bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perinatal death audit and classification of stillbirths in two provinces in Papua New Guinea: A retrospective analysis
Authors: Vallely Lisa M. , Smith Rachel , Bolnga John W. , Babona Delly , Riddell Michaela A. , Mengi Alice , Au Lucy , Polomon Cherolyn , Vogel Joshua P. , Pomat William S. , Vallely Andrew J , Homer Caroline S.E. 
Published: October 2020

AbstractObjectiveTo undertake a retrospective perinatal death audit and assessment of avoidable factors associated with stillbirths among a cohort of women in two provinces in Papua New Guinea.MethodsWe used data from an ongoing cluster‐randomized crossover trial in 10 sites among 4600 women in Papua New Guinea (from 2017 to date). The overarching aim is to improve birth outcomes. All stillbirths from July 2017 to January 2020 were identified. The Perinatal Problem Identification Program was used to analyze each stillbirth and review associated avoidable factors.ResultsThere were 59 stillbirths among 2558 births (23 per 1000 births); 68% (40/59) were classified “fresh” and 32% as “macerated”. Perinatal cause of death was identified for 63% (37/59): 30% (11/37) were due to intrapartum asphyxia and traumatic breech birth and 19% (7/37) were the result of pre‐eclampsia. At least one avoidable factor was identified for 95% (56/59) of stillbirths. Patient‐associated factors included lack of response to reduced fetal movements and delay in seeking care during labor. Health personnel‐associated factors included poor intrapartum care, late diagnosis of breech presentation, and prolonged second stage with no intervention.ConclusionFactors associated with stillbirths in this setting could be avoided through a package of interventions at both the community and health‐facility levels.
Impact of group prenatal care on key prenatal services and educational topics in Malawi and Tanzania
Authors: Liese Kylea L. , Kapito Esnath , Chirwa Ellen , Liu Li , Mei Xiaohan , Norr Kathleen F. , Patil Crystal L. 
Published: October 2020

AbstractObjectiveTo examine whether group prenatal care (PNC) increased key services and educational topics women reported receiving, compared with individual PNC in Malawi and Tanzania.MethodsData come from a previously published randomized trial (n=218) and were collected using self‐report surveys. Late pregnancy surveys asked whether women received all seven services and all 13 topics during PNC. Controlling for sociodemographics, country, and PNC attendance, multivariate logistic regression used forward selection to produce a final model showing predictors of receipt of all key services and topics.ResultsIn multivariate logistic regression, women in group PNC were 2.49 times more likely to receive all seven services than those in individual care (95% confidence interval [CI] 1.78–3.48) and 5.25 times more likely to have received all 13 topics (95% CI 2.62–10.52).ConclusionThis study provides strong evidence that group PNC meets the clinical standard of care for providing basic clinical services and perinatal education for pregnant women in sub‐Saharan Africa. The greater number of basic PNC services and educational topics may provide one explanatory mechanism for how group PNC achieves its impact on maternal and neonatal outcomes.ClinicalTrials.gov: NCT03673709, NCT02999334.
Multiple sclerosis identification in brainMRIimages using wavelet convolutional neural networks
Authors: Alijamaat Ali , NikravanShalmani Alireza , Bayat Peyman 
Published: October 2020

AbstractMultiple sclerosis (MS) is a degenerative disease of the covering around the nerves in the central nervous system. It damages the immune cells and causes small lesions in the patient's brain. Automated image recognition techniques can be employed for increasing the accuracy of detection. The use of convolutional neural networks (CNN) is the most common deep learning method for detecting lesions in image. Due to the specific features of MS lesions, the use of spectral features especially multiresolution enables the highlighting of images lesions and leads to a more accurate diagnosis. In the present study, the Haar wavelet transform was applied to make use of the spectral information. The proposed method is a combination of the two‐dimensional discrete Haar wavelet transform and the CNN network. Experiments on the image data of 38 patients and 20 healthy individuals revealed accuracy, precision, and sensitivity of 99.05%, 98.43%, and 99.14%, respectively.
Nonlinear effects of government spending shocks in the USA: Evidence from state‐level data
Authors: Mumtaz Haroon , Sunder‐Plassmann Laura 
Published: October 2020

