bluuebunny/crossref_metadata_2025_split huggingface dataset:
Methodical approach to quantitative assessment of the risks of the implementation of threats unauthorized access to an information resource automated systems of internal affairs bodies
Authors: Meshcheryakova T. V. , Rogozin E. A. , Efimov A. O. , Romanova V. R. , Konovalenko S. A. 
Published: November 2022

Objective. A characteristic feature of the current stage of development of the sphere of informatization of internal affairs bodies (OVD) is a significant increase in the volume and variety of types of service information of limited distribution, stored, processed and transmitted in automated systems (AS). This gives rise to the emergence of a large number and expansion of the range of threats to information security, primarily threats associated with unauthorized access (UAS) to the information resource of the ATS AS, and necessitates the improvement of existing methods to combat this type of crime in order to ensure the information security of objects of informatization of ATS. To obtain information that allows assessing the degree of threats, it is necessary to conduct a quantitative risk assessment.Method. The method for assessing the risks of implementing threats of unauthorized access to the information resource of the ATS AS and obtaining data in a quantitative representation is based on the use of mathematical modeling methods. The advantage of a quantitative assessment compared to a qualitative assessment is the ability to compare risks with the final result, which can be represented in monetary terms, and further use in assessing the likelihood of information threats and calculating the damage caused.Result. A methodical approach to the quantitative assessment of the risks of the implementation of UA threats to the information resource of the ATS AS is proposed, which makes it possible to assess the level of security of service information.Conclusion. The proposed methodological approach to quantitative assessment of the risks of the implementation of UA threats to the information resource of the ATS AS provides a visual representation in monetary terms of the objects of assessment (damage, costs). These calculations can be used to justify the requirements for the level of security of ATS ASs during their development and operation.
Phenotype Algorithms to Identify Hidradenitis Suppurativa Using Real-World Data: Development and Validation Study
Authors: Hardin Jill , Murray Gayle , Swerdel Joel 
Published: November 2022

Background
Hidradenitis suppurativa (HS) is a potentially debilitating, chronic, recurring inflammatory disease. Observational databases provide opportunities to study the epidemiology of HS.

Objective
This study’s objective was to develop phenotype algorithms for HS suitable for epidemiological studies based on a network of observational databases.

Methods
A data-driven approach was used to develop 4 HS algorithms. A literature search identified prior HS algorithms. Standardized databases from the Observational Medical Outcomes Partnership (n=9) were used to develop 2 incident and 2 prevalent HS phenotype algorithms. Two open-source diagnostic tools, CohortDiagnostics and PheValuator, were used to evaluate and generate phenotype performance metric estimates, including sensitivity, specificity, positive predictive value (PPV), and negative predictive value.

Results
We developed 2 prevalent and 2 incident HS algorithms. Validation showed that PPV estimates were highest (mean 86%) for the prevalent HS algorithm requiring at least two HS diagnosis codes. Sensitivity estimates were highest (mean 58%) for the prevalent HS algorithm requiring at least one HS code.

Conclusions
This study illustrates the evaluation process and provides performance metrics for 2 incident and 2 prevalent HS algorithms across 9 observational databases. The use of a rigorous data-driven approach applied to a large number of databases provides confidence that the HS algorithms can correctly identify HS subjects.
Training a Deep Contextualized Language Model for International Classification of Diseases, 10th Revision Classification via Federated Learning: Model Development and Validation Study
Authors: Chen Pei-Fu , He Tai-Liang , Lin Sheng-Che , Chu Yuan-Chia , Kuo Chen-Tsung , Lai Feipei , Wang Ssu-Ming , Zhu Wan-Xuan , Chen Kuan-Chih , Kuo Lu-Cheng , Hung Fang-Ming , Lin Yu-Cheng , Tsai I-Chang , Chiu Chi-Hao , Chang Shu-Chih , Yang Chi-Yu 
Published: November 2022

Background
The automatic coding of clinical text documents by using the International Classification of Diseases, 10th Revision (ICD-10) can be performed for statistical analyses and reimbursements. With the development of natural language processing models, new transformer architectures with attention mechanisms have outperformed previous models. Although multicenter training may increase a model’s performance and external validity, the privacy of clinical documents should be protected. We used federated learning to train a model with multicenter data, without sharing data per se.

