bluuebunny/crossref_metadata_2025_split huggingface dataset:
Leveraging of SARS-CoV-2 PCR Cycle Thresholds Values to Forecast COVID-19 Trends
Authors: Yin Nicolas , Dellicour Simon , Daubie Valery , Franco Nicolas , Wautier Magali , Faes Christel , Van Cauteren Dieter , Nymark Liv , Hens Niel , Gilbert Marius , Hallin Marie , Vandenberg Olivier 
Published: November 2021

Introduction: We assessed the usefulness of SARS-CoV-2 RT-PCR cycle thresholds (Ct) values trends produced by the LHUB-ULB (a consolidated microbiology laboratory located in Brussels, Belgium) for monitoring the epidemic's dynamics at local and national levels and for improving forecasting models.Methods: SARS-CoV-2 RT-PCR Ct values produced from April 1, 2020, to May 15, 2021, were compared with national COVID-19 confirmed cases notifications according to their geographical and time distribution. These Ct values were evaluated against both a phase diagram predicting the number of COVID-19 patients requiring intensive care and an age-structured model estimating COVID-19 prevalence in Belgium.Results: Over 155,811 RT-PCR performed, 12,799 were positive and 7,910 Ct values were available for analysis. The 14-day median Ct values were negatively correlated with the 14-day mean daily positive tests with a lag of 17 days. In addition, the 14-day mean daily positive tests in LHUB-ULB were strongly correlated with the 14-day mean confirmed cases in the Brussels-Capital and in Belgium with coinciding start, peak, and end of the different waves of the epidemic. Ct values decreased concurrently with the forecasted phase-shifts of the diagram. Similarly, the evolution of 14-day median Ct values was negatively correlated with daily estimated prevalence for all age-classes.Conclusion: We provide preliminary evidence that trends of Ct values can help to both follow and predict the epidemic's trajectory at local and national levels, underlining that consolidated microbiology laboratories can act as epidemic sensors as they gather data that are representative of the geographical area they serve.
Development and Validation of a Novel Risk Prediction Model Using Recursive Feature Elimination Algorithm for Acute-on-Chronic Liver Failure in Chronic Hepatitis B Patients With Severe Acute Exacerbation
Authors: Yu Mingxue , Li Xiangyong , Lu Yaxin , Jie Yusheng , Li Xinhua , Shi Xietong , Zhong Shaolong , Wu Yuankai , Xu Wenli , Liu Zifeng , Chong Yutian 
Published: November 2021

Background: Patients with chronic hepatitis B (CHB) with severe acute exacerbation (SAE) are at a progression stage of acute-on-chronic liver failure (ACLF) but uniform models for predicting ACLF occurrence are lacking. We aimed to present a risk prediction model to early identify the patients at a high risk of ACLF and predict the survival of the patient.Methods: We selected the best variable combination using a novel recursive feature elimination algorithm to develop and validate a classification regression model and also an online application on a cloud server from the training cohort with a total of 342 patients with CHB with SAE and two external cohorts with a sample size of 96 and 65 patients, respectively.Findings: An excellent prediction model called the PATA model including four predictors, prothrombin time (PT), age, total bilirubin (Tbil), and alanine aminotransferase (ALT) could achieve an area under the receiver operating characteristic curve (AUC) of 0.959 (95% CI 0.941–0.977) in the development set, and AUC of 0.932 (95% CI 0.876–0.987) and 0.905 (95% CI 0.826–0.984) in the two external validation cohorts, respectively. The calibration curve for risk prediction probability of ACLF showed optimal agreement between prediction by PATA model and actual observation. After predictive stratification into different risk groups, the C-index of predictive 90-days mortality was 0.720 (0.675–0.765) for the PATA model, 0.549 (0.506–0.592) for the end-stage liver disease score model, and 0.648 (0.581–0.715) for Child–Turcotte–Pugh scoring system.Interpretation: The highlypredictive risk model and easy-to-use online application can accurately predict the risk of ACLF with a poor prognosis. They may facilitate risk communication and guidetherapeutic options.
Survival Outcomes After Breast-Conserving Therapy Compared With Mastectomy for Patients With Early-Stage Invasive Micropapillary Carcinoma of the Breast: A SEER Population-Based Study
Authors: Wang Song , Zhang Yiyuan , Yin Fangxu , Wang Xiaohong , Yang Zhenlin 
Published: November 2021

