bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deep Learning-Driven Data Curation and Model Interpretation for Smart Manufacturing
Authors: Zhang Jianjing , Gao Robert X. 
Published: July 2021

AbstractCharacterized by self-monitoring and agile adaptation to fast changing dynamics in complex production environments, smart manufacturing as envisioned under Industry 4.0 aims to improve the throughput and reliability of production beyond the state-of-the-art. While the widespread application of deep learning (DL) has opened up new opportunities to accomplish the goal, data quality and model interpretability have continued to present a roadblock for the widespread acceptance of DL for real-world applications. This has motivated research on two fronts: data curation, which aims to provide quality data as input for meaningful DL-based analysis, and model interpretation, which intends to reveal the physical reasoning underlying DL model outputs and promote trust from the users. This paper summarizes several key techniques in data curation where breakthroughs in data denoising, outlier detection, imputation, balancing, and semantic annotation have demonstrated the effectiveness in information extraction from noisy, incomplete, insufficient, and/or unannotated data. Also highlighted are model interpretation methods that address the “black-box” nature of DL towards model transparency.
High risk groups for severe COVID-19 in a whole of population cohort in Australia
Authors: Liu Bette , Spokes Paula , He Wenqiang , Kaldor John 
Published: July 2021

Abstract
Background
Increasing age is the strongest known risk factor for severe COVID-19 disease but information on other factors is more limited.

Methods
All cases of COVID-19 diagnosed from January–October 2020 in New South Wales Australia were followed for COVID-19-related hospitalisations, intensive care unit (ICU) admissions and deaths through record linkage. Adjusted hazard ratios (aHR) for severe COVID-19 disease, measured by hospitalisation or death, or very severe COVID-19, measured by ICU admission or death according to age, sex, socioeconomic status and co-morbidities were estimated.

Results
Of 4054 confirmed cases, 468 (11.5%) were classified as having severe COVID-19 and 190 (4.7%) as having very severe disease. After adjusting for sex, socioeconomic status and comorbidities, increasing age led to the greatest risk of very severe disease. Compared to those 30–39 years, the aHR for ICU or death from COVID-19 was 4.45 in those 70–79 years; 8.43 in those 80–89 years; 16.19 in those 90+ years. After age, relative risks for very severe disease associated with other factors were more moderate: males vs females aHR 1.40 (95%CI 1.04–1.88); immunosuppressive conditions vs none aHR 2.20 (1.35–3.57); diabetes vs none aHR 1.88 (1.33–2.67); chronic lung disease vs none aHR 1.68 (1.18–2.38); obesity vs not obese aHR 1.52 (1.05–2.21). More comorbidities was associated with significantly greater risk; comparing those with 3+ comorbidities to those with none, aHR 5.34 (3.15–9.04).

Conclusions
In a setting with high COVID-19 case ascertainment and almost complete case follow-up, we found the risk of very severe disease varies by age, sex and presence of comorbidities. This variation should be considered in targeting prevention strategies.
LncRNA MCM3AP-AS1 sponges miR-148a to enhance cell invasion and migration in small cell lung cancer
Authors: Luo Hua , Zhang Yukun , Qin Guangmei , Jiang Bing , Miao Lili 
Published: July 2021

Abstract
Background
MCM3AP-AS1 is a recently characterized lncRNA playing an oncogenic role in several cancers. However, its role in lung cancer remains unknown. Here, we aimed to explore the functions of MCM3AP-AS1 in small cell lung cancer (SCLC) and the possible underlying mechanisms.

Methods
MCM3AP-AS1 and ROCK1 levels in SCLC patients were analyzed by qPCR. RNA pull-down and luciferase assays were performed to analyze the interaction between MCM3AP-AS1 and miR-148a. ROCK1 mRNA and protein levels were detected by qPCR and Western blot, respectively. Cell invasion and migration were analyzed by Transwell assays.

Results
MCM3AP-AS1 was upregulated in patients with SCLC, and a high MCM3AP-AS1 level was accompanied by a low survival rate. The binding of MCM3AP-AS1 to miR-148a predicted by bioinformatics analysis was verified by RNA pull-down and luciferase assays. However, MCM3AP-AS1 and miR-148a did not affect each other’s expression. ROCK1 was upregulated in SCLC tissues and positively correlated with MCM3AP-AS1. In SCLC cells, MCM3AP-AS1 overexpression increased ROCK1 and promoted cancer cell invasion and migration, while miR-148a overexpression showed the opposite effects and attenuated the effects of MCM3AP-AS1 overexpression on ROCK1 expression and cell behaviors.

