bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prediction of the clinicopathological subtypes of breast cancer using a fisher discriminant analysis model based on radiomic features of diffusion-weighted MRI
Authors: Ni Ming , Zhou Xiaoming , Liu Jingwei , Yu Haiyang , Gao Yuanxiang , Zhang Xuexi , Li Zhiming 
Published: November 2020

AbstractBackgroundThe clinicopathological classification of breast cancer is proposed according to therapeutic purposes. It is simplified and can be conducted easily in clinical practice, and this subtyping undoubtedly contributes to the treatment selection of breast cancer. This study aims to investigate the feasibility of using a Fisher discriminant analysis model based on radiomic features of diffusion-weighted MRI for predicting the clinicopathological subtypes of breast cancer.MethodsPatients who underwent breast magnetic resonance imaging were confirmed by retrieving data from our institutional picture archiving and communication system (PACS) between March 2013 and September 2017. Five clinicopathological subtypes were determined based on the status of ER, PR, HER2 and Ki-67 from the immunohistochemical test. The radiomic features of diffusion-weighted imaging were derived from the volume of interest (VOI) of each tumour. Fisher discriminant analysis was performed for clinicopathological subtyping by using a backward selection method. To evaluate the diagnostic performance of the radiomic features, ROC analyses were performed to differentiate between immunohistochemical biomarker-positive and -negative groups.ResultsA total of 84 radiomic features of four statistical methods were included after preprocessing. The overall accuracy for predicting the clinicopathological subtypes was 96.4% by Fisher discriminant analysis, and the weighted accuracy was 96.6%. For predicting diverse clinicopathological subtypes, the prediction accuracies ranged from 92 to 100%. According to the cross-validation, the overall accuracy of the model was 82.1%, and the accuracies of the model for predicting the luminal A, luminal BHER2-, luminal BHER2+, HER2 positive and triple negative subtypes were 79, 77, 88, 92 and 73%, respectively. According to the ROC analysis, the radiomic features had excellent performance in differentiating between different statuses of ER, PR, HER2 and Ki-67.ConclusionsThe Fisher discriminant analysis model based on radiomic features of diffusion-weighted MRI is a reliable method for the prediction of clinicopathological breast cancer subtypes.
Long-term trends in colorectal cancer: incidence, localization, and presentation
Authors: Høydahl Øystein , Edna Tom-Harald , Xanthoulis Athanasios , Lydersen Stian , Endreseth Birger Henning 
Published: November 2020

Abstract

Background
The purpose of this study was to assess trends in incidence and presentation of colorectal cancer (CRC) over a period of 37 years in a stable population in Mid-Norway. Secondarily, we wanted to predict the future burden of CRC in the same catchment area.

Methods
All 2268 patients diagnosed with CRC at Levanger Hospital between 1980 and 2016 were included in this study. We used Poisson regression to calculate the incidence rate ratio (IRR) and analyse factors associated with incidence.

Results
The incidence of CRC increased from 43/100,000 person-years during 1980–1984 to 84/100,000 person-years during 2012–2016. Unadjusted IRR increased by 1.8% per year, corresponding to an overall increase in incidence of 94.5%. Changes in population (ageing and sex distribution) contributed to 28% of this increase, whereas 72% must be attributed to primary preventable factors associated with lifestyle. Compared with the last observational period, we predict a further 40% increase by 2030, and a 70% increase by 2040. Acute colorectal obstruction was associated with tumours in the left flexure and descending colon. Spontaneous colorectal perforation was associated with tumours in the descending colon, caecum, and sigmoid colon. The incidence of obstruction remained stable, while the incidence of perforation decreased throughout the observational period. The proportion of earlier stages at diagnosis increased significantly in recent decades.

Conclusion
CRC incidence increased substantially from 1980 to 2016, mainly due to primary preventable factors. The incidence will continue to increase during the next two decades, mainly due to further ageing of the population.
Microincision vitrectomy surgery: experimental visualization and quantification of vitreous contamination
Authors: Machida Yumiko , Nakashizuka Hiroyuki , Shoji Jun , Shimada Hiroyuki 
Published: November 2020

Abstract

Background
To visualize and quantify vitreous contamination following microincision vitrectomy surgery (MIVS) using an experimental vitreous contamination model (EVCM).

