bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and validation of a new clinical decision support tool to optimize screening for retinopathy of prematurity
Authors: Pivodic Aldina , Johansson Helena , Smith Lois E H , Hård Anna-Lena , Löfqvist Chatarina , Yoder Bradley A , Hartnett M Elizabeth , Wu Carolyn , Bründer Marie-Christine , Lagrèze Wolf A , Stahl Andreas , Al-Hawasi Abbas , Larsson Eva , Lundgren Pia , Gränse Lotta , Sunnqvist Birgitta , Tornqvist Kristina , Wallin Agneta , Holmström Gerd , Albertsson-Wikland Kerstin , Nilsson Staffan , Hellström Ann 
Published: May 2021

Background/AimsPrematurely born infants undergo costly, stressful eye examinations to uncover the small fraction with retinopathy of prematurity (ROP) that needs treatment to prevent blindness. The aim was to develop a prediction tool (DIGIROP-Screen) with 100% sensitivity and high specificity to safely reduce screening of those infants not needing treatment. DIGIROP-Screen was compared with four other ROP models based on longitudinal weights.MethodsData, including infants born at 24–30 weeks of gestational age (GA), for DIGIROP-Screen development (DevGroup, N=6991) originate from the Swedish National Registry for ROP. Three international cohorts comprised the external validation groups (ValGroups, N=1241). Multivariable logistic regressions, over postnatal ages (PNAs) 6–14 weeks, were validated. Predictors were birth characteristics, status and age at first diagnosed ROP and essential interactions.ResultsROP treatment was required in 287 (4.1%)/6991 infants in DevGroup and 49 (3.9%)/1241 in ValGroups. To allow 100% sensitivity in DevGroup, specificity at birth was 53.1% and cumulatively 60.5% at PNA 8 weeks. Applying the same cut-offs in ValGroups, specificities were similar (46.3% and 53.5%). One infant with severe malformations in ValGroups was incorrectly classified as not needing screening. For all other infants, at PNA 6–14 weeks, sensitivity was 100%. In other published models, sensitivity ranged from 88.5% to 100% and specificity ranged from 9.6% to 45.2%.ConclusionsDIGIROP-Screen, a clinical decision support tool using readily available birth and ROP screening data for infants born GA 24–30 weeks, in the European and North American populations tested can safely identify infants not needing ROP screening. DIGIROP-Screen had equal or higher sensitivity and specificity compared with other models. DIGIROP-Screen should be tested in any new cohort for validation and if not validated it can be modified using the same statistical approaches applied to a specific clinical setting.
Reflections on John the Baptist in History and Theology by Joel Marcus
Authors: Wassén Cecilia 
Published: May 2021

Abstract
In this article, I engage with Joel Marcus’s recent book on John the Baptist, focusing on the relationship between John and the Dead Sea Scrolls. While I appreciate many parts of his detailed study, I question the claim that John was a former member of the Essenes. Although there are intriguing similarities, the question is how far reaching conclusions we may draw concerning such a relationship. I problematize some aspects of the comparison between the sources. Like many scholars, Marcus refers in particular to 1QS and the site of Khirbet Qumran for reconstructing the Essenes and hence John’s background. In response, I highlight the uncertainty about the Sitz im leben of 1QS in relation to Khirbet Qumran and ask why this particular manuscript should be privileged over others. Not least when it comes to purity halakhah there are many other documents than 1QS from Qumran that are highly relevant to the issue. Finally, I critically evaluate Marcus’s view that John the Baptist had a favorable attitude towards Gentiles, which according Marcus differed from the views of the Essenes.
Does Prematurity Play a Role in Newborn Microtia-Anotia?
Authors: Shehan Jennifer N. , Danis David O’Neil , Bains Ashank , Scott Andrew R. , Levi Jessica R. 
Published: May 2021

