bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of marital status on overall survival in adult patients with chordoma: A SEER-based study
Authors: Tang Chao , Wang Ruiliang , Lu Qingguo , Wang Shantao , Jia Gen , Cao Pengfei , Nie Xinfa , Zhang Hailong 
Published: April 2020

Abstract
Background. As a rare primary bone tumour, no studies have reported the relationship between prognosis and marital status in patients with chordoma.Methods. We classified patients with chordoma identified from the Surveillance, Epidemiology, and End Results (SEER) database from 1975 to 2016 into four groups: married, divorced/separated, widowed and single groups. Kaplan-Meier curves with log-rank test and Cox regression were used to analyse the effect of marital status on overall survival (OS).Results. A total of 1,080 patients were included in the study: 700 (64.8%) were married, 88 (8.1%) were divorced/separated, 78 (7.2%) were widowed, and 214 (19.8%) were single. Among the four groups, the 5-year OS (45.2%), 10-year OS (12.5%) and median OS (56.0 months) were the lowest in the widowed group. After including age, sex, primary site, marital status, disease stage, tumor size, histological type, and treatment pattern, multivariate analysis showed that marital status was still an independent risk factor for patients with chordoma, and widowed patients had the lowest OS (hazard ratio [HR]: 1.71; 95% confidence interval [CI]: 1.25–2.33, p<0.001) compared with married patients. Similar results were observed after stratifying the primary site and disease stage.Conclusion. Marital status was an independent prognostic indicator for adult patients with chordoma, and marital status was conducive to patient survival. Compared with married patients, widowed patients have a higher risk of death.
A Novel COMP Mutation in a Chinese Family with Multiple Epiphyseal Dysplasia
Authors: Shao Jiashen , Zhao Sen , Yan Zihui , Wang Lianlei , Zhang Yuanqiang , Lin Mao , Yu Chenxi , Wang Shengru , Niu Yuchen , Li Xiaoxin , Qiu Guixing , Zhang Jianguo , Wu Zhihong , Wu Nan 
Published: April 2020

Abstract
Background: Multiple epiphyseal dysplasia (MED) is a skeletal disorder characterized by delayed and irregular ossification of the epiphyses and early-onset osteoarthritis. At least 66% of the reported autosomal dominant MED (AD-MED) cases are caused by COMP mutations. Methods: We recruited a four-generation Chinese family with early-onset hip osteoarthritis, flatfoot, brachydactyly, and mild short stature. The assessment of family history, detailed physical examinations, and radiographic evaluations were performed on the proband and other family members, followed by the performance of whole-exome sequencing (WES). The pathogenicity of the candidate mutation was also analyzed. Results: We recruited an AD-MED family with 10 affected members and 17 unaffected members. The main radiographic findings were symmetrical changes in the dysplastic acetabulum and femoral heads, irregular contours of the epiphyses, a shortened femoral neck, and flatfoot. Lower bone density was also observed in the ankle joints, wrist joints, and knees, as well as irregular vertebral end plates. In the proband, we identified the missense mutation c.1153G>T (p. Asp385Tyr), located in exon 11 of the COMP gene. This mutation was assessed as “pathogenic” because of its low allele frequency and its high likelihood of co-segregation with disease in the reported family. Sanger sequencing identified the novel heterozygous mutation c.1153G>T (p. Asp385Tyr) in exon 11 of COMP in all affected individuals in the family. Conclusions: Our result underlined a key role of the Asp385 amino acid in the protein function of COMP, and confirmed the pathogenicity of the COMP (c.1153G>T; p. Asp385Tyr) mutation in AD-MED disease. We have therefore expanded the known mutational spectrum of COMP and revealed new phenotypic information for AD-MED.
Feasibility of Multi-Parametric Magnetic Resonance Imaging Combined with Machine Learning in the Assessment of Necrosis of Osteosarcoma after Neoadjuvant Chemotherapy: A Preliminary Study
Authors: Huang Bingsheng , Wang Jifei , Sun Meili , Chen Xin , Xu Danyang , Li Zi-Ping , Ma Jinting , Feng Shi-Ting , Gao Zhenhua 
Published: April 2020

