bluuebunny/crossref_metadata_2025_split huggingface dataset:
An optimized segmentation and quantification approach in microvascular imaging for OCTA-based neovascular regression monitoring
Authors: Wu Sheng , Wu Shaowei , Feng Hui , Hu Zizhong , Xie Yejing , Su Yun , Feng Ting , Li Li 
Published: January 2021

Abstract
Background:Quantification of neovascularization changes in terms of neovascular complex (NVC) acquired from the optical coherence tomography angiography (OCTA) imaging is extremely important for diagnosis and treatment monitoring of proliferative diabetic retinopathy (PDR). However, only few vessel extraction methods have so far been reported to quantify neovascular changes in NVC with proliferative diabetic retinopathy PDR based on OCTA images.Methods:Here we propose an optimized approach to segment blood vessels, which is based on an improved vascular connectivity analysis (VCA) algorithm and combined with morphological characterization and elimination of noise and artifacts. The length and width of vessels are obtained in the quantitative assessment of microvascular network. The feasibility of the proposed method is further studied by a treatment monitoring and statistical analysis process, as we have monitored and statistically analyzed the changes of NVC based on sampled OCTA images of PDR patients (N=14) after treatment by intravitreal injection of conbercept (IVC).Results:The proposed method has demonstrated better performance in accuracy compared with existing algorithms and can thus be used for PRD treatment monitoring. Following the PDR treatment monitoring study, our data has shown that from the 1st day to 7th day of treatment, the averaged (arithmetic mean) length of NVC has been substantially shortened by 36.8% (P<0.01), indicating significant effects of treatment. Meanwhile, the averaged (arithmetic mean) width of NVC from the 1st day to 7th day of treatment has been increased by 10.2% (P<0.05), indicating that most of the narrow neovascularization has been reduced.Conclusion:The results and analysis have confirmed that the proposed optimization process by the improved vascular connectivity analysis (VCA) method is both effective and feasible to segment and quantify the NVC with lower noise and fewer artifacts. Thus, it can be potentially applied to monitor the fibrovascular regression during the treatment period.Clinical Trial Registration: This trial is registered with the Chinese Clinical Trial Registry (Registered 27 December 2017, http://www.chictr.org.cn, registration number ChiCTR-IPR-17014160).
Effects of sevoflurane and propofol on the optic nerve sheath diameter in patients undergoing laparoscopic gynecological surgery: A Randomized controlled clinical studies
Authors: Geng Weilian , Chen Changxing , Sun Xingfeng , Huang Shaoqiang 
Published: January 2021

Abstract
Background The results of studies on changes in intracranial pressure in patients undergoing laparoscopic surgery are inconsistent. Meanwhile, previous neurosurgery studies have suggested that propofol and sevoflurane have inconsistent effects on cerebral blood flow and cerebrovascular self-regulation. The purpose of this study is to compare changes in the optic nerve sheath diameter in patients undergoing laparoscopic gynecological surgery under anesthetic maintenance with propofol versus sevoflurane. Methods This study included 110 patients undergoing laparoscopic gynecological surgery with an estimated operative time of more than 2 hours under general anesthesia. The study was a randomized controlled study. The optic nerve sheath diameter（ONSD）at various time points was measured by ultrasound, including when the patients entered the operating room (Tawake), after successful anesthesia induction and endotracheal intubation (Tinduction), when the body position was adjusted to the Trendelenburg position and the CO2 pneumoperitoneum pressure reached 14 mmHg, which was recorded as T0. Then, measurements were conducted every 15 minutes for the first 1 hour and then once every hour until the end of the surgery（T15,T30,T45 ,T1h ,T2h…）, after the end of surgery and the tracheal tube was removed (Tend), and before the patients were transferred to the ward (Tpacu).Results A significant difference in optic nerve sheath diameter was found between two groups at T15, T30, T45 (4.64±0.48mm and 4.50±0.29mm, respectively, p=0.031;4.77±0.45mm and 4.62±0.28mm, respectively, p=0.036;4.84±0.46mm and 4.65±0.30mm, respectively, p=0.012), while there was no significant difference at Tawake and other time points. Conclusion During laparoscopic gynecological surgery lasting more than 2 hours, the optic nerve sheath diameter was slightly larger in the propofol group than that in the sevoflurane group in the first 45 minutes. No significant difference was observed between the two groups 1 hour after surgery. Trial registration clinicaltrials.gov，NCT03498235. Retrospectively registered 1 March2018,https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0007UMM&selectaction=Edit&uid=U00040C5&ts=39&cx=c7i8icThe manuscript adheres to CONSORT guidelines.
Feasibility study on use of near infrared spectroscopy for rapid and non-destructive determination of gossypol content in intact cottonseeds
Authors: Li Cheng , Su Bangsong , Zhao Tianlun , Li Cong , Chen Jinhong , Zhu Shuijin 
Published: January 2021

