bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does extremely early expression of colostrum after very preterm birth improve mother’s own milk quantity? A cohort study
Authors: Levene Ilana , Quigley Maria A , Fewtrell Mary , O’Brien Frances 
Published: March 2024

ObjectiveAssess the relationship of time to first expression after very preterm birth and mothers’ own milk quantity.DesignA cohort study (nested within a randomised trial).SettingFour neonatal units in the UK.Patients132 mothers of single or twin infants born at 23+0 to 31+6 weeks postmenstrual age.ExposuresTime to the first attempt to express after birth.Primary outcomes24-hour mother’s own milk yield on days 4, 14 and 21 after birth.ResultsMedian time to first expression attempt was 6 hours. 51.7% expressed within 6 hours of birth (62/120) and 48.3% expressed more than 6 hours after birth (58/120). Expressing within 6 hours of birth was associated with higher milk yield on day 4 (88.3 g, 95% CI 7.1 to 169.4) and day 14 (155.7 g, 95% CI 12.2 to 299.3) but not on day 21 (73.6 g, 95% CI −91.4 to 238.7). There was an interaction between expressing frequency and time to first expression (p<0.005), with increased expressing frequency being associated with higher yield only in those who expressed within 6 hours. Expressing within 2 hours of birth was not associated with further milk yield increase.ConclusionsMothers who expressed within 6 hours of birth had higher milk yield, and a greater yield per expressing session, in the first 3 weeks after birth. This information will be highly motivating for families and the clinicians supporting them. There was no evidence of further benefit of extremely early expression (first 2 hours after birth).Trial registration numberISRCTN 16356650.
National COVID-19 preparedness and response plans: a global review from the perspective of services for maternal, newborn, child and adolescent health and older people
Authors: Czerniewska Alexandra , Sharkey Alyssa , Portela Anayda , Drapkin Sarah , Mustafa Saqif 
Published: March 2024

IntroductionInfectious disease outbreaks have historically led to widespread disruptions in routine essential health services. Disruptions due to COVID-19 responses led to excess deaths, including among women and children. This review builds on earlier reviews of essential health services in national COVID-19 response and preparedness plans, focusing specifically on maternal, newborn, child, adolescent and ageing health (MNCAAH) in the context of renewed global emphasis on monitoring, recovering and strengthening these services.MethodsUsing Google searches, we identified publicly available COVID-19 response and preparedness plans authored by a national government body or Public Health Institute from any country, territory and/or area, published between January 2020 and December 2022. We assessed whether each plan considered maintenance of MNCAAH services with related activities, costing or monitoring plans, and whether these considerations were integrated into the national incident management system for COVID-19.ResultsWe identified plans from 110 countries, representing 56% of our sample, in 10 languages. Most plans came from low-income and middle-income countries. Three quarters of dated documents were published between February and April 2020. 22% of plans referenced the impact of COVID-19 on MNCAAH, but only 13% included a planned activity for monitoring or mitigating this impact and less than 5% included relevant indicators, costing or integration of services in the incident management system.ConclusionWe propose that unless content specifically related to the services and needs of these populations is integrated, these services will suffer in a future disruptive event. The COVID-19 response demonstrated the need for an interdisciplinary response to address the unforeseen impacts that arose, yet plans continue to have a narrow focus and a generic approach which may be limiting.
Learning imaging in axial spondyloarthritis: more than just a matter of experience
Authors: Radny Felix , Ziegeler Katharina , Eshed Iris , Greese Juliane , Deppe Dominik , Stelbrink Carsten , Biesen Robert , Haibel Hildrun , Rios Rodriguez Valeria , Rademacher Judith , Protopopov Mikhail , Proft Fabian , Hermann Kay Geert A , Poddubnyy Denis , Diekhoff Torsten , Ulas Sevtap Tugce 
Published: March 2024

