bluuebunny/crossref_metadata_2025 huggingface dataset:
Nasopharyngeal myeloid sarcoma as a manifestation of acute monomyelocytic leukaemia
Authors: Pervaiz Arbaaz , Brimioulle Marina , Qureishi Ali , Royston Daniel
Published: December 2023

This case report describes the case of a man in his seventies presenting with a nasopharyngeal deposit of myeloid sarcoma associated with acute monomyelocytic leukaemia. He presented with right nasal obstruction associated with unilateral pulsatile tinnitus. CT and MRI scans of sinuses identified a moderately restricting mucosal swelling of the right torus tubarius, and a biopsy of the lesion diagnosed a nasal deposit of myeloid sarcoma.
Macroscopic pathology and all that: a personal view
Authors: Shepherd Neil A
Published: December 2023

I hope that this treatise adds to the excellent reviews by Varma and colleagues, emphasising the importance of accurate macroscopic assessment and report provision. I have especially highlighted the importance of not divorcing the clinical data and the macroscopic analysis from the microscopic assessment as all are required to provide an accurate and cogent overall composition. The review has also identified areas where the evolution of pathological practice has gone a little awry and requires to be modified and/or justified with evidence base. There is also an emphasis on block economy, as there is no doubt that considerable savings can be made if more attention is paid to more judicious block selection. It is also commended that subspecialties other than gastrointestinal pathology introduce reporting quality standards, like lymph node harvest numbers and other important prognostic and management indicators, to improve the quality of macroscopic pathology worldwide to the benefit of our service users and their patients.
Rare myxoid pleomorphic liposarcoma: a case report and literature review
Authors: Shen Yanying , Zhao Ling , Li Anqi , Peng Qi , Liu Qiang , Wang Lisha , Liu Zebing
Published: December 2023

We report a case of a middle-aged woman with a rapidly growing abdominal mass that was diagnosed as myxoid pleomorphic liposarcoma, a recently recognised, rare and aggressive subtype of liposarcoma. The tumour exhibits a combination of histological features from both myxoid liposarcoma and pleomorphic liposarcoma. Genetic analysis revealed mutations in TP53 and RB1, along with widespread loss of heterozygosity. However, no DDIT3 gene translocation or MDM2/CDK4 gene amplification was detected. These genetic characteristics can be used to distinguish this type of liposarcoma from others. Two unusual gene fusion/rearrangements,CREB5::TERTfusion andETV1::LFNGrearrangement, were identified. The patient underwent complete removal of the tumour without the use of radiotherapy or chemotherapy. No recurrence was observed during the follow-up period of 18 months.
Schaumann bodies deposited along myenteric plexus of the muscularis propria is a unique histopathological feature of Crohn’s disease
Authors: Liu Xinning , Huang Yan , Liu Ni , Duan Xiaoyu , Jiang Jingyi , Chen Minhu , Ren Mao , Qiu Yun , Ye Ziyin
Published: December 2023

Aims

Schaumann bodies were first identified in sarcoidosis by Dr Schaumann in 1941. They were also detected in 10% of Crohn’s disease (CD) cases in a study involving patients with surgically resected CD. However, the characteristics and significance of Schaumann bodies in CD have yet to be fully elucidated. This study aimed to determine the pathological features and diagnostic significance of Schaumann bodies in various bowel diseases.

Methods

Overall, 278 bowel specimens were collected from patients with CD, intestinal tuberculosis, ulcerative colitis, intestinal schistosomiasis, diverticulosis and idiopathic mesenteric vasculopathy. The frequency, pathology and clinical features of patients with Schaumann bodies were studied.

Results

Schaumann bodies were present exclusively in CD (27.0%, 38 of 141) and were not detected in other intestinal diseases within the series. In CD, Schaumann bodies were deposited along the myenteric plexus of the muscularis propria (84.2%, 32 of 38). These bodies were small (diameter: 60.3±32.7 µm) and exhibited a low density in the intestinal wall (1.1±0.4 per low-power field). The majority were located within the cytoplasm of multinucleated giant cells (84.2%, 32 of 38) and were not found within or adjacent to granulomas. Notably, the number of female patients with CD and Schaumann bodies was higher than that of males.

Conclusion

Schaumann bodies are common in resected CD specimens, and their characteristic deposition pattern may serve as a diagnostic indication for CD.
Seismic vulnerability assessment of post-tensioned timber building fitted with dissipative bracing systems
Authors: Odikamnoro Ikenna Harold , Badal Prakash S , Tesfamariam Solomon
Published: December 2023

A post-tensioned (PT) timber building coupled with dissipative bracing systems is a sustainable seismic-resistant structural system. This system combines desirable qualities of self-centering, energy dissipation, and lightweight timber, which attracts lesser seismic force and contributes to a better resilient system. Despite significant advancement in the provision of these sustainable seismic-resistant timber-based structural archetypes, more study is required to derive a fuller knowledge of the behaviour of these innovative structural systems under a range of ground motion intensities and limited state capacities. Direct displacement-based design, a performance-based design approach, is used for the design of this system, and performance assessment is carried out using nonlinear dynamic analysis. This study investigates the performance of the braced PT frame under different limit state considerations using ground motion records consistent with the NBC 2020 seismic hazard.
Seeding rate and sulfur drive field pea yields in the Maritime region of Canada
Authors: Mills Aaron A.S. , Fillmore Sherry A.E.
Published: December 2023

