bluuebunny/crossref_metadata_2025 huggingface dataset:
Resonance suppression and quality improvement control strategy for a three-phase grid-connected voltage-source inverter under weak grid conditions
Authors: Zhang Zhi , Li Yiyun , Zhong Caomao , Zhang Zhaoyun
Published: August 2023

The three-phase voltage-source grid-connected inverters suffer from grid-connected current quality problems due to system resonance caused by the under-damping characteristics of the filter and grid impedance, on the one hand, and the grid-connected current distortion caused by the high content of low harmonics in the grid voltage, on the other hand. To resolve this problem, a current quality improvement control strategy, combining capacitor-current feedforward active damping and harmonic virtual impedance reshaping, is proposed by analyzing the mechanisms of system resonance and grid-connected current distortion. In addition, the proposed control strategy allows determining the virtual impedance parameters by using the root locus method, so as to achieve the purpose of improving the output grid-connected current quality of the three-phase voltage-source grid-connected inverter under weak grid conditions. Finally, the correctness and effectiveness of the proposed control strategy are verified by simulation and experiment.
Attribution analysis of multi-temporal scale changes of streamflow in the source area of Lancang River with seasonal scale Budyko model
Authors: Liu Zhipei , Chen Weiqiang , Zhang Yali , Huang Junchang , Guo Yulong , Ji Guangxing
Published: August 2023

Under the influence of climate change and human activities, the intra-annual distribution characteristics of streamflow have changed, directly affecting the exploitation of water resources and the health of ecosystems. The trend-free pre-whitening Mann-Kendall (TFPW-MK) test method, concentration degree and concentration period, and Bernaola-Galvan (BG) segmentation algorithm were applied to analyze variation trend, intra-annual distribution characteristics, and abrupt year of streamflow. Then, the monthly water storage and monthly actual evaporation of the source area of the Lancang River (SALR) were calculated by the monthly ABCD model. Finally, the contributions of different factors to runoff variability at multiple time scales were quantified using the seasonal-scale Budyko hypothesis approach. The results showed that: (1) The runoff revealed a significant upward trend on the annual scale. Runoff exhibited a significant upward trend in January, October and November, and runoff in other months and seasons exhibited an insignificant upward trend. (2) The intra-annual distribution characteristics of runoff in the SALR showed an obvious “Single-peak type“ distribution, reaching a maximum in July and August. (3) The year of sudden change in streamflow was 2008. (4) The contribution of climate change and human activities to the annual runoff change was 83.3% and 16.7%, respectively. The degree of influence of climate change on runoff change was ranked as spring (96.8%), autumn (85.3%), winter (82.2%) and summer (58.2%). The order of impact of human activity on runoff change was summer (41.8%), winter (17.8%), autumn (14.7%), spring (3.2%).
Spodoptera frugiperda population structure and influence of farmers’ practices on gut biodiversity for sustainable management of the pest in Kenya
Authors: Ndung’u Kiarie E. , Khamis Fathiya M. , Ajene Inusa J. , Mbogo Kevin O. , Akutse Komivi S.
Published: August 2023

Fall armyworm (FAW), Spodoptera frugiperda, is a highly polyphagous pest that recently invaded Kenya, among other African countries. Information on the pest’s genetic diversity and mechanisms conferring insecticide resistance, in addition to farmers’ knowledge and perceptions on the applicable mitigation measures, inform the development of sustainable management strategies. Therefore, this study collected cross-sectional data from 800 farmers in Kenya and documented their knowledge and perceptions on FAW and factors influencing their choice of FAW control methods. Additionally, we identified the strains present in 8 counties in Kenya using the mitochondrial Cytochrome Oxidase sub-unit I (mt COI) gene, and correlated pesticide use to gut microbiome diversity via 16S rRNA metagenomics to investigate the probable contribution of gut bacteria towards insecticide resistance evolution. All farmers reported FAW infestations, and 24% reported limited and total non-response of FAW to insecticides. Fall armyworm rice-strain and corn-strain were detected ravaging corn fields. However, the corn-strain revealed higher microbial diversity than the rice-strain. Furthermore, pathogenic bacterial genera were elevated in the insect gut in both corn and rice strains after chemical-treatments. Insecticide–endosymbiont interactions should be further explored, and farmers’ training on effective alternative pest control methods is recommended.
Delineating intra-tumoral heterogeneity and tumor evolution in breast cancer using precision-based approaches
Authors: Xulu Kutlwano Rekgopetswe , Nweke Ekene Emmanuel , Augustine Tanya Nadine
Published: August 2023

The burden of breast cancer continues to increase worldwide as it remains the most diagnosed tumor in females and the second leading cause of cancer-related deaths. Breast cancer is a heterogeneous disease characterized by different subtypes which are driven by aberrations in key genes such as BRCA1 and BRCA2, and hormone receptors. However, even within each subtype, heterogeneity that is driven by underlying evolutionary mechanisms is suggested to underlie poor response to therapy, variance in disease progression, recurrence, and relapse. Intratumoral heterogeneity highlights that the evolvability of tumor cells depends on interactions with cells of the tumor microenvironment. The complexity of the tumor microenvironment is being unraveled by recent advances in screening technologies such as high throughput sequencing; however, there remain challenges that impede the practical use of these approaches, considering the underlying biology of the tumor microenvironment and the impact of selective pressures on the evolvability of tumor cells. In this review, we will highlight the advances made thus far in defining the molecular heterogeneity in breast cancer and the implications thereof in diagnosis, the design and application of targeted therapies for improved clinical outcomes. We describe the different precision-based approaches to diagnosis and treatment and their prospects. We further propose that effective cancer diagnosis and treatment are dependent on unpacking the tumor microenvironment and its role in driving intratumoral heterogeneity. Underwriting such heterogeneity are Darwinian concepts of natural selection that we suggest need to be taken into account to ensure evolutionarily informed therapeutic decisions.
Creatine supplementation enhances anti-tumor immunity by promoting adenosine triphosphate production in macrophages
Authors: Peng Zhenzi , Saito Suguru
Published: August 2023

