bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the usefulness of breast strain elastography for intraductal lesions
Authors: Kokubu Yumi , Yamada Keiko , Tanabe Masahiko , Izumori Ayumi , Kato Chieko , Horii Rie , Ohno Shinji , Matsueda Kiyoshi 
Published: January 2021

Abstract
Purpose
Strain elastography for imaging lesion stiffness is being used as a diagnostic aid in the malignant/benign discrimination of breast diseases. While acquiring elastography in addition to B-mode images has been reported to help avoid performing unnecessary biopsies, intraductal lesions are difficult to discriminate whether they are malignant or benign using elastography. An objective evaluation of strain in lesions was performed in this study by measuring the elasticity index (E-index) and elasticity ratio (E-ratio) of lesions as semi-quantitative numerical indicators of the color distribution of strain. We examined whether ductal carcinoma in situ (DCIS) and intraductal papilloma could be distinguished using these semi-quantitative numerical indicators.

Methods
In this study, 170 ultrasonographically detected mass lesions in 162 cases (106 malignant lesions and 64 benign lesions)—in which tissue biopsy by core needle biopsy and vacuum-assisted biopsy, or surgically performed histopathological diagnosis, was performed—were selected as subjects from among 1978 consecutive cases (from January 2014 to December 2016) in which strain elastography images were acquired, in addition to standard B-mode breast ultrasonography, by measuring the E-index and E-ratio.

Results
The cut-off values for E-index and E-ratio in the malignant/benign discrimination of breast lesions were determined to be optimal values at 3.5 and 4.2, respectively, based on receiver operating characteristic (ROC) curve analysis. E-index sensitivity, specificity, accuracy, and AUC value (area under the curve) were 85%, 86%, 85%, and 0.860, respectively, while those for E-ratio were 78%, 74%, 74%, and 0.780, respectively. E-index yielded superior results in all aspects of sensitivity, specificity, accuracy, and AUC values, compared to those of E-ratio. The mean E-index values for malignant tumors and benign tumors were 4.46 and 2.63, respectively, indicating a significant difference (P < 0.001). E-index values of 24 DCIS lesions and 25 intraductal papillomas were 3.88 and 3.35, respectively, which showed a considerably close value, while the false-negative rate for DCIS was 29.2%, and the false-positive rate for intraductal papilloma was as high as 32.0%.

Conclusion
E-index in strain elastography yielded better results than E-ratio in the malignant/benign discrimination of breast diseases. On the other hand, E-index has a high false-negative rate and false-positive rate for intraductal lesions, a factor which should be taken into account when making ultrasound diagnoses.
Does spaced education improve clinical knowledge among Family Medicine residents? A cluster randomized controlled trial
Authors: Grad Roland , Leger Daniel , Kaczorowski Janusz , Schuster Tibor , Adler Samara , Aman Marya , Archibald Douglas , Beaulieu Marie-Claude , Chmelicek John , Cornelissen Evelyn , Delleman Bethany , Hadj-Mimoune Sonia , Horvey Samantha , Macaluso Steven , Mintsioulis Stephen , Murdoch Stuart , Ng Brian , Papineau Alain , Rangwala Sohil , Rousseau Mathieu , Rudkin Teresa , Schabort Inge , Schultz Karen , Snow Pamela , Wong Eric , Wu Pearson , Brailovsky Carlos 
Published: January 2021

AbstractSpaced education is a learning strategy to improve knowledge acquisition and retention. To date, no robust evidence exists to support the utility of spaced education in the Family Medicine residency.
We aimed to test whether alerts to encourage spaced education can improve clinical knowledge as measured by scores on the Canadian Family Medicine certification examination. Method: We conducted a cluster randomized controlled trial to empirically and pragmatically test spaced education using two versions of the Family Medicine Study Guide mobile app. 12 residency training programs in Canada agreed to participate. At six intervention sites, we consented 335 of the 654 (51%) eligible residents. Residents in the intervention group were sent alerts through the app to encourage the answering of questions linked to clinical cases. At six control sites, 299 of 586 (51%) residents consented. Residents in the control group received the same app but with no alerts. Incidence rates of case completion between trial arms were compared using repeated measures analysis. We linked residents in both trial arms to their knowledge scores on the certification examination of the College of Family Physicians of Canada. Results: Over 67 weeks, there was no statistically significant difference in the completion of clinical cases by participants. The difference in mean exam scores and the associated confidence interval did not exceed the pre-defined limit of 4 percentage points. Conclusion: Further research is recommended before deploying spaced educational interventions in the Family Medicine residency to improve knowledge.
Safety and efficacy of abemaciclib plus endocrine therapy in older patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative advanced breast cancer: an age-specific subgroup analysis of MONARCH 2 and 3 trials
Authors: Goetz Matthew P. , Okera Meena , Wildiers Hans , Campone Mario , Grischke Eva-Maria , Manso Luis , André Valérie A. M. , Chouaki Nadia , San Antonio Belén , Toi Masakazu , Sledge George W. 
Published: January 2021

