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An Improved Protection Circuit Design for Fast Detection of Short-circuit in IPM
Zhaoliang Meng
Mengyang Hu

Zhaoliang Meng

and 4 more

June 13, 2022
A Short-circuit protection plays a vital role in the overall reliability of intelligent power module(IPM), and where the shorter the duration of short-circuit fault, the smaller the impact on the module. The conventional VCE(sat) detection circuit suffers from a blanking time problem, and thus to solve this problem, this paper aims to improve the IPM short-circuit fast detection and protection circuit with integrated shunts, to achieve the ultra-fast detection and protection of IPM short-circuit faults. For the improved circuit, the selection method for the component parameters of a compensation link of the improved circuit is proposed, and the functions for the remaining parts in the circuit are introduced. Finally, through experiments, it is verified that the improved circuit can quickly detect various short-circuit faults, and correspondingly start shutting down the switching tube at 490ns. Compared with the conventional method, the detection time of the proposed method and short-circuit loss for modules under different short-circuit faults are significantly reduced.
Antiviral Therapy Defiant Polyviral Retinitis Post Hematopoietic Allogeneic Stem Cell...
Nadia Gabarin
Mili Roy

Nadia Gabarin

and 4 more

June 12, 2022
Cytomegalovirus (CMV) retinitis is an uncommon presentation post allogeneic transplant and can be vision-threatening. This case demonstrates the occurrence of mixed viral retinitis (CMV and varicella zoster virus) post allogeneic stem cell transplant despite multiple prophylactic antiviral therapies, and features CMV retinitis in the absence of CMV DNAemia.
Where can distinguishing features be extracted in an image for visibility estimate?
han wang
Jia Li Liu

han wang

and 3 more

June 13, 2022
Standard convolution is difficult to provide an effective fog feature for visibility estimate tasks due to the fixed grid kernel structure. In this paper, a multiscale deformable convolution model (MDCM) is proposed to extract features that make effectively sampling discriminating features from the atmospheric region in foggy image. Moreover, to enhance performance we use RGB-IR image pair as observations and design a multimodal visibility range classification network based on the MDCM. Experimental results show that both the robustness and accuracy of visibility estimate performance are raised beyond 30% compared to standard convolutional neural networks (CNNs).
Dual band-notched UWB Antenna with T-shape Stub
Ziqin Wang
Xianglong Liu

Ziqin Wang

and 4 more

June 13, 2022
An ultra-wideband (UWB) antenna with dual band-notched characteristics is proposed in this letter. The fabricated prototype of the proposed antenna has a compact size of 30×24mm which operates at 3GHz to 11GHz and attained dual notch-bands at 3.3-3.7GHz and 5.15-5.825GHz. The result shows that the proposed antenna is compact, easy to fabricate and provides good characteristics in radiation patterns and time-domain behaviors. The simulated and measured results displayed good agreement over the entire operating frequency band. The proposed antenna can be used for wideband frequency requirement systems like indoor positioning.
Unusual facial lesions in H syndrome
Mariem Rekik
Emna Bahloul

Mariem Rekik

and 7 more

June 12, 2022
H Syndrome is a rare genodermatosis. It may include facial involvement such as : facial telangiectasia, both hypo- and hyperpigmented lesions, hirsutism, swollen cheeks due to subcutaneous infiltration and eczematous lesions. We describe a new facial phenotype with dermoscopic and histological features in the spectrum of non-Langerhans cell histiocytosis.
Two pregnant women with abnormal hemoglobin tests confirmed to have rare mutations fo...
hunjin Luo
Sainan  Tan

hunjin Luo

and 9 more

June 12, 2022
Thalassemia is a well-understood genetic disorder, and routine genetic tests typically cover 95% of known genetic mutations. Discordance between the clinical phenotype and genotypes suggest that expanded genetic studies should be performed to look for rare mutations.We report two pregnant women at 17 week gestations. Routine laboratory and geneti
Biomass-derived grapene-like porous carbon nanoflakes for advanced supercapacitor and...
Yun-Feng  Wang
Shu-Jun  Zou

