bluuebunny/crossref_metadata_2025 huggingface dataset:
Multidisciplinary Group Education for Gestational Diabetes Mellitus: A Prospective Observational Cohort Study
Authors: Minschart Caro , Amuli Kelly , Delameillieure Anouk , Calewaert Peggy , Mathieu Chantal , Benhalima Katrien
Published: February 2020

The value of diabetes education, focusing on lifestyle measures, in women with gestational diabetes mellitus (GDM) is acknowledged, but requires intensive education and input of resources if done on an individual basis. Group education could be a valuable alternative to individual education. This study aims to investigate the impact of multidisciplinary group education on women’s knowledge about GDM, education, treatment satisfaction, and emotional status. Two hundred women with GDM were enrolled in a prospective observational study. Dutch speaking women were offered group education at their first visit after GDM diagnosis. Non-Dutch speaking women or women for whom group education was not possible received individual education. Individual follow-up with a dietitian was planned within two weeks for all women. Women receiving individual education (n = 100) were more often from an ethnic minority background compared to women in group education (n = 100) (32.0% (n = 31) vs. 15.3% (n = 15), p = 0.01). Knowledge about GDM significantly improved after education, with few differences between the two education settings. Both patients in group and individual education were equally satisfied with the content and duration of the initial and follow-up education. Of all group participants, 91.8% (n = 90) were satisfied with group size (on average three participants) and 76.5% (n = 75) found that group education fulfilled their expectations. In conclusion, women diagnosed with GDM were overall satisfied with the education session’s content leading to a better understanding of their condition, independent of the education setting. Group education is a valuable alternative to better manage the increasing workload and is perceived as an added value by GDM patients.
High Plasma Branched-Chain Amino Acids Are Associated with Higher Risk of Post-Transplant Diabetes Mellitus in Renal Transplant Recipients
Authors: Osté Maryse C. J. , Flores-Guerrero Jose L. , Gruppen Eke G. , Kieneker Lyanne M. , Connelly Margery A. , Otvos James D. , Dullaart Robin P. F. , Bakker Stephan J. L.
Published: February 2020

Post-transplant diabetes mellitus (PTDM) is a serious complication in renal transplant recipients. Branched-chain amino acids (BCAAs) are involved in the pathogenesis of insulin resistance. We determined the association of plasma BCAAs with PTDM and included adult renal transplant recipients (≥18 y) with a functioning graft for ≥1 year in this cross-sectional cohort study with prospective follow-up. Plasma BCAAs were measured in 518 subjects using nuclear magnetic resonance spectroscopy. We excluded subjects with a history of diabetes, leaving 368 non-diabetic renal transplant recipients eligible for analyses. Cox proportional hazards analyses were used to assess the association of BCAAs with the development of PTDM. Mean age was 51.1 ± 13.6 y (53.6% men) and plasma BCAA was 377.6 ± 82.5 µM. During median follow-up of 5.3 (IQR, 4.2–6.0) y, 38 (9.8%) patients developed PTDM. BCAAs were associated with a higher risk of developing PTDM (HR: 1.43, 95% CI 1.08–1.89) per SD change (p = 0.01), independent of age and sex. Adjustment for other potential confounders did not significantly change this association, although adjustment for HbA1c eliminated it. The association was mediated to a considerable extent (53%) by HbA1c. The association was also modified by HbA1c; BCAAs were only associated with renal transplant recipients without prediabetes (HbA1c < 5.7%). In conclusion, high concentrations of plasma BCAAs are associated with developing PTDM in renal transplant recipients. Alterations in BCAAs may represent an early predictive biomarker for PTDM.
Risk Factors for Mortality among Patients with Pseudomonas aeruginosa Bloodstream Infections: What Is the Influence of XDR Phenotype on Outcomes?
Authors: Montero María Milagro , López Montesinos Inmaculada , Knobel Hernando , Molas Ema , Sorlí Luisa , Siverio-Parés Ana , Prim Nuria , Segura Concepción , Duran-Jordà Xavier , Grau Santiago , Horcajada Juan Pablo
Published: February 2020

This study aimed to assess the impact of extensively drug-resistant (XDR) phenotype on mortality in Pseudomonas aeruginosa bacteremia. A retrospective cohort study was performed in a tertiary hospital from January 2000 to December 2018. All consecutive prospectively recorded P. aeruginosa bacteremia in adult patients were assessed. In this study, 382 patients were included, of which 122 (31.9%) due to XDR P. aeruginosa. Independent factors associated with 14-day mortality were as follows: high-risk source of bacteremia (hazard ratio (HR) 3.07, 95% confidence interval (CI), 1.73–5.46), septic shock (HR 1.75, 95% CI, 1.12–2.75), and higher Pitt scores (one-point increments; HR 1.25, 95% CI, 1.12–1.38). Otherwise, the appropriateness of definitive antibiotic therapy was a protective factor (HR 0.39, 95% CI, 0.24–0.62). The same variables were also associated with 30-day mortality. XDR phenotype was not associated with 14- or 30-day mortality. In a subanalysis considering only high-risk source cases, combined antimicrobial therapy was independently associated with 14-day favorable outcome (HR 0.56, 95% CI, 0.33–0.93). In conclusion, XDR phenotype was not associated with poor prognosis in patients with P. aeruginosa bacteremia in our cohort. However, source of infection, clinical severity, and inappropriate definitive antibiotic therapy were risk factors for mortality. Combined antimicrobial therapy should be considered for high-risk sources.
The Inflammatory Milieu of Adamantinomatous Craniopharyngioma and Its Implications for Treatment
Authors: Whelan Ros , Prince Eric , Gilani Ahmed , Hankinson Todd
Published: February 2020

