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Deep Morphea in an Immunosuppressed Patient With Anti-U1RNP Myositis:A Case Report

International Journal of Dermatology and Venereology 2024年第2期7卷 111-114页

作者： Ahmad Berjawi Laure L.Irani Jinane R.El Khoury Department of Dermatology Gilbert and Rose Marie Chagoury School of MedicineLebanese American UniversityBeirut 1100Lebanon Department of Rheumatology Division of Internal MedicineGilbert and Rose Marie Chagoury School of MedicineLebanese American University Medical CenterBeirut 1100Lebanon

Introduction:Morphea is an inflammatory skin disease characterized by skin thickening due to increased collagen deposition in the dermis or subcutaneous ***-U1RNP myositis is a newly described entity characterized by myositis,arthritis,interstitial lung disease,and Raynaud *** present a case of a unique combination of deep morphea in a patient with anti-U1RNP *** presentation:A 64-year-old male with 5-year history of proximal muscle weakness,polyarthritis,Raynaud phenomenon,and dyspnea on multiple immunosuppressives presented with localized infiltrated,tight,and hyperpigmented plaques over the posterior thighs and mid-to-lower back developing over the last 2 years and limiting his *** workup revealed a positive ANA,anti-U1RNP antibody,anti-Jo1 antibody,and anti-Ro52 *** workup showed restrictive lung disease,kidney disease,and *** was diagnosed with anti-U1RNP *** biopsy of the back lesion showed deep ***:Association of deep morphea with anti-U1RNP myositis is not described prior in the *** of morphea is challenging since the patient is already on immunosuppressive *** patient failed methotrexate prior and is currently on Mycophenolate mofetil and Deflazacort which are reported as potential treatment for ***,physical therapy plus topical Tacrolimus were suggested as an initial measure to preserve the range of motion of his posterior thighs and *** is a case of progressive deep morphea developing in a patient with a unique autoimmune profile on immunosuppressive ***:Anti-U1RNP myositis is a challenging diagnosis and should be always thought of in patients with positive anti-U1RNP,myositis,interstitial lung disease,arthritis,kidney disease,and Raynaud ***,deep morphea treatment in immunosuppressed patients is challenging and different measures should be considered.

关键词： deep morphea immunosuppression anti-U1RNP myositis case report

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Characteristics and trends of pediatric firepit burns: insights for prevention and safety

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World Journal of Pediatric Surgery 2024年第1期7卷 54-58页

作者： Maria Fazal Charbel Chidiac Raheel Ahmad Oussama Issa Erica Hodgman Alejandro V Garcia Johns Hopkins school of medicine BaltimoreMarylandUSA Department of Surgery Division of Pediatric SurgeryJohns Hopkins School of MedicineBaltimoreMarylandUSA Division of the Biological Sciences University of ChicagoChicagoIllinoisUSA school of medicine American University of BeirutBeirutLebanon

Introduction As fire pits grow in popularity,so do the associated burn *** study examines pediatric fire pit burns characteristics to raise awareness and promote safety *** We conducted a retrospective review of pediatric patients(<21 years)with firepit burns at a tertiary care hospital from 2016 to *** Eighty-four patients were identified,of whom 70.2%were male,with a median age of 62 *** median percent total body surface area burned was 2%(interquartile range(IQR)=1-4).Thirty-five(41.7%)patients were admitted and 7(8.3%)underwent *** and trunk burns had the highest grafting rates(66%and 33%,respectively).The hands(41.7%)and the lower extremities(27.4%)were the most frequently burned body *** leading causes of burns were ashes/hot coals(34.5%),flames(31.0%),and direct contact(25.0%),often resulting from falling into the fire(59.5%)or running or playing in activities near it(26.2%).Thirty-five(41.7%)were admitted for inpatient management,while 49(58.3%)were treated as ***(13.2%)underwent at least one reconstructive surgery,7(8.4%)had at least one rehabilitation visit,and 65(77.4%)had follow-up clinic *** median length of stay was 2 days(IQR=1.0-3.5).The peak months for burns were from August through October(n=40,46.0%),with an increase observed from 10 cases in 2016to 20 cases in *** Given the significant proportion of firepit burns resulting from unsafe fire behaviors,it is crucial that caretakers are aware of proper firepit safety *** ofevidence Il.

