bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of and risk factors for abnormal left ventricular geometrical patterns in hypertensive subjects administered irbesartan
Authors: Huang Cheng , Huang Yuqing , Zhong Qi , Cai Anping , Feng Ying‐qing
Published: January 2021

Background

Distinct populations differ in LVH prevalence and impaired LV geometry. Currently, the prevalence of and risk factors for LV geometric patterns in Chinese hypertensives administered irbesartan have not been specifically addressed in large studies.

Methods

Totally 10,883 patients (6623 men and 4260 women) completed the survey, including 1181 hypertensives administered irbesartan (488 males and 693 females) that were finally enrolled. Based on LVMI and RWT derived from comprehensive echocardiography, the LV geometric patterns of irbesartan‐treated hypertensive individuals were classified into four types, including the normal, concentric remodeling, and concentric and eccentric hypertrophy groups. Logistic regression analysis was applied in males and females, respectively, for determining odds ratios (ORs) and 95% confidence intervals (CIs) for various potential risk factors for abnormal LV geometrical patterns in irbesartan‐treated hypertensives.

Results

The clinical and echocardiographic data differed significantly between males and females. The prevalence rates of concentric remodeling, concentric hypertrophy, and eccentric hypertrophy were 36.3%, 15.4%, and 6.1% in males, respectively, and 23.5%, 20.3%, and 23.8% in females, accordingly. Gender, daily dose of irbesartan, BMI, SBP, WtHR, and neck‐circumference were significantly associated with LV geometric patterns. After adjustment for confounding factors, risk factors for LVH and impaired LV geometry included SBP, WtHR in males, and MAU‐Cr and WtHR in females.

Conclusions

LVH and impaired LV geometric patterns are more prevalent in females (67.7%) compared with that in males (57.8%) among hypertensives upon irbesartan administration. For such population, risk factors beyond elevated blood pressure may be involved in the progression of LVH and impaired LV geometric patterns in both genders.
The value of platelet parameters and related scoring system in predicting esophageal varices and collateral veins in patients with liver cirrhosis
Authors: Liu Huan , Chen Peng , Jiang Bei , Li Fei , Han Tao
Published: January 2021

Objective

To explore the value of platelet parameters and related scoring system in predicting esophageal varices and collateral veins in patients with liver cirrhosis.

Method

A total of 94 patients with liver cirrhosis diagnosed in our hospital from March 2017 to July 2018 were divided into without esophageal varices group (NEV) and esophageal varices group (EV) into mild, moderate, and severe subgroups according to the results of general gastroscopy. The differences of biological indexes among different degrees of esophageal varices and collateral veins were analyzed, and the related factors of esophageal varices and collateral veins were analyzed.

Results

PLT count and PCT decreased gradually with the increase of esophageal varices in EV group. There were significant differences in PLT count and PCT, which were negatively correlated with the degree of collateral vein in esophageal collateral vein group. The maximum cross‐sectional diameter and mean diameter of esophageal collateral veins in EV group were wider than those in NEV group. Further study showed that the maximum cross‐sectional total diameter and mean diameter of esophageal collateral veins in severe esophageal varices group were wider than those in NEV group and mild esophageal varices group. Sequential Logistic regression analysis showed that PCT could effectively predict the existence of esophageal varices. Platelet parameters had no significant diagnostic value in predicting peri‐ECV and Para‐ECV. For platelet‐related FI, APRI, FIB‐4, King, Lok, GUCI, and FibroQ scoring systems, multivariate Logistic regression showed that FI, FIB‐4, Lok and FibroQ scoring systems could effectively predict the presence of EV and Para‐ECV (P<0.05), and its Lok Index is better than other rating systems, with AUROC values of 0.773 and 0.747, respectively. There is no significant predictive value for above scoring systems of peri‐ECV.

Conclusions

PCT and LOK index can effectively predict the existence of esophageal varices and para‐esophageal veins in patients with liver cirrhosis, and can be used as an effective filling method for common gastroscopy and endoscopic ultrasonography to detect EV and ECV in liver cirrhosis.
Creatine transport and pathological changes in creatine transporter deficient mice
Authors: Wawro Adam M. , Gajera Chandresh R. , Baker Steven A. , Nirschl Jeffrey J. , Vogel Hannes , Montine Thomas J.
Published: January 2021

The severe impact on brain function and lack of effective therapy for patients with creatine (Cr) transporter deficiency motivated the generation of three ubiquitous Slc6a8 deficient mice (−/y). While each mouse knock‐out line has similar behavioral effects at 2 to 3 months of age, other features critical to the efficient use of these mice in drug discovery are unclear or lacking: the concentration of Cr in brain and heart differ widely between mouse lines, there are limited data on histopathologic changes, and no data on Cr uptake. Here, we determined survival, measured endogenous Cr and uptake of its deuterium‐labeled analogue Cr‐d3 using a liquid chromatography coupled with tandem mass spectrometry assay, and performed comprehensive histopathologic examination on the Slc6a8−/y mouse developed by Skelton et al. Our results show that Slc6a8−/y mice have widely varying organ‐specific uptake of Cr‐d3, significantly diminished growth with the exception of brain, progressive vacuolar myopathy, and markedly shortened lifespan.
Impact of Atlantic multidecadal oscillation on interannual relationship between ENSO and East Asian early summer monsoon
Authors: Xu Meng , Xu Haiming , Ma Jing , Deng Jiechun
Published: January 2021

