bluuebunny/crossref_metadata_2025_split huggingface dataset:
Progression of Asymptomatic Contralateral Femur in Patients with Complete Atypical Femoral Fracture, According to Initial Radiographic Findings
Authors: Lee Kyung-Jae , Min Byung-Woo , Bae Ki-Cheor , Cho Chul-Hyun , Lee Si-Wook , Kim Beom-Soo 
Published: October 2020

Background:
Atypical femoral fracture (AFF) is associated with high prevalence rates of prodromal symptoms, bilateral involvement, complications, and the need for prophylactic fixation due to a risk of an impending fracture. Although most complete AFF cases have an asymptomatic contralateral femur at the initial presentation, there is lack of clarity on its progression. We evaluated the radiographic progression of asymptomatic contralateral femora in patients with a complete AFF and investigated the characteristics of these patients.

Methods:
The medical records of 80 consecutive patients who had been treated for a complete AFF were retrospectively evaluated. We excluded 14 patients who had been lost to follow-up, 10 whose contralateral femur initially had been symptomatic and had been treated simultaneously, and 3 whose contralateral femur had previously been treated surgically. The remaining 53 patients were all women with an average age of 71.8 years. The average duration of bisphosphonate (BP) use was 63.6 months, and the mean follow-up duration was 48.9 months. All of the contralateral femora were asymptomatic and were divided into 2 grades according to the initial radiographic findings. We evaluated the prevalence of radiographic progression according to the grades and compared patient characteristics between the progression and non-progression groups.

Results:
Radiographic progression was noted in 18 patients (34%) during the follow-up: 3 (12%) of 25 in grade 1 and 15 (53.6%) of 28 in grade 2 (p < 0.001). The mean time to progression for these 18 patients was 25.6 months, which also differed significantly depending on the grade (p = 0.02). Eleven and 9 (61.1% and 25.7%) of the patients received BP postoperatively in the progression and non-progression groups, respectively (p = 0.01).

Conclusions:
The prevalence of radiographic progression was relatively high, even though the contralateral femur was initially asymptomatic, and differed significantly according to the initial radiographic grade. The frequency of postoperative BP use was significantly higher in the progression group.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Prediction of the clinicopathological subtypes of breast cancer using a Fisher discriminant analysis model based on radiomic features of diffusion-weighted MRI
Authors: Ni Ming , Zhou Xiaoming , Liu Jingwei , Yu Haiyang , Gao Yuanxiang , Zhang Xuexi , Li Zhiming 
Published: October 2020

Abstract
Background: The clinicopathological classification of breast cancer is proposed according to therapeutic purposes. It is simplified and can be conducted easily in clinical practice, and this subtyping undoubtedly contributes to the treatment selection of breast cancer. This study aims to investigate the feasibility of using a Fisher discriminant analysis model based on radiomic features of diffusion-weighted MRI for predicting the clinicopathological subtypes of breast cancer.Methods: Patients who underwent breast magnetic resonance imaging were confirmed by retrieving data from our institutional picture archiving and communication system (PACS) between March 2013 and September 2017. Five clinicopathological subtypes were determined based on the status of ER, PR, HER2 and Ki-67 from the immunohistochemical test. The radiomic features of diffusion-weighted imaging were derived from the volume of interest (VOI) of each tumour. Fisher discriminant analysis was performed for clinicopathological subtyping by using a backward selection method. To evaluate the diagnostic performance of the radiomic features, ROC analyses were performed to differentiate between immunohistochemical biomarker-positive and -negative groups.Results: A total of 84 radiomic features of four statistical methods were included after preprocessing. The overall accuracy for predicting the clinicopathological subtypes was 96.4% by Fisher discriminant analysis, and the weighted accuracy was 96.6%. For predicting diverse clinicopathological subtypes, the prediction accuracies ranged from 92% to 100%. According to the cross-validation, the overall accuracy of the model was 82.1%, and the accuracies of the model for predicting the luminal A, luminal BHER2-, luminal BHER2+, HER2 positive and triple negative subtypes were 79%, 77%, 88%, 92% and 73%, respectively. According to the ROC analysis, the radiomic features had excellent performance in differentiating between different statuses of ER, PR, HER2 and Ki-67.Conclusions: The Fisher discriminant analysis model based on radiomic features of diffusion-weighted MRI is a reliable method for the prediction of clinicopathological breast cancer subtypes.
Dietary nutrient intake related to higher grade cervical intraepithelial neoplasia risk: A Chinese population-based study
Authors: Wang Zhe , Yang Aimin , Yang Jing , Zhao Weihong , Wang Zhilian , Wang Wei , Wang Jintao , Song Jinghui , Li Li , Lv Weiguo , Li Dongyan , Liu Huiqiang , Wang Chen , Hao Min 
Published: October 2020

