bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of the analytical performance of the NOVEOS™ System, a system which improves upon the third-generation in vitro allergy testing technology
Authors: Bauersachs Daniel , Potapova Ekaterina , Renz Harald , Benes Stephanie Hagner , Matricardi Paolo Maria , Skevaki Chrysanthi 
Published: June 2020

Abstract

Objectives
Detection of allergen-specific immunoglobulin E (sIgE) is important for the diagnosis of allergy. IgE sensitization is commonly demonstrated in vivo by skin prick testing (SPT), or in vitro utilizing automated systems. Recently, HYCOR® Biomedical launched its new system for allergen sIgE testing called the NOVEOS™ Immunoanalyzer. This study aims to evaluate the analytical performance of the NOVEOS system in a bi-center study at Philipps-University Marburg (Site-1) and Charité Medical University Berlin (Site-2), respectively.

Methods
The analytical performance was evaluated based on the guidelines I/LA20-A3, EP5-A3, EP17-A2, EP6-A, EP7-A3, and EP9-A3 of the Clinical and Laboratory Standards Institute (CLSI).

Results
The conducted repeatability and within-laboratory precision tests provided acceptable performance with 3.0%–11.9% coefficient of variation across both sites. The limit of blank (LoB) and limit of detection (LoD) were <0.1 kU/L at both centers. A within-parameter linearity for all tested allergens was reported at both sites. Of note, no significant interference was observed for high levels of biotin, methylprednisolone, diphenhydramine, omalizumab, or ranitidine. Method comparison between the NOVEOS calibration and the latest World Health Organization (WHO) reference standard showed good agreement at both sites.

Conclusions
The results from the analytical performance of the NOVEOS allergen sIgE assay and instrument testing at both sites were comparable. Overall, a good precision and linearity as well as a detection limit <0.1 kU/L were observed, with minimal impact of common interfering substances on patient recoveries. The NOVEOS is calibrated to the latest WHO reference standard and adds benefits like a small sample size and para-magnetic microparticles that improve upon third-generation allergen sIgE assays’ design and performance.
Popular water pipe smoking, medical sciences students' awareness, perceptions, and motivations
Authors: Salehi Leili 
Published: June 2020

Abstract

Objectives
This study was done to investigate popularity, awareness, perceptions, and motivations regarding water pipe smoking (WPS) among medical sciences students in 2017.

Methods
This cross sectional study was done among 385 medical sciences student in 2017.The systematic random sampling was used to recruit subjects. Multidimensional questionnaire (demographic characteristics, awareness, perceptions, action, and water pipe motivators) was used. t-test, ANOVA, X2, and logistic regression was used to analyze the data by SPSS.

Results
The mean ages of participants were 22 ± 2.64 and 89% were male. The majority of the study sample was from health school. Most participants reported having smoked before. Family entertainment was found to be the most common motivator for WPS. The second one was to be fun. WPS use was significantly associated with age (odds ratio [OR], 0.17; 95% Confidence Interval [CI], 0.04–0.61); awareness (OR, 1.55; 95% CI, 1.35–1.78); and perception (OR, 0.71; 95% CI, 0.65–0.78).

Conclusions
Results show that WPS is very popular among Iranian youth. In designing public health programs, policy makers should consider the motivators for inclination to WPS. Intervention should focus on addressing students' perception and awareness regarding WPS.
Gender-based differences in risk-taking behaviors among high school students in Southeast Iran
Authors: Bahramnejad Ali , Iranpour Abedin , Nakhaee Nouzar 
Published: June 2020

Abstract

Objectives
Risk-taking behaviors among adolescents can negatively affect different dimensions of their health. This study was conducted to identify the gender-based differences in risk-taking behaviors among high school students in a Muslim population.

Methods
Grade 10 students studying in high schools located in Kerman Province, Iran were enrolled through cluster sampling (n=2,676), and data were collected using a well-validated questionnaire about violence, sexual behaviors, and traffic-related conduct over the past 12 months. The tool also consisted questions regarding drug use over the past 30 days and over lifetime (i. e., current and ever use of drugs, respectively)

Results
The number of female participants was 1,407 (52.6%). The boys who had girlfriends (33.0%) were almost twice as many as the girls who had boyfriends (17.1%). Among the respondents, 27.8 and 12.0% of the boys and girls engaged in physical fighting, respectively. Overall, the prevalence of water pipe use in the last 30 days (18.7%) and over lifetime (43.5%) was higher than that of the consumption of other substances. The second and third most popular substances used in the past 30 days among boys and girls were alcohol and cigarettes and cigarettes and alcohol, respectively. On the whole, marijuana figured in the lowest lifetime use among the respondents.

