bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting Admissions From a Paediatric Emergency Department – Protocol for Developing and Validating a Low-Dimensional Machine Learning Prediction Model
Authors: Leonard Fiona , Gilligan John , Barrett Michael J. 
Published: April 2021

Introduction: Patients boarding in the Emergency Department can contribute to overcrowding, leading to longer waiting times and patients leaving without being seen or completing their treatment. The early identification of potential admissions could act as an additional decision support tool to alert clinicians that a patient needs to be reviewed for admission and would also be of benefit to bed managers in advance bed planning for the patient. We aim to create a low-dimensional model predicting admissions early from the paediatric Emergency Department.Methods and Analysis: The methodology Cross Industry Standard Process for Data Mining (CRISP-DM) will be followed. The dataset will comprise of 2 years of data, ~76,000 records. Potential predictors were identified from previous research, comprising of demographics, registration details, triage assessment, hospital usage and past medical history. Fifteen models will be developed comprised of 3 machine learning algorithms (Logistic regression, naïve Bayes and gradient boosting machine) and 5 sampling methods, 4 of which are aimed at addressing class imbalance (undersampling, oversampling, and synthetic oversampling techniques). The variables of importance will then be identified from the optimal model (selected based on the highest Area under the curve) and used to develop an additional low-dimensional model for deployment.Discussion: A low-dimensional model comprised of routinely collected data, captured up to post triage assessment would benefit many hospitals without data rich platforms for the development of models with a high number of predictors. Novel to the planned study is the use of data from the Republic of Ireland and the application of sampling techniques aimed at improving model performance impacted by an imbalance between admissions and discharges in the outcome variable.
Chromosomal Aneuploidy Associated With Clinical Characteristics of Pregnancy Loss
Authors: Gu Chongjuan , Li Kuanrong , Li Ru , Li Ling , Li Xiaojun , Dai Xinyu , He Yaojuan 
Published: April 2021

ObjectiveEmbryonic aneuploidy is found in about half of sporadic pregnancy losses and the associations between the chromosomal aneuploidy and clinical characteristics of pregnancy loss remain unclear. The aims of this study were to evaluate the associations between chromosomal aneuploidy of products of conception (POC) and clinical features of pregnancy loss.MethodsWe conducted a retrospective cohort study including 1,102 women experienced singleton pregnancy loss and underwent chromosomal microarray analysis (CMA) detection of POC in our hospital. The results of molecular karyotypes and clinical features including maternal age, history of pregnancy loss, gestational age, vaginal bleeding and ultrasonographic findings were extracted from the medical records. χ2test was used to compare categorical data between groups.Results631 (57.26%) POC specimens were detected to be chromosomal aneuploidy. Aneuploid rates were significantly higher in women &gt;35 years (P&lt; 0.001) and pregnancy loss &lt;11 gestational weeks (P= 0.044), but the rates of sex chromosome abnormalities and triploid were significantly higher in women ≤35 years (P&lt; 0.001,P= 0.002) and the rates of viable autosomal trisomy and sex chromosome abnormalities were significantly high in those women with pregnancy loss ≥11 weeks (P &lt; 0.001,P&lt; 0.001). Aneuploid rate was overall similar between the sporadic and the recurrent pregnancy loss (RPL) (P= 0.404), but the rate of sex chromosome abnormalities was higher in women with sporadic pregnancy loss (P= 0.03). Aneuploid rates were higher in subjects with yolk sac or embryo than in those without (P&lt; 0.001 andP= 0.001).ConclusionAdvanced maternal age is mainly associated with autosomal trisomy, while sex chromosome abnormalities and triploid might be more likely to occur in younger women. Aneuploidy rates might be no association with previous pregnancy loss except for sex chromosome abnormalities. Pregnancy loss without yolk sac or embryo might be less related to embryonic aneuploidy, and other factors should be emphasized.
Early Strength Development of Soft Clay Stabilized by One-Part Ground Granulated Blast Furnace Slag and Fly Ash-Based Geopolymer
Authors: Zheng Xiyao , Wu Jun 
Published: April 2021