Abstract
Background: Dietary nutrient intake plays a significant role in carcinogenesis. Few studies have investigated the association between dietary nutrient intake and cervical intraepithelial neoplasia (CIN) risk in China. Methods: Data on 2,304 women from an ongoing cohort comprising 40,000 women from China in 2014 were included. We randomly selected 218 out of 2304 people as subjects during 2019. All participants were surveyed through in-person interviews, physical examinations, and laboratory tests. Clinical data were obtained from physical examinations and laboratory tests. Dietary intakes were assessed using a semiquantitative food frequency questionnaire. Nutrition intakes from 26 food sources were calculated using a comprehensive validated database. Descriptive statistics were used to describe the frequency and proportion, and mean and standard deviation of the demographic characteristics. Characteristics were examined for significant differences, and Pearson chi-square tests were used for categoric variables. Logistic regression was used to obtain odds ratios (ORs) and confidence intervals (CIs) for CIN risk in each nutritional ingredient quartile relative to that in the highest quartile. Results: The food frequency questionnaire exhibited acceptable reproducibility and reasonable validity in assessing nutrient intakes among these women. After adjusting for multiple confounders, several dietary nutrients showed significant associations with CIN2+ risk. Low dietary folate intake was associated with the risk of CIN2+ (first versus fourth quartile: OR=1.55, 95% CI: 1.03-2.33). Similar results were also observed for vitamin B6 (OR=1.63, 95% CI: 1.08-2.46), vitamin C (OR=1.59, 95% CI: 1.05-2.42), niacin (OR=1.65, 95% CI: 1.08-2.51), and vitamin K (second versus fourth quartile: OR=1.60, 95% CI: 1.05-2.44). Conclusions: Low folate; vitamin B6, C, and K; and niacin intakes were associated with CIN2+ risk. Nutrients may influence the development of higher grade CIN and cervical cancer. Trial registration: The study was registered in the Chinese Clinical Trial Register (ChiCTR-ROC-15006479) (http://www.chictr.org.cn).
Clinical and imaging characteristics of primary hepatic sarcomatoid carcinoma and sarcoma: a comparative study
Authors: Shi Dongli , Sun Jun , Ma Liang , Chang Jing , Li Hongjun 
Published: October 2020

