BackgroundGastroesophageal reflux disease is a common disorder affecting a large section of the community. In addition, the numerous complications of chronic gastroesophageal reflux disease (GERD) necessitate adequate diagnosis and treatment of this common entity. Thus, to analyze the spectrum of GERD on the basis of symptoms and endoscopic findings along with the contributory effects of various risk factors including obesity, this specific study has been carried out.Study designA descriptive type of observational study was conducted on the patients visiting the outpatient department (OPD) at Acharya Vinoba Bhave Rural Hospital (AVBRH), affiliated with Datta Meghe Institute of Medical Sciences (DMIMS), Wardha, Maharashtra. The clinical symptoms, suspected risk factors, and endoscopic findings of the patients were studied, assessed, and correlated.Methods and materialPatients, more than 18 years of age complaining of a minimum of two typical symptoms of GERD for at least one month, were included in the study. Demographic data, clinical symptomatology, and personal history of the patients were noted. All the patients were subjected to esophagogastroduodenoscopy, and findings were recorded. Correlation and analysis were done on clinical and endoscopic findings.Statistical analysisThis descriptive study has been conducted after the approval of the Ethics Committee Department of Medical Education, Jawaharlal Nehru Medical College, Deemed University, Sawangi (DMIMS(DU)/IEC/Sept-2019/8403). The outcomes were recorded and analyzed at the end of the study using a Microsoft Excel Spreadsheet .Results and conclusionA total of 100 patients were included in the study. A number of male patients (58%) were more than that of female patients. Most of the patients were in the age group of 30-60 years (70%). The most common symptoms were epigastric pain (78%), regurgitation (71%), and heartburn (63%). Forty-five percent of the patients had erosive lesions suggestive of reflux esophagitis on endoscopic evaluation. Primary health care practitioners come across various common diseases during their medical service. One such common disorder is gastroesophageal reflux disease (GERD) . It is mGERD is a disease constituting symptoms or complications developed due to reflux of stomach contents back into the esophagus . This diCharacteristic symptoms commonly found and suggestive of GERD are acid regurgitation and heartburn . HoweverIn an uncomplicated GERD with classical clinical history on evaluation of the patient, prophylactic medical treatment with antacids/antisecretory drugs can be tried. If the patient does not respond to empirical therapy or clinical evaluation reveals features suggesting complicated GERD or at high risk for developing esophageal adenocarcinoma, detailed evaluation with upper gastrointestinal (GI) endoscopy, ambulatory pH monitoring, esophageal manometry, and impedance testing should be considered . Due to Even after various research, the literature is still confusing in regards to the correlation between endoscopic findings and clinical symptoms of GERD. Especially, there are few studies in Indian literature regarding this. Present India is facing a problem of obesity/overweight rather than undernutrition/malnutrition. Obesity itself being a disease entity has now become one of the important risk factors for GERD. Establishing a strong association between GERD and body mass index (BMI) which is one of the best indicators of obesity is very much important. Thus, to analyze the spectrum of GERD on the basis of symptoms and endoscopic findings along with the contributory effects of various risk factors including obesity, this specific study has been carried out.Inclusion criteriaInclusion criteria are as follows: 1. patients willing to provide informed consent before participation; 2. patients presenting to general surgery/gastroenterology outpatient department (OPD) consistent with symptoms  suggestive of GERD: a. typical symptoms: heartburn, regurgitation, and epigastric pain, and b. atypical symptoms: hoarseness, sore throat, bloating, belching, dysphagia, and vomiting; 3. patients >18 years of age; 4. patients with at least two symptoms for more than one month; and 5. patients able to attend for diagnostic endoscopy within seven days of consultation.Exclusion criteriaExclusion criteria are as follows: 1. previously diagnosed GERD patients who are on treatment; 2. pregnancy; 3. participation in a clinical study within the previous month; 4. previous gastric or upper gastrointestinal surgery; 5. patients with other serious conditions including Zollinger-Ellison syndrome and inflammatory bowel disease; 6. patients who had other significant systemic illnesses including coagulopathy; and 7. diagnosed case of upper GI malignancy.A patient with symptoms suggestive of GERD was thoroughly evaluated by complete general physical examination, systemic examination, and upper GI endoscopy. Clinical symptoms were assessed as per the presence of duration, frequency, severity, and type of symptoms. Upper GI endoscopy procedure includes keeping the patient Nil by Mouth (NBM) for six hours prior to the procedure, application of local anesthetic spray at the posterior pharyngeal wall, placement of mouthpiece, making a patient lie on his/her left side, and inserting the endoscope into mouth. This procedure takes around 15-30 minutes following which the patient will be kept under observation for about an hour.Endoscopic findings were noted which can be as follows: 1. esophageal erosions which will be graded as per the Los Angeles (LA) classification system as follows: Grade A: more than one mucosal break no longer than 5 mm, none of which extends between the tops of the mucosal folds; Grade B: more than one mucosal break more than 5 mm long, none of which extends between the tops of two mucosal folds; Grade C: mucosal breaks that extend between the tops of two or more mucosal folds, but involve less than 75% of esophageal circumference; and Grade D: mucosal breaks involving at least 75% of the esophageal circumference; and 2. other abnormal findings like Barrett’s esophagus, hiatus hernia, carcinoma (CA) esophagus, and stricture esophagus. These endoscopic findings were correlated with symptoms of GERD.Statistical analysisThis descriptive study was conducted after the approval of the Ethics Committee Department of Medical Education, Jawaharlal Nehru Medical College, Deemed University, Sawangi (DMIMS(DU)/IEC/Sept-2019/8403). This descriptive study was conducted after obtaining written consent from the patient. The outcomes were recorded and analyzed at the end of the study using a Microsoft Excel Spreadsheet .A total of 100 cases were enrolled for this study from the Departments of General Surgery, General Medicine, and Gastroenterology at Acharya Vinoba Bhave Rural Hospital (AVBRH), affiliated with Jawaharlal Nehru Medical College (JNMC), Sawangi (Meghe), Wardha, Maharashtra.Gender distributionIn our study, out of 100 cases, 58 patients were male, while 42 were female  with a mean age and standard deviation of 44.82 and 14.57, respectively  was used to measure the nutritional status of the cases taken in our study. Out of 100 cases, 89% of cases were normal or underweight; and 9% and 2% of the cases were overweight and obese, respectively  is one such disease that causes it frequently and is also the usual culprit damaging the esophagus. There are no specific diagnostic criteria that are convenient and easily available that can detect all the cases of GERD. Henceforth, it is less detected and treated only when a patient has landed up in complications due to it. However, it has not stopped fascinating the researchers as well as clinicians with its wide range of presentation, epidemiological change, unavailability of gold-standard tests to diagnose it, and emerging treatment. In the Western world, the major population getting affected by GERD is the adult age group. Several studies had found that the occurrence of it in Asia is increasing day by day. The reason behind this could be increased transformation of our lifestyle to the Western world, improved clinical diagnosis by skilled registered medical practitioners, and increased availability of advanced diagnostic modalities at a feasible value . Even afThis particular clinical research has been carried out to study the clinical spectrum of GERD, endoscopic evaluation of GERD, the contribution of risk factors, and the correlation of clinical symptoms with the endoscopic findings. Many of the findings and results of this study have been well correlated with such clinical research done earlier. In our study, out of 100 cases, 58 cases were male with a male:female ratio of 1.38:1 suggesting mild male preponderance. However, the p-value was insignificant suggestive of equivocal distribution among both genders. Similar studies done by Tidake et al. showed a ratio of 1.08:1 . Zuberi Typical symptoms comprised heartburn, regurgitation, and epigastric pain. Most of the cases had epigastric pain constituting 78% followed by regurgitation and heartburn comprising 71% and 63%, respectively. A study done by Tidake et al. also showed similar values of heartburn, regurgitation, and epigastric pain with 94%, 80%, and 22%, respectively . The preEach of the typical symptoms as well as the atypical symptoms was correlated with their endoscopic findings. Surprisingly, no significant correlation was established in all the cases due to their equitable distribution in both NERD and ERD except for regurgitation symptoms which were found statistically significant  since 37 cases out of 71 with regurgitation symptoms had erosive lesions. Duration of symptoms, frequency of symptoms, and severity of symptoms were also correlated with the endoscopic findings. Most of the cases had symptoms for four to six months (52%), mild severity (58%), and frequency of symptoms daily (31%). However, there was no statistically significant correlation established between them and endoscopic evaluation.There is evidence of an increased incidence of GERD in India. A sedentary lifestyle could be an attributable risk factor for this. In our study, 10% of the patients had a sedentary lifestyle out of which seven cases had erosive lesions on their endoscopic evaluation, while three cases had normal endoscopic study.Insomnia is a symptom of a sleep disorder, wherein the patient has difficulty in maintaining or initiating sleep. Jung et al. have done a study that revealed that there is a bidirectional association between GERD and insomnia . In our Alcohol consumption, smoking, and tobacco chewing are considered risk factors for the development of GERD symptoms. Thus, addictive history was assessed in all the cases taken in our study. It was found that 11 (24.4%) cases out of 45 cases having erosive lesions on endoscopic evaluation had a history of alcohol consumption, whereas 10 (18.2%) cases out of 55 cases having a normal study on endoscopic evaluation had a history of alcohol consumption. In a similar study done by Meira et al. and Labenz et al., 36.84% and 70% among the cases with erosive lesions and 33.25% and 63% among the cases with non-erosive lesions had a history of alcohol consumption, respectively ,21. AmonOne of the independent risk factors for GERD and hiatus hernia is obesity or excessive body weight . HoweverThis was a descriptive study done among the patients visiting the surgery, medicine, or gastroenterology OPD clinic at AVBRH, affiliated to JNMC, Sawangi (Meghe), Wardha, between September 2019 to December 2021, with symptoms suggestive of gastroesophageal reflux disease (GERD). A detailed clinical history including demographic details, duration, frequency and severity of symptoms, and possible risk factors like sedentary lifestyle, insomnia, smoking/alcohol/tobacco, height, weight, and other necessary information was taken and entered in a proforma. The patient was then convinced to undergo upper GI endoscopy, findings of which were recorded appropriately. Reflux esophagitis noted on endoscopic evaluation was graded as per LA classification. Using the obtained data, clinical spectrum, endoscopic evaluation, the correlation between symptoms and endoscopic evaluation, and contribution of risk factors in developing esophageal erosions were studied. A total of 100 patients were included in the study. A number of male patients (58%) were more than that of female patients. Most of the patients were in the age group of 30-60 years (70%). The most common symptoms were epigastric pain (78%), regurgitation (71%), and heartburn (63%). Atypical symptoms included dysphagia, hoarseness, sore throat, bloating, belching, and vomiting. A sedentary lifestyle was present in 10%. Insomnia was present in 8%. History of alcohol consumption, smoking, and tobacco chewing was present in 21%, 15%, and 14%, respectively. Overweight/obese patients as per BMI (13% of the cases) were present. Forty-five percent of the patients had erosive lesions suggestive of reflux esophagitis on endoscopic evaluation. LA Grade A (46.7%) was the most common finding among patients with erosive lesions. Among the symptoms, only regurgitation (p=0.02) showed a significant correlation with endoscopic findings.Among contributing factors, insomnia (p=0.01) and obesity (0.014) showed positive correlation with esophageal lesions. Incidence of GERD symptoms is more common in the age group of 30-60 years with mild male preponderance. The normal endoscopic finding is not uncommon among patients with GERD symptoms. There is a poor association between the duration, frequency, and severity of symptoms of GERD and the presence of erosive lesions. Among symptoms, only regurgitation has a statistically significant correlation. Among contributing risk factors, only insomnia and obesity have a statistically significant correlation.All patients with symptoms of GERD may not be associated with evidence of erosive lesions suggestive of reflux esophagitis on endoscopic evaluation. This reinforces the fact that non-erosive reflux disease (NERD) is a common entity, which forms a significant proportion of patients seeking medical attention for reflux symptoms. However, since the patients with erosive lesions, Barrett’s esophagus, are at a higher risk of developing esophageal adenocarcinoma in the future, it is suggested that all the patients with symptomatic GERD should be subjected to a simple, easily feasible, and least harmful endoscopic evaluation and biopsy if needed.


