bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective evaluation of contrast-enhanced ultrasound of breast BI-RADS 3-5 lesions
Authors: Eva Janu , Lucie Krikavova , Jirina Little , Karel Dvorak , Dagmar Brancikova , Eva Jandakova , Tomas Pavlik , Petra Kovalcikova , Kazda Tomas , Vlastimil Valek 
Published: April 2020

Abstract
Purpose: To determine the benefit of contrast-enhanced ultrasound (CEUS) in the assessment of breast lesions. Materials and Methods: A standardized contrast-enhanced ultrasound was performed in 230 breast lesions classified as BI-RADS category 3 to 5. All lesions were subjected to qualitative and quantitative analysis. MVI (MicroVascular Imaging) technique was used to derive qualitative analysis parameters; blood perfusion of the lesions was assessed (perfusion homogeneity, type of vascularization, enhancement degree). Quantitative analysis was conducted to estimate perfusion changes in the lesions within drawn regions of interest (ROI); parameters TTP (time to peak), PI (peak intensity), WIS (wash in slope), AUC (area under curve) were obtained from time intensity (TI) curves. Acquired data were statistically analyzed to assess the ability of each parameter to differentiate between malignant and benign lesions. The combination of parameters was also evaluated for the possibility of increasing the overall diagnostic accuracy. Biological nature of the lesions was verified by a pathologist. Benign lesions without histopathological verification (BI-RADS 3) were followed up for at least 24 months. Results: Out of 230 lesions, 146 (64%) were benign, 67 (29%) were malignant, 17 (7%) lesions were eliminated. Malignant tumors showed statistically significantly lower TTP parameters (sensitivity 77.6%, specificity 52.7%) and higher WIS values (sensitivity 74.6%, specificity 66.4%) than benign tumors. Enhancement degree also proved to be statistically well discriminating as 55.2% of malignant lesions had a rich vascularity (sensitivity 89.6% and specificity 48.6%). The combination of quantitative analysis parameters (TTP, WIS) with enhancement degree did not result in higher accuracy in distinguishing between malignant and benign breast lesions. Conclusion: We have demonstrated that contrast-enhanced breast ultrasound has the potential to distinguish between malignant and benign lesions. In particular, this method could help to differentiate lesions BI-RADS category 3 and 4 and thus reduce the number of core-cut biopsies performed in benign lesions. Qualitative analysis, despite its subjective element, appeared to be more beneficial. A combination of quantitative and qualitative analysis did not increase the predictive capability of CEUS.
Randomization of subjects to study-arms of a parallel study in the presence of multiple covariates
Authors: Schoen Eric , Wopereis Suzan 
Published: April 2020

Abstract
Background: Parallel intervention studies involving healthy volunteers usually require a procedure to allocate the subjects to study-arms. Statistical models to evaluate the different outcomes of the study-arms will include study-arm as a factor along with any covariate that might affect the results. To ensure that the effects of the covariates are confounded to the least possible extent with the effects of the arms, strained randomization can be applied. However, there is at present no clear-cut procedure when there are multiple covariates. Methods: We propose a D-optimal blocking procedure to allocate subjects with known values of the covariates to the study arms. We prove that the procedure minimizes the variances of the baseline differences between the arms corrected for the covariates. The procedure uses standard statistical software. Results: We demonstrate the potential of the method by an application to a human parallel intervention trial with three arms and 162 healthy volunteers. The covariates were gender, age, body mass index, an initial composite health score, and a categorical indicator called _rst-visit group, defining groups of volunteers who visit the clinical center on the same day (17 groups). Volunteers were allocated equally to the study-arms by the D-optimal blocking procedure. The D-efficiency of the model connecting an outcome with the study-arms and correcting for the covariates equals 99.2%. We simulated 10,000 random allocations of subjects to arms either unstratified or stratified by first-visit group. Intervals covering the middle 95% of the D-efficiencies for these allocations were [82.0, 92.0] and [93.2, 98.4], respectively. Conclusions: Allocation of volunteers to study-arms with a D-optimal blocking procedure with the values of the covariates as inputs substantially improves the efficiency of the statistical model that connects the response with the study arms and corrects for the covariates.
Clinical Application of Transforaminal Percutaneous Endoscopic Lumbar Discectomy Via Superior Notch of Inferior Vertebral Pedicle Approach for Very High-grade Inferiorly Migrated Disc Herniation
Authors: Chen Song , Wang Jinghuai , Suo Shiqi , Wang Yunxia , Li Chengli , Li Jiaqi , Zhang Wei 
Published: April 2020

