bluuebunny/crossref_metadata_2025_split huggingface dataset:
Automatic segmentation and melanoma detection based on color and texture features in dermoscopic images
Authors: Oukil S. , Kasmi R. , Mokrani K. , García‐Zapirain B. 
Published: November 2021

AbstractPurposeMelanoma is known as the most aggressive form of skin cancer and one of the fastest growing malignant tumors worldwide. Several computer‐aided diagnosis systems for melanoma have been proposed, still, the algorithms encounter difficulties in the early stage of lesions. This paper aims to discriminate melanoma and benign skin lesion in dermoscopic images.MethodsThe proposed algorithm is based on the color and texture of skin lesions by introducing a novel feature extraction technique. The algorithm uses an automatic segmentation based on k‐means generating a fairly accurate mask for each lesion. The feature extraction consists of the existing and novel color and texture attributes measuring how color and texture vary inside the lesion. To find the optimal results, all the attributes are extracted from lesions in five different color spaces (RGB, HSV, Lab, XYZ, and YCbCr) and used as the inputs for three classifiers (K nearest neighbors, support vector machine , and artificial neural network).ResultsThe PH2 set is used to assess the performance of the proposed algorithm. The results of our algorithm are compared to the results of published articles that used the same dataset, and it shows that the proposed method outperforms the state of the art by attaining a sensitivity of 99.25%, specificity of 99.58%, and accuracy of 99.51%.ConclusionThe final results show that the colors combined with texture are powerful and relevant attributes for melanoma detection and show improvement over the state of the art.
Current state and positive impact of hospital‐based blood donor centers in the United States
Authors: Jacquot Cyril , Mei Zhen , Khan Jenna , Dunbar Nancy , Delaney Meghan , Ziman Alyssa 
Published: November 2021

AbstractBackgroundThe COVID‐19 pandemic has brought tremendous challenges to the United States blood supply. Decreased collections have caused blood product shortages. The number of hospital‐based donor centers (HBDCs) has decreased in the past decades, but they provide important support to their hospital systems.Materials/MethodsWe identified 79 active HBDCs through an information request to the FDA. These centers were invited to participate in a survey about their activities, blood product collections, and perceived value.ResultsThirty‐six centers responded (46% response rate). The centers represented a wide range of states and geographic settings. Whole blood collection was most common, but some respondents also prepared specialized products such as COVID‐19 convalescent plasma and pathogen‐reduced platelets. Positive impacts of HBDCs included inventory availability, cost‐effectiveness/savings, community outreach, supporting special patient populations, and collecting specialty products. All respondents anticipate at least stable operations, if not growth, in the future.ConclusionHBDCs continue to be valuable assets in addressing emerging patient transfusion needs. Their unique offerings are tailored to the populations their hospitals support, and demonstrate the value in having the collection infrastructure in place to rapidly respond to critical shortages. This survey provides benchmark data about a broad group of HBDCs including products prepared, inventory self‐sufficiency levels, and reasons for positive impact.
Comparison of 12‐Hour Biweekly Versus 6‐Hour Weekly Shifts on Fatigue in Student Nurses
Authors: Grewal Alena , Holt Karyn E. 
Published: November 2021

