bluuebunny/crossref_metadata_2025 huggingface dataset:
Sequence stratigraphic framework of the mid-Cretaceous nonmarine Potomac Formation, New Jersey and Delaware
Authors: Thornburg Jesse D. , Miller Kenneth G. , Browning James V.
Published: August 2020

We developed a sequence stratigraphic framework for the (Barremian to lower Cenomanian) fluvial–deltaic (primarily delta plain) Potomac Formation in the Medford, New Jersey, Fort Mott, New Jersey, and Summit Marina, Delaware coreholes. Previous studies have correlated distinctive lithologic units with attendant pollen zones and identified tentative sequence boundaries between lithologic units I (Barremian to lower Aptian, pollen Zone I), II (Aptian to lowermost Cenomanian, pollen Zone II), and III (lower Cenomanian, pollen Zone III) at all three sites. Here, we further subdivide these units into packages known as fluvial aggradation cycles (FACs). An analysis of FAC stacking patterns reveals potential sequence boundaries and systems tracts. FACs indicate that major lithologic unit boundaries are also sequence boundaries, indicate tentative higher-order sequence boundaries, and provide potential additional correlative surfaces among Potomac Formation sites. Our study demonstrates the applicability of the FAC method to identify stacking patterns and sequence stratigraphic surfaces in fluvial–deltaic deposits and demonstrates that FACs are excellent tools to decipher the difficult-to-correlate surfaces.
Scaling of Mechanical Degradation of EOR Polymers: From Field-Scale Chokes to Capillary Tubes
Authors: Stavland Arne , Åsen Siv Marie , Mebratu Amare , Gathier Flavien
Published: August 2020

Polymer flooding is a well-known method for enhanced oil recovery (EOR). Synthetic EOR polymers are susceptible to mechanical degradation. Understanding and mitigating mechanical degradation is a key issue for successful polymer flooding.

The main concern of this work is mechanical degradation during choking. Offshore, it is necessary to have control over the injection pressure to each well. During traditional waterflooding, this is achieved by choking the fluid stream by choke valves. In choke valves, there will be sudden change in the flow field, strongly indicating that choke valves will cause mechanical degradation of polymers and thereby reduce the EOR potential of the polymer flood.

In this study we investigate mechanical degradation of conventional synthetic EOR polymers. The experiments were performed in commercial chokes and pipes with internal diameters (IDs) from 0.127 to 35 mm, lengths from 13.5 mm to 400 m, and flow rates from 0.3×10−3 to 600 dm3/min, covering several magnitudes of Reynolds number, linear velocities, shear rates, and pressure drop.

Using friction factors, f, and Reynolds number, Re, we derived a simple and practical expression for a scaling parameter, τw/η, for degradation of shear thinning polymers in circular tubes at turbulent and laminar flow, where τw=f8ρ⟨v⟩2. At laminar flow, the friction factor is ∝1Re, resulting in a scaling parameter proportional to the velocity-to-radius ratio, ∝⟨v⟩R, equal to the shear rate at the wall and practically independent of viscosity. At turbulent flow, the friction factor is ∝1Reβ, resulting in a scaling parameter at turbulent flow, which is a function of density and viscosity and valid only for high shear rates where the viscosity of shear thinning polymers approaches a fixed value.

During the large-scale test, several methods for mitigating or decreasing degradation as a function of pressure drop were identified: decreasing the pressure with several chokes in series, each below a critical pressure drop; decreasing the pressure over a long distance in a linear pressure reducer (LPR); or by choking concentrated polymer solution.
Patient-individual cancer cell lines and tissue analysis delivers no evidence of sequences from DNA viruses in colorectal cancer cells
Authors: Gock Michael , Kordt Marcel , Matschos Stephanie , Mullins Christina S. , Linnebacher Michael
Published: August 2020

Background: Several DNA viruses are highly suspicious to have oncogenic effects in humans. This study investigates the presence of potentially oncogenic viruses such as SV40, JCV, BKV and EBV in patient-derived colorectal carcinoma (CRC) cells typifying all molecular subtypes of CRC. Methods: Sample material (gDNA and cDNA) of a total of 49 patient-individual CRC cell lines and corresponding primary material from 11 patients, including normal, tumor-derived and metastasis-derived tissue were analyzed for sequences of SV40, JVC, BKV and EBV using endpoint PCR. In addition, the susceptibility of CRC cells to JCV and BKV was examined using a long-term cultivation approach of patient-individual cells in the presence of viruses. Results: No virus-specific sequences could be detected in all specimens. Likewise, no morphological changes were observed and no evidence for viral infection or integration could be provided after long term CRC cell cultivation in presence of viral particles. Conclusions: In summary, the presented data suggest that there is no direct correlation between tumorigenesis and viral load and consequently no evidence for a functional role of the DNA viruses included into this analysis in CRC development.
The utility of T-SPOT.TB for the diagnosis unconventional pleural tuberculosis is superior to ADA in high prevalence: A perspective analysis of 601 cases
Authors: Yang Xinting , zhang jing , Liang Qingtao , Pan Liping , Duan Hongfei , Yang Yang , Li Hua , Guo Chao , Sun Qi , Jia Hongyan , Du Boping , Wei Rongrong , Xing Aiying , Zhang Zongde , Chen Xiaoyou
Published: August 2020

