bluuebunny/crossref_metadata_2025_split huggingface dataset:
Autonomous screening for laser photocoagulation in fundus images using deep learning
Authors: Bressler Idan , Aviv Rachelle , Margalit Danny , Rom Yovel , Ianchulev Tsontcho , Dvey-Aharon Zack 
Published: May 2023

BackgroundDiabetic retinopathy (DR) is a leading cause of blindness in adults worldwide. Artificial intelligence (AI) with autonomous deep learning algorithms has been increasingly used in retinal image analysis, particularly for the screening of referrable DR. An established treatment for proliferative DR is panretinal or focal laser photocoagulation. Training autonomous models to discern laser patterns can be important in disease management and follow-up.MethodsA deep learning model was trained for laser treatment detection using the EyePACs dataset. Data was randomly assigned, by participant, into development (n=18 945) and validation (n=2105) sets. Analysis was conducted at the single image, eye, and patient levels. The model was then used to filter input for three independent AI models for retinal indications; changes in model efficacy were measured using area under the receiver operating characteristic curve (AUC) and mean absolute error (MAE).ResultsOn the task of laser photocoagulation detection: AUCs of 0.981, 0.95, and 0.979 were achieved at the patient, image, and eye levels, respectively. When analysing independent models, efficacy was shown to improve across the board after filtering. Diabetic macular oedema detection on images with artefacts was AUC 0.932 vs AUC 0.955 on those without. Participant sex detection on images with artefacts was AUC 0.872 vs AUC 0.922 on those without. Participant age detection on images with artefacts was MAE 5.33 vs MAE 3.81 on those without.ConclusionThe proposed model for laser treatment detection achieved high performance on all analysis metrics and has been demonstrated to positively affect the efficacy of different AI models, suggesting that laser detection can generally improve AI-powered applications for fundus images.
1 Platelet dysfunction in a model of complex military trauma
Authors: Chitambira Herbert , Bates Mark , Watts Sara , Kirkman Emrys 
Published: May 2023

BackgroundHaemorrhage is a principal contributory factor in trauma-related deaths in military (battlefield) and civilian settings. A significant proportion of severely injured casualties develop an early trauma- induced coagulopathy (TIC), which is an independent predictor of death. One aspect of TIC is an alteration in platelet function. In vivo trauma models are often essential to develop new treatments. The aim of this study was to evaluate whether an established model of trauma incorporates platelet dysfunction.MethodThe study was conducted in accordance with the Animals (Scientific Procedures) Act, 1986. Blood was collected from terminally anaesthetised pigs before (Baseline) and 30 minutes after the induction of trauma/haemorrhagic shock (S30), and again after 90 minutes of hypotensive resuscitation (R90) with either 0.9% saline, 1:1 packed red cells and plasma (PRBC:FFP) or whole blood (WB). Platelet function was assessed by aggregometry in response to ADP and TRAP (Multiplate®). Platelet count was obtained using a haematology analyser, and shock was quantified by measuring Actual Base Excess (ABE) of arterial blood.ResultsABE fell significantly from Baseline to S30 and remained negative (-7 ± 1 mM) until R90 in all groups (P<0.001), without significant difference between groups (P=0.4747). Injury, shock and resuscitation were associated with a significant fall in platelet aggregation in response to ADP (P<0.0001) and TRAP (P=0.0006), but no difference between treatment groups (P=0.9388 ADP; P=0.06385 TRAP). The response to TRAP was markedly less than that to ADP. Platelet count fell significantly (P<0.0001), again without significant difference between treatment groups (P=0.8574). After 90 minutes of resuscitation, the response to ADP had fallen to 62% of the baseline response while platelet numbers had only fallen to 85% of baseline over the same period.ConclusionsOur model of trauma results in an attenuation of platelet function that, in the early phase, is independent of resuscitation strategy.
Implementation of the YEARS algorithm to optimise pulmonary embolism diagnostic workup in the emergency department
Authors: Duffy Juliana , Berger Ferco Henricus , Cheng Ivy , Shelton Dominick , Galanaud Jean-Philippe , Selby Rita , Laing Kristine , Fedorovsky Tali , Matelski John , Hall Justin 
Published: May 2023

