bluuebunny/crossref_metadata_2025 huggingface dataset:
A new rectangular window based image cropping method for generalization of brain neoplasm classification systems
Authors: Zia Razia , Akhtar Pervez , Aziz Arshad
Published: December 2017

Classification of brain neoplasm images is one of the most challenging research areas in the field of medical image processing. The main objective of this study is to design a brain neoplasm classification system that can be trained using multiple various sized MR images of different institutions. The proposed method is a generalized classification system; it can be used in a single institute or in a number of institutions at the same time, without any restriction on image size. The generalization and unbiased capability of the proposed method can bring researchers on a single platform to work on some standard forms of computer aided diagnosis system with more efficient diagnostic capabilities. In this study, a suitable size of moveable rectangular window is used between segmentation and feature extraction stages. A semiautomatic, localized region based active contour method is used for segmentation of brain neoplasm region. Discrete wavelet transform for feature extraction, principal component analysis for feature selection and support vector machine is used as classifier. For the first time MR images of 2 sizes and from different institutions are used in training and testing of brain neoplasm classifier. Three glioma grades were classified using 92 MR images. The proposed method achieved the highest accuracy of 88.26%, the highest sensitivity of 92.23% and the maximum specificity of 93.93%. In addition, the proposed method is computationally less complex, requires shorter processing time and is more efficient in terms of storage capacity.
Development of hafnium metal and titanium‐hafnium alloys having apatite‐forming ability by chemical surface modification
Authors: Miyazaki Toshiki , Sueoka Masaya , Shirosaki Yuki , Shinozaki Nobuya , Shiraishi Takanobu
Published: December 2017

Hafnium (Hf) has attracted considerable attention as a component of biomedical titanium (Ti) alloys with low Young's moduli and/or shape‐memory functionalities, because its cytotoxicity is as low as that of Ti. The drawback of metals is that their bone‐bonding ability is generally low. It is known that apatite formation in the body is a prerequisite for bone‐bonding. Although several chemical treatments have been proposed for preparing Ti for bone‐bonding, there have been no similar investigations for Hf. In the present study, NaOH‐ and heat‐treatments were applied to pure Hf and Ti‐Hf alloys and their bone‐bonding ability was assessed in vitro with the use of simulated body fluid (SBF). After NaOH‐ and heat‐treatments, anatase formed on alloys with low Hf content (20–40% (atom%) Hf); mixtures of sodium titanate and hafnium titanate formed on alloys with similar Ti and Hf content (60% Hf); and hafnium oxide formed on alloys with high Hf content (80% Hf and pure Hf). Precipitates of apatite were observed on all the metals in SBF, except for the alloy with 60% Hf. We speculated that the hafnium titanate formed on this alloy had a low apatite‐forming ability owing to its high negative surface charge, which inhibited P adsorption. The apatite‐forming abilities of the Ti‐Hf alloys strongly depended on their Hf content. The present results indicate that Hf‐based materials have good potential for bone‐bonding. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2519–2523, 2018.
Butyrate and docosahexaenoic acid interact in alterations of specific lipid classes in differentiating colon cancer cells
Authors: Tylichová Zuzana , Slavík Josef , Ciganek Miroslav , Ovesná Petra , Krčmář Pavel , Straková Nicol , Machala Miroslav , Kozubík Alois , Hofmanová Jiřina , Vondráček Jan
Published: December 2017

Docosahexaenoic acid (DHA) and sodium butyrate (NaBt) exhibit a number of interactive effects on colon cancer cell growth, differentiation, or apoptosis; however, the molecular mechanisms responsible for these interactions and their impact on cellular lipidome are still not fully clear. Here, we show that both dietary agents together induce dynamic alterations of lipid metabolism, specific cellular lipid classes, and fatty acid composition. In HT‐29 cell line, a model of differentiating colon carcinoma cells, NaBt supported incorporation of free DHA into non‐polar lipids and their accumulation in cytoplasmic lipid droplets. DHA itself was not incorporated into sphingolipids; however, it significantly altered representation of individual ceramide (Cer) classes, in particular in combination with NaBt (DHA/NaBt). We observed altered expression of enzymes involved in Cer metabolism in cells treated with NaBt or DHA/NaBt, and exogenous Cer 16:0 was found to promote induction of apoptosis in differentiating HT‐29 cells. NaBt, together with DHA, increased n‐3 fatty acid synthesis and attenuated metabolism of monounsaturated fatty acids. Finally, DHA and/or NaBt altered expression of proteins involved in synthesis of fatty acids, including elongase 5, stearoyl CoA desaturase 1, or fatty acid synthase, with NaBt increasing expression of caveolin‐1 and CD36 transporter, which may further promote DHA incorporation and its impact on cellular lipidome. In conclusion, our results indicate that interactions of DHA and NaBt exert complex changes in cellular lipidome, which may contribute to the alterations of colon cancer cell differentiation/apoptotic responses. The present data extend our knowledge about the nature of interactive effects of dietary fatty acids.
Retracted: CUL4B promotes metastasis and proliferation in pancreatic cancer cells by inducing epithelial‐mesenchymal transition via the Wnt/β‐catenin signaling pathway
Authors: He Yue‐Ming , Xiao Yu‐Sha , Wei Lei , Zhang Jia‐Qiang , Peng Cheng‐Hong
Published: December 2017