Pediatric Adamantinomatous Craniopharyngiomas (ACPs) are histologically benign brain tumors that often follow an aggressive clinical course. Their suprasellar location leaves them in close proximity to critical neurological and vascular structures and often results in significant neuroendocrine morbidity. Current treatment paradigms, involving surgical resection and radiotherapy, confer significant morbidity to patients and there is an obvious need to discover effective and safe alternative treatments. Recent years have witnessed significant efforts to fully detail the genomic, transcriptomic and proteomic make-up of these tumors, in an attempt to identify potential therapeutic targets. These studies have resulted in ever mounting evidence that inflammatory processes and the immune response play a critical role in the pathogenesis of both the solid and cystic portion of ACPs. Several inflammatory and immune markers have been identified in both the cyst fluid and solid tumor tissue of ACP. Due to the existence of effective agents that target them, IL-6 and immune checkpoint inhibitors seem to present the most likely immediate candidates for clinical trials of targeted immune-related therapy in ACP. If effective, such agents may result in a paradigm shift in treatment that ultimately reduces morbidity and results in better outcomes for our patients.
Photochemical Internalization for Intracellular Drug Delivery. From Basic Mechanisms to Clinical Research
Authors: Jerjes Waseem , Theodossiou Theodossis A. , Hirschberg Henry , Høgset Anders , Weyergang Anette , Selbo Pål Kristian , Hamdoon Zaid , Hopper Colin , Berg Kristian
Published: February 2020

Photochemical internalisation (PCI) is a unique intervention which involves the release of endocytosed macromolecules into the cytoplasmic matrix. PCI is based on the use of photosensitizers placed in endocytic vesicles that, following light activation, lead to rupture of the endocytic vesicles and the release of the macromolecules into the cytoplasmic matrix. This technology has been shown to improve the biological activity of a number of macromolecules that do not readily penetrate the plasma membrane, including type I ribosome-inactivating proteins (RIPs), gene-encoding plasmids, adenovirus and oligonucleotides and certain chemotherapeutics, such as bleomycin. This new intervention has also been found appealing for intracellular delivery of drugs incorporated into nanocarriers and for cancer vaccination. PCI is currently being evaluated in clinical trials. Data from the first-in-human phase I clinical trial as well as an update on the development of the PCI technology towards clinical practice is presented here.
New Biopsy Techniques and Imaging Features of Transrectal Ultrasound for Targeting PI-RADS 4 and 5 Lesions
Authors: Park Byung Kwan , Park Sung Yoon
Published: February 2020

Purpose: To introduce new biopsy techniques and imaging features of transrectal ultrasound (TRUS) for targeting Prostate Imaging Reporting and Data System (PI-RADS) 4 and 5 lesions Methods: TRUS-guided targeted and/or systematic biopsies were performed in 432 men with PI-RADS 4 and 5 lesions following magnetic resonance imaging examination. A TRUS operator who was familiar with the new techniques and imaging features performed lesion detection. Overall and significant cancer detection rates (CDRs) were compared among the men with PI-RADS 4 and 5 lesions. The CDRs in the peripheral and transition zones were compared. Additionally, we assessed whether targeted or systematic biopsies contributed to cancer detection. The standard reference was a biopsy examination. Results: The overall CDRs in the men with PI-RADS 4 and 5 lesions were 49.5% (139/281) and 74.8% (113/151) (p < 0.0001); significant CDRs were 33.1% (93/281) and 58.3% (88/151) (p < 0.0001); and CDRs in the peripheral and transition zones were 53.6% (187/349) and 78.3% (65/83) (p < 0.0001), respectively. Of the 139 men with clinically significant cancer PI-RADS 4 lesions, 107 (77.0%) were diagnosed by targeted biopsy, 5 (3.6%) by systematic biopsy, and 27 (19.4%) by both. Of the 113 men with clinically significant cancer PI-RADS 5 lesions, 97 (85.8%) were diagnosed by targeted biopsy, 3 (2.7%) by systematic biopsy, and 13 (11.5%) by both. Conclusions: Most PI-RADS 4 and 5 lesions can be targeted with TRUS if the new techniques and imaging features are applied.
Why Internists Should Care About Dry Eye Disease
Authors: Galor Anat
Published: February 2020

Dry eye disease (DED) has been diagnosed and managed under the purview of the eye care professional, with internists typically not paying much attention to the condition [...]
Measuring Vitamin D Status in Chronic Inflammatory Disorders: How does Chronic Inflammation Affect the Reliability of Vitamin D Metabolites in Patients with IBD?
Authors: Aksan Aysegül , Tugal Dilem , Hein Nathalena , Boettger Katharina , Caicedo-Zea Yurani , Diehl Ina , Schumann Claudia , Armbruster Franz-Paul , Stein Jürgen
Published: February 2020

