bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Practical Blockchain Framework using Image Hashing for Image Authentication
Authors: Paul Manoranjan , White Cameron C , Chakraborty Subrata 
Published: April 2020

Abstract

Blockchain is a relatively new technology that can be seen as a decentralised database. Blockchain systems heavily rely on cryptographic hash functions to store their data, which makes it difficult to tamper with any data stored in the system. A topic that was researched along with blockchain is image authentication. Image authentication focuses on investigating and maintaining the integrity of images. As a blockchain system can be useful for maintaining data integrity, image authentication has the potential to be enhanced by blockchain. There are many techniques that can be used to authenticate images; the technique investigated by this work is image hashing. Image hashing is a technique used to calculate how similar two different images are. This is done by converting the images into hashes and then comparing them using a distance formula. To investigate the topic, an experiment involving a simulated blockchain was created. The blockchain acted as a database for images. This blockchain was made up of devices which contained their own unique image hashing algorithms. The blockchain was tested by creating modified copies of the images contained in the database, and then submitting them to the blockchain to see if it will return the original image. Through this experiment it was discovered that it is plausible to create an image authentication system using blockchain and image hashing. However, the design proposed by this work requires refinement, as it appears to struggle in some situations. This work shows that blockchain can be a suitable approach for authenticating images, particularly via image hashing. Other observations include that using multiple image hash algorithms at the same time can increase performance in some cases, as well as that each type of test done to the blockchain has its own unique pattern to its data.
Effect of preoperative segmental range of motion on patient outcomes in cervical disc arthroplasty
Authors: Wu Tingkui , Liu Hao , Ding Chen , Rong Xin , He Jun-bo , Huang Kang-kang , Hong Ying , Wang Beiyu 
Published: April 2020

Abstract
BackgroundCervical disc arthroplasty (CDA) has been demonstrated in clinical trials as an effective and safe treatment for patients diagnosed with radiculopathy and/or myelopathy. However, the current CDA indication criteria based on the preoperative segmental range of motion (ROM), comprise a wide range of variability. Although the arthroplasty level preserved ROM averaged 7°-9° after CDA, there are no clear guidelines on preoperatively limited or excessive ROM at the index level, that could be considered as suitable for CDA in any given trials.MethodsPatients who underwent CDA between January 2008 to October 2018 using Prestige-LP discs in our hospital, were reviewed retrospectively. They were divided into the small-ROM (≤5.5°) and the large-ROM (> 12.5°) groups according to preoperatively index-level ROM. Clinical outcomes, including the Japanese Orthopedics Association (JOA), Neck Disability Index (NDI), and Visual Analogue Scale (VAS) scores, were evaluated. Radiological parameters, including cervical lordosis, disc angle (DA), global and segmental ROM, disc height (DH), and complications were measured.ResultsOne hundred and twenty-six patients, with a total of 132 arthroplasty segments were analyzed. There were 64 patients in the small-ROM and 62 in the large-ROM group. There are more patients diagnosed with cervical spondylosis in the small-ROM than in the large-ROM group (P=0.046). Patients in both groups had significantly improved in JOA, NDI, and VAS scores after surgery, but the intergroup difference was not significant. Patients in the small-ROM group increased dramatically in cervical lordosis, global and segmental ROM postoperatively (P < 0.001). However, global and segmental ROM paradoxically decreased in the large-ROM group postoperatively (P < 0.001). Patients in the small-ROM group had lower DH preoperatively (P=0.012), and a higher rate of heterotopic ossification (HO) postoperatively (P=0.037).ConclusionPatients with preoperatively limited or excessive segmental ROM could achieve satisfactory clinical outcomes at 3 years postoperatively. Patients with limited segmental ROM had more, and severe HO and significantly increased segmental mobility, which decreased in patients with excessive segmental ROM after surgery.
Dynamic waitlisted design for evaluating a randomized trial of evidence-based quality improvement of comprehensive women’s health care implementation in low performing VA facilities
Authors: Hamilton Alison B. , Olmos-Ochoa Tanya , Canelo Ismelda , Rose Danielle , Hoggatt Katherine , Than Claire , Yano Elizabeth M 
Published: April 2020

