bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic role of apparent diffusion coefficient combined with intratumoral susceptibility signals in differentiating high-grade gliomas from brain metastases
Authors: Bozdağ Mustafa , Er Ali , Çinkooğlu Akın , Ekmekçi Sümeyye 
Published: December 2020

Objective The aim of this study was to assess whether tumoral and peritumoral apparent diffusion coefficient values and intratumoral susceptibility signals on susceptibility-weighted imaging could distinguish between high-grade gliomas and brain metastases, and to investigate their associations with the Ki-67 proliferation index. Materials and methods Fifty-seven patients with pathologically confirmed diagnoses of either high-grade glioma or brain metastasis were enrolled in this study (23 with high-grade gliomas and 34 with brain metastases). The minimum and mean apparent diffusion coefficients in the enhancing tumoral region (ADCmin and ADCmean) and the minimum apparent diffusion coefficient in the peritumoral region (ADCedema) were measured from apparent diffusion coefficient maps, and intratumoral susceptibility signal grades acquired by susceptibility-weighted imaging were calculated. Ki-67 proliferation index values were obtained from the hospital database. These parameters were evaluated using the Mann-Whitney U test, independent-sample t-test, Spearman correlation analysis, receiver operating characteristic curve, and logistic regression analyses. Results ADCmean, ADCmin values, and intratumoral susceptibility signal grades in brain metastases were significantly lower than those in high-grade gliomas (all p < 0.05). Ki-67 proliferation index values showed significant correlations with ADCmean, ADCmin, and intratumoral susceptibility signal grade in brain metastases (all p < 0.05), but no correlation was found in high-grade gliomas (all p > 0.05). According to receiver operating characteristic curve analysis, ADCmean achieved the highest diagnostic performance for discriminating high-grade gliomas from brain metastases. Furthermore, the combination of tumoral apparent diffusion coefficient parameters with intratumoral susceptibility signal grade provided a higher area under the curve than univariate parameters. Conclusion The combination of tumoral apparent diffusion coefficient with intratumoral susceptibility signal grade can offer better diagnostic performances for differential diagnosis. Apparent diffusion coefficient and intratumoral susceptibility signal may reflect cellular proliferative activity in brain metastases, but not in high-grade gliomas.
Immunomodulatory effects of flavonoids: An experimental study on natural-killer-cell-mediated cytotoxicity against lung cancer and cytotoxic granule secretion profile
Authors: Oo Aung Myo , Mohd Adnan Liyana Hazwani , Nor Nasir Mat , Simbak Nordin , Ahmad Nor Zidah , Lwin Ohn Mar 
Published: December 2020

Background: A new approach involving immune-cell-mediated cancer therapy has been adopted extensively for the sake of lung cancer treatments by utilizing natural killer (NK) cells. NK cell activity can be enhanced with certain agents, and among them are flavonoids. Thus, this study was conducted to investigate the immunomodulatory roles of apigenin, luteolin and quercetin on NK cell activity against lung cancer cells and on the secretions of perforin and granulysin profile. Methods: The NK-92 cells were grown in complete α-Minimum Essential Medium (MEM). NCI-H460 lung cancer cells were cultured in Roswell Park Memorial Institute 1640 media. NK cell activity against lung cancer cells were done using MTT(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. The secretions of perforin and granulysin profiles were then analysed using enzyme-linked immunosorbent assay. Results: Apigenin, luteolin and quercetin significantly increased the NK-cell-mediated cytotoxic activity against lung cancer cells at concentrations 12.5 µg/ml and 25µg/ml ( P < 0.001). The secretion levels of perforin and granulysin from NK cells were also significantly enhanced with apigenin and luteolin treatment but not with quercetin. Conclusions: All three flavonoid compounds possessed some significant immunomodulatory actions on NK cell cytotoxic activity and granule secretion profiles towards lung cancer therapy.
Immediate effect of neuromuscular electrical stimulation on swallowing function in individuals after oral and oropharyngeal cancer therapy
Authors: Costa Danila Rodrigues , Santos Paulo Sérgio da Silva , Fischer Rubira Cássia Maria , Berretin-Felix Giédre 
Published: December 2020

