bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparison of an Artificial Intelligence Tool to Fundamental Frequency as an Outcome Measure in People Seeking a More Feminine Voice
Authors: Bensoussan Yael , Park Christopher , Johns Michael , Brown Sarah , Pinto Jeremy , Chang Joseph , Courey Mark 
Published: May 2021

Objectives/HypothesisAn artificial intelligence (AI) tool was developed using audio clips of cis‐male and cis‐female voices based on spectral analysis to assess %probability of a voice being perceived as female (%Prob♀). This program was validated with 92% accuracy in cisgender speakers. The aim of the study was to assess the relationship of fo on %Prob♀ by a validated AI tool in a cohort of trans females who underwent intervention to feminize their voice with behavioral modification and/or surgery.Study DesignCohort study.MethodsFundamental frequency (fo) from prolonged vowel sounds (fo/a/) and fo from spontaneous speech (fo‐sp) were measured using the Kay Pentax Computerized Speech Lab (Montvale, NJ) in trans females postintervention. The same voice samples were analyzed by the AI tool for %Prob♀. Chi‐square analysis and regression models were performed accepting >50% Prob♀ as female voice.ResultsForty‐two patients were available for analysis after intervention. fo‐sp post‐treatment was positively correlated with %Prob♀ (R = 0.645 [P < .001]). Chi‐square analysis showed a significant association between AI %Prob♀ >50% for the speech samples and fo‐sp >160 Hz (P < .01). Sixteen of 42 patients reached an fo‐sp >160 Hz. Of these, the AI program only perceived nine patients as female (>50 %Prob♀).ConclusionPatients with fo‐sp >160 Hz after feminization treatments are not necessarily perceived as having a high probability of being female by a validated AI tool. AI may represent a useful outcome measurement tool for patients undergoing gender affirming voice care.Level of Evidence3 Laryngoscope, 131:2567–2571, 2021
CRISPR/Cas9 gene editing in legume crops: Opportunities and challenges
Authors: Bhowmik Pankaj , Konkin David , Polowick Patricia , Hodgins Connor Lorne , Subedi Maya , Xiang Daoquan , Yu Bianyun , Patterson Nii , Rajagopalan Nandhakishore , Babic Vivijan , Ro Dae‐Kyun , Tar'an Bunyamin , Bandara Manjula , Smyth Stuart J. , Cui Yuhai , Kagale Sateesh 
Published: May 2021

AbstractLegumes are an excellent source of proteins and health‐promoting phytochemicals. Recognizing their importance in human nutrition and sustainable agricultural production, significant efforts are currently being made to accelerate genetic gain related to yield, stress resilience, and nutritional quality. Recent increases in genomic resources for multiple legume crops have laid a solid foundation for application of transformative breeding technologies such as genomic selection and genome editing for crop improvement. In this review, we focus on the recent plant‐specific advances in CRISPR/Cas9‐based gene editing technology and discuss the challenges and opportunities to harnessing this innovative technology for targeted improvement of traits in legume crops. Gene‐editing methods have been successfully established for soybean, cowpea, chickpea, and model legumes such as Medicago truncatula and Lotus japonicus. However, the recalcitrance of other legumes to in vitro gene transfer and regeneration has posed a serious challenge to application of gene editing. We discuss various modifications to in vitro culture methods, in terms of the choice of explant, media composition, and DNA delivery and gene‐editing detection methods that can potentially improve the rate of transformation and regeneration of whole plant in legume crops. Although gene‐editing technology can bring enormous benefits to legume breeding, regulatory hurdles are a cause for serious concern. We compare the regulatory environments existing in the European Union and the United States of America. A favorable regulatory framework and public acceptance are important factors in realizing CRISPR's potential benefits to global food security.
Multiculturalism: A Challenge for Cognitive Screeners in Parkinson's Disease
Authors: Statucka Marta , Cherian Kirsten , Fasano Alfonso , Munhoz Renato P. , Cohn Melanie 
Published: May 2021