Abstract
Background : Women’s Health Services (WHS) in the Veterans Health Administration (VA) has long partnered with VA researchers to evaluate how VA care is organized for women Veterans. This partnership has yielded substantial evidence of 1) variations in women Veterans’ access to comprehensive healthcare services that contribute to disparities in quality and patient experience, and 2) the positive impacts of gender-specific care models for women Veterans’ quality and satisfaction. In an effort to provide support specifically to sites that were low-performing in women’s health, WHS and the VA Quality Enhancement Research Initiative co-funded an effort to roll out and evaluate evidence-based quality improvement (EBQI), an implementation strategy with demonstrated effectiveness in a prior cluster randomized trial in women’s health clinics.
Methods : We will identify 21 low-performing VA facilities through a combination of WATCH data, VA quality metrics (by gender) and other indicators. In partnership with WHS, an EBQI contractor will deliver the EBQI “package” – local consensus-development and priority-setting using stakeholder panels, multilevel stakeholder engagement, practice facilitation, local EBQI team training, and formative feedback – to participating sites. We propose a dynamic wait-listed design to evaluate the WHS plans for seven EBQI launches per year over three years. The goal is to evaluate: (1) barriers and facilitators to achieving delivery of comprehensive women’s health care in low-performing VA facilities; (2) effectiveness of EBQI in supporting low-performing VA facilities achieve improved practice features (e.g., level of comprehensive services available, care coordination arrangements, Patient Aligned Care Team (PACT) features implemented, environment of care improvements), provider/staff attitudes (e.g., improved gender awareness, women’s health knowledge and practice), quality of care, and patient experience; and (3) contextual factors, local implementation processes, and organizational changes over time.
Discussion : Access to comprehensive women’s health care reduces fragmentation of care, improves patient satisfaction and results in better patient outcomes. We hypothesize that EBQI implementation will result in changes in leadership awareness and buy-in, multilevel engagement in problem-solving, an enhanced culture of quality improvement, structural changes in care, improved provider/staff attitudes, and better quality and patient experience.
Dietary L-Citrulline supplementation modulates nitric oxide synthesis and anti-oxidant status of laying hens during summer season
Authors: UYANGA VICTORIA ANTHONY , Jiao Hongchao , Zhao Jingpeng , Wang Xiaojuan , Lin Hai 
Published: April 2020

Abstract
Background
L-Citrulline (L-Cit), a non-protein amino acid, has been implicated in several physiological functions including anti-inflammatory, anti-oxidative, and hypothermic roles, however, there is paucity of information with regards to its potential in poultry production. This study was designed to investigate the effects of dietary L-Cit supplementation on the production performance, nitric oxide production and anti-oxidant status of laying hens during summer periods. Hy-line laying hens (n = 288, 34 weeks old) were allotted to four treatment with 6 replicates of 12 chickens each. Dietary treatments of control (basal diets), 0.25%, 0.50% and 1.00% L-Cit supplementation were fed to chickens for eight (8) weeks. Production performance, egg quality characteristics, nitric oxide production and antioxidant properties were measured. Blood samples were collected at 4th and 8th weeks of experiment.
Results
Air temperature monitoring indicated average minimum and maximum recordings of 25.02 0C and 31.01 0C respectively. Dietary supplementation with L-Cit did not significantly (P > 0.05) influence the production performance, plasma biochemistry and rectal temperatures of laying hens. Egg shape index was increased with L-Cit diet, similarly, albumen heights and Haugh units also tended (P < 0.10) to improve with higher L-Cit supplementation. Plasma nitric oxide (NOx) concentration was observed to increase with highest contents at 1% L-Cit supplementation. Likewise, nitric oxide synthase (NOS) enzyme activity for both total NOS (tNOS) and inducible NOS (iNOS) were upregulated with increasing L-Cit levels, although, tNOS was not affected at week 4. Anti-oxidant enzymes including catalase and superoxide dismutase (SOD) were increased with L-Cit supplementation, however, SOD activity was unchanged at week 4. Total anti-oxidant capacity increased with L-Cit groups at week 8. L-Cit supplementation attenuated the extent of lipid peroxidation measured by malondialdehyde levels, and also inhibited glutathione peroxidase activity.
Conclusion
Dietary L-Cit supplementation enhanced nitric oxide synthesis, promoted antioxidant defense systems, and tended to improve internal egg quality traits of laying hens during summer season. 1% L-Cit supplementation proved most effective in enhancing both nitric oxide production and anti-oxidant defenses.
Metagenomic Profiling of Ocular Surface Microbiome Changes in Meibomian Gland Dysfunction
Authors: Zhao Fuxin , Zhang Dake , Ge Chaoxiang , Zhang Lei , Reinach Peter S , Tian Xiangjun , Tao Chengcheng , Zhao Zhelin , Zhao Chenchen , Fu Wenjie , Zeng Changqing , Chen Wei 
Published: April 2020

