bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does Total Hip Arthroplasty Influence the Development and Localization of Sacral Insufficiency Fractures?
Authors: Graul Isabel , Strube Patrick , Vogt Sophia , Matziolis Georg , Brodt Steffen , Hölzl Alexander 
Published: November 2021

Background:
Sacral insufficiency fractures (SIFs) are fractures related to reduced bone strength. In a previous study, we noticed that many patients with SIF had undergone total hip arthroplasty (THA). Therefore, the purpose of the present study was to research the localization of clinically apparent SIFs in relation to unilateral THA as well as the influence of unilateral THA on bone mineral density changes in the sacrum.

Methods:
In this retrospective study, 171 patients with SIFs were screened for unilateral THA. In the group of patients with SIF and THA, the rate of SIF ipsilateral and contralateral to the side of the THA was determined. In a second cohort of 39 THA patients with healthy bone, changes in bone mineral density at the sacral alae ipsilateral and contralateral to the THA were analyzed by use of computed tomography immediately postoperatively and at the 1-year follow-up.

Results:
Of the 171 patients with SIF, 50 (40 female; mean age, 79 years; range, 54 to 101 years) were previously treated with THA. Of the 50, 31 patients were treated with unilateral THA. The proportion of patients with an SIF contralateral to the THA was 42% (13 of 31) and ipsilateral to the THA was 19% (6 of 31). Twelve patients had bilateral SIFs. The mean age of the THA group without SIF was 62 years (range, 49 to 79 years); 17 were female. The median bone mineral density decreased significantly (p = 0.023), from 35.0 to 13.0 HU, at the sacral ala contralateral to the THA, whereas the decrease of ipsilateral bone mineral density, from 24.0 to 17.0 HU, was not significant (p = 0.361).

Conclusions:
The proportion of patients with an SIF contralateral to a THA was twice as high as that of patients with an SIF ipsilateral to a THA. These findings are supported by the second cohort’s decrease in bone mineral density at the sacral ala contralateral to the THA at 1 year after surgery. We conclude that THA can lead to spatially different remodeling of the sacrum, possibly affecting the development of SIFs.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
A Manipulator Control Method Based on Deep Deterministic Policy Gradient with Parameter Noise
Authors: Zhang Haifei , Jian Xu , Lei Liting , Wu Fang , Qian Lanmei , Qiu Jianlin 
Published: November 2021

Abstract
Focusing on the motion control problem of two link manipulator, a manipulator control approach based on deep deterministic policy gradient with parameter noise is proposed. Firstly, the manipulator simulation environment is built. And then the three deep reinforcement learning models named the deep deterministic policy gradient (DDPG), asynchronous advantage actor-critical (A3C) and distributed proximal policy optimization (DPPO) are established for training according to the target setting, state variables and reward & punishment mechanism of the environment model. Finally the motion control of two link manipulator is realized. After comparing and analyzing the three models, the DDPG approach based on parameter noise is proposed for further research to improve its applicability, so as to cut down the debugging time of the manipulator model and reach the goal smoothly. The experimental results indicate that the DDPG approach based on parameter noise can control the motion of two link manipulator effectively. The convergence speed of the control model is significantly promoted and the stability after convergence is improved. In comparison with the traditional control approach, the DDPG control approach based on parameter noise has higher efficiency and stronger applicability.
Changes in the Mental Health Status of Frail and Pre-Frail Older Adults Over a 1-year Period
Authors: Lai Claudia K. Y. , Liu Justina Y. W. , Cheung Daphne S. K. , Chin Kenny C. W. , Tse Mimi M. Y. 
Published: November 2021

Abstract
Background

This prospective observational study examined changes in the mental health status of frail and pre-frail older adults over a 1-year period, a topic lacking in-depth exploration in the literature.
Method

Fried Frailty Index was used to differentiate frailty status in participants recruited from community centres and residential care facilities in Hong Kong. Demographic and clinical data were collected using face-to-face interview at baseline and repeated after 12 months.
Results

Physical functioning, comorbidities, and psychological and environment domains (World Health Organization Quality of Life instrument) impacted the cognitive functioning, depressive symptoms, and sense of loneliness in the sample (N=107). Functional health and vision had a significant impact on cognitive status; depression negatively associated with comorbidity, functional health, and quality of life domains (psychological and environment); loneliness was affected by both age and environment.
Conclusion

