bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Novel Clustering Scheme For Heterogeneous Cognitive Radio Wireless Sensor Networks
Authors: Prasad Joshi Gyanendra 
Published: November 2020

Introduction: This article is the product of the research “Learning-based Spectrum Analysis and Prediction in Cognitive Radio Sensor Networks”, developed at Sejong University in the year 2019.
Problem: Most of the clustering schemes for distributed cognitive radio-enabled wireless sensor networks consider homogeneous cognitive radio-enabled wireless sensors. Many clustering schemes for such homogeneouscognitive radio-enabled wireless sensor networks waste resources and suffer from energy inefficiency because of the unnecessary overheads.
Objective: The objective of the research is to propose a node clustering scheme that conserves energy and prolongs network lifetime.
Methodology: A heterogeneous cognitive radio-enabled wireless sensor network in which only a few nodes have a cognitive radio module and the other nodes are normal sensor nodes. Along with the hardware cost, theproposed scheme is efficient in energy consumption.
Results: We simulated the proposed scheme and compared it with the homogeneous cognitive radio-enabled wireless sensor networks. The results show that the proposed scheme is efficient in terms of energyconsumption.
Conclusion: The proposed node clustering scheme performs better in terms of network energy conservation and network partition.
Originality: There are heterogeneous node clustering schemes in the literature for cooperative spectrum sensing and energy efficiency, but to the best of our knowledge, there is no study that proposes a non-cognitiveradio-enabled sensor clustering for energy conservation along with cognitive radio-enabled wireless sensors.
Limitations: The deployment of the proposed special device for cognitive radio-enabled wireless sensors is complicated and requires special hardware with better battery powered cognitive sensor nodes.
South African professional Super Rugby players’ lived experiences of career-related traumatic injuries: A descriptive phenomenological analysis
Authors: Hall Trevor , Pieter Basson Pieter Basson , Jon Patricios Jon Patricios 
Published: November 2020

Background: Historically, non-career-ending traumatic rugby injury (TRI) has been viewed from a predominantly biological perspective. However, dimensional perspectives, such as the biopsychosocial model, have highlighted the need to incorporate psychosocial understandings of TRI into treatment plans.
Aim: To describe the lived experiences of a cohort of traumatically injured South African Super Rugby players in order to add to the body of literature on the subject of TRI experience.
Methods: The employment of a qualitative, descriptive phenomenological method was used to achieve the research outcome.
Discussion: Common descriptive themes indicated that TRI seems to exist within three stages: the initial, emotional and subsequent reactions to the traumatic injury. Sub-themes described within each stage included attempts at remaining positive and appraising the severity of the injury during onset, fear responses and concomitant feelings of loss related to foregone career opportunities during the emotional reactions stage, the employment of coping mechanisms, and relying on specific support structures during subsequent reactions. Two novel experiences revealed within this study and not reported in the international literature included the injured players’ reliance on compartmentalisation and positive religious belief structures as coping strategies. All themes were reduced to descriptive phenomenological essences that describe a lifeworld or biopsychosocial experience of TRI.
Conclusion: Themes drawn from this study can be applied in the future design and implementation of expanded studies and psychological interventions aimed at assisting traumatically injured rugby players during their recovery process. The identified themes affirm aspects from the international literature while highlighting some uniquely South African outcomes.
How Does Nutritional Status Affect Outcomes in Patients with Neurological Diseases?
Authors: GÜZEL Şükran , GÜRÇAY Eda , KARACA UMAY Ebru , MERCİMEKÇİ Serdar , ÇAKCI Aytül 
Published: November 2020

Background: To evaluate the nutritional status of patients with neurological diseases during the rehabilitation process and to investigate the relationships between the nutritional status and disease severity and clinical evaluation outcomes.
Methods: In this prospective trial, 109 patients with a disease duration of <6 months, hospitalized for neurological rehabilitation in Physical Medicine and Rehabilitation Clinic, Ankara, Turkey were enrolled from 2014-17. All patients were assessed with the Mini Mental State Examination (MMSE) test, European Quality of Life Scale (Euro-QoL), Hospital Anxiety and Depression Scale (HADS), Pittsburg Rehabilitation Participation Scale (PRPS), and Functional Ambulation Category (FAC). Nutritional status was analyzed by biochemical and anthropometric parameters. The patients received a conventional rehabilitation program and a nutritional support according to clinical and laboratory findings for 4 weeks. The outcome data were evaluated at baseline and at the end of 4-week treatment.
Results: Linear regressions analysis revealed that the significant independent predictors that associated positively with baseline insulin (P=0.010) and negatively with baseline cortisol (P=0.020) levels were Brunnstrom upper and hand stages. Additionally, the significant independent predictor that associated positively with baseline insulin (P=0.041) was Brunnstrom lower stage.
Conclusion: Insulin and cortisol levels may be predictors in motor function recovery of stroke patients in rehabilitation process. Early detection and treatment of malnutrition both during hospitalization and follow-up might be important for the improvement of outcomes.
In-Vitro Activity of Nano Fluconazole and Conventional Flucon-azole against Clinically Important Dermatophytes
Authors: MUSAVI BAFRUI Najmossadat , HASHEMI HAZAVEH Seyed Jamal , BAYAT Mansour 
Published: November 2020

