bluuebunny/crossref_metadata_2025 huggingface dataset:
Withaferin A: a potential therapeutic agent against COVID-19 infection
Authors: Straughn Alex R. , Kakar Sham S.
Published: July 2020

The outbreak and continued spread of the novel coronavirus disease 2019 (COVID-19) is a preeminent global health threat that has resulted in the infection of over 11.5 million people worldwide. In addition, the pandemic has claimed the lives of over 530,000 people worldwide. Age and the presence of underlying comorbid conditions have been found to be key determinants of patient mortality. One such comorbidity is the presence of an oncological malignancy, with cancer patients exhibiting an approximate two-fold increase in mortality rate. Due to a lack of data, no consensus has been reached about the best practices for the diagnosis and treatment of cancer patients. Interestingly, two independent research groups have discovered that Withaferin A (WFA), a steroidal lactone with anti-inflammatory and anti-tumorigenic properties, may bind to the viral spike (S-) protein of SARS-CoV-2. Further, preliminary data from our research group has demonstrated that WFA does not alter expression of ACE2 in the lungs of tumor-bearing female mice. Downregulation of ACE2 has recently been demonstrated to increase the severity of COVID-19. Therefore, WFA demonstrates real potential as a therapeutic agent to treat or prevent the spread of COVID-19 due to the reported interference in viral S-protein to host receptor binding and its lack of effect on ACE2 expression in the lungs.
Nutrition of the COVID-19 patient in the intensive care unit (ICU): a practical guidance
Authors: Thibault Ronan , Seguin Philippe , Tamion Fabienne , Pichard Claude , Singer Pierre
Published: July 2020

Five to 10% of the coronavirus SARS-CoV-2-infected patients, i.e., with new coronavirus disease 2019 (COVID-19), are presenting with an acute respiratory distress syndrome (ARDS) requiring urgent respiratory and hemodynamic support in the intensive care unit (ICU). However, nutrition is an important element of care. The nutritional assessment and the early nutritional care management of COVID-19 patients must be integrated into the overall therapeutic strategy. The international recommendations on nutrition in the ICU should be followed. Some specific issues about the nutrition of the COVID-19 patients in the ICU should be emphasized. We propose a flow chart and ten key issues for optimizing the nutrition management of COVID-19 patients in the ICU.
Assembly of the threespine stickleback Y chromosome reveals convergent signatures of sex chromosome evolution
Authors: Peichel Catherine L. , McCann Shaugnessy R. , Ross Joseph A. , Naftaly Alice F. S. , Urton James R. , Cech Jennifer N. , Grimwood Jane , Schmutz Jeremy , Myers Richard M. , Kingsley David M. , White Michael A.
Published: July 2020

Background

Heteromorphic sex chromosomes have evolved repeatedly across diverse species. Suppression of recombination between X and Y chromosomes leads to degeneration of the Y chromosome. The progression of degeneration is not well understood, as complete sequence assemblies of heteromorphic Y chromosomes have only been generated across a handful of taxa with highly degenerate sex chromosomes. Here, we describe the assembly of the threespine stickleback (Gasterosteus aculeatus) Y chromosome, which is less than 26 million years old and at an intermediate stage of degeneration. Our previous work identified that the non-recombining region between the X and the Y spans approximately 17.5 Mb on the X chromosome.

Results

We combine long-read sequencing with a Hi-C-based proximity guided assembly to generate a 15.87 Mb assembly of the Y chromosome. Our assembly is concordant with cytogenetic maps and Sanger sequences of over 90 Y chromosome BAC clones. We find three evolutionary strata on the Y chromosome, consistent with the three inversions identified by our previous cytogenetic analyses. The threespine stickleback Y shows convergence with more degenerate sex chromosomes in the retention of haploinsufficient genes and the accumulation of genes with testis-biased expression, many of which are recent duplicates. However, we find no evidence for large amplicons identified in other sex chromosome systems. We also report an excellent candidate for the master sex-determination gene: a translocated copy of Amh (Amhy).

Conclusions

Together, our work shows that the evolutionary forces shaping sex chromosomes can cause relatively rapid changes in the overall genetic architecture of Y chromosomes.
Correction to: Evaluating the effects of the novel GLP-1 analogue liraglutide in Alzheimer’s disease: study protocol for a randomised controlled trial (ELAD study)
Authors: Femminella Grazia Daniela , Frangou Eleni , Love Sharon B. , Busza Gail , Holmes Clive , Ritchie Craig , Lawrence Robert , McFarlane Brady , Tadros George , Ridha Basil H. , Bannister Carol , Walker Zuzana , Archer Hilary , Coulthard Elizabeth , Underwood Ben R. , Prasanna Aparna , Koranteng Paul , Karim Salman , Junaid Kehinde , McGuinness Bernadette , Nilforooshan Ramin , Macharouthu Ajay , Donaldson Andrew , Thacker Simon , Russell Gregor , Malik Naghma , Mate Vandana , Knight Lucy , Kshemendran Sajeev , Harrison John , Hölscher Christian , Brooks David J. , Passmore Anthony Peter , Ballard Clive , Edison Paul
Published: July 2020

An amendment to this paper has been published and can be accessed via the original article.
Unusual fetal ascites and spontaneous bladder rupture in a female fetus: a case report
Authors: Cadoret Florence , Brazet Edith , Sartor Agnès , Lacroix Isabelle , Casper Charlotte , Decramer Stéphane , Parant Olivier
Published: July 2020

Background

Fetal bladder rupture causing urinary ascites is uncommon. It is generally related to invasive fetal medicine procedures or obstructive disorders such as in posterior urethral valves in male fetuses. An exceptional case of spontaneous bladder rupture in a female fetus occurred in a pregnant woman treated with high doses of opiates in an intensive care unit. This unusual obstetric situation leads to discussion of the possible causes of fetal bladder rupture, its management, and the pediatric prognosis.

