bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deep learning applied to two-dimensional color Doppler flow imaging ultrasound images significantly improves diagnostic performance in the classification of breast masses: a multicenter study
Authors: Yu Teng-Fei , He Wen , Gan Cong-Gui , Zhao Ming-Chang , Zhu Qiang , Zhang Wei , Wang Hui , Luo Yu-Kun , Nie Fang , Yuan Li-Jun , Wang Yong , Guo Yan-Li , Yuan Jian-Jun , Ruan Li-Tao , Wang Yi-Cheng , Zhang Rui-Fang , Zhang Hong-Xia , Ning Bin , Song Hai-Man , Zheng Shuai , Li Yi , Guang Yang 
Published: January 2021

Abstract

Background
The current deep learning diagnosis of breast masses is mainly reflected by the diagnosis of benign and malignant lesions. In China, breast masses are divided into four categories according to the treatment method: inflammatory masses, adenosis, benign tumors, and malignant tumors. These categorizations are important for guiding clinical treatment. In this study, we aimed to develop a convolutional neural network (CNN) for classification of these four breast mass types using ultrasound (US) images.

Methods
Taking breast biopsy or pathological examinations as the reference standard, CNNs were used to establish models for the four-way classification of 3623 breast cancer patients from 13 centers. The patients were randomly divided into training and test groups (n = 1810 vs. n = 1813). Separate models were created for two-dimensional (2D) images only, 2D and color Doppler flow imaging (2D-CDFI), and 2D-CDFI and pulsed wave Doppler (2D-CDFI-PW) images. The performance of these three models was compared using sensitivity, specificity, area under receiver operating characteristic curve (AUC), positive (PPV) and negative predictive values (NPV), positive (LR+) and negative likelihood ratios (LR−), and the performance of the 2D model was further compared between masses of different sizes with above statistical indicators, between images from different hospitals with AUC, and with the performance of 37 radiologists.

Results
The accuracies of the 2D, 2D-CDFI, and 2D-CDFI-PW models on the test set were 87.9%, 89.2%, and 88.7%, respectively. The AUCs for classification of benign tumors, malignant tumors, inflammatory masses, and adenosis were 0.90, 0.91, 0.90, and 0.89, respectively (95% confidence intervals [CIs], 0.87–0.91, 0.89–0.92, 0.87–0.91, and 0.86–0.90). The 2D-CDFI model showed better accuracy (89.2%) on the test set than the 2D (87.9%) and 2D-CDFI-PW (88.7%) models. The 2D model showed accuracy of 81.7% on breast masses ≤1 cm and 82.3% on breast masses >1 cm; there was a significant difference between the two groups (P < 0.001). The accuracy of the CNN classifications for the test set (89.2%) was significantly higher than that of all the radiologists (30%).

Conclusions
The CNN may have high accuracy for classification of US images of breast masses and perform significantly better than human radiologists.

Trial registration

Chictr.org, ChiCTR1900021375; http://www.chictr.org.cn/showproj.aspx?proj=33139.
Frequency of hepatitis B and C in patients attending oral and maxillofacial surgery department for dental extraction at Sandeman Provincial Hospital Quetta
Authors: Khan Changaiz , Khan Shahbaz , Ul Mulk Nizam , Khan Tareen Mirza , Hammad Jahangir , Zaman Kasi Mir 
Published: January 2021

Introduction:
The aim of this study is to evaluate the frequency of hepatitis B and C (HBV & HCV) in patients attending oral and maxillofacial surgery unit for dental extraction. These are blood borne viral infections which may transmit due to used dental needles, blood transfusions, used syringes, drug abuse, homosexuality, and prostitution. Dentists are considered as one of the most highly vulnerable professionals at risk. This study also highlights the importance of routine screening for these viral infections before dental surgery.

Objective:
The objective of this study was to evaluate the frequency of HBV and HCV among patients who visited for dental extraction.

Rationale:
To highlight the importance of routine screening before any dental procedure, specially before any oral surgical procedure such as tooth extraction.

Materials and Methods:
This study was conducted in exodontia section of oral and maxillofacial surgery unit, Sandeman Provincial Hospital Quetta. The total study period was 1 year, commencing from November, 2018 to November, 2019. A total of 3431 patients were screened before dental extraction.

