bluuebunny/crossref_metadata_2025 huggingface dataset:
A deep‐learning‐based approach for adenoid hypertrophy diagnosis
Authors: Shen Yi , Li Xiaohu , Liang Xiao , Xu Hai , Li Chuanfu , Yu Yongqiang , Qiu Bensheng
Published: February 2020

Purpose

Adenoid hypertrophy is a pathological hyperplasia of adenoids and may cause snoring, apnea, and impede breathing during sleep. In clinical practice, radiologists diagnose the severity of adenoid hypertrophy by measuring the ratio of adenoid width (A) to nasopharyngeal width (N) according to the lateral cephalogram, which indicates the locations of four keypoints. The entire diagnostic process is tedious and time‐consuming due to the acquisition of A and N. Thus, there is an urgent need to develop computer‐aided diagnostic tools for adenoid hypertrophy.

Methods

In this paper, we first propose the use of deep learning to solve the problem of adenoid hypertrophy classification. Deep learning driven by big data has developed greatly in the image processing field. However, obtaining a large amount of training data is hard, making the application of deep learning to medical images more difficult. This paper proposes a keypoint localization method to incorporate more prior information to improve the performance of the model under limited data. Furthermore, we design a novel regularized term called VerticalLoss to capture the vertical relationship between keypoints to provide prior information to strengthen the network performance.

Results

To evaluate the performance of our proposed method, we conducted experiments with a clinical dataset from the First Affiliated Hospital of Anhui Medical University consisting of a total of 688 patients. As our results show, we obtained a classification accuracy of 95.6%, a macro F1‐score of 0.957, and an average AN ratio error of 0.026. Furthermore, we obtained a macro F1‐score of 0.89, a classification accuracy of 94%, and an average AN ratio error of 0.027 while using only half of the data for training.

Conclusions

The study shows that our proposed method can achieve satisfactory results in the task of adenoid hypertrophy classification. Our approach incorporates more prior information, which is especially important in the field of medical imaging, where it is difficult to obtain large amounts of training data.
Automated left ventricular myocardium segmentation using 3D deeply supervised attention U‐net for coronary computed tomography angiography; CT myocardium segmentation
Authors: Jun Guo Bang , He Xiuxiu , Lei Yang , Harms Joseph , Wang Tonghe , Curran Walter J. , Liu Tian , Jiang Zhang Long , Yang Xiaofeng
Published: February 2020

Purpose

Segmentation of left ventricular myocardium (LVM) in coronary computed tomography angiography (CCTA) is important for diagnosis of cardiovascular diseases. Due to poor image contrast and large variation in intensity and shapes, LVM segmentation for CCTA is a challenging task. The purpose of this work is to develop a region‐based deep learning method to automatically detect and segment the LVM solely based on CCTA images.

Methods

We developed a 3D deeply supervised U‐Net, which incorporates attention gates (AGs) to focus on the myocardial boundary structures, to segment LVM contours from CCTA. The deep attention U‐Net (DAU‐Net) was trained on the patients’ CCTA images, with a manual contour‐derived binary mask used as the learning‐based target. The network was supervised by a hybrid loss function, which combined logistic loss and Dice loss to simultaneously measure the similarities and discrepancies between the prediction and training datasets. To evaluate the accuracy of the segmentation, we retrospectively investigated 100 patients with suspected or confirmed coronary artery disease (CAD). The LVM volume was segmented by the proposed method and compared with physician‐approved clinical contours. Quantitative metrics used were Dice similarity coefficient (DSC), Hausdorff distance (HD), mean surface distance (MSD), residual mean square distance (RMSD), the center of mass distance (CMD), and volume difference (VOD).

Results

The proposed method created contours with very good agreement to the ground truth contours. Our proposed segmentation approach is benchmarked primarily using fivefold cross validation. Model prediction correlated and agreed well with manual contour. The mean DSC of the contours delineated by our method was 91.6% among all patients. The resultant HD was 6.840 ± 4.410 mm. The proposed method also resulted in a small CMD (1.058 ± 1.245 mm) and VOD (1.640 ± 1.777 cc). Among all patients, the MSD and RMSD were 0.433 ± 0.209 mm and 0.724 ± 0.375 mm, respectively, between ground truth and LVM volume resulting from the proposed method.

Conclusions

We developed a novel deep learning‐based approach for the automated segmentation of the LVM on CCTA images. We demonstrated the high accuracy of the proposed learning‐based segmentation method through comparison with ground truth contour of 100 clinical patient cases using six quantitative metrics. These results show the potential of using automated LVM segmentation for computer‐aided delineation of CADs in the clinical setting.
Automatic detection of simulated motion blur in mammograms
Authors: Kamona Nada , Loew Murray
Published: February 2020

Purpose

To use machine‐learning algorithms and blur measure (BM) operators to automatically detect motion blur in mammograms. Motion blur has been reported to reduce lesion detection performance and mask small abnormalities, resulting in failure to detect them until they reach more advanced stages. Automatic detection of blur could support the clinical decision‐making process during the mammography exam by allowing for an immediate retake, thereby preventing unnecessary expense, time, and patient anxiety.