Abstract
Background Response evaluation of neoadjuvant chemotherapy (NACT) in patients with osteosarcoma is significant for the termination of ineffective treatment, the development of postoperative chemotherapy regimens, and the prediction of prognosis. However, histological response and tumour necrosis rate can currently be evaluated only in resected specimens after NACT. A preoperatively accurate, noninvasive, and reproducible method of response assessment to NACT is required. In this study, the value of multi-parametric magnetic resonance imaging (MRI) combined with machine learning for assessment of tumour necrosis after NACT for osteosarcoma was investigated.Methods Twelve patients with primary osteosarcoma of limbs underwent NACT and received MRI examination before surgery. Postoperative tumour specimens were made corresponding to the transverse image of MRI. One hundred and two tissue samples were obtained and pathologically divided into tumour survival areas (non-cartilaginous and cartilaginous tumour viable areas) and tumour-nonviable areas (non-cartilaginous tumour necrosis areas, post-necrotic tumour collagen areas, and tumour necrotic cystic/haemorrhagic and secondary aneurismal bone cyst areas). The MRI parameters, including standardised apparent diffusion coefficient (ADC) values, signal intensity values of T2-weighted imaging (T2WI) and subtract-enhanced T1-weighted imaging (ST1WI) were used to train machine learning models based on the random forest algorithm. Three classification tasks of distinguishing tumour survival, non-cartilaginous tumour survival, and cartilaginous tumour survival from tumour nonviable were evaluated by five-fold cross-validation.Results For distinguishing non-cartilaginous tumour survival from tumour nonviable, the classifier constructed with ADC achieved an AUC of 0.93, while the classifier with multi-parametric MRI improved to 0.97 (P=0.0933). For distinguishing tumour survival from tumour nonviable, the classifier with ADC achieved an AUC of 0.83, while the classifier with multi-parametric MRI improved to 0.90 (P<0.05). For distinguishing cartilaginous tumour survival from tumour nonviable, the classifier with ADC achieved an AUC of 0.61, while the classifier with multi-parametric MRI parameters improved to 0.81(P<0.05).ConclusionsThe combination of multi-parametric MRI and machine learning significantly improved the discriminating ability of viable cartilaginous tumour components. Our study suggests that this method may provide an objective and accurate basis for NACT response evaluation in osteosarcoma.
CT Differential Diagnosis of COVID-19 and Non-COVID-19 in Symptomatic Suspects: A Practical Scoring Method
Authors: Luo Lin , Luo Zhendong , Jia Yizhen , Zhou Cuiping , He Jianlong , Lyu Jianxun , Shen Xinping 
Published: April 2020

Abstract
BackgroundAlthough typical and atypical CT image findings are reported in current studys, overlapping CT image features with viral pneumonia and other respiratory diseases also make difficulties on exclusion diagnosis. To explore a CT practical scoring system to differentia suspected COVID-19 in general hospital.MethodsThirty confirmed cases of COVID-19 and fourty-three cases of other etiology or clinical confirmed non-COVID-19 in a general hospital were included. The clinical data including age, sex, exposure history and laboratory parameters of all patients were collected. Seven positive signs (posterior part/ lower lobe predilection, bilateral involvement, rounded GGO, subpleural bandlike GGO, crazy-paving pattern, peripheral distribution, GGO +/- consolidation) from significant COVID-19 CT image features and four negative signs (only one lobe involvement, only central distribution, tree-in-bud sign, bronchial wall thickening) from other pneumonia significant image features were set. Scoring analysis of CT features were compared between the two groups (COVID-19 and non-COVID-19).ResultsOlder age, symptoms of diarrhea, exposure history of Wuhan, lower level of white blood cell and lymphocyte count were significantly suggestive of COVID-19 rather than Non- COVID-19 (p<0.05). The receiver operating characteristic (ROC) curve of combined CT image features analysis revealed area under the curves (AUC) of the scoring system was 0.854. These cut-off values yielded a sensitivity of 56.67% and a specificity of 95.35% for Score>4, a sensitivity of 100% and a specificity of 23.26% for Score>0, and a sensitivity of 86.67% and a specificity of 67.44% for score>2.ConclusionsWith a simple and practical scoring system based on the CT image features, we can make a hierarchical diagnosis on COVID-19 and non-COVID-19 with different management suggestion.
Coronavirus (COVID-19) in Italy: knowledge, management of patients and clinical experience of Italian dentists during the spread of contagion
Authors: Putrino Alessandra , Raso Mario , Magazzino Cosimo , Galluccio Gabriella 
Published: April 2020