Yun-Feng Wang

and 8 more

June 11, 2022
It is valuable that graphene-like porous carbon materials are prepared from the biomass resources due to theirs porous structure, heteroatom, and high specific surface area. Herein, we use egg white and graphene oxides as precursor and employ post-hydrothermal carbonization approach, freeze-drying technique, carbonization, and activation methods by KOH to prepare the graphite carbon nanoflakes with Fe7C3@graphite carbon nanoflakes hybrid materials. Morphology tests imply that the formation of graphite carbon nanoflakes are mainly depended by activation step, it implies that carbon flakes are exfoliated via introducing K+ into carbon layers and further destroying the van der Waals force (VDWF). As a result, this hybrid materials exhibit a attractive capacitance (528 mF·cm-2@1 mA·cm-2) and durability (91@10 mA·cm-2, 4000 cycles). For hydrogen evolution reaction (HER), the as-collected samples also deliver a low overpotential and remarkable stability. We believes that the as-obtained hybrid materials have a greatly application value in energy storage devices.
A novel thermodynamic strategy for predicting influence of relative humidity on stabi...
Qiao Chen
Yuanhui Ji

Qiao Chen

and 1 more

June 11, 2022
In this work, the influence of polymeric excipients and relative humidity (RH) on stability of amorphous solid dispersions (ASDs) was investigated. Irbesartan and oxaprozin of BCS Ⅱ were selected as model active pharmaceutical ingredients (APIs). PVP and PVP/VA were chosen as model excipients. The water sorption and the physical stability of amorphous solid dispersions stored at constant temperature and humidity were measured. The thermodynamic phase diagrams were constructed using Perturbed-Chain Statistical Associating Fluid Theory (PC-SAFT) and Gordon-Taylor equation. The results showed that the hygroscopicity of PVP-containing was stronger than PVP/VA-containing. The water sorption was found to significantly decrease the API solubility in the polymer as well as the glass-transition temperature of the formulation. The solubility of irbesartan and oxaprozin in PVP and PVP/VA were further predicted at 25 °C with PC-SAFT. It could guide the design of amorphous solid dispersions and selection of storage conditions.
Coupled effects of biocrusts and herbaceous plants on slope hydrology and sediment yi...
Chenxi Dan
Gang Liu

Chenxi Dan

and 9 more

June 11, 2022
Biological soil crust (BSC), as a groundcover, is widely intergrown with grass. The combined effects of BSC and grass during rainfall on runoff and sediment yield are still unclear. In this study, simulated rainfall experiments were applied to a soil flume with four different slope cover treatments, namely, bare (CK) and Stipa bungeana Train. (STBU), BSC, and STBU + BSC to observe the processes of runoff and sediment yield. Additionally, the soil moisture at different depths during infiltration was observed. The results showed that the runoff generated by rainfall for all treatments was in the following order: BSC>STBU+BSC>CK>STBU. Compared with CK, the STBU promoted infiltration, and BSC and STBU+BSC inhibited infiltration. The BSCs obviously inhibited infiltration at a depth of 8 cm. As the soil depth increased to 16 cm and 24 cm, the effects of STBU on promoting infiltration were stronger than those of BSC on inhibiting infiltration. Compared with the CK, the flow velocity for the BSC, STBU and STBU + BSC treatments was reduced by 62.79%, 32.27% and 68.29%, respectively. The BSC and STBU increased the critical shear stress by increasing the resistance. Additionally, the BSC, STBU and STBU+BSC treatments reduced the sediment yield rate by 80.8%, 99.8% and 99.9%, respectively. The soil erosion process was dominated by the soil detachment capacity in the CK, BSC and STBU+BSC treatments, while the STBU treatment showed a transport-limited process. This study provided a scientific basis for the reasonable spatial allocation of vegetation in arid and semiarid areas and provided a scientific basis for the correction of vegetation cover factors in soil erosion prediction models.
Trivariate probabilistic assessments of the compound flooding events using Semiparame...
Shahid Latif
Slobodan  Simonovic

