bluuebunny/crossref_metadata_2025 huggingface dataset:
Non-injection-site soft tissue sarcoma in cats: outcome following adjuvant radiotherapy
Authors: Zajc Alenka Lavra , Harper Aaron , Benoit Jerome , Mason Sarah
Published: May 2022

Objectives

Biological behaviour and treatment options of non-injection-site soft tissue sarcomas (nFISS) in cats are less well understood than in dogs. The aim of this retrospective study was to assess the outcomes of cats with nFISS following treatment with adjuvant radiotherapy.

Methods

The medical records of cats with soft tissue sarcomas in locations not associated with, and histology reports not suggestive of, injection-site sarcomas were reviewed. All cats underwent adjuvant radiotherapy, either hypofractionated (32–36 Gy delivered in weekly 8–9 Gy fractions) or conventionally fractionated (48–54 Gy delivered in 16–18 3 Gy fractions) to microscopic disease.

Results

In total, 18 cats were included in the study, 17 with extremity nFISS and one with facial nFISS. Nine received radiotherapy after a single surgery and nine after multiple surgeries for recurrent nFISS. Eight cats were treated with a hypofractionated protocol and 10 with a conventionally fractionated protocol. The median follow-up time was 540 days (range 51–3317 days). The tumour recurred in eight (44.4%) cats following adjuvant radiotherapy; it recurred in three (37.5%) cats following a hypofractionated protocol and in five (50%) cats following a conventionally fractionated protocol. The overall median progression-free interval (PFI) for 17/18 cats was 2748 days, while the median PFI for the 7/8 cats with recurrence was 164 days. The recurrence for one cat was reported, but the date was unknown and it was therefore censored from these data. When stratifying based on the protocol, the median PFI for hypofractionated and conventionally fractionated protocols was 164 days and 2748 days, respectively. Statistically, there was no significant difference between the two protocols ( P = 0.636).

Conclusions and relevance

Adjuvant radiotherapy resulted in good long-term tumour control in 12/18 cats with nFISS. Further studies in larger populations are required to assess the significance of radiation dose and fractionation on tumour control and the effect of multiple surgeries prior to initiation of radiotherapy on outcome.
Design of actively-controlled oil lubrication to reduce rotor-bearing-foundation coupled vibrations - theory & experiment
Authors: Jensen Kenneth M , Santos Ilmar F
Published: May 2022

This paper gives theoretical and experimental contributions to the field of tribotronics, linking i) tribology of fluid film bearings, ii) flexible rotor and flexible foundation dynamics, iii) sensing systems, iv) fluid power and hydraulic actuator dynamics, and v) control theory in a holistic way. Based on a multi-physical modelling approach, a mathematical model (digital twin) is derived coupling the subsystems from i) till v). The digital twin is employed to design and optimize the feedback control system of an actively-controlled tilting pad journal bearing with the aim of attenuating vibration levels of the rotor-bearing-foundation system. The feedback control system is experimentally implemented and tested on a test rig. Significant reduction of the rotor-bearing-foundation vibrations is achieved in the frequency range of 20 until 250  Hz. Very good agreement between theory and experiment is achieved at the low rotor angular velocity used. The theoretical and experimental outcomes of the paper suggest that vi) the thermal domain needs to be included in the multi-physical modelling approach to accurately represent the bearing properties under thermoelastohydrodynamic conditions and expand the theoretical and experimental approaches to higher angular velocities.
Association between pre-treatment IQ and educational achievement after gender-affirming treatment including puberty suppression in transgender adolescents
Authors: Arnoldussen Marijn , Hooijman Evelien C , Kreukels Baudewijntje PC , de Vries Annelou LC
Published: May 2022

Background:

Concerns exist regarding effects of puberty suppression on neurodevelopment. Intelligence is strongly correlated with educational achievement in the general population. This study aimed to examine the association between pre-treatment intelligence and educational achievement after gender-affirming treatment including puberty suppression in transgender adolescents to contribute to the emerging understanding of the effect that gender-affirming treatment including puberty suppression may have on cognitive development.

Methods:

IQ was measured in 72 adolescents (45 trans boys, 27 trans girls) at clinical entry (mean age 12.78 years), educational achievement was evaluated after gender-affirming treatment (mean age 20.40 years).

Results:

IQ pre-treatment and educational achievement post-treatment were positively associated (Nagelkerke R = 0.71).

Discussion:

The association between IQ pre-treatment and educational achievement post-treatment in transgender adolescents who received gender-affirming medical treatment including puberty suppression appears to be similar to the general population. This may reflect that gender-affirming medical treatment including puberty suppression does not negatively affect the association between IQ and educational achievement.
Environmental co-benefits of urban design to mitigate urban heat island and PM2.5 pollution: Considering prevailing wind’s effects
Authors: Meng Ming-Rui , Xi Chang , Feng Zhuangbo , Cao Shi-Jie
Published: May 2022

