bluuebunny/crossref_metadata_2025 huggingface dataset:
Fe-Hemin-Metal Organic Frameworks/Three-Dimensional Graphene Composites with Efficient Peroxidase-Like Bioactivity for Real-Time Electrochemical Detection of Extracellular Hydrogen Peroxide
Authors: Zhou Shiying , Sun Human , Wang Xianfeng , Lu Peng , Huo Danqun , Li Jiawei , Luo Xiaogang , Hou Changjun
Published: November 2021

Real-time detection of extracellular hydrogen peroxide is important for dynamic monitoring of diseases and cytopathological research. Here, a novel composite of Fe-hemin-metal organic frameworks/three-dimensional graphene (Fe-hemin MOFs/3DG) was prepared by embedding hemin into amino-contained Fe-MOFs, then decorated with 3DG. The obtained Fe-hemin MOFs/3DG possessed efficient peroxidase-like bioactivity and could serve as an effective catalyst for construction of H2O2 electrochemical sensor. The electrochemical results show that the proposed sensor based on Fe-hemin MOFs/3DG has excellent catalytic activity for H2O2. With a linear range was 10−12080 μM and LOD was 0.34 μM, this sensor showed favorable selectivity, repeatability and stability, which could be used to detect H2O2 in real serum samples. Most importantly, this sensor realized the real-time determination of H2O2 released by A549 cells and possessed good biocompatibility. The outstanding electrochemical performance mainly benefited from the unique porous structure of MOFs, which could effectively protect the active center of hemin, and the introduction of 3DG greatly improved the conductivity of Fe-hemin MOFs. Therefore, the Fe-hemin MOFs/3DG could be a promising probe for real-time dynamic monitoring of H2O2.
Communication—Fe-MOF Exhibits Higher Oxygen Evolution Ability by Electronic Modulation of Sodium Hypochlorite
Authors: Mu Guomei , Miao Yujie , Wu Mengjiao , Xiang Qiaoyue , Lin Dunmin , Xu Chenggang , Xie Fengyu
Published: November 2021

Development of robust alkaline oxygen evolution reaction electrocatalysts is crucial for the efficiency of water splitting. Herein, Fe-MOF nanocones array on nickel foam are synthesized by introducing sodium hypochlorite, leading to Cl substitution of terephthalic acid in Fe-MOFs (Fe-MOF-Cl/NF). Experimental results show that Fe-MOF-Cl/NF exhibits enhanced OER activity over Fe-MOF/NF, lowering η
50 from 292.4 to 222.7 mV. In combination with density function theory calculations, the improved OER performance is attributed to engineering electronic structure of Fe sites which accelerate the third step from *O to *OOH, and promote OER kinetics. Additionally, Fe-MOF-Cl/NF can retain catalytic activity for 100 h.
CT Image Features of the FBP Reconstruction Algorithm in the Evaluation of Fasting Blood Sugar Level of Diabetic Pulmonary Tuberculosis Patients and Early Diet Nursing
Authors: Hong Lili , Lin Liling , Chen Jingping , Wu Biyu
Published: November 2021

The study was aimed at exploring the application value of the CT image based on a filtered back projection (FBP) algorithm in the diagnosis of patients with diabetes complicated with tuberculosis and at analyzing the influence of dietary nursing on patients with diabetes complicated with tuberculosis. In this study, the FBP algorithm was used to optimize CT images to effectively obtain reconstructed ROI images. Then, the deviation from measurement values of reconstructed images at different pixel levels was analyzed. 138 patients with diabetes complicated with tuberculosis were selected as research subjects to compare the number of lung segments involved and the CT imaging manifestations at different fasting glucose levels. All patients were divided into the control group (routine drug treatment) and observation group (diet intervention on the basis of drug treatment) by random number table method, and the effect of different nursing methods on the improvement of patients’ clinical symptoms was discussed. The results showed that the distance measurement value decreased with the increase in pixel level, there was no significant difference in the number of lung segments involved in patients with different fasting glucose levels (P>0.05), and there were statistically significant differences in the incidence of segmental lobar shadow, bronchial air sign, wall-less cavity, thick-walled cavity, pulmonary multiple cavity, and bronchial tuberculosis in patients with different fasting glucose levels (P<0.05). Compared with the control group, 2 h postprandial blood glucose level in the observation group was significantly improved (P<0.05), there was a statistical significance in the number with reduced pleural effusion and the number with reduced tuberculosis foci in the two groups (P<0.05), and the level of hemoglobin in the observation group was7.1±1.26, significantly lower than that in the control group (8.91±2.03,P<0.05). It suggested that the changes of CT images based on the FBP reconstruction algorithm were correlated with fasting blood glucose level. Personalized diet nursing intervention can improve the clinical symptoms of patients, which provides a reference for the clinical diagnosis and treatment of patients with diabetes complicated with tuberculosis.
Euglycemic Diabetic Ketoacidosis in a Sedated Patient after Coronary Artery Bypass Grafting: A Case Report and Literature Review
Authors: Alabdaljabar Mohamad S. , Abdullah Khaled M. , Almasood Ali , Ali Syed Salman , Ashmeg Abdullah
Published: November 2021

