bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of a Fuzzy Model for Differentiating Peanut Plant from Broadleaf Weeds Using Image Features
Authors: Bakhshipour Adel , Zareiforoush Hemad
Published: October 2020

A combination of decision tree (DT) and fuzzy logic techniques was used to develop a fuzzy model for differentiating peanut plant from weeds. Color features and wavelet-based texture features were extracted from images of peanut plant and its three common weeds. Two feature selection techniques namely Principal Component Analysis (PCA) and Correlation-based Feature Selection (CFS) were applied on input dataset and three Decision Trees (DTs) including J48, Random Tree (RT), and Reduced Error Pruning (REP) were used to distinguish between different plants. In all cases, the best overall classification accuracies were achieved when CFS-selected features were used as input data. The obtained accuracies of J48-CFS, REP-CFS, and RT-CFS trees for classification of the four plant categories namely peanut plant, Velvetleaf, False daisy, and Nicandra, were 80.83%, 80.00% and 79.17% respectively. Along with these almost low accuracies, the structures of the decision trees were complex making them unsuitable for developing a fuzzy inference system. The classifiers were also used for differentiating peanut plant from the group of weeds. The overall accuracies on training and testing datasets were respectively 95.56% and 93.75% for J48-CFS; 92.78% and 91.67% for REP-CFS; and 93.33% and 92.59% for RT-CFS DTs. The results showed that the J48-CFS and REP-CFS were the most appropriate models to set the membership functions and rules of the fuzzy classifier system. Based on the results, it can be concluded that the developed DT-based fuzzy logic model can be used effectively to discriminate weeds from peanut plant in the form of machine vision-based cultivating systems.
Combination of phenotype and polygenic risk score in breast cancer risk evaluation in the Spanish population: A case –control study
Authors: Trivino juan , Ceba A , Rubio-Solsona E , Serra D , Sanchez-Guiu I , Ribas G , Rosa R , Cabo M , Bernad L , Pita G , Gonzalez-Neira A , Legarda G , Diaz JL , García-Vigara A , Martínez-Aspas A , Escrig M , Bermejo B , Eroles P , Ibáñez J , Salas D , Julve A , Cano A , Lluch A , Miñambres R , Benitez Javier
Published: October 2020

Background: In recent years, the identification of genetic and phenotypic biomarkers of cancer for prevention, early diagnosis and patient stratification has been a main objective of research in the field. Different multivariable models that use biomarkers have been proposed for the evaluation of individual risk of developing breast cancer. Methods: This is a case control study based on a population-based cohort. We describe and evaluate a multivariable model that incorporates 92 Single-nucleotide polymorphisms (SNPs) and five different phenotypic variables and which was employed in a Spanish population of 642 healthy women and 455 breast cancer patients. Results: Our model allowed us to stratify two groups: high and low risk of developing breast cancer. The 9th decile included 1% of controls vs 9% of cases, with an odds ratio (OR) of 12.9 and a p-value of 3.43E-07. The first decile presented an inverse proportion: 1% of cases and 9% of controls, with an OR of 0.097 and a p-value of 1.86E-08. Conclusions: These results indicate the capacity of our multivariable model to stratify women according to their risk of developing breast cancer. The major limitation of our analysis is the small cohort size. However, despite the limitations, the results of our analysis provide proof of concept in a poorly studied population, and opens up the possibility of using this method in the routine screening of the Spanish population.
Does chemotherapy or radiotherapy affect the postoperative complication in patients who underwent immediate breast reconstruction with tissue expander?
Authors: Jung Sung Mi , Jeon Byung-Joon , Woo Jinsun , Ryu Jai Min , Lee Se Kyung , Chae Byung-Joo , Yu Jonghan , Kim Seok Won , Nam Seok Jin , Bang Sa Ik , Mun Goo-Hyun , Pyon Jai-Kyong , Lee Jeong Eon
Published: October 2020

Background: Immediate breast reconstruction with tissue expander in patients who were expected to receive adjuvant therapy, such as chemotherapy or radiotherapy, has been a topic of debate. Postoperative complications from tissue expander procedures can delay the timing of adjuvant treatment and subsequently increase the probability of recurrence. The purpose of this study was to identify the impact of chemotherapy and radiotherapy on postoperative complications in patients who underwent immediate reconstruction (IR) using tissue expander.Methods: We conducted a retrospective study of 1,081 breast cancer patients who underwent mastectomy and IR using tissue expander insertion between 2012 and 2017 in Samsung Medical Center. The patients were divided into two groups based on complications (complication group vs. no complication group). Complication group was regarded to have surgical removal or conservative treatment based on clinical findings such as infection, capsular contracture, seroma, hematoma, rupture, malposition, tissue viability, or cosmetic problem. The complication group had 59 patients (5.5%) and the no complication group had 1,022 patients (94.5%). Results: In univariate analysis, adjuvant radiotherapy and adjuvant chemotherapy were significantly associated with postoperative complications. In multivariate analysis, however, only higher pathologic N stage was significantly associated with postoperative complications (p < 0.001). Chemotherapy (p = 0.775) or radiotherapy (p = 0.825) were not risk factors for postoperative complications.Conclusions: IR with tissue expander after mastectomy may be a treatment option even when the patients are expected to receive adjuvant chemotherapy or radiotherapy. These results will aid patients who are concerned about the complications of IR caused by chemotherapy or radiotherapy determine whether or not to have IR.
Gap-analysis of DNA barcoding in ERMS reference libraries for ascidians and cnidarians
Authors: Paz Guy , Rinkevich Baruch
Published: October 2020

