bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cytoreductive radiotherapy combined with abiraterone in metastatic castration-resistance prostate cancer: a single center experience
Authors: Liu Yang , Long Wen , Zhang Zitong , Mai Lixin , Huang Sijuan , Liu Boji , Cao Wufei , Wu Jianhua , Zhou Fangjian , Li Yonghong , He Liru 
Published: December 2020

Abstract
Background: To investigate the potential benefit of cytoreductive radiotherapy (cRT) in metastatic castration-resistant prostate cancer (mCRPC) patients receiving abiraterone.Methods: From February 2014 to February 2019, 149 mCRPC patients treated with abiraterone were identified. Patients receiving cRT before abiraterone failure (AbiRT group) were matched by one-to-two propensity score to patients without cRT before abiraterone failure (non-AbiRT group).Results: The median follow-up was 23.5 months. Thirty patients (20.1%) were in the AbiRT group, whereas 119 patients (79.9%) were in the non-AbiRT group. The 2-year OS of patients managed by AbiRT and non-AbiRT were 89.5% and 73.5%, respectively (P = 0.0003). On multivariate analysis, only AbiRT (HR, 0.17; 95%CI, 0.05–0.58; P = 0.004) and prognostic index (HR, 2.71; 95% CI, 1.37–5.35; P = 0.004) were significant factors. After matching, AbiRT continued to be associated with improved OS (median OS not reached vs. 44.0 months, P = 0.009). Subgroup analysis revealed that patients aged ≤65 years (HR, 0.09; 95%CI, 0.01–0.65; P = 0.018), PSA ≤20 ng/mL (HR, 0.29; 95% CI, 0.09–0.99; P = 0.048), chemotherapy-naïve upon abiraterone treatment (HR, 0.20; 95% CI, 0.06–0.66; P = 0.008) and in intermediate prognosis groups by COU-AA-301 prognostic index (HR, 0.13; 95% CI, 0.03-0.57; P = 0.007) had improved OS with AbiRT. Conclusions: cRT before resistance to abiraterone may improve survival in selected mCRPC patients: age ≤65 years old, chemotherapy-naïve, with a relatively low PSA level at the diagnosis of mCRPC and intermediate prognosis.
Role of Liver Enzymes in Patients with Blunt Abdominal Trauma to Diagnose Liver Injury
Authors: Shrestha Anup , Neupane Harish Chandra , Tamrakar Kishor Kumar , Bhattarai Abhishek , Katwal Gaurav 
Published: December 2020

Abstract
Background:The liver is the second most injured organ following blunt abdominal trauma (BAT) after spleen. Although the computed tomography (CT) scan is considered as the gold standard for diagnosing liver injury in BAT, it is not readily available in the hospital. This study was performed to evaluate the role of aspartate transaminase (AST) and alanine transaminase (ALT) in patients with BAT and its significance in predicting the diagnosis and severity of the liver injury.Method:The study was conducted in Chitwan Medical College Teaching Hospital (CMCTH) study from February 2019 to May 2020. It was a prospective observational study. All the patients with BAT were received by on duty surgical residents in the Emergency Department. Based on the imaging and operative finding patients with liver injury and without liver injury were noted with the associated injury. For comparisons of clinical and grading characteristics between the two groups (liver injury and no liver injury). The Chi-squared test was used for categorical variables as appropriate, and Mann-Whitney U test used for quantitative variables (AST and ALT). The comparisons between more than two groups (grade of injury) were performed using Kruskal-Wallis test. The Receiver operating characteristic (ROC) was used to calculate the optimal cut-off value of AST and ALT.Results:Among the 96 patients admitted with BAT, 38 patients had liver injury and 58 patients had no liver injury. The median length of the intensive care unit (ICU) stay of patients with liver injury was higher than without liver injury. There was a significant difference in the median level of AST and ALT (<0.001) between patients with liver injury and no liver injury. The area under the ROC curve of AST was 0.89(95% Confidence Interval 0.86-0.98) and of ALT was 0.92(95% Confidence Interval 0.83-0.97). The area under the curve demonstrated that the test was a good predictor for the identification of liver injury and also the severity of liver enzymes. The cut-off values for the liver injury were 106 U/l and 80 U/l for AST and ALT respectively. Based on these values, AST ≥ 106 U/l had a sensitivity of 71.7 %, a specificity of 90 %, a positive predictive value of 86.8 %, and a negative predictive value of 77.6 %. The corresponding values for ALT ≥ 80 U/l were 77.8 %, 94.1%, 92.1% and 82.8 %, respectively.ConclusionIn conclusion, we report the optimal cut-off value of AST and ALT for liver injury in BAT as ≥ 106 U/l and 80 U/l respectively. The elevated level of AST and ALT might assist the emergency physicians and surgeons to timely refer the suspected patients with the liver to a tertiary center.
Influence of the knot position on the union of the greater trochanter after bipolar hip arthroplasty via the modified Dall approach: A prospective non-randomized study
Authors: Kataoka Masanao , Fujita Hiroshi , Hara Hiroaki , Harada Hideto , Okutani Yuki , Murotani Yoshiki 
Published: December 2020

