bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of carotid atherosclerosis in Egyptian chronic hepatitis C patients after treatment by direct-acting antiviral drugs
Authors: Mohamed Marwa Ahmed , Bayoumy Essam M. , Swailam Mostafa Mohamed , Allam Ahmed Samir 
Published: September 2022

Abstract
Background
Recent studies suggested association between hepatitis C virus (HCV) infection and cardiovascular disorders, including carotid atherosclerosis with evidence of an effect of HCV clearance on carotid atherosclerosis.

Objectives
We aimed to evaluate the impact of direct-acting antiviral (DAA) therapy for chronic hepatitis C virus (HCV) infection on carotid atherosclerosis.

Subjects and methods
This is a prospective cohort study that was carried out in Internal Medicine and Hepatology Department, and outpatient clinics of the Ain Shams University hospitals included 80 Egyptian patients with chronic HCV infection who started treatment in the form of IFN-free DAA-based regimen and completed the course of treatment and 6-month follow-up period. All patients were subjected to detailed history taking, full physical examination, full laboratory investigations, radiological assessment by abdominal ultrasonography, and high-resolution B-mode ultrasonography of both the common carotid arteries.

Results
The mean age of cases was 58.13 ± 7.56 years, 49 (61.25%) males and 31 (38.75%) females. IMT was significantly decreased after treatment 1.24 versus 1.57 mm p < 0.001. The number of patients with IMT ≥ 1 mm was significantly decreased after 6 months 45 (56.3%) versus 57 (71.3%). There was significant positive correlation between baseline carotid IMT and age, BMI, bilirubin, INR, CTP score, carotid plaques, and total cholesterol. Meanwhile, there was significant negative correlation between baseline carotid IMT and hemoglobin, platelets, albumin, and HDL. In patients who achieved SVR, total cholesterol, triglycerides, LDL, and HDL were significantly increased after treatment. IMT was significantly lower in SVR group compared to non-SVR group (p = 0.016).

Conclusion
Hepatitis C virus eradication by DAAs improves carotid atherosclerosis by decreasing carotid intima-media thickening.
Natural Language Processing of Computed Tomography Reports to Label Metastatic Phenotypes With Prognostic Significance in Patients With Colorectal Cancer
Authors: Causa Andrieu Pamela , Golia Pernicka Jennifer S. , Yaeger Rona , Lupton Kaelan , Batch Karen , Zulkernine Farhana , Simpson Amber L. , Taya Michio , Gazit Lior , Nguyen Huy , Nicholas Kevin , Gangai Natalie , Sevilimedu Varadan , Dickinson Shannan , Paroder Viktoriya , Bates David D.B. , Do Richard 
Published: September 2022

PURPOSE Natural language processing (NLP) applied to radiology reports can help identify clinically relevant M1 subcategories of patients with colorectal cancer (CRC). The primary purpose was to compare the overall survival (OS) of CRC according to American Joint Committee on Cancer TNM staging and explore an alternative classification. The secondary objective was to estimate the frequency of metastasis for each organ. METHODS Retrospective study of CRC who underwent computed tomography (CT) chest, abdomen, and pelvis between July 1, 2009, and March 26, 2019, at a tertiary cancer center, previously labeled for the presence or absence of metastasis by an NLP prediction model. Patients were classified in M0, M1a, M1b, and M1c (American Joint Committee on Cancer), or an alternative classification on the basis of the metastasis organ number: M1, single; M2, two; M3, three or more organs. Cox regression models were used to estimate hazard ratios; Kaplan-Meier curves were used to visualize survival curves using the two M1 subclassifications. RESULTS Nine thousand nine hundred twenty-eight patients with a total of 48,408 CT chest, abdomen, and pelvis reports were included. On the basis of NLP prediction, the median OS of M1a, M1b, and M1c was 4.47, 1.72, and 1.52 years, respectively. The median OS of M1, M2, and M3 was 4.24, 2.05, and 1.04 years, respectively. Metastases occurred most often in liver (35.8%), abdominopelvic lymph nodes (32.9%), lungs (29.3%), peritoneum (22.0%), thoracic nodes (19.9%), bones (9.2%), and pelvic organs (7.5%). Spleen and adrenal metastases occurred in < 5%. CONCLUSION NLP applied to a large radiology report database can identify clinically relevant metastatic phenotypes and be used to investigate new M1 substaging for CRC. Patients with three or more metastatic disease organs have the worst prognosis, with an OS of 1 year.
Natural Language Processing Approaches for Automated Multilevel and Multiclass Classification of Breast Lesions on Free-Text Cytopathology Reports
Authors: Nandish Sonali , R.J. Prathibha , N.M. Nandini 
Published: September 2022

