bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors associated with delayed onset of active labor following vaginal misoprostol administration among women at Mbarara Regional Referral Hospital, Uganda
Authors: Kajabwangu Rogers , Bajunirwe Francis , Lukabwe Henry , Atukunda Esther , Mugisha Dale , Lugobe Henry M. , Nakalinzi Joanita , Mugyenyi Godfrey R.
Published: October 2020

Objective

To determine the factors associated with delayed onset of active labor following labor induction with vaginal misoprostol.

Methods

We conducted a prospective cohort study over 6 months at a tertiary hospital in Uganda. We enrolled mothers with pregnancies of at least 28 weeks, who were undergoing labor induction with 50 µg of vaginal misoprostol, administered every 6 hours with a maximum of four doses, and followed them up until onset of active labor. Labor onset was considered delayed if it occurred later than 12 hours after the first dose. Bivariate and multivariate analysis was performed to determine factors associated with delayed onset of active labor.

Results

Of the 88 mothers enrolled, 22.7% (n=20) had delayed onset of active labor. Nulliparity (adjusted relative risk [aRR] 2.34, 95% confidence interval [CI] 1.17–4.68) and gestational age less than 37 weeks (aRR 3.79, 95% CI 1.40–10.23) were associated with delayed onset of active labor following vaginal misoprostol administration whereas higher body mass index (aRR 0.38, 95% CI 0.18–0.79) decreased the risk.

Conclusion

Delayed onset of active labor following labor induction remains an important obstetric care challenge. Mothers undergoing labor induction should have their body mass index documented, and nulliparous women and mothers at less than 37 weeks of gestation should have their labor monitored for a longer duration following labor induction.
COVID‐19 pandemic cybersecurity issues
Authors: Pranggono Bernardi , Arabo Abdullahi
Published: October 2020

This paper studies the cybersecurity issues that have occurred during the coronavirus (COVID‐19) pandemic. During the pandemic, cyber criminals and Advanced Persistent Threat (APT) groups have taken advantage of targeting vulnerable people and systems. This paper emphasizes that there is a correlation between the pandemic and the increase in cyber‐attacks targeting sectors that are vulnerable. In addition, the growth in anxiety and fear due to the pandemic is increasing the success rate of cyber‐attacks. We also highlight that healthcare organizations are one of the main victims of cyber‐attacks during the pandemic. The pandemic has also raised the issue of cybersecurity in relation to the new normal of expecting staff to work from home (WFH), the possibility of state‐sponsored attacks, and increases in phishing and ransomware. We have also provided various practical approaches to reduce the risks of cyber‐attacks while WFH including mitigation of security risks related to healthcare. It is crucial that healthcare organizations improve protecting their important data and assets by implementing a comprehensive approach to cybersecurity.
Atypical electrocardiographic findings in severe hyperkalemia with slow clinical course
Authors: Sasaki Osamu , Uriuda Yozo , Shinkai Masaharu , Sasaki Hideki
Published: October 2020

A 77‐year‐old woman walked into the emergency department with an episode of syncope and vomiting. She had visited at an orthopedic clinic with weakness of the lower extremities 6 weeks before, but cervical and lumbar MRI findings were unremarkable. Thereafter, she developed fingertip numbness and appetite loss at 7 and 3 days, respectively, before admission. She had been prescribed with RAS inhibitors for years. Electrocardiography while in the emergency department revealed bradycardia with normal QRS and a tented T wave. Laboratory findings revealed serum potassium 9.2 mEq/L. We discontinued RAS inhibitors and β‐blockers and added glucose‐insulin therapy. Thereafter, her general condition gradually recovered, and her symptoms completely disappeared. Elderly patients with chronic kidney disease treated with RAS inhibitors might develop slowly progressive symptoms of hyperkalemia. Electrocardiographic findings could be atypical and inconsistent with serum potassium values.
Update on MRI of Cystic Renal Masses Including Bosniak Version 2019
Authors: Krishna Satheesh , Schieda Nicola , Pedrosa Ivan , Hindman Nicole , Baroni Ronaldo H. , Silverman Stuart G. , Davenport Matthew S.
Published: October 2020

Incidental cystic renal masses are common, usually benign, and almost always indolent. Since 1986, the Bosniak classification has been used to express the risk of malignancy in a cystic renal mass detected at imaging. Historically, magnetic resonance imaging (MRI) was not included in that classification. The proposed Bosniak v.2019 update has formally incorporated MRI, included definitions of imaging terms designed to improve interobserver agreement and specificity for malignancy, and incorporated a variety of masses that were incompletely defined or not included in the original classification. For example, at unenhanced MRI, homogeneous masses markedly hyperintense at T2‐weighted imaging (similar to cerebrospinal fluid) and homogeneous masses markedly hyperintense at fat suppressed T1‐weighted imaging (approximately ≥2.5 times more intense than adjacent renal parenchyma) are classified as Bosniak II and may be safely ignored, even when they have not been imaged with a complete renal mass MRI protocol. MRI has specific advantages and is recommended to evaluate masses that at computed tomography (CT) 1) have abundant thick or nodular calcifications; 2) are homogeneous, hyperattenuating, ≥3 cm, and nonenhancing; or 3) are heterogeneous and nonenhancing. Although MRI is generally excellent for characterizing cystic renal masses, there are unique weaknesses of MRI that bear consideration. These details and others related to MRI of cystic renal masses are described in this review, with an emphasis on Bosniak v.2019. A website (https://bosniak-calculator.herokuapp.com/) and mobile phone apps named “Bosniak Calculator” have been developed for ease of assignment of Bosniak classes.

