bluuebunny/crossref_metadata_2025 huggingface dataset:
Fault-Tolerant Control of Quadrotor UAVs Based on Back-Stepping Integral Sliding Mode Approach and Iterative Learning Algorithm
Authors: Allahverdy Davood , Fakharian Ahmad , Menhaj Mohammad Bagher
Published: August 2021

In this paper, a fault-tolerant control system based on back-stepping integral sliding mode controller (BISMC) is designed and analyzed for both nonlinear translational and rotational subsystems of the quadrotor unmanned aerial vehicles (UAVs). The novelty of this paper is about combination of a classic controller with a repetitive algorithm to reduce the response time to actuator faults and have better tracking performance. The actuator fault is defined based on the loss of effectiveness and bias fault. Next, the iterative learning control algorithm (ILCA) is used to compensate for the unknown fault input according to previous recorded experiences. In the normal condition (without actuators fault), BISMC can force the actual trajectories toward the desired commands and reduce chattering about control signals, and in the presence of the actuators fault or external disturbances, the mentioned learning algorithm can incline the accuracy of the tracking performance and compensate for the occurred error. The Lyapunov theory illustrates that the proposed control strategy can stabilize the system despite the actuators’ fault and external disturbances. The simulation results show the effectiveness of the proposed scheme in comparison with another method.
MiR‐21‐3p Inhibits Adipose Browning by Targeting FGFR1 and Aggravates Atrial Fibrosis in Diabetes
Authors: Pan Jian-an , Lin Hao , Yu Jian-ying , Zhang Hui-li , Zhang Jun-feng , Wang Chang-qian , Gu Jun
Published: August 2021

A relationship between excess epicardial adipose tissue (EAT) and the risk of atrial fibrillation (AF) has been reported. Browning of EAT may be a novel approach for the prevention or treatment of AF by attenuating atrial fibrosis. Previous studies have identified microRNA‐21 (miR‐21) as a regulatory factor in atrial fibrosis. The present study examined the role of different subtypes of miR‐21 in adipose browning and atrial fibrosis under hyperglycemic conditions. Wild type and miR‐21 knockout C57BL/6 mice were used to establish a diabetic model via intraperitoneal injection of streptozotocin. A coculture model of atrial fibroblasts and adipocytes was also established. We identified miR‐21‐3p as a key regulator that controls adipocyte browning and participates in atrial fibrosis under hyperglycemic conditions. Moreover, fibroblast growth factor receptor (FGFR) 1, a direct target of miR‐21‐3p, decreased in this setting and controlled adipose browning. Gain and loss‐of‐function experiments identified a regulatory pathway in adipocytes involving miR‐21a‐3p, FGFR1, FGF21, and PPARγ that regulated adipocyte browning and participated in hyperglycemia‐induced atrial fibrosis. Modulation of this signaling pathway may provide a therapeutic option for the prevention and treatment of atrial fibrosis or AF in DM.
NP-ALT, a Liposomal:Peptide Drug, Blocks p27Kip1 Phosphorylation to Induce Oxidative Stress, Necroptosis, and Regression in Therapy-Resistant Breast Cancer Cells
Authors: Jilishitz Irina , Quiñones Jason Luis , Patel Priyank , Chen Grace , Pasetsky Jared , VanInwegen Allison , Schoninger Scott , Jogalekar Manasi P. , Tsiperson Vladislav , Yan Lingyue , Wu Yun , Gottesman Susan R.S. , Somma Jonathan , Blain Stacy W.
Published: August 2021

Resistance to cyclin D-CDK4/6 inhibitors (CDK4/6i) represents an unmet clinical need and is frequently caused by compensatory CDK2 activity. Here we describe a novel strategy to prevent CDK4i resistance by using a therapeutic liposomal:peptide formulation, NP-ALT, to inhibit the tyrosine phosphorylation of p27Kip1(CDKN1B), which in turn inhibits both CDK4/6 and CDK2. We find that NP-ALT blocks proliferation in HR+ breast cancer cells, as well as CDK4i-resistant cell types, including triple negative breast cancer (TNBC). The peptide ALT is not as stable in primary mammary epithelium, suggesting that NP-ALT has little effect in nontumor tissues. In HR+ breast cancer cells specifically, NP-ALT treatment induces ROS and RIPK1-dependent necroptosis. Estrogen signaling and ERα appear required. Significantly, NP-ALT induces necroptosis in MCF7 ESRY537S cells, which contain an ER gain of function mutation frequently detected in metastatic patients, which renders them resistant to endocrine therapy. Here we show that NP-ALT causes necroptosis and tumor regression in treatment naïve, palbociclib-resistant, and endocrine-resistant BC cells and xenograft models, demonstrating that p27 is a viable therapeutic target to combat drug resistance.

