bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality improvement time-saving intervention to increase use of a clinical decision support tool to reduce low-value diagnostic imaging in a safety net health system
Authors: Lee Bryanna , Mafi John , Patel Maitraya K , Sorensen Andrea , Vangala Sitaram , Wei Eric , Sarkisian Catherine 
Published: February 2021

ImportanceElectronic health record (EHR) clinical decision support (CDS) tools can provide evidence-based feedback at the point of care to reduce low-value imaging. Success of these tools has been limited partly due to lack of engagement by busy clinicians.ObjectiveMeasure the impact of a time-saving quality improvement intervention to increase engagement with a CDS tool for low back pain imaging ordering.Design, setting and participantsWe conducted a quasi-experimental difference-in-differences analysis at (BLINDED), examining back pain imaging orders from 29 May 2015 to 07 January 2016. The intervention site was (BLINDED) Emergency Medicine/Urgent Care Center (n=5736) and control sites included all other (BLINDED) hospitals and clinics (n=1621). In May 2015, the Department of Health Services installed a CDS tool that triggered a survey when clinicians ordered an imaging test, generating an ‘appropriateness score’ based on the American College of Radiology guidelines. Clinicians often bypassed the tool, resulting in ‘unscored’ tests.InterventionTo increase clinician engagement with the tool and decrease the rate of unscored imaging tests, a new policy was implemented at the intervention site on 15 August 2015. If clinicians completed the CDS survey and scored an appropriateness score >3, they could forego a previously mandatory telephone call for pre-imaging utilisation review with the radiology department.Main outcomes and measuresWe used EHR data to measure pre–post-intervention differences in: (1) percentage of unscored tests and (2) percentage of tests with high appropriateness scores (>7).ResultsPercentage of unscored tests decreased from 69.4% to 10.4% at the intervention site and from 50.6% to 34.8% at the control sites (between-group difference: −23.3%, p<0.001). Percentage of high scoring tests increased from 26.5% to 75.0% at the intervention site and from 17.2% to 22.7% at the control sites (between-group difference: 19%, p<0.001).ConclusionWorkflow time-saving interventions may increase physician engagement with CDS tools and have potential to improve practice patterns.
Development and evaluation of an illustrated paediatric leaflet ‘Coming to Hospital: a guide to what goes on’
Authors: Clark Elisha K R , Sanghavi Sanjana S , Farrell Stephen , Fritz Zoë 
Published: February 2021

BackgroundA paediatric information leaflet was produced to better prepare patients for time spent in hospital and to improve experience by informing them what to expect.MethodsThe ‘Coming to Hospital’ leaflet was designed with input from paediatric research groups, and in collaboration with a children’s author and publishing company. A questionnaire to evaluate the leaflet was developed; face validity was established in a pilot. The real-time patient experience of these leaflets was evaluated on paediatric wards in a university hospital.ResultsThe evaluation revealed that a significant majority of children ‘really liked’ the leaflet and found it helpful. 53 out of 72 of children reported that the leaflet made them feel ‘happy’ or ‘calm’, with no children responding that it made them feel ‘very worried’. The leaflet was found to be informative, well presented and reassuring. Many parents stated that they wished they had received the leaflet prior to their child’s first hospital visit. Suggestions for changes to the leaflet were minimal; it was considered to include all relevant information.ConclusionA leaflet designed by clinical staff, patients and a publishing company was welcomed by paediatric patients and their parents. Patients reported it made them feel calmer. Such a leaflet should be available widely to improve children’s experience of coming to hospital. Collaborations between clinicians, academics and publishing companies can produce positive results for the paediatric population.
Immediate versus delayed insertion of the copper intrauterine device after medical abortion at 17–20 gestational weeks: a randomised controlled trial
Authors: Constant Deborah , Endler Margit , Grossman Daniel , Petro Gregory , Patel Malika 
Published: February 2021

