bluuebunny/crossref_metadata_2025_split huggingface dataset:
Circulating tumor DNA as a prognostic marker in high-risk endometrial cancer
Authors: Feng Weiwei , Jia Nan , Jiao Haining , Chen Jun , Chen Yan , Zhang Yueru , Zhu Menghan , Zhu Chongying , Shen Lifei , Long Wenqing 
Published: February 2021

Abstract
Background
Currently, there is no reliable blood-based marker to track tumor recurrence in endometrial cancer (EC) patients. Liquid biopsies, specifically, circulating tumor DNA (ctDNA) analysis emerged as a way to monitor tumor metastasis. The objective of this study was to examine the feasibility of ctDNA in recurrence surveillance and prognostic evaluation of high-risk EC.

Methods
Tumor tissues from nine high-risk EC patients were collected during primary surgery and tumor DNA was subjected to next generation sequencing to obtain the initial mutation spectrum using a 78 cancer-associated gene panel. Baseline and serial post-operative plasma samples were collected and droplet digital PCR (ddPCR) assays for patient-specific mutations were developed to track the mutations in the ctDNA in serial plasma samples. Log-rank test was used to assess the association between detection of ctDNA before or after surgery and disease-free survival.

Results
Somatic mutations were identified in all of the cases. The most frequent mutated genes were PTEN, FAT4, ARID1A, TP53, ZFHX3, ATM, and FBXW7. For each patient, personalized ddPCR assays were designed for one-to-three high-frequent mutations. DdPCR analysis and tumor panel sequencing had a high level of agreement in the assessment of the mutant allele fractions in baseline tumor tissue DNA. CtDNA was detected in 67% (6 of 9) of baseline plasma samples, which was not predictive of disease-free survival (DFS). CtDNA was detected in serial post-operative plasma samples (ctDNA tracking) of 44% (4 of 9) of the patients, which predicted tumor relapse. The DFS was a median of 9 months (ctDNA detected) versus median DFS undefined (ctDNA not detected), with a hazard ratio of 17.43 (95% CI, 1.616–188.3). The sensitivity of post-operative ctDNA detection in estimating tumor relapse was 100% and specificity was 83.3%, which was superior to CA125 or HE4.

Conclusions
Personalized ctDNA detection was effective and stable for high-risk EC. CtDNA tracking in post-operative plasma is valuable for predicting tumor recurrence.
Effectiveness of companion-intensive multi-aspect weight management in Chinese adults with obesity: a 6-month multicenter randomized clinical trial
Authors: Jiang Wanzi , Huang Shushu , Ma Shuai , Gong Yingyun , Fu Zhenzhen , Zhou Li , Hu Wen , Mao Guofang , Ma Zhimin , Yang Ling , Tang Guangfeng , Sun Xiaofang , Zhang Ping , Bai Jianling , Chen Lei , Shi Bimin , Ye Xinhua , Zhou Hongwen 
Published: February 2021

Abstract
Background
Obesity is a globally increasing health epidemic requiring early lifestyle intervention. Our main objective was to examine the effectiveness of companion-intensive multi-aspect weight management (CIMWM) in Chinese adults with obesity.

Methods
In this 6-month, prospective, open-label, multicenter, randomized controlled clinical trial, we recruited 272 obese adults aged 18–50 years with a body mass index (BMI) ≥ 28.0 kg/m2 and capable of using smartphones. CIMWM (n = 136) offered both daily online instructions and monthly face-to-face guidance by physicians, dietitians, and health managers along with the provision of meal replacements in the first 3 months. Traditional multi-aspect weight management (TMWM, n = 136) provided monthly face-to-face guidance by the same panel of professionals and the same meal replacements as CIMWM group, but required subjects to complete daily self-monitoring instead of offering daily online instructions. Body composition and metabolic parameters were assessed at baseline, 1, 2, 3, and 6 months by physicians. The primary outcomes were clinically-significant weight loss and changes in BMI and body composition.

Results
Participants in both groups showed significantly reduced BMI, body fat mass (BFM), visceral fat area (VFA), and HOMA-IR (p < 0.05). CIMWM was shown to be superior to TMWM in the improvement of clinically-significant weight loss, BMI, total cholesterol (TC), the body composition parameters BFM and the skeletal muscle mass-to-visceral fat area ratio (S/V) (p < 0.05). The non-alcoholic fatty liver disease score (NFS) was negatively related to S/V at baseline. After weight management, NFS was lowered among individuals with levels in the highest tertile (p < 0.05). Metabolic memory in terms of the continuous reduction of BMI, BFM, and TC was retained up to 6 months in spite of participants transferring to self-monitoring assessment in the final 3 months.

