bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systemic TNFα correlates with residual β-cell function in children and adolescents newly diagnosed with type 1 diabetes
Authors: Overgaard Anne Julie , Madsen Jens Otto Broby , Pociot Flemming , Johannesen Jesper , Størling Joachim 
Published: September 2020

Abstract
Background
Type 1 diabetes (T1D) is caused by immune-mediated destruction of the β-cells. After initiation of insulin therapy many patients experience a period of improved residual β-cell function leading to partial disease remission. Cytokines are important immune-modulatory molecules and contribute to β-cell damage in T1D. The patterns of systemic circulating cytokines during T1D remission are not clear but may constitute biomarkers of disease status and progression. In this study, we investigated if the plasma levels of various pro- and anti-inflammatory cytokines around time of diagnosis were predictors of remission and residual β-cell function in children with T1D followed for one year after disease onset.

Methods
In a cohort of 63 newly diagnosed children (33% females) with T1D with a mean age of 11.3 years (3.3–17.7), ten cytokines were measured of which eight were detectable in plasma samples by Mesoscale Discovery multiplex technology at study start and after 6 and 12 months. Linear regression models were used to evaluate association of cytokines with stimulated C-peptide.

Results
Systemic levels of tumor necrosis factor (TNF)-α, interleukin (IL)-2 and IL-6 inversely correlated with stimulated C-peptide levels over the entire study (P < 0.05). The concentrations of TNFα and IL-10 at study start predicted stimulated C-peptide level at 6 months (P = 0.011 and P = 0.043, respectively, adjusted for sex, age, HbA1c and stage of puberty).

Conclusions
In recent-onset T1D, systemic cytokine levels, and in particular that of TNFα, correlate with residual β-cell function and may serve as prognostic biomarkers of disease remission and progression to optimize treatment strategies.

Trial Registration
The study was performed according to the criteria of the Helsinki II Declaration and was approved by the Danish Capital Region Ethics Committee on Biomedical Research Ethics (journal number H-3-2014-052). The parents of all participants gave written consent.
COVID-19 pandemic- knowledge, perception, anxiety and depression among frontline doctors of Pakistan
Authors: Amin Faridah , Sharif Salman , Saeed Rabeeya , Durrani Noureen , Jilani Daniyal 
Published: September 2020

Abstract
Background
COVID-19 is a global pandemic and has become a major public health burden worldwide. With already fragile healthcare systems it can have long lasting effects in developing countries. Outbreaks especially a pandemic situation evokes fear related behaviors among healthcare professionals and there is always an increased risk of mental health disorders. Therefore, this study aims to determine knowledge and perception about this pandemic, prevalence and factors associated with anxiety/depression among frontline physicians of Pakistan.

Methods
Data were collected through an online survey released in the last week of March-2020. 389 frontline physicians from all four provinces and 65 cities of Pakistan participated. Survey questionnaire consisted of 4 parts including informed consent section, demographic section, knowledge and perception about COVID-19 pandemic and assessment of depression through World Health Organization Self-reporting questionnaire (SRQ-20). A score of 8 or above on SRQ-20 was used as cut-off to label the participant as depressed. Data was analyzed using SPSS version22.

Results
A 43% prevalence of anxiety/depression among frontline physicians of Pakistan was reported. Almost all the doctors had moderate to high knowledge score. Majority of participants marked N-95 mask as “essential” during aerosol generating procedures, assessing patients with respiratory symptoms, in COVID patient-care area, ER triage and direct care of COVID-19 patient. Only 12% of the doctors were fully satisfied with the provision of PPEs and almost 94% felt unprotected.
In multivariable model, assessing more than five COVID suspects/day (aOR = 2.73, 95% CI: 1.65–4.52), working 20 h/week or less (aOR = 2.11, 1.27–3.49), having children among household members (aOR = 1.58, 95% CI: 1.00–2.50) and moderate to low knowledge of the infection (aOR = 2.69, 95% CI: 1.68–4.31) were found to be independent predictors of anxiety/depression among physicians.

