bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bilateral diffuse uveal melanocytic proliferation with multifocal diffuse integumentary melanocytic proliferation paraneoplastic syndrome: A case report
Authors: Navarrete‐Dechent Cristián , Monnier Jilliana , Marghoob Nadeem G , Liopyris Konstantinos , Busam Klaus J , Francis Jasmine H , Marghoob Ashfaq A 
Published: May 2021

AbstractBilateral diffuse uveal melanocytic proliferation (B‐DUMP) is a rare paraneoplastic syndrome typically presenting with bilateral visual loss. B‐DUMP is associated with extraocular systemic malignancies with the most common being lung cancer in males and uro‐gynaecological cancer in females (mainly ovarian cancer). Cutaneous and/or mucosal involvement in patients with B‐DUMP has been reported but it is not well characterised. Herein, we present a female in her 70s with diagnosis of stage IV vaginal clear‐cell carcinoma and metastatic melanoma of unknown primary that developed progressive bilateral loss of visual acuity compatible with ‘B‐DUMP’. Simultaneously, she developed multifocal bilateral bluish‐greyish patches on the skin that were shown to have a proliferation of dermal melanocytes. We propose that the clinical and histopathologic cutaneous findings seen in patients with B‐DUMP be termed ‘diffuse integumentary melanocytic proliferation (DIMP)’.
Primary HPV cervical screening: Clinical audit of outcomes of women seen at a tertiary referral centre for colposcopy in Australia
Authors: Chin Felicia H. X. , Wrede C. David H. , Richards Anthony , Steele Angela , Vicario Estefania , McNally Orla M. , Tan Jeffrey H. J. 
Published: May 2021

BackgroundPrimary human papillomavirus (HPV) screening was introduced in Australia in December 2017.AimsOutcomes for women after positive HPV in their cervical screening test (CST).Materials and MethodsA retrospective observational study of 4458 women seen at the Royal Women’s Hospital Colposcopy Clinic from 1 January 2018 to 31 July 2020.ResultsHPV16/18 was positive (considered higher‐risk CST) in 42.2% of women in the study, 16.6% with reflex possible with high‐grade squamous intraepithelial lesions (pHSIL) or worse and 54.9% with normal cytology. There were 24.8% of women with positive HPV16/18 who had histological confirmed cervical intraepithelial neoplasia grade 2 or worse (CIN2+), 10.3% CIN2+ (including six cancers) among women with reflex negative cytology and 87.7% CIN2+ among women with reflex HSIL cytology. In women with positive HPV (not 16/18), CIN2+ was found in 60.2% with reflex pHSIL or worse cytology (higher risk) and 10.2% with reflex low‐grade SIL (LSIL) or normal cytology (intermediate risk). Median waiting time to colposcopy with the intermediate‐risk group went up to 181 days. Our colposcopists were able to achieve a positive predictive value (PPV) for CIN2+ of 69.9%, higher than 57.8% PPV in the National Cervical Screening Program (NCSP) 2020 monitoring report. Women with type 3 transformation zone on colposcopy could be followed up with CST if no HSIL was suspected on screening or at colposcopy as their risk of CIN2+ was only 2.5%.ConclusionsOur findings support direct referral to colposcopy for women with higher‐risk CST, with all cancers confined to this group. The NCSP recommendation to refer for colposcopy only after three intermediate‐risk CST will need monitoring with the LSIL triage group.
Predicting QT interval prolongation in patients diagnosed with the 2019 novel coronavirus infection
Authors: Zhao Wei , Gandhi Nikhil , Affas Saif , Szpunar Susan , Mesiha Nancy , Saravolatz Louis 
Published: May 2021