BackgroundExcessive use of CT pulmonary angiography (CTPA) to investigate pulmonary embolism (PE) in the emergency department (ED) contributes to adverse patient outcomes. Non-invasive D-dimer testing, in the context of a clinical algorithm, may help decrease unnecessary imaging but this has not been widely implemented in Canadian EDs.AimTo improve the diagnostic yield of CTPA for PE by 5% (absolute) within 12 months of implementing the YEARS algorithm.Measures and designSingle centre study of all ED patients >18 years investigated for PE with D-dimer and/or CTPA between February 2021 and January 2022. Primary and secondary outcomes were the diagnostic yield of CTPA and frequency of CTPA ordered compared with baseline. Process measures included the percentage of D-dimer tests ordered with CTPA and CTPAs ordered with D-dimers <500 µg/L Fibrinogen Equivalent Units (FEU). The balancing measure was the number of PEs identified on CTPA within 30 days of index visit. Multidisciplinary stakeholders developed plan- do-study-act cycles based on the YEARS algorithm.ResultsOver 12 months, 2695 patients were investigated for PE, of which 942 had a CTPA. Compared with baseline, the CTPA yield increased by 2.9% (12.6% vs 15.5%, 95% CI −0.06% to 5.9%) and the proportion of patients that underwent CTPA decreased by 11.4% (46.4% vs 35%, 95% CI −14.1% to −8.8%). The percentage of CTPAs ordered with a D-dimer increased by 26.3% (30.7% vs 57%, 95% CI 22.2% 30.3%) and there were two missed PE (2/2695, 0.07%).ImpactImplementing the YEARS criteria may safely improve the diagnostic yield of CTPAs and reduce the number of CTPAs completed without an associated increase in missed clinically significant PEs. This project provides a model for optimising the use of CTPA in the ED.
External validation of triage tools for adults with suspected COVID-19 in a middle-income setting: an observational cohort study
Authors: Marincowitz Carl , Sbaffi Laura , Hasan Madina , Hodkinson Peter , McAlpine David , Fuller Gordon , Goodacre Steve , Bath Peter A , Omer Yasein , Wallis Lee A 
Published: May 2023

BackgroundTools proposed to triage ED acuity in suspected COVID-19 were derived and validated in higher income settings during early waves of the pandemic. We estimated the accuracy of seven risk-stratification tools recommended to predict severe illness in the Western Cape, South Africa.MethodsAn observational cohort study using routinely collected data from EDs across the Western Cape, from 27 August 2020 to 11 March 2022, was conducted to assess the performance of the PRIEST (Pandemic Respiratory Infection Emergency System Triage) tool, NEWS2 (National Early Warning Score, version 2), TEWS (Triage Early Warning Score), the WHO algorithm, CRB-65, Quick COVID-19 Severity Index and PMEWS (Pandemic Medical Early Warning Score) in suspected COVID-19. The primary outcome was intubation or non-invasive ventilation, death or intensive care unit admission at 30 days.ResultsOf the 446 084 patients, 15 397 (3.45%, 95% CI 34% to 35.1%) experienced the primary outcome. Clinical decision-making for inpatient admission achieved a sensitivity of 0.77 (95% CI 0.76 to 0.78), specificity of 0.88 (95% CI 0.87 to 0.88) and the negative predictive value (NPV) of 0.99 (95% CI 0.99 to 0.99). NEWS2, PMEWS and PRIEST scores achieved good estimated discrimination (C-statistic 0.79 to 0.82) and identified patients at risk of adverse outcomes at recommended cut-offs with moderate sensitivity (>0.8) and specificity ranging from 0.41 to 0.64. Use of the tools at recommended thresholds would have more than doubled admissions, with only a 0.01% reduction in false negative triage.ConclusionNo risk score outperformed existing clinical decision-making in determining the need for inpatient admission based on prediction of the primary outcome in this setting. Use of the PRIEST score at a threshold of one point higher than the previously recommended best approximated existing clinical accuracy.
6 The advantages of defence medical engagement
Authors:   Lt Col Robert A Salaman
Published: May 2023

