bluuebunny/crossref_metadata_2025 huggingface dataset:
Exosome inspired photo-triggered gelation hydrogel composite on modulating immune pathogenesis for treating rheumatoid arthritis
Authors: Rui Ke , Tang Xiaoxuan , Shen Ziwei , Jiang Chao , Zhu Qiugang , Liu Shiyi , Che Nan , Tian Jie , Ling Jue , Yang Yumin
Published: March 2023

Although exosome therapy has been recognized as a promising strategy in the treatment of rheumatoid arthritis (RA), sustained modulation on RA specific pathogenesis and desirable protective effects for attenuating joint destruction still remain challenges. Here, silk fibroin hydrogel encapsulated with olfactory ecto-mesenchymal stem cell-derived exosomes (Exos@SFMA) was photo-crosslinked in situ to yield long-lasting therapeutic effect on modulating the immune microenvironment in RA. This in situ hydrogel system exhibited flexible mechanical properties and excellent biocompatibility for protecting tissue surfaces in joint. Moreover, the promising PD-L1 expression was identified on the exosomes, which potently suppressed Tfh cell polarization via inhibiting the PI3K/AKT pathway. Importantly, Exos@SFMA effectively relieved synovial inflammation and joint destruction by significantly reducing T follicular helper (Tfh) cell response and further suppressing the differentiation of germinal center (GC) B cells into plasma cells. Taken together, this exosome enhanced silk fibroin hydrogel provides an effective strategy for the treatment of RA and other autoimmune diseases.
Safety and feasibility of laparoscopic resection of abdominal neuroblastoma without image-defined risk factors: a single-center experience
Authors: Chang Saishuo , Lin Yu , Yang Shen , Yang Wei , Cheng Haiyan , Chang Xiaofeng , Zhu Zhiyun , Feng Jun , Han Jianyu , Ren Qinghua , Wang Huanmin , Qin Hong
Published: March 2023

Objective

To explore the criteria, safety and efficacy of laparoscopic surgery in pediatric neuroblastoma (NB).

Methods

A retrospective study of 87 patients with NB without image-defined risk factors (IDRFs) between December 2016 and January 2021 at Beijing Children’s Hospital was conducted. Patients were divided into two groups according to the surgical procedure.

Results

Between the 87 patients, there were 54 (62.07%) cases in the open surgery group and 33 (37.93%) cases in the laparoscopic surgery group. There were no significant differences between the two groups regarding demographic characteristics, genomic and biological features, operating time or postoperative complications. However, in terms of intraoperative bleeding (p = 0.013) and the time to start postoperative feeding after surgery (p = 0.002), the laparoscopic group was obviously better than the open group. Furthermore, there was no significant difference in the prognosis between the two groups, and no recurrence or death was observed.

Conclusion

For children with localized NB who have no IDRFs, laparoscopic surgery could be performed safely and effectively. Surgeons who are skilled in this can help children reduce surgical injuries, speed up postoperative recovery, and obtain the same prognosis as open surgery.
Immunohistochemical visualization of lymphatic vessels in human dura mater: methodological perspectives
Authors: Vera Quesada César Luis , Rao Shreyas Balachandra , Torp Reidun , Eide Per Kristian
Published: March 2023

Background

Despite greatly renewed interest concerning meningeal lymphatic function over recent years, the lymphatic structures of human dura mater have been less characterized. The available information derives exclusively from autopsy specimens. This study addressed methodological aspects of immunohistochemistry for visualization and characterization of lymphatic vessels in the dura of patients.

Methods

Dura biopsies were obtained from the right frontal region of the patients with idiopathic normal pressure hydrocephalus (iNPH) who underwent shunt surgery as part of treatment. The dura specimens were prepared using three different methods: Paraformaldehyde (PFA) 4% (Method #1), paraformaldehyde (PFA) 0.5% (Method #2), and freeze-fixation (Method #3). They were further examined with immunohistochemistry using the lymphatic cell marker lymphatic vessel endothelial hyaluronan receptor 1 (LYVE-1), and as validation marker we used podoplanin (PDPN).

Results

The study included 30 iNPH patients who underwent shunt surgery. The dura specimens were obtained average 16.1 ± 4.5 mm lateral to the superior sagittal sinus in the right frontal region (about 12 cm posterior to glabella). While lymphatic structures were seen in 0/7 patients using Method #1, it was found in 4/6 subjects (67%) with Method #2, while in 16/17 subjects (94%) using Method #3. To this end, we characterized three types of meningeal lymphatic vessels: (1) Lymphatic vessels in intimate contact with blood vessels. (2) Lymphatic vessels without nearby blood vessels. (3) Clusters of LYVE-1-expressing cells interspersed with blood vessels. In general, highest density of lymphatic vessels were observed towards the arachnoid membrane rather than towards the skull.

Conclusions

The visualization of meningeal lymphatic vessels in humans seems to be highly sensitive to the tissue processing method. Our observations disclosed most abundant lymphatic vessels towards the arachnoid membrane, and were seen either in close association with blood vessels or remote from blood vessels.
Morphology analysis of the C2 pediculoisthmic component and feasibility of safe C2 pedicle screw placement: comparison of multiplanar reconstruction versus traditional radiographic methods
Authors: Wu YueLin , Liang ZhaoQuan , Bao JunHao , Wen Ling , Zhang Li
Published: March 2023

Background

Preoperatively evaluating the feasibility of safe C2 pedicle screw placement is the key to avoiding iatrogenic vertebral artery injury. However, it has not been verified whether the conventional CT measurements of C2 pediculoisthmic component (PIC) are reliable and accurate, and the results may lack validity. The purpose of this study is to analyze the evaluative performance of conventional CT measurements and to create an accurate predictor of morphometrics of C2 PIC.