Abstract
Background: In our institute, all elderly patients with displaced femoral neck fracture were treated with cemented bipolar hemiarthroplasty (BHA) using the modified Dall approach. To our knowledge, there are no reports on the knot position of the greater trochanter reattachment. The aim of this study was to determine influence of two knot positions (anterior or posterior) on the complications of the greater trochanter.Methods: This is a prospective non-randomized study conducted on 95 elderly patients (95 hips) from September 2013 to December 2017. The knot position was changed from anterior to posterior alternately. The X-ray images obtained immediately after the operation were compared with those obtained at 3 months postoperatively; thereafter, the status of the greater trochanter was classified into three types: type A, no apparent shifting and fracture; type C, over 1-mm shifting of the fragment; and type F, fracture of the greater trochanter.Results: Regarding age at operation, sex, BMI, size of the greater trochanteric fragment, stem type, and surgeon, there was no significant difference between two groups. In the anterior group, 34 hips (72.3%), 5 hips (10.6%), and 8 hips (17.0%) were classified under type A, C, and F, respectively. In the posterior group, 44 hips (91.7%), 1 hip (2.1%), and 3 hips (6.3%) were classified under type A, C, and F, respectively. There were significantly fewer greater trochanteric complications in the posterior group. Conclusions: The posterior knot position improved the union of the greater trochanter after BHA compared with the anterior knot position.Trial registration: We had approved IRB at our hospital clinical research review committee. Retrospectively registered.
Rapid water parcel transport across the Kuroshio Extension in the lower thermocline from dissolved oxygen measurements by Seaglider
Authors: Hosoda Shigeki , Inoue Ryuichiro , Nonaka Masami , Sasaki Hideharu , Sasai Yoshikazu , Hirano Mizue 
Published: December 2020

Abstract
Small water parcels, which are characterized by a low salinity and high dissolved oxygen (DO) are observed by Seaglider in the main thermocline (26.0–27.0 sq) south of the Kuroshio Extension (KE), have horizontal and vertical scales of a few ten kilometers and a few ten meters, respectively. Water mass analyses revealed larger negative salinity anomalies (<−0.05 PSS-78) and positive DO anomalies (>15 μmol kg−1) than those of the surrounding water. The characteristics are similar to those of water mass with low salinity and high DO in the subpolar Northwestern Pacific Ocean. Additionally, higher DO anomaly water parcels appear in the upper layer (<26.7 σθ) while low salinity parcels appear in the lower layer (>26.7 sq). Oxygen consumption rates from the apparent oxygen utility suggest that the small water parcels consume less oxygen than the surrounding water, implying that they migrate in a shorter time across the KE after subduction and their characteristics may reflect the sea surface temperature, salinity, and DO in the subduction region. Similar small water parcels represented by high-resolution numerical simulations indicate that they pass through the KE in one month. The simulations support the oxygen consumption rate from the Seaglider observations. The existence of a fast process for water mass migration via meso- and submesoscale subduction processes across the KE affects the amount, subduction, and exchange process of water mass. Our study indicates a small water mass contributes to the exchange process across the KE rapidly, which had not been identified in previous studies. Consequently, detailed observations using multiple Seagliders should capture detailed spatial and temporal variability of the water mass exchange process.
Feasibility of a quality improvement project to increase adherence to evidence-based pulmonary embolism diagnosis in the emergency department.
Authors: Germini Federico , Hu Yang , Afzal Sarah , Al-haimus Fayad , Puttagunta Srikanth A. , Niaz Saghar , Chan Teresa , Clayton Natasha , Mondoux Shawn , Thabane Lehana , de Wit Kerstin 
Published: December 2020

