bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors of 30‐day morbidity after hysterectomy for benign disease
Authors: Shim Seung‐Hyuk , Suh Jung‐Hwa , Park Ji‐Eun , Lee Sun‐Joo , Lee Ji‐Young , Kim Soo‐Nyung , Kang Soon‐Beom
Published: December 2018

Objective

To determine the 30‐day morbidity rate after hysterectomy for benign disease and identify predictors of 30‐day morbidity.

Methods

A retrospective study was conducted among women undergoing hysterectomy for benign indications between January 1, 2010, and December 31, 2015, at Konkuk University Hospital, South Korea. Multivariable regression analysis identified independent factors for morbidity.

Results

1609 women were included. 30‐day morbidity rates were 4.5% (n=72) for the whole cohort: 7.5% (28/371), 3.2% (22/686), and 4.0% (22/552) for abdominal hysterectomy, laparoscopic‐assisted vaginal hysterectomy (LAVH), and vaginal hysterectomy, respectively. The most common 30‐day postoperative morbidities were urinary complications (1.2%, 20/1609), wound infection (0.9%, 14/1609), and blood transfusion more than 4 units (0.7%, 11/1609). In multivariate regression analysis, Charlson comorbidity index of 2 or more, operative time, and estimated blood loss were independently associated with morbidity. Propensity score‐matching indicated no difference in morbidity rates for the abdominal hysterectomy and LAVH or vaginal hysterectomy groups (P=0.351), whereas the LAVH or vaginal hysterectomy groups were more strongly associated with operation time, estimated blood loss, and length of postoperative hospital stay.

Conclusion

Comorbidity index, operative time, and blood loss were independently associated with morbidity following hysterectomy. These findings supported the preoperative optimization of comorbidities and the appropriate selection of surgical approaches.
Predictive factors of subsequent insulin requirement for glycemic control during pregnancy at diagnosis of gestational diabetes mellitus
Authors: Ducarme Guillaume , Desroys du Roure François , Grange Joséphine , Vital Mathilde , Le Thuaut Aurélie , Crespin‐Delcourt Ingrid
Published: December 2018

Objective

To determine maternal and biological parameters at diagnosis of gestational diabetes mellitus (GDM) as predictors of antenatal insulin therapy (AIT) for glycemic control.

Methods

In this planned secondary analysis of a prospective observational study, we recruited women diagnosed with GDM between July 1, 2014, and October 31, 2015. Maternal and biological parameters were analyzed as predictors of AIT using multivariable logistic regression analyses. Predictive accuracy of a cut‐off value for a biological predictor was determined using the area under the receiver operating characteristic curve (AUC) and the Youden index (J).

Results

Of 200 women included (mean gestational age 22 ± 6 weeks), 72 (36%) required AIT. No maternal characteristic was associated with AIT. Glycated hemoglobin (HbA1c; adjusted odds ratio [aOR] 3.15, 95% CI 1.03–9.69) and elevated 1‐hour oral glucose tolerance test (OGTT; aOR 1.23, 95% CI 1.13–1.46) were predictors of AIT. Analyses suggested inaccurate prediction of AIT, with an optimal cut‐off HbA1c value of 5.4% (J=0.14; AUC 0.58, 95% CI 0.48–0.67), and an optimal 1‐hour plasma glucose OGTT value of 1.77 mg/dL (J=0.24; AUC 0.62, 95% CI 0.50–0.74).

Conclusion

HbA1c at diagnosis of GDM and elevated 1‐hour OGTT were independent predictors of AIT for glycemic control.

Clinicaltrials.gov: NCT02159378.
Use of a personalized iterative score to evaluate risk of venous thromboembolism during pregnancy and puerperium
Authors: Chau Cécile , Campagna Jennifer , Vial Marine , Rambeaud Caroline , Loundou Anderson , Bretelle Florence
Published: December 2018

Objective

To determine whether a personalized iterative venous thromboembolism (VTE) risk score improved preventive prophylaxis during pregnancy and puerperium.

Methods

An observational retrospective comparative study was conducted at single French hospital. Women who gave birth from February 1 to April 30, 2012 (n=557) or from February 1 to April 30, 2015 (n=512) underwent VTE risk assessment. The VTE risk score comprised known risk factors for this condition.

Results

Use of the VTE risk score at the first consultation increased the likelihood of appropriate treatment (odds ratio [OR] 1.5, 95% confidence interval [CI] 1.2–1.9; P=0.002) and reduced the risk of undertreatment (OR 0.5, 95% CI 0.4–0.7; P<0.001). During hospitalization and puerperium, the VTE risk score increased the likelihood of appropriate treatment. The ORs were 6.2 (95% CI 2.1–18.9; P<0.001) and 5.4 (95% CI 4.1–7.2; P<0.001), respectively. The risk of undertreatment was also reduced at these time points.

