Correlation of Pattern of Invasion, Stromal Inflammation and Lymphovascular Invasion With Histopathological Grading in Oral Squamous Cell Carcinoma: A Retrospective Study.

INTRODUCTION: Despite the progress in diagnostics and treatment modalities, the survival rate of oral squamous cell carcinoma (OSCC) patients has remained unchanged. Early diagnosis of the disease helps in better treatment and prognosis. Identifying clinicopathological and histopathological parameters that help predict disease progression is crucial. OBJECTIVES: To assess the significance of various clinical and histopathological factors in OSCC and to correlate the patterns of invasion of tumour (POI), stromal inflammation, and lymphovascular invasion with the histopathological grading of OSCC. MATERIALS AND METHODS: This study included 30 oral squamous cell carcinoma cases from 2015 to 2021. The surgically operated cases of OSCC were obtained from the archives of the Oral Pathology Department. The subjects were categorized according to the degree of differentiation of OSCC. The parameters like the pattern of invasion of tumour (POI), stromal inflammation, and lymphovascular invasion were assessed and correlated with the different histopathological grades of OSCC. RESULTS: We observed a statistically significant correlation between the pattern of invasion and stromal inflammation with histopathological grades of OSCC. There was no significant association between lympho-vascular invasion and histopathological grades of OSCC. CONCLUSION: We conclude that histopathological parameters like the pattern of invasion and stromal inflammation significantly impact different grades of OSCC. These parameters should be included in routine histo-pathological reports for predicting clinical outcomes and management of the disease.

Does foreign direct investment influence carbon emission-related environmental problems? Contextual evidence from developing countries across Sub-Saharan Africa.

Sub-Saharan African nations face multifaceted environmental problems, especially those associated with carbon discharges. Hence, this study calculates a composite carbon index in the context of 39 developing nations from this region and uses it as a proxy for the carbon emission-related environmental problems they have faced during the 2000-2020 period. This index is estimated by utilizing data regarding annual carbon dioxide discharges, output-based carbon productivity rates, and energy consumption-based carbon intensity levels in the concerned countries. Hence, policy takeaways from this study have critical relevance for the selected sub-Saharan African nations to help them achieve the objectives related to the Sustainable Development Goals agenda and the Paris Accord. Overall, the findings from the econometric analyses verify that more receipt of foreign direct investment initially raises but later on reduces environmental problems. Thus, the nexus concerning these variables depicts an inverse U-shape. Besides, the results endorse that greening the energy consumption structures of the sampled sub-Saharan African countries helps to abate their environmental problems in the long run while financial development aggravates the extent of environmental adversities that take place. Lastly, improving the quality of regulatory agencies enables the Sub-Saharan African nations to further mitigate their environmental problems. Moreover, these aforementioned findings are observed to be heterogeneous across low- and middle-income categories of the selected Sub-Saharan African countries. Furthermore, the heterogeneity of the findings is also confirmed by the outcomes derived from the country-specific analyses. Nevertheless, these nations should attract clean energy-embodying foreign direct investment, make their energy consumption structures greener by amplifying renewable energy adoption rates, introduce green funds to develop their financial sectors, and make their environmental regulatory agencies more transparent with their activities.

An empirical examination of the environmental sustainability-influencing mechanisms of renewable energy: contextual evidence from Next Eleven countries.

Recognizing the environmental development-related commitments made by the Next Eleven countries at 26th Conference of Parties (COP26), this study scrutinizes the repercussions accompanying good democratic governance, renewable energy transition, economic growth, and the ratification of the Kyoto Protocol on carbon emission figures of these emerging nations. In this regard, the period of analysis considered spans from 1990 to 2018 while the econometric analyses involve application of both parametric and non-parametric panel data estimators. Among the key findings, firstly, the outcomes from the parametric estimation methods verify that establishing better democratic governance and undergoing renewable energy transition, both independently and jointly, curb carbon emission levels, while higher economic growth and the signing of the Kyoto Protocol are responsible for boosting emissions the Next Eleven countries. Secondly, the findings derived using the non-parametric methods reveal a great deal of heterogeneity when compared with the results obtained from the parametric analysis. Notably, better democratic governance is seen to reduce carbon emissions in less and moderately polluted. Next Eleven nations, while renewable energy transition curbs emissions only in the moderately and highly polluted ones. Additionally, these variables jointly inhibit emissions only in the Next Eleven nations that are moderately polluted. Besides, better democratic governance is observed to mediate the renewable energy transition-carbon emissions nexus only for the less-polluted Next Eleven nations, while the environmental impacts of economic growth and the signing of the Kyoto Protocol vary across different emission quantiles. Accordingly, relevant policies are recommended for helping the Next Eleven countries to comply with their pledges made at the COP26.