Creatine is an indispensable organic compound utilized in physiological environments; however, its role in immunity is still poorly understood. Here, we show that creatine supplementation enhances anti-tumor immunity through the functional upregulation of macrophages by increasing adenosine triphosphate (ATP) production. Creatine supplementation significantly suppressed B16-F10-originated tumor growth in mice compared with the control treatment. Under these conditions, intratumor macrophages polarized towards the M1 phenotype rather than the M2 phenotype, and there was an increase in tumor antigen-specific CD8+ T cells in the mice. The cytokine production and antigen-presenting activity in the macrophages were enhanced by creatine supplementation, resulting in a substantial increase in tumor antigen-specific CD8+ T cells. ATP upregulation was achieved through the cytosolic phosphocreatine (PCr) system via extracellular creatine uptake, rather than through glycolysis and mitochondrial oxidative phosphorylation in the macrophages. Blockade of the creatine transporter (CrT) failed to upregulate ATP and enhance the immunological activity of macrophages in creatine supplementation, which also impaired CD8+ T cell activity. Consequently, CrT blockade failed to suppress tumor growth in the creatine-supplemented mice. Thus, creatine is an important nutrient that promotes macrophage function by increasing ATP levels, ultimately contributing to enhanced anti-tumor immunity orchestrated by CD8+ T cells.
Metabolic signature and proteasome activity controls synovial migration of CDC42hiCD14+ cells in rheumatoid arthritis
Authors: Malmhäll-Bah Eric , Andersson Karin M.E. , Erlandsson Malin C. , Silfverswärd Sofia T. , Pullerits Rille , Bokarewa Maria I.
Published: August 2023

Objective

Activation of Rho-GTPases in macrophages causes inflammation and severe arthritis in mice. In this study, we explore if Rho-GTPases define the joint destination of pathogenic leukocytes, the mechanism by which they perpetuate rheumatoid arthritis (RA), and how JAK inhibition mitigates these effects.

Methods

CD14+ cells of 136 RA patients were characterized by RNA sequencing and cytokine measurement to identify biological processes and transcriptional regulators specific for CDC42hiCD14+ cells, which were summarized in a metabolic signature (MetSig). The effect of hypoxia and IFN-γ signaling on the metabolic signature of CD14+ cells was assessed experimentally. To investigate its connection with joint inflammation, the signature was translated into the single-cell characteristics of CDC42hi synovial tissue macrophages. The sensitivity of MetSig to the RA disease activity and the treatment effect were assessed experimentally and clinically.

Results

CDC42hiCD14+ cells carried MetSig of genes functional in the oxidative phosphorylation and proteasome-dependent cell remodeling, which correlated with the cytokine-rich migratory phenotype and antigen-presenting capacity of these cells. Integration of CDC42hiCD14+ and synovial macrophages marked with MetSig revealed the important role of the interferon-rich environment and immunoproteasome expression in the homeostasis of these pathogenic macrophages. The CDC42hiCD14+ cells were targeted by JAK inhibitors and responded with the downregulation of immunoproteasome and MHC-II molecules, which disintegrated the immunological synapse, reduced cytokine production, and alleviated arthritis.

Conclusion

This study shows that the CDC42-related MetSig identifies the antigen-presenting CD14+ cells that migrate to joints to coordinate autoimmunity. The accumulation of CDC42hiCD14+ cells discloses patients perceptive to the JAKi treatment.
Heterogeneity of memory T cells in aging
Authors: Jain Abhinav , Sturmlechner Ines , Weyand Cornelia M. , Goronzy Jörg J.
Published: August 2023

Immune memory is a requisite and remarkable property of the immune system and is the biological foundation of the success of vaccinations in reducing morbidity from infectious diseases. Some vaccines and infections induce long-lasting protection, but immunity to other vaccines and particularly in older adults rarely persists over long time periods. Failed induction of an immune response and accelerated waning of immune memory both contribute to the immuno-compromised state of the older population. Here we review how T cell memory is influenced by age. T cell memory is maintained by a dynamic population of T cells that are heterogeneous in their kinetic parameters under homeostatic condition and their function. Durability of T cell memory can be influenced not only by the loss of a clonal progeny, but also by broader changes in the composition of functional states and transition of T cells to a dysfunctional state. Genome-wide single cell studies on total T cells have started to provide insights on the influence of age on cell heterogeneity over time. The most striking findings were a trend to progressive effector differentiation and the activation of pro-inflammatory pathways, including the emergence of CD4+ and CD8+ cytotoxic subsets. Genome-wide data on antigen-specific memory T cells are currently limited but can be expected to provide insights on how changes in T cell subset heterogeneity and transcriptome relate to durability of immune protection.
Investigating the influence of diet diversity on infection outcomes in a bumble bee (Bombus impatiens) and microsporidian (Nosema bombi) host-pathogen system
Authors: Martinez Abraham , Calhoun Austin C. , Sadd Ben M.
Published: August 2023

