AUTHOREA
Log in Sign Up Browse Preprints
LOG IN SIGN UP

Preprints

Explore 66,105 preprints on the Authorea Preprint Repository

A preprint on Authorea can be a complete scientific manuscript submitted to a journal, an essay, a whitepaper, or a blog post. Preprints on Authorea can contain datasets, code, figures, interactive visualizations and computational notebooks.
Read more about preprints.

Progressive liver injury and increased mortality risk in COVID-19 patients: a retrosp...
Shuisheng Zhang
Li Dong

Shuisheng Zhang

and 19 more

July 16, 2020
Background: Liver injury is common and also can be fatal, particularly in severe or critical patients with coronavirus disease 2019 (COVID-19). However, there is lack of an in-depth investigation into the risk factors of liver injury and into the effective measures to prevent subsequent mortality risk. Methods: A retrospective cohort study of 440 consecutive patients with relatively severe COVID-19 between January 28 and March 9, 2020 in Tongji Hospital, Wuhan, China was performed. Data on clinical features, laboratory parameters, medications and prognosis were collected. Results: COVID-19-associated liver injury more frequently occurred in patients aged ≥65 years, or female, or with other comorbidities, decreased lymphocyte count, elevated D-dimer or serum ferritin (all p values<0.05). The disease severity of COVID-19 was an independent risk factors of livery injury (OR 2.86; 95% CI 1.78 to 4.59 in severe patients and 13.44; 95% CI, 7.21 to 25.97 in critical patients). The elevated levels of on-admission aspartate aminotransferase (AST) and total bilirubin (TBIL) indicated the increased mortality risk (both p values <0.001). Using intravenous nutrition or antibiotics increased risk of COVID-19-associated liver injury. Hepatoprotective drugs tended to be of assistance to treat the liver injury and improve the prognosis of patients with COVID-19-associated liver injury. Conclusions: More intensive monitoring with AST or TBIL is recommended for COVID-19 patients, especially aged ≥65 years, or female, or with other comorbidities. Drug hepatotoxicity of antibiotics and intravenous nutrition should be alert for COVID-19 patients.
PIK3CA GENE MUTATIONS AS POTENTIAL PREDICTIVE BIOMARKERS IN COLORECTAL CANCER
Elena Puerta García
Marisa Cañadas Garre

Elena Puerta García

and 6 more

July 16, 2020
Associations between colorectal cancer (CRC) survival and mutations in mediator of MAPK/ERK (RAS-BRAF-MEK-ERK) and PIK3CA/AKT signaling pathways have been reported. The objective of this study was to evaluate the influence of mutations in the EGFR pathway (KRAS, NRAS, BRAF and PIK3CA) on overall survival in CRC. We conducted a retrospective observational cohort study comprising 194 paraffin tumor samples from patients diagnosed with colorectal cancer were analyzed for KRAS codons 12, 13 and 61, NRAS codons 12, 13 and 61, BRAF and PIK3CA exons 9 and 20 gene mutations. Multivariate analysis confirmed that patients with ECOG of 0 presented lower risk of death (HR = 0.17, CI95%, 0.10 -0.31, p = 1656.10-9) compared to a higher ECOG (Table 4). The only independent genetic association was between PIK3CA20 mutation (H1047Y; rs121913281) and higher risk of death (HR = 8.93, CI95%, 1.20-66.57, p = 0.03268). No association was found between the rest of the mutations analyzed and overall survival. To explore the effect of mutations in patients with different degrees of ECOG, a stratified analysis was performed. Multivariate analysis in patients with ECOG 0 group confirmed the association between mutations of PIK3CA and an increased risk of death: E545K (HR = 5.49, CI95%, 1.28-23.51, p = 0.021720) and H1047Y (HR = 53.49; %, 4.63-617.40, p = 0.001429). In conclusion, our results show PIK3CA gene mutations may predict the overall survival of CRC patients, positioning PIK3CA as a potential biomarker for survival in CRC.
Several determinantal expressions of generalized Tribonacci polynomials and sequences

