bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility of semiquantitative 18F-fluorodeoxyglucose PET/computed tomography in patients with advanced lung cancer for interim treatment evaluation of combining immunotherapy and chemotherapy
Authors: Ke Linping , Wu Leilei , Yu Jinming , Meng Xue 
Published: April 2021

Objective
This study aimed to investigate the prognosis value of 18F-fluorodeoxyglucose PET/computed tomography (18F-FDG PET/CT) in advanced lung cancer patients with immunotherapy combined with chemotherapy.

Methods
Fifty-one advanced lung cancer patients were included in this retrospective study, who underwent 18F-FDG PET/CT imaging before four cycles of immunotherapy combined with chemotherapy at our institution between January 2018 and January 2020. The following PET/CT parameters were calculated: standardized uptake value SUVmax, SUVmean, SUVpeak, SUVsd, metabolic tumor volume (MTV), total lesion glycolysis (TLG), MTV25%, MTV42%, MTV50%, MTV75%, global lung glycolysis (GLG), target-to-background ratio (TBR), SUVpeakwb, MTVwb, TLGwb, SUVmeanwb, SUVmaxwb. Logistics regression analyses were used for assessing the association between baseline metabolic parameters and response to treatment. Kaplan–Meier estimator curves and the log-rank test were constructed for survival analyses.

Results
According to RECIST, nine patients (18%) showed partial response, 25 (49%) had SD, and 17 (33%) had progressive disease. The mean ± SD of SUVmax, SUVpeak, MTV were lower in clinical benefit (CB) group than no-clinical benefit (no-CB) group (all P < 0.05). Median PFS was 3.7 months in no-CB group and 9.9 months in CB group (P < 0.001). Multivariate logistic analysis indicated that SUVmax and histology were independent factors significantly related to the evaluation of therapeutic efficiency. Furthermore, SUVmax is an independent predictor of efficacy in non-small cell lung cancer.

Conclusion
SUVmax can be used to predict interim treatment response of immunotherapy combination with chemotherapy for advanced lung cancer. Moreover, the combination of SUVmax and histology may predict treatment response with acceptable reliability. However, a large prospective multicenter trial is still needed to examine the above finding for lacking limited evidence.
Polygenic risk scores: how much do they add?
Authors: Christoffersen Mette , Tybjærg-Hansen Anne 
Published: April 2021

Purpose of review
Current methods to assess genetic risk of familial hypercholesterolemia and coronary artery disease (CAD) focus on testing monogenic mutations in well known genes. Here we review recent developments in polygenic risk scores (PRSs) for LDL cholesterol and for CAD, and how they may add to current risk prediction algorithms.

Recent findings
PRSs can identify 10–20 times as many individuals at high polygenic risk compared with monogenic mutations, and PRSs can modulate the effect of a monogenic variant on risk. Current risk factor prediction tools for prevention of CAD incompletely capture polygenic susceptibility, and PRSs may identify subgroups of patients who are likely to benefit more from lipid-lowering therapy. Finally, PRSs can be quantified already at birth, long before other risk factors used to predict CAD, and before clinical manifestations of disease.

Summary
PRSs for CAD may soon be incorporated into clinical practice. Therefore, there is an urgent need to establish both analytical and clinical reporting standards for PRSs, and for validating scores in different ethnicities. Thresholds for intervention need to be established for PRSs and integrated into established risk scores. Training programs are needed for clinical staff to learn to communicate polygenic risk in a comprehensive way to the patient.
Enhancing the learning and supervision framework for training in flexible endoscopic evaluation of swallowing
Authors: Robinson H. Fiona 
Published: April 2021

Purpose of review
This article reviews the literature on the development of competency-based training and assessment in endoscopy, comparing gastrointestinal endoscopy and flexible endoscopic evaluation of swallowing (FEES). The discussion focusses on how a robust and explicit learning framework can be translated to the delivery of training in FEES to optimize trainee outcomes and supervisor skill.

