bluuebunny/crossref_metadata_2025_split huggingface dataset:
Online randomized controlled experiments at scale: lessons and extensions to medicine
Authors: Kohavi Ron , Tang Diane , Xu Ya , Hemkens Lars G. , Ioannidis John P. A. 
Published: February 2020

Abstract
Background
Many technology companies, including Airbnb, Amazon, Booking.com, eBay, Facebook, Google, LinkedIn, Lyft, Microsoft, Netflix, Twitter, Uber, and Yahoo!/Oath, run online randomized controlled experiments at scale, namely hundreds of concurrent controlled experiments on millions of users each, commonly referred to as A/B tests. Originally derived from the same statistical roots, randomized controlled trials (RCTs) in medicine are now criticized for being expensive and difficult, while in technology, the marginal cost of such experiments is approaching zero and the value for data-driven decision-making is broadly recognized.

Methods and results
This is an overview of key scaling lessons learned in the technology field. They include (1) a focus on metrics, an overall evaluation criterion and thousands of metrics for insights and debugging, automatically computed for every experiment; (2) quick release cycles with automated ramp-up and shut-down that afford agile and safe experimentation, leading to consistent incremental progress over time; and (3) a culture of ‘test everything’ because most ideas fail and tiny changes sometimes show surprising outcomes worth millions of dollars annually.
Technological advances, online interactions, and the availability of large-scale data allowed technology companies to take the science of RCTs and use them as online randomized controlled experiments at large scale with hundreds of such concurrent experiments running on any given day on a wide range of software products, be they web sites, mobile applications, or desktop applications. Rather than hindering innovation, these experiments enabled accelerated innovation with clear improvements to key metrics, including user experience and revenue. As healthcare increases interactions with patients utilizing these modern channels of web sites and digital health applications, many of the lessons apply. The most innovative technological field has recognized that systematic series of randomized trials with numerous failures of the most promising ideas leads to sustainable improvement.

Conclusion
While there are many differences between technology and medicine, it is worth considering whether and how similar designs can be applied via simple RCTs that focus on healthcare decision-making or service delivery. Changes – small and large – should undergo continuous and repeated evaluations in randomized trials and learning from their results will enable accelerated healthcare improvements.
Inequalities in pharmacologic treatment of spasticity in Sweden – health economic consequences of closing the treatment gap
Authors: Forsmark Annabelle , Rosengren Linda , Ertzgaard Per 
Published: February 2020

Abstract
Background
The Swedish Healthcare Act states that patients should have equal access to healthcare. This study addresses at how this translates to pharmacological treatment of adult spasticity, including injections with botulinum toxin A (BoNT-A) and pumps for intrathecal baclofen (ITB). To address potential economic incentives for treatment differences, the results are also set into a health economic perspective.
Thus, the current study provides a detailed and comprehensive overview for informed decision- and policymaking.

Methods
Botulinum toxin use was retrieved from sales data. Clinical practice regarding mean BoNT-A treatment dose and proportion used for spasticity indication were validated in five county councils, while the number of ITB pumps were mapped for all county councils. Published costs and quality of life data was used for estimating required responder rates for cost-balance or cost-effectiveness.

Results
The proportion of patients treated with BoNT-A varied between 5.8% and 13.6% across healthcare regions, with a mean of 9.2% on a national level. The reported number of ITB pumps per 100,000 inhabitants varied between 3.6 and 14.1 across healthcare regions, with a national mean of 6/100,000.
The estimated incremental cost for reaching treatment equity was EUR 1,976,773 per year for BoNT-A and EUR 3,326,692 for ITB pumps. Based on expected cost-savings, responder rates ranging between 4% and 15% cancelled out the incremental cost for BoNT-A. Assuming no cost-savings, responder rates of 14% or 36% was required for cost-effectiveness.

