bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence of internal mammary node in locally advanced breast cancer and its correlation with metastatic disease: a retrospective observational study
Authors: Singh Somesh , Ramani Subhash K , Rastogi Ashita , Thakur Meenakshi H 
Published: September 2019

Objective: To determine incidence of internal mammary nodes (IMN) at baseline CT of locally advanced breast cancer (LABC) and ascertain prognostic implication. Methods and materials: Retrospective review of all LABC patients from 1 January 2012 through 31 December 2014 was performed after approval from institutional review board. CTs of 182 patients enrolled were reviewed by two radiologists independently, and IMNs were documented based on size, location and relation with location of breast primary. 3-year follow-up was analysed and incidence of metastases was calculated as overall incidence, incidence in patients with and without discernible IMN at baseline imaging. Results are presented as numbers and percentages. Differences in metastases of two groups were compared using χ2 test. 95% CI was calculated and p < 0.05 was considered significant. Results: 77 of 182 had identifiable IMN (42.3% incidence). Majority of identifiable nodes were on ipsilateral side of primary (incidence 90.90%) with higher incidence in patients with upper-outer quadrant tumours (55.9%). Majority were seen in second intercostal space (44.4%). 36 (19.7%) developed distant metastases within 3 years of therapy. Of these, 21 (27.3%) had IMN as compared with 15 (14.3 %) without IMN on baseline imaging. Patients with identifiable IMN on baseline CT had significantly higher incidence of distant metastases (p = 0.0321). Conclusion: Significant number LABC patients have identifiable IMN on baseline imaging with patients showing IMN on baseline CT showing significantly higher rate of metastatic disease following therapy. Advances in knowledge: Many LABC patients have identifiable IMNs on baseline imaging which show higher incidence of subsequent metastatic disease.
Gustatory dysfunction in relation to circumvallate papilla’s taste buds structure upon unilateral maxillary molar extraction in Wistar rats: an in vivo study
Authors: Mostafa Sana , Hakam Heba M. , El-motayam Amal 
Published: September 2019

Background: The interaction between taste sensation and dentoalveolar innervation is still under research. teeth loss can alter taste thresholds in humans, but the underlying mechanisms are still obscure. This study investigated the effect of unilateral maxillary molars extraction on the structure of circumvallate papilla in rats. Methods: Thirty-two male Wister rats, aged 3-4 months were randomly distributed into four groups (one control and 3 experimental ) each including 8 animals. The rats were euthanized 3, 6 or 9 weeks following the procedure. The changes in trough length and the taste buds structure and number of both sides of CVP were investigated using routine histological examination followed by statistical analysis. Results: the trough toward the extraction side was obviously shorter with a noticeable decrease of taste buds’ number than the non-extraction side. Taste buds were reduced in size and most of them showed signs of degeneration which was more evident in group II followed by group III, less deformity detected in group IV in comparison to the preceding 2 experimental groups. the non-extraction side of all experimental groups showed normal trough length and generally normal histology of taste buds. Conclusions: Maxillary molars extraction has a degenerative effect on the structure of taste buds and gustatory epithelium which were more marked at the extraction side and showed improvement upon elongation of follow up period
How can we make better health decisions a Best Buy for all?
Authors: O'Brien Niki , Li Ryan , Isaranuwatchai Wanrudee , Dabak Saudamini Vishwanath , Glassman Amanda , Culyer Anthony J. , Chalkidou Kalipso 
Published: September 2019

The World Health Organization (WHO) resolution calling on Member States to work towards achieving universal health coverage (UHC) has increased the need for prioritizing health spending. Such need will soon accelerate as low- and middle-income countries transition from external aid. Countries will have to make difficult decisions on how best to integrate and finance previously donor-funded technologies and health services into their UHC packages in ways that are equitable, and operationally and financially sustainable. The International Decision Support Initiative (iDSI) is a global network of health, policy and economic expertise which supports countries in making better decisions about how best and how much to spend public money on healthcare. iDSI core partners include Center For Global Development, China National Health Development Research Center, Clinton Health Access Initiative, Health Intervention and Technology Assessment Program, Thailand / National Health Foundation, Imperial College London, Kenya Medical Research Institute, and the Norwegian Institute of Public Health. In May 2019, iDSI convened a roundtable entitled Why strengthening health systems to make better decisions is a Best Buy. The event brought together members of iDSI, development partners and other organizations working in the areas of evidence-informed priority-setting, resource allocation and purchasing. The roundtable participants identified key challenges and activities that could be undertaken by the broader health technology assessment (HTA) community to further country-led capacity building, as well to foster deeper collaboration between the community itself. HTA is a tool which can assist governments and development partners with evaluating alternative investment options in a defensible and accountable fashion. The definition and scope of HTA, and what it can achieve and support, can be presented more clearly and cohesively to stakeholders. Organizations engaging in HTA must develop deeper collaboration, and integrate existing collaborations, to ensure progress in developing HTA institutionalization globally is well organized and sustainable.
Batwing mammoplasty: a safe oncoplastic technique for breast conservation in breast cancer patients with gigantomastia
Authors: Manie TM , Youssef MMG , Taha SN , Rabea A , Farahat AM 
Published: September 2019

