bluuebunny/crossref_metadata_2025 huggingface dataset:
Late Palaeozoic magmatism in the eastern Tseel Terrane of SW Mongolia evidenced by chronological and geochemical data
Authors: Hong Tao , Gao Jun , Xu Xing‐Wang , Wu Chu , Li Hao
Published: October 2020

The eastern Tseel Terrane of SW Mongolia, which is an important part of the Central Asian Orogenic Belt (CAOB), contains a segment of imbricated sheets of Late Palaeozoic granites as well as a bimodal volcanic suite. Late Devonian (380–382 Ma) granites that are enriched in Th, U, and K and depleted in Nb, Ta, P, Ba, Sr, and Ti indicate arc magmatism and are low‐K tholeiitic to medium‐K calc‐alkaline series. Zircon εHf(t) values are of +8.30 to +14.1, with crustal model ages of 0.83–0.48 Ga. The bimodal volcanic suite is composed of N‐MORB basalt and 302 ± 2 Ma rhyolite having A2‐type granite affinities, εHf(t) values ranging from +9.9 to +11.9, and crustal model ages from 0.69 to 0.59 Ga. The rhyolite mighthave originated from partial melting of juvenile lower crust, rather than fractional crystallization of coeval basaltic magma. Late Carboniferous (299–303 Ma) granites are medium‐K to high‐K calc‐alkaline series, cross‐cutting carbonaceous siltstone, emplaced into the deformed volcanic rocks and are characterized by enrichment in K, Th, and U accompanied by depletion in Ba, Nb, Ta, Sr, P, and Ti in a primitive mantle‐normalized diagram with εHf(t) values ranging from +6.05 to +10.6 and crustal model ages from 0.70 to 0.65 Ga. Thus, LA‐ICP‐MS zircon ages in combination with geochemical data document a phase of arc‐related magmatism in the Tseel Terrane at 380–382 Ma. These rocks were subsequently deformed under low‐grade metamorphic conditions and intruded by undeformed granites at c. 299–303 Ma. The coeval 302 Ma rhyolite in bimodal volcanic suite shows typical A2‐type granitic geochemical affinities and probably documents a back‐arc basin extensional environment, which was probably related to the roll‐back of the Palaeo‐Asian Oceanic Plate during the northward subduction under the Central Mongolia microcontinent.
Functional neuroanatomy of language without speech: An ALE meta‐analysis of sign language
Authors: Trettenbrein Patrick C. , Papitto Giorgio , Friederici Angela D. , Zaccarella Emiliano
Published: October 2020

Sign language (SL) conveys linguistic information using gestures instead of sounds. Here, we apply a meta‐analytic estimation approach to neuroimaging studies (N= 23; subjects = 316) and ask whether SL comprehension in deaf signers relies on the same primarily left‐hemispheric cortical network implicated in spoken and written language (SWL) comprehension in hearing speakers. We show that: (a) SL recruits bilateral fronto‐temporo‐occipital regions with strong left‐lateralization in the posterior inferior frontal gyrus known as Broca's area, mirroring functional asymmetries observed for SWL. (b) Within this SL network, Broca's area constitutes a hub which attributes abstract linguistic information to gestures. (c) SL‐specific voxels in Broca's area are also crucially involved in SWL, as confirmed by meta‐analytic connectivity modeling using an independent large‐scale neuroimaging database. This strongly suggests that the human brain evolved a lateralized language network with a supramodal hub in Broca's area which computes linguistic information independent of speech.
Magnetohydrodynamics Eyring‐Powell fluid in a vertical porous microchannel with convective boundary condition subjected to entropy generation
Authors: Gireesha B. J. , Roja A.
Published: October 2020

This investigation is concentrated on the second law analysis of a magnetohydrodynamics Eyring‐Powell fluid in a vertical microporous channel with the convective boundary conditions under the impacts of heat generation, viscous dissipation, exponential space, temperature dependence, and Joule heating. The reduced form of the governing equations is obtained with the aid of applying nondimensional variables and is resolved using Runge‐Kutta‐Fehlberg's fourth fifth‐order method. The various relevant parameters that affect the heat transfer and entropy have been discussed in detail through graphs. It is found that the impacts of suction/injection, viscous dissipation, and convective conditions are important and the thermal performance can be improved with these factors. The generation of entropy boosts up with the impacts of radiation, space/temperature‐dependent, and Biot number and slows down with Eyring‐Powel parameters. Furthermore, the heat transfer rate amplifies with the magnetic number and the drag force intensifies with the Brinkman parameters. The comparison of results has been performed and it provides an excellent agreement.
Public acceptance of Covid‐19 lockdown scenarios
Authors: Gollwitzer Mario , Platzer Christine , Zwarg Clarissa , Göritz Anja S.
Published: October 2020

By mid‐March 2020, most countries had implemented nationwide lockdown policies aimed at decelerating the spread of SARS‐CoV‐2. At that time, nobody knew how long these policies would have to remain in force and whether they would have to be extended, intensified or made more flexible. The present study aimed to illuminate how the general public in Germany reacted to the prospect of increasing the length, the intensity and/or the flexibility of distancing rules implied by different lockdown scenarios. Endorsement of and compliance with five specific lockdown scenarios were assessed in a large (N = 14,433) German sample. Results showed that lockdown length affected respondents' reactions much more strongly than intensity or flexibility. Additional analyses (i.e., mixture distribution modelling) showed that half of the respondents rejected any further extensions or intensifications, while 20% would endorse long‐term strategies if necessary. We argue that policy‐makers and political communicators should take the public's endorsement of and compliance with such scenarios into account, as should simulations predicting the effects of different lockdown scenarios.
Safe administration of ipilimumab plus nivolumab to a dialysis patient with renal cell carcinoma
Authors: Iwaki Takuya , Niimi Aya , Kano Masato , Kurokawa Yoshiaki , Yoshizaki Uran , Nozaki Keina , Nomiya Akira , Miyazaki Hideyo , Kume Haruki
Published: October 2020

