bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rapid Ventilator Splitting During COVID-19 Pandemic Using 3D Printed Devices and Numerical Modeling of 200 Million Patient Specific Air Flow Scenarios
Authors: Bishawi Muath , Kaplan Michael , Chidyagwai Simbarashe , Cappiello Jhaymie , Cherry Anne , MacLeod David , Gall Ken , Evans Nathan , Kim Michael , Shaha Rajib , Whittle John , Hollidge Melanie , Truskey George , Randles Amanda 
Published: August 2020

Abstract
There has been a pressing need for an expansion of the ventilator capacity in response to the recent COVID19 pandemic. To address this need, we present a system to enable rapid and efficacious splitting between two or more patients with varying lung compliances and tidal volume requirements. Reserved for dire situations, ventilator splitting is complex, and has been limited to patients with similar pulmonary compliances and tidal volume requirements. Here, we report a 3D printed ventilator splitter and resistor system (VSRS) that uses interchangeable airflow resistors to deliver optimal tidal volumes to patients with differing respiratory physiologies, thereby expanding the applicability of ventilator splitting to a larger patient pool. We demonstrate the capability of the VSRS using benchtop test lungs and standard-of-care ventilators, which produced data used to validate a complementary, patient-specific airflow computational model. The computational model allows clinicians to rapidly select optimal resistor sizes and predict delivered pressures and tidal volumes on-demand from different patient characteristics and ventilator settings. Due to the inherent need for rapid deployment, all simulations for the wide range of clinically-relevant patient characteristics and ventilator settings were pre-computed and compiled into an easy to use mobile app. As a result, over 200 million individual computational simulations were performed to maximize the number of scenarios for which the VSRS can provide assistance. The VSRS will help address the pressing need for increased ventilator capacity by allowing ventilator splitting to be used with patients with differing pulmonary physiologies and respiratory requirements, which will be particularly useful for developing countries and rural communities with a limited ventilator supply.
Ex Vivo Porcine Model Study on the Treatment Outcomes of Scissor-type Knife Versus Needle-type Knife in Endoscopic Submucosal Dissection Performed by Trainees
Authors: Ichijima Ryoji , Esaki Mitsuru , Yamakawa Shun , Minoda Yosuke , Suzuki Sho , Kusano Chika , Ikehara Hisatomo , Gotoda Takuji 
Published: August 2020

Abstract
BackgroundTrainee endoscopists find endoscopic submucosal dissection (ESD) for gastrointestinal neoplasms difficult to perform independently; furthermore, there is no consensus on which endo-knife type is the most suitable for them. Therefore, we conducted a prospective study comparing the treatment outcomes of scissor-type and needle-type knives in ESD performed by trainees in an ex vivo porcine model.MethodsAround 22 trainees from 13 institutions, divided into two groups according to their endoscopic experience, performed ESD in a porcine model. Each trainee performed two ESDs under expert supervision: one with a scissor-type knife (ESD-S) and the other with a needle-type knife (ESD-N). The efficacy and safety, including the procedure time and rates of self-completion, en bloc resection, and complications, were compared between ESD-S and ESD-N. ResultsEight trainees had an experience of over 1,000 endoscopies (senior trainee: S-Trainee), whereas the remaining had an experience of less than 1,000 endoscopies (junior trainee: J-Trainee). Among the S-Trainees, no significant differences were observed in any treatment outcome between ESD-S and ESD-N. Among the J-Trainees, the total procedure and mucosal incision times were significantly shorter in ESD-S than in ESD-N [total procedure time: 16.5 min (range: 10.0–31.0) vs. 22.3 min (range: 10.0–38.0), P = 0.018; circumferential incision time: 10.0 min (range: 6-16) vs. 17.0 min (range: 5.0–31.5); P = 0.019]. Regarding complications, muscular injury occurred in two patients during ESD-N performed by J-Trainees; however, no muscular injury occurred during ESD-S.ConclusionsS-Trainees could perform ESD safely in an ex vivo porcine model under expert supervision, regardless of the endo-knife type used. However, the scissor-type knife is desirable if J-Trainees were to perform the ESD procedure.
ZBTB7A functioned as an oncogene in colorectal cancer
Authors: Wang Li , Zhang Meng-Xia , Zhang Mei-Fang , Tu Zi-Wei 
Published: August 2020

