bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feto-maternal outcomes of hypertensive disorders of pregnancy in Yekatit-12 Teaching Hospital, Addis Ababa: a retrospective study
Authors: Mengistu Mekoya D. , Kuma Tilahun 
Published: April 2020

Abstract
Background
In resource poor countries, hypertensive disorders of pregnancy are common and form one of the deadly triads, along with hemorrhage and infection, which contribute greatly to maternal and fetal jeopardy.

Methods
The aim of this study was to assess the prevalence of hypertensive disorders of pregnancy, and determine the effects of hypertensive disorders of pregnancy on the feto-maternal outcomes. It was a descriptive, cross-sectional, retrospective study on randomly selected 615 women who attended delivery at Yekatit-12 Teaching Hospital from 1st of July 2017 -1st of Jan 2018. Data was analyzed using SPSS version 20 software. Descriptive statistics were used to calculate rates. Chi-square statistics were used to estimate the associations among selected predictor variables. A p-value < 0.05 was taken as statistically significant.

Results
Out of the 615 study population, the prevalence of hypertensive disorders of pregnancy was found to be 25.4%, of which the majority (52.5%) was severe pre-eclampsia. Eclampsia accounted for 2.6%, and superimposed pre-eclampsia was 2.6%. The rate of severe pre-eclampsia with HELLP syndrome was 7.1% of all mothers with the hypertensive disorders. The majority of mothers with hypertensive disorders (59.6%) had age range of 25–34 years. About 46% of mothers required interventions to terminate the pregnancy either by cesarean section (42.3%) or instrumental deliveries (3.7%) due to conditions related to Hypertensive disorders. The rate of preterm, low birth weight, and low Apgar at 1st and 5thminutes accounted for 29.5, 24.4, 22.4 and 16.7% of neonates born to mothers with hypertensive disorders, respectively. Over 10.9% of neonates required resuscitation and 11.5% NICU referral. The rate of still birth was 3.8%.

Conclusion
The prevalence of hypertensive disorders of pregnancy is high in the study area and complicates maternal and fetal outcomes of the pregnancy. To deter its detrimental effects both on fetal and maternal outcomes of pregnancy, antenatal surveillance should be expanded to enable early detection, stringent follow-up and timely intervention in severely affected pregnancies.
Serum human epididymis protein 4 level as a predictor of clinical worsening in idiopathic pulmonary arterial hypertension: a pilot study
Authors: Jin Qi , Tang Yi , Liu Zhihong , Xie Wenlin , Luo Qin , Zhao Zhihui , Zhao Qing , Huang Zhiwei , Yu Xue , Yan Lu , Xiong Changming , Ni Xinhai , Yan Yinkun 
Published: April 2020

AbstractBackgroundHuman epididymis protein 4 (HE4) was proved to be a novel biomarker for left heart failure. The purpose of this exploratory study was to evaluate the role of HE4 in patients with idiopathic pulmonary arterial hypertension (IPAH) who usually have concurrent right heart failure.Methods55 patients with newly diagnosed IPAH were continuously enrolled and serum HE4 levels were assessed at baseline. All patients were followed up from the date of blood sampling, and a composite endpoint of clinical worsening was detailedly recorded.ResultsSerum levels of HE4 were significantly higher in IPAH patients than healthy controls (6.9 ± 2.2 vs 4.4 ± 0.9 ng/ml,p < 0.05) and increased as cardiac function deteriorated. HE4 levels correlated with endothelin-1 (r = 0.331,p < 0.01) and right atrial pressure (r = 0.30,p < 0.03). After a mean follow-up of 20 ± 10 months, 13 patients experienced clinical worsening. Receiver operating characteristic analysis showed that HE4 levels > 6.5 ng/ml discriminated clinical worsening with a sensitivity of 92.31% and a specificity of 59.52% (area under the curve [AUC] = 0.81). Multivariate Cox regression analysis demonstrated that HE4 (χ2: 5.10; hazard ratio [HR] = 1.26; 95% confidence interval: 1.03 to 1.55,p < 0.02) and pulmonary vascular resistance (χ2: 4.19; HR = 1.14; 95% confidence interval: 1.00–1.29,p < 0.04) were independently predictive of clinical worsening. Patients with HE4 > 6.5 ng/ml had a worse 2-year survival rate than those with HE4 ≤ 6.5 ng/ml (58.9% vs 96.2%,p < 0.001).ConclusionsSerum levels of HE4 were elevated in IPAH patients and correlated with disease severity. HE4 was an independent predictor of clinical worsening in IPAH patients.
Genetic forms and pathophysiology of essential arterial hypertension in minor indigenous peoples of Russia
Authors: Mulerova Tatyana , Uchasova Evgenya , Ogarkov Michael , Barbarash Olga 
Published: April 2020

