Cross-sectional Area Research Articles

Evaluation of patient immunocompetence for immune checkpoint inhibitor therapy using the psoas muscle index: a retrospective cohort study

IntroductionIn patients with cancer, sarcopenia is an indicator of poor prognosis and is associated with an increased risk of chemotherapy-related adverse events. Skeletal muscle interacts with the immune system, and sarcopenia is associated with immune senescence. However, the association between sarcopenia and the response to immune checkpoint inhibitor (ICI) therapy remains unclear.MethodsThis retrospective study included patients with advanced or recurrent non-small cell lung cancer treated with nivolumab or pembrolizumab monotherapy. The association between the psoas muscle index (PMI) and both clinical response and immune-related adverse events (irAEs) was assessed using logistic regression. The PMI was calculated as the cross-sectional area of the psoas muscle divided by the square of the height based on computed tomography scans performed before the initial administration of ICI therapy.ResultsA total of 67 patients were included in the analysis. Logistic regression analysis showed that PMI was associated with the overall response (odds ratio [OR]: 1.52; 95% confidence interval [CI]: 1.04–2.22; p = 0.030) and the risk of severe irAEs (OR: 1.72; 95% CI: 1.05–2.80; p = 0.031).ConclusionThese findings suggest that PMI is both an indicator of prognosis and a surrogate marker of immunocompetence in predicting the clinical response to ICI therapy.

Potential of Acacia Extract as a Collagen Crosslinker and Stabilizer of the Resin-dentin Interface.

The aim of this study was to investigate whether different concentrations of acacia extract could improve the biological stability of dentin collagen. Slice (n=3) and beam (n=5) samples of dentin obtained from human third molars were demineralized and treated with the following solutions: G1 (control)-deionized water; G2-1% acacia extract; G3-2% acacia extract; and G4-3% acacia extract. The dentin slices were analyzed by Fourier transform infrared (FTIR) spectrophotometry to observe their interactions with collagen. The beams were submitted to digestion with type I bacterial collagenase solution, and the percentage of weight was calculated to evaluate the resistance to enzymatic biodegradation. The Adper Scotchbond Multipurpose adhesive system was applied on the flat dentin surfaces according to the manufacturer's recommendations (G1). In groups G2, G3 and G4, acacia extract at concentrations of 1%, 2%, and 3%, respectively, were applied after acid etching. A resin composite block was built on the adhesive, and the teeth were cut to obtain beams (n=7 teeth; ~12 beams per tooth) with cross-sectional areas of approximately 0.8 mm2. Half of the specimens were submitted to the microtensile bond strength (µTBS) test in a universal testing machine at a crosshead speed of 0.5 mm/min, and the other half were submitted to the µTBS test after six months of storage in distilled water. FTIR analysis showed the interactions of the three concentrations of acacia extract with collagen. According to ANOVA and Tukey tests, G1 had the highest biodegradation rate (100%), which was significantly higher than the rates of G2 (24%), G3 (23%) and G4 (17%) (p<0.05). According to two-way ANOVA and Tukey tests, only G1 showed a significant decrease in µTBS after six months of storage (p<0.05). It was concluded that 1%, 2%, and 3% acacia extract all interacted with human dentin collagen, reduced collagen biodegradation and favored the stabilization of the bonding interface at the six-month evaluation.

Sarcopenia, myosteatosis and inflammation are independent prognostic factors of SARS-CoV-2 pneumonia patients admitted to the ICU

The aims of our study were to assess the correlations between sarcopenia and myosteatosis assessed by CT-scan at T4 and/or L3 levels and inflammation in critically ill COVID patients on ICU admission, and their respective prognostic value on day 90 death (D90-death). It is a retrospective monocentric study. Sarcopenia was defined by skeletal muscle cross sectional surface area (CSA) and myosteatosis by skeletal muscle density (SMD) at L3 and T4 levels. Inflammatory biomarkers were collected on ICU admission. Of the 239 patients, 74 died by D90; 66.6% get sarcopenia on ICU admission. CSA at T4 level was an independent risk factor for D90-death (1.66[1.03; 2.66]; p = 0.04), as were procalcitonin (2.03[1.2; 3.43]; p = 0.01) and IL-6 levels (1.56[0.96; 2.54]; p = 0.07). In addition, we found correlation factors of 0.79 (p < 0.01) between SMD at T4 and L3 levels, and a correlation factor of 0.64 (p < 0.01) between CSA at T4 and L3 levels.These results indicate a poorer prognosis following a decrease in muscle surface area, a decrease in density, and an increase in inflammatory biomarkers such as Il6. It also suggests that incorporating indices of sarcopenia with inflammatory biomarkers may improve prognostic accuracy.

