bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative study between single versus dual trigger for poor responders in GnRH‐antagonist ICSI cycles: A randomized controlled study
Authors: Maged Ahmed M. , Ragab Mohamed A. , Shohayeb Amal , Saber Waleed , Ekladious Sherif , Hussein Eman A. , El‐Mazny Akmal , Hany Ayman 
Published: October 2020

AbstractObjectiveTo investigate whether dual triggering of final oocyte maturation with a combination of gonadotropin‐releasing hormone (GnRH) agonist and human chorionic gonadotropin (hCG) can improve the number of retrieved oocytes and clinical pregnancy rate in poor responders undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF‐ICSI) cycles using a GnRH‐antagonist protocol.MethodsA randomized controlled trial included poor ovarian responders indicated for ICSI using a GnRH‐antagonist protocol. They were divided equally into two groups: group I received 10 000 units of hCG plus 0.2 mg of triptorelin while group II received 10 000 units of hCG only for triggering of ovulation. The primary outcome parameter was the number of oocytes retrieved. Secondary outcomes included metaphase II oocytes number, cancellation rate, number of obtained embryos, chemical and clinical pregnancy rates.ResultsOne hundred and sixty women were included in the study, with 80 women in each treatment group. Dual triggering was associated with higher number of retrieved oocytes (5.3 ± 1.9 vs 4.5 ± 2.4, P=0.014), metaphase II oocytes (3.8 ± 1.4 vs 3.1 ± 1.7, P=0.004), total and grade 1 embryos (2.7 ± 1.1 and 2.3 ± 1.0 vs 1.9 ± 1.2 and 1.1 ± 0.2, P=0.001 and 0.021 respectively), and transferred embryos (2.2 ± 0.9 vs 1.6 ± 0.9, P=0.043, and lower cancellation rate (7.5% vs 20%, P=0.037) compared with single triggering. There were significantly higher chemical (25% vs 11.3%, P=0.039) and clinical (22.5% vs 8.8%, P=0.028) pregnancy rates in women with dual triggering compared with those with single triggering.ConclusionDual triggering is associated with better IVF outcome in poor responders compared with single trigger.
Clinical trial registration NCT04008966.
Risk factors for adverse outcomes among pregnant and postpartum women with acute respiratory distress syndrome due to COVID‐19 in Brazil
Authors: Menezes Mariane O. , Takemoto Maíra L. S. , Nakamura‐Pereira Marcos , Katz Leila , Amorim Melania M. R. , Salgado Heloisa O. , Melo Adriana , Diniz Carmen S. G. , de Sousa Liduina A. R. , Magalhaes Claudia G. , Knobel Roxana , Andreucci Carla B. ,   Brazilian Group of Studies for COVID‐19, Pregnancy
Published: October 2020

AbstractObjectiveTo evaluate whether clinical and social risk factors are associated with negative outcomes for COVID‐19 disease among Brazilian pregnant and postpartum women.MethodsA secondary analysis was conducted of the official Acute Respiratory Syndrome Surveillance System database. Pregnant and postpartum women diagnosed with COVID‐19 ARDS until July 14, 2020, were included. Adverse outcomes were a composite endpoint of either death, admission to the intensive care unit (ICU), or mechanical ventilation. Risk factors were examined by multiple logistic regression.ResultsThere were 2475 cases of COVID‐19 ARDS. Among them, 23.8% of women had the composite endpoint and 8.2% died. Of those who died, 5.9% were not hospitalized, 39.7% were not admitted to the ICU, 42.6% did not receive mechanical ventilation, and 25.5% did not have access to respiratory support. Multivariate analysis showed that postpartum period, age over 35 years, obesity, diabetes, black ethnicity, living in a peri‐urban area, no access to Family Health Strategy, or living more than 100 km from the notification hospital were associated with an increased risk of adverse outcomes.ConclusionClinical and social risk factors and barriers to access health care are associated with adverse outcomes among maternal cases of COVID‐19 ARDS in Brazil.
Comprehensive pulmonary toxicity assessment of cetylpyridinium chloride using A549 cells and Sprague–Dawley rats
Authors: Kim Haewon , Yoo Jean , Lim Yeon‐Mi , Kim Eun‐Ji , Yoon Byung‐Il , Kim Pilje , Yu Seung Do , Eom Ig‐Chun , Shim Ilseob 
Published: October 2020

