bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Role of Adjuvant Chemotherapy in Metaplastic Breast Carcinoma: A Competing Risk Analysis of the SEER Database
Authors: Lan Tian , Lu Yunyan , Zheng Ruzhen , Shao Xiying , Luo Hua , He Junling , Yang Huifen , Xu Haibin , Wang Xiaojia , Hu Zujian 
Published: April 2021

Purpose: Chemotherapy is the clinically recommended treatment for patients with operable metaplastic breast carcinoma (MBC); however, its impact remains controversial. This study investigated the possible role of chemotherapy in the treatment of MBC.Methods: The Surveillance, Epidemiology, and End Results (SEER) database was used to identify the operable MBC patients. The competing risk analysis along with the propensity score matching (PSM) method was performed to evaluate the effect of chemotherapy. Moreover, a competing risk nomogram was built to identify prognosis in patients with MBC.Results: Of the 1137 patients with MBC, 775 received chemotherapy and 362 did not receive chemotherapy. The 5-year cumulative incidence of breast cancer-specific death (BCSD) showed similar outcomes in both the Chemo and No-Chemo groups (21.1 vs. 24.3%, p = 0.57). Chemotherapy showed no apparent association with BCSD (HR, 1.07; 95% CI, 0.72–1.60; p = 0.72), even after subgroup analysis or PSM. Race, tumor size, lymph node status, and radiation were identified as the significant factors for MBC after a penalized variable selection process. In addition, a competing risk nomogram showed relatively good accuracy of prediction with a C-index of 0.766 (95% CI, 0.700–0.824).Conclusion: Our findings demonstrated that chemotherapy did not improve BCSD for operable MBC patients. Thus, it may indicate the need to reduce exposure to the current chemotherapy strategies for patients with resectable MBC. Additionally, some novel treatment strategies are required urgently to identify and target the potential biomarkers.
Intrauterine Hypoxia Changed the Colonization of the Gut Microbiota in Newborn Rats
Authors: Sun Yan , Li Lei , Song Jiayu , Mao Wei , Xiao Kaihao , Jiang Chunming 
Published: April 2021

Background: Accumulating evidence suggests a connection between the gut microbiota and neonatal diseases. Hypoxia may play an important role in the intestinal lesions in neonates.Objective: This study aims to determine whether the gut microbiota differs between intrauterine hypoxic rats and healthy controls and to identify the factors that influence the changes in the gut microbiota.Methods: We constructed an intrauterine hypoxia model in rats and collected the intestinal contents of intrauterine hypoxic newborn rats and normal newborn rats within 4 h and on the seventh day after birth. They were divided them into the intrauterine hypoxia first-day group (INH1), intrauterine hypoxia seventh-day group (INH7), normal first-day group (NOR1), and normal seventh-day group (NOR7). The contents of the intestines were sequenced with 16S rRNA sequencing, the sequencing results were analyzed for biological information, and the differences in the diversity, richness, and individual taxa among the groups were analyzed.Results: The abundance of the gut microbiota of neonatal rats with intrauterine hypoxia was higher than that of the control group rats. Intrauterine hypoxia altered the structural composition of the gut microbiota in neonatal rats. The INH1 group showed increased species richness, phylogenetic diversity, and β-diversity, and altered relative abundance in several taxa compared to those in the control group. The differences in the microbiota among the four groups were significantly higher than those within the group, and the differences in the abundance and diversity of the INH7 and NOR7 groups decreased after 7 days of suckling. Functional analysis based on the Cluster of Orthologous Groups (COG) suggested that 23 functional COG categories. There was no significant difference in the functional categories between the hypoxia group and the normal group.Conclusion: Intrauterine hypoxia changed the initial colonization of the gut microbiota in neonatal rats. It could increase the species richness and β-diversity of the gut microbiota, and altered relative abundances of several taxa.
Lack of Awareness of the Impact of Improperly Disposed Of Medications and Associated Factors: A Cross-Sectional Survey in Indonesian Households
Authors: Alfian Sofa D. , Insani Widya N. , Halimah Eli , Qonita Nabilla A. , Jannah Siti S. , Nuraliyah Nisa M. , Supadmi Woro , Gatera Vesara A. , Abdulah Rizky 
Published: April 2021