Level of Evidence

5

Technical Efficacy Stage

3
Role of Structural, Metabolic, and Functional MRI in Monitoring Visual System Impairment and Recovery
Authors: Sims Jeffrey R. , Chen Anna M. , Sun Zhe , Deng Wenyu , Colwell Nicole A. , Colbert Max K. , Zhu Jingyuan , Sainulabdeen Anoop , Faiq Muneeb A. , Bang Ji Won , Chan Kevin C.
Published: October 2020

The visual system, consisting of the eyes and the visual pathways of the brain, receives and interprets light from the environment so that we can perceive the world around us. A wide variety of disorders can affect human vision, ranging from ocular to neurologic to systemic in nature. While other noninvasive imaging techniques such as optical coherence tomography and ultrasound can image particular sections of the visual system, magnetic resonance imaging (MRI) offers high resolution without depth limitations. MRI also gives superior soft‐tissue contrast throughout the entire pathway compared to computed tomography. By leveraging different imaging sequences, MRI is uniquely capable of unveiling the intricate processes of ocular anatomy, tissue physiology, and neurological function in the human visual system from the microscopic to macroscopic levels. In this review we discuss how structural, metabolic, and functional MRI can be used in the clinical assessment of normal and pathologic states in the anatomic structures of the visual system, including the eyes, optic nerves, optic chiasm, optic tracts, visual brain nuclei, optic radiations, and visual cortical areas. We detail a selection of recent clinical applications of MRI at each position along the visual pathways, including the evaluation of pathology, plasticity, and the potential for restoration, as well as its limitations and key areas of ongoing exploration. Our discussion of the current and future developments in MR ocular and neuroimaging highlights its potential impact on our ability to understand visual function in new detail and to improve our protection and treatment of anatomic structures that are integral to this fundamental sensory system.

Level of Evidence 3

 

Technical Efficacy Stage 3
Influence of pre‐drying storage time on essential oil components in dried hops (Humulus lupulus L.)
Authors: Raut Sharvari , von Gersdorff Gardis JE , Münsterer Jakob , Kammhuber Klaus , Hensel Oliver , Sturm Barbara
Published: October 2020

BACKGROUND

It is well known that duration of pre‐drying storage impacts on hop quality. However, little knowledge exists regarding its actual effects on valuable hop components. To investigate these effects, fresh hop cones were stored for 5 or 24 h and dried for 210 min at 65 °C thereafter. Furthermore, to understand the effect of freezing hop cones on the essential oil content, both fresh and stored samples were frozen before and after drying.

RESULTS

The results from gas chromatography analysis show an increase in linalool, β‐caryophyllene, humulene, geraniol content and decrease in myrcene content dependent on the period of storage. Total colour difference ΔE values of 4.61 and 5.27 were obtained for fresh and stored hops respectively, indicating discoloration of hops during storage. Modelling of moisture curves revealed the Wang and Singh model to be suitable, with values of 0.978 and 0.989 and root‐mean‐square error values of 0.037 and 0.019 for fresh and stored hops respectively.

CONCLUSION

The results from this study provide an in‐depth understanding on the changes occurring within the hop cones both during storage and drying and will further help hop processors optimize their storage times.
An insight into volatile and non‐volatile compounds of Chinese horsebean‐chili‐paste meju produced by natural brewing and temperature‐controlled brewing methods
Authors: Tan Xinyi , Lu Yunhao , Lin Xin , Ni Nan , He Qiang , Chi Yuanlong
Published: October 2020

BACKGROUND

Chinese horsebean‐chili‐paste (CHCP) is a traditional fermented condiment in China, known as ‘the soul of Sichuan cuisine’. The horsebean‐to‐meju phase in its preparation is important for CHCP production and contributes significantly to its taste and odor. In this study, a comprehensive flavor compound profiling analysis of the naturally brewed horsebean meju (NBHM) and the temperature‐controlled brewed horsebean meju (TCBHM) was performed with two‐dimensional gas chromatography time‐of‐flight mass spectrometry (GC × GC‐TOFMS), and the analysis of physicochemical characteristics and free amino acids. Their aroma‐active components and characteristic flavor compounds were evaluated. The flavor compounds responsible for differentiating NBHM and TCBHM were also determined based on the Fisher ratio and principal component analysis.

RESULTS

The pH and the reducing sugar and amino‐acid nitrogen content of NBHM were 5.38, 64.43, and 5.76 g kg−1, respectively, whereas those of TCBHM were 5.13, 29.20, and 7.43 g kg−1. A total of 356 volatiles were identified from 2571 compounds, and 257 volatile compounds were identified in NBHM compared to 322 volatiles in TCBHM. These two horsebean mejus (HMs) exhibited a similar proportion profile for 30 aroma‐active compounds. Benzoic acid ethyl ester, 4‐ethyl‐2‐methoxy‐phenol and argnine were determined to be characteristic flavor components for NBHM, while 1‐(2‐furanyl)‐ethanone, 2,6‐dimethyl‐pyrazine, threonine, valine and tyrosine were specific to TCBHM.

