bluuebunny/crossref_metadata_2025_split huggingface dataset:
Forensic Pathological Considerations of a Unique Case of “Complicated Suicide”*,†
Authors: Gentile Guendalina , Bianchi Marta , Boracchi Michele , Goj Carlo , Tambuzzi Stefano , Zoja Riccardo 
Published: July 2020

AbstractIn the forensic literature, peculiar and uncommon cases of suicides defined as “complicated” are reported. In these circumstances, the suicide method chosen by the victim fails, and death occurs due to a subsequent unforeseen accidental event defined as secondary trauma. Through retrospective examination of 25,512 autopsies in 27 years (1993–2019) at the Bureau of Legal Medicine of Milan, a unique case of complicated suicide was identified from a total of 4497 suicides. It concerns an elderly man who, after killing his wife by inflicting incised wounds to her neck, tried to hang himself by tying a rope to a heater and jumping from the window located over the heater itself. However, the rope suddenly snapped and the man fells to the ground causing fatal traumatic injuries. Death occurred because of an accidental event caused by the failure of the hanging mechanism. Therefore, a peculiar yet characteristic case of complicated suicide is described.
Snapshot of emergency departments in Jakarta, Indonesia
Authors: Yusvirazi Liga , Sulistio Septo , Wijaya Ramlan Andi Ade , Camargo Jr Carlos A 
Published: July 2020

AbstractObjectiveEDs in Indonesia face an unprecedented increase in patient influx after the expansion of national health insurance system coverage. The present study aims to describe EDs' characteristics and capabilities utilisation in Jakarta.MethodsAn ED inventory was created from the Jakarta Provincial Health Office and the Indonesian Hospital Association registries. The EDs that were accessible to the general public 24/7 were surveyed about their characteristics during the calendar year 2017. For further ED analysis, we stratified the hospitals into four types (A, B, C and D) based on their size and capabilities, with type A being the largest.ResultsFrom the 118 (81%) out of 146 EDs that responded, there were 2 million ED visits or 202 per 1000 people. The median annual visit volume was 11 200 (interquartile range 4233–18 000). Further stratification highlights the annual visit difference among hospital types where type A hospitals reported the most with 32 000 (interquartile range 13 459–38 873). Almost half of the EDs (47%) answered that ≥60% of the inpatient census came from the ED. Less than half of the EDs (44%) can manage psychiatry, oral‐maxillofacial and plastic surgery cases. Consultant coverage varied across hospitals and by hospital type (P < 0.05), except for general surgery and obstetrics and gynaecology consultants who were available in most hospitals (74%).ConclusionPhysicians with limited experience and EDs with heterogeneous emergency care capabilities likely threatened the consistency of quality emergency care, particularly for time‐sensitive conditions. Our study provides a benchmark for future improvements in emergency care.
Over‐expression of hsa_circ_0000116 in patients with non‐obstructive azoospermia and its predictive value in testicular sperm retrieval
Authors: Lv Mo‐qi , Zhou Liang , Ge Pan , Li Yi‐xin , Zhang Jian , Zhou Dang‐xia 
Published: July 2020

AbstractBackgroundNon‐obstructive azoospermia (NOA), identified in approximately 10% of infertile males, is a multifactorial disease whose molecular mechanisms remain unknown.ObjectivesThe aim of this study was to identify the role of hsa_circ_0000116 in NOA and illustrate its predictive value in testicular sperm retrieval.Materials and methodsThe study included 78 individuals, 58 with NOA and 20 with obstructive azoospermia (OA). Serum hormones including testosterone (T), follicle‐stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), and estradiol II (E2) were measured. Testicular histopathology was analyzed by at least two pathologists. The expression of hsa_circ_0000116 in testicular tissue samples was detected using real‐time PCR, and the circRNA‐miRNA‐mRNA networks were predicted using bioinformatics analysis.ResultsOur study illustrated that the expression of hsa_circ_0000116 was significantly higher in testicular tissue samples of NOA patients than in that of OA patients. Moreover, hsa_circ_0000116 was aberrantly expressed in three different pathological types of NOA: It was significantly up‐regulated in patients with Sertoli cell–only syndrome (SCOS) when compared to patients with hypospermatogenesis (HS). In addition, the expression of hsa_circ_0000116 was negatively correlated with Johnsen score, while it was positively correlated with serum FSH level. A multivariate logistic regression model demonstrated that a high level of hsa_circ_0000116 was associated with a low rate of successful testicular sperm retrieval. Bioinformatics analysis and verification experiments showed that one of the most probable potential target miRNA for hsa_circ_0000116 was hsa‐miR‐449a. Further analysis indicated that hsa_circ_0000116 may be affecting the fertility function through a hsa_circ_0000116‐miR‐449‐autophagy‐related competing endogenous RNA (ceRNA) network.Discussion and conclusionWe report for the first time that hsa_circ_0000116 may play pivotal roles in regulating spermatogenesis and may also be a potential biomarker for the diagnosis and treatment of NOA, while acting as a predictive tool for the rate of successful testicular sperm retrieval in NOA patients.
Research of flow dynamics and occlusion condition in roller pump systems used for ventricular assist
Authors: Zhou Yang , Sun Beibei , Chen Minglong , Cui Chang 
Published: July 2020

