bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Feasibility of Ultrasound-Guided Knee Arthrocentesis Training Using Formalin-Embalmed Cadavers
Authors: Clason Joshua , Liederbach Margaret , Balkman Nathan , Davis Edwin , Zapata Isain , Mason Nena Lundgreen 
Published: September 2021

Background:
The use of ultrasound guidance during knee arthrocentesis has proven to increase operator confidence and accuracy, particularly in novice healthcare providers. Realistic and practical means of teaching this procedure to medical trainees are needed. This study is intended to assess the feasibility and efficacy of using formalin-embalmed human cadavers in the instruction of ultrasound-guided knee arthrocentesis to medical trainees.

Methods:
Twenty participants received a 30-minute didactic orientation detailing the principles of ultrasound-guided knee arthrocentesis, followed by a training practicum performed on human cadavers. The practicum included a 25-minute training period, followed by a 15-minute assessment period. Participants were objectively assessed on their ability to independently aspirate synovial fluid from the suprapatellar bursa using ultrasound guidance. Digital pretraining and posttraining questionnaires were administered to evaluate each participant’s confidence in their ability to independently locate the site of optimal needle placement and successfully aspirate synovial fluid with the guidance of ultrasound imaging.

Results:
An analysis via the Wilcoxon rank sum testing revealed that participant self-confidence increased significantly after training across all assessment items (p < 0.0001). Fifteen participants (75%) successfully aspirated 1 mL of synovial fluid on their first attempt, whereas 3 participants (15%) were successful on their second attempt. Two participants (10%) failed to perform a successful aspiration within the 15-minute time limit. The average time required to aspirate 1 mL of synovial fluid was 41 seconds.

Conclusions:
Ultrasound images of the formalin-embalmed suprapatellar bursa are of sufficient quality to use in the instruction of arthrocentesis to medical trainees. Brief instruction using formalin-embalmed cadaver models significantly increases trainee confidence and prepares first-year medical students to successfully and independently perform ultrasound-guided knee arthrocentesis.
Computer-Assisted Preoperative Planning and Patient-Specific Instrumentation for Glenoid Implants in Shoulder Arthroplasty
Authors: Levins James G. , Kukreja Mohit , Paxton E. Scott , Green Andrew 
Published: September 2021

» Glenoid component positioning affects implant survival after total shoulder arthroplasty, and accurate glenoid-component positioning is an important technical aspect.» The use of virtual planning and patient-specific instrumentation has been shown to produce reliable implant placement in the laboratory and in some clinical studies.» Currently available preoperative planning software programs employ different techniques to generate 3-dimensional models and produce anatomic measurements potentially affecting clinical decisions.» There are no published data, to our knowledge, on the effect of preoperative computer planning and patient-specific instrumentation on long-term clinical outcomes.
Stay Home Save Lives: A Machine Learning Approach to Causal Inference to Evaluate Impact of Social Distancing in the US
Authors: Osman Syed Muhammad Ishraque , Sakib Nazmus 
Published: September 2021

Abstract
Introduction: This study presents a machine learning based evaluation of the social distancing measures implemented in the US states. Objectives: Although there are a few studies that provide estimations of the impact of COVID-19 pandemic, there is a need for an actual policy evaluation of the already implemented social distancing measures. This paper presents an evaluation of the social distancing measures implemented by the US states. Methods: This research uses a machine learning based Generalized Synthetic Control Method. In doing so, it considers the US states that adopted early social distancing approaches as the treatment group and the states that adopted social distancing much later as the control group and it has controlled for state and time fixed effects, to cancel out the possible selection bias and endogeneity. Results: The results show that the first round of social distancing in the US is associated with lower COVID-19 infection growth rate (by -167%) when compared to the no policy intervention counterfactual. Conclusions: The findings from this policy evaluation establishes a robust scientific basis of the efficacy of social distancing measures on slowing down the contagion of a pandemic.
Hsa_circ_0000839 Inhibits Papillary Thyroid Carcinoma Proliferation by Targeting CDC27
Authors: Guo Jiahui , Liu Tingting , Shan Zhongyan , Teng Weiping 
Published: September 2021

