bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinicopathological Characteristics of Primary Pulmonary Hodgkin Lymphoma (PPHL): Two Institutional Experiences with Comprehensive Literature Review of 115 PPHL Cases
Authors: Jung Hera , Kim Hyun-Soo , Han Joungho , Ko Young Hyeh , Choi Yoo-Duk , Lee Taebum
Published: December 2022

Primary pulmonary Hodgkin lymphoma (PPHL) is an extremely rare condition. Its clinicopathological characteristics remain unclear because of the limited number of patients with PPHL. The aim of this study was to comprehensively analyze the clinicopathological characteristics of PPHL. We reviewed the electronic medical records and pathology slides of our 10 PPHL patients. The female-to-male ratio was 6:4, and the mean age was 41 years. Although three patients had no symptoms, seven had localized or generalized symptoms, including cough, sputum, chest discomfort/pain, and weight loss. Some cases had not been diagnosed as PPHL in the initial needle biopsy. Four patients underwent surgical resection. With chemotherapy, eight patients achieved complete remission. We also conducted a thorough literature review on 105 previously reported PPHL cases. Among a total of 115 PPHL cases, the most common subtype was nodular sclerosis (37.4%). More than half of the cases (55%) were clinically suspected as infectious pneumonia. Of 61 patients whose biopsies were available, 27 (44.3%) were diagnosed correctly as Hodgkin lymphoma, whereas the misdiagnoses included tuberculosis, Langerhans cell histiocytosis, solitary fibrous tumor, and adenocarcinoma. We demonstrated that PPHL represents a diagnostic challenge on small biopsies. Recognizing that this rare tumor can mimic infectious and inflammatory diseases as well as malignancies is important because the accurate diagnosis of PPHL is essential for adequate clinical management.
Feasibility of Combining Disease-Specific and Balance-Related Measures as Risk Predictors of Future Falls in Patients with Parkinson’s Disease
Authors: Tsai Chang-Lin , Lai Yun-Ru , Lien Chia-Yi , Huang Chih-Cheng , Chiu Wen-Chan , Chen Yueh-Sheng , Yu Chiun-Chieh , Cheng Ben-Chung , Chiang Yi-Fang , Chang Hsueh-Wen , Lu Cheng-Hsien
Published: December 2022

Evidence supports the view that postural sway in a quiet stance increases with clinical disease severity and dopaminergic therapy in idiopathic Parkinson’s disease (PD), which, in turn, increases the risk of falling. This study evaluated the feasibility of combining disease-specific and balance-related measures as risk predictors for future falls in patients with PD. The patients with PD underwent postural sway measurements (area, length, and velocity traveled by the excursion of the center of pressure) and clinical functional scores (Parkinson’s Disease Rating Scale [UPDRS] and Tinetti balance and gait score assessment) in both the on- and off-states of dopaminergic therapy. The outcome was defined as the development of a new fall. The sway area, velocity, and length increased after the medication administration. The Cox proportional hazards model showed that only previous fall history, Tinetti balance and gait score (on-state), and levodopa equivalent daily dose (LEDD) were associated with the development of future falls. The cumulative risk of fall development showed that the sway length and velocity were associated with future falls after more than six months. The combined LEDD, Tinetti balance and gait score (on-state), and velocity and length of postural sway (on-state) had the highest diagnostic accuracy (area under the curve = 0.9, p < 0.0001). Dopaminergic therapy can improve clinical functional scores but worsen balance-related measures. Increased sway length and velocity during the medication state are hallmarks of future falls, particularly in advanced PD. Combining disease-specific and balance-related measures can serve as an auxiliary diagnosis as risk predictors for future falls.
The Cystic Anechoic Zone of Uterine Cavity Newly Observed during Controlled Ovarian Hyperstimulation Affects Pregnancy Outcomes of Fresh Embryo Transfer
Authors: Tian Yizheng , Zhao Shengrui , Lv Jianan , Lv Hong , Yan Lei
Published: December 2022

During controlled ovarian hyperstimulation (COH), cystic anechoic zones in the uterine cavity are occasionally visible. This retrospective matched cohort study collected information on patients who underwent in vitro fertilization/intracytoplasmic injection (IVF/ICSI) from January 2014 to December 2020 at our center. The propensity score algorithm matched 179 cases that had uterine cystic anechoic zones, with 358 which did not have uterine cystic anechoic zones cases. After matching, the live birth rate (38.0% vs. 48.6%, p = 0.025) of patients with uterine cystic anechoic zones was lower than that in the no uterine cystic anechoic zone group, while for clinical pregnancy miscarriage rate (22.2% vs. 12.4%, p = 0.031), the rate was higher. The results showed no correlation in the association between live birth rate (r = −0.027, p = 0.718), clinical pregnancy rate (r = −0.037, p = 0.620) or biochemical pregnancy rate (r = −0.015, p = 0.840) and the diameters of the cystic anechoic zones in the uterine cavity. There was a significant difference in the type of endometrium between the two groups (p < 0.001). The result of this study can provide guidance to patients on whether to undergo fresh embryo transfer in the current cycle.
Clinical Characteristics and Predictors of In-Hospital Mortality of Patients Hospitalized with COVID-19 Infection
Authors: Gromadziński Leszek , Żechowicz Maciej , Moczulska Beata , Kasprzak Michał , Grzelakowska Klaudyna , Nowek Paulina , Stępniak Dominika , Jaje-Rykowska Natalia , Kłosińska Aleksandra , Pożarowszczyk Mikołaj , Wochna Aleksandra , Kern Adam , Romaszko Jerzy , Sobacka Agata , Podhajski Przemysław , Kubica Aldona , Kryś Jacek , Piasecki Maciej , Lackowski Piotr , Jasiewicz Małgorzata , Navarese Eliano Pio , Kubica Jacek
Published: December 2022