ABSTRACTBackgroundThe Montreal Cognitive Assessment (MoCA) and the Dementia Rating Scale‐2 (DRS‐2) are recommended screeners for Parkinson's disease mild cognitive impairment (PD‐MCI). Cross‐cultural studies examining their diagnostic precision have not addressed cultural bias in a multicultural setting.ObjectivesTo compare DRS‐2 and MoCA performance between patients born in Canada, the USA, and the UK (Anglosphere group) and immigrant patients born elsewhere (International group). To identify sources of cultural bias by comparing group characteristics, and by assessing the relationships between performance and immigration and socio‐development variables. To examine the diagnostic precision of both tools in detecting PD‐MCI in each group.MethodsWe conducted a clinical chart review of advanced PD patients who completed cognitive screeners (MoCA: n = 288, 30% International group; DRS‐2: n = 426, 31% International group). All completed a comprehensive neuropsychological assessment to apply Level II PD‐MCI diagnostic criteria.ResultsThe International group performed worse than the Anglosphere group on the MoCA and DRS‐2, and the only variable that accounted for some of the group difference was the Historical Index of Human Development, a societal variable, which fully mediated the group effect on the DRS‐2. Diagnostic precision of the MoCA was at chance level in the International group, and was poorer than that of the DRS‐II in this group and that of the MoCA in the Anglosphere group, although these were considered poor.ConclusionsOur results support the recommendation to exert caution in using cognitive screeners to capture PD‐MCI in all patients and particularly with first generation immigrants.
Trans‐Ethnic Fine‐Mapping of the Major Histocompatibility Complex Region Linked to Parkinson's Disease
Authors: Naito Tatsuhiko , Satake Wataru , Ogawa Kotaro , Suzuki Ken , Hirata Jun , Foo Jia Nee , Tan Eng‐King , Toda Tatsushi , Okada Yukinori 
Published: May 2021

ABSTRACTBackgroundDespite evidence for the role of human leukocyte antigen (HLA) in the genetic predisposition to Parkinson's disease (PD), the complex haplotype structure and highly polymorphic feature of the major histocompatibility complex (MHC) region has hampered a unified insight on the genetic risk of PD. In addition, a majority of the reports focused on Europeans, lacking evidence on other populations.ObjectivesThe aim of this study is to elucidate the genetic features of the MHC region associated with PD risk in trans‐ethnic cohorts.MethodsWe conducted trans‐ethnic fine‐mapping of the MHC region for European populations (14,650 cases and 1,288,625 controls) and East Asian populations (7712 cases and 27,372 controls). We adopted a hybrid fine‐mapping approach including both HLA genotype imputation of genome‐wide association study (GWAS) data and direct imputation of HLA variant risk from the GWAS summary statistics.ResultsThrough trans‐ethnic MHC fine‐mapping, we identified the strongest associations at amino acid position 13 of HLA‐DRβ1 (P = 6.0 × 10−15), which explains the majority of the risk in HLA‐DRB1. In silico prediction revealed that HLA‐DRB1 alleles with histidine at amino acid position 13 (His13) had significantly weaker binding affinity to an α‐synuclein epitope than other alleles (P = 9.6 × 10−4). Stepwise conditional analysis suggested additional independent associations at Ala69 in HLA‐B (P = 1.0 × 10−7). A subanalysis in Europeans suggested additional independent associations at non‐HLA genes in the class III MHC region (EHMT2; P = 2.5 × 10−7).ConclusionsOur study highlights the shared and distinct genetic features of the MHC region in patients with PD across ethnicities. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
A model selection framework to quantify microvascular liver function in gadoxetate‐enhanced MRI: Application to healthy liver, diseased tissue, and hepatocellular carcinoma
Authors: Berks Michael , Little Ross A. , Watson Yvonne , Cheung Sue , Datta Anubhav , O’Connor James P. B. , Scaramuzza Davide , Parker Geoff J. M. 
Published: May 2021

