bluuebunny/crossref_metadata_2025 huggingface dataset:
Individual factors and cisgender college students' attitudes and behaviors toward transgender individuals
Authors: Hackimer Laura , Chen Cliff Y.‐C. , Verkuilen Jay
Published: March 2021

The present study is one of few to investigate both anti‐trans discrimination and anti‐trans prejudice. It examined four individual factors (religiosity; political beliefs; affiliation with LGBTQ [lesbian, gay, bisexual, transgender, and queer] people; gender role beliefs) through a lens of hetero‐cis‐normativity to understand their association with anti‐trans attitudes and reported behaviors. Using a sample of 302 cisgender college students from across the United States, hierarchical multiple regressions on bootstrap samples were used to analyze how these factors are associated with anti‐trans attitudes and behaviors. More liberal political beliefs, affiliation with more LGBTQ friends and family members, and less traditional gender role beliefs were related to more positive attitudes toward transgender people. Less traditional gender role beliefs and more positive attitudes were associated with more positive reported behaviors toward transgender individuals. Interventions designed to challenge traditional gender role beliefs and approximate affiliation with LGBTQ persons may be most effective to reduce pervasive hetero‐cis‐normative prejudice and discrimination within schools.
Downregulation of connexin43 potentiates noradrenaline‐induced expression of brain‐derived neurotrophic factor in primary cultured cortical astrocytes
Authors: Morioka Norimitsu , Kondo Syun , Harada Nanase , Takimoto Tomoyo , Tokunaga Nozomi , Nakamura Yoki , Hisaoka‐Nakashima Kazue , Nakata Yoshihiro
Published: March 2021

Decreased expression of brain‐derived neurotrophic factor (BDNF) is involved in the pathology of depressive disorders. Astrocytes produce BDNF following antidepressant treatment or stimulation of adrenergic receptors. Connexin43 (Cx43) is mainly expressed in central nervous system astrocytes and its expression is downregulated in patients with major depression. How changes in Cx43 expression affect astrocyte function, including BDNF production, is poorly understood. The current study examined the effect of Cx43 knockdown on BDNF expression in cultured cortical astrocytes after stimulation of adrenergic receptors. The expression of Cx43 in rat primary cultured cortical astrocytes was downregulated with RNA interference. Levels of messenger RNAs (mRNAs) or proteins were measured by real‐time PCR and western blotting, respectively. Knockdown of Cx43 potentiated noradrenaline (NA)‐induced expression of BDNF mRNA in cultured astrocytes. NA treatment induced proBDNF protein expression in astrocytes transfected with small interfering RNA (siRNA) targeting Cx43, but not with control siRNA. This potentiation was mediated by the Src tyrosine kinase‐extracellular signal‐regulated kinase (ERK) pathway through stimulation of adrenergic α1 and β receptors. Furthermore, the Gq/11 protein‐Src‐ERK pathway and the G‐protein coupled receptor kinase 2‐Src‐ERK pathway were involved in α1 and β adrenergic receptor‐mediated potentiation of BDNF mRNA expression, respectively. The current studies demonstrate a novel mechanism of BDNF expression in cortical astrocytes mediated by Cx43, in which downregulation of Cx43 increases, through adrenergic receptors, the expression of BDNF. The current findings indicate a potentially novel mechanism of action of antidepressants, via regulation of astrocytic Cx43 expression and subsequent BDNF expression.
In vitro activity of itraconazole against SARS‐CoV‐2
Authors: Van Damme Ellen , De Meyer Sandra , Bojkova Denisa , Ciesek Sandra , Cinatl Jindrich , De Jonghe Steven , Jochmans Dirk , Leyssen Pieter , Buyck Christophe , Neyts Johan , Van Loock Marnix
Published: March 2021

Although vaccination campaigns are currently being rolled out to prevent coronavirus disease (COVID‐19), antivirals will remain an important adjunct to vaccination. Antivirals against coronaviruses do not exist, hence global drug repurposing efforts have been carried out to identify agents that may provide clinical benefit to patients with COVID‐19. Itraconazole, an antifungal agent, has been reported to have activity against animal coronaviruses. Using cell‐based phenotypic assays, the in vitro antiviral activity of itraconazole and 17‐OH itraconazole was assessed against clinical isolates from a German and Belgian patient infected with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). Itraconazole demonstrated antiviral activity in human Caco‐2 cells (EC50 = 2.3 µM; 3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyltetrazolium bromide assay). Similarly, its primary metabolite, 17‐OH itraconazole, showed inhibition of SARS‐CoV‐2 activity (EC50 = 3.6 µM). Remdesivir inhibited viral replication with an EC50 = 0.4 µM. Itraconazole and 17‐OH itraconazole resulted in a viral yield reduction in vitro of approximately 2‐log10 and approximately 1‐log10, as measured in both Caco‐2 cells and VeroE6‐eGFP cells, respectively. The viral yield reduction brought about by remdesivir or GS‐441524 (parent nucleoside of the antiviral prodrug remdesivir; positive control) was more pronounced, with an approximately 3‐log10 drop and >4‐log10 drop in Caco‐2 cells and VeroE6‐eGFP cells, respectively. Itraconazole and 17‐OH itraconazole exert in vitro low micromolar activity against SARS‐CoV‐2. Despite the in vitro antiviral activity, itraconazole did not result in a beneficial effect in hospitalized COVID‐19 patients in a clinical study (EudraCT Number: 2020‐001243‐15).
Ipsilateral motor pathways to the lower limb after stroke: Insights and opportunities
Authors: Cleland Brice T. , Madhavan Sangeetha
Published: March 2021

