bluuebunny/crossref_metadata_2025 huggingface dataset:
An empirical examination of the impact of country‐level corporate governance on profitability of Indian banks
Authors: Almaqtari Faozi A. , Hashid Abdulwahid , Farhan Najib H. S. , Tabash Mosab I. , Al‐ahdal Waleed M.
Published: August 2020

The main aim of the present study is to examine the impact of country‐level corporate governance on the profitability of Indian banks using a sample of 61 banks that is, 42 private and 19 public banks. The study employs descriptive statistics, correlation analysis, regression analysis of two‐way variable intercept random effect model, and robustness checks including robust regression, Generalized Methods of Moments, and Panel Correction Standard Error. The results reveal that country‐level corporate governance has a significant impact on the profitability of Indian banks. Private banks demonstrate better performance over public banks and the effect of country‐level governance on the profitability of private banks is positive and it is better than public banks. Further, the results show that demonetisation has a significant negative impact on the profitability of Indian banks as measured by Return on Assets and Return on Equity, but it also has a significant positive effect in the case of Net Interest Margin. The findings of the current study have considerable implications for regulators, policymakers, bankers, analysts, and academicians. Regulations and several policy measures could be introduced to improve the profitability of Indian banks. To promote greater transparency, better accountability, strong rule of law, and corporate governance, corruption must be eliminated to enhance higher profitability of Indian banks. This paper presents novel evidence linking country‐level corporate governance to the profitability of banks in the context of India, as an emerging economy. Therefore, it bridges an existing gap in the body of literature on the profitability of banks in India.
Triptorelin for the treatment of adenomyosis: A multicenter observational study of 465 women in Russia
Authors: Andreeva Elena , Absatarova Yulia
Published: August 2020

Objective

To evaluate the effectiveness of triptorelin for the treatment of adenomyosis, the benign invasion of endometrial tissue into the myometrium, as a fertility‐preserving alternative to the gold standard hysterectomy.

Methods

In this multicenter, open‐label, observational study in Russia, performed from November 3, 2011, to August 24, 2015, we assessed the efficacy and safety of triptorelin 3.75 mg administered intramuscularly every 28 days in Russian women who were gonadotropin‐releasing hormone agonist treatment‐naïve, aged 25–40 years, and had a diagnosis of endometriosis or adenomyosis with heavy menstrual bleeding. We performed a medical record review, interviews to assess symptom severity, and pelvic assessments including transvaginal ultrasound. Data were obtained at first injection of triptorelin (visit 1), on the day of last injection (visit 2), 6 months after last injection (visit 3), and 9 months after last injection (visit 4). Significance was assessed by Wilcoxon signed rank test.

Results

A total of 465 women were included. There was a significant improvement from baseline in severity of heavy menstrual bleeding in 390/463 (84.2%) of women 6 months after last injection (P<0.0001). Severity of dysmenorrhea, abnormal uterine bleeding, and pelvic pain was decreased at visit 3 compared with baseline (P<0.0001). Endometriosis symptoms stopped in 253/262 (96.6%) of women at visit 2 and in 243/263 (92.4%) of women at visit 3. Pregnancy was reported in 116/465 (24.9%) women within 9 months following the end of treatment.

Conclusion

Triptorelin has a favorable safety profile, is highly efficacious in treating clinical symptoms of adenomyosis, and improves reproductive function.

ClinicalTrials.gov registration number: A‐38‐52014‐191, registered October 2011.
Beyond adequate: Factors associated with quality of antenatal care in western Tanzania
Authors: Young Marisa R. , Morof Diane , Lathrop Eva , Haddad Lisa , Blanton Curtis , Maro Godson , Serbanescu Florina
Published: August 2020

Objective

To determine quality of antenatal care (ANC). Most literature focuses on ANC attendance and services. Less is known about quality of care (QoC).

Method

Data were analyzed from the 2016 Kigoma Reproductive Health Survey, a population‐based survey of reproductive‐aged women. Women with singleton term live births were included and principal component analysis (PCA) was used to create an ANC quality index using linear combinations of weights of the first principal component. Nineteen variables were selected for the index. The index was then used to assign a QoC score for each woman and linear regression used to identify factors associated with receiving higher QoC.

Results

A total of 3178 women received some ANC. Variables that explained the most variance in the QoC index included: gave urine (0.35); gave blood (0.34); and blood pressure measured (0.30). In multivariable linear regression, factors associated with higher QoC included: ANC at a hospital (versus dispensary); older age; higher level of education; working outside the home; higher socioeconomic status; and having lower parity.

Conclusion

Using PCA methods, several basic components of ANC including maternal physical assessment were identified as important indicators of quality. This approach provides an affordable and effective means of evaluating ANC programs.
Screening for cervical cancer in Africa: A proposal of a different combination of VIA test and cervical smear in Uganda
Authors: Corrado Giacomo , Mazzara Calogero , Certelli Camilla , Nsubuga John B. , Zanetto Francesca , Schurfeld Karin , Dell’Antonio Giacomo , Orti Carlino D. , Savarese Antonella , Andriani Maria T.
Published: August 2020

Objective

To evaluate the efficacy of visual inspection with acetic acid (VIA) screening combined with a cervical smear in Uganda.

Methods

Nine screening campaigns were held in Uganda between January 2011 and October 2019. In the last three campaigns, a new approach was used: the cervical smear was performed before the VIA test and, in case of a positive VIA test, the slide was sent for examination. The data collected were divided into two groups: the first six campaigns and the last three campaigns.