This study determines whether cullin 4B (CUL4B) promotes pancreatic cancer (PC) metastasis by inducing epithelial‐mesenchymal transition (EMT) via the Wnt/β‐catenin signaling pathway. A total of 64 PC patients were enrolled in this study. Human PC cell lines were distributed into blank, negative control, shCUL4B, PLOC, PLOC‐CUL4B, and PLOC‐CUL4B + siRNA‐β‐catenin groups. The expressions of CUL4B, Wnt/β‐catenin signaling pathway‐related proteins, and EMT‐related proteins were determined using RT‐qPCR and Western blotting. The positive expressions of CUL4B and β‐catenin protein in tissues were detected by immunohistochemistry. MTT assay and flow cytometry was performed for cell proliferation and cell cycle, scratch test, and transwell assay for cell migration and invasion ability. CUL4B and β‐catenin were expressed at a higher level in PC tissues than in paracancerous tissues though paracancerous tissues had higher expressions of CUL4B and β‐catenin than normal tissues. The PLOC‐CUL4B group showed increased CUL4B, Wnt, β‐catenin, LEF‐1, c‐Jun, Cyclin D1, N‐cadherin, Vimentin, Snail, and ZEB1 expression; decreased E‐cadherin expression; accelerated cell proliferation; increased S‐phase cell percentages; increased cell migration ability; more liver metastases; and enlarged tumor than the PLOC and PLOC‐CUL4B + siRNA‐β‐catenin groups. The shCUL4B group showed decreased CUL4B, Wnt, β‐catenin, LEF‐1, c‐Jun, Cyclin D1, N‐cadherin, Vimentin, Snail, and ZEB1 expression; increased E‐cadherin expression; decelerated cell proliferation; decreased S‐phase cell percentages; reduced cell migration ability; less liver metastases; and decreased tumor weight than the blank and negative control groups. We demonstrate that CUL4B promotes PC metastasis by inducing EMT via the Wnt/β‐catenin signaling pathway. Therefore, CUL4B might be the clinical target for treating PC.
The prevention of latanoprost on osteoclastgenesis in vitro and lipopolysaccharide‐induced murine calvaria osteolysis in vivo
Authors: Xu Xing , Yan Yufei , Liu Zhuochao , Qi Jin , Qian Niandong , Zhou Hanbing , Zhou Qi , Wang Tianqi , Huang Ping , Guo Lei , Jiang Min , Deng Lianfu
Published: December 2017

Identification of agents that inhibit osteoclast formation and function is important for the treatment of osteolytic diseases which feature excessive osteoclast formation and bone resorption. Latanoprost (LTP), an analog of prostaglandin F2α, is a medication which works to lower pressure inside the eyes. Prostaglandin F2α was reported to regulate bone metabolism, however, the effect of LTP in osteoclastogenesis is still unknown. Here, we found that LTP suppressed RANKL‐induced osteoclastogenesis in a dose‐dependent manner as illustrated by TRAP activity and TRAP staining. In addition, the osteoclast function was also reduced by LTP treatment, as indicated in less osteoclastic resorption pit areas. Furthermore, LTP inhibited the mRNA expressions of osteoclast marker genes such as TRAP and cathepsin K. In order to illustrate its molecular mechanism, we examined the changing of mRNA and protein levels of NFATc1 and c‐fos by LTP treatment, as well as the phosphorylation of ERK, AKT, JNK, and p38. The results suggested that LTP inhibited RANKL‐induced osteoclastgenesis and function by inhibiting ERK, AKT, JNK, and p38 cascade, following by the c‐fos/NFATc1 pathway. In agreement with in vitro results, using an in vivo lipopolysaccharide‐induced murine calvaria osteolysis mouse model, we found that administration of LTP was able to reverse the lipopolysaccharide‐induced bone loss. Together, these data demonstrated that LTP attenuated the bone loss in lipopolysaccharide‐induced murine calvaria osteolysis mice through inhibiting osteoclast formation and function. Our study thus provided the evidences that LTP was a potential treatment option against osteolytic bone diseases.
Sonographic appearance of an eccrine spiradenoma: A case report
Authors: Kwon Ki Eon , Kim Seon‐Jeong , Choi Hyun Jeong , Jung Yoon Yang , Park Noh Hyuck , Park Ji Yeon , Baek Soo Heui
Published: December 2017

Eccrine spiradenoma is a rare, benign, adnexal skin tumor of the sweat gland, which may manifest in any part of the body. It is typically located in the dermal or the subcutaneous fat layer. Eccrine spiradenomas rarely progress to malignant transformation and only a few cases of malignant transformation have been reported. Due to its rarity, there have been few reports about the sonographic appearances of eccrine spiradenoma. We report the sonographic findings in one case of eccrine spiradenoma, located in the subcutaneous fat and the deep dermal layers of the upper arm in a middle‐aged woman.
The Teaching, Learning, and Being of Leadership: Exploring Context and Practice of the Culturally Relevant Leadership Learning Model
Authors: Guthrie Kathy L. , Jones Tamara Bertrand , Osteen Laura
Published: December 2017

With a holistic approach in mind, the current article explores how the culturally relevant leadership learning (CRLL) model can be put into practice to enhance the inclusive nature of leadership education programs. Keeping context at the forefront, the teaching, learning, and being of leadership are fluid and dynamic processes, where educators constantly have to keep the complexity of this work in mind. Using a house metaphor, we argue for careful consideration regarding how we build leadership education programs to be welcoming, and structurally stable enough to provide safety for all who enter. Finally, the article provides a practical example of how one of us enacts the CRLL model, with particular attention to teaching, learning, and being as critical in creating immersive and engaging teaching and learning environments.
Dereplication‐guided isolation of a new indole alkaloid triglycoside from the hooks of Uncaria rhynchophylla by LC with ion trap time‐of‐flight MS
Authors: Zhang Jian‐Gang , Huang Xiao‐Yan , Ma Yun‐Bao , Zhang Xue‐Mei , Chen Ji‐Jun , Geng Chang‐An
Published: December 2017

