bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dual-energy CT quantitative parameters for evaluating Immunohistochemical biomarkers of invasive breast cancer
Authors: Wang Xiaoxia , Liu Daihong , Zeng Xiangfei , Jiang Shixi , Li Lan , Yu Tao , Zhang Jiuquan 
Published: January 2021

Abstract
Background
Estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) and Ki67 are the most useful immunohistochemical biomarkers of invasive breast cancer. The purpose of this study is to investigate the possibility of quantitative parameters derived from dual-energy CT (DECT) to discriminate immunohistochemical biomarkers of invasive breast cancer.

Methods
This prospective study enrolled 120 patients with invasive breast cancer who underwent preoperative contrast-enhanced DECT for staging purposes from June 2019 to January 2020. DECT quantitative parameters, including normalized iodine concentration (NIC), the slope of the spectral Hounsfield unit curve (λHu), and the normalized effective atomic number (nZeff), were obtained from reconstructed images. DECT quantitative parameters were compared with the expression status, and the correlations with the value of immunohistochemical biomarkers were evaluated. Inter-observer reproducibility analysis was performed to assess the measurement reproducibility of quantitative parameters. The diagnostic performance of the quantitative parameters was analyzed by receiver operating characteristic curve.

Results
The ER-negative group tended to display higher venous phase NIC and nZeff compared with the ER-positive group (individually, p = 0.003, 0.011; area under the curve [AUC] of 0.65, 0.60). The PR-negative group demonstrated higher arterial and venous phase NIC compared with the PR-positive group (individually, p = 0.022, 0.005; AUC of 0.63, 0.65). NIC was correlated negatively with the value of ER and PR expression (r = − 0.175 ~ − 0.265, p = 0.002 ~ 0.042). The HER2-positive group tended to display higher venous phase nZeff than the HER2-negative group (p = 0.022; AUC of 0.59). The Ki67 high-proliferation group demonstrated higher arterial phase, venous phase NIC and nZeff than the Ki67 low-proliferation group (p < 0.001 ~ 0.005; AUC of 0.67 ~ 0.75). Both the NIC and nZeff were correlated positively with the value of Ki67 (r = 0.240 ~ 0.490, p < 0.001 ~ 0.014).

Conclusions
NIC and nZeff derived from DECT could be used to discriminate expression status and may associate with the value of immunohistochemical biomarkers of invasive breast cancer.
Relationship between clinicopathologic factors and FDG avidity in radioiodine-negative recurrent or metastatic differentiated thyroid carcinoma
Authors: Ha Le Ngoc , Iravani Amir , Nhung Nguyen Thi , Hanh Ngo Thi Minh , Hutomo Febby , Son Mai Hong 
Published: January 2021

Abstract
Background
In this study, we investigated the relationship between clinicopathologic factors, BRAFV600E mutation status and [18F] F-fluoro-2-deoxyglucose (FDG) avidity in patients with radioiodine (RAI)-negative recurrent or metastatic differentiated thyroid cancer (DTC).

Methods
From 2015 to 2018 all patients with suspected recurrent or metastatic radioiodine-negative DTC patients who underwent FDG positron emission tomography/computed tomography (PET/CT) were retrospectively reviewed. Suspected lesions on FDG PET/CT were biopsied and underwent BRAFV600E mutation testing by immunohistochemistry and real-time PCR. Tumor size, recurrent versus metastatic disease, histopathologic features including classical type versus aggressive subtypes (poorly differentiated, tall cell, columnar cell, hobnail variants) and BRAFV600E mutation status were correlated with the SUVmax of highest hypermetabolic lesions on FDG PET/CT by the univariate analysis using logistic regression.

Results
Sixty-three consecutive patients, 55 (87.3%) female, with median age of 48 (range 17–81) were included. The majority of patients had BRAFV600E mutation and classical subtype, 55/63 (87.3%) and 45/63(71.4%), respectively. Thyroglobulin at the time of suspected recurrence was 262.7 ng/ml (range 16.3–1000) and patients received a median 3 prior RAI treatments. Fifty-four patients (85.7%) had local recurrence. The majority of patients 58/63 (92.1%) had FDG-avid disease on PET/CT. On univariate analysis, tumor size aggressive histopathologic types and distant metastasis are the significant factors for predicting FDG uptake, p = 0.04, p = 0.001 and p = 0.004 respectively. Although FDG uptake of BRAFV600E bearing recurrent/metastatic RAIR DTC lesions was higher than those without the mutation, the difference did not reach statistical significance, SUVmax of 7.11 versus 4.91, respectively, p = 0.2.

