bluuebunny/crossref_metadata_2025 huggingface dataset:
Validation of the Arabic version of the binge eating scale and correlates of binge eating disorder among a sample of the Lebanese population
Authors: Zeidan Rouba Karen , Haddad Chadia , Hallit Rabih , Akel Marwan , Honein Karl , Akiki Maria , Kheir Nelly , Hallit Souheil , Obeid Sahar
Published: December 2019

Objectives

To test the psychometric properties of the Arabic version of the Binge Eating Scale (BES), a self-questionnaire assessing binge eating, in a sample of the Lebanese population. The secondary objective was to evaluate factors associated with binge eating.

Methods

This cross-sectional study, conducted between January and May 2018, enrolled 811 adult participants from all districts of Lebanon. The BES was administered to study its psychometric properties. The sample was divided into two separate samples (405 for sample 1 and 406 for sample 2). An exploratory factor analysis was executed on Sample 1, followed by a confirmatory factor analysis on Sample 2 using the structure obtained in Sample 1. Three hierarchical stepwise linear regressions were conducted to assess factors associated with binge eating.

Results

The factor analysis suggested a two-factor structure for the BES explaining a total of 41.4% of the variance. All items could be extracted from the list. The internal consistency of the measurement was adequate (Cronbach’s alpha = 0.86). The confirmatory factor analysis revealed an adequate fit to the model with satisfactory Maximum Likelihood Chi-Square/Degrees of Freedom (χ2/df), Steiger-Lind RMSEA, Joreskog GFI, and AGFI. Higher BMI, depression, anxiety, emotional eating, greater body dissatisfaction, and more pressure from media to lose weight were associated with higher binge eating. Higher expressive suppression facet score was associated with lower binge eating.

Conclusion

The Arabic version of BES could be a useful tool for screening and assessing the binge eating behaviors in clinical practice and research. Also, being dissatisfied with one’s body size, having a history of sexual abuse, family history of binge eating, increased depressive/anxiety symptoms, and lower self-esteem seem to be associated with higher BES scores.
C-reactive protein concentration in bipolar disorder: association with genetic variants
Authors: Evers Ann-Kristin , Veeh Julia , McNeill Rhiannon , Reif Andreas , Kittel-Schneider Sarah
Published: December 2019

Background

Several recent studies have investigated the role of C-reactive protein (CRP) in bipolar disorder (BD), but few studies have directly investigated the interaction between CRP genetic variants and peripheral CRP concentration across different phases of BD. In this study, we aimed to replicate previous findings that demonstrated altered CRP levels in BD, and to investigate whether there is an association of peripheral protein expression with genetic variants in the CRP gene.

Methods

221 patients were included in the study, of which 183 (all episodes, 46 not medicated, 174 medicated) were genotyped for CRP single-nucleotide polymorphisms (SNPs) shown to influence peripheral CRP protein expression (rs1800947, rs2808630, rs1417938, rs1205).

Results

There were no differences in CRP levels associated with the genotypes, only regarding the rs1205 SNP there were significantly different CRP protein expression between the genotypes when taking body mass index, age, BD polarity, subtype and leukocyte number into account. However, we could show significantly elevated CRP protein expression in manic patients compared to euthymic and depressed patients, independent from genotype. Medication was found to have no effect on CRP protein expression.

Conclusions

These results indicate that low grade inflammation might play a role in mania and might be rather a state than a trait marker of bipolar disorder.
Circadian sleep/wake-associated cells show dipeptide repeat protein aggregates in C9orf72-related ALS and FTLD cases
Authors: Dedeene Lieselot , Van Schoor Evelien , Vandenberghe Rik , Van Damme Philip , Poesen Koen , Thal Dietmar Rudolf
Published: December 2019

Motor-, behavior- and/or cognition-related symptoms are key hallmarks in patients with amyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration (FTLD) with TDP-43 pathology (FTLD-TDP), respectively. It has been reported that these patients also experience sleep disturbances, which might implicate a disturbed circadian rhythm of the sleep/wake cycle. It remains unknown, however, whether cells involved in the circadian sleep/wake cycle are affected by ALS- and FTLD-related neuropathological changes including phosphorylated TDP-43 (pTDP-43) aggregates and dipeptide repeat protein (DPR) inclusions resulting from the C9orf72 hexanucleotide repeat expansion. Immunohistochemistry for DPR and pTDP-43 pathology was performed in post-mortem hypothalamus and pineal gland tissue of patients with ALS and/or FTLD-TDP with and without the C9orf72 repeat expansion and healthy controls. Circadian sleep/wake-associated cells, including pinealocytes and hypothalamic neurons related to the suprachiasmatic nucleus (SCN), were microscopically assessed. We observed numerous DPR inclusions (poly(GA), poly(GP), poly(GR) and poly(PR)) in the pinealocytes and few poly(GA) inclusions in the SCN-related neurons in C9orf72-related ALS and/or FTLD-TDP cases. These circadian sleep/wake-associated cells, however, were devoid of pTDP-43 pathology both in C9orf72- and nonC9orf72-related ALS and/or FTLD-TDP cases. Our neuropathological findings show that pinealocytes and, to a lesser extent, SCN-related neurons are affected by DPR pathology. This may reflect an involvement of these cells in sleep/wake disturbances observed in ALS and/or FTLD-TDP patients.
Plant growth stage influences heavy metal accumulation in leafy vegetables of garden cress and sweet basil
Authors: Souri Mohammad Kazem , Hatamian Mansoure , Tesfamariam Tsehaye
Published: December 2019

