bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying Latent Variables in Dynamic Bayesian Networks with Bootstrapping Applied to Type 2 Diabetes Complication Prediction
Authors: Yousefi Leila , Al-Luhaybi Mashael , Sacchi Lucia , Chiovato Luca , Tucker Allan 
Published: September 2020

Abstract
Background: Type 2 Diabetes is a chronic disease with an onset that is commonly associated with multiple life-threatening co morbidities (complications). Early prediction of diabetic complications while discovering the behaviour of associated aggressive risk factors can reduce the patients’ suffering time. Therefore, models of the time series diabetic data (which are often imbalanced, incomplete and involve complex interactions) are needed to better manage diabetic complications. Aims: The aim of this work is to both deals with imbalanced clinical data using a bootstrapping approach, whilst determining the precise position of latent variables within probabilistic networks generated from the observations. The main motivation behind this paper is to stratify patient groups by means of latent variables to discover how complications in diabetes interact. Methods: We propose a time series bootstrapping method for building Dynamic Bayesian Networks that includes hidden / latent variables, applied to a case for predicting T2DM complications. A combination of the IC* algorithm on time series bootstrapped data is utilized to identify the latent variables within Bayesian model. Then, an exploration of inference methods assessed the influences of these latent variables. Results: Our promising findings show how this targeted use of latent variables improves prediction accuracy, specificity, and sensitivity over standard approaches as well as aiding the understanding of relationships between these latent variable sand disease complications / risk factors. The contribution of this paper compared to the previous papers in which time series bootstrapping is used for re-balancing the data and providing confidence in the prediction results. Conclusion: Our results showed that our re-balancing approach by the use of Time Series bootstrapping method for an unequal number of time series visits demonstrated an improvement in the prediction performance. Additionally, the most highlighted contribution of this paper gained insight by interpreting the latent states (looking at the associated distributions of complications), which led to a better understanding of risk factors and patient-specific interventions: here the fact that the latent variable demonstrated that a patient falls into a sub-group that is hypertensive but not suffering from retinopathy.
Obstacle avoidance and multitarget tracking of a super redundant modular manipulator based on Bezier curve and particle swarm optimization
Authors: li chen , Ma Ying , Zhang Yu , Liu Jinguo 
Published: September 2020

Abstract
A super redundant serpentine manipulator has slender structure and multiple degrees of freedom. It can travel through narrow spaces and move in complex spaces. This manipulator is composed of many modules that can form different lengths of robot arms for different application sites. The increase in degrees of freedom causes the inverse kinematics of redundant manipulator to be typical and immensely increases the calculation load in the joint space. This paper presents an integrated optimization method to solve the path planning for obstacle avoidance and discrete trajectory tracking of a super redundant manipulator. In this integrated optimization, path planning is established on a Bezier curve, and particle swarm optimization is adopted to adjust the control points of the Bezier curve with the kinematic constraints of manipulator. A feasible obstacle avoidance path is obtained along with a discrete trajectory tracking by using a follow-the-leader strategy. The relative distance between each two discrete path points is limited to reduce the fitting error of the connecting rigid links to the smooth curve. Simulation results show that this integrated optimization method can rapidly search for the appropriate trajectory to guide the manipulator in obtaining the target while achieving obstacle avoidance and meeting joint constraints. The proposed algorithm is suitable for 3D space obstacle avoidance and multitarget path tracking.
Side Effects of Azathioprine in Patients with Ocular Behçet’s syndrome
Authors: Masoumi Maryam , Davatchi Fereydoun , Shahram Farhad , Akhlaghi Maassoumeh , Faezi Seyedeh Tahereh , Kavosi Hoda , Shadmanfar Soraya , Alikhani Majid , Moradi Soroush , Balasi Javad 
Published: September 2020