Stroke‐related damage to the crossed lateral corticospinal tract causes motor deficits in the contralateral (paretic) limb. To restore functional movement in the paretic limb, the nervous system may increase its reliance on ipsilaterally descending motor pathways, including the uncrossed lateral corticospinal tract, the reticulospinal tract, the rubrospinal tract, and the vestibulospinal tract. Our knowledge about the role of these pathways for upper limb motor recovery is incomplete, and even less is known about the role of these pathways for lower limb motor recovery. Understanding the role of ipsilateral motor pathways to paretic lower limb movement and recovery after stroke may help improve our rehabilitative efforts and provide alternate solutions to address stroke‐related impairments. These advances are important because walking and mobility impairments are major contributors to long‐term disability after stroke, and improving walking is a high priority for individuals with stroke. This perspective highlights evidence regarding the contributions of ipsilateral motor pathways from the contralesional hemisphere and spinal interneuronal pathways for paretic lower limb movement and recovery. This perspective also identifies opportunities for future research to expand our knowledge about ipsilateral motor pathways and provides insights into how this information may be used to guide rehabilitation.
Exploring the prognostic and therapeutic utility of expanded mutation profiling in appendix peritoneal metastasis managed with CRS/HIPEC
Authors: Zhang Chunmeng , Plambeck Benjamin D. , Craig Margaret E. , Tu Alexander , Mikus Ryan J , Shostrom Valerie , McDermott Sean P. , Igbinigie Ikponmwosa , Brown Krista , Cushman‐Vokoun Allison , Foster Jason M.
Published: March 2021

Introduction

Interrogation of cancers with next‐generation sequencing (NGS) mutation panels has become widely utilized, identifying prognostic and actionable mutations. This study explored the value of expanded mutation analysis in appendix peritoneal metastases (APM).

Methods

Forty‐eight APM patients treated 2013–2018 were retrospectively collected from a registry. Fifty‐gene NGS analysis was performed in CLIA approved lab to obtain mutation profiles. All patients underwent cytoreductive surgery (CRS)/hyperthermic intraperitoneal chemotherapy (HIPEC) with mitomycin C. Peritoneal cancer index (PCI), optimal CRS, survival (overall survival [OS] and progression‐free survival [PFS]) data were collected. Survival analyses were performed on all APM, high‐grade (HG), and low grade (LG) subsets, evaluating the impact of specific mutations on the outcome.

Results

Eighty‐three percent of APM had a mutation identified. KRAS was most frequent, 65% (88% LG 42% HG) with GNAS identified in 92% of LG‐APM. SMAD4 and/or TP53 mutations occurred in 25% of APM with observed decreased OS (46 vs. 81 months p = .0029); worse in HG‐APM (26 vs. 49 months p = .0451). SMAD4 was associated with the most significant reduction in PFS in APM (p = .0085). Actionable mutations were identified in 73% of APM patients.

Conclusions

Most frequent mutations were KRAS, TP53, and SMAD4, and actionable mutation detection was common. SMAD4 and TP53 were associated with decreased OS. NGS mutation profiling has potential utility in APM.
Emergency Department Point‐of‐Care Ultrasonography Can Reduce Length of Stay in Pediatric Appendicitis: A Retrospective Review
Authors: E. Kasmire Kathryn , Davis Joshua
Published: March 2021

Objectives

Appendicitis is the most common pediatric surgical emergency. Ultrasonography is recommended as first‐line imaging for appendicitis in children; however, this is often followed by more advanced imaging. Our goal was to determine if point‐of‐care ultrasonography (POCUS) could reduce cost and length‐of‐stay (LOS) in suspected pediatric appendicitis.

Methods

We performed a chart review of patients presenting to our pediatric emergency department (ED) from August 1, 2017 to June 30, 2019 who had imaging for appendicitis. We compared cost and LOS for patients who received POCUS to those who had magnetic resonance imaging (MRI) as first‐line imaging, which is standard at our institution.

Results

We identified 695 visits of 685 unique patients. Patients who received POCUS (n = 209) had a significantly shorter mean LOS (274 minutes) in the ED compared to patients who did not (317 minutes, P <.001). This was true regardless of the month of their visit. The POCUS group was younger, less likely to have right lower quadrant pain/tenderness, less likely to be admitted, and less likely to have appendicitis than the MRI group. Average appendix imaging cost per patient was lower in the POCUS group at $1308 compared to the MRI group at $1371 (P <.001), although patients who had both POCUS and MRI (n = 102) had the highest average imaging costs ($2010).

Conclusion

POCUS can reduce LOS and imaging cost in suspected pediatric appendicitis. Further study is warranted to determine which patients benefit the most from POCUS and whether the results are applicable in other settings.
Sublabial Approach for Repair of Congenital Nasal Pyriform Aperture Stenosis: How I Do It
Authors: Luitje Martha , Vandjelovic Nathan , McKenna Benoit Margo , Faria John
Published: March 2021

View Video S1
Consumer reactions to nudity in print advertising: Comparing same‐gender and opposite‐gender effects
Authors: Trivedi Rohit H. , Teichert Thorsten
Published: March 2021