BackgroundInvasive micropapillary breast carcinoma (IMPC) is a relatively rare pathological type of invasive breast cancer. Little is currently known on the efficacy and safety of breast-conserving treatment (BCT, lumpectomy plus postsurgical radiation) compared with mastectomy in women diagnosed with early-stage IMPC. Accordingly, we sought to investigate the long-term prognostic differences between BCT and mastectomy in patients with T1-3N0-3M0 invasive micropapillary breast carcinoma using data from the Surveillance, Epidemiology, and End Results (SEER) database.Materials and MethodsWe retrospectively analyzed 1,203 female patients diagnosed with early-stage IMPC between 2004 and 2015 from the SEER database. The impact of different surgical approaches on patient prognosis was assessed by the Kaplan-Meier method and Cox proportional risk models.ResultsA total of 609 and 594 patients underwent mastectomy and BCT, respectively. Compared with patients who underwent a mastectomy, patients in the BCT group were older and had lower tumor diameters, lower rates of lymph nodes metastasis, and higher rates of ER receptor positivity and PR receptor positivity (p &lt; 0.05). Kaplan-Meier plots showed that the overall survival (OS) and breast cancer-specific survival (BCSS) were higher in the BCT group than in the mastectomy group. In subgroup analysis, patients with T2 stage in the BCT group had better OS than the mastectomy group. Multivariate analysis showed no statistical difference in OS and BCSS for patients in the mastectomy group compared with the BCT group (hazard ratio (HR) = 0.727; 95% confidence interval (95% CI) 0.369–1.432, p = 0.357; HR = 0.762; 95% CI 0.302–1.923, p = 0.565; respectively). During the multivariate analysis and stratifying for the T stage, a better OS was found for patients with T2 stage in the BCT group than the mastectomy group (HR = 0.333, 95% CI: 0.149–0.741, p = 0.007). There was no significant difference in OS for patients with T1 and T3 stages between the BCT and mastectomy groups (p &gt; 0.05).ConclusionIn women with early-stage IMPC, BCT was at least equivalent to mastectomy in terms of survival outcomes. When both procedures are feasible, BCT should be recommended as the standard surgical treatment, especially for patients with T2 disease.
Trends in Intracranial Glioma Incidence and Mortality in the United States, 1975-2018
Authors: Lin Dongdong , Wang Ming , Chen Yan , Gong Jie , Chen Liang , Shi Xiaoyong , Lan Fujun , Chen Zhongliang , Xiong Tao , Sun Hu , Wan Shu 
Published: November 2021

PurposeGlioma incidence in the US seems to have stabilized over the past 20 years. It’s also not clear whether changes in glioblastoma incidence are associated with glioma mortality trends. Our study investigated trends in glioma incidence and mortality according to tumor characteristics.MethodsThis study obtained data from the Surveillance, Epidemiology, and End Results-9 (SEER-9) registries to calculate glioma incidence and mortality trends. Annual percent changes (APC) and 95% CIs were calculated using the Joinpoint program.Results62,159 patients (34,996 males and 55,424 whites) were diagnosed with glioma during 1975-2018, and 31,922 deaths occurred from 1995-2018. Glioblastoma (32,893 cases) and non-glioblastoma astrocytoma (17,406 cases) were the most common histologic types. During the study period, the incidence of glioma first experienced a significant increase (APC=1.8%, [95% CI, 1.3% to 2.3%]) from 1975 to 1987, and then experienced a slight decrease (APC=-0.4%, [95% CI, -0.5% to -0.3%]) from 1987 to 2018, while the APC was 0.8% for glioblastoma, -2.0% for non-glioblastoma astrocytoma, 1.1% for oligodendroglial tumors, 0.7% for ependymoma and -0.3% for glioma NOS during the study period. Glioblastoma incidence increased for all tumor size and tumor extension except for distant. From 1995 to 2018, glioma mortality declined 0.4% per year (95% CI: -0.6% to -0.2%) but only increased in patients older than 80 years [APC=1.0%, (95% CI, 0.4% to 1.6%)].ConclusionSignificant decline in glioma incidence (1987-2018) and mortality (1995-2018) were observed. Epidemiological changes in non-glioblastoma astrocytoma contributed the most to overall trends in glioma incidence and mortality. These findings can improve understanding of risk factors and guide the focus of glioma therapy.
Lessons Learned from Discontinued Clinical Developments in Duchenne Muscular Dystrophy
Authors: Markati Theodora , De Waele Liesbeth , Schara-Schmidt Urlike , Servais Laurent 
Published: November 2021