BackgroundAll-inclusive DNA barcoding libraries in the storage and analysis platform of the BOLD (Barcode of Life Data) system are essential for the study of the marine biodiversity and are pertinent for regulatory purposes, including ecosystem monitoring and assessment, such as in the context of the EU Water Framework Directive (WFD) and the Marine Strategy Framework Directive (MSFD). Here we investigate knowledge gaps in the lists of DNA barcoded organisms within two inventories, Cnidaria (Anthozoa and Hydrozoa) and Ascidiacea from the reference libraries of the European Register of Marine Species (ERMS) dataset (402 ascidians and 1200 cnidarian species). ERMS records were checked species by species, against publicly available sequence information and other data stored in BOLD system. As the available COI barcode data adequately covers just a small fraction of the ERMS reference library, it is of importance to employ quality control on existing data, to close the knowledge gaps and purge errors off BOLD. ResultsResults revealed that just 22.9% and 29.2% of the listed ascidians and cnidarians species, respectively, are BOLD barcodes of which, 58.4% and 52.3% of the seemingly barcoded species, respectively, were noted to have complete BOLD pages. Thus, only 11.44% of the tunicate and 17.07% of the cnidarian data in the ERMS lists are of high quality. Deep analyses revealed seven common types of gaps in the list of the barcoded species in addition to a wide range of discrepancies and misidentifications, discordances and errors primarily in the GenBank mined data as with the BINs assignments, among others. ConclusionsGap knowledge in barcoding of important taxonomic marine groups exist and in addition, quality management elements (quality assurance and quality control) were not employed when using the list for national monitoring projects, for regulatory compliance purposes and other purposes. Even though BOLD is the most trustable DNA barcoding reference library, worldwide projects of DNA barcoding are needed to close these gaps of mistakes, verifications, missing data and unreliable sequencing labs. Tight quality control and quality assurance is important to close the knowledge gaps of Barcoding of the European recommended ERMS reference library.
Left atrial functional assessment and mortality in patients with severe aortic stenosis with sinus rhythm
Authors: Ferreira João , Gonçalves Valdirene , Marques-Alves Patrícia , Martins Rui , Monteiro Sílvia , Teixeira Rogério , Gonçalves Lino
Published: October 2020

Background: Aortic valve stenosis (AS) is the most common primary valvular heart disease leading to surgical or percutaneous aortic valve replacement (AVR) in Europe and its prevalence keeps growing. While other risk factors in severe AS are well documented, little is known about the prognostic value of left atrial (LA) function in AS. Our aim is to clarify the relationship between LA function measured at severe AS diagnosis (evaluated by means of volumetric assessment) and all-cause mortality during follow-up.

Methods: We retrospectively evaluated patients diagnosed with severe AS for the first time at our echocardiography laboratory. We evaluated LA reservoir, conduit and pump function by measuring LA volumes at different timings of cardiac cycle. Treatment strategy was decided according to heart team consensus and patient decision. We divided patients into groups according to terciles of LA reservoir, conduit and pump function. Primary outcome was defined by the occurrence of all-cause mortality during follow-up.

Results: A total of 408 patients were included in the analysis, with a median follow-up time of 45 months (interquartile range 54 months). 57.9% of patients underwent AVR and 44.9% of patients registered the primary outcome during follow-up. Left atrial emptying fraction (LAEF) was the best LA functional parameter and the best overall parameter in discriminating primary outcome (AUC 0.845, 95%CI 0.81-0.88, P <0.001). After adjustment for clinical, demographic and echocardiographic variables, cumulative survival of patients with LAEF <37% and LAEF 37 to 53% relative to patients with LAEF ≥54% remained significantly lower (HR 13.91, 95%CI 6.20-31.19, P <0.001 and HR 3.40, 95%CI 1.57-7.37, P =0.002, respectively). After adjustment for AVR, excess risk of LAEF <37% and LAEF 37 to 53% relative to LAEF ≥54% remained significant (HR 11.71, 95%CI 5.20-26.40, P <0.001 and HR 3.59, 95%CI 1.65-7.78, P =0.001, respectively).

Conclusions: In patients with a first diagnosis of severe AS, LA function, evaluated by means of volumetric assessment, is an independent predictor of all-cause mortality and a more potent predictor of death compared to classical severity parameters. These data can be useful to identify high-risk patients who might benefit of AVR.
Effectiveness of the Close Collaboration with Parents intervention on parent-infant closeness in hospital
Authors: He Felix , Axelin Anna , Ahlqvist-Björkroth Sari , Raiskila Simo , Löyttyniemi Eliisa , Lehtonen Liisa
Published: October 2020

Background: Parent-infant closeness during hospital care of newborns has many benefits for both infants and parents. We developed an educational intervention for neonatal staff, Close Collaboration with Parents, to increase parent-infant closeness during hospital care. The aim of this study was to evaluate the effectiveness of the intervention on parent-infant closeness in nine hospitals in Finland. Methods: Parents of hospitalized infants were recruited in the hospitals during 3-month periods before and after the Close Collaboration with Parents intervention. The data were collected using daily Closeness diaries. Mothers and fathers separately filled in the time they spent in the hospital and the time of skin-to-skin contact with their infant during each hospital care day until discharge. Statistical analyses were done using a linear model with covariates. Results: Diaries were kept before and after the intervention by a total of 170 and 129 mothers and 126 and 84 fathers, respectively. Either parent was present on average 453 minutes per day before the intervention and 620 minutes after the intervention in the neonatal unit. In the adjusted model, the increase was 99 minutes per day (p=0.0007). The infants were in skin-to-skin contact on average 76 minutes per day before the intervention and 114 minutes after the intervention. In the adjusted model, skin-to-skin contact increased by 24 minutes per day (p=0.0405). Conclusion: The Close Collaboration with Parents intervention increased parents’ presence and skin-to-skin contact in nine hospitals. This study suggests that parent-infant closeness may be one mediating factor explaining benefits of parenting interventions.
Choroidal vessel density in unilateral hyperopic amblyopia using en-face optical coherence tomography
Authors: Araki Syunsuke , Miki Atsushi , Goto Katsutoshi , Yamashita Tsutomu , Yoneda Tsuyoshi , Fujiwara Atsushi , Haruishi Kazuko , Ieki Yoshiaki , Kiryu Junichi , Maehara Goro , Yaoeda Kiyoshi
Published: October 2020