Evidence gained from recent studies has generated increasing interest in the role of vitamin D in extraskeletal functions such as inflammation and immunoregulation. Although vitamin D deficiency has been implicated in the pathophysiology of inflammatory diseases including inflammatory bowel disease (IBD), evidence as to whether vitamin D supplementation may cure or prevent chronic disease is inconsistent. Since 25OH-vitamin D (25OHD) has been suggested to be an acute-phase protein, its utility as a vitamin D status marker is therefore questionable. In this study, possible interactions of vitamin D and inflammation were studied in 188 patients with IBD, with high-sensitivity C-reactive protein (hsCRP) levels ≥ 5 mg/dL and/or fecal calprotectin ≥ 250 µg/g defined as biochemical evidence of inflammatory activity. Levels of 25OHD and vitamin D-binding protein (VDBP) were determined by ELISA, and 1,25-dihydroxyvitamin D (1,25OHD) and dihydroxycholecalciferol (24,25OHD) by LC-MS/MS. Free and bioavailable vitamin D levels were calculated with the validated formula of Bikle. Serum 1,25OH2D and vitamin D binding protein (VDBP) levels were shown to differ between the inflammatory and noninflammatory groups: patients with inflammatory disease activity had significantly higher serum concentrations of 1,25OH2D (35.0 (16.4–67.3) vs. 18.5 (1.2–51.0) pg/mL, p < 0.001) and VDBP (351.2 (252.2–530.6) vs. 330.8 (183.5–560.3) mg/dL, p < 0.05) than patients without active inflammation. Serum 24,25OH2D levels were negatively correlated with erythrocyte sedimentation rate (ESR) (−0.155, p = 0.049) while concentrations of serum 1,25OH2D correlated positively with hsCRP (0.157, p = 0.036). Correlations with serum VDBP levels were found for ESR (0.150, p = 0.049), transferrin (0.160, p = 0.037) and hsCRP (0.261, p < 0.001). Levels of serum free and bioavailable 25OHD showed a negative correlation with ESR (−0.165, p = 0.031, −0.205, p < 0.001, respectively) and hsCRP (−0.164, p = 0.032, −0.208, p < 0.001 respectively), and a moderate negative correlation with fecal calprotectin (−0.377, p = 0.028, −0.409, p < 0.016, respectively). Serum total 25OHD concentration was the only vitamin D parameter found to have no specific correlation with any of the inflammatory markers. According to these results, the traditional parameter, total 25OHD, still appears to be the best marker of vitamin D status in patients with inflammatory bowel disease regardless of the presence of inflammation.
How We Manage Bone Marrow Edema—An Interdisciplinary Approach
Authors: Baumbach Sebastian F. , Pfahler Vanessa , Bechtold-Dalla Pozza Susanne , Feist-Pagenstert Isa , Fürmetz Julian , Baur-Melnyk Andrea , Stumpf Ulla C. , Saller Maximilian M. , Straube Andreas , Schmidmaier Ralf , Leipe Jan
Published: February 2020

Bone marrow edema (BME) is a descriptive term for a common finding in magnetic resonance imaging (MRI). Although pain is the major symptom, BME differs in terms of its causal mechanisms, underlying disease, as well as treatment and prognosis. This complexity together with the lack of evidence-based guidelines, frequently makes the identification of underlying conditions and its management a major challenge. Unnecessary multiple consultations and delays in diagnosis as well as therapy indicate a need for interdisciplinary clinical recommendations. Therefore, an interdisciplinary task force was set up within our large osteology center consisting of specialists from internal medicine, endocrinology/diabetology, hematology/oncology, orthopedics, pediatrics, physical medicine, radiology, rheumatology, and trauma surgery to develop a consenus paper. After review of literature, review of practical experiences (expert opinion), and determination of consensus findings, an overview and an algorithm were developed with concise summaries of relevant aspects of the respective underlying disease including diagnostic measures, clinical features, differential diagnosis and treatment of BME. Together, our single-center consensus review on the management of BME may help improve the quality of care for these patients.
Longitudinal Relationships between Asthma-Specific Quality of Life and Asthma Control in Children; The Influence of Chronic Rhinitis
Authors: van Vliet Dillys , Essers Brigitte A. , Winkens Bjorn , Heynens Jan W. , Muris Jean W. , Jöbsis Quirijn , Dompeling Edward
Published: February 2020

Managing pediatric asthma includes optimizing both asthma control and asthma-specific quality of life (QoL). However, it is unclear to what extent asthma-specific QoL is related to asthma control or other clinical characteristics over time. The aims of this study were to assess in children longitudinally: (1) the association between asthma control and asthma-specific QoL and (2) the relationship between clinical characteristics and asthma-specific QoL. In a 12-month prospective study, asthma-specific QoL, asthma control, dynamic lung function indices, fractional exhaled nitric oxide, the occurrence of exacerbations, and the use of rescue medication were assessed every 2 months. Associations between the clinical characteristics and asthma-specific QoL were analyzed using linear mixed models. At baseline, the QoL symptom score was worse in children with asthma and concomitant chronic rhinitis compared to asthmatic children without chronic rhinitis. An improvement of asthma control was longitudinally associated with an increase in asthma-specific QoL (p-value < 0.01). An increased use of β2-agonists, the occurrence of wheezing episodes in the year before the study, the occurrence of an asthma exacerbation in the 2 months prior to a clinical visit, and a deterioration of lung function correlated significantly with a decrease in the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) total score (p-values ≤ 0.01). Chronic rhinitis did not correlate with changes in the PAQLQ score over 1 year. The conclusion was that asthma control and asthma-specific QoL were longitudinally associated, but were not mutually interchangeable. The presence of chronic rhinitis at baseline did influence QoL symptom scores. β2-agonist use and exacerbations before and during the study were inversely related to the asthma-specific QoL over time.
Microperimetric Biofeedback Training After Successful Inverted Flap Technique for Large Macular Hole
Authors: Sborgia Giancarlo , Niro Alfredo , Tritto Tiziana , Albano Valeria , Sborgia Luigi , Sborgia Alessandra , Donghia Rossella , Giancipoli Ermete , Coassin Marco , Pastore Valentina , Giuliani Gianluigi , Lorenzi Umberto , Romano Mario R. , Boscia Francesco , Alessio Giovanni
Published: February 2020