Abstract
Background
Despite zinc finger and BTB domain-containing 7A (ZBTB7A) documented importance in multiple tumors, the function and clinical value in Colorectal cancer (CRC) remain elusive. The aim of this study was to evaluate the functional roles and the clinical value of ZBTB7A in CRC progression.
Methods
The level of ZBTB7A was detected in a large cohort of CRC patients (n = 189) by immunohistochemistry (IHC), and we analyzed the diagnostic and prognostic value of the protein. In addition, the functional roles of ZBTB7A on CRC were explored in vitro and in vivo.
Results
Survival analyses indicated that patients with high ZBTB7A expression made the prognosis worse (P = 0.024). Functionally, knockdown of ZBTB7A could markedly inhibit tumor proliferation in vitro and in vivo, whereas ZBTB7A overexpression displayed the opposite results.
Conclusions
ZBTB7A was associated with poor survival outcomes and functioned as an oncogene in CRC patients, indicating that it is a potential prognostic biomarker and therapeutic target for CRC patients.
Cost-effectiveness of Lung Cancer Screening in Urban Chinese Populations
Authors: Sun Chengyao , Zhang Xin , Guo Sirou , Liu Yang , Zhou Liangru , Shi Ju-Fang , Wu Ning , Zhai Zhao , Liu Guoxiang 
Published: August 2020

Abstract
Background: Lung cancer is the leading cause of cancer-related death. Currently, lung cancer screening trials have demonstrated that low-dose computed tomography (LDCT) screening can reduce lung cancer specific and overall mortality. The effectiveness of LDCT has been proven, but its economical efficiency should also be assessed. The purpose of the study is to analyze the cost-effectiveness of annual LDCT screening of high-risk populations in Chinese urban areas.Method: We use Markov model to evaluate LDCT screening from sociological perspective. The sample size is 100,000 smokers who will undergo annual LDCT screening until 76. The study contains 5 screening strategies, the initial screening ages for the five screening strategies and their corresponding unscreened strategies are 40, 45, 50, 55, and 60 years, respectively. Parameters come from the China Lung Cancer Screening Project, cancer registry data, etc. The Incremental Cost-effectiveness Ratio (ICER) between screening and non-screening strategies at the same initial age is evaluated.Result: In base-case scenario, compared with those who are not screened, specific mortality of lung cancer decreased by 18.52%-23.13% of 5 screening strategies. The ICER of LDCT screening is from 13056.82USD to 15736.06USD per quality-adjusted life year (QALY), which is greater than one time and less than three times GDP per capita in China. Initial screening age of 55 is the most cost-effective strategy.Conclusion: Baseline analysis shows that annual LDCT screening in heavy smokers in Chinese urban areas is likely to be cost-effectiveness. Sensitivity analysis shows that sensitivity, specificity and over-diagnosis rate have an impact on cost-effectiveness of LDCT screening, but the results are relatively robust，unless the sensitivity, specificity of LDCT screening and over-diagnosis rate take the worst value at the same time. Therefore, the cost-effectiveness of screening strategy depends on the performance of LDCT screening.
VCP functions to maintain nuclear size by managing DNA damage-induced MDC1–p53–autophagy axis
Authors: Chang Ya-Chu , Peng Yu-Xiang , Shih Chao-Jie , Chang Henry , Sang Tzu-Kang 
Published: August 2020

