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Background and aims: The beneficial effect of myokine irisin on ischemia-reperfusion of skin flaps has been rarely reported in clinical studies. This study was designed to determine whether irisin plays a protective role in flap transplantation and identify the factors affecting serum irisin levels. Materials and methods: We analyzed the changes in serum irisin levels and flap blood flow before and after surgery in 40 patients who underwent skin-flap transplantation. Factors affecting serum irisin levels were analyzed by metabolic parameter measurements. Results: Preoperative serum irisin levels were positively correlated with blood flow in the skin flap 7 days post-surgery. The increase in serum irisin levels in the first 3 days after surgery positively correlated with flap blood flow. A longer duration of high-intensity exercise, higher skeletal muscle content, lower body mass index, and waist-to-hip ratio were associated with higher irisin levels. Fasting blood glucose and glycosylated hemoglobin levels showed significant negative correlations with serum irisin levels. Several other indicators, including sex, were not associated with serum irisin levels. Conclusions: Serum irisin levels benefit blood flow recovery during flap transplantation. Better outcomes may be achieved by adjusting the timing and intensity of the exercise and controlling the patient's body size.

Abstract Rheumatoid arthritis (RA) is an autoimmune disorder characterized by chronic inflammation of the synovial joints and the dysfunction of regulatory T cells (Tregs) in the peripheral blood. Therefore, an optimal treatment strategy should aim to eliminate the inflammatory response in the joints and simultaneously restore the immune tolerance of Tregs in peripheral blood. Accordingly, we developed an efferocytosis‐mimicking nanovesicle that contains three functional factors for immunomodulating of efferocytosis, including “find me” and “eat me” signals for professional (macrophage) or non‐professional phagocytes (T lymphocyte), and “apoptotic metabolite” for metabolite digestion. We showed that efferocytosis‐mimicking nanovesicles targeted the inflamed joints and spleen of mice with collagen‐induced arthritis, further recruiting and selectively binding to macrophages and T lymphocytes to induce M2 macrophage polarization and Treg differentiation and T helper cell 17 (Th17) recession. Under systemic administration, the efferocytosis‐mimicking nanovesicles effectively maintained the pro‐inflammatory M1/anti‐inflammatory M2 macrophage balance in joints and the Treg/Th17 imbalance in peripheral blood to prevent RA progression. This study demonstrates the potential of efferocytosis‐mimicking nanovesicles for RA immunotherapy.

Abstract Background Flower buds of Anthurium andraeanum frequently cease to grow and abort during the early flowering stage, resulting in prolonged planting times and increased commercialization costs. Nevertheless, limited knowledge exists of the mechanism of flower development after initiation in A. andraeanum. Results In this study, the measurement of carbohydrate flow and intensity between leaves and flowers during different growth stages showed that tender leaves are strong sinks and their concomitant flowers are weak ones. This suggested that the tender leaves compete with their concomitant flower buds for carbohydrates during the early growth stages, potentially causing the abortion of the flower buds. The analysis of transcriptomic differentially expressed genes suggested that genes related to sucrose metabolism and auxin response play an important role during flower bud development. Particularly, co-expression network analysis found that AaSPL12 is a hub gene engaged in flower development by collaborating carbohydrate and auxin signals. Yeast Two Hybrid assays revealed that AaSPL12 can interact with AaARP, a protein that serves as an indicator of dormancy. Additionally, the application of exogenous IAA and sucrose can suppress the expression of AaARP, augment the transcriptional abundance of AaSPL12, and consequently expedite flower development in Anthurium andraeanum. Conclusions Collectively, our findings indicated that the combination of auxin and sugar signals could potentially suppress the repression of AaARP protein to AaSPL12, thus advancing the development of flower buds in Anthurium andraeanum.