关键词： burns admitted prevention

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Recent advances on vaccines against malaria: A review

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Asian Pacific Journal of Tropical medicine 2024年第4期17卷 143-159页

作者： Shiza Malik Yasir Waheed Bridging Health Foundation Rawalpindi 46000Pakistan Gilbert and Rose-Marie Chagoury school of medicine Lebanese American UniversityByblos 1401Lebanon MEU Research Unit Middle East UniversityAmman11831Jordan

This review aims to summarize the currently viable vaccine strategies including the approved vaccines and the those in trials for next-generation malaria *** on malaria vaccine development was collected through a comprehensive *** literature search was performed using databases including Google Scholar,PubMed,NIH,and Web of *** novel approaches of vaccination are being developed,including those based on radiation-attenuated strategies,monoclonal antibodies,targeted immunogenic peptides,RNA and DNA vaccines,nanoparticle-based vaccines,protein-based vaccination protocols,and whole organism-based vaccination *** on RTS,S have entered phase Ⅲtesting,and those based on blood-stage vaccines and vaccines to interrupt malarial transmission have advanced to higher stages of *** modeling,combined drug and vaccine strategies,mass drug administration,polyvalent vaccine formulations,and targeted vaccination campaigns is playing an important role in malarial ***,assessing coverage,accessibility,acceptability,deployment,compilation,and adherence to specific vaccination strategies in endemic regions is essential for vaccination drives against malaria.

关键词： Vaccines against malaria Drugs and adjuvant Malarial treatment Plasmodium RTS,S vaccine

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Simulation-based assessment for the emergency medicine milestones: a national survey of simulation experts and program directors

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World Journal of Emergency medicine 2024年第4期15卷 301-305页

作者： Afrah A Ali Ashley Crimmins Hegang Chen Danya Khoujah Department of Emergency medicine University of Maryland School of MedicineBaltimore 21201USA Department of Epidemiology and Public Health University of Maryland School of MedicineBaltimore 21201USA Department of Emergency medicine AdventHealth TampaTampa 33606USA

The focus of outcome-based education has shifted from the process of training to the end“product”of *** has necessitated a reframing of the teaching,learning,and ***,in 2013,the Accreditation Council for Graduate Medical Education(ACGME)implemented the educational milestones for all accredited residencies and fellowship programs.[1]The milestones have been described as“developmentally based,specialty-specific achievements that residents are expected to demonstrate at established intervals as they progress through training.”[1]Milestones are based on the six core competencies established by the ACGME and american Board of Medical Specialties(ABMS),which consist of medical knowledge(MK),patient care(PC),interpersonal and communication skills(ICS),practice-based learning and improvement(PBLI),professionalism(PROF),and systems-based practice(SBP).[2,3]ACGME,in conjunction with the american Board of Emergency medicine(ABEM),drafted 23 detailed subcompetencies relevant to emergency medicine(EM).[4]

关键词： Miles milestone education

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ADAM8 inactivation retards intervertebral disc degeneration in mice

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Genes & Diseases 2024年第3期11卷 91-94页

作者： Zuozhen Tian Frances S.Shofer Mingyue Fan Alec Z.Sandroni Lutian Yao Lin Han Ling Qin Motomi Enomoto-lwamoto Yejia Zhang Department of Physical medicine&Rehabilitation Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPA19146USA Department of Emergency medicine Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPA 19104USA Department of Orthopedic Surgery Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPA 19104USA school of Biomedical Engineering Science&Health SystemsDrexel UniversityPhiladelphiaPA 19104USA Department of Orthopedics/Sports medicine and Joint Surgery the First Hospital of China Medical UniversityShenyangLiaoning 110001China Department of Orthopedics University of Maryland School ofMedicineBaltimoreMD21201USA Section of Rehabilitation medicine Corporal Michael J.Crescenz Veterans Affairs Medical CenterPhiladelphiaPA 19104USA

ADAM8 has been identified as the fibronectin-cleaving enzyme in human degenerative intervertebral disc(IVD)tissues.^(1)Increase of the active form of ADAM8 and its cleavage product,fibronectin fragment,correlated with an increased degree of IVD degeneration.1 Furthermore,fibronectin fragments have been shown to accelerate the progression of IVD degeneration.^(2)These findings suggest that ADAM8 may play a role in degenerative disc disease,a clinical problem with tremendous socioeconomic burdens in the United States.