Can Kizilates

and 2 more

July 14, 2020
In the paper, the authors present several explicit formulas for the (p, q, r)-Tribonacci polynomials and generalized Tribonacci sequences in terms of the Hessenberg determinants and, consequently, derive several explicit formulas for the Tribonacci numbers and polynomials, the Tribonacci–Lucas numbers, the Perrin numbers, the Padovan (Cordonnier) numbers, the Van der Laan numbers, the Narayana numbers, the third order Jacobsthal numbers, and the third order Jacobsthal–Lucas numbers in terms of special Hessenberg determinants.
Missing ethnic information in current BRCA variant databases
Zixin Qin
San Ming Wang

Zixin Qin

and 1 more

July 16, 2020
BRCA variation is highly ethnic-specific. Our analysis of major BRCA reference databases shows that nearly all databases except BIC do not provide ethnic information for their collected BRCA variants. We consider that inclusion of ethnic information of BRCA variants is necessary as it will benefit the study of human BRCA evolution, understand ethnic-basis of BRCA variation and cancer, and promote ethnic-based clinical applications in diversified ethnic populations.
Single-cell transcriptome analyses reveal heterogeneity in suspension cultures and cl...
Norichika Ogata
Takeshi Omasa

Norichika Ogata

and 1 more

July 16, 2020
Cell-to-cell variability in cell populations arises from a combination of intrinsic factors and extrinsic factors related to the milieu. However, the heterogeneity of high cell density suspension cultures for therapeutic protein production remains unknown. Here, we illustrate the increasing heterogeneity in the cellular transcriptome of serum-free adapted CHO K1 cells during high cell density suspension culture over time without concomitant changes in the genomic sequence. Cell cycle--dependent subpopulations and cell clusters, which typically appear in other single-cell transcriptome analyses of adherent CHO K1 cultures, were not found in these suspension cultures. Our results indicate that cell division changes the intracellular microenvironment and leads to cell cycle--dependent heterogeneity. Whole mitochondrial single-cell genome sequencing showed cell-to-cell mitochondrial genome variation and heteroplasmy within cells. Indeed, the mitochondrial genome sequencing method developed here enables the validation of cell clonality. The culture time-dependent increase in cellular heterogeneity observed in this study did not show any attenuation in this increasing heterogeneity. Future advances in bioengineering such as culture upscaling, prolonged culturing, and complex culture systems will be confronted with the need to assess and control cellular heterogeneity, and the method described here may prove useful for this purpose.
Early diagnosis and Antibiotic Treatment for Fulminant Clostridium difficile Infectio...
Kazutaka Fukushima
Ryota Inokuchi

Kazutaka Fukushima

and 4 more

July 16, 2020
The guidelines recommend surgical treatment for fulminant Clostridium difficile infection (CDI). However, mortality remains high, and patients with severe condition are not considered for surgical treatment because of poor post-surgical outcomes. Moreover, delayed diagnosis of fulminant CDI may induce intestinal necrosis. Thus, early diagnosis is crucial.
Effect of rolling process on fatigue performance of stir zone of AA6061 DS-FSW joint
Chengchao Du
Qiuhong Pan

Chengchao Du

and 3 more

July 16, 2020
Stir zone (SZ) of AA6061-T6 double-side friction stir welding (DS-FSW) joint with a thickness of 6 mm had a poor fatigue performance compared with that of base metal (BM). The rolling process was employed to improve the fatigue performance of SZ. The results showed that rolling process increased the dislocation density in SZ and remarkably enhanced its fatigue performance. The crack initiation played a key role in the fatigue performance of SZ. It relied on the debonding of lamellar structure in SZ. The debonding of lamellar structure depended on the cracking of fine grain layer in lamellar structure.
Prenatal diagnosis of a de novo trisomy 20p detected by noninvasive prenatal testing
xu yan
Haiying Peng

xu yan

and 2 more

July 16, 2020
Trisomy 20p, resulting from duplication of all or part of the short arm of chromosome 20, is a rare chromosomal disorder while there is little case of trisomy 20p in prenatal diagnosis.Here we report firstly a case of de novo trisomy 20p detected by noninvasive prenatal testing.
Study of high-cycle rotating bending fatigue performance and fracture behavior in a p...
Xinbo Ji
Sixin Zhao

