BACKGROUND In our day-to-day practice,constipation is a common problem in the pediatric population and cause of frequent visit in outpatient and emergency department.But occult constipation(OC)remains as the most unad...BACKGROUND In our day-to-day practice,constipation is a common problem in the pediatric population and cause of frequent visit in outpatient and emergency department.But occult constipation(OC)remains as the most unaddressed problem.AIM To investigate the clinical profile of OC in children.METHODS It was a prospective observational study,done in Bangladesh from January 2022 to December 2024.It included all consecutive children diagnosed as OC and were treated accordingly.Before diagnosis,secondary causes of the presenting symptoms were excluded with appropriate investigations.They were followed up monthly for 4 months and treatment response were measured by improvement of symptoms.RESULTS A total of 404 children were included in this study with mean age group of 76.50±36.62 months,and male-female ratio of 1.67:1.The most common presenting complaint was abdominal pain(66%),followed by anorexia(49%),vomiting(24%),nausea(17%),frequent defecation with small volume stool(17%),altered bowel habit(16%),failure to thrive(14%)and recurrent helminthiasis(12%).Interestingly,2.5%children presented with persistent diarrhea.CONCLUSION Abdominal pain is the most common presentation of OC.When symptoms cannot be explained by other etiology,OC should be kept in mind.展开更多
BACKGROUND Some patients with resectable or borderline resectable pancreatic ductal adenocarcinoma(PDAC)may have distant metastases,undetected on preoperative imaging or early recurrence,within 6 months after surgery....BACKGROUND Some patients with resectable or borderline resectable pancreatic ductal adenocarcinoma(PDAC)may have distant metastases,undetected on preoperative imaging or early recurrence,within 6 months after surgery.Occult metastases(OMs)must be accurately predicted to optimize multidisciplinary treatment.AIM To investigate the efficacy of circulating tumor DNA(ctDNA)in predicting OM.METHODS Two Japanese institutions prospectively collected preoperative plasma samples from PDAC patients between July 2019 and September 2021 and evaluated ctDNA using a targeted next-generation sequencing panel covering 52 cancer-related genes.RESULTS Among 135 PDAC patients,38 had OM and 35 were positive for ctDNA.The ctDNA positivity rate was significantly higher in patients with OM than in patients without OM.ctDNA-positive patients had significantly shorter median recurrence-free survival than ctDNA-negative patients.Logistic multivariate regression revealed ctDNA positivity as an independent predictor of OM.CONCLUSION Preoperative ctDNA in resectable PDAC is an independent predictor of OM and indicates poor prognosis following pancreatectomy and may be a useful biomarker in determining multidisciplinary patient care.展开更多
BACKGROUND Occult intraocular foreign bodies(IOFBs)can present with atypical symptoms and clinical signs,making diagnosis challenging.We describe a case of an undetected IOFB that was missed on both computed tomograph...BACKGROUND Occult intraocular foreign bodies(IOFBs)can present with atypical symptoms and clinical signs,making diagnosis challenging.We describe a case of an undetected IOFB that was missed on both computed tomography and B-ultrasound,ulti-mately leading to ocular siderosis and secondary glaucoma.CASE SUMMARY A 55-year-old male patient presented to our clinic reporting a one-month history of right ocular discomfort and progressive visual deterioration.The patient had previously received a glaucoma diagnosis at a local healthcare facility.His ocular history included blunt trauma to the affected eye five years prior to presentation.Slit-lamp examination revealed corneal and iris lesions in the right eye.Pupillary dilation facilitated the identification of traumatic lens opacities.Diagnostic imaging modalities,including B-scan ultrasonography and computed tomo-graphy,showed no evidence of retained intraocular foreign material.The patient subsequently underwent uncomplicated pars plana vitrectomy,during which the occult foreign body was successfully extracted.The procedure was completed without intraoperative or immediate postoperative complications.CONCLUSION Awareness of IOFBs in individuals who work in high-risk occupations and prompt referral to a retinal surgeon are very important.展开更多
Objective:The neglect of occult lymph nodes metastasis(OLNM)is one of the pivotal causes of early non-small cell lung cancer(NSCLC)recurrence after local treatments such as stereotactic body radiotherapy(SBRT)or surge...Objective:The neglect of occult lymph nodes metastasis(OLNM)is one of the pivotal causes of early non-small cell lung cancer(NSCLC)recurrence after local treatments such as stereotactic body radiotherapy(SBRT)or surgery.This study aimed to develop and validate a computed tomography(CT)-based radiomics and deep learning(DL)fusion model for predicting non-invasive OLNM.Methods:Patients with radiologically node-negative lung adenocarcinoma from two centers were retrospectively analyzed.We developed clinical,radiomics,and radiomics-clinical models using logistic regression.A DL model was established using a three-dimensional squeeze-and-excitation residual network-34(3D SE-ResNet34)and a fusion model was created by integrating seleted clinical,radiomics features and DL features.Model performance was assessed using the area under the curve(AUC)of the receiver operating characteristic(ROC)curve,calibration curves,and decision curve analysis(DCA).Five predictive models were compared;SHapley Additive exPlanations(SHAP)and Gradient-weighted Class Activation Mapping(Grad-CAM)were employed for visualization and interpretation.Results:Overall,358 patients were included:186 in the training cohort,48 in the internal validation cohort,and 124 in the external testing cohort.The DL fusion model incorporating 3D SE-Resnet34 achieved the highest AUC of 0.947 in the training dataset,with strong performance in internal and external cohorts(AUCs of 0.903 and 0.907,respectively),outperforming single-modal DL models,clinical models,radiomics models,and radiomicsclinical combined models(DeLong test:P<0.05).DCA confirmed its clinical utility,and calibration curves demonstrated excellent agreement between predicted and observed OLNM probabilities.Features interpretation highlighted the importance of textural characteristics and the surrounding tumor regions in stratifying OLNM risk.Conclusions:The DL fusion model reliably and accurately predicts OLNM in early-stage lung adenocarcinoma,offering a non-invasive tool to refine staging and guide personalized treatment decisions.These results may aid clinicians in optimizing surgical and radiotherapy strategies.展开更多
BACKGROUND Occult pancreaticobiliary reflux(OPBR)is characterized by the absence of congenital anomalies at the pancreaticobiliary junction yet leads to altered bile composition and an increased incidence of gallbladd...BACKGROUND Occult pancreaticobiliary reflux(OPBR)is characterized by the absence of congenital anomalies at the pancreaticobiliary junction yet leads to altered bile composition and an increased incidence of gallbladder stones.AIM To explore the computed tomography(CT)imaging characteristics of gallbladder stones in patients diagnosed with OPBR.METHODS We analyzed 362 patients undergoing cholecystectomy(November 2020 to January 2022).Intraoperative bile samples were assayed for amylase(>110 U/L indicated OPBR).CT features,including stone density and visibility,were compared between 54 OPBR and 308 controls.Stone attenuation(HU)was measured under standardized conditions(uCT-780,120 kVp,160 mAs).Logistic regression and receiver operating characteristic curve analysis identified independent OPBR predictors,forming a validated nomogram.RESULTS OPBR patients exhibited significantly higher rates of CT-invisible stones(35.2%vs 12.3%)and uniform stones(87%vs 73.1%)along with lower overall stone density(P=0.01).Logistic regression identified stone visibility,uniformity,and density as independent predictors.A nomogram integrating these features with patient age achieved high diagnostic accuracy(area under the curve=0.71).CONCLUSION CT imaging distinctly identifies gallbladder stone density,indicating a heightened risk of OPBR in patients with uniform and CT-invisible stones.Such imaging is crucial for preoperative assessments to evaluate potential recurrent biliary pathologies post-cholecystectomy.展开更多
