bluuebunny/crossref_metadata_2025 huggingface dataset:
Petroleum Hydrocarbon Bioremediation Using Native Fungal Isolates and Consortia
Authors: Hamad Asmaa A. , Moubasher Hani A. , Moustafa Yasser M. , Mohamed Nermen H. , Abd-el rhim Eman H.
Published: May 2021

Crude oil spills as a result of natural disasters or extraction and transportation operations are common nowadays. Oil spills have adverse effects on both aquatic and terrestrial ecosystems and pose a threat to human health. This study have been concerned with studying the capability of six fungal species (Curvularia brachyspora, Penicillium chrysogenum, Scopulariopsis brevicaulis, Cladosporium sphaerospermum, Alternaria alternata, and Stemphylium botryosum) and three fungal consortia (FC), FC1 (P. chrysogenum and C. brachyspora), FC2 (S. brevicaulis and S. botryosum), and FC3 (S. brevicaulis, S. botryosum, and C. sphaerospermum), to remediate petroleum hydrocarbons (PHs). Qualitative and quantitative changes in polyaromatic hydrocarbons (PAHs) and saturated hydrocarbons (SH) mixtures and the patterns of PHs degradation have been examined using HPLC and GC. Studying the GC chromatogram of C. sphaerospermum revealed severe degradation of SHs exhibited by this species, and the normal-paraffin and isoparaffin degradation percentage have been valued 97.19% and 98.88%, respectively. A. alternata has shown the highest significant (at

P

 ˂ 0.05) PAH degradation percent reaching 72.07%; followed by P. chrysogenum, 59.51%. HPLC data have revealed that high-molecular-weight PAH percent/total PAHs decreased significantly from 98.94% in control samples to 68.78% in samples treated with A. alternata. FC1 and FC2 consortia have exhibited the highest significant PH deterioration abilities than did the individual isolates, indicating that these fungal consortia exhibited positive synergistic effects. The study supports the critical idea of the potential PAH and SH biodegradation as a more ecologically acceptable alternative to their chemical degradation.
Pathological and Cytological Studies on Hepatocellular Carcinoma in Cattle Slaughtered at Bishoftu Elfora Abattoir, Central Ethiopia
Authors: Mathewos Mesfin
Published: May 2021

Hepatocellular carcinoma (HCC) is one of the most common neoplasms that has been described in many domestic animal species. Hence, the disease has significant economic importance; thus, this study aimed to describe the cytopathological characteristics of hepatocellular carcinomas in cattle slaughtered at Bishoftu Elfora Abattoir, Central Ethiopia. A cross-sectional study design with a purposive sampling technique was performed from October 2017 to May 2018 using macroscopic, histopathologic, and cytological methods. For that matter, a total of sixty cattle were assessed for the presence of a hepatic tumor; however, only 1/60 (0.6%) case was found to be affected by hepatocellular carcinomas. On gross examination, hepatocellular carcinomas exhibited soft, white, multifocal nodules (10–40 mm in diameter) on different lobes of the liver. On the cut surface, the tumor revealed a sharply circumscribed border and was divided into lobules by thin connective tissue. The central zone of the tumors exhibited depression with a whitish fibrous area. Moreover, on histopathology, the tumors divulged unencapsulated carcinomatous lesions consisting of a thick, compact, somewhat ambiguous trabecular pattern of arrangement that was unglued by thin collagenous stroma. Cytological studies suggest that the tumor cells showed anisocytosis, anisokaryosis, prominent nucleoli, multinuclearity, palisading arrangements of neoplastic cells, increased N : C ratios, light eosinophilic cytoplasm, high mitotic index, and cytoplasmic and intranuclear vacuoles. In conclusion, cytopathological findings support a diagnosis of HCC in the liver; thus, further studies with a large sample size and use of immunohistochemistry are important for further characterization of hepatocellular carcinomas in cattle.
Qualitative Analysis of a Three-Species Reaction-Diffusion Model with Modified Leslie-Gower Scheme
Authors: Wang Xiaoni , Guo Gaihui , Li Jian , Du Mengmeng
Published: May 2021

The qualitative analysis of a three-species reaction-diffusion model with a modified Leslie-Gower scheme under the Neumann boundary condition is obtained. The existence and the stability of the constant solutions for the ODE system and PDE system are discussed, respectively. And then, the priori estimates of positive steady states are given by the maximum principle and Harnack inequality. Moreover, the nonexistence of nonconstant positive steady states is derived by using Poincaré inequality. Finally, the existence of nonconstant positive steady states is established based on the Leray-Schauder degree theory.
Myocardial Infarction and AGT p.Thr174Met Polymorphism: A Meta-Analysis of 7657 Subjects
Authors: Li Yan-yan , Wang Hui , Wang Hao , Zhang Yang-yang
Published: May 2021

Background. It has been suggested that the angiotensinogen (AGT) gene rs4762 (p.Thr174Met) polymorphism might be associated with myocardial infarction (MI) risk, but the study results are still debatable. Objective and Methods. In order to explore the relationship between AGT p.Thr174Met polymorphism and MI risk, the current meta-analysis involving 7657 subjects from 11 individual studies was conducted. Results. A significant association between AGT p.Thr174Met polymorphism and MI was found under recessive (OR: 2.26, 95% CI: 1.35-3.77,

