bluuebunny/crossref_metadata_2025 huggingface dataset:
Decadal changes and ecological risk assessment of trace and heavy metal elements in soils of a desert oasis, Linze County, China
Authors: Yang Rong , Du Zeyu , Kong Junqia
Published: February 2019

This study assesses decadal changes (2005–2015) in the trace and heavy metal element contents of soils from four land use types at a desert oasis and also determines associated ecological and health risks. Concentrations of boron, molybdenum, manganese, zinc, copper, cadmium, lead, and mercury increased significantly over the decade. Farmland ecosystems had higher concentrations of soil trace and heavy metal elements than natural ecosystems, but intercropping with alfalfa tended to reduce concentrations. The environmental pollution assessment indicated that soils were moderately affected by human activities, particularly in farmland ecosystems. The potential degree of ecological risk from all elements was moderate, and in relation to land use this risk decreased in the following order: long-term cultivated farmland>newly reclaimed farmlands with monoculture>newly reclaimed farmlands with intercropping>natural desert grassland. Eight soil heavy metals posed potential non-carcinogenic risks, and dermal contact was the major exposure pathway; however, the carcinogenic risk level from soil was acceptable. These results suggest that agricultural activities increased the concentrations of certain soil trace and heavy metal elements and that adopting appropriate farmland management, such as intercropping with alfalfa, limited this increasing trend.
Tillage, compaction and wetting effects on NO3, N2O and N2 losses
Authors: Thomas Stephen M. , Fraser Patricia M. , Hu Wei , Clough Timothy J. , van der Klei Gina , Wilson Samuel , Tregurtha Rebekah , Baird David
Published: February 2019

Denitrification is sensitive to changes in soil physical properties that affect solute transport, air content and gas diffusion. Using lysimeters, containing intact soil from intensively tilled (IT) and no-tilled (NT) soil used to grow forage crops, we examined how simulated animal treading at different moisture contents (above and below field capacity; >FC and <FC respectively) affected losses of nitrous oxide (N2O), dinitrogen (N2) and nitrate (NO3). We applied 15N-labelled NO3 (250kg N ha–1) to the soil surface after treading (applied at 220 kPa to 40% of the soil surface), or to untrodden soil. Drainage occurred following weekly application of water over the experiment (two pore volumes over 84 days). Treading at >FC greatly increased denitrification, especially from IT soil and produced the greatest amount of N2 (64kg N ha–1), N2O (8.2kg N ha–1), as well as the lowest N2O to N2O+N2 ratio (0.08) and NO3 leaching (136kg N ha–1 below 30cm). In both the uncompacted or compacted soils FC. Treading at <FC had minimal or no effect on denitrification compared to untrodden soil. Fluxes of N2 and N2O were strongly influenced by the weekly irrigation–drainage cycle. The N2 production and reduction in NO3 leaching were best correlated with increases in microporosity and reduced saturated hydraulic conductivity following treading. Although recovery of 15N was high (84.3%), the remainder of the balance was likely lost as either N2 or, of greater concern, as N2O. Practically, animal trampling on wet soils, especially when recently cultivated, should be avoided.
Rice used for Japanese sake making
Authors: Okuda Masaki
Published: February 2019

Sake is a Japanese traditional alcoholic beverage made from rice and water. Recently, its export and its production in countries other than Japan have increased. In accordance, both the breeding and the cultivation of sake rice varieties have been extended to wide areas of Japan. To breed new sake rice cultivars and to cultivate rice with high suitability for sake production, an understanding of the properties of the ingredient rice grains and the factors affecting sake making is important. The influence of various rice properties, such as starch structure, protein, water absorption, and grain polishing, on sake making are being revealed in detail. In this review, the properties of rice used for sake making are summarized in terms of fermentation science and rice cultivation.
New xanthine oxidase inhibitors from the fruiting bodies of Tyromyces fissilis
Authors: Mitomo Shunsuke , Hirota Mitsuru , Fujita Tomoyuki
Published: February 2019

Excessive uric acid production, which causes gout and hyperuricemia, can be blocked by inhibiting xanthine oxidase (XO). However, some agents to block on XO often cause side effects, thereby necessitating the identification of new inhibitors. During the screening of XO inhibitors from various mushroom extracts, we found that a methanolic extract of the fruiting bodies of Tyromyces fissilis, an inedible and non-toxic fungus, showed inhibitory activity. Both n-hexane and ethyl acetate layers, obtained by partitioning this extract exhibited XO inhibitory activity. Subsequently, using an activity-guided separation method, eight active compounds (1–8) were isolated. The structures of five of the new compounds, 2–4, 6, and 7, were elucidated by spectral analysis and chemical derivatization. All compounds had a salicylic acid moiety with an aliphatic group at the C-6 position. Notably, 2-hydroxy-6-pentadecylbenzoic acid (1) showed the highest level of XO noncompetitive inhibition (58.9 ± 2.2% at 25 µM).
Is EFL students’ academic writing becoming more informal?
Authors: Praminatih Gusti A. , Kwary Deny A. , Ardaniah Viqi
Published: February 2019

