bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Robust Deep Learning Segmentation Method for Hematoma Volumetric Detection in Intracerebral Hemorrhage
Authors: Yu Nannan , Yu He , Li Haonan , Ma Nannan , Hu Chunai , Wang Jia 
Published: October 2021

Background and Purpose:
Hematoma volume (HV) is a significant diagnosis for determining the clinical stage and therapeutic approach for intracerebral hemorrhage (ICH). The aim of this study is to develop a robust deep learning segmentation method for the fast and accurate HV analysis using computed tomography.

Methods:
A novel dimension reduction UNet (DR-UNet) model was developed for computed tomography image segmentation and HV measurement. Two data sets, 512 ICH patients with 12 568 computed tomography slices in the retrospective data set and 50 ICH patients with 1257 slices in the prospective data set, were used for network training, validation, and internal and external testing. Moreover, 13 irregular hematoma cases, 11 subdural and epidural hematoma cases, and 50 different HV cases into 3 groups (<30, 30–60, and >60 mL) were selected to further evaluate the robustness of DR-UNet. The image segmentation performance of DR-UNet was compared with those of UNet, the fuzzy clustering method, and the active contour method. The HV measurement performance was compared using DR-UNet, UNet, and the Coniglobus formula method.

Results:

Using DR-UNet, the segmentation model achieved a performance similar to that of expert clinicians in 2 independent test data sets containing internal testing data (Dice of 0.861±0.139) and external testing data (Dice of 0.874±0.130). The HV measurement derived from DR-UNet was strongly correlated with that from manual segmentation (R
2
=0.9979;
P
<0.0001). In the irregularly shaped hematoma group and the subdural and epidural hematoma group, DR-UNet was more robust than UNet in both hematoma segmentation and HV measurement. There is no statistical significance in segmentation accuracy among 3 different HV groups.

Conclusions:
DR-UNet can segment hematomas from the computed tomography scans of ICH patients and quantify the HV with better accuracy and greater efficiency than the main existing methods and with similar performance to expert clinicians. Due to robust performance and stable segmentation on different ICHs, DR-UNet could facilitate the development of deep learning systems for a variety of clinical applications.
Toward Cumulative Cognitive Science: A Comparison of Meta-Analysis, Mega-Analysis, and Hybrid Approaches
Authors: Koile Ezequiel , Cristia Alejandrina 
Published: October 2021

Abstract
There is increasing interest in cumulative approaches to science, in which instead of analyzing the results of individual papers separately, we integrate information qualitatively or quantitatively. One such approach is meta-analysis, which has over 50 years of literature supporting its usefulness, and is becoming more common in cognitive science. However, changes in technical possibilities by the widespread use of Python and R make it easier to fit more complex models, and even simulate missing data. Here we recommend the use of mega-analyses (based on the aggregation of data sets collected by independent researchers) and hybrid meta- mega-analytic approaches, for cases where raw data are available for some studies. We illustrate the three approaches using a rich test-retest data set of infants’ speech processing as well as synthetic data. We discuss advantages and disadvantages of the three approaches from the viewpoint of a cognitive scientist contemplating their use, and limitations of this article, to be addressed in future work.
Exploration of non-pharmacological interventions in the management of behavioural and psychological symptoms of dementia
Authors: Md Hussin Nur Sabiha , Karuppannan Mahmathi , Gopalan Yogheswaran , Tan Kit Mun , Gnanasan Shubashini 
Published: October 2021

Introduction:
Behavioural and psychological symptoms of dementia (BPSD) are considered integral parts of dementia. While pharmacotherapy is reserved for severe symptoms of BPSD, the associated adverse effects can be detrimental. Therefore, non-pharmacological intervention is recommended as the first line of treatment in the management of BPSD. This study aimed to explore the non-pharmacological approaches for the management of BPSD and the strategies and barriers to implementing them in secondary care facilities in Malaysia.