Introduction

The combination of ipilimumab plus nivolumab has been used as first‐line therapy for metastatic renal cell carcinoma. While it is well known that hemodialysis patients have a higher rate of renal cell carcinoma compared to the general population, no reports have described the safety of ipilimumab–nivolumab in metastatic renal cell carcinoma patients on hemodialysis.

Case presentation

A 73‐year‐old man with a 21‐year history of dialysis was referred to our department in 2019 for bilateral renal tumors and multiple lung nodules. He had already been diagnosed with bilateral renal tumors in 2015, without undergoing surgery due to comorbidities. In May 2019, contrast‐enhanced computed tomography revealed multiple lung metastases in addition to the existing renal tumors; consequently, he was treated with four doses of nivolumab–ipilimumab with no adverse events.

Conclusion

The combination of ipilimumab plus nivolumab was safely used in a hemodialysis patient with metastatic renal cell carcinoma.
Bone microarchitecture characterization based on fractal analysis in spatial frequency domain imaging
Authors: Zehani Soraya , Ouahabi Abdeldjalil , Oussalah Mourad , Mimi Malika , Taleb‐Ahmed Abdelmalik
Published: October 2020

This paper suggests a new technique for trabecular bone characterization using fractal analysis of X‐Ray and MRI texture images for osteoporosis diagnosis. Osteoporosis is a chronic disease characterized by a decrease in bone density that can lead to fracture and disability. In essence, the proposed fractal model makes use of the differential box‐counting method (DBCM) to estimate the fractal dimension (FD) after an appropriate image preprocessing stage that ensures a robust estimation process. In this study, we showed that within the frequency domain generated through discrete cosine transform (DCT), only a quarter of DCT coefficients are enough to characterize osteoporotic tissues. The algorithmic complexity of the developed approach is of the order ofwhereNstands for the size of the image, which, in turn, likely yields important gain in terms of medication cost. We report a successful separation of healthy and pathological cases in term of bothP − value(using statistical Wilcoxon rank sum test) and margin difference. A comparative statistical analysis has been performed using a publicly available database that contains a set of MRI and X‐Ray texture images of both healthy and osteoporotic bone tissues. The statistical results demonstrated the feasibility and accepted performance level of our fractal model‐based diagnosis to discriminate healthy and unhealthy trabecular bone tissues. The developed approach has been implemented on a medical device prototype.
Supplemental irrigation to save water while growing cactus pear in semi‐arid regions*
Authors: Zegbe Jorge A. , Servín‐Palestina Miguel
Published: October 2020

Climate change will compromise food access by causing water shortages for agricultural purposes. Supplemental irrigation (SI) was explored for its effect on crop water use, fruit yield, water use efficiency, water productivity, mean fruit mass and fruit size distribution of four cactus pear cultivars. The irrigation treatments were: non‐irrigated (NI) rainfed control, SI and full irrigation (FI). The cultivars were: ‘Cristalina’ (Opuntia albicarpa Scheinvar), ‘Amarilla Olorosa’ (O. spp.), ‘Roja Lisa’ (O. ficus‐indica L. Mill.), and ‘Dalia Roja’ (O. spp.). The experiment was conducted in a split‐block design. The SI treatment saved water, in a 3‐year‐average, by 52% for ‘Cristalina’, 51% for ‘Roja Lisa’ and 52% for both ‘Amarilla Olorosa’ and ‘Dalia Roja’. This resulted in a reduction in crop water use by 38% for ‘Cristalina’, 42% for ‘Roja Lisa’, 39% for ‘Amarilla Olorosa’ and 40% for ‘Dalia Roja’. For SI, plant‐relative water content and fruit growth were similar to the FI plants. SI plants maintained fruit yield, mean fruit mass and marketable fruit size at the level of FI plants, while it improved efficiencies of water use and water productivity. SI is therefore a feasible irrigation strategy for cactus pear for those areas where water availability is limited for agricultural activities.
Surface modification and biotribological behavior of UHMWPE nanocomposites with GO infiltrated by ultrasonic induction
Authors: Lu Peipei , Wu Meiping , Liu Xin , Ye Xiu , Duan Weipeng , Miao Xiaojin
Published: October 2020

