bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of a two step testing algorithm to improve diagnostic accuracy and stewardship of Clostridioides difficile infections
Authors: Bettger Caitlin C. , Giancola Stephanie E. , Cybulski Robert J. , Okulicz Jason F. , Barsoumian Alice E. 
Published: August 2023

AbstractIn response to national guidelines, we implemented a two-step testing algorithm for Clostridioides difficile in an effort to improve diagnostic accuracy. Following implementation, we analyzed treatment frequency between discordant and concordant patients. We found that the majority of discordant cases were treated with no significant differences in patient characteristics or outcomes between the concordant and discordant groups. Additionally, there were no differences in outcomes when discordant patients were further stratified by treatment status. Given little added diagnostic accuracy with the addition of EIA toxin testing, our facility resumed diagnosis by PCR testing alone. Further studies are needed to investigate alternative processes for improvement in diagnostic accuracy aside from toxin EIA testing including stool submission criteria and educational programs.
Multi-domain knowledge graph embeddings for gene-disease association prediction
Authors: Nunes Susana , Sousa Rita T. , Pesquita Catia 
Published: August 2023

Abstract
Background
Predicting gene-disease associations typically requires exploring diverse sources of information as well as sophisticated computational approaches. Knowledge graph embeddings can help tackle these challenges by creating representations of genes and diseases based on the scientific knowledge described in ontologies, which can then be explored by machine learning algorithms. However, state-of-the-art knowledge graph embeddings are produced over a single ontology or multiple but disconnected ones, ignoring the impact that considering multiple interconnected domains can have on complex tasks such as gene-disease association prediction.

Results
We propose a novel approach to predict gene-disease associations using rich semantic representations based on knowledge graph embeddings over multiple ontologies linked by logical definitions and compound ontology mappings. The experiments showed that considering richer knowledge graphs significantly improves gene-disease prediction and that different knowledge graph embeddings methods benefit more from distinct types of semantic richness.

Conclusions
This work demonstrated the potential for knowledge graph embeddings across multiple and interconnected biomedical ontologies to support gene-disease prediction. It also paved the way for considering other ontologies or tackling other tasks where multiple perspectives over the data can be beneficial. All software and data are freely available.
Semantic segmentation of textured mosaics
Authors: Cote Melissa , Dash Amanda , Branzan Albu Alexandra 
Published: August 2023

AbstractThis paper investigates deep learning (DL)-based semantic segmentation of textured mosaics. Existing popular datasets for mosaic texture segmentation, designed prior to the DL era, have several limitations: (1) training images are single-textured and thus differ from the multi-textured test images; (2) training and test textures are typically cut out from the same raw images, which may hinder model generalization; (3) each test image has its own limited set of training images, thus forcing an inefficient training of one model per test image from few data. We propose two texture segmentation datasets, based on the existing Outex and DTD datasets, that are suitable for training semantic segmentation networks and that address the above limitations: SemSegOutex focuses on materials acquired under controlled conditions, and SemSegDTD focuses on visual attributes of textures acquired in the wild. We also generate a synthetic version of SemSegOutex via texture synthesis that can be used in the same way as standard random data augmentation. Finally, we study the performance of the state-of-the-art DeepLabv3+ for textured mosaic segmentation, which is excellent for SemSegOutex and variable for SemSegDTD. Our datasets allow us to analyze results according to the type of material, visual attributes, various image acquisition artifacts, and natural versus synthetic aspects, yielding new insights into the possible usage of recent DL technologies for texture analysis.
Association of low-level lead exposure with all-cause and cardiovascular disease mortality in US adults with hypertension: evidence from the National Health and Nutrition Examination Survey 2003–2010
Authors: Wang Lili , Wang Chaofan , Liu Tao , Xuan Haochen , Li Xiaoqun , Shi Xiangxiang , Dai Feng , Chen Junhong , Li Dongye , Xu Tongda 
Published: August 2023

Abstract
Background
To explore the association of low-level lead exposure with all-cause mortality and cardiovascular disease (CVD) mortality among hypertensive patients.

Methods
This cohort study enrolled 6453 adults with hypertension from the National Health and Nutrition Examination Survey 2003–2010 and followed mortality information through December 31, 2019. The baseline population were divided into four groups based on quartiles of blood lead levels (Q1: < 1.2 μg/dL, Q2: 1.2–1.6 μg/dL, Q3: 1.7–2.4 μg/dL, Q4: 2.5–4.9 μg/dL). The correlation of blood lead levels to mortality was investigated by Kaplan–Meier survival curves, restricted cubic spline (RCS), proportional hazard regression model, and subgroup analysis.