Abstract
Background Behçet’s syndrome (BS) is a multifactorial, polygenic, autoinflammatory vasculitis characterized by recurrent oral and genital ulcers, uveitis, skin lesions, and arthritis. Azathioprine has been well established as an effective therapy among other immunosuppressive drugs; however, concerns remain about its safety. This study was conducted to determine the types and prevalence of adverse events related with azathioprine in patients with ocular BS.Methods We carried out a cross-sectional study of 165 patients with a confirmed diagnosis of BS who had ocular involvement. Data were collected retrospectively on disease-related characteristics and events including severity, recurrence, relapse, recovery and flare-up, as well as on azathioprine dosage and the duration of use.Results Of 165 enrolled patients, 103 (62.43%) were male and 62 (37.57%) were female. Adverse events related with azathioprine treatment occurred in 11 patients (6.67%). These side effects included elevated liver enzymes in 4 patients (2.43%), hypersensitivity reaction in 2 patients (1.21%), leukopenia in 2 patients (1.21%), nausea in 1 patient (0.61%), skin tumor in 1 patient (0.61%), and concomitant pancreatitis and hepatitis in 1 patient (0.61%). Six of these patients discontinued treatment, and 5 of them tapered the dose. In addition, we observed severe leukopenia in 2 patients.Conclusion Administration of azathioprine with due attention to the signs, symptoms, and severity of the disease, results in a reduced rate of adverse events and resolution of the ocular involvement in patients with BS.
Establishment of a Pediatric Trigger Tool Based on Global Trigger Tool to Identify Adverse Drug Events of Children: Experience in a Chinese hospital
Authors: LIU YI , YAN JUN FENG , XIE YUN FEI , BIAN YUAN 
Published: September 2020

Abstract
Background: The Global Trigger Tool (GTT)，which is a method using “triggers” to review medical record retrospectively to identify possible adverse events. Several studies showed that the GTT was effective. However, there were only a few localized trigger tools that had been established to detect pediatric adverse drug events (ADEs) in China. This study aimed to establish a pediatric trigger tool based on GTT, to examine the performance by detecting pediatric inpatients ADEs in a Chinese hospital (a retrospective review), and to investigate the factors associating with the occurrence of ADEs. Methods: The triggers were established by three steps including literature search, triggers extraction and revision, and experts investigation. A retrospective cohort study was conducted to detect ADEs by using 200 pediatric inpatient records of Sichuan Provincial People's Hospital.Results: 33 preliminary triggers were established, and 2 rounds of experts investigation were conducted. Finally, 33 triggers were established. In the retrospective review, the positive trigger rate was 64.0%, while the positive predictive value (PPV) was 24.9%. The occurrence of inpatients with ADEs was 20.5%. ADEs/100 patients were 49.0. ADEs/1000 patients days were 46.89. The most common ADE categories were leukocyte abnormalities, skin lesions and platelet abnormalities. The severity of 39 ADEs was grade 1, 55 ADEs was grade 2, 4 ADEs was grade 3. The highest frequency of ADE-related drugs was antineoplastic, followed by antibacterial. The length of stay and the leukemia in the diagnosed diseases were positively correlated with ADEs. Conclusion: The 33 pediatric triggers may detect ADEs effectively, but still need to be optimized. This study may provide some references for further research in order to improve the rationality and safety of medication.
“One-stop shop”: Safety and efficacy of combining atrial septal defect occlusion and left atrial appendage closure for patients with atrial septal defect and atrial fibrillation.
Authors: zhihui zhang , qing yao , haiyun Huang , ping zhu , xiang xu , zhiyuan Song , huakang Li 
Published: September 2020

