bluuebunny/crossref_metadata_2025 huggingface dataset:
Tracheal hamartoma masquerading as asthma
Authors: Farrugia Yanika , Pace Bardon Michael , Galea Gabriel , Micallef Josef
Published: November 2023

We present a rare case of a female non-smoker diagnosed with a large benign tracheal chondrohamartoma, masquerading as severe asthma. The patient was in her late 70s and had a history of asthma. She had presented to hospital with multiple episodes of intractable cough, shortness of breath and wheeze in the year prior to diagnosis. She had been managed for asthma for two decades by different physicians in primary care, based on documented airflow obstruction. Given her repeated admissions, the respiratory team was consulted. In view of the persistent cough despite maximal treatment, she was referred for a thoracic high-resolution CT scan which revealed a large intraluminal tracheal polypoid mass. Flexible bronchoscopy was performed and this confirmed the presence of a large pedunculated mass in the distal trachea. The patient subsequently underwent removal of the mass by means of rigid bronchoscopy, laser and electrocautery followed by argon ablation of residual tissue. She made an excellent recovery with full resolution of her respiratory symptoms and normalisation of her pulmonary function tests.
Association between perioperative neuraxial local anesthetic neurotoxicity and arachnoiditis: a narrative review of published reports
Authors: Brenna Connor T. A. , Khan Shawn , Poots Catherine , Brull Richard
Published: November 2023

Background/importance

Arachnoiditis is a rare but devastating disorder caused by various insults, one of which is purported to be local anesthetic neurotoxicity following neuraxial blockade. However, the relationship between local anesthetics administered into the neuraxis and the development of arachnoiditis has not been clearly elucidated.

Objective

We aimed to summarize the existing complex body of literature and characterize both the essential features and strength of any association between neuraxial local anesthetic neurotoxicity and arachnoiditis with a view toward mitigating risk, enhancing prevention, and refining informed consent discussions.

Evidence review

We reviewed all published reports of arachnoiditis attributed to local anesthetic neurotoxicity following perioperative neuraxial anesthesia. This narrative review was based on a systematic search methodology, which included articles published up until December 2022.

Findings

Thirty-eight articles were included, comprising 130 patients, over one-half of which were published prior to this century and inconsistent with modern practice. Neuraxial techniques included 78 epidurals, 48 spinals, and 5 combined spinal-epidurals, mostly for obstetrics. Reporting of essential procedural data was generally incomplete. Overall, at least 57% of patients experienced complicated needle/catheter insertion, including paresthesia, pain, or multiple attempts, irrespective of technique. The onset of neurological symptoms ranged from immediate to 8 years after neuraxial blockade, while the pathophysiology of arachnoiditis, if described, was heterogeneous.

Conclusions

The existing literature attributing arachnoiditis to local anesthetic neurotoxicity is largely outdated, incomplete, and/or confounded by other potential causes, and thus insufficient to characterize the features and strength of any association.
Gauge waves generation and detection in Aharonov–Bohm electrodynamics
Authors: Minotti F. , Modanese G.
Published: November 2023

The extended Aharonov–Bohm electrodynamics has a simple formal structure and allows to couple the e.m. field also to currents which are not locally conserved, like those resulting from certain non-local effective quantum models of condensed matter. As it often happens in physics and mathematics when one tries to extend the validity of some equations or operations, new perspectives emerge in comparison to Maxwell theory, and some “exotic” phenomena are predicted. For the Aharonov–Bohm theory the main new feature is that the potentials $$A^\mu $$

A
μ

become univocally defined and can be measured with probes in which the “extra-current” $$I=\partial _\mu j^\mu $$

I
=

∂
μ

j
μ

is not zero at some points. As a consequence, it is possible in principle to detect pure gauge-waves with $${\textbf{E}}={\textbf{B}}=0$$

E
=
B
=
0

, which would be regarded as non-physical in the Maxwell gauge-invariant theory with local current conservation. We discuss in detail the theoretical aspects of this phenomenon and propose an experimental realization of the detectors. A full treatment of wave propagation in anomalous media with extra-currents and of energy–momentum balance issues is also given.
Wide-angle and polarization-insensitive perfect metamaterial absorber
Authors: Kumar Raj , Kumar Hemant , Ramani Umang , Kumar Sanket , Singh Bipin K. , Singh P. P. , Pandey Praveen C.
Published: November 2023

We propose a cross-shaped resonator design of a metamaterial (MTM) absorber that shows a 98% average absorbance in the range of 400–1100[Formula: see text]nm. This design consists of three layers: a tungsten-based cross-shaped on the top, silicon dioxide (SiO2) in the middle layer, and a tungsten layer at the bottom. The finite integration technique (FIT) method is used to simulate the metamaterial absorber’s performance. We have observed the absorber’s performance on the different thicknesses of a dielectric layer. We have presented the absorption spectrum for transverse electric (TE) and transverse magnetic (TM) modes for different polarization angles (0°–90°) and incident angles (0°–60°). Additionally, we have investigated the short-circuit current density for different dielectric layer thicknesses and different incidence angles. This is theoretically analogous to parametric studies. The universal AM 1.5 solar spectrum properties have been used to investigate the feasibility of the proposed MTM absorber as a solar cell. The proposed MTM has many potential uses, including for solar cells.
First-principles study on the electronic properties of atom passivating CsPbI2Br surface
Authors: Si Fengjuan , Liu Wuyang , Hu Wei
Published: November 2023

