bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation of a comprehensive set of optimised CBCT protocols and validation through imaging quality and dose audit
Authors: Khan Marina , Sandhu Navneet , Naeem Marium , Ealden Rebecca , Pearson Michael , Ali Abdirzak , Honey Ian , Webster Amanda , Eaton David , Ntentas Georgios 
Published: August 2022

Objectives: Cone-beam computed tomography (CBCT) for radiotherapy treatment verification has increased in frequency; therefore, it is crucial to optimise image quality and radiation dose to patients. The aim of this study was to implement optimised CBCT protocols for the Varian TrueBeams for most tumour sites in adult patients Methods: A combination of patient size-specific CBCT protocols from the literature and developed in-house was used. Scans taken before and after optimisation were compared by senior radiographers and physicists to evaluate how changes affected image quality and clinical usability for online image registration. The change in dose for each new CBCT protocol was compared to the Varian default. A clinical audit was performed following implementation to evaluate the changes in imaging dose for all patients receiving a CBCT during that period. Results: Ten CBCT protocols were introduced including head and neck and patient-size-specific thorax and pelvis/abdomen protocols. Scans from 102 patients with images before and after optimisation were assessed, none of the scans showed image quality changes compromising clinical usability and for some image quality was improved. Between November 2020 and June 2021, 1185 patients had CBCTs using the new protocols. The imaging dose was reduced for 52% of patients, remained the same for 37% and increased for 12%. Conclusions: This study showed that substantial dose reductions and image quality improvements can be achieved with simple changes in the default settings of the Varian TrueBeam CBCT without affecting the radiographers’ confidence in online image registration. Advances in knowledge: This study represents a comprehensive assessment and optimisation of CBCT protocols for most sites, validated on a large cohort of patients.
Comparison of HPV testing and cervical cytology in prevention of cervical cancer
Authors: Remjasz Klaudia , Kosz Katarzyna , Kuchnicka Aleksandra , Kuchnicka Julia , Aleksandrowicz Jakub , Zielińska Martyna , Zarankiewicz Natalia , Siedlecki Wojciech , Sapuła Klaudia 
Published: August 2022

Introduction and purpose
This article aims to compare two guiding methods of cervical cancer screening: cervical cytology and HPV testing. The objective is to provide information on which method is currently more relevant in the early detection of precancerous lesions and and therefore should be more frequently used.

Materials and method
This review was mainly based on articles from around the world collected in Pubmed in 2003-2022, medical books and websites. The research was done by looking through keywords as follows: “cervical cancer”, “cytology”, “HPV testing”.
Results
All selected studies have demonstrated that HPV testing is a more appropriate indicator for initial high-grade CIN (cervical intraepithelial neoplasia) than cytology.
Conclusions
According to the cited researches, the public health system should definitely pay more attention to HPV testing as the first stage of cervical cancer screening. Moreover, it should clarify by comparing all advantages and disadvantages of methods, which further diagnostic pathway is the most effective and has the best outcomes for the patients.
Keywords
cervical cancer, cervical screening, cytology, HPV primary screening, HPV testing
Optimality of Independently Randomized Symmetric Policies for Exchangeable Stochastic Teams with Infinitely Many Decision Makers
Authors: Sanjari Sina , Saldi Naci , Yüksel Serdar 
Published: August 2022

We study stochastic teams (known also as decentralized stochastic control problems or identical interest stochastic dynamic games) with large or countably infinite numbers of decision makers and characterize the existence and structural properties of (globally) optimal policies. We consider both static and dynamic nonconvex teams where the cost function and dynamics satisfy an exchangeability condition. To arrive at existence and structural results for optimal policies, we first introduce a topology on control policies, which involves various relaxations given the decentralized information structure. This is then utilized to arrive at a de Finetti–type representation theorem for exchangeable policies. This leads to a representation theorem for policies that admit an infinite exchangeability condition. For a general setup of stochastic team problems with N decision makers, under exchangeability of observations of decision makers and the cost function, we show that, without loss of global optimality, the search for optimal policies can be restricted to those that are N-exchangeable. Then, by extending N-exchangeable policies to infinitely exchangeable ones, establishing a convergence argument for the induced costs, and using the presented de Finetti–type theorem, we establish the existence of an optimal decentralized policy for static and dynamic teams with countably infinite numbers of decision makers, which turns out to be symmetric (i.e., identical) and randomized. In particular, unlike in prior work, convexity of the cost in policies is not assumed. Finally, we show the near optimality of symmetric independently randomized policies for finite N-decision-maker teams and thus establish approximation results for N-decision-maker weakly coupled stochastic teams. Funding: This work was supported by Natural Sciences and Engineering Research Council of Canada.
The local physiological effects of a single-use topical negative pressure device in healthy volunteers: the PICO-1 study
Authors: Priyadharsini Prabakaran Praveena , Totty Joshua P , Carradice Dan , Chetter Ian C , Smith George E 
Published: August 2022