ObjectiveReliable interpretation of imaging findings is essential for the diagnosis of axial spondyloarthritis (axSpA) and requires a high level of experience. We investigated experience-dependent differences in diagnostic accuracies using X-ray (XR), MRI and CT.MethodsThis post hoc analysis included 163 subjects with low back pain. Eighty-nine patients had axSpA, and 74 patients had other conditions (mechanical, degenerative or non-specific low back pain). Final diagnoses were established by an experienced rheumatologist before the reading sessions. Nine blinded readers (divided into three groups with different levels of experience) scored the XR, CT and MRI of the sacroiliac joints for the presence versus absence of axSpA. Parameters for diagnostic performance were calculated using contingency tables. Differences in diagnostic performance between the reader groups were assessed using the McNemar test. Inter-rater reliability was assessed using Fleiss kappa.ResultsDiagnostic performance was highest for the most experienced reader group, except for XR. In the inexperienced and semi-experienced group, diagnostic performance was highest for CT&MRI (78.5% and 85.3%, respectively). In the experienced group, MRI showed the highest performance (85.9%). The greatest difference in diagnostic performance was found for MRI between the inexperienced and experienced group (76.1% vs 85.9%, p=0.001). Inter-rater agreement was best for CT in the experienced group with κ=0.87.ConclusionDifferences exist in the learnability of the imaging modalities for axSpA diagnosis. MRI requires more experience, while CT is more suitable for inexperienced radiologists. However, diagnosis relies on both clinical and imaging information.
Impact of cigarette price and tobacco control policies on youth smoking experimentation in Albania
Authors: Merkaj Elvina , Zhllima Edvin , Imami Drini , Gjika Irena , Guerrero-López Carlos Manuel , Drope Jeffrey 
Published: March 2024

BackgroundAlbania has one of the highest smoking prevalence in Europe especially among the youth. There is a lack of evidence in Albania, as well as in most of Eastern Europe and middle-income countries, regarding the effect of price on smoking experimentation.ObjectiveThe study aims to assess the effect of price and tobacco control policies on youth smoking experimentation in Albania.MethodsWe used microdata from the Global Youth Tobacco Survey in Albania for 2004, 2009, 2015 and 2020. We constructed a pseudo-longitudinal dataset and estimated a split-population model to assess the hazard of smoking experimentation.ResultsPrice is a significant predictor of smoking experimentation among teenagers in Albania for both males and females (p<0.001). Being male increases the odds for smoking experimentation by more than 50% as compared with females (p<0.001), whereas females appear to be more price sensitive. Peer and parent smoking are also important determinants for smoking experimentation. Introducing penalties for smokers and legal entities violating smoke-free policies implemented in 2014 is also associated with a lower hazard of smoking experimentation.ConclusionPrice is a significant predictor of smoking experimentation among teenagers in Albania for both males and females. A combination of increasing taxes and strengthening the rule of law to control tobacco use in public spaces, in addition to public awareness campaigns targeting both youth and smoking parents, could help to significantly reduce the probability of smoking experimentation.
Do serial troponins predict the need for cardiac evaluation in trauma patients after ground-level fall?
Authors: Bellini Alyssa R , Ross James T , Larson Madelyn , Pearson Skyler , Robles Anamaria J , Callcut Rachael A 
Published: March 2024

