Prediction of pathological complete response of breast cancer patients who received neoadjuvant chemotherapy with a nomogram based on clinicopathologic variables, ultrasound, and MRI.

OBJECTIVE: To establish a nomogram for predicting the pathologic complete response (pCR) in breast cancer (BC) patients after NAC by applying magnetic resonance imaging (MRI) and ultrasound (US). METHODS: A total of 607 LABC women who underwent NAC before surgery between January 2016 and June 2022 were retrospectively enrolled, and then were randomly divided into the training (n = 425) and test set (n = 182) with the ratio of 7:3. MRI and US variables were collected before and after NAC, as well as the clinicopathologic features. Univariate and multivariate logistic regression analyses were applied to confirm the potentially associated predictors of pCR. Finally, a nomogram was developed in the training set with its performance evaluated by the area under the receiver operating characteristics curve (ROC) and validated in the test set. RESULTS: Of the 607 patients, 108 (25.4%) achieved pCR. Hormone receptor negativity (odds ratio [OR], 0.3; P < .001), human epidermal growth factor receptor 2 positivity (OR, 2.7; P = .001), small tumour size at post-NAC US (OR, 1.0; P = .031), tumour size reduction ≥50% at MRI (OR, 9.8; P < .001), absence of enhancement in the tumour bed at post-NAC MRI (OR, 8.1; P = .003), and the increase of ADC value after NAC (OR, 0.3; P = .035) were all significantly associated with pCR. Incorporating the above variables, the nomogram showed a satisfactory performance with an AUC of 0.884. CONCLUSION: A nomogram including clinicopathologic variables and MRI and US characteristics shows preferable performance in predicting pCR. ADVANCES IN KNOWLEDGE: A nomogram incorporating MRI and US with clinicopathologic variables was developed to provide a brief and concise approach in predicting pCR to assist clinicians in making treatment decisions early.

Plasma TIGIT Level Is a Possible Marker in HIV-Related Liver Damage.

T cell immunoglobulin and ITIM domain (TIGIT), has a key role in immunopathogenesis of HIV. Previous studies on immune checkpoint receptors had mainly focused on the membrane form. To evaluate clinical significance of soluble form of TIGIT (sTIGIT) in people living with HIV. Blood samples of 61 untreated HIV-infected patients and 24 healthy individuals were collected and TIGIT concentrations in plasma were measured by ELISA method. A decreased level of plasma TIGIT in HIV-infected patients was found to be negatively associated with AST/ALT ratio (r = -0.5358, p = 0.0483) that was indicative of liver damage. Moreover, the proportion of TIGIT on CD3+CD4+ cells in HIV-infected individuals increased (47.12 ± 5.051%) compared with in healthy controls (22.13 ± 4.426%, p < 0.01), which indicated change in plasma TIGIT level was at least partially attributed to CD3+CD4+ T cells. Furthermore, there was a strong positive correlation between TIGIT plasma levels and lymphocyte activation gene-3 (LAG-3) plasma levels in HIV-infected patients with a linear correlation coefficient r = 0.904. Therefore, plasma TIGIT level is a possible marker in HIV-related liver damage and LAG-3 closely related to TIGIT possibly plays a co-ordinated role in HIV-related liver damage.

Individual and joint effects of borderline ankle-brachial index and high plasma total homocysteine on all-cause death in hypertensive adults.

BACKGROUND: The cardiovascular hazards of total homocysteine (tHcy) are long known. In addition, despite the acknowledgment on the importance of low ankle-brachial index (ABI) (< 0.9), borderline ABI (0.91-0.99) was once commonly overlooked. This study aims to explore the independent and joint effect of tHcy level and borderline ABI on all-cause death in hypertensive population. METHODS: This study included 10,538 participants from China H-type Hypertension Registry Study. ABI was described into two groups: normal ABI (1.00-1.40) and borderline ABI. tHcy level was also divided into two groups: < 15.02 and ≥ 15.02 µmo/L. Four groups were analyzed, using COX proportional hazard regression model, separately and pairwise to observe the independent and joint effect on all-cause death. RESULTS: A total of 126 (1.2%) deaths were observed in the 1.7 years follow-up time. Borderline ABI has a higher predicted risk of death than normal ABI (HR = 1.87, 95%CI: 1.17-3.00) after adjusting for potential covariates. Compare with tHcy level < 15.02 µmo/L (low tHcy), those with tHcy ≥ 15.02 µmo/L (high tHcy) had higher risk to event outcome (HR = 1.99, 95% CI: 1.30-3.05). According to the cumulative hazard curve, group with borderline ABI and high tHcy level has significantly higher altitude and larger increasing rate over follow-up period compare to other groups. Among those with borderline ABI, participants with high tHcy had higher death risk than those with low tHcy, nevertheless, no significant different between borderline and normal ABI among those with low tHcy levels. CONCLUSIONS: Borderline ABI and tHcy level both have independent predictive value on all-cause death. The combined group of borderline ABI and high tHcy has highest risk factor of outcomes, which suggested the mutual additive value of borderline ABI and tHcy. More attention should be given to the importance of borderline ABI in hypertensive population, especially with elevated tHcy level.

