bluuebunny/crossref_metadata_2025 huggingface dataset:
Novel radiographic hip fat thickness ratio correlates with early re-operation following total hip arthroplasty
Authors: Sezgin Erdem A , Ali Ali K , Ataoğlu M Baybars , Orhan Özlem , Odluyurt Mustafa , Esen Erdinç
Published: March 2021

Introduction:

Obesity is thought to lead to increased failure rates following total hip arthroplasty (THA). Site-specific fat distribution has been suggested to be a better indicator of risk, compared to body mass index. Fat thickness measurement methods were developed for total knee arthroplasty, however, there is limited data on the methods for THA. The aim of this study was to assess the interobserver and intraobserver reliability of a newly defined radiographic subcutaneous fat thickness ratio and investigate the correlation of this ratio with early failure following THA.

Methods:

321 patients who underwent primary THA at a single institution between 2014 and 2017, with at least 1-year of follow-up and a preoperative pelvis anteroposterior x-ray radiograph were included in this study. A high hip fat thickness ratio (HFTR) was arbitrarily defined as ⩾2. Early failure was defined as revision or re-operation for any reason and death related to operation first year following THA.

Results:

The HFTR was shown to have excellent intraobserver and interobserver reliability. High HFTR was associated with higher risk of early failure following THA (odds ratio 3.8, [95% confidence interval, 1.2–12.1], p < 0.05). The same association persisted when HFTR was analysed as a continuous variable ( p < 0.01) and in multivariate analysis ( p < 0.05).

Conclusions:

HFTR can be used to assess periarticular soft tissue distribution and may be regarded as a useful and reproducible tool for assessing risk of early failure following THA.
Preclinical Feasibility and Patency Analyses of a New Distal Coronary Connector: The ELANA Heart Bypass
Authors: Stecher David , Hoogewerf Marieke , Bronkers Glenn , van Putte Bart P. , Doevendans Pieter A. , Tulleken Cornelis A.F. , van Herwerden Lex , Pasterkamp Gerard , Buijsrogge Marc P.
Published: March 2021

Objective

This preclinical study determines the feasibility and 6-month patency rates of a new distal coronary connector, the Excimer Laser Assisted Nonocclusive Anastomosis (ELANA) Heart Bypass.

Methods

Twenty Dutch Landrace pigs received either a hand-sewn ( n = 8) or an ELANA ( n = 12) left internal thoracic artery to left anterior descending artery anastomosis, using off-pump coronary artery bypass grafting. Six-month patency rates were demonstrated by coronary angiography and histological evaluation. Throughout, procedural details and complication rates were collected.

Results

The ELANA Heart Bypass demonstrated 0% mortality and complication rates during follow-up. It was demonstrated feasible, with comparable perioperative flow measurements (ELANA vs hand-sewn, median [min to max], 24 [14 to 28] vs 17 [12 to 31] mL/min; P = 0.601) and fast construction times (3 [3 to 7] vs 31 [26 to 37] min; P < 0.001). Yet, an extra hemostatic stitch was needed in 25% of the ELANA versus 12.5% of the hand-sewn anastomoses. The 6-month patency rate of the ELANA Heart Bypass was 83.3% versus 100% in hand-sewn anastomoses. The 2 occluded ELANA-anastomoses were defined model-based errors.

Conclusions

The ELANA Heart Bypass facilitates a sutureless distal coronary anastomosis. A design change is suggested to improve hemostasis and will be evaluated in future translational studies. This new technique is a potential alternative to hand-sewn anastomoses in (minimally invasive) coronary surgery.
Developing a virtual reality for people with dementia in nursing homes based on their psychological needs: a feasibility study
Authors: Kim Jung-Hee , Park Seonmin , Lim Hyeongji
Published: March 2021

Background

The purpose of this study was (1) to develop a virtual reality (VR) intervention program based on the psychological needs of patients residing in nursing facilities in South Korea to alleviate their behavioral and psychological symptoms and (2) to confirm the possibility of utilizing VR in patients with dementia.

Methods

In the first phase, patients with dementia residing in nursing homes and experiencing behavioral and psychological symptoms were recruited. Surveys and questionnaires were used to identify activities that alleviated the behavioral and psychological symptoms of dementia (BPSD) among the patients. These activities were classified into five types of psychological needs. In the second phase, a fully immersive, interactive, easy-to-use VR platform was developed that reflected these psychological needs. Patients with dementia experienced the VR content. The researchers assessed the level of the participants’ immersion, preference, and interaction with the VR using a 5-point Likert scale.

Results

In the feasibility test, 10 nursing home residents were recruited. The mean immersion score was 4.93 ± 0.16 points, the mean preference score was 4.35 ± 0.41 points, and the mean interaction score was 3.84 ± 0.43 points using a 5-point Likert scale. Higher mean scores indicated a more positive outcome. Six of the 10 participants required assistance while using the VR. The mean VR experience duration was 10.00 ± 3.46 min.