Objective: Microtia-anotia (MA) describes a range of external ear anomalies which is commonly associated with various syndromes and malformations of the head and neck. Previous studies have suggested a strong association between MA and male sex, maternal diabetes, and Hispanic race/ethnicity. This study seeks to evaluate the associations between MA and preterm newborns in the United States. Methods: Population-based inpatient registry analysis was conducted. Kids’ Inpatient Database (2016) was used to identify weighted in-hospital births with diagnosis of prematurity or MA. Demographic information was obtained, and odds ratios (ORs) were used to determine associations between prematurity and MA. Results: Among patients included in our dataset, 8.655% (326 285) were preterm and 0.016% (523) had MA. 0.003% (109) of patients were preterm and had MA. Preterm infants had 2.19 times the odds (95% C.I. = 1.78-2.69) of having MA when compared to the full-term population. The binary logistic regression model accounting for possible confounding variables produced an aOR of 1.48 (95% C.I. = 1.17-1.87) for the association between prematurity and MA. Conclusion: Infants who are born preterm are more likely to have MA than full term infants. The current results will allow for improved risk stratification, maternal counseling, and interventions in the case of prematurity.
Attention and Motor Learning in Adult Patients with Neurofibromatosis Type 1
Authors: Castricum Jesminne , Tulen Joke H. M. , Taal Walter , Rietman André B. , Elgersma Ype 
Published: May 2021

Objective: Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disorder that is associated with cognitive disabilities, including attention and motor learning problems. These disabilities have been extensively studied in children with NF1 but limited studies have been performed in adults. Method: Attention, motor learning and intellectual performance were studied with neuropsychological tasks in 32 adults with NF1 and 32 controls. Results: The NF1 and control group performed similarly on attention and motor learning tasks, although controls had shorter reaction times than adults with NF1 during the motor learning task ( t[60] = −2.20, p = .03). Measures of attention or motor learning were not significantly associated with reduced intellectual performance in NF1. Conclusion: In contrast to many studies in children with NF1, our findings did not provide evidence for presence of attention or motor learning problems in adults with NF1 in neuropsychological tasks. Our observations may be of clinical importance to determine treatment focus in adults with NF1.
The association between plant-based diet and erectile dysfunction in Chinese men
Authors: Lu Yi , Kang Jiaqi , Li Zhongjia , Wang Xiao , Liu Kang , Zhou Kechong , Wang Wei , Shen Chen 
Published: May 2021

Abstract
Background
Diet, one of the components of lifestyle, has been believed to have associations with erectile dysfunction (ED). However, whether there is an association between plant-based diet and ED is remains to be explored. Thus, we conducted the nested case-control study to investigate the relationship between the plant-based diet and ED in China.

Results
ED group (92 subjeczts) and ED free group (92 subjects) were similar in terms of basic features (P > 0.05), except for lifestyle (P < 0.05). The plant-diet index (PDI) and healthy plant-diet index (hPDI) in the ED group were significantly lower than those in the control group (P < 0.001). Adjusted multivariate analysis indicated that the presence of ED was negatively associated with nitric oxide levels, PDI, and hPDI (all P < 0.05), and was positively related to body mass index, metabolic syndrome, and E-selectin levels. Furthermore, both the PDI and hPDI increased significantly as the International Index of Erectile Function (IIEF-5) scores increased within the ED group (P < 0.05). Multi-model multivariate analysis indicated the robustness of results.

Conclusions
More plant-based diet intake was associated with a reduced presence of ED and less severe ED in China. Committing to plant-based diet can be encouraged for many health benefits and to lower ED burden. Further well-designed studies are warranted to validate our findings.
How imputation can mitigate SNP ascertainment Bias
Authors: Geibel Johannes , Reimer Christian , Pook Torsten , Weigend Steffen , Weigend Annett , Simianer Henner 
Published: May 2021

Abstract
Background
Population genetic studies based on genotyped single nucleotide polymorphisms (SNPs) are influenced by a non-random selection of the SNPs included in the used genotyping arrays. The resulting bias in the estimation of allele frequency spectra and population genetics parameters like heterozygosity and genetic distances relative to whole genome sequencing (WGS) data is known as SNP ascertainment bias. Full correction for this bias requires detailed knowledge of the array design process, which is often not available in practice. This study suggests an alternative approach to mitigate ascertainment bias of a large set of genotyped individuals by using information of a small set of sequenced individuals via imputation without the need for prior knowledge on the array design.

