bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dark corner artefact and diagnostic performance of a market‐approved neural network for skin cancer classification
Authors: Sies Katharina , Winkler Julia K. , Fink Christine , Bardehle Felicitas , Toberer Ferdinand , Kommoss Felix K. F. , Buhl Timo , Enk Alexander , Rosenberger Albert , Haenssle Holger A. 
Published: May 2021

SummaryBackground and objectivesConvolutional neural networks (CNN) have proven dermatologist‐level performance in skin lesion classification. Prior to a broader clinical application, an assessment of limitations is crucial. Therefore, the influence of a dark tubular periphery in dermatoscopic images (also called dark corner artefact [DCA]) on the diagnostic performance of a market‐approved CNN for skin lesion classification was investigated.Patients and methodsA prospective image set of 233 skin lesions (60 malignant, 173 benign) without DCA (control‐set) was modified to show small, medium or large DCA. All 932 images were analyzed by a market‐approved CNN (Moleanalyzer‐Pro®, FotoFinder Systems), providing malignancy scores (range 0–1) with the cut‐off > 0.5 indicating malignancy.ResultsIn the control‐set the CNN achieved a sensitivity of 90.0 % (79.9 % – 95.3 %), a specificity of 96.5 % (92.6 % – 98.4 %), and an area under the curve (AUC) of receiver operating characteristics (ROC) of 0.961 (0.932 – 0.989). Comparable diagnostic performance was observed in the DCAsmall‐set and DCAmedium‐set. Conversely, in the DCAlarge‐set significantly increased malignancy scores triggered a significantly decreased specificity (87.9 % [82.2 % – 91.9 %], P < 0.001), non‐significantly increased sensitivity (96.7 % [88.6 % – 99.1 %]) and unchanged ROC‐AUC of 0.962 (0.935 – 0.989).ConclusionsConvolutional neural network classification was robust in images with small and medium DCA, but impaired in images with large DCA. Physicians should be aware of this limitation when submitting images to CNN classification.
The ethics of genetic screening for beta thalassemia in Vietnam
Authors: Riquier Mai‐Tram 
Published: May 2021

AbstractIn this paper, I argue that genetic screening for beta thalassemia major is ethically justified in the context of Vietnam. First, I differentiate genetic screening from the moral objections commonly associated with eugenics on the basis of the primary motive for screening (avoidance of suffering) and the preservation of voluntary choice. To lay the groundwork for ethical discussion, I explain the basics of beta thalassemia biochemistry and screening and the clinical picture of beta thalassemia major. I then elaborate on a specific example of the challenges of beta thalassemia major in Cyprus before moving on to the case of Vietnam and discuss the improbability of treatment for this disorder in Vietnam and therefore, the extensive suffering that it causes the Vietnamese people. This leads to my argument that a beta thalassemia screening in Vietnam would hold up the ethical principle of nonmaleficence and also preserves and enhances reproductive choice. I then propose that Vietnam’s successful COVID‐19 response can be used as a roadmap for beta thalassemia screening.
Fetal movements: the origin of human behaviour
Authors: Einspieler Christa , Prayer Daniela , Marschik Peter B 
Published: May 2021

The study of the onset and ontogeny of human behaviour has made it clear that a multitude of fetal movement patterns are spontaneously generated, and that there is a close association between activity and the development of peripheral and central structures. The embryo starts moving by 7.5 week’s gestation; 2 to 3 weeks later, a number of movement patterns including general movements, isolated limb and head movements, hiccup, and breathing movements, appear. Some movements (e.g. yawning, smiling, ‘pointing’; we show these in eight videos in this review) precede life‐long patterns; others have intrauterine functions, such as sucking/swallowing for amniotic fluid regulation, breathing movements for lung development, or eye movements for retinal cell diversity. In cases of developmental brain dysfunction, fetal general movements alter their sequence and gestalt, which suggests a dysfunction of the developing nervous system. The scarcity of longitudinal studies calls for further comprehensive research on the predictive value of prenatal functional deviations.
What this paper adds

Motor output can occur in the absence of sensory input.

Structural development is activity‐dependent.

