HIV Research Year in Review in Haiti

Introduction For this issue of the Epidemiologic Surveillance Bulletin, we summarize the prior year’s research on populations living with HIV (PLWH) in Haiti for World AIDS Day 2020. Methods We retrieved 50 articles from PubMed (pubmed.gov) for articles written in English using the search term [Haiti* AND (HIV OR human immunodeficiency virus OR AIDS)] from December 2019 to November 19, 2020 (approximately 1 year). We included studies that of cohorts of people living with HIV in Haiti, patients enrolled from Haiti in multi-country clinical studies and studies involving populations at substantial risk of HIV in Haiti. We excluded studies of Haitian populations in other countries, study protocols, perspectives, and opinion articles. The final review contains summaries of 28 studies. We grouped into relevant themes when possible and summarized each paper

Bilateral Axillo-Breast Approach Robotic Thyroidectomy: Introduction and Update

Bilateral axillo-breast approach (BABA) endoscopic thyroidectomy was introduced at Seoul National University Hospital in 2004, and it has been used to treat a variety of benign and malignant thyroid diseases. In 2008, we began using the da Vinci robotic system with BABA endoscopic thyroidectomy and reported our initial experiences in 2009. Since then, the outcomes of many clinical studies have been reported. In this chapter, we will introduce the BABA robotic thyroidectomy (RoT) procedure and review evidence for the safety of performing BABA. First, we will introduce the history of BABA RoT, which is based on an endoscopic BABA method. Second, we will review the BABA RoT equipment, operating room (OR) set-up, and the procedures, including surgical indications. Third, technical, oncological, and functional evidence for the safety of performing BABA will be described. Fourth, we will highlight the esthetic superiority of BABA RoT compared with conventional thyroidectomy. Finally, the BABA robotic modified radical neck dissection procedure will be introduced, with mention of our experiences and special concerns. We conclude that BABA RoT is technically, oncologically, and functionally safe. In addition, its esthetic superiority should be emphasized. Further research on the prognosis of patients treated by BABA RoT should follow in the future

Adversarial Fine-tuning using Generated Respiratory Sound to Address Class Imbalance

Deep generative models have emerged as a promising approach in the medical image domain to address data scarcity. However, their use for sequential data like respiratory sounds is less explored. In this work, we propose a straightforward approach to augment imbalanced respiratory sound data using an audio diffusion model as a conditional neural vocoder. We also demonstrate a simple yet effective adversarial fine-tuning method to align features between the synthetic and real respiratory sound samples to improve respiratory sound classification performance. Our experimental results on the ICBHI dataset demonstrate that the proposed adversarial fine-tuning is effective, while only using the conventional augmentation method shows performance degradation. Moreover, our method outperforms the baseline by 2.24% on the ICBHI Score and improves the accuracy of the minority classes up to 26.58%. For the supplementary material, we provide the code at https://github.com/kaen2891/adversarial_fine-tuning_using_generated_respiratory_sound.Comment: accepted in NeurIPS 2023 Workshop on Deep Generative Models for Health (DGM4H

Radiation Response Protein, Sialyltransferase (ST6Gal I)

Recently we identified β-galactoside α(2, 6)-sialyltransferase (ST6Gal I) as a candidate biomarker for ionizing radiation. The expression of ST6Gal I and the level of protein sialylation increased following radiation exposure in a dose-dependent manner. We also found that radiation induced ST6Gal I cleavage and the cleaved form of ST6Gal I was soluble and secreted. Sialylation of integrin β1, a glycosylated cell surface protein, was stimulated by irradiation and this increased its protein stability. Overexpression of ST6Gal I in SW480 colon cancer cells that initially showed a low enzyme activity of ST6Gal I increased the sialylation of integrin β1 and also increased the stability of the protein. Inhibition of sialylation by transfection with neuramidase or by treatment with short interfering (si) RNA targeting ST6Gal I (Si-ST6Gal I) reversed the effects of ST6Gal I expression. In addition, ST6Gal I overexpression increased clonogenic survival following radiation exposure and reduced radiation-induced cell death and caspase 3 activation. In conclusion, we suggest that exposure to ionizing radiation was found to increase sialylation of glycoproteins such as integrin β1 by inducing the expression of ST6 Gal I, and finally protein sialylation contributed to cellular radiation resistance

Environmental impacts comparison between on-site vs. prefabricated just-in-time (prefab-JIT) rebar supply in construction projects

In the on-site rebar delivery system, as the common method of rebar supply in the construction industry, reinforced steel bars are delivered in large batches from supplier's facilities through contractor's warehouse to the construction site. Rebars are then fabricated on-site and installed after assembly. In the new delivery system, called prefabrication Just-In-Time (prefab-JIT) system, the off-site cut and bend along with frequent rebar delivery to the site are applied in order to improve the process and increase its efficiency. The main objective of this paper is to assess and compare the environmental impacts resulting from the air emissions associated with the two rebar delivery systems in a case study construction project. Environmental impact categories of interest include global warming, acidification, eutrophication, and smog formation. A process-based cradle-to-gate life cycle assessment methodology is applied to perform the analysis. The results show that the prefab-JIT rebar delivery system causes less contribution to all mentioned environmental impact categories compared with a traditional on-site delivery system

Dermoid cysts: Epidemiology and diagnostic approach based on clinical experiences