Conclusions
The rate of risk-taking behaviors in female students was lower than in males, and this difference was more evident than in Western countries. This discrepancy seems to be more obvious in cases where the religious prohibition of a behavior is greater such as extramarital intimacy.
Experience of sexual and gender minority youth when accessing health care in Turkey
Authors: Apalı Özge Ceren , Baba İkra , Bayrakcı Fatma , Değerli Deniz , Erden Arda , Peker M. Sacit , Perk Fatma Gül , Sipahi İrem Sibel , Şenoğlu Ezgi , Yılmaz Salih , Zengin Nur Yıldız , Akgül Sinem 
Published: June 2020

Abstract

Objectives
Lesbian, gay, bisexual, transgender and questioning (LGBTQ) patients report alarming rates of identity-based discrimination in healthcare settings. Despite the health risks and challenges impacting LGBTQ young adults, little is known about their healthcare experience, especially in Turkey. This study aimed to increase the knowledge base on LGBTQ young individuals’ experiences when accessing health care in an attempt to address the myriad of health disparities they might face.

Methods
Participants were recruited from the division of Adolescent Medicine at Hacettepe University, and also from an LGBTQ support group. Participants’ responded to open-ended items asking about their experiences in the healthcare setting, in particular to any case of discrimination and reasons for non-disclosure of gender identity/orientation.

Results
A total of 24 LGBTQ youth completed the interview, mean age 21.1 years. Overall participants reported alarming rates of identity-discrimination and non-disclosure when accessing health care. Additionally, participants reported high rates of postponing care as they felt they would be subjected to LGBTQ-based discrimination. Furthermore results suggest that transgender individuals face additional healthcare challenges compared with their LGB and cisgender counterparts.

Conclusions
To the best of our knowledge this is the first study in Turkey to evaluate the experiences of LGBTQ youth accessing medical care. This study shows that similar to barriers observed in previous studies on LGBTQ individuals, discrimination when accessing healthcare is a serious problem. Increasing knowledge concerning the discrimination LGBTQ people face when accessing healthcare is essential to decreasing healthcare disparities.
Intentional learning: a student-centered pedagogy
Authors: Mollman Sarah , Bondmass Mary D. 
Published: June 2020

Abstract

Objective
The objective was to test the assumption that characteristics of intentional learning are not fixed and if an interview assignment enhanced intentional learning.

Methods
In order to meet the needs of practice, nursing educators have trialed student-centered pedagogies, often with resistance from students. Intentional learning appears to mirror the characteristics, such as autonomy, responsibility of one’s own learning, self-regulation, and motivation, needed by students to be successful in student-centered pedagogies. Intentional learning had not been studied in nursing. A quasi-experimental pre/post-test design was used to test intentional learning in nursing students (N=92).

Results
While the interview assignment did not enhance intentional learning scores, intentional learning scores did significantly increase over the semester (p=0.039).

Conclusion
Intentional learning scores did increase, showing that students move along the intentional learning continuum depending on their learning experiences. Future research should include testing teaching strategies that foster intentional learning.
The expression of change-of-state in the Finnic languages
Authors: Norvik Miina 
Published: June 2020

AbstractThe present article studies verbs that are used to conveychange-of-statein the Finnic languages: “to come”, “to go”, “to remain/stay”, “to get”, “will be”, “to make/do”, and “to be born/give birth”. These are polysemous core verbs, which can be expected to be integrated in constructions with (new) generalized grammatical meaning. As will be shown, in order to conveychange-of-statetypically they occur in constructions that either mark the goal and the source or leave both unmarked. In addition, change can be associated with experiential, existential, and possessive constructions, which also enable to shed more light on the development of the above-mentioned verbs, including the possible developmentchange-of-state→future. The article demonstrates that each Finnic language uses several verbs from the list presented above, but there are differences in what are the most commonly used ones and in what kind of constructions they occur. In some languages, there is a generalchange-of-stateverb, which also appears as a future copula if there is no competing future copula. In the case of Estonian, Finnish, and Livonian, the results of previous studies onchange-of-statepredicates were used; for the other Finnic languages, a separate data set was compiled using various collections of texts.
Insulin autoimmune syndrome
Authors: Yukina Marina , Nuralieva Nurana , Solovyev Maksim , Troshina Ekaterina , Vasilyev Evgeny 
Published: June 2020

