bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary pancreatic glomus tumor invading into the superior mesenteric vein: a case report
Authors: Tamaki Ichiro , Hosoda Yohei , Sasano Hironobu , Sasaki Yu , Kiyochi Hidenori , Taki Yoshiro , Komoto Izumi 
Published: November 2020

AbstractBackgroundGlomus tumors are subcutaneous tumors arising from glomus bodies, thermoregulatory components of the skin. These tumors could occur in visceral organs where glomus bodies are not normally present. Herein, we report a case of primary pancreatic glomus tumor with aggressive direct invasion into the superior mesenteric vein (SMV). To the best of our knowledge, this is the second case report of a glomus tumor arising in the pancreas.Case presentationA 46-year-old woman was referred to our hospital due to vomiting with epigastric and back pain. Dynamic-CT revealed a well-circumscribed hypervascular mass, measuring 37 mm in its maximal diameter involving the pancreatic head. Both CT and endoscopic ultrasonography (EUS) revealed direct invasion into the SMV and radiologically suspected tumor thrombus. Biopsy sample obtained by EUS-guided fine needle aspiration revealed proliferation of small cells, round-to-oval tumor cells with round nuclei and scant cytoplasm. A histological diagnosis of pancreatic neuroendocrine tumor, G1 was initially considered. Therefore, subtotal stomach-preserving pancreatoduodenectomy using Child-II reconstruction was subsequently performed. Her SMV was resected and reconstructed due to extensive tumor involvement. Subsequent histopathological analysis revealed solid tumor cells proliferation that comprised oval-shaped nuclei and scant cytoplasm around disorganized or slit-shaped vessels in hematoxylin–eosin-stained slides. Immunohistochemical analysis then demonstrated positive immunoreactivity for smooth muscle actin, vimentin, and CD34, but negative for chromogranin A, synaptophysin, CD56, and signal transducer and activator of transcription 6. Based on these histological findings of resected specimens, the lesion was subsequently diagnosed as a primary pancreatic glomus tumor harboring direct invasion into the SMV. Her postoperative course was uneventful and annual surveys for the following 4 years post-op detected no clinical signs of recurrence.ConclusionsWe report a very rare case of glomus tumor of the pancreas accompanied by venous invasion. Curative surgical resection is the best treatment option for pancreatic glomus tumors. Although pancreatic glomus tumor is rare, it should be taken into consideration in the differential diagnosis of a pancreatic solid tumor with hypervascularity.
Differentiating combined pulmonary fibrosis and emphysema from pure emphysema: utility of late gadolinium-enhanced MRI
Authors: Fleming Hannah , Clifford Simon M. , Haughey Aoife , MacDermott Roisin , McVeigh Niall , Healy Gerard M. , Lavelle Lisa , Abbara Suhny , Murphy David J. , Fabre Aurelie , McKone Edward , McCarthy Cormac , Butler Marcus , Doran Peter , Lynch David A. , Keane Michael P. , Dodd Jonathan D. 
Published: November 2020

Abstract

Background
Differentiating combined pulmonary fibrosis with emphysema (CPFE) from pure emphysema can be challenging on high-resolution computed tomography (HRCT). This has antifibrotic therapy implications.

Methods
Twenty patients with suspected CPFE underwent late gadolinium-enhanced (LGE) thoracic magnetic resonance imaging (LGE-MRI) and HRCT. Data from twelve healthy control subjects from a previous study who underwent thoracic LGE-MRI were included for comparison. Quantitative LGE signal intensity (SI) was retrospectively compared in regions of fibrosis and emphysema in CPFE patients to similar lung regions in controls. Qualitative comparisons for the presence/extent of reticulation, honeycombing, and traction bronchiectasis between LGE-MRI and HRCT were assessed by two readers in consensus.

Results
There were significant quantitative differences in fibrosis SI compared to emphysema SI in CPFE patients (25.8, IQR 18.4–31.0 versus 5.3, IQR 5.0–8.1, p < 0.001). Significant differences were found between LGE-MRI and HRCT in the extent of reticulation (12.5, IQR 5.0–20.0 versus 25.0, IQR 15.0–26.3, p = 0.038) and honeycombing (5.0, IQR 0.0–10.0 versus 20.0, IQR 10.6–20.0, p = 0.001) but not traction bronchiectasis (10.0, IQR 5–15 versus 15.0, IQR 5–15, p = 0.878). Receiver operator curve analysis of fibrosis SI compared to similarly located regions in control subjects showed an area under the curve of 0.82 (p = 0.002). A SI cutoff of 19 yielded a sensitivity of 75% and specificity of 86% in differentiating fibrosis from similarly located regions in control subjects.

