bluuebunny/crossref_metadata_2025 huggingface dataset:
Optical and Structural Properties of 2D ZnO Nanosheets Synthesized Using Simple Chemical Solution Route
Authors: Afsana  , Bansal Sonia
Published: June 2023

In the present paper, two-dimensional (2D) Zinc oxide (ZnO) nanosheets were prepared through a simple, single-step chemical solution method followed by annealing treatment without any surfactant, template or catalyst. The prepared ZnO nanosheets were characterized for their structural and optical properties by different techniques such as XRD, SEM with EDS, RAMAN, FTIR, UV-Visible and photoluminescence (PL) spectroscopy. The X-ray diffraction (XRD) spectra display sharp and highly intense peaks corresponding to the (101) plane, confirming the wurtzite crystal structure of ZnO. Scanning electron microscopy (SEM) images confirm the sheet-like structure of ZnO nanosheets with a thickness of approximately 23 nm. The elemental composition has been estimated through the Energy dispersive spectroscopy (EDS) technique. The basic reaction mechanism is discussed in detail. The stretching vibrations of Zn and O bonding were observed from FTIR spectra. The optical properties and optical bandgap have been obtained by UV-Visible and PL spectroscopy. The optical bandgap of ZnO is 3.20 eV from UV-Visible spectroscopy via Tauc’s plot. PL measurement confirming oxygen deficiency in ZnO nanosheets. These results of prepared ZnO nanosheets are expected to perform well in various applications such as photodetectors, sensors and in optoelectronic devices.
Effect of Au Doping on ZnO Nanoporous Structure for H2S Gas Sensing
Authors: Hsiao Yu-Jen , Huang Pei-Xuan , Tang I-Tseng , Wang Na-Fu
Published: June 2023

This research mainly constitutes the fabrication of semiconductor gas sensors using high Power pulse magnetron sputtering (HiPIMS) technology to deposit ZnO thin films. As a doping substance, different thicknesses of gold plating is deposited on the surface of ZnO thin films. Various thicknesses of gold used in the study are 3.3 nm, 6.6 nm, 10 nm, 13.3 nm and 16.6 nm. The structural properties of thin films were identified by X-ray- diffraction (XRD), scanning electron microscope (SEM) and energy dispersive X-ray spectroscopy (EDS). EDS analysis conveyed that gold particles filled the pores of nanoporous ZnO structures, which increased the films surface area and enhancing the gas sensing response. Various concentrations of H2S gas is used to test the gas sensing properties and the results proved the Au doped ZnO thin film sensor has enhanced sensing than the pure ZnO thin film sensor. 10 nm thickness doped Au has prime sensing properties with the operating temperature of 300 °C. Other sensing properties such as repeatability, selectivity and effect of humidity are tested and presented the data which shows the Au doping ZnO superiority over pure ZnO thin films.
Green Synthesis of Blue Light-Emitting Carbon Dots Using Tridax procumbens Leaves: Optical and Electrochemical Studies
Authors: Muthamil Selvan S. , Vijai Anand K. , Magesh Vasanth , Sundramoorthy Ashok K. , Vinitha G. , Khosla Ajit , Govindaraju K.
Published: June 2023

We report the preparation of biocompatible blue emitting carbon dots (CDs) using Tridax procumbens (T. procumbens) leaf extract as a bio-source. A one-step hydrothermal method was employed to prepare highly effective photoluminescent CDs. As-synthesized CDs were characterized using Ultraviolet-visible spectroscopy (UV-visible), Photoluminescence (PL), Fourier transform infrared (FT-IR), transmission electron microscopy (TEM) and Confocal Raman spectroscopy techniques. In addition, the third-order optical nonlinearity of the prepared CDs was carried out using Z-scan technique with the help of continuous wave diode pumped Nd:YAG laser (532 nm). The nonlinear optical (NLO) susceptibility, nonlinear absorption coefficient and nonlinear refractive index were calculated. The synthesized CDs exhibited good excitation dependent properties. The CDs/Nafion modified glassy carbon electrode (CDs/Nf/GCE) was prepared and its electrochemical and catalytic properties were evaluated by using cyclic voltammetry (CV). The CDs/Nf/GCE exhibited high electrocatalytic activity for dopamine oxidation in physiological condition. This new CDs/Nf/GCE showed a linear range of Dopamine (DA) detection from 40 to 220 μM with the limit of detection (LOD) of 2.7 μM. The stability and reproducibility of the electrode were also investigated which indicated that this green synthesized CDs could be used for the development of electrochemical sensor to determine DA concentration in biological samples.
Polyoxometalate Archetype-Boosted Stability and Charge Storage of 2D Graphene Nanosheets
Authors: Musa Ahammad , Islam Md. Mahinur , Bin Hasan Susan Md. Abu , Islam Md. Mominul
Published: June 2023

In this study, the potential of impregnation of phosphotungstic acid (PTA), a polyoxometalate in enhancing specific capacitance (C
sp) and diminishing the well-known restacking phenomenon of graphene nanosheets was explored. Graphene nanosheets were prepared chemically from graphite powder through the formation of graphene oxide (GO) and then the subsequent reduction of GO to the reduced GO (rGO). Impregnation of PTA in rGO-PTA (rGP) composites was carried out by simply dispersing rGO and PTA derived from tungstic acid. Scanning electron microscopy, X-ray diffraction analysis, UV–vis reflectance spectroscopy, and Fourier-transform infrared spectroscopy were used to analyze the elemental composition, microstates, and morphology of the composites. The charge-storing capacity and stability of the prepared rGP composites casted on a graphite electrode were examined with cyclic voltammetric, chronopotentiometric, and electrochemical impedance techniques. The effect of ions on the charging capacity of the electrodes was verified using electrolytes with different ion sizes. About 100% enhancement of C
sp of rGO with 87% capacitance retention for 2000 charging-discharging cycles was achieved by impregnating rGP composites with only 1% PTA.
Exploring the relationship between epigenetic DNA methylation and cardiac fibrosis through Raman microspectroscopy
Authors: Becker Lucas , Montes-Mojarro Ivonne A. , Layland Shannon Lee , Nsair Ali , Fend Falko , Marzi Julia , Schenke-Layland Katja
Published: June 2023

