. There has never been an appropriate tool to measure its impact on children. Early childhood oral health impact scale (ECOHIS) is a proxy-reported questionnaire developed in the United States for measuring the oral health related quality of life of preschool children and their families and widely adopted into many countries. This study translated it into Thai (Th-ECOHIS) and investigated its psychometric properties in Thai caregivers and their children. Methods: Forward–backward translation by expert was used for the scale development. A face and content validation test were conducted among a group of caregivers to revise and attain the final Th-ECOHIS. Psychometric testing was done on caregivers of 3-year-olds in Bangkok with the interviewer-administered mode. Children’s oral health was indicated by caries experience (decayed, missing and filled primary teeth, dmft). The caregivers answered the Th-ECOHIS and global questions regarding perception of their children’s oral health. Reliability was assessed by measuring internal consistency and reproducibility using Cronbach’s alpha coefficient. Test-retest reliability was managed at 2-week interval in 10% of samples using the intraclass correlation coefficient calculated by two-way analysis of variance. The discriminant validity was tested by the relationship between the severity of dental caries and Th-ECOHIS scores using Kruskal- Wallis test.Results: A total of 214 child-parent pairs participated. Of the 214 children, 22% had ECC (dmft 1-3) and 17.3% had severe ECC (dmft 4 or higher). The mean (SD) dmft score was 1.63 (2.92). All items in the original ECOHIS were retained in the Thai version. The test-retest reliability of Th-ECOHIS was 0.87; internal consistency was 0.85; the total of Th-ECOHIS scores were significantly correlated with the global rating of oral health questions (r = 0.604). The child impact section, family impact section and total Th-ECOHIS scores were significantly associated with the severity of dental caries (p < 0.001).Conclusions: Psychometric evaluation of the Th-ECOHIS demonstrated good reliability and validity and could be used to assess impacts of early childhood caries on quality of life of Thai pre-school children through caregivers and be compared with studies in other languages.
Cryopreserved, Thin, Laser-Etched Osteochondral Allograft Maintains the Functional Components of Articular Cartilage After Two Years of Storage
Authors: Rorick Carolyn B , Mitchell Jordyn A , Bledsoe Ruth H , Floren Michael L , Wilkins Ross M
Published: June 2020

Background : Despite improvements in treatment options and techniques, articular cartilage repair continues to be a challenge for orthopedic surgeons. This study provides data to support that the 2-year Cryopreserved, Thin, Laser-Etched Osteochondral Allograft (T-LE Allograft) embodies the necessary viable cells, protein signaling, and extracellular matrix (ECM) scaffold found in fresh cartilage in order to facilitate a positive clinical outcome for cartilage defect replacement and repair.

Methods: Viability testing was performed by digestion of the graft, cells were counted using a trypan blue assay. Growth factor and ECM protein content was quantified using biochemical assays. A fixation model was introduced to assess tissue outgrowth capability and cellular metabolic activity in vitro . Histological and immunofluorescence staining were employed to confirm tissue architecture, cellular outgrowth, and presence of ECM. The effects of the T-LE Allograft to signal bone marrow-derived mesenchymal stem cell (BM-MSC) migration and chondrogenic differentiation were evaluated using in vitro co-culture assays. Immunogenicity testing was completed using flow cytometry analysis of cells obtained from digested T-LE Allografts and fresh articular cartilage.

Results: Average viability of the T-LE Allograft post-thaw was found to be 94.97 ±3.38%, compared to 98.83 ±0.43% for fresh articular cartilage. Explant studies from the in vitro fixation model confirmed the long-term viability and proliferative capacity of these chondrocytes. Growth factor and ECM proteins were quantified for the T-LE Allograft revealing similar profiles to fresh articular cartilage. Cellular signaling of the T-LE Allograft and fresh articular cartilage both exhibited similar outcomes in co-culture for migration and differentiation of BM-MSCs. Flow cytometry testing confirmed the T-LE Allograft is immune-privileged as it is negative for immunogenic markers and positive for chondrogenic markers.