BACKGROUND Sessile serrated lesions(SSLs)are premalignant polyps implicated in up to 30%of colorectal cancers.Australia reports high SSL detection rates(SSL-DRs),yet with marked variability(3.1%-24%).This substantial ...BACKGROUND Sessile serrated lesions(SSLs)are premalignant polyps implicated in up to 30%of colorectal cancers.Australia reports high SSL detection rates(SSL-DRs),yet with marked variability(3.1%-24%).This substantial variation raises concerns about missed lesions and post-colonoscopy colorectal cancer.This study investigates determinants associated with SSL-DR variation in regional Australia.AIM To study how patient,clinical,and colonoscopy factors are associated with SSL detection in a regional Australian practice.We aimed to contribute high-detection data to the literature by analyzing the association of SSL detection with various determinants.METHODS This retrospective,cross-sectional analysis examined 1450 colonoscopies performed at Port Macquarie Gastroenterology during 2023.Sigmoidoscopies and repeat procedures were excluded.Multivariate logistic regression analyzed associations between SSL detection and patient demographics,clinical indications,procedural factors,and comorbidities.RESULTS The overall SSL-DR was 30.7%.Multivariate analysis identified several independent predictors:Clinical indication,bowel preparation quality,inflammatory bowel disease status,and serrated polyposis syndrome.The faecal occult blood test positive(FOBT)(+)cohort showed the highest predicted SSL detection probability(39.8%),while clinical symptoms showed the lowest(22.3%).After adjustment,SSL detection odds were 2.3 times greater among FOBT(+)patients than those with clinical symptoms(adjusted odds ratio=2.30,95%confidence interval:1.20-4.40,P=0.004).CONCLUSION SSL-DR as a quality indicator requires contextualization regarding clinical indications,bowel preparation quality,and comorbidities.There was a significantly higher prevalence of SSLs in FOBT(+)patients.Despite comprehensive adjustment,this study cannot fully explain the wide SSL-DR variation in Australia,highlighting the need for standardized detection protocols and further research to ensure optimal cancer prevention outcomes.展开更多
BACKGROUND This report describes a rare case of a small gastric cancer lesion with widespread bone metastases and markedly elevated alkaline phosphatase levels that was initially misdiagnosed as rheumatoid arthritis,a...BACKGROUND This report describes a rare case of a small gastric cancer lesion with widespread bone metastases and markedly elevated alkaline phosphatase levels that was initially misdiagnosed as rheumatoid arthritis,as the patient’s sole clinical manifestation was chronic bone pain persisting for 1 year.CASE SUMMARY An 83-year-old man was admitted due to worsening generalized joint pain over 1 year.Serum alkaline phosphatase levels were markedly elevated,and technetium-99m methylene diphosphonate single-photon emission computed tomography(CT)and fluorine-18 sodium fluoride positron emission tomography(PET)/CT images showed symmetrical diffuse uptake of the radiotracers throughout the skeleton.Initially,Paget’s disease was suspected,but abnormal hematologic tumor markers and bone biopsy confirmed metastatic adenocarcinoma.Fluorine-18-fluorodeoxyglucose PET/CT did not reveal a primary tumor.The patient had a history of colon polypectomy and tubulovillous adenoma with atypical hy-perplasia on pathological examination 10 years prior.Further investigation using gallium-68-labeled fibroblast-activation protein inhibitor PET/CT images showed increased punctate uptake in the gastric antrum.Gastroscopy demonstrated a 1.0 cm ulcerated mass in the prepyloric region,and histopathological evaluation of the biopsy specimen revealed poorly differentiated adenocarcinoma.The incidence of bone metastases from gastric cancer is very low,especially with such extensive involvement.CONCLUSION Occult gastric carcinomas with bone metastases necessitate proactive high-risk surveillance and multidisciplinary integration to improve diagnostic accuracy and clinical outcomes.展开更多
AIM:To comprehensively examine the clinical presentations,multimodal images,and long-term follow-up of Chinese patients with acute zonal occult outer retinopathy(AZOOR),a rare inflammatory disorder.METHODS:This was a ...AIM:To comprehensively examine the clinical presentations,multimodal images,and long-term follow-up of Chinese patients with acute zonal occult outer retinopathy(AZOOR),a rare inflammatory disorder.METHODS:This was a retrospective study.A total of 20 patients(32 eyes)were included.The medical records and multimodal imaging,including wide-field fundus photography,wide-field fundus autofluorescence(FAF),and swept-source optical coherence tomography(SS-OCT)were analyzed.RESULTS:The study included 20 patients with a mean age of 38.2±10.9y,and females accounted for 60%.Lesions could involve peripapillary areas,macular region,and peripheral retina.The mean best-corrected visual acuity(BCVA)at presentation was 0.38±0.60 logMAR,with no significant difference in visual acuity between acute cases(within 6mo of onset)and chronic cases(beyond 6mo of onset;P=0.390).There was no statistically significant difference in visual acuity between eyes of acute case(within 6mo of onset)and the chronic case(beyond 6mo of onset).In some chronic case,FAF examination revealed the presence of a hyperautofluorescent(hyperAF)ring around the macular area(6/18),a phenomenon not observed in the acute case(P=0.024).A higher proportion of chronic cases showed predominantly hypoautofluorescent(hypoAF)lesions compared to the acute case(13/18 vs 2/14,P=0.0016).SS-OCT examination showed that both acute and chronic cases exhibited hyperreflective dots above the retinal pigment epithelium(RPE),and ellipsoid zone(EZ)and RPE damage.In the chronic case,eyes with hyperreflective dots above the RPE were more likely to exhibit EZ and RPE damage in the macular region compared to those without these dots.CONCLUSION:Multimodal imaging plays a crucial role in the follow-up of patients with AZOOR.In chronic cases of AZOOR,the presence of hyperreflective dots above the RPE indicates a higher likelihood of outer retinal involvement in the macular region.This study provides critical insights into the complex presentation and progression of AZOOR.展开更多
Occult hepatitis B infection(OBI) is characterized by hepatitis B virus(HBV) DNA in serum in the absence of hepatitis B surface antigen(HBsAg) presenting HBsAg-negative and anti-HBc positive serological patterns.Occul...Occult hepatitis B infection(OBI) is characterized by hepatitis B virus(HBV) DNA in serum in the absence of hepatitis B surface antigen(HBsAg) presenting HBsAg-negative and anti-HBc positive serological patterns.Occult HBV status is associated in some cases with mutant viruses undetectable by HBsAg assays;but more frequently it is due to a strong suppression of viral replication and gene expression.OBI is an entity with world-wide diffusion.The failure to detect HBsAg,despite the persistence of the viral DNA,is due in most cases to the strong suppression of viral replication and gene expression that characterizes this"occult"HBV infection;although the mechanisms responsible for suppression of HBV are not well understood.The majority of OBI cases are secondary to overt HBV infection and represent a residual low viremia level suppressed by a strong immune response together with histological derangements which occurred during acute or chronic HBV infection.Much evidence suggests that it can favour the progression of liver fibrosis and the development of hepatocellular carcinoma.展开更多
BACKGROUND Occult breast cancer(OBC)has traditionally been considered to be a carcinoma of unknown primary origin with a favorable prognosis and can be treated as stage II-III breast cancer.Due to the small number of ...BACKGROUND Occult breast cancer(OBC)has traditionally been considered to be a carcinoma of unknown primary origin with a favorable prognosis and can be treated as stage II-III breast cancer.Due to the small number of cases and limited clinical experience,treatments vary greatly around the world and no standardized treatment has yet been established.AIM To investigate the clinicopathological features,psychological status and prognostic features of patients with OBC.METHODS The clinicopathological data of 33 OBC patients diagnosed and treated in the Affiliated Hospital of Xuzhou Medical University and Xuzhou Central Hospital from November 2015 to November 2022 were retrospectively analyzed.The psychological status of OBC patients was evaluated by the Self-rating Anxiety Scale and Self-rating Depression Scale.Patients’emotions,stress perception and psychological resilience were evaluated by the Positive and Negative Affect Schedule,the Chinese Perceived Stress Scale,and the Connor-Davidson Resilience Scale(CD-RISC),respectively.Patient survival was calculated using the Kaplan-Meier method,and survival curves were plotted for analysis with the log-rank test.Univariate and multivariate survival analyses were performed using the Cox regression model.RESULTS The 33 OBC patients included 32 females and 1 male.Of the 33 patients,30(91%)had axillary tumors,3(9%)had a neck mass as the primary symptom;18(54.5%)had estrogen receptor-positive tumors,17(51.5%)had progesterone receptor-positive tumors,and 18(54.5%)had Her-2-positive tumors;24(72.7%)received surgical treatment,including 18 patients who underwent modified radical mastectomy,1 patient who underwent breast-conserving surgery plus axillary lymph node dissection(ALND),and 5 patients who underwent ALND alone;12 patients received preoperative neoadjuvant therapy.All 30 patients developed anxiety and depression,with low positive affect scores and high negative affect scores,accompanied by a high stress level and poor psychological resilience.There were no differences in the psychological status of patients according to age,body mass index,or menopausal status.The overall survival and disease-free survival(DFS)of all the patients were 83.3%and 55.7%,respectively.Univariate analysis demonstrated that the initial tumor site(P=0.021)and node stage(P=0.020)were factors that may affect patient prognosis.The 5-year DFS rate of OBC patients who received radiotherapy was greater(P<0.001),while the use of different surgical methods(P=0.687)had no statistically significant effect on patient outcomes.Multivariate analysis revealed that radiotherapy(P=0.031)was an independent prognostic factor.Receiving radiotherapy had a significant effect on the CD-RISC score(P=0.02).CONCLUSION OBC is a rare breast disease whose diagnosis and treatment are currently controversial.There was no significant difference in the efficacy of other less invasive surgical procedures compared to those of modified radical mastectomy.In addition,radiotherapy can significantly improve patient outcomes.We should pay attention to the psychological state of patients while they receive antitumor therapy.展开更多