The impact of PM2.5 pollution and urban heat island (UHI) on sustainable urban development and human health has been a major concern for governments. Based on Computational Fluid Dynamics (CFD) simulation and on-site monitoring, this study investigated the airflow velocity, PM2.5 concentration and urban heat island intensity (UHII) distribution in the urban area at different prevailing wind directions, from the perspective of urban design. In order to validate the accuracy of CFD simulation results, on-site monitoring of temperature and airflow velocity was conducted on the roof of a building. A low-dimensional model was adopted to improve the efficiency of CFD data analysis. Moreover, based on the results of the low-dimensional model, PM2.5 concentration and UHII in urban areas at different prevailing wind directions were assessed by clustering analysis. The findings showed that when α = 0° and 90°, the average PM2.5 concentration was 28.9–56.8% (8.76–27.66 μg/m³) lower and the average UHII was 23.4–34.2% (0.8–1.15°C) higher, compared to α = 30°, 45° and 60°. Meanwhile, the downwind area suffers from more serious PM2.5 pollution and UHII than the upwind area. These findings could potentially provide a guide for future building/urban design to improve the urban environment from the perspective of building and road construction.
Ultra-high frequency ultrasound delineated changes in carotid and muscular artery intima-media and adventitia thickness in obese early middle-aged women
Authors: Sundholm Johnny KM , Litwin Linda , Rönö Kristiina , Koivusalo Saila B , Eriksson Johan G , Sarkola Taisto
Published: May 2022

Obesity is linked to increased arterial size, carotid intima-media thickness and arterial stiffness. The effects of obesity and body composition on muscular artery intima-media and adventitia thickness has previously not been established. The aim of this study was to explore associations between carotid and muscular artery wall layer thickness with body composition and cardiovascular risk factors in early middle-aged women. This is a cross-sectional study including 199 women aged 40±4 years. Arterial lumen (LD), intima-media (IMT) and adventitia thickness (AT) were measured from carotid, brachial and radial arteries using ultra-high frequency ultrasound (22-71 MHz). Women with obesity had increased IMT in carotid (0.47 vs 0.45 mm), brachial (0.19 vs 0.17 mm) and radial arteries (0.16 vs 0.15 mm) and increased brachial AT (0.14 vs 0.13 mm). In multiple regression models all arterial LD (β-range 0.02-0.03 mm/kg/m2), IMT (β-range 0.91-3.37 µm/kg/m2), AT (β-range 0.73-1.38 µm/kg/m2) were significantly associated with BMI. The IMT of all arteries were significantly associated with systolic blood pressure (β-range 0.36-0.85 µm/mmHg), attenuating the association between IMT and BMI (β-range 0.18-2.24 µm/kg/m2). Obese early middle-aged women have increased arterial intima media thickness and brachial artery adventitia thickness compared to non-obese counterparts. The association between BMI and intima-media thickness is partly mediated through blood pressure levels.
Experimental study of energy absorption in 3D-textile reinforced polymer composites under high-velocity impact loading
Authors: Madani Fatemeh , Ajeli Saeed , Mirdamadi Hamid Reza
Published: May 2022

In this paper, the energy absorption capacity of polymer composites reinforced with Kevlar fibers and various textile structures under high-velocity impact loading was investigated. Noobing textile, woven laminate, and stitched laminate were used as composite reinforcements. Fiber density and structural thickness were also examined in impact performance. The impact test was performed using a gas gun at a speed of 235 m/s. The impact performance of composite samples was evaluated by comparing residual velocity, ballistic limit, and impact energy absorption. To analyze the damage caused by the impact, all specimens were inspected using CT scan images. It was found that the presence of reinforcing fibers in the thickness direction can significantly improve energy absorption. In thicker composites, impact indentation was observed and the projectile could not penetrate the structure. The indentation depth of the Noobing composite was less than the stitched laminate. Increased fiber density in all three composite configurations showed an increase in energy absorption capacity and a decrease in residual impact velocity.
Lifestyle Behaviors, Depression, and Anxiety Among Individuals Living in Canada During the COVID-19 Pandemic
Authors: Simjanoski Mario , de Azevedo Cardoso Taiane , Wollenhaupt-Aguiar Bianca , Pfaffenseller Bianca , De Boni Raquel B. , Balanzá-Martínez Vicent , Frey Benicio N. , Minuzzi Luciano , Kapczinski Flavio
Published: May 2022

The aim of our study was to investigate the association between lifestyle behaviors and symptoms of depression and anxiety during the COVID-19 pandemic in Canada. A web survey was conducted between July 3–August 3, 2020, across Canada. The main outcomes considered were a positive screening for depression, as evaluated by the PHQ-2 and positive screening for anxiety, as evaluated by the GAD-7. Lifestyle behaviors were assessed using the Short Multidimensional Lifestyle Inventory Evaluation—Confinement (SMILE-C), an instrument adapted for lifestyle behaviors during the COVID-19 pandemic. The total sample size included 404 participants, of which 24.3% had a positive screen for depression, 20.5% for anxiety, and 15.5% for both. We found significant differences in SMILE-C scores between individuals with a positive and individuals with a negative screen for depression ( P < .001). Likewise, there were significant differences in SMILE-C scores between individuals with a positive and individuals with a negative screen for anxiety ( P < .001). We found an association between unhealthy lifestyle behaviors and symptoms of depression and anxiety during the COVID-19 lockdown in Canada. The findings highlight the importance of lifestyle medicine (LM) education and targeted lifestyle interventions to promote healthy behaviors and help reduce the burden of mental disorders.
Epistemic Feelings are Affective Experiences
Authors: Loev Slawa
Published: May 2022

This paper develops the claim that epistemic feelings are affective experiences. To establish some diagnostic criteria, characteristic features of affective experiences are outlined: valence and arousal. Then, in order to pave the way for showing that epistemic feelings have said features, an initial challenge coming from introspection is addressed. Next, the paper turns to empirical findings showing that we can observe physiological and behavioural proxies for valence and arousal in epistemic tasks that typically rely on epistemic feelings. Finally, it is argued that the affective properties do not only correlate with epistemic feelings but that we, in fact, capitalise on these affective properties to perform the epistemic tasks. In other words: the affective properties in question constitute epistemic feelings.
Objective ambulatory pH monitoring and subjective symptom assessment of gastroesophageal reflux disease show type of carbohydrate and type of fat matter
Authors: Gu Cihang , Olszewski Timothy , Vaezi Michael F. , Niswender Kevin D. , Silver Heidi J.
Published: May 2022

Background:

Rising prevalence of gastroesophageal reflux disease (GERD) in US Veterans is concurrent with increasing excess body weight.

