bluuebunny/crossref_metadata_2025_split huggingface dataset:
A prospective study of the adaptive changes in the gut microbiome during standard-of-care chemoradiotherapy for gynecologic cancers
Authors: El Alam Molly B. , Sims Travis T. , Kouzy Ramez , Biegert Greyson W. G. , Jaoude Joseph A. B. I. , Karpinets Tatiana V. , Yoshida-Court Kyoko , Wu Xiaogang , Delgado-Medrano Andrea Y. , Mezzari Melissa P. , Ajami Nadim J. , Solley Travis , Ahmed-Kaddar Mustapha , Lin Lilie L. , Ramondetta Lois , Jazaeri Amir , Jhingran Anuja , Eifel Patricia J. , Schmeler Kathleen M. , Wargo Jennifer , Klopp Ann H. , Colbert Lauren E. 
Published: March 2021

Background
A diverse and abundant gut microbiome can improve cancer patients’ treatment response; however, the effect of pelvic chemoradiotherapy (CRT) on gut diversity and composition is unclear. The purpose of this prospective study was to identify changes in the diversity and composition of the gut microbiome during and after pelvic CRT.

Materials and methods
Rectal swabs from 58 women with cervical, vaginal, or vulvar cancer from two institutions were prospectively analyzed before CRT (baseline), during CRT (weeks 1, 3, and 5), and at first follow-up (week 12) using 16Sv4 rRNA gene sequencing of the V4 hypervariable region of the bacterial 16S rRNA marker gene. 42 of these patients received antibiotics during the study period. Observed operational taxonomic units (OTUs; representative of richness) and Shannon, Simpson, Inverse Simpson, and Fisher diversity indices were used to characterize alpha (within-sample) diversity. Changes over time were assessed using a paired t-test, repeated measures ANOVA, and linear mixed modeling. Compositional changes in specific bacteria over time were evaluated using linear discriminant analysis effect size.

Results
Gut microbiome richness and diversity levels continually decreased throughout CRT (mean Shannon diversity index, 2.52 vs. 2.91; all P <0.01), but were at or near baseline levels in 60% of patients by week 12. Patients with higher gut diversity at baseline had the steepest decline in gut microbiome diversity. Gut microbiome composition was significantly altered during CRT, with increases in Proteobacteria and decreases in Clostridiales, but adapted after CRT, with increases in Bacteroides species.

Conclusion
After CRT, the diversity of the gut microbiomes in this population tended to return to baseline levels by the 12 week follow-up period, but structure and composition remained significantly altered. These changes should be considered when designing studies to analyze the gut microbiome in patients who receive pelvic CRT for gynecologic cancers.
Data-driven CAD-CAM vs traditional total contact custom insoles: A novel quantitative-statistical framework for the evaluation of insoles offloading performance in diabetic foot
Authors: D’Amico Moreno , Kinel Edyta , Roncoletta Piero , Gnaldi Andrea , Ceppitelli Celeste , Belli Federico , Murdolo Giuseppe , Vermigli Cristiana 
Published: March 2021

BackgroundElevated plantar pressures represent a significant risk factor for neuropathic diabetic foot (NDF) ulceration. Foot offloading, through custom-made insoles, is essential for prevention and healing of NDF ulcerations. Objective quantitative evaluation to design custom-made insoles is not a standard method. Aims: 1) to develop a novel quantitative-statistical framework (QSF) for the evaluation and design of the insoles’ offloading performance through in-shoe pressure measurement; 2) to compare the pressure-relieving efficiency of traditional shape-based total contact customised insoles (TCCI) with a novel CAD-CAM approach by the QSF.MethodsWe recruited 30 neuropathic diabetic patients in cross-sectional study design. The risk-regions of interest (R-ROIs) and their areas with in-shoe peak pressure statistically ≥200kPa were identified for each patients’ foot as determined on the average of peak pressure maps ascertained per each stance phase. Repeated measures Friedman test compared R-ROIs’ areas in three different walking condition: flat insole (FI); TCCI and CAD-CAM insoles.ResultsAs compared with FI (20.6±12.9 cm2), both the TCCI (7±8.7 cm2) and the CAD-CAM (5.5±7.3 cm2) approaches provided a reduction of R-ROIs mean areas (p<0.0001). The CAD-CAM approach performed better than the TCCI with a mean pressure reduction of 37.3 kPa (15.6%) vs FI.ConclusionsThe CAD-CAM strategy achieves better offloading performance than the traditional shape-only based approach. The introduced QSF provides a more rigorous method to the direct 200kPa cut-off approach outlined in the literature. It provides a statistically sound methodology to evaluate the offloading insoles design and subsequent monitoring steps. QSF allows the analysis of the whole foot’s plantar surface, independently from a predetermined anatomical identification/masking. QSF can provide a detailed description about how and where custom-made insole redistributes the underfoot pressure respect to the FI. Thus, its usefulness extends to the design step, helping to guide the modifications necessary to achieve optimal offloading insole performances.
Effect of Yttrium-90 transarterial radioembolization in patients with non-surgical hepatocellular carcinoma: A systematic review and meta-analysis
Authors: Lemieux Simon , Buies Alex , F. Turgeon Alexis , Hallet Julie , Daigle Gaétan , Côté François , Provencher Steeve 
Published: March 2021