Conclusions: Using our novel, proprietary cryopreservation method, the T-LE Allograft retains excellent cellular viability, with native-like growth factor and ECM composition of healthy cartilage after two years of storage at -80 o C. The successful cryopreservation of the T-LE Allograft alleviates the limited availably of conventionally used fresh osteochondral allograft (OCA), by providing a readily available and simple to use allograft solution. The results presented in this paper supports clinical data that the T-LE Allograft can be a successful option for repairing chondral defects.
Association of Serum Adipokines Levels with Glycemic Control and Metabolic Dyslipidemia in Sudanese Patients with Type 2 Diabetes Mellitus
Authors: Eltahir Halima Babiikir , Ali Elmahadi Mohamed , Mohamed Abdelrahim Osman
Published: June 2020

Background:The pathogenesis of type 2 diabetes mellitus is due to two major abnormalities including insulin resistance and dysfunction, which lead to the inability to regulate blood glucose level. Adiponectin is a hormone secreted by the adipose tissue and it takes part in glucose metabolism with insulin-sensitising properties. Low levels of adiponectin leads to reduction of fatty acid oxidation decreased glucose uptake in skeletal muscle cells and increased level of free fatty acids leading to insulin resistance. Leptin is another adipokine produced by adipose tissue involved in the control of food intake via its action on the hypothalamus, suppressing appetite and stimulating energy expenditure. Leptin plays a critical role in pathophysiology of type 2 diabetes mellitus.The aim of the study was to investigate the association of serum adipokines levels with glycemic control and metabolic dyslipidemia in Sudanese patients with type 2 diabetes mellitus.Methods: This was a case control study. 202 patients with type 2 diabetes and 102 non-diabetic controls participated after signing written consent. Weight (kg) and height (m) were measured thenthe body mass index (kg/m2) was determined. Blood samples were collected after an overnight fasting. FBG, HbA1c and lipid profiles were measured using enzymatic methods. Adiponectin and leptin were measured using sandwich ELISA.Results: Adiponectin concentrations was significantly lower in patients with type 2 diabetes compared with the controls (p<0.001) and it was inversely correlated with HbA1c (Pearson Correlation -.160, P value = 0.005), total cholesterol and LDL levels (P = 0.05) and direct correlated HDL levels (P = 0.05). Leptin concentrations was significantly higher in patients with type 2 diabetes compared with the controls (p<0.002) and it was positively correlated with HbA1c (Pearson Correlation .155, P value = 0.02), total cholesterol and LDL levels (P = 0.05), there were no correlation with HDL and TG levels. Patients had significantly higher fasting blood glucose, HbA1c levels, total cholesterol and LDL levels compared with the controls. Conclusion: Patients with type 2 diabetes mellitus had decreased levels of serum adiponectin, high levels of serum leptin. There were significant correlations found between adiponectin and leptin levels with glycemic control and metabolic dyslipidemia
Isolation and characterization of high affinity and highly stable anti-Chikungunya virus antibodies using ALTHEA Gold Libraries™
Authors: Pedraza-Escalona Martha , Guzmán-Bringas Omar , Arrieta-Oliva Ivan , Gómez-Castellano Keyla , Salinas-Trujano Juana , Torres-Flores Jesus , Muñoz-Herrera Juan , Camacho-Sandoval Rosa , Contreras-Pineda Paola , Chacón-Salinas Rommel , Pérez-Tapia Sonia Mayra , Almagro Juan Carlos
Published: June 2020

Background

More than three million infections were attributed to Chikungunya virus (CHIKV) in the 2014–2016 outbreak in Mexico, Central and South America, with over 500 deaths directly or indirectly related to this viral disease. CHIKV outbreaks are recurrent and no vaccine nor approved therapeutics exist to prevent or treat CHIKV infection. Reliable and robust diagnostic methods are thus critical to control future CHIKV outbreaks. Direct CHIKV detection in serum samples via highly specific and high affinity anti-CHIKV antibodies has shown to be an early and effective clinical diagnosis.
Methods

