bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Impact of Interruption in Adjuvant Trastuzumab Therapy in Patients with Operable HER-2 Positive Breast Cancer
Authors: Sardesai Sagar , Sukumar Jasmine , Kassem Mahmoud , Palettas Marilly , Stephens Julie , Evan Morgan , Addison Daniel , Baliga Ragavendra , Stover Daniel G. , VanDeusen Jeffrey , Williams Nicole , Cherian Mathew , Lustberg Maryam , Wesolowski Robert , Ramaswamy Bhuvaneswari 
Published: October 2020

Abstract
Background: Trastuzumab-induced cardiotoxicity (TIC) can lead to early discontinuation of adjuvant therapy, however there is limited evidence on long-term survival outcomes in patients with operable human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC) experiencing treatment interruption or discontinuation.
Methods: The primary objective of the study was to evaluate disease-free survival (DFS) in non-metastatic, HER2-positive, female BC patients who experienced treatment interruption or early discontinuation of trastuzumab therapy. Clinical and histopathological data were collected on 400 patients at The Ohio State University, an NCI-designated comprehensive cancer center between January 2005 and December 2015. Treatment interruption was defined as any delay of ≥2 weeks during trastuzumab therapy, including permanent cessation prior to completing planned therapy. TIC was defined as LVEF <50% or >15 points decline from baseline as evaluated by 2D echocardiogram after initiation of (neo) adjuvant therapy. DFS was defined as the time from diagnosis to first recurrence (loco-regional or distant recurrence) including second primary BC or death. Overall survival (OS) was defined as the time from diagnosis to death or last known follow up. OS/DFS estimates were generated using Kaplan-Meier methods and compared using Log-rank tests. Cox proportional hazard models were used to calculate adjusted hazard ratios (aHR) for OS/DFS.
Results: A total of 369 patients received trastuzumab therapy; 106 (29%) patients experienced treatment interruption at least once and 42 (11%) permanently discontinued trastuzumab prior to completing planned therapy. TIC was the most common reason for interruption (66 patients, 62%). The median duration of trastuzumab in patients with treatment interruption was 11.3 months (range: 0.5-16.9) with 24 (23%) patients receiving ≤6 months of therapy. This duration includes the time delay related to treatment interruption. Patients with any treatment interruption had worse DFS (aHR: 4.4, p=0.001) and OS (aHR: 4.8, p<0.001) after adjusting for age, stage, grade, ER, node status and TIC.
Conclusions: Treatment interruption or early discontinuation of trastuzumab therapy in early HER2-positive BC, most often from TIC, is an independent prognostic marker for worse DFS and OS in operable HER2-positive BC. Future prospective studies should consider targeting at-risk populations and optimizing cardiac function to avoid interruption in trastuzumab therapy.
Catastrophic Health Expenditures for Children with Disabilities in Iran: A National Survey
Authors: Moradi Ghobad , Bolbanabad Amjad Mohamadi , Abdullah Farman Zahir , Safari Hossein , Rezaei Satar , Aghaei Abbas , Hematpour Siros , Farshadi Salahaddin , Naleini Nima , Piroozi Bakhtiar 
Published: October 2020

Abstract
Background: Higher health costs and financial burden are imposed on people with disabilities due to their health status associated with their disability. Measuring the incidence of catastrophic health expenditures (CHE) can provide good evidence for health policymakers to assess the current state of financial protection of the health system. The aim of this study was to investigate the percentage of households with disabled children aged 0 to 8 years who had faced CHE due to the health costs of these children in Iran.Methods: This cross-sectional study was carried out on 2000 households with disabled children aged 0 to 8 years in five provinces of Iran in 2020. Data were collected using the World Health Survey questionnaire and face-to-face interview. Households whose health expenditures for disabled members in the family were more than 40% of the household payment capacity were included in the group of households with CHE. Determinants of CHE were identified using logistic regression.Findings: 32.7% of households with disabled children had faced CHE. Head of household being female (Adjusted OR=18.89, 95%CI: 10.88- 29.42), poor economic status of the household (Q1: Adjusted OR = 20.26, 95% CI, 11.42-35.94; Q2: Adjusted OR= 8.27, 95%CI, 4.45-15.36; Q3: Adjusted OR= 13.88, 95%CI, 7.89-24.41), lack of supplementary insurance by a child with disabilities (Adjusted OR= 6.13, 95%CI, 3.39-11.26), having a child with mental disability (Adjusted OR= 2.71, 95%CI, 1.60-4.69), and type of basic health insurance [having Iranian Health Insurance: Adjusted OR= 2.20, 95%CI, 1.38-3.49; having Social security insurance: Adjusted OR= 1.66, 95%CI, 1.06-2.61] significantly increased the chances of facing CHE.Conclusion: A significant percentage of households with disabled children had faced CHE because of their disabled child's health costs. The key determinants of CHE should be considered by health policy-makers in order to more financial protection of these households.
Differential response to intravitreal dexamethasone implant in naïve and previously treated diabetic macular edema eyes
Authors: Zarranz-Ventura Javier , Romero-Nuñez Barbara , Bernal-Morales Carolina , Velazquez-Villoria Daniel , Sala-Puigdollers Anna , Figueras-Roca Marc , Copete Sergio , Distefano Laura , Boixadera Anna , García-Arumí Jose , Adan Alfredo 
Published: October 2020