SummaryThis paper uses state‐level data to estimate the effect of government spending shocks during expansions and recessions. By employing a mixed‐frequency framework, we are able to include a long span of annual state‐level government spending data in our nonlinear quarterly panel VAR model. We find evidence that for the average state the fiscal multiplier is larger during recessions. However, there is substantial heterogeneity across the cross‐section. The degree of nonlinearity in the effect of spending shocks is larger in states that are subject to a higher degree of financial frictions. In contrast, states with a prevalence of manufacturing, mining and agricultural industries tend to have multipliers that are more similar across business cycle phases.
LV‐GAN: A deep learning approach for limited‐view optoacoustic imaging based on hybrid datasets
Authors: Lu Tong , Chen Tingting , Gao Feng , Sun Biao , Ntziachristos Vasilis , Li Jiao 
Published: October 2020

AbstractThe optoacoustic imaging (OAI) methods are rapidly evolving for resolving optical contrast in medical imaging applications. In practice, measurement strategies are commonly implemented under limited‐view conditions due to oversized image objectives or system design limitations. Data acquired by limited‐view detection may impart artifacts and distortions in reconstructed optoacoustic (OA) images. We propose a hybrid data‐driven deep learning approach based on generative adversarial network (GAN), termed as LV‐GAN, to efficiently recover high quality images from limited‐view OA images. Trained on both simulation and experiment data, LV‐GAN is found capable of achieving high recovery accuracy even under limited detection angles less than 60°. The feasibility of LV‐GAN for artifact removal in biological applications was validated by ex vivo experiments based on two different OAI systems, suggesting high potential of a ubiquitous use of LV‐GAN to optimize image quality or system design for different scanners and application scenarios.
Identification of Cytochrome b‐245, beta‐chain gene mutations, and clinical presentations in Iranian patients with X‐linked chronic granulomatous disease
Authors: Heydari Atefeh , Abolnezhadian Farhad , Sadeghi‐Shabestari Mahnaz , Saberi Alihossein , Shamsizadeh Ahmad , Ghadiri Ata A. , Ghandil Pegah 
Published: October 2020

AbstractBackgroundX‐linked chronic granulomatous disease (X‐CGD) is an immunodeficiency disorder caused by defects in the gp91phox subunit that leads to life‐threatening infections. We aimed to identify CYBB gene mutations and study clinical phenotypes in Iranian patients with probable X‐CGD.MethodsWe studied four unrelated Iranian patients with probable X‐CGD and their families recruited in several years. We isolated genomic DNA from whole blood and performed Sanger sequencing in the CYBB gene's coding and flanking regions. We also performed pathogenicity predictions using in silico tools.ResultsWe detected four different mutations, including a novel insertion mutation in exon 5 (p.Ile117AsnfsX6), in the patient. Bioinformatics analysis confirmed the pathogenic effect of this mutation. We predicted protein modeling and demonstrated lost functional domains. The patient with the insertion mutation presented pneumonia and acute sinusitis during his life. We also detected three other known nonsense mutations (p.Arg157Ter, p.Arg226Ter, and p.Trp424Ter) in the CYBB gene. The patient with p.Arg157Ter developed lymphadenitis and pneumonia. Moreover, the patient with inflammatory bowel disease showed p.Arg226Ter and the patient with tuberculosis presented p.Trp424Ter. We detected different clinical features in the patients compared to other Iranian patients with the same mutations.ConclusionOur results expand the genetic database of patients with X‐CGD from Iran and make it much easier and faster to identify patients with X‐CGD. Our results also help to detect carriers and enable prenatal diagnosis in high‐risk families as a cost‐effective strategy.
A practice‐based evidence investigation of God representations in spiritually integrated psychotherapies
Authors: Currier Joseph M. , McDermott Ryon C. , Stevens Laura T. , Isaak Steven L. , Davis Edward B. , Hollingsworth William‐Glenn L. , Archer Glenn D. , Stefurak Tres 
Published: October 2020