Conclusion
Anxiety/depression among more than a third of frontline doctors of Pakistan warrants the need to address mental health of doctors caring for patients during this pandemic; control modifiable factors associated with it and explore the effectiveness of interventions to promote psychological well-being of physicians.
The segment IV approach: a useful method for achieving the critical view of safety during laparoscopic cholecystectomy in patients with anomalous bile duct
Authors: Fujioka Shuichi , Nakashima Keigo , Kitamura Hiroaki , Takano Yuki , Misawa Takeyuki , Kumagai Yu , Hata Taigo , Akiba Tadashi , Ikegami Toru , Yanaga Katsuhiko 
Published: September 2020

Abstract
Background
The critical view of safety (CVS) method can be achieved by avoiding vasculo-biliary injury resulting from misidentification during laparoscopic cholecystectomy (LC). Although achieving the CVS has become popular worldwide, there is no established standardized technique to achieve the CVS in patients with an anomalous bile duct (ABD). We recently reported our original approach for securing the CVS using a new landmark, the diagonal line of the segment IV of the liver (D-line). The D-line is an imaginary line that lies on the right border of the hilar plate. The cystic structure can be securely isolated along the D-line without any misidentification, regardless of the existence of an ABD. We named this approach the segment IV approach in LC.

Methods
In this study, we adopted the segment IV approach in patients with an ABD.

Results
From October 2015 to June 2020, 209 patients underwent LC using the segment IV approach. Among them, three (1.4%) were preoperatively diagnosed with an ABD. The branching point of the cystic duct was the posterior sectional duct, anterior sectional duct, or left hepatic duct in each patient. The CVS was achieved in all cases without any complications.

Conclusion
It is a promising technique, especially even for patients with an ABD during LC.
Development and validation of a person-centered abortion scale: the experiences of care in private facilities in Kenya
Authors: Sudhinaraset May , Landrian Amanda , Afulani Patience A. , Phillips Beth , Diamond-Smith Nadia , Cotter Sun 
Published: September 2020

Abstract
Background
There is a need for a standardized way to measure person-centered care for abortion. This study developed and validated a measure of person-centered abortion care.

Methods
Items for person-centered abortion care were developed from literature reviews, expert review, and cognitive interviews, and administered with 371 women who received a safe abortion service from private health clinics in Nairobi, Kenya. Exploratory factor analyses were performed and stratified by surgical abortion procedures and medication abortion. Bivariate linear regressions assessed for criterion validity.

Results
We developed a 24-item unifying scale for person-centered abortion care including two sub-scales. The two sub-scales identified were: 1) Respectful and Supportive Care (14 items for medication abortion, 15 items for surgical abortion); and 2) Communication and Autonomy (9 items for both medication and surgical abortion). The person-centered abortion care scale had high content, construct, criterion validity, and reliability.

Conclusions
This validated scale will facilitate measurement and further research to better understand women’s experiences during abortion care and to improve the quality of women’s overall reproductive health experiences to improve health outcomes.
Leading dietary determinants identified using machine learning techniques and a healthy diet score for changes in cardiometabolic risk factors in children: a longitudinal analysis
Authors: Shang Xianwen , Li Yanping , Xu Haiquan , Zhang Qian , Liu Ailing , Du Songming , Guo Hongwei , Ma Guansheng 
Published: September 2020