IntroductionThis trial reports on use of the copper intrauterine device (IUD) after immediate compared with delayed insertion following medical abortion at 17–20 gestational weeks (GW).MethodsThis randomised controlled trial was conducted at one tertiary hospital and five community healthcare centres in Cape Town, South Africa. Eligible consenting women were randomised to immediate (within 24 hours) or delayed (3 weeks post-abortion) insertion of the copper IUD. Follow-up was at 6 weeks, 3 months and 6 months. Main outcomes were use of the original IUD and use of any IUD, including replacement IUDs at 6 weeks post-abortion. Secondary outcomes included rates of expulsion and malposition at 6 weeks, use of any IUD at 3 and 6 months, and acceptability of the IUD.ResultsWe recruited and randomised 114 women admitted for elective medical abortion between August 2018 and June 2019. In the immediate and delayed study arms, respectively, 45/55 (82%) and 12/57 (21%) women received the IUD as planned. By intention-to-treat, 56% in the immediate and 19% in the delayed arms were using the original IUD at 6 weeks (p<0.001), and 76% in the immediate and 40% in the delayed arms were using any IUD (p<0.001). Complete expulsion or removal occurred in 32% in the immediate and 7% in the delayed arms (p=0.044).ConclusionsInsertion of an IUD immediately after medical abortion at 17–20 GW results in increased use after 6 weeks compared with delayed insertion, however expulsion rates are higher than with interval insertion.Clinical trials registrationNCT03505047), Pan African Trials Registry (www.pactr.org), 201804003324963
ВИЗНАЧЕННЯ МІСЦЯ ФАРМАЦЕВТИЧНОГО ПРАВА В СУЧАСНІЙ СИСТЕМІ ПРАВА УКРАЇНИ
Authors: Kotvitska A. A. , Кubarieva I. V. , Volkova A. V. , Boldar G. E. , Cherkashyna A. V. 
Published: February 2021

Мета роботи. Визначення місце фармацевтичного права в системі права України, аналіз його предмета, методу та системи на підставі загальнотеоретичних розробок про галузь права та законодавства.
Матеріали і методи. Дослідження проведено на основі опрацювання наукової та навчальної літератури, нормативно-правових актів. Використано методи аналізу, синтезу, узагальнення, системно-структурний, формально-логічний, порівняно-правовий, тлумачення правової норми.
Результати й обговорення. Встановлено, що у вітчизняній спеціальній літературі спостерігається недостатня кількість праць, присвячених вивченню юридичної природи фармацевтичного права. Обговорення цієї проблеми більш активно здійснюється зарубіжними науковцями, ніж українськими. Привертає увагу факт відсутності єдиного підхіду до розуміння предмета та методу фармацевтичного права. Ці питання іноді висвітлюються у загальнотеоретичних роботах у рамках наукової дискусії про можливість існування комплексних галузей права в системі права. Зроблено висновок, що вчені не досягли загальної точки зору щодо галузевої належності фармацевтичного права та законодавства. Частина дослідників вважають фармацевтичне право складовою частиною (підгалуззю) медичного або економічного (господарського) права, а інші визначають як самостійну комплексну галузь права або законодавства.
Висновки. Обґрунтована наукова позиція про те, що в сучасних умовах склалися підстави вважати фармацевтичне право самостійною комплексною галуззю права, предметом якої виступають управлінські, майнові та немайнові відносини, що виникають під час здійснення фармацевтичної діяльності, для регулювання яких використовуються методи субординації (імперативний) та координації (диспозитивний). Запропоновано поділ системи фармацевтичного права на Загальну та Особливу частини, розкрито інститути кожної з них.
Machine Learning–Derived Fractal Features of Shape and Texture of the Left Atrium and Pulmonary Veins From Cardiac Computed Tomography Scans Are Associated With Risk of Recurrence of Atrial Fibrillation Postablation
Authors: Firouznia Marjan , Feeny Albert K. , LaBarbera Michael A. , McHale Meghan , Cantlay Catherine , Kalfas Natalie , Schoenhagen Paul , Saliba Walid , Tchou Patrick , Barnard John , Chung Mina K. , Madabhushi Anant 
Published: February 2021

Background:
We hypothesized that computerized morphological analysis of the left atrium (LA) and pulmonary veins (PVs) via fractal measurements of shape and texture features of the LA myocardial wall could predict atrial fibrillation (AF) recurrence after ablation.