A thesis is a formal academic writing; however, since nowadays communication tends to become more informal, some theses may also use informality features. This study aims at analyzing the undergraduate thesis abstracts from the years of 1992, 1996, 2000, 2004, 2008, 2012, and 2016 of Indonesian EFL students. This study found that the thesis abstracts contained eight types of informality features: first-person pronouns, second-person pronouns, sentence-initial conjunctions/conjunctive adverbs, sentence-final prepositions, run-on sentences/expressions, sentence fragments, contractions, and direct questions. From those eight features, four of them have constantly appeared over time. The statistical calculation shows a negative correlation between the years and these four features: the first-person pronouns, the sentence-initial conjunctions/conjunctive adverbs, the run-on sentences/expressions, and the sentence fragments. This means that the use of informality features has decreased overtime. This could signify that there has been an improvement in the teaching and learning process or that the EFL learners have become more conservative in their academic writing.
An Empirical Analysis of the Welfare Consequences of Rising Food Prices in Urban China: The Easi Approach
Authors: Hovhannisyan Vardges , Shanoyan Aleksan
Published: February 2019

The recent rise in food prices in China triggered by global commodity price spikes led to growing welfare concerns among economists and policymakers. While evidence suggests the Chinese government was successful in preventing major upswings in food prices, the true impact on consumer welfare remains unknown. This study examines consumer welfare consequences of food price increases in China based on the Fixed‐Effects Exact Affine Stone Index (FE‐EASI) demand model that accounts for unobserved consumer and provincial heterogeneity estimated on nationally representative provincial‐level panel data. The effects of actual price changes as well as two policy initiatives are evaluated. The major findings indicate that urban wages outpaced food prices, and consumer welfare loss has been moderate as a fraction of food expenditures. The results of policy analysis indicate that government subsidies overcompensated the negative effects of price increases for the relatively less affluent households.
Principal Controversies in Vaccine Safety in the United States
Authors: DeStefano Frank , Bodenstab Heather Monk , Offit Paul A
Published: February 2019

Concerns about vaccine safety can lead to decreased acceptance of vaccines and resurgence of vaccine-preventable diseases. We summarize the key evidence on some of the main current vaccine safety controversies in the United States, including (1) measles, mumps, and rubella vaccine and autism; (2) thimerosal, a mercury-based vaccine preservative and the risk of neurodevelopmental disorders; (3) vaccine-induced Guillain-Barré syndrome (GBS); (4) vaccine-induced autoimmune diseases; (5) safety of human papillomavirus vaccine; (6) aluminum adjuvant-induced autoimmune diseases and other disorders; and (7) too many vaccines given early in life predisposing children to health and developmental problems. A possible small increased risk of GBS following influenza vaccination has been identified, but the magnitude of the increase is less than the risk of GBS following influenza infection. Otherwise, the biological and epidemiologic evidence does not support any of the reviewed vaccine safety concerns.
Impact of secondary electron emission noise in SEM
Authors: Sakakibara Makoto , Suzuki Makoto , Tanimoto Kenji , Sohda Yasunari , Bizen Daisuke , Nakamae Koji
Published: February 2019

In semiconductor-device inspection using scanning electron microscopes (SEMs), the irradiation dose of the electron beam becomes lower because of increasing needs for higher throughput and lower damage to the samples. Therefore, it is necessary to form images using fewer primary electrons, making noise reduction of SEM images one of the main challenges. We have modeled the imaging process of SEMs, which consists of the generation of primary, secondary and tertiary electrons (PEs, SEs and TEs, respectively), and detection. Furthermore, a method to accurately evaluate the fluctuation in the number of SEs and TEs are proposed. We found that SEM-image noise can be minimized by directly detecting SEs generated in the sample, in which case the fluctuation in the number of SEs determines the image quality. The variance number of SEs emitted from a 500-eV PE irradiation onto a Si wafer is 1.9 times as large as the value derived assuming a Poisson process. A Monte-Carlo simulation result was used to explain the experimental results and predict that PE energy less than 1 keV suppresses the fluctuation in the number of SEs, and consequently, the SEM-image noise level. These findings provide a method for determining imaging conditions that improve the throughput of SEMs.
BCR-ABL1-like B-Lymphoblastic Leukemia/Lymphoma with FOXP1-ABL1 Rearrangement: Comprehensive Laboratory Identification Allowing Tyrosine Kinase Inhibitor Use
Authors: Yenamandra Ashwini K , Kaviany Saara , Borinstein Scott C , Friedman Debra L , Kovach Alexandra E
Published: February 2019

B-lymphoblastic leukemia/lymphoma (B-ALL) is the most common type of childhood cancer; it also occurs in teenagers and adults, in whom the prognosis is generally less favorable. Therapeutic and molecular advances have substantially improved the treatment for subtypes of B-ALL, such that subclassification by cytogenetic and molecular alterations is critical for risk stratification and management. Novel rearrangements involving ABL1, JAK2, EPO, and other kinases have been identified that may respond to inhibition akin to BCR-ABL1. This diverse group of leukemias has been recognized as a provisional entity in the 2016 revision of the World Health Organization (WHO) Classification of the Hematopoietic Neoplasms as B-lymphoblastic leukemia/lymphoma, BCR-ABL1–like (Ph-like B-ALL).