Assessment of Carpal Tunnel Syndrome in Patients With Wrist Involvement During the Course of Inflammatory Arthritis. A Cross-Sectional Study.

The aim of the study was to evaluate the ultrasonographic (United States) alterations of the median nerve, the performance of the Kamath screening questionnaire and the clinical examination (Tinel and Phanel test) in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) with previous or present inflammatory involvement of the radio-ulno-carpal joint. A cross-sectional study was carried out. Patients with RA and PsA and clinical symptoms suggestive of CTS were consecutively recruited. The main clinical-demographic characteristics were collected in all patients. The Kamath questionnaire was administered to all patients during the clinic visit. The US examination was used as a 'gold-standard' for the diagnosis of CTS (transverse nerve area >12mm2 and morpho-structural alterations) and was used to assess the sensitivity and specificity of the Kamath questionnaire and the Tinel and Phanel clinical tests. 44 patients, 34 patients with RA and 10 patients with PsA were evaluated. 7 (16%) patients had a median nerve cross-sectional area >12mm2, associated with US abnormalities of the nerve. The Kamath questionnaire showed moderate sensitivity values (71.4%) but low specificity (56.7%) for ultrasonographic diagnosis of CTS with a negative predictive value of 91.3%. Clinical tests show low sensitivity but high specificity. No statistically significant correlations were found with the main clinical variables. The screening questionnaire showed moderate sensitivity but low specificity compared to the ultrasound 'gold standard'. Clinical tests may support the diagnosis of CTS in these conditions.

Neuromuscular electrical stimulation training induces myonuclear accretion and hypertrophy in mice without overt signs of muscle damage and regeneration

BackgroundSkeletal muscle is a plastic tissue that adapts to increased mechanical loading/contractile activity through fusion of muscle stem cells (MuSCs) with myofibers, a physiological process referred to as myonuclear accretion. However, it is still unclear whether myonuclear accretion is driven by increased mechanical loading per se, or occurs, at least in part, in response to muscle injury/regeneration. Here, we developed a non-damaging protocol to evaluate contractile activity-induced myonuclear accretion/hypertrophy in physiological conditions. MethodsContractile activity was generated by applying repeated electrical stimuli over the mouse plantar flexor muscles. This method is commonly referred to as NeuroMuscular Electrical Simulation (NMES) in Human. Each NMES training session consisted of 80 isometric contractions delivered at ∼15% of maximal tetanic force to avoid muscle damage. C57BL/6J male mice were submitted to either a short (i.e., 6 sessions) or long (i.e., 12 sessions) individualized NMES training program while unstimulated mice were used as controls. Histological investigations were performed to assess the impact of NMES on MuSC number and status, myonuclei content and muscle tissue integrity, typology and size.ResultsNMES led to a robust proliferation of MuSCs and myonuclear accretion in the absence of overt signs of muscle damage/regeneration. NMES-induced myonuclear accretion was specific to type IIB myofibers and was an early event preceding muscle hypertrophy inasmuch as a mild increase in myofiber cross-sectional area was only observed in response to the long-term NMES training protocol.ConclusionWe conclude that NMES-induced myonuclear accretion and muscle hypertrophy are driven by a mild increase in mechanical loading in the absence of overt signs of muscle injury.

Laser-Induced Breakdown Spectroscopy Using 2D Structured Light: A Case of Spectral Signal Enhancement on Metal Samples.