Case presentation

We report the case of a 30-year-old nulliparous black woman with a history of mesenteric cystic lymphangioma and multiple bowel resections leading to chronic malabsorption. During her pregnancy, our patient presented with an occlusive syndrome and major bilateral renal dilation. Urinary derivation resulted in iatrogenic bilateral ureteral perforation. Our patient thus presented with major uroperitoneum, bilateral pleural effusion and acute renal failure, treated by thoracic drainage and bilateral nephrostomy. Postoperative pain required treatment with level III analgesics. In this context, 5 days after morphine treatment introduction an enlarged fetal bladder was observed, followed 3 days later by voluminous fetal ascites. The diagnosis of spontaneous bladder rupture was suspected. After multidisciplinary discussion, expectant management was decided. At 31 weeks and 4 days gestation, our patient went into spontaneous labor with a subsequent vaginal delivery. The infant required resuscitation and paracentesis of ascites at birth. Her neonatal course was favorable with a simple urethral bladder drainage. Cystography at day 9 was normal. At 2 years of follow-up, the mother and the child have a normal course.

Conclusions

An iatrogenic origin of megacystis in a female fetus must be evoked in the event of maternal administration of high doses of opiates in the second part of her pregnancy. In our case, the megacystis was followed by spontaneous bladder rupture at 30 weeks of gestation, with a favorable maternal fetal issue.
Late-onset ovarian hyperstimulation syndrome developing during ovarian stimulation in an ectopic pregnancy: a case report
Authors: Huang Haipeng , Takai Yasushi , Samejima Kouki , Narita Tatsuya , Ichinose Shunichiro , Itaya Yukiko , Ono Yoshihisa , Matsunaga Shigetaka , Saitoh Masahiro , Baba Kazunori , Hayashi Naoki , Seki Hiroyuki
Published: July 2020

Background

Ovarian hyperstimulation syndrome is normally induced by ovarian stimulation drugs. Severe cases of ovarian hyperstimulation syndrome involve complications such as renal failure and thrombosis. Evidence has recently been developed for a method to prevent ovarian hyperstimulation syndrome. Most cases of ovarian hyperstimulation syndrome are of an early-onset type, which occurs shortly after injection of human chorionic gonadotropin. However, late-onset ovarian hyperstimulation syndrome, which occurs in a pregnancy cycle, also requires caution. We report our experience in treating a woman who was transported to our hospital with a severe case of ovarian hyperstimulation syndrome occurring during ovarian stimulation and who was determined to have an ectopic pregnancy.

Case presentation

Assisted reproductive technology was planned for a 29-year-old nulligravida Japanese woman diagnosed with bilateral fallopian tube obstruction and right-sided hydrosalpinx. On day 1 of controlled ovarian stimulation, the result of her human chorionic gonadotropin urine test was negative, and her serum levels of luteinizing hormone, estradiol, and progesterone were normal. On day 11 of controlled ovarian stimulation, the levels of estradiol and progesterone had risen to 9679 pg/ml and 16 ng/ml, respectively, prompting suspension of controlled ovarian stimulation. Eleven days after controlled ovarian stimulation was suspended, the patient demonstrated ascites that did not improve despite administration of cabergoline, and she was transported to our hospital 2 days after. Late-onset ovarian hyperstimulation syndrome suggested that she was pregnant, and her serum human chorionic gonadotropin level was 27,778 IU/ml. She underwent laparoscopic bilateral salpingectomy and was diagnosed with right tubal pregnancy.

Conclusion

In an ectopic pregnancy, human chorionic gonadotropin sometimes increases later than in an intrauterine pregnancy. In our patient’s case, endogenous human chorionic gonadotropin following the start of controlled ovarian stimulation may have caused late-onset ovarian hyperstimulation syndrome. The key to early detection of similar cases may be to suspect pregnancy in the event of unexpectedly high progesterone levels during ovarian stimulation.
Ex vivo cultivated oral mucosal epithelial cell transplantation for limbal stem cell deficiency: a review
Authors: Cabral Joao Victor , Jackson Catherine Joan , Utheim Tor Paaske , Jirsova Katerina
Published: July 2020

Destruction or dysfunction of limbal epithelial stem cells (LESCs) leads to unilateral or bilateral limbal stem cell deficiency (LSCD). Fifteen years have passed since the first transplantation of ex vivo cultivated oral mucosal epithelial cells (COMET) in humans in 2004, which represents the first use of a cultured non-limbal autologous cell type to treat bilateral LSCD. This review summarizes clinical outcomes from COMET studies published from 2004 to 2019 and reviews results with emphasis on the culture methods by which grafted cell sheets were prepared.
Probucol enhances the therapeutic efficiency of mesenchymal stem cells in the treatment of erectile dysfunction in diabetic rats by prolonging their survival time via Nrf2 pathway
Authors: Wang Haoran , Zhang Keqin , Ruan Zheng , Sun Dingqi , Zhang Hui , Lin Guiting , Hu Liangliang , Zhao Shengtian , Fu Qiang
Published: July 2020

Background

Intracavernous injection of mesenchymal stem cells (MSCs) is a promising method for diabetic mellitus-induced erectile dysfunction (DMED), but short survival time of MSCs in cavernous is a fatal defect for therapy. This study investigated therapeutic efficiency and potential mechanism of probucol combined with MSCs.