Abstract
Background: To assess the efficacy of the superior notch of inferior vertebral pedicle approach of transforaminal percutaneous endoscopic lumbar discectomy for very high-grade inferiorly migrated disc herniation.Methods: Data on 32 consecutive patients operated with percutaneous endoscopic surgery via the superior notch of inferior vertebral pedicle approach were reviewed. Age, gender, clinical diagnoses, operation time, hospitalization time, a self-administered questionnaire composed of the leg pain visual analogue scale (VAS leg pain) and the Oswestry Disability Index (ODI) had been recorded before operation and 1, 3, 6 and 12 months after operation, respectively. The clinical results were assessed at the final follow-up by using modified Macnab criteria. Complications were recorded during follow-up, and postoperative X-ray, CT and MRI examinations were performed.Results: There were 21 males and 11 females. The mean age of patients was 51.8±10.6 years. MRI findings of patients with disc herniation were L2-3 level in 4 case, L3-4 level in 9 cases and L4-5 level in 19 cases, which were correlated with clinical symptoms. All patients completed a 12-month follow-up assessment after surgery. The mean operative duration was 68.2±12.8 min, and hospitalization time was 3.6±0.8 days. At 12 months follow up the VAS leg pain had improved by 6.3 (P< 0.05) and the ODI by 43.6 points (P< 0.05). Twenty-three cases (71.9%) were rated as excellent, 7 (21.9%) as good, 2 (6.2%) as fair at the final follow-up. On the basis of the modified MacNab criteria, the overall excellent and good rate was 93.8%. Two patients (6.2%) had transient dysesthesia after surgery. Postoperative radiological evaluations showed no signs of instability or recurrence of pathology.Conclusion: Transforaminal percutaneous endoscopic lumbar discectomy via the superior notch of inferior vertebral pedicle approach could be a safe and effective minimally invasive technique for very high-grade inferiorly migrated disc herniation. This technique warrants further study and clinical application.
Single-cell immune profiling of matched disease and recovery phase blood of COVID-19 patients reveals anti-LAG3 based immune checkpoint therapy as a promising option
Authors: Xiong Qing , Peng Cheng , Yan Xiaomin , Chen Lin , Yan Xueqi , Sun Beicheng , Jiao Shiping 
Published: April 2020

Abstract
We profiled the circulating immune cells in COVID-19 patients during the active disease and recovery phases via single cell RNA, TCR and BCR sequencing in order to elucidate the key anti-virus adaptive immune responses, and explore potential immunomodulatory therapeutic strategies. T cell competence plays a dominant role in anti-SARS-CoV-2 immunity. Clonally expanded CD4 T effector cells averted CD8 T cell exhaustion, and expansion of multiple CD8 T effector/memory clones was correlated with rapid virus clearance. In contrast, the patients lacking CD4 TEFF cell clonal expansion harbored exhausted CD8 TEFF cells co-expressing multiple co-inhibitory molecules. In addition, more than 90% of the exhausted cells expressed at least 2 and more than half of exhausted cells expressed at least 4 inhibitory molecules. Furthermore, co-expression of LAG3, Galectin-9, and SLAMF6 is the inhibitory molecule expression signature of exhausted T cell population in SARS-CoV-2 infection. Our findings indicate that LAG3-based immune checkpoint blockade is a promising strategy for treating COVID-19.
Invisible contaminants and food security in former coal mining areas of Santa Catarina, southern Brazil
Authors: Blanco Graziela Dias , Sühs Rafael Barbizan , Brizola Escarlet , Corrêa Patrícia Figueiredo , Campos Mari Lucia , Hanazaki Natalia 
Published: April 2020

