bluuebunny/crossref_metadata_2025_split huggingface dataset:
Application of treatment planning system assisted large-aperture computed tomography simulator in percutaneous biopsy: initial experience by a radiation therapist
Authors: Lin Xiaoyi , Hong Jun-qiang , Luo Shui-ying , Lai You-qun , Dai Yong-liang , Kong Xiang-quan 
Published: March 2020

Abstract
Background and purpose To evaluate the application of treatment planning system (TPS) assisted large-aperture computed tomography (CT) simulator in percutaneous biopsy, and report our initial experience of the accuracy and safety of this procedure.Methods From November 2018 to December 2019, treatment planning system assisted large-aperture CT simulator guided percutaneous biopsy was performed on 38 cases, with 34 of percutaneous lung biopsy, three of abdominal lesions biopsy, and one case of deep supraclavicular lymph node biopsy. The major results including planned and actual puncture parameters, the success rate, pathological information and complications were recorded. The analyses of puncture accuracy were accomplished by pared-t test and Wilcoxon rank sum test. And the risk factors of puncture accuracy and complications were further identified.Results The entire cohort achieved one-time success of biopsy. No significant differences were presented between planned and actual puncture depth and direction (P = 0.436 and 0.382), indicating the precision of the process. And the pulmonary puncture location was related to the accuracy of puncture direction (P = 0.033). Biopsy specimens were successfully obtained in 38 cases. The diagnostic rate of malignancy was 76%, of which 80% for initial treatment group and 69% for treated group, respectively. For patients with pulmonary biopsy, 12 had minor pneumothorax and 2 progressed to massive pneumothorax. Only three cases suffered needle track bleeding, and no other complications were observed. Additionally, the regression analysis found a significant correlation between puncture angle and the incidence of pneumothorax (P = 0.027).Conclusions TPS assisted large-aperture CT simulator improved the procedure of percutaneous biopsy by combining the advantages of radiotherapy specialty. The initial results suggested the increase of puncture accuracy and success rate, with satisfactory safety simultaneously. It might offer new insights into the field of CT-guided percutaneous biopsy.
Validation of machine learning models to predict dementia-related neuropsychiatric symptoms in real-world data
Authors: Mar Javier , Gorostiza Ania , Ibarrondo Oliver , Cernuda Carlos , Arrospide Arantzazu , Iruin Álvaro , Larrañaga Igor , Tainta Mikel , Ezpeleta Enaitz , Alberdi Ane 
Published: March 2020

Abstract
Background Neuropsychiatric symptoms (NPS) are the leading cause of the social burden of dementia but their role is underestimated. The objective of the study was to validate predictive models to separately identify psychotic and depressive symptoms in patients diagnosed with dementia using clinical databases representing the whole population (real-world data). Methods First, we searched the electronic health records of 4,003 patients with dementia to identify NPS. Second, machine learning (random forest) algorithms were applied to build in the training sample (N=3,003) separate predictive models for psychotic and depressive symptoms. In order to evaluate the classification ability of the models, the following statistics were calculated for each model: the area under the receiver operating curve (AUC), sensitivity, specificity, accuracy, no-information rate and Kappa index. Third, calibration and discrimination were assessed in the validation sample (N= 1,000) to assess the performance of the models. A calibration curve was drawn by plotting the predicted probabilities for groups on the x-axis and the mean observed values on the y-axis. Results Neuropsychiatric symptoms were noted in the electronic health record of 58% of patients. The AUC reached 0.80 for the psychotic symptoms model and 0.74 for the depressive symptoms model. The Kappa index and accuracy also showed better discrimination in the psychotic model. Calibration plots indicated that both types of model had less predictive accuracy when the probability of neuropsychiatric symptoms was < 25%. The most important variables in the psychotic symptom model were use of risperidone, level of sedation, quetiapine and haloperidol and the number of antipsychotics prescribed. In the depressive symptom model, the most important variable was number of antidepressants prescribed, use of escitalopram, level of sedation and age. Conclusions More than half of the sample had NPS as identified by the presence of key terms in the electronic health record. Although NPS are not encoded, they are treated with antipsychotics and antidepressants, which allows developing valid predictive models by joining machine learning tools and real-world data. Given their good performance, the predictive models can be used to estimate prevalence of NPS in population databases.
Factors associated with the burden of family caregivers of elderly patients with femoral neck fracture: a cross-sectional study
Authors: Xiao Peifeng , Zhou Yongchun 
Published: March 2020