Background Surgical management of breast cancer with gigantomastia can be challenging when planning breast conservation, as major breast reduction is required. Complex oncoplastic procedures can carry an additional surgical risk in this situation. We suggest batwing mammoplasty as a simple and safe oncoplastic procedure for those patients. Materials and methods Fourteen patients with gigantomastia diagnosed with breast cancer were included in this prospective cohort study. All underwent batwing mammoplasty and contralateral symmetrisation procedure between May 2016 and June 2018. Patient satisfaction assessed by the Breast-Q questionnaire. Results All patients had a body mass index above 30kg/m2 with a mean of 36.7kg/m2 (range 31.6–44.9kg/m2). The mean distance from midclavicular point to nipple was 42cm (range 38–50cm). The mean operative time was 83 minutes for procedures done by a single surgeon. Mean specimen weight was 1.2kg (ranging from 1.035–1.63kg). Postoperative complications occurred in 14.2% of patients. Nipple–areola complex viability was not compromised nor sensation impaired. The mean Breast-Q score for patient satisfaction with breasts was 68.6 (range 61–74). The mean score for physiological wellbeing was 77.3 (range 64–84) and the mean score for physical wellbeing was 35 (range 31–40). Conclusion Batwing mammoplasty is a safe and simple oncoplastic procedure in patients who have breast cancer with gigantomastia. It has short operative time and low complications rate. In our cohort of patients, there was no delay in the delivery of adjuvant treatment. The cosmetic outcome was favourable with a high patient satisfaction.
Lactancia materna, alimentación complementaria y suplementación con multimicronutrientes: Perspectiva intercultural
Authors: Bustamante Llatas Jessica Paola , Gordillo Julón Miguel Amberly , Díaz Manchay Rosa Jeuna , Mogollón Torres Flor de María , Vega Ramírez Angelica Soledad , Tejada Muñoz Sonia 
Published: September 2019

Introducción: La alimentación en el niño es fundamental para su adecuado crecimiento y desarrollo saludable; sin embargo algunas prácticas culturales arraigadas en diferentes comunidades han influido en la morbilidad y la mortalidad infantil, a pesar de la educación sanitaria que brinda el personal de salud.Objetivo: Describir y comprender la lactancia materna, alimentación complementaria y suplementación con multimicronutrientes al lactante menor desde una perspectiva intercultural.Métodos: Estudio cualitativo, con diseño etnográfico. La muestra estuvo conformada 25 participantes (10 enfermeros y 15 madres andinas), elegidas por conveniencia y determinada por la técnica de saturación y redundancia. Para la recolección de datos se usó la entrevista etnográfica y la observación participante, registrándose en el diario de campo, procesados mediante análisis temático. Se tuvo en cuenta los criterios de rigor científico y los principios de bioética personalista.Resultados: Emergieron tres temas culturales: A) Educación sanitaria, costumbres y lactancia materna. B) Educación sanitaria y prácticas culturales en la alimentación complementaria. C) Educación sanitaria, consumo y rechazo de multimicronutrientes. Conclusiones: El personal de salud educa a la madre andina acerca de una adecuada alimentación que deben realizar en el hogar, pero más prevalece sus costumbres y creencias, lo que puede ocasionar deficiente crecimiento y desarrollo.
LAND-SOIL CHARACTERISTICS FOR MAPPING PADDY CROPPING INTENSITY USING DECISION TREE ANALYSIS FROM SINGLE DATE ALI IMAGERY IN MAGELANG, CENTRAL JAVA, INDONESIA
Authors: Arjasakusuma Sanjiwana , Danoedoro Projo , Herumurti Sigit , Nugroho Yanuar Adji , Aryaguna Prama Ardha 
Published: September 2019

