bluuebunny/crossref_metadata_2025 huggingface dataset:
The Use of Artificial Intelligence to Program Cochlear Implants
Authors: Waltzman Susan B. , Kelsall David C.
Published: March 2020

Objective:

Cochlear implant (CI) technology and techniques have advanced over the years. There has not been the same degree of change in programming and there remains a lack of standardization techniques. The purpose of this study is to compare performance in cochlear implant subjects using experienced clinician (EC) standard programming methods versus an Artificial Intelligence, FOXTM based algorithm for programming.

Study Design:

Prospective, nonrandomized, multicenter study using within-subject experimental design

Setting:

Tertiary referral centers.

Patients:

Fifty-five adult patients with ≥ 3 months experience with a Nucleus 5, 6, Kanso, or 7 series sound processor.

Intervention:

Therapeutic Main Outcome Measures: CNC words and AzBio sentences in noise (+10 dB SNR) tests were administered in a soundproof booth followed by a direct connect psychoacoustic battery using the EC program. Tests were repeated 1 month later using the optimized FOX program. Subjective measures of patient satisfaction were also measured.

Results:

Performance for the EC program was compared to the FOX program for both measures. Group mean results revealed equivalent performance (Kruskal–Wallis ANOVA p = 0.934) with both programming methods. While some patients had better performance with the FOX method and some performed more poorly, the majority had equivalent performance and preferred the FOX system.

Conclusion:

The study demonstrated that on average, FOX outcomes are equivalent to those using traditional programming techniques. In addition, the FOX programming method can effect standardization across centers and increase access for many individuals who could benefit.
Association between serum uric acid levels and dyslipidemia in Chinese adults
Authors: Chen Shenghui , Yang Hua , Chen Yishu , Wang Jinghua , Xu Lei , Miao Min , Xu Chengfu
Published: March 2020

This study aimed to investigate the association of serum uric acid (SUA) levels with dyslipidemia and its components and to further explore the age- and gender-specific association of SUA levels with dyslipidemia in Chinese adults.

A cross-sectional study was performed among 8642 adults who underwent health examinations. A meta-analysis covering 17 studies was conducted to confirm the results.

The prevalence of hyperuricemia and dyslipidemia was 9.25% and 20.44%, respectively. Participants with hyperuricemia had higher prevalence of dyslipidemia than those without hyperuricemia (34.42% vs 19.01%, P < .005). Compared with participants with SUA in the first quintile, the odds ratio (OR) (95% confidence interval) of dyslipidemia in the second, third, fourth, and fifth quintiles of SUA were 1.095 (0.901–1.332), 1.582 (1.315–1.904), 2.095 (1.752–2.505), and 3.212 (2.702–3.818), respectively. Subgroup analysis showed that SUA quintiles were significantly correlated with the likelihood of dyslipidemia in females aged > 50 years and in males, but not in females aged ≤50 years. The meta-analysis also showed that hyperuricemia increased the likelihood of dyslipidemia and the pooled OR for the highest uric acid level vs the lowest uric acid level was 1.84 (1.49–2.28).

SUA levels are significantly associated with dyslipidemia, and this association is impacted by age and gender.
Effect of breast-conserving surgery and modified radical mastectomy on operation index, symptom checklist-90 score and prognosis in patients with early breast cancer
Authors: Qiu Han , Xu Wen-Hui , Kong Jun , Ding Xiao-Jun , Chen Deng-Feng
Published: March 2020

The present study aims to analyze the effects of breast-conserving surgery and modified radical mastectomy on operation indexes, Symptom checklist-90 scores and prognosis in patients with early breast cancer.

The clinical data of 128 patients with breast cancer who were treated in our hospital from May 2015 to May 2016 were included into the analysis. These patients were divided into 2 groups, according to the different modes of operation (n = 64): control group, patients underwent modified radical mastectomy; observation group, patients underwent early breast conserving surgery. Then, the surgical indexes and prognosis were compared between these 2 groups.

Intraoperative bleeding volume, incision length and hospitalization duration were better in the observation group than in the control group (P < .05). Furthermore, postoperative symptom checklist-90 scores in the observation group were better than scores before the operation, and were better than the scores in the control group (P < .05). Moreover, the incidence of postoperative complications was lower in the observation group (3.13%) than in the control group (21.88%, P < .05).

Early breast-conserving surgery is more advantageous for breast cancers and results to lesser bleeding, rapid recovery, and fewer complications.
The different benefits and side effects of nivolumab combined with ipilimumab in diverse cancer
Authors: Tong Hongxuan , Hao Yu , Wang Kaili , Xiang Lekang , Lu Tao
Published: March 2020

Introduction:

This systematic review protocol aims to provide the methods used to assess the total benefits and side effects in all cancer patients and their respective benefits and side effects in different cancers.

Methods and analysis:

The following electronic bibliographic databases will be selected without any language restriction: PubMed, EMBASE, The Cochrane Library, Scopus and Web of Science without an upper-limit date until July 12, 2019. Searches will also be performed in the following trials registers: ClinicalTrials.gov (www.ClinicalTrials.gov), the ISRCTN registry (www.isrctn.com), the WHO International Clinical Trials Registry Platform (www.who.int/trialsearch/Default.aspx) and the EU Clinical Trials Register (www.clinicaltrialsregister.eu). All randomized controlled trials related to the combination of nivolumab and ipilimumab for cancer patients will be included. Outcomes will include curative effect, chemotherapeutic response rate, adverse events. Study inclusion, data extraction and quality assessment will be performed independently by two reviewers. Assessment of risk of bias and data synthesis will be performed using Review Manager software.