Background Dermoid cysts are congenital tumors that are benign. Dermoid cysts with intracranial extension can cause serious neurological complications. It is important, therefore, to determine whether a patient has a dermoid cyst when their chief concern at a doctor’s visit is a mass in the head or neck area. In this study, we present a literature review of dermoid cysts and an analysis of the authors’ experiences, with the goal of providing guidance useful for the diagnosis and treatment of dermoid cysts. Methods This study retrospectively analyzed the medical records of 62 patients who visited the two medical clinics with which the authors are affiliated. The patients were enrolled between October 2003 and January 2017. Results Of the 62 patients analyzed in this study, 32 were 0 to 5 years of age (52%) and 23 were 17 years of age or older (37%). Forty-seven patients underwent 1 or more imaging study during the process of diagnosis. Thirty-two patients were suspected to have a dermoid cyst. Forty-nine patients were analyzed to determine the depth of the cyst. Bone was seen in 43 patients through imaging tests or during actual surgery, and nine of the 43 had bony problems (21%). Conclusions This study found that dermoid cysts were present in many adults, and that a high rate of deep lesions was observed, as well as many cases in which even the bone was affected. These results suggest, therefore, that dermoid cysts should be considered, and medical professionals should actively conduct imaging studies

Patch-Mix Contrastive Learning with Audio Spectrogram Transformer on Respiratory Sound Classification

Respiratory sound contains crucial information for the early diagnosis of fatal lung diseases. Since the COVID-19 pandemic, there has been a growing interest in contact-free medical care based on electronic stethoscopes. To this end, cutting-edge deep learning models have been developed to diagnose lung diseases; however, it is still challenging due to the scarcity of medical data. In this study, we demonstrate that the pretrained model on large-scale visual and audio datasets can be generalized to the respiratory sound classification task. In addition, we introduce a straightforward Patch-Mix augmentation, which randomly mixes patches between different samples, with Audio Spectrogram Transformer (AST). We further propose a novel and effective Patch-Mix Contrastive Learning to distinguish the mixed representations in the latent space. Our method achieves state-of-the-art performance on the ICBHI dataset, outperforming the prior leading score by an improvement of 4.08%.Comment: INTERSPEECH 2023, Code URL: https://github.com/raymin0223/patch-mix_contrastive_learnin

CT findings in apical versus basal involvement of pulmonary tuberculosis

PURPOSEWe aimed to compare clinical features and computed tomog- raphy (CT) findings of pulmonary tuberculosis (TB) in lower lobe basal segments and upper lobe apical or apicoposterior segments. MATERIALS AND METHODSWe retrospectively reviewed medical records and chest CT scans of 986 adults who were diagnosed with active pulmo- nary TB. Active pulmonary TB confined to the basal segments was found in 21 patients. Sixty patients had disease localized to the apical or apicoposterior segments only. Clinical features and CT abnormalities of the lung parenchyma, airways, me- diastinal and hilar lymph nodes, and pleura were compared between these two groups. RESULTSA significant difference was observed between two groups in terms of underlying disease prevalence associated with an im- munocompromised state (basal, 6/21, 28.6%; apical or apico- posterior, 3/60, 5%; P = 0.008). Chest CT findings, including consolidation (P = 0.0016), lymphadenopathy (P = 0.0297), and pleural effusion (P = 0.008), were more common in ba- sal segment TB than in apical or apicoposterior segment TB. Small nodules were less common in basal segment TB than in apical or apicoposterior segment TB (P = 0.0299). The tree-in- bud sign was the most common CT finding in both basal seg- ment TB (17/21, 81%) and apical or apicoposterior segment TB groups (53/60, 88.3%) (P = 0.4633). CONCLUSIONLower lobe basal segment TB was more commonly present with common CT findings of primary pulmonary TB including consolidation, mediastinal and hilar lymphadenopathy, and pleural effusion than apical or apicoposterior segment TB

MMP9 Processing of HSPB1 Regulates Tumor Progression

Matrix metalloproteinases regulate pathophysiological events by processing matrix proteins and secreted proteins. Previously, we demonstrated that soluble heat shock protein B1 (HSPB1) is released primarily from endothelial cells (ECs) and regulates angiogenesis via direct interaction with vascular endothelial growth factor (VEGF). Here we report that MMP9 can cleave HSPB1 and release anti-angiogenic fragments, which play a key role in tumorprogression. We mapped the cleavage sites and explored their physiological relevance during these processing events. HSPB1 cleavage by MMP9 inhibited VEGF-induced ECs activation and the C-terminal HSPB1 fragment exhibited more interaction with VEGF than did full-length HSPB1. HSPB1 cleavage occurs during B16F10 lung progression in wild-type mice. Also, intact HSPB1 was more detected on tumor endothelium of MMP9 null mice than wild type mice. Finally, we confirmed that secretion of C-terminal HSPB1 fragment was significantly inhibited lung and liver tumor progression of B16F10 melanoma cells and lung tumor progression of CT26 colon carcinoma cells, compared to full-length HSPB1. These data suggest that in vivo MMP9-mediated processing of HSPB1 acts to regulate VEGF-induced ECs activation for tumor progression, releasing anti-angiogenic HSPB1 fragments. Moreover, these findings potentially explain an anti-target effect for the failure of MMP inhibitors in clinical trials, suggesting that MMP inhibitors may have pro-tumorigenic effects by reducing HSPB1 fragmentation