BACKGROUND: Interferon Gamma Release Assay (IGRA) is still controversial in differentiating tuberculous pleural effusion (TPE), through recommended by World Health Organization (WHO) for identification of latent tuberculosis infection. OBJECTIVES: Aim to in comparison to Adenosine deaminase (ADA), evaluate the IGRA (T-SPOT.TB) diagnostic efficacy for TPE patients of different characteristics, to clarify its appropriate scene in clinical diagnosis. METHODS: A prospective, single-centre study including all suspected pleural effusion patients consecutively from June 2015 to October 2018. Through receiver operating characteristic (ROC) curves, all enrolled participants were determined technical cut-off and the utility of IGRA for pleural fluid (PF). Obtain the independent risk factors by logistic regression analysis for TPE, and evaluate the performance of T-SPOT stratified by risk factors, in comparison to ADA. RESULTS: A total of 601 individuals were consecutively recruited. The maximum of early secretory antigenic target-6 (ESAT-6) and culture filtrate protein-10 (CFP-10) in PF T-SPOT had the best diagnostic efficiency in our study, with a sensitivity of 83.0% and a specificity of 83.1%, corresponding cut-off value is 466 SFCs/10 6 mononuclear cells, which was equal to ADA (0.885 vs 0.887, P=0.957) and superior than in PB; Among the TPE patients with low ADA(<40 IU/L), the sensitivity and specificity of PF T-SPOT was still 87.9%, 90.5% respectively. The utility of ADA was negative related to age ascents, but PF T-SPOT had steady performance at any age-stage. The age (<45 yrs; odds ratio (OR) = 5.61), gender (male; OR = 2.7) and body mass index (BMI) (<22; OR = 1.93) was independently associated with the risk of TB by multivariate logistic regression analysis. Stratified by risk factors, notably the PF T-SPOT had superior sensitivity (76.5% vs. 23.5%, P =0.016) than ADA meanwhile had the non-inferior specificity (84.4% vs. 96.9%, P =0.370). CONCLUSIONS: In conclusion, the overall potency of PF T-SPOT assay is equal to ADA for diagnosing TPE. In addition, PF T-SPOT can effectively discriminate the TPE patients whose ADA lower than 40 IU/L, extremely superior to ADA in unconventional TPE patients (age>45yrs, female or BMI≧22). PF T-SPOT assay is an extremely good choice to supplement ADA to diagnose TPE.
High prevalence of Campylobacter jejuni CC21 and CC257 clonal complexes in children with gastroenteritis in Iran: A global analysis
Authors: Sarhangi Mahnaz , Bakhshi Bita , Peeraeyeh Shahin Najar
Published: August 2020

Aims: The aim of this study was to assess the distribution of GBS-related lipo-oligosaccharide (LOS) classes and capsular genotypes among Iranian clinical C. jejuni strains and to assess its relation with dnaK gene expression. Moreover, a comprehensive study of C. jejuni MLST-genotypes and global comparison with peer sequences worldwide was intended.Methods: Distribution of sialylated-LOS classes and specific capsular genotypes were investigated in C.jejuni of clinical origin. The expression of dnaK in C. jejuni strains was measured by Real-Time-PCR. MLST-genotyping was performed to investigate the clonal relationship of clinical C. jejuni strains and comparison with global sequences worldwide.Results: C. jejuni HS23/36c was the predominant genotype (45%), followed by HS2 (20%), and HS19 and HS4 (each 10%). A total of 80% of isolates were assigned to LOS class B and C. Higher expression level of dnaK gene was detected in strains with HS23/36c, HS2 and HS4 capsular genotypes and sialylated LOS classes B or C in this study. MLST analysis showed that isolates were highly diverse and represented 6 different sequence types and 3 clonal complexes. ST-21 and ST-257 complexes were dominants (75%) in our C.jejuni strains. The CC21 was the largest CC in our collection which is consistent with global C.jejuni strains worldwide. No new ST and no common ST with our neighbor countries was detected in this study.Conclusion: Global analysis of MLST results demonstrated that ST-50 (CC21) was widely distributed in different countries, while ST-19 (CC21) and ST-257 (CC257) was less ubiquitously spread. Overall, CC21 and CC353 complexes were most frequent and most widely distributed clonal complexes around the world; although, CC353 was not detected in this study. This shows a picture of movement of dominant Campylobacter strains worldwide. The occurrence of identical clonal complexes with different capsular types and LOS classes in this study is consistent with genetic variation in circulating identical genotypes and their evolution toward different pathotypes probably through acquisition of different genetic elements including LOS and CPS gene clusters.
Application of Machine Learning Methods in Nursing Home Research: Using Fall-Related Data in Nursing Homes
Authors: Lee Soo-Kyoung , Ahn Jinhyun , shin juh hyun , Lee Ji Yeon
Published: August 2020

The authors have withdrawn this preprint due to author disagreement.
NF-κB and pSTAT3 synergistically drive G6PD overexpression and facilitate sensitivity to G6PD inhibition in ccRCC
Authors: Zhang Qiao , Yang Zhe , Ni Yueli , Bai Honggang , Han Qiaoqiao , Yi Zihan , Yi Xiaojia , AGBANA Yannick Luther , Kuang Yingmin , Zhu Yuechun
Published: August 2020