Abstract
Background
To study the genetic forms and pathophysiology of arterial hypertension by evaluating plasma renin activity in the Shors, minor indigenous peoples inhabiting the south of Western Siberia.

Methods
A single-stage study of indigenous (the Shors) and non-indigenous peoples living in the villages of Gornaya Shoria of the Kemerovo region in the south of Western Siberia was conducted in the period from 2013 to 2017. One thousand four hundred nine adults (901 Shors and 508 non-indigenous inhabitants) were recruited in the study using a continuous sampling plan. Arterial blood pressure was measured according to 2018 ESC/ESH guidelines for the management of arterial hypertension. All the respondents underwent clinical and instrumental examination. Plasma renin activity was determined by enzyme-linked immunoassay with the BRG kits (Germany). Polymorphisms of ACE (I/D, rs 4340), АGT (c.803 T > C, rs699), AGTR1 (А1166С, rs5186), ADRB1 (с.145A > G, Ser49Gly, rs1801252) and ADRA2B (I/D, rs 28,365,031) genes were tested using polymerase chain reaction.

Results
Renin-dependent hypertensive patients prevailed in both ethnic groups (65.6% in the indigenous group vs. 89.8% in the non-indigenous group, p = 0.001). Prevalence of a volume-dependent AH was low in both groups (34.4% in the indigenous group vs. 10.2% in the non-indigenous group, р = 0.001). The D/D and Т/Т genotypes of the АСЕ [OR = 6.97; 95% CI (1.07–55.58)] and AGT [OR = 3.53; 95% CI (1.02–12.91)] genes were associated with the renin-dependent AH in the Shors. The C/C genotype of AGTR1 gene was found to predispose to the volume-dependent AH [OR = 5.25; 95% CI (1.03–27.89)]. The C/C genotype of AGTR1 gene was associated with moderate or high renin levels suggesting essential AH in the non-indigenous group [OR = 5.00; 95% CI (1.21–22.30), р = 0.029].

Conclusion
An in-depth understanding of AH pathophysiology and its genetic forms ensures the optimal choice of blood pressure-lowering treatment and optimizes AH control.
Epidemiological and molecular characterization of Streptococcus pneumoniae carriage strains in pre-school children in Arkhangelsk, northern European Russia, prior to the introduction of conjugate pneumococcal vaccines
Authors: Vorobieva S. Jensen V. , Furberg A-S , Slotved H-C , Bazhukova T. , Haldorsen B. , Caugant D. A. , Sundsfjord A. , Valentiner-Branth P. , Simonsen G. S. 
Published: April 2020

Abstract
Background
The 13-valent Pneumococcal Conjugate Vaccine (PCV-13) was introduced in the National Immunization Programme (NIP) schedule in Russia in March 2014. Previously, the 7-valent Pneumococcal Conjugate Vaccine (PCV-7) was marketed in Russia in 2009 but has never been offered for mass vaccination. A carriage study was performed among children in Arkhangelsk in 2006. The objective was to determine the prevalence of carriage, serotype distribution, antimicrobial susceptibility and the molecular structure of Streptococcus pneumoniae strains before marketing and introduction of PCV-13.

Methods
A cross-sectional study was conducted on a cluster-randomized sample of children and a self-administrated questionnaire for parents/guardians. Nasopharyngeal samples were collected from 438 children younger than 7 years attending nurseries and kindergartens in the Arkhangelsk region, Russia. Detailed demographic data, as well as information about the child’s health, traveling, exposure to antimicrobials within the last 3 months and anthropometric measurements were collected for all study subjects. Variables extracted from the questionnaire were analysed using statistic regression models to estimate the risk of carriage. All pneumococcal isolates were examined with susceptibility testing, serotyping and multilocus sequence typing.