Cardiomyopathies are associated with severe fibrotic remodeling of the heart, which is characterized by the excessive accumulation of collagen type I (COL I). In this study, we used marker-independent Raman microspectroscopy (RMS) to gain a deeper understanding of the disease’s underlying molecular and cellular mechanisms.
The life and times of cellular senescence in skeletal muscle: friend or foe for homeostasis and adaptation?
Authors: Dungan Cory M. , Wells Jaden M. , Murach Kevin A.
Published: June 2023

There is evidence to suggest that senescent “zombie” cells may or may not accrue in aging skeletal muscle. When muscle is perturbed regardless of age, senescent-like cells do appear, and the benefits of removing them could be age-dependent. More work is needed to determine the magnitude of accumulation and source of senescent cells in muscle. Regardless, pharmacological senolytic treatment of aged muscle is beneficial for adaptation.
Optimization of Syngas Quality for Fischer-Tropsch Synthesis
Authors: Rabah Ali A.
Published: June 2023

While fossil oil reserves have been receding, the demand for diesel and gasoline has been growing. In recent years, syngas of biomass origin has been emerging as a viable feedstock for Fischer-Tropsch (FT) synthesis, a process for manufacturing synthetic gasoline and diesel. This paper reports the optimization of syngas quality to match the FT synthesis requirement. The optimization model maximizes the thermal efficiency under the constraint of

H

2

/
C
O
≥
2.15

and operating conditions of equivalent ratio (

E
R
=
0.0

-1.0), steam to biomass ratio (

S
B
=
0.0

-5.0), and gasification temperature (

T

g

=
500

°C-1300°C). The optimization model is executed using the optimization section of the Model Analysis Tools of the Aspen Plus simulator. The model is tested using eleven (11) types of municipal solid waste (MSW). The optimum operating conditions under which the objective function and the constraint are satisfied are

E
R
=
0

,

S
B
=
0.66

-1.22, and

T

g

=
679

-763°C. Under optimal operating conditions, the syngas quality is

H

2

=
52.38

-58.67 mole percent, lower heating value

L
H
V

=
12.55

-17.15 MJ/kg, and

N

2

=
0.38

-2.33 mole percent. From an economic point of view, 12.98% to 33.12% of biomass is used as fuel for steam generation, drying, and pyrolysis. The generalized optimization model reported could be extended to any other type of biomass and coal.
High Mortality of Wild European Rabbits during a Natural Outbreak of Rabbit Haemorrhagic Disease GI.2 Revealed by a Capture-Mark-Recapture Study
Authors: Jiménez-Ruiz Saúl , Rafael Marta , Coelho Joana , Pacheco Henrique , Fernandes Manuel , Alves Paulo Célio , Santos Nuno
Published: June 2023

Rabbit haemorrhagic disease virus (RHDV) GI.2 has caused significant declines in the abundance of wild European rabbits (Oryctolagus cuniculus), contributing to the species being recently classified as “endangered” in its native range. The epidemiology of this virus is still poorly understood despite its relevance for domestic and wild rabbits. During a longitudinal capture-mark-recapture (CMR) study of wild Iberian rabbits, O. c. algirus, in a semiextensive breeding enclosure, an outbreak of RHDV GI.2 took place in January-February 2022, allowing us to estimate key epidemiological parameters of a natural outbreak. From April 2021 to July 2022, 340 rabbits were captured 466 times and individually identified, and some were vaccinated against myxoma virus (MYXV) and/or RHDV GI.2. Sera were collected and tested for IgG specific for MYXV and RHDV GI.2, and data were analyzed using multievent CMR models. During six weeks in January-February 2022, an estimated 81.0% (CI95 77.1–84.3%) of the population died. Intensive aboveground searches could recover 189 carcasses (50.5% of the estimated mortality, CI95 41.8–63.4%), with RHDV GI.2 detected in 6/7 tested. Apparent RHDV GI.2 seroprevalence rose from 15.4% (CI95 8.0–27.5%) in January 2022 to 87.9% (CI95 72.7–95.2%) in February 2022. The apparent mortality of RHDV GI.2-seropositive rabbits during the outbreak was estimated as null, while for seronegative rabbits, it was 76.0% (CI95 53.8–90.3%). Among the seronegative rabbits, mortality was higher in unvaccinated (100%) than in recently vaccinated (60.0 ± 16.6%) and in females (100%) than in males (52.0 ± 17.1%). Infected carcasses in the burrows might explain the medium-term disease persistence in the population following the outbreak. Rabbits with antibodies at the cutoff for seropositivity were fully protected from fatal infection. Females had a higher fatality rate than males, underscoring the impact of RHDV GI.2 on the population dynamics of this endangered species.
Plasmapheresis for Fulminant Wilson’s Disease Improves Mental Status and Coagulopathy
Authors: Glover Quarshie , Rose William Nicholas
Published: June 2023

