bluuebunny/crossref_metadata_2025 huggingface dataset:
Blastomycosis in solid organ transplant recipients—A retrospective series from southeastern Wisconsin
Authors: Mehta Tej I. , Kurman Jonathan , Dolan Stephen , Gill Harpreet , Thapa Bipin
Published: June 2021

Blastomycosis is a fungal infection caused primarily by Blastomyces dermatitis. The fungus is endemic to the Ohio, Mississippi, and St. Lawrence River areas of the United States. Organ transplant recipients are at risk of blastomycosis due to pharmacologic immunosuppression. Over a 20‐year period, 30 cases of blastomycosis post‐solid organ transplantation were identified at our center. The cumulative incidence of blastomycosis among SOT recipients was 0.99%. There was a male predominance (70% male) and a median age of 59 at the time of diagnosis. Regarding transplant type, 23 patients received kidney transplants, 4 received liver transplants, 2 received pancreas transplants and 1 received a heart transplant. Median time to blastomycosis identification post‐transplant was 67.8 months (range: 1‐188 months). Amphotericin B was used as initiation therapy in most cases, followed by itraconazole, voriconazole, or in select cases fluconazole or posaconazole maintenance therapy. Regarding comorbid conditions, 87% of patients had diabetes, 50% had congestive heart failure, and 20% had chronic pulmonary disease. Nine patients (30%) developed blastomycosis‐related acute respiratory distress syndrome, 33% of these died with a median time to death of 22 days (range 20 days to 2 months); these were the only deaths attributable to blastomycosis.
Pepper ubiquitin‐specific protease, CaUBP12, positively modulates dehydration resistance by enhancing CaSnRK2.6 stability
Authors: Lim Chae Woo , Baek Woonhee , Lim Junsub , Hong Eunji , Lee Sung Chul
Published: June 2021

Abscisic acid (ABA) is a plant hormone that activates adaptive mechanisms to environmental stress conditions. Plant adaptive mechanisms are complex and highly modulated processes induced by stress‐responsive proteins; however, the precise mechanisms by which these processes function under adverse conditions remain unclear. Here, we isolated CaUBP12 (Capsicum annuum ubiquitin‐specific protease 12) from pepper (C. annuum) leaves. We show that CaUBP12 expression is significantly induced after exposure to abiotic stress treatments. We conducted loss‐of‐function and gain‐of‐function genetic studies to elucidate the biological functions of CaUBP12 in response to ABA and dehydration stress. CaUBP12‐silenced pepper plants and CaUBP12‐overexpressing Arabidopsis plants displayed dehydration‐sensitive and dehydration‐tolerant phenotypes, respectively; these phenotypes were characterized by regulation of transpirational water loss and stomatal aperture. Under dehydration stress conditions, CaUBP12‐silenced pepper plants and CaUBP12‐overexpressing Arabidopsis plants exhibited lower and higher expression levels of stress‐related genes, respectively, than the control plants. We isolated a CaUBP12 interaction protein, CaSnRK2.6, which is a homolog of Arabidopsis OST1; degradation of this protein was partially inhibited by CaUBP12. Similar to CaUBP12‐silenced pepper plants and CaUBP12‐overexpressing Arabidopsis plants, CaSnRK2.6‐silenced pepper plants and CaSnRK2.6‐overexpressing Arabidopsis displayed dehydration‐sensitive and dehydration‐tolerant phenotypes, respectively. Our findings suggest that CaUBP12 positively modulates the dehydration stress response by suppressing CaSnRK2.6 protein degradation.
The new cold war and the rise of the 21st‐century infrastructure state
Authors: Schindler Seth , DiCarlo Jessica , Paudel Dinesh
Published: June 2021

The unipolar international order led by the USA has given way to a multipolar order with the emergence of China as a great power competitor. According to many commentators, the deterioration of Sino–US relations in recent years heralds a “new Cold War.” The new Cold War differs from its namesake in many respects, and in this paper we focus on its novel territorial logic. Containing the USSR was the overriding objective of American foreign policy for nearly four decades, but in contrast, the USA and China are engaged in geopolitical‐economic competition to integrate territory into value chains anchored by their domestic lead firms through the financing and construction of transnational infrastructure (e.g., transportation networks and regional energy grids). We show this competition poses risks as well as opportunities for small states to articulate and realise spatial objectives. We present cases from Nepal and Laos that demonstrate that by hedging between China and the USA and its partners, their governments are able to pursue spatial objectives. In order to achieve them, however, they must implement significant reforms or state restructuring. The result is the emergence of what we term the 21st‐century infrastructure state, which seeks to mobilise foreign capital for infrastructure projects designed to enhance transnational connectivity.
Osmotic hemolysis is a donor‐specific feature of red blood cells under various storage conditions and genetic backgrounds
Authors: Tzounakas Vassilis L. , Anastasiadi Alkmini T. , Valsami Serena I. , Stamoulis Konstantinos E. , Papageorgiou Effie G. , Politou Marianna , Papassideri Issidora S. , Kriebardis Anastasios G. , Antonelou Marianna H.
Published: June 2021

Background

Transfusion research has recently focused on the discovery of red blood cell (RBC) storage capacity biomarkers and the elucidation of donor variation effects. This shift of focus can further strengthen personalization of transfusion therapy, by revealing probable links between donor biology, RBC storage lesion profile, and posttransfusion performance.

