bluuebunny/crossref_metadata_2025 huggingface dataset:
Handgrip strength—A risk indicator for type 2 diabetes: Systematic review and meta‐analysis of observational cohort studies
Authors: Kunutsor Setor K. , Isiozor Nzechukwu M. , Khan Hassan , Laukkanen Jari A.
Published: June 2020

Aims

Evolving debate suggests that handgrip strength (HGS), a measure of muscular strength, might be associated with the risk of type 2 diabetes (T2D); however, the evidence is conflicting. Using a systematic review and meta‐analysis of published observational cohort studies in general populations, we aimed to assess the association of HGS with the future risk of T2D.

Methods

Relevant studies were sought from inception until April 2020 in MEDLINE, Embase, Web of Science, and manual search of relevant articles. Transformed or extracted relative risks (RRs) with 95% confidence intervals (CIs) comparing the top vs bottom thirds of HGS levels were pooled using random effects meta‐analysis.

Results

A total of 10 unique observational cohort studies comprising of 177 826 participants and >5167 T2D cases were eligible. The pooled multivariable RR (95% CI) for T2D comparing the top vs bottom thirds of HGS levels was 0.73 (0.63‐0.84). This association was consistent across several relevant subgroups except for evidence of effect modification by sample size (Pvalue for meta‐regression <.001): evidence of an association in smaller studies (<250 events) 0.50 (0.40‐0.63), with no significant association in bigger studies (≥250 events) 0.87 (0.73‐1.05). There was no evidence of small study effects using formal tests such as funnel plots and Egger's regression symmetry test.

Conclusion

Pooled analysis of observational cohort studies suggests that HGS may be a risk indicator for T2D in the general population. The role of utilizing HGS measurements in T2D prevention strategies warrants further investigation.
Occupancy‐derived thermal affinities reflect known physiological thermal limits of marine species
Authors: Webb Thomas J. , Lines Aaron , Howarth Leigh M.
Published: June 2020

Predicting how species will respond to increased environmental temperatures is key to understanding the ecological consequences of global change. The physiological tolerances of a species define its thermal limits, while its thermal affinity is a summary of the environmental temperatures at the localities at which it actually occurs. Experimentally derived thermal limits are known to be related to observed latitudinal ranges in marine species, but accurate range maps from which to derive latitudinal ranges are lacking for many marine species. An alternative approach is to combine widely available data on global occurrences with gridded global temperature datasets to derive measures of species‐level “thermal affinity”—that is, measures of the central tendency, variation, and upper and lower bounds of the environmental temperatures at the locations at which a species has been recorded to occur. Here, we test the extent to which such occupancy‐derived measures of thermal affinity are related to the known thermal limits of marine species using data on 533 marine species from 24 taxonomic classes and with experimentally derived critical upper temperatures spanning 2–44.5°C. We show that thermal affinity estimates are consistently and positively related to the physiological tolerances of marine species, despite gaps and biases in the source data. Our method allows thermal affinity measures to be rapidly and repeatably estimated for many thousands more marine species, substantially expanding the potential to assess vulnerability of marine communities to warming seas.
Assignment of complex species by affinity capillary electrophoresis: The case of Th(IV)‐desferrioxamine B
Authors: Sladkov Vladimir , Roques Jérôme , Meyer Michel
Published: June 2020

The electrophoretic mobility change of desferrioxamine B (DFO) was monitored by UV absorption spectrophotometry upon increasing the thorium(IV) concentration in the background electrolyte at two acidities ([HClO4]Tot = 0.0316 and 0.0100 M). These data enabled to assess the speciation model and to determine the equilibrium constant of [Th(DFO)H2]3+ at fixed ionic strength (I = 0.1 M (H,Na)ClO4). Affinity capillary electrophoresis (ACE) turned out to be most helpful in identifying the complexed species by ascertaining its charge and protonation state. The assignment of the correct stoichiometry relied on the reliable estimation of the electrophoretic mobility by assuming similar hydrodynamic radii for (DFO)H4+ and the chelate. The value of the apparent equilibrium constant (log β112 = 38.7 ± 0.4) obtained by ACE compares favorably well with those reported in the literature for thorium and a range of other metal ions, according to a linear free‐energy relationship. This method is useful for studying metal‐ligand binding equilibria and provides valuable information for further modelling the behavior of tetravalent actinides under environmental conditions. Structural information about the prevalent solution species in acidic conditions was gained by DFT calculations, confirming the bishydroxamato coordination mode of Th4+ by the diprotonated ligand.
Early warning systems in inpatient anorexia nervosa: A validation of the MARSIPAN‐based modified early warning system
Authors: Ioannidis Konstantinos , Serfontein Jaco , Deakin Julia , Bruneau Melanie , Ciobanca Anya , Holt Leah , Snelson Sarah , Stochl Jan
Published: June 2020

Objective

We aimed to evaluate the validity of a MARSIPAN‐guidance‐adapted Early Warning System (MARSI MEWS) and compare it to the National Early Warning Score (NEWS) and an adapted version of the Physical Risk in Eating Disorders Index (PREDIX), to ascertain whether current practice is comparable to best‐practice standards.

Methods

We collated 3,937 observations from 36 inpatients from Addenbrookes Hospital over 2017–2018 and used three independent raters to create a “gold standard” of deteriorating cases. We ascertained performance metrics (Receiver Operating Characteristic Area Under the curve) for MARSI MEWS, NEWS and PREDIX; we also tested the proof of concept of a machine‐learning‐based early‐warning‐system (ML‐EWS) using cross‐validation and out‐of‐sample prediction of cases.

