bluuebunny/crossref_metadata_2025_split huggingface dataset:
Finite element analysis of the initial stability of arthroscopic ankle arthrodesis with three-screw fixation: posteromedial versus posterolateral home-run screw
Authors: Wang Sen , Yu Jian , Zhao Dahang , Geng Xiang , Huang Jiazhang , Wang Xu , Ma Xin 
Published: June 2020

Abstract
Objective: Arthroscopic ankle arthrodesis (AAA) is a standard surgical method for the treatment of advanced traumatic ankle arthritis and has become more popular due to its advantages. To fix the tibiotalar joint, the use of three percutaneous screws is considered to have better mechanical stability than the use of two screws. However, it is sometimes difficult to insert three screws because they might block each other due to the small area of the tibiotalar joint surface and the large diameter of the screws; few articles illustrate how to insert three screws without the screws disturbing each other. The purpose of this study is to explore possible screw configurations of tripod fixation in arthroscopic ankle arthrodesis that avoid the collision of screws and yield better biomechanical performance.Methods: We used the finite element method to examine the impact of different screw positions and orientations on the biomechanical characteristics of a three-dimensional (3D) ankle model. Maximum and average micromotion, pressure on the articular surface, and von Mises stress values of the tibia and the talus were used to evaluate the initial stability of the ankle.﻿Results: Five kinds of three-screw configurations were identified, and finite element analysis results suggested that configurations with the posteromedial home-run screw presented lower micromotion (maximum: 17.96 ± 7.49 μm versus 22.52 ± 12.8 μm; mean: 4.88 ± 1.89 μm versus 5.19 ± 1.92 μm) (especially configuration 3) and better screw distributions on the articular surface than those with the posterolateral home-run screw.Conclusion: Screw configurations with the posteromedial home-run screw avoid collision and are more biomechanically stable than those with the posterolateral home-run screw. Thus, inserting the home-run screw through the posteromedial approach is recommended for clinical practice.
Prediction of lymph node metastasis by tumor-infiltrating lymphocytes in T1 breast cancer
Authors: Takada Koji , Kashiwagi Shinichiro , Asano Yuka , Goto Wataru , Kouhashi Rika , Yabumoto Akimichi , Morisaki Tamami , Shibutani Masatsune , Takashima Tsutomu , Fujita Hisakazu , Hirakawa Kosei , Ohira Masaichi 
Published: June 2020

Abstract
Background: Lymph node metastasis is more likely in early-stage breast cancer with lower tumor-infiltrating lymphocyte (TIL) density. Therefore, we investigated the correlation between TILs and lymph node metastasis in cT1 breast cancer patients undergoing surgery and the usefulness of TILs in predicting sentinel lymph node metastasis (SLNM) in cT1N0M0 breast cancer.Methods: We investigated 332 breast cancer patients who underwent surgery as the first-line treatment after preoperative diagnosis of cT1. A positive diagnosis of SLNM as an indication for axillary clearance was defined as macrometastasis in the sentinel lymph node (SLN) (macrometastasis: tumor diameter >2 mm). Semi-quantitative evaluation of lymphocytes infiltrating the peritumoral stroma as TILs in primary tumor biopsy specimens prior to treatment was conducted.Results: For SLN biopsy (SLNB), a median of 2 (range, 1-8) SLNs were pathologically evaluated. Sixty cases (19.4%) of SLNM (macrometastasis: 46, micrometastasis: 16) were observed. Metastasis was significantly greater in breast cancers with tumor diameter >10 mm than in those with diameter 10 mm (p = 0.016). Metastasis was significantly associated with lymphatic invasion (p <0.001). These two clinicopathological factors correlated with SLNM even in patients diagnosed with cN0 (tumor size; p=0.017, lymphatic invasion; p=0.002). Multivariate analysis for SLNM predictors revealed lymphatic invasion (p=0.008, odds ratio [OR]=2.522) and TILs (p<0.001, OR=0.137) as independent factors.Conclusions: Our results suggest a correlation between lymph node metastasis and tumor immune-microenvironment in cT1 breast cancer. TIL density may be a predictor of SLNM in breast cancer without lymph node metastasis on preoperative imaging.
Abnormal Expression and Prognostic Significance of EPB41L1 in Kidney Renal Clear Cell Carcinoma Based on Data Mining
Authors: Liang Taotao , Sang Siyao , Shao Qi , Chen Chen , Deng Zhichao , Wang Ting , Kang Qiaozhen 
Published: June 2020