Conclusion
The majority of recurrent or metastatic RAI-negative DTC have BRAFV600E mutation and detectable disease on FDG PET/CT. FDG avidity of the recurrent or metastatic RAI-negative DTC is independently associated with the aggressive histopathologic features.
Promoting traditional foods for human and environmental health: lessons from agroecology and Indigenous communities in Ecuador
Authors:   Ekomer, Deaconu Ana , Mercille Geneviève , Batal Malek 
Published: January 2021

AbstractBackgroundThe displacement of traditional dietary practices is associated with negative nutritional consequences for rural Indigenous people, who already face the brunt of both nutritional inadequacies and excesses. Traditional food (TF) consumption and production practices can improve nutritional security by mitigating disruptive dietary transitions, providing nutrients and improving agricultural resilience. Meanwhile, traditional agricultural practices regenerate biodiversity to support healthy ecosystems. In Ecuador, Indigenous people have inserted TF agricultural and dietary practices as central elements of the country’s agroecological farming movement. This study assesses factors that may promote TF practices in rural populations and explores the role of agroecology in strengthening such factors.MethodsMixed methods include a cross-sectional comparative survey of dietary, food acquisition, production and socioeconomic characteristics of agroecological farmers (n = 61) and neighboring reference farmers (n = 30) in Ecuador’s Imbabura province. Instruments include 24-h dietary recall and a food frequency questionnaire of indicator traditional foods. We triangulate results using eight focus group discussions with farmers’ associations.ResultsCompared to their neighbors, agroecological farmers produce and consume more TFs, and particularly underutilized TFs. Farm production diversity, reliance on non-market foods and agroecology participation act on a pathway in which TF production diversity predicts higher TF consumption diversity and ultimately TF consumption frequency. Age, income, market distance and education are not consistently associated with TF practices. Focus group discussions corroborate survey results and also identify affective (e.g. emotional) and commercial relationships in agroecological spaces as likely drivers of stronger TF practices.ConclusionsTraditional food practices in the Ecuadorian highlands are not relics of old, poor and isolated populations but rather an established part of life for diverse rural people. However, many TFs are underutilized. Sustainable agriculture initiatives may improve TF practices by integrating TFs into production diversity increases and into consumption of own production. Agroecology may be particularly effective because it is a self-expanding global movement that not only promotes the agricultural practices that are associated with TF production, but also appears to intensify affective sentiments toward TFs and inserts TFs in commercial spaces. Understanding how to promote TFs is necessary in order to scale up their potential to strengthen nutritional health.
CardiO Cycle: a pilot feasibility study of in-bed cycling in critically ill patients post cardiac surgery
Authors:   for the Canadian Critical Care Trials Group, Newman Anastasia N. L. , Kho Michelle E. , Harris Jocelyn E. , Zamir Nasim , McDonald Ellen , Fox-Robichaud Alison , Solomon Patricia 
Published: January 2021

Abstract
Background
In-bed cycling is a novel modality for the initiation of early mobilization in the intensive care unit. No study has investigated its use in the critically ill, off-track post cardiac surgery population. Before conducting an effectiveness trial, feasibility data are needed. The aim of this study was to determine the feasibility of in-bed cycling in a population of off-track cardiac surgery patients.

Methods
We conducted a prospective feasibility study in a 16-bed adult cardiac surgery intensive care unit in Ontario, Canada. Previously ambulatory adults (≥ 18 years) who were mechanically ventilated for ≥ 72 h were enrolled within 3 to 7 days post cardiac surgery. Twenty minutes of in-bed cycling was delivered by ICU physiotherapists 5 days/week. The primary outcome, feasibility, was the percent of patient-cycling sessions that occurred when cycling was appropriate. The secondary outcome was cycling safety, measured as cycling discontinuation due to predetermined adverse events.

