bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of preoperative white blood cell count on long-term outcome in patients undergoing surgery for colorectal cancer: A retrospective observational study of Chinese patients
Authors: Wang Bei , Li Lihong , Wang Shilai , Zhou Changming , Sun Zhirong , Weng Meilin
Published: April 2022

Purpose: The correlation between preoperative white blood cell (WBC) count and the outcome in patients who underwent surgery for colorectal cancer (CRC) was evaluated in present study.Patients and methods: A total of 8121 Chinese patients at Fudan University Shanghai Cancer Center (FUSCC) undergoing colectomy, Dixon’s or Mile’s, for CRC from January 2008 to December 2014 were enrolled in present study. Based on that the WBC optimal cut-off value was ﻿7*109, the patients were divided into two groups, the moderate leukocytosis group (the leukocytosis group) and non-leukocytosis group. The impact of preoperative WBC count on disease-free survival (DFS) and overall survival (OS) was investigated using the Kaplan-Meier method and Cox proportional hazard models.Results: Moderate leukocytosis (≥﻿7*109) was recognized as a prognostic factor for survival independently. Moderate leukocytosis was significantly associated with male sex (P﻿＜0.001), advanced T stage (P﻿＜0.001), TNM stage (P﻿＜0.001), and no preoperative chemotherapy (P﻿＜0.001). Moderate leukocytosis group was corelated with poorer overall survival (OS) (P﻿＜0.001) and disease-free survival (DFS) (P=0.024) than non-leukocytosis group. In the multivariate analysis, the moderate leukocytosis group had a 19.6% higher risk in OS (HR=1.196, 95CI%:1.088-1.314, P<0.001) and had a 13.1% higher risk in DFS (HR=1.131, 95CI%:1.016-1.259, P=0.024) than the non-leukocytosis group. We found that the association with preoperative moderate leukocytosis and poorer OS (P﻿＜0.001) or DFS (P﻿=0.001) in patients with no preoperative chemotherapy in subgroup analysis.Conclusions: Preoperative moderate leukocytosis is associated with shorter OS, DFS indicating poor outcome in CRC patients after surgery.
Realgar-induced neurotoxicity: Crosstalk between autophagic flux and the p62-NRF2 feedback loop mediates p62 accumulation to promote apoptosis
Authors: Feng Rui , Liu Jieyu , Yang Zhao , Yao Tiantian , Ye Ping , Li Xiuhan , Zhang Jiaxin , Jiang Hong
Published: April 2022

Realgar is a traditional Chinese medicine that contains arsenic. It has been reported that the abuse of medicine containing realgar has potential central nervous system toxicity, but the toxicity mechanism has not been elucidated. In this study, we established realgar exposure model in vivo and selected DMA, the end product of realgar metabolism, to treat SH-SY5Y cells in vitro. Many assays including behavioral, analytical chemistry, and molecular biology were used to elucidate the roles of autophagic flux and p62-NRF2 feedback loop in realgar-induced neurotoxicity. The results showed that arsenic could accumulate in the brain, causing cognitive impairment and anxiety-like behavior. Realgar impairs the ultrastructure of neurons, promotes apoptosis, perturbs autophagic flux homeostasis, amplifies the p62-NRF2 feedback loop, and leads to p62 accumulation. Further analysis showed that realgar activates JNK/c-Jun, promotes the formation of Beclin1/Vps34 complex, induces autophagy, and recruits p62. Meanwhile, realgar inhibits the activities of CTSB and CTSD, and changes the acidic of lysosomes, resulting in the inhibition of p62 degradation, and then accumulation. Moreover, the amplified p62-NRF2 feedback loop is also involved in the accumulation of p62. Its accumulation promotes neuronal apoptosis by up-regulating the expression levels of Bax and cleaved-caspase-9, resulting in neurotoxicity. Taken together, these data suggest that realgar can perturb the cross-talk between autophagic flux and the p62-NRF2 feedback loop to mediate p62 accumulation, promote apoptosis, and induce neurotoxicity.
Anti-NMDAR encephalitis with euthyroid sick syndrome and lateral ventricle lesions predicts a poor prognosis
Authors: Wang Gong , Liu Juan , Yue Chengsong , Zhang Xi , Wang Hongyu , Luo Xue , Yang Xuesen
Published: April 2022

Background
The aim of this study was to clarify the role of thyroid dysfunction in anti-NMDAR encephalitis (ANE) patients.
Methods
The clinical and laboratory characteristics of 42 ANE patients were analyzed, including 24 ANE patients with normal thyroid function and 18 ANE patients with thyroid dysfunction (12 ANE patients with euthyroid sick syndrome (ESS); 6 ANE patients with thyroid dysfunction but not ESS). Cranial magnetic resonance imaging (MRI) findings, cerebrospinal fluid (CSF) parameters, clinical symptoms, antibodies, and admission and discharge modified Rankin scale (mRS) scores were evaluated.
Results
ANE patients with thyroid dysfunction had more serious consciousness disorders (p = 0.008), motor disorders (p = 0.005) and status epilepticus than those without thyroid dysfunction (p = 0.007). The conditions of ANE patients with ESS were more serious than those of ANE patients without ESS in terms of language disorders (p = 0.035), status epilepticus (p = 0.001), motor disorders (p < 0.007) and consciousness disorders (p = 0.001). Moreover, the admission mRS scores of ANE patients with ESS were higher than those of ANE patients without ESS (p = 0.030). ANE patients with ESS with lateral ventricle lesions (p = 0.017) had higher discharge mRS scores than those without lateral ventricle lesions (p = 0.045).
Conclusion
The conditions of ANE patients with thyroid dysfunction were more serious than those of ANE patients without thyroid dysfunction. The conditions of ANE patients with ESS were more serious than those of ANE patients without ESS, and these patients had poorer prognoses. The lateral ventricles were not common sites of lesions in autoimmune encephalitis patients, but they might predict a worse prognosis in ANE patients with ESS. Such patients should be given more attention. However, interventions for ESS are still controversial. Prospective randomized controlled trials should be performed to further explore the possible mechanisms of ESS in ANE.
Predictors of Sick Leave among Healthcare Workers in a Lebanese Tertiary Medical Center: A Retrospective Analysis
Authors: Sakr Carine , Fakih Lina , Musharrafieh Umayya , Makki Maha , Doudakian Rita , Tamim Hani , Redlich Carrie , Slade Martin , Rahme Diana
Published: April 2022

