bluuebunny/crossref_metadata_2025 huggingface dataset:
Chemical Composition of Florida Orange Juice
Authors: Floyd Kermit M , Rogers Grayson R , Harrell Jimmy E , Wilkes Perry S
Published: February 2020

Authentic samples of Florida orange juice were analyzed for soluble solids, acidity, amino acids, polyphenolics, l-malic acid, and betaine. Samples were collected from various processing plants from December 1967 through May 1968. Authentic data and a statistical study are presented.
Constituents of Opoponax Oil: Sesquiterpene Hydrocarbons
Authors: Wenninger John A , Yates Ronald L
Published: February 2020

Sesquiterpene hydrocarbons of opoponax oil were studied, using a combination of separat i on techniques which included column chromatography on alumina, silver nitrate adduction, and gas chromatography. Compounds isolated were identified by IR and NMR spectroscopy. Eighteen sesquiterpene hydrocarbons were identified as follows: Δ-elemene, α-cubebene, α-copaene, cis-α-bergamotene, β-elemene, α-santalene, trans-α-bergamotene, caryophyllene, γ-elemene, epi-β-santalene, β-santalene, humulene, γ-muurolene, trans-α-bisabolene, β-bisabolene, ar-curcumene, Δ-cadinene, and γ-cadinene. The major products obtained when hydrocarbons are regenerated from bisabolene trihydrochloride, using sodium acetate and acetic acid as reagents, were also characterized and identified as cis-α-bisabolene and β-bisabolene.
Determination of Dicyclohexylamine in Cyclamates
Authors: Howard John W , Fazio Thomas , Williams Barbara K , White Richard H
Published: February 2020

Dicyclohexylamine can be extracted from sodium and calcium cyclamates by liquidliquid extraction, using water, carbon tetrachloride, and hexane. Final analysis is by GLC with a flame ionization detector. Recoveries of dicyclohexylamine added to the cyclamate salts at levels of 0.2, 0.5, and 1.0 ppm ranged from 90–99%. Dicyclohexylamine was isolated from three of the seven lots of sodium and calcium cyclamates analyzed at concentrations of 2.0, 2.5, and 10.8 ppm. The presence of dicyclohexylamine was confirmed by IR spectrophotometry and mass spectrometry.
Derivatization of Dieldrin and Endrin for Confirmation of Residue Identity
Authors: Wiencke Winfred W , Burke Jerry A
Published: February 2020

Dieldrin and endrin are converted to characteristic derivatives by treatment with ZnCl2 and HCI as a means of confirming residue identity. The derivatives are separated from each other and from the parent compounds by GLC. Elution order of the derivatives on a 15% QF-1/10% DC-200 GLC column is the reverse of that obtained on a 10% DC-200 column. Derivatives can be formed at levels as low as 0.1 p pm in fats and 0.01 p pm in nonfats. The procedure requires about 15 min and is directly applicable to samples prepared according to the Food and Drug Administration’s multiresidue methodology.
The impact of the 30 most cited articles on hip arthroscopy: what is the subject matter?
Authors: von Glinski Alexander , Yilmaz Emre , Goodmanson Ryan , Pierre Clifford , Frieler Sven , Shaffer Andre , Ishak Basem , Lee Cara Beth , Mayo Keith
Published: February 2020

The purpose of this study was to identify the 30 most cited articles on hip arthroscopy and discuss their influence on recent surgical treatment. Due to advancements in hip arthroscopy, there is a widening spectrum of diagnostic and treatment indications. The purpose of this study was to identify the 30 most cited articles on hip arthroscopy and discuss their influence on contemporary surgical treatment. The Thomson Reuters Web of Science was used to identify the 30 most cited studies on hip arthroscopy between 1900 and 2018. These 30 articles generated 6152 citations with an average of 205.07 citations per item. Number of citations ranged from 146 to 461. Twenty-five out of the 30 papers were clinical cohort studies with a level of evidence between III and IV, encompassing 4348 patients. Four studies were reviewed (one including a technical note) and one a case report. We were able to identify the 30 most cited articles in the field of hip arthroscopy. Most articles were reported in high-impact journals, but reported small sample sizes in a retrospective setting. Prospective multi-arm cohort trials or randomized clinical trials represent opportunities for future studies.
Impact of radiological morphology of clinical T1 renal cell carcinoma on the prediction of upstaging to pathological T3
Authors: Teishima Jun , Hayashi Tetsutaro , Kitano Hiroyuki , Sadahide Kousuke , Sekino Yohei , Goto Keisuke , Inoue Shogo , Honda Yukiko , Sentani Kazuhiro , Awai Kazuo , Yasui Wataru , Matsubara Akio
Published: February 2020

Objectives

Previous studies have reported that cases with clinical T1 renal cell cancer upstaging to pathological T3 are a risk factor to predicting postoperative recurrence after partial nephrectomy. The aim of our study was to investigate the impact of the radiological morphology of the enhanced CT scan of clinical T1 renal cell cancer on predicting upstaging to pathological T3.

Methods

Three hundred sixty-seven cases with clinical T1 renal cell cancer diagnosed from enhanced CT scans were enrolled in this study. Based on the findings from the enhanced CT scan, the cases were classified into ‘round’, the margins of which were smooth and round; ‘lobular’, one or more findings of smooth dent and no spiky dent were identified on the margin of the tumor; and ‘irregular’, one or more spiky dent were identified on the margin of the tumor. The association of postoperative upstaging with these radiological morphology and other clinical characteristics of each case was analyzed.