Conclusions

The VR-based intervention program that was developed to reduce BPSD was feasible for the participants and provided them with a high degree of satisfaction and immersion. Furthermore, this study also confirmed the convenience and safety of the program. These findings support the potential use of VR-based BPSD intervention programs to treat patients with dementia.
The association of sex-biased ATRX mutation in female gastric cancer patients with enhanced immunotherapy-related anticancer immunity
Authors: Ge You , Wei Feiran , Du Guoping , Fei Gaoqiang , Li Wei , Li Xiaoshan , Chu Jinjin , Wei Pingmin
Published: March 2021

Background

Genetic alterations have been proven to be the promising biomarkers for ICI response. However, sex biases in genetic alterations have been often ignored in the field of immunotherapy, which might specially influence the anticancer immunity and immunotherapy efficacy in male or female patients. Here, we have systematically evaluated the effect of the sex biases in somatic mutation of gastric cancer (GC) patients on the anticancer immunity and clinical benefit to immunotherapy.

Methods

Genomic and transcriptomic data of gastric cancer were downloaded from The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC). We also obtained the genomic and clinical data of a MSKCC ICI-treated cohort from cbioportal database. GC male and female-derived tumor somatic mutation profiles were compared by maftools R package. Single sample gene set enrichment analysis (ssGSEA) was conducted to calculate the score of the anticancer immunity indicators including IFN-γ signaling, cytolytic activity (CYT) and antigen presenting machinery (APM).

Results

ATRX was found to mutate more frequently in female GC patients compared to male patients (FDR = 0.0108). Female GC patients with ATRX mutation manifested significantly more MSI-high subtypes, increased TMB and PDL1 expression as well as higher scores of IFN-γ signaling, CYT and APM. Gene set enrichment analysis (GSEA) has shown that ATRX mutation might enhance the immunogenicity and anticancer immunity through affecting DNA damage repair pathways. In the ICI-treated cohort from MSKCC, GC patients with ATRX mutation were associated with prolonged overall survival. When stratifying the entire ICI-treated cohort by sex, female patients with ATRX mutation obtained significantly better survival benefits than that of ATRX mutant male patients (Female patients, HR of ATRX MT vs WT = 0.636, 95%CI = 0.455–0.890, P = 0.023; Male patients, HR of ATRX MT vs WT = 0.929, 95%CI = 0.596–1.362, P = 0.712).

Conclusions

ATRX mutation might serve as a potential predictive biomarker for favorable clinical benefit to ICI in female GC patients. ATRX mutation could be applied in combination with other biomarkers of ICI response to better identify the female GC patients who will derive greater benefits from ICI therapy.
Acquisition of cancer stem cell capacities after spontaneous cell fusion
Authors: Merle Candice , Lagarde Pauline , Lartigue Lydia , Chibon Frédéric
Published: March 2021

Background

Cancer stem/Initiating cell (CS/IC) hypothesis argues that CS/ICs are responsible of tumour initiation, drug resistance, metastasis or disease relapse. Their detection in several cancers supports this concept. However, their origin is still misunderstood. Cell fusion is shown to take part in the formation of CS/ICs, i.e. fusion between mesenchymal stem cell and cancer cell. In a previous paper, we described that fusion leads to hybrids with metastatic capacity. This process triggered genomic rearrangements in hybrid cells together with increased metastasis development. Here, we hypothesize that cell fusion could be strong enough to provoke a cellular reprogramming and the acquisition of CS/IC properties, promoting metastasis formation.

Methods

After spontaneous cell fusion between E6E7 (IMR90 with the oncogenes E6 and E7) and RST (IMR90 fully transformed) cell lines, hybrid cells were selected by dual antibiotic selection. Cancer stem cells capacities were evaluated regarding capacity to form spheres, expression of stem cell markers and the presence of ALDHhigh cells.

Results

Our data show that after cell fusion, all hybrids contain a percentage of cells with CS/ICs properties, regarding. Importantly, we lastly showed that NANOG inhibition in H1 hybrid decreases this migration capacity while having no effect on the corresponding parental cells.

Conclusions

Altogether these results indicate that the combination of CS/ICs properties and genomic rearrangement in hybrids is likely to be key to tumour progression.
The risk factors of postoperative delirium in patients with hip fracture: implication for clinical management
Authors: Xu Weifang , Ma Haiping , Li Wang , Zhang Chen
Published: March 2021

Background

Delirium is a common complication of hip surgery patients. It is necessary to investigate the epidemiological characteristics and related risk factors of delirium after hip fracture surgery, to provide evidence supports for the prevention and management of delirium.

Methods

Hip fracture patients admitted to our hospital for surgical treatment from March 2018 to March 2020 were identified as participants. The characteristics and laboratory examinations in patients with and without postoperative delirium were compared and analyzed. Logistic regression analyses were conducted to ascertain the independent risk factors, and the area under the curve (AUC) were calculated to analyze the predictive value.

Results

A total of 568 postoperative patients with hip fracture were included, the incidence of delirium in postoperative patients with hip fracture was 14.44 %. The preoperative albumin (OR 4.382, 2.501 ~ 5.538), history of delirium (OR 2.197, 1.094 ~ 3.253), TSH (OR1.245, 1.077 ~ 1.638), the resting score on the first postoperative day (OR1.235, 0.944 ~ 1.506) and age(OR1.185, 0.065 ~ 1.814) were the independent risk factors for the postoperative delirium in patients with hip fracture(all p < 0.05). The AUC of albumin, history of delirium, TSH, the resting score on the first postoperative day and age were 0.794, 0.754, 0.746, 0.721 and 0.689 respectively.