Xinbo Ji

and 7 more

July 13, 2020
To clarify the effects of ferrite morphologies and contents on high-cycle rotating bending fatigue property of pearlite-ferrite dual-phase (DP) steel used for fabrication of commercial vehicle crankshafts, two types of DP steels with different ferrite grain sizes (S10: 13.1μm and S30: 21.4μm) and ferrite contents (S10: ~9.5vol.% and S30: ~30.4vol.%) were prepared. Stress-number of high cycles to failure (S-N) fatigue of the two DP steels were evaluated. Experimental results showed a fatigue strength of 510 MPa and 400 MPa for S10 and S30 steels, respectively, at 107 cycles. Fatigue cracks in S10 steel extended preferentially along the grain boundary, but it was easy for crack propagation to extend within a pearlite colony to form a zigzag crack morphology. Crack roughness was enhanced and high stress was introduced to the crack surface due to this kind of crack propagation behavior, which has positive effects on slowing down crack propagation. However, the crack propagation in S30 steel mainly occurred inside the soft equiaxed coarse ferrite grain. Analysis revealed that little stress was introduced to the crack surface. These results show that it is possible to improve high cycle rotating bending fatigue strength of pearlite-ferrite DP steel by appropriately manipulating the volume fraction and microstructure morphology of ferrite phase.
Rethinking ranitidine use in hospitals: how the ranitidine recall exposed a lack of e...
Emily Allegretto-Smith
Kate McDougal

Emily Allegretto-Smith

and 3 more

July 13, 2020
ii. Rationale, aims and objectives Fraser Health, a large health authority, undertook an audit of standardized order sets (SOS) listing ranitidine due to the Health Canada recall of ranitidine. Our primary objective was to determine if ranitidine use on SOSs was supported by the best available evidence, in order to sparingly use ranitidine in the hospital. ii. Method Two evaluators recorded the indication of ranitidine on every SOS and a scoping review of systematic review evidence was conducted in parallel to a comprehensive review of evidence quality. Clinical practice guideline recommendations were also recorded in order to make comparisons to systematic review evidence. iii. Results Twenty-seven SOSs were found. Seven SOSs (26%) clearly indicated the medical condition ranitidine was being used for. Twenty SOSs (74%) did not list an indication or had an unclear indication. Six SOSs (22%) were supported by systematic review evidence: 4 intensive care unit (ICU) SOSs for stress ulcer prophylaxis, 1 nausea and vomiting of pregnancy SOS for heartburn, and 1 emergency department SOS for heartburn iv. Conclusion The SOS ranitidine audit conducted at Fraser Health has highlighted inconsistencies between institutional prescribing policies and evidence. Drugs listed on SOSs should be carefully considered before being used at an institutional level. To aid prescribers’ decision making, it may also be beneficial to indicate what the purpose of each drug is on a SOS Our team plans to use this as an opportunity to revise other ranitidine SOSs to reflect best evidence. Evaluation of how ranitidine or other drugs were being prescribed from SOSs is encouraged.
Synchronization or Coordination? Context dependent anti-predator vigilance to nature-...
Dejun Kong
Anders Møller

