bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preliminary Experience With a Novel Metallic Segmented Transcordal Stent Modified With Three-Dimensional Printing for Inoperable Malignant Laryngotracheal Stenosis
Authors: Shan Qungang , Huang Wei , Wang Ziyin , Xue Qingsheng , Shi Zhihong , Zhou Jianping , Wu Zhiyuan , Ding Xiaoyi , Mao Aiwu , Shang Mingyi , Wang Zhongmin 
Published: July 2021

BackgroundThis study aims to assess the feasibility of a novel metallic segmented transcordal stent modified with three-dimensional (3D) printing for treating inoperable malignant laryngotracheal stenosis and the tolerability of the stent.MethodsThis was a retrospective study. The stents were individually customized with the aid of 3D printing model based on the anatomic features of each patient’s airway. The stent was composed of two separate segments that corresponded to the larynx and the upper trachea. The stents were barrel-shaped at the proximal end to prevent migration. The proximal end of the stent was located slightly above the vocal cord. The technical and clinical success of stenting procedure, patient tolerability, and stent-related complications of patients were evaluated.ResultsTen patients with dyspnea caused by malignant laryngotracheal stenosis underwent implantation of such stents. Technical and clinical success of the stenting procedure were achieved in all patients. For all patients, basic communication in life could be maintained by speaking softly. During follow-up, one patient showed intolerance to the stent, and the stent was retrieved 2 weeks after stenting. Stent migration was found in one patient, and the position of the stent was readjusted. Granulation tissue proliferation was found in two patients and was treated with cryotherapy by bronchoscopy. There were no deaths associated with stenting.ConclusionsThe individually customized metallic segmented transcordal stent is feasible and tolerable for patients with inoperable malignant laryngotracheal stenosis. The implantation of this stent may serve as a novel alternative treatment for patients who are not suitable for surgery or tracheotomy.
Assistance by Routine CT Features Combined With 3D Texture Analysis in the Diagnosis of BRCA Gene Mutation Status in Advanced Epithelial Ovarian Cancer
Authors: Li Meng-ru , Liu Ming-zhu , Ge Ya-qiong , Zhou Ying , Wei Wei 
Published: July 2021

PurposeTo evaluate the predictive value of routine CT features combined with 3D texture analysis for prediction of BRCA gene mutation status in advanced epithelial ovarian cancer.MethodRetrospective analysis was performed on patients with masses occupying the pelvic space confirmed by pathology and complete preoperative images in our hospital, including 37 and 58 cases with mutant type and wild type BRCA, respectively (total: 95 cases). The enrolled patients’ routine CT features were analyzed by two radiologists. Then, ROIs were jointly determined through negotiation, and the ITK-SNAP software package was used for 3D outlining of the third-stage images of the primary tumor lesions and obtaining texture features. For routine CT features and texture features, Mann-Whitney U tests, single-factor logistic regression analysis, minimum redundancy, and maximum correlation were used for feature screening, and the performance of individual features was evaluated by ROC curves. Multivariate logistic regression analysis was used to further screen features, find independent predictors, and establish the prediction model. The established model’s diagnostic efficiency was evaluated by ROC curve analysis, and the histogram was obtained to conduct visual analysis of the prediction model.ResultsAmong the routine CT features, the type of peritoneal metastasis, mesenteric involvement, and supradiaphragmatic lymph node enlargement were correlated with BRCA gene mutation (P &lt; 0.05), whereas the location of the peritoneal metastasis (in the gastrohepatic ligament) was not significantly correlated with BRCA gene mutation (P &gt; 0.05). Multivariate logistic regression analysis retained six features, including one routine CT feature and five texture features. Among them, the type of peritoneal metastasis was used as an independent predictor (P &lt; 0.05), which had the highest diagnostic efficiency. Its AUC, accuracy, specificity, and sensitivity were 0.74, 0.79, 0.90, and 0.62, respectively. The prediction model based on the combination of routine CT features and texture features had an AUC of 0.86 (95% CI: 0.79–0.94) and accuracy, specificity, and sensitivity of 0.80, 0.76, and 0.81, respectively, indicating a better performance than that of any single feature.ConclusionsBoth routine CT features and texture features had value for predicting the mutation state of the BRCA gene, but their predictive efficiency was low. When the two types of features were combined to establish a predictive model, the model’s predictive efficiency was significantly higher than that of independent features.
Predicting Malignancy and Invasiveness of Pulmonary Subsolid Nodules on CT Images Using Deep Learning
Authors: Shen Tianle , Hou Runping , Ye Xiaodan , Li Xiaoyang , Xiong Junfeng , Zhang Qin , Zhang Chenchen , Cai Xuwei , Yu Wen , Zhao Jun , Fu Xiaolong 
Published: July 2021

