bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tongue fissure visualization by using deep learning – an example of the application of artificial intelligence in traditional medicine
Authors: Chang Wen-Hsien , Wu Han-Kuei , Lo Lun-chien , Hsiao William W. L. , Chu Hsueh-Ting , Chang Hen-Hong 
Published: February 2020

Abstract
Background: Traditional Chinese medicine (TCM) describes physiological and pathological changes inside and outside the human body by the application of four methods of diagnosis. One of the four methods, tongue diagnosis, is widely used by TCM physicians, since it allows direct observations that prevent discrepancies in the patient’s history and, as such, provides clinically important, objective evidence. The clinical significance of tongue features has been explored in both TCM and modern medicine. However, TCM physicians may have different interpretations of the features displayed by the same tongue, and therefore intra- and inter-observer agreements are relatively low. If an automated interpretation system could be developed, more consistent results could be obtained, and learning could also be more efficient. This study will apply a recently developed deep learning method to the classification of tongue features, and indicate the regions where the features are located.Methods: A large number of tongue photographs with labeled fissures were used. Transfer learning was conducted using the ImageNet-pretrained ResNet50 model to determine whether tongue fissures were identified on a tongue photograph. Often, the neural network model lacks interpretability, and users cannot understand how the model determines the presence of tongue fissures. Therefore, Gradient-weighted Class Activation Mapping (Grad-CAM) was also applied to directly mark the tongue features on the tongue image. Results: Only 6 epochs were trained in this study and no graphics processing units (GPUs) were used. It took less than 4 minutes for each epoch to be trained. The correct rate for the test set was approximately 70%. After the model training was completed, Grad-CAM was applied to localize tongue fissures in each image. The neural network model not only determined whether tongue fissures existed, but also allowed users to learn about the tongue fissure regions.Conclusions: This study demonstrated how to apply transfer learning using the ImageNet-pretrained ResNet50 model for the identification and localization of tongue fissures and regions. The neural network model built in this study provided interpretability and intuitiveness, (often lacking in general neural network models), and improved the feasibility for clinical application.
Overproduction of the Flv3B flavodiiron, enhances the photobiological hydrogen production by the nitrogen-fixing cyanobacterium Nostoc PCC 7120
Authors: Roumezi Baptiste , Avilan Luisana , Risoul Véronique , Brugna Myriam , Rabouille Sophie , Latifi Amel 
Published: February 2020

Abstract
Background: The ability of some photosynthetic microorganisms, particularly cyanobacteria and microalgae, to produce hydrogen (H2) is a promising alternative for renewable, clean-energy production. However, the most recent, related studies point out that much improvement is needed for sustainable cyanobacterial-based H2 production to become economically viable. In this study, we investigated the impact of induced O2-consumption on H2 photoproduction yields in the heterocyte-forming, N2-fixing cyanobacterium Nostoc PCC7120. Results: The flv3B gene, encoding a flavodiiron protein naturally expressed in Nostoc heterocytes, was overexpressed. Under aerobic and phototrophic growth conditions, the recombinant strain displayed a significantly higher H2 production than the wild type. Nitrogenase activity assays indicated that flv3B overexpression did not enhance the nitrogen fixation rates. Interestingly, the transcription of the hox genes, encoding the NiFe Hox hydrogenase, was significantly elevated, as shown by the quantitative RT-PCR analyses. Conclusion: We conclude that the overproduced Flv3B protein might have enhanced O2-consumption, thus creating conditions inducing hox genes and facilitating H2 production. The present study clearly demonstrates the potential to use metabolic engineered cyanobacteria for photosynthesis driven H2 production.
Korean medicine students' entrance factors and satisfaction with their college experience: a quantitative nationwide study
Authors: Kim Hyun-Seok , Lee Joohyun , Kim Hwimun , Yang Unho , Kim Hyunho 
Published: February 2020