Management of granulomatous lobular mastitis: an international multidisciplinary consensus (2021 edition).

Granulomatous lobular mastitis (GLM) is a rare and chronic benign inflammatory disease of the breast. Difficulties exist in the management of GLM for many front-line surgeons and medical specialists who care for patients with inflammatory disorders of the breast. This consensus is summarized to establish evidence-based recommendations for the management of GLM. Literature was reviewed using PubMed from January 1, 1971 to July 31, 2020. Sixty-six international experienced multidisciplinary experts from 11 countries or regions were invited to review the evidence. Levels of evidence were determined using the American College of Physicians grading system, and recommendations were discussed until consensus. Experts discussed and concluded 30 recommendations on historical definitions, etiology and predisposing factors, diagnosis criteria, treatment, clinical stages, relapse and recurrence of GLM. GLM was recommended as a widely accepted definition. In addition, this consensus introduced a new clinical stages and management algorithm for GLM to provide individual treatment strategies. In conclusion, diagnosis of GLM depends on a combination of history, clinical manifestations, imaging examinations, laboratory examinations and pathology. The approach to treatment of GLM should be applied according to the different clinical stage of GLM. This evidence-based consensus would be valuable to assist front-line surgeons and medical specialists in the optimal management of GLM.

Modelling of self-sustainable microbial fuel cell type oil sensors based on restricted oxygen transfer and two-population competition.

Oil leaks during oil industrial chain pose threats to the ecosystem. The microbial fuel cell-type oil sensor has been developed for early warning of such issues. Oil contacting with the sensor restricts oxygen availability and triggers correlative signal anomaly which serves as indicative of the oil presence. To extend its application for the real world, modelling of the sensor is required to pre-describe the signal behavior under unknown conditions. Therefore, by integrating Butler-Volmer, restricted oxygen transfer (ROT) and Monod equations, a dynamic ROT-MFC model with sufficient substrate precondition was developed. The ROT-MFC model was trained on the experimental single-oil-shock test (R 2 = 0.996) and validated by the experimental sequential-shocktest (R 2 = 0.998). Numerical analysis of the trained ROT-MFC model indicates that the single-shock detection has higher sensitivity (≥40.6 mV/detection) and the sequential-shocks detection spends a shorter response time (≤2.2 h). Besides, the sequential-shocks detection with proper strategy is more applicable due to flexible options on detection limit and working range. The model was further evolved into the TPC-ROT-MFC model by introducing a two-population competition (TPC) theory to describe performance under limited substrate conditions. Results indicate a critical substrate concentration range (42.1 to 62.8 mg-COD/L) for dividing baseline steadiness, and that the impact of substrate concentration on anodic charge transfer coefficient soars when the substrate concentration lessens furtherly. This sensor model is relatively easy to implement and may enhance practical use for design and operation.

Ex-situ biogas upgrading in thermophilic up-flow reactors: The effect of different gas diffusers and gas retention times.

Four different types of ceramic gas distributors (Al2O3 of 1.2 µm and SiC of 0.5, 7 and 14 µm) were evaluated to increase biomethane formation during ex-situ biogas upgrading process. Each type of gas diffuser was tested independently at three different gas retention times of 10, 5 and 2.5 h, at thermophilic conditions. CH4 production rate increased by increasing input gas flow rate for all type of distributors, whereas CH4 concentration declined. Reactors equipped with SiC gas distributors effectively improved biomethane content fulfilling natural gas standards. Microbial analysis showed high abundance of hydrogenotrophic methanogens and proliferated syntrophic bacteria, i.e. syntrophic acetate oxidizers and homoacetogens, confirming the effect of H2 to alternate anaerobic digestion microbiome and enhance hydrogenotrophic methanogenesis. A detailed anaerobic bioconversion model was adapted to simulate the operation of the R1-R4 reactors. The model was shown to be effective for the simulation of biogas upgrading process in up-flow reactors.

Influence of Shielding Gas on Microstructure and Properties of GMAW DSS2205 Welded Joints.