Bone-related disorders, such as osteoporosis, osteoarthritis, and osteosarcoma, have complex origins. Genetic, environmental factors, and significantly, oxidative stress due to Reactive Oxygen Species (ROS) play pivotal roles in these disorders. With their profound implications on global health, it becomes imperative to seek innovative therapeutic solutions. Nanozymes, known for their superior stability, cost-effectiveness, and tunable properties, present themselves as a prospective answer in mitigating ROS-driven bone ailments. This review explores the diverse applications and mechanisms of nanozymes in the context of bone health. They show potential in not only counteracting ROS-induced oxidative stress but also in modulating angiogenesis and showcasing antibacterial effects. We systematically analyze the effects of nanozymes on conditions such as osteonecrosis of the femoral head, skin flap transplantation, osteomyelitis, osteoarthritis, intervertebral disc disease, osteoporosis, and osteosarcoma, highlighting their potential roles in modulating disease processes. In addition, we discuss the challenges of applying nanozymes to orthopedic diseases. It offers insights into the transformative potential of nanozymes in bone therapeutics, underscoring the need to address challenges and capitalize on opportunities for their broader application in orthopedics.

Abstract Background Hyperuricemia can lead to synovial hyperplasia in the wrist. In severe cases, it can lead to the deposition of gouty stone in the carpal tunnel, resulting in increased pressure in the carpal tunnel and compression of the median nerve to cause carpal tunnel syndrome (CTS), which is called gouty carpal tunnel syndrome (GCTS). As for the surgical treatment of gouty carpal tunnel syndrome, scholars have different opinions on whether it is necessary to remove the superficial flexor tendon. The purpose of this study was to compare the clinical efficacy of trimming and resection of the diseased superficial flexor tendon in the treatment of gouty carpal tunnel syndrome. Methods Clinical data were collected from May 2016 to July 2021 from 10 patients (13 affected wrists) diagnosed with gouty carpal tunnel syndrome and classified into two groups according to the surgical modality: the diseased portion of the gout-eroded superficial finger tendon was trimmed in 9 wrists, and the diseased superficial finger flexor tendon was excised in 4 wrists. Values related to flexion and extension functions, 2-PD, DASH, BCTQ, VAS and recurrence in the affected fingers were compared between the two groups as well as before and after surgery in each group. Results All affected limbs used were cleared of gouty stones, finger numbness improved, no skin necrosis occurred, and all incisions healed at stage I. At follow-up (13.58 ± 5.53 months), there was no significant difference between groups in flexion and extension function, 2-PD, DASH, BCTQ, and VAS with respect to the affected fingers, and patients in both groups improved significantly before and after surgery. Treatment of only one wrist involved trimming to remove lesion-affected portions of tendon, which reappeared 1 year after surgery, and there was one case of poor recovery from greater piriformis muscle atrophy in both procedures. Conclusion Regarding surgical treatment of patients with gouty carpal tunnel syndrome in which the gouty stone has invaded the superficial flexor tendons of the fingers, the diseased superficial flexor tendons can be selectively excised, and the postoperative mobility of the affected fingers may not be impaired.

Abstract Osteoarthritis (OA) is a common degenerative joint disease characterized by progressive cartilage degradation and inflammation. In recent years, mesenchymal stem cells (MSCs) derived exosomes (MSCs-Exo) have attracted widespread attention for their potential role in modulating OA pathology. However, the unpredictable therapeutic effects of exosomes have been a significant barrier to their extensive clinical application. In this study, we investigated whether fucoidan-pretreated MSC-derived exosomes (F-MSCs-Exo) could better protect chondrocytes in osteoarthritic joints and elucidate its underlying mechanisms. In order to evaluate the role of F-MSCs-Exo in osteoarthritis, both in vitro and in vivo studies were conducted. MiRNA sequencing was employed to analyze MSCs-Exo and F-MSCs-Exo, enabling the identification of differentially expressed genes and the exploration of the underlying mechanisms behind the protective effects of F-MSCs-Exo in osteoarthritis. Compared to MSCs-Exo, F-MSCs-Exo demonstrated superior effectiveness in inhibiting inflammatory responses and extracellular matrix degradation in rat chondrocytes. Moreover, F-MSCs-Exo exhibited enhanced activation of autophagy in chondrocytes. MiRNA sequencing of both MSCs-Exo and F-MSCs-Exo revealed that miR-146b-5p emerged as a promising candidate mediator for the chondroprotective function of F-MSCs-Exo, with TRAF6 identified as its downstream target. In conclusion, our research results demonstrate that miR-146b-5p encapsulated in F-MSCs-Exo effectively inhibits TRAF6 activation, thereby suppressing inflammatory responses and extracellular matrix degradation, while promoting chondrocyte autophagy for the protection of osteoarthritic cartilage cells. Consequently, the development of a therapeutic approach combining fucoidan with MSC-derived exosomes provides a promising strategy for the clinical treatment of osteoarthritis.

