bluuebunny/crossref_metadata_2025 huggingface dataset:
SHP2 knockdown ameliorates liver insulin resistance by activating IRS‐2 phosphorylation through the AKT and ERK1/2 signaling pathways
Authors: Yue Xinxin , Han Tao , Hao Wei , Wang Min , Fu Yang
Published: October 2020

Diabetes is a chronic metabolic disease characterized by insulin resistance (IR). SHP2 has previously been identified as a potential target to reduce IR in diabetes. Here, we examined the effects of SHP2 on glucose consumption (GC), IR level and the expression of insulin receptor substrate (IRS), AKT and extracellular signal‐regulated kinase (ERK)1/2 proteins in a cellular and animal model of diabetes. IR was induced in hepatocellular carcinoma (HCC) cells, and SHP2 was up‐regulated or down‐regulated in cells. Diabetic rats were treated with SHP2 inhibitor. GC of cells, and the weight, total cholesterol, triglycerides, fasting blood glucose, fasting insulin, homeostasis model assessment‐IR index and insulin sensitivity (ISI) of the rats were analyzed. The levels of SHP2 and the activation of IRS‐2, AKT and ERK1/2 in cells and rats were measured by quantitative real‐time PCR (qRT‐PCR) or western blot. GC was reduced, but expression of SHP2 was enhanced in IR HCC cells. Phosphorylation of IRS‐2 and AKT in IR HCC cells and diabetic rats was decreased, whereas phosphorylation of ERK1/2 was enhanced. In both the cell and animal models, SHP2 knockdown enhanced GC, ameliorated IR, activated IRS‐2 and AKT, and inhibited ERK1/2 phosphorylation, in contrast with the effects of SHP2 overexpression. SHP2 knockdown may enhance GC and ameliorate IR through phosphorylation of IRS‐2 via regulating AKT and ERK1/2 in liver.
Remembering personal change for better or worse: Retrieval context matters
Authors: Boucher Chantal M. , Scoboria Alan
Published: October 2020

We investigated how focusing on the details (experience focus) versus self‐narrative significance (coherence focus) of valenced transitions informs appraisals and emotions at recall. Participants (N = 302) selected a negative or positive transition and rated their emotion. Two weeks later, they described their event using an experience or coherence focus, then rated emotion, event impact, self‐relevance, and memory characteristics. A coherence (vs. experience) focus produced lower negative affect and greater psychological impact, particularly for negative transitions. The negative‐coherence group showed the largest decrease in negation emotion over time. A coherence (vs. experience) focus resulted in less perceptual detail, reactivity, and re‐experiencing. Positive (vs. negative) events were deemed more central to identity and connected to other events. Mental focus informed psychological impact and negative affect, while event valence influenced self‐relevance. These findings remained when event type (interpersonal) was matched across groups. Motives for framing autobiographical memories and implications for adaptive self‐reflection are discussed.
On the Influence of Microstructure on the Corrosion Behavior of Fe–Mn–Al–Ni Shape Memory Alloy in 5.0 wt% NaCl Solution
Authors: Frenck Johanna-Maria , Vollmer Malte , Mandel Marcel , Krüger Lutz , Niendorf Thomas
Published: October 2020

Herein the corrosion behavior of Fe–Mn–Al–Ni shape memory alloys characterized by different microstructures in a 5.0 wt% NaCl solution is investigated. Open circuit potential and potentiodynamic polarisation tests are conducted. Generally, Fe–Mn–Al–Ni shows corrosion properties being similar to pure iron. However, the polarization curves of single crystals indicate the presence of an unstable passive system. The corrosion damage is analyzed by means of optical microscopy and electron microscopy. It is revealed that polycrystalline samples consisting of two different phases induced by heat treatment, i.e., α‐phase and γ‐phase or β‐Mn phase and γ‐phase, are suffering a selective corrosion attack of the α‐phase and β‐Mn–phase, respectively. On the contrary, the single crystal seems to form a protective layer on the surface. Upon presence of stress‐induced martensite, a selective corrosion attack of γ′–martensite is observed.
Surface‐Modified Ni‐Rich Layered Oxide Cathode Via Thermal Treatment of Poly(Vinylidene Fluoride) for Lithium‐Ion Batteries
Authors: Kang Kyung Seok , Seong Min Ji , Oh Si Hyoung , Yu Ji‐Sang , Yim Taeeun
Published: October 2020

Combination of poly(vinylidene fluoride) (PVDF) with Ni‐rich layered cathode material create artificial cathode‐electrolyte interphases by thermal decomposition of PVDF and residual Li+ species. The pressure of the cell cycled with PVDF‐treated cathode materials is markedly decreased, since the thermal treatment with PVDF selectively reduces the amounts of Li+ species. The cycling performance is improved compared to nontreated Ni‐rich layered cathodes because the artificial cathode–electrolyte interphases effectively suppress the electrolyte decomposition as determined by systematic characterization of particle hardness, surface morphology, and electrochemical impedance spectroscopy. Additional high temperature storage tests performed with 3450‐dimensioned pouch cells indicate much improved recovery rates, as well as smaller open circuit voltage drops, smaller increases in internal resistance, and less swelling for cells cycled with the PVDF‐treated Ni‐rich layered cathode than with a nontreated Ni‐rich layered cathode.
Anatomic basis for a new ultrasound‐guided, mini‐invasive technique for release of the deep transverse metatarsal ligament
Authors: Nieves Gabriel Camunas , Fernández‐Gibello Alejandro , Moroni Simone , Montes Ruben , Márquez Javier , Ortiz Mario Suárez , Vázquez Teresa , Duparc Fabrice , Moriggl Bernhard , Konschake Marko
Published: October 2020

Introduction

Morton's neuroma is an entrapment neuropathy of the third common plantar digital nerve, caused by the deep transverse metatarsal ligament (DTML). Minimally invasive or percutaneous surgery is a very common procedure, but surgical effectivity of this technique remains controversial. The goal of our study was to prove the effectiveness and safety of a new ultrasound‐guided technique for DTML‐release in a cadaver model.

