bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maternal obesity classes, preterm and post-term birth: a retrospective analysis of 479,864 births in England
Authors: Slack Emma , Best Kate E. , Rankin Judith , Heslehurst Nicola 
Published: November 2019

Abstract
Background
Preterm (< 37 weeks gestation) and post–term birth (≥42 weeks gestation) are associated with increased morbidity and mortality for mother and infant. Obesity (body mass index (BMI) ≥30 kg/m2) is increasing in women of reproductive age. Maternal obesity has been associated with adverse pregnancy outcomes including preterm and post–term birth. However, the effect sizes vary according to the subgroups of both maternal BMI and gestational age considered. The aim of this retrospective analysis was to determine the association between maternal obesity classes and gestational age at delivery.

Methods
A secondary data analysis of 13 maternity units in England with information on 479,864 singleton live births between 1990 and 2007. BMI categories were: underweight (< 18.5 kg/m2), recommended weight (18.5–24.9 kg/m2), overweight (25.0–29.9 kg/m2) and obesity classes I (30.0–34.9 kg/m2), II (35.0–39.9 kg/m2), IIIa (40–49.9 kg/m2) and IIIb (≥50 kg/m2). Gestational age at delivery categories were: Gestational age at delivery (weeks): extreme preterm (20–27), very preterm (28–31), moderately preterm (32–36), early term (37, 38), full term (39–40), late term (41) and post–term (≥42). The adjusted odds of births in each gestational age category (compared to full-term birth), according to maternal BMI categories were estimated using multinomial logistic regression. Missing data were estimated using multiple imputation with chained equations.

Results
There was a J-shaped association between the absolute risk of extreme, very and moderate preterm birth and BMI category, with the greatest effect size for extreme preterm. The absolute risk of post-term birth increased monotonically as BMI category increased. The largest effect sizes were observed for class IIIb obesity and extreme preterm birth (adjusted OR 2.80, 95% CI 1.31–5.98).

Conclusion
Women with class IIIb obesity have the greatest risks for inadequate gestational age. Combining obesity classes does not accurately represent risks for many women as it overestimates the risk of all preterm and post-term categories for women with class I obesity, and underestimates the risk for women in all other obesity classes.
MicroRNAs in Pancreatic Cancer: biomarkers, prognostic, and therapeutic modulators
Authors: Daoud Afra Z. , Mulholland Eoghan J. , Cole Grace , McCarthy Helen O. 
Published: November 2019

AbstractA severe lack of early diagnosis coupled with resistance to most available therapeutic options renders pancreatic cancer as a major clinical concern. The limited efficacy of current treatments necessitates the development of novel therapeutic strategies that are based on an understanding of the molecular mechanisms involved in pancreatic cancer progression. MicroRNAs (miRNAs) are non-coding small RNAs that regulate the expression of multiple proteins in the post-translation process and thus have promise as biomarkers, prognostic agents, and as advanced pancreatic therapies.Profiling of deregulated miRNAs in pancreatic cancer can correlate to diagnosis, indicate optimal treatment and predict response to therapy. Furthermore, understanding the main effector genes in pancreatic cancer along with downstream pathways can identify possible miRNAs as therapeutic candidates. Additionally, obstacles to the translation of miRNAs into the clinic are also considered.Distinct miRNA expression profiles can correlate to stages of malignant pancreatic disease, and hold potential as biomarkers, prognostic markers and clinical targets. However, a limited understanding and validation of the specific role of such miRNAs stunts clinical application. Target prediction using algorithms provides a wide range of possible targets, but these miRNAs still require validation through pre-clinical studies to determine the knock-on genetic effects.Graphical abstract
Methodology of predicting novel key regulators in ovarian cancer network: a network theoretical approach
Authors: Malik Md. Zubbair , Chirom Keilash , Ali Shahnawaz , Ishrat Romana , Somvanshi Pallavi , Singh R. K. Brojen 
Published: November 2019

