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Temporal Trends in Prognosis of Patients with Acute Coronary Syndrome Complicated by...
Ella Yahud
Avishag Laish Farkash

Ella Yahud

and 6 more

April 15, 2021
Objectives: To evaluate clinical characteristics and prognosis of patients presented with ventricular tachyarrhythmia (VTA) during the course of acute coronary syndrome (ACS) and to analyze it according to period of presentation. Background: VTA is an infrequent yet serious complication of ACS. There is limited data regarding the incidence and prognostic implications of VTA in the last decade as compared with the previous decade. Methods: We evaluated clinical characteristics, major adverse cardiovascular events, short and long- term mortality of patients hospitalized with ACS who were enrolled in the Acute Coronary Syndrome Israeli Survey (ACSIS) during the years 2000-2016. Patients were classified into three groups: no VTA, early VTA (≤48h of onset) and late VTA (>48h of onset). Data were analyzed according to decades of presentation (current decade vs. previous decade). Results: The study population comprised 15,200 patients. VTA occurred in 487 (3.2%) of patients. Early VTA presented in 373/487 (77%) patients and late VTA in 114/487 (23%) patients. VTA’s, occurring in ACS patients were associated with increased risk of in-hospital, 30-days, 1-year and 5-year mortality rates during both early and late periods in compared with no VTA. Moreover, late VTA was associated with the highest mortality rate with up to 65% in 5-year follow up (p<0.001). Nevertheless, late VTA was associated with lower mortality rate in the current decade (2008-2016) compared with last decade (2000-2006). Conclusions: Any VTA following ACS was associated with high short and long-term mortality rate. However, over the past decade there has been a significant improvement in survival rates, especially in patients with late VTA. This may be attributed to early and invasive reperfusion therapy, implantable cardioverter defibrillator implantation and better medical treatment.
Comparison of short- and long-axis nerve hydrodissection for carpal tunnel syndrome:...
Si-Ru Chen
Tsung-Yen Ho

Si-Ru Chen

and 6 more

April 15, 2021
Introduction This study is to compare the efficacy of two different methods of nerve hydrodissection (HD), called short- and long-axis injection, for patients with mild-to-moderate carpal tunnel syndrome (CTS). Methods Forty-seven patients with mild-to-moderate CTS were enrolled in a prospective, randomized, single-blinded, controlled trial (6 months follow-up). With ultrasound guidance, patients in both groups (short-axis or long-axis groups) were injected with normal saline (5 mL per session). Assessments were performed before and 2 weeks after the injection, as well as at 1, 3, and 6 months post-intervention. The primary outcome measure was the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) score and secondary outcomes included the cross-sectional area of the median nerve and electrophysiological studies. Results Forty-four patients (21 wrists in the short-axis group and 23 wrists in the long-axis group) completed the study. Compared with the baseline, both groups showed improved BCTQ and cross-sectional area at all follow-up assessments (p<0.05). Moreover, the short-axis group had significant improvements in BCTQ-severity and BCTQ-function 1 month post-injection compared to the long-axis group (p = 0.031 and p = 0.023, respectively). Conclusion Both short- and long-axis HD were effective for patients with mild-to-moderate CTS; however, the short-axis HD conferred relatively better efficacy 1 month after the injection.
Infectious Rupture of a Dissecting Thoracoabdominal Aortic Aneurysm Due to Citrobacte...
Masafumi Hashimoto
Kenji Mogi

Masafumi Hashimoto

and 5 more

April 15, 2021
Here we describe a case involving an elderly man with Citrobacter freundii-associated infectious rupture of a dissecting thoracoabdominal aortic aneurysm. We performed emergency thoracoabdominal aortic replacement using a rifampicin-soaked prosthetic graft and omental flap wrapping. The patient was discharged on postoperative day 255, although he experienced pseudomembranous enteritis and paraplegia.
Cervical lymphadenopathy following COVID-19 vaccine: Clinical characteristics and imp...
Ahmad Kamal Abou-Foul

Ahmad K. Abou-Foul

and 3 more

April 16, 2021
Cervical lymphadenopathy following COVID-19 vaccine: Clinical characteristics and implications for head and neck cancer servicesRunning title: COVID-19 vaccine-associated lymphadenopathyAhmad K. Abou-Foul1*, Elizabeth Ross1, Mahmoud Abou-Foul2, Ajith P. George1,3
Etiologies of Hemodynamically Significant Aortic Regurgitation and Coronary Cusp Bend...
Naoki Hoshino
Akira Yamada

