bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis and prediction of the efficacy and influencing factors of camrelizumab combined with TACE and sorafenib in the treatment of advanced hepatocellular carcinoma
Authors: Pan songsong , Zheng jiaxi , Shi changsheng
Published: May 2023

BackgroundTACE combined with targeted therapy is a method for the treatment of hepatocellular carcinoma. After adding Camrelizumab, some patients had gained benefits, but some patients have produced serious adverse reactions. Therefore, more studies are needed to prove the efficacy and adverse reactions, and prediction models are needed to help with decision-making.MethodsWith ethics committee approval, a bi-center retrospective study was finished. A total of 235 patients were enrolled and divided into the treatment group of camrelizumab combined with TACE and sorafenib and the treatment group of TACE and sorafenib. The survival rate, short-term efficacy and adverse reactions were compared, and the efficacy prediction model was established.ResultsThe 2-year survival time and objective response rate of the treatment group of camrelizumab combined with TACE plus sorafenib were higher than those of TACE plus sorafenib. Camrelizumab increased the proportion of reactive capillary proliferation, but had no effect on other adverse reactions. The established nomogram can accurately predict the response to the treatment.ConclusionsCamrelizumab combined with TACE and sorafenib can improve the survival rate of patients with hepatocellular carcinoma, and it is an effective treatment. The Nomogram model can predict the efficacy, which is beneficial for patients.
Enhancement of the Biological activity for Esterified polyethylene glycols by blending them with Sr –Co Nanoferrites
Authors: Adawy Ahmed , Ghoneim Amina , Abdeen Zizi
Published: May 2023

The poly (ethylene glycols) (PEG) were esterified with lauric acid or myristic acid, and their biological activities were improved by blending them with Sr0.25Co0.75Fe2O4 nanoparticles. The Sr0.25Co0.75Fe2O4 nanoparticles were prepared by the chemical co-precipitation method. These prepared polymeric surfactants were investigated using Fourier transformer infrared spectroscopy (FT-IR), Transmission Electron Microscope (TEM) and diffraction of Xray (XRD). Also, the surface tension was characterized at diverse temperatures for these compounds. In addition, the surface parameters as well as concentration of critical micelle (CMC), excess of maximum surface (Γmax), area of minimum surface (Amin), efficiency (Pc20) and effectiveness (πCMC) were measured and computed. It was assessed and assigned the biological activity of these designed surfactants through length of the field of the hindrance against different microorganisms. It was found as of the results, that these compounds have good surface properties and good biological activity by blending these prepared polymeric surfactants with Sr0.25Co0.75Fe2O4 to obtain polymeric surfactants nanocomposites for enhancing their biological activity.
Dynamic blood flow imaging with 99mTc-HDP as a therapeutic response marker in patients with Raynaud’s phenomenon
Authors: Yoo Jang , Cheon Miju
Published: May 2023

Objectives
We evaluated the predictive value of dynamic blood flow scintigraphy with 99mTc-HDP (hydroxymethylene diphosphonate) for therapeutic response in patients with Raynaud’s phenomenon (RP).
Methods
Eighty patients who underwent dynamic blood flow scintigraphy using the one-hand chilling method were enrolled. We analyzed the quantitative variables as the ratio of chilled fingers to ambient fingers (CAfinger), that of the chilled hand to ambient hand (CAhand), and that of chilled fingers to ambient palm (FPR) (CAFPR) at 15 and 30 s after 99mTc-HDP bolus injection. Total cumulative radioactivity counts for 180 s were obtained. We evaluated the clinical utility of these quantitative parameters with other clinical variables including RP severity, therapeutic compliance, types of RP, and scintigraphic interpretation of findings in patients with RP.
Results
Fifty-two patients showed poor therapeutic response. There were significant differences between good- and poor-therapeutic responder groups in RP intensity (p = 0.003), CAfinger15s (p = 0.008), CAfinger30s (p = 0.002), CAfinger180s (p = 0.011), CAhand15s (p = 0.008), CAhand30s (p = 0.007), CAhand180s (p = 0.017), CAFPR30s (p = 0.004), and CAFPR180s (p = 0.002). After multivariate logistic regression analysis, only CAfinger30s (p = 0.002) had an independent predictive value of therapeutic response.
Conclusion
99mTc-HDP dynamic blood flow scintigraphy could be useful in predicting the therapeutic response in patients with RP.
Recycled sand for sustainable 3D-printed sand mold processes.
Authors: Yen-Ting Li , Cheng Yih-Lin , Tang Kea-Tiong
Published: May 2023

Traditional casting industries are losing their appeal due to poor working conditions. Combining casting with additive manufacturing is a popular solution, with binder jetting being the best option for sand mold printing. However, waste management and environmental concerns in binder jetting need to be addressed. This study shows that recycled sand can produce mechanical properties comparable to new sand, while reducing waste and environmental impact. Recycled sand used less binder and hardener, resulting in cost savings and environmental benefits. This study highlights the importance of waste management and sustainability in 3D-printed sand mold processes and offers a promising solution for recycled sand powders in binder jetting.
Preparation and characterization of novel zwitterionic lignin/Nafion composite membranes
Authors: Heo Ji Won , An Liangliang , Kim Min Soo , Youn Duck Hyun , Kim Yong Sik
Published: May 2023