Ethics and dissemination:

Ethics approval is not required because individual patients’ data are not included. The findings of this systematic review will be disseminated through peer-reviewed publication.

PROSPERO registration number:

CRD42018109732
Electrocardiographic characteristics for successful radiofrequency ablation of right coronary cusp premature ventricular contractions
Authors: Im Sung Il , Lee Sung Ho , Gwag Hye Bin , Park Youngjun , Park Seung-Jung , Kim June Soo , On Young Keun , Park Kyoung-Min
Published: March 2020

Electrocardiographic (ECG) criteria identifying right- and left-sided outflow tract origins have been established. The purpose of this study was to define the criteria for premature ventricular contractions (PVCs) originating from the right coronary cusp (RCC) adequately.

We analyzed ECG and electrophysiologic study data from patients who underwent successful ablation of PVCs originating from the RCC and right ventricular outflow tract (RVOT). Eighteen RCC and 28 septal RVOT PVCs were studied. Among these 18 successful RCC PVCs, a predominantly positive QRS in lead I in 18/18 (100%), longer V1–2 R-wave duration (81.4 ± 31.1 vs 44.8 ± 7.0 ms, P = .02), V1–2 R wave duration index (RWDI) (51.3 ± 22.0 vs 31.2 ± 7.5%, P = .06) were observed compared to those with posteroseptal RVOT. Local ventricular activation time preceding QRS onset was significantly earlier (−38 ± 12 ms) at the successful RCC ablation site compared to the failed ablation site of the septal RVOT (−22 ± 8 ms), even without good pace mapping at the RVOT (P < .001). The receiver operating characteristic curve showed that a pre-QRS time of ≥−31 ms predicted successful RCC ablation with 67% sensitivity and 94% specificity. A predominantly positive QRS in lead I, longer R-wave duration and RWDI in lead V1 or V2 with a local ventricular activation preceding QRS onset by an average of −31 ms suggests an effective RCC ablation site.
Hyperthermia associated with spinal radiculopathy as determined by digital infrared thermographic imaging
Authors: Park Tae Yoon , Son Seong , Lim Tae Gyu , Jeong Taeseok
Published: March 2020

In general, in digital infrared thermographic imaging (DITI) of patients with unilateral spinal radicular pain, the thermal pattern of the extremities of the side of lesion shows hypothermia compared to the opposite, intact side. However, sometimes, DITI shows hyperthermia on the side of the lesion, and this variation can cause confusion. We compared the data of both hypothermia and hyperthermia patients to clarify the factors determining different thermal characteristics in spinal radiculopathy.

We retrospectively collected data from patients who underwent DITI at a single center. The final cohort (n = 224) was allocated into 2 groups, a hypothermia group (n = 180) or a hyperthermia group (n = 44). We compared the various factors, including demographic factors and symptom-related factors, that might affect the results of DITI.

Except the presence of trauma history (13.9% vs 31.8%, odds ratio 2.893, P = .008), no significant intergroup difference was found in baseline demographic factors, including age, gender, diabetes mellitus, spinal level of pathology, and intervention history. Among symptom-related factors, in the hyperthermia group, the symptom duration was shorter (10.64 weeks [95% confidence interval (CI) 8.36–13.04] vs 2.10 weeks [95% CI 1.05-3.53], P < .001) and Visual Analogue Scale (VAS) of radicular pain was higher (4.23 ± 1.29 vs 5.18 ± 1.40, P < .001) than in the hypothermia group. Also, in the regression analysis, significant factors for hyperthermia include the presence of trauma history, shorter symptom duration (cut-off value 2.50 weeks or less) and higher VAS of radicular pain (cut-off value 4.50 or more).

In patients with trauma history, acute phase, and severe radicular pain, hyperthermia in DITI is not unusual and careful interpretation of the DITI results is necessary for proper diagnosis and treatment decisions in spinal radiculopathy.
Can hypothyroidism be a protective factor for hepatocellular carcinoma in cirrhosis?
Authors: Sahin Tolga , Oral Alihan , Turker Fatih , Kocak Erdem
Published: March 2020

Despite many studies, the molecular mechanisms of hepatocellular carcinoma (HCC) development remain unclear. Thyroid hormone (TH) levels may vary in many chronic diseases including cirrhosis. The aim of this study was to evaluate TH status in patients with cirrhosis and HCC and to investigate the relationship between THs and HCC development.

Five hundred seventy-seven patients with cirrhosis who applied to Demiroğlu Bilim University, Faculty of Medicine, Gastroenterology Department between 2004 and 2019 were included the study. Three hundred sixty-seven patients who applied to Internal Medicine Unit for general health check-up were included in the study as healthy control group. Demographic, laboratory, and imaging findings of study groups were retrospectively reviewed and recorded from hospital information system.

In the cirrhosis group, 252 patients had HCC (43.67%), and 325 patients had non-HCC cirrhosis (56.33%). Free thyroxine (FT4) levels were higher in the control group than in the cirrhotic group but there was no significant difference (P = .501). Thyroid-stimulating hormone (TSH) and FT4 levels were similar between groups, while free triiodothyronine (FT3) levels were significantly different between HCC group, non-HCC cirrhosis group, and control group (P = .299 for TSH, P = .263 for FT4, P < .001 for FT3). FT3 levels were significantly higher in HCC group than non-HCC cirrhosis group, but significantly lower than control group (P < .05).

