bluuebunny/crossref_metadata_2025_split huggingface dataset:
Parallel model-based and model-free reinforcement learning for card sorting performance
Authors: Steinke Alexander , Lange Florian , Kopp Bruno 
Published: September 2020

AbstractThe Wisconsin Card Sorting Test (WCST) is considered a gold standard for the assessment of cognitive flexibility. On the WCST, repeating a sorting category following negative feedback is typically treated as indicating reduced cognitive flexibility. Therefore such responses are referred to as ‘perseveration’ errors. Recent research suggests that the propensity for perseveration errors is modulated by response demands: They occur less frequently when their commitment repeats the previously executed response. Here, we propose parallel reinforcement-learning models of card sorting performance, which assume that card sorting performance can be conceptualized as resulting from model-free reinforcement learning at the level of responses that occurs in parallel with model-based reinforcement learning at the categorical level. We compared parallel reinforcement-learning models with purely model-based reinforcement learning, and with the state-of-the-art attentional-updating model. We analyzed data from 375 participants who completed a computerized WCST. Parallel reinforcement-learning models showed best predictive accuracies for the majority of participants. Only parallel reinforcement-learning models accounted for the modulation of perseveration propensity by response demands. In conclusion, parallel reinforcement-learning models provide a new theoretical perspective on card sorting and it offers a suitable framework for discerning individual differences in latent processes that subserve behavioral flexibility.
Development and clinical deployment of a smartphone-based visual field deep learning system for glaucoma detection
Authors: Li Fei , Song Diping , Chen Han , Xiong Jian , Li Xingyi , Zhong Hua , Tang Guangxian , Fan Sujie , Lam Dennis S. C. , Pan Weihua , Zheng Yajuan , Li Ying , Qu Guoxiang , He Junjun , Wang Zhe , Jin Ling , Zhou Rouxi , Song Yunhe , Sun Yi , Cheng Weijing , Yang Chunman , Fan Yazhi , Li Yingjie , Zhang Hengli , Yuan Ye , Xu Yang , Xiong Yunfan , Jin Lingfei , Lv Aiguo , Niu Lingzhi , Liu Yuhong , Li Shaoli , Zhang Jiani , Zangwill Linda M. , Frangi Alejandro F. , Aung Tin , Cheng Ching-yu , Qiao Yu , Zhang Xiulan , Ting Daniel S. W. 
Published: September 2020

AbstractBy 2040, ~100 million people will have glaucoma. To date, there are a lack of high-efficiency glaucoma diagnostic tools based on visual fields (VFs). Herein, we develop and evaluate the performance of ‘iGlaucoma’, a smartphone application-based deep learning system (DLS) in detecting glaucomatous VF changes. A total of 1,614,808 data points of 10,784 VFs (5542 patients) from seven centers in China were included in this study, divided over two phases. In Phase I, 1,581,060 data points from 10,135 VFs of 5105 patients were included to train (8424 VFs), validate (598 VFs) and test (3 independent test sets—200, 406, 507 samples) the diagnostic performance of the DLS. In Phase II, using the same DLS, iGlaucoma cloud-based application further tested on 33,748 data points from 649 VFs of 437 patients from three glaucoma clinics. With reference to three experienced expert glaucomatologists, the diagnostic performance (area under curve [AUC], sensitivity and specificity) of the DLS and six ophthalmologists were evaluated in detecting glaucoma. In Phase I, the DLS outperformed all six ophthalmologists in the three test sets (AUC of 0.834–0.877, with a sensitivity of 0.831–0.922 and a specificity of 0.676–0.709). In Phase II, iGlaucoma had 0.99 accuracy in recognizing different patterns in pattern deviation probability plots region, with corresponding AUC, sensitivity and specificity of 0.966 (0.953–0.979), 0.954 (0.930–0.977), and 0.873 (0.838–0.908), respectively. The ‘iGlaucoma’ is a clinically effective glaucoma diagnostic tool to detect glaucoma from humphrey VFs, although the target population will need to be carefully identified with glaucoma expertise input.
Assessment, Diagnosis, and Treatment of Dysphagia in Patients Infected With SARS-CoV-2: A Review of the Literature and International Guidelines
Authors: Vergara José , Skoretz Stacey A. , Brodsky Martin B. , Miles Anna , Langmore Susan E. , Wallace Sarah , Seedat Jaishika , Starmer Heather M. , Bolton Lee , Clavé Pere , Freitas Susana Vaz , Bogaardt Hans , Matsuo Koichiro , de Souza Cinthia Madeira , Mourão Lucia Figueiredo 
Published: September 2020

Purpose
Speech-language pathologists are playing a crucial role in the assessment and management of patients infected with severe acute respiratory syndrome coronavirus 2. Our goal was to synthesize peer-reviewed literature and association guidelines from around the world regarding dysphagia assessment and management for this specific population.