Background: Glucose 6-phosphate dehydrogenase (G6PD) serves key roles in cancer cell metabolic reprogramming, and has been reported to be involved in certain carcinogenesis. Previous results from our laboratory demonstrated that overexpressed G6PD was a potential prognostic biomarker in clear cell renal cell carcinoma (ccRCC), the most common subtype of kidney cancer. G6PD could stimulate ccRCC growth and invasion through facilitating reactive oxygen species (ROS)-phosphorylated signal transducer and activator of transcription 3 (pSTAT3) activation and ROS-MAPK-MMP2 axis pathway, respectively. However, the reasons for ectopic G6PD overexpression and the proliferation repressive effect of G6PD inhibition in ccRCC are still unclear. Methods: The impact of ROS accumulation on NF-κB signaling pathway and G6PD expression was determined by real-time RT-PCR and Western blot in ccRCC cells following treatment with ROS stimulator or scavenger. The regulatory function of NF-κB signaling pathway in G6PD transcription was analyzed by real-time RT-PCR, Western blot, luciferase and ChIP assay in ccRCC cells following treatment with NF-κB signaling activator/inhibitor or lentivirus infection. ChIP and Co-IP assay was performed to demonstrate protein-DNA and protein-protein interaction of NF-κB and pSTAT3, respectively. MTS assay, human tissue detection and xenograft model were conducted to characterize the association between NF-κB, pSTAT3, G6PD expression level and proliferation functions.Results: ROS-stimulated NF-κB and pSTAT3 signaling over-activation could activate each other, and exhibit cross-talks in G6PD aberrant transcriptional regulation. The underlying mechanism was that NF-κB signaling pathway facilitated G6PD transcription via direct DNA–protein interaction with p65 instead of p50. p65 and pSTAT3 formed a p65/pSTAT3 complex, occupied the pSTAT3-binding site on G6PD promoter, and contributed to ccRCC proliferation following facilitated G6PD overexpression. G6PD, pSTAT3, and p65 were highly expressed and positively correlated with each other in ccRCC tissues, confirming that NF-κB and pSTAT3 synergistically promote G6PD overexpression. Moreover, G6PD inhibitor exhibited tumor-suppressor activities in ccRCC and attenuated the growth of ccRCC cells both in vitro and in vivo. Conclusion: ROS-stimulated aberrations of NF-κB and pSTAT3 signaling pathway synergistically drive G6PD transcription through forming a p65/pSTAT3 complex. Moreover, G6PD activity inhibition may be a promising therapeutic strategy for ccRCC treatment.
High-resolution habitat suitability model for Phlebotomus pedifer, the vector of cutaneous leishmaniasis in southwestern Ethiopia
Authors: Pareyn Myrthe , Rutten Anneleen , Merdekios Behailu , Wedegärtner Ronja Elisabeth Magdalene , Girma Nigatu , Regelbrugge Leo , Shibru Simon , Leirs Herwig
Published: August 2020

Background: Phlebotomus pedifer is the vector for Leishmania aethiopica causing cutaneous leishmaniasis (CL) in southwestern Ethiopia. Previous research on the transmission dynamics of CL resulted in recommendations for vector control. In order to target these interventions towards affected areas, a comprehensive understanding of the spatial distribution of P. pedifer at high spatial resolution is required. Therefore, this study determined the environmental predictors that facilitate the distribution of P. pedifer and created a map indicating the areas where conditions are suitable for survival of the vector in southwestern Ethiopia with high spatial resolution.Methods: Phlebotomus pedifer presence points were collected during two entomological surveys. Climate, vegetation and topographic variables were assembled. Climate variables were interpolated with variables derived from high-resolution digital elevation models to generate topoclimatic layers representing the climate conditions in the highlands. A Maximum Entropy model was run with the presence points, predicting variables and background points, which were selected based on a bias file. Results: Phlebotomus pedifer was the only captured Phlebotomus species in the study area and was collected at altitudes ranging between 1,685 and 2,892 m. Model projections indicated areas with suitable conditions in a ‘belt’ surrounding the high mountain peaks. Model performance was high, with test and train AUC values being 0.93 and 0.90 respectively. A multivariate environmental similarity surface (MESS) analysis showed that the model projection was only slightly extrapolated for some of the variables. The mean annual temperature was the environmental variable, which contributed most to the model predictions (60.0%) followed by the seasonality in rainfall (13.2%). Variables representing steep slopes showed very low importance to model predictions. Conclusions: Our findings indicate that the suitable habitats for P. pedifer correspond well with the altitudes at which CL was reported previously but the predictions are more widely distributed, in contrast with the description of CL to occur in particular foci. Moreover, we confirm that vector distribution is driven by climate factors, suggesting inclusion of topoclimate in sand fly distribution models. Overall, our model provides a map with a high spatial resolution that can be used to target sand fly control measures in southwestern Ethiopia.
Blinded Rechecking of AFB smear Microscopy performance in Selected private health facilities in Tigray, Northern Ethiopia
Authors: Weldemhret Letebrhan
Published: August 2020

Background: Sputum smear microscopy remains the most cost-effective tool for tuberculosis diagnosis and treatment monitoring in resource constrained settings. Random blinded rechecking is a reliable tool to measure and improve smear microscopy. So, this study was intended to assess random blinded rechecking of AFB smear microscopy performance in selected private health facilities in Tigray region, Northern Ethiopia.Methods: A cross sectional study was conducted from April 1st 2017 to May 30, 2017. The data was collected using standard data collection form. Statistical analysis was done using SPSS version 25 and the reading agreement was done using kappa statistics.Results: Of the total 269 blinded rechecked smears, 4.8% was found discrepant findings. The major and minor errors were reported by 2.6% (7/269) and 2.2% (6/269) respectively. Likewise, the major error was reported by 50% (5/10) of health facilities with microscopic center. Overall, the sensitivity, specificity, positive predictive value, and negative predictive value of the blinded rechecking smears were 87.5%, 98%, 89.7% and 97.8%, respectively with substantial reading agreement, kappa value= 0.80.Conclusions: The overall performance of blinded rechecking was satisfactory with good smear reading agreement. But, the major error reported indicated unacceptable performance. To minimize the discrepancy, private health facilities with tuberculosis smear microscopic center should adhere to national tuberculosis guidelines.
Effects of Air Pollution on COVID-19 and Public Health
Authors: Coccia Mario
Published: August 2020

