bluuebunny/crossref_metadata_2025_split huggingface dataset:
Social Exclusion, Resilience and Social Worker Preparedness: Providing Services to Gay and Bisexual Men Who Party-n-Play
Authors: Souleymanov Rusty , Brennan David J , Logie Carmen H , Allman Dan , Craig Shelley L , Halkitis Perry N 
Published: September 2020

Abstract
Party-n-Play (PNP) refers to sex between gay and bisexual men that occurs under the influence of drugs. Growing evidence suggests gay and bisexual men who PNP experience significant stigma and social exclusion. Less is known about the resilience of this population. Utilising critical discourse analysis, this study examined how gay and bisexual men who PNP talk about social exclusion and resilience in their lives. In-depth one-hour interviews were conducted with forty-four gay and bisexual men who lived in Toronto, and who used various drugs before or during sex with another man in the previous month. Study findings revealed that social exclusion was perpetuated through discourses of stigma, deviance, morality, heteronormativity, homophobia, racism, classism, risk and policing. These discourses also negatively affected participants’ interactions with health care providers. However, many participants evoked resilience discourses and described social bonds, friendships and relations of care in their networks. Social work professionals would benefit from examining the roles of social exclusion, as well as stigmatising and pathologising discourses in their practice. These findings also underscore the need for culturally sensitive social work interventions for this population that address social exclusion and foster resilience.
Unexpected Sounds Nonselectively Inhibit Active Visual Stimulus Representations
Authors: Soh Cheol , Wessel Jan R 
Published: September 2020

AbstractThe brain’s capacity to process unexpected events is key to cognitive flexibility. The most well-known effect of unexpected events is the interruption of attentional engagement (distraction). We tested whether unexpected events interrupt attentional representations by activating a neural mechanism for inhibitory control. This mechanism is most well characterized within the motor system. However, recent work showed that it is automatically activated by unexpected events and can explain some of their nonmotor effects (e.g., on working memory representations). Here, human participants attended to lateralized flickering visual stimuli, producing steady-state visual evoked potentials (SSVEPs) in the scalp electroencephalogram. After unexpected sounds, the SSVEP was rapidly suppressed. Using a functional localizer (stop-signal) task and independent component analysis, we then identified a fronto-central EEG source whose activity indexes inhibitory motor control. Unexpected sounds in the SSVEP task also activated this source. Using single-trial analyses, we found that subcomponents of this source differentially relate to sound-induced SSVEP changes: While its N2 component predicted the subsequent suppression of the attended-stimulus SSVEP, the P3 component predicted the suppression of the SSVEP to the unattended stimulus. These results shed new light on the processes underlying fronto-central control signals and have implications for phenomena such as distraction and the attentional blink.
Individual and Composite Adverse Pregnancy Outcomes in a Randomized Trial on Isoniazid Preventative Therapy Among Women Living With Human Immunodeficiency Virus
Authors: Theron Gerhard , Montepiedra Grace , Aaron Lisa , McCarthy Katie , Chakhtoura Nahida , Jean-Philippe Patrick , Zimmer Bonnie , Loftis Amy James , Chipato Tsungai , Nematadzira Teacler , Nyati Mandisa , Onyango-Makumbi Carolyne , Masheto Gaerolwe , Ngocho James , Tongprasert Fuanglada , Patil Sandesh , Lespinasse Dominique , Weinberg Adriana , Gupta Amita 
Published: September 2020

Abstract

Background
International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) P1078, a randomized noninferiority study designed to compare the safety of starting isoniazid preventive therapy (IPT) in women living with human immunodeficiency virus (HIV) either during pregnancy or after delivery, showed that IPT during pregnancy increased the risk of composite adverse pregnancy outcomes, but not individual outcomes. Many known factors are associated with adverse pregnancy outcomes: these factors’ associations and effect modifications with IPT and pregnancy outcomes were examined.

Methods
Pregnant women living with HIV from 8 countries with tuberculosis incidences &gt;60/100 000 were randomly assigned to initiate 28 weeks of IPT either during pregnancy or at 12 weeks after delivery. Using univariable and multivariable logistic regression and adjusting for factors associated with pregnancy outcomes, composite and individual adverse pregnancy outcome measures were analyzed.

