bluuebunny/crossref_metadata_2025 huggingface dataset:
Heterogeneity of T3 stage esophageal squamous cell carcinoma in different parts based on enhanced CT radiomics
Authors: Li Xiao-feng , Wang Qiang , Duan Shao-feng , Yao Biao , Liu Cai-yun
Published: August 2020

Esophageal cancer is a common malignant tumor of the digestive system with a high incidence and a poor prognosis. At the present, CT-based radiomics is providing more and more valuable information. However, the heterogeneity of the study and the poor repeatability of the texture feature parameters have limited its wider clinical application. In the present study, we focused on comparing the differences in the texture features of T3 stage esophageal squamous cell carcinoma at different locations and normal esophageal wall, aiming to provide some pieces of useful information for future research on esophageal squamous cell carcinoma.

Fifty seven cases with throat CT imaging, including esophageal cancer contrast enhanced CT and conventional CT of healthy control group. The texture characteristics in control group and tumor group among different parts were compared. Using Univariable analysis, we compared the difference and conducted receiver-operator curve analysis to evaluate the performance of tumor grade diagnosis model.

53 radiomic features were significantly different in control group and so as 93 features for tumor group. The upper section was the mostly different from the other 2 sections. Run-length matrix (RLM) features in tumor group accounted for the highest proportion, only Surface Volume Ratio was different.

There are differences in the texture features of the tube wall in different parts of the esophagus of healthy adults, and this difference is more obvious in pT3 stage esophageal squamous cell carcinoma. In the future radiomics study of esophageal squamous cell carcinoma, we need to pay attention to this to avoid affecting the accuracy of the results.
Hepatic arterial infusion chemotherapy vs transcatheter arterial embolization for patients with huge unresectable hepatocellular carcinoma
Authors: Tsai Wei-Lun , Sun Wei-Chi , Chen Wen-Chi , Chiang Chia-Ling , Lin Huey-Shyan , Liang Huei-Lung , Cheng Jin-Shiung
Published: August 2020

For the treatment of huge unresectable hepatocellular carcinoma (HCC), transcatheter arterial chemoembolization (TACE) or transcatheter arterial embolization (TAE) generally had poor effects and high complication rates. Our previous study found that Hepatic arterial infusion chemotherapy (HAIC) is a safe procedure and provides better survival than symptomatic treatment for the patients with huge unresectable HCC. The aim of the study is to compare the effect of HAIC vs TAE in patients with huge unresectable HCC.

Since 2000 to 2005, patients with huge (size > 8 cm) unresectable HCC were enrolled. Twenty-six patients received HAIC and 25 patients received TAE. Each patient in the HAIC group received 2.5 + 1.4 (range: 1–6) courses of HAIC and in the TAE group received 1.8 + 1.2 (range: 1–5) courses of TAE. Baseline characteristics and survival were compared between the HAIC and TAE group.

The HAIC group and the TAE group were similar in baseline characteristics and tumor stages. The overall survival rates at 1 and 2 years were 42% and 31% in the HAIC group and 28% and 24% in the TAE group. The patients in the HAIC group had higher overall survival than the TAE group (P = .077). Cox-regression multivariate analysis revealed that HAIC is the significant factor associated with overall survival (relative risk: 0.461, 95% confidence interval: 0.218–0.852, P = .027). No patients died of the complications of HAIC but three patients (12%) died of the complications of TAE.

In conclusion, HAIC is a safe procedure and provides better survival than TAE for patients with huge unresectable HCCs.
Probiotics, prebiotics, antibiotic, Chinese herbal medicine, and fecal microbiota transplantation in irritable bowel syndrome
Authors: He Ying , Xu Rui , Wang Wei , Zhang Jie , Hu Xiaoyu
Published: August 2020

Background:

Irritable bowel syndrome (IBS) is a functional gastrointestinal disease, with a high global incidence, which seriously influences the quality of life and work efficiency of patients. Extensive research showed that IBS is related to changes in the intestinal microenvironment. The novel treatment strategy targeting the gut microbiota is being actively implemented. Probiotics, antibiotics, prebiotics, fecal microbiota transplantation, and Chinese Herbal Medicine have been proven to be effective in the treatment of IBS, and all have an impact on the intestinal flora of patients. However, these 5 treatments have their own pros and cons and have not been systematically evaluated and compared. Therefore, this study will indirectly compare the safety and effectiveness of these 5 methods in the treatment of IBS through network meta-analysis.

Methods:

The following databases including Embase, Pubmed, Cochrane Central Register of Controlled Trials, Chinese Biomedical Literature Database, WHO International Clinical Trials Registry Platform and ClinicalTrials.gov will be retrieved from inception to June 2020 without language restrictions. Literature selection, data extraction, and bias analysis will be done by 2 researchers. The primary outcome is global symptoms improvement. The secondary outcomes will include individual IBS symptom scores, emotional response, and adverse events. The conventional pair-wise meta-analysis will be performed using Stata V.14.0 and be pooled using a random-effects model. We will use WinBUGS V.1.4.3 (Cambridge, United Kingdom) with a Bayesian hierarchical random-effects model to conduct the network meta-analysis.

Results:

This study will provide systematic reviews and indirect network comparison results about treatments of IBS.

Conclusions:

This study will systematically evaluate and compare 5 intestinal flora-related therapies for IBS and to provide an evidence-based medical decision-making basis for clinicians.