Objective: To analyze the immediate effect of sensory and motor neuromuscular electrical stimulation, in oral and pharyngeal stages of swallowing, in individuals after oral and oropharyngeal cancer therapy. Methods: The study was conducted on 10 individuals (mean age of 58 years) submitted to oral and oropharyngeal cancer therapy. The individuals were submitted to videofluoroscopy, during which they were randomly asked to swallow 5 mL of liquid, honey, and pudding, in three conditions: without stimulation, with sensory neuromuscular electrical stimulation, and with motor neuromuscular electrical stimulation. The degree of swallowing dysfunction was scored (Dysphagia Outcome and Severity Scale), as well as the presence of food stasis (Eisenhuber scale), and measurement of the oral and pharyngeal transit time. The results were statistically analyzed by the Friedman test or analysis of variance for repeated measures. Results: The Dysphagia Outcome and Severity Scale revealed improvement for one individual with both sensory and motor stimuli, and worsening in two individuals, being one with motor and one with sensory stimulus. In the Eisenhuber scale, the neuromuscular electrical stimulation changed the presence of residues to variable extents. Concerning the oral and pharyngeal transit time, no difference was observed between the different stimulation levels for the consistencies tested (p > 0.05). Conclusion: Both sensory and motor neuromuscular electrical stimulations presented a varied immediate impact on the oral and pharyngeal stages of swallowing in individuals after oral and oropharyngeal cancer therapy. Thus, the results of the immediate effect suggest that the technique is not indicated, evidencing the need of caution in the use of neuromuscular electrical stimulation for the rehabilitation of dysphagia, after HNC treatment.
A Case Report of Intravascular Hemolysis and Heme Pigment–Induced Nephropathy Following AngioJet Thrombectomy for Thrombosed DIPS Shunt
Authors: Tian Si , Sinclair Nicolette , Shah Sachin 
Published: December 2020

Rationale: The AngioJet system is a combined mechanical and pharmacological device used for thrombectomy. As a result of the mechanical disruption of clot, intravascular hemolysis is noted to occur. Rarely, intravascular hemolysis can be severe enough to cause heme pigment–induced acute kidney injury (AKI). Presenting concerns of the patient: We describe a case of a 45-year-old man with Child-Pugh class B cirrhosis, Budd-Chiari syndrome, and antiphospholipid antibody syndrome who required thrombectomy following a thrombosed direct intrahepatic portosystemic shunt (DIPS). He developed evidence of worsening anemia, dark urine, direct antiglobulin test–negative intravascular hemolysis, and severe AKI within 24 hours of the procedure. Diagnosis: Based on his severe AKI in association with elevated hemolytic markers, and the temporal association with the AngioJet procedure, the patient was diagnosed with heme pigment–induced AKI secondary to intravascular hemolysis. Interventions: The patient remained anuric and became volume-overloaded after fluid resuscitation. He was started on dialysis 72 hours after the procedure. Five days after thrombectomy, hemolytic markers returned to normal. Outcome: The patient received hemodialysis for approximately 3 weeks, followed by renal recovery and cessation of dialysis treatments. Five weeks after the AngioJet procedure, his renal function returned to normal. Teaching points: We present a case of heme pigment–induced AKI following an AngioJet procedure that required initiation of dialysis. Although this rare complication has been reported in the literature, it typically occurs when the procedure is used for larger clot burden (ie, venous thromboembolism). To our knowledge, this is the first case of severe hemolysis with associated AKI following the use of the AngioJet for a thrombosed DIPS. Due to the patient’s comorbid conditions, overlapping clinical features, and lack of appreciation of the hemolysis associated with the AngioJet system, the differential diagnosis of the patient’s AKI was quite broad. Nephrologists should be aware of this complication when managing patients with AKI to direct therapy early and avoid unnecessary diagnostic and therapeutic interventions.
An open source graphical user interface for wireless communication and operation of wearable robotic technology
Authors: Tucker Luke A , Chen Ji , Hammel Lauren , Damiano Diane L , Bulea Thomas C 
Published: December 2020

