bluuebunny/crossref_metadata_2025 huggingface dataset:
Agricultural landscape composition affects the development and life expectancy of colonies of Bombus impatiens
Authors: Gervais A. , Fournier V. , Bélisle M.
Published: July 2020

Bumble bees are essential, efficient pollinators of numerous crops, and scientists are increasingly concerned about their global decline. Although several potential causes have been put forward, the concurrent modification of landscape structure and pesticide use by agriculture are often pointed out as the main drivers of the decline. Yet, the mechanisms through which these factors cause species to decline remain elusive. Most field studies have been conducted at the individual level, and the few studies that addressed higher levels of organization only covered narrow ecological conditions. We undertook a field experiment in spring 2016 to overcome these limitations by placing four commercial Bombus impatiens colonies in each of 20 sites located along a gradient of agricultural intensity in southern Québec, Canada. We hypothesized that landscape habitat composition and configuration, as well as local floral resources, would affect colony development. We expected colonies surrounded by low‐intensity and/or flowering crops in heterogeneous landscapes to develop better and live longer, partly linked to more abundant and diversified food resources, than colonies embedded in landscapes dominated by high‐intensity crops. Colonies were weighed once a week, and workers were captured to assess pollen load diversity. Final colony weight, queen production, and presence of depredators (Aphomia sociella, Lepidoptera: Pyralidae) were also recorded. Landscape habitat composition and configuration were characterized within 1 km of colonies. Local availability of floral resources was assessed within 100 m of colonies every two weeks. As predicted, colony weight and longevity decreased with the proportion of intensive crops and increased with the amount of flowering crops, but queen production and the occurrence of A. sociella were not affected by landscape composition. Contrary to our prediction, local availability of floral resources also did not affect colonies. The pollen richness brought back to colonies decreased with the proportion of flowering crops and varied according to the proportion of intensive crops interacting with local floral resources. Our work contributes to generalize the more restrictive conclusion of local‐scale, crop‐specific studies that intensive crop farming undermines bumble bee colony development and that it may thus play a role in the large‐scale population decline of these insects.
Prednisone and azathioprine in patients with inflammatory cardiomyopathy: systematic review and meta‐analysis
Authors: Timmermans Philippe , Barradas‐Pires Ana , Ali Omar , Henkens Michiel , Heymans Stephane , Negishi Kazuaki
Published: July 2020

Aims

Chronic non‐viral myocarditis, also called inflammatory cardiomyopathy, can be treated with immune suppression on tops of optimal medical therapy (OMT) for heart failure, using a combination of prednisolone and azathioprine (IPA). However, there has been inconsistency in the effects of immunosuppression treatment. This meta‐analysis is the first to evaluate all available data of the effect of this treatment on left ventricular ejection fraction (LVEF) and the combined clinical endpoint of cardiovascular mortality and/or heart transplantation‐free survival.

Methods and results

All trials with using IPA vs. OMT in this syndrome were searched using OVID Medline and ClinicalTrials.gov, following the PRISMA guidelines. Missing data were retrieved after contacting the corresponding authors. All data was reviewed and analysed using and standard meta‐analysis methods. A random effect model was used to pool the effect sizes. A total of four trials (three randomised controlled trials and one propensity‐matched retrospective registry) including 369 patients were identified. IPA on top of OMT did not improve LVEF [mean difference 9.9% (95% confidence interval −1.8, 21.7)] with significant heterogeneity. When we limited our pooled estimate to the published studies only, significant LVEF improvement by IPA was observed [14% (1.4, 26.6)]. No cardiovascular mortality benefit was observed with the intervention [risk ratio 0.34 (0.08, 1.51)].

Conclusions

At the moment, there is insufficient evidence supporting functional and prognostic benefits of IPA added to OMT in virus negative inflammatory positive cardiomyopathy. Further adequate‐powered well‐designed prospective RCTs should be warranted to explore the potential effects of adding immunosuppressive therapy to OMT.
Dysregulation in B‐cell responses and T follicular helper cell function in ADA2 deficiency patients
Authors: Schena Francesca , Penco Federica , Volpi Stefano , Pastorino Claudia , Caorsi Roberta , Kalli Francesca , Fenoglio Daniela , Salis Annalisa , Bertoni Arinna , Prigione Ignazia , Bocca Paola , Insalaco Antonella , De Benedetti Fabrizio , Antonini Francesca , Grossi Alice , Signa Sara , Damonte Gianluca , Ceccherini Isabella , Filaci Gilberto , Traggiai Elisabetta , Gattorno Marco
Published: July 2020

Adenosine deaminase 2 deficiency (DADA2) is an autoinflammatory disease characterized by inflammatory vasculopathy, early strokes associated often with hypogammaglobulinemia. Pure red cell aplasia, thrombocytopenia, and neutropenia have been reported. The defect is due to biallelic loss of function of ADA2 gene, coding for a protein known to regulate the catabolism of extracellular adenosine. We therefore investigated immune phenotype and B‐ and T‐cell responses in 14 DADA2 patients to address if ADA2 mutation affects B‐ and T‐cell function.