Results
This secondary analysis included 925 mother-infant pairs. All mothers were receiving antiretrovirals. The adjusted odds of fetal demise, preterm delivery (PTD), low birth weight (LBW), or a congenital anomaly (composite outcome 1) were 1.63 times higher among women on immediate compared to deferred IPT (95% confidence interval [CI], 1.15–2.31). The odds of fetal demise, PTD, LBW, or neonatal death within 28 days (composite outcome 2) were 1.62 times higher among women on immediate IPT (95% CI, 1.14–2.30). The odds of early neonatal death within 7 days, fetal demise, PTD, or LBW (composite outcome 3) were 1.74 times higher among women on immediate IPT (95% CI, 1.22–2.49).

Conclusions
We confirmed higher risks of adverse pregnancy outcomes associated with the initiation of IPT during pregnancy, after adjusting for known risk factors for adverse pregnancy outcomes.
Graph fractal dimension and the structure of fractal networks
Authors: Skums Pavel , Bunimovich Leonid 
Published: September 2020

Abstract
Fractals are geometric objects that are self-similar at different scales and whose geometric dimensions differ from so-called fractal dimensions. Fractals describe complex continuous structures in nature. Although indications of self-similarity and fractality of complex networks has been previously observed, it is challenging to adapt the machinery from the theory of fractality of continuous objects to discrete objects such as networks. In this article, we identify and study fractal networks using the innate methods of graph theory and combinatorics. We establish analogues of topological (Lebesgue) and fractal (Hausdorff) dimensions for graphs and demonstrate that they are naturally related to known graph-theoretical characteristics: rank dimension and product dimension. Our approach reveals how self-similarity and fractality of a network are defined by a pattern of overlaps between densely connected network communities. It allows us to identify fractal graphs, explore the relations between graph fractality, graph colourings and graph descriptive complexity, and analyse the fractality of several classes of graphs and network models, as well as of a number of real-life networks. We demonstrate the application of our framework in evolutionary biology and virology by analysing networks of viral strains sampled at different stages of evolution inside their hosts. Our methodology revealed gradual self-organization of intra-host viral populations over the course of infection and their adaptation to the host environment. The obtained results lay a foundation for studying fractal properties of complex networks using combinatorial methods and algorithms.
Bulky granulomatous disease resulting in constrictive tuberculous pericarditis requiring pericardiectomy: a case report
Authors: Barua Sumita , Phua Bernadette , Orr Yishay , Skinner Michael 
Published: September 2020

Abstract

Background
We present a 23-year-old Nepalese migrant with mycobacterial tuberculosis (TB) pericarditis manifesting as effusive constrictive disease and subsequent rapid progression to constrictive pericarditis resulting from bulky granulomatous disease.

Case summary
Following initial presumptive diagnosis of TB pericarditis based on presence of moderate pericardial effusion and positive polymerase chain reaction on concurrent pleural aspirate, the patient was managed with standard empiric therapy. Despite treatment, he developed progressive heart failure with New York Heart Association (NYHA) class III symptoms and had confirmation of constrictive physiology on simultaneous left and right heart catheterization. He underwent pericardiectomy 4 months after his initial diagnosis, with debridement of large necrotizing granulomas and an associated immediate improvement clinical improvement. He remains well at 6-month follow-up with no residual heart failure symptoms off diuretic therapy.

Discussion
Tuberculous pericarditis accounts for 1–2% of presentations with TB infection, with progression to constrictive pericarditis in between 17 and 40% of cases. To date, pericardiectomy remains mainstay of treatment for constriction, albeit with high perioperative risk. In combination with anti-tuberculous therapy, prednisone and pericardiocentesis may reduce risk of progression to constriction, however, neither have shown mortality benefit. Our patient continued to progress, despite medical therapy and proceeded to pericardiectomy only 4 months after his initial diagnosis, with rapid improvement in symptoms, demonstrating the importance of close monitoring and revision of management strategy in these patients.
Catheter ablation or medical therapy to delay progression of atrial fibrillation: the randomized controlled atrial fibrillation progression trial (ATTEST)
Authors: Kuck Karl-Heinz , Lebedev Dmitry S , Mikhaylov Evgeny N , Romanov Alexander , Gellér László , Kalējs Oskars , Neumann Thomas , Davtyan Karapet , On Young Keun , Popov Sergey , Bongiorni Maria Grazia , Schlüter Michael , Willems Stephan , Ouyang Feifan 
Published: September 2020

Abstract

Aims
Delay of progression from paroxysmal to persistent atrial fibrillation (AF) is an important measure of long-term success of AF treatment. However, published data on the impact of catheter ablation on AF progression are limited. This study evaluates whether radiofrequency (RF) catheter ablation delays the progression of AF compared with antiarrhythmic drug (AAD) treatment using current AF management guidelines.