Our study confirmed the presence of hypothyroidism in cirrhosis patients and clearly demonstrated a strong relationship between FT3 levels and HCC development.
Prognostic nutritional index as a novel marker for prediction of prognosis in patients with peripartum cardiomyopathy
Authors: Tak Bahar Tekin , Cay Serkan , Pamukcu Hilal Erken , Ekizler Firdevs Aysenur , Kafes Habibe , Cetin Elif Hande Ozcan , Ulvan Nedret , Ozeke Ozcan , Ozcan Firat , Topaloglu Serkan , Aras Dursun
Published: March 2020

The clinical significance of poor nutritional status in patients with peripartum cardiomyopathy (PPCM) is not clearly understood. Prognostic nutritional index (PNI) is a simple nutritional assessment tool, which was first demonstrated to be valuable in patients with colorectal surgeries. We aimed to investigate the predictive value of PNI in patients with PPCM.

A total of 92 patients diagnosed with PPCM were enrolled in this study. PNI was calculated using the following formula: 10 × serum albumin value (g/dL) + 0.005 × total lymphocyte count. The primary endpoint was defined as composite adverse cardiac events that included cardiac death or hospitalization due to worsening heart failure (HF). Cardiac death, hospitalization due to worsening HF, and persistent left ventricular (LV) systolic dysfunction were evaluated, respectively, as secondary endpoints.

Primary composite endpoint was higher in the lower PNI group. After adjusting for other risk factors, PNI was found to be as an independent predictor of primary composite endpoint (odds ratio 0.805; 95% confidence interval 0.729–0.888; P 
< .001). In addition, PNI was significantly associated with secondary endpoints; persistent LV systolic dysfunction as well as cardiac death.

This study identified nutritional status assessed by the PNI seems to be a novel predictor of adverse cardiovascular outcomes in patients with PPCM.
Percutaneous transhepatic cholangiography versus endoscopic retrograde cholangiography for the pathological diagnosis of suspected malignant bile duct strictures
Authors: Chang Hai-Yang , Liu Bin , Wang Yong-Zheng , Wang Wu-Jie , Wang Wei , Li Dong , Li Yu-Liang
Published: March 2020

To compare the diagnostic performance of percutaneous transhepatic cholangiography and endoscopic retrograde cholangiography for the pathological assessment of suspected malignant bile duct stricture, using brush cytology and forceps biopsy.

The study group comprised 79 consecutive patients who underwent pathological assessment for suspected malignant biliary stricture, 38 of whom underwent percutaneous transhepatic cholangiography (group A) and the other 41 underwent endoscopic retrograde cholangiography (group B). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated. A subset analysis was performed to determine the effect of location and pathological type of the stricture on diagnostic performance, and complications were analyzed.

The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 86.7%, 100%, 100%, 66.7%, and 89.5%, respectively, in group A, and 77.1%, 100%, 100%, 42.9%, and 80.4%, respectively, in group B. For hilar biliary strictures, the sensitivity and accuracy were superior in group A than in group B. Mild complications (transient c and bile leakage) were identified in 7 cases in each group, all resolved spontaneously within 3 to 5 days.

Both brush cytology and forceps biopsy performed during percutaneous transhepatic cholangiography and endoscopic retrograde cholangiography provided good diagnostic sensitivity and accuracy. Therefore, both diagnostic approaches can play an important role in planning therapeutic strategy. However, for strictures located at the hilum, pathology sampling via percutaneous transhepatic cholangiography is preferable to endoscopic retrograde cholangiography, as it provides higher sensitivity and accuracy.
The combination of balloon-assisted antegrade transvenous obliteration and transjugular intrahepatic portosystemic shunt for the management of cardiofundal varices hemorrhage
Authors: Liu Jiacheng , Yang Chongtu , Huang Songjiang , Zhou Chen , Shi Qin , Qian Kun , Song Songlin , Xiong Bin
Published: March 2020

Objectives:

In this study, we propose a modified balloon-occluded retrograde transvenous obliteration (BRTO) strategy – balloon-assisted antegrade transvenous obliteration (BAATO), and explore the feasibility, efficacy and safety of BAATO combined with transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of cardiofundal varices (GOV2 or IGV1) hemorrhage.

Materials and methods:

In this retrospective cohort study, 15 patients with cardiofundal varices hemorrhage who received BAATO combined with TIPS procedures, from August 2017 to September 2019 in our center, were enrolled. They consisted of seven patients with GOV2 and eight patients with IGV1. The clinical efficacy and safety of BAATO + TIPS procedures were assessed by comparing the clinical symptoms, laboratory and imaging examinations before and after treatment.

Results:

The technical success rate of BAATO + TIPS procedure was 100%. After the procedure, clinical symptoms were improved and complete regression of gastric varices (GVs) was observed in all patients, besides, the control efficiency of ascites and PVT which were 77.8 and 87.5%, respectively. No patient died or had a rebleeding during the follow up, but grade II hepatic encephalopathy (HE) occurred in two patients (13.3%) and shunt dysfunction was discovered in one patient (6.7%).

Conclusion:

For the treatment of GVs, the new technique BAATO is feasible, safe and effective, and it may be a more convenient and economical method than conventional BRTO. In addition, the combination of BAATO and TIPS may play a positive role in achieving hemostasis and improving the complications of portal hypertension such as ascites and PVT.
Noninvasive Brain Stimulation Does Not Improve Neuropathic Pain in Individuals With Spinal Cord Injury
Authors: Yu Binbin , Qiu Huaide , Li Jiahui , Zhong Caiyun , Li Jianan
Published: March 2020

Objective

The aim of the study was to examine the effectiveness of noninvasive brain stimulation on neuropathic pain in individuals with spinal cord injury.