Results

During the study period, 10 520 women were screened, of whom 911 had a positive VIA test. The VIA test showed 84.2% false positives. In the first group, the VIA test was positive in 516 women, of whom 93% were referred for further examinations. In the second group, the VIA test was positive in 395 women, but the cervical smear was positive in only 65 women. Thus, only 16.5% women were referred for further examinations.

Conclusion

Combining cervical smear, VIA test, and slide analysis in positive VIA tests may allow women who need treatment to be selected more effectively, while waiting for other more expensive solutions to become more affordable for this setting.
Classification of Coronavirus (COVID‐19) from X‐ray and CT images using shrunken features
Authors: Öztürk Şaban , Özkaya Umut , Barstuğan Mücahid
Published: August 2020

Necessary screenings must be performed to control the spread of the COVID‐19 in daily life and to make a preliminary diagnosis of suspicious cases. The long duration of pathological laboratory tests and the suspicious test results led the researchers to focus on different fields. Fast and accurate diagnoses are essential for effective interventions for COVID‐19. The information obtained by using X‐ray and Computed Tomography (CT) images is vital in making clinical diagnoses. Therefore it is aimed to develop a machine learning method for the detection of viral epidemics by analyzing X‐ray and CT images. In this study, images belonging to six situations, including coronavirus images, are classified using a two‐stage data enhancement approach. Since the number of images in the dataset is deficient and unbalanced, a shallow image augmentation approach was used in the first phase. It is more convenient to analyze these images with hand‐crafted feature extraction methods because the dataset newly created is still insufficient to train a deep architecture. Therefore, the Synthetic minority over‐sampling technique algorithm is the second data enhancement step of this study. Finally, the feature vector is reduced in size by using a stacked auto‐encoder and principal component analysis methods to remove interconnected features in the feature vector. According to the obtained results, it is seen that the proposed method has leveraging performance, especially to make the diagnosis of COVID‐19 in a short time and effectively. Also, it is thought to be a source of inspiration for future studies for deficient and unbalanced datasets.
Complex adaptive system approach for improved irrigation management: The case of the Gezira scheme in Sudan*
Authors: Ibrahim Yosif A.
Published: August 2020

Several factors contribute to poor irrigation management. A set of natural, social, environmental, institutional and technological variables can collectively result in complex and messy problems. Traditional engineering systems are not well suited for addressing coupled and interlinked types of problem. To this end, a hybrid network model is introduced to study the cumulative impact of these variables on the performance of irrigation projects. The model is based on the theory of complex adaptive systems and agent‐based modelling. The Gezira scheme in Sudan is used as a case study in order to convert the vicious circle through adopting an improved and most viable irrigation management system. Six key variables are selected as dominant driving forces that influence the performance of the irrigation scheme. These are scheme governance, agricultural research, agricultural inputs and technologies, farmers, water user associations and the irrigation agency responsible for operation and maintenance. The scope of the analysis is to explore the dynamics of system enhancement under different scenarios of policy intervention. The results revealed the need for balanced and diversified investment in all entities to ensure sustainable growth. The findings emphasize the importance of having interventions with moderate growth patterns that seek to enhance cooperation and positive feedback among entities.
Automated vessel diameter quantification and vessel tracing for OCT angiography
Authors: Wei Wei , Zhang Qinqin , Rayner Samuel G. , Qin Wan , Cheng Yuxuan , Wang Fupeng , Zheng Ying , Wang Ruikang K.
Published: August 2020

Optical coherence tomography angiography (OCTA) is capable of non‐invasively imaging the vascular networks within circulatory tissue beds in vivo. Following improvements in OCTA image quality, it is now possible to extract vascular parameters from imaging data to potentially facilitate the diagnosis and treatment of human disease. In this paper, we present a method for automated mapping of vessel diameter down to the individual capillary level, through gradient‐guided minimum radial distance (MRD). During validation using well‐characterized microfluidic flow phantoms, this method demonstrated superior consistency and a nearly threefold decrease in error when compared to currently accepted techniques. In addition, the MRD technique exhibited a high tolerance to rotation of the vasculature pattern. We also incorporated a modified A* path searching algorithm to trace vessel branches and calculate the diameter of each branch from the OCTA images. After validation in vitro, we applied these algorithms to the in vivo setting through analysis of mouse cortical vasculature. Our algorithm returned results that followed Murray's law, until reaching the capillary level, agreeing well with known physiological data. From our tracing process, vessel tortuosity and branching angle could also be measured. Our techniques provide a platform for the automated evaluation of the vasculature and may aid in diagnosis of vascular diseases, especially those resulting in regional early‐stage morphological changes.
Effects of photobiomodulation on bone defects grafted with bone substitutes: A systematic review of in vivo animal studies
Authors: Hanna Reem , Dalvi Snehal , Amaroli Andrea , De Angelis Nicola , Benedicenti Stefano
Published: August 2020

A present, photobiomodulation therapy (PBMT) effectiveness in enhancing bone regeneration in bone defects grafted with or without biomaterials is unclear. This systematic review (PROSPERO, ref. CRD 42019148959) aimed to critically appraise animal in vivo published data and present the efficacy of PBMT and its potential synergistic effects on grafted bone defects. MEDLINE, CCCT, Scopus, Science Direct, Google Scholar, EMBASE, EBSCO were searched, utilizing the following keywords: bone repair; low‐level laser therapy; LLLT; light emitting diode; LEDs; photobiomodulation therapy; in vivo animal studies, bone substitutes, to identify studies between 1994 and 2019. After applying the eligibility criteria, 38 papers included where the results reported according to “PRISMA.” The results revealed insufficient and incomplete PBM parameters, however, the outcomes with or without biomaterials have positive effects on bone healing. In conclusion, in vivo animal studies with a standardized protocol to elucidate the effects of PBMT on biomaterials are required initially prior to clinical studies.
Immunomodulatory property and its regulatory mechanism of double network hydrogel on dendritic cells
Authors: Zhu Fujun , Tong Yalin , Wu Yao , Dong Ning , Sheng Zhiyong , Yao Yongming
Published: August 2020

