bluuebunny/crossref_metadata_2025 huggingface dataset:
The Tough Fibrous Tissue of The Supracondylar Groove As A Useful Landmark Via The Endoscopic Endonasal Approach To The Lower Clivus
Authors: Hu Changchen , Zhou Liyuan , Ji Hongming , Zhang Gangli , Chen Shengli , Zhao Jianwei , Zhang Shiyuan , Liu Jiangtao , Wang Kaixuan , Li Pengfei , Li Ming , Zhao Yu , Li Hang
Published: September 2021

Background: The hypoglossal canal (HGC) is the most important structural landmark for the endoscopic endonasal approach to access the lower clivus (LC). We explored the feasibility of using the tough fibrous tissue covering the supracondylar groove (SCG) as a useful landmark to identify the location of the HGC. Methods: Four cadaveric specimens were dissected and analyzed. The craniovertebral junction (CVJ) region was accessed utilizing 4-mm endoscope with either 0° or 30° lenses. CVJ exposure and the surgical corridor areas were measured. The relationship between the tough fibrous tissue covering the SCG and the HGC was analyzed.Results: Tough fibrous connective tissue was tightly attached the SCG and ran superomedially to inferolaterally. The angle between the horizontal plane and the long axis of the SCG was 30°. Separating the tough tissue inferolaterally, we could locate the external orifice (EO) of the HGC to further accurately isolate the hypoglossal nerve. Conclusion: The tough fibrous connective tissue covered the SCG to the upper part of the HGC EO. The course of the tough fibrous connective tissue was superomedial to inferolateral. Using the tough fibrous connective tissue covering the SCG as a landmark, it was possible to accurately locate the HGC EO via the endoscopic endonasal approach to access the LC.
How do General Practitioners Handle Complexities? A Team Ethnographic Study in Japan
Authors: Haruta Junji , Goto Ryohei , Sachiko Ozone , Kimura Shuhei , Teruyama Junko , Hama Yusuke , Maeno Tetsuhiro
Published: September 2021

BackgroundGeneral practitioners (GPs) commonly deal with complexities, such as patients with socio-economic-medical problems. However, the methods they use to approach these complexities are still not understood. We speculated that elucidating these methods in terms of complex adaptive systems (CAS) to comprehensively assess GPs’ daily activities would contribute to improving the professional development of GPs. This study aimed to clarify the approaches adopted by GPs in Japan to handle complexities in their daily activities and examine them in terms of CAS extracted from GPs and other healthcare professionals.MethodsWe adopted interdisciplinary team-ethnographic research. Five hospitals and four clinics in Japan, selected by purposive sampling based on the presence of expert GPs. 62 individuals of various backgrounds working in five hospitals and four clinics were interviewed. Using field notes and interview data, the researchers iteratively discussed the adequacy of our interpretations. The first author (JH) prepared a draft report, which was reviewed by the GPs at the participating facilities. Through critical and iterative consideration of the different insights obtained, the final findings emerged together with representative data.ResultsWe identified four approaches used by GPs to deal with complexities. First, GPs treat patients with complex problems as a whole being and address their problems multi-directionally. Second, GPs build horizontal, trusting relationships with other healthcare professionals and stakeholders, and thereby reduce the degree of complexity of problems. Third, GPs change the learning climate while committing to their own growth based on societal needs and by acting as role models for other professionals through daily interpersonal facilitation. Fourth, GPs share community values with multi-professionals and thereby act as a driving force for organizational change. These various interactions among GPs, healthcare professionals, organizations and communities resulted in systematization of the healthcare and welfare network in their community. ConclusionsExpert GPs developed interconnected multidimensional systems in their community health and welfare networks to adapt to fluctuating social realities using four approaches. GPs’ work environment may be considered as a complex adaptive system (CAS) and the approach of GPs to complexities is CAS-based. Our findings are expected to have practical applications for GPs.
Urban Matanuska Flood Prediction using Deep Learning with Sentinel-2 Images
Authors: Chellapa Ramasamy Sankar Ram , Rajan Santhana Krishnan , Eanoch Golden Julie , Yesudhas Harold Robinson , Kumaragurubaran Lakshminarayanan , Long Hoang Viet , Kumar Raghvendra
Published: September 2021

In this paper, we produce a novel raster dataset depending upon the Sentinel-2 satellite. They envelop over thirteen spectral bands. Our novel data set consists of ten classes within a total of 27000 Geo-referenced and labelled images. Gradient Boosting Model (GBM) used to explore this novel dataset in which the overall prediction and accuracy of 97% is obtained from the support of Graphics Processing Unit (GPU) afforded from Google Colaboratory (Colab). The obtained classification result can provide a gateway for numerous earth observation applications. Here, in this paper, we also elaborate on how this classification model might be applied for a conspicuous change in land cover and how it plays an important role in improving the graphical maps.
Bibliometric Analysis and Visualization Harm Reduction in Indonesia Indexed in Scopus
Authors: Subandi Yeyen , Nurmandi Achmad , Qodir Zuly , Jubba Hasse , Purwaningsih Titin , Rochimah Tri Hastuti Nur
Published: September 2021