Abstract
Background: To identify different response patterns to intravitreal dexamethasone implants (IDI) in naïve and previously treated (PT) diabetic macular edema (DME) eyes in a real-life setting.Methods: 342 IDI injections (203 DME eyes) were included. Number of IDI injections, percentage (%) of eyes with 1, 2, 3 and ³ 4 injections, time to reinjections, visual acuity (VA), intraocular pressure (IOP) and central retinal thickness (CRT) were evaluated for naïve and PT DME eyes over 24 months.Results: Mean number of injections was significantly lower in naïve vs PT DME eyes (1.40±0.9 vs 1.82±0.9, p<0.001). The percentage of eyes receiving 1 injection was significantly higher in naïve vs PT DME eyes (76.1 vs 47.7), (p<0.001). However, it was significantly lower for 2 (16.4 vs 29.4), or 3 injections (1.4 vs 17.6) (both p<0.001), with no differences in eyes receiving ³4 injections (5.9 vs 5.1 respectively, p=0.80). Mean time to reinjection was not significantly different between both groups for the second, third and fourth injection (9.6±4.0 vs 10.0±5.5, p=0.75, 13.2±4.0 vs 16.0±3.5, p=0.21 and 21.7±3.8 vs 19.7±5.8, p=0.55). VA scores were consistently better in naïve vs PT DME eyes at all studied timepoints, with no significant differences in CRT reduction or adverse effect rates.Conclusion: Naïve DME eyes received lower number of IDI injections and showed better VA levels than PT DME eyes for 24 months in a real-world setting. This data supports the IDI use in early DME stages and provide further evidence of better IDI response when used as first-line therapy.
Real-time in situ navigation system with indocyanine green fluorescence for sentinel lymph node biopsy in patients with breast cancer
Authors: Wang Zhaorui , Yang Xiaowei , Liu Peng , Han Chunguang , Pan Yubo , Pei Jing 
Published: October 2020

Abstract
Background: The naked-eye invisibility of indocyanine green fluorescence limits the application of near-infrared fluorescence imaging (NIR) systems for real-time navigation during sentinel lymph node biopsy (SLNB) in patients with breast cancer undergoing surgery. This study aims to evaluate the effectiveness and safety of a novel NIR system in visualizing indocyanine green fluorescence images in the surgical field and the application value of combined methylene blue (MB) and the novel NIR system in SLNB. Methods: Sixty patients with clinical node-negative breast cancer received indocyanine green (ICG) and MB as tracers. Two NIR system instruments, namely, lymphatic fluorescence imaging system (LFIS) designed by the University of Science and Technology of China and vascular imager by Langfang Mingde Medical Biotechnology Co., Ltd. (Langfang vascular imager), were used as navigation assistance to locate sentinel lymph nodes (SLNs). Excising the lymph nodes developed by both MB and ICG by two NIR systems or palpably suspicious as SLNs and undergoing rapid pathological examination. Results: Both instruments exhibited 95% (57/60) success for real-time lymphatic fluorescent images. A total of 186 SLNs were identified, of which two were pathologically confirmed as lacking any lymph node tissue. SLN identification rate was 100% (184/184) for MB plus LFIS and 86.96% (160/184) for MB alone. The average number of SLNs identified by LFIS combined with MB was 3 (range of 1–8), which was significantly higher than that by MB alone at 2 (range 1–7) (P<0.05). Conclusion: LFIS effectively detects SLNs in breast cancer, projects the fluorescence signals during surgery, and provides a continuous surgical navigation system without the need for a remote monitor. The ICG method navigated by combined LFIS and MB may be a promising alternative tracer for radioisotope in SLN mapping.
A prospective feasibility study of a 1-mm bolus for postmastectomy radiotherapy
Authors: Kawamoto Terufumi , Shikama Naoto , Kurokawa Chie , Hara Naoya , Oshima Masaki , Sasai Keisuke 
Published: October 2020

