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A genotyping by target sequencing chip for population genetic analysis of the wheat s...
Haohao Yan
Zhe Ma

Haohao Yan

and 14 more

June 13, 2024
Puccinia striiformis f. sp. tritici (Pst), the causative agent of wheat stripe rust, poses a significant threat to wheat production due to its rapid long-distance migration and epidemic properties. Understanding the genetic structure and dynamics of the Pst population is crucial for early prediction and establishment of effective control strategies. The types of molecular marker analyses used in previous population genetic studies are often costly, time-consuming, and labor-intensive. We developed a genotyping by target sequencing (GBTS) chip for Pst designed with candidate secretion proteins and highly polymorphic single nucleotide polymorphism (SNP) sites identified from genome resequencing. The chip can be used directly with diseased leaves, saving time and avoiding cross-contamination between samples. The feasibility and efficiency of the chip was tested using 225 infected leaf samples collected from the northwest oversummering region of China. This test yielded 1,293,150 high-quality SNPs with a maximum gap of 99,512 bp. Strict quality controls produced 19,139 SNPs, comprising the final Pst 20K GBTS chip. Population genetic analysis revealed frequent gene flow and similar genetic diversity of Pst between epidemic regions, consistent with wind field analysis, trajectory tracking, and field monitoring. The results demonstrated that the GBTS chip is more efficient, convenient, and lower in cost than previous methods. This study provides new insights into stripe rust population dynamics. Furthermore, the newly established chip offers a valuable method for enriching epidemiological recognition, guiding future research into inter-regional or continental transmission of an important plant pathogen.
Invasive cribriform carcinoma of the breast presenting as an erythematous papule on t...
Po-Yu Chen
Yu-Hsuan Ho