Fetal general movements are among the first movement patterns to occur.

Pregnancy‐related and maternal factors impact quantity and modulation of fetal general movements.

Prenatal general movement assessment has not yet brought the expected breakthrough.
Exploration influences problem solving in the fawn‐footed mosaic‐tailed rat (Melomys cervinipes)
Authors: Rowell Misha Kyla , Rymer Tasmin Lee 
Published: May 2021

AbstractThe relationship between an animal's personality and its problem solving ability has become a popular topic of investigation. However, results are conflicting, suggesting that these relationships may be species‐specific. We investigated these relationships in a native Australian rodent, the fawn‐footed mosaic‐tailed rat (Melomys cervinipes). We predicted that more exploratory and less anxious mosaic‐tailed rats would be better problem solvers (e.g. faster to solve the problem) as they would interact with the puzzles more and would be more willing to engage with the task. We assessed personality across two contexts (exploration in an open field and novel object test, and anxiety under simulated predation risk in a light/dark box) and over time (three repetitions). We measured problem solving using two food‐baited puzzle boxes (matchbox and cylinder), a Trixie Dog Activity Board with three problems (pillars, tiles and levers) and an obstruction task. Individual mosaic‐tailed rats showed consistent individual differences in personality, but not problem solving ability. Furthermore, we found a positive relationship between personality and problem solving ability, with more exploratory individuals solving more problems, and solving problems faster, than less exploratory individuals. Exploratory individuals could be better problem solvers because they are more willing to interact with objects and are less neophobic than less exploratory individuals. However, less exploratory individuals still persist in the population, possibly due to differences in cognitive abilities, such as discrimination or recognition, that allow them to compensate for poorer problem solving abilities.
PhD CEOs and firm performance
Authors: Urquhart Andrew , Zhang Hanxiong 
Published: May 2021

AbstractThis paper investigates the relationship between the education of a Chief Executive Officer (CEO) and firm performance and provides robust evidence that firms led by CEOs with PhDs outperform their peers. We find that CEOs with PhDs increase firm performance by 3.03% while CEOs with a PhD from a highly ranked university increase firm performance by 4.65%. Our results are robust to endogenous CEO selection, transition firms, alternative rankings, unobserved firm characteristics and the network of the CEO. We also show that the increase in firm performance is due to a tighter control of costs and superior cash flow management.
Extent and direction of introgressive hybridization of mule and white‐tailed deer in western Canada
Authors: Russell Ty , Cullingham Catherine , Ball Mark , Pybus Margo , Coltman David 
Published: May 2021

AbstractHybridization of mule deer (Odocoileus hemionus) and white‐tailed deer (O. virginianus) appears to be a semi‐regular occurrence in western North America. Previous studies confirmed the presence of hybrids in a variety of sympatric habitats, but their developing molecular resources limited identification to the earliest, most admixed generations. For this reason, estimates of hybrid production in wild populations often rely on anecdotal reports. As well, white‐tailed deer populations’ continued encroachment into historically mule deer‐occupied habitats due to changes in land use, habitat homogenization, and a warming climate may increase opportunities for interspecific encounters. We sought to quantify the prevalence and extent of hybrid deer in the prairies of western Canada using a SNP assay with enhanced discriminating power. By updating the available molecular resources, we sought to identify and characterize previously cryptic introgression. We also investigated the influence of various parameters on hybridity by way of logistic regression. We observed overall hybridization rates of ~1.0%, slightly lower than that reported by previous studies, and found white‐tailed‐like hybrids to be more common than their mule deer‐like counterparts. Here, we build upon past studies of hybridization in North American deer by increasing hybrid detection power, expanding sample sizes, demonstrating a new molecular resource applicable to future research and observing asymmetrical directionality of introgression.
Impacts of the COVID‐19 pandemic on the productivity of academics who mother
Authors: Kasymova Salima , Place Jean Marie S. , Billings Deborah L. , Aldape Jesus D. 
Published: May 2021

