bluuebunny/crossref_metadata_2025_split huggingface dataset:
Synthesis and Characterization of Zirconium Oxide Nanoparticles Based on Hemidesmus Indicus Extract: Evaluation of Biocompatibility and Bioactivity for Prosthetic Implant Coatings
Authors: Shereen Farhana P.  , Francis Arul Prakash , Gayathri R.  , Sankaran Kavitha , Veeraraghavan Vishnu Priya 
Published: March 2024

Aim: Zirconium oxide nanoparticles have unique properties that could be useful in various applications, including implants, biosensors, anticancer, and antimicrobial agents. To enhance their suitability as coatings for prosthetic implants, quercetin, a flavanol abundant in plants, serves as an effective functionalization agent, enhancing nanoparticle solubility, stability, and bioavailability. This study focuses on synthesizing zirconium oxide nanoparticles using Hemidesmus indicus (H. indicus) root extract and functionalizing them with quercetin. Further, their biocompatibility, antioxidant and antimicrobial activity are evaluated to target their application as coatings for prosthetic implants. Materials and Methods: Zirconium oxide nanoparticles were prepared using H. indicus root extract (H-ZrO2NPs) and decorated with quercetin followed by pegylation. The nanoparticles were characterized using various characterization techniques including UV–vis spectroscopy (UV–Vis), Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), scanning electron microscopy, and energy-dispersive X-ray analysis. The biological activity of the nanoparticles was evaluated using biocompatibility, antioxidant, and antibacterial assays. Biocompatibility was tested by investigating the interaction between the quercetin-functionalized zirconium oxide nanoparticles (HQZN) and erythrocytes. The antibacterial and antioxidant efficacy of H-ZrO2NPs and HQZN was tested and compared with the standard drug. The results were statistically analyzed using one-way ANOVA followed by Dunnett’s multiple comparison tests. Results: H-ZrO2NPs were successfully synthesized using H. root extract and functionalized with quercetin. The characterization of nanoparticles using various techniques confirmed their morphology, elemental composition, functionalization, crystallinity, size, and stability. The nanoparticles were appearing spherical in shape with a size range of 20–120 nm. The crystallinity of H-ZrO2NPs is found to be enhanced with quercetin functionalization. In vitro, bioactivity studies revealed the antioxidant and antibacterial efficacy of HQZN. The hemocompatibility of HQZN was proved by investigating its interaction with erythrocytes. Conclusion: The study findings revealed that the biocompatible HQZN holds notable antioxidant and antibacterial properties. On the other hand, further comprehensive investigation using an in vivo model is vital to appreciate their efficacy and toxicity profile.
Factors Associated With Knee Extension Strength Symmetry After Anterior Cruciate Ligament Reconstruction With Quadriceps Tendon Autograft
Authors: Greiner Justin J. , Drain Nicholas P. , Setliff Joshua C. , Sebastiani Romano , Herman Zachary J. , Smith Clair N. , Irrgang James J. , Musahl Volker , Lesniak Bryson P. , Hughes Jonathan D. 
Published: March 2024

Background: Diminished postoperative knee extension strength may occur after anterior cruciate ligament reconstruction (ACLR) with quadriceps tendon (QT) autograft. Factors influencing the restoration of knee extensor strength after ACLR with QT autograft remain undefined. Purpose: To identify factors that influence knee extensor strength after ACLR with QT autograft. Study Design: Case-control study; Level of evidence, 3. Methods: The authors performed a retrospective review of patients who underwent primary ACLR with QT autograft at a single institution between 2010 and 2021. Patients were included if they completed electromechanical dynamometer testing at least 6 months after surgery. Exclusion criteria consisted of revision ACLR, <6 months of follow-up, concomitant procedure (osteotomy, cartilage restoration), and concomitant ligamentous injury requiring surgery. Knee extension limb symmetry index (LSI) was obtained by comparing the peak torque of the operated and nonoperated extremities. Univariable and multivariable analyses were performed to identify factors associated with knee extension LSI in the patient, injury, rehabilitation, and preoperative patient-reported outcomes score domains. Results: A total of 107 patients (58 male; mean age, 22.8 years) were included. Mean knee extension LSI of the overall cohort was 0.82 ± 0.18 at 7.5 ± 2.0 months; 35 patients (33%) had a value of ≥0.90. Multivariable analysis demonstrated significant negative associations between knee extension LSI and female sex (−0.12; P < .001), increased age at the time of surgery (−0.01; P = .018), and larger QT graft width (−0.049; P = .053). Conclusion: Factors influencing knee extensor LSI after ACLR with QT autograft in this study population spanned patient and surgical factors, including female sex, older age at the time of surgery, and wider graft harvest. Surgeons should consider the association between these factors and lower postoperative knee extensor LSI to optimize patient outcomes.
The Effect of Uncertainty Training on the Improvement of Diagnostic Ability in Chinese Medical Students
Authors: Xia Xiaomeng , Zeng Yi , Pi Pixiang , Wu Xianqing , Fang Xiaoling , Chen Jianlin , Zhong Yan 
Published: March 2024