BACKGROUND Occult hepatitis B infection(OBI)is a globally prevalent infection,with its frequency being influenced by the prevalence of hepatitis B virus(HBV)infection in a particular geographic region,including Africa...BACKGROUND Occult hepatitis B infection(OBI)is a globally prevalent infection,with its frequency being influenced by the prevalence of hepatitis B virus(HBV)infection in a particular geographic region,including Africa.OBI can be transmitted th-rough blood transfusions and organ transplants and has been linked to the development of hepatocellular carcinoma(HCC).The associated HBV genotype influences the infection.AIM To highlight the genetic diversity and prevalence of OBI in Africa.METHODS This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and involved a comprehensive search on PubMed,Google Scholar,Science Direct,and African Journals Online for published studies on the prevalence and genetic diversity of OBI in Africa.RESULTS The synthesis included 83 articles,revealing that the prevalence of OBI varied between countries and population groups,with the highest prevalence being 90.9%in patients with hepatitis C virus infection and 38%in blood donors,indicating an increased risk of HBV transmission through blood transfusions.Cases of OBI reactivation have been reported following chemotherapy.Genotype D is the predominant,followed by genotypes A and E.CONCLUSION This review highlights the prevalence of OBI in Africa,which varies across countries and population groups.The study also demonstrates that genotype D is the most prevalent.展开更多
Internal gravity waves(IGWs)are critical in driving Martian atmospheric motion and phenomena.This study investigates Martian IGWs by using high-resolution data from China’s Tianwen-1 mission and the National Aeronaut...Internal gravity waves(IGWs)are critical in driving Martian atmospheric motion and phenomena.This study investigates Martian IGWs by using high-resolution data from China’s Tianwen-1 mission and the National Aeronautics and Space Administration’s Mars Global Surveyor(MGS)by the radio occultation(RO)technique.Key IGW parameters,such as vertical and horizontal wavelengths,intrinsic frequency,and energy density,are extracted based on vertical temperature profiles from the Martian surface to~50 km altitude.Data reveal that the Martian IGWs are predominantly small-scale waves,with vertical wavelengths between 6 and 13 km and horizontal wavelengths extending to thousands of kilometers.These waves propagate almost vertically and exhibit low intrinsic frequencies close to the inertial frequency,with the characteristic of low-frequency inertial IGWs.Tianwen-1 data indicate stronger IGW activity,higher energy density,and less dissipation than MGS data in the northern hemisphere.Moreover,MGS data in the southern hemisphere show higher buoyancy frequencies and lower vertical wavelengths,suggesting more stable atmospheric conditions conducive to IGW propagation.These extracted IGW characteristics can enhance our understanding of the atmospheric dynamics on Mars and contribute valuable information for parameterization in global circulation models.展开更多
BACKGROUND Colorectal cancer(CRC)is one of the most common malignant tumors,and early screening is crucial to improving the survival rate of patients.The combination of colonoscopy and immune fecal occult blood detect...BACKGROUND Colorectal cancer(CRC)is one of the most common malignant tumors,and early screening is crucial to improving the survival rate of patients.The combination of colonoscopy and immune fecal occult blood detection has garnered significant attention as a novel method for CRC screening.Colonoscopy and fecal occult blood tests,when combined,can improve screening accuracy and early detection rates,thereby facilitating early intervention and treatment.However,certain risks and costs accompany it,making the establishment of a risk classification model crucial for accurate classification and management of screened subjects.AIM To evaluate the feasibility and effectiveness of colonoscopy,immune fecal occult blood test(FIT),and risk-graded screening strategies in CRC screening.METHODS Based on the randomized controlled trial of CRC screening in the population conducted by our hospital May 2020 to May 2023,participants who met the requirements were randomly assigned to a colonoscopy group,an FIT group,or a graded screening group at a ratio of 1:2:2(after risk assessment,the high-risk group received colonoscopy,the low-risk group received an FIT test,and the FITpositive group received colonoscopy).The three groups received CRC screening with different protocols,among which the colonoscopy group only received baseline screening,and the FIT group and the graded screening group received annual follow-up screening based on baseline screening.The primary outcome was the detection rate of advanced tumors,including CRC and advanced adenoma.The population participation rate,advanced tumor detection rate,and colonoscopy load of the three screening programs were compared.RESULTS A total of 19373 subjects who met the inclusion and exclusion criteria were enrolled,including 8082 males(41.7%)and 11291 females(58.3%).The mean age was 60.05±6.5 years.Among them,3883 patients were enrolled in the colonoscopy group,7793 in the FIT group,and 7697 in the graded screening group.Two rounds of follow-up screening were completed in the FIT group and the graded screening group.The graded screening group(89.2%)and the colonoscopy group(42.3%)had the lowest overall screening participation rates,while the FIT group had the highest(99.3%).The results of the intentional analysis showed that the detection rate of advanced tumors in the colonoscopy group was greater than that of the FIT group[2.76%vs 2.17%,odds ratio(OR)=1.30,95%confidence interval(CI):1.01-1.65,P=0.037].There was no significant difference in the detection rate of advanced tumors between the colonoscopy group and the graded screening group(2.76%vs 2.35%,OR=1.9,95%CI:0.93-1.51,P=0.156),as well as between the graded screening group and the FIT group(2.35%vs 2.17%,OR=1.09%,95%CI:0.88-1.34,P=0.440).The number of colonoscopy examinations required for each patient with advanced tumors was used as an index to evaluate the colonoscopy load during population screening.The graded screening group had the highest colonoscopy load(15.4 times),followed by the colonoscopy group(10.2 times),and the FIT group had the lowest(7.8 times).CONCLUSION A hierarchical screening strategy based on CRC risk assessment is feasible for screening for CRC in the population.It can be used as an effective supplement to traditional colonoscopy and FIT screening programs.展开更多
BACKGROUND Occult hepatitis B infection(OBI)is characterized by the detection of hepatitis B virus(HBV)DNA in serum(usually HBV DNA<200 IU/mL)or the liver but negativity for hepatitis B surface antigen(HBsAg).The d...BACKGROUND Occult hepatitis B infection(OBI)is characterized by the detection of hepatitis B virus(HBV)DNA in serum(usually HBV DNA<200 IU/mL)or the liver but negativity for hepatitis B surface antigen(HBsAg).The diagnosis of OBI relies on the sensitivity of assays used in the detection of HBV DNA and HBsAg.HBsAg assays with inadequate sensitivity or inability to detect HBV S variants may lead to misdiagnosis of OBI in people with overt HBV infection.CASE SUMMARY We report a HBsAg-negative but hepatitis B envelope antigen-positive patient who had a significant HBV DNA level.The patient was initially diagnosed as having OBI.However,sequence analysis revealed a unique insertion of amino acid residues at positions 120-124 in the S protein,which affects the formation of a disulfide bond that is associated with the formation of a loop.It is well known that there is an overlap between the S protein and Pol protein.We found that this new insertion site occurred in polymerase/reverse transcriptase domain,indi-cating that this insertion might be involved in HBV pathogenicity.The patient was finally diagnosed with a false OBI.CONCLUSION An insertion of amino acid residues at positions 120-124 of the S protein affects the formation of immunodominant epitopes and results in negative HBsAg levels.展开更多
