Publications by authors named "Xiaojun Chen"

398 Publications

GS-441524 inhibits African swine fever virus infection in vitro.

Antiviral Res 2021 May 1:105081. Epub 2021 May 1.

Key Laboratory of Zoonosis Prevention and Control of Guangdong Province, College of Veterinary Medicine, South China Agricultural University, Guangzhou, People's Republic of China; African Swine Fever Regional Laboratory of China (Guangzhou), Guangzhou, People's Republic of China; Research Center for African Swine Fever Prevention and Control, South China Agricultural University, Guangzhou, People's Republic of China; National Engineering Research Center for Breeding Swine Industry, South China Agricultural University, Guangzhou, China. Electronic address:

African swine fever virus (ASFV) is a highly infectious and lethal swine pathogen that causes serious socio-economic consequences in endemic countries for which no safe and effective vaccine is currently available. GS-441524, a 1-cyano-substituted adenine C-nucleoside ribose analogue, inhibits viral RNA transcription by competing with natural nucleosides (ATP, TTP, CTP, and GTP) and effectively inhibits viral RNA-dependent RNA polymerase activity. However, whether GS-441524 can inhibit the replication of DNA viruses is unknown. In this study, we confirmed that GS-441524 inhibits ASFV infection in porcine alveolar macrophages (PAMs) in a dose-dependent manner; GS-441524 significantly inhibited ASFV replication at different time points after ASFV infection, particularly at the early stages of viral replication. Notably, GS-441524 did not increase the levels of antiviral cytokines or ATP in PAMs. However, an increase in the concentration of natural ATP in PAMs promoted the replication of ASFV and attenuated the inhibitory effect of GS-441524 in a dose-dependent manner. Our results suggest that GS-441524 is an effective antiviral against ASFV.
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http://dx.doi.org/10.1016/j.antiviral.2021.105081DOI Listing
May 2021

AutoImplant 2020 -First MICCAI Challenge on Automatic Cranial Implant Design.

IEEE Trans Med Imaging 2021 May 3;PP. Epub 2021 May 3.

The aim of this paper is to provide a comprehensive overview of the MICCAI 2020 AutoImplant Challenge1. The approaches and publications submitted and accepted within the challenge will be summarized and reported, highlighting common algorithmic trends and algorithmic diversity. Furthermore, the evaluation results will be presented, compared and discussed in regard to the challenge aim: seeking for low cost, fast and fully automated solutions for cranial implant design. Based on feedback from collaborating neurosurgeons, this paper concludes by stating open issues and post-challenge requirements for intra-operative use. The codes can be found at https://github.com/Jianningli/tmi.
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http://dx.doi.org/10.1109/TMI.2021.3077047DOI Listing
May 2021

The Reconstruction of Magnetic Particle Imaging: Current Approaches Based on the System Matrix.

Diagnostics (Basel) 2021 Apr 26;11(5). Epub 2021 Apr 26.

School of Life Science, Beijing Institute of Technology, Beijing 100081, China.

Magnetic particle imaging (MPI) is a novel non-invasive molecular imaging technology that images the distribution of superparamagnetic iron oxide nanoparticles (SPIONs). It is not affected by imaging depth, with high sensitivity, high resolution, and no radiation. The MPI reconstruction with high precision and high quality is of enormous practical importance, and many studies have been conducted to improve the reconstruction accuracy and quality. MPI reconstruction based on the system matrix (SM) is an important part of MPI reconstruction. In this review, the principle of MPI, current construction methods of SM and the theory of SM-based MPI are discussed. For SM-based approaches, MPI reconstruction mainly has the following problems: the reconstruction problem is an inverse and ill-posed problem, the complex background signals seriously affect the reconstruction results, the field of view cannot cover the entire object, and the available 3D datasets are of relatively large volume. In this review, we compared and grouped different studies on the above issues, including SM-based MPI reconstruction based on the state-of-the-art Tikhonov regularization, SM-based MPI reconstruction based on the improved methods, SM-based MPI reconstruction methods to subtract the background signal, SM-based MPI reconstruction approaches to expand the spatial coverage, and matrix transformations to accelerate SM-based MPI reconstruction. In addition, the current phantoms and performance indicators used for SM-based reconstruction are listed. Finally, certain research suggestions for MPI reconstruction are proposed, expecting that this review will provide a certain reference for researchers in MPI reconstruction and will promote the future applications of MPI in clinical medicine.
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http://dx.doi.org/10.3390/diagnostics11050773DOI Listing
April 2021

Augmented reality based navigation for distal interlocking of intramedullary nails utilizing Microsoft HoloLens 2.

Comput Biol Med 2021 Apr 15;133:104402. Epub 2021 Apr 15.

School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China; Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, China. Electronic address:

Background And Objective: The distal interlocking of intramedullary nail remains a technically demanding procedure. Existing augmented reality based solutions still suffer from hand-eye coordination problem, prolonged operation time, and inadequate resolution. In this study, an augmented reality based navigation system for distal interlocking of intramedullary nail is developed using Microsoft HoloLens 2, the state-of-the-art optical see-through head-mounted display.

Methods: A customized registration cube is designed to assist surgeons with better depth perception when performing registration procedures. During drilling, surgeons can obtain accurate and in-situ visualization of intramedullary nail and drilling path, and dynamic navigation is enabled. An intraoperative warning system is proposed to provide intuitive feedback of real-time deviations and electromagnetic disturbances.

Results: The preclinical phantom experiment showed that the reprojection errors along the X, Y, and Z axes were 1.55 ± 0.27 mm, 1.71 ± 0.40 mm, and 2.84 ± 0.78 mm, respectively. The end-to-end evaluation method indicated the distance error was 1.61 ± 0.44 mm, and the 3D angle error was 1.46 ± 0.46°. A cadaver experiment was also conducted to evaluate the feasibility of the system.