In this study, a novel zwitterion-decorated lignin (ZL) containing amine and sulfonic acid groups was synthesized and ZL/Nafion composite membranes were fabricated as proton exchange membranes. Kraft lignin was modified using amino-silane and 1,3-propane sultone via a continuous grafting reaction to provide zwitterionic moieties. Chemical structural analyses confirmed the successful introduction of the zwitterion moiety into lignin. In particular, the surface charge of ZL was positive in an acidic medium and negative in a basic medium, suggesting that ZL is a zwitterionic material. ZL was incorporated into Nafion membrane to enhance its ion exchange capacity, thermal stability, and hydrophilicity. ZL/Nafion 0.5% with a proton conductivity of 151.0 mS/cm was found to be 55.3% higher than unmodified ML (methanol soluble lignin)/Nafion 0.5% (97.2 mS/cm), indicating that the zwitterion moiety of ZL can enhance the proton transport ability. In addition, the evaluation of oxidative stability confirmed that ZL/Nafion 2% was chemically more durable than pure Nafion. This confirmed that the use of lignin as an additive in the membrane can yielded positive results in terms of chemical durability and oxidation stability in Nafion. Therefore, ZL is expected to be utilized as a multifunctional additive and has the potential for fuel cell applications.
Multi-quality prediction of injection molding parts using a hybrid machine learning model
Authors: Ke Kun Cheng , Wu Po Wei , Huang Ming-Shyan
Published: May 2023

With the advantages of high efficiency and low manufacturing cost, injection molding is a primary method of polymer processing. However, comprehensive inspection of part quality is limited due to high costs of time, labor, and equipment, often hindering quality control. There is an urgent need to develop a rapid and low-cost inspection method that can perform various quality inspections on injection-molded parts. Accordingly, this study proposes a virtual measurement technique based on a multi-quality prediction neural network that combines with an autoencoder network (AE) and a multilayer perceptron network (MLP). The research focused primarily on extracting and reducing the dimension of captured data using machine perception, quality index, and automatic feature extraction technologies to aid the rapid training of a hybrid AE/MLP model. Experimental case studies demonstrated that the method instantly predicted the residual stress distribution, weight, and geometric dimensions of plastic parts, and the model prediction error (root mean squared error) was less than 5% of the total tolerance. In particular, the predicted residual stress distribution was highly similar to the actual image, providing a substitute for the actual measurement of the residual stress within the molded part.
A computer vision sensor for the parallelization of actively regulated capillary slug flow microreactors
Authors: Gladius Anoj Winston , Mylenbusch Jonas A. , Agar David William
Published: May 2023

In this work, a computer vision sensor for the extraction of slug length, slug velocity and phase ratio from capillary liquid-liquid slug flows from video feeds in real-time, including the necessary post-processing algorithms, is developed. The developed sensor is shown to be capable of simultaneously monitoring multiple capillaries and provides reasonable accuracy at less than 3.5% mean relative error. Subsequently, the sensor is used for the control of a parallelized and actively regulated dual-channel slug flow capillary microreactor setup. As a model reaction, the solvent-free epoxidation of methyl oleate with hydrogen peroxide and a phase-transfer catalyst based on tungstophosphoric acid and a quaternary ammonium salt to yield the product 9,10-epoxystearic acid methyl ester is conducted. A space-time yield of 0.679 kg L-1 h-1 is achieved.
The effectiveness of problem-based learning in orthopedics education: A systematic review and meta-analysis of randomized-controlled trials
Authors: Li Ting , Song Ruohong , Zhong Wenjie , Liao Wenao , Hu Jiang , Liu Xilin , Wang Fei
Published: May 2023

Background Currently, problem-based learning (PBL) has been widely used in many disciplines, but there is no systematic review exploring the advantages and disadvantages of PBL in orthopedic education. Objective We carried out a systematic review and meta-analysis to evaluate the effectiveness of PBL teaching for orthopedics education. Methods We searched PubMed, Cochrane library, Embase, Web of Science, Scopus, Chongqing VIP Database (VIP), Chinese National Knowledge Infrastructure (CNKI), and Wan Fang Database up to April 2023 for relevant studies. Relevant studies were identified by using specific eligibility criteria and data was extracted. Results A total of 51 randomized controlled trials with 4268 patients were included. Compared with traditional education, PBL teaching had higher theoretical score (SMD = 1.10, 95%Cl: 0.78 ~ 1.41,P < 0.00001), and the operational score and case analysis score in PBL teaching were significantly higher than traditional teaching (SMD = 2.07, 95%Cl: 1.61 ~ 2.53,P < 0.00001;SMD = 1.20, 95%Cl: 0.88 ~ 1.52,P < 0.00001). What’s more, the total score in PBL teaching was higher than that traditional teaching (MD = 5.69, 95%Cl: 5.11 ~ 6.26,P < 0.00001). And PBL teaching had higher teaching interest and teaching satisfaction than that traditional teaching (OR = 4.70, 95%Cl: 3.20 ~ 6.93,P < 0.00001;OR = 5.43, 95%Cl: 3.83 ~ 7.69,P < 0.00001). However, the learning time was less and learning pressure was higher in PBL teaching (OR = 0.12, 95%Cl: 0.06 ~ 0.24,P < 0.00001;OR = 5.95, 95%Cl: 3.16 ~ 11.23,P < 0.00001). Conclusion Current evidence indicated that PBL teaching can enhance the theoretical score, operational score, and case analysis score. And students had higher teaching interest and teaching satisfaction. But students can feel the higher study pressure and less study time. However, these findings needed to be verified in further by multi-center, double-blind and large sample RCTs.
Aprepitant versus a single dose fosaprepitant for the prevention of chemotherapy-induced nausea and vomiting in children: A randomized, parallel-group, phase III trial
Authors: yu liting , Han Ya-Li , Wang Zhuo , Zhou Fen , Li Zhi-Ling , Gao Yi-Jin
Published: May 2023