Abstract
Background Korean medicine (KM) has equal legal rights with conventional Western medicine in South Korea and is taught at KM colleges. To date, no research has been conducted on the entrance factors and satisfaction of KM college students. Thus, this study attempts to fill this gap in the literature. Methods Content validity tests and face validity tests were conducted during the development of the questionnaires used in this study. The scores of each item and the correlation between items and sub-items were analyzed and factors were correlated with students’ satisfaction and willingness to re-enter KM colleges. Results A total of 420 students responded to the survey. The mean of the item considering stable incumbency and examination scores was the highest. The highest correlation between an item and sub-item concerned interaction with people. The questionnaire items or sub-questionnaire items that showed moderate high correlation with the questionnaire items asked whether participants were willing to re-enter the KM college and were both about independent choices. Conclusions Identifying college entrance factors can contribute to increasing current students’ academic satisfaction and decreasing drop-out rates. College entrance factors that are closely related to students’ motivation to become KM doctors may increase the current academic satisfaction of KM students and decrease drop-out rates. This study highlights factors that can be applied in college curriculum or subject teaching, such as interest in research on KM.
A survey exploring ophthalmologists’ attitudes and beliefs in performing Immediately Sequential Bilateral Cataract Surgery in the United Kingdom.
Authors: Lee Eunkyung , Balasingam Bagishan , Mills Emily , Zarei-Ghanavati Mehran , Liu Christopher 
Published: February 2020

Abstract
Purpose

To examine the attitudes and beliefs of UK ophthalmologists towards Immediately Sequential Bilateral Cataract Surgery (ISBCS); explore their reasons to either practise or not practise ISBCS; identify barriers hindering its implementation in the UK.

Setting

Consultant members of The Royal College of Ophthalmologists (RCOphth, UK)

Design

Survey-based, questionnaire

Methods

Distributed to members and collected electronically. An initial screening question in regards to prior experience with ISBCS directed the rest of the survey; participants were asked to rate the importance of several factors with regards to performing ISBCS. Free text options were also available. Descriptive analysis was subsequently performed.

Results

Of the 1357 recipients, 130 (9.6%) ophthalmologists completed the survey. Of those, 13.9% were currently performing ISBCS, 83.1% had never performed, and 3.1% had previously done so but since stopped. The main factors that acted as barriers were lack of: (1) College approval (20.5%); (2) medico-legal approval (20.2%); (3) evidence to support the use of ISBCS (16.0%); and (4) hospital approval (13.3%). Additionally, the perceived risk of complications for patients played an important role when considering ISBCS, with the risk of endophthalmitis being most feared.

Conclusions

This survey demonstrates some of the barriers that prevent ophthalmologist’s performing ISBCS in the UK. There is a need for further exploration in this field to evaluate the effect of addressing any of these concerns on the implementation of ISBCS.
Energy-dense nutrient-poor snacks and risk of non-alcoholic fattyliver disease: a case-control study in Iran
Authors: yari zahra , Cheraghpour Makan , Aghamohammadi Vahideh , Alipour Meysam , Ghanei Nila , Hekmatdoost Azita 
Published: February 2020

Abstract
Objective: The purpose of the present study was to determine the association between energy-dense nutrient-poor snacks intake and the risk of non-alcoholic fatty liver disease (NAFLD) in Iranian adults. For this purpose, a total of 143 cases with a newly confirmed diagnosis of NAFLD and 471 controls free of the disease were studied. Dietary intake was assessed using a food frequency questionnaire.Results: The percentage of calories from total energy-dense nutrient-poor snacks was 6.08% and 5.04%, in patients and controls, respectively (p=0.036). Compared with subjects in the lowest quartile of total energy-dense nutrient-poor snacks intake, the risk of NAFLD for those in the top quartile of consumption increased by about two times, in both crude (OR:1.94; 95% CIs: 1.16-3.26; P for trend=0.015) and adjusted (OR:2.27; 95%CIs: 1.19-4.31; P for trend=0.001) models. The relative odds of NAFLD increased significantly in the fourth quartile of dietary cake and biscuit (OR: 1.21, P for trend=0.037) and soft drinks (OR: 1.64, P for trend=0.005) intake compared with the lowest corresponding quartiles, after adjustment for age, sex, body mass index, physical activity, alcohol, energy intake. Our results indicate that there might be a moderate positive association between energy-dense nutrient-poor snacks intake and risk of NAFLD.
Degradation of Emerald Green: Scientific Studies on Multi-polychrome Vairocana Statue in Dazu Rock Carvings, Chongqing, China
Authors: Li Zhimin , Wang Lele , Chen Huili , Ma Qinglin 
Published: February 2020