Background
Recently, the use of Yttrium-90 transarterial radioembolization in non-surgical hepatocellular carcinoma was suggested but the evidence supporting its use is unclear.

Methods
We searched Medline, Embase, Web of Science and Cochrane CENTRAL from inception up to April 14, 2020 for randomized controlled trials comparing Y90-TARE to standard of care in non-surgical HCC patients. Our primary outcome was overall survival (OS). Our secondary outcomes were progression-free survival, time to progression, disease control rate, grade ≥3 adverse events and rates of gastro-intestinal ulcers. Hazard ratios (HR) and risk ratios (RR) with random-effects model were used for our analyses. The risk of bias of the included studies was assessed using Cochrane’s RoB 2 tool.

Results
Of 1,604 citations identified, eight studies (1,439 patients) were included in our analysis. No improvement in overall survival were noted when Yttrium-90 transarterial radioembolization was compared to standard treatments (HR 0.99 [95% CI 0.81–1.21], 6 studies, I2 = 77.6%). However, Yttrium-90 transarterial radioembolization was associated with fewer grade ≥3 adverse events (RR 0.64 [95% CI 0.45–0.92], 7 studies, I2 = 66%). No difference was observed on other secondary outcomes.

Discussion
In non-surgical HCC patients, Yttrium-90 transarterial radioembolization was not associated with significant effect on survival, progression-free survival, time to progression, disease control rate and the incidence of gastro-intestinal ulcers but was however associated with significantly lower rates of grade ≥3 adverse events. Further randomized controlled trials are warranted to better delineate optimal treatment.
Gender differences in unpaid care work and psychological distress in the UK Covid-19 lockdown
Authors: Xue Baowen , McMunn Anne 
Published: March 2021

Objective
To describe how men and women divided childcare and housework demands during the height of the first Covid-19 lockdown in the UK, and whether these divisions were associated with worsening mental health during the pandemic.

Background
School closures and homeworking during the Covid-19 crisis have resulted in an immediate increase in unpaid care work, which draws new attention to gender inequality in divisions of unpaid care work.

Methods
Data come from the wave 9 (2017–19) of Understanding Society and the following April (n = 15,426) and May (n = 14,150) waves of Understanding Society Covid-19 study. Psychological distress was measured using the General Health Questionnaire (GHQ) at both before and during the lockdown, and unpaid care work was measured during the lockdown. Linear regression models were used.

Results
Women spent much more time on unpaid care work than men during lockdown, and it was more likely to be the mother than the father who reduced working hours or changed employment schedules due to increased time on childcare. Women who spent long hours on housework and childcare were more likely to report increased levels of psychological distress. Working parents who adapted their work patterns increased more psychological distress than those who did not. This association was much stronger if he or she was the only member in the household who adapted their work patterns, or if she was a lone mother. Fathers increased more psychological distress if they reduced work hours but she did not, compared to neither reducing work hours.

Conclusion
There are continued gender inequalities in divisions of unpaid care work. Juggling home working with homeschooling and childcare as well as extra housework is likely to lead to poor mental health for people with families, particularly for lone mothers.
Diffusion-weighted magnetic resonance imaging for the assessment of liver fibrosis in chronic viral hepatitis
Authors: Charatcharoenwitthaya Phunchai , Sukonrut Kamonthip , Korpraphong Pornpim , Pongpaibul Ananya , Saiviroonporn Pairash 
Published: March 2021

Background
Accurate noninvasive methods for the assessment of liver fibrosis are urgently needed. This prospective study evaluated the diagnostic accuracy of diffusion-weighted magnetic resonance imaging (DWI) for the staging of liver fibrosis and proposed a diagnostic algorithm using DWI to identify cirrhosis in patients with chronic viral hepatitis.

