bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation of a computer-guided consultation in the assessment of suspected obstructive sleep apnoea syndrome
Authors: Chakrabarti Biswajit , Lewis-Burke Nadia , Pearson Mike , Craig Sonya , Davies Lisa , Sheridan Kim , England Philip , McKnight Eddie , Angus Robert 
Published: July 2020

BackgroundWe describe implementation of a clinical decision support system, a computer-guided consultation (CGC), in the assessment of subjects referred with suspected obstructive sleep apnoea syndrome (OSAS).MethodsTwo cohorts of patients were assessed. The first 100 cases had data collected with the CGC by a specialist sleep physician (stage1). A further 100 cases were assessed by a nonspecialist using the CGC (stage 2). For each case, the diagnosis suggested by the CGC was compared with the final diagnosis made by a second specialist sleep physician blinded to the CGC diagnosis.ResultsStage 1: of 100 people evaluated, a final diagnosis of OSAS was made by both the sleep specialist and CGC in 88% of cases. In 7 of the remaining 12 cases, both agreed there was “No evidence of OSAS”; in 5 cases the CGC did not reach a final diagnosis instead prompting specialist referral. Stage 2: 100 people were evaluated; 95% were evaluable. Both CGC and the sleep specialist made a diagnosis of OSAS in 83 cases (87%), in 5 cases both agreed there was no OSAS, whereas in 7 cases the CGC prompted a specialist review due to unexplained symptoms. The CGC was concordant with the final diagnosis in 95% and 93% of cases in the two cohorts, respectively and where there was doubt, prompted for clinical review. No OSAS cases were overlooked by the CGC.ConclusionAn intelligent CGC program creates opportunities in sleep medicine management pathways to safely yet effectively utilise nonspecialists working under specialist supervision.
Magnitude of problematic anger and its predictors in the Millennium Cohort
Authors: Adler Amy B. , LeardMann Cynthia A. , Roenfeldt Kimberly A. , Jacobson Isabel G. , Forbes David ,   for the Millennium Cohort Study Team
Published: July 2020

Abstract
Background
Problematic anger is intense anger associated with elevated generalized distress and that interferes with functioning. It also confers a heightened risk for the development of mental health problems. In military personnel and veterans, previous studies examining problematic anger have been constrained by sample size, cross-sectional data, and measurement limitations.

Methods
The current study used Millennium Cohort survey data (N = 90,266) from two time points (2013 and 2016 surveys) to assess the association of baseline demographics, military factors, mental health, positive perspective, and self-mastery, with subsequent problematic anger.

Results
Overall, 17.3% of respondents reported problematic anger. In the fully adjusted logistic regression model, greater risk of problematic anger was predicted by certain demographic characteristics as well as childhood trauma and financial problems. Service members who were in the Army or Marines, active duty (vs. reserves/national guard), and previously deployed with high levels of combat had increased risk for problematic anger. Veterans were also more likely to report problematic anger than currently serving personnel. Mental health predictors included posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and comorbid PTSD/MDD. Higher levels of positive perspective and self-mastery were associated with decreased risk of problematic anger.

Conclusion
Not only did 1 in 6 respondents report problematic anger, but risk factors were significant even after adjusting for PTSD and MDD, suggesting that problematic anger is more than an expression of these mental health problems. Results identify potential targets of early intervention and clinical treatment for addressing problematic anger in the military and veteran context.
Capturing the complexity of healthcare for people with Down syndrome in quality indicators - a Delphi study involving healthcare professionals and patient organisations
Authors: van den Driessen Mareeuw Francine A. , Coppus Antonia M. W. , Delnoij Diana M. J. , de Vries Esther 
Published: July 2020

Abstract
Background
Insight into quality of healthcare for people with Down Syndrome (DS) is limited. Quality indicators (QIs) can provide this insight. This study aims to find consensus among participants regarding QIs for healthcare for people with DS.

Methods
We conducted a four-round Delphi study, in which 33 healthcare professionals involved in healthcare for people with DS and two patient organisations’ representatives in the Netherlands participated. Median and 75-percentiles were used to determine consensus among the answers on 5-point Likert-scales. In each round, participants received an overview of participants’ answers from the previous round.