Abstract
Purpose
Abemaciclib in combination with endocrine therapy (ET) has demonstrated significant efficacy benefits in HR+ , HER2− advanced breast cancer patients in the Phase 3 studies MONARCH 2 (fulvestrant as ET) and MONARCH 3 (letrozole or anastrozole as ET). Here, we report age-specific safety and efficacy outcomes.

Methods
Exploratory analyses of MONARCH 2 and 3 were performed for 3 age groups (<65, 65–74, and ≥75 years). For safety, data were pooled from both studies; for efficacy, a subgroup analysis of PFS was performed for each trial independently.

Results
Pooled safety data were available for 1152 patients. Clinically relevant diarrhea (Grade 2/3) was higher in older patients receiving abemaciclib + ET (<65, 39.5%; 65–74, 45.2%; ≥75, 55.4%) versus placebo + ET (<65, 6.8%; 65–74, 4.5%; ≥75, 16.0%). Nausea, decreased appetite, and venous thromboembolic events were all moderately higher in older patients. Neutropenia (Grade ≥ 3) did not differ as a function of age in the abemaciclib + ET arm (<65, 25.8%; 65–74, 27.4%; ≥75, 18.1%). Dose adjustments and discontinuation rates were slightly higher in older patients. Abemaciclib + ET improved PFS compared with placebo + ET independent of patient age, with no significant difference in abemaciclib treatment effect between the 3 age groups (MONARCH 2: interaction p-value, 0.695; MONARCH 3: interaction p-value, 0.634). Estimated hazard ratios ranged from 0.523–0.633 (MONARCH 2) and 0.480–0.635 (MONARCH 3).

Conclusions
While higher rates of adverse events were reported in older patients, they were manageable with dose adjustments and concomitant medication. Importantly, a consistent efficacy benefit was observed across all age groups.

Clinical trial registration
ClinicalTrials.gov: NCT02107703 (first posted April 8, 2014) and NCT02246621 (first posted September 23, 2014).
Regional shape, global function and mechanics in right ventricular volume and pressure overload conditions: a three-dimensional echocardiography study
Authors: Bidviene Jurate , Muraru Denisa , Maffessanti Francesco , Ereminiene Egle , Kovács Attila , Lakatos Bálint , Vaskelyte Jolanta-Justina , Zaliunas Remigijus , Surkova Elena , Parati Gianfranco , Badano Luigi P. 
Published: January 2021

AbstractOur aim was to assess the regional right ventricular (RV) shape changes in pressure and volume overload conditions and their relations with RV function and mechanics. The end-diastolic and end-systolic RV endocardial surfaces were analyzed with three-dimensional echocardiography (3DE) in 33 patients with RV volume overload (rToF), 31 patients with RV pressure overload (PH), and 60 controls. The mean curvature of the RV inflow (RVIT) and outflow (RVOT) tracts, RV apex and body (both divided into free wall (FW) and septum) were measured. Zero curvature defined a flat surface, whereas positive or negative curvature indicated convexity or concavity, respectively. The longitudinal and radial RV wall motions were also obtained. rToF and PH patients had flatter FW (body and apex) and RVIT, more convex interventricular septum (body and apex) and RVOT than controls. rToF demonstrated a less bulging interventricular septum at end-systole than PH patients, resulting in a more convex shape of the RVFW (r = − 0.701, p < 0.0001), and worse RV longitudinal contraction (r = − 0.397, p = 0.02). PH patients showed flatter RVFW apex at end-systole compared to rToF (p < 0.01). In both groups, a flatter RVFW apex was associated with worse radial RV contraction (r = 0.362 in rToF, r = 0.482 in PH at end-diastole, and r = 0.555 in rToF, r = 0.379 in PH at end-systole, respectively). In PH group, the impairment of radial contraction was also related to flatter RVIT (r = 0.407) and more convex RVOT (r = − 0.525) at end-systole (p < 0.05). In conclusion, different loading conditions are associated to specific RV curvature changes, that are related to longitudinal and radial RV dysfunction.
Left atrial strain rate during atrial contraction predicts raised pulmonary capillary wedge pressure: evidence for left atrio-ventricular interaction
Authors: Lindqvist Per , Henein Michael 
Published: January 2021