BACKGROUND: For the recent prevention of chemotherapy-induced nausea and vomiting (CINV) in children aged 6 months and older, neurokinin-1(NK-1) receptor antagonists were suggested. However, there is little information available on how to select NK-1 receptor antagonists for pediatric patients, such as aprepitant and fosaprepitant.
METHODS: Children between the ages of 2 and 12 who were scheduled to undergo chemotherapy that was either mildly or strongly emetic were randomly randomized to receive fosaprepitant (arm-A) or aprepitant (arm-B). For the children in arm-A, ondansetron and dexamethasone were administered intravenously, followed by a fosaprepitant infusion. The identical medications were administered to children selected for arm-B, with the exception that aprepitant was used instead of fosaprepitant. Dexamethasone and ondansetron were continuously administered for 48 hours following the conclusion of treatment. The proportion of patients who experienced a complete response (CR), which is defined as no vomiting, no retching, and no need for rescue medication, during the acute phase (0-24 hours after the last dose of chemotherapy) was administered, was the study's main end point. The percentage of patients who achieved a CR overall and within the delayed period (24-120 hours) following the last chemotherapy treatment were considered secondary end goals.
RESULTS : A total of 108 patients were examined (55 in the fosaprepitant arm and 53 in the aprepitant arm). In the acute phase (95% vs 79%, P =0.018, P<0.05), delayed phase (71% vs 66%, P =0.586), and overall phase (69% vs 57%, P =0.179), CR rates were greater in the fosaprepitant arm than in the aprepitant arm. Additionally, there is no difference between the aprepitant arm (11%) and the fosaprepitant arm (7%) in terms of the desire for rescue anti-emetics. CONCLUSIONS: Adding fosaprepitant to ondansetron and dexamethasone is more beneficial than adding aprepitant for preventing CINV in the acute phase. Fosaprepitant and aprepitant, however, do not significantly differ from one another for prevention throughout the delayed and overall phases.
This study was approved by IRB of Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine (No. SCMCIRB-K2020120-2), and it was prospectively registered with the ClinicalTrials.gov on April 22, 2021 (reference number: NCT04873284 ).
Comparing Motivations, Learning Interests, and Barriers to Expansion Among Non-commercial and Commercial Maple Syrup Producers in Wisconsin
Authors: Hershberger Scott , Shaw Bret , Gorby Tricia , Solin Jeremy , Robinson Patrick , Tiles Kris , Cook Chad , Chang Chen-Ting
Published: May 2023

Maple syrup production can provide significant value to rural economies and contribute to the long-term sustainability of forest ecosystems. Producers’ experiences vary based on their type of sugaring operation, so foresters, Extension educators, and equipment suppliers can more effectively support the expansion of maple syrup production if they tailor their outreach to the needs of each type of producer. Drawing on a survey of Wisconsin maple syrup producers (n = 657), this study compares the motivations, confidence in forest management knowledge, interests in learning, interests in new behaviors, desire to expand, and barriers to expansion among three groups of maple syrup producers: non-commercial, small commercial, and large commercial producers. Most producers were motivated by spending time in nature, and as might be expected, commercial producers were more motivated by finances than non-commercial producers. All three groups expressed interest in forest health management. The producers most interested in expansion were those who already sell for income, who are motivated by finances, who have fewer seasons of experience, and are newer woodland owners. Key barriers to expansion included efficient sap collection and a lack of time for non-commercial and small commercial producers, while workforce availability and a lack of capital were key barriers to expansion for both groups of commercial producers. Based on these results, we provide recommendations for audience segmentation strategies to support maple syrup producers through education, marketing, and research.
Forecasting the groundwater scenario in Punjab: An ARIMA modelling
Authors: Singh Taptej , Singh Narinder Deep
Published: May 2023

This paper assessed the extent of groundwater exploitation and predict its future scenario in Punjab using the ARIMA modelling technique. The district-wise estimates of the groundwater table of Punjab state were derived from the block-wise information on net annual groundwater availability, net annual draft, groundwater table and stage of groundwater development. Furthermore, the forecasting had been done primarily based on an Expert Modeller of the ARIMA modelling technique. The results concluded that based on the trends of groundwater depletion in the past five decades, the over-exploited groundwater region of the Punjab state has doubled. This scenario of groundwater over-exploitation is due to increased demand for irrigation water in concern of increase in crop intensity and rice-wheat monoculture, as the surface water resources were limited and have deteriorated over time. Further, the ARIMA modelling of the groundwater table had forecasted a major decline in the groundwater table in Sangrur, Patiala, Moga, Fatehgarh Sahib, Ludhiana and Kapurthala districts of Punjab with the increase in time.
Robust Rank Aggregation Based Analysis of Hub Genes and Correlation with Immune Infiltration in Aortic Dissection
Authors: Zhang Weizong , Yuan Hong , Sun Jindong , Yu Huamin , Shi Minjuan , Hu Haiqiang , Zhang Huihui , Bai Xinhua , Shen Chaofeng , Tu Sijia , Wang Gang
Published: May 2023