Results
Participants agreed (consensus was achieved) that a QI-set should provide insight into available healthcare, enable healthcare improvements, and cover a large diversity of quality domains and healthcare disciplines. However, the number of QIs in the set should be limited in order to prevent registration burden. Participants were concerned that QIs would make quality information about individual healthcare professionals publicly available, which would induce judgement of healthcare professionals and harm quality, instead of improving it.

Conclusions
We unravelled the complexity of capturing healthcare for people with DS in a QI-set. Patients’ rights to relevant information have to be carefully balanced against providers’ entitlement to a safe environment in which they can learn and improve. A QI-set should be tailored to different healthcare disciplines and information systems, and measurement instruments should be suitable for collecting information from people with DS. Results from this study and two preceding studies, will form the basis for the further development of a QI-set.
Bayesian model selection reveals biological origins of zero inflation in single-cell transcriptomics
Authors: Choi Kwangbom , Chen Yang , Skelly Daniel A. , Churchill Gary A. 
Published: July 2020

Abstract
Background
Single-cell RNA sequencing is a powerful tool for characterizing cellular heterogeneity in gene expression. However, high variability and a large number of zero counts present challenges for analysis and interpretation. There is substantial controversy over the origins and proper treatment of zeros and no consensus on whether zero-inflated count distributions are necessary or even useful. While some studies assume the existence of zero inflation due to technical artifacts and attempt to impute the missing information, other recent studies argue that there is no zero inflation in scRNA-seq data.

Results
We apply a Bayesian model selection approach to unambiguously demonstrate zero inflation in multiple biologically realistic scRNA-seq datasets. We show that the primary causes of zero inflation are not technical but rather biological in nature. We also demonstrate that parameter estimates from the zero-inflated negative binomial distribution are an unreliable indicator of zero inflation.

Conclusions
Despite the existence of zero inflation in scRNA-seq counts, we recommend the generalized linear model with negative binomial count distribution, not zero-inflated, as a suitable reference model for scRNA-seq analysis.
Dramatic radiotherapy response in a necrotic lymphoma mass: a case report
Authors: McNeil Nicholas , Gorayski Peter , Blunt Danielle , Roos Daniel 
Published: July 2020

Abstract
Background
Diffuse large B-cell lymphoma (DLBCL) represents the most common form of non-Hodgkin lymphoma and is characterized by an aggressive natural history. It often presents with rapid symptom development and disease progression. Most lymphomas are inherently radiosensitive, which allows for effective disease control from relatively low radiation doses. We report a case of a dramatic radiotherapy response in a necrotic diffuse large B-cell lymphoma mass in an elderly patient with early-stage diffuse large B-cell lymphoma, illustrating the potential for palliative radiotherapy to reduce disease burden in patients not fit for systemic therapy. There is no current consensus recommendation for radiotherapy treatment in this setting.

Case presentation
A 97-year-old Caucasian woman presented to the emergency department of our institution with a painful, malodorous, necrotic right upper neck mass, which had progressed over a two-month period. Investigations confirmed stage 1A diffuse large B-cell lymphoma. Palliative radiotherapy was delivered to a dose of 25 Gray (Gy) in five fractions on alternate days over two consecutive weeks. After four months, the mass completely resolved with no residual symptoms.

Conclusion
Dramatic responses resulting in durable local control and improvement in quality of life are achievable with palliative radiotherapy, owing to the radiosensitivity of diffuse large B-cell lymphoma.
Riders on the storm: loggerhead sea turtles detect and respond to a major hurricane in the Northwest Atlantic Ocean
Authors: Crowe Leah M. , Hatch Joshua M. , Patel Samir H. , Smolowitz Ronald J. , Haas Heather L. 
Published: July 2020

Abstract
Background
Extreme weather events, including hurricanes, have considerable biological, ecological, and anthropogenic impacts. Hurricane Irene caused substantial economic damage when it hit the Mid-Atlantic Bight (MAB) off of the eastern United States in August of 2011. The MAB is highly stratified during the summer when a strong thermocline separates warm, surface water from deep, cold water, and this oceanographic phenomenon makes modeling hurricane strength difficult. Loggerhead sea turtles (Caretta caretta) forage in the MAB primarily during the stratified season and their dive behavior to the bottom allows them to experience the oceanographic conditions of the entire water column.

