bluuebunny/crossref_metadata_2025_split huggingface dataset:
Artificial intelligence-guided tissue analysis combined with immune infiltrate assessment predicts stage III colon cancer outcomes in PETACC08 study
Authors: Reichling Cynthia , Taieb Julien , Derangere Valentin , Klopfenstein Quentin , Le Malicot Karine , Gornet Jean-Marc , Becheur Hakim , Fein Francis , Cojocarasu Oana , Kaminsky Marie Christine , Lagasse Jean Paul , Luet Dominique , Nguyen Suzanne , Etienne Pierre-Luc , Gasmi Mohamed , Vanoli Andre , Perrier Hervé , Puig Pierre-Laurent , Emile Jean-François , Lepage Come , Ghiringhelli François 
Published: November 2019

ObjectiveDiagnostic tests, such as Immunoscore, predict prognosis in patients with colon cancer. However, additional prognostic markers could be detected on pathological slides using artificial intelligence tools.DesignWe have developed a software to detect colon tumour, healthy mucosa, stroma and immune cells on CD3 and CD8 stained slides. The lymphocyte density and surface area were quantified automatically in the tumour core (TC) and invasive margin (IM). Using a LASSO algorithm, DGMate (DiGital tuMor pArameTErs), we detected digital parameters within the tumour cells related to patient outcomes.ResultsWithin the dataset of 1018 patients, we observed that a poorer relapse-free survival (RFS) was associated with high IM stromal area (HR 5.65; 95% CI 2.34 to 13.67; p<0.0001) and high DGMate (HR 2.72; 95% CI 1.92 to 3.85; p<0.001). Higher CD3+ TC, CD3+ IM and CD8+ TC densities were significantly associated with a longer RFS. Analysis of variance showed that CD3+ TC yielded a similar prognostic value to the classical CD3/CD8 Immunoscore (p=0.44). A combination of the IM stromal area, DGMate and CD3, designated ‘DGMuneS’, outperformed Immunoscore when used in estimating patients’ prognosis (C-index=0.601 vs 0.578, p=0.04) and was independently associated with patient outcomes following Cox multivariate analysis. A predictive nomogram based on DGMuneS and clinical variables identified a group of patients with less than 10% relapse risk and another group with a 50% relapse risk.ConclusionThese findings suggest that artificial intelligence can potentially improve patient care by assisting pathologists in better defining stage III colon cancer patients’ prognosis.
Response in carcass yield, organ weights, and gut morphology of broiler chickens to incremental levels of Vachellia tortilis leaf meal
Authors: Miya A. , Sithole A.N. , Mthethwa N. , Khanyile M. , Chimonyo M. 
Published: November 2019

The objective of this study was to assess the carcass yield, organ weights, and gut morphology response to Vachellia tortilis inclusion in broilers. Unsexed 14-d-old Cobb500™ chicks were randomly assigned to six diets containing 0, 30, 60, 90, 120, and 150 g kg−1 dry matter of V. tortilis leaf meal. The slaughter weight (SW), dressed carcass weight (DCW), breast weight, thigh weight (TW), drumstick weight (DW), and internal organs were measured. Villus height (VH), crypt depth (CD), epithelial, submucosa, and muscularis thickness were taken. The apparent villus surface area (AVSA) and villus to crypt ratio were calculated. There was a linear decrease in SW and DCW (P < 0.05) with the increase of V. tortilis leaf meal. The SW and DCW decreased by 0.77 and 5.25 g for each g kg−1 increase in V. tortilis, respectively. The TW and DW showed no relationship with levels of V. tortilis leaf meal. The relative weight of gizzard, intestine, stomach, heart, and kidney increased linearly (P < 0.05) as levels of V. tortilis increased. The relative weight of the liver was not related to V. tortilis inclusion. The VH, AVSA, VH to CD ratio, as well as submucosa, muscularis, and epithelial thicknesses linearly increased as the V. tortilis inclusion level increased. There was no relationship between V. tortilis leaf meal inclusion and CD (P > 0.05). The increased morphological measurements suggest that leaf meal inclusion alters gut physiology and could influence the digestion and absorption of nutrients in broilers.
A Gendered Reading of Purity and Boundaries: 4QTohorot A (4Q274) as a Case Study
Authors: Keady Jessica M. 
Published: November 2019

