bluuebunny/crossref_metadata_2025 huggingface dataset:
Cobalt-catalyzed carboxylation of aryl and vinyl chlorides with CO2
Authors: Wang Yanwei , Jiang Xiaomei , Wang Baiquan
Published: October 2020

Cobalt-catalyzed carboxylation of aryl and vinyl chlorides and bromides with CO2 has been developed. These transformations proceed under mild conditions and exhibit a broad substrate scope and high efficiency.
Stereoselective synthesis of conjugated trienes via 1,4-palladium migration/Heck sequence
Authors: Xue Ze-Jian , Li Meng-Yao , Zhu Bin-Bin , He Zhi-Tao , Feng Chen-Guo , Lin Guo-Qiang
Published: October 2020

An efficient 1,4-palladium migration/Heck sequence was developed for the highly stereoselective synthesis of conjugated trienes.
High circularly polarized luminescence brightness from analogues of Shibasaki's lanthanide complexes
Authors: Deng Min , Schley Nathan D. , Ung Gaël
Published: October 2020

By reducing the backbone of the 1,1′-bi-2-naphthol ligands in Shibasaki's complexes into octahydro-1,1′-bi-2-naphthol, highly luminescent lanthanide complexes with amongst the strongest circularly polarized luminescence have been obtained.
Air exposed 1,4-bis(trimethylsilyl)-1,4-dihydropyrazine: an avant-garde carbonization precursor for multi-functionalized carbon material
Authors: Shoukat Ali Shaikh Saddam , Roy Kingshuk , Akula Naveenkumar , Ogale Satishchandra B. , Majumdar Moumita
Published: October 2020

1,4-Bis(trimethylsilyl)-1,4-dihydropyrazine acts as a small molecule precursor for carbonization to multi-functionalized carbon via polymeric intermediate formation upon air exposure.
Unimolecular photolysis mechanisms of formamide: the effect of thermal energy
Authors: Suwannakham Parichart , Sagarik Kritsana
Published: October 2020

The C–N dissociation is the most favorable in S1state, and radical products (1) are precursors in other channels.
Hydrophilic dangling chain interfacial segregation in polyurethane networks at aqueous interfaces and its underlying mechanisms: molecular dynamics simulations
Authors: Ghermezcheshme Hassan , Makki Hesam , Mohseni Mohsen , Ebrahimi Morteza
Published: October 2020

Brush formation of polymer networks with hydrophilic dangling chains and its underlying mechanisms.
Thermal properties, crystal structures, and phase diagrams of ionic plastic crystals and ionic liquids containing a chiral cationic sandwich complex
Authors: Mochida Tomoyuki , Sumitani Ryo , Yamazoe Tomoaki
Published: October 2020

Salts of a chiral ruthenium sandwich complex with various anions were synthesized and their phase diagrams were investigated.
UV-induced aggregation of polystyrene nanoplastics: effects of radicals, surface functional groups and electrolyte
Authors: Wang Xinjie , Li Yang , Zhao Jian , Xia Xinghui , Shi Xiaonan , Duan Jiajun , Zhang Wen
Published: October 2020

UV irradiation increased the aggregation of polystyrene nanoplastics to different extents depending on the surface functional groups and electrolyte species.
Modeling ascending infection with a feto-maternal interface organ-on-chip
Authors: Richardson Lauren S. , Kim Sungjin , Han Arum , Menon Ramkumar
Published: October 2020

The feto-maternal interface (FMi)-on-chip was developed to delineate the propagation of maternal ascending infection and host inflammatory response across the FMi, which in vivo, are major risk factors associated with preterm birth.
In situ replacement of Cu-DEN: an approach for preparing a more noble metal nanocatalyst for catalytic use
Authors: Onisuru Oluwatayo Racheal , Oseghale Charles O. , Meijboom Reinout
Published: October 2020

The advantage of dendritic monodisperse macromolecules’ dual templating ability was useful in the formation of silica-supported copper nanoparticles Cun@SiO2NPs.
Correction: FRET-based intracellular investigation of nanoprodrugs toward highly efficient anticancer drug delivery
Authors: Taemaitree Farsai , Fortuni Beatrice , Koseki Yoshitaka , Fron Eduard , Rocha Susana , Hofkens Johan , Uji-i Hiroshi , Inose Tomoko , Kasai Hitoshi
Published: October 2020

Correction for ‘FRET-based intracellular investigation of nanoprodrugs toward highly efficient anticancer drug delivery’ by Farsai Taemaitree et al., Nanoscale, 2020, 12, 16710–16715, DOI: 10.1039/D0NR04910G.
Synthesis of Mannich-type derivatives from amides activated by hydrogen bonding with ZnCl2
Authors: Hu Zhiyu , Xie Zongbo , Zhu Zhiqiang , Gong Bozhen , Jiang Guofang , Le Zhanggao
Published: October 2020

The amide group has one of the most significant functionalities found in many natural products.
The Devil in the Details Can Be Hard to Spot: Malapropisms and Children With Hearing Loss
Authors: Lowenstein Joanna H. , Nittrouer Susan
Published: October 2020

Purpose

Better auditory prostheses and earlier interventions have led to remarkable improvements in spoken language abilities for children with hearing loss (HL), but these children often still struggle academically. This study tested a hypothesis for why this may be, proposing that the language of school becomes increasingly disconnected from everyday discourse, requiring greater reliance on bottom-up phonological structure, and children with HL have difficulty recovering that structure from the speech signal.