Euglycemic diabetic ketoacidosis (EDKA) is a rare and serious adverse effect of sodium-glucose cotransporter 2 inhibitors (SGLT-2i). The diagnosis is challenging due to the rarity, nonspecific symptoms, and absence of the alarmingly high blood glucose levels, and thus, it could be initially missed resulting in delayed treatment. This is particularly important for sedated patients, as the absence of typical clinical signs and symptoms can obscure the diagnosis. We present the case of a patient with type 2 diabetes mellitus on empagliflozin who developed EDKA while sedated after coronary artery bypass grafting (CABG) despite stopping the medication 24 hours prior to surgery. We also summarize the current literature on EDKA after CABG. Physicians must be aware and maintain a high index of suspicion for the illness, especially in patients with T2DM taking SGLT-2i and undergoing a major operation such as CABG. Emergent treatment and multidisciplinary follow-up are needed to improve patient outcomes and mitigate complications. Physicians should also consider identifying the optimal time to discontinue SGLT-2i before major surgeries and possible ketone studies in such patients, especially those sedated following the surgery.
Near-Field Route Optimization-Supported Polar Ice Navigation via Maritime Radar Videos
Authors: Lin Xinwei , Wang Shengzheng , Zhang Xuesheng , Hsieh Tsung-Hsuan , Sun Zhen , Xu Tingliu
Published: November 2021

The accurate design of ship routing plans in arctic areas is not easy, considering that navigation conditions (e.g., weather, visibility, and ice thickness) may change frequently. A ship’s crew identifies sea ice in arctic channels with the help of radar echoes, and ship maneuvering decisions are made to avoid navigation interference. Ship officials must manually and consistently change the ship’s route of travel, which is time-consuming and tedious. To address this issue, we propose a near-field route optimization model for the purpose of automatically selecting an optimal route with the help of radar echo images. The ship near-field route optimization model uses a multiobjective optimal strategy considering factors of minimum navigation risk and steaming distance. We verified the model’s performance with the support of the Xuelong voyage dataset. This research finding can help a ship’s crew to design more reasonable navigation routes in polar channels.
Normal Wiggly Probabilistic Hesitant Fuzzy Information for Environmental Quality Evaluation
Authors: Noor Qasim , Alrowaili Dalal Awadh , Rashid Tabasam , Husnine Syed Muhammad
Published: November 2021

As a valuable tool for representing uncertain information, probabilistic hesitant fuzzy sets (PHFS) have gained considerable recognition and in‐depth discussion in recent years to increase the flexibility and manifest hesitant information in decision‐making problems. However, decision‐makers (DMs) cannot express all preferences only through a few probabilistic terms in actual decision‐making. Much critical information is hidden behind the original information provided by the DMs. Keeping that in mind, we are interested in mining deeper uncertain information from the original probabilistic hesitant fuzzy evaluation data. To achieve the target, we put forward a novel representation tool called the normal wiggly probabilistic hesitant fuzzy set (NWPHFS) to extract deeper uncertain preferences from original probabilistic information. NWPHFS retains the original evaluation information and carries and assesses the potential uncertain details for increasing the rationality of decision‐making outcomes. Herein, we propose some fundamental concepts of NWPHFS, for instance, some elementary operational laws, distance measures between two NWPHFSs, and score function. We also suggest two new aggregation operators, that is, the normal wiggly probabilistic hesitant fuzzy weighted averaging (NWPHFWA) and normal wiggly probabilistic hesitant fuzzy weighted geometric (NWPHFWG). A novel mechanism is proposed here to work out multiattribute decision‐making (MADM) in solving normal wiggly probabilistic decision‐making problems. Through a practical example of environmental quality assessment, the specific calculation steps of this method are epitomized. Finally, we have demonstrated the feasibility and advancement of the proposed approach via a comprehensive comparative study.
Determining the Image Base of ARM Firmware by Matching Function Addresses
Authors: Zhu Ruijin , Zhang Baofeng , Tan Yu-an , Wan Yueliang , Wang Jinmiao
Published: November 2021

Firmware is software embedded in a device and acts as the most fundamental work of a system. Disassembly is a necessary step to understand the operational mechanism or detect the vulnerabilities of the firmware. When disassembling a firmware, it should first obtain the processor type of running environment and the image base of firmware. In general, the processor type can be obtained by tearing down the device or consulting the product manual. However, at present, there is still no automated tool that can be used to obtain the image base of all types of firmware. In this paper, we focus on firmware in ARM and propose an automated method to determine the image base address. Firstly, by studying the storage rule and loading mode of the function address, we can obtain the function offset and the function address loaded by LDR instruction, respectively. Then, with this information, we propose an algorithm, named Determining image Base by Matching Function Addresses (DBMFA), to determine the image base. The experimental results indicate that the proposed method can successfully determine the image base of firmware which uses LDR instruction to load function address.
Applying the Fuzzy Analytic Hierarchy Process Method to Evaluate Key Indicators of Health Promotion Policies for the Elderly in Taiwan
Authors: Hsu Ling-Mei , Ding Ji-Feng
Published: November 2021