Objective: This study aimed to investigate the effects of a single-use negative pressure wound therapy (sNPWT) device on tissue perfusion, oxygenation and pressure in the intact skin of healthy volunteers. Method: Healthy volunteers wore a PICO sNPWT device (Smith+Nephew, UK) on their right medial calf for one week. Perfusion, tissue oxygenation and tissue pressure were recorded in superficial and deep tissues over a period of seven days. At the baseline visit, measurements were recorded before and after dressing application without activation. Macrovascular flow and transduced needle pressure measures were recorded at 0 minutes, 30 minutes and 60 minutes after device activation. Superficial tissue perfusion and both oxygenation measures were recorded continuously over the hour following activation. All outcome measures were repeated at 24 hours and again after seven days, both with the dressing and following dressing removal. Results: The device was associated with a measurable increase in perfusion of the limb in 12 healthy volunteers. Superficial tissue oxygenation adjacent to the dressing was reduced during wear, while deeper tissue demonstrated an increase in oxygenation levels. Superficial skin perfusion was observed to differ between skin overlying muscle and that overlying bone. Pressure in tissue underneath the dressing pad was increased throughout dressing wear and returned to baseline levels on dressing removal. Conclusion: sNPWT produced measurable changes in local physiology in healthy volunteers with intact skin, despite the absence of a wound. Effects may differ according to anatomical site and the composition of underlying tissues. Other factors that promote healing were not explored in this study. Declaration of interest: This study was funded by Smith+Nephew investigator-initiated grant IIS 684. The funder had no input into study design, conduct, analysis, manuscript preparation or dissemination. The authors have no conflicts of interest to declare.
The value of administering intravenous antibiotics during haemodialysis in the treatment of diabetic foot infections
Authors: Pittam Bradley , Chumber Ruby , Vashisht Gaurav , Miller Sophie , O'Dowd Christina , Ledson Thomas , Srinivas-Shankar Upendram 
Published: August 2022

Objective:People with diabetes who are on haemodialysis (HD) are at a high risk of diabetic foot infections (DFI) and related complications. We explored the value of treating DFI with intravenous (IV) antibiotics during HD.Method:This was an observational study of consecutively treated patients with DFIs with IV antibiotics during HD. Data collected included baseline characteristics, IV antibiotics used, details of multidisciplinary interventions and DFI treatment outcome.Results:A cohort of 11 patients, mean (±standard deviation) age 62.4±12.7 years, had 15 episodes of treatment with IV antibiotics during HD. Of the patients, six (54.5%) were male and nine (81.8%) had type 2 diabetes. The estimated mean glomerular filtration rate (eGFR) was 11.4±3.9ml/minute. All patients had infected foot ulceration, soft tissue infection, six (54.5%) patients had osteomyelitis, and two (18.2%) had wet gangrene. The commonest IV antibiotic used was vancomycin (10/15 episodes, 66.7%). Other IV antibiotics used were daptomycin and meropenem. In three episodes, oral ciprofloxacin was used with IV antibiotics. The mean duration of antibiotic treatment was 9.2±4.9 weeks. Of the episodes, 11 (73.3%) were treated successfully with IV antibiotics alone and two (13.3%) episodes required minor surgical debridement/amputation. Some 10 (90.9%) members of the cohort had peripheral arterial disease and of those, five (50%) underwent angioplasty during IV antibiotic treatment.Conclusion:HD provides a good opportunity for treatment with IV antibiotics in DFI. This mode of administration of IV antibiotics, along with multidisciplinary intervention, is associated with ulcer healing and resolution of infection in over three-quarters of patients with DFI.
IgG antibodies to SARS-CoV-2 in asymptomatic blood donors at two time points in Karachi
Authors: Hasan Muhammad , Moiz Bushra , Qaiser Shama , Masood Kiran Iqbal , Ghous Zara , Hussain Areeba , Ali Natasha , Simas J. Pedro , Veldhoen Marc , Alves Paula , Abidi Syed Hani , Ghias Kulsoom , Khan Erum , Hasan Zahra 
Published: August 2022

Introduction
An estimated 1.5 million cases were reported in Pakistan until 23 March, 2022. However, SARS-CoV-2 PCR testing capacity has been limited and the incidence of COVID-19 infections is unknown. Volunteer healthy blood donors can be a control population for assessment of SARS-CoV-2 exposure in the population. We determined COVID-19 seroprevalence during the second pandemic wave in Karachi in donors without known infections or symptoms in 4 weeks prior to enrollment.