The electronic properties of the bulk CsPbI2Br and the passivation of CsPbI2Br (110) surface states are calculated by using first-principles calculations. It is found that the band gap of CsPbI2Br is 1.42[Formula: see text]eV by using the generalized gradient approximation of the Perdew–Burke–Ernzerhof function. The band gap is about 1.96[Formula: see text]eV by using the more complex Heyd–Scuseria–Ernzerhof mixed functional, which is closer to the experimental value of 1.92[Formula: see text]eV. The valence band top of CsPbI2Br bulk is mainly contributed by I-5p orbital and Br-4p orbital, and the conduction band bottom is mainly contributed by Pb-6p orbital. Through the calculation of CsPbI2Br (110) surface states passivated by Cl, F and H atoms, it is found that H atom has the best passivation effect. Its adsorption energy value fluctuates less, it is less sensitive to the adsorption position, and the adsorption is stable. Followed by F atom, its passivation effect is worse than that of H atom, but better than that of Cl atom. Although the passivation position has a certain influence on it, it has little effect. The Cl atom is most affected by the passivation position. The different positions of passivated atoms have a significant impact on adsorption energy. The adsorption stability is poor, and the passivation effect is also poor. Through analyzing the charge density difference and Bader charges, it is found that the H atom gets more electrons from the I atom, which is beneficial to passivate surface states. The electron-acquiring ability of the F atom is inferior to that of the H atom and is superior to that of the Cl atom. The electron-acquiring ability and passivation ability of Cl atom are the weakest among the three elements.
A GENERALIZED FRACTAL-BASED APPROACH FOR STRESS-DEPENDENT PERMEABILITY OF POROUS ROCKS
Authors: MIAO TONGJUN , CHEN AIMIN , YANG XIAOYA , YU BOMING
Published: November 2023

The pore geometry of porous rocks is fundamental for accurate description of stress dependence of effective permeability, which is an important parameter of mass transfer in porous rocks. An important physical assumption that porous rocks contain numerous elliptical or spherical pores has been shown to be successfully applied to many aspects of hydromechanical coupling properties of porous rocks. To investigate the detailed description of pore structures on the degree of effect on the coupled hydromechanical process, in this work, a generalized stress-dependent model for permeability of porous rocks has been proposed based on fractal geometry theory and mechanics of porous rock. The proposed model is expressed as a nonlinear function of pore structure parameters, such as aspect ratio ([Formula: see text]), the fractal dimensions ([Formula: see text] and [Formula: see text]) for tortuosity, the initial fractal dimension ([Formula: see text]), and initial porosity ([Formula: see text]) as well as matrix elastic constants ([Formula: see text] and [Formula: see text]) of porous rocks without any empirical parameter. The validity of the proposed models is verified by the good agreements between available experimental data and theoretical predictions of stress-dependent permeabilities of porous rocks. Detailed discussions of the essential effects of pore structures parameters and material elastic constants of porous rocks on the dimensionless stress-dependent permeabilities are performed. It is found that the stress parameters ([Formula: see text] and [Formula: see text]) have remarkable effects on the dimensionless stress-dependent permeabilities compared with other parameters ([Formula: see text] and [Formula: see text]). The proposed model may contribute to a better quantitative understanding of the coupled hydromechanical properties of porous rocks.
Hybrid Anode Design of Polymer Electrolyte Membrane Water Electrolysis Cells for Ultra-High Current Density Operation with Low Platinum Group Metal Loading
Authors: Yasutake Masahiro , Noda Zhiyun , Matsuda Junko , Lyth Stephen M. , Nishihara Masamichi , Ito Kohei , Hayashi Akari , Sasaki Kazunari
Published: November 2023

Reducing platinum group metal (PGM) loading and high current density operation are both essential for minimizing the capital expenditure (CAPEX) of polymer electrolyte membrane (PEM) electrolyzers. Catalyst-integrated porous transport electrodes (PTEs) in which iridium acts as both a catalyst and a conductive coating on porous transport layer (PTL) surfaces, enable the preparation of Pt-coating-free PTLs, but can also result in relatively high activation and ohmic overvoltages. Here, a novel hybrid anode design combining an intermediate catalyst layer and a catalyst-integrated PTE is developed. This hybrid anode demonstrates that Ir on PTL can contribute to the oxygen evolution reaction (OER) and exhibits comparable electrolysis performance to a conventional anode consisting of Pt-coated PTL with the same Ir loadings despite Pt-coating-free on the PTL of the hybrid anode. This novel anode eliminates the need for a Pt coating whilst also enabling ultra-high current density operations up to 20 A cm−2 with a total PGM loading of only around 0.6 mg cm−2 on the anode side. This paper proposes a next-generation anode structure with new functions of PTLs for ultra-high current density operation with low PGM loading to significantly reduce green hydrogen costs.
Factors Associated with Adherence to Complete Decongestion Therapy in Women with Breast Cancer-Related Lymphedema
Authors: Pu Fulin , Zhang Lijuan , Zhang Yiheng , Sun Shihao , Li Na , Liao Haifen , Zhang Meifen
Published: November 2023