Conclusion

Use of the VTE risk score increased the number of appropriately treated patients during pregnancy and puerperium.
SAFE: Smart helmet for advanced factory environment
Authors: Altamura Angelo , Inchingolo Francesco , Mevoli Gianvito , Boccadoro Pietro
Published: December 2018

Safety is a leading theme in industrial applications such as constructions sites and production chains. Several solutions are already in use to protect workers from structural failures or traumatic events. These work instruments have proven their effectiveness, lowering the potentially hurtful, if not fatal, consequences of accidents on workplaces. In this context, the Industrial Internet of Things (IIoT) paradigm can boost the development of smart wearable systems that do not impede movements and/or operations. This work proposes Smart helmet for Advanced Factory Environment (SAFE), an autonomous and integrated wearable IIoT device. With the help of integrated sensors, SAFE is able to perform continuous monitoring activities of the worker and to promptly send alerts in case of alarms and/or accidents.
Staging mouse preimplantation development in vivo using optical coherence microscopy
Authors: Moore Emma L. , Wang Shang , Larina Irina V.
Published: December 2018

In mammals, preimplantation development primarily occurs in the oviduct (or fallopian tube) where fertilized oocytes migrate through, develop and divide as they prepare for implantation in the uterus. Studies of preimplantation development currently rely on ex vivo experiments with the embryos cultured outside of the oviduct, neglecting the native environment for embryonic growth. This prevents the understanding of the natural process of preimplantation development and the roles of the oviduct in early embryonic health. Here, we report an in vivo optical imaging approach enabling high‐resolution visualizations of developing embryos in the mouse oviduct. By combining optical coherence microscopy (OCM) and a dorsal imaging window, the subcellular structures and morphologies of unfertilized oocytes, zygotes and preimplantation embryos can be well resolved in vivo, allowing for the staging of development. We present the results together with bright‐field microscopy images to show the comparable imaging quality. As the mouse is a well‐established model with a variety of genetic engineering strategies available, the in vivo imaging approach opens great opportunities to investigate how the oviduct and early embryos interact to prepare for successful implantation. This knowledge could have beneficial impact on understanding infertility and improving in vitro fertilization. OCM through a dorsal imaging window enables high‐resolution imaging and staging of mouse preimplantation embryos in vivo in the oviduct.
Quantification of collagen fiber structure using second harmonic generation imaging and two‐dimensional discrete Fourier transform analysis: Application to the human optic nerve head
Authors: Pijanka Jacek K. , Markov Petar P. , Midgett Dan , Paterson Neil G. , White Nick , Blain Emma J. , Nguyen Thao D. , Quigley Harry A. , Boote Craig
Published: December 2018

Second harmonic generation (SHG) microscopy is widely used to image collagen fiber microarchitecture due to its high spatial resolution, optical sectioning capabilities and relatively nondestructive sample preparation. Quantification of SHG images requires sensitive methods to capture fiber alignment. This article presents a two‐dimensional discrete Fourier transform (DFT)–based method for collagen fiber structure analysis from SHG images. The method includes integrated periodicity plus smooth image decomposition for correction of DFT edge discontinuity artefact, avoiding the loss of peripheral image data encountered with more commonly used windowing methods. Outputted parameters are as follows: the collagen fiber orientation distribution, aligned collagen content and the degree of collagen fiber dispersion along the principal orientation. We demonstrate its application to determine collagen microstructure in the human optic nerve head, showing its capability to accurately capture characteristic structural features including radial fiber alignment in the innermost layers of the bounding sclera and a circumferential collagen ring in the mid‐stromal tissue. Higher spatial resolution rendering of individual lamina cribrosa beams within the nerve head is also demonstrated. Validation of the method is provided in the form of correlative results from wide‐angle X‐ray scattering and application of the presented method to other fibrous tissues.
Preparation of fibrin gel scaffolds containing MWCNT/PU nanofibers for neural tissue engineering
Authors: Hasanzadeh Elham , Ebrahimi‐Barough Somayeh , Mirzaei Esmaeil , Azami Mahmoud , Tavangar Seyed Mohammad , Mahmoodi Narges , Basiri Arefeh , Ai Jafar
Published: December 2018

Compared to the peripheral nervous system, in the central nervous system (CNS) disorders, neurons are less able to regenerate and reconstruct the neural tissue. Tissue engineering is considered as a promising approach for neural regeneration and restoring neurologic function after CNS injuries. Nanofibrous hydrogels have been recently used as three‐dimensional (3D) scaffolds for tissue engineering applications. In this kind of composites, hydrogels are incorporated with fibers to enhance their poor mechanical properties. Furthermore, introducing meshes within hydrogels can result in composites associated with advantages of both components. In the present study, we have prepared 3D nanofibrous hydrogel scaffolds based on fibrin/polyurethane/multiwall carbon nanotube (fibrin/PU/MWCNT), for application as composite scaffolds for neural tissue engineering. The fabricated fibrin/PU/MWCNT hydrogel scaffolds were characterized and their ability to support cell attachment and viability was assessed in comparison with fibrin hydrogel. Scanning electron microscopy (SEM) analysis was performed to examine the microstructural features of scaffolds. The rate of biodegradation and rheological properties of scaffolds were also investigated. After isolation of human endometrial stem cells (hEnSCs), they were cultured into the scaffolds, then their attachment and viability were assessed through SEM analysis, MTT assay and DAPI staining. Based on the results, the viability and proliferation of hEnSCs in the fibrin/PU/MWCNT hydrogels were higher than those in fibrin hydrogels. Therefore, our novel fabricated fibrin/PU/MWCNT hydrogel is able to support cell proliferation and can be used as a scaffold to provide an appropriate microenvironment for enhancing cell viability. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 802–814, 2019.
Mechanical loading induced osteocyte apoptosis and connexin 43 expression in three‐dimensional cell culture and dental implant model
Authors: Takemura Yoko , Moriyama Yasuko , Ayukawa Yasunori , Kurata Kosaku , Rakhmatia Yunia D. , Koyano Kiyoshi
Published: December 2018