Methods

A total of 304 C2 PICs were measured in 152 consecutive patients who underwent CT examination of the cervical spine between April 2020 and December 2020. We obtained the morphometric parameters of C2 PIC by measuring minimum PIC diameter (MPD) in CT multiplanar reconstruction versus conventional measurements of transverse PIC width (TPW), oblique PIC width (OPW) and definition of high-riding vertebral artery (HRVA). The outer diameter measured less than 4 mm in MPD was regarded as the standard of precluding safe C2 pedicle screw insertion. The evaluative performance of the conventional CT measurements was assessed, and the correlation between conventional CT measurements and measurements in CT multiplanar reconstruction was calculated.

Results

The parameters in OPW and MPD were measured significantly larger than those in TPW, and the preclusion of C2 pedicle screw placement evaluated from TPW and HRVA was significantly higher than that evaluated from OPW and MPD. The sensitivity of TPW was 93.09%, and the specificity was 79.31%. The sensitivity and specificity of OPW were 97.82% and 82.76%. The sensitivity of HRVA was 88.36%, and the specificity was 96.55%. Strong agreement with the highest correlation coefficient (0.879) and determination coefficient (0.7720) suggested that the outer diameter of OPW could be useful for the precise prediction of MPD.

Conclusions

CT MPR allows accurate measurement of the narrowest section of the C2 PIC. The outer diameter of OPW could be simply measured and be useful for precise prediction of MPD, which makes C2 pedicle screw placement more safely than the conventional measurement of TPW and HRVA.
Management of pulmonary aspergillosis in children: a systematic review
Authors: Terlizzi Vito , Motisi Marco Antonio , Pellegrino Roberta , Galli Luisa , Taccetti Giovanni , Chiappini Elena
Published: March 2023

Invasive pulmonary aspergillosis (IPA) is a severe condition in immunocompromised children, but the optimal management is still under debate. In order to better clarify this issue, a literature search was performed through MEDLINE/PubMed database to describe current risk factors and diagnostic, therapeutic and prophylactic tools for invasive pulmonary aspergillosis (IPA) in the paediatric age. Observational studies and clinical trials regarding diagnosis, treatment and prophylaxis were considered, and results were summarised. Five clinical trials and 25 observational studies (4453 patients) were included.

Haematological malignancies, previous organ transplant and other primary or acquired immunodeficiency were identified as risk factors for IPA in children.

Current diagnostic criteria distinguish between "proven", "probable" and "possible" disease. Consecutive galactomannan assays have good sensitivity and specificity, especially when performed on broncho-alveolar lavage. At the same time, β-D-glucan should not be used since cut-off in children is unclear. PCR assays cannot currently be recommended for routine use.

Voriconazole is the recommended first-line agent for IPA in children older than 2 years of age. Liposomal amphotericin B is preferred in younger patients or cases of intolerance to voriconazole. Its plasma concentrations should be monitored throughout the treatment. The optimal duration of therapy has yet to be determined. Posaconazole is the preferred prophylactic agent in children older than 13 years old, whereas oral voriconazole or itraconazole are the drugs of choice for those between 2–12 years. Further good-quality studies are warranted to improve clinical practice.
Unusual papillary thyroid carcinoma with hyalinizing trabecular tumor-like feature in a young female patient: a case report
Authors: Umekita Yoshiko , Umeki Kazumi , Kawano Fumiaki , Tanaka Hiroyuki , Kataoka Hiroaki
Published: March 2023

Background

Hyalinizing trabecular tumor is a rare follicular cell-derived thyroid neoplasm that is considered to be a borderline tumor with malignant potential rather than a benign tumor. The detection of RET/PTC rearrangements and nuclear cytologic features suggests a relationship between hyalinizing trabecular tumor and papillary thyroid carcinoma. Some recent observations of pathogenic genetic alterations in hyalinizing trabecular tumor have indicated that hyalinizing trabecular tumor is not related to papillary thyroid carcinoma, and should be considered an independent entity. Here we present a case of papillary thyroid carcinoma with hyalinizing trabecular tumor-like features and discuss its interesting aspects and diagnostic issues from a histopathological perspective.

Case presentation

A 19-year-old Japanese woman with an enlarged thyroid gland was admitted to our hospital. Based on fine-needle aspiration cytology, the enlarged nodule was suspected to be a follicular lesion or follicular tumor. A nodular lesion approximately 3 cm in diameter was detected in the left lobe of the thyroid gland. Histological analysis revealed that the tumor cells were mainly arranged in follicles. Solid nests with occasional trabecular arrangements and papillary structures were intermingled, and the tumor cells showed ground-glass nuclei and occasional nuclear grooving. Petaloid and block-like periodic-acid-Schiff and periodic-acid-methenamine-positive basement membrane components were observed in the interstitium of the solid portions of the tumor. Incomplete membranous immunoreactivity of MIB-1 (Ki-67 (cell prolferation marker)) was also observed in the cells within the solid areas. Moreover, this tumor displayed extracapsular invasion and metastasis to the perithyroidal lymph nodes, suggesting that it may be a malignant tumor. However, BRAFV600E mutation, RET/PTC rearrangements, and PAX8/GLIS 1 and PAX8/GLIS 3 rearrangements were not detected.