Methods:
A qualitative study design was employed. Data were collected through observations and semi-structured interviews of 12 caregivers and 11 people with dementia (PWD) at seven secondary care facilities. Observations were written in the field notes, and interviews were audio-recorded and transcribed. All data were subjected to thematic analysis.

Results:
Some personalised non-pharmacological interventions, such as physical exercise, music therapy, reminiscence therapy and pet therapy, were conducted in several nursing care centres. Collaborative care from the care providers and family members was found to be an important facilitating factor. The lack of family support led to care providers carrying additional workload beyond their job scope. Other barriers to non-pharmacological interventions were cultural and language differences between the care providers and PWD, inadequate staff numbers and training, and time constraints.

Conclusion:
Although non-pharmacological approaches have been used to some extent in Malaysia, continuous education and training of healthcare providers and the family members of PWD is needed to overcome the challenges to their successful implementation.
Colonic stenting in acute malignant large bowel obstruction: audit of efficacy and safety in a Singapore tertiary referral centre
Authors: Li James Weiquan , Ngu James Chi-Yong , Lim Kok Ren , Tay Shu Wen , Jiang Bochao , Wijaya Ramesh , Yusof Sulaiman , Ong Calvin Jianming , Kwek Andrew Boon Eu , Ang Tiing Leong 
Published: October 2021

Introduction:
Acute malignant large bowel obstruction (MBO) occurs in 8%–15% of colorectal cancer patients. Self-expandable metal stents (SEMS) have progressed from a palliative modality to use as bridge to surgery (BTS). We aimed to assess the safety and efficacy of SEMS for MBO in our institution.

Methods:
The data of patients undergoing SEMS insertion for MBO were reviewed. Technical success was defined as successful SEMS deployment across tumour without complications. Clinical success was defined as colonic decompression without requiring further surgical intervention. Rates of complications, median time to surgery, types of surgery and rates of recurrence were studied.

Results:
Seventy-nine patients underwent emergent SEMS placement from September 2013 to February 2020. Their mean age was 68.8 ± 13.8 years and 43 (54%) patients were male. Mean tumour length was 4.2 cm ± 2.2 cm; 89.9% of malignant strictures were located distal to the splenic flexure. Technical and clinical success was 94.9% and 98.7%, respectively. Perforation occurred in 5.1% of patients, with none having stent migration or bleeding. Fifty (63.3%) patients underwent SEMS insertion as BTS. Median time to surgery was 20 (range 6–57) days. Most (82%) patients underwent minimally invasive surgery. Primary anastomosis rate was 98%. Thirty-nine patients had follow-up beyond 1-year posttreatment (median 34 months). Local recurrence and distant metastasis were observed in 4 (10.3%) and 5 (12.8%) patients, respectively.

Conclusion:
Insertion of SEMS for acute MBO has high success rates and a good safety profile. Most patients in this audit underwent minimally invasive surgery and primary anastomosis after successful BTS.
Increased behavioural problems associated with corticosteroid use in children with nephrotic syndrome: a Southeast Asian perspective
Authors: Mahmud Mohamad Nizam , Othman Azizah , Ilias Mohamad Ikram 
Published: October 2021

Abstract

Introduction:
The study was performed to determine the psychological problems in children with idiopathic nephrotic syndrome (INS) while they were on steroid therapy, as compared to healthy children.

Methods:
This prospective cohort study was conducted in a paediatric clinic of a tertiary hospital. Parents of the participants in the INS group and control group (comprising children without chronic illness) completed questionnaires using the Child Behavioural Checklist (CBCL). The CBCL measures a range of age-specific emotional and psychological problems, including internalising and externalising domains. Analyses of the CBCL scores between groups were done using Mann–Whitney U test.

Results:
A total of 140 children were recruited with an equal number in the INS and control groups. There was a significant difference in the mean total CBCL scores between the INS group and the control group, specifically in the withdrawal, somatic, anxious and aggressiveness subdomains. Similar findings were demonstrated in correlation between total psychological problems and corticosteroid dosage. In the INS group, steroid dose and cushingoid features were found to have a significant positive association with internalising psychological problems.