Methods
Enucleated porcine eyes with fluoresbrite carboxylate microspheres applied to the conjunctival surface were used as a type 1 EVCM. Twenty-five- or 27-gauge (G) trocar cannulas were inserted through the conjunctiva and sclera, followed by the placing and opening of an infusion cannula. These procedures were monitored by an intraocular fiber catheter. Secondly, condensed microspheres were applied to an excised sheet of porcine sclera to serve as type 2 EVCM. Twenty-five- or 27-G trocar cannulas were inserted perpendicularly through the top of the sclera where the condensed microspheres were applied, an infusion cannula was inserted, 0.1 mL of saline solution injected through the infusion cannula, and samples collected. The fluorescence strength of samples was then measured using fluorophotometry.

Results
We visually detected fluorescent microspheres in 10/10 eyes with 25-G and 10/10 with 27-G MIVS. In the experimental quantification study, each MIVS gauge value was significantly higher than the control (P < 0.01). However, there was no significant difference between 25-G and 27-G MIVS.

Conclusions
MIVS carries the risk of introducing contamination directly into the eyes when the trocar cannula is inserted and infusion cannula is opened, even when a 27-G MIVS is used. Our study has shown it is essential that the surgeon be aware of the possibility of introducing contamination from the conjunctiva at all times during MIVS.
Clinical characteristics, treatment, and long-term outcomes in children suffering from benign convulsions with mild gastroenteritis: a retrospective study
Authors: Hao Xiao-sheng , Liang Jian-min , Wu Xue-mei , Hao Yun-peng , Wang Jiang-tao , Liu Song-yan 
Published: November 2020

Abstract

Background
Benign convulsions with mild gastroenteritis (BCWG) is a common condition in children in Asia and is generally not associated with pH or electrolyte imbalances. When BCWG is diagnosed, a lumbar puncture is usually recommended to rule out potential intracranial infections. This study examined the clinical characteristics of BCWG and evaluated the necessity of lumbar puncture.

Methods
Medical records of children admitted to the First Hospital of Jilin University with BCWG between January 2018 and May 2019 were reviewed and analyzed. Children were stratified by rotavirus positivity or lumbar puncture status. Clinical characteristics and long-term outcomes were compared between groups.

Results
A total of 51 children were included in the analyses (55.1% rotavirus [HRV] positive). The average age of convulsion onset was 21.12 ± 7.44 months, the male-to-female ratio was 1.8:1, and convulsions occurred primarily between October 2018 and April 2019. The main clinical presentations of BCWG were convulsions, vomiting, diarrhea, and fever. Convulsions occurred predominantly two days after diagnosis of gastroenteritis, were mainly generalized tonic-clonic with 88.2% of children having ≤ 3 convulsions per episode, and had a mean duration of 2.0 minutes (interquartile range [IQR]: 1.0, 3.0). Children with BCWG had mild metabolic acidosis (HCO3− 17.82 ± 3.63 mmol/L) with an elevated anion gap (AG; 20.98 ± 3.00 mmol/L), mild hyponatremia (134.56 ± 2.85 mmol/L), and slightly increased levels of creatine kinase myocardial band (CKMB). HRV + children had more severe acidosis and higher CKMB levels. Cerebrospinal fluid (CSF) samples collected via lumbar puncture were normal. No developmental abnormalities were noted as assessed by the Social Life Ability Scale.

Conclusions
BCWG is a situation-related seizure, with clinical presentations of tonic-clonic or focal convulsions and mild gastroenteritis (vomiting, diarrhea). Mild metabolic acidosis and hyponatremia may exist. The prognosis of the disease is favorable; lumbar puncture and long-term antiepileptics are unnecessary and should not be recommended.
‘The mean mummy way’ – experiences of parents instilling eye drops to their young children as described in online forums and blogs
Authors: Law Gloria C. , Bülbül Alpaslan , Jones Christina J. , Smith Helen 
Published: November 2020

Abstract

Background
Adults often have difficulty instilling eye drops in their own eyes, but little has been documented about the difficulties experienced by parents when administering eye drops to their young children, where the challenges of instillation are accentuated by their inability to cooperate. This qualitative study explores parents’ experiences of administering eye drops to their children as described in online forum discussions and blog posts.

Methods
This was an exploratory study using qualitative methods. We thematically analysed the written exchanges between parents participating in online forum discussions and blog posts about the administration of eye drops to their young children.