Results:
Of 3431 patients, 149 were found to be positive for HBV and HCV collectively. Among them 95 (2.7%) were HBV positive and 54 (1.5%) were diagnosed with HCV.

Conclusion:
This study clearly emphasizes the importance of preoperative routine screening for HBV and HCV before any dental procedure.
Brain functional changes in perimenopausal women: an amplitude of low-frequency fluctuation study
Authors: Liu Ningning , Zhang Yue , Liu Shuang , Zhang Xuening , Liu Huijun 
Published: January 2021

Abstract

Objective:
To evaluate the effects of sex hormones on amplitude of low-frequency fluctuation (ALFF) in brain regions related to cognition in perimenopausal women.

Methods:
This cross-sectional study involved 25 perimenopausal women and 25 premenopausal women who underwent behavioral evaluations, sex hormone level measurements, and functional magnetic resonance imaging (fMRI). All data and ALFF analyses were preprocessed using the Data Processing Assistant for Resting-State fMRI. Statistical analyses were performed using the Resting-State fMRI Data Analysis Toolkit to explore the differences in ALFF between perimenopausal and premenopausal women. The gray matter volume (GMV) values extracted from brain regions (regions of interest) with significantly different ALFF values between the perimenopausal and premenopausal groups were compared. We analyzed the correlations of the ALFF and GMV values of these regions of interest with the results of behavioral evaluations and sex hormone levels in the two groups.

Results:
Compared with the premenopausal group, the perimenopausal group showed significant ALFF increase in the left gyrus rectus. Regions with decreased ALFF in the perimenopausal group included the left superior temporal gyrus, left inferior frontal gyrus, and left insula. The GMV values of the left gyrus rectus and left superior temporal gyrus were reduced in perimenopausal women. Furthermore, the estradiol level was negatively correlated with the ALFF value of the left gyrus rectus in perimenopausal women.

Conclusions:
The ALFF and GMV values of certain brain regions related to cognitive function were changed in perimenopausal women. Such functional brain alterations may provide more information regarding the mechanism of cognitive dysfunction in perimenopausal women.
Associations between sleep duration, midday napping, depression, and falls among postmenopausal women in China: a population-based nationwide study
Authors: Zhou Zonglei , Yu Yu , Zhou Ruzhen , Luan Rongsheng , Li Kunpeng 
Published: January 2021

Abstract

Objective:
To explore the independent and joint associations of sleep duration, midday napping, and depression with fall accidents in Chinese postmenopausal women.

Methods:
A total of 2,378 postmenopausal women aged ≥ 45 years from the baseline survey of the China Health and Retirement Longitudinal Study were enrolled in the study. Each participant provided data on falls, sleep duration, midday napping by a self-reporting approach. We employed the Chinese version of the Center for Epidemiologic Studies Depression Scale to assess depression. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated to estimate the associations of predictor variables with falls using multivariate logistic regression.

Results:
Of the 2,378 postmenopausal women, 478 (20.10%) reported falls in the preceding 2 years. Compared with sleep duration of 7 to 8 h/night, sleep duration of 5 to 6 h/night (OR, 1.49; 95% CI, 1.03-2.15) and of ≤ 5 h/night (OR, 1.63; 95% CI, 1.18-2.25) were associated with a higher fall prevalence. However, no significant correlation was found between sleep duration of > 8 h/night and falls. Furthermore, participants with depression were more likely to report falls (OR, 1.78; 95% CI, 1.41-2.25) than their depression-free counterparts. The duration of midday napping was not independently associated with falls, but significant joint associations of sleeping ≤ 6 h/night and no napping (OR, 1.72; 95% CI, 1.07-2.76) or napping > 60 minutes (OR, 2.14; 95% CI, 1.18-3.89) with more falls were found. Similarly, a combined status of sleeping ≤ 6 h/night and depression was related to more falls (OR, 2.97; 95% CI, 1.86-4.74).

Conclusion:
The present study demonstrates that short sleep duration and depression are independently associated with more falls among postmenopausal women in China. Moreover, short sleep duration combined with no or long napping, short sleep duration combined with depression are jointly correlated with more falls. Future longitudinal studies are warranted to confirm these findings.
HYPERREFLECTIVITY ON OPTICAL COHERENCE TOMOGRAPHY IN MACULAR TELANGIECTASIA TYPE 2
Authors: Tzaridis Simone , Hess Kristina , Heeren Tjebo F. C. , Bonelli Roberto , Holz Frank G. , Friedlander Martin 
Published: January 2021

Purpose:
To define, characterize, and classify hyperreflectivity on optical coherence tomography and report its prevalence in macular telangiectasia Type 2.

