bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting dementia diagnosis from cognitive footprints in electronic health records: a case–control study protocol
Authors: Luo Hao , Lau Kui Kai , Wong Gloria H Y , Chan Wai-Chi , Mak Henry K F , Zhang Qingpeng , Knapp Martin , Wong Ian C K 
Published: November 2020

IntroductionDementia is a group of disabling disorders that can be devastating for persons living with it and for their families. Data-informed decision-making strategies to identify individuals at high risk of dementia are essential to facilitate large-scale prevention and early intervention. This population-based case–control study aims to develop and validate a clinical algorithm for predicting dementia diagnosis, based on the cognitive footprint in personal and medical history.Methods and analysisWe will use territory-wide electronic health records from the Clinical Data Analysis and Reporting System (CDARS) in Hong Kong between 1 January 2001 and 31 December 2018. All individuals who were at least 65 years old by the end of 2018 will be identified from CDARS. A random sample of control individuals who did not receive any diagnosis of dementia will be matched with those who did receive such a diagnosis by age, gender and index date with 1:1 ratio. Exposure to potential protective/risk factors will be included in both conventional logistic regression and machine-learning models. Established risk factors of interest will include diabetes mellitus, midlife hypertension, midlife obesity, depression, head injuries and low education. Exploratory risk factors will include vascular disease, infectious disease and medication. The prediction accuracy of several state-of-the-art machine-learning algorithms will be compared.Ethics and disseminationThis study was approved by Institutional Review Board of The University of Hong Kong/Hospital Authority Hong Kong West Cluster (UW 18-225). Patients’ records are anonymised to protect privacy. Study results will be disseminated through peer-reviewed publications. Codes of the resulted dementia risk prediction algorithm will be made publicly available at the website of the Tools to Inform Policy: Chinese Communities’ Action in Response to Dementia project (https://www.tip-card.hku.hk/).
COVID-19 aerosol box as protection from droplet and aerosol contaminations in healthcare workers performing airway intubation: a randomised cross-over simulation study
Authors: Noor Azhar Muhaimin , Bustam Aida , Poh Khadijah , Ahmad Zahedi Ahmad Zulkarnain , Mohd Nazri Mohd Zahir Amin , Azizah Ariffin Mohammad Aizuddin , Md Yusuf Mohd Hafyzuddin , Zambri Aliyah , Chong Johnathan Y O , Kamarudin Anhar , Ang Bin Ting , Iskandar Affan , Chew Keng Sheng 
Published: November 2020

BackgroundConcerns over high transmission risk of SARS-CoV-2 have led to innovation and usage of an aerosol box to protect healthcare workers during airway intubation in patients with COVID-19. Its efficacy as a barrier protection in addition to the use of a standard personal protective equipment (PPE) is not fully known. We performed a simulated study to investigate the relationship between aerosol box usage during intubation and contaminations on healthcare workers pre-doffing and post-doffing of PPE.MethodsThis was a randomised cross-over study conducted between 9 April to 5 May 2020 in the ED of University Malaya Medical Centre. Postgraduate Emergency Medicine trainees performed video laryngoscope-assisted intubation on an airway manikin with and without an aerosol box in a random order. Contamination was simulated by nebulised Glo Germ. Primary outcome was number of contaminated front and back body regions pre-doffing and post-doffing of PPE of the intubator and assistant. Secondary outcomes were intubation time, Cormack-Lehane score, number of intubation attempts and participants’ feedback.ResultsThirty-six trainees completed the study interventions. The number of contaminated front and back body regions pre-doffing of PPE was significantly higher without the aerosol box (all p values<0.001). However, there was no significant difference in the number of contaminations post-doffing of PPE between using and not using the aerosol box, with a median contamination of zero. Intubation time was longer with the aerosol box (42.5 s vs 35.5 s, p<0.001). Cormack-Lehane scores were similar with and without the aerosol box. First-pass intubation success rate was 94.4% and 100% with and without the aerosol box, respectively. More participants reported reduced mobility and visibility when intubating with the aerosol box.ConclusionsAn aerosol box may significantly reduce exposure to contaminations but with increased intubation time and reduced operator’s mobility and visibility. Furthermore, the difference in degree of contamination between using and not using an aerosol box could be offset by proper doffing of PPE.
Efficacy and immune-related adverse event associations in avelumab-treated patients
Authors: Kelly Karen , Manitz Juliane , Patel Manish R , D’Angelo Sandra P , Apolo Andrea B , Rajan Arun , Kasturi Vijay , Speit Isabell , Bajars Marcis , Warth John , Gulley James L 
Published: November 2020

