bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors influencing delayed presentation of breast cancer at a tertiary care hospital in Pakistan
Authors: Baig Mehreen , Sohail Iram , Altaf Humera Naz , Altaf Omar Shahzad 
Published: October 2018

AbstractBackgroundBreast cancer is the leading cause of death despite the continuous development of newer and more effective modalities of treatment for breast cancer. In Asia, Pakistan has the highest rate of breast cancer. Breast cancer treatment shows better prognosis when it is diagnosed at an early stage, but mortality increases significantly with delayed diagnosis and advanced stage of disease. Delay in diagnosis and nonavailability of treatment are the major factors responsible for advanced stage and low survival.AimsThe objective of our study was to identify the factors responsible for delayed presentation of patients with breast carcinoma.Methods and resultsA cross‐sectional study using a questionnaire method was conducted at the Foundation University Medical College from January 2015 to December 2016. A total of 89 patients gave consent and were interviewed using a prestructured questionnaire during the study. Age ranged from 25 to 64 years. Majority of patients were in stage T3N1M0 (31.5%). Second most common stage was T4N0M0 (14.6%). Thirteen patients (12.4%) were in stage T3N0M0, and 10 patients (11.2%) were in T3N2M0. Delay ranged from 3 months to more than 1 year; 43.8% presented with delay of 3 to 6 months. The reasons for delay were lack of knowledge about breast cancer (41%), lack of availability of health care services (32.6%), purdah and religious reasons (6.7%), and fear of being diagnosed with cancer (10.1%).ConclusionThe main reasons for delay identified in our study were lack of knowledge and availability of appropriate health care facilities. In order to improve outcome of breast cancer, more focus is needed on spreading awareness and improving health care services in rural areas.
Partially Reversible Thermal‐Induced Oxidation During a Dehydration Process in an H‐bonded Supramolecular System
Authors: Ferlay Sylvie , Hellwig Petra , Wais Hosseini Mir 
Published: October 2018

AbstractThe thermal behaviour of an H‐bonded molecular network A based on [FeII(CN)6]4− anions and organic bisamidium cations 12+ was investigated. Heating was found to induce the partial oxidation of [FeII(CN)6]4− into [FeIII(CN)6]3−, together with a thermochromic effect and also a loss of crystallinity was evidenced from mid and far FT‐IR spectroscopic data, XRPD and DSC/TGA analysis. Rehydration also partially reversed the redox reaction and its colour, and after that, a mixture of A with an amorphous phases was observed. FT‐IR spectroscopy revealed that the oxidation of Fe(II) was accompanied by a deprotonation of the cation.
Radiotherapy modality as a predictor of survival in hypopharyngeal cancer
Authors: Kılıç Suat , Kılıç Sarah S , Hsueh Wayne D , Eloy Jean Anderson , Baredes Soly , Woo Park Richard Chan , Mahmoud Omar 
Published: October 2018

AbstractBackgroundThe impact of radiotherapy (RT) modality and dose on survival in hypopharyngeal cancer managed with definitive RT is unclear.MethodsThe National Cancer Database was queried for patients with hypopharyngeal squamous cell carcinoma (HPSCC) treated with definitive RT. Intensity‐modulated radiotherapy (IMRT) was compared with other RT techniques. Clinicopathologic variables, RT modality, and dose impact on overall survival (OS) were assessed using log‐rank test and Cox proportional hazard models.ResultsA total of 3928 patients with HPSCC were identified. Patients receiving IMRT (2098 patients) were more likely to be white, have higher income, have advanced classification, receive ≥66 Gy, and receive chemoradiotherapy compared with those receiving non‐IMRT techniques (1830 patients). The 5‐year OS was 41.9% (95% CI = 39.4%‐44.4%) for the IMRT group and 36.8% for the non‐IMRT group (95% CI = 34.3%‐39.2%). After propensity score matching, IMRT had significantly better OS (P = .013).ConclusionIn HPSCC treated with definitive RT, IMRT may provide a significant survival benefit over non‐IMRT modalities.
The optimal hedge strategy of crude oil spot and futures markets: Evidence from a novel method
Authors: Zhao Lu‐Tao , Meng Ya , Zhang Yue‐Jun , Li Yun‐Tao 
Published: October 2018