Implications:

This study reveals that blocking p27 tyrosine phosphorylation inhibits CDK4 and CDK2 activity and induces ROS-dependent necroptosis, suggesting a novel therapeutic option for endocrine and CDK4 inhibitor-resistant HR+ tumors.
Narrow Vagina as a Predictor of Obstructive Voiding Dysfunction after Transobturator Sling Surgery
Authors: Romics Miklós , Keszthelyi Veronika , Brodszky Valentin , Molnár Péter József , Keszthelyi Attila , Oláh Orsolya , Nyirády Péter , Majoros Attila
Published: August 2021

Background: Voiding dysfunction (VD) is a potential complication after female midurethral sling operations. Objectives: Our goal was to assess the rate of obstructive VD after ­transobturator tension-free tape (TOT) procedures and to find perioperative risk factors (RFs) predicting postoperative voiding problems. Methods: We have retrospectively evaluated the perioperative data of 397 women who underwent TOT operations. Significant post-void residual (PVR) (>50 mL) was considered as the primary (objective) end point of the study, the voiding difficulty as the secondary (subjective) 1. First univariate analysis and then multivariate logistic regression were performed, with a 5% significance level. Results: Significant PVR was present in 51 (12.8%) women; catheterization was needed in 21 (5.3%) and reoperation in 3 (0.8%) cases. Seventy women (17.6%) experienced postoperative voiding difficulty. Narrow vagina (<2 cm), older age >70 years, and preoperative voiding difficulty were independent RFs for significant PVR (odds ratio: 5.07, 2.14, 5.38, respectively, p < 0.05). Preoperative overactive bladder syndrome and previous pelvic organ prolapse surgery were considered independent RFs for postoperative voiding difficulty. Conclusions: Older age, narrow vagina, or preoperative voiding difficulty increases the chance for significant postoperative PVR. These patients should be chosen and counseled appropriately.
First report of three species of the genus Diaphanosoma (Crustacea: Cladocera: Sididae) from Jammu waters (J&K), India
Authors: Sharma Nidhi , Kour Sarbjeet
Published: August 2021

Cladocera, commonly known as ‘water flea’ due to the jerky movements produced by their second antennae, form an important food component for planktivorous fishes and other aquatic invertebrates. The present investigation comprising a collection of zooplankton samples from a shallow pond located in the Bishnah tehsil of Jammu district has revealed the presence of 13 Cladocera species belonging to the families Daphniidae, Chydoridae, Moinidae, Sididae, and Macrothricidae. Three species of the family Sididae belonging to the genus Diaphanosoma, namely, senegal, sarsi and excisum are new species records to the cladoceran fauna of Jammu & Kashmir. Presently, a detailed morphological analysis has been made on all the three Diaphanosoma species. They have shown major differences in their body size with D. senegal being larger than D. sarsi and D. excisum. All three species have well observable variability with reference to their head size, eye size, shell duplicature, shape of posterior valve margin, and the number of denticles so present on posterior valve margin. All the three species have also shown coexistence with each other, but D. senegal was dominant in terms of population density.
First record of Mantispilla indica (Westwood, 1852) (Neuroptera: Mantispidae) from the Western Ghats, India
Authors: T.B. Suryanarayanan  , C. Bijoy
Published: August 2021

The species, Mantispilla indica (Westwood, 1852) of the Mantispidae family is recorded for the first time from the Western Ghats as well as from Kerala state. Besides, the distribution of the species in India is mapped.
Factors affecting the species richness and composition of bird species in a community managed forest of Nepal
Authors: Poudel Bishow , Neupane Bijaya , Joshi Rajeev , Silwal Thakur , Raut Nirjala , Thanet Dol Raj
Published: August 2021

There exists limited information on biodiversity including avifaunal diversity and habitat condition in community forests (CF) of Nepal; thus we aimed to fulfill such gaps in Tibrekot CF of Kaski district. We used the point count method for assessing bird diversity and laid out a circular plot size of radius 5-m within 15-m distance from each point count station for recording the biophysical habitat characteristics. Bird species’ diversity, richness and evenness were calculated using popular indexes and General Linear Model (GLM) was used to test the respective effect of various biophysical factors associated with the richness of bird species. In total, 166 (summer 122, winter 125) bird species were recorded in 46 sample plots. The Shannon-Wiener diversity index was calculated as 3.99 and 4.09, Margalef’s richness index as 16.84 and 17.53 and Pielou’s evenness index as 0.83 and 0.84 for summer and winter, respectively. The influencing factors for richness of bird species were season (χ21, 90= 112.21; P= 0.016) with higher richness in the summer season and low vegetation cover (χ21, 89= 113.88; P= 0.0064) with higher richness in lower percentage cover. Thus, community managed forest should be protected as it has a significant role in increasing bird diversity, which has potential for attracting avifaunal tourism for the benefit of the local communities.
Molecular Patterns of Extreme and Persistent Cholesterol Efflux Capacity
Authors: El-Ghazali Ayea , Deodhar Sneha , Saldanha Suzanne , Smyth Brooke , Izbrand Mark , Gangwar Anamika , Pahlavani Mandana , Rohatgi Anand
Published: August 2021

Objective:

Cholesterol efflux capacity (CEC), the ability of extracellular acceptors to pick-up cholesterol from macrophages, is a clinically relevant cardiovascular biomarker. CEC is inversely associated with incident atherosclerotic cardiovascular disease events. However, CEC is only modestly associated with HDL-C (high-density lipoprotein cholesterol) levels, which may explain the failure of HDL-C raising therapies to improve atherosclerotic cardiovascular disease outcomes. Determinants of variation in CEC are not well understood. Thus, we sought to establish whether extreme high and low CEC is a robust persistent phenotype and to characterize associations with cholesterol, protein, and phospholipids across the particle size distribution.

