Hepatocellular Carcinoma Presenting as a Clival Mass

Introduction: Hepatocellular carcinoma (HCC) comprises the majority of primary liver cancer and has a poor prognosis. Clivus metastasis is rare with only a few reported cases in the medical literature. We report a case of a patient who presented with clival mass found to have metastatic HCC. Case Description/Methods: A 63-year-old woman presented for neurosurgical evaluation after she was found to have a skull base mass on computerized tomography (CT) of the head at an outside hospital. She endorsed dysphagia for three months, however denied headaches or visual disturbances. A magnetic resonance imaging (MRI) revealed a 5.4 cm by 2.9 cm by 3.6 cm mass in the clivus, which was deemed as the cause of dysphagia (Figure 1a). The patient subsequently underwent an endoscopic transsphenoidal resection of the clival mass. Histopathology from the tissue revealed a hepatoid carcinoma, concerning for metastatic HCC (Figure 1b and 2c). Immunohistochemical strains were positive for hepatocytic marker arginase-1 (Figure 1d). Laboratory studies revealed alpha fetoprotein (AFP) of 56,344 ng/mL, CA-125 of 376 ng/mL, normal B-HCG and carcinoembryonic antigen (CEA). Thereafter, a triple phase CT of the liver revealed two LI-RADS 5 lesions suggestive of HCC as the primary malignancy. Patient's case was discussed at multidisciplinary tumor board with recommendations for systemic immunotherapy with atezolimumab plus bevacizumab and radiation therapy to the clivus. Discussion(s): The incidence of HCC has almost tripled since the 1980s making it the fastest rising cause of cancer related deaths. Metastasis to the brain comprises 0.26% to 2.2% of cases and the skull base is the most rarely affected anatomical site. Although CNS presentation is rare, we may see more neurological manifestations of metastatic HCC with the persistence of chronic hepatitis infections, the rise of metabolic diseases such as NASH, and an increase in alcohol-related liver disease during the COVID-19 pandemic. Although exceedingly rare, metastasis to the clivus should be considered in the differential diagnosis of skull base masses. Despite detection and treatment, prognosis remains poor and emphasis should be placed on consistent HCC surveillance. This case emphasizes that skull masses must be evaluated diligently as they can be the first sign of underlying liver malignancy. Given the morbidity and mortality associated with HCC, recognition of atypical manifestations of HCC can lead to a prompt diagnosis and initiation of life-saving treatment. (Figure Presented).

Blended teaching of medical parasitology in China during COVID-19 pandemic.

The COVID-19 pandemic has promoted the development of online teaching in various educational institutions. Different online teaching practice has shown advantages and potential problems. The combination of online and offline teaching (mixed teaching) is a new teaching practice that can exert its advantages simultaneously, and has been wildly used during the COVID-19 pandemic, even being extended to the post-pandemic era. Medical parasitology is a foundation course for medicine and a bridging course towards clinical medicine and preventive medicine. The traditional teaching of medical parasitology has presented many limitations, including outdated teaching concepts and practices, and the disconnection between theory teaching and practice teaching. In response to these difficulties, many innovative ideas and measures have been taken o reform the teaching practice of the foundation medical courses, including updating teaching program, adopting innovative teaching practice (such as blended teaching), and promoting the teaching evaluation method. In this paper, we concluded the blended teaching tools, platforms, manners, effects and evaluation methods in medical parasitology in China during the COVID-19 pandemic to provide information for the teaching reform in the post-pandemic era.Copyright © 2022, National Institute of Parasitic Diseases. All rights reserved.

Non - pharmaceutical interventions for respiratory virus infection in children and its effect.