Abstract
Background Mining activities have environmental impacts due to sediment movement and contamination of areas, and may also pose risks to people's food security. In Brazil, the majority of coal mining activities are in the south, in the Santa Catarina Carboniferous region. In this region, previously mined areas contaminated with heavy metals, frequently occur nearby inhabited zones. Heavy metals are contaminants that do not have odor, color, or taste, and are therefore difficult to detect. We aimed to verify whether people use plants from contaminated mine areas, and to understand which factors are related to plant use. Methods We conducted semi-structured interviews with residents from 14 areas nearby abandoned mines in the main municipalities of the Santa Catarina Carboniferous region. Results Out of the 196 interviewed residents, 127 (65%) reported collecting plants for medicinal and food use, directly from contaminated mine areas. Long-term residents, as well as those who noticed more environmental changes (positive and negative), cited more plants used, and had more detailed knowledge of plant use in their communities. When asked if they were aware of the possible contamination of mined areas, 85% said they knew about it. However, only 10% associated negative health effects with the use of plant species collected in contaminated mined areas. Conclusions Our study demonstrates that people living nearby contaminated areas use and consume locally sourced plants, it also reveals a lack of information about contamination, as well as a lack of actions that include local communities in contaminated area restoration strategies. This situation poses a risk to the food security of the people living nearby former coal mining areas.
Knowledge, Attitude and associated factors towards self-medication among health professionals at University of Gondar Comprehensive Specialized Hospital: Institution-based cross-sectional study
Authors: Simegn Wudneh , Dagnew Baye , Dagne Henok 
Published: April 2020

Abstract
Introduction Inappropriate self-medication results in wastage of resources, drug resistance and hence serious health risk. Knowledge acquisition and attitudinal change is required for avoiding self-medication practice. There is paucity of published articles regarding this topic. Therefore, this study aimed to study knowledge, Attitude and associated factors towards self-medication among health professionals at University of Gondar Comprehensive Specialized Hospital, northwest Ethiopia.Methods This cross-sectional study was conducted among health professionals of University of Gondar comprehensive specialized hospital using simple random sampling technique and self-administered questionnaire. We used Epi Info 7 and SPSS 20 for data entry and statistical analysis. Descriptive statistics were computed logistic regression had been performed to identify associated factors for knowledge and attitude separately. We executed crude and adjusted Odds ratio with 95% uncertainty interval. Variables with a p<0.05 were treated as significant. Results Four hundred and twelve health professionals participated in the study with 97.4% response rate. The mean age of study participants’ was 29.9 (±5.43, range; 20-60) years and 220 (53.4%) participants were males. From the participants 233(56.6%) (95% UI: 51.8-61.4%) had good knowledge about self-medication and 263 (63.8%) (95% UI: 59.2-68.4%) had good attitude towards self-medication. Knowledge of self-medication was associated with age of 32-60 years (AOR=2.19, UI: 1.14-4.22), Bachelor degree (AOR=6.49, UI: 1.86-22.69), Years after last graduation (AOR=2.49, UI: 1.41-4.41), working hours of 56-110 per week (AOR=2.35, UI: 1.18-4.67), and good attitude (AOR=2.95, UI: 1.77-4.91). Besides this, good attitude was associated with low workload out of workplace (AOR=2.78, UI: 1.03-7.50), ever taking antibiotics (AOR=2.45, UI: 1.31-4.50), and good knowledge (AOR= 2.64, UI: 1.65-4.20).Conclusion The study demonstrated that the knowledge and attitude of health professionals towards self-medication are relatively high. However still there is a need for health education on the implication and danger of self-medication. There is also need for government to increase awareness by creating training opportunity and incorporating in curricula.
Patient self-reported functioning by pain severity and usual analgesic treatment among older adults with osteoarthritis: Analysis of the 2017 Spanish National Health Survey
Authors: García-López Sofía , Llopart-Carles Natalia , Castro-Domínguez Francisco , Rejas-Gutiérrez Javier 
Published: April 2020

Abstract
Background

Osteoarthritis (OA) pain is among the leading causes of disability and social isolation worldwide. Since prevalence is high, particularly in adults aged 65 or older, it represents a significant burden for society and national health systems. The objective of this study was to determine whether patient self-reported functioning in key domains of daily living differs by pain severity and analgesic treatment among older OA patients in Spain.
Methods

The Spanish National Health Survey (ENSE), a large, nationally representative, cross-sectional general health survey administered by trained interviewers to 23,089 adults, was the data source. Subjects of both sexes aged 65 or older with a self-reported physician diagnosis of OA who completed the survey were analyzed. Patients were cross classified by pain severity (no/mild, moderate or severe) and analgesia (treated or untreated). Assessment of daily living included basic and instrumental activities of daily living and mental, social, and cognitive domains. Scores were re-scaled to a 0%-100% standardized metric (0%: no limitation [independence]; 100%: complete limitation [full dependence]).
Results