The inclusion of pulse crops in Canadian rotations has the potential to improve cropping system efficiencies, reduce the overall amount of applied nitrogen, provide economic opportunities for producers, and reduce the overall carbon footprint of the cropping system. Although primarily grown in western Canada, many pulse species—field pea in particular, are well suited to temperate growing conditions in the Maritime region of Canada. A study was conducted over 2 years at Harrington, Prince Edward Island, and consisted of four field pea varieties including two yellow varieties (AAC Lacombe and CDC Saffron) and two green varieties (CDC Limerick and CDC Raezer) planted at three plant population densities: 75, 100, and 125 plants m−2. The study also measured the effects of nitrogen fertilizer applied pre-plant (0 kg ha−1 vs. 15 kg ha−1) and applied plant available sulfur (0 kg ha−1 vs. 25 kg ha−1). Overall, yellow pea varieties were higher yielding than green pea varieties, and there was a linear increase in yield with increased seeding rate. There were no significant effects of pre-plant nitrogen fertilizer on yield, although it did slightly increase seed protein. Applied sulfur had a positive effect on yield and a slightly negative effect on thousand seed weight. This experiment provides a recommendation for the optimal seeding rate (100 plants m−2) and fertility recommendations to achieve profitable yields growing field pea in the Maritime region of Canada.
The nonleptonic decays of b-flavored mesons to S-wave charmonium and charm meson states
Authors: Dash Kalpalata , Dash P. C. , Panda R. N. , Nayak Lopamudra , Kar Susmita , Barik N.
Published: December 2023

The detection of radially excited charmonium and charm meson states, and measurement of heavy meson decays, particularly $$B_c^+\rightarrow J/\psi D_s^+$$

B
c
+

→
J
/
ψ

D
s
+

and $$B_c^+\rightarrow J/\psi D_s^{*+}$$

B
c
+

→
J
/
ψ

D
s

∗
+

, by the LHCb and ATLAS Collaborations, have aroused a lot of theoretical interest in the nonleptonic decays of b-flavored mesons. In this paper, we study the exclusive two-body nonleptonic $${\bar{B}}^0$$

B

¯

0

, $$\bar{B_s^0}$$

B
s
0

¯

, $$B^-$$

B
-

and $$B_c^-$$

B
c
-

-meson decays to two vector meson ($$V_1(nS)V_2$$

V
1

(
n
S
)

V
2

) states. Assuming the factorization hypothesis, we calculate the weak-decay form factors from the overlapping integrals of meson wave functions, in the framework of the relativistic independent quark (RIQ) model. We find a few dominant decay modes: $$B^-\rightarrow D^{*0}\rho ^-$$

B
-

→

D

∗
0

ρ
-

, $$\bar{B^0}\rightarrow D^{*+}\rho ^-$$

B
0

¯

→

D

∗
+

ρ
-

, $$\bar{B_s^0}\rightarrow D_s^{*+}\rho ^-$$

B
s
0

¯

→

D
s

∗
+

ρ
-

, $$B^-\rightarrow J/\psi K^{*-}$$

B
-

→
J
/
ψ

K

∗
-

and $$B_c^-\rightarrow J/\psi D_s^{*-}$$

B
c
-

→
J
/
ψ

D
s

∗
-

with predicted branching fractions of 1.52, 1.40, 1.16, 0.46 and 0.27 (in $$\%$$
%
), which are experimentally accessible. The predicted branching fractions for corresponding decay modes to excited (2S) states, obtained in $${{\mathscr {O}} }(10^{-3}-10^{-4})$$

O
(

10

-
3

-

10

-
4

)

lie within the detection accuracy of the current experiments at LHCb and Tevatron. Our predicted CP-odd fractions ($$R_\perp $$

R
⊥

) for color-favored $$B_c$$

B
c

-decays to two charmful states ($$D^*D^*_{(s)}$$

D
∗

D

(
s
)

∗

) are found significant as compared to similar decay modes of other b-flavored mesons.
Plasmon-associated DNA genotyping based on crystalline assemblies of metallic carbon nanotubes
Authors: Grushevskaya H. V. , Egorova V. P. , Krylova N. G. , Babenka A. S. , Krylov G. G.
Published: December 2023

Sensitivity and selectivity of modern electrochemical genotyping methods are insufficient to detect a single-oligonucleotide mismatch in low-concentration native DNA samples. Novel methods of tuning, controlling, and monitoring plasmon modes are necessary to achieve attomolar and higher sensitivity for the modern graphene-based transducers of molecular signals. The electrochemical DNA assay is promising one for applications in the molecular diagnostics of tumors with the genome single-nucleotide polymorphism (SNP) for simultaneously discriminating both wild-type and mutant alleles of the gene in very small concentrations. We offer the plasmon-associated DNA-genotyping method based on the screening effects in assemblies of Raman-optically active conjugates comprising DNA and metallic carbon nanotubes. The impedimetric DNA sensors of non-Faradaic type based on the plasmonic screening effect can be more sensitive than the Raman optical transducer based on Raman DNA optical activity resulting in the plasmon resonance due to liability of the Raman transducer parameters to environmental influence.
VARDHMAN ENVIROTECH: CREATING BLUE OCEAN AND REINVENTING BUSINESS MODEL
Authors: Ghura Amarpreet Singh , Abhishek
Published: December 2023

