bluuebunny/crossref_metadata_2025 huggingface dataset:
Whole Breast Sound Speed Measurement from US Tomography Correlates Strongly with Volumetric Breast Density from Mammography
Authors: Sak Mark , Littrup Peter , Brem Rachel , Duric Neb
Published: July 2020

Objective

To assess the feasibility of using tissue sound speed as a quantitative marker of breast density.

Methods

This study was carried out under an Institutional Review Board–approved protocol (written consent required). Imaging data were selected retrospectively based on the availability of US tomography (UST) exams, screening mammograms with volumetric breast density data, patient age of 18 to 80 years, and weight less than 300 lbs. Sound speed images from the UST exams were used to measure the volume of dense tissue, the volume averaged sound speed (VASS), and the percent of high sound speed tissue (PHSST). The mammographic breast density and volume of dense tissue were estimated with three-dimensional (3D) software. Differences in volumes were assessed with paired t-tests. Spearman correlation coefficients were calculated to determine the strength of the correlations between the mammographic and UST assessments of breast density.

Results

A total of 100 UST and 3D mammographic data sets met the selection criteria. The resulting measurements showed that UST measured a more than 2-fold larger volume of dense tissue compared to mammography. The differences were statistically significant (P < 0.001). A strong correlation of rS = 0.85 (95% CI: 0.79–0.90) between 3D mammographic breast density (BD) and the VASS was noted. This correlation is significantly stronger than those reported in previous two-dimensional studies (rS = 0.85 vs rS = 0.71). A similar correlation was found for PHSST and mammographic BD with rS = 0.86 (95% CI: 0.80–0.90).

Conclusion

The strong correlations between UST parameters and 3D mammographic BD suggest that breast sound speed should be further studied as a potential new marker for inclusion in clinical risk models.
Effects of Food Bait and Trap Type on Captures ofRhynchophorus palmarum(Coleoptera: Curculionidae) and Trap Bycatch in Southern California
Authors: Milosavljević Ivan , Hoddle Christina D , Mafra-Neto Agenor , Gómez-Marco Francesc , Hoddle Mark S
Published: July 2020

Rhynchophorus palmarum (L.) is an invasive pest responsible for killing thousands of ornamental Canary Islands date palms (Phoenix canariensis Chabaud) in San Diego County, CA. Two field experiments were conducted to compare the attractiveness of six different baits and two trap types. The tested baits were dates + water; dates + water + Saccharomyces cerevisiae; dates + water + S. bayanus; dates + water + S. pastorianus; 15% sugarcane molasses water solution mixed with 3% paraffinic oil, and a no bait control treatment. The two traps tested were white bucket traps (hanging 1.5 m above the ground and set on the ground) and black cone shaped Picusan traps (set on ground only). All traps were loaded with commercially available R. palmarum aggregation pheromone and the synergist ethyl acetate. Differences in weevil capture rates were observed across bait and trap types. Weevil captures were almost five times greater in Picusan traps compared to bucket traps that were hanging or placed on the ground. Adding dates and water alone or combined with S. cerevisiae to traps increased weevil captures compared to other baits and controls. Trap and bait types affected bycatch of nontarget arthropod species. In general, spiders, earwigs, and carabid beetles were most commonly recovered from Picusan traps, regardless of bait type. Scarab beetles, moths, and flies were found more frequently in bucket traps baited with molasses or dates mixed with S. bayanus. No effects of bait and trap type were associated with bycatch species richness.
Making the WTO (Not So) Great Again: The Case Against Responding to the Trump Trade Agenda Through Reform of WTO Rules on Subsidies and State Enterprises
Authors: Howse Robert
Published: July 2020

A range of WTO scholars, policy experts, and governmental officials have bought into the notion that the Trump Administration’s unilateralism and its assault on China’s trade policies and practices could and should be channeled instead into WTO reform efforts. While dealing with China through unilateral tariff hikes and more recently a bilateral phase I agreement, the notion of addressing some concerns through WTO reform has not fallen entirely on a deaf ear in the Administration. Thus, Japan and the EU have been able to engage the Administration in an initiative to revise and add new WTO rules in the areas of subsidies, state enterprises, and forced technology transfer. This article offers a critical assessment of this initiative, arguing that by and large the proposed changes will add incoherence to existing WTO rules and make it more difficult for WTO Members to engage in economic and industrial policies that are needed, for example, to the address the economic consequences of the COVID-19 pandemic.
Waveforms From Stylet Probing of the Mosquito Aedes aegypti (Diptera: Culicidae) Measured by AC–DC Electropenetrography
Authors: Wayadande Astri C , Backus Elaine A , Noden Bruce H , Ebert Timothy
Published: July 2020