PurposeTroponin T levels are routinely checked in trauma patients after experiencing a ground-level fall to identify potential cardiac causes of syncope. An elevated initial troponin prompts serial testing until the level peaks. However, the high sensitivity of the test may lead to repeat testing that is of little clinical value. Here, we examine the role of serial troponins in predicting the need for further cardiac workup in trauma patients after sustaining a fall.MethodsRetrospective review of all adult trauma activations for ground-level fall from January 1, 2021 to December 31, 2021 in patients who were hemodynamically and neurologically normal at presentation. Outcomes evaluated included need for cardiology consult, admission to cardiology service, outpatient cardiology follow-up, cardiology intervention and in-hospital mortality.ResultsThere were 1555 trauma activations for ground-level fall in the study period. The cohort included 560 patients evaluated for a possible syncopal fall, hemodynamically stable, Glasgow Coma Scale score of 15, and with a troponin drawn at presentation. The initial median troponin was 20 ng/L (13–37). Second troponin values were drawn on 58% (median 33 ng/L (22–52)), with 42% of patients having an increase from first to second test. 29% of patients had a third troponin drawn (median 42 ng/L (26–67)). The initial troponin value was significantly associated with undergoing a subsequent echo (p=0.01), cardiology consult (p<0.01), admission for cardiac evaluation (p<0.01), cardiology follow-up (p<0.01), and in-hospital mortality (p=0.01); the initial troponin was not associated with cardiac intervention (p=0.91). An increase from the first to second troponin was not associated with any of outcomes of interest. Analysis was done with cut-off values of 30 ng/L, 50 ng/L, 70 ng/L, and 90 ng/L; a troponin T threshold of 19 ng/L was significant for cardiology consult (p=0.01) and cardiology follow-up (p=0.04). When the threshold was increased to 50 ng/L, it was also significant for admission for cardiac issue (p<0.01). When the threshold was increased to 90 ng/L, it was significant for the same three outcomes and in-hospital mortality (p=0.04).ConclusionThe initial serum troponin has clinical value in identifying underlying cardiac disease in patients who present after ground-level fall; however, that serial testing is likely of little value. Further, using a cut-off of >50 ng/L as a threshold for further clinical evaluation would improve the utility of the test and likely reduce unnecessary hospital stays and costs for otherwise healthy patients.Level of evidenceLevel III.
Optimal Re-Materialization Strategies for Heterogeneous Chains: How to Train Deep Neural Networks with Limited Memory
Authors: Beaumont Olivier , Eyraud-Dubois Lionel , Herrmann Julien , Joly Alexis , Shilova Alena 
Published: March 2024

Training in Feed Forward Deep Neural Networks is a memory-intensive operation which is usually performed on GPUs with limited memory capacities. This may force data scientists to limit the depth of the models or the resolution of the input data if data does not fit in the GPU memory. The re-materialization technique, whose idea comes from the checkpointing strategies developed in the Automatic Differentiation literature, allows data scientists to limit the memory requirements related to the storage of intermediate data (activations), at the cost of an increase in the computational cost.
This paper introduces a new strategy of re-materialization of activations that significantly reduces memory usage. It consists in selecting which activations are saved and which activations are deleted during the forward phase and then recomputing the deleted activations when they are needed during the backward phase.
We propose an original computation model that combines two types of activation savings: either only storing the layer inputs or recording the complete history of operations that produced the outputs. This paper focuses on the fully heterogeneous case, where the computation time and the memory requirement of each layer is different. We prove that finding the optimal solution is NP-hard and that classical techniques from Automatic Differentiation literature do not apply. Moreover, the classical assumption of memory persistence of materialized activations, used to simplify the search of optimal solutions, does not hold anymore. Thus, we propose a weak memory persistence property and provide a dynamic program to compute the optimal sequence of computations.

This algorithm is made available through the
Rotor
software, a PyTorch plug-in dealing with any network consisting of a sequence of layers, each of them having an arbitrarily complex structure. Through extensive experiments, we show that our implementation consistently outperforms existing re-materialization approaches for a large class of networks, image sizes, and batch sizes.
Abstract A111: Development and analytical validation of a multiplexed targeted mass spectrometry assay to detect ovarian cancer protein biomarkers in sera
Authors: Ryu Joohyun , Boylan Kristin L. M. , Twigg Carly A. I. , Evans Richard , Skubitz Amy P. N. , Thomas Stefani N. 
Published: March 2024