Abstract
Background This study aimed to study the factors associated with caregiver burden among caregivers of elderly patients with femoral neck fracture. Methods This cross-sectional study was based on a non-probabilistic sampling of 183 elderly postoperative patients (aged 65 years or older) with femoral neck fracture who were hospitalized in the orthopaedic centre in our hospital and their primary caregivers. Data were collected from January 2016 to June 2019. Patients and primary caregivers completed the sociodemographic questionnaire. The Social Support Rating Scale (SSRS), the General Self-Efficacy Scale (GSE) and the Chinese version of the Zarit Burden Interview (ZBI) were used to evaluate social support, self-efficacy and caregiver burden, respectively. By analysing the clinical data of patients and primary caregivers and combining the factors that affect the caregiver burden in parallel studies, we selected the factors that affected the caregiver burden in this study and conducted a multivariate analysis of these factors. P <0.05 was considered statistically significant. Results We observed 176 caregivers aged 69.28 ± 7.19 years old, among whom 52.3% were male, 58.0% lived in the city, 84.0% were spouses of the patients, and 67.0% had a primary school educational background. The ZBI score of the primary caregivers was 37.8 ± 8.9, and 82.7% of the caregivers were under a moderate to severe burden. The patient’s functional status, Harris score, and pain score and the caregiver’s SSRS scores, GSE scores, and monthly income were factors that affected the caregiver burden. Conclusions Most primary caregivers of elderly patients with femoral neck fracture are subject to a considerable care burden, and social support and self-efficacy intervention are conducive to reducing the caregiver burden.
Effects of strontium ions with potential antibacterial activity on in vivo bone regeneration
Authors: Baheiraei Nafiseh , Eyni Hossein , bakhshi Bita , Najafloo Raziyeh 
Published: March 2020

Abstract
Background

Bioactive glasses (BGs) have attracted added attention in the structure of the scaffolds for bone repair applications. Different metal ions could be doped in BGs to induce specific biological responses. Among these ions, strontium (Sr) is considered as an effective and safe doping element with promising effects on bone formation and regeneration.

Methods

In this experiment, we evaluated the antibacterial activities of the gelatin-BG (Gel-BG) and Gel-BG/Sr scaffolds in vitro. The osteogenic properties of the prepared scaffolds were also assessed in rabbit calvarial bone defects for 12 weeks. Alizarin Red, Hematoxylin & Eosin (H&E) and Masson’s Trichrome staining were performed to assess bone regeneration and the obtained results were compared with those without Sr. Also, histomorphometric data were obtained to evaluate the new bone, residual graft, and connective tissue.

Results

Both scaffolds showed in vivo bone formation during 12 weeks with the newly formed bone area in Gel-BG/Sr scaffold was higher than that in Gel-BG scaffolds after the whole period. Based on the histological results, Gel-BG/Sr exhibited acceleration of early-stage bone formation in vivo. The results of antibacterial investigation showed that although both Gel-BG/Sr and Gel-BG effectively inhibited the growth of Escherichia coli (E. coli) but, only Gel-BG/Sr structure could lead to a 3 log reduction in Staphylococcus aureus (S. aureus). Conclusions: Our results confirmed that Sr doped BG is a favorable candidate for bone tissue engineering with superior antibacterial activity and bone regeneration capacity compared with similar counterparts having no Sr ion.
Can relative rotation angle serve as a sensitive predictor for the development of adjacent segment degeneration after single-segment PLIF?
Authors: Liu Xiao , Liu Haonan , Yang Xiaosong , Liu Zhongjun , liu xiaoguang , Yu Miao 
Published: March 2020