AbstractBackgroundIdentifying leading dietary determinants for cardiometabolic risk (CMR) factors is urgent for prioritizing interventions in children. We aimed to identify leading dietary determinants for the change in CMR and create a healthy diet score (HDS) to predict CMR in children.MethodsWe included 5676 children aged 6–13 years in the final analysis with physical examinations, blood tests, and diets assessed at baseline and one year later. CMR score (CMRS) was computed by summing Z-scores of waist circumference, an average of systolic and diastolic blood pressure (SBP and DBP), fasting glucose, high-density lipoprotein cholesterol (HDL-C, multiplying by − 1), and triglycerides. Machine learning was used to identify leading dietary determinants for CMR and an HDS was then computed.ResultsThe nine leading predictors for CMRS were refined grains, seafood, fried foods, sugar-sweetened beverages, wheat, red meat other than pork, rice, fungi and algae, and roots and tubers with the contribution ranging from 3.9 to 19.6% of the total variance. Diets high in seafood, rice, and red meat other than pork but low in other six food groups were associated with a favorable change in CMRS. The HDS was computed based on these nine dietary factors. Children with HDS ≥8 had a higher decrease in CMRS (β (95% CI): − 1.02 (− 1.31, − 0.73)), BMI (− 0.08 (− 0.16, − 0.00)), SBP (− 0.46 (− 0.58, − 0.34)), DBP (− 0.46 (− 0.58, − 0.34)), mean arterial pressure (− 0.50 (− 0.62, − 0.38)), fasting glucose (− 0.22 (− 0.32, − 0.11)), insulin (− 0.52 (− 0.71, − 0.32)), and HOMA-IR (− 0.55 (− 0.73, − 0.36)) compared to those with HDS ≦3. Improved HDS during follow-up was associated with favorable changes in CMRS, BMI, percent body fat, SBP, DBP, mean arterial pressure, HDL-C, fasting glucose, insulin, and HOMA-IR.ConclusionDiets high in seafood, rice, and red meat other than pork and low in refined grains, fried foods, sugar-sweetened beverages, and wheat are leading healthy dietary factors for metabolic health in children. HDS is strongly predictive of CMR factors.
Associations of foot and ankle characteristics with knee symptoms and function in individuals with patellofemoral osteoarthritis
Authors: Tan Jade M. , Crossley Kay M. , Munteanu Shannon E. , Collins Natalie J. , Hart Harvi F. , Donnar Joel W. , Cleary Gearoid , O'Sullivan Isobel C. , Maclachlan Liam R. , Derham Catherine L. , Menz Hylton B. 
Published: September 2020

AbstractBackgroundFoot and ankle characteristics are associated with patellofemoral pain (PFP) and may also relate to patellofemoral osteoarthritis (PFOA). A greater understanding of these characteristics and PFOA, could help to identify effective targeted treatments.ObjectivesTo determine whether foot and ankle characteristics are associated with knee symptoms and function in individuals with PFOA.MethodsFor this cross‐sectional study we measured weightbearing ankle dorsiflexion range of motion, foot posture (via the Foot Posture Index [FPI]), and midfoot mobility (via the Foot Measurement Platform), and obtained patient‐reported outcomes for knee symptoms and function (100 mm visual analogue scales, Anterior Knee Pain Scale [AKPS], Knee injury and Osteoarthritis Outcome Score, repeated single step‐ups and double‐leg sit‐to‐stand to knee pain onset). Pearson's r with significance set at p < 0.05 was used to determine the association between foot and ankle charateristics, with knee symptoms and function, adjusting for age.Results188 participants (126 [67%] women, mean [SD] age of 59.9 [7.1] years, BMI 29.3 [5.6] kg/m2) with symptomatic PFOA were included in this study. Lower weightbearing ankle dorsiflexion range of motion had a small significant association with higher average knee pain (partial r = − 0.272, p < 0.001) and maximum knee pain during stair ambulation (partial r = − 0.164, p = 0.028), and lower scores on the AKPS (indicative of greater disability; partial r = 0.151, p = 0.042). Higher FPI scores (indicating a more pronated foot posture) and greater midfoot mobility (foot mobility magnitude) were significantly associated with fewer repeated single step‐ups (partial r = − 0.181, p = 0.023 and partial r = − 0.197, p = 0.009, respectively) and double‐leg sit‐to‐stands (partial r = − 0.202, p = 0.022 and partial r = − 0.169, p = 0.045, respectively) to knee pain onset, although the magnitude of these relationships was small. The amount of variance in knee pain and disability explained by the foot and ankle characteristics was small (R2‐squared 2 to 8%).ConclusionsLower weightbearing ankle dorsiflexion range of motion, a more pronated foot posture, and greater midfoot mobility demonstrated small associations with worse knee pain and greater disability in individuals with PFOA. Given the small magnitude of these relationships, it is unlikely that interventions aimed solely at addressing foot and ankle mobility will have substantial effects on knee symptoms and function in this population.Trial registrationThe RCT was prospectively registered on 15 March 2017 with the Australia and New Zealand Clinical Trials Registry (ANZCTRN12617000385347).
Practical strategies to reduce nosocomial transmission to healthcare professionals providing respiratory care to patients with COVID-19
Authors: Kaur Ramandeep , Weiss Tyler T. , Perez Andrew , Fink James B. , Chen Rongchang , Luo Fengming , Liang Zongan , Mirza Sara , Li Jie 
Published: September 2020