Background
Aortic dissection (AD) is an acute critical disease of the cardiovascular system characterized by high mortality and morbidity. According to reports, immune cell infiltration is associated to AD. However, the intrinsic molecular mechanisms underlying the pathogenesis of AD still need to be clarified.
Methods
Four datasets (GSE52093, GSE98770, GSE153434 and GSE190635) were download through the Gene Expression Omnibus (GEO). Differentially expressed genes (DEGs) of each dataset were screened by robust rank aggregation (RRA) algorithms. Gene ontology (GO) functional enrichment analysis and Kyto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were performed to DEGs. Using the Search Tool for Retrieval of Interacting Genes/Proteins (STRING) database, a protein–protein interaction (PPI) network was constructed, and the hub genes were identified by Cytoscape. And, after correcting for nonbiological effects between four datasets by Rank-In algorithm, we obtained a merged matrix. Furthermore, we adopted this merged matrix to evaluate immune infiltration by using CIBERSORT and single sample gene set enrichment analysis (ssGSEA). Finally, we calculated the correlation between hub genes and immune cells.
Results
Sixty-two integrated DEGs were identified. These DEGs were mainly enriched in 69 biological process (BP) terms and the ATP-binding cassette (ABC) transporters pathways. By applying 12 methods from Cytoscape plugin CytoHubba respectively, we selected final hub genes. The final hub genes consist of angiotensin Ⅰ converting enzyme (ACE), angiotensin converting enzyme 2 (ACE2), calsequestrin 2 (CASQ2) and TIMP metallopeptidase inhibitor 1 (TIMP1). CIBERSORT showed that monocytes (P < 0.001) and activated mast cells (P < 0.05) were higher fraction in AD group. ssGSEA showed that regulatory T cell (P < 0.05), CD56 bright natural killer (NK) cell (P < 0.01), central memory CD4 T cell (P < 0.01), T follicular helper cell (P < 0.01), activated dendritic cell (P < 0.001), myeloid derived suppressor cells (MDSC) (P < 0.001), monocytes (P < 0.001), NK T cell (P < 0.001), type 1 T helper cell (Th1) (P < 0.001) and Th17 cell (P < 0.001) were higher fraction in AD group.
Conclusion
ACE, ACE2, CASQ2 and TIMP1 are engaged in the process of AD, which can be used as molecular biomarkers for the screening and diagnosis of AD. Immune cell infiltration plays a major role in the development of AD.
Predation risk, foraging and reproduction of an insectivore fish species associated with two estuarine habitats
Authors: Guedes Éden , Pereira Juan , Brito Gitá , Pessanha Andre , Júnior Alexandre
Published: May 2023

Pneumatophore fringes and mudflats are extremely valuable habitats and provide structures on which many fish species benefit in terms of food and reduced predation risk. We analysed the spatiotemporal patterns in feeding habits, reproductive aspects and effects of predatory fish presence to assess the ecological drivers of the common halfbeak, Hyporhamphus unifasciatus, in a Brazilian estuary. Sampling was conducted in the rainy (January to July 2016) and dry (August to December 2016) periods. Fish were collected in the two estuarine habitats using a beach seine. In summary, the results demonstrated that the number of predatory fishes was a strong predictor of population abundance and biomass, followed by pneumatophore complexity. The abundance and biomass values tended to increase with increasing habitat structural complexity towards the upper estuary. There was evidence that fish exhibited movement during the rainy season related to spawning events and subsequent juvenile recruitment in this area. Hymnoptera was the item most frequently ingested and made the greatest contributions to the volume of diet in habitat types throughout the year. There was an increase in the condition factor in the rainy season and thus was associated with energy reserves, reproduction and growth (fitness). We concluded that predation is an important ecological process that operates at local spatial scales and that together with the density of pneumatophores, predation is considered an important attractiveness that could affect the abundance of common halfbeak populations associated with estuarine habitats.
A case report of a continuous ambulatory drug delivery (CADD) pump to deliver opioid agonist treatment in an acute care setting
Authors: Wigg Casey , Nolen Amy , Jauhal Lisa , Sharma Malika
Published: May 2023

Background:
People with substance use disorder (SUD) are at risk of complications of drug use and frequent hospitalization, and may continue to use substances during admission to acute care. Acute care harm reduction strategies including oral or injectable prescription opioids may aid in care retention and improve health outcomes in this patient population.
Case Presentation:
A 58 year-old woman with refractory opioid use disorder was admitted to hospital for management of dysphagia secondary to esophageal stricture. She received injectable opioid agonist therapy using a continuous ambulatory drug delivery (CADD) pump in order to facilitate completion of her hospital admission.
Conclusions:
The patient successfully received acute medical care with the use of a CADD pump for consistent, patient-controlled opioid administration, with the support of an interdisciplinary team and by respecting the patient’s own substance use goals.
Effects of Certified Perioperative Nurses on the Establishment of Preoperative Outpatient and Rate of Preoperative Assessment in Japan: A Cross-Sectional Study
Authors: Hara Kentaro , Yamamoto Chie , Mills Shigeko , Osaki Kengo , Tokuyama Kaoru , Inoue Takahiro
Published: May 2023