Vardhman Envirotech (VE), a startup offering services and solutions in the field of rainwater harvesting, was started by Amit Doshi (Doshi). Doshi, a first-generation entrepreneur, started VE in June 2014 which generated revenues through consulting, selling rain top filter (RTF), selling injection recharge well (IRW) solutions and installation of IRW. VE entered B2B segment in 2017 with IRW and has expanded operations in India and abroad. VE created IRW through value innovation and the company has been successful in installing over 2,300 IRW by 2021. The case provides an opportunity for students to step into the shoes of Doshi and plan a way forward for the future growth of the company. Students have to also reflect on the journey covered so far by Doshi which followed value innovation and reinvented business model. In doing so, students should take into consideration the data regarding the water crises in India and outside India.
A Survey of Recent Advances in Deep Learning Models for Detecting Malware in Desktop and Mobile Platforms
Authors: Maniriho Pascal , Mahmood Abdun Naser , Chowdhury Mohammad Jabed Morshed
Published: December 2023

Malware is one of the most common and severe cyber threats today. Malware infects millions of devices and can perform several malicious activities including compromising sensitive data, encrypting data, crippling system performance, and many more. Hence, malware detection is crucial to protect our computers and mobile devices from malware attacks. Recently, Deep Learning (DL) has emerged as one of the promising technologies for detecting malware. The recent high production of malware variants against desktop and mobile platforms makes DL algorithms powerful approaches for building scalable and advanced malware detection models as they can handle big datasets. This work explores current deep learning technologies for detecting malware attacks on Windows, Linux, and Android platforms. Specifically, we present different categories of DL algorithms, network optimizers, and regularization methods. Different loss functions, activation functions, and frameworks for implementing DL models are discussed. We also present feature extraction approaches and a review of DL-based models for detecting malware attacks on the above platforms. Furthermore, this work presents major research issues on DL-based malware detection including future research directions to further advance knowledge and research in this field.
Beyond Accuracy: An Empirical Study on Unit Testing in Open-source Deep Learning Projects
Authors: Wang Han , Yu Sijia , Chen Chunyang , Turhan Burak , Zhu Xiaodong
Published: December 2023

Deep Learning (DL) models have rapidly advanced, focusing on achieving high performance through testing model accuracy and robustness. However, it is unclear whether DL projects, as software systems, are tested thoroughly or functionally correct when there is a need to treat and test them like other software systems. Therefore, we empirically study the unit tests in open-source DL projects, analyzing 9,129 projects from GitHub. We find that: (1) unit tested DL projects have positive correlation with the open-source project metrics and have a higher acceptance rate of pull requests; (2) 68% of the sampled DL projects are not unit tested at all; (3) the layer and utilities (utils) of DL models have the most unit tests. Based on these findings and previous research outcomes, we built a mapping taxonomy between unit tests and faults in DL projects. We discuss the implications of our findings for developers and researchers and highlight the need for unit testing in open-source DL projects to ensure their reliability and stability. The study contributes to this community by raising awareness of the importance of unit testing in DL projects and encouraging further research in this area.
Synthesis and Optical Properties Investigation of Nanosized Two-Dimensional (Fe1−xSrx Cr2O4)/MXene Nanocomposite
Authors: Akhtar Naseem , Rani Malika , Batool Kiran , Shah Aqeel Ahmad , Habila Mohamed A. , Sillanpää Mika , Arshad Maryam , Saba Hafiza
Published: December 2023

The strontium-doped iron chromite nanoparticles were synthesized using the sol-gel method. Using the co-precipitation method, two-dimensional MXene-based nanocomposite is synthesized. This is the first synthesis of MXene with doped spinel chromites. The characterization of nanocomposite Fe1−xSrxCr2O4/MXene is done using XRD, SEM, EDS, Raman spectroscopy, photoluminescence spectrum (PL), and zeta potential. In nanocomposites, Fe1−xSrxCr2O4/MXene, x = 0.2, 0.4, 0.6, 0.8 strong intensity peaks were observed as compared to MXene parent material. From SEM results it was depicted that spinel chromite Fe1−xSrxCr2O4 nanoparticles were attached to the surface of MXene. From the PL spectrum, the band gap values for MXene are 3.33 eV and decreased to 2.06 eV for nanocomposites Fe1−xSrx Cr2O4/MXene. The zeta potential has been achieved with negative values. The obtained results made this nanocomposite unique and beneficial for electrochemical applications and due to a noticeable reduction in band gap values it has potential applications in optical devices.
An Advanced Early-Stage Production Forecasting Model for Middle-High Rank Coal Development
Authors: Yuan Zhiwang , Liu Yancheng , Wu Hao , Zhang Yifan , Gao Yufei , Zhang Xu
Published: December 2023

Reasonable production prediction of coalbed methane (CBM) is of great significance for improving the economic benefit of CBM reservoirs. Current prediction methods for CBM production focus on the later stages of development, with few studies on early production forecasting. The objective of this work is to provide a reliable new idea for the early production prediction of CBM through various analyses and demonstrations. First, the CBM development modes are classified according to the production characteristics of the Panhe demonstration block of Shaanxi Province, China. Second, an efficient and feasible early production prediction model is established based on the geological potential and development potential. Finally, using the proposed model, different modes’ production characteristics and optimization strategies are analyzed. The research shows that the gas production profiles can be divided into two modes: single-peak mode (SPM) and multipeak mode (MPM). The peak production and average EUR of the SPM are 49.6% and 32.4% higher than those of the MPM, but the stable production period is only 0.2~1 year. In terms of the geological potential of CBM wells, the gas content, critical desorption pressure, and formation coefficient of the SPM are 6.7%, 13.3%, and 37.8% higher than those of the MPM, and the gas wells are mainly located in the high part of the coal seam (the average height difference is about 20 m). Besides, the concept of quasidesorption degree Pdq is innovatively introduced to characterize the development potential of gas well. The Pdq has an exponential relationship with CBM production, and the coefficient of the exponential term in SPM is approximately 22% larger than that in MPM. Moreover, the production of gas wells is greatly affected by the continuity of production. In the process of gas production, the influence of factors such as equipment shutdown should be minimized. To examine the applicability of the proposed method, the model is applied to an actual CBM well in Panhe, and the prediction accuracy is higher than 85%.
Assessments and Identification of Selected Fish-Borne Zoonotic Parasites in Nile Tilapia and African Catfish Species in Lakes of Haramaya District, Ethiopia
Authors: Tesfaye Zinabu , Hiko Adem , Belina Dinaol , Firdisa Merga
Published: December 2023