The pandemic of coronavirus disease 2019 (COVID-19), generate by a novel virus SARS-CoV-2, is rapidly spreading all over the world, generating a high number of deaths. One of the current questions in the field of environmental science is to explain the relationships determining the diffusion of COVID-19 in specific regions of countries. The research here focuses on case study of Italy, one of the countries in the World to experience a rapid increase in confirmed cases and deaths. Results suggest that diffusion of COVID-19 is very high in cities with high air pollution generating severe negative effects on public health o. In particular, results reveal that, among Italian provincial capitals, the number of infected people was higher in cities with more than 100 days per year exceeding limits set for PM10 or ozone, cities located in hinterland zones (i.e. away from the coast), cities having a low average intensity of wind speed and cities with a lower temperature. In hinterland cities (mostly those bordering large urban conurbations) with a high number of days exceeding PM10 and ozone limits, coupled with low wind speed (atmospheric stability), the average number of infected people in April 2020 more than tripled those that had less than 100 days of excessive air pollution. In fact, results show that more than 75% of infected individuals and about 81% of deaths in Italy of COVID-19 are in regions with high air pollution. This study must conclude that a long-run strategy to constrain future epidemics similar to the COVID-19, reducing the negative impact on public health has also to be designed in terms of environmental and sustainability policies and not only in terms of efficient approaches in medicine.
Automatic Segmentation of Coronary Lumen and External Elastic Membrane in IVUS Images Using 8-layer U-Net
Authors: Dong Liang , Lu Wei , Jiang Jun , Zhao Ya , Song Xiangfen , Leng Xiaochang , Zhao Hang , Wang Jian’an , Li Changling , Xiang Jianping
Published: August 2020

Background: Intravascular ultrasound (IVUS) is the golden standard in accessing the coronary lesions, stenosis, and atherosclerosis plaques. In this paper, a fully-automatic approach by an 8-layer U-Net is developed to segment the coronary artery lumen and the area bounded by external elastic membrane, i.e. EEM cross section area (EEM-CSA). The database comprises of single-vendor and single-frequency IVUS data. Particularly, the proposed data augmentation of MeshGrid combined with flip and rotation operations is implemented, improving the model performance without pre- or post-processing of the raw IVUS images.Results: The mean intersection of union (mIoU) of 0.941 and 0.750 for the lumen and EEM-CSA respectively were achieved, which exceeded the manual labeling accuracy of the clinician. Conclusion: The accuracy shown by the proposed method is sufficient for subsequent reconstruction of 3D IVUS images, which is essential for doctors’ diagnosis in the tissue characterization of coronary artery walls and plaque compositions, qualitatively and quantitatively.
Tigecycline and homoharringtonine synergistically target myeloid leukemia cells by inhibiting mitochondrial translation through mTOR/4EBP1 pathway
Authors: Yang Haiyang , Mei Chen , Ye Li , Ren Yanling , Zhang Hua , Li Kongfei , Huang Jiansong , Huang Xin , Xu Weilai , Zhou Xinping , Xu Gaixiang , Wang Lu , Shen Chuying , Tong Hongyan
Published: August 2020

BackgroundTigecycline (TIG) is a tetracycline derivative antibiotic. Successive studies have shown that TIG is efficacious for the treatment of some solid tumors and hematological malignant diseases both in vivo and in vitro, and drug combinations appear to provide better inhibition. To explore new drug combinations for myeloid leukemia, we compared the differential combination efficacy of TIG with several anti-leukemia drugs, and explored the mechanisms of the combination of TIG and homoharringtonine (HHT) in myeloid leukemia cells both in vitro and in vivo.MethodsCell proliferation was assessed using MTS (3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyph-enyl)-2-(4-sulfophenyl)-2H-tetrazolium) and CFU-GM (colony forming unit-granulocyte and macrophage) assays. Apoptosis was detected by flow cytometry. The combination of effects was confirmed in myeloid leukemia cells and tumor-bearing mouse model. The regulation of the AKT/mTOR (mammalian target of rapamycin)/4EBP1 (eukaryotic translation initiation factor 4E binding protein 1) pathway was assessed using a Western blot and immunohistochemistry.ResultsThe combination of TIG and HHT had a strong synergistic effect in myeloid leukemia cells. The use of the drug combination in vivo also effectively delayed myeloid tumor development in mice. The synergistic effect of this drug combination is likely to be achieved by inhibiting mitochondrial translation and down-regulating the AKT/mTOR/4EBP1 signaling pathway. Conclusion: The combination of TIG and HHT can synergistically enhance an anti-leukemia effect through downregulating anti-apoptotic proteins. Inhibiting mitochondrial translation through the AKT/mTOR/4EBP1 pathway might be an important mechanism.
A nomogram established by inflammatory markers predicting overall survival after radical resection of gastric cancer
Authors: Zhang Lixiang , Su Yezhou , Wei Zhijian , Chen Zhangming , Xu Peng , Wang Gang , Zhu Hai , Han Wenxiu , Xu Aman
Published: August 2020