Abstract
Background: Circular RNA (circRNA) has been reported to play multiple roles in a variety of cancers. However, the role of circRNA in papillary thyroid carcinoma (PTC) remains mostly unknown. Methods: The expression, function and potential molecular mechanisms of hsa_circ_0000839 in PTC in vitro were evaluated by quantitative RT-PCR, western blot, flow cytometry, CCK8, Edu, RNA-sequencing, luciferase reporter, and RNA immunoprecipitation assay. The function of hsa_circ_0000839 in PTC in vivo was evaluated by xenograft tumors assay.Results: Hsa_circ_0000839 was significantly downregulated in PTC tissues and plasma from patients with PTC, and its downregulation was correlated with larger tumor size in patients with PTC. The role of hsa_circ_0000839 in the proliferation of PTC cell lines was evaluated in both vitro and in vivo. Mechanistically, hsa_circ_0000839 regulated the level of CDC27 via sponging miR-149-5p in PTC. Conclusions: Hsa_circ_0000839 might act as a tumor suppressor of PTC through the hsa_circ_0000839/miR-149-5p/CDC27 axis. Hsa_circ_0000839 could serve as a potential biomarker and therapeutic target for patients with PTC.
Feasibility of a Multimodal Prehabilitation Program in Patients Undergoing Cytoreductive Surgery for Advanced Ovarian Cancer: a Pilot Study
Authors: Díaz-Feijóo Berta , Agustí Nuria , Sebio Raquel , López-Hernández Antonio , Sisó Marina , Torné Aureli , Martinez-Palli Graciela , Arguis Maria J 
Published: September 2021

Abstract
Purpose The feasibility and effects of multimodal prehabilitation in patients with advanced ovarian cancer (AOC) undergoing a cytoreductive surgery are unknown. We aimed to evaluate the feasibility of a multimodal prehabilitation program in patients with AOC and its impact on postoperative outcomes.Methods We prospectively compared 15 patients with AOC stage scheduled to undergo a citorreductive surgery between December 2019 and January 2021 after a multimodal prehabilitation program consisting of supervised exercise training, nutritional optimization and psychological preparation versus a control cohort of 19 patients matched according to clinical and surgical characteristics who underwent surgery without prehabilitation between January 2018 and November 2019. In both groups, the enhanced recovery after surgery guidelines were followed. We analyzed adherence to the program, comprehensive complication index (CCI), hospital length of stay, and time to starting chemotherapy. Results Overall adherence to the multimodal prehabilitation program was 80%, with 86.7% adherence to exercise training, 100% adherence to nutritional optimization, and 80% adherence to psychological preparation. Median hospital stay was shorter in the prehabilitation cohort [5 days (IQR, 4-6) vs. 7 days (IQR,5-9) in the control cohort, p=0.04]. CCI score in the prehabilitation cohort was 9.3 (SD 12.12) vs. 16.61 (SD 16.89) in the control cohort, p=0.2. Median time to starting chemotherapy was shorter in the prehabilitation cohort compared to control cohort [25 days (IQR, 23-25) vs. 35 days (IQR 28-45), p=0.03]. Conclusion Multimodal prehabilitation is feasible and safe in patients with AOC. This study found significantly shorter hospital stays and time to starting chemotherapy in the multimodal prehabilitation cohort.
Disseminated Salmonellosis in a child with IL12Rß1 deficiency – Case report and review of literature.
Authors: Mohite Rachna Shanbhag , Gangulappa Rajeshwari Kempireddygaripalli , Narasimhamurthy Vidya Manur , Bhattad Sagar 
Published: September 2021

Abstract
Mendelian susceptibility to mycobacterial disease (MSMD) is a group of genetic disorders characterized by a defect in interferon γ (IFN γ)–mediated immunity, with predisposition to infections caused by atypical and low virulent mycobacteria and other intra-macrophagic organisms like Salmonella, Klebsiella, Listeria etc. A 10-year-old boy, second born of a consanguineously (third-degree) married Indian couple, presented with left inguinal and submandibular lymphadenopathy with low grade fever for 10 days. Past history was significant as the child had been unwell from infancy. At the age of 4 months and 5 years, he was diagnosed to have tubercular axillary lymphadenitis and was treated with anti-tubercular drugs on each occasion and he responded to the same. On examination, he had left submandibular and inguinal lymphadenopathy and mild splenomegaly. Chest radiograph showed enlarged mediastinal nodes. He underwent left inguinal lymph node biopsy that reported granulomatous lymphadenitis. However, culture from the biopsy showed a growth of Salmonella enterica sensitive to ceftriaxone. Genetic evaluation showed pathogenic homozygous mutation c.1791 + 2T > G in exon 15 of IL12Rß1 gene by whole exome sequencing. A diagnosis of Mendelian Susceptibility to Mycobacterial Disease (MSMD) was established and he was treated with intravenous ceftriaxone followed by oral cefixime. He responded promptly and lymphadenopathy resolved. He is currently being maintained on azithromycin prophylaxis. Children and adults presenting with disseminated infections with atypical mycobacteria and salmonella must be evaluated for MSMD. Disseminated salmonellosis is a peculiar manifestation in IL12Rß1 deficiency. A detailed review of literature on IL12RB1 deficiency was performed. Index case has been discussed in light of the previously published literature.
Radioguided Surgery for Gastroenteropancreatic Neuroendocrine Tumours; a Systematic Literature Review
Authors: Cockburn Katrina Clair , Toumi Zaher , Mackie Alison , Julyan Peter 
Published: September 2021