P
=
0.002

), dominant (OR: 1.131, 95% CI: 1.016-1.260,

P
=
0.024

), codominant (OR: 2.198, 95% CI: 1.334-3.621,

P
=
0.002

), and additive (OR: 1.363, 95% CI: 1.132-1.641,

P
=
0.001

) genetic models. In the Asian subgroup, significantly increased MI risk was found under all genetic models (

P
<
0.05

). No significant association between AGT p.Thr174Met polymorphism and MI was found under all genetic models in the Caucasian subgroup (

P
>
0.05

). Conclusions. AGT p.Thr174Met variant might increase MI risk, especially within the Asian population. The Met174 allele of AGT p.Thr174Met might confer the risk for MI.
Comparison of Mid-Upper-Arm Circumference and Weight-For-Height Z-Score in Identifying Severe Acute Malnutrition among Children Aged 6–59 Months in South Gondar Zone, Ethiopia
Authors: Abitew Dereje Birhanu , Yalew Alemayehu Worku , Bezabih Afework Mulugeta , Bazzano Alessandra N.
Published: May 2021

Children with severe acute malnutrition (SAM) are identified for admission to outpatient therapeutic programs using mid-upper-arm circumference (MUAC) or weight for height (WHZ). However, MUAC and WHZ do not identify the same children, and such observed differences might have programmatic implications of missed nutrition therapy if only MUAC is used to identify children with SAM. The objective of the study was to assess any difference in prevalence and degree of agreement between MUAC and WHZ in identifying SAM affected children. A cross-sectional study was conducted in South Gondar Zone, Ethiopia, among 17 districts, with 3 districts and 10 health centers with their clustered health posts selected randomly. A total of 2,040 children were recruited, and data were collected using a parent questionnaire then entered into EpiData and analyzed using SPSS v 20. A total of 1,980 respondents (97.1%) were interviewed, all of whom were female and rural residents. Children’s mean age in months was 23.2 (SD ± 9.7), and 54% were male children. The prevalence of SAM based on MUAC <11.5 cm was 11.2% (95% CI: 9.9–12.7) and 11.0% (95% CI: 9.7–12.5) based on WHZ <−3. The agreement between MUAC and WHZ was good (k = 0.729). The proportion of children with SAM identified using both MUAC and WHZ was 61.2%. The prevalence of SAM identified using both MUAC and WHZ was comparable. A substantial degree of agreement between MUAC and WHZ was observed to diagnose SAM. Therefore, MUAC can be used as an appropriate tool in identifying children with SAM for admission into the outpatient therapeutic program (OTP) in the study area.
A Comparative Analysis of Data‐Driven Empirical and Artificial Intelligence Models for Estimating Infiltration Rates
Authors: Zakwan Mohammad , Niazkar Majid
Published: May 2021

Infiltration is a vital phenomenon in the water cycle, and consequently, estimation of infiltration rate is important for many hydrologic studies. In the present paper, different data‐driven models including Multiple Linear Regression (MLR), Generalized Reduced Gradient (GRG), two Artificial Intelligence (AI) techniques (Artificial Neural Network (ANN) and Multigene Genetic Programming (MGGP)), and the hybrid MGGP‐GRG have been applied to estimate the infiltration rates. The estimated infiltration rates were compared with those obtained by empirical infiltration models (Horton’s model, Philip’s model, and modified Kostiakov’s model) for the published infiltration data. Among the conventional models considered, Philip’s model provided the best estimates of infiltration rate. It was observed that the application of the hybrid MGGP‐GRG model and MGGP improved the estimates of infiltration rates as compared to conventional infiltration model, while ANN provided the best prediction of infiltration rates. To be more specific, the application of ANN and the hybrid MGGP‐GRG reduced the sum of square of errors by 97.86% and 81.53%, respectively. Finally, based on the comparative analysis, implementation of AI‐based models, as a more accurate alternative, is suggested for estimating infiltration rates in hydrological models.
Hybrid Pyramid Convolutional Network for Multiscale Face Detection
Authors: Hou Shaoqi , Fang Dongdong , Pan Yixi , Li Ye , Yin Guangqiang
Published: May 2021

Face detection remains a challenging problem due to the high variability of scale and occlusion despite the strong representational power of deep convolutional neural networks and their implicit robustness. To handle hard face detection under extreme circumstances especially tiny faces detection, in this paper, we proposed a multiscale Hybrid Pyramid Convolutional Network (HPCNet), which is a one‐stage fully convolutional network. Our HPCNet consists of three newly presented modules: firstly, we designed the Hybrid Dilated Convolution (HDC) module to replace the fully connected layers in VGG16, which enlarges receptive field and reduces its loss of local information; secondly, we constructed the Hybrid Feature Pyramid (HFP) to combine semantic information from higher layers together with details from lower layers; and thirdly, to deal with the problem of occlusion and blurring effectively, we introduced Context Information Extractor (CIE) in HPCNet. In addition, we presented an improved Online Hard Example Mining (OHEM) strategy, which can enhance the average precision of face detection by balancing the number of positive and negative samples. Our method has achieved an accuracy of 0.933, 0.924, and 0.848 on the Easy, Medium, and Hard subset of WIDER FACE, respectively, which surpasses most of the advanced algorithms.
An Improved Method for Parametric Spatial Spectrum Estimation in Internet of Things
Authors: Liu Yong , Zhao Jingya , Zhu Qinghua , Wang Yanqiu
Published: May 2021