BackgroundTo develop and validate a deep learning–based model on CT images for the malignancy and invasiveness prediction of pulmonary subsolid nodules (SSNs).Materials and MethodsThis study retrospectively collected patients with pulmonary SSNs treated by surgery in our hospital from 2012 to 2018. Postoperative pathology was used as the diagnostic reference standard. Three-dimensional convolutional neural network (3D CNN) models were constructed using preoperative CT images to predict the malignancy and invasiveness of SSNs. Then, an observer reader study conducted by two thoracic radiologists was used to compare with the CNN model. The diagnostic power of the models was evaluated with receiver operating characteristic curve (ROC) analysis.ResultsA total of 2,614 patients were finally included and randomly divided for training (60.9%), validation (19.1%), and testing (20%). For the benign and malignant classification, the best 3D CNN model achieved a satisfactory AUC of 0.913 (95% CI: 0.885–0.940), sensitivity of 86.1%, and specificity of 83.8% at the optimal decision point, which outperformed all observer readers’ performance (AUC: 0.846±0.031). For pre-invasive and invasive classification of malignant SSNs, the 3D CNN also achieved satisfactory AUC of 0.908 (95% CI: 0.877–0.939), sensitivity of 87.4%, and specificity of 80.8%.ConclusionThe deep-learning model showed its potential to accurately identify the malignancy and invasiveness of SSNs and thus can help surgeons make treatment decisions.
Oral Aminoacids Supplementation Improves Corneal Reinnervation After Photorefractive Keratectomy: A Confocal-Based Investigation
Authors: Roszkowska Anna M , Rusciano Dario , Inferrera Leandro , Severo Alice Antonella , Aragona Pasquale 
Published: July 2021

Aim of this retrospective study was to estimate the effect of oral supplementation with amino acids (AA) on corneal nerves regrowth after excimer laser refractive surgery with photorefractive keratectomy (PRK). Based on the pre and post-surgical treatment received, 40 patients with 12 months of follow-up were distributed in two groups: 20 patients had received oral AA supplementation 7 days before and 30 days after PRK, and 20 patients without AA supplementation, as untreated reference control. All patients followed the same standard post-operative topical therapy consisting of an association of antibiotic and steroid plus sodium hyaluronate during the first week, then steroid alone progressively decreasing during 30 days and sodium hyaluronate for the following 3 months. In vivo corneal confocal microscopy was used to evaluate the presence of sub-basal corneal nerve fibers during 12 months after PRK. Results have shown that sub-basal nerves regenerated significantly faster (p &lt;0.05), and nerve fibers density was significantly higher (p &lt;0.05) with a more regular pattern in the eyes of AA treated patients with respect to the untreated control group. Therefore, our data indicate that oral supplementation with AA improved significantly corneal nerve restoration after PRK and could thus be considered as an additional treatment during corneal surgical procedures.
The Dual Dose-Dependent Effects of Corticosterone on Hippocampal Cell Apoptosis After Traumatic Brain Injury Depend on the Activation Ratio of Mineralocorticoid Receptors to Glucocorticoid Receptors
Authors: Zhang Bin , Yang Mengshi , Yan Qiongyu , Xu Xiaojian , Niu Fei , Dong Jinqian , Zhuang Yuan , Lu Shenghua , Ge Qianqian , Liu Baiyun 
Published: July 2021

In our recent studies, we reported that mineralocorticoid receptor (MR) had the opposite effects of glucocorticoid receptor (GR) on neural cell survival after traumatic brain injury (TBI). However, whether short-term use of high-dose natural glucocorticoids, which are mixed agonists of both MR and GR, leads to neurotoxic effects by inducing excessive GR activation is unclear, as is the threshold GR activation level and the possible signaling pathways remain unclear. In this study, we examined the dual dose-dependent effects of corticosterone (CORT) on spatial memory, hippocampal cell survival and receptor-mediated downstream signaling pathways after TBI. We found that different doses of CORT exhibited dual effects on hippocampal cell survival and rat spatial memory. Low doses of CORT (0.3 and 3 mg/kg) significantly increased MR activation, upregulated Akt/CREB/Bad phosphorylation and Bcl-2 concentration, reduced the number of apoptotic neural cells, and subsequently improved rat spatial memory. In contrast, a high dose of CORT (30 mg/kg) exerted the opposite effects by overactivating GR, upregulating P53/Bax levels, and inhibiting Erk/CREB activity. The results suggest that the neuroprotective and neurotoxic effects of endogenous GC depend on a threshold level and that a higher dose of GC, even for short-term use, should be avoided after TBI.
Design, Characterisation and Performance of an Improved Portable and Sustainable Low-Field MRI System
Authors: de Vos Bart , Parsa Javad , Abdulrazaq Zaynab , Teeuwisse Wouter M. , Van Speybroeck Camille D. E. , de Gans Danny H. , Remis Rob F. , O’Reilly Tom , Webb Andrew G. 
Published: July 2021

