bluuebunny/crossref_metadata_2025_split huggingface dataset:
Audiometric Phenotypes of Noise-Induced Hearing Loss by Data-Driven Cluster Analysis and Their Relevant Characteristics
Authors: Wang Qixuan , Qian Minfei , Yang Lu , Shi Junbo , Hong Yingying , Han Kun , Li Chen , Lin James , Huang Zhiwu , Wu Hao 
Published: March 2021

Background: The definition of notched audiogram for noise-induced hearing loss (NIHL) is presently based on clinical experience, but audiometric phenotypes of NIHL are highly heterogeneous. The data-driven clustering of subtypes could provide refined characteristics of NIHL, and help identify individuals with typical NIHL at diagnosis.Methods: This cross-sectional study initially recruited 12,218 occupational noise-exposed employees aged 18–60 years from two factories of a shipyard in Eastern China. Of these, 10,307 subjects with no history of otological injurie or disease, family history of hearing loss, or history of ototoxic drug use were eventually enrolled. All these subjects completed health behavior questionnaires, cumulative noise exposure (CNE) measurement, and pure-tone audiometry. We did data-driven cluster analysis (k-means clustering) in subjects with hearing loss audiograms (n = 6,599) consist of two independent datasets (n = 4,461 and n = 2,138). Multinomial logistic regression was performed to analyze the relevant characteristics of subjects with different audiometric phenotypes compared to those subjects with normal hearing audiograms (n = 3,708).Results: A total of 10,307 subjects (9,165 males [88.9%], mean age 34.5 [8.8] years, mean CNE 91.2 [22.7] dB[A]) were included, 3,708 (36.0%) of them had completely normal hearing, the other 6,599 (64.0%) with hearing loss audiograms were clustered into four audiometric phenotypes, which were replicable in two distinct datasets. We named the four clusters as the 4–6 kHz sharp-notched, 4–6 kHz flat-notched, 3–8 kHz notched, and 1–8 kHz notched audiogram. Among them, except for the 4–6 kHz flat-notched audiogram which was not significantly related to NIHL, the other three phenotypes with different relevant characteristics were strongly associated with noise exposure. In particular, the 4–6 kHz sharp-notched audiogram might be a typical subtype of NIHL.Conclusions: By data-driven cluster analysis of the large-scale noise-exposed population, we identified three audiometric phenotypes associated with distinct NIHL subtypes. Data-driven sub-stratification of audiograms might eventually contribute to the precise diagnosis and treatment of NIHL.
Normalization of Spinal Cord Total Cross-Sectional and Gray Matter Areas as Quantified With Radially Sampled Averaged Magnetization Inversion Recovery Acquisitions
Authors: Kesenheimer Eva M. , Wendebourg Maria Janina , Weigel Matthias , Weidensteiner Claudia , Haas Tanja , Richter Laura , Sander Laura , Horvath Antal , Barakovic Muhamed , Cattin Philippe , Granziera Cristina , Bieri Oliver , Schlaeger Regina 
Published: March 2021

Background: MR imaging of the spinal cord (SC) gray matter (GM) at the cervical and lumbar enlargements' level may be particularly informative in lower motor neuron disorders, e. g., spinal muscular atrophy, but also in other neurodegenerative or autoimmune diseases affecting the SC. Radially sampled averaged magnetization inversion recovery acquisition (rAMIRA) is a novel approach to perform SC imaging in clinical settings with favorable contrast and is well-suited for SC GM quantitation. However, before applying rAMIRA in clinical studies, it is important to understand (i) the sources of inter-subject variability of total SC cross-sectional areas (TCA) and GM area (GMA) measurements in healthy subjects and (ii) their relation to age and sex to facilitate the detection of pathology-associated changes. In this study, we aimed to develop normalization strategies for rAMIRA-derived SC metrics using skull and spine-based metrics to reduce anatomical variability.Methods: Sixty-one healthy subjects (age range 11–93 years, 37.7% women) were investigated with axial two-dimensional rAMIRA imaging at 3T MRI. Cervical and thoracic levels including the level of the cervical (C4/C5) and lumbar enlargements (Tmax) were examined. SC T2-weighted sagittal images and high-resolution 3D whole-brain T1-weighted images were acquired. TCA and GMAs were quantified. Anatomical variables with associations of |r| &gt; 0.30 in univariate association with SC areas, and age and sex were used to construct normalization models using backward selection with TCAC4/C5 as outcome. The effect of the normalization was assessed by % relative standard deviation (RSD) reductions.Results: Mean inter-individual variability and the SD of the SC area metrics were considerable: TCAC4/5: 8.1%/9.0; TCATmax: 8.9%/6.5; GMAC4/C5: 8.6%/2.2; GMATmax: 12.2%/3.8. Normalization based on sex, brain WM volume, and spinal canal area resulted in RSD reductions of 23.7% for TCAs and 12.0% for GM areas at C4/C5. Normalizations based on the area of spinal canal alone resulted in RSD reductions of 10.2% for TCAs and 9.6% for GM areas at C4/C5, respectively.Discussion: Anatomic inter-individual variability of SC areas is substantial. This study identified effective normalization models for inter-subject variability reduction in TCA and SC GMA in healthy subjects based on rAMIRA imaging.
A Novel Brain MRI Image Segmentation Method Using an Improved Multi-View Fuzzy c-Means Clustering Algorithm
Authors: Hua Lei , Gu Yi , Gu Xiaoqing , Xue Jing , Ni Tongguang 
Published: March 2021