Osteocytes are thought to act as stress sensors, and are known to display a gap junction‐mediated stress‐transfer mechanism. To demonstrate the stress‐related function of osteocytes, cells of an osteocyte‐like cell line derived from murine long bone osteocyte Y4 (MLO‐Y4) were cultivated in a three‐dimensional culture and subjected to cyclic loading from a titanium plate. This application of physiological loading using a titanium plate significantly increased connexin 43 (Cx43) expression, the number of dead and apoptotic cells, and receptor activator of nuclear factor κB ligand expression. Furthermore, the conditioned medium from the loaded osteocytes induced alkaline phosphatase activity in bone marrow cell culture. In addition, we immunohistologically determined whether bone metabolism increased as a result of the occlusal force in the bone surrounding the titanium implants in a rat model. Increased Cx43 expression and apoptotic osteocytes were observed in the loading group as well as a significantly increased number of tartrate‐resistant acid phosphatase‐positive cells. These findings indicate that stress from the implant adversely affected the osteocytes, which may promote osteoclastic and osteoblastic cell formation around the implants. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 815–827, 2019.
In vitro evaluation of electrospun blends of gelatin and PCL for application as a partial thickness corneal graft
Authors: Rose James B. , Sidney Laura E. , Patient James , White Lisa J. , Dua Harminder S. , El Haj Alicia J. , Hopkinson Andrew , Rose Felicity R.A.J.
Published: December 2018

The advent of innovative surgical procedures utilizing partial thickness corneal grafts has created a need for the development of synthetic implants to recreate corneal stromal tissue. This work evaluates electrospun gelatin and polycaprolactone (PCL) scaffolds as a potential biomaterial suitable for use in regeneration of corneal stromal tissue. Electrospun gelatin has been used for many years in tissue engineering; however, post‐production modification, such as crosslinking, is usually required to mechanically strengthen such scaffolds. This article aims therefore to compare glutaraldehyde (GA) crosslinked electrospun gelatin scaffolds with electrospun blends of gelatin and PCL at different ratios. Scaffolds were fabricated using electrospinning and characterized by scanning electron microscopy, Attenuated Total Reflectance‐Fourier Transform Infrared Spectroscopy, and tensile testing. To evaluate biocompatibility, primary human corneal stromal cells (hCSC) were seeded upon the scaffolds to assess adherence, proliferation, and phenotype. Results demonstrated that scaffolds fabricated from mixtures of gelatin and PCL showed increased mechanical strength and plasticity compared to scaffolds fabricated from GA crosslinked gelatin alone. In addition, scaffolds fabricated from PCL and gelatin showed comparable support of hCSC adhesion and proliferation. In conclusion, blended mixtures of gelatin and PCL can be considered as an option in the selection of corneal repair materials in the future© 2018 The Authors. Journal of Biomedical Materials Research Part A published by Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 828–838, 2019.
Biocompatibility of synthetic ultraviolet radiation cross‐linked polymers – Subcutaneous implantation study
Authors: Zair Labib , Marchlewicz Mariola , Tejchman Karol , Zeair Samir , Kędzierska Karolina , Stępniewska Joanna , Domański Maciej , Kazimierczak Arkadiusz , Duchnik Ewa , Ostrowski Marek
Published: December 2018

Photo‐cross‐linked polymers have attracted a lot of attention in the biomedical field. The main benefits of these materials are related to the fact that they are most of the time viscous liquids or pastes that adapt a custom and fixed shape on demand of the user. Present study deals specifically with the biological response upon subcutaneous implantation of four different materials in rabbits. In the study 20 rabbits were divided into four groups (each five rabbits): Groups 1–3 were implanted with tested new obtained by us macromonomers (P1838‐DMA; P1838‐UR; PDEGA‐UR – respectively), while group 4 (control) was implanted with the mesh (PLA) routinely used for surgical treatment of a hernia. The new compounds were polarized earlier using ultraviolet radiation to obtain cross‐linked networks. The polymers in the form of discs were then implanted subcutaneously in dorsal region of rabbits. After 28 days polymers were explanted and examined. Microscopic observation evaluated: thickness of the connective tissue capsule around the discs, cells of inflammatory response, disc surface erosion, spectroscopic analysis. The examined materials cause no chronic inflammation, abscesses or tissue necrosis, and the biological response is similar to observed in control group. Therefore, new synthetic materials could be considered as biocompatible and safe. Materials undergo slow degradation of ester bonds and surface erosion and degradation products could be eliminated probably by phagocytosis. On the basis on the afore mentioned knowledge, we formulated hypothesis, that the new polymers are well tolerated by the adjacent tissues. The aim of the following study was to examine reaction of the tissue on new types of prepolymerized material implanted subcutaneously. The obtained results suggest, that the new UV cross‐linked polymers do not affect negatively on the connective tissue that is in the contact with the implants. Furthermore, the used materials are in the liquid form, thus they could be easily performed in in minimally invasive laparoscopic treatment of abdominal hernias. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1889–1897, 2019.
Ginkgetin aglycone attenuates the apoptosis and inflammation response through nuclear factor‐kB signaling pathway in ischemic‐reperfusion injury
Authors: Zhang Lei , Liu Jiangang , Geng Tao
Published: December 2018

Aims

Acute myocardial infarction (AMI) is one of the most threaten disease in the world. Ginkgetin aglycone (GA) was a new kind of Ginkgo biloba, involved in various diseases, including kidney injury and acute pancreatitis. However, the function of GA in AMI remains unknown. The aim of the study was to investigate the characteristics and function of GA in ischemic‐reperfusion injury.

Methods

H2O
2‐ and CoCl
2‐treated H9C2 cells were used to analyze the function of GA in vitro. Caspase 3, interleukin‐6 (IL‐6), and tumor necrosis factor‐α were detected to evaluate the apoptosis and inflammation response. Rat AMI was performed to elucidate the function in vivo.