Conclusions

The incidence of delirium in postoperative patients with hip fracture is rather high, especially for patients with old age and history of delirium. Monitoring albumin, TSH and resting score may be beneficial to the management of postoperative delirium.
Impact of media components from different suppliers on enterokinase productivity in Pichia pastoris
Authors: Krahulec Ján , Šafránek Martin
Published: March 2021

Background

The aim of this study was to provide an information about the homogeneity on the level of enterokinase productivity in P. pastoris depending on different suppliers of the media components.

Results

In previous studies, we performed the optimisation process for the production of enterokinase by improving the fermentation process. Enterokinase is the ideal enzyme for removing fusion partners from target recombinant proteins. In this study, we focused our optimization efforts on the sources of cultivation media components. YPD media components were chosen as variables for these experiments. Several suppliers for particular components were combined and the optimisation procedure was performed in 24-well plates. Peptone had the highest impact on enterokinase production, where the difference between the best and worst results was threefold. The least effect on the production level was recorded for yeast extract with a 1.5 fold difference. The worst combination of media components had a activity of only 0.15 U/ml and the best combination had the activity of 0.88 U/ml, i.e., a 5.87 fold difference. A substantially higher impact on the production level of enterokinase was observed during fermentation in two selected media combinations, where the difference was almost 21-fold.

Conclusions

Results demonstrated in the present study show that the media components from different suppliers have high impact on enterokinase productivity and also provide the hypothesis that the optimization process should be multidimensional and for achieving best results it is important to perform massive process also in terms of the particular media component supplier .
Preliminary feasibility torque mechanical evaluation for 3D printed orthodontic springs with different parameters: in vitro study
Authors: Othman Ahmed , Hartman Steven , Ströbele Dragan , Arnold Jassin , See von
Published: March 2021

Background

The purpose of the presented investigation is to evaluate the resulting torque on loaded 3D printed springs using different coil thickness and length.

Methods

Specimens were designed and printed using the 3D printer MAX (Asiga, Sydney, Australia) with 3D printable, experimental, flexible material (Code:BM2008, GC, Tokyo, Japan). The specimens were divided into three groups according to spring coil design. Control group (n = 18), length group (n = 19) and thickness group (n = 22). Groups were tested using a Sauter Machine for torque calculation (DB, Grindelwald, Switzerland) in conjunction with a universal testing machine (Zwick Z010, Ulm, Germany) for clock-wise and anti-clockwise testing. Statistical analysis was performed using the Steel–Dwass test to compare median values of the three groups in both testing directions (p < 0.001).

Results

The highest torque value was determined in the thickness group for both clockwise and anti-clockwise testing directions, achieving 44.00 N/mm and 39.62 N/mm respectively. The length group ranged from 21.65 to 11.04 N/mm in clockwise direction and from 18.04 to 11.38 N/mm in counter-clockwise testing. The control group ranged from 22.72 to 17.18 N/mm in the clock-wise direction while in the anti-clock wise testing it ranged from 21.34 to 16.02 N/mm.

Conclusions

The amount of torque produced from the computer aided designing/computer aided manufacturing (CAD/CAM) springs is being affected by diameter more than the length design parameter in comparison to the control group. The values of the thickness group are significantly higher than those of the length group (P < 0.001).
Correction to: Built environmental characteristics and diabetes: a systematic review and meta-analysis
Authors: den Braver N. R. , Lakerveld J. , Rutters F. , Schoonmade L. J. , Brug J. , Beulens J. W. J.
Published: March 2021

An amendment to this paper has been published and can be accessed via the original article.
The socio-economic transition and health professions education in Mongolia: a qualitative study
Authors: Amgalan Nomin , Shin Jwa-Seop , Lee Seung-Hee , Badamdorj Oyungoo , Ravjir Oyungerel , Yoon Hyun Bae
Published: March 2021

Background

Former socialist countries have undergone a socio-economic transition in recent decades. New challenges for the healthcare system have arisen in the transition economy, leading to demands for better management and development of the health professions. However, few studies have explored the effects of this transition on health professions education. Thus, we investigated the effects of the socio-economic transition on the health professions education system in Mongolia, a transition economy country, and to identify changes in requirements.

Methods

We used a multi-level perspective to explore the effects of the transition, including the input, process, and output levels of the health professions education system. The input level refers to planning and management, the process level refers to the actual delivery of educational services, and the output level refers to issues related to the health professionals, produced by the system. This study utilized a qualitative research design, including document review and interviews with local representatives. Content analysis and the constant comparative method were used for data analysis.

Results

We explored tensions in the three levels of the health professions education system. First, medical schools attained academic authority for planning and management without proper regulation and financial support. The government sets tuition fees, which are the only financial resource of medical schools; thus, medical schools attempt to enroll more students in order to adapt to the market environment. Second, the quality of educational services varies across institutions due to the absence of a core curriculum and differences in the learning environment. After the transition, the number of private medical schools rapidly increased without quality control, while hospitals started their own specialized training programs. Third, health professionals are struggling to maintain their professional values and development in the market environment. Fixed salaries lead to a lack of motivation, and quality evaluation measures more likely reflect government control than quality improvement.