Impact of the Atlantic multidecadal oscillation (AMO) on the interannual relationship between the El Niño‐Southern Oscillation (ENSO) and East Asian early summer monsoon (EAESM) is investigated using observations and community atmosphere model (CAM) outputs. We find that the interannual ENSO–EAESM relationship displays a prominent decadal variation during 1951–2018, which is consistent with the AMO phase change, that is, a high ENSO–EAESM correlation appears during the negative AMO phase, while no significant correlation is found during the positive AMO phase. Further analyses reveal that the AMO‐related sea surface temperature anomalies (SSTAs) in the western North Pacific, rather than in the North Atlantic, modulate the interannual relationship between the El Niño and EAESM. These SSTAs can prolong the existence of the anomalous western North Pacific anticyclone (WNPAC) from the ENSO mature winter to the subsequent early summer, thus affecting the ENSO–EAESM relationship for the El Niño events. In contrast, the AMO modulates the interannual relationship between the La Niña and EAESM through the North Atlantic and North Pacific. The North Atlantic warming‐induced anomalous anticyclone weakens the background cyclone over the western North Pacific during the positive AMO phase, and the mid‐latitude air–sea interaction in the North Pacific also influence the anomalous cyclone. The observed AMO's impact on the interannual relationship between the ENSO and EAESM is confirmed by atmosphere general circulation model simulations using the CAM.
Dynamic and thermodynamic contributions to Northern China dryness in El Niño developing summer
Authors: Liu Shujie , Wen Na , Li Laurent
Published: January 2021

In El Niño developing summer, Northern China shows reduced precipitation. The underlying mechanism is investigated through an analysis on the regional moisture and moist static energy budget. It is shown that the thermodynamic effect in relation to water vapour changes increases the regional wetness, but it is much smaller than the dynamic effect in relation to anomalies of atmospheric circulation. The anomalous vertical descent term is particularly pronounced. This anomalous vertical motion is mainly constrained by the horizontal advection of climatological moist enthalpy by anomalous wind, with a deficit of moist static energy in the region. A descent is then produced to compensate the energy lose and leads to dryness. Further investigation shows that an El Niño‐induced anomalous cyclone over Northeast Asia is the main ingredient in controlling the dynamic effect for both water vapour budget and moist static energy budget.
Moisture transport to a typical transitional climate zone in North China forced by atmospheric and oceanic internal variability under the background of global warming
Authors: Zhong Linhao , Hua Lijuan , Yao Yao , Feng Jinming , Zhao Tianbao
Published: January 2021

North Central China (NCC) (34°–42°N, 95°–107°E), a typical transitional climate zone between westerlies and monsoon, shows multiple time‐scale variations in precipitation under the background of global warming. Thus, NCC moisture transport (NMT) was analysed based on reanalysis data from 1979–2015. By using the spatially unbounded dynamic recycling model, main NMT pathways and moisture sources were identified for the summer rainfall of NCC. The trend pattern of NMT manifests as a seesaw pattern with a weakening northwesterly transport but an enhancing southwesterly transport, suggesting an interaction between the mid‐latitude westerlies and the Indian monsoon. The temporal evolution of the NMT trend pattern exhibits interannual and multidecadal variability superimposed on long‐term trends, which correspond to the atmospheric and oceanic physical processes, respectively. The partial least squares regression analysis demonstrated that the temporal evolution of NMT trend patterns can be well explained by atmospheric and oceanic internal climate variability (ICV). At interannual time scales, the atmospheric ICV, composed of the circumglobal teleconnection (CGT) and East Atlantic (EA) and East Atlantic/Western Russia (EAWR) teleconnections, forms a Eurasian wave train that weakens westerly transport via the Europe blocking flow and enhances southwesterly transport via local circulation anomalies with a zonal dipole structure. However, oceanic ICV, composed of the Atlantic Multidecadal Oscillation (AMO) and Pacific Decadal Oscillation (PDO), exerts influence on a multidecadal time scale to decelerate the mid‐latitude westerly jet over the North Atlantic, providing favourable upstream background conditions for the formation of the Europe blocking and further maintaining the atmospheric ICV‐induced Eurasian wave train. Thus, the internal oceanic and atmospheric processes at different time scales couple to contribute to long‐term changes in precipitation over NCC under the background of global warming.
Facial Pressure Injuries from Prone Positioning in the COVID‐19 Era
Authors: Shearer Sarah C. , Parsa Keon M. , Newark Annemarie , Peesay Tejasvi , Walsh Amanda R. , Fernandez Stephen , Gao William Z. , Pierce Matthew L.
Published: January 2021

Objective/Hypothesis

This study aimed to determine the incidence of facial pressure injuries associated with prone positioning for COVID‐19 patients as well as to characterize the location of injuries and treatments provided.

Methods

This was a retrospective chart review of 263 COVID‐19 positive patients requiring intubation in the intensive care units at MedStar Georgetown University Hospital and MedStar Washington Hospital Center between March 1st and July 26th, 2020. Information regarding proning status, duration of proning, presence, or absence of facial pressure injuries and interventions were collected. Paired two‐tailed t‐test was used to evaluate differences between proned patients who developed pressure injuries with those who did not.

Results

Overall, 143 COVID‐19 positive patients required proning while intubated with the average duration of proning being 5.15 days. Of those proned, 68 (47.6%) developed a facial pressure injury. The most common site involved was the cheek with a total of 57 (84%) followed by ears (50%). The average duration of proning for patients who developed a pressure injury was significantly longer when compared to those who did not develop pressure injuries (6.79 days vs. 3.64 days, P < .001).