Methods
In this study, we analyzed the movements and dive behavior of juvenile and adult-sized loggerhead sea turtles (n = 18) that were foraging in the MAB as Hurricane Irene moved through the region. The satellite tags deployed on these turtles transmitted location data and dive behavior as well as sea surface temperature (SST) and temperature-depth profiles during this time.

Results
Behavioral and environmental shifts were observed during and after the hurricane compared to conditions before the storm. During the hurricane, most of the turtles (n = 15) moved north of their pre-storm foraging grounds. Following the storm, some turtles left their established foraging sites (n = 8) moving south by 7.3–135.0 km, and for the others that remained (n = 10), 12% of the observed dives were longer (0.54–1.11 h) than dives observed before the storm. The in situ data collected by the turtle-borne tags captured the cooling of the SST (Mean difference = 4.47°C) and the deepening of the thermocline relative to the pre-storm conditions.

Conclusions
Some of the loggerhead behavior observed relative to a passing hurricane differed from the regular pattern of seasonal movement expected for turtles that forage in the MAB. These data documented the shifts in sea turtle behavior and distribution during an ecosystem-level perturbation and the recorded in situ data demonstrated that loggerheads observe environmental changes to the entire water column, including during extreme weather events.
Radiographic bone level around particular laser-treated dental implants: 1 to 6 years multicenter retrospective study
Authors: Mongardini C. , Zeza B. , Pelagalli P. , Blasone R. , Scilla M. , Berardini M. 
Published: July 2020

Abstract
Purpose
The aim of the present retrospective study was to evaluate clinical and radiological outcomes, in terms of implant survival rate, marginal bone loss, and peri-implantitis incidence, of a titanium implants with an innovative laser-treated surface.

Materials and methods
A total of 502 dental implants were inserted in four dental practices (Udine, Arezzo, Frascati, Roma) between 2008 and 2013. All inserted implants had laser-modified surface characterized by a series of 20-μm-diameter holes (7–10 μm deep) every 10 μm (Synthegra®, Geass srl, Italy). The minimum follow-up period was set at 1 year after the final restoration. Radiographs were taken after implant insertion (T0), at time of loading (T1), and during the follow-up period (last recall, T2). Marginal bone loss and peri-implant disease incidence were recorded.

Results
A total of 502 implants with a maximum follow-up period of 6 years were monitored. The mean differential between T0 and T2 was 0.05 ± 1.08 mm at the mesial aspect and 0.08 ± 1.11 mm at the distal with a mean follow-up period of 35.76 ± 18.05 months. After being in function for 1 to 6 years, implants reported varying behavior: 8.8% of sites did not show any radiographic changes and 38.5% of sites showed bone resorption. The bone appeared to have been growing coronally in 50.7% of the sites measured.

Conclusion
Implants showed a maintenance of marginal bone levels over time, and in many cases, it seems that laser-modified implant surface could promote a bone growth. The low peri-implant disease incidence recorded could be attributed to the laser titanium surface features that seem to prevent bacterial colonization. Future randomized and controlled studies are needed to confirm the results of the present multi-centrical retrospective analysis.
Effect of intimate partner violence of women on minimum acceptable diet of children aged 6–23 months in Ethiopia: evidence from 2016 Ethiopian demographic and health survey
Authors: Tsedal Desta Melaku , Yitayal Mezgebu , Abebe Zegeye , Tsegaye Adino Tesfahun 
Published: July 2020