Results

The MARSI MEWS system showed higher ROC AUC (0.916) compared to NEWS (0.828) or PREDIX (0.865). ML‐EWS (random forest) performed well at independent samples analysis (0.980) and multilevel analysis (0.922).

Conclusion

MARSI MEWS seems most suitable for identifying critically deteriorating cases in anorexia nervosa inpatient population. We did not examine community practice in which the PREDIX arguably remains the best to ascertain deteriorating cases. Our results also provide a first proof of concept for the development of artificial‐intelligence‐based early warning systems in anorexia nervosa. Implications for inpatient clinical practice in eating disorders are discussed.
Changes in bio‐accessibility, polyphenol profile and antioxidants of quinoa and djulis sprouts during in vitro simulated gastrointestinal digestion
Authors: Zhang Qinping , Xing Bao , Sun Menghan , Zhou Bangwei , Ren Guixing , Qin Peiyou
Published: June 2020

This study aimed to evaluate the bio‐accessibility of the phenolics and flavonoid, the polyphenolic profile and the antioxidant activity of sprouts obtained from four different quinoa genotypes and one djulis cultivar during in vitro gastrointestinal digestion. Compared to their content in sprouts, the bioavailable phenolics after the oral phase, the gastric phase, the intestinal phase, and in the dialyzable fraction were in the ranges of 45.7%–63.5%, 87.6%–116.7%, 89.6%–124.5%, and 7.4%–10.9%, respectively. The trend in flavonoid bio‐accessibility was similar to the polyphenols. The dialyzable flavonoid recoveries varied between 4.2% and 12.4%. Correspondingly, the free radical scavenging activity of the dialyzable phase decreased significantly from 84.7% to 96.5%. The main phenolic acids were vanillic acid, caffeic acid, and syringic acid during digestion. The results suggest that gastrointestinal digestion greatly affected the absorption of polyphenols and flavonoid of quinoa and djulis sprouts, as well as their antioxidant capacity.
Prognostic value of computed tomography‐based volumetric body composition analysis in patients with head and neck cancer: Feasibility study
Authors: Choi Yangsean , Ahn Kook‐Jin , Jang Jinhee , Shin Na‐Young , Jung So‐Lyung , Kim Bum‐soo , Kim Min‐Sik , Kim Yeon‐Sil
Published: June 2020

Background

This study aimed to evaluate whether computed tomography (CT)‐based volumetric body composition analysis has prognostic value in head and neck cancer (HNC) patients.

Methods

This single‐center retrospective study included 79 patients with HNC treated with definitive radiotherapy from March 2009 to December 2018. The patients were assessed for (a) weight‐based variables and (b) pretreatment and posttreatment CT‐based body composition variables. Overall survival (OS) and recurrence‐free survival (RFS) analyses were conducted using Cox proportional hazards analyses.

Results

Depletion of cervical skeletal muscle volume on presentation was associated with poor OS (hazard ratio [HR] = 3.1; 95% CI = 1.2‐7.8; P = .016). Low fat proportions before and after treatment were associated with poor OS (HR = 2.5‐3.5; 95% CI = 1.3‐9.3; P = .013‐.026). In multivariate Cox analysis, increased posttreatment fat attenuation demonstrated the greatest prognostic value for both OS (HR = 4.7; 95% CI = 2.2‐10.3; P < .001) and RFS (HR = 4.3; 95% CI = 2.0‐9.5; P < .001).

Conclusions

CT‐based body composition analysis has the potential for risk assessment in patients with HNC.
Artificial intelligence system for detecting superficial laryngopharyngeal cancer with high efficiency of deep learning
Authors: Inaba Atsushi , Hori Keisuke , Yoda Yusuke , Ikematsu Hiroaki , Takano Hiroaki , Matsuzaki Hiroki , Watanabe Yoshiki , Takeshita Nobuyoshi , Tomioka Toshifumi , Ishii Genichiro , Fujii Satoshi , Hayashi Ryuichi , Yano Tomonori
Published: June 2020

Background

There are no published reports evaluating the ability of artificial intelligence (AI) in the endoscopic diagnosis of superficial laryngopharyngeal cancer (SLPC). We presented our newly developed diagnostic AI model for SLPC detection.

Methods

We used RetinaNet for object detection. SLPC and normal laryngopharyngeal mucosal images obtained from narrow‐band imaging were used for the learning and validation data sets. Each independent data set comprised 400 SLPC and 800 normal mucosal images. The diagnostic AI model was constructed stage‐wise and evaluated at each learning stage using validation data sets.

Results

In the validation data sets (100 SLPC cases), the median tumor size was 13.2 mm; flat/elevated/depressed types were found in 77/21/2 cases. Sensitivity, specificity, and accuracy improved each time a learning image was added and were 95.5%, 98.4%, and 97.3%, respectively, after learning all SLPC and normal mucosal images.