One-part or “just add water” geopolymer is a cementitious material, which is friendly to environment and users in applications. However, the mechanical behavior of the soft soil stabilized by one-part geopolymer is not well acknowledged. In this study, soft clay was stabilized with ground granulated blast furnace slag (GGBFS) and fly ash (FA)-based geopolymer, which is a mixture of solid aluminosilicate precursor (Al-Si raw materials: GGBFS and FA), solid alkali activator, and water. The objective was to adopt one-part geopolymer as an alternative soil binder to completely replace ordinary Portland cement (OPC) for stabilizing the soft clay and evaluate the effect of the factors (i.e., GBFS/FA ratio in Al-Si precursor, activator/Al-Si precursor ratio, and water/binder ratio) that influenced the early strength. Results showed that the increase of the FA content in the Al-Si precursor increased the unconfined compressive strength (UCS) values significantly through the geopolymerization process. The highest UCS values were achieved with 90% GGBFS to 10% FA in the precursor when the activator/precursor and water/binder ratio is 0.15 and 0.7, respectively. The UCS values of geopolymer-stabilized clay could reach 1.5 MPa at 14 days at ambient temperature, which is much higher than that of OPC-stabilized clay. The microstructure and mineralogy analyses indicated that the prolific hydration products, such as calcium silicate hydrate (C-S-H), calcium aluminum hydrate (C-A-H), and calcium aluminum silicate hydrate (C-A-S-H), contributed greatly to strengthen the soft clay by forming the soil skeleton and infilling among clay particles, while sodium aluminosilicate (N-A-S-H) gel is only served to fill the part of porosities in the soil and cannot effectively enhance the UCS of the one-part geopolymer-stabilized soft clay. This paper results suggested that one-part GGBFS-FA–based geopolymers have the potential to replace OPC in the manufacture of stabilized soft clay.
Urine Cadmium as a Risk Factor for Osteoporosis and Osteopenia: A Meta-Analysis
Authors: Li Dong , Lin HaoJie , Zhang Min , Meng Jing , Hu LiYou , Yu Bo 
Published: April 2021

Background: As society ages, the incidence of osteoporosis increases. In several studies, cadmium (Cd) is thought to be related to osteoporosis. However, there are conflicting reports about the relationship between Cd and the risk of osteoporosis and osteopenia. Therefore, the purpose of this meta-analysis was to explore the relationship between Cd and osteoporosis and osteopenia.Methods: Through a review of the literature, articles published in PubMed as of December 2020 were identified and the references of related publications and reviews were reviewed. Ultimately, 17 eligible articles were selected to determine the relationship between blood and urine Cd concentrations for the risk of osteoporosis or osteopenia. In this study, we performed a classification analysis, heterogeneity test, subgroup analysis, and evaluated publication bias.Results: A total of 17 studies were included, including seven on blood Cd and 10 on urine Cd. By combining the odds ratio (OR) and 95% confidence interval (CI) for the lowest and highest categories, the odds ratio of blood Cd concentration that increased the risk of osteoporosis or osteopenia was OR 1.21 (95% CI: 0.84–1.58) and that of urine Cd concentration that increased the risk of osteoporosis or osteopenia was OR 1.80 (95% CI: 1.42–2.18), and the results of the subgroup analysis were also consistent.Conclusions: Our research indicates that while urine cadmium (Cd) concentration may be related to increased risk of osteoporosis and osteopenia, blood Cd concentration may not. Therefore, compared to blood Cd concentration, urine Cd concentration may be more reliable as a risk factor for osteoporosis and osteopenia. This result should be interpreted with caution. Currently. research on the relationship between Cd concentration and osteoporosis and osteopenia is limited, thus, further large, high-quality prospective studies are required to elucidate the relationship between Cd concentration and osteoporosis and osteopenia.
Systematic Chromatin Accessibility Analysis Based on Different Immunological Subtypes of Clear Cell Renal Cell Carcinoma
Authors: Zhang Shiqiang , Zheng Wenzhong , Jiang Donggen , Xiong Haiyun , Liao Guolong , Yang Xiangwei , Ma He , Li Jun , Qiu Miaojuan , Li Binbin , Sun Chunhui , Zhao Jing , Wang Liling , Pang Jun 
Published: April 2021

