bluuebunny/crossref_metadata_2025 huggingface dataset:
Metastatic multicentric epithelioid angiosarcoma of bone. A case report with pitfalls. Tumor seeding after percutaneous biopsy and hypercalcemia
Authors: Fuentes-Sanchez Jorge , Pena-Burgos Eva Manuela , Tapia-Viñe Mar , Pozo-Kreilinger Jose Juan , Ortiz-Cruz Eduardo Jose
Published: September 2023

BACKGROUND: Angiosarcomas are a type of malignant tumor of vascular origin. They represent less than 1% of all primary bone tumors. The multicentric or metastatic does not differ in its high aggressiveness and poor prognosis.
CASE PRESENTATION: We describe a case of an elderly male with bone angiosarcoma initially located in proximal femur. After biopsy in a non-expert sarcoma center, he presented a tumor involvement in the path of the needle, in additional finding of multicentric/metastatic that involve the sacro-coccygeal level assessed by magnetic resonance imaging. He associated tumoral hypercalcemia secondary to malignancy and was referred to our sarcoma center for therapeutic decision. He was treated by tumoral resection and reconstruction with proximal femur tumor prosthesis due to high risk of pathological fracture. In the early follow-up he presented pulmonary metastasis and new sarcoma implants in soft parts, dying a few months later.
CONCLUSIONS: Multicentric and/or metastatic epithelioid angiosarcomas require diagnostic and therapeutic thoroughness to improve the patient's quality of life and survival. Percutaneous biopsies have a risk of tumor seeding in the needle trajectory; therefore, they must be performed in centers with expertise in sarcomas. At present, multicentric or metastatic bone involvement is only of theoretical relevance since the treatment and prognosis are identical. Despite that hypercalcemia in sarcomas is a rare problem, the case has this peculiarity, and we highlight its investigation in some of these cases.
Artificial Intelligence Can Persuade Humans on Political Issues
Authors: Bai Hui , Voelkel Jan , Eichstaedt Johannes , Willer Robb
Published: September 2023

The emergence of large language models (LLMs) that leverage deep learning and web-scale corpora has made it possible for artificial intelligence (AI) to tackle many higher-order cognitive tasks, with critical implications for industry, government, and labor markets in the US and globally. Here, we investigate whether existing, openly-available LLMs are capable of influencing humans’ political attitudes, an ability recently regarded as the unique purview of other humans. Across three preregistered experiments featuring diverse samples of Americans (total N=4,836), we find consistent evidence that messages generated by LLMs (OpenAI’s GPT 3 and 3.5 models) are able to persuade humans across a number of policy issues, including highly polarized issues, such as an assault weapon ban, a carbon tax, and a paid parental-leave program. Overall, LLM-generated messages were as persuasive as messages crafted by lay humans. Our results show LLMs can persuade humans, even on highly polarized policy issues. As the capacity of LLMs is expected to improve substantially in the near future, these results suggest that LLMs may change political discourse, calling for immediate attention for the identification and regulation of potential misuse of LLMs.
Establishment and validation of a prognostic nomogram for patients with distant metastatic gallbladder cancer based on treatment benefits
Authors: Yuan Chen , Chen Wenhui , Zou Shubing , Wang Kai , Hu Zhigang
Published: September 2023

Purpose
Whether different clinical treatments can benefit for the prognosis of patients with distant metastatic gallbladder cancer (GBC), and how to screen the corresponding candidate patients remained unclear. This study aimed to construct and validate a nomogram to predict the prognosis of these patients based on treatment benefits.
Methods
Patients diagnosed of distant metastatic GBC were retrospectively enrolled from the huge database during 2000 and 2017, and were randomly divided into the training and internal validation cohorts by 7:3. Another patients cohort was retrospectively enrolled from the Second Affiliated Hospital of Nanchang University during 2010 and 2020, and was subsequently used for external validation. Clinical data including various clinical treatment modalities were collected. Univariate and multivariate analyses were used to explore the potential prognostic factors in terms of overall survival and nomograms were constructed. The area under the receiver operating characteristic (ROC) curves (AUC) and the calibration curves were used to evaluate the efficacy of the nomograms. Decision curve analysis (DCA) was used to evaluate the clinical applicability of the nomograms.
Results
A total of 580 patients with distant metastatic GBC were enrolled from the SEER database, and another 49 patients were enrolled from the authors’ hospital. Age, lymph node dissections, radiotherapy, chemotherapy, T stage, N stage, liver metastasis and bone metastasis were independent prognostic factors, and two nomograms were established based on the above factors including or not including treatment factors. Further nomogram validations showed good prediction efficacy by AUC values and calibration curves, and good clinical applicability by DCA.
Conclusion
The prognostic nomogram for patients with distant metastatic GBC based on treatment benefits was established with good prediction efficacy and good clinical applicability, which might be of good value for the evaluation of the therapeutic significance for candidate patients.
How to reverse severe midtrimester oligohydramnios secondary to non-criteria obstetricantiphospholipid syndrome: a case report
Authors: Zhang Ying , Jiang Yuan , Wei Yu , Zhu Yun
Published: September 2023