Background Structural changes of the choroid, such as choroidal thickening, have been indicated in amblyopic eyes with hyperopic anisometropia as compared to fellow or healthy eyes. The purpose of the present study was to investigate choroidal vascular density (CVD) in children with unilateral hyperopic amblyopia.Methods This study included 88 eyes of 44 patients with unilateral amblyopia due to hyperopic anisometropia with or without strabismus and 29 eyes of 29 age-matched normal controls. The CVD of Haller's layer was quantified from en-face images constructed by 3-dimensional swept-source optical coherence tomography images flattened relative to Bruch's membrane. The analysis area was a 3×3-mm square of macula after magnification correction. Relationships between CVD and other parameters [best-corrected visual acuity (BCVA), refractive error and subfoveal choroidal thickness (SFCT)] were investigated, and CVDs were compared between amblyopic, fellow, and normal control eyes.Results Mean CVD was 59.11 ± 0.66% in amblyopic eyes, 59.23 ± 0.81% in fellow eyes, and 59.29 ± 0.74% in normal control eyes. CVD showed a significant positive relationship with SFCT (p=0.004), but no relationships with other parameters. No significant differences in CVD were evident among amblyopic, fellow, and normal control eyes after adjusting for SFCT (p=0.502).Conclusions CVD was unrelated to BCVA, and CVD did not differ significantly among amblyopic, fellow and normal control eyes. These results suggest that the local CVD of Haller's layer is unaffected in unilateral hyperopic amblyopic eyes.
Repeatability of two semi-automatic artificial intelligence approaches for tumor segmentation in PET
Authors: Pfaehler Elisabeth , Mesotten Liesbet , Kramer Gem , Thomeer Michiel , Vanhove Karolien , de Jong Johan , Adriaensens Peter , Hoekstra Otto S. , Boellaard Ronald
Published: October 2020

Background: Positron Emission Tomography (PET) is routinely used for cancer staging and treatment follow up. Metabolic active tumor volume (MATV) as well as total MATV (TMATV - including primary tumor, lymph nodes and metastasis) and/or total lesion glycolysis (TLG) derived from PET images have been identified as prognostic factor or for the evaluation of treatment efficacy in cancer patients. To this end, a segmentation approach with high precision and repeatability is important. However, the implementation of a repeatable and accurate segmentation algorithm remains an ongoing challenge. Methods: In this study, we compare two semi-automatic artificial intelligence (AI) based segmentation methods with conventional semi-automatic segmentation approaches in terms of repeatability. One segmentation approach is based on a textural feature (TF) segmentation approach designed for accurate and repeatable segmentation of primary tumors and metastasis. Moreover, a Convolutional Neural Network (CNN) is trained. The algorithms are trained, validated and tested using a lung cancer PET dataset. The segmentation accuracy of both segmentation approaches is compared using the Jaccard Coefficient (JC). Additionally, the approaches are externally tested on a fully independent test-retest dataset. The repeatability of the methods is compared with those of two majority vote (MV2, MV3) approaches, 41%SUVMAX, and a SUV>4 segmentation (SUV4). Repeatability is assessed with test-retest coefficients (TRT%) and intraclass correlation coefficient (ICC). An ICC>0.9 was regarded as representing excellent repeatability.Results: The accuracy of the segmentations with the reference segmentation was good (JC median TF: 0.7, CNN: 0.73) Both segmentation approaches outperformed most other conventional segmentation methods in terms of test-retest coefficient (TRT% mean: TF: 13.0%, CNN: 13.9%, MV2: 14.1%, MV3: 28.1%, 41%SUVMAX: 28.1%, SUV4: 18.1% ) and ICC (TF: 0.98, MV2: 0.97, CNN: 0.99, MV3: 0.73, SUV4: 0.81, and 41%SUVMAX: 0.68).Conclusion: The semi-automatic AI based segmentation approaches used in this study provided better repeatability than conventional segmentation approaches. Moreover, both algorithms lead to accurate segmentations for both primary tumors as well as metastasis and are therefore good candidates for PET tumor segmentation.
COVID-19 Lung CT Image Segmentation Using Deep Learning Methods: UNET Vs. SegNET
Authors: Saood Adnan , Hatem Iyad
Published: October 2020

Background: Currently, there is an urgent need for efficient tools to assess the diagnosis of COVID-19patients. In this paper, we present feasible solutions for detecting and labeling infected tissues on CT lungimages of such patients. Two structurally-different deep learning techniques, SegNet and UNET, areinvestigated for semantically segmenting infected tissue regions in CT lung images.Methods: We propose to use two known deep learning networks, SegNet and UNET, for image tissueclassification. SegNet is characterized as as scene segmentation network and UNET as a medical segmentationtool. Both networks were exploited as binary segmentors to discriminate between infected and healthy lungtissue, also as multi-class segmentors to learn the infection type on the lung. Each network is trained usingseventy-two data images, validated on ten images, and tested against the left eighteen images. Severalstatistical scores are calculated for the results and tabulated accordingly.Results: The results show the superior ability of SegNet in classifying infected/non-infected tissues comparedto the other methods (with 0:95 mean accuracy), while the UNET shows better results as a multi-classsegmentor (with 0:91 mean accuracy).Conclusion: Semantically segmenting CT scan images of COVID-19 patients is a crucial goal because it wouldnot only assist in disease diagnosis, also help in quantifying the severity of the illness, and hence, prioritize thepopulation treatment accordingly. We propose computer-based techniques that prove to be reliable asdetectors for infected tissue in lung CT scans. The availability of such a method in today’s pandemic wouldhelp automate, prioritize, fasten, and broaden the treatment of COVID-19 patients globally.
Boerhaave Syndrome Due to Excessive Alcohol Consumption: Two Case Reports
Authors: Haba Yuichiro , Yano Shungo , Akizuki Hikaru , Hashimoto Takashi , Naito Toshio , Hashiguchi Naoyuki
Published: October 2020

