bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can a penalized-likelihood estimation algorithm be used to reduce the injected dose or the acquisition time in&nbsp;68Ga-DOTATATE PET/CT studies?
Authors: Chicheportiche Alexandre , Goshen Elinor , Godefroy Jeremy , Grozinsky-Glasberg Simona , Oleinikov Kira , Meirovitz Amichay , Gross David J. , Ben-Haim Simona 
Published: December 2020

Abstract
Background: Image quality and quantitative accuracy of Positron Emission Tomography (PET) depend on several factors such as uptake time, scanner characteristics and image reconstruction methods. Ordered subset expectation maximization (OSEM) is considered the gold standard for image reconstruction. Penalized-likelihood estimation (PL) algorithms have been recently developed for PET reconstruction to improve quantitation accuracy while maintaining or even improving image quality. In PL algorithms a regularization parameter β controls the penalization of relative differences between neighboring pixels and determines image characteristics. In the present study, we aim to compare the performance of Q.Clear (PL algorithm, GE Healthcare) and OSEM (3 iterations, 8 subsets, 6 mm post-processing filter) for 68Ga-DOTATATE (68Ga-DOTA) PET studies, both visually and quantitatively.Thirty consecutive whole-body 68Ga-DOTA studies were included. The data were acquired in list mode and were reconstructed using 3D OSEM and Q.Clear with various values of β, and various acquisition times per bed position (bp), thus generating images with reduced injected dose (1.5 min/bp: β=300-1100; 1.0 min/bp: β=600-1400 and 0.5 min/bp: β=800-2200). An additional analysis adding β values up to 1500, 1700 and 3000 for 1.5, 1.0 and 0.5 min/bp, respectively, was performed for a random sample of 8 studies. Evaluation was performed using a phantom and clinical data. Two experienced nuclear medicine physicians blinded to the variables assessed the image quality visually.Results: Clinical images reconstructed with Q.Clear, set at 1.5, 1.0 min/bp and 0.5 min/bp using β = 1100, 1300, 3000 respectively, resulted in images with noise equivalence to 3D OSEM (1.5 min/bp) with a mean increase in SUVmax of 14%, 13% and 4%, an increase in SNR of 30%, 24% and 10%, and in SBR of 13%, 13% and 2%, respectively. Visual assessment yielded similar results for β values of 1300-1500 and 1500-1700 for 1.5 and 1.0 min/bp, respectively although for 0.5 min/bp there was no significant improvement compared to OSEM.Conclusion: 68Ga-DOTA reconstructions with Q.Clear, 1.5 and 1.0 min/bp resulted in increased tumor SUVmax and in improved SNR and SBR at a similar level of noise compared to 3D OSEM. Q.Clear with β =1500-1700 enables one-third reduction of acquisition time or injected dose, with similar image quality compared to 3D OSEM.
Is achieving 7,000 steps/day cross-sectionally and prospectively associated with older adults’ lower-extremity performance?
Authors: Hsueh Ming-Chun , Lin Chien-Yu , Lai Ting-Fu , Yu Yi Chien , Chang Shao-Hsi , Bae Ju Yong , Liao Yung 
Published: December 2020

Abstract
Background: Evidence regarding the association between daily steps recommendation and older adults’ lower limb strength is lacking; thus, this study investigated whether taking at least 7,000 steps/day is cross-sectionally and prospectively related to lower-extremity performance in older Taiwanese adults. Methods: There were 89 community-dwelling adults aged over 60 years (mean age: 69.5 years) attending both baseline and follow-up surveys. This study used adjusted logistic regression analysis to explore cross-sectional and prospective relationships between their accelerometer-assessed daily steps and lower-extremity performance (five-times-sit-to-stand test). Results: This study found the older adults who took 7,000 steps/day were more likely to have better lower-extremity performance cross-sectionally (odds ratio [OR] = 3.82; 95% confidence interval [CI]: 1.04, 13.95; p = 0.04), as well as to maintain or increase their lower-extremity performance prospectively (OR=3.53; 95% CI: 1.05, 11.84; p = 0.04). Conclusions: Our findings support a minimum recommended level of step-based physical activity for older adults, namely, 7,000 steps/day, as beneficial for maintaining or increasing older adults’ lower-extremity performance.
Trends in out of pocket payments and catastrophic health expenditure in the Kyrgyz Republic post “Manas Taalimi” and “Den Sooluk” health reforms, 2012 - 2018
Authors: Iamschikova Mariia , Mogilevskii Roman , Onah Michael N 
Published: December 2020