Objective To evaluate the effect of the uncertainty training on improvement of students’ diagnostic ability. Methods Data were collected on 70 fifth-year medical students enrolled in the Case Discussion courses on Obstetrics and Gynecology in the spring of 2020. Of these students, 36 were in the uncertainty training group and 34 in the control group. The effect of training was evaluated by cognitively diagnostic assessment which mapped exam questions to 4 attributes assessing clinical reasoning and basic science knowledge. Results Uncertainty training was able to improve students’ ability to use basic science concepts for inference and problem solving, and the ability to integrate complex clinical information to arrive at a diagnosis. But it could not improve students’ ability on the basic recall of foundational concepts and the ability to use basic science concepts in clinical reasoning. Medical students could do well in integrating complex clinical information although they didn’t recall basic science knowledge well. Conclusion Uncertainty training could be used as an effective teaching method in Case Discussion course on Obstetrics and Gynecology. However, students still need to improve their basic knowledge besides the training.
Improving Antimicrobial Resistance Awareness Among Medical Students in India: The Sensitization of Medical Students on Antimicrobial Resistance (SOS-AMR) Study
Authors: Tirupakuzhi Vijayaraghavan Bharath Kumar , Ranganathan Lakshmi , Venkataraman Ramesh , Ramasubramanian Venkatasubramanian , Ramanathan Yamunadevi , Devi Sanmarkan Abarna , Kartik Prasanna , Arthur Manisha , SR Ramakrishnan , Murali Sarath , Ramakrishnan Nagarajan 
Published: March 2024

OBJECTIVES To evaluate the impact of an online educational intervention on improving knowledge of antimicrobial resistance (AMR) and stewardship among final-year medical students in Chennai, India. METHODS This was a prospective ‘before-after’ study conducted across 5 medical colleges in Chennai, India. Participants who were final-year (fourth year) undergraduate medical students were administered a pretest to evaluate baseline knowledge. Students were then provided access to online educational material comprising 20 short lectures. Lectures were delivered by content experts and covered a range of topics which included basics of microbiology, fundamental concepts in AMR and stewardship, diagnosis and management of common infections, basics of antimicrobial pharmacokinetics and pharmacodynamics, and vaccination. Students were required to take a posttest at the end of these modules. Primary outcome was improvement in test scores from pretest baseline which was analyzed using a t test. A 30% improvement in the mean scores from baseline was predefined as a measure of success. RESULTS A total of 599 students participated from 5 medical colleges among whom 339 (56.6%) were female participants; 542 (90.4%) students completed the posttest. Mean pretest score was 11.6 (maximum possible score of 25) (SD: 4.3) and the mean posttest score was 14.0 (SD: 4.6). Comparing pre and posttest scores, there was an improvement of 2.4 marks (20%) from the baseline (95% confidence interval: 1.9, 2.9) ( P < .001). Improvement in scores was similar for male and female participants. CONCLUSIONS In this before-after study evaluating the impact of an educational intervention on AMR among final-year medical students, there was an improvement in knowledge; however, the extent of improvement did not meet the predefined metric of success.
Teleyoga for Patients With Alzheimer’s Disease and Chronic Musculoskeletal Pain and Their Caregivers: A Feasibility Study
Authors: Allende Santiago , Mahoney Louise , Francisco Jasmin M , Fitz Korrine , Keaney Audrey , Parker-Bridges Kelly , Mahoney Heidi , Jo Booil , Greenberg Jason , Bayley Peter J 
Published: March 2024