The findings showed that frail and pre-frail older adults have complex needs in relation to their mental health even just over a 1-year period. Intervention programs on frailty that focus on physical aspects will not suffice. Programs for frailty also need to incorporate mental health components to enhance health and wellbeing.
Determination of Hormone Receptors, Human Epidermal Growth Factor Receptor 2 and Ki67 Status in Invasive Breast Carcinoma: A Concordance Study between Immunohistochemistry, Fluorescence in Situ Hybridization, and GeneXpert® Breast Cancer STRAT4 Assay
Authors: elaje rajaa , Naya Abdellah , KHOAJA Ayoub , Zaid Younes , Oudghiri Mounia , Weidler Jodi , Karkouri Mehdi 
Published: November 2021

Abstract
BackgroundThe accurate assessment of hormone receptors (ER and PR), HER2 and Ki-67 proliferative index provides meaningful information about breast cancer prognosis and prediction of therapy response. Immunohistochemistry, the most common method for evaluating these prognostic biomarkers, can be impacted by numerous variabilities due to pre-analytical/analytical factors and subjective interpretation by pathologists. The Xpert® Breast Cancer STRAT4, a RT-qPCR based system, can be used to classify breast invasive carcinomas based on the assessment of these 4 biomarkers. In this study, we investigated the accuracy of RT-qPCR based mRNA expression levels in a closed, single-use cartridge, automated system compared with the current gold standard, immunohistochemistry (IHC), and fluorescent in situ hybridization (FISH) for HER2 equivocal cases.Methods We evaluated ESR1, PGR, ERBB2 and MKi67 mRNA expression by Xpert Breast Cancer STRAT4 and ER, PR, HER2 and Ki67 by IHC (FISH for HER2 IHC 2+) in 200 formalin-fixed paraffin-embedded (FFPE) tissue blocks with invasive breast cancer, collected from the Pathology Department of Casablanca Ibn Rochd University Hospital.Results Concordance between Xpert ® Breast Cancer STRAT4 and IHC was 93.5% for ER, 83.51% for PR, 95% for HER2 (92% for IHC+FISH), and 81.20% for Ki67 (excluding intermediate IHC Staining 10 ≤ %IHC <20). The simple Kappa coefficient was, for ER, 0.830 (P < 0, 0001), 0.565 (P < 0, 0001) for PR, 0.838 (P < 0, 0001) for HER2-IHC, 0.771 (P< 0, 0001) for HER2 IHC+FISH and, for, Ki67, 0.458 (P < 0, 0001).Conclusions We demonstrated globally a high concordance between centrally assessed IHC, IHC+FISH and mRNA measurements of ER/ESR1 and HER2/ERBB2, and a moderate agreement between PR/PGR and Ki67/MKi67. These findings provide an additional, objective, and quantitative assessment of tumor receptor status in breast cancer.
White Blood Cells (WBC) Images Classification Using CNN-Based Networks
Authors: Jung Changhun , Abuhamad Mohammed , Mohaisen David , Han Kyungja , Nyang DaeHun 
Published: November 2021

Abstract
Background: Computer-aided methods for analyzing white blood cells (WBC) are popular due to the complexity of the manual alternatives. Recent works have shown highly accurate segmentation and detection of white blood cells from microscopic blood images. However, the classification of the observed cells is still a challenge, in part due to the distribution of the five types that affect the condition of the immune system.Methods: (i) This work proposes W-Net, a CNN-based method for WBC classification. We evaluate W-Net on a real-world large-scale dataset that includes 6,562 real images of the five WBC types. (ii) For further benefits, we generate synthetic WBC images using Generative Adversarial Network to be used for education and research purposes through sharing.Results: (i) W-Net achieves an average accuracy of 97%. In comparison to state-of-the-art methods in the field of WBC classification, we show that W-Net outperforms other CNN- and RNN-based model architectures. Moreover, we show the benefits of using pre-trained W-Net in a transfer learning context when fine-tuned to specific task or accommodating another dataset. (ii) The synthetic WBC images are confirmed by experiments and a domain expert to have a high degree of similarity to the original images. The pre-trained W-Net and the generated WBC dataset are available for the community to facilitate reproducibility and follow up research work.Conclusion: This work proposed W-Net, a CNN-based architecture with a small number of layers, to accurately classify the five WBC types. We evaluated W-Net on a real-world large-scale dataset and addressed several challenges such as the transfer learning property and the class imbalance. W-Net achieved an average classification accuracy of 97%. We synthesized a dataset of new WBC image samples using DCGAN, which we released to the public for education and research purposes.
Role of Endometrial Scratch in UnExplained infertility (RESCUE); A Randomized Clinical Trial
Authors: elkhateeb reham , Bahaa Haitham , Gamal Alaa , Ibrahim Mahmoud , Toni Nisreen , Elsherif Ameer , Mahmoud mohmmed , Mahran Ahmad 
Published: November 2021