Background:Previous studies have shown that demographic, social, and work-related factors can influence sick-leave rates among healthcare workers. In this multivariable study, we evaluated potential predictors of sick leaves among the employees of a tertiary medical center in Lebanon between the years 2015 and 2018.Methods: This study was a retrospective analysis of sick leave records of the population of healthcare workers who took sick leave between 2015 and 2018. The records included a large sample size of 2,850 employees. Descriptive statistics were run, and the number of sick leave episodes was stratified by sick leave diagnosis. Bivariate analysis was done to investigate the association of the outcome with all predictors. To identify potential predictors of sick leave episodes, a multiple linear regression was conducted, and a p-value<0.05 was considered statistically significant.Results:Infectious diseases and musculoskeletal disorders diagnoses accounted for the highest number of sick leaves throughout the study period. All diagnoses had a short duration of sick leave days, with the mean duration of all diagnoses being 2.60 days. As for predictors of number of sick leave episodes, results from multiple regression analysis showed that the female gender, older age, marital status, lower job grade, job position, smoking status, and some medical conditions (namely gastrointestinal problems, respiratory problems, kidney disease, headache, back pain, and anxiety) were all significant predictors of taking more sick-leave episodes in the study population. Conclusion:Analyzing sick leave is a complex process with multifactorial determinants, and our study found a significant association between multiple demographics, work related, and health related predictors with the number of sick leave episodes. These findings call for further research to evaluate how interventions such as smoking cessation programs, safe patient handling programs, and employee assistant programs could impact sick leave rates among healthcare workers. Such interventions would guide policies for healthier, safer, and more productive workplaces.
Relation between the number of the older adults patients hospitalized for pneumonia and air particulate matter exposure: a time-stratified case-crossover study in multiple cities
Authors: Lin Chengwei , Jiang Wanyanhan , Gao Xi , He Yi , Li Jia , Zhou Chengchao , Yang Lian
Published: April 2022

Background: Many previous studies have already proved the relationship between air pollutants and respiratory diseases. However, limited studies have so far assessed the impacts of air particulate matter exposure on the older adults patients with pneumonia. This study aims to reveal the impacts of short-term exposure to air particulate matter on the daily number of the older adults patients hospitalized due to pneumonia and calculate the economic costs attributable to this exposure.Methods: A time-stratified case-crossover study design was adopted. Hospitalization data were collected from hospitals above county levels from 9 cities in Sichuan Province, China from January 1, 2018 to December 31, 2019. A sample of 43,746 pneumonia patients aged over 65 was retrieved. After adjusting for the influence of temperature and humidity, we analyzed the relationships between the daily number of the older adults pneumonia inpatients and the levels of air particulate matters (PM2.5, and PM10) and their relevant economic burdens. Then, stratification analyses were conducted based on patient age, gender, season, and whether the patient has comorbidity.Results: Short-term exposure to air particulate matter pollution was correlated with the increase of the older adults pneumonia inpatients. The single pollutant model showed that PM2.5 and PM10 had the greatest impact on the number of the older adults pneumonia inpatients at lag7 and lag4, respectively. For every 10 μg/m3 increase in PM2.5 and PM10 concentrations, the daily number of the older adults pneumonia inpatients increased by 1.5% (95% CI: 1.010-1.021) and 1.0% (95% CI: 1.006-1.014), respectively. The 65-79 year-olds were more susceptible to air particulate pollutants (P < 0.05). During the study period, the total hospitalization costs and out-of-pocket expenses attributable to PM2.5 and PM10 exposure were 44.60 million CNY and 16.03 million CNY, respectively, with PM2.5 being the primary influencing factor.Conclusion: Short-term exposure to air particulate pollution increased the risks of hospitalization for pneumonia in the 65 plus age group, increasing economic burdens on the society and involved families. These findings can further support the policies aiming to reduce the number of the older adults pneumonia inpatients by controlling air particulate pollutant concentrations.
Role of the Specialized Proresolving Mediator in Amyotrophic lateral sclerosis
Authors: Wei Xiao-jing , Li Xi-xi , Sun Hui , Qiu Ru-qing , Yu Xue-fan
Published: April 2022