PurposeWe introduce a novel, generalized tracer kinetic model selection framework to quantify microvascular characteristics of liver and tumor tissue in gadoxetate‐enhanced dynamic contrast‐enhanced MRI (DCE‐MRI).MethodsOur framework includes a hierarchy of nested models, from which physiological parameters are derived in 2 regimes, corresponding to the active transport and free diffusion of gadoxetate. We use simulations to show the sensitivity of model selection and parameter estimation to temporal resolution, time‐series duration, and noise. We apply the framework in 8 healthy volunteers (time‐series duration up to 24 minutes) and 10 patients with hepatocellular carcinoma (6 minutes).ResultsThe active transport regime is preferred in 98.6% of voxels in volunteers, 82.1% of patients’ non‐tumorous liver, and 32.2% of tumor voxels. Interpatient variations correspond to known co‐morbidities. Simulations suggest both datasets have sufficient temporal resolution and signal‐to‐noise ratio, while patient data would be improved by using a time‐series duration of at least 12 minutes.ConclusionsIn patient data, gadoxetate exhibits different kinetics: (a) between liver and tumor regions and (b) within regions due to liver disease and/or tumor heterogeneity. Our generalized framework selects a physiological interpretation at each voxel, without preselecting a model for each region or duplicating time‐consuming optimizations for models with identical functional forms.
Two‐dimensional oxide based pressure sensors with high sensitivity
Authors: Liu Hao , Feng Bo , Bai Xiaosong , Qi Tianhang , Wei Zhiyong , Liu Ruichao , Yin Keke , Gao Jinxing , Yang Daoyuan , Zheng Guangchao , ten Elshof Johan E. , Shan Chongxin , Sun Qi‐Jun , Yuan Huiyu 
Published: May 2021

AbstractNanomaterials based pressure sensors have obtained world‐wide research interest due to their promising potential applications in health monitoring, artificial intelligence, and electronic skin (e‐skin). Despite the recent progress in sensitivity and detection range of the pressure sensors, the relatively high thickness of the active films has obstructed their applications for e‐skin and degraded the comfortability as wearable devices. We hereby report for the first time a novel pressure sensor based on two‐dimensional metal oxide nanosheets where the gaps between neighboring nanosheets are adjustable. The pressure sensors show a sensitivity of up to 7.2 × 106 kPa–1, which is the highest value ever reported for a pressure sensor. Additionally, the sensor shows good repeatability and excellent stability. The pressure‐sensing ranges can be tuned by adjusting the coverage of the nanosheet film. This work presents an effective strategy to develop ultrathin pressure sensors.
Does traditional pharmacotherapy augment behavioral modification in the treatment of nocturia?
Authors: Miller Connelly D. , Monaghan Thomas F. , Robins Dennis J. , Weiss Jeffrey P. 
Published: May 2021

AbstractAimsTo assess the efficacy of traditional first‐line non‐antidiuretic pharmacotherapy for nocturia in the real‐world outpatient urology setting.MethodsWe retrospectively analyzed voiding diaries from adult men treated for lower urinary tract symptoms (LUTS) at an outpatient urology clinic to identify pairs of voiding diaries with ≥1 nocturnal void at baseline and a corresponding follow‐up diary completed within 1 year. We compared the odds of nocturia improvement (decrease of ≥1 nocturnal void) in patients started on LUTS pharmacotherapy versus behavioral modification alone.ResultsTwo hundred and thirteen diary pairs from 93 patients were included. Fifty‐seven diary pairs were identified from patients prescribed at least one LUTS drug on the initial visit and 156 diary pairs were identified from patients receiving behavioral modification alone. All standard voiding diary parameters were assessed, and only maximum voided volume differed at baseline (240 ml [interquartile range: 200–330 ml] vs. 280 ml [200–400 ml] with and without pharmacotherapy, respectively, p = 0.04). The odds of nocturia improvement did not significantly differ between pharmacotherapy and behavioral modification treatment groups (crude odds ratio [OR]: 1.16 [95% confidence interval: 0.63–2.16], p = 0.63; maximum voided volume [MVV]‐adjusted OR: 1.19 [0.63–2.22], p = 0.59). In contrast, improvement in 24‐h urinary frequency was more likely with pharmacotherapy versus behavioral modification alone (crude OR: 2.36 [1.22–4.56], p = 0.01; MVV‐adjusted OR: 2.05 [1.05–4.01], p = 0.04). Results were consistent on subgroup analyses restricted to first diary pairs from each patient.ConclusionDespite improvement in 24‐h voiding frequency, there was no evidence that adjunctive pharmacotherapy provided a benefit in the treatment of nocturia in men receiving behavioral counseling.
Topology optimization of degradable composite structures with time‐changeable stiffness
Authors: Zhang Heng , Takezawa Akihiro , Ding Xiaohong , Xu Shipeng , Li Hao , Guo Honghu 
Published: May 2021