Conclusions
MCM3AP-AS1 sponges miR-148a, thereby increasing SCLC cell invasion and migration via upregulating ROCK1 expression.
The incidence, risk factors and predictive nomograms for early death of lung cancer with synchronous brain metastasis: a retrospective study in the SEER database
Authors: Shen Heng , Deng Gang , Chen Qianxue , Qian Jin 
Published: July 2021

Abstract
Background
The prognosis of lung cancer with synchronous brain metastasis (LCBM) is very poor, and patients often die within a short time. However, little is known about the early mortality and related factors in patients with LCBM.

Methods
Patients diagnosed with LCBM between 2010 and 2016 were enrolled from the Surveillance, Epidemiology, and End Result (SEER) database. Univariate and multivariate logistic regression analysis were used to identify significant independent prognostic factors, which were used to construct nomograms of overall and cancer-specific early death. Then, the prediction ability of the model was verified by receiver operating characteristic (ROC) curve. At last, the clinical application value of the model was tested through decision curve analysis (DCA).

Results
A total of 29,902 patients with LCBM were enrolled in this study. Among them, 13,275 (44.4%) patients had early death, and 11,425 (38.2%) cases died of lung cancer. The significant independent risk factors for overall and cancer-specific early death included age, race, gender, Gleason grade, histological type, T stage, N stage, bone metastasis, liver metastasis and marital status, which were used to construct the nomogram. The ROC curve demonstrated good predictive ability and clinical application value. The areas under the curve (AUC) of the training group was 0.793 (95% CI: 0.788–0.799) and 0.794 (95% CI: 0.788–0.799), in the model of overall and cancer-specific early death respectively. And the AUC of the validation group were 0.803 (95% CI: 0.788–0.818) and 0.806 (95% CI: 0.791–0.821), respectively. The calibration plots of the model showed that the predicted early death is consistent with the actual value. The DCA analysis indicated a good clinical application value of this model.

Conclusions
We established a comprehensive nomogram to predict early death in lung cancer patients with synchronous brain metastases. Nomograms may help oncologists develop better treatment strategies, such as clinical trials and hospice care.
“Applying Intersectionality in designing and implementing health interventions: a scoping review”
Authors: Ghasemi Elham , Majdzadeh Reza , Rajabi Fatemeh , Vedadhir AbouAli , Negarandeh Reza , Jamshidi Ensiyeh , Takian Amirhossein , Faraji Zahra 
Published: July 2021

Abstract
Background
Given the potential of intersectionality to identify the causes of inequalities, there is a growing tendency toward applying it in the field of health. Nevertheless, the extent of the application of intersectionality in designing and implementing health interventions is unclear. Therefore, this study aimed to determine the extent to which previous studies have applied intersectionality and its principles in designing and implementing health interventions.

Methods
The title and abstract of the articles which were published in different databases e.g. PubMed, Web of Science, Proquest, Embase, Scopus, Cochrane, and PsychInfo were screened. Those articles that met the screening criteria were reviewed in full text. The data about the application of principles of intersectionality, according to the stages heuristic model (problem identification, design & implementation, and evaluation), were extracted through a 38-item researcher-made checklist.

Results
Initially, 2677 articles were found through reviewing the target databases. After removing the duplicated ones and screening the titles and abstracts of 1601 studies, 107 articles were selected to be reviewed in detail and 4 articles could meet the criteria. The most frequently considered intersectionality principles were “intersecting categories” and “power”, particularly at the stages of ‘problem identification’ as well as ‘design & implementation’. The results showed that “multilevel analysis” principle received less attention; most of the studies conducted the interventions at the micro level and did not aim at bringing about change at structural levels. There was a lack of clarity regarding the attention to some of the main items of principles such as “reflexivity” as well as “social justice and equity". These principles might have been implemented in the selected articles; however, the authors have not explicitly discussed them in their studies.

Conclusions
Given the small number of included studies, there is still insufficient evidence within empirical studies to show the implication of intersectionality in designing and conducting health interventions. To operationalize the intersectionality, there is a need to address the principles at various stages of health policies and interventions. To this end, designing and availability of user-friendly tools may help researchers and health policymakers appropriately apply the intersectionality.
Clinical characteristics, injury pattern and management of pediatric pelvic fracture: An observational retrospective study from a level I trauma center
Authors: Alhammoud Abduljabbar , Moghamis Isam , Abdelrahman Husham , Ghouri Syed Imran , Asim Mohammad , Babikir Elhadi , Al-Thani Hassan , El-Menyar Ayman 
Published: July 2021

Abstract
Background
Pediatric pelvic fractures (PPF) are uncommon among children requiring hospitalization after blunt trauma. The present study explored our experience for the prevalence, patients demographics, clinical characteristics, injury pattern and management of pediatric pelvic fractures in a level I trauma center.