Abstract
Background: The optimal chest wall bolus regimen for postmastectomy radiotherapy (PMRT) remains unknown. We aimed to prospectively evaluate the use of a 1-mm-thick daily tissue-equivalent bolus in patients who received PMRT using thermoluminescent dosimeters (TLDs) and skin toxicity assessment.Materials and Methods: Patients with a 1-mm-thick daily bolus during PMRT were prospectively enrolled at The Juntendo University Hospital. The surface dose was measured in vivo under the 1-mm-thick bolus on the chest wall. We assessed the acute skin toxicity weekly during PMRT, and 1, 2, 4, and 12 weeks after the completion of PMRT.Results: A total of 19 patients aged 32−79 years old received PMRT from July 2019 to January 2020. All patients completed the protocol treatment without interruptions, and the median follow-up was 32 weeks. In vivo dosimetry analysis revealed surface doses between 77% and 113% of the prescribed dose, with a mean of 92% of the prescribed radiation dose, and a standard deviation of 7% being delivered. Grade 2 dermatitis was found in 10 patients (53%), and Grade 3 dermatitis was found in one patient (5%). All cases of Grade 2 and 3 dermatitis were improved 4 weeks after PMRT. There were no cases of Grade 4 dermatitis and no chest wall recurrences during the treatment or follow-up period.Conclusions: The results confirmed the feasibility of using the 1-mm-thick daily bolus for PMRT, with appropriate dose buildup and acceptable skin toxicity without treatment interruptions.Trial registration: The University Hospital Medical Information Network Clinical Trials Registry, UMIN000035773. Registered 1 July 2019, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000040622
Eudiplozoon Nipponicum: Morphofunctional Adaptations of Diplozoid Monogeneans for Confronting Their Host
Authors: Valigurová Andrea , Vaškovicová Naděžda , Gelnar Milan , Kováčiková Magdaléna , Hodová Iveta 
Published: October 2020

Abstract
Background: Monogeneans, in general, show a range of unique adaptations to a parasitic lifestyle, making this group enormously diverse. Due to their unique biological properties, diplozoid monogeneans represent an attractive model group for various investigations on diverse biological interactions. However, despite numerous studies, there are still gaps in our knowledge of diplozoid biology and morphofunctional adaptation.Results: In this study, we provide a complex microscopic analysis of systems/structures involved in niche searching, sensing and self-protection against the host environment, and excretory/secretory processes in Eudiplozoon nipponicum. Freeze-etching enabled us to detect syncytium organisational features not visible by TEM alone, such as the presence of a membrane subjacent to the apical plasma membrane (separated by a dense protein layer) and a lack of basal plasma membrane. We located several types of secretory/excretory vesicles and bodies, including those attached to the superficial membranes of the tegument. Giant unicellular glands were seen accumulating predominantly in the apical forebody and hindbody haptor region. Muscle layer organisation differed from that generally described, with the outer circular and inner longitudinal muscles being basket-like interwoven by diagonal muscles with additional perpendicular muscles anchored to the tegument. Abundant muscles within the tegumentary ridges were detected, which presumably assist in fixing the parasite between the gill lamellae. Freeze-etching, alongside transmission electron and confocal microscopy with tubulin labelling, enabled visualisation of the protonephridia and nervous system, including the peripheral network and receptor innervation. Three types of receptor were identified: 1) uniciliated sensory endings with a less prominent (or missing) tegumentary rim, 2) obviously raised uniciliated receptors with a prominent tegumentary rim (packed with massive innervation and muscles) and 3) non-ciliated papillae (restricted to the hindbody lateral region). Conclusions: This study points to specific morphofunctional adaptations that have evolved in diplozoid monogeneans to confront their fish host. We clearly demonstrate that the combination of different microscopic techniques is beneficial and can reveal hidden differences, even in much-studied model organisms such as E. nipponicum.
Vibronic response of a spin-1/2 state from a carbon impurity in two-dimensional WS2
Authors: Cochrane Katherine , Lee Jun-Ho , Kastl Christoph , Haber Jonah , Zhang Tianyi , Kozhakhmetov Azimkhan , Robinson Joshua , Terrones Mauricio , Repp Jascha , Neaton Jeffrey , Weber-Bargioni Alexander , Schuler Bruno 
Published: October 2020