Dejun Kong

and 2 more

July 16, 2020
Prey monitor surrounding dangers independently or cooperatively (synchronized and coordinated vigilance), with independent and synchronized scanning being prevalent. Coordinated vigilance, including unique sentinel behaviour, is rare in nature, since it is time-consuming and benefit-limited. Evidence does not indicate animals adopting alternative vigilance strategies during antipredation scanning. Considering the cooperative nature of both synchronization and coordination, we assessed whether group members could keep alert synchronously or coordinatedly under different circumstances, determining whether cooperative vigilance is context dependent. Under the framework of conservation behavior, we studied how human behaviour and species-specific variables impacted individual and collective vigilance of globally threatened Black-necked Cranes (Grus nigricollis) and explored behaviour-based wildlife management. We tested both predation risk (juveniles in group) and human disturbance (level and distance) effects on individual and collective antipredation vigilance of black-necked crane families. Adults spent significantly more time (proportion and duration) on scanning than juveniles, and parents with juveniles behaved more vigilant. Observer distance affected individual vigilance of adults while juveniles were influenced by none of these variables. With the number of juveniles and disturbance increased, crane couples decreased synchronization of vigilance and they shifted to coordination, which has so far never been reported yet. Similarly, with observer approaching, adults shift vigilance from synchronization to coordination. The collective vigilance shift from synchronization to coordination as a function of observer distance could help us determining a safe distance of c. 400m for the most vulnerable family groups with two juveniles, so as no obvious interference with the threatened birds by human proximity. We argue that vigilance behaviour could be a reliable indicator in future nature-based tourist management and decision-making, which can be derived from conservation solutions in nature.
Predictors of phrenic nerve injury during pulmonary vein isolation for curing atrial...
Shinichi Tachibana
Kaoru Okishige

Shinichi Tachibana

and 9 more

July 16, 2020
Introduction: Pulmonary vein (PV) isolation (PVI) with a balloon-based visually guided laser ablation (VGLA) is a useful tool for treating atrial fibrillation (AF), however, phrenic nerve injury (PNI) is an important complication. We investigated the predictors of developing PNI during VGLA. Methods and Results: This study included 130 consecutive patients who underwent an initial VGLA of non-valvular paroxysmal AF. During the ablation of the right-sided pulmonary veins, continuous and stable right phrenic nerve pacing was performed, and the compound motor action potentials (CMAPs) were recorded. Twenty patients developed PNI during the PVI. The patients who suffered from PNI had a significantly larger right superior PV (RSPV) ostium area (284.7 ± 47.0 mm2 vs. 233.1 ± 46.4 mm2, P < 0.01) than that of the other patients. Receiver operating characteristic analyses revealed that the area under the curve of the RSPV ostial area was 0.79 (95% confidence interval: 0.69-0.90) with an optimal cut-off point of 238.0 mm2 (sensitivity: 0.58, specificity: 0.95). In the multivariate analyses, large RSPV ostial area (HR 1.02, 95% confidence interval: 1.01-1.03, P < 0.01) and small balloon size (HR 0.72, 95% confidence interval: 0.53-0.98, P = 0.03) were independent risk factors for PNI. PNI remained in 13 patients after the procedure, but 12 of those patients recovered from PNI during the follow-up period. Conclusion: The incidence of PNI during the VGLA was relatively high, but the PNI improved in the majority of cases. During the VGLA, a large RSPV and small balloon size were predictors of PNI.
Coherent mapping helps to identify the mechanism of an atrial tachycardia after Epico...
Jan Wintrich
Valerie Pavlicek

Jan Wintrich

and 3 more

July 16, 2020
Pulmonary vein isolation (PVI) is of great importance to achieve rhythm control in patients with atrial fibrillation. Besides catheter-based procedures, the application of high-intensity focused ultrasound (HIFU) can be used for PVI. However, HIFU has been associated with rater low efficacy rates. We report a case of a 73-year old patient, in whom HIFU failed to maintain sinus rhythm but promoted the occurrence of a scar-related atrial tachycardia (AT). Coherent mapping with visualization of velocity vectors allowed the correct interpretation and the targeted ablation of this tachycardia. The coherent mapping function could simplify mapping of scar-related tachycardia in the future.
Clinical impact of long PR-interval and presence of late gadolinium enhancement on ho...
Shinya Yamada
Akiomi Yoshihisa