Methods
One hundred twenty-one treatment-naïve patients with chronic hepatitis B or C were evaluated with DWI followed by liver biopsy on the same day. Breath-hold single-shot echo-planar DWI was performed to measure the apparent diffusion coefficient (ADC) of the liver and spleen. Normalized liver ADC was calculated as the ratio of liver ADC to spleen ADC.

Results
There was an inverse correlation between fibrosis stage and normalized liver ADC (p<0.05). For the prediction of fibrosis stage ≥2, stage ≥3, and cirrhosis, the area under the receiver-operating curve of normalized liver ADC was 0.603, 0.704, and 0.847, respectively. The normalized liver ADC value ≤1.02×10−3 mm2/s had 88% sensitivity, 81% specificity, 25% positive predictive value (PPV), and 99% negative predictive value (NPV) for the diagnosis of cirrhosis. Using a sequential approach with the Fibrosis-4 index followed by DWI, normalized liver ADC ≤1.02×10−3 mm2/s in patients with Fibrosis-4 >3.25 yielded an 80% PPV for cirrhosis, and a 100% NPV to exclude cirrhosis in patients with Fibrosis-4 between 1.45 and 3.25. Only 15.7% of patients would require a liver biopsy. This sequential strategy can reduce DWI examinations by 53.7%.

Conclusion
Normalized liver ADC measurement on DWI is an accurate and noninvasive tool for the diagnosis of cirrhosis in patients with chronic viral hepatitis.
Oral health care professionals recommending and administering the HPV vaccine: Understanding the strengths and assessing the barriers
Authors: Guadiana Denise , Kavanagh Nolan M. , Squarize Cristiane H. 
Published: March 2021

Introduction
Head and neck cancer is a deadly cancer that ranks among the six most common cancers worldwide. The HPV vaccine has been used to prevent head and neck cancer of the oropharynx, and changes in health policies and state law are impacting the role of dental professionals in HPV vaccination. However, relatively little is known about dental professionals’ attitudes regarding the vaccine.

Objectives
Our study assesses dental professionals’ willingness to administer the HPV vaccine, their confidence discussing HPV with patients, beliefs about the vaccine’s efficacy, perceived barriers to administering it, and sites of referral.

Methods
We surveyed 623 dental professionals, including dentists, hygienists, dental students, and hygiene students across Michigan. Attitudes toward the vaccine and predictive characteristics were evaluated by logistic regression, ANOVAs, and t-tests.

Results
The majority of the respondents (51% of dentists, 63% of hygienists, 82% of dental students, and 71% of hygiene students) were willing to administer the HPV vaccine if allowed by law. The role of dental and dental hygiene students would be one of advocacy, educating and recommending the vaccine, and the dental students administering it once licensed. Dental professionals were variably confident discussing HPV with patients and generally believed it enhanced patients’ health. Stronger confidence and beliefs were associated with greater willingness to administer the vaccine. Barriers among professionals opposing the HPV vaccine included lack of knowledge on the subject, liability concerns, and personal beliefs.

Conclusion
Dental professionals can become leaders in preventing HPV-related cancers. Training and continuing education courses could enhance their confidence and willingness to recommend and administer the HPV vaccine.

Policy implications
Legislation that permits dental professionals to administer the vaccine could increase the vaccine’s accessibility to patients, improve vaccination rates, and population health.
Antiviral Therapy Reduces Risk of Cirrhosis in Noncirrhotic HBV Patients Among 4 Urban Safety-Net Health Systems
Authors: Wong Robert J. , Jain Mamta K. , Therapondos George , Niu Bolin , Kshirsagar Onkar , Thamer Mae 
Published: March 2021

INTRODUCTION:
To evaluate the impact of chronic hepatitis B virus infection (CHB) treatment on risk of cirrhosis, liver-related outcomes, and death among a diverse CHB cohort with a large proportion of African Americans.

METHODS:
Adults with noncirrhotic CHB without human immunodeficiency virus from 2010 to 2018 were retrospectively evaluated across 4 US safety-net health systems. CHB was identified with International Classification of Diseases, Ninth Revision/Tenth Revision diagnosis coding and confirmatory laboratory data. Propensity-score matching, Kaplan-Meier methods, and adjusted Cox proportional hazards models were used to evaluate impact of CHB treatment on risk of cirrhosis, hepatocellular carcinoma (HCC), death, and composite of cirrhosis, HCC, or death.