Background: Obstetrical antiphospholipid syndrome (OAPS) is an acquired autoimmune disorder characterized by recurrent pregnancy complications, which was orchestrated by elevated antiphospholipid (aPL) antibodies. The diagnosis of definite OAPS requires the presence of one or more typical clinical criteria and persistent aPL antibodies at least 12 weeks apart. However, the classification criteria for OAPS have generated wide debate, with a growing impression that certain patients not fully meeting these criteria might be inappropriately excluded from the classification, which is known as “non-criteria” OAPS.
Case presentation: We reported here one unique cases of “non-criteria” OAPS, complicating severer midtrimester oligohydramnios. This patient has a history of a morphologically normal fetal loss, and the presence of intermittent aPLs (<12 weeks apart). Severe oligohydramnios was detected at the pregnancy of 22 weeks, and intrauterine growth restriction occurred latter. She was treated by TNF-α blockers in combination of low dose aspirin (LDA) plus low molecular weight heparin (LMWH), and delivered a healthy baby at the pregnancy of 37 weeks. No complications were observed in the mother and child during the follow-up period of ten months.
Conclusion: TNF-α blockers in combination of LAD and LMWH appears to be a promising treatment for refractory obstetric complaints related to aPL.
Coping strategies for batch patient admission in super large temporary hospitals: A case review and effectiveness evaluation
Authors: Huang Chen , Bi Yufang , Jing Feng , Chen Erzhen , Shang Hanbing , Yang Zhitao , Chen Ying , Zhang Yibo
Published: September 2023

Background: In the beginning of March 2022, coronavirus disease-2019 (COVID-19) rapidly spread in Shanghai. In order to cope with the epidemic, more than 110 fangcang hospitals with over 250000 beds were constructed. Thus, effective batch patient admission strategies suitable to meet the characteristics of fangcang hospital are of essential importance. To summarize the experience of batch patient admission during the operation of three super large square cabin hospitals in Shanghai.
Methods: A case review and effectiveness evaluation based on the batch treatment of patients in three super large Super large temporary hospitals in Shanghai. This case review investigated two methods of batch patient admission in three large Super large temporary hospitals established in Shanghai, China, between March and May 2022, and compared the efficiency and risks of the two methods, as well as summarized the coping strategies for batch patient admission in large square cabin hospitals.
Results: Under the same staffing conditions, the batch patient admission mode of “treatment before triage” was used. The average number of patients admitted per hour, the average number of patients admitted within 72 h in each branch, and the maximum number of patients admitted per hour in each branch were significantly higher compared to the traditional patient admission mode of “triage before admission.” However, the proportion of patients who did not meet the admission criteria in this mode was high, and there was a significant medical risk.
Conclusions: Establish a scientific, standardized, and reasonable batch patient admission strategy to effectively respond to the large number of patients admitted to the shelter hospital.
WITHDRAWN: A Flexible Discrete Generator with Mathematical Characterization, Properties, Count Statistical Modeling and Inference
Authors: Alkhayyat Salwa L. , Mutairi Aned Al , Nassr Said G. , Alsuhabi Hassan , Hamedani G.G. , Ibrahim Mohamed , Mus Abdisalam Hassan , Yousof Haitham M.
Published: September 2023

In this piece of work, we examine and present a completely new discrete family of distributions that we have created. Our investigation into the relevant mathematical properties and characterizations of the system makes use of both analytical and numerical methods. We focus on a particular member of this family so that we can study its theoretical foundations as well as its graphical and numerical representations. This new model contains a number of different hazard rate functions, some of which are referred to as "increasing constant," "decreasing-constant-increasing (U)," "constant," "U-constant," "decreasing," and "J-shape." In a similar vein, the model's probability mass function provides a variety of forms, all of which are helpful and practical. These forms include "asymmetric left skewed," "right skewed with wide peak," "right skewed," "bimodal," "symmetric," and "right skewed," amongst others. Each of these forms is valuable and applicable in their own way. These forms might be discovered in the probability mass function that the model generates. In this investigation, in addition to the Bayesian estimating technique under the traditional loss function of squared errors, we investigate and make use of a total of eight estimate strategies that are not founded on Bayesian theory (classical methods). Simulations employing the Markov Chain Monte-Carlo method are run in order for comparing the Bayesian way of estimation with the more traditional approach of estimating values. According to the findings that we've compiled, the estimation strategy that is referred to as maximum likelihood yields the most accurate results across the board and for all different types of sample sizes. In addition, we evaluate and contrast the various methods of estimation by making use of four distinct real dataset sets; this indicates the versatility of the unique model that we have developed.
Atomic dynamics of electrified solid-liquid interfaces in liquid cell TEM
Authors: Zheng Haimei , Zhang Qiubo , Song Zhigang , Sun Xianhu , Liu Yang , Wan Jiawei , Betzler Sophia , Zheng Qi , Shangguan Junyi , Bustillo Karen , Ercius Peter , Narang Prineha , Huang Yu
Published: September 2023