Participants

One hundred nineteen fourth graders participated: 48 with normal hearing (NH), 19 with moderate losses who used hearing aids (HAs), and 52 with severe-to-profound losses who used cochlear implants (CIs).

Method

Three analyses were conducted.
#1:
Sentences with malapropisms were created, and children's abilities to recognize them were assessed.
#2:
Factors contributing to those abilities were evaluated, including phonological awareness, phonological processing, vocabulary, verbal working memory, and oral narratives.
#3:
Teachers' ratings of students' academic competence were obtained, and factors accounting for those ratings were evaluated, including the five listed above, along with word reading and reading comprehension.

Results

#1:
Children with HAs and CIs performed more poorly on malapropism recognition than children with NH, but similarly to each other.
#2:
All children with HL demonstrated large phonological deficits, but they were especially large for children with CIs. Phonological awareness explained the most variance in malapropism recognition for children with CIs. Vocabulary knowledge explained malapropism recognition for children with NH or HAs, but other factors also contributed.
#3:
Teachers rated academic competence for children with CIs more poorly than for children with NH or HAs, and variance in those ratings for children with CIs were primarily explained by malapropism scores.

Conclusion

Children with HL have difficulty recognizing acoustic–phonetic detail in the speech signal, and that constrains their abilities to follow conversations in academic settings, especially if HL is severe enough to require CIs.

Supplemental Material

https://doi.org/10.23641/asha.13133018
Welche Schutzmaske schützt vor COVID-19? Was ist evidenzbasiert?
Authors: Schulze-Röbbecke Roland , Reska Marcus , Lemmen Sebastian
Published: October 2020

Die COVID-19-Pandemie hat in der Patientenversorgung wie in der Öffentlichkeit zu Diskussionen geführt, mit welchen Schutzmasken man sich vor einer Ansteckung schützen kann. Ähnliche Diskussionen hatte es schon 2009/10 im Rahmen der damals weltweiten Ausbreitung einer neuen Variante des Influenzavirus A (H1N1) gegeben („Schweinegrippe“). Auffällig sind damals wie heute Unklarheiten und Verwirrungen in Bezug auf die Übertragungswege von Atemwegsinfektionen und über die sich daraus ableitenden Schutzmaßnahmen.
Clinical Characteristics and Genotype–Phenotype Correlation in Children with KMT2E Gene-Related Neurodevelopmental Disorders: Report of Two New Cases and Review of Published Literature
Authors: Sharawat Indar Kumar , Panda Prateek Kumar , Dawman Lesa
Published: October 2020

Background In recent years, many new candidate genes are being identified as putative pathogenic factors in children with developmental delay and autism. Recently, heterozygous mutations in the KMT2E gene have been identified as a cause of a unique neurodevelopmental disorder with variable combination of global developmental delay or isolated speech delay, intellectual disability, autistic features, and seizures.

Methods Here, we present two new cases of KMT2E mutation-associated neurodevelopmental disorder in a 4-year-old girl and 5-year-old boy. We also performed a pooled review of the previously published cases of KMT2E-related neurodevelopmental disorder. Articles were identified through search engines using appropriate search terms.

Results Along with the presented 2 cases, 40 cases were analyzed. Out of them, 30, 6, and 4 children had protein-truncating mutations, missense mutations, and copy number variants, respectively. The common features were global developmental delay (97%) followed by macrocephaly (35%), seizures (30%), and autism (25%). Children with missense variants had severe phenotype, with microcephaly, profound developmental delay, and increased frequency of seizures. Neuroimaging revealed nonspecific changes, including cerebral white matter signal abnormalities.

Conclusion KMT2E-related neurodevelopmental disorder remains one of the clinical differentials in children with global developmental delay and/or autistic features/seizure. With the reporting of more cases in the future, the already heterogeneous clinical spectrum of this disease is likely to be widened.
Policy Statement on Clinical Informatics Fellowships and the Future of Informatics-Driven Medicine
Authors: Kannry Joseph , Smith Jeff , Mohan Vishnu , Levy Bruce , Finnell John , Lehmann Christoph U. ,   on behalf of the Clinical Informatics Program Directors Group-AMIA
Published: October 2020

Board certified clinical informaticians provide expertise in leveraging health IT (HIT) and health data for patient care and quality improvement. Clinical Informatics experts possess the requisite skills and competencies to make systems-level improvements in care delivery using HIT, workflow and data analytics, knowledge acquisition, clinical decision support, data visualization, and related informatics tools. However, these physicians lack structured and sustained funding because they have no billing codes. The sustainability and growth of this new and promising medical subspecialty is threatened by outdated and inconsistent funding models that fail to support the education and professional growth of clinical informaticians. The Clinical Informatics Program Directors' Community is calling upon the Centers for Medicare and Medicaid Services to consider novel funding structures and programs through its Innovation Center for Clinical Informatics Fellowship training. Only through structural and sustained funding for Clinical Informatics fellows will be able to fully develop the potential of electronic health records to improve the quality, safety, and cost of clinical care.
Women’s Cardiac Health in 2020: A Systematic Review
Authors: Sozzi Fabiola B. , Belmonte Marta , Schiavone Marco , Canetta Ciro , Gupta Rakesh , Blasi Francesco
Published: October 2020

