bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of diagnostic accuracy of intracranial aneurysm detection using medical-grade versus commercial consumer-grade displays and different image reconstructions against the background of process optimization for telemedicine
Authors: Auer Timo Alexander , Münzfeld Hanna , Posch Helena , Stöckel Juliane , Tietze Anna , Bohner Georg , Böning Georg 
Published: November 2019

Background Process optimization in computed tomography (CT) and telemedicine. Purpose To compare image quality and objective diagnostic accuracy of medical-grade and consumer-grade digital displays/computer terminals for detection of intracranial aneurysms. Material and Methods Four radiologists with different levels of experience retrospectively read a total of 60 patients including 30 cases of proven therapy-naïve intracranial aneurysm detectable on a medical-grade grayscale calibrated display. They had 5 min per case reading the first 20 datasets using only axial slices, the next 20 patients using axial slices and multiplanar reconstructions (MPRs), and the last 20 patients using axial slices, MPRs, and maximum intensity projections (MIPs). Three months after the first reading session on a medical-grade display, they read all datasets again under the same standardized conditions but on a consumer-grade display. Diagnostic performance, subjective diagnostic confidence, and reading speed were analyzed and compared. Readers rated image quality on a five-point Likert scale. Results Diagnostic accuracy did not differ significantly with areas under the curve of 0.717–0.809 for all readers on both display devices. Sensitivity and specificity did not increase significantly when adding MPRs and/or MIPs. Reading speed was similar with both devices. There were no significant differences in subjective image quality scores, and overall inter-reader variability of all subjective parameters correlated positively between the two devices ( P <0.001–0.011). Conclusion Diagnostic accuracy and readers’ diagnostic confidence in detecting and ruling out intracranial aneurysm were similar on commercial-grade and medical-grade displays. Additional reconstructions did not increase sensitivity/specificity or reduce the time needed for diagnosis.
The Influence of Psychological Factors on the Incidence and Severity of Sports-Related Concussions: A Systematic Review
Authors: Trinh Lily N. , Brown Symone M. , Mulcahey Mary K. 
Published: November 2019

Background: An athlete’s preexisting psychological factors may influence the incidence and/or severity of sports-related concussions (SRCs). Purpose: To determine if emotional states, personality traits, temperament, life stressors, and explanatory styles (optimism vs pessimism) influence the incidence and severity of SRCs in athletes. Study Design: Systematic review. Methods: A systematic literature search of multiple major medical reference databases was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were included that evaluated the effect of preexisting psychological factors on the incidence and severity of SRCs in male and female athletes participating in all sports. Results: The initial search identified 1195 articles. Ten studies met our inclusion criteria and were included in our analysis. Factors such as meanness, aggression, and psychoticism were associated with an increased incidence of SRCs. Baseline traits of irritability, sadness, nervousness, and depressive symptoms were associated with worse symptomatology after SRCs. In young athletes, preexisting psychiatric illnesses, family history of psychiatric illness, and significant life stressors were associated with an increased risk of developing postconcussion syndrome after SRCs. Conclusion: This systematic review demonstrated a potential relationship between an athlete’s preexisting psychological factors and the incidence and severity of SRCs. These associations are not entirely clear owing to the heterogeneity across included studies and the low-to-moderate certainty of evidence. Future studies should attempt to evaluate men and women independently, use well-validated psychological questionnaires, and limit the usage of self-reported SRCs, when possible. Furthermore, the potential efficacy of baseline psychological factor and/or symptom reports on the prevention and management of SRCs should be explored.
Sustained Long-Term Effectiveness of an Energy Management Training Course on Employee Vitality and Purpose in Life
Authors: Das Sai Krupa , Mason Shawn T. , Vail Taylor A. , Blanchard Caroline M. , Chin Meghan K. , Rogers Gail T. , Livingston Kara A. , Turgiss Jennifer L. 
Published: November 2019