Naoki Hoshino

and 7 more

April 15, 2021
Background: While the number of patients with aortic regurgitation (AR) has been increasing in the aging society, its etiologies remain to be fully elucidated. Methods: We studied consecutive 126 patients with chronic moderate or severe AR who underwent TEE. After the study subjects were divided into 2 groups by the age of 65 years, AR etiology was examined in each group. Results: In the older group (n = 85), cusp bending was the most frequent cause of AR (48.2%), and right coronary cusp (RCC) was the most common (90.2%). In the younger group (n=41), bicuspid valve was the most frequent cause (36.5%), and cusp bending was less frequent (16.5%). Multivariate analysis revealed that age was the only factor associated with cusp bending. Conclusion: Cusp bending of RCC was the most frequent etiology of AR in the elderly. Because AR caused by cusp bending has a possibility to be mended by aortic plasty, it is important to detect it by TEE especially in the older patients.
Investigating the compounding effects of environmental factors on ecosystem services...
Liyuan Zuo
Jiangbo  Gao

Liyuan Zuo

and 1 more

April 15, 2021
Exploring the driving factors of ecosystem services (ESs) trade-offs/synergies is crucial for ecosystem management, especially in ecological conservation red line (ECRL) areas that maintain regional and national ecological security. Soil conservation (SC), water yield (WY) and carbon sequestration (CS) were simulated in the Beijing ECRL areas. Geographical weighted regression was used to explore the trade-offs/synergies, and the geographical detector was applied to quantitatively identify their driving factors. Results show that (1) the SC and CS show marked synergy which characterized more than 80% of each ECRL area; the proportion of the space area of trade-off and synergy between SC and WY, and WY and CS was roughly 3 to 7 and 4 to 6 in each ECRL area, respectively. (2) The synergy of the three pairs of ESs was most sensitive to terrain factors. The precipitation erodibility of soil and its necessity for vegetation make it a determinant of the trade-off between SC and CS; temperature was the determinant in the trade-off between WY and CS, with an explanatory power of 32.8%; potential evapotranspiration was best able to explain the spatial distribution of the trade-off between SC and WY. (3) The interaction between precipitation and other factors had the greatest explanatory power on the spatial relationship between SC and WY. Precipitation and relief amplitude are the main interactive factors respectively affecting the spatial trade-off and synergy between SC and CS. The trade-off and synergy between WY and CS were most sensitive to the interaction between climate factors and terrain factors.
Recurrent, refractory hypokalemia as a diagnostic clue to thyrotoxic periodic paralys...
Vishwanath Pattan
Ken Chiu

Vishwanath Pattan

and 2 more

April 15, 2021
Hypokalemia can be multifactorial. When the primary driver of hypokalemia is obvious it is easy to miss other contributing causes that could be vital to optimal patient management and outcomes. Our case report highlights the importance of recognizing recurrent, refractory hypokalemia as a diagnostic clue to thyrotoxic periodic paralysis.
Hepatorenal Dysfunction Predicts Operative Mortality After Triple Valve Surgery: Util...
Kevin Lim
Chi Ying Simon Chow

Kevin Lim

and 5 more

April 15, 2021
Background Despite significant advancements in operative techniques and myocardial protection, triple valve surgery (TVS) remains a formidable operation with a relatively high in-hospital mortality. We evaluated the prognostic value of Model for End-stage Liver Disease score including sodium (MELD-Na) for mortality after TVS and its predictive value when incorporated in the EuroSCORE risk model. Methods We performed a retrospective cohort study of 61 consecutive patients who underwent TVS from November 2005 to June 2016. Demographics, clinical, biochemical, and operative data were collected and analysed. Results Median follow-up duration was 8.0 years. 70.5% of patients suffered from rheumatic heart disease. 86.9% underwent mechanical double valve replacement with tricuspid valve repair. There were six operative deaths (9.84%), with the most common cause of death being multiorgan failure (83.3%). 26.2% had a moderately elevated MELD-Na score of 9 to 15, and 4.9% had a severely elevated score of >15. Patients with a MELD-Na >9 had a higher unadjusted rate of operative mortality, prolonged ventilation, need for dialysis and acute liver failure after TVS. Hierarchical logistic regression was performed using logistic EuroSCORE as the base model. After risk adjustment, each point of MELD-Na score increase was associated with 1.405 times increase in odds of operative mortality. The regression analysis was repeated by incorporating individual components of the MELD-Na score, including bilirubin, sodium, and albumin. All three biochemical parameters were significantly associated with operative mortality Conclusion MELD-Na score as a quantifier of hepatorenal dysfunction is sensitive and specific for mortality after triple valve surgery.
Blue whale (Balaenoptera musculus musculus) genome: population structure and history...
Sushma Jossey
Oliver Haddrath