Recent findings
Specialist Speech and Language Therapists (SLT) carry out FEES to inform the diagnosis and management of swallowing and voice disorders. Taught courses are generally followed by local workplace-based supervised practice to attain the competencies identified in the relevant professional guidelines. However, the curriculum for the workplace-based FEES training lacks a learning and assessment framework and little direction for the workplace-based supervisor. In gastrointestinal endoscopy training, this previously led to less than optimal outcomes for trainees and patients and so new models of training were developed.

Summary
A new learning framework for FEES underpinned by medical pedagogy has shown early promise in supporting the acquisition of competence. Incorporating a new FEES-specific systematic assessment, the framework provides direction for the supervisor and evidence of trainee progression, which subsequently enhances supervisor confidence to determine trainee competence.
Associations of Attachment and Coping Styles With Social Functioning in Patients With Bipolar Disorder I
Authors: Karaş Hakan , Çarpar Elif , Küçükgöncü Suat , Kaşer Muzaffer 
Published: April 2021

Abstract
The aim of this study was to investigate the relationship of attachment and coping mechanisms with social functioning in patients with bipolar disorder (BD). Sixty-three patients with BD type I and 63 healthy controls were evaluated. Structured Clinical Interview for DSM-IV Axis I Disorders, Hamilton Depression Rating Scale, Young Mania Rating Scale, Experiences in Close Relationships Questionnaire II, Coping Orientation to Problems Experienced (COPE) inventory, and Social Functioning Scale were used. In the BD group, adaptive coping style scores and attachment avoidance scores were significantly lower than the control group, but mean scores of maladaptive coping styles were higher than the control group. Regression analysis showed that positive reinterpretation and growth, active coping, use of emotional social support, planning, religious activities, and mental disengagement subscales of COPE were significantly associated with social functioning. Psychosocial interventions to strengthen adaptive coping mechanisms may help improve the social functioning in patients with BD.
De Novo Radiomics Approach Using Image Augmentation and Features From T1 Mapping to Predict Gleason Scores in Prostate Cancer
Authors: Makowski Marcus R. , Bressem Keno K. , Franz Luise , Kader Avan , Niehues Stefan M. , Keller Sarah , Rueckert Daniel , Adams Lisa C. 
Published: April 2021

Objectives
The aims of this study were to discriminate among prostate cancers (PCa's) with Gleason scores 6, 7, and ≥8 on biparametric magnetic resonance imaging (bpMRI) of the prostate using radiomics and to evaluate the added value of image augmentation and quantitative T1 mapping.

Materials and Methods
Eighty-five patients with subsequently histologically proven PCa underwent bpMRI at 3 T (T2-weighted imaging, diffusion-weighted imaging) with 66 patients undergoing additional T1 mapping at 3 T. The PCa lesions as well as the peripheral and transition zones were segmented pixel by pixel in multiple slices of the 3D MRI data sets (T2-weighted images, apparent diffusion coefficient, and T1 maps). To increase the size of the data set, images were augmented for contrast, brightness, noise, and perspective multiple times, effectively increasing the sample size 10-fold, and 322 different radiomics features were extracted before and after augmentation. Four different machine learning algorithms, including a random forest (RF), stochastic gradient boosting (SGB), support vector machine (SVM), and k-nearest neighbor, were trained with and without features from T1 maps to differentiate among 3 different Gleason groups (6, 7, and ≥8).

Results
Support vector machine showed the highest accuracy of 0.92 (95% confidence interval [CI], 0.62–1.00) for classifying the different Gleason scores, followed by RF (0.83; 95% CI, 0.52–0.98), SGB (0.75; 95% CI, 0.43–0.95), and k-nearest neighbor (0.50; 95% CI, 0.21–0.79). Image augmentation resulted in an average increase in accuracy between 0.08 (SGB) and 0.48 (SVM). Removing T1 mapping features led to a decline in accuracy for RF (−0.16) and SGB (−0.25) and a higher generalization error.

