bluuebunny/crossref_metadata_2025 huggingface dataset:
Catalytic pyrolysis of cellulose using acidic ionic liquids at low temperatures and explanation of the catalytic mechanism and product evolution model
Authors: Li zhishuncheng , Yuan Yongheng , Qu GuangFei , Cui Qingyuan , He Yanhua , Ning Ping , Xie Ruosong , Li Weijie , Xu Yibi
Published: August 2023

In this paper, we investigated the catalytic pyrolysis process of cellulose at temperatures of 140°C, 180°C, 260°C and 300°C with acidic [Bmim]OTf ionic liquids as catalysts. Characterization of the pyrolysis products by SEM, XRD, FTIR and GC-MS showed that the initial pyrolysis temperature of MC was significantly reduced from 315°C to 140°C with a temperature interval of nearly 200°C, and the crystalline structure of cellulose was rapidly destroyed, which might be due to the synergistic catalytic effect of CF3SO3- and [Bmim]+. The molecular potential distributions of cellulose and ionic liquids were analyzed from a microscopic perspective, and a novel mechanism model for the synergistic catalytic pyrolysis of MC by [Bmim]OTf was developed. This study provides a reference for the targeted product's targeted regulation mechanism, and finally achieves the efficient and low consumption utilization of biomass.
Investigating the causal association among 25(OH)D , 25(OH)D3 , C3-epi- 25(OH)D3 and the risk of oropharyngeal cancer using Mendelian randomization
Authors: Yu YaoHui , Zhou Yu
Published: August 2023

Background: Prior research suggested a differential association of 25-hydroxyvitamin D (25(OH)D) metabolites ,25 hydroxyvitamin D and the epimeric form (C3-epi-25(OH)D3) with the health outcomes and cancer1,2, but little is known about the causal direction of the associations in oropharyngeal cancer (OPC). We aimed to evaluate the causal effect of 25-hydroxyvitamin D (25(OH)D) metabolites ,25 hydroxyvitamin D concentration and the epimeric form (C3-epi-25(OH)D3) on the risk of OPC using Mendelian randomization (MR).
Methods: Genetic variants robustly associated with 25(OH)D , 25(OH)D3 and C3-epi-25(OH)D3 were used to perform MR analyses with summary data on 291 OPC cases, obtained from European, North America and South America. We performed two-sample MR analyses using an inverse variance weighted (IVW) as the primary approach, while using 5 additional methods (e.g., MR-Egger, weighted median(WM) and Cochran’s Q) as sensitivity analysis to detect and adjust for pleiotropy.
Results: In MR, we found that evidence for a lower causal effect of 25(OH)D3 on risk of OPC in a European population (Weighted Median(WM) OR = 0.47, 95% CI = 0.24-0.91, P = 0.03).
Although the IVW showed that it was significant, further leave-one-out results indicated that the negative results were unstable, and the results became positive after rs9304669 was excluded (OR = 0.51, 0.28-0.91, P = 0.02). The remaining results were negative. The results of sensitivity analysis were stable, and indicated that it was no heterogeneity and pleiotropy.
Conclusions: Our study found obvious associations of 25(OH)D , 25(OH)D3 and C3-epi-25(OH)D3 with OPC risk.
EGFR Mutation Impacts Recurrence in High-Risk Early-Stage Lung Adenocarcinoma in the IASLC Grading System
Authors: Nomura Kotaro , Aokage Keiju , Kaminuma Yasunori , Nakai Tokiko , Wakabayashi Masashi , Ikeno Takashi , Koike Yutaro , Taki Tetsuro , Miyoshi Tomohiro , Tane Kenta , Samejima Joji , Ishii Genichiro , Tsuboi Masahiro
Published: August 2023

Introduction: The developments of perioperative treatments for patients with high-risk early-stage lung cancer are ongoing, however, real-world data and evidence of clinical significance of genetic aberration is lacking in this population. This study aimed to identify patients with early-stage lung adenocarcinoma at high risk for recurrence based on pathological indicators of poor prognosis, including the International Association for the Study of Lung Cancer (IASLC) grade, and elucidate the prognostic impact of epidermal growth factor receptor mutation (EGFRm) status.
Methods: This retrospective study included 494 consecutive patients who underwent complete resection for pathological stage I lung adenocarcinoma between 2011 and 2016. The patients were evaluated for EGFRm and IASLC grade. Multivariable analysis was used to identify pathological factors for poor prognosis associated with recurrence-free survival (RFS) and overall survival (OS). Patients with any one of these factors were classified into the high-risk group. The prognostic impact of EGFRm was evaluated using RFS, OS, and cumulative recurrence proportion.
Results: Multivariable analysis for RFS and OS revealed that IASLC grade 3, pathological invasion size>2 cm, and presence of lymphovascular invasion were indicators of poor prognosis. EGFRm-positive patients had a higher incidence of all types of recurrence, including central nervous system (CNS) metastasis and distant metastasis in high-risk group, but not in low-risk group.
Conclusions: This study provides evidence that patients with EGFRm-positive stage I lung adenocarcinoma in the high-risk group have an increased risk of recurrence, including CNS metastasis. These findings highlight the need for development of adjuvant treatment in this population.
The investigation on medical diseases comorbidities in geriatric patients with mental disorders
Authors: Song Haining , Zhang Xu , Cao Yuying , Wei Chen , Li Xue , Gao Lingnan , Yang Zhenzhen , Wang Zhonggang
Published: August 2023