Conclusion:
Children with INS on corticosteroid treatment showed an increase in internalising and externalising scores, as compared to healthy children.
A 15-year pheochromocytoma and paraganglioma experience in a single centre: a Singapore perspective
Authors: Lee Yingshan , Tan Leon Yuan Rui , Abdul Shakoor Shaikh Abdul Kader Kamaldeen 
Published: October 2021

Introduction:
Pheochromocytomas (PCC) and paragangliomas (PGL) are rare endocrine tumours. The objective of this study was to describe our experience with these two entities in a Singapore population.

Methods:
We identified patients with positive histopathological confirmations of PCC and PGL who were treated at a tertiary Singapore hospital between January 2000 and December 2015. The results were analysed for clinical presentations, treatment and long-term outcomes.

Results:
A total of 27 cases (20 PCC, 7 PGL) were identified over a 15-year period. One case of PGL developed bilateral disease on follow-up. There were 17 male and 10 female patients with a median age of 57 (range 24–77) years. A positive family history was uncommon and present in only 3.7% of patients. Uniquely, the top three presenting symptoms were abdominal discomfort, palpitations and diaphoresis. Despite adequate preoperative preparation, intraoperative haemodynamic instability occurred in 70.4% and early postoperative hypotension occurred in 11.1% of patients. After surgery, hypertension was resolved in 41.2% (7/17) and diabetes mellitus in 60% (3/5). Disease recurrence was reported in 22.2% and distant metastases in 14.8%. At the end of the follow-up period (median 35 [range 3–148] months), 70.4% were still alive.

Conclusion:
PCC and PGL can present with a wide range of symptoms. Intraoperative haemodynamic instability was frequent despite good preoperative preparation. Disease recurrences and metastasis occurred in up to one-fifth of the patients. Genetic screening should be offered to patients with PCC and PGL.
Demographics, aetiology and outcome of paediatric acute liver failure in Singapore
Authors: Chiou Fang Kuan , Logarajah Veena , Ho Christopher Wen Wei , Goh Lynette Suk-Hui , Karthik Sivaramakrishnan Venkatesh , Aw Marion Margaret , Phua Kong Boo 
Published: October 2021

Introduction:
The aetiology of paediatric acute liver failure (PALF) varies widely according to age, and geographic and socioeconomic factors. This study aimed to examine the epidemiology, aetiology and outcome of PALF in Singapore at a single centre.

Methods:
A retrospective review was performed of patients aged 0–18 years who were diagnosed with PALF from 2007 to 2019. PALF was defined by: absence of chronic liver disease; biochemical evidence of acute liver injury; and coagulopathy, non-correctible by vitamin K, defined as prothrombin time (PT) ≥20 seconds or international normalised ratio (INR) ≥2.0 regardless of hepatic encephalopathy (HE) or PT ≥15 seconds or INR ≥1.5 in the presence of HE.

Results:
34 patients were included. Median age at diagnosis was 10 months (range 7 days to 156 months). The top three causes of PALF were indeterminate (41.2%), metabolic (26.5%) and infectious (26.5%) aetiologies. A metabolic disorder was the most frequent aetiology in infants <12 months (38.9%), whereas an indeterminate cause was the most common in children >12 months (50%). No cases of viral hepatitis A or B presenting with PALF were detected. Overall spontaneous recovery rate (survival without liver transplantation [LT]) was 38.2%, and overall mortality rate was 47.1%. Six patients underwent living-donor LT, and the post-transplant survival at one year was 83.3%.