CONCLUSION

Temperature‐controlled brewed horsebean meju possessed better physicochemical and flavor characteristics than NBHM. The temperature‐controlled brewing technique in CHCP production can be used as a promising alternative to the traditional natural brewing method. © 2020 Society of Chemical Industry
Long‐term Follow‐up After Radiation Therapy for Laryngeal Amyloidosis
Authors: Bertelsen Caitlin , Chadwick Keith , Holland John , Flint Paul , Schindler Joshua S.
Published: October 2020

Objectives

Laryngeal amyloidosis (LA) is a rare disease characterized by extracellular protein deposition within the larynx. Treatment is difficult due to the frequently submucosal and multifocal nature of disease. The mainstay of treatment is surgical resection; however, recurrence rates are high. Recently, use of radiotherapy (RT), either alone or postoperatively, for LA has been adapted from the management of extramedullary plasmacytoma and has been shown to provide local disease control. Here, we describe the experience with adjuvant RT for LA at our center.

Study Design

Retrospective case series.

Methods

Retrospective study of patients with amyloidosis of the larynx, with or without other disease sites, seen at a tertiary academic center between 2011 and 2019. Outcomes included disease characteristics, recurrence rates, treatment modalities, and pre‐ and posttreatment voice handicap index (VHI)‐10.

Results

Ten patients met eligibility criteria. Mean follow‐up time for all patients was 62.0 ± 41.0 months; mean follow‐up time after last treatment was 51 ± 55 months. All but one patient underwent surgical resection of disease. Seven patients underwent subsequent RT. Of these seven, six underwent RT at our institution; five received a dose of 45 Gray (Gy); and one received a dose of 20 Gy. All seven completed RT without toxicity‐related interruption. Patients undergoing RT underwent 2.1 ± 1.3 surgical procedures prior to RT; no patients required surgery after RT. Mean pretreatment VHI‐10 was 22.9 ± 8.1; mean posttreatment VHI‐10 was 12.9 ± 13.3.

Conclusion

RT after surgery for LA can provide good local control without unacceptable toxicity and may decrease the need for further surgery.

Level of Evidence

4 Laryngoscope, 131:1810–1815, 2021
Yield of Imaging to Evaluate Unilateral Vocal Fold Paralysis of Unknown Etiology
Authors: Politano Stephen , Morell Fernando , Calamari Kevin , DeSilva Brad , Matrka Laura
Published: October 2020

Objectives/Hypothesis

To identify the incidence and nature of positive findings on imaging studies ordered for evaluation of unilateral vocal fold paralysis (UVFP) of unknown etiology, to analyze these findings based on laterality, and to examine the use of the expanded‐field computed tomography (CT) neck protocol in this evaluation.

Study Design

Retrospective review.

Methods

A total of 145 patients from 2000 to 2018 with UVFP of unknown etiology were studied. Data on imaging studies ordered, laterality of paralysis, and significant positive results were studied. An expanded‐field CT neck protocol that included the entire course of the vagus and recurrent laryngeal nerves was instituted during the study period.

Results

A total of 20.7% of patients had an etiology for paralysis identified on imaging. Malignancies comprised the majority of findings overall (19/30), whether in the chest (12/18) or the neck (7/12). Etiology was more often found in the chest for left‐sided paralysis (15/21) and in the neck for right‐sided paralysis (6/9). In 26 patients who underwent both expanded‐field CT neck and CT chest, no findings related to the UVFP were seen on CT chest that were not captured by expanded‐field CT neck.

Conclusions

This is one of the largest retrospective studies examining the incidence of positive findings on imaging studies for evaluation of UVFP of unknown etiology. Imaging in one of five patients with UVFP of unknown etiology will reveal a causative lesion, most often malignant. Left‐sided paralysis tends to localize to the chest, and right‐sided paralysis to the neck. Expanded‐field CT neck may allow practitioners to forego dedicated CT chest in evaluation of UVFP.

Level of Evidence

4 Laryngoscope, 131:1840–1844, 2021
The impact of the plateau pika on the relationship between plant aboveground biomass and plant species richness
Authors: Pang Xiao Pan , Wang Qian , Guo Zheng Gang
Published: October 2020

Herbivores can influence plant species richness and plant aboveground biomass. However, only a few studies have examined their impact on the relationship between plant aboveground biomass and plant species richness, focusing on large herbivores. This study examined the influence of a small burrowing herbivore, the plateau pika (Ochotona curzoniae) with averaging 150 g, on the plant aboveground biomass, plant species richness, and their relationship in the alpine meadows on the Qinghai–Tibet Plateau. The study used a random stratified paired sampling design to collect data on plant species richness and plant aboveground biomass across five sites. Each site contained 10 pairs of plots. Each pair consisted of an undisturbed plot and a disturbed plot. Plant species richness was higher in the disturbed plots; whereas, plant aboveground biomass did not differ in relation to plateau pika disturbance. In the undisturbed plots, the plant species richness increased positively with plant aboveground biomass. In the disturbed plots, the plant species richness peaked at intermediate plant aboveground biomass levels. The findings suggest that small herbivores could alter the relationship between plant aboveground biomass and plant species richness by inducing an increase in plant species diversity, and they should be considered for assessing the management and conservation measures of alpine meadow.
Integrating land‐water‐people connectivity concepts across disciplines for co‐design of soil erosion solutions
Authors: Blake William H. , Kelly Claire , Wynants Maarten , Patrick Aloyce , Lewin Shaun , Lawson Joseph , Nasolwa Emmanuel , Page Annabel , Nasseri Mona , Marks Carey , Gilvear David , Mtei Kelvin , Munishi Linus , Ndakidemi Patrick
Published: October 2020

