bluuebunny/crossref_metadata_2025_split huggingface dataset:
In vitro cell culture of patient derived malignant pleural and peritoneal effusions for personalised drug screening
Authors: Wu Cheng-Guang , Chiovaro Francesca , Curioni Alessandra , Casanova Ruben , Soltermann Alex 
Published: February 2020

Abstract
Background Malignant serous effusion (MSE) denotes a manifestation of metastatic disease with typical high concentrations of both cancer and immune cells, making them an ideal resource for in vitro cytologic studies. Hence, the aim of the study was to investigate the features of 2D and 3D MSE culture systems as well as their feasibilities for in vitro drug screening. Methods Pleural and peritoneal effusions from 8 patients were collected and processed for 2D monolayer and 3D hanging drop cell culture into GravityPLUS™ plates. Representative markers for cell components, proliferation rate and tumour classification were investigated by immunohistochemistry, followed by absolute quantification using a digitalised image analysis approach. Further, we implemented another 3D cell culture model based on a low attachment method for in vitro drug sensitivity testing of carboplatin, pemetrexed and pembrolizumab for 5 patients. Results Monolayer cell culture was favourable for the growth of mesothelial cells, while hanging drop culture in GravityPLUS™ plates showed better ability for preserving cancer cells, inducing positive diagnostic markers expression and restraining the growth of mesothelial cells. For in vitro drug testing, MSE from five patients presented various drug sensitivities, and one case showed strong response to PD-1 checkpoint inhibition (pembrolizumab). For some patients, the application of combinatorial drugs had better therapeutic responses compared to monotherapy. Conclusions Digitalised quantification of data offers a better understanding of different MSE culture models. More importantly, the proposed platforms are practical and amenable for performing in vitro chemo-/immunotherapeutic drug testing by using routine cytologic MSE in a personalised manner. Next to cell blocks, our work demonstrates the prognostic and predictive value of cytologic effusion samples.
Mechanical stretching induces the apoptosis of parametrial ligament fibroblasts via the actin cytoskeleton and Nr4a1
Authors: Li Yang , Zeng Wanling , Li Bingshu , Liu Cheng , Hong Shasha , Tang Jianming , Li Sutinng , Wang Tingting , Yang Lian , Li Lu , Hong Li 
Published: February 2020

Abstract
Background The anatomical positions of pelvic floor organs are maintained mainly by ligaments and muscles. Long-term excessive mechanical tension stimulation of pelvic floor tissue beyond the endurance of ligaments or muscles will lead to the occurrence of pelvic organ prolapse (POP). In addition, cytoskeletal reconstitution is a key process by which cells respond to mechanical stimulation. The aim of the present study was to investigate the protective effect of actin cytoskeleton in resist mechanical stretching (MS)-induced apoptosis of parametrial ligament fibroblasts (PLFs) and the underlying mechanisms. Methods 8 women who underwent hysterectomy surgery for reasons excluding the presence of malignant tumors and POP served as controls, and 7 patients who underwent hysterectomy surgery for only advanced POP comprised the POP group. MS was provided by a fourpoint bending device. We examined the effects of MS on actin cytoskeleton and apoptosis of PLFs. Then the apoptosis was detected after latrunculin A (Lat-A, a potent inhibitor of actin) exposure and the interference of Nr4a1. Results MS could significantly induce apoptosis of PLFs from non-POP patients, which exhibited an apoptosis rate close to that of PLFs from POP patients, and the apoptosis rate was higher following latrunculin A treatment. In addition, Nr4a1 and Bax expression was increased while Bcl-2 and caspase-3 expression was clearly decreased after treatment with MS and Lat-A. However, the MS-induced apoptosis of PLFs was reduced when treatment with siRNA targeting Nr4a1 was used to downregulate the level of Nr4a1. Conclusions These outcomes reveal a novel mechanism that links the actin cytoskeleton and apoptosis in PLFs by Nr4a1; this mechanism will provide insight into the clinical diagnosis and treatment of POP.
Correlation study between flash dual source CT perfusion imaging and regional lymph node metastasis of non-small cell lung cancer
Authors: Huang Tingting , Sun Hui , Luo Xianli , Zhang Xuemei , Jin Kaiyuan , Wang Feng , Sun Lv , Cheng Nianlan , Wu Shuo , Lou Qin , Li Bangguo 
Published: February 2020

