bluuebunny/crossref_metadata_2025_split huggingface dataset:
Automated classification of dense calcium tissues in gray-scale intravascular ultrasound images using a deep belief network
Authors: Lee Juhwan , Hwang Yoo Na , Kim Ga Young , Kwon Ji Yean , Kim Sung Min 
Published: December 2019

Abstract
Background
IVUS is widely used to quantitatively assess coronary artery disease. The purpose of this study was to automatically characterize dense calcium (DC) tissue in the gray scale intravascular ultrasound (IVUS) images using the image textural features.

Methods
A total of 316 Gy-scale IVUS and corresponding virtual histology images from 26 patients with acute coronary syndrome who underwent IVUS along with X-ray angiography between October 2009 to September 2014 were retrospectively acquired and analyzed. One expert performed all procedures and assessed their IVUS scans. After image acquisition, the DC candidate and corresponding acoustic shadow regions were automatically determined. Then, nine image-base feature groups were extracted from the DC candidates. In order to reduce the dimensionalities, principal component analysis (PCA) was performed, and selected feature sets were utilized as an input for a deep belief network. Classification results were validated using 10-fold cross validation.

Results
The dimensionality of the feature map was efficiently reduced by 50% (from 66 to 33) without any performance decrease using PCA method. Sensitivity, specificity, and accuracy of the proposed method were 92.8 ± 0.1%, 85.1 ± 0.1%, and 88.4 ± 0.1%, respectively (p < 0.05). We found that the window size could largely influence the characterization results, and selected the 5 × 5 size as the best condition. We also validated the performance superiority of the proposed method with traditional classification methods.

Conclusions
These experimental results suggest that the proposed method has significant clinical applicability for IVUS-based cardiovascular diagnosis.
Estimating the risk of acute kidney injury associated with use of diuretics and renin angiotensin aldosterone system inhibitors: A population based cohort study using the clinical practice research datalink
Authors: Scott Jemima , Jones Tim , Redaniel Maria Theresa , May Margaret T. , Ben-Shlomo Yoav , Caskey Fergus 
Published: December 2019

Abstract
Background
The risk of acute kidney injury (AKI) attributable to renin angiotensin aldosterone (RAAS) inhibitors and diuretics remains unclear.

Methods
We conducted a prospective cohort study using the Clinical Practice Research Datalink (2008–2015) linked to Hospital Episode Statistics – Admitted Patient Care and Office for National Statistics mortality data. Patients were included if they had one or more chronic diagnoses requiring medication. Exposed patients had a first ever prescription for RAAS inhibitors/diuretics during the study period. AKI risk associated with exposure was determined by multivariable Cox regression, propensity score-adjusted Cox regression and a prior event rate ratio (PERR) analysis.

Results
One hundred forty thousand nine hundred fifty-two individuals were included. Increased AKI risk in the exposed group was demonstrated in both the multivariable and propensity score-adjusted cox regressions (HR 1.23 (95% CI 1.04–1.45) and HR 1.24 (1.05–1.47) respectively). The PERR analysis provided a similar overall hazard ratio with a wider confidence interval (HR 1.29 (0.94–1.63)). The increased AKI risk in the exposed group was present only in those receiving two or more antihypertensives. Absolute AKI risk was small.

Conclusions
RAAS inhibitors/diuretics result in an increased risk of AKI. The absolute increase in AKI risk is small, however, and needs to be considered in the context of any potential benefits.
Prevalence, risk factors and antifungal susceptibility pattern of Candida species among pregnant women at Debre Markos Referral Hospital, Northwest Ethiopia
Authors: Tsega Alem , Mekonnen Feleke 
Published: December 2019

Abstract
Background
Candida is the commonest opportunistic fungi in human. Candida species cause diverse types of diseases. Vaginal candidiasis has been reported as one of the most common type of fungal diseases among pregnant women. However; In Ethiopia, due to scarcity of data, much has not been documented regarding the prevalence of Candida among pregnant women.

Objective
This study aimed to determine the prevalence, possible risk factors and antifungal susceptibility profile of Candida species among pregnant women attending Debre Markos Referral Hospital, Northwest Ethiopia.