AbstractTo understand purity from both the male and the female perspective within the Qumran ‎communities, this article will be using 4QTohorot A (4Q274) as a case study to: review the formation and function of gender within the manuscript; permit a broadening of the critique of purity to include a range of gender ‎issues; enable a discussion of the position of women in relation to ‎female purification laws; and permit exploration of the male perspective and ‎experience from a masculinist perspective. ‎By concentrating on the ‎functionality of this particular scroll, further insights will be gained to understand the gendered ‎and identity politics at play behind such strict purity regulations in order to discern—and to ‎imagine—what it actually meant to be a constant threat of potential pollution within ‎communities where purity ruled all aspects of everyday life, and how such regulations worked on a gendered ‎level.
Ne Bis In Idem in Article 20(3) of the Rome Statute and Non-State Courts
Authors: Nuridzhanian Gaiane 
Published: November 2019

Abstract
Article 20(3) of the Rome Statute bars the International Criminal Court from trying a person for conduct proscribed by the Statute if the person has already been tried in relation to the same conduct before “another court,” provided that the proceedings in the other court were genuine. The article discusses application of Article 20(3) of the Rome Statute and, by implication, of the Court’s admissibility framework to non-State courts. It argues that Article 20(3) applies where there has a been a trial before a court of a State, whether that State is a party or not to the Rome Statute. Article 20(3) can in principle apply to a trial before a non-State court were the trial to satisfy the customary international law rules on attribution of conduct to a State.
Ears on the Hand: Reaching Three-Dimensional Targets With an Audio-Motor Device
Authors: Hanneton Sylvain , Hoellinger Thomas , Forma Vincent , Roby-Brami Agnes , Auvray Malika 
Published: November 2019

Abstract
Understanding the processes underlying sensorimotor coupling with the environment is crucial for sensorimotor rehabilitation and sensory substitution. In doing so, devices which provide novel sensory feedback consequent to body movement may be optimized in order to enhance motor performance for particular tasks. The aim of the study reported here was to investigate audio-motor coupling when the auditory experience is linked to movements of the head or the hands. The participants had to localize and reach a virtual source with the dominant hand in response to sounds. An electromagnetic system recorded the position and orientation of the participants’ head and hands. This system was connected to a 3D audio system that provided binaural auditory feedback on the position of the virtual listener located on the participants’ body. The listener’s position was computed either from the hands or from the head. For the hand condition, the virtual listener was placed on the dominant hand (the one used to reach the target) in Experiment 1 and on the non-dominant hand, which was constrained in order to have similar amplitude and degrees of freedom as that of the head, in Experiment 2. The results revealed that, in the two experiments, the participants were able to localize a source within the 3D auditory environment. Performance varied as a function of the effector’s degrees of freedom and the spatial coincidence between sensor and effector. The results also allowed characterizing the kinematics of the hand and head and how they change with audio-motor coupling condition and practice.
Wood anatomy of Ceiba speciosa (A. St.-Hil.) Ravenna under urban pollution
Authors: de Vasconcellos Thaís Jorge , Callado Cátia Henriques 
Published: November 2019