AbstractBackgroundThe absence of proper infant and young child feeding practice results in malnutrition. Intimate Partner Violence (IPV) is potentially a major factor affecting child feeding practices. However, there is limited evidence about the effect of intimate partner violence (IPV) on a minimum acceptable diet. Therefore, in this study, we hypothesized that IPV will be associated with a lack of a minimum acceptable diet among children aged 6–23 months.MethodsWe conducted a cross-sectional analysis using the Ethiopian Demographic and Health Survey (EDHS) 2016. All child-mother pairs that participated in EDHS 2016 from all regions of Ethiopia were included. The analysis included mother-child pairs where 6–23 months aged children with mothers who were ever in a committed partnership and interviewed for domestic violence were involved. The data were weighted considering enumeration areas as a cluster and place of residence as a stratum. A binary logistic regression analysis was done to identify factors independently associated with a minimum acceptable diet.ResultTotally, 1307 observations were included in the final analysis. The mean age of mothers was 29 years (standard deviation ±6.54 years), the mean age of children was 14. ± 5.02 months, and 32% of women had intimate partner violence (IPV). Of the children, 8% had a minimum acceptable diet (minimum acceptable diet), 15% had a minimum dietary diversity, and 43% had a minimum meal frequency. Having intimate partner violence decreases children minimum acceptable diet by 65% (AOR:0.35; 95% CI:0.16, 0.77). The other factors associated with the minimum acceptable diet were caregivers attaining a secondary level of education (AOR: 4.01; 95% CI: 1.04, 15.45), currently working (AOR: 2.26; 95% CI: 1.01, 5.11), and undecided fertility desire (AOR: 4.72; 95% CI: 1.37, 16.28).ConclusionIntimate partner violence against women had a negative association with the minimum acceptable diet children have received. Decreasing violence against women, educating, and increasing work opportunities for them would help in improving child feeding practice and reducing malnutrition and its consequences. Further studies that focus on possible community-based interventions aiming to decrease IPV are recommended.
Modulatory effect of dry orange (citrus sinensis) peel powder on bisphenol A-induced hepatic and splenic toxicity in rats
Authors: AbdEl-Gwaad Hager Mosaad Saad , El-Wahab Hanan M. F. Abd , Mohamed Enas Ali Kamel , Sharaf Eman Hassan Abdel Aziz , Osman Amany Abdel Hameid Mahmoud 
Published: July 2020

Abstract
Background
Bisphenol A (BPA) is used as monomer in polycarbonate synthesis, and it acts as plasticizer in baby and water bottles and the production of epoxy resins which are used as inner coatings of many food and beverage cans. This study was carried out to evaluate the possible modulatory effect of dry orange peels powder (OPP) to attenuate the toxic effects of BPA on liver and spleen in rats.

Method
Sixty male Spargue–Dawley rats weighing 130 ± 10 g were randomly divided into six groups (n = 10 for each group). Group 1: negative control, fed on balanced diet and received corn oil. Group 2: positive control, fed on balanced diet, received BPA (350 mg/kg b.w. per orally; p.o twice weekly) suspended in corn oil. Groups from 3 to 6 fed on balanced diet supplemented with OPP in the tested doses of 12.5, 25, 50, and 100 g/Kg diet respectively, and received BPA (350 mg/kg b.w. twice weekly).

Results
There was a significant increase in liver sterol regulatory element-binding transcription factor 1 gene expression (SREBF1), serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities, nitric oxide (NO), total cholesterol (TC), triacylglycerols (TAGs), low-density lipoprotein cholesterol (LDL-c), very low-density lipoprotein cholesterol (VLDL-c), interluken-4 (IL-4), immunoglobulin-E (IgE)levels, and total leukocytes count (TLC) in BPA group as compared to negative control group (P < 0.05).On the other hand, BPA caused a significant decrease in liver catalase activity, serum high-density lipoprotein cholesterol (HDL-c), serum immunoglobulin-M (IgM) levels, blood hemoglobin% (Hb), and red blood cell (RBCs) counts compared to the negative control group (P < 0.05). Also, the histopathological examination of liver and spleen sections supported biochemical parameters showed a significant destruction in the BPA group as compared to the negative control group.

Conclusion
It is observed that OPP dietary supplementation in the tested doses ameliorates deleterious effects induced by BPA. The improvement in these altered parameters in OPP supplemented groups was in a dose-dependent manner.
Role of ultrasound in predicting the molecular subtypes of invasive breast ductal carcinoma
Authors: Khalaf Lamiaa M. R. , Herdan Rania A. 
Published: July 2020

Abstract
Background
Breast cancer is a heterogeneous disease that was explained recently by the presence of multiple molecular subtypes. These subtypes are the luminal A (LA), luminal B (LB), human epidermal growth factor receptor 2 (HER2), and triple-negative (TN). In this study, we aim to investigate whether ultrasound imaging features can play a role in predicting the molecular subtypes of invasive ductal breast cancer (IDC) and to assess whether the nodal metastasis is an independent predictor for each subtype.

