bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical determinants of hospital treated deliberate self‐harm repetition: A time to recurrent event analysis
Authors: Bøe Anne Seljenes , Mehlum Lars , Melle Ingrid , Qin Ping 
Published: September 2022

AbstractIntroductionPsychiatric disorders are strongly associated with hospital treated deliberate self‐harm (DSH). However, the effect of specific disorders on risk for DSH repetition in sex‐age‐subgroups is understudied. The present study aims to assess the influence of various specific psychiatric disorders on risk for subsequent DSH repetition by way of time to recurrent event analysis on a national cohort of DSH patients.Material and MethodsIndividuals aged 18 and older presenting to somatic hospital for DSH during the period 2008–2018 was identified through national registers. A parametric shared frailty survival analysis was used to investigate the impact of various psychiatric disorders on risk of DSH repetition.ResultsThe cohort consisted of 39,508 individuals of which 8634 (21.8%) presented with 24,028 repeated episodes of hospital treated DSH. Borderline personality disorder increased the risk of DSH repetition in females (adjusted HR 1.49, CI 1.41–1.57), while alcohol use disorder (HR 1.12, CI 1.04–1.19) and substance use disorders (adjusted HR 1.22, CI 1.14–1.32) increased the risk of repetition in males. The strongest impact of psychiatric disorder on risk of repetition was found among the elderly. Previous history of DSH was associated with the highest increased risk of repetition.ConclusionPrior history of DSH was strongly associated with DSH repetition, but the influence of psychiatric disorder varied significantly by specific diagnoses and by sex and age of the patients. Efforts to prevent DSH repetition should be age and gender specific and designed to meet the needs of people with different specific psychiatric disorders.
Metamorphosis and seasonality are major determinants of chytrid infection in a paedomorphic salamander
Authors: Basanta M. D. , Anaya‐Morales S. L. , Martínez‐Ugalde E. , González Martínez T. M. , Ávila‐Akerberg V. D. , Trejo M. V. , Rebollar E. A. 
Published: September 2022

AbstractChytridiomycosis, an emerging disease caused mostly by the pathogen Batrachochytrium dendrobatidis, has caused massive amphibian population declines and extinctions worldwide. The ecology of this disease is mainly explained by the interaction of environmental factors, pathogen biology, and host traits including development. For paedomorphic salamanders, differences in B. dendrobatidis infection may be explained by metamorphosis and water physicochemical conditions. In this study, we aimed to determine the influence of environmental and host factors on B. dendrobatidis prevalence and infection intensity in the facultative paedomorphic salamander Ambystoma altamirani. We determined B. dendrobatidis prevalence and infection load in four populations of A. altamirani along 1 year (four seasons) and assessed their relationship with environmental factors and host metamorphic status (gilled or non‐gilled). We found that B. dendrobatidis prevalence and infection load are largely explained by metamorphic status and environmental factors such as elevation, seasonality, water temperature, pH, conductivity, and dissolved oxygen. To our knowledge, this is the first study to empirically show the effect of metamorphosis on B. dendrobatidis infection status across locations and seasons. This information may be used to understand the temporal dynamics of B. dendrobatidis–host interactions and to identify potential disease outbreaks that may cause cryptic sublethal effects on salamander populations. Our results will help in the development of conservation strategies for paedomorphic salamanders that are already considered threatened by anthropogenic factors such as habitat loss and climate change.
Molecular subtyping of small‐cell lung cancer based on mutational signatures with different genomic features and therapeutic strategies
Authors: Wang Haiyong , Wu Shuangxiu , Li Zhenzhen , Zhang Chenyue , Shang Xiaoling , Zhao Chenglong , Li Zhenxiang , Lin Jiamao , Guo Jun , Wang Zhehai 
Published: September 2022

