bluuebunny/crossref_metadata_2025_split huggingface dataset:
MCG&BA‐Net: Retinal vessel segmentation using multiscale context gating and breakpoint attention
Authors: Xu Pengfei , Zhao Gangjing , Liu Jinping , Jahanshahi Hadi , Tang Zhaohui , Gong Subo 
Published: May 2022

AbstractThe accurate segmentation of blood vessels plays a crucial role in screening, diagnosis and treatment of multiple diseases. However, current automated segmentation approaches do not pay enough attention to the vascular topology errors (such as mistaking vessel‐breakpoints), resulting in considerable scattered vessel‐fragments in segmentation results. This article proposes a retinal vessel segmentation model using multi‐scale context gating and breakpoint attention mechanism, called MCG&BA‐Net. Specifically, it obtains a feature map containing contextual information of vessels through an introduced multi‐scale context module, and then filters the redundant features and noises by a gated structure to highlight target features. Furthermore, a kind of breakpoint attention module is proposed, which can locate and focus on potential breakpoint areas, thereby facilitating accurate segmentation results of tree‐like fine vessels. Extensive confirmatory and comparative experiments have been conducted on five public datasets, including three benchmark datasets, that is, DRIVE, CHASDB1 and SATRE, and two clinical datasets, that is, fundusimage1000 and RFMID. The AUC scores on the benchmark datasets are 0.9878, 0.9923 and 0.9942, respectively. Among them, the AUC score on CHADEDB1 and STARE outperforms the state‐of‐the‐art results. In addition, experimental results on the two clinical datasets demonstrate strong generalization capability of the propose method, indicating high clinical application values.
Kindliche Glaukomerkrankungen
Authors: Stingl Julia V. , Hoffmann Esther M. 
Published: May 2022

ZusammenfassungGlaukomerkrankungen im Kindesalter sind selten. Da ohne Behandlung in der Regel die Erblindung eintritt, ist eine umgehende Diagnosestellung und Therapie von höchster Bedeutung. Die
Heterogenität der Erkrankung erfordert eine genaue Kenntnis der möglichen Ursachen und deren individuelle Behandlung. Dieser Artikel soll einen Überblick über die kindlichen Glaukome
vermitteln und die wichtigsten Aspekte der Therapie aufzeigen.
Wachstumsschmerzen
Authors: Corts Magga , Dichtl Karoline , Stern Cornelia , Elfgang Rita 
Published: May 2022

SummaryVier Experten stellen Behandlungsansätze bei Wachstumsschmerzen mithilfe von Osteopathie, Schüßler-Salzen, Spagyrik und Gemmotherapie vor.
Von oben bis unten
Authors: Schmid Eva C. 
Published: May 2022

SummarySummary: In der Heilpraktiker-Praxis untersucht man im Rahmen einer körperlichen Basisuntersuchung in der Regel nach dem sogenannten IPPAF-Schema: Inspektion, Palpation, Perkussion, Auskultation, Funktionsprüfung. Bei verschiedenen Symptomen wie Schwindel und Parästhesien ist der neurologische Status insbesondere durch Untersuchung der Hirnnerven und Reflexe zu ermitteln. Bei der Untersuchung der Hirnnerven I–XII werden funktionsabhängige Tests durchgeführt; beim Reflexstatus unterscheidet man zwischen Muskeleigen- und -fremdreflexen sowie Pyramidenbahnzeichen.
Ab dem ersten Moment
Authors: Rau Erika 
Published: May 2022

SummarySchon beim Erstkontakt zeigen sich verschiedene diagnostische Aspekte bei Patienten, beispielsweise durch die Stimme, den Händedruck und das Gesicht. Menschen können 3 Naturellen zugeordnet werden, dem Bewegungs-, Empfindungs- und Ruhenaturell, wobei bei den meisten Menschen Mischformen vorliegen. Äußere Erscheinungsmerkmale, insbesondere im Gesicht, können entsprechend physiognomischer Lehren auf Organschwächen oder andere Störungen hinweisen.
Ein langer Weg zur Diagnose
Authors: Gundacker Stefanie 
Published: May 2022