Conclusions

The novel AI model is helpful for detection of laryngopharyngeal cancer at an early stage.
Regorafenib Versus Nivolumab After Sorafenib Failure: Real‐World Data in Patients With Hepatocellular Carcinoma
Authors: Choi Won‐Mook , Choi Jonggi , Lee Danbi , Shim Ju Hyun , Lim Young‐Suk , Lee Han Chu , Chung Young‐Hwa , Lee Young‐Sang , Park Sook Ryun , Ryu Min‐Hee , Ryoo Baek‐Yeol , Lee So Jung , Kim Kang Mo
Published: June 2020

Regorafenib and nivolumab are drugs approved for second‐line treatment of patients with hepatocellular carcinoma (HCC) after sorafenib failure. However, the effectiveness of regorafenib and nivolumab following sorafenib has not been directly compared. This study retrospectively evaluated 373 patients with HCC who were treated with regorafenib (n = 223) or nivolumab (n = 150) after sorafenib failure between July 2017 and February 2019. Progression‐free survival (PFS; hazard ratio [HR], 0.85; 95% confidence interval [CI], 0.69‐1.06; P = 0.150), time to progression (TTP; HR, 0.95; 95% CI, 0.77‐1.19; P = 0.680), and overall survival (OS; HR, 0.83; 95% CI, 0.64‐1.07; P = 0.154) did not differ significantly between groups of patients treated with regorafenib and nivolumab, findings consistently observed by multivariable‐adjusted, propensity score‐matched, and inverse probability treatment weighting (IPTW) analyses. However, the objective response rate was significantly higher in the nivolumab than in the regorafenib group (13.3% vs. 4.0%; P = 0.002). When the effectiveness of regorafenib and nivolumab was compared in nonprogressors to treatment, defined as patients who achieved complete response, partial response, or stable disease after first response evaluation, PFS (HR, 0.50; 95% CI, 0.33‐0.75; P = 0.001), TTP (HR, 0.48; 95% CI, 0.31‐0.73; P < 0.001), and OS (HR, 0.51; 95% CI, 0.31‐0.87; P = 0.013) were significantly longer in the 59 nonprogressors to nivolumab than in the 104 nonprogressors to regorafenib, findings also observed by multivariable‐adjusted and IPTW analyses. Conclusion: Survival outcomes in patients treated with regorafenib and nivolumab after sorafenib failure did not differ significantly. However, nivolumab may be more effective than regorafenib in nonprogressors.
Downregulation of hyperpolarization‐activated cyclic nucleotide‐gated channels (HCN) in the hippocampus of patients with medial temporal lobe epilepsy and hippocampal sclerosis (MTLE‐HS)
Authors: Lin Wanrong , Qin Jiaming , Ni Guanzhong , Li Yinchao , Xie Haitao , Yu Jiabin , Li Hainan , Sui Lisen , Guo Qiang , Fang Ziyan , Zhou Liemin
Published: June 2020

Changes in the expression of HCN ion channels leading to changes in Ih function and neuronal excitability are considered to be possible mechanisms involved in epileptogenesis in kinds of human epilepsy. In previous animal studies of febrile seizures and temporal lobe epilepsy, changes in the expression of HCN1 and HCN2 channels at different time points and in different parts of the brain were not consistent, suggesting that transcriptional disorders involving HCNs play a crucial role in the epileptogenic process. Therefore, we aimed to assess the transcriptional regulation of HCN channels in Medial temporal lobe epilepsy with hippocampal sclerosis (MTLE‐HS) patients. This study included eight nonhippocampal sclerosis patients and 40 MTLE‐HS patients. The mRNA expression of HCN channels was evaluated by qRT‐PCR, while the protein expression was quantitatively analyzed by Western blotting. The subcellular localization of HCN channels in the hippocampus was explored by immunofluorescence. We demonstrated that the mRNA and protein expression of HCN1 and HCN2 are downregulated in controls compared to that in MTLE‐HS patients. In the hippocampal CA1/CA4 subregion and GCL, in addition to a large decrease in neurons, the expression of HCN1 and HCN2 on neuronal cell membranes was also downregulated in MTLE‐HS patients. These findings suggest that the expression of HCN channels are downregulated in MTLE‐HS, which indicates that the decline in HCN channels in the hippocampus during chronic epilepsy in MTLE‐HS patients leads to the downregulation of Ih current density and function, thereby reducing the inhibitory effect and increasing neuronal excitability and eventually causing disturbances in the electrical activity of neurons.
Factors associated with utilisation of health care interpreting services and the impact on length of stay and cost: A retrospective cohort analysis of audit data
Authors: Morris Darcy , Lambert Kelly , Vellar Lucia , Mastroianni Fiorina , Krizanac Josipa , Lago Luise , Mullan Judy
Published: June 2020

Issue addressed

Utilisation of professional health care interpreting services improves the quality and safety of health care among patients with limited English proficiency. Health care interpreter service utilisation is inconsistent and suboptimal in Australia. Evidence of the impact of interpreter service use on patient outcomes and costs is limited. This study aimed to identify the proportion of hospitalised patients who received a health care interpreter during admission and describe the characteristics and outcomes for those requiring interpreter services.

Methods

A retrospective cohort analysis of linked admitted patient data with internal interpreter audit data. This study included all inpatients in a health district‐wide clinical audit of interpreter service use conducted between July 2016 and March 2018. The dataset comprised 74 patients (including 79 unique hospital stays and 90 episodes) from eight hospitals in one regional health district in New South Wales, Australia.

Results

Interpreting services were utilised at least once for 54.4% (n = 43) of admissions. Females were more likely to receive an interpreter (65.1% vs 47.1%, P = .04). Age, preferred language, hospital, Diagnosis‐Related Group partition and comorbidities were not associated with interpreter service utilisation. Differences in length of stay and cost associated with use of interpreter services were not statistically significant after casemix adjustment.

Conclusions

Approximately half of those who required an interpreter received one during their hospital stay. Further investigation is needed to establish whether regular clinical audits contributed to this rate of utilisation, which is higher than reported elsewhere in the literature.

So what?

