bluuebunny/crossref_metadata_2025 huggingface dataset:
K2 observations of the pulsating subdwarf B stars UY Sex and V1405 Ori
Authors: Reed M D , Yeager M , Vos J , Telting J H , Østensen R H , Slayton A , Baran A S , Jeffery C S
Published: January 2020

We processed and analysed K2 observations of the pulsating subdwarf-B (sdBV) stars UY Sex and V1405 Ori. We detect 97 p-mode pulsations in UY Sex while we discover V1405 Ori to be a rare rich hybrid pulsator with over 100 p-mode pulsations and 19 g-mode pulsations. We detect frequency multiplets, which we use to identify pulsation modes as well as determine rotation periods. For UY Sex, we find a rotation period of the envelope of 24.6 ± 3.5 d and for V1405 Ori, we find a rotation period of 0.555 ± 0.029 d for the p modes and a marginal detection of 4.2 ± 0.4 d for the g modes. We discover that V1405 Ori is unique among sdBV stars observed to date. It is a rich hybrid pulsator, allowing us to simultaneously probe the envelope and interior; its frequency multiplets indicate V1405 Ori to be rotating differentially with the core rotating more slowly than the envelope, and it is also in a short-period binary (0.398 d) with an envelope that is nearly but not quite tidally locked. For both stars, we have obtained spectroscopic follow-up observations and examine combining them with Gaia parallaxes and archival photometry to determine fundamental properties. Our derived masses are inconsistent with spectroscopy and previous determinations and indicate problems with the methodology.
A search for pulsars in subdwarf B binary systems and discovery of giant-pulse emitting PSR J0533−4524
Authors: Oostrum L C , van Leeuwen J , Maan Y , Coenen T , Ishwara-Chandra C H
Published: January 2020

Binary millisecond pulsars (MSPs) provide several opportunities for research of fundamental physics. However, finding them can be challenging. Several subdwarf B (sdB) binary systems with possible neutron star companions have been identified, allowing us to perform a targeted search for MSPs within these systems. Six sdBs with companions in the neutron star mass range, as determined from their optical light curves, were observed with the Green Bank and Westerbork radio telescopes. The data were searched for periodic signals as well as single pulses. No radio pulsations from sdB systems were detected, down to an average sensitivity limit of $0.11\,$mJy. We did, however, discover a pulsar in the field of sdB HE0532−4503. Follow-up observations with the Giant Metrewave Radio Telescope showed that this pulsar, J0533−4524, is not spatially coincident with the sdB system. The pulsar has a relatively low magnetic field but still emits giant pulses. We place an upper limit of three to the number of radio pulsars in the six sdB systems. The non-detections may be explained by a combination of the MSP beaming fraction, luminosity, and a recycling fraction <0.5. Alternatively, the assumption of corotation between the MSP and sdB may break down, which implies the systems are more edge-on than previously thought. This would shift the predicted companion masses into the white dwarf range. It would also explain the relative lack of edge-on sdB systems with massive companions.
Sperm ultrastructure in the ocean quahogArctica islandica(Arcticidae) andNeotrapezium sublaevigatum(Trapezidae), with a discussion of relationships within the Arcticoidea and with other Euheterodonta (Bivalvia)
Authors: Healy John M , Mikkelsen Paula M , Bieler Rüdiger
Published: January 2020

Sperm ultrastructure is described for the ocean quahog Arctica islandica (Linnaeus, 1767) (Arcticidae), a long-lived, and commercially and phylogenetically important marine bivalve from the North Atlantic, and for Neotrapezium sublaevigatum (Lamarck, 1819), an Indo-Pacific member of the only other family of Arcticoidea (Trapezidae). Spermatozoa of A. islandica consist of (in anterior to posterior sequence): an elongate-conical, deeply invaginated, acrosomal vesicle (length 2.0 ± 0.2 μm; invagination occupied by a granular subacrosomal material); a straight, anteriorly-tapered, rod-shaped nucleus (length 6.6 ± 0.4 μm); a short (approximately 0.8 μm) midpiece consisting of two orthogonally arranged centrioles, surrounded by four (approximately 75% of spermatozoa observed) or, less commonly, five (approximately 25% of spermatozoa observed) spherical mitochondria; nine satellite fibres connecting the distal centriole to mitochondria and the plasma membrane; and a flagellum (length 60 ± 5.0 μm, with 9+2 axoneme), originating from the distal centriole. Contents of the acrosomal vesicle of A. islandica are differentiated into a very electron-dense basal ring (with reticulate structure) and two less electron-dense zones. Spermatozoa of N. laevigatum (Lamarck, 1819) differ substantially from those of A. islandica and are characterized by: a rounded-conical, deeply invaginated, acrosomal vesicle (length 0.43 ± 0.2 μm), with a curved basal ring and two less conspicuous components; a barrel-shaped nucleus (length 1.6 ± 0.5 μm) with a broad apical depression accommodating the base of the acrosomal vesicle; a midpiece composed of five (approximately 80% of spermatozoa observed) or four (approximately 20% of spermatozoa observed) mitochondria. Centriolar and flagellar details are essentially as for A. islandica, and putative glycogen deposits are associated with the distal centriole and mitochondria in both species. Sperm data corroborate recent transcriptomic analyses separating Arcticidae and Trapezidae in different imparidentian clades. Based on sperm morphology, A. islandica would appear more closely related to the Glauconomidae of the Cyrenoidea than to the Trapezidae, Veneroidea or any other previously examined group of euheterodonts, suggesting that it could be the only living member of the Arcticoidea. The relationships of the Trapezidae remain uncertain, with apparent sperm similarities to members of several groups of euheterodonts (e.g. Tellinoidea, Pholadoidea, Galeommatoidea), while several potentially closely related key taxa (e.g. Glossidae) remain unstudied for sperm characters.
On the Good that Moves Us
Authors: Deonna Julien A
Published: January 2020