Wilson’s disease is a rare genetic condition that affects copper metabolism, resulting in tissue copper accumulation and resultant organ damage. We report a case of a young woman who presents with Wilson’s disease complicated by hemolysis, impaired hepatic function, coagulopathy, and acute kidney injury. She was treated with plasmapheresis as a bridge to a liver transplant. Her mental state, renal function, and bilirubin level improved after starting plasmapheresis. She successfully underwent a liver transplant and remained stable post-liver transplant. We share our experience on the use of plasmapheresis in treating Wilson’s disease.
Towards an Improved Taxonomy of Attacks Related to Digital Identities and Identity Management Systems
Authors: Pöhn Daniela , Hommel Wolfgang
Published: June 2023

Digital transformation with the adoption of cloud technologies, outsourcing, and working-from-home possibilities permits flexibility for organizations and persons. At the same time, it makes it more difficult to secure the IT infrastructure as the IT team needs to keep track of who is accessing what data from where and when on which device. With these changes, identity management as a key element of security becomes more important. Identity management relates to the technologies and policies for the identification, authentication, and authorization of users (humans and devices) in computer networks. Due to the diversity of identity management (i.e., models, protocols, and implementations), different requirements, problems, and attack vectors need to be taken into account. In order to secure identity management systems with their identities, a systematic approach is required. In this article, we propose the improved framework Taxonomy for Identity Management related to Attacks (TaxIdMA). The purpose of TaxIdMA is to classify existing attacks, attack vectors, and vulnerabilities associated with system identities, identity management systems, and end-user identities. In addition, the background of these attacks can be described in a structured and systematic way. The taxonomy is applied to the Internet of Things and self-sovereign identities. It is enhanced by a description language for threat intelligence sharing. Last but not least, TaxIdMA is evaluated and improved based on expert interviews, statistics, and discussions. This step enables broader applicability and level of detail at the same time. The combination of TaxIdMA, which allows a structured way to outline attacks and is applicable to different scenarios, and a description language for threat intelligence helps to improve the security identity management systems and processes.
Hashimoto Thyroiditis beyond Cytology: A Correlation between Cytological, Hormonal, Serological, and Radiological Findings
Authors: Almahari Sayed Ali , Maki Reem , Al Teraifi Noor , Alshaikh Safa , Chandran Nisha , Taha Husain
Published: June 2023

Introduction. Hashimoto thyroiditis is the most common cause of chronic inflammation of the thyroid gland. Ultrasound is the modality for detection, while fine needle aspiration is the gold standard method for diagnosis. Serologic markers, such as antithyroidal peroxidase antibody (TPO) and antithyroglobulin antibody (TG), are usually elevated. Aim. The main objective is to appraise the incidence of neoplasms on a background of Hashimoto thyroiditis. Our second objective is to recognize the different sonographic appearances of Hashimoto thyroiditis, to focus on its nodular and focal patterns, and to measure the sensitivity of the ACR TIRAD system (2017) when interpreted on patients with Hashimoto thyroiditis. Methods. A single-center retrospective cross-sectional study. We studied 137 cases diagnosed cytologically as Hashimoto thyroiditis from January 2013–December 2019. The data collected were analyzed using SPSS (26th edition), and ultrasounds were reviewed by a single board-certified radiologist. The ACR thyroid imaging and Data System 2017 (ACR TI-RADs 2017) and the Bethesda System for reporting thyroid cytology 2017 (BSRTC 2017) were used for reporting ultrasound and cytology, respectively. Results. The mean age was 44.66 years and the female : male was 9 : 1. Serologically, anti-Tg was high in 22 cases (38%), while anti-TPO was positive in all of the 60 cases studied. Histologically, 11 cases were diagnosed with papillary thyroid carcinoma (8%) and a single case with follicular adenoma (0.7%). Ultrasonographically, 50% of the cases showed diffuse pattern, in which 13% of them showed micronodules. 32.2% were macronodular, and 17.7% were a focal nodular pattern. 45 nodules were interpreted with the ACR TIRAD system (2017), in which 22.2% were TR2, 26.6% were TR3, 17.7% were TR4, and 33.3% were TR5. Conclusion. Hashimoto thyroiditis is a risk factor for developing thyroid neoplasms, which necessitate a proper assessment of the cytological material studied and a correlation with the clinical and radiological features. Recognizing the different types of Hashimoto thyroiditis and its variable appearances is significantly important in performing and interpreting thyroid ultrasound imaging. Microcalcification is the most sensitive parameter to discriminate between PTC and nodular type of Hashimoto thyroiditis. The TIRAD system (2017) is a useful tool for risk stratification; however, it might create unnecessary FNA studies in the setting of Hashimoto thyroiditis because of its variable appearances on ultrasound. A modified TIRAD system for patients with Hashimoto thyroiditis is important to alleviate this confusion. Finally, anti-TPO is a sensitive marker for detecting Hashimoto thyroiditis, which could be used for future referencing of newly diagnosed cases.
Optimizing PV Power Output with Higher-Voltage Modules: A Comparative Analysis with Traditional MPPT Methods
Authors: Devi P. Rathi , Sivakumar P. , Prasad P. Arokiya
Published: June 2023