Conclusion

We diagnosed the tumor as a papillary thyroid carcinoma with characteristic features of hyalinizing trabecular tumor. Importantly, this case may indicate a possible relationship between papillary thyroid carcinoma and hyalinizing trabecular tumor, although specific genetic alterations could not be detected. We also discuss the preoperative diagnostic difficulties with fine-needle aspiration cytology and the unusual pathological findings in this case.
The outcome of acute kidney injury substages based on urinary cystatin C in critically ill children
Authors: Chen Jiao , Jiang Zhen , Huang Hui , Li Min , Bai Zhenjiang , Kuai Yuxian , Wei Lin , Liu Ning , Li Xiaozhong , Lu Guoping , Li Yanhong
Published: March 2023

Background

The concept of acute kidney injury (AKI) substages has been recommended to better phenotype AKI and identify high-risk patient groups and therefore improve the diagnostic accuracy of AKI. However, there remains a gap between the recommendation and the clinical application. The study aimed to explore the incidence of AKI substages based on a sensitive AKI biomarker of urinary cystatin C (uCysC), and to determine whether AKI substages were relevant with respect to outcome in critically ill children.

Results

The multicenter cohort study enrolled 793 children in pediatric intensive care unit (PICU) of four tertiary hospitals in China. Children were classified as non-AKI, sub-AKI and AKI substages A and B according to uCysC level at PICU admission. Sub-AKI was defined by admission uCysC level ≥ 1.26 mg/g uCr in children not meeting the KDIGO criteria of AKI. In children who fulfilled KDIGO criteria, those with uCysC < 1.26 was defined as AKI substage A, and with ≥ 1.26 defined as AKI substage B. The associations of AKI substages with 30-day PICU mortality were assessed. 15.6% (124/793) of patients met the definition of sub-AKI. Of 180 (22.7%) patients with AKI, 90 (50%) had uCysC-positive AKI substage B and were more likely to have classical AKI stage 3, compared to substage A. Compared to non-AKI, sub-AKI and AKI substages A and B were risk factors significantly associated with mortality, and the association of sub-AKI (adjusted hazard ratio HR = 2.42) and AKI substage B (adjusted HR = 2.83) with mortality remained significant after adjustment for confounders. Moreover, AKI substage B had increased risks of death as compared with sub-AKI (HR = 3.10) and AKI substage A (HR = 3.19).

Conclusions

Sub-AKI defined/based on uCysC occurred in 20.2% of patients without AKI and was associated with a risk of death close to patients with AKI substage A. Urinary CysC-positive AKI substage B occurred in 50% of AKI patients and was more likely to have classical AKI stage 3 and was associated with the highest risk of mortality.
A convolutional neural network based online teaching method using edge-cloud computing platform
Authors: Zhong Liu
Published: March 2023

Teaching has become a complex essential tool for students’ abilities, due to their different levels of learning and understanding. In the traditional offline teaching methods, dance teachers lack a target for students ‘classroom teaching. Furthermore, teachers have limited time, so they cannot take full care of each student’s learning needs according to their understanding and learning ability, which leads to the polarization of the learning effect. Because of this, this paper proposes an online teaching method based on Artificial Intelligence and edge calculation. In the first phase, standard teaching and student-recorded dance learning videos are conducted through the key frames extraction through a deep convolutional neural network. In the second phase, the extracted key frame images were then extracted for human key points using grid coding, and the fully convolutional neural network was used to predict the human posture. The guidance vector is used to correct the dance movements to achieve the purpose of online learning. The CNN model is distributed into two parts so that the training occurs at the cloud and prediction happens at the edge server. Moreover, the questionnaire was used to obtain the students’ learning status, understand their difficulties in dance learning, and record the corresponding dance teaching videos to make up for their weak links. Finally, the edge-cloud computing platform is used to help the training model learn quickly form vast amount of collected data. Our experiments show that the cloud-edge platform helps to support new teaching forms, enhance the platform’s overall application performance and intelligence level, and improve the online learning experience. The application of this paper can help dance students to achieve efficient learning.
Community data-driven approach to identify pathogenic founder variants for pan-ethnic carrier screening panels
Authors: Einhorn Yaron , Einhorn Moshe , Kurolap Alina , Steinberg Dror , Mory Adi , Bazak Lily , Paperna Tamar , Grinshpun-Cohen Julia , Basel-Salmon Lina , Weiss Karin , Singer Amihood , Yaron Yuval , Baris Feldman Hagit
Published: March 2023

Background

The American College of Medical Genetics and Genomics (ACMG) recently published new tier-based carrier screening recommendations. While many pan-ethnic genetic disorders are well established, some genes carry pathogenic founder variants (PFVs) that are unique to specific ethnic groups. We aimed to demonstrate a community data-driven approach to creating a pan-ethnic carrier screening panel that meets the ACMG recommendations.

Methods

Exome sequencing data from 3061 Israeli individuals were analyzed. Machine learning determined ancestries. Frequencies of candidate pathogenic/likely pathogenic (P/LP) variants based on ClinVar and Franklin were calculated for each subpopulation based on the Franklin community platform and compared with existing screening panels. Candidate PFVs were manually curated through community members and the literature.