Conclusions

Mongolia continues to face the consequences of the socio-economic transition. Medical schools’ lack of financial authority, the varying quality of educational services, and poor professional development are the major adverse effects. Finding external financial support, developing a core curriculum, and reforming a payment system are recommended.
New methods for confocal imaging of infection threads in crop and model legumes
Authors: Rae Angus E. , Rolland Vivien , White Rosemary G. , Mathesius Ulrike
Published: March 2021

Background

The formation of infection threads in the symbiotic infection of rhizobacteria in legumes is a unique, fascinating, and poorly understood process. Infection threads are tubes of cell wall material that transport rhizobacteria from root hair cells to developing nodules in host roots. They form in a type of reverse tip-growth from an inversion of the root hair cell wall, but the mechanism driving this growth is unknown, and the composition of the thread wall remains unclear. High resolution, 3-dimensional imaging of infection threads, and cell wall component specific labelling, would greatly aid in our understanding of the nature and development of these structures. To date, such imaging has not been done, with infection threads typically imaged by GFP-tagged rhizobia within them, or histochemically in thin sections.

Results

We have developed new methods of imaging infection threads using novel and traditional cell wall fluorescent labels, and laser confocal scanning microscopy. We applied a new Periodic Acid Schiff (PAS) stain using rhodamine-123 to the labelling of whole cleared infected roots of Medicago truncatula; which allowed for imaging of infection threads in greater 3D detail than had previously been achieved. By the combination of the above method and a calcofluor-white counter-stain, we also succeeded in labelling infection threads and plant cell walls separately, and have potentially discovered a way in which the infection thread matrix can be visualized.

Conclusions

Our methods have made the imaging and study of infection threads more effective and informative, and present exciting new opportunities for future research in the area.
Complete percutaneous angio-guided approach using preclosing for venoarterial extracorporeal membrane oxygenation implantation and explantation in patients with refractory cardiogenic shock or cardiac arrest
Authors: Martin-Tuffreau Anne-Sophie , Bagate François , Boukantar Madjid , Saiydoun Gabriel , Mangiameli Andrea , Rostain Laura , Mouillet Gauthier , Fiore Antonio , Langeron Olivier , Mekontso-Dessap Armand , Mongardon Nicolas , Folliguet Thierry , Teiger Emmanuel , Gallet Romain
Published: March 2021

Background

The approach for veno-arterial extracorporeal membrane oxygenation implantation (VA-ECMO) in patients with cardiogenic shock can be either surgical or percutaneous. Complete angio-guided percutaneous implantation and explantation could decrease vascular complications. We sought to describe the initial results of complete percutaneous angio-guided ECMO implantation and explantation using preclosing.

Methods

All consecutive patients who underwent peripheral femoro-femoral VA-ECMO percutaneous implantation for refractory cardiogenic shock or cardiac arrest were enrolled in a prospective registry (03/2018–12/2020). Percutaneous preclosing using two closing devices (Perclose ProGlide, Abbott) inserted before cannulation was used in both femoral artery and vein. Explantation was performed using a crossover technique under angiographic guidance. The occurrence of vascular complication was recorded.

Results

Among the 56 patients who underwent percutaneous VA-ECMO implantation for cardiogenic shock or refractory cardiac arrest, 41 underwent preclosing. Femoral vessel cannulation was successful in all patients and total cannulation time was 20 (10–40) min. Weaning from ECMO was possible in 22/41 patients (54%) and 12 (29%) patients were alive at day 30. Significant vascular complications occurred in 2/41 patients. Percutaneous decannulation was performed in 20 patients with 19/20 technical success rate. All femoral arteries and veins were properly closed using the pre-closing devices without bleeding on the angiographic control except for one patient in whom surgical closure of the artery was required. No patient required transfusion for access related significant bleeding and no other vascular complication occurred. Furthermore, no groin infection was observed after full percutaneous implantation and removal of ECMO.

Conclusion

Emergent complete percutaneous angio-guided VA-ECMO implantation and explantation using pre-closing technique can be an attractive strategy in patients referred for refractory cardiogenic shock.
Dichotomic response to interleukin-6 blockade in idiopathic multicentric Castleman disease: two case reports
Authors: Ferrero Simone , Ragaini Simone
Published: March 2021

Background

Human herpervirus-8/human immunodeficiency virus negative Idiopathic multicentric Castleman disease (iMCD) is a lymphoproliferative disorder sustained by a pro-inflammatory condition of hypercytokinemia mostly mediated by Interleukin-6 (IL-6). According to iMCD consensus guidelines, anti-IL-6 blockade should be the first-line therapy for iMCD. However, despite the existing therapeutic alternatives, a large proportion of iMCD patients still lacks an effective therapy.

Case presentation

Here, we report two real-life iMCD cases with a different response to IL-6 blockade. The first presented patient obtained a prompt resolution of symptoms and a complete regression of adenopathies after IL-6 blockade therapy administration. Conversely, the second patient did not respond neither to Rituximab and Etoposide association nor to IL-6 blockade therapy (both Siltuximab and Tocilizumab). Furthermore, Intravenous immunoglobulin, Cyclosporine A, Sirolimus and anti-Interleukin-1 Anakinra were all attempted without any results. Since no treatment was successful, after a further confirmation of iMCD diagnosis by a second lymph node biopsy, patient has been candidate for thalidomide, cyclophosphamide and prednisone association therapy.