Objective:Medical disorders in geriatric patients with mental disorders have attracted more and more attention. So far, there is still a lack of large sample studies on this issue in China. Therefore, we conducted this study to explore the clinical characteristics and effecting factors of the comorbidity of medical disease in geriatric patients with mental disorders.
Method: A total of 2125 geriatric patients with mental disorder hospitalized from January 1,2017 to December 3l,2017 were enrolled in the study. According to whether they had medical diseases, all geriatric patients were divided into the comorbid group and non-comorbid group. The demographic information and disease characteristic information questionnaire was used to collect relevant data for comparative analysis.
Results: The comorbidity rate of medical diseases in geriatric patients with mental disorders was 87.1%, with an average of 2.9 comorbidities per patient. The age, length of stay and hospital expenses of the comorbid group were significantly more than the non-comorbid group (All P <0.05). The comorbidity group’s number of patients who had positive past history, have extrovert disposition were significantly more than the non-comorbidity group (All P <0.05). The top 5 comorbid medical disorders were cerebral infarction (12.3%), hypertension (11.8%), coronary heart disease (11.2%), cerebral atrophy (6.7%) and liver and biliary tract disease (5.5%) in geriatric patients with mental disorder. The spearman analysis showed that age was significantly positively associated with the number of comorbidities (P<0.05), while marriage and residence address were significantly negatively correlated with the number of comorbidities (All P<0.05). The logistic analysis showed that age, disposition and past history were independent risk factors of comorbidities in geriatric patients (All P<0.05).
Conclusion: Geriatric patients with mental disorder have a high rate of comorbidity with medical disorders. Age, marriage, residence address and disposition may all play a role in disease comorbidity.. Medical diseases increase length of stay, the hospital expenses and the burden of geriatric patients. Psychiatrists should take positive measures to treat medical diseases.and mental disorders of geriatric patients.
Intercultural competence in Healthcare Higher Education: Adapting UNESCO Story Circles method in medical education
Authors: Milán Carolina Giménez , Güemes Luciana Acosta
Published: August 2023

The importance for culturally competent healthcare systems that can adapt and meet the needs of changing populations while accommodating cultural, religious, linguistic and gender diversity is becoming increasingly important around the world. Story Circles is a practical intercultural tool designed by UNESCO for developing and practicing intercultural competencies that can be used with different groups of people in a variety of settings. The healthcare training, where patients and healthcare providers are brought together in understanding each other’s perspectives and cultural contexts, is one of the specific contexts in which Story Circles can be used to develop individuals’ intercultural competencies. Story Circles is a tool that gives participants the opportunity to practice intercultural competencies, especially “listening for understanding”; considering that listening is considered a key skill in healthcare. We adapted the UNESCO Story Circles methodology to the specific experiences of undergraduate medical students to include discipline-specific prompts related to healthcare settings. 35 students participated in the activity and completed the final questionnaire. The findings corroborate positive reviews by all participants, and the proposal of Story Circle methodology as a complementary training activity for them to achieve intercultural competencies as well as the practice of “listening for understanding” was highly appreciated by all the participants.
Excess hospitalizations and in-hospital mortality associated with seasonal influenza in Italy: a 11-year retrospective study
Authors: Fattore Giovanni , Pongiglione Benedetta , Vezzosi Luigi
Published: August 2023

Background
Influenza and flu-like syndromes are difficult to monitor because the symptoms are not specific, laboratory tests are not routinely performed, and diagnosis codes are often lacking or incompletely registered in medical records. This may result in an underestimation of hospital admissions, associated costs, and in-hospital mortality. Therefore, this study aimed to estimate the public health and economic burden of hospitalisations associated with influenza in Italy, at the national and regional levels.
Methods
This 11-year retrospective study included patients admitted to hospitals for influenza or diagnoses attributable to influenza (including respiratory and cardiocirculatory conditions) from 2008/09 to 2018/19. Data on hospitalisations were extracted from the Italian Hospital Discharge Records. Information on weekly influenza-like syndrome incidence and weekly average temperature were used to estimate the burden of influenza in terms of hospital admissions in every Italian region and for different age groups by applying a negative binomial model. The model was also applied to estimate in-hospital mortality and the total costs of influenza and influenza-like hospital admissions.
Results
Over the study period, in addition to 3,970 average seasonal admissions coded as influenza, we estimated an average of 21,500 admissions per season attributable to influenza, which corresponds to 36.4 cases per 100,000. Most of the estimated additional hospitalisations concerned older individuals (> 65 years) and children (0–4 years) with 86 and 125 cases per 100,000, respectively. Large variations were observed across regions. Overall, the total estimated hospital burden attributable to influenza (including respiratory and cardiocirculatory conditions) was approximately €132m per year. While the in-hospital mortality for admissions with a primary diagnosis of influenza was very low (∼150 cases per season), cases increased dramatically for primary diagnoses of influenza and pneumonia (about 9,500 cases per season). The average seasonal estimated in-hospital mortality for admissions attributable to influenza was equal to 2,775 cases.
Conclusions
Our findings suggest a remarkable underestimation of the burden of influenza, mostly in the older population but not neglectable in younger individuals. Our results may aid the management of current and future flu seasons and should be used for policy making (e.g., vaccine strategies) and operation management choices (e.g., planning and staffing beds during influenza peaks). Overall, the present study supports the need for increased testing for influenza in Italy to tackle the current underestimation of influenza burden.
Assessment of Clinical Relevance of Antigen Improves Diagnostic Accuracy of Hypersensitivity Pneumonitis
Authors: Iijima Yuki , Ejima Masaru , Yamana Takashi , Shibata Sho , Shirai Tsuyoshi , Okamoto Tsukasa , Furusawa Haruhiko , Tateishi Tomoya , Adachi Takuya , Mori Mio , Kirimura Susumu , Anzai Tatsuhiko , Takahashi Kunihiko , Miyazaki Yasunari , Sonoda Shiro
Published: August 2023