Diet can have an array of both direct and indirect effects on an organism’s health and fitness, which can influence the outcomes of host-pathogen interactions. Land use changes, which could impact diet quantity and quality, have imposed foraging stress on important natural and agricultural pollinators. Diet related stress could exacerbate existing negative impacts of pathogen infection. Accounting for most of its nutritional intake in terms of protein and many micronutrients, pollen can influence bee health through changes in immunity, infection, and various aspects of individual and colony fitness. We investigate how adult pollen consumption, pollen type, and pollen diversity influence bumble bee Bombus impatiens survival and infection outcomes for a microsporidian pathogen Nosema (Vairimorpha) bombi. Experimental pathogen exposures of larvae occurred in microcolonies and newly emerged adult workers were given one of three predominantly monofloral, polyfloral, or no pollen diets. Workers were assessed for size, pollen consumption, infection 8-days following adult-eclosion, survival, and the presence of extracellular microsporidian spores at death. Pollen diet treatment, specifically absence of pollen, and infection independently reduced survival, but we saw no effects of pollen, pollen type, or pollen diet diversity on infection outcomes. The latter suggests infection outcomes were likely already set, prior to differential diets. Although infection outcomes were not altered by pollen diet in our study, it highlights both pathogen infection and pollen availability as important for bumble bee health, and these factors may interact at different stages of bumble bee development, at the colony level, or under different dietary regimes.
Evaluating effects of changing sampling protocol for a long-term ichthyoplankton monitoring program
Authors: Chang Hsiao-Yun , Sun Ming , Rokosz Katrina , Chen Yong
Published: August 2023

Abundance indices play a crucial role in monitoring and assessing fish population dynamics. Fishery-independent surveys are commonly favored for deriving abundance indices because they follow standardized or randomized designs, ensuring spatiotemporal consistency in representative and unbiased sampling. However, modifications to the survey protocol may be necessary to accommodate changes in survey goals and logistic difficulty. When the survey undergoes changes, calibration is often needed to remove variability that is unrelated to changes in abundance. We evaluated a long-term monitoring program, the Long River Survey (LRS) in the Hudson River Estuary (HRE), to illustrate the process of calibrating survey data to account for the effects of changing sampling protocol. The LRS provided valuable ichthyoplankton data from 1974 to 2017, but inconsistencies in sampling timing, location, and gears resulted in challenges in interpreting and comparing the fish abundance data in the HRE. Generalized Additive Models were developed for five species at various life stages, aiming to mitigate the impact of sampling protocol changes. Model validation results suggest the consistent performance of the developed models with varying lengths of time series. This study indicates that changes in the sampling protocol can introduce biases in the estimates of abundance indices and that the model-based estimates can improve the reliability and accuracy of the survey abundance indices. The model-estimated sampling effects for each species and life stage provide critical information and valuable insights for designing future sampling protocols.
Anesthesia methods for full-endoscopic lumbar discectomy: a review
Authors: Zheng Bin , Guo Chen , Xu Shuai , Li Haoyuan , Wu Yonghao , Liu Haiying
Published: August 2023

Full-endoscopic lumbar discectomy under local anesthesia is major trends for the treatment of lumbar disc herniation in spine minimally invasive surgery. However, sometimes local anesthesia is not enough for analgesic in surgery especially in interlaminar approach. This study summarizes the current study of anesthesia methods in full-endoscopic lumbar discectomy. Local anesthesia is still the most common anesthesia method in full-endoscopic lumbar discectomy and the comparison group for other anesthesia methods due to high safety. Compared to local anesthesia, Epidural anesthesia is less applied in full-endoscopic lumbar discectomy but reports better intraoperative pain control and equivalent safety due to the motor preservation and pain block characteristic of ropivacaine. General anesthesia can achieve totally pain block during surgery but nerve injury can not be ignored, and intraoperative neuromonitoring can assist. Regional anesthesia application is rare but also reports better anesthesia effects during surgery and equivalent safety. Anesthesia methods for full-endoscopic lumbar discectomy should be based on patient factors, surgical factors, and anesthesiologist factors to achieve satisfactory anesthesia experience and successful surgery.
Genetic diversity of non-Saccharomyces yeasts associated with spontaneous fermentation of Cabernet Sauvignon wines from Ningxia, China
Authors: Li Ruirui , Feng Danping , Wang Hui , Zhang Zhong , Li Na , Sun Yue
Published: August 2023

