bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disturbances in Metabolic Pathways and the Identification of a Potential Biomarker Panel for Early Cartilage Degeneration in a Rabbit Anterior Cruciate Ligament Transection Model
Authors: Hu Yiwen , Wu Qian , Qiao Yang , Zhang Peng , Dai Wentao , Tao Hongyue , Chen Shuang 
Published: May 2020

Objective This study aimed to assess the association between synovial fluid (SF) metabolites and magnetic resonance imaging (MRI) measurements of cartilage biochemical composition to identify potential SF biomarkers for detecting the early onset of cartilage degeneration in a rabbit model. Methods Both knees of 12 New Zealand White rabbits were used. The anterior cruciate ligament transection (ACLT) model was performed on right knees, and the sham surgery on left knees. MRI UTE-T2* scanning and SF sample collection were performed on ACLT knees at 4 and 8 weeks postsurgery and on sham surgery knees at 4 weeks postsurgery. Ultra-performance liquid chromatography–mass spectrometry and multivariate statistical analysis were used to distinguish samples in three groups. Pathway and receiver operating characteristic analyses were utilized to identify potential metabolite biomarkers. Results There were 12 knees in sham surgery models, 11 in ACLT models at 4 weeks postsurgery, and 10 in ACLT models at 8 weeks postsurgery. UTE-T2* values for the lateral tibia cartilage showed significant decreases over the study period. Levels of 103 identified metabolites in SF were markedly different among three groups. Furthermore, 24 metabolites were inversely correlated with UTE-T2* values of the lateral tibia cartilage, while hippuric acid was positively correlated with UTE-T2* values of the lateral tibia cartilage. Among 25 potential markers, N1-acetylspermidine, 2-amino-1,3,4-octadecanetriol, l-phenylalanine, 5-hydroxy-l-tryptophan, and l-tryptophan were identified as potential biomarkers with high area under the curve values and Pearson correlation coefficients. Conclusion Five differential metabolites in SF were found as potential biomarkers for the early detection of cartilage degeneration in the rabbit ACLT model.
Impact of COVID‐19 pandemic on the daily management of biotechnological therapy in inflammatory bowel disease patients: Reorganisational response in a high‐volume Italian inflammatory bowel disease centre
Authors: Scaldaferri Franco , Pugliese Daniela , Privitera Giuseppe , Onali Sara , Lopetuso Loris Riccardo , Rizzatti Gianenrico , Settanni Carlo Romano , Pizzoferrato Marco , Schiavoni Elisa , Turchini Laura , Amatucci Valeria , Napolitano Daniele , Bernabei Tiziana , Mora Vincenzina , Laterza Lucrezia , Papa Alfredo , Guidi Luisa , Rapaccini Gian Lodovico , Gasbarrini Antonio , Armuzzi Alessandro 
Published: May 2020

The coronavirus disease 2019 (COVID‐19) pandemic is having a major clinical as well as organisational impact on the national health‐care system in Italy, particularly in high‐volume hospitals which are usually active for many essential clinical needs, including inflammatory bowel disease (IBD). Here, we report major clinical and organisational challenges at a high‐volume Italian IBD centre one month after the start of the Italian government’s restrictions due to the COVID‐19 pandemic. All routine follow‐up IBD visits of patients in remission were cancelled or rescheduled for 8–12 weeks’ time. However, access to the hospital for therapy or for unstable/relapsing patients was not considered postponable. Everyone attending the centre (e.g. physicians, nurses, administrative personnel and patients) were advised to respect the general recommended rules for hand hygiene and social distancing, to disclose if they had a fever or cough or flu‐like symptoms and to wear a surgical mask and gloves. At the entrance of the therapy area, a control station was set up in order to double‐check all patients with a clinical interview and conduct thermal scanning. A total of 1451 IBD patients under biotechnological or experimental therapy actively followed in the CEMAD IBD centre were included in the study. About 65% of patients maintained their appointment schedules without major problems, while in 20% of cases planned infusions were delayed because of the patient’s decision or practical issues. About 10% of patients receiving subcutaneous therapy were allowed to collect their medicine without a follow‐up visit. Finally, 10% of patients living outside the Lazio region requested access to their therapy at a local centre closer to their home. At present, five patients have been found to be positive for SARS‐CoV‐2 infection but with minimal symptoms, 22 are in ‘quarantine’ for contact considered to be ‘at risk’ for the infection. Up to now, none of them has experienced significant symptoms. This study represents the first observational detailed report about short‐term impact of the COVID‐19 pandemic on patient organisation and management in a high‐volume IBD centre.
Reverse intermittent androgen deprivation therapy: Prostate cancer and hypopituitarism
Authors: Hill George , Persad Raj , Bolomytis Stefanos 
Published: May 2020

