bluuebunny/crossref_metadata_2025 huggingface dataset:
The Pitfalls and Strategies of Endoscopic Localization in Laparoscopic Colectomy: A Case Report
Authors: Wang Wei , Tao Feng , Lv Jieqing
Published: April 2021

Background: laparoscopic segmental colectomy is suitable for removing difficult polyps that are large, broad-based, or located in tortuous bowel segments. As we know, accurate segmental resection depends on precise localization. So far, intraoperative labeling of lesions by colonoscopy is increasingly performed for achieving appropriate resection margins, but a certain deviation is also found. There is no unified and standard endoscopic polyp localization method at present.Case presentation: A 63-year-old woman was admitted because she was diagnosed as a large and broad-based colonic polyp which was unsuitable for colonoscopic polypectomy. During endoscopy-assisted laparoscopic segmental colectomy, the irradiation angle of colonoscopy light on the polyp head was responsible for the localization errors. We proposed three-step measures of correct endoscopic polyp localization to ensure the accurate resection in laparoscopic segmental colectomy.Conclusions: Three-step measures of correct endoscopic polyp localization ensured the successful resection of colonic polyps in laparoscopic colectomy. Their advantages include simplicity, practicality and reliable localization.
Alternatively Spliced ANLN Isoforms Synergistically Contribute To The Progression of Head and Neck Squamous Cell Carcinoma
Authors: Guo Erliang , Mao Xionghui , Guo Lunhua , An Changming , Zhang Cong , Song Kaibin , Wang Guohui , Duan Chunbin , Zhang Xiwei , Yang Xianguang , Yuan Zhennan , Sun Ji , Li Xiaomei , Yang Weiwei , Meng Hongxue , Miao Susheng
Published: April 2021

Background: Head and neck squamous cell carcinoma (HNSCC) is a common cancer with high mortality. Anilin actin binding protein (ANLN) has been reported to be associated with carcinogenesis in multiple tumors. However, the expression pattern and functional effects of ANLN in HNSCC remains to be unclear.Methods: Expression of two major splice variants of ANLN was assessed in HNSCC tissues and cell lines. The functional effects and related mechanisms of ANLN isoforms were investigated in HNSCC in vitro and in vivo.Results: Our results showed that the two primary isoforms of ANLN transcripts ANLN-201 and ANLN-210 were highly expressed in HNSCC tissues and cell lines. Knockout of ANLN restrained cell proliferation, migration and invasion of SCC-9 cells. Mechanically, ANLN-201 could interact with c-Myc to keep its protein stability, thereby playing a oncogenic role in HNSCC. ANLN-210 could be transferred to macrophages via exosomes by binding to RNA binding protein hnRNPC. Exosomal ANLN-210 promoted macrophage polarization via PTEN/PI3K/Akt signaling pathway, thus stimulating tumor growth of HNSCC.Conclusions: Our findings demonstrate that alternatively spliced ANLN isoforms collaboratively promote HNSCC tumorigenesis in vitro and in vivo, which might provide the in-depth role and mechanism of ANLN in HNSCC development.
Left Renal Vein Thrombus and Pulmonary Thromboembolism Caused by Nutcracker Syndrome: a Case Report
Authors: Hori Kanta , Yamamoto Shota , Kosukegawa Maki , Yamashita Noboru , Shinno Yuichiro
Published: April 2021

Background: Nutcracker syndrome (NCS) refers to compression of the left renal vein (LRV) between the aorta and superior mesenteric artery (SMA), which results in renal venous hypertension and its resultant clinical manifestations. Left renal vein thrombus (LRVT) complicating NCS is relatively rare. To the best of our knowledge, there are only four case reports of LRVT complicating NCS. Furthermore, there are no reports of pulmonary thromboembolism (PTE) caused by NCS. Herein, we describe a rare case of NCS causing LRVT and PTE and its clinical management. Case Presentation: A 40-year-old man was admitted to our hospital with acute left flank pain. Computed tomography angiography (CTA) revealed compression of the LRV between the aorta and the SMA with an LRVT. Furthermore, CTA revealed bilateral PTE. Rivaroxaban was administered as an anticoagulant. Twenty days after initiation, CTA revealed complete resolution of PTE and LRVT, and repeat CTA at 3 and 6 months showed no recurrence. Conclusions: This case report demonstrates that NSC may be a possible cause of LRVT and PTE. We review the reported cases of NCS complicated by LRVT and discuss the imaging modalities for NCS.
Impact of Recurrent Urinary Infections on the Quality of Life of Women in Outpatient Care: a Case-control Study
Authors: Lourenção Luciano Garcia , Oliveira Jacqueline Flores de , Eduardo José Carlos Carraro , Homem Giovani Machado , Faria Carlos Augusto
Published: April 2021

Background: The repetitive urinary tract infections impact women's quality of life and represent an important problem for women's physical and mental health, causing relevant social impacts. This study aimed to evaluate the impact of recurrent urinary tract infections on the quality of life of women with recurrent infections.Methods: This is a case-control study with 49 women with recurrent urinary tract infections, confirmed by urine culture, without complications and 49 women without recurrent urinary tract infections, seen at an outpatient clinic of a public teaching hospital in the city of Niterói, Rio de Janeiro, Brazil. Quality of life was evaluated using the Brazilian version of the World Health Organization's shortened questionnaire, the WHOQOL-Bref.Results: Women with urinary tract infections showed greater impairment of quality of life in the physical (p = 0.007) and psychological (p = 0.038) domains, with lower quality of life score in their self-assessment (p = 0.002), when compared to the group control. Women with recurrent urinary infection had mean scores significantly lower than the control group in the Energy and fatigue (p = 0.003), Positive feelings (p = 0.014), Self-esteem (p = 0.040), Dependence on medication (p = 0.029), Negative feelings (p = 0.023) and Recreation and leisure (p = 0, 0.041).Conclusions: Recurrent urinary tract infections have an important impact on the quality of life of women, especially in the Physical and Psychological domains, representing a significant problem for women, health professionals, and the health system.
Studying the Effect of Alpha-Synuclein and Parkinson's Disease Linked Mutants on Inter Pathway Connectivities
Authors: Sen Sagnik , Dey Ashmita , Maulik Ujjwal
Published: April 2021