Background. Adherence to complete decongestion therapy (CDT) is of utmost importance for patients with breast cancer-related lymphedema (BCRL). However, past studies have demonstrated that adherence to CDT in BCRL patients is less than satisfactory. Our study aimed to describe the level of adherence to CDT among BCRL patients and utilize the Health Belief Model to analyse the key factors that influence adherence. Methods. We employed a convenient sampling method to select 158 patients with BCRL who were in the maintenance stage of CDT in a grade A tertiary tumour hospital in Guangzhou. A questionnaire survey was used to investigate patients’ adherence to CDT, as well as their sociodemographic characteristics, medical history characteristics, disease knowledge, and health beliefs. Results. The CDT adherence score of BCRL patients was 96.46 ± 18.46 points, with an average score of 2.61 ± 0.50 points per item. The adherence rate was 65.18 ± 12.47%, indicating a moderate level of adherence. Factors that significantly influenced CDT adherence in BCRL patients included age under 45 years, having 0 or 1 child, experiencing 9 lymphedema symptoms, and having low levels of disease knowledge and health beliefs (

p
<
0.05

). Conclusions. The level of adherence to CDT in BCRL patients is moderate and requires improvement. To enhance adherence to CDT, medical professionals should focus on patients who are younger, have fewer children, exhibit fewer symptoms of lymphedema, possess limited disease knowledge, and have weak health beliefs.
Length-Weight Relationships for Ten Fish Species from Rivers in the Qinling Mountains, China
Authors: Shi Yunrong , Yang Jieqing , Li Xinran , Li Haizhou , Yu Jinchen , Chen Lang , Zhou Jin
Published: November 2023

Length-weight relationships (LWRs) were reported for ten fish species (Abbottina rivularis, Hemibarbus labeo, Hemibarbus maculatus, Onychostoma macrolepis, Opsariichthys bidens, Rhynchocypris lagowskii, Schizothorax prenanti, Sinibrama macrops, Zacco platypus, and Siniperca scherzeri). Fishes were collected from 62 sampling stations covering an area of ∼7000 km2 in the Qinling Mountains, characterized by unique fauna and distribution pattern, using gillnets and ground cages during June to December 2022. The intercept a ranged from 0.013 for S. prenanti to 0.060 for H. labeo, and the slope b ranged from 2.537 for H. labeo to 3.079 for Z. platypus.
Metodología para el Análisis Financiero y Económico de la Empresa, Considerando el Impacto en los Estados Financieros por el Reconocimiento de un Derecho de Uso y una Obligación por Arrendamiento Operativo, Bajo Normas Internacionales de Información.
Authors: Solís Fuenzalida Gloria
Published: November 2023

Los estados financieros deben cumplir con la característica de fiabilidad y, por ende, que reflejen todos sus derechos y obligaciones; para contribuir a aquéllo se hace imprescindible mejorar la contabilidad de arriendos operativos; es por ello que se emitió el Exposure Draft ED/2010/09 Leases (borrador para discusión ED/2010/09 Arrendamientos). Si bien no se puede predecir con certeza el resultado final de la norma, el cambio ya es probable, por lo que adelantarse a sus impactos ayuda a la eficiencia de su aplicación, considerando que será un factor para contribuir a cumplir con el concepto de imagen fiel en los estados financieros y, permitir a las partes interesadas, tomar decisiones con mayor seguridad y menor incertidumbre.
Metodología de Gestión de la Variable Ambiental en la Industria de la Construcción
Authors: Bernales Álvarez María Soledad , Tapia Soto Marianela Jacqueline , Peña Cortés Angélica
Published: November 2023

Establecer una metodología que permita gestionar la variable ambiental, específicamente en la industria de la construcción, por ser una industria vinculada de manera directa con el medio ambiente, es el objeto de este artículo. La actual estructura de gestión en el área de la construcción es de difícil cambio y por ello, de complicada mejora, aunque con el compromiso de profesionales del área y los requerimientos del entorno, se considera que el cambio tendrá lugar muy poco a poco, pero será inevitable. Desde este punto de vista, este artículo propone una herramienta para el cambio e iniciar un debate sobre una manera de entender la sustentabilidad medio ambiental en el área de la construcción, y al mismo tiempo incorporar conocimientos, que actualmente quedan definidos por la realidad como absolutamente necesarios, los que deben estar relacionados y buscar soluciones efectivas para gestionar dicha variable con el propósito de derivar hacia una construcción sustentable.
Propuesta de Metodología de Gestión de los Recursos Educacionales del Obispado de Chillán
Authors: Flores Ortega Ingrid , Coloma Rodríguez Christian
Published: November 2023

Este artículo aborda la problemática que enfrentan hoy en día los establecimientos educacionales en el ámbito de gestión, basado en el caso de los establecimientos educacionales dependientes del Obispado de Chillán. El presente estudio enfatiza en que los desafíos de los colegios, hoy por hoy, son poseer cada vez más altos estándares de gestión. Por lo que se destacan los Modelos Chilenos de Gestión de Excelencia en su uso y aplicación, los que permiten alinear sus procesos a los objetivos de la institución. La investigación hace referencia a que el uso de uno de los Modelos Chileno de Gestión de Excelencia, es una poderosa herramienta que los ayudará en su objetivo institucional, por lo cual se invita a usar un Modelo de gestión en el nivel central que forme parte del movimiento de la mejora continua y la Innovación en la gestión
Association between Self-Reported Oral Health and Parkinson’s Disease: Evidence from UK Biobank
Authors: Yi Xiao , Li Chunyu , Wang Shichan , Shang Huifang
Published: November 2023