Abstract
Background：Primary hepatic sarcomatous carcinoma (PHSC) and primary hepatic sarcoma (PHS) are rare malignancies with frequent overlap in both the clinic and radiology. No comparative study of these tumors for the restricted cases has previously been undertaken. The purpose of our study was to analyze the clinical and imaging features of PHSCs and PHSs, with an emphasis on particularities and similarities through a comparison of the two tumors.Methods: We retrospectively analyzed the clinical and imaging features of 39 patients with pathologically proven PHSCs (n=23) and PHSs (n=16) from four university centers over a 9-year period from 2010-2019. Univariate analyses were performed to determine the consistent and distinctive features. Results：The background of chronic hepatitis or cirrhosis was observed with a high frequency in both of PHSCs (73.7%) and PHSs (62.5%). Tumors with a diameter greater than 10cm were significantly more common in PHSs than PHSCs (p=0.043) and cystic masses were more detected in PHSs (P=0.041). Both PHSCs and PHSs mainly presented hypovascularity (78.3% vs 81.3%). The ring hyper enhancement on the arterial phase (AP) and wash out were more frequently seen in PHSCs and the iso-hypo enhancement on the AP followed persistent or progressive enhancement was more commonly detected in PHSs (all, p<0.05). Conclusion：PHSC and PHS generally present as mass lesions with hypovascularity. The ring hyper enhancement on the AP and wash out favor the diagnosis of PHSC. The large size greater than 10cm, cystic lesion, iso-hypo persistent or progressive enhancement pattern might suggest the possibility of PHSs.
Integrating sexual and reproductive health into health system strengthening in humanitarian settings: a planning workshop toolkit to transition from minimum to comprehensive services in the Democratic Republic of Congo, Bangladesh, and Yemen
Authors: Tran Nguyen Toan , Greer Alison , Kini Brigitte , Abdi Hassan , Rajeh Kariman , Cortier Hilde , Boboeva Mohira 
Published: October 2020

Abstract
BackgroundPlanning to transition from the Minimum Initial Service Package for Sexual and Reproductive Health (SRH) toward comprehensive SRH services has been a challenge in humanitarian settings. To bridge this gap, a workshop toolkit for SRH coordinators was designed to support effective planning. This article aims to describe the toolkit design, piloting, and final product.MethodsAnchored in the Health System Building Blocks Framework of the World Health Organization, the design entailed two complementary and participatory strategies. First, a collaborative design phase with iterative feedback loops involved global partners with extensive operational experience in the initial toolkit conception. The second phase engaged stakeholders from three major humanitarian crises to participate in pilot workshops to contextualize, evaluate, validate, and improve the toolkit using qualitative interviews and end-of-workshop evaluations. The aim of this two-phase design process was to finalize a planning toolkit that can be utilized in and adapted to diverse humanitarian contexts, and efficiently and effectively meet its objectives. Pilots occurred in the Democratic Republic of Congo for the Kasai region crisis, Bangladesh for the Rohingya humanitarian response in Cox’s Bazar, and Yemen for selected Governorates.ResultsResults suggest that the toolkit enabled facilitators to foster a systematic, participatory, interactive, and inclusive planning process among participants over a two-day workshop. The approach was reportedly effective and time-efficient in producing a joint work plan. The main planning priorities cutting across settings included improving comprehensive SRH services in general, healthcare workforce strengthening, such as midwifery capacity development, increasing community mobilization and engagement, focusing on adolescent SRH, and enhancing maternal and newborn health services in terms of quality, coverage, and referral pathways. Recommendations for improvement included a dedicated and adequately anticipated pre-workshop preparation to gather relevant data, encouraging participants to undertake preliminary study to equalize knowledge to partake fully in the workshop, and enlisting participants from marginalized and underserved populations.ConclusionCollaborative design and piloting efforts resulted in a workshop toolkit that could support a systematic and efficient identification of priority activities and services related to comprehensive SRH. Such priorities could help meet the SRH needs of communities emerging from acute humanitarian situations while strengthening the overall health system.
Integrated analysis identifies a pathway-related competing endogenous RNA network in the progression of Pancreatic cancer
Authors: Zu Fuqiang , Liu Peng , Wang Huaitao , Zhu Ting , Sun Jian , Sheng Weiwei , Tan Xiaodong 
Published: October 2020