Electropenetrography (EPG) has been used for many years to visualize unseen stylet probing behaviors of plant-feeding piercing–sucking insects, primarily hemipterans. Yet, EPG has not been extensively used with blood-feeding insects. In this study, an AC–DC electropenetrograph with variable input resistors (Ri), i.e., amplifier sensitivities, was used to construct a waveform library for the mosquito arbovirus vector, Aedes aegypti (Linneaus), while feeding on human hands. EPG waveforms representing feeding activities were: 1) electrically characterized, 2) defined by visual observation of biological activities, 3) analyzed for differences in appearance by Ri level and type of applied signal (AC or DC), and 4) quantified. Electrical origins of waveforms were identified from five different Ri levels and AC versus DC. Mosquitoes produced short stylet probes (‘bites’) that typically contained five waveform families. Behaviors occurred in the following order: surface salivation (waveform family J), stylet penetration through the outer skin (K), penetration of deeper tissues and location of blood vessels/pathway activities (L), active ingestion with engorgement (M), and an unknown behavior that terminated the probe (N). Only K, L, and M were performed by every insect. A kinetogram of conditional probabilities for waveform performance demonstrated plasticity among individuals in L and M, which were alternated. Now that EPG waveforms for mosquito feeding have been defined, EPG can be used as a tool for improved biological understanding of mosquito-borne diseases.
Amyand’s hernia in a 5-year-old child: a case report and literature review
Authors: Khanal Bhawani , Agrawal Sunit , Gurung Roshan , Sah Suresh , Gupta Rakesh Kumar
Published: July 2020

Amyand’s hernia in a child is a very rare entity. It poses a diagnostic challenge to the surgeon due to its variety of presentation. We are presenting a case of a 5-year-old child who presented to our institute with right-sided irreducible inguinal hernia. On exploration, the content of the hernia was caecum with normal appendix for which herniotomy with appendectomy was done.
757. Impact of a Sepsis Improvement Team with Prospective Audit and Feedback on SEP-1 Core Measure Adherence in an Urban Community Hospital
Authors: Mena Lora Alfredo J , Sim Sue , Spencer Sherrie , Coleman Yolanda , Krill Candice , Takhsh Eden , Bleasdale Susan C
Published: July 2020

Background

Adherence to the CMS sepsis core measure (SEP-1) has been a challenge for facilities nationwide. Checklists, electronic medical record (EMR) alerts and order sets have been shown to improve compliance. We implemented a comprehensive SEP-1 guideline with order sets, checklists and EMR alerts at an urban community hospital. Subsequently, a SEP-1 improvement team with an infectious disease physician and a nurse led a prospective audit and feedback (PAF) program to help improve adherence and reduce errors. We seek to understand the impact of PAF on SEP-1 compliance.

Methods

Quasi-experimental pre- and post-intervention study of SEP-1 compliance at a 151-bed urban community hospital from January 2015 to December 2018. PAF intervention was started on July 2017. Cases were reviewed, SEP-1 failures identified, and feedback given to nurses and clinicians involved within 48 hours of admission. Gaps in adherence are identified, education given, and corrective actions taken. SEP-1 adherence before and after PAF implementation was reviewed.

Results

A total of 307 cases met the SEP-1 inclusion criteria. PAF was successfully implemented. There were 169 SEP-1 cases before and 138 after implementation of PAF. The success rate increased from 44% to 52% with PAF (Figure 1). The most common reasons for failure were initial and repeat lactic acid on both groups (Figure 2).

Conclusion

Prospective audit and feedback for SEP-1 improved compliance rates at our facility. Prospective audit can help identify core measure failures early and provide immediate feedback to clinicians, nurses and laboratory personnel. Immediate feedback by the SEP-1 improvement team may help increase SEP-1 awareness, strengthen existing protocols and promote a culture of safety. SEP-1 is a complex core measure that may transition to pay-for-performance. An ID physician-led SEP-1 improvement team with PAF may be an area for future value-based care opportunities for ID physicians.

Disclosures

All authors: No reported disclosures.
Site Preparation and Phosphorus Application Alter Early Growth of Loblolly Pine
Authors: Wilhite L. P. , McKee W. H.
Published: July 2020

Loblolly pine (Pinus taeda) was grown on three sites with a series of site preparation treatments and differential applications of herbicide to determine the impact of site preparation on early growth and nutrition of trees without the interaction of woody competition. The study sites were poorly, somewhat poorly, and moderately well-drained soils of the lower Atlantic Coastal Plain in South Carolina. One year after planting, treatments of no fertilizer, phosphorus, potassium, and phosphorus plus potassium were applied to each site preparation plot. Five years after planting, the tallest pines (12 to 15 feet) were on plots that had received the most expensive and most intensive treatment (bedding, phosphorus fertilizer, and a small amount of herbicide), but growth was good (10 to 13 feet) on plots that had received the least expensive and least intensive treatment as well (preparation with hand tools, no fertilizer, and a larger amount of herbicide). Growth was poorest (7 to 10 feet) on plots that had been rootraked and had received a medium amount of herbicide. Foliar nutrient data also indicated that rootraking was site degrading.
Eucalyptus for Low Elevation Foothill Plantations in California
Authors: LeBlanc John W. , Hasey Janine K. , Standiford Richard B. , Connor Mike , Sachs Roy M.
Published: July 2020

In March 1984 we established a test plantation of selected Eucalyptus and poplar seedlings species and clones on a range site in the Sierra Nevada foothills. The main objectives were to evaluate survival and growth of the various species and clones and to determine a rotation age for intensively managed hardwood trees grown under low elevation foothill conditions. Seedlings and clones of six species of Eucalyptus and one hybrid poplar were grown with short rotation intensive culture techniques for 7 yr. Rotation age, defined as the culmination of mean annual increment, varied from 3 to 6 yr. The best producing clone produced 8 cords of fuelwood per acre per year. The potential for damage from freezing and snow at these elevations is also discussed. West. J. Appl. For. 12(4):104-107.
Understanding underactive bladder: a review of the contemporary literature
Authors: Santos-Pereira Mariana , Charrua Ana
Published: July 2020