Purpose: Programs designed to sustainably improve employee well-being are urgently needed but insufficiently researched. This study evaluates the long-term effectiveness of a commercial well-being intervention in a worksite setting. Design: A pre/postintervention repeated analysis with follow-up at 6, 12, and 18 months. Setting: Office-based worksites (for-profit, nonprofit, and mixed work-type; n = 8). Participants: One hundred sixty-three employees with a mean age of 47 (11) years (57% female). Intervention: A 2.5-day group-based behavioral program emphasizing vitality and purpose in life (PiL). Measures: Rand Medical Outcomes Survey (MOS) 36-Item Short Form (SF-36) with a focus on vitality (primary outcome), Ryff PiL Scale, Center for Epidemiologic Studies Depression Scale, Profile of Mood States, Rand MOS Sleep Scale, physical activity, body weight, blood pressure, and blood measures for glucose and lipids at baseline, 6, 12, and 18 months. Analysis: General linear models with repeated measures for mean values at baseline and follow-up. Results: At 18-month follow-up, sustained improvements were observed for vitality, general health, and mental health domains of SF-36 and PiL ( P < .001 for all measures). Sleep, mood, vigor, physical activity, and blood pressure were also improved at 18 months ( P < .05 for all measures). Conclusions: An intensive 2.5-day intervention showed sustained improvement in employee quality of life, PiL, and other measures of well-being over 18 months.
Alveolar Cleft Reconstruction Using Morphogenetic Protein (rhBMP-2): A Systematic Review and Meta-Analysis
Authors: Uribe Francisca , Alister Juan Pablo , Zaror Carlos , Olate Sergio , Fariña Rodrigo 
Published: November 2019

Objective: This study aimed to review the existing evidence regarding reconstruction of the alveolar cleft using recombinant human bone morphogenetic protein-2 (rhBMP-2) in terms of bone volume and bone height. Design: Systematic review and meta-analysis. Patients—Participants: A systematic search was done. Randomized and nonrandomized clinical trials, where rhBMP-2 was used in the reconstruction of human alveolar cleft were included. Interventions: Reconstruction of alveolar cleft with rhBMP-2. Main Outcome Measures: Average bone volume formation and average bone height formation in the alveolar cleft. Mean difference was calculated and pooled by meta-analysis. Results: Of 709 identified articles, 5 studies met the inclusion criteria. The average bone volume formation was higher in the rhBMP-2 group than in the control group (61.11% vs 59.12%). The average bone height formation was higher in the control group compared to the rhBMP-2 group (75.4% vs 61.5%). The risk of bias in the selected articles was high. The meta-analysis showed that rhBMP-2 treatment may benefit bone formation compared to iliac crest graft (low certainty evidence; mean difference: −208.76; 95% confidence interval: −253.59 to −163.93; −I2 = 0%). Conclusions: The results obtained in primary articles are promising but have a high risk of bias and have low quality of evidence; therefore, it is necessary to conduct controlled clinical trials with a greater number of patients to recommend the use of rhBMP-2 in the treatment of the alveolar cleft. PROSPERO registration number: CRD42018077741.
An introductory preview of Autonomous Intelligent Cyber-defense Agent reference architecture, release 2.0
Authors: Kott Alexander , Théron Paul , Mancini Luigi V , Dushku Edlira , Panico Agostino , Drašar Martin , LeBlanc Benoît , Losiewicz Paul , Guarino Alessandro , Pihelgas Mauno , Rzadca Krzysztof 
Published: November 2019

The North Atlantic Treaty Organization (NATO) Research Task Group IST-152 developed a concept and a reference architecture for intelligent software agents performing active, largely autonomous cyber-defense actions on military assets. The group released a detailed report, briefly reviewed in this article, where such an agent is referred to as an Autonomous Intelligent Cyber-defense Agent (AICA). In a conflict with a technically sophisticated adversary, NATO military networks will operate in a heavily contested battlefield. Enemy malware will likely infiltrate and attack friendly networks and systems. Today’s reliance on human cyber defenders will be untenable on the future battlefield. Instead, artificially intelligent agents, such as AICAs, will be necessary to defeat the enemy malware in an environment of potentially disrupted communications where human intervention may not be possible. The IST-152 group identified specific capabilities of AICA. For example, AICA will have to be capable of autonomous planning and execution of complex multi-step activities for defeating or degrading sophisticated adversary malware, with the anticipation and minimization of resulting side effects. It will have to be capable of adversarial reasoning to battle against a thinking, adaptive malware. Crucially, AICA will have to keep itself and its actions as undetectable as possible, and will have to use deceptions and camouflage. The report identifies the key functions and components and their interactions for a potential reference architecture of such an agent, as well as a tentative roadmap toward the capabilities of AICA.
Walking pace improves all-cause and cardiovascular mortality risk prediction: A UK Biobank prognostic study
Authors: Argyridou Stavroula , Zaccardi Francesco , Davies Melanie J , Khunti Kamlesh , Yates Thomas 
Published: November 2019