Results

We found that GA could reduce the apoptosis and improved cell survival of H2O
2‐treated H9C2 cardiomyocytes and CoCl
2‐treated H9C2 cells. GA attenuated CoCl
2‐induced inflammatory response and the level of cleaved caspase 33, suggesting that GA could alleviate the cell apoptosis. GA improved the cardiac function and attenuated the inflammatory cell infiltration in vivo. We also found that nuclear factor‐kB signaling pathway, which was activated under hypoxia environment, was also suppressed in the GA‐treated group.

Conclusion

We verified the function and mechanism of GA and provide evidence that GA may play a vital role in ischemic‐reperfusion injury, and understanding the precise role of GA will undoubtedly shed new light on the clinical treatment.
Possible mechanism of GATA4 inhibiting myocardin activity during cardiac hypertrophy
Authors: Xu Yao , Liang Chen , Luo Ying , Xing Weibing , Zhang Tongcun
Published: December 2018

Myocardin is an important factor that regulates cardiac hypertrophy, and its activity can be regulated by GATA4. However, the molecular mechanism of the above process remains unclear. This paper presents three kinds of possible molecular mechanisms of GATA4 inhibiting myocardin activity in the process of cardiac hypertrophy. First, a competitive combination of GATA4 and SRF with myocardin could reduce the formation of the myocardin‐SRF‐CarG box complex when GATA4 was overexpressed. Second, overexpression of GATA4 could inhibit the combination of myocardin and p300 and downregulate acetylated myocardin levels. Finally, GATA4 could upregulate the phosphorylation of myocardin protein upon activation of the ERK pathway. These findings may provide insight into the function of GATA4 and myocardin in the occurrence and development of cardiac hypertrophy.
Derived false memories using a respondent‐type (ReT) procedure
Authors: Ruiz‐Sánchez L. Jorge , Luciano Carmen , Guinther Paul M.
Published: December 2018

The present investigation used a respondent‐type (ReT) training procedure to generate derived false memories. A one‐to‐many ReT training procedure was implemented in order to establish two stimulus equivalence classes, each consisting of one shape and 24 random words (i.e., Class 1 and Class 2). A partial test for stimulus equivalence with a subset of stimuli from each class followed. Failing an equivalence test resulted in additional ReT training and equivalence testing on new subsets of stimuli. After passing an equivalence test, participants were presented with 12 study‐list words from Class 1 for memorization, followed by a distraction task. Finally, free recall and recognition tests for the study‐list words were implemented. False recall and false recognition were more frequent for nonstudied Class 1 words than for nonstudied Class 2 words. These derived false‐memory effects were more pronounced among those participants exhibiting more training and testing cycles and higher accuracy on stimulus equivalence tests. Furthermore, false recall and false remembering of nonstudied Class 1 words were more frequent for words that had been equivalence‐tested than for words that had not been equivalence‐tested. These results show how responses to contiguous stimuli could produce derived false memories and also highlight the role played by the equivalence test in increasing their emergence.
Electron microscopic observation of photoreceptor cells in directly inserted anesthetized Drosophila into a high‐pressure freezing unit
Authors: Terada Hitomi , Saitoh Yurika , Kametani Kiyokazu , Sakaguchi Masahiko , Sakamoto Takeharu , Kamijo Akio , Terada Nobuo
Published: December 2018

The high‐pressure freezing (HPF) technique is known to cryofix water‐containing materials with little ice‐crystal formation in deep depths compared with other freezing techniques. In this study, HPF for anesthetized living Drosophila was performed by placing them directly on the carrier of the HPF unit and exposing them to light. Frozen Drosophila were freeze substituted, and their compound eyes were examined by transmission electron microscopy. The ultrastructures of ommatidia composed of photoreceptor cells were well preserved. The location of the cytoplasmic organelles inside the photoreceptor cells was observed. In some photoreceptor cells in ommatidia of the light‐exposed Drosphila, the cytoplasmic small granules were localized nearer the base of rhabdomeres, compared with those of the nonlight‐exposed Drosophila. Thus, HPF with the direct insertion of living Drosophila under light exposure into the HPF machine enabled us to examine changes to functional structures of photoreceptor cells that occur within seconds.
Rapid single‐breath hyperpolarized noble gas MRI‐based biomarkers of airspace enlargement
Authors: Westcott Andrew , Guo Fumin , Parraga Grace , Ouriadov Alexei
Published: December 2018

Background

Multi‐b diffusion‐weighted hyperpolarized‐gas MRI measures pulmonary airspace‐enlargement using apparent diffusion coefficients (ADCs) and mean‐linear‐intercepts (Lm).

Purpose

To develop single‐breath 3D multi‐b diffusion‐weighted 3He and 129Xe MRI using k‐space undersampling. Rapid, cost‐efficient, single‐breath acquisitions may facilitate clinical translation.

Study Type

Prospective.

Subjects

We evaluated 12 participants, including nine subjects (mean age = 69 ± 9) who were included in the retrospective experiment and three chronic pulmonary obstruction disease (COPD) patients (mean age = 81 ± 6) who participated in the prospective study.

Field Strength

A whole‐body 3 T 2D/3D fast gradient recall echo (FGRE) sequence.