Underactive bladder (UAB) is characterized by prolonged voiding, hesitancy, and slow and/or intermittent stream with or without a sensation of incomplete bladder emptying. The overlap of UAB lower urinary tract symptoms with those of overactive bladder or bladder outlet obstruction, as well as its multifactorial etiology, make UAB study, as well as its diagnosis and management, a very arduous and challenging task. Therefore, despite its incidence and significant impact in the quality of life of both men and women, UAB remains a poorly understood urologic condition with insufficient and ineffective treatment options available. In this review, we will focus on the etiology theories that have been proposed and the animal models available to test those theories.
The Role of the Gut Microbiota in the Prevention and Management of Gestational Diabetes Mellitus
Authors: Man Bernice , Koenig Mary Dawn , Bernabe Beatriz Penalver , Nagelli Unnathi , Tussing-Humphreys Lisa
Published: July 2020

Current nonpharmacological approaches, including diet and exercise interventions, for preventing and treating gestational diabetes mellitus are effective for less than 50% of women. Recent evidence suggests that the gut microbiome is integrally involved in maternal glucose homeostasis. Changes to the composition and metabolic behavior of the gut microbiota may play a role in the development and persistence of gestational diabetes mellitus. Thus, there is growing interest in targeting the maternal gut microbiome for preventing and managing pregnancy-related diseases including gestational diabetes mellitus. Future progress may come from a systems biology approach to elucidate the role of the gut microbiota in maternal glucose homeostasis.
Effects of different dosages of Sodium-Glucose Transporter 2 Inhibitors on lipid levels in patients with type 2 diabetes mellitus
Authors: Cai Tingyu , Gao Yang , Zhang Li , Yang Ting , Chen Qiu
Published: July 2020

Background:

Type 2 diabetes mellitus is one of the most common chronic diseases, which endangers peoples health and life qualities. Sodium-Glucose Transporter 2 (SGLT2) inhibitors have been widely recognized since their clinical application in blood glucose control. While, dyslipidemia caused by SGLT2 inhibitors has been identified that affected the prognosis of this disease.

Methods:

We will retrieve 8 databases including English and Chinese. After multiple screening, all randomized controlled trials (RCTs) related to SGLT2 inhibitors will be included by the 2 authors and data will be extracted. After completion of the risk of bias assessment, we will use these effect values including risk ratio (RR), weighted mean difference (WMD) and 95% confidence interval (CI) to conduct data analysis. Chi-Squared test and I
2 test will be used to assess heterogeneity between studies. The robustness of meta-analysis results will be determined by sensitivity analysis. It will be assessed that evidence quality of the outcomes on the GRADE.

Results:

The results of our research will be published in a peer-reviewed journal.

Conclusion:

The purpose of this systematic review and meta-analysis is to evaluate the association and degree of association between different doses of SGLT2 inhibitors and changes on blood lipid levels in patients with type 2 diabetes mellitus, in order to provide a reliable basis for clinical medication.

INPLASY registration number:

INPLASY202040201.
Methodology of dose calculation for external beam radiation combined with high dose rate brachytherapy in the era of 3-dimensional treatment planning system
Authors: Wang Fangzheng , Jiang Chuner , Liu Tongxin , Sun Quanquan , Ye Zhimin , Shi Kaiyuan , Wu Peng , Qin Weifeng , Fu Zhenfu , Jiang Yangming
Published: July 2020

Intracavitary application of brachytherapy (BT) sources followed by external beam radiation is essential for the local treatment of carcinoma of the cervix, postate, and nasopharynx. Dose distribution of external beam radiation plus BT can be challenging for the planning system because of their dose calculation by 2 different treatment planning system (TPS). The aims of this study were to introduce a novel iterative method of dose calculation preformed in the Pinnacle plan and evaluate a combined dose distribution for external beam radiation and BT.

Because it is often the goal of the planner to produce plan with uniform dose throughout the target volume and normal tissue, we present an Iridium-192 calculation program using American Association of Physicists in Medicine Task Group 43 formula and export it to other commercialized TPS though the combined dose distribution of external beam radiation and BT can be shown. To illustrate such an improved procedure, we present the treatment plans of 2 patients treated with external beam radiation plus BT.

Dose distribution of the single BT source were calculated with the Plato post loading TPS and the program model, and the results of 2 methods were similar. A nasopharyngeal case and a cervical case were shown in Pinnacle with this program. The total dose distribution of BT combined with EBRT was showed in compute tomography images. And the corresponding dose volume histogram figures could be displayed correctly in Pinnacle TPS.

We demonstrated a novel iterative method of dose calculation preformed in the Pinnacle plan to produce a combined dose distribution for external beam radiation and BT. We used it to evaluate the dose of target volume and normal tissues in the treatment of external beam radiation plus BT.
Synchronous primary pulmonary adenocarcinoma and extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue
Authors: Sun Lixia , Zhang Bing , Xuan Ke , Qi Li , Wang Jingjing , Li Quan , Liu Jianwei , Wang Yubo , Sun Liping , Li Xiaomei , Ji Hong
Published: July 2020

Rationale:

Synchronous pulmonary lymphoma and carcinoma is relatively rare. And synchronous pulmonary lymphoma and adenocarcinoma in the same site is extremely rare.

Patient concerns:

We presented a 69-year-old female with a tumor mass in right upper lung.

Diagnosis:

Pathological and immunohistochemical findings revealed lung adenocarcinoma and extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue.