BackgroundRecent research of clear cell renal cell carcinoma (ccRCC) is focused on the tumor immune microenvironment (TIME). Chromatin accessibility is critical for regulation of gene expression. However, its role in different immunological subtypes of ccRCC based on immune cell infiltration has not been systematically studied.MethodsFive hundred thirty patient data from The Cancer Genome Atlas Kidney Renal Clear Cell Carcinoma (TCGA-KIRC) were adopted to estimate immune cell infiltration. Twenty-four types of immune cells were evaluated with single-sample Gene Set Enrichment Analysis (ssGSEA). Patients were divided into two clusters based on immune cell infiltration. Systematic chromatin accessibility analysis was conducted based on the two clusters.ResultsWe compared the relative expression of the immune gene signatures among 530 patients of TCGA-KIRC using ssGSEA. Overall survival (OS) analysis revealed 10 types of immune cells were significantly associated with prognosis. Patients were divided into two clusters based on 24 types of immune cell infiltration. Immune cell signals as well as PD-1/PD-L1 signal were higher in cluster 1. Among the two clusters, 2,400 differential peaks were found in TCGA-KIRC Transposase Accessible Chromatin with high-throughput sequencing (ATAC-seq) data. The distribution of differential peaks and prognosis-related immune cells in 23 chromosomes are essentially the same. There is no peak distribution downstream. The proportion of peaks upstream of the 5’ transcription start site decreases, and both sides of binding regions of the TSS 0.1-1 kb becomes smaller. Enrichment analysis of GO and KEGG of these differential peaks showed that they are remarkably related to the immune regulation in tumor microenvironment. Known motifs and de novo motifs were found by linking motif annotations to different peaks. Survival analysis of related motif transcription factors were prognostic. The GSEA enrichment analysis showed that high SP1 expression positively correlates with TGF-beta signaling and inflammatory response, while negatively correlates with TNF-alpha signaling via NFKB. High KLF12 expression negatively correlates with interferon gamma response, IL2-STAT5 signaling, TNF-alpha signaling via NFKB, IL6-JAK-STAT3 signaling.ConclusionThe abnormality of chromatin accessibility may play an important regulatory role in ccRCC immunity.
Three-Dimensional Radiomics Features From Multi-Parameter MRI Combined With Clinical Characteristics Predict Postoperative Cerebral Edema Exacerbation in Patients With Meningioma
Authors: Xiao Bing , Fan Yanghua , Zhang Zhe , Tan Zilong , Yang Huan , Tu Wei , Wu Lei , Shen Xiaoli , Guo Hua , Wu Zhen , Zhu Xingen 
Published: April 2021

BackgroundPostoperative cerebral edema is common in patients with meningioma. It is of great clinical significance to predict the postoperative cerebral edema exacerbation (CEE) for the development of individual treatment programs in patients with meningioma.ObjectiveTo evaluate the value of three-dimensional radiomics Features from Multi-Parameter MRI in predicting the postoperative CEE in patients with meningioma.MethodsA total of 136 meningioma patients with complete clinical and radiological data were collected for this retrospective study, and they were randomly divided into primary and validation cohorts. Three-dimensional radiomics features were extracted from multisequence MR images, and then screened through Wilcoxon rank sum test, elastic net and recursive feature elimination algorithms. A radiomics signature was established based support vector machine method. By combining clinical with the radiomics signature, a clin-radiomics combined model was constructed for individual CEE prediction.ResultsThree significance radiomics features were selected to construct a radiomics signature, with areas under the curves (AUCs) of 0.86 and 0.800 in the primary and validation cohorts, respectively. Two clinical characteristics (peritumoral edema and tumor size) and radiomics signature were determined to establish the clin-radiomics combined model, with an AUC of 0.91 in the primary cohort and 0.83 in the validation cohort. The clin-radiomics combined model showed good discrimination, calibration, and clinically useful for postoperative CEE prediction.ConclusionsBy integrating clinical characteristics with radiomics signature, the clin-radiomics combined model could assist in postoperative CEE prediction before surgery, and provide a basis for surgical treatment decisions in patients with meningioma.
A Novel Immune-Related Prognostic Biomarker and Target Associated With Malignant Progression of Glioma
Authors: Zhang Yu , Yang Xin , Zhu Xiao-Lin , Wang Zhuang-Zhuang , Bai Hao , Zhang Jun-Jie , Hao Chun-Yan , Duan Hu-Bin 
Published: April 2021