AbstractCetylpyridinium chloride (CPC), a quaternary ammonium compound and cationic surfactant, is used in personal hygiene products such as toothpaste, mouthwash, and nasal spray. Although public exposure to CPC is frequent, its pulmonary toxicity has yet to be fully characterized. Due to high risks of CPC inhalation, we aimed to comprehensively elucidate the in vitro and in vivo toxicity of CPC. The results demonstrated that CPC is highly cytotoxic against the A549 cells with a half‐maximal inhibitory concentration (IC50) of 5.79 μg/ml. Following CPC exposure, via intratracheal instillation (ITI), leakage of lactate dehydrogenase, a biomarker of cell injury, was significantly increased in all exposure groups. Further, repeated exposure of rats to CPC for 28 days caused a decrease in body weight of the high‐exposure group and the relative weights of the lungs and kidneys of the high recovery group, but no changes were evident in the histological and serum chemical analyses. The bronchoalveolar lavage fluid (BALF) analysis showed a significant increase in proinflammatory cytokines interleukin (IL)‐6, IL‐1β, and tumor necrosis factor (TNF)‐α levels. ITI of CPC induced focal inflammation of the pulmonary parenchyma in rats' lungs. Our study demonstrated that TNF‐α was the most commonly secreted proinflammatory cytokine during CPC exposure in both in vitro and in vivo models. Polymorphonuclear leukocytes in the BALF, which are indicators of pulmonary inflammation, significantly increased in a concentration‐dependent manner in all in vivo studies including the ITI, acute, and subacute inhalation assays, demonstrating that PMNs are the most sensitive parameters of pulmonary toxicity.
Improvement of the mechanical and biological properties of bioactive glasses by the addition of zirconium oxide (ZrO2) as a synthetic bone graft substitute
Authors: Kang Tae‐Yun , Seo Ji‐Young , Ryu Jeong‐Hyun , Kim Kwang‐Mahn , Kwon Jae‐Sung 
Published: October 2020

AbstractIn this study, mechanical properties of bioactive glass (BAG) synthetic bone graft substitute was improved by containing ZrO2 (ZrO2‐BAG), while maintaining advantageous biological properties of BAG such as osteoinductive and osteoconductive properties. The ZrO2‐BAG was produced by adding ZrO2 in the following proportions to replace Na2O in 45S5 BAG: 1% (Zr1‐BAG), 3% (Zr3‐BAG), 6% (Zr6‐BAG), and 12% (Zr12‐BAG). Properties including XRD, XPS, SEM, DSC, fracture toughness, and Vickers microhardness were evaluated. To assess the biological properties, Ca/P apatite formation, ion release, degradation rate, cell proliferation, ALP activity (ALP), and alizarin red S staining assay (ARS) were evaluated. Also, expression of osteogenic differentiation markers, Osteopontin (OPN), confirmed by immunofluorescence staining. Finally, an in vivo test was carried out to by implanting ZrO2‐BAG into the subcutaneous tissue of rats. The results of each test were statistically analyzed with one‐way ANOVA followed by Tukey's post hoc statistical test. Amorphous ZrO2‐BAG was successfully produced with increased mechanical properties as the ZrO2 content was increased. Additionally, ZrO2‐BAG exhibited a slower ion release and degradation rate compare to BAG without ZrO2. Bioactivity of ZrO2‐BAG was confirmed with apatite layer formed on the surface, significantly higher proliferation rate and significantly enhanced ALP and the degree of ARS of the cells compare to respective controls. The tissue reactions observed in the in vivo study showed neo‐formed vessels after implantation of ZrO2‐BAG.
Branched‐chain amino acid to tyrosine ratio is an essential pre‐treatment factor for maintaining sufficient treatment intensity of lenvatinib in patients with hepatocellular carcinoma
Authors: Eso Yuji , Nakano Shigeharu , Mishima Masako , Arasawa Soichi , Iguchi Eriko , Takeda Haruhiko , Takai Atsushi , Takahashi Ken , Seno Hiroshi 
Published: October 2020