AbstractBackgroundSome challenges affecting student nurse learning include student fatigue, clinical recovery time, and hindered clinical experiences due to students experiencing long clinical shifts.AimThe aim of this study was to evaluate the differences between 12‐hour biweekly and 6‐hour weekly shifts on student nurse fatigue.MethodsA descriptive research design was used with second‐year nursing students (N = 80) upon completion of their clinical rotations of four distinct cohorts during 2019–2020. All students in these cohorts were invited to complete the Occupational Fatigue Exhaustion Recovery (OFER15) online survey, developed and validated to assess the full spectrum of fatigue.ResultsThere were no statistically significant differences in acute fatigue, chronic fatigue, or the inter‐shift recovery subscale for the 6‐hour and 12‐hour clinical groups. Student nurses, like registered nurses, would likely prefer to choose between a 6‐hour and 12‐hour clinical shift depending on their individual circumstances. In the parameters of this study, there was no statistical significance in shift length and student nurse fatigue.Linking Evidence to ActionStudent nurse fatigue levels can affect learning inside and outside of nursing clinical experiences. In this study, no statistical significances were found between 6‐hour and 12‐hour clinical experiences in second‐year nursing students. Offering both the 6‐hour and 12‐hour clinical experiences provides flexibility for students, clinical sites, and the school of nursing.
Association of CLABSI With Hospital Length of Stay, Readmission Rates, and Mortality: A Retrospective Review
Authors: Chovanec Kelli , Arsene Camelia , Gomez Cheryl , Brixey Molly , Tolles Diana , Galliers Jennifer Wheaton , Kopaniasz Renee , Bobash Tiffany , Goodwin Lamar 
Published: November 2021

AbstractBackgroundAn evidence‐based practice (EBP) approach to implementing change is relevant and pertinent to the strategy to improve outcomes for hospitalized patients with central venous catheters (CVC). As health systems endeavor to achieve the ambitious goals of improving the patient experience of care, improving the health of populations, and reducing the cost of health care, it is imperative to understand the impact of a central line‐associated bloodstream infection (CLABSI) on outcomes.AimsThe purpose of the study was to contribute to the evidence of the association of CLABSI with the outcomes of hospital length of stay (LOS), readmission rates, and mortality rates for hospitalized patients.MethodsA retrospective study was conducted, including all hospitalized patients with a CVC within four hospitals in an integrated health system in northwest Ohio and southeast Michigan. The sample population was stratified into two groups, CLABSI and no CLABSI, and the outcomes of interest for each group were compared.ResultsThe findings substantiate the association between CLABSI and the hospital mortality rate, LOS, and readmission. Patients with a CVC who develop a CLABSI were 36.6% more likely to die in the hospital and 37.0% more likely to be readmitted compared with patients with a CVC who did not develop a CLABSI. In addition, hospital LOS increased an average of 2 days compared with patients without CLABSI. This study evokes implications for EBP change to reduce the rate of CLABSI and for quality improvement during in‐hospital care.Linking Evidence to ActionThere is an association between CLABSI and hospital mortality rate, LOS, and 30‐day readmission outcomes, presenting a profound sense of urgency for EBP change. There were potential variances in processes or practice relative to insertion, maintenance, and removal in the hospitals studied, representing an opportunity to examine the best practices in the hospitals that are performing well. Implementation of EBP requires selecting effective and innovative strategies, with a focus on stakeholder involvement and needs.
Analysis of Averaging Methods for Nonuniform Total Pressure Fields
Authors: Burdett Daniel , Povey Thomas 
Published: November 2021

Abstract
A common objective in the analysis of turbomachinery components (nozzle guide vanes (NGVs) or rotor blades, for example) is to calculate performance parameters, such as total pressure or kinetic energy (KE) loss coefficients, from measurements in a nonuniform flow-field. These performance parameters can be represented in a range of ways. For example, line-averages used to compare performance between different radial sections of a 3D component; plane-averages used to assess flow (perhaps loss coefficient) development between different axial planes; and fully mixed-out values used to determine the total loss associated with a component. In the literature, the weighting method used for line- and plane-averaging (e.g., area, volume flow, mass flow, or entropy-flux) is sometimes regarded as an unimportant issue. Indeed, many authors neglect to even state which weighting method was used in their work. In certain low-speed test cases, or where measurements are made a long distance from the component, the nonuniformity in the flow will be relatively small and the practical difference between different weighting methods may be negligible. However, in high-speed applications or for measurements close to a component trailing edge, this becomes increasingly unlikely. In this paper, we compare a range of methods for calculating aerodynamic performance parameters—for example, the kinetic energy loss coefficient—including plane-average methods with different weighting schemes and several mixed-out methods. We analyze the sensitivities of the different methods to the axial location of the measurement plane, the radial averaging range, and the exit Mach number. We use high-fidelity experimental data taken in several axial planes downstream of a cascade of engine parts: high-pressure (HP) turbine NGVs operating at transonic Mach number. The experimental data are complemented by computational fluid dynamics (CFD). We discuss the underlying physical mechanisms which give rise to the observed sensitivities. The objective is to provide guidance on the accuracy of each method in a relevant, practical application.
Dispersed Carbon in Basalts of the Altered Oceanic Crust: Isotope Composition and Mechanisms of Formation
Authors: Polyakov V. B. , Shilobreeva S. N. 
Published: November 2021