Objective:

The objective of this cross-sectional study is to examine relationships between dietary macronutrients, gastrointestinal hormones, and GERD status.

Methods:

Ninety-eight veterans with overweight/obesity and empiric proton pump inhibitor (PPI) treatment were enrolled from the Tennessee Valley Healthcare System. Subjects had esophageal manometry and 24-h pH monitoring. Subjective symptoms were assessed with Gastroesophageal Reflux Disease Questionnaire (GERDQ) and Symptom Assessment Scale (GSAS). The primary outcomes, total acid exposure time (AET) and number of reflux episodes, enabled categorizing subjects as either pathologic GERD or inconclusive GERD. Data analysis included independent T-tests, Spearman Rho correlations, and multivariable linear regression modeling.

Results:

Higher intake of sugar-sweetened beverages (sugar-sweetened tea, soda, and fruit juice) associated with higher AET. Higher saturated-to-unsaturated fat intake is associated with higher AET and number of reflux episodes. Overall, sugar-sweetened beverage intake, saturated-to-unsaturated fat ratio, tomato-based food items, glucagon-like polypeptide 1 (GLP-1) level, time of first meal, and education status accounted for a significant amount of the variability in AET. Pathologic GERD subjects reported more heartburn ( p = 0.006), regurgitation ( p = 0.01), acid taste (0.001), and nausea severity ( p = 0.04). GERDQ score associated with AET ( r = 0.31, p = 0.005), but GSAS did not ( r = 0.12, p = 0.28).

Conclusion:

Of the many foods and nutrients tested, the type (not amount) of carbohydrate (simple sugars) and the type (not amount) of fat (saturated vs unsaturated fat) consumed associated with objective and/or subjective GERD testing. These novel findings contribute to the evidence base guiding specific dietary recommendations in the clinical management of GERD.
The importance of an early onset of migraine prevention: an evidence-based, hypothesis-driven scoping literature review
Authors: Gottschalk Christopher , Buse Dawn C. , Marmura Michael J. , Torphy Bradley , Pavlovic Jelena M. , Dumas Paula K. , Lalvani Nim , Blumenfeld Andrew
Published: May 2022

Recently approved migraine preventive therapies facilitate rapid control of migraine activity, potentially improving patients’ lives and minimizing the societal burden of migraine. This review synthesizes available evidence on rates and timing of early onset of migraine prevention and identifies patient-level outcomes related to early onset prevention. This evidence-based scoping review identified all available clinical trial evidence regarding the early onset of prevention of migraine, under the hypothesis ‘Patients with migraine (episodic or chronic) report additional benefits when receiving an approved migraine preventive treatment that demonstrates an early onset of prevention’. Early onset of prevention was defined as migraine preventive benefits within 30 days post-administration. PubMed, EMBASE, and CINAHL were searched for publications between 1988 and 2020. Overall, 16 publications described 18 studies. All studies were conducted in approved treatments [four anti-calcitonin gene-related peptide (CGRP) monoclonal antibodies and one chemodenervation agent] in patients with episodic/chronic migraine; no publications were identified for traditional oral agents for early migraine prevention. Compared to placebo, erenumab (three studies) reduced weekly migraine days within 1 week; fremanezumab (six studies) increased reports of no headache of at least moderate severity on Day 1 and significantly reduced migraine frequency within 1 week; galcanezumab (three studies) significantly reduced the mean number of patients with migraine beginning Day 1 and each day of the first week; eptinezumab (four studies) significantly reduced migraine attack likelihood on Day 1 by > 50% versus baseline; and onabotulinumtoxinA (two studies) reduced headache and migraine days within 1 week. Four publications described function, disability, and quality of life improvements as early as Week 4; none reported cost–benefit. Anti-CGRP monoclonal antibodies (erenumab, fremanezumab, galcanezumab, and eptinezumab) and a chemodenervation agent (onabotulinumtoxinA) provide clinically relevant benefits during the first treatment week. Literature describing clinically relevant benefits regarding early onset of prevention in patients with migraine is limited.
An Infected Bicuspid Aortic Valve, an Anomalous Coronary Artery, and a Dog-Bitten Postman
Authors: O’Dwyer Marliza , Houlihan Julie-Anne , O’Rourke Sadhbh , Young Vincent , O’Connell Brian
Published: May 2022