Results

Eighteen cases (4.9%) pathologically upstaged to T3a. Two round case (0.7%), 3 lobular cases (10.0%) and 13 irregular cases (22.0%) pathologically upstaged (P < 0.001, round + lobular versus irregular). Four of 17 cases (23.5%) with hilar tumors pathologically upstaged, while 14 of 350 cases (4%) with tumors pathologically upstaged in other sites (P < 0.001). Multivariate analysis revealed that irregular case was an independent factor in predicting upstaging to pathological T3a (P < 0.001).

Conclusions

Evaluation of the radiological morphology of clinical T1 renal cell cancer based on enhanced CT scans is useful for predicting pathological upstaging.
Assessing the Current Generation of Tourniquets
Authors: Katsnelson Shimon , Oppenheimer Jessie , Gerrasi Rafi , Furer Ariel , Wagnert-Avraham Linn , Eisenkraft Arik , Nachman Dean
Published: February 2020

Introduction

Tourniquet application is an urgent life-saving procedure. Previous studies demonstrated several drawbacks in tourniquet design and application methods that limit their efficacy; among them, loose application of the device before windlass twisting is a main pitfall. A new generation of modern combat tourniquets was developed to overcome these pitfalls. The objective of this study was to assess the effectiveness of three new tourniquet designs: the CAT Generation 7 (CAT7), the SAM Extremity Tourniquet (SAM-XT), and the SOF Tactical Tourniquet Wide (SOFTT-W) as well as its correlation to the degree of slack.

Materials and Methods

The three tourniquet models were applied in a randomized sequence on a HapMed leg tourniquet trainer, simulating an above-the-knee traumatic amputation by 60 military medicine track cadets. Applied pressure, hemorrhage control status, time until the bleeding stopped, estimated blood volume loss, and slack were measured.

Results

The mean (±SD) pressure applied using the SAM-XT (186 mmHg ±63) or the CAT7 (175 mmHg ±79) was significantly higher compared to the pressure applied by the SOFTT-W (104 mmHg ±101, P < 0.017), with no significant difference between the first two (P > 0.05). Hemorrhage control rate was similar (P > 0.05) with SAM-XT (73.3%) and CAT7 (67.7%), and both were significantly better than the SOFTT-W (35%, P < 0.017). Slack was similar between CAT7 and SAM-XT (5.2 mm ± 3.4 vs. 5 mm ± 3.5, P > 0.05), yet significantly lower compared to the SOFTT-W (9 mm ± 5, P < 0.017). A strong negative correlation was found between slack and hemorrhage control rate (3.2 mm ± 1.5 mm in success vs. 10.5 mm ± 3.4 mm in failure, P < 0.001) and applied pressure (Pearson’s correlation coefficient of −0.83, P < 0.001).

Conclusions

Both SAM-XT and CAT7 demonstrated a better pressure profile and hemorrhage control rate compared to SOFTT-W, with no significant difference between the two. The better outcome measures were strongly correlated to less slack.
A broad-host-range event detector: expanding and quantifying performance between Escherichia coli and Pseudomonas species
Authors: Khan Nymul , Yeung Enoch , Farris Yuliya , Fansler Sarah J , Bernstein Hans C
Published: February 2020

Modern microbial biodesign relies on the principle that well-characterized genetic parts can be reused and reconfigured for different functions. However, this paradigm has only been successful in a limited set of hosts, mostly comprised from common lab strains of Escherichia coli. It is clear that new applications such as chemical sensing and event logging in complex environments will benefit from new host chassis. This study quantitatively compared how the same chemical event logger performed across four strains and three different microbial species. An integrase-based sensor and memory device was operated by two representative soil Pseudomonads—Pseudomonas fluorescens SBW25 and Pseudomonas putida DSM 291. Quantitative comparisons were made between these two non-traditional hosts and two benchmark E. coli chassis including the probiotic Nissle 1917 and common cloning strain DH5α. The performance of sensor and memory components changed according to each host, such that a clear chassis effect was observed and quantified. These results were obtained via fluorescence from reporter proteins that were transcriptionally fused to the integrase and downstream recombinant region and via data-driven kinetic models. The Pseudomonads proved to be acceptable chassis for the operation of this event logger, which outperformed the common E. coli DH5α in many ways. This study advances an emerging frontier in synthetic biology that aims to build broad-host-range devices and understand the context by which different species can execute programmable genetic operations.
Aim for Clinical Utility, Not Just Predictive Accuracy
Authors: Sachs Michael C. , Sjölander Arvid , Gabriel Erin E.
Published: February 2020

The predictions from an accurate prognostic model can be of great interest to patients and clinicians. When predictions are reported to individuals, they may decide to take action to improve their health or they may simply be comforted by the knowledge. However, if there is a clearly defined space of actions in the clinical context, a formal decision rule based on the prediction has the potential to have a much broader impact. The use of a prediction-based decision rule should be formalized and preferably compared with the standard of care in a randomized trial to assess its clinical utility; however, evidence is needed to motivate such a trial. We outline how observational data can be used to propose a decision rule based on a prognostic prediction model. We then propose a framework for emulating a prediction driven trial to evaluate the clinical utility of a prediction-based decision rule in observational data. A split-sample structure is often feasible and useful to develop the prognostic model, define the decision rule, and evaluate its clinical utility. See video abstract at, http://links.lww.com/EDE/B656.
Prediction of Serum-Free and Cerebrospinal Fluid Valproic Acid Levels in Patients With Hypoalbuminemia After Craniotomy
Authors: Li Zhihong , Gao Weiqi , Liu Guifen , Chen Weihong
Published: February 2020

Background:

In patients with hypoalbuminemia after craniotomy, total serum concentrations of valproic acid (VPA) may provide poor clinical insights, owing to saturated protein binding and increased unbound fractions. However, very few clinical laboratories routinely analyze free concentrations of the drug. The aim of this study was to develop a model to predict serum-free and cerebrospinal fluid (CSF) levels of VPA based on its total concentration and to investigate the model's applicability.