Abstract
Background: Over the years, the Kyrgyz Republic has implemented health reforms that target health financing with the aim of removing financial barriers to healthcare including out-of-pocket health payments (OOPPs). This study examines the trends in OOPPs and the incidence of catastrophic health expenditure (CHE) post the “Manas Taalimi” and “Den Sooluk” health reforms. Methods: We used data from the Kyrgyzstan Integrated Household Surveys (2012 – 2018). Population-weighted descriptive statistics were used to examine the trends in OOPPs and CHE at three thresholds; 10 percent of total household consumption expenditure (Cata10), 25 percent of total household consumption expenditure (Cata25) and 40 percent of total household non-food consumption expenditure (Cata40). Panel and cross-sectional logistic regression with marginal effects were used to examine the predictors of Cata10 and Cata40. Findings: Between 2012 and 2018, OOPPs increased by about US $6 and inpatient costs placed the highest cost burden on users (US $13.6), followed by self-treatment (US $10.7), and outpatient costs (US $9). Medication continues to predominantly drive inpatient, outpatient, and self-treatment OOPPs. About 0.378 to 2.084 million people (6 – 33 percent) of the population incurred catastrophic health expenditure at the three thresholds between 2012 and 2018. Residing in households headed by a widowed or single head, or residing in rural regions, increases the likelihood of incurring catastrophic health expenditure. Conclusions: The initial gains in the reduction of OOPPs and catastrophic health expenditure appear to gradually erode since costs continue to increase after an initial decline and catastrophic health expenditure continues to rise unabated. This implies that households are increasingly incurring economic hardship from seeking healthcare. Considering that this could result to forgone expenditure on essential items including food and education, efforts should target the sustainability of these health reforms to sustain the reduction of catastrophic health payments and its dire consequences.
Treatment of Volar Defects of the Finger using Dorsal Digital–metacarpal Flap Versus Free Medial Plantar Artery Flap: A Comparative Study
Authors: Liu Quanzhe , Guo Wenlai , Qu Wenrui , Ou Xiaolan , Li Rui , Tian Heng 
Published: December 2020

Abstract
Background: The treatment of defects on the volar surface of the finger has been scarcely reported, and its utility for digital resurfacing remains unclear. This study compared the outcomes of free medial plantar artery flap (MPAF) and dorsal digital–metacarpal flap (DDMF) in finger reconstruction.Methods: This retrospective cohort study included 24 patients with soft-tissue defects on the volar surface of the finger from March 2014 to March 2017. The patients were divided into two groups: the MPAF group and the DDMF group. The operation time, complications, such as flap necrosis, graft loss, infection, paresthesia, and donor-site morbidity, as well as two-point discrimination (2-PD) were carefully recorded. The Michigan Hand Outcomes Questionnaire was used for conduct follow-up assessment.Results: After more than 12 months of follow-up, the MPAF group had a longer operative time compared with DDMF group, but there was no significant difference between postoperative complications and 2-PD test result in patients without nerve injury. And in terms of overall function, Modified VSS score and 2-PD test (the patients with nerve injury), There were relatively obvious statistical differences, MPAF was superior to DDMF (p < 0.005).Conclusion: MPAF and DDMF are reliable for reconstruction of the volar surface of the finger; however, MPAF offers better functional outcomes and is associated with a lower incidence of postoperative complications.
IFI27 may predict and evaluate the severity of respiratory syncytial virus infection in preterm infants
Authors: Gao Junyan , Zhu Xueping , Wu Mingfu , Jiang Lijun , Wang Fudong , He Shan 
Published: December 2020

