bluuebunny/crossref_metadata_2025 huggingface dataset:
Peripheral Blood Cell Ratios as Prognostic Indicators in a Neoadjuvant Chemotherapy-Treated Breast Cancer Cohort
Authors: Jalali Amirhossein , Miresse David , Fahey Matthew R. , Ni Mhaonaigh Niamh , McGuire Andrew , Bourke Emer , Kerin Michael J. , Brown James A. L.
Published: October 2022

Breast cancer represents a heterogeneous condition in which the interaction between host immune response and primary oncogenic events can impact disease progression. Ratios of systemic blood-based immunocytes have emerged as clinically-relevant prognostic biomarkers in cancer patients. The NLR (neutrophil-to-lymphocyte ratio) has been shown to be prognostic in a variety of cancers, including breast cancer. However, evaluation of the prognostic value for overall survival (OS) and disease-free survival (DFS) of other key immunocyte ratios—neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), neutrophil-to-white cell count ratio (NWR), lymphocyte-to-white cell count ratio (LWR), monocyte-to-white cell count ratio (MWR), platelet-to-lymphocyte (PLR)—by breast cancer subtypes in a neoadjuvant chemotherapy (NAC) cohort remains to be fully explored. An NAC-treated breast cancer cohort, comprised of Luminal A, Luminal B, HER2-positive, and triple negative/basal breast cancers, treated at a tertiary referral center (minimum 3-year follow-up), was used to calculate immunocyte ratios and immunocyte cut-off values, calculated with >80% specificity (using decision tree modeling). The association with subtype-specific OS, DFS, and tumor grade was analyzed using cut offs calculated using both receiver operating characteristic curves and decision tree modelling. Decision tree calculated ratios showed that LMR (5.29) and MWR (0.06) were significantly associated with Luminal A OS (p = 0.004 and p = 0.022) and DFS (p = 0.004 and p = 0.022), and Luminal B OS (p = 0.027 and p = 0.008) and DFS (p = 0.005 and p = 0.007). NLR (1.79) and LWR (0.30) were significantly associated with HER2-positive OS (p = 0.013 and p = 0.043). NLR (1.79) and NWR (0.62) were significantly associated with DFS (p = 0.035 and p = 0.021). No significant association we observed between any immunocyte ratio in the triple negative cohort. Our results demonstrate the subtype-specific prognostic value of immunocyte ratios in NAC-treated breast cancer patients. Further validation of immunocyte ratios will provide clinicians with a new prognostic aid for disease management and monitoring.
Seasonal Habitat Selection by American White Pelicans
Authors: Cunningham Frederick L. , Wang Guiming , King D. Tommy
Published: October 2022

Resource utilization strategies of avian migrants are a major concern for conservation and management. Understanding seasonal habitat selection by migratory birds helps us explain the ongoing continental declines of migratory bird populations. Our objective was to compare the second-order and third-order habitat selection by the American White Pelican (Pelecanus erythrorhynchos; hereafter pelican) between the breeding and non-breeding grounds. We tested the Lack hypothesis that habitat selection by migratory birds is stronger on the breeding grounds than on the non-breeding grounds. We used random-effect Dirichlet-multinomial models to estimate the second-order habitat selection between the seasons with the GPS locations of 32 tracked pelicans. We used Gaussian Markov random field models to estimate the third-order habitat selection by pelicans at the breeding and non-breeding grounds, accounting for spatial autocorrelation. Pelicans strongly selected waterbodies and wetlands at both non-breeding and breeding grounds, tracking their foraging habitats between the seasons at the home range level. However, pelicans exhibited seasonal differences in the strength of the third-order selection of wetlands and waterbodies with foraging habitat selection being stronger at the breeding grounds than at the non-breeding grounds, supporting the Lack hypothesis.
Shifts in Community Vegetative Organs and Their Dissimilar Trade-Off Patterns in a Tropical Coastal Secondary Forest, Hainan Island, Southern China
Authors: Yaseen Muhammad , Long Wenxing , Khalid Farhan , Bahadur Saraj , Noushahi Hamza Armghan
Published: October 2022

The ecology of functional features highlights the importance of the leaf economic spectrum (LES) in understanding plant trade-offs between conservative and commercial resource use. However, it is still unclear whether changes in the plant attributes of various vegetative organs can be altered and whether the plant economic spectrum (PES) is categorized by multiple vegetative organs. We investigated a total of 12 functional features of 174 woody tree species, with leaf and stem attributes, on Hainan Island. We used principal component analysis (PCA) to analyze the changes in attributes and connections to understand how the plant trade-offs differ. We detected that stem organic matter (SOM) and stem organic carbon (SOC) contributed most to the first principal component, followed by leaf organic matter (LOM) and leaf organic carbon (LOC). Using Spearman correlation analysis, we determined that leaf total nitrogen (LTN) and specific leaf area (SLA), LTN and leaf total phosphorus (LTP), and finally stem total nitrogen (STN) and stem total phosphorus (STP) were positively significantly correlated. These significant variations in the traits of nutrients are regulated, while the morphological traits of aboveground vegetative organs are diverse. The coexistence of species and community assembly can increase our knowledge on the tropical coastal secondary forests. Furthermore, our outcomes can help us to better understand the restoration of habitats and green infrastructure design, suggesting that selecting different species across multiple trait axes can help ensure functionality at the maximum level.
Biodiversity of Coleoptera (Insecta) in Lipetsk Region (Russia)
Authors: Mazurov Sergei G. , Egorov Leonid V. , Ruchin Alexander B. , Artaev Oleg N.
Published: October 2022