Global fish consumption increased higher than that of all other animal protein foods. The image of fish as a healthy food is the main reason for increasing demand for fish meat, but there are serious safety concerns related to the presence of fish-borne zoonotic pathogen including parasites. A cross-sectional study was conducted from December 2021 to July 2022 at Lake Haramaya, Lake Tinike, and Lake Adele on Oreochromis niloticus and Clarias gariepinus fish species to determine the prevalence of Contracaecum (Nematoda) and Clinostomum (Trematoda) infection. A total of 384 individuals of C. gariepinus 241 (62.76%) and O. niloticus 143 (37.24%) were sampled from Lake Haramaya 149 (38.8%), Lake Tinike 113 (29.4%) and Lake Adele 122 (31.8%). The overall prevalence of parasite was 30.2% (116/384) and higher overall prevalence of parasite was recorded in Lake Haramaya (36.2%) followed by Lake Adele (27.9%) and Lake Tinike (24.8%). C. gariepinus was more affected than O. niloticus fish and Contracaecum parasite was more prevalent than Clinostomum parasite (37.3% and 18.2%) and (29.9% and 14.6%), respectively. The distribution of parasite was significantly affected with respect to species of fish, sex, weight, and length categories, genera of parasite, and location of parasites. The perception of respondents on fish-borne zoonotic parasite (FBZP) was affected by demographic characteristics of respondents. Human and animals were interacted with the lakes and its environment adversely which can perpetuate the life cycle of FBZP. Moreover, unsafe fish meat processing from harvesting to consumption was the main problem at the study area, which can makes surrounding people under the risk of FBZP. However, the risks associated with FBZP can be reduced through the application of good hygiene, fishing practices, inspection of fish meat, proper storage, adequate cooking of fish, and with the promotion of the community awareness.
Do-Not-ResuscitateDecision-Making during the COVID-19 Pandemic in a Teaching Hospital: Lessons Learned for the Future
Authors: van de Wiel Mick , van Ierssel Sabrina , Verbrugghe Walter , Mertens Veerle , Janssens Annelies
Published: December 2023

Rationale. Contribute to the understanding of DNR decision-making and conducting end-of-life conversations, about which there is a paucity of data available in the current literature. Aims and Objectives. Assess how the decision-making process to determine a DNR code is implemented in the day-to-day clinical practice in a tertiary teaching hospital. Familiarity with the use of different scores as a possible objective support for DNR decisions and the influence of various elements on a DNR decision was explored. Method. A cross-sectional survey study was conducted between February 2021 and April 2021 for all doctors and doctors in training, working in the Antwerp University Hospital during the COVID-19 pandemic. Results. 127 doctors participated in this study. The familiarity with the different scores used in the triage during the COVID-10 pandemic was 51% for the Clinical Frailty Scale (CFS) and 20% for the Charlson Comorbidity Index (CCI). Participants indicated that their DNR decision is based on various aspects such as clinical assessment, comorbidities, patient’s wishes, age, prognosis, and functional state. Conclusion. The familiarity with the different scores used during triage assessments is low. The total clinical picture of the patient is needed to make a considered decision, and this total picture of the patient seems to be well encompassed by frailty measurement (CFS). Although many participants indicated that the different scores do not offer much added value compared to their clinical assessment, it can help guide DNR decisions, especially for doctors in training.
Numerical Simulations of Vertical Discrete Gusts Driven by Trailing Edge Blowing
Authors: Shi Yang , Lu Bo , Guo Peng , Lv Binbin , Guo Hongtao , Yu Li
Published: December 2023

A new type of gust generator generates the airflow oscillation in the wind tunnel through the Coanda effect of the unsteady trailing edge blowing, which has been shown to have strong potential for accurately simulating discrete gusts. It is necessary to study the relationship between the generated gust characteristics and the control parameters of such devices in order to optimize the design performance and improve gust simulation capabilities. By solving the compressible unsteady Reynolds-averaged Navier–Stokes (URANS) equations, the computational fluid dynamics model of the subsonic airflow past the gust generator in the wind tunnel was presented. The effects of jet momentum, frequency, and spanwise blowing ratio on gust intensity, shape, and spatial uniformity were investigated. Results indicate that the intensity of gusts is positively correlated with jet momentum and frequency. The gust shape matches well with the normalized jet momentum coefficient curve. However, when the frequency increases to above 10 Hz, the gust shape differs significantly from expectation due to the appearance of reverse wave peaks. In addition, the mechanism of the impact of the sidewall and partial spanwise blowing on gusts was revealed. In the three-dimensional situation, streamwise vortices are formed on the sidewall and at the spanwise position where the blowing stops, respectively. This results in an increase and noticeable nonuniformity in gust amplitude. When the blowing with a 15% spanwise length near the sidewall is turned off, the gust amplitude at the symmetry plane increases by nearly 40% due to the main vortex being closer to the main flow. The result provides a physical explanation for the availability of this operation to reduce gust attenuation.
The Impact of Relationship on Goal Attainment in a Home-Based Family Support Program
Authors: Siedlik Emily A. , Chiang Danielle F. , Gardner Stephen , Templeton Oneta
Published: December 2023