Abstract Reversible lysine methylation is essential for regulating histones and emerges to critically regulate non-histone proteins as well. Here we show that the master transcription factor OCT4 in pluripotent stem cells (PSCs) was methylated at multiple lysine residues. LSD1 that is highly expressed in PSCs can directly interact with and demethylate OCT4 at lysine 222 (K222) in the flexible linker region. Reduced LSD1 activity led to the methylation of OCT4-K222 that diminished the differentiation potential of PSCs while facilitating proteasome-independent degradation of OCT4 proteins. Furthermore, site-specifically replacing K222 with phenylalanine to mimic the constitutively methylated lysine promoted the ‘locked-in’ mode engagement of the OCT4 PORE-homodimers that tightly bind to and block the transcription of multiple PORE-motif-containing target genes regulating cell fate determination and cell junction organization, and thereby reducing the pluripotency of PSCs. Thus, LSD1-mediated demethylation of OCT4 plays a crucial role in restricting the ‘locked-in’ mode binding of OCT4 PORE-homodimers to the PORE-motif-containing genes and thereby maintaining their transcription to safeguard the pluripotency of PSCs.

Objective: The efficacy of the tight-rope (TR) technique and clavicular hook plate (CHP) for the treatment of acute acromioclavicular (AC) joint dislocation is controversial. This meta-analysis aimed to evaluate which method is more appropriate for the treatment of acute AC joint dislocation. Methods: We systematically searched the PubMed, EMBASE, Scopus, ISI Web of Science, Chinese VIP Database, and Chinese Wan-Fang databases from inception to January 2018 using the search term “acromioclavicular joint dislocation AND hook plate.” All prospective and retrospective controlled trials that had compared functional scores, pain scores, reduction loss rates, coracoclavicular (CC) distances, and complications between TR and CHP for acute AC joint dislocation were identified. A total of 13 of 587 studies with 732 patients were included. TR was preferential to CHP for AC joint dislocation given its higher Constant–Murley score, lower Visual Analog Scale pain score, and comparable reduction loss rate and CC distance. Subgroup analyses of the surgical type of TR did not affect the outcome. Results: The TR technique appears to be associated with better functional recovery and less pain than CHP. In addition, it does not increase the risk of reduction loss, CC distance, or operation time. It is also not associated with other complications except the implant migration, and does not require removal of the internal fixation. Conclusions: Thus, our results indicated that for AC joint dislocation, the TR technique may be preferential.

Abstract Background Pigmented villonodular synovitis (PVNS) is a rare, benign, proliferative neoplastic process that commonly affects synovial-lined anatomic spaces. The diffuse type (DPVNS) is characterized by invasion of the entire joint synovium, while the localized type (LPVNS) is characterized by a relatively normal synovial appearance. This report describes a unique case of massive intraarticular LPVNS with an extraarticular extension through the lateral patellar retinaculum. No similar cases have been found in the literature. Case presentation A 58-year-old woman had a history of hyperuricemia and knee trauma and presented with unilateral knee acute swelling and pain symptoms with sudden onset. Recent expansion of the LPVNS caused the development of a tender palpable soft tissue mass in the anterolateral aspect of the knee and acute reduced mobility. Preoperative magnetic resonance imaging of the knee revealed the presence of only the soft tissue mass and mild degenerative changes. Open synovectomy was performed successfully to excise the mass. Intraoperatively, macroscopic features of the bright brown inflamed synovium suggested LPVNS, which was confirmed histopathologically. Postoperatively, the symptoms of limited mobility and pain were appreciably relieved. Recurrence was not observed during the clinical follow-up at 1, 6 or 18 months after surgery. Conclusions Here, we report the unique case of localized pigmented villonodular synovitis of the knee in a misdiagnosed patient with intra- and extraarticular lesion, which might be attributed to the history of knee trauma and the focal defect of the lateral patellar retinaculum. Open synovectomy effectively relieved the symptoms of limited mobility and pain and no recurrence was observed prior to 18 months postoperatively. To reduce misdiagnosis, MRI examinations are recommended for all patients suspected of having PVNS, including those who have a history of hyperuricemia.