Trial registration number:

INPLASY202050047
Identification of novel biomarkers and small-molecule compounds for nasopharyngeal carcinoma with metastasis
Authors: Mi Jing-Lin , Xu Meng , Liu Chang , Wang Ren-Sheng
Published: August 2020

The purpose of this study was to investigate novel biomarkers and potential mechanisms in nasopharyngeal carcinoma (NPC) patients with metastasis.

Two microarray datasets (GSE103611 and GSE36682) were obtained from GEO database, differentially expressed genes (DEGs) and differentially expressed miRNA (DEMs) were identified, Gene ontology (GO) as well as Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were conducted with DEGs and DEMs targeted genes. Protein–protein interactions (PPI) network of the DEGs and DEMs targeted genes were constructed, furthermore, Connectivity Map (CMap) database was applied to select the potential drugs with therapeutic effects.

Overall, we identified 396 upregulated and 19 downregulated DEGs. Additionally, we identified 1 upregulated DEM, miR-135b, and a downregulated DEM, miR-574-5p. Functional enrichment analysis indicated that both DEGs and DEMs targeted genes participated in biological process (BP) of regulation of transcription from RNA polymerase II promoter, DNA-templated positive regulation of transcription, and Epstein-Barr virus infection signaling pathway. Besides, upregulated EP300 gene was a hub node both in DEGs and DEMs target genes. CMap database analysis indicated that sanguinarine, verteporfin, and chrysin are potential drugs for prevention and treatment of NPC metastasis.

In summary, the common hub gene, biological process and pathway identified in the study provided a novel insight into the potential mechanism of NPC metastasis. Furthermore, we identified several possible small molecule compounds for treatment of NPC metastasis.
Computer-navigated versus conventional total knee arthroplasty
Authors: Yu Yefeng , Sheng Jianming , Zhou Xiao
Published: August 2020

Background:

The literature lacks studies that confirm whether the improved radiographic alignment that can be achieved with computer-navigated total knee arthroplasty (TKA) improves patients’ activities of daily living or the durability of total knee prostheses. Thus, in this protocol, we designed a randomized controlled trial to compare implant alignment, functional scores, and survival of the implant using computer-assisted surgery versus a conventional surgical technique.

Methods:

This prospective, blinded randomized controlled trial was conducted at our single hospital. This study was approved by the ethics committee of Jiaxing Second Hospital. The patient inclusion criteria were age 20 to 80 years’ old, a body mass index of ≤35 kg/m2, and consented for primary knee arthroplasty performed through a medial parapatellar approach by the senior author. We randomized consented study participants on a 1:1 ratio to 1 of 2 study groups using a computer-generated list of random numbers in varying block sizes. The primary outcome in this study was the Knee Injury and Osteoarthritis Outcome Score. Secondary outcomes were the Knee Society Score, Western Ontario and McMaster Universities Osteoarthritis Index, complications, and range of motion together with alignment and rotational positioning of the implant. Statistical significance was defined as aPvalue of ≤0.05.

Conclusions:

Authors hypothesized that computer-assisted surgery in primary TKA improves implant alignment, functional scores, and survival of the implant compared to the conventional technique.
Bloodletting at EX-HN6 as an adjunctive therapy to eye drops for stye
Authors: Qiao Hong-wei , Liu Na-wen , Wang Jin , Huang Shan , Yu Lei , Chen Zhong
Published: August 2020

Background:

This study evaluated the effectiveness and safety of bloodletting (BL) at ear-apex (EX-HN6) as an adjunctive therapy to eye drops for stye.

Methods:

This study systematically searched electronic databases from inception to March 1, 2020 in PUBMED, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Chinese Scientific Journals Full-text Database, and WanFang Database. All potential randomized controlled trials (RCTs) investigating the effectiveness and safety of BL at EX-HN6 as an adjunctive therapy to eye drops for stye were included in this study. Study quality of all included studies was assessed by Cochrane Risk of Bias Assessment Tool. RevMan 5.3 software was used for statistical analysis and meta-analysis performance.

Results:

A total of 11 RCTs, involving 1718 subjects, were included in this study. Results showed that BL at EX-HN6 as an adjunctive therapy to eye drops was superior to the eye drops alone in enhancing total effectiveness rate (risk ratio [RR] 1.21, 95% confidence intervals [CIs] [1.11, 1.32], I
2 = 79%), and total cure rate (RR 1.28, 95% CIs [1.14, 1.43], I
2 = 69%). After removing two studies, results of subgroup analysis still showed significant improvements in total effectiveness rate (RR 1.13, 95% CIs [1.08, 1.18], I
2 = 0%), and total cure rate (RR 1.16, 95% CIs [1.08, 1.24], I
2 = 0%). No data of adverse reactions was reported in primary trials, thus, this study did not analyze adverse reactions of BL at EX-HN6 as an adjunctive therapy to eye drops for stye.

Conclusion:

BL at EX-HN6 as an adjunctive therapy to eye drops may benefit stye. However, high-quality RCTs addressing on this issue is still needed to warrant the findings of this study.
Challenges of BCLC stage C hepatocellular carcinoma
Authors: Que Jenny , Lin Chia-Hui , Lin Li-Ching , Ho Chung-Han
Published: August 2020

In this study, we evaluated the feasibility and efficacy of stereotactic body radiation therapy (SBRT) in the treatment of Barcelona Clinic Liver Cancer (BCLC) stage C hepatocellular carcinoma (HCC).