Modulation of the key immune cell subsets by biomaterial has emerged as a potential target to promote tissue repair and regeneration. Based on calcium alginate (Alg) and glycol chitosan (GC), an injectable double‐network (DN) hydrogel has been developed as a scaffold for cell delivery and cell cocultured system. Previous studies have documented the interaction between dendritic cells (DCs) and GC or Alg hydrogel, but the potential effect of DN hydrogel on activation of DCs still remains unclear. This research was conducted to explore the immunomodulatory influence and underlying mechanisms of GC/Alg DN hydrogel on DCs in vitro and in vivo. Stimulation of DCs with DN hydrogel obviously induced the maturation of DCs in vitro. In vivo, DN hydrogel did not have obvious influence on the maturation of splenic DCs on postimplantation days 3, 10, and 30. Mechanistically, we found that DN hydrogel induced the maturation of DCs via phosphorylation of phosphatidylinositol 3‐kinase/protein kinase B/mammalian target of rapamycin in vitro. It provides a novel understanding of the immunomodulatory property of DN hydrogel on DCs, which may serve as potential target for designing immune‐mediated regenerative strategies.
Comprehensive 3D‐RISM analysis of the hydration of small molecule binding sites in ligand‐free protein structures
Authors: Yoshidome Takashi , Ikeguchi Mitsunori , Ohta Masateru
Published: August 2020

Hydration is a critical factor in the ligand binding process. Herein, to examine the hydration states of ligand binding sites, the three‐dimensional distribution function for the water oxygen site, gO(r), is computed for 3,706 ligand‐free protein structures based on the corresponding small molecule–protein complexes using the 3D‐RISM theory. For crystallographic waters (CWs) close to the ligand, gO(r) reveals that several CWs are stabilized by interaction networks formed between the ligand, CW, and protein. Based on the gO(r) for the crystallographic binding pose of the ligand, hydrogen bond interactions are dominant in the highly hydrated regions while weak interactions such as CH‐O are dominant in the moderately hydrated regions. The polar heteroatoms of the ligand occupy the highly hydrated and moderately hydrated regions in the crystallographic (correct) and wrongly docked (incorrect) poses, respectively. Thus, the gO(r) of polar heteroatoms may be used to distinguish the correct binding poses.
Long noncoding RNA HULC in acute ischemic stroke: Association with disease risk, severity, and recurrence‐free survival and relation with IL‐6, ICAM1, miR‐9, and miR‐195
Authors: Chen Xia , Zhang Xihui , Su Cong , Huang Shaoming
Published: August 2020

Background

This study aimed to evaluate the clinical role of long noncoding RNA (lncRNA) HULC in acute ischemic stroke (AIS).

Methods

LncRNA HULC in plasma samples from 215 first episode AIS patients and 215 age/gender‐matched non‐AIS controls was detected by reverse transcriptional‐quantitative polymerase chain reaction (RT‐qPCR). Then, in AIS patients, interleukin‐6 and intercellular adhesion molecule 1 (ICAM1), as well as microRNA (miR) target of lncRNA HUCL (miR‐9 and miR‐195), were detected by enzyme‐linked immunosorbent assay and RT‐qPCR, respectively. Disease severity was assessed by National Institution of Health stroke scale (NIHSS) score. AIS recurrence or death was recorded, and recurrence‐free survival (RFS) was calculated.

Results

LncRNA HULC was increased in AIS patients compared to non‐AIS controls (P < .001), and receiver operating characteristic curve showed that it was correlated with increased AIS risk (area under curve: 0.876, 95% confidence interval: 0.843‐0.908). Meanwhile, lncRNA HULC was positively correlated with NIHSS score (P < .001, r = .456), interleukin‐6 (P < .001, r = .275) and ICAM1 (P < .001, r = .383), whereas negatively correlated with miR‐9 (P < .001, r = −.438) but not miR‐195 (P = .205, r = −.087) in AIS patients. Additionally, miR‐9 was negatively correlated with NIHSS score (P < .001, r = −.335), interleukin‐6 (P = .001, r = −.231), and ICAM1 (P < .001, r = −.280), while miR‐195 was only negatively associated with NIHSS score (P = .041, r = −.139) in AIS patients. Moreover, lncRNA HULC high expression predicted worse RFS (P = .013) in AIS patients.

Conclusion

LncRNA HULC is correlated with higher AIS risk, increased disease severity and worse prognosis in AIS patients. Meanwhile, it associates with higher IL‐6, elevated ICAM1, and lower miR‐9 AIS patients.
Satisfaction of optional pairing in clinical dental training
Authors: Hammad Mohammad Mahmoud , Mahasneh Sari Adel , Sawair Faleh A. , Hattar Susan Nweiser , AL‐Rabab'ah Mohammad Abdalla , Wahab Fouad Kadim
Published: August 2020

Purpose

The aim of this study was to investigate the perceived satisfaction of optional pairing in undergraduate clinical dental training of fourth‐ and fifth‐year dental students and newly graduated intern dentists in the subject of conservative dentistry and endodontics.