BackgroundGlioma is one of the most common malignancies in the central nervous system and has limited effective therapeutic options. Therefore, we sought to identify a suitable target for immunotherapy.Materials and MethodsWe screened prognostic genes for glioma in the CGGA database and GSE43378 dataset using survival analysis, receiver operating characteristic (ROC) curves, independent prognostic analysis, and clinical correlation analysis. The results were intersected with immune genes from the ImmPort database through Venn diagrams to obtain likely target genes. The target genes were validated as prognostically relevant immune genes for glioma using survival, ROC curve, independent prognostic, and clinical correlation analyses in samples from the CGGA database and GSE43378 dataset, respectively. We also constructed a nomogram using statistically significant glioma prognostic factors in the CGGA samples and verified their sensitivity and specificity with ROC curves. The functions, pathways, and co-expression-related genes for the glioma target genes were assessed using PPI networks, enrichment analysis, and correlation analysis. The correlation between target gene expression and immune cell infiltration in glioma and the relationship with the survival of glioma patients were investigated using the TIMER database. Finally, target gene expression in normal brain, low-grade glioma, and high-grade glioma tissues was detected using immunohistochemical staining.ResultsWe identified TNFRSF12A as the target gene. Satisfactory results from survival, ROC curve, independent prognosis, and clinical correlation analyses in the CGGA and GSE43378 samples verified that TNFRSF12A was significantly associated with the prognosis of glioma patients. A nomogram was constructed using glioma prognostic correlates, including TNFRSF12A expression, primary-recurrent-secondary (PRS) type, grade, age, chemotherapy, IDH mutation, and 1p19q co-deletion in CGGA samples with an AUC value of 0.860, which illustrated the accuracy of the prognosis prediction. The results of the TIMER analysis validated the significant correlation of TNFRSF12A with immune cell infiltration and glioma survival. The immunohistochemical staining results verified the progressive up-regulation of TNFRSF12A expression in normal brain, low-grade glioma, and high-grade glioma tissues.ConclusionWe concluded that TNFRSF12A was a viable prognostic biomarker and a potential immunotherapeutic target for glioma.
Prognostic Nomogram for Postoperative Patients With Gastroesophageal Junction Cancer of No Distant Metastasis
Authors: Guo Qiang , Peng YuanYuan , Yang Heng , Guo JiaLong 
Published: April 2021

BackgroundGastroesophageal junction (GEJ) was one of the most common malignant tumors. However, the value of clinicopathological features in predicting the prognosis of postoperative patients with GEJ cancer and without distant metastasis was still unclear.MethodsThe 3425 GEJ patients diagnosed and underwent surgical resection without distant metastasis in the Surveillance, Epidemiology and End Results (SEER) database from 2010 to 2015 were enrolled,and they were randomly divided into training and validation cohorts with 7:3 ratio. Univariate and multivariate Cox regression analysis were used to determine the predictive factors that constituted the nomogram. The predictive accuracy and discriminability of Nomogram were determined by the area under the curve (AUC), C index, and calibration curve, and the influence of various factors on prognosis was explored.Results2,400 patients were designed as training cohort and 1025 patients were designed as validation cohort. The percentages of the distribution of demographic and clinicopathological characteristics in the training and validation cohorts tended to be the same. In the training cohort, multivariate Cox regression analysis revealed that the age, tumor grade, T stage and N stage were independent prognostic risk factors for patients with GEJ cancer without distant metastasis. The C index of nomogram model was 0.667. The AUC of the receiver operating characteristic (ROC) analysis for 3- and 5-year overall survival (OS) were 0.704 and 0.71, respectively. The calibration curve of 3- and 5-year OS after operation showed that there was the best consistency between nomogram prediction and actual observation. In the validation cohort, the C index of nomogram model, the AUC of 3- and 5-year OS, and the calibration curve were similar to the training cohort.ConclusionsNomogram could evaluate the prognosis of patients with GEJ cancer who underwent surgical resection without distant metastasis.
Improved Treatment Outcomes by Using Patient Specific Drug Combinations in Mammalian Target of Rapamycin Activated Advanced Metastatic Cancers
Authors: Crook Timothy , Patil Darshana , Gaya Andrew , Plowman Nicholas , Limaye Sewanti , Ranade Anantbhushan , Bhatt Amit , Page Raymond , Akolkar Dadasaheb 
Published: April 2021