AbstractUrban pollution is one of the current environmental problems which most threatens the human and environmental health. In a fast-changing world, trees stand out among the sessile organisms that withstand the variations imposed by the environment throughout their lifespan. Thus, trees have become important objects of study in the evaluation of phenological, physiological and/or morphological plasticity. Previous studies have demonstrated the impact of urban environment on cambium anatomy and dendrochronology ofCeiba speciosa(Malvaceae), a native species of the Atlantic Forest. In the present study, our objective is to evaluate the impact of the urban environment on wood structure and consequently on the hydraulic architecture ofCeiba speciosa. Wood samples were collected by a non-destructive method, processed and analyzed according to the usual techniques for plant anatomy. Samples were collected in two sites: the first, an important forest remnant of the Atlantic Forest, and the second next to Avenida Brasil, the largest avenue in Rio de Janeiro, the fourth largest city in Latin America. Trees showed plasticity in seven anatomical features and significant differences in wood structure between both groups studied. Urban trees have lower hydraulic conductivity, shorter vessels and fibres, and larger, more frequent rays. These features demonstrate that in stressful situations, such as those observed in urbanized environments,Ceiba speciosainvests in more safety for water transport and in lower wood resistance, with a trade-off between high production of cells of low energy cost and providing storage of water and metabolic products for unfavorable periods.
Cardiologists’ and patients’ views about the informed consent process and their understanding of the anticipated treatment benefits of coronary angioplasty: A survey study
Authors: Astin Felicity , Stephenson John , Probyn Joy , Holt Janet , Marshall Keith , Conway Dwayne 
Published: November 2019

Background: Percutaneous coronary intervention is a common revascularisation technique. Serious complications are uncommon, but death is one of them. Seeking informed consent in advance of percutaneous coronary intervention is mandatory. Research shows that percutaneous coronary intervention patients have inaccurate perceptions of risks, benefits and alternative treatments. Aim: To assess cardiologists’ and patients’ views about the informed consent process and anticipated treatment benefits. Methods: Two cross-sectional, anonymous surveys were distributed in England: an electronic version to a sample of cardiologists and a paper-based version to patients recruited from 10 centres. Results: A sample of 118 cardiologists and 326 patients completed the surveys. Cardiologists and patients shared similar views on the purpose of informed consent; however, over 40% of patients and over a third of cardiologists agreed with statements that patients do not understand, or remember, the information given to them. Patients placed less value than cardiologists on the consent process and over 60% agreed that patients depended on their doctor to make the decision for them. Patients’ and cardiologists’ views on the benefits of percutaneous coronary intervention were significantly different; notably, 60% of patients mistakenly believed that percutaneous coronary intervention was curative. Conclusions: The percutaneous coronary intervention informed consent process requires improvement to ensure that patients are more involved and accurately understand treatment benefits to make an informed decision. Redesign of the patient pathway is recommended to allow protected time for health professionals to engage in discussions using evidence-based approaches such as ‘teach back’ and decision support which improve patient comprehension.
Burden, risk factors and maternal and offspring outcomes of gestational diabetes mellitus (GDM) in sub-Saharan Africa (SSA): a systematic review and meta-analysis
Authors: Natamba Barnabas Kahiira , Namara Arthur Araali , Nyirenda Moffat Joha 
Published: November 2019

AbstractBackgroundThe burden, determinants and outcomes of gestational diabetes mellitus (GDM) in sub-Saharan Africa are not known. We summarized existing evidence on the prevalence, risk factors and complications of GDM in the region.MethodsPubMed was searched from inception to January 31st 2019. Studies were included if carried out in any of the sub-Saharan Africa countries and were available as abstracts or full texts. Interventional studies and those only including qualitative data were excluded. We employed random effects modelling to estimate the pooled GDM prevalence and risk ratios (RRs) for risk factors and outcomes of GDM and their 95%CI.Results283 papers were identified in the initial search, 33 of which met the inclusion criteria. Data on GDM burden suggest a pooled prevalence of 9% (95%CI, 7–12%). Family history of type 2 diabetes and previous history of GDM, macrosomia, stillbirth and abortion were important risk factors of GDM. In addition, being overweight or obese, over 25 years of age or hypertensive increased the risk of GDM. In terms of complications, GDM more than doubles the risk macrosomia (RR; 95%CI: 2.2; 1.1–4.4).ConclusionsThere is a high burden of gestational diabetes mellitus in sub-Saharan Africa, but more studies are needed to document locally important risk factors as well as maternal and offspring outcomes. Interventions to reduce obesity among older African women might lead to reduced risk of GDM in sub-Saharan Africa.
Low psoas muscle index is a poor prognostic factor for lower gastrointestinal perforation: a single-center retrospective cohort study
Authors: Kayano Hajime , Nomura Eiji , Abe Rin , Ueda Yasuhiko , Machida Takashi , Fujita Chikara , Uchiyama Shohei , Endo Kazuyuki , Murakami Katsuki , Mukai Masaya , Makuuchi Hiroyasu 
Published: November 2019

