bluuebunny/crossref_metadata_2025_split huggingface dataset:
Explicit-implicit dual stream network for image quality assessment
Authors: Yang Guangyi , Ding Xingyu , Huang Tian , Cheng Kun , Jin Weizheng 
Published: October 2020

AbstractCommunications industry has remarkably changed with the development of fifth-generation cellular networks. Image, as an indispensable component of communication, has attracted wide attention. Thus, finding a suitable approach to assess image quality is important. Therefore, we propose a deep learning model for image quality assessment (IQA) based on explicit-implicit dual stream network. We use frequency domain features of kurtosis based on wavelet transform to represent explicit features and spatial features extracted by convolutional neural network (CNN) to represent implicit features. Thus, we constructed an explicit-implicit (EI) parallel deep learning model, namely, EI-IQA model. The EI-IQA model is based on the VGGNet that extracts the spatial domain features. On this basis, the number of network layers of VGGNet is reduced by adding the parallel wavelet kurtosis value frequency domain features. Thus, the training parameters and the sample requirements decline. We verified, by cross-validation of different databases, that the wavelet kurtosis feature fusion method based on deep learning has a more complete feature extraction effect and a better generalisation ability. Thus, the method can simulate the human visual perception system better, and subjective feelings become closer to the human eye. The source code about the proposed EI-IQA model is available on githubhttps://github.com/jacob6/EI-IQA.
Flip & Pair – a strategy to augment a blended course with active-learning components: effects on engagement and learning
Authors: Kannan Vijayanandhini , Kuromiya Hiroyuki , Gouripeddi Sai Preeti , Majumdar Rwitajit , Madathil Warriem Jayakrishnan , Ogata Hiroaki 
Published: October 2020

AbstractBlended learning technique has adapted many new digitized tools to facilitate students with flexible and self-phased learning opportunities. The flipped classroom strategy, one of the blended learning models has been limited by low engagement of students in the online component. In the present study, we augment a Flip and Pair (F&P), an active-learning strategy into the blended learning course. Following the AB type single group quasi-experimental design, we evaluated the effects of F&P strategy on the student’s engagement and learning while orchestrating it for an undergraduate engineering physics course. Our results highlighted that there is a positive correlation between the engagement (computed based on learning logs of TEEL (Technology-enhanced and Evidence-based Education and Learning) platform in the F&P activities with that of the performance score (knowledge quizzes and final exam). F&P strategy had a better contribution compared to Flip and Traditional Teaching (F&TT) strategy with respect to both engagement and performance. Also, students exhibited a positive perception of learning and engagement. Based on our findings, we identified the key instructional measures that an instructor can follow to increase student engagement while using the F&P strategy.
Intensified hemodialysis for complicated pregnancy in a primigravida with advanced maternal age: a case report with literature review focusing on appropriate hemodialysis management during pregnancy
Authors: Arai Hiroyuki , Mori Keita P. , Yokoi Hideki , Mizuta Ken , Ogura Jumpei , Suginami Ko , Endo Tomomi , Ikeda Yoshihiro , Matsubara Takeshi , Tsukamoto Tatsuo , Yanagita Motoko 
Published: October 2020

Abstract
Background
Pregnancy in dialysis patients is rare but challenging both for nephrologists and obstetricians. Although intensified hemodialysis is effective to achieve favorable clinical outcomes in this clinical setting, the evidence concerning reliable parameters for the optimal dialysis prescription is scarce. Herein, we report a case of a primigravida with advanced maternal age who underwent a normal spontaneous vaginal delivery at full term managed by intensified hemodialysis, and discuss reliable indicators of the appropriate dialysis prescription.

Case presentation
A 39-year-old primigravida with end-stage renal disease was referred to our department for hemodialysis management during pregnancy. She had a history of multiple gynecologic disorders, including cervical dysplasia, right tubal ectopic pregnancy and spontaneous abortion; consequently, she conceived through in vitro fertilization and embryo transfer. After pregnancy was confirmed, an intensified hemodialysis schedule with weekly duration of 36 hours was employed to prevent volume overload and the accumulation of hyperosmotic substances. Utilizing maternal blood pressure, plasma atrial natriuretic peptide levels and fetal development as indicators of volume status, we incremented her dry weight by 300–400 g per week in the first and second trimester and 100–200 g per week in the third trimester, respectively. Serum urea nitrogen levels were persistently maintained below 50 mg/dL. Throughout pregnancy, fetal growth and development were within normal limits. At 38 weeks and 3 days of gestation, she delivered a healthy child vaginally without complications. To date, the child’s development has been normal, both physically and mentally.