Background
Exposure assessment is integral to the diagnosis of hypersensitivity pneumonitis (HP). Although the clinical relevance of exposed antigens is essential for the assessment, many of the previous guidelines or reports have only evaluated a simple exposure history or immunological test. To overcome this problem, the Exposure Assessment Form (EAF) was developed as an assessment tool for classifying the exposure grade from G0 to G4. The EAF was modified from the description in the HP guidelines published by the Japanese Respiratory Society.
Methods
One hundred and seventy-two consecutive patients with interstitial lung disease who underwent multidisciplinary discussion (MDD) at our hospital were retrospectively examined. We assessed whether the use of the EAF improved the performance of guidelines in the diagnosis of HP. We also evaluated whether the exposure grade affected the prognosis of HP.
Results
Even when HP diagnosis with a confidence of 70% or higher was made according to the international guideline, almost half of these cases had different final diagnoses with exposure grades of G0, G1, or G2. When the result of the EAF was integrated into the exposure definition of the international guideline, the specificity of the diagnostic performance improved, while sensitivity was maintained. Furthermore, HP patients with an exposure grade of G3 or higher showed tendency for longer time to initiate drug treatment.
Conclusions
This is the first study to evaluate the clinical relevance of possible antigens using the EAF. Assessing the exposure grade prevents overdiagnosis and improves the diagnostic performance of the guideline.
Combined anatomical MRI differentiates pulmonary invasive adenocarcinoma from tuberculoma in noncalcified nodule: a retrospective comparison of CT with MRI
Authors: Yang Shuyi , Shi Yuxin , Liu Tiefu , Zhuo Yaoyao , Wang Qingle , Zhang Zhiyong , Shan Fei
Published: August 2023

Objective: MRI as a non-ionizing modality can be a complementary tool for nodules assessment. This study is aimed to evaluate the potential of the combined conventional and modified anatomical MRI sequences for differential diagnosis of invasive adenocarcinoma (IAC) and tuberculoma.
Materials and methods:Sixty-seven patients (median 54 years, range 18-82 years) with 82 noncalcified nodules (mean 19.56±6.85 mm, range 7-30 mm) underwent CT and MRI (T1WI-starVIBE, T1WI-VIBE, T2WI-TSE-fBLADE). Two radiologists independently assessed nodule dimensions and morphologic features (margin, morphology, lobulation, spiculation, cavity, air bronchogram, pleural indentation). Comparison of categorical variables was performed using Chi-square test. The inter-method agreement of morphologic features assessment by CT and MRI sequences were compared using Kappa test. Multivariate logistic regression analyses were applied to identify independent predictors to IAC. ROC analysis was performed to investigate the differential diagnosis capability.
Results: Thirty-eight IACs and 44 tuberculomas were identified. Readers 1 and 2 underestimated the nodules mean diameter with T1WI-starVIBE (T1WI-VIBE, T2WI-TSE-fBLADE) by 0.86±1.71 mm (1.19±2.06 mm, 0.15±1.96 mm) and 0.99±1.75 mm (1.27±2.04 mm, 0.19±1.91 mm). The inter-method agreements between MRI and CT were “fair” to “excellent” in the evaluation of morphological features except for spiculation (0.318≦Kappa≦0.895). Compared with the tuberculoma group, the IAC group was significant with unclear margin (T1WI-starVIBE, T1WI-VIBE), irregular morphology (CT, MRI), lobulation (CT, MRI), spiculation (T1WI-starVIBE, T2WI-TSE-fBLADE) and air bronchogram (CT, T1WI-starVIBE and T1WI-VIBE) (P﹤0.05). The AUC values for the logistic model by the combination of CT and MRI were 0.867/0.877 (reader 1/2: sensitivity 73.68%/76.32%, specificity 86.36%/86.36%) and were significantly higher than that by T1WI-starVIBE (P=0.002) and T1WI-TSE-fBLADE (P=0.027) (reader 1), as well as higher than that by CT (P=0.045) and T1WI-starVIBE (P=0.003) (reader 2).
Conclusion: The combined conventional and modified anatomical MRI sequences has diagnostic potential in distinguishing pulmonary IAC from tuberculoma.
A Rare Cause of Extreme Leukocytosis: Primary Plasma Cell Leukemia with High-risk Cytogenetics
Authors: Sonmez Ozge , Elverdi Tugrul , Tekin Tuba Ozkan , Kaya Selin Kucukyurt , Akı Suat Hilal , Salihoglu Ayse
Published: August 2023

