bluuebunny/crossref_metadata_2025_split huggingface dataset:
BLADE turbo gradient- and spin-echo in the assessment of sinonasal lesions: a comprehensive comparison of image quality in readout-segmented echo-planar imaging
Authors: Geng Yue , Shi Yiqian , Chen Wei , Tang Zuohua , Zhang Zhongshuai , Zhou Kun , Sha Yan 
Published: September 2021

Background A two-dimensional turbo gradient-echo and spin-echo diffusion-weighted pulse sequence with a non-Cartesian BLADE trajectory (TGSE BLADE) can eliminate image artifacts and distortion with clinically acceptable scan times. This process has the potential to overcome the shortcomings of current diffusion-weighted imaging (DWI) techniques, especially in the sinonasal region. Purpose To investigate the feasibility of TGSE BLADE in the assessment of sinonasal lesions and compare the quality of TGSE BLADE with RESOLVE images both qualitatively and quantitatively. Material and Methods A total of 36 patients with sinonasal lesions were included in this prospective study. DW images acquired using TGSE BLADE and RESOLVE were performed with the same acquisition time. Two independent observers evaluated the qualitative parameters (overall image quality, lesion visibility, and geometric distortion) and quantitative parameters (geometric distortion ratio [GDR], signal-to-noise ratio [SNR], contrast, contrast-to-noise ratio [CNR], and apparent diffusion coefficient [ADC] value) of the two sequences. Results Qualitative assessment revealed that TGSE BLADE exhibited higher overall image quality ( P < 0.001) and lesion visibility ( P < 0.001) and less geometric distortion ( P < 0.001) than RESOLVE. Quantitative assessment showed that TGSE BLADE images exhibited higher contrast ( P < 0.001) and CNR ( P < 0.001) and lower GDR ( P < 0.05) and SNR ( P < 0.001) than RESOLVE images. The ADC value of TGSE BLADE was significantly lower than that of RESOLVE ( P < 0.05). Conclusion TGSE BLADE can reduce susceptibility artifacts and geometric distortion more than RESOLVE and appears to be a promising diffusion imaging sequence for the assessment of sinonasal lesions.
Barriers to and Facilitators of Neonatal Palliative Care Among Neonatal Professionals in China
Authors: Gu Lin , Li Zhen-Zhen , Peng Niang-Huei , Zhou Jian-Fu , Wei Bi-Rong , Chang Yue-Cune 
Published: September 2021

Objectives: This study investigated institutional and personal barriers to and facilitators of neonatal palliative care facing neonatal professionals in China. Methods: A cross-sectional questionnaire surveyed 231 neonatal clinicians employed in 5 neonatal intensive care units from 2 children’s hospitals and 3 medical centers in China. Measurements: The translated modified version of the Neonatal Palliative Care Attitude Scale was used to survey neonatal clinicians’ attitudes and beliefs regarding neonatal palliative care. Results: Findings highlight 4 facilitators and 5 barriers among participating clinicians. Participants gave contradictory responses regarding the relative importance of curative treatment versus palliative care in the NICU. Negatively traumatic feelings, cultural issues and moral distress may impact this contradictory response and discourage clinicians from providing neonatal palliative care. Additionally, neonatologists and nurses held differing attitudes on several topics (p < 0.05). Conclusion: Further research should address strategies to improve knowledge and attitudes and relieve moral distress in NICU clinicians. Neonatal clinicians providing neonatal palliative care should receive regular palliative care training addressing culture-specific issues and communication skills. Practice Implications: Study findings will be beneficial to inform clinical education and practice. Regular interdisciplinary team training is needed to enhance support for palliative care and decrease clinicians’ moral distress during end-of-life care.
Emergence of cutaneous Rosai–Dorfman disease during immunosuppressive treatment of follicular B-cell lymphoma: A case report
Authors: Kipfer Sharon L , Samycia Michael , Shiau Carolyn J 
Published: September 2021