Background
Amyotrophic Lateral Sclerosis (ALS) is a devastating progressive neurodegenerative disease that affects motor neurons, leading to a relentless paralysis of skeletal muscles and eventual respiratory failure. Chronic inflammation is one of the hallmarks of ALS and may contribute to motoneurons degeneration. Accumulating evidence suggests that chronic inflammation resulting from insufficient resolution, a process operated by specialized pro-resolving mediators (SPMs). However, whether resolution of inflammation is impaired in ALS is not known. The objective of this study was to investigate the levels of SPMs in the serum and cerebrospinal fluid (CSF) of ALS patients, and to explore the roles of SPMs in clinical features of ALS.
Methods
Fourty-one patients with ALS, and 73 patients with non-inflammatory neurological diseases were enrolled in this study. Pro-resolving mediators including resolvin D1 (RvD1), maresin 1 (MaR1) and lipoxinA4(LxA4) levels were analyzed using enzyme-linked immunosorbent assay. Pro- and anti-inflammatory cytokines levels were analyzed by cytometric beads array (CBA).
Findings:
Our results showed serum RvD1 levels were decreased, whereas CSF RvD1 levels were significantly increased in ALS patients compared to controls. Serum RvD1 was also negatively correlated to disease progression rate (DPR), and positively correlated with forced vital capacity (FVC).
Conclusions
The present preliminary study allows hypothesizing impaired resolution of inflammation in patients with ALS, confirming the emerging role of bioactive lipids in this disease.
Effects of Lactobacillus plantarum inoculation on the quality and bacterial community of whole-crop corn silage at different harvest stages
Authors: Dong Jianan , Li Songze , Chen Xue , Sun Zhe , Sun Yue , Zhen Yuguo , Qin Guixin , Wang Tao , Demelash Natnael , Zhang Xuefeng
Published: April 2022

Background: Silage is achieved by anaerobic fermentation of lactic acid bacteria. However, harvest stage and Lactobacillus plantarum (L. plantarum) content affect the changes of microbial community in silage, which play an important role in silage quality and mycotoxin levels. The current study evaluated the effects exerted by the application of L. plantarum on fermentation, mycotoxins and bacterial community of whole-crop corn silage at different harvest stages. The fresh whole plant corn from the same area was harvested during the milk stage and the dough stage, following which from each harvest stage was subjected to four L. plantarum treatments: 0 cfu/kg; 1×109 cfu/kg; 1×1010 cfu/kg; and 1×1011 cfu/kg in a 2×4 factorial experimental design. Samples were collected on days 0, 7, 14, 21 and 42. Subsequently, nutrition parameters, fermentation parameters, mycotoxin levels and bacterial community were determined. Results: Prolonging the harvest stage resulted in an increase in the levels of starch and dry matter as well as deoxynivalenol in corn silage. Addition of 1×1010 cfu/kg and 1×1011 cfu/kg of L. plantarum applied after 42 d of ensilage reduced dry matter loss, which significantly lowered deoxynivalenol concentration in corn silage at the dough stage (P < 0.01). The pH of corn silage decreased, whereas the lactic acid concentration increased after ensiling. The effects exerted by the interaction (harvest stage × dose of L. plantarum ) on pH on day 21 as well as on fermentation and lactic acid on days 21 and 42 were significant (P < 0.05). Addition of 1×1010 cfu/kg of L. plantarum at the dough stage significantly increased the relative abundance of Firmicutes while decreasing that of Bacteroidetes, compared to when L. plantarum was not added (P < 0.05). Conclusion: Adding L. plantarum improved the fermentation quality and bacterial community of silage, which reduced part of mycotoxin content and relative abundance of harmful bacteria. And adding L. plantarum in dough stage resulted in greater improvements to mycotoxin content and bacterial community.
TIMP2 is associated with prognosis and immune infiltrates of gastric and colon cancer
Authors: Jian Fang , Yanhong Jiao , Limeng Wei , Guoping Niu , Yiqin Tian , Hao Lin , Zhaoji Pan
Published: April 2022

Tissue inhibitor of metalloproteinase-2 (TIMP2) is an inhibitor among the tissue inhibitors of metalloproteinase (TIMP) family members, is associated with the progression of a variety of tumors. However, the association of TIMP2 with cancer prognosis and tumor-infiltrating lymphocytes remains unclear. TIMP2 expression was analyzed by Tumor Immune Estimation Resource (TIMER), TNMplot, Gene Expression Profiling Interactive Analysis (GEPIA) database and 50 paired gastric cancer tissues. We evaluated the influence of TIMP2 on clinical prognosis using Kaplan-Meier plotter, the PrognoScan database, GEPIA and TCGA data. The correlation of TIMP2 with tumor immune infiltrates and with the set of gene markers of immune infiltrates was investigated by TIMER and GEPIA. TIMP2 is highly expressed in gastric cancer and low expressed in colon cancer. High TIMP2 expression was significantly correlated with poor overall survival (OS, hazard ratio [HR] = 1.38, 95% confidence interval [CI]: [1.16–1.63]; P = 0.0002) and progression-free survival (PFS, HR = 1.39, 95% CI: [1.14–1.7]; P = 0.0012) in gastric cancers. Specifically, high TIMP2 expression was associated with poorer OS and PFS, but not with OS and PFS in stage 1 (OS HR = 1.96, P = 0.29; PFS HR = 0.43, P = 0.19) and stage 2 (OS HR = 1.59, P = 0.12; PFS HR = 1.47, P = 0.2) and stage N0 patients (OS HR = 1.6, P = 0.35; PFS HR = 1.56, P = 0.38) of gastric cancer patients. There was a significant positive correlation between TIMP2 expression and different type of immune cells, including CD4 + T cells, CD8 + T cells, macrophages, Neutrophils, and dendritic cells in stomach adenocarcinoma (STAD) and colon adenocarcinoma (COAD). Moreover, TIMP2 expression was strongly correlated with different sets of immune markers. These results suggest that TIMP2 is associated with prognosis and level of immune infiltrating in a variety of cancers, especially colon and gastric cancer patients. Moreover, expression of TIMP2 potentially contributes to regulation of tumor-associated macrophages (TAMs), dendritic cells, T cell exhaustion and Tregs in colon and gastric cancer. These findings suggest that TIMP2 may serve as a prognostic biomarker for predicting prognosis and immune infiltration in gastric and colon cancer.
Privacy Risks of Whole-Slide Image Sharing in Digital Pathology
Authors: Holub Petr , Müller Heimo , Bíl Tomáš , Pireddu Luca , Plass Markus , Praßer Fabian , Schlünder Irene , Zatloukal Kurt , Nenutil Rudolf , Brázdil Tomáš
Published: April 2022