Background: The brain magnetic resonance imaging (MRI) image segmentation method mainly refers to the division of brain tissue, which can be divided into tissue parts such as white matter (WM), gray matter (GM), and cerebrospinal fluid (CSF). The segmentation results can provide a basis for medical image registration, 3D reconstruction, and visualization. Generally, MRI images have defects such as partial volume effects, uneven grayscale, and noise. Therefore, in practical applications, the segmentation of brain MRI images has difficulty obtaining high accuracy.Materials and Methods: The fuzzy clustering algorithm establishes the expression of the uncertainty of the sample category and can describe the ambiguity brought by the partial volume effect to the brain MRI image, so it is very suitable for brain MRI image segmentation (B-MRI-IS). The classic fuzzy c-means (FCM) algorithm is extremely sensitive to noise and offset fields. If the algorithm is used directly to segment the brain MRI image, the ideal segmentation result cannot be obtained. Accordingly, considering the defects of MRI medical images, this study uses an improved multiview FCM clustering algorithm (IMV-FCM) to improve the algorithm’s segmentation accuracy of brain images. IMV-FCM uses a view weight adaptive learning mechanism so that each view obtains the optimal weight according to its cluster contribution. The final division result is obtained through the view ensemble method. Under the view weight adaptive learning mechanism, the coordination between various views is more flexible, and each view can be adaptively learned to achieve better clustering effects.Results: The segmentation results of a large number of brain MRI images show that IMV-FCM has better segmentation performance and can accurately segment brain tissue. Compared with several related clustering algorithms, the IMV-FCM algorithm has better adaptability and better clustering performance.
Bevacizumab Treatment of Radiation-Induced Brain Necrosis: A Systematic Review
Authors: Liao Guixiang , Khan Muhammad , Zhao Zhihong , Arooj Sumbal , Yan Maosheng , Li Xianming 
Published: March 2021

BackgroundRadiation brain necrosis (RBN) is a serious complication in patients receiving radiotherapy for intracranial disease. Many studies have investigated the efficacy and safety of bevacizumab in patients with RBN. In the present study, we systematically reviewed the medical literature for studies reporting the efficacy and safety of bevacizumab, as well as for studies comparing bevacizumab with corticosteroids.Materials and MethodsWe searched PubMed, Cochrane library, EMBASE, and ClinicalTrials.gov from their inception through 1 March, 2020 for studies that evaluated the efficacy and safety of bevacizumab in patients with RBN. Two investigators independently performed the study selection, data extraction, and data synthesis.ResultsOverall, the present systematic review included 12 studies (eight retrospective, two prospective, and two randomized control trials [RCTs]) involving 236 patients with RBN treated who were treated with bevacizumab. The two RCTs also had control arms comprising patients with RBN who were treated with corticosteroids/placebo (n=57). Radiographic responses were recorded in 84.7% (200/236) of patients, and radiographic progression was observed in 15.3% (36/236). Clinical improvement was observed in 91% (n=127) of responding patients among seven studies (n=113). All 12 studies reported volume reduction on T1 gadolinium enhancement MRI (median: 50%, range: 26%–80%) and/or T2 FLAIR MRI images (median: 59%, range: 48%–74%). In total, 46 responding patients (34%) had recurrence. The two RCTs revealed significantly improved radiographic response in patients treated with bevacizumab (Levin et al.: p = 0.0013; Xu et al.: p &lt; 0.001). Both also showed clinical improvement (Levin et al.: NA; Xu et al.: p = 0.039) and significant reduction in edema volume on both T1 gadolinium enhancement MRI (Levin et al.: p=0.0058; Xu et al.: p=0.027) and T2 FLAIR MRI (Levin et al.: p=0.0149; Xu et al.: p &lt; 0.001). Neurocognitive improvement was significantly better after 2 months of treatment in patients receiving bevacizumab than in those given corticosteroids, as assessed by the MoCA scale (p = 0.028). The recurrence rate and side effects of the treatments showed no significant differences.ConclusionsPatients with RBN respond to bevacizumab, which can improve clinical outcomes and cognitive function. Bevacizumab appears to be more efficacious than corticosteroid-based treatment. The safety profile was comparable to that of the corticosteroids.
Comprehensive Comparison Between Adjuvant Targeted Therapy and Chemotherapy for EGFR-Mutant NSCLC Patients: A Cost-Effectiveness Analysis
Authors: Li Wenqian , Guo Hanfei , Li Lingyu , Cui Jiuwei 
Published: March 2021