Abstract
Background: Many evidence-based clinical decision tools are available for the diagnosis of pulmonary embolism (PE). However, these clinical decision tools have had suboptimal uptake in the everyday clinical practice in emergency departments (EDs), despite numerous implementation efforts. We aimed to test the feasibility of a multi-faceted intervention to implement an evidence-based PE diagnosis protocol.Methods: We conducted an interrupted time series study in three EDs in Ontario, Canada. We enrolled consecutive adult patients accessing the ED with suspected PE from January 1, 2018 to February 28, 2020. Components of the intervention were: clinical leadership endorsement; a new pathway for PE testing; physician education; personalized confidential physician feedback, and collection of patient outcome information. The intervention was implemented in November 2019. We identified six criteria for defining the feasibility outcome: successful implementation of the intervention in at least two of the three sites; capturing data on ≥ 80% of all CTPAs ordered in the EDs; timely access to electronic data; rapid manual data extraction with feedback preparation before the end of the month ≥ 80% of the time; time required for manual data extraction and feedback preparation ≤ 2 day per week in total.Results: The intervention was successfully implemented in two out of three sites. 5,094 and 899 patients were tested for PE in the period before and after the intervention, respectively. We captured data from 90% of CTPAs ordered in the EDs, and we accessed the required electronic data. The manual data extraction and individual emergency physician audit and feedback were consistently finalized before the end of each month. The time required for manual data extraction and feedback preparation was ≤ 2 days per week (14 hours).Conclusions: We proved the feasibility of implementing an evidence-based PE diagnosis protocol in two EDs. We were not successful implementing the protocol in the third ED.Registration: The study was not registered.Funding: CanVECTOR Network, McMaster Division of Hematology & Thromboembolism.
Metabolic Syndrome Components and Acute Pancreatitis: A Case-Control Study in China
Authors: Shen Zhemin , Wang Xueqiao , Zhen Zili , Wang Yao , Sun Peilong 
Published: December 2020

Abstract
Background: Acute pancreatitis (AP) is a common inflammatory disorder of the pancreas. Recent evidence has shown that metabolic syndrome is positively correlated with the severity of AP. However, only a few studies have revealed the relationship between metabolic syndrome and the occurrence of AP. We therefore elucidated the association between metabolic syndrome and the occurrence of AP. Methods: A hospital-based case-control study was conducted. A total of 705 patients admitted to our hospital from January 2016 to December 2018 were included in the study. Subjects were divided into case and control groups according to their diagnosis: (1) According to the revised Atlanta classification from 2012, patients diagnosed with AP were enrolled in the case group. (2) Patients without a history of AP or any disease related to metabolic syndrome were allocated into the control group. Controls were matched to cases individually by sex and age (control/case ratio=1). Results: The incidence rate of metabolic syndrome in AP patients was 30.9%, which was more frequent than that in controls (13.2%) (OR=2.837; 95% CI 1.873-4.298, p<0.001). In the multivariate regression analysis, a history of smoking or alcohol consumption and biliary stones were significantly associated with AP (OR=2.441; 95% CI 1.865-5.172, p<0.001; OR=1.777; 95% CI 1.060-2.977, p=0.029; OR=28.995; 95% CI 13.253-63.435, p<0.001). In addition, the occurrence of AP was significantly associated with total cholesterol (TC) (OR=1.992; 95% CI 1.246-3.183, p=0.004), triglyceride (TG) (OR=2.134; 95% CI 1.403-3.245, p<0.001), hyperglycaemia (OR=2.261; 95% CI 1.367-3.742, p=0.001), and apolipoprotein A (Apo A) (OR=0.270; 95% CI 0.163-0.447, p<0.001). Conclusions: Metabolic syndrome and its components were associated with AP occurrence.
Embedded fuzzy-based models in hydraulic jump prediction
Authors: Zounemat-Kermani Mohammad , Mahdavi-Meymand Amin 
Published: December 2020

