bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinicopathological Characteristics and Prognosis in Endometrial Cancer With Bone Metastasis: A SEER-Based Study of 584 Women
Authors: Hu Hejia , Wang Zhan , Zhang Miaofeng , Niu Feng , Yu Qunfei , Ren Ying , Ye Zhaoming 
Published: July 2021

PurposeBone metastasis from endometrial cancer (EC) is rare and poorly described. The purpose of the present study was to investigate the correlation between the clinically accessible factors and survival time among EC patients with bone metastasis.Patients and MethodsWe retrospectively identified and reviewed EC patients with bone metastasis from 2010 to 2016, based on the Surveillance, Epidemiology and End Results (SEER) database. Univariable and multivariable Cox regressions were applied to evaluate the effects of clinical variables on survival. Kaplan–Meier plots were used to visually demonstrate the correlation between independent risk factors and survival.ResultsClinical data of 584 EC patients with bone metastasis from the SEER database were analyzed. EC patients with bone metastasis experienced extremely poor survival, with 1-year overall survival (OS) and cancer-specific survival (CSS) rates 33.8 and 35.8%, respectively. Variables associated with OS and CSS in the univariable analysis included race, tumor grade, tumor subtype, tumor size, lung, liver and brain metastases, surgery, radiotherapy, and chemotherapy. In the multivariable analysis, tumor grade, tumor subtype, liver and brain metastases, local surgery, and systemic chemotherapy remained independent risk factors for OS and CSS. However, local radiotherapy was an independent predictor of OS, not CSS.ConclusionsWe identified several factors affect the survival of EC patients with bone metastasis, which is useful for clinicians to assess patients’ outcomes. Our study supports surgery and radiotherapy of primary EC, and systemic chemotherapy for prolonging survival among EC patients with bone metastasis, which lays a solid foundation for defining optimal treatment strategy in this specific cohort.
Clinical Characteristics and Genetic Etiology of Children With Developmental Language Disorder
Authors: Plug Marielle B. , van Wijngaarden Vivian , de Wilde Hester , van Binsbergen Ellen , Stegeman Inge , van den Boogaard Marie-José H. , Smit Adriana L. 
Published: July 2021

Objective:Developmental language delay (DLD) is one of the most common disabilities in childhood and can negatively affect a child's communication skills and academic and/or psychosocial development. To date, an increasing number of causative genes have been identified by diagnostic techniques like next generation sequencing. An early genetic diagnosis is important to properly prepare and counsel children and parents for possible future difficulties. Despite this, genetic assessment is usually not part of a standardized diagnostic set in children with developmental language delay. In this study, we aim to assess the diagnostic outcomes of children primarily assessed for speech and language delay who were subsequently referred for genetic etiological assessment.Methods:Medical records of children referred to the department of Otorhinolaryngology of the Wilhelmina Children's Hospital for diagnostic work-up for a suspected speech and language delay between June 2011 and December 2018 who were additionally referred to a geneticist were evaluated. Study parameters concerning medical history, behavioral problems, language development, intelligence, and hearing were recorded. Outcomes of genetic analysis were evaluated.Results:A total of 127 patients were diagnosed with a developmental language delay. Genetic analysis was conducted in 119 out of 127 patients with a language delay and eligible for this study. The median time between initial speech and language assessment and the first genetic consultation was 10 months (IQR 5.0–23.0). In 34 out of 127 patients a causative genetic diagnosis was found to explain their DLD.Conclusion:In approximately a quarter of the patients (26.8%) diagnosed with developmental language delay, a causative genetic diagnosis was confirmed. This demonstrates the opportunity to identify an underlying genetic etiology in children with developmental language delay. However, in order to optimize the diagnostic process and clinical care for these children, two important research gaps need to be addressed. First, research should focus on assessing the clinical impact and effect on treatment outcomes of a genetic diagnosis. Secondly, it is important to recognize for which children genetic testing is most beneficial.
Network Pharmacological Analysis and Experimental Validation of the Mechanisms of Action of Si-Ni-San Against Liver Fibrosis
Authors: Wang Siliang , Tang Cheng , Zhao Heng , Shen Peiliang , Lin Chao , Zhu Yun , Han Dan 
Published: July 2021