Diagnosis of Coexisting Valvular Heart Diseases Using Image-to-Sequence Translation of Contact Microphone Recordings.

OBJECTIVE: Development of a contact microphone-driven screening framework for the diagnosis of coexisting valvular heart diseases (VHDs). METHODS: A sensitive accelerometer contact microphone (ACM) is employed to capture heart-induced acoustic components on the chest wall. Inspired by the human auditory system, ACM recordings are initially transformed into Mel-frequency cepstral coefficients (MFCCs) and their first and second derivatives, resulting in 3-channel images. An image-to-sequence translation network based on the convolution-meets-transformer (CMT) architecture is then applied to each image to find local and global dependencies in images, and predict a 5-digit binary sequence, where each digit corresponds to the presence of a specific type of VHD. The performance of the proposed framework is evaluated on 58 VHD patients and 52 healthy individuals using a 10-fold leave-subject-out cross-validation (10-LSOCV) approach. RESULTS: Statistical analyses suggest an average sensitivity, specificity, accuracy, positive predictive value, and F1 score of 93.28%, 98.07%, 96.87%, 92.97%, and 92.4% respectively, for the detection of coexisting VHDs. Furthermore, areas under the curve (AUC) of 0.99 and 0.98 are respectively reported for the validation and test sets. CONCLUSION: The high performances achieved prove that local and global features of ACM recordings effectively characterize heart murmurs associated with valvular abnormalities. SIGNIFICANCE: Limited access of primary care physicians to echocardiography machines has resulted in a low sensitivity of 44% when using a stethoscope for the identification of heart murmurs. The proposed framework provides accurate decision-making on the presence of VHDs, thus reducing the number of undetected VHD patients in primary care settings.

Determinants of environmental quality in India: evidence using the bootstrapped ARDL model with structural breaks.

This current study examines the impact of renewable energy consumption, agriculture, and globalization on carbon emissions in India over the period from 1980 to 2018. For long-run estimates, we apply Gregory-Hansen's co-integration test, bootstrap ARDL approaches, fully modified ordinary least squares, and dynamic OLS. The empirical results of long-run estimates indicate that a 1% increase in renewable energy consumption, agriculture, and economic globalization will increase carbon emissions by 0.764%, 1.675%, and 0.517%, respectively. Moreover, this study confirms the detrimental effect of these variables on carbon dioxide emissions. Economic globalization coefficients indicate that the scale effect is valid in India. The 2002 economic crisis slowed down the country's growth rate, which reduced the ecological pollution. Several policy recommendations are derived from the empirical findings.

The severity of COVID-19 in hypertensive patients is associated with mirSNPs in the 3' UTR of ACE2 that associate with miR-3658: In silico and in vitro studies.

The SARS-CoV-2 virus targets the antigen converting enzyme 2 (ACE2) receptor, thus resulting in elevated morbidity and an increased risk of severe and fatal COVID-19 infection in individuals with hypertension and diabetes mellitus. Objectives: This study aimed to identify the association between increased susceptibility and severity in order to evaluate their impact in hypertensive COVID-19 patients using in vitro and in silico models. Methods: We identified 80 miRNA binding sites on ACE2 (for different miRNAs) as well as various 30 SNPs in the miRNA binding sites of the 3' untranslated region (3' UTR) in the ACE2 gene using different online software and tools. From August 2020 to August 2021, a total of 200 nasopharyngeal/mouth swabs samples were collected from Multan, Pakistan. In order to quantify the cDNA of ACE2 and miR-3658 genes, we used Rotor Gene qRT-PCR on hypertensive patients with COVID-19 as well as healthy controls. Results: Interestingly, the binding site of miR-3658 corresponding to the 3' UTR of ACE2 featured three SNPs (rs1457913029, C>T; rs960535757, A>C, G; rs1423809569, C>T), and its genomic sequence featured a single SNP (rs1024225815, C>T) with the same nucleotide variation (rs1457913029, C>T) which potentially increases the severity of COVID-19. Similarly, three other SNPs (rs1557852115, C>G; rs770335293, A>G; rs1024225815, C>T) were also found on the first binding site positions of miR-3658. Our in vitro study found that ACE2 gene expression had an effect on miR-3658 in COVID-19 patients who also had hypertension. In both cases, our analysis demonstrated that the in silico model captured the same biological mechanisms as the in vitro system. Conclusion: The identified SNPs could represent potential informative signatures owing to their position in the splicing site of the ACE2 gene.

