bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiotherapy Response Assessment of Multiple Myeloma: A Dual-Energy CT Approach With Virtual Non-Calcium Images
Authors: Fervers Philipp , Celik Erkan , Bratke Grischa , Maintz David , Baues Christian , Ruffing Simon , Pollman-Schweckhorst Philip , Kottlors Jonathan , Lennartz Simon , Große Hokamp Nils 
Published: September 2021

BackgroundLife expectancy of patients with multiple myeloma (MM) has increased over the past decades, underlining the importance of local tumor control and avoidance of dose-dependent side effects of palliative radiotherapy (RT). Virtual noncalcium (VNCa) imaging from dual-energy computed tomography (DECT) has been suggested to estimate cellularity and metabolic activity of lytic bone lesions (LBLs) in MM.ObjectiveTo explore the feasibility of RT response monitoring with DECT-derived VNCa attenuation measurements in MM.MethodsThirty-three patients with 85 LBLs that had been irradiated and 85 paired non-irradiated LBLs from the same patients were included in this retrospective study. Irradiated and non-irradiated LBLs were measured by circular regions of interest (ROIs) on conventional and VNCa images in a total of 216 follow-up measurements (48 before and 168 after RT). Follow-ups were rated as therapy response, stable disease, or local progression according to the MD Anderson criteria. Receiver operating characteristic (ROC) analysis was performed to discriminate irradiated vs. non-irradiated and locally progressive vs. stable/responsive LBLs using absolute attenuation post-irradiation and percentage attenuation change for patients with pre-irradiation DECT, if available.ResultsAttenuation of LBLs decreased after RT depending on the time that had passed after irradiation [absolute thresholds for identification of irradiated LBLs 30.5–70.0 HU [best area under the curve [AUC] 0.75 (0.59–0.91)] and -77.0 to -22.5 HU [best AUC 0.85 (0.65–1.00)]/-50% and -117% to -167% proportional change of attenuation on conventional and VNCa images, respectively]. VNCa CT was significantly superior for identification of RT effects in LBLs with higher calcium content [best VNCa AUC 0.96 (0.91–1.00), best conventional CT AUC 0.64 (0.45–0.83)]. Thresholds for early identification of local irradiation failure were &gt;20.5 HU on conventional CT [AUC 0.78 (0.68–0.88)] and &gt;-27 HU on VNCa CT [AUC 0.83 (0.70–0.96)].ConclusionTherapy response of LBLs after RT can be monitored by VNCa imaging based on regular myeloma scans, which yields potential for optimizing the lesion-specific radiation dose for local tumor control. Decreasing attenuation indicates RT response, while above threshold attenuation of LBLs precedes local irradiation failure.
Pediatric COVID-19: Report From Indonesian Pediatric Society Data Registry
Authors: Pudjiadi Antonius H. , Putri Nina Dwi , Sjakti Hikari Ambara , Yanuarso Piprim Basarah , Gunardi Hartono , Roeslani Rosalina Dewi , Pasaribu Ade Djanwardi , Nurmalia Lies Dewi , Sambo Catharine Mayung , Ugrasena I Dewa Gede , Soeroso Santoso , Firman Armijn , Muryawan Heru , Setyanto Darmawan Budi , Citraresmi Endah , Effendi Jaya Ariheriyanto , Habibah Lathiefatul , Octaviantie Prillye Deasy , Utami Indriyanti Natasya Ayu , Prawira Yogi , Kaswandani Nastiti , Alam Anggraini , Kadafi Kurniawan Taufiq , Pulungan Aman B. 
Published: September 2021