A total of 3,526 (3,389 surveys completed [96.1%]) older adults with OA were analyzed (women 73.3%; age 77.4 [standard deviation {SD}: 7.5]). Adjusted means (95% confidence interval [CI]) scores in domains of functioning showed significant association with pain severity (p < 0.001) but not treatment status, except basic and instrumental activities and social functioning, with higher scores in treated patients. Limitations in patients with untreated no/mild pain versus severe treated pain were as follows: in basic activities, 6.5% (5.0–8.0) versus 31.5% (30.1–32.9); in instrumental activities, 9.0% (7.2–10.8) versus 34.1% (32.3–35.8); in mental, 29.1% (27.9–30.3) versus 45.0% (43.9–46.2); in social, 3.0% (0.6–5.4) versus 42.2% (39.9–44.5); and, in cognitive, 10.9% (9.2–12.6) versus 23.4% (21.8–25.1).
Conclusions

Pain severity was a major driver of functional impairment in all the main domains of functioning analyzed in older OA patients. Regardless of pain severity, treated patients showed poorer functioning in basic, instrumental and social activities versus untreated subjects. Treated patients might have been in later disease stages, which would have affected the results. Existing analgesic treatment strategies do not meet patient needs for adequate pain management.
Isolation, molecular and phylogenetic analysis of porcine encephalomyocarditis virus strain HLJ in China
Authors: Yin Xueting , Liu Peng , Liu Haixin , Zhang Yue , Abbas Ghulam , Muhammad Ishfaq , Ren Yudong , Huang Xiaodan , Zhang Ruili , Li Guangxing 
Published: April 2020

Abstract
Background

Encephalomyocarditis virus (EMCV) is a positive single-stranded small RNA virus without envelope, which can infect a variety of mammals. Swine are the most susceptible animals, which can cause acute myocarditis and respiratory failure in piglets and reproductive failure in pregnant sows. Diseases caused by EMCV have a wide range of effects on the global swine industry.
Methods

The tissue grinding fluid of aborted fetus was inoculated on baby hamster kidney 21 (BHK-21) cells to obtain HLJ isolate by cell passage. The virus was identified by reverse transcriptase polymerase chain reaction (RT-PCR), electron microscopic observation and indirect immunofluorescence assay (IFA). HLJ strain was inoculated into mice for animal regression experiment. The whole genome of HLJ strain was amplified and sequenced. The molecular and phylogenetic analysis of its sequence was generated.
Results

HLJ strain caused the specific cytopathic effect (CPE) on BHK-21 cells and severe pathological changes in mice. Complete genome sequencing and multiple sequence alignment showed that the homology between HLJ strain and other isolates worldwide was 71.5–99.7%. Phylogenetic analysis showed that EMCV isolates fell into five clusters: lineage I, II, III, IV, and V based on the nucleotide sequences of the entire open reading frame (ORF) and VP1 gene. HLJ isolate was grouped into lineage I.
Conclusions

In this study, a strain of EMCV was isolated from an aborted fetus in Northeast China. The isolation of HLJ strain enriches the epidemiological database of EMCV.
Comparative Analysis of the Biomechanical Behavior of two different design metaphyseal-fitting short stems using digital image correlation; Finite Element Modelling and Analysis Validation
Authors: Tatani Irini , Megas Panagiotis , Panagopoulos Andreas , Diamantakos Ioannis , Nanopoulos Photis , Pantelakis Spiros 
Published: April 2020