Study design and methods

We performed a paired correlation analysis of osmotic fragility in freshly drawn RBCs and during cold storage in different preservative solutions at weekly intervals until unit's expiration date (n = 231), or following 24 h reconstitution in allogeneic plasma (n = 32) from healthy controls or transfusion‐dependent beta‐thalassemia patients.

Results

We observed exceptional correlation profiles (r > 0.700, p < 10−5 in most cases) of RBC osmotic fragility in the ensemble of samples, as well as in subgroups characterized by distinct genetic backgrounds (sex, beta‐thalassemia traits, glucose‐6‐phosphate dehydrogenase deficiency) and storage strategies (additive solutions, whole blood, RBC concentrates). The mean corpuscular fragility (MCF) of fresh and stored RBCs at each storage time significantly correlated with the MCF of stored RBCs measured at all subsequent time points of the storage period (e.g., MCF values of storage day 21 correlated with those of storage days 28, 35 and 42). A similar correlation profile was also observed between the osmotic hemolysis of fresh/stored RBCs before and following in vitro reconstitution in plasma from healthy controls or beta‐thalassemia patients.

Conclusion

Our findings highlighted the potential of osmotic fragility to serve as a donor‐signature on RBCs at every step of any individual transfusion chain (donor, blood product, and probably, recipient).
Red blood cell transfusion and associated outcomes in patients referred for palliative care: A retrospective cohort study
Authors: Chin‐Yee Nicolas , Scott Mary , Perelman Iris , Pugliese Michael , Tuna Meltem , Fitzgibbon Edward , Downar James , Tinmouth Alan , Fergusson Dean , Tanuseputro Peter , Saidenberg Elianna
Published: June 2021

Background

We aim to describe the occurrence of red blood cell transfusion and associated predictive factors and outcomes among patients referred for palliative care.

Study Design and Methods

This retrospective cohort study used linked health administrative data of adults referred for palliative care at an academic hospital from 2014 to 2018. Multivariable regression models were employed to evaluate patient characteristics associated with transfusion and the relationship between transfusion status and location of death. Survival analyses were performed using log‐rank tests and Cox proportional hazards modeling.

Results

Of 6980 evaluated patients, 885 (12.7%) were transfused following palliative care consultation. Covariate factors associated with transfusion included younger age, higher performance status, lower baseline hemoglobin, and a diagnosis of hematologic malignancy (OR = 2.97, 95% CI 2.20–4.01) or solid organ tumor (OR = 1.37, 95% CI 1.10–1.71) vs. noncancer diagnosis. Median survival from palliative care consultation was 19 (IQR 5–75) days; 83 (32–305) days in those transfused and 15 (4–57) days in the nontransfused group (p < .0001). Median survival following transfusion was 56 (19–200) days. Solid organ tumor diagnosis was independently associated with poor survival (HR = 1.7, 95% CI 1.39–2.09 vs. non‐cancer diagnosis). Among individuals who survived ≥30 days, transfusion was associated with a higher likelihood of death in hospital (OR = 2.15, 95% CI 1.71–2.70 vs. home/subacute setting).

Discussion

Transfusions commonly occurred in patients receiving palliative care, associated with cancer diagnoses and favorable baseline prognostic factors. Poor survival following transfusion, particularly in solid organ tumor patients, and the twofold likelihood of death in hospital associated with this intervention have important implications in prescribing transfusion for this population.
Hematologic variables of the Arrau turtle (Podocnemis expansa) under the effects of different anticoagulants and cytologic stains
Authors: Garcia Guilherme C. , Alves‐Júnior José R. F. , Santana Áureo E. , Stas Catherine Marie F. , da Silva Camila C. , Kanayama Cláudio Y. , Bittar Eustáquio R. , Bittar Joely F. F.
Published: June 2021

Background

The hematology of turtles of the Amazon, such as the Arrau turtle (Podocnemis expansa), has not been well described in the literature. Referencing how to collect and analyze blood samples is fundamental for the medical practice of these exotic animals.

Objectives

The aim of this study was to evaluate the hematologic parameters of Arrau turtles of the Amazon to determine the best anticoagulant (EDTA, citrate, or sodium heparin) and cytologic stain (Giemsa, Quick Panoptic, or Rosenfeld) for use with this species.

Methods

Blood samples from eight turtles were collected. Three blood smears were made using blood without anticoagulant, and the rest of the sample was distributed in three tubes, containing EDTA, citrate, and sodium heparin, for erythrogram and leukogram analyses.

Results

All blood samples anticoagulated with EDTA showed marked hemolysis. Blood collected with citrate showed minimal hemolysis, and blood collected with sodium heparin did not have any hemolysis. Some analyses were not performed on blood containing EDTA because of the intense hemolysis. The erythrocyte variables were obtained and showed better results for blood samples in heparin. Blood smears without anticoagulant were appropriate for differential leukocyte counts with the three stain types, while blood with any of the anticoagulants made it difficult to differentiate leukocytes.