Conclusions

Facial pressure injuries occur with high incidence in patients with COVID‐19 who undergo prone positioning. Longer duration of proning appears to confer greater risk for developing these pressure injuries. Hence, improved preventative measures and early interventions are needed.

Level of Evidence

4 Laryngoscope, 131:E2139–E2142, 2021
Integrative literature review of patient classification tools for nursing intensity evaluation: Focusing on comparison of South Korean and international tools
Authors: Ko Yukyung , Park Bohyun
Published: January 2021

Aim

This study aimed to review the literature on patient classification tools (PCTs) for assessing nursing strength and to compare South Korean and international tools.

Design

Integrative literature review.

Methods

We searched the relevant literature published from 2000–2017 in PubMed and two electronic databases in Korea in March 2017. Twenty‐five published studies were reviewed.

Results

In most Korean studies, patients were classified by PCT, which were tested to ensure validity and reliability, followed by measurement of nursing time and development of the conversion index. In international studies, PCTs used were simpler than those in Korean studies; the results of estimation for optimum nurse staffing were reported. Most studies insufficiently reflected indirect nursing needs and patients’ non‐clinical factors.

The current PCTs used in Korean studies inadequately reflect the reality of nursing field. Therefore, development of new PCTs reflecting nursing intensity based on direct and indirect nursing activities is necessary.
Oncologists' Attitude and Knowledge about Cancer Rehabilitation
Authors: Rosario‐Concepción Raúl A. , Calderín Yailiz B. , Aponte Christian López , López‐Acevedo Carmen E. , Sepúlveda‐Irrizarry Fernando L.
Published: January 2021

Introduction

Cancer survivors may experience multiple comorbidities related to the disease itself and adverse effects from treatment. Rehabilitation specialists could provide treatment options; however, oncologic rehabilitation services are underutilized.

Objective

To assess oncologists' awareness of the benefits of rehabilitation for cancer care patients and to identify barriers to rehabilitation referrals in adult cancer patients in Puerto Rico.

Design

Cross‐sectional study.

Setting

Regional Annual Meeting of the Association of Medical Hematology and Oncology of Puerto Rico, 4‐7 September 2015.

Participants

Forty‐two oncologists.

Interventions

Participants completed a 10‐item questionnaire focused on demographics, knowledge, and clinical practices over the previous 12 months related to rehabilitation in cancer patients.

Main Outcome Measures

Frequency, reasons, and timing for oncologist referral of cancer patients to rehabilitation. Perceived risks and benefits of rehabilitation in cancer patients and their correlation to patient referrals, prognosis, type of cancer, and type of symptoms.

Results

Thirty‐seven oncologists (88.1%) received minimal or no education about cancer rehabilitation, its benefits, and indications. This resulted in 31 oncologists (73.8%) referring less than 15% of their patients for rehabilitation, with almost a third of participants referring less than 5%. However, 39 (92.9%) agreed that rehabilitation is always or frequently beneficial for their patients. Fifteen (35.7%) said they did not refer patients if prognosis was less than 6 months, and 16 (38.0%) avoided referring patients with life expectancy of less than 3 months.

Conclusions

Although medical oncologists have some knowledge that rehabilitation is beneficial for their patients, there is a low referral rate. This could be due to lack of information about cancer rehabilitation and limited access to cancer rehabilitation specialists. Further efforts should be made to improve access to rehabilitation care for cancer patients and survivors.
A systematic analysis of the beta hairpin motif in the Protein Data Bank
Authors: DuPai Cory D. , Davies Bryan W. , Wilke Claus O.
Published: January 2021

The beta hairpin motif is a ubiquitous protein structural motif that can be found in molecules across the tree of life. This motif, which is also popular in synthetically designed proteins and peptides, is known for its stability and adaptability to broad functions. Here, we systematically probe all 49,000 unique beta hairpin substructures contained within the Protein Data Bank (PDB) to uncover key characteristics correlated with stable beta hairpin structure, including amino acid biases and enriched interstrand contacts. We find that position specific amino acid preferences, while seen throughout the beta hairpin structure, are most evident within the turn region, where they depend on subtle turn dynamics associated with turn length and secondary structure. We also establish a set of broad design principles, such as the inclusion of aspartic acid residues at a specific position and the careful consideration of desired secondary structure when selecting residues for the turn region, that can be applied to the generation of libraries encoding proteins or peptides containing beta hairpin structures.
Oral nano‐curcumin formulation efficacy in management of mild to moderate hospitalized coronavirus disease‐19 patients: An open label nonrandomized clinical trial
Authors: Saber‐Moghaddam Niloofar , Salari Soofia , Hejazi Sepideh , Amini Mahnaz , Taherzadeh Zhila , Eslami Saeed , Rezayat Seyed Mahdi , Jaafari Mahmoud Reza , Elyasi Sepideh
Published: January 2021

