bluuebunny/crossref_metadata_2025_split huggingface dataset:
Update on the Biomechanics of the Craniocervical Junction, Part II: Alar Ligament
Authors: Ishak Basem , Glinski Alexander von , Dupont Graham , Lachkar Stefan , Yilmaz Emre , Iwanaga Joe , Unterberg Andreas , Oskouian Rod , Tubbs R. Shane , Chapman Jens R. 
Published: July 2020

Study Design: In vitro biomechanical study. Objective: The strength of the alar ligament has been described inconsistently, possibly because of the nonphysiological biomechanical testing models, and the inability to test the ligament with both attachments simultaneously. The purpose of this biomechanical model was to reevaluate the alar ligament’s tensile strength with both bony attachments, while also keeping the transverse ligament intact, all in a more physiological biomechanical model that mimics the mechanism of traumatic injury closely. Methods: Eleven fresh-frozen occipito-atlanto-axial (C0-C1-C2) specimens were harvested from individuals whose mean age at death was 77.4 years (range 46-97 years). Only the alar and transverse ligaments were preserved, and the bony C0-C1-C2 complex was left intact. Axial tension was exerted on the dens to displace it posteriorly, while the occipito-axial complex was fixed anteriorly. A device that applies controlled increasing force was used to test the tensile strength (M2-200, Mark-10 Corporation). Results: The mean force required for the alar ligament to fail was 394 ± 52 N (range 317-503 N). However, both the right and left alar ligaments ruptured simultaneously in 10 specimens. The ligament failed most often at the dens (n = 10), followed by occipital condyle rupture (n = 1). The transverse ligament remained intact in all specimens. Conclusions: When both the right and left alar ligament were included, the total alar ligament failure occurred at an average force of 394 N. The alar ligament failed before the transverse ligament.
A novel cell-free formulation for the treatment of knee osteoarthritis generates better patient-reported health outcomes in more severe cases
Authors: Delgado-Enciso Ivan , Paz-Garcia Juan , Valtierra-Alvarez Jose , Preciado-Ramirez Jorge , Olmedo-Buenrostro Bertha A , Delgado-Enciso Josuel , Guzman-Esquivel Jose , Barajas-Saucedo Carlos E , Ceja-Espiritu Gabriel , Rodriguez-Sanchez Iram P , Martinez-Fierro Margarita L , Zaizar-Fregoso Sergio A , Tiburcio-Jimenez Daniel , Plata-Florenzano Jorge E , Paz-Michel Brenda 
Published: July 2020

Background: The bioactive cell-free formulation (BIOF2) for cartilage regeneration has shown a major therapeutic response in severe knee osteoarthritis. However, its effect on patients with mild or moderate stages of the disease has not been studied. Objective: To evaluate the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, minimal clinically important improvement (MCII) and sleep disturbances in mild, moderate, and severe stages of knee osteoarthritis (OA) with the novel cell-free formulation treatment (BIOF2). Methods: An open-label, nonrandomized, baseline-controlled, parallel group study on patients with mild, moderate, and severe knee OA was conducted to evaluate the effect of intra-articular administration of BIOF2. Clinical improvement was determined through the WOMAC score and MCII, whereas sleep disturbances were measured through a Likert scale questionnaire. Results: At 6 months post-treatment, the mean decrease in the total WOMAC score was 16.4 +/- 4.7%, 49.9 +/- 6.4%, and 62.7 +/- 4.5% in the patients with mild, moderate, and severe disease, respectively ( p < 0.001, analysis of variance test). MCII at 6 months was 18%, 78%, and 100% for mild, moderate, and severe disease, respectively ( p < 0.001, likelihood-ratio χ 2 test). Concerning sleep disturbances, 60% of the patients with severe OA had important sleep problems before beginning treatment, and those difficulties were overcome 6 months after treatment. Only 18% of the patients with mild disease and 16% with moderate disease had serious sleep disturbances at the beginning of the study, and there was slight improvement after treatment. No adverse events were recorded during follow-up. Conclusion: BIOF2 generates better patient-reported health outcomes (on pain, stiffness, function, and sleep) in the more severe cases of knee OA.
Each for Equal: Gender Inequity in Dentistry in Australia
Authors: Silva M. , Teoh L. 
Published: July 2020