Background: Despite the high closure rate of large macular hole (LMH) after surgery, visual recovery is often worse than expected. Microperimetric biofeedback can improve visual function in macular pathologies. We evaluated the efficacy of biofeedback on macular function after successful inverted flap technique for LMH. Methods: In this prospective comparative study, 26 patients after LMH surgical closure were enrolled. The whole sample was equally divided into two groups. In Group 1 (trained), patients underwent a double cycle of microperimetric biofeedback, using structured light stimulus plus acoustic tone; in Group 2 (control), patients underwent scheduled visits. We analyzed visual acuity, retinal sensitivity at central 12° (macular sensitivity, MS) and 4° (central macular sensitivity, CMS), and fixation stability over twelve months. Results: Visual acuity improved mainly in the trained group, without any significant differences between the groups (p > 0.05). Only after training did MS significantly improve (p = 0.01). CMS more significantly improved in the trained (p < 0.001) than the control group (p < 0.01) (Group 1 vs. 2, p = 0.004). Only in the trained group did fixation significantly improve (3 months, p ≤ 0.03; 12 months, p ≤ 0.01). An equality test on matched data confirmed a greater significant improvement of CMS (p ≤ 0.02) at all follow-up and fixation (p ≤ 0.02) at last follow-up after training. Conclusions: Microperimetric biofeedback consolidates and increases the improvement of retinal sensitivity and fixation gained after successful inverted flap technique.
Application of Artificial Intelligence Techniques to Predict Survival in Kidney Transplantation: A Review
Authors: Díez-Sanmartín Covadonga , Sarasa Cabezuelo Antonio
Published: February 2020

A key issue in the field of kidney transplants is the analysis of transplant recipients’ survival. By means of the information obtained from transplant patients, it is possible to analyse in which cases a transplant has a higher likelihood of success and the factors on which it will depend. In general, these analyses have been conducted by applying traditional statistical techniques, as the amount and variety of data available about kidney transplant processes were limited. However, two main changes have taken place in this field in the last decade. Firstly, the digitalisation of medical information through the use of electronic health records (EHRs), which store patients’ medical histories electronically. This facilitates automatic information processing through specialised software. Secondly, medical Big Data has provided access to vast amounts of data on medical processes. The information currently available on kidney transplants is huge and varied by comparison to that initially available for this kind of study. This new context has led to the use of other non-traditional techniques more suitable to conduct survival analyses in these new conditions. Specifically, this paper provides a review of the main machine learning methods and tools that are being used to conduct kidney transplant patient and graft survival analyses.
Sex-Sparing Robot-Assisted Radical Cystectomy with Intracorporeal Padua Ileal Neobladder in Female: Surgical Technique, Perioperative, Oncologic and Functional Outcomes
Authors: Tuderti Gabriele , Mastroianni Riccardo , Flammia Simone , Ferriero Mariaconsiglia , Leonardo Costantino , Anceschi Umberto , Brassetti Aldo , Guaglianone Salvatore , Gallucci Michele , Simone Giuseppe
Published: February 2020

Our aim was to illustrate our technique of sex-sparing (SS)-robot-assisted radical cystectomy (RARC) in female patients receiving an intracorporeal neobladder (iN). From January 2013 to June 2018, 11 female patients underwent SS-RARC-iN at a single tertiary referral center. Inclusion criteria were a cT ≤ 2 N0 M0 bladder tumor at baseline imaging (CT or MRI) and an absence of tumors in the bladder neck, trigone and urethra at TURB. Baseline, perioperative, and outcomes at one year were reported. The median operative time was 255 min and the median hospital stay was seven days. Low-grade Clavien complications occurred in four patients (36.3%), while high-grade complications were not observed in any. Seven patients (63.7%) had an organ-confined disease at the pathologic specimen; nodal involvement and positive surgical margins were not detected in any of the cases. At a median follow-up of 28 months (IQR 14–51), no patients developed new onset of chronic kidney disease stage 3b. After one year, daytime and nighttime continence rates were 90.9% and 86.4% respectively. Quality of life as well as physical and emotional functioning improved significantly over time (all p ≤ 0.04), while urinary symptoms and sexual function worsened at three months with a significant recovery taking place at one year (all p ≤ 0.04). Overall, 8 out of 11 patients (72.7%) were sexually active at the 12-month evaluation. In select female patients, SS-RARC-iN is an oncologically sound procedure associated with favorable perioperative and functional outcomes.
Variable Responses to Corneal Grafts: Insights from Immunology and Systems Biology
Authors: Di Zazzo Antonio , Lee Sang-Mok , Sung Jaemyoung , Niutta Matteo , Coassin Marco , Mashaghi Alireza , Inomata Takenori
Published: February 2020