Conclusions
There is a marked variation in pharmacologic treatment of adult spasticity in Sweden. Overall, the results indicate an underuse of treatment and need for harmonisation of clinical practice. Furthermore, the incremental cost for reaching treatment equity is likely to be offset by spasticity-associated cost-savings.
Efficient resourceful mobile cloud architecture (mRARSA) for resource demanding applications
Authors: Islam Asharul , Kumar Anoop , Mohiuddin Khalid , Yasmin Sadaf , Khaleel Mohammed Abdul , Hussain Mohammad Rashid 
Published: February 2020

AbstractFor mobile clients, sufficient resources with the assurance of efficient performance and energy efficiency are the core concerns. This article mainly considers this need and proposes a resourceful architecture, called mRARSA that addresses the critical need in a mobile cloud environment. This architecture consists of cloud resources, mobile devices, and a set of functional components. The performance efficiency evaluates implementing the proposed context-aware multi-criteria decision offloading algorithm. This algorithm considers both device context (network parameters) and application content (task size) at run time when offloading an executable code to allocate the cloud resources. The appropriate resources select based on offloading decisions and via the wireless communication channels. The architecture’s remarkable component is the signal strength analyzer that determines the signal quality (e.g.-60 dBm) and contributes to performance efficiency. The proposed prototype model has implemented several times to monitor the performance efficiency, mobility, performance at communication barriers, and the outcomes of resource-demanding application’s execution. Results indicate performance improvement, such as the algorithm appropriately decides the cloud resources based on device network context, application content, mobility, and the signal strength quality and range. Moreover, the results also show significant improvement in achieving performance and energy efficiency. Sufficient resources and performance efficiency are the most significant features that distinguish this framework from the other existing frameworks.
Embryos derived from donor or patient oocytes are not different for in vitro fertilization outcomes when PGT allows euploid embryo selection: a retrospective study
Authors: Schaeffer Elizabeth , Porchia Leonardo M. , Neumann Adina , Luna Almena , Rojas Tania , López‐Bayghen Esther 
Published: February 2020

AbstractBackgroundAt our facilities, patients that received embryos using donor oocyte during in vitro fertilization (IVF), usually have had at least one failed attempt to produce at least one euploid embryo with their own oocytes; however, the current debate between using donor over patient oocytes remains inconclusive. We examined the aneuploidy rate and IVF clinical outcomes from embryos derived from either donor or patient oocytes.MethodsRetrospectively, 973 cycles were examined of patients who underwent a standard IVF protocol. Chromosomal content was determined using Pre‐implantation Genetic Testing (PGT) by either microarray‐comparative genomic hybridization or Next‐generation sequencing from either Day 3 (blastocysts) or Day 5 (trophectoderm) embryo biopsies, respectively. Embryo implantation was confirmed by serum β‐hCG (> 10 m IU/mL/Day 14), whereas clinical pregnancy by a fetal heartbeat (Week 6.5–8).ResultsEmbryos derived from donor oocytes presented with more monosomies than embryos derived from patient oocytes (41.2% vs. 25.4%, p < 0.05, respectively); however, only Trisomy 7 (0.4% vs. 2.3%, p < 0.05) and Trisomy in X (0.7% vs. 2.3%, p < 0.05) were significantly less present when compared to patient oocyte derived embryos. Interestingly, rates for embryo implantation (46.7% vs. 50.8%, p = 0.35), clinical pregnancy (38.5% vs. 43.1%, p = 0.30), and live birth (30.5% vs. 30.5%, p = 0.99) were similar for embryos derived from donor and patient oocytes. These results did not change when adjusted for the number of embryos implanted.ConclusionHere, we show no significant differences in achieving pregnancy when using donor oocytes. Taking into consideration that aneuploidy rates are > 30% in embryos, independent of the oocyte origin, PGT should be recommended with donor oocytes as well.
The clinical potential of gene editing as a tool to engineer cell‐based therapeutics
Authors: Ashmore‐Harris Candice , Fruhwirth Gilbert O. 
Published: February 2020