Far from the financial gains of cyber crooks, the informed observer will see in cyber crookery a complex field of psychopathological expression where addictions and ritualistic practices intermingle. We thus carried o...Far from the financial gains of cyber crooks, the informed observer will see in cyber crookery a complex field of psychopathological expression where addictions and ritualistic practices intermingle. We thus carried out a qualitative observational study, focusing on a young Ivorian cyber-escroc, hard drug user and follower of mystical practices taken in charge by a multidisciplinary team during a resocialization course for children in conflict with the law from November to December 2022. The aim was to describe the difficulties experienced by a young Ivorian cyber crook in escaping the clutches of occult practices, internet addictions and psychoactive substances encountered in the field of cyber crookery. KA is confronted with the problem of cybercrime associated with occult practices and drug addiction. He is a heroin addict and secondary internet addict, undergoing de facto detoxification and presenting risky consumption behaviors. His fear is fuelled by the sudden death of his childhood friend, who introduced him to cyber-scams and occult practices, and the impossibility of returning his “Agbaladai” fetish when he can no longer honor the weekly sacrifices. Our results show an interweaving of psychopathological entities, namely cyberaddiction and addiction to psychoactive substances, against a backdrop of mystico-cultural practices and interpretations.展开更多
BACKGROUND Reactivation of hepatitis B virus(HBV)infection is a well-known risk that can occur spontaneously or following immunosuppressive therapies,including cancer chemotherapy.HBV reactivation can cause significan...BACKGROUND Reactivation of hepatitis B virus(HBV)infection is a well-known risk that can occur spontaneously or following immunosuppressive therapies,including cancer chemotherapy.HBV reactivation can cause significant morbidity and even mortality,which are preventable if at-risk individuals are identified through screening and started on antiviral prophylaxis.AIM To determine the prevalence of chronic HBV(CHB)and occult HBV infection(OBI)among oncology and hematology-oncology patients undergoing chemo-therapy.METHODS In this observational study,the prevalence of CHB and OBI was assessed among patients receiving chemotherapy.Serological markers of HBV infection[hepatitis B surface antigen(HBsAg)/anti-hepatitis B core antigen(HBc)]were evaluated for all patients.HBV DNA levels were assessed in those who tested negative for HBsAg but positive for total anti-HBc.RESULTS The prevalence of CHB in the study cohort was determined to be 2.3%[95%confidence interval(95%CI):1.0-4.2].Additionally,the prevalence of OBI among the study participants was found to be 0.8%(95%CI:0.2-2.3).CONCLUSION The findings of this study highlight the importance of screening for hepatitis B infection in oncology and hematology-oncology patients undergoing chemotherapy.Identifying individuals with CHB and OBI is crucial for implementing appropriate antiviral prophylaxis to prevent the reactivation of HBV infection,which can lead to increased morbidity and mortality.展开更多
Occult hepatitis B virus (HBV) infection (OBI), alternatively defined as occult hepatitis B (OHB), is a challenging clinical entity. It is recognized by two main characteristics: absence of HBsAg, and low viral replic...Occult hepatitis B virus (HBV) infection (OBI), alternatively defined as occult hepatitis B (OHB), is a challenging clinical entity. It is recognized by two main characteristics: absence of HBsAg, and low viral replication. The previous two decades have witnessed a remarkable progress in our understanding of OBI and its clinical implications. Appropriate diagnostic techniques must be adopted. Sensitive HBV DNA amplification assay is the gold standard assay for detection of OBI. Viral as well as host factors are implicated in the pathogenesis of OBI. However, published data reporting the infectivity of OBI by transfusion are limited. Several aspects including OBI transmission, infectivity and its relation to the development of chronic liver diseases and hepatocellular carcinoma have to be resolved. The aim of the present review is to highlight recent data on OBI with a focus on its virological diagnosis and clinical outcome.展开更多
Hepatitis B virus (HBV) is a highly pathogenic virus that causes chronic liver diseases in millions of people globally. In addition to a symptomatic, serologically evident infection, occult persistent HBV carriage has...Hepatitis B virus (HBV) is a highly pathogenic virus that causes chronic liver diseases in millions of people globally. In addition to a symptomatic, serologically evident infection, occult persistent HBV carriage has been identified since nucleic acid amplification assays of enhanced sensitivity became introduced for detection of hepadnaviral genomes and their replicative intermediates. Current evidence indicates that occult HBV infection is a common and long-term consequence of resolution of acute hepatitis B. This form of residual infection is termed as secondary occult infection (SOI). The data from the woodchuck model of HBV infection indicate that exposure to small amounts of hepadnavirus can also cause primary occult infection (POI) where virus genome, but no serological makers of exposure to virus, are detectable, and the liver may not be involved. However, virus replicates at low levels in the lymphatic system in both these forms. We briefly summarize the current understanding of the nature and characteristics of occult hepadnaviral persistence as well as of its documented and expected pathological consequences.展开更多
Occult hepatitis B virus infection(OBI), characterized as the persistence of hepatitis B virus(HBV) surface antigen(HBs Ag) seronegativity and low viral load in blood or liver, is a special form of HBV infection. OBI ...Occult hepatitis B virus infection(OBI), characterized as the persistence of hepatitis B virus(HBV) surface antigen(HBs Ag) seronegativity and low viral load in blood or liver, is a special form of HBV infection. OBI may be related mainly to mutations in the HBV genome, although the underlying mechanism of it remains to be clarified. Mutations especially within the immunodominant "α" determinant of S protein are "hot spots" that could contribute to the occurrence of OBI via affecting antigenicity and immunogenicity of HBs Ag or replication and secretion of virion. Clinical reports account for a large proportion of previous studies on OBI, while functional analyses, especially those based on full-length HBV genome, are rare.展开更多
AIM:To elucidate the molecular mechanisms underlying hepatitis B virus(HBV)occult infection of genotype C.METHODS:A total of 10 types of hepatitis B surface antigen(HBs Ag)variants from a Korean occult cohort were use...AIM:To elucidate the molecular mechanisms underlying hepatitis B virus(HBV)occult infection of genotype C.METHODS:A total of 10 types of hepatitis B surface antigen(HBs Ag)variants from a Korean occult cohort were used.After a complete HBV genome plasmid mutated such that it does not express HBs Ag and plasmid encoding,each HBs Ag variant was transiently co-transfected into Hu H-7 cells.The secretion capacity and intracellular expression of the HBV virions and HBs Ags in their respective variants were analyzed using real-time quantitative polymerase chain reaction assays and commercial HBs Ag enzyme-linked immunosorbent assays,respectively.RESULTS:All variants exhibited lower levels of HBs Ag secretion into the medium compared with the wild type.In particular,in eight of the ten variants,very low levels of HBs Ag secretion that were similar to the negative control were detected.In contrast,most variants(9/10)exhibited normal virion secretion capacities comparable with,or even higher than,the wild type.This provided new insight into the intrinsic nature of occult HBV infection,which leads to HBs Ag sero-negativeness but has horizontal infectivity.Furthermore,most variants generated higher reactive oxidative species production than the wild type.This finding provides potential links between occult HBV infection and liver disease progression.CONCLUSION:The presently obtained data indicate that deficiency in the secretion capacity of HBs Ag variants may have a pivotal function in the occult infections of HBV genotype C.展开更多
文摘BACKGROUND In our day-to-day practice,constipation is a common problem in the pediatric population and cause of frequent visit in outpatient and emergency department.But occult constipation(OC)remains as the most unaddressed problem.AIM To investigate the clinical profile of OC in children.METHODS It was a prospective observational study,done in Bangladesh from January 2022 to December 2024.It included all consecutive children diagnosed as OC and were treated accordingly.Before diagnosis,secondary causes of the presenting symptoms were excluded with appropriate investigations.They were followed up monthly for 4 months and treatment response were measured by improvement of symptoms.RESULTS A total of 404 children were included in this study with mean age group of 76.50±36.62 months,and male-female ratio of 1.67:1.The most common presenting complaint was abdominal pain(66%),followed by anorexia(49%),vomiting(24%),nausea(17%),frequent defecation with small volume stool(17%),altered bowel habit(16%),failure to thrive(14%)and recurrent helminthiasis(12%).Interestingly,2.5%children presented with persistent diarrhea.CONCLUSION Abdominal pain is the most common presentation of OC.When symptoms cannot be explained by other etiology,OC should be kept in mind.