Method
A review of publications available in the PubMed database and official guidelines of international groups was performed on May 23, 2020. The information was synthesized and categorized into three content areas for swallowing: clinical evaluation, instrumental assessment, and rehabilitation.

Results
Five publications were identified in the PubMed database. Following title, abstract, and full-text review, only three publications met inclusion criteria: two reviews and one narrative report. Additionally, 19 international guidelines were reviewed. To assess swallowing, a modified clinical evaluation was recommended and only following a risk assessment. Instrumental assessments were often considered aerosol generating, especially transnasal procedures such as endoscopy and manometry. For this reason, many associations recommended that these examinations be performed only when essential and with appropriate personal protective equipment. Guidelines recommended that intervention should focus on compensatory strategies, including bolus modification, maneuvers/postural changes, and therapeutic exercises that can be conducted with physical distancing. Respiratory training devices were not recommended during rehabilitation.

Conclusions
International associations have provided extensive guidance regarding the level of risk related to the management of dysphagia in this population. To date, there are no scientific papers offering disease and/or recovery profiling for patients with dysphagia and coronavirus disease 2019. As a result, research in this area is urgently needed.
Stuttering Practice Self-Assessment by School Speech-Language Practitioners
Authors: Kelly Ellen M. , Singer Cara M. , Henderson Jack K. , Shaw Kenton O. 
Published: September 2020

Purpose
The purpose of this study was to survey school speech-language practitioners' self-perceptions of their confidence, knowledge, and need for support for working with school-age students who stutter (SWS).

Method
A total of 120 school-based speech-language practitioners from 27 Nashville, Tennessee, area counties completed an online, 35-item survey examining caseloads, coursework, continuing education, experience, and perceived levels of skill and confidence in service provision to SWS. They also rated their need for consultation from speech-language pathologists who specialize in stuttering to improve their skills with SWS.

Results
Respondents were least confident in and needed most support for providing intervention to SWS. Those who needed most support for intervention rated themselves as less knowledgeable about stuttering theory, assessment, and intervention and were less confident about working with students who only stutter and with SWS who have concomitant communication concerns. Greater practitioner confidence in stuttering intervention skills was positively correlated with the number of SWS on caseloads; continuing education credits in stuttering; and knowledge of stuttering theory, assessment, and intervention. Respondents who completed a graduate course on stuttering had greater confidence in stuttering intervention and were less likely to identify a need for support from specialists.

Conclusions
School speech-language practitioners continue to report needing additional education, practice opportunities, and support, especially with intervention, and desiring specialized guidance to serve SWS. Those with more experience, education, and knowledge about stuttering are more confident and skillful, reflecting the potential positive impact of increased opportunities to learn about and work with SWS. These needs may be addressed through increased availability of specialists in stuttering to consult with school practitioners; opportunities for school-based practitioners to become peer mentors; and provision of readily available, intervention-focused continuing education experiences and resources.
The Inhibitory Effect of Curcumin on Hypoxia Inducer Factors (Hifs)
as a Regulatory Factor in the Growth of Tumor Cells in Breast Cancer Stem-Like
Cells
Authors: Sarighieh Mehrnaz Asadi , Montazeri Vahideh , Shadboorestan Amir , Ghahremani Mohammad Hossein , Ostad Seyed Nasser 
Published: September 2020

AbstractHypoxia in the microenvironment is related to chemotherapy resistance, tumor
progression, and metastasis. Curcumin, as a phenolic compound extracted from the
turmeric, has been used as an anti-cancer agent with low toxicity in recent
years. Since curcumin has inhibitory activities against hypoxia-inducible
factors (HIFs) in several cancers, this study was conducted to examine the
effect of curcumin on MCF-7 cells and cancer stem-like cells (CS-LCs) under
hypoxic and normoxic conditions. CS-LCs were isolated from MCF-7 cells using the
magnet activated cell sorting (MACS) method based on CD44
+/ CD24
- surface markers. The effects of curcumin on the viability of MCF-7
cells and CS-LCs were examined in hypoxic and normoxic conditions using the MTT
test. The effects of curcumin on apoptosis and cell cycle of CS-LCs and MCF-7
cells were analyzed using flow cytometry. Moreover, the inhibitory effects of
curcumin on the levels of HIF-1 and HIF-2α protein in CS-LCs were
investigated using the western blot method. Early apoptosis occurred in CSC-LCs
more than MCF-7 cells under hypoxic conditions. Flow cytometry assay showed that
curcumin caused cell cycle arrest of CSC-LCs and MCF-7 at the G2/M phase
under hypoxic conditions while under normoxic conditions, arrest occurred at the
G0/G1 phase in MCF-7 cells and at S and G2/M phases in CS-LCs.
Based on the results, the curcumin inhibited the expression of HIF-1 by
degrading ARNT in CS-LCs.In conclusion, curcumin has inhibitory effects on MCF- 7 cells and CS- LCs and
thus may be used as an antitumor agent.
Underwater vs conventional endoscopic mucosal resection in the management of colorectal polyps: a systematic review and meta-analysis
Authors: Kamal Faisal , Khan Muhammad Ali , Lee-Smith Wade , Khan Zubair , Sharma Sachit , Tombazzi Claudio , Ahmad Dina , Ismail Mohammad Kashif , Howden Colin W. , Binmoeller Kenneth F. 
Published: September 2020