Background: The identification of parameters that would serve as predictors of prognosis in COVID-19 patients is very important. In this study, we assessed independent factors of in-hospital mortality of COVID-19 patients during the second wave of the pandemic. Material and methods: The study group consisted of patients admitted to two hospitals and diagnosed with COVID-19 between October 2020 and May 2021. Clinical and demographic features, the presence of comorbidities, laboratory parameters, and radiological findings at admission were recorded. The relationship of these parameters with in-hospital mortality was evaluated. Results: A total of 1040 COVID-19 patients (553 men and 487 women) qualified for the study. The in-hospital mortality rate was 26% across all patients. In multiple logistic regression analysis, age ≥ 70 years with OR = 7.8 (95% CI 3.17–19.32), p < 0.001, saturation at admission without oxygen ≤ 87% with OR = 3.6 (95% CI 1.49–8.64), p = 0.004, the presence of typical COVID-19-related lung abnormalities visualized in chest computed tomography ≥40% with OR = 2.5 (95% CI 1.05–6.23), p = 0.037, and a concomitant diagnosis of coronary artery disease with OR = 3.5 (95% CI 1.38–9.10), p = 0.009 were evaluated as independent risk factors for in-hospital mortality. Conclusion: The relationship between clinical and laboratory markers, as well as the advancement of lung involvement by typical COVID-19-related abnormalities in computed tomography of the chest, and mortality is very important for the prognosis of these patients and the determination of treatment strategies during the COVID-19 pandemic.
The Bivalent COVID-19 Booster Immunization after Three Doses of Inactivated Vaccine Augments the Neutralizing Antibody Response against Circulating Omicron Sublineages
Authors: He Qiaren , Sun Shiyu , Chen Xi , Hu Zhenxiang , Zhang Yan , Peng Hua , Fu Yang-Xin , Yang Jiaming , Chen Long
Published: December 2022

A fourth dose of a COVID-19 vaccine has been recommended by a number of authorities due to waning immunity over time and the emergence of immune-escaping variants. Here, we evaluated the safety and immunogenicity of the bivalent BV-01-B5 or V-01D-351 or the prototype V-01 for heterologous boosting in three-dose inactivated COVID-19 vaccine (ICV) recipients, in comparison with ICV homologous boosting. One pilot study (NCT05583357) included 20 participants randomized at 1:1, either receiving V-01D-351 or CoronaVac. The other one (NCT05585567) recruited 36 participants randomized at 2:1, either receiving BV-01-B5 or V-01, respectively. BV-01-B5, V-01D-351, and V-01 were safe and well-tolerated as heterologous booster shots after three doses of ICV, with adverse reactions predominantly being mild and moderate in severity, similar to the safety profile of ICV boosters. The bivalent V-01D-351 and BV-01-B5 and prototype V-01 booster demonstrated remarkable cross-reactive immunogenicity against the prototype and multiple emerging variants of concern (VOCs), with the geometric mean ratio (versus CoronaVac) in particular being 31.3 (500 vs. 16), 12.0 (192 vs. 16) and 8.5 (136 vs.16) against BA.4/5 14 days after the booster, respectively. Taken together, the modified bivalent-formulation V-01 boosters induced robust neutralizing responses against multiple Omicron sublineages, better than V-01 and remarkably superior to ICV booster, without compromising the safety and tolerability.
ABO Blood Groups in Systemic Sclerosis: Distribution and Association with This Disease’s Characteristics
Authors: Collet Aurore , Zawadzki Christophe , Jeanpierre Emmanuelle , Kitel Caroline , Dubucquoi Sylvain , Hachulla Eric , Susen Sophie , Launay David
Published: December 2022

Systemic sclerosis (SSc) is an autoimmune disease associated with endothelial activation and fibrosis. Non-O blood group patients carry an increased risk of thrombosis, fibrosis and autoimmune diseases. The aim of our work was to evaluate the distribution of ABO groups in SSc patients and their association with the disease’s characteristics. ABO groups were determined in 504 SSc patients (with 131 completed by a genotypic analysis). The distribution of ABO groups and their diplotypes in SSc patients was comparable to that of the general population, except for haplotypes O1 and B (65.6% vs. 61.6% and 8.8% vs. 5.8% in SSc patients vs. the general population, respectively, p = 0.01). The frequency of interstitial lung disease, pulmonary hypertension, calcinosis, digital ulcers, digestive diseases and venous thrombosis, and the Medsger score, were higher in non-O than in O-SSc patients, although they did not display statistical significance. Patients in the non-O group had higher levels of inflammation and endothelial activation biomarkers. In conclusion, the ABO blood group distribution of SSc patients did not differ significantly from that of the general population, but non-O blood groups were associated with inflammation and endothelial activation, and with a non-significant higher frequency of pulmonary and vascular complications in SSc.
Multimodality Imaging Approach to Spontaneous Coronary Artery Dissection
Authors: Marrazzo Gemma , Palermi Stefano , Pastore Fabio , Ragni Massimo , De Luca Mariarosaria , Gambardella Michele , Quaranta Gaetano , Messalli Giancarlo , Riegler Lucia , Pergola Valeria , Manto Andrea , D’Andrea Antonello
Published: December 2022