Abstract Background Despite advances in microsurgical techniques of flap transfer, complex upper extremity trauma reconstruction remains a challenge for surgeons. This study aimed to present the outcomes in using flaps in the subacute reconstruction of complex upper extremity injuries. Methods From July 2013 to December 2016, 35 patients ranging in age from 23 to 69 years with complicated upper extremity traumatic injuries were treated using flap reconstruction in subacute period. The number and causes of injury were 12 machine crush injuries, 18 machine strangulation injuries, two chainsaw accidents, two traffic accidents, and one incident of heavy bruising. Thirty-five patients underwent flap procedures, including 24 anterolateral thigh flaps (68.57%), five latissimus dorsi flaps (14.29%), and six lateral arm flaps (17.14%). Flap sizes ranged from 3 × 4 to 42 × 16 cm2. The mean time of flap reconstruction was 14 days (range 5–29). During postoperative follow-up, flap appearance, sensory recovery, scarring and satisfaction were assessed. Results The overall flap survival rate was 94.3%.Two flaps developed partial necrosis, both of which were later treated with skin grafting. Traumatic wound infections occurred in three patients. All upper limb injuries were completely covered. The follow-up periods ranged from 18 to 62 months with an average of 2.9 months. All skin flap textures were soft with varying degrees of pigmentation. Flap sensory recovery was S1 in three cases, S2 in eight cases, S3 in 15 cases, and S4 in nine cases. There were no donor site complications other than three cases with scar hyperplasia. Conclusions The severe upper limb soft tissue defects still achieved satisfactory function and appearance with negligible complications and low amputation rates during the subacute period.

Background: Epigenetic mechanisms have been reported to play key roles in osteoarthritis (OA) development. P300/CBP-associated factor (PCAF) is a member of the histone acetyltransferases, which exhibits a strong relationship with endoplasmic reticulum (ER) stress and transcription factor nuclear factor kappa B (NF-κB) signals. Salidroside, a natural histone acetylation inhibitor, showed its anti-inflammatory and anti-apoptotic effects in lipopolysaccharide (LPS)-stimulated microglia cells in our previous study. However, whether Sal has a protective effect against OA remains unknown, and its relationships to PCAF, NF-κB, and the ER stress pathway should be explored further. Methods: We identified the role of PCAF in the pathogenesis of OA and determined the chondroprotective effect of Sal on both tumor necrosis factor alpha (TNF-α)-treated human chondrocytes and a destabilized medial meniscus (DMM) mouse OA model. Findings: We found increased PCAF expression in human OA cartilage and TNF-α-driven chondrocytes. Meanwhile, silencing of PCAF attenuated nuclear p65 and C/EBP homologous protein levels in chondrocytes upon TNF-α stimulation. Furthermore, Sal was found to specifically bind to the inhibitory site of the PCAF protein structure, which subsequently reversed the TNF-α-induced activation of NF-κB signal and ER stress-related apoptosis in chondrocytes. In addition, the protective effect of Sal and its inhibitory effects on PCAF as well as inflammatory- and ER stress-related markers were also observed in the mouse DMM model. Interpretation: Pharmacological blockade of PCAF by Sal ameliorates OA development via inhibition of inflammation and ER stress, which makes Sal a promising therapeutic agents for the treatment of OA. Keywords: PCAF, Salidroside, Osteoarthritis, NF-κB, ER stress