Conclusions
Pregnancy in dialysis patients with advanced age that leads to a normal childbirth is exceptionally rare. Our case is the hemodialysis patient with the most advanced age who achieves a normal spontaneous vaginal delivery at full term. Considering that cardiovascular system and endogenous metabolism dynamically alter during pregnancy, various clinical parameters should be closely monitored to modify dialysis settings accordingly. Of note, our case suggests that plasma atrial natriuretic peptide level is a useful parameter for the appropriate dry weight. Intensified hemodialysis is an effective and reliable measure that can achieve normal pregnancy in dialysis patients, even in a primigravida with advanced maternal age.
Prevent Cancer Foundation quantitative CT imaging workshop XVI: lung cancer, COPD and cardiovascular disease - on the cusp of transformation, Arlington, VA
Authors: Mulshine James L. , Avila Riccardo S. , Sullivan Daniel C. , Yankelevitz David F. , San José Estépar Raúl , Ambrose Laurie Fenton , Pyenson Bruce , Aldigé Carolyn R. 
Published: October 2020

AbstractThroughout the course of this Workshop, members of the advocacy community, imaging researchers, computer and measurement scientists, clinicians and policy-focused workshop attendees engaged in cross-cutting discussions from innovative technical aspects of thoracic imaging to policy approaches to ensure equitable access to all at-risk individuals when implementing lung cancer screening services. A major aspect of these implementation discussions was how to efficiently collect routine thoracic CT-based screening with de-identified clinical outcomes data to support the development of robust imaging tools, including responsible AI development, to better detect and manage early lung cancer as well as other major tobacco-related thoracic diseases. A future vision involves routinely collecting a substantial fraction of every thoracic screening CT image to establish a large, curated collection of de-identified thoracic CT images with clinical outcome data to support open research for building better computational imaging tools for early thoracic disease management. Imaging researchers are positioned to develop much better workflow software tools to promote more efficient, outpatient management of the screening process for populations at-risk for lung cancer, especially with the rapid development of promising AI tools. Efficient and effective management tools for the large numbers of at-risk ever smokers could allow the primary care community to discuss lung cancer screening despite their heavy existing clinical demands. Supporting the primary care community in this fashion may significantly improve the current slow uptake of lung cancer screening and save many lives in the process.
Auditory fatigue among call center operators with headset
Authors: Afifi Pretty Omar , Abdel Rahman Tayseer Taha Tayseer , Khafagy Ahmed Gamal 
Published: October 2020

Abstract
Background
To assess whether call center operators are subject to or suffer from any auditory fatigue when compared to normal subjects. A prospective case-control study where twenty-eight call center operators (10 females and 18 males) with an age range from 25 to 46 years and twenty controls (12 females and 8 males) with an age range from 23 to 44 years were included. All call center operators use a headset for up to 8 h daily for a minimum of two consecutive years. Audiological assessments were done to all participants that included pure tone audiometry (PTA), speech audiometry, tympanometry, and acoustic reflexes. Moreover, transient-evoked otoacoustic emission (TEOAE) absolute threshold and distortion product otoacoustic emission (DPOAE) signal to noise thresholds as well as contralateral suppression of TEOAEs and DPOAEs were recorded for both groups.

Results
There was no significant variation in auditory performances detected with either PTA or OAE (TEOAEs and DPOAEs) test. Besides, there was no statistically significant difference in OAEs (TEOAEs and DPOAEs) with contralateral suppression for both the call center operators and control groups. However, call center operators expressed a feeling of tiredness.

Conclusions
There was no detectable central or peripheral auditory fatigue experienced by the call center operators when using headsets. However, their sensation of auditory fatigue could be due to cognitive fatigue rather than noise-induced fatigue.
Postoperative Day 1 Morning Cortisol Value as a Biomarker to Predict Long-term Remission of Cushing Disease
Authors: Wang Fang , Catalino Michael P , Bi Wenya Linda , Dunn Ian F , Smith Timothy R , Guo Yunlei , Hordejuk Dawid , Kaiser Ursula B , Laws Edward R , Min Le 
Published: October 2020

Abstract

Context
Recurrence of Cushing disease (CD) can occur even decades after surgery. Biomarkers to predict recurrence of CD after surgery have been studied but are inconclusive.