BackgroundChemotherapy has been the current standard adjuvant treatment for early-stage non-small-cell lung cancer (NSCLC) patients, while recent studies showed benefits of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI). We conducted a cost-effectiveness analysis to comprehensively evaluate the benefit of EGFR-TKI compared with chemotherapy for early-stage EGFR-mutant NSCLC patients after resection from the perspective of the Chinese health care system.MethodA Markov model was established. Clinical data were based on the phase 3, ADJUVANT trial, where stage II-IIIA, EGFR-mutant NSCLC patients were randomized into gefitinib group or chemotherapy group after resection. Cost parameters mainly included costs of drugs, examinations, and adverse events (AEs). Effect parameters were evaluated by quality-adjusted life year (QALY). Outcomes contained incremental cost-effective ratio (ICER), average cost-effective ratio (ACER), and net benefit. The willingness-to-pay threshold was set as 3 times per capita gross domestic product ($30,828/QALY). Sensitivity analyses were also conducted to verify the stability of the model.ResultsPatients who received gefitinib had both a higher cost ($12,057.98 vs. $11,883.73) and a higher QALY (1.55 vs. 1.42) than patients who received chemotherapy. With an ICER of $1,345.62/QALY, adjuvant gefitinib was of economic benefit compared with chemotherapy. The ACER and net benefit were also consistent (gefitinib vs. chemotherapy, ACER: $7,802.30/QALY vs. $8,392.77/QALY; net benefit: $35,584.85 vs. $31,767.17). Sensitivity analyses indicated the stability of the model and the impact of utility.ConclusionAdjuvant EGFR-TKI application for early-stage EGFR-mutant NSCLC patients was cost-effective compared with chemotherapy, which might provide a reference for clinical decision-making and medical insurance policy formulation in China.
A Novel Nomogram to Predict Prolonged Survival After Hepatectomy in Repeat Recurrent Hepatocellular Carcinoma
Authors: Fang Qiongxuan , Yang Ruifeng , Chen Dongbo , Fei Ran , Chen Pu , Deng Kangjian , Gao Jie , Liao Weijia , Chen Hongsong 
Published: March 2021

Background: Repeat hepatectomy is an important treatment for patients with repeat recurrent hepatocellular carcinoma (HCC).Methods: This study was a multicenter retrospective analysis of 1,135 patients who underwent primary curative liver resection for HCC. One hundred recurrent patients with second hepatectomy were included to develop a nomogram to predict the risk of post-recurrence survival (PRS). Thirty-eight patients in another institution were used to externally validate the nomogram. Univariate and multivariate Cox regression analyses were used to identify independent risk factors of PRS. Discrimination, calibration, and the Kaplan–Meier curves were used to evaluate the model performance.Results: The nomogram was based on variables associated with PRS after HCC recurrence, including the tumor, node, and metastasis (TNM) stage; albumin and aspartate aminotransferase levels at recurrence; tumor size, site, differentiation of recurrences; and time to recurrence (TTR). The discriminative ability of the nomogram, as indicated by the C statistics (0.758 and 0.811 for training cohort and external validation cohorts, respectively), was shown, which was better than that of the TNM staging system (0.609 and 0.609, respectively). The calibration curves showed ideal agreement between the prediction and the real observations. The area under the curves (AUCs) of the training cohort and external validation cohorts were 0.843 and 0.890, respectively. The Kaplan–Meier curve of the established nomogram also performed better than those of both the TNM and the BCLC staging systems.Conclusions: We constructed a nomogram to predict PRS in patients with repeat hepatectomy (RH) after repeat recurrence of HCC.
Overexpression of GINS4 Is Associated With Tumor Progression and Poor Survival in Hepatocellular Carcinoma
Authors: Zhang Ziying , Chen Peng , Xie Hui , Cao Peiguo 
Published: March 2021