关键词： ADAM8 degeneration intervertebral

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Nutritional Composition and Distribution of Heracleum dissectum Ledeb. at Different Growth Stages

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Journal of Northeast Agricultural university(English Edition) 2024年第03期 20-32页

作者： Pan Yan Fan Lili Sun Yan Li Sining Zhuang Yue Sun Haixia Zhong Rongzhen State Key Laboratory of Black Soils Conservation and Utilization Northeast Institute of Geography and Agroecology Chinese Academy of Sciences College of Modern Agriculture and Ecology Heilongjiang University College of medicine American University of the Caribbean Pembroke Pines America

Abstract:Heracleum dissectum Ledeb.（HD） with high edible and medicinal values is distributed in Northeast *** provide a reference for selecting appropriate parts and periods to harvest HD,the nutrient contents in different parts of HD at three growth stages were *** nutrients being determined are essential nutrients closely related to human needs,and the crude protein content of HD was 3.58?28.43 g·100 g-1DW （dry weight）,sugar content was 2.33?30.92 g·100 g-1DW,and soluble dietary fiber content was9.71?26.09 g·100 *** protein was mainly distributed in leaf blades and inflorescences,sugar was primarily found in roots,and dietary fiber was predominantly located in *** the leaf development stage to the flowering stage and then to the late seed harvest stage,the content of moisture,crude protein and soluble sugar first decreased and then *** contrast,the content of dietary fiber and crude fat first increased and then decreased.

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Predictive modeling for postoperative delirium in elderly patients with abdominal malignancies using synthetic minority oversampling technique

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World Journal of Gastrointestinal Oncology 2024年第4期16卷 1227-1235页

作者： Wen-Jing Hu Gang Bai Yan Wang Dong-Mei Hong Jin-Hua Jiang Jia-Xun Li Yin Hua Xin-Yu Wang Ying Chen Intensive Care Unit Shanghai Fourth People’s Hospital Affiliated to Tongji University School of MedicineShanghai 200434China Department of Anesthesia and Perioperative medicine Shanghai Fourth People’s Hospital Affiliated to Tongji University School of MedicineShanghai 200434China Department of Nursing Shanghai Fourth People’s Hospital Affiliated to Tongji University School of MedicineShanghai 200434China Department of Thyroid Breast and Vascular SurgeryShanghai Fourth People’s Hospital Affiliated to Tongji University School of MedicineShanghai 200434China

BACKGROUND Postoperative delirium,particularly prevalent in elderly patients after abdominal cancer surgery,presents significant challenges in clinical *** To develop a synthetic minority oversampling technique(SMOTE)-based model for predicting postoperative delirium in elderly abdominal cancer *** In this retrospective cohort study,we analyzed data from 611 elderly patients who underwent abdominal malignant tumor surgery at our hospital between September 2020 and October *** incidence of postoperative delirium was recorded for 7 d *** were divided into delirium and non-delirium groups based on the occurrence of postoperative delirium or not.A multivariate logistic regression model was used to identify risk factors and develop a predictive model for postoperative *** SMOTE technique was applied to enhance the model by oversampling the delirium *** model’s predictive accuracy was then *** In our study involving 611 elderly patients with abdominal malignant tumors,multivariate logistic regression analysis identified significant risk factors for postoperative *** included the Charlson comorbidity index,american Society of Anesthesiologists classification,history of cerebrovascular disease,surgical duration,perioperative blood transfusion,and postoperative pain *** incidence rate of postoperative delirium in our study was 22.91%.The original predictive model(P1)exhibited an area under the receiver operating characteristic curve of *** comparison,the SMOTE-based logistic early warning model(P2),which utilized the SMOTE oversampling algorithm,showed a slightly lower but comparable area under the curve of 0.856,suggesting no significant difference in performance between the two predictive *** This study confirms that the SMOTE-enhanced predictive model for postoperative delirium in elderly abdominal tumor patients shows performance equivalent to that of tradi

关键词： Elderly patients Abdominal cancer Postoperative delirium Synthetic minority oversampling technique Predictive modeling Surgical outcomes

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Cancer immunotherapy with envelopedself-amplifying mRNA CARG-2020 thatmodulates IL-12,IL-17 and PD-L1 pathways toprevent tumor recurrence

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Acta Pharmaceutica Sinica B 2024年第1期14卷 335-349页

作者： Ju Chen Bhaskara Reddy Madina Elham Ahmadi Timur Olegovich Yarovinsky Marie Marthe Krady Eileen Victoria Meehan Isabella China Wang Xiaoyang Ye Elise Pitmon Xian-Yong Ma Bijan Almassian Valerian Nakaar Kepeng Wang Department of Immunology School of MedicineUniversity of Connecticut Health CenterFarmingtonCT 06030USA CaroGen Corporation FarmingtonCT 06030USA The Eighth Clinical Medical College of Guangzhou university of Chinese medicine Foshan Hospital of Traditional Chinese MedicineFoshan 528000China The Loomis Chaffee school WindsorCT 06095USA