Interventions:

The patient received thoracoscopic guided right upper lobectomy and focal lymph node dissection after systemic anesthesia. Besides, 6 cycles of chemotherapy were given based on meprednisone, gemcitabine and cisplatin in local hospital.

Outcomes:

In the 12-month follow-up, the patient was still alive with no local recurrence, metastasis and lymph node involvement.

Lesson:

A comprehensive literature research was performed, and 6 cases of synchronous pulmonary lymphoma and adenocarcinoma in the same site and 10 cases in different sites were identified since 2000. Most patients with synchronous pulmonary lymphoma and carcinoma were middle-aged and elderly with the median age was 64 years presenting a male predisposition. The most frequent type of primary pulmonary lymphoma was B-cell non Hodgkin lymphoma, especially mucosa-associated lymphoid tissue lymphoma, and the lung cancer is predominantly adenocarcinoma.
Kawasaki disease shock syndrome complicated with bilateral lung consolidation in a child
Authors: Song Yue , Wei Wuran , Liu Lan , Wang Yibing , Shi Xiaoqing , Li Li
Published: July 2020

Introduction:

Kawasaki disease (KD) is a systemic inflammatory disease. Standard imaging features of KD include interstitial and lobular inflammatory lesions in the lungs, while KD shock syndrome (KDSS), complicated with substantial consolidation and atelectasis in the lung, is rarely reported.

Patients concerns:

Herein, we report a single case of a 5-year-old female patient who manifested KDSS on the seventh day of the course of KD. Chest enhanced computed tomography indicated large-area consolidation in the lower lobes of the bilateral lungs.

Diagnosis:

The patient was diagnosed with KDSS complicated with non-infective lung consolidation.

Interventions:

The patient received human intravenous immunoglobulin (2 g/kg) and aspirin (30–50 mg/kg.d), methylprednisolone, a vasoactive agent, and albumin. Infective factors were excluded.

Outcomes:

The consolidation in the lower lobe of the bilateral lungs was completely recovered after 3 days of treatment.

Conclusions:

Children with KDSS may present with pulmonary lesions such as substantial consolidation and atelectasis; thus, infective factors should be excluded. If there is no etiological evidence, antibiotics should be used with caution.
Extralobar pulmonary sequestration with a complication of torsion
Authors: Yang Lei , Yang Gang
Published: July 2020

Rationale:

Pulmonary sequestration is a congenital abnormality of the lower airway. It is characterized by a nonfunctioning mass of lung tissue that lacks normal communication with the tracheobronchial tree or pulmonary arteries and always receives its arterial blood supply from the systemic circulation. Most cases of extralobar pulmonary sequestrations (ELSs) are asymptomatic and found incidentally or in prenatal ultrasound screening.

Patient concerns:

A 10-year-old boy had severe chest pain and vomiting for 2 days.

Diagnoses:

ELS was diagnosed, and torsion of the ELS had developed as a complication.

Interventions:

In video-assisted thoracoscopic surgery, the ELS was resected.

Outcomes:

The clinical symptoms were relieved the 2nd day after surgery and did not recur over a follow-up period of 3 months.

Lessons:

In young patients with sudden abdominal pain or chest pain, in whom computed tomography shows a well-defined mass of homogeneous soft-tissue density in the thorax, ELS with torsion should be suspected. The presence of a feeding artery greatly supports the diagnosis of ELS, and the absence of this classic finding may indicate torsion of the pulmonary sequestration.
Spindle cell lipoma of the larynx
Authors: Qin-ying Wang , Shui-hong Zhou , Yong-cai Liu , Hai-hong Chen
Published: July 2020

Introduction:

Lipomas are rarely found in primary mesenchymal tumors of the hypopharynx and larynx. When they do appear, they often macroscopically resemble a retention cyst or laryngeal nodule. The laryngeal spindle cell lipoma, a variant, is extremely rare.

Patient concerns:

A 65-year-old woman presented with a 3-month history of pharyngeal paraesthesia. Laryngoscopy revealed the presence of a well-encapsulated, smooth-surfaced, yellowish, pedicled mass on the left epiglottis. Magnetic resonance imaging confirmed the epiglottic mass.

Diagnosis:

Following excision of the mass, the diagnosis of an spindle cell lipoma was established and confirmed by immunohistochemistry.

Interventions:

Surgical excision of the lesion using a controlled-temperature plasma technique (coblation).

Outcomes:

At the last (4-year) follow-up evaluation, the patient was asymptomatic and without recurrence.

Conclusion:

SLC involvement of the epiglottis is rare. Coblation is an effective means to remove it.
Facial emotion recognition in adult with traumatic brain injury
Authors: Lin XiaoGuang , Zhang XueLing , Liu QinQin , Zhao PanWen , Zhang Hui , Wang HongSheng , Yi ZhongQuan
Published: July 2020

Background:

Traumatic brain injury (TBI) refers to head injuries that disrupt normal function of the brain. TBI commonly lead to a wide range of potential psychosocial functional deficits. Although psychosocial function after TBI is influenced by many factors, more and more evidence shows that social cognitive skills are critical contributors. Facial emotion recognition, one of the higher-level skills of social cognition, is the ability to perceive and recognize emotional states of others based on their facial expressions. Numerous studies have assessed facial emotion recognition performance in adult patients with TBI. However, there have been inconsistent findings. The aim of this study is to conduct a meta-analysis to characterize facial emotion recognition in adult patients with TBI.