Background: Dermatophytosis is one of the most common fungal infections in humans. Antifungals such as fluconazole are effectively used for treating dermatophytosis; however, drug resistance was observed in many cases. Therefore, a newer treatment strategy is essential.
Methods: This study (Conducted in the Laboratory of the School of Public Health, Tehran University of Medical Sciences, Tehran, Iran in 2018) evaluated the antifungal susceptibility of nano fluconazole compared to conventional fluconazole on dermatophyte isolates using CLSI M38-A2guidelines. Dermatophyte species isolated from clinical cases of dermatophytosis were identified using PCR sequencing techniques. Zeta potential and size of the nano particles containing fluconazole were measured; scanning electron microscope (SEM) was used to determine nano particle structure.
Results: The size of liposomal fluconazole obtained was 88.9 12.14 nm with –20.12 3.8 mV for zeta potential. The encapsulation rate for fluconazole was 75.1 4.2%. MIC50 for the three tested species was 32, 16, and 8 μg/ml for Trichophyton interdigitale, T. rubrum, and Epidermophyton floccosum isolates, respectively. The corresponding values for nano fluconazole were 8 μg/ml for the three tested species.
Conclusion: MIC value for nano-fluconazole was lower than conventional fluconazole in all dermatophytes species tested; therefore, nano-fluconazole could inhibit the growth of dermatophytes better than fluconazole at a lower concentration of the drug.
A Salter-Harris II Distal Radius Fracture Irreducible by Closed Methods
Authors: Carlone Andrew , Kopiec Adam , Riley Scott , Prusick Vincent 
Published: November 2020

Case:
A 10-year-old boy presented with a Salter-Harris II distal radius fracture that was irreducible by closed methods. An open reduction was performed in the operating room where a sleeve of periosteum was found interposed between the fracture fragments. Successful reduction was performed without difficulty after the periosteum was removed from the fracture.

Conclusion:
Soft-tissue interposition must be kept in mind when having difficulty performing closed reductions of pediatric distal radius physeal fractures to avoid excessive reduction attempts.
A risk score based on pediatric Sequential Organ Failure Assessment predicts 90-day mortality in children with Klebsiella pneumoniae bloodstream infection
Authors: Li Shuang , Liu Jingxian , Chen Feng , Cai Kang , Tan Jintong , Xie Wei , Qian Rong , Liu Xiaoqin , Zhang Wenhong , Du Huimin , Liu Ying , Huang Lisu 
Published: November 2020