Spontaneous Coronary Artery Dissection (SCAD) refers to the spontaneous separation of the layers of the vessel wall caused by intramural hemorrhage, with or without an intimal tear. The “typical” SCAD patient is a middle-aged woman with few traditional cardiovascular risk factors, and it’s frequently associated with pregnancy. Because of its low incidence, its pathophysiology is not fully understood. SCAD presents as an acute coronary syndrome, with chest pain, dyspnea, syncope, or heartbeat, even if diagnosis and clinical handling are different: coronary angiography is currently the main tool to diagnose SCAD; however, in doubtful cases, the use of both invasive and noninvasive cardiovascular imaging methods such as intravascular ultrasound or optical coherence tomography may be necessary. This paper aims to review the current state of knowledge on SCAD to address its demographic features, clinical characteristics, management, and outcomes, focusing on diagnostic algorithms and main multimodality imaging techniques.
Large Paraumbilical Vein Shunts Increase the Risk of Overt Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt Placement
Authors: Tang Hao-Huan , Zhang Zi-Chen , Zhao Zi-Le , Zhong Bin-Yan , Fan Chen , Zhu Xiao-Li , Wang Wei-Dong
Published: December 2022

Background: This study aimed to evaluate whether a large paraumbilical vein (L-PUV) was independently associated with the occurrence of overt hepatic encephalopathy (OHE) after the implantation of a transjugular intrahepatic portosystemic shunt (TIPS). Methods: This bi-center retrospective study included patients with cirrhotic variceal bleeding treated with a TIPS between December 2015 and June 2021. An L-PUV was defined in line with the following criteria: cross-sectional areas > 83 square millimeters, diameter ≥ 8 mm, or greater than half of the diameter of the main portal vein. The primary outcome was the 2-year OHE rate, and secondary outcomes included the 2-year mortality, all-cause rebleeding rate, and shunt dysfunction rate. Results: After 1:2 propensity score matching, a total of 27 patients with an L-PUV and 54 patients without any SPSS (control group) were included. Patients with an L-PUV had significantly higher 2-year OHE rates compared with the control group (51.9% vs. 25.9%, HR = 2.301, 95%CI 1.094–4.839, p = 0.028) and similar rates of 2-year mortality (14.8% vs. 11.1%, HR = 1.497, 95%CI 0.422–5.314, p = 0.532), as well as variceal rebleeding (11.1% vs. 13.0%, HR = 0.860, 95%CI 0.222–3.327, p = 0.827). Liver function parameters were similar in both groups during the follow-up, with a tendency toward higher shunt patency in the L-PUV group (p = 0.067). Multivariate analysis indicated that having an L-PUV (HR = 2.127, 95%CI 1.050–4.682, p = 0.037) was the only independent risk factor for the incidence of 2-year OHE. Conclusions: Having an L-PUV was associated with an increased risk of OHE after a TIPS. Prophylaxis management should be considered during clinical management.
Not Just a One-Way: Mahaim Accessory Pathway Concomitantly Supporting Orthodromic Atrioventricular Re-Entrant Tachycardia
Authors: Deaconu Alexandru , Gondos Viviana , Vatasescu Radu
Published: December 2022

Introduction: We report the case of a 41-year-old female with documented narrow QRS tachycardia. During electrophysiological study, both orthodromic and antidromic atrioventricular reentry tachycardia (AVRT) were demonstrated as well as short episodes of pre-excited atrial fibrillation. Programmed atrial stimulation resulted in decremental anterograde conduction on the AP, thus confirming an unexpected Mahaim accessory pathway (AP) diagnosis. Discussion: Limited 3D activation maps of the right atrium during orthoAVRT, respectively, and the right ventricle (RV) during antiAVRT were constructed and helped accurately describe the atrial and ventricular insertion points, which were superposed on the tricuspid ring, confirming the existence of a single short atrio-ventricular right free wall AP. Short atrioventricular APs with anterograde Mahaim-type conduction concomitantly sustaining orthodromic AVRT are extremely rare. Conclusions: Electroanatomical 3D mapping may help both to clarify the diagnosis and increase the success rate by accurately describing the insertion points of complex accessory pathways.
Effect of Age on Heart Rate Variability in Patients with Mitral Valve Prolapse: An Observational Study
Authors: Huang Jau-Kang , Huang Shiang-Yun , Lee Chih-hsien , Yang Ing-Fang , Yang Ten-Fang , Wang Yun-Ming
Published: December 2022

Age is an important determinant of heart rate variability (HRV) in healthy individuals. The incidence of arrhythmia is high in patients with mitral valve prolapse (MVP). However, the correlation of HRV in patients with MVP in different age groups is not well established. We presumed that increasing age would be prospectively associated with declining HRV measurement in MVP. Sixty patients with MVP and 120 control individuals were included and underwent 24 h HRV analysis. No significant difference was found in all parameters calculated in the time domain or in the frequency domain between the two groups. However, as patients’ age increased, a significant time domain (SDNN, RMSSD, NN50, and pNN50) decline was found in the MVP group, but not in the control group. This suggests that patients with MVP may have autonomic nervous system involvement that increases the risk of arrhythmia and heart disease with increasing age.
Patient Factors Impacting Perioperative Outcomes for T1b-T2 Localized Renal Cell Carcinoma May Guide Decision for Partial versus Radical Nephrectomy
Authors: Shah Yash , Simhal Rishabh , Wang Kerith , Goldberg Hanan , Lallas Costas , Chandrasekar Thenappan
Published: December 2022

