Ultrasonographic modeling of lung and diaphragm mechanics: clinical trial of a novel non-invasive method to evaluate pre-operative pulmonary function
Background Pre-operative pulmonary function testing (PFT) plays a key role in predicting postoperative complications or functional impairment. However, PFT requires the subject and examiner to cooperate and the results are influenced by both technical and personal factors. In contrast, the use of ultrasound (US) for structural and functional assessments of the lungs and diaphragm is on the rise, as it requires minimal patient cooperation. Dyspnea is mainly caused by lung or pleural lesions but may also be caused by weak respiratory muscles. As the diaphragm is a primary respiratory muscle, combining lung ultrasonography (LUS) with diaphragm ultrasound (DUS) may enable a more comprehensive assessement of pulmonary function. This study aims to introduce a novel approach for assessing pulmonary function using a mathematical model based on LUS and DUS. Methods This prospective study was performed at the First Affiliated Hospital of Nanchang University between June 2021 and December 2021, 208 patients were recruited and underwent PFT, LUS, and DUS examinations. An experienced physician, blinded to the clinical history and PFT results, performed LUS and DUS and explored the correlations between a mathematical model (ultrasonographic modeling score (U-score)) using LUS combined with DUS and pulmonary function parameters. Univariate, multivariate, and logistic regression analyses were also performed. Results According to the univariate and multivariable analysis, diaphragm thickness fraction in deep breathing (D-DTF) (odds ratio (OR), 0.88; 95% confidence interval (CI) [0.83–0.94]; P < 0.001), and LUS score (OR, 1.44; 95% CI [1.16–1.80]; P < 0.001) were each independently associated with pulmonary function. According to the logistics equation, a U-score of −0.126 × D-DTF + 0.368 × LUS score was produced. The U-score showed a more significant negative correlation with forced expiratory volume in the first second/forced vital capacity (FEV1/FVC) (r = −0.605, P < 0.001) than the LUS or DUS indices alone. The U-score (area under the curve (AUC) = 0.971) was greater than the other indices for assessing pulmonary function. Conclusions With validation, the U-score through both lung and diaphragm ultrasound measurements may assist in estimating pulmonary function. This approach facilitates the assessment of pulmonary function in patients who may be unable to reliably participate in PFT.
Li et al. (2024) Ultrasonographic modeling of lung and diaphragm mechanics: clinical trial of a novel non-invasive method to evaluate pre-operative pulmonary function. PeerJ 12:e18677 https://doi.org/10.7717/peerj.18677
Ferroptosis and its impact on common diseases
Ferroptosis is a novel form of programmed cell death characterized by iron accumulation, lipid peroxidation, and a decline in antioxidant capacity, all of which are regulated by gene expression. The onset of numerous diseases is closely associated with ferroptosis. Common diseases affect a large population, reduce the quality of life, and impose an increased burden on the healthcare system. The role of ferroptosis in common diseases, its therapeutic potential, and even its translation into clinical drug treatments are currently significant research topics worldwide. This study preliminarily explores the theoretical basis of ferroptosis, its mechanism and treatment prospect in common diseases including ischaemia-reperfusion injury, inflammatory bowel diseases, liver fibrosis, acute kidney injury, diabetic kidney disease, stroke, Alzheimer’s disease, cardiovascular disease, immune and cancer. This review provides a theoretical foundation for the further study and development of ferroptosis, as well as for the prevention and treatment of common diseases.
Zou et al. (2024) Ferroptosis and its impact on common diseases. PeerJ 12:e18708 https://doi.org/10.7717/peerj.18708
Diversity analysis of microorganisms on the surface of four summer fruit varieties in Baotou, Inner Mongolia, China
Improper storage of post-harvest fruits leads to significant losses, especially due to microbial-induced decay. Understanding the naturally occurring microbial communities on fruit surfaces and their functions is the first step in the development of new strategies for controlling post-harvest fruit decay. These new strategies could generate significant economic value by improving fruit preservation and extending the shelf-life of fruit. In the present study, 16S rRNA and ITS high-throughput sequencing technologies were used to analyze the diversity and composition of microorganisms on the surfaces of four different fruit varieties: three plum varieties and one apple variety, all from the same orchard in Donghe District, Baotou City, China. The results displayed no notable difference in bacterial diversity on the surfaces of the four varieties of fruits (P > 0.05), but there were significant differences in fungal diversity (P < 0.05). The most abundant bacterial phyla detected on the fruit surfaces were Proteobacteria, Bacteroidota, and Firmicutes; the most abundant fungal phyla were Ascomycota, Basidiomycota, and Mortierellomycota. Though microbial compositions on the fruit surfaces differed between the fruits, the surface microbial community structure of the three plum varieties exhibited higher similarity, indicating that fruit type is a key factor influencing the composition of surface microorganisms. There were also differences in the epidermal microbial community composition between the fruits involved in this study and fruits of the same species reported from other regions, suggesting that geographical factors also play a critical role in microbial composition. The correlation analysis revealed significant associations between the microorganisms with the highest abundance on the surface of the fruits, suggesting the existence of symbiotic and mutualistic relationships between these microorganisms, but the specific mechanisms behind these relationships need to be further explored. This study provides a basis for the establishment of post-harvest fruit preservation strategies.