Abstract
Background: EPB41L1 gene (erythrocyte membrane protein band 4.1 like 1) encodes the protein 4.1N, a member of 4.1 family, playing a vital role in cell adhesion and migration, which is associated with the malignant progression of various human cancers. However, the expression and prognostic significance of EPB41L1 in kidney renal clear cell carcinoma (KIRC) remain to be investigated. Methods: In this study, we collected the mRNA expression of EPB41L1 in KIRC through the Oncomine platform, and used the HPA database to perform the pathological tissue immunohistochemistry in patients. Then, the sub-groups and prognosis of KIRC were performed by UALCAN and GEPIA web-tool, respectively. Further, the mutation of EPB41L1 in KIRC was analyzed by c-Bioportal. The co-expression genes of EPB41L1 in KIRC were displayed from the LinkedOmics database, and function enrichment analysis was used by LinkFinder module in LinkedOmics. The function of EPB41L1 in cell adhesion and migration was confirmed by wound healing assay using 786-O cells in vitro. Co-expression gene network was constructed through the STRING database, and the MCODE plug-in of which was used to build the gene modules, both of them was visualized by Cytoscape software. Finally, the top modular genes in the same patient cohort were constructed through data mining in TCGA by using the UCSC Xena browser. Results: The results indicated that EPB41L1 was down-expressed in KIRC, leading to a poor prognosis. Moreover, there is a mutation in the FERM domain of EPB41L1, but it has no significant effect on the prognosis of KIRC. The co-expressed genes of EPB41L1 were associated with cell adhesion and confirmed in vitro. Further analysis suggested that EPB41L1 and amyloid beta precursor protein (APP) were coordinated to regulated cancer cell adhesion, thereby increasing the incidence of cancer cell metastasis and tumor invasion. Conclusions: In summary, EPB41L1 is constantly down-expressed in KIRC tissues, resulting a poor prognosis. Therefore, we suggest that it can be an effective biomarker for the diagnosis of KIRC.
Impact of a theory-informed and user-centered stroke information campaign on the public’s behaviors, attitudes, and knowledge when facing acute stroke: a controlled before-and-after study.
Authors: Haesebaert Julie , Laude C. , Termoz A. , Bravant E. , Perreton N. , Bony T. , Trehard H. , Porthault S. , Derex L. , Nighoghossian N. , Schott AM. 
Published: June 2020

Abstract
Background Public awareness of stroke symptoms is a key factor to ensure access to reperfusion strategies in due time. We designed and launched a regional theory-informed and user-centered information campaign and assessed its impact on emergency medical services (EMS) calls for stroke suspicion, time-to-call, and public attitudes and awareness concerning stroke.Methods A controlled before-and-after study was conducted during 3 sequential time-periods in 2 separate counties. Key messages of the campaign were underpinned by stroke representations and the theory of planned behavior, and focused on recognition of stroke warning signs and the need to call EMS urgently. The campaign included posters, leaflets, adverts and films displayed in bus and subway stations, internet, social networks, and local radio. Outcome measures on behavior, attitudes, and knowledge were assessed before the launch of the campaign, at 3 months, and 12 months.Results The number of EMS calls for stroke suspicion increased by 21% at 12 months in the intervention county and this change was significantly different to that observed in the control county (p = 0.02). No significant changes were observed regarding self-reported attitudes in case of stroke. An 8% significant increase in recognizing at least 2 stroke warning signs was observed in the intervention county (p = 0.04) at 3 months, while it did not change significantly in the control county (p = 0.6). However, there was no significant difference in warning sign recognition between both counties (p = 0.16).Conclusion The campaign significantly improved public’s behavior of calling EMS, although stroke knowledge was not improved as much as expected. Repeating these campaigns over time might further help improve timeliness and access to reperfusion strategies.
prevalence of Helicobacter pylori among Sudanese patients diagnosed with colon polyps and colon cancer using immunohistochemistry technique.
Authors: Mohamed Aziza K. , Elhassan Nazik M. , Awhag Zahra A. , Ali Fadwa S. , Ali Eman T. , Mhmoud Najwa A. , Siddig Emmanuel E. , Hassan Rowa , Ahmed Eiman S. , Fattahi Azam , Ahmed Ayman , Muneer Mohamed S. , Osman Hussam A. , Mohamed Nouh Saad , Edris Ali MM. 
Published: June 2020