Although substantial progress has been made toward improving gender- and sex-specific cardiovascular disease (CVD) management and outcomes, contemporary reports indicate a persistent knowledge gap with regard to optimal risk-stratification and management in female cardiac heart disease (CHD) patients. Prominent patient and system delays in diagnosing CHD are, in part, due to the limited awareness for the latent CVD risk in women, a lack of sex-specific thresholds within clinical guidelines, and subsequent limited performance of contemporary diagnostic approaches in women. Several traditional risk factors for CHD affect both women and men. But other factors can play a bigger role in the development of heart disease in women. In addition, little is known about the influence of socioenvironmental and contextual factors on gender-specific disease manifestation and outcomes. It is imperative that we understand the mechanisms that contribute to worsening risk factors profiles in young women to reduce future atherosclerotic CVD morbidity and mortality. This comprehensive review focuses on the novel aspects of cardiovascular health in women and sex differences as they relate to clinical practice and prevention, diagnosis, and treatment of CVD. Increased recognition of the prevalence of traditional cardiovascular risk factors and their differential impact in women, as well as emerging nontraditional risk factors unique to or more common in women, contribute to new understanding mechanisms, leading to worsening outcome for women.
Core values of genomic citizen science: results from a qualitative interview study
Authors: Guerrini Christi J. , Trejo Meredith , Canfield Isabel , McGuire Amy L.
Published: October 2020

Genomic citizen science initiatives that promote public involvement in the study or manipulation of genetic information are flourishing. These initiatives are diverse and range from data donation studies, to biological experimentation conducted in home and community laboratories, to self-experimentation. Understanding the values that citizen scientists associate with their activities and communities can be useful to policy development for citizen science. Here, we report values-relevant data from qualitative interviews with 38 stakeholders in genomic citizen science. Applying a theoretical framework that describes values as transcendent beliefs about desirable end states or behaviors that can be categorized according to the motivational goals they express and the interests they serve, we identified nine core values of genomic citizen science: altruism, autonomy, fun, inclusivity, openness, reciprocity, respect, safety, and solidarity.
A critical review of fuel accumulation models used in Australian fire management
Authors: Zazali Hilyati H. , Towers Isaac N. , Sharples Jason J.
Published: October 2020

Various classifications of fuel accumulation models are used to describe the complex temporal relationship between fuel loads and vegetation dynamics. Fuel accumulation models are an important tool in wildfire management as fuel is the only component that can be directly controlled by fire managers. Here we discuss various strengths and limitations of analytical fuel accumulation models that exist in the literature, with a focus on those used in Australia. Early approaches to analytical or continuous models of fuel accumulation centred around the model introduced by Olson in 1963. This model assumes that the rate at which fuel accumulates is determined as a balance between the rate of fuel accession and the rate at which it decays. The Olson model has been shown to provide a reasonable description of litter accumulation, data sparsity issues notwithstanding, but can be of limited use in describing elevated fuels, or in forest stands that exhibit more complex post-disturbance dynamics. Interactions between species and other disturbances have the potential to change the dynamics of fuel accumulation and decay processes. Moreover, post-fire vegetation stands are usually dominated by an understorey layer that eventually senesces as the dominant vegetation grows. Motivated by the critical differences between the models presented, a more general approach featuring vegetation density is proposed. A generic result is presented to indicate how the theoretical predictions of the model are able to emulate patterns of fuel accumulation that have been reported, and that can not be accounted for by the models commonly used in Australia.
Language skills and labour market returns
Authors: Ridala Svetlana
Published: October 2020

Increased migration, global trade and the introduction of digital labour platforms call for a better understanding of the
mechanisms that can enhance economic and labour market outcomes in the face of increasing disparities in culture, language and identity. The
article contributes to the literature on labour market returns on language skills, which is very heterogeneous and context-specific, by
carrying out a systematic review of that literature. The meta-regression analysis estimates the returns on language skills that come from
socio-economic, institutional and ethnolinguistic factors along with controls for the study design. The meta-regression results for the
labour market returns that stem from knowledge of the local state language, a significant local minority language or the business
language provide evidence that knowing the more influential language is associated with higher labour market rewards. Linguistic diversity
has a negative effect on the returns to skills in the business language but increases the returns to the local state language. Urbanisation
has a negative, though quantitatively modest, effect on returns to language skills in the business language, whilst the GDP level increases
the returns to minority language skills and unemployment increases returns to skills in the business language and the local state
language.
Forum Theatre as a democratic space of citizenship in secondary school: an educational experience in the Basque Country (Teatro Foro como espacio democrático de ciudadanía en Secundaria: una experiencia educativa en el País Vasco)
Authors: Uria-Iriarte Esther , Galarreta Javier
Published: October 2020

This article seeks to explore the potential implications of using the Forum Theatre technique in secondary school settings. To do so, we describe the intervention programme undertaken in four secondary schools in the Basque Country (Spain) in which the Forum Theatre technique was one of the core methodological strategies. Based on this experience, we can draw conclusions related to the relevance of this technique in generating a democratic space of citizenship where youths can debate and explore alternatives when addressing issues of interest to them from their immediate reality.
Perspectives on Africa and African immigrants: evaluation of a sample of education students (Perspectivas sobre África y los inmigrantes africanos: evaluación en una muestra de estudiantes de magisterio)
Authors: Martínez-Sánchez Alina , Benito-Ambrona Tamara
Published: October 2020