Objectives: Oral health problem is prevalent in the elderly population which is also at high risk of Parkinson’s disease (PD). However, the association between self-reported oral health and PD is still unclear. We aimed to explore the association between baseline self-reported oral health (mouth ulcers, painful gums, bleeding gums, loose teeth, toothache, dentures) and future incidence of PD. Methods and Participants: Participants were enrolled in the UK Biobank from 2006 to 2010 and those without PD at baseline were included in the current study. We used Cox regression analysis to explore the question and adjusted for age, sex, body mass index, smoking, drinking, ethnicity, education, socioeconomic status, and average total household income before tax. Results: We included 421,180 participants with a mean age of 56.26 years old, and 46.5% of them were male. And 2,339 participants were diagnosed with PD in the follow-up. Mouth ulcers, loose teeth, dentures, toothache, and bleeding gums were not related to the risk of PD. Painful gums were related to a higher risk of PD (HR: 1.39, 95% CI: 1.12–1.72, p = 0.003), and similar results were reached after adjusting for gene risk (HR: 1.39, 95% CI: 1.12–1.73, p = 0.003), or source of diagnosis (HR: 1.39, 95% CI: 1.12–1.72, p = 0.002), and time of diagnosis (HR: 1.29, 95% CI: 1.03–1.63, p = 0.02). Conclusions: Our study has demonstrated a substantial correlation between painful gums and elevated susceptibility to PD, underscoring the potential advantages of implementing oral health interventions for decreasing the risk of PD.
Gizi pada Industri Makanan
Authors: Widyanto Rahma Micho , Rahmawati Irma Sarita , Maulidiana Annisa Rizky , Istifiani Lola Ayu
Published: November 2023

Buku ini disusun guna membantu memudahkan mahasiswa Departemen Gizi memahami materi yang ada dalam perkuliahan. Terdapat 12 bab dalam buku ajar ini: Bab 1 Membahas mengenai aplikasi penelitian zat gizi pada industri makanan. Bab 2, 3, dan 4 membahas bagaimana aplikasi bioteknologi, sel punca, dan nanoteknologi pada industri makanan. Bab 5 memberikan penjelasan mengenai produk pangan keperluan gizi khusus untuk berbagai kondisi kesehatan. Bab 6 membahas mengenai teknologi suplementasi. Bab 7 dan 8 membahas fungsi QC dan QA serta peran bidang periklanan pada industri makanan. Selanjutnya pada Bab 9 dan 10 dibahas mengenai food rheology dan keju sebagai carrier food untuk probiotik. Bab 11 menjelaskan mengenai emergency food product dan bab terakhir membahas mengenai pengujian halal berbasis DNA. Harapannya semoga buku ini dapat memberikan sumbangsih keilmuan dan kemanfaatan yang luas bagi mahasiswa di Departemen Gizi pada khususnya serta khalayak pembaca pada umumnya.
A vôo de pássaro: imagens fotográficas, drones e o sublime contemporâneo nas representações recentes da paisagem e do território
Authors: Araujo Douglas Canjani
Published: November 2023

O artigo aborda os trabalhos de 3 fotógrafos paisagistas (George Love, David Maisel e Edward Burtynsky) que se valem das representações a vôo de pássaro para explicitar as relações de uso do território e da paisagem, decorrentes de forças produtivo-econômicas, e como elas se relacionam com categorias estéticas como o sublime.
Review of Nasuconia Sakakibara, 2006 (Hemiptera: Membracidae) with description of three new species
Authors: GONZALEZ-MOZO LAURA C. , WARE JESSICA L.
Published: November 2023

The treehopper genus Nasuconia Sakakibara, 2006 previously included four species and was recorded only from Brazil. Here we provide a revised diagnosis of the genus and describe three new species: Nasuconia ellenfutterae sp. nov. from Ecuador, Nasuconia guianensis sp. nov. from French Guiana and Nasuconia yasuni sp. nov. from Ecuador. The genus can be distinguished by the following combination of characters: frontoclypeus conical with transverse grooves, obliquely projected forward at least 1/3 of its length beyond suprantennal margin; pronotum navicular, low, punctate, with longitudinal elevated lines or nodes; first valvulae with ventral interlocking device distinctively sinuate. Two informal species groups are recognized based on characters of the head, forewing and leg chaetotaxy. A key to species, photographs, updated morphological descriptions, and the first descriptions of the female and male genitalia of Nasuconia species are provided. Comparisons of cucullate setae and fine abdominal integument structures are also made using scanning electron microscopy.
Influence of Weather and Climate on Multidecadal Trends in Atlantic Hurricane Genesis and Tracks
Authors: Kortum Grace , Vecchi Gabriel A. , Hsieh Tsung-Lin , Yang Wenchang
Published: November 2023

This study investigates the relative roles of sea surface temperature–forced climate changes and weather variability in driving the observed eastward shift of Atlantic hurricane tracks over the period from 1970 to 2021. A 10-member initial condition ensemble with a ∼25-km horizontal resolution tropical cyclone permitting atmospheric model (GFDL AM2.5-C360) with identical sea surface temperature and radiative forcing time series was analyzed in conjunction with historical hurricane track observations. While a frequency increase was recovered by all the simulations, the observed multidecadal eastward shift in tracks was not robust across the ensemble members, indicating that it included a substantial contribution from weather-scale variability. A statistical model was developed to simulate expected storm tracks based on genesis location and steering flow, and it was used to conduct experiments testing the roles of changing genesis location and changing steering flow in producing the multidecadal weather-driven shifts in storm tracks. These experiments indicated that shifts in genesis location were a substantially larger driver of these multidecadal track changes than changes in steering flow. The substantial impact of weather on tracks indicates that there may be limited predictability for multidecadal track changes like those observed, although basinwide frequency has greater potential for prediction. Additionally, understanding changes in genesis location appears essential to understanding changes in track location.