Laser-induced breakdown spectroscopy (LIBS), an elemental detection technique with great potential, faces many problems mainly caused by the nonideal plasma properties in the detection window. The 2D laser energy distribution on the sample surface has a crucial impact on the plasma properties and spectral emission. However, relevant studies are still limited, lacking a good degree of freedom (DOF) to systematically explore its influence. In this work, 2D structured light was generated by using a spatial light modulator (SLM). Various focal patterns with different cross-section areas were tested using metal samples so that the effects of the focal spot structure and cross-section area could be separated. The arrow-target and anticone of 200 μm diameter resulted in a line enhancement factor of more than 3 for a pure aluminum sample and a factor of about 6 for the pure copper sample over that without beam modulation. A significant improvement in the signal-to-noise ratio and a reduction in the limit of detection (LOD) of Cr, Mn, Si, Cu, and Al by a factor of about 6 were also achieved with the bearing steel sample. To better understand the mechanism behind such improvements, time-resolved spectra were measured, from which the electron density and plasma temperature evolution were calculated. The results showed that with anticone and arrow-target patterns, the electron density was increased by more than 50%, while the plasma temperature varied less than 500 K, suggesting an evident ablation enhancement. The fast images of plasma self-emission proved that the laser energy distribution substantially influenced the morphology of the plasma plume. The plasma cores produced by the anticone and arrow-target focal patterns were more compact after the expansion and cooling process, which could reduce the mixing of plasma plumes and ambient air. Thus, with the first application of SLM in LIBS, focal spot structures of micrometer resolution could be rationally designed and generated with a high DOF. Substantial spectral signal enhancement and a much lower LOD were achieved. This study provides new insights into the role of focal patterns in plasma properties, suggesting the future possibility of plasma control using structured light.

HBMSC-EVs alleviate weightlessness-induced skeletal muscle atrophy by suppressing oxidative stress and inflammation

BackgroundMuscle disuse and offloading in microgravity are likely the primary factors mediating spaceflight-induced muscle atrophy, for which there is currently no effective treatment other than exercise. Extracellular vesicles derived from bone marrow mesenchymal stem cells (BMSC-EVs) possess anti-inflammatory and antioxidant properties, offering a potential strategy for combating weightless muscular atrophy.MethodsIn this study, human BMSCs-EVs (hBMSC-EVs) were isolated using super-centrifugation and characterized. C2C12 myotube nutrition-deprivation and mice tail suspension models were established. Subsequently, the diameter of C2C12 myotubes, Soleus mass, cross-sectional area (CSA) of muscle fibers, and grip strength in mice were assessed to investigate the impact of hBMSC-EVs on muscle atrophy. Immunostaining, transmission electron microscopy observation, and western blot analysis were employed to assess the impact of hBMSC-EVs on muscle fiber types, ROS levels, inflammation, ubiquitin–proteasome system activity, and autophagy lysosome pathway activation in skeletal muscle atrophy.ResultsThe active hBMSC-EVs can be internalized by C2C12 myotubes and skeletal muscle. hBMSC-EVs can effectively reduce C2C12 myotube atrophy caused by nutritional deprivation, with a concentration of 10 × 108 particles/mL showing the best effect (P < 0.001). Additionally, hBMSC-EVs can down-regulate the protein levels associated with UPS and oxidative stress. Moreover, intravenous administration of hBMSC-EVs at a concentration of 1 × 1010 particles/mL can effectively reverse the reduction in soleus mass (P < 0.001), CSA (P < 0.01), and grip strength (P < 0.001) in mice caused by weightlessness. They demonstrate the ability to inhibit protein degradation mediated by UPS and autophagy lysosome pathway, along with the suppression of oxidative stress and inflammatory responses. Furthermore, hBMSC-EVs impede the transition of slow muscle fibers to fast muscle fibers via upregulation of Sirt1 and PGC-1α protein levels.ConclusionsOur findings indicate that hBMSC-EVs are capable of inhibiting excessive activation of the UPS and autophagy lysosome pathway, suppressing oxidative stress and inflammatory response, reversing muscle fiber type transformation, effectively delaying hindlimb unloading-induced muscle atrophy and enhancing muscle function. Our study has further advanced the understanding of the molecular mechanism underlying muscle atrophy in weightlessness and has demonstrated the protective effect of hBMSC-EVs on muscle atrophy.