AbstractCarbon contents and isotopic compositions were compared in the basalt groundmass of the oceanic crust of different age in the zone of the East Pacific Rise. In samples the basalt groundmass of the ancient oceanic crust (~270 Ma, ODP Site 801C) in which a carbonate phase was found, the isotopic composition of the oxidized carbon (δ13C = ±1.5‰) indicates that this carbon was formed by the precipitation of seawater dissolved inorganic carbon (DIC). In the samples in which no carbonate phase was identified, the low concentration (<0.1 wt % CO2) of oxidized dispersed carbon and its isotopic composition (δ13C < –7‰) are in the range of values typical of carbon dissolved in basalt glasses without crystallinity. This makes it possible to relate the oxidized dispersed carbon to residual carbon dissolved in the magmatic melt after CO2degassing. The precipitation of DIC results in a positive correlation between the concentration of total carbon and its δ13C values, along with the formation of a carbonate phase. The application of this criterion to basalt groundmass samples of the young crust (~15 Ma, ODP Site 1256D) showed that oxidized dispersed carbon in the young oceanic crust groundmass was not formed by the precipitation of DIC, contradicting the generally accepted paradigm. Constant concentration and δ13C values of the reduced dispersed carbon in the basalt groundmass of the young and ancient oceanic crusts, including lithological zones where microbial activity has not been recorded, indicate that the most probable model is high-temperature abiogenic generation of reduced dispersed carbon near the ridge axis. The Fischer–Tropsch synthesis and/or Bell–Boudouard reaction provide a possible basis for the abiogenic model. The Bell–Boudouard reaction 2CO = C + CO2leads to the formation of an adsorbed layer of elemental carbon on the fresh surfaces of minerals during background alteration of the oceanic basalt crust. The CO2–CO gas-phase equilibrium maintains the necessary depletion of the newly formed elemental carbon in the13C isotope to δ13C < –20‰. Abiogenic models for the origin of the isotopically light reduced dispersed carbon in the basalt groundmass do not assume the presence of carbon depleted in the heavy13C isotope in the magmatic melt.
Integrating ultrasound with the combined spinal-epidural kit as a rescue technique during difficult spinal anaesthesia
Authors: Stagg Phil 
Published: November 2021

Conducting spinal anaesthesia in patients with elevated body mass index is commonly difficult, yet there are no guidelines to direct best practice. Landmark techniques are sometimes insufficient, leading to increased failure rates and suboptimal patient outcomes. Although ultrasound-guided techniques are now considered standard care for central venous access and regional anaesthesia, there has been relatively sparse uptake of this widely available resource for central neuraxial block, despite evidence of its efficacy.This article outlines a successful case of ultrasound-assisted spinal anaesthesia, after landmark techniques failed, in conjunction with a combined spinal-epidural kit. This unique combination of techniques has not been published as an amalgamated rescue strategy for difficult spinal anaesthesia. This article adds to current evidence by highlighting the potential benefits of combining these techniques into a novel approach either when difficulties are expected or as a rescue technique after failed landmark-based attempts.
Deletion of GPR21 improves glucose homeostasis and inhibits the CCL2-CCR2 axis by divergent mechanisms
Authors: Riddy Darren M , Kammoun Helene L , Murphy Andrew J , Bosnyak-Gladovic Sanja , De la Fuente Gonzalez Rocio , Merlin Jon , Ziemann Mark , Fabb Stewart , Pierce Tracie L , Diepenhorst Natalie , Rueda Patricia , El-Osta Assam , Gautier Jean-Francois , Venteclef Nicolas , Charman William N , Christopoulos Arthur , Sexton Patrick M , Summers Roger J , Febbraio Mark A , Delerive Philippe , Langmead Christopher J 
Published: November 2021