Uncaria rhynchophylla (Gou‐Teng) as the monarch herb of many formulae (Fufang), e.g. “Tian‐Ma‐Gou‐Teng‐Yin,” “Ling‐Jiao‐Gou‐Teng‐Yin,” and “Yi‐Gan‐San”, is a famous traditional Chinese medicine documented in the Chinese pharmacopoeia for mental and cardiovascular diseases. In the traditional Chinese medicine system, only the hook‐bearing stems are used as the crude materials for Gou‐Teng, and the hooks are always considered more effective than the stems. Focusing on the mono‐herb and its active constituents from combinatorial formulae is the core idea of reductionism of traditional Chinese medicine theory. Detailed liquid chromatography with mass spectrometry analysis on the hooks of U. rhynchophylla was performed to profile the chemical constituents based on tandem mass spectrometry fragmentation and UV absorption. Under the guidance of liquid chromatography with ion trap/time‐of‐flight mass spectrometry, one new indole alkaloid triglycoside (1), together with five known compounds 2–6 as the main constituents, were isolated from the hooks of U. rhynchophylla by various column chromatography methods. Compound 1 showed moderate activity on MT1 and MT2 melatonin receptors with agonistic rates of 79.6 and 46.3% at the concentration of 1 mM. This dereplication strategy can be equally applicable to rapidly disclose the active constituents of other Chinese herbs through targeted purification.
Calcium channel autoimmunity: Cerebellar ataxia and lambert‐eaton syndrome coexisting
Authors: Zalewski Nicholas , Lennon Vanda A. , Pittock Sean J. , Mckeon Andrew
Published: December 2017

Introduction: Neuronal calcium channel antibodies are a biomarker of Lambert‐Eaton syndrome (LES) and cerebellar ataxia. We have encountered several patients with LES and cerebellar ataxia coexisting, and we sought to further define this association. Methods: We reviewed records of patients at our institution with a diagnosis of “Lambert‐Eaton syndrome” and “cerebellar ataxia.” Results: Seventeen patients were identified with LES and ataxia. Presenting symptoms were weakness (8), concurrent weakness and ataxia (4), ataxia (4), and other (1). Nine patients had small‐cell lung carcinoma, 3 of whom had survival greater than 100 months. Immunotherapy responses were best among patients without cancer. Nine of 17 (53%) patients were alive at last follow‐up (median survival 62 months; range, 8–240). Discussion: Calcium channel autoimmunity should be considered in patients with coexisting cerebellar ataxia and myasthenic weakness. Affected patients may survive small‐cell carcinoma or have immunotherapy‐responsive neurological symptoms. Muscle Nerve 58: 29–35, 2018
Tag Effects on Prespawn Mortality of Chinook Salmon: A Field Experiment Using Passive Integrated Transponder Tags, Radio Transmitters, and Untagged Controls
Authors: Naughton George P. , Keefer Matthew L. , Clabough Tami S. , Knoff Matthew J. , Blubaugh Timothy J. , Caudill Christopher C.
Published: December 2017

We conducted a field experiment to test the hypothesis that intragastric radio-tagging contributed to increased prespawn mortality (PSM) of adult Chinook Salmon Oncorhynchus tshawytscha after collection and transport to spawning sites above high-head hydroelectric dams. We assessed PSM rates of 970 wild and hatchery Chinook Salmon collected during trap-and-haul operations that were released untagged, tagged with passive integrated transponder (PIT) tags only, or double tagged with PIT tags and radio transmitters, and then recovered as carcasses in two Willamette River, Oregon, tributaries from 2009 to 2015. Results revealed no evidence that PSM rates were higher in PIT-tagged samples than in untagged (but not unhandled) control samples. The PSM rates in double-tagged samples were variable among years and between locations and indicated that radio-tagging effects were absent or small in effect size, on average, within each population. While we did not detect a consistent negative double-tagging effect across locations and years, results suggest that the potential for radio-tagging effects should be incorporated in study planning and design. We recommend that researchers use experimental designs that include control groups for directly evaluating tagging and handling effects on study outcomes.
An initial health economic evaluation of pharmacogenomic testing in patients treated for childhood cancer with anthracyclines
Authors: Dionne Francois , Aminkeng Folefac , Bhavsar Amit P. , Groeneweg Gabriella , Smith Anne , Visscher Henk , Rassekh Shahrad Rod , Ross Colin , Carleton Bruce
Published: December 2017

Background

Anthracyclines are a class of highly effective chemotherapeutic drugs commonly used to treat cancer patients. Anthracyclines, however, are associated with the development of serious adverse reactions, including anthracycline‐induced cardiotoxicity (ACT). It is not possible, within current practice, to accurately individualize treatment to minimize risk.

Procedure

Recently, genetic variants have been associated with the risk of ACT in children. Building on these findings and the related genetic test, a predictive model was developed which classifies pediatric patients by their risk of developing ACT. We assessed the value of this ACT‐predictive risk classification in addressing ACT.

Results

With current care, the estimated average lifetime cost of ACT is $8,667 per anthracycline‐treated patient and approximately 7% of patients are expected to die from ACT. The projected impact of the information from the new predictive model is a 17% reduction in the risk of mortality from ACT and savings of about 6%: lives saved and lower costs.