Background: Spontaneous esophageal rupture, or Boerhaave syndrome, is a fatal disorder caused by an elevated esophageal pressure owing to forceful vomiting. Patients with Boerhaave syndrome often present with chest pain, dyspnea, and shock. We report on two patients of Boerhaave syndrome with different severities that was triggered by excessive alcohol consumption and was diagnosed immediately in the emergency room.Case presentation: The patient in case 1 complained of severe chest pain and nausea and vomited on arrival at the hospital. He was subsequently diagnosed with Boerhaave syndrome coupled with mediastinitis using computed tomography (CT) and esophagogram. An emergency operation was successfully performed, in which a 3-cm tear was found on the left-posterior wall of the distal esophagus. The patient subsequently had anastomotic leakage but was discharged 41 days later. The patient in case 2 complained of severe chest pain, nausea, vomiting, and hematemesis on arrival. He was suggested of having Boerhaave syndrome without mediastinitis on CT. The symptoms gradually disappeared after conservative treatment. Upper gastrointestinal endoscopy performed on the ninth day revealed a scar on the left wall of the distal esophagus. The patient was discharged 11 days later. In addition to the varying severity between the cases, the patient in case 2 was initially considered to have Mallory–Weiss syndrome.Conclusion: Owing to similar histories and symptoms, Boerhaave syndrome and Mallory–Weiss syndrome must be accurately distinguished by emergency clinicians. CT can be a useful modality to detect any severity of Boerhaave syndrome and also offers the possibility to distinguish Boerhaave syndrome from Mallory–Weiss syndrome.
Risk factors for osteoradionecrosis of the jaw in patients with head and neck squamous cell carcinoma
Authors: Kubota Hikaru , Miyawaki Daisuke , Mukumoto Naritoshi , Ishihara Takeaki , Matsumura Megumi , Hasegawa Takumi , Akashi Masaya , Kiyota Naomi , Shinomiya Hirotaka , Teshima Masanori , Nibu Ken‑ichi , Sasaki Ryohei
Published: October 2020

Background: To evaluate factors associated with osteoradionecrosis of the jaw (ORNJ) in patients with head and neck squamous cell carcinoma (HNSCC), focusing on jaw-related dose-volume histogram (DVH) parameters.Methods: We retrospectively reviewed the medical records of 616 patients with HNSCC treated with curative-intent or postoperative radiation therapy (RT) during 2008–2018. Patient-related (age, sex, history of smoking or alcohol use, diabetes mellitus, performance status, pre-RT dental evaluation, pre- or post-RT tooth extraction), tumor-related (primary tumor site, T-stage, nodal status), and treatment-related (pre-RT surgery, pre-RT mandible surgery, induction or concurrent chemotherapy, RT technique) variables and DVH parameters (relative volumes of the jaw exposed to doses of 10 Gy–70 Gy [V10–70]) were investigated and compared between patients with and without ORNJ. The Mann–Whitney U test was used to compare RT dose parameters. Univariate and multivariate Cox regression analyses were used to assess factors associated with ORNJ development. Kaplan–Meier analyses were performed for cumulative ORNJ incidence estimation. Results: Forty-six patients (7.5%) developed ORNJ. The median follow-up duration was 40 (range, 3–145) months. The median time to ORNJ development was 27 (range, 2–127) months. DVH analysis revealed that V30-V70 values were significantly higher in patients with than in those without ORNJ. In univariate analyses, primary tumor site, pre-RT mandible surgery, post-RT tooth extraction, and V60 >14% were identified as important factors. In multivariate analyses, V60 >14% (p=0.0065) and primary tumor site (p=0.0059) remained significant. The 3-year cumulative ORNJ incidence rates were 2.5% and 8.6% in patients with V60 ≤14% and >14%, respectively (p<0.0001), and 1.4% and 9.3% in patients with oropharyngeal or oral cancer and other cancers, respectively (p<0.0001). Conclusions: V60 >14% and oropharyngeal or oral cancer were found to be independent risk factors for ORNJ. These findings might be useful to minimize ORNJ incidence in HNSCC treated with curative RT.
WITHDRAWN: Influence of trivalent rare earth (Dy3+) ions substitution on the structural, magnetic and dielectric properties of nanosized Ni0.6Cd0.4DyxFe2‒xO4 ferrites
Authors: Dubey Hemant Kumar , Lahiri Preeti
Published: October 2020

