bluuebunny/crossref_metadata_2025 huggingface dataset:
Safety of Off‐Label Use of Ferumoxtyol as a Contrast Agent for MRI: A Systematic Review and Meta‐Analysis of Adverse Events
Authors: Ahmad Faraz , Treanor Lee , McGrath Trevor A. , Walker Daniel , McInnes Matthew D.F. , Schieda Nicola
Published: October 2020

Background

Ferumoxytol has been studied as an alternative to gadolinium‐based MRI contrast agents, but regulatory body warnings currently limit its use.

Purpose

Estimate the adverse event rate in patients undergoing MRI with ferumoxytol as a contrast agent.

Study Type

Systematic review.

Population

Thirty‐nine studies including 5411 ferumoxytol administrations in 4336 patients.

Assessment

Multiple databases were searched for studies using ferumoxytol as an off‐label MRI contrast agent in any patient population as of April 2020. Studies were eligible for inclusion if they reported the number and severity of adverse events (classified by American College of Radiology [ACR] severity of acute reactions). Risk of bias was assessed using the ROBINS‐I tool.

Statistical Tests

The proportion of administrations with adverse events was calculated using random effects meta‐analysis of proportions.

Results

No deaths related to ferumoxytol administration were reported. Sixteen studies reported immediate adverse events in 3849 patients undergoing 4901 ferumoxytol administrations. Ninety‐seven immediate adverse events were reported and the pooled adverse event proportion for immediate adverse events was 0.02 (95% confidence interval [CI] 0.02–0.02). Twenty‐three studies reported time‐unspecified adverse events in 487 patients undergoing 510 ferumoxytol administrations. Five time‐unspecified adverse events were reported; the pooled adverse event proportion for time‐unspecified adverse events was 0.01 (95% CI 0.00–0.04). 88% of adverse events were mild (90/102), 11% (11/102) were moderate, and 1% (1/102) was severe. Sixteen studies were at low risk of bias, 23 studies were at serious risk of bias. Subgroup analysis by patient population revealed no significant variability (adult vs. pediatric). No studies evaluated the use of ferumoxytol as an alternative to patients who had a prior hypersensitivity reaction to gadolinium‐based contrast agents (GBCAs).

Data Conclusion

The overall adverse event rate for off‐label ferumoxytol use as an MRI contrast agent is 2%, with rare severe reactions and no deaths. To date, there are no studies evaluating the safety of ferumoxytol as an alternative to GBCAs in patients with a prior hypersensitivity reaction.

Level of Evidence

2

Technical Efficacy Stage

5
Transient left bundle branch block and poor atrioventricular conduction during ablation of accessory pathway at the left ventricle
Authors: Chiang Kuo‐Feng , Wang Chi‐Yen , Huang Jin‐Long , Hsieh Yu‐Cheng
Published: October 2020

A 56‐year‐old female with manifest Wolff‐Parkinson‐White (WPW) syndrome was sent to emergency room because of preexcited atrial fibrillation (AF) and became sinus rhythm after cardioversion. Then, she received catheter ablation of a left‐sided lateral accessory pathway. The patient immediately developed Wenckebach atrioventricular (AV) block and left bundle branch block (LBBB) during the initial ablation. The ECG still showed LBBB 1 hour after ablation. The LBBB became narrow QRS (The QRS complex in the electrocardiogram. The QRS complex includes the Q wave, R wave, and S wave) 1 day later. Two weeks later, Holter's ECG showed normal sinus rhythm with 1:1 AV conduction even at the maximum heart rate of 125 beats/min. Transient LBBB and poor AV nodal conduction could occur during ablation by the trans‐aortic approach.
Increasing energy transfer over Eurasia and the North Atlantic enhancing the Eurasian low‐frequency wave and boreal summer droughts in China
Authors: Zhang Jie , Zhao Siwen , Chen Zhiheng
Published: October 2020

The prolonged droughts that frequently occur in northern China are related to persistent anomalies of circulation and the low‐frequency waves. To explore the formation of the low‐frequency waves and the related internal variability and external forcing, the intra‐seasonal kinetic energy (KE) and the corresponding energy transfer terms are investigated algorithmically with multiscale energy and vorticity analysis. The results show two major energy sources located over the central North Atlantic (NA) and Europe, with increasing baroclinicity and energy conversion. The major energy conversion is from basic flow to intra‐seasonal KE, which corresponds to a southeastern extension of NA jet stream (JS) exit and the northward shift in the entrance of Afro Asian JS. JS shifts are helpful to the conjunction of both JS, and thereby enhance JS waveguide and wave energy dispersion. In addition, with increasing surface temperature and diabatic heating over Europe and the Mediterranean Sea, there are increase baroclinicity that facilitates the buoyancy energy conversion, ascending KE flux and positive pressure flux in the lower troposphere, those result in higher mid‐upper‐troposphere KE. The divergent energy contributes to the development and enhancement of the low‐frequency waves, favouring the extratropical eddy, wave structure, and quasi‐stationary waves amplitude, which is thereby conducive to magnified wave amplitude and extreme droughts in northern China. The results emphasize the internal dynamics and local forcing and provide prediction reference for extratropical extremes.
Elevated plasma D‐dimer concentration has higher efficacy for the diagnosis of periprosthetic joint infection of the knee than of the hip—A single‐center, retrospective study
Authors: Grzelecki Dariusz , Walczak Piotr , Grajek Aleksandra , Szostek Marta , Dudek Piotr , Bartosz Paweł , Olewnik Łukasz , Czubak‐Wrzosek Maria , Marczak Dariusz , Tyrakowski Marcin
Published: October 2020

