bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mammographic breast density and breast cancer risk in the Saudi population: a case–control study using visual and automated methods
Authors: Aloufi Areej S , AlNaeem Abdulrahman N , Almousa Abeer S , Hashem Amani M , Malik Mehreen A , Altahan Fatina M , Elsharkawi Mahmoud M , Almasar Khalid A , ElMahdy Manal H , Squires Steven E , Alzimami Khalid S , Harkness Elaine F , Astley Susan M 
Published: February 2022

Objective
This study aims to establish risk of breast cancer based on breast density among Saudi women and to compare cancer prediction using different breast density methods.

Methods
1140 pseudonymised screening mammograms from Saudi females were retrospectively collected. Breast density was assessed using Breast Imaging Reporting and Data System (BI-RADS) density categories and visual analogue scale (VAS) of 285 cases and 855 controls matched on age and body mass index. In a subset of 160 cases and 480 controls density was estimated by two automated methods, Volpara Density™ and predicted VAS (pVAS). Odds ratios (ORs) between the highest and second categories in BI-RADS and Volpara density grades, and highest vs lowest quartiles in VAS, pVAS and Volpara Density™, were estimated using conditional logistic regression.

Results:
For BI-RADS, the OR was 6.69 (95% CI 2.79–16.06) in the highest vs second category and OR = 4.78 (95% CI 3.01–7.58) in the highest vs lowest quartile for VAS. In the subset, VAS was the strongest predictor OR = 7.54 (95% CI 3.86–14.74), followed by pVAS using raw images OR = 5.38 (95% CI 2.68–10.77) and Volpara Density ™ OR = 3.55, (95% CI 1.86–6.75) for highest vs lowest quartiles. The matched concordance index for VAS was 0.70 (95% CI 0.65–0.75) demonstrating better discrimination between cases and controls than all other methods.

Conclusion
Increased mammographic density was strongly associated with risk of breast cancer among Saudi women. Radiologists’ visual assessment of breast density is superior to automated methods. However, pVAS and Volpara Density ™ also significantly predicted breast cancer risk based on breast density.

Advances in knowledge
Our study established an association between breast density and breast cancer in a Saudi population and compared the performance of automated methods. This provides a stepping-stone towards personalised screening using automated breast density methods.
Identification of potential biological targets of oxindole scaffolds via in silico repositioning strategies
Authors: Tinivella Annachiara , Pinzi Luca , Gambacorta Guido , Baxendale Ian , Rastelli Giulio 
Published: February 2022

Background: Drug repurposing is an alternative strategy to traditional drug discovery that aims at predicting new uses for already existing drugs or clinical candidates. Drug repurposing has many advantages over traditional drug development, such as reduced attrition rates, time and costs. This is especially the case considering that most drugs investigated for repurposing have already been assessed for their safety in clinical trials. Repurposing campaigns can also be designed for libraries of already synthesized molecules at different levels of biological experimentation, from null to in vitro and in vivo. Such an extension of the “repurposing” concept is expected to provide significant advantages for the identification of novel drugs, as the synthetic accessibility of the desired compounds is often one of the limiting factors in the traditional drug discovery pipeline. Methods: In this work, we performed a computational repurposing campaign on a library of previously synthesized oxindole-based compounds, in order to identify potential new targets for this versatile scaffold. To this aim, ligand-based approaches were firstly applied to evaluate the similarity degree of the investigated compound library, with respect to ligands extracted from the DrugBank, Protein Data Bank (PDB) and ChEMBL databases. In particular, the 2D fingerprint-based and 3D shape-based similarity profiles were evaluated and compared for the oxindole derivates. Results: The analyses predicted a set of potential candidate targets for repurposing, some of them emerging by consensus of different computational analyses. One of the identified targets, i.e., the vascular endothelial growth factor receptor 2 (VEGFR-2) kinase, was further investigated by means of docking calculations, followed by biological testing of one candidate. Conclusions: While the compound did not show potent inhibitory activity towards VEGFR-2, the study highlighted several other possibilities of therapeutically relevant targets that may be worth of consideration for drug repurposing.
The knowledge, attitude and practice level of dental auxiliaries regarding oral health care for pregnant patients in the eastern province of Saudi Arabia
Authors: Alibrahim Daneah , El. Mahalli Azza 
Published: February 2022

