bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic Value of Quantitative Gray-Scale Analysis of Contrast-Enhanced Spectral Mammography for Benign and Malignant Breast Lesions
Authors: Lv Yongbin , Chi Xiaoxiao , Sun Bolin , Lin Shujuan , Xing Dong 
Published: April 2020

ObjectiveThe aim of the study was to quantitatively analyze the enhancement of breast lesions by contrast-enhanced spectral mammography to improve the differential diagnosis ability of contrast-enhanced spectral mammography.MethodsA total of 283 patients with breast lesions admitted from August 2017 to May 2018 were retrospectively analyzed. Quantitative analysis of all enhancing lesions was performed to measure the gray values of the lesion region of interest (ROI), the area close to the lesion (ROI1), the area close to the chest wall (ROI2), and the chest wall (ROI3). Differences in gray values between different ROIs of benign and malignant lesions were compared. Taking the pathological results as the criterion standard, we used the receiver operating characteristic curve to evaluate the diagnostic efficacy of the ROI gray value and relative gray value (rROI) for the lesions.ResultsA total of 299 lesions were found in 283 patients, including 101 benign lesions and 198 malignant lesions. The ROI gray value, rROI1, rROI2, and rROI3 of malignant lesions were all significantly greater than those of benign lesions. The areas under the ROC curve of ROI, rROI1, rROI2, and rROI3 gray values of benign and malignant lesions were 0.795, 0.833, 0.812, and 0.741, respectively. The statistically significant difference in the area under the ROC curve was only found between rROI1 and ROI gray value and rROI1 had the greatest diagnostic value.ConclusionsThe gray value of malignant breast lesions was higher than that of benign lesions. The quantitative analysis of the gray value will help in the differential diagnosis of benign and malignant breast lesions.
Higher Mortality in Case of Small Left Atrium on Nongated Computed Tomography Pulmonary Angiography Is Associated With the Presence of Malignancy
Authors: Rozenbaum Zach , Granot Yoav , Halevi Carmel , Ziv-Baran Tomer , Berliner Shlomo , Aviram Galit 
Published: April 2020

Purpose:
The purpose of this study was to evaluate the association between small left atria (LA) according to computed tomography pulmonary angiography (CTPA) and mortality among individuals without pulmonary embolism, and to examine which volumes begin to portend adverse outcomes.

Materials and Methods:
Left atrial volume indices (LAVIs) of 752 consecutive patients who underwent CTPA, in which pulmonary embolism were ruled out, were measured retrospectively using an automatic 4-chamber volumetric analysis software. Groups of 5 percentiles within the lower quartile were investigated, and the interquartile range (25th to 75th percentiles) was regarded as the control group.

Results:
Patients within the lower 25th LAVI percentiles (<33 mL/m2; n=188) were younger and had less cardiovascular morbidities, while malignancies were less common in the control group (LAVI: 33 to 54 mL/m2; n=376). Percentiles 5th to 25th did not demonstrate an independent association with mortality. After adjustment for baseline characteristics, the risk for 30-day and 1-year mortality was 5.6 (95% confidence interval: 2.1-14.8, P=0.001) and 6.1 (95% confidence interval: 2.4-15.1, P<0.001) times higher, respectively, among the lowest five LAVI percentiles (<24 mL/m2) compared with the control group. Among patients with small LA who died within 1 year, 83% had a diagnosis of malignancy. Albeit, only a minority (3%) of patients with malignancies had small LA.

Conclusions:
Individuals undergoing CTPA whose LAVI is within the lowest five percentiles have a markedly increased risk for short-term and long-term mortality. The risk can probably be attributed to an underlying malignancy. The feasibility of 4-chamber volumetric analysis while avoiding a time-consuming process due to the automatic properties enables the introduction of this feature to clinical practice.
Incisional hernia incidence following laparotomy for combat trauma: Investigating 15 years of US war surgery
Authors: Moas Victor , Eskridge Susan , Clouser Mary , Kurapaty Steven , Dyke Christopher , Souza Jason 
Published: April 2020

BACKGROUND
While the incidence of incisional hernia (IH) following elective laparotomy has been well described, incidence following emergent laparotomy for combat trauma has been much less studied. This retrospective cohort investigates the latter to better describe the burden IH represents for the injured warfighter.