Corneal grafts interact with their hosts via complex immunobiological processes that sometimes lead to graft failure. Prediction of graft failure is often a tedious task due to the genetic and nongenetic heterogeneity of patients. As in other areas of medicine, a reliable prediction method would impact therapeutic decision-making in corneal transplantation. Valuable insights into the clinically observed heterogeneity of host responses to corneal grafts have emerged from multidisciplinary approaches, including genomics analyses, mechanical studies, immunobiology, and theoretical modeling. Here, we review the emerging concepts, tools, and new biomarkers that may allow for the prediction of graft survival.
Short-term Forecasts of the COVID-19 Epidemic in Guangdong and Zhejiang, China: February 13–23, 2020
Authors: Roosa Kimberlyn , Lee Yiseul , Luo Ruiyan , Kirpich Alexander , Rothenberg Richard , Hyman James M. , Yan Ping , Chowell Gerardo
Published: February 2020

The ongoing COVID-19 epidemic continues to spread within and outside of China, despite several social distancing measures implemented by the Chinese government. Limited epidemiological data are available, and recent changes in case definition and reporting further complicate our understanding of the impact of the epidemic, particularly in the epidemic’s epicenter. Here we use previously validated phenomenological models to generate short-term forecasts of cumulative reported cases in Guangdong and Zhejiang, China. Using daily reported cumulative case data up until 13 February 2020 from the National Health Commission of China, we report 5- and 10-day ahead forecasts of cumulative case reports. Specifically, we generate forecasts using a generalized logistic growth model, the Richards growth model, and a sub-epidemic wave model, which have each been previously used to forecast outbreaks due to different infectious diseases. Forecasts from each of the models suggest the outbreaks may be nearing extinction in both Guangdong and Zhejiang; however, the sub-epidemic model predictions also include the potential for further sustained transmission, particularly in Zhejiang. Our 10-day forecasts across the three models predict an additional 65–81 cases (upper bounds: 169–507) in Guangdong and an additional 44–354 (upper bounds: 141–875) cases in Zhejiang by February 23, 2020. In the best-case scenario, current data suggest that transmission in both provinces is slowing down.
Microinvasive Fungal Rhinosinusitis: Proposal of a New Subtype in the Classification
Authors: Seo Min Young , Seok Hyeri , Lee Seung Hoon , Choi Ji Eun , Hong Sang Duk , Chung Seung-Kyu , Peck Kyong Ran , Kim Hyo Yeol
Published: February 2020

Background: Fungal rhinosinusitis (FRS) with mucosal invasion is not classified by the current criteria, and clinical reports on the topic are limited. The aim of this study was to present our 25-year experience on fungal balls with mucosal invasion that do not appear in the FRS classification. Methods: Of 1318 patients who underwent endoscopic surgery with paranasal FRS between November 1994 and July 2019, 372 underwent mucosal biopsies. Medical chart and pathology review were performed on 13 patients diagnosed as having fungal balls with mucosal invasion without accompanying tissue invasion. Results: Histopathologic findings identified all fungi as belonging to the Aspergillus species. In 13 patients, 7 fungal balls were located in the maxillary sinus, 3 in the sphenoid sinus, and 3 in both the maxillary and ethmoid sinuses. The median age at diagnosis was 67 years (interquartile range (IQR): 62–72), and the sex ratio was 1:2 (4 men and 9 women). Five patients had comorbidities—three with diabetes mellitus and two with hematologic malignancy—all of whom received postoperative antifungal therapy. The median duration of antifungal treatment was 13 weeks (IQR: 8–17). No recurrences occurred during the median follow-up period of 30 months (IQR: 22–43). Conclusions: Patients who have been clinically diagnosed with a fungal ball and showed mucosal invasion but no vascular invasion, based on pathologic findings after surgery, may need a new FRS classification category, such as microinvasive FRS, and adjuvant antifungal treatment may be needed for immunocompromised patients with microinvasive FRS. Key points: Fungal rhinosinusitis with mucosal invasion is different from fungal ball and invasive fungal rhinosinusitis and may be classified in a separate category as microinvasive FRS.
Fractional Flow Reserve Derived from Coronary Computed Tomography Angiography Safely Defers Invasive Coronary Angiography in Patients with Stable Coronary Artery Disease
Authors: Rabbat Mark , Leipsic Jonathon , Bax Jeroen , Kauh Brian , Verma Rina , Doukas Demetrios , Allen Sorcha , Pontone Gianluca , Wilber David , Mathew Verghese , Rogers Campbell , Lopez John
Published: February 2020