Testosterone replacement in the context of untreated prostate cancer is a controversial topic, where the symptomatic benefits of testosterone therapy contrast with the risk of disease progression. We report the case of a 76-year-old gentleman, under watchful waiting for known prostate cancer, who underwent a transsphenoidal resection of a pituitary macroadenoma. The adenoma and subsequent surgical treatment resulted in secondary testosterone deficiency, effectively ‘self-commencing’ endogenous androgen deprivation therapy. After discussion with the endocrine team, careful intermittent testosterone supplementation was undertaken to address his symptoms, with the patient undergoing prostate-specific antigen surveillance. This was felt to be similar to intermittent androgen deprivation therapy in reverse. Here, we review current evidence regarding testosterone therapy in the context of prostate cancer. Level of Evidence: 5
The Impact of Combined Risk-Reducing Gynecological Surgeries on Outcomes in DIEP Flap and Tissue-Expander Breast Reconstruction
Authors: Jayaraman Avinash P. , Boyd Travis , Hampton Savannah N. , Haddock Nicholas T. , Teotia Sumeet S. 
Published: May 2020

Introduction: In addition to prophylactic mastectomies, BRCA1 and BRCA2 mutation carriers are increasingly choosing to undergo risk-reducing procedures such as hysterectomies and salpingo-oophorectomies. Sometimes these surgeries are performed in the same visit as a mastectomy or a revisionary reconstruction procedure. Literature lacks descriptions of complications and trends for these combined surgeries. Methods: Group 1 patients (n = 10, flaps = 20) had abdominal gynecologic procedures at the time of deep inferior epigastric artery perforator flap (DIEP flap) reconstruction. Group 2 patients (n = 29, breasts = 58) had gynecologic procedures at the time of mastectomy and tissue-expander placement. Group 3 patients (n = 141, breasts = 257) had mastectomy and tissue-expander reconstruction without gynecologic procedures and were used as a control group for group 2. Group 4 patients (n = 357, flaps = 673) had autologous breast reconstruction without gynecologic procedures and were used as a control for group 1. Categorical variables such as complications and flap loss were analyzed using χ2 tests. Continuous variables such as age, body mass index (BMI), operative time, length of stay were analyzed with 2-tailed t tests. Multivariate analyses were run to control for group differences. Results: Groups 1 and 4 were equivalent in age and comorbidities, except group 1 (32.8 kg/m2) had significantly higher BMI than group 4 (31.4 kg/m2), P = .028. Average operating time was statistically equivalent for group 1 patients (610 minutes) and group 4 patients (503 minutes), P = .289. Average hospital stay was equivalent as well (group 1 = 4.4 days, group 4 = 4.1 days, P = .676). Operative times for group 2 patients (457 minutes) were significantly longer than for group 3 patients (288 minutes), P < .01. Group 2 patients (3 nights) had significantly longer hospital stays than group 3 patients (2 nights), P < .01. Group 1 patients (2/20 flaps, 10%) had a significantly higher rate of flap loss than group 4 patients (8/673 flaps, 1%), P < .01. There were no differences in other flap complications. Additionally, there were no significant differences in postoperative tissue-expander complications between group 2 and group 3. Discussion: Both flap losses in Group 1 patients occurred in a single patient with BMI = 39.3 kg/m2 and a personal history of recurrent DVTs. Additionally, the rates of complications across other measures were equivalent between groups. Thus, despite the increased rate of flap loss in Group 1 (10%) vs Group 4 (1.3%), along with the increased operative times and hospital stays, certain patients can be advised that a prophylactic gynecological procedure is safe to combine with breast reconstruction.
The importance of wavelength for tight temperature control during μ-laser-assisted machining
Authors: Dennis Ashley , Goel Saurav , Al-Sayegh Rajab , O’Neill William 
Published: May 2020