Background: Sinus histiocytosis with massive lymphadenopathy, also known as Rosai–Dorfman disease, is a rare proliferation of non-Langerhans histiocytes. Cutaneous Rosai–Dorfman disease is a rare subtype of Rosai–Dorfman disease limited to the skin with variable clinical presentation. Case summary: A 59-year-old female with a history of osteoarthritis, hypothyroidism, and follicular B-cell lymphoma presented with pruritic, erythematous, dome-shaped papules that developed while on chemotherapy treatment. During cutaneous disease progression, the patient was further diagnosed with myelodysplastic syndrome. Histology review revealed patchy staining for S100 in the CD68+ histiocytes within the dermis with no enlarged histiocytes or emperipolesis. Given the absence of other findings, this was interpreted as cutaneous Rosai–Dorfman disease. Conclusion: There is still little known about the aetiology and pathogenesis of cutaneous Rosai–Dorfman disease. Non-specific immunohistochemistry in the midst of lymphoma, immunosuppressive treatments, and myelodysplastic syndrome produced a blurred diagnostic picture and delayed appropriate treatment, highlighting the diagnostic challenges of cutaneous Rosai–Dorfman disease.
Mindfulness for Singers: A Mixed Methods Replication Study
Authors: Czajkowski Anne-Marie Louise , Greasley Alinka Elizabeth , Allis Michael 
Published: September 2021

Objectives: Mindfulness has been explored in the clinical and educational fields but has rarely been studied in the music domain. This study investigated the effects of teaching eight-week Mindfulness for Singers courses on vocalists’ music education and performance. Methods: A mixed methods approach was utilized, which included controlled and randomized controlled trials using standardized and novel mindfulness measures pre- and post-intervention, interviews post-intervention and three months later, concurrent diaries, and a blinded teacher study. Participants included singing students (total n=52) and their teachers ( n=11) from a university and a music college over a period of two years. Results: Levels of mindfulness increased over the intervention for experimental participants in comparison to controls. Considering their total student cohort, teachers identified 61% of eligible mindfulness singing participants as having completed the mindfulness intervention. Experimental participants reported that learning mindfulness had positive effects in lessons, solo and group instrumental practices, and when performing on stage. They described more focus and attention, positive effects of increased body awareness on singing technique, enhanced socio-collaborative relationships, reductions in performance anxiety, and beneficial effects whilst performing, such as more expressivity and enjoyment. Conclusions: Learning mindfulness had positive holistic effects on vocal students and was well received by their mindfulness-naïve singing teachers. Findings suggest that it would be highly beneficial for mindfulness to be made available in music conservatoires and university music departments alongside singing lessons for singers to enhance their present experience as vocal students and their futures as performers and teachers.
Inter-device measurement variability of vital data parameters for keratorefractive and cataract refractive surgery
Authors: Kanclerz Piotr , Przewłócka Katarzyna , Wang Xiaogang 
Published: September 2021

Introduction: The measurements of corneal white-to-white (WTW) diameter and pupil size are critical for decision making in refractive surgery. Currently, automatic measurement of keratometry, corneal WTW, and pupil size are implemented in several ocular devices. The purpose of this study was to examine the agreement between two commonly used devices, an autorefractor and an optical biometer, for these parameters. Methods: Measurements were performed with both a Lenstar LS-900 and Nidek ARK-1 by an experienced examiner in random order. The devices were placed in close proximity within the same dimly lit room. Results: The measurements of 65 right eyes were analyzed. The results of the flat, steep, and mean keratometric reading were not significantly different ( p = 0.96, p = 0.90, p = 0.93, respectively). Corneal WTW distances showed only moderate agreement between devices and were found to be significantly different ( r = 0.8071; p < 0.01). Pupil diameters showed poor agreement between devices and were significantly different ( r = 0.4890; p < 0.01). Agreement between implantable contact lens sizing, based on the measurements obtained by the two devices, was achieved for 19 of the 51 eyes (37.3%). Conclusion: We found a significant difference in WTW and pupil size measurements between ARK-1 and Lenstar. Results for both of the devices cannot be considered interchangeable for these data parameters.
Association between emergency medical service transport time and survival in patients with traumatic cardiac arrest: a Nationwide retrospective observational study
Authors: Naito Hiromichi , Yumoto Tetsuya , Yorifuji Takashi , Nojima Tsuyoshi , Yamamoto Hirotsugu , Yamada Taihei , Tsukahara Kohei , Inaba Mototaka , Nishimura Takeshi , Uehara Takenori , Nakao Atsunori 
Published: September 2021