Objectives: In the United States, the real-world feasibility and outcome of using fractional flow reserve from coronary computed tomography angiography (FFRCT) is unknown. We sought to determine whether a strategy that combined coronary computed tomography angiography (CTA) and FFRCT could safely reduce the need for invasive coronary angiography (ICA), as compared to coronary CTA alone. Methods: The study included 387 consecutive patients with suspected CAD referred for coronary CTA with selective FFRCT and 44 control patients who underwent CTA alone. Lesions with 30–90% diameter stenoses were considered of indeterminate hemodynamic significance and underwent FFRCT. Nadir FFRCT ≤ 0.80 was positive. The rate of patients having ICA, revascularization and major adverse cardiac events were recorded. Results: Using coronary CTA and selective FFRCT, 121 patients (32%) had at least one vessel with ≥50% diameter stenosis; 67/121 (55%) patients had at least one vessel with FFRCT ≤ 0.80; 55/121 (45%) underwent ICA; and 34 were revascularized. The proportion of ICA patients undergoing revascularization was 62% (34 of 55). The number of patients with vessels with 30–50% diameter of stenosis was 90 (23%); 28/90 (31%) patients had at least one vessel with FFRCT ≤ 0.80; 8/90 (9%) underwent ICA; and five were revascularized. In our institutional practice, compared to coronary CTA alone, coronary CTA with selective FFRCT reduced the rates of ICA (45% vs. 80%) for those with obstructive CAD. Using coronary CTA with selective FFRCT, no major adverse cardiac events occurred over a mean follow-up of 440 days. Conclusion: FFRCT safely deferred ICA in patients with CAD of indeterminate hemodynamic significance. A high proportion of those who underwent ICA were revascularized.
Aortic Valve Calcium Associates with All-Cause Mortality Independent of Coronary Artery Calcium and Inflammation in Patients with End-Stage Renal Disease
Authors: Dai Lu , Plunde Oscar , Qureshi Abdul Rashid , Lindholm Bengt , Brismar Torkel B. , Schurgers Leon J. , Söderberg Magnus , Ripsweden Jonaz , Bäck Magnus , Stenvinkel Peter
Published: February 2020

Background: Aortic valve calcium (AVC) and coronary artery calcium (CAC) are common complications in end-stage renal disease (ESRD). We investigated the prognostic significance of overlapping presence of AVC and CAC, and whether AVC was associated with all-cause mortality independent of the presence of CAC in ESRD. Methods: 259 ESRD patients (median age 55 years, 67% males) undergoing cardiac computed tomography were included. Framingham risk score (FRS), presence of cardiovascular disease (CVD), statin use, nutritional status and other relevant laboratory data were determined at baseline. During follow-up for median 36 months, 44 patients died, and 68 patients underwent renal transplantation. Results: The baseline overlap presence of AVC and CAC was 37%. Multivariate regression analysis showed that FRS (odds ratio (OR) 2.25; 95% confidence interval (95% CI), 1.43–3.55) and CAC score (OR (95% CI), 2.18 (1.34–3.59)) were independent determinants of AVC. In competing-risk regression models adjusted for presence of CAC, inflammation, nutritional status, CVD, FRS and statin use, AVC remained independently associated with all-cause mortality (sub-hazard ratio (95% CI), 2.57 (1.20–5.51)). Conclusions: The overlap of AVC and CAC was 37% in this ESRD cohort. AVC was associated with increased all-cause mortality independent of presence of CAC, traditional risk factors and inflammation.
Study of Subjective Data Integrity for Image Quality Data Sets with Consumer Camera Content
Authors: Nawała Jakub , Pinson Margaret H. , Leszczuk Mikołaj , Janowski Lucjan
Published: February 2020

We need data sets of images and subjective scores to develop robust no reference (or blind) visual quality metrics for consumer applications. These applications have many uncontrolled variables because the camera creates the original media and the impairment simultaneously. We do not fully understand how this impacts the integrity of our subjective data. We put forward two new data sets of images from consumer cameras. The first data set, CCRIQ2, uses a strict experiment design, more suitable for camera performance evaluation. The second data set, VIME1, uses a loose experiment design that resembles the behavior of consumer photographers. We gather subjective scores through a subjective experiment with 24 participants using the Absolute Category Rating method. We make these two new data sets available royalty-free on the Consumer Digital Video Library. We also present their integrity analysis (proposing one new approach) and explore the possibility of combining CCRIQ2 with its legacy counterpart. We conclude that the loose experiment design yields unreliable data, despite adhering to international recommendations. This suggests that the classical subjective study design may not be suitable for studies using consumer content. Finally, we show that Hoßfeld–Schatz–Egger α failed to detect important differences between the two data sets.
Steryl Glycosides in Fungal Pathogenesis: An Understudied Immunomodulatory Adjuvant
Authors: Normile Tyler G. , McEvoy Kyle , Del Poeta Maurizio
Published: February 2020

Invasive fungal infections pose an increasing threat to human hosts, especially in immunocompromised individuals. In response to the increasing morbidity and mortality of fungal infections, numerous groups have shown great strides in uncovering novel treatment options and potential efficacious vaccine candidates for this increasing threat due to the increase in current antifungal resistance. Steryl glycosides are lipid compounds produced by a wide range of organisms, and are largely understudied in the field of pathogenicity, especially to fungal infections. Published works over the years have shown these compounds positively modulating the host immune response. Recent advances, most notably from our lab, have strongly indicated that steryl glycosides have high efficacy in protecting the host against lethal Cryptococcal infection through acting as an immunoadjuvant. This review will summarize the keystone studies on the role of steryl glycosides in the host immune response, as well as elucidate the remaining unknown characteristics and future perspectives of these compounds for the host–fungal interactions.
Vulvovaginal Candidiasis: A Current Understanding and Burning Questions
Authors: Willems Hubertine M. E. , Ahmed Salman S. , Liu Junyan , Xu Zhenbo , Peters Brian M.
Published: February 2020