Access to large volumes of so called whole-slide images, high-resolution scans of complete pathological slides, has become a cornerstone of development of novel artificial intelligence methods in digital pathology, but has broader impact for medical research and education/training. However, a methodology based on risk analysis for sharing such imaging data and applying the principle "as open as possible and as closed as necessary" is still lacking. In this article we develop a model for privacy risk analysis for whole-slide images, which focuses primarily on identity disclosure attacks, as these are the most important from a regulatory perspective. We develop a mathematical model for risk assessment and design a taxonomy of whole-slide images with respect to privacy risks. Based on these risk assessment model and the taxonomy, we design a series of experiments to demonstrate the risks on real-world imaging data. Finally, we develop guidelines for risk assessment and recommendations for low-risk sharing of whole-slide image data.
Heterogeneity in prevalence of subclinical Plasmodium falciparum and Plasmodium vivax infections but no parasite genomic clustering in the Chittagong Hill Tracts, Bangladesh
Authors: Huwe Tiffany , Kibria Mohammad Golam , Johora Fatema Tuj , Phru Ching Swe , Jahan Nusrat , Hossain Mohammad Sharif , Khan Wasif Ali , Price Ric N , Ley Benedikt , Alam Mohammad Shafiul , Koepfli Cristian
Published: April 2022

BackgroundMalaria remains endemic in Bangladesh, with the majority of cases occurring in forested, mountainous region in the Chittagong Hill Tracts (CHT). This area is home to Bengali and diverse groups of indigenous people (Pahari) residing largely in mono-ethnic villages.Methods1002 individuals of the 9 most prominent Pahari and the Bengali population were randomly selected and screened by RDT and qPCR. Parasites were genotyped by msp2 and deep sequencing of 5 amplicons (ama1-D3, cpmp, cpp, csp, and msp7) for P. falciparum (n=20), and by microsatellite (MS) typing of ten loci and amplicon sequencing of msp1 for P. vivax (n=21). Population structure was analyzed using STRUCTURE software. Identity-by-state (IBS) was calculated as a measure of parasite relatedness and used to generate relatedness networks. ResultsThe prevalence of Plasmodium falciparum and Plasmodium vivax infection was 0.7% by RDT (Pf: 6/1002; Pv: 0/1002, mixed: 1/1002) and 4% by qPCR (Pf: 21/1002; Pv: 16/1002, mixed: 5/1002). Infections were highly clustered, with 64% (27/42) of infections occurring in only two Pahari groups, the Khumi and Mro. Diversity was high; expected heterozygosity was 0.93 for P. falciparum and 0.81 for P. vivax. 85.7% (18/21) of P. vivax and 25% (5/20) of P. falciparum infections were polyclonal. No population structure was evident for either species, suggesting high transmission and gene flow among Pahari groups. ConclusionsHigh subclinical infection prevalence and genetic diversity mirror ongoing transmission. Control activities should be specifically directed to Pahari groups at greatest risk.
A multipole-based effect catalog system for the systematic identification of potential measurands
Authors: Welzbacher Peter , Kirchner Eckhard , Vorwerk-Handing Gunnar
Published: April 2022

Caused by the constantly progressing digitalization in engineering, a significant demand for information about characteristic process and state variables of technical systems arises, e.g. as basis for digital twins or predictive maintenance. However, since it is oftentimes neither obvious what nor how to measure, the integration of measuring functions, in particular in terms of a retrofit, represents a current major challenge in mechanical engineering. In order to overcome this challenge, an approach for the systematic identification of potential measurands is provided in this contribution. For this purpose, the approach of physical effect catalogs is taken up and used for the systematic identification of potential measurands, starting from a physical variable to be determined. Existing catalog systems have two major limitations with respect to the intended identification of cause-effect relationships: on the one hand, existing effect catalogs assume an effect to be realized and not a cause and, on the other hand, a consideration of design parameters of a technical system is not intended. These limitations are overcome by linking the basic ideas of existing catalog systems with the fundamentals of multipole-based modeling. In this way, a multipole-based effect catalog system is developed. The developed catalog system creates the basis to systematically include the changes and transformations of a process or state variable to be determined in a technical system into the identification of potential measurands.
Dynamical geography and transition paths of Sargassum in the tropical Atlanti
Authors: Beron-Vera Francisco J. , Olascoaga Maria J. , Putman Nathan F. , Triñanes Joaquin , Lumpkin Rick , Goni Gustavo
Published: April 2022