AbstractRoller pumps have been widely used in the ventricular assist field for many years, while the significant hemolysis caused by its mechanical stress is still a fundamental problem. Although the usual under‐occlusion setting was considered as an effective method to reduce the hemolysis rate, its nonocclusive condition of the whole process may cause serious backflow results, which exactly places many restrictions on this method. In this study, the simulation experiments based on computational fluid dynamics (CFD) is conducted, and the occlusion angle is proposed and used to explore a more reliable adjustment form of the occlusion condition. The parameterized geometry of a roller pump is established based on the occlusion angle and other parameters. In order to simulate the motion of the roller, the dynamic mesh mode is introduced to the CFD model, and the analytic formulations used to determine the boundary position are derived. In the whole operation process of the roller pump, four feature positions of the rollers were focused and extracted, and the flow characteristics and the shear stress distribution at these positions were demonstrated. It was found that the entry and exit of the rollers could cause clear shear stress peak, especially when one roller entered, the peak got extremely high. Furthermore, the roller pumps with different occlusion angles were compared, and the results showed that decreasing the occlusion angle could lead to a notable decrease in the amplitude and range of high shear stress and the hemolysis index with a small loss of the occlusion duration. It can be concluded that appropriately decreasing the occlusion angle may be an effective method to alleviate the hemolysis which should be given more attention.
Comparative study about ageing effect on retina and cerebellum of Columba livia domestica
Authors: Sabry Dalia A. 
Published: July 2020

AbstractThe present research explores the ageing impact of Columba livia domestica on retina and cerebellum. It is an available and a widespread bird species. Three ageing groups (n = 5) of male Columba were collected at about three weeks, six months and five years old. Histological studies were made. Morphometric measurement of both retinal and cerebellar cortex layer thicknesses has been determined. For evaluation of the neuronal synapses, quantitative GFAP biochemically and immunohistochemically staining was performed. Also, biochemical analysis of glucose transporter 1, serotonin and dopamine was carried out to demonstrate their functional activity. Flow cytometric assessments of quantitative cell death were accomplished by using annexin V. The present findings revealed quantitative and qualitative increase of GFAP parallel with decrease of serotonin, dopamine and glucose transporter 1 as well as increase of UR and LR annexin V reflecting cell death in old groups. These were confirmed by damaging of the retina and cerebellar layers. The present findings concluded that retinal and cerebellar cells associated with ageing were determined by sharp rise in both cell death and GFAP levels. Additionally, a decrease of dopamine, serotonin and GluT1 level manifested maybe led to functional alteration of both retina and brain.
A Bayesian adaptive phase I/II clinical trial design with late‐onset competing risk outcomes
Authors: Zhang Yifei , Cao Sha , Zhang Chi , Jin Ick Hoon , Zang Yong 
Published: July 2020

AbstractEarly‐phase dose‐finding clinical trials are often subject to the issue of late‐onset outcomes. In phase I/II clinical trials, the issue becomes more intractable because toxicity and efficacy can be competing risk outcomes such that the occurrence of the first outcome will terminate the other one. In this paper, we propose a novel Bayesian adaptive phase I/II clinical trial design to address the issue of late‐onset competing risk outcomes. We use the continuation‐ratio model to characterize the trinomial response outcomes and the cause‐specific hazard rate method to model the competing‐risk survival outcomes. We treat the late‐onset outcomes as missing data and develop a Bayesian data augmentation method to impute the missing data from the observations. We also propose an adaptive dose‐finding algorithm to allocate patients and identify the optimal biological dose during the trial. Simulation studies show that the proposed design yields desirable operating characteristics.
Understanding user trust in artificial intelligence‐based educational systems: Evidence from China
Authors: Qin Fen , Li Kai , Yan Jianyuan 
Published: July 2020