METHODS
Data were obtained from the Expeditionary Medical Encounter Database for service members who survived a combat-related injury between January 2002 and December 2016 and underwent abdominal surgery in the first 30 days after injury. Incisional hernia diagnosis at least 30 days after injury was determined from inpatient and outpatient records in the Military Health System's Medical Data Repository.
Means and SDs were reported for age and continuous Injury Severity Score, and frequency and percentages were reported for sex, branch of service, paygrade, mechanism of injury, Injury Severity Score, and maximum abdominal Abbreviated Injury Scale. Service members with and without a hernia diagnosis were compared using t test for continuous variables and χ2 or Fisher exact test (depending on cell size) for categorical variables.
Multivariate logistic regression models were used to examine relationships between IH diagnosis and the covariates previously mentioned. Data analysis was completed using SAS software version 9.4 (SAS Institute Inc., Cary, NC).

RESULTS
Of the 570 laparotomy patients, 109 (19.1%) developed IH. Of these, 58 (53%) were diagnosed within the first year after injury. An additional 21 (19%) were diagnosed within the following year, and 30 (28%) were diagnosed more than 2 years after injury. Presence of gastrointestinal injury, Abbreviated Injury Scale score of 4 and 5, and 5-year increments of age were positively associated with hernia formation.

CONCLUSION
The incidence of postlaparotomy IH in combat trauma is 19.1%, a considerable source of disability for injured warfighters. Further investigation into hernia-preventive closure strategies is warranted.

LEVEL OF EVIDENCE
Therapeutic study, level IV.
Enteric Conversion of Bladder-drained Pancreas as a Predictor of Outcomes in Almost 600 Recipients at a Single Center
Authors: Riad Samy M. , Keys Daniel O. , Jackson Scott , Vakil Viral , Berglund Danielle , Matas Arthur , Finger Erik B. , Kandaswamy Raja 
Published: April 2020

Background.
Complications associated with bladder-drained pancreata necessitating enteric conversion are common. Data on the outcomes after enteric conversion are conflicting. We studied the association between enteric conversion and the pancreas graft rejection, loss, and mortality.

Methods.
At our center, 1117 pancreas transplants were performed between 2000 and 2016. We analyzed 593 recipients with bladder-drained pancreata, of which 523 received solitary transplants and 70 received simultaneous pancreas-kidney transplants. Kaplan-Meier function was used to estimate time to conversion by transplant type. Cox proportional hazards models were utilized to evaluate patient survival, death-censored graft survival, and acute rejection-free survival while treating conversion as a time-dependent covariate. Subsequently, we examined the association between timing of conversion and the same outcomes in the conversion cohort.

Results.
At 10 y posttransplant, 48.8% of the solitary pancreas recipients and 44.3% of simultaneous pancreas-kidney transplant recipients had undergone enteric conversion. The enteric conversion was associated with 85% increased risk of acute rejection (hazard ratio [HR] = 1.85; 95% confidence interval [CI] = 1.37-2.49; P < 0.001). However, the conversion was not associated with graft loss or mortality. In the conversion cohort, a longer interval from engraftment to conversion was associated with an 18% lower rejection rate (HR = 0.82; 95% CI = 0.708-0.960; P = 0.013) and a 22% better graft survival (HR = 0.78; 95% CI = 0.646-0.946; P = 0.01).