Chikungunya virions isolated from serum of a patient in Veracruz, México, were purified and characterized via electron microscopy, SDS-PAGE and binding to diverse well-characterized anti-CHIKV monoclonal antibodies. UV-inactivated CHIKV particles were used as selector in a solid-phase panning coupled with ELISA-based screening and Next-Generation Sequencing to discover specific and high affinity anti-CHIKV antibodies from ALTHEA Gold Libraries™.
Results

The CHIKV isolate showed the typical morphology of the virus. Protein bands in the SDS-PAGE were consistent with the size of its capsid proteins. UV-inactivated CHIKV particles bound tightly the control antibodies. The lead antibodies here obtained showed high expression yield, monomeric content over 95% after a single-step Protein A purification, and importantly, a thermal stability above 75oC. Most of the antibodies recognized linear epitopes on E2, including the highest affinity antibody called C7. A sandwich ELISA implemented with C7 and a potent neutralizing antibody isolated elsewhere, also specific for E2 but recognizing a discontinuous epitope, showed a dynamic range of 0.2–40.0 µγ/mL of UV-inactivated CHIKV purified preparation. The number of CHIKV particles estimated based on the concentration of E2 in the extract suggested that the assay could detect clinically meaningful amounts of CHIKV in serum.
Conclusions

The newly discovered antibodies offer valuable tools for characterization of CHIKV isolates and development of robust diagnostic tools for CHIKV infection surveillance. Application of ALTHEA Gold Libraries™ in combination with viral particles other than CHIKV could expedite the discovery and development of antibodies for detection and control of emergent and quickly spreading viral outbreaks such as SARS-CoV-2 (COVID-19).
Are Patients with Elevated Inflammatory Indications are at Higher Risk for Developing the Severe form of COVID-19?
Authors: Rokni Mohsen , Ahmadikia Kazem , Asghari Somaye , Mashaei Shahabodin , Hassanali Fahimeh
Published: June 2020

BackgroundSince December 2019, when SARS-CoV-2 emerged with a cluster of unknown pneumonia cases in Wuhan city and rapidly spread throughout in worldwide and Iran, data have been needed on the clinical and diagnostic features of the affected Iranian patients.MethodsWe extracted data regarding 233 patients with laboratory-confirmed COVID-19 from Buali Hospital in Iran; clinical/praclinical and inflammatory indexes data were collected and analyzed. The data of laboratory examinations and chest CT findings were compared between death and non-severe patients.ResultsThe mean age of the patients was 49 years, (63%) of the patients were male. The acute respiratory distress syndrome occurred in 64 patients, including 53 who were admitted to the ICU and underwent invasive mechanical ventilation, and 28 who died. On the admission in death group, lymphopenia (79%), neutrophilia (79%), and thrombocytopenia (21%) were usually observed. Most patients had a high SII index of > 500 (68%), increased CRP level (88%). A high level of inflammatory index’s such as NLR, PLR and SII in death comparison with moderate groups were observed (P < 0.001). The most common symptoms were fever (70%) and cough (63%) on admission. Headache was uncommon (11%). On admission, ground-glass opacity with consolidation (mixed) was the most common radiologic finding on chest CT (51%). No radiographic or CT abnormality was found in 15 of 204 patients (7%). In ConclusionThese patients often presented without fever, and some did not have abnormal radiologic findings. Elevated NLR, PLR and SII can be considered as prognostic and risk stratifying factor of severe form of disease.
Glycosylated Haemoglobin A1c as An Independent Marker Predicting Coronary Artery Disease in Non-diabetic Patient Population in Primary Healthcare in Turkey: A crosssectional study
Authors: Kayali Yildiz , Ozder Aclan
Published: June 2020