There remains debate surrounding partial (PN) versus radical nephrectomy (RN) for T1b-T2 renal cell carcinoma (RCC). PN offers nephron-sparing benefits but involves increased perioperative complications. RN putatively maximizes oncologic benefit with complex tumors. We analyzed newly available nephrectomy-specific NSQIP data to elucidate predictors of perioperative outcomes in localized T1b-T2 RCC. We identified 2094 patients undergoing nephrectomy between 2019–2020. Captured variables include surgical procedure and approach, staging, comorbidities, prophylaxis, peri-operative complications, reoperations, and readmissions. 816 patients received PN while 1278 received RN. Reoperation rates were comparable; however, PN patients more commonly experienced 30-day readmissions (7.0% vs. 4.7%, p = 0.026), bleeds (9.19% vs. 5.56%, p = 0.001), renal failure requiring dialysis (1.23% vs. 0.31%, p = 0.013) and urine leak or fistulae (1.10% vs. 0.31%, p = 0.025). Infectious, pulmonary, cardiac, and venothromboembolic event rates were comparable. Robotic surgery reduced occurrence of various complications, readmissions, and reoperations. PN remained predictive of all four complications upon multivariable adjustment. Several comorbidities were predictive of complications including bleeds and readmissions. This population-based cohort explicates perioperative outcomes following nephrectomy for pT1b-T2 RCC. Significant associations between PN, patient-specific factors, and complications were identified. Risk stratification may inform management to improve post-operative quality of life (QOL) and RCC outcomes.
A Prospective Randomized Trial of Ropivacaine 5 mg with Sufentanil 2.5 μg as a Test Dose for Detecting Epidural and Intrathecal Injection in Obstetric Patients
Authors: Li Yue , Li Yannan , Yang Chen , Huang Shaoqiang
Published: December 2022

Objectives: Traditional epidural test dose is somewhat unsuited in obstetrics because of potential risk of severe adverse effects when it is accidentally injected into the subarachnoid space. Some hospitals use a proportion of the total dose of epidural labor analgesia as a test dose. The aim of our study was to assess the effectiveness and safety of ropivacaine 5 mg with sufentanil 2.5 μg to detect intrathecal injection. Methods: This prospective randomized study enrolled parturients who had the demand for epidural labor analgesia and randomly divided them into two groups. Then, 5 mL of 0.1% ropivacaine with sufentanil 2.5 μg was injected into the epidural space or the subarachnoid space in the epidural (EP) group and the intrathecal (IT) group, respectively. The ability to detect intrathecal injection and side effects were assessed to work out the effectiveness and safety. Results: For spinal injection, the sensitivity and the specificity of the symptoms of either warmth or numbness or both assessed at 3 min were both 100%, and the observed negative predictive value (NPV) and positive predictive value (PPV) were 100%. All parturients in the IT group and 2.33% of parturients in the EP group had sensory blockade to cold or pinprick (p < 0.0001). A total of 77.55% (38 of 49) of parturients in the IT group were found to have a motor block. A 10 min assessment showed the median cephalad cold and pin levels were T8 and T10, respectively, and the median Bromage score was 4 in the IT group. Incidences of adverse effects in both groups were low. Conclusions: Ropivacaine 5 mg with sufentanil 2.5 μg is effective and safe to detect intrathecal injection as an epidural test dose in obstetric patients.
Interaction between Micro-Amplitude Vibration and Thrust Force in Ultrasonic-Vibration-Assisted Drilling of Glass-Fiber-Reinforced Plastics
Authors: Xiao Xingzhi
Published: December 2022

This research intends to investigate the effect and potential of the ultrasonic vibration of tools for drilling glass-fiber-reinforced plastics (GFRPs), especially with the aim of minimizing the thrust force. As an important parameter to characterize the vibration intensity, the vibration amplitude has a significant effect on the thrust force in the ultrasonic-vibration-assisted drilling (UVD) of GFRPs. It has been observed that the thrust force also influences the vibration amplitude, which may eventually result in a failure of the vibration. In this study, a method for the in-process measurement of the vibration amplitude was introduced to enable the investigation of the interaction between the thrust force and vibration amplitude in UVD. It was investigated how variations of the thrust force and vibration amplitude influence each other from holistic and individual perspectives. The critical condition was identified to ensure a sufficient ultrasonic vibration effect during drilling. Additionally, UVD experiments with different vibration amplitudes were carried out. The interaction between thrust force and vibration amplitude in UVD was revealed. It can be concluded that the combination of a moderate thrust force, low vibration amplitude reduction ratio, and high vibration amplitude increases the thrust force reduction ratio and secondly that an excessive thrust force undermines the effect of ultrasonic vibration. This provides an in-depth understanding of the interaction between vibration and thrust force in UVD, and helps to further improve the effect of ultrasonic vibration.
A Parallax Image Mosaic Method for Low Altitude Aerial Photography with Artifact and Distortion Suppression
Authors: Xu Jing , Zhao Dandan , Ren Zhengwei , Fu Feiran , Sun Yuxin , Fang Ming
Published: December 2022

In this paper, we propose an aerial images stitching method based on an as-projective-as-possible (APAP) algorithm, aiming at the problem artifacts, distortions, or stitching failure due to fewer feature points for multispectral aerial image with certain parallax. Our method incorporates accelerated nonlinear diffusion algorithm (AKAZE) into APAP algorithm. First, we use the fast and stable AKAZE to extract the feature points of aerial images, and then, based on the registration model of the APAP algorithm, we add line protection constraints, global similarity constraints, and local similarity constraints to protect the image structure information, to produce a panorama. Experimental results on several datasets demonstrate that proposed method is effective when dealing with multispectral aerial images. Our method can suppress artifacts, distortions, and reduce incomplete splicing. Compared with state-of-the-art image stitching methods, including APAP and adaptive as-natural-as-possible image stitching (AANAP), and two of the most popular UAV image stitching tools, Pix4D and OpenDroneMap (ODM), our method achieves them both quantitatively and qualitatively.
Inferring Cognitive Abilities from Response Times to Web-Administered Survey Items in a Population-Representative Sample
Authors: Junghaenel Doerte U. , Schneider Stefan , Orriens Bart , Jin Haomiao , Lee Pey-Jiuan , Kapteyn Arie , Meijer Erik , Zelinski Elizabeth , Hernandez Raymond , Stone Arthur A.
Published: December 2022