The Ground Manoeuvre Surgical Group was established to provide DCR/DCS support to Operation Newcombe, the UK contribution to MINUSMA, a UN stabilisation and support mission in Mali. Opportunities arose during my tour to forge closer relationships with other nations’ surgical teams to the benefit of all.The UK team delivered a trauma SIM session in the as-yet untested temporary French facility during the drawdown of OP Barkhane. Several human factors issues were identified, and procedures changed prior to the facility going live. Subsequently I was invited to attend when a UK soldier required emergency care in the French facility. I gained multinational working experience and the UK soldier was reassured by a UK presence in the surgical team.Informal weekly meetings with the Germans and Swedes enabled a thorough understanding of each teams’ experience and skills. The UK team were consequently invited to lead the damage control surgery of an Egyptian UN soldier with multiple limb injuries from an IED strike. This provided valuable experience for the UK orthopaedic and general surgeons and an ODP. The UK team was subsequently able to significantly contribute to the after-action review as well as providing significant expertise and training to the greater UN team for future MMI planning.Two of the five UK Defence Engagement Strategy’s aims are “Capability and capacity building, and Access and influence. By enthusiastically engaging with the medical teams of all nations, the UK GMSG team enhanced its capability and gained significant access and influence to the benefit of injured soldiers.
Fifty-year forecasts of daily smoking prevalence: can Australia reach 5% by 2030?
Authors: Wade Stephen , Weber Marianne F , Sarich Peter , Caruana Michael , Watts Christina , Vaneckova Pavla , Ngo Preston , Cressman Sonya , Scollo Michelle , Banks Emily , Gartner Coral E , Grogan Paul B , Blakely Tony , Tammemagi Martin C , Canfell Karen 
Published: May 2023

Objective
To compare 50-year forecasts of Australian tobacco smoking rates in relation to trends in smoking initiation and cessation and in relation to a national target of ≤5% adult daily prevalence by 2030.

Methods
A compartmental model of Australian population daily smoking, calibrated to the observed smoking status of 229 523 participants aged 20–99 years in 26 surveys (1962–2016) by age, sex and birth year (1910–1996), estimated smoking prevalence to 2066 using Australian Bureau of Statistics 50-year population predictions. Prevalence forecasts were compared across scenarios in which smoking initiation and cessation trends from 2017 were continued, kept constant or reversed.

Results
At the end of the observation period in 2016, model-estimated daily smoking prevalence was 13.7% (90% equal-tailed interval (EI) 13.4%–14.0%). When smoking initiation and cessation rates were held constant, daily smoking prevalence reached 5.2% (90% EI 4.9%–5.5%) after 50 years, in 2066. When initiation and cessation rates continued their trajectory downwards and upwards, respectively, daily smoking prevalence reached 5% by 2039 (90% EI 2037–2041). The greatest progress towards the 5% goal came from eliminating initiation among younger cohorts, with the target met by 2037 (90% EI 2036–2038) in the most optimistic scenario. Conversely, if initiation and cessation rates reversed to 2007 levels, estimated prevalence was 9.1% (90% EI 8.8%–9.4%) in 2066.

Conclusion
A 5% adult daily smoking prevalence target cannot be achieved by the year 2030 based on current trends. Urgent investment in concerted strategies that prevent smoking initiation and facilitate cessation is necessary to achieve 5% prevalence by 2030.
Acetazolamide for metabolic alkalosis complicating respiratory failure with chronic obstructive pulmonary disease or obesity hypoventilation syndrome: a systematic review
Authors: Bemand Timothy John , Chatoor Richard , Natale Patrizia , Strippoli Giovanni , Delaney Anthony 
Published: May 2023

BackgroundMetabolic alkalosis may lead to respiratory inhibition and increased need for ventilatory support or prolongation of weaning from ventilation for patients with chronic respiratory disease. Acetazolamide can reduce alkalaemia and may reduce respiratory depression.MethodsWe searched Medline, EMBASE and CENTRAL from inception to March 2022 for randomised controlled trials comparing acetazolamide to placebo in patients with chronic obstructive pulmonary disease, obesity hypoventilation syndrome or obstructive sleep apnoea, hospitalised with acute respiratory deterioration complicated by metabolic alkalosis. The primary outcome was mortality and we pooled data using random-effects meta-analysis. Risk of bias was assessed using the Cochrane RoB 2 (Risk of Bias 2) tool, heterogeneity was assessed using the I2value and χ2test for heterogeneity. Certainty of evidence was assessed using GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) methodology.ResultsFour studies with 504 patients were included. 99% of included patients had chronic obstructive pulmonary disease. No trials recruited patients with obstructive sleep apnoea. 50% of trials recruited patients requiring mechanical ventilation. Risk of bias was overall low to some risk. There was no statistically significant difference with acetazolamide in mortality (relative risk 0.98 (95% CI 0.28 to 3.46); p=0.95; 490 participants; three studies; GRADE low certainty) or duration of ventilatory support (mean difference −0.8 days (95% CI −7.2 to 5.6); p=0.36; 427 participants; two studies; GRADE: low certainty).ConclusionAcetazolamide may have little impact on respiratory failure with metabolic alkalosis in patients with chronic respiratory diseases. However, clinically significant benefits or harms are unable to be excluded, and larger trials are required.PROSPERO registration numberCRD42021278757.
Production of strangeonium $$\phi (1680)$$ state in electromagnetic probe-driven scatterings and hadron–hadron ultraperipheral collisions
Authors: Dong Chen , Hou Yuhang , Wang Xiao-Yun , Xie Ya-Ping , Chen Xurong , Zhang Li 
Published: May 2023