In the present work, Ni0.6Cd0.4DyxFe2‒xO4 (x = 0.0, 0.05, 0.10, 0.15 and 0.20) nanoparticles (NPs) were synthesized by using sol-gel auto combustion method. The structural characterization was performed by XRD, FTIR, SEM, TEM and EDS analyses. XRD patterns confirmed that the pure and dysprosium substituted Ni-Cd ferrites are in single phase spinel structures, while a trace of DyFeO3 appears as a minor phase for higher concentrations (x = 0.10, 0.15 and 0.20). The Debye‒Scherrer’s method and Williamson-Hall (W-H) method were used to evaluate the crystallite sizes and lattice strain. The average crystallite size was found to be in the range from 27 to 48 nm. FT-IR confirms the formation of spinel structure. SEM images show that reduction of grain size with Dy3+ content. Elemental composition features of samples were examined by EDS. The average particles size estimated from TEM analysis are in good agreement with results obtained from the XRD. The results showed that saturation magnetization (Ms) decreases and coercivity (Hc) increases with increase in Dy3+ concentrations. The dielectric constant and the loss tangent decrease rapidly with increasing frequency and then reaches a constant value, characteristic of normal behavior of ferrites. The dielectric constant was found to decrease with increasing Dy content in Ni-Cd ferrites. Ferrite sample with Dy3+ concentration, x = 0.05 show high dielectric constant, low dielectric loss and hence can be utilized in high frequency electrical circuits.
Adults with possible food protein-induced enterocolitis syndrome with crustacean ingestion
Authors: Li Daniel Hanzhang , Wong-Pack Andrew , Macikunas Andrea Leilani , Kim Harold
Published: October 2020

Background: Food protein-induced enterocolitis (FPIES), an entity previously thought to only affect children, has been increasingly described in adults. In this study, we report a Canadian cohort of 19 adolescents and adults with recurrent non-immunoglobulin E (IgE) -mediated gastrointestinal symptoms after crustacean ingestion, consistent with FPIES. Methods: We conducted a retrospective chart review of patients in an outpatient allergy clinic from January 2005 to May 2020. Electronic records were searched using keywords for crustaceans and for symptoms consistent with FPIES. We included patients with gastrointestinal symptoms specifically to crustaceans on more than one occasion, who were 14 years or older at the time of index reaction. Exclusion criteria included symptoms suggestive of an IgE-mediated anaphylactic reaction or a likely alternative diagnosis. We identified 19 patients for our cohort who met the criteria. Results: Our cohort was 68.4% female (13) and 32.6% (6) male. The average age at first reaction to crustaceans was 34 years old with a range of 14 years to 68 years (median = 28 years; IQR = 32 years). Time from ingestion to beginning of symptoms ranged from 3 minutes to 6.5 hours, with an average of 2.8 hours (median = 2 hours; IQR = 3.25 hours). Duration of reaction ranged from less than a minute to over 48 hours, with a mean of 9.4 hours (median = 4 hours; IQR= 7.75 hours). Patients had 4.8 reactions on average; however, number of reactions ranged from 2 to 12.5 (median = 3, IQR = 3). All patients identified a “trigger” food in the crustacean group, and 12 subjects identified additional reactions to other seafood. Conclusions: This case series will better characterize and advance our understanding of this disease entity in adults. There are key differences in the presentation of FPIES in adults compared to children, namely female predominance, difference in solid food trigger, and unpredictable time course. Future studies are needed to examine the pathophysiology and natural history of adult FPIES. Specific guidelines should be developed for the diagnosis and management in adults. Trial Registration: retrospectively registered
Asphericity of tumor FDG uptake in non-small cell lung cancer: Reproducibility and implications for harmonization in multicenter studies
Authors: Rogasch Julian MM , Furth Christian , Bluemel Stephanie , Radojewski Piotr , Amthauer Holger , Hofheinz Frank
Published: October 2020

BackgroundAsphericity (ASP) of the primary tumor’s metabolic tumor volume (MTV) in FDG-PET/CT is independently predictive for survival in patients with non-small cell lung cancer (NSCLC). However, comparability between PET systems may be limited. Therefore, reproducibility of ASP was evaluated at varying image reconstruction and acquisition times to assess feasibility of ASP assessment in multicenter studies.MethodsRetrospective study of 50 patients with NSCLC (female, 20; median age, 69 years) undergoing pretherapeutic FDG-PET/CT (median, 3.7 MBq/kg; 180 s/bed position). Reconstruction used OSEM with TOF4/16 (iterations, 4; subsets, 16; in-plane filter, 2.0, 6.4 or 9.5 mm), TOF4/8 (4 it; 8 ss; filter, 2.0/6.0/9.5 mm), PSF+TOF2/17 (2 it; 17 ss; filter, 2.0/7.0/10.0 mm) or Bayesian penalized likelihood (Q.Clear; beta, 600/1750/4000). Resulting reconstructed spatial resolution (FWHM) was determined from hot sphere inserts of a NEMA IEC phantom. Data with approx. 5 mm FWHM were retrospectively smoothed to achieve 7 mm FWHM. List mode data were rebinned for acquisition times of 120/90/60s. Threshold-based delineation of primary tumor MTV was followed by evaluation of relative ASP/SUVmax/MTV differences between datasets and resulting proportions of discordantly classified cases.ResultsReconstructed resolution for narrow/medium/wide in-plane filter (or low/medium/high beta) was approx. 5/7/9 mm FWHM. Comparing different pairs of reconstructed resolution between TOF4/8, PSF+TOF2/17, Q.Clear and the reference algorithm TOF4/16, ASP differences were lowest at FWHM of 7 vs. 7 mm. Proportions of discordant cases (ASP >19.5% vs. ≤19.5%) were also lowest at 7 mm (TOF4/8, 2%; PSF+TOF2/17, 4%; Q.Clear, 10%). Smoothing of 5 mm data to 7 mm FWHM significantly reduced discordant cases (TOF4/8, 38% reduced to 2%; PSF+TOF2/17, 12% to 4%; Q.Clear, 10% to 6%) resulting in proportions comparable to original 7 mm data. Shorter acquisition time only increased proportions of discordant cases at <90s.ConclusionsASP differences were mainly determined by reconstructed spatial resolution, and multicenter studies should aim at comparable FWHM (e.g., 7 mm; determined by in-plane filter width). This reduces discordant cases (high vs. low ASP) to an acceptable proportion for TOF and PSF+TOF of <5% (Q.Clear: 10%). Data with better resolution (i.e. lower FWHM) could be retrospectively smoothed to the desired FWHM resulting in a comparable number of discordant cases.
Evaluation of Auto-Planning for Left-Side Breast Cancer After Breast-Conserving Surgery Based on Geometrical Relationship
Authors: Li Yijiang , Bai Han , Huang Danju , Chen Feihu , Liu Xuhong , Yan Jiawen , Zhu Sijin , Xia Yaoxiong
Published: October 2020