Abstract
The spontaneous degradation of pigments in painting may occur depending on environment, especially the surrounding condition of high humidity and soluble salts. Even some of these are well studied, more investigations are still in need for heritage science. Paint cross sections from Vairocana Statue in Dazu Rock Carvings, one of World Cultural Heritage, Chongqing, China are studied by optical microscopy (OM), Raman spectroscopy (Raman) and mapping, and scanning electron microscopy coupled with energy dispersive X-ray analysis (SEM–EDS). Ultramarine blue, emerald green, synthetic atacamite, vermilion, red lead, gold foil, orpiment, cerussite, gypsum and barite are identified as pigments. Moreover, lavendulan (NaCaCu5(AsO4)4Cl·5H2O) and mimetite (Pb5(AsO4)3Cl) are degradation products of emerald green (Cu(C2H3O2)2·3Cu(AsO2)2) and cerussite(PbCO3) originally used as green pigment with mixture. These secondary products is formed via multistep progresses as degradation of emerald green and cerussite, oxidation of arsenite ((AsO2)-), migration of arsenate ((AsO4)3-) and precipitation reaction of these ions with other necessary ions from environmental conditions. Based on the pigment and paint layer stratigraphy analysis, the paintings of the statue have been executed at least four times and the most recent may be after 1850s. The formation of lavendulan give rise to a highlight for identification of green copper-arsenic containing pigments and characterization of degradation in complex conditions.
The expression of BAFF in the muscles correlate with refractory autoimmune necrotizing myopathy with anti-signal recognition particle antibodies
Authors: Zhao Yawen , Zhang Wei , Liu Yilin , Wang Zhaoxia , Yuan Yun 
Published: February 2020

Abstract
BackgroundAutoimmune necrotizing myopathy with anti-signal recognition particle antibodies (ANM-SRP) is considered as a refractory myositis; some patients respond poorly to conventional immunosuppression，required the treatment of B lymphocyte clearance. We aimed to identify the factors related to refractory ANM-SRP.Results48 patients with ANM-SRP were included to identify the factors related to refractory ANM-SRP. We monitored the clinical symptoms and image changes over 12 months. Refractory ANM-SRP appeared in 32.5% patients, who showed no or minimal improvement after 12 months with steroid therapy. The clinical risk factors for refractory patients were male (19.57, 1.49-256.53), severe muscle weakness (7.51, 41.03-54.88) and concurrent interstitial lung disease (39.70, 3.04-518.38). The fatty infiltration rate of thigh muscles over 3 months was more severe (P=0.022) in refractory patients. Muscles of all patients underwent routine histology, enzyme histochemistry and immunohistochemistry staining. The first antibodies used for immunohistochemistry include anti-B cell activating factor (BAFF) and BAFF receptor (BAFF-R) antibodies. Immunohistochemical staining and western bolt showed that the expression of BAFF and BAFF-R in muscles of the patients were higher than that of the normal controls. The positive BAFF-R cells (P=0.036) and CD19 positive lymphocytes (P=0.002) in refractory patients were higher than in patients with good clinical response to therapy.ConclusionThe expression of BAFF and BAFF-R in muscles of ANM-SRP were upregulated. Male, severe muscle weakness, concurrent interstitial lung disease, quick development of muscle fatty infiltration and more BAFF-R and B-lymphocytes infiltration in muscle indicate a poor response to immunosuppressive therapy.
The global prevalence ptxP3 lineage of Bordetella pertussis was rare in young Children with the Co-purified aPV vaccination: a 5 years retrospective study
Authors: Wang Zengguo , Luan Yang , Du Quanli , Shu Chang , Peng Xiaokang , Wei Huijing , Hou Tiejun , Liu Ying , Liu Xiaoguai , Li Yarong 
Published: February 2020