Methods

In vivo study, a total of forty-eight 10-week-old male Sprague-Dawley (SD) rats were used. Twelve rats received intraperitoneal injection of PBS as the sham group; the rest received intraperitoneal injection of 60 mg/kg streptozotocin to establish DM models. DM rats were randomly divided into three groups: received intracavernosal (IC) injection of either PBS (DM group), MSCs (M group), or administrated probucol after intracavernosal injection of MSCs (P + M group). Erectile function was assessed by electrical stimulation of the cavernous nerves with real-time intracavernous pressure measurement. After euthanasia, penile tissue was investigated for histologic examination and Western blotting. In in vitro experiment, H2O2 was used to create oxidative stress environment to detect changes in cell viability. CCK8 was used to measure cell viability of MSCs treated with or without probucol. Intracellular ROS changes were detected by flow cytometry. Autophagy and apoptosis were detected by Western blotting and confocal microscopy.

Results

Recovery of erectile function was observed in the P + M group. The combination therapy decreased fibrosis and increased endothelial function compared with MSC therapy alone. Western blotting results confirmed the increased expression of Nrf2 and HO-1 in cavernous body. H2O2 induced high oxidative stress and reduced cell viability in vitro, which was gradually reversed with increased concentration of probucol. H2O2 reduced Nrf2 expression, which was reversed by probucol’s intervention. Furthermore, the expression of Bax, Caspase3, and Cleaved-Caspase3 decreased, and the expression of Bcl-2 increased in a dose-dependent manner because of probucol’s intervention. In addition, Beclin1 and LC3II both increased in a dose-dependent manner. Meanwhile, the expression of P62 decreased. In the study of autophagy flux, we found probucol did not block it.

Conclusion

Probucol enhanced therapeutic efficiency of MSCs in DMED by prolonging their survival time, which mediated through improving the transplanted microenvironment of MSCs, increasing self-antioxidant ability of MSCs, strengthening protective autophagy, and inhibiting apoptosis of MSCs via Nrf2 pathway.

Graphical abstract

Schematic model showing combined probucol and MSCs to improve DMED. Probucol increases self-antioxidant ability of MSCs, strengthening protective autophagy and inhibiting apoptosis via Nrf2/HO-1 and Nrf2/autophagy pathways.
Gender differences of morphological and hemodynamic characteristics of abdominal aortic aneurysm
Authors: Gao Zujie , Xiong Jiang , Chen Zengsheng , Deng Xiaoyan , Xu Zaipin , Sun Anqiang , Fan Yubo
Published: July 2020

Background

Gender difference in cardiovascular diseases (CVDs) is an important topic in the field of cardiovascular medicine. In this study, we focused on the mortality difference of abdominal aortic aneurysms (AAA), which is higher for female than that of male. The aim of this study was to verify whether morphological and hemodynamic factors play their roles in this phenomenon.

Methods

Patient-specific AAA models of 11 females and 23 males with similar age and body mass index (BMI) have been reconstructed based on clinical computed tomography (CT) data. Firstly, the morphological parameters (diameters, curvature, intraluminal thrombus volume, etc.) of AAA models and lumbar vertebrae models were collected and analyzed. Then, based on statistical results of morphological parameters, uniformed male and female AAA models were reconstructed, and hemodynamic simulations were conducted respectively. In post-processing, the hemodynamic performances induced by gender-different morphological geometries were analyzed and compared.

Results

The comparison of morphological parameters revealed that the average curvature of lumbar vertebrae and AAA centerline of female AAA models were obviously higher than that of the male. The amount of intraluminal thrombus in female AAA models was relatively lower than that of the male. According to the hemodynamic simulation, the uniform female AAA model has higher peak pressure, lower oscillatory shear stress index (OSI), and lower relative residence time (RRT) than that of the male model, all of which put female AAA to a relatively higher risk hemodynamic situation.

Conclusions

The morphological and hemodynamic features of AAA have very obvious gender differences that would induce higher risk of rupture for female AAA biomechanically. These findings would help to explore the mechanism of gender differences in AAA and draw attention to gender-specific consideration for AAA treatment. More morphological and hemodynamic indictors are suggested to be involved in the future guidelines.
Tomographic assessment of palatal suture opening pattern and pterygopalatine suture disarticulation in the axial plane after midfacial skeletal expansion
Authors: Colak Ozge , Paredes Ney Alberto , Elkenawy Islam , Torres Martha , Bui Joseph , Jahangiri Sara , Moon Won
Published: July 2020

Objective

The purpose of this study was to assess the palatal suture opening and the pterygopalatine suture disarticulation pattern in the tomographic axial plane after treatment with midfacial skeletal expander (MSE).