Conclusion: Our system has potential advantages over the 2D-screen based navigation system and the pointing device based navigation system in terms of accuracy and time consumption, and has tremendous application prospects.
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http://dx.doi.org/10.1016/j.compbiomed.2021.104402DOI Listing
April 2021

Clinical and reproductive outcomes of uterine smooth muscle tumor of uncertain malignant potential: a single-center retrospective study.

J Int Med Res 2021 Apr;49(4):3000605211008065

Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.

Objective: To evaluate the clinical outcomes, histopathological features, and obstetric and oncological outcomes of uterine smooth muscle tumor of uncertain malignant potential (STUMP).

Methods: We conducted a single-center, database review of patients with STUMP between January 2001 and December 2015. We investigated the clinical, operative, histopathologic, recurrence, and fertility outcomes of the included cases.

Results: Nineteen patients with STUMP were studied. Three were reclassified as sarcoma after slide review, and 16 patients were finally included in the study. The mean age was 45 years. Ki-67 expression was ≥10% in 25.0% of cases and 30% in the only recurrent case. Recurrence occurred 52 months after a diagnosis of STUMP in a 56-year-old female patient who underwent hysterectomy. Two of six patients who underwent myomectomy had fertility requirements, and both successfully delivered babies without recurrence. Recurrence was not related to mitosis, degree of atypia, or necrosis. There was also no relationship between type of surgery or surgical approach and recurrence.

Conclusions: Patients with STUMP warrant a pathological review process in centers with experience. Fertility-preservation is worth attempting, but young patients must be followed-up closely. Ki-67 might be a valuable marker predicting recurrence.
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http://dx.doi.org/10.1177/03000605211008065DOI Listing
April 2021

Prevalence and associated factors of intention of COVID-19 vaccination among healthcare workers in China: application of the Health Belief Model.

Hum Vaccin Immunother 2021 Apr 20:1-9. Epub 2021 Apr 20.

The First Affiliated Hospital of Shantou University Medical College, Shantou, China.

Healthcare workers (HCWs) are at an increased risk of coronavirus disease 2019 (COVID-19) and warrant COVID-19 vaccination to reduce nosocomial infections. This study investigated: (1) the prevalence of behavioral intention of COVID-19 vaccination (BICV) under eight scenarios combining vaccines' effectiveness/safety/cost, plus two general scenarios of free/self-paid vaccination given governmental/hospital recommendations, (2) perceptions involving preferred timing of COVID-19 vaccination and impacts of various attributes on BICV, and (3) factors of BICV based on the Health Belief Model. An anonymous online cross-sectional survey was conducted among 2,254 full-time doctors/nurses in three Chinese provinces during 10/2020-11/2020. The prevalence of BICV was 75.1%/68.0% among nurses/doctors under the most optimum scenario of this study (free/80% effectiveness/rare mild side effects); it dropped to 64.6%/56.5% if it costed 600 Yuan (USD90). Similar prevalence was obtained (72.7%/71.2%) if the vaccination was recommended by the government/hospitals but dropped to <50% if effectiveness was 50% or mild side effects were common; 13.0% preferred to take up COVID-19 vaccination at the soonest (81.8% would wait and see). Scientific proof (completion of phase III clinical trials and approval from health authorities) was rated the highest in its impacts on vaccination decision, followed by vaccines' performance, and then logistics. Multivariable logistic regression analyses showed that perceived severity, perceived barriers, cues to action, and self-efficacy (but neither perceived susceptibility nor perceived barriers) were significantly associated with the two BICV outcomes. The coverage of COVID-19 vaccination would be high only if the vaccines perform well. Health promotion may take the findings into account.
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http://dx.doi.org/10.1080/21645515.2021.1909327DOI Listing
April 2021

Semisupervised Feature Selection With Sparse Discriminative Least Squares Regression.

IEEE Trans Cybern 2021 Apr 19;PP. Epub 2021 Apr 19.

In big data time, selecting informative features has become an urgent need. However, due to the huge cost of obtaining enough labeled data for supervised tasks, researchers have turned their attention to semisupervised learning, which exploits both labeled and unlabeled data. In this article, we propose a sparse discriminative semisupervised feature selection (SDSSFS) method. In this method, the ε-dragging technique for the supervised task is extended to the semisupervised task, which is used to enlarge the distance between classes in order to obtain a discriminative solution. The flexible ℓ2,p norm is implicitly used as regularization in the new model. Therefore, we can obtain a more sparse solution by setting smaller p. An iterative method is proposed to simultaneously learn the regression coefficients and ε-dragging matrix and predicting the unknown class labels. Experimental results on ten real-world datasets show the superiority of our proposed method.
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http://dx.doi.org/10.1109/TCYB.2021.3060804DOI Listing
April 2021

Noninvasive prediction of residual disease for advanced high-grade serous ovarian carcinoma by MRI-based radiomic-clinical nomogram.

Eur Radiol 2021 Apr 16. Epub 2021 Apr 16.

Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, 215163, China.

Objectives: To develop a preoperative MRI-based radiomic-clinical nomogram for prediction of residual disease (RD) in patients with advanced high-grade serous ovarian carcinoma (HGSOC).

Methods: In total, 217 patients with advanced HGSOC were enrolled from January 2014 to June 2019 and randomly divided into a training set (n = 160) and a validation set (n = 57). Finally, 841 radiomic features were extracted from each tumor on T2-weighted imaging (T2WI) and contrast-enhanced T1-weighted imaging (CE-T1WI) sequence, respectively. We used two fusion methods, the maximal volume of interest (MV) and the maximal feature value (MF), to fuse the radiomic features of bilateral tumors, so that patients with bilateral tumors have the same kind of radiomic features as patients with unilateral tumors. The radiomic signatures were constructed by using mRMR method and LASSO classifier. Multivariable logistic regression analysis was used to develop a radiomic-clinical nomogram incorporating radiomic signature and conventional clinico-radiological features. The performance of the nomogram was evaluated on the validation set.

