bluuebunny/crossref_metadata_2025_split huggingface dataset:
External validation study on the value of deep learning algorithm for the prediction of hematoma expansion from noncontrast CT scans
Authors: Guo Dong Chuang , Gu Jun , He Jian , Chu Hai Rui , Dong Na , Zheng Yi Feng 
Published: March 2022

Abstract
Background
Hematoma expansion is an independent predictor of patient outcome and mortality. The early diagnosis of hematoma expansion is crucial for selecting clinical treatment options. This study aims to explore the value of a deep learning algorithm for the prediction of hematoma expansion from non-contrast computed tomography (NCCT) scan through external validation.

Methods
102 NCCT images of hypertensive intracerebral hemorrhage (HICH) patients diagnosed in our hospital were retrospectively reviewed. The initial computed tomography (CT) scan images were evaluated by a commercial Artificial Intelligence (AI) software using deep learning algorithm and radiologists respectively to predict hematoma expansion and the corresponding sensitivity, specificity and accuracy of the two groups were calculated and compared. Comparisons were also conducted among gold standard hematoma expansion diagnosis time, AI software diagnosis time and doctors’ reading time.

Results
Among 102 HICH patients, the sensitivity, specificity, and accuracy of hematoma expansion prediction in the AI group were higher than those in the doctor group(80.0% vs 66.7%, 73.6% vs 58.3%, 75.5% vs 60.8%), with statistically significant difference (p < 0.05). The AI diagnosis time (2.8 ± 0.3 s) and the doctors’ diagnosis time (11.7 ± 0.3 s) were both significantly shorter than the gold standard diagnosis time (14.5 ± 8.8 h) (p < 0.05), AI diagnosis time was significantly shorter than that of doctors (p < 0.05).

Conclusions
Deep learning algorithm could effectively predict hematoma expansion at an early stage from the initial CT scan images of HICH patients after onset with high sensitivity and specificity and greatly shortened diagnosis time, which provides a new, accurate, easy-to-use and fast method for the early prediction of hematoma expansion.
Knowledge and attitudes of adolescent girls and their mothers about early pregnancy: a cross-sectional study
Authors: Naghizadeh Somayyeh , Mirghafourvand Mojgan 
Published: March 2022

Abstract
Background
Adolescent pregnancy is an important public health problem and a socio-economic challenge in diverse societies. As a tremendously important problem, this issue has caused major concerns, as it exposes adolescent girls to social isolation and physical and psychological harm. So, this study aimed to determine the knowledge and attitude of adolescent girls and their mothers about early pregnancy, its causes, consequences, and predictors in Tabriz-Iran in 2020–21.

Methods
This cross-sectional study was done with 540 people (270 adolescent girls and 270 mothers) in the health centers of Tabriz. Data were collected using the questionnaires of sociodemographic information, knowledge, and adolescent girls’ attitudes and their mothers about early pregnancy, its causes, and consequences. Multivariate logistic regression was used to determine the predictors of adolescent girls and their mothers’ attitudes toward early pregnancy.

Results
The mean (SD: Standard Deviation) of knowledge of adolescent girls and their mothers about early pregnancy was 5.17 (3.11) and 5.57 (3.01), respectively (score range: 0 to 9). Most girls (94.1%) and mothers (87.1%) opposed pregnancy before 18. There was a statistically significant relationship between the knowledge and attitudes of girls (p < 0.001) and mothers (p < 0.001) about pregnancy at a young age. Adolescent girls and their mothers mentioned the lack of sufficient knowledge about sexual relations (57.4% of girls and 66.3% mothers agree) and the lack of knowledge about contraceptive methods (51.9% girl and 59.2% mother agree) important reasons for early pregnancy. Based on the multivariate logistic regression model and controlling for potentially confounding variables, girls whose parents were married under the age of 18 were about three times more likely to agree to early pregnancy than girls whose parents married over the age of 18 (OR = 3.10; 95% Cl: 0.90 to 10.69; p = 0.037). Also, mothers whose other children were married before 18 were almost five times more likely to agree to early pregnancy than women whose other children were not married before 18 (OR = 4.91; 95% Cl: 1.60 to 15.10; p = 0.045).