Assessment

Hyperpolarized 3He/129Xe MRI, spirometry, plethysmography computed tomography (CT). We evaluated 129Xe ADC/morphometry estimates by retrospectively undersampling previously acquired fully sampled multibreath, multi‐b diffusion‐weighted data. Next, we prospectively evaluated the feasibility of accelerated (AF = 7) 3He MRI static‐ventilation/T2* (extra short‐TE, b = 0 image) and ADC/morphometry (five b‐values) maps using a single gas‐dose and 16‐second breath‐hold. To conservatively evaluate cost‐improvement, we compared total costs of single vs. multiple 129Xe doses.

Statistical Tests

Multivariate analysis of variance, independent t‐tests and voxel‐by‐voxel basis difference test.

Results

For the retrospectively undersampled 129Xe data, a nonsignificant mean difference for ADC/Lm of 14%/12%, 12%/8%, and 11%/9% was observed (all, P > 0.4) between the fully sampled and accelerated data for the never‐smoker, COPD, and alpha‐1 antitrypsin deficiency (AATD) groups, respectively. The control never‐smoker group had significantly lower ADC (P < 0.001) and Lm (P < 0.001) than the COPD/AATD group for both fully sampled and accelerated data. For the prospectively acquired 3He MRI data, static‐ventilation, T2*, ADC, and morphometry maps were acquired using a single 16‐second breath‐hold scan and single gas dose. Accelerated imaging resulted in cost savings of ~$US 1000/patient, a conservative estimate based on 129Xe MRI dose savings (single vs. five doses).

Data Conclusion

This is a proof‐of‐concept demonstration of accelerated (7×) morphometry that shows that less cost‐ and time‐efficient multibreath methods that lead to variability and patient fatigue may be avoided in the future.

Level of Evidence: 2

Technical Efficacy: Stage 5

J. Magn. Reson. Imaging 2018.
MRI prognosticators for adverse maternal and neonatal clinical outcome in patients at high risk for placenta accreta spectrum (PAS) disorders
Authors: Bourgioti Charis , Zafeiropoulou Konstantina , Fotopoulos Stavros , Nikolaidou Maria Evangelia , Theodora Marianna , Daskalakis George , Tzavara Chara , Chatoupis Konstantinos , Panourgias Evangelia , Antoniou Aristeidis , Konstantinidou Anastasia , Moulopoulos Lia Angela
Published: December 2018

Background

Placenta accreta spectrum (PAS) disorders may be associated with significant mortality and morbidity for both mother and fetus.

Purpose/Hypothesis

To identify MRI risk factors for poor peripartum outcome in gravid patients at risk for PAS.

Study Type

Prospective.

Population

One hundred gravid women (mean age: 34.9 years) at third trimester, with placenta previa.

Field Strength/Sequence

T2‐SSTSE (single‐shot turbo spin echo), T2‐TSE, T1‐TSEFS (TSE images with fat‐suppression) at 1.5T.

Assessment

Fifteen MRI features considered indicative of PAS were recorded by three radiologists and were tested for any association with the following adverse peripartum maternal and neonatal events: increased operation time, profound blood loss, hysterectomy, bladder repair, ICU admission, prematurity, low birthweight, and 5‐minute APGAR score <7.

Statistical Tests

Kappa (K) coefficients were computed as a measure of agreement between intraoperative information/histology and MRI results as well as for interobserver agreement; chi‐square and Fisher's exact tests were used to explore the association of the MRI signs with clinical complications. A score was calculated by adding all recorded MRI signs and its predictive ability was tested using receiver operating characteristic (ROC) analysis, against all complications, separately; odds ratios (ORs) for optimal cutoffs were determined with logistic regression analysis.

Results

There was excellent agreement (K >0.75, P < 0.001) between MRI and intraoperative findings for invasive placenta, bladder and parametrial involvement. Intraplacental T2 dark bands, myometrial disruption, uterine bulge, and hypervascularity at the utero‐placental interface or parametrium, showed significant association (P < 0.005) with poor clinical outcome for both mother and fetus. The MRI score showed significant predictive ability for each adverse maternal event (area under the curve [AUC]: 0.85–0.97, P < 0.001). The presence of ≥3 MRI signs was the cutoff point for a complicated delivery (OR: 19.08, 95% confidence interval [CI]: 6.05–60.13) and ≥6 MRI signs was the cutoff point for massive bleeding (OR: 90.93, 95% CI: 11.3–729.23), hysterectomy (OR: 72.5, 95% CI: 17.9–293.7), or extensive bladder repair (OR: 58.74, 95% CI: 7.35–469.32). The MRI score was not significant for predicting adverse neonatal events including preterm delivery (P = 0.558), low birthweight (P = 0.097), and 5‐minute Apgar score (P = 0.078).

Data Conclusion

Preoperative identification of specific MRI features may predict peripartum course in high‐risk patients for PAS.

Level of Evidence: 1

Technical Efficacy: Stage 5

J. Magn. Reson. Imaging 2019;50:602–618.
Ultralong TE In Vivo 1H MR Spectroscopy of Omega‐3 Fatty Acids in Subcutaneous Adipose Tissue at 7 T
Authors: Gajdošík Martin , Hingerl Lukas , Škoch Antonín , Freudenthaler Angelika , Krumpolec Patrik , Ukropec Jozef , Ukropcová Barbara , Šedivý Petr , Hájek Milan , Itariu Bianca K. , Maier Bernhard , Baumgartner‐Parzer Sabina , Krebs Michael , Trattnig Siegfried , Krššák Martin
Published: December 2018

Background

Omega‐3 (n‐3) fatty acids (FA) play and important role in neural development and other metabolic diseases such as obesity and diabetes. The knowledge about the in vivo content and distribution of n‐3 FA in human body tissues is not well established and the standard quantification of FA is invasive and costly.