Method
A cross-sectional study was conducted from February to May 2017. A total of 384 pregnant women were included using a systematic random sampling technique. Vaginal specimens were collected, inoculated on Candida HiV eg culture Medium and incubated at 37 °C for 24 h.Colonies were identified using standard microbiological methods and selected for further Candida Species identification using Hi Chrome agar and germ tube test. Fungal suspensions were made and adjusted at 0.5% MacFarland standard. Modified Kirby-Bauer disk diffusion technique was used for antifungal susceptibility. Data was entered, cleaned using Ep info version 7.1and transported to Statistical Packages for Social Sciences (SPSS) version 21 for analysis. Descriptive statistics and logistic regression were performed. P. value < 0.05 at 95% confidence interval was considered as statistically significant.

Result
From a total of 384 study participants, 96 (25%) were positive for Candida species. The predominant Candida species was Candida albicans 54(56.25%) followed by Candida krusei 21(21.9%), Candida glabrata 17(17.7%), Candida tropicalis 1(1%) and 3(3.1%) were other Candida species. Contraceptive use (AOR: 0.394; 95% CI = 0.20–0.74) and prolonged antibiotic uses (AOR: 0.393; 95% CI = 0.21–0.72) were risk factors. All isolates except Candida krusei were 100% susceptible to amphotericin-B. Resistance rate was high against itraconazole and Ketoconazole 55(57.3%).

Conclusion
The prevalence of Candida species among symptomatic pregnant women was significantly higher than asymptomatic pregnant women. Age group between 26 and 40 years was significantly associated with Candida infection. Amphotericin B was the most sensitive antifungal drug. High rate of multiple drugs resistant Candida species was detected. Therefore Symptomatic women should be routinely screened and treated.
Androgen receptor and FOXA1 coexpression define a “luminal-AR” subtype of feline mammary carcinomas, spontaneous models of breast cancer
Authors: Dagher Elie , Royer Violette , Buchet Paul , Abadie Jérôme , Loussouarn Delphine , Campone Mario , Nguyen Frédérique 
Published: December 2019

AbstractBackgroundInvasive mammary carcinomas that spontaneously develop in female cats are associated with high mortality, and resemble the most aggressive human breast cancers, especially triple-negative breast cancer (TNBC). Transcriptome studies showed that TNBCs are a heterogeneous group that includes a potentially hormone-dependent subtype named luminal-AR. Some authors proposed an immunohistochemical definition of the luminal-AR subtype, which is not only positive for Androgen Receptor (AR), but also either positive for the transcription factor Forkhead box A1 (FOXA1), or negative for basal markers. The objectives of this study were to describe AR and FOXA1 expressions in feline mammary carcinomas (FMCs), their prognostic value, and if their coexpression could define a “luminal-AR” subtype of triple-negative mammary carcinomas in cats.MethodsIn a previously described retrospective cohort of 180 female cats with FMCs, with a 2-year follow-up post-mastectomy, we assessed AR, FOXA1, ER, PR, Ki-67, HER2, and CK14 expressions by automated immunohistochemistry.ResultsOf the 180 FMCs, 57 (32%) were luminal; i.e., ER and/or PR positive, and 123 (68%) were triple-negative (ER–, PR– and HER2–) FMCs. AR overexpression (found in 33 cases/180, 18%) and FOXA1 index ≥1% (64/180, 36%) were associated with a longer disease-free interval, overall survival, and cancer-specific survival in cats with FMC. Analysis of AR, FOXA1 and CK14 coexpression in triple-negative FMCs showed that AR+ triple-negative FMCs were heterogeneous: there existed an AR+ FOXA1+ CK14– subgroup (n = 7) associated with a better cancer-specific survival by multivariate survival analysis (HR = 0.26, 95% CI: 0.07–0.89,p = 0.03) compared to AR+ FOXA1–CK14+ triple-negative FMCs (n = 46) (HR = 1.00), independently of the pathologic tumor size and pathologic nodal stage. The non-basal-like subtype of triple-negative FMCs that coexpresses AR and FOXA1 (the AR+ FOXA1+ CK14– subgroup) could represent the equivalent of the luminal-AR subgroup of human triple-negative breast cancer.ConclusionsWe identified an AR+ FOXA1+ CK14– subgroup of triple-negative FMCs that might correspond to the luminal-AR subgroup of human triple-negative breast cancers. Cats with FMC may be interesting spontaneous animal models to investigate new strategies targeting the androgen receptor, especially in the aggressive subtype of AR+ basal-like triple-negative mammary carcinomas with loss of FOXA1 expression (the AR+ FOXA1–CK14+ subgroup).
Satisfaction of family members with inpatient psychiatric care and its correlates: a national survey in China
Authors: Jiang Feng , Hu Linlin , Zhao Ruiping , Zhou Huixuan , Wu Yinuo , Rakofsky Jeffrey J. , Liu Tingfang , Liu Huanzhong , Liu Yuanli , Tang Yi-Lang 
Published: December 2019

Abstract
Background
Measuring family members’ satisfaction with inpatient psychiatric care may help improve the quality of healthcare in psychiatric hospitals. This survey aimed to investigate the satisfaction of family members with inpatient psychiatric care and to explore its associated factors, using a newly-developed 5-item questionnaire.