Background
Primary plasma cell leukemia (pPCL) is a rare and highly aggressive plasma cell disorder. Extreme leukocytosis is an infrequent finding in pPCL.
Case presentation:
We reported an 82-year-old female patient who presented with marked leukocytosis (61.900/µl) and was diagnosed with pPCL. Plasma cells were found to have t(14;20) and 1q21 amplification. Following partial response after two cycles of bortezomib/dexamethasone combination, central nervous system (CNS) relapse occurred. Due to the advanced age and frailty, no further therapy could be administered. She had a fulminant disease course and died within one month of the CNS involvement.
Conclusion
PCL should be included in the differential diagnosis of leukocytosis.
Effectiveness and Safety of Pharmacopuncture therapy for chronic low back pain: A protocol for an assessor-blinded, pragmatic randomized controlled, pilot trial
Authors: Choi Youn Young , Kim Young Kyung , Won Eun Sol , Ryu Hwa Yeon , Kang Jae Hui , Lee Hyun
Published: August 2023

Background
Low back pain is a common musculoskeletal disorder worldwide with a lifetime prevalence of up to 80%, and Korean medicine treatment is often used for it. Chronic low back pain results in great personal, social, and economic burden. However, its cause is known to be non-specific. We will investigate the effectiveness and safety of pharmacopuncture for chronic low back pain since there is a current lack of research on this topic.
Methods
This will be a pragmatic randomized, and assessor-blinded pilot clinical study. The participants will be randomly allocated to the treatment group (pharmacoupunture therapy with traditional Korean medicine) or to the control group (traditional Korean medicine). The duration of the clinical trial will be 9 weeks. The primary outcome will be measured using the visual analog scale; the secondary outcomes will include the Oswestry Disability Index, Patient Global Impression of Change, no worse than mild pain, and range of motion.
Conclusions
We will evaluate the efficacy and safety of pharmacopuncture for chronic low back pain and will contribute to knowledge on the evidence-based treatment for it.
Abberviations:
LBP: low back pain, IRB: Institutional Review Board, KMD: Korean medical doctor, TKM: Traditional Korean medicine, VAS: Visual Analog Scale, ODI: Oswestry Disability Index, PGIC: Patient Global Impression of Change, ROM: Range of motion, PRCT: pragmatic randomized controlled trial, SAE: serious adverse event
Trial registration:
This study protocol was registered with the Korean National Clinical Research Information Service (CRIS) on July 17, 2023 (CRIS-KCT0008620). The participants will be retrospectively registered. https://cris.nih.go.kr/cris/search/detailSearch.do?seq=25180&search_page=L
Trends in socioeconomic inequalities in cause-specific premature mortality in Belgium, 1998-2019
Authors: OTAVOVA Martina , MASQUELIER Bruno , FAES Christel , BORRE Laura DEN , VANDENINDEN Bram , DE CLERCQ Eva , DEVLEESSCHAUWER Brecht
Published: August 2023

Background
Higher levels of socioeconomic deprivation have been consistently associated with increased risk of premature mortality, but a detailed analysis by causes of death is lacking in Belgium. Our aim is to investigate the association between area deprivation and all-cause and cause-specific premature mortality in Belgium over the period 1998–2019.
Methods
We used the 2001 and 2011 Belgian indices of multiple deprivation to assign statistical sectors, the smallest geographical units in the country, into deprivation deciles. All-cause and cause-specific premature mortality rates, population attributable fraction and potential years of life lost due to inequality were estimated by period, sex, and deprivation deciles.
Results
Men and women living in the most deprived areas were 1.96 and 1.78 times more likely to die prematurely compared to those living in the least deprived areas over the period under study (1998–2019). About 28% of all premature deaths could be attributed to socioeconomic inequality and about 30% of potential years of life lost would be averted if the whole population of Belgium faced the premature mortality rates of the least deprived areas.
Conclusion
Premature mortality rates have declined over time, but the inequality has increased due to a faster pace of decrease in the least deprived areas compared to the most deprived areas. As the causes of death related to poor lifestyle choices contribute the most into the inequality gap, more effective, country-level interventions should be put in place to target segments of the population living in the most deprived areas as they are facing disproportionately high risks of dying.
Pediatric Parosteal Osteosarcoma of the Distal Radius with Destruction of the Adjacent Ulna: A Case Report
Authors: Perloff Andrea , Park SeHoon , Panganiban Robert , deVries John
Published: August 2023

Introduction:Parosteal osteosarcomas are low-grade bony malignancies that are treated primarily with surgical resection and reconstruction. We report a unique case of a pediatric patient who presented with a parosteal osteosarcoma of the distal radius with local invasion into the ulna. Likely due to their slow-growing nonaggressive nature, parosteal osteosarcomas have not been previously described to invade adjacent bony structures through direct contact. Our patient presented in a significantly delayed manner due to social circumstances, allowing us to inadvertently describe this novel behavior. We review this rare case and describe the current understanding of this tumor.
Case presentation:Our patient is a 13-year-old male who presented with a parosteal osteosarcoma of his distal radius. He presented with a palpable wrist mass and wrist stiffness. He presented in a delayed manner with advanced local disease due to social factors. Imaging revealed an osseous radial mass that effaced the ulna and likely stunted its growth. The patient ultimately underwent complex resection and allograft reconstruction of both his distal radius and ulna. Intraoperative pathology confirmed tumor pathology with erosion of the adjacent ulna. Allograft reconstruction of the radius and ulna was performed utilizing patient-specific custom cutting guides. At the 6-month postoperative visit, the patient had no recurrence of the mass, minimal pain, and had almost regained range of motion of the extremities. Clinical radiographs at the 6-month postoperative visit demonstrated allograft incorporation.
Conclusions: We present a previously unreported case of pediatric parosteal osteosarcoma of the distal radius with erosion of the adjacent ulna through direct contact. We describe the challenges in and emphasize the importance of arriving at a definitive diagnosis in a timely manner for the proper treatment of this malignancy.
Efficacy and safety of third-generation EGFR-TKIs in patients with non-small cell lung cancer: a systematic review and meta-analysis of randomized controlled trials
Authors: Cai Zelin , Yang Huiting , Yu Zhuoran , Su Jingyang , Ren Ning , Lin Xianlei , Zhou Heran , Huang Ting
Published: August 2023

