bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical use, challenges, and barriers to implementation of deformable image registration in radiotherapy – the need for guidance and QA tools
Authors: Hussein Mohammad , Akintonde Adeyemi , McClelland Jamie , Speight Richard , Clark Catharine H 
Published: April 2021

Objective:
The aim of this study was to evaluate the current status of the clinical use of deformable image registration (DIR) in radiotherapy and to gain an understanding of the challenges faced by centres in clinical implementation of DIR, including commissioning and quality assurance (QA), and to determine the barriers faced. The goal was to inform whether additional guidance and QA tools were needed.

Methods:
A survey focussed on clinical use, metrics used, how centres would like to use DIR in the future and challenges faced, was designed and sent to 71 radiotherapy centres in the UK. Data were gathered specifically on which centres we using DIR clinically, which applications were being used, what commissioning and QA tests were performed, and what barriers were preventing the integration of DIR into the clinical workflow. Centres that did not use DIR clinically were encouraged to fill in the survey and were asked if they have any future plans and in what timescale.

Results:
51 out of 71 (70%) radiotherapy centres responded. 47 centres reported access to a commercial software that could perform DIR. 20 centres already used DIR clinically, and 22 centres had plans to implement an application of DIR within 3 years of the survey. The most common clinical application of DIR was to propagate contours from one scan to another (19 centres). In each of the applications, the types of commissioning and QA tests performed varied depending on the type of application and between centres. Some of the key barriers were determining when a DIR was satisfactory including which metrics to use, and lack of resources.

Conclusion:
The survey results highlighted that there is a need for additional guidelines, training, better tools for commissioning DIR software and for the QA of registration results, which should include developing or recommending which quantitative metrics to use.

Advances in knowledge:
This survey has given a useful picture of the clinical use and lack of use of DIR in UK radiotherapy centres. The survey provided useful insight into how centres commission and QA DIR applications, especially the variability among centres. It was also possible to highlight key barriers to implementation and determine factors that may help overcome this which include the need for additional guidance specific to different applications, better tools and metrics.
Computer tomographic differential diagnosis of ameloblastoma and odontogenic keratocyst: classification using a convolutional neural network
Authors: Bispo Mayara Simões , Pierre Júnior Mário Lúcio Gomes de Queiroz , Apolinário Jr Antônio Lopes , dos Santos Jean Nunes , Junior Braulio Carneiro , Neves Frederico Sampaio , Crusoé-Rebello Iêda 
Published: April 2021

Objective:To analyse the automatic classification performance of a convolutional neural network (CNN), Google Inception v3, using tomographic images of odontogenic keratocysts (OKCs) and ameloblastomas (AMs).Methods:For construction of the database, we selected axial multidetector CT images from patients with confirmed AM (n = 22) and OKC (n = 18) based on a conclusive histopathological report. The images (n = 350) were segmented manually and data augmentation algorithms were applied, totalling 2500 images. The k-fold × five cross-validation method (k = 2) was used to estimate the accuracy of the CNN model.Results:The accuracy and standard deviation (%) of cross-validation for the five iterations performed were 90.16 ± 0.95, 91.37 ± 0.57, 91.62 ± 0.19, 92.48 ± 0.16 and 91.21 ± 0.87, respectively. A higher error rate was observed for the classification of AM images.Conclusion:This study demonstrated a high classification accuracy of Google Inception v3 for tomographic images of OKCs and AMs. However, AMs images presented the higher error rate.
The value of serum procalcitonin in the anti-infection therapy of acute stroke patients
Authors: Wang Hui-ling , Li Ying-lei , Li Xiao-fang , Wang Zhi-zun 
Published: April 2021