Objective
This study aims to train a classification model via federated learning for ICD-10 multilabel classification.

Methods
Text data from discharge notes in electronic medical records were collected from the following three medical centers: Far Eastern Memorial Hospital, National Taiwan University Hospital, and Taipei Veterans General Hospital. After comparing the performance of different variants of bidirectional encoder representations from transformers (BERT), PubMedBERT was chosen for the word embeddings. With regard to preprocessing, the nonalphanumeric characters were retained because the model’s performance decreased after the removal of these characters. To explain the outputs of our model, we added a label attention mechanism to the model architecture. The model was trained with data from each of the three hospitals separately and via federated learning. The models trained via federated learning and the models trained with local data were compared on a testing set that was composed of data from the three hospitals. The micro F1 score was used to evaluate model performance across all 3 centers.

Results
The F1 scores of PubMedBERT, RoBERTa (Robustly Optimized BERT Pretraining Approach), ClinicalBERT, and BioBERT (BERT for Biomedical Text Mining) were 0.735, 0.692, 0.711, and 0.721, respectively. The F1 score of the model that retained nonalphanumeric characters was 0.8120, whereas the F1 score after removing these characters was 0.7875—a decrease of 0.0245 (3.11%). The F1 scores on the testing set were 0.6142, 0.4472, 0.5353, and 0.2522 for the federated learning, Far Eastern Memorial Hospital, National Taiwan University Hospital, and Taipei Veterans General Hospital models, respectively. The explainable predictions were displayed with highlighted input words via the label attention architecture.

Conclusions
Federated learning was used to train the ICD-10 classification model on multicenter clinical text while protecting data privacy. The model’s performance was better than that of models that were trained locally.
Symptom Burden before and after Dialysis Initiation in Older Patients
Authors: de Rooij Esther N.M. , Meuleman Yvette , de Fijter Johan W. , Jager Kitty J. , Chesnaye Nicholas C. , Evans Marie , Caskey Fergus J. , Torino Claudia , Porto Gaetana , Szymczak Maciej , Drechsler Christiane , Wanner Christoph , Dekker Friedo W. , Hoogeveen Ellen K. 
Published: November 2022

Background and objectives
For older patients with kidney failure, lowering symptom burden may be more important than prolonging life. Dialysis initiation may affect individual kidney failure–related symptoms differently, but the change in symptoms before and after start of dialysis has not been studied. Therefore, we investigated the course of total and individual symptom number and burden before and after starting dialysis in older patients.

Design, setting, participants, & measurements
The European Quality (EQUAL) study is an ongoing, prospective, multicenter study in patients ≥65 years with an incident eGFR ≤20 ml/min per 1.73 m2. Using the dialysis symptom index (DSI), 30 symptoms were assessed every 3–6 months between 2012 and 2021. Scores for symptom number range from zero to 30 and, for burden, from zero to 150, with higher scores indicating more severity. Using mixed effects models, we studied symptoms during the year preceding and the year after dialysis initiation.

Results
We included 456 incident patients on dialysis who filled out at least one DSI during the year before or after dialysis. At dialysis initiation, mean (SD) participant age was 76 (6) years, 75% were men, mean (SD) eGFR was 8 (3) ml/min per 1.73 m2, 44% had diabetes, and 46% had cardiovascular disease. In the year before dialysis initiation, symptom number increased +3.6 (95% confidence interval [95% CI], +2.5 to +4.6) and symptom burden increased +13.3 (95% CI, +9.5 to +17.0). In the year after, symptom number changed −0.9 (95% CI, −3.4 to +1.5) and burden decreased −5.9 (95% CI, −14.9 to −3.0). At dialysis initiation, “fatigue,” “decreased interest in sex,” and “difficulty becoming sexually aroused” had the highest prevalence of 81%, 69%, and 68%, respectively, with a burden of 2.7, 2.4, and 2.3, respectively. “Fatigue” somewhat improved after dialysis initiation, whereas the prevalence and burden of sexual symptoms further increased.