Purpose: This study aimed to evaluate (1) the performance of the Auto-Planning module embedded in the Pinnacle treatment planning system (TPS) with 30 left-side breast cancer plans and (2) the dose-distance correlations between dose-based patients and overlap volume histogram-based (OVH) patients. Method: A total of 30 patients with left-side breast cancer after breast-conserving surgery were enrolled in this study. The clinical manual-planning (MP) and the Auto-Planning (AP) plans were generated by Monaco and by the Auto-Planning module in Pinnacle respectively. The geometric information between organ at risk (OAR) and planning target volume (PTV) of each patient was described by the OVH. The AP and MP plans were ranked to compare with the geometry-based patients from OVH. The Pearson product-moment correlation coefficient (R) was used to describe the correlations between dose-based patients (APs and MPs) and geometry-based patients (OVH). Dosimetric differences between MP and AP plans were evaluated with statistical analysis. Result: The correlation coefficient (mean R = 0.71) indicated that the AP plans have a high correlation with geometry-based patients from OVH, whereas the correlation coefficient (mean R = 0.48) shows a weak correlation between MP plans and geometry-based patients. For different indicators, the dose distribution of V5Gy in the ipsilateral lung (AP: mean R = 0.82; MP: mean R = 0.58) is more relevant to geometry-based patients compared to the dose distribution of in the heart (AP: mean R = 0.4; MP: mean R = 0.19). The dosimetric comparison revealed a statistically significant improvement in ipsilateral lung V5Gy and V10Gy and in the heart V5Gy of AP plans compared to MP plans. Conclusion: The overall results of AP plans were superior to MP plans. The dose distribution in AP plans was more consistent with the distance-dose relationship described by OVH. After eliminating the interference of human factors, the AP was able to provide more stable and objective plans for radiotherapy patients.
The Top 100 Most Highly Cited Original Articles on Immune and Gut Microbiota
Authors: Wen Kaicheng , Tao Lin , Zhu Yue , Zhou Siming , Tao Zhengbo , Da Wacili , Yang Keda , Meng Yan
Published: October 2020

BackgroundCrosstalk between the gut microbiota and the host immune system is related to multiple diseases, and in recent years, this crosstalk has gradually become a research hotspot. Because the research involves many diseases, the mechanisms are extremely complicated, so both the screening out of the high-quality articles from the massive amount of literature and the in-depth interpretation of their data are helpful in guiding the direction of research.MethodsIn this study, the top 100 most highly cited original articles were obtained from a total of 43,858 papers. According to the number of citations in the Web of Science database, the results are sorted in descending order. One may download the data obtained by Web of Science into tab-delimited (Win) format and import it into VOSviewer (Leiden University, Leiden, Netherlands) for subsequent bibliometric analysis. We summarized the country, institution, journal, author and other indicators for all publications. Through the online bibliometric platform, we analyzed the publication volume and growth trends for different countries/regions. VOSviewer was used to classify keywords into different clusters based on co-occurrence analysis and color them according to the time course. ResultsThe number of citations for each article ranged from 914 to 5,460, and the most cited manuscript was written by PJ Turnbaugh and RE Ley. Washington University, the University of Colorado and Harvard University performed well in terms of the quality and quantity of publications. Manuscripts in NATURE, PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA and SCIENCE were the most influential. In addition, we identified six clusters of hotspots in the field of gut microbiota and immunity research.ConclusionsObesity and diabetes are the diseases most related to the gut microbiota, and their pathogenesis may be associated with a change in intestinal wall permeability and an imbalance of Bacteroides and Firmicutes. The balance of energy metabolism plays a key role in the crosstalk between host immunity and intestinal microbiota.
The Influence of Previous Arthroscopic Treatment on Subsequent Total Knee Arthroplasty: the Comparison Between Bilateral Knees of the Same Patient
Authors: XU Kui-shuai , ZHANG Liang , SHEN Rui , WANG Cai-lin , LI Tian-yu , ZHAO Xia , YU Teng-bo
Published: October 2020

Purpose To explore whether previous arthroscopic knee surgery affects future total knee arthroplasty results or not. Methods A total of 56 patients with the previous arthroscopic treatment on one knee underwent subsequent bilateral total knee arthroplasty in our hospital from September 2012 to July 2020. Data on each patient were collected in regards to changes in postoperative clinical and functional scores, various other scores, as well as postoperative functional recovery and complications. We defined the knees with a previous arthroscopic history as group A, and the counter side as group B.The Knee Society clinical score, functional scores, ROM, FJS, VAS scores were assessed before and after surgery. Using the Kolmogorov-Smirnov Test to test the normality of continuous variables, and the chi-square test to compare the rate of reoperation and complications between two groups. For all statistical comparisons, P<0.05 was considered significant. Results There were no statistically significance differences found in postoperative Knee Society clinical scores and functional scores between group A and group B, as well as in ROM, FJS, VAS scores and local complications. Conclusion There were no statistically significant differences found in postoperative functional recovery and complications in patients, who underwent total knee arthroplasty with previous knee arthroscopy.
The Impact of Successful Chronic Total Occlusion Percutaneous Coronary Intervention on Long-Term Clinical Outcomes in Real World
Authors: Gong Xuhe , Zhou Li , Ding Xiaosong , Chen Hui , Li Hongwei
Published: October 2020