By analyzing a time-homogeneous Markov chain constructed using trajectories of undrogued drifting buoys from the NOAA's Global Drifter Program, we find that probability density can distribute in a manner that resembles very closely the recently observed recurrent belt of high Sargassum density in the tropical Atlantic between 5-10oN coined the Great Atlantic Sargassum Belt (GASB). A spectral analysis of the associated transition matrix further unveils a forward attracting almost-invariant set in the northwestern Gulf of Mexico with a corresponding basin of attraction disconnected from the Sargasso Sea, but including the nutrient-rich regions around the Amazon and Orinoco rivers mouths and also the upwelling system off the northern coast of west Africa. This represents a data-based inference of potential remote sources of Sargassum recurrently invading the Intra-Americas Seas (IAS). By further applying Transition Path Theory (TPT) on the data-derived Markov chain model, two potential pathways for Sargassum into the IAS from the upwelling system off the coast of Africa are revealed. One TPT-inferred pathway takes place along the GASB. The second pathway is more southern and slower, first going through the Gulf of Guinea, then across the tropical Atlantic toward the mouth of the Amazon River, and finally along the northeastern South American margin. The existence of such a southern TPT-inferred pathway may have consequences for bloom stimulation by nutrients from river runoff.
A comparison of serum copper levels in patients with papillary thyroid carcinoma, nodular goiter, and healthy volunteers
Authors: Maneeprasopchoke Prachya , Phousamran Phoupong , Pongsapich Warut , Pithuksurachai Paveena , Worrakulpanit Jakrit , Keawvijit Tippanate , Poungvarin Naravat , Amornpichetkul Kanchana , Chongkolwatana Cheerasook
Published: April 2022

Serum copper (Cu) is an essential trace element that plays a key role in thyroid hormone production. An inappropriate level of serum Cu might be related to development of both benign and malignant thyroid neoplasm. Nodular goiter and papillary thyroid carcinoma (PTC) are common benign and malignant tumors of the thyroid, respectively. This study aims to compare the serum Cu levels of healthy women with women with PTC or nodular goiter. A total of 205 Thai women were recruited for this cross-sectional study. The reference group was comprised of 100 healthy volunteers. There were 61 nodular goiter and 41 PTC patients that had been treated with surgery. Serum Cu was measured using an atomic absorption spectrophotometer and the three groups were compared. The serum Cu levels of the PTC, nodular goiter and the reference group were 0.99 ± 0.27 µg/ml, 1.07 ± 0.26 µg/ml and 1.00 ± 0.30 µg/ml, respectively. The results were not statistically different (P = 0.26). A post hoc subgroup analysis in the PTC group showed serum Cu levels were significantly higher in the blood vessel invasion group (P = 0.01) and the BRAFV600E mutation group (P = 0.04), but no relationships between serum Cu and other aggressive histopathology were observed. The serum Cu levels of patients with PTC and nodular goiter were not different and did not differ significantly from the reference group. Thus, serum Cu cannot be applied to stratify risk in indeterminate thyroid nodules. Nevertheless, higher serum Cu levels were associated with blood vessel invasion and BRAFV600E mutation in PTC. Therefore, this trace element might have a potential role in prognostication of PTC.
Primary Clear Cell Carcinoma of the Pancreas
Authors: Kang Yoo Na
Published: April 2022

The most common malignant tumor of the pancreas is ductal adenocarcinoma. Focal clear cell changes in the ductal component of pancreatic ductal adenocarcinoma are rarely observed. Clear cell carcinomas composed almost entirely of clear tumor cells are very rare. We present a case of a 72-year-old man with a pancreatic mass, which was detected on abdominal computed tomography (CT), and a history of hepatitis B, hepatitis C, and hepatocellular carcinoma. He had received treatment with Zeffix, peginterferon, ribavirin, and radiofrequency ablation twice until 2 years prior. One year prior, follow-up contrast-enhanced abdominal CT revealed a newly developed pancreatic mass. Laparoscopic radical antegrade modular pancreato-splenectomy was performed under the clinical diagnosis of pancreatic ductal adenocarcinoma. An ill-defined white-to-tan firm solid mass was observed in the pancreas, approximately 2.0 cm in diameter. The tumor cells showed > 90 % clear cell features, with large round to oval nuclei and abundant clear cytoplasms, and well-defined cell membranes. Immunohistochemical staining revealed that the tumor cells were positive for pan-cytokeratin, cytokeratin 7, cytokeratin 19, HNF-1β, MUC-1, and p53. We excluded the possibility of metastatic clear renal cell carcinoma, neuroendocrine carcinoma, perivascular epithelioid cell tumor, malignant melanoma, and sarcoma because immunohistochemical staining of the tumor cells did not reveal the presence of vimentin, chromogranin, synaptophysin, and HMB45. Consequently, his condition was diagnosed as primary clear cell carcinoma of the pancreas, and he received postoperative radiotherapy and folfirinox chemotherapy after surgery. However, 11 months after surgery, a newly developed hepatic metastatic lesion was detected.
Extra-osseous Primary Ewing’s Sarcoma of the Lungs Mistakenly Diagnosed and Managed as Hemothorax: An Extremely Aggressive and Fatal Rare Tumor with an Unusual Site
Authors: Osman Ahmed Adam , Bashir Ahmed Muhammad , Mutlu Eren , Ibrahim Ismail Gedi
Published: April 2022