Conclusions
The current study results indicate that despite the negative attitude of adolescent girls and their mothers towards early pregnancy, they had a low level of knowledge about early pregnancy. Consequently, increasing the level of knowledge of girls and their families about the consequences of marriage and pregnancy at an early age and creating a culture to correct cultural and social misconceptions to prevent marriage and pregnancy of children can reduce the severity of this damage.
Overview of adjuvant radiotherapy on survival, failure pattern and toxicity in stage I to II endometrial carcinoma: a long-term multi-institutional analysis in China
Authors: Wang Wenhui , Wang Tiejun , Liu Zi , He Jianli , Sun Xiaoge , Zhong Wei , Zhao Fengjv , Li Xiaomei , Li Sha , Zhu Hong , Ma Zhanshu , Hu Ke , Zhang Fuquan , Hou Xiaorong , Wei Lichun , Zou Lijuan 
Published: March 2022

Abstract
Background
This research aimed to provide an overview of the impact of adjuvant vaginal brachytherapy (VBT) and external beam pelvic radiotherapy (EBRT) with or without VBT on survival in stage I to II EC patients in China from a long-term multi-institutional analysis.

Methods
We retrospectively analyzed stage I to II EC patients from 13 institutions treated between 2003 and 2015. All patients underwent surgical staging and received adjuvant RT. Patients were divided into groups of low-risk (LR), intermediate-risk (IR), high-intermediate-risk (HIR) and high-risk (HR). Survival statistics, failure pattern, and toxicity of different radiation modalities in different risk groups were analyzed.

Results
A total of 1048 patients were included. HR disease represented 27.6%, HIR 17.7%, IR 27.7% and LR 27.1%, respectively. Endometrioid adenocarcinoma (EAC) and non-endometrioid carcinoma (NEC) accounted for 92.8 and 7.2%. A total of 474 patients received VBT alone and 574 patients received EBRT with or without VBT.
As for EAC patients, the 5-year overall survival (OS), disease-free survival (DFS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) rate was: 94.6, 90.4, 93.0 and 91.6%, respectively. For LR patients, EBRT (with or without VBT) seemed to be a risk factor. With the higher risk category, the survival benefit of EBRT gradually became remarkable. EBRT (with or without VBT) significantly increased DFS, LRFS and DMFS compared to VBT alone in the HR group (p < 0.05). Distant metastasis was the main failure pattern for all risk groups. As for NEC patients, the 5-year OS, DFS, LRFS and DMFS rate was: 93.4, 87.2, 91.7 and 89.3%, respectively. As for toxicity, EBRT (with or without VBT) significantly increased the incidence of grade 1–2 gastrointestinal, urinary, and hematological toxicity.

Conclusions
For stage I to II EC patients, EAC accounted for the majority and had better prognosis than NEC. For EAC patients, VBT alone resulted in comparable survival to EBRT in the LR, IR and HIR groups, while EBRT significantly increased survival in the HR group. EBRT had higher rate of toxicity than VBT.
Individual socioeconomic position, neighbourhood disadvantage and mental well-being: a cross-sectional multilevel analysis of mid-age adults
Authors: Mann Emily M. , Heesch Kristiann C. , Rachele Jerome N. , Burton Nicola W. , Turrell Gavin 
Published: March 2022

Abstract
Background
Socioeconomic disadvantage is associated with mental illness, yet its relationship with mental well-being is unclear. Mental well-being is defined as feeling good and functioning well. Benefits of mental well-being include reduced mortality, improved immune functioning and pain tolerance, and increased physical function, pro-social behaviour, and academic and job performance. This study aimed to explore the relationship between individual socioeconomic position (SEP), neighbourhood disadvantage and mental well-being in mid-age adults.

Methods
Multilevel modelling was used to analyse data collected from 7866 participants from the second (2009) wave of HABITAT (How Areas in Brisbane Influence healTh and activiTy), a longitudinal study (2007–2016) of adults aged 40–65 years living in Brisbane, Australia. Mental well-being was measured using the Warwick Edinburgh Mental Well-Being Scale (WEMWBS). Exposure measures were education, occupation, household income, and neighbourhood socioeconomic disadvantage.

Results
The lowest MWB scores were observed for the least educated (β = − 1.22, 95%CI = − 1.74, − 0.71), those permanently unable to work (β = − 5.50, 95%CI = − 6.90, − 4.10), the unemployed (β = − 2.62, 95%CI = − 4.12, − 1.13), and members of low-income households (β = − 3.77, 95%CI = − 4.59, − 2.94). Residents of the most disadvantaged neighbourhoods had lower MWB scores than those living in the least disadvantaged neighbourhoods, after adjustment for individual-level SEP (β = − 0.96, 95%CI = − 1.66, − 0.28).