In this study, we have innovatively proposed a method for surface modification of ultra‐high molecular weight polyethylene (UHMWPE) artificial joint materials with graphene oxide (GO) infiltrated into UHMWPE substrate by ultrasonic induction. The mechanical properties of UHMWPE nanocomposites with GO infiltrated by ultrasonic induction were compared with that of GO mixed. The molecular structure, wettability, peak load, and bio‐tribological behavior of GO/UHMWPE nanocomposites were studied using fourier transform infrared spectroscopy, contact angle measuring instrument, electronic universal material testing machine, tribometer, and profilometer, respectively. The results show that the ultrasonic‐induction method can make GO adhere to UHMWPE surface well, and GO can significantly improve the wettability of UHMWPE substrate. When the ultrasound‐inducted time is up to 12 hr, the wetting angle of the nanocomposites (12 h‐GO/UHMWPE) is reduced to 65.24°, which is 20.51% lower than that of the pure UHMWPE. The peak load is 183 N, which is 20.22% higher than that of GO/UHMWPE prepared by the mixing method. The bio‐tribological property of UHMWPE nanocomposites with GO infiltrated by ultrasonic induction for 12 hr (12 h‐GO/UHMWPE) is the best, and its friction coefficient keeps more stable at a value of 0.0605 under the lubrication of calf serum, which is 11.81% lower than that of UHMWPE mixed with GO by a traditional method, and the wear rate is decreased to 3.25 × 10−5mm3N−1 m−1.
Quantitative Computed Tomography Assessment of Bone Deficits in Ambulatory Children and Adolescents with Spina Bifida: Importance of Puberty
Authors: Wren Tishya AL , Mueske Nicole M , Rethlefsen Susan A , Kay Robert M , Van Speybroeck Alexander , Mack Wendy J
Published: October 2020

Pathologic fractures of the femur and tibia are common in youth with spina bifida (SB). These fractures may be associated with deficient bone accrual due to decreased ambulation and skeletal loading. This prospective cohort study used quantitative computed tomography (QCT) to assess three‐dimensional (3D) bone properties in children and adolescents with SB. Eighty‐three ambulatory youth with SB underwent QCT imaging of the tibia at up to four annual visits between ages 6 to 16 years (294 total visits averaging 3.5 visits/patient). A total of 177 controls without disability and 10 non‐ambulatory youth with SB underwent imaging once. Bone geometric properties (cortical bone area, cross‐sectional area, cortical thickness, cortical density, and moments of inertia) were measured at the mid‐diaphysis (50% of bone length); cross‐sectional area, cancellous density, and density‐weighted area were measured in the proximal (13% of bone length) and distal (90% of bone length) metaphyses. Bone properties were compared between the ambulatory SB and control participants, among SB neurosegmental subgroups (sacral, low lumbar, mid lumbar and above) as a function of pubertal stage (prepubertal, pubertal, postpubertal), and considering SB type (myelomeningocele, lipomyelomeningocele) using linear mixed effects models adjusted for sex, age, height percentile, and body mass index (BMI) percentile. Only cancellous density of both metaphyses and weighted area of the proximal metaphysis differed between ambulatory children with SB and controls before puberty. However, significant deficits in all bone properties manifested during and after puberty as moderate bone growth in the SB group failed to keep pace with the large increases normally observed during puberty. The bone deficits primarily affected patients with myelomeningocele, and similar deficits were observed at all neurosegmental levels except that cancellous density was closer to normal in the sacral group. Descriptive analysis of the 10 non‐ambulatory youth with SB showed greater bone deficits than ambulatory children, particularly for cancellous density in the distal metaphysis. © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
Expression of eosinophil in peripheral blood of patients with COVID‐19 and its clinical significance
Authors: Mu Tong , Yi Zumu , Wang Minjin , Wang Junren , Zhang Chongwei , Chen Hong , Bai Mingxuan , Jiang Lingyu , Zhang Yuwei
Published: October 2020

Aims

To investigate the eosinophil cell (EC) expression in peripheral blood of patients infected with severe acute respiratory syndrome coronavirus 2(SARS‐CoV‐2) and its clinical significance of diagnosis and prognosis.

Methods

95 patients, whose nucleic acid test of SARS‐CoV‐2 was positive to make a definite diagnosis of COVID‐19, were selected as the study group. They were admitted at the Chengdu Public Health Clinical Medical Center from January 21 to March 2, 2020. Another 95 healthy subjects and 95 non‐infectious fever patients during the same period were selected as the control group. The BC‐6900 blood cell analyzer was used to continuously observe and detect ECs in 95 patients with COVID‐19 and the control group. The differences in expression levels of ECs in peripheral blood were analyzed.

Results

ECs were significantly decreased in 95 (75.8%) COVID‐19 patients (P < .01). The absolute EC count IQR was 0.01 × 10⁹/L (0 × 10⁹/L − 0.04 × 10⁹/L), and the EC percentage IQR was 0.3% (0.1% − 0.8%). As the patients’ condition improved, the ECs returned to normal, but for those without improvement, ECs continued to decline.

Conclusions

ECs decreased remarkably in patients with COVID‐19, and gradually returned to normal after the improvement of the patients’ condition, while EC continued to decrease in patients without improvement. It is suggested that ECs have certain clinical significance in the diagnosis and prognosis of COVID‐19, and may be a useful index in the early warning of acute infectious diseases.
Knowledge and attitudes about genetic counseling in patients at a major hospital in Addis Ababa, Ethiopia
Authors: Jacobs Michelle F. , O'Connor Bridget C. , Weldetsadik Abate Yeshidinber , Tekleab Atnafu Mekonnen , Bekele Delayehu , Hanson Erika , Quinonez Shane C.
Published: October 2020