Results

The samples were automatically assigned to 13 ancestries. The largest number of samples was classified as Ashkenazi Jewish (n = 1011), followed by Muslim Arabs (n = 613). We detected one tier-2 and seven tier-3 variants that were not included in existing carrier screening panels for Ashkenazi Jewish or Muslim Arab ancestries. Five of these P/LP variants were supported by evidence from the Franklin community. Twenty additional variants were detected that are potentially pathogenic tier-2 or tier-3.

Conclusions

The community data-driven and sharing approaches facilitate generating inclusive and equitable ethnically based carrier screening panels. This approach identified new PFVs missing from currently available panels and highlighted variants that may require reclassification.
Correlates of post-partum intra-uterine copper-T devices (PPIUCD) acceptance and retention: an observational study from North India
Authors: Gupta Sneha , Bansal Romi , Shergill Harbhajan Kaur , Sharma Pradeep , Garg Priyanka
Published: March 2023

Background

Postpartum intrauterine contraceptives device (PPIUCD) offers an effective means of providing contraceptive services to women in countries with high rates of unmet needs for family planning services. However, scientific literature estimating the long-term retention rates is scarce. We estimate the factors affecting acceptance and retention of PPIUCD and explore the risk factors against PPIUCD Discontinuation at six months”.

Material and method

: This prospective observational study was conducted between 2018 and 20 at a tertiary care institute in North India. PPIUCD was inserted following a detailed counseling session and consent. The women were followed up for six months. Bivariate analysis was done to depict the association between socio-demographic characteristics and acceptance. Logistic regression, cox regression, and Kaplan Meier analysis were applied to explore factors affecting acceptance and retention of PPIUCD.

Results

Of the 300 women counseled for PPIUCD, 60% accepted them. The majority of these women were between 25 and 30 years (40.6%), primigravida (61.7%), educated (86.1%), and from urban areas (61.7%). Retention rates at six months were about 65.6%, while 13.9% and 5.6% were either removed or expelled. Women declined PPIUCD due to refusal by spouses, partial knowledge, inclination towards other methods, non-willingness, religious beliefs, and fear of pain and heavy bleeding. Adjusted logistic regression depicted that higher education, housewife status, lower-middle and richest SES, Hinduism, and counseling in early pregnancy promoted acceptance of PPIUCD. The most common reasons for removal were AUB, infection, and family pressure (23.1%). Adjusted hazard ratio depicted religion other than Hinduism, counseling in late stages of pregnancy, and normal vaginal delivery were significant predictors for early removal or expulsion. While education, higher socio-economic status favoured retention.

Conclusion

PPIUCD is a safe, highly effective, low-cost, long-acting, and feasible method of contraception. Skill enhancement of healthcare personnel for insertion techniques, adequate antenatal counseling, and advocacy of PPIUCD can help increase the acceptance of PPIUCD.
Evaluation of a stakeholder advisory board for an adolescent mental health randomized clinical trial
Authors: Hoke Alicia M. , Rosen Perri , Pileggi Francesca , Molinari Alissa , Sekhar Deepa L.
Published: March 2023

Introduction

Community engagement in research is widely accepted as best practice, despite gaps in existing frameworks to evaluate its process, context, and impact on research. The Screening in High Schools to Identify, Evaluate, and Lower Depression (SHIELD) study evaluated the use of a school-based major depressive disorder screening tool in the identification of symptoms and treatment initiation among adolescents, and was developed, implemented, and disseminated in partnership with a Stakeholder Advisory Board (SAB). We summarize outcomes of the evaluation strategy applied through our partnership with the SAB and explore gaps in the available engagement evaluation tools for mixed stakeholder populations including youth.

Methods

SHIELD study SAB members (n = 13; adolescents, parents, mental health and primary care providers, and professionals from education and mental health organizations) advised on study design, implementation, and dissemination over a three-year period. Both SAB members and study team members (i.e., clinician researchers, project managers) were invited to quantitatively and qualitatively evaluate stakeholder engagement after each project year. At the conclusion of the study, SAB members and study team members were asked to evaluate the application of engagement principles in overall stakeholder engagement across the study period, using portions of the Research Engagement Survey Tool (REST).

Results

SAB members and study team members responded similarly when evaluating engagement process (i.e., valued on team, voice represented); means ranged from 3.9 to 4.8 out of 5 points across all three project years. Reported engagement within study-specific engagement activities (i.e., meetings, study newsletter) varied from year to year, with some discrepancy between SAB member and study team evaluations. Using REST, SAB members reported the alignment of their experience with key engagement principles the same or higher than study team members. Qualitative feedback at the conclusion of the study generally matched quantitative measures; adolescent SAB members, however, reported disengagement from stakeholder activities that was not accurately or effectively captured in evaluation strategies employed across the study period.

Conclusions

Challenges exist in effectively engaging stakeholders and evaluating their engagement, particularly among heterogenous groups that include youth. Evaluation gaps should be addressed through the development of validated instruments that quantify the process, context, and impact of stakeholder engagement on study outcomes. Consideration should be given to collecting parallel feedback from stakeholders and study team members to fully understand the application and execution of engagement strategy.
Biological control of the small leafhopper, Empoasca flavescens F. (Homoptera: Cicadellidae) using the entomopathogenic fungus, Verticillium lecanii
Authors: Yun Kum Song , Hyon Jong Ho , Kim Hyang Suk , Jang Song Hun
Published: March 2023

Background

Nowadays, instead of chemicals, using microbial pesticides is very important and significant to protect the environment. Verticillium lecanii (Z), the entomopathogenic fungus, is widely used for management of many pests. The aim of this work is to determine whether the small leafhopper, Empoasca flavescens F. (Homoptera: Cicadellidae), can be exterminated only by biopesticide—V. lecanii or not.