PURPOSEThe extensive growth and use of electronic health records (EHRs) and extending medical literature have led to huge opportunities to automate the extraction of relevant clinical information that helps in concise and effective clinical decision support. However, processing such information has traditionally been dependent on labor-intensive processes with human errors such as fatigue, oversight, and interobserver variability. Hence, this study aims at the processing of EHRs and performing multilevel and multiclass classification by fetching dominant characteristic features that are sufficient to detect and differentiate various types of breast lesions.PATIENTS AND METHODSIn this study, unstructured EHRs on breast lesions obtained through fine-needle aspiration cytology technique are considered. The raw text was normalized into structured tabular form and converted to scores by performing sentiment analysis that helps to decide the total polarity or class label of the EHR. Supervised machine learning approaches, namely random forest and feed-forward neural network trained using Levenberg-Marquardt training function, are used for classification of the collected EHR data set containing 2,879 records that are split in the ratio of 80:20 as training and testing data sets, respectively.RESULTSRandom forest and feed-forward neural network classifiers gave the best performance with an accuracy of 99.36%, an overall receiver operating characteristic-area under the curve of 99.2%, a correlation with ground truth of 98.3%, and a histopathologic correlation of 98.6%.CONCLUSIONNatural language processing has huge potential to automate the extraction of clinical features from breast lesions. The proposed multilevel and multiclass classification approach is used to classify 13 different types of breast lesions with 20 different labels into five classes to decide the type of treatment that should be given to patients by a physician or oncologist.
Safety and Efficacy of Pediatric Growth Hormone Therapy: Results From the Full KIGS Cohort
Authors: Maghnie Mohamad , Ranke Michael B , Geffner Mitchell E , Vlachopapadopoulou Elpis , Ibáñez Lourdes , Carlsson Martin , Cutfield Wayne , Rooman Raoul , Gomez Roy , Wajnrajch Michael P , Linglart Agnès , Stawerska Renata , Clayton Peter E , Darendeliler Feyza , Hokken-Koelega Anita C S , Horikawa Reiko , Tanaka Toshiaki , Dörr Helmuth-Günther , Albertsson-Wikland Kerstin , Polak Michel , Grimberg Adda 
Published: September 2022

Abstract

Context
The Kabi/Pfizer International Growth Database (KIGS) is a large, international database (1987-2012) of children treated with recombinant human growth hormone (rhGH) in real-world settings.

Objective
This work aimed to evaluate the safety and efficacy of rhGH from the full KIGS cohort.

Methods
Data were collected by investigators from children with growth disorders treated with rhGH (Genotropin [somatropin]; Pfizer). Safety was evaluated in all treated patients, and efficacy in those treated for 1 year or more. A subgroup included patients treated for 5 years or more (≥ 2 years prepubertal) who had reached near-adult height (NAH). Main outcomes included adverse events (AEs), serious AEs (SAEs), and height growth.

Results
The full KIGS cohort (N = 83 803 [58% male]) was treated for idiopathic GH deficiency (IGHD; 46.9%), organic GHD (10.0%), small for gestational age (SGA; 9.5%), Turner syndrome (TS; 9.2%), idiopathic short stature (ISS; 8.2%), and others (16.2%). Median rhGH treatment duration was 2.7 years and observation 3.1 years. SAEs occurred in 3.7% of patients and death in 0.4%. The most common SAEs were recurrence of craniopharyngioma (n = 151), neoplasm (n = 99), and cancer (n = 91); and scoliosis (n = 91). Median first-year delta height-SD score (SDS) (Prader) in prepubertal patients was 0.66 (IGHD), 0.55 (ISS), 0.58 (TS), and 0.71 (SGA). Median gains in NAH-SDS were 1.79 (IGHD), 1.37 (ISS), and 1.34 (SGA) for boys, and 2.07 (IGHD), 1.62 (ISS), 1.07 (TS), and 1.57 (SGA) for girls.

Conclusion
Data from KIGS, the largest and longest running international database of rhGH-treated children, show that rhGH is safe and increases short-term height gain and adult height across GHD and non-GHD conditions.
Evaluating the Progression to Hypothyroidism in Preconception Euthyroid Thyroid Peroxidase Antibody–Positive Women
Authors: Gill Sofia , Cheed Versha , Morton Victoria A H , Gill Dayna , Boelaert Kristien , Chan Shiao , Coomarasamy Arri , Dhillon-Smith Rima K 
Published: September 2022

Abstract

Context
Thyroid peroxidase antibody (TPOAb) positivity is prevalent in women of reproductive age and predisposes to thyroid dysfunction, particularly hypothyroidism, which has adverse effects on pregnancy.