Background: Indonesia has a high number of COVID-19 cases and mortalities relative to not only among the Asia Pacific region but the world. Children were thought to be less affected by the virus compared to adults. Most of the public data reported combined data between adults and children. The Indonesian Pediatric Society (IPS) was involved in the COVID-19 response, especially in the area of child health. One of IPS's activities is collecting data registries from each of their chapters to provide a better understanding of COVID-19 in children.Objective: The objective of this study was to share the data of suspected and confirmed COVID-19 cases in children from IPS's COVID-19 data registry.Method: This is a retrospective study from the IPS's COVID-19 registry data. We collected the data of COVID-19 in children during March to December 2020 from each of the IPS chapters. We analyzed the prevalence, case fatality rate (CFR), age groups, diagnosis, and comorbidities of the children diagnosed with COVID-19.Result: As of December 21, 2020, there were 35,506 suspected cases of children with COVID-19. In total, there were 522 deaths, with a case fatality ratio (CFR) of 1.4. There were 37,706 confirmed cases with 175 fatalities (CFR 0.46). The highest mortality in confirmed COVID-19 cases was from children ages 10–18 years (42 out of 159 cases: 26%). The most common comorbidity and diagnosis found were malignancy (17.3%) and respiratory failure (54.5%).Conclusion: The CFR of confirmed COVID-19 cases in children in Indonesia is high and should be a major public concern.
Myocardial Expression of Estrogen Receptor-mRNA Is Associated With Lower Markers of Post-operative Organ Damage in Young Patients With Congenital Cardiac Defect
Authors: Rouatbi Hatem , Farhat Nesrine , Heying Ruth , Vazquez-Jimenez Jaime F. , Parent Anne-Simone , Seghaye Marie-Christine 
Published: September 2021

Background:Estrogen receptors (ERs) relate to cardio-protection in adults, but their role in younger patients is not known. We aimed to assess the myocardial expression of ERα- and ERβ- mRNA in young patients with congenital cardiac disease and to analyze their putative protective role.Patients and Methods:Twenty children and young adults (seven females and 13 males) with a median age of 13.8 years (interquartile range: 12.3 years) were enrolled in this prospective study. The myocardial expression of ER-mRNA and genes involved in inflammation, growth, and stress response was assessed by real-time PCR and was correlated to post-operative (po) outcome.Results:ER-mRNA was detected in the myocardium of all patients, independently of gender and age. The expression of ER-mRNA correlated with that of mRNA coding for brain natriuretic peptide and for all cytokines tested. A higher ERα-mRNA expression correlated with lower troponin T concentrations at 24 h po (p= 0.032), higher PaO2/FiO2ratio at 4 h po (p= 0.059), lower fluid retention at 4 h po (p= 0.048), and lower aspartate aminotransferase (AST) levels at 24 h po (p= 0.047). A higher ERβ-mRNA expression was also correlated with lower fluid retention at 24 h po (p= 0.048).Patients in whom the levels of ERα- and ERβ-mRNA were &gt;P50 had lower troponin T (p= 0.003, respectively) and lower AST concentrations at 24 h po (p= 0.043, respectively) than the others.Conclusions:The expression of ERα- and ERβ-mRNA is present in the myocardium of children and young adults with congenital cardiac defect and is associated with lower markers of po organ damage. This suggests that ERs may provide perioperative organ protection in this population.
Key Determinants of Health-Related Quality of Life Among Advanced Lung Cancer Patients: A Qualitative Study in Belgium and Italy
Authors: Janssens Rosanne , Arnou Reinhard , Schoefs Elise , Petrocchi Serena , Cincidda Clizia , Ongaro Giulia , Oliveri Serena , Smith Meredith Y. , Louis Evelyne , Vandevelde Marie , Nackaerts Kristiaan , Pravettoni Gabriella , Huys Isabelle 
Published: September 2021

Background: The lung cancer (LC) treatment landscape has drastically expanded with the arrival of immunotherapy and targeted therapy. This new variety of treatment options, each with its own characteristics, raises uncertainty regarding the key aspects affecting patients’ health-related quality of life (HRQL). The present qualitative study aimed to investigate how LC patients perceive their HRQL and the factors that they consider to be most influential in determining their HRQL.Methods: This qualitative research incorporates four focus group discussions, with six LC patients in each group. In total, 24 stage III and IV LC patients were included in the discussions, with Italian (n = 12) and Belgian (n = 12) patients, age range: 42–78, median age = 62 (IQR = 9.3 years), SD = 8.5; 62% men. Using thematic analysis, transcripts and notes from the FGDs were analyzed using NVivo software (edition 12).Results: Three main themes capturing determinants of HRQL were identified. First, patients agreed on the importance of physical aspects (symptoms and side-effects) in determining their HRQL. In particular, skin conditions, nausea, fatigue, risk of infections, sensory abnormalities, pain, and changes in physical appearance were highlighted. Second, patients worried about psychological aspects, negatively impacting their wellbeing such as uncertainties regarding their future health state, and a lower degree of autonomy and independence. Third, patients underlined the importance of social aspects, such as communication with healthcare providers and social interaction with friends, family and peers.Conclusion: This study demonstrates that physical, psychological, and social aspects are key factors driving LC patients’ HRQL. Gaining a better understanding of how LC patients perceive their HRQL and how it is affected by their illness and therapy will aid patient-centric decision-making across the drug life cycle, by providing stakeholders (drug developers, regulators, reimbursement bodies, and clinicians) insights about the treatment and disease aspects of importance to LC patients as well as the unmet needs LC patients may have regarding available treatment modalities. Finally, this study underscores a need for individual treatment decision-making that is considerate of uncertainties among LC patients about their future health state, and ways for improving communication between healthcare providers and patients to do so.
Dapagliflozin Mediates Plin5/PPARα Signaling Axis to Attenuate Cardiac Hypertrophy
Authors: Yu Jing , Zhao Huanhuan , Qi Xin , Wei Liping , Li Zihao , Li Chunpeng , Zhang Xiaoying , Wu Hao 
Published: September 2021

