bluuebunny/crossref_metadata_2025 huggingface dataset:
Anticoagulation control, outcomes, and associated factors in long-term-care patients receiving warfarin in Africa: a systematic review
Authors: Tadesse Tamrat Assefa , Tegegne Gobezie Temesgen , Yadeta Dejuma , Chelkaba Legese , Fenta Teferi Gedif
Published: October 2022

Background

Oral anticoagulation therapy with warfarin requires frequent monitoring level of anticoagulation by the international normalized ratio (INR). In Africa, studies that explore anticoagulation control, treatment outcomes, and associated factors are reported in various ways in long-term patients receiving warfarin therapy to generate concrete scientific evidence.

Methods

The literature search was conducted in PubMed, Cochrane Library, African Journal of Online databases, Google Scholar, and Google. An advanced search strategy was computed to retrieve relevant studies related to anticoagulation control and outcomes. Duplication, title and abstract screening, and full-text assessment were conducted in Covidence software. Study quality was assessed using the Joanna Briggs Institute Critical appraisal quality assessment tool. The systematic review is registered in PROSPERO (CRD42021260772) and performed based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guideline.

Results

Out of 298 identified articles, 18 articles were eligible for the final review and analysis. The mean of 39.4 ± 8.4% time in therapeutic range (TTR) (29.4 to 57.3%), 36.7 ± 11.5% TTR (range 25.2–49.7%) and 46% TTR (43.5–48.5%) was computed from studies that determined TTR by Rosendaal, direct and cross-section-of-the-files methods, respectively. In this review, the lowest percentage of TTR was 13.7%, while the highest was 57.3%. The highest percentage of patients (32.25%) who had TTR ≥ 65% was reported in Tunisia, but the lowest percentages were in Namibia (10%, TTR ≥ 65%) and Kenya (10.4%, TTR ≥ 70%). Most of the included studies (11 out of 18) used Rosendaal’s method while the direct method was employed by three studies. Generally, 10.4–32.3% of study participants achieved desired optimal anticoagulation level. Regarding secondary outcomes, 1.6–7.5% and 0.006–59% of patients experienced thromboembolic complications and bleeding events, respectively. Having chronic comorbidities, taking more than two drugs, and presence of medications that potentially interact with warfarin, and patient-related factors (patients aged < 50 years old, female gender, lower education level, smoking history) were the frequently reported predictors of poor anticoagulation therapy.

Conclusions

Oral anticoagulation control was suboptimal in patients taking warfarin as evidenced by low TTR in Africa. Therefore, there is an urgent need for further improving oral anticoagulation management services.
Comparing the expression levels of tripartite motif containing 28 in mild and severe COVID-19 infection
Authors: Tavakoli Rezvan , Rahimi Pooneh , Hamidi-Fard Mojtaba , Eybpoosh Sana , Doroud Delaram , Ahmadi Iraj , Anvari Enayat , Aghasadeghi Mohammadreza , Fateh Abolfazl
Published: October 2022

Background

Tripartite motif-containing 28 (TRIM28) is an impressive regulator of the epigenetic control of the antiviral immune response. This study evaluated if the differential expression of TRIM28 correlates with the severity of coronavirus disease 2019 (COVID-19) infection.

Methods

A total of 330 COVID-19 patients, including 188 mild and 142 severe infections, and 160 healthy controls were enrolled in this study. Quantitative real-time polymerase chain reaction (qPCR) was used to determine the expression levels of TRIM28 in the studied patients.

Results

TRIM28 mRNA levels were significantly lower in both groups of patients versus the control group and in the severe group indicated further reduction in comparison to mild infection. The multivariate logistic regression analysis showed the mean age, lower levels of low-density lipoprotein (LDL), high-density lipoprotein (HDL), cholesterol, lower 25-hydroxyvitamin D, and PCR cycle threshold (Ct) value and higher levels of erythrocyte sedimentation rate (ESR) and differential expression of TRIM28 were linked to the severity of COVID-19 infection.

Conclusion

The results of this study proved that the downregulation of TRIM28 might be associated with the severity of COVID-19 infection. Further studies are required to determine the association between the COVID-19 infection severity and TRIM family proteins.
Poria cocos polysaccharides exert prebiotic function to attenuate the adverse effects and improve the therapeutic outcome of 5-FU in ApcMin/+ mice
Authors: Yin Lin , Huang Guoxin , Khan Imran , Su Lu , Xia Wenrui , Law Betty Yuen Kwan , Wong Vincent Kam Wai , Wu Qiang , Wang Jingyi , Leong Wai Kit , Hsiao W. L. Wendy
Published: October 2022

Background

As a first-line chemotherapeutic agent, 5-fluorouracil (5-FU) exhibits many side effects, weakening its efficacy in cancer treatment. In this study, we hypothesize that Poria cocos polysaccharides (PCP), a traditional Chinese herbal medicine with various bioactivities and prebiotic effects, might improve the therapeutic effect of 5-FU by restoring the homeostasis of the gut microenvironment and the commensal gut microflora.

Methods

ApcMin/+ mice were employed to evaluate the anti-cancer effect of 5-FU in conjunction with PCP treatment. Body weight and food consumption were monitored weekly. Polyp count was used to assess the anti-cancer effect of PCP and 5-FU. Expressions of mucosal cytokines and gut epithelial junction molecules were measured using qRT-PCR. 16S rRNA gene sequencing of fecal DNAs was used to evaluate the compositional changes of gut microbiota (GM). Transplantation of Lactobacillus johnsonii and Bifidobacterium animalis were performed to verify the prebiotic effects of PCP in improving the efficacy of 5-FU.