Results
The overall prevalence of asymptomatic carriage was high and peaking at 36 months with a rate of 57%. PCV-13 covered 67.3% of the detected strains. High rates of non-susceptibility to penicillin, macrolides and multidrug resistance were associated with specific vaccine serotypes, pandemic clones, and local sequence types. Nine percent of isolates represented three globally disseminated disease-associated pandemic clones; penicillin- and macrolide-resistant clones NorwayNT-42 and Poland6B-20, as well as penicillin- and macrolide-susceptible clone Netherlands3-31. A high level of antimicrobial consumption was noted by the study. According to the parent’s reports, 89.5% of the children used at least one antimicrobial regime since birth. None of the hypothesised predictors of S. pneumoniae carriage were statistically significant in univariable and multivariable logistic models.

Conclusions
The study identified a high coverage of the PCV-13-vaccine, but serotype replacement and expansion of globally disseminated disease-associated clones with non-vaccine serotypes may be expected. Further surveillance of antimicrobial resistance and serotype distribution is therefore required.
Weakly-supervised convolutional neural networks of renal tumor segmentation in abdominal CTA images
Authors: Yang Guanyu , Wang Chuanxia , Yang Jian , Chen Yang , Tang Lijun , Shao Pengfei , Dillenseger Jean-Louis , Shu Huazhong , Luo Limin 
Published: April 2020

Abstract
Background
Renal cancer is one of the 10 most common cancers in human beings. The laparoscopic partial nephrectomy (LPN) is an effective way to treat renal cancer. Localization and delineation of the renal tumor from pre-operative CT Angiography (CTA) is an important step for LPN surgery planning. Recently, with the development of the technique of deep learning, deep neural networks can be trained to provide accurate pixel-wise renal tumor segmentation in CTA images. However, constructing the training dataset with a large amount of pixel-wise annotations is a time-consuming task for the radiologists. Therefore, weakly-supervised approaches attract more interest in research.

Methods
In this paper, we proposed a novel weakly-supervised convolutional neural network (CNN) for renal tumor segmentation. A three-stage framework was introduced to train the CNN with the weak annotations of renal tumors, i.e. the bounding boxes of renal tumors. The framework includes pseudo masks generation, group and weighted training phases. Clinical abdominal CT angiographic images of 200 patients were applied to perform the evaluation.

Results
Extensive experimental results show that the proposed method achieves a higher dice coefficient (DSC) of 0.826 than the other two existing weakly-supervised deep neural networks. Furthermore, the segmentation performance is close to the fully supervised deep CNN.

Conclusions
The proposed strategy improves not only the efficiency of network training but also the precision of the segmentation.
Improving the diagnosis of common parotid tumors via the combination of CT image biomarkers and clinical parameters
Authors: Zhang Dan , Li Xiaojiao , Lv Liang , Yu Jiayi , Yang Chao , Xiong Hua , Liao Ruikun , Zhou Bi , Huang Xianlong , Liu Xiaoshuang , Tang Zhuoyue 
Published: April 2020

Abstract
Background
Our study aims to develop and validate diagnostic models of the common parotid tumors based on whole-volume CT textural image biomarkers (IBMs) in combination with clinical parameters at a single institution.

Methods
The study cohort was composed of 51 pleomorphic adenoma (PA) patients and 42 Warthin tumor (WT) patients. Clinical parameters and conventional image features were scored retrospectively and textural IBMs were extracted from CT images of arterial phase. Independent-samples t test or Chi-square test was used for evaluating the significance of the difference among clinical parameters, conventional CT image features, and textural IBMs. The diagnostic performance of univariate model and multivariate model was evaluated via receiver operating characteristic (ROC) curve and area under ROC curve (AUC).

Results
Significant differences were found in clinical parameters (age, gender, disease duration, smoking), conventional image features (site, maximum diameter, time-density curve, peripheral vessels sign) and textural IBMs (mean, uniformity, energy, entropy) between PA group and WT group (P<0.05). ROC analysis showed that clinical parameter (age) and quantitative textural IBMs (mean, energy, entropy) were able to categorize the patients into PA group and WT group, with the AUC of 0.784, 0.902, 0.910, 0.805, respectively. When IBMs were added in clinical model, the multivariate models including age-mean and age-energy performed significantly better than the univariate models with the improved AUC of 0.940, 0.944, respectively (P<0.001).