Investigation of the key indicators of health promotion policies for an aging society can shed light on the priority of the government’s health promotion efforts. This study applied the fuzzy analytic hierarchy process (AHP) method in an empirical analysis of the key indicators of the health promotion policies for Taiwan’s aging society. Based on a review of the literature and expert interviews, this paper first conducted a preliminary study and evaluation of major factors affecting health promotion policies and found 4 major evaluation aspects and 16 evaluation indicators. After employing an AHP expert questionnaire in an empirical investigation, the following findings were made: (1) “healthy living” was the most important evaluation aspect for Taiwan’s health promotion policies for its aging society. (2) The six leading key indicators of health promotion policies were “promotion of personal health awareness and behavior,” “promotion of home medical services,” “guaranteeing the economic security of the elderly,” “planning a family caregiver support service system,” “well-planned health promotion plans for the elderly,” and “training long-term care service personnel and providing professional medical care.” Following discussion, recommendations concerning these six key indicators are made as a reference for future evaluation of health promotion policies for an aging society.
Research on Dynamic and Complexity of Duopoly Price Strategies between Low‐Carbon and Nonlow‐Carbon Products under Cap‐and‐Trade Policies
Authors: Zhang Ling , Zhang Zheng
Published: November 2021

This paper studies the complexity of the pricing system for the production of low‐carbon and nonlow‐carbon products in a market composed of duopoly manufacturers under the cap‐and‐trade policies. Through nonlinear system theory and numerical derivation and simulation, it considers the influence of different market power structures, carbon trading prices, consumer environmental awareness, and other factors on price decisions, carbon emission decisions, profits, and system stability. The influence of price adjustment parameters and unit product carbon emission decision adjustment parameters on the complexity of the pricing system under different market power structures is analyzed. And, it was found that compared with the variable feedback chaos control method, the parameter adjustment chaos control method is more effective in controlling the pricing system in this paper. Our research provides management implications for market competition and operational decision‐making for low‐carbon and nonlow‐carbon products.
An Intelligent Hydroponic Device for Astragalus membranaceus Bge. var. mongolicus (Bge.) Hsiao
Authors: Chen Qiyuan , Bai Zhenqing , Zhang XiuJuan , Wang Shengli
Published: November 2021

Astragalus membranaceus Bge. var. mongolicus (Bge.) Hsiao roots are widely used as raw materials of medicine. Due to the limited arable land, cultivating medicinal plants hydroponically is increasingly concerned. However, whether the quality of A. membranaceus grown hydroponically is better than that produced in a field is still unknown. In this study, we designed an intelligent hydroponic device for A. membranaceus, and quality of the medicinal plant cultivated by this device was compared with that cultivated in the field. Results showed that hydroponics significantly increased effective components in A. membranaceus when compared with field. Specifically, astragaloside IV contents in A. membranaceus grown hydroponically for four weeks were higher than those cultivated in the field for two years. The biomass is not significantly different between four‐week hydroponics and annual cultivation. Therefore, hydroponics with our intelligent device can be used for the sustainable production of A. membranaceus in the future.
The Efficacy of Radiotherapy in the Treatment of Hepatocellular Carcinoma with Distant Organ Metastasis
Authors: Chen Lei , Wang Zhiwen , Song Songlin , Sun Tao , Ren Yanqiao , Zhang Weihua , Wang Mingfu , Liu Yiming , Zheng Chuansheng
Published: November 2021

Background. Recently, radiotherapy has been used in the treatment of hepatocellular carcinoma (HCC). However, there is no study analyzing the efficacy of radiotherapy in cases of advanced HCC. The objective of this investigation was to determine the efficacy of radiotherapy in patients with HCC invading distant organs. Methods. The data of 2342 patients diagnosed between 2010 and 2015 with HCC invading distant organs were extracted from the SEER database. Propensity score matching (PSM) was used to reduce selection bias. Results. Before PSM, the median overall survival (mOS) and median cancer-specific survival (mCSS) in the radiotherapy group (mOS = 5 months, 95% CI: 4.5–5.5; mCSS = 5 months, 95% CI: 4.4–5.6) were longer than those in the nonradiotherapy group (mOS = 3 months, 95% CI: 2.8–3.2; mCSS = 3 months, 95% CI: 2.8–3.2; both

P
<
0.001

). After PSM, mOS in the radiotherapy group (5 months, 95% CI: 4.5–5.5) was longer than that in the nonradiotherapy group (3 months, 95% CI: 2.6–3.4;

P
<
0.001

), and the mCSS in the radiotherapy group (5 months, 95% CI: 4.4–5.6) was longer than that in the nonradiotherapy group (3 months, 95% CI: 2.6–3.4;

P
<
0.001

). Before PSM, the multivariate analysis showed that all-cause and cancer-specific mortality rates were higher in the nonradiotherapy group than in the radiotherapy group. The adjusted Cox regression analysis for subgroups showed that, in the nonradiotherapy group, patients with bone metastases and multiorgan metastases had a worse survival than those in the radiotherapy group. Conclusion. HCC patients with metastases to distant organs obtain survival benefit from radiotherapy, particularly patients with bone metastases and multiorgan metastases.
Application of U-Net with Global Convolution Network Module in Computer-Aided Tongue Diagnosis
Authors: Li Meng-Yi , Zhu Ding-Ju , Xu Wen , Lin Yu-Jie , Yung Kai-Leung , Ip Andrew W. H.
Published: November 2021