It is often assumed that exposure to nude stimuli in advertising influences consumer behavior positively. However, the empirical evidence concerning the effects of nudity on consumer reactions is inconclusive. The goal of this study is to disentangle the effects of opposite‐gender and same‐gender nudity on female and male consumers' reactions. This study, thereby, offers a framework for the appropriate choice of seminude or fully clothed human stimuli based on advertisers' objectives and consumer–model gender interactions. The empirical data were derived from a large‐scale market research initiative from Germany with 61,399 consumer evaluations of 147 real ads from 16 product categories. Female consumers show positive same‐gender results for both seminude and fully clothed female models, indicating strong homophily, but nonsignificant opposite‐gender effects on information search, positive attitude change, integration of brand into consideration set, and purchase intentions. In contrast, male consumers demonstrate a significantly positive and equally strong influence of opposite‐gender and same‐gender seminude stimuli on all of the four variables.
Cannabinoid use for appetite stimulation and weight gain in cancer care: Does recent evidence support an update of the European Society for Clinical Nutrition and Metabolism clinical guidelines?
Authors: Johnson Stephani , Ziegler Jane , August David A.
Published: March 2021

Cannabinoids have been used medicinally for thousands of years. Clinical trials support their use for treatment of chemotherapy‐induced nausea and vomiting and HIV‐ and AIDS‐related anorexia. Cancer anorexia cachexia syndrome (CACS) is a common debilitating condition and is associated with poor prognosis. The 2016 European Society for Parenteral and Enteral Nutrition clinical guidelines on nutrition in cancer patients concluded that “there are insufficient consistent clinical data to recommend cannabinoids to improve taste disorders or anorexia in cancer patients.” The increased attention that cannabinoids have received in recent years warrants an updated evaluation of the literature on this topic, as practitioners are likely to encounter cancer patients interested in cannabinoid use. A systematic literature search was performed to assess the current body of evidence concerning cannabinoid use for the stimulation of appetite and oral intake by cancer patients. Over the past 20 years, 6 randomized controlled trials have evaluated the impact of cannabinoids on appetite‐related outcomes in oncology patients in comparison with a control group or placebo. Based on this literature, cannabinoids do not appear to improve appetite, oral intake, weight, chemosensory function, or appetite‐related quality of life. Limitations of the literature include small sample sizes, lack of adjustment for confounding variables, and difficulties conducting true placebo‐controlled trials with a drug that may result in psychoactive side effects. Further exploration of the impact of cannabinoid use on CACS by using large, well‐designed clinical trials is needed.
Tracking Wichita Falls' Path From DPR to IPR
Authors: Nix Daniel K. , Southard Mark , Burris Harold , Adams Hunter , Schreiber Russell
Published: March 2021

The City of Wichita Falls, Texas, made international news in 2014 when its water system became a water reuse pioneer. In response to a historic drought, the city simultaneously planned and implemented direct potable reuse (DPR) and indirect potable reuse (IPR) systems to see it through the drought and respond to future water shortages. Now, the city is a role model for water utilities around the world.
A procedural and flexible approach for specification, modeling, definition, and analysis for self‐adaptive systems
Authors: Araújo‐de‐Oliveira Patrícia , Durán Francisco , Pimentel Ernesto
Published: March 2021

An adaptive system can modify its settings at runtime as a response to changes in its operational environment. To analyse this kind of systems at design time is a difficult task since it requires considering the system together with the adaptation operations, and taking into account how such adaptations act on the system. In order to use simulation‐based techniques for the analysis of such systems, we not only need precise executable models of the systems to be analyzed, but also to capture the semantics of their adaptation mechanisms. Given the wide range and flexibility of adaptation operations, we need ways to allow the definition of new operations. We present a flexible approach for the definition and simulation‐based analysis in design‐time of adaptive component‐based systems. Our approach combines an extension of the Palladio component model in e‐Motions, a model of the adaptation mechanisms, and elastic requirements specification using the SYBL language. From the model of the system, its adaptation mechanisms, and its requirements, an executable Maude specification is generated for simulation. The application of the approach is illustrated on a use case that comprises some components and adaptations rules. The example is then analyzed using simulations. It is also shown that it is indeed possible to define additional metrics, specify adaptation requirements and rules which conduct simulations of the models in a more flexible way, and that the results of the simulation performed from these definitions can be used to carry on a valuable predictive performance analysis.
What are the most common disorders in dogs?
Authors: Mills Georgina
Published: March 2021

Georgina Mills reports on research from VetCompass looking at the top reasons why dogs visit the vets
Efficient graph‐based tensile strength simulations of random fiber structures
Authors: Harmening Marc , Marheineke Nicole , Wegener Raimund
Published: March 2021

In this paper, we propose a model‐simulation framework for virtual tensile strength testing of random fiber structures, such as those in nonwoven materials. The focus is on efficient handling of the problem‐inherent multi‐scales and randomness. In particular, the interplay between random microstructure and deterministic structural production‐related features on the macro‐scale makes classical homogenization‐based approaches computationally complex and costly. In our approach we model the fiber structure as graph‐based and of truss‐type, equipped with a nonlinear elastic material law. The tensile strength test is described by a sequence of force equilibria with varied boundary conditions. Its embedding into a singularly perturbed dynamical system is advantageous with respect to statements on solution theory and convergence of numerical methods. A problem‐tailored data reduction provides additional speed‐up, while Monte‐Carlo simulations account for randomness. This work serves as a proof of concept and opens the field for optimization.
Effect of cryopreservation on DNA damage and DNA repair activity in human blood samples in the comet assay
Authors: Bankoglu Ezgi Eyluel , Stipp Franzisca , Gerber Johanna , Seyfried Florian , Heidland August , Bahner Udo , Stopper Helga
Published: March 2021