基金Supported by the Council for Science,Technology,and Innovation(CSTI)Cross-Ministerial Strategic Innovation Promotion Program(SIP)“Innovative AI Hospital System”(National Institute of Biomedical Innovation,Health and Nutrition),No.SIPAIH18C03the Japan Society for the Promotion of Science(JSPS)KAKENHI,No.JP19K09179 and No.JP23K08158.
文摘BACKGROUND Some patients with resectable or borderline resectable pancreatic ductal adenocarcinoma(PDAC)may have distant metastases,undetected on preoperative imaging or early recurrence,within 6 months after surgery.Occult metastases(OMs)must be accurately predicted to optimize multidisciplinary treatment.AIM To investigate the efficacy of circulating tumor DNA(ctDNA)in predicting OM.METHODS Two Japanese institutions prospectively collected preoperative plasma samples from PDAC patients between July 2019 and September 2021 and evaluated ctDNA using a targeted next-generation sequencing panel covering 52 cancer-related genes.RESULTS Among 135 PDAC patients,38 had OM and 35 were positive for ctDNA.The ctDNA positivity rate was significantly higher in patients with OM than in patients without OM.ctDNA-positive patients had significantly shorter median recurrence-free survival than ctDNA-negative patients.Logistic multivariate regression revealed ctDNA positivity as an independent predictor of OM.CONCLUSION Preoperative ctDNA in resectable PDAC is an independent predictor of OM and indicates poor prognosis following pancreatectomy and may be a useful biomarker in determining multidisciplinary patient care.
基金Supported by The Tianjin Health Research Project,No.ZC20069the Foundation of the Committee of Integrated Traditional Chinese and Western Medicine,No.2021011the Science and Technology Foundation of Tianjin Eye Hospital,No.YKYB1901.
文摘BACKGROUND Occult intraocular foreign bodies(IOFBs)can present with atypical symptoms and clinical signs,making diagnosis challenging.We describe a case of an undetected IOFB that was missed on both computed tomography and B-ultrasound,ulti-mately leading to ocular siderosis and secondary glaucoma.CASE SUMMARY A 55-year-old male patient presented to our clinic reporting a one-month history of right ocular discomfort and progressive visual deterioration.The patient had previously received a glaucoma diagnosis at a local healthcare facility.His ocular history included blunt trauma to the affected eye five years prior to presentation.Slit-lamp examination revealed corneal and iris lesions in the right eye.Pupillary dilation facilitated the identification of traumatic lens opacities.Diagnostic imaging modalities,including B-scan ultrasonography and computed tomo-graphy,showed no evidence of retained intraocular foreign material.The patient subsequently underwent uncomplicated pars plana vitrectomy,during which the occult foreign body was successfully extracted.The procedure was completed without intraoperative or immediate postoperative complications.CONCLUSION Awareness of IOFBs in individuals who work in high-risk occupations and prompt referral to a retinal surgeon are very important.
基金supported by the National Natural Science Foundation of China(No.82272845)the Natural Science Foundation of Shandong(No.ZR2023ZD26).
文摘Objective:The neglect of occult lymph nodes metastasis(OLNM)is one of the pivotal causes of early non-small cell lung cancer(NSCLC)recurrence after local treatments such as stereotactic body radiotherapy(SBRT)or surgery.This study aimed to develop and validate a computed tomography(CT)-based radiomics and deep learning(DL)fusion model for predicting non-invasive OLNM.Methods:Patients with radiologically node-negative lung adenocarcinoma from two centers were retrospectively analyzed.We developed clinical,radiomics,and radiomics-clinical models using logistic regression.A DL model was established using a three-dimensional squeeze-and-excitation residual network-34(3D SE-ResNet34)and a fusion model was created by integrating seleted clinical,radiomics features and DL features.Model performance was assessed using the area under the curve(AUC)of the receiver operating characteristic(ROC)curve,calibration curves,and decision curve analysis(DCA).Five predictive models were compared;SHapley Additive exPlanations(SHAP)and Gradient-weighted Class Activation Mapping(Grad-CAM)were employed for visualization and interpretation.Results:Overall,358 patients were included:186 in the training cohort,48 in the internal validation cohort,and 124 in the external testing cohort.The DL fusion model incorporating 3D SE-Resnet34 achieved the highest AUC of 0.947 in the training dataset,with strong performance in internal and external cohorts(AUCs of 0.903 and 0.907,respectively),outperforming single-modal DL models,clinical models,radiomics models,and radiomicsclinical combined models(DeLong test:P<0.05).DCA confirmed its clinical utility,and calibration curves demonstrated excellent agreement between predicted and observed OLNM probabilities.Features interpretation highlighted the importance of textural characteristics and the surrounding tumor regions in stratifying OLNM risk.Conclusions:The DL fusion model reliably and accurately predicts OLNM in early-stage lung adenocarcinoma,offering a non-invasive tool to refine staging and guide personalized treatment decisions.These results may aid clinicians in optimizing surgical and radiotherapy strategies.
基金Supported by Key Specialty Construction Project of Shanghai Pudong New Area Health Commission,No.PWZzk2022-17Shanghai East Hospital Clinical Research Project,No.DFLC2022019the Featured Clinical Discipline Project of Shanghai Pudong District,No.PWYts2021-06.