Background: Activation of the mTOR signaling pathway is ubiquitous in cancers and a favourable therapeutic target. However, presently approved mTOR inhibitor monotherapies have modest benefits in labeled indications while poor outcomes have been reported for mTOR inhibitor monotherapy when administered in a label-agnostic setting based on univariate molecular indications. The present study aimed to determine whether patient-specific combination regimens with mTOR inhibitors and other anticancer agents selected based on multi-analyte molecular and functional tumor interrogation (ETA: Encyclopedic Tumor Analysis) yields significant treatment response and survival benefits in advanced or refractory solid organ cancers.Methods: We evaluated treatment outcomes in 49 patients diagnosed with unresectable or metastatic solid organ cancers, of whom 3 were therapy naïve and 46 were pre-treated in whom the cancer had progressed on 2 or more prior systemic lines. All patients received mTOR inhibitor in combination with other targeted, endocrine or cytotoxic agents as guided by ETA. Patients were followed-up to determine Objective Response Rate (ORR), Progression Free Survival (PFS) and Overall Survival (OS).Results: The Objective Response Rate (ORR) was 57.1%, the disease Control rate (DCR) was 91.8%, median Progression Free Survival (mPFS) was 4.9 months and median Overall Survival (mOS) was 9.4 months. There were no Grade IV treatment related adverse events (AEs) or any treatment related deaths.Conclusion: Patient-specific combination regimens with mTOR inhibition and other anti-neoplastic agents, when selected based on multi-analyte molecular and functional profiling of the tumor can yield meaningful outcomes in advanced or refractory solid organ cancers.Trial Registration: Details of all trials are available at WHO-ICTRP: https://apps.who.int/trialsearch/. RESILIENT ID CTRI/2018/02/011808. ACTPRO ID CTRI/2018/05/014178. LIQUID IMPACT ID CTRI/2019/02/017548.
Effect and Mechanism of Si-Miao-Yong-An on Vasa Vasorum Remodeling in ApoE−/− Mice with Atherosclerosis Vulnerable Plague
Authors: Li Meng , Qi Zhongwen , Zhang Junping , Zhu Ke , Wang Yueyao 
Published: April 2021

Objective: To observe the effect of Si-Miao-Yong-An (SMYA) on atherosclerosis (AS) vulnerable plaques, and to further explore the mechanism by vasa vasorum (VV) angiogenesis and maturation as an entry point.Methods: SPF-class healthy male ApoE−/− mice were randomized into model group, simvastatin group and SMYA group, and C57BL/6 mice were used as the control group. After 8 weeks of intervention, the pathological morphology of plaque was observed by HE staining; the VV density in plaque and aortic adventitia were observed by immunohistochemistry; VV maturation was measured by double-labelling immunofluorescence; the critical proteins of HIF-1α-Apelin/APJ and Ang-1/Tie signal pathways were detected by western blotting.Results: SMYA decreased the plaque area and the ratio of plaque to lumen area; increased the minimum thickness of fibrous cap and its effect was greater than simvastatin. SMYA suppressed the VV neovascularization; promoted smooth muscle cells recruitment and VV maturation, which maintained plaque stability; its effect was obviously superior to simvastatin. SMYA deceased the expression of HIF-1α, Apelin, APJ, Phospho-MEK1/2 (Ser217/221), Phospho-p44/42 MAPK (Erk1/2) (Thr202/Tyr204), Phospho-p70 S6 Kinase (Thr421/Ser424), Ang-2 and Tie-2; it also increased the expression of Ang-1, Phospho-Akt (Ser473), Phospho-FOXO1 (Ser256) and Survivin.Conclusions: SMYA can decrease the AS plaque area in ApoE−/− mice, suppress the VV neovascularization and promote the VV maturation, and stabilize AS vulnerable plaque. The mechanism could be regulating the HIF-1α-Apelin/APJ and Ang-1/Tie signal pathways.