Sushma Jossey

and 12 more

April 14, 2021
Knowledge of genetic diversity and structure is essential for developing conservation strategies for endangered species. The advances in museum genomics can assist in better understanding the effects of over-hunting on the genome by comparing historical to present-day samples. Blue whales were hunted to the point of near extinction in the mid-twentieth century. Herein, we use whole genome sequencing to elucidate the poorly understood population structure of North Atlantic (NA) blue whales (Balaenoptera musculus musculus). We generated a de novo genome assembly of 2.49 Mbp for a NA blue whale (N50 of 1.46 Mb) to analyze 19 whole genomic sequences and 28 complete mitochondrial genomes. We included present-day and historical samples (earliest from 1900) from the Atlantic and Antarctica to understand the impact of whaling on the genetic diversity. We found low population structuring, but high genetic diversity, suggesting a single, panmictic population in the NA. We identified gene flow from fin whale to blue whales, accounting for ~3.5% of the genome. Introgression between blue and fin whales was observed in all the present-day samples but were lacking in some whales sampled early in the 20th century, which suggests increasing disruption in mate choice concomitant with decline in blue whale population. We also assembled and analyzed the transcriptome and revealed positive selection of oncogenes, which may be involved in reduced cancer rates in this largest of mammals ever known. Our sequencing and population structuring studies provide a genomic framework to guide ongoing conservation strategies for this iconic species.
Surgical Management of Type A Aortic Dissection After Percutaneous Coronary Intervent...
Athanasia Makrygianni
Filippos - Paschalis Rorris

Athanasia Makrygianni

and 6 more

April 14, 2021
Type A aortic dissection after percutaneous coronary intervention is a rare and life-threatening situation. The reported incidence ranges from 0,02% to 0,6% of all diagnostic and interventional percutaneous procedures. We describe a case of aortic dissection after percutaneous coronary intervention in a patient with acute myocardial infarction from spontaneous coronary artery dissection. The patient was initially treated with primary percutaneous coronary intervention of the affected left coronary artery branches and left main coronary artery. Conservative management for the aortic dissection proved inadequate due to increasing diameter of the false lumen and the patient was referred to our cardiovascular unit for definite surgical management.
Hyperbaric oxygen therapy as adjuvant therapy for odontogenic necrotizing myositis: c...
Andrea Neville Cracchiolo
Daniela Maria Palma

Andrea Neville Cracchiolo

and 8 more

April 14, 2021
Necrotizing soft tissue infections (NSTIs) are life-threatening conditions burdened with high mortality. They’re often associated to a poor prognosis if early diagnosis and prompt treatment is not warranted. Treatment is always medical, often surgical and sometimes with hyperbaric oxygen.
Drainless Parotidectomy Using Tissue Fibrin Sealant -- A Case-Control Study
Oded Cohen
Hen Chaushu

Oded Cohen

and 4 more

April 14, 2021
Objectives: Drainless parotidectomy has been reported infrequently, mostly in patients undergoing limited partial parotidectomies. Evicel is a fibrin sealant (FS) glue whose use has not been reported in head and neck surgeries so far. The aim of the study was to investigate the impact of drainless parotidectomy using FS on the surgical outcome. Design: A retrospective matched case-control series. Settings: A single academic center, Participants: All cases of patients who underwent drainless parotidectomies, including deep lobe tumors and revision surgeries, were compared to age, sex, body mass index and tumor-matched controls in which a suction drain was inserted. Main outcome measures: length of hospital stay (LOS). Secondary outcomes included post-operative seroma and related complications. Results: A total of 123 patients (41 cases and 82 controls) were included in the study. Pre-operative and intra-operative characteristic did not differ significantly between the FS group and controls. A borderline significance was found for surgery type as the FS group had higher rates of total parotidectomy compared with the control group (25.0% vs. 10.5%, p=0.054). LOS was significantly shorter in the FS group (1.0±0.3 vs. 1.5±0.6 days, p<0.001). The rates of post-operative seroma, aspirations, local infection and post-operative antibiotic treatment were all lower in the FS group compared with the control group, but did not reach statistical significance. Conclusion: A drainless parotidectomy using the EVICEL FS is safe, reduces LOS, and may reduce post-operative seroma and its associated complications. This procedure may be applied to deep parotid tumors, parapharyngeal involvement and revision surgery.
The prevalence of oropharyngeal squamous cell carcinoma in patients admitted with sym...
Andrew Lau
Kristijonas Milinis