Methods:

A systematic literature search will be performed for eligible studies published up to March 19, 2020 in three international databases (PubMed, Web of Science and Embase). The work such as article retrieval, screening, quality evaluation, data collection will be conducted by two independent researchers. Meta-analysis will be conducted using Stata 15.0 software.

Results:

This meta-analysis will provide a high-quality synthesis from existing evidence for facial emotion recognition in adult patients with TBI, and analyze the facial emotion recognition performance in different aspects (i.e., recognition of negative emotions or positive emotions or any specific basic emotion).

Conclusions:

This meta-analysis will provide evidence of facial emotion recognition performance in adult patients with TBI.

INPLASY registration number:

INPLASY202050109.
Effects of concurrent aerobic and resistance exercise in frail and pre-frail older adults
Authors: Meng Nai-Hsin , Li Chia-Ing , Liu Chiu-Shong , Lin Chih-Hsueh , Chang Chin-Kai , Chang Heng-Wei , Yang Chuan-Wei , Li Tsai-Chung , Lin Cheng-Chieh
Published: July 2020

Background:

This study aimed to investigate the effects of supervised and home-based exercise programs on older people with frailty or pre-frailty.

Methods:

A total of 146 community-dwelling participants aged 65 and older who were prefrail or frail were randomly allocated into supervised exercise (N = 74) and home exercise (N = 72) groups. The 3-month supervised exercise training consisted of 3 exercise sessions per week, was performed at a hospital and supervised by a physical therapist. Home exercise participants took instructions on exercise and illustrated exercise handouts. The baseline and 3-month follow-up measurements included body composition, strength of selected upper and lower limb muscle groups, grip and leg press strengths, and five physical performance tests. Mixed-model repeated-measures analysis was applied to determine whether two groups differ in terms of changes before and after the intervention and to compare within-group improvements.

Results:

After 3 months of supervised or home-based exercise, the average number of frailty criteria met and fat percentage decreased significantly. Strength of knee extensors, knee flexors and leg press improved significantly in supervised exercise group. In home-based exercise group, the strength of all muscle groups tested improved significantly, except for leg press strength. Walking speed improved in both groups, and timed-up-and-go and timed chair rise tests improved significantly only in supervised exercise group.

Conclusions:

Three-month supervised or home-based exercise improved walking speed and strength of the limb muscles. Supervised group showed more improvements in the physical performance tests compared with home-based exercise group.
Designing an optimal inventory management model for the blood supply chain
Authors: Ahmadimanesh Monireh , Tavakoli Ahmad , Pooya Alireza , Dehghanian Farzad
Published: July 2020

Blood supply managers in the blood supply chain have always sought to create enough reserves to increase access to different blood products and reduce the mortality rate resulting from expired blood. Managers’ adequate and timely response to their customers is considered vital due to blood perishability, uncertainty of blood demand, and the direct relationship between the availability/lack of blood supply and human life. Further to this, hospitals’ awareness of the optimal amount of requests from suppliers is vital to reducing blood return and blood loss, since the loss of blood products surely leads to high expenses. This paper aims to design an optimal management model of blood transfusion network by a synthesis of reusable simulation technique (applicable to all bases) and deep neural network (the latest neural network technique) with multiple recursive layers in the blood supply chain so that the costs of blood waste, return, and shortage can be reduced. The model was implemented on and developed for the blood transfusion network of Khorasan Razavi, which has 6 main bases active from October 2015 to October 2017. In order to validate the data, the data results of the variables examined with the real data were compared with those of the simulation, and the insignificant difference between them was investigated by t test. The solution of the model facilitated a better prediction of the amount of hospital demand, the optimal amount of safety reserves in the bases, the optimal number of hospital orders, and the optimal amount of hospital delivery. This prediction helps significantly reduce the return of blood units to bases, increase availability of inventories, and reduce costs.
Efficacy and safety of epidural steroid injection following discectomy for patients with lumbar disc herniation
Authors: Cai Jianping , Jiang Wei , Qiu Beiming , Song Yuguang
Published: July 2020

Background:

Concerns exist regarding the analgesia effect and safety of epidural steroid injection (ESI) after discectomy. There is an urgent need of studies that efficiently control for confounding, conduct comprehensive and consecutive observation of potential risks of ESI, and investigate its clinical applicability. We thus further designed a randomized controlled study to assess the efficacy of ESI on postoperative pain and complications in patients undergoing unilateral lumbar microdiscectomy.

Methods:

This prospective, blinded randomized controlled trial was conducted at our single hospital. This study was approved by the Committee at the No.2 People's Hospital of Yibin. All procedures were performed by a single surgeon and informed consent was obtained from each patient. Ninty eligible patients diagnosed at our institution with herniated lumbar disc during a period from June 2020 to July 2021 will be assessed. Group 1 was a mixture of 1 mL of 0.5% bupivacaine and 10 mg of triamcinolone acetonide in 1 mL. Group 2 was a mixture of 1 mL of 0.5% bupivacaine and 1 mL of normal saline. The primary outcome measure was the amount of morphine consumption from a patient-controlled analgesia pump at 12, 24, and 48 hours after surgery. The following secondary outcomes were also assessed: postoperative pain score, back pain score, functional disability, and adverse effect.

Conclusions:

We hypothesized that the ESI was associated with lower pain score, morphine consumption, and hospital stay, with no significant difference in complications for ESI application after lumbar discectomy in lumbar disc herniation when compared with placebo.