Ability of Upper Airway Metrics to Predict Obstructive Sleep Apnea Severity: A Systematic Review.

The lack of consensus regarding the association between airway narrowing and the severity of obstructive sleep apnea (OSA) presents a significant challenge in understanding and diagnosing this sleep disorder. The study aimed to systematically review the literature to investigate the relationship between upper airway measurements and the severity of OSA defined by the apnea-hypopnea index (AHI). PubMed, Scopus and Web of Science were systematically searched on the 21st of March 2023 for articles of OSA patients as diagnosed by polysomnography, investigating the correlation between upper airway measurements and AHI using CBCT or MDCT. Quality assessment was done using the New Castle-Ottawa Scale. The results were subsequently synthesized descriptively. The database search identified 1253 results. Fourteen studies, encompassing 720 patients, met the eligibility criteria. Upper airway length showed moderate to weak positive correlation with AHI. Minimal cross-sectional area had varying correlations with AHI, ranging from strong negative to no correlation. Nasopharyngeal volumes showed moderate negative to weak correlations with AHI. Total upper airway volume ranged from strong negative to weak correlation with AHI. Other measurements exhibited weak or very weak correlations with AHI. Among the variables investigated, the minimal cross-sectional area and, to a lesser extent, the volume of the upper airway in OSA patients demonstrated the most promising correlation with the AHI. However, the preponderance of evidence suggests that upper airway length, cross-sectional area and volume as measured by CBCT or MDCT are weak predictors of OSA.

Changes of pharyngeal airway structure and function in patients with skeletal class III malocclusion one year after orthognathic surgery.

This study aimed to analyze changes in the pharyngeal airway structure and function in patients with skeletal Class III malocclusion one year after orthognathic surgery. In this research, cone-beam computed tomography (CBCT) images of 30 patients (14 men and 16 women; mean age 20-30 years) with skeletal Class III malocclusion who underwent Lefort I osteotomy and bilateral sagittal split osteotomy were obtained before and one year after the surgery. Changes in pharyngeal airway structure were achieved by comparing CBCT data, and changes in function were achieved by comparing fluid dynamics models. The pharyngeal airway was analyzed by Element 3D (E3D) and the nasal airway 3D model was reconstructed. The meshing was implemented in ICEM-CFD (ANSYS, Canonsburg, PA, USA), and improved the mesh quality. The meshes were imported into Fluent (ANSYS, Canonsburg, PA, USA) to stimulate a fluid analysis. The minimal anteroposterior diameter, minimal cross-sectional area and volume of pharyngeal airway were significantly reduced after surgery. There was no significant difference in the nasopharyngeal cross-sectional area. Pharyngeal airway resistance increased significantly after surgery, wall shear stress changed little before and after surgery. The anatomic structure of pharyngeal airway changed after surgery, but the morphological change of pharyngeal airway was not significant. One year after surgery, the anatomical structure and function changed compared with those before surgery, and the changes of minimal cross-sectional area of pharyngeal airway should be considered when designing the treatment plan for the patients.

Clinical Significance of Sarcopenia Defined by the Cross-Sectional Area of the Masseter Muscle in Cerebrovascular Events: A Retrospective Cohort Study

Background and Objectives: This study aimed to investigate the clinical significance of sarcopenia, defined by the cross-sectional area of the masseter muscle (CSA-M), as an early marker for sarcopenia diagnosis and its association with mortality in patients with cerebrovascular events (CVE). Materials and Methods: In this retrospective cohort study, 120 patients aged 65 years or older with CVE admitted to Bilkent City Hospital between September 2020 and September 2023 were included. Patients with malignancy, prior CVE, or incomplete data were excluded. Parameters such as CSA-M measured via brain CT, Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores, Nutritional Risk Score (NRS), duration of ICU and hospital stays, and 28-day mortality were evaluated. The CSA-M thresholds for sarcopenia were defined as &lt;400 mm2 for men and &lt;300 mm2 for women. Results: Sarcopenia prevalence was significantly associated with prolonged ICU (27.0 ± 33.1 days vs. 16.5 ± 22.4 days, p = 0.042) and hospital stays (34.8 ± 38.4 days vs. 21.3 ± 22.3 days, p = 0.017). Right and left CSA-M values were significantly lower in sarcopenic patients (p &lt; 0.001). ROC analysis revealed CSA-M cut-off values of &lt;300 mm2 (AUC = 0.82) for men and &lt;295 mm2 (AUC = 0.83) for women as strong predictors of sarcopenia. Multivariate regression analysis showed a significant association between CSA-M and 28-day mortality (p &lt; 0.05). Sarcopenia also correlated with lower albumin levels, a higher prevalence of ischemic stroke, and increased mechanical ventilation needs. Conclusions: CSA-M measured via brain CT is a reliable marker for sarcopenia and a predictor of clinical outcomes in CVE patients. Early identification and management of sarcopenia could improve patient prognosis. Further research is warranted to explore its potential in broader clinical contexts.