Results
The strategy was first tested by simulating additional ascertainment bias with a set of 1566 chickens from 74 populations that were genotyped for the positions of the Affymetrix Axiom™ 580 k Genome-Wide Chicken Array. Imputation accuracy was shown to be consistently higher for populations used for SNP discovery during the simulated array design process. Reference sets of at least one individual per population in the study set led to a strong correction of ascertainment bias for estimates of expected and observed heterozygosity, Wright’s Fixation Index and Nei’s Standard Genetic Distance. In contrast, unbalanced reference sets (overrepresentation of populations compared to the study set) introduced a new bias towards the reference populations. Finally, the array genotypes were imputed to WGS by utilization of reference sets of 74 individuals (one per population) to 98 individuals (additional commercial chickens) and compared with a mixture of individually and pooled sequenced populations. The imputation reduced the slope between heterozygosity estimates of array data and WGS data from 1.94 to 1.26 when using the smaller balanced reference panel and to 1.44 when using the larger but unbalanced reference panel. This generally supported the results from simulation but was less favorable, advocating for a larger reference panel when imputing to WGS.

Conclusions
The results highlight the potential of using imputation for mitigation of SNP ascertainment bias but also underline the need for unbiased reference sets.
Association between smoking and in-hospital mortality in patients with left ventricular dysfunction undergoing coronary artery bypass surgery: a propensity-matched study
Authors: Tang Hanwei , Hou Jianfeng , Chen Kai , Huang Xiaohong , Liu Sheng , Hu Shengshou 
Published: May 2021

Abstract
Background
Data on the effect of smoking on In-hospital outcome in patients with left ventricular dysfunction undergoing coronary artery bypass graft (CABG) surgery are limited. We sought to determine the influence of smoking on CABG patients with left ventricular dysfunction.

Methods
A retrospective study was conducted using data from the China Heart Failure Surgery Registry database. Eligible patients with left ventricular ejection fraction less than 50% underwent isolated CABGS were included. In addition to the use of multivariate regression models, a 1–1 propensity scores matched analysis was performed. Our study (n = 6531) consisted of 3635 smokers and 2896 non-smokers. Smokers were further divided into ex-smokers (n = 2373) and current smokers (n = 1262).

Results
The overall in-hospital morality was 3.9%. Interestingly, current smokers have lower in-hospital mortality than non-smokers [2.3% vs 4.9%; adjusted odds ratio (OR) 0.612 (95% CI 0.395–0.947) ]. No difference was detected in mortality between ex-smokers and non-smokers [3.6% vs 4.9%; adjusted OR 0.974 (0.715–1.327)]. No significant differences in other clinical end points were observed. Results of propensity-matched analyses were broadly consistent.

Conclusions
It is paradoxically that current smokers had lower in-hospital mortality than non-smokers. Future studies should be performed to further understand the biological mechanisms that may explain this ‘smoker’s paradox’ phenomenon.
BEFRIENding for Depression, Anxiety and Social support in older adults living in Australian residential aged care facilities (BEFRIENDAS): randomised controlled trial protocol
Authors: Doyle Colleen , Bhar Sunil , Bryant Christina , Dow Briony , Dunt David , Mnatzaganian George , O’Connor Daniel , Ratcliffe Julie , You Emily , Bagnall Anne-Marie , Major Georgia , Harper Robin , Fearn Marcia 
Published: May 2021

Abstract
Background
This protocol describes an ongoing study of the impact of befriending on depression, anxiety and loneliness in older people living in residential aged care facilities in Australia. While systematic reviews of befriending have indicated positive benefits of befriending for people in a range of ages and settings, there have been no randomised controlled trials (RCTs) of befriending for older people living in residential aged care with depression and no studies of the cost effectiveness of befriending in residential aged care facilities (RACFs) in Australia.