RESULTS:
Among 4,064 CHB patients (51.9% female, 42.0% age <45 years, 31.6% African American, 26.6% Asian, 26.7% Hispanic), 23.2% received CHB antiviral therapy and 76.8% did not. Among the propensity score–matched cohort (428 treated and 428 untreated), CHB treatment was associated with lower risk of cirrhosis (hazards ratio 0.65, 95% confidence interval 0.46–0.92, P = 0.015) and composite of cirrhosis, HCC, or death (hazards ratio 0.67, 95% confidence interval 0.49–0.94, P = 0.023). Females vs males and African Americans vs non-Hispanic whites had significantly lower risk of cirrhosis. When treatment effects were stratified by age, sex, and ethnicity, the benefits of antiviral therapies in reducing risk of cirrhosis were seen primarily in CHB patients who were females, age <45 years, and of Asian ethnicity.

DISCUSSION:
Our propensity score–matched cohort of noncirrhotic CHB patients demonstrated significant reductions in risk of cirrhosis due to CHB treatment.
The Three Villages of Hepatic Encephalopathy
Authors: Bajaj Jasmohan S. 
Published: March 2021

Abstract
Hepatic encephalopathy (HE) affects numerous stakeholders from a clinical, psychosocial, and financial perspective. The multilayered impact of HE is threefold and affects different groups or, for the purpose of this commentary, villages. The first village mediates HE development, including genetics, microbiome, and disease severity. The second village consists of those affected by HE-related consequences, including the patient, caregivers, society, and medical system. The third village required to manage HE includes a multidisciplinary team of inpatient and outpatient providers, mental health experts, physical therapists, and dietary specialists. Understanding and integration of these three villages can encourage individualized care for patients and families affected by hepatic encephalopathy.
Craft and Artisan Initiatives of the Salvadoran Civil War (1980–1992)
Authors: Velis Emilio , Samson Kate , Robles Isaac , Rodríguez Daniel 
Published: March 2021

Abstract
This article describes the testimonies of two arts and crafts collectives during the Salvadoran Civil War in the 1980s. These collectives, open to victims and refugees of the war, emerged as creative spaces during a time of significant social unrest. As participants learned to make and produce arts and crafts, these activities encouraged individual expression and allowed them to heal traumatic experiences. By describing the aspects that motivated and discouraged the involvement of participants over time, we show how the individual and collective aspects of making are important for the sustained participation of the people who engage in maker culture. We draw comparisons between the struggles of these historical movements and of current embodiments of the maker culture, in order to draw conclusions regarding how making can be a personal catalyst in the face of social hardship, the importance of economic sustainability in maker initiatives and how unjust gender dynamics take place in these spaces. The ability to compare and learn from these historical initiatives serves to unpack maker culture as a social asset that can be described beyond the mere use of digital tools and to repurpose it as a more inclusive concept that takes into account narratives from a broader range of expressions of making.
From Hacking to Making
Authors: Cuartielles Ruiz David , García Sáez César 
Published: March 2021

Abstract
This article explores the history of contemporary Spanish Do-It- Yourself (DIY) spaces (hacklabs, hackerspaces, fab labs, makerspaces and after-school academies) and the growth of each type since the 1990s. The development of these types of spaces is reflected against the commodification and commoditisation of DIY in Spain. The article argues that the removal of the political layer of the early Spanish DIY techno-tactical movements allowed a higher degree of dissemination within society in general, while reducing the emancipatory potential of these new spaces. However, the analysis of the degree of commodification and commoditisation of types of spaces in relation to the amount of spaces per type shows an anomaly for makerspaces. The authors reflect upon this anomaly and whether a data set enlargement could correct it. For their analysis, the authors constructed a data set of events of the Spanish DIY history through the design of an ad hoc mixed method. Tracing events and spaces could not be done in a simple way due to the long time span of the study: older spaces existed in the pre-social network days, and new ones exist only in dedicated platforms for niche communities of practice. This method of tracing events and spaces is another contribution of the article as it could be used to make similar causality analyses of historical data in other case studies.
Actualización y manejo clínico de los anticuerpos anti-ácido desoxirribonucleico
Authors: González Rodríguez Concepción , Aparicio Hernández M. Belén , Alarcón Torres Inmaculada 
Published: March 2021