Methods

Data were collected through a paper‐based 2‐part questionnaire. The first part was made of 3 questions; gender, undergraduate dental year, and grade point average (GPA). The second part involved 9 questions about assistant student‐year level preference, satisfaction of optional pairing and main advantages and disadvantages of pairing. Statistical analysis was performed using descriptive statistics and Chi‐square test to investigate any statistically significant differences.

Results

A total of 92.4% were satisfied with optional clinical pairing. Satisfied respondents reported most prevalent advantages were speeding things up (88.5%) and helping in transferring instruments and materials (85.6%). Unsatisfied respondents reported the most prevalent disadvantages were like to work independently (56.8%) and the assistant was not always cooperative (32.4%). Students with low grade point averages (GPAs) felt incompetent to work in pairs compared with high GPA students (P = 0.001). Only 32.4% of participants thought that the assistant student should be given an evaluation mark. About 75% of respondents reported that clinical pairing improved their diagnostic skills and treatment planning.

Conclusions

Optional pairing in clinical dental training had a high satisfaction percentage. Allowing students to choose their own assistants may reduce pairing disadvantages and enhance its advantages. Students may gain a mentoring benefit from being encouraged to optionally pair with similar or higher study‐year students
Quality assurance and authentication of herbal drug (Argyrolobium roseum and Viola stocksii) through comparative light and scanning electron microscopy
Authors: Ahmed Sidra Nisar , Ahmad Mushtaq , Yaseen Ghulam , Zafar Muhammad , Rashid Sofia , Nazir Abdul , Sultana Shazia , Anjum Farida , Ozdemir Fethi Ahmet , Kilic Omer
Published: August 2020

The quality assurance and authentication of crude herbal drugs play important role in the effective therapeutic effect of herbal drug and their products. There are many reported problems in quality assurance of herbal crude drugs concerning to their correct identification. The present study was designed with the aim to document the authentication and quality assurance of the herbal crude drugs (Argyrolobium roseum and Viola stocksii) thorough light microscopy (LM) and scanning electron microscopy (SEM). The detailed foliar anatomical studies showed polygonal epidermal cells having anticlinal walls in Argyrolobium roseum while rounded epidermal cells were observed in Viola stocksii. The anomocytic stomata type was observed in Argrolobium roseum while actinocytic was noticed in Viola stocksii. The pollen of studied species appeared as tricolporate showing reticulate exine sculpturing in Argrolobium roseum while fine perforations were recorded in Viola stocksii. Furthermore, quantitative analysis of phenols, flavonoids, and antioxidant activity showed high flavonoid and phenol content in Argyrolobium roseum as compared with Viola stocksii. It was observed that Argyrolobium roseum was discriminated from the Viola stocksii based on the leaf and pollen micromorphological traits by using LM and SEM techniques. It was concluded that LM and SEM techniques were found useful for the quality assurance of botanicals and their authentication.
Biochar impacts on nutrient dynamics in a subtropical grassland soil: 1. Nitrogen and phosphorus leaching
Authors: Lu Yanyan , Silveira Maria Lucia , O'Connor George A. , Vendramini Joao M. B. , Erickson John E. , Li Yuncong C. , Cavigelli Michel
Published: August 2020

Despite the numerous benefits of biosolids, concerns over nutrient losses restrict the extent to which biosolids can be beneficially reused. We evaluated the effectiveness of biochar in controlling the lability of nutrients in agricultural land. This study was designed to investigate the potential impacts of co‐applying biochar with biosolids or inorganic fertilizer on N and P leaching losses. A companion paper focuses on greenhouse gas responses. Nutrients were surface applied as biosolids (aerobically digested Class B) and inorganic fertilizer (ammonium nitrate and triple superphosphate) to an established perennial pasture at equivalent annual rates typical of field practices. Biochar was applied at an annual rate of 20 Mg ha−1. Leachate N and P were monitored using passive‐capillary drainage lysimeters. Results demonstrated significant temporal variability in leachate N and P, with larger pulses generally occurring during periods of high water table levels or after intensive rainfall. Inorganic fertilizer generally resulted in greater leachate N and P losses than biosolids. No differences in leachate N and P losses between biosolids and control were observed. Approximately 1% of applied N was lost via leaching from biosolids treatments vs. 16% for inorganic fertilizer. Regardless of the P source, negligible (0.1–0.2% of applied P), cumulative P leaching occurred during the 3‐yr study. Biochar had no effect on P leaching but reduced N leaching from treatments receiving inorganic fertilizer by 60%. Prudent nutrient management is possible even on biosolids‐amended Spodosols with high water tables.
Impact of stacked conservation practices on phosphorus and sediment export at the catchment scale
Authors: Law Ji Yeow , Brendel Conrad , Long Leigh Ann , Helmers Matthew , Kaleita Amy , Soupir Michelle
Published: August 2020