Hypotension often occurs during hip surgery in elderly adults with conventional posterior lumbosacral plexus block.We conducted a randomised controlled trial to determine if simple iliopsoas space block can lower the incidence of intraoperative hypotension (IOH) and provide sufficient perioperative pain relief during hip fracture surgery in elderly adults.Patients undergoing surgery for elderly hip fracture were randomised to receive either an anterior iliopsoas space block with a lateral femoral cutaneous nerve block or a posterior lumbosacral plexus block. The primary outcome was a composite measure of IOH incidence comprising frequency, absolute and relative hypotension durations.p = 0.001, respectively] along with lower absolute [5 (0–10) min] and relative  duration of IOH compared to the posterior group . The median pain levels in the post-anaesthesia care unit and median intraoperative sufentanil usage were comparable between the iliopsoas space group  and posterior group . Thermal imaging revealed that the limb injected with the iliopsoas space block had a higher skin temperature than the unblocked limb in the sacral plexus innervated region.Compared to the posterior group, the iliopsoas space block group had a decreased median frequency of IOH [1.09 (0–2. 14) vs. 3 (1.6–4.8), A single iliopsoas space block lowers the IOH incidence and provides comparable perioperative analgesia to conventional lumbosacral plexus block.www.chictr.org.cn (ChiCTR2100051394); registered 22 September 2021.Trial registration at  One of the most common fractures in senior people are hip fractures, which affect millions of people every year, causing pain, disability, and socioeconomic difficulty . The besFor hip fracture surgery, in addition to endotracheal-intubation, general and spinal anaesthesia, the lumbosacral plexus combined with laryngeal-mask general anaesthesia is currently widely promoted, especially for high-risk patients . CompareIOH is often used to characterise arterial hypotension in patients undergoing surgery under general anaesthesia . In patiPreviously, we proposed the iliopsoas space block technique to provide equivalent analgesic effects to the traditional posterior lumbosacral plexus approach , which wBetween October 2021 and August 2022, we performed a double-blind, randomised, controlled trial to compare the hemodynamic effects of ultrasound-guided iliopsoas block and posterior lumbosacral plexus block in elderly patients with hip fractures undergoing surgery. The Shanghai Sixth People’s Hospital Ethics Committee  approved the trial, which was registered atBetween October 2021 and August 2022, patients aged ≥65 years, with American Society of Anaesthesiologists (ASA) physical status class I-III and scheduled for unilateral hip surgery under general anaesthesia were recruited. All participants or their legal representatives gave their written, informed permission. Infection at the puncture site, history of hip surgery, preexisting neurological deficiency in the lower extremities, contraindications for regional anaesthesia, history of allergy to local anaesthetics, coagulopathy, substance addiction, or daily use of analgesics were exclusion criteria. Patients who refused to cooperate with the researchers were excluded from the study. Most surgeries for hip fractures took <2 h, while those that took longer were also excluded from the study.All individuals were randomly assigned to either the iliopsoas muscle space group or the posterior lumbosacral plexus group by a physician not blinded to the experimental condition. Every ultrasound-guided nerve block was administered by a professional anaesthesiologist. The next step was conducted by a research coordinator or investigator who was blinded while collecting the data.All patients underwent fasting according to the ASA guidelines and were not premedicated. A peripheral intravenous access was established as well. The nerve block was administered by a senior anaesthesiologist with >10 y of expertise in ultrasound-guided nerve blocks. The skin of the block region was cleansed with iodophor and both the sterile window sheets and probe were covered with sterile drapes. A standardised amount of local anaesthetic was administered utilising ultrasound guidance and a portable ultrasound system , a 2- to 5-MHz curved array transducer, and a 22-G needle . The impact and scope of the nerve blocks were assessed and documented. Using thermal imaging and infrared (IR) cameras , we measured bilateral lower limb skin temperature 20 min after completion of nerve block, based on previous research regarding the onset time of nerve block .In the posterior lumbosacral plexus group, the lumbar plexus block was conducted using 30 ml of 0.333% ropivacaine at L2-3 and L3-4 utilising a longitudinal paravertebral scan and out-of-plane injection approach, as described by Propofol (2–3 mg/kg) and sufentanil (5 μg) were subsequently administered to establish general anaesthesia, and a laryngeal-mask airway  was implanted. Sevoflurane administration and spontaneous breathing helped maintain the minimum alveolar concentration of sevoflurane between 0.8 and 1. Intraoperatively, a bolus dose of 2–3 μg of sufentanil was administered if the surgical stimuli caused an increase of 10 beats per minute (bpm) in heart rate or an increase of 20 mmHg in systolic blood pressure (SBP) at baseline. Sufentanil was adjusted to keep the respiratory rate < 20 bpm. The entire intraoperative sufentanil dosage was documented. During the perioperative phase, SBP, diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and pulse oxygen saturation were recorded with invasive arterial blood-pressure monitoring.The anaesthesiologist immediately delivers 3–5 mg ephedrine or 30-60 μg phenylephrine intravenously whenever IOH occurs, SBP <100 mmHg. The anaesthesiologist will administer 0.4–0.5 mg of atropine intravenously when the patient’s heart rate falls below 50 beats per minute. All cardiovascular drugs used during the surgery were documented.Every patient was admitted to the post-anaesthesia care unit (PACU) after surgery. The nursing personnel and a study coordinator blinded to conditions assessed the pain score 60 min after surgery. Using a visual analogue scale (VAS) ranging from 0 to 10, pain ratings were assessed . In the PACU, opioids were given intravenously as necessary.The definition of IOH remains controversial . Based oBased on the clinical data from our studies, we deemed a difference  of 2 in the frequency of IOH to be statistically significant. Assuming a standard deviation (SD) of 1.75 in each group, 36 participants would give 90% power to deliver an iliopsoas space block, which is related with a lower incidence of IOH than a lumbosacral posterior plexus block for senior hip fractures. Considering a drop-out rate of 20%, 44 patients were required to be enrolled in this study.p < 0.05. GraphPad Prism 6 was used to conduct statistical analysis . Two one-sided test (TOST) protocols were used to assess the secondary outcome across groups and determine if they were equivalent .Demographic information, clinical features, and hemodynamic data were included in descriptive statistics. Non-normally distributed variables are shown as medians and interquartile ranges, as opposed to means and SDs for regularly distributed data. Numeral and percentage representations of categorical variables are used. Independent Student’s t-tests were used to analyse differences in main outcomes across groups for continuous variables, while non-parametric tests were used for nominal variables. The significance threshold was fixed at This research involved 48 individuals. Four individuals were excluded, and 44 patients were finally recruited in the trial . Six werp = 0. 001, respectively}. In comparison to the posterior lumbosacral plexus group, the iliopsoas space block group had considerably shorter absolute  and relative  durations of IOH ; 1.09 (0–2.14), 3 (1.6–4.8); s of IOH ; Table 2n = 17) had a median IQR pain score of 1 (0–3), whereas those receiving an iliopsoas muscle space block (n = 21) received a score of 2(1–3), resulting in a group difference of −1  indicating that both the iliopsoas space block and posterior lumbosacral plexus block may be useful for providing analgesia during hip surgery.Sufentanil was administered in the iliopsoas space block group at a median IQR dose of 8 (6–10) μg and in the posterior group at a median IQR dose of 5 (5–8) μg . There wFLIR imaging revealed the body surface temperature at the same selected points on the patients’ blocked and unblocked sides. The selected point temperature of the heel  on the nerve-blocked side was 26.3°C while that of the unblocked side was 24.8°C. The temperature at the base of the foot  on the blocked side was 25.7°C and that on the unblocked side was 23.4°C. The temperature at selected points of the distal femur (lumbar plexus innervation) on the nerve-blocked side was 27.2°C and that on the unblocked side was 26°C. The medial (lumbar plexus innervation region) side of the thigh had a temperature of 29.5°C whereas the unblocked side had 28.9°C. The darker the colour of the corresponding region, the lower the temperature. After the nerve block, the blocked sacral plexus innervation area (sciatic innervation area) had a brighter colour, indicating a higher skin temperature and nerve blockage, compared to the unblocked side . After tBuilding on our previous work , we compPosterior lumbosacral plexus block is often utilised in hip surgery; however, IOH frequently occurs and has unanticipated outcomes . EvidencPossible causes of IOH after traditional posterior lumbosacral plexus block include nerve root block, local anaesthetics’ epidural space diffusion, sympathetic nerve block, and excessive analgesia . When peAs the lumbosacral trunk passes medially to the psoas major muscle at the level of the first sacral vertebra , it can In addition, the anterior iliopsoas block has many other advantages over the posterior lumbosacral plexus block, such as avoiding the risk of cardiovascular disturbances caused by the pain of turning over in the fracture patient, risk of thrombus dislodging from the leg vein caused by turning over, and risk of aggravated fracture injury caused by postural changes. Additionally, the anterior iliopsoas block may minimise the number of punctures and/or repeated blocks , and the occurrence of blockage-related haemorrhage, nerve damage, and total spinal anaesthesia. The anterior block provides separation from the abdominal cavity to protect the kidneys and intestines from possible injury. Therefore, it is beneficial to promote anterior iliopsoas space block in the supine posture.The present research has certain limitations. First, propofol causes hypotension following anaesthesia induction; on the other