Home-based family support programs provide early intervention to support families with young children. Home visiting models typically serve pregnant and parenting women with risk factors known to influence the caregiver-child relationship including history of trauma, low academic achievement, low income, limited support networks, maternal depression, and maternal substance use. Few, if any, home visiting models, however, were developed specifically to support families affected by maternal substance use. The Team for Infants Exposed to Substance use (TIES) Program is a home-based family support program exclusively serving families affected by maternal substance use. The model design and intensive services allow TIES participants to achieve significant positive outcomes in the program’s six goal areas: maternal substance use, parenting skills, child mental and physical health, maternal mental and physical health, family income, and family housing. Goal scores are assessed jointly by participants and staff throughout the program using a validated scale. Program staff hypothesize that goal attainment in these areas may be influenced by the therapeutic relationship developed between home visitors and participants. This relationship is assessed using the Working Alliance Inventory (WAI), a validated assessment of therapeutic alliance administered to both participants and staff. An analysis of 127 program participants shows that when controlling for home visitor WAI scores in multilevel models (MLMs), goal attainment scores improved from intake to discharge across all goal areas except for housing stability. These results stress the importance of the therapeutic relationship in maximizing TIES participants’ growth and success.
CYP2A6 Activity and Cigarette Consumption Interact in Smoking-Related Lung Cancer Susceptibility
Authors: Du Mulong , Xin Junyi , Zheng Rui , Yuan Qianyu , Wang Zhihui , Liu Hongliang , Liu Hanting , Cai Guoshuai , Albanes Demetrius , Lam Stephen , Tardon Adonina , Chen Chu , Bojesen Stig E. , Landi Maria Teresa , Johansson Mattias , Risch Angela , Bickeböller Heike , Wichmann H-Erich , Rennert Gad , Arnold Susanne , Brennan Paul , Field John K. , Shete Sanjay S. , Le Marchand Loïc , Liu Geoffrey , Andrew Angeline S. , Kiemeney Lambertus A. , Zienolddiny Shan , Grankvist Kjell , Johansson Mikael , Caporaso Neil E. , Cox Angela , Hong Yun-Chul , Yuan Jian-Min , Schabath Matthew B. , Aldrich Melinda C. , Wang Meilin , Shen Hongbing , Chen Feng , Zhang Zhengdong , Hung Rayjean J. , Amos Christopher I. , Wei Qingyi , Lazarus Philip , Christiani David C.
Published: December 2023

Cigarette smoke, containing both nicotine and carcinogens, causes lung cancer. However, not all smokers develop lung cancer, highlighting the importance of the interaction between host susceptibility and environmental exposure in tumorigenesis. Here, we aimed to delineate the interaction between metabolizing ability of tobacco carcinogens and smoking intensity in mediating genetic susceptibility to smoking-related lung tumorigenesis. Single-variant and gene-based associations of 43 tobacco carcinogen–metabolizing genes with lung cancer were analyzed using summary statistics and individual-level genetic data, followed by causal inference of Mendelian randomization, mediation analysis, and structural equation modeling. Cigarette smoke–exposed cell models were used to detect gene expression patterns in relation to specific alleles. Data from the International Lung Cancer Consortium (29,266 cases and 56,450 controls) and UK Biobank (2,155 cases and 376,329 controls) indicated that the genetic variant rs56113850 C>T located in intron 4 of CYP2A6 was significantly associated with decreased lung cancer risk among smokers (OR = 0.88, 95% confidence interval = 0.85–0.91, P = 2.18 × 10−16), which might interact (Pinteraction = 0.028) with and partially be mediated (ORindirect = 0.987) by smoking status. Smoking intensity accounted for 82.3% of the effect of CYP2A6 activity on lung cancer risk but entirely mediated the genetic effect of rs56113850. Mechanistically, the rs56113850 T allele rescued the downregulation of CYP2A6 caused by cigarette smoke exposure, potentially through preferential recruitment of transcription factor helicase-like transcription factor. Together, this study provides additional insights into the interplay between host susceptibility and carcinogen exposure in smoking-related lung tumorigenesis.

Significance:

The causal pathway connecting CYP2A6 genetic variability and activity, cigarette consumption, and lung cancer susceptibility in smokers highlights the need for behavior modification interventions based on host susceptibility for cancer prevention.
FAM3C in Cancer-Associated Adipocytes Promotes Breast Cancer Cell Survival and Metastasis
Authors: Kim Sahee , Oh Jiyoung , Park Chanho , Kim Min , Jo Woobeen , Kim Chu-Sook , Cho Sun Wook , Park Jiyoung
Published: December 2023

Adipose tissue within the tumor microenvironment (TME) plays a critical role in supporting breast cancer progression. In this study, we identified FAM3 metabolism-regulating signaling molecule C (FAM3C) produced by cancer-associated adipocytes (CAA) as a key regulator of tumor progression. FAM3C overexpression in cultured adipocytes significantly reduced cell death in both adipocytes and cocultured breast cancer cells while suppressing markers of fibrosis. Conversely, FAM3C depletion in CAAs resulted in adipocyte–mesenchymal transition (AMT) and increased fibrosis within the TME. Adipocyte FAM3C expression was driven by TGFβ signaling from breast cancer cells and was reduced upon treatment with a TGFβ-neutralizing antibody. FAM3C knockdown in CAAs early in tumorigenesis in a genetically engineered mouse model of breast cancer significantly inhibited primary and metastatic tumor growth. Circulating FAM3C levels were elevated in patients with metastatic breast cancer compared with those with nonmetastatic breast cancer. These results suggest that therapeutic inhibition of FAM3C expression levels in CAAs during early tumor development could be a promising approach in the treatment of patients with breast cancer.

