bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extended 36‐joint sonographic examination: What it reveals about bone erosions in patients with rheumatoid arthritis
Authors: Tan York Kiat , Li HuiHua , Allen John C. , Thumboo Julian 
Published: October 2019

AbstractPurposeTo identify joints commonly exhibiting bone erosions using an extended 36‐joint sonographic (US) examination in patients with rheumatoid arthritis (RA) and to study bone erosion in relation to US‐detected joint inflammation.MethodsIn this cross‐sectional study, power Doppler (PD) and gray‐scale (GS) joint inflammation scores (semi‐quantitative [0‐3] grading) at each joint recess were summed to obtain a combined US score (CUS). Bone erosion was scored as present/absent. Generalized Estimating Equations were used to compare mean US scores between joint recesses with and without bone erosion.ResultsBone erosion was found in 144/1080 (13.3%) joints and 189/1800 (10.5%) joint recesses in 30 RA patients. The five joints most frequently associated with bone erosion were: wrist, n = 49/144 (34.0%); first MTPJ, n = 19/144 (13.2%); thumb IPJ, n = 13/144 (9.0%); second MCPJ, n = 11/144 (7.6%); and third MCPJ, n = 11/144 (7.6%). Mean (95% CI) US scores for joint recesses with and without bone erosion were PD: 0.36 (0.21, 0.50) vs 0.01 (0.00, 0.02); GS: 1.77 (1.54, 2.00) vs 0.47 (0.40, 0.55); and CUS: 2.13 (1.78, 2.47) vs 0.49 (0.41, 0.57) (all differences significant at P < .001).ConclusionThe five joints most frequently showing bone erosion were identified. Joint recesses with bone erosion are more likely to exhibit greater PD and GS joint inflammation severity.
The impact of flipped classrooms on student achievement in engineering education: A meta‐analysis of 10 years of research
Authors: Lo Chung Kwan , Hew Khe Foon 
Published: October 2019

AbstractBackgroundThe flipped classroom has become more widely used in engineering education. However, a systematic and quantitative assessment of its achievement outcomes has not been conducted to date.PurposeTo address this gap, we examined the findings from comparative articles published between 2008 and 2017 through a meta‐analysis to summarize the overall effects of the flipped classroom on student achievement in engineering education.Scope/MethodWe searched and analyzed journal and conference publications on flipped classroom studies in engineering education in K‐12 and higher education contexts. Twenty‐nine comparative interventions were included in a meta‐analysis involving 2,590 students exposed to flipped classroom and 2,739 students exposed to traditional lectures. A content analysis was also conducted to determine how the flipped engineering classroom benefits student learning.ConclusionsThe meta‐analysis comparing these 29 traditional—flipped interventions in relation to student achievement showed an overall significant effect in favor of the flipped classroom over traditional lecturing (Hedges' g = 0.289, 95% CI [0.165, 0.414], p < .001). A moderator analysis showed that the effect of the flipped classroom was further enhanced when instructors offered a brief review at the start of face‐to‐face classes. Our qualitative findings suggest that self‐paced learning and more problem‐solving activities were the two most frequently reported benefits that promoted student learning. Based on quantitative and qualitative support, several implications are identified for future practice, such as offering a brief in‐class review of preclass materials. Some recommendations for future research are also provided.
Outcome of portosystemic shunt surgery on pre‐existing cholangiopathy in children with extrahepatic portal vein obstruction
Authors: Ravindranath Aathira , Sen Sarma Moinak , Yachha Surender Kumar , Lal Richa , Singh Somesh , Srivastava Anshu , Poddar Ujjal , Neyaz Zafar , Behari Anu 
Published: October 2019

