Notes

Adult-Onset Still's Ailment With Extensive Lymphadenopathy Mimicking Lymphoproliferative Malignancy.
Ingestion of PTEs was found to be a primary route of exposure, while dermal and inhalation exposure was negligible. Principal component analysis (PCA) demonstrated that there were roughly three sources of PTEs in the weathered waste-rocks of the mine, natural sources related to the weathering of parent rocks, and human sources, including industrial emissions, mining activities, and atmospheric dust deposition and resuspension. This study advances our knowledge of PTEs in mines and provides policymakers with a reference for designing strategies to protect mine-based ecosystems.We assessed fiddler crabs' (Minuca burgersi) ability to secrete metallic contaminants through ecdysis under controlled conditions. We fed them with contaminated food with different copper (Cu) and lead (Pb) amounts and measured their concentration in the released and renewed exuviae. We found a significant reduction in the average concentrations of Cu and Pb in the released and renewed exuviae-eliminating the exoskeleton in the ecdysis process helps in the metal detoxification mechanism of these animals. A portion of the concentration of metals is retained in the crustaceans' exuvia, and thus, they can be used to analyze bioaccumulation in ecosystems. Our results also reinforce the need for attention to the contamination characterization in crustaceans before and after ecdysis to avoid underestimation effects.The aim of this review was to identify the current knowledge regarding the concentration of microplastics in bivalves in the marine, estuarine, and freshwater environments. For this purpose, researches were conducted from September 2020 to February 2021 in the Scopus, Web of Science, and Google scholar databases, following a meticulous selection of articles. To comprehensively understand the selected articles, an extensive review was carried out in order to identify the methodologies employed, sampling sites, species evaluated, characteristics of the microplastics (concentrations, shapes, sizes, and polymers) and their relationship with the concentration of this particles in the environment. A total of 93 articles were selected, with an exponential growth in the number of articles from April 2014 to February 2021. Worldwide, 80 articles were realized in the Northern Hemisphere and thirteen in the Southern Hemisphere. The samplings of organisms were carried out in 36 countries, besides one in Antarctica. The concentration of microplastics were studied in 70 species, with mussels Mytilus spp. and the oysters Crassostrea spp. being the main genus studied. Due to the different methodologies used to digest the tissues of organisms and identify microplastics and species, it is difficult to make comparisons between the results of different studies. In addition, data on the concentrations of microplastics in the environment, as well as their composition and characteristics, are needed, enabling the verification of relationships with the concentrations identified in organisms, which does not occur in most studies. Thus, we suggest an increase in the number of studies to be realized in the southern hemisphere, future studies use the same methodology of digestion, the polymer identification of microplastics and samplings of the surrounding environment, enabling a greater comparison between studies.
To aid in the oncological management of multiple bilobar colorectal liver metastases (CRLMs), we describe a new surgical procedure, VEssel-Skeletonized PArenchyma-sparing Hepatectomy (VESPAH).

Of 152 patients with CRLMs treated with hepatectomy, 33 patients had multiple bilobar liver metastases (≥8 liver metastases); their surgical procedures and clinical outcomes were retrospectively summarized and compared between those who underwent VESPAH and those who underwent major hepatectomy (Major Hx).

Of the 33 patients, 20 patients were resected by VESPAH (the VESPAH group) and 13 patients by major hepatectomy (Major Hx group). The median number of CRLMs was 13 (range, 8-53) in the VESPAH group and 10 (range, 8-41) in the Major Hx group (P=0.511). No operative mortality nor severe morbidity was observed in either group. The VESPAH group showed earlier recovery of remnant liver function after surgery than the Major Hx group; the incidence of grade B/C post hepatectomy liver failure was 5% in the VESPAH group mes.
It is difficult to change dietary habits and maintain them in the long run, particularly in elderly people. We aimed to assess whether adherence to the Mediterranean diet (MedDiet) and cardiovascular risk factor were similar in the middle-aged and oldest participants in the PREDIMED study.

We analyzed participants belonging to the first and fourth quartiles of age (Q1 and Q4, respectively) to compare between-group differences in adherence to the nutritional intervention and cardiovascular risk factor (CRF) control during a 3-year follow-up. All participants underwent yearly clinical, nutritional, and laboratory assessments during the following.

A total of 2278 patients were included (1091 and 1187 in Q1 and Q4, respectively). At baseline, mean ages were 59.6 ± 2.1years in Q1 and 74.2 ± 2.6years in Q4. In Q4, there were more women, greater prevalence of hypertension and diabetes, and lower obesity and smoking rates than the younger cohort (P ≤ 0.001, all). Adherence to the MedDiet was similar in Q1 and Q4 at baseline (mean 8.7 of 14 points for both) and improved significantly (P < 0.01) and to a similar extent (mean 10.2 and 10.0 points, respectively) during follow-up. Systolic blood pressure, low density-lipoprotein cholesterol, and body weight were similarly reduced at 3years in Q1 and Q4 participants.

The youngest and oldest participants showed improved dietary habits and CRFs to a similar extent after 3years' intervention. Therefore, it is never too late to improve dietary habits and ameliorate CRF in high-risk individuals, even those of advanced age.

