bluuebunny/crossref_metadata_2025 huggingface dataset:
Xp11.2 Translocation Renal Cell Carcinoma: Clinical Characteristics and Potential Prognostic Predictors
Authors: Dong Jie , Xu Weifeng , Ji Zhigang , Pan Boju
Published: September 2021

Background. Xp11.2 translocation renal cell carcinoma, a rare malignancy, has a higher prevalence in children than in adults. It is relatively indolent in children but manifests with an aggressive course in adults. Clinical characteristics and prognostic studies for adult patients are scarce due to its rarity. Methods. This retrospective single-center study consecutively enrolled 24 newly diagnosed Xp11.2 translocation RCC adult patients. Clinical presentations were recorded, and baseline laboratory results and follow-up data were collected. Possible risk factors for progression-free survival and overall survival were first scanned with chi-square tests and

t

-tests to compare patients who suffered from progression or death with who did not. Multivariate Cox regression was further utilized to identify independent risk factors. Results. Twenty-four adult patients (median age 32, range 16-73), with a male-to-female ratio of 1 : 1, was included from April 2010 to March 2020. After follow-up for 35.7 months (+/- months), seven patients died. With univariate analysis, higher C-reactive protein-to-albumin (CRP/Alb) ratio (

p
=
0.028

), higher baseline fibrinogen (

p
=
0.006

), and presence of distant metastasis (

p
=
0.007

) were associated with progression of the disease; higher preoperative fibrinogen (

p
=
0.014

) and distant metastasis (

p
=
0.020

) were associated with death. With multivariate Cox regression, only baseline fibrinogen level (

p
=
0.001

) was identified as an independent risk factor for progression-free survival; meanwhile, fibrinogen level (

p
=
0.048

) and distant metastasis (

p
=
0.043

) were identified as independent risk factors for survival. Conclusions. Overall, relatively high CRP/Alb ratios, fibrinogen, and distant metastasis were associated with a poor prognosis of Xp11.2 tRCC adult patients; among them, only baseline fibrinogen levels independently predicted the progression of Xp11.2 tRCC; thus, it may help to identify patients with worse progression or death risk.
Gridless Multiple Measurements Method for One‐Bit DOA Estimation with a Nested Cross‐Dipole Array
Authors: Long Haining , Su Ting , Wang Xianpeng , Huang Mengxing
Published: September 2021

The gridless one‐bit direction of arrival (DOA) estimator is proposed to estimate electromagnetic (EM) sources on a nested cross‐dipole array, and the multiple measurement vectors (MMV) mode is introduced to improve the reliability of parameter estimation. The gridless method is based on atomic norm minimization, solved by alternating direction multiplier method (ADMM). With gridless method used, sign inconsistency caused by one‐bit measurements and basis mismatches by traditional grid‐based algorithms can be avoided. Furthermore, the reconstructed denoising measurements with fast convergence and stable recovery accuracy are obtained by ADMM. Finally, spatial smoothing root multiple signal classification (SSRMUSIC) and dual polynomial (DP) methods are used, respectively, to estimate the DOAs on the reconstructed denoising measurements. Numerical results show that our method one‐bit ADMM‐SSRMUSIC has a better performance than that of one‐bit SSRMUSIC used directly. At low signal to noise ratio (SNR) and low snapshot, the one‐bit ADMM‐DP has an excellent performance which is even better than that of unquantized MUSIC. In addition, the proposed methods are also suitable for both completely polarized (CP) signals and partially polarized (PP) signals.
Intelligent Channel Allocation for Age of Information Optimization in Internet of Medical Things
Authors: Wei Kefeng , Zhang Lincong , Wang Shupeng
Published: September 2021

Along with the development of realtime applications, the freshness of information becomes significant because the overdue information is worthless and useless and even harmful to the right judgement of system. Therefore, The Age of Information (AoI) used for marking the freshness of information is proposed. In Internet of Medical Things (IoMT), which is derived from the requirement of Internet of Thins (IoT) in medicine, high freshness of medical information should be guaranteed. In this paper, we introduce the AoI of medical information when allocating channels for users in IoMT. Due to the advantages of Deep Q‐learning Network (DQN) applied in resource management in wireless network, we propose a novel DQN‐based Channel Allocation (DQCA) algorithm to provide the strategy for channel allocation under the optimization of the system cost considering the AoI and energy consumption of coordinator nodes. Unlike the traditional centralized channel allocation methods, the DQCA algorithm is distributed as each user performs the DQN process separately. The simulation results show that our proposed DQCA algorithm is superior to Greedy algorithm and Q‐learning algorithm in terms of the average AoI, average energy consumption and system cost.
Poria cocos Regulates Cell Migration and Actin Filament Aggregation in B35 and C6 Cells by Modulating the RhoA, CDC42, and Rho Signaling Pathways
Authors: Lee Chia-Yu , Lee Chang-Ti , Tzeng I-Shiang , Kuo Chan-Yen , Tsai Fu-Ming , Chen Mao-Liang
Published: September 2021