Methods:

Total serum and CSF concentrations of VPA in 79 patients were measured using a validated immunoassay between January 2015 and December 2015. The demographic, clinical, and laboratory information of patients were retrieved from medical records. A multiple linear regression analysis was adopted to determine the potential variations and establish the functional relationship between CSF concentration and significant clinical factors.

Results:

Based on the stepwise multiple linear regression analysis performed using the natural logarithm of the concentration of VPA in the CSF as the dependent variable, serum concentrations of VPA (X1, β' = 0.844), serum albumin concentration (X2, β' = −0.393), and CSF protein concentration (X3, β' = 0.098) were identified as the 3 variables that significantly predicted the dependent variable:

JOURNAL/thdm/04.03/00007691-202008000-00014/inline-formula1/v/2023-08-14T203553Z/r/image-tiff

, with a coefficient of determination (R2) of 0.874. As the CSF protein level is often unavailable, the model was redefined to include 2 variables—serum concentrations of VPA (X1, β' = 0.840) and serum albumin concentration (X2, β' = −0.359):

JOURNAL/thdm/04.03/00007691-202008000-00014/inline-formula2/v/2023-08-14T203553Z/r/image-tiff

, with R2 = 0.813.

Conclusions:

Based on total VPA and serum albumin concentrations, we developed a model to predict serum-free and CSF levels of VPA. This model is useful for correcting dose adjustment in patients with hypoalbuminemia after craniotomy.
CLINICAL OUTCOMES OF DIFFERENT SUBTYPES OF NEOVASCULAR AGE-RELATED MACULAR DEGENERATION DURING AFLIBERCEPT TREATMENT
Authors: Rezar-Dreindl Sandra , Eibenberger Katharina , Buehl Wolf , Maccora Katia , Waldstein Sebastian , Baratsits Magdalena , Schmidt-Erfurth Ursula , Sacu Stefan
Published: February 2020

Purpose:

To prospectively evaluate the outcomes of different subtypes of neovascular age-related macular degeneration during intravitreal aflibercept monotherapy.

Methods:

Forty-four eyes of 44 patients with treatment-naïve polypoidal choroidal vasculopathy (PCV, n = 12), hemorrhagic choroidal neovascularization (hCNV, n = 12), pigment epithelium detachment (PED, n = 11), or retinal angiomatous proliferation (RAP, n = 9) were included and followed for 12 months. All patients received intravitreal aflibercept monotherapy.

Results:

Mean visual acuity at baseline in PCV was 67 ± 16 Early Treatment Diabetic Retinopathy Study letters (20/50 Snellen equivalent), in hCNV 55 ± 21 (20/80), in RAP lesions 64 ± 11 (20/50), and in PED 74 ± 7 (20/32). At Month 12, visual acuity in PCV was 66 ± 16 (20/50), in hCNV 69 ± 17 (20/40), in RAP 68 ± 12 (20/50), and in PED 69 ± 18 (20/40). At the 12-month follow-up, visual acuity improved or was stable (±5 letters from baseline) in 84% of eyes (37/44 patients), with hCNV showing the greatest mean visual acuity gain. Mean central retinal thickness in patients with PCV was 523 ± 251 µm, in hCNV 497 ± 171, in RAP lesions 573 ± 132, and in PED 541 ± 158 and decreased to 310 ± 91 µm in PCV, 323 ± 75 µm in hCNV, 357 ± 173 µm in RAP lesions, and 422 ± 150 µm in PED. The mean area of atrophy increased from 2.0 ± 3.6 mm2 at baseline to 4.6 ± 8.6 mm2 at Month 12 (mean difference [95% confidence interval] −0.8 [−8.5 to 7.0], P = 0.8), with the greatest atrophy in patients with PED at Month 12.

Conclusion:

All subtypes of neovascular age-related macular degeneration showed anatomical improvement and stabilization of visual function during intravitreal treatment.
Respiratory Syncytial Virus Outbreak in a Veterans Affairs Long-term Care Facility
Authors: Barrett Nancy , Bailey Lisa , Ford Florence , Thorne Monique , Azab Nancy , LeMaitre Beth , Lobo Zeena , Psevdos George
Published: February 2020

Background

Respiratory syncytial virus (RSV) is increasingly becoming an important cause of respiratory infections in adults, especially those living in long-term care facilities (LTCFs). Seasonal outbreaks peaking from October to April are common. We report an outbreak of RSV involving 2 LTCFs with total capacity of 80 beds in 2019.

Methods

Retrospective chart review of cases identified with positive RSV infection via DNA polymerase chain reaction (PCR) from January 24 to February 24, 2019, at 2 LTCF units, in close proximity to each other, at Northport Affairs Medical Center.

Results

Twenty veterans (18 men and 2 women) tested positive for RSV by rapid PCR. The median age was 73 (47–89) years, 85% are Caucasian, and 5 patients had temperature of greater than 100°F (100°F–102.4°F). All had rhinorrhea and 65% had cough. Medical history shows 45% with dementia, 30% with stroke, and 35% with diabetes; 2 patients on hemodialysis; and 2 patients with chronic obstructive pulmonary disease (COPD). Four patients required hospitalization, and 2 of them required admission to intensive care unit. Length of stay ranged from 1 to 9 days. One patient with COPD required mechanical ventilation. One patient with computed tomography finding of airway impaction had antibiotics stopped by infectious diseases consult, yet he developed Clostridium difficile diarrhea. No deaths were observed, and all patients recovered. Aggressive infection control measures were implemented.