Curcumin is proposed as a potential treatment option for coronavirus disease‐19 (COVID‐19) by inhibiting the virus entrance, encapsulation and replication, and modulating various cellular signaling pathways. In this open‐label nonrandomized clinical trial, efficacy of nano‐curcumin oral formulation has been evaluated in hospitalized patients with mild–moderate COVID‐19. Forty‐one patients who fulfilled the inclusion criteria were allocated to nano‐curcumin (n = 21) group (Sinacurcumin soft gel, contains 40 mg curcuminoids as nanomicelles, two capsules twice a day) or control (n = 20) group, for 2 weeks. Patients' symptoms and laboratory data were assessed at baseline and during follow‐up period. Most of symptoms including fever and chills, tachypnea, myalgia, and cough resolved significantly faster in curcumin group. Moreover, SaO2 was significantly higher in treatment group after 2, 4, 7, and 14 days of follow‐up and lymphocyte count after 7 and 14 days. Duration of supplemental O2 use and hospitalization was also meaningfully shorter in treatment group. It is also noteworthy to mention that no patient in treatment group experienced deterioration of infection during follow‐up period, but it occurred in 40% of control group. Oral curcumin nano‐formulation can significantly improve recovery time in hospitalized COVID‐19 patients. Further randomized placebo controlled trials with larger sample size are recommended.
Why Indian summer monsoon circulation indices? Fidelity in representing rainfall variability and teleconnections
Authors: Zahan Yasmin , Rajesh P. V. , Choudhury B. Abida , Goswami B. N.
Published: January 2021

With the recognition that the circulation is strongly coupled with the Indian summer monsoon rainfall (ISMR), a number of large‐scale circulation indices have been proposed to represent the Indian summer monsoon to aid diagnosis of teleconnections with ISMR and evaluation of simulations by climate models. The circulation indices, however, correlate poorly with ISMR raising doubts on the coupling between the two. In this study, we identify reasons behind the poor correlations and estimate a potential limit on this correlation between circulation indices and ISMR. One mechanistic reason for poor correlations between circulation indices and ISMR is that the period and variance explained by the oscillatory modes of circulation indices differ significantly from those of ISMR leading to their phases also differing between modes of circulation indices and corresponding modes of ISMR. Further, the wind anomaly patterns associated with wind indices project strongly on the climatological monsoon circulation unlike that associated with the ISMR, another reason for their poor correlation with ISMR. As a result, all circulation indices underestimate the negative correlation between June–September sea‐surface temperature (JJAS SST) over the Niño3.4 and ISMR and fail to simulate the lead–lag relationship between the two. A conservative estimate of the interannual variance explained by coupling of the JJAS rainfall over continental India and winds in the neighbourhood is strong, explaining about 55% variance distributed in three leading coupled modes. Therefore, the effectiveness of any circulation indices in explaining the ISMR variance is potentially limited to that associated with the dominant mode (∼30%). The local response of winds to deep convection over the waters of the Indian Ocean and western Pacific warm pool leads to a strong increasing trend in some of the circulation indices and adds “noise” modes contributing to the de‐correlation between circulation indices and ISMR.
Loading of stream wood following the 2016 Chimney Tops 2 Wildfire: Great Smoky Mountains National Park, Tennessee, USA
Authors: Praskievicz Sarah , Sigdel Rajesh
Published: January 2021

Large wood drives physical and ecological processes in river systems, but the relative roles of continuous individual tree mortality versus episodes of mass mortality in wood recruitment are not well understood. Here, the 2016 Chimney Tops 2 wildfire, a rare severe wildfire in the eastern United States, was used as a case study for examining the role of mass tree mortality in wood loads of streams in Great Smoky Mountains National Park (GSMNP), Tennessee. Wood surveys were conducted on four reaches in two drainage systems affected by the fire to ascertain the total frequency and volume of burned and unburned wood pieces and jams. Relative to unburned wood, the Chimney Tops 2 fire resulted in a major influx of burned wood to the study reaches, with large percentages of individual pieces (average of 47% by frequency, 48% by volume) and jams (average of 72% by frequency, 93% by volume) exhibiting burn marks. Burned wood pieces had a larger diameter than unburned pieces (p = .065). Results suggest that rare mass‐mortality events like the Chimney Tops 2 wildfire could play a major role in wood dynamics of mountain streams in humid forested regions.
Nutmeg extract potentially alters characteristics of white adipose tissue in rats
Authors: Lesmana Ronny , Siannoto Melisa , Nugraha Gaga I. , Goenawan Hanna , Feinisa Astrid K. , Pratiwi Yuni S. , Veronica Fifi , Tarawan Vita M. , Susianti Susianti , Supratman Unang
Published: January 2021

Background

Browning of white adipose tissue (WAT) is a promising approach to obesity treatment. During browning, WAT transforms into beige adipose tissue through stimulation of the peroxisome proliferator activated receptor γ (PPARγ). Nutmeg, one of the Indonesian herbs, reportedly has dual roles as a PPARα/γ partial agonist. Even though nutmeg has been traditionally used in body weight reduction, there is limited information regarding the potential role of nutmeg in browning of WAT.

Objectives

In this study, we explored the effect of nutmeg seed extract (NuSE) as a potential inductor of WAT browning.

Methods

Twelve male Wistar rats, 5–6 weeks old, were divided into control and nutmeg groups. The rats in nutmeg group were given NuSE for 12 weeks by oral gavage. After 12 weeks, the rat's inguinal WAT and brown adipose tissue (BAT) were collected, weighed and stored at − 80°C until use.

Results

We observed that even though NuSE did not reduce the final body weight, it significantly reduced body weight gain. NuSE also increased protein levels of peroxisome proliferator activated receptor γ coactivator 1α (PGC‐1α) and uncoupling protein 3 (UCP3) significantly and tended to increase UCP2 and UCP1 levels. Furthermore, NuSE induced macroscopic and microscopic morphological changes of inguinal WAT, marked by significantly increased adipocyte numbers and decreased adipocyte size.