Low-field permanent magnet-based MRI systems are finding increasing use in portable, sustainable and point-of-care applications. In order to maximize performance while minimizing cost many components of such a system should ideally be designed specifically for low frequency operation. In this paper we describe recent developments in constructing and characterising a low-field portable MRI system for in vivo imaging at 50 mT. These developments include the design of i) high-linearity gradient coils using a modified volume-based target field approach, ii) phased-array receive coils, and iii) a battery-operated three-axis gradient amplifier for improved portability and sustainability. In addition, we report performance characterisation of the RF amplifier, the gradient amplifier, eddy currents from the gradient coils, and describe a quality control protocol for the overall system.
Heart Rate Variability During a Standard Dive: A Role for Inspired Oxygen Pressure?
Authors: Lafère Pierre , Lambrechts Kate , Germonpré Peter , Balestra Ambre , Germonpré Faye Lisa , Marroni Alessandro , Cialoni Danilo , Bosco Gerardo , Balestra Costantino 
Published: July 2021

Introduction: Heart rate variability (HRV) during underwater diving has been infrequently investigated because of environment limitations and technical challenges. This study aims to analyze HRV changes while diving at variable hyperoxia when using open circuit (OC) air diving apparatus or at constant hyperoxia using a closed-circuit rebreather (CCR). We used HRV analysis in time and frequency domain adding nonlinear analysis which is more adapted to short-time analysis and less dependent on respiratory rate (Sinus respiratory arrhythmia).Materials and Methods: 18 males, 12 using OC (30 mfw for 20 min) and 6 using CCR (30 mfw for 40 min.). HRV was recorded using a polar recorder. Four samples of R-R intervals representing the dive were saved for HRV analysis. Standard deviation of normal-to-normal intervals (SDNN), square root of the mean squared differences between successive RR intervals (rMSSD), and average RR intervals (RR) in time-domain; low frequency (LF) and high frequency (HF) in frequency domain were investigated. Nonlinear analysis included fractal dimension (FrD).Results: SDNN and rMSSD were significantly increased during descent and at depth with OC, not with CCR. Mean RR interval was longer at depth with OC, but only during ascent and after the dive with CCR. HF power was higher than baseline during the descent both with OC and CCR and remained elevated at depth for OC. The LF/HF ratio was significantly lower than baseline for descent and at depth with both OC and CCR. After 30 min of recovery, the LF/HF ratio was higher than baseline with both OC and CCR. Nonlinear analysis detected differences at depth for OC and CCR.Discussion: Increased parasympathetic tone was present during diving. RR duration, SDNN; rMSSD, HF spectral power all increased during the dive above pre-dive levels. Conversely, HF power decreased (and the LF/HF increased) 30 min after the dive. Using FrD, a difference was detected between OC and CCR, which may be related to differences in partial pressure of oxygen breathed during the dive.
ETS1, ELK1, and ETV4 Transcription Factors Regulate Angiopoietin-1 Signaling and the Angiogenic Response in Endothelial Cells
Authors: Harel Sharon , Sanchez Veronica , Moamer Alaa , Sanchez-Galan Javier E. , Abid Hussein Mohammad N. , Mayaki Dominique , Blanchette Mathieu , Hussain Sabah N. A. 
Published: July 2021