Background

Contamination of vegetable crops with heavy metals is a great threat to human health. On the other hand, monitoring plant tissue content of heavy metals at different growth stages could have important implications. In this study, shoot and root samples of garden cress and sweet basil were collected from five farms, from heavy metal polluted fields located in Shahre Rey, south of Tehran, Iran, in either young (3 weeks old) or mature (7 weeks old) plants. The concentrations of cadmium (Cd), lead (Pb), nickel (Ni), arsenic (As), chromium (Cr), cobalt (Co), copper (Cu), manganese (Mn) and zinc (Zn) in plant tissues were determined using atomic absorption spectroscopy. In another study, 2 weeks (young) or 6 weeks old (mature) plants of garden cress were subjected to three concentrations of Cd and Pb (0, 5, 10 mg L−1) under hydroponic sand culture for 5 days, in which Hoagland formula was used for nutrient solution preparation.

Results

The results showed that root concentration of various heavy metals, particularly Cd, As, Ni, Co, Cu, Mn and Zn but not Pb were significantly higher than their shoot concentration in either crop under field sampling. The leaf concentration of some heavy metals was significantly different in seedling and older (mature) plant samples of either crop. Young plant leaves of sweet basil had significantly less Cd, Pb, As and higher Cu than mature plants, whereas young garden cress plants had similar Cd, Pb and higher As and Zn concentrations than mature plants. The Cr, Co, Mn and Zn concentrations were similar in young and mature plants of sweet basil. The Mn, Co, Cr and Ni concentration of young and mature plants of either crop was also similar. The result of hydroponic study showed that young plants of garden cress had higher potential to accumulate lead in shoot and root, particularly in lower (5 mg L−1) than higher (10 mg L−1) lead concentration; however, root Pb concentration at 10 mg L−1 Pb of nutrient solution showed no difference between young and mature plants. Regarding cadmium, young garden cress plants accumulated higher Cd than mature plants in their shoot, particularly under higher Cd levels (10 rather than 5 mg L−1) of nutrient solution; however, a wide difference in root Cd concentration was observed under low (5 mg L−1) than higher (10 mg L−1) cadmium concentration of nutrient solution.

Conclusion

The results of these two studies indicate that despite that young plants have a higher potential for heavy metal uptake and accumulation, the low difference in young and mature plants in the polluted fields may be due to the longer period of plant growth of mature plants that may increase the risk of exposure to polluted air and dust deposition containing high levels of heavy metals.
Influence of lung aeration on diaphragmatic contractility during a spontaneous breathing trial: an ultrasound study
Authors: Xia Jing , Qian Chuan-Yun , Yang Li , Li Mei-Ju , Liu Xiao-Xue , Yang Ting , Lu Qin
Published: December 2019

Background

A spontaneous breathing trial (SBT) is a major diagnostic tool to predict successfully extubation in patients. Several factors may lead to weaning failure, including the degree of lung aeration loss and diaphragm dysfunction. The main objective was to compare the diaphragmatic contractility between patients with high lung aeration loss and low lung aeration loss during a 30-minute SBT by ultrasound.

Methods

This was a prospective single-center study. Lung ultrasound aeration score (LUS) and diaphragmatic thickening fraction (DTF) were measured during mechanical ventilation 1 h before SBT (T-1), 30 min (T1), and 120 min (T2) after the start of the SBT during quiet breathing. The right and left DTF were compared between patients with LUS ≥ 14 (high lung aeration loss), considered at high risk of post-extubation distress, and those with LUS < 14 (low lung aeration loss). The relationship between the LUS and DTF and the changes in LUS and DTF from T-1 to T2 in patients with LUS ≥ 14 were assessed.

Results

Forty-nine patients were analyzed; 33 had LUS ≥ 14 and 16 had LUS < 14 at T1. The DTF at T1 was significantly higher in patients with LUS ≥ 14 than in those with LUS < 14: the right median (IQR) DTF was 22.2% (17.1 to 30.9%) vs. 14.8% (10.2 to 27.0%) (p = 0.035), and the left median (IQR) DTF was 25.0% (18.4 to 35.0%) vs. 18.6% (9.7 to 24.2%) (p = 0.017), respectively. There was a moderate positive correlation between the LUS and the DTF (Rho = 0.3, p = 0.014). A significant increase in the LUS was observed from T-1 to T1, whereas no change was found between T1 and T2. The DTF remained stable from T-1 to T2.

Conclusions

During a SBT, diaphragmatic contraction acts differently depending on the degree of pulmonary aeration. In patients with high lung aeration loss, increased diaphragmatic contractility indicates an additional respiratory effort to compensate lung volume loss that would contribute to successful SBT. Further studies are needed to evaluate the combined evaluation of lung aeration and diaphragmatic function to predict the successful weaning of patients from mechanical ventilation.
Periosteal incarceration versus interposition adipose tissue grafting in physeal fractures: pilot study in immature rabbits
Authors: Edmonds Eric W. , Doan Joshua D. , Farnsworth Christine L.
Published: December 2019

Purpose

The purpose of this study is to evaluate bar formation following physeal fracture with incarcerated periosteum or adipose tissue graft using radiographic and histological methods in an immature rabbit model.