The trial is registered in the London-based Current Controlled Trials Registry (ISRCTN number 35739639).
The trial is registered in the London-based Current Controlled Trials Registry (ISRCTN number 35739639).
Bösch osteotomy (BO), which is a first metatarsal subcapital osteotomy stabilised with a K-wire, is a surgical option to correct hallux valgus (HV). The aim of this study was to assess the long-term clinical and radiographic results in a cohort of patients treated at our institution with such osteotomy.

In this retrospective monocentric single-surgeon cohort study, we included 58 HVs (46 patients) who underwent HV correction by BO and were followed at a minimum of 7years. The range of motion (ROM), the American Orthopaedic Foot and Ankle Society's Forefoot scale (AOFAS-FS) and the Visual Analogic Scale (VAS) for pain were recorded. On weightbearing radiographs, the Hallux Valgus Angle (HVA), Intermetatarsal Angle (IMA), the Distal Metatarsal Articular Angle (DMAA), and the Lateral Sesamoid Position (LSP) were measured and compared with pre-operative values. The complication rate and first metatarsophalangeal joint stiffness were also assessed.

At a mean follow-up of 10 ± 2 (7-17) years, mean ± standard deviation AOFAS-FS and VAS were 89 ± 11 (67-93) and 2.1 ± 2.8 (0-7) points, respectively. In 42 (72%) cases there was no limitation in the choice of footwears. Radiographically, we found a significant improvement in the HVA (from 33.9° ± 6.7 to 18.8° ± 5.6, p < 0.001), in the IMA (14.2° ± 3.1 to 9.4° ± 2.7, p < 0.001), in the DMAA (from 30.3° ± 6.8 to 11.5° ± 5.1, p < 0.001) and in LSP (median value from 3 to 1, p < 0.001). In 36 (62%) cases the ROM was greater than 75° while in 22 (38%) it ranged between 30° and 75°. Minor complications occurred in six (10%) cases, which did not require any further surgery at the longest follow-up.

Bösch technique provided satisfactory clinical and radiographic outcomes in the treatment of hallux valgus which persisted at a mean 10-year follow-up. The complication rate did not differ from more recent techniques described in literature.

Level IV, retrospective cohort study.
Level IV, retrospective cohort study.The exploitation of ion-absorbed rare earth elements (REEs) has caused serious ecological destruction and environmental pollution. Effects on soil fungal structure and diversity exerted by mining activities are usually ignored, although fungus is one of the most important components in soil ecosystems. In the present research, quantitative polymerase chain reaction (qPCR) and high-throughput Illumina MiSeq sequencing were conducted to characterize fungal community composition and structure in soil of a rare earth mining area after in situ leaching. Statistical analyses, network, and FUNGuild were used to conduct in-depth analyses. Ascomycota, Basidiomycota, and Glomeromycota were the most abundant phyla in the mining soils. Fungal community structures were stable after leaching practice, but nutrition contents (organic matter, TC, and TN) significantly and positively contributed to fungal abundances and diversities. Saprotrophs in phyla Ascomycota and Basidiomycota were the dominant fungal trophic mode, and they played critical roles in nutrient cycling, transformation processes, and reducing REE toxicity. Proteasome inhibition Symbiotrophs of phyla Glomeromycota contributed to soil aggregation and slowing down nutrient losses after in situ leaching practice. In addition, fungi could regulate the interactions between species to resist the harsh environment of REE toxicity or ammonium caused by in situ leaching practice.A sensitive biosensor capable of detecting trace concentrations of several cancer biomarkers in clinical samples is critical for early detection of cancer because different cancer biomarkers may be expressed at different stages of cancer. Previous multiplex studies using microarrays or color-coded beads had limited multiplex detection in a single well, and difficulty in optimizing and unifying the incubation parameters for all tests made in different wells had posed challenges to small sample size and lengthened assay time. Herein, we proposed a novel approach to achieve multiplex analysis on a single three-dimensional porous calcium alginate bead. Because of the high surface area to volume ratio of the calcium alginate immuno-bead, the sensitivity and linear dynamic range of the as-proposed multiplex analysis method are significantly improved. Based on the direct sandwich immunoassay principle, dual-capturing antibodies were encapsulated into a single 3D porous calcium alginate bead as a proof-of-concept for multiplexity detection of serum-HER2 and serum-CA125 breast cancer biomarkers. High sensitivity was attained, with LODs of 0.004 ng mL-1 for serum HER2, and 0.005 U mL-1 for serum CA125, both of which are below the clinical cutoff values, enabling for early breast cancer diagnosis. Stability tests revealed that the 3D immuno-beads were stable at 4 °C and room temperature (25 °C) for at least 14 days. Most importantly, the results obtained using the developed system were in good agreement with those obtained using standard methods while analyzing real clinical samples. In addition, the analysis required only approximately 30 min, which was much less time than typical ELISA techniques. When endogenous interferences were introduced, no cross-reactivity was observed. We anticipate this approach to be potentially used in the multiplex assays and biosensors.
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