Abstract
Background: Gossypol found in cottonseeds is toxic to human beings and monogastric animals and is a primary parameter for the integrated utilization of cottonseed products. It is usually determined by the techniques relied on complex pretreatment procedures and the samples after determination cannot be used in breeding program, so it is of great importance to predict the gossypol content in cottonseeds rapidly and non-destructively to substitute the traditional analytical method.Results: Gossypol content in cottonseeds was investigated by near-infrared spectroscopy (NIRS) and High-performance liquid chromatography (HPLC). Partial least squares regression, combined with spectral pretreatment methods including Savitzky-Golay smoothing, standard normal variate, multiplicative scatter correction, and first derivate, were tested for optimizing the calibration models. NIRS technique was efficient in predicting gossypol content in intact cottonseeds, as revealed by the root-mean-square error of cross-validation (RMSECV), root-mean-square error of prediction (RMSEP), coefficient for determination of prediction (Rp2), and residual predictive deviation (RPD) values for all models, being 0.05-0.07, 0.04-0.06, 0.82-0.92, and 2.3-3.4, respectively. The optimized model pretreated by Savitzky-Golay smoothing + standard normal variate + first derivate resulted in good determination of gossypol content in intact cottonseeds. Conclusions: Near infrared spectroscopy coupled with different spectral pretreatments and PLS regression has exhibited the feasibility in predicting gossypol content in intact cottonseeds, rapidly and non-destructively. It could be used as an alternative method to substitute for traditional one to determine the gossypol content in intact cottonseeds.
Land use mix and physical activity in middle-aged and older adults: a longitudinal study examining changes in land use mix in two Dutch cohorts
Authors: Noordzij J. Mark , Beenackers M.A. , Groeniger J. Oude , Timmermans E.J. , Motoc I. , Huisman M. , Lenthe F.J. van 
Published: January 2021

Abstract
BACKGROUND With urbanization and aging increasing in coming decades, societies face the challenge of keeping aging populations active. Land use mix (LUM) has been associated with cycling and walking, but whether changes in LUM relate to changes in cycling/walking is less known. OBJECTIVES Our objective was to study the effect of LUM on cycling/walking in two Dutch aging cohorts using data with 10 years of follow-up. METHODS Data from 1,183 respondents from the Health and Living Conditions of the Population of Eindhoven and Surroundings (GLOBE) study and 918 respondents from the Longitudinal Aging Study Amsterdam (LASA) were linked to LUM in 1000-meter sausage network buffers at three time-points. Cycling/walking outcomes were harmonized to include average minutes spent cycling/walking per week. Data was pooled and limited to respondents that did not relocate between follow-up waves. Associations between LUM and cycling/walking were estimated using a Random Effects Within-Between (REWB) model that allows for the estimation of both within and between effects. Sensitivity analyses were performed on smaller (500-meter) and larger (1600-meter) buffers. RESULTS We found evidence of between-individual associations of LUM in 1000-meter buffers and walking (β: 11.10, 95% CI: 0.08 ; 21.12), but no evidence of within-associations in 1000-meter buffers. Sensitivity analyses using 500-meter buffers showed similar between-associations, but negative within-associations (β: -35.67, 95% CI: -68.85 ; -2.49). We did not find evidence of between-individual associations of LUM in any buffer size and cycling, but did find evidence of negative within-associations between LUM in 1600-meter buffers and cycling (β: -7.49, 95% CI: -14.31 ; -0.66). DISCUSSION Our study found evidence of positive associations between LUM and average walking time, but also some evidence of negative associations between a change in LUM and cycling/walking. LUM appears to be related to cycling/walking, but the effect of changes in LUM on cycling/walking is unclear.
mTOR inhibitor INK128 promotes wound healing by regulating MDSCs
Authors: Li Yi , Xu Yujun , Liu Xinghan , Yan Xin , Lin Yue , Tan Qian , Hou Yayi 
Published: January 2021