In this article, I provide a detailed characterization of being moved, which I claim is a distinct emotion. Being moved is the experience of being struck by the goodness of some specific positive value being exemplified. I start by expounding this account. Next, I discuss three issues that have emerged in the literature regarding it. These concern respectively the valence of being moved, the scope of the values that may constitute its particular objects, and the cognitive sophistication required for experiencing it. My main contention is that when we understand that the presence of the specific positive value must be apprehended as finally, importantly, and impersonally good to trigger being moved, these issues do not arise.
Stress-induced lncRNA LASTR fosters cancer cell fitness by regulating the activity of the U4/U6 recycling factor SART3
Authors: De Troyer Linde , Zhao Peihua , Pastor Tibor , Baietti Maria Francesca , Barra Jasmine , Vendramin Roberto , Dok Ruveyda , Lechat Benoit , Najm Paul , Van Haver Delphi , Impens Francis , Leucci Eleonora , Sablina Anna A
Published: January 2020

Dysregulated splicing is a common event in cancer even in the absence of mutations in the core splicing machinery. The aberrant long non-coding transcriptome constitutes an uncharacterized level of regulation of post-transcriptional events in cancer. Here, we found that the stress-induced long non-coding RNA (lncRNA), LINC02657 or LASTR (lncRNA associated with SART3 regulation of splicing), is upregulated in hypoxic breast cancer and is essential for the growth of LASTR-positive triple-negative breast tumors. LASTR is upregulated in several types of epithelial cancers due to the activation of the stress-induced JNK/c-JUN pathway. Using a mass-spectrometry based approach, we identified the RNA-splicing factor SART3 as a LASTR-interacting partner. We found that LASTR promotes splicing efficiency by controlling SART3 association with the U4 and U6 small nuclear ribonucleoproteins (snRNP) during spliceosome recycling. Intron retention induced by LASTR depletion downregulates expression of essential genes, ultimately decreasing the fitness of cancer cells.
Benefits and risks of frequent or longer haemodialysis: weighing the evidence
Authors: Sarafidis Pantelis , Faitatzidou Danai , Papagianni Aikaterini
Published: January 2020

Although the ability of individuals with end-stage renal disease to maintain body homoeostasis is equally impaired during all weekdays, conventional haemodialysis (HD) treatment is scheduled thrice weekly, containing two short and one long interdialytic interval. This intermittent nature of HD and the consequent fluctuations in volume, metabolic parameters and electrolytes have long been hypothesized to predispose to complications. Large observational studies link the first weekday with an increased risk of cardiovascular morbidity and mortality. Several schemes of frequent and/or longer, home or in-centre HD have been introduced, aiming to alleviate the above risks by both increasing total dialysis duration and reducing the duration of interdialytic intervals. Observational studies in this field have non-uniform results, showing that enhanced frequency in home (but not in-centre) HD is associated with reduced mortality. Evidence from the randomized Daily and Nocturnal Trials of the Frequent HD Network suggest the opposite, showing mortality benefits with in-centre daily but not with home nocturnal dialysis. Secondary analyses of these trials indicate that daily and nocturnal schedules do not have equal effects on intermediate outcomes. Alternative schemes, such as thrice weekly in-centre nocturnal HD or every-other-day HD, seem to also offer improvements in several intermediate endpoints, but need further testing with randomized trials. This review summarizes the effects of frequent and/or longer HD methods on hard and intermediate outcomes, attempting to provide a balanced overview of the field.
Foci of Segmentally Contracted Sarcomeres in Trapezius Muscle Biopsy Specimens in Myalgic and Nonmyalgic Human Subjects: Preliminary Results
Authors: Gerwin Robert D , Cagnie Barbara , Petrovic Mirko , Van Dorpe Jo , Calders Patrick , De Meulemeester Kayleigh
Published: January 2020

Objective

The myofascial trigger point hypothesis postulates that there are small foci of contracted sarcomeres in resting skeletal muscle. Only one example, in canine muscle, has been published previously. This study evaluated human muscle biopsies for foci of contracted sarcomeres.

Setting

The Departments of Rehabilitation Sciences and Physiotherapy at Ghent University, Ghent, Belgium.

Subjects

Biopsies from 28 women with or without trapezius myalgia were evaluated, 14 in each group.

Methods

Muscle biopsies were obtained from regions of taut bands in the trapezius muscle and processed for light and electron microscopy and for histochemical analysis. Examination of the biopsies was blinded as to group.

Results

A small number of foci of segmentally contracted sarcomeres were identified. One fusiform segmental locus involved the entire muscle fiber in tissue from a myalgic subject. Several transition zones from normal to contracted sarcomeres were found in both myalgic and nonmyalgic subjects. The distance between Z-lines in contracted sarcomeres was about 25–45% of the same distance in normal sarcomeres. Z-lines were disrupted and smeared in the contracted sarcomeres.