Introduction: Disposal of unused medications through environmentally unsafe routes is common in Indonesia. The lack of awareness of the impact of improperly disposed of medications is a significant contributing factor. The objectives of this study were to identify factors associated with lack of awareness of the impact of improperly disposed of unused medications and to assess the associations of awareness with medication disposal practices among the general population in Indonesia.Patients and methods: An observational cross-sectional survey was conducted using nonprobability sampling in Bandung, Indonesia, from November 2017 to January 2018 among respondents who were older than 18 years, had used any medication in the past, were literate, and had signed an informed consent document. Disposal practices and awareness regarding the impact of improperly disposed of unused medications were collected using an online- and a paper-based pre-validated questionnaire. The paper-based questionnaires were distributed to respondents in public places such as city center, markets, and religious places. Binary logistic regression was performed to assess associations of sociodemographic and other related factors with a lack of awareness. Odds ratios (ORs) with 95% confidence intervals (CIs) are reported.Results: Of 497 participating respondents, 433 and 64 respondents filled an online- or a paper-based questionnaire, respectively. Most respondents were female, aged between 18 and 30 years, and students/university students. Of 497 respondents, more than half (53.1%) were not aware that improper medication disposal could harm the environment and population health. Most respondents (79.5%) had never received information about proper medication disposal practices. The education level, the number of stored medications at home, and previous education about medication disposal practices were significantly associated with awareness of proper practices. In the multivariate analysis, only those with previous education about medication disposal practices were less likely to report a lack of awareness (OR: 0.043; 95% CI: 0.02–0.09). Respondents with a lack of awareness tended to dispose of their unused medications in the garbage or shared them with friends or relatives.Conclusion: There is a clear need to increase awareness of the importance of proper medication disposal practices, in particular among the student population of Bandung city, Indonesia. Healthcare providers can play an important role by educating this specific population on the proper disposal of unused medications.
Caspase-11-Gasdermin D-Mediated Pyroptosis Is Involved in the Pathogenesis of Atherosclerosis
Authors: Jiang Mengqing , Sun Xuejing , Liu Suzhen , Tang Yan , Shi Yunming , Bai Yuanyuan , Wang Yujie , Yang Qiong , Yang Qize , Jiang Weihong , Yuan Hong , Jiang Qixia , Cai Jingjing 
Published: April 2021

Background: Pyroptosis is a form of cell death triggered by proinflammatory signals. Recent studies have reported that oxidized phospholipids function as caspase-11 agonists to induce noncanonical inflammasome activation in immune cells. As the levels of oxidized phospholipids derived from ox-LDL are largely elevated in atherosclerotic lesions, this study sought to determine whether oxidized lipids trigger pyroptosis and subsequent inflammation in the pathogenesis of atherosclerosis.Methods and Results: In our current study, after integrating transcriptomic data available from the Gene Expression Omnibus with data from hyperlipidemic mice and ox-LDL-treated peritoneal macrophages, we discovered that caspase-4/11-gasdermin D-associated inflammatory signaling was significantly activated. Consistently, the mRNA expression of caspase-4 and gasdermin D was upregulated in peripheral blood mononuclear cells from patients with coronary heart disease. In particular, the expression of caspase-4 was closely associated with the severity of lesions in the coronary arteries. An in vivo study showed that caspase-11-gasdermin D activation occurred in response to a high-fat/high-cholesterol (HFHC) diet in ApoE−/− mice, while caspase-11 deletion largely attenuated the volume and macrophage infiltration of atherosclerotic lesions. An in vitro mechanistic study showed that caspase-11-mediated inflammation occurred partly via gasdermin D-mediated pyroptosis in macrophages. Suppressing gasdermin D in HFHC-fed ApoE−/− mice via delivery of an adeno-associated virus markedly decreased lesion volume and infiltrating macrophage numbers.Conclusion: Caspase-11-gasdermin D-mediated pyroptosis and the subsequent proinflammatory response in macrophages are involved in the pathogenesis of atherosclerosis. Therefore, targeting the caspase 11-gasdermin D may serve as an alternative strategy for the treatment of atherosclerosis.
Severe Bradycardia Increases the Incidence and Severity of Torsade de Pointes Arrhythmias by Augmenting Preexistent Spatial Dispersion of Repolarization in the CAVB Dog Model
Authors: van Weperen Valerie Y. H. , Dunnink Albert , Bossu Alexandre , Beekman Jet D. M. , Meijborg Veronique M. F. , de Bakker Jacques M. T. , Coronel Ruben , Varkevisser Rosanne , van der Heyden Marcel A. G. , Vos Marc A. 
Published: April 2021