Herein, we present cytogenetic and molecular analysis of a case of B-ALL in a 16-year-old Caucasian boy with t(3;9) FOXP1-ABL1 rearrangement and concurrent loss of IKZF1, CDKN2A, and RB1 gene loci, meeting WHO criteria for Ph-like ALL. This case highlights diagnostic, prognostic, and therapeutic considerations of this recently recognized entity.
Vaginal Native Tissue Repair for Posterior Compartment Prolapse: Long-term Analysis of Sexual Function and Quality of Life in 151 Patients
Authors: Schiavi Michele Carlo , D'Oria Ottavia , Faiano Pierangelo , Prata Giovanni , Di Pinto Anna , Sciuga Valentina , Colagiovanni Vanessa , Giannini Andrea , Zullo Marzio Angelo , Monti Marco , Muzii Ludovico , Panici Pierluigi Benedetti
Published: February 2019

(Abstracted from Female Pelvic Med Reconstr Surg 2018;24:419–423)

Specific types of pelvic organ prolapse (POP) are classified according to the herniating vaginal compartment: anterior (cystocele), posterior (rectocele), and apical (uterine or vault prolapse). Seventy-five percent of women with POP have a rectocele.
Telehealth Therapy Effects of Nurses and Mental Health Professionals From 2 Randomized Controlled Trials for Chronic Back Pain
Authors: Gannon Jamie , Atkinson Joseph H. , Chircop-Rollick Tatiana , D’Andrea John , Garfin Steven , Patel Shetal , Penzien Donald B. , Wallace Mark , Weickgenant Anne L. , Slater Mark , Holloway Rachael , Rutledge Thomas
Published: February 2019

Objective:

To compare the efficacy of mental health professional versus primary care nurse-delivered telehealth cognitive-behavioral therapy (CBT) and supportive care (SC) treatments for chronic low back pain, using data from 2 separate randomized controlled trials. Both trials were completed in the same hospital and used the same study design, research team, and outcome measures.

Materials and Methods:

Participants from Study 1 (Mental Health Professional Study) (N=66; 2007 to 2011) and Study 2 (Nursing Study) (N=61; 2012 to 2016) were patients with chronic low back pain (≥4/10 intensity) randomized to either an 8-week CBT or an SC telehealth condition matched for contact frequency, format, and time. Participants completed validated measures of improvement in back pain disability (Roland Morris Disability Questionnaire [RMDQ]), pain intensity (Numeric Rating Scale [NRS]), depressive symptoms (Beck Depression Inventory 2 [BDI-2]), pain catastrophizing (Pain Catastrophizing Scale [PCS]), and overall improvement (Global Clinical Impressions [GCI]).

Results:

Intent-to-treat analyses at posttreatment showed that scores on the RMDQ (Cohen d=0.33 to 0.55), NRS (d=0.45 to 0.90), PCS (d=0.21 to 0.41), and GCI (18.5% to 39.1%) improved significantly in both studies and in both treatments from pretreatment to posttreatment. Changes in BDI scores were inconsistent (d=−0.06 to 0.51). The analyses revealed no significant differences in treatment efficacy between the trained nurse versus the mental health professionals on the RMDQ, NRS, PCS, or GCI measures (P>0.20).

Discussion:

Results from these clinical trials suggest that the benefits of home-based, telehealth-delivered CBT and SC treatments for chronic back pain were comparable when delivered by a primary care nurse or mental health professional.
Biomechanical Comparison of Tension Band Fixation of Patella Transverse Fracture: Headless Screws Versus Headed Screws
Authors: Martin Jill M. , Applin Dylan T. , McGrady Linda M. , Wang Mei , Schmeling Gregory J.
Published: February 2019

Objective:

This study aimed to investigate the stability and strength of tension band wire fixation using headless compression screws versus headed screws for transverse patella fractures.

Methods:

Six matched pairs of fresh-frozen cadaveric knees with transverse osteotomies created at the midpoint of the patella were surgically fixed, with one knee randomly receiving fixation with headless screws (Acumed Acutrak 4/5) and the other with headed screws (Synthes 4.0 partially threaded cannulated screws). The specimens were mounted onto a servohydraulic load frame in a 45-degree flexed position and loaded through the quadriceps tendon. Interfragmentary movement was recorded with a motion analysis system. The initial fixation stiffness, range of interfragmentary motion, and strength of the headless screw construct were compared with the headed screw construct. Failure was defined as either a sudden drop in applied tendon force or 2 mm of separation on the anterior surface of the patella (ie, clinical failure), whichever occurred first.

Results:

Mean primary interfragmentary motion was 0.31 ± 0.28 degrees for the headed screws and 0.10 ± 0.06 degrees for headless screws under 150 N load (P = 0.03). Mean construct stiffness was 277 ± 243 N/degrees for the headed screws and 510 ± 362 N/degrees for the headless screws (P = 0.03). None of the constructs from either group displayed structural failure before reaching the clinical failure gap of 2 mm. The mean clinical failure strength was 808 ± 183 N for the headless screws construct and 520 ± 241 N for the headed screws construct (P = 0.03).

Conclusions:

Headless screw tension band fixation demonstrated superior biomechanical behaviors over standard headed screw fixation with higher construct rigidity, smaller interfragmentary motion, and greater fixation strength.
Enhanced Performance of Next-Generation Sequencing Diagnostics Compared With Standard of Care Microbiological Diagnostics in Patients Suffering From Septic Shock
Authors: Grumaz Silke , Grumaz Christian , Vainshtein Yevhen , Stevens Philip , Glanz Karolina , Decker Sebastian O. , Hofer Stefan , Weigand Markus A. , Brenner Thorsten , Sohn Kai
Published: February 2019

Objectives:

Culture-based diagnostics represent the standard of care in septic patients, but are highly insensitive and in many cases unspecific. We recently demonstrated the general feasibility of next-generation sequencing-based diagnostics using free circulating nucleic acids (cell-free DNA) in plasma samples of septic patients. Within the presented investigation, higher performance of next-generation sequencing-based diagnostics was validated by comparison to matched blood cultures.

Design:

A secondary analysis of a prospective, observational, single-center study.

Setting:

Surgical ICU of a university hospital and research laboratory.

Patients:

Fifty patients with septic shock, 20 uninfected patients with elective surgery as control cohort.

Interventions:

None.