Abstract
Background: Ovarian cancer is the most lethal gynecologic malignancy in women, and high-grade serous ovarian cancer (HGSOC) is the most common subtype. Currently, no clinical test has been approved by the FDA for the detection of ovarian cancer in the general population. This underscores the critical need for the development of a robust methodology combined with novel technology to detect diagnostic biomarkers for HGSOC in the sera of women. Targeted mass spectrometry (MS) can be used to identify and quantify specific peptides/proteins in complex biological samples with high accuracy, sensitivity, and reproducibility. In this study, we developed and conducted analytical validation of a multiplexed Tier 2 targeted MS parallel reaction monitoring (PRM) assay for the relative quantification of 23 ovarian cancer protein biomarker candidates in sera. Methods: To develop a PRM method for our target peptides, we followed nationally recognized consensus guidelines for validating fit-for-purpose Tier 2 targeted mass spectrometry (MS) assays. The endogenous target peptide concentrations were calculated using the calibration curves for each target peptide. Receiver operating characteristic (ROC) curves were analyzed to evaluate the diagnostic performance of the biomarker candidates. Results: We describe the development and analytical validation of a multiplexed Tier 2 targeted MS PRM assay to quantify ovarian cancer protein biomarker candidates in sera. Among the 64 peptides corresponding to 23 proteins in our PRM assay, 24 peptides corresponding to 16 proteins passed the assay validation acceptability criteria. Six of these peptides from insulin-like growth factor-binding protein 2 (IBP2), sex hormone-binding globulin (SHBG), and TIMP metalloproteinase inhibitor 1 (TIMP1) were quantified in sera from a cohort of 69 patients with early-stage HGSOC, late-stage HGSOC, benign ovarian conditions, and healthy (non-cancer) controls. IBP2 was identified as a diagnostic biomarker candidate based on its significantly increased abundance in the late-stage HGSOC patient sera compared to the healthy controls and patients with benign ovarian conditions. Conclusions: This study developed and validated a multiplexed targeted MS PRM assay for diagnostic biomarker analysis in HGSOC. To evaluate the clinical utility of IBP2 for HGSOC detection, further studies need to be performed using a larger patient cohort.
Citation Format: Joohyun Ryu, Kristin L. M. Boylan, Carly A. I. Twigg, Richard Evans, Amy P. N. Skubitz, Stefani N. Thomas. Development and analytical validation of a multiplexed targeted mass spectrometry assay to detect ovarian cancer protein biomarkers in sera [abstract]. In: Proceedings of the AACR Special Conference on Ovarian Cancer; 2023 Oct 5-7; Boston, Massachusetts. Philadelphia (PA): AACR; Cancer Res 2024;84(5 Suppl_2):Abstract nr A111.
Chronic Stress Exacerbates the Immunosuppressive Microenvironment and Progression of Gliomas by Reducing Secretion of CCL3
Authors: Wang Xu , Zhang Long , Zhou Yi , Wang Yan , Wang Xiang , Zhang Yining , Quan Ankang , Mao Yufei , Zhang Yu , Qi Ji , Ren Zhongyu , Gu Linbo , Yu Rutong , Zhou Xiuping 
Published: March 2024

AbstractAs understanding of cancer has deepened, increasing attention has been turned to the roles of psychological factors, especially chronic stress–induced depression, in the occurrence and development of tumors. However, whether and how depression affects the progression of gliomas are still unclear. In this study, we have revealed that chronic stress inhibited the recruitment of tumor-associated macrophages (TAM) and other immune cells, especially M1-type TAMs and CD8+ T cells, and decreased the level of proinflammatory cytokines in gliomas, leading to an immunosuppressive microenvironment and glioma progression. Mechanistically, by promoting the secretion of stress hormones, chronic stress inhibited the secretion of the chemokine CCL3 and the recruitment of M1-type TAMs in gliomas. Intratumoral administration of CCL3 reprogrammed the immune microenvironment of gliomas and abolished the progression of gliomas induced by chronic stress. Moreover, levels of CCL3 and M1-type TAMs were decreased in the tumor tissues of glioma patients with depression, and CCL3 administration enhanced the antitumor effect of anti–PD-1 therapy in orthotopic models of gliomas undergoing chronic stress. In conclusion, our study has revealed that chronic stress exacerbates the immunosuppressive microenvironment and progression of gliomas by reducing the secretion of CCL3. CCL3 alone or in combination with an anti–PD-1 may be an effective immunotherapy for the treatment of gliomas with depression.See related Spotlight by Cui and Kang, p. 514.
Abstract P36: BIOLOGY IN ACUTE LYMPHOBLASTIC LEUKEMIA FROM DIAGNOSIS TO FOLLOW-UP: A STUDY OF 48CASES
Authors: Koundio Abou A , Ndour Moussa , Diouf Mame Ndella , Akonde Fatou Binetou , Toure Awa Oumar , Raphael Martine 
Published: March 2024