Abstract
Objective To explore the correlation of flash dual source computed tomography perfusion imaging (CTPI) and regional lymph node metastasis of non-small cell lung cancer (NSCLC), and to evaluate the value of CT perfusion parameters in predicting regional lymph node metastasis of NSCLC. Methods 120 consecutive patients with NSCLC confirmed by postoperative histopathology were underwent flash dual source CT perfusion imaging in pre-operation. The CT perfusion parameters of NSCLC, such as blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability (PMB) were obtained by the image post-processing. Then microvessel density (MVD), luminal vascular number (LVN), luminal vascular area (LVA) and luminal vascular perimeter (LVP) of NSCLC were counted by immunohistochemistry. These cases were divided into two groups that patient with regional lymph node metastasis group (group A, 58 cases) and without regional lymph node metastasis group (group B, 62 cases) according to their pathological results. The CT perfusion parameters and the microvessel parameters were contrastively analysed between the two groups. Receiver operating characteristic (ROC) curve was used to assess the diagnostic efficiency of CT perfusion parameters in predicting regional lymph node metastasis of NSCLC in pre-operation. Results Group A presented signiﬁcantly lower LVA, BF and higher MTT, PMB than Group B ( P <0.05), while BV, LVN, LVP and MVD were no significant difference ( P >0.05). Correlation analysis showed that BF was correlated with LVA and LVP ( P <0.05), while BV, MTT and PMB were not correlated with LVN, LVA and LVP ( P >0.05). All the perfusion parameters were not correlated with MVD. According to the ROC curve analysis, when BF<85.16 ml/100 ml/min as a cutoff point to predict regional lymph node metastasis of NSCLC, the sensitivity, speciﬁcity, accuracy, positive predictive value and negative predictive value were 60.8%, 81.7%, 71.5%, 75.6% and 69.5% respectively. Conclusion Flash dual source CT perfusion imaging can non-invasively indicate the luminal vascular structure of tumor and BF can be used as one of the important indexes in predicting regional lymph node metastasis of NSCLC in pre-operation.
Risk factors for postoperative delirium in patients with triple-branched stent graft implantation
Authors: Lin Yanjuan , Chen Qiong , Zhang Haoruo , Chen Liang-Wan , Peng Yanchun , Huang Xizhen , Chen Yiping , Li Sailan , Lin Lingyu 
Published: February 2020

Abstract
Background: The incidence of neurological complications is relatively high after novel triple-branched stent graft implantation in patients with Stanford type A aortic dissection (AAD). But the incidence and risk factors of postoperative delirium (POD) have not been studied. The aim of this study was to investigated the incidence and risk factors of POD after novel triple-branched stent graft implantation.Methods: An observational study of AAD patients who underwent novel triple-branched stent graft implantation between January 2017 and July 2019 was followed up after surgery. Patients’ delirium is screened by the Richmond Agitation-Sedation Scale and the Confusion Assessment Method for the intensive care unit from the first day after the operation, lasted 5 days. The risk factors of POD was analyzed by the Cox proportional hazard models.Results: A total of 280 cases of AAD patients were enrolled in this research, the incidence of POD was 37.86%. Adjusting for age, body mass index, and mechanical ventilation duration, multivariate Cox regression analysis model revealed that non-manual work (adjusted hazard ratio [AHR] = .554; 95% CI: 0.335-0.915; P = .021), Acute Physiology and Chronic Health Evaluation II (APACHE-II) scores > 20 (AHR = 3.359, 95% CI: 1.707-6.609, P < .001), hypoxemia (AHR = 1.846, 95% CI: 1.118-3.048, P = .017), and more than two types of analgesics and sedatives were independently associated with POD.Conclusions: This study showed that risk factors independently associated with POD were APACHE-II score > 20, hypoxemia and more types of analgesics and sedatives, and non-manual work was the protective factor.Trial registration: This study was retrospectively registered in the Chinese Clinical Trial Registry (Registration number: ChiCTR1900022408; Date: 2019/4/10)
Short-term Outcomes of Modified Y-Graft Technique in Acute Type A Aortic Dissection Using the Femoral Artery Bypass and One Minute Systemic Circulatory Arrest Technique
Authors: Sun Xiangfei , Zhao Qi , Huo Yufeng , Zhou Jinfeng , Zhao Fen , Liu Yimin , Du Yonghai , He Songxiong , Liu Chao , Jiang Detian , Sun Wenyu 
Published: February 2020

