bluuebunny/crossref_metadata_2025_split huggingface dataset:
The added value of digital breast tomosynthesis in improving diagnostic performance of BI-RADS categorization of mammographically indeterminate breast lesions
Authors: Basha Mohammad Abd Alkhalik , Safwat Hadeer K. , Alaa Eldin Ahmed M. , Dawoud Hitham A. , Hassanin Ali M. 
Published: February 2020

Abstract
Background
Mammographic findings are seen more clearly in tomographic images with consequent improvement of Breast Imaging Reporting and Data System (BI-RADS) in categorization of indeterminate breast lesions. This study aimed to evaluate the added value of digital breast tomosynthesis (DBT) to BI-RADS classification in categorization of indeterminate breast lesions after digital mammography (DM) as an initial approach.

Methods and results
We prospectively evaluated 296 women with BI-RADS indeterminate breast lesions (BI-RADS 0, 3, and 4) by DM between January 2018 and October 2019. All patients underwent DBT. Two radiologists evaluated lesions and assigned a BI-RADS category to each lesion according to BI-RADS lexicon 2013 classification using DM, DBT, and combined DM and DBT. The results were compared in terms of main radiological features, diagnostic performance, and BI-RADS classification using histopathology as the reference standard. A total of 355 lesions were detected on DBT and 318 lesions on DM. Thirty-seven lesions were detected by DBT and not seen by DM. The final diagnoses of 355 lesions were 58.3% benign and 41.7% malignant. In comparison to DM, DBT produced 31.5% upgrading and 35.2% downgrading of BI-RADS scoring of breast lesions. DBT reduced number of BI-RADS 3 and 4, compared to DM. All upgraded BI-RADS 4 were malignant. The combination of DBT and DM significantly increased the performance of BI-RADS in the diagnosis of indeterminate breast lesions versus DM or DBT alone (p < 0.001).

Conclusion
Adding DBT to BI-RADS improves its diagnostic performance in detection and characterization of mammography indeterminate breast lesions.
Parent-reported outcomes in young children with disorders/differences of sex development
Authors: Ali Salma R. , Macqueen Zoe , Gardner Melissa , Xin Yiqiao , Kyriakou Andreas , Mason Avril , Shaikh M. Guftar , Wong Sze C. , Sandberg David E. , Ahmed S. Faisal 
Published: February 2020

Abstract
Background
There is a paucity of tools that can be used in routine clinical practice to assess the psychosocial impact of Disorders/Differences of Sex Development (DSD) on parents and children.

Objective
To evaluate the use of short Parent Self-Report and Parent Proxy-Report questionnaires that can be used in the outpatient setting.

Methods
Previously validated DSD-specific and generic items were combined to develop a Parent Self-Report questionnaire and a Parent Proxy-Report questionnaire for children under 7 years. Of 111 children approached at one tertiary paediatric hospital, the parents of 95 children (86%) with DSD or other Endocrine conditions completed these questionnaires.

Results
Questionnaires took under 10 min to complete and were found to be easy to understand. Compared to reference, fathers of children with DSD reported less stress associated with Clinic Visits (p = 0.02) and managing their child’s Medication (p = 0.04). However, parents of children with either DSD or other Endocrine conditions reported more symptoms of Depression (p = 0.03). Mothers of children with DSD reported greater Future Concerns in relation to their child’s condition (median SDS − 0.28; range − 2.14, 1.73) than mothers of children with other Endocrine conditions (SDS 1.17; − 2.00, 1.73) (p = 0.02). Similarly, fathers of children with DSD expressed greater Future Concerns (median SDS -1.60; − 4.21, 1.00) than fathers of children with other Endocrine conditions (SDS 0.48; − 2.13, 1.52) (p = 0.04).