SummaryIm vorgestellten Fall leidet eine junge Frau seit Monaten insbesondere unter Einschränkungen wie Konzentrationsmangel, wodurch ihr berufliches und privates Leben beeinträchtigt werden. Der Hausarzt der Patientin konnte keine körperliche Ursache für ihre Beschwerden finden und verschreibt ihr Psychopharmaka. Da sich keine Besserung einstellt, sucht sie die Naturheilpraxis der Autorin auf. Durch eine Blutuntersuchung in der Naturheilpraxis ergibt sich die mutmaßliche Diagnose Hashimoto-Thyreoiditis, die fachärztlich bestätigt und behandelt wird. Eine naturheilkundliche Unterstützung soll folgen.
Anamnese: Grundgerüst und hilfreiche Tipps
Authors: Bierbach Elvira 
Published: May 2022

SummaryDas Anamnese-Grundgerüst enthält neben den persönlichen Kenndaten Fragen zu Beschwerden, bisherigen Behandlungen und deren Resultate sowie Begleitsymptomen. Hinzu kommen Fragen zu unter anderem Vorerkrankungen, Operationen, Medikamenteneinnahme, Allergien und Unverträglichkeiten, zur Sozial- und Familienanamnese sowie zum Ernährungsverhalten. Für besondere Zielgruppen wie Kleinkinder und Säuglinge, ältere Menschen, Schmerzpatienten und Demenzpatienten gibt es zusätzliche spezifische Fragen.
Comparison of Assist/Control Ventilation with and without Volume Guarantee in Term or Near-Term Infants
Authors: Bezirganoglu Handan , Okur Nilufer , Buyuktiryaki Mehmet , Oguz Serife S. , Dizdar Evrim A. , Sari Fatma N. 
Published: May 2022

Objectives This study aimed to compare the effects of volume guarantee (VG) combined with assist/control (AC) ventilation to AC alone on hypocarbia episodes and extubation success in infants born at or near term.
Methods In this prospective cohort study, infants >34 weeks of gestation at birth, who were born in our hospital supported by synchronized, time-cycled, pressure limited, assist/control ventilation (AC) or assist-controlled VG mechanical ventilation (AC + VG) were included. After admission, infants received either AC or VG + AC using by Leoni Plus ventilator. The ventilation mode was left to the clinician. In the AC group, peak airway pressure was set clinically. In the VG + AC group, desired tidal volume was set at 5 mL/kg, with the ventilator adjusting peak inspiratory pressure to deliver this volume. The study was completed once the patient extubated.
Results There were 35 patients in each group. Incidence of hypocarbia was lower in the VG + AC compared with AC (%17.1 and 22.8%, respectively) but statistically not significant. Out-of-range partial pressure of carbon dioxide (PCO2) levels were lower in the VG + AC group and it reached borderline statistical significance (p = 0.06). The median extubation time was 70 (42–110) hours in the VG + AC group, 89.5 (48.5–115.5) hours in the AC group, and it did not differ between groups (p = 0.47).
Conclusion We found combining AC and VG ventilation compared with AC ventilation alone yielded similar hypocarbia episodes and extubation time for infants of >34 gestational weeks with borderline significance lower out-of-range PCO2 incidence.
Key Points
Heterogeneity of Drug Allergies and Reaction Lists in Two U.S. Health Care Systems' Electronic Health Records
Authors: Yerneni Sharmitha , Shah Sonam N. , Blackley Suzanne V. , Ortega Carlos A. , Blumenthal Kimberly G. , Goss Foster , Seger Diane L. , Wickner Paige G. , Mancini Christian M. , Bates David W. , Zhou Li 
Published: May 2022