Summary. The dynamically rising demand for electricity must be satiated by both conventional and unconventional power sources. PV electricity generation is essential. The installed PV sources are not used to their full potential due to low irradiance and poor weather. The goal of many research publications was to maximize PV power using different MPPT approaches. In order to extract the most power under the aforementioned circumstances, this study introduces a novel notion of using a voltage boosting PV panels. Additional PV panels are used in the suggested way to provide enough voltage and current. Using a voltage-boosting PV panel, a 20 kW panel is examined for low irradiance and unfavorable weather conditions. In a proposed method, results are compared with the previous INC MPPT method using a 20-kW panel. Through the power analysis, the proposed method extracted 1277.5 kW of power per year that is more than the INC MPPT method, and Rs. 10,220 per year was benefited during low irradiation alone. The power extraction and cost benefits are similar in cloudy and misty conditions. With power, cost, and efficiency analyses, the new method is contrasted with the traditional incremental conductance method and perturb and observe methods. Simulations were run using the MATLAB/Simulink programme, and experimental results were assessed using the appropriate hardware setup.
Mesenchymal-like Tumor Cells and Myofibroblastic Cancer-Associated Fibroblasts Are Associated with Progression and Immunotherapy Response of Clear Cell Renal Cell Carcinoma
Authors: Davidson Guillaume , Helleux Alexandra , Vano Yann A. , Lindner Véronique , Fattori Antonin , Cerciat Marie , Elaidi Reza T. , Verkarre Virginie , Sun Cheng-Ming , Chevreau Christine , Bennamoun Mostefa , Lang Hervé , Tricard Thibault , Fridman Wolf H. , Sautes-Fridman Catherine , Su Xiaoping , Plassard Damien , Keime Celine , Thibault-Carpentier Christelle , Barthelemy Philippe , Oudard Stéphane M. , Davidson Irwin , Malouf Gabriel G.
Published: June 2023

Immune checkpoint inhibitors (ICI) represent the cornerstone for the treatment of patients with metastatic clear cell renal cell carcinoma (ccRCC). Despite a favorable response for a subset of patients, others experience primary progressive disease, highlighting the need to precisely understand the plasticity of cancer cells and their cross-talk with the microenvironment to better predict therapeutic response and personalize treatment. Single-cell RNA sequencing of ccRCC at different disease stages and normal adjacent tissue (NAT) from patients identified 46 cell populations, including 5 tumor subpopulations, characterized by distinct transcriptional signatures representing an epithelial-to-mesenchymal transition gradient and a novel inflamed state. Deconvolution of the tumor and microenvironment signatures in public data sets and data from the BIONIKK clinical trial (NCT02960906) revealed a strong correlation between mesenchymal-like ccRCC cells and myofibroblastic cancer-associated fibroblasts (myCAF), which are both enriched in metastases and correlate with poor patient survival. Spatial transcriptomics and multiplex immune staining uncovered the spatial proximity of mesenchymal-like ccRCC cells and myCAFs at the tumor–NAT interface. Moreover, enrichment in myCAFs was associated with primary resistance to ICI therapy in the BIONIKK clinical trial. These data highlight the epithelial–mesenchymal plasticity of ccRCC cancer cells and their relationship with myCAFs, a critical component of the microenvironment associated with poor outcome and ICI resistance.

Significance:

Single-cell and spatial transcriptomics reveal the proximity of mesenchymal tumor cells to myofibroblastic cancer-associated fibroblasts and their association with disease outcome and immune checkpoint inhibitor response in clear cell renal cell carcinoma.
Gastric Metastasis 5 Years after Primary Invasive Lobular Adenocarcinoma of the Breast
Authors: Shin Dongmin , Sun Haozhe , Mantri Nikhitha , Patel Harish
Published: June 2023

Breast cancers metastasize most commonly to the bone, brain, liver, and lungs, but rarely to the gastrointestinal tract. Although metastatic breast carcinomas in the stomach can be confused with primary gastric cancers due to their nonspecific presentation and rare incidence, it is important to differentiate the two since the treatment is different. Clinical suspicion is imperative for a prompt endoscopic evaluation and a definitive diagnosis that will lead to appropriate treatment. Therefore, it is important for clinicians to be aware of the possibility of gastric metastasis of breast cancers, especially in those with a history of invasive lobular breast carcinoma and a new onset of gastrointestinal symptoms.
Optimal Meropenem Dosing Regimens in Patients Undergoing Continuous Renal Replacement Therapy: Systematic Review and Monte Carlo Simulations
Authors: Charoensareerat Taniya , Chaijamorn Weerachai , Kerdnimith Pathakorn , Kosumwisaisakul Nutsinee , Teeranaew Piyakamol , Rungkitwattanakul Dhakrit , Boonpeng Apinya , Srisawat Nattachai , Pattharachayakul Sutthiporn
Published: June 2023

Introduction: The optimal meropenem dosing regimens in critically ill patients receiving continuous renal replacement therapy (CRRT) based on pharmacokinetic and pharmacodynamic (PD) concepts are not well established. This study aimed to (1) gather the available published pharmacokinetic studies conducted in septic patients receiving CRRT and (2) to define the optimal meropenem dosing regimens in these populations via Monte Carlo simulations. Methods: We used Medical Subject Headings “meropenem,” “continuous renal replacement therapy,” and “pharmacokinetics” or related terms to identify studies for systematic review. A one-compartment pharmacokinetic model was conducted to predict meropenem levels for the initial 48 h of therapy. The PD targets were 40% of free drug above a threshold of 1 times the minimum inhibitory concentration (MIC) (40% fT > MIC), 4 times the MIC (40% fT > 4MIC), and an additional target of free drug level above 1 times MIC 100% of the time (fT > MIC). The dose that achieved at least 90% of the probability of target attainment (PTA) was defined as an optimal dose. Results: Twenty-one articles were included for our systematic review. The necessary pharmacokinetic parameters such as volume of distribution and CRRT clearance were cited in 90.5 and 71.4% of articles, respectively. None of the published studies reported completed necessary parameters. A regimen of 750 mg q 8 h was found to be the optimal dose for pre-dilution continuous venovenous hemofiltration and continuous venovenous hemodialysis modality using two effluent rates (25 and 35 mL/kg/h) which achieved the PD target of 40% fT > 4MIC. Conclusion: None of the published studies showed the necessary pharmacokinetic parameters. PD target significantly contributed to meropenem dosage regimens in these patients. Differing effluent rates and types of CRRT shared similar dosing regimens. Clinical validation of the recommendation is suggested.
Endobronchial Valve Treatment Does Not Cause Significant Nickel Deposition in Lung Tissue
Authors: Roodenburg Sharyn A. , Pouwels Simon D. , Klooster Karin , Touw Daan J. , Slebos Dirk-Jan
Published: June 2023