Measurements and Main Results:

From 256 plasma samples of 48 septic patients at up to seven consecutive time points within the 28-day observation period, cell-free DNA was isolated and analyzed by next-generation sequencing and relevance scoring. In parallel, results from culture-based diagnostics (e.g., blood culture) were obtained. Plausibility of blood culture and next-generation sequencing results as well as adequacy of antibiotic therapy was evaluated by an independent expert panel. In contrast to blood culture with a positivity rate of 33% at sepsis onset, the positivity rate for next-generation sequencing-based pathogen identification was 72%. Over the whole study period, blood culture positivity was 11%, and next-generation sequencing positivity was 71%. Ninety-six percent of positive next-generation sequencing results for acute sepsis time points were plausible and would have led to a change to a more adequate therapy in 53% of cases as assessed by the expert evaluation.

Conclusions:

Our results show that next-generation sequencing-based analyses of bloodstream infections provide a valuable diagnostic platform for the identification of clinically relevant pathogens with higher sensitivity and specificity than blood culture, indicating that patients might benefit from a more appropriate therapy based on next-generation sequencing-based diagnosis.
Impact of the Advanced Practice Provider in Adult Critical Care: A Systematic Review and Meta-Analysis*
Authors: Kreeftenberg Herman G. , Pouwels Sjaak , Bindels Alexander J. G. H. , de Bie Ashley , van der Voort Peter H. J.
Published: February 2019

Objectives:

To evaluate the effects on quality and efficiency of implementation of the advanced practice provider in critical care.

Data Sources:

PubMed, Embase, The Cochrane Library, and CINAHL were used to extract articles regarding advanced practice providers in critical care.

Study Selection:

Articles were selected when reporting a comparison between advanced practice providers and physician resident/fellows regarding the outcome measures of mortality, length of stay, or specific tasks. Descriptive studies without comparison were excluded. The methodological quality of the included studies was rated using the Newcastle-Ottawa scale. The agreement between the reviewers was assessed with Cohen’s kappa. A meta-analysis was constructed on mortality and length of stay.

Data Extraction and Synthesis:

One-hundred fifty-six studies were assessed by full text. Thirty comparative cohort studies were selected and analyzed. These compared advanced practice providers with physician resident/fellows. All studies comprised adult intensive care. Most of the included studies showed a moderate to good quality. Over time, the study designs advanced from retrospective designs to include prospective and comparative designs.

Data Synthesis:

Four random effects meta-analyses on length of stay and mortality were constructed from the available studies. These meta-analyses showed no significant difference between performance of advanced practice providers on the ICU and physician residents/fellows on the ICU, suggesting the quality of care of both groups was equal. Mean difference for length of stay on the ICU was 0.34 (95% CI, –0.31 to 1.00; I
2 = 99%) and for in hospital length of stay 0.02 (95% CI, –0.85 to 0.89; I
2 = 91%); whereas the odds ratio for ICU mortality was 0.98 (95% CI, 0.81–1.19; I
2 = 37.3%) and for hospital mortality 0.92 (95% CI, 0.79–1.07; I
2 = 28%).

Conclusions:

This review and meta-analysis shows no differences between acute care given by advanced practice providers compared with physician resident/fellows measured as length of stay or mortality. However, advanced practice providers might add value to care in several other ways, but this needs further study.
Chondroitin sulfate proteoglycan 4 enhanced melanoma motility and growth requires a cysteine in the core protein transmembrane domain
Authors: Yang Jianbo , Price Matthew A. , Wanshura Leah E.C. , He Jinsong , Yi Mei , Welch Danny R. , Li Guiyuan , Conner Sean , Sachs Jonathan , Turley Eva A. , McCarthy James B.
Published: February 2019

Chondroitin sulfate proteoglycan 4 (CSPG4) is a cell surface proteoglycan that enhances malignant potential in melanoma and several other tumor types. CSPG4 functions as a transmembrane scaffold in melanoma cells to activate oncogenic signaling pathways such as focal adhesion kinase (FAK) and extracellular signal regulated kinases 1,2, that control motility, invasion and anchorage independent growth. Here, we demonstrate that CSPG4 promotes directional motility and anchorage independent growth of melanoma cells by organizing and positioning a signaling complex containing activated FAK to lipid rafts within the plasma membrane of migrating cells. This FAK-containing signal transduction platform, which consists of syntenin-1, active Src and caveolin-1 requires the cytoplasmic domain of CSPG4 for assembly. Enhanced directional motility promoted by this complex also requires a CSPG4 transmembrane cysteine residue C2230. Substituting C2230 with alanine (CSPG4C2230A) still permits assembly of the signaling complex, however Src remains in an inactive state. CSPG4C2230A also fails to promote anchorage independent growth and activation of extracellular signal regulated kinases 1,2. Therapies that target the transmembrane domain of CSPG4 could be a novel strategy for limiting progression by disrupting its function as a compartmentalized motogenic and growth-promoting oncogenic signaling node.
A Reactive Peripheral Gamma-Delta T-cell Lymphoid Proliferation After a Tick Bite
Authors: Martin Seth M. , Flowers Richard , Saavedra Arturo P. , Gru Alejandro A.
Published: February 2019

Peripheral gamma-delta T-cell proliferations are encountered in reaction to certain infections and in primary malignancies. Identifying sources of benign reactions is key in avoiding unnecessary workup and surveillance of these aggressive malignancies. Borrelia infections have been implicated in a number of lymphoproliferative disorders, but rarely, if ever, in this setting. While gamma-delta T-cells are known to play a prominent role in the immune response to Borrelia infection, B-cell differentiation is encountered in the majority of Borrelia-associated proliferations. We present here a unique case of benign-appearing peripheral gamma-delta T-cell lymphoid proliferation in the setting of a tick-bite with subsequent erythema migrans-like skin findings.
Intraoral Cutaneous Hamartomas—Clinicopathologic and Immunohistochemical Characteristics of 3 Cases
Authors: Wilkinson Peter E. , Gopalakrishnan Rajaram , Argyris Prokopios P.
Published: February 2019