Background
In patients undergoing surgery, nurse-led preoperative assessments include preoperative outpatient and preoperative visits. Certified perioperative nurses are expected to intervene pre- and post-operatively in patients undergoing surgery. This study aimed to investigate the effects of certified perioperative nurses on preoperative outpatient and preoperative assessments.
Methods
The study period ranged from February 2021 to September 2022, and data were collected and analyzed using a questionnaire at 247 facilities that administer more than 800 general anesthetics annually. The primary outcome measure was the preoperative assessment rate of preoperative and outpatient visits. To analyze the factors affecting the rate of preoperative assessment with the primary endpoint of preoperative outpatient and preoperative visits, we performed multivariate analysis of facility characteristics, medical staff background, and the presence or absence of certified perioperative nurses. The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.
Results
Sixty-eight and forty-one institutions in the enrolled and non-enrolled groups underwent a preoperative assessment, respectively, and the enrolled group underwent a significantly higher number of preoperative assessments than did the non-enrolled group. The medians of the enrolled and non-enrolled groups were 90.0 and 83.0, respectively, indicating a significantly higher preoperative assessment rate in the enrolled group than in the non-enrolled group. Multivariate analysis of factors influencing the preoperative assessment rate revealed a significant association with certified perioperative nurse attendance.
Conclusions
Facilities where certified perioperative nurses are enrolled have a significantly higher prevalence of preoperative outpatient visits and significantly higher rates of preoperative assessments than do facilities where certified perioperative nurses are not enrolled. Enrollment of certified perioperative nurses will lead to the improvement of the quality of preoperative nursing interventions.
Changes in periphyton communities with land use in tropical mountain streams from Loja (Ecuador)
Authors: Cartuche Alonso , Manoylov Kalina , Ibelings Bastiaan W. , Venail Patrick , Aguirre Nikolay
Published: May 2023

Riparian vegetation along a stream regulates the flow of sediments and nutrients. It also provides stability to the riverbanks and controls the watershed microclimate that ultimately influences the primary production of lotic environments. The degradation of terrestrial vegetation can also have an impact on the biotic component of rivers. Periphyton communities are altered in their composition, abundance, and diversity when the natural conditions in the watershed are modified. While widely studied in Europe and North America, studies on changes in periphyton community structure in mountainous tropical ecosystems are rare. In this study, we investigated if and how alteration of the riparian vegetation results in changes in the diatom community composition of seven streams in southern Ecuador. Streams were sampled in one or 2 zones, with 5 sub-samples each. The sampled streams show different levels of degradation within their watersheds. Temperature was higher in open (i.e. deforested) areas within a stream and open areas, e.g. pastures, had higher abundance of cyanobacteria filaments. Total algal cell abundances increased from forested to open and more fully degraded zones. Species richness was lowest in the forested areas. Microbial diversity was low across all habitats, but the highest values were documented in the degraded habitats. Diatom communities dominated at all sites, followed by filamentous bacteria. Gomphonema minutum (Agardh) Agardh, G. parvulum (Kütz.) Kütz., and Achnanthidium minutissimum (Kütz.) Czarnacki were the most common and abundant species. Diatom communities from zones with different land use within a stream were as different from each other as communities from different watershed streams.
Perivascular epithelioid cell tumors (PEComas) of the bone and soft tissue: A Japanese Musculoskeletal Oncology Group (JMOG) multi-institutional study
Authors: Izubuchi Yuya , Hamada Shunsuke , Tanzawa Yoshikazu , Fujita Ikuo , Imanishi Jungo , Koyanagi Hirotaka , Shimatani Akiyoshi , Komatsubara Tadashi , Tanaka Takaaki , Fukushima Mana , Imamura Yoshiaki , Ueda Takafumi , Kawano Hirotaka , Matsumine Akihiko
Published: May 2023

Purpose: Perivascular epithelioid cell tumors (PEComas) of the bone and soft tissues are rare mesenchymal neoplasms, some of which are malignant. However, their clinical and pathological characteristics remain unclear. This study was performed to investigate the clinical and pathological characteristics of PEComas in bone and soft tissues by leveraging information from the Japanese Musculoskeletal Oncology Group.
Methods: Ten patients, including four male and six female patients with a median age of 49 years, were retrospectively reviewed. PEComas of the visceral organs, including the uterus and retroperitoneum, were excluded.
Results: Nine tumors arose in the soft tissue and one in the bone, with a mean size of 9.3 cm. Four patients showed local recurrence or distant metastasis. The 1-year survival rate was 77%. Pathologically, eight tumors were classified as malignant and two as having uncertain malignancy potential. Half of the tumors showed high MIB-1 index values of >30%. Immunohistochemically, the melanocyte marker HMB45 was expressed in 90% cases, and muscle-specific markers were expressed only in 30–50% cases. Transcription factor binding to IGHM enhancer 3 (TFE3) expression was positive in 89% of the patients. Tumors with high expression of TFE3 were classified as PEComas with malignant potential according to Folpe’s classification.
Conclusions: Bone and soft tissue PEComas may have a higher malignancy potential than other visceral PEComas and are more likely to develop as TFE3-rearranged PEComas.
Evaluation of temporal changes in fracture transmissivity in an excavation damaged zone after backfilling a gallery excavated in mudstone
Authors: Aoyagi Kazuhei , Ishii Eiichi
Published: May 2023

The long-term geological disposal of high-level radioactive waste relies on predictions of future changes in a disposal facility’s hydro-mechanical characteristics in order to assess potential leakage through fractures in the excavation damaged zone (EDZ) after backfilling the facility. This study evaluated the transmissivity of EDZ fractures using in situ hydraulic tests around the area of a full-scale, experimental, engineered barrier system in the Horonobe Underground Research Laboratory, Hokkaido, Japan. After their installation, the buffer blocks swelled, altering the stresses within the EDZ fractures. The effects of these changing stresses on the fractures’ transmissivity were assessed over a period of four years. The transmissivity continuously decreased in this period to about 26% of its value measured prior to the swelling. Using the Barton–Bandis normal-stress-dependent fracture-closure model, the decrease in transmissivity is quantitatively attributed to closure of the EDZ fractures, which was caused by the swelling pressure increasing up to 0.88 MPa. Evidence of fracture closure came from seismic tomography surveying, which revealed a slight increase in seismic velocity in the study area with increasing swelling pressure. The results show that EDZ fractures were closed by swelling of the full-scale buffer material. They also demonstrate the applicability of the Barton–Bandis model to preliminary estimation of the long-term transmissivity of EDZ fractures in facilities for the geological disposal of radioactive waste.
Verifying and Refining Early Statuses in Alzheimer’s Disease Progression: A Possibility from Deep Feature Comparison
Authors: Liu Mianxin , Cui Liang , Zhao Zixiao , Ren Shuhua , Huang Lin , Guan Yihui , Guo Qihao , Xie Fang , Huang Qi , Shen Dinggang
Published: May 2023