A detailed understanding of regional interpreting service use with evidence from the literature provides compelling and contextual evidence for change, at the level at which the service is delivered. This supports meaningful action to increase utilisation, and improve the quality and safety of health care delivered to patients with limited English proficiency.
A healthy lifestyle and survival among women with ovarian cancer
Authors: Hansen Jessy M. , Nagle Christina M. , Ibiebele Torukiri I. , Grant Peter T. , Obermair Andreas , Friedlander Michael L. , DeFazio Anna , Webb Penelope M. ,   Ovarian Cancer Prognosis and Lifestyle Study Group
Published: June 2020

Ovarian cancer has a poor survival rate and, understandably, women often want to know whether there is anything they can do to improve their prognosis. Our goal was to investigate the association between a healthy lifestyle prediagnosis and postdiagnosis and survival in a cohort of Australian women with invasive epithelial ovarian cancer. We calculated a healthy lifestyle index (HLI) based on women's self‐reported smoking status, height, weight, physical activity, diet and alcohol consumption before diagnosis (n = 678) and after completing primary treatment (n = 512). Clinical data and vital status for each woman were ascertained through medical records. Cox proportional hazards regression was conducted to calculate hazard ratios (HR) and 95% confidence interval (CI) for all‐cause mortality. There was a suggestive association between a more healthy lifestyle before diagnosis and better survival (HR 0.79, 95% CI: 0.59‐1.04), however, the association was stronger for lifestyle after diagnosis, with women in the highest tertile having significantly better survival than women in the lowest tertile (HR 0.61, 95% CI: 0.40‐0.93; P‐trend = .02). Current smoking, particularly postdiagnosis, was associated with higher mortality (HR 1.68, 95% CI: 1.17‐2.42; HR 2.82, 95% CI: 1.29‐6.14, for prediagnosis and postdiagnosis smoking, respectively), but women who quit after diagnosis had survival outcomes similar to nonsmokers (HR 0.99, 95% CI: 0.57‐1.72). Higher physical activity after diagnosis was associated with better survival (HR 0.60, 95% CI: 0.39‐0.92; P‐trend = .02). A healthy lifestyle after diagnosis, in particular not smoking and being physically active, may help women with ovarian cancer improve their prognosis.
Examining generalization of motorist yielding at an adjacent crosswalk with variations of the gateway sign configuration
Authors: Hochmuth Jonathan M. , Crowley‐Koch Brian J. , Van Houten Ron
Published: June 2020

The gateway sign configuration has been effective at increasing motorist yielding and reducing speeds at crosswalks. A gateway configuration uses in‐street signs at a crosswalk on each edge of the roadway and on each lane line. Although this intervention is effective at increasing motorist yielding at uncontrolled crosswalks, the limits of the intervention have yet to be tested. The present study examined if 1) the effects of the gateway intervention on one crosswalk would generalize to an untreated adjacent crosswalk, and 2) if the effects of an offset configuration of signs which partially treated each crosswalk could maximize the effects of that generalization. Experiment 1 showed that less yielding occurred at the untreated crosswalk than at the treated crosswalk, though yielding was higher than baseline. In Experiment 2, results showed that an offset gateway configuration could produce comparable levels of yielding at both crosswalks.
Quantitative assessment of optical coherence tomography angiography algorithms for neuroimaging
Authors: Liu Jianting , Zhu Jiang , Zhu Lianqing , Yang Qiang , Fan Fan , Zhang Fan
Published: June 2020

Optical coherence tomography (OCT) angiography can noninvasively map microvascular networks and quantify blood flow in a cerebral cortex with a resolution of 1 to 10 μm and a penetration depth of 2 to 3 mm incorporating OCT signals and angiography algorithms. Different angiography algorithms have been developed in recent years; however, the performance of the algorithms has not been assessed quantitatively for neuroimaging applications. In this paper, we developed four metrics including vascular connectivity, contrast‐to‐noise ratio, signal‐to‐noise ratio and processing time to quantitatively assess the performance of OCT angiography algorithms in image quality and computation speed. After the imaging of a rat cortex using an OCT system, the cerebral microvascular networks were visualized by seven algorithms, and the performance of the algorithms was quantified and compared. Quantitative performance assessment of the algorithms can provide suggestions for the selection of appropriate OCT angiography algorithms in neuroimaging.
Differing Effects of Zoledronic Acid on Bone Microarchitecture and Bone Mineral Density in Men Receiving Androgen Deprivation Therapy: A Randomized Controlled Trial
Authors: Cheung Ada S , Hoermann Rudolf , Ghasem-Zadeh Ali , Tinson Alistair J , Ly Vivian , Milevski Stefan V , Joon Daryl Lim , Zajac Jeffrey D , Seeman Ego , Grossmann Mathis
Published: June 2020