Methods

Blur was simulated mathematically to mimic the real blur seen in clinical practice. The blur point‐spread‐function (PSF) mask is generated by distributing pixel intensity of an image pixel moving under random motion within the range of blur effect (the maximum amount of tissue motion allowed). The random motion trajectory vector is generated on a super‐sampled image frame to accommodate smaller substeps; the vector was then sampled on a regular pixel grid using subpixel linear interpolation to generate the blur PSF mask. This randomly generated motion trajectory is constrained by several factors: the effects of variations in tissue elasticity, imaging exposure time, and size of blur effect (motion boundary in millimeters) were examined. The blur mask is convolved with a mammogram to create blur. Five motion blur magnitudes (0.1, 0.25, 0.5, 1.0, and 1.5 mm) were simulated on 244 and 434 mammograms from the INbreast and DDSM databases, respectively. Blur was quantified using nine BM operators for each mammogram and at each blur level. The mammograms were assigned to training (70%) and testing (30%) datasets to train three machine‐learning classifiers: Ensemble Bagged Trees, fine Gaussian SVM, and weighted KNN, to distinguish five levels of blurred from unblurred mammograms, using six‐way classification.

Results

For the INbreast mammograms, the average classification accuracies were 87.7%, 85.7%, and 85.7% for Ensemble Bagged Trees, fine Gaussian SVM, and weighted KNN, respectively, and the average classification accuracies for DDSM were 93.5%, 93.6%, and 92.7% for Ensemble Bagged Trees, fine Gaussian SVM, and weighted KNN, respectively.

Conclusions

Preliminary results show the potential to detect simulated blur automatically using those methods. Although limited work has been done to quantify the effects of motion blur on radiologists’ performance, there is evidence that motion blur might not be detected visually by a human observer and could negatively affect radiologists’ lesion detection performance. As of this date, no other study has investigated the ability of machine‐learning classifiers and BM operators to detect motion blur in mammograms.
Temperament and professional quality of life among Japanese nurses
Authors: Tanaka Koji , Ikeuchi Satomi , Teranishi Keiko , Oe Masato , Morikawa Yuko , Konya Chizuko
Published: February 2020

Aim

To investigate associations between temperament and professional quality of life among Japanese nurses.

Design

A descriptive‐correlational study using self‐administered anonymous questionnaires.

Methods

Questionnaires were collected from 1,267 nurses. We used analysis of covariance to examine associations between tendencies of temperament (depressive, cyclothymic, hyperthymic, irritable and anxious) and professional quality of life subscales (compassion satisfaction, burnout, compassion fatigue) first for all participants and then again after dividing the participants into two groups based on years of experience.

Results

Nurses’ professional quality of life was associated with innate temperament and years of experience. Nurses with any of depressive, cyclothymic, irritable, or anxious tendencies showed significantly lower compassion satisfaction and higher burnout and compassion fatigue than those without these tendencies. Nurses with hyperthymic tendencies showed significantly higher compassion satisfaction and lower burnout than those without the tendency.
Highly stretchable wrinkled electrode based on silver ink‐elastomer nanocomposite with excellent fatigue resistance
Authors: Won Joohye , Mondal Subhadip , Park Jongho , Wang Wonseok , Lee Hyunsang , Kim Suhyun , Shin Beomsu , Sathi Shibulal G. , Nah Changwoon
Published: February 2020

Flexible and stretchable electrodes have attracted immense attention because of their various electronic applications on the wearable sensing electronics, but challenges regarding robust and sustainable electrical performance under static and dynamic mechanical stresses still need to be overcome. Herein, with a simple effective strategy, a highly serviceable and flexible elastomeric electrode fabricated by utilizing an interpenetrating network between acrylic rubber (AR) and silicone rubber (SR), and silver (Ag) ink to increase electrical conductivity, is introduced. Oxygen (O2) plasma and sodium dodecyl sulfate (SDS) treatment on wrinkle substrate surface lead to robust adhesion of Ag ink layer, results in high electrical conductivity. Wrinkle morphology can help to stably maintain the continuous conductive Ag network during static and dynamic deformation. This stretchable electrode possessing properties such as robust and stable electrical conductivity of ~103 S/cm under 150% static tensile deformations and good sustainability after 1000 cycles of dynamic tensile deformations is a promising candidate for stretchable wearable electronics.
Interface analysis of Ag/n‐type Si contacts in n‐type PERT solar cells
Authors: Ferrada Pablo , Rudolph Dominik , Portillo Carlos , Adrian Adrian , Correa‐Puerta Jonathan , Sierpe Rodrigo , del Campo Valeria , Flores Marcos , Corrales Tomas P. , Henríquez Ricardo , Kogan Marcelo J. , Lossen Jan
Published: February 2020

To increase efficiencies of bifacial solar cells, emitter, back surface field (BSF), and metal patterns must be optimized. We study the influence of paste volume, through multiple prints, of two silver pastes on the contact formation at the rear side of n‐type passivated emitter and rear totally diffused (n‐PERT) solar cells with two BSF doping profiles. Differences in fingers' electrical properties were found between pastes. Contact resistivity shows a relative difference of 27.6%, partially explained by changes in the silver crystallites formation at the Ag/Si interface and in the crystallites' penetration depth. Variations in crystallites formation and penetration between pastes can reach 38.4% and 48.8%, respectively. Line resistance shows a difference between pastes, appearing as the main cause of an absolute efficiency difference of 2.9%. Fingers' structural and electrical properties are modified by increasing the paste volume. Microstructure analysis reveals that additional metallic printing does not only increase line cross sectional area but also increases the formation of silver crystallites, which can reach a relative increment of 23.9% between first and second prints. Further printing does not necessarily decrease contact resistivity, but reduces line resistance in up to 94.9%, which results in an absolute efficiency increase of 2.2%. In addition, the higher presence of silver oxide in the finger is related to a higher efficiency in the formation of silver crystallites. Finally, BSF doping has an influence in the open circuit voltage, short circuit current density, and contact resistivity, with differences that can reach 8.7 mV, 0.2 mA/cm2, and 6.1 mΩcm2, respectively, depending on paste and number of prints.
Systematic review of longitudinal studies on chemotherapy‐associated subjective cognitive impairment in cancer patients
Authors: Kim Hee‐Ju , Jung Sun‐Ok , Kim Hyang , Abraham Ivo
Published: February 2020

Objectives

This systematic review of longitudinal studies, assessing subjective cognitive impairment (SCI) reported by adult cancer patients, aimed to summarize evidence on the impact of chemotherapy on SCI, identify moderators of SCI, and evaluate methodological issues.