Significance Statement

From the 1970s to the present, there has been an increase in the frequency of North Atlantic hurricanes, but they have also shifted in location to the east, away from land. We explore whether this shift in hurricanes’ locations was caused by climatic factors or randomness to understand if and how these trends will persist. We also consider whether the shift was due to a change in where hurricanes started or how they moved over their lifespan. Analyzing data from observed and simulated hurricanes, we find that the shift was made more likely by climate factors, but ultimately occurred due to random variability in the hurricanes’ starting locations. These results suggest a higher uncertainty in the future location and impact of hurricanes and highlight the importance of studying why hurricanes originate where they do.
Association between MC1R gene and coat color segregation in Shanxia long black pig and Lulai black pig
Authors: Zheng Hao , Xiong San-ya , Xiao Shi-jun , Zhang Ze-kai , Tu Jin-min , Cui Deng-shuai , Yu Nai-biao , Huang Zhi-yong , Li Long-yun , Guo Yuan-mei
Published: November 2023

Background

Coat color, as a distinct phenotypic characteristic of pigs, is often subject to preference and selection, such as in the breeding process of new breed. Shanxia long black pig was derived from an intercross between Berkshire boars and Licha black pig sows, and it was bred as a paternal strain with high-quality meat and black coat color. Although the coat color was black in the F1 generation of the intercross, it segregated in the subsequent generations. This study aims to decode the genetic basis of coat color segregation and develop a method to distinct black pigs from the spotted in Shanxia long black pig.

Results

Only a QTL was mapped at the proximal end of chromosome 6, and MC1R gene was picked out as functional candidate gene. A total of 11 polymorphic loci were identified in MC1R gene, and only the c.67_68insCC variant was co-segregating with coat color. This locus isn’t recognized by any restriction endonuclease, so it can’t be genotyped by PCR-RFLP. The c.370G > A polymorphic locus was also significantly associated with coat color, and has been in tightly linkage disequilibrium with the c.67_68insCC. Furthermore, it is recognized by BspHI. Therefore, a PCR-RFLP method was set up to genotype this locus. Besides the 175 sequenced individuals, another more 1,391 pigs were genotyped with PCR-RFLP, and all of pigs with GG (one band) were black.

Conclusion

MC1R gene (c.67_68insCC) is the causative gene (mutation) for the coat color segregation, and the PCR-RFLP of c.370G > A could be used in the breeding program of Shanxia long black pig.
Comprehensive analysis of miRNA-mRNA regulatory pairs associated with colorectal cancer and the role in tumor immunity
Authors: Liu Cheng , Yu Chun , Song Guoxin , Fan Xingchen , Peng Shuang , Zhang Shiyu , Zhou Xin , zhang Cheng , Geng Xiangnan , Wang Tongshan , Cheng Wenfang , Zhu Wei
Published: November 2023

Background

MicroRNA (miRNA) which can act as post-transcriptional regulators of mRNAs via base-pairing with complementary sequences within mRNAs is involved in processes of the complex interaction between immune system and tumors.

In this research, we elucidated the profiles of miRNAs and target mRNAs expression and their associations with the phenotypic hallmarks of colorectal cancers (CRC) by integrating transcriptomic, immunophenotype, methylation, mutation and survival data.

Results

We conducted the analysis of differential miRNA/mRNA expression profile by GEO, TCGA and GTEx databases and the correlation between miRNA and targeted mRNA by miRTarBase and TarBase. Then we detected using qRT-PCR and validated the diagnostic value of miRNA-mRNA regulator pairs by the ROC, calibration curve and DCA. Phenotypic hallmarks of regulatory pairs including tumor-infiltrating lymphocytes, tumor microenvironment, tumor mutation burden, global methylation and gene mutation were also described. The expression levels of miRNAs and target mRNAs were detected in 80 paired colon tissue samples. Ultimately, we picked up two pivotal regulatory pairs (miR-139-5p/ STC1 and miR-20a-5p/ FGL2) and verified the diagnostic value of the complex model which is the combination of 4 signatures above-mentioned in 3 testing GEO datasets and an external validation cohort.

Conclusions

We found that 2 miRNAs by targeting 2 metastasis-related mRNAs were correlated with tumor-infiltrating macrophages, HRAS, and BRAF gene mutation status. Our results established the diagnostic model containing 2 miRNAs and their respective targeted mRNAs to distinguish CRCs and normal controls and displayed their complex roles in CRC pathogenesis especially tumor immunity.
Changes of gut microbiota and short chain fatty acids in patients with Peutz–Jeghers syndrome
Authors: Zhou An , Tang Bo , Xie Yuhong , Li Shengpeng , Xiao Xu , Wu Lingyi , Tu Dianji , Wang Sumin , Feng Yunxuan , Feng Xiaojie , Lai Yi , Ning Shoubin , Yang Shiming
Published: November 2023

Peutz–Jeghers Syndromeis a rare autosomal dominant genetic disease characterized by gastrointestinal hamartomatous polyps and skin and mucous membrane pigmentation. The pathogenesis of PJS remains unclear; however, it may be associated with mutations in the STK11 gene, and there is currently no effective treatment available. The gut microbiota plays an important role in maintaining intestinal homeostasis in the human body, and an increasing number of studies have reported a relationship between gut microbiota and human health and disease. However, relatively few studies have been conducted on the gut microbiota characteristics of patients with PJS. In this study, we analyzed the characteristics of the gut microbiota of 79 patients with PJS using 16 S sequencing and measured the levels of short-chain fatty acids in the intestines. The results showed dysbiosis in the gut microbiota of patients with PJS, and decreased synthesis of short-chain fatty acids. Bacteroides was positively correlated with maximum polyp length, while Agathobacter was negatively correlated with age of onset. In addition, acetic acid, propionic acid, and butyric acid were positively correlated with the age of onset but negatively correlated with the number of polyps. Furthermore, the butyric acid level was negatively correlated with the frequency of endoscopic surgeries. In contrast, we compared the gut microbiota of STK11-positive and STK11-negative patients with PJS for the first time, but 16 S sequencing analysis revealed no significant differences. Finally, we established a random forest prediction model based on the gut microbiota characteristics of patients to provide a basis for the targeted diagnosis and treatment of PJS in the future.
Cytokines in aqueous humor of patients with congenital cataract during delayed sequential bilateral cataract surgery
Authors: Hui Na , Yu Lei , Qu Laiqiang , Yan Hong
Published: November 2023

Background

To explore the changes of cytokines expression in aqueous humor (AH) of eyes of patients with congenital cataract (CC) who underwent delayed sequential bilateral cataract surgery (DSBCS).

