bluuebunny/crossref_metadata_2025_split huggingface dataset:
CT Metal Artifact Reduction based on Virtual Generated Artifacts Using Modified pix2pix
Authors: Kai Xie , Liugang Gao , Zhengda Lu , Chunying Li , Tao Lin , Jianfeng Sui , Hui Bi , Xinye Ni , Jianrong Dai 
Published: October 2020

Abstract
Background: Metal artifacts introduce challenges in image-guided diagnosis or accurate dose calculations. This study aims to reduce metal artifacts from the spinal brace by using virtual generated artifacts through convolutional neural networks and to compare the performance of this approach with two other methods, namely, linear interpolation metal artifact reduction (LIMAR) and normalized metal artifact reduction (NMAR) .Method: A total of 3,600-slice CT images of 60 vertebral metastases patients were selected. The spinal cord center was marked in each image, metal masks were added to two sides of the marker to generate artifact-insert CT images, and the CT values of the metal parts were copied to original CT images to obtain reference CT images. These images were divided into training (3,000 slices) and test (600) sets. The modified U-Net and pix2pix architecture was applied to understand the relationship between the reference and artifact-insert images. The mean absolute error (MAE), mean square error (MSE), peak signal-to-noise ratio (PSNR), and structural similarity (SSIM) were calculated between the reference CT images and the predicted CT through LIMAR, NMAR, U-Net, and pix2pix. The CT values of organs from different images were compared. Radiotherapy treatment plans for vertebral metastases were designed, and dose calculation was performed. The dose distribution in different types of images was also compared.Results: The MAE values between the reference images and those images generated by LIMAR, NMAR, U-Net, and pix2pix were 15.02, 16.16, 6.12, and 6.48 HU, respectively, and the corresponding PSNR values were 15.37, 152.70, 158.93, and 65.14 dB, respectively. Pix2pix restored more texture than U-Net according to the visual comparison. The average CT values in the artifact-insert images of the liver, spleen, and left and right kidneys were all significantly higher than those of the reference images (p<0.05). The average CT values of the organs in images processed by the four methods showed no significant differences from those of the organs in the reference images. The mean dose of planned target volume in the artifact-insert images was significantly lower than that in the reference CT images. The average γ passing rate (1%, 1 mm) of the artifact-insert images was significantly lower than that of the reference images (95.9±1.4% vs. 99.2±1.4%, p<0.05).Conclusions: U-Net and pix2pix deep learning networks can remarkably reduce metal artifacts and improve critical structure visualization compared with LIMAR and NMAR according to the simulation data of artifact-insert images in the spinal brace. Pix2pix can restore more texture with the help of a discriminator. Metal artifacts increase the dose calculation uncertainty in radiotherapy. The dose calculated through images obtained by U-Net and pix2pix was identical with that calculated through reference images.
Diagnostic Yield of Rare Skeletal Dysplasia Conditions in the Radiogenomics Era – A UK Experience
Authors: Sabir Ataf H , Morley Elizabeth , Sheikh Jameela , Calder Alistair D , Beleza-Meireles Ana , Cheung Moira S , Cocca Alessandra , Jansson Mattias , Lillis Suzanne , Patel Yogen , Yau Shu , Hall Christine M , Offiah Amaka C , Irving Melita 
Published: October 2020