Methods

Data accrued from Pubmed, EMBASE, CINAHL, PsychInfo, and the Cochrane library. Inclusion criteria were original studies, an exclusively adult sample, valid and reliable subjective cognitive measures, and at least one baseline data point prior to and another after the initiation of chemotherapy. Data were collected on the sample composition, data‐collection time points, outcome measures, statistical analysis, and major findings (ie, longitudinal changes in prevalence, severity, and associated factors).

Results

Forty articles published between 2004 and 2019 were retained: 21 examined chemotherapy‐treated patients only, and 19 employed control groups. Findings were mixed, with slightly more studies supporting the impact of chemotherapy on SCI. SCI tended to be more prevalent and severe after initiating chemotherapy, compared with patients' own baseline and controls not treated with chemotherapy. Impact appeared to be acute and more likely limited to subsamples. Most studies examining non–breast‐cancer samples reported the lack or limited impact of chemotherapy on SCI. The most consistent moderators were depression and fatigue. Methodological issues regarding sampling design, measurement, and statistical analysis were discussed.

Conclusion

More rigorously designed longitudinal studies would clarify direct and indirect effects of chemotherapy on SCI.
A Thermoelectrically Cooled nBn Type‐II Superlattices InAs/InAsSb/B‐AlAsSb Mid‐Wave Infrared Detector
Authors: Martyniuk Piotr , Michalczewski Krystian , Tsai Tsung-Yin , Wu Chao-Hsin , Wu Yuh-Renn
Published: February 2020

Herein, an nBn barrier mid‐wave infrared InAs/InAsSb (xSb = 0.4) type‐II superlattice (T2SL) detector operating in the thermoelectrical (TE) cooling condition is reported. AlAsSb (Sb‐composition, xSb ≥ 0.975) is shown not to introduce an additional barrier in the valence band in the analyzed temperature range (≥200 K) reached by four‐stage TE cooling in nBn barrier architectures with a T2SL InAs/InAsSb active layer. The dark current and photocurrent produced are analyzed in relation to the barrier and contact layer doping, with the Sb composition of the barrier indicating the optimal architecture. The results of the simulation are compared with the experimental results of the HgCdTe and InAsSb nBn barrier detectors. A detectivity of ≈1010 cmHz1/2 W−1 at 200 K is reported without an immersion lens (≈1011 cmHz1/2 W−1 is reported for an immersed detector).
Monitoring Variations in Thermal Curing of Nanoparticle Coatings through Confocal Raman Microscopy and Principal Component Analysis
Authors: Samyn Pieter , Marchal Wouter , Vandamme Dries , Adriaensens Peter , Carleer Robert
Published: February 2020

For paper coatings with organic nanoparticles of poly(styrene‐co‐maleimide), dispersive Raman spectroscopy and confocal Raman microscopy are applied for qualitative and quantitative analyses of the lateral distribution of chemical moieties as a function of different coating grades (degree of imidization) and thermal curing temperatures (120–250 °C). Raman mapping with band intensity ratios, single band intensities, and average spectral intensities illustrates that surface locations with imide moieties are sensitive to the thermal curing temperature due to the reactivity of an amount of ammonolyzed (nonimidized) maleic anhydride, whereas the styrene moieties are not sensitive to the thermal curing. A maximum in imide functionalities at the surface occurs after curing at 135–150 °C depending on the coating grade. The surface coverage of the coating moieties is complementary to the cellulose components, but local variations in specific Raman bands for the latter suggest interactions due to hydrogen bonding. Principal component analysis with two parameters allows for a good quantification of the imide content and surface coverage.
Modelling the impact of crushing on the strength performance of corrugated fibreboard
Authors: Jamsari Mohamad Aiman , Kueh Celia , Gray‐Stuart Eli M. , Dahm Karl , Bronlund John E.
Published: February 2020

This paper presents different ways of modelling the strength of corrugated fibreboard (CFB) subjected to different levels of pre‐crushing. The strength performance was measured through four‐point bending loading and edge crush test (ECT). The models used in this study were an analytical solution, an equivalent flute model, and detailed flute geometry models that consisted of idealized sine geometry and real geometry.

The study found that the bending performance was dependent on the calliper of CFB rather than the flute geometry. All models showed a similar trend in predicting the drop in bending stiffness as the level of pre‐crushing increased, albeit with different absolute value.

It was found that the real geometry model of the board predicted ECT performance better than the other models. However, at severe pre‐crushing levels (>50%), there was a significant drop in the experimental ECT force not predicted by the models. For these cases, there was evidence of delamination of the flute, a failure mechanism that was not included in any of the models.