He et al. (2024) Diversity analysis of microorganisms on the surface of four summer fruit varieties in Baotou, Inner Mongolia, China. PeerJ 12:e18752 https://doi.org/10.7717/peerj.18752
A novel model based on clinical and computed tomography (CT) indices to predict the risk factors of postoperative major complications in patients undergoing pancreaticoduodenectomy
Background Postoperative complications are prone to occur in patients after radical pancreaticoduodenectomy (PD). This study aimed to construct and validate a model for predicting postoperative major complications in patients after PD. Methods The clinical data of 360 patients who underwent PD were retrospectively collected from two centers between January 2019 and December 2023. Visceral adipose volume (VAV) and subcutaneous adipose volume (SAV) were measured using three-dimensional (3D) computed tomography (CT) reconstruction. According to the Clavien-Dindo classification system, the postoperative complications were graded. Subsequently, a predictive model was constructed based on the results of least absolute shrinkage and selection operator (LASSO) multivariate logistic regression analysis and stepwise (stepAIC) selection. The nomogram was internally validated by the training and test cohort. The discriminatory ability and clinical utility of the nomogram were evaluated by area under the receiver operating characteristic (ROC) curve (AUC), calibration curve, and decision curve analysis (DCA). Results The major complications occurred in 13.3% (n = 48) of patients after PD. The nomogram revealed that high VAV/SAV, high system inflammation response index (SIRI), high triglyceride glucose-body mass index (TyG-BMI), low prognostic nutritional index (PNI) and CA199 ≥ 37 were independent risk factors for major complications. The C-index of this model was 0.854 (95%CI [0.800–0.907]), showing excellent discrimination. The calibration curve demonstrated satisfactory concordance between nomogram predictions and actual observations. The DCA curve indicated the substantial clinical utility of the nomogram. Conclusion The model based on clinical and CT indices demonstrates good predictive performance and clinical benefit for major complications in patients undergoing PD.
Wang et al. (2024) A novel model based on clinical and computed tomography (CT) indices to predict the risk factors of postoperative major complications in patients undergoing pancreaticoduodenectomy. PeerJ 12:e18753 https://doi.org/10.7717/peerj.18753
Comparative meta-analysis of cold snare polypectomy and endoscopic mucosal resection for colorectal polyps: assessing efficacy and safety
Colorectal polyps are commonly treated with surgical procedures, with cold snare polypectomy (CSP) and endoscopic mucosal resection (EMR) being the two most prevalent techniques. This meta-analysis (PROSPERO ID: CRD42022336152) aimed to compare the efficacy and safety of CSP and EMR in the management of colorectal polyps. Comprehensive searches were conducted in PubMed, Embase, CINAHL, Web of Science, and Cochrane Library databases, covering publications up until June 2024. The primary outcome was complete resection rate, and secondary outcomes included en bloc resection rate, immediate and delayed bleeding, perforation, and procedure time. The Mantel–Haenszel method was employed for the analysis of binary endpoints, while the inverse variance method was used for continuous outcomes. Subgroup analysis was performed to explore potential sources of heterogeneity. Six studies involving 15,296 patients and 17,971 polyps were included in the meta-analysis. CSP had a significantly lower complete resection rate compared to EMR (OR: 0.44, 95% CI [0.21–0.94], p = 0.0334). However, there was no significant difference between CSP and EMR in en bloc resection rate, perforation, or procedure time. Interestingly, CSP had a significantly lower delayed bleeding rate compared to EMR (OR: 0.45, 95% CI [0.27–0.77], p = 0.0034), but there was no significant difference in immediate bleeding rate. In conclusion, CSP is a safe, efficient, and effective technique comparable to EMR. The choice of technique should be based on the individual patient and polyp characteristics.