Conclusions
Symptom burden worsened considerably before and stabilized after dialysis initiation. “Fatigue,” “decreased interest in sex,” and “difficulty becoming sexually aroused” were considered most burdensome, of which only “fatigue” somewhat improved after dialysis initiation.
GLP-1 receptor agonists and the risk of thyroid cancer
Authors: Bezin Julien , Gouverneur Amandine , Pénichon Marine , Mathieu Clément , Garrel Renaud , Hillaire-Buys Dominique , Pariente Antoine , Faillie Jean-Luc 
Published: November 2022

<p> </p>
<p><em>Objective</em></p>
<p>To determine whether the use of GLP-1 receptor agonists (RA) is associated with an increased risk of thyroid cancer.</p>
<p><em>Research Design and Methods</em></p>
<p>A nested case-control analysis was performed using the French national healthcare insurance system database (SNDS). Individuals with type 2 diabetes treated with second-line antidiabetic drugs between 2006 and 2018 were included in the cohort. All thyroid cancers were identified through hospital discharge diagnoses and medical procedures between 2014 and 2018. Exposure to GLP-1 RA was measured within the 6 years preceding a 6-month lag-time period and considered as current use and cumulative duration of use based on defined daily dose (≤1, 1 to 3, >3 years). Cases were matched with up to 20 controls on age, sex, and length of diabetes, using the risk-set sampling procedure. The risk of thyroid cancer related to the use of GLP-1 RA was estimated using a conditional logistic regression adjusted on goiter, hypothyroidism, hyperthyroidism, other antidiabetic drugs and social deprivation index.</p>
<p><em>Results</em></p>
<p>2,562 cases of thyroid cancers were included in the study and matched to 45,184 controls. The use of GLP-1 RA for 1 to 3 years was associated with an increased risk of all thyroid cancer (adjusted hazard ratio: 1.58, 95% confidence interval: 1.27 to 1.95), and medullary thyroid cancer (aHR: 1.78, 95% CI: 1.04 to 3.05). </p>
<p><em>Conclusions</em></p>
<p>The present study found an increased risk of all thyroid cancer and medullary thyroid cancer with the use of GLP-1 RA, in particular after 1 to 3 years of treatment.</p>
Information Regarding Modification of Oral Solid Medicines in Written Drug Information: Potential Consequences for Patient Safety
Authors: Zeiss Daniel Horst , Amundstuen Linda 
Published: November 2022

Oral solid medicines (oral solid dosage forms, OSDFs) are among the most used medications, and have various pharmaceutical designs ranging from relatively simple uncoated tablets with immediate-release properties, to advanced modified-release preparations slowly releasing the active ingredient. Taking medicines correctly is essential to preserve intended effects and avoid adverse effects. Still, modification of OSDFs is a common practice among patients and health care personnel, due to for example, swallowing difficulties. Modifications such as crushing tablets and opening capsules should only be done with a careful assessment of potential risks and benefits. In this study, we systematically reviewed the information relating to modification of OSDFs in the monographs of a commonly used source of medicine information in Norway, Felleskatalogen®. A total of 31 different OSDFs were identified. Results show that information on whether the medicines should be swallowed whole, could be divided, crushed, chewed, or opened, varied widely. Medicines with modified-release characteristic generally had more and stricter recommendations concerning modification than medicines with immediate-release characteristic. Recommendations varied largely between monographs, and different recommendations such as “shall”, “should” or “must” may be interpreted differently among readers. Furthermore, a relatively small proportion of the monographs contained descriptions of the potential consequences of modification.
Based on our observations, a necessary risk-benefit assessment on dosage form manipulation for health care personnel and patients is possibly being impeded. Explicit and unambiguous information, or the development and implementation of a “traffic light model” for dosage form manipulation might reduce the risk of medication errors, and thereby increase patient safety.
Perceptions of Engineers' Environmental Responsibility and Professional Codes of Ethics
Authors: Randall Emma Jane , Strong David 
Published: November 2022