BackgroundAdverse events (AEs) of special interest that arise during treatment with immune checkpoint inhibitors, including immune-related AEs (irAEs), have been reported to be associated with improved clinical outcomes. We analyzed patients treated with avelumab from the JAVELIN Solid Tumor and Merkel 200 trials, examining the association between AEs and efficacy while adjusting for confounding factors such as treatment duration and event order.MethodsWe analyzed efficacy and safety data from 1783 patients treated with the programmed death ligand 1 inhibitor avelumab who were enrolled in expansion cohorts of the JAVELIN Solid Tumor and Merkel 200 trials. To analyze the association between irAEs and efficacy with regard to survival, we used a time-dependent Cox model with time-varying indicators for irAEs, as well as multistate models that accounted for competing risks and time inhomogeneity.Results295 patients (16.5%) experienced irAEs and 454 patients (25.5%) experienced infusion-related reactions. There was a reduced risk of death in patients who experienced irAEs compared with those who did not (HR 0.71, 95% CI 0.59 to 0.85) using the time-dependent Cox model. The multistate model did not suggest that the occurrence of irAEs could predict response; however, it predicted a higher chance of irAEs occurring after a response. No association was observed between response and infusion-related reactions.ConclusionsPatients who experience irAEs showed improved survival. Although irAEs are not predictors for response to immune checkpoint inhibitors, increased vigilance for irAEs is needed after treatment with avelumab.Trial registration numbersNCT01772004 and NCT02155647.
Predictive score for complete occlusion of intracranial aneurysms treated by flow-diverter stents using machine learning
Authors: Guédon Alexis , Thépenier Cédric , Shotar Eimad , Gabrieli Joseph , Mathon Bertrand , Premat Kévin , Lenck Stéphanie , Degos Vincent , Sourour Nader , Clarençon Frédéric 
Published: November 2020

BackgroundComplete occlusion of an intracranial aneurysm (IA) after the deployment of a flow-diverter stent is currently unpredictable. The aim of this study was to develop a predictive occlusion score based on pretreatment clinical and angiographic criteria.MethodsConsecutive patients with ≥6 months follow-up were included from 2008 to 2019 and retrospectively analyzed. Each IA was evaluated using the Raymond–Roy occlusion classification (RROC) and dichotomized as occluded (A) or residual (B/C); 80% of patients were randomly assigned to the training sample. Feature selection and binary outcome prediction relied on logistic regression and threshold maximizing class separation selected by a CART tree algorithm. The feature selection was addressed by a genetic algorithm selected from the 30 pretreatment available variables.ResultsThe study included 146 patients with 154 IAs. Feature selection yielded a combination of six variables with a good cross-validated accuracy on the test sample, a combination we labeled DIANES score (IA diameter, indication, parent artery diameter ratio, neck ratio, side-branch artery, and sex). A score of more than −6 maximized the ability to predict RROC=A with sensitivity of 87% (95% CI 79% to 95%) and specificity of 82% (95% CI 64% to 96%) in the training sample. Accuracy was 86% (95% CI 79% to 94%). In the test sample, sensitivity and specificity were 89% (95% CI 77% to 98%) and 60% (95% CI 33% to 86%), respectively. Accuracy was 81% (95% CI 69% to 91%).ConclusionA score was developed as a grading scale for prediction of the final occlusion status of IAs treated with a flow-diverter stent.
Precessing and periodic motions around a black-bounce/traversable wormhole
Authors: Zhou Tian-Yi , Xie Yi 
Published: November 2020

AbstractWe investigate precessing and periodic geodesic motions of timelike particles around a black-bounce/traversable wormhole. After obtaining its semi-classic and relativistic periastron advance, we find a preliminary bound on the scale length of such a spactime based on the detected precession of the star S2 around the Galactic Center. We also study periodic orbits around it and find that the variation of the scale length can change the taxonomy of the periodic orbits and cause the transition from a periodic orbit to a quasi-periodic one and vice versa.
Myeloma-Modified Adipocytes Exhibit Metabolic Dysfunction and a Senescence-Associated Secretory Phenotype
Authors: Fairfield Heather , Dudakovic Amel , Khatib Casper M. , Farrell Mariah , Costa Samantha , Falank Carolyne , Hinge Maja , Murphy Connor S. , DeMambro Victoria , Pettitt Jessica A. , Lary Christine W. , Driscoll Heather E. , McDonald Michelle M. , Kassem Moustapha , Rosen Clifford , Andersen Thomas L. , van Wijnen Andre J. , Jafari Abbas , Reagan Michaela R. 
Published: November 2020