Results

After spraying with diluted suspension of V. lecanii spores on the small leafhopper, E. flavescens, the effects of infection and reinfection in accordance with the time, spore density and growth stage of the small leafhoppers were studied. When E. flavescens was sprayed with over 1.25 × 108 spores/ml of diluted suspension of fungal spores indoors, the reduction % was over 80% after 5 days and the decrease of imagoes was higher than that of larvae. Outdoors, E. flavescens was reduced by 50% for 3 years after treatment, while the reduction % was about 90% by reinfection year by year.

Conclusion

Ninety percentages of E. flavescens on peach trees can be effectively exterminated in 2 years by spraying the diluted suspension of V. lecanii spore, and no chemical pesticides are needed for the control of E. flavescens in practice.
Neurodegeneration with brain iron accumulation: a differential diagnosis of cerebral palsy
Authors: Ferreira de Andrade Alana , dos Santos Guimarães Grace Kelly , Ferreira da Silva João , Moura de Sousa Bruno Manuel , Honorato Marcos Manoel , de Carvalho Cremaschi Renata Maria , Santos Coelho Fernando Morgadinho
Published: March 2023

Background

Brain iron accumulation neurodegeneration (NBIA) comprises a group of rare diseases characterized by deposits of this metal in brain structures. It presents a great variability of progression, which can be fast enough to lead the patient to death in the first years of life, or slow enough to be confused with non-progressive diseases.

Case presentation

Female, 19-year-old patient, cesarean delivery at 38 weeks of gestation. History of multiple sclerosis in a second-degree paternal aunt. Normal neuropsychomotor growth and development up to 11 months, when changes in gait began. After that, it got worse, with decreased muscle strength and falls, but it progressed so slowly that she was diagnosed with cerebral palsy, a non-progressive condition. At the age of 16, she underwent molecular analysis by exome sequencing, being diagnosed with the NBIA Phospholipase A2 (PLAN) variant. Currently doing physical therapy, hydrotherapy, occupational therapy and sertraline.

Conclusions

The report draws attention to the variability of the disease and the possibility of confusion with other diagnoses, which may delay proper management.
Effect of transcranial direct current stimulation in combination with robotic therapy in upper limb impairments in people with stroke: a systematic review
Authors: Rizvi Asna , Parveen Sarah , Bazigha Farah , Noohu Majumi M.
Published: March 2023

Background

Stroke is a devastating condition, which not only affects patients’ activity, but also is a primary reason for the psychosocial impact on them, their caregivers, and the healthcare system. Transcranial direct current stimulation (tDCS) modulates cortical activity, encouraging neuro-modulation and motor recovery in stroke rehabilitation. Robotic therapy (RT) provides repetitive, high-intensity, interactive, task-specific intervention and can measure changes while providing feedback to people with stroke.

Objectives

This study aimed to evaluate and summarize the scientific literature systematically to investigate the combined effect of tDCS and RT in patients with stroke.

Methods

Four databases (MEDLINE, Web of Science, ScienceDirect, & PEDro) were searched for clinical trials investigating the effect of RT and tDCS in stroke patients with upper limb impairment. PEDro scale was used for the quality assessment of included studies.

Results

The search yielded 208 articles. A total of 213 patients with stroke who had upper limb impairment were studied. In the majority of the trials, RT combined with tDCS lead to positive improvement in various measures of upper limb function and spasticity.

Conclusions

RT along with tDCS is an effective mode of rehabilitation, although no additional effects of tDCS plus RT in comparison with RT alone were reported. Large, robust studies are needed, so that health care providers and researchers can make better decisions about merging tDCS and RT in stroke rehabilitation settings in the future.
A digital twin of a local energy system based on real smart meter data
Authors: Bayer Daniel , Pruckner Marco
Published: March 2023

The steadily increasing usage of smart meters generates a valuable amount of high-resolution data about the individual energy consumption and production of local energy systems. Private households install more and more photovoltaic systems, battery storage and big consumers like heat pumps. Thus, our vision is to augment these collected smart meter time series of a complete system (e.g., a city, town or complex institutions like airports) with simulatively added previously named components. We, therefore, propose a novel digital twin of such an energy system based solely on a complete set of smart meter data including additional building data. Based on the additional geospatial data, the twin is intended to represent the addition of the abovementioned components as realistically as possible. Outputs of the twin can be used as a decision support for either system operators where to strengthen the system or for individual households where and how to install photovoltaic systems and batteries. Meanwhile, the first local energy system operators had such smart meter data of almost all residential consumers for several years. We acquire those of an exemplary operator and discuss a case study presenting some features of our digital twin and highlighting the value of the combination of smart meter and geospatial data.
Mucinous tumors arising from ovarian teratomas as another source of pseudomyxoma peritoneii: MR findings comparison with ovarian metastases from appendiceal mucinous tumors
Authors: Tanaka Yumiko Oishi , Sugawara Emiko , Tonooka Akiko , Saida Tsukasa , Sakata Akiko , Fukunaga Yosuke , Kanao Hiroyuki , Satoh Toyomi , Noguchi Masayuki , Terauchi Takashi
Published: March 2023

Objective:

The origin of pseudomyxoma peritoneii (PMP) has been established as low-grade appendiceal mucinous tumors (AMT). However, intestinal-type ovarian mucinous tumors are known as another source of PMP. Recently, it is advocated that ovarian mucinous tumors causing PMP originates from teratomas. However, AMTs are often too small to detect on imaging; then, differentiating metastatic ovarian tumors of AMT from ovarian teratoma-associated mucinous tumors (OTAMT) is important. Therefore, this study investigates the MR characteristics of OTAMT compared to the ovarian metastasis of AMT.