Methods

A meta-analysis on pain intensity, depression, and anxiety levels was conducted to evaluate the effect of noninvasive brain stimulation on neuropathic pain in individuals with spinal cord injury. The authors searched Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (PubMed), Embase (OvidSP), PsycINFO (OvidSP), and Physiotherapy Evidence Database (PEDro). Randomized controlled trials comparing noninvasive brain stimulation with sham stimulation were included.

Results

Eleven studies were selected. The pooled analysis demonstrated no significant effect of repetitive transcranial magnetic stimulation, transcranial direct current stimulation, or cranial electrotherapy stimulation on neuropathic pain reduction after spinal cord injury. In addition, noninvasive brain stimulation showed no beneficial effect over sham stimulation on the improvement of depression, while it yielded a significant reduction of anxiety levels immediately after treatment. Subgroup analysis showed that only cranial electrotherapy stimulation had a significant effect on the reduction of anxiety levels among the three types of noninvasive brain stimulation.

Conclusions

In individuals with spinal cord injury, no significant effects of noninvasive brain stimulation on neuropathic pain and depression were observed. Cranial electrotherapy stimulation may be beneficial for the management of anxiety. These findings do not support the routine use of noninvasive brain stimulation for neuropathic pain in individuals with spinal cord injury.
Association of Plasma DPP4 Activity and Brain-Derived Neurotrophic Factor With Moderate to Severe Depressive Symptoms in Patients With Type 2 Diabetes: Results From a Cross-Sectional Study
Authors: Zheng Tianpeng , Ge Bo , Qin Linyuan , Chen Bo , Tian Li , Gao Yun , Xiao Liuping , Hu Xueping , Pan Haidong , Chen Yujie
Published: March 2020

Objective

The objective of this study was to assess the association of plasma dipeptidyl peptidase-4 (DPP4) activity, brain-derived neurotrophic factor (BDNF), and the DPP4/BDNF ratio (DBR) with moderate to severe depressive symptoms in patients with type 2 diabetes mellitus. Increased DPP4 activity and decreased BDNF in peripheral circulation have been implicated in the pathophysiology of depression.

Methods

We performed a cross-sectional study using data from 1535 patients with type 2 diabetes mellitus. The main outcome measures were plasma DPP4 activity, BDNF levels, DBR, inflammation markers, and oxidative stress parameters. Depressive symptoms were assessed using the nine-item Patient Health Questionnaire.

Results

DPP4 activity and BDNF were negatively correlated in patients with and without moderate to severe depressive symptoms (p < .001). Oxidative stress partially mediated the inverse correlation between DPP4 and BDNF. Nitrotyrosine, 8-iso-PGF2a, interleukin-6, C-reactive protein, and the nine-item Patient Health Questionnaire score increased significantly with rising quartiles of DBR. Patients in the highest quartile of DPP4 activity and DBR and lowest quartile of BDNF more often had moderate to severe depressive symptoms compared with those in the lowest quartile of DPP4 activity and DBR and the highest quartile of BDNF, respectively (p < .05). The likelihood of having moderate to severe depressive symptoms increased more with higher DPP4 activity and lower BDNF.

Conclusions

Our hypothesis-generating study demonstrates that oxidative stress might partially play a mediating role in the negative relationship between DPP4 activity and BDNF. DBR is positively related to moderate to severe depressive symptoms and thus might be used as a novel biological measure associated with depressive symptoms in patients with type 2 diabetes mellitus.
A Systematic Review of Somatic Symptoms in Children With a Chronically Ill Family Member
Authors: Elliott Lindsey , Thompson Kathryn A. , Fobian Aaron D.
Published: March 2020

Objective

Somatization and functional somatic symptoms reflect conditions in which physical symptoms are not sufficiently explained by medical conditions. Literature suggests that these somatic symptoms may be related to illness exposure in the family. Children with a parent or sibling with a chronic illness may be particularly vulnerable to developing somatic symptoms. This study provides a systematic review of the literature on somatic symptoms in children with a chronically ill family member.

Methods

A systematic review (PROSPERO registry ID: CRD42018092344) was conducted using six databases (PubMed, EMBASE, PsychINFO, Scopus, CINAHL, and Cochrane) from articles published before April 5, 2018. All authors evaluated articles by title and abstract, and then by full-text review. Relevant data were extracted by the first author and reviewed by remaining authors.

Results

Twenty-seven unique studies met the criteria. Seventeen examined somatic symptoms in children with a chronically ill parent, and seven evaluated somatic symptoms in children with a chronically ill sibling. Three studies examined somatic symptoms in children with an unspecified ill relative. The strongest relationship between child somatization and familial illness was found with children with a chronically ill parent (13/17 studies). Evidence for somatic symptoms in children with an ill sibling was mixed (4/7 studies found a positive association).

Conclusions

The literature on somatic symptoms in children suggests that parental illness is related to increased somatic symptoms in children. Research examining the effects of having a sibling with an illness on somatic symptoms is mixed. Several areas of future research are outlined to further clarify the relationship between familial chronic illness and somatic symptoms.
Systemic Defenses to Prevent Intravenous Medication Errors in Hospitals: A Systematic Review
Authors: Kuitunen Sini Karoliina , Niittynen Ilona , Airaksinen Marja , Holmström Anna-Riia
Published: March 2020

Objectives

Intravenous medication delivery is a complex process that poses systemic risks of errors. The objective of our study was to identify systemic defenses that can prevent in-hospital intravenous (IV) medication errors.

