bluuebunny/crossref_metadata_2025_split huggingface dataset:
Overlap time is an independent risk factor of radiation pneumonitis for patients treated with simultaneous EGFR-TKI and thoracic radiotherapy
Authors: Jia Wenxiao , Gao Qianqian , Wang Min , Li Ji , Jing Wang , Yu Jinming , Zhu Hui 
Published: January 2021

Abstract
Background: The exact rate and relevant risk factors of radiation pneumonitis (RP) for non-small-cell cancer (NSCLC) patients treated with the combination of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) and thoracic radiotherapy have not been reported. Thus, this study aimed to investigate the rate and risk factors of RP for EGFR-positive NSCLC patients simultaneously treated with first-generation EGFR-TKI and TRT.Patients and Methods: We retrospectively evaluated NSCLC patients simultaneously treated with first-generation EGFR-TKI and thoracic radiotherapy between January 2012 and December 2019 at Shandong Cancer Hospital and Institute, Shandong, China. RP was diagnosed via computed tomography and was classified according to the Common Terminology Criteria for Adverse Events v5.0. The risk factors of RP were identified using uni- and multivariate analyses.Results: Of the 67 patients included, 44.78% (30/67) developed grade ≥2 RP. Grade ≥2 RP occurred within a median of 3.48 (range, 1.07-13.6) months. The EGFR-TKI icotinib, ipsilateral lung V30 >34%, and overlap time of >20 days between EGFR-TKI and thoracic radiotherapy were identified to be independent predictive factors of grade ≥2 RP.Conclusions: Grade ≥2 RP is highly frequent in NSCLC patients simultaneous treated with first-generation EGFR-TKI and thoracic radiotherapy. Icotinib, ipsilateral lung V30 ≤34%, and overlap time of ≤20 days for EGFR-TKI and thoracic radiotherapy will be helpful to lower the risk of RP in these patients. The addition of thoracic radiotherapy should be cautious, and the treatment strategies can be optimized to reduce the rate of RP for patients treat with simultaneous EGFR-TKI and thoracic radiotherapy.
Highly stable organic photothermal agent based on near-infrared-II fluorophores for tumor treatment
Authors: Xu Yunjian , Wang Shiqi , Chen Zhenjiang , Hu Rui , Li Shaoqiang , Zhao Yihua , Liu Liwei , Qu Junle 
Published: January 2021

Abstract
Background: The aim to develop a highly stable near-infrared (NIR) photoinduced tumor therapy agent stems from its considerable potential for biological application. Due to its long wavelength, biological imaging exhibits a high signal-to-background ratio, deep tissue penetration and maximum permissible light power, which can minimize damage to an organism during photoinduced tumor therapy.Results: A class of stable NIR-II fluorophores (NIR998, NIR1028, NIR980, NIR1030, and NIR1028-S) based on aza–boron–dipyrromethene (aza-BODIPY) dyes with donor-acceptor-donor structures have been rationally designed and synthesized by harnessing the steric relaxation effect and intramolecular photoinduced electron transfer (IPET). These fluorophores exhibit an intense range of NIR-II emission, large Stokes shift (≥100 nm), excellent photothermal conversion performance, and superior stability against photobleaching. Among the NIR-II fluorophores, NIR998 possesses better NIR-II emission and photothermal conversion performance. NIR998 nanoparticles (NIR998 NPs) can be encapsulated by liposomes. NIR998 NPs show superior stability in the presence of light, heat, and reactive oxygen nitrogen species than that of indocyanine green NPs, as well as a higher photothermal conversion ability (η = 50.5%) compared to other photothermal agents. Finally, under the guidance of photothermal imaging, NIR998 NPs have been proven to effectively eliminate tumors via their excellent photothermal conversion performance while presenting negligible cytotoxicity.Conclusions: Utilizing IPET and the steric relaxation effect can effectively induce NIR-II emission of aza-BODIPY dyes. Stable NIR998 NPs have excellent photothermal conversion performance and negligible dark cytotoxicity, so they have the potential to act as photothermal agents in biological applications.
Disease activity index is associated with subclinical atherosclerosis in childhood-onset systemic lupus erythematosus
Authors: Medeiros Priscila Beatriz de Souza , Salomão Roberta G , Teixeira Sara R , Rassi Diane Meyre , Rodrigues Luciana , Aragon Davi Casale , Fassini Priscila Giacomo , Ued Fábio Veiga , Tostes Rita C , Monteiro Jacqueline P , Ferriani Virgínia Paes Leme , De Carvalho Luciana Martins 
Published: January 2021