Background: Coronary chronic total occlusions (CTOs) are correlated with increased risk of adverse clinical outcomes. The optimal treatment strategy for CTO has not been well established. We sought to examine the impact of CTO percutaneous coronary intervention (PCI) on long-term clinical outcome in the real world.Methods: A total of 592 consecutive patients with CTO in Beijing Friendship Hospital from June 2017 to December 2019 were enrolled, 29 patients were excluded due to Coronary artery bypass grafting (CABG). After exclusion, 563 patients were divided into the no-revascularized group (CTO-NR group, n=263) and successful revascularized group (CTO-R group, n=300). The primary endpoint was cardiac death; Secondary endpoint was major adverse cardiac and cerebrovascular events (MACCE), a composite of all-cause death, cardiac death, recurrent myocardial infarction, target lesion revascularization, re-hospitalization, heart failure, and stroke.Results: Percent of Diabetes mellitus (53.2% vs 39.7), Chronic kidney disease (8.7% vs 3.7%), CABG history (7.6% vs 1%), three vessel disease(96.2% vs 90%) and left main coronary artery disease (25.1% vs 13.7%) was significantly higher in the CTO-NR group than in success PCI group (all P<0.05). Moreover, the CTO-NR group has lower EF (0.58±0.11 vs 0.61±0.1, p=0.001) and FS (0.31±0.07 vs 0.33±0.07, p=0.002). At a median follow-up of 12 months, CTO revascularization was superior to CTO no-revascularization in terms of cardiac death (adjusted hazard ratio [HR]: 0.27, 95% conference interval [CI] 0.11-0.64). The superiority of CTO revascularization was consistent for MACCE (HR: 0.55, 95% CI 0.35-0.79). At multivariable Cox hazards regression analysis, CTO revascularization remains one of the independent predictors of lower risk of cardiac death and MACCE.Conclusions: Successful revascularization by PCI may bring more clinical benefits. The presence of LVEF＜0.5 and LM-disease was associated with an incidence of cardiac death; CTO revascularization was a protected predictor of cardiac death.
Ferulic Acid Alleviates Lipotoxicity-induced Hepatocellular Death Through SIRT1 Activating-regulated Autophagy Pathway, and Independently of AMPK and Akt in AML-12 Hepatocytes
Authors: Xu Tiantian , Song Qing , Zhou Li , Ning Hua , Qian Qianyu , Chai Hui , Han Qiang , Pan Hongzhi , Dou Xiaobing , Li Songtao
Published: October 2020

Background: Lipotoxicity-induced cell death plays a detrimental role in the pathogenesis of metabolic diseases. Ferulic acid, widespread in vegetative food, is conferred as a radical scavenger with multiple bioactivities. However, the benefits of Ferulic acid against hepatic lipotoxicity are largely unclear. Here, we investigated the protective role of ferulic acid on palmitate-induced lipotoxicity and clarify its potential mechanisms in AML-12 hepatocytes. Methods: AML-12 mouse hepatocyte was employed and exposed to palmitate to mimic lipotoxicity. Different doses (25, 50, and 100 μM) of ferulic acid were added 2 h before palmitate induction. Cell viability was detected by the measurements of lactate dehydrogenase release, nuclear staining, and the expression of cleaved-caspase3. Intracellular reactive oxygen species and mitochondrial membrane potential were analyzed by fluorescent probe. The potential mechanisms were explored by molecular biological methods, including Western-blot and quantitative real-time PCR, and further verified by siRNA interference. Results: Our data showed that ferulic acid significantly reversed palmitate-induced cell death, rescued mitochondrial membrane potential, reduced reactive oxidative species accumulation, and improved inflammatory factors activation, including IL-6 and IL-1beta. Ferulic acid significantly stimulated autophagy in hepatocytes, while, autophagy suppression blocked ferulic acid-protected lipotoxicity. Ferulic acid-activated autophagy, which was triggered by Sirt1 upregulation, was mechanistically involved in its anti-lipotoxicity benefits. Sirt1 silencing blocked ferulic acid-induced profitable alterations. Conclusions: We demonstrated that ferulic acid was a protective phytochemical against hepatic lipotoxicity in plant-based food, through Sirt1/autophagy pathway. Increasing ferulic acid-enriched food intake is a potential strategy to prevent and/or improve metabolic diseases with lipotoxicity as a typical pathological feature.
Skyrmion Phase in MnSi Thin Films Grown on Sapphire by a Conventional Sputtering
Authors: Choi Won-Young , Bang Hyun-Woo , Chun Seung-Hyun , Lee Sunghun , Jung Myung-Hwa
Published: October 2020

Topologically protected chiral skyrmion is an intriguing spin texture, which has attracted much attention because of fundamental research and future spintronic applications. MnSi with the non-centrosymmetric structure is well-known material hosting skyrmion phase. To date, preparation of MnSi crystals has been investigated by using special instruments with ultrahigh vacuum chamber. Here, we introduce a facile way to grow MnSi films on sapphire substrate using a relatively low vacuum environment of conventional magnetron sputtering. Although as-grown MnSi films have polycrystalline nature, the stable skyrmion phase in a broad range of temperatures and magnetic fields is observed by magnetotransport properties including phenomenological scaling analysis of Hall resistivities contribution. Our findings provide not only a general way to prepare the materials possessing skyrmion phase, but also insight into further research to stimulate more degrees of freedom in our inquisitiveness.
­­Prognostic analysis of tumor mutation burden combined with immune infiltration of Thymic epithelial tumors
Authors: Ruan Pinglang , Liu Dan , Wang Lili , Qin Ling , Tan Yurong
Published: October 2020