In the present study, the microstructures and properties of DSS 2205 solid wire MIG welded samples prepared in different shielding gases (pure Ar gas, 98%Ar + 2%O2 and 98%Ar + 2%N2) were investigated for improving the weldability of DSS 2205 welded joint. The work was conducted by mechanical property tests (hardness and tensile test) and corrosion resistance property tests (immersion and electrochemical tests). The results show that adding 2%O2 into pure Ar gas as the shielding gas decreases crystal defects (faults) and improves the mechanical properties and corrosion resistance of the welded joints. Phase equilibrium and microstructural homogeneity in welded seam (WS) and heat-affected zone (HAZ) can be adjusted and the strength and corrosion resistance of welded joints increased obviously by adding 2%N2 to pure Ar gas as the shielding gas. Compared with DSS 2205 solid wire MIG welding in 98%Ar + 2%O2 mixed atmosphere, the strength and corrosion resistance of welded joints are improved more obviously in 98%Ar + 2%N2 mixed atmosphere.

Contralateral axillary lymph node metastasis and molecular changes in second primary breast cancer: a case report.

Contralateral axillary metastasis (CAM) is rather rare in primary breast cancer. In this case, we present a 46-year-old female patient who underwent left breast-conserving surgery (BCS) and left axillary lymph node dissection (ALND). Two years later, an enlarged lymph node was found in her right axilla. Magnetic resonance imaging (MRI) of the breast displayed a left breast mass with multiple internal mammary lymph nodes and abnormal lymph nodes in the right axillary region. However, no abnormalities were found in the right breast. The left breast mass was diagnosed as invasive carcinoma by core needle biopsy. During the operation, we suggested that the contralateral lymph nodes were metastatic from the second primary breast cancer by preoperative 99mTc injection around the left breast. The patient underwent left mastectomy and right axillary lymph node dissection. The postoperative pathology was diagnosed as metachronous secondary primary left breast cancer, in which the initial presentation was lymph node metastasis to the contralateral axilla of the left breast. Therefore, we propose that CAM may be more common in second primary or recurrent breast cancer. It should be treated as locoregional extension. Preoperative lymph node markers are important to identify whether contralateral axillary lymph node metastasis occurs from a second primary breast cancer.

On-line monitoring of minor oil spills in natural waters using sediment microbial fuel cell sensors equipped with vertical floating cathodes.

Oil spills near natural water bodies pose considerable threats to aquatic ecosystem and drinking water system. Various detection techniques have been developed to identify the oil pollution in natural waters. These techniques mainly focus on large and major oil spills involving significant changes in environmental characteristics. However, monitoring of minor oil spills (from seepage and dripping) in waters remains a bottleneck, allowing inconspicuous and persistent oil contamination. To overcome this drawback, a sediment microbial fuel cell (SMFC) sensor equipped with a vertical floating cathode is developed for on-line and in-situ monitoring of minor oil spills in natural waters. The vertical floating cathode was intended for recognizing oil on water surface. Oil on the cathode will trigger current drop. Two kinds of natural sediments were adopted in two sensors (SMFC1 from a lake and SMFC2 from an urban stream) for comparison. Both showed linear relationship between net steady-state current decrease and oil dose (30.78 and 27.29 µA/mL of sensitivity, respectively). The current change process was fitted well to a pseudo-first order kinetic equation. A one-point/two-point dynamic identification methods were derived from the kinetic equation. Therefore, the detection time was shortened from 10 h to 10/30 min. The triggered current decrease was mainly attributed to the increase in internal resistance related to charge and mass transfer. Despite the power loss after oil contamination, results implied SMFC sensor could still achieve self-sustainability. This study shows that the SMFC sensor with vertical floating cathodes is applicable to monitoring the unnoticeable minor oil pollutions in natural waters.

A complement factor I (CFI) gene mediates innate immune responses in yellow catfish Pelteobagrus fulvidraco.

This study isolated CFI gene from Pelteobagrus fulvidraco and named it PfCFI. The cDNA of PfCFI is 2374 bp long, including a 52 bp 5' untranslated sequence, a 222 bp 3' untranslated sequence, and an open reading frame (ORF) of 2100 bp encoding polypeptide consisting of 699 amino acids. Phylogenetic analysis revealed that the PfCFI was closely related to CFI of Ictalurus punctatus. Real-time quantitative reverse transcription-PCR (qRT-PCR) analysis indicate that there is the PfCFI gene which expressed in all the rest of tested tissues in varied levels, and mainly distributed in liver and least in heart. The reseachers induce the expressions level of PfCFI gene in liver, spleen, head kidney and blood at different points in time after challenged with lipopolysaccharide (LPS), and polyriboinosinic polyribocytidylic acid (poly I:C), respectively. Together these results suggested that CFI gene plays an important role in resistance to pathogens in yellow catfish immunity.