Abstract
Anomalies in nuclear morphology have been linked to aging-related diseases and malignant transformation, although the mechanism responsible for this connection remains unclear. By expressing dominant-negative TER94 (TER94K2A) mutants in Drosophila photoreceptors, we show disruption of VCP (valosin-containing protein, TER94 ortholog in human), an AAA (ATPase associated with various cellular activities) ATPase essential for ubiquitin-dependent segregation or degradation of proteins, causes an age-dependent nuclear size increase. Loss of VCP function leads to accumulations of MDC1 (mediator of DNA damage checkpoint protein 1), a key DNA damage response gene, and increased γH2AV (an indicator of DNA damage), linking excessive DNA damages and associated responses to this enlarged nuclei defect. Indeed, MDC1-overexpression, similar to TER94K2A, increases γH2AV staining and nuclear size. Moreover, TER94 negatively influences MDC1 level and could interact with MDC1, suggesting that MDC1 is a VCP substrate. MDC1 accumulation increases p53 stability, and this VCP-MDC1-p53 connection is functional, as removal of p53 function suppresses the ability of TER94K2A and MDC1 overexpression to increase nuclear size. While p53 is capable of generating multiple isoforms, our genetic evidence suggests that the p53A isoform specifically contributes to this TER94K2A-associated nuclear size increase. Combining our results with a previous report that p53A expression disrupts autophagic flux, we propose that the failure of removing MDC1 in TER94K2A-expressing cells stabilizes p53A, which blocks autophagy and likely hinders the removal of nuclear content, resulting in aberrant nuclear size increase.
Transformer-Based Deep Neural Network Language Models for Alzheimer's Disease Detection from Targeted Speech
Authors: Roshanzamir Alireza , Aghajan Hamid , Baghshah Mahdieh Soleymani 
Published: August 2020

Abstract
Background: We developed transformer-based deep learning models based on natural language processing for early diagnosis of Alzheimer’s disease from the picture description test.Methods: The lack of large datasets poses the most important limitation for using complex models that do not require feature engineering. Transformer-based pre-trained deep language models have recently made a large leap in NLP research and application. These models are pre-trained on available large datasets to understand natural language texts appropriately, and are shown to subsequently perform well on classiﬁcation tasks with small training sets. The overall classiﬁcation model is a simple classiﬁer on top of the pre-trained deep language model.Results: The models are evaluated on picture description test transcripts of the Pitt corpus, which contains data of 170 AD patients with 257 interviews and 99 healthy controls with 243 interviews. The large bidirectional encoder representations from transformers (BERTLarge) embedding with logistic regression classiﬁer achieves classiﬁcation accuracy of 88.08%, which improves the state-of-the-art by 2.48%.Conclusions: Using pre-trained language models can improve AD prediction. This not only solves the problem of lack of suﬃciently large datasets, but also reduces the need for expert-deﬁned features.
Predicting Tumor Response to Drugs Based on Gene-expression Biomarkers of Sensitivity Learned From Cancer Cell Lines
Authors: Li YuanYuan , Umbach David M. , Krahn Juno M. , Shats Igor , Li Xiaoling , Li Leping 
Published: August 2020

Abstract
Background: human cancer cell line profiling and drug sensitivity studies provide valuable information about the therapeutic potential of drugs and their possible mechanisms of action. The goal of those studies is to translate the findings from in vitro studies of cancer cell lines into in vivo therapeutic relevance and, eventually, patients’ care. Tremendous progress has been made. Results: in this work, we built predictive models for 453 drugs using data on gene expression and drug sensitivity (IC50) from cancer cell lines. We identified many known drug-gene interactions and uncovered several potentially novel drug-gene associations. Importantly, we further applied these predictive models to ~17,000 bulk RNA-seq samples from The Cancer Genome Atlas (TCGA) and the Genotype-Tissue Expression (GTEx) database to predict drug sensitivity for both normal and tumor tissues. We created a web site for users to visualize and download our predicted data (https://edelgene.niehs.nih.gov/cancerRxTissue). Using trametinib as an example, we showed that our approach can faithfully recapitulate the known tumor specificity of the drug. Conclusions: we demonstrated that our approach can predict drugs that 1) are tumor-type specific; 2) elicit higher sensitivity from tumor compared to corresponding normal tissue; 3) elicit differential sensitivity across breast cancer subtypes. If validated, our predictions could have clinical relevance for patients’ care.
Precision-Cut Bovine Udder Slices (PCBUS) as an in-vitro-model of an early phase of infection of bovine mastitis
Authors: Filor Viviane , Petry Monique , Meißner Jessica , Kietzmann Manfred 
Published: August 2020