The area of single point diamond turning of brittle materials like semiconductors and ceramics is significantly benefitted by incorporation of laser assistance. In a new developmental technology that is now recognized as micro-laser-assisted machining (μ-LAM), a laser is shone through a diamond tool to soften the high-pressure phase transformed ductile machining phases that in turn allows thermal softening and thereby enables a higher material removal rate during ductile mode machining. One of the lasers currently used in μ-LAM is the neodymium-doped yttrium aluminum garnet (Nd:YAG) laser operating at 100 W (continuous wave) at the wavelength of 1064 nm. Although this configuration has worked to the benefit of the technology, here we report futuristic developments that will significantly enhance temperature control by selecting a laser wavelength according to the material being machined, allowing tunable machining properties. The concept is illustrated with sample calculations for μ-LAM of silicon, and it appears to offer better target temperatures, thus enhancing the performance of the μ-LAM process.
Suboptimal treatment response to anti-IL-5 monoclonal antibodies in severe eosinophilic asthmatics with airway autoimmune phenomena
Authors: Mukherjee Manali , Forero David Felipe , Tran Stephanie , Boulay Marie-Eve , Bertrand Mylène , Bhalla Anurag , Cherukat Jayant , Al-Hayyan Hajar , Ayoub Anmar , Revill Spencer D. , Javkar Tanvi , Radford Katherine , Kjarsgaard Melanie , Huang Chynna , Dvorkin-Gheva Anna , Ask Kjetil , Olivenstein Ronald , Dendukuri Nandini , Lemiere Catherine , Boulet Louis-Philippe , Martin James G. , Nair Parameswaran 
Published: May 2020

BackgroundIn clinical trials, the two anti-interleukin (IL)-5 monoclonal antibodies (mAbs: mepolizumab and reslizumab) approved to treat severe eosinophilic asthma reduce exacerbations by ∼50–60%.ObjectiveTo observe response to anti-IL-5 mAbs in a real-life clinical setting, and to evaluate predictors of suboptimal response.MethodsIn four Canadian academic centres, predefined clinical end-points in 250 carefully characterised moderate-to-severe asthmatic patients were collected prospectively to assess response to the two anti-IL-5 mAbs. Suboptimal response was determined based on failure to reduce maintenance corticosteroid (MCS) or asthma symptoms scores (Asthma Control Questionnaire (ACQ)) or exacerbations, in addition to persistence of sputum/blood eosinophils. Worsening in suboptimal responders was assessed based on reduced lung function by 25% or increase in MCS/ACQ. A representative subset of 39 patients was evaluated for inflammatory mediators, autoantibodies and complement activation in sputum (by ELISA) and for immune-complex deposition by immunostaining formalin-fixed paraffin-embedded sputum plugs.ResultsSuboptimal responses were observed in 42.8% (107 out of 250) patients treated with either mepolizumab or reslizumab. Daily prednisone requirement, sinus disease and late-onset asthma diagnoses were the strongest predictors of suboptimal response. Asthma worsened in 13.6% (34 out of 250) of these patients. The majority (79%) of them were prednisone-dependent. Presence of sputum anti-eosinophil peroxidase immunoglobulin (Ig)G was a predictor of suboptimal response to an anti-IL-5 mAb. An increase in sputum C3c (marker of complement activation) and deposition of C1q-bound/IL-5-bound IgG were observed in the sputa of those patients who worsened on therapy, suggesting an underlying autoimmune-mediated pathology.ConclusionA significant number of patients who meet currently approved indications for anti-IL5 mAbs show suboptimal response to them in real-life clinical practice, particularly if they are on high doses of prednisone. Monitoring blood eosinophil count is not helpful to identify these patients. The concern of worsening of symptoms associated with immune-complex mediated complement activation in a small proportion of these patients highlights the relevance of recognising airway autoimmune phenomena and this requires further evaluation.
A fully automatic deep learning system for COVID-19 diagnostic and prognostic analysis
Authors: Wang Shuo , Zha Yunfei , Li Weimin , Wu Qingxia , Li Xiaohu , Niu Meng , Wang Meiyun , Qiu Xiaoming , Li Hongjun , Yu He , Gong Wei , Bai Yan , Li Li , Zhu Yongbei , Wang Liusu , Tian Jie 
Published: May 2020