Electrified solid-liquid interfaces play a key role in various electrochemical processes relevant to electrocatalysis1-3, batteries4,5, and supercapacitors6,7 in energy science, and other processes in biology8 and geochemistry9. The electron and mass transport at the electrified interfaces may result in structural modifications that remarkably influence the reaction pathways, for example, electrocatalyst surface restructuring during reactions can significantly impact the catalysis mechanisms and reaction products1-3. Despite its significance, direct probing the atomic dynamics of solid-liquid interfaces under electric biasing is challenging due to the nature of being buried in liquid electrolytes and the limited spatial resolution of current techniques for in situ imaging through liquids. Here, with our development of advanced polymer electrochemical liquid cells for transmission electron microscopy, we are able to directly monitor the atomic dynamics of electrified solid-liquid interfaces during Cu-catalyzed CO2 electroreduction reactions. Our observation reveals a fluctuating liquid-like amorphous interphase. It undergoes reversible crystalline-amorphous structural transformations and flows along the electrified Cu surface, thus mediating the crystalline Cu surface restructuring and mass loss through the interphase layer. The combination of real-time observation and theoretical calculations unveils an amorphization-mediated restructuring mechanism resulting from charge-activated surface reactions with the electrolyte. Our results hold significant implications for utilizing transient interphase to control catalyst surface restructuring, thus tuning the catalytic reactions. It also opens many opportunities to explore the atomic dynamics and its impact in broad systems involving electrified solid-liquid interfaces by taking advantage of the in situ imaging capability.
H3K36 methyltransferase NSD1 protects against osteoarthritis through regulating chondrocyte differentiation and cartilage homeostasis
Authors: Zou Weiguo , Shao Rui , Suo Jinlong , zhang zhong , Kong Mingxiang , Ma Yiyang , Wen Yang , Liu Mengxue , Zhuang Lenan , Ge Kai , Bi Qing , Zhang CQ
Published: September 2023

Osteoarthritis (OA) is the most common joint diseases, there are no disease-modifying drugs, and the pathological mechanisms of OA need further study. Here, we show that H3K36 methylations were decreased in senescent chondrocytes and age-induced osteoarthritic cartilage. Transgenic K36M/+; Prrx1-Cre mice showed articular cartilage destruction and osteophytes formation. Conditional knockout Nsd1Prrx1-Cre mice, but not Nsd2Prrx1-Cre or Setd2Prrx1-Cre mice, replicated the phenotype of K36M/+; Prrx1-Cre mice. Immunostaining results showed reduced anabolic and increased catabolism in Nsd1Prrx1-Cre mice, along with decreased chondrogenic differentiation. Transcriptome and ChIP-seq data revealed Osr2 was a key factor affected by Nsd1. Intra-articular delivery of Osr2 adenovirus effectively improved the homeostasis of articular cartilage in Nsd1Prrx1-Cre mice. In human osteoarthritic cartilages, both mRNA and protein levels of NSD1 and OSR2 were decreased. Our results indicate that NSD1 induced H3K36 methylations and OSR2 expression play important roles in articular cartilage homeostasis and osteoarthritis. Targeting H3K36 methylation and OSR2 would be a novel strategy for osteoarthritis treatment.
Emergence of Broken Symmetry Via Odd Viscosity in Underdamped Spinner Swarms
Authors: Austin Robert , Li Shengkai , Phan Trung , Wang Gao , Khuri Ramzi , Wilson Jared , Liu Liyu
Published: September 2023

Broken symmetry is an emergent phenomena. We show here the unexpected broken symmetry emergence of high spin state minority spinners in an active swarm of mixed spin handedness internally driven spinners. This occurs because depending on the relative spin sign, internally driven spinners can act as their own anti-particles and annihilate their spins, transferring their spin angular momentum into orbital angular momentum, an inertial version of odd (Hall) viscosity. Since our spin drive comes from active blowers on each spinner future work will allow for the incorporation of individual computation and decision making in the dynamics of the spinners.
GPD1L As a prognostic biomarker associated with Treg immune-infiltration and lipid metabolism for Clear cell renal cell carcinoma
Authors: Yang Ming , Gong Chuhui , Pang Dejiang , Song Kangping , Huang Ning , Ma Hongbo , Gong Hui , Chen Honghan , Xu Weitong , Yang Yu , Guo Shujin , Xiao Hengyi
Published: September 2023