IntroductionA potential role for the orphan G protein-coupled receptor, GPR21, in linking immune cell infiltration into tissues and obesity-induced insulin resistance has been proposed, although limited studies in mice are complicated by non-selective deletion ofGpr21.Research design and methodsWe hypothesized that aGpr21-selective knockout mouse model, coupled with type 2 diabetes patient samples, would clarify these issues and enable clear assessment of GPR21 as a potential therapeutic target.ResultsHigh-fat feeding studies inGpr21−/−mice revealed improved glucose tolerance and modest changes in inflammatory gene expression.Gpr21−/−monocytes and intraperitoneal macrophages had selectively impaired chemotactic responses to monocyte chemoattractant protein (MCP)-1, despite unaltered expression ofCcr2. Further genotypic analysis revealed that chemotactic impairment was due to dysregulated monocyte polarization. Patient samples revealed elevatedGPR21expression in peripheral blood mononuclear cells in type 2 diabetes, which was correlated with both %HbA1c and fasting plasma glucose levels.ConclusionsCollectively, human and mouse data suggest that GPR21 influences both glucose homeostasis and MCP-1/CCL2-CCR2-driven monocyte migration. However, aGpr21−/−bone marrow transplantation and high-fat feeding study in mice revealed no effect on glucose homeostasis, suggesting that there is no (or limited) overlap in the mechanism involved for monocyte-driven inflammation and glucose homeostasis.
Type 2 diabetes and the risk of cardiovascular events in peripheral artery disease versus coronary artery disease
Authors: Sprenger Lukas , Mader Arthur , Larcher Barbara , Mächler Maximilian , Vonbank Alexander , Zanolin-Purin Daniela , Leiherer Andreas , Muendlein Axel , Drexel Heinz , Saely Christoph H 
Published: November 2021

IntroductionThe prevalence of type 2 diabetes mellitus (T2DM) is higher in peripheral artery disease (PAD) than in coronary artery disease (CAD) patients, and PAD overall confers higher cardiovascular risk than CAD. How cardiovascular risk compares between PAD and CAD patients when analyses are stratified by the presence of type 2 diabetes is unclear and is addressed in the present study.Research design and methodsWe prospectively recorded major cardiovascular events (MACE; ie, cardiovascular death, myocardial infarction or stroke) over 10.0±4.7 years in 923 patients with stable CAD, of whom 26.7% had T2DM and in 292 patients with PAD, of whom 42.1% had T2DM. Four groups were analyzed: CAD patients without diabetes (CAD/T2DM−; n=677), CAD patients with T2DM (CAD/T2DM+; n=246), PAD patients without diabetes (PAD/T2DM−; n=169) and PAD patients with T2DM (PAD/T2DM+; n=123).ResultsThe event rate for MACE increased over our four investigated groups: it was lowest in CAD/T2DM− patients (2.52 events per 100 person-years). It was significantly higher in CAD/T2DM+ patients (3.96 events per 100 person-years; p<0.001), in PAD/T2DM− patients (3.68 events per 100 person-years; p=0.022), and in PAD/T2DM+ patients (7.10 events per 100 person-years; p<0.001), who in turn were at a higher risk than CAD/T2DM+ or PAD/T2DM− patients (p=0.001 and p<0.001, respectively). Cox regression analysis after multivariate adjustment showed that the presence of T2DM (HR=1.44 (95% CI 1.09 to 1.92); p=0.012) and the presence of PAD versus CAD (HR=1.48 (95% CI 1.15 to 1.91); p=0.002) were mutually independent predictors of cardiovascular events.ConclusionsIn conclusion, our data show that T2DM as well as the presence of PAD versus CAD are mutually independent predictors of MACE. Patients with both PAD and T2DM are at an exceedingly high risk of cardiovascular events.
Validation and feasibility of a postal system for remote monitoring of HbA1c
Authors: Cross Jen , Sharma Sanjeev , John W Garry , Rayman Gerry 
Published: November 2021