The aim of this study is to evaluate the value of D‐dimers in the diagnosis of periprosthetic joint infection (PJI). The analysis was performed for revision total hip (rTHA) and revision total knee arthroplasty (rTKA) together and separately with two thresholds, one calculated by statistical methods and the second adopted from the ICM 2018 definition. The study group comprised 133 patients who underwent rTHA or rTKA: 68 patients diagnosed according to the ICM 2018 definition (PJI group) and 65 with aseptic implant loosening, instability, malposition, or implant failure with the exclusion of infection (aseptic revision total joint arthroplasty or arTJA group). Mean D‐dimer concentrations were 0.36 ± 0.25 μg/ml in the arTJA group and 0.87 ± 0.78 μg/ml in the PJI group (p < .001). For rTHA and rTKA together, the sensitivity and specificity of the evaluation were 75% and 73.8% according to the calculated cut‐off value (0.45 μg/ml), and 33.8% and 95.4% based on the ICM 2018 threshold (0.85 μg/ml). Separately, for rTHA, sensitivity and specificity were 62.5% and 62.1% for the calculated value (0.43 μg/ml) and 6.3% and 96.6% for the ICM 2018 threshold; for rTKA, sensitivity was 86.1% and specificity was 88.9% for the calculated threshold (0.48 μg/ml) and 58.3% and 94.4% for the ICM 2018 value. Our findings indicate that plasma D‐dimers have potential as markers of knee PJI, but moderate to low value for hip PJI.
Home Parenteral Nutrition Patient‐Reported Outcome Questionnaire: Sensitive to Quality of Life Differences Among Chronic and Prolonged Acute Intestinal Failure Patients
Authors: Winkler Marion F. , Machan Jason T. , Xue Zhigang , Compher Charlene
Published: October 2020

Background

Patient‐reported outcome (PRO) measures often address quality of life (QOL) and help improve communication and shared decision‐making. The home parenteral nutrition patient‐reported outcome questionnaire (HPN‐PROQ) was developed for patients to self‐assess factors that influence QOL. The aim of this study was to establish construct validity.

Method

Responses were analyzed for 77 HPN‐dependent patients with chronic and prolonged acute intestinal failure. General linear modeling was conducted to describe patterns of interactions and association between items included in the HPN‐PROQ.

Results

Most patients (78%) had chronic intestinal failure. Mean HPN duration was 3.3 ± 0.6 years. Underlying illness had a moderate or major effect on QOL for 88%; 59% reported their QOL had been negatively impacted by HPN. There was no difference in QOL among chronic patients, depending on how important they rated “being able to do what I want to do” (P = .1), whereas prolonged acute intestinal failure patients had significantly lower QOL if they rated “being able to do what I want to do” extremely vs very important (adjusted P = .02). Confidence with ability to perform HPN procedures was associated with understanding the need for HPN (P < .01). As ratings increased for emotional difficulty in coping with HPN so did HPN impact on QOL (linear trend P < .01).

Conclusion

Construct validity of the HPN‐PROQ was evident. The HPN‐PROQ considers the unique experience of living with a complex nutrition therapy.
Wide‐viewing integral imaging display using rectangular light sources
Authors: Xiao Ju‐Lan , Wu Fei
Published: October 2020

We propose a wide‐viewing integral imaging display. It consists of an organic light‐emitting diode, a barrier array, and a liquid crystal panel. The organic light‐emitting diode generates the rectangular light sources, and the liquid crystal panel displays the elemental images. The barriers are introduced to separate adjacent rectangular light sources and corresponding elemental images. Lights emitting from the rectangular light sources only illuminate the corresponding elemental images. The horizontal viewing angle and the luminance are both enhanced by increasing the horizontal width of the point light source. A prototype of the proposed integral imaging display is developed, and the experiment results agree well with the theory.
Predicting Factors for Oncological and Functional Outcome in Hypopharyngeal Cancer
Authors: Visini Miranda , Giger Roland , Shelan Mohamed , Elicin Olgun , Anschuetz Lukas
Published: October 2020

Objectives/Hypothesis

Hypopharyngeal squamous cell carcinoma (SCC) is a rare but aggressive malignancy, with low survival rates and high incidence of tumor and treatment‐related morbidity. This study aims to analyze the long‐term oncologic and functional outcomes of a large cohort of patients and to determine prognostic factors.

Study Design

Retrospective cohort study.

Methods

The records of all patients diagnosed with hypopharyngeal SCC and treated with curative intent at our tertiary referral center were reviewed. Patient and initial disease characteristics, features, and complications of primary treatment, recurrence patterns, and corresponding treatments and the oncologic and functional long‐term outcome were determined.

Results

For a total of 179 patients, primary radiotherapy (RT) was the predominant treatment modality (78%), whereas 22% underwent primary surgery. The median, 2‐year, and 5‐year overall survival (OS) for the study cohort were 47 months, 64% and 43%. The median survival after first and second relapse was 7 and 6 months, respectively. The 2 and 5‐year relapse‐free survival (RFS) was 52% and 36%. The median RFS after first relapse and salvage treatment was 9 months. A nodal status of ≥cN2 (HR = 1.89, CI:1.21–3.05, P < .005) and any other primary tumor localization than pyriform sinus (HR = 1.60, CI: 1.04–2.42, P < .05) were identified as independent risk factors for shorter OS and RFS. Regarding functional outcome, the 2‐ and 5‐year laryngectomy‐free‐survival was 55% and 37%, respectively.

Conclusions

In this large cohort with long‐term follow‐up, any other primary tumor localization than pyriform sinus and a nodal status of ≥cN2 were identified as risk factors for reduced OS and RFS.