Abstract
We demonstrate the creation of a spin-1/2 state via the atomically controlled generation of magnetic carbon radical ions (CRIs) in synthetic two-dimensional transition metal dichalcogenides. Hydrogenated carbon impurities located at chalcogen sites introduced by chemical doping are activated with atomic precision by hydrogen depassivation using a scanning probe tip. In its anionic state, the carbon impurity exhibits a magnetic moment of 1 μB resulting from an unpaired electron populating a spin-polarized in-gap orbital. By inelastic tunneling spectroscopy and density functional theory we show that the CRI defect states couple to a small number of vibrational modes, including a local, breathing-type mode. The electron-phonon coupling strength critically depends on the spin state and differs for monolayer and bilayer WS2. These carbon radical ions in TMDs comprise a new class of surface-bound, single-atom spin-qubits that can be selectively introduced, are spatially precise, feature a well-understood vibronic spectrum, and are charge state controlled.
Is Chronic Obstructive Pulmonary Disease An Independent Risk Factor For Coronary and Peripheral Atherosclerosis In Heavy Smokers?
Authors: Ferreira Maria Angélica Pires , Moreira Leila Beltrami , Torres Felipe Soares , Knorst Marli Maria 
Published: October 2020

Abstract
BACKGROUNDThere is a high prevalence of cardiovascular disease (CVD) and atherosclerosis in people with chronic obstructive pulmonary disease (COPD); sharing of risk factors could not be the only cause of the association.OBJECTIVESTo verify whether coronary atherosclerosis and peripheral vascular disease are independently associated with COPD in heavy smokers. We also investigated whether inflammation and poor lung function were related with atherosclerosis findings.METHODSHeavy smokers (≥ 20 pack-years) with COPD (group 1) or normal spirometry (group 2) were recruited. Clinical, laboratory, and anthropometric data were obtained. Main interest variables were prevalence of CCS > 75th percentile (P75), and rates of ABI < 0,9 by Doppler ultrasound. CVD risk was calculated using the Framingham risk score. Serum C-reactive protein (CRP) was measured, and lung function was assessed by spirometry. Differences between groups were compared using parametric and nonparametric tests as adequate.RESULTSWere included 87 patients, 49 with COPD (group 1). The mean ± SD age was 57.2 ± 6.0 years (58.7 ± 5.1 in group 1, 55.2 ± 6.6 in group 2, p=0.006). The mean FEV 1 % was 45.8 ± 17.24 vs. 91.7 ± 15.9 in groups 1 and 2, respectively; p<0.05. The mean smoking index was 48.6 ± 25.4, higher in the COPD group (p=0.037). Stratification by Framingham score yielded a similar distribution in both groups. The frequency of patients with CCS > P75 was 55% vs. 66% in groups 1 and 2, respectively (p=0.823); ABI <9.0 ocurred in 6,3% vs 2,6%, respectivelly ( p=0.555) . CCS and ABI were not associated to FEV 1 %. CRP was inversely associated with VEF 1 ( r s= -0.419; p<0.001), but unrelated to CCS ( r s= 0.136; p=0.265) and ABI ( r s= -0.51; p=0.677).CONCLUSIONSThe studied coronary and peripheral atherosclerosis markers were similar between heavy smokers with COPD and those with normal spirometry. Nor serum CRP neither poor lung function related to CCS or ABI. Our results suggest absence of a independent association between COPD and atherosclerosis.
Three-body correlations in nonlinear response of correlated quantum liquid
Authors: Hata Tokuro , Teratani Yoshimichi , Arakawa Tomonori , Lee Sanghyun , Ferrier Meydi , Deblock Richard , Sakano Rui , Oguri Akira , Kobayashi Kensuke 
Published: October 2020