BackgroundAngiopoietin-1 (Ang-1) is the main ligand of Tie-2 receptors. It promotes endothelial cell (EC) survival, migration, and differentiation. Little is known about the transcription factors (TFs) in ECs that are downstream from Tie-2 receptors.ObjectiveThe main objective of this study is to identify the roles of the ETS family of TFs in Ang-1 signaling and the angiogenic response.MethodsIn silico enrichment analyses that were designed to predict TF binding sites of the promotors of eighty-six Ang-1-upregulated genes showed significant enrichment of ETS1, ELK1, and ETV4 binding sites in ECs. Human umbilical vein endothelial cells (HUVECs) were exposed for different time periods to recombinant Ang-1 protein and mRNA levels of ETS1, ELK1, and ETV4 were measured with qPCR and intracellular localization of these transcription factors was assessed with immunofluorescence. Electrophoretic mobility shift assays and reporter assays were used to assess activation of ETS1, ELK1, and ETV4 in response to Ang-1 exposure. The functional roles of these TFs in Ang-1-induced endothelial cell survival, migration, differentiation, and gene regulation were evaluated by using a loss-of-function approach (transfection with siRNA oligos).ResultsAng-1 exposure increased ETS1 mRNA levels but had no effect on ELK1 or ETV4 levels. Immunostaining revealed that in control ECs, ETS1 has nuclear localization whereas ELK1 and ETV4 are localized to the nucleus and the cytosol. Ang-1 exposure increased nuclear intensity of ETS1 protein and enhanced nuclear mobilization of ELK1 and ETV4. Selective siRNA knockdown of ETS1, ELK1, and ETV4 showed that these TFs are required for Ang-1-induced EC survival and differentiation of cells, while ETS1 and ETV4 are required for Ang-1-induced EC migration. Moreover, ETS1, ELK1, and ETV4 knockdown inhibited Ang-1-induced upregulation of thirteen, eight, and nine pro-angiogenesis genes, respectively.ConclusionWe conclude that ETS1, ELK1, and ETV4 transcription factors play significant angiogenic roles in Ang-1 signaling in ECs.
Focus on the Beauty of Body: The Mediation Role of Body Appreciation Between Perfectionism and Body-Related Shame and Body-Related Guilt
Authors: Liang Zhang , Lingting Shen , Ying Cai , Xiaoyan Liu , Yan Zhang , Ronghua Ying , Dan Bi , Yanqiang Tao 
Published: July 2021

Objectives: According to traditional views, perfectionists are prone to experience shame and guilt. As a relative part of negative body image, body appreciation reflects an appreciation attitude toward physical characteristics, functionality, and health, accepting and appreciating all parts and functions of the body, predicting body-related shame and guilt.Methods: Therefore, body appreciation was examined for its potential mediating role in the relationship between two dimensions of perfectionism (e.g., healthy perfectionism and unhealthy perfectionism) and body-related shame and body-related guilt among 514 females.Results: The results highlight that body appreciation partially mediated the relationship between perfectionism and body-related shame and body-related guilt. Implications for enhancing body appreciation among females between experiencing healthy or unhealthy perfectionism and body-related shame and body-related guilt feelings are discussed.Conclusions: These findings underscore the importance of considering body appreciation in addressing perfectionism dimensions and body-related shame and body-related guilt. Research and clinical implications are also addressed.
COVID-19 Vaccine Acceptance in a Sample From the United Arab Emirates General Adult Population: A Cross-Sectional Survey, 2020
Authors: Albahri Abdulaziz Hussain , Alnaqbi Shahad Ahmed , Alshaali Asma Obaid , Alnaqbi Shatha Ahmed , Shahdoor Shaikha Mohammad 
Published: July 2021