Conclusions

Respiratory syncytial virus is highly infectious and can easily cause an outbreak in an LTCF. Polymerase chain reaction testing was contributory to identify cases rapidly. Rapid PCR results and intensified infection control measures were instrumental to halt the outbreak.
Novel double-flanged technique for managing Marfan syndrome and microspherophakia
Authors: Canabrava Sergio , Canedo Domingos Lima Ana Carolina , Arancibia Ana Elisa Loyola , Bicalho Dornelas Luiza Filgueiras , Ribeiro Guilherme
Published: February 2020

A new technique for fixating the capsular bag in patients with ectopia lentis is presented. In this technique, the capsulorhexis is performed using a femtosecond laser, followed by the insertion of a standard capsular tension ring to redistribute capsular forces. The nucleus is hydroprolapsed into the anterior chamber and nuclear disassembly is performed above the iris plane to reduce zonular stress. Finally, a 5-0 polypropylene monofilament is used to fixate a capsular tension segment and subluxated capsular bag. This novel double-flanged method, achieved with cautery, does not require direct suturing of the monofilament on the sclera. This article describes the use of this new technique in 3 eyes, 2 in patients with Marfan syndrome and 1 in a patient with microspherophakia.
Hepatitis E virus infection in liver transplant recipients: a descriptive literature review
Authors: Perisetti Abhilash , Laoveeravat Passisd , Inamdar Sumant , Tharian Benjamin , Thandassery Ragesh , Goyal Hemant
Published: February 2020

Hepatitis E virus infection has been recognized as a rising hepatotropic viral infection in the developing countries but overlooked in the developed countries, due to its lower prevalence. However, hepatitis E virus prevalence is on rise in the liver transplant recipients due to immunosuppression, which needs prompt recognition by healthcare practitioners. Hepatitis E virus infection is commonly believed to be transmitted via an animal host; but in the post-liver transplant patients, it can also be acquired via blood and blood products transfusion and autochthonous route. Previous studies have shown the significance of hepatitis E virus infection in post-liver transplant, as the patients at a high risk of progressing to chronic hepatitis and cirrhosis. Pediatric patients are at higher risk of hepatitis E virus infection post-liver transplant. Specific hepatitis E virus genotypes have the potential for greater severity. The clinical manifestation of hepatitis E virus can also present as extrahepatic features which need high level of suspicion for early recognition and treatment. Treatment options of hepatitis E virus range from immunosuppressive drug minimization, ribavirin therapy to novel direct-acting antiviral regimens. Herein, we aim to explore epidemiology, prevalence, risk factor, diagnosis, and management of hepatitis E virus infection giving special attention to liver transplant recipients.
MRI-determined liver fat correlates with risk of metabolic syndrome in patients with nonalcoholic fatty liver disease
Authors: Chen Jialiang , Duan Shaojie , Ma Jie , Wang Rongrui , Chen Jie , Liu Xinyuan , Xue Lijun , Xie Sheng , Yao Shukun
Published: February 2020

Background and aim:

Little is known about that the relationship between hepatic fat content (HFC) and metabolic syndrome (MetS). We aimed to determine whether HFC correlated with MetS in patients with nonalcoholic fatty liver disease (NAFLD).

Methods:

HFC was measured by MRI-determined proton density fat fraction (MRI-PDFF) for 131 suspected NAFLD subjects. Patients with NAFLD defined as MRI-PDFF ≥5% were stratified into two groups based on whether they were above or below the median MRI-PDFF value; the MRI-PDFF value for the control group was <5%. The primary outcome was the presence of MetS. Logistic regression models were used to obtain the associations between the severity of liver fat and MetS, and the corresponding odds ratios (ORs) and 95% confidence intervals (CIs) were recorded.

Results:

Compared to NAFLD patients with low-HFC (n = 48) and the control group (n = 35), NAFLD patients with high-HFC (n = 48) had significantly greater prevalence of central obesity, hypertension, hyperglycemia, and hypertriglyceridemia (all P < 0.05). NAFLD patients with high-HFC had a higher prevalence of MetS than NAFLD patients with low-HFC (79.2% vs. 56.2%, P < 0.05). The multivariate-adjusted OR for the prevalence of MetS comparing NAFLD patient with low-HFC and high-HFC to the control group were 4.56 (95% CI: 0.54–38.79, P = 0.165) and 22.91 (95% CI: 1.80–292.21, P = 0.016), respectively (P
trend = 0.014).

Conclusion:

Increased hepatic fat quantitatively measured by MRI-PDFF had a significant dose-relationship with the presence of MetS, and the amount of liver fat may affect cardiovascular risk.
Confederates in the Attic
Authors: Bremner J. Douglas , Wittbrodt Matthew T. , Shah Amit J. , Pearce Bradley D. , Gurel Nil Z. , Inan Omer T. , Raggi Paolo , Lewis Tené T. , Quyyumi Arshed A. , Vaccarino Viola
Published: February 2020

Da Costa originally described Soldier's Heart in the 19th Century as a syndrome that occurred on the battlefield in soldiers of the American Civil War. Soldier's Heart involved symptoms similar to modern day posttraumatic stress disorder (PTSD) as well as exaggerated cardiovascular reactivity felt to be related to an abnormality of the heart. Interventions were appropriately focused on the cardiovascular system. With the advent of modern psychoanalysis, psychiatric symptoms became divorced from the body and were relegated to the unconscious. Later, the physiology of PTSD and other psychiatric disorders was conceived as solely residing in the brain. More recently, advances in psychosomatic medicine led to the recognition of mind-body relationships and the involvement of multiple physiological systems in the etiology of disorders, including stress, depression PTSD, and cardiovascular disease, has moved to the fore, and has renewed interest in the validity of the original model of the Soldier's Heart syndrome.
Impact of Service Learning on Student Attitudes Toward the Poor and Underserved
Authors: Tillman Paula , Thomas McKinley , Buelow Janet R.
Published: February 2020

Background

Patient-centered care necessitates an appreciation of one's socioeconomic status and its influence on health and well-being.