IntroductionTorsade de pointes arrhythmias (TdP) in the chronic atrioventricular block (CAVB) dog model result from proarrhythmic factors, which trigger TdP and/or reinforce the arrhythmic substrate. This study investigated electrophysiological and arrhythmogenic consequences of severe bradycardia for TdP.MethodsDofetilide (25 μg/kg per 5 min) was administered to eight anesthetized, idioventricular rhythm (IVR) remodeled CAVB dogs in two serial experiments: once under 60 beats per minute (bpm), right ventricular apex paced (RVA60) conditions, once under more bradycardic IVR conditions. Recordings included surface electrocardiogram and short-term variability (STV) of repolarization from endocardial unipolar electrograms. TdP inducibility (three or more episodes within 10 min after start of dofetilide) and arrhythmic activity scores (AS) were established. Mapping experiments in 10 additional dogs determined the effect of lowering rate on STV and spatial dispersion of repolarization (SDR) in baseline.ResultsIVR-tested animals had longer baseline RR-interval (1,403 ± 271 ms) and repolarization intervals than RVA60 animals. Dofetilide increased STV similarly under both rhythm strategies. Nevertheless, TdP inducibility and AS were higher under IVR conditions (6/8 and 37 ± 27 vs. 1/8 and 8 ± 12 in RVA60, respectively, both p &lt; 0.05). Mapping: Pacing from high (128 ± 10 bpm) to middle (88 ± 10 bpm) to experimental rate (61 ± 3 bpm) increased all electrophysiological parameters, including interventricular dispersion, due to steeper left ventricular restitution curves, and intraventricular SDR: maximal cubic dispersion from 60 ± 14 (high) to 69 ± 17 (middle) to 84 ± 22 ms (p &lt; 0.05 vs. high and middle rate).ConclusionIn CAVB dogs, severe bradycardia increases the probability and severity of arrhythmic events by heterogeneously causing electrophysiological instability, which is mainly reflected in an increased spatial, and to a lesser extent temporal, dispersion of repolarization.
Development and Psychometric Properties of the Test of Passive Aggression
Authors: Schanz Christian G. , Equit Monika , Schäfer Sarah K. , Käfer Michael , Mattheus Hannah K. , Michael Tanja 
Published: April 2021

Background:To date, most research on aggression in mental disorders focused on active-aggressive behavior and found self-directed and other-directed active aggression to be a symptom and risk-factor of psychopathology. On the other hand, passive-aggressive behavior has been investigated less frequently and only in research on psychodynamic defense mechanisms, personality disorders, and dysfunctional self-control processes. This small number of studies primarily reflects a lack of a reliable and valid clinical assessment of passive-aggressive behavior. To address this gap, we developed the Test of Passive Aggression (TPA), a 24-item self-rating scale for the assessment of self-directed and other-directed passive-aggressive behavior.Method:Study 1 examined the internal consistency and factorial validity of the TPA in an inpatient sample (N= 307). Study 2 investigated the retest-reliability, internal consistency, and construct validity (active aggression, personality traits, impulsivity) of the TPA in a student sample (N= 180).Results:In line with our hypothesis, Exploratory Structural Equation Modeling revealed an acceptable to good fit of a bi-factorial structure of the TPA (Chi-square-df-ratio= 1.98;RMSR= 0.05, fit.off = 0.96). Both TPA scales showed good to excellent internal consistency (α= 0.83–0.90) and 4-week retest-reliability (rtt= 0.86). Correlations with well-established aggression scales, measures of personality, and impulsivity support discriminant and convergent validity of the TPA.Conclusions:The TPA is a reliable and valid instrument for the assessment of self-directed and other-directed passive-aggressive behavior.
BeatWalk: Personalized Music-Based Gait Rehabilitation in Parkinson’s Disease
Authors: Cochen De Cock Valérie , Dotov Dobromir , Damm Loic , Lacombe Sandy , Ihalainen Petra , Picot Marie Christine , Galtier Florence , Lebrun Cindy , Giordano Aurélie , Driss Valérie , Geny Christian , Garzo Ainara , Hernandez Erik , Van Dyck Edith , Leman Marc , Villing Rudi , Bardy Benoit G. , Dalla Bella Simone 
Published: April 2021