The analytical solution model provides the quickest prediction but could not predict the crushed ECT performance due to not considering the calliper variable in the equation. The equivalent model showed faster solving time compared with both real and idealized geometry models, although these microgeometry models predicted ECT the most accurately.
Do you bend or break? System dynamics in resilience planning for food security
Authors: Herrera de Leon Hugo Jose , Kopainsky Birgit
Published: February 2020

This paper discusses our experience in using system dynamics to facilitate resilience planning for food security in rural communities that are exposed to ever‐increasing climatic pressures in Guatemala. The social–ecological systems literature is rich in examples where policies to enhance resilience are deduced from factors generally accepted to be present in resilient systems (e.g. redundancy, connectivity and polycentrism). This deductive approach risks being overly simplistic. As an alternative, this paper explores how insights from analysing the structure–behaviour relationship of complex dynamic systems can be used to generate tailored policies. The results show that stability in food systems is mainly driven by key strategic resources that moderate the effects of environmental changes on food availability and affordability. Moreover, our experience highlights the importance of analysing mechanisms that determine a system's behaviour while and after the system is affected by a disturbance to formulate effective resilience policies.

© 2020 The Authors. System Dynamics Review published by John Wiley & Sons Ltd on behalf of System Dynamics Society
An energy efficient and low overhead fault mitigation technique for internet of thing edge devices reliable on‐chip communication
Authors: Ibrahim Muhammad , Baloch Naveed Khan , Anjum Sheraz , Zikria Yousaf Bin , Kim Sung Won
Published: February 2020

Soft errors in network‐on‐chip (NoC) such as single bit upsets and multibit upsets cause hazardous effects such as congestion, deadlock, livelock, and corruption of data. Error‐correcting codes (ECCs) are the best choices to handle these soft errors in links and memory buffers of NoC, which is the need of all modern systems, including internet of thing (IoT) edge devices. Many of these ECCs cannot correct both random and burst errors. Specific codes possess the correction and detection capability at the cost of an increase in area, latency, and energy. In this article, a coding technique is proposed by using a single error correction double error detection‐triple adjacent error correction‐six adjacent error detection (SEC‐DED‐TAEC‐6AED) (24,16) I5, that provides both random and burst error fault tolerance for NoC. The proposed technique decreases the area, energy, and latency cost of the whole NoC. It also reduces the area overhead to 173.41% and 117.91% compare to joint crosstalk avoidance multiple error correction (JCAMEC) and joint crosstalk multiple error correction (JMEC), respectively. Besides, the delay overhead of the proposed technique reduces to 4.2% and 91.97% compared with JCAMEC and JMEC, respectively. The simulation results show that the proposed code possesses an enhanced ability of error correction and detection with 3.5 times less redundant bits and a 30% fast code rate compared with JMEC and JCAMEC. Hence, the proposed scheme can effectively be used for detecting and correcting single and multiple bit errors for on‐chip communication.
Anthropometrische Messungen in der NAKO Gesundheitsstudie – mehr als nur Größe und Gewicht
Authors: Fischer Beate , Sedlmeier Anja M. , Hartwig Saskia , Schlett Christopher L. , Ahrens Wolfgang , Bamberg Fabian , Baurecht Hansjörg , Becher Heiko , Berger Klaus , Binder Hans , Bohn Barbara , Carr Prudence R. , Castell Stefanie , Franzke Claus-Werner , Fricke Julia , Gastell Sylvia , Greiser Karin Halina , Günther Kathrin , Jaeschke Lina , Kaaks Rudolf , Kemmling Yvonne , Krist Lilian , Kuß Oliver , Legath Nicole , Lieb Wolfgang , Linseisen Jakob , Löffler Markus , Michels Karin B. , Mikolajczyk Rafael , Niedermaier Tobias , Norman Kristina , Obi Nadia , Peters Annette , Pischon Tobias , Schikowski Tamara , Schipf Sabine , Schmidt Börge , Schulze Matthias B. , Stang Andreas , Stojicic Jelena , Tiller Daniel , Völzke Henry , Waniek Sabina , Leitzmann Michael F.
Published: February 2020

Übergewicht und Adipositas sind bedeutende Risikofaktoren für verschiedene Erkrankungen. Als Maß zu ihrer Bestimmung wurde in früheren Studien meist nur der Body-Mass-Index (BMI) verwendet. Der BMI ist allerdings ein Marker, der den Einfluss auf das Krankheitsrisiko nur unzureichend erfasst. In groß angelegten, bevölkerungsbasierten Studien besteht daher ein vordringlicher Bedarf, verbesserte Messmethoden der Körperzusammensetzung und -fettverteilung einzusetzen.

Der vorliegende Beitrag stellt die in der NAKO (Nationale Kohorte) Gesundheitsstudie eingesetzten Messverfahren zur Beschreibung von Körperzusammensetzung und -fettverteilung und die ersten deskriptiven Ergebnisse vor. Diese beziehen sich auf die Daten zur Halbzeit der Basiserhebung, welche 101.817 Teilnehmende einschließt, die in 18 Studienzentren in Deutschland zwischen März 2014 und März 2017 untersucht worden sind. Die anthropometrischen Messungen umfassten Körpergewicht, Körpergröße und -umfänge, bioelektrische Impedanzanalyse (BIA), Sonographie des Abdominalfettes, 3‑D-Bodyscanner und Magnetresonanztomographie.

Die Analyse des BMI zeigte, dass 46,2 % der Männer sowie 29,7 % der Frauen übergewichtig und 23,5 % der Männer und 21,2 % der Frauen adipös waren. Frauen wiesen im Mittel in fast allen Altersgruppen eine höhere Schichtdicke an subkutanem Fettgewebe auf als Männer. Die mittlere Schichtdicke des viszeralen Fettgewebes lag hingegen bei den Männern in allen Altersgruppen über den Werten der Frauen und stieg bei beiden Geschlechtern über die Altersgruppen kontinuierlich an.