Background and objective
The third-generation EGFR-TKIs are used in the treatment of non-small cell lung cancer. But its efficacy and safety are still unknown. This meta-analysis was conducted to evaluate the efficacy and safety of the third-generation EGFR-TKIs in randomized controlled trials (RCTs).
Methods
We searched PubMed, EMBASE, Cochrane Library, and Web of Science for studies in terms of the efficacy and safety of third-generation EGFR-TKIs in patients with non-small cell lung cancer. Meta-analysis was performed using RevMan5.4 and the odds ratio (OR) or the risk ratio (RR) or the weighted mean difference (WMD) with 95% confidence interval (95%CI) of overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), treatment-related adverse events (TRAEs), and TRAEs ≥ 3 reported in the literature.
Results
Six articles and a total of 1968 patients were finally included in this analysis. The PFS, ORR, DCR of the treatment group were significantly higher than that of the control group. The TRAEs ≥ 3 of the treatment group were significantly lower than that of the control group. Nonetheless it is no significant difference in TRAEs among these trials.
Conclusion
The third-generation EGFR-TKIs is effective and safe in the treatment of patients with NSCLC. Although the number of articles included in this article is limited, according to the search results, a large number of relevant trials are ongoing. Therefore, we look forward to the results of related trials, so that the third-generation EGFR-TKIs can be widely used and cure more patients.
Positive predictive value of axillary lymph node cortical thickness and nodal, clinical, and tumor characteristics in newly diagnosed breast cancer patients
Authors: Loonis Anne-Sophie T , Chesebro Allyson L , Bay Camden P , Portnow Leah H , Weiss Anna , Chikarmane Sona A , Giess Catherine S
Published: August 2023

Purpose
Axillary lymph nodes (LNs) with cortical thickness > 3 mm have a higher likelihood of malignancy. Examination of the positive predictive value (PPV) of axillary LN cortical thickness in newly diagnosed breast cancer patients, and nodal, clinical, and tumor characteristics associated with axillary LN metastasis.
Methods
Retrospective review of axillary LN fine needle aspirations (FNAs) performed 1/1/2018-12/31/2019 included 135 axillary FNAs in 134 patients who underwent axillary surgery. Patient demographics, clinical characteristics, histopathology and imaging features were obtained from medical records. Hypothesis testing was performed to identify predictors of axillary LN metastasis.
Results
Cytology was positive in 72/135 (53.3%), negative in 61/135 (45.2%), and nondiagnostic in 2/135 (1.5%). At surgery, histopathology was positive in 84 (62.2%) and negative in 51 (37.8%). LN cortices were thicker in metastatic compared to negative nodes (p < 0.0001). PPV of axillary LNs with cortical thickness ≥3 mm, ≥3.5 mm, ≥4 mm and ≥4.25 mm was 0.62 [95% CI 0.53, 0.70], 0.63 [0.54, 0.72], 0.67 [0.57, 0.76] and 0.74 [0.64, 0.83], respectively. At multivariable analysis, abnormal hilum was associated with nodal metastasis (OR = 3.44, p = 0.016), while focal/eccentric cortical thickening was inversely associated with metastasis (OR = 0.35, p = 0.038).
Conclusion
In newly diagnosed breast cancer patients, increasing axillary LN cortical thickness, abnormal fatty hilum, and diffuse cortical thickening are associated with nodal metastasis. PPV of axillary LN cortical thickness ≥3 mm and ≥3.5 mm is similar but increases for cortical thickness ≥4 mm. FNA of axillary LNs with cortex < 4 mm may be unnecessary for some patients undergoing sentinel LN biopsy.
Blood pressure parameters and its association with albuminuria in adolescents with type 1 diabetes mellitus and ABPM using Mobil-O-Graph.
Authors: Sołtysiak Jolanta , Skowronska Bogda , Mackowiak-lewandowicz Katarzyna , Blumczynski Andrzej , Ostalska-Nowicka Danuta , Zachwieja Jacek
Published: August 2023