Background
Clear cell renal cell carcinoma (ccRCC) is a prevalent tumor in the urinary system, presenting a poor prognosis yet being accompanied by a high degree of immune infiltration. Understanding the mechanisms underlying this abnormal infiltration and identifying prognostic biomarkers in this regard is crucial for improving therapeutic outcomes.
Methods
The expression of GPD1L in ccRCC was analyzed using a common database (TCGA). The expression of GPD1L in ccRCC cell lines and tissue samples was verified by western blotting, real time qPCR and immunohistochemistry. The predictive value of GPD1L was evaluated by survival analysis, ROC curve and Cox regression analysis. We used GO, KEGG and gene set enrichment analysis (GSEA) to verify each other. Then the single cell sequencing dataset (GEO) was further analyzed and verified, and the functional phenotype of GPD1L in ccRCC was explored by functional experiments. In addition, the correlation between the expression level of GPD1L and drug resistance of AKT-mTOR pathway was analyzed based on Genomics of Drug Sensitivity in Cancer database (GDSC).
Results
We identified glycerol-3-phosphate dehydrogenase 1-like (GPD1L) as a prognostic biomarker in ccRCC, which may facilitate the adaptive survival of tumor cells via enhanced regulatory T cells (Tregs) infiltration and lipid metabolism reprogramming in ccRCC. Our results suggest that there is a significantly diminished GPD1L in ccRCC patients with poorer survival probability. Mechanically, a significant negative correlation between GPD1L expression and Tregs infiltration, and GPD1L-related metabolic analysis reflected the correlation between Tregs and lipid metabolism. In addition, GPD1L expression levels also influence the malignant phenotype of ccRCC and the drug resistance to AKT and mTOR targeted therapy.
Conclusions
Taken together, our results supported GPD1L could be a valuable biomarker for predicting and intervening in ccRCC progression. These insights could shed light on the complex interplay between tumor cell adaptive survival and Treg infiltration, which reflected that the comprehensive and systemic role of GPD1L in ccRCC.
Barriers and Opportunities for Telemedicine Volunteerism - A Case Study in India
Authors: D'Souza Karishma , Singh Saksham , Westgard Christopher M. , Barnhardt Sharon Marie
Published: September 2023

Background
The recent growth of telemedicine in middle and lower-middle-income countries was further propelled by the COVID-19 pandemic, birthing new models of telemedicine during this period. One such model was volunteer-based telemedicine networks. By leveraging existing infrastructure and resources to more efficiently allocate health personnel, this model allayed some of the burden placed on health systems by the pandemic. However, there is insufficient understanding about volunteer-based telemedicine models, especially on the human resources engagement on such networks. This study aims to understand the motivations and barriers to medical provider engagement with a volunteer telemedicine network during COVID-19, and the mechanisms that can potentially sustain volunteer provider engagement to address healthcare demands beyond the pandemic.
Methods
In-depth qualitative interviews were conducted with medical providers volunteering on a multi-state telemedicine network in India during the COVID-19 pandemic. Data were analyzed using thematic content analysis methods.
Results
Most providers reported being motivated to volunteer by a sense of duty to serve during the pandemic.
Providers suggested organizational-level measures to make the process more efficient and facilitate a more rewarding provider-patient interaction. These included screening calls, gathering patient information prior to consultations, and allowing for follow-up calls with patients to close the loop on consultations. Many providers stated that non-financial incentives are enough to maintain providers’ volunteer engagement. However, providers expressed mixed feelings about financial incentives. Some stated that financial incentives are needed to maintain long-term provider engagement, while others stated that financial incentives would devalue the volunteer experience. Most providers highlighted that telemedicine can increase access to healthcare, especially to the rural and underserved, even after the pandemic. Providers also expressed an interest in continuing to volunteer with the network if the need arose again.
Conclusion
Our study findings suggest that medical providers are highly intrinsically motivated to volunteer during large healthcare emergencies and beyond to address the healthcare needs of the underserved. Following the recommendations presented in the study, telemedicine networks can more successfully engage and maintain volunteer providers. Volunteer-based telemedicine networks have the potential to bridge shortages of health personnel in resource-constrained settings both in times of crises and beyond.
Assessment of Readiness across Tertiary/University Teaching Hospitals in a Developing Country Nigeria to Implement Sustainable Healthcare Digital Transformation Programmes and Projects
Authors: Onyeabor Uchechukwu Solomon , Ayoola Lasebikan Omolade , Okenwa Wilfred Okwudili , Onwuasoigwe Okechukwu , Schaaf Thorsten , Pinkwart Niels , Balzer Felix
Published: September 2023

Background
The gains of healthcare's digital transformation have become phenomenal! Several healthcare institutions and providers across the globe witnessed massive integration of digital technologies (particularly during the COVID-19 crisis) to optimise healthcare service delivery. Given its massive benefits, it is also important to note that the success of digital transformation programmes and projects within any context, including healthcare, could largely depend on the readiness of the implementation environment to receive, adopt, adapt, or integrate such programmes and projects. The goal of this research was therefore to conduct an assessment of readiness across three tertiary/university hospitals in a developing country, Nigeria, to implement sustainable healthcare digital transformation programmes and projects.
Method
This research was based on quantitative methods. A survey based on a 5-point Likert Scale was distributed to clinical stakeholders across these institutions on the readiness of the institutions and stakeholders to implement healthcare digital transformation programmes and projects. A sample population of 600 clinicians was surveyed. Specifically, the survey evaluated the perceptions of clinicians on different dimensions of readiness measurements. The Data analysis and visualisation were done using SPSS and MS Excel.
Result
Out of the 600 clinicians surveyed across the three tertiary/university teaching hospitals, 580 usable questionnaires for data analysis were retrieved, which was indicative of a 96.67% success rate. On the dimension of ‘vision clarity’, 90.40% of the clinicians posited that a computer-based system was indeed needed to improve their clinical procedures. But when asked if all staff in their units were highly computer literate to support digital transformation projects, only 30% of the respondents believed that staff were highly computer literate. When this question was reframed and the respondents were asked to confirm that staff in their unit really had low computer skills, again, only 36.30% of respondents thought otherwise.
Conclusion
Our result clearly shows that low digital literacy was a major challenge across the hospitals surveyed. And without a significant level of computer literacy, there would hardly be any healthcare digital transformation project that would be sustainable. There is a need for concerted effort in the area of massive training of the clinical workforce in this area.
BCL2L1 is regulated by the lncRNA MIR4435-2HG-miR-513a-5p-BCL2L1 ceRNA axis and serves as a biomarker for pancreatic adenocarcinoma treatment and prognosis
Authors: Zhu Rongkun , Chen Wei , Bai Shanwang , Chang Liang , Li Zhen , Liu Fashun
Published: September 2023