Results

The results showed that PCP treatment alleviated the weight loss caused by 5-FU treatment and reduced the polyp burden in ApcMin/+ mice. Additionally, PCP treatment eased the cytotoxic effects of 5-FU by reducing the expressions of pro-inflammatory cytokines, increasing the anti-inflammatory cytokines; and significantly improving the gut barriers by enhancing the tight junction proteins and associated adhesion molecules. Furthermore, 16S rRNA gene sequencing data showed that PCP alone or with 5-FU could stimulate the growth of probiotic bacteria (Bacteroides acidifaciens, Bacteroides intestinihominis, Butyricicoccus pullicaecorum, and the genera Lactobacillus, Bifidobacterium, Eubacterium). At the same time, it inhibited the growth of potential pathogens (e.g., Alistipes finegoldii, Alistipes massiliensis, Alistipes putredinis., Citrobacter spp., Desulfovibrio spp., and Desulfovibrio desulfuricans). Moreover, the results showed that transplantation of L.johnsonii and B.animalis effectively reduced the polyp burden in ApcMin/+ mice being treated with 5-FU.

Conclusion

Our study showed that PCP could effectively improve the anti-cancer effect of 5-FU by attenuating its side effects, modulating intestinal inflammation, improving the gut epithelial barrier, and modulating the gut microbiota of ApcMin/+ mice.
Ventricular fibrillation immediately after the treatment of Graves’ disease coexisting with atypical angina and long QT syndrome: a case report
Authors: Iwasaki Hajime , Suwanai Hirotsugu , Sakai Hiroyuki , Ishii Keitaro , Hara Natsuko , Satomi Kazuhiro , Takada Yasuyuki , Nagamatsu Yuki , Suzuki Ryo
Published: October 2022

Background

Palpitations due to Graves’ disease are often caused by supraventricular arrhythmia. However, in rare cases, the background of coronary artery disease, genetic abnormalities, or channel abnormalities can cause ventricular fibrillation, which is a lethal arrhythmia. Here, we report a case of ventricular fibrillation after administration of beta-blockers early in the course of treatment for Graves’ disease coexisting with atypical angina and long QT syndrome.

Case presentation

A 48-year-old man consulted a local general physician for chest discomfort and palpitations for approximately 2 weeks. He was diagnosed with Graves’ disease and treated with thiamazole 15 mg, bisoprolol 1.25 mg, and nitroglycerin 0.3 mg. The patient continued to experience chest discomfort the next day and visited our hospital. The patient was treated with landiolol 0.125 mg/kg/min for heart rate control, and 20 min later, electrocardiography showed a change from the R-on-T phenomenon to ventricular fibrillation. After cardiopulmonary resumption and improvement of thyroid function, a stress test was performed, which revealed coronary angina and long QT syndrome. An implantable cardioverter defibrillator (ICD) was implanted in the patient for secondary prevention. Since then, no fatal arrhythmia has been observed to date.

Conclusions

When beta-blockers are administered to patients with Graves’ disease who have severe chest symptoms, fatal arrhythmias are possible. ICD implantation should be considered for the secondary prevention of fatal arrhythmias.
Stimulated generation of photobiogas by morphologically tuned nanostructured ZnO and ZnO/TiO2
Authors: Mbrouk Omar , Hafez H. , Mozia Sylwia , Othman A. M. , Abdel Mottaleb M. S. A.
Published: October 2022

The photocatalytic degradation (PCD) of ethanol in an inert atmosphere on catalysis was explored in a lab-scale experiment. A morphologically tuned nanostructured controlled ZnO and ZnO/TiO2 nanocomposites were synthesized using a simple hydrothermal process under the control of several functionally capping agents marking a milestone in photocatalysis. It is possible that this could be modified to produce photobiogas out of organic dye pollution. The photocatalysts were characterized by the use of X-ray diffraction (XRD), transmission electron microscopy (TEM), Brunauer, Emmett, and Teller (BET) surface area analyzer, Scanning electron microscope (SEM-EDX), and UV–Vis absorption spectroscopy. The photocatalytic activity of the ZnO and ZnO–TiO2 composite nanostructures was evaluated for the photodegradation of the Tartrazine (Tr) dye aqueous solution. Where the composite matrix exhibits higher photocatalytic activity than pure ZnO nanomaterials as a result of the synergistic interaction between ZnO and TiO2 particles. This is mainly due to its higher surface area than pure ZnO. Moreover, the photocatalytic activity of the tuned nanostructured materials is found to be enhanced by the effect of the capping agent and controlling the morphology. This increase is accompanied by a significant shift in surface shape and band gap energy. According to the findings, the designed morphologies of pure ZnO photocatalyst impacted the formation of photobiogas from the photocatalytic decomposition of ethanol as a model of organic pollutants in wastewater. However, when using composite ZnO/TiO2 photocatalysts, the rate of CH4 formation is significantly lower than when using ZnO photocatalysts alone. This may be attributed to the synergetic effect between ZnO and TiO2 particles which leads to a remarkable reduction in the newly formed band gap energy. This may result in a fast rate of recombination between the photogenerated charge carriers (e− and h+).
Immuno-digital invasive cleavage assay for analyzing Alzheimer’s amyloid ß-bound extracellular vesicles
Authors: Yuyama Kohei , Sun Hui , Igarashi Yasuyuki , Monde Kenji , Hirase Takumi , Nakayama Masato , Makino Yoichi
Published: October 2022

Background

The protracted preclinical stage of Alzheimer’s disease (AD) provides the opportunity for early intervention to prevent the disease; however, the lack of minimally invasive and easily detectable biomarkers and their measurement technologies remain unresolved. Extracellular vesicles (EVs) are nanosized membrane vesicles released from a variety of cells and play important roles in cell–cell communication. Neuron-derived and ganglioside-enriched EVs capture amyloid-ß protein, a major AD agent, and transport it into glial cells for degradation; this suggests that EVs influence Aß accumulation in the brain. EV heterogeneity, however, requires the use of a highly sensitive technique for measuring specific EVs in biofluid. In this study, immuno-digital invasive cleavage assay (idICA) was developed for quantitating target-intact EVs.