Abstract
Background:Radioguided surgery (RGS) for gastroenteropancreatic neuroendocrine tumours (GEP-NETs) has been suggested as a way to improve intraoperative lesion detection. This systematic literature review of reports of the use of RGS for GEP-NETs was performed to determine if there is a benefit.Methods: A literature search was conducted using Google Scholar and PubMed, and snowballing from any relevant literature. Full-text studies were included if they were published in the English Language and reported outcomes of RGS on human subjects with GEP-NETs. Qualitative data synthesis was performed. Results: 26 papers including a total of 209 patients were included. The tracers used were predominantly indium-111 pentetreotide, gallium-68 DOTA-Peptides, and technetium-99m EDDA/HYNIC-Peptides. Heterogeneous protocols make comparisons difficult, but most papers reported a benefit from the use of RGS in tumours in the gastrointestinal tract; utility in localisation of pancreatic tumours was less clear. Time between tracer administration and operation varied; from 16 hours to 8 days with indium-111, 0-24 hours with technetium-99m and 19-193 minutes with gallium-68. Eight teams reported the thresholding technique used for discrimination – four used a ratio, four statistical methods, and one looked at the sensitivity and specificity of different cut-offs. Six teams performed follow-up of 24 patients (three pancreas, eight gastrinoma, 13 gastrointestinal tract) for between 3 months and 3 years. Two patients relapsed (one pancreas, one gastrinoma) between six and 12 months post-surgery. Conclusions:RGS appears to aid in localisation of gastrointestinal NETs, but the benefit is more equivocal in pancreatic NETs. Further work into outcomes is warranted.
Learning Interpretable Pathology Features by Multi-task and Adversarial Training Improves CNN Generalization
Authors: Graziani Mara , Otalora Sebastian , Marchand-Maillet Stéphane , Müller Henning , Andrearczyk Vincent 
Published: September 2021

Abstract
Adopting Convolutional Neural Networks (CNNs) in daily routine of primary diagnosis requires not only near-perfect precision, but also a sufficient degree of transparency and explainability of the decision making. With physicians being accountable for the diagnosis, it is fundamental that CNNs provide a clear interpretation of their learning paradigm, ensuring that relevant pathology features are being considered. Building on top of successfully existing techniques such as multi-task learning, domain adversarial training and concept-based interpretability, this paper addresses the challenge of introducing diagnostic factors in the training objectives. Here we show that our architecture, by learning end-to-end an uncertainty-based weighting combination of multi-task and adversarial losses, is encouraged to focus on pathology features such as density and pleomorphism of nuclei, e.g. variations in size and appearance, while discarding misleading features such as staining differences. Our results on the classification of tumor in breast lymph node tissue scans show significantly improved generalization, with best average AUC 0.89 (0.01) against the baseline AUC 0.86 (0.005). This result is a starting point towards building interpretable multi-task architectures that are robust to data heterogeneity. Our code is available at https://bit.ly/356yQ2u.
Berberine Combined with Formononetin Induces Autophagy Through Downregulation of the MAPK/ERK Signaling Pathway and Inhibits the Proliferation of Nasopharyngeal Carcinoma Cells
Authors: Rui Su , Jie Liu , Jingying Fan , Ting Lin , Fangliang Zhou , faqing Tang , xianwen Wang , Daofa Tian , He Yingchun 
Published: September 2021