AbstractSmall‐cell lung cancer (SCLC) is an exceptionally lethal malignancy characterized by extremely high alteration rates and tumor heterogeneity, which limits therapeutic options. In contrast to non‐small‐cell lung cancer that develops rapidly with precision oncology, SCLC still remains outside the realm of precision medicine. No recurrent and actionable mutations have been detected. Additionally, a paucity of substantive tumor specimens has made it even more difficult to classify SCLC subtypes based on genetic background. We therefore carried out whole‐exome sequencing (WES) on the largest available Chinese SCLC cohort. For the first time, we partitioned SCLC patients into three clusters with different genomic alteration profiles and clinical features based on their mutational signatures. We showed that these clusters presented differences in intratumor heterogeneity and genome instability. Moreover, a wide existence of mutually exclusive gene alterations, typically within similar biological functions, was detected and suggested a high SCLC intertumoral heterogeneity. Particularly, Cluster 1 presented the greatest potential to benefit from immunotherapy, and Cluster 3 constituted recalcitrant SCLC, warranting biomarker‐directed drug development and targeted therapies in clinical trials. Our study would provide an in‐depth insight into the genome characteristics of the Chinese SCLC cohort, defining distinct molecular subtypes as well as subtype‐specific therapies and biomarkers. We propose tailoring differentiated therapies for distinct molecular subgroups, centering on a personalized precision chemotherapy strategy combined with immunization or targeted therapy for patients with SCLC.
Randomised controlled trial on robot‐assisted versus manual surgery for pucker peeling
Authors: Faridpooya Koorosh , van Romunde Saskia H. M. , Manning Sonia S. , van Meurs Jan C. , Naus Gerrit J. L. , Beelen Maarten J. , Meenink Thijs C. M. , Smit Jorrit , de Smet Marc D. 
Published: September 2022

AbstractBackgroundThe aim was to explore the feasibility and safety of performing common surgical steps in epiretinal membrane (ERM) peeling using the Preceyes Surgical System (PSS).MethodsIn a tertiary centre, 15 pseudophakic patients with an idiopathic ERM were randomised to robot‐assistance or manual surgery in a 2:1 ratio. In the robot‐assisted group, the following steps were performed using PSS: (1) staining the internal limiting membrane (ILM), (2) removal of the dye, (3) creating an ILM flap, (4) completing the peeling, (5) holding a light pipe and (6) fluid–air exchange. Primary outcome measures were feasibility and safety. Secondary outcome measures were duration, best‐corrected visual acuity (BCVA) and central retinal thickness (CRT). Moreover, the distance travelled by the instrument during peeling was assessed using motion tracking software.ResultsAll steps performed with PSS were feasible with no clinical adverse events or complications. The surgical time was longer in the robot‐assisted group (mean 56 min, SD = 12 vs. 24 min, SD = 5). During the study, the duration of robot‐assisted surgeries decreased from 72 to 46 min. The distance travelled by the forceps was shorter in the robot‐assisted group (mean 403 mm, SD = 186 vs. 550 mm, SD = 134). BCVA and CRT improved equally in both groups.ConclusionsThis is the world's first randomised controlled trial on robotic surgery for ERM. Although more time‐consuming, we found that several surgical steps were feasible with assistance of the PSS.
The Jungle of rights: The legal consciousness of migrant children in transit in Calais
Authors: Lendaro Annalisa , Roland Bastien 
Published: September 2022

AbstractThis article aims to explore the legal consciousness of migrant children in transit at the France–UK border. Based on secondary analysis of legal measures to help ensure child protection, and on ethnographic fieldwork in Calais, this paper shows that the legal consciousness of migrant children is shaped by several factors such as their experience of migration, their previous interactions with public institutions in Europe, their living conditions in transit areas, the police's harassment strategy, the influence of migrant peers and by their own migration plans. We will show that these factors have a deep impact on the legal consciousness of unaccompanied minors and consequently on both their (non‐)claim of protection and (non‐)use of legal tools. By mobilizing biographical sets of data, we will also show that their legal consciousness results from the combination of these contextual factors with their individual experiences and sociological characteristics (education, origin, …). From a methodological point of view, this contribution provides evidence of the importance of adopting a child‐centred approach in ethnographic research. This approach highlights discrepancies between policy aims and children's needs.
Classification, risk factors, and management of lumen apposing metal stent dysfunction during follow‐up of endoscopic ultrasound‐guided choledochoduodenostomy: Multicenter evaluation from the Leuven‐Amsterdam‐Milan Study Group
Authors: Vanella Giuseppe , Bronswijk Michiel , Dell'Anna Giuseppe , Voermans Rogier P. , Laleman Wim , Petrone Maria Chiara , van Malenstein Hannah , Fockens Paul , Arcidiacono Paolo Giorgio , van der Merwe Schalk , van Wanrooij Roy L. J. 
Published: September 2022