Conclusion
DSD was associated with greater parental concerns over the child’s future than other Endocrine conditions. Brief parent-report tools in DSD can be routinely used in the outpatient setting to assess and monitor parent and patient needs.
Risk perception of antimicrobial resistance by infection control specialists in Europe: a case-vignette study
Authors:   the Percept-R Study Group, Birgand Gabriel , Mutters Nico T. , Ahmad Raheelah , Tacconelli Evelina , Lucet Jean-Christophe , Holmes Alison 
Published: February 2020

Abstract
Background
Using case-vignettes, we assessed the perception of European infection control (IC) specialists regarding the individual and collective risk associated with antimicrobial resistance (AMR) among inpatients.

Methods
In this study, sixteen case-vignettes were developed to simulate hospitalised patient scenarios in the field of AMR and IC. A total of 245 IC specialists working in different hospitals from 15 European countries were contacted, among which 149 agreed to participate in the study. Using an online database, each participant scored five randomly-assigned case-vignettes, regarding the perceived risk associated with six different multidrug resistant organisms (MDRO). The intra-class correlation coefficient (ICC), varying from 0 (poor) to 1 (perfect), was used to assess the agreement for the risk on a 7-point Likert scale. High risk and low/neutral risk scorers were compared regarding their national, organisational and individual characteristics.

Results
Between January and May 2017, 149 participants scored 655 case-vignettes. The perceptions of the individual (clinical outcome) and collective (spread) risks were consistently lower than other MDRO for extended spectrum beta-lactamase producing Enterobacteriaceae cases and higher for carbapenemase producing Enterobacteriaceae (CPE) cases. Regarding CPE cases, answers were influenced more by the resistance pattern (93%) than for other MDRO. The risk associated with vancomycin resistant Enterococci cases was considered higher for the collective impact than for the individual outcome (63% vs 40%). The intra-country agreement regarding the individual risk was globally poor varying from 0.00 (ICC: 0–0.25) to 0.51 (0.18–0.85). The overall agreement across countries was poor at 0.20 (0.07–0.33). IC specialists working in hospitals preserved from MDROs perceived a higher individual (local, p = 0.01; national, p < 0.01) and collective risk (local and national p < 0.01) than those frequently exposed to bacteraemia. Conversely, IC specialists working in hospitals with a high MDRO clinical burden had a decreased risk perception.

Conclusions
The perception of the risk associated with AMR varied greatly across IC specialists and countries, relying on contextual factors including the epidemiology. IC specialists working in high prevalence areas may underestimate both the individual and collective risks, and might further negatively promote the MDRO spread. These finding highlight the need to shape local and national control strategies according to risk perceptions and contextual factors.
Preparation and characterisation of activated carbon from Vitisvinifera leaf litter and its adsorption performance for aqueous phenanthrene
Authors: Awe Adetunji Ajibola , Opeolu Beatrice Olutoyin , Fatoki Olalekan Siyanbola , Ayanda Olushola Sunday , Jackson Vanessa Angela , Snyman Reinette 
Published: February 2020

AbstractThe adsorption of phenanthrene onto activated carbons produced from Vitisvinifera leaf litter (a waste plant biomass) was investigated in this study. Zinc chloride (ZnCl2) and phosphoric acid (H3PO4) were utilised as activating agents in producing the activated carbons. The characterisation of the activated carbons was achieved with Fourier transform infrared spectroscopy (for surface functional groups), scanning electron microscopy (for surface morphology) and Brunauer–Emmett–Teller (BET) (for surface area determination). The adsorption of phenanthrene onto the activated carbons was optimised in terms of solution pH, adsorbent dosage, initial concentration of adsorbate solution and contact time. Experimental results showed that H3PO4 modified activated carbon gave better yield (up to 58.40%) relative to ZnCl2 modified activated carbon (only up to 47.08%). Meanwhile, surface characterisation showed that ZnCl2 modification resulted in higher BET surface area (up to 616.60 m2/g) and total pore volume (up to 0.289 cm3/g) relative to BET surface area of up to 295.49 m2/g and total pore volume of up to 0.185 cm3/g obtained from H3PO4 modified activated carbons. Adsorption equilibrium data fitted well into Freundlich isotherm model relative to other applied isotherm models, with maximum Kf value of 1.27 for ZnCl2 modified activated carbon and 1.16 Kf value for H3PO4 modified activated carbon. The maximum adsorption capacity for ZnCl2 and H3PO4 activated carbons for the removal of phenanthrene were 94.12 and 89.13 mg/g, respectively. Kinetic studies revealed that dynamic equilibrium was reached at 80 min contact time. Experimental data fitted best into the Elovich kinetic model relative to other kinetic models, based on the correlation coefficient (R2) values obtained from kinetic studies. Chemisorption was deduced as a major phenanthrene removal pathway from aqueous solution and the physicochemical characteristics of the adsorbents have major influence on phenanthrene removal efficiencies.
Behavior of Small-Scale Concrete Cylinders in Compression Laterally Confined by Basalt Fiber and PEN Fiber Reinforced Polymer Composites
Authors: Baasankhuu Batzaya , Choi Donguk , Ha Sangsu 
Published: February 2020