Results: In total, 342 tumors from 217 patients were analyzed in this study. The MF-based radiomic signature showed significantly better prediction performance than the MV-based radiomic signature (AUC = 0.744 vs. 0.650, p = 0.047). By incorporating clinico-radiological features and MF-based radiomic signature, radiomic-clinical nomogram showed favorable prediction ability with an AUC of 0.803 in the validation set, which was significantly higher than that of clinico-radiological signature and MF-based radiomic signature (AUC = 0.623, 0.744, respectively).

Conclusions: The proposed MRI-based radiomic-clinical nomogram provides a promising way to noninvasively predict the RD status.

Key Points: • MRI-based radiomic-clinical nomogram is feasible to noninvasively predict residual disease in patients with advanced HGSOC. • The radiomic signature based on MF showed significantly better prediction performance than that based on MV. • The radiomic-clinical nomogram showed a favorable prediction ability with an AUC of 0.803.
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http://dx.doi.org/10.1007/s00330-021-07902-0DOI Listing
April 2021

Homologous recombination repair gene mutations show no survival benefits in Chinese high-grade serous ovarian cancer patients.

Ann Transl Med 2021 Mar;9(5):364

Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.

Background: The purpose of our study was to identify germline and somatic homologous recombination repair (HRR) pathway gene mutations and their clinical-prognostic impact in Chinese high-grade serous ovarian cancer (HGSC) patients.

Methods: We applied next-generation sequencing (NGS) in consecutive patients who underwent primary surgery for HGSC in November and December 2015 at our institution. Paired peripheral blood (or para-carcinoma tissue) samples and tumor samples from 42 Chinese women were tested to identify both germline and somatic deleterious mutations through all exons in and 22 other core HRR genes. Clinic-pathological data were collected until February, 2020. Associations between HRR gene mutations and clinical characters and outcomes were also evaluated.

Results: Deleterious germline HRR mutations were identified in 16.7% (7/42) of the HGSC patients. One patient had both germline and mutations. Six patients had only somatic mutations, increasing the HRR mutation rate to 31.0% (13/42). Neither germline nor somatic HRR gene mutations were related with residual disease (P=0.233) nor platinum sensitivity (P=0.851). In the univariate and multivariate analyses, germline HRR gene mutation status was not associated with progression-free survival (PFS) or overall survival (OS). In addition, no prognostic differences between somatic HRR mutated patients and wild-type patients were found.

Conclusions: Our results suggest that the HRR gene defect was not associated with improved survival in our Chinese HGSC patient cohort.
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http://dx.doi.org/10.21037/atm-20-5136DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8033363PMC
March 2021

-derived peptide SJMHE1 promotes peripheral nerve repair through a macrophage-dependent mechanism.

Am J Transl Res 2021 15;13(3):1290-1306. Epub 2021 Mar 15.

State Key Lab of Reproductive Medicine, Jiangsu Key Laboratory of Pathogen Biology, Department of Pathogen Biology and Immunology, Center for Global Health, Nanjing Medical University Nanjing 211166, Jiangsu, P. R. China.

Peripheral nerve injury, a disease that affects 1 million people worldwide every year, occurs when peripheral nerves are destroyed by injury, systemic illness, infection, or an inherited disorder. Indeed, repair of damaged peripheral nerves is predominantly mediated by type 2 immune responses. Given that helminth parasites induce type 2 immune responses in hosts, we wondered whether helminths or helminth-derived molecules might have the potential to improve peripheral nerve repair. Here, we demonstrated that schistosome-derived SJMHE1 promoted peripheral myelin growth and functional regeneration via a macrophage-dependent mechanism and simultaneously increased the induction of M2 macrophages. Our findings highlight the therapeutic potential of schistosome-derived SJMHE1 for improving peripheral nerve repair.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8014408PMC
March 2021

Predictive value of sub classification of focal segmental glomerular sclerosis in Oxford classification of IgA nephropathy.

Ann Med 2021 Dec;53(1):587-595

Department of Nephrology, The Second Xiangya Hospital of Central South University; Hunan Key Laboratory of Kidney Disease and Blood Purification, Changsha, China.

Background: The Oxford classification of IgA nephropathy (IgAN) was revised in 2016 which lacked sufficient evidence for prognostic value of subclassification of focal segmental glomerular sclerosis (S lesion), and the proper proportion of S lesion for subclassification remains undetermined.

Aim: This study aimed to explore the predictive value of the new subclassification of S score on renal outcomes of IgAN patients.

Methods: 348 patients with IgAN-associated S lesion were enrolled. According to the optimal cut-off of 25% established by receiver operating characteristic (ROC) curves, we divided S1 patients into two groups: S1a group (S lesion < 25%) and S1b group (S lesion ≥ 25%). IgAN patients with mild lesion (M0E0S0T0C0) were set as the control group. The clinical features at renal biopsy, pathological findings, and follow-up parameters (follow-up time ranged from 1 to 5 years) were collected. We used univariate and multivariate analyses to assess whether the subclassification of S score could refine risk prediction and clinical utility.

Results: We demonstrated that S lesion ≥ 25% was associated with a more rapid GFR loss and a lower rate of complete remission of proteinuria even adjusted for multiple clinic pathological variables, compared to S1a group (All values <.05). And the ratio of glomeruli with T lesion and crescents were higher in patients with S lesion ≥ 25%. Data showed that IgAN patients with S lesion ≥ 25% were at an increased risk of poor renal outcomes even with immunosuppression.

Conclusion: This study might recommend new subclassification of S scores (S0 (no S lesion), S1 (S lesion <25% of glomeruli), and S2 (S lesion ≥ 25% of glomeruli)) for the Oxford classification. This model may also help to evaluate pros and cons of immunosuppressive therapy in IgAN patients with different level of S lesion.KEY MESSAGESS lesion ≥ 25% is an independent risk factor for poor renal outcome in IgAN patients.This new subclassification of S scores may help to evaluate pros and cons of immunotherapy in IgAN patients with different level of S lesion.
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http://dx.doi.org/10.1080/07853890.2021.1897664DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8032344PMC
December 2021

Obturator Oblique and Pubic Ramus Inlet Views Can Better Guide the Insertion of an Anterior Column Acetabular Screw.