Methods:

MR findings of six pathologically confirmed OTAMT were retrospectively analyzed compared to ovarian metastases of low-grade appendiceal mucinous neoplasms (LAMN). We studied the existence of PMP, uni- or bilateral disease, the maximum diameter of ovarian masses, the number of loculi, a variety of sizes and signal intensity of each content, the existence of the solid part, fat, calcification within the mass, and appendiceal diameters. All the findings were statistically analyzed using the Mann–Whitney test.

Results:

Four of the six OTAMT showed PMP. OTAMT showed unilateral disease, had a larger diameter, more frequent intratumoral fat, smaller appendiceal diameter than those in AMT, and they were statistically significant (p < .05). On the other hand, the number, variety of size, signal intensity of loculi, and the solid part, calcification within the mass did not differ from each other.

Conclusion:

Both OTAMT and ovarian metastasis of AMT appeared as multilocular cystic masses with relatively uniform signal and size of loculi. However, a larger unilateral disease with intratumoral fat and smaller size of the appendix may suggest OTAMT.

Advances in knowledge:

OTAMT can be another source of PMP, as AMT. MR characteristics of OTAMT were very similar to ovarian metastases of AMT; however, in cases with PMP combined with fat-containing multilocular cystic ovarian mass, we can diagnose them as OTAMT, not PMP caused by AMT.
Relationship between IDH1/2 and TERT promoter mutation and the prognosis of human glioma patients
Authors: Liu Xiping , Liu Ming , Cao Bing , Qiao Jianxin , Zhang Xiufeng
Published: March 2023

Objective: To investigate the relationship between isocitrate dehydrogenase (IDH) 1/2 mutation, telomerase reverse transcriptase (TERT) gene promoter mutation and the prognosis of human glioma patients.

Methods: One hundred fifteen patients with human glioma, treated surgically in The First Affiliated Hospital of Hebei North University from January 2019 to January 2020, were included. All patients were followed up until January 31, 2022. The mutations of IDH1/2 and TERT promoter were analyzed, and risk factors affecting survival of the patients with glioma were assessed.

Results: IDH1 gene mutation occurred in 82 cases, IDH2 gene mutation occurred in five cases and TERT promoter mutation occurred in 54 cases. Univariate analysis showed that tumor WHO grade, resection range, preoperative Karnofsky performance status score, postoperative radiotherapy and chemotherapy, IDH1/2 gene and TERT promoter mutation influenced postoperative survival of patients with glioma (P<0.05). Kaplan-Meier survival curve showed that IDH1/2 gene and TERT promoter mutation were significantly different from those of wild-type patients (P<0.05).

Conclusion: IDH1/2 gene and TERT promoter mutations are more frequent in patients with human glioma. These related factors can be used as molecular markers to aid in the prognosis of patients with glioma.

doi: https://doi.org/10.12669/pjms.39.3.7149

How to cite this: Liu X, Liu M, Cao B, Qiao J, Zhang X. Relationship between IDH1/2 and TERT promoter mutation and the prognosis of human glioma patients. Pak J Med Sci. 2023;39(3):843-847. doi: https://doi.org/10.12669/pjms.39.3.7149

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Efficacy and safety of surfactant administration by MIST and INSURE techniques in Neonates with Respiratory Distress Syndrome: A randomized controlled trial
Authors: Kaleem Ammara , Farah Haroon  , Bushra Fatima  , Gideon Victor  , Mazhar Qadir  , Khawaja Ahmed Irfan Waheed1
Published: March 2023

Objective: To measure the efficacy and safety of surfactant administered by MIST and INSURE to neonates with respiratory distress syndrome.

Methods: A randomized controlled trial was conducted from June 2021 to August 2022 at the NICU of the University of Child Health Sciences, Lahore. Neonates meeting inclusion criteria i.e with RDS who worsened on nasal Continuous positive airway pressure (nCPAP) (fiO2 30%, pressure 6cmH2O) were enrolled in the study in both interventional arms (MIST, n=36 and INSURE, n=36) using simple random sampling. Data was analysed using SPSS 25.

Results: The mean age of neonates in MIST was 1.27±0.40 days and 1.23±0.48 days in INSURE cohort. Neonates with MIST (n=8) required statistically significant reduced need for IMV than INSURE (n=17) technique (P-Value 0.047). This study could not achieve significant difference in duration of mechanical ventilation (1±1.67; 1.52±1.40 days, P=0.152) and duration of nCPAP (3.27±1.65;3.67±1.64 hrs, P=0.312) in MIST versus INSURE. The second dose of surfactant was administered in fewer cases in MIST (n=2) than INSURE (n=7) (P=0.075). Risk estimation, although not significant, determined less likelihood for the pulmonary haemorrhage (0.908 than 1.095), intraventricular hemorrhage (0.657 than 1.353), administration of the second dose of surfactant (0.412 than 1.690) and greater likelihood of discharge (1.082 than 0.270) at 95% confidence interval with MIST technique.