Po-Yu Chen

and 3 more

June 13, 2024
Introduction:Invasive cribriform carcinoma of the breast, initially described by Page et al in 1983 due to its predominant cribriform growth pattern in the invasive component and relatively favourable prognosis, is a rare type of breast carcinoma, accounting for 0.3 to 3.5% of primary breast carcinomas [1, 2]. ICC patients typically have a small tumour size, few axillary lymph node invasion, low distant metastasis rate, tumour with a high frequency of well differentiation, high ER and PR positive rates with rarely-observed human epidermal growth factor receptor 2 (HER2) amplification and a low proliferation index [3, 4, 5]. To date, studies of skin manifestations of invasive cribriform breast of the breast are notably scarce. We herein report a patient of ICC with a presentation as an erythematous papule on the nipple that no one has reported before.Case history / examination:A 71-year-old Asian woman visited our Department of Dermatology with a chief complaint of a reddish protruding skin lesion on the tip of her right nipple that had appeared for 6 months. Upon physical examination, the skin lesion was a solitary, well-demarcated papule, 0.2 by 0.2 cm in size, appearing centrally erythematous with violaceous in the periphery, fairly dome-shaped and firm [Figure 1a-c]. Besides, the papule was completely asymptomatic. The patient did not report any other abnormal symptoms. Her medical history was also unremarkable.Differential diagnosis and investigations:With these clues, a benign skin lesion had been impressed. Therefore, a local excision was performed to obtain a specimen of 0.7 by 0.5 by 0.3 cm in size. Biopsy results turned out to be pure invasive cribriform carcinoma of the breast (pure ICC), characterized by the invasive cribriform pattern comprising >90% of the lesion, in addition to mammary Paget’s disease (MPD) in the epidermis [Figure 2a-c]. Immunohistochemical tests showed positive expressions of both oestrogen and progesterone receptors [ER >95%, PgR >95%]. The reaction to HER2 (human epidermal growth factor receptor type 2) protein was negative [HER 2 (-)] [Figure 3a-c]. The Ki-67 labelling index was 5 %.Treatment, outcome and follow-up:In the diagnosis of pure ICC with MPD, she was referred to the Breast Surgery Department for further survey and treatment. Results on both CEA and CA15-3 levels were normal. Bilateral breast mammography (CC and MLO view) revealed segmental fine pleomorphic microcalcifications in the lower-inner quadrant of her right breast. These findings raise high suspicion for malignancy and are consistent with a classification of 4C in the BIRADS-US system. Breast ultrasound revealed two oval hypoechoic lesions with tiny calcifications which were 7.8 mm and 24.5 mm in size at the right breast near the areola. Whole body bone scan found no evidence of bone metastasis. With a previous biopsy pathology report revealing ICC and MPD, a full discussion was carried out with the patient. Finally, a simple mastectomy and sentinel lymph node biopsy were performed on her right breast.With the right side simple mastectomy, pathology of the surgical specimen showed residual multifocal ductal carcinomas in situ. Both frozen sections of sentinel lymph nodes revealed no evidence of metastasis. The pathological TNM stage was pT1aN0 according to AJCC eighth edition. Further treatment plans for this patient included a five-year Tamoxifen therapy and regular follow-up at the Breast Surgery Department.Discussion:Based on the clinical features of the papule on her nipple, our initial impressions were benign skin lesions such as pyogenic granuloma, nipple adenoma, Spitz nevus and intradermal nevus. However, the pathologic diagnosis was pure ICC with MPD in the epidermis. Although ICC usually presents as an asymptomatic mass or may even be clinically occult[1, 3], the chance of ICC presenting as skin lesions cannot be ignored. The case reported by Katarzyna et al, in which ICC mimicked a breast abscess [6], along with our case of ICC presenting as a nipple papule, collectively demonstrates ICC’s potential to primarily manifest through skin lesions. To the best of our knowledge, ICC is a tumour having a more favourable prognosis than invasive breast carcinoma with less cribriform pattern and low grade invasive ductal carcinoma [11]. Despite favourable prognosis of ICC, there are still chances of aggressive behaviour or development into an advanced stage if left untreated long enough. Mishra et al reported a case of ICC with extensive perineural infiltration and lymphovascular invasion in a 58-year-old female; and Zhang et al also reported a case of pure ICC with bone metastasis when left untreated for 13 years[7, 8]. Therefore, such manifestation of a papule on the nipple, as in our case, may result in delayed diagnosis and treatment to ICC. It is crucial for dermatologists to have early awareness about skin manifestation of ICC and to avoid misdiagnosis.Mammary Paget’s disease (MPD), first described by Sir Paget in 1874 as eczematous nipple and areola skin lesions, is a rare form of breast carcinoma comprising 1 to 3% of all breast cancers. Nearly all cases of MPD are affiliated with underlying breast carcinomas, typically located near the areola, and >90% are either ductal carcinomas in situ (DCIS) or invasive ductal carcinomas (IDC). Pathophysiologically, there are two main hypotheses proposed for the origin of MPD: the epidermotropic theory and the malignant transformation theory. The epidermotropic theory states that Paget cells originate from underlying breast carcinoma, and they migrate via the lactiferous ducts to the epidermis of the nipple. On the other hand, the malignant transformation theory states that Paget cells are malignant transformation of pluripotent keratinocyte stem cells or cells of apocrine gland ducts[9]. Although remains controversial, it is currently widely accepted that MPD is associated with underlying breast carcinoma, forming the concept based on the epidermotropic theory. In our case, ICC and MPD were diagnosed within the papular lesion on the nipple. This case stands out from >90% of cases in which mammary Paget’s disease was diagnosed exclusively with underlying DCIS or IDC. Furthermore, to the best of knowledge, only one publication focusing on radiologic characteristics of 52 MPD cases mentioned a case of invasive lobular and invasive cribriform carcinoma being diagnosed with mammary Paget’s disease presenting as a mass on mammography[10], but details or images were not provided. As to our case, it is worth knowing that the patient was diagnosed with multifocal DCIS at 1 cm near the right areola in the surgical specimen from simple mastectomy. In our opinion, it was the invasive cribriform carcinoma of the breast but not DCIS resulting in the mammary Paget’s disease in the epidermis of the papule [Figure 2c] as consistent with the epidermotropic theory. Although DCIS has been diagnosed near the areola, we believe that the chance of mammary Paget’s disease originating from the DCIS was slim. That is because malignant Paget cells were not seen at other parts of the nipple nor at the areola, but merely in the epidermis of the papule on the nipple. Furthermore, based on pathologic images, the gross pictures and the clinical manifestations of ICC and MPD, we believe that the invasive cribriform carcinoma of breast had caused the dome-shaped violaceous papule on the nipple, and mammary Paget’s disease contributed to the central erythematous part of the papular lesion [Figure 1a]. Undoubtedly, more studies are needed to bring attention to the skin manifestation of invasive cribriform carcinoma of the breast. As far as we know, no publication has ever reported on ICC with skin manifestation as a papule on the nipple. Also, no case has been reported with detailed images and descriptions regarding a pure ICC being diagnosed with MPD. In this case report, we aim to bring awareness to skin manifestation of ICC.References:1. Cong Y, Qiao G, Zou H, Lin J, Wang X, Li X, et al. Invasive cribriform carcinoma of the breast: A report of nine cases and a review of the literature. Oncol Lett. 2015;9: 1753-1758.2. Page DL, Dixon JM, Anderson TJ, Lee D, Stewart HJ. Invasive cribriform carcinoma of the breast. Histopathology. 1983;7: 525-36.3. Zhang W, Zhang T, Lin Z, Zhang X, Liu F, Wang Y, et al. Invasive cribriform carcinoma in a Chinese population: comparison with low-grade invasive ductal carcinoma-not otherwise specified. Int J Clin Exp Pathol. 2013;6: 445-57.4. Mo CH, Ackbarkhan Z, Gu YY, Chen G, Pang YY, Dang YW, et al. Invasive cribriform carcinoma of the breast: a clinicopathological analysis of 12 cases with review of literature. Int J Clin Exp Pathol. 2017;10: 9917-9924.5. Liu J, Zheng X, Han Z, Lin S, Han H, Xu C. Clinical characteristics and overall survival prognostic nomogram for invasive cribriform carcinoma of breast: a SEER population-based analysis. BMC Cancer. 2021;21: 168.6. Dobruch-Sobczak K, Roszkowska-Purska K, Chrapowicki E. Cribriform carcinoma mimicking breast abscess - case report. Diagnostic and therapeutic management. J Ultrason. 2013;13: 222-9.7. Zhang W, Lin Z, Zhang T, Liu F, Niu Y. A pure invasive cribriform carcinoma of the breast with bone metastasis if untreated for thirteen years: a case report and literature review. World J Surg Oncol. 2012;10: 251.8. Mishra S, Yadav K, Singh Anshul, Misra Vatsala, Chaudhary Kuldeep. Unusual case of Invasive Cribriform Carcinoma of Breast (ICC). JCR [serial online] 20219. Lopes Filho LL, Lopes IM, Lopes LR, Enokihara MM, Michalany AO, Matsunaga N. Mammary and extramammary Paget’s disease. An Bras Dermatol. 2015;90: 225-31.10. Günhan-Bilgen I, Oktay A. Paget’s disease of the breast: clinical, mammographic, sonographic and pathologic findings in 52 cases. Eur J Radiol. 2006;60: 256-63.
Trends, Hotspots, and Future Directions of Inflammation in Age-Related Macular Degene...
Fangfang Lu
Zhi Wang