Abstract
Background: The global prevalent ptxP3 strains varies from about 10% to about 50% of circulating B. pertussis population in different areas of China. Methods To investigate the difference of vaccination status between different genotypes in the circulating B. pertussis after 10 years of acellular pertussis vaccine (aPV) used in China. The nasopharyngeal swabs and isolates of B. pertussis from these patients were used to perform genotyping of antigen genes. We use antibiotic susceptibility test against erythromycin and sequencing methods for site 2047 of 23S rRNA to determine the resistance status. Results The ptxP1 allele with erythromycin resistant strains infection (total of 449 samples) consisted of 84.70% to 96.70% from 2012 to 2016. Only 2 of the 21 ptxP3 strains infected in children vaccinated with co-purified aPV, that showed a significant difference between the ptxP1 strains does (χ 2 =6.87, P=0.032). Conclusions The ptxP1 allele with erythromycin resistant B. pertussis was steadily increased in Xi’an, China from 2012 to 2016, where co-purified aPV was prevalence used . We assumed that the co-purified aPV might protect against ptxP3 strains more efficient, which generated a rare chance for ptxP3 strains to be under the antibiotic pressure and further developed to be erythromycin resistance. A further cohort study and the mechanisms of the additional antigen proteins of co-purified aPV protected against B. pertussis should be consideration.
Pseudoangiosarcomatous squamous cell carcinoma: first case report on penis.
Authors: Barbosa Liseana de Oliveira , Neto José Osvaldo Barbosa , Junior Antônio Augusto Lima Teixera , Nogueira Leudivan Ribeiro , Calixto José de Ribamar Rodrigues , Junior Antônio Machado Alencar , Pinho Jaqueline Diniz , Nascimento Francisco Sérgio Moura Silva do , Cunha Isabela Werneck , Silva Gyl Eanes Barros 
Published: February 2020

Abstract
Background: Pseudoangiosarcomatous squamous cell carcinoma, also called pseudovascular, pseudoangiomatoid or adenoid pseudovascular carcinoma, is an uncommon and highly aggressive variant of squamous cell carcinoma. Histologically, it is characterized by proliferation of atypical keratinocytes with acantholysis and formation of pseudovascular spaces, forming anastomosed channels lined with neoplastic cells that invade the dermis. These cells are positive for cytokeratin and vimentin and negative for vascular markers such as CD31 and CD34. There are few reports of this tumor variant in the literature. Skin, breast, lung and vulva involvement have been described. But to the best of our knowledge, no cases involving the penis have been described. This article aims to describe the first case of angiosarcomatous squamous cell carcinoma of the penis. Case Report: The patient presented with a painful lesion in the penis associated with urinary retention. Macroscopic findings exhibited an ulcerative vegetating lesion that involving the entire glans and part of the penile body, as well as infiltration of penile structures and scrotal skin. Microscopy shows atypical proliferation of sarcomatous keratinocyte pattern mimicking vascular spaces. These neoplastic squamous cells were positive for the cytokeratin marker and were negative for the CD31 and CD34 markers. Human papilloma virus biomarkers, p16, E6 protein and PCR, were all negative. Conclusion: This report presents the first reported case of penile pseudoangiosarcomatous squamous cell carcinoma, as an important differential diagnosis.
Risk of Bacterial Infection in Acquired Complement Deficiencies
Authors: Al-Shaikhly Taha , Hayward Kristen , Basiaga Matthew L , Allenspach Eric J 
Published: February 2020