Pancreatic adenocarcinoma (PAAD) is one of the most malignant cancers. After escaping death, cancer cells are made more metastatic, aggressive, and also drug-resistant through anoikis resistance. The aim of this study is to explore the molecular mechanisms of anoikis-related genes in PAAD and to identify potential key biomarkers. We integrated information about PAAD from The Cancer Genome Atlas (TCGA) and The Genotype-Tissue Expression (GTEx) databases and identified anoikis-related gene BCL2L1 by survival analysis, univariate Cox regression analysis, and multifactorial Cox regression analysis. Various bioinformatics approaches showed that BCL2L1 was a valuable prognostic marker that might be involved in PAAD development and progression through different mechanisms, including cancer intervention, genomic heterogeneity, and RNA modifications. Our analysis showed that BCL2L1 expression also closely correlates with the expression of various immune checkpoint inhibitors. In particular, we found that long non-coding RNA MIR4435-2HG acted as ceRNA sponging miR-513a-5p to promote the expression of BCL2L1, thereby promoting pancreatic cancer cells proliferation. In conclusion, BCL2L1 expression regulated by the MIR4435-2HG-miR-513a-5p-BCL2L1 ceRNA axis might be used as a biomarker for cancer prognosis, treatment selection, and follow-up in PAAD patients.
Efficacy of Nicorandil in Preventing Contrast-Induced Nephropathy in Patients with ST-segment Elevation Myocardial Infarction undergoing Primary Percutaneous Coronary Intervention
Authors: QIAN GENG , Chen Si , Jiang Xiao-si , Zhang Ying , A Xin , Li Ping , Chen Yun-dai
Published: September 2023

Objective:
It is widely reported that nicorandil could reduce contrast-induced nephropathy (CIN) after selective percutaneous coronary intervention (PCI) or coronary angiography. The aim of this multi-center prospective randomized controlled trial is to evaluate the efficacy of nicorandil for the prevention of CIN during primary PCI in patients with ST-segment elevation myocardial infarction (STEMI).
Methods:
Patients with STEMI received primary PCI were enrolled, and they were randomly assigned into nicorandil group and placebo group, receiving intravenous nicorandil or placebo, respectively. The endpoint was the incidence of CIN, defined as an absolute increase in serum creatinine (SCr) > 0.5 mg/dl or a relative increase > 25% compared with baseline SCr. The secondary endpoints were major adverse cardiovascular events (MACEs) within a year.
Results:
The final study population comprised 238 randomized patients, and 226 of them (n=113 for each group) were included in the primary analysis. Compared with the placebo group, the final TIMI grade in the nicorandil group was significantly better (P = 0.001), and the incidence of CIN in nicorandil group was significantly lower (9.7% (11/113) vs. 24.8% (28/113), P = 0.003). The logistic regression analysis revealed that nicorandil was significantly associated with the decreased odds of CIN (OR: 0.379, 95% CI: 0.166-0.861, P=0.021). Nicorandil is an independent protective factor for the development of CIN in STEMI patients undergoing primary PCI.
Conclusions:
Our study indicated that intravenous nicorandil could prevent CIN in patients with STEMI undergoing primary PCI.
Effect of choline chloride-ethylene glycol manipulation on electropolishing of metallic nickel
Authors: karim wrya
Published: September 2023

This study presents effectiveness of electrolytic bath on successful electropolishing of metallic nickel. The electrolytic bath consists of choline chloride (ChCl) and ethylene glycol (EG). The different mole ratios of these two components were prepared; namely, 1:2, 1:3, 1:4. As electrolytic bath, ChCl: EG was applied to make smooth metallic nickel electrochemically. The electrochemical conditions of the electropolishing of metallic nickel were obtained by holding the voltage at 1.5 V for 12 min at 25°C. Comparison is made with analogous measurements for three electrolytic bathes in electropolishing of metallic nickel.
A nomogram for lateral lymph nodes that have metastatic cN0 unifocal papillary thyroid microcarcinoma
Authors: Saad Hassan A , Farid Mohamed I , Eraky Mohamed E , El-Taher Ahmed K , Baz Azza , Riad Mohamed
Published: September 2023