Background: Defining effective early status of Alzheimer’s disease (AD) could be challenging, due to complexity in linking early and late stages in the progression and the internal biological heterogeneity within same status. We explore whether it is possible to verify and refine candidature early statuses in the AD progressions by comparing the neurological features learned by deep learning models.
Methods: We collect functional magnetic resonance imaging (fMRI) data from 432 subjects, including 79 healthy controls (HCs), 109 amnestic mild cognitive impairments (aMCIs), 39 non-amnestic MCIs (naMCIs), 98 subjective cognitive declines (SCDs) and 107 ADs. We train graph convolutional networks (GCNs) based on multiscale functional networks to accurately classify aMCI from naMCI and HC from MCIs. The trained models are applied to AD and SCD groups to suggest the neural feature similarity (as the ratio of predictions) among the statuses and identify clinically informative subpopulations. The corresponding demographics, cognitive assessments, T1, and PET images are used to provide supportive evidences for sub-divided populations based on the model decisions.
Results: The GCN model achieves 89.2±1.9% and 83.7±3.1% accuracies in aMCI-vs-naMCI and HC-vs-MCI classifications. The aMCI-vs-naMCI classification model identifies 71.8% of the AD subjects as aMCI. The HC-vs-MCI classification model suggests that 73.5% of the SCDs are MCI, in which 88.8% are further diagnosed as “aMCI” by the aMCI-vs-naMCI classifier. The analyses based on T1 and PET images suggests that the aMCI-like AD exhibits more globally elaborated Aβ depositions, severer glucose metabolism reduction and grey matter atrophy than naMCI-like AD after contrasted with clinical HCs. MCI-like SCD shows more reduction of glucose metabolism than HC-like SCD, baselined by clinical HCs. Further, aMCI-like SCD exhibits slightly elaborated Aβ while naMCI-like SCD shows none when compared to clinical HCs. MCI-like SCD has lower executive ability than HC-like SCD. aMCI-like SCD shows lower memory ability than naMCI-like SCD.
Conclusions: This study suggests an overall neurological similarity among SCD, aMCI and AD from perspective of brain dynamics, and verifies the position of SCD and aMCI in the AD progression. Further, it offers a potentially refined progression progress, consisting of aMCI-like SCD, aMCI, and aMCI-like AD dementia.
Clinical Trials Registration: The data collection has been registered as “ChiCTR2000036842”.
Effectiveness of Intra-thecal Methotrexate in Refractory Anti-N-methyl-d-aspartate Receptor Encephalitis
Authors: Hommady Raid , Alsohaibani Abdullah , Alayed Ruba , Alshehri Abdulaziz , AbuMelha Ahlam , Aljomah Lama , Hundallah Khalid , Almuqbil Mohammed , Altuwaijri Waleed , Alrumayyan Ahmad , Alrifai Muhammed Talal , Baarmah Duaa Mohammed
Published: May 2023

Background
Anti-N-methyl-d-aspartate receptor encephalitis is one of the most common autoimmune encephalitis for which first- and second-line therapies have been recommended following international consensus. However, some refractory cases do not respond to the first- and second-line therapy and require further immune-modulatory therapies such as intra-thecal methotrexate. In this study, we reviewed six confirmed cases of refractory anti-N-methyl-d-aspartate receptor encephalitis from two tertiary centers in Saudi Arabia that required escalation of treatment and received a six-month course of intra-thecal methotrexate. The aim of this study was to evaluate the effectiveness of intra-thecal methotrexate as immunomodulatory therapy for refractory anti-N-methyl-d-aspartate receptor encephalitis.
Methods:
We retrospectively evaluated six confirmed cases of refractory anti N-methyl-d-aspartate receptor encephalitis who did not improve after first- and second-line therapy and received monthly intra-thecal methotrexate treatment course for six consecutive months. We reviewed patient demography, underlying etiologies, and compared their modified Rankin score prior to receiving intra-thecal methotrexate and six months after completing the treatment.
Results:
Three of the six patients showed a marked response to intra-thecal methotrexate with a modified Rankin scale of 0–1 at 6-month follow-up. None of the patients experienced any side effects during or after intra-thecal methotrexate treatment, and no flareups were observed.
Conclusion:
Intra-thecal methotrexate may be a potentially effective and relatively safe escalation option for immunomodulatory therapy of refractory anti- N-methyl-d-aspartate receptor encephalitis. Future studies on intra-thecal methotrexate -specific treatment regimens may further support its utility, efficacy, and safety in treating refractory anti- N-methyl-d-aspartate receptor encephalitis.
The M6A Methyltransferase METTL3 drives thyroid cancer progression and lymph node metastasis by targeting LINC00894
Authors: Zhou Xiang , Yu Leitao , Chang Lihsa , Liang Qiaoqiao , Zhao Rongjie , Xiao Yong , Xu Zheng
Published: May 2023