ObjectivesLong‐term outcomes of endoscopic ultrasound‐guided choledochoduodenostomy (EUS‐CDS) performed with lumen apposing metal stents (LAMS) have been poorly evaluated in small or retrospective series, leading to an underestimation of LAMS dysfunction.MethodsAll consecutive EUS‐CDS performed in three academic referral centers were included in prospectively maintained databases. Technical/clinical success, adverse events (AEs), and dysfunction during follow‐up were retrospectively analyzed. Kaplan–Meier analysis was used to estimate dysfunction‐free survival (DFS), with Cox proportional hazard regression to evaluate independent predictors of dysfunction.ResultsNinety‐three patients were included (male 56%; mean age, 70 years [95% confidence interval (CI) 68–72]; pancreatic cancer 81%, metastatic disease 47%). In 67% of procedures, 6 mm LAMS were used. Technical and clinical success were achieved in 97.8% and 93.4% of patients, respectively, with AEs occurring in 9.7% (78% mild/moderate). Dysfunction occurred in 31.8% of patients after a mean of 166 days (95% CI 91–241), with an estimated 6 month and 12 month DFS of 75% and 52%, respectively; mean DFS of 394 (95% CI 307–482) days. Almost all dysfunctions (96%) were successfully managed by endoscopic reintervention. Duodenal invasion (hazard ratio 2.7 [95% CI 1.1–6.8]) was the only independent predictor of dysfunction.ConclusionsEndoscopic ultrasound‐guided choledochoduodenostomy shows excellent initial efficacy and safety, although stent dysfunctions occurs frequently during long‐term follow‐up. Almost all stent dysfunctions can be managed successfully by endoscopic reinterventions. We propose a comprehensive classification of the different types of dysfunction that may be encountered and rescue procedures that may be employed under these circumstances. Duodenal invasion seems to increase the risk of developing EUS‐CDS dysfunction, potentially representing a relative contraindication for this technique.
Reliability and validity of prognostic indicators for Guillain–Barré syndrome in children
Authors: Qinrong Huang , Yuxia Chen , Ling Liu , Huayu Luo , Lei Xu , Xiaoli Li , Nong Xiao 
Published: September 2022

AbstractAimTo explore the clinical characteristics and prognostic predictors of Guillain–Barré syndrome (GBS) in Chinese paediatric patients.MethodThe clinical features of children with GBS hospitalized in the Children's Hospital of Chongqing Medical University were summarized retrospectively. The correlation between the Erasmus GBS Outcome Score (EGOS)/modified Erasmus GBS Outcome Score (mEGOS), GBS disability score (GDS)/modified Rankin Scale (MRS), Erasmus GBS Respiratory Insufficiency Score (EGRIS), and mechanical ventilation were evaluated.ResultsOne hundred forty‐two patients (86 males, 56 females; median 62.50 months [interquartile range 41.00–97.50]) with classic GBS were enrolled in the study. In the present GBS cohort, 134 (94.37%) patients could walk independently (GDS ≤2) and 121 (85.21%) could manage without assistance (MRS ≤2) at 6 months. Eighteen (12.68%) patients with GBS required mechanical ventilation. The performance of mEGOS on admission, mEGOS on day 7, and EGOS‐predicted GDS outcome at 4 weeks, 3 months, and 6 months in the paediatric patients with GBS admitted within 2 weeks of disease onset and that of the MRS outcome were evaluated. The EGRIS in individuals who required mechanical ventilation was significantly higher than in patients without mechanical ventilation (median = 6 vs median = 3, p < 0.001).InterpretationIn Chinese paediatric patients with GBS who were admitted 2 weeks after disease onset, the mEGOS and EGOS are validated indicators for the prediction of clinical outcomes 6 months after onset. EGRIS is helpful in predicting the implementation of mechanical ventilation in the acute phase.What this paper adds