Abstract
Background: Klebsiella pneumoniae bloodstream infection (Kp-BSI) is a serious threat to pediatric patients. The objective of this study was to explore the risk factors, validate the prediction efficiency of pediatric Sequential Organ Failure Assessment (SOFA) and establish better early predictors of mortality in pediatric patients with Kp-BSI.Methods: All children diagnosed with Kp-BSI were included in this retrospective cohort study from January 2009 to June 2019. Basic characteristics, symptoms and physical examinations, treatments, laboratory statistics, and SOFA at the onset of Kp-BSI were recorded. The Cox proportional hazard model and receiver operating characteristic curves were used to assess the association between the variables and the 90-day mortality and their predictive value. DeLong’s test of receiver operating characteristic curves and integrated discrimination improvement index were used to determine the improvement in predictive capacity of the modified SOFA models. A predictive score was developed using multivariate logistic regression.Results: Of the 146 children enrolled, 33 (22.6%) patients died within 90 days. Hospitalization in the last six months, intra-abdominal source of infection, presence of organ failure, and altered levels of blood biomarkers, including C-reactive protein, albumin, and lactate were significant risk factors for 90-day mortality. The area under the curve (AUC) of SOFA for predicting 90-day mortality was 0.80 (95% CI 0.71–0.89). Moreover, we found that a prediction model combining SOFA with two other parameters, namely hospitalization in the last six months and intra-abdominal source of infection, was better at predicting mortality (AUC = 0.89, 95% CI 0.82–0.96; sensitivity = 0.86; specificity = 0.84). According to this novel risk model, we defined three statistically different groups: low-risk, medium-risk and high-risk groups, with an observed 90-day mortality of 5.4%, 35.7%, and 72.0%, respectively. With reference to the low-risk patients, the medium-risk and high-risk groups had a higher mortality, with hazard ratios of 8.36 (95% CI 3.60–27.83) and 20.27 (95% CI 7.47–54.95), respectively.Conclusions: The modified SOFA may be better than the original score to predict 90-day mortality in pediatric patients with Kp-BSI. Future prospective studies are required to validate this novel scoring system in external cohorts.
Estimating Remaining Carbon Budgets Using Emulators of CMIP6 Models
Authors: Rypdal Martin , Boers Niklas , Fredriksen Hege-Beate , Eiselt Kai-Uwe , Johansen Andreas , Martinsen Andreas , Mentzoni Endre Falck , Graversen Rune , Rypdal Kristoffer 
Published: November 2020

Abstract
A remaining carbon budget (RCB) estimates how much CO2 we can emit and still reach a specific temperature target. The RCB concept is attractive since it easily communicates to the public and policymakers, but RCBs are also subject to uncertainties. The expected warming levels for a given carbon budget has a wide uncertainty range, which we show here to increase with less ambitious targets, i.e., with higher CO2 emissions and temperatures. We demonstrate that the leading cause of the revealed RCB uncertainty is the spread in the equilibrium climate sensitivity (ECS) among climate models. In the Coupled Model Intercomparison Project Phase 6 (CMIP6) ensemble, the models with the lower ECS predict an RCB that is twice as high as that of models with the higher ECS, for temperature targets between 1.5-3.0°C.
Unify Language and Vision: An Efficient COVID-19 Tomography Image
Classification Approach
Authors: Shen Dezhou 
Published: November 2020

Abstract
An accurate and efficient image classification algorithm used in the COVID-19 detection for lung tomography can be of great help for doctors working in places without advance equipments. The machine with high accuracy COVID-19 classification model can relief the burden by making testing and checking thousands of people’s tomography images easy for a specific region which suffers from the COVID-19 outbreak incidents. By encoding image pixels and meta-data using the pre-trained language models of Bidirectional Encoder Representations from Transformers, then connect to a fully connected layer, the classification model outperforms the ResNet model and the DenseNet image classification model, and achieved accuracy of 99.51% ∼ 100.00% on the COVID-19 tomography image test set.
Machine learning magnetic resonance imaging radiomics predicts axillary lymph node metastasis in invasive breast cancer
Authors: Yu Yunfang , He Zifan , Ouyang Jie , Tan Yujie , Chen Yong-Jian , Gu Yang , Mao Luhui , Wang Jue , Ren Wei , Lin Lili , Wu Zhuo , Liu Jingwen , Li Anlin , Ou Qiyun , Hu Qiugen , Chen Kai , Li Chenchen , Lu Nian , Li Xiaohong , Su Fengxi Su , Liu Qiang , Xie Chuan-Miao , Yao Herui 
Published: November 2020

Abstract
In current clinical practice, the standard evaluation for axillary lymph node (ALN) status in breast cancer is based on the invasive procedure and many patients will suffer from operative associated complications. Hence, a novel signature incorporated tumor and lymph node magnetic resonance imaging (MRI) radiomics, clinical and pathological characteristics, and molecular subtypes based on the machine learning approach was established to accurately identify ALN metastasis in early-stage invasive breast cancer patients. Although the misjudgment of ALN status by clinicians according to preoperative MRI are common during clinical practice and even the senior radiologists make mistakes sometimes, this multiomic radiomic signature showed the superiority over clinicians and could precisely discriminate ALN metastasis among different molecular subtype patients. Furthermore, the association between MRI radiomic features and tumor-microenvironment features including immune cells, long non-coding RNAs, and types of methylated sites were found, which revealed the potential biological underpinning of MRI radiomics.
Electro-Mechanical Stresses on Bacillus Atrophaeus Bacterial Spore Germination Induced by Pulsed Electric Fields
Authors: Qiu Xing , WU Wen Jie 
Published: November 2020