Background
The need for lateral neck dissection (LND) in papillary thyroid microcarcinoma (PTMC) might be better understood by identifying risk variables for occult lateral lymph node metastasis (LLNM). This study's goal was to create a nomogram for predicting the likelihood of LLNM in individuals with cN0 unifocal PTMC.
Methods
A total of 9744 patients with cN0 unifocal PTMC who had treatment at our facility between February 2013 and April 2020 were the subject of our retrospective analysis. The risk variables for LLNM were identified using logistic regression analysis, and a nomogram was created based on these risk factors.
Results
3.2% of the population had LLNM. Compared to tumours in the lower or middle lobe with a size less than or equal to 7 mm, tumours in the upper lobe had a substantially increased risk of LLNM (odds ratio [OR] = 2.56, 95% confidence interval [CI] 1.80–3.62; p 0.001) and OR = 2.59, 95% CI 1.85–3.62. ETE tumours had a significantly increased probability of developing LLNM (OR = 1.41, 95% CI 1.01–1.99; p = 0.044). One or two central lymph node metastases (CLNMs) or three or more of them (OR = 5.84, 95% CI 3.83-8.93; p 0.001) increased the probability of LLNM in comparison to having none (OR = 2.91, 95% CI 1.93-4.42; p 0.001). The receiver operating characteristic (ROC) curve of a nomogram that took these risk factors into account showed an area under the curve (AUC) of 0.777, indicating a good level of predictive accuracy.
Conclusion
Three or more CLNMs, especially three or more, and upper lobe tumours larger than 7 mm in size were independent risk factors for LLNM in cN0 unifocal PTMC. Based on these variables, the nomogram showed good predictive value and consistency.
Can reparation deliver equality? Projections for the shared socioeconomic pathways in the USA
Authors: Shayegh Soheil
Published: September 2023

Reparations in terms of direct payments are often used to redress injustices and compensate for historical inequalities. In some parts of the United States, restoring the deferred wealth of Black population through reparations has gained traction in recent years. However, there is no consensus on which reparative policies should be implemented and how to assess their potential impact. Here we show that reparative taxation of White population can be an effective measure in closing the racial wealth gap. We found that imposing a hypothetical one-time reparative estate tax of 5% can potentially close the racial wealth gap among all skill groups (high-skilled, low-skilled, and combined). However, the impact of such reparation shock on closing the wealth gap between high-skilled and low-skilled labor can be observed only among Black population. Nevertheless, the impact of imposing a similar one-time reparative inheritance tax of 5% is less profound in closing the racial wealth gap. Overall, the low-skilled Black sub-population emerges as the group benefiting the most from these hypothetical taxation schemes. These results show how reparation policies in the form of taxation of intergenerational wealth transfers can help close the racial wealth gap while having a short-lived impact on the skill-based wealth gap. The structural economic model of overlapping generations proposed in this paper can be considered a stepping stone to the incorporation of intergenerational and interracial inequalities into the shared socioeconomic pathways (SSPs).
JEL Classification: J15 , D63 , D31
Investigation of MDR1 Gene Polymorphism and Losartan Plasma Concentration in Patients Undergoing Hypertensive Episodes While under Losartan Treatment
Authors: Cimen Uzeyir , Tug Esra , Nesetoglu Neset , Unal Duri Sehvar , Karakuş Osman , Cimen Yesim Kinaci , Kadi Gültekin , Turan Ömer Faruk , Demircan Ahmet , Uluoglu Canan
Published: September 2023

Purpose: Losartan, a drug in the angiotensin receptor blocker (ARB) family, is the substrate of the Multi Drug Resistance-1 (MDR1) drug-efflux protein encoded by the ABCB1 gene. This study seeks to investigate the MDR1 gene polymorphism and losartan concentration in order to identify drug resistance in patients presenting to the emergency department (ED) with a hypertensive episode while having losartan treatment.
Methods: The ethics approval of our study was granted by Gazi University Clinical Research Ethics Committee (dateof registration 23.10.2017, number: 496) and Ministry of Health Turkey Medicines and Medical Devices Agency (date of registration 14.02.2018, code number: 17-AKD-189). The patient cohort was comprised of 50 individuals presenting with a hypertensive episode while under losartan treatment. The control cohort included 50 patients whose blood pressure was regulated while receiving losartan treatment and who were admitted to the ED for reasons other than hypertensive episode. Allele-specific analysis was carried out PCR (Polymerase Chain Reaction) device. Plasma losartan and EXP3174 levels of the patients were measured using tandem mass spectrometry.
Results: The frequencies of GG, GT, GA, TA and TT genotypes did not differ significantly between the cohorts in G2677T/A single nucleotide polymorphism (SNP) (p>0.05), whereas those of C3435T TT and C1236T CT genotypes yielded a significant difference between the patient and control cohorts (p<0.05).
Conclusion: We provided clinical evidence that hypertensive episodes occurred more frequently in C3435T TT and less frequently in C1236T CT. However, no significant correlation was established between plasma losartan, EXP3174 concentration and G2677T/A, C3435T, and C1236T genotypes.
American Clinical Trials Registration Number: NCT05349825
The Study on Occupational Radiation Protection at Bhaktapur Cancer Hospital by Analyzing Dosimetric Data
Authors: Khatiwada Richa , Jha Bidyapati , Pokhrel Prashansa , Jha Vinaya Kumar
Published: September 2023

