Expansion of human umbilical cord derived mesenchymal stem cells in regenerative medicine

BACKGROUND

Stem cells are undifferentiated cells that possess the potential for self-renewal with the capacity to differentiate into multiple lineages. In humans, their limited numbers pose a challenge in fulfilling the necessary demands for the regeneration and repair of damaged tissues or organs. Studies suggested that mesenchymal stem cells (MSCs), necessary for repair and regeneration via transplantation, require doses ranging from 10 to 400 million cells. Furthermore, the limited expansion of MSCs restricts their therapeutic application.

AIM

To optimize a novel protocol to achieve qualitative and quantitative expansion of MSCs to reach the targeted number of cells for cellular transplantation and minimize the limitations in stem cell therapy protocols.

METHODS

Human umbilical cord (hUC) tissue derived MSCs were obtained and re-cultured. These cultured cells were subjected to the following evaluation procedures: Immunophenotyping, immunocytochemical staining, trilineage differentiation, population doubling time and number, gene expression markers for proliferation, cell cycle progression, senescence-associated β-galactosidase assay, human telomerase reverse transcriptase (hTERT) expression, mycoplasma, cytomegalovirus and endotoxin detection.

RESULTS

Analysis of pluripotent gene markers Oct4, Sox2, and Nanog in recultured hUC-MSC revealed no significant differences. The immunophenotypic markers CD90, CD73, CD105, CD44, vimentin, CD29, Stro-1, and Lin28 were positively expressed by these recultured expanded MSCs, and were found negative for CD34, CD11b, CD19, CD45, and HLA-DR. The recultured hUC-MSC population continued to expand through passage 15. Proliferative gene expression of Pax6, BMP2, and TGFb1 showed no significant variation between recultured hUC-MSC groups. Nevertheless, a significant increase (P < 0.001) in the mitotic phase of the cell cycle was observed in recultured hUC-MSCs. Cellular senescence markers (hTERT expression and β-galactosidase activity) did not show any negative effect on recultured hUC-MSCs. Additionally, quality control assessments consistently confirmed the absence of mycoplasma, cytomegalovirus, and endotoxin contamination.

CONCLUSION

This study proposes the development of a novel protocol for efficiently expanding stem cell population. This would address the growing demand for larger stem cell doses needed for cellular transplantation and will significantly improve the feasibility of stem cell based therapies.

Clinical Application of Botulinum Toxin A on Nasal Reconstruction with Expanded Forehead Flap for Asian Patients

BACKGROUND

Because of its unique advantages, frontal expansion has become a common tool for Asian nasal reconstruction, but it has the limitations of prolonging the duration and pain in the expansion area. Based on the fact that the denervation effect of botulinum toxin type A (BTX-A) has been widely used in the reconstruction of superficial organs, we hypothesized that BTX-A would shorten the length of nasal reconstruction sequence and alleviate the discomfort of patients.

METHODS

A comparative retrospective study was conducted of consecutive patients underwent sequential treatment of nasal reconstruction between June 2010 and July 2012. Data on demographics, BTX-A injection plan and expansion duration were collected and analyzed. Phased pain intensity outcomes were evaluated by visual analogue scale (VAS). Photographs were collected during the follow-up period.

RESULTS

Thirty patients were enrolled in the study; 15 (50%) with and 15 (50%) without BTX-A pre-injection. Demographic data were homogeneous. The duration of the observation group (BTX-A pretreated) (133.87 ± 13.64 days) was significantly shortened versus the control group (164.27 ± 14.08 days, P<0.001). At the initial stage, no significant difference was found in the VAS scores (P=0.64). At the medium stage, the VAS score of the observation group (2.07 ± 0.80) was significantly lower than the control group (3.00 ± 0.53, P<0.01). At the terminal stage, the VAS score of the observation group (1.93 ± 0.59) was significantly lower than the control group (2.73 ± 0.70) but with a narrower disparity.

CONCLUSION

Pre-injection of BTX-A is effective in shortening the duration of the expansion phase, as well as relieving the pain associated with expansion.

LEVEL OF EVIDENCE IV

The journal asks authors to assign a level of evidence to each article. For a complete description of Evidence-Based Medicine ratings, see the Table of Contents or the online Instructions for Authors at www.springer.com/00266 .

2-week aligner change regimes: A retrospective cohort study

Objective

: This retrospective cohort study aimed to assess and compare the accuracy of 3 different Invisalign® treatment regimens in terms of variations of aligner change frequency and type of aligner material in achieving maxillary dental buccal expansion.

Methods

: Altogether, 120 adult patients whose treatment involved maxillary dental expansion with Invisalign® were included. The patients were divided into 3 groups, with each group comprising 40 patients as follows: SmartTrack® 1-week changes (ST1), SmartTrack® 2-week changes (ST2), and EX30® 2-week changes (EX2). The groups were assessed by comparing actual changes achieved with those prescribed by ClinCheck®. The rates of clinically significant inaccuracies (CSI) observed for buccal expansion (≥ 0.5 mm) and buccolingual inclination (≥ 2°) during expansion were then determined.

Results

: In terms of expansion, the ST1 group demonstrated the highest CSI rate at all tooth levels, whereas the ST2 group had the lowest rate of CSI and the lowest mean inaccuracy for each tooth level. In terms of buccolingual inclination, the ST1 group had the highest CSI rate across all tooth levels, whereas the EX2 group had the lowest CSI rate at all tooth levels except for the canine level where the ST2 group had the lowest CSI rate. A tendency toward overexpression of buccal crown inclination, and underexpression of buccal expansion was observed at all tooth levels.

Conclusions

: Two-week aligner change regimens offer improved accuracy compared with 1-week aligner changes. SmartTrack® 2-week changes were the most accurate for buccal expansion, whereas EX30® 2-week changes were the most accurate for buccolingual inclination.

Surveys on Baylisascaris procyonis in two of the three French wild raccoon populations

Human infection by Baylisascaris procyonis can result in larva migrans syndromes, which can cause severe neurological sequelae and fatal cases. The raccoon serves as the definitive host of the nematode, harboring adult worms in its intestine and excreting millions of eggs into the environment via its feces. Transmission to paratenic hosts (such as rodents, birds and rabbits) or to humans occurs by accidental ingestion of eggs. The occurrence of B. procyonis in wild raccoons has been reported in several Western European countries. In France, raccoons have currently established three separate and expanding populations as a result of at least three independent introductions. Until now the presence of B. procyonis in these French raccoon populations has not been investigated. Between 2011 and 2021, 300 raccoons were collected from both the south-western and north-eastern populations. The core parts of the south-western and north-eastern French raccoon populations were free of B. procyonis. However, three worms (molecularly confirmed) were detected in a young raccoon found at the edge of the north-eastern French raccoon population, close to the Belgian and Luxemburg borders. Population genetic structure analysis, genetic exclusion tests and factorial correspondence analysis all confirmed that the infected raccoon originated from the local genetic population, while the same three approaches showed that the worms were genetically distinct from the two nearest known populations in Germany and the Netherlands. The detection of an infected raccoon sampled east of the northeastern population raises strong questions about the routes of introduction of the roundworms. Further studies are required to test wild raccoons for the presence of B. procyonis in the area of the index case and further east towards the border with Germany.

Prioritized single vitrified blastocyst to be warmed between grades 3 or 4 blastocyst on day 5 transfer cycles

PURPOSE

Selecting the optimal blastocyst to implant during cryopreservation and warming is critial for in vitro fertilization success. Therefore, the aim of this study was to explore which blastocyst should be prioritized to be thawed when facing a single vitrified blastocyst on day 5 transfer.

METHODS

A retrospective study including 1,976 single vitrified-warmed blastocyst transfer cycles was conducted from January 2016 to December 2020.

RESULTS

We found that grade 4 vitrified blastocyst had a higher clinical pregnancy (60.64% vs. 49.48%, P < 0.001) and live birth rates (50.12% vs 39.59%, P < 0.001) than the grade 3 vitrified blastocyst. However, no statistical difference was found between groups in miscarriage rate, birth weight, or gestational age. Besides, the grade 4 vitrified-thawed blastocyst had significant potential to develop into grade 6 blastocyst after further culturing for 16 h (73.68% vs. 48.60%, P < 0.001). The grade 6 transferred blastocyst was markedly higher in both clinical pregnancy rate (61.88% vs. 51.53%, P < 0.001) and live birth rate (50.91% vs. 40.46%, P < 0.001) compared to grade 5 transferred blastocyst.

CONCLUSIONS

Grade 4 vitrified blastocyst is recommended when facing single vitrified blastocyst on day 5 transfer. More importantly, the "embryonic escape hypothesis" was firstly proposed to reveal the findings.

Dentoskeletal effects of mini-screw assisted, non-surgical palatal expansion in adults using a modified force-controlled polycyclic protocol: a single-centre retrospective study

OBJECTIVES

This study assessed the dental and skeletal effects of pure bone-borne, non-surgical maxillary expansion, using a modified force-controlled polycyclic protocol.