Materials and methods

Pre- and post-expansion CBCT records of 50 subjects (20 males, 30 females, mean age 18 ± 3 years) who were treated with MSE (Biomaterials Korea, Seoul, Korea) appliance were superimposed and compared using OnDemand software. Reference planes were identified and the angulation of the midpalatal suture opening after expansion was calculated as well as the frequency of the pterygopalatine suture split.

Results

After MSE treatment, the mean palatal suture opening angle (SOA) was 0.57°. (− 0.8° to 1.3°). There was no significant difference between males and females in terms of the palatal suture opening pattern (P > 0.05). Only 3 out of 50 (6%) subjects presented SOA above 1 degree. Also, 3 out of 50 (6%) patients presented a negative SOA value. With regard to the pterygopalatine suture split, 84 sutures out of 100 (84%) presented openings between the medial and lateral pterygoid plates on both right and left sides. Partial split was detected with 8 patients (5 females, 3 males). Five patients had split only in the medial pterygoid plates of both pterygomaxillary sutures, and 3 patients exhibited disarticulation on the right side only. No significant differences were found in the frequency of suture opening between males and females (P = 1.000).

Conclusions

MSE appliance performed almost parallel expansion in the axial view. Remarkably, this study shows that pterygopalatine suture can be split by MSE appliance without the surgical intervention; the disarticulation of pterygopalatine suture was visible in most of the patients.
Home-based management of knee osteoarthritis during COVID-19 pandemic: literature review and evidence-based recommendations
Authors: Karasavvidis Theofilos , Hirschmann Michael T. , Kort Nanne P. , Terzidis Ioannis , Totlis Trifon
Published: July 2020

Purpose

To provide evidence-based recommendations for patients with severe knee osteoarthritis (OA), who had their knee surgery postponed due to the COVID-19 pandemic.

Methods

PubMed/Medline, Scopus and Cochrane Central databases were systematically reviewed for studies reporting outcomes of home-based treatments for knee OA. Due to between-study differences in treatment strategy and reporting methods the results were not pooled and findings of the current review were presented in a narrative manner.

Results

The comprehensive literature search yielded 33 eligible studies that were included in this review. Management is performed at home and consists of exercise, proper nutrition, physical therapy and use of corrective and assistive orthotics. Virtual education on self-management strategies should be part of coping with knee OA. Initiating an exercise programme involving gymnastics, stretching, home cycling and muscle strengthening is highly recommended. Obese patients are encouraged to set weight loss goals and adopt a healthy diet. Potential benefits but weak evidence has been shown for the use of knee braces, sleeves, foot orthotics or cushioned footwear. Walking aids may be prescribed, when considered necessary, along with the provision of instructions for their use.

Conclusion

When bridging the time to rescheduled surgery, it is essential to use appropriate home-based tools for the management of knee OA if pain is to be reduced and need for analgesics or opioid use is to be diminished while maintaining or even improving the functioning and avoiding further limitation of range of motion and subsequent muscular atrophies. Finally, none of these treatments may completely substitute for the life-changing effect of a total knee arthroplasty in patients with severe knee OA. Hence, the subsequent goal is to gradually and safely reinstate elective surgery.
A comparison of flight energetics and kinematics of migratory Brambling and residential Eurasian Tree Sparrow
Authors: Wang Yang , Yin Yuan , Ren Zhipeng , Jiang Chuan , Sun Yanfeng , Li Juyong , Nabi Ghulam , Wu Yuefeng , Li Dongming
Published: July 2020

Background

Unlike resident birds, migratory birds are generally believed to have evolved to enhance flight efficiency; however, direct evidence is still scarce due to the difficulty of measuring the flight speed and mechanical power.

Methods

We studied the differences in morphology, flight kinematics, and energy cost between two passerines with comparable size, a migrant (Fringilla montifringilla, Brambling, BRAM), and a resident (Passer montanus, Eurasian Tree Sparrow, TRSP).

Results

The BRAM had longer wings, higher aspect ratio, lower wingbeat frequency, and stroke amplitude compared to the TRSP despite the two species had a comparable body mass. The BRAM had a significantly lower maximum speed, lower power at any specific speed, and thus lower flight energy cost in relative to the TRSP although the two species had a comparable maximum vertical speed and acceleration.

Conclusions

Our results suggest that adaptation for migration may have led to reduced power output and maximum speed to increase energy efficiency for migratory flight while residents increase flight speed and speed range adapting to diverse habitats.
Effects of firewood harvesting intensity on biodiversity and ecosystem services in shrublands of northern Patagonia
Authors: Goldenberg Matías G. , Oddi Facundo J. , Gowda Juan H. , Garibaldi Lucas A.
Published: July 2020

Background

Forest management has historically focused on provisioning of goods (e.g. timber, biomass), but there is an increasing interest to manage forests also to maintain biodiversity and to provide other ecosystem services (ES).

Methods

We evaluated the effects of firewood harvesting intensity on biodiversity and different ES in three contrasting shrubland sites in northern Patagonia (Argentina). At each site, four harvesting treatments, representing various levels of harvest intensity, were randomly assigned to eight permanent sample plots of 31.5 m × 45 m during 2013–2014.

Results

We found that the effects of increasing harvesting intensity on plant diversity changed from negative to positive (and from nonlinear to more linear responses) with increasing site productivity. Harvesting intensity showed contrasting effects on variables related to fire protection ecosystem service, since it reduced fuel amount (potentially reducing fire spread) but also reduced live fuel moisture content (potentially increasing flammability) at the three sites. Two variables related to soil formation and protection ES, leaf litter cover and aerial soil cover, decreased with harvesting intensity at the three sites.