Conclusions
Both individual-level SEP and neighbourhood disadvantage are associated with mental well-being although the association is stronger for individual-level SEP. This research highlights the need to address individual and neighbourhood-level socioeconomic determinants of mental well-being.
Health professionals' knowledge and attitude towards patient confidentiality and associated factors in a resource-limited setting: a cross-sectional study
Authors: Tegegne Masresha Derese , Melaku Mequannent Sharew , Shimie Aynadis Worku , Hunegnaw Degefaw Denekew , Legese Meseret Gashaw , Ejigu Tewabe Ambaye , Mengestie Nebyu Demeke , Zemene Wondewossen , Zeleke Tirualem , Chanie Ashenafi Fentahun 
Published: March 2022

Abstract
Background
Respecting patients’ confidentiality is an ethical and legal responsibility for health professionals and the cornerstone of care excellence. This study aims to assess health professionals’ knowledge, attitudes, and associated factors towards patients’ confidentiality in a resource-limited setting.

Methods
Institutional based cross-sectional study was conducted among 423 health professionals. Stratified sampling methods were used to select the participants, and a structured self-administer questionnaire was used for data collection. The data was entered using Epi-data version 4.6 and analyzed using SPSS, version 25. Bi-variable and multivariable binary logistic regression analyses were used to measure the association between the dependent and independent variables. Odds ratio with 95% confidence intervals and P value was calculated to determine the strength of association and to evaluate statistical significance.

Result
Out of 410 participants, about 59.8% with [95% CI (54.8–68.8%)] and 49.5% with [95% CI (44.5–54.5%)] had good knowledge and favorable attitude towards patents confidentiality respectively. Being male (AOR = 1.63, 95% CI [1.03–2.59]), taking training on medical ethics (AOR = 1.73, 95% CI = [1.11–2.70]), facing ethical dilemmas (AOR = 3.07, 95% CI [1.07–8.79]) were significantly associated factors for health professional knowledge towards patients’ confidentiality. Likewise, taking training on medical ethics (AOR = 2.30, 95% CI [1.42–3.72]), having direct contact with the patients (AOR = 3.06, 95% CI [1.12–8.34]), visiting more patient (AOR = 4.38, 95% CI [2.46–7.80]), and facing ethical dilemma (AOR = 3.56, 95% CI [1.23–10.26]) were significant factors associated with attitude of health professionals towards patient confidentiality.

Conclusion
The findings of this study revealed that health professionals have a limited attitude towards patient confidentiality but have relatively good knowledge. Providing a continuing medical ethics training package for health workers before joining the hospital and in between the working time could be recommended to enhance health professionals’ knowledge and attitude towards patient confidentiality.
Establishing analytical validity of BeadChip array genotype data by comparison to whole-genome sequence and standard benchmark datasets
Authors: Cherukuri Praveen F. , Soe Melissa M. , Condon David E. , Bartaria Shubhi , Meis Kaitlynn , Gu Shaopeng , Frost Frederick G. , Fricke Lindsay M. , Lubieniecki Krzysztof P. , Lubieniecka Joanna M. , Pyatt Robert E. , Hajek Catherine , Boerkoel Cornelius F. , Carmichael Lynn 
Published: March 2022

Abstract
Background
Clinical use of genotype data requires high positive predictive value (PPV) and thorough understanding of the genotyping platform characteristics. BeadChip arrays, such as the Global Screening Array (GSA), potentially offer a high-throughput, low-cost clinical screen for known variants. We hypothesize that quality assessment and comparison to whole-genome sequence and benchmark data establish the analytical validity of GSA genotyping.

Methods
To test this hypothesis, we selected 263 samples from Coriell, generated GSA genotypes in triplicate, generated whole genome sequence (rWGS) genotypes, assessed the quality of each set of genotypes, and compared each set of genotypes to each other and to the 1000 Genomes Phase 3 (1KG) genotypes, a performance benchmark. For 59 genes (MAP59), we also performed theoretical and empirical evaluation of variants deemed medically actionable predispositions.