Background Chronic musculoskeletal pain is common in patients with Alzheimer’s disease (AD), and there is growing awareness that chronic pain has an impact on the progression of dementia. Yoga has shown promise in treating chronic pain. However, attending in-person yoga can be difficult for AD patients. Objective To assess the feasibility, acceptability and preliminary efficacy of an online yoga (teleyoga) protocol suitable for AD patients with chronic pain, and their caregivers. Methods Patients with comorbid mild AD and chronic musculoskeletal pain ( n = 15, 57-95 y/o; 73% Female) and their caregivers ( n = 15, 50-75 y/o; 67% Female) received 12-week of teleyoga individually ( n = 5 dyads) or in groups ( n = 10 dyads). Study measures included standard feasibility metrics, and secondary outcomes included the Brief Pain Inventory-Short Form (BPI-SF), Beck Depression Inventory-II (BDI-II), and cognitive function using the Cambridge Neuropsychological Test Automated Battery (CANTAB). Caregivers also completed measures of caregiver burden, and quality of life (Short Form Health Survey-36, SF-36). Results Feasibility measures showed adequate treatment adherence (85.1% in patients and 86.3% in caregivers), acceptability (mean acceptability rating = 3.0 for patients and 3.3 for caregivers, indicating positive approval), recruitment rate ( n = 16 dyads within 1-year), retention rate (87%), missing data rate (.03%), and fidelity of treatment delivery (87%). Preliminary efficacy findings in the AD group showed significant reductions in pain severity (BPI-SF mean Δ = −.93, P = .045) and depression (BDI-II; mean Δ = −9.85, P = .005). %). Preliminary efficacy findings in the caregiver group showed significant reductions in depression (BDI-II mean Δ = −6.88, P = .036) and fatigue (SF-36 mean Δ = 9.81, P = .021). Conclusion Results show that teleyoga is a feasible treatment for patients with comorbid mild AD and chronic musculoskeletal pain. Results also provide preliminary evidence of health benefits of teleyoga for both AD patients and their caregivers.
Profile of non-tuberculous mycobacteria amongst tuberculosis presumptive people in Cameroon
Authors: Donkeng Donfack Valerie Flore , Fokou Thierry Anicet Zemo , Wadje Lazare Eric Noche , Le Grand Napa Tchuedji Yves , Djieugoue Yvonne Josiane , Nguimfack Teagho Sorelle , Shile Takong Brenda , Assolo Yannick Patrick , Ongboulal Suzanne Magloire , Simo Yannick Willy Kamdem , Awungafac Stanley Nkemnji , Eyangoh Sara 
Published: March 2024

Abstract
Background
Cameroon is a tuberculosis (TB) burden country with a 12% positivity among TB presumptive cases. Of the presumptive cases with a negative TB test, some are infected with Non-tuberculous Mycobacteria (NTM). However, the diagnosis of NTM infections remains difficult due to the lack of tools in many laboratories, particularly in resource limited laboratories and remote setting. The present study was undertaken to determine NTM profile and associated comorbidities among TB presumptive people.

Methods
A retrospective study was conducted from December 2018 to December 2019 in the Tuberculosis-National Reference Laboratory (TB-NRL) for Bacteriological analysis of samples and Jamot Hospital of Yaounde (JHY) for clinical evaluation of confirmed NTM patients.
We included in this study data of 5267 TB presumptive people previously diagnosed using three consecutive samples and having culture and SD Bioline results with or without Microscopy and reverse hybridization-based Line Probe Assay(LPA) results. The data on co-morbidities or history of people infected with NTM were then collected from the three participants with available clinical data.

Results
We collected data of 5267 presumptive TB people. Among them, 3436 (65.24%), have a positive culture with 3200 (60.75%) isolates belong to Mycobacterium tuberculosis Complex (MBTC) and 236 (4.48%) to NTM. Our results showed that, 123 (52.11%) NTM were isolated from people with negative microscopy and 113 (47.88%) from people with positive microscopy. Among the 236 NTM, 108 (45.8%) isolates were identified using LPA. M. fortuitum was the most represented species (32.41%) followed by M. intracellulare (19.44%). Sputum had the highest proportion of NTM (56%), followed by bronchial aspirations (31%). The extra-pulmonary samples presented lower proportions of isolates compared to pulmonary samples. Some patients affected with NTM presented comorbidities as HIV infection, Pulmonary tuberculosis, Type 2 diabetes, Chronic bronchitis and Alveolar pneumonia.