Efficacy and safety of retention enema with traditional Chinese medicine for ulcerative colitis: A meta-analysis of randomized controlled trials.

OBJECTIVE: To assess the efficacy and safety of retention enema with traditional Chinese medicine (TCM) for ulcerative colitis (UC) through a meta-analysis of published studies. METHODS: Literatures were retrieved from five electronic databases. Quality evaluation and meta-analysis were respectively conducted using the Cochrane collaboration and RevMan5.3. Overall quality of evidence was evaluated using GRADE system. Effect sizes were pooled using random effect models. RESULTS: Seventeen RCTs were included. Compared with routine pharmacotherapies (RPs), TCM enema exhibited a statistically significant difference in clinical efficacy and reduction of the recurrence rate. The results of qualitative description for other endpoints, such as improvements in anabrosis, ulcer, diarrhea, and hematochezia, suggested that TCM enema had better efficacy than RPs. Furthermore, the incidence of side effects in TCM was lower than that in RPs. CONCLUSION: This meta-analysis confirmed the efficacy and safety of TCM enema for improving UC symptoms. However, further well-designed researches are needed.

Bioconversion of wastewater to single cell protein by methanotrophic bacteria.

Single cell protein (SCP) provides an alternative protein source to partially replace the conventional agricultural resources and support the increased nutritional needs. Inexpensive feeding source is one of the key limiting factors for the expansion of SCP production. The present study examined the valorization of biogas derived from the anaerobic digestion (AD) of sewage sludge and the discarded effluent as nutrients source to produce SCP using methanotrophic bacteria. Results indicated that the mixed methanotrophic culture can grow well on the pasteurized AD supernatant and biogas, succeeding in promising dry weight (DW) yield (0.66 ± 0.01 g-DW/g-CH4 and 11.54 ± 0.12 g-DW/g-NH4+). Methylomonas (56.26%) and Methylophilus (24.60%) spp. were the two main representatives of the mixed culture. The produced dried biomass had a protein content higher than 41% w/w, including essential amino acids like histidine, valine, phenylalanine, isoleucine, leucine, threonine and lysine. The cultivated SCP shows potential utilization as protein source for animal diets.

[Outcomes of assisted reproductive technology for patients with different types of teratozoospermia].

OBJECTIVE: To discuss the outcomes of ICSI in infertile patients with globozoospermia (GS), acephalic spermatozoa syndrome (ASS) or teratozoospermia with miniacrosome and irregular-headed sperm defect (TMRHS). METHODS: This retrospective study included 3 cases of GS, 3 cases of ASS and 2 cases of TMRHS undergoing ICSI. We analyzed the rates of fertilization, cleavage, blastocyst formation, implantation, clinical pregnancy and live birth in the three groups of patients. RESULTS: The patients of the GS and ASS groups all achieved clinical pregnancies and healthy births, but those of the TMRHS group showed a lower fertilization rate than the other two groups and achieved no clinical pregnancy. CONCLUSIONS: ICSI could achieve successful clinical pregnancy in infertile patients with globozoospermia or acephalic spermatozoa syndrome, but no satisfactory clinical outcome in those with miniacrosome and irregular-headed sperm defect, though it has to be further proved by more studies with larger-sized samples.

Impacts of Stress Relief Treatments on Microstructure, Mechanical and Corrosion Properties of Metal Active-Gas Welding Joint of 2205 Duplex Stainless Steel.

Stress relief treatments were carried out separately with a pneumatic chipping hammer, ultrasonic peening treatment, and heat treatment for metal active-gas welding (MAG) welded joints of 2205 duplex stainless steel. The effects of these methods on the residual stress, microstructure, mechanical properties and corrosion resistance of welded joints were studied. Results show the stress state of the weld and the surrounding area was effectively improved by the pneumatic chipping hammer and ultrasonic peening treatment, and the residual stress field of the surface layer changed from tensile stress to compressive stress. On the contrary, low-temperature stress relieving annealing had no obvious effect on stress distribution. After the pneumatic chipping hammer and ultrasonic peening treatment, the welded joints were machined and hardened. Correspondingly, strength and hardness were improved. However, the heat treatment only led to a slight decrease in strength and hardness due to the static recovery of the welded joint structure. All stress relief methods effectively improved the corrosion resistance of welded joints, with the ultrasonic peening treatment giving the best performance.