When massive numbers of wireless IoT devices are being deployed, cognitive spectrum management is critical to satisfy the explosive broadband requirements of IoT applications. Heterogeneous the target of the spatial spectrum estimation which is part of array signal processing is to achieve the evaluation of space signal parameters and source location, which result in that the spatial spectrum estimation becomes the most basic content of the array signal processing. It needs a method by which the large dimensional array still has its consistency. Therefore, this paper studies an improved large dimensional array parameterized spatial spectrum estimation method based on Pisarenko method, named G‐Pisarenko method. Firstly, an improved estimator about the logarithm of the covariance matrix of a certain bilinear form is analyzed which is based on the theory of large dimension random matrix. We can find out a relatively better method, i.e., MW method. The method will become the primitive method for us to improve. Then, aimed at the relating covariance matrix in MW, we use an improved large dimensional array estimation method which can improve the logarithm of the covariance matrix estimation. Finally, we compare the improved method and the original method by simulation, and it can be seen the clear advantage of G‐Pisarenko method when the sample number and observed dimensions are in the same order of magnitude.
Approximation by One and Two Variables of the Bernstein-Schurer-Type Operators and Associated GBS Operators on Symmetrical Mobile Interval
Authors: Aslan Reşat , İzgi Aydın
Published: May 2021

In this article, we purpose to study some approximation properties of the one and two variables of the Bernstein-Schurer-type operators and associated GBS (Generalized Boolean Sum) operators on a symmetrical mobile interval. Firstly, we define the univariate Bernstein-Schurer-type operators and obtain some preliminary results such as moments, central moments, in connection with a modulus of continuity, the degree of convergence, and Korovkin-type approximation theorem. Also, we derive the Voronovskaya-type asymptotic theorem. Further, we construct the bivariate of this newly defined operator, discuss the order of convergence with regard to Peetre’sK-functional, and obtain the Voronovskaya-type asymptotic theorem. In addition, we consider the associated GBS-type operators and estimate the order of approximation with the aid of mixed modulus of smoothness. Finally, with the help of the Maple software, we present the comparisons of the convergence of the bivariate Bernstein-Schurer-type and associated GBS operators to certain functions with some graphical illustrations and error estimation tables.
A Data-Driven Predictive Machine Learning Model for Efficiently Storing Temperature-Sensitive Medical Products, Such as Vaccines: Case Study: Pharmacies in Rwanda
Authors: Habiyaremye Joseph , Zennaro Marco , Mikeka Chomora , Masabo Emmanuel , Jayavel Kayalvizhi , Kumaran Santhi
Published: May 2021

Temperature control is the key element during medicine storage. Pharmacies sell some medical products which are kept in fridges. The opening and closing of the fridge while taking some medicine makes the outside hot air enter the fridge, which will increase the inner fridge temperature. When the frequency of opening and closing of the fridge is increased, the temperature may go beyond the allowed storage temperature range. In this paper, we are proposing a model with the help of machine learning that will be used in multiple chambers fridges to keep indicating the time remaining for the inner temperature to go beyond the allowed range, and if the time is short, the system will propose to the pharmacist not to open that particular room and proposes a room that has enough time slots (time to reach the upper limit temperature). By using training data got from a thermoelectric cooler-based fridge, we constructed a multiple linear regression model that can predict the required time for a given room to reach the cut-off temperature in case that room is opened. The built model was evaluated using the coefficient of determination R2 and is found to be 77%, and then it can be used to develop a multiple room smart fridge for efficiently storing highly sensitive medical products.
High PDGFRb Expression Predicts Resistance to Radiotherapy in DCIS within the SweDCIS Randomized Trial
Authors: Strell Carina , Folkvaljon Dick , Holmberg Erik , Schiza Aglaia , Thurfjell Viktoria , Karlsson Per , Bergh Jonas , Bremer Troy , Akslen Lars A. , Wärnberg Fredrik , Östman Arne
Published: May 2021

Purpose:

This study analyzes the potential of stromal platelet-derived growth factor receptor-beta (PDGFRb) expression as biomarker for radiotherapy (RT) benefit on ipsilateral breast events (IBE) in ductal carcinoma in situ (DCIS). Improved identification of DCIS patients refractory to adjuvant whole-breast RT is needed. Predictive biomarker studies in DCIS have focused on tumor cell features rather than the tumor-associated stroma, despite growing evidence of its influence on therapy efficiency.

Experimental Design:

Samples from the Swedish randomized radiotherapy DCIS trial (SweDCIS) were subjected to IHC analysis for stromal PDGFRb expression. IBE incidence at 10 years after breast-conserving surgery was the primary endpoint. Interactions between marker and treatment were analyzed.

Results:

PDGFRb score was predictive for RT benefit with regard to IBE (Pinteraction = 0.002 and Pinteraction = 0.008 adjusted multivariably). Patients of the PDGFRblow group had a strong benefit from RT regarding IBE risk [HR, 0.23; 95% confidence interval (CI), 0.12–0.45; P < 0.001] with an absolute risk reduction of 21% (cumulative risk 7% vs. 28%) at 10 years. No significant risk reduction by RT was observed for patients of the PDGFRbhigh group (HR, 0.83; 0.51–1.34; P = 0.444; cumulative risk 22% vs. 25%). The RT response–predictive effect of stromal PDGFRb was equally strong in analyses for in situ and invasive IBE when analyzed separately (in situ IBE: P = 0.029; invasive IBE: P = 0.044).