The comet assay is a commonly used method to determine DNA damage and repair activity in many types of samples. In recent years, the use of the comet assay in human biomonitoring became highly attractive due to its various modified versions, which may be useful to determine individual susceptibility in blood samples. However, in human biomonitoring studies, working with large sample numbers that are acquired over an extended time period requires some additional considerations. One of the most important issues is the storage of samples and its effect on the outcome of the comet assay. Another important question is the suitability of different blood preparations. In this study, we analysed the effect of cryopreservation on DNA damage and repair activity in human blood samples. In addition, we investigated the suitability of different blood preparations. The alkaline and FPG as well as two different types of repair comet assay and an in vitro hydrogen peroxide challenge were applied. Our results confirmed that cryopreserved blood preparations are suitable for investigating DNA damage in the alkaline and FPG comet assay in whole blood, buffy coat and PBMCs. Ex vivo hydrogen peroxide challenge yielded its optimal effect in isolated PBMCs. The utilised repair comet assay with either UVC or hydrogen peroxide-induced lesions and an aphidicolin block worked well in fresh PBMCs. Cryopreserved PBMCs could not be used immediately after thawing. However, a 16-h recovery with or without mitotic stimulation enabled the application of the repair comet assay, albeit only in a surviving cell fraction.
Key role of exopolysaccharide on di-butyl phthalate adsorbing by Lactobacillus plantarum CGMCC18980
Authors: Fan Yu-Hang , Shen Yi-Lin , Lin Zhi-Wei , Zhou Ying , Ye Bang-Ce
Published: March 2021

Plasticizers belong to hormone-like substances existing widely in the environment. According to the Environmental Protection Agency of China, they are considered to be the fourth class of toxic chemicals due to their harmful effects on normal endocrine system in human bodies. In the recent published work of our lab, Lactobacillus plantarum CGMCC18980 (strain P1) could reduce the toxicity of di-butyl phthalate (DBP) in rats effectively. The purpose of this study is to further explore the adsorption mechanism of di-butyl phthalate to L. plantarum CGMCC18980, based on optimizing the adsorption conditions. As a consequence, the adsorption effect of L. plantarum CGMCC18980 attributed to relationships between exopolysaccharide, membrane protein, and the cell wall. Experimental results demonstrated that exopolysaccharide and the cell wall were devoted to DBP binding. An obvious adsorption layer was observed outside of L. plantarum CGMCC18980 through scanning electron microscope (SEM) and transmission electron microscope (TEM). The Fourier transform infrared spectroscopy (FTIR) results showed that the functional groups involved in adsorption were mainly C=O, C-N, and C-O, which related to lipids and polysaccharides. Zeta potential analysis indicated that DBP adsorption had no significant relationship with surface charge. These results revealed that exopolysaccharide may be the key factor of strain CGMCC18980 in DBP adsorption.

Key points

• Lactobacillus plantarum CGMCC18980 has the ability to adsorb di-butyl phthalate, reaching to 58.63%.

• Exopolysaccharide is considered to play a key role in adsorption process.

• Membrane protein, cell wall, and surface charge do not contribute to adsorption.
Just another “Clever Hans”? Neural networks and FDG PET-CT to predict the outcome of patients with breast cancer
Authors: Weber Manuel , Kersting David , Umutlu Lale , Schäfers Michael , Rischpler Christoph , Fendler Wolfgang P. , Buvat Irène , Herrmann Ken , Seifert Robert
Published: March 2021

Background

Manual quantification of the metabolic tumor volume (MTV) from whole-body 18F-FDG PET/CT is time consuming and therefore usually not applied in clinical routine. It has been shown that neural networks might assist nuclear medicine physicians in such quantification tasks. However, little is known if such neural networks have to be designed for a specific type of cancer or whether they can be applied to various cancers. Therefore, the aim of this study was to evaluate the accuracy of a neural network in a cancer that was not used for its training.

Methods

Fifty consecutive breast cancer patients that underwent 18F-FDG PET/CT were included in this retrospective analysis. The PET-Assisted Reporting System (PARS) prototype that uses a neural network trained on lymphoma and lung cancer 18F-FDG PET/CT data had to detect pathological foci and determine their anatomical location. Consensus reads of two nuclear medicine physicians together with follow-up data served as diagnostic reference standard; 1072 18F-FDG avid foci were manually segmented. The accuracy of the neural network was evaluated with regard to lesion detection, anatomical position determination, and total tumor volume quantification.

Results

If PERCIST measurable foci were regarded, the neural network displayed high per patient sensitivity and specificity in detecting suspicious 18F-FDG foci (92%; CI = 79–97% and 98%; CI = 94–99%). If all FDG-avid foci were regarded, the sensitivity degraded (39%; CI = 30–50%). The localization accuracy was high for body part (98%; CI = 95–99%), region (88%; CI = 84–90%), and subregion (79%; CI = 74–84%). There was a high correlation of AI derived and manually segmented MTV (R2 = 0.91; p < 0.001). AI-derived whole-body MTV (HR = 1.275; CI = 1.208–1.713; p < 0.001) was a significant prognosticator for overall survival. AI-derived lymph node MTV (HR = 1.190; CI = 1.022–1.384; p = 0.025) and liver MTV (HR = 1.149; CI = 1.001–1.318; p = 0.048) were predictive for overall survival in a multivariate analysis.