Results
Quality analyses detected sample contamination and increased assay failure along the chip margins. Comparison to benchmark data demonstrated that > 82% of the GSA assays had a PPV of 1. GSA assays targeting transitions, genomic regions of high complexity, and common variants performed better than those targeting transversions, regions of low complexity, and rare variants. Comparison of GSA data to rWGS and 1KG data showed > 99% performance across all measured parameters. Consistent with predictions from prior studies, the GSA detection of variation within the MAP59 genes was 3/261.

Conclusion
We establish the analytical validity of GSA assays using quality analytics and comparison to benchmark and rWGS data. GSA assays meet the standards of a clinical screen although assays interrogating rare variants, transversions, and variants within low-complexity regions require careful evaluation.
Glycemic control and atrial fibrillation: an intricate relationship, yet under investigation
Authors: Papazoglou Andreas S. , Kartas Anastasios , Moysidis Dimitrios V. , Tsagkaris Christos , Papadakos Stavros P. , Bekiaridou Alexandra , Samaras Athanasios , Karagiannidis Efstratios , Papadakis Marios , Giannakoulas George 
Published: March 2022

AbstractAtrial fibrillation (AF) and diabetes mellitus (DM) constitute two major closely inter-related chronic cardiovascular disorders whose concurrent prevalence rates are steadily increasing. Although, the pathogenic mechanisms behind the AF and DM comorbidity are still vague, it is now clear that DM precipitates AF occurrence. DM also affects the clinical course of established AF; it is associated with significant increase in the incidence of stroke, AF recurrence, and cardiovascular mortality. The impact of DM on AF management and prognosis has been adequately investigated. However, evidence on the relative impact of glycemic control using glycated hemoglobin levels is scarce. This review assesses up-to-date literature on the association between DM and AF. It also highlights the usefulness of glycated hemoglobin measurement for the prediction of AF and AF-related adverse events. Additionally, this review evaluates current anti-hyperglycemic treatment in the context of AF, and discusses AF-related decision-making in comorbid DM. Finally, it quotes significant remaining questions and sets some future strategies with the potential to effectively deal with this prevalent comorbidity.
Effect of slightly elevated progesterone on hCG trigger day on clinical pregnancy rate in GnRH-ant IVF/ICSI cycles
Authors: Zhao Jing , Hao Jie , Xu Bin , Wang Yonggang , Li Yanping 
Published: March 2022

Abstract
Background
It was been agreed that significantly elevated progesterone level on the hCG trigger day have detrimental effect on clinical outcomes in IVF/ICSI cycles. However, few studies explored whether slightly elevated progesterone level also same impact on clinical outcomes.

Methods
We retrospectively studies the effect of slightly elevated progesterone level on outcomes of IVF/ICSI in GnRH-ant cycles. Propensity score matching was used to confounding variables. The women were divided into two groups according to the progesterone level: Group 1: < 1.0 ng/ml; Group 2: 1.0 ng/ml–1.5 ng/ml. Then compare the clinical pregnancy rate (CPR) between the two groups.

Result
A total of 847 IVF/ICSI cycles were included in the present study. The average CPR per transfer cycle was 51.7%. CPR of group 1 was 55.22%, significantly higher than that of group 2 (40.66%, P = 0.013). Progesterone level on the day of hCG injection was further evaluated at threshold increments of 0.1 ng/ml, and the CPR was decreased dramatically once the progesterone level higher than 1.4 ng/ml.

Conclusion
The slight elevation progesterone level on the hCG trigger day may have a negative effect on the clinical pregnancy in GnRH-ant cycles. In the case of progesterone > 1.4 ng/ml on the hCG injection day, freeze-all strategy was recommended.

Summary
The present retrospective study aimed to evaluate the effect of slightly elevated progesterone (1.0 ng/ml ~ 1.5 ng/ml) on outcomes of IVF/ICSI in GnRH-ant cycles. Slightly elevated progesterone level leaded to significant lower clinical pregnancy rate (CPR) that that of group with normal progesterone level (40.66% vs. 55.22%, P = 0.013). The CPR was decreased dramatically once the progesterone level higher than 1.4 ng/ml. So slightly elevated progesterone level on the trigger day may have a negative effect on the clinical pregnancy in GnRH-ant cycles. In the case of progesterone > 1.4 ng/ml on the hCG injection day, freeze-all strategy was recommended.
Decreased CSF clearance and increased brain amyloid in Alzheimer’s disease
Authors: Li Yi , Rusinek Henry , Butler Tracy , Glodzik Lidia , Pirraglia Elizabeth , Babich John , Mozley P. David , Nehmeh Sadek , Pahlajani Silky , Wang Xiuyuan , Tanzi Emily B. , Zhou Liangdong , Strauss Sara , Carare Roxana O. , Theise Neil , Okamura Nobuyuki , de Leon Mony J. 
Published: March 2022