Background: Si-Ni-San (SNS), a commonly used traditional Chinese medicine (TCM) formula, has potency against liver diseases, such as hepatitis and non-alcoholic fatty liver disease (NAFLD). However, the therapeutic efficacy and pharmacological mechanisms of action of SNS against liver fibrosis remain largely unclear.Methods: A carbon tetrachloride (CCl4)-induced liver fibrosis mouse model was adopted for the first time to investigate the beneficial effects of SNS on liver fibrosis. The potential mechanisms of action of SNS were explored using the network pharmacology-based strategy and validated with the aid of diverse assays.Results: SNS treatment reduced collagen and ECM deposition, downregulated fibrosis-related factor (hyaluronic acid and laminin) contents in serum, maintained the morphological structure of liver tissue, and improved liver function in the liver fibrosis model. Based on network pharmacology results, apoptosis, inflammation and angiogenesis, together with the associated pathways (including VEGF, TNF, caspase, PPAR-γ and NF-κB), were identified as the mechanisms underlying the effects of SNS on liver fibrosis. Further in vivo experiments validated the significant mitigatory effects of SNS on inflammatory infiltration and pro-inflammatory cytokine contents (IFNγ, IL-1β and TGF-β1) in liver tissues of mice with liver fibrosis. SNS suppressed pathologic neovascularization as well as levels of VEGFR1, VEGF and VEGFR2 in liver tissues. SNS treatment additionally inhibited hepatic parenchyma cell apoptosis in liver tissues of mice with liver fibrosis and regulated apoptin expression while protecting L02 cells against apoptosis induced by TNF-α and Act D in vitro. Activation of hepatic stellate cells was suppressed and the balance between MMP13 and TIMP1 maintained in vitro by SNS. These activities may be associated with SNS-induced NF-κB suppression and PPAR-γ activation.Conclusion: SNS effectively impedes liver fibrosis progression through alleviating inflammation, ECM accumulation, aberrant angiogenesis and apoptosis of hepatic parenchymal cells along with inhibiting activation of hepatic stellate cells through effects on multiple targets and may thus serve as a novel therapeutic regimen for this condition.
Development and Validation of Prediction Equation of “Athens Authentic Marathon” Men’s Race Speed
Authors: Nikolaidis Pantelis T. , Rosemann Thomas , Knechtle Beat 
Published: July 2021

AimDespite the increasing popularity of outdoor endurance running races of different distances, little information exists about the role of training and physiological characteristics of recreational runners. The aim of the present study was (a) to examine the role of training and physiological characteristics on the performance of recreational marathon runners and (b) to develop a prediction equation of men’s race time in the “Athens Authentic Marathon.”MethodsRecreational male marathon runners (n= 130, age 44.1 ± 8.6 years)—who finished the “Athens Authentic Marathon” 2017—performed a series of anthropometry and physical fitness tests including body mass index (BMI), body fat percentage (BF), maximal oxygen uptake (VO2max), anaerobic power, squat, and countermovement jump. The variation of these characteristics was examined by quintiles (i.e., five groups consisting of 26 participants in each) of the race speed. An experimental group (EXP,n= 65) was used to develop a prediction equation of the race time, which was verified in a control group (CON,n= 65).ResultsIn the overall sample, a one-way ANOVA showed a main effect of quintiles on race speed on weekly training days and distance, age, body weight, BMI, BF, and VO2max (p≤ 0.003, η2≥ 0.121), where the faster groups outscored the slower groups. Running speed during the race correlated moderately with age (r= −0.36,p&lt; 0.001) and largely with the number of weekly training days (r= 0.52,p&lt; 0.001) and weekly running distance (r= 0.58,p&lt; 0.001), but not with the number of previously finished marathons (r= 0.08,p= 0.369). With regard to physiological characteristics, running speed correlated largely with body mass (r= −0.52,p&lt; 0.001), BMI (r= −0.60,p&lt; 0.001), BF (r= −0.65,p&lt; 0.001), VO2max (r= 0.67,p&lt; 0.001), moderately with isometric muscle strength (r= 0.42,p&lt; 0.001), and small with anaerobic muscle power (r= 0.20,p= 0.021). In EXP, race speed could be predicted (R2= 0.61, standard error of the estimate = 1.19) using the formula “8.804 + 0.111 × VO2max + 0.029 × weekly training distance in km −0.218 × BMI.” Applying this equation in CON, no bias was observed (difference between observed and predicted value 0.12 ± 1.09 km/h, 95% confidence intervals −0.15, 0.40,p= 0.122).ConclusionThese findings highlighted the role of aerobic capacity, training, and body mass status for the performance of recreational male runners in a marathon race. The findings would be of great practical importance for coaches and trainers to predict the average marathon race time in a specific group of runners.
Automated Localization of Focal Ventricular Tachycardia From Simulated Implanted Device Electrograms: A Combined Physics–AI Approach
Authors: Monaci Sofia , Gillette Karli , Puyol-Antón Esther , Rajani Ronak , Plank Gernot , King Andrew , Bishop Martin 
Published: July 2021