Abstract
This study aims to evaluate the learning ability and performance of five meta-heuristic optimization algorithms in training forward and recurrent fuzzy-based machine learning models, such as adaptive neuro-fuzzy inference system (ANFIS) and RANFIS (recurrent ANFIS), to predict hydraulic jump characteristics, i.e., downstream flow depth (h2) and jump length (Lj). To meet this end, the firefly algorithm (FA), particle swarm algorithm (PSO), whale optimization algorithm (WOA), genetic algorithm (GA), and moth-flame optimization algorithm (MFO) are embedded with the fuzzy-based models, which represent the main contribution of this study. The analysis of the results of predicting hydraulic jump characteristics shows that the embedded ANFIS and RANFIS models are more accurate than the empirical relations proposed by the previous researchers. Comparing the performance of the embedded RANFISs and ANFISs methods in predicting Lj represents the superiority of the RANFIS models to the ANFISs. The results of the sensitivity analysis show that among the input independent parameters, flow discharge (Q) is the most important factor in predicting downstream flow depth in weak, oscillating, and steady hydraulic jumps (1.7 &lt; Froude number &lt; 9), while the upstream flow depth (h1) is more important than the other input parameters in strong hydraulic jumps (Froude number &gt; 9).
The spotted zebra: Cohabitation between informal solutions and public-owned infrastructures for water supply in the Rio de Janeiro Metropolitan Region
Authors: Maiello Antonella , de Paiva Britto Ana Lucia Nogueira , Quintslr Suyá 
Published: December 2020

Abstract
In many emerging and developing countries hybrid systems, not completely public nor private, have become a regrettable unstandardized ‘standard’ for water and sanitation service (WSS) provisions. These spotted zebras deserve the attention of both the scientific community and policymakers being ambiguous solutions. On the one hand, the hybrid systems allow broadening the access to the water supply service in face of the challenge to manage, maintain and adapt large infrastructures in a time of increasing climate change impacts, water-supply demand and drinking water scarcity. On the other hand, by embodying informal artefacts and unregulated behaviours to use natural resources, the hybrid systems enhance the vulnerability and precariousness of the population that is normally not reached by the formal public infrastructure. The paper presents findings of research conducted in Queimados, in the Rio de Janeiro Metropolitan Area. Our study suggests that grassroots solutions, albeit being an opportunity when integrated, represent a threat when standing alone, and it is critical to further discuss ways to promote such integration within a structured institutional public framework. Conclusions stress the need to rethink the grassroots engagement within socio-technical transition emphasizing the nexus between political culture, civic education and infrastructural solutions.
Calculation of optimal tax rate of water resources and analysis of social welfare based on CGE model: a case study in Hebei Province, China
Authors: Tian Gui-liang , Wu Zheng , Hu Yu-can 
Published: December 2020

Abstract
The determination of the optimal tax rate of water resources is one of the core as well as the key economic and technological issue in the ‘fee to tax’ work of water resources in China. Therefore, based on the introduction of the computable general equilibrium (CGE) model of water resources tax, using production parameters and consumption parameters of Hebei province in 2008–2017, the optimal tax rate of water resources is simulated and calculated, and the impact of the optimal tax rate on social welfare is analyzed. The results show that the reference of the best water resources tax rate in Hebei Province is 18%, and taxation on water resources effectively promotes the water use structure and water resources utilization efficiency in Hebei, which is beneficial to its water resources protection. The effective calculation of the optimal tax rate of water resources tax in Hebei Province proves the effectiveness of the CGE model in the formulation of water resources tax rate, which provides an important reference for the nationwide popularization of water resources ‘fee to tax reform’ in China and the formulation of water resources tax rate in other regions.
Spatial distribution of extreme precipitation in the Tibetan Plateau and effects of external forcing factors based on Generalized Pareto Distribution
Authors: Gao Jiajia , Ma Pengfei , Du Jun , Huang Xiaoqing 
Published: December 2020