Conclusions:

Results suggest high stromal PDGFRb expression as a novel biomarker identifying DCIS patients who are refractory to standard whole-breast adjuvant RT. The data imply previously unrecognized fibroblast-mediated modulation of radiosensitivity of DCIS, which should be further explored from mechanistic and targeting perspectives.
Tumor Burden Limits Bispecific Antibody Efficacy through T-cell Exhaustion Averted by Concurrent Cytotoxic Therapy
Authors: Meermeier Erin W. , Welsh Seth J. , Sharik Meaghen E. , Du Megan T. , Garbitt Victoria M. , Riggs Daniel L. , Shi Chang-Xin , Stein Caleb K. , Bergsagel Marco , Chau Bryant , Wheeler Matthew L. , Bezman Natalie , Wang Feng , Strop Pavel , Bergsagel P. Leif , Chesi Marta
Published: May 2021

BCMA/CD3-targeting bispecific antibodies (BsAb) are a recently developed immunotherapy class that shows potent tumor killing activity in multiple myeloma. Here, we investigated a murine BCMA/CD3-targeting BsAb in the immunocompetent Vk*MYC model and its immunomodulatory imide drug (IMiD)–sensitive derivative Vk*MYChCRBN model of multiple myeloma. The BCMA/CD3 BsAb was safe and efficacious in a subset of mice but failed in those with high tumor burden, consistent with clinical reports of BsAb in leukemia. The combination of BCMA/CD3 BsAb with pomalidomide expanded lytic T cells and improved activity even in IMiD-resistant high–tumor burden cases. Yet, survival was only marginally extended due to acute toxicity and T-cell exhaustion, which impaired T-cell persistence. In contrast, the combination with cyclophosphamide was safe and allowed for a tempered proinflammatory response associated with long-lasting complete remission. Concurrent cytotoxic therapy with BsAb actually improved T-cell persistence and function, offering a promising approach to patients with a large tumor burden.

Significance:

BCMA-targeted therapy induces deep but transient clinical responses. We developed an immunocompetent, IMiD-sensitive genetically engineered mouse model and show that IMiDs potentiate T-cell activation, increasing short-term efficacy of anti-BCMA/CD3 BsAb, but exacerbate T-cell exhaustion. Surprisingly, by reducing tumor burden and depleting regulatory T cells, cyclophosphamide prevents BsAb-induced T-cell exhaustion and promotes long-term multiple myeloma control.

See related commentary by Louvet et al., p. 297.
Autonomic Nervous Function in Patients with Sudden Sensorineural Hearing Loss and Its Association with Prognosis and Disease Severity
Authors: Park Soyoung , Kim Min Hee , Choi Inhwa
Published: May 2021

Introduction: Vascular disorder is considered one of the main mechanisms of sudden sensorineural hearing loss (SSNHL) due to the anatomy of the inner ear. One factor that can contribute to vascular disorder is impairment in the autonomic nervous system. This study aims to investigate autonomic function in patients with SSNHL and its association with prognosis and disease severity from January 2018 to October 2019. Methods: We conducted a cross-sectional study involving 40 healthy controls and 55 subjects with SSNHL. We compared the autonomic function of controls and patients using heart rate variability (HRV). SSNHL patients were divided into improvement and no-improvement groups and into mild and severe groups according to pure-tone audiometry results. Results: The SSNHL group had significantly decreased total power (TP), low frequency (LF), and high frequency (HF) compared to the control group. However, there were no significant differences between the mild and severe groups. In the no-improvement group, LF was significantly higher and normalized HF was significantly lower than in the improvement group. According to a multiple logistic regression analysis, age and LF were significantly correlated with improvement. Conclusion: This is the first study to evaluate the significance of HRV in patients with SSNHL, according to prognosis and disease severity. Further studies about the relationship between autonomic nervous system and SSNHL with larger sample size and prospective design are needed.
Does Auditory Environment Predict Speech Perception Outcomes in Elderly Cochlear Implant Patients?
Authors: Chow Kevin , Kaul Vivian F. , Levine-Madoff Jillian , Wanna George B. , Cosetti Maura K.
Published: May 2021

Introduction: Cochlear implantation (CI) is a reliable and safe means by which sensorineural hearing loss can be ameliorated in the elderly population. However, a high degree of variation exists in postimplantation hearing outcomes for which some modifiable factors of the daily natural auditory environment may be contributory. In this study, we analyze the relationship between cochlear implant patient age, natural auditory environment, and postimplantation speech perception among older adults. Methods: Data log from automatic environment classification enabled sound processors of postlingually deafened CI recipients ≥50 years old (n = 115) were obtained retrospectively and analyzed for time spent (hours per day) in listening environment and loudness (SPL dB). Speech perception testing was assessed in a subset of patients (n = 27) using open-set word recognition in quiet Consonant-Nucleus-Consonant in the short and intermediate postoperative period. Results: The mean subject age was 70 years (range, 53–99 years). Average daily implant use was 10.8 h and was not significantly correlated with age (p = 0.23, Spearman’s rho). Age was positively correlated with the percentage of hours spent at <40 and 40–50 dB and negatively correlated to proportional CI use at higher volume (60–70, 70–80, and >80 dB; rs = 0.21, 0.20, −0.20, −0.35, −0.43; p = 0.021, 0.036, 0.033, <0.001, <0.001, respectively). Age was positively correlated with CI use in the quiet scene (rs = 0.26, p = 0.006) and negatively correlated with scenes containing speech and noise (rs = −0.19, −0.25; p = 0.046, 0.007). Total hours of device use and time spent at <40, 40–50 dB, and quiet environments were significantly correlated with improved CNC word scores (rs = 0.48, 0.48, 0.51; p = 0.01, 0.01, <0.01, Spearman’s rho). While all speech (speech in noise + speech) was not significantly correlated to improvements in speech perception, a medium effect size was observed (rs = 0.37, p = 0.057). Discussion/Conclusion: This study supports a relationship between auditory environment and age, with older CI recipients spending a greater proportion of time in quiet. Older CI users demonstrated greater improvements in speech perception with longer daily device use. Additional examination of the relationship between auditory environment and speech perception is necessary to conclusively guide future auditory rehabilitation efforts.
Development of a Multivariable Prediction Model for Citrate Accumulation in Liver Transplant Patients Undergoing Continuous Renal Replacement Therapy with Regional Citrate Anticoagulation
Authors: Xin Xin , Tang Jing , Jia Hui-Miao , Zhang Tian-En , Zheng Yue , Huang Li-Feng , Ding Qi , Li Jun-Cong , Guo Shu-Yan , Li Wen-Xiong
Published: May 2021