Background: In our role as a preventive physician, there is a need for cheap and accessible biochemical markers that will allow the determination of the risk of coronary artery disease. We aimed to research the value of glycosylated haemoglobin (HbA1c) in the prediction of coronary artery disease. Methods: Patients aged between thirty and ninety years who were admitted to outpatient clinic of Cardiology department in a university hospital between January 2016 and June 2018 for angiography for various reasons were retrospectively screened. Patients with known diabetes or patients with HbA1c of 6.5 or above were excluded from the study. Comparative HbA1c data were obtained according to the stenosis groups and statistical significance was sought. Logistic regression analysis was used to investigate the risk factors affecting stenosis positivity. Results: A total of 247 patients were identified, 120 patients without any stenosis in any coronary artery, 56 patients with> 50% stenosis in one coronary artery, and 71 patients with > 50% stenosis in more than one coronary artery. There was a statistically significant difference between HbA1c measurements according to the degree of stenosis (p = 0.001 and p <0.01, respectively). The odd ratio for HbA1c was 6.260 (95% CI: 3,160-12,401). According to the stenosis positivity, the cut off point for HbA1c was found to be 5.6 and above. In the regression analysis, HbA1c was an independent risk factor for coronary artery disease. One unit increase in HbA1c measurements increases the risk of stenosis positive to 12.424 times (95% CI: 5,990-25,767).Conclusions: The study showed HbA1c can be used as an independent marker in determining the probability and severity of coronary artery disease in non-diabetic individuals and as an useful marker in primary care predicting coronary artery disease (CAD).
Experimental pilot study for augmented reality-enhanced elbow arthroscopy
Authors: Yamamoto Michiro , Oyama Shintaro , Otsuka Syuto , Murakami Yukimi , Yokota Hideo , Hirata Hitoshi
Published: June 2020

Background: The purpose of this study was to develop and evaluate a novel elbow arthroscopy system with superimposed bone and nerve visualization based on preoperative computed tomography (CT) and magnetic resonance imaging (MRI) data.

Methods: We obtained bone and nerve segmentation data by CT and MRI, respectively, of the elbow of a healthy human volunteer and cadaveric Japanese monkey. A life size 3-dimensional (3D) model of human organs and frame was constructed using a stereo-lithographic 3D printer. Elbow arthroscopy was performed using the elbow of a cadaveric Japanese monkey. The augmented reality (AR) range of error was examined at 1 cm and 2 cm scope–object distances.

Results: We successfully performed AR arthroscopy using the life-size 3D elbow model and the elbow of the cadaveric Japanese monkey by making anteromedial and posterior portals. The computer graphics (CG) position and shape were initially different because of lens distortion. The CG position and shape were corrected to match the arthroscopic view using lens distortion parameter estimates based on the calibration pattern. AR position and shape errors were 2.3 mm at 1 cm scope–object distance and 3.6 mm at 2 cm scope–object distance.

Conclusion: We attained reasonable accuracy and demonstrated the working of the designed system. Given the multiple applications of AR-enhanced arthroscopic visualization, it has the potential to be the next-generation technology for arthroscopy. This technique will contribute the reduction of serious complications associated with elbow arthroscopy.
Genetic spectrum of Brazilian suspected Bartter Syndrome Patients
Authors: Messa Ana Carola Hebbia Lobo , Ferreira Juliana Caires de Oliveira Achili , Fonseca Fernanda , Rangel-Santos Andreia , Vaisbich Maria Helena
Published: June 2020

Background

This paper’s goal is to show the genetic study results of suspected Bartter syndrome (BS) patients followed in a pediatric nephrology reference center in Sao Paulo/Brazil, verify a possible genotype-phenotype correlation and compare the genetic results with those from other regions of the globe.
Results