METHODS

Records of 17 adult patients, mean age 24.1 years; range 18-39 years, who had undergone maxillary expansion using a bone-borne Quad-expander (with 4 mini-screws), were analysed. In all patients, 0.17 mm/day of expansion was completed for 1 week, followed by a cyclic protocol of expansion of forward and backward turns until the force needed to turn the expander was below 400 cN, assessed weekly. After this, expansion continued at a rate of 0.17 mm/day until the desired amount of expansion was achieved. Cone beam computer tomography scans were taken pre- and post-expansion.

RESULTS

The mid-palatal suture was successfully opened in 100% of patients included in this study. Axially, the amount of skeletal opening at the posterior nasal spine was 61% of the anterior nasal spine. Expansion was pyramidal in the coronal plane. Significant increases at the dental and skeletal levels were achieved, with changes at the skeletal level reaching 73%. The alveolar bone angle increased more than the angular changes at the molars and premolars.

LIMITATIONS

This is a retrospective study with short-term results.

CONCLUSION

The Quad-expander, with a force-controlled polycyclic expansion protocol, effectively produced a significant increase in maxillary width in skeletally mature subjects in the short term.

Impact of the TOR pathway on plant growth via cell wall remodeling

Plant growth is intimately linked to the availability of carbon and energy status. The Target of rapamycin (TOR) pathway is a highly relevant metabolic sensor and integrator of plant-assimilated C into development and growth. The cell wall accounts for around a third of the cell biomass, and the investment of C into this structure should be finely tuned for optimal growth. The plant C status plays a significant role in controlling the rate of cell wall synthesis. TOR signaling regulates cell growth and expansion, which are fundamental processes for plant development. The availability of nutrients and energy, sensed and integrated by TOR, influences cell division and elongation, ultimately impacting the synthesis and deposition of cell wall components. The plant cell wall is crucial in environmental adaptation and stress responses. TOR senses and internalizes various environmental cues, such as nutrient availability and stresses. These environmental factors influence TOR activity, which modulates cell wall remodeling to cope with changing conditions. Plant hormones, including auxins, gibberellins, and brassinosteroids, also regulate TOR signaling and cell wall-related processes. The connection between nutrients and cell wall pathways modulated by TOR are discussed.

QI short report: Virtual clinics are a safe and efficient method of expanding the hospital diabetic retinopathy service

Demand for hospital diabetic retinopathy (DR) appointments is increasing and exceeding capacity, leading to long waiting lists. Delays in appropriate treatment can cause irreversible yet avoidable vision loss. We assessed if capacity of the DR service could be safely expanded by utilising virtual clinics. Virtual clinics increased the service capacity by more than 100% and did not cause delays in delivering urgent treatments. The majority of patients reviewed had low-risk disease and follow-up could be maintained in the virtual clinic.

Culture and expansion of murine proximal airway basal stem cells

BACKGROUND

The stem cell characteristic makes basal cells desirable for ex vivo modeling of airway diseases. However, to date, approaches allowing them extensively in vitro serial expansion and maintaining bona fide stem cell property are still awaiting to be established. This study aims to develop a feeder-free culture system of mouse airway basal stem cells (ABSCs) that sustain their stem cell potential in vitro, providing an experimental basis for further in-depth research and mechanism exploration.

METHODS

We used ROCK inhibitor Y-27632-containing 3T3-CM, MEF-CM, and RbEF-CM to determine the proper feeder-free culture system that could maintain in vitro stem cell morphology of mouse ABSCs. Immunocytofluorescence was used to identify the basal cell markers of obtained cells. Serial propagation was carried out to observe whether the stem cell morphology and basal cell markers could be preserved in this cultivation system. Next, we examined the in vitro expansion and self-renewal ability by evaluating population doubling time and colony-forming efficiency. Moreover, the differentiation potential was detected by an in vitro differentiation culture and a 3D tracheosphere assay.

RESULTS

When the mouse ABSCs were cultured using 3T3-CM containing ROCK inhibitor Y-27632 in combination with Matrigel-coated culture dishes, they could stably expand and maintain stem cell-like clones. We confirmed that the obtained clones comprised p63/Krt5 double-positive ABSCs. In continuous passage and maintenance culture, we found that it could be subculture to at least 15 passages in vitro, stably maintaining its stem cell morphology, basal cell markers, and in vitro expansion and self-renewal capabilities. Meanwhile, through in vitro differentiation culture and 3D tracheosphere culture, we found that in addition to maintaining self-renewal, mouse ABSCs could differentiate into other airway epithelial cells such as acetylated tubulin (Act-Tub) + ciliated and MUC5AC + mucus-secreting cells. However, they failed to differentiate into alveoli epithelial cells, including alveolar type I and alveolar type II.

CONCLUSION

We established an in vitro feeder-free culture system that allows mouse ABSCs to maintain their stem cell characteristics, including self-renewal and airway epithelium differentiation potential, while keeping up in vitro expansion stability.

Enhanced lignin degradation by Irpex lacteus through expanded sterilization further improved the fermentation quality and microbial community during the silage preservation process

Traditional autoclaving, slow degradation rate and preservation of biomass treated by fungi are the main factors restricting biological treatment. In our previous studies, strains with high efficiency and selective lignin degradation ability were obtained. To further solve the limiting factors of biological treatment, this paper proposed a composite treatment technology, which could replace autoclaves for fungal treatment and improve the preservation and utilization of fungal-pretreated straw. The autoclaved and expanded buckwheat straw were, respectively, degraded by Irpex lacteus for 14 days (CIL, EIL), followed by ensiling of raw materials (CK) and biodegraded straw of CIL and EIL samples with Lactobacillus plantarum for different days, respectively (CP, CIP, EIP). An expansion led to lactic acid bacteria, mold, and yeast of the samples below the detection line, and aerobic bacteria was significantly reduced, indicating a positive sterilization effect. Expansion before I. lacteus significantly enhanced lignin selective degradation by about 6%, and the absolute content of natural detergent solute was about 5% higher than that of the CIL. Moreover, EIL decreased pH by producing higher organic acids. The combination treatment created favorable conditions for ensiling. During ensiling, EIP silage produced high lactic acid about 26.83 g/kg DM and the highest acetic acid about 22.35 g/kg DM, and the pH value could be stable at 4.50. Expansion before I. lacteus optimized the microbial community for ensiling, resulting in EIP silage co-dominated by Lactobacillus, Pediococcus and Weissella, whereas only Lactobacillus was always dominant in CP and CIP silage. Clavispora gradually replaced Irpex in EIP silage, which potentially promoted lactic acid bacteria growth and acetic acid production. In vitro gas production (IVGP) in EIL was increased by 30% relative to CK and was higher than 24% in CIL. The role of expansion was more significant after ensiling, the IVGP in EIP was increased by 22% relative to CP, while that in CIP silage was only increased by 9%. Silage of fungal-treated samples reduced methane emissions by 28% to 31%. The study demonstrated that expansion provides advantages for fungal colonization and delignification, and further improves the microbial community and fermentation quality for silage, enhancing the nutrition and utilization value. This has practical application value for scaling up biological treatment and preserving the fungal-treated lignocellulose.

The Association Between Mother's Descriptive Language and Children with Autism's Conversational Repair: A Moderated Mediation Analysis

This study tested the role of children with autism spectrum disorder (ASD)'s conversational expansion in mediating between mothers' descriptive language and children with ASD's conversational repair, and whether this mediation was moderated by the relative complexity of mother-child language. Videos of forty children with ASD engaging in various activities with their mothers were transcribed into language samples and then coded. Mediation analyses indicated that conversational expansion mediated the association between descriptive language and conversational repair. Moderated mediation analysis further indicated that the relative complexity of mother-child language moderated the relationship between descriptive language and conversational expansion, creating a conditional indirect effect. Although preliminary, the results of this study provide parents and practitioners with a new idea of language intervention strategies.

Immunolabel-First-Expand-Later Expansion Microscopy Approach Using Stable STED Dyes

Multiple expansion microscopy approaches have been successfully used in the analysis of centrioles, centrosomes, and cilia, helping to reveal the localization of numerous centrosomal and ciliary proteins at nanoscale resolution. In this chapter, we describe the use of two stable STED dyes in combination with expansion microscopy, which allows the robust detection by conventional and STED microscopy of proteins immunolabeled prior to sample expansion. We demonstrate the stability of these dyes during the crosslinking, polymerization, and denaturation steps of an expansion protocol thereby allowing their use in an immunolabel-first-expand-later approach. Our protocol overcomes the frequent technical limitation of poor, unreproducible binding of primary antibodies to proteins after denaturation. We demonstrate the applicability of this approach by analyzing both a centriole appendage protein Cep164 and a ciliary protein ARL13B.