Die umfassenden Daten über die Körperfettverteilung und -zusammensetzung ermöglichen es zukünftig, den Einfluss von Übergewicht und Adipositas auf die Entstehung von chronischen Erkrankungen im Detail zu analysieren.
Time-dependent wettability changes on plasma-treated surfaces of unmodified and thermally modified European beech wood
Authors: Altgen D. , Altgen M. , Kyyrö S. , Rautkari L. , Mai C.
Published: February 2020

The wettability of a freshly cut wood surface will change over time, which is denoted as natural ageing. Water contact angle measurements indicated that the thermal modification of European beech reduces its wettability, but does not affect the rate at which the contact angle increases within a 4-week period. A plasma treatment of fresh wood surfaces enhanced the wettability and equaled the wettability properties of unmodified and thermally modified wood surfaces. The contact angle on plasma-treated wood surfaces increased faster than on unmodified wood surfaces, but a reduction in contact angle by the plasma treatment was still evident after ageing for 4 weeks.
Trace Elements in Crustaceans, Mollusks and Fish in the Kenyan Part of Lake Victoria: Bioaccumulation, Bioindication and Health Risk Analysis
Authors: Outa James Omondi , Kowenje Chrispin O. , Avenant-Oldewage Annemariè , Jirsa Franz
Published: February 2020

This is the first comprehensive report on the accumulation of Cr, Ni, As, and Ag in the fish species Nile tilapia Oreochromis niloticus and Nile perch Lates niloticus from Lake Victoria, complemented with recent data on Cu, Zn, Cd, and Pb. This also is the first report on Cr, Ni, As, and Ag levels in invertebrates: the shrimp Caridina nilotica, gastropod Pila ovata, and bivalve Mutela bourguignati. The study was conducted at five sites in the Kenyan part of Lake Victoria: four sites in Winam Gulf influenced by various anthropogenic pressures, including a site near Kisumu City, and one in the main lake, with lesser direct anthropogenic influence. Apart from Cu and Ag, which were highest in O. niloticus liver, the invertebrates had higher levels of trace elements than fish. Contamination of the gulf with trace elements was best mirrored by the invertebrates, whose mobility is limited; they accumulated Cr, Cd, Ag, and Pb corresponding to the levels in the surface sediment. The accumulation of trace elements in fish species and their bioindicative potential corresponded to their habitats and feeding behaviour. The tissue contents of most trace elements were higher in the inshore-dwelling, omnivorous O. niloticus compared to the pelagic, piscivorous L. niloticus. Cu (465 ± 689 mg/kg dw) and Ag (3.45 ± 1.49 mg/kg dw) in the liver of O. niloticus were up to 10 and 119 times higher than in L. niloticus, respectively. Oreochromis niloticus therefore has bioindicative potential for Cu and Ag contamination. Both the invertebrates and fish showed positive correlations between Cu and Ag concentrations, indicating similar source and/or uptake route. The target hazard quotients (THQ) show that there is no human health risk associated with the consumption of these fish. However, the levels of Zn, Cd, and Pb in P. ovata surpassed maximum food safety limits and are hence potentially unsafe for human consumption.
Perioperative Antiretroviral Regimen for HIV/AIDS Patients Who Underwent Abdominal Surgery
Authors: Yang Jing , Wei Guo , He Yong , Hua Xin , Feng Shifeng , Zhao Yong , Chen Tingyu , Wang Hua , Guo Liang
Published: February 2020

Background

A short interruption of antiretroviral therapy (ART) and reduced oral bioavailability of antiretroviral medications could occur in perioperative human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patients who undergo abdominal surgery. Therefore, we focused on the changes in HIV viral load and CD4+ T lymphocyte count in HIV/AIDS patients after surgery and explored whether the perioperative use of intravenous antiretroviral drugs is beneficial in lowering the viral load and increasing the safety of the surgery.

Methods

We prospectively collected data from HIV/AIDS patients who underwent abdominal surgery at our institution from January 2019 and April 2019. According to the use of different antiretroviral medications during the perioperative period, the HIV/AIDS patients were divided into four groups: Group I: Patients continued their original antiretroviral medications; Group II: Patients received their original antiretroviral medications plus intravenous administration of the fusion inhibitor albuvirtide (ABT); Group III: Patients received ABT alone; and Group IV: Patients did not receive ART. The primary outcomes considered were the changes in HIV load and CD4+ T lymphocyte count and the postoperative complications in the four groups.

Results

A total of 64 HIV/AIDS patients were enrolled, and their data were analyzed descriptively. There were no differences between group I and group II in terms of the changes in viral load. The viral load continued to decrease in group III within 30 days after surgery, especially from D7 to D30 (t = 2.179, p = 0.043). However, the viral load showed an upward trend after surgery in group IV. There were statistically significant differences between the two groups in the changes in viral load after surgery (p = 0.022). However, there were no statistically significant differences between group III and group IV in the postoperative changes in the CD4+ T lymphocyte count. Seven out of 64 patients had postoperative infective complications. The incidence of complications from high to low was as follows: group IV > group I > group III > group II (p < 0.05).