Abstract
Background Health care institutions have their own “picklist” for clinicians to document adverse drug reactions (ADRs) into the electronic health record (EHR) allergy list. Whether the lack of a nationally standardized picklist impacts clinician data entries is unknown.
Objectives The objective of this study was to assess the impact of defined reaction picklists on clinical documentation and, therefore, downstream analytics and clinical research using these data at two institutions.
Methods ADR data were obtained from the EHRs of patients who visited the emergency department or outpatient clinics at Brigham and Women's Hospital (BWH) and University of Colorado Hospital (UCH) from 2013 to 2018. Reported drug class ADR prevalences were calculated. We investigated the reactions on each picklist and compared the top 40 reactions at each institution, as well as the top 10 reactions within each drug class.
Results Of 2,160,116 patients, 640,444 (30%) had 928,973 active drug allergies. The most commonly reported drug class allergens were similar between BWH and UCH. BWH's picklist had 48 reactions, and UCH's had 160 reactions; 29 reactions were shared by both picklists. While the top four reactions overall (rash, GI upset/nausea/vomiting, hives, itching) were identical between sites, reactions by drug class exhibited greater documentation diversity. For example, while the summed prevalence of swelling-related reactions to angiotensin-converting-enzyme inhibitors was comparable across sites, swelling was represented by two terms (“swelling,” “angioedema”) at BWH but 11 terms at UCH (e.g., “swelling,” “edema,” by body locality).
Conclusion The availability and granularity of reaction picklists impact ADR documentation in the EHR by health care providers; picklists may partially explain variations in reported ADRs across health care systems.
Haploinsufficiency of PRRT2 Leading to Familial Hemiplegic Migraine in Chromosome 16p11.2 Deletion Syndrome
Authors: Sen Kuntal , Genser Ilyse , DiFazio Marc , DiSabella Marc 
Published: May 2022

AbstractMicrodeletion in the 16p11.2 loci lead to a distinct neurodevelopmental disorder with intellectual disability and autism spectrum disorder in addition to dysmorphia, macrocephaly, and increased body mass index. One of the deleted genes in this region is PRRT2 which codes for proline-rich transmembrane protein 2. Heterozygous variants in PRRT2 cause four distinct neurological disorders including benign familial infantile epilepsy (BFIE), paroxysmal kinesigenic dyskinesia (PKD), PKD with infantile convulsions, and familial hemiplegic migraine (FHM). A 13-year-old male with a known history of 16p11.2 deletion and resultant cognitive delay presented with sudden onset of headache, left-sided weakness, facial droop, and aphasia concerning for acute ischemic stroke. Magnetic resonance imaging of the brain was performed urgently which did not reveal any acute processes and his presentation met criteria for hemiplegic migraine. There have been reports of PKD and BFIE in this microdeletion syndrome; however, our proband is the first case that presented with FHM related to haploinsufficiency of PRRT2. This report highlights the importance of counseling patient families regarding acute paroxysmal presentations in this syndrome.
Seroprevalence of MOG and AQP4 Antibodies and Outcomes in an Indian Cohort of Pediatric Acquired Demyelinating Syndromes
Authors: Sankhyan Naveen , Rawat Amit , Vyas Sameer , Sahu Jitendra Kumar , Bhagwat Chandana , Madaan Priyanka , Saini Lokesh , Saini Arushi Gahlot , Suthar Renu , Sukhija Jaspreet , Jayashree Murlidharan 
Published: May 2022