Background: Focal ventricular tachycardia (VT) is a life-threating arrhythmia, responsible for high morbidity rates and sudden cardiac death (SCD). Radiofrequency ablation is the only curative therapy against incessant VT; however, its success is dependent on accurate localization of its source, which is highly invasive and time-consuming.Objective: The goal of our study is, as a proof of concept, to demonstrate the possibility of utilizing electrogram (EGM) recordings from cardiac implantable electronic devices (CIEDs). To achieve this, we utilize fast and accurate whole torso electrophysiological (EP) simulations in conjunction with convolutional neural networks (CNNs) to automate the localization of focal VTs using simulated EGMs.Materials and Methods: A highly detailed 3D torso model was used to simulate ∼4000 focal VTs, evenly distributed across the left ventricle (LV), utilizing a rapid reaction-eikonal environment. Solutions were subsequently combined with lead field computations on the torso to derive accurate electrocardiograms (ECGs) and EGM traces, which were used as inputs to CNNs to localize focal sources. We compared the localization performance of a previously developed CNN architecture (Cartesian probability-based) with our novel CNN algorithm utilizing universal ventricular coordinates (UVCs).Results: Implanted device EGMs successfully localized VT sources with localization error (8.74 mm) comparable to ECG-based localization (6.69 mm). Our novel UVC CNN architecture outperformed the existing Cartesian probability-based algorithm (errors = 4.06 mm and 8.07 mm for ECGs and EGMs, respectively). Overall, localization was relatively insensitive to noise and changes in body compositions; however, displacements in ECG electrodes and CIED leads caused performance to decrease (errors 16–25 mm).Conclusion: EGM recordings from implanted devices may be used to successfully, and robustly, localize focal VT sources, and aid ablation planning.
Decreased Plasma Oxytocin Levels in Patients With PTSD
Authors: Carmassi Claudia , Marazziti Donatella , Mucci Federico , Della Vecchia Alessandra , Barberi Filippo Maria , Baroni Stefano , Giannaccini Gino , Palego Lionella , Massimetti Gabriele , Dell’Osso Liliana 
Published: July 2021

IntroductionAlthough the pathophysiology of post-traumatic stress disorder (PTSD) is still unclear, growing preclinical evidences suggest that oxytocin (OT), a pleiotropic hormone, is possibly involved. However, direct studies on OT levels or clinical trials with this exogenous hormone in patients with PTSD led to inconsistent findings. Therefore, the aim of the present study was at exploring and comparing the plasma OT levels in a group of patients with PTSD and matched healthy subjects as the control group.Materials and MethodsTwenty-six outpatients (13 men, 13 women, mean age: 40.3 ± 11.5 years) suffering from PTSD, according to the Diagnostic and Statistical Manual for Mental Disorders, fifth edition (DSM-5), and 26 healthy subjects (13 men, 13 women, mean age: 43.8 ± 12.7 years) were included. The patients were assessed through the structured clinical interview for DSM-5 research version, patient edition (SCID-I/P), and the Impact for Event Scale revised (IES-R). All fasting subjects underwent three venous blood samples for the subsequent oxytocin radioimmunoassay. We used unpaired Student’st-testto assess OT levels and the intergroup difference of demographic characteristics, while anxiety, avoidance, and hyperarousal scores were compared among groups adjusting for the effect of gender and age by means of analysis of covariance (ANCOVA). The correlations between different variables were investigated by Pearson’s method.ResultsThe most common traumatic events of patients with PTSD were the following: severe car accident, physical violence, sexual violence, sudden death of a loved one, and natural disaster. The IES total score was 55 ± 15. Student’st-test revealed that the patients showed significantly lower OT levels (mean ± SD, pg/ml) than healthy control subjects (4.37 ± 1.61 vs 5.64 ± 2.17,p&lt; 0.001). We detected no correlation between the IES total score, subscales, or single items and OT plasma levels. Again, no difference between men and women was detected in the patients’ group, while healthy control women showed higher OT levels than men.DiscussionOur study, while reporting the presence of decreased plasma OT levels in outpatients with PTSD of both sexes, as compared with healthy control subjects, would support the possible involvement of OT in the pathophysiology of PTSD. However, given the complexity of the clinical picture, future investigations are necessary to better deepen the role and level of OT in PTSD.
Parental Catastrophizing and Goal Pursuit in the Context of Child Chronic Pain: A Daily Diary Study
Authors: Caes Line , van Gampelaere Cynthia , Van Hoecke Eline , Van Winckel Myriam , Kamoen Kristien , Goubert Liesbet 
Published: July 2021