Conclusion

Although trained on lymphoma and lung cancer, PARS showed good accuracy in the detection of PERCIST measurable lesions. Therefore, the neural network seems not prone to the clever Hans effect. However, the network has poor accuracy if all manually segmented lesions were used as reference standard. Both the whole body and organ-wise MTV were significant prognosticators of overall survival in advanced breast cancer.
Novel Genes Required for Surface-Associated Motility in Acinetobacter baumannii
Authors: Blaschke Ulrike , Skiebe Evelyn , Wilharm Gottfried
Published: March 2021

Acinetobacter baumannii is an opportunistic and increasingly multi-drug resistant human pathogen rated as a critical priority one pathogen for the development of new antibiotics by the WHO in 2017. Despite the lack of flagella, A. baumannii can move along wet surfaces in two different ways: via twitching motility and surface-associated motility. While twitching motility is known to depend on type IV pili, the mechanism of surface-associated motility is poorly understood. In this study, we established a library of 30 A. baumannii ATCC® 17978™ mutants that displayed deficiency in surface-associated motility. By making use of natural competence, we also introduced these mutations into strain 29D2 to differentiate strain-specific versus species-specific effects of mutations. Mutated genes were associated with purine/pyrimidine/folate biosynthesis (e.g. purH, purF, purM, purE), alarmone/stress metabolism (e.g. Ap4A hydrolase), RNA modification/regulation (e.g. methionyl-tRNA synthetase), outer membrane proteins (e.g. ompA), and genes involved in natural competence (comEC). All tested mutants originally identified as motility-deficient in strain ATCC® 17978™ also displayed a motility-deficient phenotype in 29D2. By contrast, further comparative characterization of the mutant sets of both strains regarding pellicle biofilm formation, antibiotic resistance, and virulence in the Galleria mellonella infection model revealed numerous strain-specific mutant phenotypes. Our studies highlight the need for comparative analyses to characterize gene functions in A. baumannii and for further studies on the mechanisms underlying surface-associated motility.
Bioerosion ichnodiversity in barnacles from the Ross Sea, Antarctica
Authors: Meyer Neele , Wisshak Max , Freiwald André
Published: March 2021

Breakdown of skeletal and lithic hard substrates by organisms, a process referred to as bioerosion, is part of the global carbon cycle and receives increased attention, but little is known about bioerosion in polar environments. Here, we study bioerosion traces (addressed by their respective ichnotaxa) recorded in the barnacle Bathylasma corolliforme from the Ross Sea, Antarctica. Traces were visualized via scanning electron microscopy of epoxy casts prepared with the vacuum cast-embedding technique. In 50 samples from shallow 37 m to bathyal 1680 m water depths, 16 different bioerosion traces were found, classified into microborings presumably produced by cyanobacteria (1), chlorophytes (1), fungi (9), foraminifera (1), unknown organotrophs (5), and macroborings produced by cirripeds (1). Statistical ichnodiversity analysis resulted in a significant (p = 0.001) ANOSIM with moderate differences (R = 0.5) between microbioerosion trace assemblages at different water depths and revealed two main clusters (NMDS, SIMPROF) corresponding to the photic and aphotic stations. A comparison between this study and a corresponding study from the Svalbard archipelago, Arctic Ocean, shows that the ichnodiversity in calcareous barnacle skeletons is similar in polar waters of both hemispheres. This includes several ichnotaxa that are indicative for cool- to cold-water environments, such as Flagrichnus baiulus and Saccomorpha guttulata. Nine of the investigated ichnotaxa occur in both polar regions and seven ichnotaxa show an extensive bathymetrical range down to the deep sea at bathyal 1680 m water depth.
To buy or not to buy—evaluating commercial AI solutions in radiology (the ECLAIR guidelines)
Authors: Omoumi Patrick , Ducarouge Alexis , Tournier Antoine , Harvey Hugh , Kahn Charles E. , Louvet-de Verchère Fanny , Pinto Dos Santos Daniel , Kober Tobias , Richiardi Jonas
Published: March 2021

Artificial intelligence (AI) has made impressive progress over the past few years, including many applications in medical imaging. Numerous commercial solutions based on AI techniques are now available for sale, forcing radiology practices to learn how to properly assess these tools. While several guidelines describing good practices for conducting and reporting AI-based research in medicine and radiology have been published, fewer efforts have focused on recommendations addressing the key questions to consider when critically assessing AI solutions before purchase. Commercial AI solutions are typically complicated software products, for the evaluation of which many factors are to be considered. In this work, authors from academia and industry have joined efforts to propose a practical framework that will help stakeholders evaluate commercial AI solutions in radiology (the ECLAIR guidelines) and reach an informed decision. Topics to consider in the evaluation include the relevance of the solution from the point of view of each stakeholder, issues regarding performance and validation, usability and integration, regulatory and legal aspects, and financial and support services.

Key Points

• Numerous commercial solutions based on artificial intelligence techniques are now available for sale, and radiology practices have to learn how to properly assess these tools.

• We propose a framework focusing on practical points to consider when assessing an AI solution in medical imaging, allowing all stakeholders to conduct relevant discussions with manufacturers and reach an informed decision as to whether to purchase an AI commercial solution for imaging applications.

• Topics to consider in the evaluation include the relevance of the solution from the point of view of each stakeholder, issues regarding performance and validation, usability and integration, regulatory and legal aspects, and financial and support services.
Prevalence of colorectal cancer and its precursor lesions in symptomatic patients under 55 years of age undergoing total colonoscopy: results of a large retrospective, multicenter, controlled endoscopy study
Authors: Stratmann Katharina , Czerwinska Katarzyna , Filmann Natalie , Tacke Wolfgang , Weber Christoph , Bock Herbert , Blumenstein Irina
Published: March 2021

Purpose

Colorectal cancer (CRC) is the second most common cancer in Germany. Around 60,000 people were diagnosed CRC in 2016 in Germany. Since 2019, screening colonoscopies are offered in Germany for men by the age of 50 and for women by the age of 55. It is recently discussed if women should also undergo a screening colonoscopy by the age of 50 and if there are any predictors for getting CRC.