Conclusions

A short perioperative interruption of ART may have a small impact on viral load in HIV/AIDS patients on virologic suppression after abdominal surgery. For patients with a detectable viral load, an intravenous injection of ABT in the perioperative period can reduce the viral load quickly, lower the occurrence of postoperative complications, and increase operation safety for both the HIV/AIDS patient and the surgeons.
Combination of Preoperative Plasma Fibrinogen and Neutrophil‐to‐Lymphocyte Ratio (the F‐NLR Score) as a Prognostic Marker of Locally Advanced Rectal Cancer Following Preoperative Chemoradiotherapy
Authors: Sun Yanwu , Zhang Yiyi , Huang Zhekun , Lin Huiming , Lu Xingrong , Huang Ying , Chi Pan
Published: February 2020

Background

Coagulation and inflammation play important roles in tumor progression. This study aimed to explore the prognostic impact of combined analysis of fibrinogen and neutrophil‐to‐lymphocyte (NLR) ratio (F‐NLR score) in locally advanced rectal cancer (LARC) receiving preoperative chemoradiotherapy (pCRT) and radical surgery.

Method

Totally 317 patients were included. X‐tile analysis was used to determine the optimal cutoff values of preoperative fibrinogen and NLR. F‐NLR scores were defined as 2 (both high fibrinogen and NLR), 1 (one of these abnormalities), or 0 (neither abnormality). Time‐dependent ROC analysis was used to evaluate the predictive accuracy of fibrinogen, NLR, and F‐NLR score. Cox regression analysis was performed to evaluate the prognostic impact of the F‐NLR score. A predictive nomogram for disease‐free survival (DFS) was developed and validated internally.

Results

One hundred and seventeen (36.9%), 156 (49.2%), and 44 (13.9%) patients had F‐NLR score of 0, 1, and 2, respectively. Higher F‐NLR score was associated with poorly differentiated tumors, deeper tumor invasion, lymph node metastasis, and more advanced pTNM stage (all P < 0.05). The 5‐year OS rates in the F‐NLR 0, 1, and 2 groups were 93.6%, 87.3%, and 68.4%, respectively (P < 0.001), while the 5‐year DFS rates were 91.8%, 76.8%, and 56.1%, respectively (P < 0.001). Cox regression analysis demonstrated that F‐NLR score (F‐NLR 1, HR = 2.021, P = 0.046; F‐NLR 2, HR = 3.356, P = 0.002), pTNM stage III (HR = 3.109, P = 0.009), and circumferential resection margin (CRM) involvement (HR = 3.120, P = 0.021) were independently associated with DFS. A nomogram for DFS was developed (C‐index 0.708).

Conclusion

F‐NLR score is a promising predictor for disease recurrence in LARC patients after pCRT.
Multiomic immune clockworks of pregnancy
Authors: Peterson Laura S. , Stelzer Ina A. , Tsai Amy S. , Ghaemi Mohammad S. , Han Xiaoyuan , Ando Kazuo , Winn Virginia D. , Martinez Nadine R. , Contrepois Kevin , Moufarrej Mira N. , Quake Stephen , Relman David A. , Snyder Michael P. , Shaw Gary M. , Stevenson David K. , Wong Ronald J. , Arck Petra , Angst Martin S. , Aghaeepour Nima , Gaudilliere Brice
Published: February 2020

Preterm birth is the leading cause of mortality in children under the age of five worldwide. Despite major efforts, we still lack the ability to accurately predict and effectively prevent preterm birth. While multiple factors contribute to preterm labor, dysregulations of immunological adaptations required for the maintenance of a healthy pregnancy is at its pathophysiological core. Consequently, a precise understanding of these chronologically paced immune adaptations and of the biological pacemakers that synchronize the pregnancy “immune clock” is a critical first step towards identifying deviations that are hallmarks of peterm birth. Here, we will review key elements of the fetal, placental, and maternal pacemakers that program the immune clock of pregnancy. We will then emphasize multiomic studies that enable a more integrated view of pregnancy-related immune adaptations. Such multiomic assessments can strengthen the biological plausibility of immunological findings and increase the power of biological signatures predictive of preterm birth
Modulating local airway immune responses to treat allergic asthma: lessons from experimental models and human studies
Authors: Voskamp A.L. , Kormelink T. Groot , van Wijk R. Gerth , Hiemstra P.S. , Taube C. , de Jong E.C. , Smits Hermelijn H.
Published: February 2020

With asthma affecting over 300 million individuals world-wide and estimated to affect 400 million by 2025, developing effective, long-lasting therapeutics is essential. Allergic asthma, where Th2-type immunity plays a central role, represents 90% of child and 50% of adult asthma cases. Research based largely on animal models of allergic disease have led to the generation of a novel class of drugs, so-called biologicals, that target essential components of Th2-type inflammation. Although highly efficient in subclasses of patients, these biologicals and other existing medication only target the symptomatic stage of asthma and when therapy is ceased, a flare-up of the disease is often observed. Therefore, it is suggested to target earlier stages in the inflammatory cascade underlying allergic airway inflammation and to focus on changing and redirecting the initiation of type 2 inflammatory responses against allergens and certain viral agents. This focus on upstream aspects of innate immunity that drive development of Th2-type immunity is expected to have longer-lasting and disease-modifying effects, and may potentially lead to a cure for asthma. This review highlights the current understanding of the contribution of local innate immune elements in the development and maintenance of inflammatory airway responses and discusses available leads for successful targeting of those pathways for future therapeutics.
Janus particles: from concepts to environmentally friendly materials and sustainable applications
Authors: Marschelke Claudia , Fery Andreas , Synytska Alla
Published: February 2020