Intraoral cutaneous hamartomas (ICHs) are uncommon mucosal lesions characterized microscopically by a combination of cutaneous structures, including various stages of follicular and sebaceous elements. Due to their rarity, the clinicopathologic and immunohistochemical attributes of ICHs have not been thoroughly delineated. Three cases of ICH were identified from our records, and formalin-fixed paraffin-embedded sections were immunohistochemically stained with antibodies against androgen receptor, estrogen receptor, and progesterone receptor, p63, factor XIIIα, and CD34. All 3 ICHs involved the buccal mucosa with an M:F ratio = 2:1 and mean age = 42.3 years (age range: 27–61 years). ICHs presented as thickened, painless, white and yellow plaques or nodules of long duration, measuring 0.6–1.5 cm. No history of skin graft in the area of the lesions was reported. Histopathologically, the lesions showed aggregates of rudimentary folliculosebaceous structures. Although well-defined piloerector muscles were present in all cases of ICH, bona fide hair follicles and isolated hair shafts were identified only in 1 case. The overlying oral epithelium exhibited epidermis-like morphological features, while inflammation was generally absent. Immunohistochemically, strong and diffuse nuclear staining for androgen receptor and factor XIIIα was observed in the sebaceous glands, and estrogen receptor and p63 reactivity were confined exclusively to the peripheral basal cells, while progesterone receptor staining was negative in ICHs. CD34 diffusely decorated the lesional stroma. In conclusion, ICH is a rare lesion composed of cutaneous elements in an abnormal location. A predilection for the buccal mucosa is reported in the current study.
ACUTE IDIOPATHIC MACULOPATHY COMPLICATED BY CHOROIDAL NEOVASCULARIZATION: NEW INSIGHTS INTO MULTIMODAL RETINAL IMAGING
Authors: Pajtler Rosar Ana , Bochicchio Sara , Giani Andrea , Bottoni Ferdinando , Staurenghi Giovanni
Published: February 2019

Purpose:

To report a case of acute idiopathic maculopathy complicated by choroidal neovascularization (CNV) in which multimodal imaging was used to confirm the presence of CNV and follow the response to anti–vascular endothelial growth factor treatment.

Methods:

A 39-year-old man was referred to our clinic for the evaluation of maculopathy in the right eye. Multimodal imaging was performed including fundus photography, fundus autofluorescence, infrared fundus reflectance (IR), optical coherence tomography, fluorescein angiography, indocyanine green angiography, and optical coherence tomography angiography.

Results:

On the first examination, best-corrected visual acuity was 20/63 in the right eye and 20/20 in the left eye. A diagnosis of acute idiopathic maculopathy in the right eye was made on the basis of clinical presentation and multimodal imaging. After 3 months, best-corrected visual acuity had decreased to 20/100. Fluorescein angiography and indocyanine green angiography suggested the presence of a CNV. Optical coherence tomography angiography confirmed the presence of the CNV and well outlined the extension of the neovascular network. The patient underwent 2 monthly bevacizumab intravitreal injections. One month after the second injection, best-corrected visual acuity improved to 20/25, and optical coherence tomography angiography showed regression of the neovascular network. Best-corrected visual acuity remained stable during 20 months of follow-up.

Conclusion:

Our case reports the uncommon association of acute idiopathic maculopathy complicated by CNV. Multiimaging approach allowed to document the features observed in this disease. Optical coherence tomography angiography was particularly useful in showing the extension of the neovascular network and response to treatment.
OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY FINDINGS IN A CASE OF CHOROIDAL NEOVASCULARIZATION SECONDARY TO UNILATERAL RETINAL PIGMENT EPITHELIUM DYSGENESIS TREATED WITH INTRAVITREAL BEVACIZUMAB THERAPY
Authors: Preziosa Chiara , Staurenghi Giovanni , Pellegrini Marco
Published: February 2019

Purpose:

To document by optical coherence tomography angiography the presence of a choroidal neovascularization (CNV) secondary to unilateral retinal pigment epithelium dysgenesis and describe its changes after treatment with intravitreal bevacizumab.

Methods:

Case report.

Results:

A 51-year-old woman referred to our ocular oncology service for a possible choroidal osteoma in her left eye was found to have a unilateral retinal pigment epithelium dysgenesis complicated by CNV. Best-corrected visual acuity at baseline was 20/200. A complete ophthalmological evaluation including color fundus photography, fundus autofluorescence, fluorescein angiography, indocyanine green angiography, optical coherence tomography, and optical coherence tomography angiography was performed. The CNV appeared as a tangled vascular network on optical coherence tomography angiography. After 2 intravitreal injections of bevacizumab, the best-corrected visual acuity improved to 20/50, and optical coherence tomography angiography showed a progressive contraction of the CNV. Unilateral retinal pigment epithelium dysgenesis margins remained stable at consecutive follow-up.