Objectives: To investigate the value of dynamic monitoring of serum procalcitonin (PCT) in anti-infective therapy of patients with acute stroke.
Methods: This is a case control retrospective study of acute stroke patients conducted from July 2016 to October 2018, in the Department of Neurology, Affiliated Hospital of Hebei University, who who reached within twenty four hours. They, were selected as the study subjects who were divided into infection group and non-infection group according to the inclusion and exclusion criteria. The serum PCT and CRP levels were compared between the two groups at 24 hours, 48 hours and 72 hours. In order to judge the changes of PCT level and the infection of stroke patients, different kinds of antibiotics were used for corresponding treatment. Retrospective analysis of the cases that did not monitor PCT anti infective treatment before July 2016 were compared with the cases that monitored PCT to guide anti infective treatment after July 2016, and compared the efficacy of antibiotics.
Results: The serum PCT level of patients in the infection group was significantly higher than that of patients in the noninfection group (P<0.001). For the patients whose PCT<0.5 ng/ml within 72 hour, anti-infective therapy was not administered. However, for those patients whose PCT<0.5 ng/ml and CRP rose significantly, WBC, body temperature and chest CT were closely monitored. For the patients whose PCT increased slightly (0.5 ng/ml<PCT<2.0 ng/ml), first-generation and second-generation cephalosporin or semisynthetic penicillin, such as mezlocillin, were administered. For the patients whose PCT increased moderately (5 ng/ml>PCT>2 ng/ml), mezlocillin/ sulbactam or ceftriaxone/ tazobactam was administered. For patients whose PCT increased significantly (PCT>5 ng/ml), carbapenem antibiotic or a combination of two antibiotics was administered.
Conclusion: Dynamic detection of serum PCT concentration can make accurate judgment on the severity of bacterial infection in patients with acute stroke and guide the rational application of antibiotics.
doi: https://doi.org/10.12669/pjms.37.4.3932
How to cite this:Wang H, Li Y, Li X, Wang Z. The value of serum procalcitonin in the anti-infection therapy of acute stroke patients. Pak J Med Sci. 2021;37(4):1155-1160. doi: https://doi.org/10.12669/pjms.37.4.3932
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Risk of Covid-19 infection during endoscopy: Efficacy of personal protective equipment (PPE) in protecting health professionals
Authors: Dilshad Muhammad Akif , Sarwar Shahid , Aslam Farheen , Shabbir Adnan , Rasool Shafqat , Tayyab Ghias un-Nabi 
Published: April 2021

Objectives: To correlate compliance to personal protective equipment (PPE) protocols and risk of exposure to SARS-COV-2 infection in endoscopy staff.
Methods: We included 85 endoscopic procedures performed at Lahore General Hospital from May to July 2020. Standard operating procedures (SOPs) were implemented for patient selection, risk stratification and personal protective equipment (PPE) use for endoscopy staff. Patient and endoscopy staff were followed for Covid-19 infection. PPE scores for staff and Covid-19 positivity on follow-up were correlated using student’s t test.
Results: Following 85 procedures included, 2 (2.3%) patients became Covid-19 positive. PPE score was <9 in 5 (5.8%) procedures for endoscopist and Covid-19 developed in 2 (2.3%) of them, PPE score was <9 during 19 (22.3%) procedures in 1st assistant and 9 (10.5%) developed infection and for 2nd assistant PPE score was <9 in 19(22.3%) endoscopies and 5 (5.9%) tested positive for covid-19. Infectivity of endoscopy staff was 6.2%. Association between PPE score and risk of Covid-19 was not significant. (p value 0.51 for endoscopist, 0.10 for 1st assistant and 0.09 for 2nd assistant).
Conclusion: Compliance of SOPs for infection control reduces risk of acquiring Covid-19 infection during endoscopy. Proper use of PPE is effective for safety of endoscopy staff.
doi: https://doi.org/10.12669/pjms.37.4.4057
How to cite this:Dilshad MA, Sarwar S, Aslam F, Shabbir A, Rasool S, Tayyab GN. Risk of Covid-19 infection during endoscopy: Efficacy of personal protective equipment (PPE) in protecting health professionals. Pak J Med Sci. 2021;37(4):1093-1098. doi: https://doi.org/10.12669/pjms.37.4.4057
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Are patient-reported outcomes the same following second-side surgery in primary hip and knee arthroplasty?
Authors: Tucker Adam , Warnock Jonathan M. , Cassidy Roslyn , Napier Richard J. , Beverland David 
Published: April 2021

