bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tumor stiffness measured by shear wave elastography correlates with tumor hypoxia as well as histologic biomarkers in breast cancer
Authors: Yoo Joonghyun , Seo Bo Kyoung , Park Eun Kyung , Kwon Myoungae , Jeong Hoiseon , Cho Kyu Ran , Woo Ok Hee , Song Sung Eun , Cha Jaehyung 
Published: November 2020

Abstract
Background
Shear wave elastography (SWE) is an ultrasound technique for the noninvasive quantification of tissue stiffness. The hypoxic tumor microenvironment promotes tumor stiffness and is associated with poor prognosis in cancer. We aimed to investigate the correlation between tumor hypoxia and histologic biomarkers and tumor stiffness measured by SWE in breast cancer.

Methods
From June 2016 to January 2018, 82 women with invasive breast cancer who underwent SWE before treatment were enrolled. Average tumor elasticity (Eaverage) and tumor-to-fat elasticity ratio (Eratio) were extracted from SWE. Immunohistochemical staining of glucose transporter 1 (GLUT1) was used to assess tumor hypoxia in breast cancer tissues and automated digital image analysis was performed to assess GLUT1 activities. Spearman correlation and logistic regression analyses were performed to identify associations between GLUT1 expression and SWE values, histologic biomarkers, and molecular subtypes. The Mann–Whitney U test, t test, or Kruskal–Wallis test was used to compare SWE values and histologic features according to the GLUT1 expression (≤the median vs > median).

Results
Eaverage (r = 0.676) and Eratio (r = 0.411) correlated significantly with GLUT1 expression (both p <  0.001). Eaverage was significantly higher in cancers with estrogen receptor (ER)–, progesterone receptor (PR)–, Ki67+, and high-grade (p <  0.05). Eratio was higher in cancers with Ki67+, lymph node metastasis, and high-grade (p <  0.05). Cancers with high GLUT1 expression (>median) had higher Eaverage (mean, 85.4 kPa vs 125.5 kPa) and Eratio (mean, 11.7 vs 17.9), and more frequent ER– (21.7% vs 78.3%), PR– (26.4% vs 73.1%), Ki67+ (31.7%% vs 68.3%), human epidermal growth factor receptor 2 (HER2) + (25.0% vs 75.0%), high-grade (28.6% vs 71.4%), and HER2-overexpressing (25.0% vs 75.0%) and triple-negative (23.1% vs 76.9%) subtypes (p <  0.05). Multivariable analysis showed that Eaverage was independently associated with GLUT1 expression (p <  0.001).

Conclusions
Tumor stiffness on SWE is significantly correlated with tumor hypoxia as well as histologic biomarkers. In particular, Eaverage on SWE has independent prognostic significance for tumor hypoxia in the multivariable analysis and can potentially be used as a noninvasive imaging biomarker to predict prognosis and pretreatment risk stratification in breast cancer patients.
Effect of xanthan gum-based food thickeners on the dissolution profile of fluoroquinolones oral formulations
Authors: Takahashi Nobuyuki , Fujita Yoshiaki , Takahashi Nanako , Nakamura Akihiro , Harada Tsutomu 
Published: November 2020

Abstract
Background
Xanthan gum-based food thickeners (XG-FTs) are often ingested by patients with dysphagia to prevent aspiration during drug treatment. Reportedly, XG-FTs affect tablet disintegration, drug dissolution rates, and reduce the efficacy of postprandial antihyperglycemic agents. The absorption rate and quantity of fluoroquinolone antimicrobial agents correlate with drug efficacy, raising concern about the impact of XG-FTs. Previously, we reported that film-coated tablets were less susceptible to the effects of XG-FT than conventional and orally disintegrating tablets. Here, we compare the effect of XG-FTs on dissolution profiles of three oral fluoroquinolone-based film-coated tablets by evaluating the dissolution of crushed products, fine granules, and film-coated fine granules.