Objective: The purpose of this study was to investigate the effect of dapagliflozin (DAPA), a sodium-glucose cotransporter 2 inhibitor, on relieving cardiac hypertrophy and its potential molecular mechanism.Methods: Cardiac hypertrophy induced by abdominal aortic constriction (AAC) in mice, dapagliflozin were administered in the drinking water at a dose of 25 mg/kg/d for 12 weeks was observed. Echocardiography was used to detect the changes of cardiac function, including LVEF, LVFS, LVEDd, LVEDs, HR and LV mass. Histological morphological changes were evaluated by Masson trichrome staining and wheat germ agglutinin (WGA) staining. The enrichment of differential genes and signal pathways after treatment was analyzed by gene microarray cardiomyocyte hypertrophy was induced by AngII (2 μM) and the protective effect of dapagliflozin (1 μM) was observed in vitro. The morphological changes of myocardial cells were detected by cTnI immunofluorescence staining. ELISA and qRT-PCR assays were performed to detect the expressions levels of cardiac hypertrophy related molecules.Results: After 12 weeks of treatment, DAPA significantly ameliorated cardiac function and inhibited cardiac hypertrophy in AAC-induced mice. In vitro, DAPA significantly inhibited abnormal hypertrophy in AngII-induced cardiacmyocytes. Both in vivo and in vitro experiments have confirmed that DAPA could mediate the Plin5/PPARα signaling axis to play a protective role in inhibiting cardiac hypertrophy.Conclusion: Dapagliflozin activated the Plin5/PPARα signaling axis and exerts a protective effect against cardiac hypertrophy.
Qiangji Decoction Alleviates Neurodegenerative Changes and Hippocampal Neuron Apoptosis Induced by D-Galactose via Regulating AMPK/SIRT1/NF-κB Signaling Pathway
Authors: He Li-Ling , Wang Yun-Cui , Ai Ya-Ting , Wang Ling , Gu Si-Meng , Wang Ping , Long Qing-Hua , Hu Hui 
Published: September 2021

Qiangji Decoction (QJD), a classic formula, has been widely used to treat brain aging–related neurodegenerative diseases. However, the mechanisms underlying QJD’s improvement in cognitive impairment of neurodegenerative diseases remain unclear. In this study, we employed D-galactose to establish the model of brain aging by long-term D-galactose subcutaneous injection. Next, we investigated QJD’s effect on cognitive function of the model of brain aging and the mechanisms that QJD suppressing neuroinflammation as well as improving neurodegenerative changes and hippocampal neuron apoptosis. The mice of brain aging were treated with three different dosages of QJD (12.48, 24.96, and 49.92 g/kg/d, respectively) for 4 weeks. Morris water maze was used to determine the learning and memory ability of the mice. HE staining and FJB staining were used to detect the neurodegenerative changes. Nissl staining and TUNEL staining were employed to detect the hippocampal neuron apoptosis. The contents of TNF-α, IL-1β, and IL-6 in the hippocampus were detected by using ELISA. Meanwhile, we employed immunofluorescence staining to examine the levels of GFAP and IBA1 in the hippocampus. Besides, the protein expression levels of Bcl-2, Bax, caspase-3, cleaved caspase-3, AMPKα, p-AMPKα-Thr172, SIRT1, IκBα, NF-κB p65, p-IκBα-Ser32, and p-NF-κB p65-Ser536 in the hippocampus of different groups were detected by Western blot (WB). Our findings showed that the QJD-treated groups, especially the M-QJD group, mitigated learning and memory impairments of the model of brain aging as well as the improvement of neurodegenerative changes and hippocampal neuron apoptosis. Moreover, the M-QJD markedly attenuated the neuroinflammation by regulating the AMPK/SIRT1/NF-κB signaling pathway. Taken together, QJD alleviated neurodegenerative changes and hippocampal neuron apoptosis in the model of brain aging via regulating the AMPK/SIRT1/NF-κB signaling pathway.
Upper-Critical-Solution-Temperature Polymer Modified Gold Nanorods for Laser Controlled Drug Release and Enhanced Anti-Tumour Therapy
Authors: Lin Que , Jia Mao , Fu Yi , Li Bei , Dong Zhigang , Niu Xiaoya , You Zhen 
Published: September 2021