The rapid development of intelligent manufacturing provides strong support for the intelligent medical service ecosystem. Researchers are committed to building Wise Information Technology of 120 (WIT 120) for residents and medical personnel with the concept of simple smart medical care and through core technologies such as Internet of Things, Big Data Analytics, Artificial Intelligence, and microservice framework, to improve patient safety, medical quality, clinical efficiency, and operational benefits. Among them, how to use computers and deep learning technology to assist in the diagnosis of tongue images and realize intelligent tongue diagnosis has become a major trend. Tongue crack is an important feature of tongue states. Not only does change of tongue crack states reflect objectively and accurately changed circumstances of some typical diseases and TCM syndrome but also semantic segmentation of fissured tongue can combine the other features of tongue states to further improve tongue diagnosis systems’ identification accuracy. Although computer tongue diagnosis technology has made great progress, there are few studies on the fissured tongue, and most of them focus on the analysis of tongue coating and body. In this paper, we do systematic and in-depth researches and propose an improved U-Net network for image semantic segmentation of fissured tongue. By introducing the Global Convolution Network module into the encoder part of U-Net, it solves the problem that the encoder part is relatively simple and cannot extract relatively abstract high-level semantic features. Finally, the method is verified by experiments. The improved U-Net network has a better segmentation effect and higher segmentation accuracy for fissured tongue image dataset. It can be used to design a computer-aided tongue diagnosis system.
Effect of Magnesium on Dentinogenesis of Human Dental Pulp Cells
Authors: Salem Rania M. , Zhang Chang , Chou Laisheng
Published: November 2021

Introducing therapeutic ions into pulp capping materials has been considered a new approach for enhancing regeneration of dental tissues. However, no studies have been reported on its dentinogenic effects on human dental pulp cells (HDPCs). This study was designed to investigate the effects of magnesium (Mg2+) on cell attachment efficiency, proliferation, differentiation, and mineralization of HDPCs. HDPCs were cultured with 0.5 mM, 1 mM, 2 mM, 4 mM, and 8 mM concentrations of supplemental Mg2+ and 0 mM (control). Cell attachment was measured at 4, 8, 12, 16, and 20 hours. Cell proliferation rate was evaluated at 3, 7, 10, 14, and 21 days. Crystal violet staining was used to determine cell attachment and proliferation rate. Alkaline phosphatase (ALP) activity was assessed using the fluorometric assay at 7, 10, and 14 days. Mineralization of cultures was measured by Alizarin red staining. Statistical analysis was done using multiway analysis of variance (multiway ANOVA) with Wilks’ lambda test. Higher cell attachment was shown with 0.5 mM and 1 mM at 16 hours compared to control (P<0.0001). Cells with 0.5 mM and 1 mM supplemental Mg2+ showed significantly higher proliferation rates than control at 7, 10, 14, and 21 days (P<0.0001). However, cell proliferation rates decreased significantly with 4 mM and 8 mM supplemental Mg2+ at 14 and 21 days (P<0.0001). Significantly higher levels of ALP activity and mineralization were observed in 0.5 mM, 1 mM, and 2 mM supplemental Mg2+ at 10 and 14 days (P<0.0001). However, 8 mM supplemental Mg2+ showed lower ALP activity compared to control at 14 days (P<0.0001), while 4 mM and 8 mM supplemental Mg2+showed less mineralization compared to control (P<0.0001). The study indicated that the optimal (0.5–2 mM) supplemental Mg2+ concentrations significantly upregulated HDPCs by enhancing cell attachment, proliferation rate, ALP activity, and mineralization. Magnesium-containing biomaterials could be considered for a future novel dental pulp-capping additive in regenerative endodontics.
Investigation on Numerical Simulation of Chloride Transport in Unsaturated Concrete
Authors: Zhang Qingzhang , Wang Feng , Ling Yifeng , Chen Hui , Li Zhongyuan
Published: November 2021

Marine atmosphere environment accelerates the process of chloride penetration into concrete under the coupling effect of ambient temperature and relative humidity, thereby reducing the durability and service life of concrete. This paper aims to investigate the change of water equilibrium saturation and the chloride transport properties of concrete materials in different environments. The water equilibrium saturation tests at three temperatures and five relative humidity (RH) and salt spray erosion tests at three temperatures were performed. The influence of RH and temperature on the equilibrium saturation of concrete and the influence of temperature and time on the chloride diffusion coefficient are investigated. The results show that, in the process of moisture absorption and desorption, the equilibrium saturation of concrete gradually decreases as temperature rises. At the same depth of concrete, the chloride content gradually increases with temperature increasing, as well as the chloride diffusion coefficient. However, as the corrosion time of salt spray increases, the altering of chloride diffusion coefficient becomes less. Based on the Kelvin equation, a relationship between capillary pressure and water saturation in concrete was established, and a moisture transfer model for concrete in the process of moisture absorption and desorption was derived. Further, based on the established chloride diffusion equation and heat balance equation, a model of temperature‐wet‐chloride coupling chloride transfer was derived. Theory model simulation results show the transfer speed of chloride under the coupling of diffusion and capillary is higher than pure diffusion in moisture in the absorption process. However, the opposite is true in the desorption process. Moreover, with the increment of saturation rate, the capillary effect on chloride transport is enhanced.
The Prediction Model of Risk Factors for COVID-19 Developing into Severe Illness Based on 1046 Patients with COVID-19
Authors: Lian Zhichuang , Li Yafang , Wang Wenyi , Ding Wei , Niu Zongxin , Yang Xiaohong , Wu Chao
Published: November 2021