AbstractBackgroundThis study was performed to assess the effect of portosystemic shunt surgery (PSS) on portal cavernoma cholangiopathy (PCC) in children with extrahepatic portal vein obstruction (EHPVO).MethodsChildren with EHPVO and PCC (unfit for Meso‐Rex shunt) underwent magnetic resonance cholangiogram (MRC) and magnetic resonance portovenogram (MRPV) before non‐selective PSS. PCC was graded by modified Llop classification. Those with patent shunt were re‐evaluated at least 6 months after surgery with MRC, MRPV and compared with pre‐shunt images.ResultsTwenty‐five children underwent PSS (central end to side splenorenal shunt with splenectomy [n = 24], mesocaval shunt [n = 1]). Pre‐surgery MRC showed PCC grade I in 11, grade II in 1 and grade III in 13. MRPV showed superior mesenteric vein (SMV) block in 20. Re‐assessment for PCC 18 (6 to 54) months after surgery showed grade I in 6 and grade III in 19. Thus, PCC was progressive in 6 and static in 19. Density of peribiliary collaterals decreased in 5 (SMV patent, static PCC), increased in 3 and remained unchanged in 17. Splenomegaly‐related problems, gastroesophageal varices and other intra‐abdominal (esophageal, perisplenic and perigastric) collaterals ameliorated in all.ConclusionNon‐selective PSS decompresses esophago‐gastro‐splenic venous circuit effectively but fails to ameliorate cholangiopathy and peribiliary collaterals. Persistence of cholangiopathy is attributable to SMV block.
Predictive performance of Blumgart T staging for perihilar cholangiocarcinoma in a Japanese center
Authors: Ebata Tomoki , Mizuno Takashi , Yokoyama Yukihiro , Igami Tsuyoshi , Yamaguchi Junpei , Onoe Shunsuke , Watanabe Nobuyuki , Nagino Masato 
Published: October 2019

AbstractBackgroundThe Blumgart system has been used for local tumor assessment in perihilar cholangiocarcinoma to predict resectability and survival, and T3 tumors are considered unresectable disease. The aim was to validate the predictive performance of this system using a Japanese cohort.MethodsMedical records of consecutive patients with perihilar cholangiocarcinoma between 2006 and 2016 were retrospectively reviewed. Resectability, surgical procedure, R0 resection rate, and survival were compared among T stages.ResultsAmong 729 study patients, 191 patients had T1 tumors, 94 patients had T2 tumors, and 444 (60.9%) patients had T3 tumors according to the Blumgart T stage. Resection was performed in 513 (70.4%) patients; resectability rate decreased with the progression of T stage: 89.0% in T1, 79.8% in T2, and 60.4% in T3 tumors (P < 0.001). The incidences of left hepatic trisectionectomy and portal vein resection were 44.0% and 54.1%, respectively, in patients with T3 tumors, which were significantly greater than those of T1/2 tumors (P = 0.001 and P < 0.001). R0 resection reduced with advanced T stage: 92.4% in T1, 81.3% in T2, and 70.9% in T3 tumors (P < 0.001). The 5‐year survival rate was 53.4%, 38.4%, and 19.7% in T1, T2, and T3 tumors, respectively (P < 0.001); that was 59.6%, 48.6%, and 30.7%, respectively, in the resected cohort (P < 0.001).ConclusionBlumgart T stage was closely associated with the resectability rate, surgical procedures, R0 resection rate, and survival time, suggesting that the T stage works as well as a presurgical staging system. However, the unresectable classification of T3 tumors should be revised.
Robust association between vascular habitats and patient prognosis in glioblastoma: An international multicenter study
Authors: del Mar Álvarez‐Torres María , Juan‐Albarracín Javier , Fuster‐Garcia Elies , Bellvís‐Bataller Fuensanta , Lorente David , Reynés Gaspar , Font de Mora Jaime , Aparici‐Robles Fernando , Botella Carlos , Muñoz‐Langa Jose , Faubel Raquel , Asensio‐Cuesta Sabina , García‐Ferrando Germán A. , Chelebian Eduard , Auger Cristina , Pineda Jose , Rovira Alex , Oleaga Laura , Mollà‐Olmos Enrique , Revert Antonio J. , Tshibanda Luaba , Crisi Girolamo , Emblem Kyrre E. , Martin Didier , Due‐Tønnessen Paulina , Meling Torstein R. , Filice Silvano , Sáez Carlos , García‐Gómez Juan M. 
Published: October 2019