Methods

EVs were captured onto ganglioside GM1-specific cholera toxin B subunit (CTB)-conjugated magnetic beads and detected with a DNA oligonucleotide-labeled Aß antibody. Fluorescence signals for individual EVs were then counted using an invasive cleavage assay (ICA). This idICA examines the Aß-bound and GM1-containing EVs isolated from the culture supernatant of human APP-overexpressing N2a (APP-N2a) cells and APP transgenic mice sera.

Results

The idICA quantitatively detected Aß-bound and GM1-containing EVs isolated from culture supernatants of APP-N2a cells and sera of AD model mice. The idICA levels of Aß-associated EVs in blood gradually increased from 3- to 12-month-old mice, corresponding to the progression of Aß accumulations in the brain of AD model mice.

Conclusions

The present findings suggest that peripheral EVs harboring Aß and GM1 reflect Aß burden in mice. The idICA is a valuable tool for easy quantitative detection of EVs as an accessible biomarker for preclinical AD diagnosis.
Organic matter in the pest and plant disease control: a meta-analysis
Authors: RM Silva , LP Canellas
Published: October 2022

Background

Pesticides have become a central public health problem and a source of environmental contamination. The use of organic matter is an important strategy to reduce synthetic agrochemicals, improve soil conditions, and increase nutrient uptake by plants. Organic matter can also induce plant resistance against biotic stress in some circumstances. However, the results reported for different types of organic matter applications are often very different form each other, thus making difficult their interpretation and hindering and discouraging their use as valuable alternative. Identifying the main factors involved in the efficacy of these sustainable methodologies and the associated research gaps is important to increase the efficiency of organic matter and reduce the use of pesticides.

Materials and methods

We performed a comprehensive meta-analysis of the current recent scientific literature on the use of organic matter as control method for pest and disease, using data reduction techniques, such as principal component analysis. We found 695 articles listing the keywords in the databases between 2010 and 2021 and selected 42 that met inclusion criteria.

Results

In general, all organic matter reported showed a high inhibition of pests and diseases. Control effectiveness was close to 75% for fungal diseases and 67% for the pest control. The source of organic matter most frequently reported was the vermicompost. However, humic substances showed the greatest effectiveness of 74% when compared to both fungal and bacterial disease control. The concentration of humic substances ranged from 1 to 500 mg L−1, with the highest concentrations used in case of soil application.

Conclusions

The study demonstrated the potential role of organic matter as a resistance elicitor in plants, thus allowing a partial/total reduction of pesticides in crops. Despite the efficiency reported in the works, the mechanisms of induction of pest and disease control remains poorly studied.

Graphical Abstract
Split-DNAzyme cooperating primer exchange reaction for sensitive miRNA detection
Authors: Luo Xuguo , Wu Hongze , Xiong Mingjie , Jiang Liyun , Jiang Zhihao , Gong Minyong
Published: October 2022

Sensitive quantification of microRNA (miRNA) plays a crucial role in early diagnosis and precise therapy of osteosarcoma. Herein, we build a label-free and sensitive miRNA quantification approach based on the activation of split-DNAzyme initiated primer exchange reaction (PER). Target miRNA cooperates the activation of split-DNAzyme with Mg2+ through assisting the assembly of DNAzyme to correct conformation, which enables the performance of PER-based nucleic acids amplification to produce a large amount of single-strand DNA (ssDNA) sequences. The G-quadruplexes (G4) in ssDNA sequences products bind with N-methyl mesoporphyrin IX (NMM) to form G4-NMM complex with the enhanced fluorescence respond. The results demonstrate that miRNA-21 can assist the activation of split-DNAzyme, and the active DNAzyme exhibits a high specificity and efficiency in inducing the subsequent PER. Based on the split-DNAzyme-assisted signal recycle and PER, the method eventually shows a high sensitivity and selectivity, providing a promising prospect for the for early stage tumor diagnosis and more precise tumor therapy.
Risk factors and outcomes of postoperative stroke in surgical treatment for giant intracranial aneurysms
Authors: Wang Hao , Lu Junlin , Chen Xin , Hao Qiang
Published: October 2022

Background

Giant intracranial aneurysms (GIAs) are challenges for surgical treatment. Risk factors of postoperative stroke remain unclear. This study aims to investigate the predictors of postoperative stroke in GIAs and the impact of stroke on outcomes.

Methods

We performed a retrospective medical record review of patients with GIAs who received microsurgery at our institution between 2011 and 2018. Multivariate logistic regression analyses were carried out to identify risk factors for postoperative stroke. The clinical and angiographic outcomes were compared between patients with and without stroke.