Abstract
Background Endometrial natural killer (NK) is thought to play a role in implantation and maintenance of a healthy pregnancy. However, their immunological role in unexplained infertility is yet unknown. The aim of the current study was to investigate the role of endometrial injury in treatment of unexplained infertility and to have more insight on the potential underlying mechanisms of its action methodology randomized controlled trial (RCT) done at Minia university hospital, diagnostic laparoscopy was done for both study and control group, study group had gentle scratch and specimens were sent for histopathological examination while control group had Laparoscopy only .Patients in both groups were followed up at the outpatient clinic for 3 months to assess if pregnancy achieved or not. Patients in the study group who had not achieved pregnancy had a repeated scratch using a pipelle sampler which was also sent for histopathology. Patients were counselled for intrauterine insemination (IUI) with ovulation induction while patient in control group had been counselled for IUI and ovulation induction only. Patients in both groups were followed up for further 3 months to assess patients who achieved pregnancy either naturally or after IUI . Results Baseline characteristics were comparable in both groups. Clinical pregnancy rate (CPR) was significantly higher in scratch group compared with the control group (22%; vs. 7.4%, P = 0.001) in the first three months of follow up. After second scratch and IUI cycles cumulative pregnancy rate was significantly higher in the scratch group compared with the control group (36.7% , vs. 16.2%,, P = 0.001). The mean time achieve pregnancy was found to be significantly shorter in the scratch group as compared to the control group (102 days vs.49.5 days, P = 0.01). Conclusion: Endometrial natural killer cells might play a crucial role in endometrial receptivity and therefore embryo implantation. Endometrial scratch could promote the recruitment of endometrial NK cells and give a more favourable results as regard clinical pregnancy in patients with unexplained infertility. Registration number PACTR201604001405465
Food Insecurity and Associated Factors Among Adult HIV Patients on Anti-Retroviral Therapy in Dessie Referral Hospital, South Wollo Zone, North Central Ethiopia
Authors: Demise Amanuel , Demena Melake , Hawulte Behailu , Mengistu Abrham 
Published: November 2021

Abstract
Background

Food insecurity has a paramount negative impact on the overall nutritional and health status of people living with the human immune deficiency virus, hence leading to opportunistic infections, rapid disease progression, hospitalizations, poor treatment outcomes, and mortality. Both are intertwined and worsen one another in a vicious cycle through a mixture of nutritional, mental health, and behavioral pathways that heighten vulnerability to, and worsen the severity of, each condition. Nevertheless, little is known about the magnitude of food insecurity and associated factors among adults on antiretroviral therapy in sub-Saharan Africa countries including the current study area.
Objectives

To assess the magnitude of food insecurity and associated factors among Adults on Antiretroviral Treatment in Dessie referral hospital South Wollo Zone, Northcentral Ethiopia
Methods and Materials:

An institution-based cross-sectional study was conducted among 420 randomly selected adults living with HIV/AIDS receiving ART in Dessie referral hospital. Data was entered into Epi-data version 3.1 and exported to STATA version 16.0 for cleaning and analysis. Bivariate and multivariate binary logistic regression analysis was carried out to identify factors associated with the outcome variable. Odds ratio along with 95% confidence interval was estimated to measure the strength of the association and the level of statistical significance was declared at a p-value less than 0.05
Results

The magnitude of food insecurity among adults on ART was 62.4% (95% CI: 57.6, 66.8]. CD4 count <350 [AOR=3.51, 95% CI: 1.88, 6.52], average monthly household income ≤ 40 USD [AOR= 2.34, 95% CI: 1.42, 3.84], WHO clinical stage III&IV [AOR=2.85, 95% CI: 1.61, 5.04], not getting any support [AOR= 3.04, 95% CI: 1.45, 6.38] were factors significantly associated with food insecurity.
Conclusion