Parkinson's Disease is a common neurodegenerative disease. The differential expression of alpha-synuclein within Lewy Bodies leads to this disease. Some missense mutations of alpha-synuclein may resultant in functional aberrations. In this study, our objective is to verify the functional adaptation due to early and late-onset mutation which can trigger or control the rate of alpha-synuclein aggregation. In this regard, we have proposed a computational model to study the difference and/or similarities among the Wild type alpha-synuclein and two mutations G51D and E46K which are responsible for slow and fast aggregation respectively. Evolutionary sequence space analysis is also performed in this experiment. Subsequently, a comparative study has been performed between structural information and sequence space outcomes. The study shows the structural variability among the selected subtypes. This information assists inter pathway modeling due to mutational aberrations. Based on the structural variability, we have identified the protein-protein interaction partners for each protein that helps to increase the robustness of the inter-pathway connectivity. As per the inter-pathway networks, drug addiction has clear impacts on both the mutations i.e., G51D-slow, and E46K-fast and can be considered as the reason for early-onset Parkinson’s Disease. Finally, three top pathways associated with drug addiction viz., Amphetamine addiction, alcoholism, and Cocaine addiction show the higher influence in the mutated pathway networks based on the PageRank Algorithm where Dopaminergic Synapse system is also found within the same list in terms of Parkinson’s Disease pathogenicity.
Effects of Vigorous Resistance Training On Cardiovagal Baroreflex Sensitivity: A Cross-Sectional Study
Authors: Nakamura Nobuhiro , Muraoka Isao
Published: April 2021

Background: Blunted cardiovagal baroreflex sensitivity (BRS) is correlated with elevation of central arterial stiffness and/or reduction of arterial compliance with aging. Resistance-trained who habitually perform vigorous resistance training (RT) may blunt cardiovagal BRS due to an increase in central arterial stiffness and a decrease in arterial compliance. Therefore, the purpose of this study was to examine the effect of vigorous RT on cardiovagal BRS in a cross-sectional study to compare resistance-trained with age-matched non-resistance-trained.Methods: This cross-sectional study included resistance-trained men (resistance-trained group: n = 20) and age-matched non-resistance-trained men (control group: n = 20). The β-stiffness index and arterial compliance were assessed at the right carotid artery, and the cardiovagal BRS was estimated by the slope of the R-R interval and systolic blood pressure during phase IV of the Valsalva maneuver.Results: The β-Stiffness index was significantly higher in the resistance-trained group than in the control group (4.4 ± 0.2 vs. 5.9 ± 0.3 a.u., P < 0.01). In contrast, the resistance-trained group had significantly lower arterial compliance and cardiovagal BRS than the control group (0.20 ± 0.01 vs. 0.15 ± 0.01 mm2/mmHg and 12.9 ± 1.2 vs. 9.0 ± 0.5 ms/mmHg, respectively, P < 0.01 for both measurements). Moreover, cardiovagal BRS was inversely and positively correlated with the β-stiffness index (combined: r = - 0.59, P < 0.01; control: r = - 0.56, P < 0.01; resistance-trained: r = - 0.50, P < 0.05) and arterial compliance (combined: r = 0.64; control: r = 0.61; resistance-trained: r = 0.55, all P < 0.01), respectively. Conclusion: Resistance-trained group was higher arterial stiffness and lower compliance and blunter cardiovagal BRS compared with control group. These results suggest that vigorous RT blunts cardiovagal BRS.Trial registration: University hospital Medical Information Network (UMIN) in Japan, UMIN000038116. Registered on September 27, 2019.
Prevalence and risk factors of silent obstructive sleep apnea in patients with dentofacial deformities
Authors: Jokaji Rei , Ooi Kazuhiro , Takamichi Sayuri , Nakade Yusuke , Kawashiri Shuichi , Kasahara Kazuo , Nakata Masako
Published: April 2021

Objective

Prevalence of silent obstructive sleep apnea (OSA) in patients with dentofacial deformities is unknown, although OSA is severe risk of airway obstruction in perioperative orthognathic surgery or complication after surgery. The aim of this study was to investigate prevalence and risk factors of silent OSA in patients with dentofacial deformities.
Methods

We analyzed 72 patients (24 male, 48 female) with dentofacial deformities without previous OSA symptoms. Polysomnography was performed before orthognathic surgery. Prevalence and risk factors of silent OSA were statistically analyzed as related to Apnea hypopnea index (AHI).
Results

Mean AHI was 1.6 (range: 0-12.1) /h. Three patients of 72 patients (4.1%) were diagnosed silent OSA. AHI during REM sleep phase 3.7 (0-32.3) was higher than AHI during NREM sleep phase 1.0 (0-9.7). AHI of male patients was higher than that of female. AHI was increased according to high BMI. AHI was higher in deep bite than open bite, edge to edge bite and nomal bite. AHI of mandibular asymmetry cases were higher than that of symmetry cases.
Conclusions

The prevalence of silent OSA was 4.1%. Obesity, male, deep bite, mandibular asymmetry and REM sleep phase were risk factors of silent OSA.
The Effect of Public Reporting of Acute Myocardial Infarction on the Choice of Hospital
Authors: Chae Kyunghee , Kim Mira , Jung Chai-Young , Lee Sangmin , Quan Hude , Kim Sukil
Published: April 2021

