bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fixed Versus Flexible Antagonist Protocol in Women with Predicted High Ovarian Response except PCOS : A Randomized Controlled Trial
Authors: Luo Xiu , Pei Li , Li Fujie , Li Chunli , Huang Guoning , Ye Hong 
Published: October 2020

Abstract
Background: No previous study directly compares the fixed day-5 initiation versus the flexible initiation of GnRH antagonist administration in IVF/ICSI for those patients who are predicted as high ovarian responders without PCOS. To evaluate whether the number of oocytes retrieved is different by using the two GnRH antagonist protocols in Chinese women with predicted high ovarian response except PCOS.Methods: A randomized controlled trial of 201 infertile women with predicted high ovarian response except PCOS undergoing in vitro fertilization. Ovary stimulation was performed using recombinant FSH and GnRH antagonists. GnRH antagonist ganirelix (0.25 mg/d) was started either on day 5 of stimulation (fixed group) or when LH was >10 IU/L, and/or a follicle with mean diameter >12 mm was present, and/or serum E2 was >300pg/ml. Patient monitoring was initiated on day 3 of stimulation in flexible group.Result(s): No significant difference was observed between the fixed and flexible groups regarding the number of oocyte retrieved(16.72±7.25 vs. 17.47±5.88, P=0.421), the Gonadotropin treatment duration(9.53±1.07 vs. 9.67±1.03, P=0.346)and total Gonadotropin dose(1427.75±210.6 vs. 1455.94±243.44, P=0.381). GnRH antagonist treatment duration in fixed protocol was statistically longer than the flexible protocol (6.57±1.17 vs 6.04±1.03, P=0.001). There was no premature LH surge in either protocol. Conclusion(s): Fixed GnRH antagonist administration on day 5 of stimulation appear to achieve a comparable oocyte retrieved compared with flexible antagonist administration.Trial registration: NCT02635607 posted on December 16, 2015 in clinicaltrials.gov.
Plasma Matrilysins MMP-7 and MMP-26 Concentrations as Diagnostic Biomarkers for Breast Cancer Patients
Authors: Piskór Barbara Maria , Przylipiak Andrzej , Dąbrowska Emilia , Sidorkiewicz Iwona , Niczyporuk Marek , Szmitkowski Maciej , Ławicki Sławomir 
Published: October 2020

Abstract
Background: Metalloproteinases (MMPs) are a group of proteolytic enzymes involved in the maintenance of a proper structure of extracellular matrix (ECM). Matrilysins (MMP-7 and MMP-26) are the one of the group of MMPs that could represent potential breast cancer (BC) markers. The aim of the study was to evaluate plasma levels of MMP-7, MMP-26 and CA 15-3 individually and in combination and assess the a diagnostic utility of studied matrilysins in BC patients. Methods: The study group consisted of 120 patients with BC, the control group consisted of 40 patients with benign breast cancer and 40 healthy women. Concentrations of MMP-7 and MMP-26 were determined by Enzyme-Linked Immunosorbent Assay, CA 15-3 by Chemiluminescent Microparticle Immunoassay.Results: The plasma levels of MMP-7 were significantly higher in the entire BC group than in the control group. Concentrations of MMP-26 and CA 15-3 were the highest in the III and IV stage of disease. The highest diagnostic sensitivity was observed in the III and IV stage of cancer for set of all tested markers (92.5%). The highest diagnostic specificity was noted for all tested parameters in all studied BC group (95.0%). The area under the receiver operating characteristic (ROC) curve (AUC) set of markers (MMP-7+MMP-26+CA 15-3) was the largest (0.9138) in III and IV stage. Also individual marker analysis showed that MMP-7 had the highest AUC (0.8894) in advanced stages of disease. Conclusions: Data suggested that MMP-7 can be considered as additional marker improving diagnostic utility of CA 15-3 in early stages of BC patients. Therefore, combined analysis of MMP-7 and MMP-26 with CA 15-3 might be useful in detection of disease progression. Future investigation is needed to evaluate whether matrilysins might be a potential markers improving diagnosis of BC.
Low Incidence of ABL-Class And JAK-STAT Signaling Pathway Alterations In Uniformly Treated Pediatric And Adult B-Cell Acute Lymphoblastic Leukemia Patients Using MRD Risk-Directed Approach – A Population-Based Study
Authors: Norvilas Rimvydas , Dirse Vaidas , Semaskeviciene Ruta , Mickeviciute Orinta , Gineikiene Egle , Stoskus Mindaugas , Vaitkeviciene Goda , Rascon Jelena , Griskevicius Laimonas 
Published: October 2020

