bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lessons learned from Integrated Management Program Advancing Community Treatment of Atrial Fibrillation (IMPACT-AF): a pragmatic clinical trial of computerized decision support in primary care
Authors: Nemis-White Joanna M. , Hamilton Laura M. , Shaw Sarah , MacKillop James H. , Parkash Ratika , Choudhri Shurjeel H. , Ciaccia Antonio , Xie Feng , Thabane Lehana , Cox Jafna L. ,   for the IMPACT-AF Investigators
Published: August 2021

Abstract
Background
Integrated Management Program Advancing Community Treatment of Atrial Fibrillation (IMPACT-AF) was a pragmatic, cluster randomized trial assessing the effectiveness of a clinical decision support (CDS) tool in primary care, Nova Scotia, Canada. We evaluated if CDS software versus Usual Care could help primary care providers (PCPs) deliver individualized guideline-based AF patient care.

Methods
Key study challenges including CDS development and implementation, recruitment, and data integration documented over the trial duration are presented as lessons learned.

Results
Adequate resources must be allocated for software development, updates and feasibility testing. Development took longer than projected. End-user feedback suggested network access and broadband speeds impeded uptake; they felt further that the CDS was not sufficiently user-friendly or efficient in supporting AF care (i.e., repetitive alerts).
Integration across e-platforms is crucial. Intellectual property and other issues prohibited CDS integration within electronic medical records and provincial e-health platforms. Double login and data entry were impediments to participation or reasons for provider withdrawal. Data integration challenges prevented easy and timely data access, analysis, and reporting.
Primary care study recruitment is resource intensive. Altogether, 203 PCPs and 1145 of their patients participated, representing 25% of eligible providers and 12% of AF patients in Nova Scotia, respectively. The most effective provider recruitment strategy was in-office, small group lunch-and-learns. PCPs with past research experience or who led patient consent were top recruiters. The study office played a pivotal role in achieving patient recruitment targets.

Conclusions
A rapid growth in healthcare data is leading to widespread development of CDS. Our experience found practical issues to address for such applications to succeed. Feasibility testing to assess the utility of any healthcare CDS prior to implementation is recommended. Adequate resources are necessary to support successful recruitment for future pragmatic trials. CDS tools that integrate multiple co-morbid guidelines across eHealth platforms should be pursued.

Trial registration
ClinicalTrials.gov NCT01927367. Registered on August 22, 2013
Symptoms in first-degree relatives of patients with rheumatoid arthritis: evaluation of cross-sectional data from the symptoms in persons at risk of rheumatoid arthritis (SPARRA) questionnaire in the PRe-clinical EValuation of Novel Targets in RA (PREVeNT-RA) Cohort
Authors: Costello R. E. , Humphreys J. H. , Sergeant J. C. , Haris M. , Stirling F. , Raza K. , van Schaardenburg D. , Bruce Ian N. 
Published: August 2021

Abstract
Background
First-degree relatives (FDRs) of people with rheumatoid arthritis (RA) have a fourfold increased risk of developing RA. The Symptoms in Persons At Risk of Rheumatoid Arthritis (SPARRA) questionnaire was developed to document symptoms in persons at risk of RA. The aims of this study were (1) to describe symptoms in a cohort of FDRs of patients with RA overall and stratified by seropositivity and elevated CRP and (2) to determine if patient characteristics were associated with symptoms suggestive of RA.

Methods
A cross-sectional study of FDRs of patients with RA, in the PREVeNT-RA study, who completed a study questionnaire, provided a blood sample measured for rheumatoid factor, anti-CCP and CRP and completed the SPARRA questionnaire. Moderate/severe symptoms and symmetrical, small and large joint pain were identified and described. Symptoms associated with both seropositivity and elevated CRP were considered suggestive of RA. Logistic regression was used to determine if symptoms suggestive of RA were associated with patient characteristics.

Results
Eight hundred seventy participants provided all data, 43 (5%) were seropositive and 122 (14%) had elevated CRP. The most frequently reported symptoms were sleep disturbances (20.3%) and joint pain (17.9%). Symmetrical and small joint pain were 11.3% and 12.8% higher, respectively, in those who were seropositive and 11.5% and 10.7% higher in those with elevated CRP. In the logistic regression model, seropositivity, older age and feeling depressed were associated with increased odds of small and symmetrical joint pain.