This retrospective study evaluated 139 patients with BCLC stage C HCC who underwent CyberKnife SBRT between January 2009 and September 2017. All patients had BCLC-C, Child–Turcotte–Pugh score A-B. In-field control, overall survival (OS), progression free survival (PFS), and prognostic factors were evaluated.

An objective response rate was achieved in 81.5% patients (complete response, 36.2%, partial response, 45.3%). The median survival was 15.44 months, and the 1-, 3-, 5-year OS rates were 56%, 28%, and 20%, respectively. The median PFS was 6 months, the PFS rate at 1-, 3-, and 5-year were 35%, 14%, and 10%, respectively. In-field control of 1 to 2 years was achieved in 85.1% of patients. The major pattern of failure was out-field intrahepatic failure which comprised 42.9% of patients. Multivariate analysis revealed that the Child–Turcotte–Pugh score, macrovascular invasion, advance stage (III-IV), and tumor response rate were independent predictors of OS.

The result of our study shows that SBRT is a safe and effective therapeutic option for BCLC stage C HCC lesions that are unsuitable for standard loco-regional therapies, Moreover, SBRT has acceptable local control rates and low-treatment toxicity.
Hypoglycemic agents for non-alcoholic fatty liver disease with type 2 diabetes mellitus
Authors: Liu Su-Tong , Su Kai-Qi , Zhang Li-Hui , Liu Ming-Hao , Zhao Wen-Xia
Published: August 2020

Background:

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in Western countries, and strongly associated with type 2 diabetes mellitus (T2DM). Several studies have shown that hypoglycemic agents are effective for NAFLD combined with T2DM. However, there is still controversy over which hypoglycemic agent is the best for NAFLD combined with T2DM patients.

Objective:

To systematically evaluate the efficacy and safety of hypoglycemic agents in NAFLD combined with T2DM patients.

Methods:

A comprehensive electronic search will be conducted by searching Web of Science, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Clinical Trials and Chinese Biomedical Medicine. All randomized controlled trials of hypoglycemic agents interventions for NAFLD combined with T2DM will be identified. Two reviewers independently screened and evaluated each included study and extracted the outcome indexes. ADDIS 1.16.8 software will be used for the network meta-analysis and STATA 14 software will be used for drawing network evidence plots and funnel plots.

Conclusion:

This network meta-analysis will provide stronger evidence for the efficacy and safety of hypoglycemic agents in the treatment of NAFLD combined with T2DM, and provide a reference for clinical application.

Protocol registration number:

INPLASY202070016.
Effectiveness comparisons of different Chinese herbal injection therapies for acute cerebral infarction
Authors: Li Runmin , Li Ying , Li Bingchen , Sun Haiyang , Liu Xinyu , Ge Xin , Liu Yuanxiang , Yang Jiguo
Published: August 2020

Background:

Acute cerebral infarction (ACI) has a high incidence, recurrence rate, and mortality. Chinese herbal injections (CHIs) are widely used in the substitution therapy of ACI. Due to the lack of randomized trials comparing the efficacy of various injections directly, it is still difficult to judge the relative efficacy. Therefore, we intend to conduct a network meta-analysis to evaluate the benefit among these CHIs.

Methods:

According to the retrieval strategies, randomized controlled trials (RCTs) on CHI therapies for ACI will be obtained from China National Knowledge Infrastructure, WanFang, Chinese Scientific Journals Database, PubMed, Embase and Cochrane Library, regardless of publication date or language. Studies were screened based on inclusion and exclusion criteria, and the Cochrane risk bias assessment tool will be used to evaluate the quality of the literature. The network meta-analysis will be performed in Markov Chain Monte Carlo method and carried out with Stata 14 and WinBUGS 1.4.3 software. Ultimately, the evidentiary grade for the results will be evaluated.

Results:

This study will compare the efficacy and safety of CHIs in the treatment of ACI, and give a more reasonable choice.

Conclusion:

Our findings will provide references for future clinical decision and guidance developing.

INPLASY registration number: INPLASY202060087.
Contrecoup injury of the prefronto-thalamic tract in a patient with mild traumatic brain injury
Authors: Jang Sung Ho , Kwon Young Hyeon , Lee Sung Jun
Published: August 2020

Rationale:

We report on a patient with mild traumatic brain injury (TBI) with contrecoup injury of the prefronto-thalamic tract (PTT), as demonstrated by diffusion tensor tractography (DTT).

Patient concerns:

A 62-year-old female patient suffered a head trauma after falling backward. While working at a height of 85cm above the floor, she fell backward and struck the occipital area of her head on the ground. The patient experienced cognitive dysfunction and depressive mood after the head trauma.

Diagnoses:

The patient was diagnosed as mild TBI due to falling backward.

Interventions:

Clinical evaluation of her brain was performed at 2 months after onset.

Outcomes:

DTT at 2 months after onset revealed narrowings in the right ventrolateral and both orbitofrontal PTTs, whereas both the dorsolateral and left ventrolateral PTTs were not reconstructed.

Lessons:

Injuries of the PTTs associated with a contrecoup brain injury were demonstrated in a patient with mild TBI.
Acupuncture for the treatment of dry eye
Authors: Zhu Yongzheng , Zhao Qinyu , Jia Hongling , Zhang Hongxing , Zhang Yongchen
Published: August 2020

Background:

As a common ophthalmic disease, dry eye (DE) may bring several adverse effects on the quality of life for patients. In recent years, Acupuncture (AC) is becoming increasingly popular for treating DE. Thus, we conceived this systematic review aims to evaluate the effectiveness and safety of AC for DE objectively.