Methods
We examined formulations of tosufloxacin tosylate monohydrate (TFLX), levofloxacin hemihydrate (LVFX), and ciprofloxacin hydrochloride hydrate (CPFX). The formulations were immersed in 20 mL of 1.5% (w/v) XG-FT aqueous solution for 2.5 min followed by a dissolution test using the paddle method according to the Japanese Pharmacopoeia (dissolution test solution pH 1.2; volume 900 mL; temperature 37 ± 0.5 °C). The dissolution profile was evaluated according to the dissolution quantity indicated in product specifications and guidelines for bioequivalence testing of generic drugs. The 15-min mean dissolution rate was determined for a formulation immersed in 1.5% (w/v) XG-FT aqueous solution and compared with that for a non-immersed formulation (control). Fluoroquinolone film-coated tablets were mixed with starch-based FTs, guar gum-based FTs, or XG-FTs to observe their appearances.

Results
The dissolution profile of LVFX film-coated tablets was not affected by XG-FTs, but the dissolution of TFLX and CPFX was delayed. For crushed film-coated tablets, the 15-min mean dissolution rate was significantly delayed for all three fluoroquinolones when compared with that of uncrushed products. The dissolution profile of TFLX film-coated fine granules was unchanged by XG-FTs. CPFX film-coated tablets and crushed products produced a gel-like precipitate when mixed with XG-FTs and failed to meet product-dissolution specifications. A gel-like precipitate was also observed with guar gum-based FTs.

Conclusion
The effect of XG-FTs on the dissolution profile of film-coated fluoroquinolone formulations varied depending on the formulation. The CPFX formulation formed a gel-like precipitate when immersed in XG-FTs resulting in a significantly delayed dissolution.
Congenitally corrected transposition of great arteries: a case series of five unoperated African children
Authors: Obongonyinge Bernard , Namuyonga Judith , Tumwebaze Hilda , Aliku Twalib , Lwabi Peter , Lubega Sulaiman 
Published: November 2020

Abstract
Background
Congenitally corrected transposition of great arteries (ccTGA) is rare. It is commonly associated with ventricular septal defect (VSD), pulmonary stenosis and heart block. Early anatomic repair is recommended between 3 and 6 months of age to prevent development of tricuspid valve regurgitation and systemic right ventricular failure.

Case presentation
We retrospectively identified five cases of ccTGA. Cases were between one and 13 years of age. All the cases were unoperated. Four of the five cases had associated intracardiac defects/complications. These included: VSD, pulmonary stenosis, tricuspid valve regurgitation, right ventricular systolic dysfunction and heart block.

Conclusion
These cases demonstrate the challenges of access to early diagnosis and surgery in a low resource setting. This delay in anatomic repair leads to complications of tricuspid valve regurgitation and systemic right ventricular failure.
The efficacy and safety of a novel method of peritoneal dialysis catheter insertion from the McBurney point
Authors: Ogawa Kyohei , Maruyama Yukio , Matsuo Nanae , Tanno Yudo , Ohkido Ichiro , Hirano Keita , Ikeda Masato , Yokoo Takashi 
Published: November 2020

Abstract
Background
Catheter dysfunction, especially omental wrapping, is a serious complication of peritoneal dialysis (PD). Although catheter implantation at a lower site was reported to prevent omental wrapping, this method could induce insufficient drainage of the PD solution and cause pain or a persistent desire to defecate, when the intraperitoneal catheter is of insufficient length or when its tip is in direct contact with the pelvic floor, respectively. The aim of this study was to assess the efficacy and safety of a novel PD catheter insertion method of approaching from the McBurney point, from the outer side of the abdomen.

Methods
This retrospective study included 23 patients with end-stage renal disease who were started on PD from January 2017 to July 2018 at Ashikaga Red Cross Hospital, Tochigi, Japan. Among them, 16 patients underwent a PD catheter insertion using a conventional method, whereas 7 patients underwent a novel method of approaching from the McBurney point. Infectious and mechanical complications were evaluated until August 2020.

Results
There were 18 men and 5 women, with a mean age of 63.1 ± 13.6 years. All patients were followed up postoperatively for a mean duration of 27.2 ± 13.4 months. No patient experienced omental wrapping, insufficient drainage of the PD solution, and pain or persistent desire to defecate in both groups. Both the incidence of infectious and mechanical complications (times per patient-year) were not statistically different between patients undergoing a conventional and a novel PD catheter insertion (0.18 vs. 0.24; p = 0.79 and 0.03 vs. 0.16; p = 0.16, respectively).