Background: The purpose of this research was to assess the knowledge, attitude, and practice of dental auxiliaries related to oral health care for pregnant patients in the Eastern Province of Saudi Arabia. Methods: A cross-sectional study using a questionnaire survey was conducted. The knowledge, attitude, and practice were rated using the Likert scale out of 5. Knowledge and practice were categorized using Bloom’s cut off point methods (≥80% is good, and <80% is bad). Concerning attitude, (≥80% is positive, and <80% is negative). The questionnaires were sent to all dental hygienists and assistants (N=358), and responses were collected from 218. Statistical Package for the Social Sciences (SPSS) software was utilixed to conduct statistical analysis. Results: Out of the 358, 218 responded (response rate = 61%). More than half of the respondents showed relatively good knowledge (57.3%). Most respondents had a positive attitude (89.4%). Regarding practice, approximately two-thirds had a good practice (67.4%). The knowledge score of hygienists was significantly higher than dental assistants, and respondents with experience in treating pregnant patients had significantly higher knowledge scores than others who did not have experience in treating pregnant patients. There is a statistically significant positive correlation between practice scores and education. Conclusions: The findings suggest the need to establish continuous education programs and for dental hygienists and dental assistants to adopt the best practice guidelines on perinatal oral health.
The effect of a siamese pumpkin and tuna-based powder (CHAGURO) diet in improving chol/HDL ratios in prediabetes individuals with dyslipidemia: a randomised trial
Authors: Sudargo Toto , Prameswari Atika Anif , Aulia Bianda , Aristasari Tira , Ratri Fitria Aninda , Muslichah Rahadyana , Putri Sheila Rosmala 
Published: February 2022

Background: The study aimed to examine the effect of administering CHAGURO (a product of the combination of siamese pumpkin and tuna-based powder) on the lipid profile in prediabetes individuals with dyslipidemia. Methods: The experimental trial was conducted with two intervention groups, with each group receiving a dose of 7.5g/70kg body weight (BW)/day (low dose) and 15g/70kg BW/day (high dose) for 60 days. Respondents were randomized into intervention groups using simple randomization. Before and after the intervention, pre-test and post-test examinations were performed, factors examined included hemoglobin A1c (HbA1c), lipid profile, blood pressure, food intake with the SQ-FFQ (Semi Quantitative-Food Frequency Questionnaire) interview, body mass index (BMI), and physical activity using International Physical Activity Questionnaires-Short Form (IPAQ-SF). During the intervention, blood pressure and BMI data were taken before and after the study. Statistical analysis included descriptive tests, independent and paired T-tests, and analysis of variance (ANOVA). Results: Compared to the baseline, HbA1c, total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides in the two groups did not improve significantly by 60 days. For lipid variables, a significant improvement in the cholesterol/high-density lipoprotein (chol/HDL) ratios were observed when compared against the baseline for the two groups. When comparing the changes between groups, 7.5 g of CHAGURO showed a larger improvement in HDL-C (mean differences: 1.86 mg/dL; 95% CI: -0.86-4.59), compared to 15 g of CHAGURO (mean differences: -3.62 mg/dL; 95% CI: -7.53-0.28). A significant (p<0.05) decrease in the chol/HDL ratio was observed in the 7.5 g CHAGURO group (mean differences: -0.20 mg/dL; 95% CI: -0.39-(-0.01)). Conclusions: CHAGURO can be a functional food alternative to improve the condition of prediabetes people with dyslipidemia. Trial registration: Dr. Sardjito General Hospital (KE/FK/0951/EC/2020), 27/08/2020
Aruanne Petserimaa poliitilise ja sotsiaalse olukorra kohta 1927. aastal
Authors: Koor Ott 
Published: February 2022

The issue of Petseri County is still an important element of national continuity. The Tartu Peace Treaty transferred the rural municipalities of the Petseri region, which had previously belonged to the Governorate of Pskov, to the administration of the Republic of Estonia. This severed relations with eastern regions from the period of the Russian Empire. This detour brought rapid impoverishment in some communities, giving rise to a series of social problems in the region such as unemployment, alcoholism, etc. That is why anti-state sentiments emerged in the interwar period, primarily in the eastern part of Petseri County, which was populated mainly by Russian citizens whose interests were more closely linked to Russia’s interior regions. Pro-Soviet political forces exploited such sentiments.
The published report is part of the Ministry of Internal Affairs archival collection (National Archives, RA, ERA.14.1.1395). It was drawn up in 1927 by Assistant Commissioner of the Political Police Nikolai Nuder at the request of Minister of Internal Affairs Jaan Hünerson. The reason for writing the report was the government’s aim to re-establish the position of Petseri County Commander, which had existed in the first years of independence, in order to supervise local institutions and to bind Petseri more closely with the Estonian state. S. Sommer’s comment on the report has been identified at the end of the publication. The value of the source lies in its relatively wide-ranging problematics, reflecting a clash of political and social, national and community interests in the region. In addition to the problems described, the report proposes possible solutions, yet without presenting more specific action plans. The document’s focus is on the eastern regions of Petseri County in particular, demonstrating the region’s weaker coherence with other Estonian territories. In addition to political and social aspects, the source also draws attention to man and the changing environment around him. In this case, rapid population growth and the paludification of areas along Lake Pskov led to a decrease in people’s living space in the region.
The Real Response to Uncertainty Shocks: The Risk Premium Channel
Authors: Bretscher Lorenzo , Hsu Alex , Tamoni Andrea 
Published: February 2022

