bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primitive ovarian carcinosarcoma: a clinical and radiological analysis of five cases
Authors: Xu Qiong , Zhang Xiaofei , Zou Yu 
Published: October 2020

Abstract

Background
Ovarian carcinosarcomas (OCS) are very rare tumors composed of a mixture of carcinomatous and sarcomatous elements. There have been only scattered case studies that have described the imaging findings. In order to improve the awareness of this rare tumor, this study aimed to analyze the clinical and imaging features of five cases of OCS confirmed by surgical pathologic evaluation.

Methods
This retrospective study includes five OCS patients diagnosed and treated at our institute. The clinical course and imaging findings of all patients were retrospectively analyzed. The patients were 31 to 59 years of age. All five patients underwent CT scans, two underwent MRI scans.

Results
The five patients have no specific symptoms. Four patients had elevated CA 125 levels and three patients had elevated CA 153 levels. All patients had unilateral tumors, four in the left ovary, one in the right ovary. The largest transverse diameter of the tumors ranged from 11 cm to 14 cm. Two tumors showed solid masses with unequally sized cystic areas or necrosis, one showed a multilocular cystic mass with a large solid protrusion, two tumors showed a larger cystic mass with multiple mural nodules. The solid components of the tumors demonstrated restricted diffusion (the average ADC value being 998 mm2/s and 1102 mm2/s, respectively), and showed moderate or obvious enhancement. All five patients were treated by surgical resection and adjuvant chemotherapy. One patient is currently undergoing post-operative chemotherapy 1 month after operation and clinical stable. Three patients survived and showed no obvious recurrence and / or metastasis in follow-up from 9 to 59 months. One patient died from recurrence and metastasis.

Conclusions
OCS are rare and demonstrate variable CT and MRI morphological appearances. Due to the heterogeneous nature and very low morbidity of OCS, combination of careful analysis of imaging findings and clinical features might be useful for a more accurate diagnosis of OCS.
Emergency department crowding and hospital transformation during COVID-19, a retrospective, descriptive study of a university hospital in Stockholm, Sweden
Authors: af Ugglas Björn , Skyttberg Niclas , Wladis Andreas , Djärv Therese , Holzmann Martin J. 
Published: October 2020

Abstract

Objectives
COVID-19 presents challenges to the emergency care system that could lead to emergency department (ED) crowding. The Huddinge site at the Karolinska university hospital (KH) responded through a rapid transformation of inpatient care capacity together with changing working methods in the ED. The aim is to describe the KH response to the COVID-19 crisis, and how ED crowding, and important input, throughput and output factors for ED crowding developed at KH during a 30-day baseline period followed by the first 60 days of the COVID-19 outbreak in Stockholm Region.

Methods
Different phases in the development of the crisis were described and identified retrospectively based on major events that changed the conditions for the ED. Results were presented for each phase separately. The outcome ED length of stay (ED LOS) was calculated with mean and 95% confidence intervals. Input, throughput, output and demographic factors were described using distributions, proportions and means. Pearson correlation between ED LOS and emergency ward occupancy by phase was estimated with 95% confidence interval.

Results
As new working methods were introduced between phase 2 and 3, ED LOS declined from mean (95% CI) 386 (373–399) minutes to 307 (297–317). Imaging proportion was reduced from 29 to 18% and admission rate increased from 34 to 43%. Correlation (95% CI) between emergency ward occupancy and ED LOS by phase was 0.94 (0.55–0.99).

Conclusions
It is possible to avoid ED crowding, even during extreme and quickly changing conditions by leveraging previously known input, throughput and output factors. One key factor was the change in working methods in the ED with higher competence, less diagnostics and increased focus on rapid clinical admission decisions. Another important factor was the reduction in bed occupancy in emergency wards that enabled a timely admission to inpatient care. A key limitation was the retrospective study design.
Local and distant tumor dormancy during early stage breast cancer are associated with the predominance of infiltrating T effector subsets
Authors: Aqbi Hussein F. , Coleman Cara , Zarei Melika , Manjili Saeed H. , Graham Laura , Koblinski Jennifer , Guo Chunquing , Xie Yibin , Guruli Georgi , Bear Harry D. , Idowu Michael O. , Habibi Mehran , Wang Xiang-Yang , Manjili Masoud H. 
Published: October 2020