Duchenne muscular dystrophy (DMD) is an X-linked condition caused by a deficiency of functional dystrophin protein. Patients experience progressive muscle weakness, cardiomyopathy and have a decreased life expectancy. Standards of care, including treatment with steroids, and multidisciplinary approaches have extended the life expectancy and improved the quality of life of patients. In the last 30 years, several compounds have been assessed in preclinical and clinical studies for their ability to restore functional dystrophin levels or to modify pathways involved in DMD pathophysiology. However, there is still an unmet need with regards to a disease-modifying treatment for DMD and the attrition rate between early-phase and late-phase clinical development remains high. Currently, there are 40 compounds in clinical development for DMD, including gene therapy and antisense oligonucleotides for exon skipping. Only five of them have received conditional approval in one jurisdiction subject to further proof of efficacy. In this review, we present data of another 16 compounds that failed to complete clinical development, despite positive results in early phases of development in some cases. We examine the reasons for the high attrition rate and we suggest solutions to avoid similar mistakes in the future.
Dapagliflozin has No Protective Effect on Experimental Pulmonary Arterial Hypertension and Pulmonary Trunk Banding Rat Models
Authors: Li Huayang , Zhang Yitao , Wang Shunjun , Yue Yuan , Liu Quan , Huang Suiqing , Peng Huajing , Zhang Yi , Zeng Weijie , Wu Zhongkai 
Published: November 2021

Sodium-glucose cotransporter-2 (SGLT2) inhibitors, a novel class of hypoglycemic drugs, show excellent cardiovascular benefits, and have further improved heart failure outcomes, significantly reducing cardiovascular and all-cause mortality irrespective of diabetes status. However, the efficacy of SGLT2 inhibitors in pulmonary arterial hypertension (PAH) and right ventricular (RV) dysfunction remains unknown. This study aimed to evaluate the effects of dapagliflozin in rats with PAH and RV dysfunction. PAH was induced in rats by monocrotaline (MCT) subcutaneous injection (60 mg/kg). Isolated RV dysfunction was induced in another group of rats by pulmonary trunk banding (PTB). Dapagliflozin (1.5 mg/kg) was administered daily via oral gavage one day (prevention groups) or two weeks (reversal groups) after modeling. Echocardiography and hemodynamic assessments were used to observe pulmonary vascular resistance and RV function. Histological staining was used to observe pulmonary vascular and RV remodeling. As compared with MCT group, dapagliflozin treatment did not significantly improve the survival of rats. Pulmonary arterial media wall thickness in MCT group was significantly increased, but dapagliflozin did not significantly improved vascular remodeling both in the prevention group and reversal group. In MCT group, RV hypertrophy index, RV area, the fibrosis of RV increased significantly, and RV function decreased significantly. Consistently, dapagliflozin did not show protective effect on the RV remodeling and function. In the PTB model, we also did not find the direct effect of dapagliflozin on the RV. This is a negative therapeutic experiment, suggesting human trials with dapagliflozin for PAH or RV failure should be cautious.
Current and Prospective Strategies in the Varietal Improvement of Chilli (Capsicum annuum L.) Specially Heterosis Breeding
Authors: Karim K. M. Rezaul , Rafii Mohd Y. , Misran Azizah Binti , Ismail Mohd Firdaus Bin , Harun Abdul Rahim , Khan Md Mahmudul Hasan , Chowdhury Mst. Farhana Nazneen 
Published: November 2021

Chilli (Capsicum annuum L.) is an herbaceous crop and plays an important role as common spices and vegetables. Pepper (Capsicum spp.) is one of the most cost-effective and agricultural vegetables in the world. The most significant characteristics of peppers, as spices and in various pharmacological uses, are pungency and oleoresin (color). Cabsicum annuum L. is widely used as a medicinal herb and in the Mediterranean diet (at the present, C. annuum var. acuminatum Fingerh. and Capsicum frutescens L. are considered synonyms of C. annuum L.). Capsicum annuum includes a wide range of carotenoids including capsanthin, capsorubin, beta-carotene, cryptoxanthin, lutein, fanthophyl, and xanthophyll, and capsaicinoid. However, it remains limited in production due to the lack of development in varieties especially under severe climatic circumstances such as drought, high temperature, or salt. Some reports were provided through distinct traditional approaches for genetic improvement. A combination of traditional and molecular breeding, especially breeding for heterosis, might be a good option for developing a novel genotype for ecologically adversely affected niche adaption. This review summarizes the current chilli breeding approaches with their drawbacks and highlights some recent classical efforts for the improvement of the crop. This would be the milestone for the breeders in the planning of a successful chilli breeding program to combat the adverse ecological condition. Thus, the information gathered in this article might be considered as the cornerstone of Chilli breeders at their ongoing and sustainable future programs as well.
Which Attributes Are Most and Least Important to Patients When Considering Gout Flare Burden Over Time? A Best-worst Scaling Choice Study
Authors: Holyer Jeremy , Taylor William J. , Gaffo Angelo , Hosie Graham , Horne Anne , Mihov Borislav , Su Isabel , Gamble Gregory D. , Dalbeth Nicola , Stewart Sarah 
Published: November 2021