AbstractIntroduction2019 novel coronavirus (COVID‐19) patients frequently develop QT interval prolongation that predisposes them to Torsades de Pointes and sudden cardiac death. Continuous cardiac monitoring has been recommended for any COVID‐19 patient with a Tisdale Score of seven or more. This recommendation, however, has not been validated.MethodsWe included 178 COVID‐19 patients admitted to a non‐intensive care unit setting of a tertiary academic medical center. A receiver operating characteristics curve was plotted to determine the accuracy of the Tisdale Score to predict QT interval prolongation. Multivariable analysis was performed to identify additional predictors.ResultsThe area under the curve of the Tisdale Score was 0.60 (CI 95%, 0.46–0.75). Using the cutoff of seven to stratify COVID‐19, patients had a sensitivity of 85.7% and a specificity of 7.6%. Risk factors independently associated with QT interval prolongation included a history of end‐stage renal disease (ESRD) (OR, 6.42; CI 95%, 1.28–32.13), QTc ≥450 ms on admission (OR, 5.90; CI 95%, 1.62–21.50), and serum potassium ≤3.5 mmol/L during hospitalization (OR, 4.97; CI 95%, 1.51–16.36).ConclusionThe Tisdale Score is not a useful tool to stratify hospitalized non‐critical COVID‐19 patients based on their risks of developing QT interval prolongation. Clinicians should initiate continuous cardiac monitoring for patients who present with a history of ESRD, QTc ≥450 ms on admission or serum potassium ≤3.5 mmol/L.
Information criteria for inhomogeneous spatial point processes
Authors: Choiruddin Achmad , Coeurjolly Jean‐François , Waagepetersen Rasmus 
Published: May 2021

SummaryThe theoretical foundation for a number of model selection criteria is established in the context of inhomogeneous point processes and under various asymptotic settings: infill, increasing domain and combinations of these. For inhomogeneous Poisson processes we consider Akaike's information criterion and the Bayesian information criterion, and in particular we identify the point process analogue of ‘sample size’ needed for the Bayesian information criterion. Considering general inhomogeneous point processes we derive new composite likelihood and composite Bayesian information criteria for selecting a regression model for the intensity function. The proposed model selection criteria are evaluated using simulations of Poisson processes and cluster point processes.
Mental health literacy: A systematic review of knowledge and beliefs about mental disorders in Malaysia
Authors: Munawar Khadeeja , Mukhtar Firdaus , Choudhry Fahad Riaz , Ng Alvin Lai Oon 
Published: May 2021

AbstractBackgroundMental health problems in Malaysia are on a rise. This study aimed at performing a systematic review of mental health literacy (MHL) in Malaysia.MethodsMedline, Embase, ERIC/Proquest, ScienceDirect, Pubmed, PsycINFO, CINAHL, Scopus, EBM Reviews ‐ Cochrane Central Register of Controlled Trials, Ovid Emcare and reference lists of included studies were searched in February 2020. Studies that evaluated at least one of the main components of MHL, including (1) knowledge related to mental health issues, and (2) stigma, were included irrespective of study design. As secondary findings, the review also synthesized results related to facilitators and barriers to seeking mental health services. Depending on the research design, the quality of each study was assessed through checklists.ResultsForty six studies published between 1995 to 2019 were included. Most studies used cross‐sectional designs to investigate MHL. Findings indicate that most Malaysians have stigmatizing attitudes towards mental health problems. Participants in the included studies endorsed multifactorial explanations of mental health issues with a dominance of supernatural and religious aetiologies. Likewise, the commonest barrier was considering sources other than professional sources of mental‐health services. Presence of adequate knowledge and considering providers as competent facilitated help‐seeking. Additionally, there was considerable heterogeneity in studies and a lack of standardized measures assessing MHL.ConclusionsThere is an increase in studies on MHL in Malaysia. A few of these studies, based on experimental design, have shown positive effects. Researchers, practitioners, and policymakers should develop standardized measures and interventional studies based on all the components of MHL.
Rapid‐acting antidepressants and the regulation of TrkB neurotrophic signalling—Insights from ketamine, nitrous oxide, seizures and anaesthesia
Authors: Kohtala Samuel , Rantamäki Tomi 
Published: May 2021