Abstract
Background: Adjacent segment degeneration (ASD) is a major issue after posterior lumbar interbody fusion (PLIF). Several studies have reported the potential causes of ASD based on radiography. However, the postoperative dynamic changes in the adjacent segments are not clear. This study aimed to determine the effect of PLIF on ASD using a formetric 4D system and to compare the effectiveness of this system with that of traditional radiography for the prediction of ASD. Methods: Eighty-five consecutive patients who underwent PLIF of a single-segmen t were included. The formetric 4Dsystem was used to calculate the relative rotation angle between the fusion segment and the upper and lower adjacent vertebrae preoperatively and at 6, 12 and 24 months postoperatively. The range of motion (ROM) and disc height (DH) of the adjacent segments were measured using radiography preoperatively and at 24 months postoperatively. At the final follow-up, the visual analogue scale (VAS) and Oswestry disability index (ODI) were used to evaluate the surgical outcome. The patients were divided into two groups according to the occurrence of radiographic ASD: the ASD group with progression of degeneration and the N-ASD group without progression of degeneration. The clinical outcomes and measurement data between the two groups were compared and analyzed. Results: The index fusion segments included L2-3 to L5-S1. Preoperatively, the relative rotation angles between the fused segment and the upper and lower adjacent vertebrae were 5.1°±2.2°and 3.3°±2.0°,respectively, and both angles increased significantly at all time-points after surgery ( p <0.05). The angles changed most significantly during L2-3 fusion . Radiographic ASD was noted in 13 of 85 patients (15.3%) at 24 months. There was no significant difference in the DH, ROM, or clinical outcome between the two groups ( p >0.05), while the relative rotation angle with the upper adjacent vertebra was greater in the ASD group than in the N-ASD group ( p <0.05). Conclusion: The relative rotation angle with the adjacent vertebra increased significantly after lumbar fusion surgery. It may be a more sensitive predictor for the development ofradiographic ASD than flexion-extension ROM and DH.
Construction of a sensitive and specific lead biosensor using a genetically engineered bacterial system with a luciferase gene reporter
Authors: Nourmohammadi Esmail , Hosseinkhani Saman , Nedaeinia Reza , Khoshdel-Sarkarizi Hoda , Nedaeinia Mozhdeh , Ranjbar Maryam , Ebrahimi Neshat , Farjami Zahra , Nourmohammadi Mohammad , Mahmoudi Ali , Goli Mohammad , A.Ferns Gordon , Sadeghizadeh Majid 
Published: March 2020

Abstract
Background A bacterial biosensor refers to genetically engineered bacteria that produces an assessable signal in the presence of a physical or chemical agent in the environment. Methods We designed and evaluated a bacterial biosensor expressing a luciferase-reporting gene that is controlled by pbr and cadA promoters in Cupriavidus metallidurans (previously Ralstonia metallidurans ) CH34 and pI258 plasmids of Staphylococcus aureus , respectively, for detection of heavy metals. In the present study, we produced biosensor plasmids designated pGL3-luc/pbr -biosensor and pGL3-luc/cad -biosensor, which were based on the expression of luc+ under the control of the cad promoter and the cadC gene of S. aureus plasmid pI258 and pbr promoter and pbrR gene from plasmid pMOL30 of Cupriavidus metallidurans . Results: We found that the biodegradable pGL3-luc/pbr -biosensor could measure lead concentrations between 1-100 μM in the presence of other metals such as zinc, cadmium, tin and nickel, in the presence of which gene expression of the reporter was not observed. The pGL3-luc/cad -biosensor was able to detect lead concentrations between 10 nM to 10 μM. Conclusions: This biosensor was found to be a specific sensor for identifying lead ions in both environmental and biological samples.
Comparison of survival outcomes of locally advanced cervical cancer by histopathological types in the Surveillance, Epidemiology, and End Results (SEER) database: A propensity score matching study
Authors: Tian Tian , Gong Xing , Gao Dong Xu , Li Qing Yan , Ju Wen , Ai Qin Yi 
Published: March 2020