BackgroundOsteoarthritis (OA) is a chronic degenerative disease of the joints characterized by articular cartilage damage, subchondral bone remodeling, osteophyte formation, and inflammatory changes. This work aims to investigate the protective role of long non-coding RNA (lncRNA) maternally expressed 3 (MEG3) against the apoptosis of chondrocytes.MethodsChondrocyte cell lines, CHON-001, and ATDC5 were treated with different doses of interleukin-1β (IL-1β) to mimic the inflammatory response during OA pathogenesis. Quantitative real-time polymerase chain reaction was performed to measure MEG3, miR-9-5p, and Krüppel-like factor 4 (KLF4) mRNA expression levels. MEG3 and KLF4 overexpression plasmids, MEG3 shRNA, miR-9-5p mimics, and miR-9-5p inhibitors were transfected into the cells. Cell counting kit-8, wound healing assay, and flow cytometry were conducted to determine cell viability, migration, and apoptotic rate. Dual-luciferase reporter assay was adopted to verify the targeting relationships among MEG3, miR-9-5p, and KLF4. Western blot was used to detect KLF4 protein expression. Enzyme-linked immunosorbent assay was employed to measure the levels of inflammatory factors.ResultsMEG3 expression in chondrocytes was down-regulated by the stimulation of IL-1β, and MEG3 negatively regulated miR-9-5p expression but positively regulated KLF4 expression. MEG3 overexpression strengthened the viability and migration of CHON-001 and ATDC5 cells but restrained the apoptosis and inflammatory response, while MEG3 knockdown had opposite effects. miR-9-5p inhibition or KLF4 overexpression could counteract the effects of MEG3 knockdown on chondrocytes. Besides that, MEG3 was proved to be a molecular sponge for miR-9-5p, and KLF4 was verified as the target of miR-9-5p.ConclusionMEG3 can promote chondrocyte proliferation and migration and inhibit apoptosis and inflammation by sponging miR-9-5p to induce KLF4 expression, which provides a promising therapy target for OA treatment.

Purpose: Venous anastomosis is the key procedure for Ishikawa zone Ⅱ fingertip replantation. Both palmar and lateral veins provide efficient venous drainage. This study compared the clinical effects between these venous anastomoses for fingertip replantation. Methods: In 2016–2018, 61 patients underwent Ishikawa zone Ⅱ fingertip replantation with venous anastomosis (28 and 33 cases with palmar and lateral anastomoses, respectively). Retrospective comparative analyses evaluated surgical technique and function, including operative time; rates of finger survival, venous congestion, and infection; sensation; joint motion; cold intolerance symptom severity (CISS), Disabilities of the Arm, Shoulder, and Hand (DASH), and Vancouver scar scores; and chronic regional pain syndrome (CRPS) rates. Results: There were 33 patients with lateral vein anastomosis and 28 patients with palmar vein anastomosis. The average patient follow-up was 18.2 months. The survival rates did not differ significantly between groups (87.8% (29/33) vs. 85.7% (24/28), p > 0.05); however, the operative time was shorter in the lateral vein group than in the palmar vein group (78.57 ± 7.08 min vs. 67.88 ± 5.77 min, p < 0.05). Venous congestion and infection rates did not differ significantly between groups ( p > 0.05). The replanted finger function, including joint motion, sensation, DASH scores, Vancouver scar scores, and CRPS rates, did not differ significantly between groups ( p > 0.05). However, the CISS score was higher in the palmar vein group than in the lateral vein group (44.39 ± 5.16 vs. 38.09 ± 4.49, p < 0.05). Conclusions: Venous anastomosis with either palmar or lateral veins showed high survival rates and good function in fingertip replantation. The lateral vein had a shorter operative time and benefit to arterial revision and was especially suitable for patients with finger pulp damage.

Glucocorticoid-induced osteonecrosis of the femoral head (GIONFH) is a frequently occurring type of nontraumatic osteonecrosis. A failure of the timely treatment can eventually result in the collapse of the subchondral bone structure. Luteolin (Lut), a compound extracted from Rhizoma Drynariae, is reported to possess multiple pharmacological properties including anticancer, antioxidant, antiapoptosis, and antiinflammatory properties. However, whether Lut has a protective effect on the development of GIONFH remains unclear. In this study, we evaluated the effect of Lut on Dexamethasone (Dex)-induced STAT1/caspase3 pathway in vitro and evaluated GIONFH model in vivo. In vitro, Lut inhibited the upregulation of Dex-induced phospho-STAT1, cleaved caspase9, and cleaved caspase3. In addition, Lut inhibited Dex-induced expression of Bax and cytochrome c and increased the expression of B cell lymphoma-2(Bcl-2). In vivo, Lut decreased the proportion of empty lacunae in rats with GIONFH. Taken together, these findings indicate that Lut may have therapeutic potential in the treatment of GIONFH. Further, this effect might be achieved by suppressing mitochondrial apoptosis of osteoblasts via inhibition of STAT1 activity.