Candida albicans, along with other closely related Candida species, are the primary causative agents of vulvovaginal candidiasis (VVC)—a multifactorial infectious disease of the lower female reproductive tract resulting in pathologic inflammation. Unlike other forms of candidiasis, VVC is a disease of immunocompetent and otherwise healthy women, most predominant during their child-bearing years. While VVC is non-lethal, its high global incidence and profound negative impact on quality-of-life necessitates further understanding of the host and fungal factors that drive disease pathogenesis. In this review, we cover the current state of our understanding of the epidemiology, host response, fungal pathogenicity mechanisms, impact of the microbiome, and novel approaches to treatment of this most prevalent human candidal infection. We also offer insight into the latest advancements in the VVC field and identify important questions that still remain.
Free Vibration Analysis of Curved Laminated Composite Beams with Different Shapes, Lamination Schemes, and Boundary Conditions
Authors: Qin Bin , Zhao Xing , Liu Huifang , Yu Yongge , Wang Qingshan
Published: February 2020

A general formulation is considered for the free vibration of curved laminated composite beams (CLCBs) with alterable curvatures and diverse boundary restraints. In accordance with higher-order shear deformation theory (HSDT), an improved variational approach is introduced for the numerical modeling. Besides, the multi-segment partitioning strategy is exploited for the derivation of motion equations, where the CLCBs are separated into several segments. Penalty parameters are considered to handle the arbitrary boundary conditions. The admissible functions of each separated beam segment are expanded in terms of Jacobi polynomials. The solutions are achieved through the variational approach. The proposed methodology can deal with arbitrary boundary restraints in a unified way by conveniently changing correlated parameters without interfering with the solution procedure.
The Heat Conductivity Properties of Hemp–Lime Composite Material Used in Single-Family Buildings
Authors: Pochwała Sławomir , Makiola Damian , Anweiler Stanisław , Böhm Michał
Published: February 2020

The main goal of the paper is to calculate the heat conductivity for three experimental hemp–lime composites used for structural construction purposes with the use of the experimental stand inside two compartments. Due to current construction trends, we are constantly searching for eco-friendly materials that have a low carbon footprint. This is the case of the analyzed material, and additional thermographic heat distribution inside the material during a fire resistance test proves that it is also a perfect insulation material, which could be applied in addition of popular isolating materials. This paper presents the results of certain hemp–lime composite studies and the potential for using hemp–lime composite for the structural construction industry. Hemp–lime composite heat transfer coefficient, fire resistance, and bulk density properties are compared to those of other commonly used construction materials. The obtained results show that the material together with supporting beams made of other biodegradable materials can be the perfect alternative for other commonly used construction materials.
A Modular Millifluidic Platform for the Synthesis of Iron Oxide Nanoparticles with Control over Dissolved Gas and Flow Configuration
Authors: Panariello Luca , Wu Gaowei , Besenhard Maximilian O. , Loizou Katerina , Storozhuk Liudmyla , Thanh Nguyen Thi Kim , Gavriilidis Asterios
Published: February 2020

Gas–liquid reactions are poorly explored in the context of nanomaterials synthesis, despite evidence of significant effects of dissolved gas on nanoparticle properties. This applies to the aqueous synthesis of iron oxide nanoparticles, where gaseous reactants can influence reaction rate, particle size and crystal structure. Conventional batch reactors offer poor control of gas–liquid mass transfer due to lack of control on the gas–liquid interface and are often unsafe when used at high pressure. This work describes the design of a modular flow platform for the water-based synthesis of iron oxide nanoparticles through the oxidative hydrolysis of Fe2+ salts, targeting magnetic hyperthermia applications. Four different reactor systems were designed through the assembly of two modular units, allowing control over the type of gas dissolved in the solution, as well as the flow pattern within the reactor (single-phase and liquid–liquid two-phase flow). The two modular units consisted of a coiled millireactor and a tube-in-tube gas–liquid contactor. The straightforward pressurization of the system allows control over the concentration of gas dissolved in the reactive solution and the ability to operate the reactor at a temperature above the solvent boiling point. The variables controlled in the flow system (temperature, flow pattern and dissolved gaseous reactants) allowed full conversion of the iron precursor to magnetite/maghemite nanocrystals in just 3 min, as compared to several hours normally employed in batch. The single-phase configuration of the flow platform allowed the synthesis of particles with sizes between 26.5 nm (in the presence of carbon monoxide) and 34 nm. On the other hand, the liquid–liquid two-phase flow reactor showed possible evidence of interfacial absorption, leading to particles with different morphology compared to their batch counterpart. When exposed to an alternating magnetic field, the particles produced by the four flow systems showed ILP (intrinsic loss parameter) values between 1.2 and 2.7 nHm2/kg. Scale up by a factor of 5 of one of the configurations was also demonstrated. The scaled-up system led to the synthesis of nanoparticles of equivalent quality to those produced with the small-scale reactor system. The equivalence between the two systems is supported by a simple analysis of the transport phenomena in the small and large-scale setups.
Fractal Characteristics of Chip Morphology and Tool Wear in High-Speed Turning of Iron-Based Super Alloy
Authors: Zhang Xu , Zheng Guangming , Cheng Xiang , Xu Rufeng , Zhao Guoyong , Tian Yebing
Published: February 2020

Considering that iron-based super alloy is a kind of difficult-to-cut material, it is easy to produce work hardening and serious tool wear during machining. Therefore, this work aims to explore the chip change characteristics and tool wear mechanism during the processing of iron-based super alloy, calculate the fractal dimensions of chip morphology and tool wear morphology, and use fractals to analyze their change trend. Meanwhile, a new cutting tool with a super ZX coating is used for a high-speed dry turning experiment. The results indicate that the morphology of the chip is saw-tooth, and its color changes gradually, due to the oxidation reaction. The main wear mechanisms of the tool involve abrasive wear, adhesive wear, oxidation wear, coating spalling, microcracking and chipping. The fractal dimension of the tool wear surface and chip is increased with the improvement of cutting speed. This work investigates the fractal characteristics of chip morphology and tool wear morphology. The fractal dimension changes regularly with the change of tool wear, which plays an important role in predicting this tool wear. It is also provides some guidance for the efficient processing of an iron-based super alloy.
Influence of Monomer Ratios on Molecular Weight Properties and Dispersing Effectiveness in Polycarboxylate Superplasticizers
Authors: Li Huiqun , Yao Yan , Wang Ziming , Cui Suping , Wang Yali
Published: February 2020