AbstractIn this work, the$$\gamma p\rightarrow \phi (1680) p$$γp→ϕ(1680)preaction is systematically studied based on the two gluon exchange model and the pomeron model. The calculation results show that the total cross section of$$\phi (1680)$$ϕ(1680)photoproduction can reach more than 80 nb near the center-of-mass energy$$W=4$$W=4 GeV, so it is suggested that JLab and other experiments carry out relevant measurements. Moreover, under the framework of the vector meson dominance assumption, the scattering length of$$\phi (1680)$$ϕ(1680)and proton interaction is estimated as$$0.07\pm 0.01$$0.07±0.01 fm from the cross sections predicted by the theoretical models, which is on the same order of magnitude as the$$\phi (1020)$$ϕ(1020)-pscattering length. In addition, the total cross section, number of events and rapidity distribution of$$\phi (1680)$$ϕ(1680)production are predicted at Electron-Ion colliders (EICs) and ultra-peripheral collisions (UPCs) by using eSTARlight and STARlight code. The study of$$\phi (1680)$$ϕ(1680)and relevant properties is of enlightening significance in better understanding the strangeonium family spectrum, and provides necessary data support for the future experiment of EICs and UPCs.
Local eigenvalue statistics for higher-rank Anderson models after Dietlein–Elgart
Authors: Herschenfeld Samuel , Hislop Peter D. 
Published: May 2023

We use the method of eigenvalue level spacing developed by Dietlein and Elgart [Level spacing and Poisson statistics for continuum random Schrödinger operators, J. Eur. Math. Soc. (JEMS) 23(4) (2021) 1257–1293] to prove that the local eigenvalue statistics (LES) for the Anderson model on [Formula: see text], with uniform higher-rank [Formula: see text], single-site perturbations, is given by a Poisson point process with intensity measure [Formula: see text], where [Formula: see text] is the density of states at energy [Formula: see text] in the region of localization near the spectral band edges. This improves the result of Hislop and Krishna [Eigenvalue statistics for random Schrödinger operators with non-rank one perturbations, Comm. Math. Phys. 340(1) (2015) 125–143], who proved that the LES is a compound Poisson process with Lévy measure supported on the set [Formula: see text]. Our proofs are an application of the ideas of Dietlein and Elgart to these higher-rank lattice models with two spectral band edges, and illustrate, in a simpler setting, the key steps of the proof of Dietlein and Elgart.
Metaphorical User Simulators for Evaluating Task-oriented Dialogue Systems
Authors: Sun Weiwei , Guo Shuyu , Zhang Shuo , Ren Pengjie , Chen Zhumin , de Rijke Maarten , Ren Zhaochun 
Published: May 2023

Task-oriented dialogue systems (TDSs) are assessed mainly in an offline setting or through human evaluation. The evaluation is often limited to single-turn or is very time-intensive. As an alternative, user simulators that mimic user behavior allow us to consider a broad set of user goals to generate human-like conversations for simulated evaluation. Employing existing user simulators to evaluate TDSs is challenging as user simulators are primarily designed to optimize dialogue policies for TDSs and have limited evaluation capabilities. Moreover, the evaluation of user simulators is an open challenge.In this work, we propose a metaphorical user simulator for end-to-end TDS evaluation, where we define a simulator to be metaphorical if it simulates a user’s analogical thinking in interactions with systems. We also propose a tester-based evaluation framework to generate variants, i.e., dialogue systems with different capabilities. Our user simulator constructs a metaphorical user model that assists the simulator in reasoning by referring to prior knowledge when encountering new items. We estimate the quality of simulators by checking the simulated interactions between simulators and variants. Our experiments are conducted using three TDS datasets. The proposed user simulator demonstrates better consistency with manual evaluation than an agenda-based simulator and a seq2seq model on three datasets; our tester framework demonstrates efficiency and has been tested on multiple tasks, such as conversational recommendation and e-commerce dialogues.
FDA Approval Summary: Mirvetuximab Soravtansine-Gynx for FRα-Positive, Platinum-Resistant Ovarian Cancer
Authors: Dilawari Asma , Shah Mirat , Ison Gwynn , Gittleman Haley , Fiero Mallorie H. , Shah Ankit , Hamed Salaheldin S. , Qiu Junshan , Yu Jingyu , Manheng Wimolnut , Ricks Tiffany K. , Pragani Rajan , Arudchandran Arulvathani , Patel Paresma , Zaman Shadia , Roy Arpita , Kalavar Shyam , Ghosh Soma , Pierce William F. , Rahman Nam Atiqur , Tang Shenghui , Mixter Bronwyn D. , Kluetz Paul G. , Pazdur Richard , Amiri-Kordestani Laleh 
Published: May 2023