AbstractObjectiveThis practice‐based evidence study examined trajectories of God representations and psychological distress among Christians participating in spiritually integrated psychotherapies (SIPs).MethodsIn total, 17 clinicians practicing SIPs in a mid‐sized city on the US Gulf Coast implemented session‐to‐session assessments of these outcomes with 158 clients over a 4‐month period and also reported their use of specific spiritual interventions after each session (e.g., affirmed client's divine worth).ResultsMultivariate growth modeling revealed clients' psychological distress decreased over the study period whereas authoritarian God representations increased and benevolent God representations remained stable. In addition, clients who increased in benevolent representations of God had a greater likelihood of experiencing alleviation of psychological distress.ConclusionThese findings affirm the potential efficacy of SIPs and cultural importance of belief in a benevolent deity as a source of strength, identity, and potential healing among Christians clients who prefer a spiritually integrated approach in psychotherapy.
Orofacial pain education in dentistry: A path to improving patient care and reducing the population burden of chronic pain
Authors: Costa Yuri M. , De Koninck Beatrice P. , Elsaraj Sherif M. , Exposto Fernando G. , Herrero Babiloni Alberto , Kapos Flavia P. , Sharma Sonia , Shimada Akiko 
Published: October 2020

AbstractDentists stand in an optimal position to prevent and manage patients suffering from chronic orofacial pain (OFP) disorders, such as temporomandibular disorders, burning mouth syndrome, trigeminal neuralgia, persistent idiopathic dentoalveolar pain, among others. However, there are consistent reports highlighting a lack of knowledge and confidence in diagnosing and treating OFP among dental students, recent graduates, and trained dentists, which leads to misdiagnosis, unnecessary costs, delay in appropriate care and possible harm to patients. Education in OFP is necessary to improve the quality of general dental care and reduce individual and societal burden of chronic pain through prevention and improved quality of life for OFP patients. Our aims are to emphasize the goals of OFP education, to identify barriers for its implementation, and to suggest possible avenues to improve OFP education in general, postgraduate, and continuing dental education levels, including proposed minimum OFP competencies for all dentists. Moreover, patient perspectives are also incorporated, including a testimony from a person with OFP. General dentists, OFP experts, educators, researchers, patients, and policy makers need to combine efforts in order to successfully address the urgent need for quality OFP education.
Evaluating co‐created patient‐facing materials to increase understanding of genetic test results
Authors: Dwyer Andrew A. , Au Margaret G. , Smith Neil , Plummer Lacey , Lippincott Margaret F. , Balasubramanian Ravikumar , Seminara Stephanie B. 
Published: October 2020

AbstractPatients often have difficulty understanding genetic test reports. Technical language and jargon can impede comprehension and limit patients using results to act on findings. One potential way to improve patient understanding of genetic test reports is to provide patient‐facing materials. This study aimed to examine understandability and actionability of co‐created patient‐facing materials for genetic test results in a research context. We combined interprofessional perspectives and patient engagement to co‐create patient‐facing materials for patients undergoing research genetic testing for congenital hypogonadotropic hypogonadism (Kallmann syndrome). The iterative development process was guided by principles of health literacy and human‐centered design (i.e., design thinking). Readability was assessed using eight validated algorithms. Patients and parents evaluated materials using a web‐based survey. The gold standard Patient Education Materials Assessment Tool for print materials (PEMAT‐P) was employed to measure understandability (content, style, use of numbers, organization, design, use of visual aids) and actionability. PEMAT‐P scores >80% were considered high quality. Results were analyzed descriptively and correlations performed to identify relationships between education/health literacy and PEMAT‐P ratings. A consensus score of eight algorithms indicated the materials were an 8th–9th grade reading level. Our findings are consistent with the U.S. Department of Health and Human Services ‘average difficulty’ classification (i.e., 7th–9th grade). In total, 61 patients/parents evaluated the materials. ‘Visual Aids’ received the lowest mean PEMAT‐P rating (89%). All other parameters scored 90%–97%. PEMAT‐P scores did not differ according to educational attainment (less than college vs. college or more, p = 0.28). Participants with adequate health literacy were more likely to approve of the ‘organization’ of information (p < 0.05). Respondents with low health literacy had more favorable views of ‘visual aids’ (p < 0.01). Involving patients in a co‐creation process can produce high‐quality patient‐facing materials that are easier to understand.
A case of urgent colonoscopic hemostasis of a cecal hemorrhagic ulceration in a patient receiving heparin for COVID‐19 coagulopathy
Authors: Yoshida Naohisa , Hirose Ryohei , Watanabe Makoto , Yamazaki Masaski , Hashimoto Satoru , Matsubara Shin , Kasamatsu Yu , Fujita Naohisa , Rani Rafiz Abdul , Dohi Osamu , Inoue Ken , Naito Yuji , Itoh Yoshito 
Published: October 2020