The organoleptic profile and quality of wine are affected by the presence of different non-Saccharomyces species and strains. Therefore, the identification and characterization of non-Saccharomyces yeasts are the first step to understand their function, and to develop a better strain selection program for winemaking. This study investigated the biodiversity of non-Saccharomyces yeasts associated with spontaneous fermentation of Cabernet Sauvignon wines from five sub-regions (Shi Zuishan, Yinchuan, Yu Quanying, Qing Tongxia and Hong Sibu) in Ningxia, China. Yeast species were identified by sequencing the 26S rRNA D1/D2 region, and strains at the subspecies level were discriminated using tandem repeat-tRNA (TRtRNA) PCR analysis. A total of 524 yeast colonies were isolated, and 19 non-Saccharomyces yeast species belonging to 10 genera were identified, including Aureobasidium pullulans, Cryptococcus albidus, Cryptococcus sp., C. flavescens, C. terrestris, C. magnus, Cystofilobasidium ferigula, Candida zemplinina, Filobasidium magnum, Filobasidium sp., F. elegans, Hanseniaspora uvarum, Metschnikowia pimensis, M. pulcherrima, Naganishia albida, Pichia kluyveri, P. kudriavzevii, Rhodotorula glutinis and R. graminis. Hanseniaspora uvarum, C. zemplinina, and M. pulcherrima were the three most dominated species, while other non-Saccharomyces species were only present in the early stage of spontaneous fermentations at different levels. Further, for the yeast discrimination at strain level, 34 profiles were obtained by amplification with primer pairs TtRNASC/5CAG, while 40 profiles were obtained with primer pairs TtRNASC/ISSR-MB. This study explored the diversity of non-Saccharomyces species in Ningxia, China, and made an important contribution of genetic resources for further strain development.
Association between gestational levels of toxic metals and essential elements and cerebral palsy in children
Authors: Weyde Kjell Vegard F. , Winterton Adriano , Surén Pål , Andersen Guro L. , Vik Torstein , Biele Guido , Knutsen Helle K. , Thomsen Cathrine , Meltzer Helle M. , Skogheim Thea S. , Engel Stephanie M. , Aase Heidi , Villanger Gro D.
Published: August 2023

Introduction

Cerebral palsy (CP) is the most common motor disability in childhood, but its causes are only partly known. Early-life exposure to toxic metals and inadequate or excess amounts of essential elements can adversely affect brain and nervous system development. However, little is still known about these as perinatal risk factors for CP. This study aims to investigate the associations between second trimester maternal blood levels of toxic metals, essential elements, and mixtures thereof, with CP diagnoses in children.

Methods

In a large, population-based prospective birth cohort (The Norwegian Mother, Father, and Child Cohort Study), children with CP diagnoses were identified through The Norwegian Patient Registry and Cerebral Palsy Registry of Norway. One hundred forty-four children with CP and 1,082 controls were included. The relationship between maternal blood concentrations of five toxic metals and six essential elements and CP diagnoses were investigated using mixture approaches: elastic net with stability selection to identify important metals/elements in the mixture in relation to CP; then logistic regressions of the selected metals/elements to estimate odds ratio (OR) of CP and two-way interactions among metals/elements and with child sex and maternal education. Finally, the joint effects of the mixtures on CP diagnoses were estimated using quantile-based g-computation analyses.

Results

The essential elements manganese and copper, as well as the toxic metal Hg, were the most important in relation to CP. Elevated maternal levels of copper (OR = 1.40) and manganese (OR = 1.20) were associated with increased risk of CP, while Hg levels were, counterintuitively, inversely related to CP. Metal/element interactions that were associated with CP were observed, and that sex and maternal education influenced the relationships between metals/elements and CP. In the joint mixture approach no significant association between the mixture of metals/elements and CP (OR = 1.00, 95% CI = [0.67, 1.50]) was identified.

Conclusion

Using mixture approaches, elevated levels of copper and manganese measured in maternal blood during the second trimester could be related to increased risk of CP in children. The inverse associations between maternal Hg and CP could reflect Hg as a marker of maternal fish intake and thus nutrients beneficial for foetal brain development.
The Toronto Concussion Study: a prospective investigation of characteristics in a cohort of adults from the general population seeking care following acute concussion, 2016–2020
Authors: Comper Paul , Foster Evan , Chandra Tharshini , Langer Laura , Wiseman-Hakes Catherine , Mochizuki George , Ruttan Lesley , Lawrence David W. , Inness Elizabeth L. , Gladstone Jonathan , Saverino Cristina , Tam Alan , Kam Alice , Al-Rawi Firas , Bayley Mark Theodore
Published: August 2023

Purpose

There is limited research regarding the characteristics of those from the general population who seek care following acute concussion.

Methods

To address this gap, a large cohort of 473 adults diagnosed with an acute concussion (female participants = 287; male participants = 186) was followed using objective measures prospectively over 16 weeks beginning at a mean of 5.1 days post-injury.

Results

Falls were the most common mechanism of injury (MOI) (n = 137, 29.0%), followed by sports-related recreation (n = 119, 25.2%). Male participants were more likely to be injured playing recreational sports or in a violence-related incident; female participants were more likely to be injured by falling. Post-traumatic amnesia (PTA) was reported by 80 participants (16.9 %), and loss of consciousness (LOC) was reported by 110 (23.3%). In total, 54 participants (11.4%) reported both PTA and LOC. Male participants had significantly higher rates of PTA and LOC after their injury compared to their female counterparts. Higher initial symptom burden was associated with a longer duration of recovery for both male and female participants. Female participants had more symptoms and higher severity of symptoms at presentation compared to male participants. Female participants were identified to have a longer recovery duration, with a mean survival time of 6.50 weeks compared to 5.45 weeks in male participants (p < 0.0001). A relatively high proportion of female and male participants in this study reported premorbid diagnoses of depression and anxiety compared to general population characteristics.