Abstract
Background: One-stop occlusion, which is defined as the combination of atrial septal defect [ASD] or patent foramen ovale [PFO] occlusion and left atrial appendage [LAA] closure, in patients with ASD/PFO and atrial fibrillation (AF) has not yet been investigated systematically. This study aimed to evaluate the safety and efficacy of one-stop occlusion in the treatment of adult patients with ASD/PFO and AF.Methods: Inpatients with AF and ASD/PFO were recruited between August 2014 and April 2019. Preoperatively, transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) were conducted to identify the ASD/PFO size and margin, presence of thrombus in the LAA, and LAA orifice width and depth at 0°, 45°, 90°, and 135°. After confirmation of the indications of LAA closure (LAAC) and ASD/PFO occlusion, the procedures were performed simultaneously under general anesthesia. Oral anticoagulants were administered for 45-60 days, followed with regular evaluation of TTE and TEE.Results: Forty-nine patients (age, 65.6±9.6 years) were recruited in this study, including 24 patients with ASD and 25 patients with PFO. They were treated with LAAC and ASD/PFO occlusion successfully. The mean ASD size and mean diameter of the ASD occluders were 14.2±7.7 and 25.4±8.5 mm, respectively. The mean PFO size was 3.5±0.4 mm. The mean maximal LAA orifice width and depth were 20.5±3.4 and 28.3±3.6 mm, respectively. All patients were implanted with a Watchman device (diameter, 27.1±2.9 mm). Postoperatively, all patients took anticoagulants orally for 45-60 days, and their mean postoperative follow-up duration was 29.0±12.1 months. Postoperative TEE showed that all had normal positioning of the LAA and ASD/PFO occluders. At 45-60 days after operation, TEE showed that the LAA and ASD/PFO occluder were in the normal position; however, two patients who took warfarin and novel oral anticoagulants, respectively, have developed occluder thrombosis. After adjusted anticoagulant therapy, TEE showed that the thrombus disappeared at 6 months after operation.Conclusion: One-stop occlusion is safe and effective for the treatment of adult patients with ASD/PFO and AF. It is also feasible to administer warfarin or novel oral anticoagulants after operation.
Comparison of spatiotemporal characteristics of the COVID-19 and SARS outbreaks in mainland China
Authors: Zhang Xi , Rao Huaxiang , Wu Yuwan , Huang Yubei , Dai Hongji 
Published: September 2020

Abstract
Background: Both coronavirus disease 2019 (COVID-19) and severe acute respiratory syndrome (SARS) are caused by coronaviruses and have infected people in China and worldwide. We aimed to investigate whether COVID-19 and SARS exhibited similar spatial and temporal features at provincial level in mainland China.Methods: The number of people infected by COVID-19 and SARS were extracted from daily briefings on newly confirmed cases during the epidemics, as of Mar. 4, 2020 and Aug. 3, 2003, respectively. We depicted spatiotemporal patterns of the COVID-19 and SARS epidemics using spatial statistics such as Moran’s I and the local indicators of spatial association (LISA).Results: Compared to SARS, COVID-19 had a higher overall incidence. We identified 3 clusters (predominantly located in south-central China; the highest RR=135.08, 95% CI: 128.36-142.08) for COVID-19 and 4 clusters (mainly in Northern China; the highest RR=423.51, 95% CI: 240.96-722.32) for SARS. Fewer secondary clusters were identified after the "Wuhan lockdown". The LISA cluster map detected a significantly high-low (Hubei) and low-high spatial clustering (Anhui, Hunan, and Jiangxi, in Central China) for COVID-19. Two significant high-high (Beijing and Tianjin) and low-high (Hebei) clusters were detected for SARS.Conclusions: COVID-19 and SARS outbreaks exhibited distinct spatiotemporal clustering patterns at the provincial levels in mainland China, which may be attributable to changes in social and demographic factors, local government containment strategies or differences in transmission mechanisms.
Prevalence and Significance of Serum 14-3-3η in Juvenile Idiopathic Arthritis
Authors: Reyhan Iris , Zhukov Olga S. , Lagier Robert J. , Bridgeforth Robert F. , Williams Gary J. , Popov Joanna M. , Naides Stanley J. , Reiff Andreas 
Published: September 2020

Abstract
Background: Prompt diagnosis of juvenile idiopathic arthritis (JIA) is important to avoid long term complications. Elevated serum 14-3-3η levels improve the diagnostic sensitivity of rheumatoid factor (RF) and cyclic citrullinated peptide (CCP) antibody in adult rheumatoid arthritis (RA), and have been associated with more severe phenotype. We investigated the prevalence and clinical significance of serum 14-3-3η in different types of JIA.Methods: JIA patients (n=151) followed by the Pediatric Rheumatology Core at Children’s Hospital of Los Angeles were categorized into 5 groups: polyarticular JIA RF+ (PJIA RF+; n=39), PJIA RF- (n=39), psoriatic arthritis (PsA; n=19), enthesitis-related arthritis (ERA; n=18), and oligoarticular JIA (OJIA [control group]; n=36). RF, CCP antibody, and 14-3-3η were measured for all patients. 14-3-3η serum levels >0.2ng/mL were considered positive. Disease activity was assessed by the Juvenile Arthritis Disease Activity Score-71 (JADAS-71). Results: Elevated 14-3-3h levels were detected in 34/151 (23%) patients, and across all groups tested. Most patients with 14-3-3h had titers ≥4 times above the cutoff value. The majority (22, 65%) of 14-3-3h-positive patients were also positive for RF or CCP antibodies, 16 (47%) were positive for all 3, and 12 (35%) were single-positive for 14-3-3η. The highest prevalence of 14-3-3η was in PJIA RF+ patients (49%), followed by OJIA (22%). Positivity for 14-3-3h was not significantly associated with disease activity or age at diagnosis. Conclusion: Serum 14-3-3h can be detected in all forms of JIA tested but appears to be most common in PJIA RF+. 14-3-3h does not appear to correlate with disease activity in JIA.
Can Computed Tomography-Based Radiomics Potentially Discriminate Between Anterior Mediastinal Cysts and Type B1 and B2 Thymomas
Authors: Liu Lulu , Lu Fangxiao , Pang Peipei , Shao Guoliang 
Published: September 2020