White adipose tissue: Distribution, molecular insights of impaired expandability, and its implication in fatty liver disease

We are far behind the 2025 World Health Organization (WHO) goal of a zero increase in obesity. Close to 360 million people in Latin America and the Caribbean are overweight, with the highest rates observed in the Bahamas, Mexico, and Chile. To achieve relevant progress against the obesity epidemic, scientific research is essential to establish uniform practices in the study of obesity pathophysiology (using pre-clinical and clinical models) that ensure accuracy, reproducibility, and transcendent outcomes. The present review focuses on relevant aspects of white adipose tissue (WAT) expansion, underlying mechanisms of inefficient expandability, and its repercussion in ectopic lipid accumulation in the liver during nutritional abundance. In addition, we highlight the potential role of disrupted circadian rhythm in WAT metabolism. Since genetic factors also play a key role in determining an individual's predisposition to weight gain, we describe the most relevant genes associated with obesity in the Mexican population, underlining that most of them are related to appetite control.

Changes in the geographic distribution of the blacklegged tick, Ixodes scapularis, in the United States

Ixodes scapularis (the blacklegged tick) was considered a species of no medical concern until the mid-1970s. By that time, the tick's geographic distribution was thought to be mainly in the southeastern United States (US), with additional localized populations along the Eastern Seaboard north to southern Massachusetts and in the Upper Midwest. Since 1975, I. scapularis has been implicated as a vector of seven human pathogens and is now widely distributed across the eastern US up to the border with Canada. Geographic expansion of tick-borne diseases associated with I. scapularis (e.g., Lyme disease, anaplasmosis, and babesiosis) is attributed to an expanding range of the tick. However, due to changes in tick surveillance efforts over time, it is difficult to differentiate between range expansion and increased recognition of already established tick populations. We provide a history of the documented occurrence of I. scapularis in the US from its description in 1821 to present, emphasizing studies that provide evidence of expansion of the geographic distribution of the tick. Deforestation and decimation of the white-tailed deer (Odocoileus virginianus), the primary reproductive host for I. scapularis adults, during the 1800s presumably led to the tick disappearing from large areas of the eastern US where it previously had been established. Subsequent reforestation and deer population recovery, together with recent climate warming, contributed to I. scapularis proliferating in and spreading from refugia where it had persisted into the early 1900s. From documented tick collection records, it appears I. scapularis was present in numerous locations in the southern part of the eastern US in the early 1900s, whereas in the north it likely was limited to a small number of refugia sites during that time period. There is clear evidence for established populations of I. scapularis in coastal New York and Massachusetts by 1950, and in northwestern Wisconsin by the late 1960s. While recognizing that surveillance for I. scapularis increased dramatically from the 1980s onward, we describe multiple instances of clearly documented expansion of the tick's geographic distribution in the Northeast, Upper Midwest, and Ohio Valley regions from the 1980s to present. Spread and local population increase of I. scapularis, together with documentation of Borrelia burgdorferi sensu stricto in host-seeking ticks, was universally followed by increases in Lyme disease cases in these areas. Southward expansion of northern populations of I. scapularis, for which the host questing behavior of the nymphal stage leads to substantially higher risk of human bites compared with southern populations, into Virginia and North Carolina also was followed by rising numbers of Lyme disease cases. Ongoing surveillance of ticks and tick-borne pathogens is essential to provide the data needed for studies that seek to evaluate the relative roles of land cover, tick hosts, and climate in explaining and predicting geographic expansion of ticks and tick-borne diseases.

Origin, evolution and diversification of plant mechanosensitive channel of small conductance-like (MSL) proteins

Mechanosensitive (MS) ion channels provide efficient molecular mechanism for transducing mechanical forces into intracellular ion fluxes in all kingdoms of life. The mechanosensitive channel of small conductance (MscS) was one of the best-studied MS channels and its homologs (MSL, MscS-like) were widely distributed in cell-walled organisms. However, the origin, evolution and expansion of MSL proteins in plants are still not clear. Here, we identified more than 2100 MSL proteins from 176 plants and conducted a broad-scale phylogenetic analysis. The phylogenetic tree showed that plant MSL proteins were divided into three groups (I, II and III) prior to the emergence of chlorophytae algae, consistent with their specific subcellular localization. MSL proteins were distributed unevenly into each of plant species, and four parallel expansion was identified in angiosperms. In Brassicaceae, most MSL duplicates were derived by whole-genome duplication (WGD)/segmental duplications. Finally, a hypothetical evolutionary model of MSL proteins in plants was proposed based on phylogeny. Our studies illustrate the evolutionary history of the MSL proteins and provide a guide for future functional diversity analyses of these proteins in plants.

Signatures of obstructions and expansions in the arterial frequency response

BACKGROUND AND OBJECTIVE

The blood pressure and flow waveforms carry valuable information about the condition of the cardiovascular system and a patient's health. Waveform analysis in health and pathological conditions can be performed in the time or frequency domains; the information to be emphasised defines the use of either domain. However, physicians are more familiar with the time domain, and the changes in the waveforms due to cardiovascular diseases and ageing are better characterised in such domain. On the other hand, the analysis of the vascular and geometrical variables determining the signatures in the frequency response of local vascular anomalies, such as aneurysms and stenoses, has not been thoroughly explored. This paper aims to characterise the signatures of obstructions (stenoses) and expansions (aneurysms) in the frequency response of tapered arteries.

METHODS

The first step in our methodology was to incorporate the viscous response of the arterial wall into a one-dimensional elastic formulation that solves the governing equations in the frequency domain. As a second step, we imposed a volumetric flow excitation in arteries simulating the aorta with increasing geometry complexity: from straight to tapered arteries with local expansions or obstructions; and we assessed the frequency response.

RESULTS

We found that the obstructions and expansions cause characteristic signatures in an artery's frequency response that are distinguishable from a health condition. The signatures of obstruction and expansions differ; the obstructions increase the magnitude of fundamental frequency and work as a close boundary condition. On the other hand, the expansions diminish the fundamental frequency and work as an open boundary condition. Furthermore, such signatures correlate to the distance between the artery's inlet and the anomaly's starting point and have the potential to pinpoint abnormalities non-invasively.

CONCLUSIONS

We found that the obstructions and expansions cause characteristic signatures in an artery's frequency response that have the potential to detect and follow up on the development of vascular abnormalities. For the latter purpose, constant monitoring may be required; despite this not being a common clinical practice, the new wearable technology offers the possibility of continuous monitoring of biophysical markers such as the pressure waveform.

Ex vivo expansion of natural killer cells for hematological cancer immunotherapy: a systematic review and meta-analysis

The present systematic review aimed to investigate natural killer (NK) cell ex vivo expansion protocols within the scope of clinical trials targeting hematological cancer and to conduct a meta-analysis to assess the effect of NK cell infusion on survival. Research articles of clinical studies in which cell products produced by ex vivo expansion, consisting of a certain amount of NK cells and infused to patients with hematological cancer, were included in the systematic review. We conducted a proportion analysis with random effects for product purity and viability values. Studies having control groups were included in the survival meta-analysis. Among 11.028 identified records, 21 were included in the systematic review. We observed statistically significant heterogeneity for viability (I2 = 97.83%, p < 0.001) and purity values (I2 = 99.95%, p < 0.001), which was attributed to the diversity among isolation and expansion protocols. In addition, the survival meta-analysis findings suggested that NK cell therapy favors disease-free survival (DFS) of patients with myeloid malignancies but limited to only two clinical studies (odds ratio = 3.40 (confidence interval:1.27-9.10), p = 0.01). While included protocols yielded cell products with acceptable viability, the utility of immunomagnetic methods; feeder cells such as K562 expressing membrane-bound IL15 and 4-1BBL or expressing membrane-bound IL21 and 4-1BBL might be preferable to achieve better purity. In conclusion, NK cell therapy has a potential to improve DFS of patients with myeloid malignancies.

Pattern of microimplant displacement during maxillary skeletal expander treatment: A cone-beam computed tomography study

Objective

To analyze the microimplant (MI) displacement pattern on treatment with a maxillary skeletal expander (MSE) using cone-beam computed tomography (CBCT).

Methods

Thirty-nine participants (12 males and 27 females; mean age, 18.2 ± 4.2 years) were treated successfully with the MSE II appliance. Their pre- and post-expansion CBCT data were superimposed. The pre- and post-expansion anterior and posterior inter-MI angles, neck and apical inter-MI distance, plate angle, palatal bone thickness at the MI positions, and suture opening at the MI positions were measured and compared.

Results

The jackscrew plate was slightly bent in both anterior and posterior areas. There was no significant difference in the extent of suture opening between the anterior and posterior MIs (p > 0.05). The posterior MI to hemiplate line was greater than that anteriorly (p < 0.05). The apical distance between the posterior MIs was greater than that anteriorly (p < 0.05). The palatal thickness at the anterior MIs was significantly greater than that posteriorly (p > 0.01).