Background The prognostic value of inflammatory markers have been confirmed in some tumors, this research was to explore more clinical markers and then build a reliable nomogram to predict overall survival after radical resection of gastric cancer.Methods 904 patients who underwent surgery at the First Affiliated Hospital of Anhui Medical University from January 2010 to January 2013 were included. Univariate and multivariate analyses were used to screen for prognostic risk factors. The construction of the nomogram is based on the Cox proportional hazard regression model. The construction of the new scoring model is analyzed by the receiver operator characteristic (ROC) curve and then compared with other clinical indicators.Results Multivariate analysis showed that TNM stage, CEA, the systemic immune-inflammation index (SII) and age were independent prognostic factors. The value of SII was better than other inflammatory markers. The new nomogram had a higher AUC value than TNM and other risk factors, and the C-index of the nomogram was highly consistent for evaluating survival of gastric cancer patients in the validation groups and training group.Conclusions Based on the serum markers and other clinical indicators, we developed a precise nomogram to predict the prognosis of gastric cancer patients after radical surgery. This new score system can provide effective help for surgeons and patients.
Mild dyserythropoiesis and b-like globin gene expression imbalance due to the loss of histone chaperone ASF1B
Authors: Papadopoulos Petros , Kafasi Athanassia , de Cuyper Iris , Barroca Vilma , Lewandowski Daniel , Kadri Zahra , Veldthuis Martijn , Berghuis Jeffrey , Gillemans Nynke , Cuesta Celina María Benavente , Grosveld Frank , Zwieten Rob van , Philipsen Sjaak , Vernet Muriel , Gutiérrez Laura , Patrinos George
Published: August 2020

The expression of the human b-like globin genes follows a well-orchestrated developmental pattern, undergoing two essential switches, the first one during the first weeks of gestation (e to g), and the second one during the perinatal period (g to b). The g to b globin gene switching mechanism includes suppression of fetal (g-globin, HbF) and activation of adult (b-globin, HbA) globin gene transcription. In Hereditary Persistence of Fetal Hemoglobin (HPFH), the g-globin suppression mechanism is impaired leaving these individuals with unusual elevated levels of fetal hemoglobin (HbF) in adulthood. Recently, the transcription factors KLF1 and BCL11A have been established as master regulators of the g to b globin switch. Previously a genomic variant in the KLF1 gene, identified by linkage analysis performed on twenty-seven members of a Maltese family, was found to be associated with HPFH. However, variation in the levels of HbF amongst family members, and those from other reported families carrying genetic variants in KLF1, suggest additional contributors to globin switching. ASF1B was downregulated in family members with HPFH.
Here, we investigate the role of ASF1B in g to b globin switching and erythropoiesis in vivo . Mouse-human interspecies ASF1B protein identity is 91.6%. By means of knockdown functional assays in human primary erythroid cultures and analysis of the erythroid lineage in Asf1b knockout mice, we provide evidence that ASF1B is a novel contributor to steady-state erythroid differentiation, and while its loss affects the balance of globin expression, it has no major role in hemoglobin switching.
Radiomics in evaluation of small-hepatocellular carcinoma and benign cirrhotic nodule based on magnetic resonance plain images
Authors: Gao XiaoNing , Guo Kun , Luo JiaWen , Bian Jie
Published: August 2020

Background There are adequate evidences showing that early diagnosis significantly improves the prognosis of patients. Currently, radiology diagnosis to s-HCC is still difficult. Radiomics, a new type of quantitative imaging diagnosis method, has been widely used in the study of multi-system diseases. The purpose of this study is to evaluate the value of radiomics based on MRI plain images in differentiating s-HCC and benign cirrhotic nodule.Methods A total of 78 patients with 114 lesions (89 s-HCCs and 25 benign cirrhotic nodules) were retrospectively enrolled during September 2017 to January 2020. MRI plain images (T1WI, T2WI) of each nodule was segmented to form VOI, and 1223 quantitative radiomics features were extracted from each sequence. 10 optimal features were respectively selected from the T1WI, T2WI, and T1WI+T2WI based on SelectKBest. Logistic Regression (LR) was applied in establishing 2 radiomics models based on single sequence images (T1WI and T2WI) respectively and 1 radiomics model based on T1WI+T2WI. Clinical information (including age, gender, AFP level and the longest diameter of lesion) was collected and analyzed using binary logic analysis to obtain statistically significant (p<0.05) clinical features. Combining the optimal radiomics features based on T1WI+T2WI and significant clinical features, the fusion model was established using LR and was expressed in nomogram. The AUC, sensitivity and accuracy of the 4 models were obtained. Delong test was used to compare the AUC of the 4 models. Results 78 patients with 114 lesions were included in this study. There were 89 s-HCCs, 11 of nodules were e-HCCs, and the remaining 25 were benign cirrhotic nodules, including 3 DNs and 22 RNs. There was no significant difference in diagnostic performance among the radiomics model based on T2WI, T1WI+T2WI and the fusion model. And their diagnostic performance were higher than that of the radiomics model based on T1WI. Conclusions The radiomics model based on MRI plain images can be used to differentiate s-HCC and benign cirrhotic nodule. Radiomics features obtained from T2WI played a key role in the differentiation of s-HCC and benign cirrhotic nodule.
The potential role of Transient Elastography in assessing patients with Primary Budd Chiari Syndrome
Authors: Webb Muriel , Shibolet Oren , Lurie Yoav , Maor Yakov , Katchman Helena , Philips Adam , Kopelman Yael , Steinberg David , Salomon Ophira
Published: August 2020

Background: Budd-Chiari syndrome (BCS) is a rare disease defined as hepatic venous outflow obstruction at any level from the hepatic venules up to the cavo-atrial junction. Transjugular Intrahepatic Portosystemic Shunt (TIPS) is performed as a decompressive treatment in some patients.Aim: To evaluate the potential role of Transient Elastography (TE) in assessing liver stiffness in patients with primary BCS.Methods: Twenty one BCS patients and 10 patients with liver cirrhosis with different underlying etiologies underwent abdominal ultrasound and TE.Results: Ninety-five percent of BCS patients had liver stiffness compatible with F4 with a median of 21 kPa, values which are usually obtained in patients with liver cirrhosis. Ten BCS and 10 cirrhotic patients underwent repeated TE with a median of 320 days between exams for BCS and 4.5 years for cirrhotic patients. The change of liver stiffness in BCS patients was 5.75 kPa (range − 0.4 to 26.6), compared with − 4.85 kPa (range − 15.6 to 15.0) in cirrhotic patients (p-value = 0.0029). Change in liver stiffness from baseline to follow-up in BCS patients who underwent TIPS (n = 4) was 0.2 kPa (range − 0.4 to 15.3), whereas in patients without intervention (n = 6) it was 6.75 kPa (range 1.3 to 26.6). The difference was not statistically significant.Conclusion: Liver stiffness in BCS patients is a dynamic progressive process with parameters of TE resembling liver cirrhosis. Even if TIPS seem to slow down the increment of liver stiffness, because of decreased liver congestion, it kept most patients with high score. The TE in BCS patients may be considered for monitoring for stable or upfront disease deterioration.
Impact of Two Remineralizing Agents on White Spot Lesions
Authors: Alagha Ebaa Ibrahim
Published: August 2020