Development of a Pediatric Age-Based and Weight-Adjusted Nomogram for Bladder Volumes Associated With Successful Completion of Transabdominal Pelvic Ultrasound (TPU).

To develop a nomogram for pediatric bladder volumes associated with the successful completion of transabdominal pelvic ultrasound (TPU) in female pediatric patients presenting with lower abdominal and/or pelvic pain in the emergency department. This study hypothesizes that the target bladder volumes for successful TPU vary by age and weight. We retrospectively calculated bladder volumes on all successful transabdominal pelvic ultrasound studies during a 2-year period for patients 8 to 18 years old by ellipsoid bladder volume formula using the largest cross-sectional areas captured on transverse and longitudinal cine clips. Measurements were collected by 2 study personnel with initial measurements validated by a pediatric radiologist. Bladder volume by age and weight percentile groups were descriptively analyzed, and a quantile regression model was used to regress bladder volume on age adjusting for patient weight. We analyzed bladder volumes from 1030 successful transabdominal pelvic ultrasound studies. The greatest drop in median volume was seen amongst non-overweight children in younger age groups. Nomogram bladder volumes for transabdominal pelvic ultrasound increase consistently with age and weight until approximately 13 years old and 60kg, respectively, with minimal change thereafter in patients 13 to 18 years old. We provide a pediatric age-based and weight-adjusted nomogram for bladder volumes associated with successful transabdominal pelvic ultrasound imaging. Further evaluation of its use is warranted to decrease inefficiency in bladder filling prior to TPU completion and improve timeliness in diagnosing pelvic emergencies.

Association between nasal cross-sectional areas and obstructive sleep apnea identified using acoustic rhinometry and computed tomography.

Obstructive sleep apnea (OSA) is a prevalent disorder associated with severe comorbidities. Anatomical variations, including nasal diseases, have been identified as potential contributing factors. This study aimed to explore the relationship between nasal cross-sectional areas (CSAs) and OSA, using both acoustic rhinometry (AR) and computed tomography (CT). A retrospective analysis was conducted on 355 individuals who underwent polysomnography (PSG), paranasal sinus CT, and AR. Clinical characteristics were compared among the non-OSA, mild OSA, moderate OSA, and severe OSA patients. Multiple logistic regression was used to determine the influence of nasal cross-sectional areas (CSAs) on the risk of developing moderate or severe OSA, with adjustments for sex, age, and body mass index. Significant associations between specific AR-measured CSA values of anterior nasal region and moderate-severe OSA were identified upon adjusting for confounders (p = 0.034, 0.010, and 0.025, respectively). The lower CSA measurements between the right and the left sides showed a stronger correlation with moderate-severe OSA than the summed values, suggesting the importance of the narrower nasal passage in OSA severity. No significant impact of CSA values on the development of severe OSA was observed. Nasal CSA measured using AR appears to be a better method for verifying its association with OSA than CT. Nasal CSAs at the anterior region of the inferior turbinates play a crucial role in developing OSA, independent of other known risk factors.