hand, age-related changes in vascular tone, homeostatic disturbances, and sympathetic nervous system tonic activity render the elderly more vulnerable to IOH. The perioperative bispectral index should be monitored to avoid the effect of anaesthesia depth on blood pressure fluctuations. Second, local anaesthetic concentration and volumetric titration were not assessed to obtain more accurate injection volumes and concentrations.In conclusion, this study demonstrated that a single iliopsoas muscle space block not only provides as much perioperative analgesia as the traditional lumbosacral plexus block, but also reduces the number of punctures, helps avoid position changes of the patient, and effectively reduces the incidence of IOH, thus improving patient prognosis and increasing perioperative safety.The original contributions presented in the study are included in the article/The Shanghai Sixth People’s Hospital Ethics Committee  approved the trial. The patients/participants provided their written informed consent to participate in this study.TX conceived and designed the experiments. The data collection was performed by QT, HY and JD. QT and CW analysed the data. The manuscript was written by TX, QT and CW. MC contributed materials and analysis tool. All authors contributed to the article and approved the submitted version.This work was supported by grant from the Natural Science Foundation of China (82171486), the Interdisciplinary Program of Shanghai Jiao Tong University to TX (YG2021ZD23), General Science Foundation of Shanghai Sixth People’s Hospital to TX (YNMS202114) and Scientific research fund of Shanghai Sixth People’s Hospital to MC (YNTS202005).The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


Anterior cruciate ligament (ACL) injuries in female adolescent athletes occur at disproportionately high levels compared to their male counterparts. However, limited prospective data exist on the validity of low-cost screening tools that can proactively identify ACL injury risk, specifically for female athletes. The purpose of this study was to assess the concurrent validity of a three-task injury risk factor assessment by comparing visually derived outcome scores from two-dimensional (2D) video data with dichotomized three-dimensional (3D) biomechanical variables collected using motion capture technology. A total of 41 female club volleyball athletes (14.7 ± 1.4 years) were tested and asked to perform three tasks: double-leg vertical jump (DLVJ), single-leg squat (SLS), and single-leg drop landing (SLDL). One rater was trained on the scoring criteria for the 2D data and independently scored one forward-facing and one side-facing video for each task. Risk factors identified included poor knee position, lateral trunk lean, and excessive trunk flexion/extension. In addition, 3D joint angles were calculated for the trunk and knee in the sagittal and frontal planes and converted to dichotomous variables based on biomechanical thresholds of injury risk. For comparison of 2D and 3D outcomes, percent agreement and Cohen's kappa were calculated for each risk factor individually. Overall, 2D scores were found to exhibit moderate to excellent percent agreement with 3D outcomes for trunk position (69.1–97.1%). Specifically, ipsilateral trunk lean during single-leg tasks exhibited the highest agreement (85.3–88.2%) with moderate reliability (κ = 0.452–0.465). In addition, moderate to substantial reliability was found for trunk flexion during double-leg tasks (κ = 0.521–0.653); however, an evaluation of single-leg tasks resulted in only fair reliability (κ = 0.354). Furthermore, 2D scores were not successful in identifying poor knee position as percent agreement fell below 50% for both the single-leg tasks and averaged 60% agreement across both the phases of the DLVJ. Kappa coefficients further emphasized these trends indicating no to slight concurrent validity (κ = −0.047–0.167) across tasks. Overall, these findings emphasize the potential for valid, low-cost screening tools that can identify high-risk movement patterns. Further study is needed to develop improved assessment guidelines that may be employed through visual assessment in sports environments. The annual rate of anterior cruciate ligament (ACL) injuries has nearly doubled in active adolescents over the past two decades  and increased valgus or medial collapse of the knee  or an orthopedic condition that would limit their ability to perform a jump or squat task. This study was approved by the local Institutional Review Board and all the participants who agreed to take part in this study provided informed assent/consent before testing. During the movement assessment, participants were asked to wear comfortable attire and personal athletic footwear.Before the movement assessment, participants were asked to complete a brief questionnaire to capture years of experience playing volleyball and their current activity level. Activity level was determined using the Tegner Scale of 0–10, where a higher score indicates a higher activity level , single-leg squat (SLS), and single-leg drop landing (SLDL). The DLVJ required participants to begin in a standing position and then jump as high as possible, without a preparatory step, and use their arms for momentum. To eliminate trials that were not completed correctly, errors for each task were predefined based on prior literature  or if it moved away from the midpoint and closer to a knee joint during the DLVJ. Similarly, excessive trunk flexion or extension was identified from the side-facing view and marked present if the trunk segment did not remain parallel with the lower leg (the anterior edge of the tibia was used for reference)  6 degrees of freedom model was used to compute 3D joint angles, specifically for the trunk and knee in the sagittal and frontal planes. In addition, automated custom MATLAB codes were used to detect events during each task that correlated to the corresponding time points of interest . Given each kinematic variable calculated was a continuous output, all the variables were converted to dichotomous variables based on biomechanical thresholds of injury risk preidentified in the literature  or exceeded 45.0° of forward flexion  were calculated for each risk factor individually . Percent agreement was categorized as poor (<50%), moderate (51–79%), or excellent (≥80%) and kappa values indicated slight (0.0–0.2), fair (0.21–0.40), moderate (0.41–0.60), substantial (0.61–0.80), and almost perfect or perfect (0.81–1.0) agreement  were tested and average demographic, anthropometric, and sports characteristics were calculated . Seven pOverall, 3D outcomes indicated a mean knee valgus angle of 4.7 (SD 3.2°), 5.7 (SD 3.2°), 6.3 (SD 3.0°), and 8.1° (SD 3.5°) during the SLS, SLDL, DLVJ-load, and DLVJ-land, respectively. The percentage of limbs that exceeded the predetermined knee valgus risk threshold was higher in the single-leg tasks compared to the double-leg task (SLS 52.9, SLDL 57.4, DLVJ-load 17.6, and DLVJ-land 42.6%; The average percent agreement between the 2D scores and the 3D dichotomized variables ranged from 44.1 to 100% . AgreemeThe purpose of this study was to determine the concurrent validity of a three-task injury risk factor assessment by comparing 2D visual assessment scores to dichotomized 3D outcomes based on previously reported biomechanical thresholds. The assessment consisted of an SLS, SLDL, and DLVJ task and injury risk factors assessed included poor knee position, trunk lean, and excessive trunk flexion or extension during the loading and/or landing phases of each task. Overall, 2D visual assessment scores were found to exhibit moderate to excellent percent agreement with 3D outcomes for trunk position, especially ipsilateral trunk lean during single-leg tasks with an average of 87% agreement and moderate reliability. In addition, moderate to substantial reliability was found for the trunk flexion risk factor during double-leg tasks; however, an evaluation of single-leg tasks resulted in only fair reliability. Furthermore, 2D scores were not as successful in identifying knee valgus as percent agreement fell below 50% for both single-leg tasks and averaged 60% agreement across both the phases of the DLVJ. In accounting for the possibility of chance agreement, kappa coefficients emphasized these trends indicating no to slight concurrent validity.Given the emphasis on movement screens to support injury risk reduction in adolescent athlete populations, numerous reports have investigated the agreement between 2D visual assessment and 3D biomechanical outcomes presented in this study. Specific to risk factors involving trunk position, previous 2D visual assessment studies reported a wide range of agreement compared to 3D motion analysis (Schurr et al., Unlike findings for the 2D assessment of trunk position presented here, visually identifying the presence of poor knee position, defined as the center of the knee joint collapsing medially past the inside border of the shoe, proved to be substantially more difficult across tasks, especially for the single-leg tasks. As seen in In contrast, Peebles et al. reported good to excellent agreement between 2D movement patterns and 3D motion capture measures (Peebles et al., It is also important to note that conflicting results in the literature may be due to the populations tested. Specifically, the previously referenced articles conducted movement assessments on groups of single-sport, adolescent female athletes (Ekegren et al., In addition, an inherent limitation to comparing 2D and 3D data is that the two motion analysis systems did not capture data at the same rate. Thus, it is possible that risk factors identified at a specific frame in the 2D video were not identified at the same time point in the 3D trial. As the primary goal of this study was to evaluate the concurrent validity of the visual assessment, which requires the rater to manually identify specific time points for evaluation, this was considered an acceptable and minor limitation to this study. Similarly, the sagittal and frontal views were not captured in the same trial, which potentially increased data variability. While a single camera view was chosen specifically such that implementation in the field would require less equipment and technical setup to ensure video data is synced, this is recognized as a minor limitation of this study. Last, given that 2D video and 3D motion capture data were captured simultaneously, the retroreflective markers needed for motion capture were visible in all the 2D video trials. Specifically, markers were positioned on the medial and lateral femoral epicondyle, lateral malleolus, and the jugular notch, all of which may have potentially helped the rater visually inspect the knee joint center, lower leg