Risk factors for infective endocarditis (IE) include congenital heart defects, poor dentition, immunosuppression, or recent instrumentation. The occupational hazard of a dog bite, combined with bicuspid aortic valve (BAV) led to IE. 16S ribosomal DNA was able to pinpoint the causative organism. A healthy 33-year-old postman presented in profound heart failure and sepsis due to aortic regurgitation and an aortic root abscess. He underwent emergency aortic valve replacement and was found to have a BAV and anomalous right coronary artery. Blood cultures remained negative. 16S ribosomal DNA polymerase chain reaction (PCR) revealed the causative organism was Capnocytophaga canimorsus. On review, he recalled receiving a dog bite followed by a febrile illness a few days later. Congenital BAVs may become infected by seemingly innocuous injuries. 16S rDNA PCR is a more sensitive and specific diagnostic test than culture. This case demonstrates its utility in providing appropriate antimicrobial management for IE.
The COVID-19 Pandemic Impact on Pediatric Endoscopies in a Single Center
Authors: Moyer Shannon , Aktay Sinan , Blanchard Samra
Published: May 2022

Pediatric endoscopic procedures are considered at high risk for coronavirus disease 2019 (COVID-19) transmission, as it can be aerosolized during the upper and lower endoscopy. The data on the pediatric endoscopy experience during the COVID-19 pandemic is scarce. Our research goal is to explore the influence of the pandemic on our endoscopy practice. We retrospectively reviewed the charts of pediatric patients ages 1 to 21 years during the first year of the pandemic and compared it to the previous year. We found that procedural volumes were only impacted in the first 2 months of the pandemic and then returned to normal monthly procedural volumes. We also surveyed personal protective equipment (PPE) requirements and pre-procedural screening protocols. One percent of all pediatric endoscopy patients tested positive for COVID-19 during the pandemic year. We demonstrate that the combination of pre-procedural testing and infection control precautions enabled pediatric endoscopies to be performed safely in children.
A Challenging Knowledge Gap: Estimating Modes of HIV Acquisition Among Adolescents Entering HIV Care During Adolescence
Authors: Humphrey John , Triedman Miranda , Nyandiko Winstone , Sang Edwin , Kemboi Emmanuel , Alera Marsha , Novitsky Vlad , Manne Akarsh , Jepkemboi Eslyne , Orido Millicent , Apondi Edith , Vreeman Rachel , Wools-Kaloustian Kara , Kantor Rami
Published: May 2022

Characterizing HIV acquisition modes among adolescents with HIV (AHIV) enrolling in care during adolescence is a challenging gap that impacts differential interventions. We explored whether primary data collection with targeted questionnaires may address this gap and improve understanding of risk factors and perceptions about adolescents’ HIV acquisition, in Kenyan AHIV entering care at ≥10 years, and their mothers with HIV (MHIV). Clinical data were derived through chart review. Among 1073 AHIV in care, only 26 (2%) met eligibility criteria of being ≥10 years at care enrollment, disclosed to, and with living MHIV. Among 18/26 AHIV-MHIV dyads enrolled (median age of AHIV 14 years), none had documented HIV acquisition modes. Data suggested perinatal infection in 17/18 AHIV, with 1 reported non-perinatal acquisition risk factor, and some discordance between adolescent-mother perceptions of HIV acquisition. In this difficult-to-enroll, vulnerable population of AHIV-MHIV dyads, primary data collection can enhance understanding of AHIV acquisition modes.
Preparing the Show: Organizational ventriloquism as autocommunication
Authors: Christensen Lars Thøger , Christensen Emma
Published: May 2022

The notion that communication is constitutive of organization has been developed in interesting ways, especially by the ventriloqual perspective and its observation that organizations are made present when human and non-human figures speak on their behalf. So far, this perspective has mainly been used as an analytical approach to study conversations. However, understood as a specific type of show or performance act, the ventriloquism metaphor has further potential to elucidate how organizations are constituted in communication. Ventriloqual shows are often meticulously prepared and rehearsed, especially when intended to be performed in front of an outside audience. In this conceptual paper, we extend research on organizational ventriloquism by discussing how such preparations influence organizations. To that purpose, we draw on the notion of autocommunication understood as communication through which collectives are animated by their own constructs. Specifically, we focus on those backstage settings where official presentations of organizations are contemplated and planned. In such settings, organizational ventriloquists engage in careful deliberations over the appropriateness of specific figures and discussions about how organizational presentations might be perceived by critical stakeholders. Conceptualizing such preparation as autocommunicative ventriloquism, we discuss how figures invoked in such settings can influence organizations and shape their future practices.
Management of Emergent, Incarcerated, and Strangulated Paraesophageal Hernia
Authors: Henning Justin R. , Shah Paresh C.
Published: May 2022

The most dreaded complication of paraesophageal hernia is gastric volvulus with obstruction or strangulation with resultant gastric necrosis. Emergent repair of incarcerated/strangulated paraesophageal hernia has traditionally been performed via an open approach with significant associated morbidity and mortality. In the absence of gastric ischemia, the clinical situation may be temporized with nasogastric or endoscopic decompression/detorsion to allow resuscitation, medical optimization, and transfer to higher level of care. Definitive repair should be offered during the index admission if patient risk factors and facility resources allow. Minimally invasive transabdominal approaches (laparoscopic or robotic) are effective in most cases and should be the primary approach taken.
Indications for Repair of Asymptomatic or Minimally Symptomatic Paraespophageal Hernias: Gastroenterologist’s Perspective on Management
Authors: Parekh Parth J. , Johnson David A.
Published: May 2022