AbstractIncreased glutamatergic neurotransmission and synaptic plasticity in the prefrontal cortex have been associated with the rapid antidepressant effects of ketamine. Activation of BDNF (brain‐derived neurotrophic factor) receptor TrkB is considered a key molecular event for antidepressant‐induced functional and structural synaptic plasticity. Several mechanisms have been proposed to underlie ketamine's effects on TrkB, but much remains unclear. Notably, preliminary studies suggest that besides ketamine, nitrous oxide (N2O) can rapidly alleviate depressive symptoms. We have shown nitrous oxide to evoke TrkB signalling preferentially after the acute pharmacological effects have dissipated (ie after receptor disengagement), when slow delta frequency electroencephalogram (EEG) activity is up‐regulated. Our findings also demonstrate that various anaesthetics and sedatives activate TrkB signalling, further highlighting the complex mechanisms underlying TrkB activation. We hypothesize that rapid‐acting antidepressants share the ability to regulate TrkB signalling during homeostatically evoked slow‐wave activity and that this mechanism is important for sustained antidepressant effects. Our observations urge the examination of rapid and sustained antidepressant effects beyond conventional receptor pharmacology by focusing on brain physiology and temporally distributed signalling patterns spanning both wake and sleep. Potential implications of this approach for the improvement of current therapies and discovery of novel antidepressants are discussed.
Emotion network density is a potential clinical marker for anxiety and depression: Comparison of ecological momentary assessment and daily diary
Authors: Shin Ki Eun , Newman Michelle G. , Jacobson Nicholas C. 
Published: May 2021

ObjectivesUsing two intensive longitudinal data sets with different timescales (90 minutes, daily), we examined emotion network density, a metric of emotional inflexibility, as a predictor of clinical‐level anxiety and depression.DesignMobile‐based intensive longitudinal assessments.Methods119 participants (61 anxious and depressed, 58 healthy controls) completed ecological momentary assessment (EMA) to rate a variety of negative (NE) and positive emotions (PE) 9 times per day for 8 days using a mobile phone application. 169 participants (97 anxious and depressed and 72 healthy controls) completed an online daily diary on their NE and PE for 50 days. Multilevel vector autoregressive models were run to compute NE and PE network densities in each data set.ResultsIn the EMA data set, both NE and PE network densities significantly predicted participants’ diagnostic status above and beyond demographics and the mean and standard deviation of NE and PE. Greater NE network density and lower PE network density were associated with anxiety and depression diagnoses. In the daily diary data set, NE and PE network densities did not significantly predict the diagnostic status.ConclusionsGreater inflexibility of NE and lower inflexibility of PE, indexed by emotion network density, are potential clinical markers of anxiety and depressive disorders when assessed at intra‐daily levels as opposed to daily levels. Considering emotion network density, as well as the mean level and variability of emotions in daily life, may contribute to diagnostic prediction of anxiety and depressive disorders.Practitioner points

Emotion network density, or the degree to which prior emotions predict and influence current emotions, indicates an inflexible or change‐resistant emotion system.

Emotional inflexibility or change resistance over a few hours, but not daily, may characterize anxiety and depressive disorders.

Inflexible negative emotion systems are associated with anxiety and depressive disorders, whereas inflexible positive emotion systems may indicate psychological health.

Considering emotional inflexibility within days may provide additional information beyond demographics and mean level and variability of emotions in daily life for detecting anxiety and depressive disorders.
The influence of policy and context on teachers’ social media use
Authors: Greenhalgh Spencer P. , Rosenberg Joshua M. , Russell Annelise 
Published: May 2021