AbstractHedging is an important measure for investors to resist extreme risks and improve their profits. This paper develops a FIGARCH–EVT–copula–VaR model to derive hedge ratio when hedging crude oil spot and futures markets, overcoming the limitations of static models and simple dynamic models in existing literature. The empirical results indicate that the FIGARCH–EVT–copula–VaR model is superior to the other three commonly used models based on four criteria: mean of returns, variance of returns, ratio of mean to variance of returns, and hedging effectiveness. Comparatively, the new model has superior performance to other three models during the sample period and can be used by investors to obtain excellent hedging effect.
Interrelations of U.S. market fears and emerging markets returns: Global evidence
Authors: Sarwar Ghulam , Khan Walayet 
Published: October 2018

AbstractWe investigate the interrelations between U.S. stock market uncertainty (VIX) and equity returns in several emerging markets (EMs) in an integrated multivariate system that allows the interactions through the first and second moments of VIX and return processes. Our VARMAX‐CCC‐QGARCH model finds significant interactions in the covariance terms of VIX and EM returns, which facilitate risk transmission. Changes in VIX negatively affect EM returns, which also significantly affect VIX changes. We find that VIX changes and EM returns collectively have predictive ability for each other. Further, VIX shocks contribute 22–42% to the prediction error of EM returns. Our results underscore the importance of capturing interactions between VIX changes and EM returns through their variance–covariance matrix and have important implications for global diversification, flight‐to‐safety choices, and hedging the cross‐market risks.
Ownership structure, economic fluctuation, and capital structure: Evidence from China
Authors: Wang Xi , Manry David , Rosa Gina 
Published: October 2018

AbstractWe investigate the influence of controlling shareholders, including governmental ownership, on the debt levels of Chinese firms during varying economic conditions. Consistent with previous research, we find that listed firms in China have significantly more short‐term debt than long‐term debt. We also find that as the percentage ownership of the largest shareholder increases, less debt (as a percentage of total assets) is generally preferred. During economic slowdowns, firms tend to reduce their short‐term debt levels, although long‐term debt appears to increase.Further tests reveal that entrepreneur‐controlled firms reduce long‐term debt during economic slowdowns, suggesting that they take into consideration the implications of changes in macroeconomic conditions for earnings and liquidity when making debt financing decisions. However, we also find that State‐controlled firms in China tend to increase short‐term borrowing during declines in macroeconomic conditions, consistent with the implications of “tunneling and propping.”
Financial liberalization, exchange‐rate regime, and banking crisis likelihood
Authors: Richey Greg M. 
Published: October 2018

AbstractThis paper provides empirical evidence of the impact that financial liberalization plays, within various exchange rate regimes, on the likelihood of systemic banking crisis. Using a sample of 50 banking crisis episodes over the period of 1985–2005, I investigate the impact of financial liberalization and exchange‐rate regime on the likelihood of systemic banking crisis. When interacted with an overall financial liberalization measure, exchange‐rate regime was significant and positive under a flexible regime. Other empirical results show that when interacted with financial liberalization dimensions, exchange‐rate regime variables produced significant results under intermediate and flexible exchange‐rate regimes.
Cancer of the cervix uteri
Authors: Bhatla Neerja , Aoki Daisuke , Sharma Daya Nand , Sankaranarayanan Rengaswamy 
Published: October 2018

AbstractSince the publication of the last FIGO Cancer Report there have been giant strides in the global effort to reduce the burden of cervical cancer, with WHO announcing a call for elimination. In over 80 countries, including LMICs, HPV vaccination is now included in the national program. Screening has also seen major advances with implementation of HPV testing on a larger scale. However, these interventions will take a few years to show their impact. Meanwhile, over half a million new cases are added each year. Recent developments in imaging and increased use of minimally invasive surgery have changed the paradigm for management of these cases. The FIGO Gynecologic Oncology Committee has revised the staging system based on these advances. This chapter discusses the management of cervical cancer based on the stage of disease, including attention to palliation and quality of life issues.
Uterine sarcomas
Authors: Mbatani Nomonde , Olawaiye Alexander B. , Prat Jaime 
Published: October 2018