(1) Background: Coleoptera is one of the most diverse insect lineages. Coleoptera species live in many ecosystems around the globe and their role in ecosystems is very diverse. To study the number and distribution of species, lists of species were compiled and then added into the database generation platforms. The aim of the work was to describe the modern fauna of Coleoptera based on a recently published dataset. (2) Methods: Studies were conducted from 1971 to 2022. Insects were collected by different means (searching under the bark of trees and stumps, sifting litter and wood dust, soil samples, caught in the light, in soil traps, window traps, etc.). For each observation, the coordinates of the place of discovery, the number of individuals, dates were noted. (3) Results: The dataset presents data on 2416 species and subspecies of Coleoptera from 89 families found in the Lipetsk region. In total, the number of studied specimens in the dataset was 16,184, the number of occurrences was 6192. The largest families in terms of species diversity were Staphylinidae (541 species), Curculionidae (416), Chrysomelidae (315) and Carabidae (285). (4) Conclusions: In addition, based on the analysis of additional references, 452 more species and 2 families are indicated. Thus, the biodiversity of Coleoptera of the Lipetsk region is 2868 species from 89 families.
Species Diversity of Gelidium from Southern Madagascar Evaluated by an Integrative Taxonomic Approach
Authors: Boo Ga Hun , Le Gall Line , Hwang Il Ki , Rousseau Florence , Yoon Hwan Su
Published: October 2022

The diversity of red algae is significantly increasing; in the recent interest of climate changes, taxonomic and biogeographic studies are needed in untouched regions such as ecological important islands. We examined a collection of Gelidium specimens gathered during the 2010 Atimo Vatae expedition based on the morphology and DNA sequencing of mitochondrial cox1 and plastid rbcL. Both morphological and molecular datasets demonstrated the presence of three species in Madagascar; G. leptum G.H.Boo, L.Le Gall and H.S.Yoon, sp. nov., described here, and G. sclerophyllum W.R.Taylor and G. usmanghanii Afaq-Husain and Shameel. Gelidium leptum is distinguished by thin, slender, flattened thalli with irregular branches, compactly arranged thick-walled cells in medulla, sparse rhizoidal filaments at both sides of branches, and elongate sori of tetrasporangia. Gelidium sclerophyllum, previously considered as endemic to the Tropical Eastern Pacific, is first reported in the Indian Ocean and Hawai’i; G. usmanghanii, previously reported to occur in Pakistan and Oman, also presents a first record in the Southern Hemisphere. Phylogenies inferred from cox1 and rbcL sequences suggests that each of the three species likely diverged from different ancestors. The Madagascan Gelidium comprises two geographical elements; Madagascan endemic (G. leptum) and widespread species (G. sclerophyllum and G. usmanghanii).
Characterization of Captive Breeders to Preserve the Residual Genetic Diversity of Adriatic Sturgeon (Acipenser naccarii)
Authors: Barca Federica , Dalle Palle Stefano , Schiavon Luca , Samassa Chiara , Castaldelli Giuseppe , Boscari Elisa , Congiu Leonardo
Published: October 2022

Since 1996, the Adriatic sturgeon (Acipenser naccarii) has been inscribed on the IUCN Red List as “Critically Endangered and possibly extinct in the wild”. Nowadays, its survival totally depends on restocking programs conducted by releasing juveniles generated from adult breeders reared in aquaculture. Conducting accurate genetic characterizations of all individuals potentially involved in reproduction activities is therefore of primary importance to avoid inbreeding and to maximize the genetic diversity transmitted to following generations. Since all animals reared in captivity descend from a single stock of wild origin, this offers the ideal condition for carrying out relatedness analysis based on parentage allocations. In this study, we provided the most complete characterization of about 500 individuals representing the most diverse extant stock of Adriatic sturgeon. Through the analyses of mitochondrial d-loop and 15 microsatellite loci selected from 24 genotyped loci, we identified about 30 different familiar groups, updating data on breeding stocks, increasing the genetic information already available, and extending the analyses to animals never genotyped before. Given its completeness, it will represent a reference database for any future parental allocation of recaptured animals for the inclusion of all other stocks present, as well as for the development of a long-term breeding plan. The approach used has also been proven useful on individuals of unknown genealogy, allowing for the identification of family groups and thus being proven to be promising for the analysis of stocks of other tetraploid sturgeon species.
Effects of Vetiveria zizanioides on the Restoration and Succession of Coal Gangue Mountain Plant Communities in Different Years
Authors: Shuai Honggang , Tian Sihui , Jin Baocheng , Wang Zhaoyi , Wang Jigao , Zhang Yaoyao , Wang Yuefeng , Zhao Xuechun
Published: October 2022