Conclusions

Even though NuSE did not increase UCP1 significantly, it potentially alters inguinal WAT characteristics and leads to browning through PGC‐1α and UCP3 induction. However, UCP3’s specific mechanism in WAT browning remains unclear. Our findings could contribute to obesity treatment in the future.
The role of connexin proteins and their channels in radiation-induced atherosclerosis
Authors: Ramadan Raghda , Baatout Sarah , Aerts An , Leybaert Luc
Published: January 2021

Radiotherapy is an effective treatment for breast cancer and other thoracic tumors. However, while high-energy radiotherapy treatment successfully kills cancer cells, radiation exposure of the heart and large arteries cannot always be avoided, resulting in secondary cardiovascular disease in cancer survivors. Radiation-induced changes in the cardiac vasculature may thereby lead to coronary artery atherosclerosis, which is a major cardiovascular complication nowadays in thoracic radiotherapy-treated patients. The underlying biological and molecular mechanisms of radiation-induced atherosclerosis are complex and still not fully understood, resulting in potentially improper radiation protection. Ionizing radiation (IR) exposure may damage the vascular endothelium by inducing DNA damage, oxidative stress, premature cellular senescence, cell death and inflammation, which act to promote the atherosclerotic process. Intercellular communication mediated by connexin (Cx)-based gap junctions and hemichannels may modulate IR-induced responses and thereby the atherosclerotic process. However, the role of endothelial Cxs and their channels in atherosclerotic development after IR exposure is still poorly defined. A better understanding of the underlying biological pathways involved in secondary cardiovascular toxicity after radiotherapy would facilitate the development of effective strategies that prevent or mitigate these adverse effects. Here, we review the possible roles of intercellular Cx driven signaling and communication in radiation-induced atherosclerosis.
Dimensional stabilisation of Scots pine (Pinus sylvestris L.) sapwood by reaction with maleic anhydride and sodium hypophosphite
Authors: Kim Injeong , Karlsson Olov , Jones Dennis , Mantanis George , Sandberg Dick
Published: January 2021

Wood has the ability to absorb and desorb moisture, which can affect its dimensional size when in use. Limiting this can provide products with greater shape stability and less stresses on external coatings. One method that has been investigated for achieving this has been through chemical modification. In this work, the dimensional stabilisation imparted to Scots pine sapwood by chemical modification with maleic anhydride (MA) combined with sodium hypophosphite (SHP) was investigated. The influence of concentration of MA, treatment temperature and treatment period on weight percent gain (WPG) and bulking coefficient (BC) during treatment with MA and SHP of wood was studied. Furthermore, dimensional stability was determined by the water soak/oven dry method (wet-dry cycle) through five cycles in order to determine the hydrolytic stability of the ester bond and any potential cross-linking reactions. Wood blocks (20 × 20 × 10 mm) modified with MA combined with SHP exhibited lower weight loss following water soaking than unmodified blocks or MA-treated blocks. Wood blocks modified with MA and SHP showed the best anti-swelling efficiency and minimum wet-volume (water-saturated). However, as the concentration of SHP increased, dimensional stability was diminished without any increase in weight percentage gain after water soaking. When combined with FTIR results, it appeared that the modification with MA and SHP seemed to form cross-linking between wood constituents, though high concentration of SHP did not seem to result in additional cross-linking.
Genetic variability and genome-wide association analysis of flavor and texture in cooked beans (Phaseolus vulgaris L.)
Authors: Bassett Amber , Kamfwa Kelvin , Ambachew Daniel , Cichy Karen
Published: January 2021

Key message

Cooked bean flavor and texture vary within and across 20 Andean seed types; SNPs are significantly associated with total flavor, beany, earthy, starchy, bitter, seed-coat perception, and cotyledon texture.

Common dry beans are a nutritious food recognized as a staple globally, but their consumption is low in the USA. Improving bean flavor and texture through breeding has the potential to improve consumer acceptance and suitability for new end-use products. Little is known about genetic variability and inheritance of bean sensory characteristics. A total of 430 genotypes of the Andean Diversity Panel representing twenty seed types were grown in three locations, and cooked seeds were evaluated by a trained sensory panel for flavor and texture attribute intensities, including total flavor, beany, vegetative, earthy, starchy, sweet, bitter, seed-coat perception, and cotyledon texture. Extensive variation in sensory attributes was found across and within seed types. A set of genotypes was identified that exhibit extreme attribute intensities generally stable across all three environments. seed-coat perception and total flavor intensity had the highest broad-sense heritability (0.39 and 0.38, respectively), while earthy and vegetative intensities exhibited the lowest (0.14 and 0.15, respectively). Starchy and sweet flavors were positively correlated and highest in white bean genotypes according to principal component analysis. SNPs associated with total flavor intensity (six SNPs across three chromosomes), beany (five SNPs across four chromosomes), earthy (three SNPs across two chromosomes), starchy (one SNP), bitter (one SNP), seed-coat perception (three SNPs across two chromosomes), and cotyledon texture (two SNPs across two chromosomes) were detected. These findings lay a foundation for incorporating flavor and texture in breeding programs for the development of new varieties that entice growers, consumers, and product developers alike.
Remnant preservation provides good clinical outcomes after anterior cruciate ligament reconstruction
Authors: Huang Hui , Nagao Masashi , Nishio Hirofumi , Kaneko Haruka , Saita Yoshitomo , Takazawa Yuji , Ikeda Hiroshi , Kaneko Kazuo , Ishijima Muneaki
Published: January 2021

Purpose

To evaluate the association of remnant preservation (RP) and non-RP (NRP) with patient-reported outcome measures and subsequent graft rupture at a minimum 2-year follow-up after anterior cruciate ligament (ACL) reconstruction.