Bronchoscopic lung volume reduction using endobronchial valves (EBVs) is a treatment option for patients with severe emphysema. These EBVs are made out of a nitinol mesh covered by a silicone layer. Nitinol is an alloy of nickel and titanium and is commonly used in implantable medical devices because of its biocompatibility and memory-shape properties. However, there are some concerns that nickel ions can be released from nitinol-containing devices which might cause adverse health effects, especially in patients with a known nickel hypersensitivity. In vitro, it was found that EBV release significant amounts of nickel in the first hours. Our aim was to assess the nickel concentration in lung tissue from a patient who previously underwent EBV treatment but, due to treatment failure, underwent lung volume reduction surgery and to compare this to a reference sample. We found no significant difference in the median nickel concentration between the EBV-treated patient and the non-EBV-treated patient (0.270 vs. 0.328 μg/g, respectively, p = 0.693) and these concentrations were also comparable to previously published nickel concentrations in human lung tissue samples not having any medically implanted devices in the lung. Our results suggest that there is no significant long-term nickel deposition in lung tissue after EBV treatment.
Right Hepatic and Portal Vein Embolization before Right Hepatectomy for Colorectal Cancer Liver Metastases
Authors: Montalvo-Javé Eduardo E. , Ayala-Moreno Edwin A. , Rossano García Alejandro , Diaz Girón Gidi Alejandro , Guerrero Ixtlahuac Jorge
Published: June 2023

Colon cancer has had a significant increase in its incidence in recent years. Many of the cases are diagnosed late; it is not unusual that a large number of cases present metastatic disease at the time of diagnosis, and the liver is the main organ where these lesions occur. Surgical approach to this condition has undergone many advances which have allowed a better approach to them. Local techniques such as embolization have gained momentum in recent years and are a great help to the surgical planning. We present the case of a 72-year-old female patient diagnosed with colorectal cancer and metastatic disease. Multiple liver tumors were demonstrated by imaging studies. A staged resection of the primary tumor and the metastatic hepatic tumors was planned. It was decided to perform an embolization of the hepatic artery to cause hypertrophy of the left lobe before the second stage of the surgical approach with good clinical and laboratorial findings after the surgery. Follow-up with adjuvant chemotherapy, imaging studies and tumor markers is planned. Several publications state that surgical approach of metastatic disease is still controversial and that decisions should be made under the context of each patient. Many techniques have shown good results; embolization of the hepatic tumors has a good outcome in the survival rate in selected patients. Hepatic volume and future liver remnant should be always assessed with imaging studies. Each case has to be individualized for the approach of the metastatic disease, always in a coordinated teamwork for maximum benefit of the patient.
Loss of MD1 Promotes Inflammatory and Apoptotic Atrial Remodelling in Diabetic Cardiomyopathy by Activating the TLR4/NF-κB Signalling Pathway
Authors: Shi Tonghuan , Wang Guangji , Peng Jianye , Chen Manhua
Published: June 2023

Introduction: Myeloid differentiation protein 1 (MD1), a negative regulator of toll-like receptor 4 (TLR4), is widely expressed in the heart. Recent studies have shown that MD1 plays an important role in cardiac remodelling. However, the effects and potential mechanisms underlying MD1-mediated atrial remodelling in diabetic cardiomyopathy (DCM) remain unclear. Therefore, this study was designed to explore the role of MD1 in DCM-related atrial remodelling. Methods: MD1 knockout (MD1-KO) mice and wild-type (WT) littermates were injected with streptozotocin (STZ) to establish a diabetic mouse model. These mice were then used to evaluate MD1 expression and its effects on atrial remodelling in vivo. Results: MD1 expression was significantly decreased in STZ-induced diabetic mice. The loss of MD1 aggravated atrial fibrosis, inflammation, and apoptosis in DCM mice and promoted atrial remodelling. MD1-KO diabetic mice also showed higher susceptibility to atrial fibrillation (AF) and worse cardiac function. Mechanistically, the deletion of MD1 promoted the activation of the TLR4/NF-κB signalling pathway, resulting in atrial remodelling in DCM mice via increased p65 phosphorylation. Conclusions: The deletion of MD1 plays an important role in inflammatory and apoptotic atrial remodelling and increases susceptibility to AF in DCM mice, providing a new target for the preventive treatment of DCM-related atrial remodelling.
Melatonin Regulates lncRNA NEAT1/miR-138-5p/HIF-1α Axis through MOV10 to Affect Acid-Related Esophageal Epithelial Cell Pyroptosis
Authors: Su Xin , Li Wenjie , Zhang Danping , Zhu Hong
Published: June 2023