BackgroundGlioblastoma (GBM) is the most aggressive primary brain tumor, characterized by a heterogeneous and abnormal vascularity. Subtypes of vascular habitats within the tumor and edema can be distinguished: high angiogenic tumor (HAT), low angiogenic tumor (LAT), infiltrated peripheral edema (IPE), and vasogenic peripheral edema (VPE).PurposeTo validate the association between hemodynamic markers from vascular habitats and overall survival (OS) in glioblastoma patients, considering the intercenter variability of acquisition protocols.Study TypeMulticenter retrospective study.PopulationIn all, 184 glioblastoma patients from seven European centers participating in the NCT03439332 clinical study.Field Strength/Sequence1.5T (for 54 patients) or 3.0T (for 130 patients). Pregadolinium and postgadolinium‐based contrast agent‐enhanced T1‐weighted MRI, T2‐ and FLAIR T2‐weighted, and dynamic susceptibility contrast (DSC) T2* perfusion.AssessmentWe analyzed preoperative MRIs to establish the association between the maximum relative cerebral blood volume (rCBVmax) at each habitat with OS. Moreover, the stratification capabilities of the markers to divide patients into "vascular" groups were tested. The variability in the markers between individual centers was also assessed.Statistical TestsUniparametric Cox regression; Kaplan–Meier test; Mann–Whitney test.ResultsThe rCBVmax derived from the HAT, LAT, and IPE habitats were significantly associated with patient OS (P < 0.05; hazard ratio [HR]: 1.05, 1.11, 1.28, respectively). Moreover, these markers can stratify patients into "moderate‐" and "high‐vascular" groups (P < 0.05). The Mann–Whitney test did not find significant differences among most of the centers in markers (HAT: P = 0.02–0.685; LAT: P = 0.010–0.769; IPE: P = 0.093–0.939; VPE: P = 0.016–1.000).Data ConclusionThe rCBVmax calculated in HAT, LAT, and IPE habitats have been validated as clinically relevant prognostic biomarkers for glioblastoma patients in the pretreatment stage. This study demonstrates the robustness of the hemodynamic tissue signature (HTS) habitats to assess the GBM vascular heterogeneity and their association with patient prognosis independently of intercenter variability.Level of Evidence: 3Technical Efficacy Stage: 2J. Magn. Reson. Imaging 2020;51:1478–1486.
Diagnostic accuracy of quantitative diffusion parameters in the pathological grading of hepatocellular carcinoma: A meta‐analysis
Authors: Yang Dawei , She Hualong , Wang Xiaopei , Yang Zhenghan , Wang Zhenchang 
Published: October 2019