Abstract
Background: Systemic lupus erythematosus (SLE) is an independent risk factor for cardiovascular events. The present study determined the prevalence of subclinical atherosclerosis in childhood-onset SLE using the carotid intima-media thickness (CIMT) measurement and investigated associations between traditional and nontraditional risk factors for atherosclerosis, such as medications, SLE Disease Activity Index - SLEDAI-2K and SLICC-ACR damage index and CIMT. Methods: Cross-sectional prospective study between 2017-2018. CIMT was assessed by ultrasonography. Data were collected by chart review, nutritional evaluation and laboratory tests and analyzed by Fisher, Wilcoxon-Mann-Whitney tests, multiple linear and log binomial regression. Results: Twenty-eight patients (mean age 13.9 years, SD 3) were enrolled. The prevalence of subclinical atherosclerosis was 32% (95% CI 14.8, 49.4). The mean CIMT was 0.43 ± 0.035 mm. The most common traditional risk factors observed were dyslipidemia (82.1%), uncontrolled hypertension (14.2%), obesity (14.3%), and poor diet (78.6%). Uncontrolled hypertension (p=0.04), proteinuria (p=0.02), estimated glomerular filtration rate <75ml /min/1.73 m2 (p=0.02) and SLEDAI-2K > 5 (P=0.04) were associated with subclinical atherosclerosis. SLEDAI-2K > 5 maintained association with CIMT after adjusting for control variables. Conclusion: Subclinical atherosclerosis is frequently observed in cSLE, mainly in patients with moderate to severe disease activity.
Gender Differences in Resilience Among Older Taiwanese Adults
Authors: Fergus Deleon , Chen Yi-Hua , Chuang Ying-Chih , Ma Ai-Hsuan , Chuang Kun-Yang 
Published: January 2021

Abstract
Objectives

The aim of this study was to determine whether gender impacts potential associations between social relationships, sociodemographic, health and behavioural factors with resilience among older Taiwanese adults.
Methods

High and low resilience of older adults was determined based on the median value of the Friborg’s Resilience Scale. An independent sample t-test, χ2, and multivariate logistic regression were used to examine predictors for resilience which were then stratified by gender.
Results

Older women were less likely to be resilient than older men. Marital status, age, financial stress, and satisfaction with one's living environment were only significant in women. Traditional gender roles in the wider Taiwanese context can be attributed to these differences.
Conclusions

The relationships between gender, sociodemographics, health, and social and behavioural factors with resilience provide unique insights into how culture shapes trends in data.
Mechanical Evaluation of Collapse Risk for Osteonecrosis of Femoral Head Post-Medical Treatment
Authors: Mei Yuqian , Tang Qi , Chen Songhao , Chen Duanduan 
Published: January 2021

Abstract
Background: Early-stage osteonecrosis of the femoral head can progressively induce the bone collapse and the accuracy of the collapse risk evaluation is limited. This study aims to propose a potential collapse indicator by biomechanical evaluating the treatment effectiveness. Methods: Six patient-specific models pre- (initial presentation) and post- medical treatment were established and elastic properties of the bone were assigned with a function of spatial-variant Hounsfield unit values. Morphological and mechanical analyses were compared between pre- and post-treatment models. Results: In the morphological study, four cases show the reduced ratio of low-density necrotic volume, but not consistent with one-year follow-up results. In the mechanical analysis, the equivalent stress variation near the Ward triangle shows consistency in the one-year outcome. Moreover, a parameter - relative stress index, the ratio between the mean volume stress index and the mean volume equivalent stress, is proposed. A smaller value of the relative stress index indicates stronger bone compressive strength and its variation is consistent with the follow-up results. Conclusions: Results implicate that to evaluate the effectiveness of medical treatments, the morphologic analysis should be considered but the mechanical capability and the loading transfer path through the necrotic and viable bone play a more important role.
Potential Candidate Genes and Pathways Affecting the Metabolism of Jaw Fats in Risso’s Dolphin: Based on Transcriptomics
Authors: Senevirathna Jayan , Yonezawa Ryo , Igarashi Yoji , Saka Taiki , Yoshitake Kazutoshi , Kinoshita Shigeharu , Funasaka Noriko , Asakawa Shuichi 
Published: January 2021