Methods

Ten-week-old rabbits underwent induced proximal tibia physeal fractures with a contralateral sham. Fractures had periosteum (n = 5) or adipose tissue (n = 5) interposed. Radiographs were compared over time by tibial medial-lateral side difference (TMLSD)(mm), femoral-tibial angle and tibia plateau angle, and physeal bars evidence. MicroCT was performed, growth plates reconstructed, and physeal area calculated and normalized to same animal contralateral physes. Physeal disruption and chondrocyte organization were evaluated histologically.

Results

Radiographic: After 6 weeks, physeal bars formed in both periosteum (4 of 4) and fat groups (3 of 5). The periosteum group showed a significant increase in the TMLSD between immediate post-op and 10 days later (p = 0.028); but, after 6 weeks, TMLSD change was not significantly different between the three groups (p = 0.161). MicroCT: The normalized physeal area of every physis in the fat group was more than 0.9 (0.99 ± 0.06). Only half of the periosteum group was over 0.9 (0.81 ± 0.24). Histology: Physeal disruption was seen by microscopic evaluation in none of the sham group, all 4 in the periosteum group and 4 of 5 in the fat group.

Conclusions

Fat interposition may prevent, or at least delay, the onset of bars across a fractured physis compared to periosteum, but it is not completely protective.
Bench to bedside review: therapeutic modulation of nitric oxide in sepsis—an update
Authors: Lambden Simon
Published: December 2019

Nitric oxide is a signalling molecule with an extensive range of functions in both health and disease. Discovered in the 1980s through work that earned the Nobel prize, nitric oxide is an essential factor in regulating cardiovascular, immune, neurological and haematological function in normal homeostasis and in response to infection. Early work implicated exaggerated nitric oxide synthesis as a potentially important driver of septic shock; however, attempts to modulate production through global inhibition of nitric oxide synthase were associated with increased mortality. Subsequent work has shown that regulation of nitric oxide production is determined by numerous factors including substrate and co-factor availability and expression of endogenous regulators. In sepsis, nitric oxide synthesis is dysregulated with exaggerated production leading to cardiovascular dysfunction, bioenergetic failure and cellular toxicity whilst at the same time impaired microvascular function may be driven in part by reduced nitric oxide synthesis by the endothelium. This bench to bedside review summarises our current understanding of the ways in which nitric oxide production is regulated on a tissue and cellular level before discussing progress in translating these observations into novel therapeutic strategies for patients with sepsis.
Combination of cardiac and thoracic pump theories in rodent cardiopulmonary resuscitation: a new method of three-side chest compression
Authors: Okuma Yu , Shinozaki Koichiro , Yagi Tsukasa , Saeki Kota , Yin Tai , Kim Junhwan , Becker Lance B.
Published: December 2019

Background

High-quality cardiopulmonary resuscitation (HQ-CPR) is of paramount importance to improve neurological outcomes of cardiac arrest (CA). The purpose of this study was to evaluate chest compression methods by combining two theories: cardiac and thoracic pumps.

Methods

Male Sprague-Dawley rats were used. Three types of chest compression methods were studied. The 1-side method was performed vertically with 2 fingers over the sternum. The 2-side method was performed horizontally with 2 fingers, bilaterally squeezing the chest wall. The 3-side method combined the 1-side and the 2-side methods. Rats underwent 10 min of asphyxial CA. We examined ROSC rates, the left ventricular functions, several arterial pressures, intrathoracic pressure, and brain tissue oxygen.

Results

The 3-side group achieved 100% return of spontaneous circulation (ROSC) from asphyxial CA, while the 1-side group and 2-side group achieved 80% and 60% ROSC, respectively. Three-side chest compression significantly shortened the time for ROSC among the groups (1-side, 105 ± 36.0; 2-side, 141 ± 21.7; 3-side, 57.8 ± 12.3 s, respectively, P < 0.05). Three-side significantly increased the intrathoracic pressure (esophagus, 7.6 ± 1.9, 7.3 ± 2.8, vs. 12.7 ± 2.2; mmHg, P < 0.01), the cardiac stroke volume (the ratio of the baseline 1.2 ± 0.6, 1.3 ± 0.1, vs. 2.1 ± 0.6, P < 0.05), and the common carotid arterial pressure (subtracted by femoral arterial pressure 4.0 ± 2.5, 0.3 ± 1.6, vs. 8.4 ± 2.6; mmHg, P < 0.01). Three-side significantly increased the brain tissue oxygen (the ratio of baseline 1.4±0.1, 1.3±0.2, vs. 1.6 ± 0.04, P < 0.05).

Conclusions

These results suggest that increased intrathoracic pressure by 3-side CPR improves the cardiac output, which may in turn help brain oxygenation during CPR.
Needle-free connectors catheter-related bloodstream infections: a prospective randomized controlled trial
Authors: Koeppen Michael , Weinert Franziska , Oehlschlaeger Sabrina , Koerner Andreas , Rosenberger Peter , Haeberle Helene Anna
Published: December 2019

Background

In the critically ill, catheter-related bloodstream infection can result from bacterial contamination of infusion hubs of intravascular catheters. Needle-free connectors (NFC) have been suggested to reduce the rate of bacterial contamination and subsequent catheter-related bloodstream infection (CRBSI), but data remains ambiguous. Thus, we tested if a novel NFC would reduce bacterial contamination and subsequent CRBSI.