With the emergence of new respiratory virus,it is more apparent for the vulnerability of population to respiratory viral infection. Non -pharmaceutical interventions (NPIs) for respiratory virus infection have become the main way to prevent corona virus disease 2019. Some studies had proven its effectiveness. In addition,the NPIs also significantly reduced the incidence and hospitalization rate of other respiratory disease in children. NPIs for respiratory virus infection in children have its particularity and challenge. In daily life,it is important to guide children how to do the NPIs, so as to protect susceptible children and reduce the disease burden in children's health system. Therefore, the aerosol transmission, the specificity of the NPIs in children, and the impact on childhood respiratory diseases are described in this article, to improve the prevention of common respiratory diseases in children.Copyright © 2022 Chinese Medical Journals Publishing House Co.Ltd. All Rights Reserved.

A Meta-framework for Spatiotemporal Quantity Extraction from Text

News events are often associated with quantities (e.g., the number of COVID-19 patients or the number of arrests in a protest), and it is often important to extract their type, time, and location from unstructured text in order to analyze these quantity events. This paper thus formulates the NLP problem of spatiotemporal quantity extraction, and proposes the first meta-framework for solving it. This meta-framework contains a formalism that decomposes the problem into several information extraction tasks, a shareable crowdsourcing pipeline, and transformer-based baseline models. We demonstrate the meta-framework in three domains-the COVID-19 pandemic, Black Lives Matter protests, and 2020 California wildfires-to show that the formalism is general and extensible, the crowdsourcing pipeline facilitates fast and high-quality data annotation, and the baseline system can handle spatiotemporal quantity extraction well enough to be practically useful. We release all resources for future research on this topic. © 2022 Association for Computational Linguistics.

Health, Concerns, and Finance: News Framing of Wearing Masks in China From 2001 to 2020

Since the COVID-19 outbreaks, masks have become one of the most controversial topics throughout the world. However, the pro-mask atmosphere seems to be formed smoothly in China, at least in the beginning and peak of epidemic. To understand the social construction of masks in China, this study examines the media framing of masks from 2001 to 2020 in two important newspapers, the People's Daily and the Southern Metropolis Daily. We found that pro-mask discourse portrayed wearing masks first as an emergent and undesired health strategy;later, as an inevitable measure against constant crises;and lastly, part of the new normality. The legalization of wearing masks lies in the severity of a certain health crisis, the effectiveness that masks can protect citizens from such crisis, a comparatively low cost that to exchange for normal lives under a crisis, and the fact that it could overall benefit China's national image and interests. Moreover, masks have been constructed as a financially promising business and a trendy fashion, which further justifies their existence. The counterdiscourses against masks appeared when the conditions that justified masks were questioned. © 2023 (Zhifei Mao, Huaxin Peng, Di Wang, Mengfan He, and Kun Zhou). Licensed under the Creative Commons Attribution Non-commercial No Derivatives (by-nc-nd). Available at http://ijoc.org.

Construction of a Blended Teaching Mode for Medical Parasitology in China during COVID-19 Pandemic

Facing the challenge of COVID-19 pandemic, online education rapidly occupied the daily teaching in China, which promoted the development of "Online+Offline"(blended) teaching. Medical Parasitology majorly aims to cultivate students' basic knowledge of Parasitology and the ability of "diagnosis and control of parasitic diseases". The Massive Online Open Course (MOOC), intelligent teaching software and Parasitology multimedia laboratory are used for blended teaching. Theoretical teaching includes intensive lectures, self-learning and flipped classrooms. Practices are taught in blended manner. The most representative means is the flipped classroom integrating learning with application through "case discussion - laboratory examination - uploading diagnosis basis on line - group report for peer learning". An evaluation combining formative and summative evaluation, online and offline assessment is jointly applied. We selected Clinic Medicine major as the experimental group, the Basic Medicine, Medical Experimental Technology and Biotechnology majors as the control group. The experimental group was taught in the blended teaching mode of "combining virtuality with reality, learning with application";and the control group was taught in the traditional mode of lectures in big group and practices in small groups. The scores of the final computer test and the final offline experimental test were used in comparison. The experiment and theory scores of the experimental group are both significantly higher than that of the control group. The blended teaching is highly recognized by our students, and the teaching mode has been widely demonstrated and recommended to other courses in and out of the university. This mode comprehensively cultivated students' basic knowledge of Parasitology, and the ability of diagnosis and control of parasitic diseases. This blended teaching mode of "combining virtuality with reality, learning with application"effectively improved students' academic performance and application abilities, and well cultivated students' thinking of diagnosis and control of parasitic diseases. © 2022 ACM.