Androgen deprivation therapy (ADT) given to men with prostate cancer causes rapid and severe sex steroid deficiency, leading to increased bone remodeling and accelerated bone loss. To examine the effects of a single dose of zoledronic acid on bone microarchitecture, we conducted a 2-year randomized placebo controlled trial in 76 men, mean age (interquartile range [IQR]) 67.8 years (63.8 to 73.9) with non-metastatic prostate cancer commencing adjuvant ADT; 39 were randomized to zoledronic acid and 37 to matching placebo. Bone microarchitecture was measured using high-resolution peripheral quantitative computed tomography (HR-pQCT). Using a mixed model, mean adjusted differences (MAD; 95% confidence interval [95% CI]) between the groups are reported as the treatment effect at several time points. Over 24 months, zoledronic acid showed no appreciable treatment effect on the primary outcomes for total volumetric bone mineral density (vBMD); radius (6.7 mg HA/cm3 [−2.0 to 15.4], p = 0.21) and tibia (1.9 mg HA/cm3 [−3.3 to 7.0], p = 0.87). Similarly, there were no between-group differences in other measures of microarchitecture, with the exception of a modest effect of zoledronic acid over placebo in total cortical vBMD at the radius over 12 months (17.3 mgHA/cm3 [5.1 to 29.5]). In contrast, zoledronic acid showed a treatment effect over 24 months on areal bone mineral density (aBMD) by dual-energy X-ray absorptiometry (DXA) at all sites, including lumbar spine (0.10 g/cm2 [0.07 to 0.13]), p < 0.001), and total hip (0.04 g/cm2 [0.03 to 0.05], p < 0.001). Bone remodeling markers were initially suppressed in the treatment group then increased but remained lower relative to placebo (MADs at 24 months CTX −176 ng/L [−275 to –76], p < 0.001; P1NP –18 mg/L [−32 to –5], p < 0.001). These findings suggest that a single dose of zoledronic acid over 2 years is ineffective in preventing the unbalanced bone remodeling and severe microstructural deterioration associated with ADT therapy. © 2020 American Society for Bone and Mineral Research.
Dosing Recommendations for Pediatric Patients With Renal Impairment
Authors: Al‐Khouja Amer , Park Kyunghun , Anderson Daijha J.C. , Young Caitlyn , Wang Jian , Huang Shiew Mei , Khurana Mona , Burckart Gilbert J.
Published: June 2020

A treatment gap exists for pediatric patients with renal impairment. Alterations in renal clearance and metabolism of drugs render standard dosage regimens inappropriate and may lead to drug toxicity, but these studies are not routinely conducted during drug development. The objective of this study was to examine the clinical evidence behind current renal impairment dosage recommendations for pediatric patients in a standard pediatric dosing handbook. The sources of recommendations and comparisons included the pediatric dosing handbook (Lexicomp), the U.S. Food and Drug Administration‐approved manufacturer’s labels, and published studies in the literature. One hundred twenty‐six drugs in Lexicomp had pediatric renal dosing recommendations. Only 14% (18 of 126) of Lexicomp pediatric renal dosing recommendations referenced a pediatric clinical study, and 15% of manufacturer's labels (19 of 126) described specific dosing regimens for renally impaired pediatric patients. Forty‐two products had published information on pediatric renal dosing, but 19 (45%) were case studies. When pediatric clinical studies were not referenced in Lexicomp, the renal dosing recommendations followed the adult and pediatric dosing recommendations on the manufacturer's label. Clinical evidence in pediatric patients does not exist for most renal dosing recommendations in a widely used pediatric dosing handbook, and the adult renal dosing recommendations from the manufacturer's label are currently the primary source of pediatric renal dosing information.
O anus, where art thou? An investigation of ctenostome bryozoans
Authors: Schwaha Thomas
Published: June 2020

Ctenostome bryozoans are a small group of approximately 350 currently described species that remain inadequately investigated anatomically. Recently, the importance of soft body morphology of zooids including the digestive tract has become more evident for addressing various biological aspects such as systematic, functional, or phylogenetic analyses. Particularly, the position of the anus shows considerable variation in ctenostomes and in its extreme form can either be at the lophophoral base or at the vestibular wall. However, it has never been analysed in a broader systematic, phylogenetic, or functional context. Hence, the purpose of this study is to assess the distribution of anus position among ctenostomes, analyse whether zooidal or colonial morphology affects anus position, and draw first conclusions on its functional effects. The survey shows that a vestibular anus is ubiquitously present in alcyonidioideans and several, probably closely related, walkerioideans. In other groups such as boring forms, it appears more patchily distributed, or in some currently unassignable genera, such asMonobryozoon, supports a closer relationship to alcyonidioideans. Other zooidal or colonial characters such as tentacle number or zooidal density in the colony do not show a distinct correlation to the position of the anus. It appears that the shift of the anus into a vestibular area occurred once or twice among ctenostomes; the reasons and functional effects remain unknown. Future important aspects of defecation research in bryozoans are discussed.
Analysis of 2019 novel coronavirus infection and clinical characteristics of outpatients: An epidemiological study from a fever clinic in Wuhan, China
Authors: Wei Yanqiu , Lu Yanjun , Xia Liming , Yuan Xianglin , Li Gang , Li Xinying , Liu Li , Liu Wenhua , Zhou Peng , Wang Cong‐Yi , Zhang Huilan
Published: June 2020

Background

Since the outbreak of 2019 novel coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS‐CoV‐2]) pneumonia, thousands of patients with fever or cough were flocked into fever clinic of designated hospitals in Wuhan, China. To date, no data have ever been reported to reflect the prevalence of coronavirus disease 2019 (COVID‐19) among these outpatients. Moreover, it is almost unknown to discriminate COVID‐19 and nucleic acid negative patients based on clinical features in the fever clinics.

Methods

The infectious status of SARS‐CoV‐2 was estimated among the outpatients. The epidemiological and clinical characteristics were compared between COVID‐19 and nucleic acid negative patients.

Results

The nucleic acid positive rate for SARS‐CoV‐2 in the outpatients from our fever clinic was 67·1%, while the majority of patients with COVID‐19 were mild cases. The predominant initial symptom in those patients with COVID‐19 was fever (78.2%), followed by cough (15.6%). Very significantly lower number of eosinophils was characterized in patients with COVID‐19 as compared with that of nucleic acid negative patients. More importantly, the proportion of subjects with eosinophil counts lower than normal levels in patients with COVID‐19 was much higher than that of nucleic acid negative patients. Fever combined with bilateral ground‐glass opacities in computed tomography imaging and eosinophil count below the normal level are probably a valuable indicator of COVID‐19 infection in those outpatients.