Purpose

To detect omega‐3 (n‐3 CH3) and non‐omega‐3 (CH3) methyl group resonance lines with echo times up to 1200 msec, in oils, for the assessment of n‐3 FA content, and the n‐3 FA fraction in adipose tissue in vivo.

Study Type

Prospective technical development.

Population

Three oils with different n‐3 FA content and 24 healthy subjects.

Field Strength/Sequence

Single‐voxel MR spectroscopy (SVS) with a point‐resolved spectroscopy (PRESS) sequence with an echo time (TE) of 1000 msec at 7 T.

Assessment

Knowledge about the J‐coupling evolution of both CH3 resonances was used for the optimal detection of the n‐3 CH3 resonance line at a TE of 1000 msec. The accuracy of the method in oils and in vivo was validated from a biopsy sample with gas chromatography analysis.

Statistical Tests

SVS data were compared to gas chromatography with the Pearson correlation coefficient.

Results

T2 relaxation times in oils were assessed as follows: CH2, 65 ± 22 msec; CH3, 325 ± 7 msec; and n‐3 CH3, 628 ± 34 msec. The n‐3 FA fractions from oil phantom experiments (n = 3) were in agreement with chromatography analysis and the comparison of in vivo obtained data with the results of chromatography analysis (n = 5) yielded a significant correlation (P = 0.029).

Data Conclusion

PRESS with ultralong‐TE can detect and quantify the n‐3 CH3 signal in vivo at 7 T.

Level of Evidence: 1

Technical Efficacy: Stage 1

J. Magn. Reson. Imaging 2019;50:71–82.
Influence of HLA‐B18 on liver fibrosis progression in a cohort of HIV/HCV coinfected individuals
Authors: Bavaro Davide Fiore , Saracino Annalisa , Fiordelisi Deborah , Bruno Giuseppe , Ladisa Nicoletta , Monno Laura , Angarano Gioacchino
Published: December 2018

Liver fibrosis is accelerated in human immunodeficiency virus/hepatitis C virus (HIV/HCV) coinfected compared with HCV monoinfected patients, due to multiple cofactors. Recently, HLA‐B18 haplotype has been associated with short‐term liver disease progression in this population. Our aim was to assess the influence of HLA‐B18 on the fibrosis process in HIV/HCV coinfected individuals, untreated for HCV, during a long‐term follow‐up. All consecutive HIV/HCV co‐infectedcoinfected patients followed in our center, with positive HCV‐RNA and available human leukocyte antigen (HLA) haplotypes (determined by sequence‐specific oligonucleotide primed polymerase chain reaction and simple sequence repeats polymerase chain reaction using Luminex Technology) were included. Liver fibrosis progression was assessed by means of fibrosis‐4 index for liver fibrosis (FIB‐4) and AST to platelet ratio index. The association between FIB‐4 score over time and laboratory and clinical parameters, including HLA, was evaluated by univariate and multivariate multilevel generalized linear models. A total of 29 out of 148 screened patients were excluded because of spontaneous HCV clearance (27% were HLA‐B18+). Among the remaining 119 individuals (82% males; median age at first visit = 30 years [interquartile range, IQR, 26‐35]; median follow‐up = 21.5 years [IQR, 15‐25]), 26% were HLA‐B18+. No baseline differences were evidenced between HLA‐B18+ and B18− patients. Fibrosis progression was significantly faster in HLA‐B18+ than in HLA‐B18− patients (
P < 0.001) (Figure 1). At univariate analysis, age (
P < 0.001), HLA‐B18 haplotype (
P = 0.02) and HIV‐RNA viral load overtime (
P < 0.001) were associated with liver disease progression. At multivariate analysis, only age (
P < 0.001) remained independently associated with liver fibrosis progression. Our data suggest a possible association between HLA‐B18 and an accelerated liver fibrosis in HIV/HCV coinfected with a long‐term follow‐up.
Formulating the right labor mix for a Malaysian food manufacturer
Authors: Muthusamy Vimalambigai , Abdul Rasid Siti Zaleha
Published: December 2018

A heavy dependence on an unskilled migrant labor pool with a high turnover rate was impeding productivity for a food manufacturer in Malaysia. At the same time, the Malaysian government was encouraging industries to reduce their reliance on foreign unskilled workers and improve the training of local talent to drive growth. These circumstances led the food company's managers to reevaluate its workforce model. An internal task force, which was established to analyze the company's labor mix and make workforce planning recommendations, considered desired level of stability, internal requirements, evolving government policies and legislation, and the organization's strategic direction. The new system that was proposed decreased the company's reliance on temporary, unskilled foreign labor, improved local recruitment and training, and reduced turnover among skilled personnel.
Cadmium concentrations in German soybeans are elevated in conurbations and in regions dominated by mining and the metal industry
Authors: Franzaring Jürgen , Fangmeier Andreas , Schlosser Sonja , Hahn Volker
Published: December 2018

BACKGROUND

Cadmium (Cd) is a mobile heavy metal and soybeans accumulate more of this element compared to other grain crops. Because vegan and vegetarian lifestyles are increasingly popular, plant‐based diets should be free from contaminants. Cd minimization has recently been identified as a breeding aim in addition to protein and oil levels. It is also important to consider the regional variability of Cd in crops.