Results

A total of 97 patients were included in this study. Surgical modalities included direct aneurysm neck clipping in 85 patients (87.7%), trapping with the bypass in 8 (8.2%), proximal artery ligation in 1 (1%), and bypass alone in 3 (3.1%). Postoperative stroke was found in 26 patients (26.8%). Independent factors that affect postoperative stroke were recurrent aneurysm (OR, 10.982; 95% CI, 1.976–61.045; P = 0.006) and size ≥ 3.5 cm (OR, 3.420; 95% CI, 1.133–10.327; P = 0.029). Combined perioperative mortality and morbidity was 26.8%. Follow-up was achieved from 89 patients (91.8%), with a mean follow-up period of 39 months (range 19 to 94 months). Good outcomes were observed in 75 patients (84.3%) and poor outcomes were observed in 14 patients (15.7%).

Conclusions

Postoperative stroke was significantly associated with clinical outcome. Favorable outcomes can be achieved in most patients with GIAs after appropriate microsurgical modality. Recurrent aneurysm and size ≥ 3.5 cm are risk factors of postoperative stroke.
A lightweight DDoS detection scheme under SDN context
Authors: Jia Kun , Liu Chaoge , Liu Qixu , Wang Junnan , Liu Jiazhi , Liu Feng
Published: October 2022

Software-defined networking (SDN), a novel network paradigm, separates the control plane and data plane into different network equipment to realize the flexible control of network traffic. Its excellent programmability and global view present many new opportunities. DDoS detection under the SDN context is an important and challenging research field. Some previous works attempted to collect and analyze statistics related to flows, usually recorded in switches, to address DDoS threats. In contrast, other works applied machine learning-based solutions to identify DDoS and achieved promising results. Generally, most previous works need to periodically request flow rules or packets to obtain flow statistics or features to detect stealthy exceptions. Nevertheless, the request for flow rules is very time-consuming and CPU-consuming; moreover may congest the communication channel between the controller and the switches. Therefore, we present FORT, a lightweight DDoS detection scheme, which spreads the rule-based detection algorithm at edge switches and determines whether to start it by periodically retrieving the ports state. A time-series algorithm, ARIMA, is utilized to determine the port statistics adaptively, and an SVM algorithm is applied to detect whether a DDoS attack does occur. Representative experiments demonstrate that FORT can significantly reduce the controller load and provide a reliable detection accuracy. Referring to the false alarm rate of 1.24% in the comparison scheme, the false alarm rate of this scheme is only 0.039%, which significantly reduces the probability of false alarm. Besides, by introducing the alarm mechanism, this scheme can reduce the load of the southbound channel by more than 60% in the normal state.
Socioeconomic factors affecting outcomes in total knee and hip arthroplasty: a systematic review on healthcare disparities
Authors: Alvarez Paul M. , McKeon John F. , Spitzer Andrew I. , Krueger Chad A. , Pigott Matthew , Li Mengnai , Vajapey Sravya P.
Published: October 2022

Background

Recent studies showed that healthcare disparities exist in use of and outcomes after total joint arthroplasty (TJA). This systematic review was designed to evaluate the currently available evidence regarding the effect socioeconomic factors, like income, insurance type, hospital volume, and geographic location, have on utilization of and outcomes after lower extremity arthroplasty.

Methods

A comprehensive search of the literature was performed by querying the MEDLINE database using keywords such as, but not limited to, “disparities”, “arthroplasty”, “income”, “insurance”, “outcomes”, and “hospital volume” in all possible combinations. Any study written in English and consisting of level of evidence I-IV published over the last 20 years was considered for inclusion. Quantitative and qualitative analyses were performed on the data.

Results

A total of 44 studies that met inclusion and quality criteria were included for analysis. Hospital volume is inversely correlated with complication rate after TJA. Insurance type may not be a surrogate for socioeconomic status and, instead, represent an independent prognosticator for outcomes after TJA. Patients in the lower-income brackets may have poorer access to TJA and higher readmission risk but have equivalent outcomes after TJA compared to patients in higher income brackets. Rural patients have higher utilization of TJA compared to urban patients.

Conclusion

This systematic review shows that insurance type, socioeconomic status, hospital volume, and geographic location can have significant impact on patients’ access to, utilization of, and outcomes after TJA.

Level of evidence

IV.
Social life in adult patients after Fontan procedure
Authors: Alhabdan Mohammed S. , Alzayer Eman A. , Alawami Murtadha H. , Khouqeer Fareed A.
Published: October 2022

Background

Little is known about the social life in adult patients after Fontan palliation. The study aimed to assess the long-term social life of patients after Fontan surgery, including school achievement, employment, and marital status.

Results

We conducted a cross-sectional study on patients aged 18 years or above who had a Fontan operation for a single ventricle pathology. Our outcomes were the academic performance and marital and employment status of adult Fontan patients. Patients or their families were interviewed directly or by phone, and a set of questions were asked to address their educational level, employment, and marital status. Ninety-nine patients were included in the study. Their median age was 21 years (min–max: 18–41), and 60% were females (n= 59). The most common diagnoses were double inlet left ventricle (n= 24, 24%), tricuspid atresia (n= 21, 21%), and the unbalanced atrioventricular canal (n= 21, 21%). Fourteen patients (14%) were married, and 6 of them had children (two were females). Eleven percent were college graduates (either diploma or bachelor’s degree), and 47% were high school graduates.

Conclusions

Fontan operation could negatively affect the social life of the patients. It may affect employment patterns, educational levels, and marital status.
Ultrasonographic findings in patients with chronic kidney disease with asymptomatic hyperuricemia
Authors: Hashaad Nashwa Ismail , Ganeb Sahar Saad , Hassan Saddam A. A. , Mohamed Shimaa Hamdeen , Ibrahim Noha Hosni
Published: October 2022

Background

Musculoskeletal ultrasound is a useful, noninvasive tool to detect anatomical damage in the hyaline cartilage, synovial tissue, and tendons of individuals with asymptomatic hyperuricemia. This study aimed to determine the frequency of musculoskeletal ultrasonographic findings related to hyperuricemia among CKD patients and its relation to chronic musculoskeletal pain and their quality of life.

