bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Value of Ultrasound Diagnosed Axillary Lymph Node in Avoiding Axillary Surgery in Early Breast Cancer Patients
Authors: Liu Na , Yang Liu , Wang Xinle , Wang Meiqi , Li Ruoyang , Song Zhenchuan 
Published: October 2020

Abstract
Background: Axillary lymph node dissection can be avoided in early stage breast cancer patients with negative sentinel lymph node biopsy. However, the possibility of avoiding axillary surgery in patients without axillary lymph node metastasis (ALNM) by preoperative imaging is still under exploration. Thus, the objectives of this study were to investigate the high-risk factors of false negative of ALNM diagnosed by preoperative ultrasound (US) and to find out who could be avoided axillary surgery in the US negative ALNM patients.Methods: This study retrospectively analyzed 3,361 patients with primary early breast cancer diagnosed in the Breast Center of the Fourth Hospital of Hebei Medical University from January 2010 to December 2012. All patients had undergone routine preoperative US and then axillary lymph node dissected. This study investigated the clinicopathological features of axillary lymph node (ALN) negative patients diagnosed by preoperative US and its correlation with prognosis. The follow-up data for disease-free survival (DFS) and overall survival (OS) were obtained from 2,357 patients. Results: The sensitivity, specificity and accuracy of axillary US in this cohort were 66.24%, 76.62% and 73.87%. The proportion of patients in the false negative group was higher than that in true negative in the group of age < 50 years old (P = 0.002), tumor size > 2cm (P = 0.008), estrogen receptor (ER) positive (P = 0.005), progesterone receptor (PR) high expression (P = 0.007), nuclear-associated antigen Ki-67 (Ki-67) >20% (P = 0.030), visible vascular tumor thrombus (P < 0.001) and histological grade>2 (P < 0.001). Prognostic analysis of false negative and true negative ultrasonographic diagnosis of ALN metastasis: when ALNM was not found by preoperative ultrasound, there was no significant difference in patients with ALNM≤3 compared with patients without lymph node metastasis in patients of age ≥ 50 years old, tumor size ≤ 2cm, Ki-67 ≤ 20%, or histological grade ≤ 2. Conclusion: The surgery of ALN may be avoided for the preoperative US diagnosed ALNs negative in early breast cancer patients who had advanced age, small tumor size, low expression of Ki-67 and low histological grade.
Clinical Characteristics and Prognosis of Ovarian Clear Cell Carcinoma: A 10-Year Retrospective Study
Authors: Zhu Chenchen , Zhu Jing , Qian Lili , Liu Hanyuan , Shen Zhen , Wu Dabao , Zhao Weidong , Xiao Weihua , Zhou Ying 
Published: October 2020

Abstract
Background
Ovarian clear cell carcinoma (OCCC) is a special pathological type of epithelial ovarian carcinoma (EOC), we conducted this research in order to investigate the clinical characteristics and outcomes of OCCC and to provide additional supporting evidence to aid in the clinical diagnosis and management.
Methods
This was a retrospective study investigating the clinical characteristics and survival outcomes of 87 patients with OCCC treated at our center between January 2010 and March 2020. Survival analysis was also performed on 179 patients with OCCC obtained from the Surveillance, Epidemiology and End Results (SEER) cancer registry database.
Results
The median age of participants was 49.28 ± 9.8 years old, with 74.71% diagnosed at early stage. Median CA125 level was 607.26 IU/mL, with 23.94% having normal CA125 levels. 16 patients (18.39%) had co-existing endometriosis and 8 patients (9.2%) developed venous thromboembolism (VTE). There were 5 patients received suboptimal cytoreduction. 67 patients (77.01%) underwent lymphadenectomy, and only 3 (4.48%) were found to have positive lymph nodes. Patients diagnosed at an early stage had higher 3-year overall survival (OS) and progression-free survival (PFS) rates than those with advanced stage OCCC. CA199 (P = 0.025) and ascites (P = 0.001) were significantly associated with OS, while HE4 (P = 0.027) and ascites (P = 0.001) were significantly associated with PFS. Analysis of data from the SEER database showed that positive lymph nodes is also an independent prognostic factor for OS (P = 0.001).
Conclusions
OCCC often presents at an early stage and young age with a mildly elevated CA125. CA199, HE4, massive ascites and positive lymph node are independent prognostic factors.
Caring for Sexual and Gender Minority Patients: What Factors Explain Self-Reported Competence among Health Care Professional Students?
Authors: Pratt-Chapman Mandi L. , Potter Jennifer 
Published: October 2020