Abstract
Background: Skin wounds in diabetic patients are hardly to recover. Accumulating evidence has shown that mammalian target of rapamycin (mTOR) pathway and myeloid-derived suppressor cells (MDSCs) are involved in inflammatory-related response. INK128 is a novel mTOR kinase inhibitor in clinical development. However, the exact roles of MDSCs and INK128 in healing wound of diabetic patients are unclear. Methods: Mice models of normal, diabetic, and diabetic+INK128 were constructed. Bone marrow (BM)-derived macrophages and RAW264.7 cell line co-cultured with MDSCs, which were induced at different conditions. Flow cytometry, western blot, quantitative real-time PCR, and immunohistochemical analysis were performed. Results: Diabetic mice (DM) had a slower recovery rate, thinner epidermal and dermal, and less blood vessels than those of normal mice. MDSCs were abnormally accumulated in DM and mTOR was activated in MDSCs of DM and the cells treat with high glucose. Moreover, mTOR signaling inhibitor INK128 could promote wound healing through reducing the MDSCs. MDSCs function was disordered in DM and high glucose environments, while INK128 could help retrieve their function. Furthermore, high glucose and other factors in DM could promote M-MDSCs differentiation to M1 pro-inflammatory macrophage cells, thus inhibiting wound healing. The differentiation, which was dependent on mTOR signaling, could be reversed by INK128. Conclusion: INK128 is potential to be developed as a clinical strategy to promote wound healing of diabetic patients.
Predicting the COVID-19 patients’ status using chest CT scan findings: A risk assessment model based on Decision tree
Authors: Talebi Atefeh , Borumandnia Nasrin , Jafari Ramezan , Pourhoseingholi Mohamad Amin , Jafari Nematollah Jonaidi , Ashtari Sara , Roozpeykar Saeid , Bashar Farshid R. , Vahedian-Azimi Amir 
Published: January 2021

Abstract
Background: The role of chest computed tomographic (CT) to diagnosis coronavirus disease-2019 (COVID-19) is still an open field to be explored. The aim of this study was to apply the decision tree (DT) model to predict critical or non-critical status of patients infected with COVID-19 based on available information on non-contrast CT scan.Method: This study was performed onpatients with COVID-19 who underwent chest CTscan atBaqiyatallahHospital, Tehran, Iran. In this retrospectivestudy, the medical records of 1078 patients with COVID-19 were evaluated. The classification and regression tree (CART) of decision treemodeland k-fold cross validation were used to predict the status of patients and to measure their sensitivity, specificity and area under curve (AUC).Results: Data included 169 critical cases and 909 non-critical cases. The bilateral distribution and multifocal lung involvement were165 (97.6%) and 766 (84.3%) in critical patients, respectively.According to DT model, total opacity score, age, lesion types and gender were statistically significant predictors incritical patients.Moreover, the results showed that the accuracy, sensitivity and specificity of the DT model were 93.3%, 72.8% and 97.1%, respectively.Conclusions: The presented algorithm demonstrates the factors affecting the patient's condition. In addition, this model has the potential characteristics for clinical applicationsand canalso identify high-risk subpopulations that need specific prevention.
Health education services utilization and its determinants among migrants: a cross-sectional study in urban-rural fringe areas of Beijing, China
Authors: Shao Shuang , Zhang Huirong , Chen Xiaolei , Xu xiaojingyuan , Zhao Yali , Wang Meirong , Du Juan 
Published: January 2021