Abstract
Jaw fats play a key role in echolocation in toothed whales. These fats are located along the outer and inner segments of the lower jawbone. A ribose nucleic acid (RNA) sequencing technique was employed to investigate transcriptomes of these two types of jaw fat tissues in Risso’s dolphins. We identified 1,899 upregulated common genes in both fat tissues. The differentially-expressed genes (DEGs) analysis showed that 34 and nine known genes were significantly upregulated in outer and inner jaw fats, respectively. A functional enrichment analysis was conducted by Enricher; lipid metabolism-related gene ontologies (GO) and pathways were identified (p<0.05). Based on these analyses, APOH, HNF4A, MYF6, SLC1A2, SLC2A2 and ALDOB were key genes for lipid metabolism in the outer jaw fat which are mainly involved with lipoprotein lipase activities. However, APP, DHX9, PXMP4 and THBS4 genes were highly expressed in the inner jaw fat, and their main functional enrichments were amyloid-beta formation and the activation of ECM-receptor interaction. These recent findings provide evidence for de novo lipid synthesis and as a new concept, the APP may be involved with transferring sound wave signals from the inner jaw fat to the brain via neurons, and further studies are necessary for revealing the puzzle of echolocation in toothed whales.
Without SLO BECCS, fast net-zero looks unlikely
Authors: Donnison Caspar , Trdlicova Karolina , Mohr Alison , Taylor Gail 
Published: January 2021

Abstract
Given the importance of Bioenergy with Carbon Capture and Storage (BECCS) in net-zero scenarios, it is crucial that policymakers understand how BECCS can achieve a Social License to Operate (SLO). BECCS discussions have been dominated by global scale assessments with very limited exploration of how and where the technology could be deployed at national and local scales. Failure to address key aspects of BECCS deployment may lead to public rejection, as has happened with previous technologies such as GM crops and onshore wind energy. This has major implications for the delivery of net-zero emissions: time is very short for policy makers to find alternative strategies to meet carbon budgets. We present the first media analysis of its kind to consider BECCS, using two geographical locations - the UK and California - to analyze the ‘storylines’ which frame the public discussion of BECCS. The results highlight that successful policymaking will require engagement with local communities and identification of relevant location-specific factors that determine the social and environmental impact of BECCS.
Clinical and Histological Features of Prosthetic Joint Infections May Differ In Patients With Inflammatory Arthritis and Osteoarthritis
Authors: Sculco Peter , Kapadia Milan , Moezinia Carine , Miller Andy , Donlin Laura , Henry Michael , Russell Linda , Figgie Mark , Nocon Allina , Pannellini Tania , Goodman Susan 
Published: January 2021

Abstract

Background: Inflammatory arthritis (IA) patients are at increased risk for prosthetic joint infections (PJI); however, diagnosis is challenging because active IA patients have elevated inflammatory markers that may mimic joint infection and definitive microbiologic diagnosis may be delayed. The objective of this pilot study was to identify the clinical, microbiologic, and histopathologic features of culture positive (CP) and culture negative (CN) total hip (THA) and total knee arthroplasty (TKA) PJI in IA patients and obtain preliminary data to support a definitive study to determine the optimal method for PJI diagnosis in patients with inflammatory arthritis. Methods: A retrospective cohort of THA/TKA PJIs, from 2009 to 2016, were identified using an institutional PJI registry. H&E slides of OA and IA PJI cases matched by age, sex, and culture status were histologically reviewed. Clinical characteristics were evaluated using Fisher’s exact, Chi-Square tests, Students’ t test, and Mann Whitney U test where appropriate.Results: 807 PJI cases were identified including 36 IA and 771 OA. A higher proportion of IA PJI were CN (N=10, 27%) vs. OA PJI (N=109, 14%, p=0.02). IA PJI patients compared to OA patients presented younger (p<0.001), with a higher Charlson Comorbidity Index (p=0.002), had more frequent use of glucocorticoids (p<0.001) and a larger proportion were female (p<0.001). Of 88 PJIs reviewed for histopathology, within the IA cohort, a higher proportion of CP-IA had >10 PMN per HPF (p= 0.003) and met MSIS criteria (p=0.009) but presented with less chronic inflammation (p=0.017).Conclusions: This hypothesis-generating study suggests that culture negative PJI is more frequent in patients with IA than OA. Higher rates of prior PJI, differences in histopathology, and better clinical outcomes suggest biologic differences between CN and CP PJI that should be explored further in a prospective study.
Comprehensive Geriatric Assessment in the Emergency Department for Identifying Elderly Individuals at Risk of Hip Fracture
Authors: Lin Pei-Ying , Huang Hsien-Hao , Yen David Hung-Tsang 
Published: January 2021