AbstractThe aim of the study is to document how academics who mother have reorganized work and childcare since the beginning of the coronavirus (COVID‐19) pandemic in the United States, how those shifts have affected their academic productivity, and solutions proposed by academics living these experiences. We collected data via an online survey and, subsequently, by conducting qualitative interviews with a subsample of participants. From June to August 2020, 131 female‐identified academics who mother were recruited via a Facebook group, Academic Mamas, and participated in our online survey. Twenty participants were then interviewed via phone or Zoom to explore more deeply the experiences of academics who mother. Results of our research suggest that since the start of the COVID‐19 pandemic, the pressure on academics who mother is immense. Analysis of the qualitative data revealed three major themes: (1) inability to meet institutional expectations; (2) juggling work and family life; and (3) proposed solutions. Our results suggest that significant efforts must be made by academic institutions to acknowledge and value the childcare responsibilities of academics who mother and to create solutions that fully address the challenges they face in meeting the academic expectations and requirements that largely remain unmodified despite the pandemic.
Factors explaining the fear of being infected with COVID‐19
Authors: Cerda Arcadio A. , García Leidy Y. 
Published: May 2021

AbstractBackgroundThe prevalence of COVID‐19 has a social and economic impact on people, leaving them distressed and fearful of getting infected.ObjectiveTo determine the variables attributable to the fear of contracting COVID‐19.DesignThis is a quantitative study based on an online cross‐sectional self‐administered survey in Chile between 10 July 2020 and 10 August 2020.Setting and participantsA sample of 531, comprising over 18‐year‐old participants from middle‐ and high‐income levels, was selected.Outcome measuresEstimations were obtained using a probit regression model with marginal effects.ResultsFear prevailed mainly in women. It has a positive relationship with variables such as chronic illnesses, infectious family or relatives, reduction in economic activity and perception of bad government response to a pandemic. Fear has a negative relationship with knowledge about COVID‐19, education level and ageing. Moreover, those who consider socioeconomic impact less important than health care do not fear a COVID‐19 infection.Discussionand conclusionThe socioeconomic and health aspects help predict fears. Thus, the government should prioritize these variables in implementing policies. The government's credibility and communication systems can also reduce fears of contracting COVID‐19.Patient or public contributionA pilot focus group of COVID‐19–recuperated individuals and some members of our interest groups were consulted in the design stage of the study; this helped in constructing the survey questions. Additionally, three independent individuals volunteered to read and comment on the draft manuscript.
Suppurative keloids: a complication of severe keloid disease
Authors: Delaleu Jeremie , Duverger Lucie , Shourick Jason , Tirgan Michael H. , Algain Maysoon , Tounkara Thierno , Kourouma Sarah , Bagot Martine , Petit Antoine 
Published: May 2021

AbstractBackgroundSome keloids show cystic cavities that give rise to acute inflammatory flares and oozing. These suppurative keloids (SK) have rarely been systematically studied. We conducted a retrospective cohort study to evaluate SK frequency and its risk factors. We also reviewed microbiological analyses as well as the histological features of removed SKs.MethodsBetween July 1, 2015, and September 30, 2016, all adult patients attending a specialized keloid clinic were asked to participate. Clinical information and microbiological results were extracted from each patient's file. Histological features were observed and interpreted.ResultsIn this study, we observed an SK rate of 26% for a mean keloid history of 17.2 years. Male gender, African ancestry, and a family history of keloids were significantly associated with suppuration. Microbiological examination revealed commensal skin flora 7/9 (77.8%), Staphylococcus aureus 1/9 (11.1%), and Enterococcus faecalis 1/9 (11.1%).ConclusionSuppuration is a common complication of keloids occurring in patients with severe keloid disease and may arise from pilosebaceous occlusion and aseptic inflammation.
Early growth according to protein content of infant formula: Results from the EDEN and ELFE birth cohorts
Authors: Camier Aurore , Davisse‐Paturet Camille , Scherdel Pauline , Lioret Sandrine , Heude Barbara , Charles Marie‐Aline , de Lauzon‐Guillain Blandine 
Published: May 2021