AbstractCoronavirus disease (COVID-19) is an emerging viral infection that is rapidly spreading across the globe. SARS-CoV-2 belongs to the same coronavirus class that caused respiratory illnesses such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). During the SARS and MERS outbreaks, many frontline healthcare workers were infected when performing high-risk aerosol-generating medical procedures as well as when providing basic patient care. Similarly, COVID-19 disease has been reported to infect healthcare workers at a rate of ~ 3% of cases treated in the USA. In this review, we conducted an extensive literature search to develop practical strategies that can be implemented when providing respiratory treatments to COVID-19 patients, with the aim to help prevent nosocomial transmission to the frontline workers.
A ureteral single-J stent in the right atrium: a case report
Authors: Arts Laure , Willems Sofie , Michielsen Dirk 
Published: September 2020

Abstract
Background
J stents are commonly used to support the continuity of the urinary tract. Although intravascular, and more specific intracardiac, migrations have been described, they remain infrequent and unrecognized.

Case report
We report the case of a 57-year-old Caucasian woman with an intracardial migration of a single-J stent after pelvic exenteration. The intracardiac presence of single-J stent was probably due to a perioperative misplacement of the stent in the left ovarian vein. Retrieval was done under fluoroscopic control without any adverse events.

Conclusions
Intravascular migration of urological stents is uncommon but can cause serious morbidities and even mortality. Perioperative precautions must be taken to avoid this problem. In case of migration, early diagnosis and management are primordial and involve a multidisciplinary approach.
Phylogenomic analysis of Mycoplasma bovis from Belgian veal, dairy and beef herds
Authors: Bokma Jade , Vereecke Nick , De Bleecker Koen , Callens Jozefien , Ribbens Stefaan , Nauwynck Hans , Haesebrouck Freddy , Theuns Sebastiaan , Boyen Filip , Pardon Bart 
Published: September 2020

AbstractM. bovis is one of the leading causes of respiratory disease and antimicrobial use in cattle. The pathogen is widespread in different cattle industries worldwide, but highest prevalence is found in the veal industry. Knowledge on M. bovis strain distribution over the dairy, beef and veal industries is crucial for the design of effective control and prevention programs, but currently undocumented. Therefore, the present study evaluated the molecular epidemiology and genetic relatedness of M. bovis isolates obtained from Belgian beef, dairy and veal farms, and how these relate to M. bovis strains obtained worldwide. Full genomes of one hundred Belgian M. bovis isolates collected over a 5-year period (2014–2019), obtained from 27 dairy, 38 beef and 29 veal farms, were sequenced by long-read nanopore sequencing. Consensus sequences were used to generate a phylogenetic tree in order to associate genetic clusters with cattle sector, geographical area and year of isolation. The phylogenetic analysis of the Belgian M. bovis isolates resulted in 5 major clusters and 1 outlier. No sector-specific M. bovis clustering was identified. On a world scale, Belgian isolates clustered with Israeli, European and American strains. Different M. bovis clusters circulated for at least 1.5 consecutive years throughout the country, affecting all observed industries. Therefore, the high prevalence in the veal industry is more likely the consequence of frequent purchase from the dairy and beef industry, than that a reservoir of veal specific strains on farm would exist. These results emphasize the importance of biosecurity in M. bovis control and prevention.
Vascular NRP2 triggers PNET angiogenesis by activating the SSH1-cofilin axis
Authors: Luo Xi , He Jiang-yi , Xu Jie , Hu Shao-yi , Mo Bang-hui , Shu Qiu-xia , Chen Can , Gong Yu-zhu , Zhao Xiao-long , Xie Gan-feng , Yu Song-tao 
Published: September 2020

Abstract
Background
Angiogenesis is a critical step in the growth of pancreatic neuroendocrine tumors (PNETs) and may be a selective target for PNET therapy. However, PNETs are robustly resistant to current anti-angiogenic therapies that primarily target the VEGFR pathway. Thus, the mechanism of PNET angiogenesis urgently needs to be clarified.

Methods
Dataset analysis was used to identify angiogenesis-related genes in PNETs. Immunohistochemistry was performed to determine the relationship among Neuropilin 2 (NRP2), VEGFR2 and CD31. Cell proliferation, wound-healing and tube formation assays were performed to clarify the function of NRP2 in angiogenesis. The mechanism involved in NRP2-induced angiogenesis was detected by constructing plasmids with mutant variants and performing Western blot, and immunofluorescence assays. A mouse model was used to evaluate the effect of the NRP2 antibody in vivo, and clinical data were collected from patient records to verify the association between NRP2 and patient prognosis.