Methods:
In a primary cross-sectional analysis, multimodal imaging data were retrospectively analyzed. The definition of hyperreflectivity and neovascularization on optical coherence tomography followed optical coherence tomography angiography–based criteria. Eyes were graded for the presence of hyperreflectivity and neovascularization and further categorized into three classes based on position and extent of hyperreflectivity. In a secondary analysis, eyes were reviewed for ≥24 months using optical coherence tomography imaging.

Results:
Three hundred and twenty-two eyes from 161 patients were analyzed in the cross-sectional analysis. Hyperreflectivity was found in 177 (55%) and neovascular membranes in 49 (15%) eyes. Hyperreflectivity correlated significantly with parameters indicative of disease progression. In the longitudinal analysis, 206 eyes from 103 patients were reviewed over a mean of 35.6 months. 17/86 eyes (20%) showed a de novo development of hyperreflectivity. 8/29 eyes (28%) with preexistent intraretinal hyperreflectivity developed outer retinal hyperreflectivity. A high proportion of eyes with outer retinal hyperreflectivity (17/52 [33%]) developed neovascular membranes.

Conclusion:
Hyperreflectivity represents a common finding in macular telangiectasia Type 2 but lacks a uniform definition. We propose a hyperreflectivity grading scale that may help to estimate disease progression and identify eyes at risk for developing neovascular membranes.
Ultrasound-guided transversus abdominis plane block vs trigger point injections for chronic abdominal wall pain: a randomized clinical trial
Authors: Moeschler Susan M. , Pollard E. Morgan , Pingree Matthew J. , Pittelkow Thomas P. , Bendel Mark A. , Mauck W. David , Watson James C. , Eldrige Jason S. , Loftus Conor G. , Hooten W. Michael 
Published: January 2021

Abstract
The primary aim of this randomized clinical trial is to investigate the effects of ultrasound-guided transversus abdominis plane (TAP) vs ultrasound-guided trigger point injections (TPIs) on numerical rating scale pain scores at month 3 follow-up in patients with a chronic abdominal wall pain. The primary outcome measure was the difference in mean numeric rating scale pain scores between the TAP and TPI groups at month 3 in an intent-to-treat (ITT) analysis. A total of 60 patients were randomized 1:1 to receive an ultrasound-guided TAP block (n = 30) or an ultrasound-guided TPI (n = 30). No significant group differences in baseline demographic or clinical characteristics were observed. The mean baseline pain score for the TAP and TPI groups was 5.5 and 4.7, respectively. In the ITT analysis at month 3, the between-group difference in pain scores was 1.7 (95% confidence interval, 0.3-3.0) favoring the TPI group. In a secondary per-protocol analysis, the between-group difference in pain scores was 1.8 (95% confidence interval, 0.4-3.2) favoring the TPI group. For the ITT and per-protocol analyses, the group differences in pain scores were consistent with a medium effect size. The main finding of this randomized clinical trial is that adults with chronic abdominal wall pain who received a TPI reported significantly lower pain scores at month 3 follow-up compared with patients who received a TAP block.
Photobiomodulation therapy is not better than placebo in patients with chronic nonspecific low back pain: a randomised placebo-controlled trial
Authors: Guimarães Layana de Souza , Costa Lucíola da Cunha Menezes , Araujo Amanda Costa , Nascimento Dafne Port , Medeiros Flávia Cordeiro , Avanzi Marina Athayde , Leal-Junior Ernesto Cesar Pinto , Costa Leonardo Oliveira Pena , Tomazoni Shaiane Silva 
Published: January 2021