Conclusions

Sodium heparin showed the best results and should be the anticoagulant of choice for hematologic studies inP expansa. All cytologic stains were efficient, allowing adequate identification of distinct cell groups. Leukocyte differentiation was assured and had better contrast using blood smears made from blood without an anticoagulant.
Time-dependent quantum correlations in two-dimensional expanding spacetime
Authors: Park Chanyong
Published: June 2021

In expanding universes, the entanglement entropy must be time-dependent because the background geometry changes with time. For understanding time evolution of quantum correlations, we take into account two distinct holographic models, the dS boundary model and the braneworld model. In this work, we focus on two-dimensional expanding universes for analytic calculation and comparison. Although two holographic models realize expanding universes in totally different ways, we show that they result in the qualitatively same time-dependence for eternal inflation. We further investigate the time-dependent correlations in the radiation-dominated era of the braneworld model. Intriguingly, the holographic result reveals that a thermal system in the expanding universe is dethermalized after a critical time characterized by the subsystem size.
Searching for axionlike particles with low masses in pPb and PbPb collisions
Authors: Gonçalves V. P. , Martins D. E. , Rangel M. S.
Published: June 2021

The production of axionlike particles (ALPs) with small masses in ultraperipheral Pb–p and Pb–Pb collisions at the LHC is investigated. The cross section and kinematical distributions associated to the diphoton final state produced in the $$\gamma \gamma \rightarrow a \rightarrow \gamma \gamma $$

γ
γ
→
a
→
γ
γ

subprocesses are estimated considering a realistic set of kinematical cuts. A detailed analysis of the backgrounds is performed and the expected sensitivity to the ALP production is derived. Our results demonstrate that a future experimental analysis of the exclusive diphoton production for the forward rapidities probed by the LHCb detector can improve the existing exclusion limits on the ALP–photon coupling in the mass range 2 GeV $$\le m_a \le $$

≤

m
a

≤

5 GeV.
Path-integral formulation of spreading processes in complex networks
Authors: Iannelli Flavio , Sokolov Igor M.
Published: June 2021

We introduce a path-integral formulation of network-based measures that generalize the concept of geodesic distance and that provides fundamental insights into the dynamics of disease transmission as well as an efficient numerical estimation of the infection arrival time.
On the primitive irreducible representations of finitely generated linear groups of finite rank
Authors: Tushev A. V.
Published: June 2021

In the paper, we study finitely generated linear groups of finite rank which have faithful irreducible primitive representations over a field of characteristic zero. We prove that if an infinite finitely generated linear group [Formula: see text] of finite rank has a faithful irreducible primitive representation over a field of characteristic zero then the [Formula: see text]-center [Formula: see text] of [Formula: see text] is infinite.
On the distance signless Laplacian Estrada index of graphs
Authors: Alhevaz Abdollah , Baghipur Maryam , Ramane Harishchandra , Li Xueliang
Published: June 2021

The distance signless Laplacian eigenvalues [Formula: see text] of a connected graph [Formula: see text] are the eigenvalues of the distance signless Laplacian matrix of [Formula: see text], defined as [Formula: see text], where [Formula: see text] is the distance matrix of [Formula: see text] and [Formula: see text] is the diagonal matrix of vertex transmissions of [Formula: see text]. In this paper, we define and investigate the distance signless Laplacian Estrada index of a graph [Formula: see text] as [Formula: see text], and obtain some upper and lower bounds for [Formula: see text] in terms of other graph invariants. We also obtain some relations between [Formula: see text] and the auxiliary distance signless Laplacian energy of [Formula: see text].
Triangulability of convex graphs and convex skewness
Authors: Ali Niran Abbas , Chia Gek L. , Trao Hazim Michman , Kilicman Adem
Published: June 2021

Suppose [Formula: see text] is a subgraph of a convex complete graph [Formula: see text] and [Formula: see text] contains no boundary edge of [Formula: see text] and [Formula: see text]. We determine necessary and sufficient conditions on [Formula: see text] such that [Formula: see text] admits a triangulation. For [Formula: see text], we investigate the possibility of placing [Formula: see text] in [Formula: see text] such that [Formula: see text] admits a triangulation for certain families of graphs [Formula: see text]. These results are then applied to determine the convex skewness of the convex graphs of the form [Formula: see text].
Infection Rates for Open Distal Phalangeal Fractures Treated with Kirschner Wire: A UK Regional Hand Centre Experience
Authors: Shaharan Shazrinizam , Bage Timothy , Wright Jennifer , Smock Elliott , Pearl Robert
Published: June 2021

Background: Phalangeal fractures are common in hand injuries which: comprising of 23% of all hand and forearm fractures. The current consensus is that focus of treatment should be on prompt irrigation and debridement to reduce infection risk. These infections are significant as they can lead to serious sequelae including osteomyelitis. The aim of this study was to determine the incidence of infection amongst patients with open fracture of distal phalanx who had been treated with K-wire fixation and the timing of their operative management compared to the UK national guideline.

Methods: We performed a retrospective case-note analysis of the patients treated for open distal phalangeal fractures at a regional hands centre over the period of 12 months, and compared with the national guidelines. Data collected included patient demographics, mechanism of injury, length of time taken from injury to first washout, length of time K-wire remains in situ, and infection rate.

Results: Half of the patients (n = 19) met the guideline and were treated with washout within the first 24 hours. Infection rates in this group was 11%. This compared with 26% in those patients that did not receive washout within 24 hours.

Conclusions: This study demonstrates the difficulty in always meeting national guidelines and suggests key reasons for this. The authors propose a set of local, easily-achieved interventions to raise awareness and compliance with the national guidelines and reduce infection. Furthermore, it highlights the importance of carefully selecting cases that required percutaneous K-wire fixation.
PROMIS Measures in Patients with Ganglion Cysts: Who Chooses Surgical Excision Over Non-Operative Management?
Authors: Hansen Trevor , Patrick Nathan C. , Bernstein David , Fear Kathleen , Hammert Warren C.
Published: June 2021

Background: Ganglion cysts are common soft tissue masses of the hand and wrist. It is unclear why some patients pursue surgical excision and others do not. The objective of this study is to compare Patient-Reported Outcomes Measurement Information Systems (PROMIS) scores between patients with ganglion cysts undergoing surgical versus non-surgical treatment.