Results
During a median follow-up period of 136 (interquartile range 113, 164) months, a total of 1943 (30.1%) deaths were documented, among which 553 (28.5%) were due to CVD. Blood lead showed a linear dose–response relationship with all-cause and CVD mortality. After adequate adjusting for confounders, the risk of all-cause death rose by 23% for each unit increase in continuous variable blood lead (hazard ratio (HR): 1.23; 95% confidence interval (CI):1.16–1.30). When blood lead was a quartile group variable, participants in the Q 4 group had a 73% higher risk of death than those in the Q 1 group (HR:1.73; 95% CI: 1.43–2.10; P for trend < 0.001). The association for CVD mortality was analogous. The concordant results were achieved in the subgroup analysis.

Conclusion
Elevated blood lead levels were strongly associated with an increased all-cause and CVD mortality in adults with hypertension, even at the reference range of blood lead.
Engineering the advances of the artificial neural networks (ANNs) for the security requirements of Internet of Things: a systematic review
Authors: Ali Yasir , Khan Habib Ullah , Khalid Muhammad 
Published: August 2023

AbstractInternet of Things (IoT) driven systems have been sharply growing in the recent times but this evolution is hampered by cybersecurity threats like spoofing, denial of service (DoS), distributed denial of service (DDoS) attacks, intrusions, malwares, authentication problems or other fatal attacks. The impacts of these security threats can be diminished by providing protection towards the different IoT security features. Different technological solutions have been presented to cope with the vulnerabilities and providing overall security towards IoT systems operating in numerous environments. In order to attain the full-pledged security of any IoT-driven system the significant contribution presented by artificial neural networks (ANNs) is worthy to be highlighted. Therefore, a systematic approach is presented to unfold the efforts and approaches of ANNs towards the security challenges of IoT. This systematic literature review (SLR) is composed of three (3) research questions (RQs) such that in RQ1, the major focus is to identify security requirements or criteria that defines a full-pledge IoT system. This question also focusses on pinpointing the different types of ANNs approaches that are contributing towards IoT security. In RQ2, we highlighted and discussed the contributions of ANNs approaches for individual security requirement/feature in comprehensive and detailed fashion. In this question, we also determined the various models, frameworks, techniques and algorithms suggested by ANNs for the security advancements of IoT. In RQ3, different security mechanisms presented by ANNs especially towards intrusion detection system (IDS) in IoT along with their performances are comparatively discussed. In this research, 143 research papers have been used for analysis which are providing security solutions towards IoT security issues. A comprehensive and in-depth analysis of selected studies have been made to understand the current research gaps and future research works in this domain.
Effects of Bacillus coagulans and Lactobacillus plantarum on the fermentation quality, aerobic stability and microbial community of triticale silage
Authors: Li Shengnan , Ke Wencan , Zhang Qing , Undersander Dan , Zhang Guijie 
Published: August 2023

Abstract
Background
Due to its hollow stem, ensiling triticale presents a challenge as it may cause an overabundance of oxygen during the fermentation process. This study investigated the effects of Bacillus coagulans (BC) and Lactobacillus plantarum (LP) on the fermentation characteristics, microbial community, and aerobic stability of ensiled triticale. Fresh triticale was wilted at a dry matter content of 350 g/kg. The experiment was arranged in a 2 × 2 factorial design, with both BC and commercial LP added at 0 or 1 × 106 cfu/g of fresh weight (FW) of chopped triticale.

Results
After 60 days of ensiling, the pH, water-soluble carbohydrates (WSC), neutral detergent fiber (NDF), and ammonia nitrogen (NH3-N) of inoculated groups were lower than those of the control group (P < 0.05), especially in the LP + BC treatment (P < 0.05). The lactic acid (LA) concentration, lactic acid/acetic acid (LA/AA), and aerobic stability were also higher (P < 0.05) in the LP + BC treatment than in other treatments. The bacterial diversity was reduced, and the richness was increased by the application of LP and BC individually (P < 0.05). Compared with the control silage, LP-treated silage had higher Lactobacillus (P < 0.05), while BC-treated silage had higher Bacillus and Pediococcus (P < 0.05). The LP + BC-treated silage had higher Lactobacillus, Bacillus, Enterococcus, and Serratia (P < 0.05). Bacillus was negatively correlated with NDF (P < 0.05) and AA (P < 0.05). Lactobacillus was positively correlated with LA (P < 0.05) and LA/AA but negatively with pH and NH3-N (P < 0.05).