Integrating CRISPR and isothermal amplification reactions in single-tubes for ultrasensitive detection of nucleic acids: the SARS-CoV-2 RNA example

Clustered regularly interspaced short palindromic repeats (CRISPR) and CRISPR-associated protein (CRISPR-Cas) systems have advanced rapidly for the detection of nucleic acids and molecular diagnoses. The sensitivity of techniques directly using CRISPR-Cas systems for target recognition and signal generation is limited by the kinetics of trans-cleavage. Thus, CRISPR-Cas systems have been coupled with isothermal amplification techniques. One strategy for integrating CRISPR-Cas and amplification reactions into a single-tube is to place reagents in separate locations within the tube, maintaining optimum conditions for each reaction. A more challenging strategy is to mix all reagents and allow nucleic acid amplification and CRISPR-based detection to proceed in a homogeneous solution. This desirable approach requires substantial understanding of the compatibility of enzymatic reactions, systematic optimization, and appropriate adjustments of the integrated reactions to ensure high sensitivity. Ultrasensitive techniques have been developed for the detection of SARS-CoV-2 in single-tubes. In this review, we highlight the principle, research needs, and challenges of ultrasensitive single-tube RNA detection using CRISPR technology. We stress the importance of understanding the kinetics of trans-cleavage activity of CRISPR-Cas systems. © 2022 Scientia Sinica Chimica. All rights reserved.

Blended teaching of medical parasitology in China during COVID-19 pandemic

The COVID-19 pandemic has promoted the development of online teaching in various educational institutions. Different online teaching practice has shown advantages and potential problems. The combination of online and offline teaching (mixed teaching) is a new teaching practice that can exert its advantages simultaneously, and has been wildly used during the COVID-19 pandemic, even being extended to the post-pandemic era. Medical parasitology is a foundation course for medicine and a bridging course towards clinical medicine and preventive medicine. The traditional teaching of medical parasitology has presented many limitations, including outdated teaching concepts and practices, and the disconnection between theory teaching and practice teaching. In response to these difficulties, many innovative ideas and measures have been taken o reform the teaching practice of the foundation medical courses, including updating teaching program, adopting innovative teaching practice (such as blended teaching), and promoting the teaching evaluation method. In this paper, we concluded the blended teaching tools, platforms, manners, effects and evaluation methods in medical parasitology in China during the COVID-19 pandemic to provide information for the teaching reform in the post-pandemic era. © 2022, National Institute of Parasitic Diseases. All rights reserved.

A Meta-framework for Spatiotemporal Quantity Extraction from Text

News events are often associated with quantities (e.g., the number of COVID-19 patients or the number of arrests in a protest), and it is often important to extract their type, time, and location from unstructured text in order to analyze these quantity events. This paper thus formulates the NLP problem of spatiotemporal quantity extraction, and proposes the first meta-framework for solving it. This meta-framework contains a formalism that decomposes the problem into several information extraction tasks, a shareable crowdsourcing pipeline, and transformer-based baseline models. We demonstrate the meta-framework in three domains-the COVID-19 pandemic, Black Lives Matter protests, and 2020 California wildfires-to show that the formalism is general and extensible, the crowdsourcing pipeline facilitates fast and high-quality data annotation, and the baseline system can handle spatiotemporal quantity extraction well enough to be practically useful. We release all resources for future research on this topic.(1)

Quantitative Trend Analysis of SARS-CoV-2 RNA in Municipal Wastewater Exemplified with Sewershed-Specific COVID-19 Clinical Case Counts