Orthop Surg 2021 Apr 5. Epub 2021 Apr 5.

Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China.

Objective: The objective of the present paper was to investigate the value of obturator oblique and pubic ramus inlet views in guiding anterior column acetabular screw insertion.

Methods: We collected pelvic CT scans at the diagnostic imaging center of our hospital between 2017 and 2019. Virtual three-dimensional (3D) models of the pelvis were created based on the CT scans. Then the transparency was adjusted to 30%. Two identical copies of the 3D model data were made. 3D model replications were divided into a control group and an experimental group. In the control group, the screw was inserted into the anterior acetabular column using obturator-outlet and iliac-inlet views. In the experimental group, the screw was guided under obturator oblique and pubic ramus inlet views. Based on whether the screw penetrated the hip joint and/or exited the pubic ramus, models were divided into three grades. Grade I: the screw travels completely within the anterior column bone corridor; Grade II: the screw exits the superior pubic ramus, but the length of the screw outside the channel does not exceed 1/2 of the anterior column; Grade III: the screw exits the superior pubic ramus and the length of the screw outside the corridor exceeds 1/2 of the anterior column. We compared the screw placement quality of the two groups and analyzed differences between genders. In addition, the distance between the screws and the acetabulum was recorded and compared among the two groups.

Results: A total of 110 hemipelves were selected, including those of 80 men and 30 women, with an average age of 46.76 ± 14.26 years. In the control group, the screw quality of 64 models (58.2%) was Grade I. In the experimental group, 94 models (85.5%) had Grade I screw placement quality. Grade II screw placement quality accounted for 18.2% of the control group and 7.3% of the experimental group. In the control and the experimental groups, there were 26 and 8 cases with Grade III screw placement quality, respectively. The quality of screw placement in the experimental group was significantly better than that in control group, and the difference between the two groups was statistically significant (P < 0.01). The distance between the screw and the acetabulum in the control group and experimental group was 0.92 ± 0.49 mm and 2.78 ± 1.15 mm, respectively. The difference between the two groups was statistically significant.

Conclusion: Anterior column acetabular screws can be inserted successfully and more accurately using the obturator oblique and pubic ramus inlet views.
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http://dx.doi.org/10.1111/os.12943DOI Listing
April 2021

LY3023414 inhibits both osteogenesis and osteoclastogenesis through the PI3K/Akt/GSK3 signalling pathway.

Bone Joint Res 2021 Apr;10(4):237-249

Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Aims: LY3023414 is a novel oral phosphatidylinositol 3-kinase (PI3K)/mammalian target of rapamycin (mTOR) dual inhibitor designed for advanced cancers, for which a phase II clinical study was completed in March 2020; however, little is known about its effect on bone modelling/remodelling. In this study, we aimed to explore the function of LY3023414 in bone modelling/remodelling.

Methods: The function of LY3023414 was explored in the context of osteogenesis (bone formation by osteoblasts) and osteoclastogenesis (osteoclast formation and bone resorption). Murine preosteoblast MC3T3-E1 cell line and murine bone marrow-derived macrophage cells (BMMs) were subjected to different treatments. An MTS cell proliferation assay was used to examine the cytotoxicity. Thereafter, different induction conditions were applied, such as MCSF and RANKL for osteoclastogenesis and osteogenic media for osteogenesis. Specific staining, a bone resorption assay, and quantitative real-time polymerase chain reaction (qRT-PCR) were subsequently used to evaluate the effect of LY3023414. Moreover, small interfering RNA (siRNA) was applied to knockdown Akt1 or Akt2 for further validation. Lastly, western blot was used to examine the exact mechanism of action.

Results: LY3023414 attenuated PI3K/protein kinase B (Akt)/GSK3-dependent activation of β-catenin and nuclear factor-activated T cell 1 (NFATc1) during osteogenesis and osteoclastogenesis, respectively. LY3023414 mainly inhibited osteoclast formation instead of mature osteoclast function. Moreover, it suppressed osteogenesis both in the early stage of differentiation and late stage of calcification. Similarly, gene knockdown of Akt isoforms by siRNA downregulated osteogenic and osteoclastogenic processes, indicating that Akt1 and Akt2 acted synergistically.

Conclusion: LY3023414 can suppress osteogenesis and osteoclastogenesis through inhibition of the PI3K/Akt/GSK3 signalling pathway, which highlights the potential benefits and side effects of LY3023414 for future clinical applications. Cite this article:  2021;10(4):237-249.
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http://dx.doi.org/10.1302/2046-3758.104.BJR-2020-0255.R2DOI Listing
April 2021

Overexpression of NPTX2 Promotes Malignant Phenotype of Epithelial Ovarian Carcinoma IL6-JAK2/STAT3 Signaling Pathway Under Hypoxia.

Front Oncol 2021 9;11:643986. Epub 2021 Mar 9.

Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.

Background: Epithelial ovarian cancer (EOC) is the main subtype of ovarian cancer and shows an aggressive phenotype and poor prognosis. Neuronal pentraxin II (NPTX2) is a member of the neuronal pentraxin family and plays a contradictory role in different tumors. However, there has been no report about the possible role and effect of NPTX2 in EOC.

Methods: Bioinformatics analysis, qPCR, western blotting and immunohistochemistry were used to detect the expression of NPTX2 in EOC. Lentivirus-based transfection for NPTX2 overexpression or knockdown was performed on the EOC cell lines A2780, HEY, SKOV3 and OVCAR-3. The effect of NPTX2 on the malignant phenotype of EOC was examined through methods of MTS assay, Edu assay, transwell assay, western blotting analysis, qPCR analysis, luciferase reporter assay and xenograft experiment.