Background: Harm Reduction is a program to reduce the harm of narcotics for injecting drug users. The Harm Reduction (HR) program in Indonesia was initiated in 1999 with assistance and financial support from international donor agencies that lead to policy or program implementation. 9 components of Harm Reduction are still being implemented in Indonesia. The current study was conducted to analyze the bibliometric characteristics and trends of articles on Harm Reduction in Indonesia. Methods: This study uses VOSviewer affiliate analysis to visualize and analyze trends in the form of bibliometric maps. VOSviewer can also create publication maps, country maps, or journal maps based on shared citation networks or create keyword maps based on their networks. All data is taken from the Scopus database.Results: Articles from 1999 to 2021 in 41 journals indexed by Scopus with a total of 67 documents. Research on Harm Reduction in Indonesia in the last five years has only one significant increase, namely in 2019 with 10 article documents. This shows that international publications of research on Harm Reduction in Indonesia are not yet developed and there are not many interested people. Conclusions: There are still not many researches on Harm Reduction in Indonesia, besides that the results show that research sources on Harm Reduction in Indonesia are still widely available and accessible for further research in the future.
A Rare Case of IgG4-related Disease Manifesting as an Ulcerated Gastric Cancer Complicated With Gastric Mucormycosis
Authors: Zhan Yuting , Yang Yang , Zheng Hongmei , Zhang Yuting , Gu Li , Chen Dongliang , Fan Songqing
Published: September 2021

BackgroundIgG4-related disease (IgG4-RD) is a novel clinical entity that mimics many malignant, infectious, and inflammatory disorders. Many organs or tissues are now known to be involved in IgG4-RD; however, there has been no report about IgG4-RD of stomach with fungal infection. Case presentationWe reported a 56-year-old male with IgG4-RD manifesting as ulcerated gastric cancer complicated with gastric mucormycosis. Both clinical and imaging manifestations were atypical, in clinical, it was highly suspected that the disease is a malignant tumor as ulcerated gastric cancer. However, no pathological evidence of malignancy could be found in repeated biopsies and surgically excised gastric specimen. Histological examination showed ulcer and inflammatory granulation with lymphocytes and plasma cells in sheets, inflammation of vascular wall, formation of new fibrous tissue and inflammatory necrosis with hyphae and spores. The plasma cells had immunohistochemically strong staining for CD38, CD138, kappa, lambda, IgG and IgG4. And notably, IgG4/IgG positive plasma cell ratio was more than 40%, kappa/lambda positive staining ratio was approximately 1:1. Gastric mucormycosis was diagnosed with hyphae and spores confirmed by Gomori's methenamine silver staining and immunofluorescence and confocal laser-scanning microscopy. IgG4-RD manifesting as ulcerated gastric cancer complicated with gastric mucormycosis was diagnosed by multidisciplinary team discussion from gastroenterology, radiology and pathology department. The patient vomited blood three times for the following month. An emergent exploratory laparotomy was conducted, and a mass with 10×9×8cm adhered closely to adjacent organs could be touched in lesser curvature of gastric antrum. Anastomotic leakage occurred after the surgery, symptomatic treatments (negative pressure drainage and antibiotics) were applied without steroids and anti-fungus drugs. The patient gradually recovered and was advised to consult gastroenterology department for further steroids and anti-fungus drugs treatment. Conclusions﻿To our knowledge, it is the first report about IgG4-related disease manifesting a gastric ulcer with mucormycosis infection.
Magnetic Resonance Imaging Findings Among Young Adults with Low Back Pain at Nsambya Hospital
Authors: Lukecha Komakech Richard , Geoffrey Erem , Gonzaga Mubuuke A. , Sam Bugeza
Published: September 2021

Back ground: Studies on MRI findings among patients with LBP have been conducted; especially among adolescents and young adult population in developed countries. However, MRI lumber spine evaluation findings in young adult patients with low back pain in Uganda is not known. The purpose of this study was to determine the MRI findings and their correlation to clinical features in young adult patients with low back pain in Nsambya hospitalMethods: This was a descriptive cross sectional study. One hundred and fifty-seven patients with low back pain in the 18 - 39year age group underwent MRI lumbar spine evaluation. The MRI changes in the lumbar spine and correlation to clinical features were determined. Correlation was assessed by Pearson chi square tests (Fisher’s exact test) and p-values reported at 0.05 level of significance. Results: Of the 157 patients 129 (82.2%) had severe pain, whereas ninety (57.3%) had pain that had lasted more than 10 weeks. Sixty-five (41.4%) patients were found to have MRI evidence of disc desiccation, majority (61%) of whom had multiple level disease, mostly involving the lowest 2 disc levels. Facet joint arthropathy (47.8%), marginal osteophyte (31.8%) and disc contour irregularity [disc bulge] (31.2%) were other common MRI features seen. There was an association between duration of pain and limb weakness, and development of marginal osteophytes. There was also association between clinical presentation and disc bulge. Conclusions: The MRI finding of disc degeneration among young adult patients with LBP is higher than reported. Age and pain distribution are predictors of developing disc desiccation.
Mutation of KIT In Cellular Extraskeletal Myxoid Chondrosarcoma: A Case of And Literature Review
Authors: Wang Chen , You Zhijie , Chen Xiao-Yan , Lin Jie , Wu Yi-Juan
Published: September 2021