Methods:

Preablation contrast computed tomography scans were collected for 203 patients who underwent AF ablation. The LA body, PVs, and myocardial wall were segmented using a semi-automated region growing method. Twenty-eight fractal-based shape and texture-based features were extracted from resulting segments. The top features most associated with postablation recurrence were identified using feature selection and subsequently evaluated with a Random Forest classifier. Feature selection and classifier construction were performed on a discovery cohort (D
1
) of 137 patients; classifiers were subsequently validated on an independent set (D
2
) of 66 patients. Dedicated classifiers to capture the fractal and morphological properties of LA body (C
LA
), PVs (C
PV
), and LA myocardial (C
LAM
) tissue were constructed, as well as a model (C
All
) capturing properties of all segmented compartments. Fractal-based models were also compared against a model employing machine estimation of LA volume. To assess the effect of clinical parameters, such as AF type and catheter technique, a clinical model (C
clin
) was also compared against C
All
.

Results:

Statistically significant differences were observed for fractal features of C
LA
, C
LAM
, and C
All
in distinguishing AF recurrence (
P
<0.001) on D
1
. Using the 5 top features, C
All
had the best prediction performance (area under the receiver operating characteristic curve [AUROC], 0.81 [95% CI, 0.78–0.85]), followed by C
PV
(AUROC, 0.78 [95% CI, 0.74–0.80]), and C
LA
(AUROC, 0.70 [95% CI, 0.63–0.78]) on D
2
. The clinical parameter model C
clin
yielded an AUROC, 0.70 (95% CI, 0.65–0.77), while the atrial volume model yielded an AUROC, 0.59. Combining C
All
and C
clin
on D
2
improved the AUROC to 0.87 (95% CI, 0.82–0.93).

Conclusions:
Fractal measurements of the LA, PVs, and atrial myocardium on computed tomography scans were associated with likelihood of postablation AF recurrence.
The Curious Case of the Unrecognized turba of amīr Jirbāsh Qāshiq: New Dating and Attribution
Authors: Hamza Hani 
Published: February 2021

Abstract
The borderlines between the sacred and profane, and the living and the dead, are blurred in the Mamluk Northern Cemetery of Cairo like in no other place in Egypt. Sacred burial domes, prayer chapels, mosques, ṣūfī khanqās, and zawīyyas stood side by side with profane residential quarters, kitchens, latrines, stables, kutābs, and sabīls scattered around a ḥaūsh enclosed by a wall. The Northern Cemetery was dotted with over a hundred of such Mamluk turba complexes. Many perished, but thirty-six survived.
The majority of surviving turbas are identified with certainty, but a few have controversial attributions or doubtful dating. One surviving turba stands out as not being recognized at all, let alone given an attribution or date. This is the peculiar case of the turba of Jirbāsh Qāshiq (d. 861/1456), standing between the complexes of Īnāl and of Qurqumās at the edge of the Northern Cemetery.
The plan of Ῑnāl’s complex (855–60/1451–56) has a peculiar square area protruding uncomfortably to the west, now in semi ruins. It was identified empirically by the Comité in 1919 as courtyard C of the complex of Ῑnāl. None of the later studies challenged this attribution. This paper will discuss the vague attributions of three turbas in the area in general, and as a case study challenges the Comité’s attribution of the ḥaush C as part of Īnāl’s complex; it proposes that it is a separate turba for Jirbāsh Qāshiq. This conclusion is reached through reading of several waqf manuscripts, comparisons with other monuments of the same genre and era, biographical dictionaries, and chronicles. A plan and a three-dimensional re-construction of the turba are drawn as well.
A Simple Panel of IDH1 and P53 in Differential Diagnosis Between Low-Grade Astrocytoma and Reactive Gliosis
Authors: Geramizadeh Bita , Kohandel-Shirazi Mahsa , Soltani Ahmad 
Published: February 2021