AbstractCOVID‐19 rarely causes lower gastrointestinal bleeding even though its RNA has been detected in patient's stool. Urgent colonoscopy in a COVID‐19 patient with massive bloody stool requires various procedural and equipment considerations. Here, we present a case of colonoscopic hemostasis of a cecal hemorrhagic ulceration in a patient on heparin for COVID‐19 coagulopathy. We also share various management methods for the prevention of COVID‐19 contamination. A 71‐year‐old man was diagnosed with COVID‐19 pneumonia and subsequently underwent hemodiafiltration. Heparin was initiated for COVID‐19 coagulopathy. At day 42, the patient experienced 2000 mL of bloody stool. An operator performed urgent colonoscopy with three assistants in a negative‐pressure room with full personal protective equipment. A hemorrhagic ulceration was detected at the cecum, and endoscopic hemostasis was performed. Immunohistochemistry was positive for cytomegalovirus. Postprocedure, the endoscopic systems were thoroughly cleaned, and specific measures for endoscope reprocessing and disinfection were performed to prevent contamination with COVID‐19.
The skin of birds' feet: Morphological adaptations of the plantar surface
Authors: Höfling Elizabeth , Abourachid Anick 
Published: October 2020

AbstractThe skin of the foot provides the interface between the bird and the substrate. The foot morphology involves the bone shape and the integument that is in contact with the substrate. The podotheca is a layer of keratinized epidermis forming scales that extends from the tarsometatarsus to the toe extremities. It varies in size, shape, amount of overlap and interacts with the degree of fusion of the toes (syndactyly). A study of toe shape and the podotheca provides insights on the adaptations of perching birds. Our analysis is based on micro‐CT scans and scanning electron microscopy images of 21 species from 17 families, and includes examples with different orientations of the toes: zygodactyl (toes II and III forward), anisodactyl (toes II, III, and IV forward), and heterodactyl (toes III and IV forward). We show that in these three groups, the skin forms part of a perching adaptation that involves syndactyly to different degrees. However, syndactyly does not occur in Psittacidae that use their toes also for food manipulation. The syndactyly increases the sole surface and may reinforce adherence with the substrate. Scale shape and toe orientation are involved in functional adaptations to perch. Thus, both bone and skin features combine to form a pincer‐like foot.
Large colloidal probes for atomic force microscopy: Fabrication and calibration issues
Authors: Chighizola Matteo , Puricelli Luca , Bellon Ludovic , Podestà Alessandro 
Published: October 2020

AbstractAtomic force microscopy (AFM) is a powerful tool to investigate interaction forces at the micro and nanoscale. Cantilever stiffness, dimensions and geometry of the tip can be chosen according to the requirements of the specific application, in terms of spatial resolution and force sensitivity. Colloidal probes (CPs), obtained by attaching a spherical particle to a tipless (TL) cantilever, offer several advantages for accurate force measurements: tunable and well‐characterisable radius; higher averaging capabilities (at the expense of spatial resolution) and sensitivity to weak interactions; a well‐defined interaction geometry (sphere on flat), which allows accurate and reliable data fitting by means of analytical models. The dynamics of standard AFM probes has been widely investigated, and protocols have been developed for the calibration of the cantilever spring constant. Nevertheless, the dynamics of CPs, and in particular of large CPs, with radius well above 10 μm and mass comparable, or larger, than the cantilever mass, is at present still poorly characterized. Here we describe the fabrication and calibration of (large) CPs. We describe and discuss the peculiar dynamical behaviour of CPs, and present an alternative protocol for the accurate calibration of the spring constant.
Quantification of Myelinated Nerve Fraction and Degeneration in Spinal Cord Neuropil by SHIFT MRI
Authors: Wolfe Tatiana , Hoffman Kristopher , Hogan Matthew K. , Salazar Betsy , Tang Xiufeng , Chaboub Lesley , Quini Caio C. , Lu Zhong‐Lin , Horner Philip J. 
Published: October 2020