Conclusion
LGE-MRI can differentiate CPFE from pure emphysema and may be a useful adjunct test to HRCT in patients with suspected CPFE.
Assessment of the FINDRISC tool in predicting the risk of developing type 2 diabetes mellitus in a young adult Nigerian population
Authors: Nnamudi Anthony Chibuzor , Orhue Noghayin E. Jerry , Ijeh Ifeoma Irene 
Published: November 2020

AbstractBackgroundThe global prevalence of diabetes mellitus is assuming worrisome proportions even among children and young adults. This study is aimed at predicting the risk of developing type 2 diabetes mellitus in a young adult Nigerian population using the validated FINDRISC tool.ResultsData on 134 young adults [67 (50.0%) male and 67 (50.0%) female] analyzed in this study revealed a body mass index value of 24.86 ± 3.38 kg/m2(male) and 25.42 ± 5.39 kg/m2(female) with 43.2% of participants being overweight or obese. A waist circumference of 85.94 ± 9.69 cm (male) and 83.92 ± 15.24 cm (female) was recorded with 35.8% of participants having central obesity. A fasting blood glucose level of 82.04 ± 14.52 mg/dL (male) and 84.89 ± 18.30 mg/dL (female) was recorded with 32.8% of participants being hyperglycemic. The Finnish Diabetes Risk Scoring (FINDRISC) data [4.86 ± 3.24 (male) and 7.31 ± 3.38 (female)] showed that 1.5% have a high risk (FINDRISC 15–20) while 12.0% have a moderate to high risk (FINDRISC ≥ 12) of developing diabetes.ConclusionThe FINDRISC tool is an effective diagnostic tool for assessing diabetes risk. In future studies, there may be need to also develop a more specific indigenous risk assessment tool particularly for a young adult Nigerian population.
Practical pairing-Free sensor cooperation scheme for cloud-Assisted wireless body area networks
Authors: Song Yuanzhao , Tan Haowen 
Published: November 2020

Abstract
Nowadays, the design and construction of efficient internet of things (IoTs) has become a new strategies for improving living quality of all aspects. Emerging as one of the most significant extension of medical IoTs, wireless body area networks (WBANs) is capable of monitoring crucial physiological and behavioral information through wearable sensors, offering a new paradigm for the next-generation healthcare systems. As a matter of fact, due to the inherent open wireless communicating characteristics, data security and user privacy issues of WBANs have attracted attentions from both industry and academia. So far, lots of relevant researches emphasize on secure transmission and privacy protection. However, the computation and communication limitations for individual WBAN sensor have not been taken proper consideration. Moreover, the implementation of cloud computing infrastructure has provided WBANs with superior transmission and processing qualities. Emphasizing on the above issues, this paper construct a pairing-free authentication and sensor cooperation scheme in cloud-assisted WBANs, where most of the practical requirements for WBAN sensors could be satisfied. Our design guarantee the sensor anonymity in the whole transmission session. Note that our design offers pairing-free validation procedure followed with active sensor cooperation, which is suitable for massive sensor scenarios. The security analysis proves that our designed scheme is capable of achieving desired security properties and offer adequate resistances to the charted malicious attacks. Meanwhile, security comparison demonstrates that the proposed protocol is secure compared with the state-of-the-arts.
Trend and status of out-of-pocket payments for healthcare in Iran: equity and catastrophic effect
Authors: Rezaei Satar , Woldemichael Abraha , Ebrahimi Mohammad , Ahmadi Sina 
Published: November 2020

Abstract

Background
Equity in the distribution of health care resources and mitigating the risk of out-of-pocket (OOP) catastrophic healthcare expenditures (CHE) are the major objectives of the health system of a country. This study aims to measure equity in OOP payments for healthcare and the incidence of CHE among Iranian households over time.

Methods
This retrospective cross-sectional study utilized data extracted from the household income and expenditure survey (HIES) of Iran, collected by the Statistical Center of Iran. The analysis included a total of 174,341 households’ five yearly data of 6 years starting from 1991 to 2017. Kakwani progressivity index (KPI) was used to measure the equity in OOP payment for each year and examine the households’ incidence of CHE at 20%, 30%, and 40% of their capacities to pay (CTP). The trend series regression analysis was used to examine the trend in the KPI and the incidence of the CHE over time.