Introduction Wearable robotic exoskeletons offer the potential to move gait training from the clinic to the community thereby providing greater therapy dosage in more naturalistic settings. To capitalize on this potential, intuitive and robust interfaces are necessary between robotic devices and end users. Such interfaces hold great promise for research if they are also designed to record data from the robot during its use. Methods We present the design and validation of an open source graphical user interface (GUI) for wireless operation of and real-time data logging from a pediatric robotic exoskeleton. The GUI was designed for trained users such as an engineer or clinician. A simplified mobile application is also provided to enable exoskeleton operation by an end-user or their caretaker. GUI function was validated during simulated walking with the exoskeleton using a motion capture system. Results Our results demonstrate the ability of the GUI to wirelessly operate and save data from exoskeleton sensors with high fidelity comparable to motion capture. Conclusion The GUI code, available in a public repository with a detailed description and step-by-step tutorial, is configurable to interact with any robotic device operated by a microcontroller and therefore represents a potentially powerful tool for deployment and evaluation of community based robotics.
MRI findings of spring ligament injury: association with surgical findings and flatfoot deformity
Authors: Kimura Yusuke , Yamashiro Tsuneo , Saito Yuki , Kitsukawa Kaoru , Niki Hisateru , Mimura Hidefumi 
Published: December 2020

Background Spring ligament injury is an important cause for flatfoot deformity; however, reliability of magnetic resonance imaging (MRI) findings of spring ligament injury is still ambiguous. Purpose To investigate the reliability of MRI findings for the diagnosis of spring ligament injury. Material and methods Forty-three cases with spring ligament injury proven by surgery and 29 control cases were enrolled. The spring ligament complex was demonstrated on proton density-weighted images reconstructed from 3D-isotropic MRI data. The presence of waviness, discontinuity, and abnormally high signal intensity of the spring ligament complex was evaluated by two radiologists in cooperation. Also, injury of the posterior tibial tendon (PTT) on MRI and the lateral talo-1st metatarsal angles on weight-bearing X-rays were evaluated. Results Discontinuity and abnormally high signal intensity of the superomedial calcaneonavicular ligament (SmCNL) on MRI were more frequently observed in patients with spring ligament injury than in controls ( p < 0.001). Discontinuity and abnormally high signal intensity of the SmCNL were found more often in the PTT injury group than in those without ( p < 0.001). The talo-1st metatarsal angle was greater in patients with discontinuity and abnormally high signal intensity of the SmCNL on MRI than in patients without these findings ( p < 0.001). Conclusion Discontinuity and abnormally high signal intensity are reliable MRI findings for spring ligament injury and related disorders, such as flatfoot deformity and PTT injury.
The Use of Telephone Consultation in Primary Health Care During COVID-19 Pandemic, Oman: Perceptions from Physicians
Authors: Hasani Said Al , Ghafri Thamra Al , Al Lawati Hussain , Mohammed Jamshid , Al Mukhainai Ameena , Al Ajmi Fatma , Anwar Huda 
Published: December 2020

Introduction: To enforce physical distancing measures during COVID-19, Telephone Consultation (TC), a form of telemedicine, was initiated as an alternative technology to face to face consultation in primary health care (PHC) in Muscat, Oman. This study aims to explore the perceptions of physicians about the use of TC with respect to process of implementation; challenges and limitations; lessons learned and the way forward. Method: This was a qualitative study using interpretive phenomenological analysis. Physicians who were actively conducting TC in PHC were purposively selected and individually interviewed until no new responses were obtained. All interviews were audio-recorded, transcribed verbatim, and analysed using thematic analysis. Results: Twenty-two participants were interviewed. Participants were predominantly females (98%) and qualified family physicians (77.3%). Overall, all participants accepted this initiative as a possible method to continue health services during COVID-19. Perceptions about the process of implementing TC in PHC were themed to; inconsistent implementation of the guideline, variability in roles and responsibilities, and Semi-supportive infrastructure. Five themes were identified as challenges and limitations: limited staff training on TC, suboptimal patient-physician interaction, insufficient technical support, ensuring privacy, and confidentiality of the communication, and different ways to document the TC. Physicians expressed that TC worked better in following COVID-19 cases, chronic conditions, and, in general, simple cases. They also expressed a reduction in the crowdedness in PHC facilities and the risk of acquiring COVID-19 and other types of infections. Tailoring the existing structural clinical setting, capacity building activities on the use of TC, and improving the quality of the TC are viewed as essential steps for the future sustainability of TC in PHC. Conclusion: Given the exceptional situation of COVID-19, the current evidence suggests that the use of TC in PHC, especially in chronic cases, is promising. However, measures including training of staff, improving the structural setting, and selecting suitable cases for TC are the main elements for high quality and sustainable TC services in PHC from physician’s perspective.
Contribution of Sonoelastographic Scoring to B-Mode Sonography in the Evaluation of Breast Masses
Authors: Dinç Elibol Funda , Yeniçeri Önder 
Published: December 2020