Materials and methods
We enrolled 558 healthy blood donors at the Aga Khan University Hospital between December 2020 and February 2021. ABO blood groups were determined. Serum IgG reactivity were measured to spike and receptor binding domain (RBD) proteins.

Results
Study subjects were predominantly males (99.1%) with a mean age of 29.0±7.4 years. Blood groups were represented by; B (35.8%), O (33.3%), A (23.8%) and AB (7%). Positive IgG responses to spike were detected in 53.4% (95% CI, 49.3–37.5) of blood donors. Positive IgG antibodies to RBD were present in 16.7% (95% CI; 13.6–19.8) of individuals. No significant difference was found between the frequency of IgG antibodies to spike or RBD across age groups. Frequencies of IgG to Spike and RBD antibodies between December 2020 and February 2021 were found to be similar. Seropositivity to either antigen between individuals of different blood groups did not differ. Notably, 31.2% of individuals with IgG antibodies to spike also had IgG antibodies to RBD. Amongst donors who had previously confirmed COVID-19 and were seropositive to spike, 40% had IgG to RBD.

Conclusions
Our study provides insights into the seroprevalence of antibodies to COVID-19 in a healthy cohort in Karachi. The differential dynamics of IgG to spike and RBD likely represent both exposure to SARS-CoV-2 and associate with protective immunity in the population.
Where is the greatest risk of COVID-19 infection? Findings from Germany’s largest public health department, Cologne
Authors: Broichhaus Lukas , Book Julian , Feddern Sven , Grüne Barbara , Neuhann Florian , Nießen Johannes , Wiesmüller Gerhard A. , Kossow Annelene , Joisten Christine 
Published: August 2022

Background
SARS-CoV-2 has been spreading worldwide since late 2019. Before vaccines became available, exclusively non-pharmaceutical measures were used to prevent transmission of infection. Despite the fact that vaccinations are now available, it is still important to identify relevant transmission routes in order to contain the COVID-19- or further pandemics. Therefore, this study aims to systematically analyse data from the largest public health department in Germany to determine the significance of the various known and unknown transmission situations in terms of the proportion of infections.

Methods
All infections in Cologne were systematically recorded by the local health department. In addition to clinical data, the transmission situations were recorded and categorised as pertaining to social contact, work contact, travellers, health care workers, users of educational institutions, visitors of community institutions, infection in the context of medical treatment, and unknown infection.

Findings
The analysis included 25,966 persons. A transmission situation could be identified in 82.7% of the cases (n = 21,477). Most persons (42.1%) were infected due to social contact, primarily within their own household. Another 22.3% were infected at their place of work; this was particularly common among staff members of medical facilities, nursing homes and educational institutions. In 17.3% of the cases, the transmission situation remained unknown; the cases with unknown transmission situation were slightly more often symptomatic (75.2%) than the cases with known transmission situation (69.4%).

Interpretation
Considering that during the study period the leading strains were the wild-type and alpha-variant transmission rather occurred during scenarios involving close contacts than in anonymous situations. Presumably, however, the findings can be transferred to the new variants. Therefore, in order to prevent transmission, besides vaccination regular antigen tests and/or appropriate protective measures remain relevant until this pandemic has subsided.
Heme oxygenase-1 as an important predictor of the severity of COVID-19
Authors: Hara Yu , Tsukiji Jun , Yabe Aya , Onishi Yoshika , Hirose Haruka , Yamamoto Masaki , Kudo Makoto , Kaneko Takeshi , Ebina Toshiaki 
Published: August 2022

Background and objective
A cytokine storm is caused by inflammatory cells, including pro-inflammatory macrophage phenotype (M1), and play a critical role in the pathogenesis of COVID-19, in which diffuse alveolar damage occurs in the lungs due to oxidative stress exposure. Heme oxygenase (HO)-1 is a stress-induced protein produced by the anti-inflammatory / anti-oxidative macrophage phenotype (M2), which also produces soluble CD163 (sCD163). In our study, we investigated and determined that serum HO-1 can be a predictive biomarker for assessing both the severity and the outcome of COVID-19 patients.