Abstract
Background: Preterm infants are a special population that vulnerable to respiratory syncytial virus (RSV) infection and the lower respiratory tract infections (LRTIs) caused by RSV could be severe and even life-threating. The purpose of the present study was to identify candidate genes of preterm infants who are susceptible to RSV infection and provide a new insight into the pathogenesis of RSV infection. Methods: Three datasets (GSE77087, GSE69606 and GSE41374) containing 183 blood samples of RSV infected patients and 33 blood samples of healthy controls from Gene Expression Omnibus (GEO) database were downloaded and the differentially expressed genes (DEGs) were screened out. The function and pathway enrichments were analyzed through Database for Annotation, Visualization and Integrated Discovery (DAVID) website. The protein‐protein interaction (PPI) network for DEGs was constructed through Search Tool for the Retrieval of Interacting Genes (STRING). The module analysis was performed by Cytoscape software and hub genes were identified. Clinical verification was employed to verify the expression level of top five hub genes among 72 infants including 50 RSV infected patients and 22 non-RSV-infected patients hospitalized in our center. Further, the RSV infected infants with high-expression IFI27 and those with low-expression IFI27 were compared (defined as higher or lower than the median mRNA level). Finally, the gene set enrichment analysis (GSEA) focusing on IFI27 was carried out. Results: Totally, 4028 DEGs were screened out and among which, 131 most significant DEGs were selected. Subsequently, 13 hub genes were identified and function and pathway enrichments of hub genes mainly were: response to virus, defense response to virus, regulation of viral genome replication and regulation of viral life cycle. Furthermore, IFI27 was confirmed to be the most significantly expressed in clinical verification. Gene sets associated with calcium signaling pathway, arachidonic acid metabolism, extracellular matrix receptor interaction and so on were significantly enriched when IFI27 was highly expressed. Moreover, high-expression IFI27 was associated with more severe cases (p=0.041), more requirements of mechanical ventilation (p=0.034), more frequent hospitalization (p<0.001) and longer cumulative hospital stay (p=0.012). Conclusion: IFI27 might serve to predict RSV infection and evaluate the severity of RSV infection in preterm infants.
Initial result of unselective implementation of enhanced recovery after surgery in a low-volume bariatric unit: a feasibility and safety study
Authors: Lo Hung Chieh , Chiu Wen-Kuan , Chiu Yu-Chi , Hsu An-Chih , Tai Yu-Ting 
Published: December 2020

Abstract
BackgroundThe feasibility and safety of unselectively applying an enhanced recovery after surgery (ERAS) protocol in a low-volume bariatric unit were determined. MethodsWe retrospectively reviewed all patients undergoing bariatric surgeries under a single surgeon between January 2015 and December 2018. Our ERAS protocol initiated in January 2017 with all patients enrolled unselectively. For those receiving non-primary procedures or with BMI<32.5 kg/m2 were excluded from this analysis. Demographic features and all 30-day outcome measures, including operation time, length of stay (LOS), ER visits, readmissions, reoperations were collected and compared between the ERAS (2017–2018) and control (2015-2016) groups. Results One hundred eighty-four consecutive patients underwent bariatric surgeries during the study period. Of those fulfilling the inclusion criteria, 62 (40.8%) were treated before and 90 (59.2%) were treated after ERAS implementation. No differences in baseline demographics were found between the groups except ERAS group had more Roux-en-Y gastric bypass procedures (58.9% vs. 12.9%). A markedly reduced operation time (101 min vs. 147 min; p<0.001) and shortened LOS (2.6 days vs. 3.3 days; p<0.001) were observed, with significantly more ERAS patients achieving POD1 discharge (45.6% vs. 1.6%; p<0.001). There were no significant differences in terms of ER visits (2.2% vs. 8%), readmissions (1.1% vs. 4.8%) or total complication rates between the groups (5.5% vs. 9.7%). ConclusionUnselective ERAS implementation in low-volume units is feasible and safe, with significantly reduced operation times and a shortened LOS without increased complications.
Reporting of screening and diagnostic AI rarely acknowledges ethical, legal and social implications: a mass media frame analysis
Authors: Frost Emma Kellie , Carter Stacy M 
Published: December 2020