Aim of the study: This study evaluated the impact of two remineralizing agents containing casein phosphopeptideamorphous calcium phosphate (CPPACP), and Tricalcium phosphate (TCP) on white spot lesions. Materials and Methods: A total of ninety freshly extracted upper premolars were divided in three equal groups (30 each). Group A: Control group. Group B: Varnish containing CPP–ACP. Group C: Varnish containing TCP. The teeth were subjected to Diagnodent test after inducing white spot lesions to assess any surface changes present on the teeth. The readings were repeated post demineralization and post-remineralization. Results: Statistically significant difference was present in the mean values between the tested groups. CPP-ACP group recorded higher mean value at demineralization when compared to TCP group. Statistically significant difference (p < 0.0001) was present between the baseline and the demineralization values. CPP-ACP group presented higher remineralization results when compared to TCP group. T-test proved a significant difference between the tested groups. Conclusion: CPP-ACP containing varnish had higher remineralizing effect when compared to TCP containing varnish. Clinical Significance: Recently, the focus of restorative dentistry has been directed toward a conservative approach. Prevention and non-restorative treatment of initial enamel caries is the main concern. Remineralization procedures are the most preferred way of regeneration of lost tooth structure.
Clinical Effects of Probiotic or Azithromycin as an Adjunct to Scaling and Root Planing in the Treatment of Periodontitis Stage III: A Pilot Randomized Controlled Clinical Trial
Authors: Morales Alicia , Contador Rafael , Bravo Joel , Carvajal Paola , Silva Nora , Strauss Franz Josef , Gamonal Jorge
Published: August 2020

Background
The aim of this triple- blind placebo- controlled parallel- arm randomized clinical trial was to evaluate the clinical effects of Lactobacillus rhamnosus SP1 or azithromycin as an adjunct to scaling and root planing (SRP) in patients with periodontitis stage III.
Methods
Forty-seven systemically healthy participants with periodontitis stage III were recruited. Following SRP, the participants were randomly assigned to one of three treatment modalities; 1) placebo (n = 15), 2) probiotics (n = 16) and 3) antibiotics-azithromycin (n = 16). The participants were monitored at baseline, 3, 6, 9 and 12 months after therapy. Probing pocket depth (PPD), bleeding on probing (BOP), clinical attachment loss (CAL) and plaque accumulation (PI) were evaluated.
Results
All 47 participants completed the study. At 12 months, all groups showed significant improvements of PPD and PI (p < 0.012) irrespective of the treatment modality and without significant differences between the groups. Probiotics and azithromycin showed no added benefit in terms of CAL. While the placebo (p = 0.002) and the antibiotic-azithromycin (p = 0.002) group showed a significant reduction of BOP, only the placebo group revealed a significant reduction of CAL at 12 months follow-up (p = 0.003). The number of sites and teeth with PPD ≥ 5, ≥6 and ≥ 7 mm were significantly reduced in all groups at 12 months follow-up (p < 0.025) irrespective of the treatment regime and without significant differences between the groups.
Conclusion
The use of probiotics or azithromycin as an adjunct to SRP failed to provide additional benefits in the treatment of periodontitis stage III. The benefits of these two treatment regimes as an adjunct to SRP remain unclear.
Assessment of HRQoL and its Determinants for Kidney Stone Formers
Authors: Ali Zulnorain , Khan Ahmad , Mehmood Tahir , Sami Waqas , el-Amir Zein , Anwar Naveed
Published: August 2020

Background
Quality of life is the central health-improving goal. Urolithiasis is a complex disease significantly related to disease-related morbidity and impacting patient’s health-related quality of life (HRQoL). The study aims to evaluate the HRQoL and markers of HRQoL of kidney stone formers using a disease-specific instrument.
Methods
We compared the HRQoL of kidney stone formers with healthy individuals using Wisconsin stone quality of life (WISQoL) questionnaire. A prospective, cross-sectional, case-control study was conducted at different urological settings of Rawalpindi.
Result
Multivariate analysis of variance (MANOVA) analysis depicted that compared with healthy individuals stone formers reported statistically significant (p = 0.000) differences in HRQoL in overall health and all the domains of WISQoL i.e. social, emotional, disease impact and impact on vitality. Further regression analysis evaluated that demographic factors, clinical features of the disease and surgical procedure for active removal of stone are also determinants of QoL of stone formers (p < 0.05).
Conclusion
It was concluded that urolithiasis is compromising the patient’s quality of life in all major domains of health and WISQoL was proved to be a reliable disease-specific instrument for the assessment of HRQoL of kidney stone patients.
Incidence and Risk Factors for Trocar-Site Incisional Hernia Detected by Clinical and Ultrasound Examination. Prospective Observational Study​
Authors: Ciscar Ana , Badia Josep Maria , Novell Francesc , Bolivar Santiago , Mans Esther
Published: August 2020