Shahid Latif

and 1 more

June 11, 2022
Flooding in coastal areas can result from the joint occurrence of multiple individual flood variables, resulting in compound flooding (CF) events. Individual variables may not be extreme but can result in a severe coastal impact if they occur in close succession or simultaneous. Bivariate joint distribution analysis is ineffective in assessing the likelihood of joint occurrence, thus demanding a more advanced higher dimensional probability framework. Incorporating higher dimensional joint simulation via traditional symmetric 3-D Archimedean or Elliptical copulas has statistical limits and would be incapable of preserving all lower-level dependencies. The heterogeneous dependency in hydrologic consequences can be modelled effectively via the fully nested Archimedean (FNA) copulas. Incorporating FNA under parametric distribution settings is not flexible enough since it is restricted by the prior distributional assumption of the function type for both its marginal density functions and copulas in parametric fittings. This study introduces a multivariate FNA copula under semiparametric distribution settings. The presented approach is based on relaxing the modelling of univariate marginal behaviour without any distributional assumption via the nonparametric kernel density estimation (KDE). The univariate marginal distribution of all the flood characteristics is constructed via normal KDE. The performance of FNA with nonparametric marginals outperforms the FNA copula built under parametric settings. The derived semiparametric FNA is applied to a case study in compounding the joint impact of rainfall, storm surge and river discharge observations on the west coast of Canada. The presented copula-based joint modelling is employed in multivariate analysis of flood risks in trivariate primary joint and conditional joint return periods. The trivariate hydrologic risk associated with compound events is analyzed using the failure probability (FP) statistics. Investigation reveals that trivariate hydrologic events produce a higher failure probability than bivariate (or univariate) events; neglecting trivariate joint analysis would underestimate FP. Also, it indicates that trivariate hydrologic risk values would increase with an increase in service time of the hydraulic facilities.
Use of geostatistical models to evaluate landscape and stream network controls on pos...
Allison E. Rhea
Tim Covino

Allison E. Rhea

and 3 more

June 11, 2022
Forested watersheds provide many ecosystem services that have become increasingly threatened by wildfire. Stream nitrate (NO 3 -) concentrations often increase following wildfire and can remain elevated for decades. We investigated the drivers of persistent elevated stream NO 3 - in nine watersheds that were burned to varying degrees 16 years prior by the Hayman fire, Colorado, USA. We evaluated the ability of multiple linear regression and spatial stream network modeling approaches to predict observed concentrations of the biologically active solute NO 3 - and the conservative solute sodium (Na +). Specifically, we quantified the degree to which landscape and stream network characteristics predict stream solute concentrations. No landscape variables were strong predictors of stream Na +. Rather, stream Na + variability was largely attributed to flow-connected spatial autocorrelation, indicating that downstream hydrologic transport was the primary driver of spatially distributed Na + concentrations. In contrast, vegetation cover, measured as mean normalized differenced moisture index (NDMI), was the strongest predictor of spatially distributed stream NO 3 - concentrations. Furthermore, stream NO 3 - concentrations had weak flow-connected spatial autocorrelation and high spatial variability. This pattern is likely the result of spatially heterogeneous wildfire behavior that leaves intact forest patches interspersed with high burn severity patches that are dominated by shrubs and grasses. Post-fire vegetation also interacts with watershed structure to influence stream NO 3 - patterns. For example, severely burned convergent hillslopes in headwaters positions were associated with the highest stream NO 3 ‑ concentrations due to the high proportional influence of hillslope water in these locations. Our findings suggest that reforestation is critical for the recovery of stream NO 3 - concentrations to pre-fire levels and targeted planting in severely burned convergent hillslopes in headwater positions will likely have a large impact on stream NO 3 - concentrations.
Effect of gene polymorphisms of multidrug resistance gene 1 and cytochrome P450 3A4 o...
YUAN GAO
JIE DENG

YUAN GAO

and 7 more

June 11, 2022
Objectives: We aim to exploring the association among the gene polymorphisms of multidrug resistance gene 1 (MDR1) and cytochrome P450 3A4 (CYP3A4), the blood concentration of mifepristone and the outcomes of mifepristone in medicine abortion, in order to developing an individualized treatment of mifepristone. Methods: 126 patients of medicine abortion were enrolled, which received a regimen of mifepristone and misoprostol. The blood concentration of mifepristone and monodemethyl-mifepristone was detected by LC-MS/MS analysis. Polymorphisms of MDR1 3435C>T, 1236C>T, 2677G>T/A and CYP3A4*1G were genotyped by MassARRAY technology. Results: The patients in successful outcome group have a higher blood concentration of both mifepristone and monodemethyl-mifepristone than that in failed outcome patients (P = 0.031 and 0.012, respectively). Meanwhile, there was a relationship between the C/D ratio of mifepristone, monodemethyl-mifepristone and the efficacy of mifepristone (P = 0.040 and 0.017, respectively). In addition, the occurrence of adverse reaction of mifepristone was associated with a higher blood concentration of mifepristone as well as C/D ratio of mifepristone (P = 0.010 and 0.008, respectively). MDR1 G2677T/A was linked with the C/D ratio of mifepristone and monodemethyl-mifepristone (P = 0.012 and 0.004, respectively), as well as the efficacy and adverse reaction of mifepristone (P = 0.042 and 0.001, respectively). CYP3A4*1G genotype was related with a lower blood concentration of mifepristone (P = 0.012). Conclusion: The blood concentration of mifepristone and monodemethyl-mifepristone and MDR1 2677G>T/A could be a reliable indicator in a successful outcome of mifepristone for medicine abortion and the occurrence of adverse reaction.
Metformin and outcomes in COVID-19 infection: an electronic cohort study from Wales,...
James Coulson
Mike Seaborne