Results

In a prospective, randomized controlled trial, surgical ICU patients were randomized to three-way hubs closed by caps or Bionecteur® (Vygon, Inc.) of central venous catheters. Every 72 h, infusion lines were renewed and microbiological samples were taken. Bacterial growth was analyzed by blinded microbiologists. Incidence of bacterial contamination and CRSBI were assessed. Outcome parameters like length of stay on ICU and outcome were retrospectively assessed. Two thousand seven hundred patients were screened, 111 were randomized to the NFC, and 109 into the control group. Finally, 24 patients in the NFC and 23 control patients were analyzed. The majority of samples (NFC 77%; control 70%) found no bacterial growth. Coagulase-negative staphylococci were most commonly detected on CVC samples (NFC 17%; control 21%). We found CRBSI (defined as identical pathogens in blood culture and catheter line tip culture, and clinical manifestations of infection) in two control patients and one patient of the NFC group. Their length of ICU stay did not differ between groups (NFC 19 days; control 23 days).

Conclusion

The use of NFC does not influence the rate of bacterial contamination of infusion hubs of central venous catheters.

Trial registration

Clinicaltrials.gov, NCT02134769. Registered 09 May 2014.
Bioleaching of heavy metals from printed circuit board (PCB) by Streptomyces albidoflavus TN10 isolated from insect nest
Authors: Kaliyaraj Dhanalashmi , Rajendran Menaka , Angamuthu Vignesh , Antony Annam Renita , Kaari Manigundan , Thangavel Shanmugasundaram , Venugopal Gopikrishnan , Joseph Jerrine , Manikkam Radhakrishnan
Published: December 2019

Background

E-waste management is extremely difficult to exercise owing to its complexity and hazardous nature. Printed circuit boards (PCBs) are the core components of electrical and electronic equipment, which generally consist of polymers, ceramics, and heavy metals.

Results

The present study has been attempted for removal of heavy metals from printed circuit board by metal-resistant actinobacterium Streptomyces albidoflavus TN10 isolated from the termite nest. This bacterium was found to recover different heavy metals (Al 66%, Ca 74%, Cu 68%, Cd 65%, Fe 42%, Ni 81%, Zn 82%, Ag 56%, Pb 46%) within 72 h under laboratory conditions. The metal content of PCB after bioleaching was analyzed by ICP-MS. The crude PCB and bioleaching residue were characterized by FT-IR, XRD, SEM for the determination of structural and functional group changes for confirmation of bioleaching.

Conclusion

The findings of the present study concluded that Streptomyces albidoflavus TN10 is a promising candidate for bioleaching of heavy metals from the printed circuit board as an eco-friendly and cost-effective process.
Response surface optimization of biodiesel yield from pre-treated waste oil of rendered pork from a food processing industry
Authors: Gumahin Arjun C. , Galamiton Jounnever M. , Allerite Meljane J. , Valmorida Rohoney S. , Laranang Jay-R L. , Mabayo Val Irvin F. , Arazo Renato O. , Ido Alexander L.
Published: December 2019

In this study, the waste oil of rendered pork (WO-RP) from a food processing industry was studied as a source of biodiesel. The WO-RP was characterized and was found to have a high acid value of 4.30 mg KOH/g. A pre-treatment using H2SO4was done through the standard titration method that resulted in a reduction of acid value to 0.75 mg KOH/g. The transesterification process over the KOH catalyst was carried out and optimized using the central composite design (CCD) using the Design Expert 7.0 software. The optimum conditions were found at 3:1 methanol–oil molar ratio, 0.55% catalyst loading, and 45-min reaction time. At optimum conditions, the biodiesel yield was 95.28 ± 0.15%. Its chemical characteristics were tested in terms of acid value at 0.75 mg KOH/g, ash content at 0.01 wt%, density at 0.86 g/cm3, HHV at 39.98 MJ/kg, water content at 0.10%, and kinematic viscosity at 6.9 mm2/s. The FAME profile shows the presence of linoleic, palmitic, oleic and stearic acid as major fatty acid components and functional group shows carbonyl group with traces of carboxylic at 1719 cm−1and the sharp peak of esters at 1749 cm−1indicating that the derived product is biodiesel.
Contrast-enhanced ultrasound in detecting wall invasion and differentiating bland from tumor thrombus during robot-assisted inferior vena cava thrombectomy for renal cell carcinoma
Authors: Li Qiu-Yang , Li Nan , Huang Qing-Bo , Luo Yu-Kun , Wang Bao-Jun , Guo Ai-Tao , Ma Xin , Zhang Xu , Tang Jie
Published: December 2019

Background

Vena cava thrombus is one of the main clinical manifestations of locally aggressive renal cell carcinoma (RCC). Inferior vena cava (IVC) wall invasion and presence of bland thrombus could affect the surgical outcome. This study aims to assess the value of contrast-enhanced ultrasound (CEUS) in detecting wall invasion and differentiating bland thrombus from tumor thrombus during robot-assisted IVC thrombectomy for RCC.