AbstractBackgroundAlthough breast cancer mortality is a result of distant recurrences associated with the establishment of tumor dormancy, current clinical practice guidelines recommend a wait and watch approach for tumor recurrences. This is because of our limited understanding of tumor dormancy and insufficient evidence in support of immunological control of tumor dormancy.MethodsWe used FVBN202 transgenic mice expressing rat neu oncogene in the mammary glands, and their parental FVB strain lacking neu expression. These models allowed the detection of tumor dormancy at distant sites using the rat neu protein as a tumor marker. We also used Ki67 for the detection of the indolent and quiescent types of tumor dormancy. Multicolor flow cytometry was used to detect dormant tumor cells and T cell subsets. Co-culture studies were performed to determine the role of T cells in preventing regrowth of dormant cells.ResultsWe demonstrated that dormant tumor cells were present at the site of primary breast cancer and at distant sites in the lungs and in the liver very early in the course of early stage breast cancer when no distant metastasis was evident. Dormant tumor cells were characterized as neu expressing Ki67−and Ki67lowfractions associated with the induction of local immune responses predominated by CD4+ and CD8+ T effector cell subsets. The presence of neu-autoreactive T cells from FVBN202 mice only prevented regrowth of dormant cells. On the other hand, presence of neu-alloreactive anti-tumor T cells in FVB mice prior to tumor challenge resulted in the protection of mice from the dissemination of dormant tumor cells to distant organs.ConclusionOur results suggest that immunotherapeutic targeting of semi-allogeneic mutant neoantigens during tumor dormancy might prevent distant recurrence of the disease.
Autologous peripheral blood-derived stem cells transplantation for treatment of no-option angiitis-induced critical limb ischemia: 10-year management experience
Authors: Fang Gang , Jiang Xiaolang , Fang Yuan , Pan Tianyue , Liu Hao , Ren Bichen , Wei Zheng , Gu Shiyang , Chen Bin , Jiang Junhao , Shi Yun , Guo Daqiao , Liu Peng , Fu Weiguo , Dong Zhihui 
Published: October 2020

Abstract

Background
Previous studies have demonstrated that no-option angiitis-induced critical limb ischemia (NO-AICLI) could be significantly improved by transplantation of peripheral blood-derived stem cells (PBDSCs). Additionally, a randomized controlled trial (RCT) recently conducted by us suggested that peripheral blood-derived purified CD34+ cells (PCCs) were not inferior to non-purified peripheral blood mononuclear cells (PBMNCs) at limb salvage in treatment of NO-AICLI. However, most of these clinical trials whether RCT or single-arm studies were characterized with a small sample size and absence of long-term outcomes.

Methods
To analyze long-term clinical outcomes of PBDSCs transplantation for NO-AICLI, we reviewed clinical data of patients with NO-AICLI receiving PBDSCs transplantation at our center during the past decade. Meanwhile, we first compared the long-term safety and efficacy of intramuscular transplantation of PCCs versus PBMNCs in a sizable number of patients with NO-AICLI.

Results
From May 2009 to December 2019, a total of 160 patients with NO-AICLI patients were treated by PBDSCs transplantation (82 with PCCs, 78 with PBMNCs) at our center. Baseline characteristics between two groups were similar. Up to June 2020, the mean follow-up period was 46.6 ± 35.3 months. No critical adverse events were observed in either group. There was one death during the follow-up period. A total of eight major amputations occurred. The cumulative major amputation-free survival (MAFS) rate at 5 years after PBDSCs transplantation was 94.4%, without difference between two groups (P = .855). Wound healing, rest pain, pain-free walking time, ankle-brachial index, transcutaneous oxygen pressure, and quality of life (QoL) also significantly improved after PBDSCs transplantation.