As educational institutions, Spanish universities today involve a diversity of subjects inhabiting them, which supports the imperative of turning schools into more inclusive communities. This study attempts a preliminary determination of the existence of racial and cultural prejudices and stereotyped beliefs about African immigrants in a sample of education students at the Autonomous University of Madrid. A quantitative, non-experimental, descriptive-exploratory study was performed with a sample of education students. Subtle and manifest racism scales and the scale of stereotyped beliefs about Africa and Africans were administered. The statistical analysis shows that people who identify with left-wing political ideologies have fewer stereotypes about Africa and less manifest and subtle racism, while people with right-wing or centre ideologies, or who argued that they do not identify with any ideology, revealed similar levels of subtle racism. The results of the study highlight the fact that education students have subtle and manifest prejudices, as well as stereotyped beliefs about African immigrants.
Plyometric training increases gross motor coordination and associated components of physical fitness in children
Authors: de Almeida Marcelus Brito , Leandro Carol Góis , Queiroz Daniel da Rocha , José‐da‐Silva Marivânio , Pessôa dos Prazeres Thaliane Mayara , Pereira Gleybson Maciel , das‐Neves Gabriela Silva , Carneiro Renata Cecília , Figueredo‐Alves Amanda Dayanne , Nakamura Fábio Yuzo , Henrique Rafael dos Santos , Moura‐dos‐Santos Marcos André
Published: October 2020

There is only limited evidence to suggest that training during childhood produces greater adaptations than at other ages. The aim of this study was to examine the effects of plyometric training (12 weeks, twice/week, 20 min/day) on physical fitness (PF) and gross motor coordination (GMC) in schoolboys aged 7–9 years. A total of 116 boys were assigned to two groups: plyometric training group (PT,n = 73) and control group (CG,n = 43). The CG maintained their normal daily activities. The PT consisted of twice‐weekly exercises on nonconsecutive days for twelve weeks under monitored and controlled conditions. PF (handgrip strength, standing long jump (SLJ), curl‐ups, sit and reach, square‐test, running speed, and 1 mile run test), GMC, Korper‐koordinations‐test fur Kinder (KTK), and body mass index (BMI) were assessed. The main results through a 2 × 2 (time × groups) repeated measures analysis variance demonstrated a significant time effect that improves PF and GMC according to the direction of the measure. A group effect was observed only in the abdominal strength test (CG = 12.06% and PT = 17.04%) and moving sideways (CG = 11.1% and PT = 12.4%) showing that independent of the group there was an improvement. A significant interaction effect (time × groups) was observed in the flexibility test (CG = −2.7% and PT = 3.5%) and STJ (CG = 3.1% and PT = 18.5%), as well as jumping sideways (CG = 16.3% and PT = 17.4%) and overall GMC score (CG = 9.8% and PT = 15.9%), showing that gains in these variables were greater in the PT group. The results suggest that 12 weeks of PT improve components of gross motor coordination and health‐related physical fitness in children.
Sources of information pick‐up for anticipation by skilled cricket batsmen
Authors: Müller Sean , Brenton John , Mansingh Akshai
Published: October 2020

This study investigated whether skilled West Indian cricket batsmen could use contextual and kinematic information to anticipate the type of ball being bowled. Thirty‐one participants were recruited that formed first class (n = 10), elite club (n = 10), and elite youth representative (n = 11) groups. Each group completed a video temporal occlusion batting test under two conditions. Condition one presented bowler kinematic information; that is, occlusion occurred at back‐foot, front‐foot, and ball release, with a no occlusion control. Condition two presented game contextual information in the form of field placings that was congruent with the ball types prior to temporal occlusion trials. Results revealed no significant skill group differences in the timing of information pick‐up under kinematic or contextual conditions. Prediction accuracy for all skill groups was at guessing level at each temporal occlusion that presented kinematic information, but was above chance at no occlusion. Prediction accuracy for all skill groups increased to above guessing level at advance cue temporal occlusions when contextual information was provided. Findings indicate that this group of skilled batsmen did not use kinematic information for anticipation in this temporal occlusion task, but relied heavily upon contextual information. An implication of this study is that skilled batsmen should be targeted for visual‐perceptual training to pick‐up contextual and kinematic information to guard against deception from the latter that can negatively impact batting performance.
Modeling of space charge dynamics in polyethylene under AC stress based on bipolar charge transport model
Authors: Cai Xinjing , Lin Xin , Yu Jianli , Lu Zhiwei
Published: October 2020

Space charge dynamics under AC stress is of importance as a majority of high voltage cables are under AC stress, and space charge is the driving mechanism of dielectric degradation under these conditions. Bipolar charge transport model is used to simulate space charge dynamics in polyethylene under AC stress. The current density, electroluminescence intensity and space charge density under sinusoidal, triangular and square voltages are compared. It is found that there is no phase shift between current density, electroluminescence intensity and applied voltages, which disagrees the results of Baudoin et al. The thickness of space charge layer under AC stress is much thinner that under DC stress.
Study on the interaction mechanism in the Pr–Fe–As system
Authors: He Lihua , Huang Run , Luo Jinxiao , Lv Xiaodong , Mao Juncheng , Zhang Jinzhu
Published: October 2020