Abstract

Bone marrow adipocytes (BMAd) have recently been implicated in accelerating bone metastatic cancers, such as acute myelogenous leukemia and breast cancer. Importantly, bone marrow adipose tissue (BMAT) expands with aging and obesity, two key risk factors in multiple myeloma disease prevalence, suggesting that BMAds may influence and be influenced by myeloma cells in the marrow. Here, we provide evidence that reciprocal interactions and cross-regulation of myeloma cells and BMAds play a role in multiple myeloma pathogenesis and treatment response. Bone marrow biopsies from patients with multiple myeloma revealed significant loss of BMAT with myeloma cell infiltration of the marrow, whereas BMAT was restored after treatment for multiple myeloma. Myeloma cells reduced BMAT in different preclinical murine models of multiple myeloma and in vitro using myeloma cell-adipocyte cocultures. In addition, multiple myeloma cells altered adipocyte gene expression and cytokine secretory profiles, which were also associated with bioenergetic changes and induction of a senescent-like phenotype. In vivo, senescence markers were also increased in the bone marrow of tumor-burdened mice. BMAds, in turn, provided resistance to dexamethasone-induced cell-cycle arrest and apoptosis, illuminating a new possible driver of myeloma cell evolution in a drug-resistant clone. Our findings reveal that bidirectional interactions between BMAds and myeloma cells have significant implications for the pathogenesis and treatment of multiple myeloma. Targeting senescence in the BMAd or other bone marrow cells may represent a novel therapeutic approach for treatment of multiple myeloma.

Significance:
This study changes the foundational understanding of how cancer cells hijack the bone marrow microenvironment and demonstrates that tumor cells induce senescence and metabolic changes in adipocytes, potentially driving new therapeutic directions.
Postdiagnostic Dietary Glycemic Index, Glycemic Load, Dietary Insulin Index, and Insulin Load and Breast Cancer Survival
Authors: Farvid Maryam S. , Tamimi Rulla M. , Poole Elizabeth M. , Chen Wendy Y. , Rosner Bernard A. , Willett Walter C. , Holmes Michelle D. , Eliassen A. Heather 
Published: November 2020

Abstract

Background:
We investigated the associations of postdiagnostic dietary glycemic index (GI), glycemic load (GL), insulin index (II), and insulin load (IL) with breast cancer–specific and all-cause mortality.

Methods:
Among 8,932 women with stage I–III breast cancer identified in the Nurses' Health Study (NHS; 1980–2010) and NHSII (1991–2011), we prospectively evaluated the associations between postdiagnostic GI, GL, II, and IL, and breast cancer–specific and all-cause mortality. Participants completed a validated food frequency questionnaire every 4 years after diagnosis.

Results:
During follow-up by 2014 in the NHS and 2015 in the NHSII, 2,523 deaths, including 1,071 from breast cancer, were documented. Higher postdiagnostic GL was associated with higher risk of both breast cancer–specific mortality [HRQ5vsQ1 = 1.33; 95% confidence interval (CI) = 1.09–1.63; Ptrend = 0.008] and all-cause mortality (HRQ5vsQ1 = 1.26; 95% CI = 1.10–1.45; Ptrend = 0.0006). Higher all-cause mortality was also observed with higher postdiagnostic GI (HRQ5vsQ1 = 1.23; 95% CI = 1.08–1.40; Ptrend = 0.001), II (HRQ5vsQ1 = 1.20; 95% CI = 1.04–1.38; Ptrend = 0.005), and IL (HRQ5vsQ1 = 1.23; 95% CI = 1.07–1.42; Ptrend = 0.0003). The associations were not modified by insulin receptor or estrogen receptor status of the tumor, or body mass index.

Conclusions:
We found that higher dietary GL, reflecting postprandial glucose response, after a breast cancer diagnosis was associated with higher risk of breast cancer–specific mortality. Higher dietary GI, GL, II, and IL after a breast cancer diagnosis were associated with higher risk of death from any cause.