Conclusions

We conclude that shrubland management for firewood production may enhance biodiversity without compromising certain important ES. The intensity of harvesting should be determined according to site conditions and forecasted impacts on biodiversity, fire and soil formation and protection.
The architecture of national boundary regimes: mapping immigration and citizenship policies in 23 democracies 1980–2010
Authors: Schmid Samuel D.
Published: July 2020

In this article, I introduce a typology that maps the regulation of two fundamental boundaries of modern nation-states regarding immigration: territorial boundaries and membership boundaries. Based on a theory of the structural logics underlying Immigration Regime Openness (IRO) and Citizenship Regime Inclusiveness (CRI), I make four observations on the two-dimensional policy space determined by the relative porousness of these two boundaries. First, a Categorical Principal Component Analysis (CATPCA) using a combination of original and existing panel data across 23 liberal democracies from 1980 to 2010 confirms that IRO and CRI are internally consistent and statistically distinct dimensions. Immigration policies therefore appear more coherent than often assumed. Second, the distribution of cases over the four ideal-typical policy configurations from 1980 to 2010 shows that more and more cases combine relatively liberal immigration policies with relatively liberal citizenship policies. Behind this finding are, third, overall liberalizing trajectories in both policies as well as a pattern of convergence in immigration policies. The liberalisation of immigration policies is most notable until 1996 and the level of openness fluctuates thereafter. Regarding citizenship, I provide evidence for a much-cited restrictive turn during the 2000s. In addition, I show that there has already been a restrictive turn in citizenship during the 1990s. Fourth, instead of the trade-off anticipated by much of the literature, I find an increasingly positive correlation between IRO and CRI. The new typology, its underlying theory, and the subsequent findings significantly advance our understanding of the most fundamental boundaries of modern nation-states.
The impact of patient involvement in research: a case study of the planning, conduct and dissemination of a clinical, controlled trial
Authors: Skovlund Pernille Christiansen , Nielsen Berit Kjærside , Thaysen Henriette Vind , Schmidt Henrik , Finset Arnstein , Hansen Kristian Ahm , Lomborg Kirsten
Published: July 2020

Background

The interest in patient and public involvement (PPI) in health research is increasing. However, the experience and knowledge of PPI throughout the entire research process and especially in the analysis are limited. We explored ways to embrace the perspectives of patients in a research process, and the impact and challenges our collaboration has had on patients, researchers, and the research outcomes.

Methods

This is an explorative single case study of a Danish, clinical, controlled intervention trial and a nested intervention fidelity study included herein. Five patient representatives with metastatic melanoma were part of designing, undertaking and disseminating the trial where the effect of using patient-reported outcome (PRO)-measures as a dialogue tool in the patient-physician consultation was tested. In the fidelity study, audio-recorded consultations were analyzed after training in the Verona Coding Definitions of Emotional Sequences (VR-CoDES). Results were jointly disseminated at an international scientific conference. The outcomes, impact, and challenges were explored through a workshop.

Results

In the design phase, we selected PRO-measures and validated the dialogue tool. The information sheet was adjusted according to the patients’ suggestions. The analysis of the fidelity study showed that patients and researchers had a high consensus on the coding of emotional cues and concerns. The patients contributed with a new vocabulary and perspective on the dialogue, and they validated the results. PPI caused considerations related to emotional (sadness/sorrow and existential thoughts), administrative (e.g. arranging meetings, balancing work and small talk) and intellectual (e.g. avoiding information harm, continuing activities despite the death of patients) investments. A limitation of the study was the lack of use of a solid evaluation tool to determine the impact of PPI.

Conclusion

PPI throughout the process and co-creation in the analysis was feasible and beneficial. The case is unique in the degree of workable details, sustainability, and transparency. Moreover, the co-creation provides ideas of ways to operationalize PPI. An evaluation workshop revealed considerations about emotional, administrative and intellectual investments – best described as tacit, yet important ‘work’. This knowledge and experience can be applied to other studies where patients are partners in the research.

Trial registration

ClinicalTrials.gov ID: NCT03163433, registration date: 8th May 2017.
Line blot immunoassays in idiopathic inflammatory myopathies: retrospective review of diagnostic accuracy and factors predicting true positive results
Authors: To Fergus , Ventín-Rodríguez Clara , Elkhalifa Shuayb , Lilleker James B. , Chinoy Hector
Published: July 2020

Background

Line blot immunoassays (LIA) for myositis-specific (MSA) and myositis-associated (MAA) autoantibodies have become commercially available. In the largest study of this kind, we evaluated the clinical performance of a widely used LIA for MSAs and MAAs.

Methods

Adults tested for MSA/MAA by LIA at a tertiary myositis centre (January 2016–July 2018) were identified. According to expert-defined diagnoses, true and false positive rates were calculated for strongly and weakly positive autoantibody results within three cohorts: idiopathic inflammatory myopathy (IIM), connective tissue disease (CTD) without myositis, and non-CTD/IIM. Factors associated with true positivity were determined.

Results

We analysed 342 cases. 67 (19.6%) had IIM, in whom 71 autoantibodies were detected (50 strong positives [70.4%], 21 weak positives [29.6%]). Of the strong positives, 48/50 (96.0%; 19 MSAs, 29 MAAs) were deemed true positives. Of the weak positives, 15/21 (71.4%; 3 MSAs, 12 MAAs) were deemed true positives.