orientation, or midpoint between the shoulders. While the rater was instructed to disregard the retroreflective markers, the inclusion of the marked landmarks in the 2D video data is a minor limitation of this study as it would not be available for future utilization of the movement screen.Overall, these findings emphasize the potential for less expensive, more feasible screening methods that are valid compared to more advanced methods of identifying high-risk movement patterns. However, additional study is needed to improve upon the scoring criteria. Given poor agreement was found for the knee position risk factor presented here, future studies will focus on adjusting the risk factor definition and, thus, scoring criterion, by developing a more explicit definition using easily discernible landmarks to better align with the biomechanical movement pattern. The goal of future studies should not be to increase the complexity of assessing injury risk, but rather to develop clear assessment guidelines that may be employed through visual assessment in sports environments.The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.The studies involving human participants were reviewed and approved by University of Texas Southwestern Institutional Review Board. Written informed consent to participate in this study was provided by the participants' legal guardian/next of kin.SU, AE, and AL led participant recruitment efforts and conducted data collection. SU and AE organized the database and wrote the first draft of the manuscript. SU performed the statistical analysis. AL wrote a section of the manuscript. All authors contributed to conception and design of the study and contributed to manuscript revision, read, and approved the submitted version.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


THADA) rs7578597 T>C, succinate dehydrogenase complex assembly factor 4 (SDHAF4) rs1048886 A>G, and microtubule-actin crosslinking factor 1 (MACF1) rs2296172 A>G gene polymorphisms and the risk of GDM development as well as selected clinical parameters in women with GDM. We also examined the expression of these genes in the placenta of women with and without GDM in association with clinical parameters. This case-control study included 272 pregnant women with GDM and 348 pregnant women with normal glucose tolerance. There were no statistically significant differences in the distribution of the THADA rs7578597 T>C, SDHAF4 rs1048886 A>G, and MACF1 rs2296172 A>G gene polymorphisms between pregnant control women and women with GDM. The associations between clinical parameters such as body mass before pregnancy, body mass at birth, body mass increase during pregnancy, BMI before pregnancy, BMI at birth, BMI increase during pregnancy, glycated hemoglobin (HbA1c), daily insulin requirement, childbirth time, and newborn body mass and APGAR score, and the THADA rs7578597 T>C, SDHAF4 rs1048886 A>G, and MACF1 rs2296172 A>G genotypes were statistically non-significant. We only observed lower values of body mass before pregnancy and body mass at birth in women with the SDHAF4 rs1048886 AG genotype in comparison with AA genotype carriers. There was no statistically significant difference in the expression of THADA, SDHAF4, and MACF1 genes in the placenta between women with GDM and healthy women. There were also no statistically significant correlations between THADA, SDHAF4, and MACF1 gene expression in the placenta and clinical parameters. The results of our study suggest that THADA rs7578597 T>C, SDHAF4 rs1048886 A>G, and MACF1 rs2296172 A>G gene polymorphisms are not significant factors associated with GDM onset. In addition, SDHAF4 rs1048886 A>G may be associated with body mass before pregnancy and body mass at birth in pregnant women.Gestational diabetes mellitus (GDM) is a metabolic disorder in pregnant women leading to various complications. Consequently, factors predisposing its development are being sought. Previous studies have shown that the pathogenesis of GDM is similar to that of type 2 diabetes, and it is therefore thought that the two diseases may have a common genetic basis. The aim of this study was to examine the associations between thyroid adenoma-associated ( Gestational diabetes mellitus  is a disorder of carbohydrate tolerance occurring in pregnant women . GDM is The Thyroid Adenoma Associated (THADA) gene has been identified as one of the genes associated with the risk of developing type 2 diabetes . This geSuccinate dehydrogenase (SDH) has a pivotal position in cellular energy production, linking the tricarboxylic cycle to the electron transport chain . ThroughSince these genes affect carbohydrate and lipid metabolism and pancreatic function, as well as may be associated with type 2 diabetes, we decided to investigate the association of polymorphisms of these genes with GDM. It has been shown that polymorphisms of these genes may also be associated with type 2 diabetes risk and parameters of carbohydrate metabolism .THADA rs7578597 T>C, SDHAF4 rs1048886 A>G, and MACF1 rs2296172 A>G gene polymorphisms and the risk of GDM development as well as selected clinical parameters in women with GDM. We also assessed the expression of these genes in the placenta of women with and without GDM in association with clinical parameters.In this study, we examined the associations between This case-control study included 272 pregnant women with GDM and 348 pregnant women with normal glucose tolerance (NGT) treated in the Department of Obstetrics and Gynecology, Pomeranian Medical University, Szczecin, Poland. GDM was diagnosed on the basis of a 75 g oral glucose tolerance test (OGTT) at 24–28 weeks gestation, according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria . Blood s® probes, Applied Biosystems, Waltham, MA, USA) on a 7500 Fast Real-Time PCR Detection System . In order to discriminate the polymorphisms, we employed TaqMan® Pre-Designed SNP Genotyping Assays, including appropriate primers and fluorescently labeled (FAM and VIC) MGB™ probes to detect the alleles.All samples were genotyped  using allelic discrimination assays .Genomic DNA was extracted from peripheral blood samples (200 µL) using the GeneMATRIX Quick Blood DNA Purification Kit  following the manufacturer’s manual. Genotyping was performed in a final volume of 12 µL. To discriminate For the purpose of this study, randomly selected placentas from 29 women with GDM and 29 healthy women (control group) who had a vaginal delivery after 37 weeks of gestation were obtained. All samples were collected at the Department of Obstetrics and Gynecology, Pomeranian Medical University in Szczecin. The whole placenta was placed in 0.9% NaCl and immediately transported to the Department of Physiology for preservation in further studies just after the delivery. The placental samples were resected from the maternal side of the cotyledons, approximately 100 mg tissue samples, for RNA extraction. No visible connective tissue, vessels, or calcium deposits were detected in the studied material. Total RNA was extracted from obtained cell homogenates using the RNeasy Fibrous Tissue Mini Kit  following the manufacturer’s protocol. The concentration and purity of RNA samples were determined by measuring the absorbance at 260nm using a Perkin Elmer Lambda Bio+ spectrophotometer .THADA, SDHAF4, and MACF1 genes as well as the reference gene was performed using real-time PCR on an ABI PRISM® Fast 7500 Sequence Detection System , as described previously [BMG) as the reference gene. The reference gene was determined based on the available and up-to-date literature data [−ΔCt method was used to calculate the values.mRNA isolated from each sample (0.4 μg) was reverse transcribed into cDNA  using a cDNA synthesis kit  according to the manufacturer’s manual. The expression of eviously . mRNA noure data ,18,19. Sp-values < 0.05 were considered statistically significant.The genotype distribution consistency was assessed using the exact test with Hardy–Weinberg equilibrium (HWE). A chi-squared test was used to compare the genotype and allele distributions between the analyzed groups. Quantitative variables were compared across all genotype groups using the Mann–Whitney test. A multivariate logistic regression model was used to find independent predictors of GDM risk. p > 0.05). The distribution of studied polymorphisms in the total group of pregnant women with normal carbohydrate tolerance and women with GDM is shown in THADA rs7578597 T>C, SDHAF4 rs1048886 A>G, and MACF1 rs2296172 A>G gene polymorphisms between pregnant control women and women with GDM.The distributions of the studied polymorphisms were in HWE .THADA rs7578597 T>C, SDHAF4 rs1048886 A>G, and MACF1 rs2296172 A>G gene polymorphisms and clinical parameters, such as body mass before pregnancy, body mass at birth, body mass increase during pregnancy, BMI before pregnancy, BMI at birth, BMI increase during pregnancy, glycated hemoglobin (HbA1c), daily insulin requirement, childbirth time, and newborn body mass and APGAR score in women with GDM . The expression of the SDHAF4 gene in women with and without GDM was 0.023 ± 0.019 and 0.042 ± 0.061, respectively. These differences were not statistically significant (p = 0.27). The expression of the MACF1 gene in women with GDM and with normal glucose tolerance was 0.0022 ± 0.0095 and 0.00038 ± 0.00074, respectively. No statistically significant differences were found (p = 0.56).The expression of the THADA, SDHAF4, and MACF1 genes in women with GDM and clinical parameters. The correlations between THADA, SDHAF4, and MACF1 gene expression in the placenta and clinical parameters were statistically non-significant  plays an important role in mitochondrial respiratory metabolism. The SDH complex consists of four basic subunits and a number of cofactors that must be correctly assembled to ensure enzyme function . The SDHSuccinate dehydrogenase (SDH) is an enzyme that plays a key role in cellular energy production, linking the tricarboxylic acid cycle to the electron transport chain . TherefoMACF1, also known as actin crosslinking family 7 (ACF7), is a spectraplakin present in many tissues and organs involved in numerous cellular processes, playing a key role in cell signaling. MACF1 plays a key role in regulating cell migration and proliferation and maintaining tissue integrity . It alsoIt has been shown that the MACF1 gene is associated with metabolic syndrome and inflammation . PreviouOur results suggest no association between the studied gene polymorphisms and the risk of GDM, as well as selected clinical parameters. GDM is a metabolic complication occurring in pregnant women that is caused by many factors. The influence of both environmental and genetic factors is considered in this disease. Underlying this disease are both pancreatic islet β cell dysfunction and existing insulin resistance. These processes are influenced by a number of pro-inflammatory factors, as well as disrupting carbohydrate metabolism. The genes we studied mainly affect the processes of carbohydrate metabolism. It seems that the effect of single polymorphisms on the risk of GDM is very small. Due to the complexity of the pathogenesis of this disease, it must be taken into account, along with other environmental factors that increase the risk of developing GDM. It is not excluded that the gene polymorphisms we studied may affect the risk of GDM in other populations. A complete understanding of the role of THADA rs7578597 T>C, SDHAF4 rs1048886 A>G, and MACF1 rs2296172 A>G gene polymorphisms in the pathogenesis of GDM requires multicenter studies in different populations.THADA rs7578597 T>C, SDHAF4 rs1048886 A>G, and MACF1 rs2296172 A>G gene polymorphisms are not significant factors associated with GDM onset. SDHAF4 rs1048886 A>G may be associated with body mass before pregnancy and body mass at birth in pregnant women.The results of our study suggest that the