Andrew Lau

and 10 more

April 14, 2021
ABSTRACT Objectives Anecdotal evidence suggests that oropharyngeal squamous cell carcinoma (OPSCC) should be suspected in patients presenting with symptoms of peritonsillar abscess (PTA) or cellulitis (PTC). The aim of this study was to estimate the prevalence of OPSCC in patients presenting with symptoms of PTA/PTC. Method, Setting and Participants We retrospectively identified all adults with a coded diagnosis of PTA or PTC who presented between 2012-2016 inclusive, across six ENT units in ——–. Records were compared to that of the centralised regional head and neck cancer database. The clinical records of a subset of patients were reviewed for the purposes of data validation. Results A total of 1975 patients with PTA/PTC were identified. Three patients were subsequently diagnosed with OPSCC. None of the three actually had an objective underlying diagnosis of PTA/PTC on the same side. The prevalence of OPSCC in patients admitted with symptoms of PTA/PTC was 0.15%, or approximately 1:650 admissions. The records of 510 patients who presented over a one-year period (2016) were reviewed in even greater detail. There were 298 patients with PTA (59.4%), 151 with PTC (29.1%) and 61 had an alternative diagnosis (11.9%). High risk features (age ≥40, tonsillar asymmetry or tonsillar lesion) were present in 106 patients (24%). Urgent follow up was expedited for 77 patients (73%). Conclusion This study estimates the risk of OPSCC in patients with peritonsillar symptoms. The prevalence is low, even in a region with a relatively heavy disease burden. Clinicians should, however, retain a high level of suspicion in patients with persistent symptoms.
The suppression of Brd4 inhibits peripheral plasma cell differentiation and exhibits...
Shan Zeng
Qian Qiu

Shan Zeng

and 13 more

April 14, 2021
Background and purpose: To investigate the role of bromodomain-containing protein 4 (Brd4) in regulating B cell differentiation and its therapeutic potential for B cell-mediated autoimmune diseases such as systemic lupus erythematosus (SLE). Experimental Approach: Human and murine B cells were purified and cultured with different stimuli. B cell surface markers, proliferation and apoptosis were estimated by flow cytometry. Gene expression was measured by quantitative real-time PCR. Brd4 binding sites were analysed by the luciferase reporter assay and the chromatin immunoprecipitation (ChIP) assay. PFI-1 or JQ1 was used to inhibit Brd4. Mice with B cell-specific deletion of the Brd4 gene (Brd4flox/floxCD19-Cre+/-) and MRL/lpr mice were used to perform the in vivo experiments. Key Results: Brd4 inhibition suppressed plasmablast-mediated plasma cell differentiation but did not influence proliferation or apoptosis in healthy human and murine CD19+ B cells. PFI-1 treatment reduced the secretion of IgG and IgM in the supernatants of costimulation-induced B cells. Mechanistically, Brd4 regulates the terminal differentiation of B cells into plasma cells by targeting BLIMP1 by directly binding and activating the endogenous BLIMP1 promoter. Interestingly, PFI-1 treatment decreased the percentages of plasmablasts and plasma cells from patients with SLE. PFI-1 administration reduced the percentages of plasma cells, hypergammaglobulinemia and attenuated nephritis in MRL/lpr mice. Pristane-injected Brd4flox/floxCD19-Cre+/- mice exhibited improved nephritis and reduced percentages of plasma cells. Conclusions and Implications: Brd4 is an essential factor in regulating plasma cell differentiation. Brd4 inhibition may be a potential new strategy for the treatment of B cell-associated autoimmune disorders, including SLE.
Repurposing of FDA-approved Drugs against Active Site and Potential Allosteric Drug B...
Merve Yuce
Erdem Cicek