Conclusions.
Enteric conversion was associated with increased risk of rejection, but not increased risks of graft loss or mortality. The decision to convert should consider the increased rejection risk. A longer interval from engraftment to conversion appears favorable.
Physician-patient relationship at HUEH: is it a “relationship to” or a “relationship between”
Authors: Jean Paul Axler , Leonard Yves Gardy , Saint Louis Rebecca , Camille Jackyvens , Delicat Hans Peter K. , Castra Roubytherson , Jean Ricardi , Delma Rubens , Decan Yvelo , Civil Marc Felix 
Published: April 2020

AbstractTo discover the relationship model in force between doctor and patient at the Haitian State University Hospital of Haïti (HUEH), a semi-directed survey was conducted among fifty patients. The qualitative analysis of the various interviews showed that patients were generally satisfied with their relationship with doctors. However, opinions are not sharing on their level information whether it is their illness or their therapeutic management; the results also showed that doctors had poor empathy. Hence our conclusion there is an unethical relationship in this institution, where doctors and patients coexist mainly in a “to” relationship and less so in a “between” relationship.
Particle Based Model for Airborne Disease Transmission
Authors: Dillon Michael B , Dillon Charles F 
Published: April 2020

Executive SummaryPrior literature documents cases of airborne infectious disease transmission at distances ranging from ≥ 2 m to inter-continental in scale. Physics- and biology- based models describe the key aspects of these airborne disease transmission events, but important gaps remain. This report extends current approaches by developing a new, single-particle based theory that (a) assesses the likelihood of rare airborne infections (where individuals inhale either one or no infectious particles) and (b) explicitly accounts for the variability in airborne exposures and population susceptibilities within a geographic region of interest. For these hazards, airborne particle fate and transport is independent of particulate concentration, and so results for complex releases can be determined from the results of many single-particle releases.This work is intended to provide context for both (a) the initial stages of a disease outbreak and (b) larger scale (≥ 2 m) disease spread, including distant disease “sparks” (low probability, unexpected disease transmission events that infect remote, susceptible populations). The physics of airborne particulate dispersion inherently constrains airborne disease transmission. As such, this work suggests results that,a priori, may be applicable to many airborne diseases.Model PredictionsModeling predictions of the single-particle transmission kernel suggest that outdoor airborne disease transmission events may occur episodically as the infection probabilities can vary over many orders of magnitude depending on the distance downwind; specific virus, prion, or microorganism; and meteorological conditions.Model results suggest that, under the right conditions, an indoor infected person could spread disease to a similar, or greater, number of people downwind than in the building they occupy. However, the downwind, per-person infection probability is predicted to be lower than the within-building, per-person infection probability. This finding is limited to airborne transmission considerations.This work suggests a new relative disease probability metric for airborne transmitted diseases. This metric, which is distinct from the traditional relative risk metric, is applicable when the rate at which the infectious agent losses infectivity in the atmosphere is ≲ 1 h-1.
Association of Digestive Symptoms and Hospitalization in Patients with SARS-CoV-2 Infection
Authors: Cholankeril George , Podboy Alexander , Aivaliotis Vasiliki Irene , Pham Edward A. , Spencer Sean , Kim Donghee , Hsing Ann , Ahmed Aijaz 
Published: April 2020

AbstractBackgroundHigh rates of concurrent gastrointestinal manifestations have been noted in patients with COVID-19, however the association between these digestive manifestations and need for hospitalization has not been established.MethodsFollowing expedited approval from our Institutional Review Board, we analyzed retrospectively collected data from consecutive patients with confirmed COVID-19 based on a positive polymerase chain reaction testing at our institution from March 03, 2020 to April 7, 2020. Baseline demographic, clinical, laboratory and patient-reported symptom data were collected at presentation in the emergency room. Multivariable logistic regression analyses were performed to evaluate the association between hospitalization and presence of gastrointestinal symptoms.ResultsDuring this study period, we identified 207 consecutive patients with confirmed COVID-19. 34.5% noted concurrent gastrointestinal symptoms; of which 90% of gastrointestinal symptoms were mild. In a multivariate regression model controlled for demographics and disease severity, an increased risk for hospitalization was noted in patients with any gastrointestinal symptom (adjusted OR 4.84 95% CI: 1.68-13.94]. Diarrhea was associated with a seven-fold higher likelihood for hospitalization (adjusted OR=7.58, 95% CI: 2.49-20.02, P <0.001) and nausea or vomiting had a four times higher odds. (adjusted OR 4.39, 95% CI: 1.61-11.4, P = 0.005).ConclusionWe demonstrate that a significant portion of COVID19 patients have concurrent mild gastrointestinal symptoms and that the presence of these digestive symptoms is associated with a need for hospitalization. With the current focus on streamlining triaging efforts, first responders and frontline providers should consider assessing for digestive symptoms in their initial clinical evaluation and decision-making.
Molecular Characterization of Depression Trait and State
Authors: Shukla Rammohan , Newton Dwight F. , Sumitomo Akiko , Zare Habil , Mccullumsmith Robert , Lewis David A. , Tomoda Toshifumi , Sibille Etienne 
Published: April 2020