A series of polycarboxylate superplasticizer (PCE) polymers were synthesized from acrylic acid (AA) and isoprenyloxy polyethylene glycol ether (IPEG) at the mole ratios of 3.0, 4.2, 5.0 and 6.0. In this study, the molecular weight properties of PCE polymers were recorded by size exclusion chromatography with the time interval of 1 h. Mini slump test was used to detect the dispersing effectiveness of PCE polymer in cement paste. The results indicated that the reaction rate of monomers, conversion of 52IPEG macromonomer and molecular weight of PCE polymers increased with the general adding ratio of AA to IPEG macromonomers while the side chain density of PCE polymers decreased. PCE polymers possessed molecular weight around 30,000 g/mol with low side chain density, and long main chain length presented high initial dispersing effectiveness at the low dosage around 0.12%. The majority of effective PCE polymers were formed during the adding period of acrylic acid in the first 3 h.
Effect of Graphene Oxide Modified with Organic Amine on the Aging Resistance, Rolling Loss and Wet-Skid Resistance of Solution Polymerized Styrene-Butadiene Rubber
Authors: Wan Songhan , Lu Xiaobin , Zhao Hongguo , Chen Songbo , Cai Shuwei , He Xianru , Zhang Rui
Published: February 2020

Graphene oxide (GO) was modified by p-phenylenediamine (PPD), aiming at improving the wet-skid resistance and reduce the rolling loss of solution polymerized styrene-butadiene rubber (SSBR). PPD with amino groups enabled GO to obtain anti-aging function. The structure of modified GO (PPD-GO) was characterized by Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD) and Raman spectroscopy. Mechanical tests showed that the mechanical properties of SSBR before and after aging were improved by adding PPD-GO. The results of thermogravimetric-differential scanning calorimeter synchronization analysis (TGA-DSC) indicated that SSBR/PPD-GO obtained good thermo-oxidative stability. The dynamic mechanical analysis (DMA) of SSBR composites showed that the mechanical loss factor (tanδ) peak moved to high temperature with the content of PPD-GO. The tanδ values of SSBR composites showed that it had a good effect on improving the wet-skid resistance and reducing the rolling loss of SSBR by adjusting the content of PPD-GO. In particular, with the addition of 4 phr GO, SSBR was effectively improved in mechanical properties, aging resistance, wet-skid resistance and low rolling loss.
Carbon-Based Band Gap Engineering in the h-BN Analytical Modeling
Authors: Ahmadi Mohammad Taghi , Razmdideh Ahmad , Rahimian Koloor Seyed Saeid , Petrů Michal
Published: February 2020

The absence of a band gap in graphene is a hindrance to its application in electronic devices. Alternately, the complete replacement of carbon atoms with B and N atoms in graphene structures led to the formation of hexagonal boron nitride (h-BN) and caused the opening of its gap. Now, an exciting possibility is a partial substitution of C atoms with B and N atoms in the graphene structure, which caused the formation of a boron nitride composite with specified stoichiometry. BC2N nanotubes are more stable than other triple compounds due to the existence of a maximum number of B–N and C–C bonds. This paper focused on the nearest neighbor’s tight-binding method to explore the dispersion relation of BC2N, which has no chemical bond between its carbon atoms. More specifically, the band dispersion of this specific structure and the effects of energy hopping in boron–carbon and nitrogen–carbon atoms on the band gap are studied. Besides, the band structure is achieved from density functional theory (DFT) using the generalized gradient approximations (GGA) approximation method. This calculation shows that this specific structure is semimetal, and the band gap energy is 0.167 ev.
Recycled Glass as a Substitute for Quartz Sand in Silicate Products
Authors: Borek Katarzyna , Czapik Przemysław , Dachowski Ryszard
Published: February 2020

In 2016, an average of 5.0 tons of waste per household was generated in the European Union (including waste glass). In the same year, 45.7% of the waste glass in the EU was recycled. The incorporation of recycled waste glass in building materials, i.e., concrete, cements, or ceramics, is very popular around the world because of the environmental problems and costs connected with their disposal and recycling. A less known solution, however, is using the waste glass in composite products, including sand-lime. The aim of this work was to assess the role of recycled container waste glass in a sand-lime mix. The waste was used as a substitute for the quartz sand. To verify the suitability of recycled glass for the production of sand-lime products, the physical and mechanical properties of sand-lime specimens were examined. Four series of specimens were made: 0%, 33%, 66%, and 100% of recycled waste glass (RG) as a sand (FA) replacement. The binder mass did not change (8%). The research results showed that ternary mixtures of lime, sand, and recycled waste glass had a higher compressive strength and lower density compared to the reference specimen. The sand-lime specimen containing 100% (RG) increased the compressive strength by 287% compared to that of the control specimen. The increase in the parameters was proportional to the amount of the replacement in the mixtures.