Conclusion

The newly identified genetic variants associated with the risk of ACT provide information that allows a more reliable prediction of the risk of ACT for a given patient and can be obtained at a very moderate cost, which is expected to lead to meaningful progress in reducing harm and costs associated with ACT.
Pediatric oncology clinical trial participation where the geography is vast: Development of a clinical research system for tertiary and satellite centers in Ontario, Canada
Authors: Alexander Sarah , Greenberg Mark , Malkin David , Portwine Carol , Johnston Donna , Silva Mariana , Zelcer Shayna , Sonshine Samantha , Manzo Janet , Bennett Carla , Brodeur‐Robb Kathy , Deveault Catherine , Ramachandran Nivetha , Gibson Paul
Published: December 2017

Opportunities for participation in clinical trials are a core component of the care of children with cancer. In Ontario, many pediatric patients live long distances from their cancer center. This paper describes the work that was done in order to allow patients participating in Children's Oncology Group trials to receive care, including research protocol related care, jointly between the tertiary pediatric cancer center and the closer‐to‐home satellite center. The system is a pragmatic risk‐based model, supporting excellence in care while ensuring good conduct of the research in compliance with applicable regulations and guidelines, including ethics oversight.
Cell Wall Proteome of Sugarcane Young and Mature Leaves and Stems
Authors: Fonseca Juliana G. , Calderan‐Rodrigues Maria J. , de Moraes Fabrício E. , Cataldi Thaís R. , Jamet Elisabeth , Labate Carlos A.
Published: December 2017

By characterizing the cell wall proteomes of different sugarcane organs (leaves and stems) at two developmental stages (young vs mature/apical vs basal), it is possible to address unique characteristics in each of them. Four‐month‐old leaves show a higher proportion of oxido‐reductases and proteins related to lipid metabolism (LM), besides a lower proportion of proteins acting on polysaccharides, in comparison to 4‐month‐old internodes. It is possible to note that sugarcane leaves and young stems have the highest LM rate than all species, which is assumed to be linked to cuticle formation. The data generated enrich the number of cell wall proteins (CWPs) identified in sugarcane, reaching 277. To our knowledge, sugarcane has now the second higher coverage of monocot CWP in plants.
Novel hybrid cryo‐radial method: an emerging alternative to CT‐guided biopsy in suspected lung cancer. A prospective case series and description of technique
Authors: Herath Samantha , Yap Elaine
Published: December 2017

In diagnosing peripheral pulmonary lesions (PPL), radial endobronchial ultrasound (R‐EBUS) is emerging as a safer method in comparison to CT‐guided biopsy. Despite the better safety profile, the yield of R‐EBUS remains lower (73%) than CT‐guided biopsy (90%) due to the smaller size of samples. We adopted a hybrid method by adding cryobiopsy via the R‐EBUS Guide Sheath (GS) to produce larger, non‐crushed samples to improve diagnostic capability and enhance molecular testing. We report six prospective patients who underwent this procedure in our institution. R‐EBUS samples were obtained via conventional sampling methods (needle aspiration, forceps biopsy, and cytology brush), followed by a cryobiopsy. An endobronchial blocker was placed near the planned area of biopsy in advance and inflated post‐biopsy to minimize the risk of bleeding in all patients. A chest X‐ray was performed 1 h post‐procedure. All the PPLs were visualized with R‐EBUS. The mean diameter of cryobiopsy samples was twice the size of forceps biopsy samples. In four patients, cryobiopsy samples were superior in size and the number of malignant cells per high power filed and was the preferred sample selected for mutation analysis and molecular testing. There was no pneumothorax or significant bleeding to report. Cryobiopsy samples were consistently larger and were the preferred samples for molecular testing, with an increase in the diagnostic yield and reduction in the need for repeat procedures, without hindering the marked safety profile of R‐EBUS. Using an endobronchial blocker improves the safety of this procedure.
Concise Review: Translating Regenerative Biology into Clinically Relevant Therapies: Are We on the Right Path?
Authors: Simkin Jennifer , Seifert Ashley W.
Published: December 2017

Despite approaches in regenerative medicine using stem cells, bio-engineered scaffolds, and targeted drug delivery to enhance human tissue repair, clinicians remain unable to regenerate large-scale, multi-tissue defects in situ. The study of regenerative biology using mammalian models of complex tissue regeneration offers an opportunity to discover key factors that stimulate a regenerative rather than fibrotic response to injury. For example, although primates and rodents can regenerate their distal digit tips, they heal more proximal amputations with scar tissue. Rabbits and African spiny mice re-grow tissue to fill large musculoskeletal defects through their ear pinna, while other mammals fail to regenerate identical defects and instead heal ear holes through fibrotic repair. This Review explores the utility of these comparative healing models using the spiny mouse ear pinna and the mouse digit tip to consider how mechanistic insight into reparative regeneration might serve to advance regenerative medicine. Specifically, we consider how inflammation and immunity, extracellular matrix composition, and controlled cell proliferation intersect to establish a pro-regenerative microenvironment in response to injuries. Understanding how some mammals naturally regenerate complex tissue can provide a blueprint for how we might manipulate the injury microenvironment to enhance regenerative abilities in humans.
Polycystin-2 Plays an Essential Role in Glucose Starvation-Induced Autophagy in Human Embryonic Stem Cell-Derived Cardiomyocytes
Authors: Lu Jun , Boheler Kenneth R. , Jiang Liwen , Chan Camie W. , Tse Wan Wai , Keung Wendy , Poon Ellen Ny , Li Ronald A. , Yao Xiaoqiang
Published: December 2017