SummaryBackgroundIn several systematic reviews, rapid weight gain in early life has been related to increased risk of later obesity. In line with this finding, the “early protein hypothesis” suggests that reducing early protein intake is a potential lever for obesity prevention.ObjectiveTo determine whether the variability of protein content of infant formula used in France over the period 2003‐2012 is significantly associated with early growth in children.MethodsA pooled sample of infants from the EDEN (Etude des Déterminants pré et postnatals de la santé et du développement de l'Enfant) mother‐child cohort (born in 2003‐2006) and the ELFE (Etude Longitudinale Française depuis l'Enfance) birth cohort (born in 2011) (ntotal = 5846) was used. Protein content of the infant formula received at 4 months was classified into five groups. Associations between protein content (or breastfed status) at 4 months and weight‐, length‐ and BMI‐for‐age z‐scores at 6, 12 and 18 months were analysed by multivariable linear regression.ResultsThis analysis showed a positive association between protein content and weight‐, length‐ and BMI‐for‐age z‐scores at 6 months and only for weight‐for‐age at 12 months. At 6 months, as compared with the intermediate protein‐content group (2.1‐2.5 g/100 kcal), infants receiving very‐high protein content (>2.8 g/100 kcal) had higher BMI‐for‐age z‐score and those from the very‐low protein‐content group (<2.0 g/100 kcal) had lower BMI‐for‐age z‐score. Exclusively breastfed infants had lower length and weight z‐scores than formula‐fed infants at any age.ConclusionsOur findings show a positive association, under real conditions of use, between protein contents in infant formula still on the market and weight‐, length‐ and BMI‐for‐age z‐scores from 6 to 18 months.
Lord, When did We See You? Towards a Topography of the Visual
Authors: Carnes Natalie , Whelan Matthew Philipp 
Published: May 2021

AbstractAs it outlines a Christian topography of the visual, this article argues that the gaze cultivated by attention to art and the gaze of mercy bear important affinities, even if particular artworks exhibit tensions with mercy. Drawing on Augustine, Dionysius and Gregory of Nyssa, we argue that in this topography, the visual registers in multiple depths, which we explore through four distinct moments: seeing, seeing the excess, seeing the claim and seeing the divine. By analyzing the gaze of art and the gaze of mercy together with reference to artworks created during and about El Salvador’s civil war (1980–92) – the homilies of Óscar Romero, the poetry of Carolyn Forché and the visual art of Fernando Llort – we show that the gaze of art echoes and can prepare for the gaze of mercy, particularly in the first three moments, for which there are direct analogies between art and mercy’s gazes. There is no such direct analogy in the fourth moment of seeing the divine, yet even here there is a faint foreshadowing that connects art to mercy.
Opioids in advanced lung malignancy: a clinical audit of opioid prescription, patient education and safeguarding
Authors: Anil Nagtha , Smallwood Natasha , Dunn Sadie 
Published: May 2021

AbstractBackgroundOpioids have an important role in symptom management for people with advanced cancer. Clinical guidelines recommend patient education to ensure the safe use of opioids; however, no Australian studies have explored current education and safeguarding practices when opioids are initiated to advanced cancer patients.AimsTo investigate risk assessment, safeguarding and education practices when opioids are first prescribed to advanced lung cancer patients.MethodsA retrospective medical record audit of outpatients with advanced non‐small cell lung cancer seen at a tertiary Australian hospital between 1 January 2015 and 31 December 2019 and prescribed strong opioids for cancer‐related symptoms.ResultsOf 1022 patients attending the lung cancer clinic, 205 were newly initiated on an opioid. Opioid‐related risks including previous recreational drug use (28; 13.6%) and history of falls (16; 7.9%) were infrequently documented. Opioid‐related safeguards and adverse effects management were variably instituted: written general practitioner correspondence at opioid initiation (62; 30%), clinic follow up (186; 91%) and laxative co‐prescription (55; 26.8%). Most patients (137; 66.8%) received no documented opioid education on drug initiation. There was no association between age (P = 0.653), number of comorbidities (P = 0.569) or chronic alcohol use (P = 0.263) and the provision of education on opioid initiation. Palliative care doctors or nurse practitioners were eight times more likely to document opioid education than medical oncologists (odds ratio = 8.5; confidence interval = 2.9–24.8; P < 0.0001).ConclusionGuideline‐recommended risk assessment, safeguards and patient education were infrequently documented when opioids were initiated. Clinician training, decision‐assist prompts in electronic prescribing software and written education resources for patients may address these gaps in care.
Linked color imaging versus white light imaging colonoscopy for colorectal adenoma detection: A randomized controlled trial
Authors: Miyaguchi Kazuya , Takabayashi Kaoru , Saito Daisuke , Tsuzuki Yoshikazu , Hirooka Nobutaka , Hosoe Naoki , Ohgo Hideki , Ashitani Keigo , Soma Hiromitsu , Miyanaga Ryoichi , Kimura Kayoko , Tokunaga Sotaro , Mitsui Tatsuya , Miura Miki , Ozaki Ryo , Nakamoto Hidetomo , Kanai Takanori , Hisamatsu Tadakazu , Ogata Haruhiko , Imaeda Hiroyuki 
Published: May 2021