Level of Evidence

4 Laryngoscope, 131:E1543–E1549, 2021
Unilateral Sialendoscopy for Juvenile Recurrent Parotitis: What Happens to the Other Side?
Authors: Iordanis Konstantinidis , Panagiotis Dogantzis , Angelos Chatziavramidis , Antonios Metzikofis , Alexander Delides , Sofia Alataki , Efimia Papadopoulou‐Alataki
Published: October 2020

Objective/Hypothesis

Current literature has confirmed the benefits of sialendoscopy for the treatment of juvenile recurrent parotitis (JRP). However, this procedure is often performed unilaterally, although the disease can affect both sides. This article investigated the clinical course of the contralateral parotid (CL) gland in children requiring unilateral sialendoscopy with the goal of clarifying the necessity of primary bilateral sialendoscopy.

Study Design

Prospective cohort study in a tertiary center.

Methods

Over an eight‐year period, 77 children with JRP underwent unilateral sialendoscopy. We observed the clinical course of the CL parotid over a minimum follow‐up period of 24 months. New episodes of sialadenitis were recorded on both sides along with the need for a second sialendoscopy. These data were correlated with the preoperative symptoms of the contralateral side as well as ultrasound (U/S) findings at baseline assessment.

Results

In total, six children required sialendoscopy on the CL side (7.8%), 62 children remained asymptomatic or with scarce swellings (80.5%), and nine children improved (11.7%). The preoperative U/S findings on the CL side positively correlated with the number of postoperative swellings. The proportion of children needing CL sialendoscopy was higher (21.4%) among children needing a second sialendoscopy on the operated side.

Conclusions

In the long term, the vast majority of children needing unilateral sialendoscopy do not require similar treatment of the CL parotid gland. However, a history of bilateral swellings along with U/S findings of parenchymal disorganization on the CL side significantly increases the risk of needing further sialendoscopy at a later time.

Level of Evidence

4 Laryngoscope, 131:1404–1409, 2021
Characteristics of Early Internal Laryngeal Muscle Atrophy After Recurrent Laryngeal Nerve Injuries in Rats
Authors: Wang Hong , Wang Haizhou , Li Xueyan , Xu Wen
Published: October 2020

Objectives/Hypothesis

The present study investigated the characteristics of early internal laryngeal muscle atrophy in recurrent laryngeal nerve injury (RLNI) rats.

Study Design

To observe the characteristics of early internal laryngeal muscle atrophy post RLNI.

Methods

Rats were divided into three groups: sham‐operated control group (n = 20), recurrent laryngeal nerve transverse injury group (RLNTI, n = 50), and recurrent laryngeal nerve blunt contusion group (RLNBC, n = 50). Five weeks after RLNI, certain rats were sacrificed weekly, and their laryngeal tissues were harvested. The atrophic features of internal laryngeal muscles were detected using hematoxylin and eosin. NF‐κB and MuRF‐1 levels were tested using IHC.

Results

The atrophic degree and fibrosis of thyroarytenoid, posterior cricoarytenoid, and lateral cricoarytenoid muscles were related to the type of RLNI. The average myofiber cross‐sectional areas increased before an obvious decrease in the RLNTI and RLNBC groups. Muscle recovery occurred in the RLNBC group starting 4 weeks after RLNI, but only a weak trend was observed in the RLNTI group in the 5th week. During the muscle atrophy process, MuRF‐1 and NF‐κB were upregulated early and were maintained at a high level, which showed a trend similar to muscle atrophy. However, NF‐κB expression was opposite to MuRF‐1 expression and muscle atrophy when the muscles recovered.

Conclusion

The atrophy degree of internal laryngeal muscles was associated with the type of RLNI. The NF‐κB/MuRF‐1 signaling pathway was involved in internal laryngeal muscle atrophy after RLNI, which is different from skeletal muscle after denervation.

Level of Evidence

NA Laryngoscope, 131:E1256–E1264, 2021
Liver Transplantation Using Hepatitis C Virus–Viremic Donors Into Hepatitis C Virus–Aviremic Recipients as Standard of Care
Authors: Bohorquez Humberto , Bugeaud Emily , Bzowej Natalie , Scheuermann Jennifer , Hand Jonathan , Bruce David , Carmody Ian , Cohen Ari , Joshi Shobha , Seal John , Sonnier Dennis , Therapondos George , Girgrah Nigel , Anders Stephanie , Loss George E.
Published: October 2020