Results
The predictive sonographic signs for each subtype are as follows: echogenic halo, posterior shadowing, angular or spiculated margin, and unifocal mass for LA subtype; irregular shape for LB subtype; unifocal mass, abrupt interface of the tumor boundary, and posterior enhancement or no posterior change for HER2 subtype; and circumscribed or lobulated margin, oval or rounded shape, posterior enhancement or no posterior change, abrupt interface of the tumor boundary, and parallel orientation of the mass for TN. By multivariate logistic regression, presence of nodal metastasis is the strongest independent predictor for HER2 subtype, and its absence is the strongest independent predictor for LA subtype.

Conclusions
Certain sonographic signs are predictors for each molecular subtype of IDC. Nodal metastasis is an independent predictor for HER2 subtype when present and for LA subtype when absent.
Computed tomography examination of the screaming mummy “Unknown-Woman-A”
Authors: Hawass Zahi , Saleem Sahar N. 
Published: July 2020

Abstract
Background
The Royal Cache at Deir el Bahari in Luxor, Egypt, contained the mummy of a princess named Meritamun of uncertain identity, who was consequently designated “Unknown-Woman-A.” The mummy has a widely opened mouth as if screaming, with the unusual posture of her head tilted to the right and partially flexed legs cross at the ankles. We postulated that computed tomography (CT) would help to provide insights on life and death of “Unknown-Woman-A.”

Results
CT findings indicate that “Unknown-Woman-A” died in her fifties (sixth decade of life) and suffered from advanced diffuse atherosclerosis. “Unknown-Woman-A” was well mummified and eviscerated, and her body cavity was filled with resin. The desiccated brain had shifted to the right inside her skull. We presume that “Unknown-Woman-A” died of a sudden and massive myocardial infarction. Death spasm induced her unusual posture, and the contracted body was apparently mummified before relaxing her postmortem position.

Conclusions
This CT study has provided useful information about the mummy designated “Unknown-Woman-A” including her mummification style, underlying advanced cardiovascular atherosclerosis disease, and her possible death circumstances.
Clozapine treatment and risk of COVID-19 infection: retrospective cohort study
Authors: Govind Risha , Fonseca de Freitas Daniela , Pritchard Megan , Hayes Richard D. , MacCabe James H. 
Published: July 2020

BackgroundClozapine, an antipsychotic with unique efficacy in treatment-resistant psychosis, is associated with increased susceptibility to infection, including pneumonia.AimsTo investigate associations between clozapine treatment and increased risk of COVID-19 infection in patients with schizophrenia-spectrum disorders who are receiving antipsychotic medications in a geographically defined population in London, UK.MethodUsing information from South London and Maudsley NHS Foundation Trust (SLAM) clinical records, via the Clinical Record Interactive Search system, we identified 6309 individuals who had an ICD-10 diagnosis of schizophrenia-spectrum disorders and were taking antipsychotics at the time of the COVID-19 pandemic onset in the UK. People who were on clozapine treatment were compared with those on any other antipsychotic treatment for risk of contracting COVID-19 between 1 March and 18 May 2020. We tested associations between clozapine treatment and COVID-19 infection, adjusting for gender, age, ethnicity, body mass index (BMI), smoking status and SLAM service use.ResultsOf 6309 participants, 102 tested positive for COVID-19. Individuals who were on clozapine had increased risk of COVID-19 infection compared with those who were on other antipsychotic medication (unadjusted hazard ratio HR =2.62, 95% CI 1.73–3.96), which was attenuated after adjusting for potential confounders, including clinical contact (adjusted HR = 1.76, 95% CI 1.14–2.72).ConclusionsThese findings provide support for the hypothesis that clozapine treatment is associated with an increased risk of COVID-19 infection. Further research will be needed in other samples to confirm this association. Potential clinical implications are discussed.