Conclusions
Both clinical parameter and CT textural IBMs can be used for the preoperative, noninvasive diagnosis of parotid PA and WT. The diagnostic performance of textural IBM model was obviously better than that of clinical model and conventional image model in this study. While the multivariate model consisted of clinical parameter and textural IBM had the optimal diagnostic performance, which would contribute to the better selection of individualized surgery program.
Rituximab therapy for focal segmental glomerulosclerosis and minimal change disease in adults: a systematic review and meta-analysis
Authors: Hansrivijit Panupong , Cheungpasitporn Wisit , Thongprayoon Charat , Ghahramani Nasrollah 
Published: April 2020

Abstract
Background
Use of rituximab (RTX) for focal segmental glomerulosclerosis (FSGS) and minimal change disease (MCD) is widely described in children. Clinical evidence in adults is limited. The objective of this study was to determine the treatment outcomes of RTX in adults with FSGS and MCD.

Methods
Ovid MEDLINE, SCOPUS, and Cochrane Database of Systematic Reviews were searched up to September 2019. Out of 699 studies, we included 16 studies describing the treatment outcomes of rituximab in adult patients with FSGS or MCD. Results were reported in remission rate and relapse rate. Serious adverse events were also reported.

Results
A total of 16 studies were included in our review and analysis. All studies were observational studies and included a total of 221 patients (23.1% FSGS, 76.9% MCD). Mean follow-up duration was 26.3 ± 12.8 months. From the analysis of five studies with FSGS patients (n = 51), the overall remission rate and relapse rate of RTX therapy was 53.6% (95% CI, 15.8–87.6%) and 47.3% (95% CI, 25.4–70.2%), respectively. Complete remission occurred in 42.9%. In contrast, from the analysis of 11 studies with MCD patients (n = 170), the overall remission rate and relapse rate of RTX therapy was 80.3% (95% CI, 68.5–88.5%) and 35.9% (95% CI, 25.1–48.4), respectively. Complete remission occurred in 74.7%. Subgroup analyses showed that overall remission and relapse were not different after adjusted for study year and RTX dose for both FSGS and MCD. Incidence of serious adverse events was 0.092 events/year.

Conclusions
Rituximab may be considered as an additional treatment to the standard therapy for adult patients with FSGS and MCD. Remissions and relapses are similar between FSGS and MCD. Serious adverse effects of rituximab were uncommon. We encourage further randomized controlled trials to confirm the efficacy of rituximab therapy in these patients.
Maternal health services utilization and maternal mortality in China: a longitudinal study from 2009 to 2016
Authors: Zhao Pengyu , Han Xueyan , You Lili , Zhao Yu , Yang Li , Liu Yuanli 
Published: April 2020

Abstract
Background
The Chinese government introduced the maternal health services as part of the Basic Public Health Service (BPHS) project in 2009. While China has made progress in reducing maternal mortality, the longitudinal association between the utilization rate of the maternal health services of the BPHS project and such reduction was rarely evaluated with robust methods.

Methods
We conducted a longitudinal study on the maternal health service utilization rates of the BPHS project and the maternal mortality ratios (MMR) in mainland China and its 31 provincial regions. The data were extracted from the National Health Statistic Yearbooks (2009–2016). Panel data models were used to evaluate the association between the utilization rate and the MMR after adjusting for available covariates on healthcare resources. Stepwise regression models were used to gauge the direction and magnitude of omitted variable bias.

Results
It was found that the service utilization rate increased from 79.24% in 2009 to 91.67% in 2016, while MMR decreased from 30.90 to 17.88 per 100,000 livebirths at the national level. The results of the fixed effects panel data model revealed that the utilization rate was associated with MMR deduction continuously. With every 1% increase in utilization rate, the maternal death would decrease by 0.35 per 100,000 livebirths after having the health resources variables adjusted.