The influence of different heat preservation temperatures on the interaction in the Pr–Fe–As ternary system and the principle for generating the interaction products of the Pr–Fe–As ternary system were studied by metallographic microscopy, scanning electron microscopy, and x-ray diffraction. Results showed that the α-Fe with As (i.e., the compound formed when the solubility of As in Fe exceeds the maximum solubility), Fe2As, PrAs, and a small amount of Fe17Pr2 were the main products when the atomic ratio of Pr: As is 1:3 and heat preservation for 20 h at 1173 K, 1223 K and 1273 K. PrAs decreased as the temperature increased, while the α-Fe with As decreased as the temperature decreased, and Fe2As increased gradually as α-Fe with As decreased. In the Pr–Fe–As ternary system, the diffusion of Pr is mainly short-range diffusion and double vacancies, and the PrAs develops in the margin of the penetration region, preventing the diffusion of As in Fe.
History and Development of School Social Work Within Professional Organizations
Authors: Fisher Randy A.
Published: October 2020

Professional associations have been present since the birth of the visiting teacher/school social work movement in 1906. The five major associations—National Association of School Social Workers, National Association of Social Workers, the Midwest School Social Work Council, State School Social Work Associations (both individually and as a group), and the School Social Work Association of America—collectively provide vital services such as conferences and publications that form the foundation of the profession. Their decisions have shaped the history of school social work as well as maintain the current level of services to the school social work community. The practice of school social work today is based in large part on the decisions made by the professional associations in the past and now.
Serology Curriculum for Residents Using Online, Case-Based Simulation Modules
Authors: Dent Edward , Guarner Jeannette
Published: October 2020

Background

Although serology concepts are a frequent topic of examination for Pathology trainees, serology education is challenging, in part, because the performance of serologic tests may occur in different laboratories (immunology, microbiology, or chemistry.) Serology educational topics and curriculums may be eclipsed by topics concerning the larger laboratory in which serology resides. We developed a one-week standalone curriculum in which residents were given four case-based vignettes to solve and discuss with a faculty member, eight online case-based simulation modules, and bench time in the laboratory with medical laboratory scientists performing serological tests (RPR, VDRL, hepatitis, and HIV).

Objectives

To evaluate the advantages and educational utility of online modules as adjuncts to other modalities used during a standalone serology rotation.

Methods

The online modules are housed within an e-learning Portal. Residents were asked to print the certificate of completion for the eight modules assigned at the end of the week. A survey of the week-long rotation was given to the residents one week and up to 2 months after the rotation. Residents could complete the survey anonymously.

Results

Twenty-three first-year residents (representing a 3-year period) presented completion certificates for the online modules, but only 10 (43.5%) responded to the survey. The average percentage of correct answers for online modules ranged from 73% for the HIV module to 88% for the hepatitis B module. The number of residents with scores below 80% was highest for the Epstein-Barr virus (EBV) and Cryptococcus modules (8 and 9 residents scoring <80% respectively) and lowest for hepatitis B and toxoplasmosis modules (2 and 3 respectively). On the survey, residents stated that they had repeated the online modules between 1 and 4 times, with an average of 1 to 2 attempts. Although there was not a specific module rated as the most enjoyable, the toxoplasmosis and EBV modules were picked by 3 out of 10 residents as his or her favorite. There was no consensus on which module was subjectively easiest or most difficult, nor which was the least enjoyed. The majority of the residents (7/10) found the online modules helpful and all ten residents stated that they learned more after completion of the online modules as the modules reinforced (6/10) concepts important to serologic testing.

Conclusions

The online, case-based simulation modules are an effective addition to a serology curriculum that includes case-based discussions and time spent in the laboratory participating in test performance. The online modules are an effective educational tool because they reinforce learning and provide additional structure to the serology curriculum.
CD26 Role in Early-Stage Mycosis Fungoides Diagnosis
Authors: Azimpouran M , Esmaeili H
Published: October 2020

Introduction/Objective

The diagnosis of Mycosis Fungoides(MF) at its early stage is challenging because of its similarity to Large Plaque Parapsoriasis(LPP). Although the ISCL criteria were introduced for diagnosis of early MF, there have been false positives for some of the immunopathologic and molecular biological criteria. Thus, this criterion may not be as specific as it was thought to be.

Methods

During the present descriptive-analytical study from 2013 to 2018, 27 MF and 21 LPP cases were included and IHC staining for CD26 marker was performed.

Results

Of 18 patients with MF diagnosis with a mean age of 55.55, 11 were female and 7 were male. Also, 14 patients with a diagnosis of LPP with a mean age of 51.22, 9 were female and 5 were male. There was no significant difference between patients’ age and gender (P>0.05). According to this test, there were statistically significant differences in CD5, CD7, and CD26 expressions between two groups (P=0.005, P=0.009, and P=0.005 respectively). According to the results for the expression of CD26, there is a significant discrepancy between MF and LPP (P=0.019).