Abstract
Background
Various body composition indices have been reported as prognostic factors for different cancers. However, whether body composition affects prognosis after lower gastrointestinal tract perforation requiring emergency surgery and multidisciplinary treatment has not been clarified. This study examined whether body composition evaluations that can be measured easily and quickly from computed tomography (CT) are useful for predicting prognosis.

Methods
Subjects comprised 64 patients diagnosed with perforation at final diagnosis after emergency surgery for a preoperative diagnosis of lower gastrointestinal tract perforation and penetration. They were divided into a survival group and a non-survival (in-hospital mortality) group and compared. Body composition indices (psoas muscle index (PMI); psoas muscle attenuation (PMA); subcutaneous adipose tissue index (SATI); visceral adipose tissue index (VATI); visceral-to-subcutaneous fat area ratio (VSR)) were measured from preoperative CT. Cross-sectional psoas muscle area at the level of the 3rd lumbar vertebra was quantified. Optimal cut-off values were calculated using receiver operating characteristic curve analysis. Poor prognostic factors were investigated from multivariate logistic regression analyses that included patient factors, perioperative factors, intraoperative factors, and body composition indices as explanatory variables.

Results
The cause of perforation was malignant disease in 12 cases (18.7%), and benign disease in 52 cases (81.2%). The most common cause was diverticulum of the large intestine. Emergency surgery for the 64 patients led to survival in 52 patients and death in 12 patients. On multivariate logistic regression analysis, independent predictors of poor prognosis were Sequential Organ Failure Assessment score (odds ratio 1.908; 95% confidence interval (CI) 1.235–3.681; P = 0.0020) and PMI (odds ratio 13.478; 95%CI 1.342–332.690; P = 0.0252). The cut-off PMI was 4.75 cm2/m2 for males and 2.89 cm2/m2 for females. Among survivors, duration of hospitalization was significantly longer in the low PMI group (29 days) than in the high PMI group (22 days, p = 0.0257).

Conclusions
PMI is easily determined from CT and allows rapid evaluation of prognosis following lower gastrointestinal perforation.
Primary healthcare and school health service utilisation by adolescents and young adults in KwaZulu-Natal, South Africa
Authors: Doyle Aoife M. , Mchunu Lerato , Koole Olivier , Mthembu Sandile , Dlamini Siphephelo , Ngwenya Nothando , Ferguson Jane , Seeley Janet 
Published: November 2019

Abstract
Background
Young people aged 10–24 years are a vulnerable group with poor health service access relative to other populations. Recent South African initiatives, the She Conquers campaign, the Integrated School Health Policy and the Adolescent & Youth Health Policy, include a focus on improving the breadth and quality of youth-friendly health service delivery. However, in some settings the provision and impact of scaled-up youth friendly health services has been limited indicating a gap between policy and implementation. In this study we reviewed existing sources of data on health service utilisation to answer the following question: ‘What health conditions do young people present with and what services do they receive at public health clinics, mobile clinics and school health services?’

Methods
We conducted a retrospective register review in three purposively selected primary healthcare clinics (PHCC), one mobile clinic, and one school health team in Hlabisa and Mtubatuba sub-districts of uMkhanyakude District, KwaZulu-Natal, South Africa. The focus was service utilisation for any reason by 10–24 year olds. We also conducted descriptive analysis of pre-existing data on service utilisation by young people available from the District Health Information System for all 17 PHCC in the study sub-districts.

Results
Three quarters of 4121 recorded young person visits in the register review were by females, and 40% of all young person visits were by females aged 20–24 years. The most common presenting conditions were HIV-related, antenatal care, family planning, general non-specific complaints and respiratory problems (excluding TB). There were relatively few recorded consultations for other common conditions affecting young people such as mental health and nutritional problems. Antibiotics, antiretrovirals, contraceptives, vitamins/supplements, and analgesics were most commonly provided. Routine health registers recorded limited information, were often incomplete and/or inconsistent, and age was not routinely recorded.