AbstractBackgroundPatients with traumatic cardiac arrest (TCA) are known to have poor prognoses. In 2003, the joint committee of the National Association of EMS Physicians and the American College of Surgeons Committee on Trauma proposed stopping unsuccessful cardiopulmonary resuscitation (CPR) sustained for > 15 min after TCA. However, in 2013, a specific time-limit for terminating resuscitation was dropped, due to the lack of conclusive studies or data. We aimed to define the association between emergency medical services transport time and survival to demonstrate the survival curve of TCA.MethodsA retrospective review of the Japan Trauma Data Bank. Inclusion criteria were age ≥ 16, at least one trauma with Abbreviated Injury Scale score (AIS) ≥ 3, and CPR performed in a prehospital setting. Exclusion criteria were burn injury, AIS score of 6 in any region, and missing data. Estimated survival rate and risk ratio for survival were analyzed according to transport time for all patients. Analysis was also performed separately on patients with sustained TCA at arrival.ResultsOf 292,027 patients in the database, 5336 were included in the study with 4141 sustained TCA. Their median age was 53 years (interquartile range (IQR) 36–70), and 67.2% were male. Their median Injury Severity Score was 29 (IQR 22–41), and median transport time was 11 min (IQR 6–17). Overall survival after TCA was 4.5%; however, survival of patients with sustained TCA at arrival was only 1.2%. The estimated survival rate and risk ratio for sustained TCA rapidly decreased after 15 min of transport time, with estimated survival falling below 1%.ConclusionThe chances of survival for sustained TCA declined rapidly while the patient is transported with CPR support. Time should be one reasonable factor for considering termination of resuscitation in patients with sustained TCA, although clinical signs of life, and type and severity of trauma should be taken into account clinically.
Use of intravenous N-acetylcysteine in acute severe hepatitis due to severe dengue infection: a case series
Authors: Dissanayake D. M. D. I. B. , Gunaratne W. M. S. N. , Kumarihamy K. W. M. P. P. , Kularatne S. A. M. , Kumarasiri P. V. R. 
Published: September 2021

Abstract
Background
Dengue fever is a common mosquito borne viral infection. Severe dengue fever associated severe hepatitis carries high mortality. Based on the beneficial effect of N-acetylcysteine (NAC) in paracetamol poisoning and non-acetaminophen induced liver failure, it is used in dengue fever associated hepatitis in clinical practice. We aim to study the reversal of liver enzymes with NAC in the setting of severe hepatitis due to severe dengue infection.

Methods
A retrospective analysis was conducted on hospitalized 30 adults with severe dengue fever with severe hepatitis. These 30 patients had aspartate transaminase (AST) and alanine transaminases (ALT) more than 500 U/L and/or PT INR (prothrombin time and international normalized ratio) more than 1.5. They were treated with NAC infusion of 100 mg/h for 3 to 5 days.

Results
The mean age of the group was 49.9 ± 11.46 years and 18 (60%) patients were males. Nineteen patients (63%) developed dengue shock. Of them 12 patients (40%) developed hepatic encephalopathy. Median AST on the day of administration of NAC was 1125 U/L interquartile range (IQR) 1653.25 while median ALT was 752 (IQR 459.25). There was a statistically significant reduction of both ALT (p = 0.034) and AST (p = 0.049) from day 1 to 4 after NAC infusion. Rise of platelet count between day 1 and day 4 also showed statistically significant difference (p = 0.011) but the reduction of prothrombin time and international normalized ratio (PT/INR) from 1 to day 4 did not show statistical significance difference. Mean duration of treatment with NAC was 3.61 ± 0.75 days while mean length of hospital stay was 6.2 ± 1.27 days. Only one patient died (3.3%). None of the patients reported adverse drug reaction due to NAC.

Conclusion
Majority of patients demonstrated marked clinical and biochemical improvements and they recovered fully. We observed faster and significant recovery of liver enzymes following administration of NAC. Based on the above findings, this study provides preliminary evidence for the beneficial effect of NAC in severe hepatitis in dengue infection with greater survival benefits.
Disposal practice and factors associated with unused medicines in Malaysia: a cross-sectional study
Authors: Wang Leong Seng , Aziz Zoriah , Chik Zamri 
Published: September 2021

Abstract
Background
The improper disposal of unused medicines is a worldwide concern because of its impact on the environment, economy, and health. This study aims to describe the disposal practice of unused medicine and identify factors associated with unused medicines in Malaysia.