AbstractArtificial Intelligence (AI) has penetrated the field of education. Trust has long been regarded as a driver for the acceptance of technology. Netnography and interviews were used to investigate trust in AI‐based educational systems from the perspective of users. We identified the factors influencing trust in AI‐based educational systems and categorized them as being related to technology, context and individual. Technology‐related factors encompass functionality, helpfulness, interpretability, dependability and interaction interface. Context‐related factors encompass benevolence of educational organizations, data management, teachers’ competencies, official norms and knowledge characteristics. Individual‐related factors encompass perception of the nature of learning, propensity to interact with teachers, perception of AI and autonomy orientation. The results from this paper will contribute to the literature on trust in technology and AI ethics in education.
MET amplification results in heterogeneous responses to osimertinib in EGFR‐mutant lung cancer treated with erlotinib
Authors: Nishiyama Akihiro , Takeuchi Shinji , Adachi Yuta , Otani Sakiko , Tanimoto Azusa , Sasaki Motoko , Matsumoto Shingo , Goto Koichi , Yano Seiji 
Published: July 2020

AbstractThe third‐generation epidermal growth factor receptor tyrosine kinase inhibitor (EGFR‐TKI) osimertinib is approved for untreated, or previously EGFR‐TKI–treated T790M‐positive EGFR‐mutated non‐small cell lung carcinoma (NSCLC). We investigated the heterogeneity of responses to osimertinib and its underlying mechanisms. A patient with EGFR‐L858R–mutated NSCLC was treated with erlotinib. Following treatment, he developed brain and multiple bone metastases and was eventually diagnosed with NSCLC with EGFR‐T790M mutation. The responses of various tumor specimens to osimertinib were heterogeneous. We investigated EGFR‐T790M and MET amplification using PCR and FISH in autopsy specimens of the cervical spine, lumbar spine, and brain. We established the KNZ osimertinib‐resistant (KNZ_OR) tumor cell line with MET amplification using a cervical spine lesion that was intrinsically resistant to osimertinib. We evaluated the effects of MET knockdown and MET inhibitor on KNZ_OR cell sensitivity to osimertinib in vitro and in vivo. Osimertinib‐resistant lesions (cervical spine and brain) showed EGFR‐L858R and MET amplification, but not EGFR‐T790M, whereas osimertinib‐sensitive lesions (lumbar spine) showed EGFR‐L858R and ‐T790, but not MET amplification. Osimertinib decreased the association of amplified MET with L858R‐mutated EGFR but increased that with human epidermal growth factor receptor 3 in KNZ_OR cells. MET knockdown or MET inhibitor sensitized KNZ_OR cells to osimertinib in vitro, indicating that MET amplification induced osimertinib resistance. Combination with osimertinib plus crizotinib induced tumor shrinkage in the KNZ_OR xenograft model. Hence, MET amplification might induce heterogeneous responses to osimertinib in EGFR‐mutated NSCLC. Further investigations on mutated EGFR and amplified MET might lead to the development of effective therapies.
Evaluation of a tumor electric field treatment system in a rat model of glioma
Authors: Wu Hao , Wang Chenxi , Liu Jialin , Zhou Dan , Chen Dikang , Liu Zhixiong , Wu Anhua , Yang Lin , Chang Jiusheng , Luo Chengke , Cheng Wen , Shen Shuai , Bai Yunjuan , Mu Xuetao , Li Chong , Wang Zhifei , Chen Ling 
Published: July 2020