Shinya Yamada

and 7 more

July 13, 2020
Background: The combination of electrical and structural remodeling may have a strong effect on the prognosis of non-ischemic heart failure (HF). We aimed to clarify whether prolonged PR-interval and the presence of late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (CMR) influence the outcomes of patients with non-ischemic HF. Methods: We studied 262 consecutive hospitalized patients with non-ischemic HF. In a clinically stable condition, a 12-lead electrocardiogram and CMR were performed, and the clinical characteristics and outcomes were investigated. Results: During the follow-up of 967.7±851.8 days, there were 68 (25.9%) cardiac events (HF or sudden death, re-hospitalization due to HF, or ventricular tachyarrhythmias). In a multivariable analysis, a median rate-adjusted PR (PRa)-interval of ≥173.5 ms and the presence of LGE were associated with cardiac events with a hazard ratio of 1.690 and 2.045 (P=0.044 and P=0.006, respectively). Study subjects were then divided into three groups based on PRa-interval and LGE status. The patients were given 1 point each for PRa-interval of ≥173.5 ms and the presence of LGE: score of 0 (n=79), score of 1 (n=123) and score of 2 (n=60). Cardiac events were 16.4% in score of 0, 26.0% in score of 1 and 38.3% in score of 2 (P=0.005), respectively. The multivariable analysis showed that score of 2 was an independent predictor for cardiac events compared to score of 0 (hazard ratio, 3.437, P=0.001). Conclusions: The combination of a long PRa-interval and the presence of LGE provides a better predictive value of cardiac events in non-ischemic HF.
Epidemiology and Etiology of In-Hospital Cardiac Arrest at The American University of...
Ahmed Eltarras
Youssef Jalloul

Ahmed Eltarras

and 7 more

July 13, 2020
Introduction: In-hospital cardiac arrest(IHCA) constitutes a significant cause of morbidity and mortality. we devised this study to shed some light on it to better inform both hospitals and policymakers. Methods: We analyzed retrospective data from 680 IHCAs at the American University of Beirut Medical Center between July 1st, 2016, and May 2nd, 2019. Sociodemographic variables included age, sex, and comorbidities in the Charlson Comorbidity Index(CCI). IHCA variables were the day of the week, time from activation to arrival, event location, initial cardiac rhythm, the total number of IHCA events, and the months and years of the IHCAs. We considered the return of spontaneous circulation(ROSC) and survival to discharge(StD) to be our outcomes of interest. Results: The incidence of IHCA was 6.58 per 1000 hospital admissions. Non-shockable rhythms were 90.7% of IHCAs. Most IHCAs occurred in the Closed care units(87.9%) and on weekdays(76.5%). ROSC followed 56% of the IHCAs. Only 5.4% achieved StD. Survival outcomes were not significantly different between the time of the day and were higher in cases with a shockable rhythm. ROSC wasn’t significantly different between weekdays and weekends. however, StD was higher on weekdays. A high CCI was associated with decreased StD. Conclusion: The incidence of IHCA was high, and its outcomes were lower compared to other developed countries. Survival outcomes were better for patients who had a shockable rhythm and were similar between the time of the day. These findings may help inform hospitals and policymakers about the magnitude and quality of IHCA care in Lebanon
Design Procedure of Two-Dimensional Slotted Waveguide Antenna Arrays with Controllabl...
Hilal M. El Misilmani
Mohammed Al-Husseini