Methods
This was a cross-sectional, face to face interview-based survey using a structured questionnaire. We used a convenience sampling method to recruit participants from Kuala Lumpur and Selangor in Malaysia.

Results
We interviewed 1184 participants, and the response rate was 96%. Out of the total respondents, 995 (84%) reported having unused medicines. About a quarter of respondents kept unused medicines in the cabinet, and another quarter disposed of them into the trash or toilet. Only half of the respondent who used medicines for chronic illnesses had unused medicines compared to about 90% of respondents who used medicines for acute illnesses. The main reason for having unused medicines among those who used medicines for chronic illness was non-adherence (69%, p <  0.05). Only 27% of these respondents returned unused medicines under the “Medicine Return Programme (MRP)”. The other group who used medicines for acute illnesses had unused medicines because their health conditions improved. Thus, most of the unused medicines will eventually end up in household waste. A multivariate logistic regression analysis identified respondents who used medicines for acute illnesses as the strongest predictor of having unused medicines (Odds Ratio (OR) = 29.8; p <  0.001), followed by those who pay for their medicines (OR = 6.0; p < 0.001) and those who were willing to participate the Medicine Return Programme (OR = 2.5; p = 0.009).

Conclusion
The prevalence of unused medicines and their improper disposal were high in Malaysia. Unused medicines are associated with people who use medicines for acute illnesses, pay for their medication, and are willing to participate in an MRP. Rationale prescription and optimal dispensing practice, together with a broader MRP facilities coverage, could reduce unused medicine possession.
The analysis of the geographical distribution of emergency departments’ frequent users: a tool to prioritize public health policies?
Authors: Hellmann Romain , Feral-Pierssens Anne-Laure , Michault Alain , Casalino Enrique , Ricard-Hibon Agnès , Adnet Frederic , Brun-Ney Dominique , Bouzid Donia , Menu Axelle , Wargon Mathias 
Published: September 2021

Abstract
Background
The individual factors associated to Frequent Users (FUs) in Emergency Departments are well known. However, the characteristics of their geographical distribution and how territorial specificities are associated and intertwined with ED use are limited. Investigating healthcare use and territorial factors would help targeting local health policies. We aim at describing the geographical distribution of ED’s FUs within the Paris region.

Methods
We performed a retrospective analysis of all ED visits in the Paris region in 2015. Data were collected from the universal health insurance’s claims database. Frequent Users (FUs) were defined as having visited ≥3 times any ED of the region over the period. We assessed the FUs rate in each geographical unit (GU) and assessed correlations between FUs rate and socio-demographics and economic characteristics of GUs. We also performed a multidimensional analysis and a principal component analysis to identify a typology of territories to describe and target the FUs phenomenon.

Results
FUs accounted for 278,687 (11.7%) of the 2,382,802 patients who visited the ED, living in 232 GUs. In the region, median FUs rate in each GU was 11.0% [interquartile range: 9.5–12.5]. High FUs rate was correlated to the territorial markers of social deprivation. Three different categories of GU were identified with different profiles of healthcare providers densities.

Conclusion
FUs rate varies between territories and is correlated to territorial markers of social deprivation. Targeted public policies should focus on disadvantaged territories.
Association of different pathologic subtypes of growth hormone producing pituitary adenoma and remission in acromegaly patients: a retrospective cohort study
Authors: Dehghani Maryam , Davoodi Zahra , Bidari Farahnaz , Moghaddam Amin Momeni , Khalili Davood , Bahrami-Motlagh Hooman , Jamali Elena , Alamdari Shahram , Hosseinpanah Farhad , Hedayati Mehdi , Valizadeh Majid 
Published: September 2021