Purpose

We explored how student attitudes toward poverty changed as a result of participation in an interprofessional service-learning experience.

Methods

Students from 6 health profession programs participated in an interprofessional military-sponsored free health care event serving nearly 8000 individuals from our community. Students' pre-post attitudes toward poverty were measured using the Attitude Toward Poverty Short Form (ATP-SF) and Beliefs About the Relationship Between Poverty and Health (BRPH) scale.

Results

Two subscales and 14 items on the ATP-SF and 3 items on the BRPH had significant differences between their pre and post experience. Students expressed less bias, a decrease in stereotypic views, and a heightened willingness to advocate on behalf of those with limited means of support.

Conclusion

Findings suggest that experiential, transformative service learning has a positive impact on students' attitudes toward poverty and the underserved.
Impact of Electronic Reminders on Student Grades and Attitudes in Online Courses
Authors: O'Neil Carol A. , Buckley Kathleen M.
Published: February 2020

Background

Reminders guide students in meeting course expectations for submitting assignments.

Problem

Variables linked to the effective use of reminders are unclear. The purpose of this study was to evaluate the impact on student grades and attitudes of using routine reminders for assignments in an online course.

Approach

Students enrolled in online graduate and undergraduate nursing courses were emailed weekly reminders for discussion board assignments. Students received reminders for half of the semester and served as their own control to evaluate the impact of reminders on grades.

Outcomes

There was no significant impact of reminders on grades or overall attitude. However, when undergraduate and graduate students were compared on individual questions on an attitude toward reminders' scale, undergraduate students reported that reminders were necessary, had a positive impact on their grades, and should be included in all courses.

Conclusions

Reminders should be routinely used in undergraduate online courses.
Tumor-insular Complex in Neoadjuvant Treated Pancreatic Ductal Adenocarcinoma Is Associated With Higher Residual Tumor
Authors: González Iván A. , Kang Liang-I , Williams Gregory A. , Liu Jingxia , DeNardo David G. , Hawkins William G. , Chatterjee Deyali
Published: February 2020

The tumor microenvironment in pancreatic ductal adenocarcinoma (PDAC) plays a vital role in treatment response, and therefore, patient survival. We and others have observed an intimate association of neoplastic ductal cells with non-neoplastic islet cells, recapitulating the ductoinsular complex. We define this phenomenon as tumor-insular complex (TIC). Herein, we describe the clinicopathologic characteristics of TIC in neoadjuvant treated PDAC cases for the first time. We retrospectively reviewed the pathology of 105 cases of neoadjuvant treated PDAC resected at our institution. TIC was noted in 35 cases (33.3%), the mean tumor bed size was 2.7±1.0 cm, mean percentage of residual tumor 40±28% and mean Residual Tumor Index (RTI) (an index previously established as a prognostic parameter by our group) was 1.1±1.0. TIC was significantly associated with perineural invasion (P=0.001), higher tumor bed size (P=0.007), percentage of residual tumor (P=0.009), RTI (P=0.001), ypT stage (P=0.045), and poor treatment response, grouped by a previously established criteria (P=0.010). Using our prior binary reported prognostic cutoff for RTI of ≤0.35 and >0.35, TIC was associated with a RTI >0.35 (P=0.002). Moreover, patients who did not receive neoadjuvant radiation were associated with a higher frequency of TIC (P=0.003). In this cohort, RTI but not TIC was also shown to be a significant independent prognosticator for recurrence-free survival and overall survival on multivariate analysis. In conclusion, TIC is significantly associated with a more aggressive neoplasm which shows a poor treatment response. Further studies will be needed to better understand the tumor biology of TICs.
Pulmonary Adenofibromas
Authors: Lindholm Kaleigh E. , Sansano-Valero Irene , Rodriguez Jorge L. , Ramon y Cajal Santiago , Moran Cesar A.
Published: February 2020

Thirteen cases of primary pulmonary adenofibromas are presented. The patients are 8 women and 5 men between the ages of 41 and 73 years (average: 57 y). The patients presented with nonspecific symptomatology or their tumor was identified during routine chest films. A wedge resection was performed in all cases with lymph node sampling. Grossly, the tumors varied in size from 1 to 2.5 cm in greatest dimension. The entire tumor was histologically evaluated in all cases. All the tumors shared similar histologic features namely leaf-like/phyllodes-like growth patterns with varying areas of sclerosis, focal inflammation, and entrapped epithelium. A wide panel of immunohistochemical studies was performed including epithelial, neural, muscle, and vascular markers, all of which showed negative staining. The tumors were positive only for vimentin in the stroma and keratin in the entrapped epithelium. Further evaluation in 6 cases using in situ hybridization for the solitary fibrous tumor was performed and was negative. Clinical follow-up in all the patients showed no evidence of recurrence or metastatic disease, during a period of 12 to 36 months. The current cases highlight the unusual occurrence of pulmonary adenofibromas and the importance of separating these tumors from other tumors that may have the potential to recur or metastasize. The use of proper immunohistochemical stains/molecular analysis aids in the proper classification of these tumors.
Perception of surface stickiness in different sensory modalities: an functional MRI study
Authors: So Yosup , Kim Sung-Phil , Kim Junsuk
Published: February 2020