Significance:

High FAM3C levels in cancer-associated adipocytes contribute to tumor-supportive niches and are tightly associated with metastatic growth, indicating that FAM3C inhibition could be beneficial for treating patients with breast cancer.
FIGURE 4 from Immunologic Signatures of Peripheral Blood T Cells Reveal the Outcome of p53MVA Vaccine and Pembrolizumab Treatment in Patients with Advanced Ovarian Cancer
Authors: Kos Ferdynand J. , Frankel Paul , Cristea Mihaela , Eng Melissa , Tinsley Raechelle , Dempsey Shannon , Ruel Nora , Stewart Daphne , Dellinger Thanh H. , Diamond Don J.
Published: December 2023

Multiplex gene expression analysis of pretreatment PBMC samples identifies a set of genes of potential predictive value. mRNA expression levels of indicated genes that differentiate R (green bars) from NR (red bars) are shown for two pairs of representative patients (A). Expanded analysis of mRNA expression in additional pretreatment PBMC samples in R (n = 5) and NR (n = 12), plus normal healthy controls (C, n = 3; B), confirms the trend observed in A that is further quantified in unpaired two-tailed t test. *, P < 0.05.
Topographic Consideration on the Occurrence of Ipsilesional Facial Paresis in Lateral Medullary Infarction
Authors: Kim Yong Kyun , Kim Yong Bum , Suh Bum Chun , Jeong Yun Hyeong , Ann Soei , Chung Pil Wook
Published: December 2023

Introduction: The purpose of this study was to identify course of the corticobulbar tract and factors associated with the occurrence of facial paresis (FP) in lateral medullary infarction (LMI). Methods: Patients diagnosed with LMI who were admitted to tertiary hospital were retrospectively investigated and divided into two groups based on the presence of FP. FP was defined as grade 2 or more by the House-Brackmann scale. Differences between the two groups were analyzed with respect to anatomical location of the lesions, demographic data (age, sex), risk factors (diabetes, hypertension, smoking, prior stroke, atrial fibrillation, and other cardiac risk factors for stroke), large vessel involvement on magnetic resonance angiography, other symptoms and signs (sensory symptoms, gait ataxia, limb ataxia, dizziness, Horner syndrome, hoarseness, dysphagia, dysarthria, nystagmus, nausea/vomiting, headache, neck pain, diplopia, and hiccup). Results: Among 44 LMI patients, 15 patients (34%) had FP, and all of them had ipsilesional central-type FP. The FP group tended to involve upper (p < 0.0001) and relative ventral (p = 0.019) part of the lateral medulla. Horizontally large lesion was also related to the presence of FP (p = 0.044). Dysphagia (p = 0.001), dysarthria (p = 0.003), and hiccups (p = 0.034) were more likely to be accompanied by FP. Otherwise, there were no significant differences. Conclusion: The results of present study indicate that the corticobulbar fibers innervating the lower face decussate at the upper level of the medulla and ascend through the dorsolateral medulla, where the concentration of the fibers is densest near the nucleus ambiguus.
Examining Eye Tracking Metrics and Cognitive Function in Post-Stroke Individuals: A Comparison of Visual Searching Tasks between Those with and without Cognitive Impairment
Authors: Chan Marko Ka-leung , Wong Cho Lee , Yu King Pong , Tong Raymond Kai-yu
Published: December 2023

Introduction: After a stroke, individuals commonly experience visual problems and impaired cognitive function, which can significantly impact their daily lives. In addition to visual neglect and hemianopia, stroke survivors often have difficulties with visual search tasks. Researchers are increasingly interested in using eye tracking technology to study cognitive processing and determine whether eye tracking metrics can be used to screen and assess cognitive impairment in patients with neurological disorders. As such, assessing these areas and understanding their relationship is crucial for effective stroke rehabilitation. Methods: We enrolled 60 stroke patients in this study and evaluated their eye tracking performance and cognitive function through a series of tests. Subsequently, we divided the subjects into two groups based on their scores on the HK-MoCA test, with scores below 21 out of 30 indicating cognitive impairment. We then compared the eye tracking metrics between the two groups and identified any significant differences that existed. Spearman correlation analysis was conducted to explore the relationship between clinical test scores and eye tracking metrics. Moreover, we employed a Mann-Whitney U test to compare eye tracking metrics between groups with and without cognitive impairment. Results: Our results revealed significant correlations between various eye tracking metrics and cognitive tests (p ≤ 0.001–0.041). Furthermore, the group without cognitive impairment demonstrated higher saccade velocity, gaze path velocity, and shorter time to target than the group with cognitive impairment (p ≤ 0.001–0.040). Receiver operating characteristic curve analyses were performed, and the optimal cut-off values for gaze path velocity and saccade velocity were 329.665 (px/s) (sensitivity = 0.80, specificity = 0.533) and 2.150 (px/ms) (sensitivity = 0.733, specificity = 0.633), respectively. Conclusions: Our findings indicate a significant correlation between eye tracking metrics and cognitive test scores. Furthermore, the group with cognitive impairment exhibited a significant difference in these metrics, and a cut-off value was identified to predict whether a client was experiencing cognitive impairment.
Pitfalls in Lymph Node Fine Needle Aspiration Cytology
Authors: Nga Min En
Published: December 2023