Abstract
Background: It is well acknowledged that cancer-related pathways play pivotal roles in the progression of pancreatic cancer (PC). Employing Integrated analysis, we aim to identify the pathway-related ceRNA network associated with PC progression.Methods: We divided eight GEO datasets into three groups according to their platform, and combined TCGA and GTEx databases as a group. Additionally, we screened out the differentially expressed genes (DEGs) and performed functional enrichment analysis in each group, and recognized the top hub genes in the most enriched pathway. Furthermore, the upstream of miRNAs and lncRNAs were predicted and validated according to their expression and prognostic roles. Finally, the co-expression analysis was applied to identify a pathway-related ceRNA network in the progression of PC.Results: A total of 51 significant pathways that common enriched in all groups were spotted. Enrichment analysis indicated that pathway in cancer was greatly linked with tumor formation and progression. Next, the top 20 hug genes in this pathway were recognized, and stepwise prediction and validation from mRNA to lncRNA, including 11 hub genes, 4 key miRNAs, and 2 key lncRNAs, were applied to identify a meaningful ceRNA network according to ceRNA rules. Ultimately, we identified the PVT1/miR-20b-/CCND1 axis as a promising pathway-related ceRNA axis in the progression of PC.Conclusion: Overall, we elucidate the pathway-related ceRNA regulatory network of PVT1/miR-20b-/CCND1 in the progression of PC, which can be considered as therapeutic targets and encouraging prognostic biomarkers for PC.
Did the Indian lockdown avert deaths?
Authors: Raju Suvrat 
Published: October 2020

Abstract
Within the context of SEIR models, we consider a lockdown that is both imposed and lifted at an early stage of an epidemic. We show that, in these models, although such a lockdown may delay deaths, it eventually does not avert a significant number of fatalities. Therefore, in these models, the efficacy of a lockdown cannot be gauged by simply comparing figures for the deaths at the end of the lockdown with the projected figure for deaths by the same date without the lockdown. We provide a simple but robust heuristic argument to explain why this conclusion should generalize to more elaborate compartmental models. We qualitatively discuss some important effects of a lockdown, which go beyond the scope of simple models, but could cause it to increase or decrease an epidemic's final toll. Given the significance of these effects in India, and the limitations of currently available data, we conclude that simple epidemiological models cannot be used to reliably quantify the impact of the Indian lockdown on fatalities caused by the COVID-19 pandemic.
Proposal of a new equation for estimating resting energy expenditure for acute kidney injury patients on dialysis. A Machine Learning Approach.
Authors: ponce daniela , de Goes Cassiana Regina , de Andrade Luis Gustavo Modelli 
Published: October 2020

Abstract
The objective of this study was to develop a new predictive equation of resting energy expenditure (REE) for acute kidney injury patients (AKI) on dialysis. Material and methods: A cross-sectional descriptive study was carried out of 114 AKI patients, consecutively selected, on dialysis and mechanical ventilation, aged between 19 and 95 years. For construction of the predictive model, 80% of cases were randomly separated to training and 20% of unused cases to validation. Several machine learning models were tested in the training data: linear regression with stepwise, rpart, support vector machine with radial kernel, generalised boosting machine and random forest. The models were selected by ten-fold cross-validation and the performances evaluated by the root mean square error (RMSE). Results: There were 364 indirect calorimetry (IC) measurements in 114 patients, mean age of 60.65 ± 16.9 years and 68.4% were males. The average REE was 2081 ± 645 kcal. REE was positively correlated with C-reactive protein, minute volume (MV), expiratory positive airway pressure, serum urea, body mass index and inversely with age. The principal variables included in the selected model were age, body mass index (BMI), use of vasopressors, expiratory positive airway pressure, minute volume (MV), C-reactive protein, temperature and serum urea. The final r-value in the validation set was 0.69. Conclusion: We propose a new predictive equation for estimating the REE of AKI patients on dialysis that uses a non-linear approach with better performance than actual models.
Feasibility of Anticoagulation Using Low Molecular‑Weight Heparin During Catheter-Directed Thrombolysis for Lower Extremity Deep Venous Thrombosis&nbsp;
Authors: Li Yonghui , Wang Junwei , He Rongzhou , Zheng Junmeng , Chen Zhibo , Yao Chen , Huang Kai 
Published: October 2020