Abstract
Background Recently, underwater endoscopic mucosal resection (UEMR) has shown promising results in the management of colorectal polyps. Some studies have shown better outcomes compared to conventional endoscopic mucosal resection (EMR). We conducted this systematic review and meta-analysis to compare UEMR and EMR in the management of colorectal polyps.
Methods We searched several databases from inception to November 2019 to identify studies comparing UEMR and EMR. Outcomes assessed included rates of en bloc resection, complete macroscopic resection, recurrent/residual polyps on follow-up colonoscopy, complete resection confirmed by histology and adverse events. Pooled risk ratios (RR) with 95 % confidence interval were calculated using a fixed effect model. Heterogeneity was assessed by I2 statistic. Funnel plots and Egger’s test were used to assess publication bias. We used the Newcastle-Ottawa scale (NOS) for assessment of quality of observational studies, and the Cochrane tool for assessing risk of bias for RCTs
Results Seven studies with 1291 patients were included; two were randomized controlled trials and five were observational. UEMR demonstrated statistically significantly better efficacy in rates of en bloc resection, pooled RR 1.16 (1.08, 1.26), complete macroscopic resection, pooled RR 1.28 (1.18, 1.39), recurrent/residual polyps; pooled RR 0.26 (0.12, 0.56) and complete resection confirmed by histology; pooled RR 0.75 (0.57, 0.98). There was no significant difference in adverse events (AEs); pooled RR 0.68 (0.44, 1.05).
Conclusions This meta-analysis found statistically significantly better rates of en bloc resection, complete macroscopic resection, and lower risk of recurrent/residual polyps with UEMR compared to EMR. We found no significant difference in AEs between the two techniques.
Efficacy of transoral outlet reduction in Roux-en-Y gastric bypass patients to promote weight loss: a systematic review and meta-analysis
Authors: Dhindsa Banreet Singh , Saghir Syed Mohsin , Naga Yassin , Dhaliwal Amaninder , Ramai Dayl , Cross Chad , Singh Shailender , Bhat Ishfaq , Adler Douglas G. 
Published: September 2020

Abstract
Background and study aims Transoral outlet reduction (TORe) is an endoscopic procedure used in patients with weight gain post Roux-en-Y gastric bypass (RYGB). We performed a systematic review and meta-analysis to evaluate the efficacy and safety of TORe with a full-thickness suturing device for treating patients with weight regain after RYGB.
Patients and methods We conducted a comprehensive search of several databases and conference proceedings including PubMed, EMBASE, Google-Scholar, MEDLINE, SCOPUS, and Web of Science databases (earliest inception to March 2020). The primary outcomes assessed were technical success, absolute weight loss (AWL) and percent of total weight loss (% TWL) at 3, 6, and 12 months after the procedure. The secondary outcomes assessed were pooled rate of adverse events (AEs), adverse event subtypes and association of size of gastrojejunal anastomosis (GJA) and percent TWL.
Results Thirteen studies on 850 patients were included. The pooled rate of technical success was 99.89 %. The absolute weight loss (kg) at 3, 6, and 12 months was 6.14, 10.15, and 7.14, respectively. The percent TWL at 3, 6, and 12 months was 6.69, 11.34, and 8.55, respectively. The pooled rate of AE was 11.4 % with abdominal pain being the most common adverse event. The correlation coefficient (r) was –0.11 between post TORe GJA size and weight loss at 12 months.
Conclusion TORe is an endoscopic procedure that is safe and technically feasible for post RYGB with weight gain.
Der digitale Baumzeichentest – Ein kunsttherapeutischer Ansatz für das Demenz-Screening
Authors: Robens Sibylle , Ostermann Thomas 
Published: September 2020