Summary
Insulin autoimmune syndrome (Hirata’s disease) is a disorder caused by development of autoantibodies to insulin and manifested by hypoglycaemic syndrome. The overwhelming majority of physicians do not include it in the differential diagnosis of hypoglycaemic states because of a misconception of an extremely low prevalence of this condition. This results in unnecessary drug therapy and unjustified surgical interventions in patients that otherwise would be successfully treated conservatively. This disease is strongly associated with certain alleles of the HLA gene. In most cases, this condition develops in predisposed individuals taking drugs containing sulfhydryl groups. Formation of autoantibodies to insulin may be observed in patients with other autoimmune disorders, as well as in those with multiple myeloma or monoclonal gammopathy of undetermined significance. This paper presents the first Russian case report of insulin autoimmune syndrome in an adult patient.

Learning points:

Insulin autoimmune syndrome, Hirata’s disease, anti-insulin antibodies, and hypoglycaemia.
Pituitary apoplexy induced by gonadotropin-releasing hormone agonist administration: a rare complication of prostate cancer treatment
Authors: Barbosa Mariana , Paredes Sílvia , Machado Maria João , Almeida Rui , Marques Olinda 
Published: June 2020

Summary
Gonadotropin-releasing hormone (GnRH) agonists, currently used in the treatment of advanced prostate cancer, have been described as a rare cause of pituitary apoplexy, a potentially life-threatening clinical condition. We report the case of a 69-year-old man with a known pituitary macroadenoma who was diagnosed with prostate cancer and started treatment with GnRH agonist leuprorelin (other hormones were not tested before treatment). Few minutes after drug administration, the patient presented with acute-onset severe headache, followed by left eye ptosis, diplopia and vomiting. Pituitary MRI revealed tumor enlargement and T1-hyperintense signal, compatible with recent bleeding sellar content. Laboratory endocrine workup was significant for low total testosterone. The patient was managed conservatively with high-dose steroids, and symptoms significantly improved. This case describes a rare phenomenon, pituitary apoplexy induced by GnRH agonist. We review the literature regarding this condition: the pathophysiological mechanism involved is not clearly established and several hypotheses have been proposed. Although uncommon, healthcare professionals and patients should be aware of this complication and recognize the signs, preventing a delay in diagnosis and treatment.

Learning points:

Pituitary apoplexy (PA) is a potentially life-threatening complication that can be caused by gonadotropin-releasing hormone agonist (GnRHa) administration for the treatment of advanced prostate cancer.

This complication is rare but should be taken into account when using GnRHa, particularly in the setting of a known pre-existing pituitary adenoma.

PA presents with classic clinical signs and symptoms that should be promptly recognized.

Patients should be instructed to seek medical care if suspicious symptoms occur.

Healthcare professionals should be aware of this complication, enabling its early recognition, adequate treatment and favorable outcome.
When primary hyperparathyroidism comes as good news
Authors: Gallo Daniela , Rosetti Sara , Marcon Ilaria , Armiraglio Elisabetta , Parafioriti Antonina , Pinotti Graziella , Perrucchini Giuseppe , Patera Bohdan , Gentile Linda , Tanda Maria Laura , Bartalena Luigi , Piantanida Eliana 
Published: June 2020

Summary
Brown tumors are osteoclastic, benign lesions characterized by fibrotic stroma, intense vascularization and multinucleated giant cells. They are the terminal expression of the bone remodelling process occurring in advanced hyperparathyroidism. Nowadays, due to earlier diagnosis, primary hyperparathyroidism keeps few of the classical manifestations and brown tumors are definitely unexpected. Thus, it may happen that they are misdiagnosed as primary or metastatic bone cancer. Besides bone imaging, endocrine evaluation including measurement of serum parathyroid hormone and calcium (Ca) levels supports the pathologist to address the diagnosis. Herein, a case of multiple large brown tumors misdiagnosed as a non-treatable osteosarcoma is described, with special regards to diagnostic work-up. After selective parathyroidectomy, treatment with denosumab was initiated and a regular follow-up was established. The central role of multidisciplinary approach involving pathologist, endocrinologist and oncologist in the diagnostic and therapeutic work-up is reported. In our opinion, the discussion of this case would be functional especially for clinicians and pathologists not used to the differential diagnosis in uncommon bone disorders.