AbstractBackgroundIdentification of key regulator/s in ovarian cancer (OC) network is important for potential drug target and prevention from this cancer. This study proposes a method to identify the key regulators of this network and their importance.MethodsThe protein-protein interaction (PPI) network of ovarian cancer (OC) is constructed from curated 6 hundred genes from standard six important ovarian cancer databases (some of the genes are experimentally verified). We proposed a method to identify key regulators (KRs) from the complex ovarian cancer network based on the tracing of backbone hubs, which participate at all levels of organization, characterized by Newmann-Grivan community finding method. Knockout experiment, constant Potts model and survival analysis are done to characterize the importance of the key regulators in regulating the network.ResultsThe PPI network of ovarian cancer is found to obey hierarchical scale free features organized by topology of heterogeneous modules coordinated by diverse leading hubs. The network and modular structures are devised by fractal rules with the absence of centrality-lethality rule, to enhance the efficiency of signal processing in the network and constituting loosely connected modules. Within the framework of network theory, we device a method to identify few key regulators (KRs) from a huge number of leading hubs, that are deeply rooted in the network, serve as backbones of it and key regulators from grassroots level to complete network structure. Using this method we could able to identify five key regulators, namely, AKT1, KRAS, EPCAM, CD44 and MCAM, out of which AKT1 plays central role in two ways, first it serves as main regulator of ovarian cancer network and second serves as key cross-talk agent of other key regulators, but exhibits disassortive property. The regulating capability of AKT1 is found to be highest and that of MCAM is lowest.ConclusionsThe popularities of these key hubs change in an unpredictable way at different levels of organization and absence of these hubs cause massive amount of wiring energy/rewiring energy that propagate over all the network. The network compactness is found to increase as one goes from top level to bottom level of the network organization.
Preoperative risk stratification for early recurrence of HBV-related hepatocellular carcinoma after deceased donor liver transplantation: a five-eight model development and validation
Authors: Al-Ameri Abdulahad Abdulrab Mohammed , Wei Xuyong , Lin Lidan , Shao Zhou , Guo Haijun , Xie Haiyang , Zhou Lin , Zheng Shusen , Xu Xiao 
Published: November 2019

Abstract
Background
Early recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT) is associated with poor surgical outcomes. This study aims to construct a preoperative model to predict individual risk of post-LT HCC recurrence.

Methods
Data of 748 adult patients who underwent deceased donor LT for HCC between January 2015, and February 2019 were collected retrospectively from the China Liver Transplant Registry database and randomly divided into training (n = 486) and validation(n = 262) cohorts. A multivariate analysis was performed and the five-eight model was developed.

Results
A total of 748 patients were included in the study; of them, 96% had hepatitis B virus (HBV) and 84% had cirrhosis. Pre-LT serum alpha-fetoprotein (AFP), tumor number and largest tumor diameter were incorporated to construct the 5–8 model which can stratify patients accurately according to their risk of recurrence into three prognostic subgroups; low-(0–5 points), medium-(6–8 points) and high-risk (> 8 points) with 2-year post-LT recurrence rate of (5,20 and 51%,p <  0.001) respectively. The 5–8 model was better than Milan, Hangzhou, and AFP-model for prediction of HCC early recurrence. These findings were confirmed by the results of the validation cohort.

Conclusions
The 5–8 model is a simple validated and accurate tool for preoperative stratification of early recurrence of HCC after LT.
The role of vascular mimicry as a biomarker in malignant melanoma: a systematic review and meta-analysis
Authors: Zhang Zhenhua , Imani Saber , Shasaltaneh Marzieh Dehghan , Hosseinifard Hossein , Zou Linglin , Fan Yu , Wen Qinglian 
Published: November 2019