Methods

Colonoscopies of 1553 symptomatic patients younger than 55 years were compared with colonoscopies of 1075 symptomatic patients older than 55 years. We analyzed if there are any significant differences between those two groups in the prevalence of CRC and its precursor lesions or between symptomatic men and women. We evaluated if there is a correlation between abdominal symptoms and the prevalence of CRC.

Results

In 164/1553 symptomatic patients, 194 (12.5%) polyps were detected. In total, six colorectal carcinomas (0.4%) were detected. There were no significant differences between men and women. In symptomatic patients ≥ 55 years, significantly more polyps were found (p<0.0001; 26.6% vs. 12.5%). Totally, 286 polyps (26.6%) were removed in 1075 symptomatic patients older than 55 years. Anorectal bleeding was the only abdominal symptom being a significant indicator for the prevalence of the occurrence of colon and rectum cancer in both groups (p=0.03, OR=2.73 95%-CI [1.11;6.70]), but with only low sensitivity (44%).

Conclusion

Due to no significant differences in men and women, we recommend screening colonoscopies also for women by the age of 50.
Veränderungen von Wohlbefinden und privater Unterstützung für Ältere: ein Blick auf die Auswirkungen der COVID-19-Pandemie im Frühsommer 2020
Authors: Brandt Martina , Garten Claudius , Grates Miriam , Kaschowitz Judith , Quashie Nekehia , Schmitz Alina
Published: March 2021

Hintergrund

Die Pilotstudie „Gesundheit und Unterstützung in Zeiten von Corona“ (Technische Universität Dortmund) erhob vom Mai bis Juli 2020 Veränderungen von Unterstützung und Wohlbefinden Älterer infolge der COVID-19-Pandemie.

Ziel der Arbeit

Ziel war es, empirische Erkenntnisse zu den sozialen und mentalen Folgen der Pandemie für in Privathaushalten lebende Personen der Altersgruppe 40+ Jahre zu gewinnen. Betrachtet wurden durch die Pandemie bedingte Änderungen im Erhalt und im Leisten von Unterstützung (u. a. persönliche Pflege, Hilfe im Haushalt) und Betreuungsprobleme sowie Veränderungen des Wohlbefindens.

Material und Methoden

Mithilfe deskriptiver und multivariater Analysen wurde untersucht, wie sich im Zuge der Pandemie Unterstützungsmuster änderten, ob Betreuungsprobleme entstanden, und ob sich in diesem Zuge des Wohlbefinden (Lebenszufriedenheit und Einsamkeit) veränderte.

Ergebnisse

Im Zuge der Pandemie zogen sich insbesondere Ältere und Hochaltrige aus der Unterstützung für andere zurück. Frauen berichteten häufiger von Betreuungsproblemen mit älteren Angehörigen. Das Wohlbefinden verringerte sich insgesamt, am deutlichsten aber bei Frauen und Hochaltrigen. Die multivariaten Analysen verdeutlichen, dass Betreuungsprobleme mit älteren Angehörigen im Zuge der Pandemie mit geringerem Wohlbefinden einhergingen.

Diskussion

Unsere Pilotstudie zeigt deutliche Änderungen in Unterstützungsmustern und im Wohlbefinden der Befragten. Viele berichten von mehr Einsamkeit und geringerer Lebenszufriedenheit als vor der Pandemie – insbesondere Frauen, die Unterstützungsleistungen für andere erbringen. Sorgearbeit wird durch die Pandemie und die Maßnahmen zu ihrer Bekämpfung erschwert. Zukünftige Kontaktbeschränkungen sollten mit Bedacht eingesetzt werden und dies im Blick haben.
Infectivity of deceased COVID-19 patients
Authors: Plenzig Stefanie , Bojkova D. , Held H. , Berger A. , Holz F. , Cinatl J. , Gradhand E. , Kettner M. , Pfeiffer A. , Verhoff M. A. , Ciesek S.
Published: March 2021

The duration of infectivity of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) in living patients has been demarcated. In contrast, a possible SARS-CoV-2 infectivity of corpses and subsequently its duration under post mortem circumstances remain to be elucidated. The aim of this study was to investigate the infectivity and its duration of deceased COVID-19 (coronavirus disease) patients. Four SARS-CoV-2 infected deceased patients were subjected to medicolegal autopsy. Post mortem intervals (PMI) of 1, 4, 9 and 17 days, respectively, were documented. During autopsy, swabs and organ samples were taken and examined by RT-qPCR (real-time reverse transcription-polymerase chain reaction) for the detection of SARS-CoV-2 ribonucleic acid (RNA). Determination of infectivity was performed by means of virus isolation in cell culture. In two cases, virus isolation was successful for swabs and tissue samples of the respiratory tract (PMI 4 and 17 days). The two infectious cases showed a shorter duration of COVID-19 until death than the two non-infectious cases (2 and 11 days, respectively, compared to > 19 days), which correlates with studies of living patients, in which infectivity could be narrowed to about 6 days before to 12 days after symptom onset. Most notably, infectivity was still present in one of the COVID-19 corpses after a post-mortem interval of 17 days and despite already visible signs of decomposition. To prevent SARS-CoV-2 infections in all professional groups involved in the handling and examination of COVID-19 corpses, adequate personal safety standards (reducing or avoiding aerosol formation and wearing FFP3 [filtering face piece class 3] masks) have to be enforced for routine procedures.
Does endometrial morular metaplasia represent odontogenic differentiation?
Authors: Travaglino Antonio , Raffone Antonio , Russo Daniela , Guadagno Elia , Pignatiello Sara , Moretta Paola , Zullo Fulvio , Del Basso De Caro Marialaura , Insabato Luigi , Mascolo Massimo
Published: March 2021