Abstract
BACKGROUNDSkeletal dysplasia (SD) conditions are rare genetic diseases of the skeleton, encompassing a heterogeneous group of over 400 disorders, and represent approximately 5% of all congenital anomalies. Developments in genetic and treatment technologies are leading to unparalleled therapeutic advances; thus, it is more important than ever to molecularly confirm SD conditions. Data on ‘rates-of-molecular yields’ in SD conditions, through exome sequencing approaches, is limited. Figures of 39% and 52.5% have been reported in the USA (n=54) and South Korea (n=185) respectively.We discuss a single-centre UK experience of whole-exome sequencing (WES) in a cohort of 15 paediatric patients (aged 5 months to 12 years) with SD disorders previously molecularly unconfirmed. Our cohort included patients with known clinical diagnoses and undiagnosed skeletal syndromes. Extensive phenotyping and expert radiological review by a panel of international SD radiology experts, coupled with a complex bioinformatics pipeline, allowed for both gene-targeted and gene-agnostic approaches. RESULTSSignificant variants leading to a likely or confirmed diagnosis were identified in 53.3% (n = 8/15) of patients; 46.7% (n= 7/15) having a definite molecular diagnosis and 6.7% (n= 1/15) having a likely molecular diagnosis. We discuss this in the context of a rare disease in general and specifically SD presentations. Of patients with known diagnoses pre-WES (n=10), molecular confirmation occurred in 7/10 cases, as opposed to 1/5 where a diagnosis was unknown pre-test. Thus, diagnostic return is greatest where the diagnosis is known pre-test. For WGS (whole genome sequencing, the next iteration of WES), careful case selection (ideally of known diagnoses pre-test) will yield highest returns.CONCLUSIONSOur results highlight the cost-effective use of WES-targeted bioinformatic analysis as a diagnostic tool for SD, particularly patients with presumed SD, where detailed phenotyping is essential. Thorough co-ordinated clinical evaluation between clinical, radiological, and molecular teams is essential for improved yield and clinical care. WES (and WGS) yields will increase with time, allowing faster diagnoses, avoiding needless investigations, ensuring individualised patient care and patient reassurance. Further diagnoses will lead to increased information on natural history/mechanistic details, and likely increased therapies and clinical trials.
Tocilizumab May Be a Key in Therapy for Cytokine Release Syndrome in Older Patients With Severe Symptoms of COVID-19
Authors: Lengnan Xu , Xin Liu , Yangwei Zhou , Aihua Liu , Xiaomao Xu , Xiaoxia Wang , Xuefeng Zhong , Yu Qiao , Li Wen , Mao Yonghui 
Published: October 2020

Abstract
Background Older adults are more susceptible to the novel coronavirus disease 2019 (hereafter, COVID-19) and more likely to develop severe illness. Cytokine release syndrome (CRS) may be an important factor in the development of severe disease in patients with COVID-19. Interleukin-6 (IL-6) is an important cytokine in CRS, and tocilizumab can block the IL-6 receptor. In this study, we analyzed the therapeutic effects and safety of tocilizumab on CRS in older patients with severe COVID-19. Methods Between February 10 and March 21, 2020, a total of 19 patients with severe or critical COVID-19 aged ≥ 60 years met the study inclusion criteria at Tongji hospital in Wuhan city, Hubei Province, China. Patients were divided into two groups: 1. The tocilizumab group, whose IL-6 levels exceeded the upper limit of normal by > 10-fold; and 2. The no tocilizumab group, with 1L-6 levels < 10-fold the upper normal limit. Results Patients in the tocilizumab group were older (73.20 ± 4.44 vs. 66.21 ± 5.06 years, P = 0.014); had lower lymphocyte counts (0.71 ± 0.18 vs. 1.18 ± 0.59 × 109/L, P = 0.016); and higher high-sensitivity C-reactive protein (hsCRP) levels (94.04 ± 57.24 vs. 51.65 ± 45.37 mg/L, P = 0.035). The increases in ferritin (FER) and hsCRP levels in patients in the tocilizumab group were marked. Except in one patient who died, IL-6, FER, and hsCRP levels, and the neutrophil/lymphocyte ratio, in the remaining four patients decreased following treatment with tocilizumab. Further, patient computerized tomography scan results improved after 3–8 days of tocilizumab treatment. Tocilizumab did not cause any serious adverse reactions. There were no differences in mortality or days until lung computerized tomography improvement between the two groups. The total mortality rate was 10.53%. Conclusions Our results support the therapeutic efficacy and safety of tocilizumab on older patients with severe COVID-19.
An Outbreak of Carbapenem-Resistant Klebsiella Pneumoniae of K57 Capsular Serotype in an Emergency Intensive Care Unit of a Teaching Hospital in China
Authors: Shao Chunhong , Jin Yan , Liu Shuang , Jiang Meijie , Zhao Shuping 
Published: October 2020