Conclusions

A small number of foci of segmentally contracted sarcomeres were found in relaxed trapezius muscle in human subjects, a confirmation of the only other example of spontaneous segmental contraction of sarcomeres (in a canine muscle specimen), consistent with the hypothesis of trigger point formation and with the presence of trigger point end plate noise.
Effectiveness of an Evidence-Based Amputee Rehabilitation Program: A Pilot Randomized Controlled Trial
Authors: Gailey Robert , Gaunaurd Ignacio , Raya Michele , Kirk-Sanchez Neva , Prieto-Sanchez Luz M , Roach Kathryn
Published: January 2020

Background

Despite the prevalence of lower limb amputation (LLA), only a small percentage of people with LLA actually receive physical therapy post amputation and are rehabilitated to their full potential level of function. There is a need for the development of a rehabilitation program that targets impairments and limitations specific to people with LLA.

Objective

The objective of this study was to determine whether the Evidence-Based Amputee Rehabilitation program would improve functional mobility of people with unilateral transtibial amputation (TTA) who have already completed physical therapy and prosthetic training.

Design

This study was a randomized, wait-list control, single-blinded pilot clinical trial.

Setting

This study researched participants who had received postamputation rehabilitation to varying degrees, either in an inpatient and/or outpatient settings.

Participants

The participants in this study included veterans and nonveterans with unilateral TTA due to dysvascular disease and trauma.

Intervention

This study included a prescription-based rehabilitation program for people with amputations.

Measurements

Results were measured with The Amputee Mobility Predictor with (AMPPro) and without a prosthesis (AMPnoPro) and 6-Minute Walk Test (6MWT) at baseline and at the end of the 8-week intervention.

Results

The intervention group improved on the AMPPro scores (36.4 to 41.7), AMPnoro scores (23.2 to 27.1), and 6MWT distance (313.6 to 387.7 m). The effect size for the intervention was very large (1.32). In contrast, the wait-list control group demonstrated no change in AMPPro scores (35.3 to 35.6), AMPnoPro scores (24.7 to 25.0), and 6MWT distance (262.6 m to 268.8 m).

Limitations

The sample size was small. A total 326 potential candidates were screened with 306 unable to meet inclusion criteria or unwilling to participate.

Conclusion

People with unilateral TTA who received Evidence-Based Amputee Rehabilitation program demonstrated significant improvement in functional mobility, with most participants (66.7%) improved at least 1 K-level (58.3%) and greater than the minimal detectable change (66.7%).
Distinct xylem responses to acute vs prolonged drought in pine trees
Authors: Guérin Marceau , von Arx Georg , Martin-Benito Dario , Andreu-Hayles Laia , Griffin Kevin L , McDowell Nate G , Pockman William , Gentine Pierre
Published: January 2020

Increasing dryness challenges trees’ ability to maintain water transport to the leaves. Most plant hydraulics models use a static xylem response to water stress. Yet, in reality, lower soil moisture and warmer temperatures during growing seasons feed back onto xylem development. In turn, adjustments to water stress in the newly built xylem influence future physiological responses to droughts. In this study, we investigate the annual variation of anatomical traits in branch xylem in response to different soil and atmospheric moisture conditions and tree stress levels, as indicated by seasonal predawn leaf water potential (ΨL,pd). We used a 6-year field experiment in southwestern USA with three soil water treatments applied to Pinus edulis Engelm trees—ambient, drought (45% rain reduction) and irrigation (15–35% annual water addition). All trees were also subject to a natural 1-year acute drought (soil and atmospheric) that occurred during the experiment. The irrigated trees showed only moderate changes in anatomy-derived hydraulic traits compared with the ambient trees, suggesting a generally stable, well-balanced xylem structure under unstressed conditions. The artificial prolonged soil drought increased hydraulic efficiency but lowered xylem construction costs and decreased tracheid implosion safety ((t/b)2), suggesting that annual adjustments of xylem structure follow a safety–efficiency trade-off. The acute drought plunged hydraulic efficiency across all treatments. The combination of acute and prolonged drought resulted in vulnerable and inefficient new xylem, disrupting the stability of the anatomical trade-off observed in the rest of the years. The xylem hydraulic traits showed no consistent direct link to ΨL,pd. In the future, changes in seasonality of soil and atmospheric moisture are likely to have a critical impact on the ability of P. edulis to acclimate its xylem to warmer climate. Furthermore, the increasing frequency of acute droughts might reduce hydraulic resilience of P. edulis by repeatedly creating vulnerable and less efficient anatomical structure.
Sanitation of Float Trays for the Management of Pythium Species in Tobacco Float Systems
Authors: Thiessen Lindsey D. , Ellington Grant H. , Macialek Justin A. , Johnson Chuck S. , Reed David T.
Published: January 2020

Pythium root rot is an economically important disease threatening greenhouse production of tobacco seedlings. Although methyl bromide was historically used for tray sanitation, the phase-out of the fumigant from agricultural use has left few options for growers to produce disease-free transplants. Steam sanitation at 80°C for 30 min has shown control of disease caused by Rhizoctonia solani and has been adopted for use to manage Pythium spp. This study evaluates other steam temperatures and time durations to effectively manage Pythium spp. in float-tray systems. Naturally infested trays steamed at 63, 71, and 77°C for 30 min significantly reduced Pythium spp. from trays compared with TriSan wash and CC-15 dip treatments. Float trays inoculated with Pythium spp. that were steamed at 70 and 80°C for 2 h 30 min, respectively, also significantly reduced Pythium spp. survival. Other fungi, likely saprophytic or beneficial organisms, were not significantly impacted by any steaming treatment.
Post-Traumatic Hindfoot Arthritis
Authors: Stephens Andrew R. , Grujic Leslie
Published: January 2020