Previous work at St. Paul's Hospital Millennium Medical College (SPHMMC) in Addis Ababa, Ethiopia, demonstrated a need for genetic counseling (GC) services, with 4% of pediatric, neonatal intensive care, and prenatal patients identified as having indications for genetic evaluation (Quinonez et al, 2019). The aim of this study was to investigate SPHMMC patients' familiarity with, knowledge of, and attitudes toward GC services. Surveys were adapted from previous work in North America populations (Riesgraf et al, 2015 and Gemmell et al, 2017) and administered to 102 patients, and results were compared to North American populations using Student's t test. 30% of respondents reported at least some familiarity with GC, primarily via the media or healthcare providers. Patients had generally positive attitudes toward GC, reporting they would trust information provided by a genetic counselor and that GC is in line with their values. Knowledge of GC showed similar trends overall when compared to results from North American populations. Our work indicates limited exposure to GC in this population, but generally positive feelings toward GC. Patients' attitudes toward GC were comparable to rural North American populations surveyed using the same tool on most items; however, cultural differences including views on abortions and directiveness of healthcare providers could account for discrepancies and are important considerations when implementing genetic services globally.
Comparison of effectiveness and cost for different HIV screening strategies implemented at large urban medical centre in the United States
Authors: Skaathun Britt , Pho Mai T , Pollack Harold A , Friedman Samuel R , McNulty Moira C , Friedman Eleanor E , Schmitt Jessica , Pitrak David , Schneider John A
Published: October 2020

Introduction

Incident HIV infections persist in the United States (U.S.) among marginalized populations. Targeted and cost‐efficient testing strategies can help in reaching HIV elimination. This analysis compares the effectiveness and cost of three HIV testing strategies in a high HIV burden area in the U.S. in identifying new HIV infections.

Methods

We performed a cost analysis comparing three HIV testing strategies in Chicago: (1) routine screening (RS) in an inpatient and outpatient setting, (2) modified partner services (MPS) among networks of the recently HIV infected and diagnosed, and (3) a respondent drive sampling (RDS)‐based social network (SN) approach targeting young African‐American men who have sex with men. All occurred at the same academic medical centre during the following times: routine testing, 2011 to 2016; MPS, 2013 to 2016; SN: 2013 to 2014. Costs were in 2016 dollars and included personnel, HIV testing, training, materials, overhead. Outcomes included cost per test, HIV‐positive test and new diagnosis. Sensitivity analyses were performed to assess the impact of population demographics.

Results

The RS programme completed 57,308 HIV tests resulting in 360 (0.6%) HIV‐positive tests and 165 new HIV diagnoses (0.28%). The MPS completed 146 HIV tests, resulting in 79 (54%) HIV‐positive tests and eight new HIV diagnoses (5%). The SN strategy completed 508 HIV tests, resulting in 210 (41%) HIV‐positive tests and 37 new HIV diagnoses (7.2%). Labour accounted for the majority of costs in all strategies. The estimated cost per new HIV diagnosis was $16,773 for the RS programme, $61,418 for the MPS programme and $15,683 for the SN testing programme. These costs were reduced for the RS and MPS strategies in sensitivity analyses limiting testing efficacy to the highest prevalence patient populations ($2,841 and $33,233 respectively).

Conclusions

The SN strategy yielded the highest proportion of new diagnoses, followed closely by the MPS programme. Both the SN strategy and RS programme were comparable in the cost per new diagnosis. A simultaneous approach that consists of RS in combination with SN testing may be most effective for identifying new HIV infections in settings with heterogeneous epidemics with both high rates of HIV prevalence and HIV testing.
Antiretroviral treatment interruption among people living with HIV during COVID‐19 outbreak in China: a nationwide cross‐sectional study
Authors: Sun Yinghui , Li Hui , Luo Ganfeng , Meng Xiaojun , Guo Wei , Fitzpatrick Thomas , Ao Yunlong , Feng Anping , Liang Bowen , Zhan Yuewei , Sande Amakobe , Xie Feng , Wang Ying , Qian Han‐Zhu , Cai Yong , Zou Huachun
Published: October 2020

Introduction

Social disruption associated with coronavirus disease 2019 (COVID‐19) threatens to impede access to regular healthcare, including for people living with HIV (PLHIV), potentially resulting in antiretroviral therapy (ART) interruption (ATI). We aimed to explore the characteristics and factors associated with ATI during the COVID‐19 outbreak in China.

Methods

We conducted an online survey among PLHIV by convenience sampling through social media between 5 and 17 February 2020. Respondents were asked to report whether they were at risk of ATI (i.e. experienced ATI, risk of imminent ATI, threatened but resolved risk of ATI [obtaining ART prior to interruption]) or were not at risk of ATI associated with the COVID‐19 outbreak. PLHIV were also asked to report perceived risk factors for ATI and sources of additional ART. The factors associated with the risk of ATI were assessed using logistic regression. We also evaluated the factors associated with experienced ATI.

Results

A total of 5084 PLHIV from 31 provinces, autonomous regions and municipalities in mainland China completed the survey, with valid response rate of 99.4%. The median age was 31 years (IQR 27 to 37), 96.5% of participants were men, and 71.3% were men who had sex with men. Over one‐third (35.1%, 1782/5084) reported any risk of ATI during the COVID‐19 outbreak, including 2.7% (135/5084) who experienced ATI, 18.0% (917/5084) at risk of imminent ATI and 14.4% (730/5084) at threatened but resolved risk. PLHIV with ATI were more likely to have previous interruptions in ART (aOR 8.3, 95% CI 5.6 to 12.3), travelled away from where they typically receive HIV care (aOR 3.0, 95% CI 2.1 to 4.5), stayed in an area that implemented citywide lockdowns or travel restrictions to control COVID‐19 (aOR 2.5, 95% CI 1.4 to 4.6), and be in permanent residence in a rural area (aOR 3.7, 95% CI 2.3 to 5.8).