Results
We screened 2074 patients, 29 met eligibility criteria, and 23 (92%) consented. Patients were male (78.26%) with a median [IQR] age of 76 [11] years, underwent isolated coronary bypass (39.1%), and had a median EuroScore II of 5.4 [7.8]. The mean (SD) time post-surgery to start of cycling was 5.9 (1.4) days. Patients were cycled on 80.5% (136/169) of eligible days, with limited physiotherapy staffing accounting for 48.5% of the missed patient-cycling sessions. During 136 sessions of cycling, 3 adverse events occurred in 3 individual patients. The incidence of an adverse event was 2.2 per 100 patient-cycling sessions (95% CI 0.50, 6.4).

Conclusions
In-bed cycling with critically ill cardiac surgery patients is feasible with adequate physiotherapy staffing and appears to be safe. Future studies are needed to determine the effectiveness of this intervention in a larger sample.

Trial registration
This trial was registered with Clinicaltrials.gov (NCT02976415). Registered November 29, 2016.
Choriocapillaris Island: an optical coherence tomography angiography finding observed in central serous chorioretinopathy
Authors: Estawro Rania G. , Fayed Alaa E. , Gerges Teresa K. , Baddar Dina N. 
Published: January 2021

Abstract
Purpose
To report the observation of the choriocapillaris island (CCI) on optical coherence tomography angiography (OCTA) in eyes with active central serous chorioretinopathy (CSCR), and to investigate its associated clinical features.

Design
Retrospective observational study.

Methods
Patients diagnosed with active CSCR underwent OCTA imaging (Optovue Inc, Fremont, California, USA), and the software built-in en face choriocapillaris slab was examined to demonstrate CCI, defined as an area of detectable choriocapillaris flow surrounded by an area of undetectable or diminished flow. Electronic medical records (EMR) were reviewed for demographics, clinical data, other imaging modalities and any intervention, and these parameters were correlated with CCI findings.

Results
25 eyes of 25 patients were recruited. CCI was detected in all examined eyes and was best elucidated on the en face choriocapillaris density maps. 24 eyes had focal retinal pigment epithelium (RPE) alterations overlying CCI. All 14 eyes with simultaneous fundus fluorescein angiography (FA) showed actively leaking point(s) well corresponding to the CCI location. Resolution of sub-retinal fluid in 4 eyes was associated with disappearance of CCI on follow-up OCTA scans. 1 eye showed complicating neovascularization 5 months after the initial presentation at the same location of the CCI.

Conclusion
We demonstrate the observation of the “choriocapillaris island” an OCTA finding in eyes with active CSCR underneath the area of neurosensory detachment. CCI may constitute an angiographic representation of the focal area of choriocapillaris structural and functional affection, with secondary RPE alteration jeopardizing its barrier function. Larger longitudinal studies are needed to further elucidate this finding.
First records of Cuvier’s beaked whale (Ziphius cavirostris, G. Cuvier 1823) strandings along the Tunisian coast
Authors: Karaa Sami , Jerbi Hassen , Marouani Sondes , Bradai Mohamed Nejmeddine , Rosso Massimiliano 
Published: January 2021

AbstractThe Cuvier’s beaked whale (Ziphius cavirostris) is the only member of the Ziphiidae family with a regular occurrence in the Mediterranean Sea. Much of the knowledge of this species in the Mediterranean has come from stranding data. This note reports the first records of strandings of Cuvier’s beaked whales along the Tunisian coast. The two strandings described are about two specimens, likely adult animals. The first specimens was 530 cm long and beached at El Hicha (Gulf of Gabès, south Tunisia) on March 5th, 2019. The second specimens was 630 cm long and it was reported in Ras Angla (Bizerte, north Tunisia) on June 6th, 2019. Since this species faces multiple threats in the Mediterranean basin, this contribution is intended to extend previous knowledge of this species in the region and to push towards major efforts to be undertaken to fill the knowledge gaps regarding occurrence of Cuvier’s beaked whale along northern Tunisia.
Short-term outcome in ischemic stroke patients after thrombolytic therapy
Authors: Mohamed Wafaa S. , Abdel Ghaffar Adel S. , Abdel Gawad Ahmed E. , Agban Emad L. 
Published: January 2021

Abstract
Background
Stroke represents the second leading cause of death in the world after myocardial infarction. Intravenous (IV) thrombolysis with recombinant tissue plasminogen activator (alteplase, rt-PA) is the only pharmacological therapy that was approved for treatment within 4.5 h of acute ischemic stroke (AIS) onset. We aimed to predict the 3-month outcome of AIS patients who received alteplase regarding mortality, spontaneous intra-cerebral hemorrhage (sICH), and functional outcome in comparison with non-thrombolyzed patients and to evaluate the predictors of the outcome after 3 months.