Background: Extraskeletal myxoid chondrosarcomas (EMCs) have been recognised as genetically and biologically solid tumours. Only a few studies have discussed the role of CD117 in immunohistochemical(IHC) staining or the influence of the KIT gene in EMC. We herein present a novel case of cellular EMC exhibiting EWSR1-NR4A3 fusion, KIT exon 13 mutations and a strong diffuse expression of CD117.Case presentation: A man presented with a fist-sized tumour on his left shoulder. Computed tomography(CT) revealed a tumour in the left thoracic and dorsal muscle space. The tumour was completely resected. Histologically, the tumour cells had a nodular structure and underwent infiltrative growth, with the invasion of the peripheral fat and muscle tissues. The tumour cells had uniform size, round nuclei with well-defined nucleoli and eosinophilic cytoplasm. Immunohistochemically, the tumour cells were positive for CD117, vimentin, CD56 and NSE and revealed focal expression for desmin, with negativity for myogenin, S-100, SYN, INSM1, CD34, STAT6, INI-1, Brachyury, ERG, TLE1, AE1/AE3, WT-1, CD99 and SMA. Next-generation sequencing revealed EWSR1-NR4A3 fusion and KIT exon 13 mutations. The patient had no further treatment after surgery, and no recurrence or metastasis in follow-up for nearly 2 months.Conclusions: Molecular detection is an indispensable technique for the diagnosis of EMC, especially rare variants like cellular EMC. The KIT mutations noted in this case report may offer fresh insights regarding EMC treatment.
Self-assembled network polymer electrolyte membranes for application in fuel cells at 250℃
Authors: Lee Seungju , Jo YoungSuk , Hwang Son-Jong , Park Yongha , Kim Yeong Cheon , Lee Tae Kyung , Kim Hyoung-Juhn , Nam Suk Woo , Lee So Young
Published: September 2021

Modern H2-based energy storage and conversion devices require a polymer electrolyte membrane (PEM) fuel cell–based integrated power system with synergistic heat integration. The key issue in integrated power systems is developing a PEM that can operate at 200–300 °C. However, currently used phosphoric-acid-based high-temperature PEM fuel cells limited stability at higher operating temperatures. Herein, we introduce a cerium hydrogen phosphate (CeHP) PEM that conducts protons above 200 °C through a self-assembled network (SAN). The SAN-CeHP-PBI reached maximum power densities of 2.4 W cm-2 and operate stably for over 7000 minute without any voltage decay at 250 ℃ under H2/O2 and anhydrous conditions. The developed fuel cell can be combined with an external hydrogen generator that uses a liquid hydrogen carrier such as N-ethylcarbazole and methanol as fuel, thus achieving a high energy efficiency. The thermal stability and fuel flexibility of these SAN-CeHP-PBI demonstrate potential for commercial applications.
Carcinoma of Unknown Primary Origin: Application of Immunohistochemistry
Authors: Mokhtari Maral , Safavi Dornaz , soleimani Neda , Monabati Ahmad , Safaei Akbar
Published: September 2021

Background: The primary origin of some carcinomas may be obscured to the clinicians but it is crucial to identify the origin of these carcinomas because it affects the prognosis and treatment, especially for the novel targeted therapies. Immunohistochemistry (IHC) may be useful for determination of the primary origins. In this study, we conducted a retrospective survey to evaluate the frequency and accuracy of each IHC marker used to identify the origin of these carcinomas.Method: Archival review of pathology department revealed 307 cases of carcinoma of known primary origin(CUP) between 2015 and 2020 who were available. Demographic information, site of biopsy, clinical and pathologic diagnosis, and IHC results were collected.Results: The cases consisted of 157 (51.15%) male and 150 (48.85%) female patients. The patients age range was 14-92 years and 106 cases (34.5%) were dead. In 27% of cases, the primary origin remained still unknown. The pathological and clinical diagnostic agreement was 59%. CK7+/CK20- pattern of expression was the most common pattern in CUPs(55.3%) followed by CK7-/CK20- (19%), CK7+/CK20+(15%), CK7-/CK20+(10.7%), respectively.Conclusion: IHC study may aid in the diagnosis of CUP. However, some cases will still remain unknown origin after IHC study, so more diagnostic methods or gene expression studies may be needed for definite diagnosis.
Serum Levels of IL-12, IL-6, IL-10, IL-17 and IFN-γ in Female Students with Vitamin D Deficiency
Authors: Asadikaram Gholamreza , Jamali Zahra , Igder Somayeh , Nabati Saeedeh , Bagheri Vahid , Karimabad Mojgan Noroozi , Khaksari Mohammad , Arababadi Mohammad Kazemi
Published: September 2021

Background: Several studies demonstrated the regulatory effects of vitamin D3 on the immune system. The aim of this study was to investigate the serum levels of IL-12, IL-6, IL-10, IL-17 and IFN-g cytokines in 11-17 year-old female students with 25-hydroxyvitamin D3 (25-(OH) D3) (VitD3) deficiency. Methods: 100 subjects with VitD3 deficiency were selected as the case group and an equal number of individuals with sufficient levels of VitD3 were selected as a control group. The serum levels of IL-10, IL-6, IL-12, IFN-g and IL-17 were measured by ELISA method. Results: The results showed that the serum concentrations of IL-12 (P= 0.005) and IFN-g (P= 0.019) were significantly lower in VitD3-deficient group compared to control group. There were no significant differences in serum levels of IL-6 (P= 0.66), IL-10 (P= 0.647) and IL-17 (P= 0.159) between cases and controls.Conclusion: These results suggest that VitD3deficiency may result in decreased inflammatory cytokines production, which are required for proper immune functions. However, the effects of VitD3 on IL-6 and IL-17A, as the pro-inflammatory and IL-10, as anti-inflammatory cytokines needs more investigations.
Misdiagnosis of Systemic Metastatic Melanoma for fungal infection: A case report
Authors: Sun Juan , Zhu Yun-Zhu , Shao Pan-Pan , Ke Jing , Wang Wei , Sun Qiu-Lin , Li Jia-Bin , Cheng Jun
Published: September 2021