Abstract
Objectives: Infection with the bacteria Helicobacter pylori has been classified as class one carcinogen associated with increasing susceptibility of gastritis and gastric carcinoma. This study is aiming at investigating the prevalence of H. pylori among colon polyps and colon cancer patients. A descriptive cross-sectional hospital-based study was conducted between February and June 2017. Sixty-nine formalin-fixed paraffin blocks collected from colon polyps and colon cancer patients to detect H. pylori using immunohistochemistry technique. Results: Of the Sixty-nine patients included in the study, 39 (56.5%) males and 30 (43.5%) were females, their age ranged from 21 to 80 years with a mean age of 47.1±19.7. Of the 69 colon polyps and colon cancer patients, 44 (63.8%) were diagnosed as adenocarcinoma, 10 (14.5%) colitis, 15 (21.7%) juvenile polyposis syndrome. The results of immunohistochemistry technique showed the presence of 16 (23.2%) positive patients for H. pylori infection. Of these 16, 13 (81.3%) patients were diagnosed with adenocarcinoma and 3 (18.7%) patients were diagnosed with juvenile polyps. The results of H. pylori detection among the different colon polyps and colon cancer patients were showing a statistically significant association for H. pylori infection and adenocarcinoma, P value 0.028.
Lung Adenocarcinoma with Metachronous Ovarian Metastasis: a long survival case report
Authors: Yao Shuyang , Wang Leiming , Tian Xiaoru , Zhang Yi 
Published: June 2020

Abstract
Lung adenocarcinoma which invades ovaries is very rare. However, with the increase of long-survival female lung cancer, more female patients will experience this situation. Because of the paucity of reported cases, the clinicopathological features and treatment strategies of these tumors remain unknown. This patient was stage IV lung adenocarcinoma at first diagnosis. Following multiple-line systemic treatments, she suffered extensive pelvic metastasis. After debulking surgery and reevaluation about the drive genes, she was administered by targeted therapy and finally achieved good efficacy with a long survival time. The comprehensive treatment modality for the bilateral ovarian metastasis is effective in clinical course.
One country's journey to interoperability: Tanzania's experience developing a national health information exchange
Authors: Nsaghurwe Alpha , Dwivedi Vikas , Ndesanjo Walter , Bams Haji , Busiga Moses , Nyella Edwin , Massawe Japhet Victor , Smith Dasha , Onyejekwe Kate , Metzger Jonathan , Taylor Patricia 
Published: June 2020

Abstract
Background and purpose: Robust, flexible, and integrated health information (HIS) systems are essential to achieving national and international goals in health and development. Such systems are still uncommon in most low and middle income countries. This article describes a first-phase activity in Tanzania to integrate the country’s vertical health management information system with the help of an interoperability layer that enables cross-program data exchange. Methods: From 2014 to 2019, the Tanzanian government and partners implemented a five-step procedure based on the “Mind the GAPS” (governance, architecture, program management, and standards) framework and using both proprietary and open-source tools. In collaboration with multiple stakeholders, the team developed the system to address major data challenges via four fully documented “use case scenarios” addressing data exchange among hospitals, between services and the supply chain, across digital data systems, and within the supply chain reporting system. This work included developing the architecture for health system data exchange, putting a middleware interoperability layer in place to facilitate the exchange, and training to support use of the system and the data it generates. Results: Tanzania successfully completed the five-step procedure for all four use cases. Data exchange is currently enabled among 15 separate information systems, and has resulted in improved data availability and significant time savings. The government has adopted the health information exchange within the national strategy for health care information, and the system is being operated and managed by Tanzanian officials. Conclusion: Developing an integrated HIS requires a significant time investment; but ultimately benefit both programs and patients. Tanzania’s experience may interest countries that are developing their HIS programs.
Mature B cell acute lymphoblastic leukemia with MLL-AF9 transcripts: three case reports and literature reviews
Authors: Guo Yuxia , Zhou Min , Zou Pinli , Liao Xin , Xiao Jianwen 
Published: June 2020