Materials, Methods, and Results

The DTML was visualized in 10 fresh frozen donated body to science‐feet (eight male and two females, five left and five right) using an US device (GE Logic R7; 13 MHz linear probe, Madrid, Spain). Consecutively, minimally invasive ultrasound‐guided surgery was performed. Exclusion criteria of the donated bodies to science were previous history of forefoot surgery and space occupying mass lesions. The complete release of the ligament was achieved in all specimens without damage of any important anatomical structures as proven by anatomical dissection.

Conclusions

The results of this study indicate that our novel approach of an ultrasound‐guided release of the DTML is safer and more effective compared to blind techniques. The DTML could reliably be visualized and securely cut through a dorsal, minimally invasive surgical incision of only 2 mm.
Consider storytelling to help children cope during COVID‐19
Authors: Sullivan Mary A. , Paccione‐Dyszlewski Margaret
Published: October 2020

This is a frightening time for all of us, but especially for children. Children are living through COVID‐19 and the traumatic changes the virus has had on the routine and schedule of their daily lives. School is a primary source of structure and socialization for most youngsters. As the pandemic continues to unfold, children are experiencing unprecedented shifts in school openings, learning models, extracurricular activities, and even access to play dates and other socialization venues. Without teachers, friends, coaches, or even time outside of the home, children are experiencing tremendous loss and are struggling to understand their new reality.
The importance of returning to school from SAMHSA leader
Authors: Knopf Alison
Published: October 2020

As this issue went to press (mid‐September), schools were still deciding whether and how to open. During a week when more and more schools decided not to open up classes for this fall, concerns about the welfare of children isolated at home, without the benefit of their peers or teachers, mounted as well. Elinore McCance‐Katz, M.D., Ph.D., assistant secretary for mental health and substance abuse of the Department of Health and Human Services, opined in USA Today that not opening schools would harm the mental health of children. In the limelight due to many changes in substance use disorder treatment due to the pandemic, McCance‐Katz sided with President Trump and Education Secretary Betsy DeVos in saying that ignoring these casualties would harm children more than the risks of COVID‐19. The schools should reopen, and parents should decide for themselves whether they want their children to attend, she writes.
Identification of QTL associated with cold acclimation and freezing tolerance in Zoysia japonica
Authors: Brown Jessica M. , Yu Xingwang , Holloway H. McCamy P. , Tuong Tan D. , Schwartz Brian M. , Patton Aaron J. , Arellano Consuelo , Livingston David P. , Milla‐Lewis Susana R.
Published: October 2020

Zoysiagrasses (Zoysia spp.) are relatively low‐input and warm‐season turfgrasses which have grown in popularity in the United States since their introduction in the 1890s. Over 30 improved zoysiagrass cultivars were released in the past three decades, but many lack freezing tolerance and their use is limited to warm‐humid climates. Understanding the genetic controls of winter hardiness and freezing tolerance in zoysiagrass could considerably benefit the breeding efforts to increase tolerance to freezing stress. In the present study, controlled environment acclimation and freezing tests were used to evaluate a Meyer × Victoria zoysiagrass mapping population for post‐freezing surviving green tissue (SGT) and regrowth (RG). Quantitative trait loci (QTL) mapping analysis identified nine QTL associated with SGT, eight QTL linked to RG, and 22 QTL common in both traits, accounting for between 6.4 and 12.2% of the phenotypic variation. Eleven regions of interest overlapped with putative winter injury QTL identified in a previous field study. Upon sequence analysis, homologs of several abiotic response genes were found underlying these overlapping QTL regions. The homologs of these gene encode transcription factors, cell wall modification‐related proteins, and defense signal transduction‐related proteins. After further validation, these QTL and their associated markers have potential to be used in future breeding efforts for the development of a broader pool of zoysiagrass cultivars capable of surviving in cold climates.
Time‐restricted feeding improves the reproductive function of female mice via liver fibroblast growth factor 21
Authors: Hua Lun , Feng Bin , Huang Liansu , Li Jing , Luo Ting , Jiang Xuemei , Han Xingfa , Che Lianqiang , Xu Shengyu , Lin Yan , Fang Zhengfeng , Wu De , Zhuo Yong
Published: October 2020

Background

There has been a significant increase, to epidemic levels, of obese and overweight women of reproductive age, causing impairments to reproductive health. Time‐restricted feeding (TRF) including isocaloric intake has shown to be preventive of obesity‐related disorders. However, its therapeutic ability to improve the reproductive function of female remains largely unknown.

Methods

Here, we investigated the ability of TRF to improve the reproductive function in wild‐type and liver‐specific FGF21 knockout female mice. To study fertility, a continuous and a short‐term fertility test, gonadotropin releasing‐hormone (GnRH), and Kisspeptin test were performed. Immortalized GnRH neuron was used to examine the direct role of liver fibroblast growth factor 21 (FGF21) on GnRH secretion.