Monitoring of cognitive abilities in large-scale survey research is receiving increasing attention. Conventional cognitive testing, however, is often impractical on a population level highlighting the need for alternative means of cognitive assessment. We evaluated whether response times (RTs) to online survey items could be useful to infer cognitive abilities. We analyzed >5 million survey item RTs from >6000 individuals administered over 6.5 years in an internet panel together with cognitive tests (numerical reasoning, verbal reasoning, task switching/inhibitory control). We derived measures of mean RT and intraindividual RT variability from a multilevel location-scale model as well as an expanded version that separated intraindividual RT variability into systematic RT adjustments (variation of RTs with item time intensities) and residual intraindividual RT variability (residual error in RTs). RT measures from the location-scale model showed weak associations with cognitive test scores. However, RT measures from the expanded model explained 22–26% of the variance in cognitive scores and had prospective associations with cognitive assessments over lag-periods of at least 6.5 years (mean RTs), 4.5 years (systematic RT adjustments) and 1 year (residual RT variability). Our findings suggest that RTs in online surveys may be useful for gaining information about cognitive abilities in large-scale survey research.
CCALK: (When) CVA6 Cache Associativity Leaks the Key
Authors: Martinoli Valentin , Tourneur Elouan , Teglia Yannick , Leveugle Régis
Published: December 2022

In this work, we study an end-to-end implementation of a Prime + Probe covert channel on the CVA6 RISC-V processor implemented on a FPGA target and running a Linux OS. We develop the building blocks of the covert channel and provide a detailed view of its behavior and effectiveness. We propose a realistic scenario for extracting information of an AES-128 encryption algorithm implementation. Throughout this work, we discuss the challenges brought by the presence of a running OS while carrying out a micro architectural covert channel. This includes the effects of having other running processes, unwanted cache evictions and the OS’ timing behavior. We also propose an analysis of the relationship between the data cache’s characteristics and the developed covert channel’s capacity to extract information. According to the results of our experimentations, we present guidelines on how to build and configure a micro architectural covert channel resilient cache in a mono-core mono-thread scenario.
Nucleic Acid-Based Detection of Pythium insidiosum: A Systematic Review
Authors: Sridapan Thanawat , Krajaejun Theerapong
Published: December 2022

Pythiosis, a life-threatening infectious condition caused by Pythium insidiosum, has been increasingly reported in humans and animals worldwide. Antifungal drugs usually fail to control the pathogen. The surgical removal of an infected organ is the treatment of choice. Many affected patients die due to advanced infection. A timely and accurate diagnosis could lead to a better prognosis in pythiosis patients and save their lives. Although a standard culture method is available in microbiological laboratories, it is time-consuming, laborious, and insensitive for P. insidiosum identification. Immunological assays have been developed to improve the diagnosis of pythiosis. However, immunological methods are commercially unavailable and primarily detect anti-P. insidiosum antibodies, which constitute indirect evidence of pythiosis, making it challenging to differentiate a past from a recent infection. Moreover, such immunological tests cannot diagnose patients with a local infection, such as in the eye. Nucleic acid-based tests (NATs) are efficient for the direct and rapid detection of P. insidiosum DNA in trace-amount or culture-negative specimens. The reagents and equipment required for NATs are usually available in molecular diagnostic laboratories. Herein, we provide a systematic review to comprehensively present the principal and clinical usages, advantages, and limitations of such NATs in the detection of P. insidiosum. Various NATs have been established to detect P. insidiosum, which can be classified into amplification-based (i.e., PCR assays, isothermal tests, and next-generation sequencing methods) and non-amplification-based (i.e., DNA hybridization) techniques. This concise review on NATs constitutes an up-to-date reference with which healthcare professionals can learn about and decide upon which detection method is suitable for their respective laboratory environments.
Comparative Effectiveness of Filamentous Fungi in Biocontrol of Meloidogyne javanica and Activated Defense Mechanisms on Tomato
Authors: Hajji-Hedfi Lobna , Hlaoua Wassila , Al-Judaibi Awatif A. , Rhouma Abdelhak , Horrigue-Raouani Najet , Abdel-Azeem Ahmed M.
Published: December 2022

