Notes

Granulocyte-colony exciting factor-producing cancerous phyllodes tumor of the breast: a rare case.
Themes regarding precautions included the following proper mask use, hand washing/ sanitizing, avoiding large crowds/small crowds only, physical distancing, COVID-19 testing/symptom monitoring, and COVID-19 vaccination.The Affordable Care Act's Marketplaces, by allowing subsidized purchase of insurance coverage by persons with incomes from the poverty line to middle income, and through active outreach and enrollment assistance efforts, are well situated to reduce large African American-white private coverage disparities. Using data from the National Health Interview Survey for multiyear periods before and after Affordable Care Act implementation, from 2011-2013 to 2015-2018, this study assessed how much disparity reduction occurred when Marketplaces were implemented. Analysis compared private coverage take-up by African Americans and whites for persons with incomes between 100 and 400% of the Federal Poverty Line (FPL), controlling for African American-white income differences and other covariates. African Americans' gains were significantly greater than whites' and disparities did close. However, both groups gained considerably less coverage than they might have, and some disparity remained. To make ongoing operations more effective and to guide future subsidy extensions and increases as enacted in the American Rescue Plan, more research is needed into the incentive value of subsidies and to discover which Marketplace outreach and enrollment assistance efforts were most effective. In advancing these aims, high priority should be given to identifying strategies that were particularly successful in reaching and engaging uninsured African Americans.
The addition of immune checkpoint inhibitors (ICIs) to conventional chemotherapy (CT) as first-line treatment improves survival in extensive-stage small-cell lung cancer (ES-SCLC). The aim of this meta-analysis was to determine the relative efficacy of first-line ICIs compared with CT in patients with ES-SCLC.

Two independent reviewers extracted relevant data according to PRISMA guidelines and assessed the risk of bias using the Cochrane Collaboration's risk-of-bias tool. Meta-analysis was conducted using random-effects models to calculate an average effect size for overall survival (OS), progression-free survival (PFS), and safety outcomes in the overall populations and clinically relevant subgroups.

A literature search of PubMed and Embase was performed. Six randomized controlled clinical trials (IMpower133, CHECKMATE-451, CASPIAN, KEYNOTE-604, and phase II and III ipilimumab plus CT trials) with a total of 3757 patients were included. Compared with CT alone, ICIs plus CT showed a favourable effect on OS (hazard ratio [HR] 0.85; 95% confidence intervals [CI] 0.79-0.96) and PFS (HR 0.78; 95% CI 0.72-0.83) but a non-significant increase in the risk of experiencing any adverse event (relative risk, 1.05; 95% CI 0.99-1.11). The estimated HR for OS favoured ICI combinations in all planned subgroups according to age (< 65years/≥ 65years), sex (men/women), and ECOG performance status (0/1). Analysis by specific ICI revealed significant improvements in OS only for atezolizumab + CT (HR 1.36; 95% CI 1.09-1.69) and durvalumab + CT (HR 1.35; 95% CI 1.12-1.62) compared with CT alone.

Combining anti-programmed cell death ligand 1 antibodies with platinum/etoposide is a superior therapeutic approach compared to CT alone for the first-line treatment of patients with ES-SCLC.
Combining anti-programmed cell death ligand 1 antibodies with platinum/etoposide is a superior therapeutic approach compared to CT alone for the first-line treatment of patients with ES-SCLC.
To determine whether elevation matrix data of the anterior corneal surface could be useful for the diagnosis of keratoconus.

In a cross-sectional study, subjects aged 10-40years with keratoconus (n = 74) or age-matched controls (n = 36) underwent complete ophthalmological examination, including Scheimpflug corneal topography (Pentacam HR). Exclusion criteria comprised previous ocular surgery, other eye disease, or significant corneal scarring. A raw data matrix of distance measurements to the most anterior corneal point was used to compare each subject with the mean normal cornea. A central 6-mm zone (6.1 × 6.1mm) and two inferior eccentric matrices (0.4 × 6.1 and 1.1 × 1.1mm) were used. Outcome measures were sensitivity, specificity, positive and negative predictive value, likelihood ratio, accuracy, and odds ratio.

Sensitivity of central matrix for the diagnosis of keratoconus was low (6.7%) whereas specificity reached 94.4%. Sensitivity and specificity were respectively 93.2% and 94% for the 6.1 × 0.4mm eccentric matrix and 97.2% and 97.2% for the 1.1 × 1.1mm eccentric matrix. Positive predictive and negative predictive values were 71.4% and 33%, respectively, for the central matrix; 97.1% and 87.1%; 98.6% and 94.5%, for the two eccentric matrices, respectively. The likelihood ratio of a positive test was 1.1, 16.7, and 35, respectively. Sensitivity and specificity of the eccentric matrices were significantly better in the diagnosis of subclinical keratoconus (but not definite keratoconus) than other Pentacam indices.