BackgroundPublic reporting of the quality of care delivered in hospitals is thought to improve patients’ choice and quality of care. When information about hospital rating is available, consumers may choose good-rated hospitals. To investigate the effect of public reporting of acute myocardial infarction (AMI) care on the people’s choice of hospitals. MethodsWe conducted a cross-sectional study using an online questionnaire. The survey questions include the awareness and usage of public reporting, and the impact of the public reporting on the choice of hospitals. The difference in responses before and after acquiring information about public reporting was compared using Wilcoxon Signed Rank test.ResultsThe final survey data set includes 740 respondents after a rigorous validity check (response rate: 66.7%). Before providing information about public reporting of AMI care, 62.8% of respondents selected ‘nearby hospitals’ as the best option for AMI patients, followed by ‘famous hospitals’ (14.4%), ‘usual hospitals’ (10.5%) and ‘hospitals with good rates’ (9.9%). However, after acquiring information about the public reporting of AMI care, 10.3% of respondents changed their original responses to ‘hospitals with good rates’. Among the factors of hospital choice that differ before and after obtaining public reporting information, 'nearby hospitals' and 'hospitals with good rates' increased, while 'usual hospitals’ and 'famous hospitals' decreased. Compared to the health-related occupation group, the non-health related occupation group showed a significant difference between 'famous hospitals', and 'hospitals with good rates' before and after obtaining information (Famous hospitals p=0.003, Hospitals with good rates p=0.002).ConclusionsThe publicly available hospital quality ratings influence people’s choice of hospital, increasing the risk of selecting a hospital with a good rating than the nearest hospital, which is recommended for AMI patients. Policy-makers need to stress the importance of choosing the nearest hospital when AMI symptoms occur, in addition to hospital ratings, in the public reporting.
An Open-source Model for Simulation and Corrective Measure Assessment of the 2021 Texas Power Outage
Authors: Wu Dongqi , Zheng Xiangtian , Xu Yixing , Olsen Daniel , Xia Bainan , Singh Chanan , Xie Le
Published: April 2021

Unprecedented winter storms that hit across Texas in February 2021 have caused at least 4.5 million customers to experience load shedding due to the wide-ranging generation capacity outage and record-breaking electricity demand.
While much remains to be investigated on what, how, and why such wide-spread power outages occurred across Texas, it is imperative for the broader research community to develop insights based on a coherent electric grid model and data set. In this paper, we collaboratively release an open-source large-scale baseline model that is synthetic but nevertheless provides a realistic representation of the actual energy grid, accompanied by open-source cross-domain data sets. Leveraging the synthetic grid model, we reproduce the blackout event and critically assess several corrective measures that could have mitigated the blackout under such extreme weather conditions. We uncover the regional disparity of load shedding. The analysis also quantifies the sensitivity of several corrective measures with respect to mitigating the power outage, as measured in energy not served (ENS). This approach and methodology are generalizable for other regions experiencing significant energy portfolio transitions.
Bacteria associated with the intestinal tract of three predators of Dactylopius opuntiae (Hemiptera: Dactylopiidae)
Authors: Martínez-Martínez Susana , Rodríguez-Leyva Esteban , Aranda-Ocampo Sergio , Santillán-Galicia Ma.Teresa , Hernández-López Antonio , Guzmán-Franco Ariel Wilbert
Published: April 2021

Insects depend on gut bacteria for many metabolic functions including detoxification. Dactylopius (Hemiptera: Dactylopiidae) species (e.g. D. opuntiae and D. coccus) produce carminic acid possibly acting as part of their immune response to predation; thus predators of Dactylopius species may require intestinal symbionts to metabolize carminic acid acquired from their prey. The average content of carminic acid in D. opuntiae and D. coccus is 3–5% and 19–25% respectively; the predators Leucopina bellula and Hyperaspis trifurcata are specialists on D. opuntiae while Laetilia coccidivora feeds on both D. opuntiae and D. coccus. We determined the diversity of bacteria associated with the gut of these predators to test the hypothesis that it would vary significantly depending on the level of prey specialism. Bacteria were isolated from the intestine of Le. bellula, L. coccidivora and H. trifurcata larvae and also adults of H. trifurcata. Bacteria were identified morphologically and by partial sequencing of the 16S rRNA gene. The greatest bacterial diversity was found in L. coccidivora and H. trifurcata adults, followed by H. trifurcata larvae. The lowest diversity was found in Le. bellula. Sequencing revealed the presence of Bacillus cereus, Enterococcus gallinarum and E. casseliflavus in L. coccidivora larvae; Enterobacter sp. in larvae of H. trifurcata; Lactococcus lactis in adults of H. trifurcate; and Staphylococcus sp. in larvae and adults of H. trifurcate. Bacillus pumilus was only found in Le. bellula. The possible role of these bacteria in the ability of predators to feed on D. opuntiae and D. coccus is discussed.
Neutrophil-to-Lymphocyte Ratio is a Prognostic Predictive Factor for Local Advanced Lower Rectal Cancer Treated with Curative Surgical Treatment after Neoadjuvant Chemoradiotherapy: A Single-Center Retrospective Cohort Study
Authors: Nakagawa Ryosuke , Ogawa Shimpei , Inoue Yuji , Ohki Takeshi , Bamba Yoshiko , Koshino Kurodo , Tani Kimitaka , Aihara Hisako , Itabashi Michio , Yamamoto Masakazu
Published: April 2021