Anatomic Restoration of Triple Disruption of the Superior Shoulder Suspensory Complex: A Case Report and Review of the Literature.

BACKGROUND: Multiple disruptions of the superior shoulder suspensory complex (SSSC) involving more than two components are extremely rare. In some extreme situations, three components of the SSSC structure can be involved. The ideal treatment for this type of injury is debatable. CASE PRESENTATION: A 21-year-old woman was referred to our emergency center following a traffic accident. A three-dimensional CT scan showed triple disruption of the SSSC involving concomitant ipsilateral fractures of the coracoid, the acromion, and the distal clavicle. The connection between the upper limber and the axial skeleton was destroyed. There was no evidence of associated injury and the neurovascular examination of the injured upper limb was normal. The patient underwent an open reduction and internal fixation to restore the anatomic integrity of the SSSC. The arm was supported in a broad arm sling for 2 weeks after surgery. Gentle passive range of motion activity under analgesic was encouraged from the second day postoperatively. One year and half after the operation, the patient had regained pain free and unrestricted shoulder stability and mobility. CONCLUSION: The manifestations of multiple disruptions of the SSSC may be variable. This case illustrated the challenges of treating the multiple disruption of the SSSC structure. It also showed that surgical intervention for this rare combination injury yields an excellent functional result. The good outcome achieved in this patient demonstrates that surgical intervention might be an optional resolution for multiple disruptions of the SSSC.

Characterization of the complete mitochondrial genome of Helice latimera and its phylogenetic implications in Brachyura.

Mitochondrial genomes (mitogenomes) help advance our learning of molecular evolution and phylogenetic relationships. The mitogenome of H. latimera is 16,246 bp in length, which typically contains 37 animal mitogenome genes consisting of 13 protein-coding genes (PCGs), two rRNA genes, and 22 tRNA genes, as well as a control region. The AT content of H. latimera is 69.1%. The A + T skew of the mitogenome of H. latimera was slightly negative (-0.017). The size of Thirteen PCGs is from 162 bp to 1731 bp. Twenty-two tRNA genes ranged from 62 to 73 bp and were highly A + T biased. All tRNA genes owed a typical cloverleaf structure, not including the trnS1 gene lacking a dihydroxyuridine arm. One PCG, two rRNAs, and 12 of the tRNAs were rearranged compared to the pancrustacean gene order. Phylogenetic analysis revealed the locationt of H. latimera among the Varunidae family.

Potassium inhibition during sludge and biopulp co-digestion; experimental and model-based approaches.

Process instability with consecutive low methane production are common challenges of the anaerobic digestion (AD) of municipal wastes. In the present study, the co-digestion of sewage sludge and municipal biopulp was investigated at batch and continuously fed digesters. At batch tests, the highest methane yield for co-digestion (467 ± 17 mLCH4/gVS) was achieved when biopulp contributed to 80% of organic matter content and sludge the remaining 20%. At continuous mode operation, co-digestion achieved 0.91 ± 0.11 L/(L·d) methane productivity, while mono-digestion of sludge achieved 0.62 ± 0.05 L/(L·d). Potassium inhibition was investigated at the most efficient co-digestion scenario and was found that the half maximal inhibitory concentration (IC50) occurred at 8 g-K+/L. Subsequently, the effect of K+ was investigated at different scenarios at continuous operation. Simulations based on BioModel described the inhibitory effect of K+ by introducing non-competitive inhibition of methanogens. Simulation results confirmed the strongly inhibitory effect of potassium to the AD process.

Review: recent developments of substrates for nitrogen and phosphorus removal in CWs treating municipal wastewater.

Substrates are the main factor influencing the performance of constructed wetlands (CWs), and especially play an important role in enhancing the removal of nitrogen and phosphorus from CWs. In the recent 10 years, based on the investigation of emerged substrates used in CWs, this paper summarizes the removal efficiency and mechanism of nitrogen and phosphorus by a single substrate in detail. The simultaneous removal efficiency of nitrogen and phosphorus by different combined substrates is emphatically analyzed. Among them, the reuse of industrial and agricultural wastes as water treatment substrates is recommended due to the efficient pollutant removal efficiency and the principle of waste minimization, also more studies on the environmental impact and risk assessment of the application, and the subsequent disposal of saturated substrates are needed. This work serves as a basis for future screening and development of substrates utilized in CWs, which is helpful to enhance the synchronous removal of nitrogen and phosphorus, as well as improve the sustainability of substrates and CWs. Moreover, further studies on the interaction between different types of substrates in the wetland system are desperately needed.