Conclusions

The iMCD cases we reported are coherent with the evidences that IL-6 blockade is a safe and an effective therapy for iMCD. Despite this, more than half of patients do not respond to anti IL-6 drugs. In such cases, therapeutic alternatives could be represented by Sirolimus, targeting PI3K/AKT/mTOR signaling or by associations of conventional drugs such as thalidomide, cyclophosphamide and prednisone. However, the two reported iMCD cases, confirm the need to more deeply investigate iMCD pathogenesis and to better dissect the heterogeneity of the disease in order to develop novel, effective therapeutic strategies.
Social support and strain and emotional distress among Latinos in the northeastern United States
Authors: Lerman Ginzburg Shir , Lemon Stephenie C. , Romo Eric , Rosal Milagros
Published: March 2021

Background

US Latinos report high levels of emotional distress. Having positive familial and friend social support buffers emotional distress among US Latinos, but thus far no research has been done on social support and ataque de nervios in that population, or on social strain and emotional distress.

Methods

This paper assesses social support and strain across three relationship types (partner, family, and friends) with three measures of emotional distress (depression, anxiety, and ataque de nervios). The sample for partner, family, and friend support included 508 Latino adults 21 and older. Multivariate logistic regression models were used to assess the association of social support and strain with each outcome.

Results

As all social support types increased, the odds of emotional distress symptoms decreased. Conversely, as each unit of partner and family strain increased, the odds of emotional distress symptoms increased. Increased friend strain was associated with greater odds of depressive and anxiety symptoms only.

Conclusion

Social support in all three network types (partner, family, and friend) was associated with a decrease in the odds of emotional distress, assessed as symptoms of depression, anxiety, and ataque de nervios.
Oil spill discrimination of multi-time-domain shipborne radar images using active contour model
Authors: Xu Jin , Pan Xinxiang , Wu Xuerui , Jia Baozhu , Fei Juan , Wang Haixia , Li Bo , Cui Can
Published: March 2021

Accidental oil spills cause serious pollution to the ocean and are difficult to control in short time. It is an important guarantee for emergency disposal to effectively monitor oil spills. Remote sensing is the main means to monitor oil spills. High false alarm rate has been an important bottleneck of this technology. In this paper, a multi-time-domain shipborne radar images discrimination mechanism was proposed. Based on the improved Sobel operator, Otsu and linear interpolation, the co-frequency interference noises were detected and suppressed. Gray intensity correction model (GICM) and dual-threshold method were used to eliminate highlighted continuous pixels. Oil films were extracted by using an active contour model (ACM). Finally, a multi-time-domain discrimination mechanism based on variation range tolerance of identified oil films centroids was designed to reduce the false alarm rate. It can provide technical support for decision-making and emergency response.
Automated assessment of functional lung imaging with 68Ga-ventilation/perfusion PET/CT using iterative histogram analysis
Authors: McIntosh Lachlan , Jackson Price , Hardcastle Nicholas , Bressel Mathias , Kron Tomas , Callahan Jason W. , Steinfort Daniel , Bucknell Nicholas , Hofman Michael S. , Siva Shankar
Published: March 2021

Purpose

Functional lung mapping from Ga68-ventilation/perfusion (V/Q) PET/CT, which has been shown to correlate with pulmonary function tests (PFTs), may be beneficial in a number of clinical applications where sparing regions of high lung function is of interest. Regions of clumping in the proximal airways in patients with airways disease can result in areas of focal intense activity and artefact in ventilation imaging. These artefacts may even shine through to subsequent perfusion images and create a challenge for quantitative analysis of PET imaging. We aimed to develop an automated algorithm that interprets the uptake histogram of PET images to calculate a peak uptake value more representative of the global lung volume.

Methods

Sixty-six patients recruited from a prospective clinical trial underwent both V/Q PET/CT imaging and PFT analysis before treatment. PET images were normalised using an iterative histogram analysis technique to account for tracer hotspots prior to the threshold-based delineation of varying values. Pearson’s correlation between fractional lung function and PFT score was calculated for ventilation, perfusion, and matched imaging volumes at varying threshold values.

Results

For all functional imaging thresholds, only FEV1/FVC PFT yielded reasonable correlations to image-based functional volume. For ventilation, a range of 10–30% of adapted peak uptake value provided a reasonable threshold to define a volume that correlated with FEV1/FVC (r = 0.54–0.61). For perfusion imaging, a similar correlation was observed (r = 0.51–0.56) in the range of 20–60% adapted peak threshold. Matched volumes were closely linked to ventilation with a threshold range of 15–35% yielding a similar correlation (r = 0.55–0.58).