Conclusion: Surfactant therapy through MIST is effective and there is significantly reduced need of IMV than in INSURE. Safety profile though could not achieve statistical significance yet determines less risk of complications associated with MIST than INSURE.

doi: https://doi.org/10.12669/pjms.39.3.7283

How to cite this: Kaleem A, Haroon F, Fatima B, Victor G, Qadir M, Waheed KAI. Efficacy and safety of surfactant administration by MIST and INSURE techniques in Neonates with Respiratory Distress Syndrome: A randomized controlled trial. Pak J Med Sci. 2023;39(3):848-852.  doi: https://doi.org/10.12669/pjms.39.3.7283

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copy number variations and protein expression of Cyclin E1 and Epithelial cell transforming sequence 2 genes predict the chemotherapeutic response in patients with serous ovarian carcinoma
Authors: Sarfaraz Rahat , Masood Atika , Zaki Saima , Shami Amira , Khaliq Saba , Naseem Nadia
Published: March 2023

Background & Objectives: Serous ovarian carcinoma (SOC) is characterized by extreme genomic instability, chromosomal rearrangements and copy number variations (CNVs) leading to the development of early metastasis and chemo-resistance. The present study was designed to observe the role of CNVs of Cyclin E1 (CCNE1) and Epithelial cell transforming sequence- 2 (ECT2) genes and their encoded proteins in predicting the chemotherapeutic response in SOC patients.

Methods: This observational analytical study was conducted at University of Health Sciences, Lahore, Pakistan from December 2019 till June 2022.The study included twenty-five SOC patients with resectable ovarian tumors and twenty-five control subjects. The patients were followed-up for six months for their response to chemotherapy. The CNVs in CCNE1 and ECT-2 genes were determined by real time PCR while serum levels of encoded proteins were determined in controls and cases, before and after six months of treatment, through ELISA. The response to chemotherapy was categorized as sensitive or resistant based on serum CA-125 levels and radiological scans.

Results: The copy number variations in CCNE1 and ECT2 genes showed association with the clinic-pathological characteristics and chemotherapy response. Statistically significant difference was found between the mean pre-chemotherapy protein levels of CCNE1 in cases than controls (p-value <0.001) and between the mean pre and post-chemotherapy protein levels of CCNE1 and ECT2 (p-value <0.001) in SOC patients.

Conclusion: The copy number variations of CCNE1 and ECT2 genes and their protein expression are positively associated with chemotherapeutic response in SOC patients.

doi: https://doi.org/10.12669/pjms.39.3.7304

How to cite this: Sarfraz R, Masood A, Zaki S, Shami A, Khaliq S, Naseem N. Copy number variations and protein expression of Cyclin E1 and Epithelial cell transforming sequence 2 genes predict the chemotherapeutic response in patients with serous ovarian carcinoma. Pak J Med Sci. 2023;39(3):835-842. doi: https://doi.org/10.12669/pjms.39.3.7304

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Ausgrabungen am Basler Murus Gallicus / Teil 2
Authors: Ebersbach Renate
Published: March 2023

Mit einer vergleichenden Auswertung der Tierknochen aus der Alten Landvogtei in Riehen (BS) und aus dem «Hebammenhaus» in Kaisten (AG)
Die Publikation umfasst die Auswertung der Tierknochen aus der spätkeltisch-frührömischen Übergangszeit sowie aus den neuzeitlichen Horizonten der Grabungen von 1990–1993 im Bereich des Murus Gallicus auf dem Basler Münsterhügel. In einem Exkurs werden die neuzeitlichen Tierknochen aus der Alten Landvogtei in Riehen (BS) und aus dem «Hebammenhaus» in Kaisten (AG) mit den Fundensembles vom Basler Münsterhügel verglichen und in den weiteren Zusammenhang der Wirtschafts- und Sozialgeschichte der Region Basel gestellt.
Governance of adaptive platform trials
Authors: Singh Jerome Amir
Published: March 2023

Adaptive Clinical Trials (ACT) differ from conventional clinical trials because they permit continual modifications to key components of trial design during the trial. ACTs have grown in prevalence in recent years, with Adaptive Platform Trials (APTs), in particular, having demonstrated their significant scientific, clinical, and public health utility in relation to the COVID-19 pandemic. There has been a steady increase in the number of regulations and guidelines aimed at guiding the conduct of clinical trials. However, despite the potential of APTs to expedite the testing of new interventions in emergency situations, there is a relative dearth of published literature on why and how such trials should be governed. This work attempts to address this knowledge gap.
Validation of proteins associated with pathological damage in human tuberculosis granulomas: study protocol
Authors: Mpotje Thabo , More Jessica , Rajkumar-Bhugeloo Kerishka , Moodley Denelle , Marakalala Mohlopheni J
Published: March 2023