Results
We found 64 forum discussion threads and 4 blog posts, representing 464 unique contributors expressing their experiences of eye drop administration to young children. Three major themes were identified – administration challenges, administration methods and role of health care professionals. Besides describing their children’s distress, parents discussed their own discomfort and anxiety when administering eye drops. Parents used a variety of techniques to facilitate adherence with medication, including restraining the child, role-play, reassurance, distraction, or reward. The ideas exchanged about eye drop administration occasionally included reiteration of professional advice, but were dominated by parents’ own ideas/suggestions; interestingly health care professionals were considered diagnosticians and prescribers, rather than sources of practical advice on administration.

Conclusions
Parents struggling to deliver eye drops to their young children may seek advice on how to administer treatment from parental on-line discussion forums. The distress experienced by the young child and their parents is a powerful reminder to clinicians that procedures common and routine in health care may be challenging to parents. The advice given to parents needs to go beyond the instillation of the eye drops, and include advice on child restraint, distraction techniques and allaying distress. Forewarned of the potential difficulties and provided with coping strategies parents can employ when the child resists, could alleviate their own and their child’s distress.
Level of physical activity among middle-aged and older Chinese people: evidence from the China health and retirement longitudinal study
Authors: Li Xiaowei , Zhang Wanda , Zhang Weiya , Tao Ke , Ni Wenli , Wang Kai , Li Zhanglai , Liu Qiang , Lin Jianhao 
Published: November 2020

Abstract

Background
With data from different regions accumulated, physical inactivity (PI) was found to be pandemic worldwide. Using China Health and Retirement Longitudinal Study (CHARLS), a nationwide longitudinal survey data, we aimed to delineate the prevalence, incidence and risk factors of physical inactivity (PI) among Chinese people aged 45 years and older.

Methods
The CHARLS covered nearly all provinces, autonomous regions, municipalities of mainland China. With data from CHARLS, three cross-sectional analyses and a cohort analysis were conducted. In cross-sectional studies, we used surveys at 2011, 2013 and 2015 to examine the prevalence and its trend of PI. Multivariate generalized linear model was conducted in survey at 2011 to examine the risk factors for prevalent PI. Multiple imputation of missing values was used and results before and after imputation were compared. In cohort analysis, we identified people free of PI at 2011 and followed them up until 2015 to estimate the incidence of PI. Generalized estimating equation was used to examine the risk factors associated with incidence PI. In all analyses, PI was defined as insufficient physical activity according to the International Physical Activity Questionnaire (IPAQ) criterion.

Results
6650, 5946 and 9389 participants were eligible for cross-sectional analyses, and 4525 participants were included for cohort analysis. The weighted prevalence of PI was 22.25% (95% CI: 20.63–23.95%) in 2011, 20.64% (95% CI: 19.22–22.14%) in 2013 and 19.31% (95% CI: 18.28–20.38%) in 2015. In multivariate analysis, PI was associated with older age, higher education, overweight, obesity and difficulties in daily living, and was negatively associated with working and higher level of expenditure. No material change was detected in results after multiple imputation. In cohort analysis, older age, abundant public facilities, difficulties in daily living were identified as risk factors of incidence PI, while urban areas, college and above education, and working were protective factors.

Conclusions
PI is pandemic in 45 years and older people in China. People with older age, difficulties in daily living and people who are not working are at higher risk. More efforts should be paid in estimating and promoting leisure-time physical activities.
A confirmatory factor analysis of the knowledge, attitude and practice questionnaire towards prevention of respiratory tract infections during Hajj and Umrah
Authors: Goni Mohammed Dauda , Naing Nyi Nyi , Hasan Habsah , Wan-Arfah Nadiah , Deris Zakuan Zainy , Arifin Wan Nor , Baaba Aisha Abubakar , Njaka Stanley 
Published: November 2020