Conclusions

In the coronal plane, the angulation between the anterior MIs in relation to the jackscrew plate was greater than that between the posterior MIs owing to the differential palatal bone thickness.

Effect of blastocyst shrinkage on assisted reproductive outcomes: a retrospective cohort study describing a new morphological evaluation of blastocyst pre-vitrification and post-warming

BACKGROUND

The failure of frozen-thawed blastocysts to re-expand adequately within a few hours after warming has been reported to have a negative impact on assisted reproductive technology (ART) outcomes. However, the extent to which this failure truly affects ART outcomes has not yet been presented in a manner that is easily understandable to medical practitioners and patients. This study aimed to assess the effects of blastocyst shrinkage on ART outcomes and determine a more effective morphological evaluation approach for use in clinical settings.

METHODS

This retrospective observational cohort study of frozen-thawed blastocyst transfer cycles was conducted from April 2017 to March 2022. Overall, 1,331 cycles were eligible for inclusion, of which 999 were good-quality blastocysts (GQB) and 332 were non-good-quality blastocysts (non-GQB). All frozen-thawed blastocyst transfer cycles performed during the specified study period were included in the study. Exclusion criteria were established to mitigate potential sources of bias as these cycles could impact implantations. We calculated rates and age-adjusted odds ratios of implantation, clinical pregnancy, ongoing pregnancy, and live birth of the re-expansion group, which showed sufficient expansion, and shrinkage group, which showed insufficient expansion. We also calculated the implantation, clinical pregnancy, ongoing pregnancy, and live birth rates of the re-expansion and shrinkage groups for each morphological scoring system parameter.

RESULTS

A reduced ART outcome was observed with use of blastocysts with shrinkage after vitrification/warming. The age-adjusted odds ratios for implantation, clinical pregnancy, ongoing pregnancy, and live birth were lower in the shrinkage group than in the re-expansion group.

CONCLUSIONS

This study examined the adverse effect of blastocyst shrinkage after warming and recovery culturing on reproductive outcomes in a clinically useful manner by retrospectively examining a substantial number of frozen-thawed embryo transfer cycles. The study findings can possibly reduce concerns regarding over- or under-estimation of blastocyst implantation by allowing providers and patients to refer to the data.

Facial acid postburn reconstruction with multiple contemporary procedures in a stepwise fashion

INTRODUCTION AND IMPORTANCE

Facial deformities caused by chemical burns are often complex, seriously affecting the patient's function and quality of life. Treating these injuries requires the incorporation of multi-staged procedures to achieve the desire appearance.

CASE PRESENTATION

A 32-year-old male patient had a total face disfigurement after an acid burn injury. He had apparent front, cheek, and lips scarring and complete nose deformities. His eyebrows were lost. Bilateral upper and lower eyelids adhered to the eye socket. He went through 3 primary operations with many different procedures. The treatment time was shortened over 5 months thanks to the appropriate combination of many processes in the same stage and the proper sequence of surgeries. After 7 years of follow up, the patient was satisfied with the aesthetic results, with no functional limitations.

CLINICAL DISCUSSION

Reconstruction of total facial burn sequelae is always a challenge for surgeons, as it requires much experience to schedule multi-staged procedures, which takes a long time, choose the appropriate material for different anatomical units, and achieve functional and simultaneous aesthetic improvement. The most important thing is to create a prioritized order, adhere to the principles of subunit reconstruction, pay attention to functional and simultaneous aesthetic improvement, and restore the contour and symmetry of the landmarks.

CONCLUSION

By arranging surgeries properly, using suitable reconstructive materials, and paying attention to the integrity of the facial units, an excellent aesthetic and functional outcome can be achieved in a patient with severe facial disfiguration caused by acid burns.

Synthesis of metakaolin-based geopolymer foamed materials using municipal solid waste incineration fly ash as a foaming agent

The existence of metallic aluminum in municipal solid waste incineration fly ash (MSWIFA) makes it challenging to recycle MSWIFA into cement materials because expansion occurs in the resultant matrices. Geopolymer-foamed materials (GFMs) are gaining attention in the field of porous materials due to their high-temperature stability, low thermal conductivity and low CO2 emission. This work aimed to utilize MSWIFA as a foaming agent to synthesize GFMs. The physical properties, pore structure, compressive strength and thermal conductivity were analyzed to assess different GFMs which were synthesized with various MSWIFA and stabilizing agent dosages. X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR) analysis were conducted to characterize the phase transformation of the GFMs. Results showed that when MSWIFA content was increased from 20 to 50%, the porosity of GFMs increased from 63.5 to 73.7%, and bulk density decreased from 890 to 690 kg/m3. The addition of stabilizing agent could trap the foam, refine the cell size, and homogenize the cell size range. With the stabilizing agent increase from 0 to 4%, the porosity increased from 69.9 to 76.8%, and the bulk density decreased from 800 to 620 kg/m3. The thermal conductivity decreased with increasing MSWIFA from 20 to 50%, and stabilizing agent dosage from 0 to 4%. Compared with the collected data from references, a higher compressive strength can be obtained at the same level of thermal conductivity for GFMs synthesized with MSWIFA as a foaming agent. Additionally, the foaming effect of MSWIFA results from the H2 release. The addition of MSWIFA changed both the crystal phase and gel composition, whereas the stabilizing agent dosage had little impact on the phase composition.

Clinical outcomes of arch expansion with Invisalign: a systematic review

OBJECTIVE

This study aims to assess the scientific evidence regarding the clinical outcomes of Invisalign therapy in controlling orthodontic tooth movement.

MATERIALS AND METHODS

An electronic search was conducted on PubMed, Cochrane Library, Web of Science, Embase, and Scopus from November 2015 to November 2022 to identify relevant articles. Methodological shortcomings were highlighted, and an evaluation of the quality of the included studies was completed using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool.

RESULTS

Fifteen non-randomized controlled trials were included in the analysis. Most non-randomized controlled trials (n=11; 73%) were rated with a moderate risk of bias according to the ROBINS-I tool. There were statistically significant differences between the pretreatment and posttreatment arches. The average expansion was significantly different from that predicted for each type of tooth in both the maxilla and mandible. Furthermore, the efficiency decreased from the anterior area to the posterior area in the upper arch.

CONCLUSION

Despite the fact that arch expansion with Invisalign® is not entirely predictable, clear aligner treatment is a viable option for addressing dentition crowding. The efficacy of expansion is greatest in the premolar area. More research focusing on treatment outcomes with different materials of aligners should be conducted in the future. Overcorrection should be considered when planning arch expansion with Invisalign. In the maxilla, the expansion rate decreases from the anterior to the posterior, and presetting sufficient buccal root torque of posterior teeth may result in improved efficiency of expansion.

Advances in the Xenopus immunome: Diversification, expansion, and contraction

Xenopus is a genus of African clawed frogs including two species, X. tropicalis and X. laevis that are extensively used in experimental biology, immunology, and biomedical studies. The availability of fully sequenced and annotated Xenopus genomes is strengthening genome-wide analyses of gene families and transgenesis to model human diseases. However, inaccuracies in genome annotation for genes involved in the immune system (i.e., immunome) hamper immunogenetic studies. Furthermore, advanced genome technologies (e.g., single-cell and RNA-Seq) rely on well-annotated genomes. The annotation problems of Xenopus immunome include a lack of established orthology across taxa, merged gene models, poor representation in gene pages on Xenbase, misannotated genes and missing gene IDs. The Xenopus Research Resource for Immunobiology in collaboration with Xenbase and a group of investigators are working to resolve these issues in the latest versions of genome browsers. In this review, we summarize the current problems of previously misannotated gene families that we have recently resolved. We also highlight the expansion, contraction, and diversification of previously misannotated gene families.

Schott)

Background

Taro is an important potato crop, which can be used as food, vegetable, feed, and industrial raw material. The yield and quality of taro are primarily determined by the expansion degree of taro bulb and the filling condition of starch, whereas the expansion of taro bulb is a complex biological process. However, little information is reviewed on the research progress of bulb expansion and starch enrichment in taro.

Methodology

PubMed, Web of Science, and the China National Knowledge Infrastructure databases were searched for relevant articles. After removing duplicate articles and articles with little relevance, 73 articles were selected for review.

Results

This article introduces the formation and development of taro bulb for workers engaged in taro research. The content includes the process of amyloplast formation at the cytological level and changes in bulb expansion and starch enrichment at physiological levels, which involve endogenous hormones and key enzyme genes for starch synthesis. The effects of environment and cultivation methods on taro bulb expansion were also reviewed.

Conclusions

Future research directions and research focus about the development of taro bulb were proposed. Limited research has been conducted on the physiological mechanism and hormone regulatory pathway of taro growth and development, taro bulb expansion, key gene expression, and starch enrichment. Therefore, the abovementioned research will become the key research direction in the future.