Conclusions
Our study showed the presence of NTM strains among presumptive TB people with a predominance of M. fortuitum and M. intracellulare. It is important to implement a surveillance system of NTM in TB burden country and also to develop a point-of-care test for NTM identification in limited-resource settings.
Effects of nitrate- and ammonium- nitrogen on anatomical and physiological responses of Catalpa bungei under full and partial root-zone drought
Authors: Xu Ting , Wang Zhiyong , Wang Ziye , Guo Mengfan , Wang Xintong , He Xuelian , Wang Junhui , Rahman Siddiq Ur , Bourhia Mohammed , Alsahli Abdulaziz Abdullah , Zhang Yi 
Published: March 2024

AbstractCatalpa bungei is a precious timber species distributed in North China where drought often occurs. To clarify adaptive responses of C. bungei to partial- and full- root-zone drought under the influence of nitrogen forms, a two-factor experiment was conducted in which well-watered (WW), partial root-zone drought in horizontal direction (H-PRD) and in vertical direction (V-PRD), and full root-zone drought (FRD) were combined with nitrate-nitrogen (NN) and ammonium-nitrogen (AN) treatments. C. bungei responded to FRD by sharply closing stomata, decreasing gas exchange rate and increasing leaf instantaneous water use efficiency (WUEi). Under FRD condition, the growth of seedlings was severely inhibited and the effect of N forms was covered up by the drastic drought effect. In comparison, stomata conductance and gas exchanges were moderately inhibited by PRDs. WUEi in V-PRD treatment was superior to H-PRD due to the active stomata regulation resulting from a higher ABA level and active transcription of genes in abscisic acid (ABA) signaling pathway under V-PRD. Under both PRDs and FRD, nitrate benefited antioxidant defense, stomata regulation and leaf WUEi. Under V-PRD, WUEi in nitrate treatment was superior to that in ammonium treatment due to active stomata regulation by signaling network of nitric oxide (NO), Ca2+ and ABA. Under FRD, WUEi was higher in nitrate treatment due to the favoring photosynthetic efficiency resulting from active NO signal and antioxidant defense. The interactive effect of water and N forms was significant on wood xylem development. Superoxide dismutase (SOD) and catalase (CAT) largely contributes to stress tolerance and xylem development.
Integrative physiological, metabolomic, and transcriptomic analysis reveals the drought responses of two apple rootstock cultivars
Authors: Li Xiaohan , Liu Yitong , Hu Wei , Yin Baoying , Liang Bowen , Li Zhongyong , Zhang Xueying , Xu Jizhong , Zhou Shasha 
Published: March 2024

Abstract
Background
Drought is considered the main environmental factor restricting apple production and thus the development of the apple industry. Rootstocks play an important role in enhancing the drought tolerance of apple plants. Studies of the physiology have demonstrated that ‘ZC9-3’ is a strong drought-resistant rootstock, whereas ‘Jizhen-2’ is a weak drought-resistant rootstock. However, the metabolites in these two apple rootstock varieties that respond to drought stress have not yet been characterized, and the molecular mechanisms underlying their responses to drought stress remain unclear.

Results
In this study, the physiological and molecular mechanisms underlying differences in the drought resistance of ‘Jizhen-2’ (drought-sensitive) and ‘ZC9-3’ (drought-resistant) apple rootstocks were explored. Under drought stress, the relative water content of the leaves was maintained at higher levels in ‘ZC9-3’ than in ‘Jizhen-2’, and the photosynthetic, antioxidant, and osmoregulatory capacities of ‘ZC9-3’ were stronger than those of ‘Jizhen-2’. Metabolome analysis revealed a total of 95 and 156 differentially accumulated metabolites in ‘Jizhen-2’ and ‘ZC9-3’ under drought stress, respectively. The up-regulated metabolites in the two cultivars were mainly amino acids and derivatives. Transcriptome analysis revealed that there were more differentially expressed genes and transcription factors in ‘ZC9-3’ than in ‘Jizhen-2’ throughout the drought treatment. Metabolomic and transcriptomic analysis revealed that amino acid biosynthesis pathways play key roles in mediating drought resistance in apple rootstocks. A total of 13 metabolites, including L-α-aminoadipate, L-homoserine, L-threonine, L-isoleucine, L-valine, L-leucine, (2S)-2-isopropylmalate, anthranilate, L-tryptophan, L-phenylalanine, L-tyrosine, L-glutamate, and L-proline, play an important role in the difference in drought resistance between ‘ZC9-3’ and ‘Jizhen-2’. In addition, 13 genes encoding O-acetylserine-(thiol)-lyase, S-adenosylmethionine synthetase, ketol-acid isomeroreductase, dihydroxyacid dehydratase, isopropylmalate isomerase, branched-chain aminotransferase, pyruvate kinase, 3-dehydroquinate dehydratase/shikimate 5-dehydrogenase, N-acetylglutamate-5-P-reductase, and pyrroline-5-carboxylate synthetase positively regulate the response of ‘ZC9-3’ to drought stress.