Poria is used as a traditional Chinese herbal medicine with anti-inflammatory, anticancer, and mood-stabilizing properties. Poria contains triterpenoids and polysaccharides, which are reported to regulate the cytoplasmic free calcium associated with the N-methyl-D-aspartate receptor and affect the cell function of neonatal rat nerve cells and hippocampal neurons. Although the modulatory effects of Poria on neuronal function have been widely reported, the molecular mechanism of these effects is unclear. Cell migration ability and the reorganization of actin filaments are important biological functions during neuronal development, and they can be regulated mainly by the Rho signaling pathway. We found that the cell migration ability and actin condensation in B35 cells enhanced by P. cocos (a water solution of P. cocos cum Radix Pini (PRP) or White Poria (WP)) might be caused by increased RhoA and CDC42 activity and increased expression of downstream ROCK1, p-MLC2, N-WASP, and ARP2/3 in B35 cells. Similar modulations of cell migration ability, actin condensation, and Rho signaling pathway were also observed in the C6 glial cell line, except for the PRP-induced regulation of RhoA and CDC42 activities. Ketamine-induced inhibition of cell migration and actin condensation can be restored by P. cocos. In addition, we observed that the increased expression of RhoA and ROCK1 or the decreased expression of CDC42 and N-WASP caused by ketamine in B35 cells could also be restored by P. cocos. The results of this study suggest that the regulatory effects of P. cocos on cell migration and actin filament aggregation are closely related to the regulation of RhoA, CDC42, and Rho signaling pathways in both B35 and C6 cells. PRP and WP have the potential to restore neuronal cell Rho signaling abnormalities involved in some mental diseases.
Deformation and Failure Characteristics of the Roof in an Unsupported Area during Rapid Driving of Coal Roadway
Authors: Yang Sen , Hua Xinzhu , Liu Xiao , Wang Enqian , Li Chen
Published: September 2021

In order to study the deflection and failure characteristics of the goaf roof, a mechanical model of the goaf thin plate is established and the deflection expression of the goaf roof is obtained. The results show the following: (1) under the action of single factor, the roof deflection is more sensitive to the interaction of unsupported roof distance and load, but less sensitive to the support force. (2) The influence degree of each factor on the deflection of the thin plate in the unsupported top area is as follows: unsupported roof distance and load interaction > unsupported roof distance and supporting force > supporting force and load. (3) The roof bending deformation is slow when the unsupported roof distance is within 0–2.3 m. When the vacant distance of the roof is more than 2.3 m, the bending deformation of the roof is accelerated. Using FLAC3D numerical simulation software, the distribution of vertical stress and displacement under different space distances is analyzed and the reasonable space distance is 2.0 m. Through the application of 150802 machine roadway in Liuzhuang coal mine, the driving speed of the coal roadway is improved and the monthly footage of coal roadway reaches 506 m.
Independent Research and Development or Technology Mergers and Acquisitions? Decision Mechanisms of Research and Development Strategies in a Two-Stage Game
Authors: Wang Fenglian , Zhang Zongming , Zhao Hua
Published: September 2021

This research introduces the three variables of spillover effect, research and development efficiency, and cost of mergers and acquisitions as the chief factors affecting independent research and development and technology mergers and acquisitions based on a two-stage game theory model of research and development strategies. Using these three variables, this research explains the selection of independent research and development or technology mergers and acquisitions according to profit maximization. Based on the theory model, this research finds that costs of mergers and acquisitions and spillover effects play a significant role in research and development decisions. In addition, excessive costs of mergers and acquisitions can increase research and development expenditures, therefore reducing profit and affecting the organizational operation and development. Therefore, when the costs of mergers and acquisitions exceed a certain level, companies will abandon technology mergers and acquisitions and choose independent research and development; and a higher knowledge spillover effect reduces the costs of independent research and development, therefore increasing profit. In conclusion, given certain costs of mergers and acquisitions, a higher spillover effect helps business organizations to choose independent research and development strategies.
Cognitive IoT-Based e-Learning System: Enabling Context-Aware Remote Schooling during the Pandemic
Authors: Zaguia Atef , Ameyed Darine , Haddar MohamedAmime , Cheikhrouhou Omar , Hamam Habib
Published: September 2021

The 2019–2020 coronavirus pandemic had far-reaching consequences beyond the spread of the disease and efforts to cure it. Today, it is obvious that the pandemic devastated key sectors ranging from health to economy, culture, and education. As far as education is concerned, one direct result of the spread of the pandemic was the resort to suspending traditional in-person classroom courses and relying on remote learning and homeschooling instead, by exploiting e-learning technologies, but many challenges are faced by these technologies. Most of these challenges are centered around the efficiency of these delivery methods, interactivity, and knowledge testing. These issues raise the need to develop an advanced smart educational system that assists home-schooled students, provides teachers with a range of smart new tools, and enable a dynamic and interactive e-learning experience. Technologies like the Internet of things (IoT) and artificial intelligence (AI), including cognitive models and context-awareness, can be a driving force in the future of e-learning, opening many opportunities to overcome the limitation of the existing remote learning systems and provide an efficient reliable augmented learning experience. Furthermore, virtual reality (VR) and augmented reality (AR), introduced in education as a way for asynchronous learning, can be a second driving force of future synchronous learning. The teacher and students can see each other in a virtual class even if they are geographically spread in a city, a country, or the globe. The main goal of this work is to design and provide a model supporting intelligent teaching assisting and engaging e-learning activity. This paper presents a new model, ViRICTA, an intelligent system, proposing an end-to-end solution with a stack technology integrating the Internet of things and artificial intelligence. The designed system aims to enable a valuable learning experience, providing an efficient, interactive, and proactive context-aware learning smart services.
Application of Various Machine Learning Techniques in Predicting Total Organic Carbon from Well Logs
Authors: Siddig Osama , Ibrahim Ahmed Farid , Elkatatny Salaheldin
Published: September 2021