Conclusions

Histogram normalisation may be implemented to determine the presence of tracer clumping hotspots in Ga-68 V/Q PET imaging allowing for automated delineation of functional lung and standardisation of functional volume reporting.
Continuous pericapsular nerve group block for postoperative pain management in total hip arthroplasty: report of two cases
Authors: Fujino Takashi , Odo Masahiko , Okada Hisako , Takahashi Shinji , Kikuchi Toshihiro
Published: March 2021

Background

Total hip arthroplasty (THA) is one of the surgical procedures associated with severe postoperative pain. Appropriate postoperative pain management is effective for promoting early ambulation and reducing the length of hospital stay. Effects of conventional pain management strategies, such as femoral nerve block and fascia iliaca block, are inadequate in some cases.

Case presentation

THA was planned for 2 patients with osteoarthritis. In addition to general anesthesia, continuous pericapsular nerve group (PENG) block and lateral femoral cutaneous nerve (LFCN) block were performed for postoperative pain management. Numerical rating scale (NRS) scores measured at rest and upon movement were low at 2, 12, 24, and 48 h postoperatively, suggesting that the treatments were effective for managing postoperative pain. The Bromage score at postoperative days (POD) 1 and 2 was 0.

Conclusion

Continuous PENG block and LFCN block were effective for postoperative pain management in patients who underwent THA. PENG block did not cause postoperative motor blockade.
The interplay between non-alcoholic fatty liver disease and innate immunity in hepatitis B virus patients
Authors: Megahed Fayed Attia Koutb , Zhou Xiaoling , Sun Pingnan , Elmaghrabi Marwa Mohamed
Published: March 2021

Background

Non-alcoholic fatty liver disease (NAFLD) is the most epidemic liver disorder worldwide as a result of rapid lifestyle transformation over the past few decades and is expected to elevate in the next few years as well as it is ranging from plain hepatic steatosis via non-alcoholic steatohepatitis (NASH) to liver cirrhosis and hepatocellular carcinoma (HCC).

Main text

NAFLD can also stimulate the diseases progression as diabetes and cardiovascular. Therefore, understanding the NAFLD pathogenesis is of vital clinical interest additionally is a crucial for disease treatment and prevention. After analyzing NAFLD and liver diseases prevalence, it has been a belief regarding the interaction between NAFLD and chronic hepatitis B (CHB).

Conclusion

The liver is an essential innate immune organ with large numbers of innate immune cells that contribute in NAFLD pathogenesis, additionally play the influential role that control NAFLD progression in the hepatitis B patients. Here, we summarized the recent advances in understanding and managing the NAFLD patients with chronic hepatitis B infection and interplay with innate immunity.
Association Between Midlife Obesity and Its Metabolic Consequences, Cerebrovascular Disease, and Cognitive Decline
Authors: Morys Filip , Dadar Mahsa , Dagher Alain
Published: March 2021

Context

Chronic obesity is associated with several complications, including cognitive impairment and dementia. However, we have only piecemeal knowledge of the mechanisms linking obesity to central nervous system damage. Among candidate mechanisms are other elements of obesity-associated metabolic syndrome, such as hypertension, dyslipidemia, and diabetes, but also systemic inflammation. While there have been several neuroimaging studies linking adiposity to changes in brain morphometry, a comprehensive investigation of the relationship has so far not been done.

Objective

To identify links between adiposity and cognitive dysfunction.

Methods

This observational cohort study (UK Biobank), with an 8-year follow-up, included more than 20 000 participants from the general community, with a mean age of 63 years. Only participants with data available on both baseline and follow-up timepoints were included. The main outcome measures were cognitive performance and mediator variables: hypertension, diabetes, systemic inflammation, dyslipidemia, gray matter measures, and cerebrovascular disease (volume of white matter hyperintensities on magnetic resonance imaging).

Results

Using structural equation modeling, we found that body mass index, waist-to-hip ratio, and body fat percentage were positively related to higher plasma C-reactive protein, dyslipidemia, hypertension, and diabetes. In turn, hypertension and diabetes were related to cerebrovascular disease. Finally, cerebrovascular disease was associated with lower cortical thickness and volume and higher subcortical volumes, but also cognitive deficits (largest significant pcorrected = 0.02).

Conclusions

We show that adiposity is related to poor cognition, with metabolic consequences of obesity and cerebrovascular disease as potential mediators. The outcomes have clinical implications, supporting a role for the management of adiposity in the prevention of late-life dementia and cognitive decline.
A Novel Familial PHP1B Variant With Incomplete Loss of Methylation at GNAS-A/B and Enhanced Methylation at GNAS-AS2
Authors: Hanna Patrick , Francou Bruno , Delemer Brigitte , Jüppner Harald , Linglart Agnès
Published: March 2021

Context

Pseudohypoparathyroidism type 1B (PHP1B), also referred to as inactivating PTH/PTHrP signaling disorder (iPPSD), is characterized by proximal renal tubular resistance to parathyroid hormone (PTH) leading to hypocalcemia, hyperphosphatemia, and elevated PTH values. Autosomal dominant PHP1B (AD-PHP1B) with loss of methylation at the maternal GNAS A/B:TSS-DMR (transcription start site-differentially methylated region) alone can be caused by maternal deletions involving STX16.

Objective

Characterize a previously not reported AD-PHP1B family with loss of methylation at GNAS A/B:TSS-DMR, but without evidence for a STX16 deletion on the maternal allele and assess GNAS-AS2:TSS-DMR methylation.