The hindfoot is functionally defined as the articulations between the talus, calcaneus, navicular, and cuboid. It is a biomechanically important peritalar unit for shock absorption and propulsion with the subtalar and talonavicular joint essential to its function. The primary cause of hindfoot arthritis is post-traumatic. Other causes include long-term misalignment such as adult-acquired flatfoot, cavus foot, and inflammatory arthritis. Prevention of post-traumatic hindfoot arthritis is the primary objective. Anatomical reduction and fixation of articular hindfoot fractures is the preferred pathway. This article discusses the principles of treatment of hindfoot arthritis. When post-traumatic changes cannot be managed by nonsurgical means, an anatomical well-aligned arthrodesis is indicated. This article addresses the principles of managing this condition, which have been championed by Professor Sigvard T. Hansen. New approaches and techniques are discussed that achieve the goals of a stable, functional plantigrade foot.
Technique for Open Reduction and Internal Fixation of Lateral Process Talus Fractures
Authors: Romeo Nicholas M. , Benirschke Stephen K. , Firoozabadi Reza
Published: January 2020

Lateral process fractures of the talus may occur either in isolation or in combination with a talar neck or body fracture. Screw fixation has been well described as a means of stabilization; however, many patients have multifragmentary fragments, unable to be controlled by isolated screw fixation alone. Plate fixation of the lateral process has been yet to be described in detail with presence of a clinical series. Here, we describe our technique of plate fixation for both isolated lateral process fractures and those that occur in conjunction with talar neck or body fracture.
Relative Hyperglycemia Is an Independent Determinant of In-Hospital Mortality in Patients With Critical Illness
Authors: Lee Tien F. , Drake Sophie M. , Roberts Gregory W. , Bersten Andrew , Stranks Stephen N. , Heilbronn Leonie K. , Mangoni Arduino A. , Burt Morton G.
Published: January 2020

Objectives:

To determine whether relative hyperglycemia was associated with in-hospital mortality in critically ill patients independent of other prognostic variables and whether this association is affected by background glycemia.

Design:

Prospective observational study.

Setting:

Mixed medical-surgical ICU in a metropolitan teaching hospital.

Patients:

From 2,617 admissions to ICU between January 27, 2016, and March 30, 2017, 1,262 consecutive patients who met inclusion and exclusion criteria were studied.

Interventions:

Glycosylated hemoglobin was used to estimate average glucose concentration over the prior 3 months. Glucose concentration on ICU admission was divided by estimated average glucose concentration to calculate the stress hyperglycemia ratio, an index of relative glycemia. Risk of death score was calculated using data submitted to the Australia and New Zealand Intensive Care Society.

Measurements and Main Results:

In this study, there were 186 deaths (14.7%). Admission glucose was significantly associated with mortality in univariate analysis (odds ratio = 1.08 per mmol/L glucose increment; p < 0.001) but not after adjustment for risk of death score (odds ratio = 1.01; p = 0.338). In contrast, stress hyperglycemia ratio was significantly associated with mortality both in univariate analysis (odds ratio = 1.09 per 0.1 stress hyperglycemia ratio increment; p < 0.001) and after adjustment for risk of death score (odds ratio = 1.03; p = 0.014). Unlike admission glucose concentration, stress hyperglycemia ratio was significantly associated with mortality in patients with glycosylated hemoglobin less than 6.5% (odds ratio = 1.08 per 0.1 stress hyperglycemia ratio increment; p < 0.001) and glycosylated hemoglobin greater than or equal to 6.5% (48 mmol/mol) (odds ratio = 1.08 per 0.1 stress hyperglycemia ratio increment; p = 0.005).

Conclusions:

Unlike absolute hyperglycemia, relative hyperglycemia, as assessed by the stress hyperglycemia ratio, independently predicts in-hospital mortality in critically ill patients across the glycemic spectrum. Future studies should investigate whether using measures of relative hyperglycemia to determine individualized glycemic treatment targets improves outcomes in ICU.
Examining the Impact of Corneal Tissue Transnational Activity, and Transplantation, on Import and Export Nations: A Review of the Literature
Authors: Machin Heather , Arslan Janan , Baird Paul N.
Published: January 2020

Purpose:

Globally, an estimated 12.7 million people await a corneal transplant. Of these, 53% are without routine access to a domestic supply and are reliant on transnational activity (TNA) (importation) of corneal tissue (CT) for transplantation. Although CT TNA commenced in 1961, there has been no evaluation of its impact on import and export nations.

Methods:

We wished to examine the impact of clinical and nonclinical CT TNA on export and import nations, with nonclinical aspects our primary focus, to help guide future practice. We conducted a review of the academic literature through various search engines. We prefix and place our review in the relevant historical practice and global context.

Results:

Despite commencement in 1961, we only located 14 studies (11 clinical and 3 nonclinical) pertaining to CT TNA. These were published between 1991 and 2018. Clinical papers reported death-to-preservation time, preservation-to-transplantation time, logistics, donor and recipient selection, and quality as relevant. Nonclinical studies identified emerging themes pertaining to financial, ethical, and sustainability aspects of TNA.

Conclusions:

All aspects of CT TNA are grossly under-reported, resulting in our inability to effectively analyze the overall impact to export and import nations. The few clinical studies in our review concluded that despite endothelial cell loss and other risk factors, imported CT appears comparable with domestic CT and remains an option in the absence of domestic supply. Nonclinical aspects (eg, ethical, equitable, and economic) have also not been adequately addressed.
Corneal Light Scatter After Ultrathin Descemet Stripping Automated Endothelial Keratoplasty Versus Descemet Membrane Endothelial Keratoplasty in Descemet Endothelial Thickness Comparison Trial: A Randomized Controlled Trial
Authors: Hirabayashi Kristin E. , Chamberlain Winston , Rose-Nussbaumer Jennifer , Austin Ariana , Stell Laurel , Lin Charles C.
Published: January 2020

Purpose:

To compare the degree of corneal light scatter as measured by densitometry in ultrathin Descemet Stripping Automated Endothelial Keratoplasty (UT-DSAEK) and Descemet Membrane Endothelial Keratoplasty (DMEK) in the Descemet endothelial thickness comparison trial.