Using eccentric elevation matrix data analysis of the cornea is useful in the detection of keratoconus versus normal corneas.
Using eccentric elevation matrix data analysis of the cornea is useful in the detection of keratoconus versus normal corneas.In the continuous search for versatile and better performing probes for optical bioimaging and biosensing applications, many research efforts have focused on the design and optimization of photoluminescent metal nanoclusters. They consist of a metal core composed by a small number of atoms (diameter  less then  2-3 nm), usually coated by a shell of stabilizing ligands of different nature, and are characterized by molecule-like quantization of electronic states, resulting in discrete and tunable optical transitions in the UV-Vis and NIR spectral regions. Recent advances in their size-selective synthesis and tailored surface functionalization have allowed the effective combination of nanoclusters and biologically relevant molecules into hybrid platforms, that hold a large potential for bioimaging purposes, as well as for the detection and tracking of specific markers of biological processes or diseases. Here, we will present an overview of the latest combined imaging or sensing nanocluster-based systems reported in the literature, classified according to the different families of coating ligands (namely, peptides, proteins, nucleic acids, and biocompatible polymers), highlighting for each of them the possible applications in the biomedical field.
This review provides suggestions for the evaluation of patients with osteoporosis in order to assure that the diagnosis is correct, to identify potentially correctable conditions contributing to skeletal fragility and fracture risk, and to assist in individualizing management decisions.

Some patients who appear to have osteoporosis have another skeletal disease, such as osteomalacia, that requires further evaluation and treatment that is different than for osteoporosis. Many patients with osteoporosis have contributing factors (e.g., vitamin D deficiency, high fall risk) that should be addressed before and after starting treatment to assure that treatment is effective and safe. Evaluation includes a focused medical history, skeletal-related physical examination, assessment of falls risk, appropriate laboratory tests, and rarely transiliac double-tetracycline labeled bone biopsy. Evaluation of patients with osteoporosis before starting treatment is essential for optimizing clinical outcomes.
Some patients who appear to have osteoporosis have another skeletal disease, such as osteomalacia, that requires further evaluation and treatment that is different than for osteoporosis. Many patients with osteoporosis have contributing factors (e.g., vitamin D deficiency, high fall risk) that should be addressed before and after starting treatment to assure that treatment is effective and safe. Evaluation includes a focused medical history, skeletal-related physical examination, assessment of falls risk, appropriate laboratory tests, and rarely transiliac double-tetracycline labeled bone biopsy. Evaluation of patients with osteoporosis before starting treatment is essential for optimizing clinical outcomes.This paper proposes a novel model for the cyclical and non-linear association between innovation in green and sustainable technologies and carbon dioxide (CO2) emissions using foreign direct investment, gross domestic consumption, and renewable energy consumption as control variables for OECD economies. First, the findings validated the long-run cointegration among variables. Second, the significant long-term negative nexus between renewable energy consumption, positive shocks to innovation in green and sustainable technologies, and CO2 emission was validated. Third, income per capita (GDP) and the negative shocks to innovation in green and sustainable technologies contributed to the CO2 emissions. Based on these findings, this study offers some policy implications to mitigate CO2 emissions.Land consolidation has greatly altered land use patterns and the corresponding ecosystem services (ES) in China. However, the potential consequences of different consolidation measures for the interaction of ecosystem services are still largely unknown. Here, from a simulation perspective, we predict potential separate and joint influences of three land consolidation scenarios, i.e., reclamation of abandoned mining land, intensive construction land use and their integrated scenario, on the tradeoff/ synergic relationships of food production, carbon storage, habitat quality, and water conservation. Zhaoyuan city, one of China's top 100 counties at a green transformation stage of mining industry, is taken as a case study. Our results show that land consolidation will significantly mitigate the loss of farmland and vegetation while improving use efficiency of construction land. By 2035, food production is likely to present more trade-offs with other ES, whereas carbon storage, habitat quality, and water conservation will be highly synergic with each other. In contrast, consolidation of rural/urban construction land will be more feasible to coordinate multiple ecosystem services, as well as mitigating urban expansion and rural hollowing. This work enables us to identify the optimal combinations of multiple land consolidation measures towards sustainable ecosystem management.It is evident that there is nexus among electricity consumption, foreign direct investment and aggregate economic activity. Unfortunately, the causal relationship among the three variables in Nigeria based on modern econometric methods, recent time-series data and ways that sufficiently cater for inflation and population growth has not been adequately investigated. This study, among other things, used a trivariate vector error correction model, autoregressive distributed lag bounds test for cointegration and Granger causality test to analyse the causal relationship among electricity consumption, foreign direct investment and aggregate economic activity based on time-series data from 1970 to 2018. The study found the presence of neutral causality between electricity consumption and aggregate economic activity in the short run as well as unidirectional causality from aggregate economic activity to electricity consumption in the long run. The study also found the presence of unidirectional causality from foreign direct investment to electricity consumption as well as neutral causality between foreign direct investment and aggregate economic activity in both the short run and the long run.
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