BackgroundAccurate preoperative assessment of the pathological grade of hepatocellular carcinoma (HCC) could greatly benefit prognostic predictions.PurposeTo assess and compare the diagnostic accuracy of the apparent diffusion coefficient (ADC) and tissue diffusivity (D) for the noninvasive pathological grading of HCC.Study TypeMeta‐analysis.Data SourcesPubMed/Medline, EMBASE, the Web of Science, and the Cochrane Library were searched to find related original articles published up to May 30, 2019.Field Strength/SequenceDiffusion‐weighted imaging (DWI) and/or intravoxel incoherent motion (IVIM) were performed with a 1.5T or 3.0T scanner.AssessmentThe Quality Assessment of Diagnostic Accuracy Studies 2 tool was used to assess the methodologic quality.Statistical TestsThe bivariate random‐effects model was used to obtain the pooled sensitivity and specificity, and the area under summary receiver operating characteristic curve (AUROC) was obtained. Subgroup analyses were performed.ResultsA total of 16 original articles (1428 HCCs) were included. Most studies had a low to unclear risk of bias and minimal concerns regarding applicability. For the discrimination of well‐differentiated HCCs, the pooled sensitivity and specificity of the ADC value were 85% and 92%, respectively. For the discrimination of poorly differentiated HCCs, the pooled sensitivity and specificity of the ADC value and D were 84% and 80%, and 92% and 77%, respectively. The summary AUROC of D (0.94) was significantly higher than that of ADC (0.89) (z = –2.718, P = 0.007). The subgroup analyses identified three covariates including size, number of included lesions in the studies, and blindness to the reference standard as possible sources of heterogeneity.Data ConclusionThis meta‐analysis showed that the ADC and D values had a high to excellent accuracy for the noninvasive pathological grading of HCCs and that the D value was superior to the ADC value for discriminating poorly differentiated HCCs.Level of Evidence: 3Technical Efficacy Stage: 2J. Magn. Reson. Imaging 2020;51:1581–1593.
Denoising of diffusion MRI improves peripheral nerve conspicuity and reproducibility
Authors: Sneag Darryl B. , Zochowski Kelly C. , Tan Ek T. , Queler Sophie C. , Burge Alissa , Endo Yoshimi , Lin Bin , Fung Maggie , Shin Jaemin 
Published: October 2019

BackgroundQuantitative diffusion MRI is a promising technique for evaluating peripheral nerve integrity but low signal‐to‐noise ratio (SNR) can impede measurement accuracy.PurposeTo evaluate principal component analysis (PCA) and generalized spherical deconvolution (genSD) denoising techniques to improve within‐subject reproducibility and peripheral nerve conspicuity.Study TypeProspective.SubjectsSeven healthy volunteers and three peripheral neuropathy patients.Field Strength/Sequence3T/multiband single‐shot echo planar diffusion sequence using multishell 55‐direction scheme.AssessmentImages were processed using four methods: "original" (no denoising), "average" (10 repetitions), "PCA‐only," and "PCA + genSD." Tibial and common peroneal nerve segmentations and masks were generated from volunteer diffusion data. Quantitative (SNR and contrast‐to‐noise ratio [CNR]) values were calculated. Three radiologists qualitatively evaluated nerve conspicuity for each method. The two denoising methods were also performed in three patients with peripheral neuropathies.Statistical TestsFor healthy volunteers, calculations included SNR and CNRFA (computed using FA values). Coefficient of variation (CV%) of CNRFA quantified within‐subject reproducibility. Groups were compared with two‐sample t‐tests (significance P < 0.05; two‐tailed, Bonferroni‐corrected). Odds ratios (ORs) quantified the relative rates of each of three radiologists confidently identifying a nerve, per slice, for the four methods.Results"PCA + genSD" yielded the highest SNR (meanoverall = 14.83 ± 1.99) and tibial and common peroneal nerve CNRFA (meantibial = 3.45, meanperoneal = 2.34) compared to "original" (P
SNR < 0.001; P
CNR = 0.011) and "PCA‐only" (P
SNR < 0.001, P
CNR < 0.001). "PCA + genSD" had higher within‐subject reproducibility (low CV%) for tibial (6.04 ± 1.98) and common peroneal nerves (8.27 ± 2.75) compared to "original" and "PCA‐only." The mean FA was higher for "original" than "average" (P < 0.001), but did not differ significantly between "average" and "PCA + genSD" (P = 0.14). "PCA + genSD" had higher tibial and common peroneal nerve conspicuity than "PCA‐only" (ORtibial = 2.50, P < 0.001; ORperoneal = 1.86, P < 0.001) and "original" (ORtibial = 2.73, P < 0.001; ORperoneal = 2.43, P < 0.001).Data ConclusionPCA + genSD denoising method improved SNR, CNRFA, and within‐subject reproducibility (CV%) without biasing FA and nerve conspicuity. This technique holds promise for facilitating more reliable, unbiased diffusion measurements of peripheral nerves.Level of Evidence: 2Technical Efficacy Stage: 1J. Magn. Reson. Imaging 2020;51:1128–1137.
Valvular imaging in the era of feature‐tracking: A slice‐following cardiac MR sequence to measure mitral flow
Authors: Seemann Felicia , Heiberg Einar , Carlsson Marcus , Gonzales Ricardo A. , Baldassarre Lauren A. , Qiu Maolin , Peters Dana C. 
Published: October 2019