SummaryFür die Frühdiagnostik von Demenz bestehtder Bedarf an zuverlässigen Screeningverfahren.Der Uhrentest nach Shulman weistlaut S3-Leitlinie „Demenz“ für Patientinnenund Patienten mit leichten kognitiven Einschränkungenkeine ausreichende Sensitivitätauf. Einen neuen Ansatz bietet der digitaleBaumzeichentest, der von einem multidisziplinärenTeam aus Wissenschaftlerinnenund Wissenschaftlern zusammen mit Kunsttherapeutinnenund -therapeuten entwickeltwurde. Das Zeichnen des Baummotivs erfolgthier mithilfe eines Tablets mit digitalemStift und einem einfachen Malprogramm.Durch eine softwaregestützte Berechnungund statistische Analyse wirdanhand bestimmter Zeichenmerkmale derGrad der kognitiven Beeinträchtigung erfasst.Die Forscherinnen und Forscher versprechensich durch das innovative Verfahren, neben einem diagnostischen Mehrwertzur frühen Identifizierung kognitiv eingeschränkterPersonen, eine weniger mitScham und Stress verbundene Testung, diezu einer erhöhten Motivation führt, an einemScreening teilzunehmen.
Full-thickness resection device (FTRD) for treatment of upper gastrointestinal tract lesions: the first international experience
Authors: Khashab Mouen A. , Sharaiha Reem Z. , Hajifathalian Kaveh , Ichkhanian Yervant , Dawod Qais , Meining Alexander , Schmidt Arthur , Glaser Nicholas , Vosoughi Kia , Diehl David L. , Grimm Ian S. , James Theodore , Templeton Adam W. , Samarasena Jason B. , Chehade Nabil El Hage , Lee John G. , Chang Kenneth J. , Mizrahi Meir , Barawi Mohammed , Irani Shayan , Friedland Shai , Korc Paul , Aadam Abdul Aziz , Al-Haddad Mohammad , Kowalski Thomas E. , Smallfield George , Ginsberg Gregory G. , Fukami Norio , Lajin Michael , Kumta Nikhil A. , Tang Shou-jiang , Naga Yehia , Amateau Stuart K. , Kasmin Franklin , Goetz Martin , Seewald Stefan , Kumbhari Vivek , Ngamruengphong Saowanee , Mahdev Srihari , Mukewar Saurabh , Sampath Kartik , Carr-Locke David L. 
Published: September 2020

Abstract
Background and study aims The Full-Thickness Resection Device (FTRD) provides a novel treatment option for lesions not amenable to conventional endoscopic resection techniques. There are limited data on the efficacy and safety of FTRD for resection of upper gastrointestinal tract (GIT) lesions.
Patients and methods This was an international multicenter retrospective study, including patients who had an endoscopic resection of an upper GIT lesion using the FTRD between January 2017 and February 2019.
Results Fifty-six patients from 13 centers were included. The most common lesions were mesenchymal neoplasms (n = 23, 41 %), adenomas (n = 7, 13 %), and hamartomas (n = 6, 11 %). Eighty-four percent of lesions were located in the stomach, and 14 % in the duodenum. The average size of lesions was 14 mm (range 3 to 33 mm). Deployment of the FTRD was technically successful in 93 % of patients (n = 52) leading to complete and partial resection in 43 (77 %) and 9 (16 %) patients, respectively. Overall, the FTRD led to negative histological margins (R0 resection) in 38 (68 %) of patients. A total of 12 (21 %) mild or moderate adverse events (AEs) were reported. Follow-up endoscopy was performed in 31 patients (55 %), on average 88 days after the procedure (IQR 68–138 days). Of these, 30 patients (97 %) did not have any residual or recurrent lesion on endoscopic examination and biopsy, with residual adenoma in one patient (3 %).
Conclusions Our results suggest a high technical success rate and an acceptable histologically complete resection rate, with a low risk of AEs and early recurrence for FTRD resection of upper GIT lesions.
Diagnostic performance of artificial intelligence to identify deeply invasive colorectal cancer on non-magnified plain endoscopic images
Authors: Nakajima Yuki , Zhu Xin , Nemoto Daiki , Li Qin , Guo Zhe , Katsuki Shinichi , Hayashi Yoshikazu , Utano Kenichi , Aizawa Masato , Takezawa Takahito , Sagara Yuichi , Shibukawa Goro , Yamamoto Hironori , Lefor Alan Kawarai , Togashi Kazutomo 
Published: September 2020