Unconventional resources have recently gained a lot of attention, and as a consequence, there has been an increase in research interest in predicting total organic carbon (TOC) as a crucial quality indicator. TOC is commonly measured experimentally; however, due to sampling restrictions, obtaining continuous data on TOC is difficult. Therefore, different empirical correlations for TOC have been presented. However, there are concerns about the generalization and accuracy of these correlations. In this paper, different machine learning (ML) techniques were utilized to develop models that predict TOC from well logs, including formation resistivity (FR), spontaneous potential (SP), sonic transit time (Δt), bulk density (RHOB), neutron porosity (CNP), gamma ray (GR), and spectrum logs of thorium (Th), uranium (Ur), and potassium (K). Over 1250 data points from the Devonian Duvernay shale were utilized to create and validate the model. These datasets were obtained from three wells; the first was used to train the models, while the data sets from the other two wells were utilized to test and validate them. Support vector machine (SVM), random forest (RF), and decision tree (DT) were the ML approaches tested, and their predictions were contrasted with three empirical correlations. Various AI methods’ parameters were tested to assure the best possible accuracy in terms of correlation coefficient (R) and average absolute percentage error (AAPE) between the actual and predicted TOC. The three ML methods yielded good matches; however, the RF‐based model has the best performance. The RF model was able to predict the TOC for the different datasets with R values range between 0.93 and 0.99 and AAPE values less than 14%. In terms of average error, the ML‐based models outperformed the other three empirical correlations. This study shows the capability and robustness of ML models to predict the total organic carbon from readily available logging data without the need for core analysis or additional well interventions.
Presentation of a Novel Method for Prediction of Traffic with Climate Condition Based on Ensemble Learning of Neural Architecture Search (NAS) and Linear Regression
Authors: Artin Javad , Valizadeh Amin , Ahmadi Mohsen , Kumar Sathish A. P. , Sharifi Abbas
Published: September 2021

Traffic prediction is critical to expanding a smart city and country because it improves urban planning and traffic management. This prediction is very challenging due to the multifactorial and random nature of traffic. This study presented a method based on ensemble learning to predict urban traffic congestion based on weather criteria. We used the NAS algorithm, which in the output based on heuristic methods creates an optimal model concerning input data. We had 400 data, which included the characteristics of the day’s weather, including six features: absolute humidity, dew point, visibility, wind speed, cloud height, and temperature, which in the final column is the urban traffic congestion target. We have analyzed linear regression with the results obtained in the project; this method was more efficient than other regression models. This method had an error of 0.00002 in terms of MSE criteria and SVR, random forest, and MLP methods, which have error values of 0.01033, 0.00003, and 0.0011, respectively. According to the MAE criterion, this method has a value of 0.0039. The other methods have obtained values of 0.0850, 0.0045, and 0.027, respectively, which show that our proposed model has a minor error than other methods and has been able to outpace the other models.
Determination of the Phenolic Content in Iranian Trehala Manna and Evaluation of Their Antioxidant Effects
Authors: Darikvand Farzaneh , Ghavami Mehrdad , Honarvar Masoud
Published: September 2021

One of the most challenging issues in the food and pharmaceutical industries is finding effective and safe antioxidants from natural resources compared to their synthetic compounds, which have side effects. In this regard, Trehala manna was considered a great antioxidant source categorized as the major type of manna produced naturally and by the Echinops plant in response to insect activity. In this study, the antioxidant activity and phenolic content of the numerous Trehala manna in Echinops sp. have been investigated. Different methods of radical scavenging activity comprising 2,2′-azino-bis (3-ethylbenzothiazoline-6-sulphonic acid) (ABTS) and 2, 2-diphenyl-1-picrylhydrazyl (DPPH) have been investigated to evaluate antioxidant activity. The phenolic contents were measured by Folin–Ciocalteu and standard phytochemical methods. Quantitative and qualitative amounts of phenolic content, including caffeic, ferulic, coumaric, syringic, and hydroxybenzoic acids, were quantified by high-performance liquid chromatography (HPLC). The results indicated the significant changes in the amounts of phenolics and the antioxidant properties in Trehala manna samples, based on the place of collection. Based on results, antioxidant capacity detected by DPPH and ABTS tests showed the IC50 values of 40–94 µg/mL and 28–72 µg/mL, respectively. Results of the FRAP test represented very strong ferric ion reducing activities (0.04–0.83 mmol Fe2+/g). Ferric ion reducing data were not markedly different from ABTS and DPPH ones. These samples also presented the highest phenolic content (1.32–2.28 mg GAE/100 g). Jahrom Trehala manna was the highest in both phenolic content and antioxidant value, while Sabzevar was the lowest. We found a significant relationship between the antioxidant values and total phenolic counts. It indicates that the phenolics contribute to the observed antioxidant activities of these samples.
Volatile Profile Characterization of Winter Jujube from Different Regions via HS-SPME-GC/MS and GC-IMS
Authors: Qiao Yening , Bi Jinfeng , Chen Qinqin , Wu Xinye , Gou Min , Hou Haonan , Jin Xinwen , Purcaro Giorgia
Published: September 2021