Introduction: Acid-related inflammatory damage to the esophageal epithelium is a key component in the development of gastroesophageal reflux disease. Melatonin (MT) is considered as a potential therapeutic agent, but its molecular mechanism is unknown. Methods: The expression of HIF-1α and pyroptosis-related genes (NLRP3, caspase-1, IL-1β, and IL-18) was analyzed using bioinformatics methods in GSE63401 and validated using quantitative real-time polymerase chain reaction and Western blot in an HEEC inflammation model induced by deoxycholic acid (DCA). Hoechst 33342/PI double staining was used to assess the level of pyroptosis, and the effect of MT treatment was observed. The miRDB, TarBase, miRcode, miRNet, and ENCORI databases were used to predict the long non-coding RNA (lncRNA) targeting HIF-1α and the RNA-binding protein interacting with the lncRNA. Results: The expressions of Moloney leukemia virus 10 (MOV10), lncRNA NEAT1, HIF-1α, and pyroptosis-related genes were upregulated, while the expression of miR-138-5p was downregulated in acidic DCA-induced HEEC inflammation. MOV10 may bind to lncRNA NEAT1 and stabilize its expression, while lncRNA NEAT1 upregulates the expression of HIF-1α by adsorbing miR-138-5p to activate the NLRP3 inflammasome. However, MT pretreatment can significantly inhibit these processes. Conclusions: MOV10-lncRNA NEAT1/miR-138-5p/HIF-1α/NLRP3 axis plays a crucial role in acid-related esophageal epithelial inflammatory injury, and MT may exert an esophageal protective effect by inhibiting the pathway.
MRI-Induced Neurosensory Events in Decorative Black Tattoos: Study by Advanced Experimental Methods
Authors: Alsing Kasper Køhler , Olsen Ole , Koch Christian Bender , Hansen Rasmus Hvass , Persson Daniel Pergament , Qvortrup Klaus , Serup Jørgen
Published: June 2023

Adverse reactions in tattooed skin during magnetic resonance imaging (MRI) are rare but well known. Previous reports describe sudden burning pain in tattooed skin, sometimes accompanied by mild erythema and oedema when entering MRI scanners. The pathophysiology remains unclear, but simple direct thermal heating can be excluded. It has been hypothesized that MRI-triggered torque and traction create neural sensations from magnetic pigment particles. However, this case enlightens yet another possible mechanism. We present a 35-year-old woman experiencing reoccurring stinging sensations in three decorative black tattoos just seconds after the initiation of the MRI. Single-blind tests with handheld power magnets or a dummy could reproduce painful subjective feelings in her tattooed skin. Similar events were provoked during re-evaluation with MRI. Surprisingly, chemical analyses and electron microscopy of skin samples revealed carbon black as the colouring agent – no iron-based solids were detected. Our case demonstrates that MRI tattoo reactions are not limited to magnetic contaminants alone. More distinct subgroups of MRI-induced reactions may occur. We hypothesize that radiofrequency induction of surface currents in black carbon particles adjacent to sensory axons in the dermis may lead to neurosensations.
A Narrative Review of the Rationale for Conducting Neonatal Emergency Studies with a Waived or Deferred Consent Approach
Authors: Katheria Anup , Schmölzer Georg M. , Janvier Annie , Kapadia Vishal , Saugstad Ola D. , Vento Maximo , Kushnir Alla , Tracy Mark , Rich Wade , Oei Ju Lee
Published: June 2023

Emergency research studies are high-stakes studies that are usually performed on the sickest patients, where many patients or guardians have no opportunity to provide full informed consent prior to participation. Many emergency studies self-select healthier patients who can be informed ahead of time about the study process. Unfortunately, results from such participants may not be informative for the future care of sicker patients. This inevitably creates waste and perpetuates uninformed care and continued harm to future patients. The waiver or deferred consent process is an alternative model that may be used to enroll sick patients who are unable to give prospective consent to participate in a study. However, this process generates vastly different stakeholder views which have the potential to create irreversible impediments to research and knowledge. In studies involving newborn infants, consent must be sought from a parent or guardian, and this adds another layer of complexity to already fraught situations if the infant is very sick. In this manuscript, we discuss reasons why consent waiver or deferred consent processes are vital for some types of neonatal research, especially those occurring at and around the time of birth. We provide a framework for conducting neonatal emergency research under consent waiver that will ensure the patient’s best interests without compromising ethical, beneficial, and informative knowledge acquisition to improve the future care of sick newborn infants.
Complete Response of Rare Sarcomatoid Upper Tract Urothelial Carcinoma Variant: Case Report and Literature Review
Authors: Warli Syah Mirsya , Laksmi Lidya Imelda , Lubis Nova Sabrina , Wijaya William Saputra
Published: June 2023

Infiltrating urothelial carcinoma sarcomatoid variant is a rare variant of urothelial carcinoma. We report a case of a 68-year-old female with a history of hematuria. CT scan with contrast showed a mass in the 1/3 distal of the right ureter. The biopsy result showed a high-grade infiltrating urothelial carcinoma. A radical nephroureterectomy was performed but at the follow-up after 3 months, there was a recurrent mass and gemcitabine-cisplatin chemotherapy was given. Since a high-grade infiltrating urothelial carcinoma sarcomatoid variant was an aggressive tumor, we need to give more attention to evaluating this tumor.
Patient Characteristics to Consider When Selecting an Inhaler for the Treatment of Chronic Obstructive Pulmonary Disease and Available Assessment Methods: A Narrative Review
Authors: Renaud Yann , Suter Philipp , Grandmaison Gael
Published: June 2023