Methods:

This was a prespecified secondary analysis of the Descemet endothelial thickness comparison trial, which was a prospective, randomized controlled trial. Subjects with isolated endothelial dysfunction were enrolled and were randomized to either UT-DSAEK or DMEK. Corneal opacity was quantitatively measured by Pentacam densitometry (OCULUS) at 3, 6, and 12 months.

Results:

Fifty eyes of 38 patients were enrolled at the Casey Eye Institute at Oregon Health & Science University and the Byers Eye Institute at Stanford University. Corneal densitometry for the anterior and posterior layers improved in both UT-DSAEK and DMEK after surgery. The decrease was more pronounced in the posterior layer for both groups. However, there was no difference in the degree of corneal light scatter between UT-DSAEK and DMEK at postoperative month 12, and no difference in change in densitometry was observed between the 2 arms from baseline to month 12.

Conclusions:

Both UT-DSAEK and DMEK experience an improvement in the degree of corneal light scatter after surgery. However, there was no difference in densitometry between the 2 groups at month 12. Therefore, other factors such as higher order aberrations in the posterior cornea rather than stromal–stromal interface haze mediate the superior visual outcomes in DMEK compared with UT-DSAEK.
Multidisciplinary Management of Hepatocellular Carcinoma Improves Access to Therapy and Patient Survival
Authors: Agarwal Parul D. , Phillips Paulina , Hillman Luke , Lucey Michael R. , Lee Fred , Mezrich Josh D. , Said Adnan
Published: January 2020

Background:

Given the complexity of managing hepatocellular carcinoma (HCC), it is widely accepted that a multidisciplinary team approach (tumor boards) offers the best approach to individualize therapy. The aim of this study was to determine utilization of therapies and outcomes for patients with HCC, comparing those managed through our multidisciplinary tumor board (MDTB) to those who were not.

Methods:

A database analysis of all patients with HCC managed through our MDTB, from 2007 until 2011, was performed. A database of all patients with HCC from 2002 to 2011, not managed through MDTB, was similarly created.

Results:

A total of 306 patients with HCC, from 2007 to 2011 were managed through our MDTB, in comparison with 349 patients, from 2002 to 2011 who were not. There were no significant differences in baseline demographic data or model for end-stage liver disease at presentation. Patients managed through MDTB were more likely to present at an earlier tumor stage and with lower serum alpha fetoprotein (AFP) (P=0.007). The odds of receiving any treatment for HCC was higher in patients managed through MDTB (odds ratio, 2.80; 95% confidence interval, 1.71-4.59; P<0.0001) independent of model for end-stage liver disease score, serum AFP, and tumor stage. There was significantly greater survival of patients managed through MDTB (19.1±2.5 vs. 7.6±0.9 mo, P<0.0001). Independent predictors for improved survival included management through MDTB, receipt of any HCC treatment, lower serum AFP, receipt of liver transplant, and T2 tumor stage.

Conclusions:

Patients with HCC managed through a MDTB had significantly higher rates of receipt of therapy and improved survival compared with those who were not.
Safety and Efficacy of Wireless pH Monitoring in Patients Suspected of Gastroesophageal Reflux Disease
Authors: Kessels Sharon J.M. , Newton Skye S. , Morona Judy K. , Merlin Tracy L.
Published: January 2020

Introduction:

The primary aim of this systematic review was to determine the safety, technical efficacy, and effectiveness of 48-hour wireless pH monitoring (WM) for gastroesophageal reflux disease (GERD), compared with no pH monitoring in patients who failed to tolerate a catheter. In the absence of eligible studies, the secondary aim was to determine these performance characteristics for WM relative to catheter-based pH monitoring (CBM) in patients suspected of GERD, who are able to tolerate a catheter.

Methods:

A protocol was registered on the PROSPERO database (CRD42013005852) before conducting the systematic review, which included the study selection criteria, and critical appraisal methods. Several key databases were searched to identify eligible comparative studies.

Results:

Chest pain occurred more often with WM compared with CBM; however, other adverse events were reported less frequently with WM. Technical failures, mostly due to attachment failures and early capsule detachments, were 3 times higher with WM, compared with CBM, [pooled relative risk (from meta-analysis)=3.3; 95% confidence interval, 1.63-6.81; I
2=0%; P=0.012; k=8). The sensitivity and specificity of WM varied widely, depending on type of analysis, monitoring time, capsule placement, reference standard, and diagnostic threshold.

Discussion:

WM is usually better tolerated than CBM but has more technical problems. Test accuracy was highly variable between studies; therefore, conclusions could not be drawn regarding the performance of the 2 tests. To make meaningful comparisons between WM and CBM a consensus is needed on the diagnostic threshold for GERD, monitoring time, appropriate capsule positioning, and the reference standard.
Iodine-131 metaiodobenzylguanidine (131I-mIBG) treatment in relapsed/refractory neuroblastoma
Authors: Anongpornjossakul Yoch , Sriwatcharin Wattanun , Thamnirat Kanungnij , Chamroonrat Wichana , Kositwattanarerk Arpakorn , Utamakul Chirawat , Sritara Chanika , Chokesuwattanasakul Payap , Thokanit Nintita Sripaiboonkij , Pakakasama Samart , Anurathapan Usanarat , Pongphitcha Pongpak , Chotipanich Chanisa , Hongeng Suradej
Published: January 2020

Background

131I-meta-iodo-benzylguanidine (131I-mIBG) therapy has been used in treatment of for advanced neuroblastoma for many years with promising results. There are several studies regarding predictors and outcomes of 131I-mIBG therapies in relapsed/refractory neuroblastoma patients.