Abstract
Background: Ocular surface microbiome changes can affect meibomian gland dysfunction (MGD) development, which in turn may increase the risk of tissue infection. To delineate what these changes are, we used shot-gun metagenomic analysis to determine if there are differences between the microbial communities in ocular sites surrounding the meibomian gland in healthy and patients afflicted with MGD. This comparison entailed comparing the microbe content in different microbiomes of the eyelid skin, conjunctiva and meibum with those from the same locations in healthy individuals (HC) and those with this disease. Results: The meibum bacterial content of these microbiomes was different in these two different types of individuals. Almost all of the most significant taxonomic changes in the meibum microbiome of these individuals with MGD were also present in their eyelid skin, but not in the conjunctiva. Such site-specific microbe pattern changes accompany increases in the gene expression levels controlling carbohydrate and lipid metabolism. Most of the microbiomes in MGD disease possess a microbe population capable of metabolizing benzoate. Interestingly, microbe preponderance seemed to be less in patients afflicted with more severe MGD. Nevertheless, pathogens known to underlie ocular infection were evident in these patients. In meibum samples from HC, Pseudomonas fluorescens was present in more than 90% of the samples. Cupriavidus metallidurans and Pseudomonas putida had a positive rate over 50%. MGD meibum contained instead an abundance of Campylobacter coli, Campylobacter jejuni, and Enterococcus faecium pathogens, which were almost absent from HC. Functional annotation indicated that in the microbiomes of MGD meibum their capability to undergo chemotaxis and display immune evasive virulence and mediate Type IV secretion was different than that in the microbiomes of meibum isolated from HC. Conclusions: MGD meibum contained distinct microbiota different from HC, and MGD meibum microbiome community population was much smaller than in the HC group. Profiling differences in the meibum microbiome makeup between HC and MGD patients may uncover unique targets for improved treatment of this disease.
Detecting fabrication in large-scale molecular omics data
Authors: Bradshaw Michael , Payne Samuel H 
Published: April 2020

Abstract
Background: Fraud is a pervasive problem and can occur as fabrication, falsification, plagiarism or theft. The scientific community is not exempt from this universal problem and several studies have recently been caught manipulating or fabricating data. Current measures to prevent and deter scientific misconduct come in the form of the peer-review process and on-site clinical trial auditors. As recent advances in high-throughput omics technologies have moved biology into the realm of big-data, fraud detection methods must be updated for sophisticated computational fraud. In the financial sector, machine learning and digit-preference are successfully used to detect fraud. Results: Drawing from these sources, we develop methods of fabrication detection in biomedical research and show that machine learning can be used to detect fraud in large-scale omic experiments. Using the raw data as input, the best machine learning models correctly predicted fraud with 84-95% accuracy. With digit frequency as input features, the best models detected fraud with 98%-100% accuracy. All of the data and analysis scripts used in this project are available at https://github.com/MSBradshaw/FakeData . Conclusions: Using digit frequencies as a generalized representation of the data, multiple machine learning methods were able to identify fabricated data with near perfect accuracy.
Evaluation of Small Bowel Motion and Feasibility of using the Peritoneal Space to Replace Bowel Loops for Dose Constraints during Intensity-Modulated Radiotherapy for Rectal Cancer
Authors: Li Siyuan , Gong Yanping , Yang Yongqiang , Guo Qi , Qian Jianjun , Tian Ye 
Published: April 2020