Background: The neutrophil-to-lymphocyte ratio (NLR) correlates with relapse-free survival (RFS) and may be a predictor of recurrence in patients after curative surgery for colorectal cancer. This study aimed to analyze the long-term oncological outcomes of locally advanced lower rectal cancer treated with curative surgery after neoadjuvant chemoradiotherapy (nCRT) to examine the prognostic value of the NLR and to evaluate the fluctuation of pre- and post-CRT NLR as recurrence risk factors.Methods: Fifty-two patients who underwent curative surgery were enrolled between 2009 and 2016. A cut-off pre-CRT NLR of 3.20 was used based on receiver-operating characteristic curve analysis. The primary outcome was RFS. Factors influencing recurrence after treatment according to fluctuations between the pre- and post-CRT NLR were also analyzed.Results: Univariate analysis was performed using 17 clinicopathological factors thought to affect RFS. A significant difference was found in the pre-CRT NLR (hazard ratio [HR]: 7.626, 95% confidence interval [CI]: 2.760-21.06, p<0.0001), operation time (HR: 2.949, 95% CI: 1.137-7.646, p=0.0261), and pathological T stage (HR: 8.342, 95% CI: 2.458-28.306 p=0.0007). RFS according to the pre-CRT NLR using Kaplan–Meier analysis showed that the group with pre-CRT ≥3.20 had a lower 5-year RFS (p=0.001). A lower pre-CRT NLR resulted in a significantly higher recurrence rate, regardless of the increase or decrease in the pre- and post-CRT NLR.Conclusions: The pre-CRT NLR may be a predictor of prognosis in patients with locally advanced lower rectal cancer after nCRT.
Downregulation of LANCL1-AS1 Promotes Tumorigenesis in Lung Adenocarcinoma Via the Modulation of miR-6748a-3p/PRSS8 Axis
Authors: Nie Guangjie , Liu Jun , Liang Jiakang , Yuan Yi
Published: April 2021

Background: Lung adenocarcinoma (LUAD) is one of the deadliest types of cancer worldwide. Previous studies have reported that the expression of LANCL1-AS1 was decreased in LUAD. Hence, the current study was conducted to confirm these findings and explore the probable mechanism of action.Methods: LUAD and adjacent tissue samples were collected after the surgical procedure. For experiments in vitro, CCK-8 assay and colony formation assay were employed to explore the proliferation capacity while transwell assay was performed to explore the migration and invasion ability of LUAD cell lines. Luciferase reporter assay and RNA pull-down assay were used to confirm the interaction between LANCL1-AS1 and corresponding miRNA as well as the corresponding protein target of the miRNA predicted by online bioinformatics tools. The effect of different interventions on RNA and protein expression was confirmed by qRT-PCR and western blotting.Results: It was observed that LANCL1-AS1 was low expressed in LUAD tissues and cell lines which was also associated with decreased survival of cancer patients. Overexpression of LANCL1-AS1 in cell lines was associated with decreased viability, proliferation, migration, and invasion, and with decreased subcutaneous tumor growth in nude mice. RNA pull-down and luciferase reporter gene assays suggested that LANCL1-AS1 interacted with miR-6748a-3p and LUAD tissue samples exhibited increased expression of miR-6748a-3p. Moreover, miR-6748-3p mimics decreased the RNA and protein expression of PRSS8 in LUAD cell lines. Interestingly, LUAD tissue samples exhibited low expression of PRSS8. The effects of LANCL1-AS1 overexpression on viability, proliferation, migration, and invasion capacity of LUAD cell lines were curtailed after the miR-6748a-3p overexpression or PRSS8 silencing. Conclusion: Our results suggest that upregulation of LANCL1-AS1 can suppress tumor growth in LUAD through the modulation of miR-6748a-3p and PRSS8 dependent pathways.
A close association of freedom from pain, migraine-related functional disability, and other outcomes: Results of a post hoc analysis of randomized lasmiditan studies SAMURAI and SPARTAN
Authors: Lipton Richard B , Baygani Simin K , Tepper Stewart J , Krege John H , Vasudeva Raghavendra , Pearlman Eric M , Hauck Paula , Loo Li Shen
Published: April 2021

BackgroundWhile pain freedom at 2h is a key primary outcome for current trials for acute treatment of migraine, the relationship between the degree of head pain and other efficacy measures at 2h has rarely been explored. Following lasmiditan treatment of a migraine attack with moderate or severe head pain, we contrast those who achieve pain freedom with those who achieve mild pain but not pain freedom 2h post dosing.MethodsPatient-level data were pooled across studies and treatment arms from two Phase 3 trials comparing lasmiditan and placebo, SAMURAI and SPARTAN. This post hoc analysis assessed freedom from the most bothersome symptom (MBS), freedom from migraine-related functional disability (disability), and improved patient global impression of change (PGIC) in patients who achieved 2h pain freedom compared to those who experienced 2h mild pain. Mild pain differs from pain relief which is defined as either mild pain or pain freedom.ResultsParticipants who achieved 2h pain freedom (N = 913), in comparison with those with 2h mild pain (N = 864), were significantly more likely to experience MBS freedom (91.9% vs. 44.9%), disability freedom (87.1% and 13.4%), and improved PGIC (86.5% and 31.5%) (p < 0.001 for all combinations). In addition, more patients who were pain free experienced both 2h MBS freedom and 2h functional disability freedom (83.6%) compared to those with mild pain (10.8%; p < 0.001). The proportion of patients with pain freedom who did not achieve either MBS or disability freedom was lower (4.6%) than in patients with mild pain (52.4%). Lastly, 55.2% of patients experienced mild pain before disability freedom compared to 72.1% who experienced pain freedom and disability freedom at the same time.ConclusionsThis study demonstrated that, at 2h post treatment, patients who were pain free were more likely to achieve other outcomes including freedom from their MBS, freedom from migraine-related functional disability, and improved PGIC compared to those with mild pain, confirming that 2h pain freedom is more robustly associated with other clinical outcomes than the 2h mild pain endpoint.Trial RegistrationSAMURAI (NCT02439320); SPARTAN (NCT02605174).
The effects of virtual reality exercise on the physical performance and fatigue of active young men in single-stage aerobic and anaerobic running
Authors: naji sara , Shabkhiz Fatemeh , Rezaei Mohammad Hossein , Derakhshi Elahe , Kordi Mohammad Reza
Published: April 2021