Methods

The intraoperative CEUS findings of 60 patients with RCC accompanied by IVC tumor thrombus were retrospectively analyzed. The CEUS features were compared with the intra- and post-operative pathological findings. CEUS in patients with wall invasion showed that the tumor thrombus was enhanced synchronously with the IVC wall, and the continuity of the IVC wall was lost. In contrast, in patients without wall invasion, CEUS showed that the contrast agent could pass between the tumor thrombus and the IVC wall, and the continuity of IVC wall was good. Typically, contrast-enhanced perfusion was seen in tumor thrombus but not in bland thrombus. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CEUS were statistically analyzed.

Results

The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the typical enhancement mode of CEUS were 93.1, 93.5, 93.3, 93.1, and 93.5% in identifying wall invasion and 100, 96, 96.7, 83.3, and 100% in differentiating bland thrombus from tumor thrombus, respectively. There were excellent inter-observer agreements for identifying IVC wall invasion and differentiating bland thrombus from tumor thrombus with kappa coefficients of 0.90 and 0.97.

Conclusions

The present study indicates that intraoperative CEUS plays an important role in robot-assisted IVC thrombectomy for RCC. It can detect wall invasion and differentiate bland thrombus from tumor thrombus, thus offering real-time information to the operator during surgery.
Factors affecting the fashion purchase decision-making of single Koreans
Authors: Lee Jiyong , Hwang Jinsook
Published: December 2019

The number of single consumers in Korea has recently undergone a rapid increase, making this demographic a major consumer market. Through this study, we attempt to better understand this group by focusing on single consumers’ decision-making and the factors influencing their fashion purchases. To this end, we investigate the relationships between feelings of self-consciousness, information search tendencies, decision-making, and post-purchase satisfaction of single-person households after fashion purchases. Data were obtained from 717 questionnaire responses from individuals aged 20–49 years from single-person households. The results of the study showed that the relationship between private self-consciousness and introverted information searches was stronger than that between private self-consciousness and extroverted information searches. The relationship between public self-consciousness and extroverted information searches was stronger than that between public self-consciousness and introverted information searches. In addition, introverted information searches had a positive relationship with self-determination, while extroverted information searches were significantly related only to non-self-determination. Finally, the positive relationship between satisfaction and self-determination was stronger than that between satisfaction and non-self-determination. Overall, the study identified important factors affecting the decision-making process of single Koreans. These findings are vital for Korean fashion marketers, and managerial suggestions are included to implement marketing strategies to target single people.
Deterioration from healthy to mild cognitive impairment and Alzheimer’s disease mirrored in corresponding loss of centrality in directed brain networks
Authors: Zhao Sinan , Rangaprakash D. , Liang Peipeng , Deshpande Gopikrishna
Published: December 2019

Objective

It is important to identify brain-based biomarkers that progressively deteriorate from healthy to mild cognitive impairment (MCI) to Alzheimer’s disease (AD). Cortical thickness, amyloid-ß deposition, and graph measures derived from functional connectivity (FC) networks obtained using functional MRI (fMRI) have been previously identified as potential biomarkers. Specifically, in the latter case, betweenness centrality (BC), a nodal graph measure quantifying information flow, is reduced in both AD and MCI. However, all such reports have utilized BC calculated from undirected networks that characterize synchronization rather than information flow, which is better characterized using directed networks.

Methods

Therefore, we estimated BC from directed networks using Granger causality (GC) on resting-state fMRI data (N = 132) to compare the following populations (p < 0.05, FDR corrected for multiple comparisons): normal control (NC), early MCI (EMCI), late MCI (LMCI) and AD. We used an additional metric called middleman power (MP), which not only characterizes nodal information flow as in BC, but also measures nodal power critical for information flow in the entire network.

Results

MP detected more brain regions than BC that progressively deteriorated from NC to EMCI to LMCI to AD, as well as exhibited significant associations with behavioral measures. Additionally, graph measures obtained from conventional FC networks could not identify a single node, underscoring the relevance of GC.

Conclusion

Our findings demonstrate the superiority of MP over BC as well as GC over FC in our case. MP obtained from GC networks could serve as a potential biomarker for progressive deterioration of MCI and AD.
Data mining polycystic ovary morphology in electronic medical record ultrasound reports
Authors: Cheng Jay Jojo , Mahalingaiah Shruthi
Published: December 2019

Background

Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenemia, oligo-anovulation, and numerous ovarian cysts. Hospital electronic medical records provide an avenue for investigating polycystic ovary morphology commonly seen in PCOS at a large scale. The purpose of this study was to develop and evaluate the performance of two machine learning text algorithms, for classification of polycystic ovary morphology (PCOM) in pelvic ultrasounds.

Methods

Pelvic ultrasound reports from patients at Boston Medical Center between October 1, 2003 and December 12, 2016 were included for analysis, which resulted in 39,093 ultrasound reports from 25,535 unique women. Following the 2003 Rotterdam Consensus Criteria for polycystic ovary syndrome, 2000 randomly selected ultrasounds were expert labeled for PCOM status as present, absent, or unidentifiable (not able to be determined from text alone). An ovary was marked as having PCOM if there was mention of numerous peripheral follicles or if the volume was greater than 10 ml in the absence of a dominant follicle or other confounding pathology. Half of the labeled data was used to develop and refine the algorithms, and the other half was used as a test set for evaluating its accuracy.

Results

On the evaluation set of 1000 random US reports, the accuracy of the classifiers were 97.6% (95% CI: 96.5, 98.5%) and 96.1% (94.7, 97.2%). Both models were more adept at identifying PCOM-absent ultrasounds than either PCOM-unidentifiable or PCOM-present ultrasounds. The two classifiers estimated prevalence of PCOM within the whole set of 39,093 ultrasounds to be 44% PCOM-absent, 32% PCOM-unidentifiable, and 24% PCOM-present.