Objective: While there is an increasing number of women entering the dental profession, they are still underrepresented in leadership roles in major dental organizations, academia, and journal boards. Keynote and invited speaking roles in professional and scientific conferences recognize expertise and leadership and are key factors in career advancement and academic promotions. The aim of this study was to investigate gender differences in representation at dental continuing professional development (CPD) events and conferences in Australia. Methods: An analysis of the gender of speakers was conducted with CPD and conference programs that are publicly available online from the federal and Victorian branches of the Australian Dental Association, the peak national body for dentists. Results: The planned 2020 Victorian Branch CPD program featured 30 events, with a mean 2.5 speakers per event. There were 58 scientific presentations in the schedule, 22 (38%) of which were allocated to female speakers. Seven CPD events in 2020 included only female speakers, and 13 included only male speakers. The 37th and 38th Australian Dental Congresses featured 25% and 36% of female speakers, respectively. All keynote speakers were male for both events, and men accounted for 86% and 93% of international speakers. Conclusions: While women are approaching parity in local and state-level CPD events, there is a large discrepancy in the male-to-female speaker ratio for major national conferences. Suggestions to improve gender imbalance include having women on the convening committee and developing and implementing policies to address the imbalance. There has been significant progress in addressing gender inequity in dentistry, but gender-balanced leadership in major conferences still needs to be addressed. Knowledge Transfer Statement: The findings of this study show that while women may be approaching parity with small continuing professional development events, they are still underrepresented as speakers in major conferences. It is recommended that active policies be implemented to reduce the imbalance to ensure gender-balanced leadership in one aspect of the dental profession in Australia.
Maternal childbirth experience in induced and spontaneous labour measured in a visual analog scale and the factors influencing it; a two-year cohort study
Authors: Adler Katti , Rahkonen Leena , Kruit Heidi 
Published: July 2020

Abstract
Background
Poor maternal childbirth experience plays a role in family planning and subsequent pregnancies. The aim of this study was to compare childbirth experiences in induced and spontaneous labor and to investigate the factors influencing the childbirth experience.

Methods
This two-year cohort study included all women with term singleton pregnancies in cephalic presentation aiming for vaginal delivery at Helsinki University Hospital between January 2017 and December 2018. Maternal satisfaction in the childbirth experience was measured after delivery using a Visual Analog Scale (VAS) score. A low childbirth experience score was defined as VAS < 5. The characteristics and delivery outcomes of the study population were collected in the hospital database and analyzed by SPSS.

Results
A total of 18,396 deliveries were included in the study, of which 28.9% (n = 5322) were induced and 71.1% (n = 13 074) were of spontaneous onset. The total caesarean delivery rate was 9.3% (n = 1727). Overall, 4.5% (n = 819) of the women had a low childbirth experience VAS score. The women who underwent labor induction were less satisfied with their birth experience compared to women with spontaneous onset of labor [7.5% (n = 399) vs. 3.2% (n = 420); p < 0.001]. Poor childbirth experience was associated with primiparity [OR 2.0 (95% CI 1.6–2.4)], labor induction [OR 1.6 (95% CI 1.4–1.9)], caesarean delivery [OR 4.5 (95% CI 3.7–5.5)], operative vaginal delivery [OR 3.3 (95% CI 2.7-4.0)], post-partum hemorrhage [OR 1.3 (95% CI 1.1–1.6)], and maternal infections [OR 1.7 (95% CI 1.3–2.4)].

Conclusions
Poor childbirth experience was associated with labor induction, primiparity, operative delivery, and labor complications, such as post-partum hemorrhage and maternal infections. These results highlight the aspects of care for which patient experience may be improved by additional support and counselling.
Exploring the attitudes of health science students in Spain and Bolivia towards death. A cross sectional survey
Authors: Pérez- de la Cruz Sagrario , Ramírez Ivonne 
Published: July 2020

Abstract
Background
One of the most difficult and stressful tasks faced by health science students is having to cope with death and dying due to the emotional burden of the same. Furthermore, the moral, ethical and professional values of future health professionals are influenced by the cultures where they live.