Janus particles represent a unique group of patchy particles combining two or more different physical or chemical functionalities at their opposite sides. Especially, individual Janus particles (JPs) with both chemical and geometrical anisotropy as well as their assembled layers provide considerable advantages over the conventional monofunctional particles or surfactant molecules offering (a) a high surface-to-volume ratio; (b) high interfacial activity; (c) target controlling and manipulation of their interfacial activity by external signals such as temperature, light, pH, or ionic strength and achieving switching between stable emulsions and macro-phase separation; (d) recovery and recycling; (e) controlling the mass transport across the interface between the two phases; and finally (f) tunable several functionalities in one particle allowing their use either as carrier materials for immobilized catalytically active substances or, alternatively, their site-selective attachment to substrates keeping another functionality active for further reactions. All these advantages of JPs make them exclusive materials for application in (bio-)catalysis and (bio-)sensing. Considering “green chemistry” aspects covering biogenic materials based on either natural or fully synthetic biocompatible and biodegradable polymers for the design of JPs may solve the problem of toxicity of some existing materials and open new paths for the development of more environmentally friendly and sustainable materials in the very near future. Considering the number of contributions published each year on the topic of Janus particles in general, the number of contributions regarding their environmentally friendly and sustainable applications is by far smaller. This certainly pinpoints an important challenge and is addressed in this review article. The first part of the review focuses on the synthesis of sustainable biogenic or biocompatible Janus particles, as well as strategies for their recovery, recycling, and reusability. The second part addresses recent advances in applications of biogenic/biocompatible and non-biocompatible JPs in environmental and biotechnological fields such as sensing of hazardous pollutants, water decontamination, and hydrogen production. Finally, we provide implications for the rational design of environmentally friendly and sustainable materials based on Janus particles.
Microbleeds in dementia with Lewy bodies
Authors: Donaghy Paul C. , Firbank Michael , Mitra Dipayan , Petrides George , Lloyd Jim , Barnett Nicola , Olsen Kirsty , Thomas Alan J. , O’Brien John T.
Published: February 2020

Introduction

Microbleeds are associated with the development of dementia in older people and are common in Alzheimer’s disease (AD). Their prevalence and clinical importance in dementia with Lewy bodies (DLB) is unclear. The objective of this study was to compare the rates of microbleeds in DLB with those in AD and healthy older people, and investigate associations between microbleeds and amyloid deposition, vascular risk and disease severity in DLB.

Methods

DLB (n = 30), AD (n = 18) and control (n = 20) participants underwent clinical assessment at baseline and 1 year in this longitudinal observational study. 3T MRI (including T2* susceptibility weighted imaging) and florbetapir PET were carried out at baseline. Microbleeds were rated visually and a standardised uptake value ratio (SUVR) was calculated from florbetapir PET scans.

Results

40% of DLB subjects had microbleeds compared with 50% of AD and 15% of controls. Compared to DLB without microbleeds, those with microbleeds had higher systolic BP (156 ± 26 v. 135 ± 19 mmHg; p = 0.03), but did not have greater levels of vascular disease or amyloid deposition (SUVR 1.25 ± 0.24 v. 1.25 ± 0.22; p = 0.33). There was evidence of less severe dementia in DLB participants with microbleeds, but these differences may have been driven by a shorter disease duration in those with microbleeds.

Conclusion

The presence of microbleeds in DLB is associated with higher blood pressure, but not with other measures of vascular disease or amyloid deposition. The relationship between microbleeds and clinical presentation remains unclear.
The burden of headache following aneurysmal subarachnoid hemorrhage: a prospective single-center cross-sectional analysis
Authors: Huckhagel Torge , Klinger Regine , Schmidt Nils Ole , Regelsberger Jan , Westphal Manfred , Czorlich Patrick
Published: February 2020

Background

Aneurysmal subarachnoid hemorrhage (SAH) as a serious type of stroke is frequently accompanied by a so-called initial thunderclap headache. However, the occurrence of burdensome long-term headache following SAH has never been studied in detail so far. The aim of this study was to determine the prevalence and characteristics of long-term burdensome headache in good-grade SAH patients as well as its relation to health-related quality of life (HR-QOL).

Methods

All SAH cases treated between January 2014 and December 2016 with preserved consciousness at hospital discharge were prospectively interviewed regarding burdensome headache in 2018. Study participants were subsequently scrutinized by means of a standardized postal survey comprising validated pain and HR-QOL questionnaires. A retrospective chart review provided data on the initial treatment.

Results

A total of 93 out of 145 eligible SAH patients participated in the study (62 females). A total of 41% (38/93) of subjects indicated burdensome headache at follow-up (mean 32.6 ± 9.3 months). Comparison between patients with (HA+) and without long-term headache (HA-) revealed significantly younger mean age (47.9 ± 11.8 vs. 55.6 ± 10.3 years; p < .01) as well as more favorable neurological conditions (WFNS I/II: 95% vs. 75%; p = .03) in HA+ cases. The mean average headache of the HA+ group was 3.7 ± 2.3 (10-point numeric rating scale), and the mean maximum headache intensity was 5.7 ± 2.9. Pain and HR-QOL scores demonstrated profound alterations in HA+ compared to HA- patients.

