bluuebunny/crossref_metadata_2025_split huggingface dataset:
CCEDRRN COVID-19 Infection Score (CCIS): development and validation in a Canadian cohort of a clinical risk score to predict SARS-CoV-2 infection in patients presenting to the emergency department with suspected COVID-19
Authors: McRae Andrew D , Hohl Corinne M , Rosychuk Rhonda , Vatanpour Shabnam , Ghaderi Gelareh , Archambault Patrick M , Brooks Steven C , Cheng Ivy , Davis Philip , Hayward Jake , Lang Eddy , Ohle Robert , Rowe Brian , Welsford Michelle , Yadav Krishan , Morrison Laurie J , Perry Jeffrey 
Published: December 2021

ObjectivesTo develop and validate a clinical risk score that can accurately quantify the probability of SARS-CoV-2 infection in patients presenting to an emergency department without the need for laboratory testing.DesignCohort study of participants in the Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN) registry. Regression models were fitted to predict a positive SARS-CoV-2 test result using clinical and demographic predictors, as well as an indicator of local SARS-CoV-2 incidence.Setting32 emergency departments in eight Canadian provinces.Participants27 665 consecutively enrolled patients who were tested for SARS-CoV-2 in participating emergency departments between 1 March and 30 October 2020.Main outcome measuresPositive SARS-CoV-2 nucleic acid test result within 14 days of an index emergency department encounter for suspected COVID-19 disease.ResultsWe derived a 10-item CCEDRRN COVID-19 Infection Score using data from 21 743 patients. This score included variables from history and physical examination and an indicator of local disease incidence. The score had a c-statistic of 0.838 with excellent calibration. We externally validated the rule in 5295 patients. The score maintained excellent discrimination and calibration and had superior performance compared with another previously published risk score. Score cut-offs were identified that can rule-in or rule-out SARS-CoV-2 infection without the need for nucleic acid testing with 97.4% sensitivity (95% CI 96.4 to 98.3) and 95.9% specificity (95% CI 95.5 to 96.0).ConclusionsThe CCEDRRN COVID-19 Infection Score uses clinical characteristics and publicly available indicators of disease incidence to quantify a patient’s probability of SARS-CoV-2 infection. The score can identify patients at sufficiently high risk of SARS-CoV-2 infection to warrant isolation and empirical therapy prior to test confirmation while also identifying patients at sufficiently low risk of infection that they may not need testing.Trial registration numberNCT04702945.
Protocol for a prospective double-blind, randomised, placebo-controlled feasibility trial of octreotide infusion during liver transplantation
Authors: Fabes Jeremy , Ambler Gareth , Shah Bina , Williams Norman R , Martin Daniel , Davidson Brian R , Spiro Michael 
Published: December 2021

IntroductionLiver transplantation is a complex operation that can provide significant improvements in quality of life and survival to the recipients. However, serious complications are common and include major haemorrhage, hypotension and renal failure. Blood transfusion and the development of acute kidney injury lead to both short-term and long-term poor patient outcomes, including an increased risk of death, graft failure, length of stay and reduced quality of life. Octreotide may reduce the incidence of renal dysfunction, perioperative haemorrhage and enhance intraoperative blood pressure. However, octreotide does have risks, including resistant bradycardia, hyperglycaemia and hypoglycaemia and QT prolongation. Hence, a randomised controlled trial of octreotide during liver transplantation is needed to determine the cost-efficacy and safety of its use; this study represents a feasibility study prior to this trial.Methods and analysisWe describe a multicentre, double-blind, randomised, placebo-controlled feasibility study of continuous infusion of octreotide during liver transplantation surgery. We will recruit 30 adult patients at two liver transplant centres. A blinded infusion during surgery will be administered in a 2:1 ratio of octreotide:placebo. The primary outcomes will determine the feasibility of this study design. These include the recruitment ratio, correct administration of blinded study intervention, adverse event rates, patient and clinician enrolment refusal and completion of data collection. Secondary outcome measures of efficacy and safety will help shape future trials by assessing potential primary outcome measures and monitoring safety end points. No formal statistical tests are planned. This manuscript represents study protocol number 1.3, dated 2 June 2021.Ethics and disseminationThis study has received Research Ethics Committee approval. The main study outcomes will be submitted to an open-access journal.Trial sponsorThe Joint Research Office, University College London, UK.Neither the sponsor nor the funder have any role in study design, collection, management, analysis and interpretation of data, writing of the study report or the decision to submit the report for publication.Trial registrationThe study is registered with ClinicalTrials.gov (NCT04941911) with recruitment due to start in August 2021 with anticipated completion in July 2022.Clinical trials unitSurgical and Interventional Group, Division of Surgery & Interventional Science, University College London.
TELO-SCOPE study: a randomised, double-blind, placebo-controlled, phase 2 trial of danazol for short telomere related pulmonary fibrosis
Authors: Mackintosh John A , Pietsch Maria , Lutzky Viviana , Enever Debra , Bancroft Sandra , Apte Simon H , Tan Maxine , Yerkovich Stephanie T , Dickinson Joanne L , Pickett Hilda A , Selvadurai Hiran , Grainge Christopher , Goh Nicole S , Hopkins Peter , Glaspole Ian , Reynolds Paul N , Wrobel Jeremy , Jaffe Adam , Corte Tamera J , Chambers Daniel C 
Published: December 2021