Abstract
Background: Domestic migration poses a challenge for China as migrants have little access to preventive healthcare services and are vulnerable to certain risks and diseases. This research sought to unveil and explore the determinant factors associated with health education utilization as a key aspect in basic public health services for migrants in Beijing, China.Methods: A sample of 863 inter-provincial migrants, 18 years old and above, was selected by three-stage stratified cluster sampling method in urban-rural fringe areas of Beijing during 2016 to 2017. Face-to-face structured interviews were conducted in the questionnaire survey. The effects of the explanatory variables on health education utilization from predisposing, enabling, health behaviors and need variables were used to demonstrate by Anderson health service utilization model. Results: The study revealed that 61.6% migrants desired to receive health education, while only 53.8% of them received in the past year. There were differences in the utilization and needs of health education among the migrants in different ages and genders. Many migrants desired to gain access to various types of health education information from the internet. Chi-square independence test lists such major determinant factors in migrants whole health education as age, "Hukou" registration system, marital status, education level, long-term residence plan in Beijing, one or more children in Beijing, employment status, housing source, average daily working time, exercises, health knowledge, smoking, self-rated health. The binary logistic regression indicates that the migrants with younger age, high education level, one or more children in Beijing, exercises and good self-rated health were more likely to receive whole health education. The results also show that average daily working time of enabling variables and exercise of health behavior variables were the strong and consistent determinants of three types of health education utilization, including communicable, non-communicable and occupational diseases.Conclusion: Gaps exist between the needs and utilization in health education and more attention should be given to the migrants with heavy workload and low education level. Feasible policies and measures, such as multiple health information channels, should be vigorously implemented to ensure equitable and easy access to health education for migrants.
Diagnostic measures for severe acute malnutrition in Indian infants under 6 months of age: a secondary data analysis
Authors: Chowdhury Ranadip , Nitika Nitika , Choudhary Tarun Shankar , Taneja Sunita , Martines Jose Carlos , Bhandari Nita , Bahl Rajiv 
Published: January 2021

Abstract
Background Weight for length z-score (WLZ) <- 3 is currently used to define severe acute malnutrition (SAM) among infants. However, this approach has important limitations for infants younger than 6 months of age as WLZ cannot be calculated using WHO growth standards if infant length is <45 cm. Moreover, length for age z-score (LAZ) and weight for length z-score (WLZ) are least reliable measures, with high chances of variation, and less chances of detecting undernutrition in under 6 months infants. The objective of the current analysis was to compare WLZ with WAZ and LAZ in a cohort of Indian infants in predicting the deaths between 6 weeks and 6 months of age. Methods The data was from an individually randomized trial conducted in slums of Delhi, India in which infants’ weight and length were measured at 6 weeks of age (at the time of the first immunization visit). Vital status of the infants was documented from 6 weeks to 6 months of age. The sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios, and area under curve (AUC) were calculated for WAZ<-3, WLZ<-3, and LAZ<-3 for deaths between 6 weeks and 6 months of age. Results For deaths occurring between 6 weeks to 6 months of age, the specificity ranged between 85.9-95.9% for all three anthropometric indicators. However, the sensitivity was considerably higher for WAZ; it was 64.6 % for WAZ<-3, 39.1% for LAZ<-3, and 25.0% for WLZ<-3. WAZ <-3 had higher AUC (0.75; 95% CI: 0.68, 0.82) and hence, better discriminated deaths between 6 weeks and 6 months of age than WLZ<-3. The adjusted relative risk (RR 10.6, 95% CI 5.9, 18.9) and the population attributable fraction (PAF 57.9%, 95% CI 38.8, 71.0%) of mortality was highest for WAZ<-3. Conclusions We found WAZ<-3 at 6 weeks of age to be a better predictor of death in the 6 weeks to 6 months of life in comparison to WLZ<-3 and LAZ<-3 and propose that it should be considered to diagnose SAM in this age group.
An Evaluation of Cascading Mentorship as Advocacy Training in Undergraduate Medical Education
Authors: Patel Mitesh , Aitken Devon , Xue Yunlin , Sockalingam Sanjeev , Simpson Alexander 
Published: January 2021