BackgroundMost of malignant melanomas originate from skin and often metastasize to the lungs, rarely metastasizes to the liver and bone. However, imageology characters of lung metastasis tumor are commonly similar to those of fungal infections. Case presentationA patient was admitted with unhealed plantar puncture wound for 3 years, and cough and expectoration for 2 years. The chest computed tomography (CT) revealed multiple nodules with cavities, and the patient was diagnosed of pulmonary fungal infection in another hospital and received antifungal therapy for more than 8 months, but the clinical symptoms and chest imaging findings continue to progress. After admission, the pathological results of both lung biopsy and biopsy of the plantar wound 3 years ago indicated malignant melanoma. ConclusionsThe diagnosis of lung lesions cannot rely solely on imaging diagnosis, lung biopsy should be performed if necessary.
Facile Synthesis of Metal Doped Graphite Carbon Nitride for Photocatalytic Degradation of Tetracycline Under Visible Light Irradiation
Authors: zhao yin , qin hong , luo Qianlan , wang ziwei , wang han , wang zixuan , he yangzhuo , Tian Quyang , Wang Changlin , Xu Piao
Published: September 2021

Using semiconductor photocatalysts for antibiotic contaminants degradation under visible light has become a hot topic in recent years. Herein, a novel cadmium doped graphite phase carbon nitride (Cd/g-C3N4) photocatalyst was successfully constructed via 60 °C oil bath method to degrade tetracycline. Experimental and characterization results revealed that cadmium was well doped at g-C3N4 surface and exhibited high intercontact with g-C3N4. Meanwhile, Cd/g-C3N4 presented excellent electrical conductivity and inhibited the recombination of electron-hole pairs. The introduction of cadmium significantly improved the photocatalytic activity and the degradation efficiency of 10 Cd/g-C3N4 reached to 89.09%, which was exceeded 2.0 times than pure g-C3N4 (43.99%). Additionally, the quenching experiments and electron spin-resonance tests exhibited holes (h+), hydroxyl radicals (•OH) and superoxide radicals (•O2−) were dominated active species in TC degradation. Furthermore, the effects of various conditions on the reaction process, such as different pH, initial TC concentrations and catalyst dosage, were also researched. This work gives a reasonable point to synthesize high-efficiency and economic photocatalysts.
Adjuvanticity of sliver nanoparticles with Infectious bursal disease virus VP2 protein and its effect on humoral immune response in chickens
Authors: Awandkar Sudhakar P. , Tembhurne Prabhakar A , Kurkure Nitin V , Chaudhari Sandeep P , Bonde Sachin W , Ingle Vijay C
Published: September 2021

The present study was conducted to decipher the effect of silver nanoparticles conjugated marker recombinant VP2 immunogen of Infectious bursal disease virus on humoral immune response in chickens. The hypervariable VP2 gene segment of field Infectious bursal disease virus, consisting of major and minor hydrophilic loops, was amplified using reverse transcription-polymerase chain reaction. The gene segment of size 664 bp was cloned into pGEM-T Easy plasmid followed by subcloning into pET32a plasmid vector. Truncated recombinant VP2 protein (rVP2, 19 kDa) was expressed in a prokaryotic expression system using Escherichia coli BL32DE3 cells. The rVP2 protein showed reactivity with specific anti VP2 chicken antibodies. The results of Western blot revealed its utility in serological diagnosis. The recombinant antigen was tested for immunogenic potential by vaccinating the chickens with and without silver nanoparticles. The rVP2 protein blended with adjuvant grade montanide oil showed a highly significant rise in serum IgY titers. The titers induced by rVP2 protein mixed with montanide oil were non-significant when compared with titers induced by the conventional vaccines. The IgY response was highly significant in chickens vaccinated with rVP2 protein blended with montanide oil and silver nanoparticles than in chickens vaccinated with conventional vaccines or rVP2 protein. The results represent Infectious bursal disease virus rVP2 protein as a promising candidate for the DIVA vaccine and sero-diagnostic tool. For the first time, the current study elucidated the adjuvanticity effect of silver nanoparticles on avian Infectious bursal disease virus rVP2 vaccine potency.
The Value of CT Radiomics Nomogram Analysis of Parenchyma Surrounding Pulmonary Nodules in the Differentiation of Inflammatory Nodules from Tuberculous Nodules
Authors: Fan WeiJie , Mu Ke , Zhang Si , Yang Yan , Yu Li , Huang WenJie , Wen Li , Liu Huan , Zhang Dong
Published: September 2021