Methods:

The search results are restricted to randomized controlled trials and human studies. We will establish the inclusion criteria through discussion and design a detailed literature search strategy for each database. Articles are searched from 4 English databases (the Cochrane Library, PubMed, Web of Science, and EMBASE) and 4 Chinese databases (Wangfang, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and Chinese scientific and technical journals database). The relevant studies published from the date of database inception until January 2020 will be collected. We will also search (International Clinical Trials Registry Platform), PROSPERO, and potential gray literature. Two reviewers independently perform literature screening, information extraction, and assessment of study quality. The outcome measures include primary outcome measures (Schirmer I test and break-up time), secondary outcome measures (Ocular Surface Disease Index, corneal fluorescein staining, and tear osmolarity), and safety outcome measures. Assessment of bias risk and data processing are performed using RevMan 5.3 software ( the Nordic Cochrane Centre, Copenhagen, Denmark).

Results:

We will evaluate the curative effect of AC for DE comprehensively based on multiple outcome measures.

Conclusion:

This systematic review will provide evidence for the effectiveness and safety of AC in the treatment of DE.

PROSPERO number:

CRD42019144790
His bundle pacing – a curative method
Authors: Pestrea Catalin , Gherghina Alexandra , Ortan Florin , Cismaru Gabriel , Radu Rosu
Published: August 2020

Introduction:

Pacing of the His bundle and conduction system seems an attractive site for pacing. Lead placement in His-pacing might be technically challenging due to surrounding structures and particular anatomic location.

Patient concerns:

A 62-years old male patient was admitted for recurrent syncope. Electrocardiographic monitoring revealed periods of complete atrioventricular block with left branch block morphology and a QRS duration of 160 ms.

Diagnosis:

A diagnosis of intermittent complete atrioventricular block was made with a Class I indication of permanent dual-chamber cardiac pacing.

Interventions:

A lead delivery system with a C315 His catheter and a Select Secure 3830 69 cm pacing lead was placed at the septal area of the atrioventricular junction with good pacing and sensing thresholds. An important narowing of the QRS was observed.

Outcomes:

After the procedure, good pacing and sensing parameters were observed.

Echocardiography revealed disappearance of the previously recorded ventricular dyssynchronism.

Device follow-up at 1 month and 3 months showed stable pacing and sensing parameters.

Conclusion:

Pacing the distal His bundle normalized the QRS complex, therefore “curing” both the atrioventricular and the left bundle branch conduction abnormalities. As such, the technique can be used as an alternative to cardiac electrical resynchronization therapy with acceptable pacing and detection thresholds and better ventricular activation pattern.
Intestinal tuberculosis in a patient with end-stage renal disease on hemodialysis
Authors: Lee In Hee , Kim Seong Gyu , Kwon Joong Goo , Yang Chun-Seok , Kang Sungmin , Kim Min-Kyung , Ahn Dong Jik
Published: August 2020

Rationale:

Intestinal tuberculosis (TB) is rarely seen in patients with end-stage renal disease (ESRD). We report an intestinal TB case with a clinical presentation similar to that of colon cancer in a patient with ESRD on hemodialysis.

Patient concerns:

A 49-year-old man presented with a 3-month history of general weakness and anorexia. He had been treated for stage 5 chronic kidney disease (CKD) due to diabetic nephropathy for the last 3 years. His blood urea nitrogen and serum creatinine levels were 96.9 and 8.1 mg/dL, respectively, at the time of admission; azotemia was accompanied by severe anemia, hypoalbuminemia, hyperkalemia, and metabolic acidosis. Hemodialysis was initiated for suspected exacerbation of uremia; however, intermittent fever, night sweats, and abdominal discomfort persisted.

Diagnoses:

Abdominal computed tomography (CT) and whole-body 18F-fluorodeoxyglucose positron emission tomography were indicative of ascending colon cancer with lymph node metastases. However, colonoscopy with biopsy revealed the formation of submucosal caseating granuloma and acid-fast bacillus.

Interventions:

We initiated quadruple therapy with isoniazid, rifampicin, pyrazinamide, and ethambutol. The patient continued the quadruple regimen for the first 2 months before switching to dual therapy and received anti-TB medications for a total of 12 months.

Outcomes:

After 9 months of standard anti-TB chemotherapy, polypoid residual lesions were noted during follow-up colonoscopy. Laparoscopy-assisted ileocecal resection was performed. No findings suggestive of recurrence of colonic TB were observed on follow-up abdominal CT at 6 months after discontinuation of anti-TB medications.

Lessons:

If non-specific uremic symptoms persist in patients with advanced CKD, the possibility of extrapulmonary TB such as intestinal TB must be considered. Also, in patients with radiologic suspicion of colon cancer, endoscopy with biopsy should be performed promptly to exclude colonic TB with similar clinical manifestations.
Screening of significant biomarkers with poor prognosis in hepatocellular carcinoma via bioinformatics analysis
Authors: Sun Quanquan , Liu Peng , Long Bin , Zhu Yuan , Liu Tongxin
Published: August 2020

Hepatocellular carcinoma (HCC) is a malignant tumor with unsatisfactory prognosis. The abnormal genes expression is significantly associated with initiation and poor prognosis of HCC. The aim of the present study was to identify molecular biomarkers related to the initiation and development of HCC via bioinformatics analysis, so as to provide a certain molecular mechanism for individualized treatment of hepatocellular carcinoma.