The nematicidal potential of five filamentous fungi as biological control agents (BCAs) against the root-knot nematode (RKN), Meloidogyne javanica, infecting tomato was assessed in vitro and in pot experiments. The five promising native taxa, namely Trichoderma longibrachiatum, T. harzainum, T. asperellum, Lecanicillium spp., and Metacordyceps chlamydosporia, were selected to compare their effectiveness against both chemical (Mocap, 10% ethoprophos) and biological (abamectin) nematicides on M. javanica reproduction indices and plant growth parameters. The stimulation of defense mechanisms was assessed by monitoring changes in the enzymatic activities of the polyphenol oxidase (PPO), peroxidase (POD), ascorbate peroxidase (APX), catalase (CAT), lipid peroxidation (MDA), phenols, and proteins content of tomato roots. The laboratory assays revealed that T. longibrachiatum, M. chlamydoporia, and Lecanicillium spp. seemed to be the most effective under laboratory conditions, with more than 60% of juvenile mortality. The egg infection rate was above 62%, and the egg hatching rate was below 32%. The direct parasitism by the five taxa was confirmed by scanning electron microscope observation. The results of this study found a similar parasitism mechanism for T. longibrachiatum, T. harzianum, and M. chlamydosporia, where their hyphae and spores adhered to the M. javanica juveniles cuticle layer and formed trapping rings around them. The pot experiment results showed that T. harzianum and Lecanicillium spp. enhanced the plant growth parameters. Trichoderma longibrachiatum, abamectin, and the ethoprophos-based nematicides effectively decreased the reproduction rates of the nematode. The Trichoderma species and M. chlamydosporia significantly reduced the gall index and female fecundity of RKN. The treatment with BCAs and chemical nematicides involved a significant increase in the antioxidant activities of nematode-infected plants. The ethoprophos and fungal treatments decreased the MDA and total phenols content compared with the nematode-infested seedlings. This paper analyzes the advancements made towards the effective and efficient biocontrol of M. javanica using different fungal taxa, especially T. longibrachiatum and M. chlamydosporia, and the implications of these advancements for sustainable agriculture and food security.
Colorectal Liver Metastases: A Literature Review of Viable Surgical Options with a Special Focus on Microwave Liver Thermal Ablation and Mini-Invasive Approach
Authors: Finotti Michele , D’Amico Francesco Enrico , Romano Maurizio , Brizzolari Marco , Scopelliti Michele , Zanus Giacomo
Published: December 2022

Colorectal cancer (CRC) is the third most common tumor worldwide and it is characterized in 20–30% of cases by liver involvement, which strongly affects the long-term patient outcome. There are many available therapies for liver colorectal metastases (CRLMs); the current standard of care is represented by liver resection, and when feasible, associated with systemic chemotherapy. Microwave thermal ablation (MWA) is a viable option in unresectable patients or to achieve treatment with a parenchymal spearing approach. A literature review was performed for studies published between January 2000 and July 2022 through a database search using PUBMED/Medline and the Cochrane Collaboration Library with the following MeSH search terms and keywords: microwave, ablation, liver metastases, colorectal neoplasm, and colon liver rectal metastases. The recurrence rate and overall patients’ survival were evaluated, showing that laparoscopic MWA is safe and effective to treat CRLMs when resection is not feasible, or a major hepatectomy in fragile patients is necessary. Considering the low morbidity of this procedure, it is a viable option to treat patients with recurrent diseases in the era of effective chemotherapy and multimodal treatments.
The Association between Electroencephalography with Auditory Steady-State Response and Postoperative Delirium
Authors: Arai Naohiro , Miyazaki Takahiro , Nakajima Shinichiro , Okamoto Shun , Moriyama Sotaro , Niinomi Kanta , Takayama Kousuke , Kato Jungo , Nakamura Itta , Hirano Yoji , Kitago Minoru , Kitagawa Yuko , Takahashi Tatsuo , Shimizu Hideyuki , Mimura Masaru , Noda Yoshihiro
Published: December 2022

Delirium is a disorder of consciousness and a risk factor for cognitive dysfunction and poor prognosis. We hypothesized that preoperative gamma activities would be linked to postoperative delirium. We enrolled 71 subjects for elective surgery and recorded auditory steady-state response (ASSR) by electroencephalography (EEG) before the surgery and examined postoperative delirium with DSM-5. The EEG data were analyzed for baseline power, and ASSR evoked power (EP) and phase-locking factor (PLF) within the gamma range. Postoperative delirium was found in 18 patients (delirium group) but not in 53 patients (non-delirium group). There were no significant differences in the 40-Hz EP or PLF between the two groups. The baseline gamma activity negatively correlated with the 40-Hz PLF in the non-delirium group (ρ = −0.444, p < 0.01). The correlation between baseline gamma activity and 40-Hz EP was not significant in either the delirium or non-delirium group. In all patients, both preoperative PLF and EP had no significant correlations with the Delirium Rating Scale Revised-98 and the Memorial Delirium Assessment Measure at the post-operation, respectively. The disruption of the neurophysiological relationship between baseline gamma activity before sound stimuli and the PLF of the 40-Hz ASSR may be one of the potential neurophysiological indicators associated with postoperative delirium.
Urine-Based Detection of Biomarkers Indicative of Chronic Kidney Disease in a Patient Cohort from Ghana
Authors: Wruck Wasco , Boima Vincent , Erichsen Lars , Thimm Chantelle , Koranteng Theresa , Kwakyi Edward , Antwi Sampson , Adu Dwomoa , Adjaye James
Published: December 2022