Abstract
Objective: Aortic arch replacement in acute type A aortic dissection patients remains a most challenging cardiovascular operation. This article aims to show our Modified Y-Graft Technique using the Femoral Artery Bypass (FAB) and the One Minute Systemic Circulatory Arrest (OSCA) Technique and assess the short-term outcomes of the patients.Methods: Between February 2015 and November 2017, 51 patients with acute type A aortic dissection underwent aortic arch replacement. Among them, 23 patients’ procedure used FAB and 28 patients utilized both FAB and OSCA. The intraoperative data and postoperative follow-up data were recorded. The follow-up data of patients with traditional Y-graft technique were collected from previous reported studies.Results: In FAB group, two patients died for pulmonary infection (30-day survival rate 91.3%), and two patients paralyzed from the waist down. The hemodialysis was performed for five patients (21.7%) before hospital discharge. Fifteen patients (65.2%) received more than 2-day’s respiratory support and 8 patients (34.8%) received more than 5-day’s respiratory support. These follow-up data are basically flat or precede to the patients with traditional Y-graft technique. Furthermore, compared to the FAB Group, the morbidity of the neurologic dysfunction and the acute renal failure was significantly reduced in FAB+OSCA Group. Besides, the respiratory support, the length of the postoperative stay and the ICU stay were shortened.Conclusions: This study clarified the feasibility of FAB and OSCA technique in modifying Y-graft technique. The acute type A aortic dissection patients tend to have less surgical complications and favorable short-term outcomes by this surgery.
Adaptive filter based on Monte Carlo method to improve the target tracking in radar systems
Authors: Zarai Khaireddine , Adnane Cherif 
Published: February 2020

Abstract
The state estimation and tracking of random target is an attractive research problem in radar system. The information received in the radar receiver was reflected by the target, that it is received with many white and Gaussian noise due to the characteristics of the transmission channel and the radar environment. After detection and location scenarios, the radar system must track the target in real time. We aim to improve the state estimation process for too random target at the given instant in order to converge to the true target state and smooth their true path for a long time, it simplifies the process of real-time tracking. In this framework, we propose a new approach based on the numerical methods presented by MONTE CARLO (MC) counterpart the method conventionally used named Extended KALMAN Filter (EKF), we showed that the first are more successful. Keywords: Radar, Monte Carlo, Extended KALMAN Filter, Tracking, PF, Random target.
The relationship between thyroid hormone and lipid metabolism/body fat content in euthyroid male patients with type 2 diabetes mellitus in China: A cross-sectional study
Authors: Sun Xia , Chen Liping , Wu Rongzhen , Zhang Dan , He Yinhui 
Published: February 2020

Abstract
Background: This study compared the relationship between thyroid hormones and lipid metabolism/body fat content in euthyroid male patients with type 2 diabetes mellitus (T2DM) in China. Methods: A total of 64 male patients who were diagnosed as T2DM and 64 non-diabetic males who underwent health examination were matched according to age at a 1:1 ratio. Results: The 32 subjects in each sub-group showed differences in age, body mass index (BMI), mean arterial pressure, waist circumference, visceral fat content, body fat percentage, HbA1c, HOMA-IR, FT3, TSH, HDL-c, adiponectin, leptin, visfatin and TNF-α (all P < 0.05). In the overall population, FT3 was positively correlated with body fat percentage (r=0.21, P=0.02), and negatively correlated with HOMA-IR (r=-0.18, P=0.04) and visfatin (r=-0.47, P <0.01); TSH was positively correlated with body fat percentage (r=0.23, P=0.01). In the T2DM-OB group FT3 was positively correlated with BMI (r=0.45, P <0.05), visceral fat content (r=0.50, P <0.05), and body fat percentage (r=0.44, P <0.05); FT4 was positively correlated with visceral fat content (r=0.38, P <0.05); and TSH was positively correlated with HOMA-IR (r=0.39, P <0.05). Conclusion: TSH increased in obese people and FT3 was lower in patients with T2DM.
How to Design a Remote Patient Monitoring System A French Case Study
Authors: Ferrua Marie , Minvielle Etienne , Fourcade Aude , Lalloué Benoît , Sicotte Claude , Palma Mario Di , Mir Olivier 
Published: February 2020