Abstract
Background: The optimal anticoagulant scheme during catheter-directed thrombolysis (CDT) for deep venous thrombosis (DVT) remains unknown. This study was performed to evaluate the feasibility of anticoagulation therapy using low molecular‑weight heparin (LMWH) during CDT for DVT.Methods: The clinical data of DVT patients who underwent CDT during the past six years was retrospectively collected and reviewed. Patients were divided into therapeutic-dose anticoagulation (TPDA) and sub therapeutic-dose anticoagulation (sub-TPDA) groups according to LMWH dosage.Results: A total of 61 patients involving 61 limbs were comprised. Acute and subacute DVT were identified in 39 (63.9%) and 22 (36.1%) patients, respectively. Thrombosis involving the iliac vein was identified in 34 (55.7%) patients. Inferior vena cava filter placement was performed in 38 (62.3%) patients. Intraoperatively, adjunctive balloons, stents, and thrombectomy were provided for nine (14.8%), four (6.6%), and one (1.6%) patients, respectively. Twenty (32.8%) patients accepted TPDA therapy, while 41 (67.2%) patients were administrated with sub-TPDA therapy. Median urokinase infusion rate was 2.5 (0.83 to 5) x 104 U/h. Median infusion duration time was 4 (2 to 14) days, and median urokinase dose infused was 2.4 (0.6 to 10.80) x 106 U. During CDT, five (8.2%) cases of minor bleeding were observed, and blood transfusion was not required. No major bleeding, symptomatic pulmonary embolisms, or death occurred. Complete (>90%) and partial thrombolysis (50~90%) were achieved in 56 (91.8%) patients. In comparison with sub-TPDA group, TPDA group exhibited no significant difference in baseline characteristics, clinical improvement, thrombolysis results, and complications. Conclusions: Anticoagulation therapy using low molecular‑weight heparin during CDT with low infusion rate for DVT is likely to be feasible and safe. Sub-therapeutic-dose anticoagulation and therapeutic-dose could be used for CDT with similar clinical outcome and bleeding complications.
Generation and Starch Characterization of Non-Transgenic BEI and BEIIb Double Mutant Rice (Oryza sativa) with Ultra-high Level of Resistant Starch
Authors: Miura Satoko , Koyama Nana , Crofts Naoko , Hosaka Yuko , Abe Misato , Fujita Naoko 
Published: October 2020

Abstract
Background: Cereals high in resistant starch (RS) are gaining popularity, as their intake is thought to help manage diabetes and prediabetes. Number of patients suffering from diabetes is also increasing in Asian countries where people consume rice as a staple food, hence generation of practically growable high RS rice line has been anticipated. It is known that suppression of starch branching enzyme (BE) IIb increases RS content in cereals. To further increase RS content and for more practical use, we generated a non-transgenic be1 be2b double mutant rice (Oryza sativa) line, which completely lacked both proteins, by crossing a be1 mutant with a be2b mutant. Results: The be1 be2b mutant showed a decrease in intermediate amylopectin chains and an increase in long amylopectin chains compared with be2b. The amylose content of be1 be2b mutant (51.7%) was the highest among all pre-existing non-transgenic rice lines. To understand the effects of chewing cooked rice and cooking rice flour on RS content, RS content of mashed and un-mashed cooked rice as well as raw and gelatinized rice flour were measured using be1 be2b and its parent mutant lines. The RS contents of mashed cooked rice and raw rice flour of be1 be2b mutant (28.4% and 35.1%, respectively) were 3-fold higher than those of be2b mutant. Gel-filtration analyses of starch treated with digestive enzymes showed that the RS in be1 be2b mutant was composed of the degradation products of amylose and long amylopectin chains. Seed weight of be1 be2b mutant was approximately 60% of the wild type and rather heavier than that of be2b mutant. Conclusions: The endosperm starch in be1 be2b double mutant rice were enriched with long amylopectin chains. This led to a great increase in RS content in cooked rice grains and rice flour in be1 be2b compared with be2b single mutant. be1 be2b generated in this study must serve as a good material for an ultra-high RS rice cultivar.