Conclusions
The combination of BC and LP may lead to improved ensiled triticale fermentation quality and aerobic stability by inducing alterations in the composition of bacterial communities, which is crucial for the efficient utilization of triticale resources.

Graphical Abstract
Covid Pandemic Effects on the Physical Fitness of Primary School Children: Results of the German EMOTIKON Project
Authors: Teich Paula , Fühner Thea , Bähr Florian , Puta Christian , Granacher Urs , Kliegl Reinhold 
Published: August 2023

AbstractBackgroundIn spring of 2020, the Sars-CoV-2 incidence rate increased rapidly in Germany and around the world. Throughout the next 2 years, schools were temporarily closed and social distancing measures were put in place to slow the spread of the Covid-19 virus. Did these social restrictions and temporary school lockdowns affect children’s physical fitness? The EMOTIKON project annually tests the physical fitness of all third-graders in the Federal State of Brandenburg, Germany. The tests assess cardiorespiratory endurance (6-min-run test), coordination (star-run test), speed (20-m sprint test), lower (powerLOW, standing long jump test), and upper (powerUP, ball-push test) limbs muscle power, and static balance (one-legged stance test with eyes closed). A total of 125,893 children were tested in the falls from 2016 to 2022. Primary analyses focused on 98,510 keyage third-graders (i.e., school enrollment according to the legal key date, aged 8 to 9 years) from 515 schools. Secondary analyses included 27,383 older-than-keyage third-graders (i.e., OTK, delayed school enrollment or repetition of a grade, aged 9 to 10 years), who have been shown to exhibit lower physical fitness than expected for their age. Linear mixed models fitted pre-pandemic quadratic secular trends, and took into account differences between children and schools.ResultsThird-graders exhibited lower cardiorespiratory endurance, coordination, speed and powerUP in the Covid pandemic cohorts (2020–2022) compared to the pre-pandemic cohorts (2016–2019). Children’s powerLOW and static balance were higher in the pandemic cohorts compared to the pre-pandemic cohorts. From 2020 to 2021, coordination, powerLOW and powerUP further declined. Evidence for some post-pandemic physical fitness catch-up was restricted to powerUP. Cohen’s |ds| for comparisons of the pandemic cohorts 2020–2022 with pre-pandemic cohorts 2016–2019 ranged from 0.02 for powerLOW to 0.15 for coordination. Within the pandemic cohorts, keyage children exhibited developmental losses ranging from approximately 1 month for speed to 5 months for cardiorespiratory endurance. For powerLOW and static balance, the positive pandemic effects translate to developmental gains of 1 and 7 months, respectively. Pre-pandemic secular trends may account for some of the observed differences between pandemic and pre-pandemic cohorts, especially in powerLOW, powerUP and static balance. The pandemic further increased developmental delays of OTK children in cardiorespiratory endurance, powerUP and balance.ConclusionsThe Covid-19 pandemic was associated with declines in several physical fitness components in German third-graders. Pandemic effects are still visible in 2022. Health-related interventions should specifically target those physical fitness components that were negatively affected by the pandemic (cardiorespiratory endurance, coordination, speed).
Military culture and collaborative decision-making in mental healthcare: cultural, communication and policy considerations
Authors: Treichler Emily B. H. , Reznik Samantha J. , Oakes David , Girard Vanessa , Zisman-Ilani Yaara 
Published: August 2023

Summary
Military culture relies on hierarchy and obedience, which contradict the implementation and use of collaborative care models. In this commentary, a team of lived experience, clinical and research experts discuss, for the first time, cultural, communication and policy considerations for implementing collaborative care models in military mental healthcare settings.
Systemic Therapy for Melanoma: ASCO Guideline Update
Authors: Seth Rahul , Agarwala Sanjiv S. , Messersmith Hans , Alluri Krishna C. , Ascierto Paolo A. , Atkins Michael B. , Bollin Kathryn , Chacon Matias , Davis Nancy , Faries Mark B. , Funchain Pauline , Gold Jason S. , Guild Samantha , Gyorki David E. , Kaur Varinder , Khushalani Nikhil I. , Kirkwood John M. , McQuade Jennifer Leigh , Meyers Michael O. , Provenzano Anthony , Robert Caroline , Santinami Mario , Sehdev Amikar , Sondak Vernon K. , Spurrier Gilliosa , Swami Umang , Truong Thach-Giao , Tsai Katy K. , van Akkooi Alexander , Weber Jeffrey 
Published: August 2023