Coronavirus disease 2019 (COVID-19) has spread globally, and medical resources become insufficient in many regions. Fast diagnosis of COVID-19 and finding high-risk patients with worse prognosis for early prevention and medical resource optimisation is important. Here, we proposed a fully automatic deep learning system for COVID-19 diagnostic and prognostic analysis by routinely used computed tomography.We retrospectively collected 5372 patients with computed tomography images from seven cities or provinces. Firstly, 4106 patients with computed tomography images were used to pre-train the deep learning system, making it learn lung features. Following this, 1266 patients (924 with COVID-19 (471 had follow-up for >5 days) and 342 with other pneumonia) from six cities or provinces were enrolled to train and externally validate the performance of the deep learning system.In the four external validation sets, the deep learning system achieved good performance in identifying COVID-19 from other pneumonia (AUC 0.87 and 0.88, respectively) and viral pneumonia (AUC 0.86). Moreover, the deep learning system succeeded to stratify patients into high- and low-risk groups whose hospital-stay time had significant difference (p=0.013 and p=0.014, respectively). Without human assistance, the deep learning system automatically focused on abnormal areas that showed consistent characteristics with reported radiological findings.Deep learning provides a convenient tool for fast screening of COVID-19 and identifying potential high-risk patients, which may be helpful for medical resource optimisation and early prevention before patients show severe symptoms.
Predicting extubation outcomes using the Heart Rate Characteristics index in preterm infants: a cohort study
Authors: Chakraborty Mallinath , Watkins William John , Tansey Katherine , King William E. , Banerjee Sujoy 
Published: May 2020

A strategy of early extubation to noninvasive respiratory support in preterm infants could be boosted by the availability of a decision support tool for clinicians. Using the Heart Rate Characteristics index (HRCi) with clinical parameters, we derived and validated predictive models for extubation readiness and success.Peri-extubation demographic, clinical and HRCi data for up to 96 h were collected from mechanically ventilated infants in the control arm of a randomised trial involving eight neonatal centres, where clinicians were blinded to the HRCi scores. The data were used to produce a multivariable regression model for the probability of subsequent re-intubation. Additionally, a survival model was produced to estimate the probability of re-intubation in the period after extubation.Of the 577 eligible infants, data from 397 infants (69%) were used to derive the pre-extubation model and 180 infants (31%) for validation. The model was also fitted and validated using all combinations of training (five centres) and test (three centres) centres. The estimated probability for the validation episodes showed discrimination with high statistical significance, with an area under the curve of 0.72 (95% CI 0.71–0.74; p<0.001). Data from all infants were used to derive models of the predictive instantaneous hazard of re-intubation adjusted for clinical parameters.Predictive models of extubation readiness and success in real-time can be derived using physiological and clinical variables. The models from our analyses can be accessed using an online tool available atwww.heroscore.com/extubation, and have the potential to inform and supplement the confidence of the clinician considering extubation in preterm infants.
First-line carboplatin plus pemetrexed with pemetrexed maintenance in HIV-positive patients with advanced non-squamous non-small cell lung cancer: the phase II IFCT-1001 CHIVA trial
Authors: Lavole Armelle , Greillier Laurent , Mazières Julien , Monnet Isabelle , Kiakouama-Maleka Lize , Quantin Xavier , Spano Jean Philippe , Lena Herve , Fraisse Philippe , Janicot Henri , Audigier-Valette Clarisse , Langlais Alexandra , Morin Franck , Makinson Alain , Cadranel Jacques 
Published: May 2020