Objective

To identify the predictors and outcomes of 131I-mIBG treatment in relapsed/refractory neuroblastoma.

Methods

This study was a retrospective review of 22 patients with high risk stage IV relapsed/refractory neuroblastoma who received at least one cycle of 131I-mIBG therapy. Patient’ characteristics, hematologic toxicity, scintigraphic semi-quantitative scoring, and overall survival were recorded. Factors predicting survival were analyzed.

Results

Twenty-two patients (50% male) with mean age of 3.7 years (4.8 months to 8.3 years) received 131I-mIBG therapies at an average of 3.8 and mean dose of 136 mCi (5032 MBq) per treatment. Most common acute hematologic toxicity was thrombocytopenia. Overall 5-year survival rate was 37% (95% confidence interval: 16.3–58.0) and median survival time was 2.8 year (95% confidence interval: 1.38–6.34). Patients with rising Curie score of ≥25% upon the second therapy were major determinants of overall survival with poorer response to treatment. At least three treatments of 131I-mIBG were needed to identify some degrees of survival prolongation (crude hazard ratio: P-value = 0.003). Age, sex, metastatic status, and baseline Curie scoring system were good predictors associated with survival. Seven patients (32%) demonstrated objective responses.

Conclusion

Despite multimodality therapy, high risk neuroblastoma had a propensity of treatment failure in terms of relapsed or refractory, with some objective responses after 131I-mIBG treatments. The declined or non-rising Curie score upon second post-treatment total body scan was an important predictor of survival and aided a decision whether or not to proceed with bone marrow transplantation.
Effects of nucleo(s)tide analogs therapy on chronic hepatitis B as evaluated by hepatosplenic radionuclide angiography
Authors: Wang Li , Wu Zhe , Wang Ange , Jin Xuehang , Qiu Yunqing
Published: January 2020

Objectives

Hepatosplenic radionuclide angiography is a relatively noninvasive method for evaluating hepatic portal perfusion. We used hepatosplenic radionuclide angiography to assess the effects of nucleo(s)tide analogs therapy on patients with chronic hepatitis B (CHB).

Patients and methods

A retrospective analysis was performed on patients who underwent hepatosplenic radionuclide angiography from January 2012 to May 2017 at the First Affiliated Hospital, College of Medicine, Zhejiang University. The correlations between the results of routine laboratory tests and hepatic perfusion index (HPI) were evaluated. The Wilcoxon signed-rank test and one-way ANOVA of repeated measures were used to compare the HPIs of patients who received nucleo(s)tide analogs therapy.

Results

There is a positive correlation between HPI and cholinesterase and serum albumin (ALB) and a negative correlation between HPI and aspartate aminotransferase-to-platelet ratio index and bilirubin (TBiL). An improvement in HPI was observed in patients with an initial HPI <61% after nucleo(s)tide analogs therapy.

Conclusions

Hepatosplenic radionuclide angiography can reflect the functional reserve of the liver and monitor liver fibrosis indirectly. It can also comprehensively assess the effects of antiviral therapy on patients with CHB, and antiviral therapy is critical for the treatment of hepatitis.
Micronutrients, Metabolic Complications, and Inflammation in Ugandan Children With HIV
Authors: Dirajlal‐Fargo Sahera , Shan Lingpeng , Sattar Abdus , Kulkarni Manjusha , Bowman Emily , Funderburg Nicholas , Nazzinda Rashidah , Karungi Christine , Kityo Cissy , Musiime Victor , McComsey Grace A.
Published: January 2020

Background:

Selenium, zinc, and chromium are essential micronutrients. Their alterations have been associated with HIV disease progression, metabolic complications, and mortality.

Methods:

This is a cross‐sectional study in children with perinatally acquired HIV (PHIV, n = 57), HIV‐exposed uninfected (HEU, n = 59), and HIV‐unexposed uninfected (HIV−, n = 56) children aged 2 to 10 years old, age‐ and sex‐matched, enrolled in Uganda. PHIV were on stable antiretroviral therapy (ART) with undetectable viral load. We measured plasma concentrations of selenium, zinc, and chromium as well as markers of systemic inflammation, monocyte activation, and gut integrity.

Results:

Among PHIV children, 93% had viral load ≤20 copies/mL, median CD4 was 37%, and 77% were receiving a nonnucleotide reserve transcriptase regimen. Median age of all participants was 8 years and 55% were girls. Median selenium concentrations were higher in PHIV compared with the HEU and HIV groups (P < 0.001), 46% of children overall had low zinc status (P = 0.18 between groups). Higher selenium, but not chromium or zinc, was associated with lower IL6, sTNFRI and II, and higher beta d glucan, a marker of fungal translocation, zonulin, a marker of gut permeability, oxidized LDL and insulin resistance (P ≤ 0.01).