Background：Long non-coding RNAs (lncRNAs) are significant contributors to various human malignancies. The aberrant expression of lncRNA LINC00894 has been referred to in various human malignancies. Consequently, our aim is to illustrate the role of LINC00894 and its underlying mechanism in the development of papillary thyroid carcinoma (PTC).
Method：Bioinformatics analysis of differentially expressed RNA from TCGA and GEO datasets and selected the target lncRNA LINC00894.The analysis of SRAMP found that there are abundant M6A methylation sites in LINC00894. And further analysis from StarBase, GEPIA, and TCGA datasets to find related differentially expressed genes METTL3. The Colony formation and CCK8 assay confirmed the relationship between LINC00894, METTL3, and the proliferative capacity of PTC cells. The analysis of AnnoLnc2, Starbase datasets, and meRIP-PCR, qRT-PCR confirmed the influence of Mettl3-mediated modification of M6A on LINC00894. The study employed KEGG enrichment analysis as well as Western blotting to investigate the impact of LINC00894 on the expression of proteins related to the Hippo signaling pathway.
Results：LINC00894 hypoexpression was detected in PTC tissues and cells and even lower in PTC with lymphatic metastasis. LINC00894 inhibits the lymphangiogenesis of vascular endothelial cells and the proliferation of cancer cells. METTL3 enhances PTC progression by upregulating LINC00894, which relies on enhancing the LINC00894 mRNA stability through the M6A-YTHDC2-dependent pathway.LINC00894 may inhibit PTC malignant phenotypes through the Hippo signaling pathway.
Conclusion： The METTL3-YTHDC2 axis stabilizes LINC00894 mRNA in an M6A-dependent manner and subsequently inhibits tumor malignancy through the Hippo signaling pathway.
Comparative study between Enhanced Recovery After Surgery versus conventional peri-operative care in elective gastrointestinal surgery and compliance to ERAS protocols at an Indian tertiary care public hospital
Authors: Shukla Pragati , Jhaveri Rupen , Yadav Anurag , Kacheriwala Samir
Published: May 2023

Introduction: The benefits of fast track surgery protocols have been well established for abdominal surgeries. They are now being used for other surgeries also including urology and even neurosurgery. However very few Indian public hospitals implement these protocols. There is difficulty in complying to the stated protocols.
Materials and Methods:A prospective randomized control study carried out from September, 2021 to October, 2022 at the Department of General Surgery, Sir Sayajirao General Hospital, Vadodara amongst all patients undergoing elective abdominal surgeries. Patients were divided into two groups (ERAS and Control) by closed envelope technique, each having 30 patients. ERAS group patients received peri-operative care defined by ERAS criteria while the control group patients received conventional care.
Results: Stoma closure was the most commonly performed surgery among both groups. The mean time of starting liquids was 1.2 ± 0.4 days in the ERAS group compared to 4.4 ± 0.8 days in the control group. Soft diet was also started early in the ERAS group (2.2 ± 0.4 days vs 5.7 ± 1.2 days.) The mean time of first defecation was 2.4 ± 0.6 days in the ERAS group and 4.7 ± 0.9 days in the control group. Foley’s catheter inserted intra-operatively was removed after a mean 1.3 ± 0.7 days in the ERAS group compared to 1.7 ± 0.9 days in the control group. The patients in ERAS group needed an average of 3.3 days of post op IV opioid analgesia as compared to 4.5 days of control group. The mean length of hospital stay was 13.2 ± 6.2 days for the ERAS group compared to 19.3 ± 8.8 days in the control group. Total number of patients who developed complications were 7 in ERAS group and 18 in control group. The compliance to pre-, peri-, and post-operative components was 80%, 65% and 88.3% respectively.
Conclusion: Due to the significantly decreased length of stay and lesser complications, ERAS protocols, or at least some elements of the ERAS protocols can be implemented even in the public hospital setup. Higher bed turnover ratio can help in maximizing the benefits of the existing resources to help more number of patients.
Up-regulation of Myocardial Klotho Expression to Promote Cardiac Functional Recovery in Old Mice following Endotoxemia
Authors: Li Xueting , Zhai Yufeng , Yao Qingzhou , The Erlinda , Ao Lihua , Fullerton David A. , Yu Kai-Jiang , Meng Xianzhong
Published: May 2023

Objective: Endotoxemic cardiac dysfunction contributes to greater morbidity and mortality in elderly patients with sepsis. This study tested the hypothesis that Klotho insufficiency in aging heart exaggerates and prolongs myocardial inflammation to hinder cardiac function recovery following endotoxemia.
Methods:Endotoxin (0.5 mg/kg, iv) was administered to young adult (3-4 months) and old (18-22 months) mice with or without subsequent treatment with recombinant interleukin-37 (IL-37, 50 µg/kg, iv) or recombinant Klotho (10 µg/kg, iv). Cardiac function was analyzed using a microcatheter 24, 48 and 96 h later. Myocardial levels of Klotho, ICAM-1, VCAM-1 and IL-6 were determined by immunoblotting and ELISA.
Results: In comparison to young adult mice, old mice had worse cardiac dysfunction accompanied by greater myocardial levels of ICAM-1, VCAM-1 and IL-6 at each time point following endotoxemia and failed to fully recover cardiac function by 96 h. The exacerbated myocardial inflammation and cardiac dysfunction were associated with endotoxemia-caused further reduction of lower myocardial Klotho level in old mice. Recombinant IL-37 promoted inflammation resolution and cardiac functional recovery in old mice. Interestingly, recombinant IL-37 markedly up-regulated myocardial Klotho levels in old mice with or without endotoxemia. Similarly, recombinant Klotho suppressed myocardial inflammatory response and promoted inflammation resolution in old endotoxemic mice, leading to complete recovery of cardiac function by 96 h.
Conclusion: Myocardial Klotho insufficiency in old endotoxemic mice exacerbates myocardial inflammatory response, impairs inflammation resolution and thereby hinders cardiac functional recovery. IL-37 is capable of up-regulating myocardial Klotho expression to improve cardiac functional recovery in old endotoxemic mice.
Three plant- and animal-based dietary patterns and their relationship to serum uric acid levels
Authors: Mao Danhui , Feng Jin , Zhou Yangzilin , Li Honggang
Published: May 2023

