bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associations of reproductive breast cancer risk factors with breast tissue composition
Authors: Yaghjyan Lusine , Austin-Datta Rebecca Jane , Oh Hannah , Heng Yujing J , Vellal Adithya D , Sirinukunwattana Korsuk , Baker Gabrielle M , Collins Laura C , Murthy Divya , Rosner Bernard , Tamimi Rulla M 
Published: August 2020

Abstract
Background
We investigated the associations of reproductive factors with percentage of epithelium, stroma, and fat tissue in benign breast biopsy samples.
Methods
This study included 983 cancer-free women with biopsy-confirmed benign breast disease (BBD) within the Nurses’ Health Study and Nurses’ Health Study II cohorts. Percentage of each tissue type (epithelium stroma, and fat) was measured on whole section images with a deep-learning technique. All tissue measures were log-transformed in all the analyses to improve normality. The data on reproductive variables and other breast cancer risk factors were obtained from biennial questionnaires. Generalized linear regression was used to examine the associations of reproductive factors with percentage of tissue types, while adjusting for known breast cancer risk factors.
Results
As compared to parous women, nulliparous women had a smaller percentage of epithelium (β= -0.26, 95% confidence interval [CI] -0.41, -0.11) and fat (β= -0.34, 95% CI -0.54, -0.13) and a greater percentage of stroma (β = 0.04, 95% CI 0.01, 0.08). Among parous women, number of children was inversely associated with percentage of stroma (β per child= -0.01 (-0.02, -0.00). Duration of breastfeeding of ≥ 24 months was associated with a reduced proportion of fat (β= -0.30, 95% CI -0.54, -0.06; p-trend = 0.04). In a separate analysis restricted to premenopausal women, older age at first birth was associated with a greater proportion of epithelium and a smaller proportion of stroma.
Conclusions
Our findings suggest that reproductive factors with a protective effect on breast cancer risk may be associated with a greater proportion of epithelium and a smaller proportion of stroma, potentially suggesting importance of epithelial-stromal interactions. Future studies are warranted to confirm our findings and to elucidate the underlying biological mechanisms.
Clinical presentations and long-term prognosis of childhood-onset polyarteritis nodosa in a single centre: a retrospective study
Authors: Lee Jeong-Seon , Kim JoongGon , Lee Soyoung 
Published: August 2020

Abstract
Background: Polyarteritis nodosa (PAN) is a systematic necrotizing vasculitis involving medium-sized arteries. Childhood-onset PAN ranges from mild to severe systematic disease causing damage and early mortality. As it is a rare disease in children, there is less study on clinical features, diagnosis and treatment than adults. And diagnosis occurs relatively late in most paediatric patients with polyarteritis nodosa. Therefore, this study aimed to investigate clinical manifestations, laboratory findings, treatment strategies, and long-term outcomes among patients with childhood-onset polyarteritis nodosa treated at a single-centre in Korea. We further aimed to evaluate the usefulness of the Birmingham Vasculitis Activity Score (BVAS) and Five-Factor Score (FFS) in paediatric patients.Methods: We retrospectively analysed data collected from patients with childhood-onset PAN treated at our institution from March 2003 to February 2020. Results: Nine patients (6 male and 3 female) were included in the study. The median ages at symptom onset and diagnosis were 7.6 (3–17.5) and 7.7 (3.5–17.6) years, respectively. The median follow-up duration was 7.0 (1.6–16.3) years. Eight patients were diagnosed with systemic PAN, while one was diagnosed with cutaneous PAN. All patients exhibited skin manifestations, while five exhibited Raynaud’s phenomenon. Organ involvement was observed in one patient. Constitutional symptoms such as fever, arthralgia, myalgia, and weight loss were also observed. Antineutrophil cytoplasmic antibodies were absent in all patients. The median BVAS at diagnosis was 8 (range: 2–29), and one patient had an FFS of 1. Prednisolone was initially used for induction in all patients, and other drugs were added in cases refractory to prednisolone. All patients survived despite some complications such as intracranial haemorrhage or digital necrosis requiring amputation.Conclusions: Early diagnosis and treatment may minimise sequelae in patients with childhood-onset PAN. Further multicentre studies are required to clarify the unique characteristics of childhood-onset PAN and establish treatment guidelines, early detection strategies, and biomarkers. Trial registration: Retrospectively registered.
Health seeking behavior of Japanese retirees in Thailand: a cross-sectional study
Authors: Miyashita Yumiko , Akaleephan Chutima , Vedrasco Liviu 
Published: August 2020