Association between changes in intrinsic foot muscle swelling and improvements in navicular drop height after toe flexor exercises

Background Exercise efficacy can be determined by muscle swelling confirmed through ultrasound, but this method has not been investigated for the intrinsic foot muscles (IFM). Objective To investigate changes over time in muscle swelling and navicular drop (ND) values after IFM exercises and evaluated the relationship between changes in muscle swelling and ND values. Methods In total, 40 feet (10 men; 10 women) were included. The navicular height (NVH) in sitting and standing positions and four IFM cross-sectional areas (CSAs) were measured. Measurements were taken pre-exercise, immediately, and 10 and 20 min after the toe flexor exercise (TFE) at 80% or greater intensity for 40 times. Changes over time in muscle swelling and ND values in men and women and their relationship were evaluated. Results Significant increases were observed in CSAs of all IFMs and improved navicular bone height in sitting and standing positions post-exercise. There was a moderate correlation between changes in CSAs of abductor hallucis (AbH) in women from pre-exercise and changes in ND values from pre-exercise up to 20 min post-exercise. Conclusion A positive correlation between AbH muscle swelling and ND values was observed in women, suggesting the importance of the AbH muscle in arch support.

Galium verum L. extract mitigates cardiovascular events in psoriasis rats.

Psoriasis has been considered a systemic immune-mediated disease that can affect function of the heart. However, certain herbal therapy approaches may nullify side effects of psoriasis on the heart. The aim of this study was to investigate the cardioprotective effects of Galium verum extract administration of the heart of psoriatic rats. The study included 24 Wistar albino male rats, divided into 4 groups: control (CTRL), G.verum (GV), psoriasis (PSORI), and psoriasis with G.verum (PSORI + GV). Seven-day topical application of 5% imiquimod cream was used for induction of psoriasis. After induction, animals were received 125mg/kg G.verum extract for 4weeks. Isolated hearts were perfused on the Langendorff apparatus and measured: dp/dt max/min, SLVP, DLVP, HR and coronary flow. The oxidative stress biomarkers: TBARS, NO2, O2- and H2O2 were measured in coronary venous effluent. Isolated hearts were fixed and stained with H/E and Picro-sirius red staining. Psoriasis decreased cardiac contractility and relaxation and increased SLVP and DLVP at all perfusion pressure. Treatment with G.verum in psoriasis rats improved contractility and relaxation of the heart and rise SLVP and DLVP. In PSORI + GV group, the decrease of oxidative stress biomarkers were observed in comparison to PSORI group. Diameter and cross-section area of cardiomyocytes were increased in PSORI and PSORI + GV groups compared to the control. Collagen content was increased in PSORI group by 283% and in PSORI + GV group by 188% compared to control. Treatment with G.verum extract exhibited a positive effect on cardiac function, morphometry and redox state of heart of psoriatic rats.

Repair and Strengthening of Cantilever Continuous Bridges using External Prestressed Cables: The Case Study of the Tan De Bridge in Vietnam

Continuous cantilever bridges utilizing cross-sectional box girders have been widely used worldwide, as well as in Vietnam, with outstanding advantages, such as the ability to cover large spans, good torsional resistance, high stability, and low maintenance costs. The arrangement of the prestressed cables in the span can use all internal cables (cables arranged in a box cross-section) or a combination of internal wires and external cables (cables arranged in a box cavity). The arrangement of the external cables helps reduce the cross-sectional area and self-weight of the span, leading to savings in foundation costs and an increase in the ability to exceed the span. However, the external cables degrade and become damaged. Therefore, repair and strengthening solutions are required to ensure the longevity of the project. This study focused on researching solutions to restore and enhance span structures using external prestressed cables through specific projects implemented in Vietnam.

Comparison of upper airway volume and hyoid position after camouflage orthodontic or orthodontic-orthognathic treatment in patients with skeletal class Ⅲ malocclusion with normal-angle vertical pattern.