IntroductionThe COVID-19 pandemic has reduced the accessibility to hemoglobin A1c (HbA1c) tests required for virtual diabetes clinics. The aim was to develop and validate a user-friendly postal system for remote HbA1c monitoring.Research design and methodsValidation: A total of 123 capillary blood samples from people with diabetes (PWD) needing face-to-face consultations along with healthy volunteers were measured on a point-of-care (POC) Siemens DCA Vantage Analyzer. Another sample of 5–10 drops was simultaneously collected in a K2EDTA tube (BD Microtainer) and stored for up to 12 days at room temperature for subsequent retesting. Feasibility: During October to December 2020, a total of 286 postal HbA1c kits were sent to PWD prior to their virtual consultation. These contained sample collection guidance, the necessary equipment and a feedback form. As per Packing Instruction 650 regulations, these were posted back to the diabetes center for HbA1c testing on the POC analyzer.ResultsThere was a strong correlation between the first and the stored sample (R2=0.978). There was a small clinically insignificant negative bias −1.53 mmol/mol (2 SD = 3.10 mmol/mol). Bland-Altman plots showed 93% of results within 2 SD. Of the 87% of returned kits, only one sample failed to be analyzed. 94% of PWD who provided feedback were happy to use the postal HbA1c system again.ConclusionsA robust user-friendly postal HbA1c system has been created and successfully integrated into clinical practice using the existing POC equipment at the diabetes center. It provides accurate HbA1c results and is an invaluable tool for remote monitoring of HbA1c in PWD—both during and after the pandemic.
Availability of population-level data sources for tracking the incidence of deaths and injuries from road traffic crashes in low-income and middle-income countries
Authors: Mitra Sudeshna , Neki Kazuyuki , Mbugua Leah Watetu , Gutierrez Hialy , Bakdash Leen , Winer Mercer , Balasubramaniyan Ramshankar , Roberts Jaeda , Vos Theo , Hamilton Erin , Naghavi Mohsen , Harrison James E , Job R F Soames , Bhalla Kavi 
Published: November 2021

IntroductionTracking progress towards Sustainable Development Goal (SDG) 3·6 of reducing traffic deaths and serious injuries poses a measurement challenge in most low-income and middle-income countries (LMICs) due to large discrepancies between reported official statistics and estimates from global health measurement studies. We assess the extent to which national population censuses and health surveys can fill the information gaps.MethodsWe reviewed questionnaires for nationally representative surveys and censuses conducted since 2000 in LMICs. We identified sources that provide estimates of household ownership of vehicles, incidence of traffic deaths and non-fatal injuries, and prevalence of disability.ResultsWe identified 802 data sources from 132 LMICs. Sub-Saharan African countries accounted for 43% of all measurements. The number of measurements since 2000 was high, with 97% of the current global LMIC population having at least one measurement for vehicle ownership, 77% for deaths, 90% for non-fatal injuries and 50% for disability due to traffic injuries. Recent data (since 2010) on traffic injuries were available from far fewer countries (deaths: 21 countries; non-fatal injuries: 62 and disability: 12). However, there were many more countries with recent data on less-specific questions about unintentional or all injuries (deaths: 41 countries, non-fatal: 87, disability: 32).ConclusionTraffic injuries are substantially underreported in official statistics of most LMICs. National surveys and censuses provide a viable alternative information source, but despite a large increase in their use to monitor SDGs, traffic injury measurements have not increased. We show that relatively small modifications and additions to questions in forthcoming surveys can provide countries with a way to benchmark their existing surveillance systems and result in a substantial increase in data for tracking road traffic injuries globally.