Surface texture can be perceived not only from tactile, but also from auditory and visual sensory cues. In our previous psychophysical study, we demonstrated that humans can recognize surface stickiness using only one kind of sensory modality without any difficulty. However, the brain regions that would be activated by non-corresponding sensory cues, for example, auditory and visual cues, remain unknown. In this human functional MRI study, we explored brain regions associated with surface stickiness perception in each of three different sensory modalities, and sought for common neural activities across modalities. In the tactile condition, participants actually touched a sticky surface with their right index finger. In the auditory and visual conditions, audio and video clips of tactile explorations of a sticky surface were presented and participants were asked to recall the perceived stickiness as vividly as possible. Our results, based on a general linear model analysis, showed that somatosensory cortices including postcentral gyrus, anterior insula, and anterior intraparietal sulcus were significantly activated across all modalities. Moreover, we observed significant activation of primary sensory regions of each modality. A follow-up conjunction analysis identified that postcentral gyrus, anterior intraparietal sulcus, precentral gyrus, and supplementary motor area were activated in common. These findings could deepen our understanding of the surface stickiness perception in the human brain.
Pollutants in Hong Kong Soils: As, Cd, Cr, Cu, Hg, Pb and Zn
Authors: Chung M.K. , Cheung K.C. , Wong M.H.
Published: February 2020

Six heavy metals (Hg, Cu, Cd, Cr, Pb, Zn) and 1 metalloid (As) in surface soils of Hong Kong were investigated in 10 land use categories (urban park, greening area, country park, rural area, restored landfill, agricultural farmland, orchard farm, crematorium, industrial and near highway area). Edaphic Hg concentration in Hong Kong was firstly reported here. Clustering of land uses was observed based on total pollutants concentrations (sum of 7 metals). The most polluted cluster consisted of industrial and highway areas (median: 617 to 833 mg kg-1) and the runner-up cluster included urban park, greening area and restored landfill (median: 400 to 500 mg kg-1). However, this general finding was not observed for Hg, where higher concentration was found in agricultural farmland (median 109 μg kg-1). The use of low quality fertilizers, together with the contribution from exhausts and wearable parts from automobiles were believed to be the major sources of Cr, Cu and Zn in Hong Kong, while the application of Hg-containing agrochemicals maybe the main mechanism of Hg contamination in agricultural soil. Based on the daily intake assumption of 0.2 g d-1of soil particles by USEPA, direct ingestion of Hg-containing soils is not a major exposure pathway for population in Hong Kong. When comparing the edaphic heavy metal concentrations with Dutch soil quality guidelines demonstrated that Hg, Cd and Pb were not in level of health concerns, while Cu, Cr and Zn in less than 6% of total samples were found to exceed the Dutch intervention values sporadically. In contrast, suburban soils from northern and northeastern Hong Kong were mostly contaminated with As (10% of total samples) at concentration that could be potentially causing adverse health impacts to the nearby population.

Pollutant in Hong Kong soils series

Chung, M. K., Hu, R., Cheung, K. C. & Wong, M. H. Pollutants in Hong Kong soils: Polycyclic aromatic hydrocarbons. Chemosphere 67, 464–473 (2007).http://doi.org/10.1016/j.chemosphere.2006.09.062

Chung, M. K., Cheung, K. C. & Wong, M. H. Pollutants in Hong Kong Soil: As, Cd, Cr, Cu, Hg, Pb and Znhttps://doi.org/10.1101/2020.02.16.951558

Chung, M. K., Hu, R., Cheung, K. C. & Wong, M. H. Pollutants in Hong Kong Soils: Organochlorine Pesticides and Polychlorinated Biphenylshttps://doi.org/10.1101/2020.02.16.951541
Trends and prediction in daily incidence of novel coronavirus infection in China, Hubei Province and Wuhan City: an application of Farr’s law
Authors: Xu Jie , Cheng Yajiao , Yuan Xiaoling , Li Wei V. , Zhang Lanjing
Published: February 2020

Background

The recent outbreak of novel coronavirus (2019-nCoV) has infected tens of thousands of patients in China. Studies have forecasted future trends of the incidence of 2019-nCoV infection, but appeared unsuccessful. Farr’s law is a classic epidemiology theory/practice for predicting epidemics. Therefore, we used and validated a model based on Farr’s law to predict the daily-incidence of 2019-nCoV infection in China and 2 regions of high-incidence.

Methods

We extracted the 2019-nCoV incidence data of China, Hubei Province and Wuhan City from websites of the Chinese and Hubei health commissions. A model based on Farr’s law was developed using the data available on Feb. 8, 2020, and used to predict daily-incidence of 2019-nCoV infection in China, Hubei Province and Wuhan City afterward.

Results

We observed 50,995 (37001 on or before Feb. 8) incident cases in China from January 16 to February 15, 2020. The daily-incidence has peaked in China, Hubei Providence and Wuhan City, but with different downward slopes. If no major changes occur, our model shows that the daily-incidence of 2019-nCoV will drop to single-digit by February 25 for China and Hubei Province, but by March 8 for Wuhan city. However, predicted 75% confidence intervals of daily-incidence in all 3 regions of interest had an upward trend. The predicted trends overall match the prospectively-collected data, confirming usefulness of these models.