The nature of endometrial morular metaplasia (MorM) is still unknown. The nuclear β-catenin accumulation and the not rare ghost cell keratinization suggest a similarity with hard keratin-producing odontogenic and hair matrix tumors rather than with squamous differentiation. We aimed to compare MorM to hard keratin-producing tumors. Forty-one hard keratin-producing tumors, including 26 hair matrix tumors (20 pilomatrixomas and 6 pilomatrix carcinomas) and 15 odontogenic tumors (adamantinomatous craniopharyngiomas), were compared to 15 endometrioid carcinomas with MorM with or without squamous/keratinizing features. Immunohistochemistry for β-catenin, CD10, CDX2, ki67, p63, CK5/6, CK7, CK8/18, CK19, and pan-hard keratin was performed; 10 cases of endometrioid carcinomas with conventional squamous differentiation were used as controls. In adamantinomatous craniopharyngiomas, the β-catenin-accumulating cell clusters (whorl-like structures) were morphologically similar to MorM (round syncytial aggregates of bland cells with round-to-spindled nuclei and profuse cytoplasm), with overlapping squamous/keratinizing features (clear cells with prominent membrane, rounded squamous formations, ghost cells). Both MorM and whorl-like structures consistently showed positivity for CD10 and CDX2, with low ki67; cytokeratins pattern was also overlapping, although more variable. Hard keratin was focally/multifocally positive in 8 MorM cases and focally in one conventional squamous differentiation case. Hair matrix tumors showed no morphological or immunophenotypical overlap with MorM. MorM shows wide morphological and immunophenotypical overlap with the whorl-like structures of adamantinomatous craniopharyngiomas, which are analogous to enamel knots of tooth development. This suggests that MorM might be an aberrant mimic of odontogenic differentiation.
An advanced empirical model for quantifying the impact of heat and climate change on human physical work capacity
Authors: Foster Josh , Smallcombe James W. , Hodder Simon , Jay Ollie , Flouris Andreas D. , Nybo Lars , Havenith George
Published: March 2021

Occupational heat stress directly hampers physical work capacity (PWC), with large economic consequences for industries and regions vulnerable to global warming. Accurately quantifying PWC is essential for forecasting impacts of different climate change scenarios, but the current state of knowledge is limited, leading to potential underestimations in mild heat, and overestimations in extreme heat. We therefore developed advanced empirical equations for PWC based on 338 work sessions in climatic chambers (low air movement, no solar radiation) spanning mild to extreme heat stress. Equations for PWC are available based on air temperature and humidity, for a suite of heat stress assessment metrics, and mean skin temperature. Our models are highly sensitive to mild heat and to our knowledge are the first to include empirical data across the full range of warm and hot environments possible with future climate change across the world. Using wet bulb globe temperature (WBGT) as an example, we noted 10% reductions in PWC at mild heat stress (WBGT = 18°C) and reductions of 78% in the most extreme conditions (WBGT = 40°C). Of the different heat stress indices available, the heat index was the best predictor of group level PWC (R2= 0.96) but can only be applied in shaded conditions. The skin temperature, but not internal/core temperature, was a strong predictor of PWC (R2= 0.88), thermal sensation (R2= 0.84), and thermal comfort (R2= 0.73). The models presented apply to occupational workloads and can be used in climate projection models to predict economic and social consequences of climate change.
A dynamic discarding technique to increase speed and preserve accuracy for YOLOv3
Authors: Martinez-Alpiste Ignacio , Golcarenarenji Gelayol , Wang Qi , Alcaraz-Calero Jose Maria
Published: March 2021

This paper proposes an acceleration technique to minimise the unnecessary operations on a state-of-the-art machine learning model and thus to improve the processing speed while maintaining the accuracy. After the study of the main bottlenecks that negatively affect the performance of convolutional neural networks, this paper designs and implements a discarding technique for YOLOv3-based algorithms to increase the speed and maintain accuracy. After applying the discarding technique, YOLOv3 can achieve a 22% of improvement in terms of speed. Moreover, the results of this new discarding technique were tested on Tiny-YOLOv3 with three output layers on an autonomous vehicle for pedestrian detection and it achieved an improvement of 48.7% in speed. The dynamic discarding technique just needs one training process to create the model and thus execute the approach, which preserves accuracy. The improved detector based on the discarding technique is able to readily alert the operator of the autonomous vehicle to take the emergency brake of the vehicle in order to avoid collision and consequently save lives.
Past medical history of tumors other than meningioma is a negative prognostic factor for tumor recurrence in meningiomas WHO grade I
Authors: Biczok Annamaria , Karschnia Philipp , Vitalini Raffaela , Lenski Markus , Greve Tobias , Thorsteinsdottir Jun , Egensperger Rupert , Dorn Franziska , Tonn Jörg-Christian , Schichor Christian
Published: March 2021

Background

Prognostic markers for meningioma recurrence are needed to guide patient management. Apart from rare hereditary syndromes, the impact of a previous unrelated tumor disease on meningioma recurrence has not been described before.