Here, we show a significant decrease in memory B cells, in particular class switch memory, and an expansion of CD21low B cells in DADA2 patients. In vitro stimulated B lymphocytes were able to secrete nonfunctional ADA2 protein, suggesting a cell intrinsic defect resulting in an impairment of B‐cell proliferation and differentiation. Moreover, CD4+ and CD8+ T cells were diminished; however, the frequency of circulating T follicular helper cells was significantly increased but they had an impairment in IL‐21 production possibly contributing to an impaired B cell help. Our findings suggest that ADA2 mutation could lead to a B‐cell intrinsic defect but also to a defective Tfh cell function, which could contribute to the immunodeficient phenotype reported in DADA2 patients.
Reactions of BCl3 with Diiminopyridine Ligands
Authors: Tidwell John R. , Africa Abigail K. , Dunnam Thomas , Martin Caleb D.
Published: July 2020

The reactions of boron trichloride with diiminopyridine ligands featuring 2,6‐diisopropylphenyl groups on the imine nitrogen atoms and varying groups on the α‐carbon atoms (H, CH3, and Ph) were investigated. N,N'‐chelated cationic BCl2 complexes with BCl4– counteranions were isolated with the hydrogen and phenyl‐substituted ligands while a mixture was obtained for the methyl variant.
Design and analysis of robust fuzzy logic maximum power point tracking based isolated photovoltaic energy system
Authors: Asif Rao Muhammad , Ur Rehman Ateeq , Ur Rehman Saif , Arshad Jehangir , Hamid Jamshaid , Tariq Sadiq Muhammad , Tahir Sohaib
Published: July 2020

Photovoltaic (PV) energy is highly promising because of its renewable, green, and environment‐friendly nature. In this article, the design and analysis of an isolated PV system using a push‐pull converter with a fuzzy logic‐based maximum power point tracking (MPPT) algorithm is presented. Furthermore, DC‐DC converters, along with intelligent controllers fed with MPPT algorithms, are used to ensure the maximum extraction of incident energy. The proposed methodology utilizes fuzzy logic MPPT techniques based on an isolated push‐pull boost converter to optimize the power output of PV modules, as well as to achieve isolation and high DC gain for DC/AC inversion. This work also presents a single‐phase inverter with fuzzy logic close loop control analysis with LCL filter design. A Canadian solar panel of 250 W is assumed in this research work, which has an open circuit voltage 59.9 V, short circuit current 5.49 A at 25°C temperature, and 1000 W/m2 irradiance. The voltages are tracked, through the MPPT algorithm. These voltages represent a boost to 340 V DC through push‐pull boost converter and are inverted up to 220 V AC through fuzzy logic voltage source inverter. In addition, a unipolar switching technique is used to remove the total harmonic distortion under linear load. The proposed methodology is simulated in MATLAB/Simulink. The simulation results verify that the proposed methodology can efficiently track the MPPT. Finally, the hardware prototype of the proposed system has been experimentally validated.
Temperature analysis of steel structures protected by intumescent paint with steel claddings in fire
Authors: Ma Zhongcheng , Havula Jarmo , Wald Frantisek , Cabova Kamila
Published: July 2020

It is of great interest to understand the stabilization effect of steel structures by steel claddings in fire. Structural fire analysis using finite‐element method, including temperature analysis and structural analysis, is important to investigate the stabilization effect. However, temperature‐dependent thermal material data for the insulation layer of sandwich panels and the intumescent paint for fire protection of steel sections are still scarce. In this paper, the available thermal properties of these materials from the literature are summarized, and 2D and 3D temperature analyses were carried out for steel sections with steel claddings, such as sandwich panels with mineral wool and polyisocyanurate (PIR) cores and trapezoidal sheeting with mineral wool insulation. The analysis results were compared with the fire tests conducted in European research project STABFI (Stabilization of Steel Structures by Steel Claddings in Fire). The study shows reasonable accuracy of modeling using existing thermal material data for temperature‐dependent insulation properties and thermal data for intumescent paint, for intumescent coatings (IC) protected steel beam with mineral wool sandwich panel and trapezoidal sheeting claddings. Larger discrepancy between finite element (FE) prediction and test measurement was observed for the case of sandwich cladding with PIR core. Gaps for further research were identified. The study also shows the heat sink effect of the steel section by sandwich panels with a mineral wool core. Therefore, it is recommended that the sandwich panels should be included in the thermal analysis model for steel sections with sandwich claddings.
Evaluation and validation of Physiological and Operative Severity Score for the enumeration of mortality and morbidity and Portsmouth‐POSSUM scores in predicting morbidity and mortality in patients undergoing head and neck cancer surgeries
Authors: Karan Nupur , Siddiqui Suhail , Sharma Kailash S. , Pantvaidya Gouri H. , Divatia Jigeeshu V. , Kulkarni Atul P.
Published: July 2020

Background

Identification of risk factors for perioperative complications helps in the prognostication. We wanted to determine whether Physiological and Operative Severity Score for the enumeration of mortality and morbidity (POSSUM) and Portsmouth‐POSSUM (P‐POSSUM) can be used in patients undergoing head and neck oncosurgery.

Methods

We conducted a retrospective analysis of 1265 patients after they had major head and neck oncosurgeries. Demographic, surgical and outcome data was collected. We separately analyzed data for patients who had undergone cancer surgery for oral cavity, pharynx, and larynx. We calculated the POSSUM and P‐POSSUM scores.

Results

POSSUM scoring system had moderate discrimination (AUC = 0.61) and good calibration (P = .36) for the entire study cohort and in the subgroup. Since there were no deaths in the entire cohort, we were not able to check predictive ability of the scores, for mortality.