Method
The serum concentrations of HO-1 and sCD163 of COVID-19 patients were measured on admission. The relationship between these biomarkers and other clinical parameters and outcomes were evaluated.

Results
Sixty-four COVID-19 patients (11 mild, 38 moderate, and 15 severe cases) were assessed. The serum HO-1 tended to increase (11.0 ng/mL vs. 24.3 ng/mL vs. 59.6 ng/mL with severity). Serum HO-1 correlated with serum lactate dehydrogenase (R = 0.422), C-reactive protein (R = 0.463), and the ground glass opacity (GGO) and consolidation score (R = 0.625) of chest computed tomography. The serum HO-1 showed a better area under the curve (AUC) for predicting ICU admission than the serum sCD163 (HO-1; 0.816 and sCD163; 0.743). In addition, composite parameters including serum HO-1 and the GGO and consolidation score showed a higher AUC for predicting ICU admission than the AUC of a single parameter.

Conclusion
Clinically, serum HO-1, reflecting the activation of M2, could be a very useful marker for evaluating disease severity and predicting prognoses for COVID-19 patients. In addition, controlling activated M2 might be a preventative COVID-19 therapeutic target.
Medical student attitudes on vaccination relevance: A mixed-method study
Authors: Herrmann-Werner Anne , Festl-Wietek Teresa , Gille Christian , Zipfel Stephan , Wiechers Steffen 
Published: August 2022

Background and objectives
The study aims to investigate the attitudes of medical students regarding the importance and relevance of vaccinations, whether vaccinations should be compulsory and how to employ a new teaching concept to deal with vaccination-critical parents.

Methods
This mixed-method study consists of a quantitative questionnaire and focus groups. Quantitative data were analysed by calculating the descriptive statistics, and interviews were analysed using Mayring’s content analysis.

Results
A total of 170 medical students completed the questionnaire, and 59 students participated in 9 focus groups. Students reported that they felt more confident dealing with vaccination-critical parents after learning the new teaching concept. Similar results were found for medical students prior to and during the pandemic. During the pandemic, medical students viewed vaccinations for several diseases, such as measles or COVID-19, as important (range: M = 3.56, SD = 0.54 to M = 3.97, SD = 0.17). Similar results were found for medical students prior to the pandemic (range: M = 3.26, SD = 0.77 to M = 3.94, SD = 0.24). In the focus groups, however, medical students displayed controversial attitudes regarding compulsory vaccinations.

Conclusions
While the medical students agreed on the use of vaccination for highly infectious diseases, their level of agreement decreased depending on the severity of the disease. Practical recommendations that come out of the study are creating a trustful relationship with and delivering information to patients.
The impact of the COVID-19 pandemic on mental health and functional outcomes in Veterans with psychosis or recent homelessness: A 15-month longitudinal study
Authors: Wynn Jonathan K. , McCleery Amanda , Novacek Derek M. , Reavis Eric A. , Senturk Damla , Sugar Catherine A. , Tsai Jack , Green Michael F. 
Published: August 2022

Background
The COVID-19 pandemic has had unprecedented effects on mental health and community functioning. Negative effects related to disruption of individuals’ social connections may have been more severe for those who had tenuous social connections prior to the pandemic. Veterans who have recently experienced homelessness (RHV) or have a psychotic disorder (PSY) are considered particularly vulnerable because many had poor social connections prior to the pandemic.

Methods
We conducted a 15-month longitudinal study between May 2020 –July 2021 assessing clinical (e.g., depression, anxiety) and community (e.g., social functioning, work functioning) outcomes. Eighty-one PSY, 76 RHV, and 74 Veteran controls (CTL) were interviewed over 5 assessment periods. We assessed changes in mental health and community functioning trajectories relative to pre-pandemic retrospective ratings and examined group differences in these trajectories.

Results
All groups had significantly increased symptoms of depression, anxiety, and concerns with contamination at the onset of the pandemic. However, RHV and PSY showed faster returns to their baseline levels compared to CTL, who took nearly 15 months to return to baseline. With regards to functioning, both RHV and PSY, but not CTL, had significant improvements in family and social networks over time. Work functioning worsened over time only in PSY, and independent living increased over time in both RHV and PSY but not CTL.