Abstract
Background: The coronavirus infection that emerged in China in the last few months of 2019 has now spread globally. Italy registered its first case in the second half of February, and in a short time period, it became the top country in Europe in terms of the number of infected people and the first in the world in terms of deaths. The medical and scientific community has been called upon to manage the emergency and to take measures. Dentists also need to take new precautions during their clinical activity to protect themselves, coworkers and patients from the risks of contagion and to avoid further spread of infection. Methods: Following the data published in the international literature as well as the guidelines and directives constantly updated by the WHO and by the national health authorities, a questionnaire to be completed anonymously was submitted online to Italian dentists using social tools and online professional platforms. The collected data were processed statistically, providing descriptive data and analysis of correlations of the most significant parameters using the Pearson’s χ2, the Likelihood-Ratio χ2, Cramér’s V, Fisher’s exact test, Goodman and Kruskal’s γ, and Kendall’s τb (p<0.05). Results: A total of 535 dentists from Italy participated in the survey. A good level of scientific knowledge about coronavirus and the extra precautionary measures needed to limit the spread was related to the age of respondents and their sex. Coming from areas with higher concentrations of cases affected knowledge, level of attention and perception of risk related to dental activity. Conclusions: At the moment, there are no therapies or vaccines to contain the infection with the new coronavirus that is causing many infections, many of which are fatal, worldwide. Dentists are one of the categories at highest risk of encountering diseases and infections because they work in close proximity with patients, and in their procedures, there is always contact with aerosols with high bacterial and viral potential. Therefore, during this COVID-19 emergency, it is important that dentists are properly informed and take the appropriate precautionary measures.
Effectiveness of a Psycho-Education Intervention by Midwives (BILIEF protocol) on childbirth fear and childbirth self-efficacy in fearful first time pregnant women: a randomized controlled trial
Authors: Firouzan Laya , Kharaghani Roghieh , Zenoozian Saeedeh , Moloodi Reza , Jafari Elham 
Published: April 2020

Abstract
Background

The present study investigated the effectiveness of a Psycho-Education Intervention by Midwives (BILIEF protocol) in decreasing childbirth fear and childbirth self-efficacy among fearful first pregnant women in Iran.

Methods

From among 171 pregnant women screened to participate in the study, 80 women who got score ≥ 66 on the Wijma Delivery Expectancy/Experience Questionnaire were recruited. They were randomly assigned into two groups: intervention (n = 40) and control group (n = 40). The intervention group received two face-to-face counseling sessions in the 24th week and 34th week of pregnancy. Between this two counseling sessions, intervention group had 8 weekly telephone counseling sessions. The control group only received the prenatal routine care. The outcome measures were childbirth fear, childbirth self-efficacy, and childbirth preference.

Results

At the post-test, the intervention group showed significantly higher reduction in childbirth fear and higher increase in childbirth self-efficacy compared to the control group. Also, at posttest more women in the intervention group reported that they preferred to give birth via normal vaginal birth than women in the control group.

Conclusions

The BILIEF protocol could be effective approach to improve childbirth fear and childbirth self-efficacy in fearful first pregnant women.

Trial registration number

IRCT20101219005417N3, Date of Registration: 12-19-2018.
Evaluation of the eighth AJCC TNM stage for lung cancer (NSCLC): a meta-analysis of 8 validation studies
Authors: Wankhede Durgesh 
Published: April 2020

Abstract
Introduction

The AJCC eighth edition TNM classification for lung cancer was released in 2017 and included major newer modifications. External validation studies have evaluated the efficacy of the new system and obtained paradoxical results.

Methods

A meta-analysis was performed of these studies to evaluate the new classification. Eight eligible studies with 654,185 patients were included in the analysis. Hazard ratios (HRs) and associated 95% confidence intervals were extracted from identified studies. The primary outcomes were survival discrimination and prognostic value of the new staging system with respect to the 7 th edition.

Results

The HRs for the eighth edition staging system were found to increase steadily showing linear progression with 1.52 in IB, 1.82 in IIA, 1.97 in IIB, 2.19 in IIIA, 5.03 in IIIB, and 7.15 in IIIC compared with IA. The prognostic values of both systems were almost the same.