Methods
All the clinical, National Institute of Health Stroke Scale (NIHSS) scores, radiological, and laboratory data of 40 AIS patients and received rt-PA during the period from 2016 to 2018 were collected and analyzed retrospectively. For comparison, 40 patients, as a control group, were selected to match the alteplase group as regards the baseline data and received regular treatment, rather than rt-PA within the first 24 h, that were obtained. The outcome of the thrombolyzed patients after 3 months was evaluated in comparison with controls by using a modified ranking scale.

Results
After a 90-day follow-up period, the death rate was slightly higher among the rt-PA group (7.5%) in comparison with the control group (5%). sICH occurred in 7.5% of the patients in the alteplase group and in 5% of the non-thrombolyzed patients; however, this difference was not significant. More patients had a favorable outcome (mRS = 0–2) in the rt-PA group than in the control group (65% vs 60%, OR 1.38, 95% CI 0.50–3.6, P = 0.51). NIHSS score on admission, body mass index (BMI) (≥ 30), and previous transient ischemic attacks (TIA)/previous ischemic stroke were significant predictors of outcome after IV thrombolysis. Age, sex, hypertension (HTN), diabetes mellitus (DM), dyslipidemia, smoking, atrial fibrillation (AF), stroke subtype, size of infarction, and hyperdense middle cerebral artery had a non-significant effect.

Conclusion
After 3 months of follow-up, rt-PA had a non-significant more increase of favorable outcome with increased risk of sICH and death than controls. Baseline NIHSS, BMI, and history of TIA or previous ischemic stroke were significant predictors of outcome after thrombolysis.
An unusual presentation of posterior reversible encephalopathy syndrome—a case report
Authors: Rajeshwari K. Soundarya , Agarwal Vishaka , Satish S. , Jayakumar K. T. 
Published: January 2021

Abstract
Background
Acute neurological emergencies in pregnant and postpartum women presenting as headache, visual disturbances, seizures, and elevated blood pressure are usually attributed to preeclampsia and eclampsia. However cerebral venous sinus thrombosis (CVST) and posterior reversible encephalopathy syndrome (PRES) are two important, rare conditions which should be considered. PRES is a rare neuroradiological syndrome characterised by vasogenic oedema of subcortical white matter, commonly involving posterior cerebral hemispheres. Preeclampsia and eclampsia are the common causes of PRES. However, late postpartum eclampsia concurrent to PRES is rare. Here, we report a rare case of PRES secondary to late postpartum eclampsia with atypical radiological findings.

Case presentation
A 25-year-old married woman with prior history of two spontaneous abortions presented to us on day 5 postpartum, post lower segment caesarean section (LSCS) with complaints of headache followed by one episode of new onset generalised tonic-clonic seizures. There was no history of seizures prior to the pregnancy and no history of hypertension or diabetes during any of her pregnancies. On examination, BP was 140/90 mm Hg and PR 98 bpm. Systemic examination revealed GCS 15/15, no focal neurological deficits, and bilateral flexor plantar response. Fundus examination was normal with no evidence of hypertensive retinopathy. Preliminary haematological and biochemical tests including antiphospholipid antibody (APLA) profile were done in view of prior abortions and were within normal limits. Lumbar puncture was done—normal study. EEG was normal. MRI with MRV was suggestive of atypical posterior encephalopathy. In view of late onset postpartum seizure, the patient was started on injection of magnesium sulphate, anti-hypertensives, and antiepileptics; following which, she improved and was discharged.

Conclusion
Though preeclampsia and eclampsia are usually screened entities, we should also follow women in puerperium for late postpartum eclampsia which is defined as seizures beyond 48 h of delivery up to 4 weeks postpartum. So it is important to follow-up postpartum women for complications like PRES because early detection and treatment can lessen the morbidity and mortality as they are completely reversible. Thus, health care professionals should be educated about the same. Apart from antenatal and intrapartum care, postpartum care should also be given equal importance.
Corrected QT interval and QT dispersion in temporal lobe epilepsy
Authors: Nasef Maram Samy , Gaber Ahmed Abdelmonem , Abdelhamid Yousry Aboelnaga , Bastawy Islam , Abdelhady Salem Taha , Wahid el din Mona Mokhtar 
Published: January 2021

Abstract
Background
Cardiac arrhythmias are expected among patients with epilepsy due to the effect of anti-epileptic drugs. Temporal lobe epilepsy also causes autonomic seizures that may affect heart rhythm. Prolongation of the corrected QT interval and QT dispersion is a risk factor for cardiac arrhythmia.