Abstract
Background: Mature B cell acute lymphoblastic leukaemia (BAL) is characterized by ALL-L3 morphology and the presence of surface immunoglobulin (sIgM) light chain restriction. t(8;14)(q24;q32) or its variants related to the MYC rearrangement (MYCr) are usually present in BAL, and BAL is considered the leukaemic phase of Burkitt lymphoma (BL). BAL with MLL rearrangement (MLLr) is rare. Methods: Three children with BAL and MLLr are presented. We also reviewed the context of 24 previously reported cases, and the features, treatment and prognosis were analysed. Results: Three BAL patients with MLLr were reported between January 2017 and November 2019, accounting for 1.37% of the B-ALL population; 24 patients were found in the literature. Thirteen males and 14 females were included, and the average age at diagnosis was 19.5 ± 4.95 months. Renal, CNS and skin involvement were present in 6, 4 and 3 patients, respectively. Twenty-six (96.30%) patients showed non-ALL-L3 morphology; negative or suspicious expression of CD20 was found in 64% of patients. MLLr was reported, but MYCr was not observed. Twenty-five (92.59%) patients achieved complete remission. Prospective event-free survival (pEFS) in patients who received allogeneic haematopoietic stem cell transplantation (allo-HSCT) was higher than that in patients who received chemotherapy (83.33% vs 41.91%). Conclusion: BAL patients with MLLr had unique manifestations, including a younger age at diagnosis and overexpression of CD19; expression of CD20 was rare, and MYCr was undetectable. The patients were sensitive to chemotherapy, but the pEFS was higher in patients undergoing allo-HSCT than in patients undergoing chemotherapy.
Comparative Analysis of Titanium Coating on Cobalt Chrome Alloy in Vitro &amp; Vivo-Direct Metal Fabrication vs. Plasma Spraying
Authors: Suh Dongwhan , Jo Woo Lam , Kim Seung Chan , Kim Yong Sik , Kwon Soon Yong , Lim Young Wook 
Published: June 2020

Abstract
BackgroundTitanium surface coating on Cobalt-Chromium (CoCr) alloy has characteristic desirable for orthopedic implant; strength, osteointegrative capability, biocompatibility. Creating such coated surface takes challenging process and two dissimilar metals are not easily welded. In our study, we utilized additive manufacturing with 3D printing called direct metal fabrication (DMF) and compared it to plasma spraying method (TPS), to coat titanium onto CoCr alloy. We hypothesized that this would yield a coated surface quality as acceptable or better than already established method of plasma spraying. For this, we compared characteristics of titanium coated surfaces created by direct metal fabrication method (DMF) and titanium plasma spraying (TPS), both in-vitro & in-vivo, for (1) cell morphology, (2) confocal microscopy images of immunofluorescent assay of RUNX2 and fibronectin, (3) Quantification of cell proliferation rate, (4) push-out biomechanical test, and (5) bone histomorphometry. MethodFor in vitro study, human osteoblast cells were seeded onto the coated surfaces. Cellular morphology was observed with scanning electron microscope. Cellular proliferation was validated with ELISA, immunofluorescent assay. For in vivo study, coated rods were inserted into distal femur of rabbit and then harvested. The rods were biomechanically tested with push out test and observed for histomorphometry to evaluate microscopic bone to implant ratio. ResultFor cell morphology observation, lamellipodia and filopodia, a cytoplasmic projection extending into porous structure, formed on both surfaces created by DMF and TPS. Proliferation of the osteoblasts, the DMF group showed better result at different optic density levels (p = 0.035, 0.005, 0.001). Expression and distribution of fibronectin and Runx-2 genes showed similar degrees of expressions. Biomechanical push-out test yielded similar result (p = 0.714). Histomorphometry analysis also showed similar result (p = 0.657).Conclusion In conclusion, DMF is a method which can reliably create proper titanium surface on CoCr alloy. The resulting product of the surface shows similar quality to that of plasma spraying method, both in vivo and in vitro, in terms of biological and mechanical property.
Social and cognitive interactions through an interactive school service for RTT patients at the COVID-19 time
Authors: Dovigo Lucia , Caprì Tindara , Iannizzotto Giancarlo , Nucita Andrea , Semino Martina , Giannatiempo Samantha , Zocca Lia , Fabio Rosa Angela 
Published: June 2020