Conclusions
Autologous PBDSCs intramuscular transplantation could significantly decrease the major amputation rates and improve the QoL in patients with NO-AICLI. Long-term observation of a large sample of patients confirmed that the clinical benefits of PBDSCs transplantation were durable, without difference between the PCCs and PBMNCs groups.
Body mass index and self-reported body image in German adolescents
Authors: Sarrar Lea , Vilalta Marie , Schneider Nora , Correll Christoph U. 
Published: October 2020

Abstract

Background
Despite knowledge about eating disorder symptoms in children and adolescents in the general population, relatively little is known about self-reported and sex-specific eating-disorder-related psychopathology, as well as its specific correlates.

Methods
880 German school-attending adolescents (15.4 ± 2.2 years) and 30 female patients with AN (16.2 ± 1.6 years) were studied. All participants completed the Eating Disorder Inventory-2 and a Body Image Questionnaire.

Results
There were more overweight males than females (15.2% vs 10.1%, p < 0.001), but more females with underweight than males (6.2% vs. 2.5%, p < .001). Negative body evaluations (p < .001) and dissatisfaction (p < .001) were significantly more frequent in females. Compared to underweight female patients with AN, underweight school-attending females had less negative body evaluations (p < .001) and lower scores on 5 of the 11 EDI-2 subscales (p < .001; p < .05).

Conclusions
Males were more overweight than females, females more underweight. Body image was more important to female than to male youth, yet without reaching pathological values when compared to female patients with AN. Complex emotional and cognitive challenges seem to be a representative factor for eating pathology rather than simply being underweight. These aspects may be relevant for the shift from a thinness-related focus in girls in the general population to the development of an eating disorder.
Comparison of approaches for intrusion detection in substations using the IEC 60870-5-104 protocol
Authors: Egger Michael , Eibl Günther , Engel Dominik 
Published: October 2020

Abstract
Electrical networks of transmission system operators are mostly built up as isolated networks without access to the Internet. With the increasing popularity of smart grids, securing the communication network has become more important to avoid cyber-attacks that could result in possible power outages. For misuse detection, signature-based approaches are already in use and special rules for a wide range of protocols have been developed. However, one big disadvantage of signature-based intrusion detection is that zero-day exploits cannot be detected. Machine-learning-based anomaly detection methods have the potential to achieve that. In this paper, various such methods for intrusion detection in substations, which use the asynchronous communication protocol International Electrotechnical Commission (IEC) 60870-5-104, are tested and compared. The evaluation of the proposed methods is performed by applying them to a data set which includes normal operation traffic and four different attacks. While the results of supervised and semi-supervised machine learning approaches are rather encouraging, the unsupervised and signature-based methods suffer from general bad performance and had difficulties to detect some attacks.
State description of cyber-physical energy systems
Authors: Klaes Marcel , Narayan Anand , Patil Amit Dilip , Haack Jonas , Lindner Martin , Rehtanz Christian , Braun Martin , Lehnhoff Sebastian , Meer Hermann de 
Published: October 2020

AbstractThe integration of ICT into power systems has increased the interdependencies between the two systems. The operation of power system depends on several ICT-enabled grid services which manifest the interdependencies. ENTSO-E system state classification is a tool that is widely used by operators to determine the current operational state of the power system. However, it does not adequately describe the impact of ICT disturbances on the operation of the power system. Despite their interconnections, the operational states of both systems have been described separately so far. This paper bridges the well-established ENTSO-E systems state classification with an ICT system state classification, forming a new model considering the state classification of the ICT-enabled grid services. The model is developed by first identifying the ICT-enabled services, remedial actions and the respective performance requirements that are required by the power system. Then the states of these services are specified based on the supporting ICT system. The resulting joint state description shows how performance degradation of ICT-enabled services (introduced by disturbances) can affect the operation of the interconnected power system. Two case studies of such ICT-enabled services, namely state estimation and on-load tap changer control, are investigated in terms of how their operational states affect the states of the power system. A third case study highlights the interdependencies that exist between the services. These case studies demonstrate the interdependencies that exist between power and ICT systems in modern cyber-physical energy systems, thus highlighting the usage of a unified system state description.
Non intrusive load monitoring for demand side management
Authors: Salani Matteo , Derboni Marco , Rivola Davide , Medici Vasco , Nespoli Lorenzo , Rosato Federico , Rizzoli Andrea E. 
Published: October 2020