Abstract
Background

Despite widespread cross-border migration of retirees, little is known about their healthcare seeking behavior in a destination country. This study explores factors related to the use of health services in Thailand by Japanese long-stay retirees.
Methods

A survey of Japanese long-stay retirees aged 50 and older was conducted in cooperation with nine Japanese self-help clubs in Bangkok, Chiang Mai, Chiang Rai, and Phuket. The dependent variable was receiving medical treatment in Thailand in the previous 12 months. People who did not receive treatment in Thailand were divided into two groups; those who had treatment only in Japan and those who did not have treatment anywhere. Independent variables included i) predisposing factors: age, sex, years lived in Thailand, ii) enabling factors: marital status, adjusted annual household income, and iii) need factors: existence of chronic diseases, and health related Quality of Life.
Results

Of 226 eligible participants, 106 persons (47%) received medical treatment in Thailand, 41 (18%) received treatment only in Japan, and 79 (35%) did not in either country in the previous 12 months. The multivariate analysis identified that Japanese retirees who stayed in Thailand less than five years were less likely to see doctors in Thailand. Retirees who had no chronic diseases and did not return to Japan tended not to receive treatment anywhere while those who were covered by Japan’s national health insurance and stayed in Thailand for shorter periods in the past 12 months were more likely to get treatment only in Japan.
Conclusion

Thai government’s retirement tourism promotion policy should encourage sharing of transparent medical quality and pricing information by medical facilities to promote the trust in Thai medical services. Further studies are required on the impact of the 2017 and 2019 government policy on mandatory health insurance for retirees on their health seeking behaviors. It is also important to explore possible long-term impacts of the COVID-19 pandemic on the international retirement migration trends including on the Japanese and other retirees in Thailand.
Assessment of the Relationship Between Gametocyte Density, Multiplicity of Infection and Mosquito Infectivity in Plasmodium Falciparum Infections
Authors: Touray Abdoulie O. , Mobegi Victor Atunga , Wamunyokoli Fred , Butungi Hellen , Herren Jeremy K. 
Published: August 2020

Abstract
Background: Malaria is a major public health threat in sub-Saharan Africa. Asymptomatic P. falciparum gametocyte carriers are potential infectious reservoirs for sustaining transmission in many malaria endemic regions. The aim of the study was to assess the prevalence of gametocyte carriage and some of its associated risk factors among asymptomatic schoolchildren (age 5-15 years) in Mbita, western Kenya and further analyse the association between gametocyte density, multiplicity of infection (MOI) and mosquito infection prevalence.Methods: Rapid diagnostic test (RDT) was used to screen for P. falciparum parasite infection among asymptomatic schoolchildren (5-15 years old) residing in Mbita, Western Kenya and the results were further verified using microscopy. Microscopy positive gametocyte carriers were selected to feed laboratory reared An. gambiae s.s. mosquitoes using membrane feeding method. Genomic DNA was extracted from dry blood spots (DBS) samples and P. falciparum populations were genotyped using 10 polymorphic microsatellite markers. Assessment of the association between MOI and gametocyte density and mosquito infection rates was conducted. Results: The prevalence of Plasmodium falciparum infection among the study population was 29.11% (1421/4881). A significantly higher prevalence of P. falciparum infection was found among the male gender 31.54% (764/2422) (p-value < 0.001) compared to the females 26.72% (657/2459). The microscopy gametocyte prevalence among the study population was 2% (84/4881). Children (5-9 years) have a higher risk of gametocyte carriage (Odd Ratios = 2.1 [95% CI = 1.3–3.4], P = 0.002) as compared to those between the ages of 10-15 years. Our results indicate that, about 68.1% of the variation in mosquito infection prevalence is accounted for by the gametocytes density and MOI (R-SQR. = 0.681, p < 0.001).Conclusion: The study reports a P. falciparum infection prevalence of 29.11% with a gametocyte prevalence of 2% among the study population as determined by microscopy. Age was a significant risk factor for gametocyte carriage as indicated by the higher risk of gametocyte carriage among the younger children (5-9 years). The gametocyte density and multiplicity of infection statistically significantly predicted mosquito infection prevalence. Both of the variables added significantly to the prediction, (p < 0.05).
Performance evaluation and analysis of distributed multi-agent optimization algorithms with sparsified communication
Authors: Fodor Lidija , Jakovetić Dušan , Nataša Krejić , Jerinkić Nataša Krklec , Škrbić Srđan 
Published: August 2020