AbstractAxial compression test was conducted to investigate the effect of confinement on plain concrete cylinders by wrapping polyethylene naphthalate fiber reinforced polymer (PEN FRP) with large rupture strain (LRS) capacity. To draw comparison on the confinement effect by PEN FRP wrapping, the confining effect by basalt FRP (BFRP) wrapping was also investigated. A total of 25 tests was completed. Test variables were two different FRP composites (PEN FRP, BFRP) and number of FRP layers (1, 2, 3 layers of PEN FRP and 2, 4, 6 layers of BFRP) in the main confinement tests (21 tests). In the additional confinement tests, the test variable was overlap length of PEN FRP (four tests). Confinement by BFRP and LRS PEN FRP was both effective as demonstrated by continuously ascending stress–strain relationship of the confined concrete. The PEN FRP wrapped concrete deformed more both axially and laterally to develop strength equivalent to that of the BFRP wrapped concrete. A simplified procedure for rational modelling of stress–strain relationship of the confined concrete was suggested. The suggested procedure is applicable for both BFRP and PEN FRP confined circular concretes on condition that basic confinement test data specific to the FRP composite are provided.
Oculopalatal tremor following sequential medullary infarcts that did not cause hypertrophic olivary degeneration
Authors: Kattah Jorge C. , Elble Rodger J. , De Santo Jeffrey , Shaikh Aasef G. 
Published: February 2020

Abstract
Background
The syndrome of oculopalatal tremor is a known consequence of lesions in the dentate-olivary pathway. Hypertrophic degeneration of the inferior olive is a recognized pathological correlate of these lesions and hypothesized to cause tremorogenic olivary hypersynchrony. However, oculopalatal tremor also occurs in Alexander disease, which produces severe inferior olive degeneration without intervening hypertrophy.

Methods
Serial clinical, imaging, video-oculography and kinematic tremor recording of a patient with oculopalatal and limb tremor.

Case study
We report an unusual presentation of oculopalatal tremor and right upper extremity myorhythmia following sequential right dorsolateral and left anteromedial medullary infarcts directly involving both inferior olives. As in adult Alexander disease, our patient did not have hypertrophic olivary degeneration during 10 years of follow-up.

Conclusion
Contemporary theories have emphasized the role of cerebellar maladaptation in “shaping” oscillations generated elsewhere, the inferior olive in particular. Our patient and published Alexander disease cases illustrate that oculopalatal tremor can occur in the absence of hypertrophic olivary degeneration. Therefore, cerebellar maladaptation to any form of olivary damage may be the critical pathophysiology in producing oculopalatal tremor.
Development of an Aerosol Dose Collection Apparatus for In Vitro Dissolution Measurements of Orally Inhaled Drug Products
Authors: Price Robert , Shur Jagdeep , Ganley William , Farias Gonçalo , Fotaki Nikoletta , Conti Denise S. , Delvadia Renishkumar , Absar Mohammad , Saluja Bhawana , Lee Sau 
Published: February 2020