Extraosseous Ewing's sarcoma of the lungs is a rare soft tissue tumor of pediatric and adolescent usually found in the extremities. In this case report, we describe such a case in a four year-old-male child presented with shortness of breath, cough, left side chest pain, and hemoptysis for two months. We reviewed clinical, radiological and pathological findings for this rare malignancy. This rare and fatal malignancy has been misdiagnosed and managed inappropriately because of low suspicion of index of taking this into the differential diagnosis.
Acoustic observations of lava fountain activity during the 2021 Fagradalsfjall eruption, Iceland
Authors: Lamb Oliver , Gestrich Julia , Barnie Talfan , Jónsdóttir Kristín , Ducrocq Cécile , Shore Michael , Lees Jonathan , Lee Stephen
Published: April 2022

The 2021 eruption within the Fagradalsfjall volcanic system in Iceland provided a rare opportunity to record acoustic data generated by a basaltic fissure. Eruptive activity in May 2021 was defined by a sequence of repetitive lava fountaining activity. Here we describe key observations and analysis conducted on acoustic data recorded by a four-element infrasound microphone array near the eruption site. Detailed inspection of acoustic waveforms and comparisons with seismic data and lava fountain height measurements revealed a complex eruptive sequence during each lava fountain event: acoustic tremor during peak lava fountaining was followed by a transition to Strombolian-style activity with distinct high-amplitude impulsive waveforms. Quantitative comparisons to jet noise spectra finds complex turbulence acoustics during each event, with evidence of variations in the wavefield centred on peak lava fountain heights. Strombolian explosions could mostly be modelled by oscillations of bursting gas slugs at the top the magma column, with a minor number of events exhibiting Helmholtz resonance behaviour instead. We find an increase in bubble radii between early and late May, suggesting a widening of the upper conduit during the lava fountain sequence. Finally, we propose that higher acoustic amplitudes, in addition to a wider conduit in late May, indicates higher gas flux through the conduit culminating in shorter lava fountain events. This study highlights the value of deploying acoustic sensors for providing additional constraints on eruption dynamics and source parameters during effusive fissure eruptions in Iceland and elsewhere.
Identification of key molecules and significant signaling pathways in HNRNPK regulated lung cancer cells
Authors: Guo Hongmei , Wang Mengshan
Published: April 2022

Lung cancer is the primary cause of cancer deaths in the United States. Many potential therapeutic targets for which drugs are constantly under development. Heterogeneous nuclear ribonucleoprotein K (HNRNPK) is a regulatory protein that is related to various cancer development. However, the mechanism is still not clear. Here, our objective is to identify the key molecules and signaling pathways by analyzing the RNA-seq data. The GSE197946 was created by the Illumina HiSeq 2000 (Homo sapiens). The KEGG and GO analyses revealed Apelin signaling pathway and Oxytocin signaling pathway were the main changed biological processes. Moreover, we further identified several interactive genes including EGFR, FOS, NOTCH1, EGR1, MMP2, ITGAM, PRKACB, ICAM1, H6PD, and SPP1. Our study may provide novel insights into the treatment of lung cancer.
Hyperoxia in the ICU and what has changed in 100 years in the tactics of using oxygen in medicine: a review
Authors: Orlov Yuriy P. , Govorova N. V. , Lukach V. N. , Kondratyev A. I. , Kakulya E. N. , Klementyev A. V. , Baytugaeva G. A. , Glushchenko A. V. , Tsilina S. V. , Khilenko I. A.
Published: April 2022

INTRODUCTION. Oxygen, discovered in the XVIII century, is not only a necessary chemical element for the normal functioning of cells and the maintenance of life, but also an important component of the treatment of a wide range of critical conditions occurring with various variants of acute respiratory failure underlying the development of multiple organ failure. The use of oxygen in medicine is an indispensable tool in various critical situations. OBJECTIVES. To highlight in the review the predominantly toxic effects of oxygen, as well as existing data from experimental and fundamental studies on the potentiation role of hyperoxia in the processes of activation of free radical oxidation, leading to excessive synthesis of reactive oxygen species, which, in turn, are a leading factor in the pathogenesis of any critical condition always associated with hypoxia. MATERIALS AND METHODS. The review presents data from experimental studies, meta-analyses, randomized clinical trials that reflect the contribution of hyperoxia to the mortality rates of patients of intensive care units in a wide range of critical conditions. CONCLUSIONS. Maintaining tissue oxygenation by titrating oxygen concentrations to target pO2 and SpO2 levels against the background of constant monitoring of gas exchange parameters will avoid manifestations of toxic effects of oxygen (hyperoxia) in conditions of intensive care of critical conditions.
The use of combined extracorporeal detoxification in the treatment of toxic rhabdomyolysis complicated by acute kidney injury: single-center prospective randomized trial
Authors: Masolitin Sergey V. , Protsenko D. N. , Tyurin I. N. , Mamontova O. A. , Magomedov M. A. , Kim T. G. , Popov A. Y.
Published: April 2022