Conclusion

This study indicated that the survival discrimination of the eighth edition of the TNM classification is valid but its prognostic ability needs further evaluation.
Perceived barriers &amp; facilitators for bedtime routines in families with young children living in economically deprived areas
Authors: Kitsaras George , Goodwin Michaela , Allan Julia , Kelly Michael P , Pretty Iain A 
Published: April 2020

Abstract
Background: Bedtime routines are a highly recurrent family activity with important health, social and behavioural consequences. Despite their importance, information regarding formation, establishment and maintenance of bedtime routines remains limited. This study examined perceived barriers to, and facilitators of, formulating, establishing and maintaining optimal bedtime routines in families with young children from deprived socio-economic areas.Methods: A total of 12 parents participated in the study. Most participants (N=11) were females, had between 1 and 2 children (N=10), were white (N=9) and stay at home parents (N=6). They completed a semi-structured interview based on the Theoretical Domains Framework (TDF). Analysis followed a deductive, theory-informed mapping approach.Results: Key barriers included lack of appropriate knowledge and sources of information, problematic skills development, social influences, cognitive overload, lack of self-monitoring, lack of motivation and negative emotions. Facilitators included social role/identity, environment/access to resources, positive intentions, beliefs about consequences and reinforcement. In particular, optimal bedtime routines were less likely to be enacted when parents were tired/fatigued and there was a strong effect of habit, with suboptimal routines maintained over time due to past experiences and a lack of awareness about the contents and importance of a good bedtime routine. Conclusions: Several theory-based, and potentially modifiable, determinants of optimal bedtime routines were identified in this study, providing important information for future interventions. Several of the key determinants identified were transient (tiredness) and/or non-conscious (habit), suggesting that future interventions may need to be deployed in real time, and should extend beyond conventional techniques.
Risk Factors for Sub–therapeutic Serum Concentrations of Magnesium Sulfate in Severe Preeclampsia of Chinese Patients
Authors: Li Jingjing , Tang Lian , Tang Ruiheng , Peng Lan , Chai Liqiang , Zhu Liping , Yu Yanxia 
Published: April 2020

Abstract
Background: Magnesium sulfate (MgSO4) is the ideal drug for eclampsia prophylaxis and treatment. In China, the effective therapeutic serum magnesium level is 1.8–3.0 mmol/L. Although there have been individual reports on the use of MgSO4 in pregnant women with severe preeclampsia, there is little information on how to achieve and maintain effective therapeutic concentrations in China. This study aimed to investigate risk factors for sub-therapeutic serum concentrations of MgSO4 in patients with severe preeclampsia.Methods: Patients with severe preeclampsia who received MgSO4 intravenous (IV) infusion were retrospectively reviewed. The maternal demographic characteristics, regimens for the administration of MgSO4, and lab test results of patients were collected. Multivariate logistic regression analysis and receiver operating characteristic (ROC) curve analysis were conducted for the risk factors influencing the serum magnesium concentration.Results: A total of 93 patients with severe preeclampsia were included in the study. There were 41 (44.09%) patients attained therapeutic serum magnesium levels and 52 (55.91%) patients did not. A multivariate logistic regression analysis identified creatinine clearance (Ccr), whether the loading dose was given, and measurement time of serum magnesium concentration (referring to the time interval from measurement of blood magnesium concentration to the beginning of maintenance dose administration) as independent risk factors for sub-therapeutic serum magnesium concentration (P < 0.05). ROC curve analysis indicated that the continuous variable Ccr had a significant predictive value for the serum magnesium concentration, which resulted in the area under ROC curve of 0.715 and a cutoff point of 132.82 mL/min, while measurement time had limited predictive value, with the area under ROC curve of 0.650 and cutoff point of 2.375 h.Conclusions: Ccr, whether the loading dose was given, and measurement time were independent risk factors for sub-therapeutic serum magnesium concentration. A loading dose of MgSO4 everytime before the maintenance dose, as well as an infusion time of more than 2.375 hours for MgSO4 maintenance dose are recommended for all the patients with severe PE. Routine evaluation of serum magnesium levels is a recommended practice for women with severe PE and whose Ccr is ≥ 132.82 mL/min.
Does internal limiting membrane peeling during epiretinal membrane surgery induce microscotomas on microperimetry? Study protocol for PEELING, a randomized controlled clinical trial
Authors: Ducloyer Jean-Baptiste , Ivan Juliette , Poinas Alexandra , Lebreton Olivier , Bonissent Alexandre , Fossum Paul , Volteau Christelle , Tadayoni Ramin , creuzot-garcher Catherine , Mer Yannick Le , Perol Julien , Fortin June , Chiffoleau Anne , Billaud Fanny , Ivan Catherine , Weber Michel 
Published: April 2020