IntroductionRecent discoveries have identified shortened telomeres and related mutations in people with pulmonary fibrosis (PF). There is evidence to suggest that androgens, including danazol, may be effective in lengthening telomeres in peripheral blood cells. This study aims to assess the safety and efficacy of danazol in adults and children with PF associated with telomere shortening.Methods and analysisA multi-centre, double-blind, placebo-controlled, randomised trial of danazol will be conducted in subjects aged >5 years with PF associated with age-adjusted telomere length ≤10th centile measured by flow fluorescence in situ hybridisation; or in children, a diagnosis of dyskeratosis congenita. Adult participants will receive danazol 800 mg daily in two divided doses or identical placebo capsules orally for 12 months, in addition to standard of care (including pirfenidone or nintedanib). Paediatric participants will receive danazol 2 mg/kg/day orally in two divided doses or identical placebo for 6 months. If no side effects are encountered, the dose will be escalated to 4 mg/kg/day (maximum 800 mg daily) orally in two divided doses for a further 6 months. The primary outcome is change in absolute telomere length in base pairs, measured using the telomere shortest length assay (TeSLA), at 12 months in the intention to treat population.Ethics and disseminationEthics approval has been granted in Australia by the Metro South Human Research Ethics Committee (HREC/2020/QMS/66385). The study will be conducted and reported according to Standard Protocol Items: Recommendations for Interventional Trials guidelines. Results will be published in peer-reviewed journals and presented at international and national conferences.Trial registration numbersNCT04638517; Australian New Zealand Clinical Trials Registry (ACTRN12620001363976p).
The W mass and width measurement challenge at FCC-ee
Authors: Azzurri Paolo 
Published: December 2021

AbstractThe FCC-ee physics program will deliver two complementary top-notch precision determinations of the W boson mass, and width. The first and main measurement relies on the rapid rise of the W-pair production cross section near its kinematic threshold. This method is extremely simple and clean, involving only the selection and counting of events, in all different decay channels. An optimal threshold-scan strategy with a total integrated luminosity of $$12\,\mathrm{ab}^{-1}$$

12

ab

-
1

shared on energy points between 157 and 163 GeV will provide a statistical uncertainty on the W mass of 0.5 MeV and on the W width of 1.2 MeV. For these measurements, the goal of keeping the impact of systematic uncertainties below the statistical precision will be demanding, but feasible. The second method exploits the W-pair final state reconstruction and kinematic fit, making use of events with either four jets or two jets, one lepton and missing energy. The projected statistical precision of the second method is similar to the first method’s, with uncertainties of $$\sim 0.5$$

∼
0.5

(1) MeV for the W mass (width), employing W-pair data collected at the production threshold and at 240–365 GeV. For the kinematic reconstruction method, the final impact of systematic uncertainties is currently less clear, in particular uncertainties connected to the modeling of the W hadronic decays. The use and interplay of Z$$\gamma $$
γ
and ZZ events, reconstructed and fitted with the same techniques as the WW events, will be important for the extraction of W mass measurements with data at the higher 240 and 365 GeV energies.
For Whom the Bell Tolls? A Toll-Like Receptor 9 Agonist's Journey from Vaccine Adjuvant to Promising Agent in Anti–PD-1–Resistant Melanoma
Authors: Sullivan Ryan J. 
Published: December 2021