AbstractThe clinical application of ex vivo gene edited cell therapies first began a decade ago with zinc finger nuclease editing of autologous CD4+ T‐cells. Editing aimed to disrupt expression of the human immunodeficiency virus co‐receptor gene CCR5, with the goal of yielding cells resistant to viral entry, prior to re‐infusion into the patient. Since then the field has substantially evolved with the arrival of the new editing technologies transcription activator‐like effector nucleases (TALENs) and clustered regularly interspaced short palindromic repeats (CRISPR), and the potential benefits of gene editing in the arenas of immuno‐oncology and blood disorders were quickly recognised. As the breadth of cell therapies available clinically continues to rise there is growing interest in allogeneic and off‐the‐shelf approaches and multiplex editing strategies are increasingly employed. We review here the latest clinical trials utilising these editing technologies and consider the applications on the horizon.
Stopover departure decisions in songbirds: do long-distance migrants depart earlier and more independently of weather conditions than medium-distance migrants?
Authors: Packmor Florian , Klinner Thomas , Woodworth Bradley K. , Eikenaar Cas , Schmaljohann Heiko 
Published: February 2020

AbstractBackgroundSongbirds following distinct migration strategies (e.g. long- vs. short- to medium-distance migrants) often differ in their speed of migration during autumn and, thus, are assumed to face different time constraints. During migration, most songbird species alternate migratory flights with stopover periods. Many of them restrict these migratory flights to the night, i.e., they are nocturnal migrants. At stopover, nocturnal migrants need to select a specific night (night-to-night decision) and time of night (within-night decision) to resume migration. These departure decisions, which largely determine the speed of migration, are jointly affected by a set of intrinsic and extrinsic factors, i.e., departure cues. Here we aim to assess whether the set of intrinsic and extrinsic factors and the magnitude of their respective effects on stopover departure decisions differs between nocturnally migrating songbird species, depending on their migration strategy and associated time constraints.MethodsWe radio-tracked migrating Northern Wheatears (Oenanthe oenanthe; long-distance migrant), European robins (Erithacus rubecula) and Common Blackbirds (Turdus merula; both medium-distance migrants) during autumn stopover and analysed their night-to-night and within-night departure timing in relation to intrinsic and extrinsic factors.ResultsSpecies generally differed in their departure timing on both temporal scales, with shortest stopovers and earliest nocturnal departures in the long-distance migrant. Some factors, such as day of year, fuel load, cloud cover and crosswind, had consistent effects on stopover departure decisions in all three species. However, species differed in the effects of tailwind assistance, change in atmospheric pressure and air temperature on their stopover departure decisions. Whereas night-to-night decisions were affected by these extrinsic factors in either both or one of the medium-distance migrants, such effects were not found in the long-distance migrant.ConclusionsOur results suggest that the general timing of departures in songbirds is affected by the species-specific migration strategy and associated time constraints. Further, they imply that the assessment and usage of specific extrinsic factors, i.e., weather conditions, as departure cues is adjusted based on this migration strategy, with the long-distance migrants being least selective at departure. Other intrinsic and extrinsic factors, however, seem to be used as departure cues independent of migration strategy.
Adsorbent media for the sustainable removal of organic air pollutants from museum display cases
Authors: Schieweck Alexandra 
Published: February 2020

Abstract
The application of adsorbents in museum display cases appears auspicious, as the selection of low-emitting building and decoration materials does not necessarily ensure low pollution levels. Furthermore, historical furnishings may form an integral part of a museum and consequently cannot be substituted. Therefore, comprehensive experiments regarding the filtration efficiency of 37 different adsorbent media, both under active and passive conditions, have been conducted in order to simulate conditions in display cases with/without forced air exchange. The adsorbent media comprised pure and impregnated activated charcoal, charcoal foams and cloths, zeolites, molecular sieves and materials specially designed for museum purposes, such as archival cardboard, textiles and silica gels. Formaldehyde, formic acid, acetic acid, toluene and alpha-pinene were chosen as ubiquitous airborne pollutants in the museum environment. Tests were performed in environmental test chambers. The air exchange rate during active-mode tests was 0.5 h−1. The concentrations of single substances in the chamber air ranged between 0.3 mg m−3 and 6 mg m−3. For the passive-mode experiments, the chamber air was doped with 432 µg m−3 to 1371 µg m−3 of the target compounds. Under active conditions, most of the pure and impregnated charcoals were able to reduce pollutant levels quickly. The lowest adsorption efficiency was found for charcoal foam and cloths, zeolites, molecular sieves and special products designed for museum purposes. However, these materials also removed pollutants very efficiently within a short time under passive conditions with no forced air circulation. As pure activated charcoals performed best in both experiments, there is no need to use impregnated or cost-intensive sorbents in museum display cases. However, regular monitoring during application is recommended, as it was found that some adsorbent media might act as emission sources themselves by releasing volatile organics both before and after exposure to pollutants. It was also shown that emissions might be generated due to fragmentation reactions or pollutant-adsorber interactions; the selection and application of sorbents should therefore be performed with caution.
A comparison of the metabolic effects of treadmill and wheel running exercise in mouse model
Authors: Kim Youn Ju , Kim Hye Jin , Lee Won Jun , Seong Je Kyung 
Published: February 2020