Conclusions
The utilization of maternal health services increased continuously after the introduction of BPHS project in 2009 and MMR went downward from then on. The utilization of maternal health services did have significant association with MMR and could reduce MMR effectively. Such improvement could be attributed to the fact that this program was designed to serve the targeted population throughout the continuum of maternal care and the government’s rigorous efforts in stressing equality and standard care in program implementation.
Three-dimensional ultrasonographic features of diamniotic conjoined twins with body stalk anomaly
Authors: Xiang Guishuang , Wen Yanting , Zhang Li , Tong Xiaoqian , Li Lu 
Published: April 2020

Abstract
Background
Since conjoined twins were thought to be monoamniotic in the past, diamniotic conjoined twins would be improbable theoretically. Body stalk anomaly is a severe defect of the body wall, which is rare among twins. Body stalk anomaly in monochorionic diamniotic conjoined twins has never been reported prenatally so far as we know.

Case presentation
Here we present an extremely rare case of concordant body stalk anomaly in monochorionic diamniotic conjoined twins. Ultrasonography at 9 + 5 weeks revealed one chorionic and two amniotic cavities, close apposition of abdomen, limited movement, and common umbilical vessels. Follow-up ultrasonography at 11 + 6 weeks and 13 + 2 weeks showed close apposition of the lower abdominal region with cystic structures and a small bowel-like mass between the two fetuses. Three-dimensional ultrasonography assisted in observing the entire appearance of both twins in earlier first trimester, including amnioticity, conjoined region and umbilical vessels. We attribute this diamniotic conjoined twin in our case to the fusion theory. A single yolk sac was observed, challenging the idea that yolk sac number predicts amnionicity. Identification of single yolk sac and its allantois may form a common body stalk during this fusion, leading to concordant body stalk anomaly in monochorionic diamniotic twins.

Conclusions
Our case may provide important insights into both ultrasonographic features and embryogenesis of this extremely rare anomaly.
Establishment and characterization of patient-derived xenografts as paraclinical models for head and neck cancer
Authors: Kang Han Na , Kim Jae-Hwan , Park A-Young , Choi Jae Woo , Lim Sun Min , Kim Jinna , Shin Eun Joo , Hong Min Hee , Pyo Kyoung-Ho , Yun Mi Ran , Kim Dong Hwi , Lee Hanna , Yoon Sun Och , Kim Da Hee , Park Young Min , Byeon Hyung Kwon , Jung Inkyung , Paik Soonmyung , Koh Yoon Woo , Cho Byoung Chul , Kim Hye Ryun 
Published: April 2020

Abstract
Background
We investigated whether head and neck squamous cell carcinoma (HNSCC) patient-derived xenografts (PDXs) reaffirm patient responses to anti-cancer therapeutics.

Methods
Tumors from HNSCC patients were transplanted into immunodeficient mice and propagated via subsequent implantation. We evaluated established PDXs by histology, genomic profiling, and in vivo anti-cancer efficacy testing to confirm them as the authentic in vivo platform.

Results
From 62 HNSCCs, 15 (24%) PDXs were established. The primary cancer types were tongue (8), oropharynx (3), hypopharynx (1), ethmoid sinus cancer (1), supraglottic cancer (1), and parotid gland (1); six PDXs (40%) were established from biopsy specimens from advanced HNSCC. PDXs mostly retained donor characteristics and remained stable across passages. PIK3CA (H1047R), HRAS (G12D), and TP53 mutations (H193R, I195T, R248W, R273H, E298X) and EGFR, CCND1, MYC, and PIK3CA amplifications were identified. Using the acquisition method, biopsy showed a significantly higher engraftment rate when compared with that of surgical resection (100% [6/6] vs. 16.1% [9/56], P < 0.001). Specimens obtained from metastatic sites showed a significantly higher engraftment rate than did those from primary sites (100% [9/9] vs. 11.3% [6/53], P < 0.001). Three PDX models from HPV-positive tumors were established, as compared to 12 from HPV-negative (15.8% [3/19] and 27.9% [12/43] respectively, P = 0.311), suggesting that HPV positivity tends to show a low engraftment rate. Drug responses in PDX recapitulated the clinical responses of the matching patients with pan-HER inhibitors and pan-PI3K inhibitor.

Conclusions
Genetically and clinically annotated HNSCC PDXs could be useful preclinical tools for evaluating biomarkers, therapeutic targets, and new drug discovery.