Background: Despite daily variability in children's chronic pain experiences, little is known about how parents' emotions and goals toward their child's pain are influenced by these daily changes. This diary study examined how daily child pain intensity (as perceived by parents) moderates the associations between parental catastrophic thoughts about child pain on the one hand, and daily parental distress and parents' goals with regard to their child's pain (pain control vs. activity engagement) on the other hand.Method: Participants were 25 parents of 20 different children (N = 18; 90% girls). Children, aged 8–14 years (M = 9.5, SD = 2.09), experienced either chronic headache or functional abdominal pain with an average pain duration of 22.5 months (SD = 24.5 months). Daily parental responses (i.e., perceived child pain intensity, distress and goal endorsement) were collected through a 3-week daily diary (resulting in 413 valid diary reports). Parents completed the Pain Catastrophizing Scale for Parents prior to starting the diary (PCS-P general) and a daily measure (PCS-P daily) included in the diary. To account for the interdependence of the data, the data were analyzed using multilevel modeling.Results: Perceived daily child pain intensity moderated the impact of parental general and daily catastrophic thoughts on parents' daily distress. Only for parents experiencing low general catastrophic thoughts an increase in distress was observed on days when they perceived their child's pain intensity as high. For all parents, high levels of perceived child pain intensity were related to more distress on days where parents reported high levels of catastrophic thinking (i.e., PCS-P daily). Perceived daily child pain intensity also moderated the impact of parental general catastrophic thinking on parents' daily endorsement of goals. Parents with high levels of general catastrophic thinking reported a lower focus on child pain control on days when child pain intensity was perceived to be low. Parents with low general catastrophic thinking reported lower endorsement of the activity engagement goal on days where the child's pain intensity was perceived to be low.Conclusion: These findings highlight the complexity of daily fluctuations in parental distress and goals regarding their child's pain. Clinical implications and future directions are critically assessed.
Association Between Diet Quality and Prevalence of Obesity, Dyslipidemia, and Insulin Resistance Among Filipino Immigrant Women in Korea: The Filipino Women's Diet and Health Study
Authors: Kim Hee Sun , Lee Heejin , Provido Sherlyn Mae P. , Kang Minji , Chung Grace H. , Hong Sangmo , Yu Sung Hoon , Lee Chang Beom , Lee Jung Eun 
Published: July 2021