Objective: Exercise with virtual reality (VR) is a novel approach to the promotion of health and the components of fitness. Our objective was to investigate the effects of exercise with VR on physical performance, mental fatigue, and physical fatigue in single-stage aerobic and anaerobic running.Materials and Methods: Twenty physically active, healthy, age-matched male university students executed the exercise test in aerobic and anaerobic groups in two separate sessions of VR (first-person perspective in a simulator) and non-VR (traditionally in the laboratory). The simulated environment was a graphic tunnel route. The aerobic and anaerobic groups engaged in the Bruce protocol and anaerobic speed test, respectively. Exercise test duration, blood serum lactate concentration, rating of fatigue (ROF), and heart rate were recorded at the end of both sessions.Results: Intragroup comparisons using the dependent t-test indicated that the exercise test duration significantly increased in the VR session of the anaerobic group compared to the traditional method considering the effect size (t7=0.804; P=0.804). However, the test duration remained unchanged in both sessions of the aerobic group (t9=1.373; P=0.203). Serum lactate concentration significantly decreased in the VR session compared to the non-VR session in the aerobic group (t9=4.734; P=0.001) and anaerobic group (t9=2.321; P=0.045). ROF and heart rate of the aerobic and anaerobic groups remained unchanged in both sessions.Conclusion: The findings indicated that as an alternative for improving physical performance in exercise, running with VR in an imaginative virtual environment decreased physical fatigue in a single stage of aerobic and anaerobic running.
Complete Remission of Metastatic Osteosarcoma using Combined Modality Therapy: A Retrospective Analysis of Unselected Patients in China
Authors: Xie Lu , Xu Jie , Li Xiaowei , Zhou Zuli , Zhuang Hongqing , Sun Xin , Liu Kuisheng , Liu Xingyu , Sun Kunkun , Wu Yiming , Gu Jin , Guo Wei
Published: April 2021

Background
Complete surgical remission (CSR) is the best predictor of overall survival (OS) for patients with metastatic osteosarcoma. However, metastasectomy has not been widely implemented in China in the last decade due to various factors, and instead, most physicians choose hypofractionated radiotherapy to treat pulmonary lesions. This study aimed to retrospectively evaluate the outcomes of different local treatments for pulmonary lesions and identify the best local therapy strategies for these patients.
Methods
We reviewed the clinical courses of osteosarcoma patients with pulmonary metastases who were initially treated in two sarcoma centres in Beijing, China, from June 1st, 2009, to March 26th, 2020. With a median follow-up of 32.4 (95% confidence interval (CI): 30.8, 36.1) months, a total of 127 patients with 605 pulmonary nodules, all of whom had received local therapy and firstly achieved CSR or complete radiated/metabolic remission (CRR), were included in the analysis. A total of 102 patients with 525 nodules were initially diagnosed with resectable lung metastases, while 25 patients had 80 indeterminate nodules at presentation and relapsed with pulmonary metastases within 6 months after the completion of adjuvant chemotherapy.
Results
Eighty-eight of 127 (69.3%) patients had fewer than 5 nodules at the time of local therapy, with 48 of 127 (37.8%) located in the unilateral pleura. No patient underwent thoracotomy, and 42 of 127 patients (85 nodules) received video-assisted thoracoscopic surgery (VATS). In addition, 79 of 127 patients (520 nodules) received hypofractionated stereotactic body radiotherapy (RT), such as Gamma Knife radiosurgery or CyberKnife radiosurgery. The twelve-month event-free survival (EFS) (from local therapy to progression) rate of this entire study cohort was 35.6% (95% CI: 26.8%, 44.4%), without a significant difference between the two groups (44.7% for VATS vs. 28.4% for RT, P = 0.755). Radiation-induced pneumonitis was observed in 62 of 86 (72.1%) patients, with one patient (1/86, 1.2%) in grade 4.
Conclusions
Our past data showed a similar prognosis with the use of hypofractionated radiotherapy and VATS for the treatment of pulmonary metastasis and no inferiority to thoracotomy regarding historical outcomes. Currently, high-resolution chest computed tomography (CT) provides sufficient information on nodules, and less invasive modalities can thus be considered for treatment.
Impact of Capital Flow on Economic Growth in Ethiopia: Empirical evidence from (1980-2010) using ARDL Approach
Authors: Gashu Bewket Aschale
Published: April 2021

Evidence abound that some transitioning and developing countries are attracting large inflows of foreign capital that could engender economic growth or have destabilizing effects on their economies if not well managed. This has undoubtedly aroused anxiety over its potential effects on economic growth, the competitiveness of the export and external sectors viability. The study examines the impact of capital flow on economic growth in Ethiopia as well as the causal short-run and long-run relationship among the variables, using time series data from 1980–2010. Using the ARDL Approach, the result revealed that all the variables are statistically significant; which implies that the capital flow has an impact on economic growth in both short- and long-run dynamic equilibrium models. Additionally, VAR and Innovative Accounting Techniques approach to Granger causality analysis showed that there exists bidirectional causality between gross capital flow and economic growth. Consequently, these findings suggest that policy makers should critically understand, the nature, what drives the capital flows and the impact of its sudden surge or reversal on economy. Moreover, it is also recommended that government should continue to pursue trade and foreign exchange policies that would ensure competitiveness of the export sector viability and economic growth.
Safety and Efficacy of Multi-chamber Bag Parenteral Nutrition
Authors: Islami Muna , Alsharhan Mohammad , Alfattani Areej , Alawwad Manar , Almeshari Haya
Published: April 2021