Results
The findings indicated that the households’ expenditure on health out of their monthly budgets for the years 1991 and 2017 were 2.1% and 10.1%, respectively. The KPI for the OOP payment was negative for all 6-year observations (1991 = − 0.680; 1996 = − 0.608; 2001 = − 0.554; 2006 = − 0.265; 2011 = − 0.225, and 2017 = − 0.207), indicating that the OOP payments for healthcare are regressive and more concentrated among the socioeconomically disadvantaged households. There was a statistically significant (p = 0.003) increase in the KPI (i.e., decline in the regressivity) over time. The incidence of the CHE (1.12, 1.93, and 3.71%) in 1991 at the CTP levels of 20%, 30%, and 40% was lower than the incidence at the corresponding levels of CTP (5.26, 10.88, and 22.16) in 2017. The findings of the time-series regression indicated a statistically significant (p < 0.05) increase in the incidence of the CHE at the 20%, 30%, and 40% levels of the households’ CTP.

Conclusions
The current study demonstrated that OOP payment as a source of healthcare funding in Iran is inequitable. While the use of interventions such as the prepaid and publicly funded programs may contribute to the reduction of CHE and improvement of equity in healthcare financing, further inequality analyses in the incidence of the CHE among households and its main determinants can contribute to evidence-informed planning to reduce the CHE in the context.
Antidiabetic Treatment, Level of Glycemic Control, and Risk of Fracture in Type 2 Diabetes: a Nested, Case-Control Study
Authors: Charlier Sarah , Vavanikunnel Janina , Becker Claudia , Jick Susan S , Meier Christian , Meier Christoph R 
Published: November 2020

Abstract

Context
Patients with type 2 diabetes mellitus (T2DM) have an increased risk of low-trauma fractures. However, the effect of antidiabetic medication in relation to glycemic control on the risk of fracture is poorly understood.

Objective
This work aimed to evaluate the association between the level of glycemic control, use of antidiabetic medication, and risk of low-trauma fractures in patients with newly diagnosed T2DM.

Methods
We conducted a nested case-control analysis among individuals registered in the Clinical Practice Research Datalink. The base population consisted of patients with newly diagnosed T2DM from 1995 to 2017. Cases were patients with a low-trauma fracture after T2DM diagnosis. We matched 4 controls to each case. Exposures of interest were glycemic control (last glycated hemoglobin [HbA1c] level before fracture) and type of diabetes treatment. We conducted conditional logistic regression analyses adjusted for several confounders.

Results
We identified 8809 cases and 35 219 controls. Patients with current metformin use and HbA1c levels of less than 7.0% and between 7.0-8.0% had a reduced risk of fractures (adjusted odds ratio 0.89; 95% CI, 0.83-0.96 and 0.81; 95% CI, 0.73-0.90, respectively) compared with untreated patients. However, in patients receiving metformin plus 1 or 2 other antidiabetic drugs, or insulin (alone or in addition to other antidiabetic medication), the level of glycemic control was not associated with the risk of fracture compared with untreated patients.

Conclusions
While patients with good or medium glycemic control receiving current metformin monotherapy had a lower risk of fracture compared with untreated patients, glycemic control in patients receiving treatment other than metformin was not associated with risk of fracture.
Thyroid Dysfunction in Relation to Immune Profile, Disease Status, and Outcome in 191 Patients with COVID-19
Authors: Lui David Tak Wai , Lee Chi Ho , Chow Wing Sun , Lee Alan Chun Hong , Tam Anthony Raymond , Fong Carol Ho Yi , Law Chun Yiu , Leung Eunice Ka Hong , To Kelvin Kai Wang , Tan Kathryn Choon Beng , Woo Yu Cho , Lam Ching Wan , Hung Ivan Fan Ngai , Lam Karen Siu Ling 
Published: November 2020

Abstract

Objective
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–related thyroiditis is increasingly recognized. The role of thyroid autoimmunity and SARS-CoV-2 viral load in SARS-CoV-2–related thyroid dysfunction is unclear. We evaluated the thyroid function of a cohort of coronavirus disease 2019 (COVID-19) patients, in relation to their clinical features, and biochemical, immunological, and inflammatory markers.

Methods
Consecutive adult patients, without known thyroid disorders, admitted to Queen Mary Hospital for COVID-19 from July 21 to August 21, 2020, were included. Serum levels of thyroid-stimulating hormone (TSH), free thyroxine, free triiodothyronine (fT3), and antithyroid antibodies were measured on admission.