Abstract
In this work, the electro-mechanical stresses induced by pulsed electric fields (PEF) on bacterial spore germination was modeled and empirically tested using Bacillus atrophaeus spores. Specifically, a new model, termed as Qiu-Wu’s electro-mechanical (QW’s EM) spore model, was derived to analyze the effect of electro-mechanical stresses on spores subjected under electric fields. A non-linear inverse relationship was found between electric fields and thickness change of spore coat. SEM, pH, hydrophobicity and electrochemical measurements were implemented for verification of the model. PEF-treated spores germinated with a faster rate and a higher degree of homogeneity. The longer the treatment time, the better the homogeneity. The speed of dipicolinic acid (DPA) release was around 20% faster in PEF-treated samples, while the peak intensity of terbium-DPA from PEF-treated samples was up to 80% lower. Theoretical analysis and empirical results were consistent to show that PEF introduces electro-mechanical stresses to expedite spore germination. The significance and impact of this study is obvious: bacterial spore is implicated in food spoilage and foodborne diseases primarily via the process of germination, and PEF technology has been introduced to inactivate microorganisms in food. Understanding the mechanism of germination under PEF can provide deep understanding for inactivation of foodborne pathogens and better food preservation methods.
SARS-CoV-2 induced CYP19A1 expression in the lung correlates with increased aromatization of testosterone-to-estradiol in male golden hamsters
Authors: Stanelle-Bertram Stephanie , Schaumburg Berfin , Kouassi Nancy Mounogou , Beck Sebastian , Zickler Martin , Beythien Georg , Becker Kathrin , Bai Tian , Jania Hanna , Müller Zacharias , Reis Vinicius Pinho dos , Krump-Buzumkic Vanessa , Kadek Alan , Uetrecht Charlotte , Schroeder Maria , Jarczak Dominik , Nierhaus Axel , Kluge Stefan , Scaturro Pietro , Baumgärtner Wolfgang , Klingel Karin , Guelsah Gabriel 
Published: November 2020

Abstract
SARS-CoV-2 infection is associated with increased morbidities in men compared to women. Androgens are believed to play an important role in SARS-CoV-2 pathogenesis in men due to the postulated androgen-dependency of ACE2 and TMPRSS2. However, it is yet unclear whether the sex bias is mediated by SARS-CoV-2 infection itself or by other confounding factors. Here, using the golden hamster model, we show that SARS-CoV-2 infection attacks reproductive organs, causes massive dysregulation of sex hormones and induces elevated transcription of the androgen-to-estrogen converting enzyme aromatase CYP19A1 in the lung. In male hamsters, SARS-CoV-2 infection causes severely depleted testosterone and highly elevated estradiol levels. In female hamsters, SARS-CoV-2 infection causes reduced estradiol levels. Hormonal dysregulation in infected animals is followed by severe weight loss compared to control groups treated with poly(I:C) or PBS. Lungs of SARS-CoV-2 infected animals present abundant CYP19A1 expression in the endothelium and in macrophages, particularly in males. Prominent CYP19A1 expression in endothelial cells and macrophages was verified in lung sections of deceased Covid-19 males compared to females. Our results demonstrate that SARS-CoV-2 infection leads to massive dysregulation of sex hormones, which may increase the risk for sex-specific disease outcome particularly in combination with comorbidities. These findings provide insights into the complex metabolic cross talk between SARS-CoV-2 infection and sex hormones.
Diagnosis and Treatment for Squamous Cell Carcinoma of the Oral Tongue in a Patient with Fanconi Anemia
Authors: Deng Siyao , Ye Wenjing , Zhang Shichuan , Zhang Peng , Song Yanqiong , Zhou Jie , Lang Jinyi , Lu Shun 
Published: November 2020