Paraesophageal hernias (PEHs) are a relatively uncommon type of hiatal hernia, thought to comprise only 5% of all hiatal hernias, affecting mainly older adults. Historically, surgical repairs for PEHs were reserved for symptomatic hernias refractory to medical management (i.e., reflux, dysphagia, regurgitation, anemia, dyspnea, or abdominal pain) or complications related to (i.e., bleeding, obstruction, or volvulus). Elective repair in asymptomatic or minimally symptomatic patients remain controversial. Here, we overview the indications and up to date evidence for repair for the asymptomatic and minimally symptomatic PEHs. Our approach is reflective of opinion, based on evidence and our experience, and focused on the following questions regarding PEHs: (1) What is the natural history for untreated PEHs and (2) What is the reported value for surgical repair of PEHs versus observation.
Shared Decision Making Surrounding the Role of Paraesophageal Hernia Repair in Elderly Patients
Authors: Merriman Nathan , Dunbar Kerry , Litle Virginia R.
Published: May 2022

Paraesophageal hernias in older patients can present a management dilemma for the patient, surgeon, and gastroenterologist. “Watch and wait” or operate are the 2 choices influenced by age. Shared decision making in the discussion of options is necessary to reflect a respect for the patient’s values. A team-based approach involving the patient and family provides a clear clinical pathway and connection across primary care, gastroenterology, and foregut surgery.
Indications for Repair of Minimally Symptomatic Paraesophageal Hernia: A Surgical Perspective
Authors: Buckley Francis P. , Hill Charles E. , Furay Elisa
Published: May 2022

Paraesophageal hernias (PEH) represent a minority of hiatal hernias and yet have the highest potential for catastrophic consequences for patients. Patients with paraesophageal hernias tend to be older with more comorbidities. The risk to benefit calculation in the treatment of patients with a minimally symptomatic PEH can complicated. Surgical repair and management of hiatal hernias has come a long way since the first repairs were undertaken. Surgical risk has become minimal, while gains in quality of life have increased. Decisions for surgery should be undertaken by well informed patients who have benefited from consultation with a gastroenterologist and foregut surgeon. For most patients suffering with a symptomatic PEH, the risk benefit calculation has swung firmly toward surgical repair when a multi-specialty approach is taken.
DNMT3A mutations define a unique biological and prognostic subgroup associated with cytotoxic T cells in PTCL-NOS
Authors: Herek Tyler A. , Bouska Alyssa , Lone Waseem , Sharma Sunandini , Amador Catalina , Heavican Tayla B. , Li Yuping , Wei Qi , Jochum Dylan , Greiner Timothy C. , Smith Lynette , Pileri Stefano , Feldman Andrew L. , Rosenwald Andreas , Ott German , Lim Soon Thye , Ong Choon Kiat , Song Joo , Jaffe Elaine S. , Wang Gang Greg , Staudt Louis , Rimsza Lisa M. , Vose Julie , d’Amore Francesco , Weisenburger Dennis D. , Chan Wing C. , Iqbal Javeed
Published: May 2022

Peripheral T-cell lymphomas (PTCLs) are heterogenous T-cell neoplasms often associated with epigenetic dysregulation. We investigated de novo DNA methyltransferase 3A (DNMT3A) mutations in common PTCL entities, including angioimmunoblastic T-cell lymphoma and novel molecular subtypes identified within PTCL–not otherwise specified (PTCL-NOS) designated as PTCL-GATA3 and PTCL-TBX21. DNMT3A-mutated PTCL-TBX21 cases showed inferior overall survival (OS), with DNMT3A-mutated residues skewed toward the methyltransferase domain and dimerization motif (S881–R887). Transcriptional profiling demonstrated significant enrichment of activated CD8+ T-cell cytotoxic gene signatures in the DNMT3A-mutant PTCL-TBX21 cases, which was further validated using immunohistochemistry. Genomewide methylation analysis of DNMT3A-mutant vs wild-type (WT) PTCL-TBX21 cases demonstrated hypomethylation in target genes regulating interferon-γ (IFN-γ), T-cell receptor signaling, and EOMES (eomesodermin), a master transcriptional regulator of cytotoxic effector cells. Similar findings were observed in a murine model of PTCL with Dnmt3a loss (in vivo) and further validated in vitro by ectopic expression of DNMT3A mutants (DNMT3A-R882, -Q886, and -V716, vs WT) in CD8+ T-cell line, resulting in T-cell activation and EOMES upregulation. Furthermore, stable, ectopic expression of the DNMT3A mutants in primary CD3+ T-cell cultures resulted in the preferential outgrowth of CD8+ T cells with DNMT3AR882H mutation. Single-cell RNA sequencing(RNA-seq) analysis of CD3+ T cells revealed differential CD8+ T-cell subset polarization, mirroring findings in DNMT3A-mutated PTCL-TBX21 and validating the cytotoxic and T-cell memory transcriptional programs associated with the DNMT3AR882H mutation. Our findings indicate that DNMT3A mutations define a cytotoxic subset in PTCL-TBX21 with prognostic significance and thus may further refine pathological heterogeneity in PTCL-NOS and suggest alternative treatment strategies for this subset.
Large left moiety renal tumor with renal vein thrombus in a horseshoe kidney
Authors: Bhat Abhishek , Kava Bruce
Published: May 2022

Background

Management of large renal tumors in a horseshoe kidney has received little attention due to the highly infrequent occurrence. Surgical management for tumors in horseshoe kidney is challenging due to complex aberrant vascular anatomy, relative fixity of the renal moieties and other associated conditions such as ectopia and malrotation. An added component of a renal vein thrombus in this scenario often adds to the surgical conundrum. Inadequate peri-operative management may cause devastating complications and increased morbidity and mortality. Careful pre-operative planning and meticulous intra-operative dissection limits blood loss and thereby complications.