Liver transplantation (LT) using allografts from hepatitis C virus (HCV)‐viremic/nucleic acid testing–positive donors’ (DNAT+) organs into HCV‐aviremic recipients (rHCV−) has been limited owing to nearly universal HCV transmission and concerns regarding availability, safety, and efficacy post‐LT with direct‐acting antiviral (DAA) therapy. We report our experience of LT using DNAT+ organs into rHCV− as a routine standard of care. Following verification of DAA access, absence of critical drug‐drug interactions (DDIs) with DAAs, and informed consent, allocated DNAT+ organs were offered to patients on the waiting list for LT irrespective of recipient HCV status. Between June 2018 and December 2019, 292/339 rHCV− received an LT. Forty‐seven patients were excluded from analysis because of recipient HCV viremia, refusal to receive DNAT+ organs, or inability to receive DAA therapy post‐LT. Of these 292 patients, 61 rHCV− received DNAT+ livers (study group), and 231 rHCV− received DNAT− (aviremic donors [nuclear acid test‐negative donors]) livers (control group). Recipient and donor characteristics as well as 1‐year post‐LT patient and graft survival were similar between groups. In the study group, 4 patients died, and 1 patient required retransplantation within the first year post‐LT (all unrelated to HCV); 56 patients received DAA therapy, with a median time from LT to the start of DAA treatment of 66.9 days (interquartile range [IQR], 36‐68.5), and 51 patients completed DAA treatment, all achieving sustained virologic response for 12 or more weeks (SVR‐12) (1 patient required retreatment owing to relapse following initial DAA therapy). No patients had evidence of fibrosing cholestatic hepatitis or extrahepatic manifestations of HCV. This report indicates that transplantation of DNAT+ livers into rHCV− and subsequent DAA therapy is associated with clinical outcomes comparable to those achieved with DNAT− allografts.
Triple‐Phase Computed Tomography May Replace Dual‐Energy X‐ray Absorptiometry Scan for Evaluation of Osteoporosis in Liver Transplant Candidates
Authors: Izzy Manhal , Addissie Benyam D. , Arab Juan Pablo , Hilscher Moira B. , Cartee Amanda , Lee David C. , Lee Yong , Fletcher Joel G. , Keaveny Tony M. , Sanchez William
Published: October 2020

Assessment of bone density is an important part of liver transplantation (LT) evaluation for early identification and treatment of osteoporosis. Dual‐energy X‐ray absorptiometry (DXA) is currently the standard clinical test for osteoporosis; however, it may contribute to the appointment burden on LT candidates during the cumbersome evaluation process, and there are limitations affecting its accuracy. In this study, we evaluate the utility of biomechanical analysis of vertebral images obtained during dual‐energy abdominal triple‐phase computed tomography (TPCT) in diagnosing osteoporosis among LT candidates. We retrospectively reviewed cases evaluated for LT between January 2017 and March 2018. All patients who underwent TPCT within 3 months of DXA were included. The biomechanical computed tomography (BCT) analysis was performed at a centralized laboratory (O.N. Diagnostics, Berkeley, CA) by 2 trained analysts blinded to the DXA data. DXA‐based osteoporosis was defined as a T score ≤−2.5 at the hip or spine. BCT‐based osteoporosis was defined as vertebral strength ≤4500 N for women or ≤6500 N for men or trabecular volumetric bone mineral density ≤80 mg/cm3. Comparative data were available for 91 patients who had complete data for both DXA and BCT: 31 women and 60 men, age 54 ± 11 years (mean ± standard deviation), mean body mass index 28 ± 6 kg/m2. Using DXA as the clinical reference, sensitivity of BCT to detect DXA‐defined osteoporosis was 83.3% (20/24 patients) and negative predictive value was 91.7%; specificity and positive predictive value were 65.7% and 46.5%, respectively. BCT analysis of vertebral images on triple‐phase computed tomography, routinely obtained during transplant evaluation, can reliably rule out osteoporosis in LT candidates. Patients with suspicion of osteoporosis on TPCT may need further evaluation by DXA.
Telling a different story: How nonprofit organizations reveal strategic purpose through storytelling
Authors: Mitchell Sarah‐Louise , Clark Moira
Published: October 2020

Responding to a call for research into storytelling within the nonprofit context, the paper contributes to an emerging research conversation about communicating organizational strategy through storytelling. The research analyses one hundred stories across 10 leading organizations to identify how they are being deployed and what that tells us about the underpinning strategy. Through bringing story character, classification, and content together for the first time, the paper presents a holistic perspective on the story construct. It identifies that, when viewed as a whole, the stories told by organizations can be a powerful communication tool for reaching external audiences. However, the research also identifies that their ability to convey strategic purpose through storytelling is moderated by storytelling capability. It finds that organizations with stronger storytelling capability use this craft to differentiate themselves more effectively. It concludes with contributing a new conceptual model for understanding organizational storytelling and a roadmap for practitioners to strengthen storytelling capability.
The Role of the Subthalamic Nucleus in Sequential Working Memory in De Novo Parkinson's Disease
Authors: Ye Zheng , Zhang Guanyu , Zhang Yingshuang , Li Shuaiqi , Liu Na , Zhou Xiaolin , Xiao Weizhong , Münte Thomas F.
Published: October 2020

Background

Deficits in maintaining and manipulating sequential information online can occur even in patients with mild Parkinson's disease. The subthalamic nucleus may play a modulatory role in the neural system for sequential working memory, which also includes the lateral prefrontal cortex.

Objectives

The objective of this study was to investigate neural markers of sequential working memory deficits in patients with de novo Parkinson's disease.

Methods

A total of 50 patients with de novo Parkinson's disease and 50 healthy controls completed a digit ordering task during functional magnetic resonance imaging scanning. The task separated the maintenance (“pure recall”) and manipulation of sequences (“reorder & recall” vs “pure recall”).

Results

In healthy controls, individual participants' task accuracy was predicted by the regional activation and functional connectivity of the subthalamic nucleus. Healthy participants who showed lower subthalamic nucleus activation and stronger subthalamic nucleus connectivity with the putamen performed more accurately in maintaining sequences (“pure recall”). Healthy participants who showed greater ordering‐related subthalamic nucleus activation change exhibited smaller accuracy costs in manipulating sequences (“reorder & recall” vs “pure recall”). Patients performed less accurately than healthy controls, especially in “reorder & recall” trials, accompanied by an overactivation in the subthalamic nucleus and a loss of synchrony between the subthalamic nucleus and putamen. Individual patients' task accuracy was predicted only by the subthalamic nucleus connectivity. The contribution of the subthalamic nucleus activation or activation change was absent. We observed no change in the lateral prefrontal cortex.