Background: To investigate the value of CT Radiomics nomogram based on pulmonary nodules and surrounding parenchyma in differentiating non-tuberculous inflammatory pulmonary nodules from tuberculous nodules.Methods: A retrospective analysis was performed on 273 patients with pulmonarynodules confirmed by surgery and pathology in the Second Affiliated Hospital of Army Military Medical University from January 2015 to March 2021, including 164 cases of non-tuberculous inflammatory nodules and 109 cases of tuberculous nodules.Pulmonary nodule (ROI1), 3mm parenchymal band around nodule (ROI2) and nodules with external expansion (ROI3) were segmented andradiomic features were extracted by A.K. software. The stability of the features was analyzed by ICC, and the features were divided into the training set and the verification set by random stratified sampling according to the ratio of 7:3. The radiomics label was constructed by using the maximum relevance and minimum redundancy method (mRMR) and the least absolute shrinkage and selection operator method (LASSO) after two dimensional reduction.Finally, multiple Logistic regression analysis was conducted to select the optimal model among the three models, and the classification model including the radiomicfeatures and clinical risk factors was established.The identification effectiveness of the model was evaluated in terms of average area under curve (AUC), accuracy, sensitivity, and specificity, and was independently validated in a validation cohort.Results: There was significant difference in the type of pulmonary nodules between the two groups (p< 0.05). Nodules with external expansion model has the best diagnostic performance, and combined with clinical features (nodular type) to construct a classification model.The AUC of both the training cohort and the validation cohort was 0.93. Decision curve analysis showed that the radiomics nomogram had good value in classification of the two categories of nodules.Conclusions: The CT radiomics nomogram based on nodule plus surrounding substance has good performance in judging non-tuberculous inflammatory nodules and tuberculous nodules, which can provide reference for clinical diagnosis and treatment, and has good clinical application value and development prospect.
Latent Tuberculosis Infection Among Individuals with Pulmonary Fibrosis in Rural China: A Screening Study
Authors: Xin Henan , Zhang Haoran , Cao Xuefang , Liu Jianmin , Pan Shouguo , Du Ying , Feng Boxuan , Guan Ling , Shen Fei , Liu Zisen , Wang Dakuan , Guan Xueling , Zhang Zhanjiang , Yan Jiaoxia , Quan Zhusheng , Jin Qi , Gao Lei
Published: September 2021

Background: Individuals with pulmonary fibrotic radiological lesions, indicating prior tuberculosis (TB), have been suggested to be at high likelihood of developing active disease from latent TB infection (LTBI). The burden of LTBI among this specific population has been rarely studied in China.Methods: We conducted a population-based screening study to investigate the prevalence of fibrotic radiological lesions and their TB infection rate among rural residents in China. Chest radiography examination was performed for all eligible participants, and Interferon Gamma Release Assay (IGRA) testing was conducted for those with a history of anti-TB treatment and those with radiographic abnormalities suggestive of prior TB. Risk factors associated with the present of fibrosis and IGRA positivity were analyzed.Results: A total of 45,901 rural residents participated in the study, 2,231 of them reported a history of anti-TB treatment. The prevalence of pulmonary fibrosis was 34.16% (762/2,231) and 2.81% (1,230/43,670) among the participants with and without anti-TB treatment. The present of fibrosis was found to be more frequent among individuals with a history of relapse of TB (50.35%, 72/143) or previous smear positive TB (44.23%,157/355). Among participants with fibrotic radiological lesions, IGRA positivity was 50.39% (384/762) and 25.44% (313/1,230) for those with and without anti-TB treatment records, respectively. Males, younger age and a previous smear positive TB were associated with higher IGRA positivity among individuals with anti-TB treatment record.Conclusions: Individuals with fibrotic radiological lesions and their remarkably high burden of TB infection should be attached more attention for TB control in China.
Prognostic Impact of the Number of Peritumoral Alveolar Macrophages in Patients With Stage I Lung Adenocarcinoma
Authors: Noritake Osamu , Aokage Keiju , Suzuki Ayako , Tane Kenta , Miyoshi Tomohiro , Samejima Joji , Yoshikawa Toyohumi , Nakai Tokiko , Tsuboi Masahiro , Ishii Genichiro
Published: September 2021

Purpose:Intratumoral macrophages are reportedly involved in tumor progression in non-small cell lung cancer; however, little is known about the prognostic impact and function of alveolar macrophages (AMs). This study aims to investigate the prognostic impact of the number of peritumoral AMs in patients with stage I lung adenocarcinoma.Methods:We investigated 514 patients with pathological stage I lung adenocarcinoma who underwent complete resection with lobectomy or pneumonectomy. The number of peritumoral AMs were counted, and patients were classified into two groups based on the number of peritumoral AMs. Using the Cancer Genome Atlas (TCGA) database of stage I lung adenocarcinoma, we compared gene expression profiles of high and low peritumoral AM contents.Results:The median number of peritumoral AMs per alveolar space was 15.5. Patients with a high peritumoral AM content had significantly shorter disease-free survival and overall survival than patients with a low peritumoral AM content (both p < 0.01). In the multivariate analyses, a higher number of peritumoral AMs was an independent prognostic factor (p = 0.02). The analysis of TCGA database revealed that patients with a high peritumoral AM content had shorter disease-free survival than those with a low peritumoral AM content (p = 0.04). Gene expression analysis of TCGA stage I lung adenocarcinoma revealed enrichment of biological processes, such as chemotaxis and epithelial proliferation, in patients with a high peritumoral AM content.Conclusion:The number of peritumoral AMs had a strong impact on disease-free survival in patients with stage I lung adenocarcinoma.
Functional Analysis of a Viral Promoter From the Strawberry Vein Banding Virus (SVBV) Chinese Isolate
Authors: Jiang Lei , Chen Jing , Yang You-zhi , Li Rui , Li Shuang , Wang Zhan-qi , Jiang Tong
Published: September 2021