Results
Among 191 patients with COVID-19 (mean age 53.5 ± 17.2 years; 51.8% male), 84.3% were mild, 12.6% were moderate, and 3.1% were severe. Abnormal thyroid function was seen in 13.1%. Ten patients had isolated low TSH, suggestive of subclinical thyrotoxicosis due to thyroiditis, although the contribution of autoimmunity was likely in 2 of them. Autoimmune thyroiditis probably also contributed to subclinical hypothyroidism in another patient. Ten patients had isolated low fT3, likely representing nonthyroidal illness syndrome. Lower SARS-Cov-2 polymerase chain reaction cycle threshold values and elevated C-reactive protein were independently associated with occurrence of low TSH (P = .030) and low fT3 (P = .007), respectively. A decreasing trend of fT3 with increasing COVID-19 severity (P = .032) was found. Patients with low fT3 had more adverse COVID-19-related outcomes.

Conclusion
Around 15% of patients with mild to moderate COVID-19 had thyroid dysfunction. There may be a direct effect of SARS-CoV-2 on thyroid function, potentially leading to exacerbation of pre-existing autoimmune thyroid disease. Low fT3, associated with systemic inflammation, may have a prognostic significance.
Evaluation of different teaching methods in the radiographic diagnosis of proximal carious lesions
Authors: Rocha Beatriz de Carvalho , Rosa Beatriz Salomão Porto-Alegre , Cerqueira Thaís Santos , de-Azevedo-Vaz Sergio Lins , Barbosa Gabriella Lopes de Rezende , Ferreira Liana Matos , Verner Francielle Silvestre , Visconti Maria Augusta 
Published: November 2020

Objectives: To evaluate four different teaching methodologies in the radiographic diagnosis of proximal carious lesions and in the students’ perception of these methodologies. Methods: 71 undergraduate dental students were subdivided into 4 groups according to the teaching methodologies used (traditional, hybrid, e-learning and problem-based learning). All methods were applied by two properly trained researchers. Initially, students completed a pre-methodology test (index test). After applying the teaching methodologies, the students were submitted to a post-methodology test containing periapical radiographs for evaluation of proximal carious lesions. Then, the students answered a questionnaire to verify their perception of the different teaching methodologies. Statistical analysis was done. Results: There were no relationship between the results of pre- and post-methodologies tests, irrespective of the teaching methodology employed (p > 0.05). No differences between the teaching methodologies studied (p > 0.05) were found regarding the amount of correct answers. However, the students who participated in the active (e-learning and problem-based learning) and hybrid teaching methodology reported a positive impact in relation to their diagnostic skills at the questionnaire. Conclusions: All the tested methodologies had a similar performance; however, the traditional methodology showed less acceptance by the students when analyzed subjectively and comparatively. The results of the present study increase comprehension about teaching methodologies for radiographic diagnosis of proximal carious lesions, and there is a potential to build on the knowledge base and provide practical support for students and educators.
Cost-effectiveness and public health impact of RTS,S/AS01E malaria vaccine in Malawi, using a Markov static model
Authors: Ndeketa Latif , Mategula Donnie , Terlouw Dianne J. , Bar-Zeev Naor , Sauboin Christophe J. , Biernaux Sophie 
Published: November 2020

Background: The RTS,S/AS01E malaria vaccine is being assessed in Malawi, Ghana and Kenya as part of a large-scale pilot implementation programme. Even if impactful, its incorporation into immunisation programmes will depend on demonstrating cost-effectiveness. We analysed the cost-effectiveness and public health impact of the RTS,S/AS01E malaria vaccine use in Malawi. Methods: We calculated the Incremental Cost Effectiveness Ratio (ICER) per disability-adjusted life year (DALY) averted by vaccination and compared it to Malawi’s mean per capita Gross Domestic Product. We used a previously validated Markov model, which simulated malaria progression in a 2017 Malawian birth cohort for 15 years. We used a 46% vaccine efficacy, 75% vaccine coverage, USD5 estimated cost per vaccine dose, published local treatment costs for clinical malaria and Malawi specific malaria indicators for interventions such as bed net and antimalarial use. We took a healthcare provider, household and societal perspective. Costs were discounted at 3% per year, no discounting was applied to DALYs. For public health impact, we calculated the DALYs, and malaria events averted. Results: The ICER/DALY averted was USD115 and USD109 for the health system perspective and societal perspective respectively, lower than GDP per capita of USD398.6 for Malawi. Sensitivity analyses exploring the impact of variation in vaccine costs, vaccine coverage rate and coverage of four doses showed vaccine implementation would be cost-effective across a wide range of different outcomes. RTS,S/AS01 was predicted to avert a median of 93,940 (range 20,490–126,540) clinical cases and 394 (127–708) deaths for the three-dose schedule, or 116,480 (31,450–160,410) clinical cases and 484 (189–859) deaths for the four-dose schedule, per 100 000 fully vaccinated children. Conclusions: We predict the introduction of the RTS,S/AS01 vaccine in the Malawian expanded programme of immunisation (EPI) likely to be highly cost effective.
High precision line-of-sight angle measuring and large ranging laser radar system for deep-space rendezvous and docking
Authors: Feng Zhihui , Yue Yongjian , Dai Dongjun , Yuan Linchen , Nan Yaming 
Published: November 2020