Conclusion:

Optical coherence tomography angiography is a useful imaging technique for the diagnosis and follow-up of CNVs secondary to unilateral retinal pigment epithelium dysgenesis. Anti–vascular endothelial growth factor agents represent an effective therapy for the treatment of CNV in patients with this disease.
Design and validation of a noninvasive diagnostic criteria for biliary atresia in infants based on the STROBE compliant
Authors: Liu Xiaoguai , Peng Xiaokang , Huang Yanxia , Shu Chang , Liu Pan , Xie Weike , Dang Shuangsuo
Published: February 2019

It is difficult for clinicians to distinguish biliary atresia (BA) from other causes of neonatal cholestasis (NC) at an early stage. The aim of this study was to design and validate noninvasive diagnostic criterion for early diagnosis of BA in infants.

In this retrospective cohort study, a total of 482 medical records of patients with NC were recruited to design diagnostic criteria. Parameters showing a significant difference between BA (n = 166) and non-BA (n = 316) patients were analyzed by logistic regression to predict the occurrence of BA, and then a nomogram scoring system was designed and validated in another cohort that included 190 cases of NC.

A prediction diagnostic criterion with parameters including direct bilirubin, total bilirubin, globulin, albumin, gamma glutamyl transpeptidase, cholesterol, total bile acid, hepatobiliary scintigraphy, birth weight, and stool color was established; the sensitivity and specificity of this diagnostic criterion was 89% and 84%, respectively. The accuracy was 86% and the AUC was 0.91 [95% CI (0.88–0.97)]. The total score ranged from 0 to 402, with a cut-off value of ≥254 discriminating BA from other causes of NC. By applying this score in the validation set with age <60 days, the accuracy was 95.3%, the sensitivity was 93.8% and the specificity was 96.0%, respectively.

This prediction diagnostic criterion could facilitate clinicians to distinguish infants with and without BA based on a particular series of parameters, reducing treatment burden and enhancing therapeutic efficiency.
Association of SENPs single-nucleotide polymorphism and breast cancer in Chinese population
Authors: Cai Jiaqin , Wei Xiaoxia , Zhang Guifeng , Sui Yuxia , Zhuang Jie , Liu Zhenhua , Sun Hong
Published: February 2019

SUMO-specific Cysteine Proteases (SENPs) have involvement in the initiation and progression of human cancers. In the present study, we evaluated the association of SENPs polymorphism with susceptibility as well as clinicopathologic features and patients’ response of breast cancer (BC) in a Chinese population.

We genotyped SENP1 (rs61918808), SENP2 (rs6762208), SENP7 (rs61697963) by sequencing in a case–control study including 210 BC patients and 225 healthy volunteers. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to assume the association strength.

No significant association was found between polymorphism of the 3 SENPs and BC susceptibility. However, SENP1 rs61918808 (C>T) and SENP7 rs61697963 (A>C) was associated with HER-2 expression (P < .05). SENP2 rs6762208(C>A) was correlated with increasing risk of lymph node metastases (P < .05). Among the patients who received neoadjuvant chemotherapy, T allele and TT genotype of SENP1 rs61918808 were less likely to achieve pCR (P < .05).

We first reported SENPs variants were not associated with BC risk in Chinese population, but presented specific effect on clinicopathological features of BC. Moreover, SENP1 rs61918808 may be a predictor for the clinical response in local advanced BC patients who received neoadjuvant chemotherapy.
Tobramycin/dexamethasone eye drops as a better choice for lacrimal duct probing in persistent congenital nasolacrimal duct obstruction
Authors: Xiang Qin , Hu Dan , Gao Xu
Published: February 2019

Background:

Congenital nasolacrimal duct obstruction (CNLDO) is common and. lacrimal duct probing is the major treatment. But persistent CNLDO in older children makes the success rate rapidly decreased due to long-term chronic inflammation. To improve the success rate, probing combined with tobramycin/dexamethasone ointment is considered effective. But in practice, we found a lot of problems in using the ointment. So we tried tobramycin/dexamethasone eye drops as a replacement. The results is surprising, so we hope to do some further research in order to prove it is worth to clinical application.

Objective:

To evaluate the effect of lacrimal duct probing combined with tobramycin/dexamethasone eye drops or ointment on persistent CNLDO in children older than 1-year-old.

Methods:

This randomized controlled study included 409 subjects (496 eyes) older than 1-year-old with persistent CNLDO in southwest China, and classified into 3 groups: 96 cases (123 eyes) were the tobramycin/dexamethasone eye drops group (drops group), 88 cases (104 eyes) were the tobramycin/dexamethasone ointment group (ointment group), and 225 cases (269 eyes) were control group which probing with normal saline (NS group). The data of age, sex, and laterality were analyzed through pairwise comparison. Then the 3 groups were divided into 2 subgroups by age, 12 to 24 months and 25 to 36 months. The surgical findings and success rate in two subgroups were compared.

Results:

The success rates in the tobramycin/dexamethasone eye drops group in both 2 age subgroups were significantly higher than that in the ointment group and NS group (P < .05).

Conclusions:

Probing combined with tobramycin/dexamethasone eye drops was effective and easy-to-perform in the clinic, and it may be a better choice for persistent CNLDO.
Heart rate variability based machine learning models for risk prediction of suspected sepsis patients in the emergency department
Authors: Chiew Calvin J. , Liu Nan , Tagami Takashi , Wong Ting Hway , Koh Zhi Xiong , Ong Marcus E. H.
Published: February 2019

Early identification of high-risk septic patients in the emergency department (ED) may guide appropriate management and disposition, thereby improving outcomes. We compared the performance of machine learning models against conventional risk stratification tools, namely the Quick Sequential Organ Failure Assessment (qSOFA), National Early Warning Score (NEWS), Modified Early Warning Score (MEWS), and our previously described Singapore ED Sepsis (SEDS) model, in the prediction of 30-day in-hospital mortality (IHM) among suspected sepsis patients in the ED.