Methods: Patients presenting to a tertiary, academic hand clinic diagnosed with a wrist ganglion cyst, based on clinical exam, were identified. PROMIS Physical Function (PF), Pain Interference (PI), and Depression scores at the time of diagnosis were reviewed. Data were then stratified according to surgical or non-surgical intervention, with subgroup analysis of dorsal versus volar ganglions and patients that chose to trial cyst aspiration. All results were compared utilizing the appropriate statistical methods.

Results: Of 757 ganglion cyst patients, 264 underwent surgical excision and 493 were treated non-surgically. No difference was noted in PROMIS PF or Depression scores. However, the surgical cohort reported significantly increased preoperative PI scores (Table 2). A higher percentage of patients treated non-surgically received an aspiration attempt compared to those who ultimately received surgery (Table 3). Finally, patients with volar ganglion cysts had significantly increased PI and depression scores, as well as lower PF scores (Table 4).

Conclusions: Presenting PROMIS PI may indicate an increased tendency to pursue surgical treatments and aid in the identification of ganglion cyst patients who are more likely to pursue surgical excision. Further research should focus on correlating absolute differences in PROMIS values with clinical significance.
Arthroscopic Bone Grafting for Scaphoid Nonunion: A Retrospective Study of 42 Cases
Authors: Lamon Bérangère , Ardouin Ludovic , Bellemère Philippe , Dautel Gilles , Athlani Lionel
Published: June 2021

Background: The purpose of this retrospective study was to report outcomes of arthroscopic bone grafting and K-wire fixation to treat scaphoid non-union.

Methods: We included in at two healthcare facilities, 42 consecutive patients (34 men, 8 women) with a mean age of 25 years (range 15–56 years) with scaphoid non-union of the proximal and middle third without intracarpal deformity or SNAC osteoarthritis. All patients were evaluated (pain, range of motion, strength, function, X-rays) by an independent examiner.

Results: At the mean follow-up of 18 months (range 12–56), pain was significantly reduced from 7 to 1 on a visual analogue scale (out of 10). The scores on the Quick Disabilities of the Arm, Shoulder and Hand questionnaire and Patient Rated Wrist Evaluation were improved significantly. At the last review, grip strength was 83% of the contralateral side, the average wrist flexion-extension was 125° and the radioulnar deviation was 58°. Bone union was achieved in 37 cases (88%). The mean time of checking the bone union was 3 months (range, 2–8). Four patients required revision surgery because of failed union.

Conclusions: Based on our findings, we found that this procedure can be used as a surgical treatment for scaphoid non-union of the proximal and middle third without intracarpal deformity or osteoarthritis. The arthroscopic bone grafting is a reliable, effective, and minimally invasive procedure.
Simple Osteotomy Site Repair Method for the Trans-Olecranon Approach: Tension Band Wiring with Ring Pins
Authors: Lee Seung Hoo , Kim Min Bom , Lee Young Ho
Published: June 2021

Background: The trans-olecranon approach is commonly used to treat intra-articular distal humeral fractures (DHFs). We describe an osteotomy site repair technique that is both simple and safe.

Methods: We retrospectively reviewed 30 patients with intra-articular DHFs who were treated via olecranon osteotomies repaired by tension band wiring (TBW) with ring pins. Medical records and radiographs were retrospectively assessed in terms of injuries, operative characteristics, clinical outcomes, and complications, as well as any need for hardware removal. Clinical outcomes were evaluated by deriving the range-of-motion and the Mayo elbow performance score.

Results: Thirty patients (nine men, 21 women; mean age, 49.7 years) with Arbeitsgemeinschaft für Osteosynthesefragen (AO) type 13-B and 13-C DHFs were included; the mean follow-up time was 49.9 months (range, 12–145 months). Anatomical reduction and bony union were achieved at all osteotomy sites. The mean elbow flexion was 121.7° (range, 100–135°) and the mean elbow extension was 11.3° (range, 0–30°). The mean Mayo elbow performance score was 90 points (range, 55–100 points); outcomes were excellent in 15 patients, good in 12 patients, fair in two patients, and poor in one patient. Olecranon implant removal was performed for 10 patients (33.3%; total removal in nine and isolated olecranon implant removal in one). Four of these patients (13.3%) complained of olecranon implant discomfort. Implants were removed during other surgical procedures from the remaining six patients (20%). No implant migration/breakage or wound complications were encountered.

Conclusions: TBW with ring pins is a simple and safe method for olecranon osteotomy site repair.
Biomechanical Study of Asymmetric Flexor Tendon Repair Using 3 Different Suture Materials
Authors: Teo Shuo Ling , Sarvananthan Rajragavan , Lim Rebecca Qian Ru , Wong Yoke Rung
Published: June 2021

Background: The asymmetric technique for flexor tendon repairs has various advantages but further improvement is possible by using a suitable suture material. In this study, we compare the biomechanical performance of asymmetric repairs using 3 suture materials: Supramid Extra II 4-0, Tendo-Loop 4-0, and FiberLoop 4-0.