Results

We found that TRF rescues female mice from bodyweight gain and glucose intolerance, as well as ovarian follicle loss and dysfunction of estrus cyclicity induced by high‐fat diet. Furthermore, the beneficial effects of the TRF regimen on the reproductive performance were also observed in mice fed both chow and high‐fat diet. However, those beneficial effects of TRF on metabolism and reproduction were absent in liver‐specific FGF21 knockout mice. In vitro, FGF21 directly acted on GnRH neurons to modulate GnRH secretion via extracellular regulated protein kinases (ERK1/2) pathway.

Conclusions

Overall, time‐restricted feeding improves the reproductive function of female mice and liver FGF21 signaling plays a key role in GnRH neuron activity in female mice.
The association between prenatal alcohol consumption and preschool child stress system disturbance
Authors: Grimm Jennifer , Stemmler Mark , Golub Yulia , Schwenke Eva , Goecke Tamme W. , Fasching Peter A. , Beckmann Matthias W. , Kratz Oliver , Moll Gunther H. , Kornhuber Johannes , Eichler Anna
Published: October 2020

Background

Drinking alcohol during pregnancy is considered a risk factor for child development; however, child biomarkers of prenatal alcohol exposure have been rarely studied. We examined whether a meconium alcohol metabolite (ethyl glucuronide, EtG) was associated with child cortisol concentrations at primary school age.

Methods

For 137 children, prenatal alcohol exposure was operationalized by the meconium biomarker EtG and by maternal self‐reports during pregnancy. Two EtG cut‐offs (EtG ≥10 ng/g and EtG ≥112 ng/g) were applied. Cortisol concentrations were measured in saliva and hair samples.

Results

Children with EtG ≥10 ng/g showed significantly reduced hair cortisol concentrations (HCCs) (p = .050,  = 0.042). For children with EtG ≥112 ng/g, the cortisol awakening response (CAR) was significantly decreased (p = .025,  = 0.070). These effects were also present in correlational analyses with continuous EtG data, speaking for partly dose‐dependent effects. Especially, within the EtG ≥112 ng/g group, the basal (CAR: rp = −.642, p = .120) and cumulative (HCC: rp = −.660, p = .107) cortisol parameters were associated with child emotional symptoms at medium effect size.

Conclusions

The present study showed both the biological association of intrauterine alcohol exposure with the cortisol stress system, partly dose‐dependent, and the functional association with emotional and behavioral symptoms.
Knockout of the gene encoding the extracellular matrix proteinSNED1results in early neonatal lethality and craniofacial malformations
Authors: Barqué Anna , Jan Kyleen , De La Fuente Emanuel , Nicholas Christina L. , Hynes Richard O. , Naba Alexandra
Published: October 2020

Background

The extracellular matrix (ECM) is a fundamental component of multicellular organisms that orchestrates developmental processes and controls cell and tissue organization. We previously identified the novel ECM protein SNED1 as a promoter of breast cancer metastasis and showed that its level of expression negatively correlated with breast cancer patient survival. Here, we sought to identify the roles of SNED1 during murine development.

Results

We generated two novelSned1knockout mouse strains and showed thatSned1is essential since homozygous ablation of the gene led to early neonatal lethality. Phenotypic analysis of the surviving knockout mice revealed a role for SNED1 in the development of craniofacial and skeletal structures sinceSned1knockout resulted in growth defects, nasal cavity occlusion, and craniofacial malformations.Sned1is widely expressed in embryos, notably by cell populations undergoing epithelial‐to‐mesenchymal transition, such as the neural crest cells. We further show that mice with a neural‐crest‐cell‐specific deletion ofSned1survive, but display facial anomalies partly phenocopying the global knockout mice.

Conclusions

Our results demonstrate requisite roles for SNED1 during development and neonatal survival. Importantly, the deletion of 2q37.3 in humans, a region that includes theSNED1locus, has been associated with facial dysmorphism and short stature.
An Efficient Bio‐inspired Oxygen Reduction Reaction Catalyst: MnOx Nanosheets Incorporated Iron Phthalocyanine Functionalized Graphene
Authors: Wu Xing , Cheng Yi , Veder Jean‐Pierre , Jiang San Ping
Published: October 2020

Oxygen reduction reaction (ORR) catalysts play a critical role in energy storage and conversion devices and have been attracted enormous interests, and however, it remains challenging to develop highly active cheap catalysts in a simple and green route. Inspired by the heme‐copper oxidases (HOCs), in which the ORR active center is originated from the incorporation of Fe‐N4 with copper atom, we here developed a fine manganese oxide nanosheets (MnOx NSs) integrated with iron phthalocyanine (FePc) anchored on highly conductive graphene (MnOx/FePc‐G) through a green route only involve ethanol as the reagent. The bio‐inspired catalyst MnOx/FePc‐G demonstrated high ORR activity with a half‐wave potential (E1/2) of 0.887 V, about 57 mV more positive than that of Pt/C. And the current density (j) at 0.9 V is about 1.9 mA cm−2, which is three times of Pt/C and FePc‐G. More importantly, the bio‐inspired systems show superior stability in comparison to commercial Pt/C, showing a potential of 0.863 V to deliver a j of 3 mA cm−2 after 18 000 s polarization, about 80 mV higher than that of 0.783 V for Pt/C. The high activity is contributed by the integration of the FePc and MnOx NSs that plays the role to assist the cleavage of the O2 bond. Our approach provides a new evidence to develop highly efficient ORR catalysts through imitate the naturally involved systems through a simple route.
Isolated atrial amyloidosis suspected by electrophysiological voltage mapping and diagnosed by 99mTc‐DPD scintigraphy
Authors: Schöppenthau Doreen , Schatka Imke , Berger Alexander , Pieske Burkert , Hahn Kathrin , Knebel Fabian , Kleefeld Felix , Alexander Tobias , Gerds‐Li Jin‐Hong , Messroghli Daniel
Published: October 2020