A combined untargeted and targeted approach was established for fingerprinting volatile organic compounds in winter jujubes from eight regions of China. Volatiles, including alcohols, aldehydes, acids, esters, and alkenes, were identified by gas chromatography-ion mobility spectrometry (GC-IMS). Benzyl alcohol, octanoic acid, 2-hexenal, linalool, 2-nonenal, and ethyl decanoate were the most common compounds present in all jujubes. Principal component analysis (PCA) from GC-IMS and untargeted E-nose showed that the main volatile organic compounds (VOCs) of most jujubes were similar. The volatile organic compounds of winter jujubes from Yuncheng city, Shanxi province, and Aksu region, Xinjiang province, were significantly different from those from other regions. 1-Penten-3-ol, ethyl hexanoate, methyl laurate, and 2-formyltoluene were the markers of XJAKS with green and fruity aroma, and SXYC could be labeled by acetone and 2-methoxyphenol with woody and pungent aroma. GC-IMS was an effective method for volatile fingerprinting of jujubes with high sensitivity and accuracy.
Novel Mouse Models of Bladder Cancer Identify a Prognostic Signature Associated with Risk of Disease Progression
Authors: Park Soonbum , Rong Lijie , Owczarek Tomasz B. , Bernardo Matteo Di , Shoulson Rivka L. , Chua Chee-Wai , Kim Jaime Y. , Lankarani Amir , Chakrapani Prithi , Syed Talal , McKiernan James M. , Solit David B. , Shen Michael M. , Al-Ahmadie Hikmat A. , Abate-Shen Cory
Published: September 2021

To study the progression of bladder cancer from non–muscle-invasive to muscle-invasive disease, we have developed a novel toolkit that uses complementary approaches to achieve gene recombination in specific cell populations in the bladder urothelium in vivo, thereby allowing us to generate a new series of genetically engineered mouse models (GEMM) of bladder cancer. One method is based on the delivery of adenoviruses that express Cre recombinase in selected cell types in the urothelium, and a second uses transgenic drivers in which activation of inducible Cre alleles can be limited to the bladder urothelium by intravesicular delivery of tamoxifen. Using both approaches, targeted deletion of the Pten and p53 tumor suppressor genes specifically in basal urothelial cells gave rise to muscle-invasive bladder tumors. Furthermore, preinvasive lesions arising in basal cells displayed upregulation of molecular pathways related to bladder tumorigenesis, including proinflammatory pathways. Cross-species analyses comparing a mouse gene signature of early bladder cancer with a human signature of bladder cancer progression identified a conserved 28-gene signature of early bladder cancer that is associated with poor prognosis for human bladder cancer and that outperforms comparable gene signatures. These findings demonstrate the relevance of these GEMMs for studying the biology of human bladder cancer and introduce a prognostic gene signature that may help to stratify patients at risk for progression to potentially lethal muscle-invasive disease.

Significance:

Analyses of bladder cancer progression in a new series of genetically engineered mouse models has identified a gene signature of poor prognosis in human bladder cancer.
Impaired CD4 T-cell Response to SARS-CoV-2: Rationale for PD-1 Blockade in Patients with Cancer and COVID-19?
Authors: Salomé Bérengère , Horowitz Amir
Published: September 2021

Cancer is a strong risk factor for severe COVID-19 disease. In this issue of Cancer Discovery, Bilich and colleagues demonstrate impaired preexisting and newly generated CD4 T-cell response to SARS-CoV-2 in patients with cancer.

See related article by Bilich et al., p. 1982.
Body Adiposity Index Is Predictive of Weight Loss after Roux-en-Y Gastric Bypass
Authors: Liu Fangcen , He Jielei , Zhu Ye , Wang Hongdong , Feng Wenhuan , Sun Xitai , Bi Yan , Zhu Dalong
Published: September 2021

Background/Aims: Roux-en-Y gastric bypass (RYGB) is one of the most effective therapies for morbid obesity, yet some patients who have taken the surgery still undergo insufficient weight loss. Visceral adiposity index (VAI), lipid accumulation product (LAP), body adiposity index (BAI), and cardiometabolic index (CMI) have been regarded as clinical indicators of adiposity phenotypes that associated closely with obesity-related metabolic diseases. However, no studies have evaluated the relationship between these indexes and weight loss after bariatric surgery. In this prospective study, we aimed to evaluate whether VAI, LAP, BAI, and CMI would predict postoperative weight loss outcomes after RYGB. Methods: This study included 38 men and 67 women who have undergone RYGB between January 2017 and May 2018 and recorded their %TWL (percent of total weight loss), %EBMIL (percent of excess body mass index loss), %EWL (percent of excess weight loss), anthropometric indices, and biochemical parameters before and 12 months after the surgery. In addition, VAI, LAP, BAI, and CMI were measured with anthropometric measures or lipid profiles using related equations and analyzed with metabolic characteristics. Results: Subjects with lower BAI (<32.54 in men and 37.39 in women) displayed higher %EBMIL and %EWL 12 months after surgery. BAI was independently associated with %EWL 12 months after surgery in both men and women (both p < 0.05). The area under the receiver operating characteristic curve for BAI was significantly higher (0.773 in men and 0.818 in women) than VAI, LAP, and CMI. Conclusions: BAI serves as a reliable surrogate marker of the weight loss outcome after RYGB. The predictivity of adiposity indexes in beneficial outcomes after weight loss therapies is of important referential value for the implementation and optimization of individualized and refined weight loss treatments for obese patients.
Subungual Exostosis: A Case Series of 48 Patients
Authors: Chiheb Soumiya , Slimani Yasmine , Karam Rajaa , Marnissi Farida , Hali Fouzia
Published: September 2021

