bluuebunny/crossref_metadata_2025_split huggingface dataset:
PUMCH-SLN nomogram for the preoperative prediction of sentinel lymph node metastasis in breast cancer
Authors: Wang Xue-fei , Zhang Guo-chao , Zuo Zhi-chao , Zhu Qing-li , Liu Zhen-zhen , Wu Sha-fei , Li Jia-xin , Du Jian-hua , Yan Cun-li , Ma Xiao-ying , Shi Yue , Shi He , Zhou Yi-dong , Mao Feng , Lin Yan , Shen Song-jie , Zhang Xiao-hui , Sun Qiang 
Published: August 2020

Abstract
Background: To investigate associations between clinicopathological features and sentinel lymph node (SLN) status of breast cancer, then constructed a nomogram to predict SLN metastasis.Methods: Patients treated with SLN dissection from 2014 to 2019 at Peking Union Medical College and Hospital (PUMCH), were retrospectively analyzed as the training set (n = 472). Lymph node ultrasound and pathological characteristics were compared using chi-squared and t-tests. To verify the accuracy of the model, internal (n = 175) and external (3 centers, n = 81) validation groups were established for patients in 2019. A nomogram predicting SLN metastasis was constructed using multivariable logistic regression models; discrimination and calibration of the nomogram were assessed by C statistics and calibration curve. Clinical use by decision curve analysis.Results: In the training set the SLN+ rate was 23.73%. Statistically significant factors associated with SLN positivity were: histology type (P < 0.001); PR (P = 0.003); Her-2 status (P = 0.049); and ultrasound lymph node (ALN-US) shape (P = 0.034), corticomedullary demarcation (P < 0.001), and blood flow (P = 0.001). Five independent variables were integrated into the nomogram (C-statistic 0.714 [95% CI: 0.688-0.740], validated internally (0.816 [(95% CI: 0.784-0.849]) and externally (0.942 [95% CI: 0.918-0.966]). Thus, the model had good predictive accuracy and clinical applicability.Conclusions: The PUMCH-SLN nomogram provides a direct and reliable tool for prediction and individual evaluation of SLN status preoperatively, emphasizing the role of ALN-ultrasound morphology for predicting SLN metastasis. This nomogram should aid decisions concerning ALN dissection and adjuvant treatment.
Detection of somatic mutations in circulating cell-free DNA from patients with esophageal squamous cell carcinoma
Authors: Yuan Zuyang , Wang Xinfeng , Geng Xiao , Li Yin , Mu Juwei , Tan Fengwei , Xue Qi , Gao Shugeng , He Jie 
Published: August 2020

Abstract
Background: The aim of this study was to assess whether both ubiquitous and heterogeneous somatic mutations could be detected in circulating cell-free DNA (cfDNA) from patients with esophageal squamous cell carcinoma (ESCC). Methods: Paired multi-regional tumor tissues, cfDNA and white blood cells (WBCs) collected from five ESCC patients before treatment from a prospective study (NCT02395705). Of them, samples from Cohort 1 (E102 and E110) were sequenced by whole-exome sequencing (WES) and those from Cohort 2 (E104, E111 and E121) were sequenced by targeted captured sequencing with a panel of 560 cancer-related genes respectively. To call somatic single nucleotide variations (SNVs) by comparing the solid tumor or cfDNA with matched WBCs, the minimal variant allele frequency (VAFmin) as 0.1% and P value <0.05 were allowed. Results: Genomic DNA (gDNA) and plasma-derived cfDNA from 26 samples were successfully sequenced. In Cohort 1, 596 (596/712, 83%) and 562 (562/796, 71%) were heterogeneous SNVs in E102 and E110 respectively. There was a statistically significant linear relationship between the VAFs for tumor and cfDNA (R2 = 0.78, P <0.0001). In Cohort 2, 296 (296/323, 92%), 384 (384/423, 91%) and 331 (331/357, 93%) were heterogeneous SNVs in E104, E111 and E121respectively. cfDNA could recover an average of 60.7% (31/51; range, 35.7%-76.2%) of somatic mutations present in matched solid tumors. The correlation of VAFs between cfDNA and matched solid tumor was significantly positive (r2 =0.92, P <0.0001).Conclusions: Both sequencing approaches revealed the highly intratumoral heterogeneity in ESCC and enabled the detection of both ubiquitous and heterogeneous mutations in cfDNA. Further validation in cfDNA is required to define its potential utility for ESCC in clinical practice. Trial registrationAll patients selected in this study were from the registered clinical trial from ClinicalTrials.gov (NCT02395705). Date of registration: March 24, 2015.
A Cross-country Investigation of Perceived Stress During COVID-19 Pandemic: The Impact of Situational Factors and Personality Traits
Authors: Do Ngoc Minh 
Published: August 2020