Methods

28 patients with CC underwent DSBCS. AH samples were collected from each eye before surgery. The contents of cytokines in AH were detected by Luminex xMAP Technology.

Results

There was no significant difference in the expression of IL-8, IP-10, MCP-1 and PDGFAA in the AH of the first and second eyes (P = 0.35, 0.39, 0.17, respectively). The level of IL-8 in the first-eye AH was negatively correlated with age (ρ=– 0.519, P = 0.008). IP-10 and MCP-1 in the second-eye AH were negatively correlated with age (ρ=– 0.483, P = 0.009; ρ=– 0.445, P = 0.018,respectively).

Conclusion

The first-eye surgery in patients with CC may not cause the change of cytokines in the contralateral eye. The expression of IL-8, IP-10 and MCP-1 in the AH was negatively correlated with the age of patients.

Trial registration

The study was registered at www.chictr.org.cn on March 22, 2022 and the clinical trial number is ChiCTR2200057927.
Should lymphadenectomy performed routinely in patients with primary intrahepatic cholangiocarcinoma undergoing curative hepatectomy? A retrospective cohort study with propensity-score matching analysis
Authors: Huang Shan , Song Jiu-Lin , Li Bo , Yi Peng-Sheng , Yang Jian
Published: November 2023

Background

The benefit of routine lymphadenectomy (LD) in improving outcomes for patients with primary intrahepatic cholangiocarcinoma (ICC) undergoing curative hepatectomy remains unclear.

Materials and methods

This study enrolled 269 consecutive patients who underwent liver resection for primary ICC from January 2009 to July 2020 in West China Hospital. The association of the nodal status with disease-free survival (DFS) and overall survival (OS) was analyzed using the Cox proportional hazards model and 1:1 propensity score matching (PSM) analysis.

Results

Seventy-five (27.9%) patients underwent curative liver resection combined with LD (LD+ group), while 194 (72.1%) patients received curative liver resection without LD (LD- group and Nx group). Among the LD+ group, metastatic disease was present in 36 patients (48%, N1 group) and absent in 39 patients (N0 group). During the follow-up period, 116 patients (43.1%) experienced tumor recurrence and 101 patients (37.5%) died due to recurrence. Multivariate analysis revealed that lymph node metastasis (N1, HR 3.682, 95% CI 1.949–6.957, p < 0.001) was associated with worse OS, while LD+ status (HR 0.504, 95% CI 0.298–0.853, p = 0.011) was associated with improved OS. Adjuvant therapy was a protective factor for both DFS (HR 0.602, 95% CI, 0.447–0.810, p = 0.001) and OS (HR 0.683, 95% CI 0.484–0.963, p = 0.030). After 1:1 PSM, the LD+ patients (n = 74) displayed similar 1-, 3- and 5-year DFS rates (40.0, 7.9 and 7.9% vs. 29.0, 13.7 and 13.7%, p = 0.741) and OS rates (56.0, 26.6 and 22.2% vs. 58.9, 25.6, and 16.4%, p = 0.644) to the LD- patients (n = 74). Additionally, among the 75 LD+ patients, 48 patients underwent hepatic hilar lymphadenectomy (HHL), and 27 patients underwent extended hepatic hilar lymphadenectomy (EHL). Both DFS (p = 0.504) and OS (p = 0.215) were similar between the HHL and EHL groups.

Conclusion

Routine LD and adjuvant therapy may contribute to improved OS according to the crude analysis. LD could provide accurate staging without excessive risk and guide adjuvant therapy based on the tumor stage, potentially resulting in better survival. These results suggest that a routine LD should be considered during curative hepatectomy for ICC.
The utility of accessibility clauses in resident contracts
Authors: Clarke Quinten K.
Published: November 2023

Resident organizations and unions have a powerful role in advocating for resident physicians with disabilities. Ongoing efforts to ensure accessibility for resident physicians with disabilities would be promoted through the inclusion of clauses in resident contracts that ensure accessible work environments.
Usability evaluation of emergency information systems in educational hospitals in Kerman, Iran
Authors: Behnam Farzaneh , khajouei Reza , Nabizadeh Amir Hossein , Saedi Saeed , Ghaemi Mohammad Mahdi
Published: November 2023

Background

Smart and practical health information systems and applications with fewer errors are crucial for healthcare facilities. One method that ensures the proper design of health information systems (HIS) and applications is usability evaluation.

Objective

This study aimed to evaluate the usability of the emergency information systems used at the emergency departments of four educational hospitals in Kerman, Iran.

Method

This study was conducted in two phases. In the first phase, the information systems' errors and shortages were identified using a semi-structured questionnaire by users (nurses and the IT staff). In the second phase, based on the results of the first phase, two questionnaires were designed for each group of users to their opinions about the usability of the emergency information systems.

Results

The average score of “reducing and facilitating user’s daily activities” was significantly different among hospitals (p = 0.03). Shahid Beheshti Hospital obtained the lowest usability score (17.5), and Afzalipour Hospital received the highest usability score (21.75). Moreover, the average score in “use of the HIS” for nurses and IT staff was 2.93 and 3.54 on a scale of 5, respectively.