Abstract
Photobiomodulation therapy (PBMT) has been used in several musculoskeletal disorders to reduce pain, inflammation, and promoting tissue regeneration. The current evidence about the effects of PBMT on low back pain (LBP) is still conflicting. We aimed to evaluate the effects of PBMT against placebo on pain intensity and disability in patients with chronic nonspecific LBP. This was a prospectively registered, randomised placebo-controlled trial, with blinded patients, therapists, and assessors. The study was conducted on an outpatient physical therapy clinic in Brazil, between April 2017 and May 2019. A total of 148 patients with chronic nonspecific LBP were randomised to either active PBMT (n = 74) or placebo (n = 74). Patients from both groups received 12 treatment sessions, 3 times a week, for 4 weeks. Patients from both groups also received an educational booklet based on “The Back Book.” Clinical outcomes were measured at baseline and at follow-up appointments at 4 weeks, 3, 6, and 12 months after randomisation. The primary outcomes were pain intensity and disability measured at 4 weeks. We estimated the treatment effects using linear mixed models following the principles of intention-to-treat. There was no clinical important between-group differences in terms of pain intensity (mean difference = 0.01 point; 95% confidence interval = −0.94 to 0.96) and disability (mean difference = −0.63 points; 95% confidence interval = −2.23 to 0.97) at 4 weeks. Patients did not report any adverse events. Photobiomodulation therapy was not better than placebo to reduce pain and disability in patients with chronic nonspecific LBP.
Brief preoperative mind–body therapies for total joint arthroplasty patients: a randomized controlled trial
Authors: Hanley Adam W. , Gililland Jeremy , Erickson Jill , Pelt Christopher , Peters Christopher , Rojas Jamie , Garland Eric L. 
Published: January 2021

Abstract:
Although knee and hip replacements are intended to relieve pain and improve function, up to 44% of knee replacement patients and 27% of hip replacement patients report persistent postoperative joint pain. Improving surgical pain management is essential. We conducted a single-site, 3-arm, parallel-group randomized clinical trial conducted at an orthopedic clinic, among patients undergoing total joint arthroplasty (TJA) of the hip or knee. Mindfulness meditation (MM), hypnotic suggestion (HS), and cognitive-behavioral pain psychoeducation (cognitive-behavioral pain psychoeducation) were each delivered in a single, 15-minute group session as part of a 2-hour, preoperative education program. Preoperative outcomes—pain intensity, pain unpleasantness, pain medication desire, and anxiety—were measured with numeric rating scales. Postoperative physical functioning at 6-week follow-up was assessed with the Patient-Reported Outcomes Measurement Information System Physical Function computer adaptive test. Total joint arthroplasty patients were randomized to preoperative MM, HS, or cognitive-behavioral pain psychoeducation (n = 285). Mindfulness meditation and HS led to significantly less preoperative pain intensity, pain unpleasantness, and anxiety. Mindfulness meditation also decreased preoperative pain medication desire relative to cognitive-behavioral pain psychoeducation and increased postoperative physical functioning at 6-week follow-up relative to HS and cognitive-behavioral pain psychoeducation. Moderation analysis revealed the surgery type did not differentially impact the 3 interventions. Thus, a single session of a simple, scripted MM intervention may be able to immediately decrease TJA patients' preoperative clinical symptomology and improve postoperative physical function. As such, embedding brief MM interventions in surgical care pathways has the potential to improve surgical outcomes for the millions of patients receiving TJA each year.
Functional Training in Portuguese Firefighters
Authors: Lajoso-Silva Nuno , Bezerra Pedro , Silva Bruno , Carral José Maria Cancela 
Published: January 2021

Objective:
To investigate the influence of specific functional training (FT) with and without personal protective equipment (PPE) and self-contained breathing apparatus (SCBA), on firefighters (FFs) physical fitness condition.

Methods:
Sixty FFs run a 24 weeks intervention, divided into three groups (EG1 training with PPE+SCBA; EG2 training with regular equipment, and Control Group). FFs anthropometric and physical fitness (PF) were assessed pre- and post-intervention.

Results:
Significant differences were found between the training groups and control group. Both training groups interventions were effective in improving PF and lean mass. However, EG1 presented a higher percentage of improvement.