AbstractThis study aimed to determine the seropositivity of myelin oligodendrocyte glycoprotein antibodies (MOG-Ab) and aquaporin-4 antibodies (AQP4-Ab) and outcomes in children with acquired demyelinating syndromes (ADSs). Children (6 months–15 years) with suspected ADS were enrolled and tested for MOG-Ab and AQP4-Ab prospectively over 18 months at a tertiary care hospital in North India. Children with proven nonimmune-mediated neurological disorders were enrolled as controls. Of 79 children with suspected ADS, 66 were enrolled. Among the enrolled children with ADS, acute demyelinating encephalomyelitis (ADEM) (25) was the most common first clinical event followed by optic neuritis (ON) (20) and transverse myelitis (TM) (19; one child had ON and TM simultaneously [neuromyelitis optica spectrum disorders [NMOSDs]]), while two children had clinically isolated syndrome (CIS) apart from ON and TM. Fourteen (21.2%, confidence interval [CI] 11.3–31.1) tested positive for one antibody (12 [18.1%; 95% CI 10.5–25.5%] for MOG-Ab and 2 [3%; 95% CI 0–7.2%] for AQP4-Ab). None of the 62 controls tested positive for any antibody. The final diagnosis in those with the monophasic ADS was ADEM (21), ON (13), TM (16), and other CIS (1) while that in children with recurrent events was multiphasic disseminated encephalomyelitis (MDEM) (2), NMOSD (3), ADEM-ON (4), recurrent ON (4), and MS (2). Among those with the first event, 4/51 (7.8%; 95% CI 0.5–15.2%) were MOG-Ab positive and 2 AQP4-Ab positive, whereas 8/15 (53.3% [95% CI 28.1–78.6%]) with recurrent events (MDEM [2], ADEM-ON [4], recurrent ON [1], and recurrent TM [1]) were MOG-Ab positive. Hence, MOG-Abs are the most common antibodies detected in one in five children with pediatric ADS, especially in relapsing disease. AQP4-Abs are rare in children with ADS.
Video-Assisted Informed Consent in a Clinical Trial of Resuscitation of Extremely Preterm Infants: Lessons Learned
Authors: Odackal Namrita J. , Caruso Catherine G. , Klitzman Melissa , Rincon Monica , Byrne Bobbi J. , Winter Jameel , Petroni Gina R. , Fairchild Karen D. , Warren Jamie B. 
Published: May 2022

Objective Obtaining informed consent for clinical trials is challenging in acute clinical settings. For the VentFirst randomized clinical trial (assisting ventilation during delayed cord clamping for infants <29 weeks' gestation), we created an informational video that sites could choose to use to supplement the standard in-person verbal and written consent. Using a postconsent survey, we sought to describe the impact of the video on patient recruitment, satisfaction with the consent process, and knowledge about the study.
Study Design This is a descriptive survey-based substudy.
Results Of the sites participating in the VentFirst trial that obtained institutional review board (IRB) approval to allow use of the video to supplement the standard informed consent process, three elected to participate in the survey substudy. From February 2018 to January 2021, 82 women at these three sites were offered the video and completed the postconsent survey. Overall, 73 of these 82 women (89%) consented to participate in the primary study, 78 (95%) indicated the study was explained to them very well or extremely well, and the range of correct answers on five knowledge questions about the study was 63 to 98%. Forty-six (56%) of the 82 women offered the video chose to watch it. There were no major differences in study participation, satisfaction with the consent process, or knowledge about the study between the women who chose to watch or not watch the video.
Conclusion Watching an optional video to supplement the standard informed consent process did not have a major impact on outcomes in this small substudy. The ways in which audiovisual tools might modify the traditional informed consent process deserve further study.
Key Points
Intra-Parenchymal Cerebellar Metastasis—A Rare Presentation of Castration-Resistant Prostate Cancer
Authors: Ibrahim Sufyan , Reddy Vyjayanth , Menon Girish 
Published: May 2022