Results

Double contour (DC) was found in12%,18%, and 22% of the knee, ankle, and 1st MTPs joints, respectively. Hyper-echoic cloud was present in 2% and 6% of the knee and 1st MTPs, respectively. Synovitis was seen in 8%, 4%, and 16% of the knee, ankle, and 1st MTPs joints, respectively. Patellar tendon showed enthesopathy in 14% and tophus in 8% of cases. Tibialis posterior tenosynovitis was in 2% and peroneii tenosynovitis in 2%. Achilles tendon showed calcific foci in 24%, enthesopathy in 20%, and tophi in 4%. First MTPs showed erosion in 10% and tophi in 4%. There were statistically significant relations of pain index to DC, synovial thickening at the knee and at ankle joint. There were statistically significant relations of serum uric acid level to DC.There were statistically significant correlations of serum uric acid level to the 36-Item Short Form Survey (SF-36).

Conclusions

Untreated hyperuricemia might cause musculoskeletal ultrasonographic changes that could cause chronic musculoskeletal pain and decrease quality of life in chronic kidney disease patients.
Evaluation of a new emergency department avoidance model of care, the Cancer Urgent Assessment Clinic, in response to the COVID-19 pandemic
Authors: Haugstetter Corrine , Mason Robert , Sanmugarajah Jasotha , Hattingh H. Laetitia
Published: October 2022

Introduction

The Cancer Urgent Assessment Clinic (CUAC) was an emergency department (ED) avoidance/unscheduled model of care implemented in response to the COVID-19 pandemic. The aim was to reduce the risk of COVID-19 exposure and infection by providing an alternative to ED for cancer patients while undergoing anticancer treatments.

Methods

The clinic incorporated a telephone triage process and face-to-face appointments 8am to 8pm, 7 days per week. CUAC operated between 23 March '20 and 31 July '20, led by a nurse practitioner candidate, oncology registrars, cancer nurse specialists, and overseen by oncology consultants. Evaluation followed a mixed-methods approach through (1) analysis of CUAC patient data, (2) comparison of ED cancer patient presentation data from a previous period (23 March 2019–31 July 2019), and (3) a patient survey.

Results

In total, 400 patients were telephone triaged via CUAC, with 166 recorded as having avoided ED. There was a reduction in the number of cancer patient admissions to the ED short stay unit during the clinic period compared with the same time-period in 2019: 130 vs. 234, associated with 615 fewer hours. Patient satisfaction was positive particularly regarding ease of access, time to treatment, confidence in assessment and treatment of cancer-related concerns, and likelihood of presenting to hospital when unwell during the pandemic.

Discussion

While initially being implemented to reduce the risk of COVID-19 exposure, this evaluation demonstrated the CUAC model was an efficient and potentially cost-saving model of care for the management of cancer patients with mild to moderate severity of disease and treatment-related concerns.
Surgical resection of mediastinal metastasis from small cell carcinoma of bladder: case report
Authors: Isono Tomomi , Kimura Toru , Kimura Kenji , Karube Ryusuke , Ando Koshiro , Ishida Hiroto , Nagoya Akihiro , Taniguchi Seiji , Funaki Soichiro , Shintani Yasushi
Published: October 2022

Background

Isolated mediastinal metastasis from a malignant tumor and small cell carcinoma of the bladder are both very rare.

Case presentation

A 76-year-old woman who had undergone surgery for bladder cancer twice was referred to our hospital for a right paracardiac mass noted in chest computed tomography findings, and resection of the tumor was performed. Histological analysis of the mediastinal tumor revealed it to be a metastatic small cell carcinoma of the bladder. At 4 months after surgery, multiple metastatic lesions were found in the chest and liver, and chemotherapy for small cell carcinoma was started.

Conclusions

We present this case of mediastinal metastasis of small cell carcinoma of the bladder, which is very rare, to show the importance of surgical resection of an isolated mediastinal tumor. Such a procedure should be considered, as histological diagnosis of the tumor could be useful for determining therapeutic options.
Improving Time to Molecular Testing Results in Patients With Newly Diagnosed, Metastatic Non–Small-Cell Lung Cancer
Authors: Ossowski Stephanie , Neeman Elad , Borden Charles , Stram Douglas , Giraldo Lucy , Kotak Dinesh , Thomas Sachdev , Suga J. Marie , Lin Amy , Liu Raymond
Published: October 2022

PURPOSE:

Next-generation sequencing (NGS) is a crucial component of evaluation of patients with newly diagnosed metastatic non–small-cell lung cancer (NSCLC) to determine appropriate first-line treatment. This quality improvement project aimed to reduce time to NGS results in patients with metastatic NSCLC.

METHODS:

We reviewed electronic medical records of patients with newly diagnosed, untreated metastatic NSCLC from December 2018 to August 2021 and determined the number of days from pathologic diagnosis to NGS results. We reviewed process maps for oncology, pathology, the Division of Research, and a NGS vendor to determine factors leading to preventable delays. Since November 2020, we created an automated, electronic weekly report to provide earlier identification of new pathologic diagnoses in patients with metastatic NSCLC. On June 2021, we worked with our NGS vendors to expand days of the week to accept specimens.