Resumen
Los anticuerpos contra el ácido desoxirribonucleico [DNA] en el laboratorio clínico, están íntimamente ligados al diagnóstico y monitorización del lupus eritematoso sistémico [LES]; no obstante, las características de los métodos analíticos y las propiedades de los propios anticuerpos son heterogéneas Revisar la definición y propiedades de los anticuerpos anti-DNA de doble cadena [anti-dsDNA], la adecuación de los métodos analíticos y los requerimientos clínicos para este biomarcador. A través de PubMed se investiga la bibliografía existente con los términos anti-dsDNA, editorial, review, guideline, meta-analysis y LES. La última búsqueda, anti-dsDNA y LES restringuida a los últimos dos años. Se amplía información a través de artículos relacionados y los publicados en organismos oficiales estatales relacionados con anti-dsDNA y LES. Se analizan los métodos del laboratorio clínico para el análisis de los anti-dsDNA y sus características. Se revisa la utilidad clínica de los anti-dsDNA en sus aspectos diagnóstico, de asociación clínica y seguimiento del LES. Existe una amplia variabilidad en los métodos analíticos y persisten déficits en la estandarización. Forman parte de los criterios actuales clasificatorios de LES y se utilizan como marcadores en el seguimiento de la enfermedad. La utilidad diagnóstica mejora cuando se determinan en pacientes con ANA positivos. En el seguimiento, es interesante la cuantificación, preferiblemente con el mismo método analítico (dado los déficits de estandarización).
Prozesskomposition in verteilten Automatisierungssystemen
Authors: Schweizer Hartmut , Braunisch Nico , Alt Raphael , Schmitz Katharina , Wollschlaeger Martin 
Published: March 2021

Zusammenfassung
Die aktuellen Entwicklungen in der Automation führen zu einer zunehmenden Dezentralisierung der Steuerung und Organisation der eingesetzten Maschinen bzw. Komponenten. Dies betrifft auch die an der Fertigung beteiligten Prozesse und stellt neue Ansprüche an deren Ablauforganisation in einer flexibel zusammengeschalteten Komponenten-Struktur. Der vorliegende Beitrag stellt hierzu einen Ansatz auf Basis der IEC-62264-Implementierung B2MML vor. Mittels Verwaltungsschalen wurde basierend auf diesem Ansatz innerhalb des Projektes „Funktionsnachweis der Interoperabilität von fluidtechnischen Komponenten am Beispiel von Plug-and-Produce“ die automatisierte Inbetriebnahme eines pneumatischen Handling-Systems realisiert.
Expressing uncertainty in neural networks for production systems
Authors: Multaheb Samim Ahmad , Zimmering Bernd , Niggemann Oliver 
Published: March 2021

Abstract
The application of machine learning, especially of trained neural networks, requires a high level of trust in their results. A key to this trust is the network’s ability to assess the uncertainty of the computed results. This is a prerequisite for the use of such networks in closed-control loops and in automation systems. This paper describes approaches for enabling neural networks to automatically learn the uncertainties of their results.
Using machine learning to identify clotted specimens in coagulation testing
Authors: Fang Kui , Dong Zheqing , Chen Xiling , Zhu Ji , Zhang Bing , You Jinbiao , Xiao Yingjun , Xia Wenjin 
Published: March 2021

Abstract

Objectives
A sample with a blood clot may produce an inaccurate outcome in coagulation testing, which may mislead clinicians into making improper clinical decisions. Currently, there is no efficient method to automatically detect clots. This study demonstrates the feasibility of utilizing machine learning (ML) to identify clotted specimens.

Methods
The results of coagulation testing with 192 clotted samples and 2,889 no-clot-detected (NCD) samples were retrospectively retrieved from a laboratory information system to form the training dataset and testing dataset. Standard and momentum backpropagation neural networks (BPNNs) were trained and validated using the training dataset with a five-fold cross-validation method. The predictive performances of the models were then assessed based on the testing dataset.

Results
Our results demonstrated that there were intrinsic distinctions between the clotted and NCD specimens regarding differences in the testing results and the separation of the groups (clotted and NCD) in the t-SNE analysis. The standard and momentum BPNNs could identify the sample status (clotted and NCD) with areas under the ROC curves of 0.966 (95% CI, 0.958–0.974) and 0.971 (95% CI, 0.9641–0.9784), respectively.

Conclusions
Here, we have described the application of ML algorithms in identifying the sample status based on the results of coagulation testing. This approach provides a proof-of-concept application of ML algorithms to evaluate the sample quality, and it has the potential to facilitate clinical laboratory automation.