Aims The purpose of this study was to quantify and rank the prognostic relevance of dietary, physical activity and physical function factors in predicting all-cause and cardiovascular mortality in comparison with the established risk factors included in the European Society of Cardiology Systematic COronary Risk Evaluation (SCORE). Methods We examined the predictive discrimination of lifestyle measures using C-index and R2 in sex-stratified analyses adjusted for: model 1, age; model 2, SCORE variables (age, smoking status, systolic blood pressure, total and high-density lipoprotein cholesterol). Results The sample comprised 298,829 adults (median age, 57 years; 53.5% women) from the UK Biobank free from cancer and cardiovascular disease at baseline. Over a median follow-up of 6.9 years, there were 2174 and 3522 all–cause and 286 and 796 cardiovascular deaths in women and men, respectively. When added to model 1, self-reported walking pace improved C-index in women and men by 0.013 (99% CI: 0.007–0.020) and 0.022 (0.017–0.028) respectively for all-cause mortality; and by 0.023 (0.005–0.042) and 0.034 (0.020–0.048) respectively for cardiovascular mortality. When added to model 2, corresponding values for women and men were: 0.008 (0.003–0.012) and 0.013 (0.009–0.017) for all-cause mortality; and 0.012 (–0.001–0.025) and 0.024 (0.013–0.035) for cardiovascular mortality. Other lifestyle factors did not consistently improve discrimination across models and outcomes. The pattern of results for R2 mirrored those for C-index. Conclusion A simple self-reported measure of walking pace was the only lifestyle variable found to improve risk prediction for all-cause and cardiovascular mortality when added to established risk factors.
Ultrafiltration in Pediatric Cardiac Surgery Review
Authors: Bierer Joel , Stanzel Roger , Henderson Mark , Sett Suvro , Horne David 
Published: November 2019

Introduction: The use of cardiopulmonary bypass in pediatric cardiac surgery is associated with significant inflammation, fluid overload, and end-organ dysfunction yielding morbidity and mortality. For decades, various intraoperative ultrafiltration techniques such as conventional ultrafiltration, modified ultrafiltration (MUF), zero-balance ultrafiltration (ZBUF), and combination techniques (ZBUF-MUF) have been used to mitigate these toxicities and promote improved postoperative outcomes. However, there is currently no consensus on the ultrafiltration technique or strategy that yields the most benefit for infants and children undergoing open heart surgery. Methods: A librarian-conducted PubMed literature search from 1990 to 2018 yielded 90 clinical studies or publications on the various forms of ultrafiltration and the impact on physiologic markers and clinical outcomes. All publications were reviewed, summarized, and conclusions synthesized. The data sets were not combined for systematic or meta-analysis due to significant heterogeneity in study protocols and patient populations. Results: Modified ultrafiltration significantly promotes improved myocardial function, reduction in fluid overload, and reduced bleeding and transfusion complications. Furthermore, ZBUF has shown a consistent reduction in inflammatory cytokines and improved pulmonary function and compliance. There is conflicting evidence that MUF, ZBUF, and ZBUF-MUF culminate in reduced ventilation time and intensive care unit stay. Conclusion: Various modes of ultrafiltration have been shown to be associated with improved physiologic function or clinical outcomes in pediatric cardiac surgery. There are some inconsistent trial results that can be explained by heterogeneity in ultrafiltration, clinical staff preferences, and institution protocols. Ultrafiltration has some essential benefit as it is ubiquitously used at pediatric heart centers; however, the optimal protocol could be yet identified.
Autologous Right Auricular Versus PTFE Cavopulmonary Lateral Tunnel: Influence of Surgical Technique on Arrhythmias
Authors: Arrigoni Sara C. , van den Heuvel Freek , Willems Tineke P. , Veeger Nic J.G.M. , Schoof Paul , Ebels Tjark 
Published: November 2019