This descriptive study included 22 patients (21 families) with clinical diagnosis of BS. Pathogenic variants in BS-related genes were detected in 19/22 patients. No BS-related genes were detected in three patients (one case of Congenital Chloride Diarrhea and two siblings with clinical Antenal BS that, in fact, had Gitelman Syndrome). We observed that 16/19 BS-confirmed patients had CLCNKB mutations (BS type 3) with a large phenotypical diversity. Among them, the deletion of the entire gene (del 1–20) was the most frequent variant detected. Interestingly, we observed that patients with homozygous or heterozygous del 1–20 presented earlier manifestations than patients with other CLCNKB mutations. They presented no other clinical significant difference.
Conclusion

This study demonstrates the importance of an appropriate investigation of clinically suspected BS patients to rule out pseudo-BS. This data also confirms the difficult to differentiate these patients based just on clinical findings, similar to what has been reported in other studies. There were patients with clinical Antenatal BS in whom the genetic analysis confirmed the final diagnosis of GS or BS type 3. Among BS cases, BS type 3 was the most frequent in this Brazilian cohort and del 1–20 was the most frequently variant detected. In addition, BS type 3 patients with homozygous or heterozygous del 1–20 had earlier manifestations than patients with other CLCNKB mutations. Brazilian community has a particular characteristic miscegenation as well as different origins such as Europeans, Africans and Asians and comparing our results with those from other regions we can suppose the genetic background of this Brazilian cohort is related to African and Portuguese inheritance, probably originated in the early period of immigration (colonization and slavery period). Limitations: low number of patients from a single center. However, as a rare disease all data can contribute to the improvement for diagnosis and treatment.
Development and Validation of a Novel Five-Gene-Based RNA Binding Protein Associated Prognostic Model for Human Colon Cancer
Authors: Liu Haoling , Bai Qingquan , Lu Zhaoyang , Song Xuan , Liu Yao , Jin Ye , Meng Fanzheng , Guo Hongrui , Pei Tiemin , Liang Shuhang , Song Ruipeng , Liang Yingjian , Wang Jiabei , Yin Dalong , Qu Zhibo , Guo Huaxin , Jiang Hongchi , Yang Haiyan
Published: June 2020

Background: Dysregulation of RNA binding protein (RBP) expression has been reported in various malignant tumors, and it is related to the occurrence and development of cancer. However, the role of RBPs in colon cancer remains unclear. Methods: We downloaded the RNA sequencing data of colon cancer from The Cancer Genome Atlas (TCGA) database, and determined the differently expressed RBPs between normal and cancer tissues. Then, through a series of bioinformatics analysis, we systematically studied the expression and prognostic value of these RBPs.Result: A total of 490 different expression differently expressed RBPs were identified, including 323 up-regulated and 167 down regulated RBPs. Five RBPs (PNLDC1, NSUN6, NOL3, PPARGC1A, LRRFIP2) were identified as prognosis related genes for the construction of prognostic model. Further analysis showed that the overall survival rate (OS) of patients in the high-risk subgroup was worse than that in the low-risk subgroup based on this model. The area under the characteristic curve of time-dependent receiver was 0.691 in TCGA and 0.624 in GEO, which confirmed the prognostic model to be a good one. We also established a nominal map based on the internal validation in 5 RBPs mRNAs and TCGA sequeues, showing a good ability to differentiate colon cancer.Conclusions: We screened RBPs expression differences between colon cancer and adjacent non tumor colon tissues using the TCGA database to identify potential gene biomarkers.Besides,a very effective prediction model was constructed and tested based on the differential expression of RBPs using the TCGA and Gene Expression Omnibus (GEO) database.We also Validated of the relationship between the expression of five RBPs and prognosis
Neurovascular, Muscle, and Skin Changes on [18f]FDG PET/MRI in Foot Complex Regional Pain Syndrome (CRPS)
Authors: Yoon Daehyun , Xu Yingding , Cipriano Peter W. , Alam Israt S. , Aparici Carina Mari , Tawfik Vivianne L. , Curtin Catherine M. , Carroll Ian R. , Biswal Sandip
Published: June 2020