PURPOSE To provide guidance to clinicians regarding the use of systemic therapy for melanoma. METHODS American Society of Clinical Oncology convened an Expert Panel and conducted an updated systematic review of the literature. RESULTS The updated review identified 21 additional randomized trials. UPDATED RECOMMENDATIONS Neoadjuvant pembrolizumab was newly recommended for patients with resectable stage IIIB to IV cutaneous melanoma. For patients with resected cutaneous melanoma, adjuvant nivolumab or pembrolizumab was newly recommended for stage IIB-C disease and adjuvant nivolumab plus ipilimumab was added as a potential option for stage IV disease. For patients with unresectable or metastatic cutaneous melanoma, nivolumab plus relatlimab was added as a potential option regardless of BRAF mutation status and nivolumab plus ipilimumab followed by nivolumab was preferred over BRAF/MEK inhibitor therapy. Talimogene laherparepvec is no longer recommended as an option for patients with BRAF wild-type disease who have progressed on anti–PD-1 therapy. Ipilimumab- and ipilimumab-containing regimens are no longer recommended for patients with BRAF-mutated disease after progression on other therapies. This full update incorporates the new recommendations for uveal melanoma published in the 2022 Rapid Recommendation Update. Additional information is available at www.asco.org/melanoma-guidelines .
A Randomized Clinical Trial of Intravenous Methylprednisolone With 2 Protocols in Patients With Graves Orbitopathy
Authors: Li Zhangfang , Luo Yaosheng , Huang Quandi , Chen Zhi , Song Dandan , Pan Daoyan , Hu Shidi , Jiang Wei , Cai Qiuyue , Feng Xiaoting , Zhang Qing , Weng Chanyan , Zhong Qiang , Zhao Tongfeng , Li Chenzhong , Zhang Tong , Shen Jie 
Published: August 2023

AbstractContextIntravenous glucocorticoid (IVGC) is an accessible and affordable treatment for Graves orbitopathy (GO); the 4.5-g protocol is well studied, but many details of treatment protocols need to be clarified.ObjectiveTo compare the efficacy and safety of weekly and monthly protocol of IVGC in GO.MethodsA prospective, randomized, observer-masked, single-center clinical trial, followed up to week 24, at the third affiliated hospital of Southern Medical University; 58 patients with active and moderate to severe GO, aged 18-60 years old, who had not received relevant treatment were included. The intervention was weekly protocol or monthly protocol of IVGC; both received a cumulative dose of methylprednisolone 4.5 g and had a duration of 12 weeks. The overall effective rate, improvement of quality of life (QOL) and signal intensity ratio (SIR) were measured.ResultsThere was no significant difference in the effective rate between the 2 groups at week 12 and week 24 (86.21% vs 72.41%, P = .195; 86.21% vs 82.61%, P = .441), there was no significant difference in the improvement of clinical activity score, exophthalmos, soft tissue involvement, diplopia, and QOL. At week 24, the mean SIR and maximum SIR of the 2 groups were lower than those before treatment, and there were no statistically significant difference between the 2 groups. There was no significant difference in the incidence of adverse events between the 2 groups (31.03% vs 27.59%, P = .773).ConclusionThe efficacy and safety of the 2 protocols are comparable; the monthly protocol could be used as an alternative to the weekly protocol.
Frequency and Predictive Factors of Hypoglycemia in Patients Treated With rhIGF-1: Data From the Eu-IGFD Registry
Authors: Bang Peter , Polak Michel , Bossowski Artur , Maghnie Mohamad , Argente Jesús , Ramon-Krauel Marta , Sert Caroline , Perrot Valerie , Mazain Sarah , Woelfle Joachim 
Published: August 2023

Abstract

Context
The European Increlex® Growth Forum Database (Eu-IGFD) is an ongoing surveillance registry (NCT00903110) established to collect long-term safety and effectiveness data on the use of recombinant human insulin-like growth factor-1 (rhIGF-1, mecasermin, Increlex) for the treatment of children/adolescents with severe primary insulin-like growth factor-1 deficiency (SPIGFD).