Adult patients who presented to Singapore General Hospital (SGH) ED between September 2014 and April 2016, and who met ≥2 of the 4 Systemic Inflammatory Response Syndrome (SIRS) criteria were included. Patient demographics, vital signs and heart rate variability (HRV) measures obtained at triage were used as predictors. Baseline models were created using qSOFA, NEWS, MEWS, and SEDS scores. Candidate models were trained using k-nearest neighbors, random forest, adaptive boosting, gradient boosting and support vector machine. Models were evaluated on F1 score and area under the precision-recall curve (AUPRC).

A total of 214 patients were included, of whom 40 (18.7%) met the outcome. Gradient boosting was the best model with a F1 score of 0.50 and AUPRC of 0.35, and performed better than all the baseline comparators (SEDS, F1 0.40, AUPRC 0.22; qSOFA, F1 0.32, AUPRC 0.21; NEWS, F1 0.38, AUPRC 0.28; MEWS, F1 0.30, AUPRC 0.25).

A machine learning model can be used to improve prediction of 30-day IHM among suspected sepsis patients in the ED compared to traditional risk stratification tools.
ZNF582 methylation as a potential biomarker to predict cervical intraepithelial neoplasia type III/worse
Authors: Li Na , He Ya , Mi Peng , Hu Yuanjing
Published: February 2019

Objective:

DNA methylation markers have been assessed as potential biomarkers for early cervical cancer detection. Herein, we evaluated the diagnostic performance of zinc finger protein 582 (ZNF582) methylation for cervical cancer detection.

Methods:

Eligible studies were systematically searched from the electronic databases. The quality of enrolled studies was evaluated using the second version of the check list for Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). The bivariate meta-analysis model was employed to plot the summary receiver operator characteristic (SROC) curve using Stata 14.0 software. Cochran's Q test and I2 statistics were applied to assess heterogeneity among studies. Publication bias was evaluated by the Deeks’ funnel plot asymmetry test.

Results:

Seven studies composed of 1749 patients were eventually included. The pooled sensitivity of ZNF582 methylation was estimated to be 0.71 [95% confidence interval (CI): 0.67–0.75] in differentiating patients with cervical intraepithelial neoplasia type III/worse (CIN3+), corresponding to a specificity of 0.81 (95% CI: 0.79–0.83) and area under the curve (AUC) of 0.85. Our stratified analysis suggested that sequential combined of HPV DNA and ZNF582 methylation test (AUC, sensitivity, and specificity of 0.876, 0.75, and 0.87, respectively) achieved higher diagnostic accuracy than single HPV DNA testing test (AUC, sensitivity and specificity of 0.669, 0.96, and 0.41, respectively).

Conclusions:

ZNF582 methylation has a prospect to be an auxiliary biomarker for cervical cancer screening. A new strategy of co-testing HPV DNA and ZNF582 methylation test in cervical scrapings confers an improved diagnostic accuracy than single HPV DNA testing.
Integrative analysis reveals driver long non-coding RNAs in osteosarcoma
Authors: Luo Zhenguo , Xiao Li , Li Jing , Dong Buhuai , Wang Chunsheng
Published: February 2019

Transcriptome profiling of osteosarcoma (OS) by next generation sequencing technology (NGS) has been broadly performed by previous researches, which uncovers a large number protein-coding driver genes, facilitates our understanding of the molecular mechanisms of OS formation, progression and metastasis. Recently, more and more researchers realize the importance of long non-coding RNAs (lncRNAs) on the development of OS. However, few studies focus on discovering driver lncRNAs.

Here we collected somatic copy number alterations (SCNAs) and gene expression profiles of 84 samples from Therapeutically Applicable Research to Generate Effective Treatments (TARGET) project. The RNA sequencing data detected 13,903 expressed lncRNAs, 157 of which were previously reported to be associated with cancer based on the annotations from Lnc2Cancer database.

By analyzing the SNP array data, several significant SCNAs were detected, such as the amplifications on chromosomes 1q, 4q, 17p, 17q, and 19q, and deletions on 1q, 3q, 9p, 10q, and 15q. With the SCNA and gene expression profiles, we identified 167 driver genes by integrative analysis, including 162 novel driver lncRNAs, 2 lncRNAs reported to be associated with OS, and another 3 associated with other cancers. Furthermore, functional characterization and survival analysis revealed that RP11-241F15.10 may function as a tumor suppressor in OS, and loss of function may contribute to activation of Wnt signaling pathway.

This study not only facilitates our understanding of the oncogenic or tumor-suppressor role of lncRNAs in OS, but also provides potential therapies for the patients with OS with metastasis or relapse.
A prospective comparative study of intravenous alendronate and ibandronate for the treatment of osteoporosis
Authors: Horikawa Akira , Miyakoshi Naohisa , Hongo Michio , Kasukawa Yuji , Kodama Hiroyuki , Shimada Yoichi
Published: February 2019

Rationale:

Few comparative studies have evaluated the differences between intravenous alendronate (ALN) and ibandronate (IBN) in patients with osteoporosis. This study was to compare the effects of these 2 drugs on bone mineral density (BMD), bone metabolic markers, and adverse events in patients with osteoporosis.

Patient concerns:

Seventy-eight subjects were assigned to the ALN group and 66 to the IBN group.

Diagnoses:

The diagnosis of osteoporosis was based on BMD values of the femoral neck or lumbar spine less than −2.5 SD below the reference values.

Interventions:

This study was designed as a 52-weeks, prospective, non-randomized study involving a parallel-group comparison between intravenous ALN and intravenous IBN in elderly women with osteoporosis.