Conclusions
This is the first time the SPARRA questionnaire has been applied in FDRs of patients with RA and has demonstrated that the presence of symmetrical and small joint pain in this group may be useful in identifying people at higher risk of developing RA.
Joint optimization of BS-VS association and power control in secure HSR communication systems
Authors: Xu Hao , Yan Lu , Liu Haixiang , Li Ke , Wang Jian 
Published: August 2021

AbstractIn this paper, the secure transmission for high-speed railway (HSR) communication system is studied. The considered HSR wireless communication system consists of a macro base station, B roadside base stations, and K vehicle stations (VSs) on the top of the train, and the eavesdropping user is a mobile unmanned aerial vehicle (UAV). We consider maximizing the sum of the minimum security rate of each time slot as the objective function, and the constraint conditions contain the quality of service (QoS), switch requirements and the total power constraint. The original optimization problem is mixed-integer and non-convex, it is intractable to solve directly. The block coordinate descent (BCD) method is applied, and the original problem can be decoupled into two sub-problems. The one is the joint BS-VS association problem, and the other is the power control problem. The first sub-problem of optimizing BS-VS association can be solved by the successive convex approximation (SCA) algorithm, and the second one of optimizing transmit power can be solved by the lagrangian dual method. Simulation results show that the proposed algorithms have good convergence.
Stability of solutions for generalized fractional differential problems by applying significant inequality estimates
Authors: Kassim Mohammed D. , Abdeljawad Thabet , Ali Saeed M. , Abdo Mohammed S. 
Published: August 2021

AbstractIn this research paper, we intend to study the stability of solutions of some nonlinear initial value fractional differential problems. These equations are studied within the generalized fractional derivative of various orders. In order to study the solutions’ decay to zero as a power function, we establish sufficient conditions on the nonlinear terms. To this end, some versions of inequalities are combined and generalized via the so-called Bihari inequality. Moreover, we employ some properties of the generalized fractional derivative and appropriate regularization techniques. Finally, the paper involves examples to affirm the validity of the results.
Bacterial colonization dynamics and antibiotic resistance gene dissemination in the hospital environment after first patient occupancy: a longitudinal metagenetic study
Authors: Klassert Tilman E. , Leistner Rasmus , Zubiria-Barrera Cristina , Stock Magdalena , López Mercedes , Neubert Robert , Driesch Dominik , Gastmeier Petra , Slevogt Hortense 
Published: August 2021

AbstractBackgroundHumans spend the bulk of their time in indoor environments. This space is shared with an indoor ecosystem of microorganisms, which are in continuous exchange with the human inhabitants. In the particular case of hospitals, the environmental microorganisms may influence patient recovery and outcome. An understanding of the bacterial community structure in the hospital environment is pivotal for the prevention of hospital-acquired infections and the dissemination of antibiotic resistance genes. In this study, we performed a longitudinal metagenetic approach in a newly opened ward at the Charité Hospital (Berlin) to characterize the dynamics of the bacterial colonization process in the hospital environment after first patient occupancy.ResultsThe sequencing data showed a site-specific taxonomic succession, which led to stable community structures after only a few weeks. This data was further supported by network analysis and beta-diversity metrics. Furthermore, the fast colonization process was characterized by a significant increase of the bacterial biomass and its alpha-diversity. The compositional dynamics could be linked to the exchange with the patient microbiota. Over a time course of 30 weeks, we did not detect a rise of pathogenic bacteria in the hospital environment, but a significant increase of antibiotic resistance determinants on the hospital floor.ConclusionsThe results presented in this study provide new insights into different aspects of the environmental microbiome in the clinical setting, and will help to adopt infection control strategies in hospitals and health care-related buildings.
A segmental osteotomy with 3D virtual planning to move a malpositioned dental implant
Authors: Bastidas Dario Andrés , Roldan Lina , Ramirez Pamela , Munera Andrés 
Published: August 2021