BackgroundIn mitral valve dysfunction, noninvasive measurement of transmitral blood flow is an important clinical examination. Flow imaging of the mitral valve, however, is challenging, since it moves in and out of the image plane during the cardiac cycle.PurposeTo more accurately measure mitral flow, a slice‐following MRI phase contrast sequence is proposed. This study aimed to implement such a sequence, validate its slice‐following functionality in a phantom and healthy subjects, and test its feasibility in patients with mitral valve dysfunction.Study TypeProspective.Phantom and SubjectsThe slice‐following functionality was validated in a cone‐shaped phantom by measuring the depicted slice radius. Sixteen healthy subjects and 10 mitral valve dysfunction patients were enrolled at two sites.Field Strength/Sequence1.5T and 3T gradient echo cine phase contrast.AssessmentA single breath‐hold retrospectively gated sequence using offline feature‐tracking of the mitral valve was developed. Valve displacements were measured and imported to the scanner, allowing the slice position to change dynamically based on the cardiac phase. Mitral valve imaging was performed with slice‐following and static imaging planes. Validation was performed by comparing mitral stroke volume with planimetric and aortic stroke volume.Statistical TestsMeasurements were compared using linear regression, Pearson's R, parametric paired t‐tests, Bland–Altman analysis, and intraclass correlation coefficient (ICC).ResultsPhantom experiments confirmed accurate slice displacements. Slice‐following was feasible in all subjects, yielding physiologically accurate mitral flow patterns. In healthy subjects, mitral and aortic stroke volumes agreed, with ICC = 0.72 and 0.90 for static and slice‐following planes; with bias ±1 SDs 23.2 ± 13.2 mls and 8.4 ± 10.8 mls, respectively. Agreement with planimetry was stronger, with ICC = 0.84 and 0.96; bias ±1 SDs 13.7 ± 13.7 mls and –2.0 ± 8.8 mls for static and slice‐following planes, respectively.Data ConclusionSlice‐following outperformed the conventional sequence and improved the accuracy of transmitral flow, which is important for assessment of diastolic function and mitral regurgitation.Level of Evidence: 2Technical Efficacy: Stage 2J. Magn. Reson. Imaging 2020;51:1412–1421.
Extracellular matrix alterations in low‐grade lung adenocarcinoma compared with normal lung tissue by imaging mass spectrometry
Authors: Angel Peggi M. , Bruner Evelyn , Bethard Jennifer , Clift Cassandra L. , Ball Lauren , Drake Richard R. , Feghali‐Bostwick Carol 
Published: October 2019