We demonstrate a new methodology for quantitative trend analysis (QTA) to analyze and interpret SARS-CoV-2 RNA wastewater surveillance results concurrently with clinical case data. This demonstration is based on the work completed under the Ontario (Canada) Wastewater Surveillance Initiative (WSI) by two laboratories in four wastewater treatment plants (WWTPs) at each of four large sewersheds, which were sampled over a 9-month period, along with sewershed-specific clinical case counts. The data from the last 5-months, representing a range of high and low case counts, was used for this demonstration. The QTA integrated clinical and wastewater virus signals, while combining recommendations from the United States Centers for Disease Control and Prevention (US CDC) and the Public Health Agency of Canada (PHAC). The key steps in the QTA consisted of signal normalization with pepper mild mottle virus (PMMoV), as a fecal biomarker, statistical linear break-point trend analysis and integration of both wastewater virus signal and clinical cases trend results. Using this approach, the wastewater virus and clinical cases trends, direction, and magnitude were clearly identified and provided a unified complementary tool to support public health decisions on a targeted, sewershed-specific basis.

Non - pharmaceutical interventions for respiratory virus infection in children and its effect

With the emergence of new respiratory virus,it is more apparent for the vulnerability of population to respiratory viral infection. Non -pharmaceutical interventions (NPIs) for respiratory virus infection have become the main way to prevent corona virus disease 2019. Some studies had proven its effectiveness. In addition,the NPIs also significantly reduced the incidence and hospitalization rate of other respiratory disease in children. NPIs for respiratory virus infection in children have its particularity and challenge. In daily life,it is important to guide children how to do the NPIs, so as to protect susceptible children and reduce the disease burden in children's health system. Therefore, the aerosol transmission, the specificity of the NPIs in children, and the impact on childhood respiratory diseases are described in this article, to improve the prevention of common respiratory diseases in children. © 2022 Chinese Medical Journals Publishing House Co.Ltd. All Rights Reserved.

Efficacy of convalescent plasma in the treatment of coronavirus disease 2019: a systematic review

Objective To systematically review the efficacy of convalescent plasma (CP) in the treatment of coronavirus disease 2019 (COVID-19). Methods PubMed, EMbase, The Cochrane Library, VIP, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of CP in the treatment of COVID-19 from inception to September 15th, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies;then, meta-analysis was performed using RevMan 5.4.1 software. Results A total of 16 RCTs involving 15 301 patients were included. The results of meta-analysis showed that CP treatment did not reduce mortality compared with no-placebo (RR=0.99, 95%CI 0.93 to 1.05, P=0.63) or normal saline (RR=1.06, 95%CI 0.60 to 1.86, P=0.84). However, compared with standard plasma, the mortality of CP group was lower (RR=0.59, 95%CI 0.37 to 0.95, P=0.03). In addition, compared with no-placebo or normal saline, CP treatment could not improve the clinical condition at 28-30 days, reduce mortality at early treatment and in patients without invasive mechanical ventilation when randomized. Conclusion Current evidence shows that compared with no-placebo or normal saline, CP does not reduce mortality in patients with COVID-19. However, when the disease progresses to the point where standard plasma is required, CP may reduce mortality. In addition, use of CP in patients with early or noncritical COVID-19 failed to reduce mortality. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusion. © 2022 West China University of Medical Science. All rights reserved.

Single cell analysis reveals deeper insight of the gateway cell type for SARS-CoV-2 in kidney