RESULTS:

Our interventions reduced the median time from pathologic diagnosis to NGS results from 24 (standard deviation [SD] 9) to 16 (SD 6) days. The median time from biopsy results to NGS order was reduced from 7 days to 1 day. The time from the specimen being sent from pathology to the NGS vendor was a median of 6 days in both cohorts. The total time from pathologic diagnosis to appropriate treatment was reduced from 33 (SD 18) to 22 (SD 8) days.

CONCLUSION:

NGS processing in a community setting can be complex. Using a systems focused approach to quality improvement is crucial in identifying the greatest barriers in an organization. We found that delays in time to NGS results can be reduced by improved communication and workflows among departments.
Just as Tall on Testosterone; a Neutral to Positive Effect on Adult Height of GnRHa and Testosterone in Trans Boys
Authors: Willemsen Lieve Anne , Boogers Lidewij Sophia , Wiepjes Chantal Maria , Klink Daniel Tatting , van Trotsenburg Adrianus Sarinus Paulus , den Heijer Martin , Hannema Sabine Elisabeth
Published: October 2022

Context

Growth is an important topic for many transgender boys. However, few studies have investigated the impact of puberty suppression (PS) and gender-affirming hormone treatment (GAHT) on growth and adult height.

Objective

To evaluate the effect of PS and GAHT on growth and adult height.

Design

Retrospective cohort study.

Setting

Specialized gender identity clinic.

Participants

A total of 146 transgender boys treated with GnRH analogues and testosterone who reached adult height.

Main outcome measures

Growth, bone age (BA), adult height, and difference between adult height and predicted adult height (PAH) and midparental height.

Results

In those with BA ≤14 years at start (n = 61), a decrease in growth velocity and bone maturation during PS was followed by an increase during GAHT. Adult height was 172.0 ± 6.9 cm; height SD score was similar to baseline (0.1; 95% CI, −0.2 to 0.4). Adult height was 3.9 ± 6.0 cm above midparental height and 3.0 ± 3.6 cm above PAH at start of PS. A younger BA at start PS was associated with an adult height significantly further above PAH.

Conclusion

During PS, growth decelerated followed by an acceleration during GAHT. Although adult height SD score was similar to baseline, adult height was taller than predicted based on BA at baseline, especially in those who started treatment at a younger BA. It is reassuring that PS and GAHT do not have a negative impact on adult height in transgender boys and might even lead to a slightly taller adult height, especially in those who start at a younger age.
Novel Causal Plasma Proteins for Hypothyroidism: A Large-scale Plasma Proteome Mendelian Randomization Analysis
Authors: Yang Hongqun , Chen Lanlan , Liu Yahui
Published: October 2022

Context

Although several risk proteins for hypothyroidism have been reported in recent years, many more plasma proteins have not been tested.

Objective

To determine potential mechanisms and novel causal plasma proteins for hypothyroidism using Mendelian randomization (MR).

Methods

A large-scale plasma proteome MR analysis was conducted using protein quantitative trait loci (pQTLs) for 2297 plasma proteins. We classified pQTLs into 4 different groups. MR analyses were conducted within the 4 groups simultaneously. Significant proteins were discovered and validated in 2 different cohorts. Colocalization analysis and enrichment analysis were conducted using proteins found with MR.

Results

Thirty-one proteins were identified in the discovery cohort. Among them, 13 were validated in the validation cohort. Nine of the 13 proteins are risk factors (ISG15, Fc receptor-like protein 2, tumor necrosis factor ligand superfamily member 14, Rab-2A, FcRL3, thrombomodulin, interferon [IFN]-lambda-1, platelet glycoprotein Ib alpha chain, IL-7RA) for hypothyroidism, whereas others are protective proteins (protein O-glucosyltransferase 1 [POGLUT1], tumor necrosis factor ligand superfamily, 3-hydroxyisobutyryl-CoA hydrolase, transferrin receptor protein 1). Among the significant proteins, POGLUT1 strongly colocalized with expression quantitative trait loci from whole blood (posterior probability of colocalization [PP4] = 0.978) and the thyroid (PP4 = 0.978). Two different trans-pQTLs (rs2111485 PP4 = 0.998; rs35103715 PP4 = 0.998) for IFN-lambda-1 strongly colocalized with hypothyroidism in different chromosomes.

Conclusion

Thirteen various proteins were identified and validated to be associated with hypothyroidism using univariable MR. We reinforced and expanded the effect of IFN on hypothyroidism. Several proteins identified in this study could explain part of the association between the coagulation system and hypothyroidism. Our study broadens the causal proteins for hypothyroidism and provides the relationships between plasma proteins and hypothyroidism. The proteins identified in this study can be used as early screening biomarkers for hypothyroidism.
From the Sky to the Streets, and Back
Authors: Al-Bulushi Samar
Published: October 2022

Against the Eurocentric, heteronormative paradigms that continue to structure analysis of post-9/11 global warfare, this article asks what it means to decenter the view from the imperial war room, illustrated most poignantly in the 2016 thriller Eye in the Sky. Highlighting the role played by the Kenyan state in the ongoing war against the Somali militant group al-Shabaab, it takes seriously the African subjects who co-constitute geographies of war making in East Africa today, from the political and business elite who normalize militarized masculinities and femininities, to the African troops whose affective and violent labor sustains war making in Somalia. Far from a celebration of subaltern agency, the article engages the notion of a “subaltern geopolitics” that is mindful of asymmetries of power and that foregrounds ambiguous positions of marginality that are neither dominant nor resistant. Attention to entanglement disrupts binary analytical paradigms of global/local and masculine/feminine, and calls for a deeper consideration of collaboration and complicity.
Η έκφραση της εθνικής ταυτότητας στον Pedro Henríquez Ureña και στον Ίωνα Δραγούμη
Authors: Κορέας Λυμπέρης
Published: October 2022