BACKGROUND: Trocar site incisional hernia (TSIH) is the most frequent complication associated with laparoscopic surgery. Few studies currently describe its incidence or risk factors. The aim of this report is to determine the real incidence of TSIH and to identify risk factors. METHODS: A cross-sectional prospective study was performed including consecutive patients who underwent a laparoscopic procedure during a four months period. All the patients were assessed both clinically (TSIHc) and by an ultrasonographic examination (TSIHu). The main variable studied was the incidence of TSIH. A multivariate analysis was performed to identify risk factors. RESULTS: 76 patients were included. 27.6% of patients were clinically diagnosed as having TSIH (TSIHc) but only 23.7% of those cases were radiologically confirmed (TSIHu). In the logistic regression analysis, age > 70 years (OR 3.462 CI 1.14 - 10.515, p = 0.028) and body mass index (BMI) ≥30 Kg / m2 (OR 3.313 CI 1.037-10.588, p = 0.043) were identified as risk factors for TSIH. The size of the trocar also showed statistically significant differences (p <0.001). Mean follow-up time was 34 months.CONCLUSIONS: TSIH is under-diagnosed due to the lack of related symptomatology and the inadequacy of the postoperative follow-up period. We detected discrepancies between the clinical and ultrasonographic examinations. TSIHu should be considered as the gold standard for the diagnosis of TSIH. Risk factors such as age, BMI and size of the trocar were confirmed. Patients should be followed-up for a minimum of 2 years.TRIAL REGISTRATION: The study has been registered in Clinicaltrials.gov, under registration number: NCT04410744.
A correlation study of the effectiveness of renal scintigraphy and sonography in the detection and evaluation of renal disorders
Authors: Alsubhi Maithaa H. , Alghanmi Atheer A. , Alzabidi Yara H. , Bafail Alhanouf K. , Bafaraj Saeed Muhammad
Published: August 2020

Background: This retrospective study was undertaken to assess correlation between renal scintigraphy employing technetium Tc-99m chelated with radiopharmaceutical drug Diethylenetriamine Penta Acetic Acid (DTPA) and renal ultrasonography morphological findings. Methods: For this purpose, ninety six patients imaging data was statistically analyzed including 43 females and 53 males. All the patients were subjected to renal scintigraphy while 68 patients underwent renal ultrasonography. Renal U/S reported anatomical renal anomaly in 94.1% patients versus 85.4% detected by scintigraphy. There were 41 patients out of 68 diagnosed with hydronephrosis and 21 of them were suffering with mild hydronephrosis as suggested by U/S imaging. ﻿Results: Renal scintigraphy of 41 hydronephrotic patients validated that 19 patients having non-obstructive bilateral pelvic dilation while remaining 22 with mild to severe obstruction. Ultrasonography diagnosed 4 patients with renal obstruction. Conversely, renal scintigraphy validated 2 of them with renal obstruction on the basis of renal function. In total, 19 out 96 patients were reported with renal obstruction through scintigraphy and validated obstruction in 1 of the 3 patients who were diagnosed with abnormal postvoid residual volume through U/S. Conclusion: Renal scintigraphy is not significant in diagnosing kidney disease; rather this is a vibrant imaging tool providing supplementary data on the basis of renal function. Effectively targeted intervention regime can be achieved by correlating renal scintigraphy and renal ultrasonography results to minimize renal disease incidence.
Associations Between Preoperative Glucose and Hemoglobin A1c Level and Myocardial Injury After Noncardiac Surgery: a Retrospective Cohort Study
Authors: Park Jungchan , Oh Ah Ran , Lee Seung-Hwa , Lee Jong Hwan , Min Jeong Jin , Kwon Ji-hye , Kim Jihoon , Yang Kwangmo , Choi Jin-ho , Lee Sang-Chol , Gwon Hyeon-Cheol , Kim Kyunga , Ahn Joonghyun , Lee Sangmin Maria
Published: August 2020

BackgroundPerioperative blood glucose level has shown an association with postoperative outcomes. We compared the incidences of myocardial injury after noncardiac surgery (MINS) and 30-day mortality according to preoperative blood glucose and hemoglobin A1c (HbA1c) level.methodsThe patients were divided according to blood glucose level within one day before surgery. The poorly-controlled group was defined with fasting glucose > 140 mg/dl or random glucose > 180 mg/dl. Additionally, we compared the outcomes according to HbA1c > 6.5% among patients with available HbA1c within 3 months before surgery. The primary outcome was MINS, and 30-day mortality was also compared.ResultsA total of 12,304 patients was enrolled and divided into 8,324 (67.7%) in the well-controlled group and 3,980 (32.3%) in the poorly-controlled group. After adjustment with inverse probability of weighting, the poorly-controlled group exhibited significantly higher incidences of MINS and 30-day mortality (18.7% vs. 27.6%; odds ratio [OR], 1.29; 95% confidence interval [CI], 1.18–1.42; P < 0.001 and 2.0% vs. 5.1%; hazard ratio [HR], 2.00; 95% CI, 1.61–2.49; P < 0.001, respectively). In contrast to blood glucose, HbA1c was not associated with MINS or 30-day mortality.ConclusionPreoperative hyperglycemia was associated with MINS and 30-day mortality, while HbA1c was not. Immediate glucose control may be more crucial than long-term glucose control in patients undergoing noncardiac surgery.Trial registration: KCT0004244
Identification of Repurposable Cytoprotective Drugs in Vanishing White Matter Disease Patient-Derived cells
Authors: Ng Neville , Cabral-da-Silva Mauricio Castro , Maksour Simon , Berg Tracey , Engel Martin , Silva Dina M. , Do-Ha Dzung , Lum Jeremy S. , Muñoz Sonia Sanz , Suarez-Bosche Nadia , Stevens Claire H. , Ooi Lezanne
Published: August 2020