Autophagy is a process essential for cell survival under stress condition. The patients with autosomal dominant polycystic kidney disease, which is caused by polycystin-1 or polycystin-2 (PKD2) mutation, display cardiovascular abnormalities and dysregulation in autophagy. However, it is unclear whether PKD2 plays a role in autophagy. In the present study, we explored the functional role of PKD2 in autophagy and apoptosis in human embryonic stem cell-derived cardiomyocytes. HES2 hESC line-derived cardiomyocytes (HES2-CMs) were transduced with adenoviral-based PKD2-shRNAs (Ad-PKD2-shRNAs), and then cultured with normal or glucose-free medium for 3 hours. Autophagy was upregulated in HES2-CMs under glucose starvation, as indicated by increased microtubule-associated protein 1 light chain 3-II level in immunoblots and increased autophagosome and autolysosome formation. Knockdown of PKD2 reduced the autophagic flux and increased apoptosis under glucose starvation. In Ca2+ measurement, Ad-PKD2-shRNAs reduced caffeine-induced cytosolic Ca2+ rise. Co-immunoprecipitation and in situ proximity ligation assay demonstrated an increased physical interaction of PKD2 with ryanodine receptor 2 (RyR2) under glucose starvation condition. Furthermore, Ad-PKD2-shRNAs substantially attenuated the starvation-induced activation of AMP-activated protein kinase (AMPK) and inactivation of mammalian target of rapamycin (mTOR). The present study for the first time demonstrates that PKD2 functions to promote autophagy under glucose starvation, thereby protects cardiomyocytes from apoptotic cell death. The mechanism may involve PKD2 interaction with RyR2 to alter Ca2+ release from sarcoplasmic reticulum, consequently modulating the activity of AMPK and mTOR, resulting in alteration of autophagy and apoptosis.
Minimum covariance determinant and extensions
Authors: Hubert Mia , Debruyne Michiel , Rousseeuw Peter J.
Published: December 2017

The minimum covariance determinant (MCD) method is a highly robust estimator of multivariate location and scatter, for which a fast algorithm is available. Since estimating the covariance matrix is the cornerstone of many multivariate statistical methods, the MCD is an important building block when developing robust multivariate techniques. It also serves as a convenient and efficient tool for outlier detection. The MCD estimator is reviewed, along with its main properties such as affine equivariance, breakdown value, and influence function. We discuss its computation, and list applications and extensions of the MCD in applied and methodological multivariate statistics. Two recent extensions of the MCD are described. The first one is a fast deterministic algorithm which inherits the robustness of the MCD while being almost affine equivariant. The second is tailored to high‐dimensional data, possibly with more dimensions than cases, and incorporates regularization to prevent singular matrices.

This article is categorized under:

Statistical and Graphical Methods of Data Analysis > Multivariate Analysis

Statistical and Graphical Methods of Data Analysis > Robust Methods

Statistical Learning and Exploratory Methods of the Data Sciences > Knowledge Discovery
Totally minimally invasive two-stage esophagectomy with intrathoracic hand-sewn anastomosis: short-term clinical and oncological outcomes
Authors: Elshaer M , Gravante G , Tang C-B , Jayanthi N V
Published: December 2017

Several esophageal resection techniques have been reported in literature. The objective of this study is to assess postoperative and oncological outcomes of two-stage minimally invasive esophagectomy (MIE) in a prone position using thoracoscopic hand-sewn anastomosis. Consecutive patients who underwent two-stage MIE in 2016 performed by the senior author were included. This was compared with the preceding cohort of consecutive patients who underwent two-stage hybrid esophagectomy (HE). The primary outcome was 30-day morbidity and mortality. The secondary outcomes were operation duration, length of stay (LOS), total nodes examined (TNE), number of positive nodes (NPN), and resection margin. Overall, 15 patients underwent MIE and 11 patients underwent HE. Respiratory complications occurred in three (20.0%) patients in the MIE group and in five (45.5%) patients in the HE group (P = 0.218). Cardiac complications occurred in two (18.2%) patients, and two other patients (18.2%) experienced anastomotic leak in the HE group. Mean operative duration was 349 ± 41.6 min in MIE and 309 ± 47.8 min in HE (P = 0.040). Median LOS was 10 days (range: 7–70) in MIE and 13 days (range: 10–116) in HE (P = 0.045). Median TNE was 23 (range: 12–36) in MIE and 20 (range: 14–47) in HE (P = 0.775). Longitudinal margin was involved in one patient (9.1%) in HE and no longitudinal margin was involved in the MIE group. Circumferential resection margin was involved in seven patients (46.7%) in MIE and in four patients (36.4%) in HE (P = 0.391). Two-stage MIE using hand-sewn technique is safe and feasible without compromising surgical and oncological outcomes. A multicenter large trial is recommended to confirm these results.
Assessment of the cPAS-based BGISEQ-500 platform for metagenomic sequencing
Authors: Fang Chao , Zhong Huanzi , Lin Yuxiang , Chen Bing , Han Mo , Ren Huahui , Lu Haorong , Luber Jacob M , Xia Min , Li Wangsheng , Stein Shayna , Xu Xun , Zhang Wenwei , Drmanac Radoje , Wang Jian , Yang Huanming , Hammarström Lennart , Kostic Aleksandar D , Kristiansen Karsten , Li Junhua
Published: December 2017

Background

More extensive use of metagenomic shotgun sequencing in microbiome research relies on the development of high-throughput, cost-effective sequencing. Here we present a comprehensive evaluation of the performance of the new high-throughput sequencing platform BGISEQ-500 for metagenomic shotgun sequencing and compare its performance with that of 2 Illumina platforms.