AbstractBackgroundCorrect positioning and alignment of dental implants are crucial to successfully meet the aesthetic and functional criteria in implant-prosthetic rehabilitation. When an implant is in the wrong position, especially in the esthetical zone, there are limited options to solve it. Some techniques have been described to reposition implants, such as reverse torque, trephine drills, and segmental osteotomies; current approaches aim to reduce the damage of the periimplant tissues.Case presentationA 20-year-old man with good general health was referred to the oral and maxillofacial surgery department of the CES University, Medellin Colombia in 2017, He had undergone a previous camouflage orthodontic therapy for a dental Class III, which finished in 2014, posteriorly a dental implant was placed in 2015 to replace upper right lateral incisor (1.2) before vertical growth of maxilla was complete; therefore, the implant was retained in a coronal position. A segmental osteotomy was suggested to reposition the implant in a more caudal position, a 3D surgical cut guide obtained by virtual planning was used to increase osteotomy accuracy and lower human error, to avoid the risk of damaging the adjacent tissues and to achieve a predictable result.ConclusionsThe segmental alveolar osteotomy is an effective alternative to reposition an implant; however, it must be carefully planned because human error remains a possibility that may affect the final result. Therefore, 3D planning is a better way to minimize these mistakes during the surgical procedure and the final position of the implant.
Data mining in clinical big data: the frequently used databases, steps, and methodological models
Authors: Wu Wen-Tao , Li Yuan-Jie , Feng Ao-Zi , Li Li , Huang Tao , Xu An-Ding , Lyu Jun 
Published: August 2021

AbstractMany high quality studies have emerged from public databases, such as Surveillance, Epidemiology, and End Results (SEER), National Health and Nutrition Examination Survey (NHANES), The Cancer Genome Atlas (TCGA), and Medical Information Mart for Intensive Care (MIMIC); however, these data are often characterized by a high degree of dimensional heterogeneity, timeliness, scarcity, irregularity, and other characteristics, resulting in the value of these data not being fully utilized. Data-mining technology has been a frontier field in medical research, as it demonstrates excellent performance in evaluating patient risks and assisting clinical decision-making in building disease-prediction models. Therefore, data mining has unique advantages in clinical big-data research, especially in large-scale medical public databases. This article introduced the main medical public database and described the steps, tasks, and models of data mining in simple language. Additionally, we described data-mining methods along with their practical applications. The goal of this work was to aid clinical researchers in gaining a clear and intuitive understanding of the application of data-mining technology on clinical big-data in order to promote the production of research results that are beneficial to doctors and patients.
Coronary artery aneurysms in children is not always Kawasaki disease: a case report on Takayasu arteritis
Authors: Lee Michelle , Meidan Esra , Son MaryBeth , Dionne Audrey , Newburger Jane W. , Friedman Kevin G. 
Published: August 2021

Abstract
Background
Coronary artery (CA) aneurysms in children are a rare but potentially life-threatening finding and are highly associated with Kawasaki disease (KD).

Case presentation
We describe a four-year-old female with a vasculitis and CA aneurysms. She had a prolonged course with recurrent fever and systemic inflammation several times upon discontinuation of steroid treatment. Due in part to the CA aneurysms, she initially was diagnosed with KD but due to the unusual clinical course, further evaluation was performed. Abdominal and chest MRI/A revealed diffuse aortitis suggestive of a large vessel vasculitis, specifically Takayasu arteritis. With treatment targeted for Takayasu arteritis, there was resolution of fever and inflammation and the CA aneurysms improved.

Conclusions
This case demonstrates the utility in broadening the differential diagnosis in cases of presumed KD with CA involvement in which the clinical course is atypical for KD.
Susceptibility of the fall armyworm, Spodoptera frugiperda (J.E. Smith, 1797) (Lepidoptera: Noctuidae), to four species of entomopathogenic nematodes (Steinernematidae and Heterorhabditidae) from Mizoram, North-Eastern India
Authors: Lalramnghaki Hrang Chal , Lalramliana  , Lalremsanga Hmar Tlawmte , Vanlalhlimpuia  , Lalramchuani Mary , Vanramliana  
Published: August 2021

Abstract
Background
Outbreak of the fall armyworm Spodoptera frugiperda (J.E. Smith, 1797)
(Lepidoptera: Noctuidae) occurred in Mizoram, North-Eastern India. The infestation spread in the entire state covering a total area of around 2840 hectares of maize cultivated land. Entomopathogenic nematodes (EPNs) represent potential candidates for the biological control of S. frugiperda. In the study,
the susceptibility of the pest against 4 locally isolated EPN species Heterorhabditis indica, H. baujardi, Steinernema sangi and S. surkhetense was evaluated.