Background: Subungual exostosis is an unusual benign nail tumor, mostly located on the big toe. It generally affects young people and manifests as uncomfort during footwear. Method: A monocentric retrospective study was conducted at the outpatient consultation for nail disorders at the Department of Dermatology of the University of Casablanca, Casablanca, Morocco, between April 2006 and October 2019. Results: We diagnosed subungual exostosis in 48 patients, including 25 men and 23 women, with an average age of 20 years. The subungual exostosis was located on the hallux in 34 cases, the second toe in 10 cases, and the index finger in 2 cases. Nail trauma was found in 27 patients. The tumor was entirely excised in all the patients. Conclusion: Large series of subungual exostosis are reported by orthopedic surgeons. However, our outpatient consultation for nail disorders allowed the diagnosis and appropriate management of subungual exostosis.
Introduction of a Quality Improvement Bundle Is Associated with Reduced Exposure to Mechanical Ventilation in Very Preterm Infants
Authors: Lo Stacey Chi-Yan , Bhatia Risha , Roberts Calum T.
Published: September 2021

Introduction: Exposure to mechanical ventilation (MV) is a risk factor for bronchopulmonary dysplasia (BPD) in very preterm infants (VPTIs). We assessed the impact of a quality improvement (QI) bundle in VPTIs (<32 week gestation) on exposure to MV. Methods: We introduced a QI bundle consisting of deferred cord clamping (DCC), nasal bubble continuous positive airway pressure (bCPAP) in the delivery room (DR), and minimally invasive surfactant therapy (MIST). We compared respiratory outcomes and neonatal morbidity in historical pre-QI (July–December 2017) and prospective post-QI (February–July 2019) cohorts (QICs) of VPTIs. We pre-specified an adjusted analysis to account for the effects of gestational age, sex, antenatal steroids, and any demographic data that significantly differed between cohorts. Results: The pre-QI and post-QICs included 87 and 98 VPTIs, respectively. The post-QIC had decreased rates of MV in the DR (adjusted odds ratio [aOR] 0.26, 95% confidence interval [CI] 0.09–0.71), in the first 72 h of life (aOR 0.27, 95% CI 0.11–0.62) and during admission (aOR 0.28, 95% CI 0.12–0.66). Rates of BPD, combined BPD/death, and BPD severity were similar. The post-QIC was less likely to be discharged with home oxygen (aOR 0.27, 95% CI 0.08–0.91). Necrotising enterocolitis grade ≥2 increased (aOR 19.01, 95% CI 1.93–188.6) in the post-QIC. Conclusion: In this rapid-cycle QI study, implementation of a QI bundle consisting of DCC, early nasal bCPAP, and MIST in VPTIs was associated with reduced rates of MV in the DR, in the first 72 h of life and during admission, and reduced need for home oxygen.
Bronchoscopic Targeted Lung Denervation in Patients with Severe Asthma: Preliminary Findings
Authors: Hartman Jorine E. , Srikanthan Karthi , Caneja Cielito , ten Hacken Nick H.T. , Kerstjens Huib A.M. , Shah Pallav L. , Slebos Dirk-Jan
Published: September 2021

Treatment options for severe asthma are limited, particularly in those patients who do not meet criteria for biologicals. Targeted lung denervation (TLD) is the bronchoscopic ablation of the peribronchial vagal nerve trunks to reduce cholinergic stimulation of airway smooth muscle and submucosal glands. This report describes the experience of the first 2 asthma patients treated with TLD worldwide. The participants were 54 and 51 years of age, and both had severe asthma (GINA 5) (FEV1: 53% and 113% of predicted; AQLQ scores: 5.3 and 4.4). Both participants were treated with TLD in a single day-case procedure under general anaesthesia. Lung function, health status, and adverse event data were collected at baseline and 12 months after TLD. No treatment-related serious adverse events were reported up to 12 months. Cough symptoms improved in both participants, and 1 participant reported a marked reduction in rescue medication use at 6 months. There were no significant changes in spirometry, lung volumes, or health status. In conclusion, TLD was performed safely in both participants, but more evidence is needed to clarify safety and efficacy of TLD in severe asthma. Therefore, further investigation of the treatment in severe asthma patients would be useful.
Natural History of Allergy to Hen’s Egg: A Prospective Study in Children Aged 6 to 12 Years
Authors: Taniguchi Hiroaki , Ogura Kiyotake , Sato Sakura , Ebisawa Motohiro , Yanagida Noriyuki
Published: September 2021