Three datasets (GSE101685, GSE112790, and GSE121248) from the GEO database were used for the bioinformatics analysis. Differentially expressed genes (DEGs) of HCC and normal liver samples were obtained using GEO2R online tools. Gene ontology term and Kyoto Encyclopedia of Gene and Genome (KEGG) pathway analysis were conducted via the Database for Annotation, Visualization, and Integrated Discovery online bioinformatics tool. The protein–protein interaction (PPI) network was constructed by the Search Tool for the Retrieval of Interacting Genes database and hub genes were visualized by Cytoscape. Survival analysis and RNA sequencing expression were conducted by UALCAN and Gene Expression Profiling Interactive Analysis.

A total of 115 shared DEGs were identified, including 30 upregulated genes and 85 downregulated genes in HCC samples. P53 signaling pathway and cell cycle were the major enriched pathways for the upregulated DEGs whereas metabolism-related pathways were the major enriched pathways for the downregulated DEGs. The PPI network was established with 105 nodes and 249 edges and 3 significant modules were identified via molecular complex detection. Additionally, 17 candidate genes from these 3 modules were significantly correlated with HCC patient survival and 15 of 17 genes exhibited high expression level in HCC samples. Moreover, 4 hub genes (CCNB1, CDK1, RRM2, BUB1B) were identified for further reanalysis of KEGG pathway, and enriched in 2 pathways, the P53 signaling pathway and cell cycle pathway.

Overexpression of CCNB1, CDK1, RRM2, and BUB1B in HCC samples was correlated with poor survival in HCC patients, which could be potential therapeutic targets for HCC.
Is cognition considered in post-stroke upper limb robot-assisted therapy trials? A brief systematic review
Authors: Everard Gauthier J. , Ajana Khawla , Dehem Stéphanie B. , Stoquart Gaëtan G. , Edwards Martin G. , Lejeune Thierry M.
Published: August 2020

The aim of this systematic review was, first, to determine whether or not individuals with cognitive deficits after stroke were enrolled in trials that investigated upper limb robot-assisted therapy effectiveness, and, second, whether these trials measured cognitive outcomes. We retrieved 6 relevant systematic reviews covering, altogether, 66 articles and 2214 participants. Among these 66 clinical trials, only 10 (15%) enrolled stroke participants with impaired cognition, whereas 50 (76%) excluded those with impaired cognition. The remaining six trials (9%) were classified as unclear as they either excluded individuals unable to understand simple instructions or did not specify if those with cognitive disorders were included. Furthermore, only 5 trials (8%) used cognitive measures as outcomes. This review highlights a lack of consideration for individuals with cognitive impairments in upper limb robotic trials after stroke. However, cognition is important for complex motor relearning processes and should not be ignored.
Rasch analysis of the Incontinence Impact Questionnaire short version (IIQ-7) in women with urinary incontinence
Authors: Monticone Marco , Ferriero Giorgio , Giordano Andrea , Foti Calogero , Franchignoni Franco
Published: August 2020

Urinary incontinence is a clinical condition that can negatively affect activities, psychosocial well-being, and health-related quality of life. The Incontinence Impact Questionnaire short version (IIQ-7) is useful to quantify quickly the urinary incontinence-related life-impact. Previous psychometric studies on the IIQ-7, using classical test theory methods, demonstrated good internal consistency, test–retest reliability, and a substantial unidimensionality of the tool. This latter property is a prerequisite for performing advanced modern psychometric analyses such as Rasch analysis. In this study, we aimed to examine in depth – through Rasch analysis – some key metric properties of the IIQ-7. We analyzed data from 100 women with urinary incontinence. Results confirmed the correct functioning of the four response categories of the questionnaire and indicated an adequate level of internal structural validity. Given the good fit of the items to the Rasch model, it was possible to obtain a nomogram to transform the total raw scores of the IIQ-7 into linear measure estimates. Our findings obtained through Rasch analysis confirm the substantial unidimensionality and good psychometric properties of the IIQ-7 found in previous studies. They enhance the confidence in the use of this short tool – for group-level decisions – to assess the life-impact related to stress, urge or mixed urinary incontinence among women.
Effects of serious games in strength and functionality of patients with ulnar nerve lesion: two single-case reports
Authors: Borges Juliana Valentino , de Souza Luciane Aparecida Pascucci Sande , Bertoncello Dernival , Fernandes Luciane Fernanda Rodrigues Martinho
Published: August 2020

The objective of this study was to investigate the effect of serious games on hand muscle strength and functionality in a series of cases with ulnar nerve damage. Two patients were included in this 16-week intervention study using biofeedback. Electromyography electrodes and dynamometers were used in treatment. Functionality was assessed by Rosen and Lundborg score, Disabilities of the arm, shoulder and hand (DASH) questionnaire and International Classification of Functioning, Disability and Health (ICF). Grip and pinch strength were assessed by dynamometers. Results revealed an increase in sensory domain of Rosen and Lundborg score of the two patients. Patients increased values from the DASH questionnaire; however, they got better results with ICF. Grip strength of the two patients increased; pinch strength varied between patients; key pinch had the best results. Serious games can be effective to enhance hand strength and improve functionality in patients with ulnar nerve damage.
Fracture treatment in the setting of cutaneous aspergillosis: a case report
Authors: Zhang Ting , Christopher Michael , Simske Natasha M. , Saddler Christopher M. , Keenan Thomas , Whiting Paul S.
Published: August 2020