Uncertainty shocks are also risk premium shocks. With countercyclical risk aversion (RA), a positive shock to uncertainty increases risk and elevates RA as consumption growth falls. The combination of high RA and high uncertainty produces significant equity risk premia in bad times, which in turn, exacerbate the decline of macroeconomic aggregates and equity prices. Moreover, in the cross-section of equity returns, investors demand a risk premium for stocks that perform poorly in times of high uncertainty and elevated risk aversion. In a model with endogenously time-varying RA, uncertainty shocks lead to large falls in investment and equity prices that closely match state-dependent data responses. This paper was accepted by Tomasz Piskorski, finance. Supplemental Material: The data files and online appendix are available at https://doi.org/10.1287/mnsc.2022.4335 .
Olecranon fractures: applied anatomy, clinical assessment and evidence-based management
Authors: Karthikappallil Dileep , Cash Thomas , Fischer Jochen , Waseem Mohammad 
Published: February 2022

Olecranon fractures are common injuries, making up 10% of all fractures of the upper limb. They usually result from a fall from standing height in older people, or from a direct blow in young people. The olecranon's superficial location, with poor soft tissue and muscle protection, make it liable to fracture following direct impact. Factors such as the degree of initial force and the quality of the patient's bone result in a range of injury patterns, from simple undisplaced fractures to complex open fracture dislocations. In the context of high energy trauma, the patient should first be assessed for life-threatening injuries. A thorough history and clinical examination including neurovascular assessment should then be completed. Antero-posterior and lateral X-rays are sufficient to confirm the diagnosis. Initial management includes immobilisation in an above elbow backslab, a sling and analgesia. Owing to the pull of the triceps muscle which attaches to the tip of the olecranon, fracture displacement is common and surgical intervention is often required, usually with good outcomes. Surgical techniques include tension band wiring, open reduction internal fixation with a pre-contoured locking plate and tension band suture fixation. Undisplaced fractures or displaced fractures in older patients can be managed conservatively with an above elbow cast for 4 weeks. This article covers applied anatomy, initial presentation, clinical assessment and evidence-based management.
Clinician preferences in the treatment of acutely symptomatic hernia: the ‘MASH’ survey
Authors: O’Connor OM , Burns FA , Proctor VK , Green SK , Sayers AE , Smart NJ , Lee MJ 
Published: February 2022

Introduction There is limited high-quality evidence to guide the management of acute hernia presentation. The aim of this study was to survey surgeons to assess current trends in assessment, treatment strategy and operative decisions in the management of acutely symptomatic hernia. Methods A survey was developed with reference to current guidelines, and reported according to Checklist for Reporting Results of Internet E-Surveys guidelines. Ethical approval was obtained from the University of Sheffield (UREC:034047). The survey explored practice in groin, umbilical/paraumbilical and incisional hernia presenting acutely. It captured respondent demographics, and preferences for investigations, treatment strategies and repair techniques for each hernia type, using a five-point Likert scale. Results Some 145 responses were received, of which 39 declared a specialist hernia practice. Essential investigations included urea and electrolytes (58.6%) and inflammatory markers (55.6%). Computed tomography scan of the abdomen was essential for assessment of incisional hernia (90.9%), but not for other hernia types. Bowel compromise drives early surgery, and increasing American Society of Anesthesiology score pushes towards non-operative management. Type of repair was driven by hernia contents, with increasing contamination associated with increased rates of suture repair. Where mesh was proposed in contaminated settings, biological types were preferred. There was variation in the potential use of laparoscopy for groin hernia. Conclusions This survey provides a snapshot of current trends in the management of acutely symptomatic hernia. It demonstrates variation across aspects of assessment and repair technique. Additional data are required to inform practice in these areas.
Sexual harassment in secondary school: Prevalence and ambiguities. A mixed methods study in Scottish schools
Authors: Sweeting Helen , Blake Carolyn , Riddell Julie , Barrett Simon , Mitchell Kirstin R. 
Published: February 2022