Best management practices (BMPs) are effective in reducing nutrient and sediment export, but further understanding of the benefits of the stacked BMPs is needed. This catchment‐scale study was established to evaluate the impact of hydrology and BMPs on phosphorus (P) and sediment losses. Two adjacent catchments, one with a lower level of BMP adoption (Low‐BMP #11) and one with a higher level (High‐BMP #12), were compared for total P (TP) and total suspended solids (TSS) export. The BMPs include nutrient management plans, reduced tillage, grassed waterways, terraces, and perennial vegetation. The TP event‐flow‐weighted (EFW) concentration was significantly higher at Low‐BMP #11 (0.293 mg L−1) than at High‐BMP #12 (0.069 mg L−1). There was no significant difference in TP base‐flow‐weighted (BFW) concentrations between Low‐BMP #11 (0.035 mg L−1) and High‐BMP #12 (0.037 mg L−1). The TSS‐EFW (148.0 vs. 18.6 mg L−1) and TSS‐BFW (13.3 vs. 6.9 mg L−1) concentrations were also higher at Low‐BMP #11 than at High‐BMP #12. High‐BMP #12 had lower TP (0.36 vs. 0.59 kg ha−1 yr−1) and TSS (253 vs. 1,961 kg ha−1 yr−1) loading than Low‐BMP #11. The lower TP export at High‐BMP #12 was likely attributed to the effectiveness of stacked erosion control BMPs and nutrient management plans. Overall, lower P and sediment loading was observed when a greater areal extent of stacked practices was implemented at the catchment level. This finding provides vital information to encourage wider BMP adoption at the watershed scale.
Biochar impacts on nutrient dynamics in a subtropical grassland soil: 2. Greenhouse gas emissions
Authors: Lu Yanyan , Silveira Maria Lucia , Cavigelli Michel , O'Connor George A. , Vendramini Joao M. B. , Erickson John E. , Li Yuncong C.
Published: August 2020

Land application of biochar reportedly provides many benefits, including reduced risk of nutrient transport, greenhouse gas (GHG) emission mitigation, and increased soil C storage, but additional field validation is needed. We evaluated the effectiveness of biochar in controlling the lability of nutrients in agricultural land. This study was designed to evaluate the impacts of biochar co‐applied with various N and P sources on GHG fluxes from a subtropical grassland. Nutrients (inorganic fertilizer and aerobically digested Class B biosolids) were surface applied at a rate of 160 kg plant available N ha−1 yr−1 with or without biochar (applied at 20 Mg ha−1). Greenhouse gas (CO2, CH4, and N2O) fluxes were assessed using static chambers and varied significantly, both temporally and with treatments. Greenhouse gas fluxes ranged from 1,247 to 23,160, −0.7 to 42, and −1.4 to 376 mg m−2 d−1 for CO2, N2O, and CH4, respectively. Results of the 3‐yr field study demonstrated strong seasonal variability associated with GHG emissions. Nutrient source had no effect on soil CO2 and CH4 emissions, but annual and cumulative (3‐yr) N2O emissions increased with biosolids (8 kg N2O ha−1 yr−1) compared with inorganic fertilizer (5 kg N2O ha−1 yr−1) application. Data suggested that environmental conditions played a more important role on GHG fluxes than nutrient additions. Biochar reduced CO2 emissions modestly (<9%) but had no effects on N2O and CH4 emissions.
Prognosis Prediction in Initially Diagnosed Multiple Myeloma Patients Using Intravoxel Incoherent Motion‐Diffusion Weighted Imaging and Multiecho Dixon Imaging
Authors: Jo Aram , Jung Joon‐Yong , Lee So‐Yeon , Lee Seung Eun , Park Hyerim , Lee Sung‐Eun , Min Chang‐Ki
Published: August 2020

Background

Multiparametric MRI provides complementary information for the diagnosis and management of multiple myeloma (MM).

Purpose

To evaluate the association of prognostic factors of MM and parameters derived from intravoxel‐incoherent motion diffusion‐weighted imaging (IVIM‐DWI) and multiecho (ME) Dixon.

Study Type

Retrospective.

Population

In all, 78 MM patients.

Field Strength/Sequences

T1‐weighted turbo spin‐echo sequences (TSE), IVIM‐DWI, ME 3D gradient echo sequence with multistep adaptive fitting at 3T.

Assessment

The region of interest (ROI) on the vertebral body was independently measured on four parametric maps (Dslow, Dfast and perfusion fraction [f], and proton‐density fat‐fraction [Ff] maps) by two readers. All patients were categorized into three groups based on the International Staging System (ISS).

Statistical Tests

Three groups were compared using analysis of variance (ANOVA) and post‐hoc tests with Bonferroni correction. Logistic regression analysis was performed to predict the advancement of disease (early vs. advanced). Principal component analysis (PCA) was used to find the deterministic parameters.

Results

Dslow and Ff were significantly different among ISS‐1 (n = 38), ISS‐2 (n = 22), and ISS‐3 (n = 18) groups in both readers: 0.36, 0.41, and 0.58 × 10−3 mm2/s for Dslow (P < 0.05), and 46%, 30%, and 15% for Ff (P < 0.05) in reader 1; 0.34, 0.41, and 0.58 × 10−3 mm2/s for Dslow (P < 0.05), 43%, 27%, and 13.2% for Ff (P < 0.05) in reader 2, respectively. Dfast between ISS‐3 and the other groups was significantly different in one reader only: 2.03, 2.29, and 2.85 × 10−3 mm2/s (P < 0.05). There was no significant difference in f among the groups in both readers. Logistic regression by stepwise selection indicated Ff as the single most significant factor for differentiating early and advanced stages of MM with an accuracy of 76% and area under the curve (AUC) of 0.83 (P < 0.05). PCA revealed Ff, and Dslow as the deterministic parameters, with a cumulative proportion of 0.84.

Data Conclusion

D slow and Ff are associated with the prognostic factor of MM.

Level of Evidence 3

Technical Efficacy Stage 5.