Conclusions
These results reveal that vulnerable Veterans with access to VA mental health and case management services exhibited lower negative impacts of the COVID-19 pandemic on mental health and community functioning than expected.
Effect of CYP2D6*4, CYP2D6*10 polymorphisms on the safety of treatment with timolol maleate in patients with glaucoma
Authors: Moshetova Larisa K. , Soshina Maria M. , Turkina Ksenia I. , Grishina Elena A. , Sozaeva Zhannet A. , Kachanova Anastasia A. , Akmalova Kristina A. , Ivashchenko Dmitriy V. , Zastrozhin Mikhail S. , Fisenko Vladimir P. , Sychev Dmitry A. 
Published: August 2022

Abstract

Objectives
Timolol maleate is used for the treatment of glaucoma and metabolized by cytochrome CYP2D6 in the liver. The aim of this study was the evaluation of the influence of CYP2D6*4 and CYP2D6*10 gene polymorphisms on the safety of medications containing 0.5% of timolol maleate as glaucoma treatment in patients with primary open-angle glaucoma (POAG).

Methods
105 patients with POAG were prescribed glaucoma medications, containing 0.5% timolol maleate. The safety of glaucoma treatment was determined by electrocardiography (ECG) (to assess heart rate (HR) and PQ interval) and blood pressure (BP) measurements. The real-time polymerase chain reaction method was used for the detection of single nucleotide polymorphisms (SNP).

Results
The risk of adverse drug reactions was higher in patients with the CYP2D6*4 GA genotype compared with GG: mean HR change at 1 month (2.88 ± 4.68 and 6.44 ± 5.57, p<0.001) and 6 months (5.14 ± 8.93 and 7.88 ± 5.65, p<0.001), mean PQ interval change at 1 (0.01 ± 0.031 and 0.02 ± 0.022, p=0.003) and 6 months (0.01 ± 0.032 and 0.02 ± 0.024, p=0.003). The risk of adverse drug reactions was higher in patients with the CYP2D6*10 CT genotype compared with CC: mean HR change at 1 month (2.94 ± 4.65 and 6.34 ± 5.66, p<0.001) and 6 months (5.20 ± 8.90 and 7.78 ± 5.75, p<0.001), mean PQ interval change at 1 (0.01 ± 0.032 and 0.02 ± 0.021, p=0.014) and 6 months (0.01 ± 0.033 and 0.02 ± 0.022, p=0.014).

Conclusions

CYP2D6*4 and CYP2D6*10 gene polymorphisms may affect a higher risk of timolol-induced bradycardia and increased PQ interval of treatment medications containing 0.5% of timolol maleate in patients with POAG.
Improving diagnostic decision support through deliberate reflection: a proposal
Authors: Schmidt Henk G. , Mamede Sílvia 
Published: August 2022

Abstract
Digital decision support (DDS) is expected to play an important role in improving a physician’s diagnostic performance and reducing the burden of diagnostic error. Studies with currently available DDS systems indicate that they lead to modest gains in diagnostic accuracy, and these systems are expected to evolve to become more effective and user-friendly in the future. In this position paper, we propose that a way towards this future is to rethink DDS systems based on deliberate reflection, a strategy by which physicians systematically review the clinical findings observed in a patient in the light of an initial diagnosis. Deliberate reflection has been demonstrated to improve diagnostic accuracy in several contexts. In this paper, we first describe the deliberate reflection strategy, including the crucial element that would make it useful in the interaction with a DDS system. We examine the nature of conventional DDS systems and their shortcomings. Finally, we propose what DDS based on deliberate reflection might look like, and consider why it would overcome downsides of conventional DDS.
Crystal structure of {N,N′-bis(4-fluoro-salicylaldehyde)-3,6-dioxa-1,8-diaminooctane-κ4
O,N,N′,O′}zinc(II), C20H20F2N2O4Zn
Authors: Zhao Ji-Xing , Wang Xiao-Jun 
Published: August 2022

Abstract
C20H20F2N2O4Zn, triclinic,

P

1
‾

$P\overline{1}$

(no. 2), a = 8.4062(2) Å, b = 10.9987(3) Å, c = 11.8247(3) Å, α = 97.969(1)°, β = 103.217(1)°, γ = 110.601(1)°, V = 967.04(4) Å3, Z = 2, Rgt
(F) = 0.0415, wRref
(F
2) = 0.1167, T = 173(2) K.