Soil resources in East Africa are being rapidly depleted by erosion, threatening food, water and livelihood security in the region. Here we demonstrate how the integration of evidence from natural and social sciences has supported a community‐led change in land management in an agro‐pastoral community in northern Tanzania. Geospatial analysis of erosion risk and extent (based on a drone survey across a 3.6 km2 sub‐catchment) revealed that recently converted land had ca 12‐times greater rill density than established slow‐forming terraced plots (987 ± 840 m2 ha−1 vs. 79 ± 110 m2 ha−1). Slope length and connectivity between plots were key factors in the development of rill networks rather than slope per se wherein slope length was augmented by weak boundaries between newly formed plots. Erosion evidence, supported by communication of 'process' and 'structural' hydrological connectivity, was integrated with local environmental knowledge within participatory community workshops. Demonstration of the critical time window of hillslope‐scale rill erosion risk during early phases of slow‐forming terrace development catalysed a community‐led tree planting and grass seed sowing programme to mitigate soil erosion by water. This was grounded in an implicit farmer understanding of the need for effective governance mechanisms at both community and District levels, to enable community‐led actions to be implemented effectively. The study demonstrates the wide‐reaching impact of integrated and interdisciplinary 'upslope‐downslope' thinking to tackle global soil erosion challenges.
Strengthening immunity through healthy lifestyle practices: Recommendations for lifestyle interventions in the management of COVID‐19
Authors: Monye Ifeoma , Adelowo Abiodun Bamidele
Published: October 2020

Although the practice of strengthening the immune system may not guarantee that people will not contract severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), there is evidence that suggests that the likelihood and severity of many viral infections can be considerably reduced if appropriate measures are taken to increase the efficacy of the immune response to invading organisms. Evidence‐based public health measures to reduce viral spread include—personal isolation, physical distancing, wearing facial masks, frequent hand washing with soap and running water, not touching the face, vaccination, etc. However once infected, recovery relies on host immunity to eradicate the foreign invaders, with symptomatic management, which is the core management strategy in COVID‐19 management guidelines. Researchers have observed that severe COVID‐19 prevalence and mortality is highest in people with preexisting conditions. Eighty percent of these preexisting diseases are lifestyle related. Also, the science of strengthening the immune system by adopting appropriate lifestyle changes is still evolving, especially among the suspected and confirmed COVID‐19 cases. This article briefly highlights the immune response to viral infections including COVID‐19 and refers to evidence that healthy lifestyle practices, enshrined as core aspects of lifestyle medicine, can strengthen the immune response to infections. This may improve outcome in COVID‐19. We therefore recommend specific evidence‐based lifestyle intervention measures that should be considered in the management of COVID‐19.
More market awareness, more profit? Competitive environments, business expansions, and two‐sided markets
Authors: Li Jing , Zhang Yulin
Published: October 2020

Purpose: This study presents a game‐theoretic model in which a potential entrant platform expands a new business to compete with an incumbent platform. Findings: The results indicate that the potential entrant platform will never increase the market awareness of its new business beyond a threshold value, even if it is cost‐free. In addition, the profit of the incumbent platform may be even greater when facing competition. Furthermore, the optimal pricing of the potential entrant platform depends on the network effects. Conclusion and managerial implications: In order to compete with the incumbent platform, the potential entrant platform needs to increase its market awareness rationally, and the incumbent platform may accommodate the entry of a potential entrant under certain conditions.
RoadSurf‐Pedestrian: a sidewalk condition model to predict risk for wintertime slipping injuries
Authors: Hippi Marjo , Kangas Markku , Ruuhela Reija , Ruotsalainen Johanna , Hartonen Sari
Published: October 2020

Icy and snowy sidewalks are typical wintertime phenomena in Finland. Wintertime slipping injuries are common and lead to substantial economic costs to health care as well as losses to society due to long sick leaves. In Finland, almost every second person slips and falls outdoors annually, and around 70,000 persons are injured needing medical attention. Typically, the most slippery conditions are encountered when the daily average temperature is slightly below 0°C or temperature crosses 0°C and there is precipitation in some form. The Finnish Meteorological Institute (FMI) has developed a numerical weather model that simulates the level of slipperiness on the sidewalks. The model classifies the sidewalk slipperiness into three classes; normal, slippery and very slippery. The FMI issues warnings of hazardous sidewalk conditions to the general public. Pedestrians' road safety can be increased with sidewalk condition forecasts and warnings. When warned, people can choose proper footwear or use anti‐slip devices, change the route or mode of transport, postpone the journey or cancel it altogether. Precise and reliable weather and sidewalk condition forecasts enable targeted and more effective sidewalk maintenance activities that can improve the grip of sidewalks and thus reduce the risk of accidents and injuries. This study presents the sidewalk condition model RoadSurf‐Pedestrian, its physical principles and examples of model runs. There are some challenges in the modelling of the slipperiness but the model gives valuable information on the slipperiness for duty forecasters. Slipping injury statistics are also presented and used as verification data.
Groups push bill to prevent, reduce suicide among HC workers
Authors: Canady Valerie A.
Published: October 2020