Learning points:

Brown tumors develop during the remodelling process of bone in advanced and long-lasting primary or secondary hyperparathyroidism.

Although rare, they should be considered during the challenging diagnostic work-up of giant cell lesions.

Coexistence of high parathyroid hormone levels and hypercalcemia in primary hyperparathyroidism is crucial for the diagnosis.

A detailed imaging study includes bone X-ray, bone scintiscan and total body CT; to rule out bone malignancy, evaluation of bone lesion biopsy should include immunostaining for neoplastic markers as H3G34W and Ki67 index.

If primary hyperparathyroidism is confirmed, selective parathyroidectomy is the first-line treatment.

In advanced bone disease, treatment with denosumab should be considered, ensuring a strict control of Ca levels.
Prenatal Antidepressant Use and Risk of Adverse Neonatal Outcomes
Authors: Bandoli Gretchen , Chambers Christina D. , Wells Alan , Palmsten Kristin 
Published: June 2020

OBJECTIVES:
To estimate the risk of neonatal outcomes from patterns of prenatal antidepressant use.

METHODS:
From the OptumLabs Data Warehouse, 226 932 singleton deliveries were identified. Antidepressant claims with coverage between the last menstrual period and 35 weeks’ gestation were converted to fluoxetine equivalents, and a longitudinal cluster analysis was performed. Outcomes included major cardiac malformations (11.7 of 1000 births), preterm birth (75.7 of 1000 births), and newborn respiratory distress (54.2 of 1000 births). The lowest trajectory was the primary reference group, and depression and anxiety with no antidepressant claims served as secondary reference groups.

RESULTS:
From 15 041 (6.6%) pregnancies exposed to an antidepressant, use patterns were best described as (1) low use (∼10 mg/day) with first-trimester reduction, (2) low sustained use (∼20 mg/day), (3) moderate use (∼40 mg/day) with first-trimester reduction, (4) moderate sustained use (∼40 mg/day), and (5) high sustained use (∼75 mg/day). Moderate sustained use increased the risk of major cardiac malformations, although results included the null when compared with depression or anxiety reference groups. Moderate sustained (adjusted risk ratio [RR] 1.31; 95% confidence interval [CI] 1.16–1.49) and high sustained (adjusted RR 1.78; 95% CI 1.48–2.14) trajectories were associated with an increased risk of preterm birth. All 4 trajectories increased the risk of neonatal respiratory distress in a dose-response fashion (adjusted RRs 1.36 [95% CI 1.20–1.50] to 2.23 [95% CI 1.83–2.77]).

CONCLUSIONS:
Although findings support continuation of the lowest effective dose to treat depression or anxiety, which benefits the mother, they also highlight an increased risk for newborn respiratory distress in all groups and preterm birth at moderate to high sustained doses.
Physical rehabilitation after acute myocardial infarction: focus on body weight
Authors: Bubnova M. G. , Aronov D. M. 
Published: June 2020

Aim. To study the effectiveness of 1-year exercise training (ET) after acute myocardial infarction (AMI) during outpatient cardiac rehabilitation in patients with different body mass index (BMI).Material and methods. The study included 312 patients after AMI, who were randomized into four groups depending on BMI: patients who used ET program with BMI <30 kg/m2 (group 1 (n=78)) and BMI >30 kg/m2 (group 2 (n=78)); patients who did not use ET program with BMI <30 kg/m2 (group 3 (n=78)) and BMI >30 kg/m2 (group 4 (n=78)). ET of moderate intensity (60% of the threshold value) was carried out 3 times a week for a year.Results. In patients with obesity, ET was associated with decrease of blood pressure by 3,3/3,6% (p<0,01 for each) and BMI by 7,7% (p<0,001), while there was an increase by 4,2/3,6% (p<0,05 for each) and 2,1% (p<0,05), respectively, in obese patients without ET. In patients without obesity, ET was associated only with BMI decrease by 3,3% (p<0,01), while in patients without obesity and ET it did not change. Daily physical activity after ET increased regardless of BMI, and without ET it decreased in obese patients. ET was associated with the increase of duration and intensity of training in non-obese patients by 39,2% (p<0,001) and 47,1% (p<0,001), respectively; in obese patients — by 23,8% (p<0,001) and 26,5% (p <0,001), respectively. In control groups it has not changed. After ET with any BMI, the levels of low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) decreased, and the high-density lipoprotein-cholesterol (HDL-C) increased. In the control groups, the concentration of TG increased, and with obesity there was also an increase in LDL-C and a decrease in HDL-C. Against the background of ET, the fibrinogen values decreased with any BMI, in contrast to the control groups. After 1-year ET number of cardiovascular events (CVE) significantly decreased in nonobese patients by 37,5% (p<0,05) and in obese ones by 28,6% (p<0,05).Conclusion. Long-term aerobic ET in patients with any BMI reduced cardiovascular risk factors and the risk of CVE. At the same time, with concomitant obesity, the maximum effect of cardiac rehabilitation was not achieved, which confirms the importance of controlling BMI in patients after AMI.
Automated Conjecturing II: Chomp and Reasoned Game Play
Authors: Bradford Alexander , Day J. Kain , Hutchinson Laura , Kaperick Bryan , Larson Craig , Mills Matthew , Muncy David , Van Cleemput Nico 
Published: June 2020