Background: Kidney injury is one of the extrapulmonary injury manifestations of COVID-19. Due to the specific expression of SARS-CoV-2 receptor angiotensinase 2 (ACE2), renal tubular epithelial cells are the main target cells of SARS-CoV-2 during kidney infection, although studies have found that the evidence of SARS-CoV-2 infection of glomerular cells. However, detailed mechanism of SARS-CoV-2 infecting kidneys still needs to be identified. Since mice don't express ACE2, humanized organoids have become important carriers for studying the mechanism of viral infection in vitro. It is still unclear whether the existing kidney organoids are suitable for studying SARS-CoV-2 virus infection. Methods: Data source: All scRNA-seq/bulk RNA-seq were downloaded from the Gene expression Omnibus. ScRNA-seq analysis: The scRNA-seq was analyzed using Seurat R package. Cell communication analysis: Cell communication was analyzed using CellPhoneDB and Cellchat R package. SCENIC analysis: Gene regulatory network was analyzed using SCENIC R package. Bulk RNA-seq analysis: We used MuSiC R package to deconvolute bulk RNA-seq data. GSEA analysis: GSEA was performed using clusterProfiler package. Results: We mined the available scRNA-seq dataset of human adult kidneys (GSE140989, GSE131882), and identified a proximal tubule subgroup, PTv cells, is susceptible to SARS-CoV-2 infection. PTv cells are highly enriched a variety of factors related to viral infections (such as ACE2, DPP4, ANPEP, CTSB, TMPRSS2 etc.). Through cell communication and gene regulatory network analysis, we inferred that PTv cells are more active than other PT cells in terms of repairment, fibrosis, development, and reabsorption. Further by analysis in the datasets of GSE139061 and GSE126805, we found that the proportion of PTv increased during acute kidney injury, suggesting that PTv could be used to predict the progression of kidney injury. Analyzing human kidney organoid scRNA-seq data (GSE109718, GSE115986, GSE108291, GSE147863, GSE119561, GSE114802, GSE136314, GSE118184), we identified that the PTv widely present in kidney organoids, indicating that kidney organoids can be used in SARS-CoV-2 related research. Conclusions: We revealed the characteristics of the PTv, a gateway cell for SARSCoV-2 in kidney, and provided a molecular basis for the feasibility of renal organoids to study the renal tropism of SARS-CoV-2.

Identification of a special cell type as a determinant of the kidney tropism of SARS-CoV-2

Background: Coronavirus disease-2019 (COVID-19) is an infectious disease caused by a novel discovered coronavirus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The kidney tropism of SARS-CoV-2 has been well-validated clinically and often leads to various forms of renal damage in COVID-19 patients. However, the underlying mechanisms and diagnostic approaches remain to be determined. Methods: We interrogated the expression of virus-related host factors in singlecell RNA sequencing (scRNA-seq) datasets of normal human kidneys and kidneys with pre-existing diseases. We validated the results with immunohistochemistry and urinary proteomics of COVID-19 patients and healthy individuals. We also assessed the effects of genetic variants on kidney susceptibility using expression quantitative trait loci (eQTLs) databases. Results: We identified a subtype of renal tubular cells, which we named PT-3 cells, as being vulnerable to SARS-COV-2 infections in the kidneys. PT-3 cells were enriched in viral entry factors and replication and assembly machinery, but lacked antiviral restriction factors. PT-3 demonstrated higher proportion of ACE2+/CTSB+ double positive cells compared with other PTECs (20.54% vs 2.24%). Immunohistochemistry confirmed positive staining of PT-3 cells marker SCL36A2 (according to single cell RNA-seq datasets) on kidney sections from COVID-19 patients and healthy individuals. Urinary proteomics confirmed that the protein levels of PT-3 markers, in addition to ACE2, CTSB, and restriction factors, were significantly increased in the urine of COVID-19 patients. We further found that the proportion of PT-3 cells increased in diabetic nephropathy but decreased in kidney allografts and lupus nephropathy, suggesting that kidney susceptibility varied among these diseases. We finally identified several eQTLs that regulate the expression of host factors in kidney cells. Conclusions: We comprehensively characterized the expression patterns and expression levels of viral host factors in human kidney cells and identified PT-3 cells, a special subtype of PTECs that facilitates the SARS-CoV-2 invasion of the kidney. The detection of PT-3 cells markers in human urine may be used to assess the risk of renal infection during COVID-19.