Results: EOC tissues showed higher NPTX2 expression than the normal tissues with poor prognosis. NPTX2 overexpression can promote the proliferation, invasion, migration and tumorigenesis of EOC IL6-JAK2/STAT3 signaling pathway. Moreover, hypoxia-inducible factor-1(HIF-1) can promote the transcription and expression of NPTX2 under the hypoxic environment. NPTX2 knockdown abolished the hypoxia-induced malignant phenotypes in ECO.

Conclusions: The above results suggest that NPTX2 may play a novel role in ovarian cancer's malignant phenotype and act as a promising treatment target for EOC molecular therapy.
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http://dx.doi.org/10.3389/fonc.2021.643986DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7985451PMC
March 2021

Non-contrast CT-based radiomic signature for screening thoracic aortic dissections: a multicenter study.

Eur Radiol 2021 Mar 23. Epub 2021 Mar 23.

Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, 54 Youdian Road, Hangzhou, 310000, China.

Objective: To develop a non-contrast CT-based radiomic signature to effectively screen for thoracic aortic dissections (ADs).

Methods: We retrospectively enrolled 378 patients who underwent non-contrast chest CT scans along with CT angiography or MRI from 4 medical centers. The training and validation sets were from 3 centers, while the external test set was from a 4th center. Radiomic features were extracted from non-contrast CT images. The radiomic signature was created on the basis of selected features by a logistic regression algorithm. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve, accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were conducted to assess the predictive ability of radiomic signature.

Results: The radiomic signature demonstrated AUCs of 0.91 (95% confidence interval [CI], 0.86-0.95) in the training set, 0.92 (95% CI, 0.86-0.98) in the validation set, and 0.90 (95% CI, 0.82-0.98) in the external test set. The predicted diagnosis was in good agreement with the probability of thoracic AD. In the external test group, the diagnostic accuracy, sensitivity, specificity, PPV, and NPV were 90.5%, 85.7%, 91.7%, 70.6%, and 96.5%, respectively.

Conclusions: A radiomic signature based on non-contrast CT images can effectively predict thoracic ADs. This method may serve as a potential screening tool for thoracic ADs.

Key Points: • The non-contrast CT-based radiomic signature can effectively predict the thoracic aortic dissections. • This radiomic signature shows better predictive performance compared to the current clinical model. • This prediction method may be a potential tool for screening thoracic aortic dissections.
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http://dx.doi.org/10.1007/s00330-021-07768-2DOI Listing
March 2021

A Novel Nonenzymatic Hydrogen Peroxide Sensor Based on Magnetic Core-Shell FeO@C/Au Nanoparticle Nanocomposite.

Int J Anal Chem 2021 8;2021:8839895. Epub 2021 Mar 8.

College of Chemistry and Molecular Engineering, Nanjing Tech University, Nanjing 211800, China.

FeO@C/Au nanoparticle (AuNP) nanocomposites were prepared through electrostatic adsorption of AuNPs onto PDDA-functionalized core/shell FeO@C magnetic nanospheres, which had been synthesized by a facile solvothermal method. The morphology and composition of the nanocomposites were characterized by transmission electron microscopy (TEM), scanning electron microscopy (SEM), Fourier transform infrared (FT-IR), etc. Moreover, highly electrocatalytic activity to the reduction of hydrogen peroxide (HO) was also exhibited on the FeO@C/AuNP-modified indium tin oxide (ITO) electrode. The effect of solution pH and the modification amount of FeO@C/AuNPs on the performance of electrocatalytic HO reduction was investigated. Under the optimal conditions, the catalytic current showed a linear relationship with the increase of HO concentration in the range of 0.007-15 mM and a detection limit of 5 M. The HO sensor showed high selectivity for HO detection, which could effectively resist the interference of ascorbic acid (AA), uric acid (UA), and citric acid (CA). Finally, the HO sensor was used in the real fetal bovine serum to detect HO and obtained satisfactory results with the recovery values ranging from 95.14 to 103.6%.
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http://dx.doi.org/10.1155/2021/8839895DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7960058PMC
March 2021

Schistosome infection promotes osteoclast-mediated bone loss.

PLoS Pathog 2021 Mar 18;17(3):e1009462. Epub 2021 Mar 18.

State Key Lab of Reproductive Medicine, Jiangsu Key Laboratory of Pathogen Biology, Department of Pathogen Biology and Immunology, Center for Global Health, Nanjing Medical University, Nanjing, P. R. China.

Infection with schistosome results in immunological changes that might influence the skeletal system by inducing immunological states affecting bone metabolism. We investigated the relationships between chronic schistosome infection and bone metabolism by using a mouse model of chronic schistosomiasis, affecting millions of humans worldwide. Results showed that schistosome infection resulted in aberrant osteoclast-mediated bone loss, which was accompanied with an increased level of receptor activator of nuclear factor-κB (NF-κB) Ligand (RANKL) and decreased level of osteoprotegerin (OPG). The blockade of RANKL by the anti-RANKL antibody could prevent bone loss in the context of schistosome infection. Meanwhile, both B cells and CD4+ T cells, particularly follicular helper T (Tfh) cell subset, were the important cellular sources of RANKL during schistosome infection. These results highlight the risk of bone loss in schistosome-infected patients and the potential benefit of coupling bone therapy with anti-schistosome treatment.
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http://dx.doi.org/10.1371/journal.ppat.1009462DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8009420PMC
March 2021

Development of a novel label-free impedimetric electrochemical sensor based on hydrogel/chitosan for the detection of ochratoxin A.

Talanta 2021 May 5;226:122183. Epub 2021 Feb 5.