BackgroundPromoter is an important factor during gene expression in cells. In this study, we cloned a full-length promoter from the strawberry vein banding virus (SVBV) Chinese isolate and produced several its deletion mutants.MethodsThe full-length promoter of SVBV (SP1) and its three deletion mutants (SP2, SP3, and SP4) were amplified using polymerase chain reaction (PCR). The expression activities controlled by the SVBV SP1, SP2, SP3, and SP4 were evaluated using β-glucuronidase (GUS) and green fluorescent protein (GFP) reporter genes.ResultsOur transient expression assays showed that the SVBV SP1 promoter as well as its three deletion mutants all expressed the reporter genes, but to very different levels. Interestingly, the expression activity driven by the SP1 promoter was much higher than that shown by the CaMV 35S promoter. After stable transformation of a GUS gene into Nicotiana tabacum plants, the transgene expression level driven by the SVBV SP1 promoter was about 2.6-fold greater than that driven by the CaMV 35S promoter. In addition, the GUS gene expression levels could be enhanced by co-infiltrating the plants with the SP1 promoter-driven vector carrying the GUS gene and the vector expressing the SVBV ORF V or ORF VI.Conclusions﻿The SVBV Chinese isolate promoter SP1 is a stronger promoter than the CaMV 35S and FLt-US promoter, may be more useful for production of stable transgenic plants.
Pd-catalyzed Cyanation of Arenediazonium Tetrafluoroborate with 2-(piperidin-1- yl)acetonitrile as CN Source Under Mild Conditions
Authors: Ahmad Muhammad Siddique , Shafiq Zahid
Published: September 2021

The present study reports a new organic CN reagent, 2-(piperidin-1-yl)acetonitrile which could cyanate commercially aryldiazonium tetrafluoroborate with Palladium as catalyst under mild reaction conditions. A large substrate scope for Pd-catalyzed cyanation of aromatic diazonium substrates was found, yielding cyanated products in medium to high amounts (50%‒88%). An attempt is also made to modify the method for preparation of etravirine and strategies for the transformations of 2-cyanoindole which are used as anti-AIDS, NMDA receptor antagonists and have high potential against mutant HIV strains. The mechanism of this Pd-catalyzed cyanation of aryldiazonium tetrafluoroborate involved CN ions construction was proved by paper indicator strategy. However, Pd/(Me3Si)2 system has been identified to cleave C − CN bond at low temperature and transferred the CN group to aryl ring of diazonium substrate in one pot.
New Risk Scoring System for Predicting 3-month Mortality after Acute Exacerbation of Idiopathic Pulmonary Fibrosis
Authors: Sakamoto Susumu , Shimizu Hiroshige , Isshiki Takuma , Nakamura Yasuhiko , Usui Yusuke , Kurosaki Atsuko , Takai Yujiro , Homma Sakae , Isobe Kazutoshi
Published: September 2021

Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is often fatal. A straightforward staging system for AE-IPF would improve prognostication, guide patient management, and facilitate research. The aim of study is to develop a multidimensional prognostic AE-IPF staging system that uses commonly measured clinical variables. This retrospective study analyzed data from 353 consecutive patients with IPF admitted to our hospital during the period from January 2008 through January 2018. Multivariate analysis of information from a database of 103 recorded AE-IPF cases was used to identify factors associated with 3-month mortality. A clinical prediction model for AE-IPF was developed by using these retrospective data. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance of this model. Logistic regression analysis showed that PaO2/FiO2 ratio, diffuse HRCT pattern, and serum C-reactive protein (CRP) were significantly associated with 3-month mortality; thus, PaO2/FiO2 ratio < 250 (P), CRP ≥ 5.5 (C), and diffuse HRCT pattern (radiological) (R) were included in the final model. A model using continuous predictors and a simple point-scoring system (PCR index) was developed. For the PCR index, the area under the ROC curve was 0.7686 (P < 0.0001). The sensitivity of the scoring system was 78.6% and specificity was 67.8%. The PCR index identified four severity grades (0, 1, 2, and 3), which were associated with a 3-month mortality of 7.7%, 29.4%, 54.8%, and 80%, respectively. The present PCR models using commonly measured clinical and radiologic variables predicted 3-month mortality in patients with AE-IPF.
Early Feeding Practices and Body Mass Index Z-Score among Saudi Preschoolers: A Cross-Sectional Study
Authors: Mosli Rana
Published: September 2021

ObjectivesTo characterize early feeding practices among mothers in Saudi Arabia and examine their associations with child birthweight and BMI z-score (BMIz) at preschool. Study DesignCross-sectional study. MethodsMother-child dyads (n=209) were recruited from different preschools around the city of Jeddah. Mothers completed the study questionnaire over the telephone and preschoolers’ anthropometric measurements were objectively measured. Descriptive statistics were used to characterize early feeding practices. Bivariate analyses and linear regression were used to examine the association of early feeding practices with child birthweight and BMIz at preschool. ResultsThe majority of mothers (92.3%) initiated breastfeeding, with an average duration of 9.34 months (SD= 8.04). About half of the mothers reported that they have offered fruit juice and/or date syrup-milk mixture in a baby bottle (52.2% and 45.9% respectively), with an average duration of 11.5 months (SD= 7.73) and 5.90 months (SD= 6.13), respectively. Children who were offered fruit juice and/or date syrup-milk mixture in a baby bottle had significantly lower birthweights compared to children who were not (M= 2.79, SD= 0.59 vs. M= 3.06, SD=0.69, P< 0.01 and M= 2.79, SD= 0.67 vs. M= 3.03, SD=0.62, P< 0.01, respectively). There was a negative association between introducing fruit juice in a baby bottle and child BMIz at preschool (b: 0.18, 95% confidence interval (CI): -0.83, -0.11); This association was not significant after adjusting for child birthweight and other covariates (b: -0.10, 95% CI: -0.64, 0.09). ConclusionLongitudinal and interventions studies are needed to inform counseling guidelines and community campaigns in order to improve early feeding practices in the region.
Conducting Public Health Surveillance in Areas of Armed Conflict and Restricted Population Access: A Qualitative Case Study of Polio Surveillance in Conflict-affected Areas of Borno State, Nigeria
Authors: Wiesen Eric , Dankoli Raymond , Musa Melton , Higgins Jeff , Forbi Joseph , Manu Jibrin , Ndadilnasiya Endie , Ogunbodede Oladapo , Mohammed Kabiru , Adamu Usman , Pinsker Eve
Published: September 2021