Abstract
Background
The aim of this study was the establishment of precision-cut bovine udder slices (PCBUS) as an in-vitro-model to investigate pathophysiological processes in the early phase of mastitis in order to have the possibility to investigate new therapeutic approaches for the treatment of such udder inflammation in later studies. Furthermore, this model should contribute to substitute in-vivo-experiments. Bovine mastitis is one of the most common and costly infectious diseases in the dairy industry, which is largely associated with the use of antimicrobial agents. Given this problem of antimicrobial resistance, it is essential to step up research into bacterial infectious diseases. Thus, the transfer of the in-vitro-model of precision-cut tissue slices to the bovine udder enables broad research into new therapeutic approaches in this area and can also be used to address issues in basic research or the characterization of complex pathophysiological processes.
Results
A stimulation with LPS, PGN or the combination of both substances (LPS:PGN) demonstrated the ability of the PCBUS to react with a significant secretion of IL-1ß, TNF-α and PGE2.
Conclusion
The slices represent an instrument for investigating pharmacological interactions with udder tissue, which can be useful for studies on pharmacological questions and the understanding of complex pathophysiological processes of infection and inflammation.
Psychometric validation of the Laval Developmental Benchmarks Scale for Family Medicine
Authors: Renaud Jean-Sebastien , Lacasse Miriam , Côté Luc , Théorêt Johanne , Rheault Christian , Simard Caroline 
Published: August 2020

Abstract
Background
With the implementation of competency-based education in family medicine, there is a need for summative end-of-rotation assessments that are criterion-referenced rather than normative. Laval University’s family residency program therefore developed the Laval Developmental Benchmarks Scale for Family Medicine (DBS-FM), based on competency milestones. This psychometric validation study investigates its internal structure and its relation to another variable, two sources of validity evidence.
Methods
We used the assessment data from a cohort of residents (n = 1 432 assessments) and the Rasch Rating Scale Model to investigate its reliability, dimensionality, rating scale functioning, targeting of items to residents’ competency levels, biases (differential item functioning), items hierarchy (adequacy of milestones ordering), and score responsiveness. Convergent validity was estimated by its correlation with the clinical rotation decision (pass, in difficulty/fail).
Results
The DBS-FM can be considered as a unidimensional scale with good reliability for non-extreme scores (.83). The correlation between expected and empirical items hierarchies was of .78, p < .0001.Year 2 residents achieved higher scores than year 1 residents. It was associated with the clinical rotation decision.
Conclusion
Advancing its validation, this study found that the DBS-FM has a sound internal structure and demonstrates convergent validity.
Analysis of the Impact of Cervical Excision Procedure on Delivery Mode
Authors: YUAN Min , WU Jian-hong , ZHANG Chun-liu , YANG Fan , WEI Zhi-yao , Dai Yin-mei 
Published: August 2020

Abstract
Background: Many young women with a history of prior cervical excision procedure have reproductive intention. However, the relationship between having a prior cervical excision procedure and delivery mode has not drawn enough attention from physicians. The aim of this study was to observe the delivery mode of women with a prior cervical excision procedure, and analyze the relationship between having a prior cervical excision procedure and delivery mode.Methods: In this retrospective cohort study of nulliparous women with a singleton pregnancy who have given birth at Beijing Obstetrics and Gynecology Hospital, Capital Medical University between May 2016 and April 2018, delivery mode of women with a history of prior cervical excision procedure were compared with those without such a history. Bivariable analysis were performed to identify whether there was a correlation between having a prior cervical excision procedure and delivery mode, and logistic regression were used modeling on cervical excision procedure for delivery mode outcome.Results: (1) The proportion of premature rupture of fetal membrane (38.3% vs 27.0%, p=0.034) , forceps delivery (12.2% vs 5.9%, p=0.043), and Caesarean sections delivery (33.9% vs. 30.2%,p=0.484 ) were higher among women with a prior cervical excision procedure. (2) The main indication for forceps delivery was to shorten the second stage of labor among women with a prior cervical excision procedure, significantly higher (50% vs 7.7%, p=0.033) among women without such a history. There were no differences in indications for Caesarean sections delivery in two groups (p>0.05). (3) The time interval between cervical excision procedure and pregnancy was not associated with delivery mode (p=0.445). (4) By setting spontaneous labor as control, forceps delivery was associated with cervical excision procedure (OR=0.403, 95%CI=0.179-0.906, p=0.028).Conclusions: Our findings revealed a relationship between having a prior cervical excision procedure and delivery mode. Women with a prior cervical excision procedure were at an increased risk of forceps delivery. The time interval between cervical excision procedure and pregnancy did not affect delivery mode.
Increase of non-HBV, non-HCV related hepatocellular carcinoma - Over 20 years single institution study-
Authors: Nagaoki Yuko , Hyogo Hideyuki , Ando Yuwa , Kosaka Yumi , Uchikawa Shinsuke , Nishida Yuno , Teraoka Yuji , Morio Kei , Fujino Hatsue , Ono Atsushi , Nakahara Takashi , Murakami Eisuke , Yamauchi Masami , Okamoto Wataru , Kawaoka Tomokazu , Tsuge Masataka , Hiramatsu Akira , Miki Daiki , Imamura Michio , Takahashi Shoichi , Chayama Kazuaki , Aikata Hiroshi 
Published: August 2020