Wang et al. (2024) Comparative meta-analysis of cold snare polypectomy and endoscopic mucosal resection for colorectal polyps: assessing efficacy and safety. PeerJ 12:e18757 https://doi.org/10.7717/peerj.18757
Bone histology and growth curve of the earliest ceratopsian Yinlong downsi from the Upper Jurassic of Junggar Basin, Northwest China
Yinlong downsi, the earliest known ceratopsian, is represented by dozens of specimens of different sizes collected from the Upper Jurassic of the Junggar Basin, northwestern China. Here, we present the first comprehensive study on the bone histology of Yinlong downsi based on ten specimens varying in size. Four ontogenetic stages are recognized: early juvenile, late juvenile, subadult, and adult. The reconstructed growth curve suggests that Yinlong may reach sexual maturity at 6 years old, which is earlier than that of the well-studied early-diverging ceratopsian Psittacosaurus (9 years old) but later than ceratopsids (about 3 to 5 years old). This may indicate that sexual maturity begins earlier during the evolution of ceratopsians, and that the giant size of ceratopsids is acquired by accelerating growth rates. The cortex of the tibia mainly consists of fibrolamellar bone tissues, but parallel-fibered bone and lines of arrested growth (LAGs) are very common throughout ontogeny, suggesting a moderate growth rate. Quantitative analysis indicates that Yinlong has a maximum growth rate similar to those of other small-sized dinosaurs such as Psittacosaurus, Dysalotosaurus, and Troodon, and their maximum growth rates are higher than those of extant squamates and crocodiles but lower than those of extant mammals and large dinosaurs. This suggests that body size plays a more important role in growth rate than other factors such as phylogenetic position and/or diet among non-avian dinosaurs.
Han et al. (2024) Bone histology and growth curve of the earliest ceratopsian Yinlong downsi from the Upper Jurassic of Junggar Basin, Northwest China. PeerJ 12:e18761 https://doi.org/10.7717/peerj.18761
Flipped classroom-based application of Peyton’s four-step approach in standardized training of ultrasound residents for thyroid and cervical lymph node zoning
Background To investigate whether combining the flipped classroom approach with Peyton’s four-step method can enhance teaching effectiveness in ultrasound (US) zoning of the thyroid and cervical lymph nodes for standardized residency training. Methods A total of 66 resident training students were randomly divided into a control group and an observation group. The control group received traditional teaching methods, including “see one, do one” learning, lecture-based learning (LBL), and case-based learning (CBL). The observation group was taught using Peyton’s four-step teaching method, the flipped classroom approach, and CBL. Assessments were conducted through skill operation and clinical case analysis. A questionnaire survey was used to evaluate student satisfaction. Assessment scores and questionnaire ratings between the two teaching methods were compared. Results 1) Assessment results demonstrated higher scores in skill operation and clinical case analysis for the observation group compared to the control group [(87.64 ± 3.72) vs. (80.48 ± 5.92) points, (87.94 ± 4.46) vs. (82.85 ± 4.24) points]. 2) The questionnaire survey indicated that resident trainees taught using Peyton’s four-step method showed greater improvement in learning interest [(4.61 ± 0.57) vs. (3.70 ± 0.85) points] and experienced reduced exam pressure compared to the control group [(4.52 ± 0.62) vs. (3.21 ± 0.70) points]. These differences were statistically significant (P < 0.05). Conclusion Peyton’s four-step approach combined with the flipped classroom method improved resident training students’ scores in skill operation and clinical case analysis for ultrasound zoning of the thyroid and cervical lymph nodes. It also stimulated learning interest and alleviated exam pressure, making it an effective teaching method for enhancing standardized US training outcomes in resident education.