Findings

Using fecal samples from 20 healthy individuals, we evaluated the intra-platform reproducibility for metagenomic sequencing on the BGISEQ-500 platform in a setup comprising 8 library replicates and 8 sequencing replicates. Cross-platform consistency was evaluated by comparing 20 pairwise replicates on the BGISEQ-500 platform vs the Illumina HiSeq 2000 platform and the Illumina HiSeq 4000 platform. In addition, we compared the performance of the 2 Illumina platforms against each other. By a newly developed overall accuracy quality control method, an average of 82.45 million high-quality reads (96.06% of raw reads) per sample, with 90.56% of bases scoring Q30 and above, was obtained using the BGISEQ-500 platform. Quantitative analyses revealed extremely high reproducibility between BGISEQ-500 intra-platform replicates. Cross-platform replicates differed slightly more than intra-platform replicates, yet a high consistency was observed. Only a low percentage (2.02%–3.25%) of genes exhibited significant differences in relative abundance comparing the BGISEQ-500 and HiSeq platforms, with a bias toward genes with higher GC content being enriched on the HiSeq platforms.

Conclusions

Our study provides the first set of performance metrics for human gut metagenomic sequencing data using BGISEQ-500. The high accuracy and technical reproducibility confirm the applicability of the new platform for metagenomic studies, though caution is still warranted when combining metagenomic data from different platforms.
Flipping the Nursing Classroom Without Flipping Out the Students
Authors: Greenwood Victoria Anne , Mosca Caroline
Published: December 2017

Flipping the class has been touted as a method of increasing student participation and improving learning outcomes. In this study, nursing students were introduced to the flipped classroom. They were instructed to listen to narrated PowerPoint presentations before class and be ready to participate in case studies that would enhance their understanding of important concepts. When comparing student test scores before and after flipping the classroom, we found a statistically significant increase of 8.04 points after the change in instruction. Results support the hypothesis that a flipped classroom may improve learning outcomes.
Resource Allocation Strategies to Increase the Efficiency and Sustainability of Gavi’s Health System Strengthening Grants
Authors: Mimche Honoré , Squires Ellen , Miangotar Yodé , Mokdad Ali , El Bcheraoui Charbel
Published: December 2017

Background:

Despite the increase in Health System Strengthening (HSS) grants, there is no consensus among global health actors about how to maximize the efficiency and sustainability of HSS programs and their resulting gains. To formally analyze and compare the efficiency and sustainability of Gavi’s HSS grants, we investigated the factors, events and root causes that increased the time and effort needed to implement HSS grants, decreased expected outcomes and threatened the continuity of activities and the sustainability of the results gained through these grants in Cameron and Chad.

Methods:

We conducted 2 retrospective independent evaluations of Gavi’s HSS support in Cameroon and Chad using a mixed methodology. We investigated the chain of events and situations that increased the effort and time required to implement the HSS programs, decreased the value of the funds spent and hindered the sustainability of the implemented activities and gains achieved.

Results:

Root causes affecting the efficiency and sustainability of HSS grants were common to Cameroon and Chad. Weaknesses in health workforce and leadership/governance of the health system in both countries led to interrupting the HSS grants, reprogramming them, almost doubling their implementation period, shifting their focus during implementation toward procurements and service provision, leaving both countries without solid exit plans to maintain the results gained.

Conclusions:

To increase the efficiency and sustainability of Gavi’s HSS grants, recipient countries need to consider health workforce and leadership/governance prior, or in parallel to strengthening other building blocks of their health systems.
Lidocaine Spray Versus Paracervical Block During Loop Electrosurgical Excision Procedure: A Randomized Trial
Authors: Limwatanapan Nopporn , Chalapati Wadwilai , Songthamwat Srisuda , Saenpoch Surapong , Buapaichit Kuanoon , Songthamwat Metha
Published: December 2017

Objective

The aim of the study was to compare the effectiveness of pain control between lidocaine spray (LS) and paracervical block (PB) with lidocaine during the loop electrosurgical excision procedure (LEEP).

Materials and Methods

A single-blinded randomized controlled trial was conducted on 132 women who underwent LEEP of the cervix. The participants were randomly allocated to either a PB group or a LS group. The PB group participants were anesthetized by PB using 10 mL of 2% lidocaine with 1:100,000 of epinephrine. The LS group participants were locally anesthetized with four puffs (40 mg) of 10% LS, which was applied thoroughly to the cervix. Pain scores, using 10-cm visual analog scales, were obtained and compared for participants in both groups during anesthesia, during excision and 30 minutes after excision.

Results

A total of 132 LEEPs were performed with 66 in LS group and 66 in PB group. The mean (SD) pain scores during excision were 5.2 (2.4) in the LS group and 4.2 (3.3) in the PB group (mean difference = 1.1, 95% CI = 0.8 to 2.1, p = .033), which was within the nonclinically significant margin of this study. The baseline pain score after speculum examination was not significantly different in both groups. There was no adverse effect in the LS group compared with eight cases in the PB group (tinnitus, numbness, palpitation or tachycardia, and hypertension).