INTRODUCTION. Rhabdomyolysis (RM) occurs in 40–60 % of patients with acute poisoning and is accompanied by acute kidney injury (AKI). The most effective method of treatment is the use of extracorporeal detoxification. The most promising is the combined methods of detoxification. OBJECTIVES. Improve outcomes in patients with toxic RM complicated by AKI through early use of selective hemosorption and hemodiafiltration. MATERIALS AND METHODS. The study included 57 patients with toxic genesis RM complicated by AKI. The first group received standard intensive therapy. For the treatment of the second group at the early stage of AKI, hemodiafiltration and selective hemoperfusion were used. We performed a comparative analysis of the dynamics of the main clinical and laboratory parameters, as well as treatment outcomes between groups. RESULTS. The use of selective hemoperfusion and hemodiafiltration at the early stage of AKI allowed to increase the decrease in the level of myoglobin in the blood from 26.3 to 88.0 % and KIM-1 in the urine from 76.1 to 99.0 % during the first week of treatment in the ICU (intensive care unit). Combined detoxification reduced the duration of RRT use from 15 to 6 days, which led to a significant decrease in the level of hospital mortality from 14.3 to 6.9 %, the duration of inpatient treatment from 19.5 to 11 days and the period of stay in the ICU from 11 to 4 days. CONCLUSIONS. Early use of combined extracorporeal detoxification leads to a significant decrease in the level of endogenous intoxication factors, which ultimately made it possible to reduce the duration of treatment in the ICU, hospital and reduce the level of hospital mortality.
A pas de deux of osteoporosis and sarcopenia: osteosarcopenia
Authors: Yakushevskaya O. V. , Yureneva S. V. , Komedina V. I.
Published: April 2022

The growing interest in the tandem of osteoporosis and sarcopenia is dictated by a higher level of low-traumatic fractures, disability, and mortality than against the background of individual diseases. Osteoporosis and sarcopenia are associated with aging and are characterized by a simultaneous decrease in bone and muscle mass. Osteoporosis and sarcopenia share common risk factors (genetic, endocrine, dietary and lifestyle conditions) and etiopathogenetic pathways that combine diseases into a single syndrome known as osteosarcopenia. Among the hormonal factors that play a leading role in the development and maintenance of the functional state of bone and muscle tissue, it is necessary to single out estrogens. Currently available research results confirm the protective effect of hormone replacement therapy in relation to osteoporosis. Data on sarcopenia and hormone replacement therapy require further research. Correct understanding and application of therapeutic strategies is essential in order to stop the growing wave of low-traumatic fractures.
The interplay of hormonal and infectious factors in the pathogenesis of complicated pregnancy
Authors: Amiraslanova M. M. , Zemlina N. S. , Kuznetsova I. V.
Published: April 2022

Introduction. The causes for adverse pregnancy outcomes are usually complex and, in some cases, can worsen each other.

Aim. To assess the role and establish the interplay of hormonal and infectious factors in the pathological course of pregnancy in women with threatened spontaneous miscarriage.

Materials and methods. A total 120 pregnant women were enrolled for the observational prospective study, in which they were divided into 4 groups. Group 1 included 32 patients with threatened spontaneous miscarriage and hyperandrogenism (HA), who received glucocorticosteroids (GCS); group 2 included 28 patients with threatened spontaneous miscarriage and HA, who did not receive GCS; group 3 included 30 patients with threatened spontaneous miscarriage without HA; group 4 (control) included 30 women with a physiological course of pregnancy. The following examination methods were used: clinical assessment of the course of pregnancy; measurement of the serum levels of dehydroepiandrosterone sulfate (DHEA-S), 17-hydroxyprogesterone (17-OHP) and total testosterone at weeks 5 to 8, 9 to 12, 13 to 18, 19 to 24 and 25 to 32 of gestation; microbiological tests of  vaginal discharge.

Results. The evaluation of androgenic status showed that the levels of the tested hormonal parameters in women with HA significantly exceeded those of the control group, while the changes in 17-OHP and testosterone secretion was comparable to that in women without HA, and DHEA-S level decreased to control values by the third trimester. The use of corticosteroids was associated with significant changes in the values and secretion levels of 17-OHP and DHEA-S, but not testosterone; DHEA-S levels decreased to the values that were significantly lower as compared to all groups in the third trimester of pregnancy.

Conclusions. Vaginal infections play an important role in the genesis of gestational failures. Hyperandrogenism exacerbates the problem of miscarriage, however, the use of corticosteroids does not result in improved hormonal characteristics and clinical pregnancy outcomes, deteriorating the vaginal biocenosis.
Pregnancy outcomes and thyroid dysfunction: preterm birth risk assessment
Authors: Mateykovich E. A. , Chernova A. L. , Shevlyukova T. P. , Sukhanov A. A.
Published: April 2022

Introduction. Subclinical hypothyroidism occurs in 2–3% of pregnant women and is often associated with pregnancy complications, including preterm birth.

Aim – to study correlations between thyroid dysfunction and pregnancy outcomes.

Materials and methods. 64 clinical cases of managing pregnant women in the Perinatal Center (Tyumen) were analyzed for 2017– 2021: 28 women with thyroid-stimulating hormone (TSH) > 2.5 mU/l, 36 women with TSH ≤ 2.5 mU/l) during the entire period of pregnancy. Quantitative features are described by absolute and relative (percentage) indicators. The probability of outcome depending on the presence of a clinical-amnestic factor was assessed by determining the relative risk (RR) and 95% confidence interval (CI). The level of statistical significance in testing the null hypothesis is p < 0.05.