The restoration of vegetation on coal gangue mountains has always been an area of concern, and therefore, an important area of research. Liupanshui city in Guizhou province, China, has a large number of coal gangue mountains, and for this reason, was chosen for studying vegetation succession on these sites. Vetiveria zizanioides is known to accelerate the restoration of vegetation on coal gangue mountains and to shorten community succession timeframes. Because of this, we investigated different successional stages after the planting of V. zizanioides on coal gangue mountains in the Dahe coal mine comprehensive environmental governance project area in Liupanshui city. Through field community surveys and model prediction, the effects of planted V. zizanioides on the species composition, species diversity, and community succession of gangue mountains 3, 6, 8, 10, and 13 years after planting were explored. In total, 35 plant species belonging to 17 families and 32 genera were recorded across the five different coal gangue mountains. With more time after planting, the height, coverage, density, and biomass of V. zizanioides all decreased, but increased for Miscanthus floridulus. The Simpson diversity index, Shannon–Wiener diversity index, and Pielou evenness index all first increased before decreasing over time; maximum values were recorded for the coal gangue mountain 8 years after planting of V. zizanioides. According to different similarity and dissimilarity indices, the successional stages became more similar with increasing time after planting. According to biomass fitting and prediction curves, the succession process of coal gangue mountain plant communities could be divided into a V. zizanioides community stage, a M. floridulus community stage, and a woody plant stage, that starts to approach the natural community of evergreen broad-leaved forests, with durations of 0–5.62 years, 5.62–17.48 years, and over 17.48 years, respectively.
Orbital Tumors—Clinical, Radiologic and Histopathologic Correlation
Authors: Vogele Daniel , Sollmann Nico , Beck Annika , Haggenmüller Benedikt , Schmidt Stefan Andreas , Schmitz Bernd , Kapapa Thomas , Ozpeynirci Yigit , Beer Meinrad , Kloth Christopher
Published: October 2022

Orbital masses include a broad spectrum of benign and malignant entities. Often these masses are asymptomatic or show a slow growth rate, so that emergence of clinical symptoms is prolonged. In this context, cross-sectional imaging plays an elementary role in the characterization of these lesions. Aside from the characterization of the underlying entity, an evaluation of the involved compartments is possible by sufficient imaging, which also facilitates optimal treatment and surgery planning. The purpose of this review is to explore different benign and malignant orbital tumors and their typical appearance in imaging together with histopathologic findings.
Benefits and Limitations of OCT-A in the Diagnosis and Follow-Up of Posterior Intraocular Inflammation in Current Clinical Practice: A Valuable Tool or a Deceiver?
Authors: Herbort Carl P. , Papasavvas Ioannis , Tugal-Tutkun Ilknur
Published: October 2022

Purpose: Optical coherence tomography angiography (OCT-A) has been applied to uveitis and intraocular inflammation since its availability after 2014. The imaging of retinal and choroidal vascularization without the use of dyes was a major development and represented a potentially valuable tool in ocular research. In addition to such use, OCT-A is often put forward as being able to potentially replace invasive methods needing dye injection, such as fluorescein angiography (FA) and indocyanine green angiography (ICGA). The aim of this review was to establish whether OCT-A was sufficiently useful in everyday routine clinical practice to monitor disease evolution and to perform treatment adjustments to the extent that it could reliably replace the standard dye methods. Methods: Selective literature review and analysis of own data and experience. Results: OCT-A is a technologically high-grade imaging modality allowing to analyze retinal circulation in inflammatory diseases of the posterior pole with a high sensitivity useful for research purposes. However, there is no evidence that it reaches equal effectiveness in the routine management of posterior uveitis involving the retina. OCT-A is unable to show leakage. In choriocapillaritis involving pre-capillary vessels, it shows capillary drop-out but does not seem to have an advantage over ICGA except that it can be repeated easily, not being invasive, and so allows a closer follow-up. It is, however, less useful in end-choriocapillary non-perfusion, such as in MEWDS. For choroidal stromal inflammation, OCT-A is ill-suited as it only shows inconsistent secondary circulatory changes produced by choroidal foci. OCT-A seems to be useful in the diagnosis and follow-up of inflammatory chorioneovascularisation (iCNV), although dye exams are more precise in showing the activity of the iCNV. Conclusion: In summary, OCT-A is a very sensitive modality for the retinal circulation in uveitis for research purposes; it is sometimes useful for close follow of choriocapillary drop-out but not in end-capillary non-perfusion. Its use for monitoring purposes in stromal choroiditis, however, is questionable. Its claim to possibly replace classical angiographic work-up for the practical management of posterior uveitis is largely overrated.
Fatal Fulminant Hepatitis E in a Diabetic Patient on Metformin
Authors: Peroni Erika , Mora Pierre , Motte Anne , Gerolami René , Aherfi Sarah , Colson Philippe
Published: October 2022

Hepatitis E is mostly autochthonous in Western developed countries, eating pig-derived products being the most frequently documented source. Hepatitis E virus (HEV) infection is usually asymptomatic or self-limiting, but it can cause acute liver failure. HEV serological testing was performed using EUROIMMUN immunoenzymatic assays. HEV RNA in the serum was determined using an in-house real-time reverse transcriptase PCR procedure. The HEV genotype was determined through phylogenetic analysis after Sanger sequencing was performed using an in-house procedure. The case patient, an immunocompetent patient in his 60s with type 2 diabetes and no documented chronic liver disease, was hospitalized in February 2021 in an intensive care unit due to an initially unexplained coma. He presented metformin overdose and fulminant hepatitis E (HEV RNA in the serum was 4,140,000 copies/mL) that evolved toward death. The HEV genotype was 3f. We identified eight previous hepatitis E in diabetic patients, but with no metformin excessive plasma concentration, in the literature. Three patients were liver transplant recipients and three died. HEV infection can be severe and life-threatening in diabetic patients, which warrants HEV testing in this special population in the case of an altered general condition and/or liver cytolysis.
Proposals for Standardization of Intraoperative Facial Nerve Monitoring during Parotid Surgery
Authors: Chiang Feng-Yu , Lien Ching-Feng , Wang Chih-Chun , Wang Chien-Chung , Hwang Tzer-Zen , Shih Yu-Chen , Tseng Hsin-Yi , Wu Che-Wei , Huang Yaw-Chang , Huang Tzu-Yen
Published: October 2022