AbstractResearch on teachers’ use of social media has typically assumed that it is a) driven by a need for professional learning and b) best understood in terms of individual motivations. In this study, we use a dataset of nearly 600,000 tweets posted to one or more of 48 Regional Educational Twitter Hashtags associated with 44 U.S. states. To explore the influence of local contextual factors on hashtag‐ and account‐level activity in these hashtags, we use an analytic approach heretofore uncommon in social media‐focussed education research: generalised linear and multilevel modelling. At the hashtag level, higher numbers of teachers within a state, proportions of students receiving subsidised meals, student‐to‐teacher ratios, and amounts of state spending per child are associated with more activity within a regional hashtag; by contrast, more left‐leaning state governments and citizenries are associated with less activity. At the account level, more experienced accounts and accounts in more right‐leaning states contribute more tweets to these hashtags. These findings reinforce established understandings of Twitter as a site for teacher learning; however, they also underline the importance of acknowledging other important purposes of teachers’ Twitter use, including receiving emotional support and engaging in activism.Practitioner notesWhat is already known about this topic

Many teachers use Twitter (and other social media platforms) for professional purposes.
Teachers have identified professional learning—among other purposes—as motivating their use of Twitter.
Regional Educational Twitter Hashtags are diverse learning spaces for teachers and other education stakeholders.
What this paper adds

Local context and policy factors help influence teachers’ use of Twitter.
Teachers may turn to Twitter because of a lack of emotional or political support—not just a lack of material support or professional development opportunities.
Individual and idiosyncratic factors remain important in explaining teachers’ engagement with social media.
Implications for practice and/or policy

Informal spaces like social media may supplement formal support mechanisms for teachers.
Teachers’ use of social media may help administrators and policymakers identify existing gaps to be repaired in those formal support mechanisms.
Support for teachers should be conceived holistically and include emotional and political support.
Adapting educational practices in emergency remote education: Continuity and change from a student perspective
Authors: Manca Stefania , Delfino Manuela 
Published: May 2021

AbstractIn this study, we adopt an ecological perspective to reflect on how a specific Italian school cluster adapted to the challenges of the COVID‐19 pandemic by focusing on how students experienced the interplay between continuity and change in school teaching and learning practices caused by the pandemic. Specifically, the study investigates how the school's physical/virtual learning system was (re)configured to provide new opportunities for learning to a thousand‐plus population of primary and secondary students, and how they reacted to the transition to distance learning in terms of participation, autonomy, motivation and engagement. The research adopts a mixed method approach, based on school management system data and a survey tool, and analyses the students’ response to the emergency from the perspectives of the students themselves, their teachers and their parents. While these converged in positive evaluation of the experience, a number of lessons were learnt, such as the importance of building on favourable pre‐existing conditions and leveraging a solid shared school culture to promote a prompt reaction to the emergency. Significantly, students with an immigrant background displayed varying degrees of participation in online activities. Overall, for each of the three stakeholder groups surveyed, solid pre‐existing digital competence levels and close collaboration within the school community were the most important factors for non‐traumatic transition to distance learning.Practitioner notesWhat is already known about this topic?Research on the relationship between the COVID‐19 pandemic and the effects on teaching and learning processes is constantly increasing.Most recently published studies focus on higher education, while very few investigate the impact of the COVID‐19 pandemic on K‐12 education.Very few papers have studied the interplay between change and continuity within an educational ecosystem in times of crisis.What this paper adds?This is one of the first studies to analyse the process of systematic transition from onsite learning to online learning within the Italian school system in response to the pandemic.This study employs a multiple perspective research approach to analyse Emergency Remote Education in a sizeable school cluster, with a specific focus on student response.Teachers, students and their families all saw solid pre‐existing digital competence and close school community collaboration as key factors facilitating rapid adjustment to the emergency.Implications for practice and policyHaving a solid common school culture to rely on facilitates prompt emergency reaction.Encouraging the creation of professional communities of practice that comprise both expert and novice teachers can help prepare educators to deal with an educational emergency through adoption and appropriate use of technological solutions.Collaboration between school and families proves to be a key factor for dealing with emergencies.
Risk stratification in men with a negative prostate biopsy: an interim analysis of a prospective cohort study
Authors: Sandahl Mads , Pedersen Bodil Ginnerup , Ulhøi Benedicte Parm , Borre Michael , Sørensen Karina Dalsgaard 
Published: May 2021