AbstractObjectiveGlioma is a devastating disease lacking effective treatment. Tumor electric field therapy is emerging as a novel non‐invasive therapy. The current study evaluates the efficacy and safety of a self‐designed tumor electric field therapy system (TEFTS ASCLU‐300) in a rat orthotopic transplantation model of glioma.MethodsA model of intracranial orthotopic transplantation was established in rats using glioma C6 cells. For electric field therapy, glioma‐bearing rats were exposed to alternating electric fields generated by a self‐developed TEFTS starting on either 1st (Group 2) or 3rd (Group 3) day after transplantation, while other conditions were maintained the same as non‐treated rats (Group 1). Glioma size, body weight, and overall survival (OS) were compared between groups. Immunohistochemical staining was applied to access tumor cell death and microvessel density within the tumor. In addition, the systemic effects of TEFTS on blood cells, vital organs, and hepatorenal functions were evaluated.ResultsTEFTS treatment significantly elongated the OS of tumor‐bearing rats compared with non‐treated rats (non‐treated vs treated: 24.77 ± 7.08 days vs 40.31 ± 19.11 days, P = .0031). Continuous TEFTS treatment starting on 1st or 3rd day significantly reduced glioma size at 2 and 3 weeks after tumor cell inoculation (Week 2: Group 1:289.95 ± 101.69 mm3; Group 2:70.45 ± 17.79 mm3; Group 3:73.88 ± 33.21 mm3, P < .0001. Week 3: Group 1:544.096 ± 78.53 mm3; Group 2:187.58 ± 78.44 mm3; Group 3:167.14 ± 109.96 mm3, P = .0005). Continuous treatment for more than 4 weeks inhibited tumor growth. The TEFTS treatment promoted tumor cell death, as demonstrated by increased number of Caspase 3+ cells within the tumor (non‐treated vs treated: 38.06 ± 10.04 vs 68.57 ± 8.09 cells/field, P = .0007), but had minimal effect on microvessel density, as shown by CD31 expression (non‐treated vs treated: 1.63 ± 0.09 vs 1.57 ± 0.13% of positively stained areas, P > .05). No remarkable differences were observed in hepatorenal function, blood cell counts, or other vital organs between non‐treated and treated groups.ConclusionThe TEFTS developed by our research team was proved to be effective and safe to inhibit tumor growth and improve general outcomes in a rat model of brain glioma.
Diagnostic utility of high‐risk human papillomavirus mRNA in situ hybridisation in squamous cell carcinoma of unknown primary in the head and neck and implementing American Society of Clinical Oncology guideline recommendations
Authors: Daneshpajouhnejad Parnaz , Miller James Adam , Maleki Zahra 
Published: July 2020

AbstractIntroductionThe American Society of Clinical Oncology (ASCO)‐endorsed College of American Pathologists guideline recommends high‐risk human papillomavirus (HPV) testing for metastatic squamous cell carcinoma (SCC) of lymph nodes level II/III of unknown primary. Herein, the performance of HPV‐RNA in situ hybridisation (ISH) in detection of HPV‐related SCC is evaluated implementing the ASCO guideline recommendations.MethodsEighty head and neck (HN) SCC fine needle aspirations, which utilized HPV‐RNA ISH/P16, were evaluated at Johns Hopkins Hospital (2015‐2018) to investigate their performance and concordance with histology. The results were compared to a prior study of 59 HNSCCs, which HPV‐DNA ISH.ResultsOf the 80 reviewed fine needle aspirations, 65 (50 male, 15 female) were included. The mean age was 63.2 ± 14.0 years. The most common site was neck lymph nodes (47, 72.3%). Fifty‐five cases (84.6%) were accompanied by concurrent core biopsy, and 48 cases (59.4%) had surgical follow‐ups. HPV‐RNA ISH was positive in 44 (67.7%), and P16 was strongly positive in 46 (70.8%). The HPV‐RNA ISH/ P16 concordance rate was 92.3% on cytology material. The cytology/surgical concordance rate for HPV‐RNA ISH was 88.9% (16/18). There was a discordance between the results in five cases (7.7%; HPV‐RNA ISH‐/P16+).ConclusionHPV‐RNA ISH is a robust and reliable method for detecting HPV‐related HNSCC on cytology material showing concordance rate of 92.3% between HPV‐RNA ISH and P16, which is a sensitive but non‐specific marker. Compared to HPV‐DNA ISH, HPV‐RNA ISH reproducibly identifies HPV‐related HNSCC with fewer discrepancies between cytology and histology. The findings of this study are in agreement with the ASCO recommendations.
Communication disorders in young children with cerebral palsy
Authors: Pennington Lindsay , Dave Mona , Rudd Jennifer , Hidecker Mary Jo Cooley , Caynes Katy , Pearce Mark S 
Published: July 2020