Objective
The aim of our study was to identify specific biomarkers that can predict long-term remission after neurosurgery.

Design
Identification of specific biomarkers to predict long-term remission of CD was performed by logistic regression analysis followed by Kaplan–Meier survival analysis, using recurrence as the dependent variable.

Setting
A total of 260 patients with CD identified from our institutional research patient data registry search tool and from patients who presented to our longitudinal multidisciplinary clinic between May 2008 and May 2018 underwent statistical analysis.

Interventions
Data on clinical features, neuro-imaging study, pathology, biochemistry, and treatments were collected by reviewing digital chart records.

Main Outcome Measure
Postoperative cortisol as a biomarker to predict long-term remission after surgical treatment for CD.

Results
By logistic regression analysis, postoperative day 1 (POD1) morning (5-10 am) serum cortisol, female sex, and proliferative index had significant association with CD recurrence (odds ratio [OR] = 1.025, 95% CI: 1.002-1.048, P = .032). In contrast, the postoperative nadir cortisol (OR = 1.081, 95% CI: 0.989-1.181, P = .086), urinary free cortisol (OR = 1.032, 95% CI: 0.994-1.07, P = .098), and late night salivary cortisol (OR = 1.383, 95% CI: 0.841-2.274, P = .201) had no significant correlation with recurrence. A significant association between POD1 morning serum cortisol and long-term CD remission was verified by Kaplan–Meier analysis when using POD1 morning serum cortisol &lt;5 μg/dL as the cut-off.

Conclusions
The POD1 morning serum cortisol level has a significant association with CD recurrence.
Efficacy and Safety of Thermal Ablation for Solitary T1bN0M0 Papillary Thyroid Carcinoma: A Multicenter Study
Authors: Cao Xiao-Jing , Liu Juan , Zhu Ya-Lin , Qi Lu , Liu Geng , Wang Hong-Ling , Wang Zhong-Hua , Zhou Ying , He Jun-Feng , Guo Jian-Qin , Shi Li-Li , Jian Mei , Shataer Aini , Yan Guo-Zhen , Zhao Zhen-Long , Wei Ying , Peng Li-Li , Li Yan , Che Ying , Wang Shu-Rong , Yu Ming-An 
Published: October 2020

Abstract

Background
Ultrasound-guided thermal ablation plays an important role in the management of thyroid disease. The objective of this study was to evaluate the feasibility, efficacy, and safety of thermal ablation for patients with solitary T1bN0M0 papillary thyroid carcinoma (PTC) who are ineligible for or unwilling to undergo surgery.

Materials and Methods
Data pertaining to 172 patients (38 males and 134 females) who received thermal ablation therapy at 12 hospitals between April 2015 and March 2020 were retrospectively analyzed. The mean duration of follow-up was 24.9 ± 14.1 months (range, 12–60). The technical feasibility, technical success, efficacy, and safety of treatment were analyzed. Postablation tumor size at various time points was compared with preablation measurement.

Results
All patients selected for thermal ablation received enlarged ablation, according to contrast-enhanced ultrasound postablation. The maximum diameter and volume of ablation zone at 6, 12, 18, 24, 36, and 48 months postablation were significantly smaller than those recorded preablation (P &lt; 0.05 for all). At the most recent follow-up, 106 (61.6%) tumors had completely disappeared. The rate of lymph node metastasis was 0.6% (1/172) and the incidence of new tumors was 1.2% (2/172). The overall complication rate was 5.2% (9/172) (major complications: 4.6% [8/172]; minor complications: 0.6% [1/172]). All major complications were relieved within 4 months postablation.