Abstract
Background Remote Patient Monitoring Systems (RPMS) based on e-health, Nurse Navigators (NNs) and patient engagement can improve patient follow-up and have a positive impact on quality of care (by limiting adverse events) and costs (by reducing readmissions). However, the extent of this impact depends on effective implementation which is often restricted. This is partly due to the lack of attention paid to the RPMS design phase prior to implementation. The content of the RPMS can be carefully designed at this stage and various obstacles anticipated. Our aim was to report on an RPMS process design to provide an insight into the methodology required in order to manage this phase and the ultimate outcome in terms of RPMS content. Methods This study was carried out at Gustave Roussy, a comprehensive cancer centre in France. A multidisciplinary team comprising hospital managers, healthcare professionals and health service researchers coordinated the CAPRI RPMS design process (2013-2015). It is based on data collected during eight studies conducted in accordance with the principle framework of the UK Medical Research Council (MRC). This project was approved by the French National Data Protection Authorities. Results Based on the study results, the multidisciplinary team defined strategies for resolving obstacles and risks prior to the implementation of CAPRI. Consequently, the final CAPRI design includes a web app with two interfaces (patient and health care professionals) and two NNs. The NNs provide regular follow-up via telephone and/or email to manage patients' symptoms and toxicity, treatment compliance and care packages. Patients contact the NNs via a secure messaging system. Eighty graduation and orientation algorithms enable NNs to prioritise and decide on the course of action to be taken. Conclusion In our experience, the RPMS design process and, more generally, that of any complex intervention programme, is an important phase that requires a sound methodological basis. This study also suggests that an RPMS is more than a technological innovation. Indeed, it is an organisational innovation, the merits of which will depend on the precise definition given to the action taken by NNs and other healthcare professionals as well as patients throughout their interactions.
The impact of commercial drivers with type 2 diabetes on the risk for road traffic collisions in TBDCS study
Authors: Wang Ying Chuan , Lin Yu-Jen , Wu Trong-Neng , Liou Saou-Hsing , Wu Wei-Te 
Published: February 2020

Abstract
Background : Identification of the relationship between diabetes mellitus (DM) and road traffic collision (RTC) that lead to hospital admissions and death in commercial motor vehicle (CMV) drivers is crucial to develop preventive strategies. A cohort study was used to follow up the outcomes of DM and receiving blood glucose-lowering therapy to assess the 6-year risk of RTCs in CMV drivers. Methods: This cohort recruited 1,650 CMV drivers in 2005. Each subject completed the basic and working patterns questionnaire. Researchers found 84 DM cases in 2005, and 152 RTC events between 2005 and 2010. The data analysis was conducted in 2015. The Cox model and the extended Cox model were used to estimate the hazard ratio (HR) for first RTC events only and recurrent RTC events. Results: Type 2 DM ( T2DM) increased the 6-year RTC risks among CMV drivers (HR: 2.39, 95% CI: 1.35 to 4.24), after adjusting for confounders. The extended Cox models were used and showed that T2DM increased HR of the recurrent RTC events. Conclusion: T2DM and oral antidiabetic drugs (OADs) used days pose possible risk factors for RTCs in CMV drivers. Labor or health care professionals and authorities should be aware of the risks and contribute in establishing effective RTC- prevention strategies for DM drivers with or without insulin treatment.
Public awareness and knowledge of factors associated with dementia in China
Authors: Zheng Yong-bo , Shi Le , Gong Yi-Miao , Wang Xiao-Xiao , Lu Qing-Dong , Que Jian-Yu , Khan Muhammad Zahid , Bao Yan-Ping , Lu Lin 
Published: February 2020