Conclusions

We found that POSSUM had moderate discrimination and good calibration for morbidity prediction in head and neck cancer surgeries, as well as for the selected subgroup.
Transcriptome Profiling Identifies TIGIT as a Marker of T‐Cell Exhaustion in Liver Cancer
Authors: Ostroumov Dmitrij , Duong Steven , Wingerath Jessica , Woller Norman , Manns Michael P. , Timrott Kai , Kleine Moritz , Ramackers Wolf , Roessler Stephanie , Nahnsen Sven , Czemmel Stefan , Dittrich‐Breiholz Oliver , Eggert Tobias , Kühnel Florian , Wirth Thomas C.
Published: July 2020

BACKGROUND AND AIMS

Programmed death 1 (PD‐1) checkpoint inhibition has shown promising results in patients with hepatocellular carcinoma, inducing objective responses in approximately 20% of treated patients. The roles of other coinhibitory molecules and their individual contributions to T‐cell dysfunction in liver cancer, however, remain largely elusive.

APPROACH AND RESULTS

We performed a comprehensive mRNA profiling of cluster of differentiation 8 (CD8) T cells in a murine model of autochthonous liver cancer by comparing the transcriptome of naive, functional effector, and exhausted, tumor‐specific CD8 T cells. Subsequently, we functionally validated the role of identified genes in T‐cell exhaustion. Our results reveal a unique transcriptome signature of exhausted T cells and demonstrate that up‐regulation of the inhibitory immune receptor T‐cell immunoreceptor with immunoglobulin and immunoreceptor tyrosine‐based inhibitor motif domains (TIGIT) represents a hallmark in the process of T‐cell exhaustion in liver cancer. Compared to PD‐1, expression of TIGIT more reliably identified exhausted CD8 T cells at different stages of their differentiation. In combination with PD‐1 inhibition, targeting of TIGIT with antagonistic antibodies resulted in synergistic inhibition of liver cancer growth in immunocompetent mice. Finally, we demonstrate expression of TIGIT on tumor‐infiltrating CD8 T cells in tissue samples of patients with hepatocellular carcinoma and intrahepatic cholangiocarcinoma and identify two subsets of patients based on differential expression of TIGIT on tumor‐specific T cells.

CONCLUSIONS

Our transcriptome analysis provides a valuable resource for the identification of key pathways involved in T‐cell exhaustion in patients with liver cancer and identifies TIGIT as a potential target in checkpoint combination therapies.
Implementation of a multi‐center digital trauma registry: Experience in district and central hospitals in Malawi
Authors: Croke Kevin , Chokotho Linda , Milusheva Sveta , Bertfelt Jonna , Karpe Saahil , Mohammed Meyhar , Mulwafu Wakisa
Published: July 2020

Background

Trauma is a rapidly growing component of the burden of disease in developing countries; yet systematic data collection about trauma in such contexts is relatively rare.

Methods

This paper describes the implementation of a trauma registry in 10 government‐run hospitals in Malawi, with a focus on implementation logistics, stakeholder engagement strategies, and data quality procedures.

Results

51 337 trauma cases were recorded over the first 14 months of registry operations. The number of cases per month, data accuracy, and the geographic coverage of the registry improved over time as data quality measures were implemented.

Conclusions

Multi‐center digital trauma registries are feasible in low‐resource settings. Stakeholder engagement, periodic in‐person and frequent digital follow up with data teams, and regular channeling of findings back to data collection teams help to improve data quality and completeness over a 14 month period. Financial and staffing constraints remain challenges for sustainability over time, but this experience demonstrates the feasibility of large‐scale registry operations.
Thermal, environmental, and cost analysis of effective solar portable vaccine refrigerator by COMSOL Multiphysics
Authors: Al‐Madhhachi Hayder , Al‐Najideen Mohammad
Published: July 2020

A thermal, environmental, and cost analysis of an effective solar portable vaccine refrigerator is presented. Combining Peltier module with appropriate finned heat sink, choosing advanced software for thermal analysis, evaluating the environmental impacts of the combination, and comparing with other refrigerators are the key objectives of the present research. The Peltier module and the finned heat sink are professionally designed to enhance the thermal performance of the solar portable vaccine refrigerator. A competent solar panel is proposed to power the Peltier module for clean thermal energy. A set of equations are applied to calculate the overall surface efficiency and the total heat dissipation out of the refrigerator. COMSOL Multiphysics is employed to compute the temperature gradient and the heat flux of the Peltier module with the finned heat sink at steady‐state process. The thermal results show that the maximum overall surface efficiency is 78% with one Peltier module and 10 fins. The environmental results show that the values of the carbon footprint and total energy consumption of the solar portable vaccine refrigerator are reasonable according to the sustainability assessment methodology. The results also show that the manufacturing cost of the solar portable vaccine refrigerator is affordable as compared to others.
The effect of wealth on the choice of household drinking water sources in West Africa
Authors: Zoungrana Tibi Didier
Published: July 2020