We present not‐yet‐seen multimodal images of a 55‐year‐old female patient with isolated atrial amyloidosis (IAA) who clinically suffered from multiple atrial arrhythmias and heart failure symptoms with preserved left ventricular ejection fraction. We aim to show structural and functional abnormalities detected by electrophysiological voltage mapping, cardiac magnetic resonance imaging (MRI) [cMRI; atrial strain measurements, late gadolinium enhancement (LGE) visualization], and 99mTc‐DPD scintigraphy. Bipolar voltage mapping performed during two electrophysiological procedures showed diffuse left atrial low‐voltage areas (bipolar < 0.5 mV) and also a moderately diseased right atrium suspected of infiltrative cardiomyopathy. Catheter ablation did successfully treat a left atrial and two right atrial focal tachycardias. For further diagnostics, a 3T cMRI was performed, revealing a subendocardial circumferential left atrial LGE and pathological atrial strain measurements, especially during conduit and reservoir phase. Afterwards, nuclear imaging with 559 MBq of 99mTc‐DPD was performed. The scan revealed amyloid infiltration of the left atrium. Neither an uptake in the ventricular myocardium nor an extra‐cardiac uptake of DPD was seen. Genetic testing for transthyretin amyloidosis mutations in this patient was negative, and peripheral neuropathy was ruled out by electromyogram analysis. The synopsis of these findings reveals IAA as the most possible diagnosis and showed isolated atrial nuclear tracer uptake with 99mTc‐DPD scintigraphy for the first time. Non‐invasive imaging techniques might help in suggesting IAA but need further investigation.
Human pregnancy levels of estrogen and progesterone contribute to humoral immunity by activating TFH/B cell axis
Authors: Monteiro Clarice , Kasahara Taissa , Sacramento Priscila M. , Dias Aleida , Leite Simone , Silva Vander G. , Gupta Sudhir , Agrawal Anshu , Bento Cleonice A. M.
Published: October 2020

Circulating TFH (cTFH) cells express CXCR5, PD‐1, and, when activated, ICOS, and release IL‐21. According to the production of IFN‐γ, IL‐4, and IL‐17 and expression of FoxP3, these cells are also classified as cTFH1, cTFH2, cTFH17, and cTFR cells, respectively. This CD4+T‐cell subset is pivotal to efficient humoral immunity, and pregnancy appears to favor IgG production. Here, not only pregnancy amplified the in vivo production of anti‐HBsAg IgG in HBV immunized women, but the frequency of cTFH cells was directly correlated with estradiol levels. In vitro, pregnancy‐related dose of 17‐β‐estradiol (E2) directly increased the percentage of different cTFH subsets. While E2 and progesterone (P4) increased the proportion of differentiated TFH cells derived from naïve CD4+T‐cells, only E2 amplified the release of IL‐21 in those cell cultures. In addition, E2 and P4 increased the proportion of memory B cells and plasma cells, respectively. In SEB‐activated B/TFH cell co‐cultures, E2, in the presence of P4, increased the production of total IgG. Finally, among the hormones, P4 was stronger in upregulating the percentage of IL‐10+TFR cells. Collectively, our findings suggested that E2 and P4 cooperate in the humoral immune response by favoring the expansion of different cTFH and B cell subsets.
Seismic performance of two classes of earth dams
Authors: Masini Luca , Rampello Sebastiano , Donatelli Riccardo
Published: October 2020

In the last decades, Italy has experienced several strong earthquakes, triggering the attention on the high seismic risk associated with the potential instability of large existing earth dams. Under intense seismic events, dam response depends on various factors including the geometry and the type of water retention scheme. This paper explores the influence of these factors, comparing the seismic performance of two idealized earth dams: a homogeneous dam and a zoned dam. The simplified models adopted in the analyses are representative of these two classes of earth dams, often adopted in the sixties to design various dams located in southern Italy. The idealized models, here examined in detail, have comparable heights and foundation soil conditions, differing in terms of water retention scheme. The seismic response of the dams was evaluated through time‐domain nonlinear dynamic analyses in which the same input ground motion, represented by real‐time histories, was applied at the base of the models. It is shown that for highly inelastic systems, such as those at hand, duration of input motion should be accounted for in addition to compatibility criteria with a design elastic response spectrum. Also, different slopes of dam flanks, shear strength mobilization at the end of dam construction and high stiffness contrast at the shells‐core contacts are shown to result in different deformation patterns at the end of earthquake loading. Some peculiarities in the behavior of these classes of earth dams are highlighted in the paper, providing a guidance for the rational assessment of their seismic performance.
Renewable energy in Russia: A critical perspective
Authors: Pagliaro Mario
Published: October 2020

Partly explaining the low uptake of energy production from renewable energy sources, Russia accesses huge oil, natural gas, coal, and uranium resources and hosts advanced nuclear energy, oil, and natural gas industries. Yet, the combined effect of the exceedingly low cost of electricity generation via today's photovoltaic modules and wind turbines combined with energy storage in Li‐ion battery and hydrogen obtained via water electrolysis will shortly have a profound impact on Russia's economy and manufacturing industry. The buildup of Russia's clean energy technology industry will require proper planning, rationalization efforts, and the development of creative and effective policies, which will include new educational initiatives in today's new energy technologies and energy management.
Comparative study between single versus dual trigger for poor responders in GnRH‐antagonist ICSI cycles: A randomized controlled study
Authors: Maged Ahmed M. , Ragab Mohamed A. , Shohayeb Amal , Saber Waleed , Ekladious Sherif , Hussein Eman A. , El‐Mazny Akmal , Hany Ayman
Published: October 2020

Objective

To investigate whether dual triggering of final oocyte maturation with a combination of gonadotropin‐releasing hormone (GnRH) agonist and human chorionic gonadotropin (hCG) can improve the number of retrieved oocytes and clinical pregnancy rate in poor responders undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF‐ICSI) cycles using a GnRH‐antagonist protocol.