Trial registration:

This study protocol was registered in Research Registry (researchregistry5683).
A protocol of systematic review and meta-analysis of narrow band imaging endoscopy in detection of early gastric cancer
Authors: Liu Xiao-yu , Zhang Jun
Published: July 2020

Background:

Although previous studies have utilized narrow band imaging endoscopy diagnosis (NBIED) in detection of patients with early gastric cancer (EGC), there are still inconsistent results. Thus, this study will explore the accuracy of NBIED in detection of patients with EGC.

Methods:

We propose to perform literature search of potential studies investigating the accuracy of NBIED in detection of patients with EGC in MEDLINE, EMBASE, Cochrane Library, Web of Science, WANGFANG, VIP database and China National Knowledge Infrastructure from the beginning of each database to January 31, 2020 without restrictions to language and publication time. Two authors will independently scrutinize these databases to identify studies that satisfy all predefined eligibility criteria. We will check study quality and analyze outcome data using Quality Assessment of Diagnostic Accuracy Studies tool, and RevMan 5.3 software respectively.

Results:

We anticipate the results of this study will afford additional insight into the appraising of the accuracy of NBIED in patients with EGC.

Conclusion:

The findings of this study will be useful informing diagnostic decisions for the diagnosis of patients with EGC.

PROSPERO registration number: PROSPERO CRD42020171053.
Factors associated with clearance of hepatitis B virus surface antigen in patients infected with human immunodeficiency virus
Authors: Tsutsumi Takeya , Sato Hidenori , Kikuchi Tadashi , Ikeuchi Kazuhiko , Lim Lay Ahyoung , Adachi Eisuke , Koga Michiko , Okushin Kazuya , Kawahara Takuya , Koibuchi Tomohiko , Yotsuyanagi Hiroshi
Published: July 2020

Owing to similar routes of transmission, hepatitis B virus (HBV) and human immunodeficiency virus (HIV) coinfection commonly occurs. Compared with patients infected with only HBV, coinfected patients develop persistent HBV infection followed by advanced liver diseases. However, the characteristics of HIV-infected patients who can achieve the clearance of HBV surface antigen (HBsAg) have not been clarified. In this study, we retrospectively examined patients coinfected with HBV and HIV and determined the host factors associated with HBsAg clearance.

Among HIV-infected patients who visited our hospital between 1994 and 2017, we examined medical records of those who were seropositive for HBsAg at least once. Among them, patients who cleared HBsAg afterward were regarded as “cured,” while those who remained HBsAg-seropositive until 2017 were “chronic.”

HBsAg seropositivity was found in 57 patients, and among them, 27 male patients were cured whereas 18 were chronic. The cured patients were significantly younger and had higher CD4 cell and platelet counts than the chronic patients. In addition, the cured patients had higher levels of transaminases after the detection of HBsAg. Multivariate analysis revealed age as an independent factor. Analyses of the patients infected with genotype A also showed that the cured patients had significantly higher CD4 cell counts.

Considering that the CD4 cell and platelet counts were higher in the cured patients, immunological and liver functions were closely associated with HBsAg clearance. Higher levels of transaminases in the cured patients may also reflect the immunological function leading to HBsAg clearance.
Infective endocarditis mimicking ANCA-associated vasculitis: does it require immunosuppressive therapy?
Authors: Shi Xiao-dong , Li Wan-yu , Shao Xue , Qu Li-mei , Jiang Zhen-yu
Published: July 2020

Rationale:

In the course of endocarditis, the development of antineutrophil cytoplasmic antibody (ANCA)-mediated disease introduces the dilemma of determining the best treatment approach for immune conditions, whether immunosuppressant therapy should be added to antibiotic treatment has remained controversial.

Patient concerns:

A 33-year-old man presented with progressive fever lasting for 7 months, and swelling, pain, and purpura in the arms and legs. The patient showed multiple autoantibodies including cytoplasmic ANCA, antiproteinase 3, rheumatoid factor, and anti-beta 2 glycoprotein I. Blood culture was positive for viridans streptococcus, and renal biopsy revealed glomerulonephritis and interstitial nephritis.

Diagnosis:

Endocarditis caused by viridans streptococci, ANCA-associated vasculitis, and congenital ventricular septal defect.

Interventions:

In addition to effective antibiotics, he also received twice intravenous corticosteroids and intravenous immunoglobulin therapy, and a low dose of cyclophosphamide. At last, the patient received congenital ventricular septal defect repair and debridement.

Outcomes:

The abnormal clinical manifestations, including renal failure and loss of strength, recovered rapidly with corticosteroid therapy in addition to antibiotic treatment. After 6 months without any medications, he remained asymptomatic and was able to live normally.