文摘BACKGROUND Occult pancreaticobiliary reflux(OPBR)is characterized by the absence of congenital anomalies at the pancreaticobiliary junction yet leads to altered bile composition and an increased incidence of gallbladder stones.AIM To explore the computed tomography(CT)imaging characteristics of gallbladder stones in patients diagnosed with OPBR.METHODS We analyzed 362 patients undergoing cholecystectomy(November 2020 to January 2022).Intraoperative bile samples were assayed for amylase(>110 U/L indicated OPBR).CT features,including stone density and visibility,were compared between 54 OPBR and 308 controls.Stone attenuation(HU)was measured under standardized conditions(uCT-780,120 kVp,160 mAs).Logistic regression and receiver operating characteristic curve analysis identified independent OPBR predictors,forming a validated nomogram.RESULTS OPBR patients exhibited significantly higher rates of CT-invisible stones(35.2%vs 12.3%)and uniform stones(87%vs 73.1%)along with lower overall stone density(P=0.01).Logistic regression identified stone visibility,uniformity,and density as independent predictors.A nomogram integrating these features with patient age achieved high diagnostic accuracy(area under the curve=0.71).CONCLUSION CT imaging distinctly identifies gallbladder stone density,indicating a heightened risk of OPBR in patients with uniform and CT-invisible stones.Such imaging is crucial for preoperative assessments to evaluate potential recurrent biliary pathologies post-cholecystectomy.
文摘BACKGROUND Sessile serrated lesions(SSLs)are premalignant polyps implicated in up to 30%of colorectal cancers.Australia reports high SSL detection rates(SSL-DRs),yet with marked variability(3.1%-24%).This substantial variation raises concerns about missed lesions and post-colonoscopy colorectal cancer.This study investigates determinants associated with SSL-DR variation in regional Australia.AIM To study how patient,clinical,and colonoscopy factors are associated with SSL detection in a regional Australian practice.We aimed to contribute high-detection data to the literature by analyzing the association of SSL detection with various determinants.METHODS This retrospective,cross-sectional analysis examined 1450 colonoscopies performed at Port Macquarie Gastroenterology during 2023.Sigmoidoscopies and repeat procedures were excluded.Multivariate logistic regression analyzed associations between SSL detection and patient demographics,clinical indications,procedural factors,and comorbidities.RESULTS The overall SSL-DR was 30.7%.Multivariate analysis identified several independent predictors:Clinical indication,bowel preparation quality,inflammatory bowel disease status,and serrated polyposis syndrome.The faecal occult blood test positive(FOBT)(+)cohort showed the highest predicted SSL detection probability(39.8%),while clinical symptoms showed the lowest(22.3%).After adjustment,SSL detection odds were 2.3 times greater among FOBT(+)patients than those with clinical symptoms(adjusted odds ratio=2.30,95%confidence interval:1.20-4.40,P=0.004).CONCLUSION SSL-DR as a quality indicator requires contextualization regarding clinical indications,bowel preparation quality,and comorbidities.There was a significantly higher prevalence of SSLs in FOBT(+)patients.Despite comprehensive adjustment,this study cannot fully explain the wide SSL-DR variation in Australia,highlighting the need for standardized detection protocols and further research to ensure optimal cancer prevention outcomes.
文摘BACKGROUND This report describes a rare case of a small gastric cancer lesion with widespread bone metastases and markedly elevated alkaline phosphatase levels that was initially misdiagnosed as rheumatoid arthritis,as the patient’s sole clinical manifestation was chronic bone pain persisting for 1 year.CASE SUMMARY An 83-year-old man was admitted due to worsening generalized joint pain over 1 year.Serum alkaline phosphatase levels were markedly elevated,and technetium-99m methylene diphosphonate single-photon emission computed tomography(CT)and fluorine-18 sodium fluoride positron emission tomography(PET)/CT images showed symmetrical diffuse uptake of the radiotracers throughout the skeleton.Initially,Paget’s disease was suspected,but abnormal hematologic tumor markers and bone biopsy confirmed metastatic adenocarcinoma.Fluorine-18-fluorodeoxyglucose PET/CT did not reveal a primary tumor.The patient had a history of colon polypectomy and tubulovillous adenoma with atypical hy-perplasia on pathological examination 10 years prior.Further investigation using gallium-68-labeled fibroblast-activation protein inhibitor PET/CT images showed increased punctate uptake in the gastric antrum.Gastroscopy demonstrated a 1.0 cm ulcerated mass in the prepyloric region,and histopathological evaluation of the biopsy specimen revealed poorly differentiated adenocarcinoma.The incidence of bone metastases from gastric cancer is very low,especially with such extensive involvement.CONCLUSION Occult gastric carcinomas with bone metastases necessitate proactive high-risk surveillance and multidisciplinary integration to improve diagnostic accuracy and clinical outcomes.
文摘AIM:To comprehensively examine the clinical presentations,multimodal images,and long-term follow-up of Chinese patients with acute zonal occult outer retinopathy(AZOOR),a rare inflammatory disorder.METHODS:This was a retrospective study.A total of 20 patients(32 eyes)were included.The medical records and multimodal imaging,including wide-field fundus photography,wide-field fundus autofluorescence(FAF),and swept-source optical coherence tomography(SS-OCT)were analyzed.RESULTS:The study included 20 patients with a mean age of 38.2±10.9y,and females accounted for 60%.Lesions could involve peripapillary areas,macular region,and peripheral retina.The mean best-corrected visual acuity(BCVA)at presentation was 0.38±0.60 logMAR,with no significant difference in visual acuity between acute cases(within 6mo of onset)and chronic cases(beyond 6mo of onset;P=0.390).There was no statistically significant difference in visual acuity between eyes of acute case(within 6mo of onset)and the chronic case(beyond 6mo of onset).In some chronic case,FAF examination revealed the presence of a hyperautofluorescent(hyperAF)ring around the macular area(6/18),a phenomenon not observed in the acute case(P=0.024).A higher proportion of chronic cases showed predominantly hypoautofluorescent(hypoAF)lesions compared to the acute case(13/18 vs 2/14,P=0.0016).SS-OCT examination showed that both acute and chronic cases exhibited hyperreflective dots above the retinal pigment epithelium(RPE),and ellipsoid zone(EZ)and RPE damage.In the chronic case,eyes with hyperreflective dots above the RPE were more likely to exhibit EZ and RPE damage in the macular region compared to those without these dots.CONCLUSION:Multimodal imaging plays a crucial role in the follow-up of patients with AZOOR.In chronic cases of AZOOR,the presence of hyperreflective dots above the RPE indicates a higher likelihood of outer retinal involvement in the macular region.This study provides critical insights into the complex presentation and progression of AZOOR.
文摘Occult hepatitis B infection(OBI) is characterized by hepatitis B virus(HBV) DNA in serum in the absence of hepatitis B surface antigen(HBsAg) presenting HBsAg-negative and anti-HBc positive serological patterns.Occult HBV status is associated in some cases with mutant viruses undetectable by HBsAg assays;but more frequently it is due to a strong suppression of viral replication and gene expression.OBI is an entity with world-wide diffusion.The failure to detect HBsAg,despite the persistence of the viral DNA,is due in most cases to the strong suppression of viral replication and gene expression that characterizes this"occult"HBV infection;although the mechanisms responsible for suppression of HBV are not well understood.The majority of OBI cases are secondary to overt HBV infection and represent a residual low viremia level suppressed by a strong immune response together with histological derangements which occurred during acute or chronic HBV infection.Much evidence suggests that it can favour the progression of liver fibrosis and the development of hepatocellular carcinoma.
基金Supported by Jiangsu Provincial Health Commission’s 2020 High-Level Health Talents“Six Ones Project”Top-Notch Talent Research Project,No.LGY20200062021 Youth Medical Science Innovation Project of Xuzhou Health Commission,No.XWKYHT20210580.