Posterior capsular opacification (PCO), the highest incidence complication after cataract surgery, is mainly due to the attachment, proliferation, and migration of the residual lens epithelial cells (LECs). Although the drug-eluting IOLs have been proved to be an effective way to prevent PCO incidence, its preparations are time consuming and require tedious preparation steps. Herein, the thermoreversible agarose is adopted to prepare drug-eluting IOL. Such functional coating can be obtained easily by simple immersion in the antiproliferative drug containing hot agarose and taken out for cooling, which not only does not affect the optical property but also can effectively decrease the PCO incidence after intraocular implantation. As a result, the proposed agarose coating provides a rapid and economical alternative of drug-eluting IOL fabrication for PCO prevention. Cataract, the opacification of the lens caused by various reasons, is the most common blinding eye disease in the world . PhacoemNumerous studies have been investigated to reduce the PCO incidence, such as surgical method improvement and new IOL-type design . In addiβ-d-galactose and 1,4-linked 3,6-lactone-l-galactose (Agarose (Aga) is a linear polysaccharide obtained from natural seaweed . It consalactose . Due to alactose . In addialactose . Moreovealactose . Due to Agarose , calcein/PI live/dead cell assay kit, Hoechst 33342 staining solution, cell counting kit-8 (CCK-8), DiO cell plasma membrane staining kit, and hematoxylin/eosin staining kit were purchased from Beyotime Biotechnology Co. . Polyethylenimine  and fluorescein diacetate (FDA) were obtained from Sigma-Aldrich . Doxorubicin hydrochloride (Dox) and advanced antifade mounting medium with DAPI were procured from Meilun Biotechnology Co., Ltd. . Fetal bovine serum (FBS), 0.05% trypsin-ethylenediaminetetraacetic acid solution (Trypsin–EDTA), penicillin–streptomycin solution, Dulbecco’s modified Eagle’s medium/nutrient mixture F-12 , phosphate-buffered saline (PBS), and other cell culture-related reagents were purchased from Invitrogen . Human lens epithelial cell line HLE B3  was originated from American Type Culture Collection. Foldable hydrophobic IOL were obtained from 66 Vision Tech Co., Ltd. . The clinical postoperative administration drugs were supplied by the Eye Hospital of Wenzhou Medical University . All other chemicals were of analytical grade and used without further purification.The medical polyester materials , quartz, and commercialized IOL were used as the substrates for the Aga coating fabrication for adapting to different experimental and testing purposes. Briefly, the substrates were cleaned and immersed in 3 mg/ml PEI solution overnight so as to obtain the hydrophilic surface prior to Aga gel coating fabrication. The dip coating solution was prepared with a certain concentration of Aga and Dox in hot water (90°C). The pretreated substrates were soaked in coating solution at 90°C for a certain minutes and then taken out into the room temperature. Due to temperature changes, the Dox-loaded Aga coating (defined as Dox@Aga) was easily fabricated on the material surface. For optimizing the coating solution parameters, the coating obtained by different Aga concentrations  and different Dox concentrations  were prepared and investigated. To optimize the soaking time, 5, 15, 30, 60, and 120 min were used for investigation.μL Dox release solution was aspirated at predetermined time intervals  from the vial and equal volume of fresh PBS were provided in the meanwhile. The experiment was carried out at 37°C to simulate intraocular physiological environment. Dox release solution was added into the photophobic well plates and then ascertained by the absorbance at 490 nm using a microplate reader. Thus, Dox content in release liquid can be calculated and curve of cumulative Dox release percentage could be drawn.In order to evaluate the Dox release behavior, the Dox@Aga substrates were released into a vial containing 3.3 ml PBS buffer solution (pH = 7.4). The 200 The surface morphologies of the coating modified substrates were observed by the scanning electron microscope  and stereomicroscopy . The surface wettability was characterized by water contact angle analysis . The light transmittance and absorbance of the Dox@Aga-coated substrates were examined by ultraviolet–visible spectrometer . The drug loading density was calculated according to the absorbance of the coating eluent. The refractive index (RI) of the IOL with or without coating modification was performed by digital gem refractometer.2. After confluence, the cells were detached by 0.05% trypsin and resuspended in the culture medium and distributed onto cell culture plates containing the materials with a certain cell density.The LEC were passaged and cultured according to the standard cell culture procedures . Briefly3 cells per well. After 24 h of incubation, the cell culture medium was replaced by the 10% leach liquors supplemented cell culture medium and the cells were cultured for another 24, 48, and 72 h. The cells were stained by FDA and observed by the fluorescent microscope . The cell densities on the wells in both groups were calculated and compared.For the biocompatibility evaluation, the sterilized leach liquors of the materials with or without Aga coating were prepared in advance. The cells were seeded in the 96-well plates at a density of 8 × 103 cells per well. Serial Dox feeding concentrations, including 100, 200, 300, and 400 μg/ml in the Dox@Aga coating preparation, were investigated. The pure Aga coating (Dox feeding concentration = 0 μg/ml) as well as the pristine material without coating modification served as controls. The cells were cultured for another 24, 48, and 72 h. The FDA staining and fluorescent microscopic observation were carried out at each time point. The cell morphology and distribution were also observed by SEM, calcein/PI staining, and Hoechst 33342 staining after another 24 h culture. The cell densities on different material surfaces were calculated and compared. The cell viability was also evaluated by the cell counting kit-8 (CCK-8) assay on a microplate reader  at an optical density of 450 nm.For investigating the cell elimination effect of the Dox@Aga coating, the cells were seeded into the sterilized Dox@Aga coated materials layered on the 96 wells at density of 8 × 10The cells were also fluorescent co-stained by Hoechst 33342 and DiO to evaluate the cellular uptake of the Dox in the coating when cell cultured. In detail, as Dox had an autofluorescence, the cellular co-localization fluorescent images were taken using confocal laser scanning microscope, in which cell nuclei was stained by Hoechst 33342 and cell membrane stained with DiO. The DiO and Dox signals were simultaneously excited at 488 nm, while the emission wavelengths were 490–511 nm for DiO and 570–590 nm for Dox.4 cells per well in a circle along the periphery of the 24-well plates. After 24 h, the IOL materials with or without Dox@Aga coating modification as well as the pure Aga coating modification was placed into the center of each well. The cells were cultured for another 48 h and the antimigration effect was characterized by hematoxylin–eosin staining and stereomicroscopic images were taken under bright field.To monitor the cell migration and proliferation in lens capsule, the LECs were seeded at a density of 1.5 × 10New Zealand White rabbits, 2.5 ± 0.5 kg in weight, were provided by the Wenzhou Medical University Animal Laboratory. The in vivo experiments were approved by the Laboratory Animal Ethics Committee of Wenzhou Medical University and all in vivo treatments were carried out in accordance with the Animal Experimentation Guidelines of the Wenzhou Medical University. The eyes were treated with levofloxacin eye drops before surgery to prevent infection and dilated with compound tropicamide eye drops. The involved surgical procedures for the intraocular IOL implantation were similar to that mentioned in our previous publication . In ordep < 0.05. Differences with p > 0.05 were considered statistically insignificant, whereas those with p < 0.05 (*) were considered significant, and those with p < 0.01 (**), p < 0.001 (***), and p < 0.0001 (****) were considered very significant.At least three duplicates for each sample were set in the experiments. The results were expressed as the mean ± standard error of the mean. Statistical analysis, one-way analysis, and two-way analysis of variance were performed using GraphPad Prism (version 9.0). The significance level was set at Aga is a temperature-sensitive, thermoreversible, natural polysaccharide. The self-gelling behavior has been considered as its most fascinating feature, which is ascribed to the intramolecular and intermolecular hydrogen bonds formation when temperature decreases . Taking As aiming to realize the rapid preparation of IOL coating, the soaking time is also one of the important parameters when dip coating the Aga solution. The Aga coatings were prepared with optimized concentration (0.5 mg/ml) of Aga coating solution by different soaking time periods, from 5 to 120 min. The light transmittance and the drug loading density in the coating were also investigated. As shown in After the parameter optimization of Aga concentration and soaking time, the optimization of the Dox concentration while preparating the coating solution was also conducted to ensure satisfied cytocidal effects. It is optimized by the cell elimination effect by in vitro cell culture. LECs were seeded on the Aga coating modified materials prepared by Aga solutions mixed with different concentrations of Dox . The obtained coatings were identified as Dox@Aga