Case presentation

We present the peri-operative management of a large renal tumor with a renal vein thrombus in a horseshoe kidney moiety as a case report with literature review focusing on the intra-operative surgical approach that may be adopted for these tumors. A 12 cm × 10 cm left renal moiety mass with renal vein thrombus with no distant metastasis was diagnosed. After confirmation of thrombus extent with CT as well as MRI Abdomen, the patient underwent left moiety radical nephrectomy with renal vein thrombectomy. Careful intra-operative dissection and division of the vascular supply of the left renal moiety was performed. Vessel stapler was used for division of isthmus that resulted in minimal blood loss, complete oncologic clearance and minimal post operative morbidity.

Conclusions

Large renal tumor with renal vein thrombus in horseshoe kidneys is an uncommon condition. Pre operative cross-sectional imaging and intra-operative use of vessel sealants like Ligasure, harmonic scalpel and vessel staplers contribute to minimizing blood loss and thereby result in excellent patient outcomes. We report a case of a large left renal moiety tumor with renal vein thrombus successfully managed with open radical left moiety nephrectomy and isthmectomy with tumor thrombectomy.
Economic growth, energy consumption and environmental degradation nexus in heterogeneous countries: does education matter?
Authors: Osuntuyi Busayo Victor , Lean Hooi Hooi
Published: May 2022

Background

Environmental concerns are growing globally. The world has suffered severe environmental deterioration over the years. Undeniably, the impact of environmental degradation on the earth’s geographical space is alarming, making environmental stakeholders to be worried. Existing literature has examined several factors affecting the environment, but the focus has now shifted to education and the need to maximize its potentials. Although studies have examined the direct impacts of education on the environment, those investigating its moderating role are relatively new and scarce, particularly across income groups. Understanding the channel through which education might affect the environment requires the knowledge of its moderating role. Therefore, this study employs FMOLS, DOLS, ARDL-PMG, CCEMG and heterogeneous panel causality test methodologies to investigate the direct and moderating effects of education in the growth-energy-environment linkages in heterogeneous income groups of 92 countries from 1985 to 2018.

Results

The findings of this study indicate that economic growth is a long-term solution to environmental deterioration in high and upper-middle-income countries, while the opposite holds for lower-middle-income and low-income countries. In addition, energy consumption is linked with environmental degradation across all income groups. Also, the study finds that education’s direct effects aggravate environmental degradation across all income groups. Moreover, its moderating role ameliorates the adverse effects of energy consumption on environmental degradation in high and upper-middle-income groups but worsens it in the lower-middle-income and low-income groups.

Conclusion

This study examines the role of education in economic growth, energy consumption and environmental degradation nexus. The study concludes that education is important for environmental sustainability as it encourages pro-environmental behaviors and attitudes and supports energy-efficient products and investments in green technologies. However, education may also aid energy-intensive activities and dirty technology by supporting lifestyles that are not eco-friendly. It is important, therefore, to provide education that promotes better environmental quality.
Comparative transcriptome analysis of heat-induced domesticated zebrafish during gonadal differentiation
Authors: Wang Chenchen , Chen Xuhuai , Dai Yu , Zhang Yifei , Sun Yuandong , Cui Xiaojuan
Published: May 2022

Background

The influence of environmental factors, especially temperature, on sex ratio is of great significance to elucidate the mechanism of sex determination. However, the molecular mechanisms by which temperature affects sex determination remains unclear, although a few candidate genes have been found to play a role in the process. In this study, we conducted transcriptome analysis of the effects induced by high temperature on zebrafish during gonad differentiation period.

Results

Totals of 1171, 1022 and 2921 differentially expressed genes (DEGs) between high temperature and normal temperature were identified at 35, 45 and 60 days post-fertilization (dpf) respectively, revealing that heat shock proteins (HSPs) and DNA methyltransferases (DNMTs) were involved in the heat-exposed sex reversal. The Gene Ontology (GO) terms and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway that were enriched in individuals after heat treatment included Fanconi anemia (FA) pathway, cell cycle, oocyte meiosis and homologous recombination.

Conclusions

Our study provides the results of comparative transcriptome analyses between high temperature and normal temperature, and reveals that the molecular mechanism of heat-induced masculinization in zebrafish is strongly related to the expression of HSPs and DNMTs and FA pathway during gonad differentiation.
A time-course transcriptome analysis of gonads from yellow catfish (Pelteobagrus fulvidraco) reveals genes associated with gonad development
Authors: Gao Dong , Huang Junrou , Lin Genmei , Lu Jianguo
Published: May 2022

Background

The yellow catfish, Pelteobagrus fulvidraco, is a commercially important fish species. It is widely distributed in the fresh water areas of China, including rivers, lakes, and reservoirs. Like many other aquaculture fish species, people have observed significant size dimorphism between male and female yellow catfish and it shows a growth advantage in males.

Results

Here, at the first time, the time-course transcriptome was used to explore the various expression profiles of genes in different gonad developmental stages and genders. A total of 2696 different expression genes (DEGs) were identified from different stages. Based on these DEGs, 13 gonad development related genes were identified which showed time-specific or sex biased expression patterns.