Conclusion

IHC staining for CD26 marker can be successfully used in combination with other known criteria to discriminate patchy MF than LPP with significant precision.
Solitary Cardiac Low-Grade Neuroendocrine Tumor: A Case Report and Review of the Literature
Authors: Kavesh M , Drew P , Stewart B
Published: October 2020

Introduction/Objective

Primary tumors of the heart are uncommon; even rarer are primary cardiac neuroendocrine tumors. To our knowledge, only two cases have been described to date, both being high-grade tumors. We report a solitary low-grade neuroendocrine tumor of the heart, unexpectedly discovered on the wall of the right ventricle in a 44-year-old man during aortic valve repair for infectious bacterial endocarditis.

Results

Frozen section was sent intraoperatively and showed a plasmacytoid neoplasm. Final pathology of the biopsies showed a tumor composed of both cohesive and discohesive plasmacytoid cells separated by a vascular network and strands of fibrosis. Neither necrosis nor a mitotic rate greater than 2 mitoses per 2 mm2 were seen. The tumor showed strong reactivity for AE1/3, synaptophysin and CDX2 with focal reactivity for chromogranin-A and CD56, confirming the diagnosis of a low-grade neuroendocrine tumor. Both an esophagogastroduodenoscopy and colonoscopy were performed and showed no evidence of a primary gastrointestinal tumor. PET-CT DOTATATE performed after complete resection of the tumor showed no abnormal radiotracer uptake. The possibility of an intestinal neuroendocrine tumor undetected by DOTATATE PET-CT with a single known metastasis to the heart was considered. This too, on the basis of the literature, was considered exceedingly rare. Complete resection of this patient’s tumor was considered sufficient treatment; the patient was advised to follow up annually with medical oncology.

Conclusion

The presentation and management of a solitary cardiac low-grade neuroendocrine tumor has not previously been described in the literature.
Gastric Adenocarcinoma with Enteroblastic Differentiation: A Rare Find
Authors: Kumar S , Jabbar K
Published: October 2020

Casestudy: Gastric adenocarcinoma with enteroblastic differentiation (GAED), also called clear cell gastric carcinoma, is a subtype of alpha-fetoprotein (AFP) producing adenocarcinoma. GAED is not a well-documented malignancy. Due to rarity, it is often skipped from the list of gastric adenocarcinoma subtypes. We report a case of Gastric adenocarcinoma with enteroblastic differentiation in a 69-year-old male, who had an endoscopy that revealed an ulcerated, circumferential, malignant-appearing mass at the distal esophagus. The patient then underwent proximal gastrectomy with distal esophagectomy. Received was a portion of the proximal stomach and distal esophagus. On gross examination, a 2.6 cm ulcerated mass was present at the gastroesophageal junction with white, friable, and focally necrotic cut surface. H&E stained slides demonstrated a malignant tumor composed of cuboidal to columnar neoplastic cells with clear cytoplasm and prominent nucleoli. The neoplastic cells were arranged in tubular, solid, and trabecular growth patterns. There were also areas of admixed conventional moderately differentiated adenocarcinoma with overlying glandular dysplasia and focal intestinal metaplasia. Immunohistochemical stains demonstrated tumor positivity for CDX2 (strong) and AFP (focal). Neuroendocrine markers were negative within the tumor. In Conclusion, GAED is a rare malignancy with distinctive clinicopathologic features and associated aggressive behavior. Morphology and immunohistochemical stains are helpful in making the diagnosis of this rare malignancy.
Primary Appendiceal Gastrointestinal Stromal Tumor: A Case of an Incidental Tumor
Authors: Balikani L
Published: October 2020

Introduction/Objective

Gastrointestinal stromal tumors (GISTs) are rare with an approximate prevalence of 2%. Though rare, they are the most common mesenchymal neoplasm of the gastrointestinal tract. They commonly occur in the stomach (50-60%), small intestine (20-30%), large intestine and esophagus (<10%). GISTs arising in the appendix are very rare, with less than 20 cases reported in the English literature to date. The clinical presentation varies from appendicitis-like symptoms to incidental findings on imaging, during surgery for other diseases or at autopsy. The differential diagnosis of GIST from other stromal tumors is often difficult on hematoxylin and eosin (H&E) examination alone. The use of immunohistochemistry (IHC) plays a key role in confirming the diagnosis. GISTs can be graded based on a four-tier risk stratification system, including high, intermediate, low and very low risk, taking size tumor and mitotic activity into consideration. Most of the previously reported cases of primary appendiceal GIST were low or very low risk but one case of malignant GIST arising in the appendix has been reported.

Methods

We present the case of a 65-year-old male with a slightly thickened appendix and fluid in the distal aspect incidentally found on computer tomography (CT) scan for diverticulitis workup. An appendectomy with adequate was performed. The gross specimen revealed a 0.2-0.4 cm thick wall with no gross perforations or masses. Histologically, the tumor measured 0.8 cm and was composed of spindle cells with no nuclear atypia and absent to low mitotic activity. The IHC profile of the tumor was positive for CD117, DOG1 and CD34. A diagnosis of Gastrointestinal stromal tumor, low grade was rendered.