Introduction: Patients with impaired citrate metabolism may experience citrate accumulation (CA), which causes life-threatening metabolic acidosis and hypocalcemia. CA poses a challenge for clinicians when deciding on the use of regional citrate anticoagulation (RCA) for patients with liver dysfunction. This study aimed to develop a prediction model integrating multiple clinical variables to assess the risk of CA in liver transplant patients. Methods: This single-center prospective cohort study included postoperative liver transplant patients who underwent continuous renal replacement therapy (CRRT) with RCA. The study end point was CA. A prediction model was developed using a generalized linear mixed-effect model based on the Akaike information criterion. The predictive values were assessed using the receiver operating characteristic curve and bootstrap resampling (times = 500) to estimate the area under the curve (AUC) and the corresponding 95% confidence interval (CI). A nomogram was used to visualize the model. Results: This study included 32 patients who underwent 133 CRRT sessions with RCA. CA occurred in 46 CRRT sessions. The model included lactate, norepinephrine >0.1 μg/kg/min, alanine aminotransferase, total bilirubin, and standard bicarbonate, which were tested before starting each CRRT session and body mass index, diabetes mellitus, and chronic kidney disease as predictors. The AUC of the model was 0.867 (95% CI 0.786–0.921), which was significantly higher than that of the single predictor (p < 0.05). A nomogram visualized the prediction model. Conclusions: The prediction model integrating multiple clinical variables showed a good predictive value for CA. A nomogram visualized the model for easy application in clinical practice.
Impact of Autologous Transobturator Sling Surgery on Female Sexual Function: A Comparative Study with Mesh Used Mid-Urethral Sling Surgeries
Authors: Çubuk Alkan , Şahan Ahmet , Özkaptan Orkunt , Dinçer Erdinç , Karaaslan Onur , Sarılar Ömer , Akça Oktay
Published: May 2021

Introduction: To avoid mesh-related complications, autologous transobturator-tape (a-TOT) technique is a viable option in stress urinary incontinence (SUI) surgery. The method differs from TOT and retropubic tape (RT) in the usage of autologous tissue. We hypothesized that a-TOT improves female sexual dysfunction (FSD) more than TOT and RT. Methods: This is a retrospective cohort study. Patients who underwent a-TOT, TOT, and RT surgeries were surveyed regarding the cure of SUI, complications, and FSD parameters. The groups were compared according to baseline and postoperative data. Results: A-TOT, TOT, and RT groups included 37, 69, and 36 patients, respectively. The median follow-up time was 19 months. The groups were similar in terms of preoperative characteristics. The objective cure, subjective cure, and overall complication rates were comparable among the groups (p > 0.05). A-TOT group had significant improvements in mean female sexual function index (FSFI) scores, TOT group deteriorated, and RT group remained stable (p = 0.001, p = 0.001, and p = 0.226, respectively). The postoperative mean total FSFI scores were 25.73 ± 2.46, 23.17 ± 3.35, and 21.53 ± 2.47 for the a-TOT, TOT, and RT groups, respectively. The a-TOT group had better results than the TOT and RT groups (p < 0.05 and p < 0.05), and besides, the difference between the TOT and RT groups was statistically significant (p < 0.05). According to percentage changes in domain scores following the operations, the a-TOT group had significantly better results in desire, arousal, lubrication, satisfaction, and pain domains than the TOT group (p < 0.05) as well as better desire, arousal, and pain domains (p < 0.05) than the RT group. Discussion/Conclusions: Besides comparable outcomes in SUI treatment, the a-TOT technique provides improvements in female sexual functions while TOT worsens and RT does not change. Favorable outcomes in sexual functions caused by improvements in desire, arousal, satisfaction, and pain domains are observed following the a-TOT technique.
Choroidal Melanoma with Ultrasound-Guided Episcleral Brachytherapy: Long-Term Results and Risk of Metastasis
Authors: Quiles Beatriz , Mataix Jorge , Guinot José Luis , Wang Isabel , De los Dolores Victor , Peña Marina , La Rosa Alonso , Tortajada Maribel , Santos Miguel , Arribas Leoncio
Published: May 2021