We demonstrate the use of a program that generates conjectures about positions of the combinatorial game Chomp—explanations of why certain moves are bad. These could be used in the design of a Chomp-playing program that gives reasons for its moves. We prove one of these Chomp conjectures—demonstrating that our conjecturing program can produce genuine Chomp knowledge.
The conjectures are generated by a general purpose conjecturing program that was previously and successfully used to generate mathematical conjectures. Our program is initialized with Chomp invariants and example game boards—the conjectures take the form of invariant-relation statements interpreted to be true for all board positions of a certain kind. The conjectures describe a theory of Chomp positions.
The program uses limited, natural input and suggests how theories generated on-the-fly might be used in a variety of situations where decisions—based on reasons—are required.
Evaluating the Age-Based Recommendations for Long-Term Follow-Up in Breast Cancer
Authors: Witteveen Annemieke , de Munck Linda , Groothuis-Oudshoorn Catharina G.M. , Sonke Gabe S. , Poortmans Philip M. , Boersma Liesbeth J. , Smidt Marjolein L. , Vliegen Ingrid M.H. , IJzerman Maarten J. , Siesling Sabine 
Published: June 2020

Abstract

Background
After 5 years of annual follow-up following breast cancer, Dutch guidelines are age based: annual follow-up for women &lt;60 years, 60–75 years biennial, and none for &gt;75 years. We determined how the risk of recurrence corresponds to these consensus-based recommendations and to the risk of primary breast cancer in the general screening population.

Subjects, Materials, and Methods
Women with early-stage breast cancer in 2003/2005 were selected from the Netherlands Cancer Registry (n = 18,568). Cumulative incidence functions were estimated for follow-up years 5–10 for locoregional recurrences (LRRs) and second primary tumors (SPs). Risks were compared with the screening population without history of breast cancer. Alternative cutoffs for age were determined by log-rank tests.

Results
The cumulative risk for LRR/SP was lower in women &lt;60 years (5.9%, 95% confidence interval [CI] 5.3–6.6) who are under annual follow-up than for women 60–75 (6.3%, 95% CI 5.6–7.1) receiving biennial visits. All risks were higher than the 5-year risk of a primary tumor in the screening population (ranging from 1.4% to 1.9%). Age cutoffs &lt;50, 50–69, and &gt; 69 revealed better risk differentiation and would provide more risk-based schedules. Still, other factors, including systemic treatments, had an even greater impact on recurrence risks.

Conclusion
The current consensus-based recommendations use suboptimal age cutoffs. The proposed alternative cutoffs will lead to a more balanced risk-based follow-up and thereby more efficient allocation of resources. However, more factors should be taken into account for truly individualizing follow-up based on risk for recurrence.

Implications for Practice
The current age-based recommendations for breast cancer follow-up after 5 years are suboptimal and do not reflect the actual risk of recurrent disease. This results in situations in which women with higher risks actually receive less follow-up than those with a lower risk of recurrence. Alternative cutoffs could be a start toward risk-based follow-up and thereby more efficient allocation of resources. However, age, or any single risk factor, is not able to capture the risk differences and therefore is not sufficient for determining follow-up. More risk factors should be taken into account for truly individualizing follow-up based on the risk for recurrence.