The Erasmus Guillain–Barré syndrome (GBS) Outcome Score (EGOS) and modified EGOS are reliable prognostic predictors in paediatric patients with GBS.
The Erasmus GBS Respiratory Insufficiency Score (EGRIS) is an effective predictor of mechanical ventilation in paediatric patients with GBS.
An EGRIS of ≥5 indicates a high risk of mechanical ventilation in the acute phase.
Expanding the natural history of CASK‐related disorders to the prenatal period
Authors: Gafner Michal , Boltshauser Eugen , D'Abrusco Fulvio , Battini Roberta , Romaniello Romina , D'Arrigo Stefano , Zanni Ginevra , Leibovitz Zvi , Yosovich Keren , Lerman‐Sagie Tally ,   The Cask Study Group
Published: September 2022

AbstractAimTo assess whether microcephaly with pontine and cerebellar hypoplasia (MICPCH) could manifest in the prenatal period in patients with calcium/calmodulin‐dependent serine protein kinase (CASK) gene disorders.MethodIn this international multicentre retrospective study, we contacted a CASK parents' social media group and colleagues with expertise in cerebellar malformations and asked them to supply clinical and imaging information. Centiles and standard deviations (SD) were calculated according to age by nomograms.ResultsThe study consisted of 49 patients (44 females and 5 males). Information regarding prenatal head circumference was available in 19 patients; 11 out of 19 had a fetal head circumference below –2SD (range −4.1SD to −2.02SD, mean gestational age at diagnosis 20 weeks). Progressive prenatal deceleration of head circumference growth rate was observed in 15 out of 19. At birth, 20 out of 42 had a head circumference below –2SD. A total of 6 out of 15 fetuses had a TCD z‐score below –2 (range −5.88 to −2.02).InterpretationThis study expands the natural history of CASK‐related disorders to the prenatal period, showing evidence of progressive deceleration of head circumference growth rate, head circumference below –2SD, or small TCD. Most cases will not be diagnosed according to current recommendations for fetal central nervous system routine assessment. Consecutive measurements and genetic studies are advised in the presence of progressive deceleration of head circumference growth rates or small TCD.What this paper adds

Progressive deceleration of fetal head circumference growth rate can be observed.
A small transcerebellar diameter is an additional important manifestation.
Most cases will not be diagnosed according to current recommendations for fetal central nervous system routine assessment.
Consecutive measurements are advised when measurements are within the low range of norm.
Comparison between PFN1 and SOD1 mutations in amyotrophic lateral sclerosis
Authors: Corcia Philippe , Lejeune Pascal , Vourc'h Patrick , Beltran Stephane , Piegay Anne‐Sophie , Blasco Helene , Meininger Vincent 
Published: September 2022

AbstractBackgroundThe objective of this study was to characterize the prototypical phenotype of patients with amyotrophic lateral sclerosis (ALS) associated with PFN1 mutations in profilin 1 (PFN1) and to determine clinical indications to test for mutations in this gene.Material and methodsThe phenotype of three relatives carrying the M114V PFN1 mutation are detailed here and are compared with those of patients with ALS linked to PFN1 previously reported in the literature.ResultsIn this pedigree and in the literature, the main clinical findings which best describe familial ALS linked to PFN1 might be the following characteristics: pedigrees over five cases, age of onset around 50 years, site of onset systematically lower limbs and the absence of cognitive impairment.ConclusionFirst, the infrequent incidence of patients with ALS linked to PFN1 mutation supports the pursuit of a precise characterization of the phenotype linked to PFN1 mutations. Then, the numerous similarities between the phenotype amongst patients linked to SOD1 and PFN1 mutations and between histological features amongst both mice models prompts a review of the current ALS classifications, taking into consideration both phenotype and genotype.
Clinical characteristics, treatments, outcome, and prognostic factors of severe autoimmune encephalitis in the intensive care unit: Standard treatment and the value of additional plasma cell–depleting escalation therapies for treatment‐refractory patients
Authors: Schwarz Lisa , Akbari Nilufar , Prüss Harald , Meisel Andreas , Scheibe Franziska 
Published: September 2022