Conclusion

Usability evaluation of health information systems is essential to ensure that these systems provide sufficient and accurate information and requirements for users and health care providers. Also, modifying health information systems based on the user views and expectations improves the quality of the system and user-system Interaction.
Occupational exposure to respirable crystalline silica and lung cancer: a systematic review of cut-off points
Authors: Rey-Brandariz Julia , Martínez Cristina , Candal-Pedreira Cristina , Pérez-Ríos Mónica , Varela-Lema Leonor , Ruano-Ravina Alberto
Published: November 2023

Background

Respirable crystalline silica (RCS) is associated with the development of lung cancer. However, there is uncertainty around the exposure threshold at which exposure to RCS may pose a clear risk for the development of lung cancer. The objective of this study was to review the cut-off points at which the risk of mortality or incidence of lung cancer due to occupational exposure to RCS becomes evident through a systematic review.

Methods

We conducted a search in PubMed, including cohort and case-control studies which assessed various categories of RCS exposure. A search was also conducted on the webpages of institutional organizations. A qualitative data synthesis was performed.

Results

Twenty studies were included. Studies that assessed lung cancer mortality and incidence displayed wide variability both in RCS exposure categories and related risks. Although most studies found no significant association for RCS exposure categories, it appears to be a low risk of lung cancer for mean concentrations of less than 0.07mg/m3. Regulatory agencies set annual RCS exposure limits ranging from 0.025mg/m3 through 0.1mg/m3.

Conclusions

There is a wide degree of heterogeneity in RCS exposure categories, with most studies observing no significant risk of lung cancer for the lowest exposure categories. Cut-off points differ between agencies but are nonetheless very similar and do not exceed 0.1mg/m3.
Long bone shaft metastasis: a comparative study between cement filling and intercalary prosthesis
Authors: Fan Yichao , Zhang Boya , Guo Liangyv , Yao Weitao
Published: November 2023

Background

Metastatic bone lesions in the extremities can cause severe pain and pathological fractures, significantly affecting patients’ quality of life. Timely intervention and effective management of long bone metastases can positively influence patient outcomes, including survival rates and subsequent treatment options.

Objective

The objective of this study is to compare the efficacy and associated complications of two surgical reconstruction techniques and propose a more effective limb reconstruction approach for long bone metastases.

Methods

A retrospective study was conducted on 28 patients with complete clinical data who underwent a surgical procedure for long bone metastases of the extremities in our department between January 2017 and June 2022. The patients were divided into two groups based on their surgical methods. In group 1, the affected bones were curetted and filled with cement, then secured with plates or intramedullary nails. In group 2, the affected bone segments were completely removed and replaced with custom intercalary prostheses. Various factors, including general patient information, surgical details, surgical effectiveness, and common complications, were compared and analyzed.

Results

There were no significant differences in general patient information between the two groups, including age, gender, surgical site, and primary tumor type. The operative times were 115.37 min for group 1 and 108.90 min for group 2, respectively (p > 0.05). However, intraoperative blood loss differed significantly between the groups, with 769 ml in group 1 and 521 ml in group 2 (p < 0.05). The postoperative MSTS scores were 91% for group 1 and 92% for group 2 (p > 0.05). Postoperative complications included two cases of internal fixation failure and three cases of tumor recurrence in group 1, resulting in a 33% incidence rate, while group 2 experienced a 15% incidence rate with two cases of internal fixation failure.

Conclusion

The results of this study suggest that both surgical techniques are effective for the treatment of long bone metastases of the extremities. However, the custom intercalary prostheses technique in group 2 showed a lower incidence of complications and less intraoperative blood loss. Therefore, it may be a more effective limb reconstruction approach for long bone metastases. Further studies with larger sample sizes are needed to confirm these findings.
CP-25 inhibits the hyperactivation of rheumatic synoviocytes by suppressing the switch in Gαs-Gαi coupling to the β2-adrenergic receptor
Authors: Ge Mingli , Wu Li , He Feng , Tai Yu , Fang Ruhong , Han Dafei , Guo Paipai , Liu Hao , Hu Yong , Xu Shenglin , Wei Wei , Wang Qingtong
Published: November 2023

In essence, the β2 adrenergic receptor (β2AR) plays an antiproliferative role by increasing the intracellular cyclic 3’,5’-adenosine monophosphate (cAMP) concentration through Gαs coupling, but interestingly, β2AR antagonists are able to effectively inhibit fibroblast-like synoviocytes (FLSs) proliferation, thus ameliorating experimental RA, indicating that the β2AR signalling pathway is impaired in RA FLSs via unknown mechanisms. The local epinephrine (Epi) level was found to be much higher in inflammatory joints than in normal joints, and high-level stimulation with Epi or isoproterenol (ISO) directly promoted FLSs proliferation and migration due to impaired β2AR signalling and cAMP production. By applying inhibitor of receptor internalization, and small interfering RNA (siRNA) of Gαs and Gαi, and by using fluorescence resonance energy transfer and coimmunoprecipitation assays, a switch in Gαs-Gαi coupling to β2AR was observed in inflammatory FLSs as well as in FLSs with chronic ISO stimulation. This Gαi coupling was then revealed to be initiated by G protein coupled receptor kinase 2 (GRK2) but not β-arrestin2 or protein kinase A-mediated phosphorylation of β2AR. Inhibiting the activity of GRK2 with the novel GRK2 inhibitor paeoniflorin-6′-O-benzene sulfonate (CP-25), a derivative of paeoniflorin, or the accepted GRK2 inhibitor paroxetine effectively reversed the switch in Gαs-Gαi coupling to β2AR during inflammation and restored the intracellular cAMP level in ISO-stimulated FLSs. As expected, CP-25 significantly inhibited the hyperplasia of FLSs in a collagen-induced arthritis (CIA) model (CIA FLSs) and normal FLSs stimulated with ISO and finally ameliorated CIA in rats. Together, our findings revealed the pathological changes in β2AR signalling in CIA FLSs, determined the underlying mechanisms and identified the pharmacological target of the GRK2 inhibitor CP-25 in treating CIA.
Radiation exposure doses to the surgical team during hip surgery is significantly higher during lateral imaging than posteroanterior imaging: a cadaveric simulation study
Authors: Tamaki Yasuaki , Yamashita Kazuta , Nakajima Daiki , Omichi Yasuyuki , Takahashi Yoshinori , Takai Michihiro , Tamaki Shunsuke , Goto Tomohiro , Hayashi Hiroaki , Higashino Kosaku , Tsuruo Yoshihiro , Sairyo Koichi
Published: November 2023