Suspension culture improves iPSC expansion and pluripotency phenotype

BACKGROUND

Induced pluripotent stem cells (iPSCs) offer potential to revolutionize regenerative medicine as a renewable source for islets, dopaminergic neurons, retinal cells, and cardiomyocytes. However, translation of these regenerative cell therapies requires cost-efficient mass manufacturing of high-quality human iPSCs. This study presents an improved three-dimensional Vertical-Wheel® bioreactor (3D suspension) cell expansion protocol with comparison to a two-dimensional (2D planar) protocol.

METHODS

Sendai virus transfection of human peripheral blood mononuclear cells was used to establish mycoplasma and virus free iPSC lines without common genetic duplications or deletions. iPSCs were then expanded under 2D planar and 3D suspension culture conditions. We comparatively evaluated cell expansion capacity, genetic integrity, pluripotency phenotype, and in vitro and in vivo pluripotency potential of iPSCs.

RESULTS

Expansion of iPSCs using Vertical-Wheel® bioreactors achieved 93.8-fold (IQR 30.2) growth compared to 19.1 (IQR 4.0) in 2D (p < 0.0022), the largest expansion potential reported to date over 5 days. 0.5 L Vertical-Wheel® bioreactors achieved similar expansion and further reduced iPSC production cost. 3D suspension expanded cells had increased proliferation, measured as Ki67⁺ expression using flow cytometry (3D: 69.4% [IQR 5.5%] vs. 2D: 57.4% [IQR 10.9%], p = 0.0022), and had a higher frequency of pluripotency marker (Oct4⁺Nanog⁺Sox2⁺) expression (3D: 94.3 [IQR 1.4] vs. 2D: 52.5% [IQR 5.6], p = 0.0079). q-PCR genetic analysis demonstrated a lack of duplications or deletions at the 8 most commonly mutated regions within iPSC lines after long-term passaging (> 25). 2D-cultured cells displayed a primed pluripotency phenotype, which transitioned to naïve after 3D-culture. Both 2D and 3D cells were capable of trilineage differentiation and following teratoma, 2D-expanded cells generated predominantly solid teratomas, while 3D-expanded cells produced more mature and predominantly cystic teratomas with lower Ki67⁺ expression within teratomas (3D: 16.7% [IQR 3.2%] vs.. 2D: 45.3% [IQR 3.0%], p = 0.002) in keeping with a naïve phenotype.

CONCLUSION

This study demonstrates nearly 100-fold iPSC expansion over 5-days using our 3D suspension culture protocol in Vertical-Wheel® bioreactors, the largest cell growth reported to date. 3D expanded cells showed enhanced in vitro and in vivo pluripotency phenotype that may support more efficient scale-up strategies and safer clinical implementation.

APEX1 Nuclease and Redox Functions are Both Essential for Adult Mouse Hematopoietic Stem and Progenitor Cells

Self-renewal and differentiation of hematopoietic stem and progenitor cells (HSPCs) are carefully controlled by extrinsic and intrinsic factors, to ensure the lifelong process of hematopoiesis. Apurinic/apyrimidinic endonuclease 1 (APEX1) is a multifunctional protein implicated in DNA repair and transcriptional regulation. Although previous studies have emphasized the necessity of studying APEX1 in a lineage-specific context and its role in progenitor differentiation, no studies have assessed the role of APEX1, nor its two enzymatic domains, in supporting adult HSPC function. In this study, we demonstrated that complete loss of APEX1 from murine bone marrow HSPCs (induced by CRISPR/Cas9) caused severe hematopoietic failure following transplantation, as well as a HSPC expansion defect in culture conditions maintaining in vivo HSC functionality. Using specific inhibitors against either the nuclease or redox domains of APEX1 in combination with single cell transcriptomics (CITE-seq), we found that both APEX1 nuclease and redox domains are regulating mouse HSPCs, but through distinct underlying transcriptional changes. Inhibition of the APEX1 nuclease function resulted in loss of HSPCs accompanied by early activation of differentiation programs and enhanced lineage commitment. By contrast, inhibition of the APEX1 redox function significantly downregulated interferon-stimulated genes and regulons in expanding HSPCs and their progeny, resulting in dysfunctional megakaryocyte-biased HSPCs, as well as loss of monocytes and lymphoid progenitor cells. In conclusion, we demonstrate that APEX1 is a key regulator for adult regenerative hematopoiesis, and that the APEX1 nuclease and redox domains differently impact proliferating HSPCs.

Ex vivo expansion of hematopoietic stem cells

Hematopoietic stem cells (HSCs) are multipotent progenitor cells that can differentiate into various mature blood cells and immune cells, thus reconstituting hematopoiesis. By taking advantage of the tremendous potential of HSCs, varied hereditary and hematologic diseases are promised to be alleviated or cured. To solve the contradiction between the growing demand for HSCs in disease treatment and the low population of HSCs in both cord blood and bone marrow, ex vivo HSC expansion along with multiple protocols has been investigated for harvesting adequate HSCs over the past two decades. This review surveys the state-of-the-art techniques for ex vivo HSC self-renewal and provides a concise summary of the effects of diverse intrinsic and extrinsic factors on the expansion of HSCs. The remaining challenges and emerging opportunities in the field of HSC expansion are also presented.

The lineage-specific evolution of the oleosin family in Theaceae

Oleosins play essential roles in stabilization of lipid droplets (LDs) and seed oil production. However, evolution of this gene family has not been reported in Theaceae, a large plant family that contains many important tea and oil tea species. In this study, a total of 65 oleosin genes were identified in nine genome-sequenced Theaceae species. Among these genomes, the gene number of oleosin showed significant difference, with Camellia sinensis var. sinensis cv. Shuchazao and Camellia lanceoleosa displayed more oleosin numbers than other species. Phylogenetic analyses revealed that Theaceae oleosin genes were classified into three clades (U, SL, SH) respectively. Proteins within the same clade had similar gene structure and motif composition. Segmental duplication was the primary driving force for the evolution of oleosin genes in Shuchazao (SCZ), Huangdan (HD), C.lanceoleosa (Cla), and wild tea (DASZ). Synteny analysis showed that most oleosin genes displayed inter-species synteny among tea and oil tea species. Expression analysis demonstrated that oleosin genes were specifically expressed in seed and kernel of Huangdan (HD) and C.lanceoleosa. Moreover, expression divergence was observed in paralogous pairs and ∼1-2 oleosin genes in each clade have become activate. This study leads to a comprehensive understanding of evolution of oleosin family in Theaceae, and provides a rich resource to further address the functions of oleosin in tea and oil tea species.

"Doc in the Box": The impact of an emergency department move on interprofessional collaboration, patient care, and clinician job satisfaction

OBJECTIVE

Health care organizations undergo unit space reconfiguration (e.g., expansion) projects in order to accommodate rising patient volumes with limited health care space. The purpose of this study was to describe the impact of an emergency department physical space move on clinician-perceived interprofessional collaboration, patient care delivery, and clinician job satisfaction.

METHOD

A secondary qualitative, descriptive data analysis of 39 in-depth interviews from an ethnography was conducted from August 2019 to February 2021 at an academic medical center emergency department with nurses, physicians, and patient care technicians in the Southeastern United States. The Social Ecological Model was a conceptual guide for the analysis.

RESULTS

Three study themes, "It's like an old dive bar", "spatial blind spot", and "privacy and aesthetic work environment" emerged from the 39 interviews. Clinicians perceived that the move from a centralized to decentralized work space impacted interprofessional collaboration through divided clinician work spaces. Increased square footage in the new emergency department was beneficial for patient satisfaction but contributed to difficulty monitoring patients for care escalation. However, increased space and individualized patient rooms increased perceived clinician job satisfaction.

CONCLUSION

Space reconfiguration projects inhealth carecan have positive implications for patient care, but may result in inefficiencies to the health care team and patient care that must be considered. Study findings inform health care work environment renovation projects on an international level.

Understanding the Origin and Evolution of Tea (Camellia sinensis [L.]): Genomic Advances in Tea

Tea, which is processed by the tender shoots or leaves of tea plant (Camellia sinensis), is one of the most popular nonalcoholic beverages in the world and has numerous health benefits for humans. Along with new progress in biotechnologies, the refined chromosome-scale reference tea genomes have been achieved, which facilitates great promise for the understanding of fundamental genomic architecture and evolution of the tea plants. Here, we summarize recent achievements in genome sequencing in tea plants and review the new progress in origin and evolution of tea plants by population sequencing analysis. Understanding the genomic characterization of tea plants is import to improve tea quality and accelerate breeding in tea plants.