ObjectiveSeveral factors contribute to the patient experience of gout flares, including pain intensity, duration, frequency, and disability. It is unknown which of these factors are most important to patients when considering flare burden over time, including those related to the cumulative experience of all flares, or the experience of a single worst flare. This study aimed to determine which flare attributes are the most and least important to the patient experience of flare burden over time.MethodsParticipants with gout completed an anonymous online survey. Questions were aimed at identifying which attributes of gout flares, representing both individual and cumulative flare burden, were the most and least important over a hypothetical 6-month period. A best-worst scaling method was used to determine the importance hierarchy of the included attributes.ResultsFifty participants were included. Difficulty doing usual activities during the worst flare and pain of the worst flare were ranked as the most important, whereas average pain of all flares was considered the least important. Overall, attributes related to the single worst gout flare were considered more important than attributes related to the cumulative impact of all flares.ConclusionWhen thinking about the burden of gout flares over time, patients rank activity limitation and pain experienced during their worst gout flare as the most important contributing factors, whereas factors related to the cumulative impact of all flares over time are relatively less important.
Evaluation of the Perceived Confidence of Undergraduate Dental Students in Performing Endodontic Treatment
Authors: Iranmanesh Pedram , Tabatabaei Saghar Alavi , Saatchi Masoud , Tahani Bahareh , Binandeh Elham S. , Khademi Abbasali 
Published: November 2021

Introduction:
Dental students’ confidence is a crucial factor affecting the success of endodontic teaching. The aim of this study was to determine the dental students’ confidence level in performing endodontic treatment.

Materials and Methods:
A total of 150 dental students of Isfahan University of Medical Sciences participated in this descriptive study by census sampling. A self-administered questionnaire, including demographic data, endodontic experience, confidence in performing different stages of endodontic treatment, and suggestions for improving the quality of endodontic training, was distributed among the fourth to sixth year students. Data were analyzed with SPSS version 20.0 (IBM Corp., Armonk, New York, USA), using t test, ANOVA, and linear regression analysis (α = 0.05).

Results:
The response rate was approximately 88%, and the highest and lowest confidence scores (standard deviation) were reported for establishing proper communication with patients with 4.0 (34.67) and finding all root canals with 3.0 (23.88). The confidence score of male students was significantly higher than female students (P < 0.05). There was no significant association between the total score of confidence and difficulty level of the first endodontic treatment and educational level (P > 0.05). The multiple linear regression showed a significant correlation between the difficulty level of the first endodontic treatment and confidence (β = −2.1, P = 0.02, 95% CI: −3.9–−0.2).

Conclusion:
Given the low confidence level of students in some skills, the following are suggested to be taught practically and theoretically. Female students should be provided with a technique to improve confidence. Moreover, the first tooth for endodontic treatment should be selected more thoughtfully.
Completeness of Informed Consent Documents in Synopsis of Postgraduate Medical Students of a Medical College of Western Maharashtra
Authors: Choudhary Laxmikant , Awasthi Promod Chandra , Ray K Rahul , Kunte Renuka , Yadav Arun Kumar 
Published: November 2021

Introduction:
Research is a key requirement and is an integral part of postgraduate (PG) studies. In biomedical and health research involving human participants, obtaining voluntary informed consent is a must requirement for researchers' respect for individual autonomy as well as safeguard of participants against abuses and exploitations. The Indian Council of Medical Research (ICMR) has come out with the Revised National Ethical Guidelines for Biomedical and Health Research Involving Human Participants – 2017 giving essential and additional elements of an informed consent document (ICD).

Materials and Methods:
The study was a descriptive study done over a period of 12 weeks. A sample of 155 PG students were selected, who had submitted their synopsis in medical research unit of a medical college of Western Maharashtra. ICDs were scrutinized and evaluated with a checklist given by the ICMR guidelines 2017 and analyzed using SPSS version 20.