Conclusions

The local 40 mg of 10% LS can be used to substitute for PB for pain control during LEEP of the cervix. It also resulted in fewer adverse effects.
Discovery and characterization of coding and non-coding driver mutations in more than 2,500 whole cancer genomes
Authors: Rheinbay Esther , Nielsen Morten Muhlig , Abascal Federico , Tiao Grace , Hornshøj Henrik , Hess Julian M. , Pedersen Randi Istrup , Feuerbach Lars , Sabarinathan Radhakrishnan , Madsen Tobias , Kim Jaegil , Mularoni Loris , Shuai Shimin , Lanzós Andrés , Herrmann Carl , Maruvka Yosef E. , Shen Ciyue , Amin Samirkumar B. , Bertl Johanna , Dhingra Priyanka , Diamanti Klev , Gonzalez-Perez Abel , Guo Qianyun , Haradhvala Nicholas J. , Isaev Keren , Juul Malene , Komorowski Jan , Kumar Sushant , Lee Donghoon , Lochovsky Lucas , Liu Eric Minwei , Pich Oriol , Tamborero David , Umer Husen M. , Uusküla-Reimand Liis , Wadelius Claes , Wadi Lina , Zhang Jing , Boroevich Keith A. , Carlevaro-Fita Joana , Chakravarty Dimple , Chan Calvin W.Y. , Fonseca Nuno A. , Hamilton Mark P. , Hong Chen , Kahles Andre , Kim Youngwook , Lehmann Kjong-Van , Johnson Todd A. , Kahraman Abdullah , Park Keunchil , Saksena Gordon , Sieverling Lina , Sinnott-Armstrong Nicholas A. , Campbell Peter J. , Hobolth Asger , Kellis Manolis , Lawrence Michael S. , Raphael Ben , Rubin Mark A. , Sander Chris , Stein Lincoln , Stuart Josh , Tsunoda Tatsuhiko , Wheeler David A. , Johnson Rory , Reimand Jüri , Gerstein Mark B. , Khurana Ekta , López-Bigas Núria , Martincorena Iñigo , Pedersen Jakob Skou , Getz Gad
Published: December 2017

Discovery of cancer drivers has traditionally focused on the identification of protein-coding genes. Here we present a comprehensive analysis of putative cancer driver mutations in both protein-coding and non-coding genomic regions across >2,500 whole cancer genomes from the Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium. We developed a statistically rigorous strategy for combining significance levels from multiple driver discovery methods and demonstrate that the integrated results overcome limitations of individual methods. We combined this strategy with careful filtering and applied it to protein-coding genes, promoters, untranslated regions (UTRs), distal enhancers and non-coding RNAs. These analyses redefine the landscape of non-coding driver mutations in cancer genomes, confirming a few previously reported elements and raising doubts about others, while identifying novel candidate elements across 27 cancer types. Novel recurrent events were found in the promoters or 5’UTRs ofTP53, RFTN1, RNF34,andMTG2,in the 3’UTRs ofNFKBIZandTOB1,and in the non-coding RNARMRP.We provide evidence that the previously reported non-coding RNAsNEAT1andMALAT1may be subject to a localized mutational process. Perhaps the most striking finding is the relative paucity of point mutations driving cancer in non-coding genes and regulatory elements. Though we have limited power to discover infrequent non-coding drivers in individual cohorts, combined analysis of promoters of known cancer genes show little excess of mutations beyondTERT.
Comparative analysis of genetic diversity and differentiation of cauliflower (Brassica oleraceavar.botrytis) accessions from twoex situgenebanks
Authors: Yousef Eltohamy A. A. , Müller Thomas , Börner Andreas , Schmid Karl J.
Published: December 2017

Cauliflower (Brassica oleraceavar.botrytis) is an important vegetable crop for human nutrition. We characterized 192 cauliflower accessions from the USDA and IPK genebanks with genotyping by sequencing (GBS). They originated from 26 different countries and represent about 44% of all cauliflower accessions in both genebanks. The analysis of genetic diversity revealed that accessions formed two major groups that represented the two genebanks and were not related to the country of origin. This differentiation was robust with respect to the analysis methods that included principal component analysis, ADMIXTURE and neighbor-joining trees. Genetic diversity was higher in the USDA collection and significant phenotypic differences between the two genebanks were found in three out of six traits investigated. GBS data have a high proportion of missing data, but we observed that the exclusion of single nucleotide polymorphisms (SNPs) with missing data or the imputation of missing SNP alleles produced very similar results. The results indicate that the composition and type of accessions have a strong effect on the structure of genetic diversity ofex situcollections, although regeneration procedures and local adaptation to regeneration conditions may also contribute to a divergence.Fst-based outlier tests of genetic differentiation identified only a small proportion (<1%) of SNPs that are highly differentiated between the two genebanks, which indicates that selection during seed regeneration is not a major cause of differentiation between genebanks. Seed regeneration procedures of both genebanks do not result in different levels of genetic drift and loss of genetic variation. We therefore conclude that the composition and type of accessions mainly influence the level of genetic diversity and explain the strong genetic differentiation between the twoex situcollections. In summary, GBS is a useful method for characterizing genetic diversity in cauliflower genebank material and our results suggest that it may be useful to incorporate routine genotyping into accession management and seed regeneration to monitor the diversity present inex situcollections and to reduce the loss of genetic diversity during seed regeneration.
Entrainment of theta, not alpha, oscillations is predictive of the brightness enhancement of a flickering stimulus
Authors: Bertrand Jennifer K. , Wispinski Nathan J. , Mathewson Kyle E. , Chapman Craig S.
Published: December 2017