Abstract
In the context of a pilot project, the Lugaggia Innovation Community (LIC), we address the problem of non-intrusive load monitoring for the purpose of demand side management on low voltage grids in presence of distributed power generation (photovoltaic). From the power readings of smart meters, we estimate the photovoltaic production and detect the activation of major loads (heatpumps and domestic water heaters). Experiments, conducted with real data and in silico, show that exploiting meter readings only, we can estimate PV production with MAPE ranging from 4.6% (best case) to 41.9% (worst case). Even with non negligible photovoltaic production estimation errors, the proposed method is capable of detecting the activation of heatpumps and domestic water heaters.
Methodological and ethical challenges while conducting qualitative research on spirituality and end of life in a Muslim context: a guide to novice researchers
Authors: Lalani Nasreen , Ali Gulnar 
Published: October 2020

AbstractSpirituality could be understood as a personal belief, a relation with sacred, divine experience, a sense of purpose and meaning towards life, authenticity and connectedness. It is a continually evolving, highly complex, contextual, subjective, and sensitive construct. A continuous development is seen around understanding about spirituality and spiritual concepts, such as spiritual experiences, spiritual pain and spiritual distress, especially among patients and families at the end of life. The concepts, values, attitudes, and beliefs around spirituality, spiritual needs and expressions vary among different individuals, cultures, and religions. There is a dearth of literature around spirituality, especially among Muslim patients and families at the end of life. The complexities around the concept of spirituality in the literature raise several ethical and methodological concerns for a novice researcher while planning and conducting a study on spirituality during end-of-life care in a hospice setting, especially among a Muslim population. This paper aims to share some of the methodological and ethical challenges that can be faced by qualitative researchers while conducting research around spirituality and end-of-life care in an Islamic/Muslim context. Major challenges include defining the term spirituality, spirituality and culture, communication, power relations, language and translation, recruitment and selection of the participants, emotional distress, and reflexivity and reciprocity. Having an in-depth understanding of these challenges can guide researchers to address these issues adequately in their spirituality research in a Muslim context.
Oxidative Stress Responses and Nutrient Starvation in MCHM Treated Saccharomyces cerevisiae
Authors: Ayers Michael C , Sherman Zachary N , Gallagher Jennifer E G 
Published: October 2020

Abstract
In 2014, the coal cleaning chemical 4-methylcyclohexane methanol (MCHM) spilled into the water supply for 300,000 West Virginians. Initial toxicology tests showed relatively mild results, but the underlying effects on cellular biology were underexplored. Treated wildtype yeast cells grew poorly, but there was only a small decrease in cell viability. Cell cycle analysis revealed an absence of cells in S phase within thirty minutes of treatment. Cells accumulated in G1 over a six-hour time course, indicating arrest instead of death. A genetic screen of the haploid knockout collection revealed 329 high confidence genes required for optimal growth in MCHM. These genes encode three major cell processes: mitochondrial gene expression/translation, the vacuolar ATPase, and aromatic amino acid biosynthesis. The transcriptome showed an upregulation of pleiotropic drug response genes and amino acid biosynthetic genes and downregulation in ribosome biosynthesis. Analysis of these datasets pointed to environmental stress response activation upon treatment. Overlap in datasets included the aromatic amino acid genes ARO1, ARO3, and four of the five TRP genes. This implicated nutrient deprivation as the signal for stress response. Excess supplementation of nutrients and amino acids did not improve growth on MCHM, so the source of nutrient deprivation signal is still unclear. Reactive oxygen species and DNA damage were directly detected with MCHM treatment, but timepoints showed these accumulated slower than cells arrested. We propose that wildtype cells arrest from nutrient deprivation and survive, accumulating oxidative damage through the implementation of robust environmental stress responses.
A szemészeti állapot és az életminőség kapcsolódó mérőszámai különböző korcsoportokban
Authors: Zeffer Tamás , Szalay László , Deák Klára , Vass Attila , Fejes Imre , Czibula Ágota , Zubreczki Anita , Facskó Andrea , Skribek Ákos 
Published: October 2020