Objectives: The study aims were to evaluate the contribution of sonoelastography to Breast Imaging Reporting, and Data System (BI-RADS) scoring of breast images. Materials and Methods: Two observers evaluated the BI-RADS category, Tsukuba score, and the strain index of 83 lesions of 73 consecutive patients. A new scoring system was established to evaluate the lesions by using the BI-RADS score, Tsukuba score, and strain index ratio. Results: There was a statistically significant difference between the strain index value of benign (3.08 ± 2.71) and malignant group (4.62 ± 2.70) ( P < .05). The sensitivity and specificity were 59.1% and 65.1% for the 3.12 cut-off value for the strain index. In the receiver operating characteristic (ROC) analysis, the area under the curve (AUC) of the only BI-RADS score was 0.834, both BT (BI-RADS + revised Tsukuba score) score and the total score (BI-RADS + revised Tsukuba score + strain index score) was 0.843. The interclass correlation coefficient for the two observers’ measurements of the strain index was weak, with .266 ( P < .05). Conclusion: The potential contribution of sonoelastography on lesion characterization is still controversial. In this study, the agreement among the observers was inadequate, and the contribution of sonoelastography on BI-RADS classification was limited. In addition, in the daily practice of sonoelastograpic evaluation, the Tsukuba score, was easier to apply and should be used rather than strain index measurements.
Expansion of senescent megakaryocyte-lineage cells maintains CML cell leukemogenesis
Authors: Tanabe Yamato , Kawamoto Shimpei , Takaku Tomoiku , Morishita Soji , Hirao Atsushi , Komatsu Norio , Hara Eiji , Mukaida Naofumi , Baba Tomohisa 
Published: December 2020

Abstract
BCR-ABL, an oncogenic fusion gene, plays a central role in the pathogenesis of chronic myeloid leukemia (CML). Oncogenic signaling induces oncogene-induced senescence and senescence-associated secretory phenotype (SASP), which is characterized by enhanced production of various cytokines. BCR-ABL gene transduction confers senescent phenotype in vitro; however, the in vivo relevance of senescence has not been explored in this context. Transplantation of BCR-ABL–expressing hematopoietic stem/progenitor cells caused CML in mice with an increase in bone marrow BCR-ABL+CD41+CD150+ leukemic megakaryocyte-lineage (MgkL) cells, which exhibited enhanced senescence-associated β-galactosidase staining and increased expression of p16 and p21, key molecules that are crucially involved in senescence. Moreover, knockout of p16 and p21 genes reduced both BCR-ABL–induced abnormal megakaryopoiesis and the maintenance of CML cell leukemogenic capacity, as evidenced by attenuated leukemogenic capacity at secondary transplantation. The expression of transforming growth factor-β1 (TGF-β1), a representative SASP molecule, was enhanced in the leukemic MgkL cells, and TGF-β1 inhibition attenuated CML cell leukemogenic capacity both in vitro and in vivo. Furthermore, BCR-ABL–expressing MgkL cells displayed enhanced autophagic activity, and autophagy inhibition reduced bone marrow MgkL cell number and prolonged the survival of CML mice, which had transiently received the tyrosine kinase inhibitor, imatinib, earlier. Thus, BCR-ABL induced the expansion of senescent leukemic MgkL cells, which supported CML leukemogenesis by providing TGF-β1.
Crisis challenges of small firms in Macao during the COVID-19 pandemic
Authors: Alves Jose C. , Lok Tan Cheng , Luo Yubo , Hao Wei 
Published: December 2020

AbstractThis research develops a framework that combines crisis stages, stakeholder engagement, and crisis challenges. The framework is applied to small firms in Macao during the 2019 novel coronavirus disease (COVID-19) pandemic crisis. We conduct a qualitative study based on semi-structured interviews with the leaders of six small firms in Macao. The findings suggest that the COVID-19 pandemic has turned into a “normal” context, which blurs the traditional crisis termination stage. We also find that participating firms engage more with internal stakeholders than external ones. The strategies adopted by small firms include flexible human resource (HR) practices, cost reduction, enhancing customer relations, and using government support schemes. These strategies are effective in the short term; firms need to pay attention to diversity and learning for the long term.
Overactive bladder symptoms recurrence after sudden versus gradual weaning of Solifenacin
Authors: Abdelbary Ahmed , Al-Dessoukey Ahmad Aref , Moussa Ayman Salah , El-nasr Mohamed Saif , Elmarakbi Akrm Ahmed , Ragheb Ahmed Medhat , Elbatanouny Ahmed Mohamed , Abdellateef Ahmed , Sayed Osama , Lotfy Amr , Mohyelden Khaled , Abdelhamid Amr Mohamad , Galal Ehab Mohamad , Massoud Amr , Ibrahim Rabie M. 
Published: December 2020