Abstract
Background
We previously reported the trends of etiologies of hepatocellular carcinoma (HCC) between 1995 and 2009. By updating this study, we aimed to evaluate the incidence of HCC with non- hepatitis B viral and non- hepatitis C viral (NBNC) etiologies and also explore the clinical characteristics.
Methods
Consecutive 2171 HCC patients at our institution were enrolled between 1992 and 2018 in this retrospective cohort study. A comparative study was conducted by dividing into two groups, an early group from 1992 to 2009 and a late group from 2010 to 2018.
Results
NBNC-HCC account for 514 patients (23.6%). The proportion of NBNC-HCC has continued to increase from 26.5% in 2009 to 46.3% in 2018. NBNC-HCC were getting older (median ages, 67 to 73 years). Type 2 diabetes mellitus (48.5–60.3%: P = 0.008), hypertension (48.5–57.4%: P = 0.047), and hyperlipidemia (39.2–53.8%: P = 0.001) has increased significantly in recent years. The median FIB-4 index have decreased (4.37 to 3.61: P = 0.026) and the median platelet counts have increased (15.1 to 17.9: P = 0.013) significantly. Among 514 NBNC-HCC, 194 patients underwent hepatic resection in which 14.9%, 29.3%, and 55.8% were based on nonalcoholic steatohepatitis (NASH), alcoholic liver disease (ALD), and cryptogenic, respectively. Cirrhosis was detected in 72.4%, 38.6%, and 15.5% of NASH, ALD and cryptogenic, respectively. The prevalence of cirrhosis in NASH were significantly higher than other groups (P < 0.001), overall, 70% of the background liver of NBNC-HCC was not cirrhosis. On the other hands, the median FIB-4 index in cryptogenic HCC were 2.56 and significantly lower than other groups, FIB-4 index considered as one of useful screening of HCC.
Conclusions
NBNC-HCC has rapidly been increasing in recent years even in regional university hospital. The presence of metabolic syndrome may be important risk factors. Also, HCC from non-cirrhotic liver needs attention. Accordingly, it is speculated that these patients should receive periodic surveillance for HCC development.
Description of a Palliative Approach to Care to Patients in the Last Year of Life in a Primary Care Setting
Authors: Gallagher Erin , Carter-Ramirez Daniel , Boese Kaitlyn , Winemaker Samantha , MacLennan Amanda , Hansen Nicolle , Hafid Abe , Howard Michelle 
Published: August 2020

Abstract
Background: Most patients nearing the end of life can benefit from a palliative approach in primary care. We currently do not know how to measure a palliative approach in family practice. The objective of this study was to describe the provision of a palliative approach and evaluate their clinicians’ perceptions of the results.Methods: We conducted a descriptive study of deceased patients in an interprofessional team family practice. We integrated conceptual models of a palliative approach to create a chart review tool to capture a palliative approach in the last year of life and assessed a global rating of whether a palliative approach was provided. Clinicians completed a questionnaire before learning the results and after, on perceptions of how often they believed a palliative approach was provided by the team.Results: Among 79 patients (mean age at death 73 years, 54% female) cancer and cardiac diseases were the top conditions responsible for death. One-quarter of patients were assessed as having received a palliative approach. 53% of decedents had a documented discussion about goals of care, 41% had nurse involvement, and 15.2% had a discussion about caregiver well-being. These indicators had the greatest discrimination between a palliative approach or not. Agreement that elements of a palliative approach were provided decreased significantly on the clinician questionnaire from before to after viewing the results. Conclusions: This study identified measurable indicators of a palliative approach in family practice, that can be used as the basis for quality improvement.