HIV infection is an exclusion criterion in lung cancer trials. This multicentre phase II trial aimed to assess feasibility, efficacy and safety of first-line carboplatin plus pemetrexed (CaP) followed by pemetrexed (P) maintenance in people living with HIV (PLHIV) with advanced non-squamous non-small cell lung cancer (NS-NSCLC).Four cycles of CaP were followed by P-maintenance therapy in patients with Eastern Cooperative Oncology Group performance status ≤2. The primary objective was a disease control rate (DCR) ≥30% after 12 weeks.Of the 61 PLHIV enrolled, 49 (80%) had a performance status of 0–1, and 19 (31%) had brain metastases. Median CD4 lymphocyte count was 418 cells·µL−1(range 18–1230), median CD4 lymphocyte nadir was 169.5 cells·µL−1(1–822); 48 (80%) patients were virologically controlled. Four-cycle inductions were achieved by 38 (62%) patients, and 31 (51%) started P-maintenance (median of 4.1 cycles (range 1–19)). The 12-week DCR was 50.8% (95% CI 38.3–63.4) and partial response rate 21.3%. Median progression-free survival and overall survival were 3.5 (95% CI 2.7–4.4) and 7.6 months (5.7–12.8), respectively. Patients with a performance status of 0–1 had the longest median progression-free survival (4.3 months, 95% CI 3.1–5.2) and overall survival (11.9 months, 95% CI 6.4–14.3). During induction, CaP doublet was well tolerated apart from grade 3–4 haematological toxicities (neutropenia 53.8%; thrombocytopenia 35.0%; anaemia 30.0%). Two fatal treatment-related sepses were reported. No opportunistic infections were experienced.In PLHIV with advanced NS-NSCLC, first-line four-cycle CaP induction followed by P-maintenance was effective and reasonably well-tolerated. Further studies should evaluate combination strategies of CaP with immunotherapy in PLHIV.
Micro- and mesozooplankton at the edges of coastal tropical reefs (Tamandaré, Brazil)
Authors: Brito-Lolaia Morgana , Santos Gleice S. , Neumann-Leitão Sigrid , Schwamborn Ralf 
Published: May 2020

AbstractTropical reef ecosystems are generally considered to be sinks of marine zooplankton, mainly due to the predation by scleractinian corals and other planktivores. The present study aims to evaluate the zooplankton community of a coastal reef in two specific environments: the reef edge and open-water channels between patch reefs. Sampling was carried out at two patch reefs that border the Tamandaré coastal lagoon system (Pernambuco State, Brazil). Two passive stationary nets (64 μm mesh size) were used: the Reef Edge Net (REN) and the Channel Midwater Neuston Net (CMNN). Sampling was performed simultaneously at both reefs during eight nocturnal sampling campaigns, always at new moon ebb tides. Zooplankton was classified by “origin” (estuarine, reef, neritic and neritic/estuarine). During all campaigns and at both sites, a significant buildup of zooplankton at the reefs was observed. Reef edges showed significantly higher abundance (77,579 ± 73,985 ind. m−3) and biomass (48.9 ± 45.5 mg C m−3) of zooplankton compared to open-water channels (9982 ± 11,427 ind. m−3and 11.4 ± 21.9 mg C m−3, respectively). A total of 65 taxonomic groups were identified. Copepods were the most abundant group with a contribution of 69% for total zooplankton abundance, followed by foraminiferans, gastropod veligers, appendicularians, cirripedians nauplii, and polychaete larvae. Copepods from neritic/estuarine environments dominated the reef edges in both relative abundance and relative biomass (91% and 88%, respectively). The unexpectedly high abundance of copepods and other holoplankton at the reef edges, when compared to Indo-Pacific and Caribbean reefs, is probably due to very low cover of corals and other zooplanktivorous sessile animals (< 0.2%) on these coastal reefs, which leads to a very low predation mortality for zooplankters. Also, we propose that the reduced water column above the reef top leads to a buildup of very high densities in these environments.