This study analyzed the risk factors for patients with COVID-19 developing severe illnesses and explored the value of applying the logistic model combined with ROC curve analysis to predict the risk of severe illnesses at COVID-19 patients’ admissions. The clinical data of 1046 COVID-19 patients admitted to a designated hospital in a certain city from July to September 2020 were retrospectively analyzed, the clinical characteristics of the patients were collected, and a multivariate unconditional logistic regression analysis was used to determine the risk factors for severe illnesses in COVID-19 patients during hospitalization. Based on the analysis results, a prediction model for severe conditions and the ROC curve were constructed, and the predictive value of the model was assessed. Logistic regression analysis showed that age (OR = 3.257, 95% CI 10.466–18.584), complications with chronic obstructive pulmonary disease (OR = 7.337, 95% CI 0.227–87.021), cough (OR = 5517, 95% CI 0.258–65.024), and venous thrombosis (OR = 7322, 95% CI 0.278–95.020) were risk factors for COVID-19 patients developing severe conditions during hospitalization. When complications were not taken into consideration, COVID-19 patients’ ages, number of diseases, and underlying diseases were risk factors influencing the development of severe illnesses. The ROC curve analysis results showed that the AUC that predicted the severity of COVID-19 patients at admission was 0.943, the optimal threshold was −3.24, and the specificity was 0.824, while the sensitivity was 0.827. The changes in the condition of severe COVID-19 patients are related to many factors such as age, clinical symptoms, and underlying diseases. This study has a certain value in predicting COVID-19 patients that develop from mild to severe conditions, and this prediction model is a useful tool in the quick prediction of the changes in patients’ conditions and providing early intervention for those with risk factors.
Pitfalls in Diagnosing Heterotopic Pregnancy in Sub-Saharan Africa: A Case Report at the Yaounde University Teaching Hospital (Cameroon)
Authors: Dipanda Andre Ngandji , Fouogue Jovanny Tsuala , Mve Valere Koh , Kenfack Bruno , Kemfang Jean Dupont Ngowa
Published: November 2021

Heterotopic pregnancy (HP) is a dizygotic twin pregnancy in which one gestational sac is intrauterine and the other is extrauterine. The prevalence of HP is unknown in Cameroon where the diagnosis is difficult and usually fortuitous like in other resource-poor settings. We herein depict pitfalls and delays in the diagnosis and management of a ruptured heterotopic pregnancy at the Yaounde University Teaching Hospital. After a wrong diagnosis and inadequate treatment, our patient presented at our emergency unit with severe pelvic pain and clinical signs of hemoperitoneum with shock. She underwent a total left salpingectomy through laparotomy. She had a complete spontaneous abortion five days after the surgery. Given that sonography is not routinely available in emergency departments in resource-poor settings, it may be relevant for practitioners to always bear HP in mind when facing ruptured ectopic pregnancies.
Construction and Bioinformatics Analysis of the miRNA-mRNA Regulatory Network in Diabetic Nephropathy
Authors: Li Yameng , Xu Yukun , Hou Yawei , Li Rui
Published: November 2021

Background. MicroRNA (miRNA) has been confirmed to be involved in the occurrence, development, and prevention of diabetic nephropathy (DN), but its mechanism of action is still unclear. Objective. With the help of the GEO database, bioinformatics methods are used to explore the miRNA-mRNA regulatory relationship pairs related to diabetic nephropathy and explain their potential mechanisms of action. Methods. The DN-related miRNA microarray dataset (GSE51674) and mRNA expression dataset (GSE30122) are downloaded through the GEO database, online analysis tool GEO2R is used for data differential expression analysis, TargetScan, miRTarBase, and miRDB databases are used to predict potential downstream target genes regulated by differentially expressed miRNAs, and intersection with differential genes is used to obtain candidate target genes. According to the regulatory relationship between miRNA and mRNA, the miRNA-mRNA relationship pair is clarified, and the miRNA-mRNA regulatory network is constructed using Cytoscape. DAVID is used to perform GO function enrichment analysis and KEGG pathway analysis of candidate target genes. By GeneMANIA prediction of miRNA target genes and coexpressed genes, the protein interaction network is constructed. Results and Conclusions. A total of 67 differentially expressed miRNAs were screened in the experiment, of which 42 were upregulated and 25 were downregulated; a total of 448 differentially expressed mRNAs were screened, of which 93 were upregulated and 355 were downregulated. Using TargetScan, miRTarBase, and miRDB databases to predict downstream targets of differentially expressed miRNAs, 2283 downstream target genes coexisting in 3 databases were predicted to intersect with differentially expressed mRNAs to obtain 96 candidate target genes. Finally, 44 miRNA-mRNA relationship pairs consisting of 12 differentially expressed miRNAs and 27 differentially expressed mRNAs were screened out; further analysis showed that miRNA regulatory network genes may participate in the occurrence and development of diabetic nephropathy through PI3K/Akt, ECM-receptor interaction pathway, and RAS signaling pathway.
Qualitative Diagnosis of Liver Tumors Based on Ultrasound-Guided Automatic Biopsy
Authors: Peng Bin
Published: November 2021

The goal of this study was to see if automatic biopsy guided by ultrasound could be used to provide a qualitative diagnosis of a liver tumor. Methods. A total of 40 patients (101 focuses) were treated with automatic liver parenchyma biopsy under ultrasound guidance, and the correlation between pathological outcomes and ultrasound images was investigated. The lesion size in the observation group was compared to that in the control group using conventional ultrasound (

P

 > 0.05), and there was no significant difference. Under contrast-enhanced ultrasound (CEUS), there was no statistically significant difference in lesion size between the observation and control groups (