Chronic kidney disease (CKD) is a global health burden with a continuously increasing prevalence associated with an increasing incidence of diabetes and hypertension in aging populations. CKD is characterized by low glomerular filtration rate (GFR) and other renal impairments including proteinuria, thus implying that multiple factors may contribute to the etiology this disease. While there are indications of ethnic differences, it is hard to disentangle these from confounding social factors. Usually, CKD is detected in later stages of the disease when irreversible renal damage has already occurred, thus suggesting a need for early non-invasive diagnostic markers. In this study, we explored the urine secretome of a CKD patient cohort from Ghana with 40 gender-matched patients and 40 gender-matched healthy controls employing a kidney injury and a more general cytokine assay. We identified panels of kidney-specific cytokine markers, which were also gender-specific, and a panel of gender-independent cytokine markers. The gender-specific markers are IL10 and MME for male and CLU, RETN, AGER, EGFR and VEGFA for female. The gender-independent cytokine markers were APOA1, ANGPT2, C5, CFD, GH1, ICAM1, IGFBP2, IL8, KLK4, MMP9 and SPP1 (up-regulated) and FLT3LG, CSF1, PDGFA, RETN and VEGFA (down-regulated). APOA1—the major component of HDL particles—was up-regulated in Ghanaian CKD patients and its co-occurrence with APOL1 in a subpopulation of HDL particles may point to specific CKD-predisposing APOL1 haplotypes in patients of African descent—this, however, needs further investigation. The identified panels, though preliminary, lay down the foundation for the development of robust CKD-diagnostic assays.
Higher Prevalence of Chronic Endometritis in Women with Cesarean Scar Defect: A Retrospective Study Using Propensity Score Matching
Authors: Wei Longlong , Xu Chunyu , Zhao Yan , Zhang Cuilian
Published: December 2022

(1) Background: A cesarean scar defect may cause localized inflammation of the endometrial tissue, and various researchers believe that the presence of a cesarean scar defect is associated with chronic endometritis. However, there is no report on the possible association between cesarean scar defects and chronic endometritis thus far. This study aimed to assess the role of having a cesarean scar defect in a person’s susceptibility to chronic endometritis. (2) Methods: This retrospective propensity-score-matched study comprised 1411 patients with chronic endometritis that were admitted to Henan Provincial People’s Hospital in China from 2020 to 2022. Based on whether a cesarean scar defect was present or not, all cases were assigned to the cesarean scar defect group or the control group. (3) Results: Of the 1411 patients, 331 patients with a cesarean scar defect were matched to 170 controls. All unbalanced covariates between groups were balanced after matching. Before matching, the prevalence of chronic endometritis in the cesarean scar defect group and in the control group was 28.8% and 19.6%, respectively. After correcting for all confounding factors, a logistic regression analysis showed that cesarean scar defect occurrence may increase the risk of chronic endometritis (odds ratio (OR), 1.766; 95% confidence interval (CI), 1.217–2.563; p = 0.003). After matching, the prevalence of chronic endometritis was 28.8% in the cesarean scar defect group and 20.5% in the control group. Thus, even after correcting for all confounding factors, the logistic regression analysis still showed that a cesarean scar defect remained an independent risk factor for chronic endometritis prevalence (OR, 1.571; 95% CI, 1.021–2.418; p = 0.040). The findings were consistent throughout the sensitivity analyses. (4) Conclusions: The present results suggest that the onset of a cesarean scar defect may increase the risk of chronic endometritis.
Acute Antibody-Mediated Rejection in Liver Transplant Recipients with Autoimmune Liver Disease: A Clinical and Pathologic Study of 4 Cases
Authors: Jiang Hongmei , Guo Hui , Yang Bo , Zhao Yuanyuan , Wei Lai , Chen Zhishui , Chen Dong
Published: December 2022

Background: Acute antibody-mediated rejection (AMR) is an uncommon complication after ABO-compatible liver transplantation (LT). This case series investigated the clinicopathologic characteristics and outcomes of acute AMR in LT recipients with autoimmune liver disease (ALD). Patients and Methods: Among 809 patients who underwent LT from January 2014 to December 2020, four ALD patients developed AMR, which was confirmed based on clinical features, histopathology of liver biopsy, donor-specific antibodies (DSA) or panel reactive antibody (PRA) level. Therapies were individualized based on clinical manifestations. Results: The incidence of acute AMR was 0.49%, and the incidence of acute AMR with ALD and non-ALD recipients was 11.1% and 0%, respectively. Three patients had strongly positive HLA class II DSA, and one patient was with the PRA class I and II sensitivities, which were >80%; complement component 4d (C4d) staining was negative in all patients. The first patient underwent re-LT, and the other three patients had good prognoses with treatments. Conclusions: ALD patients are prone to acute AMR after LT, thus should be kept vigilant against the occurrence of acute AMR.
Comprehensive Analysis of Necroptosis-Related Genes as Prognostic Factors and Immunological Biomarkers in Breast Cancer
Authors: Xu Yingkun , Wu Qiulin , Tang Zhenrong , Tan Zhaofu , Pu Dongyao , Tan Wenhao , Zhang Wenjie , Liu Shengchun
Published: December 2022

Breast cancer (BC) is a lethal malignancy with a poor prognosis. Necroptosis is critical in the progression of cancer. However, the expression of genes involved in necroptosis in BC and their association with prognosis remain unclear. We investigated the predictive potential of necroptosis-related genes in BC samples from the TCGA dataset. We used LASSO regression to build a risk model consisting of twelve necroptosis-related genes in BC. Using the necroptosis-related risk model, we were able to successfully classify BC patients into high- and low-risk groups with significant prognostic differences (p = 4.872 × 10 −7). Additionally, we developed a matched nomogram predicting 5, 7, and 10-year overall survival in BC patients based on this necroptosis-related risk model. Our next step was to perform multiple GSEA analyses to explore the biological pathways through which these necroptosis-related risk genes influence cancer progression. For these twelve risk model genes, we analyzed CNV, SNV, OS, methylation, immune cell infiltration, and drug sensitivity in pan-cancer. In addition, immunohistochemical data from the THPA database were used to validate the protein expression of these risk model genes in BC. Taken together, we believe that necroptosis-related genes are considered potential therapeutic targets in BC and should be further investigated.
The Short-Term Efficacy of Large-Focused and Controlled-Unfocused (Radial) Extracorporeal Shock Wave Therapies in the Treatment of Hip Osteoarthritis
Authors: Şah Volkan
Published: December 2022