Radiation is the release of energy in the form of electromagnetic waves or particles, and it is used for cancer treatment for therapeutic treatments like radiation therapy as well as diagnostic imaging methods like X-rays. However, the use of radiation in cancer hospitals presents an occupational hazard for medical workers who are exposed to it, necessitating rigorous adherence to safety procedures, suitable shielding, and monitoring to reduce the risk of radiation-related health impacts. This research analyzes the distribution of radiation exposure levels among Bhaktapur Cancer Hospital (BCH) personnel over a number of years. The data shows that the mean exposure levels in 2011 and 2012 were relatively low, with only one employee having a non-zero exposure value each year. The mean exposure levels fluctuated throughout the years but were largely within acceptable limits. However, an exception was found in 2022, where the maximum exposure value was substantially greater than in previous years, with the highest exposure of 5 mSv for one of the employees. This anomaly might be related to decreased functioning of specific devices during the COVID-19 pandemic and an increase in patients following the pandemic. Overall, the radiation exposure of employees during the evaluated years (2011-15 and 2021-22) was found to be within the safe level. Moreover, the cumulative life exposure up to 2015 was below the recommended safety limit. The study emphasizes hospital radiation safety with protective gear, shielding, and dosimeter monitoring. Besides this given exposure, when incorporating the background radiation absorbed in the supervised region requiring TLD placement, the calculated value within BCH was determined to be 1.4025 mSv. Furthermore, the combined highest and lowest sum of individual total exposures during work hours, inclusive of background radiation, was found to be (1.4025 and 6.4025) mSv, respectively. This total also falls within the safety limit set by the ICRP(International Commission on Radiological Protection ). However, even if the radiation exposure is within the safety limit, cumulative exposure over the years can have hazardous effects on health workers.
Impact the solar ventilation on thermal comfort and energy efficiency of buildings using phase change materials.
Authors: BENACHIR NOUHAILA , Farida Bendriaa , MOUHIB TAOUFIQ
Published: September 2023

This article aims to provide an overview of best practices for the design and construction of more energy efficient building envelopes. So the effects of carbon fuel consumption on the environment have stimulated development of a ‘net-zero’ energy measurement in buildings envelope for sustainable buildings a net-zero energy is key to reducing energy use and saving money .For several decades, low-income citizens in Moroccan cities have been suffering from thermal inequality, energy poverty and thermal comfort constraints. They resist indoor temperatures of less than 16°C and more than 32°C, which causes the phenomenon of thermal stress. Among the sources of energy consumption, Heating, Ventilation and Air Conditioning (HVAC) systems represent about 50% of the total expenditure in buildings this considerable proportion can be explained in part by the great temperature variations recorded in Morocco, which make it essential to provide air conditioning or heating almost at all times. The development of green buildings thus inevitably requires an optimization of the use of HVAC SYSTEMS. The article presents the integrated the mechanical solar ventilation and phase change materials into the building envelope using the simulation software of the thermal behavior in dynamic regime TRNSYS, this project aims at the design of a single-family house whose energy balance over one year of operation. In particular when the air temperature is close to the melting temperature 22°C. A global building model consisting of a building envelope modeled and simulated in TRNSYS and EnergyPlus and the modeled exchanger Mechanic solar ventilation air/PCM fan system is simulated under climate (CASABLANCA NOUSSEUR). The energy consumption related to the specific uses of electricity is taken into account in the annual energy balance. The results show that the Mechanical solar ventilation with the phase change materials (PCM + MSV) reduces the operating temperature of the house significantly and relative humidity and maintain the demand energy from HVAC system. Indeed, the Mechanical solar ventilation has decreased its average operating temperature by about 2.7°C-3°C and created the fresh and comfort space.
Molecular Findings Among Patients for Whole Exome Sequencing and mitochondrial genome assessment
Authors: Sun Gege , Huang Wei , Wang Li , Wu Jinlin , Zhao Ganye , Ren Huanan , Liu Lina , Kong Xiangdong
Published: September 2023

Objective: Whole exome sequencing (WES) is increasingly used as a diagnostic tool in medicine. We report the diagnostic yield of WES and mitochondrial genome in 2226 consecutive cases at a single clinical laboratory.
Methods: We performed a retrospective analysis of consecutive WES reports of 2226 patients affected by a range of genetic disorders. The WES was performed solely for the probands and in a higher diagnostic capacity. We determined the diagnostic rate of WES overall as well as by phenotypic category, mode of inheritance, mitochondrial genome variant, and copy number variants (CNVs).
Results: Of 2226 individuals having diagnostic WES proband-only, the overall diagnostic yield of WES was 34.59%. autosomal dominant (45.58%), followed by autosomal recessive (31.95%), X-linked (9.61%), and mitochondrial (0.65%), The remaining diagnoses were based on a total of 94 copy number variants (12.21%) reported from WES data. The CNV variation in children accounted for 67.02% of the total CNV variation. Molecular diagnoses were reported for 31.14% (373/1198) of adults, lower than a primarily pediatric population (38.62%, 397/1028). A While the majority of molecular diagnoses were related to nuclear genes, mitochondrial genome sequencing included in the WES test yielded five diagnoses, and all confirmed mitochondrial diseases were detected in adults. The highest positivity rate was observed in children aged 1-4 years old (43.72%, 80/183). Patients with integument system disorders had the highest diagnostic yield (58.33%, 59/151). The endocrine and metabolic disorders were the most common systems in both adults and children (261, 217). However, in adults, the highest diagnosis rate was for integument system disorders (71.43%, 30/42), while in children, the highest diagnosis rate was for disorders involving hearing (61.73%, 50/81). In addition to cases with a definitive diagnosis, in 8.4% of cases a candidate gene was reported that may later be reclassified as being associated with a definitive diagnosis.
Conclusions: WES proband-only provided a definitive molecular diagnosis for 34.59% of a large cohort of patients referred for evaluation for evaluation of suspected genetic conditions, that analysis of WES simultaneously analyze the SNVs, Exons, mitochondrial genome and CNVs significantly improves the diagnostic yield compared with WES single detection method, and facilitates identification of novel candidate genes. The yield of whole exome sequencing in this study may have advantages over reported molecular diagnostic methods.
Choroidal vascularity features of fundus tessellation in adults with high myopia
Authors: Zhang Rongrong , Xue Jiarui , Zheng Minmin , Cao Xiao , Li Chenhao , Wu Changfan
Published: September 2023