Methods

A systematic review adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted. We searched MEDLINE (Ovid), Scopus, CINAHL, and EMB reviews for articles published between January 2005 and June 2016. Peer-reviewed journal articles published in English were included. Two reviewers independently selected articles according to a predetermined PICO tool. The quality of studies was assessed using the Grading of Recommendations Assessment, Development and Evaluation system, and the evidence was analyzed using qualitative content analysis.

Results

Forty-six studies from 11 countries were included in the analysis. We identified systemic defenses related to administration (n = 24 studies), prescribing (n = 8), preparation (n = 6), treatment monitoring (n = 2), and dispensing (n = 1). In addition, 5 studies explored defenses related to multiple stages of the drug delivery process. Systemic defenses including features of closed-loop medication management systems appeared in 61% of the studies, with smart pumps being the defense most widely studied (24%). The evidence quality of the included articles was limited, as 83% were graded as low quality, 13% were of moderate quality, and only 4% were of high quality.

Conclusions

In-hospital IV medication processes are developing toward closed-loop medication management systems. Our study provides health care organizations with preliminary knowledge about systemic defenses that can prevent IV medication errors, but more rigorous evidence is needed. There is a need for further studies to explore combinations of different systemic defenses and their effectiveness in error prevention throughout the drug delivery process.
Inpatient Respiratory Arrest Associated With Sedative and Analgesic Medications: Impact of Continuous Monitoring on Patient Mortality and Severe Morbidity
Authors: McGrath Susan P. , McGovern Krystal M. , Perreard Irina M. , Huang Viola , Moss Linzi B. , Blike George T.
Published: March 2020

Objectives

The primary study objective was to investigate the impact of surveillance monitoring (i.e., continuous monitoring optimized for deterioration detection) on mortality and severe morbidity associated with administration of sedative/analgesic medications in the general care setting. A second objective was consideration of the results in the context of previous investigations to establish practice recommendations for this approach to patient safety.

Methods

Retrospective review of available rescue event and patient safety data from a tertiary care hospital in a rural setting was performed for a 10-year period. Systematic analysis of all adult general care inpatient data followed by chart review for individual patients was used to identify patient death or permanent harm (i.e., ventilator dependency, hypoxic encephalopathy) related to administration of sedative/analgesics.

Results

Of 111,488 patients in units with surveillance monitoring available, none died or were harmed by opioid-induced respiratory depression when surveillance monitoring was in use. One patient died from opioid-induced respiratory depression in a unit where surveillance monitoring was available; however, the patient was not monitored at the time of the adverse event. In unmonitored units (15,209 patients during 29 months of incremental implementation), three patients died from opioid overdose (19.73 deaths per 100,000 at risk patients). The reduced death rate when surveillance monitoring was available (0.0009%) versus not available (0.02%) was significant (P = 0.03).

Conclusions

For a 10-year period, the rescue system with continuous surveillance monitoring had a profound effect on death from sedative/analgesic administration in the general care setting. This approach to patient safety can help address the risk of sedative/analgesic-related respiratory arrests in hospitals.
Improving the Quality of Cerebral Perfusion Maps With Monoenergetic Dual-Energy Computed Tomography Reconstructions
Authors: van Ommen Fasco , Bennink Edwin , Dankbaar Jan W. , Kauw Frans , de Jong Hugo W. A. M.
Published: March 2020

Objective

We compared 40- to 70-keV virtual monoenergetic to conventional computed tomography (CT) perfusion reconstructions with respect to quality of perfusion maps.

Methods

Conventional CT perfusion (CTP) images were acquired at 80 kVp in 25 patients, and 40- to 70-keV images were acquired with a dual-layer CT at 120 kVp in 25 patients. First, time-attenuation-curve contrast-to-noise ratio was assessed. Second, the perfusion maps of both groups were qualitatively analyzed by observers. Last, the monoenergetic reconstruction with the highest quality was compared with the clinical standard 80-kVp CTP acquisitions.

Results

Contrast-to-noise ratio was significantly better for 40 to 60 keV as compared with 70 keV and conventional images (P < 0.001). Visually, the difference between the blood volume maps among reconstructions was minimal. The 50-keV perfusion maps had the highest quality compared with the other monoenergetic and conventional maps (P < 0.002).

Conclusions

The quality of 50-keV CTP images is superior to the quality of conventional 80- and 120-kVp images.
Differences in Facial Fracture Patterns in Pediatric Nonaccidental Trauma
Authors: Wasicek Philip J. , Gebran Selim G. , Elegbede Adekunle , Ngaage Ledibabari M. , Rasko Yvonne , Ottochian Marcus , Liang Fan , Grant Michael P. , Nam Arthur J.
Published: March 2020

Background:

The purpose of this study was to characterize differences in facial fracture injury patterns among pediatric patients at highest risk of abusive head trauma/nonaccidental trauma (age ≤ 5 years).

Methods:

Using the National Trauma Databank from 2007 to 2015, patients (age ≤ 5 years) suffering facial fractures were included. Demographics and injury characteristics were compared between those sustaining accidental versus nonaccidental trauma (NAT).