Methods

Patients in this retrospective study underwent primary isolated ACL reconstruction by the RP or NRP technique with a four- to five-strand hamstring tendon graft. Multivariate linear or logistic regression and Cox regression analyses were performed to compare the physical and psychological outcomes by the International Knee Documentation Committee subjective knee form (IKDC-SKF) and the Japanese Anterior Cruciate Ligament questionnaire 25 (JACL-25), respectively; satisfaction rate; and prognosticators of graft rupture.

Results

In total, 120 patients (mean age, 30.6 ± 12.7 years; 54 RP, 66 NRP) with a mean follow-up of 3.2 ± 1.6 years were enrolled in this study. At the latest postoperative follow-up, the RP group showed a mean IKDC-SKF score of 92.3 ± 8.5 and mean JACL-25 score of 13.2 ± 11.2, while these scores in the NRP group were 86.4 ± 12.2 and 24.4 ± 19.5, respectively (P = 0.016 and 0.007, respectively). No significant differences were found in the return-to-sports rate (RP vs. NRP, 79.5% vs. 67.5%) or satisfaction rate (RP vs. NRP, 89.2% vs. 74.4%) (n.s.); however, a significant difference was found in the rate of return to the preinjury sports level (RP vs. NRP, 64.1% vs. 37.5%; P = 0.014). The graft rupture rate was significantly higher in the NRP than RP group (9/66 vs. 1/54; hazard ratio 9.29; 95% confidence interval 1.04–82.81). Younger age (≤ 18 years) was the other important risk factor for graft rupture (hazard ratio 8.67; 95% confidence interval 2.02–37.13).

Conclusion

Patients who underwent ACL reconstruction with the RP technique obtained somewhat better physical and psychological results than those who underwent ACL reconstruction with the NRP technique. With respect to clinical relevance, patients treated with the RP technique may obtain better outcomes in terms of graft rupture and return to the preinjury sports level than those treated with the NRP technique, but with no differences in overall return to sports or satisfaction.

Level of evidence

IV.
A diagnostic strategy for Parkinsonian syndromes using quantitative indices of DAT SPECT and MIBG scintigraphy: an investigation using the classification and regression tree analysis
Authors: Iwabuchi Yu , Kameyama Masashi , Matsusaka Yohji , Narimatsu Hidetoshi , Hashimoto Masahiro , Seki Morinobu , Ito Daisuke , Tabuchi Hajime , Yamada Yoshitake , Jinzaki Masahiro
Published: January 2021

Purpose

We aimed to evaluate the diagnostic performances of quantitative indices obtained from dopamine transporter (DAT) single-photon emission computed tomography (SPECT) and 123I-metaiodobenzylguanidine (MIBG) scintigraphy for Parkinsonian syndromes (PS) using the classification and regression tree (CART) analysis.

Methods

We retrospectively enrolled 216 patients with or without PS, including 80 without PS (NPS) and 136 with PS [90 Parkinson’s disease (PD), 21 dementia with Lewy bodies (DLB), 16 progressive supranuclear palsy (PSP), and 9 multiple system atrophy (MSA). The striatal binding ratio (SBR), putamen-to-caudate ratio (PCR), and asymmetry index (AI) were calculated using DAT SPECT. The heart-to-mediastinum uptake ratio (H/M) based on the early (H/M [Early]) and delayed (H/M [Delay]) images and cardiac washout rate (WR) were calculated from MIBG scintigraphy. The CART analysis was used to establish a diagnostic decision tree model for differentiating PS based on these quantitative indices.

Results

The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 87.5, 96.3, 93.3, 92.9, and 93.1 for NPS; 91.1, 78.6, 75.2, 92.5, and 83.8 for PD; 57.1, 95.9, 60.0, 95.4, and 92.1 for DLB; and 50.0, 98.0, 66.7, 96.1, and 94.4 for PSP, respectively. The PCR, WR, H/M (Delay), and SBR indices played important roles in the optimal decision tree model, and their feature importance was 0.61, 0.22, 0.11, and 0.05, respectively.

Conclusion

The quantitative indices showed high diagnostic performances in differentiating NPS, PD, DLB, and PSP, but not MSA. Our findings provide useful guidance on how to apply these quantitative indices in clinical practice.
Optimal Assessment of Frailty Predicts Postoperative Complications in Older Patients with Colorectal Cancer Surgery
Authors: Tamura Koichi , Matsuda Kenji , Fujita Yoichi , Iwahashi Makoto , Mori Kazunari , Yamade Naohisa , Hotta Tsukasa , Noguchi Kohei , Sakata Yoshifumi , Takifuji Katsunari , Iwamoto Hiromitsu , Mizumoto Yuki , Yamaue Hiroki
Published: January 2021

Objectives

The increasingly elderly worldwide population has affected the incidence of colorectal cancer. Establishment of reliable assessment of frailty and proposals for multi‐disciplinary interventions are urgently required in oncology practices. Kihon Checklist (KCL) was published by the Japanese Ministry of Health, Labor and Welfare originally to identify individuals ≥ 65 years old at probable risk for requiring care or social support. We investigate the validity of KCL for frailty assessment to predict postoperative complication in older patients with colorectal cancer.