Approach and Results:

CEC was previously measured in 2924 participants enrolled in the Dallas Heart Study, a multi-ethnic population-based study from 2000 to 2002. We prospectively recruited those who were below the 10th and above 90th percentile of CEC. Our study revealed that extreme low and high CEC are persistent, robust phenotypes after 15 years of follow-up. Using size exclusion chromatography, CEC to fractionated plasma depleted of apolipoprotein B (fraction-specific CEC) demonstrated significant differences in CEC patterns between persistent high and low efflux groups. Fraction-specific CEC was correlated with fraction-specific total phospholipid but not apolipoprotein A-I, cholesterol, or total protein. These correlations varied across the size distribution and differed among persistent high versus low efflux groups.

Conclusions:

Extreme high and low CEC are persistent and robust phenotypes. CEC patterns in fractionated plasma reveal marked variation across the size distribution. Future studies are warranted to determine specific molecular species linked to CEC in a size-specific manner.
Initial Experience With the PASCAL Ace Implant System for Treatment of Severe Tricuspid Regurgitation
Authors: Aurich Matthias , Volz Martin J. , Mereles Derliz , Geis Nicolas A. , Frey Norbert , Konstandin Mathias H. , Raake Philip W.
Published: August 2021

Background:

Percutaneous tricuspid valve leaflet repair is an emerging treatment option for severe tricuspid regurgitation (TR). Recent studies demonstrated the usefulness and feasibility of the lately introduced TriClip and PASCAL Transcatheter Valve Repair System. However, initial experiences regarding safety and efficacy of the novel transcatheter PASCAL Ace implant system have not yet been reported.

Methods:

Sixteen patients with severe, massive, or torrential TR underwent tricuspid leaflet repair using the PASCAL Ace implant at our cardiology department. All patients suffered from symptomatic right-sided heart failure with New York Heart Association functional class III or IV. Clinical, laboratory, echocardiographic, and procedural data were assessed. The primary efficiency end point was postprocedural reduction in TR of at least 1 grade. Secondary end points were feasibility, safety, clinical outcome, and improvement of structural and functional right heart parameters obtained by echocardiography.

Results:

Eleven procedures (69%) resulted in successful reduction of TR. In 4 patients, PASCAL Ace implantation was not successful and one patient did not achieve TR reduction despite PASCAL Ace implantation. One major bleeding related to the intervention occurred. Eight patients (73%) with successful TR reduction reported a significant improvement of New York Heart Association functional class 4 weeks after implantation (
P
=0.008). A significant reduction in right atrial volume from 84±41 mL/m
2
to 69±36 mL/m
2
(
P
=0.004) and right ventricular end-diastolic diameter from 50±7 mm to 47±8 mm (
P
=0.013) was observed; however, we did not see an improvement in right ventricular function directly after implantation.

Conclusions:

Tricuspid valve leaflet repair using the transcatheter PASCAL Ace implant system has the potential to improve clinical status and right heart reverse remodeling in patients with severe TR.
An updated checklist of bryophytes for the state of Paraíba, a Brazilian hotspot: new records and biological spectrum in a Seasonally Dry Tropical Forest fragment
Authors: FERNANDES DE SOUZA EVYLLEN RITA , SILVA JOAN BRUNO , PINTO ANDERSON SILVA , LOPES SÉRGIO DE FARIA
Published: August 2021

As a result of bryological explorations in the the state of Paraíba (Brasil), a total of 36 bryophtes belonging to 18 genera and 14 families were identified from a Seasonally Dry Tropical Forest fragment. Of these, 17 taxa are liverworts and 19 taxa are mosses. In addition, we added nine new records for the bryophyte flora of state of Paraíba with this paper. Among them, two mosses (Rhodobryum roseum and Cryphaea filiformis) and two liverworts (Caudalejeunea lehmanniana and Cheilolejeunea conchifolia) are for the first time in dry tropical forest.
A Self-Powered Wearable Ultraviolet Radiation Detector Integrated with Wireless Devices Based on T-ZnO/PVDF Composite Fabric
Authors: Zhang Wanglinhan , Xue Xinyu
Published: August 2021

Research on wearable devices has promoted the development of real-time ultraviolet intensity monitoring technology. This paper proposes a self-powered wearable ultraviolet radiation detector based on T-ZnO nanowires/PVDF composite fabric. The soft fabric base allows the device to attach
to various muscles of the human body. Due to the piezoelectric and photoelectric properties, the devices can transform mechanical energy into electrical energy. The output closely relates to the ultraviolet intensity. Therefore, this kind of stable, flexible, and micro device can output piezoelectric
voltage as both an energy source and a sensing signal on human bodies. Experiments have proved that the wearable ultraviolet detector has high sensing stability and can work on the skin. The self-powered feature allows it to integrate with wireless transmission equipment, which can upload
the ultraviolet intensity data collected by the self-powered wearable ultraviolet radiation detector to the Big Data Cloud. This system will contribute to the formation of the Internet of Things.
Study on the Properties of Low-Dimensional NbAs Based on First Principles
Authors: Diao Xinfeng , Gu Qinzhong , Xie Yu , Tang Yanlin
Published: August 2021