AbstractBackgroundRegarding the inconclusive results of previous investigations, this study aimed to determine the association between pathology, as a possible predictor, with remission outcomes, to know the role of pathology in the personalized decision making in acromegaly patients.MethodsA retrospective cohort study was performed on the consecutive surgeries for growth hormone (GH) producing pituitary adenomas from February 2015 to January 2021. Seventy-one patients were assessed for granulation patterns and prolactin co-expression as dual staining adenomas. The role of pathology and some other predictors on surgical remission was evaluated using logistic regression models.ResultsAmong 71 included patients, 34 (47.9%) patients had densely granulated (DG), 14 (19.7%) had sparsely granulated (SG), 23 (32.4%) had dual staining pituitary adenomas. The remission rate was about 62.5% in the patients with SG and DG adenomas named single staining and 52.2% in dual staining groups. Postoperative remission was 1.53-folds higher in the single staining adenomas than dual staining-one (non-significant). The remission rate was doubled in DG group compared to two other groups (non-significant). By adjusting different predictors, cavernous sinus invasion and one-day postoperative GH levels decreased remission rate by 91% (95% CI: 0.01–0.67;p = 0.015) and 64% (95% CI: 0.19–0.69;p < 0.001), respectively. Responses to the medications were not significantly different among three groups.ConclusionVarious pathological subtypes of pituitary adenomas do not appear to have a predictive role in estimating remission outcomes. Cavernous sinus invasion followed by one-day postoperative GH is the strongest parameter to predict biochemical remission.
Privacy-preserving dataset combination and Lasso regression for healthcare predictions
Authors: van Egmond Marie Beth , Spini Gabriele , van der Galien Onno , IJpma Arne , Veugen Thijs , Kraaij Wessel , Sangers Alex , Rooijakkers Thomas , Langenkamp Peter , Kamphorst Bart , van de L’Isle Natasja , Kooij-Janic Milena 
Published: September 2021

AbstractBackgroundRecent developments in machine learning have shown its potential impact for clinical use such as risk prediction, prognosis, and treatment selection. However, relevant data are often scattered across different stakeholders and their use is regulated, e.g. by GDPR or HIPAA.As a concrete use-case, hospital Erasmus MC and health insurance company Achmea have data on individuals in the city of Rotterdam, which would in theory enable them to train a regression model in order to identify high-impact lifestyle factors for heart failure. However, privacy and confidentiality concerns make it unfeasible to exchange these data.MethodsThis article describes a solution where vertically-partitioned synthetic data of Achmea and of Erasmus MC are combined using Secure Multi-Party Computation. First, a secure inner join protocol takes place to securely determine the identifiers of the patients that are represented in both datasets. Then, a secure Lasso Regression model is trained on the securely combined data. The involved parties thus obtain the prediction model but no further information on the input data of the other parties.ResultsWe implement our secure solution and describe its performance and scalability: we can train a prediction model on two datasets with 5000 records each and a total of 30 features in less than one hour, with a minimal difference from the results of standard (non-secure) methods.ConclusionsThis article shows that it is possible to combine datasets and train a Lasso regression model on this combination in a secure way. Such a solution thus further expands the potential of privacy-preserving data analysis in the medical domain.
Waardenburg syndrome type 2A in a large Iranian family with a novel MITF gene mutation
Authors: Zardadi Safoura , Rayat Sima , Hassani Doabsari Maryam , Keramatipour Mohammad , Morovvati Saeid 
Published: September 2021

AbstractBackgroundThe characteristics of Waardenburg syndrome (WS) as a scarce heritable disorder are sensorineural hearing loss and deficits of pigmentation in the skin, hair, and eye. Here, clinical features and detection of the mutation in theMITFgene of WS2 patients are reported in a sizable Iranian family.MethodsA man aged 28-years represented with symptoms of mild unilateral hearing loss (right ear), complete heterochromia iridis, premature graying prior to 30 years of age, and synophrys. In this research, there was a sizable family in Iran comprising three generations with seven WS patients and two healthy members. Whole exome sequencing was applied for proband for the identification of the candidate genetic mutations associated with the disease. The detected mutation in proband and investigated family members was validated by PCR-Sanger sequencing.ResultsA novel heterozygous mutation, NM_198159.3:c.1026dup p.(Asn343Glufs*27), in exon 9 of theMITFgene co-segregated with WS2 in the affected family members. The variant was forecasted as a disease-causing variant by the Mutation Taster. According to the UniProt database, this variant has been located in basic helix-loop-helix (bHLH) domain of the protein with critical role in DNA binding.ConclusionsA frameshift was caused by a nucleotide insertion, c.1026dup, in exon 9 of theMITFgene. This mutation is able to induce an early termination, resulting in forming a truncated protein capable of affecting the normal function of the MITF protein. Helpful information is provided through an exactly described mutations involved in WS to clarify the molecular cause of clinical characteristics of WS and have a contribution to better genetic counseling of WS patients.