Wang et al. (2024) Flipped classroom-based application of Peyton’s four-step approach in standardized training of ultrasound residents for thyroid and cervical lymph node zoning. PeerJ 12:e18633 https://doi.org/10.7717/peerj.18633
Different prevalence and spectrum of malignancy between Chinese patients and American patients with rheumatoid arthritis: a comparative study
Objective To characterize the epidemiological characteristics of malignancy in Chinese patients with rheumatoid arthritis (RA) versus American patients and investigate their associated factors. Methods Data were collected from a real-world Chinese RA population and American patients with RA from the National Health and Nutritional Examination Survey. The prevalence and subtypes of malignancy and their potential associated factors were investigated in both populations. Results A total of 2,073 Chinese and 2,928 American patients with RA were included. There was a lower prevalence of malignancy in Chinese than in their American counterparts before (5.7% vs. 17.1%) and after matching (6.2% vs. 12.6%, both P < 0.001). Gender discrepancies in malignancy prevalence were observed, with a male predilection for RA with malignancy in China (8.2% vs. 5.5%), while it was the opposite in American patients (10.1% vs. 13.5%, both P < 0.05). The top type of malignancy among male patients with RA was lung cancer in Chinese (2.29%), but non-melanoma skin cancer (3.43%) in American; while among female patients was breast cancer both in Chinese (1.72%) and American (3.43%). Multivariate logistic regression analyses showed that older age (odds ratio (OR) = 1.050) and positive anti-cyclic citrullinated peptide antibody (OR = 2.752) were independently associated with malignancy in Chinese patients with RA, while female (OR = 1.395), older age (OR = 1.033), active smoking (OR = 1.580) and cardiovascular diseases (OR = 1.523) in American patients. Conclusion The prevalence, subtypes and risk factors of malignancy were substantially different in Chinese patients with RA and their American counterparts, which implied the importance of individualized malignancy screening strategies for patients with RA.
Ouyang et al. (2024) Different prevalence and spectrum of malignancy between Chinese patients and American patients with rheumatoid arthritis: a comparative study. PeerJ 12:e18650 https://doi.org/10.7717/peerj.18650
Comparative analysis of Hymenasplenium (Aspleniaceae) chloroplast genomes from China
Hymenasplenium is one of the two genera in the large fern family Aspleniaceae. A previous study explored the molecular phylogeny of this genus using several chloroplast DNA fragments and identified three major clades, one of which is the monophyletic Old World clade with southwestern China as its diversity center. To date, there were only a few studies conducted on chloroplast genomes in Hymenasplenium or Aspleniaceae, limiting the understanding of the plastome features and its role in evolution of this group. Here, we studied the complete chloroplast genomes of 12 Hymenasplenium species covering all four subclades of the Old World clade distributed in China. The length of the Hymenasplenium plastomes ranged from 151,617 to 151,930 bp, and contained 129 genes in total, comprising 87 protein-coding, 34 tRNA, and eight rRNA genes. The GC content ranged from 41.8% to 42.1%. Comparative analyses of the Hymenasplenium chloroplast genomes displayed conserved genomic structure and identical gene arrangement. A total of 1,375 simple sequence repeats and 1,639 large repeats were detected. In addition, we detailed hypervariable regions that can be helpful for further phylogenetic research and species delimitation in Hymenasplenium. Furthermore, we supported phylogenetic relationships among major groups as well as possible cryptic speciation found in previous research in the genus. Our study provides new insights into evolutionary history and basic resources for phylogenetic and taxonomic studies of the genus Hymenasplenium.
Chang et al. (2024) Comparative analysis of Hymenasplenium (Aspleniaceae) chloroplast genomes from China. PeerJ 12:e18667 https://doi.org/10.7717/peerj.18667
The effect of varying thicknesses of mineral trioxide aggregate (MTA) and Biodentine as apical plugs on the fracture resistance of teeth with simulated open apices: a comparative in vitro study
Background This study evaluates the fracture resistance of apical plugs created from Biodentine and mineral trioxide aggregate (MTA) in thicknesses of 3 and 5 mm within simulated open apex tooth models. Methods Fifty human maxillary central incisors were obtained from a pool of freshly extracted teeth. In order to replicate open apices without cavity preparation, ten teeth in the control group received apical-to-coronal preparation with Peeso reamers. The remaining 40 teeth were randomly assigned to four experimental groups and received either 3 or 5 mm Biodentine or MTA apical plugs. Results The mean fracture loads observed in this study were as follows: control group, 431.48 N (±34.55); 3 mm MTA, 774.88 N (±62.74); 5 mm MTA, 752.65 N (±73.79); 3 mm Biodentine, 918.25 N (±59.09); and 5 mm Biodentine, 903.42 N (±24.48). Specifically, teeth in the Biodentine group demonstrated considerably stronger fracture resistance compared to those in the MTA group (p < 0.001). However, no significant differences were observed between the 3 and 5 mm thicknesses (MTA: p = 0.98, Biodentine: p = 0.99), suggesting that plug thickness did not affect fracture resistance within both groups. Conclusion Biodentine apical plugs provided the highest fracture resistance among the materials, regardless of thickness.
Panjwani et al. (2024) The effect of varying thicknesses of mineral trioxide aggregate (MTA) and Biodentine as apical plugs on the fracture resistance of teeth with simulated open apices: a comparative in vitro study. PeerJ 12:e18691 https://doi.org/10.7717/peerj.18691