Conclusion

Although premorbid diagnoses of depression and/or anxiety were associated with higher symptom burden at the initial visit, the duration of symptoms was not directly associated with a pre-injury history of psychological/psychiatric disturbance. This cohort of adults, from the general population, seeking care for their acute concussion attained clinical and functional recovery over a period of 4–12 weeks.
Functional electrical stimulation therapy controlled by a P300-based brain–computer interface, as a therapeutic alternative for upper limb motor function recovery in chronic post-stroke patients. A non-randomized pilot study
Authors: Ramirez-Nava Ana G. , Mercado-Gutierrez Jorge A. , Quinzaños-Fresnedo Jimena , Toledo-Peral Cinthya , Vega-Martinez Gabriel , Gutierrez Mario Ibrahin , Pacheco-Gallegos María del Refugio , Hernández-Arenas Claudia , Gutiérrez-Martínez Josefina
Published: August 2023

Introduction

Up to 80% of post-stroke patients present upper-limb motor impairment (ULMI), causing functional limitations in daily activities and loss of independence. UMLI is seldom fully recovered after stroke when using conventional therapeutic approaches. Functional Electrical Stimulation Therapy (FEST) controlled by Brain–Computer Interface (BCI) is an alternative that may induce neuroplastic changes, even in chronic post-stroke patients. The purpose of this work was to evaluate the effects of a P300-based BCI-controlled FEST intervention, for ULMI recovery of chronic post-stroke patients.

Methods

A non-randomized pilot study was conducted, including 14 patients divided into 2 groups: BCI-FEST, and Conventional Therapy. Assessments of Upper limb functionality with Action Research Arm Test (ARAT), performance impairment with Fugl–Meyer assessment (FMA), Functional Independence Measure (FIM) and spasticity through Modified Ashworth Scale (MAS) were performed at baseline and after carrying out 20 therapy sessions, and the obtained scores compared using Chi square and Mann–Whitney U statistical tests (𝛼 = 0.05).

Results

After training, we found statistically significant differences between groups for FMA (p = 0.012), ARAT (p < 0.001), and FIM (p = 0.025) scales.

Discussion

It has been shown that FEST controlled by a P300-based BCI, may be more effective than conventional therapy to improve ULMI after stroke, regardless of chronicity.

Conclusion

The results of the proposed BCI-FEST intervention are promising, even for the most chronic post-stroke patients often relegated from novel interventions, whose expected recovery with conventional therapy is very low. It is necessary to carry out a randomized controlled trial in the future with a larger sample of patients.
Holter STAT-ON™ against other tools for detecting MF in advanced Parkinson’s disease: an observational study
Authors: Cabo-Lopez Iria , Puy-Nuñez Alfredo , Redondo-Rafales Nuria , Teixeira Baltazar Sara , Calderón-Cruz Beatriz
Published: August 2023

Background

Different screening tools to identify advanced Parkinson’s disease (APD) have emerged in recent years. Among them, wearable medical devices, such as STAT-ON™, have been proposed to help to objectively detect APD.

Objectives

To analyze the correlation between STAT-ON™ reports and other assessment tools to identify APD and to assess the accuracy of screening tools in APD patients, using the STAT-ON™ as the gold standard.

Methods

In this retrospective, observational study, data from the University Hospital Complex of Pontevedra database on 44 patients with potential APD who wore STAT-ON™ were extracted. Data were collected according to different sources of tools for identifying APD: (1) STAT-ON™, (2) information provided by the patient, (3) questionnaire for advanced Parkinson’s disease (CDEPA), (4) 5-2-1 Criteria, and (5) Making Informed Decisions to Aid Timely Management of Parkinson’s Disease (MANAGE-PD). Considering STAT-ON™ recordings as a reference, the sensitivity, specificity, and positive and negative predictive values for each tool were calculated. The kappa index assessed the degree of agreement between the gold standard and the other instruments.

Results

Although no statistically significant association was found between STAT-ON™ recordings and any screening methods evaluated, the CDEPA questionnaire demonstrated the highest sensitivity and VPN values to detect patients with APD candidates for second-line therapy (SLT). According to the correlation analyses, MANAGE-PD demonstrated the highest degree of concordance with STAT-ON™ recordings to identify the SLT indication and to predict the SLT decision.

Conclusion

STAT-ON™ device may be a helpful tool to detect APD and to guide treatment decisions.
Resting-state networks representation of the global phenomena
Authors: Amemiya Shiori , Takao Hidemasa , Hanaoka Shouhei , Abe Osamu
Published: August 2023

Resting-state functional magnetic resonance imaging (rsfMRI) has been widely applied to investigate spontaneous neural activity, often based on its macroscopic organization that is termed resting-state networks (RSNs). Although the neurophysiological mechanisms underlying the RSN organization remain largely unknown, accumulating evidence points to a substantial contribution from the global signals to their structured synchronization. This study further explored the phenomenon by taking advantage of the inter- and intra-subject variations of the time delay and correlation coefficient of the signal timeseries in each region using the global mean signal as the reference signal. Consistent with the hypothesis based on the empirical and theoretical findings, the time lag and correlation, which have consistently been proven to represent local hemodynamic status, were shown to organize networks equivalent to RSNs. The results not only provide further evidence that the local hemodynamic status could be the direct source of the RSNs’ spatial patterns but also explain how the regional variations in the hemodynamics, combined with the changes in the global events’ power spectrum, lead to the observations. While the findings pose challenges to interpretations of rsfMRI studies, they further support the view that rsfMRI can offer detailed information related to global neurophysiological phenomena as well as local hemodynamics that would have great potential as biomarkers.
Lung cancer survival among Florida male firefighters
Authors: Koru-Sengul Tulay , Pinheiro Paulo S. , Zhao Wei , Hernandez Monique N. , Hernandez Diana R. , Maggioni Alessandra , Kobetz Erin N. , Caban-Martinez Alberto J. , Lee David J.
Published: August 2023

Introduction

Lung cancer is a leading cause of cancer incidence and death in the United States. Although most firefighters are fit and do not smoke, they are exposed to many known carcinogens during and in the aftermath of firefighting activities. Comprehensive epidemiologic investigations on lung cancer survival for both career and volunteer firefighters have not been undertaken.