Conclusion

We endeavor to highlight the importance of considering GIST in the differential diagnosis in patients with nonspecific symptoms and/or atypical image findings of the appendix especially in ruling out a possible malignant GIST.
EBV+ Inflammatory Pseudotumor-like Follicular/Fibroblastic Dendritic Cell Sarcoma: An Uncommon and Challenging Tumor
Authors: Bharadwaj H , Freeman J
Published: October 2020

Casestudy: Inflammatory pseudotumor-like follicular/fibroblastic dendritic cell sarcoma (IP-L FDC/FRC) is a rare dendritic cell neoplasm recognized as a specific entity in the WHO classification of tumors of the hematopoietic and lymphoid tissues. The tumor has specific clinical features, including a predominance in young to middle-aged women typically involving the liver or spleen, with neoplastic cells typically positive for Epstein-Barr virus.

Morphologically, the tumor poses a diagnostic challenge to distinguish it from inflammatory pseudotumor and inflammatory myofibroblastic tumor, with which it shares considerable morphologic and immunohistochemical overlap. We present a case report of a 35-year-old female who presented with weight loss, malaise, and intraabdominal mass. MRI revealed a 14 cm large ovoid solid mass with central hemorrhage and necrosis. Biopsy and subsequent resection of the tumor confirmed IP-L FDC/FRC sarcoma. Histologically, the tumor was composed of spindle cells admixed with many lymphocytes and prominent plasma cells. Immunohistochemical stains showed neoplastic spindle cells focally positive for dendritic cell markers CD21, CD23, and CD35, diffuse positivity for SMA, and striking in situ hybridization for Epstein-Barr virus (EBER). Due to its rarity, biologic behavior and outcomes are not well established. The tumors are generally regarded as indolent with a risk of repeated intraabdominal recurrence, although recurrences may be related to the ease and completeness of surgical resection. It is essential to distinguish this tumor from other high- grade sarcomas with greater metastatic potential and overall worse prognosis.
Primary Amyloidosis
Authors: Bhuyan R , Tran T T , Mc Phaul L , Liu Y
Published: October 2020

Introduction/Objective

Amyloid light chain (AL) results from the deposition of immunoglobulin light chain fragments, and can lead to dysfunction in multiple organs. Our patient was being investigated for unknown malignancy with high differential for plasma cell neoplasm for severe amyloidosis leading to renal failure, uncontrolled ascites and thickening of the skin. The patient died of progressive liver and renal failure. Our autopsy findings show severe amyloidosis deposition in spleen, heart, kidney and liver with no significant plasma cells in the bone marrow, the findings correlate with a rare condition of primary AL amyloidosis.

Methods

63 years old man with no past medical history presenting with progressive leg swelling with 15 pounds weight loss. He was admitted to another hospital a month ago. Patient was a smoker with a pack in 2-3 days for 38 years, occasional alcohol intake with no history of heavy alcohol use and no drug use. The patient worked as a chef and lived with his wife. Physical examination shows temporal wasting with cachecxia, had difficulty in staying upright and wanting to sleep when presented to the emergency department. Physical examination was significant for decreased breath sound bilaterally, more on left side, central weakness noted given difficultly sitting upright from laying down flat. Also, there were some lymphadenopathy in the jugular digastric region. Laboratory showed an increase elevation in alkaline phosphatase to the 1000s along with elevated LDL to 300s, nephrotic range proteinuria. Chest X-ray showed left pleural effusion and CT chest and abdomen showed slight hepatosplenomegaly with hypoattenuation and focal calcification. Autopsy finding indicated heavy spleen (260 grams) with a stiff and hard texture. Liver weighs in upper limit of normal (1660 grams) with a yellow firm surface. There is significant amyloid deposition in spleen. Also, moderate amyloid deposition was seen in all the organs including liver, kidney, heart and, also in the skin. No definite lesion was seen in the gross, nor cancer cells found in the microscopy examination. Bone marrow examination did not reveal plasma cells, ruling out the possibility of multiple myeloma or plasma cell dyscrasia.

Conclusion

This is a rare case of AL primary amyloidosis with aggressive progression and poor prognosis not associated with plasma cell neoplasm.
Simple And Cost-Effective Classics Are Back- Revisiting The Role Of Urine Microscopic Analysis For Assessing Severity Of Renal Involvement In Lupus Nephritis
Authors: Venkataraman S , Murari M , Agrawal V , Pandey R , Aggarwal A
Published: October 2020

Casestudy

Urinalysis is important to assess disease activity in Lupus nephritis (LN). Hematuria, pyuria, cellular/granular casts and proteinuria are scored separately for assessing renal activity in SLEDAI. However, pyuria is not specific, and could indicate infection. We studied the correlation of microscopic urinalysis and degree of lymphocyturia with histological ISN/RPS 2018 class of LN.

Methods

Pre-biopsy urine was collected in 76 LN patients. The urine sediment was analyzed using light and phase- contrast microscope. Smear stained with supravital stain Sternheimer Malbin, was assessed semi-quantitatively for lymphocytes (per HPF). Renal biopsy was classified into proliferative (Class III/IV ± V)[N=64] and non-proliferative LN (Class I, II, V, VI) [N=12].