Background: Reactive gliosis is a response of glial tissue to different types of injury such as brain abscess, trauma, hemorrhage, or even neoplastic process. In some circumstances, especially when the tissue biopsy is small, there may be difficulty to discriminate this reactive condition with low-grade diffuse astrocytoma (World Health Organization [WHO] grade II) by conventional hematoxylin and eosin (H&E) slides, so some immunohistochemical and molecular markers have been introduced for this differential diagnosis. One of the important aspects of updated WHO classification in 2016 has been dividing some of the glial tumor according to IDH1 (isocitrate dehydrogenase 1) mutation. Objectives: In this study, we tried to evaluate IDH1 and P53 mutation by immunohistochemistry as a simple and highly specific and sensitive method to differentiate low-grade astrocytoma and reactive gliosis. Material and methods: For 5 years (2013-2018), 50 cases of clinically documented reactive gliosis and 50 cases of low-grade astrocytoma were evaluated for the presence or absence of IDH1 and P53 mutation by immunohistochemistry. Results: Isocitrate dehydrogenase 1 was positive in 92% and 4% of the astrocytoma and reactive gliosis cases and P53 was positive in 90% and 4% of the cases with the final diagnosis of astrocytoma and reactive gliosis, respectively. Discussion and conclusion: Combination of P53 and IDH1 as an immunohistochemical panel showed specificity of 96% and sensitivity of 91% for differential diagnosis of reactive gliosis and low-grade astrocytoma. These 2 markers can be extremely helpful for this differential diagnosis.
Quantitative assessment of vascular density in diabetic retinopathy subtypes with optical coherence tomography angiography
Authors: Ghassemi Fariba , Fadakar Kaveh , Berijani Sahar , Babeli Ameneh , Gholizadeh Alireza , Sabour Siamak 
Published: February 2021

Abstract
Background
Quantitative assessment of vascular density (VD) of retinal and choriocapillaris (CC) in various stages of diabetic retinopathy (DR) using spectral domain optical coherence tomography angiography (SD OCTA).

Methods
188 eyes of 97 participants were recruited in this cross-sectional study. The macular OCTA (3x3mm) scan was performed and the computer algorithm assessed VD at the level of superficial capillary plexus (SCP), deep capillary plexus (DCP) and CC.

Results
All measured parameters were decreased in retinal VD at the more extreme stages of DR, with the exception of SCP foveal VD. There was a constant pattern of decrease in VD of CC from normal cases to cases of NDR and NPDR and then a slight increase occurred in the PDR stage but never touching the normal quantities. Age, fasting blood sugar, and years of diabetes mellitus were correlated with reduced VD in different segments. Multivariate linear regression analysis showed that best-corrected visual acuity (BCVA) was positively correlated with parafoveal VD at SCP and VD of foveal area at CC. VD of all subfields of macular area except foveal DCP VD showed reduced levels in diabetic macular edema (DME) patients compared to those without DME.

Conclusions
The findings of the study endorse retina VD changes as a potential biomarker for DR development before retinopathy becomes clinically evident. It seems that parafoveal VD of SCP and foveal VD of CC are good biomarkers to predict VA in the diabetic patients.
Analyzing brain structural differences among undergraduates with different grades of self-esteem using multiple anatomical brain network
Authors: Peng Bo , Pang Gaofeng , Saxena Aditya , Liu Yan , Hu Baohua , Wang Suhong , Dai Yakang 
Published: February 2021

AbstractBackgroundSelf-esteem is the individual evaluation of oneself. People with high self-esteem grade have mental health and can bravely cope with the threats from the environment. With the development of neuroimaging techniques, researches on cognitive neural mechanisms of self-esteem are increased. Existing methods based on brain morphometry and single-layer brain network cannot characterize the subtle structural differences related to self-esteem.MethodTo solve this issue, we proposed a multiple anatomical brain network based on multi-resolution region of interest (ROI) template to study the brain structural connections of self-esteem. The multiple anatomical brain network consists of ROI features and hierarchal brain network features that are extracted from structural MRI. For each layer, we calculated the correlation relationship between pairs of ROIs. In order to solve the high-dimensional problem caused by the large amount of network features, feature selection methods (t-test, mRMR, and SVM-RFE) are adopted to reduce the number of features while retaining discriminative information to the maximum extent. Multi-kernel SVM is employed to integrate the various types of features by appropriate weight coefficient.ResultThe experimental results show that the proposed method can improve classification accuracy to 97.26% compared with single-layer brain network.ConclusionsThe proposed method provides a new perspective for the analysis of brain structural differences of self-esteem, which also has potential guiding significance in other researches involved brain cognitive activity and brain disease diagnosis.
Gene function finding through cross-organism ensemble learning
Authors: Moro Gianluca , Masseroli Marco 
Published: February 2021

Abstract
Background
Structured biological information about genes and proteins is a valuable resource to improve discovery and understanding of complex biological processes via machine learning algorithms. Gene Ontology (GO) controlled annotations describe, in a structured form, features and functions of genes and proteins of many organisms. However, such valuable annotations are not always reliable and sometimes are incomplete, especially for rarely studied organisms. Here, we present GeFF (Gene Function Finder), a novel cross-organism ensemble learning method able to reliably predict new GO annotations of a target organism from GO annotations of another source organism evolutionarily related and better studied.