Conclusions
The CIMWM strategy in obese Chinese adults is proved to be more effective than TMWM in weight loss, and motivates greater adherence to intervention and lifestyle reprogramming.
Trial registration Chinese Clinical Trial Registry, ChiCTR1800017463, Registered July 31, 2018. http://www.chictr.org.cn/showproj.aspx?proj=29649.
Early intravenous tranexamic acid intervention reduces post-traumatic hidden blood loss in elderly patients with intertrochanteric fracture: a randomized controlled trial
Authors: Ma Huixu , Wang Hairuo , Long Xiaotao , Xu Zexiang , Chen Xiaohua , Li Mingjin , He Tao , Wang Wei , Liu Lei , Liu Xi 
Published: February 2021

Abstract
Purpose
Elderly patients with intertrochanteric fractures exhibit post-traumatic hidden blood loss (HBL). This study aimed to evaluate the efficacy and safety of reducing post-traumatic HBL via early intravenous (IV) tranexamic acid (TXA) intervention in elderly patients with intertrochanteric fracture.

Methods
A prospective randomized controlled study was conducted with 125 patients (age ≥ 65 years, injury time ≤ 6 h) who presented with intertrochanteric fracture from September 2018 and September 2019. Patients in the TXA group (n = 63) received 1 g of IV TXA at admission, whereas those in the normal saline (NS) group (n = 62) received an equal volume of saline. Hemoglobin (Hgb) and hematocrit (Hct) were recorded at post-traumatic admission (PTA) and on post-traumatic days (PTDs) 1–3. HBL was calculated using the Gross formula. Lower extremity venous ultrasound was performed to detect venous thrombosis.

Results
Hgb on PTDs 2 and 3 was statistically higher in the TXA group than in the NS group. Hct and HBL on PTDs 1–3 were significantly less in the TXA group compared to the NS group. Preoperative transfusion rate was significantly lower in the TXA group compared with the NS group. There was no difference between the two groups with regard to the rates of complications.

Conclusion
Early IV TXA intervention could reduce post-traumatic HBL and pre-operative transfusion rate in elderly patients with intertrochanteric fractures without increasing the risk of venous thrombosis.
A randomized, double-blind, placebo-controlled study to assess efficacy of mirtazapine for the treatment of diarrhea predominant irritable bowel syndrome
Authors: Khalilian Alireza , Ahmadimoghaddam Davoud , Saki Shiva , Mohammadi Younes , Mehrpooya Maryam 
Published: February 2021

Abstract
Background
Ample evidence indicates the efficacy of serotonin type 3 (5-HT3) receptor antagonists in the treatment of patients with diarrhea-predominant irritable bowel syndrome (IBS-D). Mirtazapine is an atypical antidepressant with a well-known 5-HT3 receptor antagonist property. This study, therefore, was undertaken to investigate whether compared to placebo, mirtazapine would be efficacious and safe in the treatment of patients with IBS-D.

Methods
From November 2019 until July 2020, 67 patients meeting Rome IV criteria for IBS-D were randomized in a double-blind fashion into either the mirtazapine treatment group (n = 34) or the placebo treatment group (n = 33). Patients started with mirtazapine 15 mg/day at bedtime for one-week; after which the dose was increased to 30 mg/day for an additional 7-week. Outcomes included changes in the total IBS symptom severity score (IBS-SSS), Hospital anxiety and depression scale score (HADS), and IBS Quality of Life. Additionally, changes in the diary-based symptoms scores including pain, urgency of defecation, bloating, stool frequency, and stool consistency based on the 7-point Bristol Stool Form Scale (BSFS), and a number of days per week with pain, urgency, diarrhea, or bloating, once during the 1-week run-in period, and once during the last week of treatment were recorded.

Results
All analyses were performed on an Intention-to-Treat (ITT) analysis data set. The results showed compared to placebo, mirtazapine is more efficacious in decreasing the severity of IBS symptoms (P-value = 0.002). Further, at the end of the treatment period, all diary-derived symptoms except bloating showed significantly more improvement in the mirtazapine-treated subjects compared to the placebo-treated subjects. While was well-tolerated, mirtazapine also significantly improved the patients’ quality of life (P-value = 0.04) and anxiety symptoms (P-value = 0.005).