AimsUp to one in five patients undergoing primary total hip (THA) and knee arthroplasty (TKA) require contralateral surgery. This is frequently performed as a staged procedure. This study aimed to determine if outcomes, as determined by the Oxford Hip Score (OHS) and Knee Score (OKS) differed following second-side surgery.MethodsOver a five-year period all patients who underwent staged bilateral primary THA or TKA utilizing the same type of implants were studied. Eligible patients had both preoperative and one year Oxford scores and had their second procedure completed within a mean (2 SDs) of the primary surgery. Patient demographics, radiographs, and OHS and OKS were analyzed.ResultsA total of 236 patients met the inclusion criteria, of which 122 were THAs and 114 TKAs. The mean age was 66.5 years (SD 9.4), with a 2:1 female:male ratio. THAs showed similar significant improvements in outcomes following first- and second-side surgery, regardless of sex. In contrast for TKAs, although male patients demonstrated the same pattern as the THAs, female TKAs displayed significantly less improvement in both OKS and its pain component following second-side surgery.ConclusionFemale patients undergoing second-side TKA showed less improvement in Oxford and pain scores compared to the first-side. This difference in outcome following second-side surgery did not apply to male patients undergoing TKA, or to either sex undergoing THA. Cite this article: Bone Jt Open 2021;2(4):243–254.
Effects of realistic e-learning cases on students’ learning motivation during COVID-19
Authors: Rahm Ann-Kathrin , Töllner Maximilian , Hubert Max Ole , Klein Katrin , Wehling Cyrill , Sauer Tim , Hennemann Hannah Mai , Hein Selina , Kender Zoltan , Günther Janine , Wagenlechner Petra , Bugaj Till Johannes , Boldt Sophia , Nikendei Christoph , Schultz Jobst-Hendrik 
Published: April 2021

BackgroundKeeping up motivation to learn when socially isolated during a pandemic can be challenging. In medical schools, the COVID-19 pandemic required a complete switch to e-learning without any direct patient contact despite early reports showing that medical students preferred face-to-face teaching in clinical setting. We designed close to real-life patient e-learning modules to transmit competency-based learning contents to medical students and evaluated their responses about their experience.MethodsWeekly e-learning cases covering a 10-week leading symptom-based curriculum were designed by a team of medical students and physicians. The internal medicine curriculum (HeiCuMed) at the Heidelberg University Medical School is a mandatory part of clinical medical education in the 6thor 7thsemester. Case-design was based on routine patient encounters and covered different clinical settings: preclinical emergency medicine, in-patient and out-patient care and follow-up. Individual cases were evaluated online immediately after finishing the respective case. The whole module was assessed at the end of the semester. Free-text answers were analyzed with MaxQDa following Mayring`s principles of qualitative content analyses.ResultsN = 198 students (57.6% female, 42.4% male) participated and 1252 individual case evaluations (between 49.5% and 82.5% per case) and 51 end-of-term evaluations (25.8% of students) were collected. Students highly appreciated the offer to apply their clinical knowledge in presented patient cases. Aspects of clinical context, interactivity, game-like interface and embedded learning opportunities of the cases motivated students to engage with the asynchronously presented learning materials and work through the cases.ConclusionsSolving and interpreting e-learning cases close to real-life settings promoted students’ motivation during the COVID-19 pandemic and may partially have compensated for missing bedside teaching opportunities.
Intimate partner violence is a barrier to antiretroviral therapy adherence among HIV-positive women: Evidence from government facilities in Kenya
Authors: Biomndo Bornice C. , Bergmann Alexander , Lahmann Nils , Atwoli Lukoye 
Published: April 2021

Introduction
Intimate Partner Violence (IPV) is linked to low engagement with HIV management services and adverse clinical outcomes, including poor ART adherence. In sub-Saharan Africa, studies on pregnant/postpartum women and transactional sex workers have produced divergent evidence regarding IPV’s association with poor ART adherence. We investigate this association among a broad group of women.