AbstractFor effective bone healing, the stiffness of the bone plate should be adjusted to different bone‐healing processes. Thus, the design of stiffness‐changeable structures that take into account the time effect is of importance. To this end, this study introduces a novel topological optimization approach for the composite structural layout design considering material degradation to realize structures with changeable stiffness over time. In this approach, two sets of variables are used: a density field that defines the material layout, and a time field that determines the effect of material degradation on mechanical performance. The continuous degradation update formula is proposed by integrating the Heaviside projected function and Kreisselmeier–Steinhauser function to guarantee its derivability. The objective is to minimize the summed compliance in some specified time steps subject to the constraints of volume fraction. The sensitivity of the aforementioned objective with respect to the design variable is deduced by considering the material degradation over time. The proposed design formulation is general and is demonstrated with several design analyses, considering different fix and degradable interface boundary conditions. Moreover, the results are compared with the results of not considering material degradation and demonstrate the effectiveness of the proposed method.
Validity and reliability of the RAC adult infection risk scale: A new instrument to measure healthcare‐associated infection risk
Authors: Rodríguez‐Acelas Alba Luz , de Abreu Almeida Miriam , Schmarczek Figueiredo Manoela , Monteiro Mantovani Vanessa , Mattiello Rita , Cañon‐Montañez Wilson 
Published: May 2021

AbstractHealthcare‐associated infections represent a public health problem, and they have repercussions for patient safety. The aim of this study was to determine the psychometric properties of the Rodríguez–Almeida–Cañon (RAC) adult infection risk scale, focusing on the construct and predictive validity and reliability. The study enrolled 278 patients at a large hospital in southern Brazil. The research process involved the following three phases: construct validation, assessing predictive validity, and assessing reliability. Confirmatory factor analysis showed a good fit using a two‐factor model with 15 items. The logistic regression analysis showed an association between the scale score and prediction of developing healthcare‐associated infections (odds ratio: 1.18; 95% confidence interval: 1.08–1.28). The Cronbach's alpha was 0.72 for intrinsic factors subscale and 0.71 for extrinsic factors subscale. A high level of inter‐rater agreement (intraclass correlation coefficient ≥0.97) was found for both subscales. The Bland and Altman method showed narrow agreement limits, demonstrating good agreement between evaluators. The findings of this study showed that the RAC adult infection risk scale is a new, reliable, and psychometrically valid instrument to assess healthcare‐associated infections risk. Future research using this scale may lead to a better understanding of the healthcare‐associated infections risk and assist health professionals in decision‐making for interventions to improve patient safety.
FDA Approval Summary: Nivolumab Plus Ipilimumab for the Treatment of Patients with Hepatocellular Carcinoma Previously Treated with Sorafenib
Authors: Saung May Tun , Pelosof Lorraine , Casak Sandra , Donoghue Martha , Lemery Steven , Yuan Mengdie , Rodriguez Lisa , Schotland Peter , Chuk Meredith , Davis Gina , Goldberg Kirsten B. , Theoret Marc R. , Pazdur Richard , Fashoyin-Aje Lola 
Published: May 2021

Abstract

On March 10, 2020, the U.S. Food and Drug Administration (FDA) granted accelerated approval to nivolumab in combination with ipilimumab for the treatment of patients with hepatocellular carcinoma (HCC) previously treated with sorafenib. The recommended approved dosage was nivolumab 1 mg/kg i.v. plus ipilimumab 3 mg/kg i.v. every 3 weeks for four cycles, followed by nivolumab 240 mg i.v. every 2 weeks. The approval was based on data from cohort 4 of CheckMate 040, which randomized patients with advanced unresectable or metastatic HCC previously treated with or who were intolerant to sorafenib to receive one of three different dosing regimens of nivolumab in combination with ipilimumab. Investigator-assessed overall response rate (ORR) was the primary endpoint, and ORR assessed by blinded independent central review (BICR) was an exploratory endpoint. BICR-assessed ORR and duration of response (DoR) form the primary basis of the FDA's regulatory decision, and BICR-assessed ORR was comparable in all three arms at 31%–32% with 95% confidence interval [CI] 18%–47%. The DoR ranged from 17.5 to 22.2 months across the three arms, with overlapping 95% CIs. Adverse events (AEs) were generally consistent with the known AE profiles of nivolumab and ipilimumab, and no new safety events were identified. This article summarizes the FDA review of the data supporting the approval of nivolumab and ipilimumab for the treatment of HCC.

