bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accuracy of advanced deep learning with tensorflow and keras for classifying teeth developmental stages in digital panoramic imaging
Authors: Mohammad Norhasmira , Muad Anuar Mikdad , Ahmad Rohana , Yusof Mohd Yusmiaidil Putera Mohd 
Published: April 2022

Abstract
Background
This study aims to propose the combinations of image processing and machine learning model to segment the maturity development of the mandibular premolars using a Keras-based deep learning convolutional neural networks (DCNN) model.

Methods
A dataset consisting of 240 images (20 images per stage per sex) of retrospect digital dental panoramic imaging of patients between 5 and 14 years of age was retrieved. In image preprocessing, abounding box with a dimension of 250 × 250 pixels was assigned to the left mandibular first (P1) and second (P2) permanent premolars. The implementation of dynamic programming of active contour (DP-AC) and convolutions neural network on images that require the procedure of image filtration using Python TensorFlow and Keras libraries were performed in image segmentation and classification, respectively.

Results
Image segmentation using the DP-AC algorithm enhanced the visibility of the image features in the region of interest while suppressing the image's background noise. The proposed model has an accuracy of 97.74%, 96.63% and 78.13% on the training, validation, and testing set, respectively. In addition, moderate agreement (Kappa value = 0.58) between human observer and computer were identified. Nonetheless, a robust DCNN model was achieved as there is no sign of the model's over-or under-fitting upon the learning process.

Conclusions
The application of digital imaging and deep learning techniques used by the DP-AC and convolutions neural network algorithms to segment and identify premolars provides promising results for semi-automated forensic dental staging in the future.
KCNQ1 and lymphovascular invasion are key features in a prognostic classifier for stage II and III colon cancer
Authors: Uil Sjoerd H. , Coupé Veerle M. H. , Bril Herman , Meijer Gerrit A. , Fijneman Remond J. A. , Stockmann Hein B. A. C. 
Published: April 2022

Abstract
Background
The risk of recurrence after resection of a stage II or III colon cancer, and therefore qualification for adjuvant chemotherapy (ACT), is traditionally based on clinicopathological parameters. However, the parameters used in clinical practice are not able to accurately identify all patients with or without minimal residual disease. Some patients considered ‘low-risk’ do develop recurrence (undertreatment), whilst other patients receiving ACT might not have developed recurrence at all (overtreatment). We previously analysed tumour tissue expression of 28 protein biomarkers that might improve identification of patients at risk of recurrence. In the present study we aimed to build a prognostic classifier based on these 28 biomarkers and clinicopathological parameters.

Methods
Classification and regression tree (CART) analysis was used to build a prognostic classifier based on a well described cohort of 386 patients with stage II and III colon cancer. Separate classifiers were built for patients who were or were not treated with ACT. Routine clinicopathological parameters and tumour tissue immunohistochemistry data were included, available for 28 proteins previously published. Classification trees were pruned until lowest misclassification error was obtained. Survival of the identified subgroups was analysed, and robustness of the selected CART variables was assessed by random forest analysis (1000 trees).

Results
In patients not treated with ACT, prognosis was estimated best based on expression of KCNQ1. Poor disease-free survival (DFS) was observed in those with loss of expression of KCNQ1 (HR = 3.38 (95% CI 2.12 – 5.40); p < 0.001). In patients treated with ACT, key prognostic factors were lymphovascular invasion (LVI) and expression of KCNQ1. Patients with LVI showed poorest DFS, whilst patients without LVI and high expression of KCNQ1 showed most favourable survival (HR = 7.50 (95% CI 3.57—15.74); p < 0.001). Patients without LVI and loss of expression of KCNQ1 had intermediate survival (HR = 3.91 (95% CI 1.76 – 8.72); p = 0.001).