Results
Using a supervised method, GeFF predicts unknown annotations from random perturbations of existing annotations. The perturbation consists in randomly deleting a fraction of known annotations in order to produce a reduced annotation set. The key idea is to train a supervised machine learning algorithm with the reduced annotation set to predict, namely to rebuild, the original annotations. The resulting prediction model, in addition to accurately rebuilding the original known annotations for an organism from their perturbed version, also effectively predicts new unknown annotations for the organism. Moreover, the prediction model is also able to discover new unknown annotations in different target organisms without retraining.We combined our novel method with different ensemble learning approaches and compared them to each other and to an equivalent single model technique. We tested the method with five different organisms using their GO annotations: Homo sapiens, Mus musculus, Bos taurus, Gallus gallus and Dictyostelium discoideum. The outcomes demonstrate the effectiveness of the cross-organism ensemble approach, which can be customized with a trade-off between the desired number of predicted new annotations and their precision.A Web application to browse both input annotations used and predicted ones, choosing the ensemble prediction method to use, is publicly available at http://tiny.cc/geff/.

Conclusions
Our novel cross-organism ensemble learning method provides reliable predicted novel gene annotations, i.e., functions, ranked according to an associated likelihood value. They are very valuable both to speed the annotation curation, focusing it on the prioritized new annotations predicted, and to complement known annotations available.
Challenges and advances in clinical applications of mesenchymal stromal cells
Authors: Zhou Tian , Yuan Zenan , Weng Jianyu , Pei Duanqing , Du Xin , He Chang , Lai Peilong 
Published: February 2021

AbstractMesenchymal stromal cells (MSCs), also known as mesenchymal stem cells, have been intensely investigated for clinical applications within the last decades. However, the majority of registered clinical trials applying MSC therapy for diverse human diseases have fallen short of expectations, despite the encouraging pre-clinical outcomes in varied animal disease models. This can be attributable to inconsistent criteria for MSCs identity across studies and their inherited heterogeneity. Nowadays, with the emergence of advanced biological techniques and substantial improvements in bio-engineered materials, strategies have been developed to overcome clinical challenges in MSC application. Here in this review, we will discuss the major challenges of MSC therapies in clinical application, the factors impacting the diversity of MSCs, the potential approaches that modify MSC products with the highest therapeutic potential, and finally the usage of MSCs for COVID-19 pandemic disease.
Physalis alkekengi L. var. francheti alleviates neuronal cell death caused by activated microglia in vitro
Authors: Park Byoung Hee , Kwon Oh Wook , Kim In Sung , Lee Hae Min , Roh Yeon Jin , Kim Minseo , Jo Youngho , Cho Hwayeon , Park Jung Kuk , Zhi Zheng , Lee Byung Cheon 
Published: February 2021

AbstractMicroglia are the macrophages that reside in the brain. Activated microglia induces further activation of astrocytes and neuronal cells for mounting an immune response. However, activated microglia release neurotoxic mediators causing neuroinflammation, which is associated with chronic etiology of neurodegenerative diseases. We investigated the effect of ethanol extract of Physalis alkekengi L. var. francheti fruit (PAFE) on neuronal cell death mediated by activated microglia. PAFE decreased NO production and IL-6 secretion in LPS-stimulated BV-2 and primary microglial cells without reducing cell viability. Consistently, treatment with PAFE decreased iNOS and COX-2 expression and ERK phosphorylation in LPS-stimulated BV-2 cells. Finally, apoptosis of N2a cells grown in conditioned media prepared from LPS-stimulated BV-2 cells containing PAFE was inhibited via downregulation of the Bax/Bcl-2 ratio. Taken together, PAFE alleviates neuronal cell death by reducing neurotoxic mediators such as NO and IL-6 from activated microglia. Therefore, it could be a potential candidate to treat neurodegenerative diseases caused by chronic neuroinflammation.