Conclusions

A significant proportion of PLHIV in China are at risk of ATI during the COVID‐19 outbreak and some have already experienced ATI. Correlates of ATI and self‐reported barriers to ART suggest that social disruptions from COVID‐19 have contributed to ATI. Our findings demonstrate an urgent need for policies and interventions to maintain access to HIV care during public health emergencies.
Continuum‐based teleconnection indices of United States wintertime temperature variability
Authors: Schulte Justin
Published: October 2020

It is well‐documented that United States (US) wintertime temperature variability is related to teleconnection patterns that are commonly extracted using Empirical Orthogonal Function (EOF) analysis. However, recent work suggests that EOF patterns are not necessarily physical or strongly related to temperature variability at a specified location. In this paper, US wintertime temperature variability is understood using an alternative continuum approach to teleconnection patterns, contrasting with many previous studies that adopt an EOF‐based approach. Using the continuum approach, two patterns resembling the East Pacific‐North Pacific pattern are identified that are more strongly related to US wintertime temperature than common EOF‐based patterns. Using a simple correlation method and a teleconnection impact index, 13 teleconnection indices were ranked based on how much US wintertime temperature variability they can explain. The ranking methodologies revealed that three continuum‐based dipole patterns are the leading modes of US wintertime temperature variability and that common EOF‐based patterns like the Arctic Oscillation are relatively weak temperature influencers. It is also shown that the dipole patterns are related to a tropical sea surface temperature pattern termed the pan‐Niño (PN) pattern whose associated index was created using the continuum approach. The PN pattern was found to have moderate to strong relationships with the dipole patterns and US wintertime temperature, suggesting that tropical processes have contributed to recent wintertime temperature variability. These results have important implications for research focusing on seasonal forecasting, recent cooling trends across the eastern US, and the impact of Arctic warming on US winter weather.
Towards broad‐scale temperature reconstructions for Eastern North America using blue light intensity from tree rings
Authors: Harley Grant L. , Heeter Karen J. , Maxwell Justin T. , Rayback Shelly A. , Maxwell R. Stockton , Reinemann Ty E. P. , H. Taylor Alan
Published: October 2020

Summer temperatures across eastern North America (hereafter East) will soon reach a level consistently above any observation experienced during the instrumental period. Increasing temperatures will have negative impacts on natural (e.g., water, plant and animal communities) and human (e.g., health, infrastructure, economies) systems upon which the large and growing centres of human population across the region depend. Within the network of Northern Hemisphere tree‐ring temperature proxy records, one of the most obvious geographic holes is the East, where few temperature‐sensitive proxies exist. Here we present the first steps towards building a network of temperature‐sensitive proxy records across the East using blue light intensity (BI) methods applied to the tree rings of multiple temperature sensitive tree species situated from North Carolina to Maine, USA. Our overall objective is to report on the most viable species for BI analysis across different regions of the East (e.g., Southeast US, Midwest US, Northeast US/Canadian Maritimes) by exploring temporal (e.g., since ca. 1900) and spatial relationships between instrumental temperatures and BI metrics. We found BI to be a strong predictor of March–October mean air temperature (R2 = 0.61) across the Northeast US/eastern Canada, and Sep‐Oct maximum air temperature (R2 = 0.42) across the Southeast US. Of all species tested, Tsuga canadensis and Picea rubens contained the strongest BI temperature signal. Adding more BI sites from these and potentially other species, as well as inclusion of other temperature proxies (e.g., ring widths) will allow for the development of a skilful broad‐scale and long‐term temperature field reconstruction across the East.
Immediate Intraoperative Repair of the Recurrent Laryngeal Nerve in Thyroid Surgery
Authors: Simó Ricard , Nixon Iain J. , Rovira Aleix , Vander Poorten Vincent , Sanabria Alvaro , Zafereo Mark , Hartl Dana M. , Kowalski Luiz P. , Randolph Gregory W. , Kamani Dipti , Shaha Ashok R. , Shah Jatin , Marie Jean‐Paul , Rinaldo Alessandra , Ferlito Alfio
Published: October 2020

Objectives

Recurrent laryngeal nerve (RLN) injury is a recognized risk during thyroid and parathyroid surgery and can result in significant morbidity. The aim of this review paper is to consider the optimal approach to the immediate intraoperative repair of the RLN during thyroid surgery.

Methods

A PubMed literature search was performed from inception to June 2020 using the following search strategy: immediate repair or repair recurrent laryngeal nerve, repair or reinnervation recurrent laryngeal nerve and immediate neurorraphy or neurorraphy recurrent laryngeal nerve.

Results

Methods of immediate intraoperative repair of the RLN include direct end‐to‐end anastomosis, free nerve graft anastomosis, ansa cervicalis to RLN anastomosis, vagus to RLN anastomosis, and primary interposition graft. Techniques of nerve repair include micro‐suturing, use of fibrin glue, and nerve grafting. Direct micro‐suture is preferable when the defect can be repaired without tension. Fibrin glue has also been proposed for nerve repair but has been criticized for its toxicity, excessive slow reabsorption, and the risk of inflammatory reaction in the peripheral tissues. When the proximal stump of the RLN cannot be used, grafting could be done using transverse cervical nerve, supraclavicular nerve, vagus nerve, or ansa cervicalis.