Abstract
Background: ABL-class and JAK-STAT signaling pathway activating alterations have been associated with both poor post-induction minimal residual disease (MRD) response and inferior outcome in B-cell acute lymphoblastic leukemia (B-ALL). However, in most of the studies patients received non-uniform treatment. Methods: We performed population-based analysis of 160 (122 pediatric and 38 adult) Lithuanian BCR-ABL1-negative B-ALL patients who had been uniformly treated according to MRD-adapted NOPHO ALL-2008 protocol. Targeted RNA sequencing and FISH analysis was performed in cases without canonical B-ALL genomic alterations (high hyperdiploids and low hypodiploids included). Results: We identified ABL-class fusions in 3 (1.9%) B-ALL patients (exclusively in adults (p=0.032)). JAK-STAT pathway fusions were present in 4 (2.5%) cases. Of note, P2RY8-CRLF2 fusion was absent in both pediatric and adult B-ALL cases. Patients with ABL-class or JAK-STAT pathway fusions had poor MRD response and were assigned to the higher risk groups, had worse event-free survival (EFS) and overall survival (OS) compared to patients without these fusions. In multivariate analysis, positivity for ABL-class and JAK-STAT fusions was a risk factor for worse EFS (p=0.043) but not for OS (p=0.278) in adults. Conclusions: We show low overall frequency of ABL-class and JAK-STAT fusions and the absence of P2RY8-CRLF2 gene fusion in the Lithuanian BCR-ABL1 negative B-ALL cohort. Poor event-free survival in ABL-class / JAK-STAT fusion-positive adult patients despite MRD-directed therapy should be confirmed in future studies.
The Safety of Early Administration of Oral Fluid Following&nbsp;General Anesthesia in Children Undergoing Tonsil Operation: A Prospective Randomized Controlled Trial
Authors: Wu Meng-Hang , Liu Chang-qing , Zeng Xiao-qi , Jia An-na , Yin Xiao-rong 
Published: October 2020

Abstract
Background: The feasibility and safety of giving a small amount of water to children in the recovery period after tonsillectomy under general anesthesia to reduce the thirst and its associated restlessness reaction remain unknown. Methods: This study was approved by our institutional ethics committee, and which adhered to CONSORT guidelines. Pediatric patients undergoing tonsil surgery who met the inclusion and exclusion criteria of our study were randomized into the experimental and control groups. In the experimental group, patients were given a small amount of water instantly after recovering from the general anesthesia, which included the recovery of cough and deglutition reflex, and attaining grade V of muscle strength. The control group was given a small amount of water 4 to 6 hours after the operation. The incidence of nausea and vomiting and the degree of thirst relief were measured and compared between the two groups. Results：300 patients were randomized into each group. There was no significant difference in the incidence of nausea and vomiting 20 minutes after drinking water between the two groups (P>0.05). The thirst score of children over 5 years old in the experimental group was significantly lower than that of the control group (P<0.05). Conclusion: The early administration of a small amount of oral fluid in children undergoing tonsil surgery and recovering from the general anesthesia is not only safe but also effective in reducing postoperative thirst. Trial registration: Current Controlled Trials ChiCTR1800020058, 12-12-2018.
Association Between Knowledge, Attitudes and Practices (KAP) Towards The COVID-19: A Cross-Sectional Study in South Korea
Authors: Lee Minjung , Kang Bee-Ah , You Myoungsoon 
Published: October 2020

Abstract
Background It is imperative for the public to routinely practice precautionary behaviors to contain transmission of COVID-19, as no vaccines and anti-viral treatments are available. This paper attempts to examine knowledge, attitudes, and practices related to COVID-19, and the relationship between them and identification of the vulnerable population.Methods The data collection took place over three days (June 26–29) through an online survey five months after the Korea Centers for Disease Control and Prevention (KCDC) confirmed the first case in South Korea; 970 subjects were included in the analysis.Results The level of knowledge, attitude and practice were examined. Knowledge directly affected both attitude (e.g., perceived risk and efficacy belief) and practice (e.g., preventive measures and social distancing). Among the influencing factors, efficacy belief turns out to be the most effective and significant factor on practice and also mediated the relationship between knowledge and all three preventive behaviors (wearing facial masks, practicing hand hygiene, and avoiding crowded places). Knowledge level varied by sociodemographic characteristics. Females (β = 0.06, p < 0.05) and individuals with higher level of education (β = 0.06, p < 0.05) had higher knowledge.Conclusion To successfully increase precautionary behaviors among the public, public health officials and policy makers must promote knowledge and efficacy belief. Also, the consequent interventions and policies should be developed and implemented in a way they reduce, rather than reinforce, health disparities, by embracing vulnerable populations to COVID-19.
Neuroendocrine Carcinoma of the Breast is More Aggressive Than Breast Invasive Ductal Carcinoma: A Propensity Score Matching Study Based on SEER&nbsp;Database
Authors: Chen Yu-Qiu , Xue Yu , Xu Xiao-Fan , Wang Xu-Lin , Huo Li-Qun , Wang Lu , Di Tian-Yu , Xu Jia-Wei , Gu Jun , Zhou Guo-hua 
Published: October 2020