Methods: We divided 30 porcine flexor tendons into 3 arms. Each arm of tendons were repaired by using 1 of the 3 proposed suture materials. Each repaired tendon was tested by using a mechanical tester. Ultimate tensile strength (UTS), load to 2 mm gap force, failure mechanism and stiffness of the tendons were investigated.

Results: FiberLoop® achieved the highest UTS (90.4 ± 17.9 N), followed by Tendo-Loop (85.3 ± 10.3 N). The difference was no statistically significant. The UTS of repairs using Supramid® was significantly lower (64.0 ± 8.4 N). For load to 2 mm gap force, FiberLoop® achieved 20.7 ± 4.8 N while Tendo-Loop® had 20.5 ± 4.2 N. The difference was also no statistically significant. The repairs using Supramid® had a significantly lower load to 2 mm gap force of 14.2 ± 2.7 N. The stiffness of asymmetric repairs using FiberLoop® and Tendo-Loop® was 5.64 ± 1.7 N/mm and 5.63 ± 0.7 N/mm. The difference was also no statistically significant. The repairs using Supramid® had a significantly lower stiffness of 4.15 ± 1.0 N/mm. Failure mechanisms for the repaired specimens were reported as such: Supramid had 100% suture rupture; Tendo-Loop had 90% suture rupture and 10% suture pullout; FiberLoop had 20% suture rupture and 80% suture pullout.

Conclusions: The asymmetric repair configuration is able to produce superior biomechanical performance by using Tendo-Loop® or FiberLoop®. Improvement of the asymmetric technique by using Tendo-Loop® or FiberLoop® could potentially contribute to better surgical outcomes of flexor tendon repair.
Tension Reducing Muscle Stretch Protocol to Obtain Full Distal Tendon Excursion: A New Rehabilitation Protocol after Flexor Tendon Repair
Authors: Sakamoto Sotetsu , Doi Kazuteru , Hattori Yasunori , Chia Dawn Sinn Yii , Hayashi Kota
Published: June 2021

Background: Flexor tendon rehabilitation protocols minimize repair tension by limiting range of movement to prevent tendon rupture. The resultant muscle contracture inhibits finger extension, increases resistance in tendon gliding distally, and progress to proximal interphalangeal (PIP) joint flexion contracture. This study describes our new rehabilitation protocol, the Tension Reducing Muscle Stretch (TRMS), designed to prevent flexor muscle contracture and obtain full distal tendon excursion.

Methods: We reviewed retrospectively 14 fingers in 13 consecutive patients with primary repair of complete zone I or II flexor digitorum profundus (FDP) tendon rupture were treated with our protocol between 2007 and 2019. Our rehabilitation following FDP 4-strand repairs consisted of three steps. The first step comprised of exercises from traditional protocols such as Duran, Kleinert, Synergistic-wrist-motion, and Place-and-hold. The second step comprised the TRMS exercise to prevent the onset of muscle contracture. Anatomically, FDP tendons arise from the same FDP muscle belly. TRMS involved placing the affected finger in full passive flexion while unaffected fingers were passively extended to full extension. This made the affected FDP muscle stretched. The final step incorporated the early active flexion motion exercise, in which simple fisting was performed, from a fully extended position.

Results: The mean total active motion at the final follow up was 235° (range 170–265). Using the Strickland criteria, eight achieved excellent, four had good, two had fair results. The mean angle of passive extension deficit at the PIP joint at four weeks after surgery was −7° (−30–0), and at the final follow up was −3° (−20–0). No tendon repair was ruptured.

Conclusions: This protocol reduced tension in the affected tendon muscle and encouraged tendon excursion distal to the repair site without complications. It allows full tendon excursion and prevents PIP joint contractures.
A Comparison of Non-vascularized Bone Grafting and Internal Fixation in the Treatment of Unstable Scaphoid Waist Nonunion
Authors: Kim Jin Young , Lee Sang Lim , Park Sung Yoon , Kim KyungHwi , Yeo Ji Hyun
Published: June 2021

Background: When nonunion of scaphoid waist is treated with non-vascularized bone grafting with internal fixation, bony union would be affected not only type of bone graft but also fixation method. Thus, we attempted to investigate whether the bony union depends on how surgeons combine bone grafting and internal fixation.

Methods: We treated 38 consecutive patients with unstable nonunion of scaphoid waist. The patients were treated with one of three types of non-vascularized bone grafting and internal fixation by random sampling, regardless of the configuration of the nonunion; cortico-cancellous bone grafting with Kirschner wire (K-wire) fixation group (12 cases), cortico-cancellous bone grafting with headless compression screw fixation group (13 cases) and cancellous bone grafting with K-wire fixation group (13 cases). We compared “union rate” and “time to union” between groups with statistical analysis. We described clinical features of “failure to union” cases.

Results: The mean time to union of cancellous bone grafting with K-wire fixation group was significantly shorter than those of other groups. There was also significant difference in mean time to union between cortico-cancellous bone grafting with K-wire fixation group and cancellous bone grafting with K-wire fixation group (when the type of bone grafting was different). All the “failure to union” cases were sclerotic (Herbert type D2) nonunion treated by cortico-cancellous bone grafting.