James Coulson

and 4 more

June 11, 2022
There is considerable interest in repurposing metformin as an adjunctive therapy in the treatment of SARS-CoV-2 infection, COVID-19. The efficacy, optimum dose and relevant target-population are, however, undefined. This study used data from the Secure Anonymised Information Linkage (SAIL) Databank to test the hypothesis that COVID-19 outcomes, in terms of hospital admissions or death, were lower in adults with prescribed metformin compared with those not prescribed metformin. 10,247 patient records were identified, of which 2,123 (21%) were prescribed metformin. In those who were either admitted or died within 14 days of a positive COVID-19 result, the mean time to admission (or death) was comparable in both the metformin and metformin groups at 5.3 days (CI95% 5.0-5.7) and 5.7 days (CI95% 5.5-5.9), respectively. There is no evidence from this study that metformin is associated with any benefit to those who contract COVID-19 in the community if they are already prescribed metformin.
Gully Recognition and Spatial-temporal Evolution Law of Gully Based on SegNet Model
Boyang Liu
Biao Zhang

Boyang Liu

and 6 more

June 11, 2022
Gully erosion is one of the main modes of slope erosion on the Loess Plateau, which plays a connecting role in the slope gully erosion system. The Loess Plateau has wide and densely distributed gullies. The study selected a typical small watershed in the hilly and gully region of the Loess Plateau to measure the morphological characteristics and spatial-temporal distribution of gullies. A deep learning image semantic segmentation model was used to identify and extract the morphological features of gullies at the watershed scale from 2009 to 2021 based on remote sensing images (0.5 m resolution) and then analyze their temporal and spatial distribution characteristics. The results revealed that: (1) most gullies occurred in the hilly southern parts of the watershed, which has complex landforms and large slope gradients; (2) gully number increased from 1,159 in 2009 to 2,312 in 2021 (average 97 per year), with a frequency development rate of 2.87 km –2 y –1; (3) gully length generally ranged from 25–40 m, with an average growth rate is 1.66 m y –1 and density development rate of 0.12 km km –2 y –1; (4) gully width ranged from 0.5–1.5 m, with an average growth rate of 0.04 m y –1. (5) the total gully area increased from 0.0566 km² in 2009 to 0.1072 km² in 2021, with a development rate of 4,213.39 m² y –1 and dissection degree development rate of 0.0125% y –1. This study provides a theoretical and scientific basis for gully erosion control and eco-environmental protection at the watershed scale on the Loess Plateau.
High-lipid treatment regulates atherosclerotic development and aortic endothelial cel...
Chao Liu
Hongliang Cong