Abstract
BackgroundFanconi anemia (FA) is a rare genetic disorder characterized by congenital anomalies, progressive bone marrow failure and high susceptibility to various solid tumors, especially head and neck squamous cell carcinoma (HNSCC). Management of FA patients with head and neck cancer is a challenge due to increased risk of surgery, poor tolerance of chemotherapy, and severe myelotoxicity of radiotherapy.MethodsWe present a case of a 33-year-old man with carcinoma of the oral tongue (T1N2M0), who experienced prolonged and profound bone marrow failure as a consequence of concurrent cisplatin/radiation. The young patient who developed HNSCC without risk factors, the myelotoxicity after exposure to the platinum-based agent cisplatin and the further evaluation of phenotypic characteristics raised suspicion of FA. Whole exome sequencing performed for the patient and parents ultimately established the diagnosis of FA.ResultsGenetic testing in the 23 FANC genes revealed two novel heterozygous mutations, c.367C>T (p.Gln123*) and c.3971_3972delCGinsTT (p.Pro13241.cu) in FANCA gene of the patient, which were inherited from his father and mother, respectively. Radiotherapy with reduced dose has successfully alleviated the symptoms of tumor invasion and progression, and the radiation-related side effects were acceptable. Unfortunately, the patient died of locoregional disease progression.ConclusionsThis case highlights the importance of considering the diagnosis of FA in young patients who develop HNSCC in the absence of risk factors, thus permitting more effective oncological treatment strategies and improved outcomes. In general, any decision on different modalities of management in such patients should be based on a balance between locoregional control and therapeutic toxicity.
ERK-Mediated Phosphorylation of EZH2 Regulates HER2 Expression on Long-term Genistein-induced Acquired Endocrine Resistance in Estrogen-Receptor-Positive Breast Cancer Cells
Authors: Hu Chunyan , Zhou Qian , Yang Bingmo , Xiao Wei , Jiao Kailin , Yang Keke , Zhou Ming , Li Zhong 
Published: November 2020

Abstract
BackgroundGenistein, a soy isoflavones, is the most important phytoestrogens in typical oriental diet. Many studies have shown that genistein at lower concentrations promotes breast cancer cells growth through the estrogen receptor pathway. However, recent research has found that long-term consumption of low doses of genistein results in hormone-independent growth phenotypes of MCF-7 tumors, with increased expression of HER2. Overexpression of HER2 has been causally associated with endocrine therapy resistance in human breast cancer. The mechanism by which prolonged exposure to genistein leads to increased HER2 expression is unclear. Whether genistein-induced HER2 expression is the cause of endocrine resistance remains to be determined. MethodsWe selected the MCF-7 and T47D breast cancer cells model with higher ERα and lower HER2. It was investigated whether prolonged exposure to genistein induced TAM-sensitive breast cancer cells to TAM-refractory cells by increasing HER2 expression. Furthermore, it was explored whether HER2 expression and endocrine resistance were associated with EZH2. ResultsWe found that genistein had estrogen-like effect and inhibited HER2 expression during short-term exposure. However, long-term exposure to genistein induced acquire endocrine resistance, because of increased expression of HER2. During long-term exposure to genistein, the continuous activation of ERK1/2 phosphorylated EZH2 at Ser21, resulting in a decrease of lysine 27 trimethylation. As H3K27me3 level decreased, the expression of IL-6 and IL-8 increased, and HER2 level gradually increased, forming a feedback loop of ERK1/2 / EZH2/ IL-6 and IL-8 / HER2. ConclusionsThese findings indicated that high HER2 expression caused by EZH2 phosphorylation was an important mechanism of endocrine resistance. The study also provided a new insight for genistein-induced acquired endocrine resistance. For breast cancer patients, long-term use of soy supplements has potential health risk. Especially, monitoring dietary exposure to genistein is advisable when treated with tamoxifen.
Effect of Fe2O3 and CeO2 on Transmittance of Y2O3 Stabilized Tetragonal Zirconia Polycrystals
Authors: Chen Jianfeng , Xue Chundong , Liu Zhaocen , Liang Zhuoran , Wang Bo , Zhao Lisheng , Dang Ruijie , Wen Ning , Dai Guanghai 
Published: November 2020

Abstract
The present study is to investigate the effect of metal oxides Fe2O3 and CeO2 on the structural and optical characteristics of Y2O3 stabilized tetragonal zirconia ceramic (Y-TZP). Different concentrations of Fe2O3 and CeO2 are added into Y-TZP to fabricate the colored Y-TZP. The chromaticity and transmittance were measured by spectrophotometer. The effect of each colorant on color and transmittance of Y-TZP is quantitatively studied. Most of the previous related studies used indirect methods for measurement, but in order to get more accurate results, we chose the direct measurement method. It is found that the addition of Fe2O3 and CeO2 not only changes the color of Y-TZP, but also reduces the light transmittance. The SEM characterization and XRD analysis are then performed to check the microstructure and crystal structure respectively, by which we try to understand the microscopic principle. Our findings can improve the understanding of coloration of Y-TZP by mental oxides, and support a quantitative assessment approach for aesthetic performance of dental restoration material.