Abstract

Summary:
Developing effective therapies in anti–PD-1–resistant melanoma is a key unmet need. The combination of pembrolizumab with the intralesional TLR9 agonist vidutolimod showed promise in this patient population with correlative analysis suggesting that patients with a “cold” tumor immune microenvironment may be the best patients to study further.
See related article by Ribas et al., p. 2998.
Attitude and Knowledge Relationship with Sexual Behavior at Risk of Sexually Transmitted Infection (STI) in Male Adolescents in Indonesia (IDHS Data Analysis 2017)
Authors: Asiah Nur , Yohana Sondi Agnes , Parlina Nining , Jovanka Della Raymena 
Published: December 2021

Introduction: Indonesia Population Demographic Survey in 2017 recorded that 8% of teenage boys and 2% of teenage girls admitted to having sexual intercourse. This certainly worries all of us who hope today's youth will be a demographic bonus. Sexual behavior is at risk of impacting the issue of Unwanted Pregnancy (KTD), abortion, Sexually Transmitted Infections (STIs), and the ongoing incidence of HIV and AIDS. Objective: to confirm the relationship of attitudes and knowledge with risky sexual behavior in adolescent boys in Indonesia. Methods: This type of research is quantitative analytics using a cross-sectional design and sourced from secondary data of the Indonesian Health Demographic Survey 2017. The population in this study was 13,079 adolescent men aged 15-24, sampling 10,710 with saturated sampling techniques. Bivariate data analysis using the chi-square test (0.05). Results: were obtained by adolescents with a positive attitude of 52.1%, knowledgeable 77.8%, and 13.1% risky sexual behavior. Test results showed there was an attitude relationship with risky sexual behavior with p-value = 0.000 and there was a knowledge relationship with risky sexual behavior with p-value = 0.000. Conclusions: This study are expected to be used as input for the creation of risky sexual behavior prevention programs in adolescents and form the basis for the creation of an educational model related to adolescent reproductive health for parents and educational institutions.
Midlife Cardiorespiratory Fitness and the Development of Peripheral Artery Disease in Later Life
Authors: Keshvani Neil , Willis Benjamin , Leonard David , Gao Ang , DeFina Laura , McDermott Mary M. , Berry Jarett D. , Kumbhani Dharam J. 
Published: December 2021

Background
Data are sparse on the prospective associations between physical activity and incidence of lower extremity peripheral artery disease (PAD).

Methods and Results

Linking participant data from the CCLS (Cooper Center Longitudinal Study) to Medicare claims files, we studied 19 023 participants with objectively measured midlife cardiorespiratory fitness through maximal effort on the Balke protocol who survived to receive Medicare coverage between 1999 and 2009. The study aimed to determine the association between midlife cardiorespiratory fitness and incident PAD with proportional hazards intensity models, adjusted for age, sex, body mass index, and other covariates, to PAD failure time data. During 121 288 person‐years of Medicare follow‐up, we observed 805 PAD‐related hospitalizations/procedures among 19 023 participants (21% women, median age 50 years). Lower midlife fitness was associated with a higher rate of incident PAD in patients aged 65 years and older (low fit [quintile 1]: 11.4, moderate fit [quintile 2 to 3]: 7.8, and high fit [quintile 4 to 5]: 5.7 per 1000 person years). After multivariable adjustment for common predictors of incident PAD such as age, body mass index, hypertension, and diabetes, these findings persisted. Lower risk for PAD per greater metabolic equivalent task of fitness was observed (hazard ratio [HR], 0.93 [95% CI, 0.90–0.97];
P
<0.001). Among a subset of patients with an additional fitness assessment, each 1 metabolic equivalent task increase from baseline fitness was associated with decreased risk of incident PAD (HR, 0.90 [95% CI, 0.82–0.99];
P
=0.03).

Conclusions
Cardiorespiratory fitness in healthy, middle‐aged adults is associated with lower risk of incident PAD in later life, independent of other predictors of incident PAD.
Real‐Time Arrhythmia Detection Using Hybrid Convolutional Neural Networks
Authors: Bollepalli Sandeep Chandra , Sevakula Rahul K. , Au‐Yeung Wan‐Tai M. , Kassab Mohamad B. , Merchant Faisal M. , Bazoukis George , Boyer Richard , Isselbacher Eric M. , Armoundas Antonis A. 
Published: December 2021

Background
Accurate detection of arrhythmic events in the intensive care units (ICU) is of paramount significance in providing timely care. However, traditional ICU monitors generate a high rate of false alarms causing alarm fatigue. In this work, we develop an algorithm to improve life threatening arrhythmia detection in the ICUs using a deep learning approach.