Abstract
There has been significant interest in distributed optimization algorithms, motivated by applications in Big Data analytics, smart grid, vehicle networks, etc. While there have been extensive theory and theoretical advances, a proportionally small body of scientific literature focuses on numerical evaluation of the proposed methods in actual practical, parallel programming environments. This paper considers a general algorithmic framework of first and second order methods with sparsified communications and computations across worker nodes. The considered framework subsumes several existing methods. In addition, a novel method that utilizes unidirectional sparsified communications is introduced and theoretical convergence analysis is also provided. Namely, we prove R-linear convergence in the expected norm. A thorough empirical evaluation of the methods using Message Passing Interface (MPI) on a High Performance Computing (HPC) cluster is carried out and several useful insights and guidelines on the performance of algorithms and inherent communication-computational trade-offs in a realistic setting are derived.
Treatment-related Biomarkers in Pulmonary Hypertension Patients on Oral Therapies
Authors: Swaminathan Aparna C , Zhu Hongmei , Tapson Victor , Lokhnygina Yuliya , Poms Abby , Kelleher Zachary , Gaspard Elijah , Kennedy Karla , Fee Brian , Fortin Terry , Mason S. Nick , Parikh Kishan , McMahon Tim 
Published: August 2020

Abstract
Background: Multiple classes of oral therapy are available for the treatment of pulmonary arterial hypertension (PAH), but there is little to guide clinicians in choosing a specific regimen or therapeutic class. We aimed to investigate whether treatment-relevant blood biomarkers can predict therapy response in prevalent PAH patients.Methods: This prospective cohort study longitudinally assessed biomarkers along the endothelin-1 (ET-1) and nitric oxide (cGMP, ADMA, SDMA, nitrite, and S-nitrosohemoglobin) pathways along with the cGMP/NT-proBNP ratio over 12 months in patients with WHO Group 1 PAH on oral PAH-specific therapies. The relationship between biomarkers and 6MWD at the same and future visits was examined using mixed linear regression models. As cGMP can be elevated when NT-proBNP is elevated, we also tested the relationship between 6MWD and the cGMP/NT-pro BNP ratio. Patients with PAH with concomitant heart or lung disease or chronic thromboembolic pulmonary hypertension (CTEPH) were included in a sensitivity analysis. Results: The study cohort included 58 patients with PAH treated with either an endothelin receptor antagonist (27.6%), phosphodiesterase-5 inhibitor (29.3%) or a combination of the two (43.1%). Among biomarkers along the current therapeutic pathways, ET-1 and the cGMP/NT-proBNP ratio associated with same visit 6MWD (p = 0.04 and p=0.009 respectively). ET-1 (p=0.01) and cGMP/NT-proBNP ratio (p < 0.001) also predicted future 6MWD in the larger cohort (n = 108) of PAH patients with concomitant left heart disease (n = 17), lung disease (n = 20), or CTEPH (n = 13). Finally, in the larger cohort, SDMA associated with 6MWD at the same visit (p = 0.003) in all subgroups and ADMA associated with 6MWD in PAH patients with concomitant lung disease (p=0.027) and PAH patients on ERA therapy (p = 0.01). Conclusions: ET-1, cGMP/NTproBNP ratio, and dimethylarginines ADMA and SDMA are mediators along pathways targeted by oral PAH therapies that associate with or predict 6MWD.
Resumption of the Treatment for Non-COVID-19 Gynecologic Patients after Lifting Lock down: Experiences from Wuhan
Authors: Dong Weihong , Gao Rui , Cai Jing , Yang Shouhua , Guo Jianfeng , Zhao Jing , Wang Zehua , Cai Liqiong 
Published: August 2020