Abstract
The study investigates the public mental health cross-national during the global COVID-19 pandemic. Analysis of data collected from people across different countries shows that people are experiencing moderate stress level and demonstrates that stress level is affected by internal genetic factor and external conditions. Specifically, perceived stress is affected by personality traits and contextual settings namely residence location, personal finance situation, and usage of social media during the pandemic.
Rescue operations lead to increased cardiovascular stress in HEMS Crew Members - A prospective pilot study of a German HEMS cohort
Authors: Strauss Markus , Dahmen Janosch , Hutter Sophia , Brade Marko , Leischik Roman 
Published: August 2020

Abstract
BackgroundHelicopter emergency medical service (HEMS) is an important part of prehospital emergency medicine. The working conditions lead to high physical stress, especially in rescue operations. To date, little is known about the cardiovascular stress of HEMS crew members in the rescue service. Examinations of professional groups in public security have shown a significant risk in these. The present study aims to determine the cardiovascular stress profile during rescue situations in HEMS crew members.MethodsA total number of 21 (male n=20) HEMS crew members (11 emergency physicians and 10 paramedics) participated in the prospective study. Heart rate (HR), blood pressure (BP) and long-term ECG measurements were recorded at the whole operation day. The changes of measurements during rescue operation (in total 52 operations) were compared to these of standby time.ResultsRescue operations lead to increased load on the cardiovascular system. Expression of this is significantly higher BP, HR values and rate of cardiac events compared to standby time. Significantly higher of both, mean and maximal, diastolic and systolic blood pressure were measured on duty. Especially the difference in BP sys mean is 7.4 ± 9.0 mmHg (7.4, CI [5.1; 9.7], p <0.001). HR minimal, mean and maximal were also significantly higher during rescue operations. HR max was 33.7 bpm higher on average than in the standby time (CI [26.2; 40.8], p <0.001). Cardiac events occurred significantly more frequently during the period of rescue operation than in standby time hours (time volume of 1 hour, p = 0.02).ConclusionsThe results show a significant load on the cardiovascular system during rescue operations in HEMS crew members. This is expressed in a higher occurrence of extrasystoles, HR and BP values during rescue operation than on standby time. Therefore, it is important to carry out a risk stratification of the personnel deployed in the HEMS crew members to prevent cardiovascular risk and events.
Equivalency between the shock index and subtracting the systolic blood pressure from the heart rate: An observational cohort study
Authors: Kamikawa Yohei , Hayashi Hiroyuki 
Published: August 2020

Abstract
Background: Although the shock index is known to predict mortality and other severe outcomes, deriving it requires complex calculations. Subtracting the systolic blood pressure from the heart rate may produce a simple shock index that would be a clinically useful substitute for the shock index. In this study, we investigated whether the simple shock index was equivalent to the shock index.Methods: This observational cohort study was conducted at 2 tertiary care hospitals. Patients who were transported by ambulance were recruited for this study and were excluded if they were aged < 15 years, had experienced prehospital cardiopulmonary arrest, or had undergone inter-hospital transfer. Pearson’s product-moment correlation coefficient and regression equation were calculated, and two one-sided tests were performed to examine their equivalency.Results: Among 5,429 eligible patients, the correlation coefficient between the shock index and simple shock index was extremely high (0.917, 95% confidence interval 0.912 to 0.921, P < .001). The regression equation was estimated as sSI = 258.55 log SI. The two one-sided tests revealed a very strong equivalency between the shock index and the index estimated by the above equation using the simple shock index (mean difference was 0.004, 90% confidence interval 0.003 to 0.005).Conclusion: The simple shock index strongly correlated with the shock index.
Upregulated Expression of Toll Like Receptor 7 in Peripheral Blood Basophils of Patients With Allergic Rhinitis
Authors: Wang Lihong , Zhan Mengmeng , Wang Junling , Chen Dong , Zhao Nan , Wang Ling , Wang Wei , Huang Yixia , Zhang Huiyun , He Shaoheng 
Published: August 2020