Merve Yuce

and 5 more

April 14, 2021
The novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) still has serious negative effects on health, social life, and economics. Recently, vaccines from various companies have been urgently approved to control SARS-CoV-2 infections. However, any specific antiviral drug has not been confirmed so far for regular treatment. An important target is the main protease (Mpro), which plays a major role in replication of the virus. In this study, Gaussian and residue network models are employed to reveal two distinct potential allosteric sites on Mpro that can be evaluated as drug targets besides the active site. Then, FDA-approved drugs are docked to three distinct sites with flexible docking using AutoDock Vina to identify potential drug candidates. 14 best molecule hits for the active site of Mpro are determined. 6 of these also exhibit high docking scores for the potential allosteric regions. Full-atom molecular dynamics simulations with MM-GBSA method indicate that compounds docked to active and potential allosteric sites form stable interactions with high binding free energy (∆Gbind) values. ∆Gbind values reach -52.06 kcal/mol for the active site, -51.08 kcal/mol for the potential allosteric site 1, and -42.93 kcal/mol for the potential allosteric site 2. Energy decomposition calculations per residue elucidate key binding residues stabilizing the ligands that can further serve to design pharmacophores. This systematic and efficient computational analysis successfully determines ivermectine, diosmin and selinexor currently subjected to clinical trials, and further proposes bromocriptine, elbasvir as Mpro inhibitor candidates to be evaluated against SARS-CoV-2 infection
Four key challenges in the era of big data: Ecology must move beyond Noah's ark

Roberto Salguero-Gómez

April 14, 2021
Long-term, individual-level records are of great importance in biological sciences. By understanding how individuals contribute to their populations during representative temporal scales, we can answer pressing questions in ecology, evolution, and conservation biology. These questions include identifying which, how, and where species’ populations will go extinct or become invasive. Calls for the collection, curation, and release of these kinds of ecological data have contributed to the open data revolution in ecology. Birds, particularly, have been the focus of much citizen science and international research for decades, resulting in a number of uniquely longterm studies. However, accessing some of these individual-based, long-term datasets can be challenging. Culina et al. (2021) introduce an online repository of individual level, long-term bird records with ancillary data (e.g. genetics). Similar efforts have also been undertaken for mammals, fish, and even more recently for corals and insects. By releasing these ecological data open-access, the research community is starting to fill “Noah’s ecological ark”. However, important challenges still lay ahead to address the most pressing research questions. Here, I briefly overview the open access landscape of long-term animal ecological studies, provide suggestions for how to most efficiently expedite our knowledge of long-term animal population dynamics, and highlight four key challenges in the use (and misuse) of these large volumes of animal ecological data.
A Case Report on Using Biofeedback for Psychological Assessment
Tomoko Muramatsu

Tomoko Muramatsu

April 14, 2021
A psychological assessment using biofeedback was performed for an adjustment disorder inpatient who showed less verbal and non-verbal expressions, and experienced difficulty in receiving favorable results from treatment. The assessment revealed hidden problems behind the symptoms. She was subsequently discharged, after which no clinical intervention was required, including medication.
Automated audio recording as a means of surveying Tinamous (Tinamidae) in the Peruvia...
Reid Rumelt
Arianna Basto

Reid Rumelt

and 2 more

April 14, 2021
1. The use of machine learning technologies to process large quantities of remotely-collected audio data is a powerful emerging research tool in ecology and conservation. 2. We applied these methods to a field study of tinamou (Tinamidae) biology in Madre de Dios, Peru, a region expected to have high levels of interspecies competition and niche partitioning as a result of high tinamou alpha diversity. We used autonomous recording units to gather environmental audio over a period of several months at lowland rainforest sites in the Los Amigos Conservation Concession and developed a Convolutional Neural Network-based data processing pipeline to detect tinamou vocalizations in the dataset. 3. The classified acoustic event data are comparable to similar metrics derived from an ongoing camera trapping survey at the same site, and it should be possible to combine the two datasets for future explorations of the target species’ niche space parameters. 4. Here we provide an overview of the methodology used in the data collection and processing pipeline, offer general suggestions for processing large amounts of environmental audio data, and demonstrate how data collected in this manner can be used to answer questions about bird biology.
The function-dominance correlation drives the direction and strength of biodiversity-...
Michael Crawford
Kathryn Barry