Abstract
Background: To share our experiences of resumption of the treatment for gynecologic patients after lifting lockdown in a hotspot area of the Corona Virus Disease 2019 (COVID-19)pandemic.Methods: The triage process used to resume the medical activities for gynecologic patients at the Wuhan Union Hospital after a 76-day lockdown of the city is described and its effectiveness to avoid COVID-19 nosocomial transmission is shown.Results:The non-emergency patients are pre-triaged by contact history and body temperature at outpatient clinic and negative COVID-19 screening tests are required for an admissionin the buffering rooms at the gynecologic department. The buffering lastsfor at least three days for symptom monitoring and a second round of COVID-19 tests before they can be transferred to the regular gynecologic wards. For patients who need emergency surgery, the first screening should be completed at the quarantine wards after the surgery, followed by buffering at the gynecologic department. We received 19298 outpatient visits, admitted 326 patients, and performed 223 operations in the first two months after the lockdown was lifted, andno single COVID-19 case occurredin the hospitalized patients while the proportion of potentially high-risk patients with cancer and severe anemia were increased in comparison with the same period in 2019 and the latest two months before the lockdown.Conclusions:We provide an effective triage system with buffering at two levels to guarantee safe and timely treatment for non-COVID-19 gynecologic patients in a post-lockdown phase.
Selocalcitol: Scope of inhalational formulation for prevention and cure of COVID-19 illness
Authors: Kaur Sumanpreet , Yadav Deepak , Singh Sukhpreet , Kumari Monu , Kumar Deepak , Syal Kirtimaan , Bhattacharyya Rajasri , Banerjee Dibyajyoti 
Published: August 2020

Abstract
Vitamin D has generated interest in the context of COVID-19 pandemic. Some authorities believe that it is beneficial; others think that without proven deficiency it should not be administered. The results of clinical trial are still awaited. Therefore nothing regarding the matter is conclusively known. In this context we believe that selocalcitol, a Vitamin D analogue if administered via inhalational route, has the potential to prevent SARS-CoV2 infection. The basis of this idea is presented here.
An Intersectional Analysis Providing More Precise Information on Inequities in Self-Rated General Health
Authors: Wemrell Maria , Karlsson Nadja , Vicente Raquel Perez , Merlo Juan 
Published: August 2020

Abstract
BackgroundIntersectionality theory combined with an analysis of individual heterogeneity and discriminatory accuracy (AIHDA) can facilitate our understanding of health disparities. This enables a more precise application of proportionate universalism for resource allocation in public health. Analyzing self-rated general health in Sweden, we show how an intersectional perspective allows for a detailed mapping of health inequalities while avoiding simplification and stigmatization based on indiscriminate interpretations of differences between group averages. MethodsWe analyzed responses (n=133,244) to 14 consecutive National Public Health Surveys conducted in Sweden in 2004–2016 and 2018. Applying AIHDA, we investigated the risk of bad self-rated general health across 12 intersectional strata defined by gender, income and migration status, adjusted by age and survey year. We calculated prevalence ratios (with 99% confidence intervals) to evaluate between-strata differences, using native men with high income as the comparison reference. We calculated the area under the receiver operating characteristic curve (AUC) to evaluate the discriminatory accuracy of the intersectional strata. ResultsThe analysis of intersectional strata showed a clear social gradient where the risk of bad self-rated health among immigrated women with low income was six times higher (PR 6.01 [99% CI 5.32–6.79]) than that of native men with high income. A large degree of heterogeneity was present, however, as the discriminatory accuracy of the intersectional strata for identifying individuals according to their self-assessed general health status was relatively low (AUC=0.674).ConclusionsAn intersectional AIHDA approach provides more precise information on the distribution of bad self-assessed general health in the population and could thus guide public health interventions according to the principle of proportionate universalism.
An entropy-based image watermarking scheme by improving robustness in shearlet and wavelet domain
Authors: Zhuang Yujian , Zhou Xiaoyi , Liu Sheng 
Published: August 2020