Phenotype and management of neurologic intronic repeat disorders (NIRDs)

During recent years an increasing number of neurologic disorders due to expanded tri-, tetra-, penta-, or hexa-nucleotide repeat motifs in introns of various genes have been described (neurologic intronic repeat disorders (NIRDs)). The repeat may be pathogenic in the heterozygous or homozygous form. Repeat lengths vary considerably and can be stable or unstable during transmission to the next generation. The most well-known NIRDs are Friedreich ataxia, spinocerebellar ataxia types-10, -31, and -36, CANVAS, C9Orf72 familial amyotrophic lateral sclerosis (fALS), and myotonic dystrophy-2 (MD2). Phenotypically, NIRDs manifest as mono-organ (e.g. spinocerebellar ataxia type 31) or multi-organ disease (e.g. Friedreich ataxia, myotonic dystrophy-2). A number of other more rare NIRDs have been recently detected. This review aims at summarising and discussing previous findings and recent advances concerning the etiology, pathophysiology, clinical presentation, and therapeutic management of the most common NIRDs.

Controlled amplification in oncology dose-finding trials

In oncology clinical trials the guiding principle of model-based dose-finding designs for cytotoxic agents is to progress as fast as possible towards, and identify, the dose level most likely to be the MTD. Recent developments with non-cytotoxic agents have broadened the scope of early phase trials to include multiple objectives. The ultimate goal of dose-finding designs in our modern era is to collect the relevant information in the study for final RP2D determination. While some information is collected on dose levels below and in the vicinity of the MTD during the escalation (using conventional tools such as the Continual Reassessment Method for example), designs that include expansion cohorts or backfill patients effectively amplify the information collected on the lower dose levels. This is achieved by allocating patients to dose levels slightly differently during the study in order to take into account the possibility that "less (dose) might be more". The objective of this paper is to study the concept of amplification. Under the heading of controlled amplification we can include dose expansion cohorts and backfill patients among others. We make some general observations by defining these concepts more precisely and study a specific design that exploits the concept of controlled amplification.

Measuring urban expansion pattern using spatial matrices in Khulna City, Bangladesh

Khulna, the third-largest metropolitan area in Bangladesh, has become a potential site for the polycentric urbanization for multiple mega-projects. Measurement of urban expansion is essential for regulating haphazard growth and achieving effective management. This study aims to quantify and compare the urban expansion pattern of Khulna City Corporation (KCC) and surrounding areas' development hotspots. Landsat remote sensing images of 1990, 2000, 2010 and 2020 were used to perform supervised classification using Geographic Information System (GIS). To quantify urban expansion, we compute Annual Urban Expansion Rate, Urban Expansion Intensity Index, and Urban Expansion Differentiation Index. Although annual urban expansion in the study area was slow during the first two decades, it accelerated to 6.76% during the last decade. 48% of the total built-up areas have grown during 2010-2020 alone. Even though KCC experienced continuous urban growth over a thirty-year period, after 2010, the rate of urban expansion in peripheral areas exceeded that of KCC. Transboundary and intra-regional transportation and economic corridor development, establishment of economically potential zones (EPZ), urban to rural migration, availability of rich agriculture hinterland, low land price and several direct transportation links between the core and periphery are the major influencing factors of peri-urbanization.

Rapid maxillary expansion vs slow maxillary expansion in patients with cleft lip and/or palate: a systematic review and meta-analysis

OBJECTIVES

To compare the dentoalveolar outcomes of slow maxillary expansion (SME) and rapid maxillary expansion (RME) used for maxillary expansion before secondary alveolar bone grafting in patients with cleft lip and/or palate (CL/P). Secondarily, the advantages and disadvantages of SME vs RME were reviewed.

MATERIALS AND METHODS

A systematic search was conducted up to November 2021, including Medline (via PubMed), Embase (via Ovid), Web of Science, Cochrane Central, and Google Scholar. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Risk-of-bias assessment was performed using the Risk of Bias (RoB 2.0) and Risk Of Bias In Non-randomized Studies of Interventions (ROBINS I) tool. Overall quality was assessed using the Grading of Recommendations Assessment, Development, and Evaluation tool.

RESULTS

Of 4007 records, five studies met the inclusion criteria. The randomized control trial (RCT) had a low risk of bias, the non-RCTs presented with a moderate risk of bias. Arch width and perimeter increased significantly with both SME and RME treatments. No difference in the increase in palatal depth was found. The meta-analysis showed a greater anterior-to-posterior expansion ratio for the Quad Helix (QH) appliance. The results for dental tipping were not conclusive.

CONCLUSIONS

SME and RME promote equal posterior expansion in cleft patients. The anterior differential expansion is greater with SME (QH appliance). No clear evidence exists concerning the amount of dental adverse effects of SME and RME in cleft patients.

In Vitro Analysis of CTLA-4-Mediated Transendocytosis by Regulatory T Cells

Regulatory T Cells (Tregs) constitutively express the inhibitory receptor CTLA-4, which is fundamental to their role in immune suppression. Mechanistically, CTLA-4 on Tregs can attenuate T cell activation by physically removing and internalizing costimulatory ligands CD80 and CD86 from the surface of antigen-presenting cells by transendocytosis. Therefore, the process of transendocytosis can be harnessed as a tool to study the molecular basis of CTLA-4 biology and a key aspect of Treg suppressive function. In this chapter, we describe a method of human Treg isolation and expansion resulting in high CTLA-4 expression. We then detail a transendocytosis assay using artificial antigen-presenting cells (DG-75 B Cell lines) expressing fluorescently tagged ligands mixed with the expanded Tregs. This methodology can be applied to testing of patients carrying CTLA-4 mutations, providing a robust model to assess the degree of functional disruption.

Natural Killer Cell Expansion and Cytotoxicity Differ Depending on the Culture Medium Used

Background

Adoptive cell therapy using umbilical cord blood (UCB)-derived allogeneic natural killer (NK) cells has shown encouraging results. However, because of the insufficient availability of NK cells and limited UCB volume, more effective culture methods are required. NK cell expansion and functionality are largely affected by the culture medium. While human serum is a major affecting component in culture media, the way it regulates NK cell functionality remains elusive. We elucidated the effects of different culture media and human serum supplementation on UCB NK cell expansion and functionality.

Methods

UCB NK cells were cultured under stimulation with K562-OX40L-mbIL-18/21 feeder cells and IL-2 and IL-15 in serum-containing and serum-free culture media. The effects of the culture media and human serum supplementation on NK cell expansion and cytotoxicity were evaluated by analyzing the expansion rate, activating and inhibitory receptor levels, and the cytotoxicity of the UCB NK cells.

Results

The optimal medium for NK cell expansion was Dulbecco’s modified Eagle’s medium/Ham’s F12 with supplements and that for cytotoxicity was AIM V supplemented with Immune Cell Serum Replacement. Shifting media is an advantageous strategy for obtaining several highly functional UCB NK cells. Live cell imaging and killing time measurement revealed that human serum enhanced NK cell proliferation but delayed target recognition, resulting in reduced cytotoxicity.

Conclusions

Culture medium supplementation with human serum strongly affects UCB NK cell expansion and functionality. Thus, culture media should be carefully selected to ensure both NK cell quantity and quality for adoptive cell therapy.

Comparing Expansion of Maxillary Antrum between Periapical Surgery and Extraction of Permanent Maxillary First Molar in Pediatric Patients Using CBCT

AIM

To compare the expansion of maxillary antrum between periapical surgery and extraction of permanent maxillary first molar in pediatric patients using cone-beam computed tomography (CBCT).

MATERIALS AND METHODS

In this study, 136 participants in the age-group of 11-18 years were included. The participants were divided into two groups. Group A consisted of patients who underwent extraction of the permanent maxillary first molars. Group B consisted of patients who underwent endodontic microsurgery in the periapical area. Group A included 68 participants while group B also included 68 study subjects. The expansion of the maxillary antrum was obtained after evaluating the change in volume of maxillary antrum at 6 months and 24 months in relation to the volume of maxillary antrum at the time of the procedure (baseline). For calculating the volume of the maxillary antrum, three parameters were taken into consideration. These parameters were an anteroposterior (AP) dimension, mesiodistal dimension (MD), and superoinferior (SI) dimension. Cone-beam computed tomography was used for carrying out these measurements with the help of Dolphin software.

RESULTS

An expansion of 675.27 ± 32 mm³ was observed in group A between baseline and 6 months of extraction, while the expansion of 765.47 ± 24 mm³ was observed between 6 months and 24 months of extraction. This intragroup difference was statistically significant (p = 0.001). On the other hand, an expansion of 652.28 ± 43 mm³ was observed in group B between baseline and 6 months after periapical surgery and expansion of 969.43 ± 12 mm³ was observed between 6 months and 24 months after periapical endodontic surgery. This intragroup difference was statistically significant. In the control group, an expansion of 152.11 ± 12.101 mm³ was observed between baseline and 6 months after procedures while an expansion of 347.01 ± 6.781 mm³ was observed between 6 months and 24 months of procedures. The intragroup difference was significant statistically.

CONCLUSION

In this study, expansion of maxillary antrum was observed in both extraction of the maxillary permanent first molar in pediatric patients and the periapical endodontic surgery, and the expansion of maxillary antrum was more in cases of periapical endodontic surgery; however, the difference was non-significant statistically.