In Canada, provincial and territorial level Professional Engineering Codes of Ethics (PECoEs) derived from national guidelines presented by Engineers Canada, provide principles for engineers to aid in decision making and to evaluate the ethical correctness of professional behaviour [1]. Engineers Canada states that engineers must, “Hold paramount the safety, health and welfare of the public and the protection of the environment and promote health and safety within the workplace” [1]. This is frequently the only guideline directly related to the environment included in Canadian provincial and territorial PECoEs)[2-13]; Notably, Ontario’s PECoE currently does not explicitly mention the environment in any capacity [14]. Present professional engineering ethics guidelines for environmental responsibility are either missing or largely open to interpretation in Canada, and complex environmental issues may require more robust ethical frameworks to be effectively approached long-term within engineering industry.
Developing PECoEs requires a better understanding of how engineers view their ethical responsibility with respect to the environment. This paper outlines a study to investigate the ethical beliefs and PECoE interpretations of participants through an online survey with ethical case studies, and interviews. The ultimate goal of this research is to aid the development of PECoEs and engineering ethics education to support sustainable practice.
Efectos de edad, periodo y cohorte en la mortalidad por cáncer de cuello uterino en Colombia entre 1985 y 2014.
Authors: Buitrago Reyes Lina Angélica , Gamboa Garay Oscar Andrés , Hernández Jairo Alonso 
Published: November 2022

Objetivo:Analizar las tendencias de la mortalidad por cáncer de cuello uterino en Colombia, teniendo en cuenta los efectos de edad, periodo y cohorte.
Métodos:Los datos de mortalidad y de población se tomaron de las bases oficiales del Departamento Administrativo Nacional de Estadísticas, DANE. Se ajustaron cinco modelos, la significancia de los efectos se obtuvo comparándolos a través de la prueba de razón de verosimilitud.
Resultados:La tasa de mortalidad ajustada por edad, en muertes fue de 15.09/100,000 mujeres, para el periodo 1985-1989 y 10.21 para el periodo 2010-2014. El cambio promedio porcentual anual fue de -1.45% (IC 95%: -1.57% a -1.34%). Se encontraron efectos de edad, periodo y cohorte.
Conclusiones:Los factores demográficos podrían explicar el comportamiento de la mortalidad por cáncer de cuello uterino en Colombia, al igual que la instauración de medidas de salud pública en las dos últimas décadas.
Tendencias en la incidencia y la mortalidad por cáncer en Manizales, Colombia, 2008-2017
Authors: Arias-Ortiz Nelson Enrique , Rodríguez-Betancourt Juan David 
Published: November 2022

Objetivo
Describir las tendencias en incidencia y mortalidad por cáncer en Manizales, Colombia, entre 2008-2017.
Métodos
Se incluyeron todos los casos incidentes de cáncer en Manizales captados por el Registro Poblacional de Cáncer de Manizales entre el 1º de enero de 2008 y el 31 de diciembre de 2017, así como todas las muertes causadas por cáncer en el mismo periodo. La población en riesgo se obtuvo de las estadísticas del DANE. Se calcularon tasas de incidencia y mortalidad ajustadas por edad según sexo y localización del cáncer. Se evaluaron cambios en las tendencias mediante una regresión Joinpoint.
Resultados
Se registraron 11,188 casos incidentes, 56.7% en mujeres. Ocurrieron 4,996 muertes por cáncer, 52.6% en mujeres. Los cánceres de mama, próstata, estómago, tiroides, pulmón y colon, representaron el 50% de todos los casos incidentes. Durante este periodo, la incidencia en mujeres descendió y equiparó a la de los hombres, a partir de una disminución significativa en los cánceres de cérvix, estómago, y pulmón, entre otros; asimismo, la mortalidad en mujeres disminuyó levemente, debido a la reducción en muertes por cáncer de cérvix, estómago, esófago y tejidos blandos. En contraste, en hombres la incidencia y la mortalidad general no variaron.
Conclusiones
El envejecimiento poblacional ha contribuido a una mayor carga de cáncer. En términos de incidencia y mortalidad, los avances en la lucha contra esta enfermedad aún son discretos. Es prioritario reforzar las estrategias para el control del cáncer con enfoque diferencial por sexo.
Trends in long-term cancer survival in Cali, Colombia: 1998-2017
Authors: Bravo Luis Eduardo , Garcia Luz Stella , Collazos Paola , Holguin Jorge Alirio , Soerjomataram Isabelle , Miranda-Filho Adalberto 
Published: November 2022

Background:
Population-based cancer survival is an indicator of the effectiveness of cancer services that reflects the survival of all cancer patients in the population, regardless of socioeconomic status and disease characteristics.