Abstract
Background: Klebsiella pneumoniae is a common causative pathogen of nosocomial infections. The emergence of carbapenem-resistant hypervirulent K. pneumoniae (CR-hvKP) strains has further increased the threat posed by this bacterium. Here, we described an outbreak of 32 CR-hvKP isolates from the emergency intensive care unit (EICU) of a teaching hospital in China. Methods: From January 29, 2019 to March 11, 2019, 32 CRKp isolates were collected from 6 patients and their surrounding environment in EICU. Patient information including age, gender, length of EICU stay, diagnosis, treatment, and outcomes were obtained from electronic medical records. The isolates were identified using Vitek-MS system. The hypermucoviscosity phenotype was determined by the “string test”. Antimicrobial susceptibility testing was performed using VITEK 2 compact system, E-test or the broth microdilution method. All isolates were serotyped for K1, K2, K5, K20, K54, and K57 serotypes, antimicrobial resistance genes and twelve virulence-associated genes were screened using PCR and DNA sequencing. Multilocus sequence typing (MLST) and pulse-field gel electrophoresis (PFGE) were employed to characterize the genetic relationships among the CPKP isolates. The virulence capability of 11 CRKp isolates from 6 patients was evaluated through Galleria mellonella larva infection assay. Results: This outbreak involved 6 patients and lasted for 40 days. All 32 CR-hvKp isolates were obtained from 6 patients and their surrounding environment. PFGE showed that all 32 isolates belonged to one cluster, and MLST revealed that belonged to ST11. All isolates exhibited high resistance to β-lactam antibiotics, quinolones, and aminoglycosides. They were susceptible to ceftazidime/averbatan, tigecycline, and colistin. All 32 isolates harbored multiple resistance determinants, including blaKPC-2, blaSHV-11, blaTEM-1, rmtB, and qnrD. The serotype of all 32 isolates was K57 that was rarely reported. In the virulence gene analysis, all 32 isolates contained 6 virulence genes, namely, fimH, iucB, mrkD, rmpA, uge, and wabG. Infection assays demonstrated high mortality in the Galleria mellonella model. Following measures implemented by the hospital, the outbreak was controlled. The mortality rate was 83.3%.Conclusions: The epidemiology of CR-hvKP should be monitored closely to detect early indications of this emerging public health threat.
Development of Antibiogram for Evaluation of Antibiotic Resistance Pattern in Tertiary Care Teaching Hospital: a Cross Sectional Study
Authors: DIKKAT MANOJ SRIHARI , Mansuri Firdosh , Chaudhari Madhuri , Marathe Anant , Vaghasiya Jitendra , Nath Mukesh 
Published: October 2020

Abstract
Background: Antimicrobial resistance threatens the effective prevention and treatment of increasing number of cases of antibiotic resistance worldwide. So there is need of effective implementation of the treatment strategy to rationalize the antimicrobial use in the treatment of infectious disease. So the present study is aims to attempts to find the local antibiotic resistance, various microorganism responsible for infection using the antibiogram in the tertiary care teaching hospital.Methods: A cross-sectional study was carried out to check the Antibiotic resistance pattern based on the inclusion and exclusion criteria at Parul Sevasharam Hospital, Vadodara, Gujarat. Total 150 patients were included in study, culture sensitivity test and bacterial identification was done as per the microbiology department standard guidelines. Patient’s data regarding to demographic details, culture sensitivity test results and prescribed antibiotics was collected for 6 months’ duration from October 2019 to March 2020. Results: Total 150 samples were collected throughout the study period of six months in the various departments in the hospital. The main finding of our study,greater resistance found in Ceftriaxone (78%), Meropenem (71%), Azithromycin (66%), linezolid (66%), Amoxicillin+clavulanic acid (63%), Ciprofloxacin (56%) of patients in these antibiotics. Greater susceptibility was found in Clindamycin (75%), Amikacin (65%), Piperacilline+tazobactum (62%), Cefoperazone (48%), ciprofloxacin (44%) of the patients. During our study, 20 antibiotics were commonly prescribed out of which ceftriaxone was most commonly prescribed in our study and which was found to most resistant in patient population. The most common bacteria identified in our study was gram negative bacteria in that E. Coli, Pseudomonas Aeruginosa and KlebseillaPneuminiae was most commonly isolated.Conclusion: This study shows that there is increasing cases of antibiotic resistance identified in the hospital. Ceftriaxone is found to be most resistant in our study. So there is need of effective treatment strategies and use of antibiogram to find out the local antibiotic resistance pattern and to develop antibiotic policy for the safe use of antibiotic which is helpful for to reduce the antibiotic resistance.
Comparison of the Surgical Effect and the Long-term Clinical Outcomes Between Robotic and Sternotomy Mitral Valve Replacement
Authors: Zhao Haizhi , Gao Changqing , Yang Ming , Wang Yao , Kang Wenbin , Wang Rong , Zhang Huajun 
Published: October 2020