Fangfang Lu

and 6 more

June 13, 2024
Background Inflammation significantly impacts the pathogenesis of age-related macular degeneration (AMD), the primary cause of vision loss in the elderly. With the aging global population and increasing incidence of AMD, understanding the inflammation-related mechanisms and identifying potential therapeutic targets have become paramount. This study aims to offer a bibliometric analysis of global research contributions focused on inflammation in AMD, shedding light on research trends, collaborations, and future directions. Methods We retrieved publications related to inflammation in AMD from 2003 to 2023 from the Web of Science Core Collection database. A total of 2044 articles were analyzed using VOSviewer, CiteSpace, and R-bibliometrix to examine publication trends, influential countries, institutions, authors, and journals, as well as emerging research topics. Results Our analysis revealed a steady global increase in annual publications. The United States and China emerged as leading contributors, demonstrating substantial collaboration and investment in AMD research. Among institutions, the National Eye Institute in the United States and the University of Eastern Finland stood out for their prolific contributions. Key researchers such as K. Kaarniranta have been central to advancing the field, offering potential collaboration opportunities. Investigative Ophthalmology & Visual Science and Experimental Eye Research were identified as the top journals publishing significant work on inflammation in AMD. Keywords such as “oxidative stress,” “complement” “autophagy,” “macrophage,” and “microglia” were frequently mentioned, highlighting these as current research hotspots. Conclusion This analysis underscores the importance of inflammation in AMD and maps the evolution of research, suggesting future directions that may offer new therapeutic strategies.
Real-World Evidence of Indapamide-Induced Rhabdomyolysis: A Retrospective Analysis of...
Raseel  Aroba
Almaha Alfakhri

Raseel Alroba

and 4 more

June 13, 2024
Purpose: This study aims to investigate the potential causal relationship between the use of indapamide and rhabdomyolysis. Previous research and pharmacovigilance monitoring activities have suggested a potential association between indapamide use and rhabdomyolysis. However, limited information is available on this association. Methods: A case-control study conducted using EHR data, between July 1,2016, and December 31,2022. Patients who have rhabdomyolysis event (cases) were matched to four controls bases on age, gender and date. We examined the odds for indapamide exposure through three risk periods: current use, recent use, and former. The study outcome was ascertained through the presence of CK level over 1,000 U/L (i.e. rhabdomyolysis event). Subsequently, a multivariable conditional logistic regression analysis was utilized to assess the causal impact of indapamide exposure on the likelihood of developing rhabdomyolysis, while accounting for potential confounding variables. Results: The study population consisted of 2,965 cases and 11,860 controls. The results of the conditional logistic regression analysis indicated a lack of association between exposure to indapamide for the current users the OR was 0.7 (95% CI: 0.49 - 0.92) and the AOR was 0.6 (95% CI: 0.39 - 1.05). The recent users showed OR of 0.9 (95% CI: 0.56 - 1.50) and AOR of 0.2 (95% CI: 0.14 - 0.47). Lastly, the former users demonstrated an OR of 0.8 (95% CI: 0.47 - 1.26), and AOR of 0.1 (95% CI: 0.07 - 0.23). Conclusions: In this study, we did not find association between indapamide use and rhabdomyolysis regardless timing of exposure.
Clinical and Reproductive Outcomes Following Hormone Treatments after Hysteroscopic E...
Jie Liu
Wei Xiong

Jie Liu

and 5 more

June 13, 2024
Objective: To investigate whether hormone treatments following hysteroscopic resection of endometrial polyps can further effectively alleviate clinical symptoms and enhance reproductive outcomes and to analyze the factors that influence successful conception in such cases. Design: A large-scale, single-center, retrospective cohort study was conducted in the Day Surgery Department of a tertiary teaching hospital. Setting: The study included pre-menopausal women aged 18-55 with endometrial polyps who underwent hysteroscopic polypectomy. Following the procedure, patients were prescribed oral progesterone/dydrogesterone, combined oral contraceptives, a levonorgestrel-releasing intrauterine system, or received no postoperative medication. Population: A total of 1021 patients were enrolled in the study. Methods: Data were collected and analyzed using SPSS Statistics 26.0 software. Main Outcome Measures: Data including postoperative menstrual status and reproductive outcomes. Results: Among 1021 patients, 222 individuals received either progesterone or dydrogesterone following hysteroscopy, 173 received combined oral contraceptives, 84 were fitted with a levonorgestrel-releasing intrauterine system, and 542 did not receive any postoperative medication. Most patients in the progesterone group (94.6%) and the combined oral contraceptives group (83.8%) received short-term drug treatment within 3 months after the hysteroscopic polypectomy. Prior to treatment, 696 patients (68.2%) had experienced abnormal uterine bleeding. The percentage of patients with resolved abnormal uterine bleeding symptoms post-operation was 78.2% in the progesterone group, 70.2% in the combined oral contraceptives group, 22.2% in the levonorgestrel-releasing intrauterine system group, and 73.4% in the no-medication group. There was no significant difference among the progesterone group, combined oral contraceptives group and no-medication group (p>0.05). Despite having the lowest rate of relief for abnormal uterine bleeding (p=0.000), levonorgestrel-releasing intrauterine system exhibited the highest rate of normal endometrial ultrasound images during follow-up (p=0.001). Out of the 300 participants aiming to conceive, a successful pregnancy was achieved by 78.3%. The success rates of pregnancy were higher in both the progesterone group (82.9%) and the combined oral contraceptives group (85.0%) compared to the no-medication group (74.7%). However, statistical analysis revealed no significant difference (p=0.179) among the groups. Increasing age (OR 1.153, 95% CI 1.078-1.234, p=0.000), persistent abnormal uterine bleeding (OR 5.742, 95% CI 2.269-14.531, p=0.000), and reduced menstrual volume after treatment (OR 3.810, 95% CI 1.398-10.383, p=0.009) identified as unfavorable factors for successful pregnancy. Conclusions: Adding short-term combined oral contraceptive or progesterone after hysteroscopy does not significantly increase the long-term remission of abnormal uterine bleeding symptoms or the pregnancy rates compared to hysteroscopy alone. The LNG-IUS seems to be most beneficial in preventing the postoperative recurrence of EPs. Funding: None. Keywords: Endometrial polyps, Hysteroscopic polypectomy, Abnormal uterine bleeding, Pregnancy, Hormone medication
Novel use of the rectus abdominus muscle flap for vaginal reconstruction in complex o...
Patel T.
Brown R.