Abstract
BackgroundPhysicians are in a position of great influence to advocate for health equity. As such, it is important for physicians-in-training to develop the knowledge and skills necessary to fulfil this role. Although various undergraduate medical programs have implemented health advocacy training, they often lack experiential learning and physician involvement. These aspects are foundational to the Advocacy Mentorship Initiative (AMI) which utilizes cascading mentorship as a novel approach to advocacy training. Medical students develop advocacy competency as peer mentors to youth raised in at-risk environments, while also being mentored themselves by physician residents. We aim to determine whether there are specific advantages to utilizing cascading mentorship to facilitate the attainment of advocacy competencies in undergraduate medical education.MethodsMedical students participating in AMI between 2017 to 2020 completed pre- and post-exposure questionnaires. Questionnaires assessed confidence in advocacy-related skills and knowledge of youth advocacy concepts, as well as learning goals, skills gained, benefits of AMI and resident mentors, and impact on future career. Sign tests were utilized to analyze quantitative results, and content analysis was used for open-ended responses. A triangulation protocol was also utilized.ResultsFifty mentors participated, 24 (48%) of which completed both pre- and post-exposure questionnaires. Participants gained confidence in advocacy-related skills (p<0.05) such as working with vulnerable populations and advocating for medical and non-medical needs. They also reported significant improvements (p<0.01) in their understanding of social determinants of health and concepts related to children’s health and development. Content analysis showed that participants built meaningful relationships with mentees in which they learned about social determinants of health, youth advocacy, and developed various advocacy-related skills. Participants greatly valued mentorship by residents, identifying benefits such as support and advice regarding relations with at-risk youth, and career mentorship. AMI impacted participants’ career trajectories in terms of interest in working with youth, psychiatry, and advocacy.ConclusionsAMI offers a unique method of advocacy training through cascading mentorship that engages medical students both as mentors to at-risk youth and mentees to resident physicians. Through cascading mentorship, medical students advance in their advocacy-related skills and understanding of social determinants of health.
Interaction between early-life pet exposure and methylation pattern of ADAM33 on allergic rhinitis among children aged 3-6 years in China
Authors: zhang yu , Tan Meiyu , Qian Xiaoqiong , Li Cong , Yue Lei , Liu Yuehong , Shi Song 
Published: January 2021

Abstract
Background: Recent research has pointed out the important roles of epigenetic modifications in the development and persistence of allergic rhinitis (AR), especially in relation to DNA methylation of disease-associated genes. We investigated whether AR susceptibility genes were epigenetically regulated, and whether methylation modulation of these genes in response to early-life environment could be a molecular mechanism underlying the risk for AR onset in a cohort of children aged 3-6 years in China.Methods: Peripheral blood mononuclear cell (PBMC) samples were collected from 130 children patients, aged 3-6 years and diagnosed with AR; and 154 matched controls to detect promoter methylation in 25 AR susceptibility genes with the MethylTarget approach. Methylation levels were compared for each CpG site, each amplified region, and each gene. In addition, the relationship among DNA methylation, early-life environmental risk factors and AR onset were assessed. Results: Maternal allergic history (P = 0.0390) and pet exposure (P = 0.0339) were significantly associated with increased AR risk. Differential methylation analyses were successfully performed for 507 CpG sites, 34 amplified regions and 17 genes and significant hypomethylation was observed in the promoter region of ADAM33 in AR patients [multiple test-corrected (FDR) P-value < 0.05]. Spearman correlation analysis revealed that the hypomethylation of ADAM33 was significantly associated with higher eosinophil counts (Spearman's ρ: -0.187, P-value = 0.037). According to the results of the multiple regression analysis, after adjusting for cofounders, the interaction of early-life pet exposure with methylation level of ADAM33 increased the risk for AR onset 1.423 times more in children (95% CI = 0.0290-4.109, P-value = 0.005). Conclusion: This study provides evidence that early-life pet exposure and low methylation level of ADAM33 increase AR risk in children, and the interaction between pet exposure and methylation level of ADAM33 may play an important role in the development of AR.