Implications for Practice
Nivolumab and ipilimumab combination therapy is another option for patients with advanced hepatocellular carcinoma who experience radiographic progression during or after sorafenib or sorafenib intolerance. No new toxicities were identified, but, as expected, increased toxicity was observed with the addition of ipilimumab to nivolumab as compared with nivolumab alone, which is also approved for the same indication. Whether to administer nivolumab as a single agent or in combination with ipilimumab is expected to be a joint decision between the oncologist and patient, taking into consideration the potential for a higher likelihood of response and the potentially higher rate of toxicity with the combination.
Effect of coir fiber and inorganic filler on physical and mechanical properties of epoxy based hybrid composites
Authors: H. M. Kavya , Bavan Saravana , B. Yogesha , M. R. Sanjay , Siengchin Suchart , Gorbatyuk Sergey 
Published: May 2021

AbstractThe present work's target is to study the impact of fly ash or TiC nanoparticles or both on the characteristics of coir fiber epoxy hybrid composites. Mechanical characteristics like tensile, flexural, inter‐laminar shear strength, impact strength, shore D hardness, and thermal stability or degradation characteristics were determined. The microstructure of the samples was observed from a scanning electron microscopy. It was observed that the addition of coir fiber, fly ash, and TiC nanoparticles in the epoxy polymer enhanced the mechanical and thermal characteristics of composites. It can be assigned to the better interaction and uniform distribution between the fillers and the epoxy polymer. Fillers acted a critical role in enhancing the characteristics of epoxy hybrid composites. Additionally, water absorption characteristics were also investigated for all specimens. A comparative examination was performed between various fabricated composite specimens. Results exhibited that, the water absorption of the composites improves considerably with the addition of reinforcements. Also, thermogravimetric analysis exhibited that the fabricated epoxy hybrid composites were stable thermally.
Self‐reported sensitivity to pain in early and moderately‐late preterm‐born adolescents: A community‐based cohort study
Authors: van Dokkum Nienke H. , de Kroon Marlou L. A. , Reijneveld Sijmen A. , Bos Arend F. 
Published: May 2021

AbstractWe aimed to compare ratings of self‐reported and parent‐reported pain sensitivity between early preterm (EP), moderately‐late preterm (MLP), and full‐term (FT) adolescents. For EP adolescents, we aimed to determine whether pain sensitivity was associated with early‐life events. EP (n = 68, response rate 47.4%), MLP (n = 128, response rate 33.0%), and FT (n = 78, response rate 31.1%) adolescents and their parents (n = 277) answered an author‐generated question on pain sensitivity at 14‐15 years of age within a community‐based cohort study. Differences between groups were determined using the chi‐square test for trends. For EP adolescents, we assessed associations of treatment modalities (inotrope treatment, mechanical ventilation, and C‐section) and neonatal morbidities (sepsis/necrotizing enterocolitis, small‐for‐gestational age status, asphyxia, and cerebral pathologies) with adolescent pain sensitivity using logistic regression analyses. Increased pain sensitivity was reported by 18% of EP adolescents, compared with 12% of MLP adolescents, and 7% of FT adolescents (P = 0.033). Parent‐reported pain sensitivity did not differ by gestational age group. For EP adolescents, inotrope treatment was associated with increased pain sensitivity (odds ratio, 5.00, 95% confidence interval, 1.23‐20.4, P = 0.025). No other neonatal treatment modalities or morbidities were associated with pain sensitivity in adolescence. In conclusion, we observed higher proportions of increased pain sensitivity for EP and MLP adolescents. Physicians treating preterm adolescents should be aware of altered pain sensitivity.