Conclusions
This novel method of PD catheter insertion from the McBurney point was safe, caused less discomfort, and was effective in preventing catheter dysfunction.
Determinants of HIV-malaria co-infection among people living with HIV on anti-retroviral therapy in Northeast Ethiopia: unmatched case control study
Authors: Yibeltal Tenaw , Abitew Dereje Birhanu , Melese Amsalu Birara , Mulu Yared 
Published: November 2020

Abstract
Background
HIV and malaria are the leading causes of morbidity and mortality in the developing world including Ethiopia. Globally, HIV-malaria co-infection causes approximately 3 million deaths per year. However, both these infections are preventable if measures are taken on determinant factors. The objective of the study was therefore to assess factors associated with HIV-malaria co-infection among HIV-positive people who lived in Shewarobit district, northeast Ethiopia.

Methods
Unmatched case-control study was conducted among people living with HIV (PLWHA) in Shewarobit district from February 28, 2018, to April 30, 2018. The sample size was determined taking the assumption of 95% CI, 85% power, 3:1 control to case ratio, the proportion of PLWHA-malaria coinfection of 22.7%, OR 2.73, and 10% non-response rate. The final sample size was 262 (66 cases and 196 controls). Cases were adults on anti-retroviral therapy and diagnosed positive for malaria by microscopy while controls were adults on anti-retroviral therapy and diagnosed negative for malaria by microscopy in the previous 6 months before the survey.

Result
The median age of cases and controls in years was 35 (IQR = 19) and 38 (IQR = 19) respectively. Variables that had a significant association with HIV-malaria co-infection were non-in-door residual spraying (adjusted odds ratio (AOR) = 4.91; 95% CI 4.03, 15.13), poor perception on the health risk of HIV-malaria co-infections (AOR = 4.11; 95% CI 1.28, 10.17), non-use of insecticidal treated bed nets (AOR = 6.21; 95%CI 2.74, 14.11), non-use of cotrimoxazole prophylaxis (AOR = 2.42; 95% CI 1.11, 5.28), and not received health education on the risk of HIV-malaria interaction (AOR = 4.11; 95% CI 1.24, 4.84).

Conclusion
Provision of cotrimoxazole prophylaxis, sleeping under an insecticidal treated bed net, and indoor residual spraying help to reduce HIV-malaria co-infection-associated morbidity/mortality.
Going, going, gone: competitive decision-making in Dutch auctions
Authors: Bennett Murray , Mullard Rachel , Adam Marc T. P. , Steyvers Mark , Brown Scott , Eidels Ami 
Published: November 2020

AbstractIn a Dutch auction, an item is offered for sale at a set maximum price. The price is then gradually lowered over a fixed interval of time until a bid is made, securing the item for the bidder at the current price. Bidders must trade-off between certainty and price: bid early to secure the item and you pay a premium; bid later at a lower price but risk losing to another bidder. These properties of Dutch auctions provide new opportunities to study competitive decision-making in a group setting. We developed a novel computerised Dutch auction platform and conducted a set of experiments manipulating volatility (fixed vs varied number of items for sale) and price reduction interval rate (step-rate). Triplets of participants ($$N=66$$N=66) competed with hypothetical funds against each other. We report null effects of step-rate and volatility on bidding behaviour. We developed a novel adaptation of prospect theory to account for group bidding behaviour by balancing certainty and subjective expected utility. We show the model is sensitive to variation in auction starting price and can predict the associated changes in group bid prices that were observed in our data.
Recent progress on peripheral neural interface technology towards bioelectronic medicine
Authors: Cho Youngjun , Park Jaeu , Lee Chengkuo , Lee Sanghoon 
Published: November 2020

AbstractModulation of the peripheral nervous system (PNS) has a great potential for therapeutic intervention as well as restore bodily functions. Recent interest has focused on autonomic nerves, as they regulate extensive functions implicated in organ physiology, chronic disease state and appear tractable to targeted modulation of discrete nerve units. Therapeutic interventions based on specific bioelectronic neuromodulation depend on reliable neural interface to stimulate and record autonomic nerves. Furthermore, the function of stimulation and recording requires energy which should be delivered to the interface. Due to the physiological and anatomical challenges of autonomic nerves, various forms of this active neural interface need to be developed to achieve next generation of neural interface for bioelectronic medicine. In this article, we present an overview of the state-of-the-art for peripheral neural interface technology in relation to autonomic nerves. Also, we reveal the current status of wireless neural interface for peripheral nerve applications. Recent studies of a novel concept of self-sustainable neural interface without battery and electronic components are presented. Finally, the recent results of non-invasive stimulation such as ultrasound and magnetic stimulation are covered and the perspective of the future research direction is provided.
Mechanical removal of surface residues on graphene for TEM characterizations
Authors: Kim Dong-Gyu , Lee Sol , Kim Kwanpyo 
Published: November 2020