Abstract
Intracranial metastases from prostate carcinoma are uncommon and usually manifest as dural secondaries in the supratentorial compartment. We present an unusual case of intra-parenchymal posterior fossa prostatic metastasis in a 61-year-old gentleman and discuss the diagnostic and management challenges involved. A 61-year-old hypertensive, diabetic man presented with gait unsteadiness for 1-month duration and no other neurological deficits. He had previously undergone bilateral orchiectomy for prostate carcinoma with multiple osseous metastases. Magnetic resonance imaging showed a well-defined lobulated, intraventricular, peripherally enhancing lesion in the fourth ventricle with obstructive hydrocephalus. He underwent sub-occipital craniectomy and decompression, and histological examination was consistent with metastatic prostate adenocarcinoma. Although cerebellar secondaries are atypical, a suspicion of metastasis should be upheld in all patients with the history of prostate carcinoma, regardless of their location and radiological characteristics of the intracranial lesion.
Diversity in Machine Learning: A Systematic Review of Text-Based Diagnostic Applications
Authors: Fitzsimmons Lane , Dewan Maya , Dexheimer Judith W. 
Published: May 2022

Abstract
Objective As the storage of clinical data has transitioned into electronic formats, medical informatics has become increasingly relevant in providing diagnostic aid. The purpose of this review is to evaluate machine learning models that use text data for diagnosis and to assess the diversity of the included study populations.
Methods We conducted a systematic literature review on three public databases. Two authors reviewed every abstract for inclusion. Articles were included if they used or developed machine learning algorithms to aid in diagnosis. Articles focusing on imaging informatics were excluded.
Results From 2,260 identified papers, we included 78. Of the machine learning models used, neural networks were relied upon most frequently (44.9%). Studies had a median population of 661.5 patients, and diseases and disorders of 10 different body systems were studied. Of the 35.9% (N = 28) of papers that included race data, 57.1% (N = 16) of study populations were majority White, 14.3% were majority Asian, and 7.1% were majority Black. In 75% (N = 21) of papers, White was the largest racial group represented. Of the papers included, 43.6% (N = 34) included the sex ratio of the patient population.
Discussion With the power to build robust algorithms supported by massive quantities of clinical data, machine learning is shaping the future of diagnostics. Limitations of the underlying data create potential biases, especially if patient demographics are unknown or not included in the training.
Conclusion As the movement toward clinical reliance on machine learning accelerates, both recording demographic information and using diverse training sets should be emphasized. Extrapolating algorithms to demographics beyond the original study population leaves large gaps for potential biases.
The Simons Observatory: A large-diameter truss for a refracting telescope cooled to 1 K
Authors: Crowley Kevin D. , Dow Peter , Shroyer Jordan E. , Groh John C. , Dober Bradley , Spisak Jacob , Galitzki Nicholas , Bhandarkar Tanay , Devlin Mark J. , Dicker Simon , Gallardo Patricio A. , Harrington Kathleen , Iuliano Jeffrey , Johnson Bradley R. , Johnson Delwin , Kofman Anna M. , Kusaka Akito , Lee Adrian , Limon Michele , Nati Federico , Orlowski-Scherer John , Page Lyman , Randall Michael , Teply Grant , Tsan Tran , Wollack Edward J. , Xu Zhilei , Zhu Ningfeng 
Published: May 2022

We present the design and measured performance of a new carbon fiber strut design that is used in a cryogenically cooled truss for the Simons Observatory small aperture telescope. The truss consists of two aluminum 6061 rings separated by 24 struts. Each strut consists of a central carbon fiber tube fitted with two aluminum end caps. We tested the performance of the strut and truss by (i) cryogenically cycling and destructively pull-testing strut samples, (ii) non-destructively pull-testing the final truss, and (iii) measuring the thermal conductivity of the carbon fiber tubes. We found that the strut strength is limited by the mounting fasteners and the strut end caps, not the epoxy adhesive or the carbon fiber tube. This result is consistent with our numerical predictions. Our thermal measurements suggest that the conductive heat load through the struts (from 4 to 1 K) will be less than 1 mW. This strut design may be a promising candidate for use in other cryogenic support structures.
Fanconi syndrome in a patient receiving pre-exposure prophylaxis for HIV infection: case report
Authors: Drak Douglas , Lin Jasper , Gowers Andrew , Gracey David M. 
Published: May 2022