PurposeOur research was aimed to identify the expression, clinical value and biological significance of GINS complex subunit 4 (GINS4) in hepatocellular carcinoma (HCC).Materials and MethodsGINS4 was initially screened through weighted gene co-expression network analysis (WGCNA). The TCGA, GEO, and TIMER databases were applied for analyzing the GINS4 mRNA expression in HCC. GINS4 protein levels were detected via immunohistochemistry (IHC). Receiver operating characteristic (ROC) curve was applied for estimating the diagnostic significance of GINS4 in HCC. Kaplan-Meier plots, Cox model, and nomogram were used to assess the prognostic performance of GINS4 in HCC. Nomogram validation was conducted through time-dependent ROC and decision curve analysis (DCA). The Wanderer, UALCAN, and DiseaseMeth databases were utilized to identify GINS4 methylation levels in HCC. Genes co-expressed with GINS4 in HCC were estimated through the TCGA, cBioPortal, and GEPIA. GO, KEGG, and GSEA unraveled the possible biological mechanisms of GINS4 in HCC.ResultsWGCNA confirmed that GINS4 was one of hub genes significantly associated with histological grade of HCC. Multiple databases confirmed the significant upregulation of GINS4 in HCC tissues compared with non-tumor controls. IHC analysis of 35 HCC patients demonstrated that overexpressed GINS4 positively correlated with advanced TNM stage and poor pathological differentiation. GINS4 could effectively differentiate HCC cases from healthy individuals, with an AUC of 0.865. Increased GINS4 expression predicted unsatisfactory prognosis in HCC patients, especially in age &gt;60 years, histological grade 1, HBV infection-negative, and occurring relapse subgroup. Nomogram incorporating GINS4 level and TNM stage displayed satisfactory predictive accuracy and clinical utility in predicting HCC prognosis. Upregulated GINS4 exhibited hypomethylated levels in HCC. Functional analysis indicated that GINS4 potentially positively modulated cell cycle and PI3K/AKT/mTOR pathway.ConclusionGINS4 is overexpressed in HCC and is correlated with undesirable survival of HCC patients.
Anatomical investigation, phytochemical screening and pharmacognostical evaluation of the plant root - Ixora johnsonii Hook.f
Authors: M Usha , M Reginald Appavoo , V Mohanraj , G Immanuel 
Published: March 2021

A preliminary investigation is provided to encouraging results for comprehensive studies on different aspects of the plant root - Ixora johnsonii Hook.f. Root of this plant was studied to fix the parameters for pharmacognostical standards. The present study are highlights the pharmacognostical evaluation of root which includes macroscopic and microscopic features. Further, preliminary phytochemical analyses, organoleptic character, fluorescence behavior of different extracts and histochemical localization of phytochemicals. As there is no pharmacognostical work on record of this ethno botanically much valued drug, the present work was taken up with a view to lay down standards, which could be useful to detect the authenticity of this pretty plant.
ANALISIS OPTIMALISASI DAMPAK PEMBINAAN CITRA PRODUK IKM TERHADAP DAYA SAING UMKM KABUPATEN CIANJUR
Authors: Kasmiri Kasmiri , Sufiandi Hana Amalia 
Published: March 2021