Abstract
OBJECTIVE: ALL is the most common cancer in children and the most common cause of cancer death before the age of 20. In low- and middle-income countries, ALL is associated with poor outcomes. Many constraints are at the root of management failures. Therefore, in view of the progressive improvements in the efficacy of chemotherapeutic regimens, we deemed it necessary to conduct this study, the objective of which is to evaluate the role of biology in the management of children with ALL in the Oncopediatric Unit of Dakar. METHODS: This is a prospective analytical study that started on November 15th, 2021 at the UOP in collaboration with the hematology and immunology laboratories. All newly diagnosed patients with ALL based-on cytology and/or immunophenotyping, treated according to the ALL-GFAOP protocol and registered in the REDcap database are included. RESULTS: From November, 15th 2021 to July, 31th 2023, 48 patients were diagnosed with de novo ALL. With an average age of 7.8 years, female represented the main group (52,08%). According to immunophenotyping, the B profile was found in 25.0 % and the T profile in 22.9 %. The ALL T group was older (9.2 vs 4.4 years) and have had higher platelet counts (122272.7 vs 46916.7) at diagnosis than the ALL B group. This latter had higher hemoglobin (7.4 vs 6.8), white blood cell (127296.2 vs 56511.2) and blast counts at diagnosis in peripheral blood (69.4% vs 55.1%) and also in bone marrow (84.2% vs 72.5%) and higher rate of residual blast counts at Day8 after induction (9198.4 vs 1301.4). Regarding corticosensitivity at D8 of induction, no difference was found according to the number of blasts, the hemoglobinlevel and the immunological profile at diagnosis. However, patients with hyperleukocytic ALL with a relatively higher platelet count were more sensitive to corticosteroid therapy. CONCLUSIONS: Understanding the biology of acute ALL is of major interest in the effectiveness of therapeutic approaches to this type of hematology malignancies.
Citation Format: Abou A Koundio, Moussa Ndour, Mame Ndella Diouf, Fatou Binetou Akonde, Awa Oumar Toure, Martine Raphael. BIOLOGY IN ACUTE LYMPHOBLASTIC LEUKEMIA FROM DIAGNOSIS TO FOLLOW-UP: A STUDY OF 48CASES [abstract]. In: Proceedings of the Blood Cancer Discovery Symposium; 2024 Mar 4-6; Boston, MA. Philadelphia (PA): AACR; Blood Cancer Discov 2024;5(2_Suppl):Abstract nr P36.
Retinal waves in adaptive rewiring networks orchestrate convergence and divergence in the visual system
Authors: Luna Raúl , Li Jia , Bauer Roman , van Leeuwen Cees 
Published: March 2024

Abstract
Spontaneous retinal wave activity shaping the visual system is a complex neurodevelopmental phenomenon. Retinal ganglion cells are the hubs through which activity diverges throughout the visual system. We consider how these divergent hubs emerge, using an adaptively rewiring neural network model. Adaptive rewiring models show in a principled way how brains could achieve their complex topologies. Modular small-world structures with rich-club effects and circuits of convergent-divergent units emerge as networks evolve, driven by their own spontaneous activity. Arbitrary nodes of an initially random model network were designated as retinal ganglion cells. They were intermittently exposed to the retinal waveform, as the network evolved through adaptive rewiring. A significant proportion of these nodes developed into divergent hubs within the characteristic complex network architecture. The proportion depends parametrically on the wave incidence rate. Higher rates increase the likelihood of hub formation, while increasing the potential of ganglion cell death. In addition, direct neighbors of designated ganglion cells differentiate like amacrine cells. The divergence observed in ganglion cells resulted in enhanced convergence downstream, suggesting that retinal waves control the formation of convergence in the lateral geniculate nuclei. We conclude that retinal waves stochastically control the distribution of converging and diverging activity in evolving complex networks.
SmallTAL: Real-Time Egocentric Online Temporal Action Localization for the Data-Impoverished
Authors: Joyce Eric C. , Chen Yao , Neeter Eduardo , Mordohai Philippos 
Published: March 2024

Abstract
We propose a real-time, online temporal action localization system that requires a small amount of annotated data. The main challenges we address are high intra-class variability and a large and diverse background class. We address these using a flexible frame descriptor, dynamic time warping, and a novel approach to database construction. Our solution receives egocentric RGB-D streams as input and makes predictions at regular temporal intervals. We validate our approach by localizing actions in a digital twin of an electrical substation, in which certain objects have been replaced by functional virtual replicas.