Methods
This study included 1598 family members of psychiatric inpatients in 32 tertiary public psychiatric hospitals in 29 provinces of China. Satisfaction and demographic data were collected by research staff while patient and hospital data were retrieved separately.

Results
We found that the overall satisfaction level was 93.84% (23.46/25). The total satisfaction score in Northeast China was the highest, followed by the East, Middle and West regions (p < 0.001). There was no significant sex difference in total family satisfaction scores. Family members with a lower educational background (elementary school or less) had significantly lower satisfaction. Family members of patients who were diagnosed with schizophrenia were significantly less satisfied with doctor-family communication. In different treatment response subgroups, the marked improvement subgroup had significantly higher total satisfaction scores and subscores. Meanwhile, lower self-payment expenses and a higher number of psychologic treatments offered per day were significantly associated with higher total satisfaction scores and all subscores. Logistic regression showed a higher educational background, more psychologic treatments offered per day, adequacy of professional staffing (higher doctor/bed, nurse/bed and psychologist/bed ratio) were all significantly associated with higher family satisfaction.

Conclusions
We suggest government and hospital managers recruit more mental health professions to improve family satisfaction. If feasible, providing more psychologic treatments to inpatients may also improve families’ satisfaction and involvement.
Sub-national levels and trends in contraceptive prevalence, unmet need, and demand for family planning in Nigeria with survey uncertainty
Authors: Mercer Laina D. , Lu Fred , Proctor Joshua L. 
Published: December 2019

Abstract
Background
Ambitious global goals have been established to provide universal access to affordable modern contraceptive methods. To measure progress toward such goals in populous countries like Nigeria, it’s essential to characterize the current levels and trends of family planning (FP) indicators such as unmet need and modern contraceptive prevalence rates (mCPR). Moreover, the substantial heterogeneity across Nigeria and scale of programmatic implementation requires a sub-national resolution of these FP indicators. The aim of this study is to estimate the levels and trends of FP indicators at a subnational scale in Nigeria utilizing all available data and accounting for survey design and uncertainty.

Methods
We utilized all available cross-sectional survey data from Nigeria including the Demographic and Health Surveys, Multiple Indicator Cluster Surveys, National Nutrition and Health Surveys, and Performance, Monitoring, and Accountability 2020. We developed a hierarchical Bayesian model that incorporates all of the individual level data from each survey instrument, accounts for survey uncertainty, leverages spatio-temporal smoothing, and produces probabilistic estimates with uncertainty intervals.

Results
We estimate that overall rates and trends of mCPR and unmet need have remained low in Nigeria: the average annual rate of change for mCPR by state is 0.5% (0.4%,0.6%) from 2012-2017. Unmet need by age-parity demographic groups varied significantly across Nigeria; parous women express much higher rates of unmet need than nulliparous women.

Conclusions
Understanding the estimates and trends of FP indicators at a subnational resolution in Nigeria is integral to inform programmatic decision-making. We identify age-parity-state subgroups with large rates of unmet need. We also find conflicting trends by survey instrument across a number of states. Our model-based estimates highlight these inconsistencies, attempt to reconcile the direct survey estimates, and provide uncertainty intervals to enable interpretation of model and survey estimates for decision-making.
Airway inflammation after inhalation of nano-sized zinc oxide particles in human volunteers
Authors: Monsé Christian , Raulf Monika , Hagemeyer Olaf , van Kampen Vera , Kendzia Benjamin , Gering Vitali , Marek Eike-Maximilian , Jettkant Birger , Bünger Jürgen , Merget Rolf , Brüning Thomas 
Published: December 2019