Results:
Of 155 students, 131 (91.6%) were males as compared to 24 (15.48%) females, and 43 (27.7%) belonged to clinical specialty as compared to 112 (78.3%) from para and nonclinical. Of 155 students, 143 (92.3%) had attached informed consent forms (ICFs) as compared to 12 (7.7%) who had not attached in their synopsis. In ICFs among 143 students, 59 (41.1%) students used English and local language (Marathi) and 84 (58.7%) used only English language.

Conclusion:
PG students have appropriately prepared ICFs; however, there are some discrepancies in some of the elements. There is a requirement of sensitizing PG students through regular training programs to reduce discrepancies in ICDs.
American Medical Trainee Perspectives on Ethical Conflicts during a Short-Term Global Health Rotation in Ethiopia: A Qualitative Analysis of 30 Cases
Authors: Modlin Chelsea E. , C. Vilorio Andrea , Stoff Benjamin , L. Comeau Dawn , Gebremariam Tewodros H. , Derbew Miliard , M. Blumberg Henry , del Rio Carlos , Kempker Russell R. 
Published: November 2021

ABSTRACT.
There has been a significant increase in the number of students, residents, and fellows from high-income settings participating in short-term global health experiences (STGHEs) during their medical training. This analysis explores a series of ethical conflicts reported by medical residents and fellows from Emory University School of Medicine in the United States who participated in a 1-month global health rotation in Ethiopia. A constant comparative analysis was conducted using 30 consecutive reflective essays to identify emerging categories and themes of ethical conflicts experienced by the trainees. Ethical conflicts were internal; based in the presence of the visiting trainee and their personal interactions; or external, occurring due to witnessed events. Themes within internal conflicts include issues around professional identity and insufficient preparation for the rotation. External experiences were further stratified by the trainee’s perception that Ethiopian colleagues agreed that the scenario represented an ethical conflict (congruent) or disagreed with the visiting trainee’s perspective (incongruent). Examples of congruent themes included recognizing opportunities for collaboration and witnessing ethical conflicts that are similar to those experienced in the United States. Incongruent themes included utilization of existing resources, issues surrounding informed consent, and differing expectations of clinical outcomes. By acknowledging the frequency and roots of ethical conflicts experienced during STGHEs, sponsors may better prepare visiting trainees and reframe these conflicts as collaborative educational experiences that benefit both the visiting trainee and host providers.
STRATEGI GURU BK DALAM MENUMBUHKAN SIKAP TOLERANSI PESERTA DIDIK
Authors: Fitriyana Arina 
Published: November 2021

Tujuan penelitian ini adalah untuk mengetahui gambaran umum sikap intoleransi peserta didik dan strategi yang dilakukan guru bimbingan dan konseling dalam menumbuhkan sikap toleransi peserta didik. Jenis penelitian ini menggunakan penelitian deskriptif kualitatif. Data penelitian didapat dari hasil observasi, wawancara, dan studi dokumentasi. Data tersebut kemudian dianalisis melalui tiga tahapan yaitu reduksi data, penyajian data, dan penarikan kesimpulan. Hasil analisis disajikan berupa data deskripsi mengenai fokus yang diteliti. Berdasarkan hasil penelitian diketahui bahwa mayoritas peserta didik di SMP N 18 Semarang telah memiliki sikap toleransi tetapi masih ada peserta didik yang menunjukkan sikap intoleransi. Sikap intoleransi yang ditunjukkan oleh peserta didik berdasarkan hasil observasi dan wawancara adalah peserta didik yang merasa tidak berkewajiban untuk menghormati agama orang lain, tidak suka bergaul dengan orang yang kedudukannya lebih rendah ataupun lebih tinggi, mengolok-olok teman yang berbeda dengan dirinya, dan adanya pengelompokan peserta didik sehingga ada peserta didik yang merasa dikucilkan. Dalam menyikapi fenomena tersebut, guru BK di SMP N 18 Semarang melakukan layanan bimbingan kelompok dengan memadukan teknik diskusi kelompok dengan teknik symbolic modeling. Layanan bimbingan kelompok tersebut menjadi strategi guru BK dalam menumbuhkan sikap toleransi peserta didik kelas VIII SMP N 18 Semarang. Layanan bimbingan kelompok dengan teknik diskusi kelompok yang dipadukan dengan teknik symbolic modeling ini diharapkan dapat digunakan oleh guru BK tidak hanya di tempat penelitian tetapi dapat digeneralisasikan di sekolah-sekolah yang lain. Selain itu, masih terbuka peluang bagi peneliti selanjutnya untuk meneliti strategi yang dapat dilakukan oleh guru BK melalui berbagai layanan bimbingan dan konseling.