Many developing countries are experiencing high population growth rates (an average of 2.7%). The increase in their respective populations leads to an increase in the need for drinking water. However, governments fail to provide the population with sufficient hydraulic infrastructure in terms of quality and quantity, with regard to the various priorities. In such situations, households take individual initiatives. However, the weakness of the available means may be a significant obstacle. This article seeks to identify the factors that determine the choice of household water sources in West African countries by putting an emphasis on the role of wealth. The study covers four countries, Burkina Faso, Mali, Ghana and Nigeria, and uses data from 28,444 observations from the United States Agency for International Development (USAID) and statistics agencies of the four countries being studied. When applied to the adjusted logit model, the data reveal that the higher the household wealth, the greater the chance of using piped water. There are also other factors, such as household size, the number of women and children, and the level of education that also determine the choice of water sources. These results suggest that governments need to increase their efforts to reduce inequalities between rural and urban areas in terms of improved access to drinking water and introduce a subsidy or fee policy to enable poor households to have adequate access to drinking water.
In vivo and ex vivo confocal microscopy for the evaluation of surgical margins of melanoma
Authors: Cinotti Elisa , Belgrano Valerio , Labeille Bruno , Grivet Damien , Douchet Catherine , Chauleur Celine , Cambazard Frédéric , Thomas Alix , Prade Virginie , Tognetti Linda , Cartocci Alessandra , Rubegni Pietro , Perrot Jean Luc
Published: July 2020

We report the first series of melanomas (MMs) where the surgical margins were evaluated both by ex vivo confocal microscopy (EVCM) and in vivo reflectance confocal microscopy (RCM). We evaluated the surgical margins of 42 cutaneous MMs of lentigo maligna/lentigo maligna melanoma type and 2 mucosal MMs with EVCM. Cutaneous MMs also underwent RCM mapping. Imaging results were compared with histopathology. The rate of correct identification of the tumor margins (invaded or not invaded) was 97.6% for RCM (evaluations of cutaneous MMs) and 95.5% for EVCM (evaluations of both cutaneous and mucosal MMs). Our study showed that the MM extension is visible under EVCM and that the combination of in vivo RCM and EVCM can be a new strategy for the evaluation of surgical margins of MMs.
Incidence of Fractures Before and After Dialysis Initiation
Authors: Iseri Ken , Carrero Juan Jesús , Evans Marie , Felländer-Tsai Li , Berg Hans E , Runesson Björn , Stenvinkel Peter , Lindholm Bengt , Qureshi Abdul Rashid
Published: July 2020

Fractures are common in dialysis patients, but little is known about the trajectory of incidence rates of different types of fractures before and after dialysis initiation. To address this, we investigated the incidence of major fractures before and after dialysis initiation. We performed a retrospective statistical analysis using the Swedish Renal Registry of 9041 incident dialysis patients (median age 67 years, 67% men) starting dialysis 2005 through 2015 to identify major fractures (hip, spine, humerus, and forearm) occurring during the dialysis transition period from 1 year before until 1 year after dialysis initiation. Using flexible parametric hazard models and the Fine-Gray model, we estimated adjusted fracture incidence rates and predictors of major fractures. We identified 361 cases with primary diagnosis of major fracture, of which 196 (54%) were hip fractures. The crude incidence rate of major fractures before dialysis initiation was 17 per 1000 patient-years (n = 157) and after dialysis initiation it was 24 per 1000 patient-years (n = 204). The adjusted incidence rate of major fractures began to increase 6 months before dialysis initiation, and then stabilized at a higher rate after 1 year. The adjusted incidence rate of hip fractures started to increase sharply 3 months before dialysis initiation, peaked at initiation, and declined thereafter. In contrast, the adjusted incidence rate of non-hip fractures was stable during the transition period and gradually increased over time. Higher age, female sex, and history of previous major fractures were associated with increased fracture incidence both before and after dialysis initiation. We conclude that the incidence of major fractures, especially hip fractures, start to rise 6 months before initiation of dialysis therapy, indicating that heightened surveillance with implementation of preventive measures to avoid fractures is warranted during the transition period to dialysis. © 2020 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
Overexpression of P‐glycoprotein and resistance to Imatinib in chronic myeloid leukemia patients
Authors: Ammar Mariam , Louati Nour , Frikha Imen , Medhaffar Moez , Ghozzi Hanen , Elloumi Moez , Menif Hela , Zeghal Khaled , Ben Mahmoud Lobna
Published: July 2020

Background

The P‐glycoprotein (P‐gp) is one of the mechanisms of Imatinib (IM) resistance in chronic myeloid leukemia (CML). P‐gp has been identified as an efflux pump involved in releasing of IM outside CML cells. To date, the P‐gp involvement in the IM resistance development was not completely understood. Therefore, the present study aimed at measuring the P‐gp expression level on lymphocytes from Tunisian patients with CML and correlating this level with a molecular response to IM.

Method

The expression of P‐gp on peripheral blood lymphocytes from 59 Tunisian patients with CML (27 IM responder patients vs 32 IM non‐responder patients) was evaluated by flow cytometry.

Result

Our finding showed significantly positive expression of P‐gp in the lymphocytes from the IM non‐responder group when compared to the IM‐responder group (P = .001). In IM non‐responder CML patients, the comparison between CCyR achievers and non‐achievers showed a high mean fluorescence intensity (MFI) of P‐gp expression in patients who did not achieve their CCyR (P = .001). The comparison between patients with primary and secondary resistance to IM showed an increasing MFI value in patients with primary resistance to IM (P = .001). Besides, the comparison between nilotinib‐treated and dasatinib‐treated patients proved a high value of MFI in nilotinib‐treated patients (P = .001).