coating. The tissue culture polystyrene (TCPS) plates served as the control. FDA is an effective living cell dye for the cytoplasm staining. The observation of cell morphology and distribution were carried out by FDA staining and fluorescence microscope observation. The results were shown in As a result, taking the rapidity, economical efficiency, as well as effectiveness of IOLs coating purpose, the preparation conditions of the targeted Dox@Aga coating for IOLs surface modification were set as follows: coating solution was 0.5 mg/ml Aga with 400 mg/ml Dox, whereas coating time was 5 min. The Dox@Aga coating modified materials in the following investigations were prepared by such optimized parameters.The inside of Aga has a structure full of interconnected pores, which can ensure that nutrients, drugs, oxygen, and cells reach the surface of the Aga from the inside. In the study of Dox release behaviors, the Dox@Aga coating modified substrates were dipped in an environment similar to the physiological conditions in the eyes. As shown in The surface wettability is one of the important properties of the IOL for their clinical applications. Currently, the most commonly used IOL types in the clinic are hydrophobic acrylic IOLs. With surface water contact angle (WCA) around 70–90°, silicone oil adhesion as well as lens epithelial cell adhesion and proliferation are prone to occur after their implantation. Surface hydrophilic modification proved to decrease these complications due to their antifouling properties . Herein,2 after 24, 48, and 72 h culture, respectively. There was no significant difference found between the two groups  staining assay of the cell on the material surfaces after cultured for 24 h. The cells with green fluorescence are alive, whereas with red fluorescence are apoptotic. As shown in Dox triggers cell apoptosis by inserting into adjacent base pairs of DNA to generate active free radicals and break the DNA strand . Herein,The above investigations demonstrated that the obtained Dox@Aga coating could eliminate the cell on its surface effectively. As the PCO is the result of residual LECs proliferation, migration toward central optical area of IOL in the lens capsular bag after cataract surgery proliferate and migrate in the capsular bag, the antimigration effect of such coating was also investigated by in vitro monitor. LECs were seeded along well plates and the coating modified materials were placed in the center of each well. The pristine material served as control. The antimigration was reflected in The Dox@Aga coating modified IOLs were thus implanted into the animal eyes for evaluating the effect in PCO inhibition. The anterior segment changes and PCO developing progress were observed by the slit lamp microscope on 1, 7, 14, and 21 days postoperatively. After the whole observation period, rabbits were euthanized humanely and the eyeballs were enucleated and dissected to get lens capsule for the following assessments. Miyake-Apple view observations  and histThe safety and biocompatibility of Dox@Aga IOLs were either checked from the view of morphology, presented by the specular microscope, intraocular pressure (IOP) examination, and histological sections.The specular microscope was used to visualize the corneal endothelial cells morphology and calculate the cell density. The operative eyes which were implanted with pristine IOLs, Aga IOLs, and Dox@Aga IOLs and nonoperative eyes were enrolled to compare. As shown in In addition to this, the cornea in the Dox@Aga group consisted of five-layer structure under bright field , which wAs the most common complication after cataract surgery, PCO is a confused clinical problem to be solved urgently. Modified IOL, the most widely studied in recent years, is the most promising means to realize clinical translation for PCO prevention. And more and more studies proved that drug-eluting IOL has more desirable effect on PCO prevention when compared with hydrophilic modified IOL.However, PCO is closely related to the adhesion, proliferation, migration, epithelial mesenchymal transition (EMT), and fibrosis of LECs, extracellular matrix (ECM) deposition . VariousWhen it comes to other applications of Aga, there are various fields. As a natural plant polysaccharide, there are many unique features of Aga which include repair of damaged tissues and organs. First, Aga has good biocompatibility and nontoxicity. Second, physicochemical property and feature of Aga is tunable. For example, Aga could be mixed with other materials to acquire the desirable mechanical properties. In addition, Aga has limited cell attachment, while it could increase cell affinity to agarose after chemical modifications. Third, the inside network structure of Aga gel is desirable platform for nutrients, oxygen, drugs, and even cells delivery. Based on aforementioned points, Aga and its derivatives and blends have been made into scaffold templates and widely used in tissue engineering, tissue regeneration, and drugs delivery, such as cartilage regeneration  and mussIn this study, a rapid and economical Aga coating was developed for drug-eluting IOLs fabrications on the purpose of PCO inhibition after intraocular implantation. Taking advantages of the temperature-sensitive property, Aga coating can be easily obtained by simple soaking in hot solution and room temperature cooling gelation process. The coating solution, including the concentrations of coating polymer (Aga) and the loading drug (Dox), was optimized on the purposes for the IOLs surface coating feasibility and LECs elimination effectiveness. The coating time was also optimized for the fast and economical fabrication objective. Such biocompatible Aga coating obtained at the optimized coating parameters does not influence the optical properties of IOLs, whereas it evidently improves the surface hydrophilicity, thus resulted in the cell adhesion repelling feature of such coating surfaces. The in vitro and in vivo investigations of the Dox@Aga coating modified IOLs demonstrated that such rapid and economical Dox-loaded Aga coating could eliminate residual LECs, and thus inhibit the PCO development effectively. Such drug-eluting IOLs by fast, convenient, feasible, and economical Aga coating technique with sufficient PCO prevention effect may have great potential in the clinical transformation.


Breeding for Al tolerance is the most sustainable strategy to reduce yield losses caused by Al toxicity in plants. The use of rapid, cheap and reliable testing methods and environments enables breeders to make quick selection decisions. The objectives of this study were to (i) identify high dry matter yielding and stable quality protein maize (QPM) lines grown under Al toxic and optimum conditions and (ii) compare the discriminating power of laboratory- and greenhouse-based testing environments. A total of 75 tropical QPM inbred lines were tested at seedling stage for dry matter yield and stability under optimum and Al toxic growing conditions across six laboratory- and greenhouse-based environments. The nutrient solution method was used for the laboratory trials, while the soil bioassay method was used for the greenhouse trials. A yield loss of 55% due to Al toxicity was observed, confirming the adverse effects of Al toxicity on maize productivity. The ANOVA revealed the presence of genetic variation among the set of genotypes used in this study, which can be exploited through plant breeding. Seventeen stable and high-yielding lines were identified and recommended. Greenhouse-based environments were more discriminating than laboratory environments. Therefore, we concluded that greenhouse environments are more informative than laboratory environments when testing genotypes for Al tolerance. Zea mays L.) productivity in the tropics. Acidic soils are widely distributed in tropical and subtropical areas, constituting about 50% of the world’s potentially arable soils. They are found in approximately 20% of the world’s maize mega environments 3).3+) are dependent on the pH of the solution. The control solution had a pH of 5.8, which is optimum for seedling growth. The seedlings were harvested after the 72 h in stress conditions and weighed for dry matter determination.Five uniform seedlings per genotype were used for data collection, and each treatment was replicated three times in a completely randomized design (CRD). The Al concentration used in this study was adopted from , who rep2 [SO4]3) for 48 h before planting. A pressure plate apparatus was used to determine the field capacity of the soil [2 [SO4]3) was applied at the rate of 24 mg kg−1 of soil because the critical concentration of exchangeable cations above which toxicity is observed in the soil for most cereals is 23–24 mg/kg−1 [3+ in the soil would be available to the plant throughout the experiment.The experiment was laid out in a randomized complete block design (RCBD) with three replications in three blocks. The experimental procedure was adopted from  where althe soil . Aluminu mg/kg−1 . At planIn the laboratory the plants were harvested at 3 days after exposure to Al stress, and in the greenhouse tunnel 4 weeks after planting. This was followed by oven-drying the harvested plants at 65 °C until a constant weight was reached. The dry weight was determined by weighing the samples using a Microgram balance manufactured in Germany .® 17th edition statistical software. A combined analysis of variance (ANOVA) across the environments allowed an estimation of the differences between the main effects (G), environment (E) and their interactions (G × E) on dry matter yield. To determine the stability values, the data on dry matter yield were further subjected to an AMMI analysis. A GGE biplot was used to assess the discriminating power of testing environments.Statistical analyses were performed using GenStatOur study has shown that the set of 75 QPM inbred lines used have genetic variation for Al tolerance. Hence, it is feasible to apply selection to improve dry matter yield under Al toxic and optimum growing conditions. However, more sources of variation should be introduced since the level of observed genetic variation was not very high. It was also revealed that greenhouse-based environments have better discriminating ability for Al tolerance and susceptibility than laboratory-based environments. Seventeen experimental lines were identified to possess a desired combination of high dry matter yield above the grand mean and ASVs that are less than the grand mean. They are therefore recommended for advancement to the field-testing stage. These are QSW 26, QSY 3, IBL 20, QSY 23, IBL4, IBL12, QSY 28, QSY16, QSW2, QSW 25, QSW 21, QSW 12, QSW 7, IBL17, IBL 21, IBL 15 and IBL 16. The findings of the study may be applied by maize breeders in their breeding programs.