Conclusion
KCNQ1 and LVI were identified as key features in prognostic classifiers for disease-free survival in stage II and III colon cancer patients.
Assessing and improving public mental health literacy concerning rTMS
Authors: Morrison Amanda S. , Uusberg Andero , Ryan Julia , Goldenberg Amit , Etkin Amit , Gross James J. 
Published: April 2022

Abstract
Background
Repetitive transcranial magnetic stimulation (rTMS) has received empirical support as a viable treatment alternative for treatment-resistant major depressive disorder. Nevertheless, patients and the public-at-large may be hesitant to adopt rTMS. In three studies, we sought to (1) assess and (2) improve public perceptions of rTMS as a treatment for depression.

Methods
In Study 1 (N = 107), we administered questionnaires on Amazon’s Mechanical Turk (MTurk) to individuals from the US and Canada in a cross-sectional design to assess perceptions of rTMS compared to psychopharmacology, electroconvulsive therapy (ECT), and talk therapy. In Study 2 (N = 106), we again used an MTurk sample and a cross-sectional design to assess perceptions of rTMS after providing participants with a relatively long description of rTMS. In Study 3 (N = 308), we conducted an experiment in undergraduate students. Participants were randomized to one of four experimental conditions manipulating participants’ understanding of the causal mechanisms of depression prior to assessing their perceptions of rTMS.

Results
Public perceptions of rTMS were more negative than pharmacotherapy and talk therapy but not ECT (Study 1). rTMS perceptions were notably better when participants were given thorough information about rTMS procedures, pain, and side-effects (Study 2), compared to the previous study when they were given a very brief description of rTMS. Finally, perceptions of rTMS were significantly better when participants were given a brain circuitry-based causal explanation of depression compared to when they were given a psychological explanation of the causes of depression (Study 3).

Conclusions
Public perceptions of rTMS are relatively poor. To improve rTMS acceptability, practitioners should carefully consider patients’ prior attitudes and beliefs when explaining rTMS as a treatment alternative. Given that beliefs can have powerful effects on treatment outcome (e.g., placebo, nocebo), future research should explore whether rTMS effects on depression can be improved by facilitating less negative perceptions of rTMS.
Effectiveness of a community health worker-led case management programme to improve outcomes for people with psychotic disorders in Thailand: a one-year prospective cohort study
Authors: Jirapramukpitak Tawanchai , Jaisin Kankamol , Supanya Suttha , Takizawa Patcharapim 
Published: April 2022

Abstract
Background
Intensive case management (ICM) programmes for psychotic patients are effective in improving outcomes, but often unfeasible in resource-poor settings, as they typically require extensive human resources and expertise. We developed and evaluated the effectiveness of a less intensive case management program (LICM), led by community health workers, on one-year social functioning and service use.

Methods
A prospective cohort study was conducted on patients aged 18 and above residing in a hospital catchment area. Outcomes were compared between LICM (n = 64) and non-LICM participants (n = 485). A counterfactual framework approach was applied to assess causal effects of the LICM on outcomes. The programme effectiveness was analyzed by augmented-inverse probability of treatment weighting (AIPW) to estimate potential outcome mean (POM) and average treatment effect (ATE). Outcomes were employment status and use of emergency, inpatient and outpatient services. Analyses were stratified by the number of previous psychotic relapse (≤ 1, > 1) to assess heterogeneity of treatment effect on those in an early and later stages of psychotic illness.

Results
In the early-stage cohort, the likelihood of being employed at one year post-baseline was significantly greater in LICM participants than non-LICM participants (ATE 0.10, 95%CI 0.05–0.14, p < 0.001), whereas service use of all types, except outpatient, was not significantly different between the two groups. In the later-stage cohort, the likelihoods of employment between the two groups at post-baseline were similar (ATE -0.02, 95%CI -0.19–0.15, p = 0.826), whereas service use of all types was significantly higher in LICM participants.

Conclusion
LICM in a setting where community mental services are scarce may benefit those at an early stage of psychotic illness, by leading to better social functioning and no higher use of unscheduled services at the end of the programme, possibly through their better prognosis and medication adherence. A more intensive case management model may be appropriate for those in a later stage of the illness.
Trajectories of depressive symptoms among community-dwelling Korean older adults: findings from the Korean longitudinal study of aging (2006–2016)
Authors: Shin Jinhee , Cho Eunhee 
Published: April 2022

Abstract
Background
Depression among older adults is an important public health concern associated with increased risk of suicide and decreased physical, cognitive, and social functioning. This study identified trajectories of depressive symptoms and investigated predictive variables of group-based trajectory modeling among Korean community-dwelling older adults.