Abstract
Background: Lesbian, gay, bisexual, transgender, queer and intersex people comprise approximately 5% of the U.S. population, yet health care professional student education on sexual and gender minority (SGM) health is sparse. This study explored the degree to which sociodemographic factors and student affiliation with SGM people explained self-reported competence in caring for SGM patients. Methods: Multiple linear regression was used to test the value of an eight-variable exploratory (Full Model) for each of five criterion variables. Independent variables that explained a meaningful amount (≥0.15) of total variance were retained in Reduced Models for parsimony. The criterion variables were: Basic Knowledge, Attitudinal Awareness and Clinical Preparedness (subscales of the Lesbian, Gay, Bisexual, Transgender Development of Clinical Skills Scale); and Beliefs and Behaviors (subscales of the Gay Affirming Practice Scale). Results: Political affiliation, religiosity, and SGM affiliation were predictor variables in half of the Reduced Models. SGM-specific health training hours were included in Reduced Models for Clinical Preparedness and affirming Behaviors. Conclusion: Sociodemographic factors, lived experiences, and amount of training in SGM-specific health matter when it comes to health care professional students’ sense of preparedness in caring for SGM patients.
Trait Mindfulness and College Student Interpersonal Sensitivity: The Mediating Role of Negative Emotions and the Moderating Role of Effectiveness/Authenticity
Authors: Ding Xiaoqian , Zhao Tian , Li Xiaoxi , Yang Zirong , Tang Yi-Yuan 
Published: October 2020

Abstract
Background: College student interpersonal sensitivity has received increased attention in recent years, and trait mindfulness has been found to be a protective factor in interpersonal relationships. However, little is known about the mediating and moderating mechanisms underlying this relation. The aim of this study was to investigate (a) the mediating role of negative emotions in the association between trait mindfulness and interpersonal sensitivity, and (b) the moderating role of the effectiveness/authenticity in the indirect relationship between trait mindfulness and college student interpersonal sensitivity. Methods: This model was examined with 1419 Chinese college students (mean age=18.38 years, SD= 0.86); the participants completed measurements regarding trait mindfulness, negative emotions, the effectiveness/authenticity, and interpersonal sensitivity. Results: The correlation analyses indicated that trait mindfulness was significantly negatively associated with college student interpersonal sensitivity, and the effectiveness/authenticity was significantly negatively associated with college student interpersonal sensitivity. Mediation analyses revealed that negative emotions partially mediated the link between trait mindfulness and interpersonal sensitivity. Moderated mediation further indicated that the relationship between trait mindfulness and negative emotions was more significant for college students with high level of effectiveness/authenticity; the relationship between negative emotions and interpersonal sensitivity was more significant for college students with low level of effectiveness/authenticity.Conclusion: Mindfulness training may help reduce interpersonal sensitivity in college students. When college students have strong effectiveness/authenticity, lower negative emotions may be a protective factor to prevent interpersonal sensitivity.
Sp1-activated Long Noncoding RNA NCK1-AS1&nbsp;Facilitates Cell Growth of Breast Cancer via Sponging miR-361-5p&nbsp;
Authors: Jia Hongyao , Wu Di , Zhang Zhiru , Li Sijie 
Published: October 2020

Abstract
Background: Breast cancer (BC) is one of the most lethal and malignant tumors in the world. Accumulating documents have illuminated the vital roles of long noncoding RNAs (lncRNAs) which are closely related to the progression of human cancers, including BC. LncRNA NCK1-AS1 was reported to be an oncogene in some cancers; nevertheless, its functionality is not well elucidated in BC. Methods: NCK1-AS1 expression status was detected in human breast cancer tissues and cell lines by the means of RT-qPCR. The impacts of NCK1-AS1 deficiency on breast cancer cell stemness, viability, proliferation, migration, invasion, and apoptosis were measured in vitro via sphere formation assay, western blot analysis, CCK-8, colony formation, transwell, TUNEL and flow cytometry analysis. Furthermore, luciferase reporter assay, RIP and ChIP were used to verify the mutual effects between molecules.Results: In this study, lncRNA NCK1-AS1 was verified to be elevated in BC tissues and cells. In addition, NCK1-AS1 silencing hampered BC cell growth by inhibiting cell stemness, viability, proliferation, migration and invasion as well as promoting cell apoptosis. Moreover, NCK1-AS1 functioned as a molecular sponge for miR-361-5p and modulated SP1 expression. Rescue experiments signified that SP1 overexpression restored NCK1-AS1 silencing-mediated suppression on BC cell growth. Importantly, SP1 was uncovered to bind with NCK1-AS1 promoter, suggesting a positive feedback loop of NCK1-AS1/miR-361-5p/SP1 in BC cells. Conclusion: Taken together, these findings showed for the first time that NCK1-AS1 served as a carcinogenic gene in BC cells via combining with miR-361-5p to upregulate SP1.
MiR-150-5p-modified Bone Marrow Mesenchymal Stem Cells Derived Exosomes Ameliorate Osteonecrosis of Femoral Head by Promoting Endothelial Cell Angiogenesis
Authors: Fang Shanhong , He Tianmin , Jiang Jiarun , Li Yongfeng , Huang Heling , Chen Peng 
Published: October 2020