Frequency-dependent brightness enhancement, where a flickering light can appear twice as bright as an equiluminant constant light, has been reported to exist within the alpha (8 – 12 Hz) band. Could oscillatory neural activity be driving this perceptual effect? Here, in two experiments, human subjects reported which of two flickering stimuli were brighter. Strikingly, 4 Hz stimuli were reported as brighter more than 80% of the time when compared to all other tested frequencies, even though all stimuli were equiluminant and of equal temporal length. Electroencephalography recordings showed that inter-trial phase coherence (ITC) of theta (4 Hz) was: 1) Significantly greater than alpha, contralateral to the flickering stimulus; 2) Enhanced by the presence of a second ipsilateral 4 Hz flickering stimulus; and 3) Uniquely lateralized, unlike the alpha band. Importantly, on trials with two identical stimuli (i.e. 4 Hz vs 4 Hz), the brightness discrimination judgment could be predicted by the hemispheric balance in the amount of 4 Hz ITC. We speculate that the theta rhythm plays a distinct information transfer role, where its ability to share information between hemispheres via entrainment promotes a better processing of visual information to inform a discrimination decision.
Accuracy and Repeatability of Trajectory Rod Measurement Using Laser Scanners
Authors: Liscio Eugene , Guryn Helen , Stoewner Daniella
Published: December 2017

Three‐dimensional (3D) technologies contribute greatly to bullet trajectory analysis and shooting reconstruction. There are few papers which address the errors associated with utilizing laser scanning for bullet trajectory documentation. This study examined the accuracy and precision of laser scanning for documenting trajectory rods in drywall for angles between 25° and 90°. The inherent error range of 0.02°–2.10° was noted while the overall error for laser scanning ranged between 0.04° and 1.98°. The inter‐ and intraobserver errors for trajectory rod placement and virtual trajectory marking showed that the range of variation for rod placement was between 0.1°–1° in drywall and 0.05°–0.5° in plywood. Virtual trajectory marking accuracy tests showed that 75% of data values were below 0.91° and 0.61° on azimuth and vertical angles, respectively. In conclusion, many contributing factors affect bullet trajectory analysis, and the use of 3D technologies can aid in reduction of errors associated with documentation.
Accuracy and Reliability of Total Body Mass Estimation Techniques from Stature and Bi‐iliac Breadth in Non‐Hispanic U.S. Whites from the Bass Donated Skeletal Collection
Authors: Schaffer William C. , Dunn Tyler E.
Published: December 2017

This paper tests the fidelity of a recent method that used the NHANES III dataset as a proxy to estimate total body mass from stature and bi‐iliac breadth in U.S. White males and females. The bi‐iliac breadths of 230 males and 152 females identified as non‐Hispanic U.S. White from the Bass Donated Skeletal Collection were measured, and along with stature from predonor paperwork, total body mass estimates were calculated and then compared to body masses recorded on predonor paperwork. Male and female samples were subdivided by body mass index (BMI [kg/m2]) categories established by the World Health Organization. Our results suggest that total body mass estimates can be accurately assessed provided that the individual is within 18.50 ≤ BMI ≤ 29.99 for White males and 18.50 ≤ BMI ≤ 24.99 for White females. Recommendations on how to report total body mass estimates are also presented.
Coarse fibrillatory waves in atrial fibrillation predict success of electrical cardioversion
Authors: Zhao Tian X. , Martin Claire A. , Cooper John P. , Gajendragadkar Parag R.
Published: December 2017

Background

To determine whether the presence of “coarse” fibrillatory waves (Fw) seen on surface ECGs of patients with persistent atrial fibrillation (AF) predict maintenance of sinus rhythm (SR) at 6 weeks after electrical cardioversion (ECV).

Methods

Preprocedure ECGs from 94 consecutive patients with persistent AF scheduled to undergo ECV at a single centre were classified as having coarse Fw (≥0.1 mV) or fine Fw (<0.1 mV) in leads II or V1. The primary outcome was ECG rhythm at 6‐week clinical follow‐up. Demographic and echocardiographic data were also collected.

Results

Thirty‐two patient ECGs (34%) had coarse Fw on baseline ECG in either or both leads II or V1 with no significant differences in baseline demographics compared to those patients with fine Fw. At 6 weeks post‐ECV, in the coarse Fw group 72% of patients maintained SR vs. 42% in the fine Fw group (χ2, p = .006) with the odds ratio (OR) of maintaining SR at 6 weeks in the presence of coarse Fw being 3.5 (95% CI: 1.4–8.9, p = .007). Across the overall study population, there were no other significant univariate predictors of SR at 6 weeks post‐ECV.

Conclusion

Classifying persistent AF using the maximal Fw amplitude on a surface ECG is a simple and reproducible method of predicting medium‐term success of ECV, independent of traditional risk factors.
Placental pathologic lesions with a significant recurrence risk – what not to miss!
Authors: Chen Athena , Roberts Drucilla J.
Published: December 2017

Here, we review three important placental pathologies with significant clinical implications and recurrence risks. They are, in order of most to least frequently seen, villitis of unknown etiology, chronic histiocytic intervillositis, and massive perivillous fibrin deposition (also known as maternal floor infarction). These entities occur in both preterm and term gestations and are observed more frequently with maternal and obstetric disorders including prior pregnancy loss, hypertension/preeclampsia, and autoimmune disease. They are associated with, and probably the cause of, significant perinatal morbidity and mortality including intrauterine growth restriction, fetal and neonatal demise, and fetal/neonatal neurocompromise (seizures and cerebral palsy). All three entities have high recurrence risks, with recurrence rates ranging from 34 to 100%. The histologic features of villitis of unknown etiology, chronic histiocytic intervillositis, and massive perivillous fibrin deposition are described herein. We discuss the clinical associations and suggest the subsequent clinical and pathological evaluation. Hypotheses as to the biology of these lesions are reviewed.