AimTo test the prediction of communication disorder severity at 5 years of age from characteristics at 2 years for children with cerebral palsy (CP) whose communication is giving cause for concern.MethodIn this cohort study, 77 children (52 males; 25 females) with communication difficulties and CP were visited at home at 2 (mean 2y 4mo; SD 3mo) and 5 (mean 5y 5mo; SD 4mo) years of age. Information on the type and distribution of motor disorder, seizures, gross and fine motor function, hearing, and vision were collected from medical notes. Non‐verbal cognition, language comprehension, language expression, spoken vocabulary, and methods of communication were assessed directly at age 2 years. At 5 years, communication and speech function were rated using the Communication Function Classification System (CFCS), Functional Communication Classification System (FCCS), and Viking Speech Scale (VSS).ResultsIn multivariable regression models, CP type, Gross Motor Function Classification System level, vision, the amount of speech understood by strangers, non‐verbal cognition, and number of consonants produced at age 2 years predicted the CFCS level at age 5 years (R2=0.54). CP type, Manual Ability Classification System level, amount of speech understood, vision, and number of consonants predicted the FCCS level (R2=0.49). CP type, amount of speech understood by strangers, and number of consonants predicted the VSS level (R2=0.50).InterpretationCharacteristics at 2 years of age predict communication and speech performance at 5 years, and should inform referral to speech and language therapy.
Combination therapy with pioglitazone/exenatide improves beta‐cell function and produces superior glycaemic control compared with basal/bolus insulin in poorly controlled type 2 diabetes: A 3‐year follow‐up of the Qatar study
Authors: Abdul‐Ghani Muhammad , Migahid Osama , Megahed Ayman , DeFronzo Ralph A. , Al‐Ozairi Ebaa , Jayyousi Amin 
Published: July 2020

AbstractAimTo examine the long‐term efficacy of thiazolidinedione plus a glucagon‐like peptide‐1 receptor agonist versus basal‐bolus insulin on glycaemic control and beta‐cell function in patients with poorly controlled type 2 diabetes (T2D) on metformin plus sulphonylurea.Materials and MethodsThree hundred and thirty‐one patients with poorly controlled T2D were recruited over 3 years and were followed for an additional year. Subjects received a 75 g oral glucose tolerance test (OGTT) at baseline and at study end. After completing the baseline OGTT, subjects were randomized to receive either pioglitazone plus weekly exenatide (combination therapy) or basal/bolus insulin (insulin therapy) to maintain an HbA1c of less than 7.0%. The primary outcome of the study was the difference in HbA1c at study end between the two treatment groups.ResultsBoth therapies caused a robust decrease in HbA1c. However, combination therapy caused a greater decrement (−1.1%, P < .0001) than insulin therapy, and more subjects in the combination therapy group (86%) achieved the American Diabetes Association goal of glycaemic control (HbA1c < 7.0%) than those in the insulin therapy group (44%) (P < .0001). Both therapies improved insulin secretion. However, the improvement in insulin secretion with combination therapy was 2.5‐fold greater (P < .001) than with insulin therapy (50%). Insulin therapy caused more weight gain and hypoglycaemia.ConclusionBoth combination therapy and insulin therapy effectively reduced HbA1c in poorly controlled T2D on multiple oral agents. However, combination therapy produced a greater improvement in insulin secretion and decrease in HbA1c with a lower risk of hypoglycaemia.
Saddle pulmonary embolism and thrombus‐in‐transit straddling the patent foramen ovale 28 days after COVID symptom onset
Authors: Fujikura Kana , Fontes Joao D. , Taub Cynthia C. 
Published: July 2020

AbstractWe present a late presentation of saddle pulmonary embolism and thrombus‐in‐transit straddle the patent foramen on patient who successfully recovered from severe acute respiratory syndrome coronavirus‐2 (COVID‐19) pneumonia. Seven days postdischarge (ie, 28 days after initial COVID‐19 symptom onset), she was readmitted to hospital for severe dyspnea. Computer tomography angiogram and echocardiography confirmed the diagnosis. Severe pro‐inflammatory and pro‐thrombotic states with endothelial involvement have been reported associated with severe COVID‐19 infection. However, the duration of hypercoagulable state has not yet known. This case highlights the risk of thromboembolic phenomena for prolonged periods of times after recovering from COVID‐19 pneumonia.