Conclusions

This study shows the daily-incidence of 2019-nCoV in China, Hubei Province and Wuhan City has reached the peak and was decreasing. However, there is a possibility of upward trend.
Estimating the risk of 2019 Novel Coronavirus death during the course of the outbreak in China, 2020
Authors: Mizumoto Kenji , Chowell Gerardo
Published: February 2020

Since the first case of Novel Coronavirus (2019-nCov) was identified in December 2019 in Wuhan City, China, the number of cases continues to grow across China and multiple cases have been exported to other countries. The cumulative number of reported deaths is at 637 as of February 7, 2020. Here we statistically estimated the time-delay adjusted death risk for Wuhan as well as for China excluding Wuhan to interpret the current severity of the epidemic in China. We found that the latest estimates of the death risk in Wuhan could be as high as 20% in the epicenter of the epidemic whereas we estimate it ∼1% in the relatively mildly-affected areas. Because the elevated death risk estimates are likely associated with a breakdown of the medical/health system, enhanced public health interventions including social distancing and movement restrictions should be effectively implemented to bring the epidemic under control.
A Note on COVID-19 Diagnosis Number Prediction Model in China
Authors: Li Yi , Yin Xianhong , Liang Meng , Liu Xiaoyu , Hao Meng , Wang Yi
Published: February 2020

Importance

To predict the diagnosed COVID-19 patients and the trend of the epidemic in China. It may give the public some scientific information to ease the fear of the epidemic.

Objective

In December 2019, pneumonia infected with the novel coronavirus burst in Wuhan, China. We aimed to use a mathematical model to predict number of diagnosed patients in future to ease anxiety on the emergent situation.

Design

According to all diagnosis number from WHO website and combining with the transmission mode of infectious diseases, the mathematical model was fitted to predict future trend of outbreak.

Setting

Our model was based on the epidemic situation in China, which could provide referential significance for disease prediction in other countries, and provide clues for prevention and intervention of relevant health authorities.

Participants

In this retrospective, all diagnosis number from Jan 21 to Feb 10, 2020 reported from China was included and downloaded from WHO website.

Main Outcome(s) and Measure(s)

We develop a simple but accurate formula to predict the next day diagnosis number:,where Niis the total diagnosed patient till theith day, andαwas estimated as 0.904 at Feb 10.

Results

Based on this model, it is predicted that the rate of disease infection will decrease exponentially. The total number of infected people is limited; thus, the disease will have limited impact. However, new diagnosis will last to March.

Conclusions and Relevance

Through the establishment of our model, we can better predict the trend of the epidemic in China.
Early Prediction of Disease Progression in 2019 Novel Coronavirus Pneumonia Patients Outside Wuhan with CT and Clinical Characteristics
Authors: Feng Zhichao , Yu Qizhi , Yao Shanhu , Luo Lei , Duan Junhong , Yan Zhimin , Yang Min , Tan Hongpei , Ma Mengtian , Li Ting , Yi Dali , Mi Ze , Zhao Hufei , Jiang Yi , He Zhenhu , Li Huiling , Nie Wei , Liu Yin , Zhao Jing , Luo Muqing , Liu Xuanhui , Rong Pengfei , Wang Wei
Published: February 2020

Objective

To determine the predictive value of CT and clinical characteristics for short-term disease progression in patients with 2019 novel coronavirus pneumonia (NCP).

Materials and Methods

224 patients with confirmed 2019 novel coronavirus (COVID-19) infection outside Wuhan who had chest CT examinations were retrospectively screened. Clinical data were obtained from electronic medical records. CT images were reviewed and scored for lesion distribution, lobe and segment involvement, ground-glass opacities, consolidation, and interstitial thickening. All included patients with moderate NCP were observed for at least 14 days from admission to determine whether they exacerbated to severe NCP (progressive group) or not (stable group). CT and clinical characteristics between the two groups were compared, and multivariate logistic regression and sensitivity analyses were performed to identify the risk factors for developing severe NCP.

Results

A total of 141 patients with moderate NCP were included, of which 15 (10.6%) patients developed severe NCP during hospitalization and assigned to the progressive group. Multivariate logistic regression analysis showed that higher neutrophil-to-lymphocyte ratio (NLR) (odds ratio [OR] and 95% confidence interval [CI], 1.26 [1.04-1.53];P= 0.018) and CT severity score (OR and 95% CI, 1.25 [1.08-1.46];P= 0.004) on admission were independent predictors for progression to severe NCP, and sensitivity analysis confirmed the consistent results in nonimported patients but not in imported patients. However, no significant difference in lung involvement was found on CT between imported and nonimported patients (allP> 0.05). Patients who were admitted more than 4 days from symptom onset tended to have more severe lung involvement. Spearman correlation analysis showed the close association between CT severity score and inflammatory indexes (r= 0.17∼0.47, allP< 0.05).

Conclusion

CT severity score was associated with inflammatory levels and higher NLR and CT severity score on admission were independent risk factors for short-term progression in patients with NCP outside Wuhan. Furthermore, early admission and surveillance by CT should be recommended to improve clinical outcomes.
NovelKITLG/SCFregulatory variants are associated with lung function in African American children with asthma
Authors: Mak Angel CY , Sajuthi Satria , Joo Jaehyun , Xiao Shujie , Sleiman Patrick M , White Marquitta J , Lee Eunice Y , Saef Benjamin , Hu Donglei , Gui Hongsheng , Keys Kevin L , Lurmann Fred , Jain Deepti , Abecasis Gonçalo , Kang Hyun Min , Nickerson Deborah A. , Germer Soren , Zody Michael C , Winterkorn Lara , Reeves Catherine , Huntsman Scott , Eng Celeste , Salazar Sandra , Oh Sam S , Gilliland Frank D , Chen Zhanghua , Kumar Rajesh , Martínez Fernando D , Wu Ann Chen , Ziv Elad , Hakonarson Hakon , Himes Blanca E , Williams L Keoki , Seibold Max A , Burchard Esteban G.
Published: February 2020