AbstractBackgroundVasculogenic mimicry (VM) a microvascular system consisting of non-endothelial cells that is newly formed by aggressive tumors, has been proposed as an important therapeutic target in malignant melanoma (MM). We performed a systematic literature review to evaluate the diagnostic and prognostic accuracy of VM status for overall survival of MM patients.MethodsThe quality of the included studies was evaluated using the QUADAS-2 tool. Diagnostic capacity of VM variables, including sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and the area under summary receiver operating characteristic (SROC), were pooled using Meta-DiSc software.ResultsA retrospective observational study was conducted based on twelve clinical studies including 978 clinically confirmed melanoma patients with proportion (P). VM+ melanoma cells were associated with poor prognosis in 38% of MM group (P = 0.35, 95% confidence intervals (CI): 0.27–0.42,p < 0.001). The pooled sensitivity and specificity were 0.82 (95% CI: 0.79–0.84) and 0.69 (95% CI: 0.66–0.71), respectively. Furthermore, the pooled PLR, NLR, and DOR were 2.56 (95% CI: 1.94–3.93), 0.17 (95% CI: 0.07–0.42), and 17.75 (95% CI: 5.30–59.44), respectively. Furthermore, the AUC of SROC was 0.63, indicating high reliability of VM status as a biomarker. Importantly, subgroup results suggested that VM+ status is a significantly accurate prognostic biomarker when diagnosed by the CD31−/PAS+ staining methods in Asian MM samples (p < 0.001).ConclusionsOur findings support the potential of VM status of tumors as a promising prognostic biomarker and emphasize an effective adjuvant therapeutic strategy in the prognosis of Asian MM patients.
Application of contrast-enhanced ultrasonography in the diagnosis of post-kidney transplant lymphoproliferative disorder in native kidney- a case report
Authors: Zhang Jian-Chao , Lan Hui-Xia , Zhao Hui-Juan , Lei Yang-Yang , Ma Li , Xie Xiao-Yan , Lu Ming-de , Wang Wei 
Published: November 2019

Abstract
Background
Post-transplant lymphoproliferative disorders (PTLDs) represent a spectrum of heterogenetic lymphoid proliferations. PTLD is a serious complication that affects the long-term survival of kidney transplant patients. Imaging examination is an important method for detecting and diagnosing PTLD. Contrast-enhanced ultrasonography (CEUS) and CEUS-guided biopsy are important modalities for tumor detection and diagnosis. In this case, we describe a 69 years old man in whom a native kidney PTLD was confirmed by CEUS.

Case presentation
A 69-year-old male patient who had a kidney transplant 1 year earlier presented with 3 months of progressive myasthenia of both lower limbs associated with amyotrophy and weight loss. Although positron emission tomography/computed tomography (PET-CT) showed a high metabolic lesion in the untransplanted kidney, abdominal contrast enhanced computed tomography cannot detect the lesion in the atrophic left kidney. The above examinations showed that the transplanted kidney was normal. CEUS can detect a homogeneously enhanced lesion in the same location as PET-CT. Subsequently, a biopsy was performed under CEUS guidance, and the final pathological diagnosis was diffuse large B-cell lymphoma. The patient then received the R-CHOP treatment. Unfortunately, pulmonary thromboembolism occurred 2 weeks later, and the patient’s condition was not alleviated through active treatment. Finally, the patient’s family gave up treatment, and the patient was discharged.

Conclusion
The case suggested that CEUS was a valuable imaging method for patient with renal transplantation to detect and diagnose of PTLD.
Purtscher-like retinopathy presented a honeycomb-like pattern in optical coherence topography angiography
Authors: Li Bing , Li Donghui , Chen Youxin 
Published: November 2019

Abstract
Background
To report a case of Purtscher-like retinopathy (PUR) and the optical coherence tomography (OCT) and OCT angiography (OCT-A) findings before and after treatment.

Case presentation
A 65-year-old male presented with acute onset of vision loss for 2 weeks. Fundus examination revealed cotton-wool spots, retinal haemorrhage, and Purtscher flecken spread around the optic disc in the right eye. He was diagnosed with Purtscher-like retinopathy because he lacked any traumatic medical history. OCT presented some band-like hyperreflective lesions at the inner nuclear layer, which are indicative of paracentral acute middle maculopathy (PAMM). OCT-A revealed apparent reduction in blood flow signal at the deep retina and choriocapillaris layers with a honeycomb-like hypointense signal pattern. After 3 months of follow-up, OCT revealed resolution of retinal oedema, but PAMM lesions remained visible. Based on OCT-A, the honeycomb-like pattern turned into a homogeneous reduction in blood flow with small patches of hypointense signal areas in the choriocapillaris.