Abstract
Background
The goal of this study was to assess small bowel motion and explore the feasibility of using peritoneal space (PS) to replace bowel loops (BL) via the dose constraint method to spare the small bowel during intensity-modulated radiotherapy (IMRT) for rectal cancer.
Methods
A total of 24 patients with rectal cancer who underwent adjuvant radiotherapy were selected. Weekly repeat CT scans from pre-treatment to the fourth week of treatment were acquired and defined as Plan, 1W, 2W, 3W, and 4W. BL and PS contours were delineated in all of the scans. Two IMRT plans called PPS and PBL were designed on Plan CT using two dose PS and BL constraint methods, respectively, and then copied to CT 1 ~ 4W. The shift%, dose volume, and NTCP of the small bowel in PPS and PBL during treatment were evaluated.
Results
Overall, 109 sets of CT scans from 24 patients were acquired, and 218 plans were designed and copied. The PS and BL volumes were 1339.28 cc and 250.27 cc. The BL and PS shift% V15 was 28.48% and 11.79% (p = 0.000), which was less in the prone position than in the supine position (25.24% vs 32.10%, p = 0.000; 9.9% vs 14.85%, p = 0.000). On all of the CT scans, most PPS small bowel dose volumes were less than from PBL. V15 was 170.07 cc vs 178.58 cc (p = 0.000), and they had a significant correlation. The NTCP of chronic and acute side effects from PPS was significantly less than PBL (2.80% vs 3.00%, p = 0.018; 57.32% vs 58.64%, p = 0.000).
Conclusions
This study indicated that small bowel motion may lead to uncertainties in its dose volume and NTCP evaluation during IMRT for rectal cancer. The BL movements were significantly greater than PS, and the prone position was significantly less than the supine position. Using PS instead of BL can spare the small bowel. V15 < 830 cc is the dose constraint standard.
Development of risk prediction models to predict urine culture growth for patients with suspected urinary tract infection in the emergency department: protocol for an electronic health record study from a single UK hospital
Authors: Rockenschaub Patrick , Gill Martin J , McNulty David , Carroll Orlagh , Freemantle Nick , Shallcross Laura 
Published: April 2020

Abstract
Background: Urinary tract infection (UTI) is a leading cause of hospital admissions and is diagnosed based on urinary symptoms and microbiological cultures. Due to lags in the availability of culture results of up to 72 hours, and the limitations of routine diagnostics, many patients with suspected UTI are started on antibiotic treatment unnecessarily. Predictive models based on routinely collected clinical information may help clinicians to rule out a diagnosis of bacterial UTI in low-risk patients shortly after hospital admission, providing additional evidence to guide antibiotic treatment decisions.Methods: Using electronic hospital records from Queen Elizabeth Hospital Birmingham (QEHB) collected between 2011 and 2017, we aim to develop a series of models that estimates the probability of bacterial UTI at presentation in the emergency department (ED) among individuals with suspected urinary tract infection syndromes. Predictions will be made during ED attendance and at different time points after hospital admission to assess whether predictive performance may be improved over time as more information becomes available about patient status. All models will be externally validated for expected future performance using QEHB data from 2018/19.Discussion: Risk prediction models using electronic health records offer a new approach to improve antibiotic prescribing decisions, integrating clinical and demographic data with test results to stratify patients according to their probability of bacterial infection. Used in conjunction with expert opinion, they may help clinicians to identify patients that benefit the most from early antibiotic cessation.
Staging Procedures Fail to Benefit Women with Borderline Ovarian Tumours Who Want to Preserve Fertility: A Retrospective Analysis of 448 cases
Authors: Li Na , Gou Jinhai , Li Lin , Ming Xiu , Hu Tingwenyi , Li Zhengyu 
Published: April 2020