Conclusion:
The aetiologic spectrum of PALF in Singapore is similar to that in developed Western countries, with indeterminate aetiology accounting for the majority. PALF is associated with poor overall survival; hence, timely LT for suitable candidates is critical to improve survival outcomes.
Farmers’ Perception and Adaptation Strategies to Climate Change in Central Mali
Authors: Amadou Traoré , Falconnier Gatien N. , Mamoutou Kouressy , Georges Serpantié , Alassane B. A. , François Affholder , Michel Giner , Benjamin Sultan 
Published: October 2021

AbstractAdaptation of the agricultural sector to climate change is crucial to avoid food insecurity in sub-Saharan Africa. Farmers’ perception of climate change is a crucial element in adaptation process. The aim of this study was (i) to compare farmers’ perception of climate change with actual weather data recorded in central Mali, (ii) to identify changes in agricultural practices implemented by farmers to adapt to climate change, and (iii) to investigate the link between farmers’ perception of climate change and implementation of adaptation practices. Focus group discussions and individual surveys were conducted to identify climate-related changes perceived by farmers and agricultural adaptation strategies they consider relevant to cope with these changes. A majority (>50%) of farmers perceived an increase in temperature, decrease in rainfall, shortening of growing season, early cessation of rainfall, and increase in the frequency of dry spells at the beginning of the growing season. In line with farmers’ perception, analysis of climate data indicated (i) an increase in mean annual temperature and minimum growing season temperature and (ii) a decrease in total rainfall. Farmers’ perception of early cessation of rainfall and more-frequent drought periods were not detected by climate data analysis. To cope with the decrease in rainfall and late start of the growing season, farmers used drought-tolerant cultivars and implemented water-saving technologies. Despite a perceived warming, no specific adaptation to heat stress was mentioned by farmers. We found evidence of a link between farmers’ perception of climate change and the implementation of some adaptation options. Our study highlights the need for a dialogue between farmers and researchers to develop new strategies to compensate for the expected negative impacts of heat stress on agricultural productivity.
Tornado Warning Guidance and Graphics: Implications of the Inclusion of Protective Action Information on Perceptions and Efficacy
Authors: Sutton Jeannette , Fischer Laura , Wood Michele M. 
Published: October 2021

AbstractEffective warning messages should tell people what they should do, how they should do it, and how to maximize their health and safety. Guidance essentially delivers two types of information: 1) information that instructs people about the actions to take in response to a threat, and 2) information about how and why these recommended protective actions will reduce harm. However, recent research reported that while automated tornado warnings, sent by the National Weather Service Storm Prediction Center via the account @NWStornado on Twitter, included useful information about the location of the threat, the potential impacts, and populations at risk, it failed to provide content that would contribute to successful protective actions. In this experimental study we investigate how the inclusion and presentation of protective action guidance affects participant perceptions of a tornado warning message and their perceived ability to act upon the information (i.e., self- and response-efficacy). We find that the inclusion of protective action guidance results an increase in the participants’ understanding of the message, their ability to decide what to do, and their perceived self- and response-efficacy. Knowing how to take action to protect oneself, and believing the actions will make oneself safe, are key motivators to taking action when faced with a significant threat. Future warning research should draw from other persuasive messaging and health behavior theories, and should include self- and response- efficacy as important causal factors. It should also look across additional hazards to determine if these outcomes differ by the length of forewarning and hazard type.
A Cross-Sectional Survey of Risky Travel and Leisure Behaviors During the COVID-19 Pandemic
Authors: Maddock Jay E. , Suess Courtney 
Published: October 2021