Methods and analysis
We are conducting a single blind pragmatic RCT comparing two groups of older people living in RACFs, one receiving an intervention consisting of weekly befriending for 4 months from a trained volunteer and the other receiving treatment as usual. Participants undergo eligibility screening for depression (GDS-15 ≥ 4) and cognitive impairment (GPCog ≥ 4) and assessments at three measurement time points: baseline prior to randomisation, 2 months post-baseline and 4 months post-baseline. The primary outcome measure is depression, and secondary outcome measures are anxiety, loneliness, social isolation and quality of life. The economic evaluation will take the form of a cost-utility analysis based on the outcome of quality of life. The primary and secondary outcomes will be analysed using negative binomial and logistic regressions utilizing the Generalised Estimating Equations approach.

Discussion
To our knowledge, this is the first RCT evaluating the effectiveness of befriending on older people with depression living in residential aged care. It is expected that the befriending intervention will reduce the severity of depression symptoms experienced by older people living in residential aged care. If the intervention proves effective it may be incorporated into volunteer training programs and adopted as a way of supporting older people’s mental health.

Trial registration
Trial registered with the Australian and New Zealand Clinical Trial Registry (ANZCTR) Number: ACTRN12619000676112, registered 06/05/2019 – retrospectively registered.
“A good death but there was all this tension around”- perspectives of residential managers on the experience of delivering end of life care for people living with dementia
Authors: Borbasi Jessica A. L. , Tong Allison , Ritchie Alison , Poulos Christopher J. , Clayton Josephine M. 
Published: May 2021

Abstract
Background
End of life care for residents with advanced dementia in the aged care setting is complex. There is prolonged and progressive cognitive decline, uncertain disease trajectory, significant symptom burden and infrequent access to specialist palliative care. Residential aged care managers offer a unique perspective in understanding the experience of providing end of life care for residents with advanced dementia. They bring insight from the coalface to the broader policy context. The aim of this study was to describe the experience and perspectives of residential aged care managers on providing end of life care for residents living with dementia.

Methods
Focus groups and semi-structured interviews were conducted with residential or care managers from various care homes from one dementia specific aged care organisation in Australia. A comprehensive sampling strategy was used in participating care homes. Transcripts were analysed using thematic analysis.

Results
20 residential or care managers from 11 aged care homes in two states of Australia participated in two focus groups (total 16 participants) or individual interviews (4 participants). Six themes were identified: laying the ground work to establish what families understand about dementia, playing the peacemaker in the face of unrealistic family demands and expectations, chipping away at denial and cultivating a path towards acceptance of death, recruiting general practitioners as allies, supporting and strengthening the front line, and dedication to optimal care is relentless but rewarding.

Conclusion
Aged care manager participants described provision of end of life dementia care as a rewarding but sometimes fraught experience requiring persistent personalisation of care and communication to enable family acceptance of the resident’s terminal condition. The findings suggest that continuous front line aged care staff skill development, iterative family discussions, and partnership building between aged care staff and general practitioners, are all required to promote optimal end of life dementia care in residential aged care settings.
Added value of contrast-enhanced ultrasound (CEUS) in the diagnosis of primary retroperitoneal serous adenocarcinoma: a case report
Authors: Zhou Lin-Yu , Zhu Xiao-Dan , Jiang Jian , Bai Yan-Feng , Jiang Tian-An 
Published: May 2021

Abstract
Background
Primary retroperitoneal serous adenocarcinoma (PRSA) is a rare malignant disease. Given the rarity of the disease, the imaging features of PRSA are unclear. Contrast-enhanced ultrasound (CEUS) also plays an important role in the evaluation of the differential diagnosis of retroperitoneal lesions.

Case presentation
We report the case of a 62-year-old woman of with increased CA125 levels for 1 year who was referred to our hospital. After conducting contrast-enhanced computed tomography and magnetic resonance imaging, the mass was misdiagnosed as a chocolate cyst. After transvaginal ultrasound (TUS) combined with CEUS, cystadenocarcinoma was considered as the initial diagnosis. Pathology results confirmed PRSA as the final diagnosis.