Methods

Data from the Florida Cancer Data System (1981–2014) were linked with firefighter certification records from the Florida State Fire Marshal’s Office to identify all patients of this occupational group; lung cancer cause-specific survival data were compared with other occupational groups using Cox regression models with occupation as the main effect. Adjusted hazard ratios (aHR) and 95% confidence intervals (95% CI) were calculated.

Results

Out of 210,541 male lung cancer cases diagnosed in Florida (1981–2014), 761 were firefighters (604 career, 157 volunteer). Lung cancer death was similar between volunteer (75.2%) and career firefighters (74.0%) but lower than non-firefighters (80.0%). Survival at 5 years was higher among firefighters (29.7%; career: 30.3%; volunteer: 27.4%) than non-firefighters (23.8%). In a multivariable model, compared with non-firefighters, firefighters have significantly higher cause-specific survival (aHR = 0.84; 95% CI: 0.77–0.91; p < 0.001). However, there were no significant survival differences between career and volunteer firefighters (1.14; 0.93–1.39; p = 0.213). In a separate multivariable model with firefighters as the comparator, other broad occupational groups had significantly lower cause-specific survival [white collar: 1.11 (1.02–1.21); blue collar: 1.15 (1.05–1.25); service: 1.13 (1.03–1.25); others/unknown: 1.21 (1.12–1.32); all p-values < 0.02].

Conclusion

Lung cancer survival is significantly higher among firefighters compared with non-firefighters, but there is no significant difference between career and volunteer firefighters. Improved survival for firefighters might be due to a healthy worker effect, lower smoking prevalence relative to other worker groups, and possibly superior treatment adherence and compliance. Many firefighters are cross-trained as EMTs/paramedics and possess a level of medical knowledge that may favorably impact treatment engagement and better navigation of complex cancer care.
Perioperative, functional, and oncological outcomes of robotic vs. laparoscopic partial nephrectomy for complex renal tumors (RENAL score ≥7): an evidence-based analysis
Authors: Wang Li , Deng Jing-ya , Liang Cai , Zhu Ping-yu
Published: August 2023

Objective

To evaluate the current literature comparing outcomes of robotic partial nephrectomy (RPN) versus laparoscopic partial nephrectomy (LPN) treating complex renal tumors (RENAL nephrometry score ≥7).

Methods

We systematically searched the Cochrane Library, PubMed, Google Scholar, EMBASE, and Scopus databases up to March 2023. Review Manager 5.4 performed a pooled analysis of the data for random effects. Besides, sensitivity and subgroup analyses to explore heterogeneity, Newcastle-Ottawa scale, and GRADE to evaluate study quality and level of evidence.

Results

Eight observational studies comprising 1346 patients (RPN: 695; LPN: 651) were included in this study. Compared to LPN, RPN had a shorter operative time (OT) (weight mean difference [WMD]: -14.73 min; p = 0.0003), shorter warm ischemia time (WIT) (WMD: -3.47 min; p = 0.002), lower transfusion rate (odds ratio [OR]: 0.66; p = 0.04), shorter length of stay (LOS) (WMD: -0.65 days; p < 0.00001), lower postoperative estimated glomerular filtration rate (eGFR) change (WMD = -2.33 mL/min/1.73 m2; p = 0.002) and lower intraoperative complications (OR: 0.52; p = 0.04). No significant differences were observed between the two groups in terms of estimated blood loss (EBL) (p = 0.84), conversion to radical nephrectomy (p = 0.12), postoperative complications (p = 0.11), major complications (defined Clavien–Dindo grade 3 (p = 0.43), overall complications (p = 0.15), postoperative eGFR (p = 0.28), local recurrence (p = 0.35), positive surgical margin (PSM) (p = 0.63), overall survival (OS) (p = 0.47), cancer-specific survival (CSS) (p = 0.22) and 3-year recurrence-free survival (RFS) (p = 0.53).

Conclusion

Patients with complex renal tumors (RENAL score ≥7), RPN is superior to LPN in decreasing the OT, WIT, LOS, transfusion rate, change in eGFR and the incidence of intraoperative complications while maintaining oncological control and avoiding a decline in renal function. However, our findings need further validation in a large-sample prospective randomized study.
Clinical outcomes after vascular reconstruction using synthetic grafts for limb salvage in patients with lower extremity sarcoma: a single-center retrospective experience
Authors: Zheng Chuanxi , Xu Gang , Li Wei , Weng Xin , Yang Hongwei , Wang Zuhui , Zhang Shiquan
Published: August 2023

Introduction

Limb-salvage surgery has become the mainstream approaches for the treatment of sarcoma in the lower extremity. In cases where the sarcoma infiltrates the primary vessel, concurrent resection of the vessels and vascular reconstruction are required to ensure sufficient resection and preservation of limb function. The objective of this study is to assess the clinical outcomes of patients who underwent vascular reconstruction utilizing synthetic grafts for limb salvage, specifically in terms of postoperative complications and limb functional status.

Methods

Between September 2016 and October 2021, 15 consecutive patients who underwent 15 arterial and 3 venous reconstruction procedures were included in this retrospective study. Incidence of postoperative morbidity, graft patency, rate of limb salvage, and overall survival of patients were analyzed.