AbstractAerobic exercise is well known to have a positive impact on body composition, muscle strength, and oxidative capacity. In animal model, both treadmill and wheel running exercise modalities have become more popular, in order to study physiological adaptation associated with aerobic exercise. However, few studies have compared physiological adaptations in response to either treadmill exercise (TE), or voluntary wheel running exercise (WE). We therefore compared each exercise intervention on body composition and oxidative markers in male C57BL/6 N mice. The total distance run was remarkably higher in the WE group than in the TE group. Both forms of exercise resulted in the reduction of body weight, fat mass, and adipocyte size. However, the average for grip strength of WE was higher than for control and TE. Interestingly, PGC-1α expression was increased in the gastrocnemius (glycolytic-oxidative) and soleus (oxidative) muscle of TE group, whereas WE showed a significant effect on PGC-1α expression only in the soleus muscle. However, muscle fiber type composition was not shifted remarkably in either type of exercise. These results suggest that TE and WE may exert beneficial effects in suppressing metabolic risks in mouse model through attenuating body weight, fat mass, size, and increase in mitochondria biogenesis marker, PGC-1α.
Highlighting the classical MRI findings in transient global amnesia
Authors: Vella Stephanie , Grech Reuben 
Published: February 2020

Transient global amnesia (TGA) is a disorder characterised by a temporary, reversible disruption of short-term memory. While the diagnosis of TGA is based on its clinical features, neuroimaging is important to exclude other sinister causes of global amnesia. Furthermore, classical MRI changes in TGA have been well described in the literature. These consist of unilateral or bilateral punctuate areas of hyperintensity in the hippocampal cornu ammonis 1 (CA1) region on diffusion-weighted imaging. We describe a case of a 61-year-old gentleman, presenting with symptoms of transient memory loss and confusion. A stroke was initially suspected in view of his multiple risk factors. Timely MRI demonstrated the typical findings associated with TGA. Recognition of these imaging features is of the utmost importance for radiologists in order to allow for an accurate diagnosis and differentiation from ischaemic pathology.
Multidrug-resistant Campylobacter jejuni, Campylobacter coli and Campylobacter lari isolated from asymptomatic school-going children in Kibera slum, Kenya
Authors: Gitahi Nduhiu , Gathura Peter B. , Gicheru Michael M. , Wandia Beautice M. , Nordin Annika 
Published: February 2020

Background:The objective of this study was to determine the prevalence of thermophilicCampylobacterspp. in asymptomatic school-going children and establish the antibiotic resistant patterns of the isolates towards the drugs used to treat campylobacteriosis, including macrolides, quinolones and tetracycline.Campylobacterspp. are a leading cause of enteric illness and have only recently shown resistant to antibiotics.Methods:This study isolatedCampylobacterspp., includingCampylobacter coli,Campylobacter jejuniandCampylobacter lari, in stool samples from asymptomatic school-going children in one of the biggest urban slums in Kenya. The disc diffusion method using EUCAST breakpoints was used to identify antibiotic-resistant isolates, which were further tested for genes encoding for tetracycline resistances using primer-specific polymerase chain reaction.Results:In total, 580 stool samples were collected from 11 primary schools considering both gender and age. Subjecting 294 biochemically characterizedCampylobacterspp. isolates to genus-specific PCR, 106 (18.27% of stool samples) isolates were confirmedCampylobacterspp. Out of the 106 isolates, 28 (4.83%) wereCampylobactercoli, 44 (7.58%) wereCampylobacter jejuniwhile 11 (1.89%) wereCampylobacterlari.Campylobacter jejunihad the highest number of isolates that were multi-drug resistant, with 26 out of the 28 tested isolates being resistant to ciprofloxacin (5 mg), nalidixic acid (30 mg), tetracycline (30 mg) and erythromycin (15 mg).Conclusions:In conclusion, a one-health approach, which considers overlaps in environment, animals and human ecosystems, is recommended in addressing campylobacteriosis in humans, since animals are the main reservoirs and environmental contamination is evident.
GAGACHAT КАК ОДНА ИЗ КОММУНИКАТИВНЫХ ФОРМ СЕТЕВОГО ФОЛЬКЛОРА НА ПРИМЕРЕ АНГЛОЯЗЫЧНОГО ИНСТАГРАМ-АККАУНТА ЛЕДИ ГАГИ
Authors: Yukhmina Elena Aleksandrovna , Obvintseva Nadezhda Valerevna 
Published: February 2020