Background: To compare the incidence of arrhythmias and the overall survival at long-term follow-up of the right auricular baffle technique (RA) versus Gore-Tex® (GT) baffle as intra-atrial cavopulmonary lateral tunnel, as well as the Nakata index and tunnel dimensions on cardiac magnetic resonance. Methods: Data were retrospectively collected. Serial 24-hour Holter recordings and cardiac magnetic resonance findings of the two groups were compared. Results: There was no significant difference in the estimated freedom from arrhythmias (87% at 10 years and 78% at 15 years vs 80% at 10 years and 70% at 15 years in RA and GT, respectively; P = .44) nor cumulative survival (86% at 10 years and 84% at 15 years vs 97% at 10 years and 81% at 15 years in RA and GT, respectively; P = .8). Also, no difference between the groups was observed in the Nakata index. The tunnel dimensions on cardiac magnetic resonance were significantly wider in the RA group. In reference to other potential risk indicators, using Cox proportional hazard regression analysis, only age (5 years or older at the time of total cavopulmonary connection) was associated with an increased risk for both arrhythmia and mortality. Conclusions: This study demonstrated that there was no difference in freedom from arrhythmias, Nakata index, or survival between the two groups. This study confirmed the growth potential of the right auricular tunnel. However, the growth of the tunnel did not influence the incidence of arrhythmias.
Ivabradine as an Adjunct for Refractory Junctional Ectopic Tachycardia Following Pediatric Cardiac Surgery: A Preliminary Study
Authors: Kumar Vivek , Kumar Gaurav , Tiwari Nikhil , Joshi Sajan , Sharma Vipul , Ramamurthy Ravi 
Published: November 2019

Objectives: Junctional ectopic tachycardia (JET) is a relatively common narrow complex rhythm typically characterized by atrioventricular dissociation or retrograde atrial conduction in a 1:1 pattern. Junctional ectopic tachycardia can be a life-threatening disorder, causing severe hemodynamic compromise and increased morbidity and mortality. The treatment of refractory JET can be very difficult, even with multimodal therapeutic interventions. The purpose of this study was to assess the role of ivabradine in cases of JET refractory to amiodarone and esmolol. Methods: A total of 480 congenital heart surgeries were carried out at our center in 2017. Twenty (4.16%) patients had postoperative JET. Among these, five infants, aged 7 to 12 months (median: 8 months), had refractory JET. These patients (three tetralogy of Fallot, one ventricular septal defect, one complete atrioventricular septal defect) were treated with oral ivabradine in the dose range of 0.1 to 0.2 mg/kg/12 h as an adjunct to amiodarone. Results: All five patients achieved rate reduction and eventual conversion to sinus rhythm. Mean duration to achieve heart rate of <140 bpm after initiation of ivabradine therapy was 16.8 hours (±7.2 hours), while mean duration to achieve sinus rhythm was 31.6 hours (±13.6 hours). No patient had any recurrence of JET. No patient exhibited any hemodynamic derangement nor side effects attributable to oral ivabradine. Conclusion: Oral ivabradine has the potential to be used as an adjunct to amiodarone in the treatment of JET in infants after surgery for congenital heart disease.
Surgical Anatomy of the Medial Cuneiform (Cotton) Osteotomy
Authors: Wei Baofu , Lau Brian C. , Amendola Annunziato 
Published: November 2019