Patel T.

and 7 more

June 13, 2024
Globally, obstetric fistula is a tragic outcome following obstructed labor. Failure of complex repairs and post-operative incontinence are common. We describe an innovative surgical technique incorporating the rectus abdominis muscle flap at the time of fistula repair. We report outcomes from six patients at the Fistula Care Center in Lilongwe, Malawi in October 2023. At three months following discharge, five patients (80.0%) were continent; one patient was unable to follow-up but was continent at a one-month phone follow-up. There were no major complications. The rectus abdominis muscle flap may be considered in challenging obstetric fistula repairs.
Angular free-positioning wireless power transfer using a three-dimensional diagonaliz...
Hoàng Lê

Hoang Le-Huu

and 1 more

July 01, 2024
In this paper, a three-dimensional diagonalized transmitting coil (DAG-Tx) structure is proposed for improving angular free-positioning in a wireless power transfer (WPT) system. The magnetic field distribution is analyzed to transfer power effectively to a rectangular receiver (Rx) in spatial freedom. A mathematical method is adopted to calculate mutual inductance between the proposed Tx and rectangular Rx. In addition, the inductor-capacitor-capacitor (LCC) and capacitor-capacitor (CC) impedance matching networks are proposed and implemented on the Tx and Rx sides to improve the power transfer efficiency (PTE). Experimental results show that the WPT system can transfer with PTE of up to 80% in a face-to-face transmission distance of 100 mm. Moreover, the PTE maintains above 70% by rotating Rx from 0 o to 135 o around three coordinate axes.
Optimal Distributed Energy Resources Accommodation with Techno-Economic Benefits Usin...
Muhammad Shaarif
Muhammad  Yousif

Muhammad Shaarif

and 5 more

June 13, 2024
The planning and operation of radial distribution networks (RDN) face increasing challenges such as active power losses and voltage instability, prompting a focus on integrating renewable energy resources (RER) to mitigate these issues. This study presents a techno-economic optimization framework leveraging the Cheetah optimizer (CO), a recently introduced metaheuristic technique, to optimize the accommodation of distributed energy resource (DER) units within the IEEE 33-bus radial distribution networks (RDN) utilizing MATLAB environment. Both single and multi-objective perspectives are explored, demonstrating significant reductions in active power losses, minimized voltage deviation, improved stability, and maximized economic benefits. The Cheetah optimizer (CO) efficacy is showcased through notable achievements, including a 94.20% reduction in active power losses and annual savings of up to $77,933 for optimal power factor (OPF) mode in multi-objective optimization, surpassing existing literature. Additionally, reliability analysis conducted with ETAP software underscores the effectiveness of DER integration, particularly with wind turbine systems, in enhancing network reliability.
Atomic size mismatch induced consecutive compressive strain on intermetallic compound...
Jiankun Li
Zeyu Guan

Jiankun Li

and 7 more

June 12, 2024
Modulating lattice strain in intermetallic compounds could effectively alter their electronic structure and binding energy, thus impacting catalytic activity. Strain is usually induced through lattice mismatch, achieved by constructing core-shell nanostructures or metal-substrate interfaces with complex reciprocity and distractors. However, in situ induced strain without interface-construction or lattice mismatch presents challenges. In this study, we precisely manipulate consecutive compressive strain from -0.5% to -0.8% in CoPt 3Pd intermetallic compound by inducing interior atomic radius mismatch. Precise strain control results in a negative shift of d-band center, dynamic charge distribution, and facilitates water dissociation, leading to the enhanced electrocatalytic activity. The CoPt 3Pd catalyst with -0.5% compressive strain exhibits exceptional hydrogen evolution activity, with an overpotential of 169 mV at 1 A cm -2. Our approach offers a straightforward method to manipulate compressive strain on intermetallic compound by atomic size mismatch, with broad implications for catalytic processes.
Uniform exponential stability approximations of semi-discretization schemes for two h...
Fu Zheng
Lu Zhang

Fu Zheng

and 3 more

June 12, 2024
The uniform exponential stabilities (UESs) of two hybrid control systems comprised of a wave equation and a second-order ordinary differential equation are investigated in this study. Linear feedback law and local viscosity are considered, as are nonlinear feedback law and internal anti-damping. The hybrid system is first reduced to a first order port-Hamiltonian system with dynamical boundary conditions, and the resulting system is discretized using the average central-difference scheme. Second, the UES of the discrete system is obtained without prior knowledge of the exponential stability of the continuous system. The frequency domain characterization of UES for a family of contractive semigroups and the discrete multiplier approach are used to validate the main conclusions. Finally, the Trotter-Kato Theorem is used to perform a convergence study on the numerical approximation approach. Most notably, the exponential stability of the continuous system is derived by the convergence of energy and UES, which is a novel approach to studying the exponential stability of some complex systems. Numerical simulation is used to validate the effectiveness of the numerical approximating strategy.
Unraveling the Temporal Interplay of Slow-Paced Breathing and Prefrontal Transcranial...
Zefeng Li
Emmanuelle Schoonjans