Background
To investigate alterations in choroidal vascularity among highly myopic adults with fundus tessellation, utilizing optical coherence tomography.
Methods
Total of 143 highly myopic adults (234 eyes) with fundus tessellation were collected in this retrospective study, which was stratified into different lesion groups based on the novel tessellated classification. Subfoveal choroidal thickness (SFCT), luminal area (LA), stromal area (SA), total choroidal area (TCA), and choroidal vascularity index (CVI) were analyzed utilizing optical coherence tomography (OCT) with enhanced depth imaging (EDI) mode, enabling precise quantification of these parameters.
Results
Comparison analysis demonstrated notable distinctions in spherical equivalent (SE), axial length (AL), and SFCT across the four tessellated grades (p < 0.001). Considerations of the choroidal vascularity parameters, LA, TCA, CVI were significant differences among the four groups (p < 0.001), while no significant variations were observed in SA when comparing Grade 1 versus Grade 2, as well as Grade 2 versus Grade 3 (p > 0.05). Logistic regression analyses illustrated that the higher grade of tessellated exhibited a positive association with AL (OR = 1.701, p = 0.027), while negatively associated with SFCT (OR = 0.416, p = 0.007), LA (OR = 0.438, p = 0.010) and CVI (OR = 0.529, p = 0.004). Multiple regression analyses demonstrated a significant negative association between CVI and both SE and AL after adjusting for age, while positively associated with SFCT (p < 0.05).
Conclusion
Subtle choroidal vascularity changes may have a meaningful contribution to the development and progression of fundus tessellation. CVI and LA were dramatically decreased during the early tessellation development and maintained relatively stable status when developing into severity tessellated grades.
RNNHC: A hybrid error correction algorithm for long reads based on Recurrent Neural Network
Authors: Wang Rongshu , Chen Jianhua
Published: September 2023

Long reads generated by third-generation sequencing technologies show irreplaceable advantages in downstream analysis by virtue of their ultra-long read lengths. However, their high error rate also affects the accuracy of downstream analysis. Meanwhile, deep learning has shown its talents in the processing of long gene sequence problems. In this work, a hybrid error correction algorithm is proposed, which uses the idea of processing multi-class tasks with a recurrent neural network to capture the long-term dependencies in the long reads to solve the problem of long-read error correction. RNNHC first aligns the long reads to the high-precision short reads to generate the corresponding feature vectors and labels, then adopts a recurrent neural network to capture the dependencies between bases, and finally trains the model so that it can be used later for prediction and error correction. We demonstrate that the performance of RNNHC is better than that of state-of-the-art hybrid error correction methods on real-world PacBio and ONT data sets including E. coli, S. cerevisiae, and Drosophila melanogaster. As shown in our experimental results that RNNHC can improve the alignment identity while maintaining read length and continuity of the sequence, and spending less user time than other hybrid error correction algorithms. Furthermore, RNNHC is applicable to data from two mainstream sequencing platforms.
Dignity Preservation Among Hospitalized Patient: A Case study of Bugando Medical Centre, Northwestern Tanzania
Authors: Mabega Ndakibae Gabriel , Mwaisungu Halima , Mwing’a Gerald Phares , Razaro Haule AS
Published: September 2023

Background Dignity preservation is regularly emphasized as one of the basic patient rights in both national and international codes of ethics in medical practices. Therefore, it is important to explore this concept based on the patient's experience to maintain and respect their dignity, improve the quality of health services, and increase patient satisfaction in health care.Material and Methods This was a qualitative descriptive study in which 20 hospitalized patients were recruited. Purposive sampling was used to select study participants from wards of different departments of Bugando Medical Centre (BMC). Patients were interviewed about the experience related to the preservation of their dignity during their hospital stay. Data were analyzed using qualitative content analysis.Aim The study aimed to explore the experience of dignity preservation among hospitalized patients during their hospital stay.Results Four major themes emerged from the analysis of the data obtained from the interview. Patient-Provider relationship, patient involvement in treatment plan, Inadequate privacy and confidentiality, Accessibility and Affordability of health services.Conclusion From the patient’s experience, human dignity needs to be preserved and maintained in hospitals. Respect for their privacy, confidentiality, and patient involvement in the treatment plan should be taken into consideration.