Paddy field area and its cropping intensity are main information used to measure the crop production and the response of crop to changing climate conditions. Remote sensing technology has been used widely to map cropping pattern of paddy mostly using spectral analysis of multi temporal multispectral data of remote sensing. However, the cropping intensity of paddy was also influenced by the characteristics of planted land to paddy field which defines the level of land suitability for planting paddy. This research aimed to map paddy rotation by using single date ALI imagery by assessing the land and soil characteristics based on the land suitability parameters for planting paddy. Soil characteristics such as texture, acidity level, P205 (phosphor) and C-organic level collected from field work and terrain characteristics such as landform, surface water, and drainage density from visual delineation of SRTM 90 m was collected as inputs for the decision tree analysis to map the repetition of paddy planting throughout the year. The results showed the overall accuracy of 85% ± 8% (95 % level of confidence) for the final paddy rotation map where 2-times paddy per year was mostly found in the study area.
Unusual accessory peroneal muscles, peroneus quartus, peroneus digiti quinti, and their association with peroneus brevis tendon tear
Authors: Dangintawat Pimpimol , Apinun Jirun , Huanmanop Thanasil , Agthong Sithiporn , Akkarawanit Prim , Chentanez Vilai 
Published: September 2019

Abstract

Background
Anatomic variation and supernumerary contents in the superior peroneal tunnel, and the prominence of the retrotrochlear eminence and peroneal tubercle are related to peroneal tendon disorders.

Objectives
To investigate the prevalence, origin, and insertion of accessory peroneal muscles, the prominence of the retrotrochlear eminence and peroneal tubercle, and their association with peroneal tendon tears.

Methods
We examined 109 formalin-embalmed legs of cadavers from Thai donors. Accessory peroneal muscles and peroneal tendon tears were noted. Associations with peroneal tendon tears were evaluated using a χ2 test.

Results
We found 48 accessory peroneal muscles comprising 13 peroneus quartus (PQ), 33 peroneus digiti quinti (PDQ), and 2 unusual muscles. All PDQ originated from the PB tendon and inserted on various parts of the 5th toe. The PQ originated mostly from the PB muscle belly and less from the tendinous part with various insertions on the retrotrochlear eminence, peroneal tubercle, cuboid, and dorsolateral surface of the 5th metatarsal base. Two unusual accessory muscles were identified, 1 coexisting with the PQ. A PB tendon tear was found in 13% of specimens. We found no association between the peroneal tendon tears and the accessory peroneal muscles, or prominence of the retrotrochlear eminence or peroneal tubercle.

Conclusions
The prevalence of PQ, PDQ, and unusual accessory peroneal muscles was concordant with previous findings. We noted a new type of unusual accessory peroneal muscle coexisting with the PQ. No association was found between peroneal tendon tears and the PQ, PDQ, or prominence of the retrotrochlear eminence or peroneal tubercle.
Practical approach to method verification in plasma and validation in cerebrospinal fluid under accreditation using a flexible scope in molecular virology: setting up the HIV, HBV and HCV Aptima™ Quant Dx assays
Authors: Lefeuvre Caroline , Pivert Adeline , Tran Cong T. , Lunel-Fabiani Françoise , Ducancelle Alexandra , Le Guillou-Guillemette Hélène 
Published: September 2019

AbstractBackgroundOur laboratory obtained the ISO 15189 accreditation for the plasmatic HIV-1, HBV and HCV viral load (VL) using the m2000 RealTime™ system, which was recently changed for the platform Panther®. Here, we discuss a strategy for performing method validation/verification very quickly.MethodsWe performed the mandatory (repeatability, internal quality assessment [IQA], measurement uncertainty [MU]) and optional technical verifications for CE/IVD assays using the flexible scope range A. We also performed the mandatory assays for the validation of HIV-1 VL in the cerebrospinal fluid (CSF) using the flexible scope range B. The change was checked by following up on the turnaround time (TAT).ResultsThe coefficient of variation (CV%) for repeatability and IQA complied with the limit of 0.25 log. The MU results ranged from 0.04 to 0.25 log copies or IU/mL. The comparisons of methods showed excellent correlations (R2 = 0.96 for the three parameters) but a delayed centrifugation on HCV VL showed variations of up to 2 log IU/mL. An excellent linearity for HIV-1 in the CSF was obtained from 1.5 to 5 log copies/mL with R2 = 0.99. The TAT increased (84%–98%) in routine usage.ConclusionsThe three Aptima assays are well suited for routine laboratory use and can be integrated within less than 2 weeks in accordance with flexible scope range A. Our data allows us to confidently perform HIV-1 VL in CSF following flexible scope range B. Finally, we provide an organizational guide for flexible scope management in molecular virology within a short time frame.
Pre-, post- or no acidification of urine samples for calcium analysis: does it matter?
Authors: Chenevier-Gobeaux Camille , Rogier Marie , Dridi-Brahimi Imane , Koumakis Eugénie , Cormier Catherine , Borderie Didier 
Published: September 2019