School of Pharmaceutical Sciences, Nanjing Tech University, Nanjing, 211816, PR China; School of Food Science and Pharmaceutical Engineering, Nanjing Normal University, Nanjing, 210023, PR China. Electronic address:

Ochratoxin A (OTA) is one of the most abundant mycotoxins that contaminate various food products. Herein, we propose a novel label-free impedimetric electrochemical sensor consisting of chitosan/dipeptide nanofibrous hydrogel and immobilized DNA probes with OTA aptamer for the detection of OTA. The thin film of chitosan/dipeptide nanofibrous hydrogel was used as sensing interface and carrier for hybridization chain reaction (HCR) of OTA aptamer and DNA2 strand to form DNA concatemer. The concatemer was dissociated to single-stranded DNA (ssDNA) in the presence of target OTA, and the signal amplification was further implemented by introducing RecJ exonuclease, which could digest the single-stranded DNA resulting in OTA recycle. Electrochemical impedance spectroscopy (EIS) has been employed to characterize the properties of the fabricated sensor. A linear detection range of 0.1-100 ng mL was obtained for OTA with a low detection limit of 0.03 ng mL. Furthermore, the developed sensor was demonstrated in white wine to detect OTA, indicating that the proposed impedimetric sensor has a promising potential application in the food industry.
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http://dx.doi.org/10.1016/j.talanta.2021.122183DOI Listing
May 2021

LINC01224 accelerates malignant transformation via MiR-193a-5p/CDK8 axis in gastric cancer.

Cancer Med 2021 Feb;10(4):1377-1393

Oncology Department, Jiangdu People's Hospital Affiliated to Medical College of Yangzhou University, Yangzhou, Jiangsu, China.

Background: Gastric cancer (GC) is a malignant tumor with a significantly high mortality rate, yet, its pathogenesis is not fully understood. Bioinformatics predicted that LINC01224 is highly expressed in stomach adenocarcinoma (STAD), and showed that LINC01224 adsorbed miR-193a-5p to target CDK8. Therefore, this study intended to verify the effect of the LINC01224/miR-193a-5p/CDK8 axis on the biological behavior of gastric cancer.

Methods: Expressions of LINC01224, miR-193a-5p, CDK8, apoptosis-, and EMT-related genes were analyzed using the GEPIA website, RT-qPCR, in situ hybridization, and Western blot as needed. Bioinformatics and dual luciferase assay were used to evaluate the relationship between LINC01224, miR-193a-5p, and CDK8. Functional experiments and rescue experiments (MTT assay, flow cytometry, wound healing assay, and Transwell) were conducted to detect the effects of the above genes on the biological characteristics of GC cells. Tumorigenesis assay was used to verify the results of in vitro experiments.

Results: LINC01224 adsorbed miR-193a-5p to target and upregulate CDK8. The expressions of LINC01224 and CDK8 were increased, while the expression of miR-193a-5p was decreased in GC. Overexpressed LINC01224 promoted cell viability, migration and invasion, accelerated tumor formation, attenuated apoptosis, inhibited the expressions of apoptosis-related proteins, and promoted the expressions of EMT-related proteins, whereas silenced LINC01224 led to the opposite effect. MiR-193a-5p inhibitor partially offset the effect of silenced LINC01224; interestingly, siCDK8 significantly reversed the effect of miR-193a-5p inhibitor on GC cells.

Conclusion: LINC01224 affects the biological behavior of gastric cancer by mediating miR-193a-5p to regulate CDK8.
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http://dx.doi.org/10.1002/cam4.3726DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7926023PMC
February 2021

Experience of Comprehensive Three Dimensional Epicanthoplasty With Upper Blepharoplasty in Asian Patients.

Ann Plast Surg 2021 03;86(3S Suppl 2):S235-S238

From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.

Purpose: To introduce the experience of comprehensive 3-dimensional epicanthoplsty with upper blepharoplasty in Asian patients.

Methods: The patients who underwent comprehensive 3-dimensional epicanthoplsty with upper blepharoplasty at the Shanghai Ninth People's hospital from January 2018 to January 2019 were included in our study. The interepicanthal distance was evaluated preoperatively and 6 months after the surgery, scar visibility and patient's satisfaction were documented 6 months after the surgery.

Results: A total of 72 patients (144 eyelids) were included in this study with ages ranging from 18 to 37 years (mean, 23.83 ± 4.64 years) and follow-up duration ranging from 6 to 12 months (mean, 7.82 ± 1.92 months). All patients were female and achieved esthetically favorable results without serious complications. No patients required revision surgery showing high patient satisfaction (score, 4.4). The preoperative mean interepicanthal distance was 33.13 ± 2.25 mm and decreased to 29.28 ± 2.26 mm postoperatively showing statistical significance (P < 0.001). Twenty-nine (40.3%) patients had no visible scarring, and 42 (58.3%) patients had minimal scarring, which was accepted by the patients.

Conclusions: The comprehensive 3-dimensional epicanthoplasty with upper blepharoplasty is a surgical technique that is easy to perform, reliable, and effective in treatment of all types of epicanthal folds except type 4 with increase intercanthal distance, less visible scar, and high patient satisfaction in Asian patients.
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http://dx.doi.org/10.1097/SAP.0000000000002589DOI Listing
March 2021

Comparison of Survival Between Primary Debulking Surgery Versus Neoadjuvant Chemotherapy for Ovarian Cancers in a Personalized Treatment Cohort.

Front Oncol 2020 10;10:632195. Epub 2021 Feb 10.

Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.

Objective: To compare survival between primary debulking surgery (PDS) and neoadjuvant chemotherapy (NACT) for the treatment of ovarian cancer patients per our selective protocol.

Methods: Between Sep 1, 2015, and Aug 31, 2017, 161 patients were enrolled in our prospective cohort. All of the patients received preoperative clinic-radiological assessments, according to the Suidan criteria for R0 resection. Patients with a score of 0-2 received PDS. Patients with a score of ≥3 were counseled on the choices of PDS, NACT, or an optional staging laparoscopy, according to the Fagotti criteria. Clinic-pathological data were prospectively collected until May 1, 2020, and the impacts of different treatment strategies on progression-free survival (PFS) and overall survival (OS) were analyzed.