Purpose COVID-19 is largely spread through close contact with infected people in indoor spaces. Avoiding these spaces is one of the most effective ways to slow the spread. This study assessed who had engaged in risky travel and leisure behaviors before the availability of vaccines. Design National cross-sectional on-line survey collected in November and December 2020. Setting: United States; Participants: 2589 adults representative by gender and race/ethnicity to the US population; Measures: The survey assessed if people had resumed 11 risky behaviors during the pandemic, prior to vaccines. Independent variables included age, race/ethnicity, region of the country, education, income, preexisting conditions, perceived severity and susceptibility, positive COVID diagnosis, and political ideology. Analysis Univariate analysis and logistic regressions were used to assess demographic and psychological factors of those resuming these behaviors. Results: Most (60.3%) of people had resumed at least 1 behavior with eating inside of restaurants (33.2%) and visiting family and friends (37.5%) being the most prevalent. In the multivariate analyses, perceived susceptibility was significant across all behaviors. Young people, fiscal conservatives, and people with higher perceived severity were more likely to perform several of the behaviors. Preexisting conditions did not predict any of the behaviors. Conclusions Travel and leisure behaviors vary by type of risk and may need specific tailored, prevention messages to promote risk reduction during future pandemics.
Maintenance and Welfare of Parents and Senior Citizens Act 2007: A Critical Appraisal
Authors: Issac Thomas Gregor , Ramesh Abhishek , Reddy Shiv Shanker , Sivakumar Palanimuthu T. , Kumar Channaveerachari Naveen , Math Suresh Bada 
Published: October 2021

Background: The sociocultural changes associated with globalization and development have weakened the traditional values and family support systems for senior citizens (age 60 years and above). There is an increase in the prevalence of elder abuse and difficulties in getting appropriate care and support. This has mandated legal measures to protect the rights of the senior citizens and provide them care and support by the family and other stakeholders. Consequent to being the signatory for the “Madrid International Plan of Action on Ageing, 2002,” several countries, including India, have introduced legislation for the social protection of senior citizens. “The Maintenance and Welfare of Parents and Senior Citizens(MWP) Act, 2007” is an important legislation in India to safeguard the elderly from exploitation and abuse. Methods: This article critically evaluates the implementation of the MWP Act, 2007, and the related challenges in protecting senior citizens from abuse. The article will also highlight the proposed amendments in the Act to strengthen the effective implementation of legal protection for senior citizens and ensure their well-being and dignity. Conclusions: The MWP act is an important legal measure to ensure mainatinence and welfare of senior citizens and protect them from abuse and neglect. There is an immediate need to incorporate the necessary amendments so that the act gets more pragmatic value and becomes and important tool for elderly care and protection and reduce vulnerabilities and ensure holistic care with support in various bio-psycho-social domains.
Concurrent Chemoradiotherapy With Weekly Low-Dose Cisplatin for Japanese Patients With Head and Neck Squamous Cell Carcinoma
Authors: Shinohara Shogo , Takebayashi Shinji , Hamaguchi Kiyomi , Michida Tetsuhiko , Tobe Yota , Ikenaga Tadashi , Yasumoto Mami , Hamamoto Ayami , Imagumbai Toshiyuki , Mitsuyoshi Takamasa , Ashida Ryo , Iwai Takahiro , Okabayashi Shun 
Published: October 2021

Background: Concurrent chemoradiotherapy (CCRT) with tri-weekly high-dose cisplatin (HDC) is considered the standard regimen. However, due to significant toxicity, various weekly low-dose schedules have been increasingly used. We investigated the tolerability and survival of patients with head and neck squamous cell carcinoma (HNSCC) who underwent CCRT with low-dose weekly cisplatin (LDC) for Japanese population. Methods: A retrospective review was conducted among patients with HNSCC who were treated with CCRT/LDC in our institute. Ninety-five patients who met the criteria were enrolled in this study. We evaluated the cycle and cumulative cisplatin dose, completion rate of radiotherapy, adverse events, and survival outcome. Results: The mean cycles and cumulative cisplatin dose were 4.7 cycles and 187 mg/m2. All patients completed planned dose of radiation without prolonged breaks. Leucopoenia was the most frequent dose-limiting factor and 44% patients developed grade 3 or 4 toxicity. The 2-year overall survival and recurrence-free survival were 93% and 74%, respectively. The significant differences of survival outcomes between the patients with total cisplatin dose (⩾200 mg and <200 mg) or among age distribution (35-55, 56-75, and ⩾76) were not observed. Conclusions: Concurrent chemoradiotherapy/LDC can be safely administered with acceptable toxicity and survival outcome even if the patients with higher age, lower eGFR, and so on.