AbstractBackground/PurposeLenvatinib was recently approved as a novel agent for hepatocellular carcinoma. To maximize the therapeutic effect of anticancer drugs, it is essential to maintain treatment intensity by avoiding dose reduction or discontinuation. We aimed to identify essential factors contributing to achieve sufficient treatment intensity of lenvatinib.MethodsSeventy‐one patients who received treatment with lenvatinib were included in this study. We used the delivered dose intensity/body surface area ratio (DBR) to measure treatment intensity of lenvatinib.Results2M‐DBR (DBR for the first 60 days) of lenvatinib (≥206.7) was strongly correlated with objective response and was the significant factor contributing to prolonged progression‐free survival (PFS). Patients with high 2M‐DBR had significantly prolonged PFS compared with those who had low 2M‐DBR (P < .001). Multivariate analysis revealed that pre‐treatment α‐fetoprotein and branched‐chain amino acid to tyrosine ratio (BTR) were significant factors in maintaining high 2M‐DBR of lenvatinib. Furthermore, patients with high pre‐treatment BTR (≥4.50) showed significantly longer PFS than those with low BTR (P = .032).ConclusionsMaintaining high 2M‐DBR of lenvatinib is essential to increase response rate and PFS. To achieve high 2M‐DBR levels, preservation of pre‐treatment BTR is essential, suggesting the importance of nutritional management in the treatment for hepatocellular carcinoma with lenvatinib.
Endoscopic ultrasound guided–antegrade biliary stenting vs percutaneous transhepatic biliary stenting for unresectable distal malignant biliary obstruction in patients with surgically altered anatomy
Authors: Iwashita Takuji , Uemura Shinya , Mita Naoki , Iwasa Yuhei , Ichikawa Hironao , Mukai Tsuyoshi , Yasuda Ichiro , Shimizu Masahito 
Published: October 2020

AbstractBackground/PurposeUnresectable distal malignant biliary obstruction (DMBO) in patients with surgically altered anatomy is traditionally managed with percutaneous transhepatic biliary drainage (PTBD) and stenting because the anatomical features complicate the endoscopic approach to the biliary orifice. EUS‐guided approaches recently emerged as alternative treatments; however, limited data comparing the procedures are available. The aim of this study was to compare EUS–antegrade biliary stenting (ABS) with PTBD for DMBO in patients with surgically altered anatomy.MethodsThe medical records of patients who underwent EUS‐ABS or PTBD for the management of DMBO and had a history of upper intestinal surgery at two tertiary centers between 2007 and 2019 were retrospectively evaluated. The study outcomes were technical, clinical, and internalization success rates and adverse event rates.ResultsOf the 64 enrolled patients, 35 underwent EUS‐ABS and 29 had PTBD. Basic characteristics including age, sex, performance status, primary malignancy, and reconstruction method did not differ significantly between groups. The technical, clinical, and internalization success rates in the EUS‐ABS and PTBD groups were 97.1% vs 96.6% (P = 1.00), 97.1% vs 93.1% (P = .586), and 97.1% vs 75.9% (P = .01), respectively. The adverse event rate was 11.4% vs 27.6% (P = .119). No significant long‐term difference was seen in time to recurrent biliary obstruction and survival. Multivariate analysis confirmed EUS‐ABS was not an independent risk factor for survival.ConclusionsSimilar to PTBD, EUS‐ABS can effectively and safely manage DMBO in patients with surgically altered anatomy. Further well‐designed trials are warranted to confirm these findings.
Larger Carpathian region climate according to Köppen, Feddema and the Worldwide Bioclimatic Classification System methods
Authors: Szabó Amanda Imola , Ács Ferenc , Breuer Hajnalka 
Published: October 2020

AbstractThe Köppen method, the Worldwide Bioclimatic Classification System (WBCS), and Feddema's descriptive climate classification method are used to analyse the Larger Carpathian Region (LCR) climate. Minimum, maximum and average temperature, precipitation and latitude and elevation data as input data are taken from the CarpatClim dataset. It refers to the period 1961–2010 with a 1‐day temporal resolution and a spatial resolution of 0.1° × 0.1°. The methods are compared in terms of their capability to represent climate heterogeneity and thermal and moisture characteristics on the annual and seasonal time scales. The region's climate is analysed separately for lowland, hill, mountain and high mountain regions using the results of the Köppen method as reference. The WBCS gave the highest spatial climate heterogeneity, followed by Feddema's method, and then the Köppen method in all three region types. However, the WBCS has the largest data input requirement. The rarest climate type according to the Köppen method is ET. This climate type is registered according to the Feddema and WBCS methods by three different climate types. The most frequent climate type according to the Köppen method is Cfb. This climate type is represented by 19 and 14 climate types according to the Feddema and the WBCS methods, respectively. The most frequent climate type according to Feddema's method is cool and dry with extreme seasonality of T and according to WBCS it is temperate continental steppic supratemperate sub‐humid. The coldest climate is produced by Feddema, the warmest by the WBCS. The Feddema method treats seasonality in the most comprehensive way. The Feddema and the WBCS methods reproduced the large climate heterogeneity of the LCR. The results can also be used as basic information in the PannEx project, as well as in future environmental and regional climate change‐related investigations for estimating thermal and moisture stresses.
Analyzing the predictability of the Kwok and Caton periodontal prognosis system: A retrospective study
Authors: Nguyen Lincoln , Krish Goutam , Alsaleh Ahmed , Mailoa James , Kapila Yvonne , Kao Richard T. , Lin Guo‐Hao 
Published: October 2020