Chao Liu

and 2 more

June 11, 2022
Background:Endothelial cell apoptosis plays an important role in the progression of atherosclerosis. Oxidized low density lipoprotein (Ox-LDL) induces endothelial cell apoptosis through multiple signaling pathways. We investigated the role of FOXO3 activation in the development of atherosclerosis and ox-LDL induced mouse aortic endothelial cell (MAEC) apoptosis. Methods: In vivo, ApoE-/- mice atherosclerosis model was induced by high fat feeding and the FOXO3 expression in aorta endothelium were measured by IHC. In vitro,MAECs were induced with ox-LDL to establish an atherosclerosis model. The cell viability and apoptosis were measured by MTT and Hoechst 33342 staining. The FOXO3 expression was measured by Q-PCR. Then we constructed two plasmids: the interference vector for FOXO3 and the expression vector for FOXO3. The effects of the two plasmids on MAECs were evaluated. Results: The results of in vivo experiments showed that FOXO3 activation in mouse aortic endothelium was associated with atherosclerosis (ApoE −/− mice model of atherosclerosis). Furthermore, ox-LDL triggers MAEC apoptosis. FOXO3 activation was associated with Ox-LDL-induced MAEC apoptosis. RNA interference-mediated reduction of FOXO3 expression blunted Ox-LDL-induced MAEC apoptosis. In contrast, overexpression of FOXO3 promoted Ox-LDL-induced MAEC apoptosis. Conclusions: FOXO3 activation is therefore involved in the development of atherosclerosis and MAEC apoptosis.
Risk of skin erosion and local pocket infections in population of patients with cardi...
Anna Polewczyk
Wojciech Jacheć

Anna Polewczyk

and 2 more

June 11, 2022
The thinning of the skin over the pocket is an occasional phenomenon in patients with cardiac implantable electronic devices (CIEDs) most often associated with the technique of implantation of the device. It is likely that the thinning of the skin over the generator is a risk factor for the development of infectious complications in patients with CIED. Analysis of large database of 3706 patients undergoing transvenous lead extraction (TLE) showed higher number of points of PADIT score and more often previous pocket plastic surgery in patients with too shallow pocket. Most likely, diagnosing only a too shallow CIED pocket is often an early symptom of infection.
Marsupialization of a Large Dentigerous Cyst In The Mandible: A Case Report
Ali Mahfuri
Khaldoun Darwich

Ali Mahfuri

and 2 more

June 11, 2022
Dentigerous cysts are the most common developmental odontogenic cyst in the jaws , they are usually asymptomatic and associated with the crown of an unerupted or impacted tooth , This case report expresses the importance of conservative treatment of large oral cysts (by marsupialization) in the preservation of jaw bones.
Contributing factors on metabolic mechanism-based CYP3A4-activated/deactivated antica...
Fengling Wang
Xue Zhang

Fengling Wang

and 5 more

June 11, 2022
Cytochrome P450 3A4 (CYP3A4), one of important members of the cytochrome P450 subfamily, acts as a critical catalyst for multiple drug metabolism. Pharmacological activities and clinical outcomes of CYP3A4-metabolized anticancer drugs greatly depend on this enzyme activity and expression, as it catalyzes a variety of reactions for drug activation or inactivation. In view of the complex tumor environments as well as various factors concerning CYP3A4 expression, function, and regulation such as physiological factors, disease complications, concomitant drugs, inflammation response and gene polymorphisms, the pharmacokinetics of most anticancer drugs are influenced by the degree of induction or inhibition CYP3A4 mediated metabolism. This inter-individual variability, together with the narrow therapeutic index of most anticancer drugs, therefore have important implications for achieving the expected efficacy and minimized toxicity from cancer chemotherapy in individuals. Goals of the review were to outline and discuss significant underlying factors that contribute to differences in drug metabolism in detail, including the expression, activity regulation and genotype of CYP3A4 in tumor tissues. The purpose is to highlight the clinically meaningful of CYP3A4 induction or inhibition for metabolic activation/inactivation-based cancer therapy. Assessing inter-individual variability of metabolic activity from multiple dimensions will facilitate the development of robust pharmacokinetics modeling approaches that may predict an individual’s CYP3A4-activated/deactivated drug metabolizing capacity and drug response, thereby selecting optimal treatment regimens.
Trapping of betanin in alginate microcapsules: Stability studies under accelerated co...
Ebru Kurtulbaş
İrem Toprakçı

Ebru Kurtulbaş

and 2 more

June 11, 2022
Microcapsules including red beet extract rich in betanin was produced by ionic gelation. Sodium alginate was used as wall material. Impacts of coating amount and active material were assessed with respect to encapsulation efficiency (EE) of the capsules in terms of total phenolic content (TPC). Encapsulation of the red beet extract in alginate microbeads was satisfying with >80% under the best conditions of ionic gelation (15% calcium chloride concentration and 2% sodium alginate for 15 min of hardening time). The interaction between the active material and the alginate beads were also investigated by diffuse reflectance fourier transform (DRIFT) spectroscopy. Accelerated oxidation test was employed to measure the stability of the microcapsules against oxidation by means of Rancimat method. Stability of the produced microbeads were evaluated in terms of kinetic and thermodynamic analyzes. After the induction times were determined under different temperature conditions (110, 120, 130 and 140 ºC) by Rancimat test, kinetic and thermodynamic parameters of the product were analyzed. The findings (∆H ++>0, ∆S ++<0, and ∆G ++ >0) indicates that low entropy value is attributed to more stable microbeads with less energy (<40 kJ mol -1).
Identification of three novel variants in the UGT1A1 gene as a cause of Crigler-Najja...
Mohammad Javad Ghorbani
Seyed Mohsen Dehghani