Background: Thymic epithelial tumors (TETs) are uncommon neoplasms with poor prognosis and limited effective therapeutic options. This study aims to investigate the prognosis of tumor mutation burden (TMB) and the potential association with immune infiltrates in TETs. Methods: Tumor mutation burden (TMB) was calculated using Maftools package and the samples were classified into high-TMB and low- TMB groups. Differentially expressed genes (DEGs) combined with immune cell infiltration and survival rate were analyzed between the low-TMB and high-TMB groups.Results: Single nucleotide polymorphism (SNP) occurred more frequently than insertion or deletion, and C>T was the most common single nucleotide variants (SNV) in TETs. The results of Kaplan–Meier curve indicated that a high TMB was associated with worse clinical outcomes of TETs. Moreover, 3 hub immune genes associated with immune infiltration were significantly associated with prognosis. Besides, the TMB-related signature (TMBRS) model based on the three hub immune genes possessed good predictive value with area under curve (AUC) 0.729, and patients with higher TMBRS scores showed worse TETs outcomes. In addition, infiltration levels of native CD4+ T cell, activated memory CD4+ T cell and follicular helper T cells in low-TMB group were higher than those in high-TMB group, which were correlated positively with prognosis of TETs. Conclusion: TETs patients with low TMB have better prognosis than those with high TMB, and TMB might affect the development of TETs by regulating immune infiltration.
Muscle manifestations and CK levels in COVID infection: results of a large cohort of patients inside a Pandemic COVID-19 Area
Authors: Rosa Anna De , Verrengia Elena Pinuccia , Merlo Ivan , Rea Federico , Siciliano Gabriele , Corrao Giovanni , Prelle Alessandro Cesare
Published: October 2020

Objective: to investigate both muscular manifestations and CK levels of a large cohort of patients with COVID-19 infection and to determine whether hyperckemia is associated with morbidity and mortality.Methods: Data of 615 patients discharged from ASST Ovest Milanese (Milan, Lombardy, Italy) with final diagnosis of COVID-19 infection were retrospectively extracted from electronical medical records from 21 February to 1 May 2020. Patients were descriptively analyzed with respect to the following variables: sex, age, muscular manifestations (including myalgia/arthralgia and fatigue), respiratory involvement (SARS pneumonia or respiratory failure) and history of falls. Association between patients’ characteristics and CK levels was investigated. In addition, the proportion of patients who died following access to the ER was calculated. Finally, the effect of CK levels and other patients’ features on mortality was estimated using a logistic regression model.Results: 176 (28.6%) patients had raised serum CK levels. 88 (14.3%) had muscular manifestations, of which 81 (13.2%) complained fatigue and 17 (2.8%) had myalgia and/or arthralgia. CK levels were significantly associated with respiratory involvement and fatal outcome.Conclusions: Our study provides preliminary evidence that hyperckemia is a predictor of respiratory involvement and fatal outcome in patients with COVID-19 infection. For patients with muscle damage symptoms, screening for COVID-19 infection is recommended together with the dosage of CK level.
Determinants of Uncontrolled Asthma Among Adult Asthmatic Patients on Follow-Up at Chest Clinic of Jimma Medical Center: Unmatched Case-Control Study
Authors: Geleta Leta Adugna , Dadi Lelisa Sena , Sona Alemayehu Atomsa
Published: October 2020

BackgroundUncontrolled asthma is a notorious public health problem throughout the world despite the presence of effective treatments. Characterizing phenotypes of patients with uncontrolled asthma and searching for risk factors of uncontrolled asthma have been suggested as priority research agenda in the prevention of chronic respiratory diseases. This study aimed to identify the determinants of uncontrolled asthma.MethodsInstitution-based case-control study was conducted on asthmatic patients who were on follow-up at chest clinic of Jimma University Medical (JMC) from March to May, 2020. A total of 59 cases and 118 controls were included in the study. Logistic regression was employed to identify determinants of uncontrolled asthma. Adjusted odds ratios (AORs) with their corresponding confidence intervals (CI) were used to assess the strengths of association between uncontrolled asthma and its determinants at p values ≤ 0.05.ResultsAge of the patients [AOR: 2.78; 95% CI: 1.14, 6.81], age of the cases’ residential houses [AOR: 3.65; 95% CI: 1.30, 10.28], presence of pets within the houses [AOR: 2.78; 95% CI: 1.29, 5.96], having rhinitis [AOR: 3.34; 95% CI: 1.17, 9.52], past asthma exacerbation [AOR: 2.38, 95% CI: 1.05, 5.40], non-adherence to treatment [AOR: 2.81; 95% CI: 1.30, 6.08] and smoking [AOR: 7.09; 95% CI: 1.84, 27.33] were found to be determinants of uncontrolled asthma.Conclusions﻿Uncontrolled asthma is resulted from multiple sociodemographic, environmental, clinical, and behavioral factors. Therefore, interventions targeting to improve asthma control should consider those factors comprehensively.
Preliminary Results of Tocilizumab and Interferon a-2b Treatment of SARS-CoV-2.
Authors: Fleming M PhD Richard M , Fleming NRP BA BS Matthew R
Published: October 2020

Seven patients receiving Hydroxychloroquine (HCQ) and Zinc (Zn) for CoVid-19 with PCR positive results were admitted to hospital after failing to improve. Following NCT04349410 protocol and failure to improve with elevated interleukin-6 and ferritin levels, patient’s treatment were changed following measurement of Corona Virus Pneumonia (CVP). Follow up measurements of CVP confirmed improvement with combined intravenous Tocilizumab, Interferon a-2b nebulizer, Atrovent nebulizer and SQ heparin treatments.