AbstractThe aim of the study was to develop a robust and standardized in vitro dissolution methodology for orally inhaled drug products (OIDPs). An aerosol dose collection (ADC) system was designed to uniformly deposit the whole impactor stage mass (ISM) over a large filter area for dissolution testing. All dissolution tests were performed under sink conditions in a sodium phosphate buffered saline solution containing 0.2%w/w sodium dodecyl sulphate. An adapted USP Apparatus V, Paddle over Disk (POD), was used throughout the study. The dissolution characteristics of the ISM dose of a commercial metered-dose inhaler (MDI) and a range of dry powder inhaler (DPI) formulations containing inhaled corticosteroids were tested. The uniform distribution of the validated ISM dose considerably reduced drug loading effects on the dissolution profiles for both MDI and DPI formulations. The improvement in the robustness and discriminatory capability of the technique enabled characterization of dissolution rate differences between inhaler platforms and between different DPI product strengths containing fluticasone propionate. A good correlation between in vivo mean absorption time and in vitro dissolution half-life was found for a range of the inhaled corticosteroids. The ADC system and the reproducible in vitro POD dissolution measurements provided a quantitative-based approach for measuring the relationship between the influence of device and the dispersion characteristics on the aerosol dissolution of low solubility compounds. The in vitro dissolution method could potentially be applied as a dissolution methodology for compendial, quality control release testing, and during development of both branded orally inhaled drug products and their generic counterparts.
Impact of Intraoperative Cell Salvage on Blood Coagulation Factor Concentrations in Patients Undergoing Cardiac Surgery
Authors: Adam Elisabeth H. , Funke Moritz , Zacharowski Kai , Meybohm Patrick , Keller Harald , Weber Christian F. 
Published: February 2020

BACKGROUND:Cardiothoracic surgery is associated with major blood loss and allogeneic transfusion of red blood cell concentrates. To minimize allogeneic red blood cell (RBC) transfusion, intraoperative cell salvage has been effectively used for years. The objective of this study was to evaluate the impact of cell salvage on blood coagulation factors.METHODS:We enrolled 30 patients scheduled for cardiac surgery in a prospective single-center observational cohort study at an academic hospital. Blood samples from the cell salvage system were obtained from both the reservoir and the processed red blood cell concentrate. Coagulation factors, fibrinogen, antithrombin and von Willebrand activity, and antigen were assessed before and after cell salvage. Statistical analysis was performed using Wilcoxon matched-pairs signed rank test.RESULTS:Our results revealed a significant decrease of fibrinogen (P< .001), coagulation factors II (P= .004), factors VII, X, and XIII (P< .001), and all other measured coagulation factor concentrations/activities in the processed red blood cell concentrate, when compared to the concentrations/activities of the reservoir.CONCLUSIONS:The results of the present study revealed a significant reduction of coagulation factor concentrations/activities by the washing process. Therefore, physicians need to consider adequate management of coagulation in patients with major blood loss and the need of large volumes of RBC transfusion.
Systematic study of the effect of short range correlations on the form factors and densities of s-p-d shell nuclei
Authors: Moustakidis H. C. , Massen S. E. 
Published: February 2020

Analytical expressions of the one- and two-body terms in the cluster expansion of the charge form factors and densities of the s-p and s-d shell nuclei with N=Z are derived. They depend on the harmonic oscillator parameter 6 and the parameter β which originates from the Jastrow correlation function. These expressions are used for the systematic study of the effect of short range correlations on the form factors and densities and of the mass dependence of the parameters ò and β. These parameters have been determined by fit to the experimental charge form factors. The inclusion of the correlations reproduces the experimental charge form factors at the high momentum transfers (q > 2 fm^-1). It is found that while the parameter β is almost constant for the closed shell nuclei, 4He, 16O and 40Ca, its values are larger (less correlated systems) for the open shell nuclei, indicating a shell effect in the closed shell nuclei.
DNA methylation changes in biomarker loci occur early in cancer progression
Authors: Vrba Lukas , Futscher Bernard W. 
Published: February 2020