Conclusions
CEUS features of PRSA are reported for the first time based on this case, potentially aiding in the differential diagnosis of this rare entity before surgery.
Descriptive epidemiology of nasopharyngeal carcinoma at Tikur Anbessa Hospital, Ethiopia
Authors: Beyene Elizabeth Tadesse , Ketema Siraw Girum , Alebachew Assaye Nibret , Saleh Mizan Yeshanew , Gebremariam Tsigereda Atumo 
Published: May 2021

Abstract
Background
Nasopharyngeal cancer is distinguished from other cancers of the head and neck in its epidemiology, histopathology, clinical characteristics, and therapeutic outcome. Its unique clinico-epidemiologic pattern of the disease is an area focus for this investigation. Accordingly, the study investigated the demographic and histologic characteristics, as well as the clinical stage at presentation of nasopharyngeal carcinoma patients at Tikur Anbessa Specialized hospital.

Methods
Hospital based retrospective descriptive study was conducted from September 2017 – October 2020. All biopsy proven incidental cases during the study period are included. SPSS version 26 is used for data entry and analysis.

Result
A total of 318 patients with histologically confirmed nasopharyngeal carcinoma cases during the study period were included. There were 218 males and 90 females, with a male: female ratio of 2.5:1. The age of patients ranges from 13 to 81 years with a mean age of 37.8 ± 15 years. The median age at diagnosis was 38 years. Age distribution has two peaks for males, first between 30 to 39 and second 50 to 59 years of age. While the peak age of occurrence for females is in the 20–39 age range. Juvenile cases constituted 34% of the study group. The study revealed, nonkeratinizing carcinoma as the most prevalent histology at 94.3% (undifferentiated type 85.9% and differentiated keratinizing squamous cell carcinoma 8.4%) and 5.7% of the cases showed keratinizing squamous cell carcinoma. Majority of the patients, 86%, presented late with stage III and IV disease.

Conclusion
Nasopharyngeal cancer is commonly found among the young and productive age group, under the age 30. Nonkeratinizing carcinoma is the predominant histopathologic variant resembling that seen in endemic areas of the world. Thus, genetic and early life environmental exposures should be well studied to identify possible risk factors in the region. Late-stage presentation at diagnosis impacts the treatment outcome of patients, thereby indicating the need for a raised index of suspicion among health professionals for early diagnosis and better prognosis of patients.
Assessing causality by means of the Naranjo scale in a paediatric patient with life threatening respiratory failure after alemtuzumab administration: a case report
Authors: Smeets Nori J. L. , Eijk Ruud J. R. , de Wildt Saskia N. , Bootsma-Robroeks Charlotte M. H. H. T. 
Published: May 2021

AbstractBackgroundAlemtuzumab is a T cell depleting antibody agent used as induction immunosuppressant therapy in solid organ transplant recipients. In addition, it is being increasingly used to treat severe or glucocorticoid-resistant graft rejection. Despite the effectiveness of the treatment, severe adverse events have been reported related to alemtuzumab administration. We present a similar event illustrating the severity of this adverse drug reaction (ADR) and we highlight the structure causality assessment provides in approaching such a case.Case presentationWe report a case of life-threatening respiratory failure after alemtuzumab administration in a 17 year old paediatric kidney transplant recipient. He developed near fatal severe respiratory and circulatory failure based on acute respiratory distress syndrome (ARDS) with diffuse alveolar oedema and haemoptysis hours after his second alemtuzumab administration. As it was questionable whether alemtuzumab could be regarded as the origin of his reaction and in order to assess the causality of this reaction as well as to structure clinical reasoning, we applied a widely used ADR probability scale to systematically review our case.Discussion and conclusionsOur case shows a severe ADR after alemtuzumab administration. It illustrates the importance of proper causality assessment, the structure it provides and the benefit of a clinical pharmacology consultation when a severe reaction is suspected to be an ADR. By taking our case as an example, we demonstrate the added value of structured causality assessment to clinical reasoning and in generating differential diagnoses.