Results:

Over 9 years 9741 patients were included with 193 patients (2.0%) suffering NAT. Nonaccidental trauma patients were younger (median [interquartile range]; 0 [0, 2] versus 3 [1, 4], P < 0.001), and more frequently were insured by Medicaid (76.7% versus 41.9%, P < 0.001). NAT patients were more likely to sustain mandible fractures (38.9% versus 21.1%, P < 0.001), but less likely to sustain maxilla (9.8% versus 18.3%, P = 0.003), or orbital fractures (31.1% versus 53.4%, P < 0.001). Nonaccidental trauma patients had fewer instances of multiple facial fracture sites (8.9% versus 22.6%, P < 0.001). Among those sustaining mandible fractures, NAT patients were more likely to sustain condylar fractures (75.8% versus 48.4%, P < 0.001), but less likely to sustain subcondylar fractures (0% versus 13.2%, P = 0.002), or angle fractures (1.6 versus 8.7%, P = 0.048).

Conclusions:

Differences exist in facial fracture patterns in accidental versus nonaccidental trauma within the pediatric population at highest risk for abusive head trauma. Specifically, NAT is associated with fractures of the mandibular condyle and involve fewer facial fracture sites. In the appropriate context, presence of these fractures/patterns should increase suspicion for NAT.
Incidence and Prevalence of Head and Neck Pathological Spectrum in a Pediatric Population
Authors: Sharma Pradeep , Kocher Varun , Soni Kratika , Ghosh Rajarshi , Garg Balram , Kumar Sanjeev
Published: March 2020

Aim:

The aim of this study is to determine the frequency of pediatric pathologies and their distribution according to age, gender, site and types of lesions reported over a period of 2004 - 2019 in two prominent Dental Colleges at Western UP, India.

Material and Methods:

All the cases of pediatric pathology were retrospectively analyzed and reviewed that reported in the Department of Oral And Maxillofacial Surgery of 2 prominent dental colleges of Western UP, India. All consecutive patients (< 18 years), between 2004 to 2019, histologically diagnosed as having an intraosseous tumor or tumor-like lesions and cystic lesion, vascular lesions, patients with space infections and hardware infection formed the study population. Patients fulfilling the inclusion criteria were only considered for further study. The study was granted an exemption by the institutes. The entire study material was analyzed and grouped into prominent categories for logical conclusions: The accumulated data was grouped, entered, and analyzed.

Results:

One hundred two cases fulfilled the criteria. Gender distribution was equal, with mandible predominance and a predominance of non-odontogenic lesions. There were 4 malignant and 57 benign conditions. There were 23 lesions in the anterior jaw and 38 lesions were present in the posterior jaw.

Conclusion:

The pattern of pediatric pathology presentation from this part of India has been documented. In this study, the pediatric jaw tumors are less common compared to those in adult jaw tumors with non-odontogenic tumors being more common.
Public Perception of Helical Rim Deformities and Their Correction With Ear Molding
Authors: Patel Viren , Mazzaferro Daniel M. , Swanson Jordan W. , Taylor Jesse A. , Bartlett Scott P.
Published: March 2020

Background:

Among congenital ear deformities, helical rim deformities are most common. Non-surgical ear molding has emerged as an effective option to treat helical rim deformities and could reduce the need for surgery later in a child's life. Despite this, there has never been a study examining how the general public rates corrections after ear molding.

Methods:

A retrospective chart review was conducted of all consecutive patients with helical rim deformities treated with InfantEar TM Molding System. Amazon Mechanical Turk (MTurk) was used to survey blinded respondents using photographs of patients’ ears to determine the degree of normalcy on a scale of 1 (not normal) to 10 (completely normal) before and after molding. Ratings of ears were compared using a paired t test and percent improvement from baseline.

Results:

A total of 59 ears met criteria for evaluation by 497 MTurk respondents. Average age of patients at the time of treatment was 34.2 ± 16.8 days and mean therapy duration was 31.3 ± 13.1 days. A paired t test analysis found that MTurk respondents identified significant improvement in 91.5% of ears (n = 54) (P < 0.05). The percent improvement in observed helical rim change was on average 82.7 ± 61.1%.

Conclusion:

Ear molding is an effective and safe way to address helical rim deformities early in the neonatal period. The general public is able to recognize ears with rim deformities as abnormal, and appreciate the difference in architecture after molding. Crowdsourcing technology offers an opportunity to measure laypeople's perceptions regarding outcomes after ear molding.
An extracellular cold-inducible RNA-binding protein-derived small peptide targeting triggering receptor expressed on myeloid cells-1 attenuates hemorrhagic shock
Authors: Gurien Steven D. , Aziz Monowar , Cagliani Joaquin , Denning Naomi-Liza , Last Jordan , Royster William , Coppa Gene F. , Wang Ping
Published: March 2020

BACKGROUND

Extracellular cold-inducible RNA-binding protein (eCIRP) is a damage-associated molecular pattern, which is released into the circulation after hemorrhagic shock (HS). Recently, we discovered that triggering receptor expressed on myeloid cells-1 (TREM-1) serves as a new receptor of eCIRP to exaggerate inflammation. Here, we hypothesize that by inhibiting the interaction between eCIRP and TREM-1 with the use of a novel short peptide derived from human eCIRP known as M3, we can inhibit the inflammatory response and acute lung injury in HS.

METHODS

Hemorrhagic shock was induced using C57BL/6 mice by cannulating both femoral arteries. One femoral artery was used for removal of blood while the other was used for continuous monitoring of mean arterial blood pressure. The mean arterial pressure of 25 mm Hg to 30 mm Hg was maintained for 90 minutes, followed by a resuscitation phase of 30 minutes with 1 mL of normal saline. The treatment group was given 10 mg/kg of M3 during the resuscitation phase. Four hours after resuscitation, serum and lungs were collected and analyzed for various injury and inflammatory markers by using colorimetry, real-time polymerase chain reaction, and enzyme-linked immunosorbent assay.