Zefeng Li

and 9 more

June 12, 2024
The neurovisceral integration model proposes that information flows bidirectionally between the brain and the heart via the vagus nerves and vagally-mediated heart rate variability (vmHRV) can be used to index heart-brain interaction. Recent research has shown that voluntary reduction of breathing rate (slow-paced breathing, SPB) can enhance cardiac vagal control. Additionally, prefrontal transcranial direct current stimulation (tDCS) can modulate the excitability of the prefrontal region and influence the vagus nerve. However, fundamental research on the combination of SPB and prefrontal tDCS to increase vmHRV and other physiological indices of the autonomic nervous system is scarce. Therefore, 200 healthy participants were assigned to four experimental groups. Each group received either 20 min of active or sham tDCS combined with 5.5 breath per minute (BPM) or 15 BPM breathing. Regardless of the tDCS condition, the SPB group showed a significant increase in vmHRV over 20 minutes, suggesting an increase in parasympathetic activity. In addition, a significant decrease in HR at the first and second 5-minute epochs of the intervention. Regardless of breathing condition, the active tDCS group exhibited higher HR at the fourth 5-minute epoch of the intervention compared to the sham tDCS group, suggesting more sympathetic arousal. However, there was no combined effect on vmHRV, HR, skin conductance, or blood pressure. SPB is a robust technique for increasing vmHRV, whereas prefrontal tDCS may produce effects that counteract those of SPB. More research is necessary to test whether and how top-down and bottom-up approaches can be combined to improve vagal control.
The role of research facilitation positions in health services: A scoping review
Caitlin BRANDENBURG
Rachel BRIMELOW

Caitlin BRANDENBURG

and 6 more

June 12, 2024
Abstract Background: Research facilitation (RF) positions are a developing workforce in health services. The aim of this review was to explore literature on the role and impact of these positions. Methods: A scoping review was conducted using three inclusion criteria. 1. Population: Articles about RF positions; 2. Concept: Articles that describe the roles and duties of RF positions, and/or report how their impact is evaluated; 3. Context: RF positions employed by, or have a significant role within, health services. Medline, EMBASE and CINAHL electronic databases were searched in June 2022 for records from 2000-present. Full text articles published in English were included. Data were extracted regarding the structure, responsibilities, and evaluation of RF positions. Results : Eighteen articles were included, representing 86 RF positions. Most positions were orientated to support nursing or allied health research. Position titles and structure varied widely. Whilst key responsibilities were highly heterogeneous, almost all included providing direct support to health service staff to engage in research, and many included facilitating research education. A range of measures were used to evaluate RF positions, with traditional academic outputs such as publications and grants most frequent. Quantitative evidence of the impact of RF positions was weak, though positive. Qualitative evaluations revealed the important role of RF positions in research capacity and evidence-based practice. Conclusion: RF positions provided a wide variety of supports to clinicians and health services. While there is some positive evidence of the value of RF positions, further research is needed on their structure and outcomes.
Cartilaginous Choristoma of the Oral Cavity: A Rare Presentation in the Nasopharynx
Maryam Al Ali
Anastasios Hantzakos

Maryam Al Ali

and 1 more

June 12, 2024
INTRODUCTIONCartilaginous choristomas, characterized by the presence of mature hyaline cartilage in aberrant locations (Chou et al., 1991). While these lesions are more frequently encountered in other anatomical sites, their occurrence within the oral mucosa remains a rarity (Karatayli Ozgursoy et al., 2015). This case report explores a distinctive presentation of a cartilaginous choristoma in the oral cavity of a 30-year-old male patient, highlighting the challenges associated with its diagnosis and emphasizing the significance of distinguishing it from other oral lesions.The oral cavity is a dynamic and complex anatomical region susceptible to a myriad of pathological conditions. Lesions arising from mesenchymal tissue, such as cartilaginous choristomas, are particularly unusual within the oral mucosa, posing diagnostic dilemmas for clinicians (Tohill et al., 1987). This report aims to contribute to the limited body of literature on oral cartilaginous choristomas by detailing the clinical and histopathological features of a singular case, shedding light its presentation, diagnosis, and management.Through a thorough examination of the patient’s clinical history, surgical and histopathological findings, we aim to provide valuable insights into the distinctive characteristics of cartilaginous choristomas case, we seek to enhance the understanding of oral cartilaginous choristomas, ultimately contributing to a more accurate and hastened diagnosis and improved patient care.
COVID-19 in Pregnancy with Findings of Reduced Head Circumference: A Retrospective Co...
Kristen Lee MORIARTY
Kelsey MANFREDI

Kristen Lee MORIARTY

and 7 more

June 12, 2024
Objective: We investigated the relationship between trimester-specific SARS-CoV-2 infection and newborn growth metrics. We hypothesize that COVID-19 may result in disproportion between neonatal head measurements and weight without increasing the risk of SGA, and that this relationship may be associated with timing of COVID-19 exposure in pregnancy. Design: Retrospective cohort Setting: Northeast USA academic tertiary hospital Population of sample: COVID-19-infected (n=140) and COVID-19-uninfected (n=136) patients Methods: Inclusion criteria: a) singleton birth between April 28, 2020, and December 31, 2022; and b) maternal COVID-19 infection diagnosed via PCR. Exclusion criteria: < 12 years of age, major fetal anomalies, and fetal loss < 15 weeks. Main Outcomes Measures: Outcomes were a comparison of newborn growth measurements (length, weight, and head circumference (HC) at birth), Ponderal Index (PI), and development of SGA between SARS-CoV-2-infected and uninfected patients. Maternal and neonatal characteristics were descriptively summarized, and multivariate analyses and linear regression models were performed. Results: Baseline maternal demographics did not significantly differ among the uninfected and infected cohorts. Compared to the uninfected cohort, COVID-19 diagnosed in the third trimester was associated with a lower neonatal HC compared to newborns of uninfected patients (β=-0.38 [0.38 SD lower], 95% CI -0.65 to -0.10, p=0.024). There was no significant difference among the cohorts for birth length, weight, or diagnosis of small for gestational age. Conclusion: We found that COVID-19 infection in the third trimester was associated with a lower neonatal head circumference without associated SGA. The cause underlying this association is unknown. Further research to determine the risk of neurotropic fetal infection by SARS-CoV-2, like ZIKA’s effect on the fetal immune system leading to microcephaly, is urgently needed.
Pediatric Patients with Von Hippel-Lindau and Hemangioblastomas Treated Successfully...
Emily Duan
Michael Robinson