J. MAGN. RESON. IMAGING 2021;53:491–501.
Behavioral manipulation—key to the successful global spread of the new coronavirus SARS‐CoV‐2?
Authors: Bouayed Jaouad , Bohn Torsten
Published: August 2020

Human‐severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) interaction can have an array of various outcomes—it could be mortal, morbid or merely carrying minor health consequences. The very rapid global spread has raised the issue whether there are further multi‐dimensional consequences of SARS‐CoV‐2 infection on human behavior, the key of its transmission. During the coronavirus crisis, odd, abnormal, and irresponsible behavior has been reported in coronavirus disease 2019 (COVID‐19) individuals, particularly in super‐spreaders, that is, persons with a high viral load, thus constituting also super‐emitters. Indeed, cases of infected persons ignoring self‐confinement orders, intentionally disregarding physical distancing and multiplying social interactions, or even deliberately sneezing, spitting or coughing were reported. While it is known that some other viruses, such as rabies and even influenza do change human behavior, this remains unclear for SARS‐CoV‐2. In this perspective, we highlight the possibility that COVID‐19 is facilitated by altered human social behavior that benefits SARS‐CoV‐2 transmission, through showcasing similar virus‐induced changed behavior by other pathogens and relating this to reports from the gray literature.
Rainfall and streamflow extreme events in the São Francisco hydrographic region
Authors: Oliveira Danilo Henrique Morais Castro , Lima Kellen Carla , Spyrides Maria Helena Constantino
Published: August 2020

Extreme rainfall and streamflow events are becoming increasingly more relevant to discussions concerning potential climate changes on planet earth. In most cases, impacts related to the occurrence of such phenomena can be amplified due to the lack of planning and structure. In this context, the main objective of the study is to estimate the period and level of return of intense rainfall events in homogeneous subregions of the São Francisco hydrographic region, as well as to define which of these subregions are most vulnerable to the recurrence of these episodes. We used rainfall data from 105 rain gauges and streamflow data from 103 stream gauges comprising the years from 1988 to 2017. Through cluster analysis, four homogeneous rainfall subregions were defined and validated by the silhouette index, capable of identifying misallocated stations in the clustering process. A generalized Pareto distribution from the extreme value theory was used to calculate the period and level of return of intense rainfall events in each subregion. We then related the retrieved estimates with information about the drainage network, streamflow, land use and occupation, and socioeconomic and demographic factors in the watershed region. Results indicated the existence of subregions vulnerable to hydrological and geological processes intensified due to human activity and the recurrence of hydrometeorological phenomena. The scenarios found for the recurrence of intense rainfall events indicated the severity to which some subregions may be subjected, moreover, they reinforce the need for the development of public policies for the prevention and minimization of impacts.
Facile Hydrothermal Synthesis of Hierarchical Sodium P Zeolite as a Nonphosphate Detergent Builder
Authors: Koohsaryan Esmat , Anbia Mansoor , Sepehrian Mohammad , Maghsoodlu Mohammad
Published: August 2020

This study reports the preparation of hierarchical NaP zeolite with the aim of obtaining a non‐phosphate detergent builder as an alternative for environmental remediation from eutrophication phenomenon. Hierarchically structured NaP zeolite was easily synthesized hydrothermally and under different syntheses conditions. Samples were characterized using several standard techniques such as X‐ray diffraction (XRD), scanning electron microscopy (SEM), Fourier transform infrared (FT‐IR) spectroscopy, and N2 adsorption–desorption analysis. Three powder detergents were prepared by mixing main components such as linear alkylbenzene sulfonate, sodium sulfate, sodium silicate, and sodium carbonate as well as different amounts of as‐synthesized zeolite and sodium tripolyphosphate in the detergent formulation as potential detergency builders. Some different detergency tests as pH value, water insolubility, foam height, moisture content, alcohol insolubility, and surface tension measurement were carried out for all synthetic detergent samples and two commercial ones. The results demonstrated that the high cleaning performance of the powders was obtained as using eco‐friendly zeolite builders in comparison with phosphate‐based commercial and synthetic detergent samples.
Critical number of lymph node involvement in esophageal and gastric cancer and its impact on long‐term survival—A single‐center 8‐year study
Authors: Askari Alan , Munster Alex B. , Jambulingam Periyathambi , Riaz Amjid
Published: August 2020

Background

Nodal disease in esophageal and gastric cancer is associated with poor survival.

Objectives

To determine the critical level of lymph node involvement where survival becomes significantly compromised.

Methods

Survival analyses using multivariable Cox regression and receiver operator characteristics (ROC) were undertaken to determine what number of positive lymph nodes were most sensitive and specific in predicting survival.

Results

A total of 317 patients underwent esophagectomy (n = 190, 59.9%) and gastrectomy (n = 127, 40.1%) for adenocarcinoma. At multivariable analyses, four nodes positivity (irrespective of T‐category) was associated with nearly a fivefold increased risk of mortality when compared to node‐negative patients (hazard ratio [HR], 4.9; interquartile range 2.0‐11.5; P < .001). A positive ratio of up to 50.0% was not associated with worse survival than having four nodes positive (HR, 4.6; 95% confidence interval, 2.6‐8.1; P < .001). ROC analysis demonstrated four lymph nodes positive to have a sensitivity of 80.5%, a specificity of 60.1%, and an accuracy of 77.8 (P < .001).

Conclusion

The absolute number of nodes positive for cancer is more important than the proportion of positive nodes in predicting survival in esophageal/gastric cancer. Four positive lymph nodes are associated with a fivefold increase in mortality. Beyond this, increasing numbers of positive lymph nodes make no appreciable difference to survival.
Innate inflammatory markers for predicting survival in retroperitoneal sarcoma
Authors: Netanyahu Yael , Gerstenhaber Fabian , Shamai Sivan , Sher Osnat , Merimsky Ofer , Klausner Joseph M. , Lahat Guy , Nizri Eran
Published: August 2020

Introduction

Existing prognostic tools for retroperitoneal sarcomas (RPS) utilize parameters that can be accurately determined only postoperatively. This study evaluated the application of the neutrophil‐to‐lymphocyte ratio (NLR) and C‐reactive protein (CRP) levels for predicting prognosis in primary RPS.