In CTD without myositis cases (n = 120), 31/61 (51.0%; 5 MSAs, 26 MAAs) autoantibodies were strongly positive, with 24/31 (77.4%; 0 MSAs, 24 MAAs) true positives. 30/61 (49.2%; 13 MSAs, 17 MAAs) were weakly positive, with 16/30 (53.3%; 0 MSAs, 16 MAAs) true positives. In non-CTD/IIM cases (n = 155), all 24 MSAs and 22 MAAs were false positives; these results included 17 (37.0%; 7 MSAs, 10 MAAs) strong positives.

Individual autoantibody specificities were > 98.2 and > 97.5% for weakly and strongly positive results, respectively. True positivity was associated with high pre-test for IIM (odds ratio 50.8, 95% CI 13.7–189.2, p < 0.001) and strong positive (versus weak positive) results (4.4, 2.3–8.3, p < 0.001).

Conclusions

We demonstrated the high specificity of a myositis LIA in a clinical setting. However, a significant burden of false positive results was evident in those with a low pre-test likelihood of IIM and for weakly positive autoantibodies.
Left omental artery bleeding in two patients with segmental arterial mediolysis successfully isolated with coil embolization
Authors: Nishiyama Tomoya , Yamada Daisuke , Oba Ken , Kurihara Yasuyuki
Published: July 2020

Background

Segmental arterial mediolysis (SAM) is a rare, nonatherosclerotic, noninflammatory arteriopathy of unknown etiology, rarely involving omental artery (OA). No case reports have described left OA bleeding successfully treated with transarterial embolization (TAE) with coils. This report describes two cases of SAM-affected left OA bleeding successfully embolized using isolation technique with coils, recognizing the potential for the greater omentum to have arterial collateral network between OAs.

Case presentation

Case 1.

A 55-year-old male with no significant past medical history presented with an acute abdomen. Contrast-enhanced computed tomography (CT) revealed possible hemorrhagic ascites involving the left portion of the greater omentum and dilated, stenotic change of the left OA with a possible hematoma. SAM-associated left OA bleeding was suspected. Given its acute-angled branching from a splenic artery or branch and long, tortuous catheter-trajectory, we used a triaxial catheter system. Left OA angiography revealed the proximal dilated, stenotic change and a distal pseudoaneurysm. Isolation was successfully performed with coils. Because he had no abdominal pain or progressive anemia, he was discharged on hospital day 5. Neither recurrence nor new SAM-associated findings were observed during two-years of follow-up.

Case 2.

A 60-year-old-man with no significant past medical history presented with an acute abdomen. CT revealed similar finding as Case 1. SAM-associated left OA bleeding was suspected. Left OA angiography revealed proximal dilated, stenotic change with distal occlusion. Despite having no signs of active bleeding, review of the CT and angiography findings suggested the left OA as the bleeding site. Given proximal embolization at this point could lead to incomplete hemostasis or rebleeding via the arterial collateral network between OAs, an attempt was made to navigate the microcatheter into the distal side beyond the occlusion. Distal left OA angiography confirmed that the distal OA over the occlusion was intact and directly communicated with a right OA arising from right gastroepiploic artery. The SAM-associated lesion was successfully isolated with coils. Because he had no abdominal pain or progressive anemia, he was transported to another hospital on hospital day 3. Neither recurrence nor new SAM-associated findings were observed during two-years follow-up.

Conclusion

SAM can involve left OA and be controlled using an isolation technique with coils.
Projection-domain iteration to estimate unreliable measurements
Authors: Zeng Gengsheng L.
Published: July 2020

Due to the beam-hardening effect of the broad energy spectrum of the X-ray source in computed tomography, the reconstructed images usually suffer from severe artifacts when metallic objects are being imaged. Metal artifact correction methods are usually sophisticated and not practical, especially in some non-medical applications, in which the linear attenuation coefficients are unknown. This paper suggests a simple and effective algorithm to estimate the unreliable measurements. The proposed algorithm is an iterative algorithm, in which the iteration is performed in the projection domain, while the objective function is set up in the image domain. The final image is reconstructed with the conventional filtered backprojection algorithm. The feasibility of the proposed method is verified with airport bags that contain some unknown metals.
Detection and genomic characterization of hepatitis E virus genotype 3 from pigs in Ghana, Africa
Authors: El-Duah Philip , Dei Dickson , Binger Tabea , Sylverken Augustina , Wollny Robert , Tasiame William , Oppong Samuel , Adu-Sarkodie Yaw , Emikpe Benjamin , Folitse Raphael , Drexler Jan Felix , Phillips Richard , Drosten Christian , Corman Victor Max
Published: July 2020

Background

Hepatitis E virus (HEV) is a major cause of human hepatitis worldwide. Zoonotic genotypes of the virus have been found in diverse animal species with pigs playing a major role. Putative risk of zoonotic infection from livestock particularly swine in Sub-Saharan Africa including Ghana is poorly understood due to scarcity of available data, especially HEV sequence information.