Objectives
We aimed to assess corrected QT interval and QT dispersion in patients with epilepsy and if there is a difference between patients with temporal epilepsy versus non-temporal epilepsy.

Methods
This study was conducted on 100 patients (50 patients with temporal epilepsy and 50 patients with non-temporal epilepsy) and 50 age- and sex-matched healthy controls. They underwent a prolonged (6 to 24 h) 22 channel computerized electroencephalogram monitor with a 10–20 system. QT dispersion, QT interval, and corrected QT interval (using Bazett’s formula) were calculated.

Results
This study showed significantly higher QT dispersion and corrected QT interval in patients with epilepsy when compared to the age- and sex-matched control group (P < 0.001, P < 0.001). Also, the corrected QT interval and QT dispersion were significantly higher in temporal epilepsy patients when compared to the non-temporal group (P < 0.001, P < 0.001).

Conclusion
Corrected QT interval and QT dispersion are higher in epileptic patients and more among temporal epilepsy patients in comparison to non-temporal epilepsy patients.
Anosmia and COVID-19: perspectives on its association and the pathophysiological mechanisms involved
Authors: da Silva Júnior Paulo Roberto , Gomes André Luis Oliveira Ramos , Coelho Lucas Eugênio Araújo , Morais Mariana Almeida , de Almeida Pedro Vinícius Furtado Carneiro , Neri Wagner José Raia , Mascena Guilherme Veras , de Farias Leal Adriana Amorim 
Published: January 2021

AbstractWith the spread of SARS-CoV-2, contingency measures and plans to facilitate the screening of infected patients are needed. Changes in olfaction have been cited as symptoms of the disease, and it is important to prove or exclude its association with this condition to refine the symptomatic criteria for early isolation. This article aims to analyze the association between olfactory disorders and SARS-CoV-2 infection as well as investigate the possible underlying pathophysiological mechanisms. The research was carried out using the PubMed, Science Direct, and LILACS databases on May 9, 2020, and updated on May 21. Combinations of MeSH descriptors and the Boolean operator, “AND,” were used: coronavirus infections AND olfactory disorders, coronavirus infections, and neurological manifestations. A total of 1187 articles were found in the databases, of which 17 were included in the study. The data suggest that changes in smell are strongly associated with Covid-19, especially in women and patients with fever; these changes increase the degree of suspicion of Covid-19, and they warrant early implementation of isolation and surveillance measures. There are still gaps in the elucidation of the pathways involved in the loss of smell caused by SARS-CoV-2; however, the great affinity of the virus for ACE-2 receptors, which are present in large quantities in the nasal cavity and olfactory bulb, has been considered.
Life cycle analysis of potential municipal solid wastes management scenarios in Tanzania: the case of Arusha City
Authors: Richard Edwin N. , Hilonga Askwar , Machunda Revocatus L. , Njau Karoli N. 
Published: January 2021

AbstractThe municipal solid wastes (MSW) management technologies in most cities of developing countries pose a continuous risk of contaminating the environment and affecting human health adversely; often because MSW technologies are not comprehensively analyzed before their implementation. For this purpose, the life cycle assessment methodology was applied to access the different MSW management scenarios in Arusha City, Tanzania. Three different scenarios of recycling and sanitary landfilling (RSL) were developed as the business as usual scenario (RSL) (SN-1), RSL combined with composting (SN-2), and RSL combined with anaerobic digestion (SN-3). Results obtained showed that no scenario performed better in all impact categories, however with the current focus on climate change and limited funds in developing countries, the best option would be SN-2. The SN-2 which is the combination of recycling, composting and the landfill had the least economic cost and environmental burdens in most categories when compared to the other scenarios. The sensitivity analysis results indicated that improving diesel consumptions, reducing methane emissions to air and increasing the recycling rate of papers and plastics would reduce the total environmental impacts on all scenarios.