Conclusion

The overexpression of P‐gp on lymphocytes has significantly correlated with the failed molecular response to IM in patients with CML.
The impact of COVID‐19: Considerations for future dental conferences
Authors: Rekawek Peter , Rice Pamela , Panchal Neeraj
Published: July 2020

The onset of coronavirus disease 19 (COVID‐19) impacted all facets of global communities. As such, dental organizations must reconsider the traditional format of conferences in order to abide by public health guidelines. Such an adjustment is required in an effort to limit the footprint and ensure the safety of its participants. This article aims to provide guidance to reformat a traditional conference to a virtual platform. Recommendations are made pertaining to the structure of organizational committees, the intricacies of digital platforms, any associated costs, and adjustments to advertising and sponsorships. The authors also provide direction regarding changes in scheduling, and suggestions in order to replicate the social aspect of academic conferences. Careful consideration of the existing format can help design an efficient virtual platform that will continue to yield professional growth and drive the frontier of research in dentistry during this pandemic.
Difference in characteristics and nutrient retention between biochars produced in nitrogen‐flow and air‐limitation atmospheres
Authors: Zhang Huiying , Chen Weifeng , Li Qingyang , Zhang Xia , Wang Caiting , Yang Liuming , Wei Ran , Ni Jinzhi
Published: July 2020

The different effects of nitrogen‐flow (NF) and air‐limitation (AL) pyrolysis on the characteristics and nutrient retention of biochars (BCs) are unclear. Hence, in this study, BCs derived from bamboo, corn straw, and wheat straw were produced in AL and NF atmospheres at various temperatures (300–750 °C), and their different characteristics and nutrient retention rates were compared systematically. Nitrogen‐flow pyrolysis facilitates C retention and graphitic C formation, and AL pyrolysis improves the polarity and supports the formation of oxygen‐containing groups. With increasing pyrolysis temperature, C retention and graphitic C formation in BCs derived from AL pyrolysis decreases more significantly compared with BCs from NF pyrolysis. At 750 °C, the polarity and oxygen‐containing groups of BCs derived from AL pyrolysis increase, whereas those from BCs derived from NF pyrolysis decrease. The observations are attributable to the AL and high‐temperature–enhanced oxidization and gasification of C. An AL atmosphere with a higher pyrolysis temperature supports porosity and results in a larger specific surface area. Although pyrolysis temperature and atmosphere have negligible effects on nutrient retention, a low pyrolysis temperature facilitates the formation of water‐soluble Ca, Mg, and P, and AL pyrolysis facilitates the formation of water‐soluble P because the high pyrolysis temperature improves the pH and mineral stability of BCs, and air limitation facilitates the oxidation of organic P into PO43−. This study provides a reference for selecting AL or NF pyrolysis based on various pyrolysis temperatures to produce BCs and applying these in C sequestration, contaminant sorption, and soil quantity improvement.
METTL3 polymorphisms and Wilms tumor susceptibility in Chinese children: A five‐center case–control study
Authors: Lin Ao , Zhou Mingming , Hua Rui‐Xi , Zhang Jiao , Zhou Haixia , Li Suhong , Cheng Jiwen , Xia Huimin , Fu Wen , He Jing
Published: July 2020

Background

Wilms tumor is a common pediatric tumor worldwide. Methyltransferase like 3 (METTL3) is a core gene of the N6‐methyladenosine (m6A) modification that widely affects the transcription of tumor‐related genes in eukaryotes. METTL3 has been extensively investigated in various tumors but not Wilms tumor.

Methods

We describe a five‐center case–control study with 414 patients and 1199 controls aiming to explore the associations between METTL3 polymorphisms (rs1061026 T>G, rs1061027 C>A, rs1139130 A>G and rs1263801 G>C) and Wilms tumor susceptibility. A TaqMan real‐time polymerase chain reaction was performed for genotyping. Odds ratios (ORs) and 95% confidence intervals (CIs) were reported as evaluation indicators to determine any associations.

Results

Referring to the preliminary analysis results, protective genotypes were identified as rs1061026 TG/GG, rs1061027 CA/AA, rs1139130 GG and rs1263801 GC/CC. The children with three protective genotypes were less likely to develop Wilms tumor than children without protective genotypes (adjusted OR = 0.68, 95% CI = 0.46–0.999, p = 0.0496). Similarly, stratified analysis of the subgroup aged > 18 months, carrying 3 or 4 protective genotypes, was a protective factor for Wilms tumor compared to carrying 0–2 protective genotypes (adjusted OR = 0.59 95% CI = 0.39–0.91, p = 0.016). However, we did not observe any other significant results.

Conclusions

The combined effect of METTL3 polymorphisms reduce Wilms tumor susceptibility in Chinese children. This conclusion requires further verification.
Deep Learning Approach for Anterior Cruciate Ligament Lesion Detection: Evaluation of Diagnostic Performance Using Arthroscopy as the Reference Standard
Authors: Zhang Lingyan , Li Mifang , Zhou Yujia , Lu Guangming , Zhou Quan
Published: July 2020

Background

MRI is the most commonly used imaging method for diagnosing anterior cruciate ligament (ACL) injuries. However, the interpretation of knee MRI is time‐intensive and depends on the clinical experience of the reader. An automated detection system based on a deep‐learning algorithm may improve interpretation time and reliability.

Purpose

To determine the feasibility of using a deep learning approach to detect ACL injuries within the knee joint on MRI.

Study Type

Retrospective.

Population

In all, 163 subjects with an ACL tear and 245 subjects with an intact ACL. There were 285, 81, and 42 volumes for training, validation, and test sets, respectively.

Field Strength/Sequence

2D sagittal proton density‐weighted spectral attenuated inversion recovery sequences at 1.5T and 3.0T.

Assessment

Based on the architecture of 3D DenseNet, we constructed a classification convolutional neural network. We tested this deep learning approach with different inputs and two other algorithms, including VGG16 and ResNet. Then we had both inexperienced radiologists and senior radiologists read the MR images.