Conclusions

The overactivation and weakened functional connectivity of the subthalamic nucleus are the neural markers of sequential working memory deficits in de novo Parkinson's disease. © 2020 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
Lie symmetries for analyzing interaction of a characteristic shock with a singular surface in a non‐ideal reacting gas with dust particles
Authors: Shah Sarswati , Singh Randheer
Published: October 2020

Using the invariance group properties of the system describing one‐dimensional unsteady flow of a non‐ideal dusty reacting gas, the evolutions of characteristic shock and singular surface are investigated. The effects of non‐idealness, reaction mechanism, and dusty gas parameters on the characteristic shock and singular surface are analyzed. Further, the amplitude of reflected wave and (or) transmitted wave along with bounce in the acceleration of shock, which generated from the interaction of a characteristic shock with a singular surface, are obtained.
Salted and Unsalted Zhàcài (Brassica juncea var. tumida) Alleviated High‐Fat Diet‐Induced Dyslipidemia by Regulating Gut Microbiota: A Multiomics Study
Authors: Li Wenfeng , Chen Chunlian , Chen Mengting , Zhang Xiangyang , Ji Qin , Wang Yu , Zheng Qiaoran , Tan Si , Gao Xiaoxv , Lu Yalong
Published: October 2020

Scope

Zhàcài (ZC), a salting‐processed Brassica juncea var. tumida vegetable, is widely consumed as a pickle, but little is known about the health benefits of both salted and unsalted ZC as a whole food.

Methods and Results

The preventive effects of salted and unsalted ZC against dyslipidemia are assessed in high‐fat (HF) diet‐fed mice. HF intake for 12 continuous weeks cause dyslipidemia in mice, as evidenced by the elevations in serum total triglyceride, total cholesterol, and low‐density lipoprotein cholesterol levels by 30%, 66%, and 117%, respectively. Metabolomics analysis and the 16S rRNA genes sequencing suggest that dietary administration of salted and unsalted ZC (2.5% w/w) alleviates HF‐induced dyslipidemia, metabolic disorders of short‐chain fatty acids, and disturbance of intestinal flora in mice. These positive effects of unsalted ZC are stronger than those of salted ZC. Moreover, fecal bacteria transplantation confirms the antidyslipidemia of ZC.

Conclusion

These results suggest that consumption of ZC may prevent HF‐induced dyslipidemia by regulating gut microbiota.
Metabolic syndrome and peripheral neuropathy
Authors: Kazamel Mohamed , Stino Amro Maher , Smith Albert Gordon
Published: October 2020

Diabetic peripheral neuropathy and metabolic syndrome (MetS) are both global health challenges with well‐established diagnostic criteria and significant impacts on quality of life. Clinical observations, epidemiologic evidence, and animal models of disease have strongly suggested MetS is associated with an elevated risk for cryptogenic sensory peripheral neuropathy (CSPN). MetS neuropathy preferentially affects small unmyelinated axons early in its course, and it may also affect autonomic and large fibers. CSPN risk is linked to MetS and several of its components including obesity, dyslipidemia, and prediabetes. MetS also increases neuropathy risk in patients with established type 1 and type 2 diabetes. In this review we present animal data regarding the role of inflammation and dyslipidemia in MetS neuropathy pathogenesis. Several studies suggest exercise‐based lifestyle modification is a promising treatment approach for MetS neuropathy.
Plasticity of Behavioral and Growth Responses to Two Feeding Regimes and Implications for the Domestication of Steelhead Trout
Authors: Tatara Christopher P. , Endicott Robert C. , Atkins Jeffrey J. , Berejikian Barry A.
Published: October 2020

The effects of domestication selection on fitness are of serious concern in hatchery-reared anadromous salmonids, which often experience selection for rapid growth and associated deviations from natural agonistic and feeding behaviors. The high rations that are used to raise age-1 smolts and the reduced rations that are used to produce age-2 smolts potentially result in very different behavioral tactics and social dynamics of competition in hatchery tanks. Consequently, steelhead Oncorhynchus mykiss hatchery programs with recovery or conservation goals may need to change their aquaculture practices to minimize domestication selection. This study investigated how the feeding rate (proportion of presented food items that were successfully captured) and relative competitive ability (ability to monopolize food items in small groups) of age-1 and age-2 steelhead corresponded to feeding location (surface or bottom) and growth rate in hatchery rearing tanks. We raised steelhead from a common broodstock to smolt at age 1 or age 2 by manipulating their rations (age-1 fish received the high ration, age-2 the low ration). The fish in the age-1 treatment had a lower feeding rate than did those in the age-2 treatment. Feeding rate was positively correlated with both body size and with growth rate in the rearing tanks at both rations. The age-2 steelhead were more likely to be detected at a single feeding location than were the age-1 fish, which were more frequently detected at both locations. The more competitive age-1 fish were more frequently detected at both feeding locations, and the less competitive fish were detected at only one location. Relative competitive ability was not associated with feeding location in the age-2 treatment, nor was it associated with growth rate in either treatment. Age-2 steelhead that were detected only at the bottom or at both feeding locations had higher growth rates than those that were detected only at the surface, suggesting greater scramble competition near the point of food delivery under the restricted ration. Feeding location was not associated with growth rate in the age-1 treatment. The results indicate that ration directly affects feeding rate and that ration and relative competitive ability interact to influence feeding rate. Because feeding rate was positively associated with growth rate at both ration levels in the hatchery tanks, behaviors that are associated with feeding motivation may be an important trait under selection in salmonid hatcheries.
Juvenile Chinook Salmon Weight Prediction Using Image-Based Morphometrics
Authors: Holmes Eric J. , Jeffres Carson A.
Published: October 2020