AbstractBackgroundWorkers in the zinc production and processing of galvanized sheet steel are exposed to a complex mixture of particles and gases, including zinc oxide (ZnO) that can affect human health. We aimed to study the effects of short-term controlled exposure to nano-sized ZnO on airway inflammatory markers in healthy volunteers.MethodsSixteen subjects (8 females, 8 men; age 19–42, non-smokers) were exposed to filtered air and ZnO nanoparticles (0.5, 1.0 and 2.0 mg/m3) for 4 h, including 2 h of cycling with a low workload. Induced sputum samples were collected during a medical baseline and a final examination and also about 24 h after each exposure. A number of inflammatory cellular and soluble markers were analyzed.ResultsFrequency and intensity of symptoms of airway irritation (throat irritation and cough) were increased in some subjects 24 h after ZnO exposures when compared to filtered air. The group comparison between filtered air and ZnO exposures showed statistically significant increases of neutrophils and interleukin-8 (IL-8), interleukin-6 (IL-6), matrix metalloproteinase (MMP-9) and tissue inhibitors of metalloproteinases (TIMP-1) in sputum starting at the lowest ZnO concentration of 0.5 mg/m3. However, a concentration-response relationship was absent. Effects were reversible. Strong correlations were found between neutrophil numbers and concentrations of total protein, IL-8, MMP-9, and TIMP-1.ConclusionsControlled exposures of healthy subjects to ZnO nanoparticles induce reversible airway inflammation which was observed at a concentration of 0.5 mg/m3and higher. The lack of a concentration-response relationship warrants further studies.
The overexpression of peroxiredoxin-4 affects the progression of idiopathic pulmonary fibrosis
Authors: Hanaka Tetsuya , Kido Takashi , Noguchi Shingo , Yamada Sohsuke , Noguchi Hirotsugu , Guo Xin , Nawata Aya , Wang Ke-Yong , Oda Keishi , Takaki Tsutomu , Izumi Hiroto , Ishimoto Hiroshi , Yatera Kazuhiro , Mukae Hiroshi 
Published: December 2019

Abstract
Background
Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is life-threatening. Several serum biomarkers, such as Krebs von den Lungen-6 (KL-6) and surfactant protein D (SP-D), are clinically used for evaluating AE-IPF, but these biomarkers are not adequate for establishing an early and accurate diagnosis of AE-IPF. Recently, the protective roles of the members of the peroxiredoxin (PRDX) family have been reported in IPF; however, the role of PRDX4 in AE-IPF is unclear.

Methods
Serum levels of PRDX4 protein, KL-6, SP-D and lactate dehydrogenase (LDH) in 51 patients with stable IPF (S-IPF), 38 patients with AE-IPF and 15 healthy volunteers were retrospectively assessed using enzyme-linked immunosorbent assay. Moreover, as an animal model of pulmonary fibrosis, wild-type (WT) and PRDX4-transgenic (Tg) mice were intratracheally administered with bleomycin (BLM, 2 mg/kg), and fibrotic and inflammatory changes in lungs were evaluated 3 weeks after the intratracheal administration.

Results
Serum levels of PRDX4 protein, KL-6, SP-D and LDH in patients with S-IPF and AE-IPF were significantly higher than those in healthy volunteers, and those in AE-IPF patients were the highest among the three groups. Using receiver operating characteristic curves, area under the curve values of serum PRDX4 protein, KL-6, SP-D, and LDH for detecting AE-IPF were 0.873, 0.698, 0.675, and 0.906, respectively. BLM-treated Tg mice demonstrated aggravated histopathological findings and poor prognosis compared with BLM-treated WT mice. Moreover, PRDX4 expression was observed in alveolar macrophages and lung epithelial cells of BLM-treated Tg mice.

Conclusions
PRDX4 is associated with the aggravation of inflammatory changes and fibrosis in the pathogenesis of IPF, and serum PRDX4 may be useful in clinical practice of IPF patients.
Size-adjusted muscle power and muscle metabolism in patients with cystic fibrosis are equal to healthy controls – a case control study
Authors: Ruf Katharina , Beer Meinrad , Köstler Herbert , Weng Andreas Max , Neubauer Henning , Klein Alexander , Platek Kathleen , Roth Kristina , Beneke Ralph , Hebestreit Helge 
Published: December 2019