Photothermal therapy (PTT) has become effective method for the treatment of malignant cancer. The development of PTT system with high anti-tumour effect is still the feasible research direction. Here, a new type of gold nanorods (AuNRs)-doxorubicin (DOX)/mPEG10K-peptide/P(AAm-co-AN) (APP-DOX) nano drug delivery system was proposed. Among them, AuNRs was used as high-efficiency photothermal agent. APP-DOX had a suitable size and can be targeted to accumulate in tumour tissues through circulation in the body. The abundant matrix metalloproteinase 2 (MMP-2) in the tumour environment intercepted and cut off the short peptide chain structure grafted on APP-DOX. At the same time, the removal of the PEG segment leaded to an increase in the hydrophobic properties of the system. Nanoparticles aggregated into large particles, causing them to stay and aggregate further at the tumour site. When irradiated by 808 nm near-infrared laser, APP-DOX achieved a gradual heating process. High temperature can effectively ablate tumours and enable UCST polymer to achieve phase transition, resulting in more anti-cancer drugs loaded in the polymer layer DOX was released, effectively killing cancer cells. Animal experiments had verified the possibility of the nano drug-carrying system and good tumour treatment effect. What’s more worth mentioning is that compared with free DOX, the nano drug delivery system had lower biological toxicity and not cause obvious harmful effects on normal organs and tissues.
Latent Profile of Internet and Internet Game Usage Among South Korean Adolescents During the COVID-19 Pandemic
Authors: Kim Dongil , Lee Junwon , Nam JeeEun Karin 
Published: September 2021

Introduction: Globally, more people are spending time on the Internet and gaming since the outbreak of the Coronavirus Disease 2019 (COVID-19). Consequently, concerns about developing behavioral addiction of adolescents have been raised. Such risk could be greater for adolescents in South Korea where the majority of adolescents have access to the Internet and own a smartphone. In fact, statistics indicate that Korean youths are spending significantly more time on the Internet and gaming during the COVID-19 pandemic. Previous studies on the patterns of time spent on the Internet and Internet gaming show inconsistent results. The aim of this study is to investigate the latent profiles of the Internet and Internet game usage among adolescents in South Korea.Method: Data from a national survey on elementary and middle school students across South Korea were used. The sample consists of 3,149 respondents, and 2,984 responses were analyzed after removing missing responses. Latent profile analysis was performed to investigate the number of latent profiles for the Internet and Internet game usage time. To validate the profiles, differences in problematic gaming behavior, sex, and neuroticism were examined.Results: Seven profiles were found: Casual User, Moderate User, Smartphone User, Internet User, PC Internet Gamer, Heavy User, and Excessive User. Validation of the profiles indicated differences in problematic gaming behavior, sex, and neuroticism among selected profiles.Conclusion: This study presented different profiles of the Internet and Internet game usage among adolescents in South Korea. Profiles with higher game usage time scored higher in problematic game use compared to other profiles. Males were more likely to be in the profiles with high gaming time, and females were more likely to be in Internet and Smartphone User profiles. The results indicate that Internet and Internet gaming usage patterns could be classified by the type of device used and the content of the Internet.
Meningioma Segmentation in T1-Weighted MRI Leveraging Global Context and Attention Mechanisms
Authors: Bouget David , Pedersen André , Hosainey Sayied Abdol Mohieb , Solheim Ole , Reinertsen Ingerid 
Published: September 2021