Conclusions

Those findings may provide critical information for the regions, such as Europe and United States that are facing the same situation as Wuhan experienced, and could be valuable to prevent those nucleic acid negative patients from misdiagnosis before antibody testing.
A cross‐sectional community‐based observational study of asymptomatic SARS‐CoV‐2 prevalence in the greater Indianapolis area
Authors: Meyers Kristin J. , Jones Meghan E. , Goetz Iris A. , Botros Fady T. , Knorr Jack , Manner David H. , Woodward Brad
Published: June 2020

The Asymptomatic novel CORonavirus iNfection (ACORN) study was designed to investigate the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection in the asymptomatic adult population of the Indianapolis metropolitan area, to follow individuals testing positive for the development of symptoms, and to understand duration of positive test results. ACORN is a cross‐sectional community‐based observational study of adult residents presenting asymptomatic for COVID‐like illness, defined as the self‐reported absence of the following three symptoms in the last 7 days: fever (≥100°F), new‐onset or worsening cough, and new‐onset or worsening shortness of breath. SARS‐CoV‐2 infection was determined by real‐time reverse transcription‐polymerase chain reaction in nasopharyngeal swab samples. SARS‐CoV‐2 infection prevalence was expressed as a point estimate with 95% confidence interval (CI). Test results are reported for 2953 participants who enrolled and underwent nasopharyngeal swab testing between 7 April 2020 and 16 May 2020. Among tested participants, 91 (3.1%; 95% CI: 2.5%‐3.7%) were positive for SARS‐CoV‐2. Overall, baseline characteristics, medical history, and infection risk factors were comparable between SARS‐CoV‐2 positive and negative participants. Within the ongoing 14‐day follow‐up period for positive participants, 58 (71.6%) of 81 assessed participants remained asymptomatic while others (n = 23, 28.4%) reported one or more symptoms. Indiana had “Stay‐at‐Home” orders in place during nearly the entire test period reported here, yet 3.1% of asymptomatic participants tested positive for SARS‐CoV‐2. These results indicate screening questions had limited predictive utility for testing in an asymptomatic population and suggest broader testing strategies are needed. Importantly, these findings underscore that more research is needed to understand the viral transmission and the role asymptomatic and presymptomatic individuals play in this global pandemic.
Viral load of respiratory syncytial virus among children from primary care and hospital settings admitted to a university hospital in Brazil (2009‐2013)
Authors: Cruz Jéssica Santiago , de Souza Luna Luciano Kleber , Alves Vitória Rodrigues Guimarães , Conte Danielle Dias , Bellei Nancy Cristina Junqueira
Published: June 2020

Respiratory syncytial virus (RSV) is a relevant cause of acute respiratory infection among children. Viral replication and immune conditions may account for severity. RSV viral load (VL) was assessed in 486 children (290 hospitalized and 196 from primary care) attended at São Paulo Hospital from 2009 to 2013. VL was calculated by real‐time reverse transcription‐polymerase chain reaction and expressed in Log10 RNA copies/mL. Coinfection with rhinovirus (RV) and influenza A virus was also tested. Young children (<1 year of age) had a higher mean VL than older children at primary care (6.35 and 4.34 Log10 RNA copies/mL, respectively; P = .0006). Conversely, hospitalized children ≥2 years of age, presented higher mean VL compared with the same age children of primary care (6.10 and 4.26, respectively; P = .0024). RV was the most codetected virus in RSV positive patients (20% from primary care and 14% in hospitalized), and influenza A virus was found in 11% of primary care and 0.4% in hospitalized children with RSV, without RSV VL association (P = .2903). These findings may guide future therapies and immunization policies considering the role of viral load on clinical presentation among older hospitalized children and also the change of infection transmissions.
Bright ultrashort echo time SWIFT MRI signal at the osteochondral junction is not located in the calcified cartilage
Authors: Nykänen Olli , Leskinen Henri P. P. , Finnilä Mikko A. J. , Karhula Sakari S. , Turunen Mikael J. , Töyräs Juha , Saarakkala Simo , Nissi Mikko J.
Published: June 2020

In this study, we aimed to precisely localize the hyperintense signal that is generated at the osteochondral junction when using ultrashort echo time magnetic resonance imaging (MRI) and to investigate the osteochondral junction using sweep imaging with Fourier transformation (SWIFT) MRI. Furthermore, we seek to evaluate what compositional properties of the osteochondral junction are the sources of this signal. In the study, we obtained eight samples from a tibial plateau dissected from a 68‐year‐old male donor, and one additional osteochondral sample of bovine origin. The samples were imaged using high‐resolution ultrashort echo time SWIFT MRI and microcomputed tomography (μCT) scans. Localization of the bright signal in the osteochondral junction was performed using coregistered data sets. Potential sources of the signal feature were examined by imaging the bovine specimen with variable receiver bandwidths and by performing variable flip angle T1 relaxation time mapping. The results of the study showed that the hyperintense signal was found to be located entirely in the deep noncalcified articular cartilage. The intensity of this signal at the interface varied between the specimens. Further tests with bovine specimens indicated that the imaging bandwidth and T1 relaxation affect the properties of the signal. Based on the present results, the calcified cartilage has low signal intensity even in SWIFT imaging. Concomitantly, it appears that the bright signal seen in ultrashort echo time imaging resides within the noncalcified cartilage. Furthermore, the most likely sources of this signal are the rapid T1 relaxation of the deep cartilage and the susceptibility‐induced effects arising from the calcified tissues.
Orientation anisotropy of quantitative MRI parameters in degenerated human articular cartilage
Authors: Hänninen Nina Elina , Nykänen Olli , Prakash Mithilesh , Hanni Matti , Nieminen Miika Tapio , Nissi Mikko Johannes
Published: June 2020