Conclusions
When data are limited, image augmentations and features from quantitative T1 mapping sequences might help to achieve higher accuracy and lower generalization error for classification among different Gleason groups in bpMRI by using radiomics.
Robot-assisted Treatment of Epigastric Hernias With a Suprapubic Approach
Authors: Pini Ramon , Di Giuseppe Matteo , Toti Johannes M.A. , Mongelli Francesco , Marcantonio Maria , Spampatti Sebastiano , La Regina Davide 
Published: April 2021

Background:
Robot-assisted ventral hernia repair has shown itself to be feasible and safe in abdominal wall surgery. Presently, the ports are placed laterally to meet the distance from the fascial defect. The aim of our study is to report our experience of epigastric hernia treatment with trocar insertion in the suprapubic region.

Materials and Methods:
On a prospectively collected dataset on robot-assisted surgery, patients treated for epigastric hernias with suprapubic approach were identified. Demographic and clinical data were collected and analyzed.

Results:
Twelve patients were selected. Median age was 58.5 years [interquartile range (IQR): 47.8 to 67.3 y]; 4 patients were male (33.3%) and the median body mass index was 23.9 kg/m2 (IQR: 22.3 to 26.2 kg/m2). All patients were referred to surgery because of pain. The median measure of the hernia defect was 30 mm (IQR: 13.75 to 31.0 mm); median larger mesh diameter was 13.5 cm (IQR: 9.5 to 15.0 cm); and median operative time was 136.5 minutes (IQR: 120.0 to 186.5 min). No intraoperative complication or conversion to open surgery occurred. Postoperatively, 2 patients presented a seroma and median length of hospital stay was 2.0 days (IQR: 1.75 to 3 d). No case of hernia recurrence was recorded at a mean follow-up of 11.2 months (range: 4 to 29 mo).

Conclusions:
In the robot-assisted treatment of hernias of the epigastric region, a suprapubic port placement can be considered instead of a lateral one to have a better field overview, especially in subxiphoid hernias. Further studies are needed to assess the benefits and limitations of such technique.
Robotic General Surgery Resident Training Curriculum: A Pilot Experience
Authors: Grannan Hailee R. , Hetzel Emily , Goldblatt Matthew I. , Gould Jon C. , Higgins Rana M. 
Published: April 2021

Background:
The purpose of this study was to report the impact of a pilot robotic general surgery resident training curriculum.

Materials and Methods:
A single institution pilot robotic general surgery training curriculum was instituted in 2016. Accreditation Council for Graduate Medical Education operative case log trends, resident simulation performance, and surveys were analyzed.

Results:
Forty-three general surgery residents participated in the robotic surgery training curriculum, 2016 to 2019. In total, 161 robotic cases were logged, increasing each academic year. Residents acted as bedside assistant in 42.9% (n=69) and as console surgeon in 57.1% (n=92). Fifteen first-year residents were surveyed on the training curriculum. On the postcurriculum survey, 100% found the curriculum to be very helpful, notably the hands-on in-service and skills simulator.

Conclusions:
Since the curriculum onset, residents participated in an increasing number of robotic operative cases and were actively engaged in simulation exercises. The establishment of this curriculum has facilitated the integration of resident education into the utilization of robotic technology. This study highlights the value of a formal robotic surgery curriculum for general surgery residency training.
Analysis and Augmentation of Small Datasets with Unsupervised Machine Learning
Authors: Dolgikh Serge 
Published: April 2021

AbstractAnalysis of small datasets presents a number of essential challenges not in the least due to insufficient sampling of characteristic patterns in the data making confident conclusions about the unknown distribution elusive and resulting in lower statistical confidence and higher error. In this work, a novel approach to augmentation of small datasets is proposed based on an ensemble of neural network models of unsupervised generative self-learning. Applying generative learning with an ensemble of individual models allowed to identify stable clusters of data points in the latent representations of the observable data. Several techniques of augmentation based on identified latent cluster structure were applied to produce new data points and enhance the dataset. The proposed method can be used with small and extremely small datasets to identify characteristics patterns, augment data and in some cases, improve accuracy of classification in the scenarios with strong deficit of labels.
Efficacy of universal masking for source control and personal protection from simulated cough and exhaled aerosols in a room
Authors: Lindsley William G. , Beezhold Donald H. , Coyle Jayme , Derk Raymond C. , Blachere Francoise M. , Boots Theresa , Reynolds Jeffrey S. , McKinney Walter G. , Sinsel Erik , Noti John D. 
Published: April 2021