Background There is a significant degree of debate regarding the use of standardized parenteral solutions. Multi-chamber bag parenteral nutrition (MCB-PN) showed advantages over compounded PN in previous literature. Meanwhile, some literature has shown the limitations in use of MCB-PN. This study was conducted to evaluate the nutritional efficacy and safety of commercially available MCB-PN.Methods All adult hospitalized patients who have been on MCB-PN for at least seven consecutive days at King Faisal Specialist Hospital & Research Center in Riyadh from January 2015 until December 2019 were included. Laboratory parameters were evaluated before PN started, which was used as a baseline, and every seven days while on PN. Primary outcomes were the percentage of patients who achieved calculated target calories and protein and the percentage of patients who developed electrolyte abnormalities. The secondary outcome was a percentage of adverse drug reactions during the treatment period.Results Two hundred and thirty-one patients met the inclusion criteria. Among the included subjects, 101 (44%) achieved target calories; 29 (12.6%) were underweight; 40 (17.3%) were normal weight; 18 (7.8%) were overweight; and 14 (6.1%) were in obese subgroups, with p-value 0.145. Sixty-eight (29.6%) achieved the target protein dose; 26 (11.3%) were underweight; 33 (14.3%) were normal weight; five (2.2%) were overweight; and four (1.7%) were in obese subgroups, with p-value < 0.01. One hundred and ninety-one (83.4%) developed electrolyte imbalances; 39 (16.9%) were underweight; 87 (37.7%) were normal weight; 34 (14.7%) were overweight; and 34 (14.7%) were in obese subgroups, with p-value 0.085, during the treatment period. A small percentage of ADRs and metabolic abnormalities were reported during the treatment period.Conclusion Among patients receiving MCB-PN, only 44% achieved the caloric target, and 29.6% achieved the target protein dose with fewer percentages of ADRs.
Ensuring safety of electric networks
Authors: Kustov O. M.
Published: April 2021

Ensuring safety of electrical networks is based on the exclusion of severe injuries or deaths at the facilities. The paper analyzes the violation of regulatory acts, which cause severe consequences and deaths. Investigation of accidents is carried out in accordance with orders, methods, regulations and instructions of ministries and departments. Methodologically, they involve the collection, systematization, generalization, analysis, comparison of information with regulatory requirements. Violations of the operating regime causing fatal and serious accidents affect professional workers and employees of housing associations, as well as people who consume electricity for personal needs. On the basis of the division of responsibility for transmission lines from the producer to the consumer, areas of responsibility have been identified. Responsibility is regulated by civil and criminal laws. The article examines their provisions. It is necessary to develop a unified standard for the maintenance of electricity facilities and improve control measures.
Impacts of forest fires on the number of hunting fauna populations in Irkutsk region
Authors: Belykh L. I. , Sadovskaya E. A.
Published: April 2021

Using the statistical data for 2004-2018, the dynamics of forest fires and the number of hunting and fishing fauna in Irkutsk region and in one of its specially protected natural area - Olkhon district as part of the Baikal national Park were studied. Against the background of the positive dynamics of forest fire indicators, the dependence of the number of animals on their family, species and fires in adjacent areas and the region as a whole was established. The linear correlations confirmed the positive impact of fires on the population of deer (Cervidae), canids (Canidae), cats (Felidae), bears (Ursidae) and pheasants (Phasianidae), determined by the migration of animals from mountainous areas. The unstable and negative population dynamics was revealed for the Kunya family (Mustelidae).
Incorporation mechanism of structurally bound gold in pyrite: Insights from an integrated chemical and atomic-scale microstructural study
Authors: Meng Lei , Zhu Sanyuan , Li Xiaochun , Chen Wei Terry , Xian Haiyang , Gao Xinyu , Zhao Taiping
Published: April 2021

Pyrite is one of the most important carriers for Au in hydrothermal deposits, but the incorporation mechanism of structurally bound Au has long been a matter of debate. This is due to a poor understanding of the chemical state and coordination environments of Au in the pyrite structure. Arsenian pyrite is the dominant Au-hosting mineral from the Shanggong Au deposit (130 t Au) in the southern margin of the North China Craton. Our EPMA and LA-ICP-MS results show that the arsenian pyrite has remarkably high Au (0.05–0.78 wt%) and As (0.39–4.60 wt%) contents. Au is negatively correlated with Fe but positively correlated with As. Z-contrast HAADF-STEM imaging reveals that Au atoms sit at the Fe atom sites in the arsenian pyrite structure. Our μ-XANES results and previously reported data suggest that Au and As in arsenian pyrite are predominant of chemically bound Au+ and As–, respectively. We thus propose that Au+ and As– are both structurally bound and sit at the Fe and S atom sites of pyrite, respectively. As may not be necessary but favorable for the incorporation of structurally bound Au in pyrite. These results have significant implications for understanding the enrichment mechanism of Au from ore-forming fluids with low-Au and low-As concentrations into arsenian pyrite and for revealing the role of As in Au mineralization of hydrothermal deposits.
Coupled hydrogen and fluorine incorporation in garnet: New constraints from FTIR, ERDA, SIMS, and EPMA
Authors: Mosenfelder Jed L. , von der Handt Anette , Withers Anthony C. , Bureau Hélène , Raepsaet Caroline , Rossman George R.
Published: April 2021