Conclusions: When treating unstable nonunion of scaphoid waist with non-vascularized bone grafting with internal fixation, cancellous bone grafting with K-wire fixation seems to be advantageous in terms of mean time to union. It seems that both bone grafting and fixation method affected “mean time to union” but the type of bone grafting was more influential in achieving union. The failure to union might be frequent in case of Herbert type D2 nonunion combined with cortico-cancellous bone grafting.
Fatal Brucellosis Infection in a Liver Transplant Patient: A Case Report and Review of the Literature
Authors: Piedrahita Daniela , Martinez-Valencia Alvaro Jose , Agudelo Rojas Olga Lucia , Tafur Eric , Rosso Fernanto
Published: June 2021

Brucellosis is the most common zoonosis, particularly in developing countries. The true incidence of human brucellosis is unknown. The WHO points out that 500,000 cases of brucellosis are reported each year from around the world. In Colombia, there is currently no regular surveillance of the event in humans and its prevalence is low due a low clinical suspicion. We report a case of a 66-year-old man, an urban merchant, who had received a liver transplant 11 years ago. The patient presented to the emergency department for two months of fatigue, severe myalgia, paresis of the extremities, loss of muscle strength, and progressive deterioration of functional class. In the emergency room, he became disoriented and was transferred to the intensive-care unit. He had a white blood cell count of 18990/uL and creatine phosphokinase 10302 U/L. Routine blood cultures were positive for Brucella melitensis. The patient reported consumption of unpasteurized bovine milk. He was treated with doxycycline and ciprofloxacin. Despite antibiotic management, after one month of hospitalization and in the context of septic shock with multiorgan failure, the patient died. Brucellosis is an unsuspected and underdiagnosed disease. It can occur in people with or without risk factors. Although the mortality is low, immunocompromised patients can develop fatal infections. A presumptive diagnosis can be established through the correlation of patient history and classic laboratory findings, which include transaminitis, anemia, and leukopenia with relative lymphocytosis; however, other findings can help us to guide the diagnosis, such as rhabdomyolysis, which appears as a complication in different infections; however, it had not been described before in brucellosis. A partnership between clinical suspicion laboratory diagnostic tests and improved disease surveillance systems is necessary to fight the disease.
The Multiplicity of Nontrivial Solutions for a New
p

x

-Kirchhoff-Type Elliptic Problem
Authors: Chu Chang-Mu , Xiao Yu-Xia
Published: June 2021

In the paper, we study the existence of weak solutions for a class of new nonlocal problems involving a

p

x

-Laplacian operator. By using Ekeland’s variational principle and mountain pass theorem, we prove that the new

p

x

-Kirchhoff problem has at least two nontrivial weak solutions.
Systematic Analysis Method for the Unusual Large Displacement in the Excavations in Soft Soil Area
Authors: Ni Xiaodong , Lu Jiangfa , Wang Chen , Huang Songxian , Tang Donghua
Published: June 2021

Based on a subway station excavation construction project in the soft soil area in Nanjing, an informationized monitoring scheme was conducted during the construction of excavation, and the theories of displacement prediction were introduced into the scheme for the evaluation of the horizontal displacement of the retaining structure and the settlement of the surroundings around the excavation. Based on these theories and the monitoring data, a numerical simulation based on the commercial FEM numerical analysis software, Midas GTS NX, was conducted to simulate the whole construction process. To handle the large displacement of the retaining structure observed during the construction, the actual soil layers’ status discovered by excavating, which can reflect the physical characteristics of the soil, the construction condition, and the variation trend of the monitoring data, was used in the back analysis of the factors that induced the large deformation of the retaining structure, and the analysis result was fed back to the countermeasurement organization and design such as erecting temporary steel strut. The effectiveness of these measurements in the aspect of the reduction of the deformation rate was verified, which can provide reference to the design and construction of a similar project in soft soil area.
Acquiring Data Traffic for Sustainable IoT and Smart Devices Using Machine Learning Algorithm
Authors: Huang Yi , Nazir Shah , Ma Xinqiang , Kong Shiming , Liu Youyuan
Published: June 2021

Billions of devices are connected via the Internet which has produced various challenges and opportunities. The increase in the number of devices connected to the Internet of things (IoT) is nearly beyond imagination. These devices are communicating with each other and facilitating human life. The connection of these devices has provided opening directions for the smart applications which are one of the growing areas of research. Among these opportunities, security and privacy are considered to be one of the major issues for researchers to tackle. Proper security measures can prevent attackers from interrupting the security of IoT network inside the smart city for secure data traffic. Keeping in view the security consideration of data traffic for smart devices and IoT, the proposed study presented machine learning algorithms for securing the data traffic based on a firewall for smart devices and IoT network. The study has used the dataset of “Firewall” for validation purposes. The experimental results of the approach show that the hybrid deep learning model (based on convolution neural network and support vector machine) outperforms than decision1 rules and random forest by generating a recognition rate of 95.5% for the hybrid model, 68.5% for decision rules, and 78.3% accuracy for random forest. The validity of the proposed model is also tested based on other performance metrics such as f score, error rate, recall, and precision. This high accuracy rate and other performance values show the applicability of the proposed hybrid model to secure data traffic purposes in smart devices. This can be used in many research areas of the smart city for security purposes.
Detecting COVID‐19 in Chest X‐Ray Images via MCFF‐Net
Authors: Wang Wei , Li Yutao , Li Ji , Zhang Peng , Wang Xin
Published: June 2021