Methods
Participants comprised 2016 community-dwelling Korean adults over 65 years. Data from the years 2006–2016 of the Korean Longitudinal Study of Aging, a nationally representative panel survey that has been conducted every two years since 2006, were used. We employed a group-based trajectory modeling analysis to identify depressive symptom trajectories. Multinomial logistic regression analysis was conducted to identify predictors of each class of depressive symptoms.

Results
Five depressive symptom trajectory groups were identified: Group 1, “None” (28.9%); Group 2, “Slowly worsening” (24.3%); Group 3, “Rapidly worsening” (17.5%); Group 4 “Improving” (12.4%); and Group 5, “Persistently severe” (16.9%). Older adults followed five distinct depressive symptom trajectories over 10 years. Mini-Mental State Examination scores, number of chronic diseases, educational level, and social activity were predictors associated with increasing depressive symptoms.

Conclusions
This study showed that many older adults living in the community have depressive symptoms. To prevent and treat depression and aid successful mental health aging among older adults, the development of interventions should be tailored to target specific needs for each symptom trajectory. It is necessary to develop community-based interventions and strategies to identify and prevent depressive symptom trajectories among older adults.
Alcohol consumption and closed borders - how COVID-19 restrictions have impacted alcohol sales and consumption in Europe
Authors: Leifman Håkan , Dramstad Kalle , Juslin Emil 
Published: April 2022

Abstract
Background
The closing of bars, restaurants and international borders during the COVID-19 pandemic led to significant changes in alcohol availability. This study provides a first systematic overview of the monthly development of alcohol sales in Europe during the pandemic in order to determine the effect of closed borders on the sales and consumption of alcohol.

Methods
The study covers 72 months from January 2015 to December 2020 in 14 countries from northern, central and western Europe with excise revenue data for beer, spirits, wine separately and summed, converted into litres of pure alcohol per capita 15+ as a proxy for alcohol sales. March–December 2020 is seen as the pandemic period. The analyses consist of (1) descriptive trends of sales before and during the pandemic, (2) assessment of the pandemic impact on sales by time-series analyses and (3) case studies of countries and a region with substantial cross-border inflow or outflow of alcohol.

Results
The result shows an overall reduction in alcohol sales with 3.6% during the pandemic. Nevertheless, the results differ based on the level of cross-border purchasing flows pre-pandemic, as countries with high cross-border inflow saw an increase in domestic sales as the pandemic hit. Norway, for example, saw a 23% increase in domestic sales during the pandemic period March–December 2020 compared to the same period in 2019.

Conclusion
The closing of intra-European borders had a significant redistributing effect on alcohol sales. While noting sales increases, cross-border inflow countries generally saw a decrease in total amount of alcohol consumed per capita as not all cross-border purchases were replaced by domestic sales. This has important policy implications as large volumes of cross-border inflow of alcohol can negatively affect excise revenue as well as public health outcomes.
The methodology can be used to further explore the reliance of different purchasing streams in a domestic alcohol market.
Sustaining Maternal and Neonatal Tetanus Elimination (MNTE) in countries that have been validated for elimination – progress and challenges
Authors: Yusuf Nasir , Steinglass Robert , Gasse Francois , Raza Azhar , Ahmed Bilal , Blanc Diana Chang , Yakubu Ahmadu , Gregory Christopher , Tohme Rania A. 
Published: April 2022

Abstract
Background
As of October 2021, 47 (80%) of the 59 countries, identified at highest risk for Maternal and Neonatal Tetanus (MNT), had been validated for elimination. We assessed sustainability of MNT elimination (MNTE) in 28 countries that were validated during 2011‒2020.