Abstract
On November 14, 2022, the FDA granted accelerated approval to mirvetuximab soravtansine-gynx for treatment of adult patients with folate receptor-α (FRα)-positive, platinum-resistant epithelial ovarian, fallopian tube, or primary peritoneal cancer who have received one to three prior systemic therapies. The VENTANA FOLR1 (FOLR-2.1) RxDx Assay was approved as a companion diagnostic device to select patients for this indication. Approval was based on Study 0417 (SORAYA, NCT04296890), a single-arm, multicenter trial. In 104 patients with measurable disease who received mirvetuximab soravtansine-gynx, the overall response rate was 31.7% [95% confidence interval (CI), 22.9–41.6] with a median duration of response of 6.9 months (95% CI, 5.6–9.7). Ocular toxicity was included as a Boxed Warning in the U.S. Prescribing Information (USPI) to alert providers of the risks of developing severe ocular toxicity including vision impairment and corneal disorders. Pneumonitis and peripheral neuropathy were additional important safety risks included as Warnings and Precautions in the USPI. This is the first approval of a targeted therapy for FRα-positive, platinum-resistant ovarian cancer and the first antibody–drug conjugate approved for ovarian cancer. This article summarizes the favorable benefit–risk assessment leading to FDA's approval of mirvetuximab soravtansine-gynx.
O direito à recusa de tratamento médico na Resolução n. 2.232/2019 do Conselho Federal de Medicina
Authors: Lara Mariana Alves , Tomasevicius Filho Eduardo 
Published: May 2023

O presente trabalho teve por objeto a análise crítica dos contornos e limites do direito à recusa de tratamento médico na Resolução n. 2.232/2019 do Conselho Federal de Medicina. Realizou-se investigação teórica, de vertente jurídico dogmática e tipo compreensivo-propositivo, em que se vislumbrou a autonomia privada como direito fundamental. Por meio desse percurso metodológico, chegou-se à conclusão de que, contrariamente ao disposto na referida Resolução do Conselho, o direito ao livre desenvolvimento da personalidade abrange, como regra, a possibilidade de recusa terapêutica, por meio de consentimento expresso, inequívoco, livre, informado e personalíssimo, mesmo em casos de risco iminente de morte. Constatou-se também que, em muitos julgados dos tribunais brasileiros, a autonomia do paciente é desconsiderada quando a vida está ameaçada, sendo-lhe imposta determinada intervenção, conduta que não se amolda a um Estado Democrático de Direito e aos valores da Constituição Federal de 1988.
Yugoslavia with Strings Attached: Boris Kralj's My Belgrade (2011) and Dubravka Ugrešić and Davor Konjikušić's There's Nothing Here (2020)
Authors: Beronja Vladislav 
Published: May 2023

Abstract
This article examines the contemporary photographic representations of Yugoslav modernist architecture and its ruins that serve as a counterpoint to the 2019 MoMA exhibition, Toward a Concrete Utopia: Architecture in Yugoslavia, 1948–1980, a project that brought socialist architectural modernism to international visibility. In particular, I focus on Boris Kralj's photo-diary My Belgrade (2011) and Dubravka Ugrešić and Davor Konjikušić's photo-essay There's Nothing Here! (2020) to explore the ruins of Yugoslav socialist modernity not only as an object of aesthetic fascination, but also as an emotionally and politically charged site of collective nostalgia and politicized mourning in the postsocialist now. While Kralj documents the vanishing remains of socialism in millennial Belgrade to recollect a diasporic, increasingly non-normative and “queer” Yugoslav identity, Ugrešić and Konjikušić foreground the ruins of Yugoslav anti-fascist monuments as a traumatic void—a discursive silence about the effects of racialized, ethno-nationalist violence in EU's new borderlands. I argue that both projects stage architectural photography as a situated and contextual practice by inscribing affective attachments and politically oppositional meanings into the postsocialist architectural palimpsest.