Hilal M. El Misilmani

and 2 more

July 13, 2020
This paper presents a complete design procedure, with an optimized feeding method, of two-dimensional slotted waveguide antenna arrays (2D SWAs). For a desired sidelobe level ratio, the proposed system provides a pencil shape pattern with a narrow halfpower beamwidth, large sidelobe level ratio (SLR), and very low sidelobe levels (SLL), which makes it suitable for high power microwave applications. The radiating slotted waveguide antennas use longitudinal slots, designed for a specified slidelobe level ratio and resonance frequency. The resulting two-dimensional slotted waveguide antenna array is formed by stacking a number of similarly designed radiating SWAs, and fed with an additional SWA. The proposed feeding method uses longitudinal coupling slots rather than the conventional inclined coupling slots, which can provide better values of SLR and easily obtain very low SLLs, in comparison with the conventional systems. The feeder dimensions and slots positions are deduced from the dimensions and total number of the radiating SWAs. For a desired SLR, the slots excitation in the radiating and feeder SWAs are calculated based on a specified distribution. Then, using simplified closed-form equations and for a desired resonance frequency, the slots lengths, widths, and their distribution along the length of the radiating SWAs and feeder SWA can be found. Two examples are illustrated with different number of slots and radiating elements, and one is fabricated and tested. Chebyshev distribution is used to estimate the excitations of the SWA slots in the examples. The obtained measured and simulated results are in accordance with the design objectives.
Characterization and virulence factors distribution of blaCTX-M and mcr-1 carrying Es...
Muhammad Shafiq
Jinhu Huang

Muhammad Shafiq

and 6 more

July 16, 2020
Escherichia coli is considered as one of the critical pathogens causing contagious mastitis. The aim of the current study was to investigate the occurrence of ESBL and colistin resistant E. coli and its genotypic characterization and identification of virulence determinants in cases of bovine mastitis in Jiangsu Province, China. Five hundred and thirty-five (535) milk samples presenting mastitis symptoms were collected from three dairy farms. Susceptibility testing was identified by micro-dilution method. E. coli isolates were used to detect ESBL genes (blaCTX-M, blaSHV and blaTEM) as well as COL-resistant genes mcr-(1-9). Multiplex PCR approach was used for the detection of major CTX-M groups, different phylo-groups, and virulence genes. The clonal relationship of the isolates was then evaluated with MLST, MLSA and PFGE. Multi-drug resistance (MDR) was found in more than 85% of ESBL and/or COL resistant E. coli isolates. Genotypic characterization indicated a dominance of CTX-M-1 group, and the most prevalent alleles observed in this study were blaCTX-M-28 (38.37%), blaCTX-M-14 (17.44%), blaCTX-M-66 (13.95%), blaCTX-M-55 (10.46%), and blaCTX-M-69 (6.97%), blaCTX-M-15 (4.65%), blaCTX-M-177 (4.65%), and blaCTX-M-148 (3.48%). The results confirmed that group A was the most predominant group with 54.73%, followed by group B1 and B2 (24.21%, 10.52%) respectively. The targeted virulence genes were detected in 97.89% (n=93) isolates. All isolates belong to group A, B1, B2, C, D, and E showed the presence of virulence factors. Among virulent genes ompC, was detected in 97.89% (n=93) isolates followed by fimH in 61.05% (n=58), ECs3703 57.89% (n=55), ompF 50.52% (n=48). MLST and PFGE of the 22 E. coli isolates were determined for clonal relatedness and yielded clear fingerprint patterns. Majority of the E. coli isolates carrying ESBL and mcr-1 isolates were clonally unrelated. Sequence types 58 and ST410 were the most predominant comprising 2 each (2/20=20%).
Exclusive photosystem II photoinhibition derived from photoinactivation of oxygen-evo...
Wei Zhao
Xiaoqi Yang