Introduction: The COVID-19 pandemic has placed a tremendous stress on economies and healthcare systems worldwide. Having a vaccine is one of the promising solutions. However, vaccination hesitancy is becoming a recognized future challenge. This study aims to evaluate the current vaccine hesitancy in a segment of the United Arab Emirates (UAE) general public and its associated factors.Methods: This was an online cross-sectional survey that took place from the 14th to the 19th of September 2020 across the UAE. The questionnaire asked the participants about their willingness to receive the COVID-19 vaccine in the future. Multivariable logistic regression analysis was used to assess the association between vaccination willingness and the participants' sociodemographic factors, experiences and beliefs regarding COVID-19, and previous influenza vaccine uptake.Results: There was a total of 2,705 participants; 72.5% were females, and 69.8% were Emirati nationals. A total of 1,627 (60.1%) participants were willing to take the COVID-19 vaccine in the future. There were statistically significant associations between the following factors and vaccine acceptance: male gender, non-Emiratis, younger age group, residents of Sharjah and the Northern Emirates, having lesser educational attainment, perceived increased personal or public risk of contracting the disease [aOR = 1.71, 95% CI (1.35–2.17), p &lt; 0.0001; aOR = 1.84, 95% CI (1.44–2.36), p &lt; 0.0001, respectively], and increased perception of serious outcome from the disease. Conversely, vaccine hesitancy was associated with unemployment, not receiving the influenza vaccine within the past 2 years [aOR = 0.36, 95% CI (0.30–0.44), p &lt; 0.0001], not believing in the seriousness of the COVID-19 situation or the vaccine's ability to control the pandemic, and not believing that the public authorities are handling the pandemic adequately. Having contracted the disease or knowing someone who has did not show a statistically significant association with vaccine acceptance. Vaccine safety, side effects, and the belief that one needs to develop immunity naturally were the top reasons for vaccination hesitancy.Conclusion: Given the level of vaccine hesitancy in the study population, this needs to be evaluated in a more representative sample of the whole population. If confirmed, this would signify the need for coordinated local and international initiatives to combat vaccine misinformation and reassure the public regarding vaccine safety and efficacy.
Predicting Treatment Nonresponse in Hispanic/Latino Children Receiving Silver Diamine Fluoride for Caries Arrest: A Pilot Study Using Machine Learning
Authors: Ruff Ryan Richard , Paul Bidisha , Sierra Maria A. , Xu Fangxi , Li Xin , Crystal Yasmi O. , Saxena Deepak 
Published: July 2021

Objectives: Silver diamine fluoride (SDF) is a nonsurgical therapy for the arrest and prevention of dental caries with demonstrated clinical efficacy. Approximately 20% of children receiving SDF fail to respond to treatment. The objective of this study was to develop a predictive model of treatment non-response using machine learning.Methods: An observational pilot study (N = 20) consisting of children with and without active decay and who did and did not respond to silver diamine fluoride provided salivary samples and plaque from infected and contralateral sites. 16S rRNA genes from samples were amplified and sequenced on an Illumina Miseq and analyzed using QIIME. The association between operational taxonomic units and treatment non-response was assessed using lasso regression and artificial neural networks.Results: Bivariate group comparisons of bacterial abundance indicate a number of genera were significantly different between non-responders and those who responded to SDF therapy. No differences were found between non-responders and caries-active subjects. Prevotella pallens and Veillonella denticariosi were retained in full lasso models and combined with clinical variables in a six-input multilayer perceptron.Discussion: The acidogenic and acid-tolerant nature of retained bacterial species may overcome the antimicrobial effects of SDF. Further research to validate the model in larger external samples is needed.
Critical Linkages Between Livestock Production, Livestock Trade and Potential Spread of Human African Trypanosomiasis in Uganda: Bioeconomic Herd Modeling and Livestock Trade Analysis
Authors: Okello Walter O. , MacLeod Ewan T. , Muhanguzi Dennis , Waiswa Charles , Shaw Alexandra P. , Welburn Susan C. 
Published: July 2021

Background: Tsetse-transmitted human African trypanosomiasis (HAT) remains endemic in Uganda. The chronic form caused by Trypanosoma brucei gambiense (gHAT) is found in north-western Uganda, whereas the acute zoonotic form of the disease, caused by T. b. brucei rhodesiense (rHAT), occurs in the eastern region. Cattle is the major reservoir of rHAT in Uganda. These two forms of HAT are likely to converge resulting in a public health disaster. This study examines the intricate and intrinsic links between cattle herd dynamics, livestock trade and potential risk of spread of rHAT northwards.Methods: A bio-economic cattle herd model was developed to simulate herd dynamics at the farm level. Semi-structured interviews (n = 310), focus group discussions (n = 9) and key informant interviews (n = 9) were used to evaluate livestock markets (n = 9) as part of the cattle supply chain analysis. The cattle market data was used for stochastic risk analysis.Results: Cattle trade in eastern and northern Uganda is dominated by sale of draft and adult male cattle as well as exportation of young male cattle. The study found that the need to import draft cattle at the farm level was to cover deficits because of the herd structure, which is mostly geared towards animal traction. The importation and exportation of draft cattle and disposal of old adult male cattle formed the major basis of livestock movement and could result in the spread of rHAT northwards. The risk of rHAT infected cattle being introduced to northern Uganda from the eastern region via cattle trade was found to be high (i.e. probability of 1).Conclusion: Through deterministic and stochastic modelling of cattle herd and cattle trade dynamics, this study identifies critical links between livestock production and trade as well as potential risk of rHAT spread in eastern and northern Uganda. The findings highlight the need for targeted and routine surveillance and control of zoonotic diseases such as rHAT.