AbstractThis study aimed to assess the relationship between different LA strain components and PCWP as well as to the relationship with other established methods. We studied 144 symptomatic patients, age 63 ± 14 years, 54 males, using conventional transthoracic echocardiography protocols, including LA and LV myocardial deformation from speckle tracking technique investigations along with simultaneous right heart catheterization (RHC) using established techniques. From RHC, pulmonary artery pressure (PAP), and pulmonary capillary wedge pressure (PCWP) were measured and pulmonary vascular resistance (PVR) calculated. LA strain rate during atrial contraction (LASRa) was the strongest correlate with PCWP (r2 =  − 0.40, p < 0.001), over and above both LASR during LV systole (LASRs) and LA longitudinal strain during ventricular systole (LASs) (r2 = 0.21 and 0.19, respectively, p < 0.001 for both). The correlation between LASRa and PCWP was stronger in patients with post-capillary PH compared to pre-capillary PH (r2 = 0.21 vs. r2 = 0.02, respectively). The strongest relationship between LASRa and PCWP was in patients with enlarged LA volume > 34 ml/m2 (r2 = 0.60, p < 0.001). In all patients LASRa <  = 0.9 1/s was 88% accurate in predicting LA pressure > 15 mmHg which was superior to recently proposed uni- and multi-variable models. LASR during atrial contraction is the strongest predictor of PCWP, particularly in patients with post-capillary PH and with dilated LA cavity. Furthermore, it proved superior to recently proposed uni- and multi-variable based algorithms. Its close relationship with LV strain rate counterpart reflects important left heart chamber interaction in patients with raised LA pressure.
A Pedagogy of Preparation: Helping Underprepared Students Succeed in College-Level Coursework in Community Colleges
Authors: Brower Rebecca L. , Nix Amanda N. , Daniels Hollie , Hu Xinye , Jones Tamara Bertrand , Hu Shouping 
Published: January 2021

AbstractThis paper presents an overall educational philosophy of working with students underprepared for college-level work, which we term “a pedagogy of preparation.” We consider how instructors scaffolded instruction to foster college readiness in students who were now able to enroll in college-level work regardless of academic preparation after state-level legislation (SB 1720) that dramatically altered the delivery of developmental education in the Florida College System (FCS). We also consider how collaboration increased among campus personnel after the legislation to foster college readiness in students underprepared for college-level work.
Comprehensive evaluation of corneas from normal, forme fruste keratoconus and clinical keratoconus patients using morphological and biomechanical properties
Authors: Zhang Hui , Tian Lei , Guo Lili , Qin Xiao , Zhang Di , Li Lin , Jie Ying , Zhang Haixia 
Published: January 2021

Abstract
Objective
To more comprehensively evaluate the ability of the parameters reflecting the morphological and biomechanical properties of the cornea to distinguish clinical keratoconus (CKC) and forme fruste keratoconus (FFKC) from normal.

Methods
Normal eyes (n = 50), CKC (n = 45) and FFKC (n = 15) were analyzed using Pentacam, Corvis ST and ORA. Stepwise logistic regression of all parameters was performed to obtain the optimal combination model capable of distinguishing CKC, FFKC from normal, named SLR1 and SLR2, respectively. Receiver operating characteristic (ROC) curves were applied to determine the predictive accuracy of the parameters and the two combination models, as described by the area under the curve (AUC). AUCs were compared using the DeLong method.

Results
The SLR1 model included only the TBI output by Pentacam, while the SLR2 model included the morphological parameter F.Ele.Th and two parameters from the Corvis ST, HC DfA and SP-A1. The majority of the parameters had sufficient strength to differentiate the CKC from normal corneas, even the seven separate parameters and the SLR1 model had a discrimination efficiency of 100%. The predictive accuracy of the parameters was moderate for FFKC, and the SLR2 model (0.965) presented an excellent AUC, followed by TBI, F.Ele.Th and BAD-D.