Abstract
Background: Osteonecrosis of femoral head (ONFH) is a common ischemic disease that induces femoral head necrosis. The role of exosomes and miRNA in ONFH has been elucidated, however, whether miRNA-modified exosomes improve the therapy of ONFH is not clear.Methods: We screened ONFH-related miRNAs by RNA sequencing in plasma exosomes of ONFH patients and healthy donors. The key miRNA was overexpressed in bone marrow mesenchymal stem cells (BMSC) exosomes. The regulatory functions of miRNA-modified BMSC exosomes in vascular endothelial cells were illustrated through angiogenesis assay and scratch assay.Results: We identified 9 differently expressed miRNAs (DEmiRNAs) in plasma exosomes between ONFH and healthy groups, with 6 up-regulated and 3 down-regulated miRNAs. Function and pathway analysis revealed DEmiRNAs were primarily involved in angiogenesis, cell migration, focal adhesion. Moreover, miR-150-5p was declined in ONFH exosomes and regulated multiple angiogenesis-related pathways. The miR-150-5p-overexpressed BMSC exosomes were successfully obtained and transported miR-150-5p to endothelial cells. Moreover, the miR-150-5p-modified BMSC exosomes promoted the angiogenesis and migration of endothelial cells.Conclusion: Our results elucidate the exosomal miRNA expression profiles in ONFH, and miR-150-5p-modified BMSC exosomes protect against ONFH by promoting angiogenesis, suggesting a new molecular knowledge for the clinical application of ONFH.
Epidermal Growth Factor or Platelet Rich Plasma Combined With Induced Membrane Technique in the Treatment of Segmental Femur Defects: An Experimental Study
Authors: Bilal Ökkeş , Topak Duran , Kınaş Mustafa , Kurutaş Ergül Belge , Kızıldağ Betül , Bahar Abdulkadir Yasir 
Published: October 2020

Abstract
Objective: Extensive bone defects remain a therapeutic challenge necessitating alternative surgical approaches with better outcomes. Can increase the effectiveness of PRP or EGF treatment in surgical treatment of large bone defects with masquelet technique?Aim of this study examined potential therapeutic benefits of the Masquelet technique with induced membranes in combination with platelet rich plasma (PRP) or epidermal growth factor (EGF) in a rat model of segmental femur defect.Methods: Three groups each consisting of 20 Sprague-Dawley rats were defined as follows: EGF group, PRP group, and control group. A femoral bone defect was created and filled with antibiotic embedded polymethyl metacrylate. Half of the animals in each group were sacrificed at week 6 and the pseudo-membranes formed were analyzed. In the remaining half, the cement was removed and the space was filled with autograft. After another six weeks, the structures formed were examined radiologically, histologically and biochemically.Results: At week 6, both PRP and EGF groups had significantly higher membrane CD31, TGF and VEGF levels than controls. At week 12, when compared to controls, PRP and EGF groups had significantly higher membrane CD31 levels and PRP group had significantly higher membrane TGF levels. Regarding bone tissue levels, PRP and EGF groups had significantly higher VEGF levels and EGF group had significantly higher BMP levels. In addition, PRP and EGF groups had higher radiological scores than controls. However, the two experimental groups did not differ with respect to any parameter tested in this study. Conclusion: Both PRP and EGF seems to be associated with histological, biochemical, and radiological improvements in experimental rat model of Masquelet technique, warranting in further clinical studies.
B4C-TiB2 Composite Ceramics with Ultra-High Fracture Toughness Fabricated by Spark Plasma Sintering
Authors: Yan Xingheng , Zhou Xingui , Wang Honglei 
Published: October 2020