Results

The median follow-up was 12.5 months (range, 4.5-72.0). Graft thrombosis occurred in 5 patients (33.3%) and graft occlusion occurred in 3 patients (20.0%). The median overall survival was 28.0 months with the estimated 2-year and 5-year overall survival of 57.8% and 43.4% respectively. The 1-year and 2-year estimated patency rates of arterial reconstructions were 82.3% and 62.1%, respectively. None of the included patients with limb amputation were observed as a consequence of severe vascular complications, while two patients underwent amputation due to the repeat recurrence, resulting in a limb salvage rate of 86.7%.

Conclusion

Our results show that the combination of vascular reconstruction and oncologic resection is a feasible option for preserving limbs in cases of musculoskeletal sarcoma with vessel involvement in the lower extremity. When vascular reconstruction surgery is performed, synthetic substitutes can be effectively used with low perioperative morbidity and an acceptable rate of limb salvage.
Clinicopathological characteristics and prognosis of adolescents and young adults with gastric cancer after gastrectomy: a propensity score matching analysis
Authors: Chu Hongwu , Chen Xiaoyan , Liu Xin , Deng Cuncan , Bi Bo , He Yulong , Huo Mingyu , Zhang Changhua
Published: August 2023

Background

Gastric cancer (GC) among adolescents and young adults (AYAs, aged 15-39 years) has limited data on clinicopathological characteristics and prognosis. This study aimed to compare the clinicopathological characteristics, perioperative outcomes, and long-term outcomes of AYAs and older adults (OAs, aged > 39 years) with GC who underwent curative gastrectomy.

Methods

From January 1994 to June 2019, patients with GC undergoing curative gastrectomy were enrolled and divided into AYA group and OA group. The clinicopathological characteristics, treatment variables, perioperative outcomes and long-term outcomes were compared between the two groups, both before and after propensity score matching (PSM).

Results

AYAs had fewer comorbid conditions and were more likely to be females, have normal carcinoembryonic antigen (CEA) levels, poorly differentiated tumors with perineural invasion, and receive adjuvant chemotherapy. AYA patients had lower incidence of postoperative complications and shorter length of postoperative hospital stay than OA patients. No significant differences in postoperative 30-day or 90-day mortality were observed between AYAs and OAs, both before and after PSM. In the entire cohort, AYAs had similar median overall survival (OS) to OAs. However, in the PSM cohort, AYAs had significantly shorter median OS. Young age (15-39 years) was an independent risk factor for OS in GC patients following gastrectomy.

Conclusion

The clinicopathological characteristics were significantly different between AYA and OA patients with GC. AYA patients with GC had worse long-term prognosis than OA patients, and young age was an independent risk factor for OS in GC patients following gastrectomy.
Dermatomyositis with intrahepatic cholangiocarcinoma: a case report and data mining based on machine learning
Authors: Zhang Xusheng , Chen Bendong
Published: August 2023

Cancer secondary to dermatomyositis (DM) is defined as paraneoplastic dermatomyositis, which is one of the major subtypes of DM. However, cases of DM with intrahepatic cholangiocarcinoma (ICC) are rarely reported. In the course of our clinical work, we encountered a case of a middle-aged female patient who was diagnosed with DM for 7 years and then diagnosed with ICC, and we would like to share this case. In addition, in order to further investigate the deeper mechanism of ICC associated with DM, we also analyzed the dataset related to DM and ICC in the Gene Expression Omnibus (GEO) database based on the machine learning methods and found that poly(ADP-ribose) polymerase family member 12 (PARP12) and metallothionein 1M (MT1M) were closely associated with ICC secondary to DM. They are potentially important biomarkers for predicting the occurrence of ICC in patients with DM.
Clinicopathological characteristics of synchronous multiple primary early esophageal cancer and risk factors for multiple lesions
Authors: Su Jing , Wei Shuchun , Li Wenjie , Chen Han , Li Lurong , Xu Lijuan , Zhao Ping , Zhang Guoxin , Yan Jin
Published: August 2023

Background

With the development of endoscopic technology, the detection rate of synchronous multiple primary early esophageal cancer (SMPEEC) is increasing; however, the risk factors remain unclear. We aimed to assess the clinicopathological characteristics of patients with SMPEEC and investigate the risk factors contributing to the development of multiple lesions.

Methods

A retrospective cohort study was conducted on 911 consecutive patients who underwent Endoscopic submucosal dissection (ESD) for primary esophageal neoplasms from January 2013 to June 2021. The patients were divided into the SMPEEC group and the solitary early esophageal cancer (SEEC) group. We compared the differences in clinicopathological characteristics between the two groups and investigated the risk factors linked to multiple lesions. Additionally, we investigated the relationship between the main and accessory lesions.

Results

A total of 87 SMPEEC patients were included in this study, and the frequency of synchronous multiple lesions was 9.55% in patients with early esophageal cancer. The lesions in the SMPEEC group were mainly located in the lower segment of the esophagus (46[52.9%]), whereas those in the SEEC group were in the middle segment (412[50.0%]). The pathology type, tumor location, and circumferential rate of lesions were independent risk factors(P<0.05) for SMPEEC by logistic regression analysis. Significant positive correlations were observed between the main and accessory lesions in terms of morphologic type (r=0.632, P=0.000), tumor location(r=0.325, P=0.037), pathologic type (r=0.299, P=0.003), and depth of invasion (r=0.562, P=0.000).