Introduction: The aim of this study was to elucidate the long-term outcomes in patients with choroidal melanoma who received episcleral brachytherapy with 125-I seeds; analyse cause-specific survival (CSS), metastasis-free survival (MFS), and local control; and establish the relationship between tumour size and metastases. Methods: From May 2007 to February 2013, 88 patients classified according to the American Joint Committee on Cancer guidelines underwent ultrasound-guided episcleral brachytherapy with a total prescribed dose of 72.40 Gy to the apex. Results: Among the included cases, 47.7 and 44.3% had a clinical tumour stage of T2 and T3, respectively. With a median follow-up of 84 (range 7–153) months, local control at 5 and 10 years was 100 and 95%, respectively. Among the 88 patients, 9 (10.2%) were enucleated after brachytherapy. Those with T1–T2 and T3–T4 disease had a 10-year CSS of 100 and 87.3%, respectively (p = 0.017). MFS at 5 and 10 years was 100% in those with T1–T2 disease and 92.1 and 83.1% in those with T3–T4, respectively (p = 0.016). Five patients had liver metastases, all of whom had T3–T4 disease. Conclusion: Ultrasound-guided episcleral brachytherapy with 125-I seeds yielded excellent local control for choroidal melanoma, with low complication rates and 90% eye preservation. Given the association between tumour stage and liver metastases, which remain the main cause of death, stricter control should be employed for T3–T4 tumours for the early detection and treatment of relapses.
Efficacy of Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors in the Adjuvant Setting for Patients with Resected Epidermal Growth Factor Receptor Mutant Non-Small Cell Lung Cancer: A Meta-Analysis with 11 Trials
Authors: Yin Qifan , Xun Xuejiao , Yang Guang , Cui Hongshang , Liu Huining
Published: May 2021

Background: Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have recently become the standard first-line therapy for advanced non-small cell lung cancer (NSCLC) patients harboring EGFR mutations. This study aimed to define the role of EGFR-TKI treatment in the adjuvant setting of patients with resected EGFR-mutant NSCLC. Methods: Three online databases (PubMed, Embase, and the Cochrane Library) were used to conduct systematic research to search for studies published before June 1, 2020. The disease-free survival (DFS) and overall survival (OS) of patients with resected EGFR-mutant NSCLC after radical surgery treated with EGFR-TKIs versus non-EGFR-TKIs in the adjuvant setting were compared. Based on rigorous self-defined inclusion and exclusion criteria, studies were selected, and a meta-analysis was performed using hazard rate (HR) and 95% CIs as effective measures. Results: Eleven studies, published between 2011 and 2020, with a total of 1,900 patients, were included in this meta-analysis. EGFR-TKI treatment showed a significant beneficial effect on DFS (HR 0.42; 95% CI 0.31–0.57) and OS (HR 0.62; 95% CI 0.45–0.86) for patients with resected EGFR-mutant NSCLC after radical resection in the adjuvant setting. Conclusion: Our meta-analysis results suggested that EGFR-TKI treatment improved the DFS and OS of completely resected patients with EGFR-mutant NSCLC compared with non-EGFR-TKI treatment in the adjuvant setting. In the future, our conclusion should be confirmed by additional large-scale and well-designed clinical trials.
Antifibrotic Therapy: Is There a Role in Myositis-Interstitial Lung Disease?
Authors: Soskis Alyssa , Hallowell Robert
Published: May 2021

Interstitial lung disease (ILD) is a cause of substantial morbidity and mortality amongst autoimmune diseases, including myositis. Despite first-line therapy with immunosuppression, many inflammatory ILDs advance to a fibrotic stage. In such patients, progressive fibrosis may be amenable to treatment with antifibrotic medications, which were initially studied and approved for the treatment of idiopathic pulmonary fibrosis. We here review the available data that support the use of antifibrotics in connective tissue diseases and progressive fibrosing ILDs. There is now a growing body of evidence in both large randomized clinical trials and on the evolving pathophysiologic pathways to support the use of antifibrotics in select patients with autoimmune ILD and a fibrotic phenotype. Further study of antifibrotics in combination with immunosuppressive medications, and in the myositis-ILD population, is needed.
Specific Electrocardiograph Intervals Predict Hospitalization with Atrial Fibrillation in Those with Chronic Kidney Disease
Authors: Scovner Katherine Mikovna , Correa Simon , Claggett Brian L. , Barrett Conor D. , Waikar Sushrut S. , Solomon Scott D. , Mc Causland Finnian R.
Published: May 2021

Introduction: Atrial fibrillation (AF) is common in patients with chronic kidney disease (CKD) and is associated with higher rates of hospitalization compared to those without AF. Whether routine electrocardiographic parameters are predictive of future hospitalizations with AF is not clear. Methods: The present study is an analysis of a prospective cohort of 2,759 patients without baseline AF from the Chronic Renal Insufficiency Cohort, a large prospective multicenter study of patients with nondialysis-dependent CKD. Unadjusted and adjusted Cox regression models were fit to examine the association of baseline categories of QTc, QRS, and PR intervals with time to first hospitalization with AF. Restricted cubic splines were used to display nonlinear associ­ations. Results: The mean age of subjects at baseline was 58 ± 11 years, 55% were male, and 44% were Black. The mean follow-up was 6.6 years during which 224 participants experienced a hospitalization with AF. The association of baseline QTc interval with risk of AF hospitalization was nonlinear, such that the lowest and highest quartiles of QTc (<407 and >431 ms, respectively) had higher adjusted risk of AF hospitalization, compared with the second quartile (407–416 ms) (aHR Q1:Q2 1.58, 95% CI 1.03–2.41; p = 0.03; aHR Q4:Q2 1.84, 95% CI 1.22–2.78; p < 0.01). Longer QRS was associated with a higher risk of hospitalization with AF among the subgroup of patients with a history of heart failure (HF). PR interval was not associated with AF hospitalization. Discussion/Conclusion: The association of QTc with risk for hospitalization with AF among patients with CKD is nonlinear, while the association of longer QRS with AF hospitalization is restricted to patients with baseline HF. Electrocardiography may represent a simple and widely accessible method for risk stratification of future AF in patients with CKD.
Plaque Longitudinal Heterogeneity in Morphology, Property, and Mechanobiology
Authors: Paritala Phani Kumari , Yarlagadda Tejasri , Mendieta Jessica Benitez , Wang Jiaqiu , McGahan Tim , Lloyd Thomas , Yarlagadda Prasad K.D.V. , Li Zhiyong
Published: May 2021