We developed an empirical weight prediction model for juvenile Chinook Salmon Oncorhynchus tshawytscha ranging from 33–113 mm FL and 0.35–14.86 g using morphometrics analysis on images that were collected from live fish in the field. This method relies on consumer-grade hardware and free software and addresses the issue of a lack of valuable weight and condition data for life history and survival modeling. A blind test revealed that the method was relatively precise, with a mean absolute error of 0.075 g and a mean absolute percentage of error of 2.86%, and unbiased, with a mean error of −0.001 g. Given the inherent variability in field wet-weight measurements that are estimated, with an average standard deviation of 0.030 g and CV of 1.02% from a blind repeated-measurements experiment, the observed level of predictive error suggests that the method is an adequate substitute for measuring field weight when conditions (i.e., boat sampling) preclude conventional scale taring and accurate weight measurement. Additionally, this method is useful in an automated data-quality-control workflow to identify erroneous length and/or weight measurements. The image landmark placement closely follows previous work on juvenile Chinook Salmon and can be incorporated with existing methodologies such as stock analysis and phenotypic differentiation to increase the available biometric information.
An emergency department optimized protocol for qualitative research to investigate care seeking by patients with non‐urgent conditions
Authors: Truter Piers , Edgar Dale , Mountain David , Bulsara Caroline
Published: October 2020

Aim

To describe a tailored qualitative research methodology for exploring the complex interaction of factors driving non‐urgent care seeking in the emergency department.

Design

Qualitative descriptive design with a literature informed semi‐structured interview and analysis structure. Triangulation with the State‐Trait Anxiety Inventory allows expedited exploration of biopsychosocial factors. Consolidated criteria for reporting qualitative research requirements integrated.

Methods

With a short 10‐ to 15‐min interview and a low‐inference analysis process, this methodology offers a structured way to explore the “go to ED” decision, to understand the patient perspective on their healthcare needs and feed into the development of suitable local services that meet patient healthcare needs.

Results

This methodology offers a structured way for clinician–researchers to explore the factors that influence patients seeking care in the emergency departments for non‐urgent conditions that are specific to their local health service environment. The described methodology is accessible to novice qualitative researchers and includes the semi‐structured interview, coding and analysis frameworks.
Transient electromagnetic inversion based on particle swarm optimization and differential evolution algorithm
Authors: Li Ruiyou , Yu Nian , Li Ruiheng , Zhuang Qiong , Zhang Huaiqing
Published: October 2020

For transient electromagnetic inversion, a gradient‐based algorithm is strongly dependent on the quality of the initial model, while any non‐gradient‐based algorithm often falls too easily into local optima. This paper proposes a joint differential‐evolution–particle‐swarm‐optimization inversion algorithm, which provides a better global optimization. A dual‐population evolution strategy and information exchange mechanism is presented. For verification, this is followed by adoption of a layered inversion model in the transient electromagnetic inversion with a central loop. The results show that the differential‐evolution–particle‐swarm‐optimization joint algorithm can reduce the probability of a premature phenomenon (i.e. falling into local optima) and improve the inversion accuracy, efficiency and stability, with a fast convergence occuring in the early stages. Furthermore, the proposed algorithm has a higher degree of fitting (prediction ability) for data inversion and is feasible for transient electromagnetic inversion.
Counselor Surveillance of Digital Self‐Monitoring Data: A Pilot Randomized Controlled Trial
Authors: Butryn Meghan L. , Martinelli Mary K. , Crane Nicole T. , Godfrey Kathryn , Roberts Savannah R. , Zhang Fengqing , Forman Evan M.
Published: October 2020

Objective

This pilot study tested counselor access to participants’ digital self‐monitoring (SM) data as a means of improving long‐term lifestyle modification (LM) outcomes.

Methods

After 12 weeks of weight‐loss treatment, participants (N = 77) were randomized to LM or LM+SHARE for weeks 13 to 52. All participants received monthly phone calls and weekly text messages from weeks 13 to 52 and were instructed to engage in daily digital SM of weight, eating, and exercise. In LM+SHARE, but not LM, counselors had access to SM device data. Assessments were conducted as weeks 0, 13, 26, and 52.

Results

Retention, engagement, and treatment satisfaction were excellent. LM+SHARE participants, compared with LM, had more frequent SM of weight and eating. Weight loss continued at a similar rate in both conditions from weeks 13 to 26. From weeks 26 to 52, those in LM regained approximately 2 kg, whereas those in LM+SHARE maintained weight loss, a significant difference. Nonetheless, total weight loss did not significantly differ by condition. Engagement in dietary SM mediated the effect of condition on weight.

Conclusions

Counselor access to SM data is feasible and acceptable. Additional research is warranted to determine whether it can meaningfully improve outcomes.
The Prognostic and Therapeutic Value of the Mutational Profile of Blood and Tumor Tissue in Head and Neck Squamous Cell Carcinoma
Authors: Wilson Harper L. , D'Agostino Ralph B. , Meegalla Nuwan , Petro Robin , Commander Sara , Topaloglu Umit , Zhang Wei , Porosnicu Mercedes
Published: October 2020

Background

The purpose of this study was to explore the genomic landscape of head and neck squamous cell carcinoma (HNSCC) in circulation (circulating tumor DNA [ctDNA]) and tumor (tumor tissue DNA [tDNA]) and understand the implications of ctDNA sequencing for prognosis and precision oncology treatments.

Materials and Methods

This is a retrospective review of 75 patients with HNSCC for both tDNA and ctDNA. Results were analyzed for concordance between tDNA and ctDNA and for their individual and combined association with demographics, survival, and presence and extent of disease at last visit (DLV).