Does the depth of the Financial Markets matter for establishing Green Growth? Assessing Financial sector's potency in decoupling Economic Growth and Environmental Pollution.

China's 2060 carbon neutrality agenda requires implementation of policies that can decouple its economic growth from environmental pollution. Consequently, establishing green growth in the Chinese economy is of utmost significance. Against this milieu, this study questions whether the depth of Chinese financial markets matters for establishing green growth in China. Besides, the green growth effects of renewable energy use, technological innovation, and urbanization are also examined. Accordingly, quarterly frequency data from 1990Q1 to 2020Q4 are utilized to perform econometric tests that accommodate structural break concerns in data. Overall, the findings reveal that the depth of the Chinese financial markets facilitates the prospects of greening the Chinese economy. Notably, deepening of financial markets is seen to initially inhibit green growth while stimulating it later on; thus, the financial markets' depth-green growth nexus is evidenced to depict a U-shape. On the other hand, green growth in China is also found to be catalyzed by the renewable transformation of the Chinese energy sector and through technological innovation in the long-run. Conversely, urbanization is witnessed to inflict anti-green growth impacts. Furthermore, the causality analysis verifies bi-directional causal associations between renewable energy use and green growth while unidirectional causalities running from financial markets' deepening, technological innovation, and urbanization to green growth are also discovered. Therefore, it is recommended that China should try to persistently develop its stock and debt markets so that clean investment can be boosted to decouple economic growth and environmental pollution. Besides, it is also important to undergo renewable energy transition, develop clean technologies, and design low-energy urbanization strategies.

Lack of association between the eNOS rs1800779 (A/G) polymorphism and the myocardial infarction incidence among the Iraqi Kurdish population.

Objectives: The genetic polymorphisms of the endothelial nitric oxide synthase (eNOS) gene are strongly associated with several cardiovascular diseases (CVDs) in various populations. The current study aimed to investigate the association of the eNOS rs1800779 (A/G) polymorphism with the progress of myocardial infarction (MI). Methods: Eighty-five healthy subjects and 80 patients with MI admitted to the Erbil Cardiac Centre in the Kurdistan Region of Iraq were enrolled in the study. All participants were Kurdish from the same ethnic group. The amplification refractory mutation system polymerase chain reaction (ARMS-PCR) was used to determine the rs1800779 (A/G) polymorphism of eNOS, and the nitric oxide (NO) serum level was detected by spectrophotometer. Results: The genotypic frequencies of the eNOS rs1800779 AA (wild type), AG, and GG were 58.75%, 33.75%, and 7.50%, respectively, in the MI patients, and 49.41%, 43.53%, and 7.06%, respectively, for the control group. The frequencies of the A and the G alleles were 75.6% and 24.4%, respectively, in the MI group, and 71.2% and 28.8%, respectively, in the control subjects. The results revealed a lack of association of the rs1800779 genotype distribution with the level of NO serum and increased risk of MI. Conclusion: The study concluded that there is a lack of association between the genotypes and alleles of the rs1800779 eNOS and susceptibility to MI in the studied population.

Repercussions of Hydroelectricity use on Carbon Emissions in Bangladesh: Evidence using Novel Fourier-Bootstrapped ARDL and Fourier-Gradual Shift Causality analyses.