COVID‐19 is a respiratory disease caused by severe acute respiratory syndrome coronavirus (SARS‐CoV‐2). Due to the rapid spread of COVID‐19 around the world, the number of COVID‐19 cases continues to increase, and lots of countries are facing tremendous pressure on both public and medical resources. Although RT‐PCR is the most widely used detection technology with COVID‐19 detection, it still has some limitations, such as high cost, being time‐consuming, and having low sensitivity. According to the characteristics of chest X‐ray (CXR) images, we design the Parallel Channel Attention Feature Fusion Module (PCAF), as well as a new structure of convolutional neural network MCFF‐Net proposed based on PCAF. In order to improve the recognition efficiency, the network adopts 3 classifiers: 1‐FC, GAP‐FC, and Conv1‐GAP. The experimental results show that the overall accuracy of MCFF‐Net66‐Conv1‐GAP model is 94.66% for 4‐class classification. Simultaneously, the classification accuracy, precision, sensitivity, specificity, and F1‐score of COVID‐19 are 100%. MCFF‐Net may not only assist clinicians in making appropriate decisions for COVID‐19 diagnosis but also mitigate the lack of testing kits.
A 5-Year Survival Prediction Model for Chronic Heart Failure Patients Induced by Coronary Heart Disease with Traditional Chinese Medicine Intervention
Authors: Guan Hui , Dai Guo-Hua , Gao Wu-Lin , Zhao Xue , Cai Zhen-Hao , Zhang Jia-Zhen , Yao Jiu-Xiu
Published: June 2021

Objective. This study aimed to construct a 5-year survival prediction model of coronary heart disease (CHD) induced chronic heart failure (CHF), which is supported by the traditional Chinese medicine (TCM) factor, and to verify the model. Methods. Inpatients from January 1, 2012, to December 31, 2017, in seven hospitals in Shandong Province were studied. The random number table was used to randomly divide the seven hospitals into two groups (training set and verification set). In the training set, the least absolute shrinkage selection operator regression was first used to screen the independent variables. Logistic regression was then applied to construct a survival prediction model. The following nomogram visualizes the prediction model results. Finally, C-indices, calibration curves, and decision curves were used to discriminate and calibrate the established model and evaluate its practicability in the clinic. Bootstrap resampling and the verification set were used for internal and external verification, respectively. Results. A total of 424 eligible patients were included in the model construction and verification. In this 5-year survival prediction model of patients with CHF induced by CHD, eight independent predictors were included. The series of C-indices for the training set, bootstrap resamples, and verification set was 0.885, 0.867, and 0.835, respectively, demonstrating the credibility of our model. Additionally, the receiver operating characteristic curve, calibration curve, and clinical decision curve analysis of the training and verification sets showed that this 5-year survival prediction model was good in discrimination, calibration, and clinical practicability. Conclusion. This work highlights eight independent factors affecting 5-year mortality in patients with CHF induced by CHD after discharge and further helps reallocate medical resources rationally by precisely identifying high-risk groups. The constructed prediction model not only plays a credible role in prediction but also demonstrates TCM intervention as a protective factor for the 5-year death of patients with CHF induced by CHD, thereby advancing the use of TCM in CHF.
PLOD3 Is Associated with Immune Cell Infiltration and Genomic Instability in Colon Adenocarcinoma
Authors: Deng Xianyu , Pan Yun , Yang Muqing , Liu Ying , Li Jiyu
Published: June 2021

Procollagen‐lysine, 2‐oxoglutarate 5‐dioxygenases (PLODs) are a family of enzymes. However, the clinical and functional roles of PLOD3 in colon adenocarcinoma (COAD) have not been investigated. The present study found that PLOD3 was highly upregulated in COAD, which may be resulted from its aberrant DNA methylation. The upregulation of both PLOD3 mRNA and protein was confirmed in our tissue samples. Moreover, high PLOD3 was identified to be associated with unfavorable prognosis in COAD. As genome instability is a hallmark of cancer, PLOD3 was expressed higher in COAD samples with high chromosomal instability (CIN‐high) than those with low CIN (CIN‐low) and higher in those with low MSI than high MSI, indicating that PLOD3 expression was associated with tumor genomic instability. Furthermore, immune cells showed significantly different infiltrating levels between the high and low PLOD3 expression groups, and the immune score was negatively correlated with PLOD3 expression and higher in samples with low PLOD3 expression, suggesting that high PLOD3 expression was associated with reduced immune cell infiltrating levels in COAD. To further uncover the underlying mechanism of PLOD3 in PLOD3, we compared the COAD samples of high PLOD3 expression with those of low PLOD3 expression and found that high expression of PLOD3 was associated with reduced expression of immune regulators and enhanced activities of two tumor‐promoting pathways, including gluconeogenesis and TGF‐beta signaling in epithelial‐mesenchymal transition (EMT), suggesting that high expression of PLOD3 causes poor prognosis in COAD by weakening the immune cell infiltration and enhancing activities of tumor‐promoting pathways. In summary, the present study highlights the importance of PLOD3 and provides the evidence about the functional role of PLOD3 in COAD.
The S100 Protein Family as Players and Therapeutic Targets in Pulmonary Diseases
Authors: Sattar Zeeshan , Lora Alnardo , Jundi Bakr , Railwah Christopher , Geraghty Patrick
Published: June 2021