Abstract
Background The epiretinal membrane (ERM) is a degenerative condition associated with age, which can cause loss of vision and/or metamorphopsia. The treatment of symptomatic ERM involves surgical removal including a vitrectomy followed by peeling of the ERM using a microforceps. As the internal limiting membrane (ILM) is adherent to the ERM, it is sometimes removed with it (spontaneous peeling). If ILM remains in place, it can be removed to reduce ERM recurrence. However, it is important to clarify the safety of ILM peeling while it increases surgical risks and cause histological disorganization of the retina that can lead to microscotomas maybe responsible for definitive visual discomfort.Methods PEELING is a prospective, randomized, controlled, single-blind and multi-centered trial with two parallel arms. This study investigates the benefit/risk ratio of active ILM peeling among subjects undergoing ERM surgery without spontaneous ILM peeling. Randomization is done in the operating room after ERM removal if ILM remains in place. After randomization, the two groups “active peeling of the ILM” and “no peeling of the ILM” are compared during a total of three follow-up visits scheduled at M1, M6 and M12. Primary endpoint is the difference in microscotomas before surgery and 6 months after surgery. Patients with spontaneous peeling are not randomized and are included in the ancillary study with the same follow-up visits and the same examinations as the principal study. Relevant inclusion criteria involve subjects over 18 years living with idiopathic symptomatic ERM, including pseudophakic patients with transparent posterior capsule or open capsule or lensed patients with age-related cataracts. The calculated sample size corresponds to 53 randomized eyes (1eye/patient) per arm that means 106 randomized eyes (106 randomized patients) in total and a maximum of 222 included patients (116 spontaneous peeling).Discussion ILM peeling is often practiced in ERM surgery to reduce ERM recurrence. It does not impair post-operative visual acuity but it increases the surgical risks and causes anatomical damages. If active ILM peeling is significantly associated with more microscotomas, it may contraindicate the ILM peeling during primitive idiopathic ERM surgery.Trial Registration ClinicalTrials.gov NCT02146144. Registered May 22, 2014. Recruitment is still ongoing
Nowcast Deep Learning Models For Constraining Zero-Day Pathogen Attacks – Application on Chest Radiographs to Covid-19
Authors: Kuo Michael D. , Chiu Wan Hang Keith , Vardhanabhuti Varut , Poplavskiy Dymtro , Yu Philip LH , Du Richard , Yap Alistair Yun Hee , Zhang Sailong , Fong Ambrose Ho-Tung , Chin Thomas Wing-Yan , Lee Jonan Chun Yin , Leung Siu Ting , Lo Christine Shing Yen , Lui Macy Mei-Sze , Fang Benjamin Xin Hao , Ng Ming-Yen 
Published: April 2020

Abstract

Outbreaks due to emergent pathogens like Covid-19 are difficult to contain as the time to gather sufficient information to develop a detection system is outpaced by the speed of transmission. Here we develop a general pneumonia (PNA) CXR Deep Learning (DL) model (MAIL1.0) follow by a second-generation DL model (MAIL2.0) for detection of Covid-19 on chest radiographs (CXR). We validate the models on two prospective cohorts of high-risks patients screened for Covid-19 reverse transcriptase-polymerase chain reaction (RT-PCR). MAIL1.0 has an Area Under the Receiver Operating Characteristics (AUC) of 0.93, sensitivity and specificity of 90.5% and 76.7% in detection of visible pneumonia and MAIL2.0 has an AUC of 0.81, sensitivity and specificity of 84.7% and 71.6%, significantly outperforming radiologists, especially amongst asymptomatic and patients presenting with early symptoms. Nowcast DL models may be an effective tool in helping to constrain the outbreak, particularly in resource-stretched healthcare systems.