Conclusion:

In this cohort of PHIV on ART in Uganda, there is a high prevalence of low zinc status overall. Higher plasma selenium concentrations were associated with lower systemic inflammation and higher gut integrity markers. Although our findings do not support the use of micronutrient supplementation broadly for PHIV in Uganda, further studies are warranted to assess the role of selenium supplements in attenuating heightened inflammation.
PrEP4Love: The Role of Messaging and Prevention Advocacy in PrEP Attitudes, Perceptions, and Uptake Among YMSM and Transgender Women
Authors: Phillips Gregory , Raman Anand B. , Felt Dylan , McCuskey David J. , Hayford Christina S. , Pickett Jim , Lindeman Peter T. , Mustanski Brian
Published: January 2020

Background:

Despite high efficacy, use of pre-exposure prophylaxis (PrEP) remains low among young men who have sex with men (MSM) and transgender women (TW), primarily because of barriers such as stigma and resource awareness. We evaluated a social marketing campaign known as PrEP4Love that works to eliminate PrEP stigma; and awareness gaps through targeted advertising.

Setting:

Chicago, Illinois.

Methods:

Participants were enrolled within a cohort study of young MSM and TW (RADAR). Data were collected between June 2017 and April 2018 from HIV-negative individuals attending a follow-up visit. Surveys assessed demographics, PrEP attitudes and perceptions, and PrEP4Love campaign awareness. Associations between PrEP4Love awareness and PrEP perceptions, uptake, and behaviors were assessed using multiple logistic regression controlling for age, race/ethnicity, gender, sexual identity, and ever having used PrEP.

Results:

Of 700 participants, the majority (75.9%) indicated seeing PrEP4Love ads in Chicago. Those who had seen ads were more likely to be out to their providers (odds ratio = 1.95; 95% confidence interval: 1.17 to 3.23) than those who had not, and those who had conversations were significantly more likely to have initiated the conversation themselves. Individuals who had seen ads were more likely to have taken PrEP in the last 6 months (odds ratio = 1.87; 95% confidence interval: 1.15 to 3.16) and more likely to believe their friends and the general public approved of and used PrEP.

Conclusion:

Social marketing campaigns are promising interventions that have the potential to alleviate barriers to HIV prevention, particularly among MSM and TW. Future research should evaluate the impact of these initiatives at multiple time points.
Estimated Number of Men Who Have Sex With Men With Indications for HIV Pre-exposure Prophylaxis in a National Sexual Network Study
Authors: Weiss Kevin M. , Prasad Pragati , Ramaraju Ramya , Zlotorzynska Maria , Jenness Samuel M.
Published: January 2020

Background:

A 2015 CDC analysis estimated that 24.7% of sexually active men who have sex with men (MSM) had indications for HIV pre-exposure prophylaxis (PrEP) based on 2014 US Public Health Service (USPHS) clinical practice guidelines. Given that the USPHS revised these guidelines in 2017, updated estimates of the fraction of MSM indicated for PrEP overall and stratified by demographic factors and geography are needed to scale-up PrEP for MSM in the US.

Methods:

We conducted a national web-based study of 4904 MSM aged 15–65 who had ever had sex with another man between July 2017 and January 2019. We estimated the percentage of HIV-negative, sexually active MSM meeting USPHS indications for PrEP by demographic category.

Results:

Of 3511 sexually active, HIV-negative MSM, 34.0% (95% confidence interval: 32.4 to 35.6) met USPHS indications for PrEP, with percentages consistent across US census region and varying slightly by race/ethnicity (Black: 32.2%, White: 33.7%, Hispanic: 36.4%, Other: 33.6%). Among individuals meeting USPHS PrEP indications, 93.5% reported condomless anal intercourse in the prior 6 months. Among all survey respondents, PrEP eligibility was lowest among non-Hispanic black (18.4%) and younger respondents (15–17: 4.1%; 18–24: 18.1%).

Conclusions:

Estimated percentages of MSM meeting indications for PrEP exceeded the previous CDC estimate across race/ethnicity, age, and census regions, with one-third of adult, sexually active, HIV-negative MSM exhibiting indications for PrEP. This study suggests, given current guidelines for PrEP indications, that a different fraction of eligible MSM could be receiving PrEP than previously estimated.
Image Quality Measured From Ultra-Low Dose Chest Computed Tomography Examination Protocols Using 6 Different Iterative Reconstructions From 4 Vendors, a Phantom Study
Authors: Afadzi Mercy , Fosså Kristian , Andersen Hilde Kjernlie , Aaløkken Trond Mogens , Martinsen Anne Catrine T.
Published: January 2020

Purpose

This study aimed to evaluate image quality of ultra-low dose chest computed tomography using 6 iterative reconstruction (IR) algorithms.

Method

A lung phantom was scanned on 4 computed tomography scanners using fixed tube voltages and the lowest mAs available on each scanner, resulting in dose levels of 0.1 to 0.2 mGy (80 kVp) and 0.3 to 1 mGy (140 kVp) volume CT dose index (CTDIvol). Images were reconstructed with IR available on the scanners. Image noise, signal-to-noise ratios, contrast-to-noise ratios, uniformity, and noise power spectrum (NPS) were assessed for evaluation of image quality.

Results

Image quality parameters increased with increasing dose for all algorithms. At constant dose levels, model-based techniques improved the contrast-to-noise ratio of lesions more than the statistical algorithms. All algorithms tested at 0.1 mGy showed lower NPS peak frequencies compared with 0.39 mGy. In contrast to the statistical techniques, model-based algorithms showed lower NPS peak frequencies at the lowest doses, indicating a coarser and blotchier noise texture.