RESULTS

There was an increase in the serum levels of tissue injury markers (alanine aminotransferase, aspartate aminotransferase, and lactate dehydrogenase) as well as cytokines (TNF-α and IL-6) when comparing the vehicle group versus the sham group. This increase was significantly inhibited in the M3-treated group. The mRNA expression of proinflammatory cytokines TNF-α, IL-6, and IL-1β and the chemokines MIP-2 and KC in lungs was significantly increased in the vehicle-treated HS mice, while their expression was significantly decreased in M3-treated HS mice. Finally, M3 treatment significantly decreased the lung injury score compared with vehicle-treated HS mice.

CONCLUSION

The novel eCIRP-derived TREM-1 antagonist (M3) can be a potential therapeutic adjunct in the management of hemorrhagic shock.
Arenimonas fontis sp. nov., a bacterium isolated from Chukotka hot spring, Arctic region, Russia
Authors: Zayulina Kseniya S. , Prokofeva Maria I. , Elcheninov Alexander G. , Voytova Margarita P. , Novikov Andrei A. , Kochetkova Tatiana V. , Kublanov Ilya V.
Published: March 2020

A moderately thermophilic, neutrophilic, aerobic, Gram-negative bacterium, strain 3729kT, was isolated from a thermal spring of the Chukotka Peninsula, Arctic region, Russia. It grew chemoorganoheterotrophically, utilizing proteinaceous substrates, including highly rigid keratins as well as various polysaccharides (glucomannan, locust bean gum, gum guar and xanthan gum). The major fatty acids of strain 3729kTwere iso-C15 : 0(60.9%), iso-C17 : 0(12.0%), C16 : 0(9.9%) and iso-C16 : 0(7.4%). Isoprenoid quinones were Q-8 (95%) and Q-9 (5%). The major polar lipids were phosphatidylglycerol, phosphatidylethanolamine, phosphatidylmethylethanolamine and three unidentified polar lipids. Strain 3729kTwas inhibited by chloramphenicol, neomycin, novobiocin, kanamycin, tetracycline, ampicillin and polymyxin B, but resistant to rifampicin, vancomycin and streptomycin. At the same time, strain 3729kTinhibited growth ofMicrococcus luteusand its genome possessed genes for antimicrobial activity against Gram-positive bacteria (a single putative bacteriocin and several secreted lysozymes and peptidoglycan lytic transglycosylases). The DNA G+C content was 69.8 mol%. 16S rRNA gene sequence-based phylogenetic analysis placed strain 3729kTinto a distinct species/genus-level branch within the familyXanthomonadaceae(Proteobacteria). Phylogenetic analysis of 120 conservative protein sequences of allXanthomonadaceaewith validly published names and publicly available genomic sequences supported a species-level position of strain 3729kTwithin the genusArenimonas. Pairwise ANI values between strain 3729kTand otherArenimonasspecies were of 75–80 %, supporting the proposal of a novel species. Accordingly,Arenimonas fontissp. nov., with the type strain 3729kT(=VMK В−3232Т=DSM 105847T), was proposed.
Communicative hand gestures as an implicit measure of artificial limb embodiment and daily usage
Authors: Maimon-Mor Roni O. , Obasi Emeka , Lu Jenny , Odeh Nour , Kirker Stephen , MacSweeney Mairéad , Goldin-Meadow Susan , Makin Tamar R.
Published: March 2020

When people talk, they move their hands to enhance meaning. Here we ask whether people spontaneously use their artificial limbs (prostheses) to gesture, and whether prosthesis gesture behaviour relates to everyday prosthesis use and perceived embodiment. One-handed participants with congenital and acquired hand loss and two-handed controls participated in gesture-facilitating tasks, measured using acceleration monitors and further validated with offline video coding. Everyday functional prosthesis use and perceived prosthesis embodiment were assessed using questionnaires. Perhaps surprisingly, one- and two-handed participants did not differ in the amount of gestures they produced. However, they did differ in their gesture profile. One-handers performed more, and bigger, movements with their intact hand while gesturing relative to their prosthesis, whereas two-handers produced more equal movements across hands. Importantly, one-handers who incorporated their prosthesis more into gesturing, that is — produced gestures that were more similar to their two-handed counterparts — also showed more frequent prosthesis use in day-to-day life. Although as a group, one-handers only marginally agreed that their prosthesis feels like a body-part, people reporting positive embodiment also showed great prosthesis habits, both for communication and daily function. We propose that measuring gesture behaviour in prosthesis-users can be used as an implicit and objective clinical tool to monitor and assess successful prosthesis adoption.
A Method to Model Outbreaks of New Infectious Diseases with Pandemic Potential such as COVID-19
Authors: Odendaal Willem G.
Published: March 2020

The emergence of the novel coronavirus (a.k.a. COVID-19, SARS-CoV-2) out of Wuhan, Hubei Province, China caught the world by surprise. As the outbreak began to spread outside of China, too little was known about the virus to model its transmission with any acceptable accuracy. World governments responded to rampant misinformation about the virus leading to collateral disasters, such as plunging financial markets, that could have been avoided if better models of the outbreak had been available. This is an engineering approach to model the spread of a new infectious disease from sparse data when little is known about the infectious agent itself. The paper is not so much about the model itself - because there are many good scientific approaches to model an epidemic - as it is about crunching numbers when there are barely any numbers to crunch. The coronavirus outbreak in USA is used to illustrate the implementation of this modeling approach. A Monte Carlo approach is implemented by using incubation period and testing efficiency as variables. Among others it is demonstrated that imposing early travel restrictions from infected countries slowed down the outbreak in the USA by about 26 days.
Spread of SARS-CoV-2 Coronavirus likely constrained by climate
Authors: Araújo Miguel B. , Naimi Babak
Published: March 2020