The death by suicide of a health care worker four months ago has not only prompted her family to advocate on her behalf for attention to mental health issues for physicians, but it also prompted lawmakers to introduce a bipartisan bill creating grant programs for evidence‐informed best practices, employee education, and mental health and behavioral support for health care workers.
Former U.S. surgeon general discusses MH concerns, disparities
Authors: Canady Valerie A.
Published: October 2020

This country needs to work together to eliminate health disparities, and the fight needs to continue for the Affordable Care Act (ACA), given that Congress, and maybe even the Supreme Court, could declare it illegal. About 250 attendees heard these thoughts delivered by the former surgeon general of the United States during a virtual conference held last week.
Study finds wide variation in follow‐up MH care for children
Authors: Canady Valerie A.
Published: October 2020

A new study has found that many children in the United States receiving mental health care do not receive follow‐up care. The researchers found wide variations in treatment depending on the children's ZIP code.
A comparative study of gradient nonlinearity correction strategies for processing diffusion data obtained with ultra‐strong gradient MRI scanners
Authors: Rudrapatna Umesh , Parker Greg D. , Roberts Jamie , Jones Derek K.
Published: October 2020

Purpose

The analysis of diffusion data obtained under large gradient nonlinearities necessitates corrections during data reconstruction and analysis. While two such preprocessing pipelines have been proposed, no comparative studies assessing their performance exist. Furthermore, both pipelines neglect the impact of subject motion during acquisition, which, in the presence of gradient nonlinearities, induces spatio‐temporal B‐matrix variations. Here, spatio‐temporal B‐matrix tracking (STB) is proposed and its performance compared to established pipelines.

Methods

Diffusion tensor MRI (DT‐MRI) was performed using a 300 mT/m gradient system. Data were acquired with volunteers positioned in regions with pronounced gradient nonlinearities, and used to compare the performance of six different processing pipelines, including STB.

Results

Up to 30% errors were observed in DT‐MRI parameter estimates when neglecting gradient nonlinearities. Moreover, the order in which inhomogeneity, eddy current and gradient nonlinearity corrections were performed was found to impact the consistency of parameter estimates significantly. Although, no pipeline emerged as a clear winner, the STB approach seemed to yield the most consistent parameter estimates under large gradient nonlinearities.

Conclusions

Under large gradient nonlinearities, the choice of preprocessing pipeline significantly impacts the estimated diffusion parameters. Motion‐induced spatio‐temporal B‐matrix variations can lead to systematic bias in the parameter estimates, that can be ameliorated using the proposed STB framework.
Accelerating in vivo fast spin echo high angular resolution diffusion imaging with an isotropic resolution in mice through compressed sensing
Authors: Naeyaert Maarten , Aelterman Jan , Van Audekerke Johan , Golkov Vladimir , Cremers Daniel , Pižurica Aleksandra , Sijbers Jan , Verhoye Marleen
Published: October 2020

Purpose

Echo planar imaging (EPI) is commonly used to acquire the many volumes needed for high angular resolution diffusion Imaging (HARDI), posing a higher risk for artifacts, such as distortion and deformation. An alternative to EPI is fast spin echo (FSE) imaging, which has fewer artifacts but is inherently slower. The aim is to accelerate FSE such that a HARDI data set can be acquired in a time comparable to EPI using compressed sensing.

Methods

Compressed sensing was applied in either q‐space or simultaneously in k‐space and q‐space, by undersampling the k‐space in the phase‐encoding direction or retrospectively eliminating diffusion directions for different degrees of undersampling. To test the replicability of the acquisition and reconstruction, brain data were acquired from six mice, and a numerical phantom experiment was performed. All HARDI data were analyzed individually using constrained spherical deconvolution, and the apparent fiber density and complexity metric were evaluated, together with whole‐brain tractography.

Results

The apparent fiber density and complexity metric showed relatively minor differences when only q‐space undersampling was used, but deteriorate when k‐space undersampling was applied. Likewise, the tract density weighted image showed good results when only q‐space undersampling was applied using 15 directions or more, but information was lost when fewer volumes or k‐space undersampling were used.

Conclusion

It was found that acquiring 15 to 20 diffusion directions with a full k‐space and reconstructed using compressed sensing could suffice for a replicable measurement of quantitative measures in mice, where areas near the sinuses and ear cavities are untainted by signal loss.
High‐resolution MRI of mummified tissues using advanced short‐T2 methodology and hardware
Authors: Baadsvik Emily Louise , Weiger Markus , Froidevaux Romain , Rösler Manuela Barbara , Brunner David Otto , Öhrström Lena , Rühli Frank Jakobus , Eppenberger Patrick , Pruessmann Klaas Paul
Published: October 2020

Purpose

Evolutionary medicine aims to study disease development from a long‐term perspective, and through the analysis of mummified tissue, timescales of several thousand years are unlocked. Due to the status of mummies as ancient relics, noninvasive techniques are preferable, and, currently, CT imaging is the most widespread method. However, CT images lack soft‐tissue contrast, making complementary MRI data desirable. Unfortunately, the dehydrated nature and short T2 times of mummified tissues render them practically invisible to standard MRI techniques. Specialized short‐T2 approaches have therefore been used, but currently suffer severe resolution limitations. The purpose of the present study is to improve resolution in MRI of mummified tissues.