Conclusions
Overall, mirtazapine seems to have a potential benefit in the treatment of patients with IBS-D, particularly those with concomitant psychological symptoms. However, further studies are warranted to determine whether these findings are replicated.

Trial registration
Trial registration: Registration number at Iranian Registry of Clinical Trials: IRCT20120215009014N311. Registration date: 2019-10-21.
Signature mRNA markers in extracellular vesicles for the accurate diagnosis of colorectal cancer
Authors: Cha Byung Seok , Park Ki Soo , Park Jun Seok 
Published: February 2021

AbstractBackgroundWith the increasing incidence of colorectal cancer (CRC), its accurate diagnosis is critical and in high demand. However, conventional methods are not ideal due to invasiveness and low accuracy. Herein, we aimed to identify efficient CRC mRNA markers in a non-invasive manner using CRC-derived extracellular vesicles (EVs). The expression levels of EV mRNAs from cancer cell lines were compared with those of a normal cell line using quantitative polymerase chain reaction. Eight markers were evaluated in plasma EVs from CRC patients and healthy controls. The diagnostic value of each marker, individually or in combination, was then determined using recessive operating characteristics analyses and the Mann-Whitney U test.ResultsEight mRNA markers (MYC, VEGF, CDX2, CD133, CEA, CK19, EpCAM, and CD24) were found to be more abundant in EVs derived from cancer cell lines compared to control cell lines. A combination of VEGF and CD133 showed the highest sensitivity (100%), specificity (80%), and accuracy (93%) and an area under the curve of 0.96; hence, these markers were deemed to be the CRC signature. Moreover, this signature was found to be highly expressed in CRC-derived EVs compared to healthy controls.ConclusionsVEGF and CD133 mRNAs comprise a unique CRC signature in EVs that has the potential to act as a novel, non-invasive, and accurate biomarker that would improve the current diagnostic platform for CRC, while also serving to strengthen the value of EV mRNA as diagnostic markers for myriad of diseases.
Superoxide dismutase reduces monosodium glutamate-induced injury in an organotypic whole hemisphere brain slice model of excitotoxicity
Authors: Liao Rick , Wood Thomas R. , Nance Elizabeth 
Published: February 2021

Abstract
Background
Knowledge of glutamate excitotoxicity has increased substantially over the past few decades, with multiple proposed pathways involved in inflicting damage. We sought to develop a monosodium glutamate (MSG) exposed ex vivo organotypic whole hemisphere (OWH) brain slice model of excitotoxicity to study excitotoxic processes and screen the efficacy of superoxide dismutase (SOD).

Results
The OWH model is a reproducible platform with high cell viability and retained cellular morphology. OWH slices exposed to MSG induced significant cytotoxicity and downregulation of neuronal excitation-related gene expression. The OWH brain slice model has enabled us to isolate and study components of excitotoxicity, distinguishing the effects of glutamate excitation, hyperosmolar stress, and inflammation. We find that extracellularly administered SOD is significantly protective in inhibiting cell death and restoring healthy mitochondrial morphology. SOD efficacy suggests that superoxide scavenging is a promising therapeutic strategy in excitotoxic injury.

Conclusions
Using OWH brain slice models, we can obtain a better understanding of the pathological mechanisms of excitotoxic injury, and more rapidly screen potential therapeutics.
Mechanical colon obstruction due to the alimentary limb after Roux-en-Y gastric bypass: a case report
Authors: Peterson Caspar Joyce , Klasen Jennifer , Delko Tarik , Schneider Romano 
Published: February 2021

Abstract
Background
Small bowel obstruction is a known and potentially lethal complication after gastric bypass surgery, in both the early and the late postoperative course. Colon or large bowel obstruction, on the other hand, seems to be rare after gastric bypass surgery and thus is not routinely considered.

Case presentation
We present the case of a 21-year old morbidly obese caucasian patient who underwent laparoscopic Roux-en-Y gastric bypass surgery and developed an early severe transverse colon obstruction due to compression of the transverse colon by the antecolic alimentary limb. Emergency revisional surgery showed a short and tense alimentary limb mesentery and possibly tight closure of Petersen’s space contributing to the compression. Through opening of Petersen’s space and mobilization of alimentary limb mesentery, decompression was achieved, and the patient fully recovered.