AbstractBackgroundThe aim of this study was to analyze the predictability of the Kwok and Caton periodontal prognosis system by investigating tooth survival within a 64‐month period and to compare this to other well‐established prognosis systems.MethodsThis retrospective study included the records of patients who had a minimum of two dental exams at least 12 months apart at a single University‐affiliated Dental Center. Data including patients’ age, sex, length of follow‐up period, initial tooth prognosis, revised tooth prognosis, tooth type, and number of teeth lost at the latest exam were recorded. Descriptive analysis was used for data interpretation.ResultsA total of 4,046 teeth from 174 patients qualified for the study. Teeth with initial poorer prognosis had a higher chance of being extracted compared with those with a better initial prognosis. Tooth survival rate at the latest follow‐up for those with an initial favorable, questionable, unfavorable, and hopeless prognosis was 97.9%, 90.7%, 62.5%, and 17.7%, respectively. Teeth initially assigned to a poorer prognosis category had a higher proportion that changed to a worse prognosis at the latest periodontal exam.ConclusionsThe Kwok and Caton prognosis system can predictably determine tooth survivability within a 5‐year period. The defined categories of this prognosis system are more reliable than that of other systems in the short‐term. However, long‐term (>5 years) prediction accuracy of this prognosis system needs further investigation.
Comprehensive polyphenolic profiling in promising resistant grapevine hybrids including 17 novel breeds in northern Italy
Authors: Gratl Verena , Sturm Sonja , Zini Elena , Letschka Thomas , Stefanini Marco , Vezzulli Silvia , Stuppner Hermann 
Published: October 2020

AbstractBACKGROUNDA promising way to overcome the susceptibility of Vitis vinifera L. to fungal diseases is the integration of genetic resistance by the interspecific crossing between V. vinifera varieties and resistant species. However, the products of such hybrids are still not accepted by customers, particularly due to their organoleptic characteristics, not least influenced by their polyphenolic profile.RESULTSA total of 58 resistant breeding lines, 41 from international programs and 17 new progeny individuals, were grown in one untreated vineyard to exclude any variances by climatic and pedologic conditions or vineyard practice. A total of 60 polyphenols (including acids, anthocyanins, flavonols, flavan‐3‐ols, and stilbenoids) were determined in grapevine berries by ultrahigh‐performance liquid chromatography–mass spectrometry in two consecutive years. The overall profiles were rather consistent (variation P > 0.05) within the two harvests, with the exceptions of epicatechin and caftaric acid. Anthocyanin diglucosides were found in ten of the red breeding lines, malvidin‐3,5‐O‐diglucoside being predominant in nine of them. Total polyphenol content of the unknown progeny individuals and international breeding lines was comparable, with the exception of significantly increased amounts of gallic acid and some flavonoids.CONCLUSIONThe comprehensive study reported herein of the polyphenolic profile of hybrids from international breeding programs, but also of new breeds from private initiatives, all cultivated in the same vineyard, will support the selection of promising candidates for further breeding programs to overcome impairment due to undesired sensory characteristics of new highly resistant varieties.
Effects of supplemental LED light quality and reduced growth temperature on swede (Brassica napus L. ssp. rapifera Metzg.) root vegetable development and contents of glucosinolates and sugars
Authors: Mølmann Jørgen AB , Hansen Espen , Johansen Tor J 
Published: October 2020