Quantitative magnetic resonance (MR) relaxation parameters demonstrate varying sensitivity to the orientation of the ordered tissues in the magnetic field. In this study, the orientation dependence of multiple relaxation parameters was assessed in cadaveric human cartilage with varying degree of natural degeneration, and compared with biomechanical testing, histological scoring, and quantitative histology. Twelve patellar cartilage samples were imaged at 9.4 T MRI with multiple relaxation parameters, including T1, T2, CW − T1ρ, and adiabatic T1ρ, at three different orientations with respect to the main magnetic field. Anisotropy of the relaxation parameters was quantified, and the results were compared with the reference measurements and between samples of different histological Osteoarthritis Research Society International (OARSI) grades. T2 and CW − T1ρ at 400 Hz spin‐lock demonstrated the clearest anisotropy patterns. Radial zone anisotropy for T2 was significantly higher for samples with OARSI grade 2 than for grade 4. The proteoglycan content (measured as optical density) correlated with the radial zone MRI orientation anisotropy for T2 (r = 0.818) and CW − T1ρ with 400 Hz spin‐lock (r = 0.650). Orientation anisotropy of MRI parameters altered with progressing cartilage degeneration. This is associated with differences in the integrity of the collagen fiber network, but it also seems to be related to the proteoglycan content of the cartilage. Samples with advanced OA had great variation in all biomechanical and histological properties and exhibited more variation in MRI orientation anisotropy than the less degenerated samples. Understanding the background of relaxation anisotropy on a molecular level would help to develop new MRI contrasts and improve the application of previously established quantitative relaxation contrasts.
Tibial forces are more useful than varus‐valgus laxities for identifying and correcting overstuffing in kinematically aligned total knee arthroplasty
Authors: Roth Joshua D. , Howell Stephen M. , Hull Maury L.
Published: June 2020

Identifying and correcting varus‐valgus (V‐V) malalignment of the tibial component is important when balancing a kinematically aligned total knee arthroplasty (TKA). Accordingly, the primary objective was to determine whether the tibial forces or V‐V laxities are more sensitive to, and thus more useful for identifying and correcting, V‐V malalignments of the tibial component that overstuff a compartment. Calipered kinematically aligned TKA was performed on nine human cadaveric knees. Medial and lateral tibial forces and V‐V laxities were measured from 0° to 120° flexion with an unmodified reference tibial component and modified tibial components that introduced ±1° and ±2° V‐V malalignments from the reference component to overstuff either the medial or lateral compartment. Changes in the tibial forces were most sensitive to V‐V malalignments at 0° flexion (medial = 118 ± 34 N/deg valgus malalignment and lateral = 79 ± 20 N/deg varus malalignment). The varus and valgus laxities were most sensitive to V‐V malalignments at 30° flexion (−0.6 ± 0.1 deg/deg varus malalignment) and 120° flexion (−0.4 ± 0.2 deg/deg valgus malalignment), respectively. The maximum average signal‐to‐noise ratios of the sensitivities in tibial forces and V‐V laxities (ie, signals) to reported measurement errors using current intraoperative technologies (14 N and 0.7°) (ie, noise) were 8.4 deg−1 and 0.9 deg−1, respectively. Because of the greater signal‐to‐noise ratios, measuring tibial forces is more useful than measuring V‐V laxities for identifying and correcting V‐V malalignments of the tibial component that overstuff a compartment. Clinical Significance: The sensitivities of tibial forces provide objective guidance to surgeons performing V‐V recuts of the tibia.
Evaluation of articular cartilage with quantitative MRI in an equine model of post‐traumatic osteoarthritis
Authors: Kajabi Abdul Wahed , Casula Victor , Sarin Jaakko K. , Ketola Juuso H. , Nykänen Olli , te Moller Nikae C. R. , Mancini Irina A. D. , Visser Jetze , Brommer Harold , René van Weeren P. , Malda Jos , Töyräs Juha , Nieminen Miika T. , Nissi Mikko J.
Published: June 2020

Chondral lesions lead to degenerative changes in the surrounding cartilage tissue, increasing the risk of developing post‐traumatic osteoarthritis (PTOA). This study aimed to investigate the feasibility of quantitative magnetic resonance imaging (qMRI) for evaluation of articular cartilage in PTOA. Articular explants containing surgically induced and repaired chondral lesions were obtained from the stifle joints of seven Shetland ponies (14 samples). Three age‐matched nonoperated ponies served as controls (six samples). The samples were imaged at 9.4 T. The measured qMRI parameters included T1, T2, continuous‐wave T1ρ (CWT1ρ), adiabatic T1ρ (AdT1ρ), and T2ρ (AdT2ρ) and relaxation along a fictitious field (TRAFF). For reference, cartilage equilibrium and dynamic moduli, proteoglycan content and collagen fiber orientation were determined. Mean values and profiles from full‐thickness cartilage regions of interest, at increasing distances from the lesions, were used to compare experimental against control and to correlate qMRI with the references. Significant alterations were detected by qMRI parameters, including prolonged T1, CWT1ρ, and AdT1ρ in the regions adjacent to the lesions. The changes were confirmed by the reference methods. CWT1ρ was more strongly associated with the reference measurements and prolonged in the affected regions at lower spin‐locking amplitudes. Moderate to strong correlations were found between all qMRI parameters and the reference parameters (ρ = −0.531 to −0.757). T1, low spin‐lock amplitude CWT1ρ, and AdT1ρ were most responsive to changes in visually intact cartilage adjacent to the lesions. In the context of PTOA, these findings highlight the potential of T1, CWT1ρ, and AdT1ρ in evaluation of compositional and structural changes in cartilage.
The Modification of Chrome Tanned Leather by Polyethylene Glycol‐Linked Gemini Fatty Alcohol Phosphate
Authors: Qiang Xihuai , Jian Ting , Xu Wei
Published: June 2020