Intraoperative facial nerve monitoring (FNM) has been widely accepted as an adjunct during parotid surgery to facilitate identification of the facial nerve (FN) main trunk, dissection of FN branches, confirmation of FN function integrity, detection of FN injury and prognostication of facial expression after tumor resection. Although the use of FNM in parotidectomy is increasing, little uniformity exists in its application from the literature. Thus, not only are the results of many studies difficult to compare but the value of FNM technology is also limited. The article reviews the current literature and proposes our standardized FNM procedures during parotid surgery, such as standards in FNM setup, standards in general anesthesia, standards in FNM procedures and application of stimulus currents, interpretation of electrophysiologic signals and prediction of the facial expression outcome and pre-/post-operative assessment of facial expressions. We hope that the FNM standardized procedures will provide greater uniformity, improve the quality of applications and contribute to future research.
Acute Distal Vertebral Artery Occlusion in Patients with Asymmetrical Vertebral Artery Geometry: Role of Black-Blood-Enhanced MR Imaging
Authors: Jeong Youngsun , Park Chan Sol , Lee Ui Yun , Hwang Seung Bae , Chung Gyung Ho , Kwak Hyo Sung
Published: October 2022

Background: The purpose of this study was to evaluate the diagnostic value of contrast enhancement in a unilateral distal vertebral artery (VA) using black blood (BB)-enhanced magnetic resonance (MR) imaging in patients with acute neurological symptoms and asymmetrical VA geometry. Methods: From January 2020 to August 2021, we retrospectively analyzed BB-contrast-enhanced MR imaging and MR angiography (MRA) findings in stroke patients visiting the emergency room for an evaluation of acute neurological symptoms. We classified four patterns according to asymmetrical VA geometry using MRA and contrast enhancement using BB-enhanced MR imaging: type 1 = enhanced VA + no visualization of VA, type 2 = enhanced VA + hypoplastic VA, type 3 = non-enhanced VA + hypoplastic VA, or type 4 = non-enhanced VA + no visualization of VA. Results: In total, 288 patients (type 1 = 65, type 2 = 17, type 3 = 130, type 4 = 76) were enrolled in this study. Of these patients, 82 (28.5%) showed contrast enhancement of a unilateral distal VA on BB-enhanced MR imaging, and 51 (17.8%) had positive findings on diffusion-weighted imaging (DWI) in the ipsilateral medulla, pons, or posterior inferior cerebellar artery (PICA) territory. The contrast enhancement of a unilateral distal VA using BB-enhanced MR imaging demonstrated a significantly higher prevalence in patients with acute infarction on DWI (50.0% vs. 4.9%, p < 0.001). Conclusions: The contrast enhancement of a unilateral distal VA on BB-enhanced MR imaging is associated with acute infarction of the medulla, pons, or PICA territory and suggests acute occlusion of a distal VA.
An Explainable Machine Learning Pipeline for Stroke Prediction on Imbalanced Data
Authors: Kokkotis Christos , Giarmatzis Georgios , Giannakou Erasmia , Moustakidis Serafeim , Tsatalas Themistoklis , Tsiptsios Dimitrios , Vadikolias Konstantinos , Aggelousis Nikolaos
Published: October 2022

Stroke is an acute neurological dysfunction attributed to a focal injury of the central nervous system due to reduced blood flow to the brain. Nowadays, stroke is a global threat associated with premature death and huge economic consequences. Hence, there is an urgency to model the effect of several risk factors on stroke occurrence, and artificial intelligence (AI) seems to be the appropriate tool. In the present study, we aimed to (i) develop reliable machine learning (ML) prediction models for stroke disease; (ii) cope with a typical severe class imbalance problem, which is posed due to the stroke patients’ class being significantly smaller than the healthy class; and (iii) interpret the model output for understanding the decision-making mechanism. The effectiveness of the proposed ML approach was investigated in a comparative analysis with six well-known classifiers with respect to metrics that are related to both generalization capability and prediction accuracy. The best overall false-negative rate was achieved by the Multi-Layer Perceptron (MLP) classifier (18.60%). Shapley Additive Explanations (SHAP) were employed to investigate the impact of the risk factors on the prediction output. The proposed AI method could lead to the creation of advanced and effective risk stratification strategies for each stroke patient, which would allow for timely diagnosis and the right treatments.
Characteristics of Hepatitis B Virus Genotype and Sub-Genotype in Hepatocellular Cancer Patients in Vietnam
Authors: Ho Phat , Balzanelli Mario , Distratis Pietro , Lazzaro Rita , Tran Duy , Nguyen Kieu , Bui Tri , Nguyen Thinh , Pham Son , Nguyen Huy , Tran Vinh , Ho Toan , Dipalma Gianna , Inchingolo Francesco , Quek Camelia , Pham Huong , Isacco Ciro , Santacroce Luigi , Pham Van
Published: October 2022