AbstractBackgroundRespiratory tract infections are one of the common infection associated with Hajj pilgrimage that is of great public health and global concern. This study is aimed at determining the factor structure of the knowledge, attitude, and practice questionnaire for the prevention of respiratory tract infections during Hajj by confirmatory factor analysis (CFA).MethodsA multistage cluster sampling method was conducted on Malaysian Umrah pilgrims during the weekly Umrah orientation course. A total of 200 Umrah pilgrims participated in the study. The knowledge, attitude and practice (KAP) questionnaire was distributed to pilgrims at the beginning of the orientation and retrieved immediately at the end of the orientation. Data analysis was done using R version 3.5.0 after data entry into SPSS 24. The robust maximum likelihood was used for the estimation due to the multivariate normality assumption violation. A two-factor model was tested for measurement model validity and construct validity for each of the attitude and practice domains.ResultsCFA of a 25-item in total, the two-factor model yielded adequate goodness-of-fit values. The measurement model also showed good convergent and discriminant validity after model re-specification. A two-factor model was tested for measurement model validity and construct validity for each of the attitude and practice domains. The result also showed a statistically significant value (p < 0.001) with χ2(df) values of 76.8 (43) and 121 (76) for attitude and practice domains, respectively.ConclusionThe KAP questionnaire was proven to have a valid measurement model and reliable constructs. It was deemed suitable for use to measure the KAP of Hajj and Umrah pilgrims towards the prevention for all respiratory tract infections.
Underreporting of the 5-year tetanus, diphtheria, pertussis and polio booster vaccination in the Danish Vaccination Register
Authors: Voss Sidsel Skou , Glode Helmuth Ida , Hiul Suppli Camilla , Valentiner-Branth Palle 
Published: November 2020

Abstract

Background
In Denmark, vaccination coverage is measured using the Danish Vaccination Register (DDV). In general, the vaccination coverage is high, but for some vaccinations, the coverage is suboptimal with geographical variation. This study aims to validate the vaccination coverage of the 5-year booster and identify overall reasons for non-vaccination in Copenhagen.

Methods
We validated the coverage of the 5-year tetanus, diphtheria, pertussis and polio booster for children born in 2010 and living in Copenhagen municipality in 2018, an area with low coverage (current estimate: 89%). We identified all children born in 2010 in the Civil Registration System and sent an electronic questionnaire to parents of children without a record of the 5-year booster in the DDV.

Results
Parents of 692 children were contacted and 49% participated. Of those, 186 (55%) reported that the child was vaccinated: 61% by their general practitioner and 34% abroad. The most common reason for non-vaccination was forgetfulness (31%), 26% did not want their child vaccinated and 17% had migrated from abroad and were not aware of the vaccination schedule. Considering only children with documentation for the vaccination, the corrected vaccination coverage was 91%.

Conclusions
We conclude that the coverage of the 5-year booster in Copenhagen is currently underestimated and should be adjusted by 2%. We recommend increased awareness from general practitioners and tailored communication about the vaccination programme targeting immigrants in Denmark.
Pulmonary benign metastasizing leiomyomas: a case series of 23 patients at a single facility
Authors: Fan Rong , Feng Fengzhi , Yang Hua , Xu Kaifeng , Li Shanqing , You Yan , Wan Xirun , Zhu Lan 
Published: November 2020

Abstract

Background
Pulmonary benign metastasizing leiomyoma (PBML) is a rare disease characterized by leiomyoma of benign histopathology existing in the lungs. Because of its rarity, limited literature with a single case or small number of cases has been regarding to the clinical course, pathology or management of PBML.

Methods
A retrospective study was performed of all PBML cases diagnosed and managed at Peking Union Medical College Hospital (PUMCH) from 2001 to 2019. The clinical characteristics, pathology, treatment and outcomes of each case were studied.

Results
There were 25 PBML patients identified in the 19-year period in PUMCH, and 23 patients’ data was analyzed. The median age at diagnosis was 46 years. There were 7 patients (30.4%) diagnosed with postmenopausal status. Two patients (8.7%) had no uterine leiomyoma, and 3 patients (13.0%) had no gynecologic surgery history. Immunohistochemistry of most lesions demonstrated positive for desmin, SMA and Estrogen/Progesterone Receptors; and negative for S-100 were shown in 7 cases. After curative or diagnostic surgeries for the PBML, several treatments from observation to medical or surgical castration were performed. Nine premenopausal patients preserved their ovaries at first. At a median follow-up of 8 years, 3 patients finally had oophorectomy.