Absztrakt:
Bevezetés: Az Egészségügyi Világszervezet adatai szerint 1,3
milliárd ember él a látásgyengeség valamilyen formájával, melynek mintegy 80%-a
megelőzhető lenne. Kutatások alátámasztják, hogy a látás csökkenése befolyásolja
az életminőséget, és megrövidíti a várható élettartamot.
Célkitűzés: A Szegedi Tudományegyetem több klinikájának
együttműködésével zajló, a 40 és 80 év közötti életkorú, dél-magyarországi
lakosság körében végzett felmérés (OTKA-NN-110932) szemészeti vizsgálati
eredményeinek rögzítése és ezek életminőséget befolyásoló hatásainak elemzése.
Módszer: Az Országos Tudományos Kutatási Alap által
finanszírozott keresztmetszeti kutatási programban összesen 731, 40 és 80 év
közötti személy vett részt. A bevont 731 alanyból 717 fő (397 nő és 320 férfi)
vett részt teljes körű szemészeti vizsgálaton és töltötte ki a NEI-VFQ-25
honosított kérdőívet. A statisztikai analízishez egy szempontos ANOVA- és
Mann–Whitney-próbát használtunk. A szignifikancia szintjeként a p<0,05
értéket határoztuk meg. Eredmények: A vizsgálatban részt vevő
személyeket 4 korcsoportra osztottuk: 1) 40–50 év, 2) 51–60 év, 3) 61–70 év, 4)
71–80 év. A szemszárazság, a lencsehomályok előfordulása, a szemüvegviselés, az
időskori maculadegeneratióra utaló eltérések jelenléte az életkor
előrehaladtával nőtt. A NEI-VFQ-25 kérdőív alskálái az életminőség romlását
mutatják a kor növekedésével és a szemészeti eltérések előfordulási
gyakoriságának fokozódásával összefüggésben. Következtetés: A
látás, mint a külvilág észlelésének meghatározó lehetősége, kiemelkedő helyet
foglal el az életminőséget befolyásoló tényezők között. Kutatásunk tendenciái
mutatják, hogy a látással kapcsolatos életminőséget jelző értékek a kor
előrehaladtával hogyan csökkennek. Ezért is tekintjük szükségesnek az idősebb
populáció rendszeres ellenőrzését, felismerendő és lehetőség szerint
kiküszöbölendő az életminőséget negatívan befolyásoló tényezőket. Orv Hetil.
2020; 161(43): 1824–1830.
Prediction of temporary disability due to of circulatory system diseases in housing and communal services employees
Authors: Bendyuk G Ya , Grishina N K , Dokhov M A , Sidorov A A 
Published: October 2020

Aim. To develop a prognostic model of incidence of temporary (short-term) disability due to cardiovascular diseases in a housing and communal services employees using the example of the State Unitary Enterprise (SUE) Vodokanal of St. Petersburg.
Methods. The study included 4634 people, observed in the departmental outpatient clinic of SUE Vodokanal of St. Petersburg, between 2015 and 2017 years. We calculated extensive indicators determining the disease patterns and intensive indicators characterizing the prevalence of the pathological process in the study of morbidity by the findings of periodic health examinations and incidence of short-term disability. The incidence of short-term disability was predicted by using the method of sequential analysis A. Wald modified by E.V. Gubler and the neural network.
Results. We found that based on the operational and statistical data of the medical and sanitary unit, using a neural network, relying on linear and nonlinear dependence of comorbidity, in particular, respiratory diseases, it is possible to predict (in 92.4% of cases) the incidence of temporary disability due to cardiovascular diseases in employees of the housing and communal services SUE Vodokanal of St. Petersburg. The high sensitivity (97.7%) and specificity (90.7%) of the method allows it to predict the need for treatment and prophylaxis measures in the contingent attached to the medical and sanitary unit.
Conclusion. The developed model allows to determine the main directions of preventive work to reduce the incidence of circulatory system diseases with temporary disability: prevention of high blood pressure and respiratory diseases.