Bangladesh has recently pledged at the 26th Conference of Parties (COP26) to reduce its carbon dioxide emission figures by 22% at the end of 2030. However, since this South Asian country has always turned to fossil fuels for electricity generation purposes, achieving this emission reduction goal is a challenging task for the Bangladesh government. Nevertheless, considering the negative environmental implications associated with the generation and consumption of unclean energy, particularly electricity, it is critically important for Bangladesh to expedite the process of clean transformation of its traditional pollution-intensive power system. Hence, the objective of this study is to dissect the repercussions of hydroelectricity use on Bangladesh's fossil fuel consumption-related carbon dioxide As opposed to the traditional method of quantifying environmental quality using total carbon dioxide emissions, this study considers Bangladesh's annual carbon dioxide emissions generated from the combustion of gas, oil, and coal. Besides, novel Fourier-based econometric methods that effectively handle structural break problems in data are utilized in this study. Based on the results, it is found that up-scaling hydroelectricity consumption levels exert emission-inhibiting effects while greater economic globalization activities are witnessed to boost the emissions. More importantly, hydroelectricity consumption and economic globalization are observed to jointly curb fossil fuel consumption-based emissions of carbon dioxide. Additionally, the results verify the environmental Kuznets curve hypothesis for Bangladesh. Furthermore, financial sector development is found to be effective in reducing the natural gas consumption-related carbon dioxide emissions while urbanization is held responsible for amplifying emissions generated from all three types of fossil fuels. Therefore, considering these findings, the Bangladesh government needs to particularly emphasize scaling up production and consumption of hydroelectricity to decarbonize its economy.

Diagnosis of Peripheral Artery Disease Using Backflow Abnormalities in Proximal Recordings of Accelerometer Contact Microphone (ACM).

OBJECTIVE: The development of an accurate, non-invasive method for the diagnosis of peripheral artery disease (PAD) from accelerometer contact microphone (ACM) recordings of the cardiac system. METHODS: Mel frequency cepstral coefficients (MFCCs) are initially extracted from ACM recordings. The extracted MFCCs are then used to fine-tune a pre-trained ResNet50 network whose middle layers provide streams of high-level-of-abstraction coefficients (HLACs) which could provide information on blood pressure backflow caused by arterial obstructions in PAD patients. A vision transformer is finally integrated with the feature extraction layer to detect PAD, and stratify the severity level. This architecture is coined multi-stream-powered vision transformer (MSPViT). The performance of MSPViT is evaluated on 74 PAD and 21 healthy subjects. RESULTS: Sensitivity, specificity, F1 score, and area under the curve (AUC) of 99.45%, 98.21%, 99.37%, and 0.99, respectively, are reported for the binary classification which ensures accurate detection of PAD. Furthermore, MSPViT suggests average sensitivity, specificity, F1 score, and AUC of 96.66%, 97.34%, 96.29%, and 0.96, respectively, for the classification of subjects into healthy, mild-PAD, and severe-PAD classes. The silhouette score is calculated to assess the separability of clusters formed for classes in the penultimate layer of MSPViT. An average silhouette score of 0.66 and 0.81 demonstrate excellent cluster separability in PAD detection and severity classification, respectively. CONCLUSION: The achieved performance suggests that the proximal ACM-driven framework can replace state-of-the-art techniques for PAD detection. SIGNIFICANCE: This study presents a fundamental step towards prompt and accurate diagnosis of PAD and stratification of its severity level.

Case Report: Basaloid Squamous Cell Carcinoma of the Tongue: A Case Report.

Basaloid squamous cell carcinoma (BSCC) is a rare variant of conventional squamous cell carcinoma (SCC) frequently affecting the upper aerodigestive tract. The hypopharynx, tonsil, supraglottic larynx, tongue (base), and head-neck regions are particularly susceptible to BSCC. Clinically, the presentation of BSCC and conventional SCC is similar, but BSCC has a poorer prognosis. BSCC is distinguished histopathologically by a dimorphic pattern, a distinctive basal cell component paired with a squamous component. However, its similar features to conventional SCC makes it difficult to diagnose. Therefore, histopathology and immunohistochemistry play a crucial role in diagnosing such tumors. Here we present the case of a 70-year-old male diagnosed with BSCC involving the tongue.

Role of proliferative markers in assessing recurrences in surgical margins of oral squamous cell carcinoma: A systematic review.