Conclusion
The F.Ele.Th from Pentacam was the most sensitive morphological parameter for FFKC, and the combination of F.Ele.Th, HC DfA and SP-A1 made the diagnosis of FFKC more efficient. The CRF and CH output by ORA did not improve the combined diagnosis, despite the corneal combination of morphological and biomechanical properties that optimized the diagnosis of FFKC.
Effect of light quality and quantity on productivity and phycoerythrin concentration in the cryptophyte Rhodomonas sp.
Authors: Latsos Christos , van Houcke Jasper , Blommaert Lander , Verbeeke Gabrielle P. , Kromkamp Jacco , Timmermans Klaas R. 
Published: January 2021

AbstractThe cryptophyteRhodomonassp.is a potential feed source for aquaculture live feed and resource for phycoerythrin (PE) production. This research investigates the influence of light, both quality and quantity, on the biomass productivity, composition and growth rate ofRhodomonassp. The incident light intensity used in the experiments was 50 μmolphotonsm−2 s−1, irrespective of the colour of the light, and cultivation took place in lab-scale flat-panel photobioreactors in turbidostat mode. The highest productivity in volumetric biomass (0.20 gdry weightL−1 day−1), measured under continuous illumination, was observed under green light conditions. Blue and red light illumination resulted in lower productivities, 0.11 gdry weightL−1 day−1and 0.02 g L−1 day−1respectively. The differences in production are ascribed to increased absorption of green and blue wavelength by phycoerythrin, chlorophyll and carotenoids, causing higher photosynthetically usable radiation (PUR) from equal photosynthetically absorbed irradiance (PAR). Moreover, phycoerythrin concentration (281.16 mg gDW−1) was stimulated under red light illumination. Because photosystem II (PSII) absorbs poorly red light, the algae had to induce more pigments in order to negate the lower absorption per unit pigment of the incident available photons. The results of this study indicate that green light can be used in the initial growth ofRhodomonassp.to produce more biomass and, at a later stage, red light could be implemented to stimulate the synthesis of PE. Fourier-transform infrared spectroscopy (FTIR) analysis demonstrated a significant difference between the cells under different light quality, with higher contents of proteins for samples ofRhodomonassp.cultivated under green light conditions. In comparison, higher carbohydrate contents were observed for cells that were grown under red and blue light.
Possibility of an integrated transmission electron microscope: enabling complex in-situ experiments
Authors: Hattar Khalid , Jungjohann Katherine L. 
Published: January 2021

Abstract
Multimodal in-situ experiments are the wave of the future, as this approach will permit multispectral data collection and analysis during real-time nanoscale observation. In contrast, the evolution of technique development in the electron microscopy field has generally trended toward specialization and subsequent bifurcation into more and more niche instruments, creating a challenge for reintegration and backward compatibility for in-situ experiments on state-of-the-art microscopes. We do not believe this to be a requirement in the field; therefore, we propose an adaptive instrument that is designed to allow nearly simultaneous collection of data from aberration-corrected transmission electron microscopy (TEM), probe-corrected scanning transmission electron microscopy, ultrafast TEM, and dynamic TEM with a flexible in-situ testing chamber, where the entire instrument can be modified as future technologies are developed. The value would be to obtain a holistic understanding of the underlying physics and chemistry of the process-structure–property relationships in materials exposed to controlled extreme environments. Such a tool would permit the ability to explore, in-situ, the active reaction mechanisms in a controlled manner emulating those of real-world applications with nanometer and nanosecond resolution. If such a powerful tool is developed, it has the potential to revolutionize our materials understanding of nanoscale mechanisms and transients.

Graphical Abstract
Defect structures of sodium and chloride co-substituted hydroxyapatite and its osseointegration capacity
Authors: Yoo Dong Su , Cho Jung Sang , Chung Yong-Chae , Rhee Sang-Hoon 
Published: January 2021

AbstractA defect structure and osseointegration capacity of sodium and chloride co-substituted hydroxyapatite (NaClAp) were newly studied. The NaClAp was prepared by reacting H3PO4 and Ca(OH)2 with NaNO3 and NH4Cl followed by sintering; pure hydroxyapatite (HAp) was synthesized as a control. After sintering, the co-substitution of Ca and OH with Na and Cl, respectively, produced charged point defects at Ca and PO4 sites. Also, OH molecules partially adopted a head-on structure. The calculated total system energy of NaClAp was higher, whereas the binding energies between each constituent elements and system were lower than those of HAp. These results suggest that NaClAp was less stable than HAp, due to the formation of various defects by co-substitution of Na and Cl. Indeed, NaClAp exhibited higher dissolution behavior in simulated body fluid (SBF) compared with HAp. Accordingly, this increased the capability to produce low crystalline hydroxyl carbonate apatite, likely due to the increasing degree of apatite supersaturation in SBF. Besides, the NaClAp granules showed noticeable improvements in osseointegration capacity four weeks after in vivo test compared with HAp. Collectively, these results imply that the defects made by multiple ion substitutions are useful to increase osseointegration capacity of hydroxyapatite.
Serum Sp17 Autoantibody Serves as a Potential Specific Biomarker in Patients with SAPHO Syndrome
Authors: You Hongqin , Dang Guanglei , Lu Bichao , Zhang Siya , Li Chen , Wang Lun , Hu Yu , Chen Hui , Zhang Jianmin , He Wei 
Published: January 2021

AbstractSAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome shows a wide variability in musculoskeletal and cutaneous manifestations, and it is therefore underrecognized and misdiagnosed in the clinic due to a lack of specific markers. In this study, we aimed to identify specific biomarkers by screening serum autoantibodies in SAPHO patients with a 17K human whole-proteome microarray. The serum anti-Sp17 autoantibody was identified and verified to be a specific biomarker in patients with SAPHO syndrome. Indeed, the level of the anti-Sp17 autoantibody was significantly increased in patients with active SAPHO compared to patients with an inactive disease and healthy controls (P < 0.05). Additionally, serum anti-Sp17 autoantibody levels correlated with those of serum hypersensitive C-reactive protein (hsCRP), the erythrocyte sedimentation rate (ESR), and β-crosslaps (β-CTx) in patients with active SAPHO disease. Moreover, anti-Sp17 autoantibody levels were markedly decreased after anti-inflammatory treatment with pamidronate disodium, which downregulated levels of hsCRP and ESR in patients with active SAPHO. Thus, serum levels of the anti-Sp17 autoantibody might serve as a specific biomarker for the diagnosis of SAPHO syndrome or for monitoring the disease status.
Off-Axis Current Drive with Helicon Waves for CFETR
Authors: Yang Yuqing , Zhang Xinjun , Zhao Yanping , Qin Chengming 
Published: January 2021

AbstractOff-axis current drive is necessary for Tokamak to maintain and regulate the current profile. Helicon wave is the high order harmonic fast wave and helicon wave current drive (HCD) is one of the key issues in the China Fusion Engineering Test Reactor (CFETR). The theory of HCD is briefly introduced and the simulation results are listed. Helicon waves can realize off-axis current drive under CFETR plasma parameters when the frequency is greater than 1 GHz and drive current is insensitive to the launched value of the parallel index of refraction n||, so wave accessibility issues can be reduced. Travelling Wave Antenna was analyzed by the commercial software package-CST. Near the resonant frequency of the antenna, the Voltage Standing Wave Ratio < 1.2 is obtained for the antenna in the bandwidth of 50 MHz, which means that the antenna does not require a matching system.
Population pharmacokinetic modeling of intramuscular and oral dexamethasone and betamethasone in Indian women
Authors: Krzyzanski Wojciech , Milad Mark A. , Jobe Alan H. , Peppard Thomas , Bies Robert R. , Jusko William J. 
Published: January 2021

AbstractPopulation analysis of pharmacokinetic data for five differing dosage forms and routes for dexamethasone and betamethasone in 48 healthy nonpregnant Indian women was performed that accounted for a partial and complex cross-over design. Single doses of 6 mg dexamethasone phosphate (DEX-P), betamethasone phosphate (BET-P), or 1:1 mixture of betamethasone phosphate and acetate (BET-PA) were administered orally (PO) or intramuscularly (IM). Plasma concentrations collected for two periods over 96 h were described with a two-compartment model with differing PO and IM first-order absorption inputs. Clearances and volumes were divided by the IM bioavailability $${F}_{IM}$$

F

IM

. The homogeneous ages, body weights, and ethnicity of the women obviated covariate analysis. Parameter estimates were obtained by the Laplace estimation method implemented in NONMEM 7.4. Typical values for dexamethasone were clearance ($${CL/F}_{IM})$$

C
L
/
F

IM

)

of 9.29 L/h, steady-state volume ($${{V}_{ss}/F}_{IM})$$

V

ss

/
F

IM

)

of 56.4 L, IM absorption constant $$\left({k}_{aIM}\right)$$

k

aIM

of 0.460 1/h and oral absorption constant ($${k}_{aPO})$$

k

aPO

)

of 0.936 1/h. Betamethasone parameters were CL/FIM of 5.95 L/h, $${Vss/F}_{IM}$$

V
s
s
/
F

IM

of 72.4 L, $${k}_{aIM}$$

k

aIM

of 0.971 1/h, and $${k}_{aPO}$$

k

aPO

of 1.21 1/h. The PO to IM F values were close to 1.0 for both drugs. The terminal half-lives averaged about 7.5 h for DEX, 17 h for BET, and 78 h for BET from BET-PA with the latter reflecting very slow release of BET from the acetate ester. Overall, BET exhibited slower clearance, larger volume of distribution, faster absorption, and longer persistence than DEX. These data may be useful in considering exposures when substituting one form of corticosteroid for another.