Methods
This is a retrospective review of prospectively collected data obtained from trauma registry database for all pediatrics trauma patients of age ≤18 years. Data were analyzed according to different aspects relevant to the clinical applications such as Torode classification for pelvic ring fracture (Type I–IV), open versus closed triradiate cartilage, and surgical versus non-surgical management.

Results
During the study period (3 and half years), a total of 119 PPF cases were admitted at the trauma center (11% of total pediatric admissions); the majority had pelvic ring fractures (91.6%) and 8.4% had an acetabular fracture. The mean age of patients was 11.5 ± 5.7, and the majority were males (78.2%). One hundred and four fractures were classified as type I (5.8%), type II (13.5%), type III (68.3%) and type IV (12.5%). Patients in the surgical group were more likely to have higher pelvis AIS (p = 0.001), type IV fractures, acetabular fractures and closed triradiate cartilage as compared to the conservative group. Type III fractures and open triradiate cartilage were significantly higher in the conservative group (p < 0.05). Patients with closed triradiate cartilage frequently sustained spine, head injuries, acetabular fracture and had higher mean ISS and pelvis AIS (p < 0.01) than the open group. However, the rate of in-hospital complications and mortality were comparable among different groups. The overall mortality rate was 2.5%.

Conclusion
PPF are uncommon and mainly caused by high-impact trauma associated with multisystem injuries. The majority of PPF are stable, despite the underlying high-energy mechanism. Management of PPF depends on the severity of fracture as patients with higher grade fractures require surgical intervention. Furthermore, larger prospective study is needed to understand the age-related pattern and management of PPF.
Engaging family caregivers and health system partners in exploring how multi-level contexts in primary care practices affect case management functions and outcomes of patients and family caregivers at end of life: a realist synthesis
Authors: Warner Grace , Baird Lisa Garland , McCormack Brendan , Urquhart Robin , Lawson Beverley , Tschupruk Cheryl , Christian Erin , Weeks Lori , Kumanan Kothai , Sampalli Tara 
Published: July 2021

Abstract
Background
An upstream approach to palliative care in the last 12 months of life delivered by primary care practices is often referred to as Primary Palliative Care (PPC). Implementing case management functions can support delivery of PPC and help patients and their families navigate health, social and fiscal environments that become more complex at end-of-life. A realist synthesis was conducted to understand how multi-level contexts affect case management functions related to initiating end-of-life conversations, assessing patient and caregiver needs, and patient/family centred planning in primary care practices to improve outcomes. The synthesis also explored how these functions aligned with critical community resources identified by patients/families dealing with end-of-life.

Methods
A realist synthesis is theory driven and iterative, involving the investigation of proposed program theories of how particular contexts catalyze mechanisms (program resources and individual reactions to resources) to generate improved outcomes. To assess whether program theories were supported and plausible, two librarian-assisted and several researcher-initiated purposive searches of the literature were conducted, then extracted data were analyzed and synthesized. To assess relevancy, health system partners and family advisors informed the review process.

Results
Twenty-eight articles were identified as being relevant and evidence was consolidated into two final program theories: 1) Making end-of-life discussions comfortable, and 2) Creating plans that reflect needs and values. Theories were explored in depth to assess the effect of multi-level contexts on primary care practices implementing tools or frameworks, strategies for improving end-of-life communications, or facilitators that could improve advance care planning by primary care practitioners.

Conclusions
Primary care practitioners’ use of tools to assess patients/families’ needs facilitated discussions and planning for end-of-life issues without specifically discussing death. Also, receiving training on how to better communicate increased practitioner confidence for initiating end-of-life discussions. Practitioner attitudes toward death and prior education or training in end-of-life care affected their ability to initiate end-of-life conversations and plan with patients/families. Recognizing and seizing opportunities when patients are aware of the need to plan for their end-of-life care, such as in contexts when patients experience transitions can increase readiness for end-of-life discussions and planning. Ultimately conversations and planning can improve patients/families’ outcomes.
Anticoagulation for patients with mechanical heart valves at the end of life: understanding clinician attitudes and improving decision making
Authors: Raby Jonathan , Bradley Victoria , Sabharwal Nikant 
Published: July 2021

Abstract
Background
Decisions regarding continuation or cessation of anticoagulation for patients with mechanical heart valves nearing the end of life represent a difficult balance of risks. The risk of suffering and disability that may result from thromboembolism must be weighed against the burden of continued anticoagulation therapy and the excess bleeding risk this confers. Data allowing quantification of the relative risks are scarce, and this translates to a lack of published guidance on the topic. Here we describe how this lack of guidance is impacting upon healthcare professionals and their patients through misconception of risk and under-confidence in decision-making. We also present local guidance we have developed that aims to improve objective risk assessment and promote individualised, patient-centred decision-making.