Abstract
Background
To evaluate and compare the recurrence rate of overactive bladder (OAB) symptoms after solifenacin treatment in patients who stop the drug suddenly versus those who gradually wean the drug after improvement of their condition.

Methods
Our study included 60 patients with idiopathic OAB and treated with solifenacin 5 mg twice daily for one month. After improvement of their condition, we divided the responders into two groups, group I stopped the drug suddenly, while group II underwent gradual weaning of the drug.

Results
The recurrence rate of symptoms of OAB was 33.3% and 60% after 1 and 3 months in patients who stopped the solifenacin suddenly after improvement of their symptoms, while it was 6.7% and 23.3% after 1 and 3 months in patients who gradually weaned solifenacin.

Conclusion
After the improvement of OAB symptoms, gradual weaning of solifenacin can help in decreasing the recurrence rate of symptoms.
Nanomedicine-mediated induction of immunogenic cell death and prevention of PD-L1 overexpression for enhanced hepatocellular carcinoma therapy
Authors: Zhu Hanzhang , Zhou Weijiang , Wan Yafeng , Ge Ke , Lu Jun , Jia Changku 
Published: December 2020

Abstract
Background
The present study aims to develop a nanoparticle encapsulating doxorubicin (DOX) and programmed death-ligand 1 (PD-L1) siRNA and evaluate its anti-tumor effects on hepatoma carcinoma (HCC).

Methods
Nanoparticle encapsulating DOX and PD-L1 siRNA (NPDOX/siPD-L1) was characterized by dynamic light scattering and transmission electron microscopy. Flow cytometry was applied to analyze cell populations, NPDOX/siPD-L1 internalization, and cell apoptosis. Real-Time (RT)-quantitative reverse transcription (qPCR) and western blotting were used to determine the mRNA and protein levels, respectively. Released ATP was determined using ATP determination kit and cytokines were determined using specific ELISAs. A tumor-bearing animal model was established to evaluate the anti-tumor effects of NPDOX/siPD-L1.

Results
Treatment of NPDOX/siPD-L1 induced immunogenic cell death (ICD) and PD-L1 overexpression in HCC. In vivo study demonstrated that intravenously injection of NPDOX/siPD-L1 significantly inhibited the tumor volume and PD-L1 expressions of tumor tissue in the H22 tumor-bearing animal model. Besides, the treatment of NPDOX/siPD-L1 also regulated the populations of matured dendritic cells and cytotoxic T cells and the productions of cytokines in the tumor tissues.

Conclusion
Taken together, NPDOX/siPD-L1 showed significant anti-tumor effects on HCC by the induction of ICD and inhibition of PD-L1 overexpression.
Generation of digital patients for the simulation of tuberculosis with UISS-TB
Authors: Juárez Miguel A. , Pennisi Marzio , Russo Giulia , Kiagias Dimitrios , Curreli Cristina , Viceconti Marco , Pappalardo Francesco 
Published: December 2020

Abstract
Background
The STriTuVaD project, funded by Horizon 2020, aims to test through a Phase IIb clinical trial one of the most advanced therapeutic vaccines against tuberculosis. As part of this initiative, we have developed a strategy for generating in silico patients consistent with target population characteristics, which can then be used in combination with in vivo data on an augmented clinical trial.

Results
One of the most challenging tasks for using virtual patients is developing a methodology to reproduce biological diversity of the target population, ie, providing an appropriate strategy for generating libraries of digital patients. This has been achieved through the creation of the initial immune system repertoire in a stochastic way, and through the identification of a vector of features that combines both biological and pathophysiological parameters that personalise the digital patient to reproduce the physiology and the pathophysiology of the subject.

Conclusions
We propose a sequential approach to sampling from the joint features population distribution in order to create a cohort of virtual patients with some specific characteristics, resembling the recruitment process for the target clinical trial, which then can be used for augmenting the information from the physical the trial to help reduce its size and duration.