Abstract

Background
Measuring 24 h-urine calcium concentration is essential to evaluate calcium metabolism and excretion. Manufacturers recommend acidifying the urine before a measurement to ensure calcium solubility, but the literature offers controversial information on this pre-analytical treatment. The objectives of the study were (1) to compare pre-acidification (during urine collection) versus post-acidification (in the laboratory), and (2) to evaluate the impact of acidification on urinary calcium measurements in a large cohort.

Methods
We evaluated the effects of pre- and post-acidification on 24-h urine samples collected from 10 healthy volunteers. We further studied the impact of acidification on the calcium results for 567 urine samples from routine laboratory practice, including 46 hypercalciuria (≥7.5 mmol/24 h) samples.

Results
Calciuria values in healthy volunteers ranged from 0.6 to 12.5 mmol/24 h, and no statistical significance was found between non-acidified, pre-acidified and post-acidified conditions. A comparison of the values (ranging from 0.21 to 29.32 mmol/L) for 567 urine samples before and after acidification indicated 25 samples (4.4%) with analytical differences outside limits of acceptance. The bias observed for these deviant values ranged from −3.07 to 1.32 mmol/L; no patient was re-classified as hypercalciuric after acidification, and three patients with hypercalciuria were classified as normocalciuric after acidification. These three deviant patients represent 6.5% of hypercalciuric patients.

Conclusions
Our results indicate that pre- and post-acidification of urine is not necessary prior to routine calcium analysis.
DOAC-Remove abolishes the effect of direct oral anticoagulants on activated protein C resistance testing in real-life venous thromboembolism patients
Authors: Kopytek Magdalena , Ząbczyk Michał , Malinowski Krzysztof P. , Undas Anetta , Natorska Joanna 
Published: September 2019

Abstract

Background
Direct oral anticoagulants (DOACs) may cause false results of activated protein C resistance (APC-R) ratio. DOAC-Remove, a new reagent based on activated carbon, has been designed to eliminate the interference of DOACs on coagulation assays. The aim of the study was to investigate whether the use of DOAC-Remove enables to determine APC-R in patients treated with DOACs.

Methods
We assessed 74 venous thromboembolism (VTE) patients, including 25 on rivaroxaban, 25 on apixaban and 24 taking dabigatran. APC-R was determined using the Russell Viper Venom Time (RVVT)-based clotting test. APC-R and DOAC concentrations were tested at baseline and following DOAC-Remove. Thrombophilia, including factor V Leiden (FVL) mutation was tested.

Results
FVL mutation was found in 20 (27%) patients. The APC-R ratio at baseline was measurable in 43 patients (58.1%), including 20 (80%) on rivaroxaban, 19 (76%) on apixaban and four (16.7%) on dabigatran. In patients with measurable APC-R at baseline, the ratio >2.9 was found in 23 patients (53.5%). In 16 (37.2%) subjects APC-R ratio <1.8 suggested FVL mutation which was genetically confirmed. Four (9.3%) FVL carriers on dabigatran showed negative/equivocal APC-R results. In 11 (14.9%) patients taking rivaroxaban or apixaban, in whom blood was collected 2–5 h since the last dose, we observed unmeasurable APC-R. DOAC-Remove almost completely eliminated all plasma DOACs. After addition of DOAC-Remove all APC-R ratios were measurable. In four FVL carriers on dabigatran with false negative APC-R, DOAC-Remove resulted in APC-R ratios <1.8.