This study aims to compare the effects of two orthodontic treatment modalities for skeletal class Ⅲ malocclusion on specific changes in airway volume, morphology, palatal angle, mandibular rotation, and bone displacement. Results provide scientific evidence for the selection of orthodontic treatment plans and reduce the risk of developing obstructive sleep apnea hypopnea syndrome (OSAHS). Thirty-six patients diagnosed with skeletal class Ⅲ malocclusion at the Department of Orthodontics, the Affiliated Stomatological Hospital of Nanjing Medical University from September 2018 to December 2023 were divided into two groups: orthodontic-orthognathic treatment group (18 patients) and camouflage orthodontic treatment group (18 patients). Changes in airway volume, cross-sectional area, palatal angle, mandibular, and tongue positions were observed through pre- and post-operative cone beam computed tomography and 3D cephalometric measurements. In the camouflage orthodontic treatment group, nasopharyngeal volume and oropharyngeal volume statistically increased after treatment (P<0.05). In the orthodontic-orthognathic treatment group, changes in nasopharyngeal volume, nasopharyngeal airway, distance from posterior tongue to pharyngeal wall, palatal angle, mandibular rotation, and hyoid bone displacement were statistically significant after surgery (P<0.05). In the comparison between the two groups after treatment, changes in the distance from posterior tongue to pharyngeal wall, palatal angle, and distance from hyoid bone to sella turcica point were statistically significant (P<0.05). Patients in the orthodontic-orthognathic treatment group showed significantly greater changes in oropharyngeal cross-sectional area, palate angle, and tongue position compared with patients in the camouflage orthodontic treatment group. As individuals susceptible to OSAHS often exhibit mandibular retrusion and decreased minimum airway cross-sectional area, special attention should be paid to airway morphology changes when adopting orthodontic-orthognathic treatment to avoid adverse consequences.

Adeno-Associated Virus 8 and 9 Myofibre Type/Size Tropism Profiling Reveals Therapeutic Effect of Microdystrophin in Canines.

Adeno-associated virus (AAV) 8 and 9 are in clinical trials for treating neuromuscular diseases such as Duchenne muscular dystrophy (DMD). Muscle consists of myofibres of different types and sizes. However, little is known about the fibre type and fibre size tropism of AAV in large mammals. We evaluated fibre type- and size-specific transduction properties of AAV8 and AAV9 in 17 dogs that received systemic gene transfer (dose 1.94 ± 0.52 × 1014 vg/kg; injected at 2.86 ± 0.30 months; harvested at 20.79 ± 3.30 months). For AAV8, two DMD dogs and three carrier dogs received an alkaline phosphatase (AP) reporter vector, and five DMD dogs received a four-repeat microdystrophin (uDys) vector. For AAV9, one normal and one DMD dog received the AP vector, and five DMD dogs received a five-repeat uDys vector. Association between AAV transduction and the fibre type/size was studied in three muscles that showed mosaic transgene expression, including the biceps femoris, teres major and latissimus dorsi. Transgene expression was detected in 30%-45% of myofibres. In the AP reporter vector-injected dogs, neither AAV8 nor AAV9 showed a statistically significant fibre type preference. Interestingly, AP expression was enriched in smaller fibres. In uDys-treated DMD dogs, slow and fast myofibres were equally transduced. Notably, uDys-expressing myofibres were significantly larger than uDys-negative myofibres irrespective of the AAV serotype (p < 0.0001). In AAV8 uDys vector-injected dogs, the mini-Feret diameter was 15%, 16% and 23% larger in uDys-positive slow, fast and hybrid fibres, respectively; the cross-sectional area was 30%, 34% and 46% larger in uDys-positive slow, fast and hybrid fibres, respectively. In AAV9 uDys vector-injected dogs, the mini-Feret diameter was 12%, 13% and 25% larger in uDys-positive slow, fast and hybrid fibres, respectively; the cross-sectional area was 25%, 28% and 59% larger in uDys-positive slow, fast and hybrid fibres, respectively. Our studies suggest that AAV8 and AAV9 transduce fast and slow myofibres at equivalent efficiency. Importantly, uDys therapy effectively prevented dystrophic myofibre atrophy. Our study provides important insight into systemic muscle AAV delivery in large mammals and supports further development of uDys gene therapy for DMD.

Establishing Normative Values for Entire Spinal Cord Morphometrics in East Asian Young Adults.