BackgroundVanishing white matter disease (VWMD) is a rare leukodystrophy caused by mutations of the guanine exchange factor eIF2B that typically presents with juvenile onset. There are few treatments and no cures for the disease. Recent progress in the field has established mitochondrial dysfunction and endoplasmic reticulum (ER) stress to be strongly implicated in observed glial cell pathology. Drug repurposing offers a rapid approach toward translation of therapeutics with already-licensed drugs. ObjectiveThe aim of this study was to use fibroblasts and induced pluripotent stem cell (iPSC)-derived astrocytes from patients bearing the EIF2B5R113H/A403V or EIF2B2G200V/E213G VWMD mutations to identify potentially repurposable FDA-approved drugs based on in vitro assays. MethodsCell viability in the presence or absence of stress was assessed by resazurin reduction activity assay, mitochondrial membrane potential by TMRE fluorescence, and oxidative stress by H2DCFDA oxidation. Relative eIF2B phosphorylation, GADD34 and CHOP were quantified by fluorescent western blot. ResultsDysregulated GADD34 and CHOP were identified in patient fibroblasts and iPSC-derived astrocytes under induced stress conditions. A drug screen from a 2,400 FDA-approved drug library with EIF2B5R113H/A403V VWMD patient fibroblasts identified 113 anti-inflammatory drugs as a major class of hits with cytoprotective effects. A panel of potential candidate drugs, including berberine, deflazacort, ursodiol, zileuton, guanabenz and Anavex 2-73, and preclinical ISRIB, increased cell survival of EIF2B5R113H/A403V or EIF2B2G200V/E213G VWMD astrocytes, and were further investigated for their effect on the integrated stress response and mitochondrial stress. Ursodiol demonstrated capacity to ameliorate oxidative stress and loss of mitochondrial membrane potential in VWMD patient iPSC-derived astrocytes in the presence or absence of stress conditions. ConclusionPatient-derived cells can be used to identify cellular phenotypes and for large-scale drug screening. Anti-inflammatory compounds, such as berberine, deflazacort, ursodiol and zileuton are potentially repurposable drug candidates for VWMD that should be further investigated for translation in vivo.
Effects of Quran Recitation on The Reduction of Anxiety Before Elective Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Gavgani Vahideh Zarea , Ghojazadeh Mortaza , Khodapanah Tahmineh , Sadeghi-Ghyassi Fatemeh
Published: August 2020

Background: Anxiety is a common reaction among patients undergoing surgery. Religious believes are regarded as psychological methods that are used for the management of anxiety. The aim of this study is assessing the effectiveness of Quran recitation on reducing the anxiety before the elective surgery.Methods: A systematic review of the citations in the Medline, EMBASE, Cochrane Library, PsycInfo, Arab World Research Source and other relevant databases was performed to collect the data. Randomized clinical trials about the effect of Quran recitation on the reduction of anxiety before elective surgery were included without any Language and date restriction. Interventions with self-reading/self-recitation were excluded. The Cochran’s Q statistic and the (I2) with 50 percent threshold was used for calculation of the heterogeneity and the inconsistency index. The funnel plot has been used to evaluate the possibility of the publication bias.Results: We identified 2381 studies from the systematic search. Of these, twelve were included in the qualitative synthesis and nine studies included in the quantitative synthesis. Our meta-analysis showed a significant reduction in the anxiety level with Quran recitation. The heterogeneity of the included studies was statistically significant (Q=23.05, I2=65.29, P=0.003). The pooled effect size of the anxiety was d=−8.893; 95% CI=[−10.763 to −7.022] (P < 0.001), and there was no publication bias (t=0.907, P=0.39) in the studies.Conclusion: Quran recitation can be considered as a non-invasive and peaceful intervention to reduce anxiety before elective surgery.
The Medication Adherence Score: A Predictive Analytic Tool
Authors: Brouwer Tom , Knops Reinoud E. , Burke Martin C. , Reddy Vivek Y.
Published: August 2020

Background

Poor medication adherence is wide-spread and associated with poor clinical outcomes. Herein, we introduce the Medication Adherence Score, a predictive analytic tool designed to provide clinicians insight into adherence behavior over the subsequent twelve months. The aim of the study was to demonstrate the feasibility of such scoring of patients at the individual level.
Methods

This is a single arm, non-randomized, 2-center, retrospective cohort study conducted among patients diagnosed with atrial fibrillation. The model, developed by Fair Isaac Corporation on pharmacy refill data, predicts adherence behavior to cardiovascular drugs using demographic, geographic and socio-economic predictors. The primary outcome was the number of patients that could be scored at the individual level without reliance on past individual refill behavior. The score was normalized between zero (lowest adherence score) and one (highest adherence score) and patients were grouped: low adherence < 0.6, intermediate adherence between 0.6 and 0.8, high adherence > 0.8. The institutional review board approved the study.
Results

A total of 1110 patients were included in the study with a median age of 71 (IQR 63, 79). Most patients (807, 73%) could be scored at the patient level, and the remaining patients (303, 27%) were scored based on characteristics associated with the geography of their home address. There were 488 patients (44%) with a high adherence score (score > 0.8), 382 (34%) with an intermediate adherence score (score between 0.6 and 0.8) and 240 patients (22%) with a low score. Younger patients had on average lower scores than older patients, and males also had higher scores.
Conclusions

The Medication Adherence Score was successfully applied to an unselected group of atrial fibrillation patients: nearly a quarter of the cohort were identified as at risk for non-adherence. Future studies are necessary to assess the association of this predictive analytic model with clinical outcomes.