Around two-thirds of the adult people living with HIV on ART at Dessie referral Hospital were experiencing food insecurity. Thus, social protection interventions targeting patients with CD4 <350, income less than 40 USD/month, WHO clinical stage III &IV, and those patients with no support are crucial interventions for food security.
Proliferative Effect of Aqueous Extract of Sea Cucumber (Holothuria Parva) Body Wall on Human Umbilical Cord Mesenchymal Stromal/stem Cells
Authors: Rasekh Poorya , Kameli Ali , Khoradmehr Arezoo , Baghban Neda , Mohebbi Gholamhossein , Barmak Alireza , Nabipour Iraj , Azari Hossein , Heidari Yaser , Daneshi Adel , Bargahi Afshar , Khodabandeh Zahra , Zare Shahrokh , Shirazi Reza , Almasi-turk Sahar , Tamadon Amin 
Published: November 2021

Abstract
Background: The sea cucumber potentials for stem cell proliferation induction and their mechanisms of bioactive compounds in its extract have been studied. Human umbilical cord mesenchymal stromal/stem cells (hUC-MSCs) were exposed to aqueous extract of Holothuria parva body wall. Methods: Using GC-MS analysis on aqueous extract of H. parva, proliferative molecules were detected. The extract concentrations of 5, 10, 20, 40, and 80 µg/mL and 10 and 20 ng/mL of human epidermal growth factor (EGF) as positive controls were used. MTT proliferation, cell count, viability, and cell cycle assays were performed. Using Western blot analysis, effects of aqueous extract of H. parva and EGF on cell proliferation markers were detected. Computational modeling done to detect effective proliferative compounds in aqueous extract of H. parva. Results: MTT assay showed that the 10, 20, and 40 µg/mL aqueous extract of H. parva had proliferative effects on hUC-MSCs. Count of the cells treated with the 20 µg/mL of the extract was increased faster and higher than the control group (P<0.05). This concentration of extract did not have significant effects on hUC-MSCs viability. The cell cycle assay of hUC-MSCs showed that percent of cells in the G2 stage of the extract was biologically higher than the control group (P>0.05). Expression of the cyclin D1, cyclin D3, cyclin E, HIF-1α, and TERT were increased comparing with the control group. Moreover, expression of the p21 and PCNA decreased after treating hUC-MSCs with the extract. However, the CDC-2/cdk-1 and ERK1/2 had almost the same expression as the control group. The expression of the cdk-4 and cdk-6 was decreased after treatment with the extract. Between the detected compounds, 1-methyl-4-(1-methylethenyl)-benzene showed better affinity to cdk-4 and p21 than tetradecanoic acid. Conclusions: The H. parva aqueous extract showed proliferative potential on the hUC-MSCs.
Discovery of Genes Positively Modulating Treatment Effect Using Potential Outcome Framework and Bayesian Update
Authors: Lee Young Keun , Kim Jisoo , Seo Sung Wook 
Published: November 2021

Abstract
BackgroundThe recent explosion of cancer genomics provides extensive information about mutations and gene expression changes in cancer. However, most of the identified gene mutations are not clinically utilized. It remains uncertain whether the presence of a certain genetic alteration will affect treatment response. Conventional statistics have limitations for causal inferences and are hard to gain sufficient power in genomic datasets. Here, we developed and evaluated an algorithm for searching the causal genes that maximize the effect of the treatment.MethodsThe algorithm was developed based on the potential outcome framework and Bayesian posterior update. The precision of the algorithm was validated using a simulation dataset. The algorithm was implemented to a cBioPortal dataset. The genes discovered by the algorithm were externally validated within CancerSCAN screening data from Samsung Medical Center.ResultsSimulation data analysis showed that the C-search algorithm was able to identify nine causal genes out of ten. The C-search algorithm shows the discovery rate rapidly increasing until the 1500 number of data. Meanwhile, the log-rank test shows a slower increase in performance. The C-search algorithm was able to suggest nine causal genes from the cBioPortal Metabric dataset. Treating the patients with the causal genes are associated with better survival outcome in both the cBioPortal dataset and the CancerSCAN dataset which is used for external validation.ConclusionsOur C-search algorithm demonstrated better performance to identify causal effects of the genes than multiple rog-rank test analysis especially within a limited number of data. The result suggests that the C-search can discover the causal genes from various genetic datasets, where the number of samples is limited compared to the number of variables.
Application of Hip Amputation Under Non-Ischemic Condition in the Treatment of Sarcomar
Authors: Zhou Rang , Sun Yang , Pan Zhihao , Shi Qingyu 
Published: November 2021