AbstractContamination on two-dimensional (2D) crystal surfaces poses serious limitations on fundamental studies and applications of 2D crystals. Surface residues induce uncontrolled doping and charge carrier scattering in 2D crystals, and trapped residues in mechanically assembled 2D vertical heterostructures often hinder coupling between stacked layers. Developing a process that can reduce the surface residues on 2D crystals is important. In this study, we explored the use of atomic force microscopy (AFM) to remove surface residues from 2D crystals. Using various transmission electron microscopy (TEM) investigations, we confirmed that surface residues on graphene samples can be effectively removed via contact-mode AFM scanning. The mechanical cleaning process dramatically increases the residue-free areas, where high-resolution imaging of graphene layers can be obtained. We believe that our mechanical cleaning process can be utilized to prepare high-quality 2D crystal samples with minimum surface residues.
Leiomyosarcoma of ileal mesentery in a middle age female: a rare case report
Authors: Ahmed Maria , Babar Jahanzaib , Khan Hina , Rana Maheen , Khan Sarah , Abbasi Mujeeb Ur Rehman , Memon Amjad Siraj 
Published: November 2020

Abstract
Background
Leiomyosarcoma arising from mesentery is a rare tumor associated with worse prognosis. The tumor arises from smooth muscles in vascular wall. Ileal mesentery is common site of this tumor origin.

Case presentation
A middle age female was presented with complain of abdominal distension. A mass was palpable on abdominal examination. CT scan showed large mesenteric cyst. 15 × 10 cm large mass excised with associated mesentery and small bowel segment and on histopathology was found, and it was diagnosed as mesenteric leiomyosarcoma. The patient was discharged and referred to oncology for chemotherapy.

Conclusion
Leiomyosarcoma is a rare disease with grave prognosis. There is a paucity of literature and proper guidelines for its management; however, surgical excision with healthy margins is a mainstay of management. Close follow-up is recommended post-operatively because there are high chances of recurrence and metastasis.
Provider perspectives of implementation of an evidence-based insomnia treatment in Veterans Affairs (VA) primary care: barriers, existing strategies, and future directions
Authors: Koffel Erin , Hagedorn Hildi 
Published: November 2020

Abstract
Background
Cognitive behavioral therapy for insomnia (CBT-I) is a highly effective nonpharmacological intervention that is widely considered the gold standard for insomnia treatment. Insomnia is a prevalent and debilitating public health concern. Up to one third of the general population struggles with chronic insomnia, greatly increasing the risk for chronic pain and inflammation, depression and suicide, and cognitive decline. Over the last 10 years, the Veterans Health Administration (VHA) evidence-based psychotherapy training program has trained nearly 1000 providers to deliver CBT-I in hospitals and clinics nationwide. Despite increased access, most patients with insomnia receive sleeping medications instead of CBT-I. This is particularly concerning for vulnerable populations, like older adults, who may be at increased risk of harms from medications. The goal of this study was to obtain a broad range of perspectives on CBT-I implementation from providers who commonly utilize and deliver CBT-I. This work identifies barriers and successful strategies used to overcome these barriers to guide future implementation efforts promoting evidence-based sleep care.

Methods
Semi-structured interviews, using the Consolidated Framework for Implementation Research (CFIR) as a guide, were conducted with 17 providers from five Veterans Affairs (VA) facilities (8 primary care physicians, 4 primary care psychologists, and 5 CBT-I coordinators). We used a thematic analysis approach in which common ideas were identified across interviews and then grouped into larger conceptual themes. Data were concurrently collected and analyzed with rapid assessment process (RAP) techniques.

Results
Findings suggested implementation barriers and facilitators related to the CFIR constructs of intervention characteristic (e.g., providers unfamiliar with primary evidence of CBT-I effectiveness), inner setting (e.g., sleep as a low relative priority in primary care), and outer setting (e.g., lack of external incentives for increasing CBT-I use), as well as several successful strategies, including use of local champions and supportive opinion leaders.