Methods
This prospective, randomized, controlled, two-arm, open-label trial was conducted at 29 hospitals and medical centres across 13 countries. Patients were randomized 1 : 1 to RF ablation or AAD treatment. The primary endpoint was the rate of persistent AF/atrial tachycardia (AT) at 3 years.

Results
After early study termination following slow enrolment, 255 (79%) of the planned 322 patients were enrolled (RF ablation, n = 128, AAD, n = 127); 36% of patients in the RF ablation group and 41% in the AAD group completed 3 years of follow-up. For the primary endpoint, the Kaplan–Meier estimate of the rate of persistent AF/AT at 3 years was significantly lower with RF ablation [2.4% (95% confidence interval (CI), 0.6–9.4%)] than with AAD therapy [17.5% (95% CI, 10.7–27.9%); one-sided P = 0.0009]. Patients ≥65 years were ∼4 times more likely to progress to persistent AF/AT than patients &lt;65 years, suggesting RF ablation can delay disease progression [hazard ratio: 3.87 (95% CI, 0.88–17.00); P = 0.0727]. Primary adverse events were reported for eight patients in the RF ablation group.

Conclusions
Radiofrequency ablation is superior to guideline-directed AAD therapy in delaying the progression from paroxysmal to persistent AF.
Development of a narrow-band imaging classification to reduce the need for routine biopsies of gastric polyps
Authors: Asztalos Ivor B , Colling Caitlin A , Buchner Anna M , Chandrasekhara Vinay 
Published: September 2020

Abstract

Background
Most incidental gastric polyps identified during upper endoscopy are considered low-risk. However, current guidelines recommend sampling all gastric polyps for histopathologic analysis. We aimed to devise a simple narrow-band imaging (NBI) classification to reduce the need for routine biopsies of low-risk gastric polyps.

Methods
Pairs of NBI and white-light images were collected from 73 gastric polyps for which concurrent histopathologic diagnosis was available. A diagnostic accuracy cohort study was performed. Two blinded endoscopists independently analysed NBI features of each polyp for color, vessel pattern, surface pattern, and any combinations thereof to develop a classification scheme to differentiate low-risk polyps (fundic-gland or hyperplastic) from high-risk polyps (adenomatous or adenocarcinoma) and fundic-gland polyps (FGPs) from non-FGPs.

Results
An isolated lacy vessel pattern and a homogenous absence of surface pattern successfully differentiated low-risk from high-risk gastric polyps. Combining both descriptors into a single algorithm resulted in a negative predictive value (NPV) of 100% [95% confidence interval (CI): 100%–100%], positive predictive value (PPV) of 13.7% (95% CI: 2.6–24.8), sensitivity of 100% (95% CI: 100%–100%), and specificity of 53.7% (95% CI: 45.3%–62.0%) for high-risk polyps. This would reduce the number of polyps requiring biopsy by 50%, while still capturing all high-risk polyps. Regarding FGPs, using a rule not to biopsy polyps with isolated lacy vessels resulted in a 94.9% NPV (95% CI: 89.2%–100%), 63.2% PPV (95% CI: 47.2%–79.2%), 94.8% sensitivity (95% CI: 89.5%–100%), and 63.6% specificity (95% CI: 51.3%–76.0%) for non-FGPs.

Conclusion
In this derivation cohort study, NBI is helpful for differentiating between high-risk and low-risk gastric polyps, thereby reducing the need for routine sampling of low-risk polyps. These results need to be validated in a separate test population.
Effective use of online depression information and associated literacies among US college students
Authors: Gu Yulong , Kalibatseva Zornitsa , Song Xu 
Published: September 2020