Results

48 patients had active urinary sediment. Cellular and/or granular casts were identified only in proliferativeLN (n=15/64; 23.4%). Hematuria (Range 0-65/HPF) was seen in 45 patients. Dysmorphic RBCs were identified in proliferative (n=17/41; mean 9.9 RBCs/HPF) and were absent in non-proliferative LN (mean 1.4 RBCs/HPF). 20 of the 34 patients with pyuria showed predominant lymphocytes. Lymphocyturia (Range 0-20/HPF) was significantly higher in proliferative LN (Mean 4.6/HPF) as compared to non-proliferative LN (Mean 1.5/HPF). Degree of pyuria or proteinuria had no correlation with biopsy class or activity. Lymphocyturia and hematuria showed correlation with biopsy activity index (r=0.30 and 0.39; p<0.05 and <0.001 respectively). A cut-off of average 6 RBCs/HPF or 5 lymphocytes/HPF could correctly identify proliferative LN with 100% specificity (p<0.001; AUC 0.72 and 0.74 respectively, combined AUC 0.81) and sensitivity of 0.42 and 0.36 respectively.

Conclusion

Although renal biopsy is the gold standard for assessment of renal lesions in LN, urine lymphocytes ≥5 and RBCs ≥6/HPF have a high specificity to differentiate proliferative and non-proliferative LN. This may be especially important in patients having comorbidities contraindicating a renal biopsy. Defining urine sediments using lymphocytes can increase the specificity of clinical activity indices.
Qualification of a 17β-estradiol (E2) Assay in Sprague Dawley Rat Serum
Authors: Martin J A , Figueiredo J , Wang L
Published: October 2020

Introduction/Objective

Significant technical issues are associated with methods used for the measurement of estradiol.The objective of this study was to qualify an electrochemiluminescent (ECL) assay for the quantification of 17β-estradiol (E2) in rat serum. Hemolysis has been identified as a factor that interferes with accurate measurement.The impact of hemolysis was also assessed.

Methods

Approximately 1.0 mL of whole blood was collected from male and female rats into separate red top tubes and processed to serum.

The LoQ for E2 was evaluated by analyzing the low calibrator or at least 6 serum samples diluted to produce a value at the low end of the reportable range 8 times in the same run.The mean, standard deviation, and %CV were calculated for each sample.The data set was analyzed by plotting the data and determining the concentration at the intersection of the precision profile curve.

Linearity of dilution was performed using commercially available calibration verification material and E2 stripped rat serum.The correlation coefficient, the slope, and the % Nominal were calculated.

Intra assay precision was evaluated by analyzing 8 consecutive times in a single run one rat serum sample that was not diluted or spiked. This analysis was performed during the evaluation of the LoQ.The mean, SD and %CV were calculated.

The interference of hemolysis with the E2 assay was tested by analyzing at least 5 rat serum samples/pools spiked with hemolyzed rat serum at different hemoglobin concentrations.The %RE was calculated.

Results

The LoQ assays were acceptable. For all samples tested, the % CV was less than or equal to 25%.The LoQ was verified to be 8.50 pg/mL. The %CV was 15.6%. For samples with estradiol concentrations below the LoQ, a value of 4.25 pg/ml was reported.

Linearity of dilution for E2 was acceptable.The correlation coefficients were greater than or equal to 0.9000, the slopes were between 0.7500 and 1.2500, and the % nominals for each level were between 75-125%.

The intra-assay precision was considered acceptable with a %CV of 8.6%.

There was no hemolysis interference in the assay when samples were spiked with hemoglobin concentrations of up to 70 mg/dL, based on the %RE of less than or equal to 25% of non-hemolyzed samples.

Conclusion

Qualification of the ECL method, demonstrates the assay is suitable for the determination of E2 in serum samples from rats and absence of hemolysis interference up to 70 mg/dL of hemoglobin concentration.
Serum Folate of Less than 7.0 ng/mL is a Marker of Malnutrition
Authors: Mattox S N , Kozman D , Singh G
Published: October 2020

Introduction/Objective

To identify clinical/laboratory factors associated with folate deficiency in tertiary care patients.

Methods

We reviewed the medical records of 1019 patients with serum folate <7.0 ng/mL, 301 patients with serum folate of 15 ng/mL, and 300 patients with serum folate > 23 ng/mL.

Results

Serum prealbumin levels were subnormal in 54.8% of patients with serum folate <7.0 ng/mL. Vitamin B12, hemoglobin, and serum albumin levels were significantly lower in the <7.0 ng/mL folate group. In 62.4% of patients with serum folate <7.0 ng/mL, 1 or more markers of malnutrition were present. The low-folate group had a significantly higher prevalence of gastrointestinal (GI) disorders, sepsis, and abnormal serum creatinine level. There were no significant differences in the 2 groups regarding diabetes; behavioral/neurological disorders, including drug and alcohol abuse; bariatric surgery; or a diagnosis of malnutrition. The average body mass index (BMI) for the <7.0 ng/mL and 15 ng/mL folate groups was significantly different (28.89 and 28.31, respectively), although the difference does not appear to be clinically meaningful.

Conclusion

The prevalence of folate deficiency depends on what is considered a normal serum folate level. Approximately 10% of tertiary care patients have levels <7.0 ng/mL and exhibit other markers of malnutrition. It is recommended that patients with GI disorders, chronic kidney disease, and sepsis be routinely tested for serum folate levels, before administration of vitamin supplements. Patients with serum folate levels <7.0 ng/mL should be evaluated for malnutrition, despite BMI > 25. Folate supplementation should be administered only after excluding coexisting vitamin B12 deficiency.