This paper studies the properties of low-dimensional Weyl material niobium arsenide based on first-principles. Firstly, the quantum point and nanowire structure of material niobium arsenide are constructed by using the Visualizer module of Material Studio software, and then the DMOL3
module is used to optimize and calculate the density of states, highest occupied molecular orbital and lowest unoccupied orbital levels. The quantum dot size was chosen to be 0.6 nm, 0.8 nm, 1.0 nm, and 1.2 nm. It was found that the band gap decreased with the increase of quantum dot size,
the distribution of electrons in the frontier orbit is decreasing. The nanowire has a band gap near −5 eV to −8 eV. The presence of bandgap indicates the properties of semiconductor at low temperature. It indicates that the material is not suitable for superconducting materials
at very low temperature. Then we discuss the charge distribution and phonon spectrum of the one-dimensional NbAs structure to help us analyze the law and stability of the interaction between particles inside the material. It provides a theoretical basis for us to explore NbAs materials in
the future.
Proportional-Integral-Derivative Control of Four-Variable Chaotic Oscillatory Circuit Based on DNA Strand Displacement
Authors: An Xiaoyu , Meng Zijie , Wang Yanfeng , Sun Junwei
Published: August 2021

DNA molecular computing based on DNA strand displacement (DSD) technology is a potential computing model. Different functions can be realized by constructing DNA strand displacement analog circuit and analyzing its dynamic characteristics. In this paper, exploiting chemical reaction
networks (CRNs) as the middle layer, a new chaotic oscillation circuit is constructed via DNA strand displacement and controlled by PID controller. The design of four-variable chaotic oscillatory circuit requires the combination and cascade by five DNA reaction modules. Based on the theory
of stability and design principle of controller, the proportion terms, integration terms, and differentiation terms are added to chaotic oscillatory circuit for implementing PID controller. PID controller is implemented by five DNA reaction modules to stabilize the chaotic oscillation circuit.
The validity of reaction modules circuit with their corresponding DSD reaction modules and controller is verified by visual DSD and Matlab. The PID controller may have better performance than PI controller, and it is an extension of PI controller.
A Fast Adaptive Beamforming Algorithm Based on Gram-Schmidt Orthogonalization
Authors: Qian Bing-Feng , Gao Shi-Jie , Li Quan-Feng , Zhang Qian , Wang Ye
Published: August 2021

Fast implementation is one of the important indexes of the ADBF algorithm. The advantages of the Gram-Schmidt (GS) orthogonalization algorithm are that it can reconstruct the interference subspace well under the high signal-to-noise ratio and has fast convergence speed and low computational
complexity. This paper studies the RGS algorithm for GS orthogonalization of sampling covariance matrix. To estimate the interference subspace more accurately, this paper modifies the orthogonal adaptive threshold of covariance matrix, and extends the proposed GS orthogonal algorithm of covariance
matrix based on data preprocessing to the adaptive beamforming processing at subarray level.
Characterization and comparison of properties of cryogenic conditioned CNT reinforced thermoset (epoxy) and thermoplastic (poly vinyl alcohol) composite yarns
Authors: Chen Wei , Wang Yifan , Zhang Kun , Xu Fujun
Published: August 2021

Carbon nanotube (CNT) fiber/yarn reinforced composites are considered as a new generation of advanced materials for applications in aerospace and space industry. In this study, two types of CNT composite yarns were produced by twisting CNT films and infiltrating with thermoset epoxy (EP) and thermoplastic poly vinyl alcohol (PVA) resins. The tensile strength of CNT/PVA and CNT/EP composite yarn was 409.91 MPa and 206.87 MPa, much higher than that of pure CNT yarn (129.94 MPa). After mono-cryogenic condition, the mechanical and electrical properties of CNT/EP and CNT/PVA composite yarns were both enhanced due to the structure reorder of the CNT bundles and improvement of interfacial bonding. However, after 60 times cyclic-cryogenic conditions, CNT/EP composite yarn showed a ∼10% degradation of tensile strength; while CNT/PVA composite yarn exhibited 6% increment. This study provides fundamental data of the CNT reinforced thermoset and thermoplastic composite yarns for their practical applications in cryogenic environment.
EBV+ lymphoproliferative diseases: opportunities for leveraging EBV as a therapeutic target
Authors: Toner Keri , Bollard Catherine M.
Published: August 2021

Epstein-Barr virus (EBV) is a ubiquitous human tumor virus, which contributes to the development of lymphoproliferative disease, most notably in patients with impaired immunity. EBV-associated lymphoproliferation is characterized by expression of latent EBV proteins and ranges in severity from a relatively benign proliferative response to aggressive malignant lymphomas. The presence of EBV can also serve as a unique target for directed therapies for the treatment of EBV lymphoproliferative diseases, including T cell–based immune therapies. In this review, we describe the EBV-associated lymphoproliferative diseases and particularly focus on the therapies that target EBV.
Treatment-free remission in patients with chronic myeloid leukemia: recommendations of the LALNET expert panel
Authors: Pavlovsky Carolina , Abello Polo Virginia , Pagnano Katia , Varela Ana Ines , Agudelo Claudia , Bianchini Michele , Boquimpani Carla , Centrone Renato , Conchon Monica , Delgado Nancy , Funke Vaneuza , Giere Isabel , Luise Ingrid , Meillon Luis , Moiraghi Beatriz , Navarro Juan Ramon , Pilleux Lilian , Prado Ana Ines , Undurraga Soledad , Cortes Jorge
Published: August 2021