Baseline lung function, quantified as forced expiratory volume in the first second of exhalation (FEV1), is a standard diagnostic criterion used by clinicians to identify and classify lung diseases. Using whole genome sequencing data from the National Heart, Lung, and Blood Institute TOPMed project, we identified a novel genetic association with FEV1on chromosome 12 in 867 African American children with asthma (p = 1.26 × 10−8, β = 0.302). Conditional analysis within 1 Mb of the tag signal (rs73429450) yielded one major and two other weaker independent signals within this peak. We explored statistical and functional evidence for all variants in linkage disequilibrium with the three independent signals and yielded 9 variants as the most likely candidates responsible for the association with FEV1. Hi-C data and eQTL analysis demonstrated that these variants physically interacted withKITLG (aka SCF)and their minor alleles were associated with increased expression ofKITLGgene in nasal epithelial cells. Gene-by-air-pollution interaction analysis found that the candidate variant rs58475486 interacted with past-year SO2exposure (p = 0.003, β = 0.32). This study identified a novel protective genetic association with FEV1, possibly mediated throughKITLG, in African American children with asthma.
The efficacy of convalescent plasma for the treatment of severe influenza
Authors: Xu Zhiheng , Zhou Jianmeng , Huang Yongbo , Liu Xuesong , Xu Yonghao , Chen Sibei , Liu Dongdong , Lin Zhimin , Liu Xiaoqing , Li Yimin
Published: February 2020

Background

Administration of convalescent plasma may be of clinical benefit for treatment of severe acute viral respiratory infections. However, no clear evidence exists to support or oppose convalescent plasma use in clinical practice. We conducted a systematic review and meta-analysis to assess the evidence of randomized controlled trials (RCTs) in the convalescent plasma for the treatment of severe influenza.

Methods

Healthcare databases were searched in February 2020. All records were screened against the eligibility criteria. Data extraction and risk of bias assessments were undertaken. The primary outcome was case-fatality rates by influenza.

Results

We identified 5 RCTs of severe influenza. The pooled analyses showed no evidence for a reduction in mortality (Odds Ratio (OR) 1.06; 95% confidence interval (CI) 0.51–2.23; p = 0.87; I2 = 35%). We also found non-significant reductions in days in ICU and hospital, and days on mechanical ventilation. There seemed to have a biological benefit of increasing HAI titer levels and decreasing influenza B virus loads and cytokines after convalescent plasma treatment. No serious adverse events was reported between two groups. Studies were commonly of low risk of bias with high quality.

Conclusions

Convalescent plasma appears safe but may not reduce mortality in severe influenza. This therapy should be studied within the context of a well-designed clinical trial for treatment of SARS-Cov-2 infection.
Variation in the Availability and Cost of Essential Medicines for Non-Communicable Diseases in Uganda: a descriptive time series analysis
Authors: Armstrong-Hough Mari , Sharma Srish , Kishore Sandeep P. , Akiteng Ann R , Schwartz Jeremy I.
Published: February 2020

Background

Availability of essential medicines for non-communicable diseases (NCDs) is poor in low- and middle-income countries. Availability and cost are conventionally assessed using cross-sectional data. However, these characteristics may vary over time.

Methods

We carried out a prospective, descriptive analysis of the availability and cost of essential medicines in 23 Ugandan health facilities over a five-week period. We surveyed facility pharmacies in-person up to five times, recording availability and cost of 19 essential medicines for NCDs and four essential medicines for communicable diseases.

Results

Availability of medicines varied substantially over time, especially among public facilities. Among private-for-profit facilities, the cost of the same medicine varied from week to week. Private-not-for-profit facilities experienced less dramatic fluctuations in price.

Conclusions

We conclude that there is a need for standardized, continuous monitoring to better characterize the availability and cost of essential medicines, understand demand for these medicines, and reduce uncertainty for patients.
Single cell transcriptomic heterogeneity in invasive ductal and lobular breast cancer cells
Authors: Chen Fangyuan , Ding Kai , Priedigkeit Nolan , Elangovan Ashuvinee , Levine Kevin M. , Carleton Neil , Savariau Laura , Atkinson Jennifer M. , Oesterreich Steffi , Lee Adrian V.
Published: February 2020

Invasive lobular breast carcinoma (ILC), one of the major breast cancer histological subtypes, exhibits unique clinical and molecular features compared to the other well-studied ductal cancer subtype (IDC). The pathognomonic feature of ILC is loss of E-cadherin, mainly caused by inactivating mutations within theCDH1gene, but the extent of contribution of this genetic alteration to ILC-specific molecular characteristics remains largely understudied. To profile these features transcriptionally, we conducted single cell RNA sequencing on a panel of IDC and ILC cell lines, as well as an IDC cell line (T47D) with CRISPR-Cas9-mediated knock out (KO) ofCDH1. Inspection of intra-cell line heterogeneity illustrated genetically and transcriptionally distinct subpopulations in multiple cell lines and highlighted rare populations of MCF7 cells highly expressing an apoptosis-related signature, positively correlated with a pre-adaptation signature to estrogen deprivation. Investigation ofCDH1KO-induced alterations showed transcriptomic membranous systems remodeling, elevated resemblance to ILCs in regulon activation, and suggestsIRF1as a potential mediator of reduced proliferation and increased cytokine-mediated immune-reactivity in ILCs.