Summary
Mental health issues, such as depression, are rising among young people, who may benefit from online depression-related information. However, the competencies required to search for health information on the Internet and evaluate it before use may be poor among this population. This research aimed to investigate how college students use the Internet for solving problems in realistic case scenarios relevant to depression and to understand whether various literature-indicated literacies and factors may predict effective utilization of relevant online resources. We designed a web-based questionnaire survey including four depression-related case scenarios. A total of 218 undergraduate students who were enrolled in a Northeastern public US university were invited to participate in the survey in 2016, with 192 completed responses being included in this analysis (response rate = 88%; the participants’ median age = 20; 79% female). Approximately half of the participants (47%) answered the depression-related questions in the case scenarios with 90% or higher accuracy. In a multiple linear regression model, prior depression knowledge and eHealth information literacy significantly predicted the effective use of online depression information. However, medical literacy and critical health literacy were not significant predictors. A few additional demographic and experience related factors were positively associated with the effective Internet use (e.g. female, non-Hispanic, psychology or health science major and prior experience with depression). These findings identify a need for college students to develop domain-specific knowledge and literacies in order to facilitate effective use of online information about depression.
Reproductive outcomes of women aged 40 and older undergoing IVF with donor sperm
Authors: Bortoletto P , Willson S , Romanski P A , Davis O K , Rosenwaks Z 
Published: September 2020

Abstract

STUDY QUESTION
Do women ≥40 years old without a male partner who utilize donor sperm have the same reproductive outcomes as those who utilize their partner’s sperm?

SUMMARY ANSWER
After controlling for relevant confounders, women ≥40 years old using donor sperm for IVF have significantly higher odds of having a live birth compared to those utilizing their partner’s sperm.

WHAT IS KNOWN ALREADY
Women who are unpartnered or in same-sex relationships are by definition not infertile, but may choose to conceive using donor sperm. It is not known how IVF outcomes are affected with the use of donor sperm compared to women utilizing their partner’s sperm, particularly at very advanced maternal ages.

STUDY DESIGN, SIZE, DURATION
This is a retrospective cohort study conducted at a university-affiliated center of women undergoing IVF with fresh embryo transfer between 2008 and 2018.

PARTICIPANTS/MATERIALS, SETTING, METHODS
Patients were divided into two groups based on the ejaculated sperm source utilized: donor or partner sperm. Live birth rate was the primary outcome. Pregnancy rate was the secondary outcome. Multivariable logistic regression was performed and adjusted for age, the developmental stage of the embryo, and the number of embryos transferred. Unadjusted odds ratio (OR) and adjusted OR (aOR) with 95% CI for pregnancy and live birth were estimated. Statistical significance was denoted by P &lt; 0.05.

MAIN RESULTS AND THE ROLE OF CHANCE
A total of 3910 cycles in women ≥40 years old were analyzed, of which 307 utilized donor sperm and 3603 utilized their partner’s sperm to conceive. In the univariate analysis, patients utilizing donor sperm were found to have similar pregnancy rates as those utilizing partner sperm (41.0 vs 39.8%, OR: 0.95, 95% CI: 0.75–1.20). After adjusting for age, the number of embryos transferred and the developmental stage of the embryos, the model estimates did not vary (aOR: 1.22, 95% CI: 0.95–1.56). Similarly, the univariate analysis for live birth did not demonstrate a difference between groups (19.2 vs 17.8%, OR: 0.91, 95% CI: 0.67–1.22). However, after a similar adjustment was made for confounders, the use of donor sperm was associated with statistically significant increased odds of live birth (aOR: 1.38, 95% CI: 1.01–1.88).

LIMITATIONS, REASONS FOR CAUTION
As with any retrospective study, the potential for residual confounding exists, despite attempts to control for this with regression modeling.

WIDER IMPLICATIONS OF THE FINDINGS
Women ≥40 years old who are unpartnered or in same-sex relationships can be counseled that their odds of a live birth are slightly better than women in heterosexual relationships utilizing their partner’s sperm. These findings serve to further refine and individualize counseling on the expected IVF outcomes for women in this population.

STUDY FUNDING/COMPETING INTEREST(S)
No funding was sought for this study. The authors declare no competing interests.

TRIAL REGISTRATION NUMBER
N/A.
Potential limitations in COVID-19 machine learning due to data source variability: A case study in the nCov2019 dataset
Authors: Sáez Carlos , Romero Nekane , Conejero J Alberto , García-Gómez Juan M 
Published: September 2020

Abstract

Objective
The lack of representative coronavirus disease 2019 (COVID-19) data is a bottleneck for reliable and generalizable machine learning. Data sharing is insufficient without data quality, in which source variability plays an important role. We showcase and discuss potential biases from data source variability for COVID-19 machine learning.