Statistical Tests

Using arthroscopic results as the reference standard, the performance of three different inputs and three different algorithms, the residents and senior radiologists assessed the classification accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve (AUC).

Results

The accuracy, sensitivity, specificity, PPV, and NPV of our customized 3D deep learning architecture was 0.957, 0.976, 0.944, 0.940, and 0.976, respectively. The average AUCs were 0.946, 0.859, 0.960 for ResNet, VGG16, and our proposed network, respectively. The diagnostic accuracy of our model, residents, and senior radiologists was 0.957, 0.814, and 0.899, respectively.

Data Conclusion

Our study demonstrated the feasibility of using an automated deep‐learning‐based detection system to evaluate ACL injury.

Level of Evidence

3

Technical Efficacy Stage

1 J. MAGN. RESON. IMAGING 2020;52:1745–1752.
The mechanistic rationale of drugs, primary endpoints, geographical distribution of clinical trials against severe acute respiratory syndrome‐related coronavirus‐2: A systematic review
Authors: Venkatesulu Bhanu Prasad , Thoguluva Chandrasekar Viveksandeep , Giridhar Prashanth , V Pragathee , Patel Harsh K. , Manteuffel Jacob
Published: July 2020

There are numerous ongoing studies assessing treatment options for preventing, treating, and managing complications of coronavirus disease‐2019 disease. The objective of this study was to do a systematic review and critical appraisal of the ongoing clinical trials with an aim to provide insight into the various interventions tested, clinical rationale, geographical distribution of the trials as well as the endpoints assessed in the studies. ClinicalTrials.gov, World Health Organization International Clinical Trials Registry Platform, and PubMed were assessed till 11 May 2020. The search resulted in 3242 ongoing studies of which 829 studies were included. There are 134 different drug‐based interventions being assessed in 463 clinical trials as treatment options China accounts for 35% of all ongoing clinical studies followed by USA 23% and other countries together account for 42%. Amongst the 463 studies assessing drug‐based treatment options, studies that are funded by federal and academic institutions are 79.6%, pharmaceutical company‐funded studies are 15.11%, and no funding information is available in 5.10%. The definitive outcomes like mortality are being assessed as primary outcome in 22.8% of the studies only and need for ventilator in 6.2% of the studies. Amongst the pharmaceutical company‐funded drug‐based studies, only 20% of the studies had mortality as the primary outcome. Only 5.5% of the ongoing clinical trials are specifically designed to assess the most vulnerable population like elderly, patients with comorbidities and cancer. Multiple intervention‐based clinical studies against severe acute respiratory syndrome‐related coronavirus‐2 are being performed throughout the world with a high concentration of clinical trials in the developed world with concern that of elderly and patients with comorbidities are being underrepresented and definite endpoints like mortality are being assessed in only one‐fifth of the studies.
Qualitative assessment of SARS‐CoV‐2‐specific antibody avidity by lateral flow immunochromatographic IgG/IgM antibody assay
Authors: Valdivia Arantxa , Torres Ignacio , Huntley Dixie , Alcaraz María J. , Albert Eliseo , Colomina Javier , Ferrer Josep , Carratalá Arturo , Navarro David
Published: July 2020

Knowledge of the precise timing of SARS‐CoV‐2 infection may be of clinical and epidemiological relevance. The presence of low‐avidity IgGs has conventionally been considered an indicator of recent infection. Here, we carried out qualitative assessment of SARS‐CoV‐2‐specific antibody avidity using an urea (6M) dissociation test performed on a lateral flow immunochromatographic IgG/IgM device. We included a total of 76 serum specimens collected from 57 COVID‐19 patients, of which 39 tested positive for both IgG and IgM and 37 only for IgG. Sera losing IgG reactivity after urea treatment (n = 28) were drawn significantly earlier (P = .04) after onset of symptoms than those which preserved it (n = 48). This assay may be helpful to estimate the time of acquisition of infection in patients with mild to severe COVID‐19.
COVID‐19 and pregnancy: An opportunity to correct an historic gender bias
Authors: Comas Carmina , Carreras Elena
Published: July 2020

Current literature and clinical guidelines do not include pregnant women as an a priori risk group for COVID‐19. However, a gender vision of health begs the question: Why are pregnant women not considered a risk group for COVID‐19? The answer is clear: historically, most community scientific studies have not considered female gender, or pregnancy as a state, to be a focus of special interest or effort. Unfortunately, this bias seems to be maintained in the COVID‐19 epidemic: most current guidelines for diagnosing SARS‐CoV‐2 infection during pregnancy apply the same standard criteria as for the general population.
Vitamin D insufficiency as a potential culprit in critical COVID‐19 patients
Authors: Munshi Ruhul , Hussein Mohammad H. , Toraih Eman A. , Elshazli Rami M. , Jardak Christina , Sultana Nasrin , Youssef Mohanad R. , Omar Mahmoud , Attia Abdallah S. , Fawzy Manal S. , Killackey Mary , Kandil Emad , Duchesne Juan
Published: July 2020

Background

As an immune modulator, vitamin D has been implicated in the coronavirus disease‐2019 (COVID‐19) outcome. We aim to systematically explore the association of vitamin D serum levels with COVID‐19 severity and prognosis.