P

 > 0.05). The difference in lesion size between the conventional ultrasonography and CEUS observation groups was statistically significant (

P

0.05). Conclusion. Ultrasound-guided automated biopsy of the liver parenchyma is a simple and effective procedure with fewer problems and a high diagnostic rate, and it deserves to be promoted clinically.
Sudden Cardiac Death: The Most Feared but Potentially Preventable Presentation of Wolff-Parkinson-White Syndrome
Authors: Pereira Ana Rita , Briosa Alexandra , Miranda Rita , Almeida Sofia Sequeira , Brandão Luís , Pereira Hélder
Published: November 2021

Background. Wolff-Parkinson-White syndrome is an uncommon cardiac disorder characterized by the presence of one or more accessory pathways that predispose patients to frequent episodes of arrhythmias. The prognosis is usually good, but there is a lifetime risk of malignant arrhythmias and sudden cardiac death. Case Summary. A 25-year-old male presented a witnessed out-of-hospital cardiac arrest with ventricular fibrillation rhythm. Due to rapid initiation of prehospital advanced life support, return of spontaneous circulation was observed. During the transport to the hospital, an irregular wide complex tachycardia suggestive of preexcited atrial fibrillation with haemodynamic instability was also observed and a synchronized shock was applied. Baseline 12-lead electrocardiogram was compatible with sinus rhythm and ventricular preexcitation pattern. After clinical stabilization, an electrophysiological study was performed confirming the presence of a left anterolateral accessory pathway with a short antegrade effective refractory period. Successful radiofrequency catheter ablation was achieved. Discussion. The reported clinical case recalls fundamental features of the Wolff-Parkinson-White syndrome and outlines the increasing evidence and importance of the invasive risk stratification and even catheter ablation in asymptomatic patients who suffer from this uncommon disease that may have a dramatic and fatal initial clinical manifestation.
Characterization of Co2+- and Fe3+-Codoped TiO2 Nanomaterials for Photocatalytic Degradation of Organic Pollutants under Visible Light Irradiation
Authors: Mai Nguyen Thi Tuyet , Nga Nguyen Kim , Hue Dang Thi Minh , Dung Ta Ngoc , Chinh Huynh Dang , Huy Tran Quang
Published: November 2021

In this study, TiO2 nanomaterials were prepared using a solvothermal method and codoped with Co2+ and Fe3+ ions for the photocatalytic degradation of organic pollutants under visible light. The physicochemical properties of the obtained materials were studied by powder X-ray diffraction, field emission electron scanning microscopy, energy-dispersive X-ray spectroscopy, and nitrogen adsorption isotherms. Optical absorption was characterized by UV-vis absorption spectroscopy. The photocatalytic activities of the prepared materials were evaluated through methylene blue (MB) degradation under visible light irradiation. Results showed the excellent performance of MB degradation investigated on TiO2 samples codoped with Co2+ and Fe3+ in comparison with undoped and Co2+-doped TiO2 samples. The codoped TiO2 samples degraded 85%–90% of MB after 120 min, whereas all the prepared TiO2 samples were composed of pure anatase phase and had a spherical-like shape and mean crystalline size ranging from 6.2 nm to 7.8 determined by Scherrer’s equation. The optical absorption of the TiO2 codoped with Co2+ and Fe3+ was significantly enhanced toward the visible light region. The pseudo-second-order kinetic model fits well for the degradation of MB on as-prepared TiO2 codoped with Co2+ and Fe3+.
Analysis of Torque Maintenance and Fracture Resistance after Fatigue in Retention Screws Made of Different Metals for Screw-Retained Implant-Borne Prosthesis Joints
Authors: Bello Taborda Maria Beatriz , Yaguinuma Gonçalves Gabriela Sumie , Alves de Sousa Cecília , Gonçalves Assunção Wirley
Published: November 2021

Purpose. The aim was to evaluate the effect of different metallic alloys used in the manufacture of retention screws for universal cast to long abutment (UCLA) abutments for external hexagon (HE) and Morse taper (MT) connection implants, as well as of mechanical cycling on torque maintenance and fracture resistance through electromechanical fatigue testing by mastication followed by compression testing. Methods. Sixty implants were used, 30 MT and 30 HE, with their respective titanium UCLA abutments and retention screws of 5 different materials (n = 6): Ti cp grade 2, Ti cp grade 4, Ti cp grade 4 hard, Ti grade 5—Ti6Al4V and surgical steel (DSP® Biomedical). The assemblies were positioned in an electromechanical masticatory fatigue testing machine. The fracture strength test was performed by compression testing in a universal testing machine EMICDL-200. Results. The cycled screws and new screws of each alloy group for each connection type were evaluated, obtaining the maximum force (FM), in order to verify the effect of mechanical cycling. The data were tabulated and submitted to appropriate statistical analysis (α = 0.05). Conclusion. It was concluded that for the MT, the alloy with the best performance was steel, both in the maintenance of torque and in the compression test, and cycling negatively influenced the maintenance of preload for this connection. The alloy material did not influence torque maintenance for HE. The new screws that were subjected to EMIC showed higher strength. The alloy with the lowest strength was Ti grade 2.
EEG Contribution to the Diagnosis of Antibody-Negative Autoimmune Encephalitis: A Case Report
Authors: Mito Mayusa , Sakurai Kotaro , Nakamura Yuichi , Nagai Azusa , Seo Sho , Tanaka Keiko , Yabe Ichiro , Kusumi Ichiro
Published: November 2021