Abstract
Background: Anterior mediastinal cysts (AMC) are often misdiagnosed as thymomas and undergo surgical resection, which caused unnecessary treatment and medical resources waste. The purpose of this study was to explore potential possibility of computed tomography (CT)-based radiomics for the diagnosis of AMC and type B1 and B2 thymomas. Methods: A group of 188 patients with pathologically confirmed AMC (106 cases mischarged as thymomas in CT) and thymomas (82 cases) and underwent routine chest CT from January 2010 to December 2018 were retrospectively analyzed. The lesions were manually delineated using ITK-SNAP software, and radiomics features were performed using the Artificial Intelligence Kit (AK) software. A total of 396 tumor texture features were extracted from enhanced CT and unenhanced CT, respectively. The general test, correlation analysis and LASSO were used to features selection and then the radiomics signature (radscore) were obtained. The combined model including radscore and independent clinical factors were developed. The model performances were evaluated on discrimination, calibration curve. Results: Two radscore model were constructed from the unenhanced and enhanced phases based on the selected 4 and 3 features, respectively. The AUC, sensitivity, and specificity of the enhanced radscore model were 0.928, 89.3% and 83.8% in the training dataset and 0.899, 84.6%, 87.5% in the test dataset (higher than the unenhanced radscore model). The combined model of enhanced CT including radiomics features and independent clinical factors yielded an AUC, sensitivity and specificity of 0.941, 82.1%, and 94.6% in the training dataset and 0.938, 92.3%, and 87.5% in the test dataset (higher than the unenhanced combined model and enhanced radscore model). Conclusions: The study suggested the possibility that the combined model in enhanced CT provided a potential tool to facilitate the differential diagnosis of AMC and type B1 and B2 thymomas.
­­­­­­An Integrated Autophagy-Related Gene Signature Predicts Prognosis in Human Endometrial Cancer
Authors: Zhang Jun , Wang Ziwei , Zhao Rong , An Lanfen , Zhou Xing , Zhao Yingchao , Wang Hongbo 
Published: September 2020

Abstract
Background: Globally, endometrial cancer is the fourth most common malignant tumor in women and the number of women being diagnosed is increasing. Tumor progression is strongly related to the cell survival-promoting functions of autophagy. We explored the relationship between endometrial cancer prognoses and the expression of autophagy genes using human autophagy databases.Methods: The Cancer Genome Atlas was used to identify autophagy related genes (ARGs) that were differentially expressed in endometrial cancer tissue compared to healthy endometrial tissue. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes were referenced to identify important biological functions and signaling pathways related to these differentially expressed ARGs. A prognostic model for endometrial cancer was constructed using univariate and multivariate Cox, and Least Absolute Shrinkage and Selection Operator regression analysis. Endometrial cancer patients were divided into high- and low-risk groups according to risk scores. Survival and receiver operating characteristic (ROC) curves were plotted for these patients to assess the accuracy of the prognostic model. Using immunohistochemistry the protein levels of the genes associated with risk were assessed.Results: We determined 37 ARGs were differentially expressed between endometrial cancer and healthy tissues. These genes were enriched in the biological processes and signaling pathways related to autophagy. Four ARGs (CDKN2A, PTK6, ERBB2 and BIRC5) were selected to establish a prognostic model of endometrial cancer. Kaplan–Meier survival analysis suggested that high-risk groups have significantly shorter survival times than low-risk groups. The area under the ROC curve indicated that the prognostic model for survival prediction was relatively accurate. Immunohistochemistry suggested that among the four ARGs the protein levels of CDKN2A, PTK6, ERBB2, and BIRC5 were higher in endometrial cancer than healthy endometrial tissue.Conclusions: Our prognostic model assessing four ARGs (CDKN2A, PTK6, ERBB2, and BIRC5) suggested their potential as independent predictive biomarkers and therapeutic targets for endometrial cancer.
Oral health status of 12-year-old children in Lisu minority ethnic group in China: a cross-sectional study
Authors: Chen Kitty Jieyi , Li Yuexiao , Xu Biao , Liu Juan , Li Yanhong , Zhang Shinan , Chu Chun Hung 
Published: September 2020