Conclusions
PBML is a rare disease and should be treated by individualization according to the patients’ age, symptoms and extent of lesion. Curative surgery for patients with limited lesions can achieve the complete response. For patients that are young and asymptomatic, close observation is recommended as the first choice. All patients should undergo long-term surveillance.
Intensity of resistance training via self-reported history is critical in properly characterizing musculoskeletal health
Authors: Shoepe Todd C. , LaBrie Joseph W. , Mello Grant T. , Leggett Allison G. , Almstedt Hawley C. 
Published: November 2020

AbstractBackgroundIntensity of resistance training history might be omitted or poorly ascertained in prescreening or data questionnaires involving musculoskeletal health. Failure to identify history of high-versus low-intensity training may overlook higher effect sizes with higher intensities and therefore diminish the precision of statistical analysis with resistance training as a covariate and bias the confirmation of baseline homogeneity for experimental group designation. The purpose was to determine the degree to which a single question assessing participant history of resistance training intensity predicted differences in musculoskeletal health.MethodsIn the first research aim, participants were separated into groups with a history (RT) and no history (NRT) of resistance training. The second research aim evaluated the history of resistance trainingintensityon muscular strength, lean mass, and bone mineral density (BMD), RT participants were reassigned into a low- (LIRT) or high-intensity resistance training group (HIRT). 83 males and 87 females (19.3 ± 0.6 yrs., 171.1 ± 9.9 cm, 67.1 ± 10.5 kg, 22.9 ± 2.8 BMI, 26.2 ± 7.2% body fat) completed handgrip dynamometry (HG) and dual-energy x-ray absorptiometry scans (DXA) for BMD and bone mineral-free lean mass (BFLM).ResultsA 3-group method (NRT, LIRT, HIRT) reduced type-I error compared with the 2-group method (NRT, RT) in characterizing the likely effects of one’s history of resistance training. For the second aim, HIRT had significantly (p < 0.05) greater HG strength (76.2 ± 2.2 kg) and arm BFLM (6.10 ± 0.16 kg) than NRT (67.5 ± 1.3 kg; 4.96 ± 0.09 kg) and LIRT (69.7 ± 2.0 kg; 5.42 ± 0.14 kg) while also showing significantly lower muscle quality (HG/BFLM) than NRT (13.9 ± 0.2 vs. 12.9 ± 0.3). HIRT had greater BMD at all sites compared to NRT (whole body = 1.068 ± 0.008 vs. 1.120 ± 0.014; AP spine = 1.013 ± 0.011 vs. 1.059 ± 0.019; lateral spine = 0.785 ± 0.009 vs. 0.846 ± 0.016; femoral neck = 0.915 ± 0.013 vs. 0.970 ± 0.022; total hip = 1.016 ± 0.012 vs. 1.068 ± 0.021 g/cm2) while LIRT revealed no significant skeletal differences to NRT.ConclusionsRetrospective identification of high-intensity history of resistance training appears critical in characterizing musculoskeletal health and can be ascertained easily in as little as a single, standalone question. Both retrospective-questionnaire style investigations and pre-screening for potential participation in prospective research studies should include participant history of resistance trainingintensity.
Incidental para-ureteral aggressive angiomyxoma: a rare case report and literature review
Authors: Liu Ming , Zhai Ting-Shuai , Zhao Xiao-Feng , Feng Li-Jin , Lyu Xin-Sheng , Hu Lan-Ting , Wang Zheng-Xin , Ma Wei-Guo , Zhang Jian , Chen Xiao , Su Bin-Jie , Yao Xu-Dong , Lu Jing-Yi , Ye Lin 
Published: November 2020

AbstractBackgroundAggressive angiomyxoma (AA) is a rare tumor that typically occurs in the pelvis and perineum, most commonly in women of reproductive age. However, no para-ureteral AA has been reported according to the literature.Case presentationWe herein describe the first case of para-ureteral AA. A 62-year-old male presented to our institute in March 2017 with a para-ureteral mass that was 15 mm in diameter incidentally. No symptom was observed and laboratory analysis was unremarkable. Magnetic resonance and computed tomography imaging showed a non-enhancing mass abutting the left ureter without causing obstruction. Laparoscopic resection of the mass was performed without injury to the ureter. Pathologic and immunohistochemical results were consistent with AA. Till now, no recurrence was noticed.ConclusionsWe reported a rare case of para-ureteral AA, along with a literature review. Early diagnosis, proper surgical plan and long-term close follow-up is recommended for its high risk of recurrence and malignant potential.