ABSTRAKPenelitian ini dilatar belakangi oleh adanya pembinaan terhadap Usaha Mikro Kecil dan Menengah (UMKM) sebagai produsen Industri Kecil Menengah (IKM) melalui program pembinaan fasilitasi yang telah diselenggarakan oleh DISKOPERDAGIN Kabupaten Cianjur terhadap UMKM dalam rangka meningkatkan citra produk IKM. Pembinaan yang telah diberikan berupa pembinaan fasilitasi untuk meningkatkan daya saing produk IKM melalui upaya peningkatan citra produk yang meliputi pembinaan fasilitasi P-IRT, label halal, desain kemasan, dan pendaftaran HAKI merek dagang. Tujuan penilitian ini adalah untuk menganalisis Optimalisasi dampak pembinaan citra produk IKM terhadap daya saing UMKM Kabupaten Cianjur (Studi Kasus Pembinaan UMKM pada DISKOPERDAGIN Kabupaten Cianjur). Pendekatan penelitian bersifat penelitian kualitatif dan kuantitatif, dengan metode penelitian analisis deskriptif. Data dikumpulkan melalui studi kepustakaan, observasi partisipatif dan wawancara selama melakukan Kuliah Kerja Lapangan. Temuan penelitian menyimpulkan bahwa pembinaan fasilitasi yang diberikan DISKOPERDAGIN dalam meningkatkan daya saing produk melalui pembinaan citra produk UMKM, seperti pembinaan fasilitasi PIRT,label halal, kemasan dan merek dagang ,nampak masih belum optimal untuk meningkatkan daya saing produk UMKM Kabupaten Cianjur, karena secara kuantitatif cakupan pembinaan fasilitasinya masih terbatas. ABSTRACTThis research is motivated by implementation program of fasilitation for enchance competitive advantage of Cianjur IKM’S product. The scope area program are fasilitation for PIRT sertificate, Halal’S label, Packaging Design, and Brand Register product. The aims of this research to analyze optimalization impact of implementation DISKOPERDAGIN fasilitation program to enchance product competitive advantage of Cianjur IKM product. The methodology of this research are quantitative and qualitative research, with a descriptive analysis research method. Data was collected through literature study, par ticipatory observation and interviews was conducted during the KKL program in DIS KOPERDAGIN Cianjur District. Conclution of the research, that impact DISKOPERDAGIN fasilitation program to enchance IKM product’S competitive advantage not yet. Qualitative that fhenomena condition occur from limited number participant program fasilitation coverage.
HÁBITOS DE VIDA SALUDABLES Y RENDIMIENTO ESCOLAR EN ESTUDIANTES UNIVERSITARIOS
Authors: Ojeda Ramírez Mario Miguel , Muñoz León José Juan , Menéndez Acuña Ernesto Pedro 
Published: March 2021

Es incuestionable que los buenos comportamientos respecto a la salud tienen beneficios, algunos muy tangibles y otros no tan claros. Los hábitos de vida saludables (HVS) se deben adquirir en el marco de la familia, pero se deben reforzar y promover en el ámbito escolar. Generalmente esto se realiza en la educación primaria y secundaria. No obstante, se tiene evidencia que en la educación superior los HVS no se practican de la mejor forma. Se ha señalado que esto último puede impactar en el rendimiento académico. En este estudio se presenta la modelación del rendimiento escolar dependiente de los hábitos de vida saludables (HVS) --alimentación (A), actividad física y ejercicio (AE), manejo del estrés (ME), apoyo interpersonal (AI), autorrealización (AU) y responsabilidad en salud (RS)-- considerando la influencia del sexo y el nivel de avance en los estudios. Para la medición de los HVS se utilizó una adaptación de la prueba de Walker, Sechrist & Pender (1987). Se obtuvo una muestra por cuotas de estudiantes de las carreras de Estadística, Economía, Geografía, Redes y Servicios de Computo, Ingeniería de Software, y Tecnologías Computacionales, garantizando representatividad equivalente de sexo (M=masculino y F=femenino) y nivel de avance en el programa educativo (I=inicial y A=avanzado). Los datos de rendimiento escolar se obtuvieron del registro de calificaciones; se tomó el promedio general. Se compararon los HVS no encontrándose diferencias entre programas educativos. Se construyó e interpretó un índice de HVS a través de la técnica de componentes principales y se postuló y ajustó un modelo de regresión simple para cada grupo en la interacción de sexo y nivel de avance. Los resultados muestran que el rendimiento escolar tiene una dependencia de los HVS al considerar una agrupación de los estudiantes por sexo y nivel de avance en el programa educativo.
Introduction: Approaches to the Paper Revolution: The Registration and Communication of Knowledge, Value and Information
Authors: Pérez Fernández José María 
Published: March 2021

Invented in China and brought to Europe by Muslim merchants across the Silk Road, the use of paper in the West took off in the Mediterranean towards the end of the Middle Ages. Overshadowed in cultural and media history by the invention of print, paper has played a fundamental role as the media infrastructure for innumerable processes involving the registration and communication of knowledge and value in communities and institutions, from religious orders, mercantile societies, to global empires.
This thematic section of Cromohs features four essays. Three essays examine particular cases of paper as a medium for the codification and exchange of knowledge, information and value, whereas the fourth outlines the state of the art on the history of the so-called paper revolution and methodological issues illustrated with relevant case studies. These essays exemplify the research conducted by the Paper in Motion workgroup within the People in Motion COST action.