Emily Duan

and 9 more

June 12, 2024
Hemangioblastomas are the most common tumor associated with Von Hippel-Lindau (VHL) and a leading cause of mortality. We present five pediatric patients with VHL-associated hemangioblastomas treated with belzutifan, a HIF2a inhibitor. Three patients were started on belzutifan due to vision loss from progressive retinal hemangioblastomas. Within 1 year of treatment, all three patients had improvement in hemangioblastoma size and visual acuity. For patients with intracranial lesions, belzutifan resulted in an improvement in neurologic symptoms and hemangioblastoma size. Four patients experienced grade 1-2 anemia and two patients required a dose reduction. Our report suggests that belzutifan can be an effective therapy for pediatric patients with VHL-associated hemangioblastomas.
Successful open partial cystectomy for muscle invasive squamous cell bladder carcinom...
CHARLES NHUNGO
Joseph Lori

CHARLES NHUNGO

and 7 more

June 12, 2024
ABSTRACT.Squamous cell carcinoma (SCC) of the bladder is a rare urologic malignancy, estimated to affect 3% to 5% of the bladder. Squamous cell carcinoma (SCC) of the bladder remains the most common subtype throughout Africa. Most literatures focused on management of Transitional cell carcinoma(TCC) with fewer discussion in SCC management. TCC typically presents with painless hematuria, whereas SCC presents with painful hematuria, bladder mass, and necroturia. SCC is mostly radioresistant and does not respond to chemotherapy. The mainstay treatment is Partial Cystectomy or radical cystectomy, which can be performed through open surgery, laparoscopic or robot-assisted approach, all techniques with acceptable results. We report a case with favourable outcome following partial cystectomy which was managed by open surgery. In a 12months follow up the patient remained asymptomatic with good surgical outcome.
A Qualitative Research on The Applicability of Value Based Payment Method in The Heal...
SIDIKA KAYA
Merve Karaer

SIDIKA KAYA

and 1 more

June 12, 2024
Objective: In the healthcare system, it is discussed worldwide in the evaluation of appropriate payment. To improve productivity, economic efficiency and quality of care, patient-centered repayment models need to be improved. Value-based payment reforms are designed to reduce healthcare spending, promote high-quality care, and ensure that healthcare is paid for quality rather than quantity. In this study, it is aimed to get the opinions of the participants about this method, to determine what the value means, with which parameters it can be measured. Methods: Grounded theory approach and delphi technique, one of the qualitative study methods, are used in the study. In accordance with the purpose of the thesis, 28 participants among the health system stakeholders are determined through purposeful sampling. Analysis of the data is done through Maxquda 2020. The value parameters obtained because of the qualitative analysis are graded by the participants according to their importance with the delphi study. Results: At the end of the study, the value in health is defined as “a quality service”. Although there are some deficiencies, the participants think that the value-based repayment method should be applied. In the study, 15 parameters that can be used in the calculation of the value are determined. It is recommended to take measures against those who will oppose the transition and the groups that do not want to innovate. As a result, it is thought that Turkey will be successful by making the necessary revisions in the value-based payment method.
Tracing urban drinking water sources: global state of the art and insights from an IA...
Ricardo Sánchez-Murillo