Michael Crawford

and 12 more

April 14, 2021
Community composition is a primary determinant of how biodiversity change influences ecosystem functioning and, therefore, the relationship between biodiversity and ecosystem functioning (BEF). We examine the consequences of community composition across six structurally realistic plant community models. We find that a positive correlation between species’ functioning in monoculture vs. their dominance in mixture with regards to a specific function (the “function-dominance correlation”) generates a positive relationship between realized diversity and ecosystem functioning across species richness treatments. However, because realised diversity declines when few species dominate, a positive function-dominance correlation generates a negative relationship between realized diversity and ecosystem functioning within species richness treatments. Removing seed inflow strengthens the link between the function-dominance correlation and BEF relationships across species richness treatments but weakens it within them. These results suggest that changes in species’ identities in a local species pool may more strongly affect ecosystem functioning than changes in species richness.
Novel XLF/Cernunnos mutation linked to severe combined immunodeficiency, microcephaly...
Shirly Frizinsky
Erez Rechavi

Shirly Frizinsky

and 7 more

April 14, 2021
Background: During the process of generating diverse T and B cell receptor (TCR and BCR, respectively) repertoires, double strand DNA breaks are produced. Subsequently, these breaks are corrected by a complexed system led mainly by the non-homologous end-joining (NHEJ). Mutations in proteins involved in this process, including the XLF/ Cernunnos gene, cause severe combined immunodeficiency syndrome (SCID) along with neurodevelopmental disease and susseptability to inoizing radiation. Objective: To provide new clinical and immunological insights on XLF/Cernunnos deficiency, arising from a newly diagnosed patient with severe immunodeficiency. Methods: A male infant, born to consanguineous parents, suspected of having primary immunodeficiency underwent immunological and genetic work up. This included a thorough assessment of T cell phenotyping and lymphocyte activation by mitogen stimulation tests, whole exome sequencing (WES), TCR repertoire Vβ repertoire via flow cytometry analysis and TCR and BCR via next generation sequencing (NGS). Results: Clinical findings included microcephaly, recurrent bacterial viral pneumonia and failure to thrive. Immune workup revealed lymphopenia, reduced T cell function and hypogammaglubolinemia. A skewed TCR Vβ repertoire, TCR gamma (TRG) repertoire and BCR repertoire were determined in the patient. Genetic analysis identified a novel autosomal recessive homozygous missense mutation in XLF/Cernunnos c. A580Ins.T; p. M194fs. The patient underwent a successful hematopoietic stem cell transplantation (HSCT). Conclusions: A novel XLF/Cernunnos mutation is reported in a patient presented with SCID phenotype that displayed clonally expanded T and B cells. An adjusted HSCT was safe to ensure full T cell immune reconstitution.
Glowing Plants Can Light Up the Night Sky? A Review
Bolong Li
Ru Chen

Bolong Li

and 3 more

April 14, 2021
Luminescence, a physical phenomenon that producing cool light in vivo, has been found in bacteria, fungi and anminals but not yet in terrestrial higher plants. Through genetic engineering, it is feasible to introduce luminescence system into living plant cells as biomarkers. Recently, some plants transformed with luminescent systems can glimmer in darkness, which can be observed by our naked eyes and provide a novel lighting resource. In this review, we summarized the development of luminescence in plant cells, followed by exampling the successful cases of glowing plants transformed with diverse luminescent systems. The potential key factors to optimize a glowing plant are also discussed. Our review is useful for the creation of the optimized glowing plants, which can be used not only in scientific research, but also as promising substitutes of artificial light sources in the future.
RELIABILITY OF BLADDER VOLUME DETERMINATION IN CHILDREN BY PORTABLE ULTRASONOGRAPHIC...
TANER CEYLAN
Hasan Serkan Dogan