文摘BACKGROUND Occult breast cancer(OBC)has traditionally been considered to be a carcinoma of unknown primary origin with a favorable prognosis and can be treated as stage II-III breast cancer.Due to the small number of cases and limited clinical experience,treatments vary greatly around the world and no standardized treatment has yet been established.AIM To investigate the clinicopathological features,psychological status and prognostic features of patients with OBC.METHODS The clinicopathological data of 33 OBC patients diagnosed and treated in the Affiliated Hospital of Xuzhou Medical University and Xuzhou Central Hospital from November 2015 to November 2022 were retrospectively analyzed.The psychological status of OBC patients was evaluated by the Self-rating Anxiety Scale and Self-rating Depression Scale.Patients’emotions,stress perception and psychological resilience were evaluated by the Positive and Negative Affect Schedule,the Chinese Perceived Stress Scale,and the Connor-Davidson Resilience Scale(CD-RISC),respectively.Patient survival was calculated using the Kaplan-Meier method,and survival curves were plotted for analysis with the log-rank test.Univariate and multivariate survival analyses were performed using the Cox regression model.RESULTS The 33 OBC patients included 32 females and 1 male.Of the 33 patients,30(91%)had axillary tumors,3(9%)had a neck mass as the primary symptom;18(54.5%)had estrogen receptor-positive tumors,17(51.5%)had progesterone receptor-positive tumors,and 18(54.5%)had Her-2-positive tumors;24(72.7%)received surgical treatment,including 18 patients who underwent modified radical mastectomy,1 patient who underwent breast-conserving surgery plus axillary lymph node dissection(ALND),and 5 patients who underwent ALND alone;12 patients received preoperative neoadjuvant therapy.All 30 patients developed anxiety and depression,with low positive affect scores and high negative affect scores,accompanied by a high stress level and poor psychological resilience.There were no differences in the psychological status of patients according to age,body mass index,or menopausal status.The overall survival and disease-free survival(DFS)of all the patients were 83.3%and 55.7%,respectively.Univariate analysis demonstrated that the initial tumor site(P=0.021)and node stage(P=0.020)were factors that may affect patient prognosis.The 5-year DFS rate of OBC patients who received radiotherapy was greater(P<0.001),while the use of different surgical methods(P=0.687)had no statistically significant effect on patient outcomes.Multivariate analysis revealed that radiotherapy(P=0.031)was an independent prognostic factor.Receiving radiotherapy had a significant effect on the CD-RISC score(P=0.02).CONCLUSION OBC is a rare breast disease whose diagnosis and treatment are currently controversial.There was no significant difference in the efficacy of other less invasive surgical procedures compared to those of modified radical mastectomy.In addition,radiotherapy can significantly improve patient outcomes.We should pay attention to the psychological state of patients while they receive antitumor therapy.
文摘BACKGROUND Occult hepatitis B infection(OBI)is a globally prevalent infection,with its frequency being influenced by the prevalence of hepatitis B virus(HBV)infection in a particular geographic region,including Africa.OBI can be transmitted th-rough blood transfusions and organ transplants and has been linked to the development of hepatocellular carcinoma(HCC).The associated HBV genotype influences the infection.AIM To highlight the genetic diversity and prevalence of OBI in Africa.METHODS This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and involved a comprehensive search on PubMed,Google Scholar,Science Direct,and African Journals Online for published studies on the prevalence and genetic diversity of OBI in Africa.RESULTS The synthesis included 83 articles,revealing that the prevalence of OBI varied between countries and population groups,with the highest prevalence being 90.9%in patients with hepatitis C virus infection and 38%in blood donors,indicating an increased risk of HBV transmission through blood transfusions.Cases of OBI reactivation have been reported following chemotherapy.Genotype D is the predominant,followed by genotypes A and E.CONCLUSION This review highlights the prevalence of OBI in Africa,which varies across countries and population groups.The study also demonstrates that genotype D is the most prevalent.
基金National Natural Science Foundation of China(Grant Nos.42174192,12241101,and 91952111).
文摘Internal gravity waves(IGWs)are critical in driving Martian atmospheric motion and phenomena.This study investigates Martian IGWs by using high-resolution data from China’s Tianwen-1 mission and the National Aeronautics and Space Administration’s Mars Global Surveyor(MGS)by the radio occultation(RO)technique.Key IGW parameters,such as vertical and horizontal wavelengths,intrinsic frequency,and energy density,are extracted based on vertical temperature profiles from the Martian surface to~50 km altitude.Data reveal that the Martian IGWs are predominantly small-scale waves,with vertical wavelengths between 6 and 13 km and horizontal wavelengths extending to thousands of kilometers.These waves propagate almost vertically and exhibit low intrinsic frequencies close to the inertial frequency,with the characteristic of low-frequency inertial IGWs.Tianwen-1 data indicate stronger IGW activity,higher energy density,and less dissipation than MGS data in the northern hemisphere.Moreover,MGS data in the southern hemisphere show higher buoyancy frequencies and lower vertical wavelengths,suggesting more stable atmospheric conditions conducive to IGW propagation.These extracted IGW characteristics can enhance our understanding of the atmospheric dynamics on Mars and contribute valuable information for parameterization in global circulation models.
文摘BACKGROUND Colorectal cancer(CRC)is one of the most common malignant tumors,and early screening is crucial to improving the survival rate of patients.The combination of colonoscopy and immune fecal occult blood detection has garnered significant attention as a novel method for CRC screening.Colonoscopy and fecal occult blood tests,when combined,can improve screening accuracy and early detection rates,thereby facilitating early intervention and treatment.However,certain risks and costs accompany it,making the establishment of a risk classification model crucial for accurate classification and management of screened subjects.AIM To evaluate the feasibility and effectiveness of colonoscopy,immune fecal occult blood test(FIT),and risk-graded screening strategies in CRC screening.METHODS Based on the randomized controlled trial of CRC screening in the population conducted by our hospital May 2020 to May 2023,participants who met the requirements were randomly assigned to a colonoscopy group,an FIT group,or a graded screening group at a ratio of 1:2:2(after risk assessment,the high-risk group received colonoscopy,the low-risk group received an FIT test,and the FITpositive group received colonoscopy).The three groups received CRC screening with different protocols,among which the colonoscopy group only received baseline screening,and the FIT group and the graded screening group received annual follow-up screening based on baseline screening.The primary outcome was the detection rate of advanced tumors,including CRC and advanced adenoma.The population participation rate,advanced tumor detection rate,and colonoscopy load of the three screening programs were compared.RESULTS A total of 19373 subjects who met the inclusion and exclusion criteria were enrolled,including 8082 males(41.7%)and 11291 females(58.3%).The mean age was 60.05±6.5 years.Among them,3883 patients were enrolled in the colonoscopy group,7793 in the FIT group,and 7697 in the graded screening group.Two rounds of follow-up screening were completed in the FIT group and the graded screening group.The graded screening group(89.2%)and the colonoscopy group(42.3%)had the lowest overall screening participation rates,while the FIT group had the highest(99.3%).The results of the intentional analysis showed that the detection rate of advanced tumors in the colonoscopy group was greater than that of the FIT group[2.76%vs 2.17%,odds ratio(OR)=1.30,95%confidence interval(CI):1.01-1.65,P=0.037].There was no significant difference in the detection rate of advanced tumors between the colonoscopy group and the graded screening group(2.76%vs 2.35%,OR=1.9,95%CI:0.93-1.51,P=0.156),as well as between the graded screening group and the FIT group(2.35%vs 2.17%,OR=1.09%,95%CI:0.88-1.34,P=0.440).The number of colonoscopy examinations required for each patient with advanced tumors was used as an index to evaluate the colonoscopy load during population screening.The graded screening group had the highest colonoscopy load(15.4 times),followed by the colonoscopy group(10.2 times),and the FIT group had the lowest(7.8 times).CONCLUSION A hierarchical screening strategy based on CRC risk assessment is feasible for screening for CRC in the population.It can be used as an effective supplement to traditional colonoscopy and FIT screening programs.