Outcomes:

The non-switched-IBN subgroup showed significant decrease in serum collagen type I cross-linked telopeptide (NTX) at 6 and 12 months compared with baseline, and the decrease in NTX were significantly greater in the non-switched-IBN subgroup than in the non-swithed-ALN subgroup. BMD in the lumbar spine in the non-switched-IBN subgroup showed a significant increase at 12 months and the increase in BMD were significantly larger than in the non-switched-ALN subgroup.

Lessons:

Intravenou IBN might result in a significantly greater increase of BMD and decrease in NTX, but it had a higher incidence of adverse drug reactions than ALN.
Blastic plasmacytoid dendritic cell neoplasm with unusual extracutaneous manifestation
Authors: Lee Seung Eun , Park Ha Young , Kwon Dohee , Jeon Yoon Kyung , Kim Wook Youn
Published: February 2019

Rationale:

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and aggressive hematologic malignancy. This disease almost always presents with cutaneous involvement.

Patient concerns:

The 1st patient was a 16-year-old girl who presented with recurrent epistaxis. The 2nd patient was a 17-year-old female who presented with nasal obstruction and voice change for a month.

Diagnoses:

In the 1st patient, sinonasal computed tomography (CT) revealed a 2.9-cm sized, polypoid mass in the nasal cavity. In the 2nd patient, CT scans revealed a large enhancing nasopharyngeal mass involving adenoid and several small indeterminate lymph nodes at the neck. Cutaneous examination was unremarkable for either patient. Biopsy of these 2 masses and bone marrow biopsy were performed. Histologic diagnosis of the 2 cases was BPDCN.

Interventions:

Both patients were treated with induction chemotherapy and received allogenic peripheral blood stem-cell transplant.

Outcomes:

No relapse was observed in the 2 patients for 14 and 11 months, respectively, after transplantation. Interestingly, they had no skin lesions at initial diagnosis or during the course of their illness.

Lessons:

We 1st identified nasal cavity as an unusual site of BPDCN. BPDCN should be considered in differential diagnosis of blastic leukemia with an undifferentiated and ambiguous immunophenotype despite the absence of skin lesions.
Associations between short-term efficacy and clinical characteristics of infantile hemangioma treated by propranolol
Authors: Wu Changhua , Guo Lei , Wang Liang , Li Jing , Wang Changfeng , Song Dan
Published: February 2019

Propranolol is the mainstay of treatment for infantile hemangiomas (IHs) benefited from its low complication in the present study. However, it has an uncertainty treating period with cumbersome methods which may be related to clinical features. This study sought to considered possible influences of short-term efficacy to medication.

Retrospective analysis of 82 patients with IHs treated by propranolol was performed. The patients were grouped according to effect (excellent, good and fair/poor). ANOVA or t test was used to assess the relationships between effect and clinical features of IHs.

Twenty-seven patients were males and 55 were females. The median age of treatment initiation was 3.5 (±2.11) months. Mean follow-up time for the group was 6.2 months (1.5–16 months). There were no significant associations between short-term efficacy and gender, time points of treatment, diameter of tumor and multifocality. However, tumor thickness was associated with short-term efficacy (P = .013). Moreover, an obvious difference of short-term efficacy has been found when tumor thickness <1.2 cm.

In the present study, tumor thickness was associated with the short-term efficacy in patients with IHs. Propranolol may be gets a better outcome when tumor thickness <1.2 cm at a short time.
Manifestations of and risk factors for acute myocardial injury after acute organophosphorus pesticide poisoning
Authors: Chen Kai-Xiang , Zhou Xin-Hua , Sun Cheng-Ai , Yan Pei-Xia
Published: February 2019

This study aimed to explore the risk factors for acute myocardial injury (AMI) caused by acute organophosphorus pesticide poisoning (AOPP).

The clinical data of 98 patients, who were treated in our hospital due to oral AOPP from April 2013 to April 2017, were retrospectively analyzed. These patients were divided into two groups: AMI group and control group. The incidence of AMI was analyzed. Furthermore, the dosage forms and dose of the pesticide, and the interval between pesticide taking and doctor visit were compared between these two groups. Moreover, their clinical symptoms were observed; the serum cholinesterase levels, myocardial injury, and heart failure markers were detected, and the occurrence of arrhythmia and the structure and function of the heart were investigated through continuous electrocardiographic monitoring and transthoracic echocardiography.

Among these 98 AOPP patients, 51 patients were complicated with AMI, and the incidence was 52.0%. The main manifestations of these 51 patients with AMI were as follows: the serum levels of myocardial injury markers (creatine kinase-Mb [CK-Mb] and cardiac troponin I [cTnI]) and heart failure markers (N-terminal pro B-type natriuretic peptide [NT-pro BNP]) were significantly higher, when compared with the control group (P < .001), and the incidence of arrhythmia (FVPB, P = .02; RAA, P = .03; RVA, P = .02; ST-T changes, P = .01) and heart failure (P = .04) was also significantly higher when compared with the control group. With regard to dosage forms of the pesticides, the number of patients taking the pesticides with solvents containing aromatic hydrocarbons was significantly higher in the AMI group than in the control group (P = .001). And the number of patients taking over 100 mL of pesticides was also significantly higher in the AMI group than in the control group (P < .001). Significantly more patients in the AMI group had an interval of over 1 h between pesticide taking and doctor visit than in the control group (P < .001).

Risk factors for AMI after AOPP may include the dose and dosage form of the pesticide, and the interval between pesticide taking and doctor visit.