The dendrogram generated from the ERIC-PCR banding patterns grouped the test rhizobial isolates into 16 major clusters (Cluster I–XVI), with three isolates, namely TUTAHeS60, TUTGMeS3 and TUTAHeS127, forming outgroups of Clusters IV, VI and IX, respectively. Furthermore, the 76 test isolates were grouped into 56 ERIC-PCR types at 70% similarity level. The phylogenetic analysis of the 16S rRNA gene and multilocus sequence analysis of four housekeeping  and two symbiotic (nifH and nodC) genes showed that all three legumes  were nodulated by bacterial symbionts belonging to the genus Bradyrhizobium, with some isolates exhibiting high divergence from the known reference type strains. The results also showed that B. arachidis, B. iriomotense and B. canariense were the closest type strains to the groundnut isolates, while B. pachyrhizi and B. elkanii were the closest relatives to the bacterial symbionts associated with the nodulation of both jack bean and soybean. This study is the first report to describe of the bacterial symbionts nodulating jack bean in African soils.This study assessed the genetic diversity and phylogenetic relationships of rhizobial isolates obtained from root nodules of groundnut, jack bean and soybean planted in different locations within Eswatini. Seventy-six rhizobial isolates were studied using ERIC-PCR  fingerprinting and PCR amplification of 16S rRNA, housekeeping genes ( Rhizobial symbionts of legumes are phylogenetically diverse and are distributed in fifteen bacterial genera including Bradyrhizobium, Azorhizobium, Ensifer (Sinorhizobium), Mesorhizobium, Rhizobium, Burkholderia and Cupriavidus among others2. Although these diverse rhizobia may share similar morphological and cultural characteristics, they sometimes exhibit some level of host specificity3. For example, groundnut (Arachis hypogea) is generally nodulated by both slow and fast-growing rhizobia belonging to the Rhizobium and Bradyrhizobium genera7. On the other hand, soybean is predominantly nodulated by rhizobial species in the Bradyrhizobium genus, and to a lesser extent by species belonging to the genera Rhizobium, Mesorhizobium and Sinorhizobium10.In legumes, Biological Nitrogen Fixation (BNF) occurs via a symbiotic relationship with soil bacteria collectively known as “rhizobia”2-fixing trait for improved crop production through their formulation into inoculants11. Earlier studies have reported the phylogenetic relationships among symbionts of cultivated legumes such as soybean13 and groundnut5 in Africa. These reports have shown that the dominant symbionts of these legumes are genetically diverse species in the Bradyrhizobium genus. Several authours have carried out bacterial phylogenetic analyses through analyses of the 16S ribosomal RNA (16S rRNA) gene sequences, a range of “housekeeping” and symbiotic genes14. While it is important to continue exploring the symbionts of cultivated legumes in different environments, it is equally crucial to study rhizobia nodulating underutilized legumes such as the jack bean  in the hope of discovering super rhizobia. Despite the high yield potential and food value of jack bean, this legume is neglected by researchers and producers. As a result, little information exists on the microsymbionts nodulating jack bean.Exploring the types of rhizobia nodulating different legumes is one of the steps towards harnessing the benefits of their NatpD, dnaK, glnll and rpoB) and symbiotic genes (nifH and nodC).The aim of this study was to assess the genetic diversity and the phylogenetic relationships among rhizobial symbionts of two important cultivated grain legumes in Africa (groundnut and soybean), and an underutilized legume (jack bean) at different locations in Eswatini, using ERIC-PCR fingerprinting, multilocus sequence analysis of the 16S rRNA gene, housekeeping . The chemical properties of the soils from the various locations are presented in Supplementary Table 15 in alternation with sterile water. Thus, the plants relied solely on symbiosis to meet their N requirements. The plants were harvested at 60 DAP and root nodules plucked and stored in silica gel at 4 °C prior to bacterial isolation within one week. We can confirm that the use of plants in different aspects of this study complied with international, national and/or institutional guidelines.Where nodules could not be obtained from field grown plants, soils were sampled from Malkerns Research Station, Ka-Zulu, Luve and New Heaven in Eswatini for trapping rhizobia under glasshouse conditions. Jack bean accession 493 and five soybean genotypes  were used as host plant to trap rhizobia. Three surface sterilised seeds of each legume were planted per pot, with three replications per location. After germination, seedlings were thinned to one seedling per pot, with three replicate pots per soil type. Soil inocula were prepared by adding 20 g of each soil sample to 100 mL sterile distilled water and the soil suspension used to inoculate the seedlings. To avoid the possible suppression of nodulation by nitrogen fertilization, the plants were irrigated with N-free nutrient solution16. The plates were sealed using parafilm and incubated at 28 °C for 7–10 days. Bacterial growth on the YMA plates was observed daily for the appearance of single colonies. Colony characteristics such as colour, texture, size (diameter) and appearance were recorded. For long-term storage, cultures of pure single colonies were stored in 30% glycerol at − 20 °C17.The nodules were rehydrated in water for two hours, rinsed with sterile distilled water and surface-sterilised by immersing in 95% ethanol for 5 s followed by transferring to a 3% sodium hypochlorite solution for 5 min. The nodule was then rinsed 5–6 times with sterile distilled water. Each surface-sterilised nodule was crushed in a sterile petri dish, and the nodule suspension was streaked on yeast-mannitol agar (YMA) plate15, and alternated with sterile water where necessary. Three replicate pots were used per isolate. Uninoculated plants were included as control. The plants were harvested at 60 days after planting and assessed for nodulation.The bacterial isolates were used to inoculate their respective homologous hosts in the glasshouse and observed for nodulation in fulfilment of Koch’s postulate. The plants were watered with sterile N-free nutrient solution−1) extracted DNA. The PCR amplification was performed in a Thermal cycler .To extract bacterial genomic DNA, the isolates were cultured in YM broth to late log phase. DNA was extracted using the GenElute bacterial genomic DNA extraction kit  according to the manufacturer’s instructions. The extracted DNA were subjected to ERIC  PCR using universal primers . Cluster analysis was done to generate a dendrogram using the unweighted pair group method with arithmetic mean (UPGMA) algorithm using the software Bionumerics (version 8).atpD, dnaK, glnll and rpoB) and symbiotic genes (nifH and nodC) were individually performed in a 25 µL PCR reaction volume, which contained 1 µL DNA (50 to 70 ng µL−1), 3 µL MyTaq buffer (5×), 1 µL each of forward and reverse primers of the gene of interest  database. Multiple and pairwise sequence alignments were carried-out using CLUSTALW, and phylogenetic trees were constructed using MEGA 7 software by means of the maximum likelihood statistical method19. The robustness of the tree branching was estimated using 1000 bootstrap replicates20. The sequences obtained were deposited in the NCBI GenBank to obtain accession numbers OM721967–OM721998 (16S rRNA), OM744177–OM744199 (atpD), OM839789–OM839804 (dnaK), OM839805–OM839832 (glnII), OM839833–OM839864 (rpoB), OM839865–OM839870; OM839872-OM839876; OM839882-OM839884 (nifH) and OM846520–OM846539 (nodC).Prior to sequencing, the amplified PCR products were purified using a PCR Cleanup kit , according to the manufacturer’s guidelines. Thereafter, the amplified PCR products were sequenced at Macrogen (Netherlands). The quality of the sequences was assessed using the software BioEdit 7.0.9.024.The pH and other chemical properties of soils from the various test locations were transformed into a matrix using principal component analysis (PCA). Out of 10 PC axes, the first two were used for clear visualization of the data. Data were analyzed in the R platform using the libraries ‘‘FactoMineR”, ‘‘factoextra” and ‘‘corrplot”A total of 133 bacterial isolates were obtained from the root nodules of groundnut, of which 24 could form root nodules on the homologous host. Of the 34 bacterial isolates from the root nodules of jack bean, 22 nodulated the host plant in an authentication study, while 30 out of 48 bacterial isolates from soybean induced root nodules on the host plant. Thus, there were a total of 76 authenticated rhizobial isolates from the three test legume species. These rhizobial isolates showed differences in growth rate, colony colour, shape, texture, size and appearance , with three isolates  forming outgroups of Clusters II, IV and IX, respectively. The 76 test isolates grouped into 56 ERIC-PCR types if considered at a 70% similarity cut-off point  was done to assess the influence of soil chemical properties on the distribution of microsymbionts across the test locations Fig. . The resBradyrhizobium  from New Heaven and another isolate (TUTGMeS3) from Luve; and they shared 94.7 to 100% sequence similarity with B. pachyrhizi, B. brasilense, B tropiciagri and B. elkanii  within the genus atpD, dnaK, glnII and rpoB) were selected for a robust multilocus sequence phylogenetic analysis. The PCR amplification of the atpD, dnaK, glnII and rpoB genes yielded band sizes of 600 bp, 650 bp, 700 bp and 700 bp, respectively. However, final lengths of 419 bp, 214 bp, 433 bp and 314 bp were used to construct the phylogenies of atpD, dnaK, glnII and rpoB, respectively. With a few exceptions, the maximum likelihood phylogenetic trees from the individual housekeeping genes were consistent with the phylogram from the 16S rRNA gene  and showed closeness with B. elkanii and B. pachyrhizi; however, isolate TUTCEeS14 grouped with B. elkanii as an outgroup of the other isolates in the atpD gene phylogeny  genes grouped the test isolates into various clusters within the Bradyrhizobium genus , jack bean  and soybean (Glycine max) in soils from Eswatini, ERIC PCR fingerprinting and multilocus sequence typing was carried out on authenticated rhizobial isolates of the test legume species. These isolates showed marked differences in colony growth, colour, shape, and size/diameter. The ERIC-PCR profiles of the isolates from the three legumes revealed a high genetic diversity as they constituted 56 ERIC-PCR types if considered at a 70% similarity level  and symbiotic (nifH and nodC) genes were sequenced and analysed. Analysis of the 16S rRNA gene sequences aligned all the isolates from the three legumes to species in the genus Bradyrhizobium. Though Bradyrhizobium species are well established symbionts of groundnut31 and soybean32 as found in this study, no previous reports could be retrieved regarding the rhizobial symbionts of jack bean. Thus, based on this study, Bradyrhizobium species are the preferred symbionts of this underutilized legume in African soils. The observed clustering of the groundnut isolates TUTAHeS3, TUTAHeS29 and TUTAHeS26 with B. iriomotense and B. arachidis was similarly reported by Chen et al.33 as well as Jaiswal et al.4. It was interesting to note that most of the jack bean and soybean isolates grouped with B. elkanii and B. pachyrhizi in this study, suggesting that the bradyrhizobial symbionts of these test legumes may share higher phylogenetic similarity when compared to their counterparts nodulating groundnut in the test locations.To assess the phylogenetic relationships among the diverse rhizobia isolated from the three test legumes in Eswatini, the 16S rRNA, housekeeping  and nodC (79.3–99.1% sequence similarity) phylogenies. Furthermore, although the groundnut isolates grouped separately in the housekeeping gene and concatenated atpD-glnII-rpoB gene phylogenies, they clustered together with the jack bean and soybean isolates in the nifH phylogeny. Incongruencies among single gene phylogenies as observed in this study are largely attributed to the frequency of horizontal gene transfer among prokaryotes34. Among rhizobia for example, the acquisition of symbiotic genes from distantly related bacteria as well as differences in evolutionary processes of chromosomes can partly contribute to the observed inconsistencies in the phylogenies of single genes35. Similar discrepancies in phylogenies of housekeeping and symbiotic genes were also observed in earlier reports on the symbionts of legumes such as cowpea and Soybean12.Although the concatenated Bradyrhizobium genus, while others showed high divergence from the known reference type strains based on 16S rRNA, atpD, glnII, rpoB and dnaK gene sequences. Moreover, based on the symbiotic gene sequences, a few symbionts of the test legumes showed close alignment with B. arachidis and B. kavangense in the nifH phylogeny, while only the jack bean isolate TUTCEeS1 aligned with B. pachyrhizi in the nodC phylogram. Thus, most of the rhizobial symbionts evaluated were highly divergent from the known symbiovars. In the absence of any retrievable information on the rhizobia nodulating jack bean, these findings could be the first report of the crop’s microsymbionts in an African soil.The findings of this study revealed a high genetic diversity among the bradyrhizobial symbionts of groundnut, jack bean and soybean in the soils of Eswatini. A few of the rhizobial symbionts of the test legumes belonged to specie in the Supplementary Information.