Abstract
Background and study aims Colorectal cancers (CRC) with deep submucosal invasion (T1b) could be metastatic lesions. However, endoscopic images of T1b CRC resemble those of mucosal CRCs (Tis) or with superficial invasion (T1a). The aim of this study was to develop an automatic computer-aided diagnosis (CAD) system to identify T1b CRC based on plain endoscopic images.
Patients and methods In two hospitals, 1839 non-magnified plain endoscopic images from 313 CRCs (Tis 134, T1a 46, T1b 56, beyond T1b 37) with sessile morphology were extracted for training. A CAD system was trained with the data augmented by rotation, saturation, resizing and exposure adjustment. Diagnostic performance was assessed using another dataset including 44 CRCs (Tis 23, T1b 21) from a third hospital. CAD generated a probability level for T1b diagnosis for each image, and > 95 % of probability level was defined as T1b. Lesions with at least one image with a probability level > 0.95 were regarded as T1b. Primary outcome is specificity. Six physicians separately read the same testing dataset.
Results Specificity was 87 % (95 % confidence interval: 66–97) for CAD, 100 % (85–100) for Expert 1, 96 % (78–100) for Expert 2, 61 % (39–80) for both gastroenterology trainees, 48 % (27–69) for Novice 1 and 22 % (7–44) for Novice 2. Significant differences were observed between CAD and both novices (P = 0.013, P = 0.0003). Other diagnostic values of CAD were slightly lower than of the two experts.
Conclusions Specificity of CAD was superior to novices and possibly to gastroenterology trainees but slightly inferior to experts.
Experience of nurse practitioners performing colonoscopy after endoscopic training in more than 1,000 patients
Authors: Riegert Monica , Nandwani Monica , Thul Bonny , Chiu Angela Chang , Mathews Simon C. , Khashab Mouen A. , Kalloo Anthony Nicholas 
Published: September 2020

Abstract
Background and study aims The demand for screening colonoscopy has continued to rise over the past two decades. As a result, the current workforce of gastroenterologists is unable to meet the needs for colorectal cancer (CRC) screening. Therefore, solutions are needed to improve this disparity, with non-physician endoscopists being a potential option. However, current literature on the performance of non-physicians in endoscopy is limited. The aim of this study was to assess the quality of colonoscopy performed by three gastrointestinal fellowship-trained nurse practitioners (NPs).
Methods This was a retrospective study performed at a single tertiary academic medical center. Colonoscopies performed by three gastrointestinal-specialized NPs after having completed training of at least 140 supervised colonoscopies were reviewed for analysis. Inclusion criteria were patients undergoing colonoscopy for colorectal cancer screening purposes. Outcomes included colonoscopy quality indicators as defined by the American Society for Gastrointestinal Endoscopy/American College of Gastroenterology Taskforce (ASGE/ACG) Taskforce.
Results The study included 1,012 subjects (mean age 56.2 years, female 51.5 %, African American 73.9 %) who underwent screening colonoscopies by three NPs. Cecal intubation was successful in 997 subjects (98.5 %). Mean adenoma detection rate was 35.6 %. Mean withdrawal time was 18.9 minutes. There were no adverse events including colonic perforations or delayed post-polypectomy bleeding.
Conclusions Three fellowship-trained NPs in colonoscopy in the United States satisfied the quality indicators proposed by the ASGE/ACG Task force, demonstrating that adequately trained NPs can perform colonoscopy safely and effectively. With the demand for colonoscopy exceeding the supply, non-physicians could be part of the solution to meet the demands for CRC screening.
Tissue acquisition and pancreatic masses: Which needle and which acquisition technique should be used?
Authors: Mangiavillano Benedetto , Sosa-Valencia Leonardo , Deprez Pierre , Eisendrath Pierre , Robles-Medranda Carlos , Eusebi Leonardo H. , Di Leo Milena , Auriemma Francesco , Bianchetti Mario , Anderloni Andrea , Carrara Silvia , Repici Alessandro 
Published: September 2020

Abstract
Background and study aims Pancreatic cancer represents the fourth most common cause of cancer-related deaths in Western countries and the need of a low-risk investigation to obtain an accurate histopathological diagnosis has become increasingly pressing. Endoscopic ultrasonography (EUS) with fine-needle aspiration (FNA) is the standard method for obtaining samples from pancreatic masses. In recent years, there has been an increasing need to obtain histological specimens during EUS procedures, rather than cytological ones, to guide oncological treatment options, leading to the so-call “FNB concept.” Different needles have been developed for fine-needle biopsy (FNB) in recent years, enabling acquisition of larger specimens on which to perform histological and molecular analyses. The aim of this narrative review was to assess the role of EUS-guided FNA and FNB in patients with pancreatic masses, and to identify which needle and which acquisition technique should be used to improve tissue acquisition.