Conclusion
Thermal ablation may be a feasible, effective, and safe treatment option for patients with solitary T1bN0M0 PTC who are ineligible for or unwilling to undergo surgery. It may provide a novel treatment option for selected patients.
Adrenal Insufficiency at the Time of COVID-19: A Retrospective Study in Patients Referring to a Tertiary Center
Authors: Carosi Giulia , Morelli Valentina , Del Sindaco Giulia , Serban Andreea Liliana , Cremaschi Arianna , Frigerio Sofia , Rodari Giulia , Profka Eriselda , Indirli Rita , Mungari Roberta , Resi Veronica , Orsi Emanuela , Ferrante Emanuele , Dolci Alessia , Giavoli Claudia , Arosio Maura , Mantovani Giovanna 
Published: October 2020

AbstractContextCoronavirus disease 2019 (COVID-19) represents a global health emergency, and infected patients with chronic diseases often present with a severe impairment. Adrenal insufficiency (AI) is supposed to be associated with an increased infection risk, which could trigger an adrenal crisis.ObjectiveOur primary aim was to evaluate the incidence of COVID-19 symptoms and complications in AI patients.Design and SettingWe conducted a retrospective case-control study. All patients were on active follow-up and lived in Lombardy, Italy, one of the most affected areas.PatientsWe enrolled 279 patients with primary and secondary AI and 112 controls (patients with benign pituitary lesions without hormonal alterations). All AI patients had been previously trained to modify their replacement therapy on stress doses.InterventionBy administering a standardized questionnaire by phone, we collected data on COVID-19 suggestive symptoms and consequences.ResultsIn February through April 2020, the prevalence of symptomatic patients (complaining at least 1 symptom of viral infection) was similar between the 2 groups (24% in AI and 22.3% in controls, P = 0.79). Highly suggestive COVID-19 symptoms (at least 2 including fever and/or cough) also occurred equally in AI and controls (12.5% in both groups). No patient required hospitalization and no adrenal crisis was reported. Few nasopharyngeal swabs were performed (n = 12), as indicated by sanitary regulations, limiting conclusions on the exact infection rate (2 positive results in AI and none in controls, P = 0.52).ConclusionsAI patients who are adequately treated and trained seem to display the same incidence of COVID-19-suggestive symptoms and disease severity as controls.
An Unusual Cause of Secondary Amenorrhea in an Adolescent: Expanding the Differential
Authors: Okawa Erin R , Gardner Roxanne , Feltmate Colleen , Hirsch Michelle S , Craig Jeffrey W , Chan Yee-Ming 
Published: October 2020

Abstract
Secondary amenorrhea is not uncommon in the adolescent female population. There are multiple etiologies to consider, and a comprehensive evaluation is often pursued. Sometimes, however, despite a thorough workup, the diagnosis remains unclear. Here, we report an unusual cause of secondary amenorrhea in a 15-year-old girl. Our patient presented with secondary amenorrhea after a 4-year history of regular menstrual cycles. Her evaluation was notable for very low FSH and low estradiol but normal LH; pregnancy, adrenal, thyroid, prolactin studies, and brain magnetic resonance imaging scan did not reveal a cause of her amenorrhea. Her transabdominal ultrasound showed an enlarged right ovary, initially suggestive of a hemorrhagic cyst. Inhibin A and B were measured because of the persistently low FSH; these were found to be very elevated, concerning for an inhibin-producing tumor. The patient had surgical removal of her right ovary; pathology revealed a juvenile granulosa-cell tumor. Postoperatively, the patient had normalization of serum inhibin A and B and resumption of normal menstrual cycles. This report illustrates that careful consideration of laboratory findings and other studies is essential for correctly identifying the underlying cause of secondary amenorrhea, particularly when the results are not consistent with common causes of this condition.
The Folding of Trp-cage is Regulated by Stochastic Flip of the Side Chain of Tryptophan
Authors: Yasuda Takunori , Shigeta Yasuteru , Harada Ryuhei 
Published: October 2020

Abstract
Trp-cage is an artificial 20-residue protein and forms a hydrophobic core at its central cage upon folding. In the present study, the folding of Trp-cage was addressed by parallel cascade selection molecular dynamics (PaCS-MD). Our results of PaCS-MD indicate that flip of the side chain of tryptophan (W6) was correlated with the overall folding. In conclusion, flip of stochastic side chain of W6 regulates the folding into the native or mis-folded states of Trp-cage.
International transfer and translation of an end of life care intervention: the case of the Liverpool Care Pathway for the dying patient
Authors: Clark David , Inbadas Hamilton , Seymour Jane 
Published: October 2020