Wei Zhao

and 7 more

July 16, 2020
Photoinhibition is the popular topic in plant photosynthesis. However, restricted to experimental systems of in vitro membranes, knowledge of photosystem II (PSII) donor-side photoinhibition remains limited. Here, we report the first in vivo study of the mechanism in the marine higher plant Zostera marina. Preferential oxygen-evolving complex photoinactivation decreased the light-harvesting capacity and enhanced photosystem I cyclic electron flow (CEF). Non-photochemical quenching was inefficient and alternative electron flows, e.g. chlororespiration, Mehler reaction, malic acid synthesis, and photorespiration, remained unactivated, thereby reducing the unnecessary consumption of limited electron resources and maintaining a well carbon assimilation level. At variance with the PSII acceptor-side photoinhibition, the PSII photodamage of Z. marina was not attributed to 1O2 but was associated with the long-lived P680+ resulted from the photoinactivated OEC. Furthermore, we provided the novel insights into the PSII donor-side photoinhibition that rare PSII-CEF and ascorbate assumed photoprotective roles in Z. marina, which could donate electrons to the PSII reaction center to prevent the oxidative damage by P680+. This study addressed an important knowledge gap in PSII donor-side photoinhibition, providing a novel understanding of photosynthetic regulation mechanism responding to light stress.
Germline development and seed set of metallophyte Biscutella laevigata L. (Brassicace...
Monika Kwiatkowska
Karolina Kłosowska

Monika Kwiatkowska

and 2 more

July 16, 2020
The costs of Biscutella laevigata adaptation, a facultative metallophyte, to an environment polluted with heavy metals were established by analyzing the differences in embryological processes between plants from two populations in Southern Poland (a mountain, in the Tatra Mountains and calamine, in Bolesław). Disturbances in male and female lineage development and degeneration processes occurred in the anthers and ovules of plants from both populations, but with a higher frequency in the calamine population where A part of stamens/anthers and ovules in flowers were in a stage of degenertion. which could be interpreted as a strategy to save resources limited by the environment. The distribution of high-esterified homogalacturonan detected by LM20 antibody in the cell walls of embryos from the calamine population could be part of a resistance/defense system. The results from both populations indicate that B. laevigata has already developed adaptation/tolerance, enabling maintenance of the calamine population over time. Tolerant species could be an important source for revitalization and/or phytoremediation of polluted environments.
Heart-Lung Transplant in Congenitally Corrected Transposition of the Great Arteries a...
Magdy El-Sayed Ahmed
Mathew Thomas

Magdy El-Sayed Ahmed

and 7 more

July 16, 2020
Background and aim of the study: Congenitally corrected transposition of the great arteries (cc-TGA) is a rare type of congenital heart disease and heart-lung transplant (HLTx) is the potential solution if the patient developed severe biventricular failure.. Aim of the study is to present a challenging case of cc-TGA with dextrocardia managed by HLTx. Methods: A 53-year-old male patient was presented to our institution with biventricular failure. The echocardiogram revealed cc-TGA, dextrocardia with situs solitus, atrioventricular discordance and ventriculoatrial discordance, severe systemic and sub-pulmonary atrioventricular valves regurgitation, and severe pulmonary hypertension. He underwent heart-lung transplant. Results: The patient was discharged on postoperative day 25 on room air with normal left ventricular ejection fraction. Conclusion: This case highlights the complexity of preoperative and intraoperative management of cc-TGA, and demonstrates the challenges which the surgeons and anesthesiologists may face during the procedure of HLTx.
Species and metabolic pathways involved in bioremediation of Vietnamese soil contamin...
Thi Lan Anh Nguyen
Thi Cam Ha Dang