Abstract
Background
The closure of all educational institutions and most rehabilitation centers represents a precautionary measure to face the COVID-19 pandemic, but the isolation and social distancing may be particularly challenging for children with special needs and disabilities (SEND), such as Rett Syndrome (RTT). The main aim of this study was to promote cognitive and social interactions among children and girls with RTT, through the interactive school program
Methods
The Interactive School palimpsest was composed of moments in which the teacher spoke directly to the subjects with RTT and expected a response through eye gaze, and moments in which stories-cartoon were presented while tracking the eye gaze of the patients. We investigated behavioural, social and cognitive parameters.
Results
Patients attended both social and cognitive tasks with the spontaneous reduction of stereotypies and with the increase of attention. They recalled more significant indexes when the music or the song was presented together with the cartoon or the cognitive task.
Conclusions
this study provides initial insights in promoting cognitive and social interactions and into the support needs of families with a child with RTT during the COVID-19 pandemic.
Early Differences in Auditory Processing Relate to Autism Spectrum Disorder Traits in Infants with Neurofibromatosis Type 1
Authors: Ali Jannath Begum , Kolesnik Anna , Quiroz Isabel , Mason Luke , Garg Shruti , Green Jonathan , Johnson Mark H. , Jones Emily J. H. 
Published: June 2020

Abstract
Background: Sensory modulation difficulties are common in children with conditions such as Autism Spectrum Disorder (ASD), and could contribute to other social and non-social symptoms. Positing a causal role for sensory processing differences requires observing atypical sensory reactivity prior to the emergence of other symptoms, which can be achieved through prospective studies of elevated likelihood populations. Methods: We examined auditory habituation and change detection in 5 and 10-month-old infants with and without Neurofibromatosis Type 1 (NF1), a condition associated with higher likelihood of developing ASD. Results: in typically developing infants, habituation to vowel repetition and enhanced responses to vowel/pitch change decreased with age over posterior regions; age-related change was diminished in the NF1 group. Whilst both groups detected changes in vowel and pitch, the NF1 group were largely slower to show a differentiated neural response. Auditory responses did not relate to later language but were related to later ASD traits. Conclusions: These findings represent the first demonstration of atypical brain responses to sounds in infants with NF1, and suggests they may relate to the likelihood of later ASD.
Hybrid Resampling Technique to Tackle the Imbalanced Classification Problem
Authors: Gulati Payal 
Published: June 2020

Abstract
In the real-world domain, many learning models faces challenge in handling the imbalanced classification problem. Imbalanced classification is a scenario where the number of data points in minority class is much lower than that of the majority. Our primary concern is the minority class, which is often neglected by learning models while predicting the values. This problem can be tackled at the data-level by using resampling techniques. In this research, hybrid of Synthetic Minority Oversampling Technique (SMOTE) and Neighborhood Cleaning Rule (NCL) is proposed to balance the data points of the classes. For experiment real-world dataset of credit card transaction has been utilized where the fraudulent (or malefactor) transaction needs to be identified. This imbalanced dataset after resampling is classified by using the logistic regression model. The experimental results depict that the learning model has correctly identified the malefactor in the balanced dataset than the original dataset. Through balancing the datasets, the proposed technique aims to enhance the performance of the learning model in order to correctly identify the cases of the minority class.