Abstract
The daily precipitation data of the years 1955–2017 from May to September were retrieved; then a Generalized Pareto Distribution (GPD) and maximum likelihood methods were adopted to understand trends and calculate the reappearance period of heavy precipitation in the Tibetan Plateau (TP). The daily precipitation values at 22 stations in the TP were found to conform to the model, and theoretical and measured frequencies were consistent. According to the spatial distribution of the maximum precipitation value, the extreme values of Shigatse and Lhasa showed large fluctuations, and the probability of record-breaking precipitation events was low. In the western part of Nagqu, the probability of extreme precipitation was relatively low, and that of record-breaking precipitation was relatively high. The peak values of extreme precipitation in the flood season in the TP generally exhibited a decreasing trend from southeast to northwest, and the extreme value of the flood season that reappeared in the southeast region was approximately twice that of the northwest region. The maximum rainfall in most areas will exceed 20 mm in the next 5–10 years, and the maximum rainfall in Shigatse will reach 52.7 mm. After 15 years of recurrence in various regions, the peak rainfall in the flood season has become low. Most of the regions in the model have different responses to ENSO and Indian Ocean monsoon indices with external forcing factors.
Selective adsorption behavior of Cd2+ imprinted acrylamide-crosslinked-poly(alginic acid) magnetic polymers: fabrication, characterization, adsorption performance and mechanism
Authors: Li Zuyu , Guo Shuangzhen , Li Da , Zang Lihua 
Published: December 2020

Abstract
Poly(acrylamide) grafted and glutaraldehyde-crosslinked alginic acid nano-magnetic adsorbent (AAMA) was prepared by selecting Cd2+ as a template ion. Scanning electron microscope (SEM), thermo-gravimetric analyzer (TGA), vibrating sample magnetometer (VSM) and infrared spectroscopy (IR) were used to characterize the morphology and structure of AAMA. The adsorption of AAMA for different metal ions was compared and the impact of various factors for adsorption of Cd2+ was systematically investigated. These results suggested that the AAMA was the aggregates of Fe3O4 nanoparticles with a diameter of about 50–100 nm and had selectivity for Cd2+ adsorption. The maximum adsorption capacity for Cd2+ is 175 mg/g at pH 5.0 and 303 K. The experimental data were well described by the Langmuir isotherm model and pseudo-second-order model. The parameters of adsorption thermodynamics concluded that the adsorption progress is spontaneous and endothermic in nature. The parameters of adsorption activation energy suggested that there is physical adsorption and chemisorption on the adsorption of metal ions. AAMA could be regenerated by EDTA and still keep 71% adsorption capacity in the fifth consecutive adsorption-regeneration cycle. Therefore, AAMA would be useful as a selective and high adsorption capacity nano-magnetic adsorbent in the removal of Cd2+ from wastewater.
Metabolism of Direct-acting Antiviral Agents (DAAs) in Hepatitis C Therapy: A Review of the Literature
Authors: Mikolasevic Ivana , Kanizaj Tajana F. , Bozic Dorotea , Puz Petra , Shapeski Sanja S. , Puljiz Zeljko , Radic-Kristo Delfa , Lalovac Milos , Mijic Maja , Delija Bozena , Juric Toni , Bogadi Ivan , Virovic-Jukic Lucija 
Published: December 2020

Background::
Hepatitis C virus (HCV) infection is still one of the leading causes of chronic liver disease,
with chronically infected making up approximately 1% of the global population. Of those infected, 70%
(55-85%) will develop chronic HCV infection. Chronic HCV infection causes substantial morbidity and mortality,
with complications including cirrhosis, end-stage liver disease, hepatocellular carcinoma, and eventually
death.

Objective::
Therapeutic options for chronic HCV infection have evolved dramatically since 2014, with a translation
from pegylated interferon and ribavirin (associated with suboptimal cure and high treatment-related toxicity)
to oral direct-acting antiviral treatment. There are four classes of direct-acting antivirals which differ by
their mechanism of action and therapeutic target. They are all pointed to proteins that form the cytoplasmic viral
replication complex. Multiple studies have demonstrated that direct-acting antiviral therapy is extremely
well tolerated, highly efficacious, with few side effects.

Methods::
We performed an indexed MEDLINE search with keywords regarding specific direct-acting antiviral
regimes and their pharmacokinetics, drug-drug interactions, and metabolism in specific settings of pregnancy,
lactation, liver cirrhosis, liver transplantation and HCC risk, kidney failure and kidney transplantation.

Results::
We present a comprehensive overview of specific direct-acting antiviral metabolism and drug-drug interaction
issues in different settings.

Conclusion::
Despite its complex pharmacokinetics and the possibility of drug-drug interactions, direct-acting
antivirals are highly efficacious in providing viral clearance, which is an obvious advantage compared to possible
interactions or side effects. They should be administered cautiously in patients with other comorbidities,
and with tight control of immunosuppressive therapy.