The COVID-19 pandemic and the potential treatment of the novel coronavirus SARS-CoV-2

Coronavirus SARS-CoV-2 is a novel coronavirus and the seventh that can infect human beings and result in severe and acute respiratory syndrome and deaths. Currently, the world is undergoing a global health emergency due to the SARS-CoV-2 pandemic. As of May 18, SARS-CoV-2 has spread to over two hundred countries and infected more than 4.8 million people, resulting in over 300,000 deaths since the first case of a novel pneumonia (COVID-19) patient was discovered in Wuhan, China at the end of December 2019. Currently, there are no effective and/or approved targeting drugs for it though various supportive therapy drugs such as small molecule drugs, vaccines, antibodies and even Chinese herb medicines have been used in the treatment of the first-line patients. However, certain drugs such as remdesivir and S416 are under clinical investigation and may become therapeutic drugs. In this article, we review and discuss SARS-CoV-2, its person-to-person transmission, genomics and proteomics, and the potential for drug development.

Change Point Modeling of Covid-19 Data in the United States

To simultaneously model the change point and the possibly nonlinear relationship in the Covid-19 data of the US, a continuous second-order free knot spline model was proposed. Using the least squares method, the change point of the daily new cases against the total confirmed cases up to the previous day was estimated to be 04 April 2020. Before the point, the daily new cases were proportional to the total cases with a ratio of 0.287, suggesting that each patient had 28.7% chance to infect another person every day. After the point, however, such ratio was no longer maintained and the daily new cases were decreasing slowly. At the individual state level, it was found that most states had change points. Before its change point for each state, the daily new cases were still proportional to the total cases. And all the ratios were about the same except for New York State in which the ratio was much higher (probably due to its high population density and heavy usage of public transportation). But after the points, different states had different patterns. One interesting observation was that the change point of one state was about 3 weeks lagged behind the state declaration of emergency. This might suggest that there was a lag period, which could help identify possible causes for the second wave. In the end, consistency and asymptotic normality of the estimates were briefly discussed where the criterion functions are continuous but not differentiable (irregular).

[Impact of the COVID-19 epidemic on anxiety among the elderly in community].

Objective: To compare the prevalence of anxiety among old people before and during the COVID-19 epidemic in China, and to provide scientific evidence for psychological intervention of the elderly during public health emergencies. Methods: In 2019, the National Psychological Care Project for the Elderly was launched, covering 818 communities across the country, and 188 407 subjects received psychological assessment. In April and May 2020, a convenient sample of 6 467 aged 65 and above subjects were followed up on the anxiety status and its influencing factors during the epidemic period by using structurized questionnaire. Data collection and management were carried out using the national elderly psychological care project data collection platform. McNemar test was used to compare the difference of the prevalence of anxiety among elderly before (October 2019 to January 23, 2020) and during the epidemic (April-May 2020). The difference of the prevalence of anxiety among elderly with different characteristics was compared by chi square test. The influencing factors of anxiety before and during the epidemic situation were analyzed by multivariate logistic regression model. Results: The prevalence of anxiety symptoms in the elderly population was 4.95% (95%CI: 4.42%-5.48%) before the outbreak of COVID-19, and 10.10% (95%CI: 9.36%-10.83%) during the epidemic which was twice as high as before the outbreak. The difference was statistically significant (P<0.05). Multivariate logistic regression analysis showed that the risk factors of anxiety symptoms before the outbreak were with one underlying disease (OR=1.57, 95%CI: 1.05-2.37), with two or more underlying diseases (OR=3.10, 95%CI: 2.13-4.51), and the protective factors were with hobbies, good relationship between children, good relationship with spouse, positive aging attitude and good psychological resilience (all P<0.05). The risk factors of developing anxiety symptoms during the epidemic were living in rural areas (OR=1.77, 95%CI: 1.42-2.20), participating in social activities regularly (OR=1.23, 95%CI: 1.02-1.48), having a good relationship with friends (OR=1.42, 95%CI: 1.11-1.82) and were quarantined or people around were quarantined for medical observation (OR=2.80, 95% CI: 1.90-4.13). Conclusion: The COVID-19 epidemic leads to a double increase in anxiety among the elderly. We should pay more attention to the psychological state of the elderly in rural area and who is being quarantined or people around being quarantined for medical observation.