ObjectiveTo investigate whether a risk score for prostate cancer (PCa) lifetime risk can be used to optimise triaging of patients with a negative prostate biopsy, but under sustained suspicion of PCa.Patients and MethodsIn this prospective clinical study, we included, and risk scored patients who had a PCa‐negative transrectal ultrasonography (TRUS)‐guided prostate biopsy, but elevated prostate‐specific antigen (PSA), a suspicious prostate digital rectal examination and/or a positive family history (FH) of PCa. The risk score estimated individual lifetime risk of PCa, based on a polygenic risk score (33 single nucleotide polymorphisms), age, and FH of PCa. Patients were followed, under urological supervision, for up to 4 years with annual controls, always including PSA measurements. Multiparametric magnetic resonance imaging (mpMRI) and/or prostate biopsy was performed at selected annual controls depending on risk score and at the urologist’s/patient’s discretion, which means that the follow‐up differed based on the risk score.ResultsWe included 429 patients. After risk scoring, 376/429 (88%) patients were allocated to a normal‐risk group (<30% PCa lifetime risk) and 53/429 (12%) to a high‐risk group (≥30% PCa lifetime risk). The high‐risk group had significantly different follow‐up, with more biopsy and mpMRI sessions compared to the normal‐risk group. PCa was detected in 89/429 (21%) patients, with 67/376 (18%) patients diagnosed in the normal‐risk group and 22/53 (42%) in the high‐risk group. There was no statistically significant difference in the cumulative incidence of PCa between the normal‐risk group and the high‐risk group after 4 years of follow‐up. Currently, 67/429 (16%) patients are still being followed in this ongoing study.ConclusionIn a 4‐year perspective, our PCa lifetime risk score did not demonstrate significant prognostic value for triaging patients, with a negative TRUS‐guided biopsy and sustained suspicion of PCa.
Assessment of prostate‐specific antigen screening: an evidence‐based report by the German Institute for Quality and Efficiency in Health Care
Authors: Paschen Ulrike , Sturtz Sibylle , Fleer Daniel , Lampert Ulrike , Skoetz Nicole , Dahm Philipp 
Published: May 2021

ContextProstate‐specific antigen (PSA) testing increases prostate cancer diagnoses and reduces long‐term disease‐specific mortality, but also results in overdiagnoses and treatment‐related harms.ObjectiveTo systematically assess the benefits and harms of population‐based PSA screening and the potential net benefit to inform health policy decision‐makers in Germany.Evidence AcquisitionWe performed a protocol‐guided comprehensive literature search according to the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) statement. All steps were performed by one or two investigators; any discrepancies were resolved by consensus. To allow subgroup analyses for identifying the optimal screening parameters, the eight national trials conducted under the umbrella of the European Randomised study of Screening for Prostate Cancer (ERSPC) were included as individual trials.Evidence SynthesisWe included a total 11 randomised controlled trials (RCTs) with a total of 416 000 study participants. For all‐cause mortality, we found neither benefit nor harm. PSA screening was associated with a reduced risk of both prostate cancer mortality and the development of metastases. For the outcomes of health‐related quality of life, adverse effects and the consequences of false‐negative screening results there was no difference; however, this was due to the lack of eligible RCT data. Finally, PSA screening was associated with large numbers of overdiagnoses with adverse downstream consequences of unnecessary treatment (e.g. incontinence, erectile dysfunction) and large numbers of false‐positive PSA tests leading to biopsies associated with a small but not negligible risk of complications. Limitations of this assessment include the clinical heterogeneity and methodological limitations of the underlying studies.ConclusionsThe benefits of PSA‐based prostate cancer screening do not outweigh its harms. We failed to identify eligible screening studies of newer biomarkers, PSA derivatives or modern imaging modalities, which may alter the balance of benefit to harm.Patient SummaryIn the present study, we reviewed the evidence on the PSA blood test to screen men without symptoms for prostate cancer. We found that the small benefits experienced by some men do not outweigh the harms to many more men.