The quantitative assessment of spinal cord volume is still in the early stages of development. Recently, normative morphometric values of the cervical spinal cord have been reported. This study aimed to establish normative values for spinal cord morphometry, extending beyond the cervical region to include the thoracic and lumbar spinal cord, and to examine the influence of sex and ethnicity on these measurements. This prospective study included 28 young, healthy, East Asian volunteers (14 males and 14 females; mean age, 30.14 ± 4.07 years) who underwent spinal cord MRI using a 3T scanner. The cross-sectional areas (CSAs), anteroposterior (AP) and transverse diameters, and compression ratios of the entire spinal cord were calculated. Additionally, the effects of sex and ethnicity on spinal cord volumetry were evaluated, with the influence of ethnicity assessed by comparing the findings with a Caucasian dataset from the PAM50 study. The CSAs demonstrated two enlargements at the cervical and lumbar levels. The cervical enlargement at C4-5 exhibited an elliptical shape, while the lumbar enlargement at T12 appeared more circular. The CSAs and AP and transverse diameters of the spinal cords in males were significantly larger than that of females (P < 0.001). The spinal cord compression ratios in East Asians were significantly lower than those in Caucasians (P < 0.001). This study revealed that the two spinal cord enlargements exhibit different patterns and suggest significant differences in spinal cord morphometric values according to sex and ethnicity.

MiR-495 reverses in the mechanical unloading, random rotating and aging induced muscle atrophy via targeting MyoD and inactivating the Myostatin/TGF-β/Smad3 axis.

Mechanical unloading can lead to homeostasis imbalance and severe muscle disease, in which muscle atrophy was one of the disused diseases. However, there were limited therapeutic targets for such diseases. In this study, miR-495 was found dramatically reduced in atrophic skeletal muscle induced by mechanical unloading models both in vitro and in vivo, including the random positioning model (RPM), tail-suspension (TS) model, and aged mice model. Enforced miR-495 expression by its mimic could enormously facilitate the differentiation and regeneration of both mouse myoblast C2C12cells and muscle satellite cells. Furthermore, MyoD was proved as the directly interacted gene of miR-495, and their interaction was crucial for myotube formation. Enforced miR-495 expression could intensively strengthen the muscle mass, in situ muscular electrophysiological indexes, including peak tetanic tension (Po) and peak twitch tension (Pt), and the cross-sectional areas (CSA) of muscle fibers via targeting MyoD and inactivating the Myostatin/TGF-β/Smad3 signaling pathway, indicating that miR-495 can be proposed as an effective target for muscle atrophy treatment induced by in the mechanical unloading, random rotating and aging.

The impact of maximum cross-sectional area of lesion on predicting the early therapeutic response of multidrug-resistant tuberculosis.

Early evaluation of culture conversion after 6-month treatment of multidrug-resistant tuberculosis (MDR-TB) is vital for outcome prediction. This study aims to merge the maximum lesion cross-sectional area observed via computed tomography (CT) imaging during treatment to predict therapeutic response. We retrospectively involved MDR-TB patients who completed 6 months of treatment from two hospitals. Patients were categorized into culture conversation and no culture conversation groups based on sputum culture results. The data from the two hospitals were used as internal training and external testing cohorts, respectively. Logistic regression and random forest models were developed using the maximum lesion cross-sectional area and most important predictive features. The model performance was evaluated using the area under the curve (AUC), accuracy, sensitivity, specificity, and F1 score. In the model without the maximum lesion cross-sectional area to predict culture conversion for MDR-TB after 6 months of treatment, logistic regression and random forest models achieved AUC values of 0.796 and 0.958, sensitivities of 0.725 and 0.993, and F1 scores of 0.803 and 0.957 in the training cohort, respectively. In the testing cohort, logistic regression and random forest models achieved AUC values of 0.889 and 0.855, respectively. Evaluating the maximum lesion cross-sectional area at baseline, 2 months, and 6 months, logistic regression and random forest models in the training cohort yielded AUC values of 0.819 and 0.998, sensitivities of 0.674 and 1.000, and F1 scores of 0.772 and 0.986. In the testing cohort, the AUC values were 0.869 and 0.920, sensitivities were 0.933 and 1.000, and F1 scores were 0.848 and 0.841, respectively. The integration of maximum lesion cross-sectional area during treatment can improve the prediction of early treatment response in MDR-TB. When applied in a clinical setting, the random forest model is more suitable for guiding appropriate treatment plans quickly.