Tumor-specific DNA methylation can be used for cancer diagnostics and monitoring. We have recently reported a set of DNA methylation biomarkers that can distinguish plasma samples from lung cancer patients versus healthy controls with high sensitivity and specificity. Furthermore, the DNA methylation signal from the biomarker loci detected in plasma samples correlated with tumor size and decreased after surgical resection of lung tumors. In order to determine the timing of DNA methylation of these loci during carcinogenesis and thus the potential of the biomarkers to detect early stages of the disease we analyzed the DNA methylation of the biomarker loci in five precancerous conditions using available data from the GEO database. We found that the DNA methylation of the biomarker loci is gained early in carcinogenesis since most of the precancerous conditions already have biomarker loci hypermethylated. Moreover, these DNA methylation biomarkers are able to distinguish between precancerous lesions with malignant potential and those that stay benign where data is available. Taken together, the biomarkers have the potential to detect the earliest cancer stages; the only limitation to detection of cancer from plasma samples or other liquid biopsies is the timing when tumors start to shed enough DNA into body fluids.
Transcranial direct current stimulation and attention skills in burnout patients: a randomized blinded sham-controlled pilot study
Authors: Van Noppen Pia , van Dun Kim , Depestele Siel , Verstraelen Stefanie , Meesen Raf , Manto Mario 
Published: February 2020

Background: Burnout is characterized by deficiencies in attention and several components of the working memory, of which the lingering effects of impaired attention and executive functions are the most frustrating. We hypothesized that anodal transcranial direct current stimulation (atDCS) over the left dorsolateral prefrontal cortex (DLPFC) can improve the executive control of attention and possibly several other components of working memory in patients with burnout. Methods: This was a randomized double-blind sham-controlled pilot study with two groups. Patients with burnout received three weeks of daily sessions (15 sessions in total) of atDCS or sham stimulation in addition to three weekly sessions of standard behavioral therapy. The primary outcome measure was attention and the central executive of the working memory. Secondary, the effect of atDCS was measured on other components of working memory, on burnout and depression scores, and on quality of life (QoL). Results: We enrolled and randomly assigned 16 patients to a sham or real stimulation group, 15 (7 sham, 8 real) were included in the analysis. atDCS had a significant impact on attention. Post-hoc comparisons also revealed a trend towards more improvement after real tDCS for inhibition and shifting, updating and control, and encoding. Both groups improved on burnout and depression scores. Conclusion: These data provide preliminary evidence for the value of atDCS over the left DLPFC in rehabilitating attention deficits, and possibly also central executive and encoding deficits, in burnout. However, the current study has some limitations, including the sample size and heterogeneous patient population. More elaborate studies are needed to elucidate the specific impact of atDCS over the left DLPFC on burnout. Trial registration: ISRCTN.com (ISRCTN94275121) 17/11/19
Medical grade honey for the treatment of paediatric abdominal wounds: a case series
Authors: Smaropoulos Eleftherios , Cremers Niels AJ 
Published: February 2020

Objective: Children are at high risk of injuries and wounds. The application of medical grade honey is a promising approach to improving the healing of wounds of various origin and severity. However, the use of medical grade honey in young paediatric patients remains limited. The aim of this study is to show the safety, efficacy and usefulness of medical grade honey in abdominal wounds, of different causes, in paediatric patients. Method: This was a prospective, observational case series evaluating five young infants with abdominal wounds at the General Hospital in Thessaloniki. All wounds were treated in the same manner with daily medical grade honey applied to the wound area and closely monitored. Results: All treated wounds rapidly presented granulation tissue formation and underwent re-epithelialisation. Peripheral oedema and inflammation decreased upon initial application. Necrotic tissue was effectively debrided when present. Slough was removed and no signs of infection were detected, irrespective of initial wound presentations. Scar formation was minimal and the full range of motion was preserved in all cases. Conclusion: Based on this case study, medical grade honey is safe and effective in treating different abdominal wounds, including infected or dehisced wounds as well as burns. The easy application and broad applicability make medical grade honey recommendable as a first-line treatment in paediatric patients.