Methods
Our survey was developed by specialists in palliative care and cardiology. The survey explored respondents' conception of the risks of stopping anticoagulation for patients with mechanical heart valves at the end of life, as well as their ability to identify patient factors that modify this risk. Respondent decision-making, confidence, and readiness to accept further guidance were also explored. Healthcare professionals at two university teaching hospitals were invited to participate in the survey. The study population included hospital specialists, generalists, and trainees.

Results
Fifty-two healthcare professionals completed the survey, including 16 palliative care specialists. 47 (90%) of respondents felt poorly informed of the risks of stopping or continuing anticoagulation. 6 (12%) correctly identified risk of thromboembolism in patients with mechanical heart valves who are not anticoagulated. The remainder overestimated risk by a factor of two (18, 35%) or five (27, 52%). 49 (94%) would find further guidance on this issue helpful.

Conclusions
The healthcare professionals we surveyed felt poorly informed and ill-equipped to make decisions regarding anticoagulation for patients with mechanical heart valves at the end of life. They were objectively poor at estimating the risks involved. In the absence of robust data to support protocolisation of practice, we believe these decisions must be taken in conversation with the patient, taking account of individual circumstances and priorities. We have developed guidance for local use to support such individualised decision-making.
Chinese medical students’ disposition for critical thinking: a mixed methods exploration
Authors: Huang Lei , Fan Angela Pei-Chen , Su Na , Thai Jessica , Kosik Russell Olive , Zhao Xudong 
Published: July 2021

Abstract
Background
Critical thinking (CT) is an essential competency for medical students. This study’s aim was to evaluate Chinese medical students’ disposition for CT and to explore the impact of current trends in medical education on students’ CT development.

Methods
We used multistage stratified cluster sampling to recruit a total of 1241 medical students among five different years of training and from three medical institutions in China. The Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV) and self-reported information were used to collect cross-sectional data. Based on the data from the CTDI-CV, 112 medical students in clinical course training from a single institution continued one-year follow-up. Their one-year CTDI-CV score changes were collected regarding various medical education variables.

Results
The mean CTDI-CV score of the 1241 medical students was 287.04 with 729 (58.7%) students receiving a score of 280 or higher. There were statistically significant differences in schools attended(F = 3.84, P < 0.05), year of school attended(F = 10.32, P < 0.001), GPA(F = 6.32, P < 0.01), weekly time spent learning after class(F = 14.14, P < 0.001), attitude toward medicine(F = 28.93, P < 0.001), desire to be a doctor after graduation(t = − 3.35, P < 0.001), familiarity with CT(F = 20.40, P < 0.001), and perception of importance of CT(F = 22.25, P < 0.001). The participants scored the highest on the CTDI-CV subscales of “inquisitiveness” and the lowest on “truth seeking.” The 112 students in the longitudinal study had significantly lower total CT scores after one academic year follow-up.

Conclusions
Chinese medical students generally exhibited positive CT dispositions. The cross-sectional survey and one-year longitudinal study indicated that students’ CT disposition diminished as they progressed through traditional medical training. Our study contributes to understanding the status of Chinese medical education of and influential factors on medical students’ CT disposition.
Hidden labour: the skilful work of clinical audit data collection and its implications for secondary use of data via integrated health IT
Authors: McVey Lynn , Alvarado Natasha , Greenhalgh Joanne , Elshehaly Mai , Gale Chris P. , Lake Julia , Ruddle Roy A. , Dowding Dawn , Mamas Mamas , Feltbower Richard , Randell Rebecca 
Published: July 2021

AbstractBackgroundSecondary use of data via integrated health information technology is fundamental to many healthcare policies and processes worldwide. However, repurposing data can be problematic and little research has been undertaken into the everyday practicalities of inter-system data sharing that helps explain why this is so, especially within (as opposed to between) organisations. In response, this article reports one of the most detailed empirical examinations undertaken to date of the work involved in repurposing healthcare data for National Clinical Audits.MethodsFifty-four semi-structured, qualitative interviews were carried out with staff in five English National Health Service hospitals about their audit work, including 20 staff involved substantively with audit data collection. In addition, ethnographic observations took place on wards, in ‘back offices’ and meetings (102 h). Findings were analysed thematically and synthesised in narratives.ResultsAlthough data were available within hospital applications for secondary use in some audit fields, which could, in theory, have been auto-populated, in practice staff regularly negotiated multiple, unintegrated systems to generate audit records. This work was complex and skilful, and involved cross-checking and double data entry, often using paper forms, to assure data quality and inform quality improvements.ConclusionsIf technology is to facilitate the secondary use of healthcare data, the skilled but largely hidden labour of those who collect and recontextualise those data must be recognised. Their detailed understandings of what it takes to produce high quality data in specific contexts should inform the further development of integrated systems within organisations.