Abstract Herbivory‐induced responses in plants can both negatively affect subsequently colonizing herbivores and mitigate the effect of herbivory on the host. However, it is still less known whether plants exhibit specific responses to specialist and generalist herbivores in non‐secondary metabolite traits and how specificity to specialists and generalists differs between invasive and native plant populations. We exposed an invasive plant, Alternanthera philoxeroides, to Agasicles hygrophila (Coleoptera, Chrysomelidae; specialist), Spodoptera litura (Lepidoptera, Noctuidae; generalist), manual clipping, or application of exogenous jasmonic acid and examined both the specificity of elicitation in traits of fitness (e.g., aboveground biomass), morphology (e.g., root:shoot ratio), and chemistry (e.g., C/N ratio and lignin), and specificity of effect on the subsequent performance of A. hygrophila and S. litura. Then, we assessed variation of the specificity between invasive and native populations (USA and Argentina, respectively). The results showed S. litura induced higher branching intensity and specific leaf area but lower C/N ratio than A. hygrophila, whereas A. hygrophila induced higher trichome density than S. litura. The negative effect of induction on subsequent larval growth was greater for S. litura than for A. hygrophila. Invasive populations had a weaker response to S. litura than to A. hygrophila in triterpenoid saponins and C/N ratio, while native populations responded similarly to these two herbivores. The specific effect on the two herbivores feeding on induced plants did not vary between invasive and native populations. Overall, we demonstrate specificity of elicitation to specialist and generalist herbivores in non‐secondary metabolite traits, and that the generalist is more susceptible to induction than the specialist. Furthermore, chemical responses specific to specialist and generalist herbivores only exist in the invasive populations, consistent with an evolutionary change in specificity in the invasive populations.

China's universal medical insurance system (UMIS) is designed to promote social fairness through improving access to medical services and reducing out-of-pocket (OOP) costs for all Chinese. However, it is still not known whether UMIS has a significant impact on the accessibility of medical service supply and the affordability, as well as the seeking-care choice, of patients in China.Segmented time-series regression analysis, as a powerful statistical method of interrupted time series design, was used to estimate the changes in the quantity and quality of medical service supply before and after the implementation of UMIS. The rates of catastrophic payments and seeking-care choices for UMIS beneficiaries were selected to measure the affordability and medical service flow of patients after the implementation of UMIS.China's UMIS was established in 2008. After that, the trending increase of the expenditure of the UMIS was higher than that of increase in revenue compared to previous years. Up to 2014, the UMIS had covered 97.5% of the entire population in China. After introduction of the UMIS, there were significant increases in licensed physicians, nurses, and hospital beds per 1000 individuals. In addition, hospital outpatient visits and inpatient visits per year increased compared to the pre-UMIS period. The average fatality rate of inpatients in the overall hospital and general hospital and the average fatality rate due to acute myocardial infarction (AMI) in general hospitals was significantly decreased. In contrast, no significant and prospective changes were observed in rural physicians per 1000 individuals, inpatient visits and inpatient fatality rate in the community centers and township hospitals compared to the pre-UMIS period. After 2008, the rates of catastrophic payments for UMIS inpatients at different income levels were declining at three levels of hospitals. Whichever income level, the rate of catastrophic payments for inpatients of Urban Employee's Basic Medical Insurance was the lowest. For the low-income patients, a single hospitalization at a tertiary hospital can lead to catastrophic payments. It is needless to say what the economic burden could be if patients required multiple hospitalizations within a year. UMIS beneficiaries showed the intention of growth to seek hospitalization services in tertiary hospitals.Introduction of the UMIS contributed to an increase in available medical services and the use thereof, and a decrease in fatality rate. The affordability of UMIS beneficiaries for medical expenses was successfully ameliorated. The differences in patients' affordability are mainly manifested in different medical insurance schemes and different seeking-care choices. The ability of the poor patients covered by UMIS to resist catastrophic medical payments is still relatively weak. Therefore, the current UMIS should reform the insurance payment model to promote the integration of medical services and the formation of a tiered treatment system. UMIS also should establish supplementary medical insurance packages for the poor.