Abstract
Background: Lisu is an ethnic minority group and most of them are living in Yunnan, China. This study investigated the oral health status among 12-year-old Lisu children in Yunnan.Method: This survey employed a multistage sampling method to recruit 12-year-old Lisu children. Two calibrated dentists performed the oral examinations in the primary schools. They examined dental caries, gingival bleeding and dental fluorosis using the diagnosis criteria recommended by the World Health Organization. A self-administrated questionnaire was distributed to the children to collect their sociodemographic background information and oral health-related behaviours. A chi-square test, the Mann-Whitney U test, zero-inflated negative binomial (ZINB) regression and multivariate logistic regression were used for statistical analysis.Results: This survey invited 512 children, and 482 children (48% boys) participated in the study (response rate: 94%). Their caries prevalence was 35% and their caries experience in mean (SD) DMFT scores was 0.63 (0.10). The mean (SD) DT score was 0.60 (1.10), consisting 95% of the mean DMFT scores. No dental fluorosis was observed; whereas 426 children (88%) had gingival bleeding. Results of ZINB model indicated sex and sugary-snacking habits were related to the dental caries experience (p<0.05). The gingival-bleeding prevalence was associated with the mother’s education level, the child’s monthly-pocket money and daily toothbrushing frequency (p<0.05).Conclusion: Dental caries and gingival bleeding were prevalent among 12-year-old Lisu children in the Yunnan province in China, and most of the decayed teeth were unrestored. Dental fluorosis was not observed in the children.
Validation of the Palliative Prognostic Index, Performance Status–Based Palliative Prognostic Index and Chinese Prognostic Scale in a Home Palliative Care Setting for Patients with Advanced Cancer in China
Authors: Zhou Jun , Xu Sitao , Cao Ziye , Tang Jing , Qin Ling , Zhou Fangping , He Yuzhen , Zhong Xueren , Hu Mingcai , Wang Yan , Lu Fengjuan , Bao Yongzheng , Dai Xiangheng , Wu Qiang 
Published: September 2020

Abstract
Background: The predictive value of the prognostic tool for patients with advanced cancer is uncertain in mainland China, especially in the home-based palliative care (HPC) setting. This study aimed to compare the accuracy of the Palliative Prognostic Index (PPI), the Performance Status–Based Palliative Prognostic Index (PS-PPI), and the Chinese Prognosis Scale (ChPS) for patients with advanced cancer in the HPC setting in mainland China.Methods: Patients with advanced cancer admitted to the hospice center of Yuebei People’s Hospital between January 2014 and December 2018 were retrospectively calculated the scores according to the three prognostic tools. The Kaplan-Meier method was used to compare survival times among different risk groups. Receiver operating characteristic curve analysis was used to assess the predictive value. The accuracy of 21-, 42- and 90-day survival was compared among the three prognostic tools. Results: A total of 1863 patients were included. Survival time among the risk groups of all prognostic tools was significantly different from each other except for the PPI. The AUROC of the ChPS was significantly higher than that of the PPI and PS-PPI for 7-, 14, 21-, 42-, 90-, 120-, 150- and 180-day survival (P <0.05). The AUROC of the PPI and PS-PPI were not significantly different from each other (P >0.05).Conclusions: The ChPS is more suitable than the PPI and PS-PPI for advanced cancer patients in the HPC setting. More researches are needed to verify the predictive value of the ChPS, PPI, and PS-PPI in the HPC setting in the future.