Methods
We sampled 408 HIV-positive women receiving free ART from different types of HIV clinics at government health facilities, assessing for IPV exposure by a current partner, ART adherence rate, and other factors that affect ART adherence (e.g. education, disclosure). ART adherence rates were measured using the Visual Analogue Scale (VAS); responses were dichotomised at a ≥95% cut-off. Multiple logistic regression models assessed the association between the independent variables and ART adherence.

Results
The participants’ mean age was 38.6 (range: 18–69 years). The majority had ever attended school (94%, n = 382), were in monogamous marriages (70%, n = 282), and had disclosed status to partners (94%, n = 380). Overall, 60% (n = 242) reported optimal ART adherence (≥ 95%) in the previous 30 days. The prevalence of IPV by the current partner was 76% (CI95 = 72–80%). Experiencing physical IPV (AOR 0.57, CI95: 0.34–0.94, p = .028), sexual IPV (AOR 0.50, CI95: 0.31–0.82, p = .005), or controlling behaviour (AOR 0.56, CI95: 0.34–0.94, p = .027) reduced the odds of achieving optimal adherence, while a higher education level and having an HIV-positive partner increased the odds.

Conclusion
IPV is common and is associated with suboptimal ART adherence rates among a broad group of HIV-positive women. ART programs could consider incorporating basic IPV interventions into regular clinic services to identify, monitor and support exposed women, as they might be at risk of poor ART adherence. Still, there is need for more research on how IPV affects ART adherence.
Impact of cachexia on oncologic outcomes of sarcopenic patients with upper tract urothelial carcinoma after radical nephroureterectomy
Authors: Chen Hao-Wei , Chen Yu-Chen , Yang Li-Hwa , Shih Ming-Chen Paul , Li Ching-Chia , Chueh Kuang-Shun , Wu Wen-Jeng , Juan Yung-Shun 
Published: April 2021

Objectives
To investigate the prognostic significance of sarcopenic cachexia compared to sarcopenia without cachexia in the outcomes of upper urinary tract urothelial carcinoma (UTUC) patients treated with radical nephroureterectomy (RNU).

Materials and methods
Between 2011 and 2016, 163 patients with UTUC who received RNU at a tertiary medical center were included. Pre-operatively clinical data, history, and abdominal computer tomography scans were analyzed retrospectively. The diagnosis of sarcopenia was based on abdominal computed tomography data on the patient’s skeletal muscles. Outcomes of relapse-free, cancer-specific, and overall survival were analyzed by multivariate Cox regression.

Results
After adjusting for age, sex, pre-operatively estimated glomerular filtration rate, body mass index, underlying diseases, tumor grade, and tumor stage, cachexia was a significant poor prognostic factor for relapse-free survival (hazard ratio [HR]: 18.5, 95% confidence interval [CI]: 2.87–118, p = 0.002) and cancer-specific survival (HR: 26.6, 95% CI: 4.04–175, p = 0.001). In contrast, sarcopenia without cachexia was not a significant predictor of cancer outcomes.

Conclusions
To date, this is the first study to investigate the effect of cachexia among sarcopenic patients with UTUC treated with RNU. We identified the prognostic significance of cachexia on outcomes. Indeed, when UTUC is treated with RNU, we should evaluate not only sarcopenia status but also cachexia. The low survival rate among patients with UTUC complicated with cachexia deserves attention.
Copeptin and stress-induced hyperglycemia in critically ill patients: A prospective study
Authors: Henrique Lilian Rodrigues , Crispim Daisy , Vieceli Tarsila , Schaeffer Ariell Freires , Bellaver Priscila , Leitão Cristiane Bauermann , Rech Tatiana Helena 
Published: April 2021

Objectives
Copeptin, an equimolar indicator of serum antidiuretic hormone levels, has been associated with higher mortality in critically ill patients and with the development of diabetes in the general population. The aim of the present study was to investigate the association of copeptin levels with glycemic parameters in critically ill patients and to compare the time-course of copeptin in survivors and non-survivors.