The authors present the case of a patient who developed an Aspergillosis flavus (A flavus) superficial cutaneous infection which was identified at the time of cast removal, 2 weeks after immobilization of a closed distal third humerus fracture. Clinical and microbiological findings, as well as the treatment of this patient, are reported. An otherwise healthy 27-year-old male presented to the orthopaedic surgery clinic 2 weeks after a closed distal humerus fracture, which was initially immobilized with a functional removable brace. Upon cast removal, the patient was noted to have significant brown hyperkeratotic patches and plaques, studded with pustules in an annular configuration on his left posterior and lateral arm. Fungal culture later grew A flavus. The patient was started on both oral and topical antifungals and operative management of the displaced fracture was delayed until skin lesions resolved. Once clinical examination and negative repeat bedside potassium hydroxide were confirmed, open reduction and internal fixation was performed. The fracture healed uneventfully, and the patient did not develop any signs or symptoms of postoperative infection.
Outcomes of civilian pediatric craniocerebral gunshot wounds: A systematic review
Authors: Duda Taylor , Sharma Arjun , Ellenbogen Yosef , Martyniuk Amanda , Kasper Ekkehard , Engels Paul T. , Sharma Sunjay
Published: August 2020

BACKGROUND

Pediatric craniocerebral gunshot injuries (CGIs) occur both in the context of accidental and intentional trauma. The incidence and physiology of pediatric CGIs merit reexamination of prognostic factors and treatment priorities. This study characterizes the current understanding of mortality and prognostic factors in this patient population.

METHODS

A systematic search was conducted. Selection criteria included all studies published since 2000, which described civilian isolated CGIs in pediatric patients. Data were analyzed qualitatively and quantitatively to identify factors prognostic for the primary outcome of mortality. Secondary outcomes included functional outcome status, requirement for surgery, and injury complications. Study quality was assessed with the Newcastle-Ottawa Scale. This study was registered with PROSPERO (CRD42019134231).

RESULTS

Initial search revealed 349 unique studies. Forty underwent full text screening, and eight studies were included in the final synthesis. The overall mortality rate was 44.8%. Most CGIs occurred in older teenagers. Aggressive surgical treatment was recommended by one author, while remaining studies emphasized clinical judgment. Reported prognostic factors include initial Glasgow Coma Scale, pupil reactivity, involvement of multiple lobes or deep nuclei, and bihemispheric injuries. Reported complications from CGIs included seizure, meningitis, abscess, cerebrospinal fluid leak, bullet migration, focal neurological deficits, endocrine abnormalities, cognitive deficits, and neuropsychological deficits. The Glasgow Outcome Scale was the predominant measure of function and demonstrated a moderate recovery in 17.4% and a good recovery in 27.3% of patients.

CONCLUSION

This systematic review analyzed the existing evidence for prognostic factors in the context of pediatric CGIs. Significant long-term clinical improvement is possible with interventions including urgent surgical therapy. Fixed bilateral pupils and low initial Glasgow Coma Scale correlate with mortality but do not predict all patient outcomes. Patients younger than 15 years are underreported and may have differences in outcome. The literature on pediatric CGIs is limited and requires further characterization.

LEVEL OF EVIDENCE

Systematic Review, level IV.
Lateralization correlates with individual differences in inhibitory control in zebrafish
Authors: Lucon-Xiccato Tyrone , Montalbano Giulia , Dadda Marco , Bertolucci Cristiano
Published: August 2020

Individual fitness often depends on the ability to inhibit behaviours not adapted to a given situation. However, inhibitory control can vary greatly between individuals of the same species. We investigated a mechanism that might maintain this variability in zebrafish (
Danio rerio
). We demonstrate that inhibitory control correlates with cerebral lateralization, the tendency to process information with one brain hemisphere or the other. Individuals that preferentially observed a social stimulus with the right eye and thus processed social information with the left brain hemisphere, inhibited foraging behaviour more efficiently. Therefore, selective pressures that maintain lateralization variability in populations might provide indirect selection for variability in inhibitory control. Our study suggests that individual cognitive differences may result from complex multi-trait selection mechanisms.
Alexander Dalgarno. 5 January 1928—9 April 2015
Authors: Hartquist Thomas W. , Van Dishoeck Ewine F.
Published: August 2020

Alexander (Alex) Dalgarno greatly advanced the quantitative study of fundamental atomic and molecular processes, contributed significantly to atmospheric science and ‘established molecular astrophysics as a unified intellectual field of great scientific endeavour, impact and achievement’ (Flannery 2010). Alex developed and applied techniques that simplify calculations and lead to reliable solutions, enabling him to make landmark contributions to the knowledge of collisionally induced charge transfer, rotational and vibrational excitation of molecules, spin exchange and ultracold chemistry. His wide-ranging curiosity, disciplined steps to broaden his programme and ability to identify dominant physical processes and calculate their rates led to his many important contributions to atmospheric science. For example, Alex greatly expanded the knowledge of terrestrial airglow features, photoabsorption and collisional processes in the terrestrial ozone layer and deposition by energetic electrons in the atmospheres of other planets. In molecular astrophysics, he applied that same systematic approach to studies of a range of environments from the early Universe to present-day UV-irradiated interstellar clouds, shocks and supernova ejecta. Alex made availability to students a priority and encouraged them to pursue problems that they devised, despite his seemingly inexhaustible supply of suitable projects. His community service included his 29-year long editorship ofAstrophysical Journal Letters, starting in 1973, and the founding of the Institute of Theoretical Atomic and Molecular Physics at the Harvard-Smithsonian Center for Astrophysics, in 1988, owing to his concerns for the health of the fields of theoretical atomic and molecular physics and fundamental quantum mechanics, which the Institute did much to reinvigorate.
On the consistency of a class of
R
-symmetry gauged 6
D
N = (1,0) supergravities
Authors: Pang Yi , Sezgin Ergin
Published: August 2020