AbstractBackground and purposeTo investigate severe autoimmune encephalitis (AE) in the intensive care unit (ICU) with regard to standard treatment in responsive patients and additional escalation therapies for treatment‐refractory cases.MethodsThis retrospective, single‐center study analyzed medical records of ICU‐dependent AE patients for clinical characteristics, treatments, prognostic factors, and neurological outcome as quantified by modified Rankin Scale (mRS) and Clinical Assessment Scale for Autoimmune Encephalitis (CASE).ResultsFrom 40 enrolled patients (median age = 52 years; range = 16–89 years) with AE mediated by neuronal surface antibodies (nsAb; 90%) and AE with onconeuronal antibodies (10%), 98% received first‐line therapy. Of those, 62% obtained additional second‐line therapy, and 33% received escalation therapy with bortezomib and/or daratumumab. Good neurological outcome, defined as mRS = 0–2, was observed in 47% of AE with nsAb (CASE = 5), 77% of anti‐N‐methyl D‐aspartate receptor encephalitis patients (CASE = 1), whereas AE patients with onconeuronal antibodies had the poorest outcome (mRS = 6, 100%). Treatment‐refractory AE patients with nsAb requiring escalation therapy achieved similarly good recovery (mRS = 0–2, 39%, CASE = 3) as patients improving without (mRS = 0–2, 54%, CASE = 4), although they presented a higher disease severity at disease maximum (mRS = 5 100% versus 68%, CASE = 24 versus 17; p = 0.0036), had longer ICU stays (97 versus 23 days; p = 0.0002), and a higher survival propability during follow‐up (p = 0.0203). Prognostic factors for good recovery were younger age (p = 0.025) and lack of preexisting comorbidities (p = 0.011).ConclusionsOur findings suggest that treatment‐refractory AE patients with nsAb in the ICU can reach similarly good outcomes after plasma cell–depleting escalation therapy as patients already responding to standard first‐ and/or second‐line therapies.
Threshold multiparty multi‐randomness secure partially homomorphic encryption for data security in cloud
Authors: Boomija M D , Kasmir Raja S V 
Published: September 2022

AbstractThreshold cryptography is used to secure a cryptographic secret by dividing it into N shares and storing each claim on a diverse server. Any subgroup of t servers can use the secret without re‐making it. However, an adversary cannot recover the secret by compromising t − 1 servers. Homomorphic encryption operates directly on the ciphertext. In this study, a Threshold multiparty multi‐randomness secure partially homomorphic encryption (TM‐MR‐SPHE) algorithm is proposed to secure the outsourced data and perform multiplication and division operations on the ciphertext. The model is implemented in Eclipse IDE and AWS Toolkit for Eclipse and deployed in Amazon Elastic Beanstalk (EB) environment. This model is mainly used to secure the patient e‐health details and perform computation on outsourced data. The patient details are encrypted by the algorithm MR‐SPHE and uploaded in AWS (Amazon Web Service) S3 bucket. AWS identity and access management (IAM) creates the users' service and secret shares among multiple users in the EB environment. The proposed model performance is studied by comparing with other partially homomorphic Elgamal, Pailler, and Benaloh. This model achieves data integrity and confidentiality using the threshold multiparty with multi‐randomness secure partially homomorphic encryption.
Emotional expression in jewellery design under the background of artificial intelligence
Authors: Liang Meng , Wanli Zhao 
Published: September 2022

AbstractIn order to improve the emotional expression effect of jewellery, this article combines artificial intelligence technology to analyse the emotional expression in jewellery design. Aiming at the characteristics of high‐gloss materials such as strong reflectivity and translucency, starting from the classic ray tracing algorithm, this article strengthens the reflected light and projected light on the surface of the material, and proposes a realistic rendering algorithm for high‐gloss materials. Moreover, this article introduces the CUDA parallel computing architecture to give full play to the computing power of multi‐core computers, accelerate the calculation speed of the ray tracing algorithm, save the consumption of storage space, and improve the speed of real‐time rendering under the premise of ensuring realism. The experimental research results show that the emotional expression system for smart jewellery design proposed in this article has a certain effect, which can effectively improve the effect of jewellery design.