ABSTRACTMajor Depressive disorder (MDD) is a chronic and recurrent brain disorder characterized by episode and remission phases, and poor therapeutic responses. The molecular correlates of MDD have been investigated in case-control settings, but the biological changes associated with trait (regardless of episode/remission) or state (illness phases) remains largely unknown, hence preventing therapeutic opportunities. To address this gap, we generated transcriptome profiles in the subgenual anterior cingulate cortex of MDD subjects who died during a single or recurrent episode or when in remission. We show that biological changes associated with MDD trait (inflammation, immune activation, reduced bioenergetics) are distinct from those associated with MDD phases or state (neuronal structure and function, neurotransmission). On the cell-type level, gene variability in subsets of GABAergic interneurons positive for corticotropin-releasing hormone, somatostatin or vasoactive-intestinal peptide was associated with MDD phases. Applying a probabilistic Bayesian network approach, we next show that gene modules enriched for immune system activation, cytokine response and oxidative stress, may exert causal roles across MDD phases. Finally, using a database of drug-induced transcriptome perturbations, we show that MDD-induced changes in putative causal pathways are antagonized by families of drugs associated with clinical response, including dopaminergic and monoaminergic ligands, and uncover potential novel therapeutic targets. Collectively, these integrative transcriptome analyses provide novel insight into cellular and molecular pathologies associated with trait and state MDD, and a method of drug discovery focused on disease-causing pathways.One Sentence SummaryIntegrating transcriptomic with various in-silico analyses identified cellular, molecular and putative biological causal pathways in trait and state depression
Embedded Enzyme Nanoclusters Depolymerize Polyesters via Chain-End Mediated Processive Degradation
Authors: DelRe Christopher , Kwon Junpyo , Kang Philjun , Ma Le , Hall Aaron , Ruan Zhiyuan , Zolkin Kyle , Li Tim , Ritchie Robert O. , Xu Ting 
Published: April 2020

AbstractMany bioactive elements, long perceived as non-viable for material development, are now emerging as viable building blocks to encode material lifecycle and to ensure our harmonious existence with nature. Yet, there is a significant knowledge gap on how bio-elements interface with synthetic counterparts and function outside of their native environments. Here, we show that when enzymes are dispersed as nanoclusters confined within macromolecular matrices, their reaction kinetics, pathway, and substrate selectivity can be modulated to achieve programmable polymer degradation down to repolymerizable small molecules. Specifically, when enzyme nanoclusters are dispersed in trace amount (~0.02wt%) in polyesters, i.e. poly(caprolactone) (PCL) and poly(lactic acid) (PLA), chain-end mediated processive depolymerization can be realized, leading to scalable bioactive plastics for efficient sorting, such as recovery of precious metal filler from flexible electronics. Present studies demonstrate that when the enzyme is confined at dimensions similar to that of polymer chains, their behaviors are governed by the polymer conformation, segmental dynamic and thermal history, highlighting the importance to consider bioactive plastics differently from solution enzymology.
Interspecies differences in proteome turnover kinetics are correlated with lifespans and energetic demands
Authors: Swovick Kyle , Firsanov Denis , Welle Kevin A. , Hryhorenko Jennifer R. , Wise John P. , George Craig , Sformo Todd L. , Seluanov Andrei , Gorbunova Vera , Ghaemmaghami Sina 
Published: April 2020