Methods

Serum samples were collected from cattle, sheep, goats and pigs from Kumasi in the Ashanti region of Ghana. Samples were subjected to nested RT-PCR screening and quantification of HEV RNA-positive samples using real-time RT-PCR and the World Health Organization International Standard for HEV. Testing of all pig samples for antibodies was done by ELISA. Sanger sequencing and genotyping was performed and one representative complete genome was generated to facilitate genome-wide comparison to other available African HEV sequences by phylogenetic analysis.

Results

A total of 420 samples were available from cattle (n = 105), goats (n = 124), pigs (n = 89) and sheep (n = 102). HEV Viral RNA was detected only in pig samples (10.1%). The antibody detection rate in pigs was 77.5%, with positive samples from all sampling sites. Average viral load was 1 × 105 (range 1.02 × 103 to 3.17 × 105) International Units per mL of serum with no statistically significant differences between age groups (≤ 6 month, > 6 months) by a T-test comparison of means (t = 1.4272, df = 7, p = 0.1966). Sequences obtained in this study form a monophyletic group within HEV genotype 3. Sequences from Cameroon, Ghana, Burkina Faso and Madagascar were found to share a most recent common ancestor; however this was not the case for other African HEV sequences.

Conclusion

HEV genotype 3 is highly endemic in pigs in Ghana and likely poses a zoonotic risk to people exposed to pigs. HEV genotype 3 in Ghana shares a common origin with other virus strains from Sub-Saharan Africa.
Psychiatric problems and its contributing factors in children and adolescents with hemophilia: a single centre study in a Turkish sample
Authors: Cikili-Uytun Merve , Çetin Fatih Hilmi , Yılmaz Rabia , Uytun Salih , Babadağı Zehra , Karadogan Meriban , Mutlu Fatma Turkan , Altuner-Torun Yasemin
Published: July 2020

Background

We aimed to evaluate the psychiatric symptoms in addition quality of life in children and adolescents with hemophilia and to determine which factors contributed to psychiatric problems of them.

A total of 20 children and adolescents with hemophilia A or B and 20 healthy controls, aged 6–16 years old, were included. Kiddie-Schedule for Affective Disorders and Schizophrenia, present and life time version (K-SADS-PL) was applied to parents. Sociodemographic questionnaire, Child Depression Inventory (CDI), The Spielberger State-Trait Anxiety Inventory (STAI), and KINDLR Questionnaire was used for children and adolescents in both groups. Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and KINDL parent form were used for mothers in both groups.

Results

The study results demonstrated higher anxiety scores and increased anxiety disorder diagnosis among children and adolescents with hemophilia. However, mother’s anxiety and depression scores are higher than control group, and QoL of their children also shows lower scores in parents’ KINDL forms. Mothers’ depression and anxiety scores are associated with childrens’ depression, anxiety, and QoL scores.

Conclusion

Psychiatric factors should not be ignored in the treatment and follow-up of children and adolescents with hemophilia and their parents.
Airway Pressure Release Ventilation Combined With Prone Positioning in Acute Respiratory Distress Syndrome: Old Tricks New Synergy: A Case Series
Authors: Lee Si Jia , Lee Yilin , Kong Andrew , Ng Shin Yi
Published: July 2020

Airway pressure release ventilation (APRV) shares several overlapping mechanisms with prone positioning in improving ventilation-perfusion mismatch in patients with acute respiratory distress syndrome (ARDS). However, the combination of APRV and prone positioning is seldom performed because assist/controlled ventilation remains the mainstay ventilatory mode. We describe 5 cases of severe ARDS where APRV and prone positioning were applied. All patients’ partial pressure of arterial oxygen (Pao
2):inspired oxygen concentration (Fio
2) ratios improved after treatment, and 3 patients were extubated within 72 hours of turning supine. In our experience, APRV can be safely used in the prone position in a select subgroup of ARDS patients with resulting significant oxygenation improvement.
Going beyond conventional parameters to unveil sperm quality in fish: the use of fibre optic technology to assess mitochondrial respiratory performance
Authors: Locatello Lisa , Rigoni Giovanni , Soriano Maria E. , Rasotto Maria B. , Poli Federica
Published: July 2020

Sperm fertilisation success depends on both intrinsic quality and the interactions with the surrounding reproductive fluids. In several fish species these interactions have a variable effect on sperm performance. Although specific responses to reproductive fluids may depend on intrinsic differences in sperm quality, variations in the traditionally recorded sperm functional traits do not fully account for the observed patterns. New methods to enhance the evaluation of sperm quality may result valuable at both applied and theoretical levels, by improving the breeding protocol of reared species and the understanding of mating success in sperm competition contexts. Here we develop a fibre optic-based technique, adequate also for small ejaculate samples, to test the role of mitochondrial respiratory efficiency in deciphering sperm performance variability. We purposely used as model the grass goby, Zosterisessor ophiocephalus, a fish with guard-sneaker mating tactics, in which, although sperm of the two male tactics have similar intrinsic quality (velocity, viability, ATP content), sneakers’ sperm better exploit territorials’ seminal fluid. We found that sperm differed in their mitochondrial respiratory efficiency, which was higher in sneakers’ sperm compare to territorials’ ones. This result draws the attention to an indicator of sperm quality that might be helpful in disentangling the mechanisms driving sperm-reproductive fluid interactions.
Accuracy of Exercise-based Equations for Estimating Cardiorespiratory Fitness
Authors: PETERMAN JAMES E. , HARBER MATTHEW P. , IMBODEN MARY T. , WHALEY MITCHELL H. , FLEENOR BRADLEY S. , MYERS JONATHAN , ARENA ROSS , KAMINSKY LEONARD A.
Published: July 2020

Equations are often used to predict cardiorespiratory fitness (CRF) from submaximal or maximal exercise tests. However, no study has comprehensively compared these exercise-based equations with directly measured CRF using data from a single, large cohort.