Purpose
This study sought to compare and analyze the perception on end of life among a sample of health science students in Spain and Bolivia.

Methods
A descriptive, cross-sectional and multi-centric study. The total sample (548 students) was comprised of three groups: medical, nursing and physiotherapy students, of whom 245 were from Bolivia, and 303 were Spanish students. The measurement instruments used were the Bugen’s Coping with Death Scale and the Death Self-Efficacy Scale by Robbins.

Results
No statistically significant differences were observed between Spanish and Bolivian students (t (546) = − 0.248, p = 0.804) using the Bugen scale. This implies that there are no differences between the perception of both groups of students and that both groups use similar strategies to cope with death. Additionally, the beliefs and attitudes of both groups were similar, with Bolivian students presenting a trend towards improved scores. No differences were found between Spain and Bolivia in the results obtained on the Robbins scale, with students from both countries displaying similar skills and capabilities for facing death.

Conclusions
The beliefs on death of health science students from Spain and Bolivia were not affected by the respective cultures, type of degree studied, students’ age, or the country of origin, however, we found that students in Bolivia value death as something more natural than their Spanish counterparts.

Practice implications
To appropriately prepare students for this topic, education on coping with death and dying must be included within the university curriculum.

Trial registration
2016DEC018.
Privacy-preserving approximate GWAS computation based on homomorphic encryption
Authors: Kim Duhyeong , Son Yongha , Kim Dongwoo , Kim Andrey , Hong Seungwan , Cheon Jung Hee 
Published: July 2020

AbstractBackgroundOne of three tasks in a secure genome analysis competition called iDASH 2018 was to develop a solution for privacy-preserving GWAS computation based on homomorphic encryption. The scenario is that a data holder encrypts a number of individual records, each of which consists of several phenotype and genotype data, and provide the encrypted data to an untrusted server. Then, the server performs a GWAS algorithm based on homomorphic encryption without the decryption key and outputs the result in encrypted state so that there is no information leakage on the sensitive data to the server.MethodsWe develop a privacy-preserving semi-parallel GWAS algorithm by applying an approximate homomorphic encryption scheme HEAAN. Fisher scoring and semi-parallel GWAS algorithms are modified to be efficiently computed over homomorphically encrypted data with several optimization methodologies; substitute matrix inversion by an adjoint matrix, avoid computing a superfluous matrix of super-large size, and transform the algorithm into an approximate version.ResultsOur modified semi-parallel GWAS algorithm based on homomorphic encryption which achieves 128-bit security takes 30–40 minutes for 245 samples containing 10,000–15,000 SNPs. Compared to the truep-value from the original semi-parallel GWAS algorithm, theF1score of ourp-value result is over 0.99.ConclusionsPrivacy-preserving semi-parallel GWAS computation can be efficiently done based on homomorphic encryption with sufficiently high accuracy compared to the semi-parallel GWAS computation in unencrypted state.
Semi-Parallel logistic regression for GWAS on encrypted data
Authors: Kim Miran , Song Yongsoo , Li Baiyu , Micciancio Daniele 
Published: July 2020

Abstract
Background
The sharing of biomedical data is crucial to enable scientific discoveries across institutions and improve health care. For example, genome-wide association studies (GWAS) based on a large number of samples can identify disease-causing genetic variants. The privacy concern, however, has become a major hurdle for data management and utilization. Homomorphic encryption is one of the most powerful cryptographic primitives which can address the privacy and security issues. It supports the computation on encrypted data, so that we can aggregate data and perform an arbitrary computation on an untrusted cloud environment without the leakage of sensitive information.

Methods
This paper presents a secure outsourcing solution to assess logistic regression models for quantitative traits to test their associations with genotypes. We adapt the semi-parallel training method by Sikorska et al., which builds a logistic regression model for covariates, followed by one-step parallelizable regressions on all individual single nucleotide polymorphisms (SNPs). In addition, we modify our underlying approximate homomorphic encryption scheme for performance improvement.