Objective
This study aimed to report the rate of development of abnormal thyroid function among initially euthyroid TPOAb-positive women recruited into the TABLET trial, to identify factors associated with the development of hypothyroidism, and to compare outcomes between euthyroid and treated hypothyroid individuals.

Methods
This observational cohort study, conducted at 49 UK hospitals between 2011 and 2016, included euthyroid TPOAb-positive women 16 to 40 years of age with a history of miscarriage or subfertility, planning pregnancy, randomized to levothyroxine 50 mcg daily or placebo. Abnormal thyroid function, conception rate, and live birth rate (LBR) ≥34 weeks were analyzed.

Results
Among the women, 70/940 (7.4%) developed subclinical (SCH) or overt (OH) hypothyroidism: 27/470 taking levothyroxine and 43/470 placebo (relative risk [RR] 0.63; 95% CI, 0.39-1.00; P = 0.05); 83% of cases emerged prepregnancy. Baseline median serum TSH concentrations and TPOAb titers were significantly higher in those who developed hypothyroidism vs those who did not (P &lt; 0.001). Treated SCH/OH demonstrated a higher failure-to-conceive rate compared with euthyroid women (adjusted RR 2.02 [1.56-2.62]; P &lt; 0.001). The LBR ≥ 34 weeks was similar in the treated SCH/OH and euthyroid groups (adjusted RR 1.09 [0.77-1.55]; P = 0.6).

Conclusion
Approximately 7% of euthyroid TPOAb-positive women will develop hypothyroidism within 1 year preconception or in pregnancy. Conception rates are lower in women with treated SCH/OH compared with euthyroid women, but LBR are comparable. Thyroid function in TPOAb-positive women should be monitored regularly, when trying to conceive, to ensure prompt diagnosis and appropriate treatment initiation.
Identification of 4 New Loci Associated With Primary Hyperparathyroidism (PHPT) and a Polygenic Risk Score for PHPT
Authors: Soto-Pedre Enrique , Newey Paul J , Srinivasan Sundararajan , Siddiqui Moneeza K , Palmer Colin N A , Leese Graham P 
Published: September 2022

AbstractContextA hypothesis-free genetic association analysis has not been reported for patients with primary hyperparathyroidism (PHPT).ObjectiveWe aimed to investigate genetic associations with PHPT using both genome-wide association study (GWAS) and candidate gene approaches.MethodsA cross-sectional study was conducted among patients of European White ethnicity recruited in Tayside (Scotland, UK). Electronic medical records were used to identify PHPT cases and controls, and linked to genetic biobank data. Genetic associations were performed by logistic regression models and odds ratios (ORs). The combined effect of the genotypes was researched by genetic risk score (GRS) analysis.ResultsWe identified 15 622 individuals for the GWAS that yielded 34 top single-nucleotide variations (formerly single-nucleotide polymorphisms), and LPAR3-rs147672681 reached genome-wide statistical significance (P = 1.2e-08). Using a more restricted PHPT definition, 8722 individuals with data on the GWAS-identified loci were found. Age- and sex-adjusted ORs for the effect alleles of SOX9-rs11656269, SLITRK5-rs185436526, and BCDIN3D-AS1-rs2045094 showed statistically significant increased risks (P &lt; 1.5e-03). GRS analysis of 5482 individuals showed an OR of 2.51 (P = 1.6e-04), 3.78 (P = 4.0e-08), and 7.71 (P = 5.3e-17) for the second, third, and fourth quartiles, respectively, compared to the first, and there was a statistically significant linear trend across quartiles (P &lt; 1.0e-04). Results were similar when stratifying by sex.ConclusionUsing genetic loci discovered in a GWAS of PHPT carried out in a Scottish population, this study suggests new evidence for the involvement of genetic variants at SOX9, SLITRK5, LPAR3, and BCDIN3D-AS1. It also suggests that male and female carriers of greater numbers of PHPT-risk alleles both have a statistically significant increased risk of PHPT.
Ischemic stroke in a pediatric patient – a case report
Authors: Głaz Aneta , Knop Kinga , Kochanowska Anna , Nowicki-Sak Karol , Woźniak Magdalena 
Published: September 2022