R
-symmetry gauged 6
D
 (1, 0) supergravities free from all local anomalies, with gauge groups
G
 × 
G

R

where
G

R

is the R-symmetry group and
G
is semisimple with rank greater than one, and which have no hypermultiplet singlets, are extremely rare. There are three such models known in which the gauge symmetry group is
G
1
 × 
G
2
 × 
U
(1)

R

, where the first two factors are

(

E
6

/

Z

3

)
×

E
7

,
G
2
 × 
E
7
and
F
4
 × 
Sp
(9). These are models with single tensor multiplet, and hyperfermions in the (1, 912), (14, 56) and (52, 18) dimensional representations of
G
1
 × 
G
2
, respectively. So far, it is not known if these models follow from string theory. We highlight key properties of these theories, and examine constraints which arise from the consistency of the quantization of anomaly coefficients formulated in their strongest form by Monnier and Moore. Assuming that the gauged models accommodate dyonic string excitations, we find that these constraints are satisfied only by the model with the
F
4
 × 
Sp
(9) × 
U
(1)

R

symmetry. We also discuss aspects of dyonic strings and potential caveats they may pose in applying the stated consistency conditions to the
R
-symmetry gauged models.
Optimal lockdown strategies for SARS-CoV2 mitigation— an Indian perspective
Authors: Pathak Anagh , Mohan Varun Madan , Banerjee Arpan
Published: August 2020

We sought to identify optimal temporal windows for lockdown-based mitigation strategies on infectious disease spreads. An age-structured multi-compartmental Susceptible- Infected-Recovered (SIR) model was used to estimate infection spreads under parametric variation of lockdown intensity and duration from the data of SARS-CoV2 cases in India between January to July, 2020. The resulting parameter values were used to simulate lockdown outcomes for a wide range of start times and durations. Lockdowns were simulated as intervention strategies that modified weights assigned to social contact matrices for work, school and other places. Lockdown efficacy was assessed by the maximum number of infections recorded during a simulation run. Our analysis shows that lockdown outcomes depend sensitively on the timing of imposition and that it is possible to minimize lockdown durations while limiting case loads to numbers below the hospitalization thresholds. Such timing based effects arise naturally from the non-linear nature of SIR dynamics.

Notation

NTotal Population

SNumber of susceptible individuals

INumber of infected individuals

RNumber of recovered/removed individuals

βPer-individual disease transmission rate

γRecovery rate

τLockdown start-time

Δ Duration of lockdown

pPost-lockdown coefficient

hTotal number of hospital beds

ξMaximum fraction of infected individuals

ξ0Hospitalization threshold
Evaluation of Convalescent Plasma Versus Standard of Care for the Treatment of COVID-19 in Hospitalized Patients: study protocol for a phase 2 randomized, open-label, controlled, multicenter trial
Authors: Diago-Sempere Elena , Bueno José Luis , Sancho-López Aránzazu , Rubio Elena Múñez , Torres Ferrán , de Molina Rosa Malo , Fernández-Cruz (AFC) Ana , de Diego Isabel Salcedo , Velasco-Iglesias Ana , Payares-Herrera Concepción , Flecha Inmaculada Casas , Avendaño-Solà Cristina , Palomino Rafael Duarte , Ramos-Martínez Antonio , Ruiz-Antorán Belén
Published: August 2020

Background

COVID-19 is a respiratory disease caused by a novel coronavirus (SARS-CoV-2) and causes substantial morbidity and mortality. At the time this clinical trial was planned, there were no available vaccine or therapeutic agents with proven efficacy, but the severity of the condition prompted the use of several pharmacological and non-pharmacological interventions.

It has long been hypothesized that the use of convalescent plasma (CP) from infected patients who have developed an effective immune response is likely to be an option for the treatment of patients with a variety of severe acute respiratory infections (SARI) of viral etiology. The aim of this study is to assess the efficacy and safety of convalescent plasma in adult patients with severe COVID-19 pneumonia.

Methods/Design

The ConPlas-19 study is a multicenter, randomized, open-label controlled trial. The protocol has been prepared in accordance with the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) guidelines. The study has been planned to include 278 adult patients hospitalized with severe COVID-19 infection not requiring mechanical ventilation (invasive or non-invasive). Subjects are randomly assigned in a 1:1 ratio (139 per treatment arm), stratified by center, to receive intravenously administered CP (single infusion) plus SOC or SOC alone, and are to be followed for 30 days. The primary endpoint of the study is the proportion of patients that progress to categories 5, 6 or 7 (on the 7-point ordinal scale proposed by the WHO) at day 15. Interim analyses for efficacy and/or futility will be conducted once 20%, 40%, and 60% of the planned sample size are enrolled and complete D15 assessment.