Introduction: This study aimed to evaluate the blood pressure (BP) status, including circadian profile, arterial stiffness parameters, and hemodynamic indicators, and its association with albuminuria in adolescents with type 1 diabetes mellitus.
Methods: The study included 46 patients, with an average diabetes duration of 7.38 ± 3.48 years. Ambulatory blood pressure monitoring (ABPM) was conducted using an oscillometric device, the Mobil-O-Graph, which is a Pulse Wave Analysis Monitor.
Results: Hypertension arterialis (HA) was diagnosed in 30% of the patients, prehypertension (preHA) in 53%, and normal blood pressure (N) in 17%. In most cases, elevated BP was attributed to isolated nocturnal diastolic BP increases (42% in preHA and 50% in HA). The preHA and HA groups exhibited significantly increased pulse wave velocity (PWV), a measure of arterial stiffness. Non-dipping status, characterized by the absence of nocturnal diastolic BP dipping, was only associated with urinary albumin excretion (UAE). UAE was positively correlated with 24-hour diastolic peripheral and central BP, diastolic load, heart rate, augmentation index (AIx@75), and nocturnal total vascular resistance (TVR).
Conclusions: Hypertension is a common complication of type 1 diabetes mellitus in adolescents, primarily caused by elevated nocturnal diastolic BP. Arterial stiffness, as indicated by PWV, appears to be the main contributor to increased BP in adolescents with type 1 diabetes mellitus. Albuminuria is mainly associated with diastolic BP, particularly during the nocturnal period, including non-dipping status. The association of UAE with AIx@75 and nocturnal TVR suggests the presence of early-stage vascular disease in diabetic adolescents.
Rocky Mountain West COVID-19 Modeling: A descriptive assessment of the current public health needs during the COVID-19 pandemic to endemic transition
Authors: Quandelacy Talia M. , Kasarskis Irina , Wu Emma , Carlton Elizabeth
Published: August 2023

Background: Mathematical models of infectious diseases have played a key role in the response to the COVID-19 pandemic and many prior infectious disease outbreaks. Effective models require understanding decision-makers' needs. While much attention was placed on the needs of public health leaders in the early phase of the pandemic, by summer 2022, the way needs evolved was poorly documented. Moreover, needs in rural areas have never been well-understood. Getting a more complete and up-to-date description of these needs is key to designing modeling and data visualization tools that can aid in public health response.
Methods: We conducted semi-structured interviews with public health leaders representing state, local, and tribal health departments in the Rocky Mountain West in the summer of 2022 to understand their priorities, decision-making needs, and data resources over two years into the COVID-19 pandemic.
Results: Public health leaders from six organizations representing three states, local, regional, and tribal public health agencies in the Rocky Mountain West participated in our interviews. Responses to priorities and needs covered a broad range of topics. Priorities included having timely information on vaccines, anticipating COVID-19 demands on hospitals, understanding the potential impacts of emerging variants and communicating immunity concepts to the public. Decisions focused on making public health recommendations as opposed to mandates. Travel-related introductions of SARS-CoV-2 infections were not a present concern compared to earlier in the pandemic. Limited access to timely COVID-19 data and challenges tracking COVID-19 hospitalizations was a challenge mentioned by multiple interviewees.
Conclusions: Over two years since SARS-CoV-2 emerged, there is still an important role for modeling during epidemic and pandemic responses. There remain major gaps in data availability, particularly related to COVID-19 hospital demand, that make it challenging to utilize timely and granular data to inform and parameterize models.
PD-L1 expression in Advanced Urothelial Carcinomas in two reference institutions in Colombia.
Authors: Hinestrosa Francisco Vicente , Diaz Jorge Augusto , Aristizabal Fabio Ancizar
Published: August 2023

OBJECTIVE: To determine and characterize the expression level of PD-L1 in a group of local patients analyzed by: age, gender, functional status, and other potential prognostic factors.
METHODS: Descriptive, retrospective, observational cohort study. PD-L1 expression levels were measured by a validated immunohistochemistry method using 22C3 antibody, with the Combined Positive Score methodology. Demographics and other variables were collected from medical records.
RESULTS: 59 tissue samples were collected for biomarker testing. 22.0% (n=13) of the Urothelial cancer samples had a PD-L1 CPS score ≥10 and 54.2% (n=32) had a PD-L1 ≥1; for the score of ≥5 28.8% of samples fell in that category. Most cases were bladder cancers, in histopathological diagnosis most of cases were either High grade Urothelial Carcinoma or High grade Papillary Urothelial Carcinoma (64%).
CONCLUSION: The PD-L1 expression prevalence in a cohort of urothelial Colombian population has been studied. PD-L1 CPS score ≥10 prevalence was less for UC when compared with previous reports for these tumors in clinical trials. Further studies focused on evaluating PD-L1 expression in Colombian patient influenced by own environment and genetics are needed to define characteristics that could support decision-making for tumor treatment.
Integration of single-cell and bulk transcriptome analyses unravels a macrophage-based gene signature for prognostication and treatment in triple-negative breast cancer
Authors: Huang Yuan , Yu Yuan , Zhang Huangping , Zhang Ziwen , Zheng Yabing , Wang Xiaojia , Wang Xiaowei
Published: August 2023