Abstract
Background Neuroendocrine carcinoma (NEC) of the breast is a very rare malignant tumor whose clinic pathological features and prognosis are not well defined. The aim of this study was to compare the clinic pathological features and clinical outcome between breast neuroendocrine carcinoma and breast invasive ductal carcinoma (IDC) and to know the independent prognostic risk factors of NEC.Method Patients with breast NEC and breast IDC were identified through the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2015. Then we compared the clinic pathological features and outcome between the two cohorts. Propensity score matching (PSM) was performed to balance the effects of baseline clinic pathological differences. Potential prognostic factors of breast NEC were identified by the univariate and multivariate Cox analysis.Results In total, we identified 208 patients with breast NEC and 275,878 cases with breast IDC.Compared with IDC, NEC was significantly correlated with higher stage, larger tumor size, more distant transfers and no population of HER2 enriched subtype. There were significant differences on the choice of treatment therapy between NEC and IDC (p=0.000). More patients chose not to undergo surgery (35.1% vs. 9.0%), and fewer patients chose breast conserving surgery than IDC patients (32.2% vs. 51.1%). Compared with IDC patients, NEC patients were more likely to choose chemotherapy (p=0.039) and more conservative in radiotherapy (p=0.000). The 66-month overall survival (OS) rate in NEC and IDC was 44.5% and 80.2% before PSM and was 49.8% and 71.4% after PSM, respectively. The 66-month breast cancer specific survival (BCSS) rate in NEC and IDC was 56.3% and 88.8% before PSM and was 54.1% and 80.5% after PSM, respectively. Finally, we identified independent prognostic factors, age, stage, pathological type, distant metastasis, chemotherapy, and molecular typing. Conclusions Breast NEC has distinct clinic pathological features and a significantly worse clinical outcome than common IDC.
Retrospective Analysis of Real-World Treatment Patterns and Clinical Outcomes in Patients With Advanced Non-Small Cell Lung Cancer Starting First-Line Systemic Therapy in the United Kingdom
Authors: Lester Jason , Escriu Carles , Khan Sarah , Hudson Emma , Mansy Talal , Conn Andrew , Chan Samuel , Powell Ceri , Brock Juliet , Conibear John , Nelless Lauren , Nayar Vaneet , Zhuo Xiaohui , Durand Adeline , Amin Amerah , Martin Peter , Zhang Xinke , Pawar Vivek 
Published: October 2020

Abstract
Background: The treatment landscape for advanced non-small cell lung cancer (aNSCLC) has evolved rapidly since immuno-oncology (IO) therapies were introduced. This study used recent data to assess real-world treatment patterns and clinical outcomes in aNSCLC in the United Kingdom. Methods: Electronic prescribing records of treatment-naive patients starting first-line (1L) treatment for aNSCLC between June 2016 and March 2018 (follow-up until December 2018) in the United Kingdom were assessed retrospectively. Patient characteristics and treatment patterns were analyzed descriptively. Outcomes assessed included overall survival (OS), time to treatment discontinuation, time to next treatment, and real-world tumor response.Results: In all, 1003 patients were evaluated (median age, 68 years [range, 28-93 years]; 53.9% male). Use of 1L IO monotherapy (0%-25.9%) and targeted therapy (11.8%-15.9%) increased during the study period, but chemotherapy remained the most common 1L treatment at all time points (88.2%-58.2%). Median OS was 9.5 months (95% CI, 8.8-10.7 months) for all patients, 8.1 months (95% CI, 7.4-8.9 months) with chemotherapy, 14.0 months (95% CI, 10.7-20.6 months) with IO monotherapy, and 20.2 months (95% CI, 16.0-30.5 months) with targeted therapy. In the 28.6% of patients who received second-line treatment, IO monotherapy was the most common drug class (used in 51.6%).Conclusions: Although use of 1L IO monotherapy for aNSCLC increased in the United Kingdom during the study period, most patients received 1L chemotherapy. An OS benefit for first-line IO monotherapy vs chemotherapy was observed but was numerically smaller than that reported in clinical trials. Targeted therapy was associated with the longest OS, highlighting the need for improved treatment options for tumors lacking targetable mutations.
Morphological and Genetic Heterogeneity of Synchronous Multifocal Lung Adenocarcinoma in a Chinese Cohort
Authors: Zhu Donglin , Cao Dan , Shen Minghong , Lv Jinghuan 
Published: October 2020