AbstractBACKGROUNDLow growth temperatures and the special light qualities of midnight sun in northern Scandinavia, have both been shown to improve eating quality of swede root bulbs. To study the combined effect of these factors on root development and sensory‐related compounds, plants were grown in phytotron under different 24 h supplemental light‐emitting diode (LED) light colours, at constant 15 °C, or reduced end‐of‐season temperature at 9 °C.RESULTSFar‐red LED (740 nm) light induced longer leaves and produced more roundly shaped bulbs, than the other light quality treatments. At constant 15 °C, supplemental light of far‐red LED also produced a stronger purple crown skin colour than the other LED treatments. This difference between light quality treatments disappeared at 9 °C, as all bulb crowns developed a purple colour. There were no significant effects of LED‐supplements on sugar concentrations, while the reduced temperature on average did increase concentrations of d‐fructose and d‐glucose. Total glucosinolate concentrations were not different among treatments, although the most abundant glucosinolate, progoitrin, on average was present in highest concentration under LEDs containing far‐red light, and in lower concentration at 9 °C compared to 15 °C.CONCLUSIONThe light quality of 24 h photoperiods in combination with temperature appears primarily important for growth and morphological traits in swede root bulbs. Influence of light quality and low temperature on appearance and sensory‐related compounds may be utilized in marketing of root vegetables with special quality related to growth conditions of high latitude origin. © 2020 Society of Chemical Industry
Deep learning‐based digitization of prostate brachytherapy needles in ultrasound images
Authors: Andersén Christoffer , Rydén Tobias , Thunberg Per , Lagerlöf Jakob H. 
Published: October 2020

PurposeTo develop, and evaluate the performance of, a deep learning‐based three‐dimensional (3D) convolutional neural network (CNN) artificial intelligence (AI) algorithm aimed at finding needles in ultrasound images used in prostate brachytherapy.MethodsTransrectal ultrasound (TRUS) image volumes from 1102 treatments were used to create a clinical ground truth (CGT) including 24422 individual needles that had been manually digitized by medical physicists during brachytherapy procedures. A 3D CNN U‐net with 128 × 128 × 128 TRUS image volumes as input was trained using 17215 needle examples. Predictions of voxels constituting a needle were combined to yield a 3D linear function describing the localization of each needle in a TRUS volume. Manual and AI digitizations were compared in terms of the root‐mean‐square distance (RMSD) along each needle, expressed as median and interquartile range (IQR). The method was evaluated on a data set including 7207 needle examples. A subgroup of the evaluation data set (n = 188) was created, where the needles were digitized once more by a medical physicist (G1) trained in brachytherapy. The digitization procedure was timed.ResultsThe RMSD between the AI and CGT was 0.55 (IQR: 0.35–0.86) mm. In the smaller subset, the RMSD between AI and CGT was similar (0.52 [IQR: 0.33–0.79] mm) but significantly smaller (P < 0.001) than the difference of 0.75 (IQR: 0.49–1.20) mm between AI and G1. The difference between CGT and G1 was 0.80 (IQR: 0.48–1.18) mm, implying that the AI performed as well as the CGT in relation to G1. The mean time needed for human digitization was 10 min 11 sec, while the time needed for the AI was negligible.ConclusionsA 3D CNN can be trained to identify needles in TRUS images. The performance of the network was similar to that of a medical physicist trained in brachytherapy. Incorporating a CNN for needle identification can shorten brachytherapy treatment procedures substantially.
Breast ultrasound lesion classification based on image decomposition and transfer learning
Authors: Zhuang Zhemin , Kang Yuqiang , Joseph Raj Alex Noel , Yuan Ye , Ding Wanli , Qiu Shunmin 
Published: October 2020

PurposeIn medical image analysis, deep learning has great application potential. Discovering a method for extracting valuable information from medical images and integrating that information closely with medical treatment has recently become a major topic of interest. Because obtaining large volumes of breast lesion ultrasound image data is difficult, transfer learning is usually employed to obtain benign and malignant classification of breast lesions. However, because of blurred unclear regions of interest in breast lesion ultrasound images and severe speckle noise interference, convolutional neural networks have proven ineffective in extracting features, thus providing unreliable classification results.MethodsThis study employs image decomposition to obtain fuzzy enhanced and bilateral filtered images to enrich input information of breast lesions. Fuzzy enhanced, bilateral filtered, and original ultrasound images comprise multifeature data, which are presented as inputs to a pre‐trained model to realize knowledge fusion. Therefore, effective features of breast lesions are extracted and then used to train fully connected layers with ground truths provided by a doctor to accomplish the classification.ResultsA pre‐trained VGG16 model was used to extract features from multifeature data, and these features were fused to train the fully connected layers to realize classification. The performance score reported is as follows: accuracy of 93%, sensitivity of 95%, specificity of 88%, F1 score of 0.93, and AUC of 0.97.ConclusionsCompared with using a single original ultrasound image for feature extraction, multifeature data based on image decomposition enables the pre‐trained model to extract more relevant features, thereby providing better classification results than those from traditional transfer learning techniques.