Abstract
To investigate whether the combination of berberine and formononetin can inhibit the proliferation of nasopharyngeal carcinoma cells by regulating the MAPK/ERK signaling pathway and affecting cell autophagy. Methods: RTCA and CytationTM 5 cell imaging systems were used to detect cell proliferation. MDC staining and transmission electron microscopy were used to detect cell autophagy. Western blot was used to detect the expression levels of autophagy and proliferation-related proteins and the expression levels of key proteins in the MAPK/ERK signaling pathway. Results: The combination of berberine and formononetin can inhibit the proliferation of nasopharyngeal carcinoma cells (P < 0.05) and induce autophagy (P < 0.05) and. After berberine combined with formononetin for 24 h, the expression of LC3 II/I and Beclin1 increased, whereas the expression of P62 and PCNA decreased. The expression of key proteins p-c-Raf, p-MEK, and p-ERK1/2 in the MAPK/ERK signaling pathway was downregulated (P < 0.05). Inhibiting autophagy or activating the MAPK/ERK signaling pathway significantly reduced the effect of berberine combined with formononetin on upregulating the expression of LC3 II/I and Beclin1 and downregulating the expression of P62 and PCNA. At the same time, it significantly reduced the effects of berberine combined with formononetin in inducing autophagy and inhibiting cell proliferation (P < 0.05). Conclusion: Berberine combined with formononetin inhibits the proliferation of nasopharyngeal carcinoma cells by downregulating the activity of the MAPK/ERK signaling pathway and then upregulating LC3 II/I and Beclin1, and downregulating the expression of P62 and PCNA.
Intimate Partner Violence Disclosure and Associated Factors Among Pregnant Women Attending a City Hospital in South-Western Uganda: A Cross-sectional Study
Authors: Katushabe Eve , Asiimwe John Baptist , Batwala Vincent 
Published: September 2021

Abstract
Background: Pregnancy-associated Intimate Partner violence (IPV) is a significant public health problem in Uganda impacting on maternal and newborn health outcomes adversely. However, IPV disclosure and related factors among gravid women have remained poorly documented in southwestern Uganda. Methods: In a cross-sectional design, 283 women attending Mbarara City Hospital Antenatal Clinic (ANC) were recruited into the study. The current analysis included 199 women reporting emotional, physical and sexual violence experiences through the present pregnancy. Results: Of the 199 (70.3%) women who experienced IPV, 99(49.7%) disclosed it to someone. Majority (66.7%) disclosed IPV to their family of birth, 55.5% to friends, 35.3% to husband’s family member, 12.1% to neighbors, 9.1% to the healthcare providers, 8.1% to religious leaders, and 3.1% to police. Gravidity, OR= 1.9[95%CI: 1.07-3.31, p=0.027], parity OR=1.9[95%CI: 1.08-3.34, p=0.026] and witnessed IPV OR: 5.4[95%CI: 1.93-14.96; p=0.001] were significantly associated with IPV disclosure.Conclusion: Half the participants disclosed their IPV experience. Majority of the women disclosed to their female family of birth and very few to healthcare workers. These findings point to the need for healthcare providers to routinely screen for IPV during antenatal care if a high IPV disclosure rate is to be achieved.
Identification of hub genes and their clinical value for predicting the development of prostate cancer from benign prostate hyperplasia by bioinformatic analysis
Authors: Chen Xi , Ma Junjie , Xu Chengdang , Wang Licheng , Yao Yicong , Wang Xinan , Zi Tong , Bian Cuidong , Wu Denglong , Wu Gang 
Published: September 2021