Results

The five most frequently altered genes were TP53, CDKN2A, TERT, BRCA2, and NOTCH1. Twenty percent of patients had NOTCH1 alterations in tDNA, with none found in ctDNA. Concordance among altered genes was 13.0%, and 65.3% of patients had actionable ctDNA alterations. ctDNA alterations were significantly associated with decreased overall survival (OS) and presence and extent of DLV. In DNA repair genes, alterations in ctDNA alone and combined with tDNA were significantly associated with decreased OS and presence of DLV. Similar significant associations were found in TP53 for ctDNA alone and combined with tDNA. DNA repair gene alterations in ctDNA and unique ctDNA alterations within partially concordant genes were significantly associated with decreased OS in multivariate analysis.

Conclusion

This study illustrates the circulating and tumor genomic profile in the largest HNSCC cohort to date, underscoring the potential utility of ctDNA in prognostication and precision oncology treatment. For the first time, the presence of ctDNA alterations and specific ctDNA sequencing results were shown to be significantly associated with poor prognosis in HNSCC.

Implications for Practice

The use of precision genomic targeted therapies in head and neck squamous cell carcinoma (HNSCC) lags behind many other cancers, and poor survival in advanced stages indicates the urgent need for improved treatment options. This exploratory analysis of circulating tumor DNA (ctDNA) and tumor tissue DNA (tDNA) sequencing in the largest cohort to date of patients with HNSCC provides a novel depiction of the ctDNA genome, with two thirds of patients having actionable ctDNA alterations. This study reports for the first time the prognostic value of ctDNA sequencing, with the presence of ctDNA alterations, specific ctDNA alterations in DNA repair genes and TP53, and unique ctDNA alterations within partially concordant genes predicting poor survival.
Antibiotic‐based silk fibroin films for burn wound healing
Authors: Yerra Aparna , D. M. Mamatha
Published: October 2020

Silk fibroin (SF), which is a protein‐based biomacromolecule, proved to be an important biomaterial in biomedical applications and tissue engineering. The present study mainly focused to investigate the effective antibiotic against the common pathogens found at the site of burn wounds. The SF films prepared with selected antibiotics had shown activity against the target bacterial pathogens, but no activity was found against fungal species. The release of antibiotics from films resulted in the microbial susceptibility. Results have shown Ciprofloxacin—6 μg, Amoxicillin—15 μg, and Nystatin—70 μg at minimal inhibition concentration (MIC) has shown maximum zone of inhibition when compared with other antibiotics. The antibiotic‐based silk fibroin (ABSF) films have shown a positive effect on cell viability and cell adhesion on the L929 fibroblast cell line. The structural conformations of films were also carried out by FTIR and XRD, an increase in the crystalline size was observed in the antibiotic‐based film. Results demonstrate that ABSF films can act against the pathogens without losing their drug nature, can reduce the chance of infections at the site of the wound, and also can establish the basis for the accelerated healing process of the burn wound.
Prospective phase II study of children affected by bilateral intraocular retinoblastoma with macular involvement of both eyes or in the only preserved eye. Macular tumor control, eye preservation rate, and visual outcome
Authors: Russo Ida , Levy‐Gabriel Christine , Dupont Axelle , Lumbroso‐Le Rouic Livia , Cassoux Nathalie , Desjardins Laurence , Bertozzi Anne‐Isabelle , Coze Carole , Doz François , Savignoni Alexia , Aerts Isabelle
Published: October 2020

Background

Conservative treatments of intraocular retinoblastoma often consist of chemotherapy and focal treatments. The protocols vary and currently may combine two or three drugs, with different number of cycles, associated to the ocular treatments. In case of macular/paramacular involvement, tumor location and retinal scars induced by focal treatments often have a major negative impact on final visual outcome.

Methods

This study aimed to include children affected by bilateral intraocular macular/paramacular retinoblastoma in a prospective phase II study. The protocol consisted of six cycles of a three‐drug combination (vincristine, etoposide, carboplatin), and the addition of macula‐sparing transpupillary thermotherapy (TTT) to the third cycle. The primary endpoint was the local control rate without external beam radiotherapy (EBR) and/or enucleation.

Results

Nineteen patients (26 eyes) were included from July 2004 to November 2009. Thirteen eyes belonged to group V of the Reese‐Ellsworth classification and 10 to group D of the International Intraocular Retinoblastoma Classification. Macular/paramacular tumors were treated with chemotherapy alone in nine eyes, and with chemotherapy associated with macula‐sparing TTT in 17 eyes. Four eyes experienced macular relapse. At a median follow up of 77 months, 23 eyes (88.5%) were saved without EBR, two were enucleated and one received EBR. The median visual acuity of the 24 saved eyes was 20/50. No severe adverse effect was observed.