BackgroundAdolescence is characterized by identity formation, exploration and initiation of intimate relationships. Much of this occurs at school, making schools key sites of sexual harassment. Schools often lack awareness and understanding of the issue, and UK research on the topic is scarce. We explored prevalence and perceptions of sexual harassment in a school-based mixed-methods study of 13–17 year-old Scottish adolescents.MethodsA student survey (N = 638) assessed past 3-months school-based victimization and perpetration prevalence via 17 behavioral items based on the most commonly used school-based sexual harassment measure (‘Hostile Hallways’). Eighteen focus groups (N = 119 students) explored which of 10 behaviors were perceived as harassing/unacceptable and why.ResultsTwo-thirds reported anyvictimization: 64.7% ‘visual/verbal’ (e.g. sexual jokes) and 34.3% ‘contact/personally-invasive’ behaviors (e.g. sexual touching; most of whom also reported experiencing visual/verbal types) in the past 3-months. Data suggested a gateway effect, such that contact/personally-invasive behaviors are more likely to be reported by those also reporting more common visual/verbal behaviors. Some survey participants reported being unsure about whether they had experienced certain behaviors; and in focus groups, participants expressed uncertainty regarding the acceptability of most behaviors. Ambiguities centered on behavioral context and enactment including: degree of pressure, persistence and physicality; degree of familiarity between the instigator-recipient; and perception of the instigator’s intent. In attempting to resolve ambiguities, students applied normative schemas underpinned by rights (to dignity, respect and equality) and ‘knowingness’, usually engendered by friendship.ConclusionsOur study confirms school-based sexual harassment is common but also finds significant nuance in the ways in which students distinguish between acceptable and harassing. School-based strategies to tackle sexual harassment must engage with this complexity.
The impact of background liver disease on the long-term prognosis of very-early-stage HCC after ablation therapy
Authors: Takaura Kenta , Kurosaki Masayuki , Inada Kento , Kirino Sakura , Yamashita Kouji , Muto Tomohiro , Osawa Leona , Sekiguchi Shuhei , Hayakawa Yuka , Higuchi Mayu , Kaneko Shun , Maeyashiki Chiaki , Tamaki Nobuharu , Yasui Yutaka , Itakura Jun , Tsuchiya Kaoru , Nakanishi Hiroyuki , Takahashi Yuka , Izumi Namiki 
Published: February 2022

Background and aim
The long-term prognosis of hepatocellular carcinoma (HCC) treated at a very-early-stage (the Barcelona Clinical Liver Cancer (BCLC) classification stage 0) was unclear, especially in terms of background liver disease.

Methods
This single-center, retrospective study included 302 patients with BCLC stage 0 HCC treated with radiofrequency ablation (RFA) and followed for at least six months. We examined the impact of background liver disease on overall survival and recurrence.

Results
The median age was 72 (range; 36–91) years; the median tumor diameter was 15 (range; 8–20) mm. The etiologies of background liver disease were hepatitis B virus infection (HBV) in 24 cases, hepatitis C virus infection (HCV) in 195 cases, and non-viral (NBNC) in 83 cases. Among the patients with HCV, 63 had achieved sustained virological response (SVR) by antiviral therapy (HCV SVR) before developing HCC (n = 37) or after HCC treatment (n = 26), and 132 had active HCV infection (HCV non-SVR). The median overall survival was 85 (95% CI; 72–98) months, and the median recurrence-free survival was 26 (95% CI; 20–30) months. Active infection with hepatitis C virus negatively contributed to overall survival (HR 2.91, 95% CI 1.31–3.60, p = 0.003) and recurrence-free survival (HR 1.47, 95% CI 1.06–2.05, p = 0.011).

Conclusions
The prognosis of RFA treatment for very early-stage HCC was favorable. Achieving SVR in hepatitis C was important for further prognosis improvement.
Pregnancy resumption following contraceptive discontinuation: Hazard survival analysis of the Indonesia Demographic and Health Survey Data 2007, 2012 and 2017
Authors: Gayatri Maria , Utomo Budi , Budiharsana Meiwita , Dasvarma Gouranga 
Published: February 2022

Objective
The objective of this research is to estimate the probability of pregnancy resumption after discontinuing reversible contraceptives—pills, injectables, implants and IUDs, and to examine the factors associated with the resumption of fertility.

Method
The study uses pregnancy calendar data from Indonesia Demographic and Health Surveys (IDHS) of 2007, 2012 and 2017. A hazard model survival method is used for estimating the time needed to resume pregnancy since discontinuing reversible contraceptives. Retrospective data on 4,573; 5,183 and 5,989 episodes of reversible contraceptive discontinuation at the three surveys respectively have been analysed.

Results
This study shows that women regained fecundity within one year of discontinuing IUD, pill, injectables or implants. Women using IUD could resume their pregnancy faster than those using implants, pills and injectables. Over the three IDHS 2007, 2012 and 2017 the age-specific percentages of women becoming pregnant after one year of contraceptive discontinuation vary between 72 and 85 for IUD, 75 and 81 for pills, 72 and 76 for implants and 64 and 67 for injectables, with the percentages being higher among younger women. The analysis further shows that length of contraceptive use, parity, prior sexually transmitted infections, knowledge of fertile period, household wealth status and place of residence have no impact on occurrence of pregnancy after contraceptive discontinuation.

Conclusion
The analysis disproves a myth that reversible contraceptives make women infertile. Depending on the type of reversible contraceptive used, 65% to 85% of the women were able to conceive after one year of discontinuation.