Abstract
Background: There has been limited research on the comparison of squamous cell carcinoma (SCC) and adenocarcinoma (AC) of cervical cancer and that lack of information may have significant bearing on the treatment of patients. We compared survival outcomes between squamous cell carcinoma and adenocarcinoma in locally advanced cervical cancer patients and examined factors related to the prognosis of cervical cancer. Methods: We identified 4,061 patients with stage IB2-ⅣA cervical cancer patients diagnosed between 2010 and 2015 by using the Surveillance, Epidemiology, and End Results (SEER) database. Variables related to the prognosis of cervical cancer were compared using both univariate and multivariate Cox models and log-rank method before and after propensity score matching. We compared the efficacy of radiotherapy alone to radiotherapy combined with chemotherapy or/and surgery in overall survival of SCC and AC.Results: Our sample included 3,385 patients with SCC (83.4%) and 676 patients with AC (16.6%). The 5-year overall survival on comparing the squamous cell carcinoma group and adenocarcinoma group was not significant (P>0.05). Using propensity score matching, 676 pairs of patients were selected. The 5-year overall survival of matched patients did not differ significantly (P>0.05). Histology was not independently associated with overall survival in multivariate Cox model (P>0.05). Factors affecting overall survival included FIGO stage IVA (P<0.05), chemotherapy (P<0.05), and external radiation combined with brachytherapy (P<0.05). Patients with SCC that were treated with radiation alone had significantly worse OS than AC patients receiving radiation only (P<0.05). Conclusions : The OS in AC of the cervix is similar to that in when treated with radiotherapy combined with chemotherapy and/or surgery but better when treated with radiation alone.
Clinical characteristics of a group of deaths with COVID-19 pneumonia in Wuhan, China: retrospective case series
Authors: Yao Tao , Gao Yan , Cui Qin , Peng Bo , Chen Yan , Li Jiansheng , Huang Chao , He Chunping , Pu Jie , Wei Jiajun , Zhan Yanqiang , Yan Jie , Tian Jinghua , Zhang Zhaohui , Liu Zhichao 
Published: March 2020

Abstract
Background: With the widespread outbreak of novel coronavirus diseases 2019(COVID-19), more and more death cases were reported, however, limited data are available for the patients who died. We aimed to explore the clinial characteristics of deaths with COVID-19 pneumonia Methods: We abstracted and analyzed epidemiological, demographic, clinical, and laboratory data from 83 death cases with COVID-19 pneumonia in East hospital of Wuhan university Renmin hospital,between January 26, 2020, and February 28, 2020.Results: Of the 83 deaths, none was the medical staff. The mean age was 71.8 years (SD 13.2; range, 34-97 years) and 53(63.9%) were male. The median from onset to admission was 10 days (IQR 7-14: range, 2-43 days), to death was 17days (IQR 14-21: range, 6-54 days). Most deaths (66[80%]) had underlying comorbid diseases, the most of which was hypertension [47(57%)]. The main initial symptoms of these 83 deaths were shortness of breath(98.8%), fever(94%) and myalgia or fatigue(90.4%). Laboratory analyses showed the lymphocytopenia in 69(83%) deaths, hypoalbuminemia in 77(93%) deaths, the elevation of lactate dehydrogenase in 79(95%) deaths, procalcitonin in 69(83%) deaths and C-reactive protein in 79(95%) deaths. All 83 patients received antiviral treatment, 81(97.6%) deaths received antibiotic therapy, and 54(65.1%) deaths received glucocorticoid therapy and 20(24.1%) patients received invasive mechanical ventilation.Conclusion: Most of the deaths with COVID-19 pneumonia were elderly patients with underlying comorbid diseases, especially those over 70 years of age. The time of death was mostly 15-21 days after the onset of the disease. More care should be given to the elderly in the further prevention and control strategies of COVID-19.
A simple algorithm helps early identification of SARS-CoV-2 infection patients with severe progression tendency
Authors: Li Qiang , Zhang Jianliang , Ling Yun , Li Weixia , Zhang Xiaoyu , Lu Hongzhou , Chen Liang 
Published: March 2020

Abstract
Objectives We aimed to develop a simple algorithm helps early identification of SARS-CoV-2 infection patients with severe progression tendency. Methods 322 SARS-COV-2 infection patients were respectively enrolled. The univariable and multivariable analysis were computed to identify the independent predictors of severe progression, and the prediction model was established based on independent predictors. The areas under the ROC curves (AUROCs) were used to evaluate the diagnostic performances. Results Of 322 confirmed SARS-COV-2 infection patients, 11 were diagnosed as severe cases on admission, 15 developed to severe cases after admission, and 296 were non-severe cases. The multivariable analysis identified age (OR=1.061, p=0.028), lactate dehydrogenase (LDH) (OR=1.006, p=0.037), and CD4 count (OR=0.993, p=0.006) as the independent predictors of severe progression. Consequently, the age-LDH-CD4 algorithm was derived as (age×LDH)/CD4. The AUROC of the age-LDH-CD4 model was significantly higher than that of single CD4 count, LDH, or age (0.92, 0.85, 0.80, and 0.75, respectively). The age-LDH-CD4 model ≥ 82 has high sensitive (81%) and specific (93%) for the early identification of patients with severe progression tendency following SARS-CoV-2 infection. Conclusions The age-LDH-CD4 model is a simple algorithm for early identifying cases with severe progression tendency in SARS-CoV-2 infection patients, and warrants further validation.
Chest CT imaging features of critically ill COVID-19 patients
Authors: Zhang Nan , Xu Xunhua , Zhou Ling-Yan , Chen Gang , Li Yu , Yin Huiming , Sun Zhonghua 
Published: March 2020