With the development of automatic rendezvous and docking missions from Earth orbit to deep space, new sensors are needed to perceive precise ranging and bearing information of the target at a longer distance. A new type of laser line-of-sight (LOS) deviation measuring and ranging system is developed, which is characterized by an operational range of 0.5 m to 20 km with a precision of 0.4 m (far) and 0.025 m (near), and a scanning range of up to

120

∘

×

145

∘

with an precision of LOS angle up to 0.025°. In addition, gaze-tracking capability enables the system to capture and track high-speed targets. The scheme of the designed system is presented in detail, including optical path design, scanning strategy for tracking, ranging signal processing, and LOS measurement. Meanwhile, the performance of the designed system is verified by extensive indoor and outdoor experiments, including ground simulated rendezvous and docking experiments from about 20 km to 0.5 m.
Baseline correction method based on improved asymmetrically reweighted penalized least squares for the Raman spectrum
Authors: Ye Jianfeng , Tian Ziyang , Wei Haoyun , Li Yan 
Published: November 2020

We present a baseline correction method based on improved asymmetrically reweighted penalized least squares (
IarPLS
) for the Raman spectrum. This method utilizes a new S-type function to reduce the risk of baseline overestimation and speed up the reweighting process. Simulated spectra with different levels of noise and measured spectra with strong fluorescence background from different samples are used to validate the performance of the proposed algorithm. Considering the drawbacks of the weighting rules for the asymmetrically reweighted penalized least squares (
arPLS
) method, we adapt an inverse square root unit (
ISRU
) function, which performs well in baseline correction. Compared with previous penalized least squares methods, such as asymmetric least squares, adaptive iteratively reweighted penalized least squares, and
arPLS
, experiments with the simulated Raman spectra have confirmed that the proposed method yields better outcomes. Experiments with the measured Raman spectra show that the
IarPLS
method can improve real Raman spectra within 20 ms. The results show that the proposed method can be successfully applied to the practical Raman spectrum as a strong basis for quantitative analysis.
Design, simulation, and analysis of an ultra-broadband polarization-insensitive terahertz metamaterial absorber
Authors: Pan Hao , Zhang Haifeng , Tian Xingliang , Zhang Dan 
Published: November 2020

A novel ultra-broadband polarization-insensitive metamaterial absorber is presented in this paper, which can work in the terahertz (THz) regime. By stacking two layers with a certain proportion separated by dielectric spacing layers, on which six nested rings of different sizes and other metal resonators are arranged, the metamaterial absorber for a TE wave can achieve absorption of over 90% at 2.28–5.58 THz, and that for the TM wave is located at 2.3–5.82 THz, whose relative bandwidths (RBWs) are 82.5% and 88%, respectively, which is shown in the simulation results. Moreover, the absorption performance of such an absorber remains stable at 2.3–5.58 THz, whose RBW is 82% when the wave is incident with different polarization angles, which implies that the metamaterial absorber has insensitivity towards polarization. The absorption mechanism for this absorber originates from the Fabry–Perot resonances among different layers and the magnetic resonances among the metal resonators, based on analysis of the distributions of the power loss density, surface current, and magnetic fields. The metamaterial absorber presented in this work is promising for application owing to its broad absorption band and insensitivity towards polarization.
Long-range Bloch surface waves in photonic crystal ridges
Authors: Perani Tommaso , Liscidini Marco 
Published: November 2020

We theoretically study light propagation in guided Bloch surface waves (BSWs) supported by photonic crystal ridges. We demonstrate that low propagation losses can be achieved just by a proper design of the multilayer to obtain photonic band gaps for both light polarizations. We present a design strategy based on a Fourier analysis that allows one to obtain intrinsic losses as low as 5 dB/km for a structure operating in the visible spectral range. These results clarify the limiting factors to light propagation in guided BSWs and represent a fundamental step towards the development of BSW-based integrated optical platforms.