Background: Fine needle aspiration cytology (FNAC) is an accurate, minimally invasive, and cost-effective biopsy method for enlarged lymph nodes. While the role of lymph node FNAC in the diagnosis of infectious or reactive conditions and metastatic malignancy is unquestioned, differing views still exist on its role in the diagnosis of lymphoma. Nevertheless, regardless of the practice setting, pitfalls and potential for error exist, and it is incumbent upon the pathologist to be aware of these pitfalls, as this is the first line of defence against errors. Summary: This discussion will focus on potential interpretational errors, specifically highlighting scenarios leading to false-negative and false-positive diagnosis and errors in tumour classification, with an emphasis on cytomorphology. Potential entities that may fly below the radar of the pathologist – so-called off-radar entities – are also discussed, as a reminder to consider broad differentials in cases with unusual morphologic features. Some reasons for false-negative diagnoses include low-grade lymphomas that mimic a mixed, polymorphous reactive lymphoid population or aspirates with a paucity of lesional cells, through either sampling error or the intrinsic nature of the entity, e.g., nodular lymphocyte predominant Hodgkin lymphoma. Some of the potential causes of false-positive diagnoses that are discussed include viral-associated lymphadenopathy, Kikuchi-Fujimoto lymphadenitis, or benign adnexal lesions mimicking metastatic malignancy. Errors in tumour classification covered include metastatic carcinoma, sarcoma, melanoma, and lymphoma mimicking each other, and Hodgkin lymphoma and its mimics. Finally, less common entities such as follicular dendritic cell sarcoma and others are briefly mentioned, to remind us of conditions that may slip under our diagnostic radar. Key Messages: A systematic review of diagnostic pitfalls and traps is elucidated here, with some tips to avoid these traps. The triple approach to the diagnostic workup is emphasised, which includes rigorous clinicopathologic correlation, attention to cytomorphology, and judicious application of ancillary tests.
Pitfalls in Thyroid Fine-Needle Aspiration Cytopathology: An Approach to Atypical Findings
Authors: Juhlin C. Christofer , Baloch Zubair W.
Published: December 2023

Background: Thyroid nodules are prevalent among the general population, thus imposing substantial demands upon healthcare providers to establish effective management paradigms when investigating these lesions. A pivotal component in the diagnostic process involves the cytomorphological evaluation of fine-needle aspiration (FNA) specimens extracted from the nodule under scrutiny. This examination serves the critical purpose of enabling a comprehensive assessment for the risk of either a neoplasm or malignancy, thereby providing the clinical team with the requisite information to render decisions regarding potential surgical intervention and/or a structured clinical follow-up. A subset of FNA specimens obtained from the thyroid gland present a vexing challenge for interpretation and cannot be classified based on cytomorphology as either benign or malignant and are classified as “indeterminate” for neoplasm or malignancy. The indeterminate thyroid FNA diagnosis in the third iteration of the Bethesda classification is termed as “atypia of undetermined significance” (AUS). Summary: The thyroid FNA specimens classified as “atypical” constitute a perplexing category, necessitating considerations such as repeated cytological evaluations, supplementary molecular analyses, diagnostic lobectomy, or vigilant surveillance. This review article draws upon the most recent Bethesda classification guidelines and delineates various potential pitfalls encountered during the interpretation of atypia observed in thyroid fine-needle aspiration and histopathologic counterparts. Additionally, it proffers strategic algorithms devised to effectively navigate these diagnostic challenges. Key Messages: It is important to recognize the value of an integrated approach when triaging AUS lesions, considering various clinical, morphological, and sometimes also immunocytochemical or molecular features.
Predictors of Intracranial Hemorrhage Volume Expansion in Patients Receiving Factor Xa Inhibitors in ANNEXA‐4: Time and Severity Matter Most
Authors: Concha Mauricio , Xu Lizhen , Horn MacKenzie , Ohara Tomoyuki , Nakamya Juliet , Beyer‐Westendorf Jan , Shoamanesh Ashkan , Cohen Alexander , Ladenvall Per , Connolly Stuart J. , Demchuk Andrew M.
Published: December 2023

Background

Andexanet alfa, a specific reversal agent for factor Xa inhibitors, resulted in effective hemostasis in 79% of patients with intracranial bleeding in the ANNEXA‐4 (Andexanet Alfa, a Novel Antidote to the Anticoagulation Effects of Factor Xa Inhibitors) trial (NCT02329327). However, little is known about predictors associated with hematoma expansion in patients with factor Xa inhibitor–associated intracranial hemorrhage (ICrH) receiving andexanet alfa.

Methods

The ANNEXA‐4 trial was a prospective, single‐arm, open‐label study of andexanet alfa in patients with acute major bleeding within 18 hours after taking a factor Xa inhibitor. Hematoma volumes at baseline and 12 hours after andexanet alfa treatment were measured using a computerized‐assisted volumetric method. Univariable and multivariable logistic regression analyses of clinical and nonclinical parameters were performed to identify factors predictive of different volumes of hematoma expansion. To this end, an ICrH Expansion Scale was developed.