Methods
We assessed the attainment of the following MNTE sustainability indicators: 1) ≥ 90% coverage with three doses of Diphtheria-Tetanus-Pertussis vaccine (DTP3) among infants < 1 year, 2) ≥ 80% coverage with at least two doses of tetanus toxoid-containing vaccine (TTCV2 +) among pregnant women, 3) ≥ 80% protection at birth (PAB), 4) ≥ 70% skilled birth attendance (SBA), and 4) ≥ 80% first (ANC1) and fourth antenatal care (ANC4) visits. We assessed the introduction of TTCV booster doses. Data sources included the 2020 WHO /UNICEF Joint Reporting Forms, and the latest Demographic and Health Survey (DHS) or Multi-Indicator Cluster Surveys (MICS) for each country, if available. We reviewed literature and used DHS/MICS data to identify barriers to sustaining MNTE.

Results
Of 28 assessed countries, 7 (25%) reported ≥ 90% DTP3 coverage, 4 of 26 (16%) reported ≥ 80% TTCV2 + coverage, and 23 of 27 (85%) reported ≥ 80% PAB coverage. Based on DHS/MICS in 15 of the 28 countries, 10 (67%) achieved ≥ 70% SBA delivery, 13 (87%) achieved ≥ 80% ANC1 visit coverage, and 3 (20%) ≥ 80% ANC4 visit coverage. We observed sub-optimal coverage in many countries at the subnational level. The first, second and third booster doses of TTCV respectively have been introduced in 6 (21%), 5 (18%), and 1 (4%) of 28 countries. Only three countries conducted post-MNTE validation assessments. Barriers to MNTE sustainability included: competing program priorities, limited resources to introduce TTCV booster doses and implement corrective immunization in high-risk districts and socio-economic factors.

Conclusions
Despite good performance of MNTE indicators in several countries, MNTE sustainability appears threatened in some countries. Integration and coordination of MNTE activities with other immunization activities in the context of the Immunization Agenda 2030 lifecourse vaccination strategy such as providing tetanus booster doses in school-based vaccination platforms, during measles second dose and HPV vaccination, and integrating MNTE post-validation assessments with immunization program reviews will ensure MNTE is sustained.
Association between sleep duration and cardiometabolic factors in adolescents
Authors: Confortin Susana Cararo , Aristizábal Liliana Yanet Gómez , da Silva Magalhães Elma Izze , Barbosa Aline Rodrigues , Ribeiro Cecilia Claudia Costa , Batista Rosângela Fernandes Lucena , Silva Antônio Augusto Moura da 
Published: April 2022

AbstractBackgroundThe sleep reduction can change healthy people's hemodynamic control and cardiovascular regulation through increased inflammatory response and altered endothelial function. The objective the study to analyze the association between sleep duration and cardiometabolic risk factors in adolescents in the birth cohort of São Luís (1997/98).MethodsThis is a cross-sectional study with adolescents participating in the birth cohort of São Luís (1997/98). Sleep duration was evaluated using accelerometer data (Actigraph wGT3X-BT). Glycemia, systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c) and triglycerides were considered cardiometabolic factors. The Directed Acyclic Graph (DAG) was used to identify the minimum set of adjustment for confounding.ResultsOut of 1,268 adolescents, 50.3% of them were male. The prevalence of sleep duration of less than 6 h per day was 31.1%. The mean glycemia value was 91.8 mg/dL (± 15.9), DBP was 71.3 mmHg (± 7.5), SBP was 114.9 mmHg (± 12.3), HDL was 48.5 mg/dL (± 11.6), LDL was 89.0 mg/dL (± 25.7), the total cholesterol was 156.0 mg/dL (± 31.1), and triglycerides was 93.6 mg/dL (± 47.2). The crude analysis showed an association between sleep duration and SBP and LDL-c. In the adjusted analysis, the associations did not remain.ConclusionOur study showed no association between sleep duration and cardiometabolic outcomes in adolescents.
Correlation between musculoskeletal mass and perfusion in patients with gastrointestinal malignancy: a preliminary study based on quantitative CT and CT perfusion
Authors: Ji Rui , Zhang Lin , Shen Yongju , Tang Rui , Tu Yun , Tang Guangyu , Zhu Jingqi 
Published: April 2022

Abstract
Background
To investigate the correlation between musculoskeletal mass and perfusion using quantitative computer tomography (QCT) and CT perfusion (CTP) in patients with gastrointestinal malignancy.