Discussion

This clinical trial is designed to evaluate the efficacy and safety of passive immunotherapy with convalescent plasma for the treatment of adult patients hospitalized with COVID-19. The results of this study are expected to contribute to establishing the potential place of CP in the therapeutics for a new viral disease.

Trial registration

Trial registration at clinicaltrials.gov; Registration Number: NCT04345523; https://clinicaltrials.gov/ct2/show/NCT04345523; Registered on 30 March, 2020. First posted date: April 14, 2020.
The COVID-19 Consequences of College Class Continuity Calculator: A Tool to Provide Students and Administrators with Estimated Risks of Returning to Campus
Authors: Bewick Sharon , Ludden Erika , Robertson Suzanne , Demers Jeffrey
Published: August 2020

As schools prepare for the start of the Fall 2020 semester, many are struggling to make decisions regarding whether or not to return to on-campus classes or whether to remain fully online. Unfortunately, there is no ‘one-size-fits-all’ answer, and schools must balance their own risks against the costs of remote learning. We present a tool that integrates information about study body composition with predictions of COVID-19 infection rates in order to provide clarity and insight into the decisions facing colleges and universities nationwide. Our tool is freely available and currently hosted at the following location: https://bewicklab.shinyapps.io/covid-1/
Face masks to prevent transmission of respiratory diseases: Systematic review and meta-analysis of randomized controlled trials*
Authors: Ollila Hanna M. , Partinen Markku , Koskela Jukka , Savolainen Riikka , Rotkirch Anna , Laine Liisa T.
Published: August 2020

Abstract

Objective

To examine the effect of face mask intervention in respiratory infections across different exposure settings and age groups.

Design

Systematic review and meta-analysis.

Data sources

PubMed, Cochrane Central Register of Controlled Trials, and Web of Science were searched for randomized controlled trials investigating the effect of face masks on respiratory infections published by November 18th, 2020. We followed PRISMA guidelines.

Eligibility criteria for selecting studies

Randomized controlled trials investigating face masks in respiratory infections across different exposure settings. Two reviewers performed the search, extracted data, and assessed the risk of bias. Random effects meta-analysis with risk ratio, adjusted odds ratios, and number needed to treat were performed. Findings by source control or wearer protection, age groups, exposure settings, and role of non-compliance were evaluated.

Results

Seventeen studies were included, (N=11,601 cases and N=10,286 controls, follow-up from 4 days to 19 months). Fourteen trials included adults and children and three trials included children only. Twelve studies showed non-compliance in treatment and eleven in control group. Four studies supported the use of face masks. Meta-analysis across all studies with risk ratios found no association with number of infections (RR=0.957 [0.810 − 1.131], p=0.608). Meta-analysis using odds ratios adjusted for age, sex, and vaccination (when available) showed protective effect of face masks (OR=0.850 [0.736 − 0.982], p=0.027). Subgroup meta-analysis with adjusted odds ratios found a decrease in respiratory infections among adults (14 studies, OR = 0.829 [0.709 − 0.969], p=0.019) in source control setting (OR = 0.845 [0.7375 − 0.969], p=0.0159) and when face masks were used together with hand hygiene OR = 0.690 [0.568 − 0.838], p=0.0002). Overall between-study heterogeneity was large also in the subgroup analyses.

Conclusion

Despite the large between study heterogeneity, compliance bias and differences by environmental settings, the findings support the use of face masks to prevent respiratory infections. PROSPERO registration number CRD42020205523.
Circumventing the optical diffraction limit with customized speckles
Authors: Bender Nicholas , Sun Mengyuan , Yılmaz Hasan , Bewersdorf Joerg , Cao Hui
Published: August 2020

Speckle patterns have been widely used in imaging techniques such as ghost imaging, dynamic speckle illumination microscopy, structured illumination microscopy, and photoacoustic fluctuation imaging. Recent advances in the ability to control the statistical properties of speckles has enabled the customization of speckle patterns for specific imaging applications. In this work, we design and create special speckle patterns for parallelized nonlinear pattern-illumination microscopy based on fluorescence photoswitching. We present a proof-of-principle experimental demonstration where we obtain a spatial resolution three times higher than the diffraction limit of the illumination optics in our setup. Furthermore, we show that tailored speckles vastly outperform standard speckles. Our work establishes that customized speckles are a potent tool in parallelized super-resolution microscopy.
HPLC analysis ofWithania somnifera(Linn.) Dunal reveals two chemotypes in Indian germplasm and seasonal and genetic variability in Withaferin A -Content
Authors: Kaushik Nutan
Published: August 2020

HPLC methods for profiling and estimation of withanolide inWithaniahave been developed to study seasonal, geographical and genetic variation in Withaferin-A content and identify chemotypes. Highest withanolide content was observed during the vegetative phase and slight decrease was observed during reproductive phase. However, the content drastically reduced at the maturity. No significant effect of location was observed on the withanolide content when same genotypes were grown at two diverse locations. Withaferin-A content in Indian population ofWithania somniferavaried from 0.22 to 3.38 % with a mean value of 1.099 in the leaves during vegetative stage.Whereas during maturity the content ranged from 0.0056 to 1.99 % with a mean value of 0.5942 %. In the roots, Withaferin-A content ranged from 0.0028 to 0.75 % with a mean value of 0.1242 during vegetative phase and 0.0008 to 0.1489 with a mean value of 0.00213 % at maturity of the plant. The population segregated into two chemotypes identified as chemotype-I and as an intermediate of Chemotype–I and Chemotype-II.