Autoimmune encephalitis (AE) is a group of inflammatory brain diseases that are characterized by prominent neuropsychiatric symptoms. Early therapeutic intervention is important for AE. Therefore, without waiting for autoantibody test results, clinicians must consider the possibility of AE based solely on clinical symptoms and conventional test results. The case described herein is of antibody-negative encephalitis with abnormalities shown only by EEG, which contributed to the diagnosis and treatment. The patient, a 20-year-old woman, showed autonomic seizures in addition to movement disorders, psychiatric symptoms, and cognitive dysfunction, which worsened subacutely. Her seizures and movement disorders were not responsive to antiepileptic medications. Results obtained from MRI and cerebrospinal fluid (CSF) were normal; EEG findings showed repeated spikes in the right temporal area, with changes over time. Based on the clinical course and EEG, along with administered immunotherapy, which resolved seizures, movement disorders, and psychiatric symptoms, we suspected AE. For diagnosis of AE and for evaluating treatment responsiveness, EEG was useful. Results indicate that EEG can assist clinicians even with AE cases for which MRI and CSF findings are normal.
A Case of Triple-Negative Breast Cancer with Germline Pathogenic Variants in Both BRCA1 and BRCA2
Authors: Kitahara Miyuki , Hozumi Yasuo , Machinaga Mitsuki , Hayashi Yuka
Published: November 2021

We report a rare case of hereditary breast and ovarian cancer syndrome (HBOC) with pathogenic variants in both BRCA1 and BRCA2. The patient was a 78-year-old woman who visited the hospital after noticing a lump in her left breast 6 months before, which gradually increased in size. According to her family history, her maternal aunt developed breast cancer in her 40s. On palpation, a 4-cm large mass was palpated in the upper outer part of the left breast. A needle biopsy revealed invasive ductal carcinoma of the breast, which was negative for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor type 2. The patient was diagnosed with cT2N0M0 stage IIA, and primary systemic treatment was planned. The patient developed drug-induced interstitial pneumonia after receiving paclitaxel. Although she recovered spontaneously, she did not wish to receive further chemotherapy, and thus surgery was performed. Four months after the surgery, the patient became aware of dyspnea. After a thorough examination, she was diagnosed with postoperative cancer recurrence of the left breast with multiple liver metastases, cancerous peritonitis, multiple bone metastases, and multiple lymph node metastases. Genetic testing was performed, and pathogenic variants were found in both BRAC1 and BRCA2. However, her condition worsened, and she died 8 months after the surgery. BRCA pathogenic variants had more advanced breast cancer on initial diagnosis and worse cancer-related outcomes. It is desirable to consider the optimal approach to the treatment of breast cancer in pathogenic variants. In elderly patients with triple-negative breast cancer, HBOC may be suspected, based on biomarkers and family history. It is important to provide information on genetic counseling, genetic testing, and effective treatment plans proactively.
Malignancy-Associated Membranous Nephropathy with Positive Anti-PLA2R Autoantibodies: Coincidence or Connection
Authors: Baker Lyle W. , Jimenez-Lopez Jaime , Geiger Xochiquetzal J. , Aslam Nabeel
Published: November 2021

Membranous nephropathy (MN) is currently classified as either primary – often associated with positive anti-phospholipase-A2 receptor (PLA2R) autoantibodies – or as secondary – associated with malignancy, infection, medications, or autoimmune disease. We present a case of biopsy-proven MN with very high serum titer of anti-PLA2R autoantibodies in a patient with a synchronous diagnosis of poorly differentiated esophageal adenocarcinoma and renal cell carcinoma who presented with nephrotic syndrome. Based on the current classification, MN in the presence of active malignancy is diagnosed as secondary and unlikely to have positive anti-PLA2R autoantibodies. This raises several questions: whether this patient has secondary MN associated with malignancy and coincidentally discovered anti-PLA2R autoantibodies, primary MN due to anti-PLA2R autoantibodies with coincidentally discovered malignancy, or whether malignancy can induce the formation of anti-PLA2R autoantibodies that result in MN. This case report highlights the importance of age-appropriate cancer screening, even in patients with presumed primary MN and positive anti-PLA2R autoantibodies.
Factors Influencing Reintervention Following Ductal Artery Stent Implantation for Ductal-Dependent Pulmonary Blood Flow: Results From the Congenital Cardiac Research Collaborative
Authors: Shahanavaz Shabana , Qureshi Athar M. , Petit Christopher J. , Goldstein Bryan H. , Glatz Andrew C. , Bauser-Heaton Holly D. , McCracken Courtney E. , Kelleman Michael S. , Law Mark A. , Nicholson George T. , Zampi Jeffrey D. , Pettus Joelle , Meadows Jeffery
Published: November 2021

Background:

Stenting of the patent ductus arteriosus (PDA) is an established palliative option for infants with ductal-dependent pulmonary blood flow. Following initial palliation, reintervention on the PDA stent is common, but risk factors have not been characterized.

Methods:

Infants with ductal-dependent pulmonary blood flow palliated with PDA stent between 2008 and 2015 were reviewed within the Congenital Cardiac Research Collaborative. Rates and risk factors for reintervention were analyzed.