Conclusion
This case presented a new OCT-A sign in PUR with a honeycomb-like hypointense signal at the choriocapillaris layer, indicating the involvement and ischaemia of the choroid during the pathological process.
A modified intrascleral intraocular lens fixation technique with fewer anterior segment manipulations: 27-gauge needle-guided procedure with built-in 8–0 absorbable sutures
Authors: Yang Yuan , Yao Teng-teng , Zhou Ya-li , Wang Yi-xiao , Wang Zhao-yang 
Published: November 2019

AbstractBackgroundTo report a modified surgical technique for intrascleral intraocular lens (IOL) fixation with fewer anterior segment manipulations in eyes lacking sufficient capsular support.MethodsEyes from 14 patients who underwent 27-gauge needle-guided intrascleral IOL fixation with built-in 8–0 absorbable sutures were studied. The 8–0 absorbable sutures were inserted into 27-gauge round needles and used to create sclerotomies at the 4 o’clock and 10 o’clock positions under the scleral flap. The sutures were used to tie knots at the end of each haptic and guide haptic externalization through the sclerotomy. After externalization, a sufficient flange was created at the end of each haptic and fixed under the scleral flaps. The best corrected visual acuity (BCVA), corneal endothelial cell density (ECD), IOL tilt and decentration, previous surgery history, and complications were determined.ResultsFourteen cases were analyzed. The majority of eyes exhibited an improvement in the BCVA after surgery. When comparing the last follow-up to preoperative visual acuity, the mean change in BCVA was + 26.32 letters (p = 0.011). Postoperative complications included postoperative hypotony in 3 eyes, ocular hypertension in 2 eyes. No cases of postoperative cystoid macular edema (CME), vitreous hemorrhage (VH), IOL dislocation, or endophthalmitis were observed.ConclusionsThe 27-gauge needle-guided intrascleral IOL fixation technique with built-in 8–0 absorbable sutures is easy to perform with fewer anterior chamber manipulations and achieves both anatomical and optical stability.
Unilateral visual impairment in a patient undergoing chemotherapy: a case report and clinical findings
Authors: Yuan Xia , Feng Yuliang , Li Dan , Li Mei 
Published: November 2019

Abstract
Background
Visual impairment occurred as an infrequent form of chemotherapeutic toxicity and was often underestimated despite of several reports. We described a case of acute unilateral visual impairment after one cycle of intravenous chemotherapy of a normal dose, aiming at raising attention to chemotherapy-induced ocular toxicity.

Case presentation
The patient developed a progressive vision loss in the right eye during the chemotherapy. After one cycle of intravenous chemotherapy, her visual acuity decreased by 0.6 in the right eye (VOD = 0.4) compared to the previous value of 1.0 (VOD = 1.0). No evidence of ocular infiltration was observed from the cerebral magnetic resonance imaging (MRI). During her follow-up period, we documented the ophthalmologic examinations including visual acuity, visual field (VF), visual evoked potential (VEP), electroretinogram (ERG), fundus photograph (FP), fundus fluorescein angiography (FFA) and optical coherence tomography (OCT). Ophthalmoscope examination and fundus photograph showed optic disc edema, fuzzy boundary and linear hemorrhages in her right eye. Fundus fluorescein angiography (FFA) revealed capillary underdevelopment at the nasal and superior temporal area of the optic disc in the early phase and capillary fluorescein leakage in the late phase. The result of VEP test suggested the impaired function of the optic nerve. Thus, a diagnosis of nonarteritic anterior ischemic optic neuropathy (NAION) was made by the ophthalmologist according to these results. The patient was prescribed prednisone combined with neuroprotective drugs, which did not work. After the cessation of chemotherapy, her impaired vision gradually recovered.