Thi Lan Anh Nguyen

and 7 more

July 16, 2020
Four bacterial strains were isolated from enrichment cultures inoculated with soil from Bien Hoa military base in Vietnam contaminated with the herbicides 2,4-dichlorophenoxyacetate (2,4-D) and 2,4,5-trichlorophenoxyacetate (2,4,5-T). They were classified as Pseudomonas aeruginosa BT1 2.2, Sphingomonas histidinilytica BT1 5.2, Bordetella petrii BT1 9.2, and Achromobacter xylosoxidans BT1 10.2, respectively. All 4 of them were able to degrade 2,4-D and 2,4,5-T during cultivation, but only the last 3 species used them as sole sources of carbon and free energy. We obtained a comprehensive insight into their degradation pathways by genomic analysis of these strains. A gene cluster with tfdCDEF genes was found in A. xylosoxidans BT1 10.2. The gene organization along with the amino acid sequences of the gene products are almost identical to those in B. petrii DSM12804. The B. petrii BT1 9.2 strain that we isolated has a full complement of the tfdABCDEF genes. Surprisingly, the gene organization along with the amino acid sequences of the gene products are virtually identical to those of Cupriavidus pinatubonensis JMP134, referred to as type I tfd genes, and clearly different from those of A. xylosoxidans and B. petrii DSM12804. Altogether, our enrichment approach has successfully resulted in boosting 3 different types of proteobacterial species that are equipped with metabolic pathways to use the herbicides as sole sources of carbon and free energy. We hypothesize that some of the corresponding genetic potential may have been recruited in recent mating events between these species and other members of the β- and γ-proteobacteria.
Prognostic and clinical significance for the combination of systemic inflammation res...
Xin Yin
Tianyi Fang

Xin Yin

and 7 more

July 13, 2020
Abstract Background Tumor immunity plays an important role in assessing the tumor progression. The purpose of this study was to investigate the prognostic value of combined systemic inflammation response index (SIRI) and platelet–lymphocyte ratio (PLR) for treatment of gastroesophageal junction cancer (AEG) and upper gastric cancer (UGC). Methods In this retrospective cohort study, patients from 2003 to 2014 were divided into training set (n=194) and validation set (n=177). The prognostic accuracy of each variable was compared using time-ependent ROC analysis. The scoring system was calculated by cut-off values of SIRI and PLR by ROC curve for survival in 5 years. Kaplan-Meier and Log-rank tests were used to analyze overall survival (OS). The chi-square test was used to analyze the association between clinical characteristics and the scoring system. Univariate and multivariate analyses based on the competitive risk regression model were used to analyze independent predictors of death due to AGC and UGC. The R software was used to construct the Nomogram model of risk assessment. Results Patients with SIRI–PLR=2 had worse survival time than those with 0 and 1 (P<0.001) and more suitable for postoperative adjuvant chemotherapy (P=0.003) and proximal gastrectomy (P=0.045). SIRI and PLR were independent predictors in training set (P=0.036, P=0.045), which could be combined with age and pTNM to construct Nomogram for predicting OS. Conclusions Preoperative SIRI–PLR score was an independent predictor for patients with AEG and UGC. The Nomogram model constructed by age, SIRI, PLR and pTNM can correctly predict the prognosis of patients.
The disruption of a keystone interaction erodes pollination and seed dispersal networ...
Agustin Vitali
Yamila Sasal

Agustin Vitali

and 3 more

July 16, 2020
Understanding the impacts of global change on mutualistic networks is a major challenge in modern ecology. The gain or loss of particular species and the disruption of key interactions are both consequences and drivers of global change that can lead to the disassembly of complete mutualistic webs. We explored whether the disruption of a hummingbird-mistletoe-marsupial keystone interaction by the invasion of non-native species can have cascading effects on both pollination and seed dispersal networks in the temperate forest of Patagonia. We found that the disruption of the keystone interaction resulted in diverse indirect effects that led to less complex pollination and seed dispersal networks. Similarly, the disruption of the keystone interaction decreased the functional redundancy among generalist plants and pollinators. Our results demonstrate how the disruption of a keystone interaction can have cascading effects through the community, reducing the complexity and stability of ecological networks.
Herbal Treatment of Female Urogenital Atrophy Results of a Retrospective Cohort Analy...
Dorin Ritzmann

Dorin Ritzmann

July 16, 2020
A document by Dorin Ritzmann. Click on the document to view its contents.
← Previous 1 2 … 2486 2487 2488 2489 2490 2491 2492 2493 2494 … 2754 2755 Next →

| Powered by Authorea.com

  • Home