Methods

The standardized mean difference (SMD) or odds ratio and 95% confidence interval (CI) were applied to estimate pooled results from six studies. The prognostic performance of vitamin D serum levels for predicting adverse outcomes with detection of the best cutoff threshold was determined by receiver operating characteristic curve analysis. Decision tree analysis by combining vitamin D levels and clinical features was applied to predict severity in COVID‐19 patients.

Results

Mean vitamin D serum level of 376 patients, was 21.9 nmol/L (95% CI = 15.36–28.45). Significant heterogeneity was found (I2 = 99.1%, p < .001). Patients with poor prognosis (N = 150) had significantly lower serum levels of vitamin D compared with those with good prognosis (N = 161), representing an adjusted standardized mean difference of −0.58 (95% Cl = −0.83 to −0.34, p < .001).

Conclusion

Serum vitamin D levels could be implicated in the COVID‐19 prognosis. Diagnosis of vitamin D deficiency could be a helpful adjunct in assessing patients' potential of developing severe COVID‐19. Appropriate preventative and/or therapeutic intervention may improve COVID‐19 outcomes.
Twelve‐lead and signal‐averaged electrocardiographic parameters among beta‐thalassemia major patients
Authors: Patsourakos Dimitrios , Gatzoulis Konstantinos A. , Aggeli Constantina , Delicou Sophia , Dimitroglou Yannis , Xydaki Katerina , Toutouzas Konstantinos , Androulakis Aristeidis , Tousoulis Dimitrios
Published: July 2020

Background

The majority of beta thalassemia major (β‐TM) patients suffer from cardiac disease, while a significant proportion of them die suddenly. Twelve‐lead and signal‐averaged electrocardiography (SAECG) are simple, inexpensive, readily available tools for identifying an unfavorable arrhythmiological substrate by detecting the presence of arrhythmias, conduction abnormalities, and late potentials (LPs) in these patients.

Methods

A total of 47 β‐TM patients and 30 healthy controls were submitted to 12‐lead and signal‐averaged electrocardiography. Basic electrocardiographic parameters and prevalence of LPs were recorded. Basic echocardiographic parameters were estimated by transthoracic echocardiography. T2* was calculated by cardiac magnetic resonance imaging wherever available.

Results

β‐TM patients demonstrated a more prolonged PR interval (167.74 msec vs 147.07 msec) (P = .043), a higher prevalence of PR prolongation (21.05% vs 0%) (P = .013), and a higher prevalence of LPs (18/47, 38.3% vs 2/30, 6.7%) (P = .002) compared with controls. The prevalence of atrial fibrillation among b‐TM patients was estimated at 10.64%. Patients had also greater E/e′ ratio (8.35, SD = 2.2 vs 7, SD = 2.07) (P = .012) and LAVI (30.7 mL/m2, SD = 8.76 vs 24.6 mL/m2, SD = 6.57) (P = .002) than controls. Regression analysis showed that QTc and LAVI could correctly predict the presence of LPs in the 80.9% of the patients.

Conclusions

β‐TM patients have a higher prevalence of a prolonged PR interval, atrial fibrillation, and LPs. Twelve‐lead and SAECG performance was feasible in all subjects and constitutes a readily available tool for assessing myocardial electrophysiological alterations in this patient group.
Occupational boundary play: Crafting a sense of identity legitimacy in an emerging occupation
Authors: Murphy Chad , Kreiner Glen E.
Published: July 2020

In emerging occupations, individuals are given very little prepackaged identity “content”—for example, occupational values, legitimating ideologies, clear goals, tasks, and/or routines—to help them build their individual‐level occupational identities. By contrast, individuals in well‐established occupations (e.g., professions) are given ample identity content, and prior identity research has examined identity work processes almost exclusively in the context of such occupations. Consequently, prior theory assumes that identity work is mostly a matter of tailoring prepackaged identity content to fit one's individual‐level preferences and objectives. Prior theory is therefore of limited use in emerging occupations, where the key identity problem is not one of tailoring identity content effectively but creating an identity in the first place—more specifically, an identity whose existence feels justified and valid. Thus, in this paper, we ask: how do individuals in emerging occupations construct an internal sense that “who they are” is necessary, desirable, and appropriate (i.e., legitimate) within the broader occupational landscape? On the basis of a grounded theory study of health coaches, we suggest that individuals in such circumstances can craft this sense of “identity legitimacy” via a sensemaking process we call occupational boundary play. This process consists of both “occupational boundary setting” and “occupational boundary blurring,” the former providing for individuals a sense of identity novelty and the latter providing a sense of identity familiarity. Taken together, this subjective experience of both novelty and familiarity provides for individuals the sense that “who they are” is legitimate within the broader occupational landscape.
Impact of different surgical protocols on dimensional changes of free soft tissue autografts: A randomized controlled trial
Authors: Arzouman Akemi , Deas David E. , Mills Michael P. , Huynh‐Ba Guy , Prihoda Thomas J. , Mealey Brian L.
Published: July 2020

Background

To determine if there is a difference in the amount of shrinkage during healing of free soft tissue autografts (FSTAs) using different surgical techniques—suturing the vestibular flap margin apically to the base of the recipient bed versus leaving the flap margin free and unsutured.

Methods

Twenty‐eight patients with mucogingival defects requiring FSTAs were recruited and enrolled in the study. Patients were randomized into test and control groups (14 per group) and received ≥1 FSTAs on non‐molar mandibular teeth. In the test group the mucosal flap margin was sutured apically to the periosteum at the base of the graft; whereas, the mucosal flap margin in the control group was left free. Graft dimensional measurements were taken at time of surgery, then at 1, 3, and 6 months post‐surgery.