AbstractBackgroundSkeletal muscle function dysfunction has been reported in patients with cystic fibrosis (CF). Studies so far showed inconclusive data whether reduced exercise capacity is related to intrinsic muscle dysfunction in CF.MethodsTwenty patients with CF and 23 age-matched controls completed an incremental cardiopulmonary cycling test. Further, a Wingate anaerobic test to assess muscle power was performed. In addition, all participants completed an incremental knee-extension test with31P magnetic resonance spectroscopy to assess muscle metabolism (inorganic phosphate (Pi) and phosphocreatinine (PCr) as well as intracellular pH). In the MRI, muscle cross-sectional area of theM. quadriceps(qCSA) was also measured. A subgroup of 15 participants (5 CF, 10 control) additionally completed a continuous high-intensity, high-frequency knee-extension exercise task during31P magnetic resonance spectroscopy to assess muscle metabolism.ResultsPatients with CF showed a reduced exercise capacity in the incremental cardiopulmonary cycling test (VO2peak: CF 77.8 ± 16.2%predicted (36.5 ± 7.4 ml/qCSA/min), control 100.6 ± 18.8%predicted (49.1 ± 11.4 ml/qCSA/min);p < 0.001), and deficits in anaerobic capacity reflected by the Wingate test (peak power: CF 537 ± 180 W, control 727 ± 186 W; mean power: CF 378 ± 127 W, control 486 ± 126 W; power drop CF 12 ± 5 W, control 8 ± 4 W. all:p < 0.001). In the knee-extension task, patients with CF achieved a significantly lower workload (p < 0.05). However, in a linear model analysing maximal work load of the incremental knee-extension task and results of the Wingate test, respectively, only muscle size and height, but not disease status (CF or not) contributed to explaining variance. In line with this finding, no differences were found in muscle metabolism reflected by intracellular pH and the ratio of Pi/PCr at submaximal stages and peak exercise measured through MRI spectroscopy.ConclusionsThe lower absolute muscle power in patients with CF compared to controls is exclusively explained by the reduced muscle size in this study. No evidence was found for an intrinsic skeletal muscle dysfunction due to primary alterations of muscle metabolism.
Solitary fibrous tumor of the scrotum: a case report and review of the literature
Authors: Chang Tsung-Hsin , Chen Marcelo , Lee Chih-Chiao 
Published: December 2019

AbstractBackgroundSolitary fibrous tumor (SFT) is a rare soft tissue tumor originally reported in the pleura. Although it has been reported in various extra-pleural sites, the occurrence of SFT in the scrotum is extremely rare. Herein, we present a 48-year-old man who had scrotal SFT. There are very few reported cases of genitourinary SFTs, this is only the fifth report of SFT of the scrotum in the English medical literature.Case presentationIn this study, we report on a 48-year-old man who presented with a 5 × 8 cm scrotal mass between his testes. Physical examination revealed a 4.7 × 8.5 cm lobulated tumor mass located between his testicles. Surgical excision of the tumor with scrotal approach was done and pathology reported a SFT. The patient was alive without tumor recurrence or distant metastasis during ongoing follow-up for 9 months post-operatively..ConclusionScrotal SFTs are very rare and only five cases have been reported in English literature to date. Treatment often involves surgical resection, and a definite diagnosis is made with the help of immunohistochemistry. The current general consensus for the management of SFTs is long-term follow-up after surgical excision of the tumor.
The effect of the waiting room’s environment on level of anxiety experienced by children prior to dental treatment: a case control study
Authors: Fux-Noy Avia , Zohar Maayan , Herzog Karin , Shmueli Aviv , Halperson Elinor , Moskovitz Moti , Ram Diana 
Published: December 2019

AbstractBackgroundIn addition to visit purpose, one of the environmental factors that can cause anxiety prior to dental treatment includes the waiting room experience, specifically the amount of time spent awaiting treatment and the waiting room environment. The purpose of this study was to compare the effect of the waiting room’s environment on the level of anxiety experienced by children in multisensory and traditional waiting rooms.MethodsCase control study. Test group waited for treatment in a multisensory waiting room, which consisted of a lighting column that children could touch and climb; as well as, rhythmic music played on loudspeakers. Control group waited for treatment in a traditional waiting room. Study participants were asked to answer the “Venham Picture Test”, a dental anxiety scale, while in the waiting room prior to entering the treatment room. Chi-squared, Fisher’s Exact tests, and linear regression were utilized. Ap-value less than 0.05 was considered statistically significant.ResultsNo significant difference in dental anxiety scores was found between the test and control groups according to waiting room type (p > .05). Dental anxiety was significantly higher in patients who had longer waiting time prior to treatment (p = 0.019). In addition, dental anxiety was significantly associated with visit purpose (p < .001): children waiting for dental examination or those scheduled for dental treatment with conscious sedation were less anxious than children waiting for emergency treatment.ConclusionsA sensory adapted waiting room environment may be less important in reducing children’s anxiety prior to dental treatment. Children’s dental anxiety can be reduced by preventing emergency treatments, scheduling routine dental visits and decreasing waiting time.Trial registrationTRNNCT03197129, date of registration June 20, 2017.