Conclusions
These findings suggest promising opportunities to improve implementation of CBT-I, especially at facilities with less well-established CBT-I programs. Formal implementation trials are needed to systematically determine the real-world impact of strategies such as enlisting CBT-I champions, informing opinion leaders about CBT-I services, and promoting network weaving among primary care, mental health, and sleep clinics.
Role of Risk Aversion in Price Postponement Under Supply Random Yield
Authors: Kouvelis Panos , Xiao Guang , Yang Nan 
Published: November 2020

Price postponement is an effective mechanism to hedge against the adverse effect of supply random yield. However, its effectiveness and the resulting production decisions have not been studied for risk-averse firms. In this paper, we investigate the impact of price postponement and risk aversion under supply yield risk. Specifically, we study a risk-averse monopoly firm’s production and pricing decisions under supply random yield with two distinct pricing schemes: (1) ex ante pricing in which the firm simultaneously makes the sales price and sourcing decisions before production takes place and (2) responsive pricing in which the pricing decision is postponed until after the production yield realization. We adopt conditional value at risk (CVaR) as the risk-aversion measurement and investigate the impact of the firm’s risk-aversion level on its optimal decisions and the corresponding profit. Among other results, we show that, for each pricing scheme, there exists a unique risk-aversion threshold under which the firm chooses not to produce. Interestingly, price postponement has no impact on the risk-aversion threshold as the cutoff values under both pricing schemes are the same. We further show that the value of CVaR improvement from responsive pricing may not be monotonic in the firm’s risk-aversion level. Consequently, our results indicate that, although price postponement induces operational flexibility by better matching demand with available supply, whether the firm should adopt responsive pricing needs to be carefully evaluated as the benefit may not justify the potential fixed cost associated with price postponement, especially for a highly risk-averse firm. In addition, we show that responsive pricing, even with its ex post revenue-maximization behavior, benefits the end-market consumers in equilibrium. Finally, we conduct extensive numerical studies to check and confirm the robustness of our results. This paper was accepted by Charles Corbett, operations management.
Prevalence of combined abnormalities of tibial and femoral torsion in patients with symptomatic hip dysplasia and femoroacetabular impingement
Authors: Lerch Till D. , Liechti Emanuel F. , Todorski Inga A. S. , Schmaranzer Florian , Steppacher Simon D. , Siebenrock Klaus A. , Tannast Moritz , Klenke Frank M. 
Published: November 2020

Aims The prevalence of combined abnormalities of femoral torsion (FT) and tibial torsion (TT) is unknown in patients with femoroacetabular impingement (FAI) and hip dysplasia. This study aimed to determine the prevalence of combined abnormalities of FT and TT, and which subgroups are associated with combined abnormalities of FT and TT. Methods We retrospectively evaluated symptomatic patients with FAI or hip dysplasia with CT scans performed between September 2011 and September 2016. A total of 261 hips (174 patients) had a measurement of FT and TT. Their mean age was 31 years (SD 9), and 63% were female (165 hips). Patients were compared to an asymptomatic control group (48 hips, 27 patients) who had CT scans including femur and tibia available for analysis, which had been acquired for nonorthopaedic reasons. Comparisons were conducted using analysis of variance with Bonferroni correction. Results In the overall study group, abnormal FT was present in 62% (163 hips). Abnormal TT was present in 42% (109 hips). Normal FT combined with normal TT was present in 21% (55 hips). The most frequent abnormal combination was increased FT combined with normal TT of 32% (84 hips). In the hip dysplasia group, 21% (11 hips) had increased FT combined with increased TT. The prevalence of abnormal FT varied significantly among the subgroups (p < 0.001). We found a significantly higher mean FT for hip dysplasia (31°; SD 15)° and valgus hips (42° (SD 12°)) compared with the control group (22° (SD 8°)). We found a significantly higher mean TT for hips with cam-type-FAI (34° (SD 6°)) and hip dysplasia (35° (SD 9°)) compared with the control group (28° (SD 8°)) (p < 0.001). Conclusion Patients with FAI had a high prevalence of combined abnormalities of FT and TT. For hip dysplasia, we found a significantly higher mean FT and TT, while 21% of patients (11 hips) had combined increased TT and increased FT (combined torsional malalignment). This is important when planning hip preserving surgery such as periacetabular osteomy and femoral derotation osteotomy. Cite this article: Bone Joint J 2020;102-B(12):1636–1645.