Methods

Consecutive colorectal cancer patients aged ≥ 65 (n = 500) were prospectively examined between May 2017 and December 2018. Preoperative frailty assessment was conducted by the G8 questionnaire and KCL. The main outcome measures were correlation between frailty, other clinical variables, and postoperative complications within 30 days after elective surgery.

Results

Of the 500 patients, 278 (55.6%) and 164 (32.8%) patients were classified as ‘frail’ by G8 and KCL, respectively. Overall complications counted among 97 patients (19.4%), and they were significantly associated with KCL ≥ 8‐frail (46/164, p = 0.001), as opposed to G8 ≤ 14‐frail (56/278, p = 0.531). Multivariate analysis showed that KCL ≥ 8 (hazard ratio 1.88, 95% confidence interval 1.16–3.04, p = 0.011) was an independent risk factor for these complications.

Conclusions

KCL assessment can identify frail older patients likely to suffer from postoperative complications after colorectal cancer surgery. Preoperative screening of frailty, particularly by KCL, would help older patients prevent their worse outcomes in colorectal cancer.

Trial registration

UMIN000026689.
A Systematic Review and Meta‐Analysis of Sentinel Lymph Node Biopsy in Gastric Cancer, an Optimization of Imaging Protocol for Tracer Mapping
Authors: Huang Yuqiang , Pan Mengting , Chen Bo
Published: January 2021

Background

Sentinel lymph node biopsy (SLNB) plays an essential role in the evaluation of lymph node (LN) metastasis status and the extent of LN dissection in gastric cancer. The aim of our study was to perform a systematic review and meta‐analysis for corresponding identification rate and sensitivity of different SLNB techniques.

Methods

Systematic search using PubMed, Embase, and Cochrane library databases was conducted for studies on SLNB in patients with gastric cancer. Studies were stratified according to the sentinel lymph node (SLN) biopsy technique: blue dye (BD), radiocolloid tracer (RI), indocyanine green (ICG), a combination of radiocolloid with blue dye (RI + BD), and a combination of radiocolloid with ICG (RI + ICG). A random‐effect model was used to pool the identification rate, sensitivity, and accuracy.

Results

A total of 54 eligible studies (3767 patients) was included. The pooled identification rates of SLNB using BD, RI, ICG, RI + BD, RI + ICG were 95% (95%CI: 92–97%), 95% (95%CI: 93–97%), 99% (95%CI: 97–99%), 97% (95%CI: 96–98%), and 95% (95%CI: 87–99%), respectively. The pooled sensitivities were 82% (95%CI: 77–86%), 87% (95%CI: 81–92%), 90% (95%CI: 82–95%), 89% (95%CI: 84–93%), and 88% (95%CI: 79–94%), respectively. The pooled accuracies were 94% (95%CI: 91–96%), 95% (95%CI: 92–97%), 98% (95%CI: 95–99%), 97% (95%CI: 95–99%), and 98% (95%CI: 95–99%), respectively.

Conclusions

The current meta‐analysis provides reliable evidence that favors the use of ICG and dual tracer method (RI + BD/ICG) for the identification of the SLN. Considering the high costs and potential biohazard of using radioactive substances in dual tracer method, performing SLNB with ICG is the technique of choice for experienced surgeons.
Evaluation of the impact of renal impairment on the pharmacokinetics of glasdegib in otherwise healthy volunteers
Authors: Shaik Naveed , LaBadie Robert R. , Hee Brian , Chan Geoffrey
Published: January 2021

Purpose

Glasdegib is being developed for indications in myeloid malignancies. The effect of renal impairment on the pharmacokinetics (PK) of a single, oral, 100-mg glasdegib dose under fasted conditions was assessed.

Methods

Open-label, parallel-group study (NCT03596567). Participants of good general health were selected and categorized, based on their estimated glomerular filtration rate, into normal (≥ 90 mL/min), moderate (≥ 30 to < 60 mL/min), or severe (< 30 mL/min) renal impairment groups. Blood samples were collected up to 120 h post-dose. PK exposure parameters were calculated using non-compartmental analysis.

Results

All 18 participants completed the study. Respectively, ratios of adjusted geometric means (90% confidence interval) for glasdegib area under the curve from time 0 to infinity and peak plasma concentration versus normal participants were 205% (142–295%) and 137% (97–193%) in the moderate group, and 202% (146–281%) and 120% (77–188%) in the severe group. Glasdegib median time to peak plasma concentration was 2.0 h in both impairment groups and 1.5 h in the normal group. Mean oral clearance was decreased by approximately 50% in both renal impairment groups compared with the normal group. The plasma-free fraction of glasdegib was not altered by renal impairment. Five all-causality adverse events were reported in three participants; two were considered treatment-related.

Conclusion

The similar changes in exposure observed for participants with renal impairment, coupled with the known safety data from clinical experience, suggest that a lower starting dose of glasdegib may not be required for moderate or severe renal impairment.