Objective
As a dominant component within the tumor microenvironment, macrophages exert an essential role in almost all aspects of triple-negative breast cancer (TNBC). This work explored macrophage-associated signature genes for prognostication and treatment for TNBC.
Methods
Single-cell (GSE180286) and bulk transcriptome profiles (TCGA-TNBC, GSE96058 and GSE45255) were analyzed by executing multiple computational approaches. The expression of signature genes was verified in breast cancer cells (MDA-MB-231, and MCF-7) and mammary epithelial cells (MCF10A) through RT-qPCR and western blot. After RNA interference or overexpression, wound scratch assay was implemented.
Results
A single-cell map of the microenvironment of non-TNBC and TNBC was depicted. Both at the single-cell and bulk levels, macrophages exhibited the higher abundance in TNBC versus non-TNBC. A macrophage-based gene signature was built, containing CTSD, CTSL, ELK4, HSPA8, and XRCC4. High risk score was predictive of worse prognostic outcomes. Based upon external validation, the signature could reliably predict patient prognosis, notably one-year survival. High-risk patients were more responsive to immunotherapy. The aberrant expression of CTSD, CTSL, ELK4, HSPA8, and XRCC4 was proven in breast cancer cells and mammary epithelial cells. Knockdown of XRCC4 attenuated migrative abilities of MDA-MB-231, MCF-7, and MCF10A cells, with opposite findings for overexpressed CTSD, CTSL, and HSPA8.
Conclusions
Altogether, a novel macrophage-based gene signature was proposed for estimating survival outcomes and treatment response in TNBC. The aberrant expression of the signature genes contributed to tumor aggressiveness. Our findings exert a positive impact on future clinical research involving macrophages in TNBC.
Influence of Occupational stress, Personality and Job demand on Mental health of Police officers in Nigeria
Authors: Esther Bobade , Obosi A. C
Published: August 2023

Personality type, continuous exposure of police officers to traumatic and stressful events, and the demanding nature of their job are factors discovered through extensive literature review, to affect police officers’ mental health globally. Hence, a need to investigate the influence of occupational stress, personality, and job demand on police officers’ mental health in Ibadan, Nigeria was identified. The biopsychosocial model and Big Five personality model are the theoretical foundations for this study. A cross-sectional research design was adopted for this study. Cochran formula (1977) was used to determine the sample size of this study and a Multistage cluster sampling technique was used to select the research participants. A 75-item self-report questionnaire comprising socio-demographic, operational police stress scale (α .88), organizational police stress scale (α .91), job demand (α .54), personality (α .61), and mental health (α .66) was administered to the 328 participants. Descriptive statistics were used to analyze the socio-demographic variables, while Pearson product-moment correlation and multiple regression were used to test the two hypotheses for this study which was computed at < 0.05. Participants' mean age was 36.49 ± 10.56. Occupational stress has a significant negative relationship with mental health; the five personality dimensions have a significant positive relationship with mental health and the three independent variables of this study jointly predicted the mental health of Police officers in Ibadan. However, only four of the five personality dimensions independently predicted police officers in Ibadan’s Mental health and Job demand has no relationship with the mental health of Police officers in Ibadan.
Manufacturing Process of Personalized 3D Printed Occlusal Guides for Maxillofacial Fractures
Authors: Wang Honghao , Chi Yifan , Hu Yukun , Lin Lisong , Hou Jun
Published: August 2023

Objective
Restoration of the occlusal relationship is critical in the treatment of maxillofacial fractures. Poor restoration of the occlusal relationship has a serious impact on the patient's oral function and physical and mental health.
Materials and Methods
This study is based on computer-aided design and manufacturing and aimed to use computed tomography (CT) data to establish a maxillofacial bone model and perform virtual reduction of such fractures. The upper and lower dentition models were established and reconstructed via 3D printing. After the occlusal relationship was determined by the prosthodontist using the model, the occlusal relationship was obtained through an oral three-dimensional scanner. Based on the reconstructed occlusal relationship, an occlusal reduction guide plate was designed and manufactured to precisely reduce the occlusal relationship in patients with maxillofacial fractures.
Results
This study proposes a design process for occlusal guides for maxillofacial fractures that optimizes the traditional surgical processes and enhances surgical convenience.
Conclusion
This study presents new ideas for the design of personalized surgical guides for maxillofacial fractures. Clinical Relevance: The application of the occlusal guide can assist the surgeon to accurately reset the occlusal relationship and fix the occlusal relationship, which can significantly improve the operation efficiency.
"My English seems not enough": Moving from language deficit views to Kazakhstani CLIL teachers' funds of knowledge.
Authors: Bedeker Michelle , Kerimkulova Sulushash
Published: August 2023

In Kazakhstan, the rich diversity of local knowledge seems to be ignored by policymakers who favor discourses of globalization and internationalization that disempower local expertise in favor of dominant Eurocentric thinking. Such discourses can marginalize teachers' philosophical assumptions, beliefs, and values that underlie their teaching practices. This article argues for including teachers' Funds of Knowledge (FoK) and practice-based insights to foreground their responsive and lived pedagogies despite their limited English proficiency. We used a qualitative approach that included teachers' reflections on multimodal teaching scenarios (comics) to elicit their values and beliefs about science pedagogy. The second instrument was teachers' narrative descriptions of language use in their science classrooms, collected and observed during a 45-hour professional development program. The third instrument was focus group interviews to identify biology teachers' practical, theoretical, and value-laden pedagogical choices. We conclude that a FoK framework diverted our gaze from measuring teachers against a Western-oriented standard and allowed us to foreground teachers' professional identities and practice-based EMI pedagogies as locally and contextually relevant.
Automated analysis of knee joint alignment using detailed angular values in long leg radiographs based on deep learning
Authors: Lee Hong Seon , Hwang Sangchul , Kim Sung-Hwan , Nam Bum Joon , Kim Hyeongmin , Hong Yeong Sang , Kim Sungjun
Published: August 2023