Abstract
B4C-TiB2 composite ceramics with ultra-high fracture toughness were successfully prepared via spark plasma sintering using B4C and 30 vol.% Ti3SiC2 as raw materials at different sintering temperatures. The results show that compared with pure B4C ceramics sintered by SPS, the flexural strength and fracture toughness are significantly improved, especially the fracture toughness has been improved by leaps and bounds. When the sintering temperature is 1900 ℃, the B4C-TiB2 composite ceramic has the best comprehensive mechanical properties: hardness, bending strength and fracture toughness are 27.28 GPa, 405.11 MPa and 18.94 MPa·m1/2, respectively. The main two reasons for the ultra-high fracture toughness are the formation of TiB2 three-dimensional network covering the whole composites, and the existence of lamellar graphite at the grain boundary.
Premenstrual Dysphoric Disorder is Associated with the Longer Length from Clitoris to Urethra
Authors: Li Zheng , Xu Meng-jiao , Jin Ying , Zhu Bing-gen 
Published: October 2020

Abstract
Background: Premenstrual dysphoric disorder (PMDD) is a common, recently recognized, psychiatric condition among reproductive women, reflecting abnormal responsivity to ovarian steroids. Moreover, the organizational effects of prenatal sex hormones during the embryonic environment that may determine individual sensitivity to fluctuation of sex hormones, have got attentions, but there have been considerably less of researches on this topic. The aim of this research was to investigate the possible role of prenatal androgen in the PMDD.Methods: Anogenital distance (AGD), the distance between a woman’s clitoris and her urethral meatus (CUMD), left and right 2D:4D ratios were measured in 77 subjects (25 patients with PMDD), as these anthropometric indicators are considered to indirectly reflect prenatal androgen exposures in utero. Results: Patients with PMDD had a longer CUMD than controls (25.03±4.73 vs 22.07 ± 4.30, P=0.008), while there were no significant difference between PMDD group and control group in the AGD and right and left 2D:4D ratios.Conclusion: Atypical high prenatal androgen exposure might predispose individuals to be susceptible to PMDD.
Adaptation of Gut Microbiotas to Transgenic Pigs Secreting β-Glucanase, Xylanase and Phytase
Authors: Mo Jianxin , Li Guoling , Huang Guangyan , Wang Haoqiang , Shi Junsong , Zhou Rong , Cai Gengyuan , Yang Huaqiang , Wu Zhenfang , Zhang Xianwei 
Published: October 2020

Abstract
BackgroundThe gut microbiotas play an important role in digestive function and feed efficiency in pigs. However, the effect of exogenous digestive enzymes on the composition and functional contributions of swine intestinal microbes is unclear. The objective of this study was to investigate the change of gut microbiotas in the transgenic pigs secreting microbial digestive enzymes in their salivary glands.MethodsEGFP marker-free transgenic (MF-TG) pigs were generated by deleted the EGFP coding genes in the transgenic pigs we previously generated. Samples of chyme from the ileum, caecum and colon of five MF-TG and five wild-type (WT) sows were collected for investigating the gut microbiomes via metagenomics analyses.ResultsThe levels of probiotics were abundant in the caecum of MF-TG pigs and higher than those of WT pigs. By contrast, the levels of some harmful microorganisms were higher in the caecum of WT pigs than those of MF-TG pigs. In addition, the microorganisms in the colon of MF-TG pigs had high fractional abundance in DNA (cytosine-5)-methyltransferase 1 and serine-type D-Ala-D-Ala carboxypeptidase, whereas the aspartate carbamoyltransferase regulatory subunit and outer membrane protein pathways were enriched in WT pigs. Moreover, the levels of numerous carbohydrases in the caecum of MF-TG pigs were higher than those of WT pigs. ConclusionsThe results indicated that intestinal microbes can change adaptively to the secretion of transgenic enzymes, thereby forming a benign cooperation with their host.
Sampling in Difficult Settings: A Simulation Study Comparing Several Sampling Methods
Authors: Shannon Harry , Emond Patrick D. , Bolker Benjamin M. , Viveros-Aguilera Román 
Published: October 2020