A series of polyethylene glycol‐linked Gemini fatty alcohol phosphate surfactants (GFAP) were prepared with long chain n‐alkanol (C = 8, 12, 16, 18), polyethylene glycol (PEG‐200, PEG‐400, PEG‐600, PEG‐800, PEG‐1000) and phosphorus oxychloride (POCl3). The structure of the prepared surfactants was characterized by Fourier transform infrared spectrometer (FT‐IR). The surfactants were employed for the modification of chrome‐tanned leather. The morphological changes of chrome‐tanned leather and modified chrome‐tanned leather were observed by scanning electron microscopy (SEM). The relationship between the alkyl chain length and molecular weight of the PEG and the hydrophobicity, softness, mechanical strength of modified chrome‐tanned leather was also discussed. The experimental results showed that the mechanical strength and softness of modified chrome‐tanned leather were enhanced with an increase of alkyl chain length, while the hydrophobicity, mechanical strength and softness were decreased with an increase of molecular weight of the PEG. The hydrophobicity, mechanical strength and softness of modified chrome‐tanned leather were optimized for an alkyl chain length of 16. Therefore, 16–200 Gemini phosphate surfactants with an alkyl chain length of 16 and a PEG molecular weight of 200 have a good comprehensive modification effect on Chrome‐tanned leather, the tensile strength, tear strength and softness of modified chrome‐tanned leather are 57.07 N mm−2, 79.49 N mm−1, 9.73 mm, respectively.
Stereoisomer separation of flavanones and flavanone‐7‐O‐glycosides by means of nanoliquid chromatography employing derivatized β‐cyclodextrins as mobile‐phase additive
Authors: Zátopková Renata , Aturki Zeineb , Bednář Petr
Published: June 2020

A nanoliquid chromatographic method for the stereoisomer separation of some flavanone aglycones and 7‐O‐glycosides has been proposed employing a C18 capillary column and a chiral mobile‐phase additive such as cyclodextrin. The chiral separation of eriodictyol, naringenin, and hesperitin was obtained by addition of carboxymethyl‐β‐cyclodextrin to the mobile phase, whereas eriocitrin, naringin, narirutin, and hesperidin diastereoisomers were resolved by using sulfobutyl ether‐β‐cyclodextrin. The influence of the composition of the mobile phase, the length of the capillary column, and the flow rate on the chiral recognition were investigated. At optimum conditions, baseline separation for the selected aglycones and glycosylated forms were achieved with a mobile phase consisting of 50 mM sodium acetate buffer pH 3 and 30% methanol containing 20 mM of carboxymethyl‐β‐cyclodextrin and 10 mM of sulfobutyl ether‐β‐cyclodextrin, respectively. Precision, linearity, and sensitivity of the method were tested. Limits of detection and quantification for the studied flavanone glycosides were in the range 1.3‐2.5 and 7.5‐12.5 µg/mL, respectively. The method was used for the determination of the diastereomeric composition of the flavanone‐7‐O‐glycosides in Citrus juices after solid‐phase extraction procedure.
Association of Perfusion Characteristics and Posttransplant Liver Function in Ischemia‐Free Liver Transplantation
Authors: Zhang Zhiheng , Tang Yunhua , Zhao Qiang , Wang Linhe , Zhu Caihui , Ju Weiqiang , Wang Dongping , Yang Lu , Wu Linwei , Chen Maogen , Huang Shanzhou , Gao Ningxin , Zhu Zebin , Zhang Yixi , Sun Chengjun , Xiong Wei , Shen Yuekun , Ma Yi , Hu Anbin , Zhu Xiaofeng , Rong Jian , Cai Changjie , Guo Zhiyong , He Xiaoshun
Published: June 2020

It has been shown that normothermic machine perfusion (NMP), a novel preservation method, is able to assess and resuscitate liver grafts with risk factors. However, there is no consistent criteria for the assessment of liver grafts with NMP. Ischemia‐free liver transplantation (IFLT) includes innovative surgical techniques and NMP, which can protect liver grafts from ischemia throughout organ procurement, preservation, and implantation. In our center, 28 human livers from donation after brain death donors were subjected to IFLT between July 2017 and October 2018. The correlation between posttransplant liver function tests with the perfusion parameters, blood gas analysis of perfusate, and bile biochemistry were analyzed. During the preservation phase, the vascular flow was stable, and the lactate level decreased rapidly. The transaminase release in the perfusate was low but stable, whereas the glucose level remained high. The perfusate lactate and aspartate aminotransferase (AST) levels at 1 hour of perfusion were correlated with the posttransplant peak AST level. There were negative correlations between the portal vein and hepatic artery flows at the end of perfusion and the peak transaminase levels within 7 days after transplantation. In conclusion, during IFLT, NMP is able to bridge the liver grafts from donors to recipients and can allow the assessment of liver function by perfusion characteristics.