Abstract
Background
The progressive evolution in hip replacement research is directed to follow the principles of bone and soft tissue sparing surgery. Regarding hip implants, a renewed interest has been raised towards short uncemented femoral implants. A heterogeneous group of short stems have been designed with the aim to approximate initial, post-implantation bone strain to the preoperative levels in order to reduce the risk of stress shielding. This study aims to investigate the biomechanical properties of two distinctly designed femoral implants based on experiments and numerical simulations. Nevertheless, finite element models of implant–bone constructs should be evaluated for their validity against mechanical tests wherever it is possible. In this work, the validation was performed via a direct comparison of the FE calculated strain fields with their experimental equivalents obtained using the digital image correlation technique.
Results
Design differences between Trilock BPS and Minima S femoral stems conditioned different strain pattern distributions. A distally shifting load distribution pattern as a result of implant insertion and also an obvious decrease of strain in the medial proximal aspect of the femur was noted for both stems. Strain changes induced after the implantation of the Trilock BPS stem at the lateral surface were greater compared to the non-implanted femur response, as opposed to those exhibited by the Minima S stem. Linear correlation analyses of the FE model-predicted strains against corresponding experimentally-measured strains revealed a strong correlation indicating that the developed FE models can be used for the calculation of stresses and strains at the implanted femurs.
Conclusion
The study findings support the use of DIC technique as a preclinical evaluation tool of the biomechanical behavior induced by different implants and also identify its potential for experimental FE model validation. Furthermore, this study demonstrates that stress shielding effect cannot be avoided as proximal unloading of the femur was noted after the implantation of both short stem designs. Design specific variations in short stems were sufficient to produce dissimilar biomechanical behaviors, although their clinical implication must be investigated through comparative clinical studies.
Far-UVC light efficiently and safely inactivates airborne human coronaviruses
Authors: Buonanno Manuela , Welch David , Shuryak Igor , Brenner David J. 
Published: April 2020

Abstract
A direct approach to limit airborne transmission of pathogens is to inactivate them within a short time of their production. Germicidal ultraviolet light (UV), typically at 254 nm, is effective in this context, but it is a health hazard to the skin and eyes. By contrast, far-UVC light (207-222 nm) efficiently kills pathogens without harm to exposed human cells or tissues. We previously demonstrated that 222-nm UV light efficiently kills airborne influenza virus (H1N1); here we extend the far-UVC studies to explore efficacy against human coronaviruses from subgroups alpha (HCoV-229E) and beta (HCoV-OC43). We found that low doses of, respectively 1.7 and 1.2 mJ/cm2 inactivated 99.9% of aerosolized alpha coronavirus 229E and beta coronavirus OC43. Based on these results for the beta HCoV-OC43 coronavirus, continuous far-UVC exposure in public locations at the currently recommended exposure limit (3 mJ/cm2/hour) would result in 99.9% viral inactivation in ~ 25 minutes. Increasing the far- UVC intensity by, say, a factor of 2 would halve these disinfection times, while still maintaining safety. As all human coronaviruses have similar genomic size, a key determinant of radiation sensitivity, it is realistic to expect that far-UVC light will show comparable inactivation efficiency against other human coronaviruses, including SARS-CoV-2.
A ILEGALIDADE COMO FATOR PRECURSOR DA VIOLÊNCIA NA POLÍTICA DE DROGAS
Authors: GARCIA Leonardo Cesar Gomes 
Published: April 2020

: inserida na legislação especial ou extravagante, a lei federal nº 11.343/2006, que dispõe e institui o Sistema Nacional de Políticas Públicas sobre Drogas (SISNAD) restou-se infrutífera frente ao propósito inicial a que se destinava. Se a vigente Lei de Drogas, editada no ano de 2006, almejava atenuar ou amenizar o excesso do punitivismo estatal, seu efeito prático acabou por vir em sentido oposto. O inchaço da população carcerária propiciou o surgimento das organizações criminosas, que comportam estatísticas alarmantes, sem olvidar os recentes massacres ocorridos em estabelecimentos prisionais, palcos de pavorosas violações contra os direitos humanos e constitucionais. Nesse diapasão, os resultados obtidos frente às reflexões objetivadas durante a presente reflexão evidenciaram o senso coletivo unânime e inexpugnável de que a Guerra às Drogas traduzida pelo modelo proibicionista-belicista, também conhecido como war on drugs, asseverou diversas precarizações sociais, dentre estas, a imensa intensificação do encarceramento brasileiro bem como o fomento da violência e injustiça social. Nada disso por si só, tem o condão de solucionar os efeitos da violência em torno das drogas, contudo, mostra-se indispensável o reconhecimento da concepção de que a existência de incoerências gravíssimas no ordenamento jurídico proporcionaram o surgimento de pessoas que, embora usam drogas, não praticam crime algum, enquantoa outras se valem das primeiras para cometer atos atrozes. Em meio à evidente dificuldade que enfrenta o intérprete da norma, tem-se inúmeros erros originados pela vã tentativa de manter uma imposição legal insustentável, que mesmo diante de seus reflexos negativos e destrutivos, ainda procura resistir.