Background: The Cotton osteotomy, or dorsal-opening wedge osteotomy of the medial cuneiform (MC), is used to address medial column alignment to restore the static-triangle of support. There are many described techniques regarding the incision and osteotomy. Successful completion of the osteotomy requires knowledge of the anatomy, particularly the location of the medial dorsal cutaneous nerve (MDCN). This study describes the relationship between MDCN, tibialis anterior, extensor-hallucis-longus tendon, and ligamentous attachments to the MC. A technique to determine a safe location for the osteotomy is also described. Methods: Twelve fresh-frozen adult foot specimens were used for this study (7 male and 5 female). The MDCN and its branches were dissected and its relationship with the MC was documented. Osteotomy tilt angle and relationship to structures around the MC were measured. Results: MDCN traveled medially and distally over the dorsum of the MC, and a small branch to the MC was observed. The tilt angle was 80.1 ±1.4 degrees. There was no significant difference between the distance from the distal-articular surface to the midline of the cuneiform and to the interosseous ligament ( P = .69), or between the distance from the distal-articular surface to the second tarsometatarsal joint and to the origin of the Lisfranc ligament ( P = .12). Conclusions: The dorsal-medial-oblique incision effectively protected MDCN and the MC. We believe the osteotomy should be performed in the safe zone to maintain the stability of the opening wedge. Clinical relevance: The dorsal-medial-oblique incision could reduce the risk of injury to the MDCN and the tibialis-anterior tendon.
An Attachment Including a +20-D Lens to Gain Extended Field Images in Wide-Angle Optical Coherence Tomography Angiography
Authors: Sawada Osamu , Mori Takamasa , Ichiyama Yusuke , Obata Shumpei , Kakinoki Masashi , Sawada Tomoko , Saishin Yoshitsugu , Ohji Masahito 
Published: November 2019

Purpose: This article evaluates the clinical usefulness of an attachment involving a +20-D lens to gain extended field images on wide-angle optical coherence tomography angiography (OCTA). Methods: An attachment with a +20-D lens was developed to take OCTA images of anterior segments, and it was used to obtain extended field images of the posterior segment in this study. Ten eyes of 5 individuals who did not have a history of ocular or systemic disease underwent wide-angle OCTA with a 12 × 12-mm center field using the PLEX Elite 9000 with and without the attachment. The ratio of the area of the center field to the area of the extended field with the attachment was calculated. Results: The mean area of the center image was 125 disc areas and that of the field extended by the attachment was 210 disc areas. The mean ratio between the center field and the extended field was 1.67. Conclusions: The attachment involving the +20-D lens seems to be clinically useful to gain extended field images on wide-angle OCTA.
PyGMQL: scalable data extraction and analysis for heterogeneous genomic datasets
Authors: Nanni Luca , Pinoli Pietro , Canakoglu Arif , Ceri Stefano 
Published: November 2019

Abstract

Background
With the growth of available sequenced datasets, analysis of heterogeneous processed data can answer increasingly relevant biological and clinical questions. Scientists are challenged in performing efficient and reproducible data extraction and analysis pipelines over heterogeneously processed datasets. Available software packages are suitable for analyzing experimental files from such datasets one by one, but do not scale to thousands of experiments. Moreover, they lack proper support for metadata manipulation.

Results
We present PyGMQL, a novel software for the manipulation of region-based genomic files and their relative metadata, built on top of the GMQL genomic big data management system. PyGMQL provides a set of expressive functions for the manipulation of region data and their metadata that can scale to arbitrary clusters and implicitly apply to thousands of files, producing millions of regions. PyGMQL provides data interoperability, distribution transparency and query outsourcing. The PyGMQL package integrates scalable data extraction over the Apache Spark engine underlying the GMQL implementation with native Python support for interactive data analysis and visualization. It supports data interoperability, solving the impedance mismatch between executing set-oriented queries and programming in Python. PyGMQL provides distribution transparency (the ability to address a remote dataset) and query outsourcing (the ability to assign processing to a remote service) in an orthogonal way. Outsourced processing can address cloud-based installations of the GMQL engine.

Conclusions
PyGMQL is an effective and innovative tool for supporting tertiary data extraction and analysis pipelines. We demonstrate the expressiveness and performance of PyGMQL through a sequence of biological data analysis scenarios of increasing complexity, which highlight reproducibility, expressive power and scalability.