Results: 110 patients underwent PDS, and 51 patients received NACT with consequent interval debulking surgery. The R0 resection rate was 57.8%. All but one of the patients received platinum-based chemotherapy, and 105 (65.2%) patients were platinum-sensitive. Based on the univariate analysis, the PDS group exhibited prolonged PFS compared with the NACT group (P=0.029). The subgroup analysis showed that patients receiving NACT with residual disease (RD) exhibited the worst PFS (P=0.001). Based on the multivariate analysis, NACT with RD was still an independent impaired factor for PFS (P=0.04). However, NACT did not affect OS in the univariate or multivariate analyses.

Conclusion: In our prospective cohort, NACT ovarian patients exhibited inferior PFS and noninferior OS compared with PDS patients. Given our selective protocol, NACT cannot be arbitrarily denied while appropriate PDS is still a priority.
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http://dx.doi.org/10.3389/fonc.2020.632195DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7902759PMC
February 2021

Semisupervised Feature Selection via Structured Manifold Learning.

IEEE Trans Cybern 2021 Feb 26;PP. Epub 2021 Feb 26.

Recently, semisupervised feature selection has gained more attention in many real applications due to the high cost of obtaining labeled data. However, existing methods cannot solve the ``multimodality'' problem that samples in some classes lie in several separate clusters. To solve the multimodality problem, this article proposes a new feature selection method for semisupervised task, namely, semisupervised structured manifold learning (SSML). The new method learns a new structured graph which consists of more clusters than the known classes. Meanwhile, we propose to exploit the submanifold in both labeled data and unlabeled data by consuming the nearest neighbors of each object in both labeled and unlabeled objects. An iterative optimization algorithm is proposed to solve the new model. A series of experiments was conducted on both synthetic and real-world datasets and the experimental results verify the ability of the new method to solve the multimodality problem and its superior performance compared with the state-of-the-art methods.
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http://dx.doi.org/10.1109/TCYB.2021.3052847DOI Listing
February 2021

The development of computer-aided patient-specific template design software for 3D printing in cranio-maxillofacial surgery.

Int J Med Robot 2021 Feb 12:e2243. Epub 2021 Feb 12.

School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China.

Background: The patient-specific templates for osteotomy often have complex surface features. Using current commercial software to design such templates is quite complicated, tedious and unrepeatable.

Aims: In this study, a novel surgical planning system for oral and maxillofacial surgery named EasyTemplate is developed, aiming to help doctors shorten the modelling time and assure the reliability in template design.

Materials & Methods: In the simplified design process of an osteotomy guide, the main template can be formed efficiently using a surface offsetting algorithm, which is based on isosurface extraction and oriented bounding box. Thereafter, the cutting grooves can be generated automatically.

Results: A complicated surgical guide could be built accurately in about 10 min. Clinical orthognathic cases were conducted successfully using osteotomy and repositioning templates designed by EasyTemplate.

Discussion: Compared with commercially available softwares, higher efficiency and simpler design process were achieved, moreover, the time cost is one-third or even less.

Conclusion: EasyTemplate can be a useful alternative to traditional softwares. This software allows the auto-generation algorithm which helps avoid a tedious modeling process while providing basic shapes for designers.
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http://dx.doi.org/10.1002/rcs.2243DOI Listing
February 2021

A Preliminary Study on Animal Experiments of Robot-Assisted Craniotomy.

World Neurosurg 2021 May 1;149:e748-e757. Epub 2021 Feb 1.

Institute of Forming Technology & Equipment, Shanghai, China; Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, China. Electronic address:

Background: Traditional craniotomy relies on the surgeon's experience and can be complicated owing to excessive skull bone removal, undesirable brain tissue penetration, or severe bleeding. For craniotomy, we developed a robot system based on intraoperative cone-beam computed tomography image guidance and human-robot cooperative interaction, aiming to improve the safety and accuracy of surgery and reduce the labor-intensiveness of the procedure.

Methods: Intraoperative cone-beam computed tomography image guidance was adopt to improve the accuracy in our experiment. Craniotomy was performed using an interactive method based on human-robot collaboration, which could achieve a natural interactive method in accordance with surgeons' operating habits. The frequency-based method of contact distinction and the method of torque estimation were used to improve the safety of the designed robot.

Results: An animal experiment was conducted to verify the effectiveness of the robot system. During the drilling process, the position error was 0.92 ± 0.17 mm (upper surface) and 0.97 ± 0.11 mm (lower surface), and the angle error was 3.37 ± 1.43°. During the milling process, the position error was 1.06 ± 0.13 mm (upper surface) and 1.09 ± 0.09 mm (lower surface). The results showed that the system had sufficient precision and could better complete craniotomy with human-robot collaboration. In addition, with the feedback of multisensor information, the robot system could achieve a sufficient level of safety.

Conclusions: The robot system can achieve accurate positioning and safe user-friendly human-robot interaction, which solves problems encountered in the drilling and milling of craniotomy, meets clinical needs, and provides a new method for robot-assisted craniotomy.
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http://dx.doi.org/10.1016/j.wneu.2021.01.108DOI Listing
May 2021

Choroid Segmentation of Retinal OCT Images Based on CNN Classifier and - Fitter.

Comput Math Methods Med 2021 15;2021:8882801. Epub 2021 Jan 15.

Department of Applied Mathematics, The Hong Kong Polytechnic University, Hong Kong.