The presence of the Tuberculosis (TB) disease-causing pathogen, Mycobacterium Tuberculosis (Mtb), induces the development of a pathological feature termed granuloma, which the host uses to contain the bacteria. However, the granuloma may dissociate resulting in detrimental caseation of the lung. The disease contributes to a growing global burden of lung function challenges, warranting for more understanding of the TB-induced immunopathology. The current study aims to explore in detail host factors that drive pathological features of TB contributing to extensive lung tissue destruction. Lung tissue sections obtained from patients undergoing surgical resection will be processed and analyzed using histopathological assays including Immunohistochemistry, Immunofluorescence, Hematoxylin and Eosin staining and Laser Capture Microdissection. The findings will provide key host factors that associate with exacerbated lung immunopathology during TB.
Applicability of the Methods Used in Determining Income (Profi t, Proceeds) for Tax Purposes in Transactions with Related Parties
Authors: Arabyan Knarik
Published: March 2023

The article discusses the applicability of different methods that are used in determining income (profit, revenue) for tax purposes in transactions with related parties. The influence of functional analysis and risks on pricing in comparable transactions is investigated. Th e court case of joint-stock company Uralkali is analyzed from the perspective of the tax authorities.
On the Relationship Between the Theory of International Relations and Accounting Methodology
Authors: Mislavskaya N.
Published: March 2023

The article actualizes the importance of the methodology of accounting knowledge in the development of the state economy. The relationship and interdependence of the adoption of appropriate management decisions on the information generated within the framework of the national accounting system is shown. The question has been raised about the relevance of applying IFRS in the context of modern international relations. In this regard, the possibility of practical implementation of the fundamental qualitative characteristics of accounting (financial) statements, declared in IFRS, is considered. It is concluded that it is necessary to make changes to the methodology of the national accounting system and accounting (financial) statements, in order to increase the reliability of the financial and economic data provided by the accounting system.
Measurement of energy distribution for low power nanoflares
Authors: Bogachev Sergei , Erkhova Natalia
Published: March 2023

We propose a method to measure the energy distribution of low-energy flares (nanoflares) in the energy range below 1023 erg. As an example, we measured the spectrum of nanoflares in the 1021–1026 erg range for two Sun’s frames observed by the SDO/AIA telescope in the 171 Å channel. Nanoflares are shown to have the power law spectrum in the 1022–1026 erg range. The spectral index is approximately constant, i.e. energy-independent. For energies below 1022 erg, the spectrum begins to collapse. For lower energies, below 1021 erg, the method does not give statistically significant results due to major errors. The results of the study indicate that solar nanoflares can be detected up to 1021–1022 erg energies. Results have previously been reported only for 1023 erg and above. The total energy flux of nanoflares in the energy range above 1022 erg, according to our data, is P2104 erg cm–2 s–1, which is about 15 times less than heating losses of the solar corona.
A quiet day empirical model of electron density in the Indian equatorial F-region
Authors: Chamua Minakshi , Bhuyan Pradip , Bhuyan Kalyan
Published: March 2023

In this paper, we present a quiet day empirical model of electron density (Ne) for the Indian equatorial zone at an altitude of 500 km. The model is applicable to all levels of solar activity and is based on the observation that the electron density in the F-region of the Indian zone is correlated with the F10.7 cm solar flux at each local time and in every month. Using this characteristic, we describe the model for electron density. In this model, we have used the least square fit and the polynomial fit. The electron density measured by the Retarding Potential Analyzer (RPA) on board the SROSS C2 satellite from 1995 to 2000 and FORMOSAT-1 (ROCSAT-1) satellite, operated by the National Space Organization (NSPO, now the Taiwan Space Agency (TASA)) of the Republic of China (Taiwan), from 1999 to 2004 is used to derive the relationship between Ne and F10.7. The average altitudes of SROSS-C2 and FORMOSAT-1 are 500 km and 600 km respectively. Due to this height difference, the observed data obtained by FORMOSAT-1 is normalized to match the SROSS-C2 data. The model is compared with the observations and is found to be in good agreement with them. It is applicable to quiet (Ap<15) conditions and is limited to a fixed altitude of 500 km within the latitude range of 10° S to 10° N around the 75° E meridian.
Features of artificial ionosphere turbulence induced by the O- and X-mode HF heating near the F2-layer critical frequency
Authors: Borisova Tatiana , Blagoveshchenskaya Nataly , Kalishin Alexey
Published: March 2023

We present experimental results from the studies of large-scale inhomogeneities along the external magnetic field with increased electron density, electron temperature, and excitation of elongated plasma waves (Langmuir and ion-acoustic), induced by the ordinary (O-mode) and extraordinary (X-mode) HF heating near the F2-layer critical frequency, in the high-latitude ionospheric F-region. The experiments have been carried out at the EISCAT/Heating facility (Tromsø, Norway). Powerful HF radio waves radiated towards the magnetic zenith through a step change in the effective radiated power at frequencies fH near and below the F2-layer critical frequency fₒF2. The EISCAT incoherent scatter radar (930 MHz), co-located with the EISCAT/Heating facility, was utilized for diagnostics of ionospheric modification effects. We calculated the electric field of a powerful HF radio wave near the reflection altitude, taking into account the non-deflective absorption along the propagation path. We determined the conditions for electric field generation and its threshold (minimum) values required for electron density enhancements in a wide altitude range, excitation of Langmuir and ion-acoustic plasma waves under fH~fₒF2 and fH<fₒF2. The possible generation mechanisms for the electron density enhancements above the reflection altitude of the powerful HF radio wave of O- and X-polarization are discussed.