Conclusions
This is the first reported case of acute visual impairment in a patient who underwent chemotherapy of a normal dose. It is indicated that while receiving benefits from chemotherapy, cancer patients simultaneously suffer from the risk of vision loss.
Effects of excimer laser phototherapeutic keratectomy in limbal-conjunctival autograft transplantation for recurrent pterygium: a retrospective case control study
Authors: Chen Di , Liu Xiaowei , Long Qin , Wang Zhonghai , Li Ying 
Published: November 2019

Abstract
Background
Repeated surgery excisions could induce obvious irregular astigmatism in patients with recurrent pterygium. Our study is aimed to illustrate the effect of adjunct excimer laser phototherapeutic keratectomy (PTK) in limbal-conjunctival autograft transplantation on visual quality for patients with recurrent pterygium.

Methods
Retrospective case-control study. Eyes that underwent pterygium excision with (PTK group) or without (control group) PTK from 2006 to 2017 were retrospectively included. Recurrence rate, preoperative and postoperative surface regularity index (SRI), surface asymmetry index (SAI), cylinder and LogMAR vision were collected. Postoperative anterior segment optical coherence topography and in vivo confocal microscopy were performed to monitor the cornea epithelium healing and cellular recovery process respectively.

Results
A total of 99 eyes of 99 patients were collected, of which 39 were treated with PTK and 60 without PTK. The mean follow-up time was 50.4 ± 38.1 months. The recurrence rate was 10.3% (4 eyes) in the PTK group and 13.3% (8 eyes) in the control group (p = 0.759). The SRI decreased 0.53 (range: − 0.88, 2.81), SAI decreased 0.53 (range: − 0.64, 2.94), and the cylinder decreased 2.08 (range:-0.16, 9.40) D in the PTK group, and the corresponding values were 0.48 (range:-0.45, 2.27), 0.27 (range:-1.06, 2.21) and 0.71 (range:-1.75, 3.55) D in the control group, respectively (Z = 1.76, 2.15, and 3.97, p = 0.005, 0.016, and 0.000 respectively). LogMAR vision improved in both groups after surgery, with an improvement of 0.18 (range: 0.00, 0.70) in the PTK group and 0.06 (range: − 0.12, 0.50) in the control group (Z = 4.08, p = 0.000). Besides, the eyes treated with PTK showed faster re-epithelization and better cellular recovery.

Conclusions
For recurrent pterygium, surgical excision with adjunct PTK might be a better option with improved corneal surface and vision outcomes.
Screening four broad categories of eating disorders: suitability of a clinical algorithm adapted from the SCOFF questionnaire
Authors: Tavolacci Marie-Pierre , Gillibert André , Zhu Soubise Aurélien , Grigioni Sébastien , Déchelotte Pierre 
Published: November 2019

AbstractBackgroundWe evaluated the performance of a clinical algorithm (Expali™),combining two or more positive answers to SCOFF questionnaire with Body Mass Index (BMI), to identify four Broad Categories of eating disorders (ED) derived from DSM-5.MethodsThe clinical algorithm (Expali™)was developed from 104 combinations of BMI levels and answers to five SCOFF questions with at least two positive answers. Two senior ED physicians allocated each combination to one of the four Broad Categories of ED derived from DSM-5: restrictive disorder, bulimic disorder, hyperphagic disorder and other unspecified ED diagnosed by ED clinicians. The performance of Expali™was evaluated on data from 206 patients with ED. Sensitivity, specificity values and Youden index were calculated for each category.ResultsThe 206 patients were diagnosed as follows: 31.5% restrictive disorder, 18.9% bulimic disorder, 40.8% hyperphagic disorder and 8.8% other ED. The sensitivity of Expali™for restrictive, bulimic, hyperphagic and other unspecified ED were respectively: 76.9, 69.2, 79.7 and 16.7%. The Youden index was respectively 0.73, 0.57, 0.67 and 0.07.ConclusionsIn a SCOFF-positive ED population (at least two positive answers), the clinical algorithm Expali™demonstrated good suitability by correctly classifying three of the four Broad Categories of eating disorders (restrictive, bulimic and hyperphagic disorder). It could be useful both to healthcare professionals and the general population to enable earlier detection and treatment of ED and to improve patient outcomes.