Results
We evaluated the performance of our solution through experiments on real-world dataset. It achieves the best performance of homomorphic encryption system for GWAS analysis in terms of both complexity and accuracy. For example, given a dataset consisting of 245 samples, each of which has 10643 SNPs and 3 covariates, our algorithm takes about 43 seconds to perform logistic regression based genome wide association analysis over encryption.

Conclusions
We demonstrate the feasibility and scalability of our solution.
Development and preliminary evaluation of the QUALIKO: an observational quality of life instrument for patients with Korsakoff’s syndrome
Authors: ten Klooster Peter M. , Rensen Yvonne C. M. , Postma Jorrit F. , Kessels Roy P. C. 
Published: July 2020

AbstractBackgroundTo develop a Korsakoff-specific measure of quality of life (QoL), to be rated by professional caregivers, and to field-test its psychometric properties in a sample of patients with Korsakoff’s syndrome (KS) living in a specialized nursing home.MethodsA research version of the QUALIKO was developed based on an existing instrument for dementia (the QUALIDEM), literature review and two rounds of surveys among expert professionals involved in the care for patients with KS. Next, QoL was independently rated using the preliminary QUALIKO for 77 patients with KS by two primary caregivers.ResultsThe research QUALIKO consisted of 48 items describing observable behaviors across ten aspects of QoL relevant to patients with KS. Six items demonstrated poor scalability in the field test. The remaining 42 items all formed subscales with moderate to strong scalability according to Mokken scale analysis. Reliability was acceptable to good across both raters for all subscales (Mokken rho’s = 0.70–0.90), except for the two 2-item subscales of negative affect and positive self-image (Mokken rho’s = 0.47–0.71). Inter-observer agreement was excellent for five subscales (ICCs = 0.75–0.89) and fair to moderate for the other five subscales (ICCs = 0.59–0.72). The multidimensional internal structure was confirmed and all subscales were significantly correlated with primary caregivers’ global ratings of QoL except for positive self-image. Missing item values were low and floor and ceiling effects acceptable for most subscales.ConclusionsThe QUALIKO holds promise as a feasible, reliable, and valid measure of QoL in residential KS patients. Future research in larger samples is needed to confirm the psychometric dimensionality of the instrument, to gather normative data and to examine its test-retest reliability.
POCUS and POCDUS: essential tools for the evaluation and management of carotid artery pseudoaneurysms after a gunshot wound
Authors: Montorfano Lisandro , Sarkissyan Marianna , Wolfers Matthew , Rodríguez Federico , Pla Fernando , Montorfano Miguel 
Published: July 2020

Abstract
Background
Evaluation of asymptomatic penetrating vascular injuries can be done with Point-of-care ultrasound (POCUS) and Point-of-care Doppler ultrasound (POCDUS).

Case presentation
A 21-year-old woman was admitted to the Emergency Department with a small wound and pain on the left side of her neck. The patient stated she was standing outside her home and suddenly felt acute pain in the neck. She denied trauma or being assaulted and reported no significant past medical or surgical history. On physical exam the only positive finding was a small gunshot entry wound on the left side of her neck without hard signs of vascular injury. Bedside POCUS demonstrated soft tissue swelling and a hematoma next to the left carotid artery. A round in shape bullet was visualized in contact with the posterior left common carotid artery wall and two small saccular pseudoaneurysms were seen at left common carotid artery wall. POCDUS showed a patent left carotid artery and turbulent flow in the two saccular aneurysms. A computed tomography angiogram (CTA) was performed confirming the findings and a stent in left carotid artery was placed. The patient tolerated the procedure well and was discharged 4 days after the procedure. At the sixth month follow-up, Doppler ultrasound showed patent stent and resolution of the muscular hematoma.