This study examined the impact of armed conflict on public health surveillance systems, the limitations of traditional surveillance in this context, and innovative strategies to overcome these limitations. A qualitative case study was conducted to examine the factors affecting the functioning of poliovirus surveillance in conflict-affected areas of Borno state, Nigeria using semi-structured interviews of a purposeful sample of participants. The main inhibitors of surveillance were inaccessibility, the destroyed health infrastructure, and the destroyed communication network. These three challenges created a situation in which the traditional polio surveillance system could not function. Three strategies to overcome these challenges were viewed by respondents as the most impactful. First, local community informants were recruited to conduct surveillance for acute flaccid paralysis in children in the inaccessible areas. Second, the informants engaged in local-level negotiation with the insurgency groups to bring children with paralysis to accessible areas for investigation and sample collection. Third, GIS technology was used to track the places reached for surveillance and vaccination and to estimate the size and location of the inaccessible population.A modified monitoring system tracked tailored indicators including the number of places reached for surveillance and the number of acute flaccid paralysis cases detected and investigated, and utilized GIS technology to map the reach of the program. The surveillance strategies used in Borno were successful in increasing surveillance sensitivity in an area of protracted conflict and inaccessibility. This approach and some of the specific strategies may be useful in other areas of armed conflict.
Neutrophil Side Fluorescence: A New Indicator for Predicting the Severity of Patients with Bronchiectasis
Authors: Wang Jinhong , Chen Youming , Li Shiqi , Yu Chunxiao , Jie Hongyu , Han Xinai , Zou Shujing , Tan Quanguang , Luo Shugeng
Published: September 2021

Background: Neutrophilic inflammation in the airway is a hallmark of bronchiectasis. Neutrophil extracellular traps (NETs) have been reported to play an important role in the occurrence and development of bronchiectasis. Neutrophil side fluorescence is one of the characteristics of neutrophils that can reflect the activation of neutrophils and the formation of NETs.Objective: To explore the relationship between the values of neutrophil side fluorescence (NEUT-SFL) in the peripheral blood of bronchiectasis patients, and the severity of the disease.Methods: 82 patients with bronchiectasis from the Department of Respiratory and Critical Medicine, at the Third Affiliated Hospital of Southern Medical University and were scored with Bronchiectasis Severity Index (BSI) (2019-2021). The clinical data such as the value of NEUT-SFL, neutrophil count, C-reactive protein, and procalcitonin levels were collected and retrospectively analyzed. NEUT-SFL values neutrophil count from 28 healthy subjects were also used to ascertain cut-off values. A single-sample SW test was used to test the normality for the data. The independent sample T-test was performed on the normal data, and Chi-square test and non-parametric test were used for non-normally distributed data and count data. The Pearson correlation analysis method was used for analyzing the correlation between each group of data.Results: Based on the BSI scores, patients were divided into three categories as mild (32%), moderate (29%), and severe (39%). Our results showed that the values of NEUT-SFL were higher in bronchiectasis patients compared to healthy controls. The levels of NEUT-SFL positively correlated with the high BSI scores in patients (P = 0.037, r = 0.23) and negatively correlated with the lung function in these patients (r = -0.35, P = 0.001). The area under the ROC curve was 0.813, the best cut-off was 42.145, indicating that NEUT-SFL values >42.145 can potentially predict the severity of bronchiectasis. Conclusions: The values of NEUT-SFL in the peripheral blood can be used for predicting the severity of bronchiectasis.
CT Imaging Manifestations of Tubercular Aortic Aneurysm
Authors: Xing Xiaona , Sun Zhonghua , Chen Li , Zhu Zhishan , Zhang Nan , Xiong Wei , Li Yu
Published: September 2021

Tubercular aortic aneurysm is a rare complication of tuberculosis but associated with very high mortality. Early diagnosis is critical, however, it is challenging due to nonspecific symptoms. This study summarized the CT features of tubercular aortic aneurysm in order to assist timely clinical diagnosis. Seventeen patients with confirmed tubercular aortic aneurysm between 2016 and 2020 were included in this study. The clinical manifestations, past medical history, laboratory and imaging examinations, treatments and other data were collected. CT angiography was routinely performed in all patients. Clinical and CT imaging data was collected and analyzed. All tuberculous aneurysms were pseudoaneurysms, which were located in the thoracic aorta, abdominal aorta, junction of thoracic and abdominal aorta or iliac aorta. The shapes of aneurysms were saccular or lobular. The diameter of aneurysm ranged from 30 to 120 mm. Thirteen patients had atherosclerosis. Mural thrombus was shown in 14 patients. Twelve patients showed enlarged lymph nodes which were found closely related to the aneurysm. Nine patients had tuberculous spondylitis including tuberculosis of thoracic lumbar and lumbosacral spine. Psoas abscess was showed in four patients and iliopsoas abscess was in one patient. Compared with other infectious aneurysms, tuberculous aneurysms typically show more cystic and lobulated shapes on CT scan, which are imaged as poured and unstressed. Another point of differential diagnosis is that the surrounding tissues and adjacent organs of tubercular aneurysms are usually infected with tuberculosis and most of them are accompanied by other sites of tuberculosis.
Clinical Characteristics and Genetic Analysis of Birt-Hogg-Dubé Syndrome With Congenital Contractural Arachnodactyly in a Family
Authors: Qiu Jiayong , Lou Yao , Zhu Yingwei , Wang Min , Peng Huifang , Hao Yingying , Jiang Hongwei , Mao Yimin
Published: September 2021