Lessons:

In this case with endocarditis and ANCA-associated vasculitis, we highlighted the importance of biopsy and immunosuppressive therapy. Histopathologic examination is required for diagnosis and treatment in such case. Identifying patients who have endocarditis and ANCA positivity with vasculitis pathologic features will require corticosteroid/immunosuppressives in addition to the antibiotics therapy.
Epidemiology and transmission dynamics of COVID-19 in two Indian states
Authors: Laxminarayan Ramanan , Wahl Brian , Dudala Shankar Reddy , Gopal K. , Mohan Chandra , Neelima S. , Jawahar Reddy K. S. , Radhakrishnan J. , Lewnard Joseph A.
Published: July 2020

Although most COVID-19 cases have occurred in low-resource countries, there is scarce information on the epidemiology of the disease in such settings. Comprehensive SARS-CoV-2 testing and contact-tracing data from the Indian states of Tamil Nadu and Andhra Pradesh reveal stark contrasts from epidemics affecting high-income countries, with 92.1% of cases and 59.7% of deaths occurring among individuals <65 years old. The per-contact risk of infection is 9.0% (95% confidence interval: 7.5-10.5%) in the household and 2.6% (1.6-3.9%) in the community. Superspreading plays a prominent role in transmission, with 5.4% of cases accounting for 80% of infected contacts. The case-fatality ratio is 1.3% (1.0-1.6%), and median time-to-death is 5 days from testing. Primary data are urgently needed from low- and middle-income countries to guide locally-appropriate control measures.
uBin – a manual refining tool for metagenomic bins designed for educational purposes
Authors: Bornemann Till L.V. , Esser Sarah P. , Stach Tom L. , Burg Tim , Probst Alexander J.
Published: July 2020

Resolving bacterial and archaeal genomes from metagenomes has revolutionized our understanding of Earth’s biomes, yet producing high quality genomes from assembled fragments has been an ever-standing problem. While automated binning software and their combination produce prokaryotic bins in high-throughput, their manual refinement has been slow and sometimes difficult. Here, we present uBin, a GUI-based, standalone bin refiner that runs on all major operating platforms and was specifically designed for educational purposes. When applied to the public CAMI dataset, refinement of bins was able to improve 78.9% of bins by decreasing their contamination. We also applied the bin refiner as a standalone binner to public metagenomes from the International Space Station and demonstrate the recovery of near-complete genomes, whose replication indices indicate active proliferation of microbes in Earth’s lower orbit. uBin is an easy to install software for bin refinement, binning of simple metagenomes and communication of metagenomic results to other scientists and in classrooms. The software is open source and available underhttps://github.com/ProbstLab/uBin.
Next generation cytogenetics: genome-imaging enables comprehensive structural variant detection for 100 constitutional chromosomal aberrations in 85 samples
Authors: Mantere Tuomo , Neveling Kornelia , Pebrel-Richard Céline , Benoist Marion , van der Zande Guillaume , Kater-Baats Ellen , Baatout Imane , van Beek Ronald , Yammine Tony , Oorsprong Michiel , Olde-Weghuis Daniel , Majdali Wed , Vermeulen Susan , Pauper Marc , Lebbar Aziza , Stevens-Kroef Marian , Sanlaville Damien , Smeets Dominique , Dupont Jean Michel , Hoischen Alexander , Schluth-Bolard Caroline , El Khattabi Laïla
Published: July 2020

Chromosomal aberrations and structural variations are a major cause of human genetic diseases. Their detection in clinical routine still relies on standard cytogenetics, karyotyping and CNV-microarrays, in spite of the low resolution of the first one and the inability to detect neither balanced SVs nor to provide the genomic localization or the orientation of duplicated segments, of the latter. We here investigated the clinical utility of high resolution optical mapping by genome imaging for patients carrying known chromosomal aberrations in a context of constitutional conditions.

For 85 samples, ultra-high molecular weight gDNA was isolated either from blood or cultured cells. After labeling, DNA was processed and imaged on the Saphyr instrument (Bionano Genomics). Ade novogenome assembly was performed followed by SV and CNV calling and annotation. Results were compared to known aberrations from standard-of-care tests (karyotype, FISH and/or CNV-microarray).

In total, we analyzed 100 chromosomal aberrations including 7 aneuploidies, 35 translocations, 6 inversions, 2 insertions, 39 copy number variations (20 deletions and 19 duplications), 6 isochromosomes, 1 ring chromosome and 4 complex rearrangements. High resolution optical mapping reached 100% concordance compared to standard assays for all aberrations with non-centromeric breakpoints.

Our study demonstrates the ability of high resolution optical mapping to detect almost all types of chromosomal aberrations within the spectrum of karyotype, FISH and CNV-microarray. These results highlight its potential to replace these techniques, and provide a cost-effective and easy-to-use technique that would allow for comprehensive detection of chromosomal aberrations.
COVID-19 Detection on Chest X-Ray and CT Scan Images Using Multi-image Augmented Deep Learning Model
Authors: Purohit Kiran , Kesarwani Abhishek , Kisku Dakshina Ranjan , Dalui Mamata
Published: July 2020

COVID-19 is posed as very infectious and deadly pneumonia type disease until recent time. Despite having lengthy testing time, RT-PCR is a proven testing methodology to detect coronavirus infection. Sometimes, it might give more false positive and false negative results than the desired rates. Therefore, to assist the traditional RT-PCR methodology for accurate clinical diagnosis, COVID-19 screening can be adopted with X-Ray and CT scan images of lung of an individual. This image based diagnosis will bring radical change in detecting coronavirus infection in human body with ease and having zero or near to zero false positives and false negatives rates. This paper reports a convolutional neural network (CNN) based multi-image augmentation technique for detecting COVID-19 in chest X-Ray and chest CT scan images of coronavirus suspected individuals. Multi-image augmentation makes use of discontinuity information obtained in the filtered images for increasing the number of effective examples for training the CNN model. With this approach, the proposed model exhibits higher classification accuracy around 95.38% and 98.97% for CT scan and X-Ray images respectively. CT scan images with multi-image augmentation achieves sensitivity of 94.78% and specificity of 95.98%, whereas X-Ray images with multi-image augmentation achieves sensitivity of 99.07% and specificity of 98.88%. Evaluation has been done on publicly available databases containing both chest X-Ray and CT scan images and the experimental results are also compared with ResNet-50 and VGG-16 models.
The malaria parasite sheddase SUB2 governs host red blood cell membrane sealing at invasion
Authors: Collins Christine R , Hackett Fiona , Howell Steven A , Snijders Ambrosius P , Russell Matthew RG , Collinson Lucy M , Blackman Michael J
Published: July 2020