Tyrosine kinase inhibitors (TKIs) have dramatically changed the survival of chronic myeloid leukemia (CML) patients, and treatment-free remission (TFR) has recently emerged as a new goal of CML treatment. The aim of this work was to develop recommendations for TKI discontinuation in Latin America (LA), outside of clinical trials. A working group of CML experts from LA discussed 22 questions regarding TFR and reached a consensus for TFR recommendations in the region. TFR is indicated in patients in first chronic phase, with typical BCR-ABL transcripts, under TKI treatment of a minimum of 5 years, in sustained deep molecular response (DMR; molecular response 4.5 [MR4.5]) for 2 years. Sustained DMR must be demonstrated on at least 4 international reporting scale quantitative polymerase chain reaction (PCR) tests, separated by at least 3 months, in the immediate prior 2 years. After second-line therapy, TFR is indicated in previously intolerant, not resistant, patients. Molecular monitoring is recommended monthly for the first 6 months, every 2 to 3 months from months 7 to 12, and every 3 months during the second year, indefinitely. Treatment should be reintroduced if major molecular response is lost. Monitoring of withdrawal syndrome, glucose levels, and lipid profile is recommended after discontinuation. After TKI reintroduction, molecular monitoring is indicated every 2 to 3 months until MR4.0 achievement; later, every 3 to 6 months. For the TFR attempt, having standardized and reliable BCR-ABL PCR tests is mandatory. These recommendations will be useful for safe discontinuation in daily practice and will benefit patients who wish to stop treatment in emergent regions, in particular, with TKI-related chronic adverse events.
Transfusion of target antigens to preimmunized recipients: a new mechanism in transfusion-related acute lung injury
Authors: Bayat Behnaz , Nielsen Kaspar René , Bein Gregor , Traum Annalena , Burg-Roderfeld Monika , Sachs Ulrich J.
Published: August 2021

Transfusion-related lung injury (TRALI) is a serious side effect of blood transfusion. Exclusion of antibody carriers from the donor pool has significantly decreased the number of cases, but TRALI remains the leading cause of transfusion-related morbidity and mortality in industrialized countries. Here, we show that proteins released from donor cells during processing of blood components are capable of inducing a new type of reverse TRALI when transfused to preimmunized recipients. First, we show that soluble neutrophil surface protein CD177 in complex with proteinase 3 (sCD177/PR3) is not only present in human plasma but also in packed red blood cell (PRBC) supernatant. Filtration or storage enhances the concentration of sCD177/PR3 in PRBCs. Second, we show that sCD177/PR3 specifically binds to PECAM-1 on stimulated (but not on unstimulated) endothelial cells (ECs). Third, we provide evidence that the sCD177/PR3/PECAM-1 complex is functional. In the presence of monoclonal or human antibodies against CD177 or PR3, ECs produce reactive oxygen species and become apoptotic. Albumin flux through an EC monolayer increases significantly whenever antibodies and the cognate antigens are present. Finally, we describe a clinical case in which anti-CD177 present in a transfusion recipient precipitated TRALI after the transfusion of CD177-positive, but not CD177-negative, PRBCs. In conclusion, we introduce a new TRALI mechanism based on the specific binding of transfused, soluble antigens to activated ECs in preimmunized recipients. We suggest that further studies and clinical work-up of TRALI should also include antibody investigation of the recipient.
Outcome of limited-stage nodular lymphocyte-predominant Hodgkin lymphoma and the impact of a PET-adapted approach
Authors: Cheng Phoebe T. M. , Villa Diego , Tonseth R. Petter , Scott David W. , Gerrie Alina S. , Freeman Ciara L. , Pickles Tom , Lo Andrea C. , Farinha Pedro , Craig Jeffrey W. , Slack Graham W. , Gascoyne Randy D. , Bénard François , Wilson Don , Skinnider Brian , Connors Joseph M. , Sehn Laurie H. , Savage Kerry J.
Published: August 2021

Radiotherapy (RT) is typically incorporated into the treatment of limited-stage nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL), although it remains unknown whether chemotherapy alone may be suitable in select patients. We evaluated outcomes of limited-stage NLPHL at BC Cancer on the basis of era-specific guidelines: routine RT era, 1995 to 2005 (n = 36), combined modality with 2 cycles of doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) chemotherapy followed by RT or RT alone; positron emission tomography (PET) era, after 2005 (n = 63), ABVD alone (4 cycles) if the PET scan after the second cycle of ABVD (PET2) is negative, or treatment is changed to RT if PET2 is positive. Median age of patients was 38 years (range, 16-82 years), 73% were male, and 43% had stage II. With a median follow-up of 10.5 years for all patients, 5-year progression-free survival (PFS) was 93% and was 97% for overall survival (OS), with no difference by treatment era (PFS, P = .13; OS, P = .35). For the 49 patients who had a PET2 scan, 86% were PET negative and 14% were PET positive by Deauville criteria with 5-year PFS rates of 92% and 80% (P = .70), respectively. This is the largest study of a PET-adapted approach in NLPHL and supports that ABVD alone may be a viable option in select patients with a negative PET2 scan, with consideration of acute and long-term toxicities.
Development of the indirect flight muscles of Aedes aegypti, a main arbovirus vector
Authors: Celestino-Montes Antonio , Hernández-Martínez Salvador , Rodríguez Mario Henry , Cázares-Raga Febe Elena , Vázquez-Calzada Carlos , Lagunes-Guillén Anel , Chávez-Munguía Bibiana , Rubio-Miranda José Ángel , Hernández-Cázares Felipe de Jesús , Cortés-Martínez Leticia , Hernández-Hernández Fidel de la Cruz
Published: August 2021

Background

Flying is an essential function for mosquitoes, required for mating and, in the case of females, to get a blood meal and consequently function as a vector. Flight depends on the action of the indirect flight muscles (IFMs), which power the wings beat. No description of the development of IFMs in mosquitoes, including Aedes aegypti, is available.