Ricardo Sánchez-Murillo

July 16, 2024
1. Introduction to urban isotope hydrologyThe urban population growth (e.g., a 2.5 billion increase projected over the next 30 years; He et al., 2021; Mahtta et al., 2022), escalating living standards, and fast-expanding metropolitan centers across inland and coastal regions collectively exert unprecedented pressure on the available drinking water sources and invoke the urgent need for innovative approaches to assessing urban water management (Daigger, 2009). Commonly, water scarcity issues are intensified in densely populated centers (Jenkins et al., 2003; Padowski & Gorelick, 2014), where large disproportionality exists between water demand and headwater supply systems (Jenerette & Larsen, 2006). These urban centers often depend on water recharge across mountain ranges, extensive groundwater or surface water extraction, and water transfer from nearby or distant river basins (Viviroli et al., 2007; de Andrade et al., 2011; de Graaf et al., 2019; Inmerzeel et al., 2020; Kellner & Brunner; 2021). In addition, opportunistic or programmed water allocation from multiple sources is altering environmental flows (in time and magnitude) and the overall ecological functioning of perennial and intermittent urban streams (e.g., urban stream syndrome; Walsh et al., 2005; Dickson and Dzombak, 2017: Wenger et al., 2009; Breyer et al., 2018; Marx et al., 2021). These impacts have notably disturbed the urban watershed continuum (e.g., natural and engineered hydrologic flow paths) by modifying water fluxes and solute transport (vertically and horizontally) (Kaushal & Belt, 2012; Kaushal et al., 2014).These challenges are exacerbated by the current inter-annual climate variability (Brown et al., 2019) and water-related issues such as direct and diffuse pollution, inadequate or inexistent sewage treatment systems (Sánchez-Gutiérrez et al., 2023), drinking water leakage (i.e., water losses within the pipe network) and groundwater depletion, which underscore the critical need to evaluate and monitor urban water storage, sources, use, and distribution to ensure long-term sustainability (Lee & Schwab, 2005; Foster et al., 2013; Marsalek, 2014; Chini & Stillwell, 2018; Olivares et al., 2019; Luo et al., 2019; Xu et al., 2019; Oswald et al., 2023). Water is at the core of sustainable development goals (SDG No.6; Sadoff et al., 2020), which address issues related to drinking water, sanitation, and hygiene and the quality and sustainability of water resources worldwide. However, despite the global awareness of urban drinking water vulnerability, the water sources and distribution networks of most cities are still poorly evaluated, hampering the current and future spatial and temporal assessment of urban drinking water stress under drought (i.e., water scarcity) and extreme precipitation conditions (i.e., the incursion of traditional and emergent contaminants into the distribution system).Environmental tracers constitute a well-established and reliable tool for urban hydrology, as isotopes can provide important information to water managers to assess sources and interactions between water bodies (Ehleringer et al., 2016). The provision of water for domestic supply in urban areas is complex. Usually, it involves many sources (i.e., precipitation harvesting, streams, canals, lakes and reservoirs, springs, groundwater, and inter-basin water transfer, among others) with different isotopic compositions (see Kuhlemann et al. 2020 for an example of the city Berlin, Germany). These unique compositions can define sources, pathways, transit times, and interactions of water bodies in urban environments. For instance, stable water isotopes can be used to understand links between water consumption and sources, which is key for developing strategies to ensure the long-term sustainability of domestic water supplies (Jameel et al., 2016). National-scale surveys of stable isotope ratios of drinking water have been reported to provide information on the stability of water supply and provide warning signals for impending water resource changes (Bowen et al., 2007; West et al., 2014; Zhao et al., 2017; Bhuiyan et al., 2023). On a local scale, the spatiotemporal distribution of stable water isotope ratios across a single metropolitan area can be used to understand and monitor the function of municipal water systems at finer scales, an important and common issue for water managers in urban systems (Jameel et al., 2018; Sánchez-Murillo et al., 2020; Nagode et al., 2021; Kebede et al., 2023; Sánchez-Murillo et al., 2022). Moreover, the past two decades have seen the rapid development of water isotope sampling and low-cost analytical capabilities (Wassenaar et al., 2018; Terzer-Wassmuth et al., 2020), which have led to novel data analysis approaches such as isoscapes (Bowen, 2010) that can provide useful information to water managers to understand and predict the availability and quality of freshwater resources.One of the main needs of urban water managers and practitioners is to track the water source and movement in the pipe network and monitor water quality modifications and blending ratios (mixing) between the points of treatment and use (Boryczko et al., 2014). Tracking drinking water sources is required as the associated quantity (e.g., water source depletion) and quality (e.g., source contamination) risks differ among sources. Water quality at the point of use may differ from the source because of chemical, physical, and biological modification processes within the distribution network (Liu et al., 2018; Mohammed et al., 2021). In cities with centralized water sourcing and engineered pipe networks, it may be feasible to determine the water source using pipe network maps (Okwori et al., 2021) and pressure distribution within the system. However, this task becomes more difficult in rapidly growing urban centers in developing countries, whereby multiple decentralized water sources (e.g., seasonal reservoirs, well fields, solitary wells, and springs) (Peter-Varbanets et al., 2009) contribute to the piped network. In this context, stable isotopes have the potential to backtrack the water source and determine the transit time of different water sources at the point of use.In addition, understanding the vulnerability of freshwater sources to pollution is key for water managers to improve water security. Pollution problems caused by point or non-point sources in urban areas can be readily identified by the use of a multi-stable isotope approach (e.g., oxygen, hydrogen, nitrogen, carbon, boron, and sulfur) combined with conventional hydrochemical data (e.g., major ions, trace elements, electrical conductivity) (Petrucci et al., 2014). Environmental isotopes provide information on water sourcing, identification of hydrological and biogeochemical processes, detection of leaky distribution systems for domestic supply, and defective sewers into urban aquifers. Determining the age of freshwater resources is also paramount as it provides information on circulation and renewability, which is critical for water resource planning. Environmental isotopes such as3H, 3He, 14C,222Rn industrial gases (e.g., CFCs, SF6), and noble gases are well-established dating tools and provide information on the transit time of water through the water cycle (Newman et al., 2010). Over the past decades, the application of dating tools in urban tracer hydrology has been facilitated by improving analytical and modeling techniques, easier sampling techniques, and lower analytical costs (Smith et al., 2023).
Normalized solutions for Chern-Simons-Schrödinger system with mixed dispersion and cr...
Chenlu Wei
Lixi Wen

Chenlu Wei

and 1 more

June 12, 2024
This paper focuses on the existence of normalized solutions for the Chern-Simons-Schrödinger system with mixed dispersion and critical exponential growth. These solutions correspond to critical points of the underlying energy functional under the L 2 -norm constraint, namely, ∫ R 2 u 2 d x = c > 0 . Under certain mild assumptions, we establish the existence of nontrivial solutions by developing new mathematical strategies and analytical techniques for the given system. These results extend and improve the results in the existing literature.
Real-Time Lightweight Deep Learning Models for Human Activity Recognition Using FMCW...
Fahad Ayaz

Fahad Ayaz

and 4 more

June 24, 2024
Radar-based Human Activity Recognition (HAR) has attracted much attention in various fields such as smart security, medical monitoring, and human computer interaction. Integrating Convolutional Neural Networks (CNNs) with radar spectrum techniques for HAR is becoming increasingly popular. However, traditional network models usually have a large number of parameters and require long training and inference times, making them less suitable for real-time applications. To address these issues, this study proposes a lightweight CNN model based on Frequency-Modulated Continuous Wave (FMCW) radar, designed for edge devices for efficient real-time monitoring. We compare three different 2D domain radar data preprocessing techniques - Time Range (TR), Short-Time Fourier Transform (STFT), and Smoothed Pseudo-Wigner-Ville Distribution (SPWVD) - along with four state-of-the-art neural networks. Our approach achieves high accuracy in HAR classification and effectively addresses the challenges posed by limited radar data through Transfer Learning (TL), demonstrating the potential for real-time applications. After evaluating 12 configurations of CNN models and preprocessing methods, we found that MobileNetV2 with STFT was the most efficient and lightweight, with STFT taking only 220 ms to generate a spectrogram sample. This combination achieved an inference time of only 2.57 ms per sample and a recognition accuracy of 96.30%, setting a new benchmark for real-time intelligent systems on edge devices.
Migration routes and adult survival of the Critically Endangered Yellow-breasted Bunt...
Wieland Heim