Results
NRP2, a VEGFR2 co-receptor, was positively correlated with vascularity but not with VEGFR2 in PNET tissues. NRP2 promoted the migration of human umbilical vein endothelial cells (HUVECs) cultured in the presence of conditioned medium PNET cells via a VEGF/VEGFR2-independent pathway. Moreover, NRP2 induced F-actin polymerization by activating the actin-binding protein cofilin. Cofilin phosphatase slingshot-1 (SSH1) was highly expressed in NRP2-activating cofilin, and silencing SSH1 ameliorated NRP2-activated HUVEC migration and F-actin polymerization. Furthermore, blocking NRP2 in vivo suppressed PNET angiogenesis and tumor growth. Finally, elevated NRP2 expression was associated with poor prognosis in PNET patients.

Conclusion
Vascular NRP2 promotes PNET angiogenesis by activating the SSH1/cofilin/actin axis. Our findings demonstrate that NRP2 is an important regulator of angiogenesis and a potential therapeutic target of anti-angiogenesis therapy for PNET.
Deep learning scheme for character prediction with position-free touch screen-based Braille input method
Authors: Shokat Sana , Riaz Rabia , Rizvi Sanam Shahla , Abbasi Abdul Majid , Abbasi Adeel Ahmed , Kwon Se Jin 
Published: September 2020

AbstractSmart devices are effective in helping people with impairments, overcome their disabilities, and improve their living standards. Braille is a popular method used for communication by visually impaired people. Touch screen smart devices can be used to take Braille input and instantaneously convert it into a natural language. Most of these schemes require location-specific input that is difficult for visually impaired users. In this study, a position-free accessible touchscreen-based Braille input algorithm is designed and implemented for visually impaired people. It aims to place the least burden on the user, who is only required to tap those dots that are needed for a specific character. The user has input English Braille Grade 1 data (a–z) using a newly designed application. A total dataset comprised of 1258 images was collected. The classification was performed using deep learning techniques, out of which 70%–30% was used for training and validation purposes. The proposed method was thoroughly evaluated on a dataset collected from visually impaired people using Deep Learning (DL) techniques. The results obtained from deep learning techniques are compared with classical machine learning techniques like Naïve Bayes (NB), Decision Trees (DT), SVM, and KNN. We divided the multi-class into two categories, i.e., Category-A (a–m) and Category-B (n–z). The performance was evaluated using Sensitivity, Specificity, Positive Predicted Value (PPV), Negative Predicted Value (NPV), False Positive Rate (FPV), Total Accuracy (TA), and Area under the Curve (AUC). GoogLeNet Model, followed by the Sequential model, SVM, DT, KNN, and NB achieved the highest performance. The results prove that the proposed Braille input method for touch screen devices is more effective and that the deep learning method can predict the user's input with high accuracy.
Lightweight image classifier using dilated and depthwise separable convolutions
Authors: Sun Wei , Zhang Xiaorui , He Xiaozheng 
Published: September 2020

AbstractThe image classification based on cloud computing suffers from difficult deployment as the network depth and data volume increase. Due to the depth of the model and the convolution process of each layer will produce a great amount of calculation, the GPU and storage performance of the device are extremely demanding, and the GPU and storage devices equipped on the embedded and mobile terminals cannot support large models. So it is necessary to compress the model so that the model can be deployed on these devices. Meanwhile, traditional compression based methods often miss many global features during the compression process, resulting in low classification accuracy. To solve the problem, this paper proposes a lightweight neural network model based on dilated convolution and depthwise separable convolution with twenty-nine layers for image classification. The proposed model employs the dilated convolution to expand the receptive field during the convolution process while maintaining the number of convolution parameters, which can extract more high-level global semantic features to improve the classification accuracy. Also, the depthwise separable convolution is applied to reduce the network parameters and computational complexity in convolution operations, which reduces the size of the network. The proposed model introduces three hyperparameters: width multiplier, image resolution, and dilated rate, to compress the network on the premise of ensuring accuracy. The experimental results show that compared with GoogleNet, the network proposed in this paper improves the classification accuracy by nearly 1%, and the number of parameters is reduced by 3.7 million.