Results:

Among 105 infants who underwent successful PDA stenting, 41 patients (39%) underwent a total of 53 reinterventions on the PDA stent, with all but one occurring within 6 months of the initial intervention. Stent redilation constituted the majority of reintervention (n=35; 66%) followed by additional stent placement (n=11; 21%) and surgical shunt placement (n=7; 13%). The majority of reintervention was nonurgent, and there were no deaths during the reintervention procedure. All but one reintervention occurred within 6 months of the initial procedure. On univariate analysis, risk factors for reintervention included anticipated single-ventricle physiology, lack of prior balloon pulmonary valvuloplasty, use of drug-eluting stent, and increased ductal tortuosity.

Conclusions:

In infants with ductal-dependent pulmonary blood flow palliated with PDA stent implantation, reintervention is common, can be performed safely, and is associated with both anatomic/procedural factors and anticipated final physiology.
VE-Cadherin Is Required for Cardiac Lymphatic Maintenance and Signaling
Authors: Harris Natalie R. , Nielsen Natalie R. , Pawlak John B. , Aghajanian Amir , Rangarajan Krsna , Serafin D. Stephen , Farber Gregory , Dy Danielle M. , Nelson-Maney Nathan P. , Xu Wenjing , Ratra Disha , Hurr Sophia H. , Qian Li , Scallan Joshua P. , Caron Kathleen M.
Published: November 2021

Background:

The adherens protein VE-cadherin (vascular endothelial cadherin) has diverse roles in organ-specific lymphatic vessels. However, its physiological role in cardiac lymphatics and its interaction with lymphangiogenic factors has not been fully explored. We sought to determine the spatiotemporal functions of VE-cadherin in cardiac lymphatics and mechanistically elucidate how VE-cadherin loss influences prolymphangiogenic signaling pathways, such as adrenomedullin and VEGF (vascular endothelial growth factor)-C/VEGFR3 (vascular endothelial growth factor receptor 3) signaling.

Methods:

Cdh5

flox/flox

;Prox1CreER

T2

mice were used to delete VE-cadherin in lymphatic endothelial cells across life stages, including embryonic, postnatal, and adult. Lymphatic architecture and function was characterized using immunostaining and functional lymphangiography. To evaluate the impact of temporal and functional regression of cardiac lymphatics in
Cdh5

flox/flox

;Prox1CreER

T2

mice, left anterior descending artery ligation was performed and cardiac function and repair after myocardial infarction was evaluated by echocardiography and histology. Cellular effects of VE-cadherin deletion on lymphatic signaling pathways were assessed by knockdown of VE-cadherin in cultured lymphatic endothelial cells.

Results:

Embryonic deletion of VE-cadherin produced edematous embryos with dilated cardiac lymphatics with significantly altered vessel tip morphology. Postnatal deletion of VE-cadherin caused complete disassembly of cardiac lymphatics. Adult deletion caused a temporal regression of the quiescent epicardial lymphatic network which correlated with significant dermal and cardiac lymphatic dysfunction, as measured by fluorescent and quantum dot lymphangiography, respectively. Surprisingly, despite regression of cardiac lymphatics,
Cdh5

flox/flox

;Prox1CreER

T2

mice exhibited preserved cardiac function, both at baseline and following myocardial infarction, compared with control mice. Mechanistically, loss of VE-cadherin leads to aberrant cellular internalization of VEGFR3, precluding the ability of VEGFR3 to be either canonically activated by VEGF-C or noncanonically transactivated by adrenomedullin signaling, impairing downstream processes such as cellular proliferation.

Conclusions:

VE-cadherin is an essential scaffolding protein to maintain prolymphangiogenic signaling nodes at the plasma membrane, which are required for the development and adult maintenance of cardiac lymphatics, but not for cardiac function basally or after injury.
Improvement in Surgical Quality Following Pancreaticoduodenectomy With Increasing Case Volume in a Rural Hospital
Authors: Mitsakos Anastasios T. , Vohra Nasreen A. , Fitzgerald Timothy L. , Buccini Peter , Parikh Alexander A. , Snyder Rebecca A. , Zervos Emmanuel E.
Published: November 2021

Background

The literature is replete with studies that define the nexus of quantity and quality in complex surgical operations. These observations have heralded a call for centralization of care to high-volume centers. The purpose of this study was to chronicle improvements in quality associated with pancreaticoduodenectomy (PD) as a rural hospital matures from a low- to very high-volume center.

Methods

A retrospective review of a prospective pancreatic surgery database was undertaken from July 2007 to June 2020. Annual periods were characterized as low (≤12/year), high (13-29/year), and very high volume (≥30/year). Data for the following quality benchmarks were aggregated and compared: length of stay (LOS), 30-day readmissions, 30-day mortality, and 1- and 3-year survival. A subgroup analysis was undertaken in those patients undergoing PD for adenocarcinoma detailing margin status and number of lymph nodes harvested. Outcomes were compared using the Fisher’s exact and Student’s t-test.

Results

375 PD were completed over the 13-year period; 62.1% were undertaken for ductal adenocarcinoma. There was a significant decrease in LOS and 30-day readmissions as the institution matured toward very high volume. There were no significant differences in 30-day mortality, 1- and 3-year survival, or margin negativity rates associated with volume. Extent of lymph node harvest significantly improved as institutional experience increased.

Discussion

Our pancreatic surgery program matured rapidly from low to very high volume with institutional commitment and dedicated resources. As the institution matured, operational efficiencies and surgical quality improved. Not unexpectedly, biology trumped volume as reflected in 1- and 3-year survival rates.