Methods

A randomized controlled trial included poor ovarian responders indicated for ICSI using a GnRH‐antagonist protocol. They were divided equally into two groups: group I received 10 000 units of hCG plus 0.2 mg of triptorelin while group II received 10 000 units of hCG only for triggering of ovulation. The primary outcome parameter was the number of oocytes retrieved. Secondary outcomes included metaphase II oocytes number, cancellation rate, number of obtained embryos, chemical and clinical pregnancy rates.

Results

One hundred and sixty women were included in the study, with 80 women in each treatment group. Dual triggering was associated with higher number of retrieved oocytes (5.3 ± 1.9 vs 4.5 ± 2.4, P=0.014), metaphase II oocytes (3.8 ± 1.4 vs 3.1 ± 1.7, P=0.004), total and grade 1 embryos (2.7 ± 1.1 and 2.3 ± 1.0 vs 1.9 ± 1.2 and 1.1 ± 0.2, P=0.001 and 0.021 respectively), and transferred embryos (2.2 ± 0.9 vs 1.6 ± 0.9, P=0.043, and lower cancellation rate (7.5% vs 20%, P=0.037) compared with single triggering. There were significantly higher chemical (25% vs 11.3%, P=0.039) and clinical (22.5% vs 8.8%, P=0.028) pregnancy rates in women with dual triggering compared with those with single triggering.

Conclusion

Dual triggering is associated with better IVF outcome in poor responders compared with single trigger.

Clinical trial registration NCT04008966.
Risk factors for adverse outcomes among pregnant and postpartum women with acute respiratory distress syndrome due to COVID‐19 in Brazil
Authors: Menezes Mariane O. , Takemoto Maíra L. S. , Nakamura‐Pereira Marcos , Katz Leila , Amorim Melania M. R. , Salgado Heloisa O. , Melo Adriana , Diniz Carmen S. G. , de Sousa Liduina A. R. , Magalhaes Claudia G. , Knobel Roxana , Andreucci Carla B. ,   Brazilian Group of Studies for COVID‐19, Pregnancy
Published: October 2020

Objective

To evaluate whether clinical and social risk factors are associated with negative outcomes for COVID‐19 disease among Brazilian pregnant and postpartum women.

Methods

A secondary analysis was conducted of the official Acute Respiratory Syndrome Surveillance System database. Pregnant and postpartum women diagnosed with COVID‐19 ARDS until July 14, 2020, were included. Adverse outcomes were a composite endpoint of either death, admission to the intensive care unit (ICU), or mechanical ventilation. Risk factors were examined by multiple logistic regression.

Results

There were 2475 cases of COVID‐19 ARDS. Among them, 23.8% of women had the composite endpoint and 8.2% died. Of those who died, 5.9% were not hospitalized, 39.7% were not admitted to the ICU, 42.6% did not receive mechanical ventilation, and 25.5% did not have access to respiratory support. Multivariate analysis showed that postpartum period, age over 35 years, obesity, diabetes, black ethnicity, living in a peri‐urban area, no access to Family Health Strategy, or living more than 100 km from the notification hospital were associated with an increased risk of adverse outcomes.

Conclusion

Clinical and social risk factors and barriers to access health care are associated with adverse outcomes among maternal cases of COVID‐19 ARDS in Brazil.
Comprehensive pulmonary toxicity assessment of cetylpyridinium chloride using A549 cells and Sprague–Dawley rats
Authors: Kim Haewon , Yoo Jean , Lim Yeon‐Mi , Kim Eun‐Ji , Yoon Byung‐Il , Kim Pilje , Yu Seung Do , Eom Ig‐Chun , Shim Ilseob
Published: October 2020

Cetylpyridinium chloride (CPC), a quaternary ammonium compound and cationic surfactant, is used in personal hygiene products such as toothpaste, mouthwash, and nasal spray. Although public exposure to CPC is frequent, its pulmonary toxicity has yet to be fully characterized. Due to high risks of CPC inhalation, we aimed to comprehensively elucidate the in vitro and in vivo toxicity of CPC. The results demonstrated that CPC is highly cytotoxic against the A549 cells with a half‐maximal inhibitory concentration (IC50) of 5.79 μg/ml. Following CPC exposure, via intratracheal instillation (ITI), leakage of lactate dehydrogenase, a biomarker of cell injury, was significantly increased in all exposure groups. Further, repeated exposure of rats to CPC for 28 days caused a decrease in body weight of the high‐exposure group and the relative weights of the lungs and kidneys of the high recovery group, but no changes were evident in the histological and serum chemical analyses. The bronchoalveolar lavage fluid (BALF) analysis showed a significant increase in proinflammatory cytokines interleukin (IL)‐6, IL‐1β, and tumor necrosis factor (TNF)‐α levels. ITI of CPC induced focal inflammation of the pulmonary parenchyma in rats' lungs. Our study demonstrated that TNF‐α was the most commonly secreted proinflammatory cytokine during CPC exposure in both in vitro and in vivo models. Polymorphonuclear leukocytes in the BALF, which are indicators of pulmonary inflammation, significantly increased in a concentration‐dependent manner in all in vivo studies including the ITI, acute, and subacute inhalation assays, demonstrating that PMNs are the most sensitive parameters of pulmonary toxicity.
Improvement of the mechanical and biological properties of bioactive glasses by the addition of zirconium oxide (ZrO2) as a synthetic bone graft substitute
Authors: Kang Tae‐Yun , Seo Ji‐Young , Ryu Jeong‐Hyun , Kim Kwang‐Mahn , Kwon Jae‐Sung
Published: October 2020