Mohammad Javad Ghorbani

and 1 more

June 11, 2022
Crigler-Najjar syndrome type I (CN-I) is a rare inherited disorder with a frequency of one per million at birth. Patients with CN-I have severe hyperbilirubinemia and usually die due to kernicterus. CN-I occurs due to variants within the UGT1A1 gene. The present study aimed to identify genetic defects underlying CN-I.
New frontiers in CRISPR/Cas9 delivery systems delivery for gene editing
Kazem Khoshaman
Mahbobeh  Nasiri

Kazem Khoshaman

and 16 more

June 11, 2022
Since its discovery in early 1980s to date, our knowledge about CRISPR has evoloved so much. CRISPR/Cas system confers the immunization ability against phages to the bacteria and is comprised of three stages: acquisition, biogenesis, and interference. It was first in 2012 when Charpentier and Doudna proposed Cas9 enzyme as a novel gene editing tool. They opened a new gate on the way of gene editing which led to new discoveries as well as novel treatments for diseases. It must be taken into consideration that the delivery of CRISPR/Cas9 remains a great barrier on the way of mass clinical exploition. The delivery of CRISPR/Cas9 requires a cargo and a vehicle. There are three types of cargos: plasmids, mRNAs, and enzymes. There two main types of vehicles as well: viral and non-viral. Non-viral delivery can be subdivided into physical and various nanoparticle mediated delivery. In this systematic review, we aimed to give an overall insight to the all delivery methods used for the delivery of CRISPR/Cas9 used for gene editing both in-vitro and in-vivo. We conducted a thorough search from two databases: Medline and scopus. After the screening Process we found 77 eligible papers and the results are illustrated in table 1,2, and 3.
To guard the rhythm of the heart: Constructing a wall of ice with surgical endocardia...
Dimitris Tsiachris
Antonis Pitsis

Dimitris Tsiachris

and 4 more

June 11, 2022
Surgical atrial fibrillation (AF) ablation is a valid option in cases of concomitant cardiac surgery. Electroanatomical mapping before and after the procedure can assess the substrate and verify durable lesion formation. It is likely that a routine combined cardiosurgical and electrophysiological approach may yield the greatest benefit for such patients.
On certain class of IFSs and their attractors
Nicolae Adrian Secelean
Dariusz Wardowski

Nicolae Adrian Secelean

and 1 more

June 11, 2022
Our purpose in this paper is to consider a new class of iterated function systems (IFS) based on the concept of orbital condition introduced by R. Miculescu et al. (Iterated function systems consisting of continuous functions satisfying Banach’s orbital condition, Analele Universităt¸ii de Vest, Timi¸soara, Seria Matematică-Informatică LVI, 2, (2018),71-80). On the given IFS there are imposed some sufficient conditions guaranteeing the existence of an attractor. There are also established some further results which describe the nature of the attractors of the considered type. The introduced theory is supported by some examples of IFSs for which the attractors are also depicted.
The presentation of nephrotic syndrome during immunosuppressive treatment for aplasti...
Masato Yanagi
Ryoji Kobayashi

Masato Yanagi

and 6 more

June 11, 2022
Most cases of aplastic anemia (AA) complicated by nephrotic syndrome (NS) have been reported to be the effects of chronic graft-versus-host disease after hematopoietic stem cell transplantation (HSCT). We describe a 16-year-old boy with AA with monosomy 7 who developed NS during immunosuppressive treatment for AA alone without HSCT. Recently, there appeared a report of MIRAGE syndrome caused by gain-of-function mutation of SAMD9 gene on chromosome 7 who developed NS. No such mutation was detected in our patient and thus the genetic factors leading to the complication of two diseases remain unknown at this time.
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