Aim:
Provision of an up-to-date survival estimate of patients recorded within Cali Population Cancer Registry (RPCC) in 1998-2017. As a second objective, results will be compared with those reported by the CONCORD study for cancers prioritized by the current Ten-Year Cancer Control Plan of Colombia, 2012-2021.

Methods:
Adult cancer cases (aged 15 to 99 years) for nine cancer types diagnosed between 1998 and 2017, with follow-up to 2018, were obtained from the RPCC. The 5-year age-standardized net survival estimates (NS) were estimated using the Pohar-Perme. The results for the period 1995- 2014 were compared with those reported by the CONCORD study for the following locations: stomach (C16), breast (C50), cervix (C53), prostate
(C61), and lung (C33-34).

Results:
Five-year survival estimates for breast and prostate cancers improved ten percentage points through 2007 (70.8 to 81.1 for breast and 79.9 to 90.2 for prostate) and remained stable during 2008-2017. For cervical cancer, survival estimates has remained stable for the last two decades at 53%. For stomach cancer and lung cancer, five-year NS was lower than 25% over the study period. For colorectal cancer, survival estimates increased from 37.9% in 1998-2002 to 54.8% in 2013-2017. Compared to previous 5-year survival estimates of cases diagnosed in 2010-2014, the estimates in this study are significantly higher than those obtained by CONCORD. Survival estimates of patients diagnosed in 1995-2009 showed no difference to CONCORD study.

Conclusions:
Periodic update of vital status and date of last contact reduces bias in survival estimates in population-based cancer registries with passive follow-up.
Antibody deficiencies with normal IgG in adults with Non-cystic fibrosis bronchiectasis or recurrent pneumonia: Cross-sectional study
Authors: Zea-Vera Andres F , Chacón Mario Alejandro , Parra Beatriz 
Published: November 2022

Background
Inborn errors of immunity, mainly Predominantly Antibody deficiencies with normal IgG levels, are unrecognized in adults with lung diseases such as bronchiectasis or recurrent pneumonia.
Objective
To determine IgM, IgA, IgG2 subclass deficiencies, and Specific antibody deficiency (anti-pneumococcal polysaccharide antibodies) in adults with non-cystic fibrosis bronchiectasis or recurrent pneumonia.
Methods
Cross-sectional study. Consecutive patients with non-cystic fibrosis bronchiectasis or recurrent pneumonia were recruited in Cali, Colombia. IgG, IgA, IgM; IgE, IgG2 subclass, and IgG anti-pneumococcal serum levels were measured.
Results
Among the 110 participants enrolled, Antibody deficiencies with normal serum IgG levels were found in 11(10%) cases. IgA deficiency (3 cases), IgM deficiency (2 cases), and IgG2 deficiency (2 cases) were the most frequent primary immunodeficiencies. In addition, IgG2+IgA deficiency, Ataxia-telangiectasia, Hyper-IgE syndrome and Specific Antibody Deficiency(anti-polysaccharides) were found in one case each.
Conclusions
Predominantly antibody deficiencies with normal IgG levels are an important etiology of non-cystic fibrosis bronchiectasis and recurrent pneumonia in adults.
Microsurgical technique for reconstruction of Hemi-uterus with non-communicating rudimentary uterine horns
Authors: Herrera Enrique , Piñeros Castillo William Andres , Paredes Soto Marlly Paola 
Published: November 2022

Case description:
Three patients diagnosed with Hemi-uterus with non-communicating functional rudimentary cavity are reported.
Clinical findings:
Adolescent patients with disabling pelvic pain during menstrual periods, depressive states, and functional disability secondary to pain.
Treatment and outcome:
Reconstruction of Hemi-uterus with non-communicating functional rudimentary cavity using a microsurgical technique, without the need for non-communicating horn resection. The patients were assessed at the 1st, third, and sixth months, showing a marked improvement in their dysmenorrhea. In addition, there was an improvement in the depressive state; there was no change in the volume of her menstrual bleeding, and one of these patients achieved pregnancy with normal prenatal control and cesarean delivery, obtaining a full-term newborn without complications.
Clinical Relevance:
Description of a novel microsurgical technique for the management of the hemi-uterus with a non-communicating functional rudimentary cavity, which could benefit not only the reduction of associated symptoms but could also become an alternative to improve fertility.