Background
Childhood ischemic stroke (AIS) is a relatively rare disease with an estimated incidence of 1.3-13/100,000/year. It most commonly affects children under the age of 5. Major risk factors include arteriopathies, heart disease, hypercoagulable states and infections.
Case report
A 2-year-old patient was admitted to the Department of Neurology at the University Children's Hospital in Lublin after suffering a head injury 3 days earlier. Neurological examination revealed features of left hemiparesis. A CT scan revealed an uncharacteristic hypodense, poorly demarcated area, an indication for further diagnostics. MR imaging revealed diffuse ischemic lesions. Angio-MR showed a lack of signal within the branches of the right posterior cerebral artery. Based on the clinical picture and additional examinations, a diagnosis of ischemic stroke was made and pharmacological treatment was implemented. To determine the cause of the stroke, an echocardiogram was performed, which showed flaccid atrial septal tissue with a defect and a trace left-right leak. Genetic testing for congenital thrombophilia confirmed a 4G/4G polymorphism in the PAI-1 gene.
Conclusions
Ischemic stroke is a life-threatening condition that requires prompt diagnosis and appropriate treatment. The relatively rare occurrence among children and nonspecific symptoms may result in difficulties in making a definitive diagnosis. Each case of stroke in children requires a comprehensive diagnosis including neuroimaging studies and identification of specific risk factors.
The Bright Side of Inequity Aversion
Authors: Li Xi , Li Xinlong 
Published: September 2022

Modern consumers are concerned about not only their material payoff, but also the fairness of the transaction when making purchasing decisions. In this paper, we investigate how consumers’ inequity aversion affects a manufacturer who sources inputs from upstream suppliers. We find that, when the manufacturer sources from a single supplier or when consumers observe the manufacturer’s cost, inequity aversion hurts both the supplier’s and manufacturer’s profits. However, when the manufacturer sources from multiple suppliers and consumers do not observe the manufacturer’s cost, inequity aversion reduces both the suppliers’ and manufacturer’s margins, which significantly alleviates the double marginalization problem, increases consumer demand, and improves channel efficiency. As a result, inequity aversion benefits the suppliers, manufacturer, and consumers alike, leading to a “win–win–win” outcome. By comparing cases in which consumers observe and do not observe the manufacturer’s cost, we also find that, when faced with inequity-averse consumers, a manufacturer may find it optimal to withhold its cost information to help secure lower procurement costs from upstream suppliers. This paper was accepted by Dmitri Kuksov, marketing. Funding: This work was supported by the Hong Kong Research Grants Council [Grant 21500920].
Solving Optimal Stopping Problems via Randomization and Empirical Dual Optimization
Authors: Belomestny Denis , Bender Christian , Schoenmakers John 
Published: September 2022

In this paper, we consider optimal stopping problems in their dual form. In this way, the optimal stopping problem can be reformulated as a problem of stochastic average approximation (SAA) that can be solved via linear programming. By randomizing the initial value of the underlying process, we enforce solutions with zero variance while preserving the linear programming structure of the problem. A careful analysis of the randomized SAA algorithm shows that it enjoys favorable properties such as faster convergence rates and reduced complexity compared with the nonrandomized procedure. We illustrate the performance of our algorithm on several benchmark examples. Funding: This work was supported by the Deutsche Forschungsgemeinschaft via the MATH+ Cluster of Excellence [Project AA4-2].
“Smart Room” Media Peraga Sains yang Edukatif dan Interaktif Guna Menunjang Pembelajaran Tematik di SDN Garahan 1 Jember
Authors: Fadhilah Nur , Risanti Doty , Wahyuono Ruri Agung , Sawitri Dyah , Mawarani Lizda , Abdullah Zulkifli , Muharja Maktum 
Published: September 2022

Pada pembelajaran tematik lebih menekankan pada keterlibatan peserta didik dalam proses pembelajaran secara aktif sehingga memperoleh pengalaman langsung untuk dapat menemukan pengetahuan yang dipelajarinya secara mandiri. Namun, di SDN Garahan 1 Jember proses pembelajaran tematik masih menggunakan metode konvensional yang bersumber dari buku dan hanya mentranfer pengetahuan atau pikiran guru kedalam pikiran siswa. Akibatnya siswa di kelas secara umum terlihat pasif, aktivitas siswa lebih banyak mencatat dan mendengarkan guru. Oleh karena itu, pada program pengabdian masyarakat ini dibuat alat bantu pembelajaran berupa “Smart Room” media peraga sains guna menunjang pembelajaran tematik di SDN Garahan 1 Jember. Alat peraga dirancang mengikuti standar kompetensi dan materi pokok pada silabus pelajaran Tematik kurikulum 2013. Pada setiap alat peraga terdapat modul yang berisi tentang petunjuk penggunaan, penjelasan ilmiah mengenai fenomena yang terjadi, beberapa pertanyaan dan sebuah artikel. Alat peraga dapat digunakan guru saat proses belajar mengajar dan dapat diakses dengan mudah oleh para siswa. Dengan adanya media peraga tersebut guru dapat lebih muda dalam penyampaian materi dan mempercepat dalam pencapaian tujuan pembelajaran. Sehingga dapat meningkatkan rasa keingintahuan dan minat belajar siswa, serta merangsang daya fikir dan nalar siswa.
Using a learning health system framework to examine COVID-19 pandemic planning and response at a Canadian Health Centre
Authors: Cassidy Christine , Sim Meaghan , Somerville Mari , Crowther Daniel , Sinclair Douglas , Elliott Rose Annette , Burgess Stacy , Best Shauna , Curran Janet A. 
Published: September 2022