Results
The results indicated that all the isolated EPN species showed a high rate of larvicidal and pupicidal activities against the pest. Mortality between 43.75–100.00 and 25.00–100.00% of 3rd and 5th larval instars, respectively (at concentrations 10–800 IJs/larva), and 37.50–68.75% mortality of pupae (at concentrations 200–1600 IJs /pupa) were found after exposure to the EPN species. The mortality rate of the pest showed significant variations with life stages of the host insect, nematode concentrations and incubation time. Based on the median lethal concentration (LC50), H. indica was the most pathogenic species, followed by S. sangi, H. baujardi and S. surkhetense. The LC50 values of H. indica at 72 h post-incubation were 20.26 and 62.07 IJs/larva for the 3rd and 5th larval instars, respectively, and 913.34 IJs/pupa. The penetration assay showed that H. indica had the highest penetration rate into the hosts, 27.24, 21.30 and 20.00% in the 3rd, 5th larval instars and pupae, respectively. Furthermore, all the EPN isolates were capable of successful multiplication inside the cadaver of S. frugiperda that showed significant differences with the EPN isolates and life stages of the pest. Among the isolates, H. indica showed the highest multiplication rates, 17,692.25 ± 2103.59, 8345.63 ± 785.34 and 79,146.38 ± 5943.73 IJs per 3rd instar larva, 5th instar larva and pupa, respectively.

Conclusions
The study revealed that the 4 species of EPNs showed a high potency against S. frugiperda, thereby having the potential to be developed as a biological control agent against the pest. Moreover, the isolated EPN species could potentially serve as alternatives for chemical insecticides and could further be incorporated into the Integrated Pest Management (IPM).
Randomized Phase III Trial of Prophylactic Cranial Irradiation With or Without Hippocampal Avoidance for Small-Cell Lung Cancer (PREMER): A GICOR-GOECP-SEOR Study
Authors: Rodríguez de Dios Núria , Couñago Felipe , Murcia-Mejía Mauricio , Rico-Oses Mikel , Calvo-Crespo Patricia , Samper Pilar , Vallejo Carmen , Luna Javier , Trueba Itziar , Sotoca Amalia , Cigarral Cristina , Farré Núria , Manero Rosa M. , Durán Xavier , Gispert Juan Domigo , Sánchez-Benavides Gonzalo , Rognoni Teresa , Torrente Margarita , Capellades Jaume , Jiménez Mar , Cabada Teresa , Blanco Miguel , Alonso Ana , Martínez-San Millán Juan , Escribano José , González Beatriz , López-Guerra José Luis 
Published: August 2021