Untreated chronic hepatitis B virus (HBV) infection can lead to chronic liver disease and may progress to cirrhosis or hepatocellular carcinoma (HCC). HBV infection has been prevalent in Vietnam, but there is little information available on the genotypes, sub-genotypes, and mutations of HBV in patients with HBV-related HCC confirmed by histopathological diagnosis. We studied the molecular characteristics of HBV and its genetic variants in Vietnamese HCC patients after liver tumor resection. We conducted a descriptive cross-sectional study on 107 HBV-related HCC hospitalized patients from October 2018 to April 2019. The specimens collected included EDTA anticoagulant blood and liver tissues. Extracted HBV DNA was subjected to whole genome sequencing by the Sanger method. We discovered 62 individuals (57.9%) with genotype B and 45 patients (42.1%) with genotype C, with only sub-genotypes B4 and C1. Among the mutations, the double mutation, A1762T-G1764A, had the most significant frequency (73/107 samples; 68.2%) and was higher in genotype C than in genotype B (p < 0.001). The most common genotypes found in HCC patients in this investigation were B and C, with sub-genotypes B4 and C1 for each. The prevalence of genotype B4 was greater in HBV-infected Vietnamese HCC patients.
The CHA2DS2-VASc Score Predicts New-Onset Atrial Fibrillation and Hemodynamic Complications in Patients with ST-Segment Elevation Myocardial Infarction Treated by Primary Percutaneous Coronary Intervention
Authors: Cozac Dan Alexandru , Lakatos Eva Katalin , Demjen Zoltan , Ceamburu Alexandru , Fișcă Paul Ciprian , Șuș Ioana , Hadadi Laszlo , Scridon Alina
Published: October 2022

Arrhythmic and hemodynamic complications related to ST-segment elevation myocardial infarction (STEMI) represent a major clinical challenge. Several scores have been developed to predict mortality in STEMI. However, those scores almost exclusively include factors related to the acute phase of STEMI, and no score has been evaluated to date for its ability to specifically predict arrhythmic and hemodynamic complications. We, thus, aimed to assess the ability of chronic risk factors burden, as expressed by the CHA2DS2-VASc score, to predict STEMI-related arrhythmic and hemodynamic complications. Data were collected from 839 consecutive STEMI patients treated by primary percutaneous coronary interventions (pPCI). CHA2DS2-VASc and GRACE scores were calculated for all patients, and their ability to predict STEMI-related arrhythmic (i.e., new-onset atrial fibrillation (AF), ventricular tachycardia/fibrillation) and hemodynamic (i.e., cardiogenic shock, asystole) complications was assessed in univariate and multiple regression analysis. Arrhythmic and hemodynamic complications occurred in 14.8% and 10.2% of patients, respectively. Although the GRACE score outweighed the CHA2DS2-VASc score in the ability to predict STEMI-related hemodynamic complications (p < 0.0001), both scores had a similar predictive value for STEMI-related new-onset AF (p = 0.20), and both remained independent predictors of new-onset AF and of hemodynamic complications in the multiple regression analyses. A CHA2DS2-VASc score > 2 points independently predicted new-onset AF (p < 0.01) and hemodynamic complications (p = 0.04). Alongside the GRACE score, the CHA2DS2-VASc score independently predicted new-onset AF and hemodynamic complications in STEMI patients treated by pPCI. These data suggest that a combination of acute and chronic risk factors could provide additional benefit in identifying patients at risk of STEMI-related complications, who could benefit from closer follow-up and more intensive prophylactic and therapeutic strategies.
Soft-Tissue Healing Assessment after Extraction and Socket Preservation Using Platelet-Rich Fibrin (PRF) in Smokers: A Single-Blinded, Randomized, Controlled Clinical Trial
Authors: Alrayyes Yasser , Aloraini Saleh , Alkhalaf Ahmed , Aljasser Reham
Published: October 2022

Background: Wound healing is essential in any surgical procedure, and multiple factors, such as smoking, can impair it. The aim of this clinical trial was to evaluate the ability of platelet-rich fibrin to enhance socket wound healing in smokers. Methods: A total of 18 smoker participants with forty non-restorable upper molars indicated for extraction were recruited to the study and were randomly allocated to four different groups for the assessment of four techniques: advanced platelet-rich fibrin (A-PRF), factor-enriched bone graft matrix with advanced platelet-rich fibrin (A/S-PRF), freeze-dried bone allograft and crosslinked collagen membrane (FDBA/CM), and resorbable collagen plug (RCP). One examiner clinically measured soft-tissue closure and the healing pattern using a periodontal probe and a healing index. Each subject was given a questionnaire after each follow-up visit to record several patient-reported experience measures (PREMs). This was conducted at baseline and 10, 21, and 28 days after the extraction procedure. Results: Both A-PRF and A/S-PRF showed significant results in terms of mesio-distally (p = 0.012), and healing pattern parameters (p < 0.0001), while RCP showed the least favorable outcome. Conclusions: Different forms of PRF exhibited enhanced wound closure and healing patterns, as well as reduced post-operative complications among smokers.
Detecting Parkinson’s Disease through Gait Measures Using Machine Learning
Authors: Li Alex , Li Chenyu
Published: October 2022