Introduction: There are limited reports on the natural history of hen’s egg (HE) allergy (HEA) in children <6 years. We aimed to investigate the natural history of HEA in children aged 6–12 years and the factors affecting its tolerance acquisition. Methods: Using the database in our hospital, a total of 137 patients diagnosed with a definitive immediate-type reaction to HE when they turned 6 years were enrolled, and the natural course of HEA was prospectively examined until patients turned 12 years. Tolerance was defined as being able to pass an oral food challenge to consume a half or whole heated HE or consume heated HE freely without symptoms. Thirty patients (21.9%) who were enrolled for oral immunotherapy and 21 (15.3%) who discontinued follow-up were considered dropouts. Kaplan-Meier estimation was used to evaluate the rate of tolerance. Results: Fifty-five of the 137 patients (40.1%) had a previous HE anaphylaxis history; 61 (44.5%) patients had acquired tolerance to HE by age 12 years; and 25 (18.2%) continued total or partial HE elimination. The estimated acquired tolerance rates by ages 7, 9, and 12 years were 14.6%, 40.8%, and 60.5%, respectively. A previous history of HE anaphylaxis before 6 years of age, reacting to small amounts of heated HE by 6 years of age, and higher ovomucoid-specific immunoglobulin E values at the same age were associated with persistent HEA. Conclusion: This study provides important insights into the natural course of HEA beyond early childhood, with the acquisition of HE tolerance continuing throughout the duration of the study.
Mediastinal Nodular Lymphocyte Predominant Hodgkin Lymphoma Achieved by Endoscopic Transesophageal Cryobiopsy
Authors: Huang Zan-Sheng , Zhou Dong , Zhang Jing , Fu Wan-Lei , Wang Jing , Wu Xian-Li , Herth Felix J.F. , Fan Ye
Published: September 2021

Guidelines have recommended endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and endoscopic ultrasound-guided fine-needle aspiration biopsy as initial sampling approaches of mediastinal lymph nodes for lung cancer staging. However, the small sample volume might restrict the diagnostic utility of needle aspiration in certain mediastinal diseases. We have recently shown that transbronchial mediastinal cryobiopsy, which is capable of providing larger amounts of intact tissue, improves diagnostic yield in rare tumors and benign diseases compared to EBUS-TBNA. Here, we present a case of mediastinal nodular lymphocyte predominant Hodgkin lymphoma successfully diagnosed by endoscopic transesophageal cryobiopsy.
Role of Endothelial Prolyl-4-Hydroxylase Domain Protein/Hypoxia-Inducible Factor Axis in Acute Kidney Injury
Authors: Tiwari Ratnakar , Kapitsinou Pinelopi P.
Published: September 2021

Ischemia reperfusion injury (IRI) results from a cessation or restriction of blood supply to an organ followed by reestablishment of perfusion and reoxygenation. In the kidney, IRI due to transplantation, cardiac surgery with cardiopulmonary bypass, and other major vascular surgeries contributes to acute kidney injury (AKI), a clinical condition associated with significant morbidity and mortality in hospitalized patients. In the postischemic kidney, endothelial damage promotes inflammatory responses and leads to persistent hypoxia of the renal tubular epithelium. Like other cell types, endothelial cells respond to low oxygen tension by multiple hypoxic signaling mechanisms. Key mediators of adaptation to hypoxia are hypoxia-inducible factors (HIF)-1 and -2, transcription factors whose activity is negatively regulated by prolyl-hydroxylase domain proteins 1 to 3 (PHD1 to PHD3). The PHD/HIF axis controls several processes determining injury outcome, including ATP generation, cell survival, proliferation, and angiogenesis. Here, we discuss recent advances in our understanding of the endothelial-derived PHD/HIF signaling and its effects on postischemic AKI.
Ovotesticular Difference of Sex Development: Genetic Background, Histological Features, and Clinical Management
Authors: Syryn Hannes , Van De Vijver Koen , Cools Martine
Published: September 2021

Background: Ovotesticular disorder/difference of sex development (DSD) refers to the co-presence of testicular and ovarian tissue in one individual. Childhood management is challenging as there are many uncertainties regarding etiology, gonadal function, and gender outcome. Summary: Ovotesticular DSD should mainly be considered in 46,XX children with atypical genitalia and normal adrenal steroid profiles. Various underlying genetic mechanisms have been described. Histological assessment of ovotestes requires expert revision and has many pitfalls. Neonatal sex assignment is essential, but as gender outcome is unpredictable, this should be regarded as provisional until a stable gender identity has developed. Therefore, it is crucial not to perform any irreversible medical or surgical procedure in affected individuals until adolescents can give their full informed consent. Gonadal function mostly allows for spontaneous pubertal development; however, fertility is compromised, especially in boys. Specific long-term outcome data for ovotesticular DSD are lacking but can be extrapolated from studies in other DSD populations. Key Messages: Management of ovotesticular DSD has changed in recent years, prioritizing the child’s future right for autonomy and self-determination. The benefits and pitfalls of this new approach have not been documented yet and require intensive monitoring on an international scale.
Sex Differences in Patients With Suspected Cardiac Sarcoidosis Assessed by Cardiovascular Magnetic Resonance Imaging
Authors: Kalra Rajat , Malik Shray , Chen Ko-Hsuan Amy , Ogugua Fredrick , Athwal Pal Satyajit Singh , Elton Andrew C. , Velangi Pratik S. , Ismail Mohamed F. , Chhikara Sanya , Markowitz Jeremy S. , Nijjar Prabhjot S. , von Wald Lisa , Roukoz Henri , Bhargava Maneesh , Perlman David , Shenoy Chetan
Published: September 2021

Background:

There are few data on sex differences in suspected cardiac sarcoidosis.

Methods:

Consecutive patients with histologically proven sarcoidosis and suspected cardiac involvement were studied. We investigated sex differences in presenting features, cardiac involvement, and the long-term incidence of a primary composite end point of all-cause death or significant ventricular arrhythmia and secondary end points of all-cause death and significant ventricular arrhythmia.