BackgroundNeurodegeneration is a complex cellular process linked to prompt changes in myelin integrity and gradual neuron loss. Current imaging techniques offer estimations of myelin volumes in lesions/remyelinated areas but are limited to detect subtle injury.PurposeTo investigate whether measurements detected by a signal hierarchically isolated as a function of time‐to‐echo (SHIFT) MRI technique can determine changes in myelin integrity and fiber axolemma.Study TypeProspective animal model.Animal ModelSurgically demyelinated spinal cord (SC) injury model in rodents (n = 6).Field Strength/SequenceGradient‐echo spin‐echo at 3T.AssessmentMulticompartment T2 relaxations were computed by SHIFT MRI in 75‐microns‐resolution images of the SC injury penumbra region 2 weeks post‐trauma. G‐ratio and axolemma delamination were assessed by transmission electron microscopy (TEM) in intact and injured samples. SC myelinated nerve fraction was computed by SHIFT MRI prospectively and assessed histologically.Statistical TestsRelations between SHIFT‐isolated T2‐components and TEM measurements were studied using linear regression and t‐tests. Pearson's correlation and significance were computed to determine the SHIFT's sensitivity to detect myelinated fibers ratio in gray matter. Regularized least‐squares‐based ranking analysis was employed to determine SHIFT MRI's ability to discern intact and injured myelinated nerves.ResultsBiexponential signals isolated by SHIFT MRI for intact vs. lesion penumbra exhibited changes in T2, shifting from intermediate components (25 ± 2 msec) to long (43 ± 11 msec) in white matter, and similarly in gray matter regions‐of‐interest (31 ± 2 to 46 ± 16 msec). These changes correlated highly with TEM g‐ratio and axon delamination measurements (P < 0.05). Changes in short T2 components were observed but not statistically significant (8.5 ± 0.5 to 7 ± 3 msec, P = 0.445, and 4.0 ± 0.9 to 7 ± 3 msec, P = 0.075, respectively). SHIFT MRI's ability to detect myelinated fibers within gray matter was confirmed (P < 0.001).Data ConclusionChanges detected by SHIFT MRI are associated with abnormal intermembrane spaces formed upon mild injury, directly correlated with early neuro integrity loss.Level of Evidence 1Technical Efficacy Stage 2
Safety of Off‐Label Use of Ferumoxtyol as a Contrast Agent for MRI: A Systematic Review and Meta‐Analysis of Adverse Events
Authors: Ahmad Faraz , Treanor Lee , McGrath Trevor A. , Walker Daniel , McInnes Matthew D.F. , Schieda Nicola 
Published: October 2020

BackgroundFerumoxytol has been studied as an alternative to gadolinium‐based MRI contrast agents, but regulatory body warnings currently limit its use.PurposeEstimate the adverse event rate in patients undergoing MRI with ferumoxytol as a contrast agent.Study TypeSystematic review.PopulationThirty‐nine studies including 5411 ferumoxytol administrations in 4336 patients.AssessmentMultiple databases were searched for studies using ferumoxytol as an off‐label MRI contrast agent in any patient population as of April 2020. Studies were eligible for inclusion if they reported the number and severity of adverse events (classified by American College of Radiology [ACR] severity of acute reactions). Risk of bias was assessed using the ROBINS‐I tool.Statistical TestsThe proportion of administrations with adverse events was calculated using random effects meta‐analysis of proportions.ResultsNo deaths related to ferumoxytol administration were reported. Sixteen studies reported immediate adverse events in 3849 patients undergoing 4901 ferumoxytol administrations. Ninety‐seven immediate adverse events were reported and the pooled adverse event proportion for immediate adverse events was 0.02 (95% confidence interval [CI] 0.02–0.02). Twenty‐three studies reported time‐unspecified adverse events in 487 patients undergoing 510 ferumoxytol administrations. Five time‐unspecified adverse events were reported; the pooled adverse event proportion for time‐unspecified adverse events was 0.01 (95% CI 0.00–0.04). 88% of adverse events were mild (90/102), 11% (11/102) were moderate, and 1% (1/102) was severe. Sixteen studies were at low risk of bias, 23 studies were at serious risk of bias. Subgroup analysis by patient population revealed no significant variability (adult vs. pediatric). No studies evaluated the use of ferumoxytol as an alternative to patients who had a prior hypersensitivity reaction to gadolinium‐based contrast agents (GBCAs).Data ConclusionThe overall adverse event rate for off‐label ferumoxytol use as an MRI contrast agent is 2%, with rare severe reactions and no deaths. To date, there are no studies evaluating the safety of ferumoxytol as an alternative to GBCAs in patients with a prior hypersensitivity reaction.Level of Evidence2Technical Efficacy Stage5