Results

Overall, 305 ANNEXA‐4 study patients with baseline and follow‐up imaging were included, 15.7% of whom showed evidence of any ICrH expansion ≥6‐mL. Patients with ≥6‐mL ICrH expansion had a significantly (
P<
0.05) higher proportion of ICrH with multiple compartment involvement (36% versus 14.3%); shorter times from symptom onset to baseline computed tomography (median, 1.6 hours [interquartile range (IQR), 1.2–4.3 hours] versus 3.7 hours [IQR, 1.6–7.0 hours]); lower Glasgow Coma Scale scores (14 [IQR, 12–15] versus 15 [IQR, 14–15]); higher systolic blood pressure 15 minutes before andexanet alfa bolus (mean, 151.6 mm Hg [SD, 24.1 mm Hg] versus 143.3 mm Hg [SD, 22.3 mm Hg]); and larger median baseline ICrH volumes (29.3 mL [IQR, 13.3–50.8 mL] versus 8.6 mL [IQR, 2.1–22.4 mL]). Multivariable analysis confirmed shorter symptom onset‐to‐computed tomography time and larger ICrH volume as independent predictors of ≥6‐mL growth and ICrH Expansion Scale change. Lower Glasgow Coma Scale showed a trend (
P
= 0.06) as an independent predictor of ≥6‐mL growth but was an independent predictor of ICrH Expansion Scale change.

Conclusion

Shorter time from symptom onset to computed tomography, larger hematoma volumes, and lower Glasgow Coma Scale score at presentation increased the risk of ICrH expansion in patients with factor Xa inhibitor–associated ICrH treated with andexanet alfa.
Sexual dimorphism in cortical theta rhythms relates to elevated internalizing symptoms during adolescence
Authors: Petro Nathan M. , Picci Giorgia , Ott Lauren R. , Rempe Maggie P. , Embury Christine M. , Penhale Samantha H. , Wang Yu-Ping , Stephen Julia M. , Calhoun Vince D. , Taylor Brittany K. , Wilson Tony W.
Published: December 2023

Psychiatric disorders frequently emerge during adolescence, with girls at nearly twice the risk compared to boys. These sex differences have been linked to structural brain differences in association regions, which undergo profound development during childhood and adolescence. However, the relationship between functional activity in these cortical regions and the emergence of psychiatric disorders more broadly remains poorly understood. Herein, we investigated whether differences in internalizing and externalizing symptoms among youth are related to multispectral spontaneous neural activity. Spontaneous cortical activity was recorded using magnetoencephalography (MEG) in 105 typically-developing youth (9-15 years-old; 54 female) during eyes-closed rest. The strength of spontaneous neural activity within canonical frequency bands was estimated at each cortical vertex. The resulting functional maps were submitted to vertex-wise regressions to identify spatially specific effects whereby sex moderated the relationship between externalizing and internalizing symptoms, age, and spontaneous neural activity. The interaction between sex, age, and internalizing symptoms was significant in the theta frequency band, wherein theta activity was weaker for older relative to younger girls (but not boys) with greater internalizing symptoms. This relationship was strongest in the temporoparietal junction, with areas of the cingulate cortex exhibiting a similar relationship. The moderating role of sex in the relationship between age, internalizing symptoms, and spontaneous theta activity predominantly implicated association cortices. The negative relationship between theta and internalizing symptoms may reflect negative rumination with anxiety and depression. The specificity of this effect to older girls may reflect the selective emergence of psychiatric symptoms during adolescence in this subgroup.
Aesthetic In-Access: Notes from the CripTech Metaverse Lab
Authors: Mondelli Frank , Justice Jennifer
Published: December 2023

Metaverse technologies, such as spatial audio, virtual reality (VR), and augmented reality (AR), present new possibilities for disabled artists. To explore how artists use metaverse technologies—as well as the frictions that inhibit access—the authors describe the events of CripTech Metaverse Lab, which invited a cohort of disabled artists to a three-day workshop featuring metaverse experiences and a speculative design lab. Observing how participants creatively navigated these encounters, the authors introduce “aesthetic in-access” as a shared praxis developed by disabled users that transforms barriers to access into artistic expression. In doing so, the authors outline a metaverse future that centers disabled people’s expression and joy.
Culture and the Illusion of Self-Evidence: Spiritual Beliefs in the Ongwen Trial
Authors: Nistor Adina-Loredana
Published: December 2023

By definition, criminal trials are set to determine the guilt or innocence of the accused. In this process, judges are tasked with assessing not only evidence that presents itself in quantifiable forms, but also as personal experiences. In the case of Dominic Ongwen, a former child soldier and commander of the Lord’s Resistance Army (lra), the issue of spiritualism played a significant role, particularly in relation to the affirmative defences of mental incapacity and duress. Assessing such culturally charged evidence, inherently interconnected to local beliefs, through the lens of an international criminal law trial raises a number of challenges. In the construction of the legal truth, such immaterial evidence undergoes a process through which only certain elements, which are deemed relevant in light of specific arguments, are ultimately selected, filtered through the legal framework, contested by the parties and ultimately decided upon by the judges. Spiritual beliefs therefore become patterns, and patterns become certainties. Based on an in-depth analysis of 408 trial transcripts, along with main submissions and decisions, this article sheds light into how framing spiritualism according to the criteria laid out in the Rome Statute has played out in the trial of Dominic Ongwen. It maps the way in which cultural concepts related to spirituality have been introduced into the trial, by which parties and for what purpose. It also looks at how the system of spiritual powers guiding the lra and its fighters was assessed by the judges and potentially why.