Abstract
Background: Healthcare is a rapidly expanding area of application for Artificial Intelligence (AI). Although there is considerable excitement about its potential, there are also substantial concerns about the negative impacts of these technologies. Since screening and diagnostic AI tools now have the potential to fundamentally change the healthcare landscape, it is important to understand how these tools are being represented to the public via the media. Methods: Using a framing theory approach, we analysed how screening and diagnostic AI was represented in the media and the frequency with which media articles addressed the benefits and the ethical, legal, and social implications (ELSIs) of screening and diagnostic AI. Results: All the media articles coded (n=136) fit into one of three frames: social progress (n=132), economic development (n=59), and alternative perspectives (n=9). The vast majority of the articles were positively framed, with 135 of the articles discussing benefits of screening and diagnostic AI, and only 9 articles discussing the ethical, legal, and social implications. Conclusions: We found that media reporting of screening and diagnostic AI was overwhelmingly positive. Screening and diagnostic AI may be represented more positively in the mass media than AI in general. This represents an opportunity for health journalists to provide publics with deeper analysis of the ethical, legal and social implications of screening and diagnostic AI, and to do so now before these technologies become firmly embedded in everyday healthcare delivery.
Cloning of long sterile lemma (lsl2), a single recessive gene regulating spike germination in rice (Oryza sativa L.)
Authors: Yang Dewei , He Niqing , Zheng Xianghua , Zhen Yanmei , Xie Zhenxin , Cheng Chaoping , Huang Fenghuang 
Published: December 2020

Abstract
Background: Rice is a typical monocotyledonous plant and an important cereal crop. The structural units of rice flowers are spikelets and florets, and floral organ development and spike germination affect rice reproduction and yield.Results: In this study, we identified a novel long sterile lemma (lsl2) mutant from an EMS population. First, we mapped the lsl2 gene between the markers Indel7-22 and Indel7-27, which encompasses a 25-kb region. The rice genome annotation indicated the presence of four candidate genes in this region. Through gene prediction and cDNA sequencing, we confirmed that the target gene in the lsl2 mutant is allelic to LONG STERILE LEMMA1 (G1)/ELONGATED EMPTY GLUME (ELE), hereafter referred to as lsl2. Further analysis of the lsl2 and LSL2 proteins showed a one-amino-acid change, namely, the mutation of serine (Ser) 79 to proline (Pro) in lsl2 compared with LSL2, and this mutation might change the function of the protein. Knockout experiments showed that the lsl2 gene is responsible for the long sterile lemma phenotype. The lsl2 gene might reduce the damage induced by spike germination by decreasing the seed germination rate, but other agronomic traits of rice were not changed in the lsl2 mutant. Taken together, our results demonstrate that the lsl2 gene will have specific application prospects in future rice breeding.Conclusions: The lsl2 gene is responsible for the long sterile lemma phenotype and might reduce the damage induced by spike germination by decreasing the seed germination rate.
A qualitative inquiry of access to and quality of primary healthcare in seven communities in East and West Africa (SevenCEWA): perspectives of stakeholders, healthcare providers and users
Authors: Ameh Soter , Akeem Bolarinwa Oladimeji , Ochimana Caleb , Oluwasanu Abayomi Olabayo , Mohamed Shukri F , Okello Samson , Muhihi Alfa , Danaei Goodarz 
Published: December 2020

Abstract
Background: Universal health coverage is one of the Sustainable Development Goal targets known to improve population health and reduce financial burden. There is little qualitative data on access to and quality of primary healthcare in East and West Africa. The aim of this study was to describe the viewpoints of healthcare users, healthcare providers and other stakeholders on health-seeking behaviour, access to and quality of healthcare in seven communities in East and West Africa.Methods: A qualitative study was conducted in four communities in Nigeria and one community each in Kenya, Uganda and Tanzania in 2018. Purposive sampling was used to recruit: 155 respondents (mostly healthcare users) for 24 focus group discussions, 25 healthcare users, healthcare providers and stakeholders for in-depth interviews and 11 healthcare providers and stakeholders for key informant interviews. The conceptual framework in this study combined elements of the Health Belief Model, Health Care Utilisation Model, four ‘As’ of access to care, and pathway model to better understand the a priori themes on access to and quality of primary healthcare as well as health-seeking behaviours of the study respondents. A content analysis of the data was done using MAXQDA 2018 qualitative software to identify these a priori themes and emerging themes.Results: Access to primary healthcare in the seven communities was limited, especially use of health insurance. Quality of care was perceived to be unacceptable in public facilities whereas cost of care was unaffordable in private facilities. Health providers and users as well as stakeholders highlighted shortage of equipment, frequent drug stock-outs and long waiting times as major issues, but had varying opinions on satisfaction with care. Use of herbal medicines and other traditional treatments delayed or deterred seeking modern healthcare in the Nigerian sites. Conclusions: There was a substantial gap in primary healthcare coverage and quality in the selected communities in rural and urban East and West Africa. Alternative models of healthcare delivery that address social and health inequities, through affordable health insurance, can be used to fill this gap and facilitate achieving universal health coverage.
Effect of groundwater forced seepage on heat transfer characteristics of borehole heat exchangers
Authors: Ma Jiuchen , Jiang Qian , Zhang Qiuli , Xie Yacheng , Wang Yahui , Yi Feiyu 
Published: December 2020