Conclusions
Penetrating trauma-related vascular injuries are complex cases to handle within an acute setting. POCUS and POCDUS are increasingly being used for the workup and decision-making process of gunshot-related vascular injuries to the neck and are a fundamental part of the follow-up after definitive therapy.
Evaluating flight coordination approaches of UAV squads for WSN data collection enhancing the internet range on WSN data collection
Authors: Olivieri de Souza Bruno José , Endler Markus 
Published: July 2020

AbstractWireless sensor networks (WSNs) are an important means of collecting data in a variety of situations, such as the monitoring of large or hazardous areas. The retrieval of WSN data can yield better results through the use of unmanned aerial vehicles (UAVs), for example, concerning the increase in the amount of data collected and the decrease in the time between the collection and use of the data. In particular, disaster areas may be left without communication resources and with high residual risk to humans, at which point a WSN can be quickly launched by air to collect relevant data until other measures can be established. The set of rules of each problem’s component (e.g., number of UAVs, UAVs dislocation control, sensors, communication) is considered the approaches to solve the problem. In this meaning, some studies present approaches for the use of UAVs for the collection of WSN data, focusing primarily on optimizing the path to be covered by a single UAV and relying on long-range communication that is always available; these studies do not explore the possibility of using several UAVs or the limitations on the range of communication. This work describes DADCA, a distributed scalable approach capable of coordinating groups of UAVs in WSN data collection with restricted communication range and without the use of optimization techniques. The results reveal that the amount of data collected by DADCA is similar or superior to path optimization approaches by up to 1%. In our proposed approach, the delay in receiving sensor messages is up to 46% shorter than in other approaches, and the required processing onboard UAVs can reach less than 75% of those using optimization-based algorithms. The results indicate that the DADCA can match and even surpass other presented approaches, since the path optimization is not a focus, while also incorporating the advantages of a distributed approach.
Reference genome and transcriptome informed by the sex chromosome complement of the sample increase ability to detect sex differences in gene expression from RNA-Seq data
Authors: Olney Kimberly C. , Brotman Sarah M. , Andrews Jocelyn P. , Valverde-Vesling Valeria A. , Wilson Melissa A. 
Published: July 2020

Abstract
Background
Human X and Y chromosomes share an evolutionary origin and, as a consequence, sequence similarity. We investigated whether the sequence homology between the X and Y chromosomes affects the alignment of RNA-Seq reads and estimates of differential expression. We tested the effects of using reference genomes and reference transcriptomes informed by the sex chromosome complement of the sample’s genome on the measurements of RNA-Seq abundance and sex differences in expression.

Results
The default genome includes the entire human reference genome (GRCh38), including the entire sequence of the X and Y chromosomes. We created two sex chromosome complement informed reference genomes. One sex chromosome complement informed reference genome was used for samples that lacked a Y chromosome; for this reference genome version, we hard-masked the entire Y chromosome. For the other sex chromosome complement informed reference genome, to be used for samples with a Y chromosome, we hard-masked only the pseudoautosomal regions of the Y chromosome, because these regions are duplicated identically in the reference genome on the X chromosome. We analyzed the transcript abundance in the whole blood, brain cortex, breast, liver, and thyroid tissues from 20 genetic female (46, XX) and 20 genetic male (46, XY) samples. Each sample was aligned twice: once to the default reference genome and then independently aligned to a reference genome informed by the sex chromosome complement of the sample, repeated using two different read aligners, HISAT and STAR. We then quantified sex differences in gene expression using featureCounts to get the raw count estimates followed by Limma/Voom for normalization and differential expression. We additionally created sex chromosome complement informed transcriptome references for use in pseudo-alignment using Salmon. Transcript abundance was quantified twice for each sample: once to the default target transcripts and then independently to target transcripts informed by the sex chromosome complement of the sample.

Conclusions
We show that regardless of the choice of the read aligner, using an alignment protocol informed by the sex chromosome complement of the sample results in higher expression estimates on the pseudoautosomal regions of the X chromosome in both genetic male and genetic female samples, as well as an increased number of unique genes being called as differentially expressed between the sexes. We additionally show that using a pseudo-alignment approach informed on the sex chromosome complement of the sample eliminates Y-linked expression in female XX samples.