Results

Thirty‐five grafts were performed (15 test, 20 control). All FSTAs experienced vertical shrinkage after 6 months, but there was no significant difference (P = 0.51) in the mean amount of shrinkage after 6 months between the test (23.20% ± 20.88%) and control (21.10% ± 21.88%) groups. There was significantly greater horizontal shrinkage in the test (loss of 7.59% ± 10.20%) compared with the control (small gain of 0.32% ± 4.20%) group (P = 0.01).

Conclusions

The findings suggest that there is similar vertical shrinkage when performing FSTA surgery when the mucosal flap margin is left free and unsutured when compared with leaving the flap margin free.
Impacts of the coronavirus pandemic on Europe's tourism industry: Addressing tourism enterprises and workers in the undeclared economy
Authors: Williams Colin Charles
Published: July 2020

The coronavirus pandemic has led to revenue loss for tourism enterprises and workers due to restrictions on movement. In response, governments have made available temporary financial support, but not to those tourist enterprises and workers in the undeclared economy. Reporting a 2019 Eurobarometer survey, this paper reveals that one in 165 European citizens engage in undeclared work in tourism and the groups involved. To bring these enterprises and workers onto the radar of the state, a voluntary disclosure initiative is advocated offering access to the temporary financial support for undeclared enterprises and workers disclosing their previous undeclared work.
Measurement of the Internal Carotid Artery Cross‐Sectional Area
Authors: Kliewer Mark A. , Lee Lisa J. , Bagley Anjuli R.
Published: July 2020

Objectives

To determine how measurements of the internal carotid artery (ICA) cross‐sectional area will differ systematically when obtained by grayscale, color Doppler, and power Doppler imaging.

Methods

A total of 451 patients had greater than 40% diameter stenosis in at least a single ICA. Anteroposterior and transverse luminal diameters were measured in 609 arteries on grayscale, color, and power Doppler transverse images of the carotid bulb and proximal and distal ICAs. Cross‐sectional areas were calculated and compared by a repeated‐measures analysis of variance model to assess for significant differences.

Results

Mean ICA cross‐sectional areas ± SDs as measured by grayscale, power Doppler, and color Doppler imaging were 122 ± 81, 122 ± 79, and 125 ± 79 mm2, respectively. The mean ICA area estimated by color Doppler imaging was significantly greater than that estimated by power Doppler imaging (P < .0001) and grayscale imaging (P = .02). Area estimates on grayscale and power Doppler images were not significantly different (P = .99). After accounting for the correlation of repeated measurements within single vessels, color Doppler estimates of the luminal area were on average 3.44 and 9.5 mm2 greater than grayscale and power Doppler estimates. Relative cross‐sectional area estimates were on average 9.4% greater with color Doppler imaging at smaller luminal diameters (<60 mm2) compared with larger luminal diameters.

Conclusions

Measurements of the ICA cross‐sectional area by color Doppler imaging were significantly greater than those obtained by power Doppler or grayscale imaging. This difference should be considered when stenosis estimates are confirmed or graded by luminal measurements.
Caribou Distribution and Movements in a Northern Alaska Oilfield
Authors: Prichard Alexander K. , Lawhead Brian E. , Lenart Elizabeth A. , Welch Joseph H.
Published: July 2020

As industrial development increases in the range of barren‐ground caribou (Rangifer tarandus granti) across the warming Arctic, the need to understand the responses of caribou to development and to assess the effectiveness of mitigation measures increase accordingly. The Central Arctic Herd (CAH) of caribou ranges across northern Alaska, USA, and the herd's summer range includes the Prudhoe Bay and Kuparuk oilfields, where the herd has been exposed to oil development for >4 decades. We used location data from global positioning system (GPS) radio‐collars deployed on female CAH caribou for 106 collar‐years, recording locations every 2 hours during 2008–2019, to examine caribou distribution and movements during 7 different seasons of the year in relation to infrastructure in the Kuparuk oilfield, which is characterized by more design improvements and mitigation measures than the older Prudhoe Bay oilfield. We examined movement metrics in terms of distance to gravel infrastructure (roads and pads) and time before and after movements across infrastructure (crossings). We also employed integrated step‐selection analysis to compare caribou movements with random movements. Caribou distribution was influenced by insect activity, distance to coast, landcover, and terrain ruggedness, and we found large seasonal differences in caribou responses to infrastructure. Consistent with previous research findings, avoidance of areas near roads and pads was strongest during the calving season and some caribou used roads and pads as insect‐relief habitat when oestrid flies (warble fly [Hypoderma tarandi] and nose bot fly [Cephenemyia trompe]) were active. Caribou moved through the Kuparuk oilfield repeatedly during summer, averaging >2 road or pad crossings a day when harassment by mosquitoes (Aedes [Ochlerotatus] spp.) and oestrid flies were the predominant factors influencing caribou movements. Caribou moved faster while crossing roads and pads but showed little pattern in speed or turn angle with distance to roads and pads. These results demonstrate that the effects of petroleum development on a caribou herd with long‐term exposure to industrial activity vary widely by season. Maternal caribou avoid active roads and pads during calving, but the incorporation of appropriate mitigation measures in oilfield design allows caribou to move through the Kuparuk oilfield during other snow‐free seasons. © 2020 The Authors. The Journal of Wildlife Management published by Wiley Periodicals LLC on behalf of The Wildlife Society.