Objective. To examine the association between metformin use and cancer stage at diagnosis among elderly men with preexisting diabetes mellitus and incident prostate cancer. Methods. This study used a population-based observational cohort of elderly men (≥66 years) with preexisting diabetes and incident prostate cancer between 2008 and 2009 (N=2,652). Cancer stage at diagnosis (localized versus advanced) was based on the American Joint Cancer Committee classification. Metformin use and other independent variables were measured during the one year before cancer diagnosis. Logistic regressions with inverse probability treatment weights were used to control for the observed selection bias. Results. A significantly lower percentage of metformin users were diagnosed with advanced prostate cancer as compared to nonusers (4.7% versus 6.7%, p

This study estimated excess home healthcare use and expenditures among elderly Medicare beneficiaries (age ≥ 65 years) with Parkinson’s disease (PD) compared to those without PD and analyzed the extent to which predisposing, enabling, need factors, personal health choice, and external environment contribute to the excess home healthcare use and expenditures among individuals with PD. A retrospective, observational, cohort study design using Medicare 5% sample claims for years 2006-2007 was used for this study. Logistic regressions and Ordinary Least Squares regressions were used to assess the association of PD with home health use and expenditures, respectively. Postregression nonlinear and linear decomposition techniques were used to understand the extent to which differences in home healthcare use and expenditures among elderly Medicare beneficiaries with and without PD can be explained by individual-level factors. Elderly Medicare beneficiaries with PD had higher home health use and expenditures compared to those without PD. 27.5% and 18% of the gap in home health use and expenditures, respectively, were explained by differences in characteristics between the PD and no PD groups. A large portion of the differences in home healthcare use and expenditures remained unexplained.

Release from specialist insect herbivores may allow invasive plants to evolve traits associated with decreased resistance and increased competitive ability. Given that there may be genetic trade-off between resistance and tolerance, invasive plants could also become more tolerant to herbivores. Although it is widely acknowledged that light availability affects tolerance to herbivores, little information is available for whether the effect of light availability on tolerance differ between the introduced and native populations. We conducted a common garden experiment in the introduced range of Alternanthera philoxeroides using ten invasive US and ten native Argentinean populations at two levels of light availability and in the presence or absence of a specialist stem-boring insect Agasicles hygrophila. Plant biomass (total and storage root biomass), two allocation traits (root/shoot ratio and branch intensity, branches biomass/main stem biomass) and two functional traits (specific stem length and specific leaf area), which are potentially associated with herbivore resistance and light capture, were measured. Overall, we found that A. philoxeroides from introduced ranges had comparable biomass and tolerance to specialist herbivores, lower branch intensity, lower specific stem length and specific leaf area. Moreover, introduced populations displayed higher shade tolerance of storage root biomass and lower plastic response to shading in specific stem length. Finally, light availability had no significant effect on evolution of tolerance to specialist herbivores of A. philoxeroides. Our results suggest that post-introduction evolution might have occurred in A. philoxeroides. While light availability did not influence the evolution of tolerance to specialist herbivores, increased shade tolerance and release from specialist insects might have contributed to the successful invasion of A. philoxeroides.

The article presents a study on the effects of Thymosin β4 on the survival of cutaneous flaps in rats and its activation of the Wnt/β-catenin pathway. Skin flap transplantation is a common procedure for treating soft tissue defects, but the survival of the transplanted flap is often compromised due to inadequate blood supply. Thymosin β4, a regenerative peptide, has shown promise in wound healing and anti-inflammatory activities. The study found that treatment with Thymosin β4 improved the survival of the flaps and increased angiogenesis. It also upregulated the levels of NF-κB, VEGF, β-catenin, and c-Myc, which are involved in immune, inflammatory, and angiogenetic responses. The study suggests that Thymosin β4 may be a useful treatment option for improving the survival of skin flaps in reconstructive surgery. [Extracted from the article]