Conclusions

Current evidence is low‐level; however, it suggests that when the RLN has been severed, avulsed, or sacrificed during thyroid surgery it should be repaired intraoperatively. The immediate repair has on balance more advantages than disadvantages and should be considered whenever possible. This should enable the maintenance of vocal cord tone, better and prompter voice recovery and avoidance of aspiration. Laryngoscope, 131:1429–1435, 2021
Network Medicine Approach in Prevention and Personalized Treatment of Dyslipidemias
Authors: Benincasa Giuditta , de Candia Paola , Costa Dario , Faenza Mario , Mansueto Gelsomina , Ambrosio Giuseppe , Napoli Claudio
Published: October 2020

Dyslipidemias can affect molecular networks underlying the metabolic homeostasis and vascular function leading to atherogenesis at early stages of development. Since disease‐related proteins often interact with each other in functional modules, many advanced network‐oriented algorithms were applied to patient‐derived big data to identify the complex gene–environment interactions underlying the early pathophysiology of dyslipidemias and atherosclerosis. Both the proprotein convertase subtilisin/kexin type 7 (PCSK7) and collagen type 1 alpha 1 chain (COL1A1) genes arose from the application of TFfit and WGCNA algorithms, respectively, as potential useful therapeutic targets in prevention of dyslipidemias. Moreover, the Seed Connector algorithm (SCA) algorithm suggested a putative role of the neuropilin‐1 (NRP1) protein as drug target, whereas a regression network analysis reported that niacin may provide benefits in mixed dyslipidemias. Dyslipidemias are highly heterogeneous at the clinical level; thus, it would be helpful to overcome traditional evidence‐based paradigm toward a personalized risk assessment and therapy. Network Medicine uses omics data, artificial intelligence (AI), imaging tools, and clinical information to design personalized therapy of dyslipidemias and atherosclerosis. Recently, a novel non‐invasive AI‐derived biomarker, named Fat Attenuation Index (FAI™) has been established to early detect clinical signs of atherosclerosis. Moreover, an integrated AI‐radiomics approach can detect fibrosis and microvascular remodeling improving the customized risk assessment. Here, we offer a network‐based roadmap ranging from novel molecular pathways to digital therapeutics which can improve personalized therapy of dyslipidemias.
Biogeography of macrophyte productivity: Effects of oceanic and climatic regimes across spatiotemporal scales
Authors: Menge Bruce A. , Close Sarah L. , Hacker Sally D. , Nielsen Karina J. , Chan Francis
Published: October 2020

Spatiotemporal variability in primary producer growth rates is a fundamental aspect of community structure. Understanding drivers of these patterns and their response to climate variability and change are ongoing challenges. Nutrient and light limitations often are invoked as proximate drivers of these patterns, but many other environmental and biological factors vary across spatial and temporal scales. In temperate rocky intertidal habitats, macrophytes are major space occupiers and the base of the food web, and thus their patterns of primary production relate directly to their functions and services in these communities. We investigated spatiotemporal patterns of the primary production of two species of macrophytes, the kelp Hedophyllum sessile and the surfgrass Phyllospadix scouleri, across 908 km of Oregon and California coastline. Spatiotemporal variability in macrophyte growth rates and their relationships to regional or local‐scale environmental variables (upwelling, nutrients, temperature, light, phytoplankton blooms) and climate regimes were explored. Paradoxically, we found that both warmer water temperature (e.g., warm phases of climate patterns, weaker upwelling) and increased nutrients (e.g., with stronger upwelling) increased macrophyte productivity. Kelp growth decreased with dense phytoplankton blooms, while surfgrass growth decreased with increasing air temperature. Growth rates reflected tissue elemental content in surfgrass but only weakly in kelp. Hence, as climate warms and/or if upwelling intensifies, productivity of these and perhaps other macrophytes should increase, at least until thermal conditions, particularly low tide air temperature, become too stressful.
FANCM c5791C>T stopgain mutation (rs144567652) is a familial colorectal cancer risk factor
Authors: Cannon‐Albright Lisa A. , Teerlink Craig C. , Stevens Jeffrey , Snow Angela K. , Thompson Bryony A. , Bell Russell , Nguyen Kim N. , Sargent Nykole R. , Kohlmann Wendy K. , Neklason Deborah W. , Tavtigian Sean V.
Published: October 2020

Purpose

While familial aggregation of colorectal cancer (CRC) is recognized, the majority of the germline predisposition factors remain unidentified, and many high‐risk CRC pedigrees remain unexplained by known risk variants. Fanconi Anemia genes have been recognized to be associated with cancer risk. Notably, FANCM (OMIM 609644) variants have been reported to confer risk for CRC and breast cancer.

Methods

Exome sequencing of CRC‐affected cousins in a set of 47 independent extended high‐risk CRC pedigrees identified a candidate set of rare, shared variants. Variants were tested for association with risk in 744 Utah CRC cases and 1525 controls, and for segregation with CRC in affected relatives.

Results

A FANCM stopgain variant was observed in two CRC‐affected cousin pairs, each from an independent Utah high‐risk pedigree, and yielded a nonsignificant, but elevated OR = 2.05 in a set of Utah cases and controls. Segregation of the variant to other related CRC‐affected cases was observed in the two extended pedigrees.