Abstract
Background: Synchronous multifocal lung cancer (SMLC) is seen with increasing frequency in clinical practice globally. Because of innate variation in clinical management and outcome, it is vital to distinguish properly between synchronous multifocal primary lung cancer (SMPLC) and intrapulmonary metastasis (IM). The pathologic features and principal classification criteria of multifocal lung cancer remain unclear. Methods: We have collected a unique cohort of Chinese patients with SMLC, and fully explored the morphologic, immunohistochemical, and molecular features of the disease. Twenty-one SMLC patients with a total of 50 tumors were included in our study. The pathological features presented by these cases were analyzed, including tumor location, tumor size, pathological types, predominant pattern of adenocarcinoma, and immunohistochemical staining. We undertook molecular testing of nine driver oncogenes associated with lung cancer, including EGER, KRAS, BRAF, NRAS, ALK, ROS1, RET, HER2, and PIK3CA. Results: According to Martini-Melamed classification and refined standard, 8 and 17 cases were considered as SMPLC respectively. Gene mutations were identified in 18 tumors (36%). There were 12 patients had different gene mutations. Conclusions: We demonstrate that conventional morphological assessment is not sufficient to establish clearly the clonal relationship of SMPLC. Instead the evaluation of histological subtypes, including non-mucinous adherent components, is required. Multiplex genotypic analysis may also prove a useful additional tool.
The Complexity of Scaling Up an mHealth Intervention. SMS for Life: A Case Study from a Health Systems Integration Perspective
Authors: Fruchtman Carmen Sant , Mbuyita Selemani , Mwanyika-Sando Mary , Braun Marcel , de Savigny Don , Cobos Daniel 
Published: October 2020

Abstract
BackgroundThe objective of this study was to apply systems thinking to examine the opportunities and challenges of scaling up and integrating a new electronic health technology into a complex health system. We used the implementation cycle of the supply chain management solution (SMS for Life 1.0) in Tanzania as a case study. SMS for Life was one of the earliest large-scale implementations of mHealth innovations worldwide. It aimed to bring visibility to antimalarial stock-outs through the use of SMS technology.MethodsA qualitative case-study approach was used. This included a literature review, a document review of 61 project documents, a timeline of key events and the collection and analysis of 28 interviews with key stakeholders involved in or affected by the SMS for Life programme. Using the WHO mHealth Assessment and Planning for Scale (MAPS) Toolkit as a framework, we carried out a joint thematic analysis and identified the key reasons for the discontinuation of the programme.ResultsSMS for Life was reliable at scale and raised awareness of stock-outs with real-time monitoring. However, it was discontinued in 2015 after four years of a national rollout. The main reasons identified for the discontinuation were the programme’s failure to adapt to the continuous changes in Tanzania’s health system, the focus on stock-outs rather than ensuring appropriate stock management, and that it was perceived as costly by policy-makers.Despite its discontinuation, SMS for Life, together with co-existing technologies, triggered the development of the capacity to accommodate and integrate future technologies in the health system.ConclusionThis study shows the importance of engaging appropriate stakeholders from the outset, understanding and designing system-responsive interventions appropriately when scaling up and ensuring value to a broad range of health system actors. These shortcomings are common among digital health solutions and need to be better addressed in future implementations.
Predictive Factors of Bell’s Palsy: Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio
Authors: Pokharel Apar , Mayya Jaya Prakash 
Published: October 2020

Abstract
Objectives: Inflammation plays an important role in the pathogenesis of Bell’s palsy. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are indicators of inflammation. The aim of this study was to find the prevalence of Bell's palsy and the mean of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio among them. Result: Out of all patients who visited ENT outpatient department during the study period, the overall prevalence of Bell’s palsy was 0.6% (117) at a 95% confidence interval (0.5-0.72%). Among them, the mean neutrophil to lymphocyte ratio was 5.014±1.63, and the mean platelet to lymphocyte ratio was 207.38±54.59.Both NLR and PLR values were raised in Bell’s palsy. Therefore, NLR and PLR can be used as auxiliary param­eters in the management of Bell’s palsy.
Application of Artificial Intelligence in Chronic Liver Diseases: A Systematic Review and Meta-analysis
Authors: Decharatanachart Pakanat , Chaiteerakij Roongruedee , Tiyarattanachai Thodsawit , Treeprasertsuk Sombat 
Published: October 2020