Materials and Methods

We retrospectively analyzed our database of patients with primary RPS operated between 2008 and 2018. The NLR was calculated from preoperative blood tests and its association with outcomes was determined.

Results

The NLR values of 78 suitable patients were analyzed. Patients were classified in the NLR‐high group if the NLR was ≥2.1. High‐grade tumors were more common in the NLR‐high group (71.6% vs 48%, P = .02). NLR‐high patients had impaired overall survival (OS) and progression‐free survival (PFS) compared to NLR‐low patients (median OS not reached vs 74 months 95% confidence interval [CI]: 21.6‐126.4, P = .03; median PFS not reached vs 48 months 95% CI: 6.5‐98.6, P = .06, respectively). Multivariate analysis showed statistical significance only for PFS but not for OS (hazard ratio [HR] = 4.1, P = .03; HR = 2.3, P = .3). Patients with low CRP levels had improved OS and PFS.

Conclusions

The NLR may serve as a preoperative, easily derived marker for prognosis in RPS. Serum biomarkers may prove useful in these large and spatially heterogeneous tumors.
Prevalence and Correlates of Mental Health Problems in Norwegian Peacekeepers 18–38 Years Postdeployment
Authors: Gjerstad Christer Lunde , Bøe Hans Jakob , Falkum Erik , Martinsen Egil Wilhelm , Nordstrand Andreas Espetvedt , Tønnesen Arnfinn , Reichelt Jon Gerhard , Lystad June Ullevoldsæter
Published: August 2020

Peacekeeping missions involve experiences that may impact the mental health of participating soldiers. However, research on the long‐term mental health consequences of peacekeeping is sparse. The present study aimed to find the prevalence of mental health problems (MHPs), possible MHP predictors, and associations between predictors and MHPs in Norwegian peacekeepers 18–38 years after deployment to a United Nations peacekeeping mission. We used data from a cross‐sectional, postdeployment survey of Norwegian peacekeepers who served in Lebanon between 1978 and 1998 (N = 10,605). Participants were assessed for posttraumatic stress disorder (PTSD); anxiety; depression; insomnia; alcohol misuse; drug misuse; and exposure to pre‐, peri‐, and postdeployment stressors. Logistic regressions were executed to explore key variables associated with MHPs. Total MHP prevalence was 15.1%, 95% CI [14.4, 15.8]. The estimates for specific disorders were 0.1% for drug misuse, 3.4% for alcohol misuse, 4.0% for depression, 6.2% for PTSD, 6.4% for anxiety, and 9.3% for insomnia. Postdeployment stressors, OR = 1.91, 95% CI [1.79, 2.04]; employment status, OR = 1.41, 95% CI [1.33, 1.48]; and traumatic exposure during deployment, OR = 1.11, 95% CI [1.09, 1.12], were positively related to PTSD, χ2(17, N = 8,568) = 1,791.299, p < .001. Similar patterns were found for the other MHPs. Considering that most participants (84.9%) reported low symptom levels, our findings challenge the widespread public perception that most peacekeepers have MHPs. Moreover, our results indicate that future peacekeepers should be prepared for challenges they may face not only during deployment but also in the years following their homecoming.
Ultrasound Features of Fetal Anemia Lessons From Hemoglobin Bart Disease
Authors: Thammavong Keooudone , Luewan Suchaya , Wanapirak Chanane , Tongsong Theera
Published: August 2020

Insights gained from this review are as follows: (1) Ultrasound is highly effective in early detection of fetal hemoglobin (Hb) Bart disease. (2) The most sensitive parameters in predicting Hb Bart anemia appear to be the cardiac diameter–to–thoracic diameter ratio, middle cerebral artery peak systolic velocity, and placental thickness. (3) Several other ultrasound markers are helpful in increasing specificity, such as hepatosplenomegaly. (4) Hydrops fetalis is not a consequence of heart failure but rather of hypervolemia and high vascular permeability of fetuses, whereas heart failure is a very late consequence of a long‐standing overworked heart. (5) Management guidelines for fetuses at risk of Hb Bart disease are proposed.
Mode‐specific pressure effects on the relaxation of an excited nitromethane molecule in an argon bath
Authors: Rivera‐Rivera Luis A. , Wagner Albert F.
Published: August 2020

The vibrational and rotational mode‐specific relaxations of CH3NO2 with 50 kcal/mol of initial internal energy in an argon bath is computed at 300 K at pressures of 10‐400 atm. This work uses archived information from our previously published [J. Chem. Phys. 142, 014303 (2015)] molecular dynamics simulations and employs our previous published [J. Chem. Phys. 151, 034303 (2019)] method for projecting time‐dependent Cartesian velocities onto normal mode eigenvectors. The computed relaxations cover three types of energies: vibrational, rotational, and Coriolis. In general, rotational and Coriolis relaxations in all modes are initially fast followed by an orders of magnitude slower relaxation. For all modes, that slower relaxation rate is approximately comparable to the vibrational relaxation rate. For all three types of energies, there are small‐scale mode‐to‐mode variations. Of particular prominence is the exceptionally fast relaxation shared in common by the external rotation about the CN axis, the internal hindered rotation of the CH3 group relative to the NO2 group, and the symmetric stretch of the CH3 group.
Multifactorial Characteristics of Pediatric Dizziness and Imbalance
Authors: Wang Alicia , Zhou Guangwei , Lipson Sophie , Kawai Kosuke , Corcoran Meghan , Brodsky Jacob R.
Published: August 2020

Objectives

To examine the relative prevalence of individual diagnoses in children and adolescents presenting with dizziness and/or imbalance, and to assess the proportion of patients assigned multiple contributing diagnoses.