PURPOSE Radiation dose received by the neural stem cells of the hippocampus during whole-brain radiotherapy has been associated with neurocognitive decline. The key concern using hippocampal avoidance-prophylactic cranial irradiation (HA-PCI) in patients with small-cell lung cancer (SCLC) is the incidence of brain metastasis within the hippocampal avoidance zone. METHODS This phase III trial enrolled 150 patients with SCLC (71.3% with limited disease) to standard prophylactic cranial irradiation (PCI; 25 Gy in 10 fractions) or HA-PCI. The primary objective was the delayed free recall (DFR) on the Free and Cued Selective Reminding Test (FCSRT) at 3 months; a decrease of 3 points or greater from baseline was considered a decline. Secondary end points included other FCSRT scores, quality of life (QoL), evaluation of the incidence and location of brain metastases, and overall survival (OS). Data were recorded at baseline, and 3, 6, 12, and 24 months after PCI. RESULTS Participants' baseline characteristics were well balanced between the two groups. The median follow-up time for living patients was 40.4 months. Decline on DFR from baseline to 3 months was lower in the HA-PCI arm (5.8%) compared with the PCI arm (23.5%; odds ratio, 5; 95% CI, 1.57 to 15.86; P = .003). Analysis of all FCSRT scores showed a decline on the total recall (TR; 8.7% v 20.6%) at 3 months; DFR (11.1% v 33.3%), TR (20.3% v 38.9%), and total free recall (14.8% v 31.5%) at 6 months, and TR (14.2% v 47.6%) at 24 months. The incidence of brain metastases, OS, and QoL were not significantly different. CONCLUSION Sparing the hippocampus during PCI better preserves cognitive function in patients with SCLC. No differences were observed with regard to brain failure, OS, and QoL compared with standard PCI.
Timing of increased temperature sensitivity coincides with nervous system development in winter moth embryos
Authors: van Dis Natalie E. , van der Zee Maurijn , Hut Roelof A. , Wertheim Bregje , Visser Marcel E. 
Published: August 2021

ABSTRACT
Climate change is rapidly altering the environment and many species will need to genetically adapt their seasonal timing to keep up with these changes. Insect development rate is largely influenced by temperature, but we know little about the mechanisms underlying the temperature sensitivity of development. Here, we investigate seasonal timing of egg hatching in the winter moth, one of the few species which has been found to genetically adapt to climate change, likely through selection on temperature sensitivity of egg development rate. To study when during development winter moth embryos are most sensitive to changes in ambient temperature, we gave eggs an increase or decrease in temperature at different moments during their development. We measured their developmental progression and time of egg hatching, and used fluorescence microscopy to construct a timeline of embryonic development for the winter moth. We found that egg development rate responded more strongly to temperature once embryos were in the fully extended germband stage. This is the phylotypic stage at which all insect embryos have developed a rudimentary nervous system. Furthermore, at this stage, timing of ecdysone signaling determines developmental progression, which could act as an environment dependent gateway. Intriguingly, this may suggest that, from the phylotypic stage onward, insect embryos can start to integrate internal and environmental stimuli to actively regulate important developmental processes. As we found evidence that there is genetic variation for temperature sensitivity of egg development rate in our study population, such regulation could be a target of selection imposed by climate change.
Cumulative radiation doses due to nuclear medicine examinations: a systematic review
Authors: Brambilla Marco , Kuchcińska Agnieszka , Matheoud Roberta , Muni Alfredo 
Published: August 2021

Objectives:
To systematically review the published data regarding the cumulative exposure to radiation in selected cohorts of adults or paediatric patients due to diagnostic nuclear medicine examinations.

Methods:
We conducted PubMed/Medline searches of peer-reviewed papers on cumulated effective dose (CED) from diagnostic nuclear medicine procedures published between 01 January 2010 until 31 January 2021. Studies were considered eligible if the contribution of nuclear medicine examinations to total CED was &gt;10%. Studies reporting cumulative doses in a single episode of care or in a limited time (≤1 year) were excluded. The main outcomes for which data were sought were the CED accrued by patients, the period in which the CED was accrued, the percentage of patients with CED &gt; 100 mSv and the percentage contribution due to nuclear medicine procedures to the overall CED.

Results:
The studies included in the synthesis were 18 which enrolled a total of 1,76,371 patients. Eleven (1,757 patients), three (1,74,079 patients) and four (535 patients) were related to oncological, cardiologic and transplanted patients, respectively. All the studies were retrospective; some of the source materials referred to small number of patients and some of the patients were followed for a short time. Not many studies accurately quantified the contribution of nuclear medicine procedures to the overall radiation exposure due to medical imaging. Finally, most of the studies covered an observation period which extended mainly in the 2000–2010 decade.

Conclusions:
There is a need of prospective, multicentric studies enrolling a greater number of patients, followed for longer period in selected groups of patients to fully capture the cumulative exposure to radiation in these settings

Advances in knowledge:
This systematic review allows to identify selected group of patients with a specific health status in which the cumulated exposure to radiation may be of concern and where the contribution of nuclear medicine procedures to the total CED is significant.