AbstractUterine sarcomas account for approximately 3%–7% of all uterine cancers. Since carcinosarcomas are currently classified as metaplastic carcinomas, leiomyosarcomas remain the most common subtype. Exclusion of several histologic variants of leiomyoma, as well as atypical smooth muscle tumors (so‐called “smooth muscle tumors of uncertain malignant potential”), has highlighted that the vast majority of leiomyosarcomas are high‐grade tumors associated with poor prognosis even when apparently confined to the uterus. Low‐grade endometrial stromal sarcomas are indolent tumors associated with long‐term survival. High‐grade endometrial stromal sarcomas and undifferentiated endometrial sarcomas behave more aggressively than tumors showing nuclear uniformity. Adenosarcomas have a favorable prognosis except for tumors showing myometrial invasion or sarcomatous overgrowth. The prognosis for carcinosarcomas (which are considered here in a postscript fashion) is usually worse than that for grade 3 endometrial carcinomas. Tumor stage is the single most important prognostic factor for uterine sarcomas.
Targeted therapy for gynecologic cancers: Toward the era of precision medicine
Authors: Basu Partha , Mukhopadhyay Asima , Konishi Ikuo 
Published: October 2018

AbstractRecent advances in molecular biology of cancer have led to the development of targeted agents, mainly of monoclonal antibodies and small‐molecule compounds. Unlike traditional drugs that inhibit DNA synthesis and mitosis, these agents target the signaling pathways of cancer cells, stroma, and vasculature in tumor tissues. For gynecologic cancers, drugs targeting angiogenesis such as anti‐VEGF antibody have been used in the treatment of advanced or recurrent ovarian and cervical cancers, and the drugs targeting homologous recombination deficiency such as PARP inhibitors have been approved for maintenance after chemotherapy in platinum‐sensitive ovarian cancer. In addition, novel immunotherapy using the immune checkpoint inhibitors such as anti‐PD‐1 antibody has received much attention for modulation of local immunity, resulting in the durable response of platinum‐resistant ovarian cancer. In the precision medicine era, further understanding of cancer genomics and identification of predictive biomarkers are essential to ensure better health for women with gynecologic cancer.
Effect of locally tailored clinical guidelines on intrapartum management of severe hypertensive disorders at Zanzibar's tertiary hospital (the PartoMa study)
Authors: Maaløe Nanna , Andersen Camilla B. , Housseine Natasha , Meguid Tarek , Bygbjerg Ib C. , van Roosmalen Jos 
Published: October 2018

AbstractObjectiveTo estimate the effect of locally tailored clinical guidelines on intrapartum care and perinatal outcomes among women with severe hypertensive disorders in pregnancy (sHDP).MethodsA pre–post study at Zanzibar's low‐resource Mnazi Mmoja Hospital was conducted. All labouring women with sHDP were included at baseline (October 2014 to January 2015) and at 9–12 months after implementation of the ongoing intervention (October 2015 to January 2016). Background characteristics, clinical practice, and delivery outcomes were assessed by criterion‐based case file reviews.ResultsOverall, 188 of 2761 (6.8%) women had sHDP at baseline, and 196 of 2398 (8.2%) did so during the intervention months. The median time between last blood pressure recording and delivery decreased during the intervention compared with baseline (P=0.015). Among women with severe hypertension, antihypertensive treatment increased during the intervention compared with baseline (relative risk [RR] 1.37, 95% confidence interval [CI] 1.14–1.66). Among the neonates delivered (birthweight ≥1000 g), stillbirths decreased (RR 0.56, 95% CI 0.35–0.90) and Apgar scores of seven or more increased during the intervention compared with baseline (RR 1.17, 95% CI 1.03–1.33).ConclusionAlthough health system strengthening remains crucial, locally tailored clinical guidelines seemed to help work‐overloaded birth attendants at a low‐resource hospital to improve care for women with sHDP.ClinicalTrials.orgNCT02318420.
DL‐3‐n‐butylphthalide alleviates vascular cognitive impairment by regulating endoplasmic reticulum stress and the Shh/Ptch1 signaling‐pathway in rats
Authors: Niu Xiao‐Li , Jiang Xin , Xu Guo‐Dong , Zheng Gui‐Min , Tang Zhi‐Peng , Yin Nan , Li Xiu‐Qin , Yang Yan‐Yan , Lv Pei‐Yuan 
Published: October 2018