Taking regular walks when living with Parkinson’s disease (PD) has beneficial effects on movement and quality of life. Yet, patients usually show reduced physical activity compared to healthy older adults. Using auditory stimulation such as music can facilitate walking but patients vary significantly in their response. An individualized approach adapting musical tempo to patients’ gait cadence, and capitalizing on these individual differences, is likely to provide a rewarding experience, increasing motivation for walk-in PD. We aim to evaluate the observance, safety, tolerance, usability, and enjoyment of a new smartphone application. It was coupled with wearable sensors (BeatWalk) and delivered individualized musical stimulation for gait auto-rehabilitation at home. Forty-five patients with PD underwent a 1-month, outdoor, uncontrolled gait rehabilitation program, using the BeatWalk application (30 min/day, 5 days/week). The music tempo was being aligned in real-time to patients’ gait cadence in a way that could foster an increase up to +10% of their spontaneous cadence. Open-label evaluation was based on BeatWalk use measures, questionnaires, and a six-minute walk test. Patients used the application 78.8% (±28.2) of the prescribed duration and enjoyed it throughout the program. The application was considered “easy to use” by 75% of the patients. Pain, fatigue, and falls did not increase. Fear of falling decreased and quality of life improved. After the program, patients improved their gait parameters in the six-minute walk test without musical stimulation. BeatWalk is an easy to use, safe, and enjoyable musical application for individualized gait rehabilitation in PD. It increases “walk for exercise” duration thanks to high observance.Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT02647242.
Automated classification of dry eye type analyzing interference fringe color images of tear film using machine learning techniques
Authors: Yabusaki Katsumi , Arita Reiko , Yamauchi Takanori 
Published: April 2021

The unstable balance in secretions of lipids and aqueous fluid to tear film is a significant cause of dry eye disease (DED). Arita et al. demonstrated a simple but very effective method that classifies dry eye types to the aqueous deficient dry eye (ADDE) and the evaporative dry eye (EDE) by focusing on the dry eye type-unique appearances of interference fringe colors and patterns of tear films. We thought this simple classification is very helpful for diagnoses and treatments. However, diagnostic bias by unskilled observers remains an issue to be solved.
The artificial intelligence (AI)-based support for diagnosis is one of the hottest topics in the field of ophthalmology research. We expected that the AI-based model would reduce bias in DED-type diagnoses. Many studies have been reported targeting retinal diseases like age-related macular degeneration and/or diabetic retinopathy. Most of the works established AI-based predicting models using images taken by fundus cameras and/or optical coherence tomography (OCT) devices to capture disease-related structural disorders. In contrast, the interference fringes dynamically change the colors and patterns spatiotemporally. To the best of our knowledge, there is no AI-based model studied for distinguishing ADDE and EDE using interference fringe images. However, an AI-based study classifying the condition of the tear lipid layer by analyzing the textures of interference fringes compared to the device-unique grades has been reported. This suggested the possibility of using the unstructured characteristics, such as colors and/or complexities of interference fringes, as the numerical image features when building AI-based prediction models. In this study, we first examined several types of image characteristics extracted from the colors and patterns of fringes to obtain effective image features for the DED-type classification. We then evaluated whether the AI-based models would have sufficient abilities for this type of prediction by comparing their diagnoses with those made by an ophthalmologist skilled in this classification (the founder of this type classification).
Analisis Fitokimia dan Uji Toksisitas Daun Leleng Merah (Graptophyllum pictum (L.) Griffith) dengan Metode Brine Shrimp Lethality Test
Authors: Ba'u Defrikson , Katja Dewa G , Kamu Vanda S , Yamlean Paulina V.Y , Runtuwene Max R.J 
Published: April 2021