Conclusion

This study will provide the crucial information on the molecular mechanism of gonad development of female and male yellow catfish. Especially, during the different gonad development stages, these 13 gonad development related genes exhibit various expression patterns in female and male individual respectively. These results could inspire and facilitate us to understanding the various roles of these genes play in different gonad development stages and genders.
Opportunities and challenges in delivering remote primary care during the Coronavirus outbreak
Authors: Kaufman-Shriqui V , Shani M , Boaz M , Lahad A , Vinker S , Birk R
Published: May 2022

Background

Social distancing and lockdowns were implemented during the first period of the COVID-19 pandemic. Primary care physicians needed to adapt quickly to deliver remote care/telemedicine.

Methods

A cross-sectional, 47-item online Google Survey was distributed through the Israel Association of Family Physicians (IAFP) mailing list between March 31-May 5, 2020. The questionnaire included demographics, physician characteristics, and information on usage and perceived telemedicine quality. Sampling weights by sex and age groups were applied.

Results

One hundred fifty-nine primary care physicians (10.6% of registered IAFP members; 63.5% women; mean age 53.4 ± 10.4 years and median professional experience 21.3 years) replied to the survey. The majority (59.7%) of the participants performed a mixture of in-person along with phone counseling. About 40% had no former telemedicine experience. The majority indicated that telephone and video formats were inferior to in-person consultation (68%, 57.1% online and phone, respectively). The overall counseling quality grade (on a 1–10 scale,)median (IQR)) was 6.2 (3) for telephone and 7(2) for video. While 66.9% reported experiencing no challenges, 10% had technical problems, 10% interpersonal problems, 5.6% scheduling difficulties, and 7.5% other difficulties. Majority of 56.6% physicians indicated they prescribed more antibiotics,16.4% sent more blood tests, 24.5% referred more to experts, and 49.7% referred more to imaging in comparison to usual counseling. Higher phone quality score was significantly associated with physicians who indicated not prescribing more antibiotics during the pandemic (OR = 0.30, 95%CI 0.134–0.688, p = 0.004).

Higher online quality score was associated with physicians who indicated not sending more blood tests during the pandemic (OR = 0.06 95%CI 0.008–0.378, P = 0.003).

Conclusions

Our findings suggest telehealth holds considerable promise for counseling in the primary care setting. However, interpersonal challenges raised by physicians should be understood in-depth to develop tailored training and further examine it in randomized trials while integrating patient-reported outcomes. Finally, further research on utility, cost, and cost-efficiency during remote counseling with follow-ups, medical prescribing, and additional referrals is needed.
Multicenter epidemiological survey of pneumatosis intestinalis in Japan
Authors: Ohmiya Naoki , Hirata Ichiro , Sakamoto Hirotsugu , Morishita Toshifumi , Saito Eiko , Matsuoka Katsuyoshi , Nagaya Tadanobu , Nagata Shinji , Mukae Miyuki , Sano Koji , Suzuki Takayoshi , Tarumi Ken-ichi , Shimizu Seiji , Kawashima Kousaku , Hibi Toshifumi ,   Intractable Diseases, the Health and Labour Sciences Research Group, Ohmiya Naoki , Hirata Ichiro , Sakamoto Hirotsugu , Morishita Toshifumi , Saito Eiko , Matsuoka Katsuyoshi , Nagaya Tadanobu , Nagata Shinji , Mukae Miyuki , Sano Koji , Suzuki Takayoshi , Tarumi Ken-ichi , Shimizu Seiji , Kawashima Kousaku , Hibi Toshifumi , Imamura Akimichi , Minato Yohei , Matsueda Kazuhiro , Kuwata Go , Sakaguchi Masahiro , Saito Daisuke , Mikami Sakae , Fujishiro Mitsuhiro , Fujii Shigehiko , Umeno Junji , Aoi Kenji , Nutahara Daisuke , Kinjo Fukunori , Fujiya Mikihiro , Harada Keita , Matsushita Mitsunobu , Chiba Toshimi , Sasaki Yutaka , Tanaka Shinji , Aomi Yoshiaki , Kasugai Kunio , Yamamoto Shojiro , Yagi Nobuaki , Yoshie Tomoo , Yoshida Masaki , Fukudo Shin , Yamada Takanori , Kitsugi Kensuke , Kuriyama Shigeru , Miura Soichiro , Fujimoto Yoshiya , Niwa Yasumasa , Nishikawa Takashi , Okawa Kiyotaka , Sanomura Makoto , Nakamura Masanao , Mizoshita Tsutomu
Published: May 2022

Background

Pneumatosis intestinalis (PI) is a rare condition characterized by gas collection in the intestinal wall. We aimed to determine the etiology and affected segments associated with complications, treatment, and outcome.

Methods

We conducted a multicenter epidemiological survey using a standardized data collection sheet in Japan. Complicating PI was defined as strangulation or bowel necrosis, bowel obstruction, adynamic ileus, sepsis, shock, and massive gastrointestinal bleeding requiring blood transfusion.