It is well known that some garnet compositions can incorporate hydrogen and/or fluorine at levels up to several wt%. However, accurate measurement of these elements can be difficult at trace to minor concentration levels, so they are frequently ignored in routine chemical analysis. Furthermore, the mechanisms of H incorporation are still under debate, and only one mechanism for F substitution is commonly considered. We employed infrared spectroscopy (FTIR), elastic recoil detection analysis (ERDA), secondary ion mass spectrometry (SIMS), and electron probe microanalysis (EPMA) to measure H and F concentrations and constrain incorporation mechanisms in ten grossular garnets. We also present SIMS data for 11 spessartine and two andradite garnets. Three grossular garnets were measured with ERDA to obtain an infrared integral molar absorption coefficient (εi) for H2O of 13 470 L/(mol·cm2). Grossular H2O and F concentrations range from 0.017 to 0.133 wt% and 0.012 to 0.248 wt%, respectively. Correlations between 16OH and 19F and interpretation of FTIR spectra prompt us to consider various coupled substitutions of H and F for Si, which can explain some high-frequency IR absorption bands that have been attributed previously to “hydrogrossular clusters” (variably sized clusters in which 4H substitute for Si) or to inclusions of hydrous minerals. A strong correlation between 16OH and 19F in spessartine and similar high-frequency IR bands implies a similar role for H-F substitution. Coupled H-F substitution is also probably relevant to some andradite-rich garnets, rare pyrope from the Dora Maira massif, and some synthetic garnets. Improvements in analytical methods for trace to minor H and F open up more possibilities for using these elements to calculate the activities of H2O and F-species in fluids that were in equilibrium with garnet-bearing phase assemblages, as well as constraining the recycling of these elements into the mantle via study of xenoliths.
Texture, geochemistry, and geochronology of titanite and pyrite: Fingerprint of magmatic-hydrothermal fertile fluids in the Jiaodong Au province
Authors: Li Xing-Hui , Fan Hong-Rui , Zhu Ri-Xiang , Steele-MacInnis Matthew , Yang Kui-Feng , Liu Cai-Jie
Published: April 2021

The Au mineralization in the giant Jiaodong Au province is enigmatic and difficult to fit current classic mineralization models, primarily because of uncertainties as to the sources of ore-forming fluids and metals. The ca. 120 Ma Au mineralization has been previously proposed to have occurred during a magmatic lull, which would negate a magmatic-hydrothermal genetic model. However, recent drilling has revealed a buried mineralized monzonite equivalent in age to the Au mineralization in the Linglong goldfield. Here, we present comprehensive textural, geochemical [LA-(MC)-ICP-MS trace element, Nd and S isotopes] and geochronological (LA-ICP-MS U-Pb dating) analyses of titanite and pyrite from this previously unrecognized monzonite. Three types of titanite were distinguished, including magmatic Ttn1 and hydrothermal Ttn2 and Ttn3, which show indistinguishable U-Pb ages (120.7 ± 3.1 and 120.9 ± 2.6 Ma), REE patterns and Nd isotopes [εNd(t) = –14.7 to –12.9], implying that hydrothermal fluids were directly exsolved from the monzonitic magma, contemporaneous with the large-scale Au mineralization at ca. 120 Ma. The Nd isotopes of titanite potentially indicate a lower crustal source mixed with mantle materials for the monzonite. Four types of pyrite were analyzed, including magmatic Py1 from fresh biotite monzonite, hydrothermal Py2 from altered biotite monzonite, hydrothermal Py3 from quartz-pyrite veins with a monazite U-Pb age of 118.2 ± 4.6 Ma, and magmatic Py4 from mafic enclaves of the Gushan granite at ca.120 Ma. The δ34S values of magmatic Py1 and Py4 (+1.9 to +6.3‰, and +5.0 to +6.4‰, respectively) and hydrothermal Py2 and Py3 (+6.4 to +9.5‰ and +6.5 to +7.6‰, respectively) are consistent with sulfur isotopic fractionation between melt and fluid. Hydrothermal Py2 and Py3 also have higher Co, As, Ag, Sb, and Bi contents and submicrometer gold inclusions, implying that the magmatic-hydrothermal fluids were fertile for mineralization. This study highlights the importance of monzonite magmatism and exsolved fertile fluids in regional Au mineralization. Hydrous magmas at ca.120 Ma probably extracted Au efficiently from the lower crustal-mantle sources and released auriferous fluids at the late magmatic stage, leading to the formation of Au deposits in the Jiaodong province.
Políticas públicas do setor energético renovável no Estado da Paraíba (Nordeste do Brasil): limitações legislativas, entraves técnicos e perspectivas regulamentares
Authors: Duarte Junior Edvanil Albuquerque , Menezes Raimundo Aprígio de , Gonçalves Charlie Salvador , Andrade Edson Ramos de
Published: April 2021