TANER CEYLAN

and 6 more

April 14, 2021
Aim: We aimed to compare pre-voiding bladder and post-voiding residual (BV, PVR) volumes measured by portable ultrasonic scanner (PUS) in standing and supine positions. Material and Methods: A total of 436 children were included. We composed 2 groups (group-1: PUS vs. volume by catheter, group-2: PUS vs. infused volume during urodynamic study) to evaluate the agreement of PUS measurements with actual bladder volume and then third group (group-3) to analyze the correlation of PUS measurements in standing vs. supine positions. In groups 1 and 2, agreement of measurements were evaluated by paired sample T or Wilcoxon signed rank tests. Following confirmation of agreement, correlations were analyzed by Pearson’s or Spearman’s coefficients in all groups. Interpretation of coefficients were done as 0.90-1.00 (very high correlation) and 0.70-0.90 (high correlation), respectively. Results: In group-1, measurements (catheter vs. PUS) were similar (Wilcoxon Signed rank test, p= 0.976) and were highly correlated (r=0.873). In group-2, measurements of bladder volumes infused by urodynamic device and volumes by PUS were similar that revealed the agreement of PUS measurements on different volumes and highly correlated at the 25th and very highly correlated at the 50th, 75th and 100th percentiles of the EBC (estimated bladder capacity related to age). In group-3, BV and PVR measurements by PUS in standing and supine positions were highly correlated that revelaed PUS can be used in both positions. Conclusion: Measurements of BV before uroflowmetry or PVR volume by PUS in standing position gave similar results with those in supine position.
LESSONS FOR COVID 19 ERA: IMPACT OF DELAYS IN SURGERY ON BIOCHEMICAL RECURRENCE-FREE...
Bahadir Sahin
Ozan Bozkurt

Bahadir Sahin

and 10 more

April 14, 2021
OBJECTIVE To assess the impact of the surgical delay for localized prostate cancer (PCa) on adverse pathological features and oncological outcomes. MATERIALS AND METHODS Patients who underwent surgery for localized prostate cancer were included from the Turkish Urooncology Association (TUA) Prostate Cancer database. A History of previous treatment or active surveillance (AS) were considered as exclusion criteria from the study. Patients were divided into two groups according the time period between the diagnosis and surgery; less than or equal to 90 days (group 1) or longer than 90 days (group 2). Surgical pathology results and oncological outcomes were compared between the two groups. RESULTS A total of 2454 out of 3646 patients were assessed. Pathological findings of the radical prostatectomy (RP) specimens were similar between two groups. However, there was slightly more seminal vesicle invasion in final surgical pathology in group 1 (12.9% vs. 9.3%, respectively p=0.042). 5-year biochemical recurrence free survival times were similar across all D’Amico risk categories between two groups. The regression analysis demonstrated the seminal vesicle invasion as the only factor affecting time to PSA progression in high-risk patients (p<0.001 HR:2.51 CI: 1,58-4,45). CONCLUSION In conclusion, our results in this large cohort suggest that surgical delay does not cause a deterioration for prostate cancer surgical outcomes even in high-risk group of patients. These findings may be helpful for planning the limited healthcare resources especially in conditions like the Covid-19 pandemic where the availability and optimal use of healthcare system resources is crucial.
Understudied, underrepresented, and unknown: methodological biases that limit detecti...
Nicole Reynolds
Michelle A. Jusino

Nicole Reynolds

and 3 more

April 14, 2021
Metabarcoding is an important tool for understanding fungal communities. The internal transcribed spacer (ITS) rDNA is the accepted fungal barcode but has known problems. The large subunit (LSU) rDNA has also been used to investigate fungal communities but available LSU metabarcoding primers were mostly designed to target Dikarya (Ascomycota + Basidiomycota) with little attention to early diverging fungi (EDF). However, evidence from multiple studies suggests that EDF comprise a large portion of unknown diversity in community sampling. Here we investigate how DNA marker choice and methodological biases impact recovery of EDF from environmental samples. We focused on one EDF lineage, Zoopagomycota, as an example. We evaluated three primer sets (ITS1F/ITS2, LROR/LR3, and LR3 paired with new primer LR22F) to amplify and sequence a Zoopagomycota mock community and a set of 146 environmental samples with Illumina MiSeq. We compared two taxonomy assignment methods and created an LSU reference database compatible with AMPtk software. The two taxonomy assignment methods recovered strikingly different communities of fungi and EDF. Target fragment length variation exacerbated PCR amplification biases and influenced downstream taxonomic assignments, but this effect was greater for EDF than Dikarya. To improve identification of LSU amplicons we performed phylogenetic reconstruction and illustrate the advantages of this critical tool for investigating identified and unidentified sequences. Our results suggest much of the EDF community may be missed or misidentified with “standard” metabarcoding approaches and modified techniques are needed to understand the role of these taxa in a broader ecological context.
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