Conclusions

Although accuracy measured on the test set and inter-rater agreement between the two classifiers (Cohen’s Kappa = 0.988) was high, a major limitation of our approach is that it uses the ultrasound report text as a proxy and does not directly count follicles from the ultrasound images themselves.
A randomized trial comparing the Tennant Biomodulator to transcutaneous electrical nerve stimulation and traditional Chinese acupuncture for the treatment of chronic pain in military service members
Authors: Peacock Kimberly S. , Stoerkel Erika , Libretto Salvatore , Zhang Weimin , Inman Alice , Schlicher Michael , Cowsar John D. , Eddie David , Walter Joan
Published: December 2019

Background

The present investigation tested the efficacy of the Tennant Biomodulator, a novel pain management intervention that uses biofeedback-modulated electrical stimulation, to reduce chronic pain and its psychosocial sequelae in a sample of current and former military service members. The Tennant Biomodulator used on its most basic setting was compared to two commonly used, non-pharmacological pain treatments—traditional Chinese acupuncture and transcutaneous electrical nerve stimulation (TENS)—in a comparative efficacy, randomized, open-label trial.

Methods

Participants included 100 active duty and retired service men and women with chronic pain undergoing treatment at the Brooke Army Medical Center in Texas, USA, randomly assigned to receive six, weekly sessions of either Tennant Biomodulator treatment, traditional Chinese acupuncture, or TENS, in addition to usual care. Recruitment was conducted between May 2010 to September 2013. Outcome measures were collected at intake, before and after each treatment session, and at a 1-month follow-up. Intent-to-treat analyses were used throughout, with mixed models used to investigate main effects of group, time, and group × time interactions with consideration given to quadratic effects. Outcomes measured included ratings of chronic pain, pain-related functional disability, and symptoms of post-traumatic stress disorder (PTSD) and depression.

Results

On average, regardless of their treatment group, participants exhibited a 16% reduction in pain measured by the Brooke Army Medical Center’s Clinic Pain Log [F(1, 335) = 55.7, P <  0.0001] and an 11% reduction in pain-related disability measured by the Million Visual Analog Scale [MVAS: F(1, 84) = 28.3, P <  0.0001] from baseline to the end of treatment, but no one treatment performed better than the other, and the reductions in pain and pain-related disability were largely lost by 1-month follow-up. Symptoms of PTSD and depression did not change significantly as a function of time or group.

Conclusions

Findings build on previous work suggesting that traditional Chinese acupuncture and TENS can reduce pain and its functional sequelae without risks associated with pharmacological pain management. The Tennant Biomodulator used on its most basic setting performs as well as these other interventions. Based on the present findings, large, randomized controlled trials on the Tennant Biomodulator are indicated. Future work should test this device using its full range of settings for pain-related psychological health.

Trial registration

Clincialtrials.gov (NCT01752010); registered December 14, 2012.
Relationship between the effects of food on the pharmacokinetics of oral antineoplastic drugs and their physicochemical properties
Authors: Omachi Fukiko , Kaneko Masaki , Iijima Ryosuke , Watanabe Machiko , Itagaki Fumio
Published: December 2019

Background

Food is known to affect drug absorption by delaying gastric emptying time, altering gastrointestinal pH, stimulating bile flow, increasing splanchnic blood flow, or physically interacting with drugs. Although food is known to affect the pharmacokinetics of oral antineoplastic drugs, the relationship between the effects of food and the physicochemical properties of drugs remains unclear.

Methods

In this study, we surveyed the literature on three kinds of pharmacokinetic changes, AUC ratio, Cmax ratio and Tmax ratio, in the fasted and fed state for 72 oral antineoplastic drugs that were listed on the drug price standard in May 2018 in Japan. We further predicted the physicochemical properties from the 2D chemical structure of the antineoplastic drugs using in silico predictions.

Results

As a result of analyzing the relationship between the effects of food and physicochemical properties, we found that compounds that show increased absorption in the fed state had higher logP and lower solubility in fasted-state simulated intestinal fluid (FaSSIF). However, compounds with delayed absorption had higher solubility in FaSSIF. Furthermore, as a result of decision tree analysis, it was classified as AUC increase with logP ≥4.34. We found that an AUC increase in the fed state did not occur with compounds with low lipid solubilities (logP < 1.59). From these results, it is predicted that 7 compounds out of the 24 compounds for which the effects of food are unknown are at risk for increased absorption in the fed state and that no increase in absorption would occur in 13 compounds.

Conclusion

In this study, we found that drugs that will show increased absorption in the fed state and drugs for which absorption is not dependent on food can generally be predicted by logP. These results suggest that logP can be a useful parameter for predicting the effects of food on drug absorption.
Right inferior phrenic artery pseudoaneurysm after a laparoscopic gastrectomy: a case report
Authors: Funakoshi Kaoruko , Ishibashi Yuji , Yoshimura Shuntaro , Yamazaki Ryoto , Hatao Fumihiko , Morita Yasuhiro , Imamura Kazuhiro
Published: December 2019

Background

Ruptured pseudoaneurysms are a rare complication of gastrectomy, but when they do develop, they are often fatal. We presented herein the first report of a case of pseudoaneurysm arising from the right inferior phrenic artery (RIPA) after a laparoscopic gastrectomy.