Objectives: Diet quality may be a key modifiable factor for the prevention of non-communicable disease. We aimed to investigate the association between diet quality and prevalence of obesity, dyslipidemia, and insulin resistance among Filipino immigrant women in Korea.Methods: A total of 413 participants from the 2014–2016 baseline population of the Filipino Women's Diet and Health Study (FiLWHEL) were examined. Individual dietary intakes were evaluated through 24-h recalls and then converted into two dietary quality assessments: Minimum Dietary Diversity for Women (MDD-W) developed by the Food and Agriculture Organization (FAO) and the Data Derived Inflammation Index (DDII) originally developed by our group. Fasting blood levels of triglycerides, high-density lipoprotein cholesterols, glucose, and insulin were measured. We used logistic regression models for odds ratios (ORs) with 95% confidence intervals (CIs).Results: We found a statistically significant association between MDD-W scores and decreased prevalence of abdominal obesity; ORs (95% CIs) of the 3rd vs. 1st tertiles were 0.58 (0.36–0.94; p for trend = 0.029). Increased DDII was associated with elevated prevalence of dyslipidemia and insulin resistance; ORs (95% CIs) of the 5th vs. 1–3rd quintiles were 6.44 (2.56–16.20) for triglycerides (TG), 3.90 (1.92–7.90) for low-density lipoprotein (LDL) cholesterol, 3.36 (1.81–6.24) for total cholesterol (TC), 6.25 (2.53–15.41) for abnormal TG/HDL ratios, 3.59 (1.96–6.59) for HbA1c, 2.61 (1.11–6.17) for fasting blood glucose levels, 9.67 (4.16–22.48) for insulin levels, and 9.73 (4.46–21.25) for homeostasis model assessment of insulin resistance (HOMA-IR) (p for trend &lt;0.001 for all, except 0.033 for fasting blood glucose).Conclusions: Greater dietary diversity was inversely associated with the prevalence of abdominal obesity in Filipino immigrant women. Proinflammatory scores based on diet and lifestyle factors were associated with an increased prevalence of dyslipidemia and insulin resistance. Further, epidemiological studies on the relationship between dietary acculturation and chronic disease are warranted.
Understanding American Public Support for COVID-19 Risk Mitigation: The Role of Political Orientation, Socio-Demographic characteristics, Personal Concern, and Experience, the United States, 2020
Authors: Shao Wanyun , Hao Feng 
Published: July 2021

Objectives:COVID-19 is the most challenging public health crisis in decades in the United States. It is imperative to enforce social distancing rules before any safe and effective vaccines are widely available. Policies without public support are destined to fail. This study aims to reveal factors that determine the American public support for six mitigation measures (e.g., cancel gatherings, close schools, restrict non-essential travel).Methods:Based on a nationally representative survey, this study uses Structural Equation Modelling to reveal the relationships between various factors and public support for COVID-19 mitigation.Results:1). Democrats are more likely than Republicans to support mitigation measures; 2).Favorability towards the political leader (Biden or Trump) can slant public support for COVID-19 mitigation measures among different segments of the public.; 3). Indirect experience, rather than direct experience with COVID-19 can motivate people to support mitigation; 4). Concern for COVID-19 is a strong motivator of support for mitigation.Conclusion:Political polarization poses an enormous challenge to societal well-being during a pandemic. Indirect experience renders COVID-19 an imminent threat.
Approach to Multi-Attribute Decision-Making Methods for Performance Evaluation Process Using Interval-Valued T-Spherical Fuzzy Hamacher Aggregation Information
Authors: Jin Yun , Kousar Zareena , Ullah Kifayat , Mahmood Tahir , Yapici Pehlivan Nimet , Ali Zeeshan 
Published: July 2021

Interval-valued T-spherical fuzzy set (IVTSFS) handles uncertain and vague information by discussing their membership degree (MD), abstinence degree (AD), non-membership degree (NMD), and refusal degree (RD). MD, AD, NMD, and RD are defined in terms of closed subintervals of [0, 1] that reduce information loss compared to the T-spherical fuzzy set (TSFS), which takes crisp values from [0, 1] intervals; hence, some information may be lost. The purpose of this manuscript is to develop some Hamacher aggregation operators (HAOs) in the environment of IVTSFSs. To do so, some Hamacher operational laws based on Hamacher t-norms (HTNs) and Hamacher t-conorms (HTCNs) are introduced. Using Hamacher operational laws, we develop some aggregation operators (AOs), including an interval-valued T-spherical fuzzy Hamacher (IVTSFH) weighted averaging (IVTSFHWA) operator, an IVTSFH-ordered weighted averaging (IVTSFHOWA) operator, an IVTSFH hybrid averaging (IVTSFHHA) operator, an IVTSFH-weighted geometric (IVTSFHWG) operator, an IVTSFH-ordered weighted geometric (IVTSFHOWG) operator, and an IVTSFH hybrid geometric (IVTSFHHG) operator. The validation of the newly developed HAOs is investigated, and their basic properties are examined. In view of some restrictions, the generalization and proposed HAOs are shown, and a multi-attribute decision-making (MADM) procedure is explored based on the HAOs, which are further exemplified. Finally, a comparative analysis of the proposed work is also discussed with previous literature to show the superiority of our work.