Although the classical treatments listed in the guidelines for osteoarthritis are widely used, the majority of patients do not fully recover from their pain. It is a fact that new treatment methods are needed both to relieve pain and restore deteriorated joint function. No study has been found to date that evaluated the efficacy of ESWT in hip OA. This pilot trial is the first in the literature to investigate the comparative effects of the two ESWT types (f-ESWT and r-ESWT) in the treatment of hip OA. Briefly, 148 patients were randomly distributed into the three ESWT groups: focused (f-ESWT), radial (r-ESWT), and sham (s-ESWT). Patients were assessed with the Visual Analog Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores just before the treatment (0 week), just after the treatment (4th week), and 1 month after completion of the treatment (8th week). VAS and all WOMAC scores were significantly reduced at follow-up points (4th and 8th weeks) in both the f-ESWT and r-ESWT groups compared with baseline (0 week) (for all, p < 0.001). Statistical comparisons between the f-ESWT and r-ESWT groups showed that f-ESWT was superior to r-ESWT for the decrease in VAS and WOMAC scores from baseline to the 4th and 8th weeks (p < 0.001 or p < 0.002). Both r-ESWT and f-ESWT were found to have significant treatment efficacy compared with s-ESWT. However, f-ESWT produced a superior improvement in follow-up parameters compared to r-ESWT.
Bone Metastasis in Bladder Cancer
Authors: Yi Lei , Ai Kai , Li Xurui , Li Zhihong , Li Yuan
Published: December 2022

Bladder cancer (BCa) is the 10th most common and 13th most deadly malignancy worldwide. About 5% of BCa patients present initially with metastatic disease, with bone being the most diagnosed site for distant metastasis. The overall one-year survival of patients with BCa is 84%, whereas it is only 21% in patients with bone metastasis (BM). Metastasis of BCa cells to bone occurs by epithelial-to-mesenchymal transition, angiogenesis, intravasation, extravasation, and interactions with the bone microenvironment. However, the mechanism of BCa metastasis to the bone is not completely understood; it needs a further preclinical model to completely explain the process. As different imaging mechanisms, PET-CT cannot replace a radionuclide bone scan or an MRI for diagnosing BM. The management of BCa patients with BM includes chemotherapy, immunotherapy, targeted therapy, antibody-drug conjugates, bisphosphonates, denosumab, radioisotopes, and surgery. The objective of these treatments is to inhibit disease progression, improve overall survival, reduce skeletal-related events, relieve pain, and improve the quality of life of patients.
GameStop or Game Just Started? Leveling the Playing Field for Social Media Meme Investors to Rebuild the Public’s Trust
Authors: Yang Zi
Published: December 2022

Against the GameStop frenzy in 2021, this article defines meme investors as a new group of investors in financial markets while demonstrating meme investors’ regulatory and social implications. By comparing meme investors with traditional investors under the MiFID II regime, this article finds that meme investors are significantly less wealthy than traditional investors, trade via digital trading platforms, and rely on social media information for investment decision making. This article argues that the emergence of meme investors is an expression of the public’s desire for financial inclusion and their frustration with traditional financial institutions. Therefore, properly engaging with meme investors is crucial for rebuilding the public’s trust towards regulators. After illustrating meme investors’ exposure to default risks, legal uncertainty, and online misinformation, this article calls for regulators to engage with social media meme investors and improve financial literacy among the public.
Evaluating Edge Computing and Compression for Remote Cuff-Less Blood Pressure Monitoring
Authors: Goossens Ward , Mustefa Dino , Scholle Detlef , Fotouhi Hossein , Denil Joachim
Published: December 2022

Remote health monitoring systems play an important role in the healthcare sector. Edge computing is a key enabler for realizing these systems, where it is required to collect big data while providing real-time guarantees. In this study, we focus on remote cuff-less blood pressure (BP) monitoring through electrocardiogram (ECG) as a case study to evaluate the benefits of edge computing and compression. First, we investigate the state-of-the-art algorithms for BP estimation and ECG compression. Second, we develop a system to measure the ECG, estimate the BP, and store the results in the cloud with three different configurations: (i) estimation in the edge, (ii) estimation in the cloud, and (iii) estimation in the cloud with compressed transmission. Third, we evaluate the three approaches in terms of application latency, transmitted data volume, and power usage. In experiments with batches of 64 ECG samples, the edge computing approach has reduced average application latency by 15%, average power usage by 19%, and total transmitted volume by 85%, confirming that edge computing improves system performance significantly. Compressed transmission proved to be an alternative when network bandwidth is limited and edge computing is impractical.
Community Drawing and Storytelling to Understand the Place Experience of Walking and Cycling in Dushanbe, Tajikistan
Authors: Smith Carl A.
Published: December 2022

Transit infrastructure is a critical determinant of the layout and sustainability performance of residential landscapes and neighborhoods. Though the spatial aspects of transit design and their associated impact on health, congestion, air pollution, accident rates, and emissions of greenhouse gases are well understood, the experiential-qualitative aspects of mobility have often been ignored in the travel and transport literature. This paper presents the place-understandings of pedestrians and cyclists concerning neighborhood safety in Dushanbe, the capital city of Tajikistan. Community perspectives were captured through drawing and storytelling workshops as a method of public engagement through creative experience. While reporting on the veracity of this collaborative, creative, and place-based methodology, the paper presents workshop outcomes that describe problematic non-auto neighborhood transit experiences that, if unchecked, could constitute a significant challenge to the sustainable post-Soviet transformation of Dushanbe’s residential neighborhoods.