Conclusion

Pathology type, tumor location, and circumferential rate of lesions were identified as independent risk factors for SMEPPC. Understanding these risk factors and the correlation between the main and accessory lesions could significantly improve the detection rate of SMPEEC.
Real-world survival outcomes of wedge resection versus lobectomy for cT1a/b cN0 cM0 non-small cell lung cancer: a single center retrospective analysis
Authors: Bertolaccini Luca , Cara Andrea , Chiari Matteo , Diotti Cristina , Glick Nimrod , Mohamed Shehab , Uslenghi Clarissa , Mazzella Antonio , Brambilla Daniela , Bertolotti Raffaella , Sedda Giulia , Spaggiari Lorenzo
Published: August 2023

Background

JCOG0802/WJOG4607L showed benefits in overall survival (OS) of segmentectomy. CALGB 140503 confirmed that sublobar resection was not inferior to lobectomy concerning recurrence-free survival (RFS) but did not provide specific OS and RFS according to the techniques of sublobar resections. Hence, we retrospectively analyze the survival differences between wedge resection and lobectomies for stage IA lung cancer.

Methods

We reviewed the clinical records of patients with clinical stage IA NSCLC over 20 years. The inclusion criteria were: preoperative staging with CT scan and whole body CT/PET; tumor size <20 mm; wedge resections or lobectomies with or without lymph node dissection; NSCLC as the only primary tumor during the follow-up period. We excluded: multiple invasive lung cancer; positive resection margin; preoperative evidence of nodal disease; distant metastasis at presentation; follow-up time <5 years. The reverse Kaplan – Meier method estimated the median OS and PFS and compared them by the log-rank test. The stratified backward stepwise Cox regression model was employed for multivariable survival analyses.

Results

539 patients were identified: 476 (88.3%) lobectomies and 63 (11.7%) wedge resections. The median OS time for the whole cohort was 189.7 months (range: 173.7 – 213.9 months). The 5-year wedge resection and lobectomy OS were 82.2% and 87.0%. The 5-year RFS of wedge resection and lobectomy were 17.8% and 28.9%. The log-rank test showed no significant differences (p = 0.39) between wedge resections and lobectomies regarding OS and RFS (p = 0.23).

Conclusions

Lobectomy and wedge resection are equivalent oncologic treatments for individuals with cN0/cM0 stage IA NSCLC <20 mm. Validating the current findings requires a prospective, randomized comparison between wedge resection and standard lobectomy to establish the prognostic significance of wedge resection.
Benefit of continuous kidney replacement therapy for managing tumor lysis syndrome in children with hematologic malignancies
Authors: Anderson Ashlea , Shoulders Laurie , James Vinson , Ashcraft Emily , Cheng Cheng , Ribeiro Raul , Elbahlawan Lama
Published: August 2023

Introduction

Tumor lysis syndrome (TLS) is often diagnosed in children with hematological malignancies and can be life threatening due to metabolic disturbances. Continuous renal replacement therapy (CKRT) can reverse these disturbances relatively quickly when conventional medical management fails. Our objective was to investigate the benefit of CKRT in the management of TLS in children admitted to the intensive care unit with hematologic malignancies. In addition, we sought to assess risk factors for acute kidney injury (AKI) in the setting of TLS.

Methods

Retrospective review of all children admitted to the intensive care unit with TLS who received CKRT from January 2012 to August 2022.

Results

Among 222 children hospitalized with TLS from January 2012 to August 2022, 20 (9%) underwent CKRT to manage TLS in the intensive care unit. The patients’ median age was 13 years (range 3-17 y), and most were males (18/20). T-cell acute lymphoblastic leukemia was the most common diagnosis (n=10), followed by acute myeloid leukemia (n=4), Burkitt lymphoma (n=4), and B-cell acute lymphoblastic leukemia (n=2). Five patients required mechanical ventilation, and 2 required vasopressors. The most common indication for CKRT was hyperphosphatemia, followed by, hyperuricemia, and hyperkalemia. All metabolic abnormalities corrected within 12 h of initiation of CKRT. CKRT courses were brief, with a median duration of 2 days (range 1-7 days). Having higher serum phosphorus levels 12 h preceding CKRT was significantly associated with severe acute kidney injury (AKI). The median phosphorus level was 6.4 mg/dL in children with no/mild AKI and 10.5 mg/dL in children with severe AKI (p=0.0375). Serum uric acid levels before CKRT were not associated with AKI. All children survived to hospital discharge, and the one-year survival rate was 90%.

Conclusion

CKRT is safe in children with hematologic malignancies with severe TLS and reverses metabolic derangements within 6-12 h. Most patients had AKI at the initiation of CKRT but did not require long-term kidney replacement therapy. Hyperphosphatemia before initiation of CKRT is associated with higher risk of AKI.
Case Report: Tumor-to-tumor metastasis with prostate cancer metastatic to lung cancer: the first reported case
Authors: Liu Shiyue , Li Hong , Dong Youhong , Zhang Dongdong
Published: August 2023

Tumor-to-tumor metastasis (TTM) occurs rarely in tumor progression, but this event has significant clinical implications. Although the impact of TTM on patient prognosis and survival has been increasingly recognized, understanding of TTM biology and treatment is limited. Prostate cancer is among the most common malignancies threatening male health. Prostate cancer can potentially metastasize to primary lung Cancer; however, this is an exceedingly rare event. We here report for the first time a case of TTM from a prostate cancer to a coexisting primary lung cancer.