Methods

A. aegypti thoraces of larvae 3 and larvae 4 (L3 and L4) instars were analyzed using histochemistry and bright field microscopy. IFM primordia from L3 and L4 and IFMs from pupal and adult stages were dissected and processed to detect F-actin labelling with phalloidin-rhodamine or TRITC, or to immunodetection of myosin and tubulin using specific antibodies, these samples were analyzed by confocal microscopy. Other samples were studied using transmission electron microscopy.

Results

At L3–L4, IFM primordia for dorsal-longitudinal muscles (DLM) and dorsal–ventral muscles (DVM) were identified in the expected locations in the thoracic region: three primordia per hemithorax corresponding to DLM with anterior to posterior orientation were present. Other three primordia per hemithorax, corresponding to DVM, had lateral position and dorsal to ventral orientation. During L3 to L4 myoblast fusion led to syncytial myotubes formation, followed by myotendon junctions (MTJ) creation, myofibrils assembly and sarcomere maturation. The formation of Z-discs and M-line during sarcomere maturation was observed in pupal stage and, the structure reached in teneral insects a classical myosin thick, and actin thin filaments arranged in a hexagonal lattice structure.

Conclusions

A general description of A. aegypti IFM development is presented, from the myoblast fusion at L3 to form myotubes, to sarcomere maturation at adult stage. Several differences during IFM development were observed between A. aegypti (Nematoceran) and Drosophila melanogaster (Brachyceran) and, similitudes with Chironomus sp. were observed as this insect is a Nematoceran, which is taxonomically closer to A. aegypti and share the same number of larval stages.
Case report: Diagnosis and emergency surgery on a young patient with extensive aortic dissection without any risk factors
Authors: Shafiee Masoud , Shafiee Mohsen , Tahery Noorollah , Azadbakht Omid , Nassari Zeinab , Baghbani Reza
Published: August 2021

Background

Type A aortic dissection is a very dangerous, fatal, and emergency condition for surgery. Acute aortic dissection is a rare condition, such that many patients will not survive without reconstructive surgery.

Case presentation

We present a case 24-year-old male who came with symptoms of shortness of breath and cough. The patient underwent ECG, chest radiology, and ultrasound, where the patient was found to have right pleural effusion while his ECG was normal. In the history taken from the patient, he had no underlying disease, no history of heart diseases in his family. For a better diagnosis, ETT and aortic CT angiography was performed on the patient which confirmed the evidence of dissection. Immediately after the diagnosis, necessary arrangements were made for open heart surgery and the patient was prepared for surgery. The patient was admitted in the cardiac surgery ICU for 5 days and his medication was carefully administered. After the conditions were stabilized, the patient was transferred to the post-cardiac surgery ICU ward. The patient was discharged from the hospital one week after the surgery and returned to the office as an OPD one week after his discharge.

Conclusion

Various risk factors can play a role in creating aortic dissection. Therefore, it is necessary to pay attention to patients’ history for achieving a quick and definitive diagnosis. Therefore, to control the complications of placing the cannula as well as the duration of the surgery, it is very important to reduce the duration of pumping on the patient and to be very careful during the cannula placement.
Kidney biopsy practice amongst Australasian nephrologists
Authors: Burke J. P , Pham T , May S , Okano S , Ratanjee S. K , Thet Z , Wong J. K.W , Venuthurupalli S , Ranganathan D
Published: August 2021

Background

Percutaneous kidney biopsy is the gold standard investigation for the diagnosis of kidney diseases. The associated risks of the procedure depend on the skill and experience of the proceduralist as well as the characteristics of the patient. The Kidney Health Australia – Caring for Australasians with Renal Impairment (KHA-CARI) guidelines on kidney biopsies, published in 2019, are the only published national kidney biopsy guidelines. As such, this study surveys current kidney biopsy practices in Australasia and examines how they align with the Australian guidelines, as well as international biopsy practice.

Methods

A cross-sectional, multiple-choice questionnaire was developed examining precautions prior to kidney biopsy; rationalisation of medications prior to kidney biopsy; technical aspects of kidney biopsy; complications of kidney biopsy; and indications for kidney biopsy. This was distributed to all members of the Australian and New Zealand Society of Nephrology (ANZSN).

Results

The response rate for this survey is approximately 21.4 % (182/850). Respondents found agreement (> 75.0 %) in only six out of the twelve questions (50.0 %) which assessed their practice against the KHA-CARI guidelines.

Conclusions

This is the first study of its kind where kidney biopsy practices are examined against a clinical guideline. Furthermore, responses showed that practices were incongruent with guidelines and that there was a lack of consensus on many issues.
A neuro-cardiac self-regulation therapy to improve autonomic and neural function after SCI: a randomized controlled trial protocol
Authors: Craig Ashley , Pozzato Ilaria , Arora Mohit , Middleton James , Rodrigues Dianah , McBain Candice , Tran Yvonne , Davis Glen M. , Gopinath Bamini , Kifley Annette , Krassioukov Andrei , Braithwaite Jeffrey , Mitchell Rebecca , Gustin Sylvia M. , Schoffl Jacob , Cameron Ian D.
Published: August 2021

Background

Spinal cord injury (SCI) is associated with autonomic imbalance and significant secondary conditions, including cardiac and brain dysfunction that adversely impact health and wellbeing. This study will investigate the effectiveness (intention-to-treat) of a neuro-cardiac self-regulation therapy to improve autonomic and neural/brain activity in adults with SCI living in the community.