Background Birt-Hogg-Dubé Syndrome (BHD syndrome) and congenital contractural arachnodactyly (CCA) or Beals Hecht Syndrome (BHS) are clinically rare autosomal dominant genetic diseases. In this study, we find an extremely rare family with BHD Syndrome with CCA.Objective To investigate the clinical and genetic variation characteristics of a family with BHD Syndrome with CCA.Methods The patient was examined for chest Computed Tomography (CT), abdominal and heart color ultrasound, rheumatism immune-related indexes, and hand Direct Digital Radiography (DR), and Whole Exome Sequencing (WES) was performed on family members.Results The proband, male, developed symptoms of chest tightness and shortness of breath, accompanied by irritant cough 2 years ago, and then repeated spontaneous pneumothorax four times. Chest CT showed: spontaneous pneumothorax on the right side, emphysema in both lungs, and bullae in both lungs. No manifestations of kidney tumors and skin lesions. His son had a history of pulmonary bullobes and occurred spontaneous pneumothorax twice. He, his mother, and his son were all born with a hand deformity. Sequencing results showed that both the proband and his son were folliculin (FLCN) gene c.1015C>T（p.Gln339Ter） heterozygous variation, Fibrillin 2 gene (FBN2) gene c.3485G>A（p.Cys1162Tyr） heterozygous variation, associated with BHD syndrome and CCA.Conclusion For patients with chest tightness, shortness of breath, recurrent spontaneous pneumothorax, and congenital hand deformity without inducement, genetic testing should be carried out as soon as possible to make a clear diagnosis, which can guide treatment and genetic counseling.
Reducing the Amount of M1 Microglia by Inhibiting CXCR4 and iNOS Exerts Neuroprotection in a Rat Model of Subarachnoid Hemorrhage
Authors: Qu Wenhao , Cheng Ying , Peng Wei , Rui Tongyu , Luo Chengliang , Zhang Jian
Published: September 2021

Early inflammation is a significant factor in acute pathophysiological events of early brain injury (EBI) after subarachnoid hemorrhage (SAH). Although there have been numerous studies of neuroinflammation and SAH, the effect of M1 microglia on the progressions of neuroinflammation in SAH remains non-elucidated. CXCR4 is thought to be the critical regulator of the migration and recruitment of microglia, and early studies found that iNOS/NO• does represent an effective ferroptosis regulator and leads to the M1 microglia more resistant to the initiator of ferroptosis. Thus, we investigated the effect of AMD3100 (a highly selective antagonist of CXCR4) and L-NIL (an inhibitor of iNOS) on neuroinflammation in a rat SAH model. We found AMD3100 could suppress the migration of M1 microglia through the CXCL12/CXCR4 pathway. Treatment of AMD3100 could decrease the level of related inflammation factors and improved the prognosis within 24 h after SAH. Moreover, L-NIL could inhibit the expression of (i)NOS and promote the expression of ferroptosis-related proteins and the degree of lipid peroxidation. Importantly, the combination of AMD3100 and L-NIL could reduce the quantity of M1 microglia in the injured brain area and reduce the secretion of related inflammatory factors to improve the prognosis. To sum up, these data indicate that inhibiting CXCR4 and iNOS following SAH produces cerebral protection, and its anti-inflammation provides a potential therapeutic target for treating SAH.
A Sigh of Relief: Vaccine-Associated Hypermetabolic Iymphadenopathy Following the Third Covid-19 Vaccine Dose is Short in Duration and Uncommonly Interferes with the Interpretation of [18F]FDG PET-CT Studies Performed in Oncologic Patients
Authors: Cohen Dan , Krauthammer Shir Hazut , Wolf Ido , Even-Sapir Einat
Published: September 2021

Purpose: The incidence of Covid-19 vaccine-associated hypermetabolic lymphadenopathy (VAHL) is high following the administration of the first and second BNT162b2 vaccine doses. The impact of this finding on [18F]FDG PET-CT interpretation and its correlation with the induced humoral immunity have been reported. Assuming the amnestic immune response is different following the third vaccine dose, we aimed to explore the incidence of VAHL over time after the third BNT162b2 dose administration, and its relevance to [18F]FDGPET-CT interpretation in oncologic patients.Methods: A total of 179 consecutive oncologic patients that underwent [18F]FDG PET-CT after a third BNT162b2 vaccine dose were included. The presence of VAHL was assessed. On VAHL-positive scans, the SUVmax, number, location and size of the“hot” nodes were recorded. The median time interval between vaccination and imagingwas 8 (IQR,5-14) days.Results: The incidences of all-grade VAHL and grade 3-4 VAHL were 47.5% and 8.9%,respectively. VAHL was identified on 82.5% of studies performed within the first 5 days from vaccination. Grade 3-4 VAHL was observed on 28.1% of studies performed within the first 5 days from vaccination, but was not detected on studies performed more than 5 days from vaccination. Separation between VAHL and malignant lymphadenopathy was not possible in only 2 of the 179 study patients. On a multivariable logistic regression, independent predictors of grade 3-4 VAHL were short time interval between vaccination and imaging (Pv<0.01), younger age (Pv<0.01) and lower BMI (Pv=0.03).Conclusion: VAHL is commonly identifiedon [18F]FDG PET-CT performed within the first 5 days from the third BNT162b2 vaccine doseadministration. High-grade VAHL is unlikely to be observed on a scan performed 6 days or longer from vaccination, and is even less likely in older and obese patients.