Background:
Malalignment in the lower limb structure occurs due to various causes. Accurately evaluating limb alignment in situations where malalignment needs correction is necessary.
Purpose
To create an automated support system to evaluate lower limb alignment by quantifying mechanical tibiofemoral angle (mTFA), mechanical lateral distal femoral angle (mLDFA), medial proximal tibial angle (MPTA), and joint line convergence angle (JLCA) on full-length weight-bearing radiographs of both lower extremities.
Materials and Methods
In this retrospective study, we analysed 404 radiographs from one hospital for algorithm development and testing and 30 radiographs from another hospital for external validation. The performance of segmentation algorithm was compared to that of manual segmentation using the dice similarity coefficient (DSC). The agreement of alignment parameters was assessed using the intraclass correlation coefficient (ICC) for internal and external validation. The time taken to load the data and measure the four alignment parameters was recorded.
Results
The segmentation algorithm demonstrated excellent agreement with human-annotated segmentation for all anatomical regions (average similarity: 89–97%). Internal validation yielded good to very good agreement for all the alignment parameters (ICC ranges: 0.7213- 0.9865). Interobserver correlations between manual and automatic measurements in external validation were good to very good (ICC scores: 0.7126-0.9695). The computer-aided measurement was 3.44 times faster than was the manual measurement.
Conclusion
Our deep learning-based automated measurement algorithm accurately quantified lower limb alignment from radiographs and was faster than manual measurement.
Thermodynamics of continental deformation
Authors: Kumar Ajay , Cacace Mauro , Scheck-Wenderoth Magdalena
Published: August 2023

Plate tectonics theory postulates the existence of rigid mobile plates. However, what defines and controls their internal deformation, particularly within continents, is not yet fully understood. Using data-driven thermomechanical modelling of the Alpine Himalayan Collision Zone, we hypothesize that deviations from an equilibrium between mantle dynamics, plate-boundary forces, and thermochemical configuration of the lithosphere controls continental deformation. We quantify such balance between the internal energy of the plate and tectonic forces in terms of a critical crustal thickness, that match the global average of present-day continental crust. It follows that thicker intraplate domains than the critical crust (orogens) must undergo weakening due to their increased internal energy, and, in doing so, they dissipate the acquired energy within a diffused zone of deformation, unlike the localized deformation seen along plate boundaries. This evolution is controlled by a dissipative thermodynamic feedback loop between thermal and mechanical relaxation of the driving energy in the orogenic lithosphere. Exponentially growing energy states, leading to runaway extension are efficiently dampened by enhanced dissipation from radioactive heat sources. This ultimately drives orogens with their thickened radiogenic crust towards a final equilibrium state. Our results suggest a genetic link between the thermochemical state of crust and the tectonic evolution of silicate Earth-like planets.
Energy Efficient Cluster Head Selection Using Cognitive Radio in WSN
Authors: thaseen Aliya , Anusha A , Punithavathi I. s. Hephzi , Nazeer Mohd , Obulesh A.
Published: August 2023

In this paper, taking account of the number of channel allocation and the quality of spectrum channels from the global and the instant point of view, we propose two CSN routing metrics. In the first routing metric, the delivery success probability through all possible channels is defined in the constraint that only one retransmission is permitted to reduce rerouting. Similarly, the second routing metric considers the average transmission delay overall possible channels are presented. Based on the two routing metrics, the related routing algorithms are then designed, in which the optimal route is determined in an ON-demand route style. To increase the practicability, the channel assignments are not permanent and any relay nodes carrying packets could choose the channel with the largest routing metric at that time. We conduct extensive simulations, which validates the route performance of our routing schemes compared with other CSN routing protocols. It has been proved that proposed protocols reduces the number of re transmission and delay and increases the throughput compared to the existing routing protocols.
Characteristics of Peripheral refractive errors in Eyes of Patients with Non- amblyopic Myopic Anisometropia
Authors: Tong Gengmin , Jin Yuanhui , Wu Hongyan , Zhou Yao
Published: August 2023

Background
This study aims to investigate relative peripheral refractive (RPR) characteristics in children with non-amblyopic myopic anisometropia and explore potential associations between relative peripheral refractive errors (RPRE) and myopia.
Methods
Relative peripheral refractive errors were assessed in 64 children diagnosed with non-amblyopic myopic anisometropia utilizing multispectral refraction topography (MRT). Evaluated parameters encompassed total defocus values (TRDV), defocus values at eccentricities spanning 0 to 15 degrees (RDV-15), 0 to 30 degrees (RDV-30), 0 to 45 degrees (RDV-45), as well as superior (RDV-S), inferior (RDV-I), temporal (RDV-T), and nasal (RDV-N) positions.
Results
The study revealed a noteworthy contrast in TRDV values between Group ME (0.52 ± 0.36) and Group FE (0.17 ± 0.41), with a substantial significance (P < 0.0001). While no significant RDV-15 difference emerged between Group ME (0.01 ± 0.05) and Group FE (-0.01 ± 0.07) (P > 0.05), a meaningful RDV-30 difference existed between Group ME (0.11 ± 0.14) and Group FE (0.03 ± 0.19) (P = 0.0017). A significant discrepancy in RDV-45 was also observed between Group ME (0.39 ± 0.29) and Group FE (0.13 ± 0.34) (P < 0.001). Notably, RDV-I and RDV-T positions demonstrated marked differences between Group ME and Group FE (P < 0.0001), whereas no significant disparity was noted in RDV-S and RDV-N positions (P > 0.05).
Conclusion
Eyes exhibiting greater myopia manifested more hyperopic peripheral defocus in the context of anisometropia. MRT as a novel ophthalmic evaluation technique, holds promising potential for broader clinical applications in the future.