Methods

A two-arm parallel, randomised controlled trial in which adults with SCI living in the community post-rehabilitation will be randomly assigned to a treatment or control group. The treatment group (N = 60) aged 18–70 years with a chronic traumatic or non-traumatic SCI, will receive intervention sessions once per week for 10 weeks, designed to regulate autonomic activity using computer-based feedback of heart rate variability and controlled breathing (called HRV-F). Comprehensive neurophysiological and psychological assessment will occur at baseline, immediate post-treatment, and 6 and 12-months post-treatment. Primary outcome measures include electrocardiography/heart rate variability (to assess autonomic nervous system function) and transcranial doppler sonography (to assess cerebral blood circulation in basal cerebral arteries). Secondary outcomes measures include continuous blood pressure, electroencephalography, functional near-infrared spectroscopy, respiration/breath rate, electrooculography, cognitive capacity, psychological status, pain, fatigue, sleep and quality of life. Controls (N = 60) will receive usual community care, reading material and a brief telephone call once per week for 10 weeks and be similarly assessed over the same time period as the HRV-F group. Linear mixed model analysis with repeated measures will determine effectiveness of HRV-F and latent class mixture modelling used to determine trajectories for primary and selected secondary outcomes of interest.

Discussion

Treatments for improving autonomic function after SCI are limited. It is therefore important to establish whether a neuro-cardiac self-regulation therapy can result in improved autonomic functioning post-SCI, as well as whether HRV-F is associated with better outcomes for secondary conditions such as cardiovascular health, cognitive capacity and mental health.

Trial registration

The study has been prospectively registered with the Australian and New Zealand Clinical Trial Registry (ACTRN12621000870853.aspx).

Date of Registration: 6th July 2021.

Trial Sponsor: The University of Sydney, NSW 2006.

Protocol version: 22/07/2021.
Multiprofessional perinatal care in a pregnant patient with acute respiratory distress syndrome due to COVID-19
Authors: Palmrich Pilar , Roessler Bernhard , Wisgrill Lukas , Kampf Stephanie , Gattinger Pia , Valenta Rudolf , Fleischmann Edith , Berger Angelika , Kiss Herbert , Farr Alex
Published: August 2021

Background

The coronavirus disease (COVID-19) pandemic has caused ongoing challenges in health services worldwide. Despite the growing body of literature on COVID-19, reports on perinatal care in COVID-19 cases are limited.

Case presentation

We describe a case of severe acute respiratory distress syndrome (ARDS) in a 36-year-old G5/P2 pregnant woman with morbid obesity, confirmed severe acute respiratory syndrome coronavirus 2 infection, and fulminant respiratory failure. At 28+ 1 gestational weeks, the patient delivered an uninfected newborn. Using ImmunoCAP ISAC® technology, we found no immunoglobulin (Ig) M antibodies, suggesting that no mother-to-child viral transmission occurred during pregnancy or delivery. The maternal respiratory state improved rapidly after delivery; both maternal and neonatal outcomes were encouraging given the early gestational age and fulminant course of respiratory failure in our patient.

Conclusions

The management of ARDS in pregnant women with COVID-19 is complex and requires an individualized, multidisciplinary approach, while considering maternal and fetal outcomes.
Uterine rhabdomyosarcoma complicated by cerebral venous thrombosis and uterine inversion in a young woman: case report and literature review
Authors: Peng Hongfa , Jiang Jingjing , Huang Xianghua
Published: August 2021

Background

Uterine rhabdomyosarcoma is an extremely rare malignant tumor that usually affects young women and has a poor prognosis.

Case presentation

A 19-year-old nulliparous woman presented to the emergency department under sedation due to seizures. Imaging examination revealed cerebral venous thrombosis. During thrombolytic therapy, she developed vaginal bleeding followed by uterine inversion secondary to uterine rhabdomyosarcoma. The inverted uterus was mistaken for a cervical tumour and was removed vaginally. The patient’s disease progressed despite chemotherapy with vincristine, actinomycin D and cyclophosphamide and she died within 6 months. To our knowledge, this is the first case of uterine rhabdomyosarcoma complicated with cerebral venous thrombosis.

Conclusions

Malignancy is an important diagnostic in patients with cerebral venous thrombosis with no obvious cause. This case demonstrates the importance of considering uterine neoplasms in the differential diagnosis of adolescent girls with abnormal uterine bleeding. Further, careful anatomical evaluation of vaginal masses should be performed prior to surgical intervention.
Development and preliminary evaluation of a novel physician-report tool for assessing barriers to providing care to autistic patients
Authors: Walsh Chloe , Lydon Sinéad , Geoghegan Rosemary , Carey Cornelia , Creed Michael , O’Loughlin Lauren , Walsh Ellen , Byrne Dara , O’Connor Paul
Published: August 2021

Background

Individuals on the autism spectrum face significant disparities in health and physicians often report difficulties in providing care to autistic patients. In order to improve the quality of care autistic individuals receive, it is important to identify the barriers that physicians experience in providing care so that these may be addressed. This paper reports the initial development and preliminary evaluation of a physician-report ‘Barriers to Providing Healthcare’ measurement tool.