Abstract
Background: Recently, it has been reported that Toll-like receptor 7 (TLR7) agonists can improve allergic rhinitis (AR) symptoms by up-regulation of Th1 cytokine release and suppression of Th2 cell functions. However, little is known of the expression of TLR7 in basophils of AR.Objective: To explore the expression of TLR7 in basophils of AR, and influence of allergens on TLR7 expression.Methods: The expression levels of TLR7 in basophils of patients with AR were determined by flow cytometry, and the influence of allergens on TLR7 expression was examined by real time (q) PCR.Results: The percentages of TLR7+CCR3+ cells, TLR7+CD123+HLA-DR- cells and TLR7+CCR3+CD123+HLA-DR- cells in blood granulocyte and mononucleated cell populations of the patients with AR were increased, respectively compared with HC subjects. TLR7 MFI on CCR3+ cells, CD123+HLA-DR- cells and CCR3+CD123+HLA-DR- cells were enhanced. Allergens Der p1 and OVA provoked upregulation of TLR7 expression at both protein and mRNA levels and IL-13 production in KU812 cells. House Dust Mite extract (HDME), Artemisia sieversiana wild allergen extract (ASWE), IL-31, IL-33, IL-37, and TSLP provoked elevation of IL-6 release from KU812 cells following 2 h incubation period.Conclusions: The percentage of TLR7+ basophils and TLR7 expression intensity in a single basophil are both increased in the blood of patients with AR, indicating that basophils likely contribute to the pathogenesis of AR via TLR7. Trial Registration: Trial registry: Chinese clinical trial; registration number: ChiCTR-BOC-16010279.
Complex Scenarios with Competing Factors - A Conception Paper Applied to the COVID-19 Case
Authors: Brandão Mauricio Pazini 
Published: August 2020

Abstract
A model to analyze complex systems facing threats with competing factors has been introduced. The Principle of Energy, in integral form, is used to conceive a theory in which competing factors dispute available resources to minimize undesirable outcomes. The general result indicates that the minimum response is obtained by a combination of the factors weighted by their corresponding criticalities. The theory has been applied to the case of the COVID-19 pandemic with two competing factors: Health and Economy. As result, to minimize the grand total number of deaths, the best recommendation is to balance the emphasis on both factors. The model can be generalized even further and may evolve from a qualitative to a quantitative status. In this evolution, it may allow for computational simulations and comparisons with field statistics for validation and forecasting. As such, this approach may become a useful tool for decision-making regarding resources allocations in order to reduce guessing in scenarios full of uncertainties.
Evaluation of the Durability of Long-Lasting Insecticidal Nets in Guatemala
Authors: Castellanos María Eugenia , Rodas Soledad , Juárez José Guillermo , Lol Juan Carlos , Chanquin Sayra , Morales Zoraida , Vizcaino Lucrecia , Smith Stephen C. , Eng Jodi Vanden , Woldu Henok G. , Lenhart Audrey , Padilla Norma 
Published: August 2020