Ο εθνικισμός είναι μια από τις κομβικές ιδεολογίες του 19ου και του 20ου αιώνα. Απαντάται με διάφορες μορφές, ανάλογα με τις ανάγκες, τις ιστορικές ιδιαιτερότητες, τις πολιτικές ή άλλες διεκδικήσεις κάθε κοινωνίας και κάθε λαού. Η παρούσα μελέτη εστιάζει σε δυο παραδείγματα, σε αυτά της Λατινικής Αμερικής και της Ελλάδας. Άξονες της μελέτης είναι το έργο δυο στοχαστών σύγχρονων μεταξύ τους, του Pedro Henríquez Ureña και του Ίωνα Δραγούμη. Ο στόχος της μελέτης είναι να μελετήσουμε τις διαφορετικές απαντήσεις που δίνονται από τον κάθε στοχαστή, πράγμα που συμβαίνει επειδή ο εθνικισμός απαντά πάντα σε συγκεκριμένες ανάγκες και διακυβεύματα και δεν αποτελεί μια θεωρία άκαμπτη. Κεντρικά σημεία στον κάθε στοχαστή είναι αυτά που απαντούν στις προκλήσεις που έχει να αντιμετωπίσει. Κοινός στόχος και στους δυο στοχαστές είναι η διερεύνηση και η ανάδειξη της ιδιαιτερότητας και του χαρακτήρα του πολιτισμού στον οποίο καθένας ανήκει. Στην ουσία πρόκειται για πορείες παράλληλες και όχι τεμνόμενες, που δείχνουν με μεγαλύτερη ενάργεια τις διαφορετικές απαντήσεις του εθνικισμού σε διαφορετικά πολιτισμικά περιβάλλοντα.
Providers’ views on hormonal family planning methods for young women: a qualitative study from Dosso, Niger
Authors: Maytan-Joneydi Amelia , MacLachlan Ellen W. , Agali Balki Ibrahim , Louis-Charles Kyria , Chaibou Sanoussi , Amadou Garba Souleymane , Moumouni Abdoul Nouhou , Speizer Ilene S.
Published: October 2022

Background: Family planning (FP) providers play an important role in ensuring that clients are offered a full range of FP methods. This qualitative study explores providers’ views on three hormonal FP methods and why they think young women may choose these methods in Niger.            

                                       

Methods: In-depth interviews were conducted with 24 FP providers in 24 government health centers in Dosso region, Niger between February-March 2020. Providers were asked about the suitability of different FP methods for women, including unmarried adolescents and young married women with children. The interviews were translated and transcribed from Hausa and Zarma into French, thematically coded, and qualitatively analyzed.

Results: Many providers believed discretion to be the most important method attribute for women. Providers report preferring implants for young clients because of the more rapid return to fertility. They disagreed on whether implants or injectables are more discrete for clients. That said, providers felt that clients appreciate the implant’s discretion, effectiveness, long-acting nature, and ease of use.  Providers perceived that the majority of women choose injectables due to familiarity with the method, the fact that it is “invisible” to an outsider, and a lack of awareness of implants. Providers stated that while women may not initially choose the implant, when given more information about it, they were more open to adopting it, or switching from another method, and less likely to believe local myths. Providers believed that women find pills to be indiscreet.

Conclusions: The findings highlight that while providers have perspectives on suitable methods for certain women, they also recognize that clients have their own preferences, such as how discreet the method is. As programs continue to expand method choice and new contraceptive technologies undergo research and development, highly desirable features such as discretion need to be considered.
Antagonistic Atrial Natriuretic Peptide with the Renin-Angiotensin-Aldosterone System and Effects on Systemic Blood Pressure Regulation
Authors: Araujo Fellipe Genasculi , Ramos Rogério Rodrigo
Published: October 2022

The atrial natriuretic peptide (ANP) presents, from the point of view of systemic blood pressure regulation, a relevant antagonistic association when compared to the renin-angiotensin-aldosterone system (RAAS). Through a careful review, the aim of the study was to evidence the process and the link between systems and hormones, from prohormone secretion, conversion, interaction with receptors, ANP action, correlating its antagonistic effects to RAAS, and the association between the mechanisms of action and SBP. The method adopted was a systematic review through electronic scientific articles in the database of the Virtual Health Library, PubMed and Cochrane. The process of searching and selecting the articles followed the rule of systematic review – PRISMA. The study demonstrates that the effects of ANP release due to cardiac atrial expansion are effectively counterregulators to the effects of RAAS malfunction, acting in a way to preserve the back, cardiac and vascular issues from blood pressure control. This mechanism acts via hydroelectrolytic regulation, especially through processes of resorption and excretion of sodium and water by the removal tubules, where the RAAS acts to increase blood volume and ANP acting to potentiate diuretic mechanisms. It is concluded that the degrading effects of the malfunction of RAAS, to some extent, be counter-regulated by the effects of ANP release, acting in the control of systemic blood pressure, alone or concomitantly with pharmacological treatment.
Effect of Fiber Laserprocess Parameters on Texture Dimensions Fabricated on Cast Iron Piston Ring Segments
Authors: Patil Atulkumar S. , Wakchaure Vishnu D. , M. Shirsat Uddhav
Published: October 2022