Abstract
Background Hip fracture (HF) is a major challenge for healthcare systems in terms of increased costs and lengths of stay, and it has been estimated that by 2050, half of the projected 6.26 million global HFs will occur in Asia. Owing to the high morbidity and mortality associated with HF in elderly individuals, it is crucial to recognize at-risk elderly patients in the ED so that special precautions and preventive measures can be taken. While comprehensive geriatric assessment (CGA) has been shown to improve outcomes and prevent secondary fractures in elderly individuals with HF in outpatient settings, there is a lack of data to support the use of CGA in the emergency department (ED) to identify elderly Asian patients who are at risk of HF. Aim To identify the characteristics of elderly Asian patients in the ED who have an increased risk of HF via CGA. Methods A case-control study was conducted in the ED at Taipei Veterans General Hospital, a medical center located in Taipei, Taiwan, from October 2018 to December 2019. Patients ≥75 years old with and without HF were compared using data obtained from CGAs conducted by trained nurses. Results A total of 85 HF patients (cases) and 680 non-HF patients were enrolled, among whom 85 non-HF control individuals (controls) were selected by simple random sampling. HF occurred more frequently in women and in patients with depressive symptoms. An association between decreased handgrip strength and HF risk, especially in men, was also identified (P < 0.001). The variables independently associated with the presence of HF in the multivariate analysis were female sex (odds ratio (OR) = 2.937; 95% CI = 1.519-5.677) and decreased handgrip strength (OR = 3.739; 95% CI = 1.641-8.519). Conclusions By performing CGAs in the ED, we found that female sex and decreased handgrip strength were associated with HF risk. Therefore, we propose that targeted assessment of handgrip strength in female patients aged ≥75 years in the ED may identify those at greatest risk of HF, resulting in improved emergency care for geriatric patients.
Making Mistakes Saves the Single World of the Extended Wigner’s Friend Experiment
Authors: Łukaszyk Szymon 
Published: January 2021

Abstract
The Extended Wigner’s Friend thought experiment comprising a quantum system containing an agent who draws conclusions, upon observing the outcome of a measurement of a qubit prepared in two non-orthogonal versions by another agent led its authors to conclude that quantum theory cannot consistently describe the use of itself. It has also been proposed that this thought experiment is equivalent to coherent entangled state (Bell type) experiments. It is argued in this paper that the assumption of the freedom of choice of the first Wigner’s friend invalidates such equivalency. It is also argued that the assumption of locality (physical space) introduces superfluous identity of indiscernibles metric axiom, which is invalid in quantum domain and generally disproven by the Ugly duckling mathematical theorem.
Developing a Diagnostic Decision Support Tool With Machine Learning Classification Algorithms to Improve Breast Cancer Screening: A Cross-Sectional Study on Iranian Women
Authors: Mousavi Seyed Amirreza , Noorchenarboo Mohammad , Moheimani Hamed 
Published: January 2021