Results:

Among 324 patients, 163 (50.3%) were female and 161 (49.7%) were male patients. Female patients had a greater prevalence of chest pain (37.4% versus 23.6%;
P
=0.010) and palpitations (39.3% versus 26.1%;
P
=0.016) than male patients but not dyspnea, presyncope, syncope, or arrhythmias at presentation. Female patients had a lower prevalence of late gadolinium enhancement on cardiovascular magnetic resonance imaging (20.2% versus 35.4%;
P
=0.003) and less often met criteria for a clinical diagnosis of cardiac sarcoidosis (Heart Rhythm Society consensus criteria, 22.7% versus 36.0%;
P
=0.012 and 2016 Japanese Circulation Society guideline criteria, 8.0% versus 19.3%;
P
=0.005), indicating lesser cardiac involvement. However, the long-term incidence of all-cause death or significant ventricular arrhythmia was not different between female and male patients (23.2% versus 23.2%;
P
=0.46). Among the secondary end points, the incidence of all-cause death was not different between female and male patients (20.7% versus 14.3%;
P
=0.51), while female patients had a lower incidence of significant ventricular arrhythmia compared with male patients (4.3% versus 13.0%;
P
=0.022). On multivariable analyses, sex was not associated with the primary end point (hazard ratio for female patients, 1.36 [95% CI, 0.77–2.43];
P
=0.29).

Conclusions:

We observed distinct sex differences in patients with suspected cardiac sarcoidosis. A paradox was identified wherein female patients had a greater prevalence of chest pain and palpitations than male patients, but lesser cardiac involvement, and a similar long-term incidence of all-cause death or significant ventricular arrhythmia.
Stress and Coping Among Family Caregivers of Patients With a Destination Therapy Left Ventricular Assist Device: A Multicenter Mixed Methods Study
Authors: McIlvennan Colleen K. , Jones Jacqueline , Makic Marybeth , Meek Paula M. , Chaussee Erin , Thompson Jocelyn S. , Matlock Daniel D. , Allen Larry A.
Published: September 2021

Background:

Family caregivers of patients with a destination therapy left ventricular assist device play a central and formalized role in postimplant care. We aimed to characterize longitudinal stress, predictors and correlates of stress, and coping processes among left ventricular assist device caregivers.

Methods:

We performed a sequential, exploratory, mixed-methods study from 6 diverse left ventricular assist device programs. The primary outcome for the quantitative analysis was the Perceived Stress Scale-10 at 6 months (0–40). Based on the quantitative findings and guided by the Transactional Model of Stress and Coping, semistructured interviews explored causes of stress and coping processes. Integration was performed during the qualitative and interpretation phase.

Results:

A total of 96 caregivers met inclusion criteria for quantitative analysis. Mean (SD) Perceived Stress Scale score was 14.3 (5.5) preimplant and 11.8 (6.9) at 6 months. Preimplant, only decreased preparedness for caregiving was associated with higher Perceived Stress Scale score at 6 months. At 6 months, increased caregiver depressive symptoms, decreased caregiver preparedness for caregiving, and lower patient quality of life were associated with higher Perceived Stress Scale score. Qualitative analysis of 25 caregivers revealed the causes of stress coalesced around 3 themes: (1) lack of preparedness to be a caregiver, (2) uniqueness of stress for the caregiver and patient situation, and (3) caregiving responsibilities physically and emotionally impacting caregivers. To cope with stress, most caregivers employed emotion-focused coping.

Conclusions:

In family caregivers of patients with a left ventricular assist device, higher perceived stress was associated with lower caregiver preparedness, higher caregiver depressive symptoms, and lower patient quality of life. Emotion-focused coping strategies were common for caregivers. Future work should better prepare caregivers for this role and support them through the caregiving experience.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02344576.
Cardiac Hypertrophy Is Associated With Advanced Brain Aging in the General Population
Authors: Frenzel Stefan , Wittfeld Katharina , Bülow Robin , Völzke Henry , Friedrich Nele , Habes Mohamad , Felix Stephan B. , Dörr Marcus , Grabe Hans J. , Bahls Martin
Published: September 2021

Background

Hypertrophy of the left ventricle (LV) has recently been associated with adverse changes of brain structure in older adults, notably increased burden of white matter hyperintensities (WMHs). Whether greater LV size or mass is also related to WMH burden in middle‐aged adults is currently unclear. In addition, its relation with alterations in cortical thickness (CT) has not been studied to date.

Methods and Results

Data from 1602 participants of the population‐based SHIP (Study of Health in Pomerania) with LV ejection fraction >40% and no history of myocardial infarction were included (aged 21–82 years; median age, 49 years; 53% women). Participants underwent both echocardiography and magnetic resonance imaging of the head. Imaging markers of brain aging (ie, CT and WMH volume) were determined from magnetic resonance imaging scans. LV mass and diameter were associated with lower global CT and greater WMH volume, while adjusting for age, sex, body height, fat‐free body mass, and intracranial volume. Moreover, thicknesses of the interventricular septum and posterior wall were also associated with lower global CT. These associations could not be explained by cardiovascular risk factors (including hypertension), inflammatory markers, or sociodemographic factors. Regional analyses showed distinct spatial patterns of lower CT in association with LV diameter and posterior wall thickness.