Abstract
Background: Taking a representative sample to determine prevalence of variables like disease is difficult when little is known about the target population. Several methods have been proposed, including a recent revision of the World Health Organization’s Extended Program on Immunization (EPI) surveys. The original method uses probability proportional to size to sample towns and a nearest neighbour approach to sampling households within towns. The new version samples from relatively small areas and conducts a probability sample of households within those areas. Other techniques sample within towns from circles around randomly identified points (‘Circles’) or from randomly sampled squares in a superimposed grid (‘Square’). We compared these sampling methods in multiple virtual populations using computer simulation.Methods: We constructed 50 virtual populations with varying characteristics. Populations comprised about a million people across 300 towns. We created three more populations with different prevalences of disease but with uniform characteristics across each population. We created a binary exposure variable and allocated disease statuses to individuals assuming different Relative Risks of exposure. We simulated thirteen methods of sampling: simple random sampling; the original EPI method and variants; the Square and Circle methods; and the new EPI method. For each population, each sampling method, and each of three sample sizes per cluster (7, 15, and 30), we simulated 1,000 samples. For most sampling methods, the clusters were towns. We conducted simulations using the same 30 clusters and using a freshly-chosen set of clusters. For each simulation we estimated prevalence and RRs and computed the Root Mean Squared Error for the 1,000 samples.Results: The Circle and Square methods produced almost identical results, so we report only the Square method results. The Root Mean Squared Error for the Square method was almost universally best relative to simple random sampling for estimating prevalence, and generally best when estimating Relative Risks. The revised EPI approach was less good, but generally better than the original EPI. Conclusions: The Square method is recommended as statistically optimal, unless practical considerations favour another approach.
Obesity Induces Different Regional Patterns of Lymph Node Involvement: Assay on 8,979 Thyroid Cancers
Authors: Li Changlin , Liang Nan , Dionigi Gianlorenzo , Guan Haixia , Sun Hui 
Published: October 2020

Abstract
Introduction Lymph node (LN) metastasis is the first station of extra-gland metastasis of thyroid cancer. LN status can influence clinical decisions and the prognosis of patients. The aim of our study was to explore the relationship between obesity and regional patterns of LN involvement in papillary thyroid carcinoma (PTC).Materials and methods This study retrospectively analyzed the data from 8,979 thyroid cancer patients. The rate of LN metastasis, the number of LN metastasis, the maximum diameter of positive LN, the number of LN dissections, and the LN ratios (LNR) were compared between normal-weight and obese patients.Results LN metastasis was more common in the obese group than normal-weight patients with PTC (52.6 vs. 42.0%, P <0.001). The number of LN metastasis and the maximum diameter of positive LNs were also higher in obese patients (2.41 vs. 1.79, P <0.001; 2.00 vs. 1.60, P =0.007, respectively). The number of lateral neck LN dissections was higher in the obese group (14.37 vs. 12.10, P <0.001), there was no significant difference in the central LNs. The LNR was higher in the central LNs of obese patients (0.18 vs. 0.14, P <0.001), yet there was no difference in the lateral LNs.Conclusions Obesity was associated with poor prognoses with PTC, which was related to the LNs. There was an inverse regional difference (central and lateral LNs) between obesity and the number of LN dissections and LNR, suggesting that caution was needed when performing central neck dissection in obese patients.
An Effective Processing Pipeline for Harmonizing DNA Methylation Data from Illumina’s 450K and EPIC Platforms for Epidemiological Studies
Authors: Vanderlinden Lauren A , Johnson Randi K , Carry Patrick M , Dong Fran , DeMeo Dawn L. , Yang Ivana V , Norris Jill M , Kechris Katerina 
Published: October 2020

Abstract
Objective: Illumina BeadChip arrays are commonly used to generate DNA methylation data for large epidemiological studies. Updates in technology over time create challenges for data harmonization within and between studies, many of which obtained data from the older 450K and newer EPIC platforms. The pre-processing pipeline for DNA methylation is not trivial, and influences the downstream analyses. Incorporating different platforms adds a new level of technical variability that has not yet been taken into account by recommended pipelines. Our study evaluated the performance of various tools on different versions of platform data harmonization at each step of pre-processing pipeline, including quality control (QC), normalization, batch effect adjustment, and genomic inflation. We illustrate our novel approach using 450K and EPIC data from the Diabetes Autoimmunity Study in the Young (DAISY) prospective cohort. Results: We found normalization and probe filtering had the biggest effect on data harmonization. Employing a meta-analysis was an effective and easily executable method for accounting for platform variability. Correcting for genomic inflation also helped with harmonization. We present guidelines for studies seeking to harmonize data from the 450K and EPIC platforms, which includes the use of technical replicates for evaluating numerous pre-processing steps, and employing a meta-analysis.