Study Design

Retrospective cohort study.

Methods

We retrospectively reviewed our internal database of all patients seen at our pediatric vestibular program between January 2012 and March 2019 to determine the incidence of common diagnoses and groups of diagnoses for patients ages 21 or younger.

Results

One thousand twenty‐one patients were included with a mean age of 12.5 ± 4.9 years (range: 9 months–21 years). Of this total, 624 patients were female and 397 were male. Common diagnoses included vestibular migraine (VM; 35.0%), benign paroxysmal positional vertigo (BPPV; 21.6%), primary dysautonomia (15.7%), anxiety disorder (13.5%), and persistent postural perceptual dizziness (PPPD; 11.2%). A high proportion of patients (44.4%) received multiple contributing diagnoses. VM was frequently diagnosed with BPPV or PPPD, and 22 patients were diagnosed with all three concurrently.

Conclusion

The causes of dizziness and imbalance in the pediatric population are diverse, and many patients have multiple diagnoses that are often interrelated. It is important that providers recognize that the causes of vestibular symptoms in children and adolescents may be multifactorial and may span across multiple specialties.

Level of Evidence

4 Laryngoscope, 131:E1308–E1314, 2021
Detecting the short term impact of soil and water conservation practices using stage as a proxy for discharge—A case‐study from the Tana sub‐basin, Ethiopia
Authors: Weldegebriel Liya , Kruskopf Mikaela , Thompson Sally Elizabeth , Tebeje Kibret
Published: August 2020

Efforts to tackle land degradation worldwide have spurred the adoption of soil and water conservation (SWC) practices intended to reduce surface runoff and erosion. Despite their widespread implementation, missing or incomplete monitoring remains a pervasive problem preventing evaluation of how well SWC practices meet these aims. When using runoff and sediment loss as main parameters to evaluate SWC efficacy, the key metrics are the production of flow per unit rainfall (runoff ratio), and exported sediment (sediment concentration). We develop a method to assess changes in these metrics in the absence of a flow rating curve, using more complete and reliable measurements of stage (flow depth). We apply these methods to datasets with incomplete rating curve collected from five watersheds included in the Tana and Beles Integrated Water Resource Development Project (TBIWRDP) in the Abay (Blue Nile) basin, Ethiopia. Changes in runoff ratio and sediment concentration relative to the first year of treatment varied by season. In the long wet season (Kiremt) that generates most runoff and erosion, reductions in runoff ratio and in sediment concentration occurred in four watersheds. Reductions in the runoff ratio were directly proportional to the areal density of SWC treatments in the watersheds, suggesting that SWC treatments were effective in controlling runoff and erosion.We suggest that stage and sediment concentration information can be used to assess watershed responses to SWC treatments. Focusing on these measurements, may facilitate the design of reliable and affordable monitoring programs, and ultimately facilitate improved financing approaches based on reasonable estimates of likely SWC practice performance.
Diagnosing nasal obstruction and its common causes using the nasal acoustic device: A pilot study
Authors: Li Chia‐Hung , Kaura Anika , Tan Calvin , Whitcroft Katherine L. , Leung Terence S. , Andrews Peter
Published: August 2020

Objectives

There is a need to develop a medical device which can accurately measure normal and abnormal nasal breathing which the patient can better understand in addition to being able to diagnose the cause for their nasal obstruction.

The aim is to evaluate the accuracy of the nasal acoustic device (NAD) in diagnosing the common causes for nasal obstruction and diagnosing normal and abnormal (nasal obstruction) nasal breathing.

Methods

This pilot study recruited 27 patients with allergic rhinitis (AR), chronic rhinosinusitis (CRS), and a deviated nasal septum (DNS) which represents the common causes for NO and 26 controls (with normal nasal breathing). Nasal breathing sounds were recorded by the NAD akin to two small stethoscopes placed over the left and right nasal ala. The novel outcome metrics for the NAD include inspiratory nasal acoustic score (INA) score, expiratory nasal acoustic (ENA) score and the inspiratory nasal obstruction balance index (NOBI). The change in acoustic score following decongestant is key in this diagnostic process.

Results

Pre‐decongestant ENA score was used to detect the presence of nasal obstruction in patients compared to controls, with a sensitivity of 0.81 (95% CI: 0.66‐0.96) and a specificity of 0.77 (0.54‐1.00). Post‐decongestant percentage change in INA score was used to identify the presence of AR or CRS, with a sensitivity of 0.87 (0.69‐1.00) and specificity of 0.72 (0.55‐0.89) for AR; and a sensitivity of 0.92 (0.75‐1.00) and specificity of 0.69 (0.52‐0.86) for CRS. Post‐decongestant inspiratory NOBI was used to identify DNS, with a sensitivity of 0.77 (0.59‐0.95) and specificity of 0.94 (0.82‐1.00).

Conclusion

We have demonstrated that the NAD can help distinguish between normal and abnormal nasal breathing and help diagnose AR, CRS, and DNS. Such a device has not been invented and could revolutionize COVID‐19 recovery telemedicine.

Level of Evidence

Diagnostic accuracy study—Level III.