Case presentation

A 61-year-old male patient underwent a laparoscopic distal gastrectomy and D1+ lymph node dissection with Roux-en-Y reconstruction for early gastric cancer. He was discharged on postoperative day (POD) 9 without any complications, such as anastomotic or pancreatic leakage. On POD 19, he was referred to the emergency room for upper abdominal pain. Enhanced abdominal computed tomography revealed a 60 × 70 mm hematoma, indicating intra-abdominal bleeding and a 10-mm pseudoaneurysm in the RIPA. Selective digital subtraction angiography confirmed the presence of a pseudoaneurysm in the RIPA, which was embolized using multiple microcoils. Thereafter, no clinical signs were observed, and the patient was discharged from the hospital 15 days after angiography without any recurrence of bleeding. We hypothesized that the cause of the pseudoaneurysm was mechanical vascular injury due to the thermal spread of the ultrasonically activated devices (USADs) during lymphatic node dissection.

Conclusion

Given the thermal spread of USADs, safe and appropriate lymph node dissection based on precise anatomical knowledge is crucial to preventing postoperative pseudoaneurysms.
Characterization of in-vitro antioxidant, cytotoxic, thrombolytic and membrane stabilizing potential of different extracts of Cheilanthes tenuifolia and Stigmasterol isolation from n-hexane extract
Authors: Mahfuz Ananna , Salam Fayad Bin Abdus , Deepa Kanij Nahar , Hasan A. H. M. Nazmul
Published: December 2019

Background

Cheilanthes tenuifolia, a member of the Pteridaceae family, is an evergreen and small fern could be abundant of bioactive compounds. The present study was designed to investigate its many therapeutic properties and isolation of bioactive compounds from extracts ofCheilanthes tenuifolia.

Methods

The dried coarse plant powder was extracted with methanol and dried with rotary evaporator. The extract was further partitioned according to the increasing polarity: N-hexane < chloroform < ethyl-acetate < methanol by modified Kupchan method. Then each extract fractions were investigated for their pharmacologic properties. Compounds were isolated from n-hexane fraction through column chromatography, followed by TLC and structure was determined by analysis of sample using1H-NMR and matched with published phytochemistry report.

Results

Methanol fraction ofCheilanthes tenuifoliashowed highest amount of total phenol content (11.32 ± 0.28 mg/gm GAE) followed by chloroform fraction (9.71 ± 0.31 mg/gm GAE) > N-hexane fraction (6.69 ± 0.67 mg/gm GAE) > ethyl acetate fraction (5.36 ± 0.54 mg/gm GAE). The methanol fraction ofCheilanthes tenuifoliapossessed highest amount (7.11 ± 0.52 mg/gm QE) of total flavonoid content. Our present study indicates that methanol extract was most potent (IC50 = 9.926 μg/ml) inhibitor of DPPH free radicals. In brine shrimp lethality bio assay, all the extracts showed dose dependent increment of mortality and chloroform extract was found most cytotoxic (LC50= 34.493 μg/ml) compared to other plant extracts. The chloroform fraction ofCheilanthes tenuifoliawas most potent in terms of thrombolytic activity. A compound was isolated (CT-2) using column chromatography followed by TCL and PTLC (35% pet ether in CHCl3) and analyzed by1H-NMR. The structure of stigmasterol was confirmed by comparing the1H-NMR data with previously published phytochemistry report.

Conclusion

Cheilanthes tenuifoliacould be a potential candidate for bioactive compounds and further studies on isolation and characterization of its bioactive compounds are highly required.
Contested externalisation: responses to global inequalities
Authors: Faist Thomas
Published: December 2019

What is new about contemporary remote control across borders? An important element is the reference to human rights norms by various political actors such as NGOs, migrant associations but also national governments, international organisations and an activist judiciary. It is evident that externalisation policies mirror stark power asymmetries of the global and regional political orders, and thus reflect social inequalities more generally. The contestation around externalized migration control has gone through several periods. Integral to an understanding of control are the practices of migrants themselves, how they seek to circumvent controls or even resist. Thinking further ahead, we may conceive of the border as a paradox, involving both connecting and separating humans and artefacts. Such an understanding of border allows for the possibility of coexistence; difference between two or more entities being a requirement. The border does not belong to either side. How to imagine such a type of border between states is a formidable challenge to social theory.
Orbicularis oris muscle reconstruction and cheiloplasty with Z-plasty in a patient with a transverse facial cleft
Authors: Koh Sung-Hyuk , Jeong Yeon-Woo , Han Jeong Joon , Jung Seunggon , Kook Min-Suk , Oh Hee-Kyun , Park Hong-Ju
Published: December 2019

Background

Transverse facial clefts are Tessier’s number 7 facial cleft among numbers 1–15 in Tessier’s classification of craniofacial malformations, which varies from a simple widening oral commissure to a complete fissure extending towards the external ear.

Case presentation

In a patient with a transverse facial cleft, to functionally arrange the orbicularis oris muscle and form the oral commissure naturally, we performed a surgical procedure including orbicularis oris muscle reconstruction and cheiloplasty with Z-plasty.