Method

An established taxonomy of healthcare barriers for autistic individuals informed the initial draft of a 22-item measurement tool. This measurement tool was distributed to physicians working in various healthcare specialties and settings. Exploratory factor analysis (EFA) was conducted to determine the construct validity of the tool; discriminant validity between, and internal consistency of, the resultant factors were assessed. Multiple regressions were used to explore variables potentially associated with barriers endorsed by physicians.

Results

A total of 203 physicians were included in the analyses. The EFA resulted in a 17-item tool with three distinct factors which explained 37.6% of the variance: 1) Patient-related barriers (Cronbach’s α = 0.83; e.g., the patient’s reactivity to the healthcare environment); 2) Healthcare provider (HCP)/family-related barriers (Cronbach’s α = 0.81; e.g., a lack of providers willing to work with autistic patients); and 3) System-related barriers (Cronbach’s α = 0.84; e.g., there is a lack of support for patients and families). Discriminant validity between the factors was adequate (r < .8). The barriers that were most frequently endorsed as occurring ‘often’ or ‘very often’ included a lack of support for patients and families (endorsed by 79.9% of physicians); communication difficulties (73.4%); and a lack of coordination between services (69.9%). The regression analyses identified no significant associated variables.

Conclusion

A preliminary version of a novel physician-report tool to assess barriers to providing care to autistic patients has been developed although further validation work is required. The use of this tool will help physicians to identify issues specific to different medical specialities and healthcare settings. This information may help identify the supports physicians require to recognise and implement the required accommodations. Future research which elucidates barriers to healthcare provision for autistic patients is required to support systemic change in healthcare so as to improve care experiences and health outcomes for people on the autism spectrum.
Development and validation of a risk prediction score for patients with nasopharyngeal carcinoma
Authors: Xue Ning , Ou Guoping , Ma Weiguo , Jia Lina , Sheng Jiahe , Xu Qingxia , Liu Yubo , Jia Miaomiao
Published: August 2021

Background

We aimed to develop and validate a predictive model for the overall survival (OS) of patients with nasopharyngeal carcinoma (NPC).

Methods

Overall, 519 patients were retrospectively reviewed in this study. In addition, a random forest model was used to identify significant prognostic factors for OS among NPC patients. Then, calibration plot and concordance index (C-index) were utilized to evaluate the predictive accuracy of the nomogram model.

Results

We used a random forest model to select the three most important features, dNLR, HGB and EBV DNA, which were significantly associated with the OS of NPC patients. Furthermore, the C-index of our model for OS were 0.733 (95% CI 0.673 ~ 0.793) and 0.772 (95% CI 0.691 ~ 0.853) in the two cohorts, which was significantly higher than that of the TNM stage, treatment, and EBV DNA. Based on the model risk score, patients were divided into two groups, associated with low-risk and high-risk. Kaplan–Meier curves demonstrated that the two subgroups were significantly associated with OS in the primary cohort, as well as in the validation cohort. The nomogram for OS was established using the risk score, TNM stage and EBV DNA in the two cohorts. The nomogram achieved a higher C-index of 0.783 (95% CI 0.730 ~ 0.836) than that of the risk score model 0.733 (95% CI 0.673 ~ 0.793) in the primary cohort (P = 0.005).

Conclusions

The established risk score model and nomogram resulted in more accurate prognostic prediction for individual patient with NPC.
Effects of RNA methylation N6-methyladenosine regulators on malignant progression and prognosis of melanoma
Authors: Liu Jinfang , Zhou Zijian , Ma Ling , Li Chujun , Lin Yu , Yu Ting , Wei Ji-Fu , Zhu Lingjun , Yao Gang
Published: August 2021

Background

Melanoma is an extremely aggressive type of skin cancer and experiencing a expeditiously rising mortality in a current year. Exploring new potential prognostic biomarkers and therapeutic targets of melanoma are urgently needed. The ambition of this research was to identify genetic markers and assess prognostic performance of N6-methyladenosine (m6A) regulators in melanoma.

Methods

Gene expression data and corresponding clinical informations of melanoma patients as well as sequence data of normal controls are collected from The Cancer Genome Atlas (TCGA) and the Genotype-Tissue Expression (GTEx) databases. Quantitative real-time PCR (qRT-PCR) analysis was carried out to detect the RNA expression of IGF2BP3 in A375 cell line, melanoma tissues, and normal tissues. Western blot, cell proliferation, and migration assays were performed to assess the ability of IGF2BP3 in A375 cell line.

Results

Differently expressed m6A regulators between tumor samples and normal samples were analyzed. A three-gene prognostic signature including IGF2BP3, RBM15B, and METTL16 was constructed, and the risk score of this signature was identified to be an independent prognostic indicator for melanoma. In addition, IGF2BP3 was verified to promote melanoma cell proliferation and migration in vitro and associate with lymph node metastasis in clinical samples. Moreover, risk score and the expression of IGF2BP3 were positively associated with the infiltrating immune cells and these hub genes made excellent potential drug targets in melanoma.

Conclusion

We identified the genetic changes in m6A regulatory genes and constructed a three-gene risk signature with distinct prognostic value in melanoma. This research provided new insights into the epigenetic understanding of m6A regulators and novel therapeutic strategies in melanoma.