Abstract
The existing robust digital watermarking schemes mainly embed information in the fixed positions or with fixed embedding strength, while seldom considering adaptive adjustment based on the characteristics of the cover image, thus it reduces the imperceptibility and the robustness of watermarking. Aiming at these issues, we propose a scheme which can be able to dynamically adjust the watermark embedding position and strength. Therefore, it guarantees the trade-off between robustness and imperceptibility. The appropriate embedding positions are dynamically selected for the watermark by comparing the image entropy, and the embedding strength of the image blocks are adaptively adjusted according to the entropy and the Just Noticeable Difference (JND) model in the Human Visual System (HVS)-based wavelet domain. Singular Value Decomposition (SVD) is performed on the image blocks to ensure the resistant ability of geometric attacks. The experimental results show that the scheme has good imperceptibility as well as strong robustness against various attacks. The robustness in common attacks is improved by at least 1% compared with similar watermarking schemes.
Coinfection with SARS-CoV-2 and dengue virus: a case report
Authors: Hariadi Prasetyo , Lokida Dewi , Naysilla Adhella M , Lukman Nurhayati , Kosasih Herman , Mardian Yan , Andru Gestana , Pertiwi Inggar , Sugiyono Retna I , Pradana Antonius A , Salim Gustiani , Butar-butar Deni P , Lau Chuen-Yen , Karyana Muhammad 
Published: August 2020

Abstract
Background: Since its emergence in China, SARS-CoV-2 has infected more than 15.5 million people worldwide, including in regions where dengue virus (DENV) is hyperendemic such as Latin America and Southeast Asia, including Indonesia. Hence, anticipation for simultaneous infection by DENV and SARS-CoV-2 has been raised.Case presentation: We describe a 68-year-old woman with diabetes mellitus type II who was admitted to the Tangerang District Hospital on 14 April 2020. She lived in a neighborhood where a few people were contracting dengue fever. She presented with five days of fever, malaise, anorexia, nausea, myalgia, and arthralgia. Hematology results revealed anemia, thrombocytopenia, normal leukocyte count, increased neutrophil proportion, and decreased lymphocyte proportion and absolute lymphocyte. Her chest X-ray showed right pericardial infiltrates. Although dengue was clinically suspected, as she met COVID-19 screening criteria, she was also tested for SARS-CoV-2 infection. The patient was treated with ceftriaxone, paracetamol, azithromycin, oseltamivir, and chloroquine. She was clinically improved four days later and was discharged from the hospital on 25 April 2020 after SARS-CoV-2 rRT-PCR was negative on two consecutive samples. Dengue was diagnosed retrospectively based on sero-conversion of dengue IgM and a very high dengue IgG index (Focus Diagnostics®, ELISA), and sero-conversion of dengue IgM and positive IgG (PanBio ®Dengue duo cassette), which was equivalent to high hemagglutination inhibition antibody titer found in secondary dengue infection.Conclusion: The overlapping clinical presentations of COVID-19 and dengue; limited diagnostic capacity of laboratories in resource constrained settings; and complexities of interpreting results make identification of COVID-19 in the dengue endemic setting challenging. Clinicians in endemic areas must maintain a high index of suspicion for the possibility of COVID-19 coinfection with DENV and other tropical pathogens.
Synaptic Signals from Glutamate-Treated Neurons Induce Aberrant Post-Synaptic Signals in Untreated Neuronal Networks
Authors: Guaraldi Mary , Lee Sangmook , Shea Thomas B. 
Published: August 2020

Background and Objective:
Glutamate neurotoxicity is associated with a wide range of disorders and can impair synaptic function. Failure to clear extracellular glutamate fosters additional cycles and spread of regional hyperexcitation.

Methods and Results:
Using cultured murine cortical neurons, herein it is demonstrated that synaptic signals generated by cultures undergoing glutamate-induced hyperactivity can invoke similar effects in other cultures not exposed to elevated glutamate.

Conclusion:
Since sequential synaptic connectivity can encompass extensive cortical regions, this study presents a potential additional contributor to the spread of damage resulting from glutamate excitotoxicity and should be considered in attempts to mitigate neurodegeneration.