Trial registration: ClinicalTrials.gov: NCT03596567 (started May 17, 2018).
Systematic volumetric analysis predicts response to CSF drainage and outcome to shunt surgery in idiopathic normal pressure hydrocephalus
Authors: Wu Dan , Moghekar Abhay , Shi Wen , Blitz Ari M. , Mori Susumu
Published: January 2021

Objectives

Idiopathic normal pressure hydrocephalus (INPH) is a neurodegenerative disorder characterized by excess cerebrospinal fluid (CSF) in the ventricles, which can be diagnosed by invasive CSF drainage test and treated by shunt placement. Here, we aim to investigate the diagnostic and prognostic power of systematic volumetric analysis based on brain structural MRI for INPH.

Methods

We performed a retrospective study with a cohort of 104 probable INPH patients who underwent CSF drainage tests and another cohort of 41 INPH patients who had shunt placement. High-resolution T1-weighted images of the patients were segmented using an automated pipeline into 283 structures that are grouped into different granularity levels for volumetric analysis. Volumes at multi-granularity levels were used in a recursive feature elimination model to classify CSF drainage responders and non-responders. We then used pre-surgical brain volumes to predict Tinetti and MMSE scores after shunting, based on the least absolute shrinkage and selection operator.

Results

The classification accuracy of differentiating the CSF drainage responders and non-responders increased as the granularity increased. The highest diagnostic accuracy was achieved at the finest segmentation with a sensitivity/specificity/precision/accuracy of 0.89/0.91/0.84/0.90 and an area under the curve of 0.94. The predicted post-surgical neurological scores showed high correlations with the ground truth, withr= 0.80 for Tinetti andr= 0.88 for MMSE. The anatomical features that played important roles in the diagnostic and prognostic tasks were also illustrated.

Conclusions

We demonstrated that volumetric analysis with fine segmentation could reliably differentiate CSF drainage responders from other INPH-like patients, and it could accurately predict the neurological outcomes after shunting.

Key Points

• We performed a fully automated segmentation of brain MRI at multiple granularity levels for systematic volumetric analysis of idiopathic normal pressure hydrocephalus (INPH) patients.

• We were able to differentiate patients that responded to CSF drainage test with an accuracy of 0.90 and area under the curve of 0.94 in a cohort of 104 probable INPH patients, as well as to predict the post-shunt gait and cognitive scores with a coefficient of 0.80 for Tinetti and 0.88 for MMSE.

• Feature analysis showed the inferior lateral ventricle, bilateral hippocampus, and orbital cortex are positive indicators of CSF drainage responders, whereas the posterior deep white matter and parietal subcortical white matter were negative predictors.
What is the optimal lipid emulsion for preventing intestinal failure-associated liver disease following parenteral feeding in a rat model of short-bowel syndrome?
Authors: Machigashira Seiro , Kaji Tatsuru , Onishi Shun , Yano Keisuke , Harumatsu Toshio , Yamada Koji , Yamada Waka , Matsukubo Makoto , Muto Mitsuru , Ieiri Satoshi
Published: January 2021

Purpose

Composite lipid emulsion (CLE) has been used for intestinal failure-associated liver disease (IFALD) to compensate for the disadvantages of soybean oil lipid emulsion (SOLE) or fish oil lipid emulsion (FOLE). However, the influence of its administration is unclear. We evaluated the effects of these emulsions on IFALD using a rat model of the short-bowel syndrome.

Methods

We performed jugular vein catheterization and 90% small bowel resection in Sprague–Dawley rats and divided them into four groups: control (C group), regular chow with intravenous administration of saline; and total parenteral nutrition co-infused with SOLE (SOLE group), CLE (CLE group) or FOLE (FOLE group).

Results

Histologically, obvious hepatic steatosis was observed in the SOLE and CLE groups but not the FOLE group. The liver injury grade of the steatosis and ballooning in the FOLE group was significantly better than in the SOLE group (p < 0.05). The TNF-α levels in the liver in the FOLE group were significantly lower than in the SOLE group (p < 0.05). Essential fatty acid deficiency (EFAD) was not observed in any group.

Conclusion

Fish oil lipid emulsion attenuated hepatic steatosis without EFAD, while CLE induced moderate hepatic steatosis. The administration of CLE requires careful observation to prevent PN-induced hepatic steatosis.
Preferential performance of Thal fundoplication for gastroesophageal reflux disease: a single institution experience
Authors: Ishii Daisuke , Miyamoto Kazutoshi , Hirasawa Masatoshi , Miyagi Hisayuki
Published: January 2021

Purpose

Nissen fundoplication (NF) is the most commonly used surgical treatment for persistent gastroesophageal reflux disease (GERD). We introduced to the alternative Thal fundoplication (TF) (partial anterior wrapping) in 1998. The purpose of this paper is to review and report on the effectiveness of TF in our department.

Methods

We retrospectively analyzed cases of 281 patients who underwent TF for GERD at our hospital from 1998 to 2019.

Results

Average age, 16.3 ± 18.1 years; average body weight, 21.0 ± 16.0 kg; average operative time, 89.1 ± 43.0 min; average volume of bleeding, 11.6 ± 29.2 g; enteral feeding commenced after an average of 3.4 ± 1.3 postoperative days (PODs), and average postoperative full enteral feeding was 6.3 ± 1.4 PODs. Five patients (1.8%) had Clavien–Dindo classification III or higher; average hospital stay duration was 10.3 ± 6.0 days, with symptom recurrence affecting 17 patients (6.1%).

Conclusion

TF may be an effective and simple treatment for GERD that has few recurrences and avoids complications common to NF, but further studies to compare it with other techniques are needed.