Abstract
Background: Improper patient navigation and follow-up measures hamper breast cancer screening programs. To augment existing programs, we aimed to develop a decision support system for early breast cancer detection, by training and validating machine learning classification algorithms on routinely available patient data.Methods: Data were collected prospectively from eligible consenting women who visited a single university affiliated center in Tehran, Iran, during a two-year period. We selected 17 features from patient demographics, history, clinical examination and screening imaging. Breast cancer diagnosis was assessed one year after initial data collection. Positive outcomes where confirmed with tissue biopsy. Six supervised machine learning classification algorithms (including two artificial neural networks) were trained on 743 cases. Odds ratios were calculated using logistic regression.Results: 34% of participants were diagnosed with breast cancer. Highest adjusted odds ratios (95%CI) belonged to ultrasound: 24.8 (12.4,52.0) and mammography: 21.7 (8.8,58.5). When evaluated on all patients, random forest model possessed the highest AUC (95%CI) of 0.98 (0.97,0.99). The results of 10-fold stratified cross-validation supported model stability. Based on the mean of ten validation iterations, random forest provided the highest accuracy (93.3%) sensitivity (91.9%) and NPV (96.2%). K-nearest-neighbors model provided the highest specificity (95.9%) and PPV (91.9%).Conclusions: Machine learning models trained on basic demographics, history, clinical examination and breast screening imaging can predict breast cancer accurately. Such decision support tools when added to existing programs can boost the effectiveness of screening measures. Implementation ultimately depends on future works which will focus on external validation, interface development and cost-effectiveness analysis.
Performance Comparison of Public Hospitals between 2014 and 2018 in Different Regions of Guangdong Province, China, Following 2017 Medical Service Price Reforms
Authors: Weng Kaiyuan , Xia Feng , Wang Yibao 
Published: January 2021

Abstract
BackgroundThis study analyzed performance of public hospitals and regional differences in performance following reform of medical service prices in Guangdong province, China. From three cities in four regions, we randomly selected a total of 12 traditional Chinese medicine hospitals and 12 general tertiary hospitals.MethodsSix questionnaires were completed by the hospitals, using 2014–2018 internal data. Principal components analysis was used to compare performances of the hospitals and regions following price reform. The extent to which medical service prices were adjusted varied considerable for different procedures in the same region and for the same category of procedures among regions. ResultsAfter reform, compensation for medical services in public hospitals reached the target of 80%, except in the Western region. However, annual growth of costs to patients was generally above 4%; the burden on patients was not alleviated by fee control. Reforms were more effective for comprehensive than Chinese traditional medicine hospitals. Performance scores of general hospitals in the Pearl River Delta, Eastern, Western, and Northern regions were 1.24, 1.16, -0.22, and -1.01, respectively. This is consistent with ranking by level of economic development of each region.ConclusionThe government should implement a regional medical service pricing mechanism. Additionally, comprehensive and traditional Chinese medicine hospitals should each have appropriate pricing policies. Future policies should focus on controlling costs incurred by patients.
A dynamic control strategy to produce riboflavin with lignocellulose hydrolysate in the thermophile Geobacillus thermoglucosidasius
Authors: Wang Junyang , Li Zilong , Wang Weishan , Pang Shen , Qi Fengxian , Yao Yongpeng , Yuan Fang , Wang Huizhuan , Xu Zhen , Pan Guohui , Chen Yihua , Fan Keqiang 
Published: January 2021

Abstract
The efficient utilization of both glucose and xylose, the two most abundant sugars in biomass hydrolysates, is one of the main objectives of biofermentation with lignocellulosic materials. The utilization of xylose is commonly inhibited by glucose, which is known as glucose catabolite repression (GCR). Here we report a GCR-based dynamic control (GCR-DC) strategy aiming at a better co-utilization of glucose and xylose, by decoupling the cell growth and biosynthesis of riboflavin as a product. Using the thermophilic strain Geobacillus thermoglucosidasius DSM2542 as a host, we constructed extra riboflavin biosynthetic pathways that were activated by xylose but not glucose. The engineered strains showed a two-stage fermentation process. In the first stage, glucose was preferentially used for cell growth and no production of riboflavin was observed, while in the second stage where glucose was nearly depleted, xylose was effectively utilized for riboflavin biosynthesis. Using the corn cob hydrolysate as a carbon source, the optimized riboflavin yields of strains DSM2542-DCall-MSS (full pathway dynamic control strategy) and DSM2542-DCrib (single module dynamic control strategy) were 5.26 and 2.26 folds higher than that of the control strain DSM2542 Rib-Gtg constitutively producing riboflavin, respectively. This GCR-DC strategy should also be applicable to the construction of cell factories that can efficiently use natural carbon sources with multiple sugar components for the production of high-value chemicals in future.