Methods

The zero‐TE‐based hybrid filling technique, together with a high‐performance magnetic field gradient, was used to image three ancient Egyptian mummified human body parts: a hand, a foot, and a head. A similar pairing has already been shown to increase resolution and image quality in MRI of short‐T2 tissues.

Results

MRI images of yet unparalleled image quality were obtained for all samples, reaching isotropic resolutions of 0.6 mm and SNR values above 100. The same general features as present in CT images were depicted but with different contrast, particularly for regions containing embalming substances.

Conclusion

Mummy MRI is a potentially valuable tool for (paleo)pathological studies, as well as for investigations into ancient mummification processes. The results presented here show sufficient improvement in the depiction of mummified tissues to clear new paths for the exploration of this field.
Nanoparticle ink‐based silicon Schottky diodes operating up to 2.84 GHz
Authors: Kühnel Laura , Neumann Kevin , Neises Julian , Langer Fabian , Erni Daniel , Schmechel Roland , Benson Niels
Published: October 2020

Today's printed, flexible electronics are often limited by the electronic performance enabled by the used functional semiconductor ink. Thin films from such inks typically exhibit a low charge carrier mobility, which inhibits high frequency device operation and limits their use for applications within the Internet‐of‐Things concept, such as wireless electronic tags and sensors. Our approach to overcome this issue is the use of printable silicon. The silicon is deposited using nanoparticle inks and is subsequently processed into self‐organized crystalline μ‐cone shaped structures using an excimer laser treatment. Due to the high crystallinity of the Si μ‐cones, they can be used for devices capable of high frequency operation. In this article, this is demonstrated on the example of a Schottky diode operating at switching speeds up to 2.84 GHz and thereby putting printable high frequency electronics within reach.
Responsive make‐to‐order supply chain network design
Authors: Aboolian Robert , Berman Oded , Wang Jiamin
Published: October 2020

In this article, we address two network design problems for a responsive supply chain that consists of make‐to‐order (make‐to‐assemble) facilities facing stochastic demand and service time. The response time to customer orders, critical to the success of the supply chain, is the sum of the flow time in the facility and the delivery time to the customers. The response time performance in our models is measured by the probability that the response time is shorter than a constant. This nonlinear performance measure makes the models less or not tractable. The objective of both problems is to minimize the expected network cost that consists of the cost of delivery to customers as a function of the time of delivery (or the mode of transportation), the fixed cost of locating facilities and the capacity cost as a linear function of the processing capacity. The main decision variables are the number and locations of facilities, the resources allocated to them and the delivery mode selected between facilities and demand. In the first problem, a constraint is imposed to ensure an acceptable response time level. In the second problem, a penalty is charged on the number of days that each unit is delivered later than the targeted response time and is incorporated into the objective function. In the first problem, the probabilistic constraint on the flow time can be linearized and the problem can be formulated as an integer linear programming model. In the second problem, we propose an approximation approach to linearize the objective function and an iterative search and cut algorithm to combine linear approximation with neighborhood search. A multi‐start meta‐heuristic is also suggested. Computational experiments are conducted to evaluate the performance of these solution procedures. Recommendations are made on the basis of the computational results. This appears to be the first study in the area of locating capacitated facilities with stochastic demand to incorporate the delivery mode choice decision and to evaluate the expected congestion cost as a function of the actual flow time in the facilities, instead of the average one. The models developed enable the decision maker to investigate the effect of a combination of facility location, capacity allocation, and delivery mode decisions on the expected network cost and the response time. In addition, the findings of the computational experiments shed light on tuning parameters of approximation algorithms.
Numerical and theoretical discussions for solving nonlinear generalized Benjamin–Bona–Mahony–Burgers equation based on the Legendre spectral element method
Authors: Dehghan Mehdi , Shafieeabyaneh Nasim , Abbaszadeh Mostafa
Published: October 2020

This article is devoted to solving numerically the nonlinear generalized Benjamin–Bona–Mahony–Burgers (GBBMB) equation that has several applications in physics and applied sciences. First, the time derivative is approximated by using a finite difference formula. Afterward, the stability and convergence analyses of the obtained time semi‐discrete are proven by applying the energy method. Also, it has been demonstrated that the convergence order in the temporal direction isO(dt). Second, a fully discrete formula is acquired by approximating the spatial derivatives via Legendre spectral element method. This method uses Lagrange polynomial based on Gauss–Legendre–Lobatto points. An error estimation is also given in detail for full discretization scheme. Ultimately, the GBBMB equation in the one‐ and two‐dimension is solved by using the proposed method. Also, the calculated solutions are compared with theoretical solutions and results obtained from other techniques in the literature. The accuracy and efficiency of the mentioned procedure are revealed by numerical samples.
Homeopathic Treatment as an Add-On Therapy May Improve Quality of Life and Prolong Survival in Patients with Non-Small Cell Lung Cancer: A Prospective, Randomized, Placebo-Controlled, Double-Blind, Three-Arm, Multicenter Study
Authors: Frass Michael , Lechleitner Peter , Gründling Christa , Pirker Claudia , Grasmuk-Siegl Erwin , Domayer Julian , Hochmair Maximilian , Gaertner Katharina , Duscheck Cornelia , Muchitsch Ilse , Marosi Christine , Schumacher Michael , Zöchbauer-Müller Sabine , Manchanda Raj K. , Schrott Andrea , Burghuber Otto
Published: October 2020

Lessons Learned

Conventional medicine and homeopathy work well together. Quality of life improves with additive homeopathy in patients with non-small cell lung cancer (NSCLC). Survival improves with additive homeopathy in patients with NSCLC.