ABSTRACTFace masks reduce the spread of infectious respiratory diseases such as COVID-19 by blocking aerosols produced during coughs and exhalations (“source control”). Masks also slow and deflect cough and exhalation airflows, which changes the dispersion of aerosols. Factors such as the directions in which people are facing (orientation) and separation distance also affect aerosol dispersion. However, it is not clear how masking, orientation, and distance interact. We placed a respiratory aerosol simulator (“source”) and a breathing simulator (“recipient”) in a 3 m x 3 m chamber and measured aerosol concentrations for different combinations of masking, orientation, and separation distance. When the simulators were front-to-front during coughing, masks reduced the 15-minute mean aerosol concentration at the recipient by 92% at 0.9 and 1.8 m separation. When the simulators were side-by-side, masks reduced the concentration by 81% at 0.9 m and 78% at 1.8 m. During breathing, masks reduced the aerosol concentration by 66% when front-to-front and 76% when side-by-side at 0.9 m. Similar results were seen at 1.8 m. When the simulators were unmasked, changing the orientations from front-to-front to side-by-side reduced the cough aerosol concentration by 59% at 0.9 m and 60% at 1.8 m. When both simulators were masked, changing the orientations did not significantly change the concentration at either distance during coughing or breathing. Increasing the distance between the simulators from 0.9 m to 1.8 m during coughing reduced the aerosol concentration by 25% when no masks were worn but had little effect when both simulators were masked. During breathing, when neither simulator was masked, increasing the separation reduced the concentration by 13%, which approached significance, while the change was not significant when both source and recipient were masked. Our results show that universal masking reduces exposure to respiratory aerosol particles regardless of the orientation and separation distance between the source and recipient.
An emerging role of microplastics in the etiology of lung ground glass nodules
Authors: Chen Qiqing , Gao Jiani , Yu Hairui , Su Hang , Yang Yan , Cao Yajuan , Zhang Qun , Ren Yijiu , Shi Huahong , Chen Chang , Liu Haipeng 
Published: April 2021

AbstractPulmonary ground glass nodules (GGNs) have been increasingly identified in past decades and is becoming an important clinical dilemma in oncology. Meanwhile, humans persistently inhale microplastics which are dominant in the air. However, the retention of “non-self” microplastics in human lung and its correlation with pulmonary GGNs remains elusive. In this study, we firstly demonstrated the presence of microfibers and microplastics in human lung, with higher detection rates in GGNs in comparison to those in normal tissue. Moreover, both types and colors of microfibers in tumor were richer than those in normal tissues. Intriguingly, high risk of microfibers exposure predisposes the formation of pulmonary GGN. Further, increased roughness surface was observed in microfibers isolated in human lung, indicating the possible link of surface roughness to the formation of pulmonary GGN. Collectively, our findings reveal an emerging role of environmental microplastics exposure in the etiology of pulmonary GGN.One Sentence SummaryThe exposure of environmental microplastics is a risk factor of pulmonary GGN.
Point of Care Testing using rapid automated Antigen Testing for SARS-COV-2 in Care Homes – an exploratory safety, usability and diagnostic agreement evaluation
Authors: Micocci Massimo , Buckle Peter , Hayward Gail , Allen A. Joy , Davies Kerrie , Kierkegaard Patrick , Spilsbury Karen , Thompson Carl , Astle Anita , Heath Ros , Sharpe Claire , Akrill Cyd , Lasserson Dan , Perera Rafael , Body Richard , Gordon Adam L 
Published: April 2021