Conclusion

Six cycles of a three‐drug combination associated with macula‐sparing TTT achieved good tumor control, improved eye preservation rates without EBR, and decreased macular damage, often providing satisfactory visual results with long‐term follow up.
Are children with SARS‐CoV‐2 infection at high risk for thrombosis? Viscoelastic testing and coagulation profiles in a case series of pediatric patients
Authors: Al‐Ghafry Maha , Aygun Banu , Appiah‐Kubi Abena , Vlachos Adrianna , Ostovar Gholamabbas , Capone Christine , Sweberg Tod , Palumbo Nancy , Goenka Pratichi , Wolfe Lawrence C. , Lipton Jeffrey M. , Acharya Suchitra S.
Published: October 2020

The coagulopathy of the novel severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is well documented in adults, with increases in D‐dimer and prothrombin time found to be strong predictors of mortality, and anticoagulation shown to decrease this mortality. Viscoelastic parameters such as elevations in maximum clot firmness (MCF) on rotational thromboelastometry (ROTEM) have correlated with a hypercoagulable state in adults with SARS‐CoV‐2. We report our experience in children infected with SARS‐CoV‐2, with noted elevations in D‐dimer and MCF on ROTEM (indicating hypercoagulability). Exploration of viscoelastic testing to provide additional laboratory‐based evidence for pediatric‐specific risk assessment for thromboprophylaxis in SARS‐CoV‐2 is warranted.
131I‐Meta‐iodobenzylguanidine followed by busulfan and melphalan and autologous stem cell rescue in high‐risk neuroblastoma
Authors: Giardino Stefano , Piccardo Arnoldo , Conte Massimo , Puntoni Matteo , Bertelli Enrica , Sorrentino Stefania , Montera Mariapina , Risso Marco , Caviglia Ilaria , Altrinetti Vania , Lanino Edoardo , Faraci Maura , Garaventa Alberto
Published: October 2020

Introduction

Despite the progress in current treatments, the event‐free survival of high‐risk neuroblastoma (HR‐NB) patients does not exceed 40%‐50%, and the prognosis of refractory or relapsed patients is poor, still representing a challenge for pediatric oncologist. Therapeutic Iodine‐131 meta‐iodobenzylguanidine (Th‐131I‐MIBG) is a recognized safe and potentially effective treatment for NB.

Materials

This retrospective study reports the outcomes of 28 MIBG‐avid NB patients with advanced disease either refractory or relapsed, which was undertaken from 1996 to 2014. Th‐131I‐MIBG was administered shortly before (median: 17 days) high‐dose chemotherapy with busulfan and melphalan (HD‐BuMel) and autologous stem cell rescue (ASCR) at the Gaslini Institute in Genoa, with the aim of analyzing the feasibility, safety, and efficacy of this approach.

Results

Engraftment occurred in all patients after a median of 14 (11‐29) and 30 days (13‐80) from ASCR for neutrophils and platelets, respectively. No treatment‐related deaths were observed. The main high‐grade (3‐4) toxicity observed was oral and gastrointestinal mucositis in 78.6% and 7.1% of patients, respectively, whereas high‐grade hepatic toxicity was observed in 10.7%. Two patients developed veno‐occlusive‐disease (7.1%), completely responsive to defibrotide. Hypothyroidism was the main late complication that occurred in nine patients (31.1%). After Th‐131MIBG and HD‐BuMel, 19 patients (67.8%) showed an improvement in disease status. Over a median follow‐up of 15.9 years, the three‐year and five‐year overall survival (OS) probabilities were 53% (CI 0.33‐0.69) and 41% (CI 0.22‐0.59), and the three‐year and five‐year rates of cumulative risk of progression/relapse were 64% (CI 0.47‐0.81) and 73% (CI 0.55‐0.88), respectively. MYCN amplification emerged as the only risk factor significantly associated with OS (HR, 3.58;P = 0.041).

Conclusion

Th‐131I‐MIBG administered shortly before HD‐BuMel is a safe and effective regimen for patients with advanced MIBG‐avid NB. These patients should be managed in centers with proven expertise.
Structural and mechanical impact of synthetic clay in composite foams made via high‐internal phase emulsions
Authors: Mayr Lina , Simonyan Arsen , Breu Josef , Joseph Wingert Maxwell
Published: October 2020

Impacts of organophilic clay on open cell foams created from high‐internal phase emulsion templating were explored. Improving mechanical properties such as compression modulus by fillers is typically most challenging to realize. We investigated the effect of two different fillers: synthetic hectorite organophilized with a custom‐made organo‐cation and commercial organophilic montmorillonite. Contrary to the montmorillonite, the hectorite could significantly improve the foam mechanics, up to four times for foams with a relative density of 4.1%. Investigation of bulk mechanics and the morphology of foams led to the conclusion that the foam mechanics improvement is not due to a reinforcement of the struts. Instead, the organophilic hectorite might act as a Pickering emulsifier in addition to the molecular surfactants to achieve a more consistent structure, which in particular possesses more uniform strut thickness and improved mechanical properties.
Effects of processing parameters for vacuum‐bag‐only method on void content and mechanical properties of laminated composites
Authors: Mujahid Yasir , Sallih Nabihah , Abdullah Mohamad Zaki , Mustapha Mazli
Published: October 2020

Process parameters for vacuum‐bag‐only (VBO) method are of critical importance to control manufacturing‐induced void content and mechanical properties of laminated composites. Currently, no comparative studies are readily available on various VBO processing parameters namely bagging techniques, cure cycles, and laminate thicknesses on induced defects and mechanical properties. Hence, this study investigates the effects of these parameters on manufacturing‐induced void content and mechanical properties of composite laminates. Laminate samples were manufactured using L27 Taguchi orthogonal array experimental plan. Void contents, tensile and flexural properties of these samples were evaluated. Double VBO technique and direct (modified) cure cycle were found to be the most promising parameters in achieving the lowest void content among choices of bagging techniques and cure cycles, respectively. However, improved mechanical properties were achieved using a single VBO technique due to the higher fiber reinforcement volume fraction. In comparison to a typical cure cycle, the modified cure cycles were able to reduce surface porosity and through‐thickness void by 48.33% and 23.7%, respectively, whereas the tensile and flexural properties were increased by 2% to 3% and 17% to 20%, respectively. In addition, no significant interaction between parameters was observed.