Abstract
BackgroundProstate cancer (PCa) and benign prostate hyperplasia (BPH) are commonly encountered diseases in elderly males. The two diseases have some commonalities: both are growth depend on hormone and respond to antiandrogen therapy. Some studies have shown that genetic factors are responsible for the occurrences of both diseases. There may be a correlation between BPH and PCa. MethodsThe GEO database can help determine the differentially expressed genes (DEGs) between BPH and PCa. Gene Ontology (GO) term enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were utilized to find pathways in which the DEGs were enriched. The STRING database can provide a protein–protein interaction (PPI) network, and Cytoscape software can find hub genes in PPI network. GEPIA can be used to analyze expression and survival data for hub genes. R software was used to progress regression analysis, decision curve analysis and built nomograph. UALCAN and The Human Protein Atlas was utilized to test the results. Finally, we made clinical and cell experiments to verify the results.ResultsSixty DEGs, consisting of 15 up-regulated and 45 down-regulated genes, were found based on the GEO database. Using Cytoscape, we found 7 hub gene in the PPI network. The hub gene expression was tested on TCGA database. Except CXCR4, all hub genes expressed differently between tumor and normal samples. Meanwhile, all hub genes exclude CXCR4 has diagnostic value in predicting PCa and their mutations are risk factors leading to PCa. The expression of CSRP1, MYL9 and SNAI2 changed in different tumor stage. CSRP1 and MYH11 could affect the disease-free survival (DFS). The same results reflected in different database. In addition, we also chose three hub gene, MYC, MYL9, and SNAI2, to validate their functions in clinical specimens and cells.ConclusionThese identified hub genes can help us to understand the process and mechanism by which BPH develops into PCa and provide achievable targets for predicting which BPH patients may later develop PCa.
BiomeSeq: A Tool for the Characterization of Animal Microbiomes from Metagenomic Data
Authors: Mulholland Kelly A. , Keeler Calvin L. 
Published: September 2021

Abstract
BackgroundThe complete characterization of a microbiome is critical in elucidating the complex ecology of the microbial composition within healthy and diseased animals. Many microbiome studies characterize only the bacterial component, for which there are several well-developed sequencing methods, bioinformatics tools and databases available. The lack of comprehensive bioinformatics workflows and databases have limited efforts to characterize the other components existing in a microbiome. BiomeSeq is a tool for the analysis of the complete animal microbiome using metagenomic sequencing data. With its comprehensive workflow and customizable parameters and microbial databases, BiomeSeq can rapidly quantify the viral, fungal, bacteriophage and bacterial components of a sample and produce informative tables for analysis. ResultsSimulated datasets were constructed, which contained known abundances of microbial sequences, and several performance metrics were analyzed, including correlation of predicted abundance with known abundance, root mean square error and rate of speed. BiomeSeq demonstrated high precision (average of 99.52%) and sensitivity (average of 93.01%). BiomeSeq was employed in detecting and quantifying the respiratory microbiome of a commercial poultry broiler flock throughout its grow-out cycle from hatching to processing and successfully processed 780 million reads. For each microbial species detected, BiomeSeq calculated the normalized abundance, percent relative abundance, and coverage as well as the diversity for each sample. Rate of speed for each step in the pipeline, precision and accuracy were calculated to examine BiomeSeq’s performance using in silico sequencing datasets. When compared to bacterial results generated by the commonly used 16S rRNA sequencing method, BiomeSeq detected the same most abundant bacteria, including Gallibacterium, Corynebacterium and Staphylococcus, as well as several additional species. ConclusionsBiomeSeq provides for the detection and quantification of the microbiome from next-generation metagenomic sequencing data. This tool is implemented into a user-friendly container that requires one command and generates a table containing taxonomical information for each microbe detected. It also determines normalized abundance, percent relative abundance, genome coverage and sample diversity calculations for each sample.
How Does China Promote Integrated Care Development? A Policy Content Analysis
Authors: Yue Xin , Liu Lihang , Song Zhiqiang 
Published: September 2021

Abstract
Background: Multiple countries' experiences have illustrated that integrated care is an ideal choice regarding improving the quality of health care. In China, the central government has enacted a large number of policies to promote the development of integrated care in recent years. Yet, no existing research has examined how these policies to support the development of integrated care. In this paper we seek to address that gap. Methods: Document content analysis method was used in this paper. Data were collected by carrying out a review of integrated care policies (N=21) published from January 2015 to December 2020. The policy documents of integrated care issued by central governments are retrieved through the Internet. IHSDNSs (Integrated Health Service Delivery Networks)’s essential attributes framework was used to guide data analysis. Results: The most commonly referenced principal domains of integrated care in China were model of care, there were 45 references to the organization and management, financial allocation and incentives was the least often referenced source of information. The main purpose of reference to information was to support the reform of integrated care decision-making. Conclusions: A whole range of policies on integrated care were issued in a relatively short time. These policies propose a macro conceptual and operational framework for the development of integrated care. The development of integrated care has been mainly driven by the policy stimulus in China. However, the concrete measures still need clear negotiation and management by the local municipalities. Future policy should improve complementary policies such as financial allocation and financial incentive policy.