Abstract
Objectives To analyze the findings of computed tomography (CT) imaging in critically ill patients diagnosed with coronavirus disease 2019 (COVID-19).Methods This retrospective study reviewed 60 critically ill patients (43 males and 17 females, mean age 64.4±11.0 years) with COVID-19 pneumonia who were admitted to two different clinical centers. Their clinical and medical records were analyzed, and the chest CT images were assessed to determine the involvement of lobes and the distribution of lesions in the lungs between the patients who recovered from the illness and those who died.Results Patients were significantly older in the death group (10/60, 16.67%) than in the recovery group (50/60, 83.33%) (p=0.044). C-reactive protein (CRP) (67.9±50.5 mg/L) was significantly elevated in the death group as opposed to the recovery group (p<0.001). The neutrophil-to-lymphocyte ratio (NLR) was higher in the death group when compared with the recovery group (p=0.030). Involvement of five lung lobes was found in 98% of the patients, with medial or parahilar area involvement observed in all the death patients. Ground-glass opacities (97%), crazy-paving pattern (92%) and air bronchogram (93%) were the most common radiological findings. Presence of emphysema was more prevalent in the death group than in the recovery group (30% vs 2%, p=0.011).Conclusions The degree of lung involvement and lesion distribution with dominance in the medial and parahilar pulmonary areas were more severe in the death patients than in those who recovered. Patient’s age, emphysema, CRP and NLR could be combined with CT to predict the disease outcomes.
Clinical and CT imaging characteristics of COVID-19 cases in Wenzhou city: A retrospective analysis
Authors: Fu Li-ping , Gao Yuan-tong , Zhou Ke , Luo Min , Ma Peng-Cheng , Song Fa-Huan , Li Yong-chou 
Published: March 2020

Abstract
Background: In December 2019, Wuhan witnessed the outbreak of an “unexplained pneumonia” caused by a novel coronavirus strain infection and was dubbed the COVID-19 by the WHO. The disease quickly spread to China. This study aimed to investigate the disease’s evolving epidemiological history, as well as analyze the clinical and CT imaging characteristics, treatment regimens, and patients’ prognosis.Methods: This was a retrospective study whose cases were 64 patients with a confirmed diagnosis of COVID-19. The clinical data were obtained from patients who were admitted to the isolation ward from 21 January 2020 to 19 February 2020.Results: 60 out of 64 patients had a definitive history of exposure to people who had traveled from Wuhan City. The median time from onset of symptoms to first hospital admission was 3.9±1.9 days. The initial symptoms included fever (46/64), dry cough (38/64), fatigue or myalgia (23/64), sore throat (10/64), diarrhea (3/64) along with late-onset symptoms like chest pains (2/64) and headaches (2/64). The majority of the patients (43/64) had normal white blood cell counts while 29.7 % (19/64) had leukopenia. Only two patients (3.1 %) presented with leukocytosis. 58 of the 64patients had abnormal radiological findings on chest CTs. The first chest CTs (within 2 days) was more sensitive in detecting COVID-19 infection (85.9 %) compared to the initial RT-PCR (56.3 %; p<0.01). The CTs showed lesions in multiple lung lobes in three-quarters of the patients while 15.6 % had lesions localized to one lobe. Most of the lesions were typically dense with ground-glass opacity co-existing with consolidation or cord-like shadows. Most of these patients (50/64) have recovered and got discharged giving a mean length of hospital stay of 13.5±4.8 days. Our hospital unit has not reported any COVID-19 related death so far. Conclusions: Early intervention in COVID-19 disease improves patients’ prognosis. Our data demonstrate the superiority of early radiological tests ahead of RT-PCR. The initial and dynamic CT changes in COVID-19 patients along with other clinical data shared above can better guide clinical decision making.