Background

Patients with advanced non-small cell lung cancer (NSCLC) have limited treatment options. Alongside conventional anticancer treatment, additive homeopathy might help to alleviate side effects of conventional therapy. The aim of the present study was to investigate whether additive homeopathy might influence quality of life (QoL) and survival in patients with NSCLC.

Methods

In this prospective, randomized, placebo-controlled, double-blind, three-arm, multicenter, phase III study, we evaluated the possible effects of additive homeopathic treatment compared with placebo in patients with stage IV NSCLC, with respect to QoL in the two randomized groups and survival time in all three groups. Treated patients visited the outpatients' centers every 9 weeks: 150 patients with stage IV NSCLC were included in the study; 98 received either individualized homeopathic remedies (n = 51) or placebo (n = 47) in a double-blinded fashion; and 52 control patients without any homeopathic treatment were observed for survival only. The constituents of the different homeopathic remedies were mainly of plant, mineral, or animal origin. The remedies were manufactured by stepwise dilution and succussion, thereby preparing stable Good Manufacturing Practice grade formulations.

Results

QoL as well as functional and symptom scales showed significant improvement in the homeopathy group when compared with placebo after 9 and 18 weeks of homeopathic treatment (p < .001). Median survival time was significantly longer in the homeopathy group (435 days) versus placebo (257 days; p = .010) as well as versus control (228 days; p < .001). Survival rate in the homeopathy group differed significantly from placebo (p = .020) and from control (p < .001).

Conclusion

QoL improved significantly in the homeopathy group compared with placebo. In addition, survival was significantly longer in the homeopathy group versus placebo and control. A higher QoL might have contributed to the prolonged survival. The study suggests that homeopathy positively influences not only QoL but also survival. Further studies including other tumor entities are warranted.
α‐Tocopherol suppresses hepatic steatosis by increasing CPT‐1 expression in a mouse model of diet‐induced nonalcoholic fatty liver disease
Authors: Tokoro Masanori , Gotoh Koro , Kudo Yoko , Hirashita Yuka , Iwao Masao , Arakawa Mie , Endo Mizuki , Oribe Junya , Masaki Takayuki , Honda Koichi , Kakuma Tetsuya , Seike Masataka , Murakami Kazunari , Shibata Hirotaka
Published: October 2020

Aim

Antioxidant therapy for with vitamin E appears to be effective for the treatment of nonalcoholic fatty liver disease　(NAFLD). However, the mechanism of action and optimal therapeutic dosage is unclear. The present study was undertaken to examine whether the effects of α‐tocopherol (α‐Toc) on NAFLD are dose‐dependent in a diet‐induced obese model.

Methods

Male mice were fed standard chow, high‐fat (HF) diet, HF diet with low‐dose, or with high dose of α‐Toc supplementation. Histological findings, triglyceride content, and the levels of protein expression related to fatty acid synthesis/oxidation such as carnitine palmitoyltransferase I (CPT‐1) of liver were evaluated. In addition, 2‐tetradecylglycidic acid (TDGA), a CPT‐1 inhibitor, was administered to mice fed HF diet with low‐dose of α‐Toc. Finally, HepG2 cells in fat‐loaded environment were treated with 0–50 μM α‐Toc.

Results

Treatment of low‐dose of α‐Toc decreased HF‐induced hepatic fat accumulation, but this finding was not observed in treatment of high dose of α‐Toc. HF‐induced reduction of CPT‐1 was attenuated with low‐dose of α‐Toc but not with high dose of α‐Toc. TDGA suppressed the improvement of histological findings in liver induced by low‐dose of α‐Toc treatment. CPT‐1 expression in HepG2 cells increased in response to low‐dose of α‐Toc, but not in high dose.

Conclusions

Dual action of α‐Toc on CPT‐1 protein levels was observed. The effect of vitamin E on NAFLD may be not be dose‐dependent.
Guanine oxidation signal amplification in single strand DNA molecules with heat‐treated polyacrylonitrile/sulfuric acid micro/nanofibrous system
Authors: Aydin Seval , Tanik Nilay A. , Aykut Yakup
Published: October 2020

Effect of sulfuric acid (SA) on the heat treatment of electrospun polyacrylonitrile (PAN) fibers and their application on guanine oxidation detection in single‐strand DNA molecules (ssDNA) were studied. In this regard, two different approaches were performed. Aqueous sulfuric acid solutions were poured on the pure PAN nanofibers and heat treatment process was performed to determine the maximum temperature at which fiber structures does not deteriorate. Also, SA was directly added into electrospinning solutions with different ratios and heat treatment process was applied to the as‐spun PAN/SA fibers. The fibers were produced both directly on a grounded plate and cylindrical pencil graphite surfaces (PGE) for the fiber characterizations and biosensor measurements. Single strand DNA (ssDNA) molecules were immobilized on the samples for the electrochemical investigation of guanine oxidation signal. 0.971 and 3.69 μA guanine oxidation signal intensities were detected for neat PGE and heat‐treated PAN/SA fiber coated PGE. The formation of sulfonic groups on the fibers has driven more ssDNA attachment on the surface, and hence increased the guanine oxidation signal intensity dramatically (about 261.4% increment). The results have shown promising future of heat‐treated PAN/SA micro/nanofibers for sensitive detection of guanine oxidation signal from genetic molecules.
Spinal changes after craniospinal irradiation in pediatric patients
Authors: Oshiro Yoshiko , Mizumoto Masashi , Pan Haitao , Kaste Sue C. , Gajjar Amar , Merchant Thomas E.
Published: October 2020

Background

To evaluate long‐term degenerative changes in bone and soft tissue after craniospinal irradiation (CSI).