Methods
In this prospective study, 96 patients (mean age 66 years, range 25–90; 63.5% male) with gastrointestinal malignancy underwent QCT and CTP between May 2019 and February 2021. Bone mineral density (BMD) and body composition [perivertebral muscular mass index (PMI), skeletal muscular mass index (SMI) and muscular fat fraction] were evaluated through QCT. Musculoskeletal perfusion parameters were measured by CTP. Differences in these parameters between (or among) two (or three) groups (grouped by BMD, SMI, and TNM staging) were analyzed.

Results
There were significant differences in PMI and muscular fat fraction among normal (n = 30), osteopenia (n = 43), and osteoporosis (n = 23) groups (both P < 0.001). Blood flow (r = 0.336, P = 0.001; adjusted for age and gender, r = 0.383, P < 0.001), blood volume (r = 0.238, P = 0.011; adjusted for age and gender, r = 0.329, P = 0.001), and flow extraction product (r = 0.217, P = 0.034; adjusted for age and gender, r = 0.320, P = 0.002) vaules of vertebral perfusion showed positive correlation with BMD. However, the relationships between PMI and perfusion parameters of perivertebral muscle were not significant. No significant differences were found in musculoskeletal mass and perfusion parameters between different TNM staging.

Conclusions
The changes of bone mass and perivertebral muscular mass in patients with gastrointestinal malignancy are synchronous. Decreased vertebral bone mass is accompanied with reduced perivertebral muscular mass, increased muscular fat, and decreased bone perfusion. However, the changes of perfusion in vertebra and perivertebral muscles are asynchronous. Musculoskeletal mass and perfusion have no correlation with TNM staging of the patients with gastrointestinal malignancy.

Trial registration
SHSY-IEC-4.1/20–242/01 (Registered 09–12-2020, Retrospectively registered).
Biomechanical features of drop vertical jump are different among various sporting activities
Authors: Harato Kengo , Morishige Yutaro , Kobayashi Shu , Niki Yasuo , Nagura Takeo 
Published: April 2022

Abstract
Background
Risk for non-contact anterior cruciate ligament (ACL) injury can be assessed based on drop vertical jump (DVJ). However, biomechanics of DVJ may differ with various sporting activities. The purpose of the present study was to clarify whether biomechanical features of DVJ are different among various sporting activities in female athletes.

Methods
A total of 42 female athletes, including 25 basketball, 8 soccer and 9 volleyball players, participated in the current investigation. DVJ was done for each female athlete using a three-dimensional motion analysis system which consisted of six cameras, two force plates and 46 retro-reflective markers. Kinematic and kinetic data were recorded for both limbs in each athlete. Simultaneously, frontal and sagittal plane views of the DVJ were recorded using two different high-resolution video cameras to evaluate Landing Error Scoring System (LESS) score. Three-dimensional biomechanical parameters at the knee joint and LESS were compared among three different sporting activities using ANOVA or Kruskal–Wallis test after confirming normality assumption. Thereafter post hoc Tukey or Steel–Dwass was utilized for multiple comparison.

Results
Soccer players had better LESS score, and peak knee flexion angle was significantly larger in soccer players compared to the other sports. In addition, knee abduction angle at initial contact (IC), peak knee abduction angle, knee internal rotation angle, and knee abduction moment within 40 ms from IC were significantly smaller in soccer players, compared to basketball players. In terms of volleyball players, knee abduction angle at IC and knee internal rotation angle at IC were significantly larger than soccer players, whereas no significant biomechanical differences were found between basketball and volleyball players.

Conclusions
From the present study, female basketball and volleyball players have worse LESS score, smaller peak knee flexion angle, greater knee abduction angle at IC and greater knee internal rotation angle at IC, compared to female soccer players. Thus, female basketball and volleyball players may have an increased risk of non-contact ACL injury during the jump-landing task, compared to soccer players. Biomechanics of DVJ depends on characteristics of the athlete's primary sport.