Conclusions
This is a rare case of colon obstruction caused by direct compression of the transverse colon by the antecolic alimentary limb. We propose that a combination of short tense alimentary limb mesentery and perhaps tight closure of Petersen’s space was responsible for the obstruction in this case. Surgeons and treating physicians need to be aware of such rare causes of early postoperative bowel obstruction and take these into consideration when evaluating patients.
Deep multiple instance learning for foreground speech localization in ambient audio from wearable devices
Authors: Hebbar Rajat , Papadopoulos Pavlos , Reyes Ramon , Danvers Alexander F. , Polsinelli Angelina J. , Moseley Suzanne A. , Sbarra David A. , Mehl Matthias R. , Narayanan Shrikanth 
Published: February 2021

AbstractOver the recent years, machine learning techniques have been employed to produce state-of-the-art results in several audio related tasks. The success of these approaches has been largely due to access to large amounts of open-source datasets and enhancement of computational resources. However, a shortcoming of these methods is that they often fail to generalize well to tasks from real life scenarios, due to domain mismatch. One such task is foreground speech detection from wearable audio devices. Several interfering factors such as dynamically varying environmental conditions, including background speakers, TV, or radio audio, render foreground speech detection to be a challenging task. Moreover, obtaining precise moment-to-moment annotations of audio streams for analysis and model training is also time-consuming and costly. In this work, we use multiple instance learning (MIL) to facilitate development of such models using annotations available at a lower time-resolution (coarsely labeled). We show how MIL can be applied to localize foreground speech in coarsely labeled audio and show both bag-level and instance-level results. We also study different pooling methods and how they can be adapted to densely distributed events as observed in our application. Finally, we show improvements using speech activity detection embeddings as features for foreground detection.
Ciphertext-policy attribute-based encryption with hidden sensitive policy from keyword search techniques in smart city
Authors: Meng Fei , Cheng Leixiao , Wang Mingqiang 
Published: February 2021

AbstractCountless data generated in Smart city may contain private and sensitive information and should be protected from unauthorized users. The data can be encrypted by Attribute-based encryption (CP-ABE), which allows encrypter to specify access policies in the ciphertext. But, traditional CP-ABE schemes are limited because of two shortages: the access policy is public i.e., privacy exposed; the decryption time is linear with the complexity of policy, i.e., huge computational overheads. In this work, we introduce a novel method to protect the privacy of CP-ABE scheme by keyword search (KS) techniques. In detail, we define a new security model calledchosen sensitive policy security: two access policies embedded in the ciphertext, one is public and the other is sensitive and hidden. If user's attributes don't satisfy the public policy, he/she cannot get any information (attribute name and its values) of the hidden one. Previous CP-ABE schemes with hidden policy only work on the “AND-gate” access structure or their ciphertext size or decryption time maybe super-polynomial. Our scheme is more expressive and compact. Since, IoT devices spread all over the smart city, so the computational overhead of encryption and decryption can be shifted to third parties. Therefore, our scheme is more applicable to resource-constrained users. We prove our scheme to be selective secure under the decisional bilinear Diffie-Hellman (DBDH) assumption.
Body cooling effects of immersion of the forearms in high-concentration artificial carbonic acid water at 25°C
Authors: Tanaka Yuuki , Nagano Hisaho , Taimura Akihiro 
Published: February 2021

Abstract
Background
This study examined the effects of immersion in stirred, high-concentration, artificial carbonic acid water on body cooling.

Methods
Seven healthy male students (23 ± 2 years old) participated in the experiment. Signed informed consent was obtained from all subjects before the experiment. The subjects changed into shorts and T-shirts and entered an experimental room (with room temperature controlled at 30 °C and relative humidity maintained at 70%) at least 30 min before starting the experiment. After starting the experiment, the subjects were asked to rest on an exercise bike for 5 min and then pedal for 20 min. The exercise load was set to reach 50% of each subject’s presumed maximum oxygen intake at 5 min after starting exercise. Subjects then continued pedaling for 1 min to cool down. After this exercise, subjects sat on a chair and immersed forearms in tap water or artificial carbonic acid water (CO2 water) at 25 °C for 20 min. During immersion, tap water or CO2 water was stirred slowly with a pump. After immersion, subjects rested for 10 min. Skin temperature and skin blood flow (left forearm), as well as heart rate and ear canal temperature, were measured continuously. Thermal sensation and thermal comfort were measured intermittently.