Design
Prospective cohort study.

Patients
From June to October 2019, critically ill patients were prospectively enrolled and followed for 90 days.

Measurements
Plasma copeptin levels were determined at intensive care unit (ICU) admission (copeptin T1), 24 h (copeptin T2), and 48 h (copeptin T3) after study entry. Blood glucose and glycated hemoglobin levels were measured. ICU, in-hospital, and 90-day mortality, and length of stay in the ICU and hospital were evaluated.

Results
104 patients were included. No significant correlation was detected between copeptin levels and blood glucose (r = -0.17, p = 0.09), HbA1c (r = 0.01, p = 0.9), glycemic gap (r = -0.16, p = 0.11), and stress hyperglycemia ratio (r = -0.14, p = 0.16). Copeptin T3 levels were significantly higher in survivors than in non-survivors at hospital discharge (561 [370–856] vs 300 [231–693] pg/mL, p = 0.015) and at 90 days (571 [380–884] vs 300 [232–698] pg/mL, p = 0.03).

Conclusions
No significant correlations were found between copeptin levels and glycemic parameters, suggesting that copeptin is not a relevant factor in the induction of hyperglycemia during critical illness. Copeptin levels at ICU day 3 were higher in survivors than in non-survivors.
Abriendo Fronteras: Enfoques Interdisciplinares de la Coreología, Cecilia Nocilli and Ana María Díaz Olaya (eds) (2018)
Authors: Cisneros Rosemary ‘Rosa’ 
Published: April 2021

Review of: Abriendo Fronteras: Enfoques Interdisciplinares de la Coreología, Cecilia Nocilli and Ana María Díaz Olaya (eds) (2018)
Malaga Libargo, 214 pp.,
ISBN 978-84-944433-9-8, p/bk, €17.95
Ein Beitrag zur Problematik der Übersetzung des Wortes מִנְחָה in Gen 4,3–5a
Authors: Dzikiewicz Daniel 
Published: April 2021

At the end of 2016, a revised edition of the Catholic Bible translation (Einheitsübersetzung) was published. One of the many corrections introduced referred to the word מִנְחָה in Gen 4,3–5a. It was translated as “a gift” (Gabe). The previous translation (1980) read this word as “a sacrifice” (Opfer). This article examines the validity of a given correction, proposing to combine both translation traditions into one as “a sacrificial gift” (Opfergabe).
Learning and Revealing the Thoughts of the Holy Scriptures through the Preachers as Perceived by Rev. Zygmunt Pilch (1888–1962)
Authors: Bucki Łukasz 
Published: April 2021

The text of the article is an analysis of selected issues from the teaching of Rev. Zygmunt Pilch (1888–1962) PhD, who directed his thoughts not only to students of preaching but also to preachers. His teaching is still relevant today. The homiletics lecturer appealed to the preachers of the Word of God that they were obliged to communicate the Word of Salvation to the world. The text of the Holy Scriptures, according to the homiletics teacher, is a natural source of preaching, as it is the Spirit of God Himself who speaks through it, through the teaching Church. From the inspired text, the preacher should draw content, spirit, anointing, life and grace. A preacher reading the Scriptures is bound to grasp the meaning of God’s speech. By reading the text, he looks for thoughts and meanings, wanting to capture the inner content of the text. The primary concern in reading the Bible is to know its literal meaning, which is directly apparent from the words of the text. There is also a typical sense in the holy books. The preacher’s task is to convince the faithful to live by faith, according to the Lord’s thought contained in types. Reading the Word of God requires appropriate methods that understand its symbolic meaning, revealed in allegories. Christ often made use of parables as the means of visual teaching, drawing images from everyday life. Devoted completely to preaching, Z. Pilch reminded that the Holy Scriptures, being the treasury of the revealed truth, were the main literature for every preacher. The teaching of the prelate Zygmunt Pilch seems to be still relevant and is still an undiscovered treasury.