Parkinson’s disease (PD) is one of the most common long-term degenerative movement disorders that affects the motor system. This progressive nervous system disorder affects nearly one million Americans, and more than 20,000 new cases are diagnosed each year. PD is a chronic and progressive painful neurological disorder and usually people with PD live 10 to 20 years after being diagnosed. PD is diagnosed based on the identification of motor signs of bradykinesia, rigidity, tremor, and postural instability. Though several attempts have been made to develop explicit diagnostic criteria, this is still largely unrevealed. In this manuscript, we aim to build a classifier with gait data from Parkinson patients and healthy controls using machine learning methods. The classifier could help facilitate a more accurate and cost-effective diagnostic method. The input to our algorithm is the Gait in Parkinson’s Disease dataset published on PhysioNet containing force sensor data as the measurement of gait from 92 healthy subjects and 214 patients with idiopathic Parkinson’s Disease. Different machine learning methods, including logistic regression, SVM, decision tree, KNN were tested to output a predicted classification of Parkinson patients and healthy controls. Baseline models including frequency domain method can reach similar performance and may be another good approach for the PD diagnostics.
Deep Learning Assisted Automated Assessment of Thalassaemia from Haemoglobin Electrophoresis Images
Authors: Salman Khan Muhammad , Ullah Azmat , Khan Kaleem Nawaz , Riaz Huma , Yousafzai Yasar Mehmood , Rahman Tawsifur , Chowdhury Muhammad E. H. , Abul Kashem Saad Bin
Published: October 2022

Haemoglobin (Hb) electrophoresis is a method of blood testing used to detect thalassaemia. However, the interpretation of the result of the electrophoresis test itself is a complex task. Expert haematologists, specifically in developing countries, are relatively few in number and are usually overburdened. To assist them with their workload, in this paper we present a novel method for the automated assessment of thalassaemia using Hb electrophoresis images. Moreover, in this study we compile a large Hb electrophoresis image dataset, consisting of 103 strips containing 524 electrophoresis images with a clear consensus on the quality of electrophoresis obtained from 824 subjects. The proposed methodology is split into two parts: (1) single-patient electrophoresis image segmentation by means of the lane extraction technique, and (2) binary classification (normal or abnormal) of the electrophoresis images using state-of-the-art deep convolutional neural networks (CNNs) and using the concept of transfer learning. Image processing techniques including filtering and morphological operations are applied for object detection and lane extraction to automatically separate the lanes and classify them using CNN models. Seven different CNN models (ResNet18, ResNet50, ResNet101, InceptionV3, DenseNet201, SqueezeNet and MobileNetV2) were investigated in this study. InceptionV3 outperformed the other CNNs in detecting thalassaemia using Hb electrophoresis images. The accuracy, precision, recall, f1-score, and specificity in the detection of thalassaemia obtained with the InceptionV3 model were 95.8%, 95.84%, 95.8%, 95.8% and 95.8%, respectively. MobileNetV2 demonstrated an accuracy, precision, recall, f1-score, and specificity of 95.72%, 95.73%, 95.72%, 95.7% and 95.72% respectively. Its performance was comparable with the best performing model, InceptionV3. Since it is a very shallow network, MobileNetV2 also provides the least latency in processing a single-patient image and it can be suitably used for mobile applications. The proposed approach, which has shown very high classification accuracy, will assist in the rapid and robust detection of thalassaemia using Hb electrophoresis images.
Whole-Exome Sequencing Revealed New Candidate Genes for Human Dilated Cardiomyopathy
Authors: D’Agostino Ylenia , Palumbo Domenico , Rusciano Maria Rosaria , Strianese Oriana , Amabile Sonia , Di Rosa Domenico , De Angelis Elena , Visco Valeria , Russo Fabio , Alexandrova Elena , Salvati Annamaria , Giurato Giorgio , Nassa Giovanni , Tarallo Roberta , Galasso Gennaro , Ciccarelli Michele , Weisz Alessandro , Rizzo Francesca
Published: October 2022

Dilated cardiomyopathy (DCM) is a complex disease affecting young adults. It is a pathological condition impairing myocardium activity that leads to heart failure and, in the most severe cases, transplantation, which is currently the only possible therapy for the disease. DCM can be attributed to many genetic determinants interacting with environmental factors, resulting in a highly variable phenotype. Due to this complexity, the early identification of causative gene mutations is an important goal to provide a genetic diagnosis, implement pre-symptomatic interventions, and predict prognosis. The advent of next-generation sequencing (NGS) has opened a new path for mutation screening, and exome sequencing provides a promising approach for identifying causal variants in known genes and novel disease-associated candidates. We analyzed the whole-exome sequencing (WES) of 15 patients affected by DCM without overloading (hypertension, valvular, or congenital heart disease) or chronic ischemic conditions. We identified 70 pathogenic or likely pathogenic variants and 1240 variants of uncertain clinical significance. Gene ontology enrichment analysis was performed to assess the potential connections between affected genes and biological or molecular function, identifying genes directly related to extracellular matrix organization, transcellular movement through the solute carrier and ATP-binding cassette transporter, and vitamin B12 metabolism. We found variants in genes implicated to a different extent in cardiac function that may represent new players in the complex genetic scenario of DCM.
Prognostic Factors for Invasiveness and Recurrence of Pituitary Adenomas: A Series of 94 Patients
Authors: Stefanidis Petros , Kyriakopoulos Georgios , Seretis Andreas Miltiadis , Korfias Stefanos , Theocharis Stamatios , Angelousi Anna
Published: October 2022