Abstract
Background: Amputation is an effective treatment for sarcoma of the hip. Traditional amputation is performed by separating the major arteries and veins of the limb and blocking the blood supply to the limb, which may have adverse effects on the patient.Methods: Ten patients with pathologically clearly diagnosed bone and soft tissue sarcoma undergoing hip amputation in a non-ischemic state between April 2019 and April 2021 at the Affiliated Cancer Hospital of Harbin Medical University were selected. Factors related to operative time, intraoperative bleeding, phantom limb pain, incisional infection, and flap necrosis were statistically evaluated at 7 days postoperatively and 3 months postoperatively.Results: Ten patients were followed up for 3-24 months with a mean of 13 months. No bleeding secondary surgical complications occurred in all patients, and none had postoperative infections. Postoperative flap necrosis occurred in one case in the modified hemipelvic amputation patients, and no flap necrosis occurred in the hip disarticulation patients. In the non-ischemic hemipelvic amputation group, the operation time was 4.5-5.5h, with a mean of 5h, and the operation bleeding volume was 300-1000ml, with a mean of 700ml; in the hip disarticulation group, the operation time was 2.5-3.5h, with a mean of 2.9h, and the operation bleeding volume was 300-450ml, with a mean of 357ml; phantom limb pain in the non-ischemic amputation group 7 days after operation, the VAS pain score was 4 -6 points, mean 4.5 points; VAS pain score 3-4 points, mean 3.4 points at 3 months postoperatively.Conclusions: In hip amputation for bone and soft tissue sarcoma, the main arterial and venous approaches to the limb are ligated near the end of surgery, leaving the amputated limb in a non-ischemic state at the distal end of the amputation, without pathological reactions due to limb ischemia. Non-ischemic hip amputation is more suitable for the surgical treatment of locally advanced lesions of sarcoma.Trial registration: retrospectively registered
Comprehensive Analysis of the Immune Microenvironment Reveals that CD52 is a Marker for Breast Cancer Treatment with Immune Checkpoint Inhibitors
Authors: Wang Qiang , Liu Xuxu , Wang Pengfei , Luo Dankun , Gao Wenqi , Sun Yuanyuan , Ma Biao , Xue Dongbo , Sun Hezheng 
Published: November 2021

Abstract
Background:Breast cancer (BC) is one of the most common tumors in women. Recent years, immune checkpoint inhibitors (ICIs) have brought good news to BC patients. Although significant achievements have been made through treatment with ICIs, some people who experience serious immune-related adverse events (IrAEs) are still insensitive to this approach. The response to ICI treatment depends on the type of tumor microenvironment (TME). Methods:WGCNA (weighted gene co-expression network analysis), ESTIMATE algorithm, LASSO regression analysis, survival analysis, functional enrichment analysis are conducted to analyze the BC data in the TCGA database. Immunohistochemistry was used to verify the expression of CD52 in BC.Results:WGCNA and ESTIMATE algorithm found that the CD52 is closely related to the immune microenvironment. CD52 highly expressed in various breast cancer subtypes, and patients with high expression of CD52 have longer survival time. Compared with the low-CD52 group, the high-CD52 group had more immune cell infiltration. TIMER database verification results showed that CD8+ T cells, activated memory CD4 T cells, memory B cells, γδ T cells, and Tregs were positively correlated with CD52 expression, while M2 macrophages were negatively correlated. CD52 can change the trend of TIC (CD8+ T) and tumor-associated macrophage (TAM) infiltration with respect to the survival time of breast cancer patients. Based on the expression of CD52, we explored the relationship between CD52 and the adaptive immune response (AIR). CD52 is a marker of AIR stratification in breast cancer patients. We constructed a CD52-related adaptive immune response gene signature (CD52rAIRGsig) which is an independent prognostic factor for breast cancer and related to genome instability and the immune cells infiltration in the TME. CD52 and CD52rAIRGsig were associated with PD-1 signaling and immune checkpoint inhibitor markers, which proves that patients with high CD52 expression and low risk of CD52rAIRGsig are more suitable for ICI treatment. We then screened chemotherapeutics for personalized medicine based on CD52rAIRGsig. Conclusion:Therefore, we have discovered a new marker to guide the treatment and prognosis of breast cancer patients with ICIs. This provides a combined treatment strategy including different combinations of ICIs combined with chemotherapeutic drugs to treat breast cancer.