Conclusion:
This 24-week FT intervention improved participants’ muscle strength, endurance, and power, and it led to increases in lean body mass. Regularly FT with PPE+SCBA helps FFs maintain a healthy general physical condition and develop optimum fitness levels related to firefighting specific tasks, specially torso muscular endurance.
Bisphosphonates and risk of lung cancer
Authors: Li Minghao , Zhong Muyan , Guan Chengnong 
Published: January 2021

Abstract
The association between the use of bisphosphonates (BPs) and the risk of lung cancer has been concerned recently. There is no explicit study indicating that whether the use of BPs would affect the risk of lung cancer. So, we conducted a meta-analysis to figure out the relationship between BPs and lung cancer.
We searched the databases of PubMed and Embase. The random effects were used to calculate the pooled odds ratios (ORs) and 95% confidence interval (CIs) for the risk of lung cancer in BPs users compared with non-users. The stability of our results was evaluated by the sensitivity analysis. The publication bias was assessed in our study. The data in our study comes from the public database, therefore ethical approval is not necessary. Also, our study did not involve patient consent.
Four studies met our inclusion criteria. All the included studies are cohort studies. Our analysis indicated that there was no significant association between the use of BPs and the risk of lung cancer (OR 1.02, 95%CI 0.85- 1.24, I
2 71%). In our secondary analysis, the use of alendronate may increase the risk of lung cancer. The pooled OR of 3 studies is (OR 1.10, 95%CI 0.84–1.45, I
2 77%), but when we performed a sensitivity analysis, 1 of the OR is (OR 1.23, 95%CI 1.02–1.49, I
2 4.1%).
This is the most detailed meta-analysis on this topic. And there was no significant association between the use of BPs and lung cancer. However, exposure to alendronate may increase the risk of lung cancer. More studies are needed to confirm our findings.
Postoperative acute kidney injury and early and long-term mortality in acute aortic dissection patients
Authors: Meng Wenbin , Li Rui , E Lihua , Zha Nashunbayaer 
Published: January 2021

Abstract

Objective:
To evaluate the impact of postoperative acute kidney injury (AKI) on early and long-term mortality in patients with acute aortic dissection by conducting a meta-analysis.

Methods:
An extensive literature search was performed in PubMed and Embase databases until February 15, 2020. Observational studies that reported the associations between postoperative AKI and early (in-hospital and within 30 days) or long-term mortality in patients with acute aortic dissection were included.

Results:
Seven studies comprising 1525 acute aortic dissection patients were identified. A random effect meta-analysis showed that postoperative AKI was significantly associated with higher risk of long-term mortality (risk ratio [RR] 2.32; 95% confidence interval [CI] 1.50–3.59). Subgroup analysis revealed that the pooled RR of long-term mortality was 1.42 (95% CI 0.90–2.22) for stage 1 AKI, 1.72 (95% CI 0.95–3.12) for stage 2 AKI, and 4.46 (95% CI 2.72–7.32) for stage 3 AKI, respectively. Furthermore, postoperative stage 3 AKI was associated with an increased risk of early mortality (RR 11.3; 95% CI 4.2–30.5).

Conclusions:
This meta-analysis provided clinical evidence that postoperative stage 3 AKI is associated with higher risk of early and long-term mortality, even after adjusting important confounding factors. However, the current findings should be interpreted with caution due to the retrospective nature and limited number of studies analyzed.
Comparing the different viewpoints on overseas transplantation demands between genders and roles
Authors: Chen Hong-Mei , Shih Fu-Jong , Hu Rey-Heng , Shih Fu-Jin , Sheu Shuh-Jen 
Published: January 2021

Abstract
This study examined the different demands for overseas liver transplantation between genders and roles from the perspective of overseas liver transplant recipients and primary caregivers.
An exploratory qualitative method was employed using a purposive sample of individuals who had received overseas liver transplantation. We recruited 28 recipients and 29 family members from a leading hospital in Taiwan. Face-to-face semi-structured interviews were conducted with each participant, and data were analyzed using qualitative content analysis.
Three demands were identified across gender and roles:
Different patterns and meanings related to gender and roles were discussed. Male recipients were less enthusiastic about receiving the overseas liver transplantation. Rather, they complained about losing the economic and decision-making power due to body deterioration after overseas liver transplantation. Their primary need was to increase their dignity and significant position in the family. Female recipients were apprehensive for overseas liver transplantation and required more psychological support and positive experiences from other transplant recipients. Most male primary caregivers required a nursing aide quickly. Most female primary caregivers would engage in the health care task but needed more medical personnel, assistance, and high emotional support from relatives.
This study revealed the common and urgent demands of overseas liver transplant recipients and primary caregivers. The unique demands of recipients and primary caregivers based on their gender and roles were rooted in the potential influences of traditional cultures and modern medicine in an ethnic-Chinese society.