Objective
This analysis of Eu-IGFD data aimed to identify the frequency and predictive factors for hypoglycemia adverse events (AEs) in children treated with rhIGF-1.

Methods
Data were collected from December 2008 to May 2021. Logistic regression was performed to identify predictive risk factors for treatment-induced hypoglycemia AEs. Odds ratios (ORs) are presented with 95% CIs for each factor.

Results
In total, 306 patients were enrolled in the registry; 84.6% were diagnosed with SPIGFD. Patients who experienced ≥ 1 hypoglycemia AE (n = 80) compared with those with no hypoglycemia AEs (n = 224) had a lower mean age at treatment start (8.7 years vs 9.8 years), a more frequent diagnosis of Laron syndrome (27.5% vs 10.3%), and a history of hypoglycemia (18.8% vs 4.5%). Prior history of hypoglycemia (OR 0.25; 95% CI: [0.11; 0.61]; P = .002) and Laron syndrome diagnosis (OR 0.36; 95% CI: [0.18; 0.72]; P = .004) predicted future hypoglycemia AEs. Total hypoglycemia AEs per patient per treatment year was 0.11 and total serious hypoglycemia AEs per patient per treatment year was 0.01.

Conclusion
Hypoglycemia occurs more frequently in patients with prior history of hypoglycemia and/or Laron syndrome compared with patients without these risk factors, and these patients should be carefully monitored for this AE throughout treatment.
La cité de Dieu des patriotes
Authors: Tricoire Damien 
Published: August 2023

PrécisCet article étudie les origines religieuses de la Révolution, au sens de ce qui a rendu possible l'idée même de révolution. Il suggère que la Révolution a eu des origines religieuses dans un sens bien plus direct que ce que suggèrent les études sur les controverses autour du jansénisme. C'est parce que l'ordre divin était considéré comme supérieur à tout ordre créé par les humains que la rupture avec les coutumes et traditions du royaume a pu être conçue comme légitime. En ce sens, la Révolution française est comparable aux révolutions qui l'ont précédée. Cet article invite à reconsidérer la pensée politique des Lumières françaises, irriguées par la pensée théocratique. La thèse principale est que ce qui change dans la France des Lumières par rapport à celle du XVIIe siècle, c'est une insistance nouvelle sur les lois immuables et éternelles établies par Dieu. Les origines profondes de cette pensée théocratique, qui remontent à la scholastique médiévale, y sont considérées.
Sagittal Synostectomy With Tension Band Sutures for Correction of Sagittal Craniosynostosis
Authors: Hersh Andrew M. , Cohen Alan R. 
Published: August 2023

BACKGROUND AND OBJECTIVES:
Premature fusion of the sagittal suture is the most common form of craniosynostosis and can be treated using a variety of open or endoscopic approaches. Existing approaches have varying degrees of effectiveness. Open approaches, whether performed early or late, can be associated with significant blood loss and the need for transfusion. Endoscope-assisted approaches are minimally invasive but require months of postoperative helmet therapy to help remodel the skull. Implantation of springs or distractors requires a second operation for removal of the devices. Here, we present an alternative technique for early correction of sagittal craniosynostosis combining sagittal synostectomy with tension band sutures to remodel the skull without need for transfusion or helmet therapy.

METHODS:
We retrospectively reviewed the medical records of all patients treated for sagittal craniosynostosis using a synostectomy with tension band sutures at a single tertiary care institution. Data on patient demographics, operative factors, and postoperative course were collected.

RESULTS:
Thirty-four patients underwent the novel procedure. The median preoperative cephalic index was 68 and improved to 76 immediately postoperatively. The median blood loss was 10 mL while the operative duration was 112 minutes. No blood transfusions were needed. One small dural laceration was encountered that was promptly repaired. There were no postoperative complications. Patients presenting for follow-up visits showed continued improvement in head shape and cephalic index.

CONCLUSION:
A modified sagittal craniectomy with tension band sutures to remodel the skull is effective in achieving immediate correction of sagittal craniosynostosis. The correction remains durable over long-term follow-up. Importantly, the technique can be performed with minimal blood loss and reduces transfusion risk, operative time, and overall morbidity compared with traditional open approaches while avoiding the need for helmet therapy necessitated by endoscopic approaches.