Conclusions

Our results suggest that a considerable proportion of SAH patients suffers from burdensome headache even years after the hemorrhage. Moreover, long-term headache is associated with reduced HR-QOL in these cases.
Hydrogeologie im Tauernfenster – Fallbeispiel Rauristal, Salzburg
Authors: Dirnberger Daniel , Hilberg Sylke
Published: February 2020

Die Fallstudie in einem kleinräumigen Einzugsgebiet im Salzburger Rauristal diente dazu, die Hydrogeologie einiger für das Tauernfenster typischer Lithologien und Strukturen beispielhaft zu beleuchten. Das Untersuchungsgebiet ist geprägt von metamorphen geklüfteten Gesteinen des Penninikums und Subpenninikums (Schiefer und Gneise) und quartären Ablagerungen, wobei hier vor allem ein großer Bergsturz als prägendes Element zu nennen ist. Es wurde eine geologisch-hydrogeologische Kartierung des knapp 10 km2 großen Gebietes auf Seehöhen zwischen 1500 und 2500 m durchgeführt. Im Fokus der Geländearbeiten standen dabei hydrogeologische Aspekte wie Quellen, Vernässungen, Versickerungen oder Oberflächengewässer. Ergänzend wurden an drei Terminen Abflussmessungen am Hauptgerinne und drei seichte Bohrungen in einer Bergsturzmasse durchgeführt, um deren hydraulische Eigenschaften zu erkunden. Es wurden fünf Fließsysteme identifiziert: (1) Schichtquellen sind an den Übergang zwischen Zentralgneis und Schieferhülle gebunden. (2) Stauquellen treten in Verbindung mit Grundmoränen auf. (3) Quellhorizonte innerhalb der Schiefer und Gneise verlaufen entlang regionaler Kluftrichtungen. (4) Diffuse Quellaustritte sind auf oberflächennahe Zirkulationssysteme zurückzuführen. (5) Der Bergsturzkörper stellt einen sehr gut durchlässigen Aquifer dar. Eine Verwitterungsschwarte bildet eine oberflächliche Abdichtung, verbunden mit der Ausbildung zahlreicher kleiner stehender Gewässer.
On fairness of systemic risk measures
Authors: Biagini Francesca , Fouque Jean-Pierre , Frittelli Marco , Meyer-Brandis Thilo
Published: February 2020

In our previous paper “A unified approach to systemic risk measures via acceptance sets” (Mathematical Finance, 2018), we have introduced a general class of systemic risk measures that allow random allocations to individual banks before aggregation of their risks. In the present paper, we prove a dual representation of a particular subclass of such systemic risk measures and the existence and uniqueness of the optimal allocation related to them. We also introduce an associated utility maximisation problem which has the same solution as the minimisation problem associated to the systemic risk measure. In addition, the optimiser in the dual formulation provides a risk allocation which is fair from the point of view of the individual financial institutions. The case with exponential utilities which allows explicit computation is treated in detail.
Trees, Coral, and Seaweed: An Interpretation of Sketches Found in Darwin’s Papers
Authors: van Putten Kees
Published: February 2020

The sole diagram inOn the Origin of Speciesis generally considered to be merely an illustration of Darwin’s ideas, but such an interpretation ignores the fact that Darwin himself expressly stated that the diagram helped him to discover and express his ideas. This article demonstrates that developing the so-called “tree diagram” substantially aided Darwin’s heuristics. This demonstration is based on an interpretation of the diagram and of 17 sketches found in Darwin’s scientific papers. The key to this interpretation is the meaning that Darwin assigned to the graphic elements (points, lines, and spaces) he used to construct the preliminary sketches and the diagram. I argue that each of the sketches contributed to the shaping of Darwin’s ideas and that, in their succession, each added new elements that ultimately resulted in the fully developed published diagram.
Integrating over quiver variety and BPS/CFT correspondence
Authors: Kimura Taro
Published: February 2020

We show the vertex operator formalism for the quiver gauge theory partition function and the qq-character of the highest weight module on quiver, both associated with the integral over the quiver variety.
Impact of a Unit-Based Clinical Pharmacist on Communication of Medication Information in an Orthopedic Hospital
Authors: Guerin Kelly , Quinlan Patricia , Wessolock Robert , Goldberg Stephanie , Nguyen Joseph T. , Stone Patricia W.
Published: February 2020

Background

Medication management, a complex yet essential part of patient care, requires that clinicians and patients understand indication, dosage, frequency, and adverse effects in order to maximize benefits and minimize errors, as well as to transition patients from hospital to home. Clinical pharmacists improve care transitions and safety by interacting with patients, prescribers, and nurses on medication management and self-care. However, little is known on the use of clinical pharmacists on interdisciplinary teams at the unit level within orthopedics.

Questions/Purposes

This study sought to measure the impact of unit-based clinical pharmacists on patient perceptions of communication specific to medication during hospitalization at an orthopedic specialty hospital and on the frequency of medication errors.

Methods

A retrospective, quasi-experimental, two-group evaluative design with nonequivalent controls was used. Consumer Assessment of Healthcare Providers and Systems (HCAHPS) data on six inpatient units was analyzed 6 months before and 6 months after assignment of clinical pharmacists to half these units. Data specific to questions that measure quality of communication as well as medication understanding were analyzed. Additionally, data on medication error frequency were collected and compared between units with and without clinical pharmacists.

Results

A total of 2022 surveys were analyzed. The percentage of patients who reported receipt of medication information and medication understanding increased significantly after the implementation of unit-based clinical pharmacists. Comparison of intervention and non-intervention groups showed no statistically significant difference in the frequency of medication errors.

Conclusion

Results suggest that a clinical pharmacist assigned to an inpatient unit in orthopedics significantly influences patient perceptions of communication about and understanding of their medications.