Background Tenofovir disoproxil is efficacious in the preventing HIV infection as part of a pre-exposure prophylaxis (PrEP) regimen. Although its use has been associated with impaired renal function, instances of Fanconi syndrome are extremely rare. This may change with increased uptake of PrEP. Methods A 55-year-old male patient (he/him/his) was commenced on PrEP with a baseline estimated glomerular filtration rate (eGFR) of approximately 60 mL/min/1.73 m2. Results Within 6 months, he developed new and worsening proteinuria, glycosuria and aminoaciduria despite no apparent change in eGFR. PrEP was discontinued and his urinary abnormalities rapidly resolved. The patient remains off PrEP. Conclusions Fanconi syndrome is a rare, but known complication of tenofovir disoproxil. This is the first report related to PrEP in Australia. While tenofovir associated nephrotoxicity in patients taking PrEP is uncommon, the patient’s age and pre-existing renal impairment placed him at substantially higher risk. At-risk patients need more frequent monitoring of their eGFR and proteinuria. Urinary protein to creatinine ratio is the preferred to dipstick testing for proteinuria and the latter does not readily detect the low molecular wight proteinuria characteristic of tenofovir toxicity. Early recognition of these patients is essential, as prompt cessation of PrEP can often reverse renal abnormalities.
A brain-enriched lncRNA shields cancer cells from immune-mediated killing for metastatic colonization in the brain
Authors: Liu Weiguang , Sun Peng , Xia Lingling , He Xilin , Xia Zhengmiao , Huang Yehong , Liu Wenzhuo , Li Lulu , Chen Liming 
Published: May 2022

Significance
Brain metastasis with current limited treatment options is a common complication in advanced cancer patients, and breast-to-brain metastasis (B2BM) is one of the major types. In this work, we report that brain metastasis oncogenic long noncoding RNA (BMOR) is a key brain-enriched long noncoding RNA for the development of B2BM. We demonstrate that BMOR allows B2BM cells to colonize the brain tissue by evading immune-mediated killing in the brain microenvironment. At the molecular level, BMOR binds and inactivates IRF3 in B2BM cells. Finally, BMOR silencer can effectively suppress the development of brain metastasis in vivo. Therefore, our findings reveal a way in which cancer cells evade immune-mediated killing in the brain microenvironment for brain metastasis development and establish therapeutic targets with potential targeted strategies against B2BM.
Regulatory effects of gradient microtopographies on synapse formation and neurite growth in hippocampal neurons
Authors: McNaughton Ryan , Huo Yuda , Li Guicai , Di Via Ioschpe Anais , Yan Lei , Man Heng-Ye , Zhang Xin 
Published: May 2022

Abstract
Among approaches aiming toward functional nervous system restoration, those implementing microfabrication techniques allow the manufacture of platforms with distinct geometry where neurons can develop and be guided to form patterned connections in vitro. The interplay between neuronal development and the microenvironment, shaped by the physical limitations, remains largely unknown. Therefore, it is crucial to have an efficient way to quantify neuronal morphological changes induced by physical or contact guidance of the microenvironment. In this study, we first devise and assess a method to prepare anisotropic, gradient poly(dimethylsiloxane) micro-ridge/groove arrays featuring variable local pattern width. We then demonstrate the ability of this single substrate to simultaneously profile the morphologcial and synaptic connectivity changes of primary cultured hippocampal neurons reacting to variable physical conditons, throughout neurodevelopment, in vitro. The gradient microtopography enhanced adhesion within microgrooves, increasing soma density with decreasing pattern width. Decreasing pattern width also reduced dendritic arborization and increased preferential axon growth. Finally, decreasing pattern geometry inhibited presynaptic puncta architecture. Collectively, a method to examine structural development and connectivity in response to physical stimuli is established, and potentially provides insight into microfabricated geometries which promote neural regeneration and repair.