We explore how and why the Liverpool Care Pathway (LCP) for the dying patient was transferred to 20 countries beyond the UK, and with what consequences for policy and practice. Our paper synthesises findings from 95 publications contained in a historical narrative literature review on the implementation of the LCP outside the United Kingdom, alongside data from 18 qualitative interviews with 19 key actors involved with the LCP in 14 countries. We use the review to explore the timelines and patterns of development and implementation in the specific countries, to consider what forms of research and evaluation about the LCP were undertaken to establish its effectiveness, and to summarise the resulting findings and their consequences. We use the interviews to gain insights into the elements, processes and dynamics that shaped the transfer and translation of the LCP from one location to another, across national boundaries. Using six questions from the policy transfer literature we then explain who were the key actors involved; what was transferred; from where lessons were drawn; the different degrees of transfer that took place; what restricted or facilitated transfer; and how transfer was related to ‘success’ or ‘failure’. We conclude that the spread of the LCP took place mostly in prosperous countries, and was sustained over around 15 years. It took in differing geographies and cultures, and a variety of linguistic, policy and practice contexts. If it did not succeed in a wider transformational goal, it appears to have been well received and perceived as beneficial in many contexts, largely avoiding accusations of mis-use and harm that had occurred in the UK, and in some cases fostering a sustained international collaboration and ongoing use of local variants, even after withdrawal in its country of origin in 2014.
Declining antibody levels to Trypanosoma cruzi correlate with polymerase chain reaction positivity and electrocardiographic changes in a retrospective cohort of untreated Brazilian blood donors
Authors: Buss Lewis F. , Campos de Oliveira- da Silva Léa , Moreira Carlos H. V. , Manuli Erika R. , Sales Flavia C. , Morales Ingra , Di Germanio Clara , de Almeida-Neto Cesar , Bakkour Sonia , Constable Paul , Pinto-Filho Marcelo M. , Ribeiro Antonio L. , Busch Michael , Sabino Ester C. 
Published: October 2020

Background
Although infection with Trypanosoma cruzi is thought to be lifelong, less than half of those infected develop cardiomyopathy, suggesting greater parasite control or even clearance. Antibody levels appear to correlate with T. cruzi (antigen) load. We test the association between a downwards antibody trajectory, PCR positivity and ECG alterations in untreated individuals with Chagas disease.

Methodology/Principal findings
This is a retrospective cohort of T. cruzi seropositive blood donors. Paired blood samples (index donation and follow-up) were tested using the VITROS Immunodiagnostic Products Anti-T.cruzi (Chagas) assay (Ortho Clinical Diagnostics, Raritan NJ) and PCR performed on the follow-up sample. A 12-lead resting ECG was performed. Significant antibody decline was defined as a reduction of > 1 signal-to-cutoff (S/CO) unit on the VITROS assay. Follow-up S/CO of < 4 was defined as borderline/low. 276 untreated seropositive blood donors were included. The median (IQR) follow-up was 12.7 years (8.5–16.9). 56 (22.1%) subjects had a significant antibody decline and 35 (12.7%) had a low/borderline follow-up result. PCR positivity was lower in the falling (26.8% vs 52.8%, p = 0.001) and low/borderline (17.1% vs 51.9%, p < 0.001) antibody groups, as was the rate of ECG abnormalities. Falling and low/borderline antibody groups were predominantly composed of individuals with negative PCR and normal ECG findings: 64% and 71%, respectively.

Conclusions/Significance
Low and falling antibody levels define a phenotype of possible spontaneous parasite clearance.
CORPO SEM VONTADE IMERSO EM COISAS VIVAS
Authors: Bastos Helena 
Published: October 2020

Que lugar é dado a vida? Talvez, uma ideia de escuta possa nos afinar sobre que corpo vem se projetando e se intensificando ao nosso alcance. Este texto propõe uma exploração espaço-temporal de percepções que nos invadem enquanto trajetórias espiraladas.
A ação do diálogo como potencia de criação teatral na escola
Authors: Matias Barbara Leite 
Published: October 2020

Esse ensaio apresenta uma possível reflexão através dos conceitos do educador brasileiro Paulo Freire em conexão com a ação do ensino teatral. Tendo como mote jogos e improvisação compartilhado na escola pública foi possível experimentar nesse cotidiano como os conceitos intrínsecos a prática e filosofia do trabalho do ator se aproximam da perspectiva de educação de Freire, nesse sentido buscará também refletir como é possível verificar e aplicar esses procedimentos de atuação teatral através do cotidiano escolar e a partir essencialmente da troca entre os educandos e educador.
Palavras Chave: Teatro na escola, processo criativo, Diálogo.