GLUT4) genetic polymorphisms in the patients with coronary heart disease (CHD) in Han and Uygur Chinese populations in Xinjiang, China.To explore possible associations between glucose transporter 4 (GLUT4 polymorphisms (rs5418 and rs5435) were genotyped in 1262 Han  and 896 Uyghur  Chinese populations.Two P > 0.05). However, in the Uygur population, there were significant differences in genotype and allele distributions for rs5418 between CHD and the control group . Binary Logistic regression analysis showed that carriers with the rs5418 A allele had a higher risk of CHD compared to carriers of the rs5418 G allele , after adjustment for gender, age, drinking and smoking behavior, hypertension and diabetes. Furthermore, haploid association analysis of the two SNP loci of the GLUT4 gene showed that the AC haplotype was associated with CHD in the Uygur population .In the Han Chinese population, there were no significant differences in allelic or genotypic distribution of rs5418 and rs5435 between the CHD and control groups (all GLUT4 gene variants are associated with CHD in the Uygur Chinese population.rs5418 The online version contains supplementary material available at 10.1186/s12872-022-02630-9. Coronary heart disease (CHD), also known as ischemic heart disease, is caused by myocardial ischemia and hypoxia due to changes in coronary circulation and represents the greatest mortality risk globally of all diseases. Prior reports suggest that ischemic heart disease causes 12.9 million deaths, accounting for one quarter of all global deaths annually, and is the main cause of death , sex 4]4], metabGLUT) are necessary for glucose uptake in cells of nearly all species [GLUT genes, GLUT 1, 2, 3, and 4 have been implicated in human disease. In particular GLUT4 has been the subject of significant study as it is the main glucose transporter found in muscles and adipocytes [GLUT4 is regulated by insulin through a complex mechanism, the aberration of which contributes to obesity [GLUT4 gene  encodes the GLUT4 solute carrier [GLUT4 polymorphisms and human disease including insulin resistance [GLUT4 gene and CHD [GLUT4 gene polymorphisms and CHD risk in Han and Uygur populations in Xinjiang, China.Glucose transporters  older than 18 years of age, (2) a diagnosis of CHD according to the World Health Organization (WHO) CHD diagnostic criteria set in 1979, and (3) single vessel stenosis of > 70%, or multiple vessel stenosis of > 50%. The controls consisted of a random sample of adult’s individuals above 18 years of age who were visiting the hospital for a routine checkup and had medical records. The inclusion criteria were being devoid from any type of cardiovascular diseases and having a normal coronary artery with no evidence of plaque or peripheral vascular disease as confirmed by angiography, medical profile, or previous medical history as documented in their medical records. Individuals were excluded if they had the following conditions: cancer, acute or chronic inflammatory disease, cardiomyopathy or heart valve disease, variant angina without fixed coronary stenosis, coronary artery dilatation, X syndrome, serious liver disease , serious kidney disease (blood CR > 2.5 mg/dl), blood disease and pregnancy.Baseline characteristics of all patients, such as sex, age, and smoking status were collected and are summarized in Table Cubital venous blood was collected from subjects after fasting for > 12 h. Blood biochemical indexes were tested by the Medical Laboratory Center of the First Affiliated Hospital of Xinjiang Medical University using the Abbott C16000 biochemical immunity instrument (United States). The Whole Blood Genome Extraction Kit  was used to extract DNA from whole blood samples. A Nanodrop ND-2000 Ultramicro Nucleic Acid Analyzer was used to detect the concentration and purity of DNA, which was then diluted to 20 ng/ul.In this study, single nucleotide polymorphisms (SNPs) were typed using the TM Multiple SNP Typing Kit (Shanghai Genesky Biotechnology). The SNP allelic site was identified using a high specificity ligase reaction. Then, the ligated products of different lengths were obtained by introducing varied length non-specific sequences at the end of the ligase probe and using a ligase addition reaction. The ligated products were PCR amplified using universal primers labeled with fluorescence, as shown in Supplementary material, and the amplified products were separated by fluorescence capillary electrophoresis. Finally, the genotypes of each SNP locus were obtained by analyzing the electrophoretic patterns.http://analysis.bio-x.cn) was used to assess Hardy- Weinberg equilibrium (HWE). PLINK (http://pngu.mgh.harvard.edu/purcell/plink/) software was used to analyze the allelic and genotypic association with disease [P ≤ 0.05.SPSS 20.0 software was used for statistical analysis. Student t-test is applied for the continuous variables, while Pearson chi-square test is for categorical variables. Wilcoxon Rank-Sum test was applied for body mass index (BMI). The software program SHEsis or chi-square test ( disease . Linkage disease . HaplotyP < 0.001), age (P < 0.001), drinking and smoking behavior (P < 0.001), hypertension (P < 0.001) and diabetes (P < 0.001). Accordingly, these variants were used as the covariates in the following binary logistic regression analysis. No statically significant difference in the BMI was found between CHD patients and controls.The clinical characteristics of study subjects in the Han and Uygur populations are shown in Tables The Hardy–Weinberg analysis showed no deviations from Hardy–Weinberg Equilibrium for rs5418 and rs5435 in either the Han or Uygur populations.P > 0.05). However, in the Uygur population, the allelic frequencies of A and G at the rs5418 locus were 46.22 and 53.78% in the CHD group, and 39.28 and 60.72% in the control group, respectively, representing a significant difference in allelic distribution . The risk of having CHD in patients with the A allele was 1.33 times greater than that of the controls. The frequencies of the T and C alleles at the rs5435 locus in the Uygur CHD group were 33.12 and 66.88%, respectively, compared to 37.37 and 62.63% in the control group, respectively, representing no significant difference in the distribution of the alleles and genotypes between the two groups at the rs5435 locus . We conducted further binary logistic regressions based on the additive, dominant and recessive model after controlling for the influence of gender, age, drinking and smoking behavior, hypertension and diabetes, which revealed a significant association between the rs5418 locus and the risk of CHD under all the genetic models. Compared with the G allele, the A allele increased the risk of coronary heart disease 1.33×. These data are summaries in Tables In the Han population, neither rs5418 nor rs5435 variants showed any significant differences in allelic frequencies and genotypic distribution between the CHD and control groups . In the Uygur population, haploid frequency analysis of two GLUT4 SNP loci identified four haplotypes. In particular, AC haplotype distribution was significantly different between the CHD and control groups in the Uygur population (P < 0.05) and the risk of developing CHD increased 1.36 for the AC haplotype carriers , (IL)-1 (interleukin 1), IL-18 (interleukin 18), ANGPTL4 (Angiopoietin-like 4), and PIN1  [GLUT4 polymorphisms and CHD. We studied GLUT4 polymorphisms and potential associations with CHD in multiple ethnic groups within a Chines population and identified a specific GLUT4 gene polymorphism that is significantly associated with the risk of developing CHD in the Uygur Chinese population.Previous studies have shown close relationships between the incidence of CHD and cting 1) –31 but fGLUT4 is the primary glucose transporter in the human heart, which accounts for approximately 70% of all glucose transport [GLUT1 and GLUT4, due to changes in heart glucose metabolism. GLUT4 is translocated to the cell surface in response to ischemia, insulin, and catecholamines, allowing it to increase glucose transport into cardiomyocytes. However, in the absence of stimulation, GLUT4 is trapped intracellularly [GLUT1 and GLUT4 from the intracellular ventricle to the sarcolemma. Many studies have reported GLUT4 gene polymorphisms in association with type 2 diabetes [GLUT4 gene polymorphisms in CHD patients.ransport . In hearllularly . Ischemillularly  and alsollularly . The incdiabetes , 36–38, GLUT4 polymorphisms, rs5418 is located in the gene promoter region [GLUT4 gene was detected in normal glucose tolerance and type 2 diabetes, and found differences in the ACGT haplotype of rs5418 [Of the known r region . One prif rs5418 . Anotherf rs5418 . The rs5f rs5418 . HoweverGLUT4 gene are associated with susceptibility to CHD in the Uygur Chinese population, it may be beneficial provide for future clinical diagnosis and treatment. This study was limited to only patients from two ethnic groups in Xinjiang, China. Future studies should include more ethnic groups from this area or study populations in other regions of China or worldwide. Further functional validation of increased susceptibility to CHD development is also needed to confirm a definitive role of rs5418 site mutations in the GLUT4 gene and elucidate the effects of these mutations on CHD pathogenesis or etiology.In this study, we found that the genotypic and allelic frequencies of rs5418 locus were not significantly different in either the CHD or the control group of a Han Chinese population. However, in the Uygur population, we found that the distribution frequencies of the three genotypes and alleles in the two groups were significantly different. Differences in findings between these populations are likely related to the races studied. As a multi-ethnic region, Xinjiang has 45 ethnic groups, in addition to the Han and Uygur populations. In addition to the different genetic backgrounds of these groups, there are a variety of cultural and lifestyle differences that may also play a contributing role. Our findings that the AA genotype and the A allele at the rs5418 site GLUT4 gene polymorphisms at the rs5418 site were associated with CHD susceptibility in the Uygur, but not Han, Chinese population of Xinjiang, China.Additional file 1: Table S1. Baseline characteristic of the Han population according to the genotype of rs5418. Table S2. Baseline characteristic of the Uygur population according to the genotype of rs5418.Additional file 2: Figure S1. Haploview analysis for D' and r2 pairwise measures of LD between rs5418 and rs5435. D' values and confidence levels (LOD) are represented as black for D' = 1, LOD > 2; shades of pink for high D', LOD < 2; white for D' < 1, LOD < 2. r2 values are represented as black for r2 = 1, white for r2 = 0, with intermediate values for 0 < r2 < 1 indicated by shades of grey. The numbers within the squares represent the D' or r2 scores for pairwise LD.