Impact:
These results suggest that carbohydrate quantity and quality may be important in breast cancer prognosis.
See related commentary by McTiernan, p. 252
North Korea’s Science and Technology Policy and the Development of Technology-Intensive Industries
Authors: Mah Jai S. 
Published: November 2020

Abstract
The North Korean government declared a pursuit of the Military-First Policy and the Ideology of Focusing on Science and Technology in the late 1990s. It thus made science and technology central to its goal of the Establishment of Strong and Prosperous State. North Korea came to perceive science and technology as engines for promoting both nuclear armament and economic development. The switch of policy attention to science and technology has facilitated the development of some selected technology-intensive industries. In 2017, North Korea declared that it had completed development of nuclear weapons and intercontinental ballistic missiles (ICBMs). Although North Korea’s development of hi-tech arms including nuclear bombs and ICBMs appears inconsistent with its low level of economic development, it can be understood in light of the North Korean government’s emphasis on science and technology and prioritization of the allocation of resources to defense.
Compulsory Vaccination and the Turkish Constitutional Court
Authors: Yıldırım Engin 
Published: November 2020

Abstract
As vaccine hesitancy is on the rise around the world, apex courts in some countries have confronted the difficult task of striking a fair balance between individual rights and the common good. Against this background, the article discusses the compulsory vaccination cases heard by the Turkish Constitutional Court (TCC). The TCC’s case law illustrates that any interference with bodily integrity must first comply with the principle of lawfulness and its rulings addressed an important shortage of the current Turkish compulsory childhood vaccination policy. The article suggests that the principle of lawfulness in compulsory vaccination cases should not be taken lightly, even if it serves compelling public interests.
Using Surveillance Data to Respond to an Outbreak of Congenital Syphilis in Arizona Through Third-Trimester Screening Policies, 2017-2018
Authors: Sykes Kaitlyn J. , Scranton Rebecca A. , Villarroel Lisa , Anderson Bree V. , Salek Sara , Stall Jonathan 
Published: November 2020

Introduction The number of congenital syphilis (CS) cases in Arizona quadrupled from an average of 14 cases annually before 2017 to 61 cases in 2018, and a statewide outbreak was declared. The Arizona Department of Health Services (ADHS) analyzed statewide surveillance data to identify missed opportunities for prevention and collaborated with the Arizona Health Care Cost Containment System (AHCCCS) to inform response activities. Methods ADHS developed a metric to identify missed opportunities for CS prevention during pregnancy by using medical records, vital records, and case investigation notes for all mothers of infants born with CS from January 1, 2017, through June 30, 2018. AHCCCS conducted a cost-effectiveness analysis to calculate the effect of increasing perinatal syphilis screening. Results Arizona had 57 cases of CS during the study period, of which 17 (29.8%) could have been prevented through third-trimester screening for women who were in prenatal care but screened late (n = 9), were infected after their first prenatal visit screen (n = 7), or were reinfected after an initial reactive syphilis test and appropriate treatment and not rescreened (n = 1). The estimated net cost of combining the additional primary (screening) and secondary (treatment) costs of a third-trimester screen for all pregnant AHCCCS members and the estimated total per-year savings of all newborn hospitalizations was $527. Practice Implications Third-trimester syphilis screening could prevent CS in regions where syphilis transmission is high. Partnering with health insurance agencies to evaluate the cost effectiveness of screening recommendations may improve the accuracy of the estimate of the potential cost savings by using insurance agency–specific data for the population at risk for CS.
Prevalence and Correlates of Intimate Partner Violence Experience Among Partners of Naval Personnel in Lagos, Nigeria
Authors: Igwe Chinedu Paul , Yusuf Oyindamola B. , Fawole Olufunmilayo I. 
Published: November 2020