Abstract
Background. Insecticide-treated bednets (ITNs) are widely used for the prevention and control of malaria. In Guatemala, since 2006, ITNs have been distributed free of charge in the highest risk malaria-endemic areas and constitute one of the primary vector control measures in the country. Despite relying on ITNs for almost 15 years, there is a lack of data to inform the timely replacement of ITNs whose effectiveness becomes diminished by routine use. Methods. We assessed the survivorship, physical integrity, insecticide content and bio-efficacy of ITNs through cross-sectional surveys conducted at 18, 24 and 32 months after a 2012 distribution of PermaNet® 2.0 in a malaria focus in Guatemala. A total of 988 ITNs were analyzed (290 at 18 months, 349 at 24 months and 349 at 32 months). Results. The functional survivorship of bednets decreased over time, from 92% at 18 months, to 81% at 24 months and 69% at 32 months. Independent of the time of the survey, less than 80% of the bednets that were still present in the household were reported to have been used the night before. Most of the bednets had been washed at least once (88% at 18 months, 92% at 24 months and 96% at 32 months). The proportion of bednets categorized as “in good condition” per WHO guidelines of the total hole surface area, diminished from 77% at 18 months to 58% at 32 months. The portion of ITNs with deltamethrin concentration less than 10mg/m2 increased over time (14% at 18 months, 23% at 24 months, and 35% at 32 months). Among the bednets for which bioassays were conducted, the percentage that met WHO criteria for efficacy dropped from 90% at 18 months to 52% at 32 months. Conclusion. While our assessment demonstrated that nets were in relatively good physical condition over time, the combination of declining bio-efficacy over time and low use rates limited the overall effectiveness of the LLINs. Efforts to encourage the community to retain, use, and properly care for the LLINs may improve their impact. Durability assessments should be included in future campaigns.
Correlation of COVID-19 Fatality Risk with Health Care Access and Quality in 87 Countries
Authors: Su Shih-Yung , Fang Chi-Tai , Lee Wen-Chung 
Published: August 2020

Abstract
Background. The coronavirus disease 2019 (COVID-19) pandemic has been a severe threat to global health.Method. We calculated Spearman rank correlation coefficients between a country’s case fatality risk at various stages of the pandemic and the Healthcare Access and Quality (HAQ) index in 87 countries.Results. COVID-19 case fatality risks and HAQ indexes were negatively correlated at <1000 confirmed cases. This negative correlation decreased and even turned positive (but nonsignificantly) as countries approached >5000 confirmed cases. As for per-capita cases, the aforementioned correlation was significantly negative at <100 cases per million people. This negative correlation decreased (r = −0.0429) and became nonsignificant as countries approached >500 cases per million people.Conclusion. Negative correlations between COVID-19 case fatality risks and HAQ indexes weakened and then disappeared with the progressive burden of COVID-19 infection over time. In the end, even the best public health systems were overwhelmed by the COVID-19 pandemic.
ANLN promotes carcinogenesis in oral cancer by regulating PI3K/mTOR signaling pathway
Authors: Wang Bing , Zhang Xiaoli , Li Chenxi , Liu Ningning , Hu Min , Gong Zhongcheng 
Published: August 2020

Abstract
Background: Oral cancer is a malignant disease threatening human’s life and severely reduces human’s life-quality. Gene ANLN was reported to promote progression in cancer. This study aims at investigating the role of ANLN and molecular mechanism in oral cancer. Methods: ANLN was down-regulated by RNAi technology. The effect of ANLN on cell behaviors including proliferation, cycle distribution, invasion, and apoptosis was detected. Western blotting analysis was used to disclose the mechanism of ANLN in oral cancer. Results: ANLN was shown to express significantly higher in tumor tissues compared to the normal control tissues based on TCGA data. Patients with higher expression of ANLN displayed worse survival rate. Then ANLN was shown to express abundantly in cancer cell lines CA127 and HN30. When ANLN was reduced in CA127 and HN30 cells, cell proliferation and colony formation ability was inhibited. Cell invasion ability was suppressed. But cell apoptosis was induced reversely. In addition, expression of critical molecules including PI3K, mTOR, Akt, and PDK-1 were reduced after ANLN knockdown in CA127 cells. Conclusions: ANLN contributes to the progression in oral cancer and regulates activation of PI3K/mTOR signaling pathway. This study will provide guidance and new drug target for oral cancer.
Adult-Onset IgE-Mediated Food Allergy in Manitoba
Authors: Walter Graham , Kalicinsky Chrystyna 
Published: August 2020