Purpose

This study aimed to compare the accuracy of exercise-based prediction equations with directly measured CRF and evaluate their ability to classify an individual’s CRF.

Methods

The sample included 4871 tests from apparently healthy adults (38% female, age 44.4 ± 12.3 yr (mean ± SD)). Estimated CRF (eCRF) was determined from 2 nonexercise equations, 3 submaximal exercise equations, and 10 maximal exercise equations; all eCRF calculations were then compared with directly measured CRF, determined from a cardiopulmonary exercise test. Analysis included Pearson product–moment correlations, standard error of estimate values, intraclass correlation coefficients, Cohen κ coefficients, and the Benjamini–Hochberg procedure to compare eCRF with directly measured CRF.

Results

All eCRF values from the prediction equations were associated with directly measured CRF (P < 0.01), with intraclass correlation coefficient estimates ranging from 0.07 to 0.89. Although significant agreement was found when using eCRF to categorize participants into fitness tertiles, submaximal exercise equations correctly classified an average of only 51% (range, 37%–58%) and maximal exercise equations correctly classified an average of only 59% (range, 43%–76%).

Conclusions

Despite significant associations between exercise-based prediction equations and directly measured CRF, the equations had a low degree of accuracy in categorizing participants into fitness tertiles, a key requirement when stratifying risk within a clinical setting. The present analysis highlights the limited accuracy of exercise-based determinations of eCRF and suggests the need to include cardiopulmonary measures with maximal exercise to accurately assess CRF within a clinical setting.
Nonconventional concept for continuous reproduction of target movement
Authors: Martirosyan A. E. , Kostanyan R. B. , Muzhikyan P. H. , Azizbekyan H. H.
Published: July 2020

We demonstrate a novel concept, to the best of our knowledge, for reproduction of the target movement without the frame-by-frame display technique elaborated by the Lumiere brothers. The specially designed elements—apodizing filters with axially quadratic transmittance of radiation, are used to continually record a target position change in time. The recording system deals with nonmatrix detectors and requires only one-step conversion of light energy into an electrical signal to monitor the target under study. The concept makes it possible to develop new techniques for night vision in the near-infrared and thermal spectra. The path and speed of a bouncing and receding ball in the computer screen animation are recorded and reproduced in 3D.
Multipoint stable radio frequency long distance transmission over fiber based on tree topology, with user fairness and deployment flexibility
Authors: Hu Chen , Luo Bin , Pan Wei , Yan Lianshan , Zou Xihua
Published: July 2020

In this paper, we propose a multipoint stable radio frequency (RF) optical transmission system with tree structure. Based on the principle of phase conjugation, the phase jitter induced by environment variation can be compensated by frequency mixing. Different from other schemes, the RF signal is modulated on a optical comb at local and each tooth is grouped with a near subcarrier for a user. By using wavelength division multiplexer, these groups are separated and transmitted to the multiple points over fiber. Therefore, the degradation of compensation performance caused by the wavelength difference between the common main carrier and farther subcarrier can be avoided, and the accumulated power loss induced by the branch points will be significantly reduced. In addition, an acousto-optic modulator is used at the local station to depress the impact of Rayleigh scattering. Experimentally, we demonstrate 2.4 GHz RF signal transmission to the two users over 25 and 100 km fiber during 1 × 104 seconds, and the phase jitter mean square errors are 2.50 × 10−2 and 4.27 × 10−2 rad, respectively.
On the interplay between physical and content priors in deep learning for computational imaging
Authors: Deng Mo , Li Shuai , Zhang Zhengyun , Kang Iksung , Fang Nicholas X. , Barbastathis George
Published: July 2020

Deep learning (DL) has been applied extensively in many computational imaging problems, often leading to superior performance over traditional iterative approaches. However, two important questions remain largely unanswered: first, how well can the trained neural network generalize to objects very different from the ones in training? This is particularly important in practice, since large-scale annotated examples similar to those of interest are often not available during training. Second, has the trained neural network learnt the underlying (inverse) physics model, or has it merely done something trivial, such as memorizing the examples or point-wise pattern matching? This pertains to the interpretability of machine-learning based algorithms. In this work, we use the Phase Extraction Neural Network (PhENN) [Optica 4, 1117-1125 (2017)], a deep neural network (DNN) for quantitative phase retrieval in a lensless phase imaging system as the standard platform and show that the two questions are related and share a common crux: the choice of the training examples. Moreover, we connect the strength of the regularization effect imposed by a training set to the training process with the Shannon entropy of images in the dataset. That is, the higher the entropy of the training images, the weaker the regularization effect can be imposed. We also discover that weaker regularization effect leads to better learning of the underlying propagation model, i.e. the weak object transfer function, applicable for weakly scattering objects under the weak object approximation. Finally, simulation and experimental results show that better cross-domain generalization performance can be achieved if DNN is trained on a higher-entropy database, e.g. the ImageNet, than if the same DNN is trained on a lower-entropy database, e.g. MNIST, as the former allows the underlying physics model be learned better than the latter.