AbstractIntroductionSuccessful adoption of POCTs (Point-of-Care tests) for COVID-19 in care homes requires the identification of ideal use cases and a full understanding of contextual and usability factors that affect test results and minimise biosafety risks. This paper presents findings from a scoping-usability and test performance study of a microfluidic immunofluorescence assay for COVID-19 in care homes.MethodsA mixed-methods evaluation was conducted in four UK care homes to scope usability and to assess the agreement with qRT-PCR. A dry run with luminescent dye was carried out to explore biosafety issues.ResultsThe agreement analysis was carried out on 227 asymptomatic participants (159 staff and 68 residents) and 14 symptomatic participants (5 staff and 9 residents). Asymptomatic specimens showed 50% (95% CI: 1.3%-98.7%) positive agreement and 96% (95% CI: 92.5%-98.1%) negative agreement with overall prevalence and bias-adjusted Kappa (PABAK) of 0.911 (95% CI: 0.857-0.965). Symptomatic specimens showed 83.3% (95% CI: 35.9%-99.6%) positive agreement and 100% (95% CI: 63.1%-100%) negative agreement with overall prevalence and bias-adjusted Kappa (PABAK) of 0.857 (95% CI: 0.549-1).The dry run showed four main sources of contamination that led to the modification of the standard operating procedures. Simulation after modification showed no further evidence of contamination.ConclusionCareful consideration of biosafety issues and contextual factors associated with care home are mandatory for safe use the POCT. Whilst POCT may have some utility for ruling out COVID-19, further diagnostic accuracy evaluations are needed to promote effective adoption.
Optimal health and economic impact of non-pharmaceutical intervention measures prior and post vaccination in England: a mathematical modelling study
Authors: Tildesley Michael J. , Vassall Anna , Riley Steven , Jit Mark , Sandmann Frank , Hill Edward M. , Thompson Robin N. , Atkins Benjamin D. , Edmunds John , Dyson Louise , Keeling Matt J. 
Published: April 2021

AbstractBackgroundEven with good progress on vaccination, SARS-CoV-2 infections in the UK may continue to impose a high burden of disease and therefore pose substantial challenges for health policy decision makers. Stringent government-mandated physical distancing measures (lockdown) have been demonstrated to be epidemiologically effective, but can have both positive and negative economic consequences. The duration and frequency of any intervention policy could, in theory, could be optimised to maximise economic benefits while achieving substantial reductions in disease.MethodsHere we use a pre-existing SARS-CoV-2 transmission model to assess the health and economic implications of different strengths of control through time in order to identify optimal approaches to non-pharmaceutical intervention stringency in the UK, considering the role of vaccination in reducing the need for future physical distancing measures. The model is calibrated to the COVID-19 epidemic in England and we carry out retrospective analysis of the optimal timing of precautionary breaks in 2020 and the optimal relaxation policy from the January 2021 lockdown, considering the willingness to pay for health improvement.ResultsWe find that the precise timing and intensity of interventions is highly dependent upon the objective of control. As intervention measures are relaxed, we predict a resurgence in cases, but the optimal intervention policy can be established dependent upon the willingness to pay (WTP) per QALY loss avoided. Our results show that establishing an optimal level of control can result in a reduction in net monetary loss of billions of pounds, dependent upon the precise WTP value.ConclusionsIt is vital, as the UK emerges from lockdown, but continues to face an on-going pandemic, to accurately establish the overall health and economic costs when making policy decisions. We demonstrate how some of these can be quantified, employing mechanistic infectious disease transmission models to establish optimal levels of control for the ongoing COVID-19 pandemic.
Estimation of local time-varying reproduction numbers in noisy surveillance data
Authors: Li Wenrui , Bulekova Katia , Gregor Brian , White Laura F. , Kolaczyk Eric D. 
Published: April 2021

1AbstractA valuable metric in understanding local infectious disease dynamics is the local time-varying reproduction number, i.e. the expected number of secondary local cases caused by each infected individual. Accurate estimation of this quantity requires distinguishing cases arising from local transmission from those imported from elsewhere. Realistically, we can expect identification of cases as local or imported to be imperfect. We study the propagation of such errors in estimation of the local time-varying reproduction number. In addition, we propose a Bayesian framework for estimation of the true local time-varying reproduction number when identification errors exist. And we illustrate the practical performance of our estimator through simulation studies and with outbreaks of COVID-19 in Hong Kong and Victoria, Australia.