Conclusion

A rare stopgain variant in FANCM (rs144567652) that is recognized as a breast cancer predisposition variant, and that has previously been proposed, but not confirmed, as a CRC predisposition variant, is validated here as a risk factor for familial CRC.
Coffee, Black Tea, and Green Tea Consumption in Relation to Plasma Metabolites in an Asian Population
Authors: Seow Wei Jie , Low Dorrain Yanwen , Pan Wen‐Chi , Gunther Samuel H. , Sim Xueling , Torta Federico , Herr Deron R. , Kovalik Jean‐Paul , Ching Jianhong , Khoo Chin Meng , Wenk Markus R. , Tai E Shyong , van Dam Rob M.
Published: October 2020

Scope

Coffee and tea are among the most popular beverages in the world. However, the association between habitual coffee, green tea, and black tea consumption with metabolomics profiles in Asian populations remain largely unknown.

Methods and Results

158 metabolites (14 amino acids, 45 acylcarnitines, and 99 sphingolipids) in the blood plasma of participants are measured from the population‐based Singapore Prospective Study Program cohort using mass spectrometry (MS). Linear regression models are used to obtain the estimates for the association between coffee and tea consumption with metabolite levels, adjusted for potential confounders and false discovery rate (FDR). Coffee consumption is significantly associated with higher levels of 63 sphingolipids (29 sphingomyelins, 32 ceramides, a sphingosine‐1‐phosphate, and a sphingosine) and lower levels of 13 acylcarnitines and alanine. Black tea consumption is significantly associated with higher levels of eight sphingolipids, and lower levels of an amino acid, whereas green tea is significantly inversely associated with four metabolites (C8:1‐OH acylcarnitine, ganglioside GM3 d18:1/16:0, sphingomyelins d18:2/18:0 and d18:1/14:0).

Conclusions

Coffee, black tea, and green tea consumption are associated with plasma levels of certain classes of sphingolipids and acylcarnitines in an Asian population, particularly sphingomyelins, which may mediate the health benefits of these beverages.
Reproducibility analysis of multi‐institutional paired expert annotations and radiomic features of the Ivy Glioblastoma Atlas Project (Ivy GAP) dataset
Authors: Pati Sarthak , Verma Ruchika , Akbari Hamed , Bilello Michel , Hill Virginia B. , Sako Chiharu , Correa Ramon , Beig Niha , Venet Ludovic , Thakur Siddhesh , Serai Prashant , Ha Sung Min , Blake Geri D. , Shinohara Russell Taki , Tiwari Pallavi , Bakas Spyridon
Published: October 2020

Purpose

The availability of radiographic magnetic resonance imaging (MRI) scans for the Ivy Glioblastoma Atlas Project (Ivy GAP) has opened up opportunities for development of radiomic markers for prognostic/predictive applications in glioblastoma (GBM). In this work, we address two critical challenges with regard to developing robust radiomic approaches: (a) the lack of availability of reliable segmentation labels for glioblastoma tumor sub‐compartments (i.e., enhancing tumor, non‐enhancing tumor core, peritumoral edematous/infiltrated tissue) and (b) identifying “reproducible” radiomic features that are robust to segmentation variability across readers/sites.

Acquisition and validation methods

From TCIA’s Ivy GAP cohort, we obtained a paired set (n = 31) of expert annotations approved by two board‐certified neuroradiologists at the Hospital of the University of Pennsylvania (UPenn) and at Case Western Reserve University (CWRU). For these studies, we performed a reproducibility study that assessed the variability in (a) segmentation labels and (b) radiomic features, between these paired annotations. The radiomic variability was assessed on a comprehensive panel of 11 700 radiomic features including intensity, volumetric, morphologic, histogram‐based, and textural parameters, extracted for each of the paired sets of annotations. Our results demonstrated (a) a high level of inter‐rater agreement (median value of DICE ≥0.8 for all sub‐compartments), and (b) ≈24% of the extracted radiomic features being highly correlated (based on Spearman’s rank correlation coefficient) to annotation variations. These robust features largely belonged to morphology (describing shape characteristics), intensity (capturing intensity profile statistics), and COLLAGE (capturing heterogeneity in gradient orientations) feature families.

Data format and usage notes

We make publicly available on TCIA’s Analysis Results Directory (https://doi.org/10.7937/9j41‐7d44), the complete set of (a) multi‐institutional expert annotations for the tumor sub‐compartments, (b) 11 700 radiomic features, and (c) the associated reproducibility meta‐analysis.

Potential applications

The annotations and the associated meta‐data for Ivy GAP are released with the purpose of enabling researchers toward developing image‐based biomarkers for prognostic/predictive applications in GBM.
Deep learning algorithms for brain disease detection with magnetic induction tomography
Authors: Chen Ruijuan , Huang Juan , Song Yixiang , Li Bingnan , Wang Jinhai , Wang Huiquan
Published: October 2020

Purpose

In order to improve the reconstruction accuracy of magnetic induction tomography (MIT) and achieve fast imaging especially in the detection of cerebral hemorrhage, artificial intelligence algorithms are proposed to improve the accuracy of MIT inverse problem.

Methods

According to the standard geometric data of human head, a three‐dimensional (3D) head model containing four layer tissues is established for brain image reconstruction of MIT. Four deep learning (DL) networks, including restricted Boltzmann machine (RBM), deep belief network (DBN), stacked autoencoder (SAE), and denoising autoencoder (DAE), are used to solve the nonlinear reconstruction problem of MIT, and the reconstruction results of DL networks and back‐projection algorithm are compared. Finally, in order to verify the practical value of DL algorithms, the phantom experiment is carried out with MIT detection system.