Targeting multiple immune mechanisms may overcome therapy resistance and further improve cancer immunotherapy for ***,we describe the application of virus-like vesicles(VLV)for delivery of three immunomodulators alone and in combination,as a promising approach for cancer *** vectors were designed to deliver single chain interleukin(IL)-12,shorthairpin RNA(shRNA)targeting programmed death ligand 1(PD-L1),and a dominant-negative form of IL-17 receptor A(dn-IL17RA)as a single payload or as a combination *** delivery of the VLV vector expressing IL-12 alone,as well as the trivalent vector(designated CARG-2020)eradicated large established ***,only CARG-2020 prevented tumor recurrence and provided long-term survival benefit to the tumor-bearing mice,indicating a benefit of the combined *** abscopal effects of CARG-2020 on the non-injected contralateral tumors,as well as protection from the tumor cell re-challenge,suggest immune-mediated mechanism of protection and establishment of immunological ***,CARG-2020 potently activates Th1 immune mechanisms and inhibits expression of genes related to T cell exhaustion and cancer-promoting *** ability of CARG-2020 to prevent tumor recurrence and to provide survival benefit makes it a promising candidate for its development for human cancer immunotherapy.

关键词： Virus-like vesicles Oncolytic virus IL-12 IL-17 PD-L1 T cell exhaustion Combination therapy Cancer immunotherapy

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New evidence for the epigenetic regulation of skeletal stem cells

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Science Bulletin 2024年第13期69卷 2004-2006页

作者： Liming Zhao Jun Xiao Charles K.F.Chan Institute for Stem Cell Biology and Regenerative medicine Stanford University School of MedicineStanford CA 94305USA Department of Surgery Division of Plastic and Reconstructive SurgeryStanford University School of MedicineStanford CA 94305USA Department of Orthopaedic Surgery Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China

Skeletal stem cells(SSCs)are crucial for skeletal development and regeneration,yet the epigenetic regulation of these cells remains poorly *** studies have delineated the epigenetic landscape across the developmental trajectory of SSCs,highlighting the involvement of Ptip in regulating SSC *** skeletal system undergoes dynamic remodeling throughout *** stem cells(SSCs),residing within the skeleton and lineage-restricted,serve as a cellular reserve to foster development and maintain skeletal *** categorized within the broader mesenchymal stromal/stem cells(MSCs).

关键词： skeletal involvement maintain

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Early endotracheal intubation is not associated with the rate of return of spontaneous circulation following cardiac arrest at the emergency department:an exploratory analysis

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World Journal of Emergency medicine 2024年第4期15卷 297-300页

作者： Siwat Neamjun Phichayut Phinyo Borwon Wittayachamnankul Wachira Wongtanasarasin Department of Emergency medicine Faculty of MedicineChiang Mai UniversityChiang Mai 50200Thailand Department of Family medicine Faculty of MedicineChiang Mai UniversityChiang Mai 50200Thailand Center for Clinical Epidemiology and Clinical Statistics Faculty of MedicineChiang Mai UniversityChiang Mai 50200Thailand Department of Emergency medicine University of California Davis School of MedicineSacramento 95817USA

Cardiac arrest poses a significant global public health challenge,manifesting in approximately 550,000 cases annually within the United States.[1]In-hospital cardiac arrest(IHCA)is commonly attributed to airways and respiratory issues.[2]Recommendations emphasize the expertise of responders in airway management.[3]Various options exist,such as chest compression-only cardiopulmonary resuscitation(CPR),bag-mask ventilation(BMV),and advanced *** BMV and advanced airways are not deemed equivalent or superior based on previous evidence.[4]Achieving consistency in choosing and timing the optimal airway approach during IHCA is *** current american Heart Association guidelines suggest an advanced airway strategy when endotracheal intubation(ETI)success rates are high,but the optimal time for advanced airway management remains unclear.[5]Wong et al[6]revealed that survival improved by less than 5 min with advanced airway *** to a subgroup analysis of IHCA patients in emergency departments(EDs),early intubation was associated with a 1.5-fold greater rate of return of spontaneous circulation(ROSC)than in other locations.[7]ED patients’constant monitoring and immediate management,with readily available intubation equipment,enhance early intubation and survival rates.[6]Nonetheless,IHCA patients intubated within the first 15 min had a lower ROSC rate.

关键词： intubation return annually

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