Background

Fluoroscopy is indispensable when determining appropriate and effective interventions in orthopedic surgery. On the other hand, there is growing concern about the health hazards of occupational radiation exposure. The aim of this cadaveric simulation study was to measure radiation exposure doses to the surgical team during hip surgery.

Methods

We reproduced the intraoperative setting of hip surgery using 7 fresh frozen cadavers (5 male, 2 female) to simulate patients and mannequins to simulate the surgeon, scrub nurse, and anesthesiologist. Six real-time dosimeters were mounted at sites corresponding to the optic lens, thyroid gland, chest, gonads, foot, and hand on each mannequin. The radiation exposure dose to each team member was measured during posteroanterior and lateral fluoroscopic imaging.

Results

Radiation exposure doses to the surgeon were significantly higher during 3 min of lateral imaging than during 3 min of posteroanterior imaging at the optic lens (8.1 times higher), thyroid gland (10.3 times), chest (10.8 times), and hand (19.8 times) (p = 0.018, p = 0.018, p = 0.018, and p = 0.018, respectively). During lateral imaging, the radiation doses to the nurse were 0.16, 0.12, 0.09, 0.72, and 0.38 times those to the surgeon at the optic lens, thyroid, chest, gonads, and foot, respectively. The radiation dose to the anesthesiologist was zero at all anatomic sites during posteroanterior imaging and very small during lateral imaging.

Conclusions

Radiation exposure dose was significantly higher during lateral imaging up to 19.8 times comparing to the posteroanterior imaging. It is effective to reduce the lateral imaging time for reducing the intraoperative radiation exposure. In addition, appropriate distance from fluoroscopy resulted in very low exposure for nurses and anesthesiologists. Surgeon should pay attention that surgical staff do not get closer than necessary to the irradiation field.
Prenatal identification of an inverted duplicated 13q marker chromosome with a neocentromere
Authors: van der Laan Liselot , Hoekman Daniel R. , Wortelboer Esther J. , Mannens Marcel M. A. M. , Kooper Angelique J. A.
Published: November 2023

In this case report, we describe a rare prenatal finding of a small marker chromosome. This marker chromosome corresponds to an inverted duplication of the 13q region 13q31.1q34 (or 13q31.1 → qter) with a neocentromere, detected during genetic analysis of a chorionic villus sample in a fetus with multiple congenital anomalies after a normal prenatal screening result by noninvasive prenatal testing.
Rib pseudoarthrosis with thoracic outlet syndrome in pediatric gymnast: a case report
Authors: Kraft Jessica , Contrucci Ann L.
Published: November 2023

Background

This case study evaluates the diagnosis and treatment of a 12 year old Caucasian male gymnast who had several diagnoses including an isolated first rib fracture, resultant pseudoarthrosis of the first rib, and the development of symptomatic thoracic outlet syndrome. We discuss the causes, prevalence, and suggestions for prompt diagnosis and treatment of these conditions in pediatric patients. Although all three conditions are rare in a child, this case highlights the importance of having a high clinical index of suspicion in recurrent pain in pre-pubertal athletes.

Case presentation

A 12 year old Caucasian male underwent several years of conservative treatment with physical therapy and rest without resolution of his left shoulder pain. He was subsequently diagnosed with pseudoarthrosis of the first rib and thoracic outlet syndrome, which was curative by surgical removal of the first rib, and allowed him to return to his baseline activity level.

Conclusions

Since each of these diagnoses are rare, especially in the pediatric population, we aim to educate the medical community on the prompt diagnosis and treatment of these conditions.
Chronic myeloid leukemia with sleep-related painful erections as a first symptom: a case report
Authors: Han Yao-dong , Chen Hong-jie
Published: November 2023

Background

Sleep-related painful erections are characterized by deep penile pain that occurs during erections in the rapid eye movement stage of sleep.

Case presentation

This case presents a 43-year-old Chinese Han patient with sleep-related painful erections. Turgid painful erections (4–5 episodes of tumescence) during the sleep hours caused pain. Further, blood testing revealed an abnormal increase in white blood cells (123 × 109/L). The patient was diagnosed with chronic myeloid leukemia by bone marrow biopsy, BCR::ABL1 fusion gene testing, and Philadelphia chromosome. However, the sleep-related painful erections have dramatically decreased in frequency of erectile pain after chemotherapy for Chronic myeloid leukemia in our case.

Conclusion

We considered that the occurrence of sleep-related painful erections was related to chronic myeloid leukemia and the case might be secondary sleep-related painful erections.