Conclusion

We achieved good results functionally and esthetically by orbicularis oris muscle reconstruction and cheiloplasty with Z-plasty. The surgical modality of our anatomical repair and 3 months follow-up results are presented.
Anterior hyaloid membrane dissection using the conventional surgical microscope: a novel surgical approach in 2 patients
Authors: Ajlan Radwan S. , Luvisi Joey
Published: December 2019

Background

To describe the dissection and removal of the anterior hyaloid membrane using the conventional surgical microscope.

Case presentation

This microscopic surgical approach involves dissecting the anterior hyaloid at the natural anatomical plane. A 30-gauge needle mounted on a 3.0 cc syringe is used to inject filtered air anterior to the anterior hyaloid membrane. Two patients needed this procedure; the first patient was pseudophakic with proliferative diabetic retinopathy, tractional retinal detachment, and vitreous hemorrhage. The second patient was phakic with proliferative diabetic retinopathy, anterior proliferative vitreoretinopathy, and recurrent vitreous hemorrhage. Both patients tolerated the procedure well with no complications.

Conclusion

Pneumatic dissection of the anterior hyaloid membrane is previously thought to be only possible with the aid of ophthalmic endoscopy. This novel surgical approach provides surgeons with the option to perform pneumatic dissection of the anterior hyaloid when ophthalmic endoscopy is not available. Prospective studies are needed to reveal possible additional benefits or risks associated with this approach.
Researchers’ perceptions of research misbehaviours: a mixed methods study among academic researchers in Amsterdam
Authors: Haven Tamarinde L. , Tijdink Joeri K. , Pasman H. Roeline , Widdershoven Guy , ter Riet Gerben , Bouter Lex M.
Published: December 2019

Background

There is increasing evidence that research misbehaviour is common, especially the minor forms. Previous studies on research misbehaviour primarily focused on biomedical and social sciences, and evidence from natural sciences and humanities is scarce. We investigated what academic researchers in Amsterdam perceived to be detrimental research misbehaviours in their respective disciplinary fields.

Methods

We used an explanatory sequential mixed methods design. First, survey participants from four disciplinary fields rated perceived frequency and impact of research misbehaviours from a list of 60. We then combined these into a top five ranking of most detrimental research misbehaviours at the aggregate level, stratified by disciplinary field. Second, in focus group interviews, participants from each academic rank and disciplinary field were asked to reflect on the most relevant research misbehaviours for their disciplinary field. We used participative ranking methodology inducing participants to obtain consensus on which research misbehaviours are most detrimental.

Results

In total, 1080 researchers completed the survey (response rate: 15%) and 61 participated in the focus groups (3 three to 8 eight researchers per group). Insufficient supervision consistently ranked highest in the survey regardless of disciplinary field and the focus groups confirmed this. Important themes in the focus groups were insufficient supervision, sloppy science, and sloppy peer review. Biomedical researchers and social science researchers were primarily concerned with sloppy science and insufficient supervision. Natural sciences and humanities researchers discussed sloppy reviewing and theft of ideas by reviewers, a form of plagiarism. Focus group participants further provided examples of particular research misbehaviours they were confronted with and how these impacted their work as a researcher.

Conclusion

We found insufficient supervision and various forms of sloppy science to score highly on aggregate detrimental impact throughout all disciplinary fields. Researchers from the natural sciences and humanities also perceived nepotism to be of major impact on the aggregate level. The natural sciences regarded fabrication of data of major impact as well. The focus group interviews helped to understand how researchers interpreted ‘insufficient supervision’. Besides, the focus group participants added insight into sloppy science in practice. Researchers from the natural sciences and humanities added new research misbehaviours concerning their disciplinary fields to the list, such as the stealing of ideas before publication. This improves our understanding of research misbehaviour beyond the social and biomedical fields.
Evaluation of inflammatory markers and mean platelet volume as short-term outcome indicators in young adults with ischemic stroke
Authors: Dahshan Ahmed , Ebraheim Asmaa M. , Rashed Laila A. , Farrag Mohammed A. , El Ghoneimy Ahmed T.
Published: December 2019

Background

Studying outcome predictors in patients with onset of cerebral infarction in early adult life may enhance our knowledge of disease pathophysiology and prognosis.

Aim

The aim is to identify independent predictors of short-term outcome of first-ever ischemic stroke in young adults with special emphasis on inflammatory and thrombogenic markers.

Methods

We enrolled 33 patients aged 19–44 years with first-ever ischemic stroke admitted to Kasr Alainy Stroke Unit and 33 matched controls. Clinical, radiological, and laboratory (adhesion molecules, C-reactive protein, prolactin, and mean platelet volume) evaluations were carried out. Functional outcome at 7 days after stroke onset was assessed using the modified Rankin scale, and independent predictors were identified.

Results

The most frequently identified risk factor was cardiac abnormality. Patients exhibited significantly higher levels of baseline inflammatory and thrombogenic markers compared with controls. These markers were significantly correlated with the stroke severity. Logistic regression model showed that high National Institutes of Health Stroke Scale (NIHSS) score (odds ratios [OR] = 0.13; 95% confidence interval [CI], 0.04–0.24; P = 0.01) and large infarction size (OR = 0.11; 95% CI, 0.09–0.17; P = 0.04) but not the laboratory markers were independent predictors of unfavorable outcome.

Conclusion

Our data suggested that higher NIHSS scores and large infarction size served as independent predictors of short-term unfavorable outcome, while inflammatory and thrombogenic markers did not.