Background: The goal of this study is to demonstrate the feasibility of [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET)/magnetic resonance imaging (MRI) for non-invasive visualization of muscular, neurovascular, and skin changes secondary to complex regional pain syndrome (CRPS). Methods: Seven adult patients with CRPS in the lower extremity and seven healthy adult controls participated in our [18F]FDG PET/MRI study. All participants received whole-body PET/MRI scans one hour after the injection of 10mCi [18F]FDG. Resulting PET/MRI images were reviewed by two radiologists. Metabolic and anatomic abnormalities identified, were grouped into muscular, neurovascular, and skin lesions. The [18F]FDG uptake of each lesion was compared with that of corresponding areas in controls using a Mann-Whitney U-test. Results: On PET images, muscular, neurovascular, and skin abnormalities were found in 5, 4 and 2 patients, respectively. However, on MRI images, no muscular abnormalities were detected. Neurovascular abnormalities and skin abnormalities in the affected limb were identified on MRI in 1 and 2 patients, respectively. The difference in [18F]FDG uptake between the patients and the controls was significant in muscle (p = 0.018) and neurovascular bundle (p = 0.0005).Conclusions: The increased uptake of [18F]FDG in the symptomatic areas likely reflects the increased metabolism due to the inflammatory response causing pain. Therefore, our approach combining metabolic ([18F]FDG PET) and anatomic (MRI) imaging may offer non-invasive monitoring of the distribution and progression of inflammatory changes associated with CRPS. Trial registration: ClinicalTrials.gov, NCT03195270. Registered 19 June 2017 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03195270
Plasma Radio–Metabolite Analysis of PET Tracers for Dynamic PET Imaging: TLC and Autoradiography
Authors: Li Fiona , Hicks Justin W , Yu Lihai , Desjardin Lise , Morrison Laura , Hadway Jennifer , Lee Ting-Yim
Published: June 2020

Background In molecular imaging with dynamic PET, the binding and dissociation of a targeted tracer is characterized by kinetics modeling which requires the arterial concentration of the tracer to be measured accurately. Metabolism of the radiolabeled parent tracer in the body due to hydrolysis, methylation and other biochemical processes, results in the production and accumulation of different metabolites in blood which can be labeled with the same PET radionuclide as the parent. Since these radio-metabolites cannot be distinguished by PET scanning from the parent tracer, their contribution to the arterial concentration curve has to be removed for the accurate estimation of kinetic parameters from kinetic analysis of dynamic PET. High performance liquid chromatography has been used to separate and measure radio-metabolites in blood plasma, however, the method is labor intensive and remains a challenge to implement for each individual patient. The purpose of this study is to develop an alternate technique based on thin layer chromatography (TLC) and a sensitive commercial autoradiography system (Beaver, Ai4R, Nantes, France) to measure radio-metabolites in blood plasma of two targeted tracers  [18F]FAZA and [18F]FEPPA , for imaging hypoxia and inflammation respectively. Results Radioactivity as low as 17Bq in 2µL of plasma can be detected on the TLC plate using autoradiography. Peaks corresponding to the parent tracer and radio-metabolites could be distinguished in the line profile through each sample (n=8) in the autoradiographic image. Significant inter-subject and intra-subject variability in radio-metabolites production could be observed with both tracers. For [18F]FEPPA, 50% of plasma activity was from radio-metabolites as early as 5 min post injection while for [18F]FAZA, significant metabolites did not appear until 50 min post. Simulation study investigating the effect of radio-metabolite in the estimation of kinetic parameters indicated that 32-400% parameter error can result without radio-metabolites correction.Conclusion TLC coupled with autoradiography is a good alternative to high performance liquid chromatography for radio-metabolite correction. The advantages of requiring only small blood samples (~ 100 L) and of analyzing multiple samples simultaneously, make the method suitable for individual dynamic PET studies.
Facial Alveolar Bone Thickness and Modifying Factors of Anterior Maxillary Teeth: A Systematic Review and Meta-Analysis of Cone-Beam Computed Tomography Studies
Authors: Rojo-Sanchis Julio , Soto-Peñaloza David , Peñarrocha-Oltra David , Peñarrocha-Diago Miguel , Viña-Almunia Jose
Published: June 2020