Abstract
BackgroundRobot-assisted mitral valve surgery has been increasingly used by surgeons to achieve better results. This study was to assess the safety and effectiveness of totally endoscopic robotic mitral valve replacement (TE-MVR) and to provide evidence that it is a reasonable surgical choice by analyzing the clinical experience, surgical efficacy, and follow-up outcomes of this procedure.MethodBetween October 2008 and October 2015, 47 patients underwent da Vinci TE-MVR. From March 2002 to June 2014, 293 patients underwent conventional sternotomy mitral valve replacement (CS-MVR), of whom 47 patients were selected to match the TE-MVR group (1:1). We performed a retrospective study by collecting perioperative data and assessed TE-MVR efficacy by comparing clinical outcomes and echocardiography with CS-MVR in a 10-year follow-up period.ResultsAll cases were conducted successfully. No operative deaths were observed, and the complications were not significantly different between the groups. The cardiopulmonary bypass time (122.02±25.45 min) and aortic cross-clamping time (85.68±20.70 min) were longer in TE-MVR group (P<0.001). The perioperative complications are similar in two groups, but the drainage volume, blood product transfusion, ICU stay and postsurgical hospital stay are better in robotic group (P<0.001). During the follow-up period, 42 patients (89.4%) in TE-MVR group and 40 patients (87.0%) in CS-MVR group were followed. Long-term event-free survival is similar in both groups. ConclusionRobotic MVR is a feasible, effective and safe minimally-invasive alternative to sternotomy MVR, and the long-term clinical and echocardiographic results are comparable to sternotomy MVR in selected patients.
Novel pH-Responsive Nanohybrid for Stimultaneous Delivery of Doxorubicin and Paclitaxel: An In-Silico Insight
Authors: Alimohammadi Ehsan , Maleki Reza , Akbarialiabad Hossein , Dahri Mohammad 
Published: October 2020

Abstract
Background: The distribution of drugs could not be controlled in the conventional drug delivery system. This has led to the development of a smart nanoparticle-based drug delivery system, known as smart drug delivery systems. In cancer research, novel biocompatible nanocarriers have received much attention for various ranges of anticancer drugs.In the current study, the effect of a novel co-polymer "dimethyl acrylamide-trimethyl chitosan" was investigated on drug delivery of doxorubicin and paclitaxel utilizing modified fullerene nanocarrier. This study was performed via molecular dynamics simulation based on acidic pH sensitivity of the cancer microenvironment. Furthermore, hydrogen bonds, diffusion coefficient, gyration radius, and drug-carrier interaction energies were investigated here. Interestingly, a simultaneous pH and temperature-sensitive system was proposed for paclitaxel and doxorubicin for a co-polymer. A pH-sensitive and temperature-sensitive copolymer was used based on trimethyl chitosan and dimethyl acrylamide, respectively. In such a dualistic approach, co-polymer makes an excellent option to have two properties in one bio-polymer. Results: The results suggest the dramatic and indisputable role of the co-polymer in the release of doxorubicin and paclitaxel in cancerous tissues, as well as an increased biocompatibility and drug uptake in a neutral state. The validation test was performed by repeated simulations of a similar article. The results are very close to those of the reference paper .Conclusions: Overall, conjugated fullerene and dimethyl acrylamide-trimethyl chitosan (DMAA-TMC) as carriers can be a good proposition for loading, delivery, and release of anti-cancer drugs based on a pH/temperature-sensitive smart drug delivery system.
Research on the Noise Reduction and Efficiency Increase for Axial Fan with Wave Leading Edge Blades
Authors: Li Bo , Wu Yujing , Guo Dange , Luo Dan , HUANG Diangui 
Published: October 2020

Abstract
This paper imitates the raised structure of the leading edge of the humpback whale fin limbs, designed six bionic blades. The aerodynamic analysis show that: the wave leading edge blade can improve the total pressure efficiency of the axial flow fan, and under off-design conditions, the aerodynamic performance of bionic fan is better than that of prototype fan. The noise analysis shows that: under the condition of constant wave number, increasing wave amplitude can reduce the overall sound pressure level at the monitoring point, in the middle and high frequency range, the sound pressure level of the bionic fan at the monitoring point is significantly lower than that of the prototype fan, and the noise reduction effect increases with the increase of wave amplitude; under the condition of constant wave amplitude, increasing the wave number can reduce the fan noise. At a certain wave number and amplitude, the overall sound pressure level of the bionic fan at the monitoring point is at most 2.91 dB lower than that of the prototype fan. In this paper, the noise reduction effect of increasing wave number is more obvious than that of increasing wave amplitude.
PDIA6 Contributes to Aerobic Glycolysis and Cancer Progression in Oral Squamous Cell Carcinoma
Authors: Mao Ling , Wu Xiaoweng , Gong Zhengpeng , Yu Ming , Huang Zhi 
Published: October 2020