RESULTS

A large sample collection (n = 602) was subjected to Cd analyses. Soybeans were grown using a standard protocol by private gardeners in a citizen science program. Some 12.5% of samples exceeded European Union limits, although Cd concentrations and exceedances showed regional variation around the national mean (0.13 mg kg−1). Contamination was higher in densely populated regions, possibly as a result of the long‐term emissions of heavy metal loaded dusts from industry, traffic and energy production. Cd concentrations were also elevated in regions once characterized by mining and heavy industry. Values were low overall in rural areas and agricultural regions despite potential inputs via phosphate fertilizers.

CONCLUSION

Grain Cd levels are highly variable across Germany. Soybean farming may be problematic in regions with a long history of mining and heavy metal deposition. © 2018 Society of Chemical Industry
Twenty‐five years of total antioxidant capacity measurement of foods and biological fluids: merits and limitations
Authors: Pellegrini Nicoletta , Vitaglione Paola , Granato Daniel , Fogliano Vincenzo
Published: December 2018

This review summarises 25 years of investigations on antioxidants research in foods and biological fluids and critically analyses the merits and limitations of using the total antioxidant capacity (TAC) measurement in the metabolomic era. An enormous bulk of knowledge was produced regarding the antioxidant capacity of foods and large TAC databases were developed. A direct link between a food TAC value and any health benefit is erroneous and has led to several cases of consumer deception. However, the striking epidemiological evidence associating a high dietary TAC with some disease prevention and the availability of well‐constructed TAC databases deserve attention and must be taken into account to establish the usefulness of measuring TAC in both foods and biological samples. The in vivo TAC measurement, usually performed in plasma, is influenced by many external factors, such as dietary habits, as well as environmental and behavioural factors, which are integrated towards homeostatic control by fine physiological mechanisms with high inter‐individual variability. Therefore, plasma TAC cannot be considered as a unique biomarker of individual antioxidant status. However, the combined evaluation of plasma TAC with known markers of disease, individual metabolism, inflammation and genetics, as well as with markers of gut microbiota composition and activity, may lead to the identification of populations that are more responsive to food/diet TAC. In this framework, the appropriate use of TAC measurement both in food and in vivo can still provide support for the interpretation of complex phenomena and be a tool for sample screening when making a quick decision toward in‐depth research investigations. © 2018 Society of Chemical Industry
Evaluation of the Optic Nerve by Strain and Shear Wave Elastography in Patients With Migraine
Authors: Şahan Mehmet Hamdi , Doğan Adil , İnal Mikail , Alpua Murat , Asal Neşe
Published: December 2018

Objectives

To investigate the optic nerve's elastic properties using shear wave and strain elastography in patients with migraine compared to healthy individuals.

Methods

The migraine group consisted of 30 patients (16 with visual auras and 14 without auras) who had previously had a diagnosis of migraine. These were age and sex matched with healthy participants to form the control group. The findings from shear wave and strain elastography in the groups were compared. The elastographic examination was performed with a 6–15‐MHz multifrequency linear array transducer.

Results

The evaluation involved 30 patients with migraine (3 male and 27 female), whose mean age ± SD was 34.63 ± 10 years, and 30 healthy participants (3 males, 27 females), whose mean age was 36.4 ± 10.5 years. In strain elasticity patterns, a statistically insignificant hardening of the optic nerve in the patients with migraine was observed (P = .052). Analysis of the shear wave elastic modulus values (9.8 ± 3.34 and 12.3 ± 5.25 kPa; P = .03) revealed that differences between the healthy participants and patients with migraine were statistically significant. The results for elasticity patterns and the shear modulus suggested that the differences between migraines with and without visual auras were insignificant (P > .05). A positive correlation was discovered between the duration of the disease and the shear modulus in the patients with migraine (r = 0.496; P < .01).

Conclusions

Histopathologic changes in the optic nerve may be seen in patients with migraine due to possible fibrotic changes. Elastographic techniques can be useful diagnostic tools for investigating these changes.
Photodegradation of Direct Blue‐199 in carpet industry wastewater using iron‐doped TiO2 nanoparticles and regenerated photocatalyst
Authors: Saroj Sudhakar , Singh Laxman , Singh Satya Vir
Published: December 2018

Fe‐doped TiO2, Ti1–xFexO2 (x = 0.00, 0.02, 0.04, 0.06, 0.08, and 0.10), photocatalysts have been successfully synthesized via citric acid–assisted autocombustion method. The synthesized photocatalysts were characterized using different characterization techniques, such as X‐ray diffraction (XRD), diffuse reflectance spectroscopy (DRS), Fourier transform infrared (FT‐IR), transmission electron microscopy (TEM), energy dispersive x‐ray spectroscopy (EDX), and x‐ray photoelectron spectroscopy (XPS). The XRD diffraction patterns revealed that synthesized photocatalysts have the anatase phase of TiO2. The DRS analysis indicates a slight increment in absorbance in the visible light region by the Fe doping in TiO2. The FT‐IR spectra reveal the various stretching and bending vibrational bands of the Ti–O lattice. The XPS spectra confirm the presence of elements titanium, oxygen, and iron in the synthesized samples and determine binding energy of elements. TEM analysis shows the shape of the synthesized photocatalyst, and it was used to calculate the average particle sizes of undoped and Fe‐doped TiO2 (Ti0.96Fe0.04O2) photocatalysts using a histogram. The photocatalytic activities of synthesized photocatalysts were determined by photodegradation of dye (Direct Blue 199), contaminating carpet industry wastewater in the photochemical reactor and open pan reactor. The maximum photodegradation activity was shown by the Ti0.96Fe0.04O2 photocatalyst among all the synthesized undoped and Fe‐doped photocatalysts. The synthesized photocatalyst (Ti0.96Fe0.04O2) had better photocatalytic activity when compared to both, undoped TiO2 and Aeroxide (Degussa) P‐25. The used Fe‐doped TiO2 photocatalyst (Ti0.96Fe0.04O2) was regenerated five times and investigated for its photocatalytic activity.
Patient opinions regarding surgeon presence, trainee participation, and overlapping surgery
Authors: Arambula Alexandra , Bonnet Kemberlee , Schlundt David G. , Langerman Alexander
Published: December 2018

Objectives

To explore patient opinions and underlying values regarding overlapping surgery (OS) scenarios, specifically evaluating the effect of attending surgeon presence and availability, as well as trainee participation on patient comfort level and willingness to consent.