Background: Understanding the anatomy of the facial alveolar bone (FAB), provides a prognostic tool for estimating the degree of dimensional ridge alterations after tooth extraction. This study aimed to systematically review the FAB thickness of anterior maxillary teeth measured by CBCT scans. A secondary objective was to assess the facial distance from the cementoenamel junction (CEJ) to the bone crest.Methods: An electronic search was made of Medline, Embase, Web of Science, Cochrane Library and Google Scholar up to December 2019. Studies that analyze and quantitatively compare FAB thickness at maxillary teeth by CBCT scans were included. The methodological quality of the included studies was appraised using the ROBINS-I tool from the Cochrane Collaboration. A meta-analysis of single means, subgroup analysis and meta-regression of covariates were conducted.Results: Twenty-nine studies, including 17,321 teeth, were selected. Seventeen studies considered the facial bone crest, and 12 the CEJ as a reference point for their measurements. Mean FAB thickness was ≤ 1 mm in maxillary incisors and canines (0.75-1.05 mm) and 1-2 mm in premolars. Patients over 50 years of age and females exhibited a thinner FAB at some apico-coronal locations of maxillary incisors and canines. Thicker gingival phenotypes were associated with a thicker FAB in maxillary incisors and canines. The geographical setting proved to be an effect modifier that could explain up to 87% of the heterogeneity in FAB thickness, being Asian populations that showed the lowest FAB thickness values. The CEJ-bone crest distance was 2-2.5 mm in all teeth analyzed. Population over 50 years of age exhibited greater CEJ-bone crest distances, and males also showed a trend for greater distance. The prevalence of bone dehiscences at maxillary incisors and canines was 12.3-20.1%; while the prevalence of fenestrations was between 6.4% and 23.8%.Conclusions: Facial alveolar bone is thin, heterogeneous in width along its apico-coronal dimensions, and increases in thickness in maxillary premolars. The prevalence of < 1 mm FAB thickness was 69.9% in central incisors, 64.5% in lateral incisors, 55% in canines and 40.4% at first premolars. The CEJ-bone crest distance presented homogeneous and similar values in all teeth analyzed.
Bacterial Etiology of Sputum from Tuberculosis Suspected Patients and Antibiogram of the Isolates
Authors: Regmi Ramesh Sharma , Khadka Sujan , Sapkota Sanjeep , Adhikari Sanjib , Dhakal Khuma Kumari , Dhakal Bishnu , Lamsal Bandana , Kafle Sarad Chandra
Published: June 2020

Objective The current study aims to explore the bacteriology of sputum of tuberculosis (TB) suspected patients. A cross-sectional study was carried out in the sputum samples of 150 TB suspected patients visiting District Public Health Office, Bharatpur, Nepal. The samples were subjected to cultural, microscopic and biochemical analyses for the identification of the isolates. In addition, antibiotic susceptibility tests were carried out with a special focus on ESBL and MBL production following Clinical and Laboratory Standard Institute guidelines.ResultsBacterial growth was recovered in 47% (71/150) of the TB suspected patients of which 12.66% (19/150) had pulmonary TB infection. Streptococcus spp. (9%) and Pseudomonas aeruginosa (9%) were the most frequently isolated bacteria. Enterobacteriaceae accounted for 35% of the total isolates. Occurrence of bacterial pathogens was more in males (69%) than in females (31%).The incidence of bacterial pathogen was seen associated with the gender of the patients and with the TB infection (p<0.05) but independent with the age of the patients and HIV infection(p>0.05). Tetracycline was effective against Streptococcus spp. whereas gentamicin was effective against Bacillus spp. Imipenem and co-trimoxazole were effective drugs for Gram-negative isolates. Among 83 isolates, 35 were multi-drug resistant, 9 were ESBL producers and 4 were MBL producers.
A mixed-method study to determine the readiness of medical and health sciences students for interprofessional education in a Gulf university
Authors: Sulaiman Nabil , Hasan Hayder , Rishmawy Youssef , Hussein Amal , Saber-Ayad Maha , Alzubaidi Hamzah , Kawas Sausan Al , Guraya Salman
Published: June 2020