In this study, mechanical properties of bioactive glass (BAG) synthetic bone graft substitute was improved by containing ZrO2 (ZrO2‐BAG), while maintaining advantageous biological properties of BAG such as osteoinductive and osteoconductive properties. The ZrO2‐BAG was produced by adding ZrO2 in the following proportions to replace Na2O in 45S5 BAG: 1% (Zr1‐BAG), 3% (Zr3‐BAG), 6% (Zr6‐BAG), and 12% (Zr12‐BAG). Properties including XRD, XPS, SEM, DSC, fracture toughness, and Vickers microhardness were evaluated. To assess the biological properties, Ca/P apatite formation, ion release, degradation rate, cell proliferation, ALP activity (ALP), and alizarin red S staining assay (ARS) were evaluated. Also, expression of osteogenic differentiation markers, Osteopontin (OPN), confirmed by immunofluorescence staining. Finally, an in vivo test was carried out to by implanting ZrO2‐BAG into the subcutaneous tissue of rats. The results of each test were statistically analyzed with one‐way ANOVA followed by Tukey's post hoc statistical test. Amorphous ZrO2‐BAG was successfully produced with increased mechanical properties as the ZrO2 content was increased. Additionally, ZrO2‐BAG exhibited a slower ion release and degradation rate compare to BAG without ZrO2. Bioactivity of ZrO2‐BAG was confirmed with apatite layer formed on the surface, significantly higher proliferation rate and significantly enhanced ALP and the degree of ARS of the cells compare to respective controls. The tissue reactions observed in the in vivo study showed neo‐formed vessels after implantation of ZrO2‐BAG.
Branched‐chain amino acid to tyrosine ratio is an essential pre‐treatment factor for maintaining sufficient treatment intensity of lenvatinib in patients with hepatocellular carcinoma
Authors: Eso Yuji , Nakano Shigeharu , Mishima Masako , Arasawa Soichi , Iguchi Eriko , Takeda Haruhiko , Takai Atsushi , Takahashi Ken , Seno Hiroshi
Published: October 2020

Background/Purpose

Lenvatinib was recently approved as a novel agent for hepatocellular carcinoma. To maximize the therapeutic effect of anticancer drugs, it is essential to maintain treatment intensity by avoiding dose reduction or discontinuation. We aimed to identify essential factors contributing to achieve sufficient treatment intensity of lenvatinib.

Methods

Seventy‐one patients who received treatment with lenvatinib were included in this study. We used the delivered dose intensity/body surface area ratio (DBR) to measure treatment intensity of lenvatinib.

Results

2M‐DBR (DBR for the first 60 days) of lenvatinib (≥206.7) was strongly correlated with objective response and was the significant factor contributing to prolonged progression‐free survival (PFS). Patients with high 2M‐DBR had significantly prolonged PFS compared with those who had low 2M‐DBR (P < .001). Multivariate analysis revealed that pre‐treatment α‐fetoprotein and branched‐chain amino acid to tyrosine ratio (BTR) were significant factors in maintaining high 2M‐DBR of lenvatinib. Furthermore, patients with high pre‐treatment BTR (≥4.50) showed significantly longer PFS than those with low BTR (P = .032).

Conclusions

Maintaining high 2M‐DBR of lenvatinib is essential to increase response rate and PFS. To achieve high 2M‐DBR levels, preservation of pre‐treatment BTR is essential, suggesting the importance of nutritional management in the treatment for hepatocellular carcinoma with lenvatinib.
Endoscopic ultrasound guided–antegrade biliary stenting vs percutaneous transhepatic biliary stenting for unresectable distal malignant biliary obstruction in patients with surgically altered anatomy
Authors: Iwashita Takuji , Uemura Shinya , Mita Naoki , Iwasa Yuhei , Ichikawa Hironao , Mukai Tsuyoshi , Yasuda Ichiro , Shimizu Masahito
Published: October 2020

Background/Purpose

Unresectable distal malignant biliary obstruction (DMBO) in patients with surgically altered anatomy is traditionally managed with percutaneous transhepatic biliary drainage (PTBD) and stenting because the anatomical features complicate the endoscopic approach to the biliary orifice. EUS‐guided approaches recently emerged as alternative treatments; however, limited data comparing the procedures are available. The aim of this study was to compare EUS–antegrade biliary stenting (ABS) with PTBD for DMBO in patients with surgically altered anatomy.

Methods

The medical records of patients who underwent EUS‐ABS or PTBD for the management of DMBO and had a history of upper intestinal surgery at two tertiary centers between 2007 and 2019 were retrospectively evaluated. The study outcomes were technical, clinical, and internalization success rates and adverse event rates.