Results. There were no differences in pregnant women with and without subclinical hypothyroidism when considering such medical and social factors as age, marital status, work, education, nicotine addiction, obesity, kidney disease. An increased risk of preterm delivery was found in patients with a TSH level > 2.5 mU/l: RR 1.41 (0.59–3.37), especially against the background of a positive test for antibodies to thyroperoxidase: RR 1.63 (0.62–4.28). In the absence of treatment, the risk of early delivery, preterm birth, preeclampsia was revealed.

Conclusions. A universal approach to determining the threshold values of TSH for the diagnosis of subclinical hypothyroidism in pregnant women, to the need and tactics of its treatment has not been developed. Diseases of the thyroid gland are endemic for Western Siberia, often associated with iron deficiency anemia, their high frequency in the anamnesis of pregnant women is  noted. Establishing a  correlation between subclinical hypothyroidism, hormonal correction and pregnancy complications requires further research. An obstacle is the lack of proper diagnosis of the TSH level in women who give birth on an emergency basis in early gestational periods.
An innovative approach to the prevention and treatment of acute respiratory tract infections in children
Authors: Larkova I. A. , Revyakina V. A.
Published: April 2022

The problem of prevention and treatment of acute respiratory infections of the upper respiratory tract remains extremely at the top. Although viruses are the etiological factor in more than 90% of acute respiratory infections, the fact of the active use of antibiotics in the treatment of patients with this patology, along with the lack of effective antiviral agents can cause increasing concern, since this is assocatied with an increase in bacterial resistance, sensitization and inflammatory diseases and therefore requires the development of completely different alternative methods of treatment. Since the discovery of the human microbiome over the past two decades, not only the microbiota as a participant in the infectious process, but also probiotics as a factor in managing the immune responses of the macroorganism in viral infections have been actively studied. In addition, the antiviral activity of different probiotic strains has been demonstrated in the scientific literature, which explains the interest of the scientific community in the use of probiotics in acute respiratory infections, especially since probiotics have shown not only efficacy, but aalso high safety in patients of different age groups, including infants. Thus, the literature review showed that the currently available data both from clinical studies and experimental work on the use of probiotics in acute respiratory infections indicate the potential of such an innovative strategy not only for the prevention but also for the treatment of the acute period of the disease, which should be the basis for its wider use in real practice.
Obesity, caesarean section, antibiotics and their impact on the distortion of the breast milk microbiota
Authors: Kuchina A. E. , Zakharova I. N.
Published: April 2022

The autonomous regulation of the composition of breast milk according to the baby’s needs is perhaps the most unique and mysterious mechanism. Under physiological conditions, the first drops of milk are rich in antioxidants that the newborn needs to combat oxygen deprivation. Milk to nourish boys is more nutritious and night milk is rich in melatonin, which can soothe and put the baby to sleep. Unfortunately, the conditions surrounding a pregnant woman and her newborn baby are not always natural. Many external factors are considered in the context of the risk of adverse effects on the health of the mother and the baby. This article discusses the most common factors that distort the microbiota of breast milk: obesity, delivery mode and antibiotic prophylaxis. Caesarean section, which significantly depletes the bacterial diversity of breast milk, is reported to be the most important factor. The associated disruption of  microbial colonisation in  infancy leads to a  high risk of  inflammatory bowel disease  (including Crohn’s disease and ulcerative colitis), diabetes mellitus, rheumatoid arthritis and  celiac disease in  children. However, there is another opinion that attributes all the consequences of caesarean section to the necessary preoperative antibiotic prophylaxis in most countries. Maternal obesity also leads to low microbial diversity and impoverishment of breast milk with members of the Bifidobacterium genus, which in turn leads to reduced immunomodulatory potential of breast milk in these women. Often these three factors constitute a  vicious circle of  problems that interfere with the  natural and proper process of forming a healthy microbiome in the newborn and require individualised and professional paediatric care.
Current guidelines for the selection of an antibacterial drug in children with community-acquired pneumonia
Authors: Zaytseva S. V. , Zaytseva O. V.
Published: April 2022

The COVID-19 pandemic has affected the incidence of acute respiratory infections in the modern world. Despite the growing etiological significance of viruses in the structure of infectious diseases, the importance of bacterial pathogens in the development of  respiratory pathology remains. The risk of  unreasonable prescription of  antibacterial drugs increases. The irrational use of antibacterial drugs has affected the spread of microorganisms with high resistance to antibiotics. The article presents current knowledge on the role of the most common pathogens of community-acquired pneumonia in children, data concerning the S. pneumoniae strain with reduced sensitivity and resistance to penicillin, macrolides. Information about isolates of S. Pneumoniae with decreased susceptibility to third-generation parenteral cephalosporins (cefotaxime and ceftriaxone) have appeared. The number of β-lactamase-producing strains of H. influenzae resistant to unprotected aminopenicillins is rising. The main steps of the diagnostic process of community-acquired pneumonia approved in the clinical guidelines for community-acquired pneumonia in children in 2022, which were adopted by the Russian Ministry of Health, are considered. This document sets out clear algorithms for diagnosing and selecting antibacterial therapy in children on an outpatient basis. Algorithms for selecting initial antibacterial therapy in outpatient settings are also proposed. In most cases, S. pneumoniae is a causative agent of community-acquired pneumonia in children, which defines the selection of an initial antibacterial drug. According to the clinical guidelines, oral amoxicillin at a standard dose of 45–55 mg/kg/day given in 2–3 divided doses is such a drug for children aged 3 months and older. Particular attention is paid to amoxicillin in the form of dispersible tablets.