Background High‐quality patient care is a complex phenomenon that requires collaboration among healthcare professionals. Research has shown that Interprofessional Education (IPE) carries promise to improve collaborative work and patient care. So far, collaboration among various medical disciplines remains a challenge. Several survey-based studies have reported attitudes about IPE, but very few mixed methods studies, particularly in Arabic-speaking countries, have been conducted to determine medical students’ perspectives and readiness. Methods A two-staged sequential mixed methods study was conducted among medical and health sciences students of University of [---],[country]. The perspectives of students toward IPE and collaborative practice were first gathered by administering a validated instrument; namely Readiness for Interprofessional Learning Scale (RIPLS). This was followed by detailed focused group discussions. Quantitative and qualitative data analysis were performed using SPSS and NVivo, respectively.Results This study cohort included 282 students. All respondents showed readiness to adopt IPE as all statement of RIPLS survey scored high means. Highest mean of 5 was achieved for IPE elements of identifying and resolving patients’ problems and small group work. Three main themes were generated; prior knowledge, need for IPE framework and its implementation. Information workload, lack of clarity and less focused teaching pedagogies of IPE were considered as perceived barriers. Conclusion This study demonstrates substantial agreement of medical and health sciences students towards readiness and perceived effectiveness of IPE. Educators are urged to embed new IPE program into the existing curricular framework that can potentially enhance collaborative learning and improve quality of patient care.
Mesenchymal stem cells-derived exosomal miRNA-28-3p promotes apoptosis of pulmonary endothelial cells in pulmonary embolism
Authors: Mao Hongyu , Liu Lina , Hu Yamin
Published: June 2020

Background

Pulmonary embolism (PE) is a primary clinical manifestation of venous thromboembolism (VTE). It has been demonstrated that pulmonary endothelial cells (PECs) are apoptotic-resistance in PE. In this study, PECs were collected from PE patients and mouse models. Western blot, RT-PCR, flow cytometry, H&E and TUNEL assay, confocal and TEM microscopy, and luciferase reporter assay were performed to determine the effects of miR-28-3p on PECs apoptosis and if exosomes can act as the shuttle to transport miR-28-3p to PECs.
Material and Methods

The results revealed that apoptosis and miR-28-3p were downregulated in PECs of PE. The miR-28-3p mimics and inhibitor enhanced and further inhibited apoptosis in PECs, respectively.
Results

Both miR-28-3p-modified adipose tissue-derived mesenchymal stem cells (AMSCs) and AMSC-derived exosomes upregulated miR-28-3p expression in PECs, leading to elevated apoptosis of PECs. Apoptosis inhibitor 5 (API5) was a direct target gene of miR-28-3p, and the overexpression of API5 in miR-28-3p-modified PECs further suppressed apoptosis.
Conclusions

Furthermore, the administration of miR-28-3p-modified exosomes to PE mouse model promoted apoptosis in PECs. In conclusion, exosomal miR-28-3p could ameliorate PE-associated apoptosis-resistance in PECs through targeting API5 in vitro and in vivo. Therefore, AMSCs-derived exosome is a promising way to deliver functioning miRNA to PECs, providing insight into novel therapy of PE.