Results

Of the 64 enrolled patients, 35 underwent EUS‐ABS and 29 had PTBD. Basic characteristics including age, sex, performance status, primary malignancy, and reconstruction method did not differ significantly between groups. The technical, clinical, and internalization success rates in the EUS‐ABS and PTBD groups were 97.1% vs 96.6% (P = 1.00), 97.1% vs 93.1% (P = .586), and 97.1% vs 75.9% (P = .01), respectively. The adverse event rate was 11.4% vs 27.6% (P = .119). No significant long‐term difference was seen in time to recurrent biliary obstruction and survival. Multivariate analysis confirmed EUS‐ABS was not an independent risk factor for survival.

Conclusions

Similar to PTBD, EUS‐ABS can effectively and safely manage DMBO in patients with surgically altered anatomy. Further well‐designed trials are warranted to confirm these findings.
Larger Carpathian region climate according to Köppen, Feddema and the Worldwide Bioclimatic Classification System methods
Authors: Szabó Amanda Imola , Ács Ferenc , Breuer Hajnalka
Published: October 2020

The Köppen method, the Worldwide Bioclimatic Classification System (WBCS), and Feddema's descriptive climate classification method are used to analyse the Larger Carpathian Region (LCR) climate. Minimum, maximum and average temperature, precipitation and latitude and elevation data as input data are taken from the CarpatClim dataset. It refers to the period 1961–2010 with a 1‐day temporal resolution and a spatial resolution of 0.1° × 0.1°. The methods are compared in terms of their capability to represent climate heterogeneity and thermal and moisture characteristics on the annual and seasonal time scales. The region's climate is analysed separately for lowland, hill, mountain and high mountain regions using the results of the Köppen method as reference. The WBCS gave the highest spatial climate heterogeneity, followed by Feddema's method, and then the Köppen method in all three region types. However, the WBCS has the largest data input requirement. The rarest climate type according to the Köppen method is ET. This climate type is registered according to the Feddema and WBCS methods by three different climate types. The most frequent climate type according to the Köppen method is Cfb. This climate type is represented by 19 and 14 climate types according to the Feddema and the WBCS methods, respectively. The most frequent climate type according to Feddema's method is cool and dry with extreme seasonality of T and according to WBCS it is temperate continental steppic supratemperate sub‐humid. The coldest climate is produced by Feddema, the warmest by the WBCS. The Feddema method treats seasonality in the most comprehensive way. The Feddema and the WBCS methods reproduced the large climate heterogeneity of the LCR. The results can also be used as basic information in the PannEx project, as well as in future environmental and regional climate change‐related investigations for estimating thermal and moisture stresses.
Analyzing the predictability of the Kwok and Caton periodontal prognosis system: A retrospective study
Authors: Nguyen Lincoln , Krish Goutam , Alsaleh Ahmed , Mailoa James , Kapila Yvonne , Kao Richard T. , Lin Guo‐Hao
Published: October 2020

Background

The aim of this study was to analyze the predictability of the Kwok and Caton periodontal prognosis system by investigating tooth survival within a 64‐month period and to compare this to other well‐established prognosis systems.

Methods

This retrospective study included the records of patients who had a minimum of two dental exams at least 12 months apart at a single University‐affiliated Dental Center. Data including patients’ age, sex, length of follow‐up period, initial tooth prognosis, revised tooth prognosis, tooth type, and number of teeth lost at the latest exam were recorded. Descriptive analysis was used for data interpretation.

Results

A total of 4,046 teeth from 174 patients qualified for the study. Teeth with initial poorer prognosis had a higher chance of being extracted compared with those with a better initial prognosis. Tooth survival rate at the latest follow‐up for those with an initial favorable, questionable, unfavorable, and hopeless prognosis was 97.9%, 90.7%, 62.5%, and 17.7%, respectively. Teeth initially assigned to a poorer prognosis category had a higher proportion that changed to a worse prognosis at the latest periodontal exam.

Conclusions

The Kwok and Caton prognosis system can predictably determine tooth survivability within a 5‐year period. The defined categories of this prognosis system are more reliable than that of other systems in the short‐term. However, long‐term (>5 years) prediction accuracy of this prognosis system needs further investigation.
Comprehensive polyphenolic profiling in promising resistant grapevine hybrids including 17 novel breeds in northern Italy
Authors: Gratl Verena , Sturm Sonja , Zini Elena , Letschka Thomas , Stefanini Marco , Vezzulli Silvia , Stuppner Hermann
Published: October 2020

BACKGROUND

A promising way to overcome the susceptibility of Vitis vinifera L. to fungal diseases is the integration of genetic resistance by the interspecific crossing between V. vinifera varieties and resistant species. However, the products of such hybrids are still not accepted by customers, particularly due to their organoleptic characteristics, not least influenced by their polyphenolic profile.

RESULTS

A total of 58 resistant breeding lines, 41 from international programs and 17 new progeny individuals, were grown in one untreated vineyard to exclude any variances by climatic and pedologic conditions or vineyard practice. A total of 60 polyphenols (including acids, anthocyanins, flavonols, flavan‐3‐ols, and stilbenoids) were determined in grapevine berries by ultrahigh‐performance liquid chromatography–mass spectrometry in two consecutive years. The overall profiles were rather consistent (variation P > 0.05) within the two harvests, with the exceptions of epicatechin and caftaric acid. Anthocyanin diglucosides were found in ten of the red breeding lines, malvidin‐3,5‐O‐diglucoside being predominant in nine of them. Total polyphenol content of the unknown progeny individuals and international breeding lines was comparable, with the exception of significantly increased amounts of gallic acid and some flavonoids.