This study investigates the effect of various fiber laser process parameters on texture diameter, depth and surface roughness of circular shaped textures fabricated on the commercially cast iron piston ring segments. Piston ring segments with hardness 410 HV, Young’s Modulus of 250 Gpa and surface roughness of 0.482 µm were used for the experimentation. The fiber laser system (Marko Laser, Germany), was used for the fabrication of textures on the cast iron segments having specifications like power of 20W, wavelength of 1062nm, maximum frequency 200KHz, maximum speed range of 15000 mm/s. The laser frequency, power, speed and number of loops are the input parameters which were varied to find its effect on the texture dimensions. The approximate target values to be achieved for circular texture dimensions are texture diameter of 100µm (bilateral tolerance of 10µm), texture depth of 20µm (bilateral tolerance of 3µm) and texture surface roughness of 3µm (bilateral tolerance of 0.5µm) respectively. A confocal microscope with three dimensional surface profiler was used to measure the surface topography of the textured surfaces. It has been observed that with increase in laser power initially texture diameter has been reduced but found to be increased for the maximum power condition, while dimple depth and surface roughness of the textures found to be increased gradually. Also with increase in frequency has not a significant effect on the texture diameter but the texture depth and surface roughness has been enhanced drastically. In the similar way with increase in the laser speed and number of loops, initially there was decrease in the texture dimensions but as the speed and number of loops increased the texture dimensions also has a slight enhancement on it. It may be concluded that laser power and laser frequency has a significant impact on the texture dimensions as compared to laser speed and number of loops. Also it can be summarized that for achieving the targeted values of the texture dimensions like texture diameter, texture depth and texture surface roughness on the piston ring surface the laser power of 12W, 8W and 8W, laser frequency of 25 KHz, 25 KHz and 20 KHz, laser scan speed of 170 mm/sec, 140 mm/sec and 110 mm/sec and number of laser loops of 5, 4 and 2 may be used respectively. KEYWORDS: Confocal Microscope; Fiber Laser; Laser Power; Laser Texturing; Texture Dimensions
Efficient 3D measurement of a HDR surface based on adaptive fringe projection
Authors: Hu Jialing , Zhu Jiangping , Zhou Pei
Published: October 2022

3D measurement methods of a high-dynamic-range (HDR) surface based on adaptive
fringe projection have aroused extensive research interest. They tend
to pixel-wise adjust the fringe projection intensity to ensure
full-field phase quality in light or dark regions, which has two
problems: (1) traditional image intensity-based temporal phase
unwrapping (TPU) is susceptible to noise in dark regions, and
(2) it is time-consuming to project orthogonal fringe patterns
for coordinate mapping and 3D reconstruction. Aiming to address these
issues, we present an efficient adaptive fringe projection method
where misaligned Gray code patterns are adopted to remove the phase
error induced by low-frequency fringe patterns. Compared with
traditional image intensity-based TPU, misaligned Gray-code-based TPU
provides a better noise-suppression effect in dark regions, as Gray
codes are generally better preserved than image intensity. Moreover,
the images captured in the coordinate mapping process are shared for
optimal projection intensity calculation and 3D reconstruction to
reduce the number of total projection patterns, thus improving
measurement efficiency. Extensive contrast experiments are conducted
to demonstrate that the proposed method retrieves the 3D shapes of
micro-scale HDR surfaces with high accuracy and a minimum number of
projection patterns on the premise of high measurement integrity.
Single-shot temporal speckle correlation imaging using rolling shutter image sensors
Authors: Yi Changyoon , Jung Jaewoo , Im Jeongmyo , Lee Kyung Chul , Chung Euiheon , Lee Seung Ah
Published: October 2022

We propose a single-shot wide-field imaging method that maps local temporal intensity decorrelations of dynamic speckle fields. Our method, named rolling shutter speckle imaging (RSSI), utilizes short time intervals between each row of a rolling shutter complementary metal–oxide–semiconductor (RS-CMOS) image sensor to discern fast temporal changes in the speckle field, which otherwise requires sequential measurements with high-speed cameras. RSSI generates elongated speckle patterns on an RS-CMOS image sensor and quantifies temporal decorrelations of speckle fields from row-by-row intensity correlations (RICs) within a single image. To quantify the local speckle decorrelation times of dynamic scattering media, we derived a theoretical model for RIC and verified the model using numerical simulations and flow-phantom experiments. Further, our in vivo imaging results show that RSSI can map the flow rate distributions in cerebral blood vessels with the correction of static scattering in the tissue, demonstrating that RSSI is a powerful and cost-effective imaging tool for in vivo quantitative blood flow measurements.
Soliton-pair dynamical transition in mode-locked lasers
Authors: Sulimany Kfir , Tziperman Offek , Bromberg Yaron , Gat Omri
Published: October 2022

The self-assembly of solitons into nonlinear superpositions of multiple solitons plays a key role in the complex dynamics of mode-locked lasers. These states are extensively studied in light of their potential technological applications and their resemblance to molecules that offer opportunities for studying molecular interactions. However, progress along these endeavors is still held back by the lack of effective means to manipulate multi-soliton waveforms. Here we show it is possible to control inter-soliton interactions in mode-locked fiber lasers using a single control knob, the laser gain. We experimentally demonstrate a 2-orders-of-magnitude reduction in the separation of bound soliton pairs by sweeping the pumping current of the laser. The sweep induces a dynamical transition between a phase-incoherent loosely bound state and a phase-locked tightly bound state. Using numerical simulations and a simplified analytical model, we find that the dynamical transition is governed by noise-mediated interactions, which can be switched between repulsion and attraction. The discovery of a single control parameter that sets the nature of the inter-soliton interaction points to possibilities for controlling multi-soliton states for optical communication systems and pump-probe spectroscopy.