Conclusions
DOAC-Remove effectively reduces DOACs concentration in plasma, which enables FVL testing using APC-R.
Inter-individual variability of EEG features during microsleep events
Authors: Golz Martin , Schenka Adolf , Haselbeck Florian , Pauli Martin Patrick 
Published: September 2019

Abstract
This paper examines the question of how strongly the spectral properties of the EEG during microsleep differ between individuals. For this purpose, 3859 microsleep examples were compared with 4044 counterexamples in which drivers were very drowsy but were able to perform the driving task. Two types of signal features were compared: logarithmic power spectral densities and entropy measures of wavelets coefficient series. Discriminant analyses were performed with the following machine learning methods: support-vector machines, gradient boosting, learning vector quantization. To the best of our knowledge, this is the first time that results of the leave-one-subject-out cross-validation (LOSO CV) for the detection of microsleep are presented. Error rates lower than 5.0 % resulted in 17 subjects and lower than 13 % in another 11 subjects. In 3 individuals, EEG features could not be explained by the pool of EEG features of all other individuals; for them, detection errors were 15.1 %, 17.1 %, and 27.0 %. In comparison, cross validation by means of repeated random subsampling, in which individuality is not considered, yielded mean error rates of 5.0 ± 0.5 %. A subsequent inspection of raw EEG data showed that in two individuals a bad signal quality due to poor electrode attachment could be the cause and in one individual a very unusual behavior, a high and long-lasting eyelid activity which interfered the recorded EEG in all channels.
Relationship between core body temperature and heart rate variability in an ultrashort sleep-wake schedule
Authors: Heinze Christian , Golz Martin 
Published: September 2019

Abstract
The circadian rhythm that drives the human sleepwake cycle manifests itself in the variation of the core body temperature (CBT). Measuring CBT continuously, however, is intricate. Heart rate and its variability also varies notably over the course of the day, but is more accessible to measure. We present first results from a study that investigates the biorhythmic relationship between the circadian rhythm of CBT and measures of heart rate variability (HRV). Twelve subjects participated in a 50-hour experiment that was segmented into one hundred 30-minute blocks. In each block, subjects attempted to sleep for ten minutes. CBT and the ECG were continuously recorded. To date, intervals between successive heart beats (RR intervals) were determined for three subjects. From RR intervals of each attempted-sleep episode, power spectral densities (PSD) were estimated with the Lomb-Scargle periodogram and averaged into 0.02-Hz wide bands. The periodogram of each RR-frequency-band time series was estimated and compared against the periodogram of CBT, which, as expected, shows a dominant maximum at a period length of 24 hours. Mutual information, an entropy-based measure of interdependence, was used for the comparison. The highest coherence towards CBT was found for the RR-PSD between 0.24 and 0.34 Hz. This RR-PSD range usually includes the respiratory rate, which may indicate that heart rate is more closely linked to respiration at certain times of the day than at others.
Heart Rate Variability Analysis During Lower Body Negative Pressure Test Induced Central Hypovolemia
Authors: Tigges Timo , Bajrami Lorik , Pielmuş Alexandru-Gabriel , Klum Michael , Orglmeister Reinhold , Wiegank Ludwig , Feldheiser Aarne 
Published: September 2019

Abstract
In clinical patient monitoring scenarios, the detection of hemorrhage is still a major problem. Traditional vital signs like heart rate and blood pressure are insensitive to blood loss due to compensatory mechanisms in the body that can sustain these parameters until shortly before cardiovascular collapse. These compensatory mechanisms during blood loss are primarily driven by the autonomic nervous system. Heart rate variability analysis is a viable tool in the quantitative analysis of the autonomic nervous system and shows promising results in the context of hypovolemia detection. In order to investigate if HRV parameters suitably reflect a mild to moderate blood volume reduction, we conducted a lower body negative pressure test study with 30 volunteering participants thereby simulating progressive central hypovolemia. Here, HRV parameters from the time domain (mean HR, SDNN, RMSSD, rSDRM, pNN50), the frequency domain (VLF, LF, HF, LF/HF), non-linear HRV parameters (SD1, SD2, SD1/SD2, SampEn, ApEn) and the respiratory rate (RR) were collected. The changes of the evaluated parameters as a consequence of the reduced blood volume were statistically evaluated. A statistically significant deviation from their baseline values could be found for RMSSD, rSDRM, pNN50, HF, LF/HF, SD1 and SD1/SD2 at a chamber pressures starting at −30 mmHg. Therefore, we support the proposition that heart rate variability analysis can help in detecting otherwise occult hypovolemia.