Results

Using the nonlinear data learning ability of DL algorithms, the rapid and high‐precision imaging of cerebral hemorrhage can be realized. Compared with the back‐projection algorithm, the DL improves the artifact and the accuracy of the reconstruction image. The location and volume of bleeding can be reconstructed and the prediction time reaches 20 ms. Moreover, the anti‐noise performance of the networks can reach 20 dB.

Conclusions

The DL can effectively improve the reconstruction accuracy and prediction speed of the image when it is applied to the reconstruction of cerebral hemorrhage in MIT. This feasibility study MIT to be a potential technology for brain diseases to fully meet the needs of accurate, rapid, and low‐cost clinical diagnosis and continuous monitoring.
Impact of range uncertainty on clinical distributions of linear energy transfer and biological effectiveness in proton therapy
Authors: Hahn Christian , Eulitz Jan , Peters Nils , Wohlfahrt Patrick , Enghardt Wolfgang , Richter Christian , Lühr Armin
Published: October 2020

Purpose

Increased radiation response after proton irradiation, such as late radiation‐induced toxicity, is determined by high dose and elevated linear energy transfer (LET). Steep dose‐averaged LET (LETd) gradients and elevated LETd occur at the end of proton range and might be particularly sensitive to uncertainties in range prediction. Therefore, this study quantified LETd distributions and the impact of range uncertainty in robust dose‐optimized proton treatment plans and assessed the biological effect in normal tissues and tumors of patients.

Methods

For each of six cancer patients (two brain, head‐and‐neck, and prostate), two nominal treatment plans were robustly dose optimized using single‐ and multi‐field optimization, respectively. For each plan, two additional scenarios with ±3.5% range deviation relative to the nominal plan were derived by global rescaling of stopping‐power ratios. Dose and LETd distributions were calculated for each scenario using the beam parameters of the corresponding nominal plan. The variability in relative biological effectiveness (RBE) and probability of late radiation‐induced brain toxicity (PIC) was assessed.

Results

The optimization technique (single‐ vs multi‐field) had a negligible impact on the LETd distributions in the clinical target volume (CTV) and in most organs at risk (OARs). LETd distributions in the CTV were rather homogeneous with arithmetic mean of LETd below 3.2 keV/µm and robust against range deviations. The RBE variability within the CTV induced by range uncertainty was small (≤0.05, 95% confidence interval). In OARs, LETd hotspots (>7 keV/µm) occurred and LETd distributions were inhomogeneous and sensitive to range deviations. LETd hotspots and the impact of range deviations were most prominent in OARs of brain tumor patients which translated in RBE values exceeding 1.1 in all brain OARs. The near‐maximum predicted PIC in healthy brain tissue of brain tumor patients was smaller than 5% and occurred adjacent to the CTV. Range deviations induced absolute differences in PIC up to 1.2%.

Conclusions

Robust dose optimization generates LETd distributions in the target volume robust against range deviations. The current findings support using a constant RBE within the CTV. The impact of range deviations on the considered probability of late radiation‐induced toxicity in brain tissue was limited for robust dose‐optimized treatment plans. Incorporation of LETd in robust optimization frameworks may further reduce uncertainty related to the RBE‐weighted dose estimation in normal tissues.
Experimental investigation of TRS‐483 reference dosimetry correction factors for Leksell Gamma Knife® Icon™ beams
Authors: Häger Wille , Kaveckyte Vaiva , Benmakhlouf Hamza
Published: October 2020

Purpose

Radiosurgery using the Leksell Gamma Knife® (LGK) Icon™ is an established technique used for treating intracranial lesions. The largest beam field size the LGK Icon can produce is a 16 mm diameter sphere. Despite this, reference dosimetry on the LGK Icon is typically performed using ionization chambers calibrated in 10 × 10 cm2 fields. Furthermore, plastic phantoms are widely used instead of liquid water phantoms. In an effort to resolve these issues, the International Atomic Energy Agency (IAEA) in collaboration with American Association of Physicists in medicine (AAPM) recently published Technical Report Series No. 483 (TRS‐483) as a Code of Practice for small‐field dosimetry. TRS‐483 includes small‐field correction factors, , intended to account for the differences between setups when using small‐field modalities such as the LGK Icon, and conventional setups. Since the publication of TRS‐483, at least three new sets of values of for the LGK Icon have been published. The purpose of this study was to experimentally investigate the published values of for commonly used phantom and ionization chamber (IC) models for the LGK Icon.

Methods

Dose‐rates from two LGK units were determined using acrylonitrile butadiene styrene (ABS) and Certified Medical Grade Solid Water® (SW) phantoms, and PTW 31010 and PTW 31016 ICs. Correction factors were applied, and the resulting dose‐rates compared. Relative validity of the correction factors was investigated by taking the ratios of dose‐rate correction factor products. Additionally, dose‐rates from the individual sectors were determined in order to calculate the beam attenuation caused by the ABS phantom adapter.

Results and Conclusions

It was seen that the dose‐rate is underestimated by at least 1% when using the ABS phantom, which was attributed to fluence perturbation caused by the IC and phantom adapter. Published correction factors account for these effects to varying degree and should be used. The SW phantom is unlikely to underestimate the dose‐rate by more than 1%, and applying could not be shown to be necessary. Out of the two phantom models, the ABS phantom is not recommended for use in LGK reference dosimetry. The use of newly published values of should be considered.