Abstract
Background: Acquired complement deficiency can occur in the setting of autoimmune syndromes, such as systemic lupus erythematosus (SLE), with very low or, occasionally, undetectable C3 levels. Based on data from patients with inherited complement defects, a perceived risk for serious bacterial infection exists amongst patients with transiently low complement, but the degree of risk related to C3 level is unknown. Methods: We performed a retrospective study of all pediatric patients with an undetectable total complement activity or absent individual complement components measured at our institution from 2002 to 2018. We assessed annual rate of serious bacterial infection (SBI) defined as requiring hospitalization and/or parenteral antibiotics. Among included SLE patients, we assessed the 30-day probability of SBI for given C3 measurements using a logistic regression model to determine risk. Results: Acquired complement deficiency secondary to SLE-related disease [n=44] was the most common underlying diagnosis associated with depressed complement levels. While controlling for immunosuppression level and lupus nephritis diagnosis, our logistic regression analysis of pediatric patients with SLE showed low C3 level was temporally associated with having an SBI event. Even in patients with equivalent immunosuppression, patients with an SBI were found to have lower C3 levels preceding the infection relative to patients without SBI. Conclusion: Pediatric patients with the diagnosis of SLE can develop very low C3 levels that are independently associated with risk of serious bacterial infection. Patients prone to complement consumption may particularly be at risk.
How is migration background considered in the treatment and care of people - a comparison of national dementia care guidelines in Europe
Authors: Schmachtenberg Tim , Monsees Jessica , Hoffmann Wolfgang , Berg Neeltje van den , Stentzel Ulrike , Thyrian Jochen René 
Published: February 2020

Abstract
Background People with a migration background are a vulnerable group regarding dementia. Providing care for this group is a public health challenge in Europe. Many countries are issuing care guidelines, but a systematic overview of their references to migration is lacking. This study aims to determine the extent to which care guidelines take people with a migration background into account, which migration-related content focuses are set and to what extent specific actions are considered or recommendations are made to ensure their care. Methods This study is a systematic analysis of national dementia care guidelines of the EU and EFTA (European Free Trade Association) countries. Using the discourse analysis model by Rainer Keller (2011), n=43 documents from n= 24 EU and n=3 EFTA countries were systematically screened for migration references via keyword and context analysis. The content of the migration-related section was paraphrased, memos and comments were added and the individual text passages were coded using the strategy of open coding. Results 27 of the 35 EU- and EFTA countries have guidelines or similar documents on care for people with dementia and twelve refer to migration. Norway, Sweden, and Northern Ireland refer to this topic in detail. The focus of the migration-related documents is on the early detection and diagnosis of dementia. The main message is that standardized diagnostic tools such as the Mini-Mental State Examination (MMSE) or the clock test are not suitable for linguistic minorities. Nine countries make recommendations for the care of people with a migration background and dementia but only Norway, Sweden, and Denmark point to available healthcare services. A key recommendation is that the linguistic and cultural background of people should be taken into account when selecting diagnostic tests. Several countries refer to the validity of the RUDAS (Rowland Universal Dementia Assessment Scale) for migrants. Conclusions The topic of migration plays a subordinate role in the care guidelines of European countries. Almost all countries lack appropriate diagnostic tools and healthcare services for people with a migration background. Consequently, people with a migration background are a risk group for underdiagnosis and a lower level of care.
Evaluation of a novel lower radiation computed tomography protocol for assessment of tunnel position post anterior cruciate ligament reconstruction
Authors: vasudeva varun , Key Stephen , Phillips Alfred , Kahane Steve , Stevens Joseph , Wall Chris , Gallie Price 
Published: February 2020

Abstract
Background Anterior cruciate ligament (ACL) reconstruction is a common orthopaedic procedure. We developed a novel, low dose computed tomography (LDCT) protocol to assess tunnel position post-operatively. The effective radiation dose of this protocol is <0.5mSv, which is significantly less than the 2mSv dose for a conventional CT protocol. The aim of this study was to assess the accuracy of the LDCT protocol for determining tunnel position. Methods Twenty-six patients who underwent primary ACL reconstruction were included in the study. A LDCT scan was performed six weeks post-operatively. Femoral and tibial tunnel positions were measured on three dimensional (3D) reconstructions using previously validated techniques. Measurements were performed independently by three observers at two time points, four weeks apart. Results There was excellent intra- and inter-rater reliability for all measurements using the images obtained from the LDCT protocol. Intra-class correlation coefficient (ICC) values were >0.9 for all measurements. Conclusions The LDCT protocol described in this study accurately demonstrates femoral and tibial tunnels post ACL reconstruction, while exposing the patient to a quarter of the radiation dose of a conventional CT. This protocol could be used by orthopaedic surgeons for routine post-operative imaging, in place of plain film radiographs.