(1) Background: The aim of the current study is to evaluate the immunohistochemical expression of Ki-67, CD-56, Cyclin-D1 and E-Cadherin in the tissues samples of pituitary adenomas (PAs) and its association with PAs clinical manifestation tumor size, invasiveness and the risk of recurrence. (2) Materials and Methods: Ninety-four patients who underwent endoscope transsphenoidal excision of PAs were included in our study. The immunohistochemical expression of the Cyclin-D1, CD-56, E-Cadherin and Ki-67 markers was analyzed in paraffin-embedded tissue samples. (3) Results: The expression of Cyclin-D1 and Ki-67 index levels was positively correlated with the size (p < 0.001, r = 0.56 and p < 0.001, r = 0.43, respectively), the recurrence (p < 0.001, r = 0.46 and p = 0.007 r = 0.3, respectively), the extrasellar extension (p < 0.001, r = 0.48 and p < 0.001, r = 0.4, respectively) and the cavernous sinus invasion of (p < 0.001, r = 0.39 and p < 0.001, r = 0.3, respectively). No correlation was found between CD-56 and E-Cadherin expression with the size, the invasiveness and the recurrence of PAs. (4) Conclusion: Cyclin-D1 and Ki-67 are promising immunohistochemical markers in predicting the invasive behavior and recurrence of PAs in contrast to E-Cadherin and CD-56 which did not seem to be associated with PAs behavior post-surgery. However, larger studies are required in order to establish their role in the routine evaluation of PAs.
Clinical Application of Cardiac Magnetic Resonance in ART-Treated AIDS Males with Short Disease Duration
Authors: Hou Keke , Fu Hang , Xiong Wei , Gao Yueqin , Xie Liqiu , He Jianglin , Feng Xianbiao , Zeng Tao , Cai Lin , Xiong Lei , Jiang Nan , Jiang Min , Kang Bin , Zheng Haiyan , Zhang Na , Guo Yingkun
Published: October 2022

Cardiac complications are common in antiretroviral therapy-treated (ART-treated) acquired immune deficiency syndrome (AIDS) patients, and the incidence increases with age. Myocardial injury in ART-treated AIDS patients with a relatively longer disease duration has been evaluated. However, there is no relevant study on whether patients with a short AIDS duration have cardiac dysfunction. Thirty-seven ART-treated males with AIDS and eighteen healthy controls (HCs) were prospectively included for CMR scanning. Clinical data and laboratory examination results were collected. The ART-treated males with AIDS did not have significantly reduced biventricular ejection fraction, myocardial edema, or late gadolinium enhancement. Compared with the HCs, the biventricular volume parameters and left ventricle myocardial strain indices in ART-treated males with AIDS were not significantly reduced (all p > 0.05). ART-treated males with AIDS were divided into subgroups according to their CD4+ T-cell counts (<350 cells/μL and ≥350 cells/μL) and duration of disease (1–12 months, 13–24 months, and 25–36 months). There was no significant decrease in left or right ventricular volume parameters or myocardial strain indices among the subgroups (all p > 0.05). In Pearson correlation analysis, CD4+ T-cell counts were not significantly correlated with biventricular volume parameters or left ventricular myocardial strain indices. In conclusion, ART-treated males with AIDS receiving ART therapy with a short disease duration (less than 3 years) might not develop obvious cardiac dysfunction as evaluated by routine CMR, so it is reasonable to appropriately extend the interval between cardiovascular follow-ups to more than 3 years.
Measurement of Plasma Galectin-3 Concentrations in Patients with Catheter Infections: A Post Hoc Retrospective Cohort Study
Authors: Iftimie Simona , Hernández-Aguilera Anna , López-Azcona Ana F. , Castañé Helena , Rodríguez-Tomàs Elisabet , Baiges-Gaya Gerard , Camps Jordi , Castro Antoni , Joven Jorge
Published: October 2022

Catheter-related infections (CRIs) include catheter-associated urinary tract infections (CAUTIs) and central line-associated bloodstream infections (CLABSIs), and they are associated with high morbidity, mortality, and healthcare costs. The diagnosis of a CRI is made difficult by its non-specific symptoms. We aimed to investigate the factors influencing the plasma concentration of galectin-3 in catheter-bearing patients and to explore its potential usefulness as an index for CRIs. Circulating the concentrations of galectin-3, we measured the chemokine (C-C) motif ligand 2, procalcitonin, and C-reactive protein in 110 patients with a central catheter, in 165 patients with a urinary catheter, and in 72 control subjects. Catheter-bearing patients had higher concentrations (p < 0.001) of galectin-3 than the control group [central catheter: 19.1 (14.0–23.4) µg/L; urinary catheter: 17.1 (12.7–25.4) µg/L; control group: 6.1 (5.0–8.7) µg/L]. We identified chronic kidney disease as an independent determinant of galectin-3 concentrations in patients with a central catheter, and serum creatinine, cardiovascular disease, and number of days that the catheter was indwelling were identified as determinants in urinary catheter patients. We found that measuring galectin-3 concentrations in urinary catheter patients with a CRI was more accurate for diagnosis than the other parameters. We conclude that the measurement of galectin-3 concentration may be useful for assessing the inflammatory status of catheter-bearing patients and may contribute to the diagnosis of CRIs in those with a urinary catheter.
Insights into Clinical Features and Outcomes of Adrenal Cortical Carcinosarcoma
Authors: Branham Zachery , Fox Ashley D. , Ullah Asad , Patel Nikhil G. , Terris Martha , Parikh Jigarkumar
Published: October 2022