Methods and Results
This study involves a total of 953 independent life‐threatening arrhythmia alarms generated from the ICU bedside monitors of 410 patients. Specifically, we used the ECG (4 channels), arterial blood pressure, and photoplethysmograph signals to accurately detect the onset and offset of various arrhythmias, without prior knowledge of the alarm type. We used a hybrid convolutional neural network based classifier that fuses traditional handcrafted features with features automatically learned using convolutional neural networks. Further, the proposed architecture remains flexible to be adapted to various arrhythmic conditions as well as multiple physiological signals. Our hybrid‐ convolutional neural network approach achieved superior performance compared with methods which only used convolutional neural network. We evaluated our algorithm using 5‐fold cross‐validation for 5 times and obtained an accuracy of 87.5%±0.5%, and a score of 81%±0.9%. Independent evaluation of our algorithm on the publicly available PhysioNet 2015 Challenge database resulted in overall classification accuracy and score of 93.9% and 84.3%, respectively, indicating its efficacy and generalizability.

Conclusions
Our method accurately detects multiple arrhythmic conditions. Suitable translation of our algorithm may significantly improve the quality of care in ICUs by reducing the burden of false alarms.
Bilateral Transcutaneous Electrical Nerve Stimulation Improves Upper Limb Motor Recovery in Stroke: A Randomized Controlled Trial
Authors: Chen Peiming , Liu Tai-Wa , Kwong Patrick W.H. , Lai Claudia K.Y. , Chung Raymond C.K. , Tsoh Joshua , Ng Shamay S.M. 
Published: December 2021

Background:
Recent evidence has shown bilateral transcutaneous electrical nerve stimulation (Bi-TENS) combined with task-oriented training (TOT) to be superior to unilateral transcutaneous electrical nerve stimulation (Uni-TENS)+TOT in improving lower limb motor functioning following stroke. However, no research explored the effect of Bi-TENS+TOT in improving upper limb motor recovery. This study aimed to compare Bi-TENS+TOT with Uni-TENS+TOT, Placebo transcutaneous electrical nerve stimulation (Placebo-TENS)+TOT, and no treatment (Control) groups in upper limb motor recovery.

Methods:
This is a 4-group parallel design. One hundred and twenty subjects were given either Bi-TENS+TOT, Uni-TENS+TOT, Placebo-TENS+TOT, or Control without treatment in this randomized controlled trial. Twenty 60-minute sessions were administered 3× per week for 7 weeks. The outcome measure was the Fugl-Meyer Assessment of Upper Extremity, which was assessed at baseline, after 10 sessions (mid-intervention) and 20 sessions (post-intervention) of intervention, and at 1- and 3-month follow-up.

Results:

Patients in the Bi-TENS+TOT group showed greater improvement in the Fugl-Meyer Assessment of Upper Extremity scores than Uni-TENS+TOT (mean difference, 2.13;
P
=0.004), Placebo-TENS+TOT (mean difference, 2.63;
P
<0.001), and Control groups (mean difference, 3.11;
P
<0.001) at post-intervention. Both Bi-TENS+TOT (mean difference, 3.39;
P
<0.001) and Uni-TENS+TOT (mean difference, 1.26;
P
=0.018) showed significant within-group improvement in the Fugl-Meyer Assessment of Upper Extremity scores. Patients in the Bi-TENS+TOT group showed earlier within-group improvement in the Fugl-Meyer Assessment of Upper Extremity scores at mid-intervention than Uni-TENS+TOT. These improvements were maintained at the 3-month follow-up assessment.