Background Military personnel are one of the high risk groups recognized as perpetrators of intimate partner violence (IPV). Little is known about IPV experience of partners of naval personnel. This study determined the prevalence and correlates of IPV experience among partners of naval personnel. Methods A cross-sectional survey of 435 male and female partners of naval personnel selected using the multistage sampling technique from the Navy Barracks in Lagos, Nigeria was conducted. Data were collected using a 40 item interviewer-administered questionnaire between August and September 2017. Univariate, bivariate and multivariate analysis was done to identify the predictors of partners’ experience of IPV. Analysis was done at p-value ≤0.05. Results The mean age of the respondents was 32.7 ± 7.86yrs and 72% were females. The lifetime prevalence of any IPV experience was 40.7% (with 74.4% of this experienced by females, CI: 0.81–1.91). The prevalence of controlling behaviour, psychological, sexual, economic and physical IPV were 31.5%, 16.3% 12.4%, 12.0% and 8.5% respectively. There was a positive association between experience of IPV and respondents’ occupational status (p < 0.0001), lifetime experience of physical (p < 0.0001), sexual abuse (<0.0001), and history of childhood abuse (p < 0.0001). After adjustment for confounders, age (AOR = 2.11, CI = 1.07–4.16), occupational status (AOR = 4.56, CI = 2.30–9.02), history of childhood abuse (AOR = 2.10, CI = 1.26–3.49,) and partners’ alcohol use (AOR = 3.41, CI = 1.38–8.39) remained significant factors influencing experience of IPV. Conclusion The prevalence of IPV experience among partners of naval personnel was high. Being unemployed, experience of abuse in childhood and having a partner who consumed alcohol increased partners’ vulnerability to IPV. Naval personnel would benefit from marital counseling and training on non-violence conflict resolution strategies.
Ablation therapy using a low dose of radioiodine may be sufficient in low- to intermediate-risk patients with follicular variant papillary thyroid carcinoma
Authors: Li Fuxin , Li Wei , Gray Katherine D. , Zarnegar Rasa , Wang Dan , Fahey Thomas J. 
Published: November 2020

Objectives Follicular variant papillary thyroid carcinoma (FVPTC) is treated similarly to classical variant papillary thyroid carcinoma (cPTC). However, FVPTC has unique tumour features and behaviours. We investigated whether a low dose of radioiodine was as effective as a high dose for remnant ablation in patients with FVPTC and evaluated the recurrence of low-intermediate risk FVPTC. Methods Data from cPTC and FVPTC patients treated with I-131 from 2004 to 2014 were reviewed. Demographics, tumour behaviour, lymph node metastasis, and local recurrence data were compared between FVPTC and cPTC patients. Then, low-intermediate risk FVPTC patients were divided into low, intermediate, and high I-131 dose groups, and postoperative I-131 activities were analysed to evaluate the effectiveness of I-131 therapy for thyroid remnant ablation. Results In total, 799 cases of FVPTC (n = 168) and cPTC (n = 631) treated with I-131 were identified. Patients with FVPTC had a larger primary nodule size than cPTC, but lymph node metastases and local recurrence were more prevalent in cPTC than in FVPTC. For the low-, intermediate-, and high-dose groups, success rates of ablation did not differ (82.0%, 80%, and 81.3%, respectively). Conclusion FVPTC differs from cPTC in behaviour. Low-dose ablation may be sufficient in FVPTC patients with low-intermediate disease risk.
Do Social Inequalities in Smoking Differ by Immigration Status in Young Adults Living in an Urban Setting? Findings From the Interdisciplinary Study of Inequalities in Smoking
Authors: Kalubi Jodi , Tchouaga Zobelle , Ghenadenik Adrian , O’Loughlin Jennifer , Frohlich Katherine L 
Published: November 2020

Objectives: We assessed whether social inequalities in smoking observed among young adults born in Canada were also apparent in same-age immigrants. Methods: Data were drawn from an investigation of social inequalities in smoking conducted in an urban setting (Montreal, Canada). The sample included 2077 young adults age 18 to 25 (56.6% female; 18.9% immigrants who had lived in Canada 11.6 (SD 6.4) years on average). The association between education and current smoking was examined in multivariable logistic regression analyses conducted separately in young adults born in Canada and in immigrants. Results: About 19.5% of immigrants were current smokers compared to 23.8% of young adults born in Canada. In immigrants, relative to those with university education, the adjusted odds ratios (OR) (95% confidence interval) for current smoking were 1.2 (0.6, 2.3) among those with pre-university/vocational training and 1.5 (0.7, 2.9) among those with high school education. In non-immigrants, the adjusted ORs were 1.9 (1.4, 2.5) among those with pre-university/vocational training and 4.0 (2.9, 5.5) among those with high school. Conclusion: Young adults who had immigrated to Canada did not manifest the strong social gradient in smoking apparent in young adults born in Canada. Increased understanding of the underpinnings of this difference could inform development of interventions that aim to reduce social inequalities in smoking.