Inhaler misuse is common among patients with chronic obstructive pulmonary disease and associated with poor disease control. Many patient characteristics are reported to impact inhaler use, but there are no studies in the literature on the best way to evaluate them. This narrative review aims to identify patient characteristics that influence the correct use of an inhaler and describe the tools available for their assessment. First, we searched four different databases to identify reviews describing patient characteristics reported to impact inhaler use. In a second step, ways to characterize these aspects were searched using the same databases. Fifteen patient characteristics impacting on the use of inhalers were identified. Peak inspiratory flow, dexterity, and cognitive impairment were the most studied characteristics and appeared to have the highest impact on the correct use of inhalers. Notably, peak inspiratory flow can be reliably assessed in clinical practice using the In-Check Dial®. Triggering coordination, breath retention, collaboration/consciousness, and muscle strength in the fingers were important characteristics, but insufficient data exist to recommend the use of a specific tool for their assessment in daily practice. Other identified characteristics have a more uncertain impact. A demonstration of inhalation technique by the patient, combined with the measurement of peak inspiratory flow using the In-Check Dial®, appears to be an effective strategy to assess the characteristics with the highest impact on the correct use of an inhaler. In the future, “smart” inhalers could also play a decisive role in this area.
Differentiating between Laryngopharyngeal Dysesthesia and Hypersensitivity Reactions to Oxaliplatin and Addressing Dyspnea: 2 Case Reports
Authors: Kawaguchi Fumitaka , Aoyama Takeshi , Tsuneki Takafumi , Kaneko Kentaro , Kawamura Ryoichiro , Sato Hiroki , Kobayashi Michiko
Published: June 2023

Oxaliplatin is a key drug for colorectal cancer and causes peripheral neuropathy. Oxaliplatin-induced laryngopharyngeal dysesthesia is an acute peripheral neuropathy similar to a hypersensitivity reaction. Hypersensitivity reactions to oxaliplatin do not require immediate discontinuation, but re-challenge and desensitization therapy can be very burdensome for patients. We encountered 2 cases in which laryngopharyngeal dysesthesia could be differentiated from hypersensitivity reactions to oxaliplatin, and treatment could continue. The first case was that of a 58-year-old woman who developed dyspnea during the first course of combination therapy with capecitabine and oxaliplatin as the primary treatment for advanced rectal cancer. After laryngopharyngeal dysesthesia was differentiated from hypersensitivity reaction based on these typical symptoms, she was considered to have grade 3 (Common Terminology Criteria for Adverse Events [CTCAE] ver. 5) laryngopharyngeal dysesthesia. The second course of oxaliplatin was extended from 2 to 4 h, but symptoms recurred. The third course was performed with a reduced dose of oxaliplatin from 130 mg/m2 to 100 mg/m2, and the patient could complete the treatment without symptom recurrence. The second case involved a 76-year-old woman who developed grade 3 laryngopharyngeal dysesthesia during the first course of combination therapy with capecitabine and oxaliplatin as the primary treatment for localized colon cancer. Based on the experience of the first case, we reduced the oxaliplatin dose from 130 mg/m2 to 100 mg/m2 for the second course, and the patient completed the treatment without symptoms. This dose reduction was effective for grade 3 laryngopharyngeal dysesthesia caused by oxaliplatin without reducing therapeutic efficacy.
The Role of Blood Purification by HA330 as Adjunctive Treatment in Children with Septic Shock
Authors: Siripanadorn Tatiya , Samransamruajkit Rujipat
Published: June 2023

Introduction: Despite advances in supportive care for critically ill patients, sepsis remains an important cause of death worldwide in the PICU. One of the hallmarks of sepsis is hyperinflammation due to the excessive release of inflammatory mediators. Recently, new therapeutic approaches, such as immune modulation and blood purification, have been tried to improve outcomes in patients with septic shock. Methods: This study is a prospective observational study composed of children with septic shock and the PELOD-2 score ≥10 or the PRISM-3 score ≥15. All received 2–4 h of HA330 treatment on 2 consecutive days, used as adjunctive therapy. The effectiveness of HA330 hemoperfusion was evaluated by improving the PELOD-2 and PRISM-3 scores, the vasoactive inotropic score (VIS), and inflammatory markers from baseline to 72 h after the use of HA330 hemoperfusion. Results: Twelve patients hospitalized in the PICU and diagnosed with septic shock between July 2021 and May 2022 were included in this study and received hemoperfusion with HA330. The average PELOD-2 and PRISM-3 scores decreased significantly from 9.5 (IQR: 6.5–13.0) at baseline to 2.0 (IQR: 0–6.5) at 72 h (p = 0.002) and from 16.5 (IQR: 15.0–20.5) at baseline to 5.5 (IQR: 2.0–9.5) at 72 h (p = 0.002), respectively. The VIS decreased significantly from baseline to 72 h (p = 0.003). IL-6, procalcitonin, and lactate levels also decreased significantly from baseline to 72 h (p = 0.005, 0.03, and 0.03, respectively). Two of 12 patients expired due to their underlying condition (2/12, 16.7%). Device-related adverse events did not occur in this study. Conclusions: Our observational case series suggests a possible role for HA330 hemoperfusion as an adjunctive treatment of refractory septic shock in children with high severity scores in the context of rapid improvement in organ dysfunction, without serious adverse effects.
Big Data in Transfusion Medicine and Artificial Intelligence Analysis for Red Blood Cell Quality Control
Authors: Lopes Marcelle G.M. , Recktenwald Steffen M. , Simionato Greta , Eichler Hermann , Wagner Christian , Quint Stephan , Kaestner Lars
Published: June 2023