Red blood cell (RBC) invasion by malaria merozoites involves formation of a parasitophorous vacuole into which the parasite moves. The vacuole membrane seals and pinches off behind the parasite through an unknown mechanism, enclosing the parasite within the RBC. During invasion, several parasite surface proteins are shed by a membrane-bound protease called SUB2. Here we show that genetic depletion of SUB2 abolishes shedding of a range of parasite proteins, identifying previously unrecognized SUB2 substrates. Interaction of SUB2-null merozoites with RBCs leads to either abortive invasion with rapid RBC lysis, or successful entry but developmental arrest. Selective failure to shed the most abundant SUB2 substrate, MSP1, reduces intracellular replication, whilst conditional ablation of the substrate AMA1 produces host RBC lysis. We conclude that SUB2 activity is critical for host RBC membrane sealing following parasite internalisation and for correct functioning of merozoite surface proteins.

Key highlights

Many malaria parasite surface proteins are shed by SUB2 during RBC invasion

SUB2-null merozoites either induce rapid host RBC lysis, or invade then die

Merozoite surface protein shedding is crucial for host RBC membrane sealing
Immunohistochemical Detection of early and late Human Papillomaviruses (HPV) proteins in Retinoblastoma tumors
Authors: Diniz Nara , Melo Thatiana C , Araldi Rodrigo P , Carvalho Rodrigo F. , Beçak Willy , de Medeiros Jonathan W , Albuquerque Giwellington S , Gurgel Ana Pavla , Hassan Rocio , Muniz Maria TC , de Cassia Stocco Rita
Published: July 2020

In this study, we evaluated the presence of early and late Human Papillomavirus (HPV) proteins in retinoblastoma Brazilian patients. For this, 8 formalin-fixed paraffin-embedded retinoblastoma tissue blocks were used. HPV DNA presence was determined by in situ hybridization (ISH). Immunohistochemistry were performed to verify HPV16/18 E6, E1^E4, and L1 proteins. HPV was detected in all retinoblastoma tumors and viral DNA was labeled in tumor cells, retinal layers and optical nerve structures. In addition, E1^E4, E6 and L1 proteins were detected in all samples in the same areas where HPV DNA was detected. Our data showed the presence and expression of early and late HPV proteins in retinoblastoma tumors from Brazilian children. However, further studies should be performed to clarify the role of HPV infection in retinoblastoma tumor.
Tele- Yoga therapy for Patients with Chronic Pain during Covid-19 Lockdown: A Prospective Nonrandomized Single Arm Clinical Trial
Authors: Sharma Neha , Modi Dipa , Nathwani Asha , Pandya Bhavna , Joshi Jaydeep
Published: July 2020

Background

Pain management services and support programs have been closed during pandemic. Self-management options, particularly for chronic pain, is required which can be undertaken at one’s own convenience and without leaving home.

Objectives

To evaluate the impact of tele-yoga therapy on patients suffering with chronic pain reducing pain intensity, disability, anxiety and depression.

Material and methods

In total 18 patients with different chronic pain diagnosis were recruited to individual yoga Therapy sessions twice a week at home (tele-yoga) using a videoconference app. Each participant followed set of practices every day at home. Main outcome measures included pain intensity, pain disability, anxiety and depression scores. Data were collected at baseline and after 6-weeks of intervention.

Results

There were significant improvement in pain intensity from Baseline to 6-weeks (P<0.001); also pain disability (P<0,001). Both scores of anxiety and depression reduced at the end of intervention period (P<0,001; P<0,001).

Conclusions

Pilot results suggest that tele-yoga therapy may be an effective tool to self-manage chronic pain and related functional and psychological impacts. Further larger studies, randomized, controlled trials are needed to confirm the preliminary outcome.

Trial Registration

ClinicalTrials.govNCT04457388; https://clinicaltrials.gov/ct2/show/NCT04457388
HiFi-SIM: reconstructing high-fidelity structured illumination microscope images
Authors: Wen Gang , Li Simin , Wang Linbo , Chen Xiaohu , Sun Zhenglong , Liang Yong , Jin Xin , Tang Yuguo , Li Hui
Published: July 2020

Structured illumination microscopy (SIM) has been a widely-used super-resolution (SR) fluorescence microscopy technique, but artifacts often appear in reconstructed SR images which reduce its fidelity and might cause misinterpretation of biological structures. We present HiFi-SIM, a high-fidelity SIM reconstruction algorithm, by engineering the effective point spread function (PSF) into an ideal form. HiFi-SIM can effectively reduce commonly-seen artifacts without loss of fine structures and improve the axial sectioning. Since results of HiFi-SIM are not sensitive to used PSF and reconstruction parameters, it lowers the requirements for dedicated PSF calibration and complicated parameter adjustment, thus promoting SIM as a daily imaging tool.