Results

We enrolled 167 patients from 48 facilities. Multivariate analysis revealed that older age (adjusted OR, 1.05 and 95% confidence intervals [CI], 1.02–1.09, P = 0.0053) and chronic kidney disease (adjusted OR, 13.19 and 95% CI 1.04–167.62, P = 0.0468) were independent predictors of the small-bowel-involved type. Complicating PI was associated with the small-bowel-involved combined type (adjusted OR, 27.02 and 95% CI 4.80–152.01, P = 0.0002), the small-bowel-only type (adjusted OR, 3.94 and 95% CI 1.02–15.27, P = 0.0472), and symptomatic PI (adjusted OR, 16.24 and 95% CI 1.82–145.24, P = 0.0126). Oxygen therapy was performed in patients with a past history of bowel obstruction (adjusted OR, 13.77 and 95% CI 1.31–144.56, P = 0.0288) and surgery was performed in patients with complicating PI (adjusted OR, 8.93 and 95% CI 1.10–72.78, P = 0.0408). Antihypertensives (adjusted OR, 12.28 and 95% CI 1.07–140.79, P = 0.0439) and complicating PI (adjusted OR, 11.77 and 95% CI 1.053–131.526; P = 0.0453) were associated with exacerbation of PI. The complicating PI was the only indicator of death (adjusted OR, 14.40 and 95% CI 1.09–189.48, P = 0.0425).

Discussion

Small-bowel-involved type and symptomatic PI were associated with complications which were indicators of poor prognosis.
Serum O-glycosylated hepatitis B surface antigen levels in patients with chronic hepatitis B during nucleos(t)ide analog therapy
Authors: Murata Ayato , Angata Kiyohiko , Sogabe Maki , Sato Shunsuke , Ichida Takafumi , Narimatsu Hisashi , Genda Takuya
Published: May 2022

Background

Serum hepatitis B surface antigen (HBsAg) is a component of both hepatitis B virus (HBV) virions and non-infectious subviral particles (SVPs). Recently, O-glycosylation of the PreS2 domain of middle HBsAg protein has been identified as a distinct characteristic of genotype C HBV virions versus SVPs. This study aimed to evaluate serum O-glycosylated HBsAg levels in patients with chronic hepatitis B (CHB) treated with nucleos(t)ide analogs (NAs).

Methods

Forty-seven treatment-naïve patients with genotype C CHB were retrospectively enrolled. Serum O-glycosylated HBsAg levels at baseline and after 48 weeks of NA therapy were quantified by immunoassay using a monoclonal antibody against the O-glycosylated PreS2 domain of middle HBsAg, and their correlations with conventional HBV marker levels were analyzed.

Results

At baseline, the serum O-glycosylated HBsAg levels were significantly correlated with the HBV DNA (P = 0.004), HBsAg (P = 0.005), and hepatitis B-core related antigen (HBcrAg, P = 0.001) levels. Both HBV DNA and O-glycosylated HBsAg levels were decreased after 48 weeks of NA therapy. The significant correlation of the O-glycosylated HBsAg level with the HBsAg or HBcrAg level was lost in patients who achieved undetectable HBV DNA (HBsAg, P = 0.429; HBcrAg, P = 0.065). Immunoprecipitation assays demonstrated that HBV DNA and RNA were detected in the O-glycosylated HBsAg-binding serum fraction, and the proportion of HBV RNA increased during NA therapy (P = 0.048).

Conclusion

Serum O-glycosylated HBsAg levels change during NA therapy and may reflect combined levels of serum HBV DNA and RNA virions. An O-glycosylated HBsAg-based immunoassay may provide a novel means to monitor viral kinetics during NA therapy.
Reactogenicity after heterologous and homologous COVID-19 prime-boost vaccination regimens: descriptive interim results of a comparative observational cohort study
Authors: Warkentin Lisette , Zeschick Nikoletta , Kühlein Thomas , Steininger Philipp , Überla Klaus , Kaiser Isabelle , Gall Christine , Sebastião Maria , Hueber Susann
Published: May 2022

Background

Due to safety signals after vaccination with COVID-19 vector vaccines, several states recommended to complete the primary immunization series in individuals having received one dose of ChAdOx1 (AstraZeneca) with an mRNA vaccine. However, data on safety and reactogenicity of this heterologous regimen are still scarce. The aim of this study was therefore to compare the reactogenicity and the frequency of medical consultations after boost vaccination in a heterologous regimen with ChAdOx1 and mRNA-vaccines (BNT162b2, BioNTech/Pfizer or mRNA-1273, Moderna) to homologous regimens with ChAdOx1 or mRNA-vaccines, respectively.

Methods

In an observational cohort study reactogenicity and safety were assessed 14–19 days (short-term) and 40 to 56 days (long-term) after the boost vaccination using web-based surveys. In the short-term survey solicited and unsolicited reactions were assessed, while the long-term survey focussed on health problems leading to medical consultation after the vaccination, including those that were not suspected to be vaccine-related.

Results

In total, 9146 participants completed at least one of the surveys (ChAdOx1/ChAdOx1: n = 552, ChAdOx1/mRNA: n = 2382, mRNA/mRNA: n = 6212). In the short-term survey, 86% with ChAdOx1/mRNA regimen reported at least one reaction, in the ChAdOx1/ChAdOx1 and mRNA/mRNA cohorts 58% and 76%, respectively (age and sex adjusted p < 0.0001). In the long-term survey, comparable proportions of individuals reported medical consultation (ChAdOx1/ChAdOx1 vs. ChAdOx1/mRNA vs. mRNA/mRNA: 15% vs. 18% vs. 16%, age and sex adjusted p = 0.398). Female gender was associated with a higher reactogenicity and more medical consultations. Younger age was associated with a higher reactogenicity, whereas elderly people reported more medical consultations.

Conclusion

Although the short-term reactogenicity was higher with the heterologous regimen than with the homologous regimens, other factors such as higher efficacy and limited resources during the pandemic may prevail in recommending specific regimens.