Results
Skin blood flow of the immersed forearms was higher in CO2 water than in tap water during immersion. The blood flow in the last 5 min (average at rest was 100%) was significantly higher in CO2 water (290.85 ± 84.81%) than in tap water (104.80 ± 21.99%). Thermal sensation and thermal comfort were not different between conditions. Ear canal temperature significantly declined more in CO2 water (− 0.56 ± 0.31 °C) than in tap water (− 0.48 ± 0.30 °C) during immersion.

Conclusions
Our study suggests that immersion of the forearms in slowly stirred CO2 water at 25 °C reduces core temperature elevated by heat stress or exercise more effectively than does tap water at the same temperature. Immersion of the forearms in stirred CO2 water at 25 °C could be useful as a preventive measure against heat stroke from summer work or exercise.
Civilian gunshot wounds to the head: a case report, clinical management, and literature review
Authors: Qi Haoyi , Li Kunzheng 
Published: February 2021

Abstract
Background
Civilian gunshot wounds to the head refer to brain injury caused by projectiles such as gun projectiles and various fragments generated by explosives in a power launch or explosion. Gunshot wounds to the head are the deadliest of all gun injuries. According to literature statistics, the survival rate of patients with gunshot wounds to the head is only 9%. Due to the strict management of various types of firearms, they rarely occur, so the injury mechanism, injury and trauma analysis, clinical management, and surgical standards are almost entirely based on military experience, and there are few related reports, especially of the head, in which an individual suffered a fatal blow more than once in a short time. We report a case with a return to almost complete recovery despite the patient suffering two gunshot injuries to the head in a short period of time.

Case presentations
We present a case of a 53-year-old man who suffered two gunshot injuries to the head under unknown circumstances. On initial presentation, the patient had a Glasgow Coma Scale score of 6, was unable to communicate, and had loss of consciousness. The first bullet penetrated the right frontal area and finally reached the right occipital lobe. When the patient reflexively shielded his head with his hand, the second bullet passed through the patient’s right palm bone, entered the right frontotemporal area, and came to rest deep in the lateral sulcus. The patient had a cerebral hernia when he was admitted to the hospital and immediately entered the operating room for rescue after a computed tomography scan. After two foreign body removals and skull repair, the patient recovered completely.

Conclusions
Gunshot wounds to the head have a high mortality rate and usually require aggressive management. Evaluation of most gunshot injuries requires extremely fast imaging examination upon arrival at the hospital, followed by proactive treatment against infection, seizure, and increased intracranial pressure. Surgical intervention is usually necessary, and its key points include the timing, method, and scope of the operation.
Genome-wide identification and expression analysis of the GhIQD gene family in upland cotton (Gossypium hirsutum L.)
Authors: DOU Lingling , LV Limin , KANG Yangyang , TIAN Ruijie , HUANG Deqing , LI Jiayin , LI Siyi , LIU Fengping , CAO Lingyan , JIN Yuhua , LIU Yang , LI Huaizhu , WANG Wenbo , PANG Chaoyou , SHANG Haihong , ZOU Changsong , SONG Guoli , XIAO Guanghui 
Published: February 2021

Abstract
Background
Calmodulin (CaM) is one of the most important Ca2+ signaling receptors because it regulates diverse physiological and biochemical reactions in plants. CaM functions by interacting with CaM-binding proteins (CaMBPs) to modulate Ca2+ signaling. IQ domain (IQD) proteins are plant-specific CaMBPs that bind to CaM by their specific CaM binding sites.

Results
In this study, we identified 102 GhIQD genes in the Gossypium hirsutum L. genome. The GhIQD gene family was classified into four clusters (I, II, III, and IV), and we then mapped the GhIQD genes to the G. hirsutum L. chromosomes. Moreover, we found that 100 of the 102 GhIQD genes resulted from segmental duplication events, indicating that segmental duplication is the main force driving GhIQD gene expansion. Gene expression pattern analysis showed that a total of 89 GhIQD genes expressed in the elongation stage and second cell wall biosynthesis stage of the fiber cells, suggesting that GhIQD genes may contribute to fiber cell development in cotton. In addition, we found that 20 selected GhIQD genes were highly expressed in various tissues. Exogenous application of MeJA significantly enhanced the expression levels of GhIQD genes.

Conclusions
Our study shows that GhIQD genes are involved in fiber cell development in cotton and are also widely induced by MeJA. Thw results provide bases to systematically characterize the evolution and biological functions of GhIQD genes, as well as clues to breed better cotton varieties in the future.