Optical coherence tomography (OCT) is a noninvasive cross-sectional imaging technology used to examine the retinal structure and pathology of the eye. Evaluating the thickness of the choroid using OCT images is of great interests for clinicians and researchers to monitor the choroidal thickness in many ocular diseases for diagnosis and management. However, manual segmentation and thickness profiling of choroid are time-consuming which lead to low efficiency in analyzing a large quantity of OCT images for swift treatment of patients. In this paper, an automatic segmentation approach based on convolutional neural network (CNN) classifier and - (0 < < 1) fitter is presented to identify boundaries of the choroid and to generate thickness profile of the choroid from retinal OCT images. The method of detecting inner choroidal surface is motivated by its biological characteristics after light reflection, while the outer chorioscleral interface segmentation is transferred into a classification and fitting problem. The proposed method is tested in a data set of clinically obtained retinal OCT images with ground-truth marked by clinicians. Our numerical results demonstrate the effectiveness of the proposed approach to achieve stable and clinically accurate autosegmentation of the choroid.
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http://dx.doi.org/10.1155/2021/8882801DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7826219PMC
January 2021

A real time image-guided reposition system for the loosed bone graft in orthognathic surgery.

Comput Assist Surg (Abingdon) 2021 Dec;26(1):1-8

Faculty of Mathematics and Computer Science, University of Münster, Münster, Germany.

In traditional orthognathic surgery, the dental splint technique is typically used to assist surgeons to reposition the maxilla or mandible. However, the design and manufacturing of dental splints is time-consuming and labor-intensive, and the templates may not applicable for some complicated cases due to the anatomic intricacies in the maxillofacial region. During recent years, computer-aided navigation technology has been widely used in oral and maxillofacial surgery. However, due to the limitation of current calibration and registration methods, it has been rarely reported for the motion tracking of intraoperative reposition for the loosed bone graft. In this study, a novel surgical navigation system was developed. With the use of this system, not only the surgical saw can be tracked in real-time, but also the loosed bone graft can be navigated under the guidance of the interactive 2D and 3D views until it is aligned with the preoperatively planned position. The phantom experiments validated the feasibility of our surgical navigation system, and the mean error of image-guided reposition was 1.03 ± 0.10 mm, which was significantly more accurate than the mean error of 5.57 ± 1.40 mm based on the non-navigated methods.
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http://dx.doi.org/10.1080/24699322.2021.1874535DOI Listing
December 2021

Conservative management of grade 2 stage IA endometrial carcinoma and literature review.

J Obstet Gynaecol Res 2021 Mar 5;47(3):984-991. Epub 2021 Jan 5.

Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.

Purpose: To explore the clinical outcomes of megestrol acetate alone or plus metformin in young women with grade 2 stage IA endometrial carcinoma who ask for preserved fertility.

Methods: Patients with stage IA grade 2 endometrial carcinoma who asked for fertility-sparing treatment in the Obstetrics and Gynecology Hospital of Fudan University between 2015 and 2017 were enrolled and retrospectively reviewed.

Results: Four patients were included and treated with oral megestrol acetate (160 mg per day), while metformin (500 mg, thrice daily) was added for patients with metabolic syndrome. Regular hysteroscopic examination was performed every 3 months during the conservative treatment. Overall, 75% (3/4) of the patients had a complete response, one relapsed and achieved a complete response after changing the therapy plan, and one patient had an indication of myometrial invasion during fertility-sparing treatment and chose to remove uterus.

Conclusions: Fertility-sparing treatment for stage IA grade 2 endometrial carcinoma patients is worth exploration. Megestrol acetate with or without metformin combined with hysteroscopic lesion ablation may be an effective therapy.
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http://dx.doi.org/10.1111/jog.14646DOI Listing
March 2021

An electromagnetic tracking implantation navigation system in dentistry with virtual calibration.

Int J Med Robot 2021 Apr 19;17(2):e2215. Epub 2021 Jan 19.

School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China.

Background: Dental implant placement navigation systems based on optical tracking have been widely used in clinics. However, electromagnetic (EM) navigation method that does not suffer from problems of hidden line-of-light has not yet been described.

Methods: This work proposes an EM-guided navigation method named TianShu-ESNS with virtual calibration. Model (12 implants) and animal experiments (pig head: six implants) were conducted to evaluate its performance and stability.

Result: The mean virtual calibration error was 0.83 ± 0.20 mm. The mean deviations at the entry point, end point and angle in the phantom experiment of TianShu-ESNS were 1.23 ± 0.17 mm, 1.59 ± 0.20 mm and 1.83 ± 0.27°, respectively. In the animal experiment, the same deviations were 1.25 ± 0.07 mm, 1.57 ± 0.35 mm and 1.90 ± 0.60°, respectively.

Conclusions: The experimental results show that TianShu-ESNS with the virtual calibration method could serve as a promising tool to eliminate the line-of-light hidden problem and simplify operation procedure in dental implant placement.
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http://dx.doi.org/10.1002/rcs.2215DOI Listing
April 2021

Psychological Nursing of Patients With Stroke in China: A Systematic Review and Meta-Analysis.

Front Psychiatry 2020 11;11:569426. Epub 2020 Dec 11.

Department of Operating Room, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

The present study aimed to evaluate the efficacy of psychological nursing of patients with stroke in China. The Embase, PubMed, Cochrane Library, CNKI, and Wanfang databases were searched from inception to February 1, 2020. Randomized controlled trials (RCTs) reporting the efficacy of psychological nursing of patients with stroke were included. Revman 5.3 and Stata 15.0 were used for data analysis. Twelve RCTs and 1,013 patients with stroke were included in this systematic review and meta-analysis. The results revealed a significant difference in the Hamilton depression score between the psychological nursing and usual care groups. The meta-analysis of three studies ( = 235) that used a depressive symptom control of ≥25% as the outcome measure showed a significant difference between the two groups. In addition, significant differences were detected in the National Institute of Health stroke scale score and activities of daily living score between the two groups. The present meta-analysis suggests that in China, compared to the usual care, psychological nursing is more effective for alleviating depressive symptoms, improving neurological rehabilitation, and recovering the ability of daily life.
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http://dx.doi.org/10.3389/fpsyt.2020.569426DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7759468PMC
December 2020