AbstractBackground and AimThe adenoma detection rate is an important indicator of colonoscopy quality and colorectal cancer incidence. We compared the adenoma detection rates between white light imaging (WLI) and linked color imaging (LCI) colonoscopy.MethodsPatients undergoing colonoscopy for positive fecal immunochemical tests, follow‐up of colon polyps, and abdominal symptoms at three institutions were randomly assigned to the LCI or WLI groups. Mean adenoma number per patient (including based on endoscopists' experience), adenoma detection rate, cecal intubation time, withdrawal time, mean adenoma number per location, and adenoma size were compared.ResultsThe LCI and WLI groups comprised 494 and 501 patients, respectively. No significant differences in the cecal intubation rate (LCI vs WLI: 99.5% vs 99.4%), cecal intubation time, and withdrawal time were noted between groups. The mean adenoma number per patient was significantly higher in the LCI group than in the WLI group (1.07 vs 0.88, P = 0.04), particularly in the descending [0.12 (58/494) vs 0.07 (35/501), P = 0.01] and sigmoid colon [0.41 (201/494) vs 0.30 (149/501), P ≤ 0.001]. However, the adenoma detection rate was 47.1% in the LCI group and 46.9% in the WLI group, with no significant difference (P = 0.93). The total number of sessile‐type adenomas was significantly higher in the LCI group than in the WLI group (346/494 vs 278/501, P = 0.04). As for polyp size, small polyps (≤ 5 mm) were detected at a significantly higher rate in the LCI group (271/494 vs 336/501, P = 0.04).ConclusionLinked color imaging is significantly superior to WLI in terms of mean adenoma number per patient.
Life cycle greenhouse gas emissions of aluminum based on regional industrial transfer in China
Authors: Ding Ning , Liu Ning , Lu Bin , Yang Jianxin 
Published: May 2021

AbstractAluminum production is a major energy consumer and source of greenhouse gas (GHG) emissions. The regional transfer of the primary aluminum (PA) industry, which mainly consists of the processes of electrolysis and aluminum ingot casting, is currently an important international trend in aluminum industrial development. However, the changes in GHG emissions from aluminum production for such transfers are unclear. This study has established a life cycle assessment model of aluminum industry based on regional transfers in the context of China, determined the GHG emissions of PA and secondary aluminum (SA) production, examined the GHG emission changes of PA production based on regional industry transfer between the years 2007 and 2017, and explored seven driving factors that affect GHG emissions in the aluminum industry. GHG emissions per unit PA and SA production in China decreased by 18.6% and 6.3%, respectively, but the total GHG emissions from aluminum industry still increased by 2.2 times between the years 2007 and 2017. The driving factor analysis showed that the major positive effects of GHG emissions from China's aluminum industry from 2007 to 2017 included the production scale effect of SA and the energy structure effect. Existing regional transfers (between the years 2007 and 2017) did not deliver significant annual GHG emissions reductions. Currently, Xinjiang, Henan, Shandong, and Inner Mongolia are the main PA production provinces in China, although regional transfers have been implemented. This study provides a basis for the improvement and sustainable development of the aluminum industry, suggests policies for regional aluminum development, and proposes a beneficial layout of the aluminum industry.