AbstractLung adenocarcinoma (LUAD) is the second most common cancer, affecting both men and women. Fibrosis is a hallmark of LUAD occurring throughout progression with excess production of extracellular matrix (ECM) components that lead to metastatic cell processes. Understanding the ECM cues that drive LUAD progression has been limited due to a lack of tools that can access and report on ECM components within the complex tumor microenvironment. Here, we test whether low‐grade LUAD can be distinguished from normal lung tissue using a novel ECM imaging mass spectrometry (ECM IMS) approach. ECM IMS analysis of a tissue microarray with 20 low‐grade LUAD tissues and 20 normal lung samples from 10 patients revealed 25 peptides that could discriminate between normal and low‐grade LUAD using area under the receiver‐operating curve (AUC) ≥0.7, P value ≤.001. Principal component analysis demonstrated that 62.4% of the variance could be explained by sample origin from normal or low‐grade tumor tissue. Additional work performed on a wedge resection with moderately differentiated LUAD demonstrated that the ECM IMS analytical approach could distinguish LUAD spectral features from spectral features of normal adjacent lung tissue. Conventional liquid chromatography with tandem mass spectrometry (LC‐MS/MS) proteomics demonstrated that specific sites of hydroxylation of proline (HYP) were a main collagen post translational modification that was readily detected in LUAD. A distinct peptide from collagen 3A1 modified by HYP was increased 3.5 fold in low‐grade LUAD compared with normal lung tissue (AUC 0.914, P value <.001). This suggests that regulation of collagen proline hydroxylation could be an important process during early LUAD fibrotic deposition. ECM IMS is a useful tool that may be used to define fibrotic deposition in low‐grade LUAD.
Mass spectrometry imaging of endogenous metabolites in response to doxorubicin in a novel 3D osteosarcoma cell culture model
Authors: Palubeckaitė Ieva , Crooks Lucy , Smith David P. , Cole Laura M. , Bram Heijs , Le Maitre Christine , Clench Malcolm R. , Cross Neil A. 
Published: October 2019

AbstractThree‐dimensional (3D) cell culture is a rapidly emerging field, which mimics some of the physiological conditions of human tissues. In cancer biology, it is considered a useful tool in predicting in vivo chemotherapy responses, compared with conventional two‐dimensional (2D) cell culture. We have developed a novel 3D cell culture model of osteosarcoma composed of aggregated proliferative tumour spheroids, which shows regions of tumour heterogeneity formed by aggregated spheroids of polyclonal tumour cells. Aggregated spheroids show local necrotic and apoptotic regions and have sizes suitable for the study of spatial distribution of metabolites by mass spectrometry imaging (MSI). We have used this model to perform a proof‐of‐principle study showing a heterogeneous distribution of endogenous metabolites that colocalise with the necrotic core and apoptotic regions in this model. Cytotoxic chemotherapy (doxorubicin) responses were significantly attenuated in our 3D cell culture model compared with those of standard cell culture, as determined by resazurin assay, despite sufficient doxorubicin diffusion demonstrated by localisation throughout the 3D constructs. Finally, changes to the distribution of endogenous metabolites in response to doxorubicin were readily detected by MSI. Principal component analysis identified 50 metabolites which differed most in their abundance between treatment groups, and of these, 10 were identified by both in‐software t test and mixed‐effects analysis of variance (ANOVA). Subsequent independent MSIs of identified species were consistent with principle component analysis findings. This proof‐of‐principle study shows for the first time that chemotherapy‐induced changes in metabolite abundance and distribution may be determined in 3D cell culture by MSI, highlighting this method as a potentially useful tool in the elucidation of chemotherapy responses as an alternative to in vivo testing.
Potential contribution of winter dominant atmospheric mode over the mid‐latitude Eurasia to the prediction of subsequent spring Arctic Oscillation
Authors: Han Shuangze , Sun Jianqi 
Published: October 2019

AbstractSpring Arctic Oscillation (AO) has been revealed to exert a great impact on the Northern Hemispheric climate; however, its seasonal prediction skill has been limited so far. In this paper, we find that the dominant mode of the winter 500‐hPa geopotential height anomalies over the mid‐latitude Eurasia has a close connection with the succeeding spring AO. The analysis on the physical processes indicates that the troposphere–stratosphere interaction plays an important role in the connection between the two. This predominant atmospheric mode in the mid‐latitude Eurasia during winter can change the vertical wave activity and lead to an anomalous stratospheric polar vortex. Thereafter, the signal of the anomalous stratospheric polar vortex propagates downward to troposphere in the subsequent spring, consequently inducing the anomalous AO pattern in the troposphere. The results in this study imply that this previous winter leading atmospheric mode over the mid‐latitude Eurasia may supply a potential source for a spring AO's prediction.