Conclusion

This study shows the importance of evaluating IR when introduced clinically.
Machine Learning to Predict the Rapid Growth of Small Abdominal Aortic Aneurysm
Authors: Hirata Kenichiro , Nakaura Takeshi , Nakagawa Masataka , Kidoh Masafumi , Oda Seitaro , Utsunomiya Daisuke , Yamashita Yasuyuki
Published: January 2020

Objective

The purpose of this study was to determine whether computed tomography (CT) angiography with machine learning (ML) can be used to predict the rapid growth of abdominal aortic aneurysm (AAA).

Materials and Methods

This retrospective study was approved by our institutional review board. Fifty consecutive patients (45 men, 5 women, 73.5 years) with small AAA (38.5 ± 6.2 mm) had undergone CT angiography. To be included, patients required at least 2 CT scans a minimum of 6 months apart. Abdominal aortic aneurysm growth, estimated by change per year, was compared between patients with baseline infrarenal aortic minor axis. For each axial image, major axis of AAA, minor axis of AAA, major axis of lumen without intraluminal thrombi (ILT), minor axis of lumen without ILT, AAA area, lumen area without ILT, ILT area, maximum ILT area, and maximum ILT thickness were measured. We developed a prediction model using an ML method (to predict expansion >4 mm/y) and calculated the area under the receiver operating characteristic curve of this model via 10-fold cross-validation.

Results

The median aneurysm expansion was 3.0 mm/y. Major axis of AAA and AAA area correlated significantly with future AAA expansion (r = 0.472, 0.416 all P < 0.01). Machine learning and major axis of AAA were a strong predictor of significant AAA expansion (>4 mm/y) (area under the receiver operating characteristic curve were 0.86 and 0.78).

Conclusions

Machine learning is an effective method for the prediction of expansion risk of AAA. Abdominal aortic aneurysm area and major axis of AAA are the important factors to reflect AAA expansion.
The Diagnostic Accuracy of Magnetic Resonance Imaging in Restaging of Rectal Cancer After Preoperative Chemoradiotherapy: A Meta-Analysis and Systematic Review
Authors: Wei Ming-Zhu , Zhao Zhen-Hua , Wang Jian-Yun
Published: January 2020

Objective

To evaluate the overall diagnostic value of magnetic resonance imaging (MRI) in restaging of rectal cancer after preoperative chemoradiotherapy based on qualified studies.

Methods

PubMed, Cochrane, and EMBASE database were searched by the index words to identify the qualified studies, and relevant literature sources were also searched. The latest research was done in April 2019. Heterogeneity of the included studies was tested, which was used to select proper effect model to calculate pooled weighted sensitivity, specificity, and diagnostic odds ratio (DOR). Summary receiver operating characteristic (SROC) analyses were also performed.

Result

Nineteen studies with 1262 patients were involved in the meta-analysis exploring the diagnostic accuracy of MRI for rectal cancer. The diagnostic accuracy of MRI in T3–T4 rectal cancer was as follows: sensitivity, 81% (95% confidence interval [CI], 67%–90%); specificity, 67% (95% CI, 51%–80%); positive likelihood ratio, 2.48 (95% CI, 1.57–3.91); negative likelihood ratio, 0.28 (95% CI, 0.15–0.52); global DOR, 6.86 (95% CI, 3.07–15.30); the area under the SROC was high (0.81; 95% CI, 0.78–0.84). The diagnostic accuracy of MRI in lymphatic metastasis of rectal cancer was as follows: sensitivity, 77% (95% CI, 65%–86%); specificity, 77% (95% CI, 63%–87%); positive likelihood ratio, 3.40 (95% CI, 2.07–5.59); negative likelihood ratio, 0.30 (95% CI, 0.20–0.45); DOR, 10.81 (95% CI, 4.99–23.39); area under the SROC was high (0.84; 95% CI, 0.80–0.87).

Conclusions

This study provides a systematic review and meta-analysis of diagnostic accuracy studies of MRI for rectal cancer. The results indicate that MRI is a highly accurate diagnostic tool for rectal cancer T3–T4 staging and N staging but sensitivity and specificity are not high.
Magnetic Resonance Imaging Texture Analysis in Differentiating Benign and Malignant Breast Lesions of Breast Imaging Reporting and Data System 4: A Preliminary Study
Authors: Wang Yanfang , Liao Xing , Xiao Feng , Zhang Hanfei , Li Jianyu , Liao Meiyan
Published: January 2020

Rationale and Objectives

This novel study aims to investigate texture parameters in distinguishing malignant and benign breast lesions classified as Breast Imaging Reporting and Data System 4 in dynamic contrast-enhanced magnetic resonance imaging (MRI).

Materials and Methods

This retrospective study included 203 patients with 136 breast cancer and 67 benign lesions who underwent breast MRI between November 23, 2016, and August 27, 2018. Co-occurrence matrix-based texture features were extracted from each lesion on T1-weighted contrast-enhanced MRI using MatLab software. The association between texture parameters and breast lesions was analyzed, and the diagnostic model for breast cancer was created. Classification performance was evaluated by the area under the receiver operating characteristic curve, sensitivity, and specificity.

Results

Significant differences were seen between malignant and benign lesions for a number of textural features, including contrast, correlation, autocorrelation, dissimilarity, cluster shade, and cluster performance (P < 0.05). After the analysis of the multicollinearity, 5 texture features (contrast, correlation, dissimilarity, cluster shade, and cluster performance) were included for the next principal component analysis. The differentiation accuracy of breast cancer based on the diagnostic model was 0.948 (95% confidence interval, 0.908–0.974).

Conclusions

Texture features that measure randomness, heterogeneity, or homogeneity may reflect underlying growth patterns of breast lesions and show great difference in malignant and benign lesions. Therefore, texture analysis may be a valuable assisted tool for diagnostic analysis on breast.