Methods

DNA from 24 patients and 10 controls were investigated. AD-PHP1B patients without STX16 deletion from a single family (n = 5), AD-PHP1B patients with STX16 deletion (n = 9), sporPHP1B (n = 10), unaffected controls (n = 10), patUPD20 (n = 1), and matUPD20 (n = 1). Methylation and copy number analyses were performed by pyrosequencing, methylation-sensitive multiplex ligation-dependent probe amplification, and multiplex ligation-dependent probe amplification.

Results

Molecular cloning of polymerase chain reaction–amplified, bisulfite-treated genomic DNA from healthy controls revealed evidence for 2 distinct GNAS-AS2:TSS-DMR subdomains, named AS2-1 and AS2-2, which showed 16.0 ± 2.3% and 31.0 ± 2.2% methylation, respectively. DNA from affected members of a previously not reported AD-PHP1B family without the known genetic defects revealed incomplete loss of methylation at GNAS A/B:TSS-DMR, normal methylation at the 3 well-established maternal and paternal DMRs, and, surprisingly, increased methylation at AS2-1 (32.9 ± 3.5%), but not at AS2-2 (30.5 ± 2.9%).

Conclusion

The distinct methylation changes at the novel GNAS-AS2:TSS-DMR will help characterize further different PHP1B/iPPSD3 variants and will guide the search for underlying genetic defects, which may provide novel insights into the mechanisms underlying GNAS methylation.
Fenofibrate Delays the Need for Dialysis and Reduces Cardiovascular Risk Among Patients With Advanced CKD
Authors: Yen Chieh-Li , Fan Pei-Chun , Lin Ming-Shyan , Lee Cheng-Chia , Tu Kun-Hua , Chen Chao-Yu , Hsiao Ching-Chung , Hsu Hsiang-Hao , Tian Ya-Chung , Chang Chih-Hsiang
Published: March 2021

Context

Fenofibrate provides limited cardiovascular (CV) benefits in the general population; however, little is known about its benefit among advanced chronic kidney disease (CKD) patients.

Objective

This study compared outcomes among advanced CKD patients treated with fenofibrate, statins, a combination of both, and none of these.

Methods

This national cohort study was based on Taiwan’s National Health Insurance Research Database. Patients younger than 20 years with advanced CKD were identified and further divided into 4 groups according to treatment. The inverse probability of treatment weighting was used to balance baseline characteristics. Patients received fenofibrate, statins, a combination of fenofibrate and statins, or none of these in the 3 months preceding the advanced CKD date. Main outcome measures included all-cause mortality, CV death, and incidence of permanent dialysis.

Results

The fenofibrate and statin groups exhibited a lower risk of CV death (fenofibrate vs nonuser: hazard ratio [HR]: 0.84; 95% CI, 0.75-0.94; statins vs nonuser: HR: 0.94; 95% CI, 0.90-0.97) compared with the nonuser group. The fenofibrate group further exhibited the lowest incidence of permanent dialysis (fenofibrate vs nonuser: subdistribution HR [SHR]: 0.78; 95% CI, 0.77-0.80; statins vs fenofibrate: SHR: 1.27; 95% CI, 1.26-1.29; combination vs fenofibrate: SHR: 1.15; 95% CI, 1.13-1.17). Furthermore, the combined administration of fenofibrate and high-intensity statins exhibited a lower risk of major adverse cardiac and cerebrovascular events.

Conclusion

For patients with advanced CKD, continuing fenofibrate may provide a protective effect on CV outcomes equal to that of statins, and it may further delay the need for permanent dialysis. The combination of fenofibrate and high-intensity statins may have additional benefits.
Insights from system leaders about operationalising a knowledge translation department in the Oman Ministry of Health
Authors: Al Sabahi Sultana , Wilson Michael G. , Lavis John N. , El-Jardali Fadi , Moat Kaelan
Published: March 2021

Background: Oman has prioritised enhanced efforts for supporting evidence-informed policymaking (EIPM), including establishing a knowledge translation department in the Omani Ministry of Health (MOH).

Aim and objective: Our aim was to gather insights to guide the process of activating this department.

Methods: We conducted a document review and in-depth, semi-structured interviews with policymakers, researchers, and stakeholders who are familiar with the Omani system.

Findings: We conducted 17 interviews, which highlighted that policymakers in Oman use multiple sources of data and evidence to inform policymaking about health systems. However, several challenges to using evidence were identified, including low quality and limited availability of local evidence, system fragmentation, low interest in research, and lack of skills, capacity and time for finding, synthesising and using research evidence. Five possible activities for the department were refined with participants: building capacity, finding evidence, sparking action, embedding supports, and evaluating innovations. Participants viewed each of these activities as equally important and they should be pursued simultaneously. However, when asked to rank the most important option, participants identified capacity building as the most important to enable cultural changes needed within the MOH.