Background and Purpose: The hemodynamic environment of an atherosclerotic plaque varies along the longitudinal direction. Investigating the changes in plaque morphology and its biomechanical environment along the longitudinal direction and their correlations will enhance our understanding of plaque progression and arterial remodeling. Methods: Six male patients with carotid stenosis >70% were recruited. Multisequence high-resolution MRI was performed at the carotid bifurcation. Carotid endarterectomy was performed following MRI, and the plaque tissue was collected for histological and mechanical testing. Patient-specific biomechanical modeling and simulations were conducted to calculate the mechanical stresses (wall shear stress [WSS] and von Mises stress [VMS]). Changes in plaque cross-sectional morphology, WSS, and VMS as well as their correlations were evaluated. Results: Positive correlations were found between % stenosis and % inflammation (MA) (p = 0.019), % lipid area and % MA (p = 0.026), and % calcification area and VMS (p = 0.007). Negative correlations were found between VMS and % stenosis (p = 0.028) and VMS and average WSS (p = 0.034). Moreover, the peak stresses and neovessels were found to be in the shoulder regions. High-stress concentrations were found in the interface regions of the calcification and surrounding tissue, thereby increasing plaque vulnerability. Conclusions: Correlations between the morphology and stresses suggest that arterial remodeling is a dynamic interaction between mechanical environment and plaque progression resulting in plaque heterogeneity. Our finding indicates that plaque heterogeneity is associated with plaque progression and can be combined with mechanical stresses for identifying high-risk plaques.
The Upregulation of a Novel Long Noncoding RNA AK097647 Promotes Enterovirus 71 Replication and Decreases IFN-λ1 Secretion
Authors: Chu Min , Zhou Bingfei , Tu Huilin , Li Min , Huang Li , He Yuan , Liu Luo , Han Song , Yin Jun , Peng Biwen , He Xiaohua , Liu Wanhong
Published: May 2021

Background: Enterovirus 71 (EV71) infects millions of children every year in China and has become a challenge to public health. However, there is no effective treatment for EV71 infection. Long noncoding RNAs (lncRNAs) have been found to play various roles in virus replication and infection. Objective: We aimed to explore the role of a novel long noncoding RNA AK097647 (lncRNA-AK097647) during EV71 infection. Methods: To assess the role of lncRNA-AK097647 during EV71 infection, siRNAs were used to silence lncRNA-K097647 expression. RT-qPCR assay and Western blotting were applied to measure the mRNA and protein levels of EV71 VP1 and the phosphorylation of NF-κB. ELISA was used to detect the level of IFN-λ1 expression. Results: The novel lncRNA-AK097647 was upregulated in human rhabdomyosarcoma cells and the blood of hand, foot, and mouth disease patients infected with EV71, as demonstrated by RT-qPCR. Interestingly, RNAi-mediated knockdown of lncRNA-AK097647 dramatically increased the level of IFN-λ1 expression, resulting in the suppression of EV71 replication. In contrast, overexpression of lncRNA-AK097647 decreased the level of IFN-λ1 expression and resulted in increased EV71 replication. In addition, we found that lncRNA-AK097647 could inhibit the phosphorylation of NF-κB. Conclusion: These results suggest a novel mechanism by which EV71 evades the IFN-mediated host antiviral response by increasing lncRNA-AK097647 expression.
Fourier-Transform Infrared Spectroscopy of Epiretinal Membranes and Internal Limiting Membranes after Pars Plana Vitrectomy with Membrane Peeling
Authors: Leisser Christoph , Paschalis Eleftherios , Rokidi Stamatia , Behanova Martina , Ruiss Manuel , Burgmüller Wilhelm , Findl Oliver
Published: May 2021

Introduction: Fourier-transform infrared imaging (FTIRI) enables examination of protein secondary structure in the analyzed tissues. The aim of our study was to examine the distribution of secondary structures in epiretinal membranes (ERMs) and internal limiting membranes (ILMs), and to explore possible associations to other diagnostic variables. Methods: This prospective pilot study included patients scheduled for pars plana vitrectomy with membrane peeling. ERMs and ILMs were harvested during surgery and placed on a BaF2 window for postsurgical FTIRI analysis. Infrared hyperspectral images were subjected to second and fourth derivative analysis to obtain information of the protein secondary structures present in the tissues. Results: Samples of 43 patients were analyzed, with the triple helical domain showing the highest prevalence in the examined tissues. The other secondary structures (beta-sheet, random coil, and beta-turn) showed a heterogenous distribution in the examined samples, without specific associations to indication of surgery, comorbidities, outcomes from optical coherence tomography, and intrasurgical findings. Conclusions: FTIRI enables analysis of the spatial distribution of protein secondary structures in the examined tissues; thus, it is a useful analytical technique for the analysis of ERMs and ILMs.
Der Stand der Therapie bei der refraktären/rezidivierenden chronischen lymphatischen Leukämie: Neuartige Wirkstoffe im Fokus
Authors: Smolewski Piotr , Robak Tadeusz
Published: May 2021