The primary goal of this systematic analysis is to determine the predictive significance of proliferative markers in surgical margins of patients with oral squamous cell carcinoma (OSCC). A thorough literature search was done on databases like MEDLINE/Pub-Med, Cochrane and Scopus libraries for similar studies until December 2022. All the relevant original research studies (retrospective and prospective) published in the literature assessing the predictive value of proliferative markers in surgical margins in OSCC were included. Seventeen studies with 1159 patients were included. The research included here used p53, p44/p42, proliferating cell nuclear antigen (PCNA), epidermal growth factor receptor (EGFR), Ki-67, Bcl2, Nibrin, AgNORs, Cyclin B1, Cornulin, ISG 15antibodies, MCM3 in OSCC. Four studies were done on oral premalignant lesions and OSCC. Among these studies, Ki-67 was the most accurate, followed by p53 (75%) and AgNORs, while PCNA had the least accuracy. To minimize the risk of bias panel of antibodies was suggested in most studies. For interobserver variability, analysis of variance and Chi-square test were used in most studies. The chance of recurrence rate was calculated using a log-rank test and a Kaplan-Meier curve. The significance of proliferative markers in surgical margins of OSCC has been emphasized in the present review. Future research should focus on selecting antibodies, preferably a panel, with a large sample size and extended follow-up.

The Global Health Security Index is not predictive of vaccine rollout responses among OECD countries.

OBJECTIVE: This study sought to evaluate the utility of the Global Health Security (GHS) index in predicting the launch of COVID-19 vaccine rollout by Organization for Economic Cooperation and Development (OECD) member countries. METHODS: Country-level data on the preparedness to respond to infectious disease threats through vaccination rollout were collected using the GHS index. OECD member countries were rank-ordered based on the percentage of their populations fully vaccinated against COVID-19. Rank-ordering was conducted from the lowest to the highest, with each country assigned a score ranging from 1 to 33. Spearman's rank correlation between the GHS index and the percentage of the population that is fully vaccinated was also performed. RESULTS: Israel, ranked 34th in the world on the GHS index for pandemic preparedness, had the highest percentage of the population that was fully vaccinated against COVID-19 within 2 months of the global vaccine rollout. The Spearman rank correlation coefficient between GHS index and the percentage of population fully vaccinated was -0.1378, with a p-value of 0.43. CONCLUSION: The findings suggest an absence of correlation between the GHS index rating and the COVID-19 vaccine rollout of OECD countries, indicating that the preparedness of OECD countries for infectious disease threats may not be accurately reflected by the GHS index.

Statins use and COVID-19 outcomes in hospitalized patients.

BACKGROUND: There is an urgent need for novel therapeutic strategies for reversing COVID-19-related lung inflammation. Recent evidence has demonstrated that the cholesterol-lowering agents, statins, are associated with reduced mortality in patients with various respiratory infections. We sought to investigate the relationship between statin use and COVID-19 disease severity in hospitalized patients. METHODS: A retrospective analysis of COVID-19 patients admitted to the Johns Hopkins Medical Institutions between March 1, 2020 and June 30, 2020 was performed. The outcomes of interest were mortality and severe COVID-19 infection, as defined by prolonged hospital stay (≥ 7 days) and/ or invasive mechanical ventilation. Logistic regression, Cox proportional hazards regression and propensity score matching were used to obtain both univariable and multivariable associations between covariates and outcomes in addition to the average treatment effect of statin use. RESULTS: Of the 4,447 patients who met our inclusion criteria, 594 (13.4%) patients were exposed to statins on admission, of which 340 (57.2%) were male. The mean age was higher in statin users compared to non-users [64.9 ± 13.4 vs. 45.5 ± 16.6 years, p <0.001]. The average treatment effect of statin use on COVID-19-related mortality was RR = 1.00 (95% CI: 0.99-1.01, p = 0.928), while its effect on severe COVID-19 infection was RR = 1.18 (95% CI: 1.11-1.27, p <0.001). CONCLUSION: Statin use was not associated with altered mortality, but with an 18% increased risk of severe COVID-19 infection.

'Adrenal rush' in a patient with Neurofibromatosis-1.

Neurofibromatosis-1 (NF-1) is a genetic neuro-cutaneous disorder that is associated with an increased prevalence of pheochromocytoma (PHEO). However, this association may not be commonly anticipated by physicians, as patients may be normotensive. In addition, NF-1 patients can be asymptomatic and/or normotensive. These factors can result in a delayed or missed diagnosis of pheochromocytoma leading to catastrophic complications. Currently, it is recommended to perform annual blood pressure monitoring in patients with NF-1 and to test for pheochromocytoma only if found to be hypertensive. However, recent studies show that this practice may lead to underdiagnosis of pheochromocytoma. Therefore, suggesting routine biochemical testing for pheochromocytoma in all patients with NF-1. In this case report, we discuss the factors which can lead to a delayed diagnosis of pheochromocytoma in a patient with known NF-1 and hypertension.