CLINICAL SIGNIFICANCE

Maxillary antrum expansion is clinically important during maxillary permanent tooth extraction or endodontic periapical surgery in pediatric patients because the growth of maxillary bones is in the growing stage in these patients. There are certain limitations of conventional two-dimensional (2D) radiographic techniques such as shortening, elongation, and superimposition of images. Recently, three-dimensional technique (3D) such as CBCT has been introduced in which these disadvantages have been eliminated.

Managing the moral expansion of medicine

Science and technology have vastly expanded the realm of medicine. The numbers of and knowledge about diseases has greatly increased, and we can help more people in many more ways than ever before. At the same time, the extensive expansion has also augmented harms, professional responsibility, and ethical concerns. While these challenges have been studied from a wide range of perspectives, the problems prevail. This article adds value to previous analyses by identifying how the moral imperative of medicine has expanded in three ways: (1) from targeting experienced phenomena, such as pain and suffering, to non-experienced phenomena (paraclinical signs and indicators); (2) from addressing present pain to potential future suffering; and (3) from reducing negative wellbeing (pain and suffering) to promoting positive wellbeing. These expansions create and aggravate problems in medicine: medicalization, overdiagnosis, overtreatment, risk aversion, stigmatization, and healthism. Moreover, they threaten to infringe ethical principles, to distract attention and responsibility from other competent agents and institutions, to enhance the power and responsibility of professionals, and to change the professional-beneficiary relationship. In order to find ways to manage the moral expansion of medicine, four traditional ways of setting limits are analyzed and dismissed. However, basic asymmetries in ethics suggest that it is more justified to address people’s negative wellbeing (pain and suffering) than their positive wellbeing. Moreover, differences in epistemology, indicate that it is less uncertain to address present pain and suffering than future wellbeing and happiness. Based on these insights the article concludes that the moral imperative of medicine has a gradient from pain and suffering to wellbeing and happiness, and from the present to the future. Hence, in general present pain and suffering have normative priority over future positive wellbeing.

Evolutionary history of the NLR gene families across lophotrochozoans

NOD-like receptor (NLR) genes are critical innate immune receptors in animals and plants. Lophotrochozoans represent one of the most species-rich superphyla that includes molluscs, segmented worms, flatworms, bryozoans, and other invertebrates, which is crucial to our understanding of immune system evolution in bilaterians. However, NLRs have not been systematically described in lophotrochozoans. We annotated 185 NLRs in 29 lophotrochozoan genomes, and analyzed their domain organization, phylogenetic distribution, molecular evolution, and gene expression. We found that all the 24 molluscan genomes studied encoded no more than three NLRs. None of these molluscan NLRs represented an inducible expression pattern under the infection of eight pathogens; some molluscan NLRs showed developmental stage-specific expression patterns. Instead, 29 molluscan incomplete NLR (incNLR) genes, encoding for proteins absent in the NACHT domain were upregulated under pathogen infection. We also documented the species-specific expansion of NLRs in the clades Polychaeta and Pteriidae. Our study revealed that gene duplication, domain shuffling, gene loss, and novel expression pattern played important roles in the molecular evolution of NLRs.

Expanding the living liver donor pool in countries having limited deceased donor activity: Pakistani perspective

Over the last decades, liver transplantation (LT) has evolved into a life-saving procedure. Due to limited deceased donor activities in the eastern world, living donor liver transplantation (LDLT) had flourished tremendously in most Asian countries. Yet, these LDLT activities fall short of meeting the expected demands. Pakistan, a developing country, bears a major burden of liver diseases. Currently, only few centers offer LDLT services in the country. On the other hand, deceased donor liver transplantation (DDLT) activities have not started due to social, cultural, and religious beliefs. Various strategies can be adopted successfully to overcome the scarcity of live liver donors (LLDs) and to expand the donor pool, keeping in view donor safety and recipient outcome. These include consideration of LLDs with underlying clinical conditions like G6PD deficiency and Hepatitis B core positivity. Extended donor criteria can also be utilized and relaxation can be made in various donors' parameters including upper age and body mass index after approval from the multidisciplinary board. Also, left lobe grafts, grafts with various anatomical variations, and a low graft-to-recipient ratio can be considered in appropriate situations. ABO-incompatible LT and donor swapping at times may help in expanding the LLDs pool. Similarly, legislation is needed to allow live non-blood-related donors for organ donations. Finally, community education and awareness through various social media flat forms are needed to promote deceased organ donation.

Clinical application of maxillary tissue bone-borne expander and biocreative reverse curve system in the orthodontic retreatment of severe anterior open bite with transverse discrepancy: A case report

Anterior open bite and transverse discrepancy are often accompanied by hyperdivergent skeletal patterns. In addition, degenerative joint disorders and vertical maxillary excess contribute to an unfavorable convex facial profile with a retruded chin. Correction of this complex three-dimensional problem with orthodontic treatment alone is considered challenging owing to anatomical limitations. Moreover, a history of orthodontic treatment with premolar extraction makes retreatment difficult. This case report illustrates the application of a maxillary tissue bone-borne expander and biocreative reverse curve system in a 23-year-old female patient with a severe anterior open bite and transverse discrepancy who underwent orthodontic treatment with four premolar extractions. By setting the treatment target under precise diagnosis and using appropriate appliances, a satisfactory treatment result could be achieved without orthognathic surgery.

Effect and stability of miniscrew-assisted rapid palatal expansion: A systematic review and meta-analysis

Objective

This study aimed to systematically analyze the effect and stability of miniscrew-assisted rapid palatal expansion (MARPE) to provide a reference for the clinical treatment of patients with maxillary transverse deficiency (MTD).

Methods

We searched PubMed, Science Direct, Web of Science, Embase, Cochrane Library, CNKI, and Wanfang Database for relevant studies published before February 18, 2021 and selected them according to the eligibility criteria. The Cochrane Handbook for Systematic Reviews (version 5.1.0) criteria were used for the quality assessment of randomized controlled trials, while the scoring protocol of the methodological index for non-randomized studies was used for non-randomized controlled trials. Statistical analysis was performed using the RevMan5.3 software.

Results

All the included studies showed a relatively high success rate of expansion. The changes in both the intermolar and alveolar widths after MARPE were statistically significant. MARPE exhibited greater skeletal expansion effects than did conventional RPE. The midpalatal suture was opened in parallel after MARPE. A small amount of relapse was observed 1 year after expansion. MARPE caused tooth inclination and a decrease in alveolar height, but it was less significant than in conventional RPE.

Conclusions

MARPE may be an effective treatment modality for patients with MTD. It causes great transverse skeletal expansion in late adolescence. In comparison to conventional RPE, MARPE has lower detrimental periodontal effects and has certain clinical advantages.

Bioengineered 3D microfibrous-matrix modulates osteopontin release from MSCs and facilitates the expansion of hematopoietic stem cells

The osteopontin released from mesenchymal stem cells (MSC) undergoing lineage differentiation can negatively influence the expansion of hematopoietic stem cells (HSCs) in co-culture systems developed for expanding HSCs. Therefore, minimising the amount of osteopontin in the co-culture system is important for the successful ex vivo expansion of HSCs. Towards this goal, a bioengineered 3D microfibrous-matrix that can maintain MSCs in less osteopontin-releasing conditions has been developed, and its influence on the expansion of HSCs has been studied. The newly developed 3D matrix significantly decreased the release of osteopontin, depending on the MSC culture conditions used during the priming period before HSC seeding. The culture system with the lowest amount of osteopontin facilitated a more than 24-fold increase in HSC number in 1 week time period. Interestingly, the viability of expanded cells and the CD34+ pure population of HSCs were found to be the highest in the low osteopontin-containing system. Therefore, bioengineered microfibrous 3D matrices seeded with MSCs, primed under suitable culture conditions, can be an improved ex vivo expansion system for HSC culture. This article is protected by copyright. All rights reserved.

Genomic insights into lineage-specific evolution of the oleosin family in Euphorbiaceae

BACKGROUND

Lipid droplets (LDs) present in land plants serve as an essential energy and carbon reserve for seed germination and seedling development. Oleosins, the most abundant structural proteins of LDs, comprise a small family involved in LD formation, stabilization and degradation. Despite their importance, our knowledge on oleosins is still poor in Euphorbiaceae, a large plant family that contains several important oil-bearing species.