Abstract
Understanding the properties of correlated quantum liquids is a fundamental issue of condensed matter physics. Even in such a correlated case, fascinatingly, we can tell that the equilibrium fluctuations of the system govern its linear response to an external field, relying on the fluctuation dissipation relations based on the two-body correlations. Going beyond, up to the three-body correlations, is of importance for van der Waals force [1], the three-body force in nuclei [2], the Efimov state [3, 4], the ring exchange interaction in solid 3He [5, 6], and frustrated spin systems [7]. In our work, we have used a quantum dot in the Kondo regime, which is a controllable realization of such a correlated quantum liquid [8–11]. Thanks to the quality of our sample, where the Kondo effect in the unitary limit was achieved, we could quantitatively measure the three-body correlations and their role in the non-equilibrium regime, in perfect agreement with recent results of the Fermi liquid theory [12– 15]. In particular, we have demonstrated its importance when time-reversal symmetry is broken, solving a long-standing puzzle of the Kondo systems under the magnetic field [13]. The demonstrated method to relate three-body correlation and non-equilibrium transport opens up a way for further investigation of the dynamics of quantum many-body systems.
Establishment and Application of Reverse Transcription Recombinase-Aided Amplification as A Rapid Detection Method for SARS-COV-2
Authors: Ai Lele , Liu Wei , Ye Fuqiang , Ding Chenxi , Dai Han , Han Yifang , Zhu Changqiang , Lv Ruichen , Han Zhaojiu , Zou Xiaobo , Qi Yong , Tan Weilong 
Published: October 2020

Abstract
Background: By the end of August 2020, >23 million cases and 800,000 deaths were attributed to SARS-CoV-2 in >200 countries. The improvement of simple, rapid, and efficient detection methods is of great significance for the early detection, timely isolation, and protection of susceptible populations. This study aimed to provide an alternative method for the rapid detection of viral nucleic acid.Methods: This study provided a rapid nucleic acid detection method mediated by recombinant enzyme based on the novel coronavirus (SARS-CoV-2). Primers and probes were designed based on the N gene sequence of coronavirus. The method was performed at 39 °C, the detection time was short (<20 min), and the detection limit was up to 101 copies/mL.Results: The primer-probe did not show any cross-reaction with adenovirus, Zika virus, influenza B virus, and chikungunya virus, with good specificity. A total of 106 clinical throat swab samples were compared by reverse transcription recombinase-aided amplification (RT-RAA) and commercial reverse transcription-quantitative real-time polymerase chain reaction (RT-qPCR); the results were identical.Conclusions: The novel coronavirus RT-RAA method established in this study had high sensitivity, strong specificity, simple operation, and fast detection speed, and hence, is suitable for the rapid detection of novel coronavirus under the current epidemic situation.
The Effect of Maximum Average Temperature on Suicide Rates in California, 2008-2017: An Ecological Study
Authors: Qamar Mavra , Cheng Sierra , Plouffe Rebecca , Nanos Stephanie , Fisman David N , Soucy Jean-Paul R 
Published: October 2020

Abstract
Background: Suicide prevention is a salient public health responsibility, as it is one of the top ten leading causes of premature mortality in the United States. Risk factors of suicide transcend the individual and societal level as risk can increase based on climatic variables. Previous studies have been country-based. Currently, studies focused solely on regions, provinces, or states, such as California, are limited. The present study holds two purposes: i) to assess the effect of maximum temperature on suicides, and ii) to evaluate the effect of number of monthly heat events on suicide rates, in California from 2008-2017.Methods: The exposure was measured as the average Californian daily maximum temperature within each month, and the number of monthly heat events, which was calculated as a count of the days exhibiting a >15% increase from the historical monthly temperature. The outcome was measured as California’s monthly suicide rate. Negative binomial regression models assessed the relationship between maximum temperature and suicides, and heat events and suicide. A seasonal decomposition of a time series and auto-correlogram further analyzed the seasonality of suicide and the trend from 2008-2017. Results: There were 40,315 deaths by suicide in California between 2008-2017. Negative binomial regression indicated a 6.1% increase in suicide incidence rate ratio (IRR) per 10°F increase in maximum temperature (IRR=1.00590 per 1°F, 95% CI: 1.00387, 1.00793, p<0.0001) and a positive, non-significant association between suicide rates and number of heat events adjusted for month of occurrence (IRR 1.00148 per heat event, 95% CI: 0.99636, 1.00661, p=0.572). The time series analysis and auto-correlogram suggested seasonality of deaths by suicide.Conclusion: The present study provided preliminary evidence that will generate future directions for research. We must seek to further illuminate the relationship of interest and apply our findings to public health interventions that will lower the rates of death by suicide as we are confronted with the effects of climate change.