Study Design

Mixed methods.

Methods

Forty adults participated in semi‐structured interviews. Interviews included vignettes involving three scenarios of OS (1: attending present; 2: attending absent for wound closure; 3: attending absent and unavailable for wound closure, with covering attending), visual analog scale ratings of participants’ comfort with scenarios, and cognitive debriefing. Themes and subthemes were identified using hierarchical coding of transcripts, and quantitative and qualitative analyses were conducted.

Results

Quantitative analysis revealed anticipated decreases in comfort with decreasing attending presence/availability (mean comfort level 94% vs. 78% vs. 63% for scenarios 1 vs. 2 vs. 3, P < 0.005), although many patients reported improved comfort with scenario 3 if meeting the covering attending. Participants demonstrated a preference for less trainee involvement (P < 0.005, scenario 1) and greater trainee experience (P < 0.05, all scenarios). However, not all individuals were uncomfortable with attending absence or trainee independence. Themes important for decision making included trust in the surgeon, surgeon experience, trainee involvement, disease severity, cost, and wait time.

Conclusion

Patients varied highly in their willingness to consent to OS scenarios. In settings of trainee independence and covering surgeons, many patients desired meeting these members of the treatment team, which improved comfort for some. For some patients, tradeoffs and incentives of timeliness, cost, and convenience modified their willingness to have OS.

Level of Evidence

4

Laryngoscope, 129:1337–1346, 2019
Otologic considerations in a full face transplant recipient
Authors: Cammarata Michael J. , Jethanamest Daniel , Rodriguez Eduardo D.
Published: December 2018

Facial transplantation provides a functional and aesthetic solution to severe facial disfigurement previously unresolved by conventional reconstruction. Few facial allografts have been ear containing; hence, there is limited knowledge of the postoperative otologic considerations. We describe the case of a 44‐year‐old man who underwent transplantation of the total face, eyelids, ears, scalp, and skeletal subunits in 2015 after an extensive thermal injury. We detail the patient's transition from osseointegrated prosthetic ears to an ear‐containing facial allograft, and describe the unique surgical approach and challenges encountered. Subsequent bilateral revision meatoplasties were performed, which provided relief from stenosis of the external auditory meatus.

Laryngoscope, 129:2008–2011, 2019
Observations from a pediatric dysphagia clinic: Characteristics of children at risk of aspiration pneumonia
Authors: Pavithran Jayanthy , Puthiyottil Indu Vadakke , Narayan Mythili , Vidhyadharan Sivakumar , Menon Jayakumar R. , Iyer Subramania
Published: December 2018

Objectives

The clinical variables that are predictive of aspiration pneumonia are not clear in the pediatric population. This study was conducted in order to identify the demographic, clinical, and radiological risk factors for the development of aspiration pneumonia in children referred to the dysphagia clinic.

Methods

A retrospective analysis of medical records of 88 children referred to the dysphagia clinic who had undergone videofluroscopic swallow study (VFSS).

Results

Oropharyngeal dysphagia was found in 61.3% (54 of 88). Incidence of aspiration pneumonia was 39.8% (35 of 88).

Conclusion

Respiratory symptoms such as cough, choking, excessive secretions, and pharyngeal dysmotility other than aspiration in VFSS were not predictors of pneumonia. Infants and children with laryngotracheal anomalies, demonstrable aspiration in VFSS, and major cardiac illness are at risk of presenting with aspiration pneumonia. Whether gastroesophageal reflux disease (GERD) or esophageal dysmotility are causative of aspiration in the rest of the population needs to be investigated by future prospective studies.

Level of Evidence

3b. Laryngoscope, 129:2614–2618, 2019
cd44 deletion suppresses atypia in the precancerous mouse testis
Authors: Li Huaibiao , Shukla Shalmali , Frappart Lucien , Herrlich Peter , Ploubidou Aspasia
Published: December 2018

Loss‐of‐function of RHAMM causes hypofertility and testicular atrophy in young mice, followed by germ cell neoplasia in situ (GCNIS) of the testis, cellular atypia, and development of the testicular germ cell tumor (TGCT) seminoma. These pathologies reflect the risk factors and phenotypes that precede seminoma development in humans and—given the high prevalence of RHAMM downregulation in human seminoma—link RHAMM dysfunction with the aetiology of male hypofertility and GCNIS‐related TGCTs. The initiating event underlying these pathologies, in RHAMM mutant testis, is premature displacement of undifferentiated progenitors from the basal compartment. We hypothesized that cd44 (both cancer initiating cell‐ and oncogenic progression marker) will drive GCNIS development, induced by RHAMM‐loss‐of‐function in the mouse. We report that cd44 is expressed in a specific subset of GCNIS testes. Its genetic deletion has no effect on GCNIS onset, but it ameliorates oncogenic progression. We conclude that cd44 expression, combined with RHAMM dysfunction, promotes oncogenic progression in the testis.