Цель. В статье рассматривается «виртуальный флэшмоб» (на примере комментариев к англоязычному посту) как одна из коммуникативных форм сетевого фольклора с целью описания его функций и форм проявления, а также классификации комментариев по тематическим группам и анализа их основных лингвистических особенностей. Эмпирическую базу настоящего исследования составили комментарии активных пользователей социальной сети Инстаграм. Теоретическая база – труды российских и зарубежных исследователей по виртуальному фольклору Nathan Chandler, Simon J. Bronner, Trevor J. Blank, В.П. Рукомойниковой, Ю.М. Соколова, А.С. Каргина и др.Метод или методология проведения работы. В исследовании использовались методы наблюдения и описания, а также структурно-семантического и интерпретационного анализа с элементами прагмалингвистического анализа.Результаты. Новизна данной работы состоит в том, что здесь представлен анализ новейшего языкового феномена – «виртуального флэшмоба» в социальной сети Инстаграм. Составлена тематическая классификация комментариев к англоязычному посту, проанализирован язык комментариев с точки зрения фольклорных особенностей, рассмотрены прецедентные феномены, выявлено место комментариев в общей типологии сетевого фольклора с опорой на проведенное ранее исследование авторов.Область применения результатов. Результаты исследования могут быть применены в сфере PR-коммуникации, для проведения лингвистических исследований.
A centralised complex venous service model in an NHS hospital
Authors: Lim Chung Sim , Halliday Charlotte , Harvey Vanessa , Quintana Belen , Thulasidasan Narayanan , Black Stephen 
Published: February 2020

Background/aims Recent evidence supporting the efficacy and safety of deep venous interventions is likely to increase the demand for complex venous services on the NHS. This study aimed to analyse the clinical activity of a tertiary-referral complex venous service model and the estimated costs in an NHS hospital over a period of 1 year. Methods The clinical activity, admission type and treatment cost of all the patients managed by an NHS complex venous service between 1 February 2015 and 31 May 2016 were reviewed. Findings The mean monthly demand for outpatient services for new referrals and follow-ups was 22 and 82.9 respectively. The total number of admissions was 328 (mean of 27.3 admissions per month), with the outpatient cost totaling at £141 888 in 1 year. Conclusions The analysis suggests that the current complex venous service model is feasible and potentially sustainable in an NHS hospital.
The impact of electronic medical records' functions on the quality of health services
Authors: Sharikh Ekhlas Abu , Shannak Rifat , Suifan Taghrid , Ayaad Omar 
Published: February 2020

Background/aims Electronic medical records are the most common E-health application and they are starting to be implemented worldwide. In Jordan, the introduction of electronic medical records helps to improve quality and reduce service costs. This article aimed to examine how the implementation of electronic medical records impacted health service quality in Jordan. Methods A cross-sectional study was conducted in Jordanian hospitals that used electronic medical records. The data were collected using a self-administered questionnaire, which 582 healthcare professionals returned. The Statistical Package for Social Sciences was used to perform descriptive and statistical analyses. Results The results showed that there was a statistically significant impact when using electronic medical records. These findings were divided into two categories: function (practice management, communication, documentation or data entry, and medication management) and on the quality of services (reliability, responsiveness, assurance, and empathy). Conclusions The research indicated that using electronic medical records improved the quality of health services.