Conclusions:
Bi-TENS combined with TOT is an effective therapy for improving upper limb motor recovery following stroke.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03112473.
Deepening a Sense of Being Taiwanese
Authors: Yeh Shu-ling , Chang Ying-Cheng 
Published: December 2021

Abstract
This paper examines how the Amis, the largest indigenous community in Taiwan, draw on their Catholic faith to understand what it means to be Taiwanese. For over a century, the Amis were treated as marginalised citizens by the Japanese colonial government and the Han-Chinese Kuomintang under Chiang Kai-shek and Chiang Ching-kuo. Their predicament changed when political priorities shifted from cultural assimilation to multiculturalism after 1987. Successive Taiwanese governments since then have actively sought to incorporate indigenous culture as a core part of Taiwanese identity. Focusing on how the Amis intertwined their adopted Catholic notions and practices with pre-Christian ideas, social structure, and rituals, this paper demonstrates the ways in which the Amis carve out a place for themselves in wider Taiwanese society. It adds to ongoing discussions about the relationship between conversion and cultural transformation in Oceania by arguing that Catholicism empowered the Amis to deepen their sense of belonging to the island republic and, for the first time, assert themselves fully as Taiwanese.
Archaeology of Early Chinese Settlement in Southeast Asia
Authors: Miksic John 
Published: December 2021

Abstract
Little historical information is available about early Chinese settlement in Southeast Asia. By the 15th century several Chinese settlements of significant size had formed, but they vanished by the time the Portuguese reached the region. This article surveys the historical literature on these early overseas Chinese settlements, and summarizes the contributions which archaeology can make to clarifying the timing and nature of the process.
Association between lesion enhancement and breast cancer in contrast-enhanced spectral mammography
Authors: Boy Fatma Nur Soylu , Goksu Kamber , Tasdelen Iksan 
Published: December 2021

Background Contrast-enhanced spectral mammography (CESM) may help to determine the malignancy potential of lesions according to the degree of enhancement. Purpose To investigate the correlation between the degree of contrast enhancement of the lesions in contrast-enhanced spectral mammography (CESM) and the final histopathological diagnosis in patients with BI-RADS 4 and 5 lesions. Material and Methods CESM was performed in 128 patients who had BI-RADS 4 and 5 lesions on mammography and underwent histopathological examination. A total of 128 index lesions were scored using a 4-point scale regarding the degree of contrast enhancement (0 = no contrast enhancement, 1 = minimal, 2 = moderate, 3 = marked), a score of 2 and 3 was accepted as suggestive of malignancy. The study was approved in our institutional scientific committee. Results In total, 76 (59.4%) of the lesions had benign histopathological results, whereas 52 of them had malignant results. Contrast enhancement was not observed in 22.7% of the lesions while 24.2% had minimal enhancement, 18.8% had moderate enhancement, and 34.4% had marked enhancement in CESM. The sensitivity of the degree of contrast enhancement in CESM was 98.1%, when the specificity was 77.6%, positive predictive value was 75%, negative predictive value was 98.3%, and accuracy was 85.9%. Conclusion This study demonstrated that the degree of contrast enhancement of the lesions in CESM may be used in daily practice with easily performing a visual scale in predicting the malignancy potential of the lesions.
High dose valacyclovir for cytomegalovirus prophylaxis following allogeneic hematopoietic cell transplantation
Authors: Hawks Kelly G , Fegley Amanda , Sabo Roy T , Roberts Catherine H , Toor Amir A 
Published: December 2021

Introduction Cytomegalovirus (CMV) is one of the most common and clinically significant viral infections following allogeneic hematopoietic cell transplantation (HCT). Currently available options for CMV prophylaxis and treatment present challenges related to side effects and cost. Methods In this retrospective medical record review, the incidence of clinically significant CMV infection (CMV disease or reactivation requiring preemptive treatment) following allogeneic HCT was compared in patients receiving valacyclovir 1 g three times daily versus acyclovir 400 mg every 12 h for viral prophylaxis. Results Forty-five patients who received valacyclovir were matched based on propensity scoring to 35 patients who received acyclovir. All patients received reduced-intensity conditioning regimens containing anti-thymocyte globulin. Clinically significant CMV infection by day + 180 was lower in the valacyclovir group compared to the acyclovir group (18% vs. 57%, p = 0.0004). Patients receiving valacyclovir prophylaxis also had less severe infection evidenced by a reduction in CMV disease, lower peak CMV titers, delayed CMV reactivation, and less secondary neutropenia. Conclusion Prospective evaluation of valacyclovir 1 g three times daily for viral prophylaxis following allogeneic HCT is warranted. Due to valacyclovir's favorable toxicity profile and affordable cost, it has the potential to benefit patients on a broad scale as an option for CMV prophylaxis.