基金Supported by the Shanghai Municipal Commission of Health and Family Planning,No.PKJ2018-Y05.
文摘BACKGROUND Occult hepatitis B infection(OBI)is characterized by the detection of hepatitis B virus(HBV)DNA in serum(usually HBV DNA<200 IU/mL)or the liver but negativity for hepatitis B surface antigen(HBsAg).The diagnosis of OBI relies on the sensitivity of assays used in the detection of HBV DNA and HBsAg.HBsAg assays with inadequate sensitivity or inability to detect HBV S variants may lead to misdiagnosis of OBI in people with overt HBV infection.CASE SUMMARY We report a HBsAg-negative but hepatitis B envelope antigen-positive patient who had a significant HBV DNA level.The patient was initially diagnosed as having OBI.However,sequence analysis revealed a unique insertion of amino acid residues at positions 120-124 in the S protein,which affects the formation of a disulfide bond that is associated with the formation of a loop.It is well known that there is an overlap between the S protein and Pol protein.We found that this new insertion site occurred in polymerase/reverse transcriptase domain,indi-cating that this insertion might be involved in HBV pathogenicity.The patient was finally diagnosed with a false OBI.CONCLUSION An insertion of amino acid residues at positions 120-124 of the S protein affects the formation of immunodominant epitopes and results in negative HBsAg levels.
文摘Far from the financial gains of cyber crooks, the informed observer will see in cyber crookery a complex field of psychopathological expression where addictions and ritualistic practices intermingle. We thus carried out a qualitative observational study, focusing on a young Ivorian cyber-escroc, hard drug user and follower of mystical practices taken in charge by a multidisciplinary team during a resocialization course for children in conflict with the law from November to December 2022. The aim was to describe the difficulties experienced by a young Ivorian cyber crook in escaping the clutches of occult practices, internet addictions and psychoactive substances encountered in the field of cyber crookery. KA is confronted with the problem of cybercrime associated with occult practices and drug addiction. He is a heroin addict and secondary internet addict, undergoing de facto detoxification and presenting risky consumption behaviors. His fear is fuelled by the sudden death of his childhood friend, who introduced him to cyber-scams and occult practices, and the impossibility of returning his “Agbaladai” fetish when he can no longer honor the weekly sacrifices. Our results show an interweaving of psychopathological entities, namely cyberaddiction and addiction to psychoactive substances, against a backdrop of mystico-cultural practices and interpretations.
文摘BACKGROUND Reactivation of hepatitis B virus(HBV)infection is a well-known risk that can occur spontaneously or following immunosuppressive therapies,including cancer chemotherapy.HBV reactivation can cause significant morbidity and even mortality,which are preventable if at-risk individuals are identified through screening and started on antiviral prophylaxis.AIM To determine the prevalence of chronic HBV(CHB)and occult HBV infection(OBI)among oncology and hematology-oncology patients undergoing chemo-therapy.METHODS In this observational study,the prevalence of CHB and OBI was assessed among patients receiving chemotherapy.Serological markers of HBV infection[hepatitis B surface antigen(HBsAg)/anti-hepatitis B core antigen(HBc)]were evaluated for all patients.HBV DNA levels were assessed in those who tested negative for HBsAg but positive for total anti-HBc.RESULTS The prevalence of CHB in the study cohort was determined to be 2.3%[95%confidence interval(95%CI):1.0-4.2].Additionally,the prevalence of OBI among the study participants was found to be 0.8%(95%CI:0.2-2.3).CONCLUSION The findings of this study highlight the importance of screening for hepatitis B infection in oncology and hematology-oncology patients undergoing chemotherapy.Identifying individuals with CHB and OBI is crucial for implementing appropriate antiviral prophylaxis to prevent the reactivation of HBV infection,which can lead to increased morbidity and mortality.
文摘Occult hepatitis B virus (HBV) infection (OBI), alternatively defined as occult hepatitis B (OHB), is a challenging clinical entity. It is recognized by two main characteristics: absence of HBsAg, and low viral replication. The previous two decades have witnessed a remarkable progress in our understanding of OBI and its clinical implications. Appropriate diagnostic techniques must be adopted. Sensitive HBV DNA amplification assay is the gold standard assay for detection of OBI. Viral as well as host factors are implicated in the pathogenesis of OBI. However, published data reporting the infectivity of OBI by transfusion are limited. Several aspects including OBI transmission, infectivity and its relation to the development of chronic liver diseases and hepatocellular carcinoma have to be resolved. The aim of the present review is to highlight recent data on OBI with a focus on its virological diagnosis and clinical outcome.
基金operating research grants from the Canadian Institutes of Health Research, Canada and the Canada Research Chair Program, and the Canada Foundation for Innovation
文摘Hepatitis B virus (HBV) is a highly pathogenic virus that causes chronic liver diseases in millions of people globally. In addition to a symptomatic, serologically evident infection, occult persistent HBV carriage has been identified since nucleic acid amplification assays of enhanced sensitivity became introduced for detection of hepadnaviral genomes and their replicative intermediates. Current evidence indicates that occult HBV infection is a common and long-term consequence of resolution of acute hepatitis B. This form of residual infection is termed as secondary occult infection (SOI). The data from the woodchuck model of HBV infection indicate that exposure to small amounts of hepadnavirus can also cause primary occult infection (POI) where virus genome, but no serological makers of exposure to virus, are detectable, and the liver may not be involved. However, virus replicates at low levels in the lymphatic system in both these forms. We briefly summarize the current understanding of the nature and characteristics of occult hepadnaviral persistence as well as of its documented and expected pathological consequences.
基金Supported by the Specialized Research Fund for the Doctoral Program of Higher Education of ChinaNo.20093420120005+1 种基金the National Science Foundation of ChinaNo.81273142
文摘Occult hepatitis B virus infection(OBI), characterized as the persistence of hepatitis B virus(HBV) surface antigen(HBs Ag) seronegativity and low viral load in blood or liver, is a special form of HBV infection. OBI may be related mainly to mutations in the HBV genome, although the underlying mechanism of it remains to be clarified. Mutations especially within the immunodominant "α" determinant of S protein are "hot spots" that could contribute to the occurrence of OBI via affecting antigenicity and immunogenicity of HBs Ag or replication and secretion of virion. Clinical reports account for a large proportion of previous studies on OBI, while functional analyses, especially those based on full-length HBV genome, are rare.
基金Supported by National Research Foundation of Korea grant funded by the Korean Government(Ministry of Education,Science,and Technology),Grant No.2013-005810
文摘AIM:To elucidate the molecular mechanisms underlying hepatitis B virus(HBV)occult infection of genotype C.METHODS:A total of 10 types of hepatitis B surface antigen(HBs Ag)variants from a Korean occult cohort were used.After a complete HBV genome plasmid mutated such that it does not express HBs Ag and plasmid encoding,each HBs Ag variant was transiently co-transfected into Hu H-7 cells.The secretion capacity and intracellular expression of the HBV virions and HBs Ags in their respective variants were analyzed using real-time quantitative polymerase chain reaction assays and commercial HBs Ag enzyme-linked immunosorbent assays,respectively.RESULTS:All variants exhibited lower levels of HBs Ag secretion into the medium compared with the wild type.In particular,in eight of the ten variants,very low levels of HBs Ag secretion that were similar to the negative control were detected.In contrast,most variants(9/10)exhibited normal virion secretion capacities comparable with,or even higher than,the wild type.This provided new insight into the intrinsic nature of occult HBV infection,which leads to HBs Ag sero-negativeness but has horizontal infectivity.Furthermore,most variants generated higher reactive oxidative species production than the wild type.This finding provides potential links between occult HBV infection and liver disease progression.CONCLUSION:The presently obtained data indicate that deficiency in the secretion capacity of HBs Ag variants may have a pivotal function in the occult infections of HBV genotype C.