Abstract
Background
In sporadic Alzheimer’s disease (AD), brain amyloid-beta (Aβ) deposition is believed to be a consequence of impaired Aβ clearance, but this relationship is not well established in living humans. CSF clearance, a major feature of brain glymphatic clearance (BGC), has been shown to be abnormal in AD murine models. MRI phase contrast and intrathecally delivered contrast studies have reported reduced CSF flow in AD. Using PET and tau tracer 18F-THK5117, we previously reported that the ventricular CSF clearance of the PET tracer was reduced in AD and associated with elevated brain Aβ levels.

Methods
In the present study, we use two PET tracers, 18F-THK5351 and 11C-PiB to estimate CSF clearance calculated from early dynamic PET frames in 9 normal controls and 15 AD participants.

Results
we observed that the ventricular CSF clearance measures were correlated (r = 0.66, p < 0.01), with reductions in AD of 18 and 27%, respectively. We also replicated a significant relationship between ventricular CSF clearance (18F-THK5351) and brain Aβ load (r =  − 0.64, n = 24, p < 0.01). With a larger sample size, we extended our observations to show that reduced CSF clearance is associated with reductions in cortical thickness and cognitive performance.

Conclusions
Overall, the findings support the hypothesis that failed CSF clearance is a feature of AD that is related to Aβ deposition and to the pathology of AD. Longitudinal studies are needed to determine whether failed CSF clearance is a predictor of progressive amyloidosis or its consequence.
Postoperative drainage for 6, 12, or 24 h after burr-hole evacuation of chronic subdural hematoma in symptomatic patients (DRAIN-TIME 2): study protocol for a nationwide randomized controlled trial
Authors: Grønhøj Mads Hjortdal , Jensen Thorbjørn Søren Rønn , Sindby Ann Kathrine , Miscov Rares , Hundsholt Torben , Debrabant Birgit , Bjarkam Carsten Reidies , Bergholt Bo , Fugleholm Kåre , Poulsen Frantz Rom 
Published: March 2022

Abstract
Background
Chronic subdural hematoma (CSDH) is a common acute or subacute neurosurgical condition, typically treated by burr-hole evacuation and drainage. Recurrent CSDH occurs in 5–20% of cases and requires reoperation in symptomatic patients, sometimes repeatedly. Postoperative subdural drainage of maximal 48 h is effective in reducing recurrent hematomas. However, the shortest possible drainage time without increasing the recurrence rate is unknown.

Methods
DRAIN-TIME 2 is a Danish multi-center, randomized controlled trial of postoperative drainage time including all four neurosurgical departments in Denmark. Both incapacitated and mentally competent patients are enrolled. Patients older than 18 years, free of other intracranial pathologies or history of previous brain surgery, are recruited at the time of admission or no later than 6 h after surgery. Each patient is randomized to either 6, 12, or 24 h of passive subdural drainage following single burr-hole evacuation of a CSDH. Mentally competent patients are asked to complete the SF-36 questionnaire. The primary endpoint is CSDH recurrence rate at 90 days. Secondary outcome measures include SF-36 at 90 days, length of hospital stay, drain-related complications, and complications related to immobilization and mortality.

Discussion
This multi-center trial will provide evidence regarding the shortest possible drainage time without increasing the recurrence rate. The potential impact of this study is significant as we believe that a shorter drainage period may be associated with fewer drain-related complications, fewer complications related to immobilization, and shorter hospital stays—thus reducing the overall health service burden from this condition. The expected benefits for patients’ lives and health costs will increase as the CSDH patient population grows.

Trial registration
ISRCTN Registry ISRCTN15186366. Registered in December 2020 and updated in October 2021. This protocol was developed in accordance with the SPIRIT Checklist and by use of the structured study protocol template provided by BMC Trials.