Abstract
Background Dementia is a global public health priority. Many modifiable factors have been shown to influence the development of dementia, but these factors are not adequately known by the general public. This study assessed public awareness of the factors that are associated with dementia among the general population in China. Methods A cross-sectional study was conducted from May to October 2019 using an Internet-based questionnaire. We collected basic sociodemographic characteristics and investigated participants’ knowledge of risk and protective factors that are associated with dementia. The primary outcome measures were the proportions of participants who identified each option as a risk or protective factor. Logistic regression analysis was performed to compare levels of the knowledge of factors that are associated with dementia across populations with different demographic characteristics. Results Data from a total of 3,338 respondents were analyzed. The percentages of participants who accurately identified dementia risk factors were the following: 84.24% for negative affect, 65.07% for alcohol use, 56.68% for smoking, 48.74% for hypertension, and 42.66% for diabetes. The percentages of participants who accurately identified dementia protective factors were the following: 90.00% for exercise, 84.69% for social activity, 80.92% for intelligence games, 74.45% for reading, and 6.14% for antihypertensive or hypolipidemic drugs. The majority of Chinese people correctly recognized the role of lifestyle factors in the development of dementia but not medical factors. Levels of knowledge of the factors that are associated with dementia were significantly distinct across populations with different characteristics. The following sociodemographic characteristics were associated with more comprehensive knowledge of dementia risk and protective factors: women, young age, high education levels, white-collar jobs, and contact with individuals with dementia. Conclusions Public awareness and knowledge of risk and protective factors for dementia in China are still insufficient. More efforts are needed to publicize information about dementia to reduce risk and prevent dementia.
Hardware design for Blind Source Separation using a Fast Time-Frequency Mask Technique
Authors: Tsai Tsung-Han , Liu Pei-Yun , Chiou Yu-He 
Published: February 2020

Abstract
In this paper, we propose a fast time-frequency mask technique for blind source separation in order to separate a mixture of two input sounds in single signal automatically. Mostly previous methods utilize a linear sensor array, and therefore they cannot separate symmetrically positioned sources. To overcome such problems, we first define two features which are normalized level-ratio and phase-difference. Next, we use our method to decrease Direction of Arrival (DOA), this can reduce the variance of features so that it can reduces iterations of k-means. Finally, according to the clustered features, a mask is generated. Our method does not require any prior information or parameter estimation and we have made a real demonstration system. We use Signal to Distortion Ratio ( SDR ) and Signal to Interference Ratio ( SIR ) to compare our method. Then we present hardware design. Hardware design uses TSMC 90-nm CMOS process. As a cost-effective result, it consumes about 120K gates and executes with frequency of 10MHz. The power consumption is only 2.92 mW with low power design considerations.
Sildenafil for Treating Peripheral Ischemia and Gangrene: A Case Report and Review
Authors: Hsieh Miyuki Hsing-Chun , Tsai Chi-Lun , Su Hui-Chen , Lai Edward Chia-Cheng 
Published: February 2020

Abstract
Background Peripheral gangrene is a clinical condition characterized with digital ischemia of extremities usually seen in patients with sepsis or shock that resulted in a hypoperfusion state. It is not common but often complicated with high mortality rate. Currently, there is no definite treatment for peripheral gangrene which often result in amputation. Methods We reported a 74-year-old female case of shock-related peripheral gangrene of both feet who was partially and successfully treated by oral sildenafil with a dose of 50mg twice daily. We also reviewed present evidences regarding effectiveness of sildenafil in managing distal ischemia caused by different clinical conditions. Results Except for limited regions which had already shown evident dark discoloration (i.e., the 4 th and 5 th toe on the right foot) at the time of treatment initiation, all other region of peripheral ischemia significantly improved after systemic oral sildenafil treatment for 7 days. The 4 th and 5 th toe of the right foot eventually turned into a darker area of necrosis with an obvious margin, in contrast to recovered regions. Literature showed relief of pain and reversal of other ischemic symptoms after a few days to months sildenafil therapy. Conclusions In accordance with the reported case and current literature, systemic sildenafil shows great potential in ameliorating peripheral ischemia and gangrene as an off-label drug of choice.