RESULTS

To uncover lineage-specific evolution of oleosin genes in Euphorbiaceae, in this study, we performed a genome-wide identification and comprehensive comparison of the oleosin family in Euphorbiaceae species with available genome sequences, i.e. castor bean (Ricinus communis), physic nut (Jatropha curcas), tung tree (Vernicia fordii), Mercurialis annua, cassava (Manihot esculenta) and rubber tree (Hevea brasiliensis), and a number of five, five, five, five, eight and eight members were found, respectively. Synteny analysis revealed one-to-one collinear relationship of oleosin genes between the former four (i.e. castor bean, physic nut, tung tree and M. annua) as well as latter two species (i.e. cassava and rubber tree), whereas one-to-one and one-to-two collinear relationships were observed between physic nut and cassava, reflecting the occurrence of one recent whole-genome duplication (WGD) in the last common ancestor of cassava and rubber tree. The presence of five ortholog groups representing three previously defined clades (i.e. U, SL and SH) dates back at least to the Malpighiales ancestor, because they are also conserved in poplar (Populus trichocarpa), a tree having experienced one Salicaceae-specific recent WGD. As observed in poplar, WGD was shown to be the main driver for the family expansion in both cassava and rubber tree. Nevertheless, same retention patterns of WGD-derived duplicates observed in cassava and rubber tree are somewhat different from that of poplar, though certain homologous fragments are still present in rubber tree. Further transcriptional profiling revealed an apparent seed-predominant expression pattern of oleosin genes in physic nut, castor bean and rubber tree. Moreover, structure and expression divergence of paralogous pairs were also observed in both cassava and rubber tree.

CONCLUSION

Comparative genomics analysis of oleosin genes reported in this study improved our knowledge on lineage-specific family evolution in Euphorbiaceae, which also provides valuable information for further functional analysis and utilization of key members and their promoters.

The Impact of Different Cell Culture Mediums on CD8+ T Cells Expansion: A Bioinformatics Study

Objective

Different Cell Culture medias can affect the expansion of T cells. The aim of this study is to assess signaling pathways, protein interactions and genes in T cells cultured in different common T cell expansion medias to select the best candidate.

Materials and Methods

In this in silico observational study, with the use of bioinformatics analysis and the use of enrichment databases, gene expression profiles were investigated using microarray analysis.

Results

The results of this study were the joint selection of 26 upregulated genes and 59 downregulated genes that were involved in SREBP control of lipid synthesis, co-stimulatory signal during T-cell activation mitosis and chromosome dynamics, telomeres, telomerase, and cellular aging signal pathways.

Conclusion

Using bioinformatics analyzes, integrated and regular genes were selected as common genes CD80, LST1, ATM and ITM2B 4-1BBL, Akt inhibitor, interleukin 7 and 15 expansion media.

Expansion of eigenvalues of the perturbed discrete bilaplacian

We consider the family H ^ μ : = Δ ^ Δ ^ - μ V ^ , μ ∈ R , of discrete Schrödinger-type operators in d-dimensional lattice Z d , where Δ ^ is the discrete Laplacian and V ^ is of rank-one. We prove that there exist coupling constant thresholds μ o , μ o ≥ 0 such that for any μ ∈ [ - μ o , μ o ] the discrete spectrum of H μ ^ is empty and for any μ ∈ R \ [ - μ o , μ o ] the discrete spectrum of H μ ^ is a singleton { e ( μ ) } , and e ( μ ) < 0 for μ > μ o and e ( μ ) > 4 d 2 for μ < - μ o . Moreover, we study the asymptotics of e ( μ ) as μ ↘ μ o and μ ↗ - μ o as well as μ → ± ∞ . The asymptotics highly depends on d and V ^ .

Nanocasting of fibrous morphology on a substrate for long-term propagation of human induced pluripotent stem cells

Human-induced pluripotent stem cells (hiPSCs) can be self-renewed for many generations on nanofibrous substrates. Herein, a casting method is developed to replicate the nanofibrous morphology into a thin layer of polymethylsiloxane (PDMS). The template is obtained by electrospinning and chemical crosslinking of gelatin nanofibers on a glass slide. The replicas of the template are surface-functionalized by gelatin and used for propagation of hiPSCs over tenth generations. The performance of the propagated hiPSCs is checked by immunofluorescence imaging, flowcytometry, and RT-PCR, confirming the utility of the method. The results are also compared with those obtained using electrospun nanofiber substrates. Inherently, the PDMS replicas is of low stiffness and can be reproduced easily. Compared to other patterning techniques, casting is more flexible and cost-effective, suggesting that this method might find applications in cell-based assays that rely on stringent consideration of both substrate stiffness and surface morphology.

Comparison of 2,3,5,4'-tetrahydroxystilbene-2-O-b-D-glucoside-induced proliferation and differentiation of dental pulp stem cells in 2D and 3D culture systems-gene analysis

Background/purpose

Culture environments play a critical role in stem cell expansion. This study aimed to evaluate the effects of 2,3,5,4′-tetrahydroxystilbene-2-O-b-D-glucoside (THSG) on the proliferation and differentiation of human dental pulp stem cells (DPSCs) in 2-dimensional (2D) and 3-dimensional (3D) culture systems.

Materials and methods

Human DPSCs were seeded in T25 flasks for 2D cultivation. For the 3D culture system, DPSCs were mixed with microcarriers and cultured in spinner flasks. Cells in both culture systems were treated with THSG, and cell proliferation was determined using a cell counter and a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide assay. In THSG-treated DPSCs, the genes associated with proliferation, adipogenesis, neurogenesis, osteogenesis, pluripotency, oncogenesis, and apoptosis were analyzed using real-time polymerase chain reactions.

Results

The spinner flask time-dependently improved cell numbers, cell viability, and expansion rates in THSG-treated DPSCs. In both the T25 and spinner flasks, the messenger RNA (mRNA) levels of proliferation, osteogenesis, and pluripotent-related genes had a significant maximum expression with 10 μM THSG treatment. However, 0.1 μM of THSG may be the most suitable condition for triggering neurogenesis and adipogenesis gene expression when DPSCs were cultured in spinner flasks. Furthermore, the number of oncogenes and apoptotic genes decreased considerably in the presence of THSG in both the T25 and spinner flasks.

Conclusion

The spinner flask bioreactor combined with THSG may upregulate proliferation and lineage-specific differentiation in DPSCs. Thus, the combination can be used to mass-produce and cultivate human DPSCs for regenerative dentistry.

Interleukin-1beta triggers the expansion of circulating granulocytic myeloid-derived suppressor cell subset dependent on Erk1/2 activation

Chronic inflammation contributes to cancer development and progression. Although interleukin-1beta (IL-1β) has been observed to be associated with an general immune suppression of T cell response and the immunosuppression strongly correlates with accumulation of myeloid-derived suppressor cells (MDSCs), the relationship and mechanism between MDSCs expansion and IL-1β expression remain ambiguous. Here, we showed that the concentration of IL-1β was highly correlated with G-MDSC subset, rather than mo-MDSC subset. Recombinant IL-1β increased the percentage of G-MDSCs in the blood of tumor-bearing mice, and IL-1Ra attenuated the accumulation of G-MDSCs in the tumor-bearing mice. In addition, the IL-1β-overexpressing B16F10 cells induced higher level of G-MDSCs compared with wild-type B16F10 cells. Moreover, we found that the accumulation of G-MDSCs induced by IL-1β was dependent on the activation of extracellular signal-regulated kinases 1 and 2 (Erk1/2). Collectively, these findings show a novel role of IL-1β in G-MDSCs accumulation by activating Erk1/2, which suggests that IL-1β elimination or Erk1/2 signaling blockade could decrease G-MDSCs generation and thereby improve host immunosurveillance.

Spatio-temporal evaluation of the urban agglomeration expansion in the middle reaches of the Yangtze River and its impact on ecological lands

In developing countries, urban agglomerations have become one of the most important carriers of urbanization. In China, one of the largest national urban agglomerations is the UAMRYR (urban agglomeration in the middle reaches of the Yangtze River), which has the fastest urban development in Central China and is home to critical ecological spaces. On this basis, this study analyzed the urban expansion and loss of ecological lands in UAMRYR by establishing a spatial database, grid system, rose maps, and scenario simulation. The highlights of results are as follows: the urban expansion of UAMRYR includes four stages of development: steady growth, accelerated development, peak, and deceleration. Polarized development has occurred in the region, with the Wuhan, Changsha-Zhuzhou-Xiangtan, and Nanchang metropolitan areas having high levels of urban expansion while the other cities have varying levels of urban growth. The loss of ecological land was found to have a highly similar curve and spatial distribution with the urban growth. In terms of ecological land types, the loss of agricultural land accounted for more than half of ecological lands lost overall. Losses in forests, grasslands, wetlands, and water areas varied for different areas, depending on particular conditions and specific environmental characteristics of the city. The three metropolitan areas experienced the highest increases in urban built-up areas; they also had the highest loss of ecological land, which can have critical consequences given their proximity to the Yangtze River, Poyang Lake, Dongting Lake, and other important environmental sensitive areas. The simulation results show that the UAMRYR is projected to maintain a rapid expansion rate from 2020 to 2030. If the urban expansion, particularly in the metropolitan areas, is not managed well and controlled, serious ecological damage could be inflicted on the Yangtze River Basin.