A tendência global de buscar fontes renováveis de geração de energia elétrica como alternativa para o gradual aumento da demanda energética é latente. No Brasil não é diferente, por encontrar-se em processo de diversificação de sua matriz energética. As políticas públicas brasileiras de fomento à geração de energia renovável multimatrizes não contam com forte presença estatal, como no modelo chinês. Também não possuem foco em parcerias público-privadas, como nos modelos estadunidense e europeu. A legislação nacional apenas traça normas gerais como norte, a estados e municípios, quanto à elaboração de projetos que atendam às suas necessidades. A legislação do Estado da Paraíba, um dos estados da Região Nordeste do Brasil, falha ao instituir por meio de duas leis, uma política de fomento à utilização de energia solar e eólica, principalmente por não conceder benefícios fiscais e tributários para a energia eólica. A legislação pernambucana, em seu turno, demonstra relação direta entre objetivos normatizados e medidas necessárias à concretização dos projetos. Diante disso, o objetivo geral da pesquisa visa, a partir do modelo nacional de estímulo à geração de energia renovável, a estudar a fragilidade legislativa do Estado da Paraíba em relação à utilização das matrizes energéticas renováveis solar e eólica. A pesquisa foi realizada através do método bibliográfico, com foco em doutrina, legislação e periódicos das áreas jurídica, legislativa e energética. O principal resultado aponta para a necessidade de elaboração de projetos de leis que incorporem a geração de energia renovável à rotina diária de empresas e do cidadão, como forma de reforçar o elo entre a normatização da matéria, a demonstração da necessidade social e sua implementação, conduzindo o poder público ao atendimento dos interesses da coletividade.
BREAST TUBERCULOSIS SIMULATING MALIGNANT TUMOR: A CASE REPORT
Authors:   Department of Obstetrics and Gynecology, Military Training Hospital Mohammed V, Rabat, Morocco., Khadija Benchakroun , Saad Benali ,   Department of Obstetrics and Gynecology, Military Training Hospital Mohammed V, Rabat, Morocco., Khalid Guelzim ,   Department of Obstetrics and Gynecology, Military Training Hospital Mohammed V, Rabat, Morocco., Moulay El Mehdi El Hassani ,   Department of Obstetrics and Gynecology, Military Training Hospital Mohammed V, Rabat, Morocco.,   Mohamed Ben Abdellah University, Fes, Morocco., Abdellah Babahabib ,   Department of Obstetrics and Gynecology, Military Training Hospital Mohammed V, Rabat, Morocco.,   Mohamed Ben Abdellah University, Fes, Morocco., Jaouad Kouach ,   Department of Obstetrics and Gynecology, Military Training Hospital Mohammed V, Rabat, Morocco.,   Mohamed V University, Souissi, Rabat, Morocco.
Published: April 2021

Breast tuberculosisis an infection that affects youngwomen in theirgenitally active period. It isoftenprimary and creates issues in terms of diagnosis and treatment. Treatmentisactuallybased on antitubercularchemotherapy, ocassionallyassociated to surgery. The prognosisis favorable undertreatment. We have to mention that in case of breasttuberculosis, Histopathologicalexaminationremains the onlymean of diagnosis. Referring to the medicalliteraturewritten about the affection, wewillanalyzeitsparticularities.
A RANDOMIZED CONTROLLED TRIAL ON THE EFFICACY OF VACHADI CHOORNA IN SPEECH IMPAIRMENT IN CHILDREN UP TO 12 YEARS
Authors:   Associate Professor and HOD, Department of Kaumarbhritya, Motherhood Ayurveda Medical College and Hospital, Roorkee, Uttarakhand., Kumar Dubey Arvind , Ramachandran S.K. ,   Professor and Ex. HOD, Department of Kaumarbhritya,Government Ayurveda College, Thiruvananthapuram, Kerala.
Published: April 2021

Speech Impairment is the most common impairments presenting in early childhood (8-9%). It can make the children difficult to communicate with other people and often affects a childs quality of life. Objective: The aim of the study was to assess the efficacy of Vachadi Choorna in speech impairment in children up to 12 years. Experimental approach: The study was carried out as a Randomized Controlled Trial, with speech therapy as a control of which efficacy has been proved by earlier studies. Children with speech impairment satisfying the inclusion criteria were included in the study. The subjects were randomly distributed into the study and control groups using simple random sampling. Children in the study group received Vachadi Choorna in two divided doses for internal administration for 45 days while control group received speech therapy as per schedule fixed by Speech-Language pathologist for 45 days. Findings: The graded responses in both groups were assessed after the treatment and after follow up, clinically and also by using a scale based on Stuttering Severity Instrument for stuttering and Malayalam Articulation Test for Articulation. Discussion: Analysis of the data using the most appropriate statistical test showed that the trial drug and the speech therapy were effective in improving speech (p<0.001). Conclusion: The effect of the trial drug in improving speech was significantly greater than that of control group (p<0.05). Thus the efficacy of the drug combination applied in the trial group and its superiority over the control therapy was proved.
LARGE OVARIAN CYSTADENOMA HERNIATING THROUGH A PARA-UMBILICAL HERNIA :A CASE REPORT
Authors:   Resident, Ibn Rochd Hospital Center, Faculty of Medicine and Pharmacy, Hassan 2 University, Casablanca, Morocco., A Akarramou , C Khalloufi ,   Resident, Ibn Rochd Hospital Center, Faculty of Medicine and Pharmacy, Hassan 2 University, Casablanca, Morocco., M Mourabbih ,   Resident, Ibn Rochd Hospital Center, Faculty of Medicine and Pharmacy, Hassan 2 University, Casablanca, Morocco., S Mahdaoui ,   Professor, Ibn Rochd Hospital Center, Faculty of Medicine and Pharmacy, Hassan 2 University, Casablanca, Morocco., N Samouh ,   Chief doctor, Ibn Rochd Hospital Center, Faculty of Medicine and Pharmacy, Hassan 2 University, Casablanca, Morocco.
Published: April 2021

Introduction: Incisional hernia or eventration is a frequent complication that affects approximately 10 to 25% of the patients after a laparotomy. These hernias must be repaired because of their significant morbidity. The usual hernial content is the omentum and intestines, the incarceration of other abdominal structures, such as the genitals, is very rare. Observation: We present an unusual case of a large ovarian cystadenoma herniating through a para-umbilical hernia, resection led to full recovery. Discussion: Large para-umbilical hernias are usually irreducible and incarcerated. Omentum, small and large intestine are commonly encountered in these hernias. By reviewing the literature, we found that incarceration of other abdominal structures is quite rare. Thus the transvaginal sonography is the first-line imaging, we may usually need further investigations such as CT, MRI or even surgical exploration, to avoid any unnecessary delay. Conclusion: In conclusion, para-umbilical hernia in adults can be the site of the incarceration of any abdominal organ and urgent exploration is recommended in these cases.