Penelitian ini bertujuan untuk menentukan total phenolic content (TPC), total flavonoid content (TFC), condensed tannin content (CTC) dan nilai toksisitas dari daun leleng merah. Daun leleng merah diekstraksi dengan metode maserasi dan dipartisi menggunakan pelarut n-heksana, etil asetat, dan air. Penentuan nilai TPC menggunakan metode Folin-Ciocalteu. Penentuan nilai TFC menggunakan metode AlCl3. Penentuan nilai CTC menggunakan metode vanillin-HCl. Penentuan nilai toksisitas menggunakan metode BSLT. Nilai TPC yang diperoleh pada fraksi n-heksana (FH), fraksi air (FA), dan fraksi etil asetat (FEA) daun Leleng Merah berturut-turut, adalah: 20,48; 31,7; dan 37,57 (mg/g). Nilai TFC diperoleh pada FH, FA, dan FEA berturut-turut, adalah: 0,64; 0,99; dan 1,27 (mg/g). Nilai CTC diperoleh pada FH, FA, dan FEA berturut-turut, adalah: 0,56; 2,17; dan 6,52 (mg/g). Nilai toksisitas diperoleh pada FEA, FA, FH berturut-turut, adalah: 21,93; 100,7; dan 117,22 (mg/L). FEA memiliki nilai toksisitas dan kandungan fitokimia tertinggi. Daun leleng merah bersifat toksik.Kata Kunci : Brine shrimp lethality test, leleng merah, fitokimia, Phytochemical Analysis and Toxicity Test of Leleng Merah Leaves (Graptophyllum pictum (L.) Griffith) Using the Brine Shrimp Lethality Test ABSTRACTThis study aims to determine the total phenolic content (TPC), flavonoids (TFC), condensed tannins (CTC) and toxicity value of Leleng Merah leaves. Leleng merah leaves were extracted by maceration method and partitioned using n-hexane, ethyl acetate, and water solvent. TPC values were determined using the Folin-Ciocalteu method. TFC values were determined using the AlCl3 method. CTC values were determined using the vanillin-HCl method. Toxicity values were determined using the BSLT method. TPC values obtained in the n-hexane (FH), water (FA), and ethyl acetate (FEA) fraction of the Leleng Merah leaves, were: 20.48; 31.7; 37.57 (mg / g) respectively. TFC values obtained in FH, FA, and FEA, were : 0.64; 0.99; 1.27 (mg / g) respectively. CTC values obtained at FH, FA, FEA, were: 0.56; 2.17; 6.52 (mg/g) respectively. Toxicity values obtained at FEA, FA, FH, were: 21.93; 100.7; 117.22 (mg/L) respectively. FEA has the highest toxicity and phytochemical content. Leleng Merah Leaf is toxic.Keywords : Brine Shrimp Lethality Test, leleng merah, phytochemistry
Desorption of carbon dioxide from monoethanolamine solution via calcium chloride addition under ultrasound irradiation and evaluation of the characteristics of generated calcium carbonate
Authors: Kitamura Yuya , Okawa Hirokazu , Kato Takahiro , Sugawara Katsuyasu 
Published: April 2021

Abstract
We report the desorption of carbon dioxide [CO2(g)] from monoethanolamine (MEA) solution via the addition of calcium chloride (CaCl2) into a CO2-absorbed MEA solution (0.2 M, pH 8.2) under ultrasound treatment (28 kHz, 200 kHz) and stirring (1500 rpm). Ultrasound at 28 kHz had a higher CO2(g) desorption ratio than either ultrasound at 200 kHz or stirring after 1 min [9.2% (28 kHz), 6.2% (stirring), and 5.8% (200 kHz)]. Treatment with ultrasound at 28 kHz resulted in the highest Ca recovery ratio, 89.1%, at 1 min treatment time. The desorption of CO2(g) from the MEA solution using 28 kHz ultrasound started immediately after the initiation of CaCO3 formation. Furthermore, it was found that the average particle size of CaCO3 obtained by ultrasound treatment at 28 kHz and a treatment time of 1 min was 0.91 μm, with a narrow particle size distribution.
Depletion effects in moderately doped TiO2 layers from C–V characteristics of MIS structures on Si
Authors: Lontchi Jackson , Doghmen Hajer , Krumpmann Arnaud , Snyders Rony , Flandre Denis 
Published: April 2021

Abstract
This letter investigates the large spread of values of capacitance measured in Si/TiO2 MIS structures for different properties of the TiO2 layer and proposes an approach to understand the behavior of the system. Experimental results show large variations of the maximum capacitance with TiO2 thickness for the as-deposited structures and further highlight the change of trend after annealing. Simulations qualitatively depict the theoretical trends explaining the C–V characteristics to the first order, by the different behaviors of the oxide layer in the structure and the distribution of the majority carriers showing depletion effects.