CONCLUSION

The comprehensive study reported herein of the polyphenolic profile of hybrids from international breeding programs, but also of new breeds from private initiatives, all cultivated in the same vineyard, will support the selection of promising candidates for further breeding programs to overcome impairment due to undesired sensory characteristics of new highly resistant varieties.
Effects of supplemental LED light quality and reduced growth temperature on swede (Brassica napus L. ssp. rapifera Metzg.) root vegetable development and contents of glucosinolates and sugars
Authors: Mølmann Jørgen AB , Hansen Espen , Johansen Tor J
Published: October 2020

BACKGROUND

Low growth temperatures and the special light qualities of midnight sun in northern Scandinavia, have both been shown to improve eating quality of swede root bulbs. To study the combined effect of these factors on root development and sensory‐related compounds, plants were grown in phytotron under different 24 h supplemental light‐emitting diode (LED) light colours, at constant 15 °C, or reduced end‐of‐season temperature at 9 °C.

RESULTS

Far‐red LED (740 nm) light induced longer leaves and produced more roundly shaped bulbs, than the other light quality treatments. At constant 15 °C, supplemental light of far‐red LED also produced a stronger purple crown skin colour than the other LED treatments. This difference between light quality treatments disappeared at 9 °C, as all bulb crowns developed a purple colour. There were no significant effects of LED‐supplements on sugar concentrations, while the reduced temperature on average did increase concentrations of d‐fructose and d‐glucose. Total glucosinolate concentrations were not different among treatments, although the most abundant glucosinolate, progoitrin, on average was present in highest concentration under LEDs containing far‐red light, and in lower concentration at 9 °C compared to 15 °C.

CONCLUSION

The light quality of 24 h photoperiods in combination with temperature appears primarily important for growth and morphological traits in swede root bulbs. Influence of light quality and low temperature on appearance and sensory‐related compounds may be utilized in marketing of root vegetables with special quality related to growth conditions of high latitude origin. © 2020 Society of Chemical Industry
Deep learning‐based digitization of prostate brachytherapy needles in ultrasound images
Authors: Andersén Christoffer , Rydén Tobias , Thunberg Per , Lagerlöf Jakob H.
Published: October 2020

Purpose

To develop, and evaluate the performance of, a deep learning‐based three‐dimensional (3D) convolutional neural network (CNN) artificial intelligence (AI) algorithm aimed at finding needles in ultrasound images used in prostate brachytherapy.

Methods

Transrectal ultrasound (TRUS) image volumes from 1102 treatments were used to create a clinical ground truth (CGT) including 24422 individual needles that had been manually digitized by medical physicists during brachytherapy procedures. A 3D CNN U‐net with 128 × 128 × 128 TRUS image volumes as input was trained using 17215 needle examples. Predictions of voxels constituting a needle were combined to yield a 3D linear function describing the localization of each needle in a TRUS volume. Manual and AI digitizations were compared in terms of the root‐mean‐square distance (RMSD) along each needle, expressed as median and interquartile range (IQR). The method was evaluated on a data set including 7207 needle examples. A subgroup of the evaluation data set (n = 188) was created, where the needles were digitized once more by a medical physicist (G1) trained in brachytherapy. The digitization procedure was timed.

Results

The RMSD between the AI and CGT was 0.55 (IQR: 0.35–0.86) mm. In the smaller subset, the RMSD between AI and CGT was similar (0.52 [IQR: 0.33–0.79] mm) but significantly smaller (P < 0.001) than the difference of 0.75 (IQR: 0.49–1.20) mm between AI and G1. The difference between CGT and G1 was 0.80 (IQR: 0.48–1.18) mm, implying that the AI performed as well as the CGT in relation to G1. The mean time needed for human digitization was 10 min 11 sec, while the time needed for the AI was negligible.

Conclusions

A 3D CNN can be trained to identify needles in TRUS images. The performance of the network was similar to that of a medical physicist trained in brachytherapy. Incorporating a CNN for needle identification can shorten brachytherapy treatment procedures substantially.
Breast ultrasound lesion classification based on image decomposition and transfer learning
Authors: Zhuang Zhemin , Kang Yuqiang , Joseph Raj Alex Noel , Yuan Ye , Ding Wanli , Qiu Shunmin
Published: October 2020

Purpose

In medical image analysis, deep learning has great application potential. Discovering a method for extracting valuable information from medical images and integrating that information closely with medical treatment has recently become a major topic of interest. Because obtaining large volumes of breast lesion ultrasound image data is difficult, transfer learning is usually employed to obtain benign and malignant classification of breast lesions. However, because of blurred unclear regions of interest in breast lesion ultrasound images and severe speckle noise interference, convolutional neural networks have proven ineffective in extracting features, thus providing unreliable classification results.

Methods

This study employs image decomposition to obtain fuzzy enhanced and bilateral filtered images to enrich input information of breast lesions. Fuzzy enhanced, bilateral filtered, and original ultrasound images comprise multifeature data, which are presented as inputs to a pre‐trained model to realize knowledge fusion. Therefore, effective features of breast lesions are extracted and then used to train fully connected layers with ground truths provided by a doctor to accomplish the classification.

Results

A pre‐trained VGG16 model was used to extract features from multifeature data, and these features were fused to train the fully connected layers to realize classification. The performance score reported is as follows: accuracy of 93%, sensitivity of 95%, specificity of 88%, F1 score of 0.93, and AUC of 0.97.

Conclusions

Compared with using a single original ultrasound image for feature extraction, multifeature data based on image decomposition enables the pre‐trained model to extract more relevant features, thereby providing better classification results than those from traditional transfer learning techniques.