Abstract
Background/Objective: Accumulated evidence has demonstrated that aerobic glycolysis serves as a regulator of tumor cell growth, invasion and angiogenesis. Herein, we explored the role of protein disulfide isomerase family 6 (PDIA6) in the aerobic glycolysis and the progression of oral squamous cell carcinoma (OSCC). Methods: The expression pattern of PDIA6 in OSCC tissues was determined by qPCR and western blotting. Lentivirus and small interfering RNAs (siRNAs) were introduced into cells to upregulate and downregulate PDIA6 expression. CCK-8, flow cytometry, transwell and xenotransplantation models were applied to detect cell proliferation, apoptosis, migration, invasion and tumorigenesis, respectively. Results: A high expression pattern of PDIA6 was observed in OSCC tissues, which was closely associated with lower overall survival and malignant clinical features in OSCC. Compared with the control group, overexpression of PDIA6 induced significant enhancements in cell growth, migration, invasiveness and tumorigenesis and decreased cell apoptosis, while knockdown of PDIA6 caused opposite results. In addition, overexpression of PDIA6 increased glucose consumption, lactate production and ATP level in OSCC cells.Conclusion: This study demonstrated that PDIA6 expression was elevated in OSCC tissues, and overexpression of it promoted OSCC progression and aerobic glycolysis.
The Taxonomic Signal of the Internal Mosquito Wing Cells.
Authors: Chonephetsarath Somsanith , Raksakoon Chadchalerm , Sumruayphol Suchada , Dujardin Jean-Pierre , Potiwat Rutcharin 
Published: October 2020

Abstract
BackgroundPrevious publications revealed a clear taxonomic signal embedded in the external contour of the wings. Our study explored this signal also for internal cells of the wings, with the following question: do internal cells uniformly provide the same taxonomic information? MethodsOur study focused on four species, three of them of medical importance: Ae. aegypti, Ae. albopictus, Ae. scutellaris and Ve. dux, each of them represented by 30 female wings. Each cell was characterized for size and shape after an elliptic Fourier analysis. For each cell to be tentatively assigned to its respective species, i.e., to measure its amount of taxonomic information, we used the shape of the contour, not its size. ResultsWe showed that the taxonomic signal of shape was not uniformly spread among internal cells of the wing, ranging on average from 80% to 94%. Four internal cells out of six performed better than the external contour of the wing. The amount of taxonomic information of internal cells could not be related to their size nor to their shape complexity, but clearly depended on which species were compared. The closest species of our sample, Ae. albopictus and Ae. scutellaris, two species frequently found in the same water collections in Thailand, were almost perfectly separated (97%) by a single cell. ConclusionIt has already been said that the wing can be used for mosquito identification even if the whole body is not available, we showed that even partly damaged wings could contain extractable and more accurate taxonomic information.
3d Printed Ti6al4v Bone Scaffolds With Different Pore Structure Effects on Bone Ingrowth
Authors: Deng Fuyuan , Liu Linlin , Li Zhong , Liu Juncai 
Published: October 2020

Abstract
The pore size, pore structure and porosity of porous scaffold play a vital role in bone regeneration, but its optimal shape is still unclear. In this study four kinds of porous titanium alloy scaffolds with similar porosity (65%) and pore size (650µm) and different structures were prepared by selective laser melting. Four scaffolds were implanted into the distal femur of rabbits to evaluate their bone tissue growth in vivo. Micro-CT and hard tissue sections were performed 6 and 12 weeks after the operation to reveal the bone growth of the porous scaffold. The results show that diamond lattice unit (DIA) bone growth is the best in four topological scaffolds. Through computational fluid dynamics (CFD) analysis, the permeability, velocity and flow trajectory inside the scaffold structure were calculated. The internal fluid velocity difference of the DIA structure is the smallest, and the trajectory of fluid flow inside the scaffold is the longest. It is beneficial to the growth of blood vessels and the transport of nutrients, and can promote bone formation. In this study, the mechanism of bone growth in different structures was revealed by the method of in vivo experiment combined with CFD, providing a new theoretical basis for the design of bone scaffolds in the future.