AbstractBackgroundDL‐3‐n‐butylphthalide (NBP) has been approved to be effective in improving cognitive deficits. The aim of the current study was to determine whether NBP protects against cognitive deficits in a rat model of vascular dementia (VD) induced by chronic cerebral hypoperfusion (CCH) by regulating the sonic hedgehog (Shh)/patched1 (Ptch1) pathway and endoplasmic reticulum stress (ERS)‐related markers.MethodsAdult male Sprague‐Dawley rats were subjected to permanent bilateral occlusion of the common carotid arteries (2VO) to established the model of VD. These rats were randomly divided into five groups: sham, model, NBP30 (30 mg/kg), NBP
60 (60 mg/kg), and NBP
120 (120 mg/kg) groups. The Morris water maze test was used to assess for cognitive function at 4 weeks after operation.ResultsNBP significantly alleviated spatial learning and memory impairment, and inhibited the loss of neurons in the CA1 region of the hippocampus. Western blot analysis and real‐time quantitative polymerase chain reaction analysis revealed that plasticity‐related synaptic markers and the Shh/Ptch1 pathway significantly increased in the NBP treated groups, while ERS‐related markers decreased.ConclusionThe results of the current study prove that the Shh/Ptch1 pathway plays an essential role in the model of VD. NBP had protective effects on cognitive impairment induced by CCH. This mechanism was associated with ERS and the Shh/Ptch1 pathway. Meanwhile, the Shh/Ptch1 pathway and ERS may interact with each other.
3D convolutional neural networks for detection and severity staging of meniscus and PFJ cartilage morphological degenerative changes in osteoarthritis and anterior cruciate ligament subjects
Authors: Pedoia Valentina , Norman Berk , Mehany Sarah N. , Bucknor Matthew D. , Link Thomas M. , Majumdar Sharmila 
Published: October 2018

BackgroundSemiquantitative assessment of MRI plays a central role in musculoskeletal research; however, in the clinical setting MRI reports often tend to be subjective and qualitative. Grading schemes utilized in research are not used because they are extraordinarily time‐consuming and unfeasible in clinical practice.PurposeTo evaluate the ability of deep‐learning models to detect and stage severity of meniscus and patellofemoral cartilage lesions in osteoarthritis and anterior cruciate ligament (ACL) subjects.Study TypeRetrospective study aimed to evaluate a technical development.PopulationIn all, 1478 MRI studies, including subjects at various stages of osteoarthritis and after ACL injury and reconstruction.Field Strength/Sequence3T MRI, 3D FSE CUBE.AssessmentAutomatic segmentation of cartilage and meniscus using 2D U‐Net, automatic detection, and severity staging of meniscus and cartilage lesion with a 3D convolutional neural network (3D‐CNN).Statistical TestsReceiver operating characteristic (ROC) curve, specificity and sensitivity, and class accuracy.ResultsSensitivity of 89.81% and specificity of 81.98% for meniscus lesion detection and sensitivity of 80.0% and specificity of 80.27% for cartilage were achieved. The best performances for staging lesion severity were obtained by including demographics factors, achieving accuracies of 80.74%, 78.02%, and 75.00% for normal, small, and complex large lesions, respectively.Data ConclusionIn this study we provide a proof of concept of a fully automated deep‐learning pipeline that can identify the presence of meniscal and patellar cartilage lesions. This pipeline has also shown potential in making more in‐depth examinations of lesion subjects for multiclass prediction and severity staging.Level of Evidence: 2Technical Efficacy: Stage 2J. Magn. Reson. Imaging 2019;49:400–410.
Epstein‐Barr virus, but not human cytomegalovirus, is associated with a high‐grade human papillomavirus–associated cervical lesions among women in North Carolina
Authors: Kienka Tamina , Varga Matthew G. , Caves Josie , Smith Jennifer S. , Sivaraman Vijay 
Published: October 2018