Der Einsatz neuartiger, zielgerichteter Wirkstoffe ist dabei, die Behandlungsparadigmen der chronischen lymphatischen Leukämie (CLL) von Grund auf zu verändern. Verschiedene Wirkstoffe für das Management der rezidivierenden/refraktären (R/R)-CLL haben große Verbesserungen bei den Überlebensraten der R/R-CLL-Patienten bewirkt, insbesondere Inhibitoren der Bruton-Tyrosinkinase (Ibrutinib und Acalabrutinib), der Phosphatidylinositol-3-Kinase (Idelalisib und Duvelisib) und von B-Zell-Lymphoma-2 (Venetoclax) sowie neuartige monoklonale Antikörper gegen CD20. Patienten mit rezidivierender, aber asymptomatischer CLL bedürfen jedoch keiner sofortigen alternativen Behandlung, sondern sollten bis zu manifesten Anzeichen einer Progression beobachtet werden. Von den bereits zugelassenen Therapien wird Venetoclax plus Rituximab für 24 Monate oder Ibrutinib als Dauertherapie empfohlen. Eine weitere, weniger empfohlene, Option ist Idelalisib in Kombination mit Rituximab. Die Wahl der passenden Behandlungsoption richtet sich danach, welche Therapie vorher angewendet wurde, wie der Patient darauf ansprach und welche Nebenwirkungen aufgetreten sind, welche Komorbiditäten vorliegen und welches Toxizitätsrisiko besteht. Allogene hämatopoetische Stammzelltransplantationen und experimentelle Therapien wie z. B. chimäre Antigenrezeptor-T-Zell-Therapien stellen vielversprechende Optionen für Hochrisikopatienten dar, einschließlich derer mit Krankheitsprogression nach einer oder mehreren zielgerichteten Therapien. In der vorliegenden Übersichtsarbeit werden die aktuellen Behandlungsstrategien für Patienten mit R/R CLL besprochen.
End-of-Life: Patientinnen und Patienten rechtzeitig einbinden
Authors: Zimmermann Tanja
Published: May 2021

Background: Decisions to limit treatment (DLTs) are important to protect patients from overtreatment but constitute one of the most ethically challenging situations in oncology practice. In the Ethics Policy for Advance Care Planning and Limiting Treatment study (EPAL), we examined how often DLT preceded a patient’s death and how early they were determined before (T1) and after (T2) the implementation of an intrainstitutional ethics policy on DLT. Methods: This prospective quantitative study recruited 1.134 patients with haematological/oncological neoplasia in a period of 2×6 months at the University Hospital of Munich, Germany. Information on admissions, discharges, diagnosis, age, DLT, date and place of death, and time span between the initial determination of a DLT and the death of a patient was recorded using a standardised form. Results: Overall, for 21% (n = 236) of the 1.134 patients, a DLT was made. After implementation of the policy, the proportion decreased (26% T1/16% T2). However, the decisions were more comprehensive, including more often the combination of ‘Do not resuscitate’ and ‘no intense care unit’ (44% T1/64% T2). The median time between the determination of a DLT and the patient’s death was similarly short with 6 days at a regular ward (each T1/T2) and 10.5/9 (T1/T2) days at a palliative care unit. For patients with solid tumours, the DLTs were made earlier at both regular and palliative care units than for the deceased with haematological neoplasia. Conclusion: Our results show that an ethics policy on DLT could sensitise for treatment limitations in terms of frequency and extension but had no significant impact on timing of DLT. Since patients with haematological malignancies tend to undergo intensive therapy more often during their last days than patients with solid tumours, special attention needs to be paid to this group. To support timely discussions, we recommend the concept of advance care planning.
The Association between Adherence to the MIND Diet and Irritable Bowel Syndrome
Authors: Nouri-Majd Saeedeh , Salari-Moghaddam Asma , Keshteli Ammar Hassanzadeh , Esmaillzadeh Ahmad , Adibi Peyman
Published: May 2021

Background and Aims: No earlier study examined the association between adherence to the MIND (Mediterranean-DASH Diet Intervention for Neurodegenerative Delay) diet and odds of irritable bowel syndrome (IBS). This study was conducted to examine the relationship between adherence to the MIND diet and odds of IBS among Iranian adults. Methods: In this cross-sectional study, dietary intakes of 3,362 adults were examined using a validated Dish-Based 106-item Semi-Quantitative Food Frequency Questionnaire (DS-FFQ). The MIND diet score was constructed based on participants’ dietary intakes obtained from DS-FFQ. IBS was evaluated using a modified Persian version of the Rome III questionnaire. Results: Overall, 22.2% of the study population were affected by IBS (n = 748). We observed no significant relationship between adherence to the MIND diet and odds of IBS in the whole population (OR: 0.97; 95% CI: 0.71–1.31). By gender and BMI status, no significant association between adherence to the MIND diet and odds of IBS was seen. Also, no significant association was found between adherence to the MIND diet and IBS subtypes. Conclusion: No significant association was found between adherence to the MIND diet and odds of IBS. Further studies are needed to examine the association between dietary patterns and IBS.