Conclusions
This study enhances our understanding of the response of apple rootstocks to drought stress at the physiological, metabolic, and transcriptional levels and provides key insights that will aid the cultivation of drought-resistant apple rootstock cultivars. Especially, it identifies key metabolites and genes underlying the drought resistance of apple rootstocks.
The impact of communication training on the clinical care of hypertension in general practice: a cluster randomized controlled trial in China
Authors: Zou Chuan , Deng Lili , Luo Jianzhao , Dai Hua , Zhang Yu , Guo Ru , Luo Xiaolu , Yang Rong , Song Haiqi , Spicer John , Zhao Qian , Liao Xiaoyang 
Published: March 2024

Abstract
Background
Hypertension is one of the most common chronic diseases with a low control rate globally. The effect of communication skills training contributing to hypertension control remains uncertain. The aim of the present study was to assess the effectiveness of an educational intervention based on the Calgary-Cambridge guide in improving hypertensive management.

Methods
A cluster randomized controlled trial enrolled 27 general practitioners (GPs) and 540 uncontrolled hypertensive patients attending 6 community health centers in Chengdu, China. GPs allocated to the intervention group were trained by an online communication course and two face-to-face workshops based on Calgary-Cambridge guides. The primary outcome was blood pressure (BP) control rates and reductions in systolic and diastolic BP from baseline to 3 months. The secondary outcome was changes in GPs’ communication skills after one month, patients’ knowledge and satisfaction after 3 months. Bivariate analysis and the regression model assessed whether the health provider training improved outcomes.

Results
After the communication training, the BP control rate was significantly higher (57.2% vs. 37.4%, p < 0.001) in the intervention groups. Compared to the control group, there was a significant improvement in GP’s communication skills (13.0 vs 17.5, p < 0.001), hypertensive patients’ knowledge (18.0 vs 20.0, p < 0.001), and systolic blood pressure (139.1 vs 134.7, p < 0.001) after 3 months of follow-up. Random effects least squares regression models showed significant interactions between the intervention group and time period in the change of GP’s communication skills (Parameter Estimated (PE): 0.612, CI:0.310,0.907, p = 0.006), hypertensive patient’s knowledge (PE:0.233, CI: 0.098, 0.514, p < 0.001), satisfaction (PE:0.495, CI: 0.116, 0.706, p = 0.004), SBP (PE:-0.803, CI: -1.327, -0.389, p < 0.001) and DBP (PE:-0.918, CI: -1.694, -0.634, p < 0.001), from baseline to follow-up.

Conclusion
Communication training based on the Calgary-Cambridge guide for GPs has shown to be an efficient way in the short term to improve patient-provider communication skills and hypertension outcomes among patients with uncontrolled BPs.

Trial registration
The trial was registered on Chinese Clinical Trials Registry on 2019–04-03. (ChiCTR1900022278).
High expression of RTEL1 predicates worse progression in gliomas and promotes tumorigenesis through JNK/ELK1 cascade
Authors: Wang Guanjie , Ren Xiaojuan , Li Jianying , Cui Rongrong , Zhao Xumin , Sui Fang , Liu Juan , Chen Pu , Yang Qi , Ji Meiju , Hou Peng , Gao Ke , Qu Yiping 
Published: March 2024

AbstractGliomas are the most common primary intracranial tumor worldwide. The maintenance of telomeres serves as an important biomarker of some subtypes of glioma. In order to investigate the biological role of RTEL1 in glioma. Relative telomere length (RTL) and RTEL1 mRNA was explored and regression analysis was performed to further examine the relationship of the RTL and the expression of RTEL1 with clinicopathological characteristics of glioma patients. We observed that high expression of RTEL1 is positively correlated with telomere length in glioma tissue, and serve as a poor prognostic factor in TERT wild-type patients. Further in vitro studies demonstrate that RTEL1 promoted proliferation, formation, migration and invasion ability of glioma cells. In addition, in vivo studies also revealed the oncogene role of RTEL1 in glioma. Further study using RNA sequence and phospho-specific antibody microarray assays identified JNK/ELK1 signaling was up-regulated by RTEL1 in glioma cells through ROS. In conclusion, our results suggested that RTEL1 promotes glioma tumorigenesis through JNK/ELK1 cascade and indicate that RTEL1 may be a prognostic biomarker in gliomas.