Conclusions

LV diameter and mass are associated with lower global and regional CT as well as greater WMH burden in the general population. These findings highlight the brain structural underpinnings of the associations of LV hypertrophy with cognitive decline and dementia.
Forced Self-Reliance: The Kamakura Bakufu Defense against the Mongol Invasion of Japan
Authors: Choi Lyong , Yi Sang Hun
Published: September 2021

When faced with the threat of invasion by the Mongol Empire and Goreyo, its vassal state, Kamakura Japan could have followed a diplomatic course with the Mongols or formed an alliance with anti-Mongol forces on the continent. Authorities in Japan, however, rejected both options, choosing instead to fight the Mongols alone on their own soil. International-relations models fail adequately to explain Kamakura Japan’s preference for self-reliance. By contrast, Asuka Japan, when faced with a similar invasion from Tang–Silla forces in an earlier era, opted to form an alliance with Baekjae, which culminated in a battle on the continent. Despite the copious scholarly treatment of the Mongol invasion, an important question about the Mongol–Japan War remains unanswered: How and why did Kamakura Japan’s governmental structure incline it to choose defensive self-reliance rather than diplomacy or military alliance?
Giant water scavenger beetles Hydrophilus subgenus Dibolocelus (Coleoptera: Hydrophilidae) from Mexico with description of two new species
Authors: ARCE-PÉREZ ROBERTO , ARRIAGA-VARELA EMMANUEL , NOVELO-GUTIÉRREZ RODOLFO , NAVARRETE-HEREDIA JOSÉ L.
Published: September 2021

The Hydrophilus (Dibolocelus) Bedel species from Mexico and adjacent areas are treated on the basis of the study of 142 adult specimens and published data. Two new species are herein recognized and described: H. (D.) nucleoensis Arce-Pérez & Arriaga-Varela sp. nov. from Mexico, Guatemala and Nicaragua, H. (D.) pseudovatus Arce-Pérez & Arriaga-Varela sp. nov. from Mexico. Three already known species are re-described and their geographical distribution is updated, H. (D.) ovatus Gemminger & Harold and H. (D.) pollens Sharp and H. (D.) violaceonitens Jacquelin du Val, a species resurrected as distinct to H. (D.) smaragdinus. Hydrophylus (D.) cf. purpurascens (Régimbart) is also redescribed but their identity is questionable. The lectotype of H. (D.) pollens Sharp is designated. Within Mexico, the state with the highest known diversity is Veracruz with five species. A key to the species of Hydrophilus (Dibolocelus) from Mexico and Central America is provided.
A new species of Stegonotus (Serpentes: Colubridae) from the remnant coastal forests of southern Timor-Leste
Authors: KAISER HINRICH , KAISER CHRISTINE M. , MECKE SVEN , O’SHEA MARK
Published: September 2021

During the first amphibian and reptile survey of Timor-Leste, we discovered a population of groundsnakes, genus Stegonotus, in the last remnant of lowland coastal forest along the country’s southern coast, which represents a new species. This sexually dimorphic species can be differentiated from all other Wallacean Stegonotus by a combination of 17-17-15 dorsals, ventrals (female 206; males 197–207), paired subcaudals (female 61; males 71–75), the “gull wing +” condition of the rostral, large squared prefrontals that each are 2.5 times the area of the internasals and two-thirds the size of the frontal, a snout-scale ratio of near 0.4 and a frontal-parietal suture ratio of ≤ 1.0, a labial scale formula of 73+4 | 94, five gulars separating the posterior genial and the anteriormost ventral, and an overall brown body coloration that lightens progressively from the vertebral scale row in a dorsal–lateral direction and features color gradients of dark brown posterior edges to lighter brown anterior edges on individual scales. The species is most similar in overall morphology to S. modestus from the central Moluccas and to S. lividus, a species known only from tiny Semau Island that lies off the western end of Timor Island, in close proximity to Kupang, the capital of the Indonesian province of East Nusa Tenggara.
Studies on Neotropical Pseudophyllinae: The status of the genus Brachyauchenus Brunner von Wattenwyl, 1895 and its species (Orthoptera: Tettigoniidae: Pseudophyllinae: Platyphyllini)
Authors: CADENA-CASTAÑEDA OSCAR J. , RODRÍGUEZ NIXON OSCAR PARRA , TAVARES GUSTAVO COSTA , RODRÍGUEZ DIANA MARCELA TRUJILLO , ARIAS RONALD FERNANDO QUINTANA
Published: September 2021

In this contribution to the subfamily Pseudophyllinae in the Neotropics, we focus on reviewing the status of the genus Brachyauchenus and its four included species. After this revision, the genus remains monotypic, including only B. castaneus (type species), so it is necessary to provide a new diagnosis, since the current has characteristics of species that in the past was moved to Triencentrus, in addition to the characteristics of the species that are being excluded here. B. castaneus is redescribed to complement the characteristics of the genus, the unknown female is described, and new distribution data are provided, refuting the presence of this species in Bogotá, Colombia, its type locality. Brachyauchenus festae and B. minutus are grouped into the new genus Mikrischyrum n. gen. (Platyphyllini) which is similar to Baliophyllum and Drepanoxiphus, and a key is provided to differentiate these species. Brachyauchenus varicosus is being moved to the genus Stenoschema (Pleminiini), restricting the distribution of Brachyauchenus to the center and north of the eastern slope of the Colombian Andes and the new genus in Panama and the Peruvian Amazon. A map is included with the distribution data of the species studied here. Finally, the variation of the coloration of some species and the current taxonomic panorama of the tribe Platyphyllini are discussed.