Materials and Methods
We used the publicly available nCov2019 dataset, including patient-level data from several countries. We aimed to the discovery and classification of severity subgroups using symptoms and comorbidities.

Results
Cases from the 2 countries with the highest prevalence were divided into separate subgroups with distinct severity manifestations. This variability can reduce the representativeness of training data with respect the model target populations and increase model complexity at risk of overfitting.

Conclusions
Data source variability is a potential contributor to bias in distributed research networks. We call for systematic assessment and reporting of data source variability and data quality in COVID-19 data sharing, as key information for reliable and generalizable machine learning.
Encapsulated Papillary Carcinoma of the Breast: Imaging Features with Histopathologic Correlation
Authors: Bonnet Sarah E , Carter Gloria J , Berg Wendie A 
Published: September 2020

Abstract
Encapsulated papillary carcinoma (EPC) is a rare, clinically indolent breast malignancy most common in postmenopausal women. Absence of myoepithelial cells at the periphery is a characteristic feature. Mammographically, EPC typically presents as a mostly circumscribed, noncalcified, dense mass that can have focally indistinct margins when there is associated frank invasive carcinoma. Ultrasound shows a circumscribed solid or complex cystic and solid mass, and occasional hemorrhage in the cystic component may produce a fluid-debris level; the solid components typically show intense washout enhancement on MRI. Color Doppler may demonstrate a prominent vascular pedicle and blood flow within solid papillary fronds. Encapsulated papillary carcinoma can exist in pure form; however, EPC is often associated with conventional ductal carcinoma in-situ and/or invasive ductal carcinoma, no special type. Adjacent in-situ and invasive disease may be only focally present at the periphery of EPC and potentially unsampled at core-needle biopsy. In order to facilitate diagnosis, the mass wall should be included on core-needle biopsy, which will show absence of myoepithelial markers. Staging and prognosis are determined by any associated frankly invasive component, with usually excellent long-term survival and rare distant metastases.
Characteristics and Outcome of SARS-CoV-2 Infection in Cancer Patients
Authors: Basse Clémence , Diakite Sarah , Servois Vincent , Frelaut Maxime , Noret Aurélien , Bellesoeur Audrey , Moreau Pauline , Massiani Marie-Ange , Bouyer Anne-Sophie , Vuagnat Perrine , Malak Sandra , Bidard François-Clément , Vanjak Dominique , Kriegel Irène , Burnod Alexis , Bilger Geoffroy , Ramtohul Toulsie , Dhonneur Gilles , Bouleuc Carole , Cassoux Nathalie ,   Institut Curie COVID Group,, Paoletti Xavier , Bozec Laurence , Cottu Paul 
Published: September 2020

AbstractBackgroundConcerns have emerged about the higher risk of fatal coronavirus disease 2019 (COVID-19) in cancer patients. In this article, we review the experience of a comprehensive cancer center.MethodsA prospective registry was set up at Institut Curie at the beginning of the COVID-19 pandemic. All cancer patients with suspected or proven COVID-19 were entered and actively followed for 28 days.ResultsAmong 9842 patients treated at Institut Curie between March 13 and May 1, 2020, 141 (1.4%) were diagnosed with COVID-19, based on reverse transcription polymerase chain reaction testing and/or computerized tomography scan. In line with our case mix, breast cancer (40.4%) was the most common tumor type, followed by hematological and lung malignancies. Patients with active cancer therapy or/and advanced cancer accounted for 87.9% and 68.9% of patients, respectively. At diagnosis, 78.7% of patients had COVID-19–related symptoms, with an extent of lung parenchyma involvement inferior to 50% in 95.8% of patients. Blood count variations and C-reactive protein elevation were the most common laboratory abnormalities. Antibiotics and antiviral agents were administered in 48.2% and 6.4% of patients, respectively. At the time of analysis, 26 patients (18.4%) have died from COVID-19, and 100 (70.9%) were cured. Independent prognostic factors at the time of COVID-19 diagnosis associated with death or intensive care unit admission were extent of COVID-19 pneumonia and decreased O2 saturation.ConclusionsCOVID-19 incidence and presentation in cancer patients appear to be very similar to those in the general population. The outcome of COVID-19 is primarily driven by the initial severity of infection rather than patient or cancer characteristics.