Methods

We retrospectively searched our database for patients with meningioma WHO grade I and complete resection provided between 2002 and 2016. Demographical, clinical, pathological, and outcome data were recorded. The following covariates were included in the statistical model: age, sex, clinical history of unrelated tumor disease, and localization (skull base vs. convexity). Particular interest was paid to the patients’ past medical history. The study endpoint was date of tumor recurrence on imaging. Prognostic factors were obtained from multivariate proportional hazards models.

Results

Out of 976 meningioma patients diagnosed with a meningioma WHO grade I, 416 patients fulfilled our inclusion criteria. We encountered 305 women and 111 men with a median age of 57 years (range: 21–89 years). Forty-six patients suffered from a tumor other than meningioma, and no TERT mutation was detected in these patients. There were no differences between patients with and without a positive oncological history in terms of age, tumor localization, or mitotic cell count. Clinical history of prior tumors other than meningioma showed the strongest association with meningioma recurrence (p = 0.004, HR = 3.113, CI = 1.431–6.771) both on uni- and multivariate analysis.

Conclusion

Past medical history of tumors other than meningioma might be associated with an increased risk of meningioma recurrence. A detailed pre-surgical history might help to identify patients at risk for early recurrence.
POR polymorphisms are associated with 21 hydroxylase deficiency
Authors: Pecori Giraldi F. , Einaudi S. , Sesta A. , Verna F. , Messina M. , Manieri C. , Menegatti E. , Ghizzoni L.
Published: March 2021

Purpose

Genotype–phenotype correlation in congenital 21 hydroxylase deficiency is strong but by no means absolute. Indeed, clinical and hormonal features may vary among patients carrying similar CYP21A2 mutations, suggesting that modifier genes may contribute to the phenotype. Aim of the present study was to evaluate whether polymorphisms in the p450  oxidoreductase (POR) gene may affect clinical features in patients with 21 hydroxylase deficiency

Methods

Sequencing of the POR gene was performed in 96 patients with 21 hydroxylase deficiency (49 classic, 47 non-classic) and 43 control subjects.

Results

Prevalence of POR polymorphisms in patients with 21 hydroxylase was comparable to controls and known databases. The rs2228104 polymorphism was more frequently associated with non-classic vs classic 21 hydroxylase deficiency (allelic risk 7.09; 95% C.I. 1.4–29.5, p < 0.05). Classic 21 hydroxylase-deficient carriers of the minor allele in the rs2286822/rs2286823 haplotype presented more frequently the salt-wasting form (allelic risk 1.375; 95% C.I. 1.138–1.137), more severe Prader stage at birth (allelic risk 3.85; 95% C.I. 3.78–3.92), higher ACTH levels, and younger age at diagnosis.

Conclusions

Polymorphisms in the POR gene are associated with clinical features of 21 hydroxylase deficiency both as regards predisposition to classic vs non-classic forms and severity of classic adrenal hyperplasia.
Outlawing Opposition, Imposing Rule of Law: Authoritarian Constitutionalism in Cambodia
Authors: LAWRENCE Benjamin
Published: March 2021

Cambodia's Constitution, promulgated in September 1993, was to be the foundation of a transition to liberal, multiparty democracy. Yet, despite the document's seeming commitment to those very principles, constitutional provisions are frequently used to undermine liberal rule of law and to impose restrictions on political processes, freedoms, and rights. Focusing on the events of 2016–2017, including the jailing of opposition politicians, controversial legal reforms, and the dissolution of the country's foremost opposition party, this article demonstrates how authoritarian practices in Cambodia are framed in terms of adherence – even fidelity – to the Constitution. Further, it explores how ideas of ‘stability’ and ‘law and order’ often elide with those of rule of law in discourses and practices that simultaneously exalt and hollow out the normative power of the Constitution. This article posits that a socio-legal approach that pays particular attention to discourse can shed new light on the empirical fact of authoritarian constitutionalism, but also the processes of meaning-making that accompany, facilitate, and legitimize its practice. Far from merely a sham, then, Cambodia's Constitution – like many others – is imbricated in a complex web of contestation and legitimation that extends far beyond the walls of any courtroom.
Ἵππος χλωρός (Rev 6.8): A Methodology for the Study of Colour Terms in the New Testament
Authors: Ureña Lourdes Garcia
Published: March 2021

The meaning of χλωρός in Rev 6.8 has been given a variety of interpretations (green, yellow, pale, vigorous etc.) due to its polysemic character; that is, it possesses a chromatic as well as an achromatic meaning and, in addition, if it denotes colour, can express a wide spectrum of hues. From this arises the need for a methodology that offers not merely a gloss, but rather a ‘meaning’. This methodology is based on: an analysis of the text; the use of the term; the concept of colour that existed in antiquity and the entity in which the colour was embodied; and the use of various lexicographical tools provided by the field of cognitive linguistics.
A Fuzzy Approach for the Kinematic Reliability Assessment of Robotic Manipulators
Authors: Lara-Molina Fabian A. , Dumur Didier
Published: March 2021

This paper aims at developing a novel method to assess the kinematic reliability of robotic manipulators based on the fuzzy theory. The kinematic reliability quantifies the probability of obtaining positioning errors within acceptable limits. For this purpose, the fuzzy reliability evaluates the effect of the joint clearances on the end-effector position to compute a failure possibility index. As an alternative to the conventional methods reported in the literature, this failure possibility index conveys a novel assessment of the kinematic performance. The numerical results are compared with the well-known probabilistic approach based on the Monte Carlo simulation.