As new cases of COVID-19 are being confirmed pressure is mounting to increase understanding of the factors underlying the spread the disease. Using data on local transmissions until the 23rd of March 2020, we develop an ensemble of 200 ecological niche models to project monthly variation in climate suitability for spread of SARS-CoV-2 throughout a typical climatological year. Although cases of COVID-19 are reported all over the world, most outbreaks display a pattern of clustering in relatively cool and dry areas. The predecessor SARS-CoV-1 was linked to similar climate conditions. Should the spread of SARS CoV-2 continue to follow current trends, asynchronous seasonal global outbreaks could be expected. According to the models, temperate warm and cold climates are more favorable to spread of the virus, whereas arid and tropical climates are less favorable. However, model uncertainties are still high across much of sub-Saharan Africa, Latin America and South East Asia. While models of epidemic spread utilize human demography and mobility as predictors, climate can also help constrain the virus. This is because the environment can mediate human-to-human transmission of SARS-CoV-2, and unsuitable climates can cause the virus to destabilize quickly, hence reducing its capacity to become epidemic.
Preliminary evaluation of voluntary event cancellation as a countermeasure against the COVID-19 outbreak in Japan as of 11 March, 2020
Authors: Sugishita Yoshiyuki , Kurita Junko , Sugawara Tamie , Ohkusa Yasushi
Published: March 2020

Background

To control COVID-19 outbreak in Japan, sports and entertainment events were canceled in Japan for two weeks from 26 February to 11 March. It has been designated as voluntary event cancellation (VEC).

Object

This study predicts the effectiveness of VEC enduring and after its implementation.

Method

We applied a simple susceptible–infected–recovery model to data of patients with symptoms in Japan during 14 January to VEC introduction and after VEC introduction to 8 March. We adjusted the reporting delay in the latest few days.

Results

Results suggest that the basic reproduction number, R0, before VEC introduced as 2.50 with a 95% confidence interval (CI) was [2.43, 2.55] and the effective reproduction number, Rv, after VEC introduced as 1. 88; its 95% CI was [1.68,2.02].

Discussion and Conclusion

Results demonstrated that VEC can reduce COVID-19 infectiousness by 35%, but R0 remains higher than one.
The biomedical sensor Cell-Fit-HD4D, reveals individual tumor cell fate in response to microscopic ion deposition
Authors: Niklas M , Schlegel J , Liew H , Walsh DWM , Zimmermann F , Dzyubachyk O , Holland-Letz T , Rahmanian S , Greilich S , Runz A , Debus J , Abdollahi A
Published: March 2020

Here we present the biomedical sensorcell-fluorescentiontrackhybriddetector4D(Cell-Fit-HD4D)to reveal individual tumor cell fate in response to microscopic ion deposition in ion beam therapy. The sensor enables long-term monitoring of single tumor cells after clinical ion beam irradiation in combination with single-cell dosimetry.Cell-Fit-HD4Dis read outin-situby conventional optical microscopy. Direct visualization of a clinical ion beam is hereby possible for the first time. The possibility to reveal fate of individual cells from a cell cohort demonstrates that our biomedical sensor clearly differs from conventional experiments that characterize cellular response after radiation on a population level.Cell-Fit-HD4Dis therefore used to mimics the clinical situation of a defined tumor depth during tumor treatment by ion beam therapy. Our biomedical sensor is able to provide crucial input for current mechanistic approaches to biophysical modelling of the effect of ionizing radiation on biological matter. In the clinical context, obtaining multi-dimensional physical and biological information on individual tumor cells is an important step to further transform ion beam therapy into a highly precise discipline within oncology.
Elucidating Direct Kinase Targets of Compound Danshen Dropping Pills Employing Archived Data and Prediction Models
Authors: Wang Tongxing , Liang Lu , Zhao Chunlai , Sun Jia , Wang Hairong , Wang Wenjia , Lin Jianping , Hu Yunhui
Published: March 2020

The research on the direct target of traditional Chinese medicine (TCM) is the key to study the mechanism and material basis of TCM, but there is still no effective technical methods at present. For Compound Danshen dropping pills (CDDP), there is no report about its direct targets. In this study, the direct targets of CDDP were studied for the first time, especially focusing on the protein kinase family, which plays causal roles in a variety of human disease. Firstly, the literature database of CDDP was constructed by literature retrieval, and the important components contained in CDDP were extracted. Secondly, the potential direct targets of important components was obtained through querying public database and predicted by Multi-voting SEA algorithm. Then, the KinomeX system was used to predict and to filter the potential kinase targets of CDDP. Finally, the experimental verification was carried out. In total, 30 active kinase targets was obtained at 25 μg/ml concentration of CDDP, and 9 dose-dependent targets were obtained at 250 μg/ml concentration of CDDP. This is an efficient and accurate strategy by integrating the targets recorded in several public databases and the targets calculated by two in silico modelling approaches predict potential direct targets of TCM, which can lay an important foundation for the study of the mechanism and material basis of them, promoting the modernization of TCM.