Abstract
Background: The gold standard for the diagnosis of liver fibrosis and nonalcoholic fatty liver disease (NAFLD) is liver biopsy. Various noninvasive modalities, e.g., ultrasonography, elastography and clinical predictive scores, have been used as alternatives to liver biopsy, with limited performance. Recently, artificial intelligence (AI) models have been developed and integrated into noninvasive diagnostic tools to improve their performance. Methods: We systematically searched for studies on AI-assisted diagnosis of liver fibrosis and NAFLD on MEDLINE, Scopus, Web of Science and Google Scholar. The pooled sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic odds ratio (DOR) with their 95% confidence intervals (95%CIs) were calculated using a random effects model. A summary receiver operating characteristic curve and the area under the curve was generated to determine the diagnostic accuracy of the AI-assisted system. Subgroup analyses by diagnostic modalities were performed.Results: We included 17 studies reporting the performances of AI-assisted ultrasonography, elastrography, computed tomography (CT), magnetic resonance imaging (MRI) and clinical parameters for the diagnosis of liver fibrosis and steatosis. For the diagnosis of liver fibrosis, the pooled sensitivity, specificity, PPV, NPV and DOR were 0.78 (0.70 – 0.84), 0.88 (0.79 – 0.94), 0.73 (0.58 – 0.84), 0.91 (0.88 – 0.94) and 29.57 (10.65 – 82.10), respectively, for cirrhosis; 0.86 (0.80 – 0.91), 0.87 (0.79 – 0.92), 0.85 (0.74 – 0.91), 0.88 (0.82 – 0.92) and 37.95 (15.52 – 92.77), respectively; for advanced fibrosis; and 0.86 (0.78 – 0.92), 0.81 (0.77 – 0.84), 0.88 (0.80 – 0.93), 0.77 (0.58 – 0.89) and 26.79 (14.47 – 49.62), respectively, for significant fibrosis. Subgroup analyses showed significant differences in performance for the diagnosis of fibrosis among different modalities. The pooled sensitivity, specificity, PPV, NPV and DOR were 0.97 (0.76 – 1.00), 0.91 (0.78 – 0.97), 0.95 (0.87 – 0.98), 0.93 (0.80 – 0.98) and 191.52 (38.82 – 944.81), respectively, for the diagnosis of liver steatosis. Conclusions: AI-assisted systems have promising potential for the diagnosis of liver fibrosis and NAFLD. Validations of their performances are warranted before implementing these AI-assisted systems in clinical practice.Trial registration: The protocol was registered with PROSPERO (CRD42020183295).
Mn2+ Induced Significant Improvement and Robust Stability of Radioluminescence in Cs3Cu2I5 for High Performance Nuclear Battery
Authors: Zeng Haibo , Li Xiaoming , Chen Jiaxin , Yang Dandan , Chen Xi , Geng Dongling , Jiang Lianfu , Wu Ye , Meng Cuifang 
Published: October 2020

Abstract
Fluorescent type nuclear battery (NB) consisting of scintillator and photovoltaic device (PVD) enables semipermanent power source for both small and large devices working under harsh circumstances without instant energy supply. In spite of the progress of device structure design, the development of scintillators with high light yield (LY) and longer emission wavelength catering to PVDs is far behind. Here, a novel Cs3Cu2I5: Mn scintillator, which exhibits an ultrahigh LY of ~ 67000 ph/MeV at an emission wavelength of 564 nm is presented, and this is the highest value at such a long wavelength based on low cost precursors. Besides, doping and intrinsic features endow Cs3Cu2I5: Mn with robust thermal stability and irradiation hardness that 71% or > 90% of the initial radioluminescence (RL) intensity can be maintained in an ultra-broad temperature range of 77 K-433 K or after a total irradiation dose of 38.7 Gy at 333 K, respectively. These superiorities allow the fabrication of an efficient and stable NB, which showed an output improvement of 337% respect to that without scintillator. Luminescence mechanisms including self-trapped exciton, energy transfer, and impact excitation are proposed for the dramatic RL improvement. It is expected that such a new and robust scintillator will open a window for the fields of NBs and radiography.