Purpose: Meningiomas are the most common type of primary brain tumor, accounting for ~30% of all brain tumors. A substantial number of these tumors are never surgically removed but rather monitored over time. Automatic and precise meningioma segmentation is, therefore, beneficial to enable reliable growth estimation and patient-specific treatment planning.Methods: In this study, we propose the inclusion of attention mechanisms on top of a U-Net architecture used as backbone: (i) Attention-gated U-Net (AGUNet) and (ii) Dual Attention U-Net (DAUNet), using a three-dimensional (3D) magnetic resonance imaging (MRI) volume as input. Attention has the potential to leverage the global context and identify features' relationships across the entire volume. To limit spatial resolution degradation and loss of detail inherent to encoder–decoder architectures, we studied the impact of multi-scale input and deep supervision components. The proposed architectures are trainable end-to-end and each concept can be seamlessly disabled for ablation studies.Results: The validation studies were performed using a five-fold cross-validation over 600 T1-weighted MRI volumes from St. Olavs Hospital, Trondheim University Hospital, Norway. Models were evaluated based on segmentation, detection, and speed performances, and results are reported patient-wise after averaging across all folds. For the best-performing architecture, an average Dice score of 81.6% was reached for an F1-score of 95.6%. With an almost perfect precision of 98%, meningiomas smaller than 3 ml were occasionally missed hence reaching an overall recall of 93%.Conclusion: Leveraging global context from a 3D MRI volume provided the best performances, even if the native volume resolution could not be processed directly due to current GPU memory limitations. Overall, near-perfect detection was achieved for meningiomas larger than 3 ml, which is relevant for clinical use. In the future, the use of multi-scale designs and refinement networks should be further investigated. A larger number of cases with meningiomas below 3 ml might also be needed to improve the performance for the smallest tumors.
The Magnitude of Black/Hispanic Disparity in COVID-19 Mortality Across United States Counties During the First Waves of the COVID-19 Pandemic
Authors: Im Cindy , Munasinghe Lalani L. , Martínez José M. , Letsou William , Bagherzadeh-Khiabani Farideh , Marin Soudabeh , Yasui Yutaka 
Published: September 2021

Objectives:To quantify the Black/Hispanic disparity in COVID-19 mortality in the United States (US).Methods:COVID-19 deaths in all US counties nationwide were analyzed to estimate COVID-19 mortality rate ratios by county-level proportions of Black/Hispanic residents, using mixed-effects Poisson regression. Excess COVID-19 mortality counts, relative to predicted under a counterfactual scenario of no racial/ethnic disparity gradient, were estimated.Results:County-level COVID-19 mortality rates increased monotonically with county-level proportions of Black and Hispanic residents, up to 5.4-fold (≥43% Black) and 11.6-fold (≥55% Hispanic) higher compared to counties with &lt;5% Black and &lt;15% Hispanic residents, respectively, controlling for county-level poverty, age, and urbanization level. Had this disparity gradient not existed, the US COVID-19 death count would have been 92.1% lower (177,672 fewer deaths), making the rate comparable to other high-income countries with substantially lower COVID-19 death counts.Conclusion:During the first 8 months of the SARS-CoV-2 pandemic, the US experienced the highest number of COVID-19 deaths. This COVID-19 mortality burden is strongly associated with county-level racial/ethnic diversity, explaining most US COVID-19 deaths.
Numerical Investigation of Degasification in an Electrocoagulation Reactor
Authors: Höhne Thomas , Asl Vahid Farhikhteh , Ople Villacorte Loreen , Herskind Mark , Momeni Maryam , Al-Fayyad Douha , Taș-Köhler Sibel , Lerch André 
Published: September 2021

In order to enhance retention of particulate and colloidal (organic) matter, chemical coagulation (CC) is often used prior to pressure-driven membrane filtration. This combined hybrid membrane system may be a potential solution for environmental problems dealing with drinking water treatment, water reuse, and rational waste management. In this study, an EC reactor with spiral electrodes was investigated numerically, focusing on modeling with a given design/geometry configuration and boundary conditions. Two-phase flow interactions between water and hydrogen were modeled via computational fluid dynamics (CFD). Different flow rates (Q=1−1000 L/h) through two batches of the watering stage (Case 1–3) and the degassing stage (Case 4–6) were simulated. The results provided information about flow characteristics such as sufficient retention time, water circulation, undesirable gas penetration into the water inlet channel, gas holdup during watering and degassing, and finally the optimal period for the degasification. Retention time decreases with increasing water velocity and thirty seconds seemed to be the optimal time with gas holdup of 0.020%, 0.028%, and 0.027%, respectively, for Case 4, Case 5, and Case 6. Another finding is that the consideration for the most abundant gas holdup for the typical BC was the smallest ratio of water to gas flow.