Abstract
BackgroundIt is a putatively understood phenomenon that the overall prevalence of allergic disease has been increasing in recent decades – particularly in industrialized nations. Despite this, there is a relative scarcity of data concerning the development of food-related allergic disease in the adult population. In addition, the paucity of data as it pertains to the Canadian population is particularly marked when compared to other nations. We sought to determine common culprit foods and the reactions they elicited in a series of 14 patients seen in the Winnipeg allergy and immunology clinic. MethodsWe conducted a retrospective review of patients identified by academic allergists in Winnipeg, Manitoba as fitting criteria for adult-onset IgE-mediated food allergy from May 2018 – July 2020. We included patients with IgE-mediated symptoms, including the food pollen syndrome which developed at the age of 16 or later. We collected data regarding the food which induced the reaction, what the reaction was, and any concomitant atopic disease.ResultsThe most common culprit food identified was shellfish, followed by finfish, food pollen syndrome, and wheat/flour. The most common reaction experienced was anaphylaxis, followed by food-dependent exercise-induced anaphylaxis and isolated (muco)cutaneous symptoms. With regard to concomitant atopic disease, allergic rhinitis/rhinoconjunctivitis stood out as the most prevalent.ConclusionsAdult-onset food allergy – particularly with resultant anaphylaxis – is an important phenomenon to recognize, even when patients have previously tolerated the food in question.
Method for Obtaining Phenotypic Traits of Weeds in Complex Field Environments Based on Instance Segmentation
Authors: longzhe Quan , Wu Bing , Mao Shou ren , Feng Huaiqu , Yang Chunjie , Wei Jiang , Li Hengda 
Published: August 2020

Abstract
Background: Weeds are the biggest threat to crop growth, and leaf age and central area of weeds are important phenotypic traits of weeds. They have an important role in understanding the morphological structure of weeds, guiding precision for target weeding and reducing the use of herbicides. However, it is still a substantial challenge to obtain weed types, leaf age and central area in the complex field conditions of light changes, variation in appearance of plants, leaf occlusion. The latest developments in deep learning provide new tools for solving challenging computer vision tasks.Results: In this study, we present a weed phenotype segmentation method based on Mask R-CNN that obtains weed types, leaf age and central area in the complex field conditions. By shooting three different angles of the main weeds (Solanum nigrum, Barnyard grass, and Abutilon theophrasti Medicus) in the field through mobile devices, two datasets (data enhancement and without data enhancement) were produced and used as input to the network, two backbone networks was tested, namely ResNet50 and ResNet101, and the detection results and instance segmentation results of the model were evaluated. The results showed that data enhancement can improve the performance of the model. In the case of data enhancement, the F1 value with ResNet101 as the backbone network was 0.9214, the mAP scores were 0.6932 and 0.5244 (for IOU thresholds of 0.5 and 0.7, respectively), the mIOU reached 0.585, and the best segmentation performance example was obtained. Furthermore, the weed image taken from the top view angle compared to the other two angles achieved the highest detection accuracy.Conclusion: Mask R-CNN can achieve accurate segmentation of weeds to obtain the types, leaf age and central area of weeds. Data enhancement and the weed image taken from the top view angle can help to improve the performance of the model. This dataset and research results may provide important resources for the development of precision agriculture in the future.
LIM and SH3 Protein 1 Stands for a Bio-Marker for Cholangiocarcinoma Detection
Authors: Wang Ning , Li Yanni , Zheng Yanfang , Chen Huoming , Wen Xiaolong , Li Zhaoxia 
Published: August 2020

Abstract
Background: LIM and SH3 protein 1 (LASP-1) has been demonstrated to be overexpression in several types of cancers. The aim of this study was to verify the serum level of LASP-1 and investigate its diagnostic value in cholangiocarcinoma (CCA) patients.Methods: Quantitative real-time polymerase chain reaction (qRT-PCR) was performed to detect the expression level of LASP-1 in CCA patients and healthy controls. The correlation of LASP-1 expression with clinicopathological characteristic of CCA patients was analyzed via Chi-square test. Receiver operating characteristic (ROC) curve was built to evaluate the diagnostic value of serum LASP-1 in CCA.Results: Serum levels of LASP-1 were upregulated in CCA compared with healthy controls (P<0.01). And the serum level and tissue level of LASP-1 mRNA exhibited significant correlation (R=0.454, P=0.000). Serum expression of LASP-1 was closely associated with lymph node metastasis (P=0.018) and TNM stage (P=0.021). ROC curve analysis revealed that serum LASP-1 was of great value in differentiating CCA patients from healthy individuals. The area under the ROC curve (AUC) value was 0.879 corresponding with a sensitivity of 81.9% and a specificity of 79.6%.Conclusions: Serum LASP-1 might be an useful diagnostic biomarker for CCA.