Background
Dietary patterns play an important role in the development of hyperuricemia and gout, but evidence for the association between different kinds of plant-based and animal-based dietary patterns and individual serum uric acid levels is scarce and inconsistent.
Methods
We analyzed data from the sixth wave of the China Health and Nutrition Survey. The plant-based diet of 7,806 participants was determined using three consecutive 24-hour dietary recalls, and latent profile analysis was used to identify dietary patterns among participants. Serum uric acid levels were analyzed using the enzymatic colorimetric method. The association between intakes of different types of dietary pattern and individual serum uric acid levels was analyzed using linear regression analysis, after adjusting for confounding variables.
Results
We identified three types of plant-based dietary patterns, namely, low tuber starches and vegetable plant-based diet (LTVP), high cereal, tuber starches and vegetable plant-based diet (HCTVP), and high legume and fruit plant-based diet (HLFP). We also identified three types of animal-based dietary patterns, namely, high milk and egg animal-based diet (HMiEA), low egg and fish animal-based diet, and high meat and fish animal-based diet (HMeFA). Significant coefficients for participant serum uric acid levels were observed for the HCTVP diet (β = −0.022, P = 0.031) and HMeFA diet (β = 0.061, P < 0.001). The median intake of foods in the HCTVP diet was as follows: cereals and cereal products, 444.83 g/d; tubers and starch products, 166.67 g/d; dried legumes and legume products, 8.33 g/d; vegetables and vegetable products, 333.33 g/d; and fruits and fruit products, 0 g/d. The median intake of foods in the HMeFA diet was as follows: meat and meat products, 73.33 g/d; poultry and poultry products, 0 g/d; milk and milk products, 0 g/d; eggs and egg products, 26.67 g/d; and fish, shellfish, and mollusks, 180.00 g/d.
Conclusion
We showed that individual serum uric acid levels (1) might decrease under the plant-based HCTVP diet, (2) might increase under the animal-based HMeFA diet, (3) might not decrease under the plant-based HLFP diet, and (4) might not increase under the animal-based HMiEA diet. Further studies are needed to confirm these associations.
The Relationship Between Systemic Inflammation Index, Systemic Immune-Inflammatory Index, and Inflammatory Prognostic Index and 90-Day Outcomes in Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis
Authors: Ma Fei , Li Lulu , Xu Liang , Wu Jiacheng , Zhang Aimei , Liao Junqi , Chen Jingyi , Li Yunze , Li， Li , Chen Zhaoyao , Li Wenlei , Zhu Qing , Zhu Yuan , Wu Minghua
Published: May 2023

Background and purpose
This study aimed to explore the association between the systemic inflammatory index (SIRI), systemic immune-inflammatory index (SII), and inflammatory prognosis index (IPI) with the 90-day outcomes of patients with acute ischemic stroke (AIS) after intravenous thrombolysis.
Methods
190 AIS patients who underwent intravenous thrombolysis from September 2019 to December 2022 were enrolled in the present study. The National Institutes of Health Stroke Scale (NIHSS) and modified Rankin score (mRS) were assessed in AIS patients who met the inclusion criteria before thrombolysis, immediately after thrombolysis, and at 90 days. Peripheral venous blood was collected within 24 hours after admission and used to assess the following parameters: neutrophil count, lymphocyte count, monocyte count, platelet count, average platelet volume, and albumin. Next, the SIRI, SII, and IPI values were calculated, respectively. The correlation among SIRI, SII, IPI, and admission NIHSS scores was examined by Spearman correlation analysis. ROC curve analysis was conducted to determine the optimal cut-off value of SIRI, SII, and SIRI and their corresponding sensitivity and specificity to evaluate their predictive value on admission for poor prognosis. To investigate whether high SIRI, SII, and IPI were independent predictors of poor outcomes within 90 days, variables with P-value < 0.05 during univariate analysis were included in multivariate analysis.
Results
Compared with the good outcome group, the poor outcome group had higher age, baseline NIHSS, neutrophil count, mRS, NLR, SIRI, IPI, and SII, while the lymphocyte count was lower. Spearman correlation analysis showed that the SIRI, IPI, and SII levels significantly correlated with the admission NIHSS score (r = 0.338, 0.356, 0.427, respectively; Ps < 0.001). The Mann-Whitney U test showed that the SIRI, SII, and IPI levels in patients with moderate and severe AIS were higher than in patients with mild AIS (P < 0.001). Univariate analysis showed that admission NIHSS, NLR, SIRI, SII, and IPI were significantly correlated with poor 90-day prognosis. Although age, smoking and drinking history, and underlying diseases were not significantly associated with prognosis, they were considered potential risk factors for AIS and included in the analysis as potential confounding factors. Using the optimal cut-off value determined by ROC analysis, multivariate logistic regression analysis revealed high SIRI, SII, and IPI values as independent risk factors for poor 90-day prognosis (OR = 2.867, 3.721, and 2.877, respectively).
Conclusions
High SIRI, IPI, and SII values are correlated with poor 90d outcomes in AIS patients undergoing intravenous thrombolysis.