Background
The COVID-19 pandemic has presented a unique opportunity to explore how health systems adapt under rapid and constant change and develop a better understanding of health system transformation. Learning health systems (LHS) have been proposed as an ideal structure to inform a data-driven response to a public health emergency like COVID-19. The aim of this study was to use a LHS framework to identify assets and gaps in health system pandemic planning and response during the initial stages of the COVID-19 pandemic at a single Canadian Health Centre.

Methods
This paper reports the data triangulation stage of a concurrent triangulation mixed methods study which aims to map study findings onto the LHS framework. We used a triangulation matrix to map quantitative (textual and administrative sources) and qualitative (semi-structured interviews) data onto the seven characteristics of a LHS and identify assets and gaps related to health-system receptors and research-system supports.

Results
We identified several health system assets within the LHS characteristics, including appropriate decision supports and aligned governance. Gaps were identified in the LHS characteristics of engaged patients and timely production and use of research evidence.

Conclusion
The LHS provided a useful framework to examine COVID-19 pandemic response measures. We highlighted opportunities to strengthen the LHS infrastructure for rapid integration of evidence and patient experience data into future practice and policy changes.
Utility of the lateral flow urine lipoarabinomannan tuberculosis assay in patients with advanced HIV disease at antiretroviral therapy centres in Mumbai, India
Authors: Acharya Shrikala , Deshpande Prashant , Asirvatham Edwin Sam , Palkar Amol , Sarman Charishma Jones , Laxmeshwar Chinmay , Setia Maninder Singh , Rathod Dhirubhai , Koli Sagar , Dale Jayesh , Yeldandi Vijay , Allam Ramesh , Agarwal Reshu , Verma Sanjeev , Upadhyaya Sunita , Nyendak Melissa 
Published: September 2022

Background
People with Advanced HIV Disease (AHD) are at higher risk of TB coinfection and mortality. However, there are challenges in TB diagnosis with the currently recommended diagnostic tools. WHO recommends lateral flow urine lipoarabinomannan (LF-LAM) assay to assist TB diagnosis among AHD patients. We assessed the utility and acceptability of using urine LF-LAM assay for TB diagnosis among patients at public Antiretroviral Therapy (ART) Centres in Mumbai.

Methods
The cross-sectional study was conducted among adult AHD patients accessing care from 17 ART centres during November,2020-June, 2021. Urine LF-LAM was offered as routine care for eligible patients in combination with standard diagnostic tests. We calculated the proportion of positive LF-LAM results by CD4 categories and TB symptoms and performed multivariable logistic regression to determine the factors associated with LF-LAM positivity.

Results
Among 2,390 patients, the majority (74.5%) had CD4 between 101–200 cells/mm3. The mean age was 43.7 years (SD:10.6), 68.6% were male, 8.4% had TB symptoms and 88.0% were on ART. The overall proportion of patients with urine LF-LAM positive results was 6.4%. Among PLHIV with CD4≤100 cells/mm3, the positivity was 43.0% and 7.7% in symptomatic and asymptomatic patients, respectively. Among PLHIV with a CD4>100 cells/mm3, the positivity was 26.7% and 2.7% in symptomatic and asymptomatic patients respectively. Urine LF-LAM positivity was higher among inpatients, ART naïve, patients on treatment for <6 months, symptomatic and in WHO clinical stage III/IV of HIV disease as compared to the reference categories. We detected an additional 131 TB cases with urine LF-LAM in combination with the standard diagnostic tests.

Conclusion
The study demonstrated the utility of urine LF-LAM for TB diagnosis among AHD patients and the simple, user-friendly test was acceptable as part of routine care. Inclusion of urine LF-LAM test in the current diagnostic algorithm may facilitate early TB diagnosis among AHD patients.