Adrenal cortical carcinosarcomas are a rare and typically aggressive malignancy with few reported cases in medical literature. We present a case of a 78-year-old female who presented with complaints of fatigue and right shoulder pain. Imaging of the abdomen with computed tomography visualized a large mass in the right upper quadrant. The mass was radiologically described as a 22 × 17 × 13 cm heterogeneous mass with its epicenter in the area of the right adrenal gland, with medial and peripheral effacement of all structures in the right upper quadrant. Non-contrasted images demonstrated anterior mid-portion calcifications. The mass parasitized its blood supply from several surrounding structures, including the liver and right psoas muscle, and extensively invaded the psoas muscle. Resection of the mass was performed with pathology, which revealed a high mitotic index and nuclear atypia with two morphologically and immunophenotypically distinct components. One of these components stained positively for calretinin and inhibin, which is indicative of adrenal cortical carcinoma; the other exhibited strong expression of vimentin and desmin, which was concordant with sarcomatous change and confirmed the diagnosis of adrenal cortical carcinosarcoma. This unique histology with both carcinomatous and sarcomatous components presents a diagnostic challenge for clinicians. As such, adrenal carcinosarcomas should be kept on the differential when evaluating retroperitoneal masses. Additionally, this study includes a review of 34 previously reported cases of adrenal cortical carcinosarcomas along with a discussion about the future exploration of this pathology.
Bone Fracture Detection Using Deep Supervised Learning from Radiological Images: A Paradigm Shift
Authors: Meena Tanushree , Roy Sudipta
Published: October 2022

Bone diseases are common and can result in various musculoskeletal conditions (MC). An estimated 1.71 billion patients suffer from musculoskeletal problems worldwide. Apart from musculoskeletal fractures, femoral neck injuries, knee osteoarthritis, and fractures are very common bone diseases, and the rate is expected to double in the next 30 years. Therefore, proper and timely diagnosis and treatment of a fractured patient are crucial. Contrastingly, missed fractures are a common prognosis failure in accidents and emergencies. This causes complications and delays in patients’ treatment and care. These days, artificial intelligence (AI) and, more specifically, deep learning (DL) are receiving significant attention to assist radiologists in bone fracture detection. DL can be widely used in medical image analysis. Some studies in traumatology and orthopaedics have shown the use and potential of DL in diagnosing fractures and diseases from radiographs. In this systematic review, we provide an overview of the use of DL in bone imaging to help radiologists to detect various abnormalities, particularly fractures. We have also discussed the challenges and problems faced in the DL-based method, and the future of DL in bone imaging.
Clinical Added Value of SARS-CoV-2 Antigen Detection in Blood Samples
Authors: Oueslati Saoussen , Manai Bouokazi Melek , Ramdhani Ikrame , Escaut Lélia , Pham Tài , Ouzani Souad , Anguel Nadia , Bulifon Sophie , Vauloup-Fellous Christelle , Coilly Audrey , Legros Laurence , Guichardon Magali , Fortineau Nicolas , Dortet Laurent , Roque-Afonso Anne-Marie , Naas Thierry
Published: October 2022

This study evaluated the performances of immunoassays (LFIA and ELISA) designed for SARS-CoV-2 Antigen (Ag)-detection in nasopharyngeal (NP) and serum samples in comparison to RT-PCR. NP samples from patients with respiratory symptoms (183 RT-PCR-positive and 74 RT-PCR-negative samples) were collected from March to April and November to December 2020. Seroconversion and antigen dynamics were assessed by symptom onset and day of RT-PCR diagnosis. Serum samples from 87 COVID-19 patients were used to investigate the added value of Ag quantification, at diagnosis and during follow-up. The sensitivity of COVID-VIRO-LFIA on samples with Ct ≤ 33, considered as the contagious threshold, was 86% on NPs (CI 95%: 79–90.5) and 76% on serum samples (CI 95%: 59.4–88), with a specificity of 100%. Serum N-Ag was detected during active infection as early as day two from symptom onset, with a diagnostic sensitivity of 81.5%. Within one week of symptom onset, diagnostic sensitivity and specificity reached 90.9% (95% CI, 85.1%–94.6%) and 98.3% (95% CI, 91.1%–99.9%), respectively. Serum N-Ag concentration closely correlated with disease severity. Longitudinal analysis revealed the simultaneous increase of antibodies and decrease of N-Ag. Sensitivities of COVID-VIRO-LFIA and COV-QUANTO-ELISA tests on NP and serum samples were close to 80%. They are suitable COVID-19-laboratory diagnostic tests, particularly when blood samples are available, thus reducing the requirement for NP sampling, and subsequent PCR analysis. ELISA titers may help to identify patients at risk of poor outcomes.
An Overview of Cytomegalovirus Infection in Pregnancy
Authors: Plotogea Mihaela , Isam Al Jashi , Frincu Francesca , Zgura Anca , Bacinschi Xenia , Sandru Florica , Duta Simona , Petca Razvan Cosmin , Edu Antoine
Published: October 2022

The objective of this review was to bring to attention cytomegalovirus (CMV) infection during pregnancy, taking into consideration all relevant aspects, such as maternal diagnosis, fetal infection and prevention, prenatal diagnosis, and postnatal prognosis. A literature review was performed regarding adult and congenital infection. General information regarding this viral infection and potential related medical conditions was provided, considering the issues of maternal infection during pregnancy, transmission to the fetus, and associated congenital infection management. Prenatal diagnosis includes maternal serum testing and the confirmation of the infection in amniotic fluid or fetal blood. Additionally, prenatal diagnosis requires imaging techniques, ultrasound, and complementary magnetic resonance to assess cortical and extracortical anomalies. Imaging findings can predict both fetal involvement and the postnatal prognosis of the newborn, but they are difficult to assess, even for highly trained physicians. In regard to fetal sequelae, the early diagnosis of a potential fetal infection is crucial, and methods to decrease fetal involvement should be considered. Postnatal evaluation is also important, because many newborns may be asymptomatic and clinical anomalies can be diagnosed when sequelae are permanent.