Discussion and conclusions: This study provides insights for activating the knowledge translation department in the Omani MOH. Fully operationalising the department will require convening a codesign process to reach consensus on the scope of the activities undertaken by the department. Implementation will also require capitalising on the relevant experience of highly qualified staff and existing infrastructure as well as continuing to foster a supportive climate for EIPM.
The feminist and domestic workers’ movements: disconnected practices, discursive convergences
Authors: Geymonat Giulia Garofalo , Cherubini Daniela , Marchetti Sabrina
Published: March 2021

The article explores the relationship between women’s rights and feminist and domestic workers’ movements by drawing on qualitative data gathered in a comparative study on domestic workers’ rights in Italy, Germany, Spain, India, the Philippines, Taiwan, Colombia, Brazil and Ecuador (2016–21). Despite the frequent disconnection between the two movements at the practical level, a possible convergence may be identified in the discursive frames that domestic workers’ rights activists make use of. The analysis focuses on two feminist anti-capitalist frames recurring in mobilisations for domestic workers’ rights, addressing the valorisation of reproductive labour and the transnational commodification of care. Domestic workers’ activism tends to build on these frames beyond their mainstream forms and to expand them in intersectional ways, enlarging their capacity to include racialised, low-class, migrant and other minority groups. This becomes a creative force at the level of discourse, where different alliances may take place in a less visible way.
Photoacoustic dual-scan mammoscope: results from 38 patients
Authors: Nyayapathi Nikhila , Zhang Huijuan , Zheng Emily , Nagarajan Srinidhi , Bonaccio Ermelinda , Takabe Kazuaki , Fan Xinhao C. , Xia Jun
Published: March 2021

We have developed a photoacoustics-based imaging system, the dual-scan mammoscope (DSM), that combines optical contrasts with acoustic detection, to obtain the angiographic features in human breast. In this study, we investigated whether the system can differentiate malignant tumor and healthy breast. We have imaged 38 patients with various tumor types and compared results of tumor-bearing breast with healthy breast for each patient. We also compared the photoacoustic and ultrasound imaging results with clinical US. Vascular features in and around the tumor mass were visualized. We found that tumor-bearing breast contained vessels of larger caliber and exhibited stronger variations in the background signals than those in the contralateral healthy breasts. Preliminary data on photoacoustic and ultrasound images also indicate that the technique has potential in differentiating different tumor types. Overall, our results indicate that combining photoacoustic and ultrasound images can improve breast cancer screening.
Free space optic channel monitoring using machine learning
Authors: Esmail Maged A. , Saif Waddah S. , Ragheb Amr M. , Alshebeili Saleh A.
Published: March 2021

Free space optic (FSO) is a type of optical communication where the signal is transmitted in free space instead of fiber cables. Because of this, the signal is subject to different types of impairments that affect its quality. Predicting these impairments help in automatic system diagnosis and building adaptive optical networks. Using machine learning for predicting the signal impairments in optical networks has been extensively covered during the past few years. However, for FSO links, the work is still in its infancy. In this paper, we consider predicting three channel parameters in FSO links that are related to amplified spontaneous emission (ASE) noise, turbulence, and pointing errors. To the best of authors knowledge, this work is the first to consider predicting FSO channel parameters under the effect of more than one impairment. First, we report the performance of predicting the FSO parameters using asynchronous amplitude histogram (AAH) and asynchronous delay-tap sampling (ADTS) histogram features. The results show that ADTS histogram features provide better prediction accuracy. Second, we compare the performance of support vector machine (SVM) regressor and convolutional neural network (CNN) regressor using ADTS histogram features. The results show that CNN regressor outperforms SVM regressor for some cases, while for other cases they have similar performance. Finally, we investigate the capability of CNN regressor for predicting the channel parameters for three different transmission speeds. The results show that the CNN regressor has good performance for predicting the OSNR parameter regardless of the value of transmission speed. However, for the turbulence and pointing errors, the prediction under low speed transmission is more accurate than under high speed transmission.
Adiabatic evolution of optical beams in nonlocal nonlinear media of gradual nonlocality
Authors: Liang Guo , Kong Xiangwei , Li Yuan , Wang Qing
Published: March 2021

We theoretically investigate the evolution of optical beams in nonlocal nonlinear media of gradual nonlocality, which is governed by the nonlocal nonlinear Schrödinger equation with variable coefficient. With the variational approach, the evolution equation of beam width is derived. When the characteristic length of response function gradually changes with any functional forms, beams can exhibit a kind of adiabatic evolution. The variational results are well confirmed by numerical simulations.
Simulation of optical absorption in conical nanowires
Authors: Wilson D. P. , LaPierre R. R.
Published: March 2021

The optical absorptance from arrays of GaAs nanowires (NWs) was examined by the finite element method. Absorptance in cylindrical NWs, frustum nanocones (with base wider than the top) and inverted frustum nanocones (with top wider than the base) was compared. The introduction of higher order HE1n modes, the red-shift of the HE1n modes along the NW length due to NW tapering, and the red-shift of the modes due to increase of the overall NW diameter all contribute to a broadening of the absorption spectrum in conical NWs as compared to NWs with a constant diameter. The optical reflectance versus NW top diameter shows a minimum due to a balance between reflectance from the top of the NWs and reflectance from the substrate between NWs. The optimum geometry for photovoltaic energy conversion was determined from the total photocurrent. An optimum photocurrent of 26.5 mAcm-2 was obtained, corresponding to a conical NW morphology with base diameter of 200 nm, top diameter of 110 nm, and length of 2000 nm. An optimized inverse tapered conical morphology gave comparable performance.