Procedure

An analysis was performed for 892 vertebral bodies in 220 pediatric patients treated with CSI. To analyze vertebral growth, vertebral body height was calculated. Signal changes for vertebral bodies on MRI, scoliosis and kyphosis, degenerative changes of vertebral bones and discs, and wedging or vertebral height loss were analyzed on images, and factors that influenced these changes were investigated.

Results

Vertebral growth was significantly correlated with radiation dose and growth hormone (GH) deficiency. Growth rate was significantly worse at a dose >39 Gy. Fatty marrow change was found in 83% of patients, 31% had disc degenerative changes, 13% had degenerative changes of spinal bones, 17% had wedging or spinal height loss, and 27% had scoliosis.

Conclusions

Vertebral bone growth was significantly reduced when high doses were administered, and adequate GH replacement was important for bone growth. Even with symmetrical irradiation, the risk of scoliosis is high after CSI. There was also frequent progression of spinal demineralization and degenerative changes after CSI. Therefore, careful attention should be paid to spinal symptoms as pediatric patients grow into adulthood.
Integrated DNA and RNA sequencing reveals targetable alterations in metastatic pediatric papillary thyroid carcinoma
Authors: Potter Samara L. , Reuther Jacquelyn , Chandramohan Raghu , Gandhi Ilavarasi , Hollingsworth Faith , Sayeed Hadi , Voicu Horatiu , Kakkar Nipun , Baksi Koel Sen , Sarabia Stephen F. , Lopez Monica E. , Chelius Daniel C. , Athanassaki Ioanna D. , Mahajan Priya , Venkatramani Rajkumar , Quintanilla Norma M. , Lopez‐Terrada Dolores H. , Roy Angshumoy , Parsons D. Williams
Published: October 2020

Background

Pediatric papillary thyroid carcinoma (PTC) is clinically and biologically distinct from adult PTC. We sequenced a cohort of clinically annotated pediatric PTC cases enriched for high‐risk tumors to identify genetic alterations of relevance for diagnosis and therapy.

Methods

Tumor DNA and RNA were extracted from FFPE tissue and subjected to next‐generation sequencing (NGS) library preparation using a custom 124‐gene hybridization capture panel and the 75‐gene Archer Oncology Research Panel, respectively. NGS libraries were sequenced on an Illumina MiSeq.

Results

Thirty‐six pediatric PTC cases were analyzed. Metastases were frequently observed to cervical lymph nodes (29/36, 81%), with pulmonary metastases less commonly found (10/36, 28%). Relapsed or refractory disease occurred in 18 patients (18/36, 50%). DNA sequencing revealed targetable mutations in 8 of 31 tumors tested (26%), most commonly BRAF p.V600E (n = 6). RNA sequencing identified targetable fusions in 13 of 25 tumors tested (52%): RET (n = 8), NTRK3 (n = 4), and BRAF. Mutually exclusive targetable alterations were discovered in 15 of the 20 tumors (75%) with both DNA and RNA analyzed. Fusion‐positive PTC was associated with multifocal disease, higher tumor staging, and higher American Thyroid Association risk levels. Both BRAF V600E mutations and gene fusions were correlated with the presence of cervical metastases.

Conclusions

Targetable alterations were identified in 75% of pediatric PTC cases with both DNA and RNA evaluated. Inclusion of RNA sequencing for detection of fusion genes is critical for evaluation of these tumors. Patients with fusion‐positive tumors were more likely to have features of high‐risk disease.
Hematological manifestations of SARS‐CoV‐2 in children
Authors: Kosmeri Chrysoula , Koumpis Epameinondas , Tsabouri Sophia , Siomou Ekaterini , Makis Alexandros
Published: October 2020

Infection from severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2), though mainly a respiratory disease, can impair many systems, including causing hematological complications. Lymphopenia and hypercoagulability have been reported in adults with coronavirus disease 2019 (COVID‐19) and are considered markers of poor prognosis. This review summarizes the hematological findings in children with SARS‐CoV‐2 infection. The majority of infected children had a normal leukocyte count, while the most common white blood cell abnormality was leukopenia. Lymphopenia, which may be a marker of severe disease, was rarer in children than in adults, possibly due to their immature immune system or due to the less severe manifestation of COVID‐19 in this age group. Age may have an impact, and in neonates and infants the most common abnormality was lymphocytosis. Abnormalities of red blood cells and platelets were uncommon. Anemia and hypercoagulability were reported mainly in children presenting the novel multisystem inflammatory syndrome (MIS) associated with SARS‐CoV‐2.