Wieland Heim

and 20 more

July 16, 2024
Migratory animals rely on multiple sites during their annual cycles. Deteriorating conditions at any site can have population-level consequences, with long-distance migrants seen as especially susceptible to such changes. Reduced adult survival caused by persecution at non-breeding sites has been suggested a major reason for the catastrophic decline of a formerly abundant, Eurasian, longdistance migratory songbird, the Yellow-breasted Bunting Emberiza aureola. However, it is unknown whether the extinction of the species in the west of its range could be related to differences in migration routes. We investigated survival rates and migration routes of populations from both western and eastern parts of the breeding range. We found moderate apparent survival rates in eastern populations, but observed no returning birds in western populations. Our tracking data highlights 1) a joint migration corridor of eastern populations through eastern China, 2) long autumn stopovers likely used for moult and re-fuelling, and 3) very long occurrences at non-breeding sites. These areas should be given priority for future conservation measures. The lack of returning individuals in the western populations could hint at reduced survival rates due to additional pressures as a consequence of their potentially longer migration route or lower breeding site fidelity.
On gain scheduling trajectory stabilization for nonlinear systems: theoretical insigh...
Nicolas Matthias Kessler
Lorenzo Fagiano

Nicolas Matthias Kessler

and 1 more

July 10, 2024
Steering a nonlinear system from one state to a desired one is a common task in control. While a nominal trajectory can be obtained rather systematically using a model, for example via numerical optimization, heuristics, or reinforcement learning, the design of a computationally fast and reliable feedback control law that guarantees robust asymptotic stability of the found trajectory can be much more involved. An approach that does not require high online computational power and is well-accepted in the industry is gain-scheduling. The results presented here pertain to the stability guarantees and the region of attraction of gain scheduled control laws, based on subsequent linearizations along the reference trajectory. The approach bounds the uncertainty arising from the linearization process, builds polytopic sets of linear time varying systems covering the nonlinear dynamics along the trajectory, and exploits sufficient conditions for robust stability to attempt the derivation of the desired gain-scheduled controller, via the solution of Linear Matrix Inequalities (LMIs). A result to estimate an ellipsoidal region of attraction is provided too. Moreover, arbitrary scheduling strategies between the control gains are considered in the analysis, and the method can be used also to check/assess the stability properties obtained with an existing gain-scheduled law. The approach is demonstrated experimentally on a small quadcopter as well as in simulation to design a scheduled controller for a chemical reactor model and to validate an existing control law for a gantry crane model.
Peptide RL-QN15 regulates epidermal stem cell function to accelerate wound healing vi...
Yuansheng Li
Qiuye Jia

Yuansheng Li

and 14 more

June 12, 2024
Peptide RL-QN15 derived from skin secretions of Rana limnocharis has a pronounced pro-healing effect on acute and chronic wounds, but its precise mechanism is remains to be elucidated. Epidermal stem cells are of utmost importance in wound healing and thus constitute a primary focus of wound repair research. Here, we explored the mechanism of RL-QN15 promoting wound healing by regulating epidermal stem cells. Our results showed that RL-QN15 activated the Wnt/β-catenin signaling pathway by binding to the FZD8. This interaction resulted in the up-regulation of target genes MYC and CCND1, thereby facilitating the proliferation of epidermal stem cells. MMP3 can degrade E-cadherin and activate Wnt/β-catenin pathway further. This enhanced pathway activity induced epithelial-to-mesenchymal transition and N-cadherin expression, further encouraging cell proliferation and migration. RL-QN15 can also effect the stemness of epidermal stem cells. In summary, as an excellent candidate for novel pro-healing agent, RL-QN15 can promote the activation of Wnt/β-catenin pathway through binding with membrane receptor FZD8, thus regulating epidermal stem cell functions and promoting wound healing. This study elucidated a novel mechanism by which amphibian-derived peptides promote skin wound healing, focusing on the regulatory role of epidermal stem cells and providing a new target for skin regeneration research.
Molecular dynamics study of thermal rippling phenomena of pristine and functionalised...
Junjie Chen

Junjie Chen

June 24, 2024
Little research has been conducted to determine the thermal properties and phenomena of graphane and fluorographene. A clear understanding of the thermal problems involved is needed, which may provide a basis for further research on other material properties. In the present study, molecular dynamics simulations were performed to investigate the thermal properties of graphane and fluorographene and especially the phenomena involved, including thermal fluctuations and bending rigidities. Furthermore, comparisons of thermal properties and the phenomena involved were made computationally between pristine and functionalised graphene. The thermal fluctuations and bending rigidities were determined at different temperatures. The present study aims to provide a clear understanding of the thermal problems involved in hydrogenated and fluorinated graphene. The results indicated that while thermally excited ripples spontaneously appear in graphene, fully hydrogenated or fluorinated graphene is substantially unrippled due to their very high bending rigidities. There is no significant effect of thermal rippling throughout graphane and fluorographene due to their very high bending rigidities. However, partially hydrogenated or fluorinated graphene exhibits strong thermal fluctuations. Graphene behaves differently from graphane and fluorographene with regard to the dependence of bending rigidity on temperature. Furthermore, significant out-of-plane fluctuations may occur in partially fluorinated graphene. Thermal fluctuations of graphene are more sensitive to temperature than those of graphane and fluorographene.Keywords: Thermal properties; Molecular dynamics; Thermal rippling; Thermal fluctuations; Bending rigidities; Thermal phenomena
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