Background: “Artificial intelligence” and “big data” increasingly take the step from just being interesting concepts to being relevant or even part of our lives. This general statement holds also true for transfusion medicine. Besides all advancements in transfusion medicine, there is not yet an established red blood cell quality measure, which is generally applied. Summary: We highlight the usefulness of big data in transfusion medicine. Furthermore, we emphasize in the example of quality control of red blood cell units the application of artificial intelligence. Key Messages: A variety of concepts making use of big data and artificial intelligence are readily available but still await to be implemented into any clinical routine. For the quality control of red blood cell units, clinical validation is still required.
Chronic Myeloid Leukemia following Exposure to Radioactive Iodine (I131): A Systematic Review
Authors: Ali Hailan Yousef Mohammed , Al-Dubai Husam Nabil , Yassin Mohamed A.
Published: June 2023

Background: Therapy-related leukemia is a term that describes the occurrence of leukemia following exposure to hematotoxins and radiation to emphasize the difference from leukemia that arises de novo. Many agents and host factors contribute to this entity of leukemias. Therapy-related acute myeloid leukemia has an extensive literature review in contrast to therapy-related chronic myeloid leukemia (t-CML). Radioactive iodine (RAI), an established agent in the management of differentiated thyroid carcinomas, has raised concern due to its possible carcinogenic effects. Summary: In this article, we reviewed all the reports from the 1960s to date related to t-CML following RAI on Google Scholar and PubMed. We have identified 14 reports and found that most reports were for men under the age of 60 years with primary papillary thyroid carcinoma and mixed follicular-papillary thyroid carcinoma who developed t-CML mainly between 4 and 7 years after exposure to varying doses of I131. However, the mean dose was 287.78 millicuries (mCi). It was reported that a statistically significant increase in leukemia following RAI therapy (relative risk of 2.5 for I131 vs. no I131). Also, there was a linear relationship between the cumulative dose of I131 and the risk of leukemia. Doses higher than 100 mCi were associated with a greater risk of developing secondary leukemia, and most of the leukemias developed within the initial 10 years of exposure. The precise mechanism through which RAI provokes leukemia is largely unclear. A few mechanisms have been proposed. Key Messages: Although the risk for t-CML appears to be low based on current reports and does not represent a contraindication to RAI therapy, it should not be disregarded. We suggest including it in the risk-benefit discussion before initiating this therapy. Long-term follow-up for patients is advisable for those who received doses over 100 mCi with a complete blood count, possibly yearly, for the first 10 years. The new onset of significant leukocytosis post RAI exposure should raise the suspicion for t-CML. Further studies are needed to establish or refute a causal relationship.
The Importance of Symptom Reduction for Functional Improvement after Cognitive Behavioral Therapy for Anxiety and Depression: A Causal Mediation Analysis
Authors: Smith Otto R.F. , Aarø Leif E. , Knapstad Marit
Published: June 2023

Introduction: The temporal relationship between symptoms and functioning in the context of cognitive behavioral therapy (CBT) for anxiety and depression is not fully understood, and there are few high-quality studies that have examined to what extent late intervention effects of CBT on functioning are mediated by initial intervention effects on symptoms while accounting for the initial effects on functioning and vice versa. Objective: The aim of the study was to investigate whether intervention effects on symptoms and functioning at 12-month follow-up were mediated by intervention effects on these outcomes at 6-month follow-up. Methods: Participants with anxiety and/or mild-to-moderate depression were randomly assigned to a primary mental health care service (n = 463) or treatment-as-usual (n = 215). Main outcomes were depressive symptoms (Patient Health Questionnaire [PHQ-9]), anxiety (General Anxiety Disorder-7 [GAD-7]), and functioning (Work and Social Adjustment Scale [WSAS]). Direct/indirect effects were derived using the potential outcomes and counterfactual framework. Results: The intervention effect on functioning at 12 months was largely explained by intervention effects at 6 months on depressive symptoms (51%) and functioning (39%). The intervention effect on depressive symptoms at 12 months was largely explained by the intervention effect at 6 months on depressive symptoms (70%) but not by functioning at 6 months. The intervention effect on anxiety at 12 months was only partly accounted for by intervention effects at 6 months on anxiety (29%) and functioning (10%). Conclusions: The findings suggest that late intervention effects of CBT on functioning were to a substantial degree explained by initial intervention effects on depressive symptoms even after accounting for initial effects on functioning. Our results support the importance of symptoms as an outcome in the context of CBT delivered in primary health care.
Complete Response to Enfortumab Vedotin in a Hemodialysis Patient with Metastatic Urothelial Carcinoma: A Case Report
Authors: Isoda Bunpei , Shiga Masanobu , Kandori Shuya , Nagumo Yoshiyuki , Yoshino Takayuki , Ikeda Atsushi , Kawahara Takashi , Kimura Tomokazu , Negoro Hiromitsu , Hoshi Akio , Mathis Bryan J , Nishiyama Hiroyuki
Published: June 2023

Enfortumab vedotin (EV) is an antibody-drug conjugate and a promising agent for metastatic urothelial carcinoma (mUC). However, evaluations in end-stage renal disease patients undergoing hemodialysis are unreported. Here, we report such a case. A 74-year-old woman with mUC, on hemodialysis for complete urinary tract extirpation, was diagnosed with multiple pulmonary metastases after treatment with gemcitabine-carboplatin followed by pembrolizumab. As third-line therapy, she received a standard dose of EV. She achieved complete response after 2 cycles without grade 3 or higher adverse events, demonstrating the utility of EV in this setting.