The S100 protein family consists of over 20 members in humans that are involved in many intracellular and extracellular processes, including proliferation, differentiation, apoptosis, Ca2+ homeostasis, energy metabolism, inflammation, tissue repair, and migration/invasion. Although there are structural similarities between each member, they are not functionally interchangeable. The S100 proteins function both as intracellular Ca2+ sensors and as extracellular factors. Dysregulated responses of multiple members of the S100 family are observed in several diseases, including the lungs (asthma, chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, cystic fibrosis, pulmonary hypertension, and lung cancer). To this degree, extensive research was undertaken to identify their roles in pulmonary disease pathogenesis and the identification of inhibitors for several S100 family members that have progressed to clinical trials in patients for nonpulmonary conditions. This review outlines the potential role of each S100 protein in pulmonary diseases, details the possible mechanisms observed in diseases, and outlines potential therapeutic strategies for treatment.
Serum IL-5 and IFN-γ Are Novel Predictive Biomarkers for Anti-PD-1 Treatment in NSCLC and GC Patients
Authors: Zhao Qiu , Bi Yanzhi , Sun Huiting , Xiao Min
Published: June 2021

Background. Because responses of patients with cancer to immunotherapy can vary in success, effective biomarkers are urgently needed for predicting clinical response with anti-PD-1 treatment. We aimed to evaluate the IL-5 and IFN-γ level with the response of anti-PD-1 blockade in non-small-cell lung cancer (NSCLC) and gastric cancer (GC). Methods. Metastatic NSCLC and GC patients treated with anti-PD-1 monoclonal antibody were studied. Blood samples were taken before PD-1 McAb treatment, after the first cycle treatment, and during efficacy evaluation. The association between IL-5 and IFN-γ levels and clinical response were analyzed by the nonparametric Wilcoxon matched-pairs ranked tests. The progression-free survival (PFS) time was obtained by imaging evaluation and telephone follow-up of all the patients. Kaplan-Meier and the log rank test were used to plot the survival curve. Results. IL-5 and IFN-γ levels were detected in the peripheral blood of 40 NSCLC and 35 GC patients who have received anti-PD-1 treatment. In effective group, IL-5 and IFN-γ levels at best response points significantly decreased (P<0.001) compared with pretherapeutic levels in NSCLC and GC patients with lymph node or distant metastasis. Compared with pretherapeutic levels, IL-5 and IFN-γ levels largely increased as the tumor progresses (P<0.01). Higher IL-5 and IFN-γ levels before treatment indicated shorter progression-free survival in patients with NSCLC metastasis (P=0.007,P=0.0111). Moreover, their levels also accurately reflected the pseudoprogression of two NSCLC patients to anti-PD-1 treatment. Conclusions. Our results suggested that serum IL-5 and IFN-γ levels could be an effective indicator for predicting clinical efficacy and survival with anti-PD-1 blockade in NSCLC and GC patients.
Oxidative Stability of a New Peanut Butter Bite Product
Authors: Pidatala Pranav Kaushik , Bellmer Danielle , McGlynn William
Published: June 2021

Peanut butter continues to be a mainstay in the American diet, but in its current form, peanut butter lacks the convenience of other foods. A peanut butter bite snack food has been developed that is individually wrapped, high in protein, and made mostly from peanut butter. The target market for the product is the active, health-conscious segment of the population that wants a high-protein peanut butter snack that is easy to pack, carry, and eat. The objective of the current study was to evaluate the shelf life of peanut butter bites under different storage and packaging conditions and specifically to monitor oxidative stability of the samples over time. Peanut butter bite samples were prepared with three different levels of added antioxidant (vitamin E). Products were sealed in two different types of packaging (metallized polyethylene and plastic polyethylene) and were stored at two different temperatures to determine the rate of deterioration of the product under various conditions. Oxidative stability was evaluated using two different analytical methods (peroxide value and TBARS assay) to evaluate primary and secondary oxidation products over a six month time period. All treatments were conducted in triplicate. Results show that higher levels of vitamin E resulted in greater stability. As expected, oxidation proceeded more quickly under higher temperature storage conditions. A shelf stable individually wrapped peanut butter snack product may be appealing to a large audience and could result in an increase in the consumption of peanuts.
Investigation of IL-17A Serum Levels in Patients with Nonmelanoma Skin Cancer
Authors: Ghahartars Mehdi , Sedaghat Fatemeh , Khajavi Elham , Nejat Amir Ali , Malekzadeh Mahyar , Ghaderi Abbas , Fattahi Mohammad Javad
Published: June 2021

Background. Role of interleukin 17A (IL-17A) in carcinogenesis and cancer growth is controversial. Although some researches support its antitumor activity, some others suggest that it promotes the growth and development of different types of cancer including skin cancer by activation of STAT3. Although the function of the cytokines such as IL-17A has been extensively studied in various types of cancer, nonmelanoma skin cancer (NMSC) has not received much attention. Therefore, the present study was aimed to investigate the serum levels of IL-17A in NMSC patients. Methods. This cross-sectional study was performed on 60 patients with basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) as well as 57 age-sex matched healthy individuals as control group. Measurement of IL-17A serum levels in both case and control groups was performed by a commercially reliable sandwich enzyme-linked immunosorbent assay (ELISA) kit. Results. In this study, we observed that IL-17A serum levels in NMSC patients were significantly higher than the control groupP<0.001. Also, both BCC and SCC patients had higher levels of IL-17A in their sera in comparison to the controls (P=0.001andP<0.001, respectively). However, there was no significant difference between SCC and BCC patients regarding serum levels of IL-17A. Conclusion. According to our results, it can be concluded that IL-17A may play a role in inducing the growth and progression of NMSC and it can be used as a therapeutic target in these patients in future.