Abstract
A borehole heat exchangers (BHEs) combined with pumping-injection well is established in areas where groundwater is shallow but the seepage velocity is weak, which sets up pumping and injection wells on both sides of the BHEs. According to the three-dimensional unsteady state heat transfer model in aquifer, we derive the convection-dispersion analytical solution of excess temperature in aquifer that considers groundwater forced seepage and thermal dispersion effects in aquifer and the axial effect of the BHEs. Then, we use dimensional analysis method and similarity criteria to build a controllable forced seepage sandbox. The theoretical analysis is combined with the indoor experiment test to verify the correctness and accuracy of the numerical simulation software FEFLOW7.1. On this basis, we perform the numerical simulation calculation to explore the effects of different pumping-injection flow volume on the Darcy flow velocity of the aquifer where the BHEs are located, the average heat transfer efficiency and the heat transfer rates per unit borehole depth of the BHEs. The results show that when the pumping flow volume is increased from 200 m3∙d-1 to 1200 m3∙d-1, the Darcy velocity correspondingly increases to about 10 times the previous velocity. The average heat efficiency coefficient of the BHEs increases by 11.5% in cooling stage, and by 7.5% in heating stage. When the pumping-injection flow volume is 400~600 m3∙d-1, the increment of heat transfer rates per unit borehole depth of the BHEs reaches 12.8~17.9 W∙m-1 and 3.6~4.2 W∙m-1 during the cooling stage and heating stage respectively, and then decreases as the flow volume increases gradually.
WITHDRAWN: Relevance of glomerular C4d deposition in pediatric patients with Henoch-Schönlein Purpura compared to IgA nephritis
Authors: Benz Kerstin , Ferrazzi Fulvia , Galiano Matthias , Sauerstein Katja , Vonbrunn Eva , Daniel Christoph , Büttner-Herold Maike , Amann Kerstin 
Published: December 2020

Abstract
Background
IgA nephropathy (IgAN) is the most common primary glomerulonephritis (GN) in western countries and Henoch-Schönlein purpura nephritis (HSPN) is the most common form of vasculitis in childhood. Renal biopsy findings in both nephropathies are often similar and are characterized by mesangioproliferative GN with mesangial or mesangiocapillary IgA and C3c deposits. Aim of this study was to investigate the significances of glomerular C4d-deposition as discriminating factor between pediatric HSPN and IgAN
Methods
We retrospectively analysed patient records and renal biopsies from 53 pediatric patients from one single center with a median age of 10.5 years [range 2.3–18 years]. Twenty-two patients suffered from IgAN and 31 from HSPN. Work-up of all renal biopsies was performed using standard protocols including immunohistochemistry for C4d.
Results
Pediatric IgAN patients were older, presented more often with gross hematuria, lower rates of proteinuria and less endocapillary hypercellularity on histology compared to HSPN patients. However, the rate of glomerular C4d-positivity was not different between IgAN (36%) and HSPN (42%). Comparing all cases with positive versus negative glomerular C4d-staining, pediatric patients with glomerular C4d-positivity showed lesser gross hematuria, but slightly more proteinuria, hypertension, higher rates of immunosuppressive treatment and renal insufficiency at last follow-up compared to C4d-negative patients.
Conclusions
In conclusion, glomerular C4d does not differ between pediatric HSPN and IgAN as the rate of C4d-positivity was comparable in our study. However, in individual cases of pediatric IgAN and most importantly HSPN glomerular C4d-positivity may indicate a more severe course of the disease and might thus be helpful for therapeutic decisions.