Conclusions
Measuring morbidity and service provision are fundamental to informing policy and promoting responsive health systems. Efforts should be intensified to improve the quality and completeness of health registers, with attention to the documentation of important, and currently poorly documented, young people’s health issues such as mental health and nutrition.
“We just get paid for 12 hours a day, but we work 24”: home health aide restrictions and work related stress
Authors: Shotwell Jillian L. , Wool Eve , Kozikowski Andrzej , Pekmezaris Renee , Slaboda Jill , Norman Gregory , Rhodes Karin , Smith Kristofer 
Published: November 2019

Abstract
Background
Home-bound patients in New York State requiring long-term care services have seen significant changes to their benefits due to turmoil in the Managed Long Term Care (MLTC) market. While there has been research conducted regarding the effect of MLTC challenges on beneficiaries, the impact of MLTC regulatory changes on home health aides has not been explored.

Methods
Qualitative interviews were conducted with formal caregivers, defined as paid home health aides (HHAs) (n = 13) caring for patients in a home-based primary care program in the New York City metropolitan area. HHAs were asked about their satisfaction with the home based primary care program, their own job satisfaction, and whether HHA restrictions affect their work in any way. Interviews were audio-recorded, transcribed, and analyzed.

Results
Two main themes emerged: (1) Pay, benefits and hours worked and (2) Concerns about patient well-being afterhours. HHAs are working more hours than they are compensated for, experience wage stagnation and loss of benefits, and experience stress related to leaving frail clients alone after their shifts end.

Conclusions
HHAs experience significant job-related stress when caring for frail elderly patients at home, which may have implications for both patient care and HHA turnover. As government bodies contemplate new policy directions for long-term care programs which rely on HHAs the impact of these changes on this vulnerable workforce must be considered.
Low-moderate arsenic exposure and respiratory in American Indian communities in the Strong Heart Study
Authors: Powers Martha , Sanchez Tiffany R. , Grau-Perez Maria , Yeh Fawn , Francesconi Kevin A. , Goessler Walter , George Christine M. , Heaney Christopher , Best Lyle G. , Umans Jason G. , Brown Robert H. , Navas-Acien Ana 
Published: November 2019

Abstract
Background
Arsenic exposure through drinking water is an established lung carcinogen. Evidence on non-malignant lung outcomes is less conclusive and suggests arsenic is associated with lower lung function. Studies examining low-moderate arsenic (< 50 μg/L), the level relevant for most populations, are limited. We evaluated the association of arsenic exposure with respiratory health in American Indians from the Northern Plains, the Southern Plains and the Southwest United States, communities with environmental exposure to inorganic arsenic through drinking water.

Methods
The Strong Heart Study is a prospective study of American Indian adults. This analysis used urinary arsenic measurements at baseline (1989–1991) and spirometry at Visit 2 (1993–1995) from 2132 participants to evaluate associations of arsenic exposure with airflow obstruction, restrictive pattern, self-reported respiratory disease, and symptoms.

Results
Airflow obstruction was present in 21.5% and restrictive pattern was present in 14.4%. The odds ratio (95% confidence interval) for obstruction and restrictive patterns, based on the fixed ratio definition, comparing the 75th to 25th percentile of arsenic, was 1.17 (0.99, 1.38) and 1.27 (1.01, 1.60), respectively, after adjustments, and 1.28 (1.02, 1.60) and 1.33 (0.90, 1.50), respectively, based on the lower limit of normal definition. Arsenic was associated with lower percent predicted FEV1 and FVC, self-reported emphysema and stopping for breath.

Conclusion
Low-moderate arsenic exposure was positively associated with restrictive pattern, airflow obstruction, lower lung function, self-reported emphysema and stopping for breath, independent of smoking and other lung disease risk factors. Findings suggest that low-moderate arsenic exposure may contribute to restrictive lung disease.