Abstract
Background: To evaluate the effect of clinicopathologic factors on the prognosis and fertility outcomes of BOT patients.Methods: We performed a retrospective analysis of BOT patients who underwent surgical procedures in West China Second University Hospital from 2008 to 2015. The DFS outcomes, potential prognostic factors and fertility outcomes were evaluated.Results: 448 patients were included; 52 recurrences were observed. 92 patients undergoing FSS achieved pregnancy. No significant differences in fertility outcomes were found between the staging and unstaged surgery groups. Staging surgery was not an independent prognostic factor for DFS. Laparoscopy resulted in better prognosis than laparotomy in patients with stage I tumours and a desire for fertility preservation.Conclusion: Patients with BOT fail to benefit from surgical staging. Laparoscopy is recommended for patients with stage I disease who desire to preserve fertility. Physicians should pay more attention to risk of recurrence in patients who want to preserve fertility.
Multimorbidity patterns, polypharmacy and their association with liver and kidney abnormalities in people over 65 years of age: a longitudinal study
Authors: Villen Noemi , Guisado-Clavero Marina , Fernández-Bertolín Sergio , Troncoso Amelia , Foguet-Boreu Quinti , Amado Ester , Pons-Vigues Mariona , Roso-Llorach Albert , Violán Concepción 
Published: April 2020

Abstract
Background: The implementation of individual clinical practice guidelines in patients with multimorbidity often results in polypharmacy. Our aim was to analyse medication use according to longitudinal multimorbidity patterns (MPs) and determine during a 5-year which MPs are associated with abnormal liver and kidney function in primary care patients over 65 years of age living in Catalonia. Methods: Design: Longitudinal study (years 2012 to 2016) based on the electronic health records (EHR) contained in the primary care information system database of the Catalan Institute of Health (SIDIAP). Variables : age, sex, MPs, medication and polypharmacy (drug exposure obtained from the Pharmacy Invoice Registry). Medicines were classified in accordance with the Anatomical Therapeutic Chemical Classification System. Glomerular filtration rate was used to determine abnormal kidney function, and serum levels of alkaline phosphatase, alanine transaminase and gamma-glutamyl transpeptidase were used to diagnose abnormal liver function. Statistics : For medication use in MPs, we calculated annual mean packages of each drug in each MP, and observed/expected ratios (O/E-ratios) were obtained by dividing mean packages in the cluster by mean packages of the same drug in the overall population. Logistic regression models were fitted to estimate the association between MPs at baseline and abnormal kidney and liver function tests during follow up. Results: 916,619 patients were included, and 743,827 completed the follow up. We identified one polypharmacy profile per MP, and concluded that the most prescribed drugs in each pattern corresponded to the diseases overrepresented in that specific MP. The median of drugs ranged from 3 (Cluster 1 - Non-Specific) to 8 (Cluster 10 - Multisystem Pattern). Abnormal kidney function was most commonly observed in the C4-Cardio-Circulatory and Renal (OR 2.19; CI 95% 2.15-2.23) and C3-Minority Metabolic Autoimmune-Inflammatory (OR 2.16; CI 95% 2.12-2.20) MPs. A higher risk of abnormal liver function was observed in the C8-Digestive (OR 3.39; CI 95% 3.30-3.49), and C4-Cardio-Circulatory and Renal (OR 1.96; CI 95% 1.91-2.02) MPs. Conclusions: A higher risk of abnormal kidney and liver function was observed in specific MPs. The long-term characterisation of MPs and polypharmacy illustrates the burden of chronic multimorbidity and polypharmacy in the elderly population.