AbstractCells continually degrade and replace damaged and old proteins. However, the high energetic demand of protein turnover generates reactive oxygen species (ROS) that compromise the long-term health of the proteome. Thus, the relationship between aging, protein turnover and energetic demand remains unclear. Here, we used a proteomic approach to measure rates of protein turnover within primary fibroblasts isolated from a number of species with diverse lifespans including the longest-lives rodent, the naked mole rat and the longest-lived mammal, the bowhead whale. We show that organismal lifespan is negatively correlated with turnover rates of highly abundant proteins. In comparison to mice, cells from long-lived naked mole rats have slower rates of protein turnover, lower levels of ATP production and reduced ROS levels. Despite having slower rates of protein turnover, naked mole rat cells tolerate protein misfolding stress more effectively than mouse cells. We suggest that in lieu of rapid constitutive turnover, long-lived species may have evolved more energetically efficient mechanisms for selective detection and clearance of damaged proteins.
Episodic memories: how do the hippocampus and the entorhinal ring attractors cooperate to create them?
Authors: Kovács Krisztián A. 
Published: April 2020

AbstractThe brain is capable of registering a constellation of events, encountered only once, as an episodic memory that can last for a lifetime. As evidenced by the clinical case of the patient HM, memories preserving their episodic nature still depend on the hippocampal formation, several years after being created, while semantic memories are thought to reside in neocortical areas. The neurobiological substrate of one-time learning and life-long storing in the brain, that must exist at the cellular and circuit level, is still undiscovered. The breakthrough is delayed by the fact that studies jointly investigating the rodent hippocampus and entorhinal cortex are mostly targeted at understanding the spatial aspect of learning. Here we present the concept of an entorhinal cortical module, termed EPISODE module, that could explain how the representations of different elements constituting episodic memories can be linked together. The new model that we propose here reconciles the structural and functional observations made in the entorhinal cortex and explains how the downstream hippocampal processing organizes the representations into meaningful sequences.
Antibiotic-dependent relationships between nasal microbiome and secreted proteome in chronic rhinosinusitis and nasal polyps
Authors: Kim Yi-Sook , Han Dohyun , Mo Ji-Hun , Kim Yong-Min , Kim Dae Woo , Choi Hyo-Guen , Park Jong-Wan , Shin Hyun-Woo 
Published: April 2020

AbstractBackgroundAntibiotics are commonly prescribed to treat chronic rhinosinusitis (CRS); however, the effects of antibiotics on the microbiome and secreted proteome remain unknown in regard to CRS.ObjectiveWe analyzed the effects of antibiotics on the nasal microbiome and secreted proteome in the context of CRS using multi-omic analysis.MethodsNasal secretions were collected from 29 control, 30 CRS patients without nasal polyps (CRSsNP), and 40 CRS patients with nasal polyps (CRSwNP). A total of 99 subjects were divided into two groups that included subjects who had taken antibiotics 3 months prior to sampling (ABX) and those who had not (NABX). We performed 16S rDNA sequence analyses and Orbitrap mass spectrometry-based proteomic analyses in data-independent acquisition (DIA) on the nasal secretions. Spearman correlation was used to assess the correlations between the nasal microbiome and secreted proteome.ResultsWe observed a strong association between the nasal microbiome and secreted proteome according to disease status. Antibiotic use reduced differences in the microbial community and secreted proteome according to disease status. Interestingly, in nasal polyp (NP) patients, antibiotics exhibited strong effects not only on the nasal microbiome and the secreted proteome but also on their associations. Additionally, their correlations were strengthened in subjects who had taken antibiotics.ConclusionIntegrative analyses revealed that the correlations between the microbiome and the secreted proteome could be altered and strengthened in subjects who used antibiotics. These findings provide novel insight into the effects of antibiotics on the nasal environment and the host responses in CRS.