Statement of the problemHuman papillomavirus (HPV) infection is known to contribute to cervical carcinogenesis, yet other cofactors that may contribute to oncogenesis are poorly understood. Herein, we examine whether the Epstein‐Barr virus (EBV) and human cytomegalovirus (CMV), two oncomodulatory viruses, are associated with HPV‐mediated cervical neoplastic progression.MethodsSixty patient cervical brush samples from a study of North Carolina women were obtained. HPV RNA positivity was determined by Aptima testing (Hologic Corporation, Marlborough, MA). The level of viral transcripts for EBV and CMV was quantified (reverse transcription polymerase chain reaction analysis), and the coinfection status with HPV was then compared with the patient's cervical cytology grade.ResultsOver one‐third (38.3%) of the study population was CMV positive, whereas 43.3% was EBV positive. When sample data were stratified by the cytology grade, 36.5% (19/52) of normal patients, 75% (3/4) of low‐grade squamous intraepithelial lesions (LSIL), and 100% (4/4) of patients with high‐grade SIL (HSIL) were EBV positive. Conversely, 35.2% (18/52) of normal patients, 25% (1/4) of patients with LSIL, and 50% (2/4) of patients with HSIL were CMV positive. When examining only HPV positive–associated HSIL, 100% (4/4) were positive for both HPV and EBV detection. This suggests that co‐viral detection with HPV and EBV is associated with more advanced HSIL cervical lesions, while CMV displayed no clear association with a higher grade of cervical cytology.ConclusionsCo‐viral detection with EBV may increase the oncogenicity and/or serve as a viral marker of progression to HPV‐associated high‐grade cervical dysplasia.
On tree‐decompositions of one‐ended graphs
Authors: Carmesin Johannes , Lehner Florian , Möller Rögnvaldur G. 
Published: October 2018

AbstractA graph is one‐ended if it contains a ray (a one way infinite path) and whenever we remove a finite number of vertices from the graph then what remains has only one component which contains rays. A vertex v dominates a ray in the end if there are infinitely many paths connecting v to the ray such that any two of these paths have only the vertex v in common. We prove that if a one‐ended graph contains no ray which is dominated by a vertex and no infinite family of pairwise disjoint rays, then it has a tree‐decomposition such that the decomposition tree is one‐ended and the tree‐decomposition is invariant under the group of automorphisms. This can be applied to prove a conjecture of Halin from 2000 that the automorphism group of such a graph cannot be countably infinite and solves a recent problem of Boutin and Imrich. Furthermore, it implies that every transitive one‐ended graph contains an infinite family of pairwise disjoint rays.
A compact dual circular patch pattern reconfigurable antenna
Authors: Abdulkawi Wazie M. , Malik Waqar A. , Sheta Abdel‐Fattah A. , Alkanhal Majeed A. 
Published: October 2018

AbstractThis paper presents a low‐profile wideband pattern reconfigurable dual circular patch antenna. The basic unit of the antenna is based on the mathematical model of a circular patch antenna design. Although to optimize the large size of the structure, an innovative way of introducing slots is presented that effectively reduces the overall size. Two different types of slotted circular structures are proposed with optimized sizes. The first design is based on L‐slots, while the second is the dual vertical slotted antenna. Both structures are designed and simulated on FR4 and RT‐Duriod 5880 substrates using the EM simulators, IE3D, and HFSS. The optimized antenna structure among the proposed ones has dual circular patches and the pattern reconfigurability is achieved by only two PIN diode switches. Thus, a steering capability of the antenna beam in two different directions at the same resonant frequency is achieved. The antenna covers a wideband of 500 MHz (ie, 1.3‐1.8 GHz) with a high gain of 3.95 and 4.05 dB for both switching cases. To validate the designs, the antennas are fabricated on FR4 epoxy substrate. The measured results are closely related to the simulated results, thus making the design suitable for recent and upcoming multistandard wireless communication systems.
A compact patch antenna with enhanced bandwidth and efficiency on a fishnet metasurface ground plane in extremely low profile
Authors: Wei Juzheng , Deng Xiao , Xu Xiaofei 
Published: October 2018

AbstractA compact patch antenna is proposed in this work which is designed on a fishnet metasurface ground plane. The impedance bandwidth and radiation efficiency are further enhanced for the proposed meta‐antenna, compared with a conventional one. To verify the design, one proof of the conceptual patch antenna is studied on an optimized metasurface ground plane. Simulated and measured results are in good agreement. Measured results show that the meta‐antenna has a compact patch size as 0.22λ0 × 0.22λ0. The measured −10 dB impedance bandwidth is 1.74% and the radiation efficiency is 74%. However for the conventional antenna, the patch size is much larger as 0.31λ0 × 0.31λ0. The bandwidth is only 0.73% and the efficiency is 52%. Prominent enhancement of bandwidth and efficiency has been observed for the meta‐antenna while the patch area has reduced nearly 50% compared with those for a conventional antenna. Note the meta‐antenna substrate thickness is only 0.5 mm (0.0036λ0), the extremely low profile makes it easy to be integrated with other circuit modules for future portable wireless applications.